First Responder – Initial Assessment and Management -aka SAFE

							‘SAFE TAC’
     AIMS OF THIS PRESENTATION
• By the end of this presentation you will:
  – Have a structured method in which to approach
    an incident - known as ‘SAFE TAC’
  – Know how to signal for help
  – Know how to send a (M)ETHANE report
                BACKGROUND
• Why you should know this:
  – Any one of us can come across an emergency
    situation, anywhere, at any time.
  – People look towards those with medical training
    for help.
  – If you have a general system to work through:
     • You will be calmer
     • You will be more organised
     • It will help afterwards when you reflect on what has
       happened.
 S – SHOUT / SIGNAL / SEND FOR HELP
          6 minute
         BLASTS
          every


                            FIRE AT NIGHT, SMOKE
SHOUT FOR HELP                    IN THE DAY




           999
         KEEP LINE OF    SURVIVAL BAG /
        COMMUNICATION   OTHER GROUND TO
            OPEN!         AIR SIGNALS
            A – ASSESS SCENE
• What has happened?
• What danger is there?
• What injuries is the casualty likely to have?

• Always walk the last 5m in, gives you time to
  think.
F – FREE SCENE FROM DANGER, FIND (&
           FREE) CASUALTY
• Free from danger
  – Stop traffic            - Don IPE
  – Turn off engines        - Put out fires
• Find casualty
  – Actively search for casualties, especially in mass
    incidents.
• Free casualty
  – If too dangerous to assess / treat
     • (4Fs: fire, flood, fumes, fuel)
          E- EVALUATE CASUALTY
• QUICK evaluation as you walk towards the
  casualty
  – Noisy breathing = airway problem
  – Chest rising & falling too quickly / not enough =
     breathing problem
  – Blood spurting = circulation problem


• QUICK primary survey (i.e. sufficient for triage)
• Remember: Catastrophic Haemorrhage is
         dealt with before anything else.
                          T - TRIAGE
Can the patient
                      Y                                   P3 - Delayed
     walk?
       N

Open airway, if
   needed                                                    Dead
                                                N
 Is the patient                   Two rescue breaths.
   breathing?         N
                                    Any response?
       Y
                                                Y
Repiratory Rate
                              Y                          P1- Immediate
  <10 or 30<
       N
                                  Y

  Pulse >120              N                                P2 - Urgent

      “Don’t pause to treat or you will have failed in your task”
                A - ASSESS
• Full Primary Survey:
  –Airway – ‘ALOA’
  –Breathing – RR, Sound, ‘TWELVE FLAPS’
  –Circulation – Pulse, CR, ‘Blood on floor + 4 more’
  –Disability – AVPU, PEARL
  –Exposure / Environment / Evacuation
  –(DEFG = Don’t Ever Forget Glucose)
           C - COMMUNICATION
• (M)ETHANE:
  – (Major Incident or My call sign [military] )

  –Exact location
  –Type of Incident
  –Hazards
  –Access / Egress
  –Number of Casualties
  –Emergency services / Equipment required
             C - COMMUNICATION
E – Exact location: Simonside Hills, Grid Ref NU 030990

T – Type of incident: Man fallen out of tree

H – Hazards: Possible falling branches

A – Access and Egress: Forestry track 50m due West, can
be accessed from road running SE from Gt Tosson, right turn
approx 1.5 km from village.

N – Number of casualties: One casualty – adult male

E – Emergency services required – Mountain Rescue
• Any questions?
     AIMS OF THIS PRESENTATION
• By the end of this presentation you will:
  – Have a structured method in which to approach
    an incident
  – Know how to signal for help
  – Know how to send a (M)ETHANE report
                  SUMMARY
•   Send / Shout / Signal for help
•   Assess the scene
•   Free scene from danger, find (&free) casualty
•   Evaluate casualty
•   Triage
•   Assess ABCs
•   Communication – ETHANE report
References / Acknowledgements
• MIRA course handbook
• Wilderness SSC wiki space:
  – http://ssc2008.wikispaces.com
• Hill Walking – Long 2004
• Casualty Care in Mountain Rescue – Ellerton
  2006
• BATLS handbook – JRAMC
• RAC Crewman Class 3
• Rose & Alison’s photos