Incident Response and Reporting

It’s impossible to foresee all injuries or incidents that may occur when working in uncontrolled environments, but first aid skills and having emergency plans in place will help manage situations effectively and potentially mitigate negative consequences. Once a situation is stable and urgent medical care needs are met, report incidents to UCLA EH&S or IRM to trigger University support and evaluation. Reporting procedures, as well as mechanisms to debrief and review lessons learned, are outlined below. As a University, we must also comply with a variety of reporting regulations, including but not limited to, reporting of injuries and fatalities to Cal/OSHA, via contacting the office of Environment, Health & Safety, Title IX reporting of sexual harassment and criminal behavior, environmental releases or spills, and loss/theft/misuse of research materials or funds.

First aid training includes valuable hands-on practice that cannot be replicated in any other way. Keep your certifications current! Refresher training and practice is vital to maintain competency in first aid.

  • Life-Threatening Injuries or Illness

Call 911 or seek medical care immediately. Always know your physical location; everyone in your group should be able to provide Emergency Medical Services (EMS) accurate directions to the field site.

  • Basic First Aid

By administering immediate care during an emergency, you can help an ill or injured person before EMS arrive. First Aid Steps (adapted from the American Red Cross1):

  • Scene Size Up

Before administering care to an ill or injured person, check the scene and the person. Size up the scene and form an initial impression. Pause and look at the scene and the person before responding. Answer the following questions: Is the scene safe to enter?

  1. What happened?
  2. How many people are involved? - What is my initial impression about the nature of the person’s illness or injury?
  3. Does the person have any life-threatening conditions, such as severe, life-threatening bleeding?
  4. Is anyone else available to help?
  • Awake and Responsive

If the Person is Awake and Responsive and there is no severe life-threatening bleeding:

  1. Obtain consent: Tell the person your name, type and level of training, what you think is wrong and

what you plan to do, and ask permission to provide care.

  1. Tell a bystander to get the AED and first aid kit: Point to a bystander and speak out loud.
  2. Use appropriate PPE: Put on gloves.
  3. Interview the person: Use SAMPLE questions to gather more information about signs and symptoms, allergies, medications, pertinent medical history, last food or drink and events leading up to the incident.
  4. Conduct a head-to-toe check: Check head and neck, shoulders, chest and abdomen, hips, legs and feet, arms and hands for signs of injury.
  5. Provide care consistent with knowledge and training according to the conditions you find.
  • If the Person Appears Unresponsive

Shout to get the person’s attention, using the person’s name if it is known. If there is no response, tap the person’s shoulder (if the person is an adult or child) or the bottom of the person’s foot (if the person is an infant) and shout again, while checking for normal breathing. Check for Responsiveness and breathing for no more than 5-10 seconds.

  • If the Person is Breathing
  1. Send someone to call 911 or the designated emergency number and obtain an AED and first aid kit.
  2. Proceed with gathering information from bystanders using the SAMPLE2 questions
  3. Conduct a head-to-toe check.
  4. Roll the person onto his or her side into a recovery position if there are no obvious signs of injury.

 

  • If the Person is NOT Breathing
  1. Send someone to call 911 or the designated emergency number and obtain an AED and first aid kit.
  2. Ensure that the person is face-up on a firm, flat surface such as the floor or ground.
  3. Begin CPR (starting with compressions) or use an AED if one is immediately available, if you are trained in giving CPR and using an AED.
  4. Continue administering CPR until the person exhibits signs of life, such as breathing, an AED becomes available, or EMS or trained medical responders arrive on scene.

 

CPR/AED Instructions

The 2017 American Heart Association Guideline Updates3 continue to recommend that lay rescuers trained in CPR give chest compressions and rescue breaths at a ratio of 30:2 for adults in cardiac arrest. The same 30:2 ratio is advised for pediatric cardiac arrest4; but if a second rescuer can assist, a 15:2 ratio should be followed.

Anaphylaxis

Allergic reactions range from mild (e.g. hay fever) to severe (e.g. anaphylaxis). Anaphylaxis (an-a-fi-LAK-sis) is a serious, life-threatening allergic reaction. The most common anaphylactic reactions are to foods, insect stings, or medications. Symptoms may develop immediately, rapidly progress over minutes, or develop slowly over hours. Anaphylaxis requires immediate medical treatment, including a prompt injection of epinephrine and a trip to a hospital emergency room. If it isn’t treated properly, anaphylaxis can be fatal.1

Note: Epinephrine requires a medical prescription. Individuals with known allergy may carry their own epinephrine auto-injector, typically in a two-pack. California law does allow trained “lay rescuers” to carry epinephrine auto-injectors in first aid supplies and administer to a person experiencing anaphylaxis, but the “lay rescuer” must have a current Epinephrine Certification Card issued by the State of California Emergency Medical Services Authority and meet all other requirements of UC’s Epinephrine Auto-Injector Program. In all situations when an epinephrine auto-injector is administered, the patient must immediately be taken to an emergency room for medical evaluation.

Signs and Symptoms of Anaphylaxis may include9:

  • Red rash, with hives / welts, that is usually itchy*
  • Swollen throat or swollen areas of the body
  • Wheezing
  • Passing out
  • Chest tightness
  • Difficulty breathing, cough
  • Hoarse voice
  • Difficulty swallowing
  • Vomiting
  • Diarrhea
  • Stomach cramping
  • Pale or red color to the face and body
  • Feeling of impending doom

*It is possible to have a severe allergic reaction without skin symptoms

  1. Contact EMS by calling 911
  2. If possible, separate the patient from the allergen
  3. If the patient can speak and swallow, give oral antihistamines (adult dose = 25mg -50mg of Diphenhydramine hydrochloride every 4-6 hours) and continue until EMS takes responsibility for care.
  4. Inject epinephrine via auto-injector (adult dose = 0.3mg intramuscular into the upper thigh) for:
    • any airway swelling (lips, tongue, uvula, voice changes)
    • large areas of swelling
    • respiratory compromise or shock
    • If severe allergic reaction continues, administer a second dose of epinephrine via auto-injector.
  5. Evacuate to seek emergency medical care for the patient immediately.

Directions for Use of Auto-injectors

  1. Never put thumbs, fingers, or hands over the tip of the auto-injector.
  2. Wear gloves (Nitrile)
  3. Inform the patient of your actions and obtain consent from the patient before administering epinephrine. Ifunresponsive, implied consent is acceptable in a life-threatening situation.
  4. Form a fist around the auto-injector.
  5. With your other hand, remove the safety-caps.
  6. Jab the auto-injector firmly into patient’s outer thigh so that the auto-injector is perpendicular to the thigh.
  7. Hold the auto-injector firmly in the thigh for 10 seconds to allow time for the medication to disperse.
  8. Remove the auto-injector, and then massage the injection area for several seconds.
  9. Store used auto-injectors in their carrying case, inserting them carefully and needle-first into the labeled side.
  10. Continuously monitor the patient and immediately seek emergency medical care.
  11. As needed, a second dose of epinephrine may be administered 15 minutes after the initial dose.

 

Additional Guidelines for Auto-injectors

  • Become familiar with the auto-injector before the need to use it arises; know where it is physically located.
  • Epinephrine should be administered at the first sign of anaphylaxis.
  • If a participant or coworker is experiencing signs/symptoms of anaphylaxis, and does not have a prescription for epinephrine, only trained staff with an Epinephrine Certificate Card may administer auto-injector(s) as described in their emergency action plan.
  • ANY administration of epinephrine, intentional or accidental, initiates an evacuation to emergency medical care.
  • Protect auto-injectors from heat/light and do not refrigerate.
  • Replace and do not use auto-injectors if solution is discolored, cloudy, or contains particles.