Trainer Resource Guide - California Department of ... 1, Session 9: RISK MANAGEMENT: ENVIRONMENTAL SAFETY TRAINER RESOURCE GUIDE T-3 • Remember what you learned in Session 3: Preventing

Year 1, Session 9: RISK

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9. Risk Management: Environmental Safety

Trainer Resource Guide


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Materials• LCDprojectorandcomputer• FlashDrive• Chartpaper• Coloredmarkers• Maskingtape

Show Slide #1: Risk Management Environmental Safety

Show Slide #2: Practice and Share• Reviewtheassignment.• Askforvolunteerswhowouldliketosharewhattheydiscovered.• Inthelastsession,youlearnedaboutchangesthatyoumay

observethatmighttellyouofanillnessorinjuryofanindividualyouaresupporting.

• Inthissession,youwillcontinuetolearnaboutthingsthatmaypresentarisktoanindividualyouaresupporting.Thefocusisonidentifyingandpreparingtodealwithenvironmentalrisks.

Show Slides #3, #4 and #5: Outcomes• Reviewoutcomesforthesession.

Show Slide #6: Key Words• Reviewkeywordsforthesession.• Givestudents5minutestothinkaboutandrewritedefinitionsin

theirownwordsinthespacesprovided.

T r a i n e r G u i d e : S E S S I O N 9


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RiskManagement:EnvironmentalSafetyS t u d e n t R e s o u r c e G u i d e : S E S S I O N 9

O U T C O M E S

Whenyoufinishthissession,youwillbeableto:

Environmental Emergency

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• Describehowtopreventandrespondtopoisoning.

• Describehowtopreventandrespondtofalls.

• Describehowtopreventandrespondtofires.

• Describehowtopreventandrespondtodrowning.

• Listtheprinciplesofgoodbodymechanics.

• Listthefourgroupsofexercisethathelppreventbackproblems.

• Listtherulesforsafelytransportinganindividualinawheelchair.

• Defineamedicalemergency.

• Giveexamplesofenvironmentalemergencies.

• Followthe4“P’s.”

K E Y W O R D S

Key Word Meaning In My Own WordsAdisasteroraccidentthatmaycausedamagetopeopleorproperty;forexample,aflood,fire,earthquake,orchemicalspill.

First Aid Emergencycaregiventoanillorinjuredpersonbeforemedicalhelparrives.

Hazard Asourceofdanger.

Lifting Toraiseanindividualoranobject.

Safety Thepracticeofdoingthingscorrectlyandinacarefulmannerinordertohaveanenvironmentthatisfreeofdanger.


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ACTIVITY: What Do You Want to Know?• Readdirectionsaloud.• Askforstudentvolunteerstoshareanswers.• Makenoteofstudentanswersandlinkbacktostudentknowledge

andinterestsasappropriateasyoureviewsessioncontent.• Attheendofthissessionyouwillreturntothisactivitytogive

studentsanopportunitytoanswerthethirdquestion.


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A C T I V I T Y

What Do You Want to Know?

Directions: Think about the topic of this training session. Answer the first two questions in the space provided below. You will come back to this page at the end of the session to answer the last question.

Whatdoyoualready knowaboutenvironmentalrisksandsafety?

Whatdoyouwant to knowaboutenvironmentalrisksandsafety?

Tobeansweredattheendofthesession,duringreview:Whathave you learnedaboutenvironmentalrisksandsafety?

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• RememberwhatyoulearnedinSession3:PreventingseriousaccidentsistheNumber One priority!

• AsaDSP,youcanpreventaccidents,and,iftheydooccur,respondtotheminawaythatminimizesinjurytobothyouandtheindividual.

Practices that Reduce the Risk of InjuryShow Slides #7 and #8: Practices that Reduce Risk of Injury • Review.• Askstudentshowmanyofthemhavechildrenorworkinahome

withchildren.Ifapplicable,referthemtoAppendix9-Aforadditionalpracticesthatmustbetakentoreducetheriskofinjurywhenchildrenarepresentinthehome.

Show Slide #9, Scene 19: Home Hazards• Clickontheicontoshowthevideoclip.• DiscussandanswerquestionsatendofScene19.Answers:

— Whathazardsdidyouobserve?Hazards included dishes sitting on the edge of the counter, newspaper on the stove while the stove was on, knives and medication out on the counter, a broken chair, a disconnected smoke detector, spills on the floor, a cluttered room, and tangled electrical cords.

— Whataretheriskstopeopleinthehome? Possible risks include cuts, fires, poisoning, falls, electrocution and other injuries.

— Howcanthoserisksbemitigated?Be aware of what makes for a safe environment, assess the situation, and practice the principles of risk management to create a safe environment. More specifically, lock medications, ensure that furniture is in good condition, keep floors clean and rooms tidy, and use power strips and electrical cord organizers.

Safety Around the HouseShow Slide #10: Safety Around the House• Review.


Safety Is About Awareness and Prevention


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Safety Is About Awareness and Prevention

Safetymeansdoingthingsinacorrectandcarefulmannerinordertohaveanenvironment

thatisfreeofdangerorhazard.Butaccidentshappen,don’tthey?Istheresomewaytopreventthem?Inthefirstriskmanagementsession,wediscussedanumberofwaystominimizeriskfortheindividualswesupport.Wespokeofassessingriskssowecouldanticipateproblemsbeforetheyoccurred.Wealsotalkedaboutstrategiestolessenthoserisks.Infact,thefirstsafetyprincipleforDirectSupportProfessionalsispreventing serious incidents is the Number One Priority.

AsaDSP,youcanpreventaccidentsand,iftheydooccur,respondtotheminawaythatreducesinjurytobothyouandtheindividual.Followingaresomebasicpracticesthatreducetheriskofinjurytoindividualsandstaff.Ifchildrenarepresent,additionalpracticesandstepstopreventinjurymustbetaken.SeeAppendix9-A.

Practices that Reduce the Risk of Injury• Knowandpracticetheprinciplesof

riskmanagement.• Keepmedicationsanddangerous

substancesinlockedcabinetsorcontainers.

• Havegoodlighting.• Provideenoughspaceforpeopleto

movearoundfreelyandwithoutclutter.• Removeanytrippinghazards.• Practiceproperbodymechanicswhen

lifting.• Assistwithproperwheelchairhandling.• Shareinformationabouthazards.• Knowandpracticeemergency

responseplans.• Knowfirstaid.• KnowCPR(cardiopulmonary

resuscitation).• Limitdistractions,includingtextingand

cellphoneuse,whileworking.• Focusontheindividualsyousupport

andwhatishappeningintheenvironment.

Safety Around the House

Woulditsurpriseyoutoknowthat20,000personsdieeachyearintheUnitedStatesfrom

homeaccidents?Manythingsmaycauseinjuriesinthehomeandcommunity.Threemajorsourcesofinjuriesathomeandinthecommunityarepoisonings,fallsandfires.About85%ofallU.S.firedeathsoccurinhomes.Everydaynearly82peopledieasaresultofunintentionalpoisoning;another1,941aretreatedinemergencyrooms.Fallswerethethirdleadingcauseofinjury-relateddeathsamongAmericansofallagesandweretheleadingcauseofinjury-relateddeathsamongpeopleages65andolder.

DSPscanincreasesafetyandreducethelikelihoodofinjuryordeathby:• Creatingandmaintainingasafe

environment• Doingthingsinasafemanner• Learninghowtorespondappropriately

wheninjuriesoccur

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ACTIVITY: Using “Feeling Safe, Being Safe” worksheet

Show Slide #11: ACTIVITY: Using “Feeling Safe Being Safe” worksheet• Groupings:pairs.• Instructstudentstocompletethe“FeelingSafe,BeingSafe”worksheet.(See Appendix 9-C)• Discussthefollow-upquestions.

Activity Background: Feeling Safe Being SafeFeelingSafe,BeingSafeistheresultofacommitmenttoassistallpeoplewithdisabilitiestotakechargeoftheirownwell-beingandpersonalpreparednessbycreatingtoolsandtrainingthatcouldbereadilyunderstoodandusedeffectivelyintheirhomes.

TheConsumerAdvisoryCommittee(CAC)producedFeelingSafe,BeingSafesomoreindividualscanthinkaboutwhatmakesthemfeelsafe,createaplan,andputitintoaction.DSPscanutilizethismaterialtoassisttheindividuals

TheDDSSafetyNetwebsitehasinformationandtoolsforDSPsandtheindividualstheysupportonhowtobesafeandhealthy.Thewebsitehasvideos,articles,andtoolsthatusebestpracticesfromacrossthenation.YoucansignupformonthlySafetyNetemails.

If you have internet access, pull up the website (http://www.ddssafety.net/) and ask DSPs to give a topic related to this section as an example. Then, using the search function, explore the related articles, videos, and tools.


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A C T I V I T Y

Training Safety AwarenessUsing the "Feeling Safe, Being Safe" worksheet

Emergencies and disasters can happen anytime, anywhere and sometimes without warning. As part of maintaining health, safety, and well-being is providing training support to the individuals you serve so that they are prepared in the event of an emergency or disaster.

Directions: Pair up with a classmate and complete each section of the "Feeling Safe Being Safe" worksheet. When finished discuss the following questions:

1. Has anyone used a "Feeling Safe, Being Safe" worksheet before?2. Why is using a "Feeling Safe, Being Safe" worksheet important?3. How would you use the "Feeling Safe, Being Safe" worksheet and materials with

the individuals you support?

Contact Information:DepartmentOfDevelopmentalServicesConsumerAdvisoryCommitteeOfficeofHumanRightsandAdvocacyServices16009thStreet,Room240Sacramento,CA95814916.654.1888www.dds.ca.gov**Feeling Safe Being Safematerialscanbefoundonlineat:http://www.dds.ca.gov/ConsumerCorner/EmergencyPreparedness.cfm

TheDDSSafetyNetwebsitehasinformationandtoolsforDSPsandtheindividualstheysupportonhowtobesafeandhealthy.Thewebsitehasvideos,articles,andtoolsthatusebestpracticesfromacrossthenation.YoucansignupformonthlySafetyNetemails(http://www.ddssafety.net/).


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T-5

Show Slide #12: ACTIVITY: Accidents at Home• Groupings:pairs.• Instructstudentsto takeamomenttothinkaboutanddiscuss

twoorthreeaccidentstheyorsomeoneintheirownhomehaveexperienced.

• Askforstudentvolunteerstoshareexampleswiththelargegroupandwriteexamplesonaflipchart.Whenthetextaddressesthoseexamples,referbacktothisactivity.

• Askthestudentsiftherearethingstheychangedintheirhomestoreducethelikelihoodofaccidents.

Poisoning• Thisinformationrelatestoasessionoutcomeandmayappearon

thequiz.Outcome: Describe how to prevent and respond to poisoning.

Show Slide #13: Poisoning • Review.• Potentiallypoisonousproductsfoundinthehomerequirespecialhandling.

Show Slide #14: Preventing Poisonings • Review.• Askthestudentsiftheirfacilityhasanypoliciesorproceduresthat

specificallydealwithhowtohandlehouseholdchemicals.Ifso,whatarethosepoliciesorprocedures?

Show Slide #15: Some Common Household Poisons

ACTIVITY: Identifying Household Poisons

Show Slide #16: ACTIVITY: Identifying Household Poisons• Groupings:individual.• Readdirectionsaloudandgivestudents5minutestocomplete

theactivity.• Askstudentstoraisetheirhandsiftheyputan“X”nextto5

productsthatmaybepoisonous?10products?20products?• Thisactivitydemonstratesthattherearealotofopportunitiesfor

poisoningstooccurandthatitisveryimportantthatweimplementstepstopreventpoisonings.



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Poisoning

Oneofthemosttragicandpreventablecausesofinjuryanddeathisaccidentalpoisoning.Apoisonisasubstancethatcausesinjuryorillnessifitgetsintothebody.

Therearefourwaysapoisoncanenterthebody:• Swallowing• Breathing• Touching• Injecting

Combinationsofcertainsubstancescanbepoisonous,althoughifusedbythemselvestheymightnotcauseharm.Noteveryonereactstopoisonsinthesameway.Asubstancethatisharmfultoonemaynotalwaysbeharmfultoanother.

Preventing PoisoningsManycommonhouseholdchemical

productsarepoisonousandneedspecialhandlingandlabeling.Allpotentiallypoisonousproductsfoundinthehomemustbe:• Storedintheiroriginalcontainers• Keptseparatefromfooditems• Keptoutofeasyreachandlockedup

topreventindividualsfromeatingordrinkingthemorgettingthemontheirskinorintheireyes

A C T I V I T Y

Identifying Household Poisons

Directions: Read this list of common household products and put an “X” next to the ones that are in the facility you work in. Next, identify additional products that may be poisonous that an individual may swallow or digest. Consider how easily individuals in the home can get to them and what steps you might take to prevent an accidental poisoning. This will not be shared with the large group, so use this exercise as a strategy to make your home even safer!

Common Household Poisons□ Alcohol □ Laundry detergent□ Dishwasher detergent □ Nail polish and nail polish remover □ Drain cleaner□ Oven cleaner □ Drugs of any kind □ Glass cleaner □ Furniture polish

□ Scouring powder/pads □ Toilet cleaner □ Weed killer□ Air freshener □ Insecticide□ Bleach □ Cosmetics □ Grease remover □ Any cleaning product

□ Paint and paint thinner □ Any medications not prescribed

Additional products:□____________________□____________________□____________________□____________________

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ACTIVITY: Strategies for Minimizing Risk of Poisoning Around the House

Show Slide #17: ACTIVITY: Strategies for Minimizing the Risk of Poison-ing Around the House• Groupings:individual,pairs,smallgroups,largegroup.• Readdirectionsaloud.• Askforvolunteerstosharesomeoftheriskstheyidentifiedandplanstomanage

thoserisks.For example, Matthew is curious and tends to put things in his mouth which is a potential poisoning risk. A plan to manage that risk is to ensure that potentially poisonous products are inaccessible to Matthew and others in the home.



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Strategies for Minimizing the Risk of Poisoning Around the House

Directions: Read the scenario. In the “Risk” column, write down specific risks for Matthew regarding accidental poisoning. In the “Plans for Minimizing Risk” column, write down ideas for how to minimize the risk of poisoning.

Matthewisan8-year-oldboywithintellectual/developmentaldisabilities.HelivesinasmallfamilyhomelocatedjustoutsideofBakersfield.Matthewhasbeenlivingthereforthepasttwoyears.Heisacurious,engagingyoungmanwhocommunicatesinarangeofways,suchassinglewords,signlanguage(approximately15signs),pointing,andusingpictures.Matthewhasrecentlystartedusingapictureexchangecommunicationsystem,andheisabletofindfamiliarpicturesinhisbook.BecauseMatthewhasmildcerebralpalsy,hisgaitisunsteady,andhisbalanceispoor.

Matthewisabletoundressindependentlyandcandomostofhisowndressing.Heneedsreminderstousethebathroomandsupporttodomostofhishygiene.Matthewmakessomepoordecisionsregardinghispersonalsafety;forexample,hetendstoputthingsintohismouth,andthereforestaffneedstostayclosetohiminthecommunity.

JimhasbeenworkingasaDSPforthepastmonth.Thisishisfirstexperiencewithindividualswithdisabilities.Sofar,heenjoysthejobandhasdevelopedanicerelationshipwithMatthew.Healsolikestheadministrator,AprilYoung,asshehasbeenveryhelpful.

Description of Risk* Plans to Manage Risk

* Remember to think about the individual's behavior, daily living skills, environment, and lifestyle choices.

S-6*Remember to think about the individual’s health, behavior, daily living skills, environment, and lifestyle choices.


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Be Prepared

• Accidentalpoisoningsmayoccurevenwithcareandattention.• DSPsmustalwaysbeprepared.• In1997,theCaliforniaStatePoisonControlSystemwasstarted

andnoweveryoneinCaliforniacanusethesamephonenumberforPoisonControl.

• Thefirststepinbeingpreparedtohandleapoisoningistopostthephonenumbernexttothephone:1-800-222-1222.

Show Slide #18: Emergency Response to Poisoning• Reviewinformationonslide.



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Be Prepared

Evenwhenstepsaretakentopreventpoisoning,anaccidentalpoisoningmayoccur.Ifthishappens,theDSPmustgetemergencymedicalassistanceasquicklyaspossible.Inemergencysituations,theDSPwhoispreparedandwhostayscalmisthemosthelpful.Wemightbelievethatweknowwhatwewoulddoinanemergency,butit’sjustatthiscriticaltimethatwerealizewearen’tprepared.Wethoughtthepoisoncontrolnumberwasherebythephone.Whomovedit?Are

wesupposedtomakehimvomitornot?Shouldwegethiminthecarandrushtothehospital?

In1997,theCaliforniaStatePoisonControlSystembegan.EveryoneinCaliforniacanuseacommonnumbertocallforhelpandinformation.Callsareansweredbytrainedhealthcareprofessionals.PostthePoisonControlphonenumber—1-800-222-1222—nexttothephoneinthehomewhereyouworksothenumbercan’tbemoved.

Emergency Response to a Poisoning Incident

If you think an individual might have been poisoned, immediately call the Poison Control Center and:• Remain calm. • Have someone stay with the individual.• Report what was taken (brand name and label, if possible).• Report how much was taken (if you don’t know, say so).• Report age and weight of the person.• Report how much time has passed since the poisoning happened.• Report how the individual is doing.

Poison Control Center: 1-800-222-1222

Important information on Ipecac Syrup:Formanyyears,Ipecacsyrup

wasusedtomakeapersonvomittogetthepoisonoussubstanceoutofthebodyquickly.However,itisrarelyrecommendednow.Withsomepoisons(forexample,petroleum-basedproductsoracids),vomitingisnotagoodapproachbecauseofthepossibleinjurytothethroat,lungs,ormouth.DonotuseittoinducevomitingunlessPoisonControlsaystodoso.Ifvomitingoccurs,savewhatisthrownup.

If Ipecac syrup is kept on hand, it should be locked up. Check expiration datesasitlosesitseffectivenessovertime.

First Steps After Common Accidental Poisonings

CallthePoisonControlCenter,and• For eyes:Flood(flush)theeyewith

lukewarmwaterfor15minutes;haveindividualblinkwhileflushingtheeye.

• For swallowed medicine:Donotgiveanythingbymouth.

• For household chemicals:Giveasmallamountofwater;donotmakeindividualvomit.

• For inhaled substance:Getintofreshair;opendoorsandwindows.

• For skin:Removeclothingifpoisonisonit;floodtheskinwithwaterfor15minutes,thengentlywash.

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ACTIVITY: Dealing with Poisoning or Drug OverdoseShow Slide #19: Activity: Dealing with Poisoning or Drug Overdose• Groupings:pairs.• Readdirectionsaloud.



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A C T I V I T Y

Dealing with Poisoning or Drug Overdose

Directions: Pair up with another student and role-play calling the Poison Control Center. One person will perform the role of the DSP calling the Poison Control Center, and the other person will act as the Poison Control Center staff. There are four situations. Each student should make two of the calls.

Scenario #1

DSPstaffmember:“Oneofourchildrenwasplayinginthefieldbesideourhouseandateamushroomthatwasgrowingthere.Hebroughtinasmallpieceofthestem,butIdon’tknowhowtoidentifypoisonousfromnon-poisonousmushrooms.WhatshouldIdo?”

PoisonControlstaff:1. Wherewasthemushroomgrowing?Ongrass,neartrees,onwood?2. Whendidthishappen?3. Howistheindividualdoing?4. Doestheindividualhaveanymedicalconditions?5. Whatisthenameandageoftheindividual?6. Whatisthenameofthecaller,thephonenumber,andzipcode?7. Howcloseisthenearestemergencyroom?

Scenario #2

DSPstaffmember:“Wejustadmittedanewresidenttothehome.WediscoveredthathehadvariousstrengthThorazine(chlorpromazine)inthepocketsofhispantsandindifferentboxes.Apparently,hisroommatefoundatleastoneonthefloorandateit.ThepillsdolooklikeM&Ms.Theroommatefellasleepeatingdinner.Wewokehimandtriedtofindoutwhatcolorthepillwas,butheisunsure.Itwaseitherbrownorred.Whatshouldwedo?”

PoisonControlstaff:1. Isheawake?Ifnot,canyouwakehim?Ishebreathingokay?2. Howlongagodidthishappen?3. AreyousureitwasThorazine?4. Wasthereonlyonepillinvolved,orcouldhehaveeatenseveral?5. Howoldishe?6. Howmuchdoesheweigh?7. Doeshehaveanymedicalconditions?8. Ishetakinganymedications?

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T-9

Activity: Dealing with Poisoning or Drug Overdose (cont.)• Debriefwiththestudents:Was it hard to answer the Poison Control

representative’s questions? Why? What tools from the DSP Toolbox do you think you need to use when calling Poison Control? Did you have any insights about what information you would need to have as you called Poison Control?



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A C T I V I T Y

Scenario #3

DSPstaffmember:“Amanwithadevelopmentaldisabilitywholiveswithmewasdoingthedishes,andhesaysthatheatesomeofthepowdereddishwasherdetergent.WhatshouldIdo?”

PoisonControlstaff:1. Isthemanhavinganysymptoms?2. Isthisautomaticdishwashingdetergent?3. Hashereceivedanywaterormilk?4. Arethereanyburnsinhismouth,orishehavingproblemsswallowing?5. Doeshehaveanymedicalconditions?

Scenario #4

DSPstaffmember:“SamwasusingSuperGlueonhismodelairplaneproject.Whenhewasbrushingbackhishair,hegotsomeoftheglueinhiseye,oratleastIthinkhedidbecausehiseyeisclosed.WhatshouldIdo?”

PoisonControlstaff:1. Ishecomplainingofanyeyepain?2. Haveyoutriedtofloodhiseyewithwaterunderthekitchenfaucetorunder

theshower?3. Aretheskinsurfacesgluedtogetherorjusttheeyelashes?4. Doeshewearcontactlenses?

Dealing with Poisoning or Drug Overdose (cont.)

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Falls

• Thisinformationrelatestoasessionoutcomeandmayappearonthequiz.

Outcome: Describe how to prevent and respond to falls. • Allofus,atonetimeoranother,havefallen.• Approximately19,700olderAmericansdiefromfallinjuriesannually.• Fallscommonlyoccuronflightsofstairs,ladders,chairsandstools,

roofsandgettinginandoutofbathtubs.• Theindividualswesupportareatanincreasedriskoffallingand

sufferinginjuriesduetotheir: — Disabilities — Medications — Healthproblems• Forexample,individuals with epilepsy sometimes experience hard

falls with resultant injuries during sudden unexpected seizures.

Show and review Slides #20, #21, #22, and #23: Preventing Falls



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Falls

Allofus,atonetimeoranother,havefallen.Sometimesweweretrippedbyanotherperson,orwe

werejustcarelessandnotlookingwhereweweregoing.Mostofthetime,it’sonlyourpridethatisinjured,buttoooften,fallsresultinphysicalinjuries.Infact,over19,700olderadultsdiefromunintentionalfallinjuriesannually.Fallsmayoccuronstairs,ladders,chairsandstools,roofs,andwhengettinginandoutofbathtubs.Somefallsarecausedbyindividualssteppingonanunseenobjectsuchasmarblesoraskateboard.Individualsofallagesfalloutofbedorwhilegettingoutofbed.Over90%ofhipfracturesarecausedbyfalls.

Fallsmaybecausedbycarelessbehavior.Anindividualmaybemovingintoomuchofahurry,playingroughly,ornotpayingattentiontoobjectswheretheyarewalking.Somefallsarecausedbyhealthproblemssuchasfainting,pooreyesight,hypertension,jointproblems,orbybeingovermedicated.Sometimespeoplefallwhentheyarehelpingothersinsomeway.

TheindividualsthatDSPssupport,becauseoftheirdisabilities,medication,andattimes,healthproblems,areatanincreasedriskoffallingandofreceivinginjuriessuchasbrokenteeth,hips,legs,ankles,andarms.Forexample,individualswithepilepsymayfallandbeinjuredduringtheirseizures.Similarly,problemswithmusclemovementthatcomewithcerebralpalsycancausesomeonetofall,especiallywhentheindividualwalksinanunsteadyway.

Preventing FallsThereareanumberofwaysaDSP

canreducetheriskoffallsinthehomeforbothindividualswithintellectual/developmentaldisabilitiesandstaffincluding:• Identifyindividualsatriskforfalling

andincludefallprecautionsintheIndividualProgramPlan(IPP).

• Besureindividualsneedingassistivedevices(canes,walkers)usethemandstorethemproperly.

• Keepcords,wires,andhosesoutofwalkways.

• Makesureenoughstaffareinvolvedwhenanindividualisbeingtransferredfromoneplacetoanother,andmakesurethereisenoughspace.

• Providehandrailsandguardrailsatallraisedwalkwaysorstairs.

• Usesafetyequipmentintheshower,suchasarubbermat,grabbarornon-slipstripsinthebathtuborashowerstall,and/orashowerbenchwhentheindividualisunsteadyornotwellcoordinated.

• Keepthefloorsdry;wipeupspills.• Installnightlightsinbedrooms,halls,

andbathrooms.• Besurenothing(clothes,toys,book,

etc.)isleftonstairwaysoronthefloor.• Usenon-skidmattingortapeunder

floorrugs.• Carpetstairs(rubberrunneronstairs

tobasement).• Replaceoldcarpet.• Usealadder(ormoveone)rather

thanstretchingtoreachsomething.• Usewell-maintainedladdersand

alwayshaveanotherpersoncloseby.• Providegoodoutdoorlightingonwalks

anddriveways.• Whereitisicy,putsandorsalton S-10


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T-11

Emergency Response to a Fall Incident• Reviewemergencyresponseproceduresforfallincidentson pageS-11.Show Slide #24: Emergency Response to a Fall Incident• Reviewthecircumstancesunderwhichyoudonotmovea person.• Allfallingincidentsshouldbedocumentedintheindividual’s

recordandaSpecialIncidentReport(SIR).

Show Slide #25• ClickonicontoshowDSPTV,Scene20:Falls.• DiscussandanswerquestionsatendofScene20.

Answers:— Howcouldthisinjuryhavebeenprevented?This injury

could have been prevented by cleaning the spill immediately, placing a barrier around the spill, and informing Marissa about the spill when she entered the room.

— Whatistheappropriateresponse?Since Marissa lost consciousness, the appropriate response would be to call 911 and not move her.

— Whatkindofdocumentationmustbedone?The fall must be documented in Marissa’s record and a Special Incident Report must be completed.



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Emergency Response to a Fall Incident

Evenwiththebestprecautions,fallsmayoccur.HowwelltheDSPperformsinprovidingimmediateassistance,preventingadditionalinjury,andobtainingmedicalassistanceifnecessaryiswhatmakesthedifferenceintheresultofafall.

OncetheDSPbecomesawareofthesituation,theDSPneedstocarefullyandquicklyassessthesituationbylistening, observing, and questioning:

• Listentowhattheindividualistellingyou.• Observethepositionoftheindividual’sbodyandlookforsignsofbleeding,

brokenbones,orbreathingproblems.• Asktheindividualwhatheorsheisfeeling.

TheresponseoftheDSPtoanindividual’sfalldependsonthecircumstancesofthefall,theperson’songoinghealthstatus,andwhatinjurythepersonappearstohavesustained.

Ifanindividualappearstobeseriouslyhurt,isbleedingbadly,complainsofsharppain,appearstohaveabrokenbone(s)suchasanarm,leg,hip,orback,orappearstohaveachangeofconsciousness,CALL 911 FOR ASSISTANCE.DO NOT MOVE THE INDIVIDUAL.

Documentallfallingincidentsintheindividual’srecordandcompleteaSpecialIncidentReport(SIR).

S-11

Falls (cont.)


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T-12

ACTIVITY: Identifying Fall Risks

Show Slide #26: ACTIVITY: Identifying Fall Risks• Groupings:individualorteamsofstudentsworkinginsame

home.• Readdirectionsaloud.• Askforvolunteerstosharepotentialfallrisksandplansto

managethoserisks.



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A C T I V I T Y

Identifying Fall Risks

Directions: Think about the home you work in. Are there unsafe conditions that could lead to falls? For example, are there:• Objects, items, or slippery surfaces in the home that could lead to falls?• Unsafe practices by individuals that could lead to falls?• Unsafe practices by staff that could lead to falls?In the “Description of Risk” column, write down specific unsafe conditions. Then think of possible actions that would eliminate or reduce the risks. In the “Plans to Manage Risk” column, write down ideas for minimizing the risk of falling.



S-12

*Remember to think about the individual’s health, behavior, daily living skills, environment, and lifestyle choices.


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T-13

Fires


Outcome: Describe how to prevent and respond to fires.• Firedepartmentsrespondtoapproximately384,000homefires eachyear.• PreventionoffiresistheNumber One Priority.• Manyfiresaretheresultsofneglect(forexample,careless

smoking).Thesearethekindsofthingsyoucandosomethingabout.

• DataSourcefrompageS-13:KarterMJ.Fire loss in the United States during 2010.Quincy(MA):National Fire Protection Association, Fire Analysis and Research Division; 2011.

Preventing Fires• Residentialsprinklersystemsarethebestwaytoprovidesafety

inahousefire.Suchsystemswillsuppress9outof10firesandprovidea“windowofopportunity”forpeopletoescape.

Show Slides #27 - #31: Preventing Fires• Reviewthethingsthatcanbedonetominimizefirehazardsinthe



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Fires

Mostrecentstatisticsshowthatfiredepartmentsrespondtoapproximately384,000home

firesintheUnitedStates.Firesoftenresultinseriousinjuryandcausepropertydamage.OnaverageintheUnitedStates,someonediesinafireevery169minutes,andsomeoneisinjuredevery30minutes.

PreventingfireistheNumber One Priority.Manyfiresaretheresultofcarelessnessorlaziness,andwecandosomethingaboutthesethings.

Preventing FiresIn-homesprinklersystemsarethe

best way toprotectlivesinahousefire.Suchsystemswillputout9outof10firesandprovidetimeforpeopletoexit.Use“rateofrise”heatdetectorsinkitchensandgarages,placesmorelikelytohaveafirewherethereisasuddenchangeoftemperaturewithlittlesmoke.Bedroomsandlivingroomsshouldhavebuilt-insmokedetectorswithbatterypowerforback-up.Smokedetectorslinkedtoanalarmsystemprovideadditionalsafety.Ifthedetectorsarebatteryoperated,theyshouldbecheckedmonthly,andbatteriesshouldbereplacedatleasttwiceayear.

Firepreventionisateamactivity.Anumberofthingscanbedonetominimizefirehazardsinthehome.• Testsmokedetectorsmonthly,and

replacebatteriestwiceayearorasneeded.

• Usecannedsmoke,notanopenflame,totestsmokedetectors.

• Placefireextinguishersinappropriateplaces,suchasthekitchen.

• Trainstafftousefireextinguishers.• Havefireextinguishersserviced

regularly.• Practicefiredrillseverymonth.

• Donotallowsmokinginbed.Evenbetter,donotallowsmokinginthehouse.

• Donotleavematchesorlightersinthehouse.

• Alwaysuseashtrays.• Disposeofcigarettebuttsinatincan

withsand.Donotemptythiscanuntilallthecigarettesarecold.

• Cleanovensandfireplacesregularly.• Donotoverloadelectricalwiring.

(Donotpluginandusetoomanyappliancesononeoutlet.)

• Donotlayextensioncordsunderrugs.• Replacedamagedorfrayedelectrical

cordsimmediately.• Useextremecarewithspaceheaters.

Besurethehome’selectricalwiringcanhandletheheater.

• Donotletthings(especiallypaper,rags,andoldclothes)pileupunderstairs,intheattic,orinthebasement.

• Keepflammableliquids(liquidsthatmaycatchfire)intightlyclosedmetalcontainers,awayfromheatsources.

• Ragsusedtowipeupoil,paintorotherchemicalsmustbestoredanddisposedofproperly.Contactyourlocalofficethatdealswithhazardoushouseholdwasteforinformation.

• Ifyousmellgas,allpeopleshouldleavethehouse;thencallthegascompany.

• Becarefulwithallelectricalappliances(haircurlingiron,toaster,irons,orspaceheaters)andmakesuretheyareingoodworkingcondition.

• Useproperwattagebulbsinlamps.

S-13


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T-14

Responding to a Fire

What to Do if You Smell Smoke or Discover a FireShow Slide #32: Emergency Response to a Fire • Reviewwhattodo.• Remembertostaycalm.

Show and review Slide #33: Preparing for Fire Emergencies

Fire Drills, Preparation and Planning• CommunityCareFacilitiesarerequiredtohavedrillsregularly,with

documentationoftheresults.

Homes Must Have Fire Escape Plans• Reviewwhatbelongsinafireescapeplanandencourage

studentstostudytheplanfortheirhome— CommunitycarehomesuseABCfireextinguishers.ABCfire

extinguisherscanbeusedonalltypesoffires.



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Responding to a Fire

Learnaboutandusethepreventionservicesoflocalfiredepartments.DisasterPlans(Appendix9-B)shouldbecheckedoutwithfiredepartmentofficialsandrevisedaccordingtorecommendationsmadebythesefirepreventionexperts.

What to Do If You Smell Smoke or Discover a Fire

Havingaplanforrespondingtoafireandpracticingtheplaniscritical.ADisasterPlanshouldbesimple.Inanemergency,staycalmandtakespecificactions.

In Case of Fire:• Helpeveryonegetoutofthehouse

asfastaspossibleandmeetinthedesignatedplace.

• Donotstoptogetanybelongings.• Onceout,STAYOUT.Nevergo

backintoaburningbuildingforanyreason.Ifsomeoneismissing,tellthefirefighters.

• Call911fromaneighbor’shouseorcellphone.

• Ifthereissmokeintheroom,getonthefloorandcrawltotheexit.

• Ifyoucan’tescape,putwetclothorbathtowelsorfabricarounddoorstoblockoffsmoke,crawltoawindow,andopenit.Yelloutthewindowforhelpandwaveasheetorclothforattention.Ifthereisaphoneintheroom,call911.

Fire Drills, Preparation and PlanningCommunitycarefacilitiesarerequired

tohavefiredrillsregularly,anddocumenttheresults.Firedrillsareplannedtimestopracticetheplanforrespondingtoafire.Inpreparationfordrills,orinadditiontodrills,herearesomethingstoteachindividualslivinginyourhome:• Ifyouhearanalarm,leavethehouse,

movingawayfromthefire.• Remaincalmandwalk,crawl,or

wheeloutofthehouse.• Onceoutsidethehouse,gotoan

agreeduponmeetingpoint,suchastheedgeofthestreetinfrontoftheneighbor’shouse,inordertobeaccountedfor.

Homes Must Have Fire Escape PlansHerearesomethingsthatbelongin

theplan:• Floorplans,showingescaperoutes.• Ameetingpointthatisoutsidethe

homeandawayfromdanger.• Specificrolesandresponsibilitiesof

DSPsandresidents.• Locationoffireextinguishers.

Communitycarehomesusemulti-purposefireextinguishers,labeled“ABC.”An“ABC”fireextinguishercanbeusedonalltypesoffires:wood,clothandpaperfires;oil,gasandkerosenefires;andelectricalfiresaswell.Othertypesoffireextinguishersworkonlyoncertaintypesoffires.

S-14


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T-15

Responding to a Fire (cont.)

• Fireextinguishersareusefulifafireissmallandcanbeeasilyputout,butitisimportantforstafftofollowfireescapeplans.

• Thefireescapeplansshouldbepracticedregularlyanddrillsshouldbescheduledtocovervariousshifts.

• Themorepracticeindividualshave,themorelikelytheywillactresponsiblyandsafelyintheeventofarealfire.

Emergency Treatment for Burns• Whilestaffwaitsforassistance,itmightbenecessarytoprovide

someimmediatetreatmentforburns.

Show and review Slide #34: Emergency Treatment for Burns

— Minorburns:submergeaffectedareainwaterandapplyadrydressingifnecessary.

— Second-degreeburns:Immerseincold(notice)waterandblotdry.Youmayapplysteriledressingandelevatethelimbs.Donotuseointments.

— Third-degreeburns:Call911andleavetomedicalemergencystaff.Leaveclothingintactandwatchforpossiblebreathingcomplications.Youmightapplycoldpackstoface,handsor



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Fireextinguishersareusefulifafireissmallandcanbeeasilyputout,butitisimportantforstafftofollowfireescapeplans.Practicingtheseplansshouldbearegularandfrequentactivityforbothstaffandresidents.Drillsshouldbescheduledduringdifferentshifts,andsomeshouldbescheduledtointerrupttheregularroutinesofindividualsandstaff(bedtime,bathtime).Themorepracticeindividualshave,themorelikelytheywillknowwhattodointheeventofarealemergency.

Emergency Treatment for BurnsIfthereisafire,staffmayneedto

providesomeimmediatetreatmentforburns.Minor burns(forexample,contactwithhotobjects)aretreatedbyholdingtheaffectedareaunderwaterandapplyingadrydressing(bandage)ifnecessary.

Second-degree burnsaredeeperandoftenblisterandappeartobewet.Theyaretreatedbyholdingtheaffectedareaundercold(notice)waterandgentlydabbingdry.Applysteriledressingandkeepthelimbsraised.Donotapplylotionsorgels.

Third-degree burnsarethosewithcompletelossofalllayersofskinandawhite,charredappearance.Call9-1-1andleavetomedicalemergencystaff.Whilewaitingformedicalstaff,leaveclothingintactandwatchforpossiblebreathingproblems.Applycoldpackstoface,hands,orfeetforcomfort,butdonotholdburnedareasinicewater.

Afireemergencyissomethingnoneofuswanttoeverexperience.Bytakingpreventionseriously,wecanavoidfiresinmostcases.Havingaclearplanandpracticingthatplanfrequentlywilloffermoreassurancethatstaffandresidentswillactresponsiblyandsafelyinanemergency.

S-15

Responding to a Fire (cont.)


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T-16

ACTIVITY: Identifying Fire Risks

Show Slide #35: ACTIVITY: Identifying Fire Risks• Groupings:individualsorteamsofstudentsworkinginsame

home.• Readdirectionsaloud.• Askforvolunteerstosharepotentialfirerisksandplansto

managethoserisks.



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A C T I V I T Y

Identifying Fire Risks

Directions: Think about the home you work in. Are there unsafe conditions that could lead to fire? For example:• Are smoke detectors tested monthly?• Are matches and lighters left out on counters?• Do you know where the fire extinguishers are and how to use them?• Are there piles of old clothes or newspapers in the home?In the “Description of Risk” column, write down specific unsafe conditions. Then think of possible actions that would eliminate or reduce the risks. In the “Plans to Manage Risk” column, write down ideas for how to minimize the risk of fire.



S-16

*Remember to think about the individual’s health, behavior, daily living skills, environment, and lifestyle choices.


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T-17

Drowning• Thisinformationrelatestoasessionoutcomeandmayappearon

thequiz. Outcome: Describe how to prevent and respond to drowning.

Facts About Drowning• ReviewtheFactsaboutDrowningattopofthepage.• Neardrowningisatermusedwhenapersonsurvivesforatleast

24hoursfollowingsuchanevent.• Regionalcentersprovideservicestoover500individualswho

havedevelopmentaldisabilitiescausedbyneardrowningaccidents.

• Individualswithdevelopmentaldisabilitiesareatincreasedriskfordrowningbecausetheymaylackwatersafetyawareness.

• Individualswithepilepsyareatincreasedrisk,andsufferingaseizureinthewatercanbefatal.

• FactSourcefrompageS-17:Centers for Disease Control and Prevention, National Center for Injury Prevention and Control.Web-basedInjuryStatisticsQueryandReportingSystem(WISQARS)[online].[cited2011April6].

Preventing DrowningShow Slides #36 and #37: Preventing Drowning• Review.



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Drowning

Facts About Drowning• Morethanoneinfivepeoplewhodie

fromdrowningarechildren14andyounger.

• Individualscandrownnotonlyinrivers,lakesandoceans,butinbathtubs,swimmingpools,andhottubs.

• Drowningisthesixthleadingcauseofunintentionalinjurydeathforpeopleofallages,andthesecondleadingcauseofdeathforchildrenages1to14years.

• Alcoholuseisinvolvedinabouthalfofteendeathsinvolvingwaterrecreation.

• Nearly80%ofpeoplewhodiefromdrowningaremale.

“Neardrowning”isthetermusedwhenapersonsurvivesforatleast24hoursfollowingadrowningevent.Foreachchildwhodiesfromdrowning,approximatelyfourchildrenarehospitalizedforneardrowning.Non-fataldrowningscancausebraindamagethatmayresultinlong-termdisabilities,includingmemoryproblems,learningdisabilities,andpermanentlossofbasicfunctioning(e.g.,permanentvegetativestate).Regionalcentersprovideservicestoover500personsinCaliforniawhohaveintellectual/developmentaldisabilitiescausedbyneardrowningaccidents.

Individualswithintellectual/developmentaldisabilitiesareatincreasedriskfordrowningbecausetheymaylackwatersafetyawareness.Individualswithepilepsyareatincreasedrisk,becausehavingaseizureinthewatercanbefatal.

Preventing Drowning CommunityCareLicensingrequires

swimmingpoolstobesurroundedbyfencesthatareclimb-resistantandatleastfivefeethigh.Theremustbelockedgatesandcarefulsupervisionofindividualsinthewaterbysomeonetrainedandcertifiedinwatersafety.Herearesomeadditionalactionstopreventdrowning:• Neverleaveanyonewithan

intellectual/developmentaldisabilityaloneinabathtub,showerstall,hottub,swimmingpool,wadingpool,orotherbodyofwaterforanyreason.

• Don’tallowdivingintowaterthatislessthansixfeetdeep.

• Don’tallowroughplayorrunningnearaswimmingpool.

• Donotleavewaterincontainers,pails,orbuckets.

• Keepelectricalcordsanddevicesawayfromwater.

• Teacheveryonewatersafetyand,ifpossible,howtoswim.

• Requireeveryonetouseanapprovedpersonalflotationdevicewheneverridingonaboatorfishingandpreferablywhileplayingnearariver,lake,orocean.

• Donotdrinkalcoholwhileswimmingoratthebeach.

S-17


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T-18

Helping with Transfers, Positioning, and Lifting

Show Slide #38: Helping with Transfers, Positioning, and Lifting• Readthescenarioontheoppositepagealoud.

— Askthestudentsifanyoftheindividualsintheirhomeneedassistancetomove.

• TwoReasonsforbecomingmoreskilledattransfers,positioningandlifting:

— Topreventinjuringtheindividualweareassisting. — Topreventstrainandinjurytoourownbacks.

Lifting and Protecting One’s Back

Show Slide #39: Lifting and Protecting One’s Back• Minimizingbackproblemscallsfor2things: — Usingourbodiesproperlywhenlifting,pushingorreaching. — Practicingexercisestostrengthenourbacks.• Reviewthingsyoucandowhenlifting,pushingorreaching

forsomething.Useexamplesand/ordemonstratetherightmovementsusinganobjectlikeaboxorabook.

— Usewheeldeviceswhenpossible. — Push,don’tpull,items. — Movetotheitem,ratherthanreachforit.• ReferstudentstopicturesonpageS-18asyoureviewthe

followingprinciplesofgoodbodymechanics.Thisinformationrelatestoasessionoutcomeandmayappearonthequiz.

Outcome: Identify the principles of good body mechanics.— Squat,ratherthanbendover,toreachdownforsomething.— Turn,ratherthantwist,togoinadifferentdirection.— Keepthenaturalcurveofthespineintact.— Liftloadsataboutwaistheight.



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Helping with Transfers, Positioning, and Lifting

Assistingindividualstomoveinvolvesthreeactivities:transfer,positioning,andlifting.Transfers

involveshiftinganindividualfromoneplacetoanother,forinstancefromawheelchairtoabed,withtheindividualbearingsomeweight.Positioningmeansarrangesomeone’sbodyonasurface.Liftingmeansbearinganindividualsfullweightwhilemovingthemfromoneplacetoanother.Therearetworeasons

tobecomemoreskilledattransfers,positioning,andlifting.First,wedonotwanttoinjuretheindividualwearesupporting.Second,wedonotwanttoinjureourselves.Assistinganindividualtomovecanputagreatdealofstrainonourbodiesunlesswepracticetheproperstrategies.Atsometimeduringtheirlives,fouroutoffivepeoplehavebackproblemssuchasseveremusclespasms,strainedbackmuscles,oraninjureddisc.TheDSPisnoexception.

Amber is a young woman who uses a wheelchair. She is able to move the chair by herself, but needs assistance to transfer from her bed, another chair, or the toilet to her wheelchair. Direct Support Professionals who work in Amber’s home have become used to lifting her into her chair. They do this on the average of six times a day, and she only weighs about 95 pounds. While they know they should follow certain steps in assisting her, the DSPs are often in a hurry and take some short cuts. Phyllis, a DSP who has supported Amber for the past eight months, has recently begun to feel some pain in her lower back in the mornings. It seems that as she gets going, her back loosens up, so she’s not that concerned about it. A couple of anti-inflammatory pills usually make her back feel better.

Lifting and Protecting One’s BackUnfortunately,Phyllismaybe

experiencingearlysignsthatsheisdoingsomedamagetoherback.Ambermaynotweighmuch,butlifting95poundsinthiswayisputtingastrainonPhyllis’back.HowcanPhyllisminimizebackproblemswithoutleavingthisjobsheloves?

Minimizingbackproblemscallsfortwothings:1. Usingourbodiesproperly.2. Practicingexercisestostrengthenour

backs.Wecandoanumberofthings

whenwehavetolift,push,orreachforsomething,nomatterhowlighttheitemis.

Whenliftingormovinganobject:• Use tools with wheels whenever

possible.

• Push, don’t pull, items such as a garbage container or a cart.

• Move to the item, rather than reach for it.

• Bend at the knees, not the waist, when reaching.

• Turn the whole body, rather than twisting at the waist, to go in a differentdirection.Twistingmotions,especiallywithaheavyload,placeconsiderablestressonthespine.

• Keep the natural curve of the spine during the movement; don’t round or arch the back.Acommonproblemisliftingloadsfromthefloor.Butoverheadloadscanalsobehazardous.Storeloadsoffthefloor(abovekneeheight)andbelowshoulderheighttoavoidtheneedtoobendover.

S-18


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T-19

Lifting and Protecting One’s Back (cont.)

• Whenpossible,elevatebathtubsandinstallwallhungtoiletstoprovidetoespacetoimprovelifting.

Principles of Good Body Mechanics• ContinuereferringtoSlide#38andpicturesinStudentGuide.• Inaddition,hydraulictilters,springloadedbottoms,anddrop-down

orremovablesidesontubsandbinscaneliminatebackstressduetoreachingintotubsandbins.



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E• Lift loads at about waist height.

Changeableheightstandscanbeusedtoraiseboxesupanddowntotherightheight(andalsotoaccommodateemployeesofdifferentheights).Reachingdownintotubsandbinsisacommonsourceofbackstress.Usetoolsthatwilltilttheloadforyouandboxeswithdropdownorremovablesides.

• When possible raise bath tubs and install wall hung toilets to provide enough room for lifting and transferring individuals.

Principles of Good Body Mechanics

Keep the natural curve of the spine

Acommonproblemisliftingloadsfromthefloor.Butoverheadloads

canalsobehazardous.Storeloadsoffthefloor(abovekneeheight)

andbelowshoulderheighttoavoidtheneedtobendover.

Lift loads at about waist heightIdeally,loadsshouldbeataboutwaistheightwhenlifted.Usechangeableheightstandstoraiseboxesupanddowntotherightheight(andalsotoaccommodateemployeesofdifferentheights).

Reachingdownintotubsandbinsisacommonsourceofbackstress.Usetoolsthatwilltilttheloadtoward

youandboxeswithdrop-downorremovablesides.

Avoid twisting motionsTwistingmotions,especiallywithaheavyload,placeagreatamountofstressonthespine.Arrangefurnitureandactivitiestoreducetheneedtotwistatthewaist.

Adjustable-height “scissors lift”

S-19

Lifting and Protecting One’s Back (cont.)


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T-20

Helping Individuals with Abnormal Muscle Tone and Mobility Issues

Show Slide #40: Helping Individuals with Abnormal Muscle Tone and Mobility Issues• Individualsvaryinsize,muscletone,andcontroloftheirbodies.Theyalso

havedifferentneedsinregardtohelpinmovingabout.• Aplanshouldbedevisedforeachindividual.Theplanshouldinclude

trainingfortheDSPs.ReviewprincipleslistedinStudentGuideandshowinginSlide#39.

• Inanysituation,whenpositioningortransferringsomeone,DSPsshouldfollowtheseprinciples:— Taketime.— Asktheindividualhowheorshewantstobeassisted.— Encourageasmuchparticipationaspossiblebytheindividualyouare

assisting.— Useequipmentwhenpossible.— Teamupwithanotherpersonwhenatwo-personliftisneeded.— Usegoodbodymechanics,liketheoneswejustdiscussed.

Exercises for Preventing Back Problems

Show Slide #41: Exercises for Preventing Back Problems.• Strengtheningyourentirebodypreventsfuturebackproblemsandalso

improvesyourgeneralhealth.• Besuretocheckwithyourdoctororotherhealthcareprofessionalbefore

startingtheexercises.• THESEEXERCISESARENOTRECOMMENDEDFORUSEDURING

ANACUTEBACKPROBLEMORSPASM.IFANYEXERCISECAUSESINCREASEDORCONTINUINGBACKPAIN,STOPTHEEXERCISEANDTRYSOMETHINGELSE.STOPANYEXERCISETHATCAUSESPAINTORADIATEAWAYFROMYOURSPINEINTOYOURBUTTOCKSORLEGS,EITHERDURINGORAFTERTHEEXERCISE.

• Youdon’tneedtodoeveryexercise.• Startwithfiverepetitionsthreetofourtimesadayandgraduallyincreaseto

10.• Doallexercisesslowly.



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Exercises for Preventing Back Problems

AsaDSP,usingpropertechniquesforliftingandmovingpeopleandobjectsensuresthesafetyoftheindividualbeingassistedandpreventsinjurytoyou.Youmayalsobeabletohelpyourselfbydoingexercisestostrengthenyourback.

Strengtheningyourentirebodypreventsfuturebackproblemsandalsoimprovesyourgeneralhealth.Manyexercisesandsportsstrengthenyourarmsandlegs,andspecialexercisestostrengthenyourabdominalmusclesarealsoencouraged.Keepingyourbodyflexiblehelpsyoutouseproperbodymechanicsthatprotectyourback.

Besuretocheckwithyourphysicianorotherhealthcareprofessionalbeforestartingtheexercises.

THESEEXERCISESARENOTRECOMMENDEDFORUSEDURINGANACUTEBACKPROBLEMORSPASM.IFANYEXERCISECAUSESINCREASEDORCONTINUINGBACKPAIN,STOPTHEEXERCISEANDTRYSOMETHINGELSE.STOPANYEXERCISETHATCAUSESTHEPAINTORADIATEAWAYFROMYOURSPINEINTOYOURBUTTOCKSORLEGS,EITHERDURINGORAFTERTHEEXERCISE.

Youdonotneedtodoeveryexercise.Stickwiththeonesthathelpyoumost.Startwith5repetitionsthreetofourtimesaday,andgraduallyincreaseto10.Doallexercisesslowly.Thebasictypesofexercisesthatcanhelpyourbackincludeflexion,extension,stretchingandstrengthening.

Helping Individuals with Abnormal Muscle Tone and Mobility Issues

SomeSpecificTransferandPositioning Guidelines.

Individualsvaryinsize,muscletone,andcontroloftheirbodies.Theyalsohavedifferentneedswithregardtohelpinmovingabout.Somepeopleneedhelpturninginbed.Someneedhelptositup.Someneedhelpinscootingforwardorbackwardinachairorbed.Someneedhelpmovingfromthebedtoachair,fromachairtothetoilet,fromachairtobed,orfromachair(orbed)tothefloor.Someneedhelpwalkingfromoneplacetoanotherwithoutfalling.

There should be a plan, for each individual who needs assistance with moving. The plan should include whatever training is needed for the DSPs and individual.

Sometimes,asinglehelpercanassistsomeone.

Sometimes,twoormorepeoplemayneedtoworktogether.

Sometimes,mechanicalaidssuchasaHoyerliftmaybeneeded.

Inanysituation,whenpositioningand/ortransferringsomeone,DSPsshouldattendtothefollowingprinciples:• Take time to think before you lift.

Besurethereisenoughroomtodothelift.Makesureyouhavegoodfootingandlight.

• Ask the individual how he or she wants to be assisted.

• Encourage as much participation as possible by the individual you are assisting.

• Use equipment (boards, sheets, lifts, and so forth) when possible.

• Team up with another person when a two-person lift is needed.

• Use good body mechanics (good technique).

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Exercises for Preventing Back Problems (cont.)

Show Slide #41: Exercises for Preventing Back Problems (cont.)

• Thebasicexercisesonthenexttwopagesfallintofourgroups: — Flexion — Extension — Stretching — Strengthening• Thisinformationreferstoasessionoutcomeandmayappearonthequiz. Outcome: List the four groups of exercises that help prevent back problems.• Reviewexercises.• Thisisagoodopportunitytogetstudentsmoving.Askifstudentsare

interestedintryingsomeoftheexercisesandleadthemthroughacoupleofsimpleones,likethepelvictiltandbackwardbend.



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Basic ExercisesThefollowingbasicexercisesfallinto

fourgroups:

• Flexion exercisesstretchthelowerbackmusclesandstrengthenthestomachmuscles.

• Extensionexercisesstrengthenyourlowerbackmuscles.

• Stretchingwarmsupmusclesformovementandwalking.

• Strengthening weightresistancetrainingimprovesmuscletoneandstrength.

Flexion ExercisesCurl-Ups

Curl-upsstrengthenyourabdominalmuscles,whichworkwithyourbackmusclestosupportyourspine.• Lieonyourbackwithkneesbent(60

degreeangle)andfeetflatonthefloor,armscrossedonyourchest.Donothookyourfeetunderanything.

• Slowlycurlyourheadandshouldersafewinchesupuntilyourshoulderbladesbarelyrisefromthefloor.Keepyourlowerbackpressedtothefloor.Toavoidneckproblems,remembertoliftyourshouldersanddonotforceyourheaduporforward.Holdfor5to10seconds(donotholdyourbreath),andthencurldownveryslowly.

Pelvic TiltsThisexercisegentlymovesthespine

andstretchesthelowback.• Lieonyourbackwithkneesbentand

feetflatonthefloor.

• Slowlytightenyourstomachmusclesandpressyourlowbackagainstthefloor.Yourpelvis(hips)shouldcomeofftheflooraboutaninch.Holdfor10seconds(donotholdyourbreath).Slowlyrelax.

Extension ExercisesPress-Ups

Beginandendeverysetofexerciseswithafewpress-ups.• Liefacedownwithhandsatshoulders,

palmsflatonfloornearyourshoulders.• Liftyourheadand

shouldersupoffthefloor,keepingyourhandsandelbowsonthefloorandthelowerhalfofyourbodyrelaxed.

• Ifit’scomfortable,pressyourchestforward.

• Keephipspressedtothefloor.Feelthestretchinyourlowback.

• Lowerupperbodytothefloor.Repeat3to10times,slowly.

Backward BendPracticethebackwardbendatleast

onceadayanddoitfrequentlywhenworkinginabentforwardposition.• Standuprightwithyourfeet

slightlyapart.Backuptoacountertopforgreatersupportandstability.

• Placeyourhandsinthesmallofyourbackandgentlybendbackward.Keepyourkneesstraight(notlocked)andbendonlyatthewaist.

• Holdthebackwardstretchforonetotwoseconds. S-21



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Show Slide #41: Exercises for Preventing Back Problems (cont.)


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Stretching ExercisesHamstring Stretch

Thisstretchesthemusclesinthebackofyourthighthatallowyoutobendyourlegswhilekeepinganaturalcurveinyourback.• Lieonyourbackinadoorwaywith

onelegthroughthedoorwayonthefloorandthelegyouwanttostretchstraightupwiththeheelrestingonthewallnexttothedoorway.

• Keepthelegstraightandslowlymoveyourheelupthewalluntilyoufeelagentlepullinthebackofyourthigh.Donotoverstretch.

• Relaxinthatpositionfor30seconds,thenbendthekneetorelievethestretch.Repeatwiththeotherleg.

Hip Flexor StretchThisstretchesthemusclesinthefront

ofyourhip,whichavoids“swayback”causedbytighthipmuscles.• Kneelononekneewithyourotherleg

bentandfootinfrontofyou.Keepanaturalcurveinyourback.

• Slowlyshiftyourweightontoyourfrontfoot,maintaininganaturalcurveinyourback.Holdfor10seconds.Youshouldfeelastretchinthetopofthefrontofthelegyouarekneelingon.Repeatwiththeotherleg.

Strengthening ExercisesProne Buttocks Squeeze

Thisexercisestrengthensthebuttocksmuscles,whichsupportthebackandaidinliftingwiththelegs.• Lieflatonyourstomachwithyour

armsatyoursides.• Slowlytightenyourbuttocksmuscles.

Holdfor5to10seconds(donotholdyourbreath).Slowlyrelax.

• Youmayneedtoplaceasmallpillowunderyourstomachforcomfort.

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Safely Transporting an Individual in a Wheelchair

Show Slide #42: Safely Transporting an Individual in a Wheelchair • Awheelchairisanexampleofadaptiveequipmentthatmustbe

individualizedfortheindividualusingit.• Ourfirstconsiderationistoassistanindividualtomoveandatthe

sametime,toreducetheriskofinjurywhenheorsheusesthewheelchair.

• RefertoSlide#42andtheStudentGuide;reviewthingstoconsiderwhenassistinganindividualwhousesawheelchair.


Outcome: List the rules for safely transporting an individual in a wheelchair.



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Safely Transporting an Individual in a Wheelchair

Someofushavebecomesousedtoseeingpeopleusingwheelchairsthatweforgetthattherearethingsweneedtodotoensuretheirsafetyandcomfort.Awheelchairisanexampleofadaptiveequipmentthatmustbeindividualizedforthepersonusingit.Ourfirstconsiderationistoassistanindividualtomoveandatthesametime,toreducetheriskofinjurywhenheorsheusesthechair.Wealsoneedtoremembertoincludetheindividualsoheorshecanbepartofanysocialinteraction.Inschools,someteachershavecreatedwheelchairsafetyclassesforpeerswhoareinterestedinpushingtheirfriendswhousewheelchairs.Completingthisclassandgainingawheelchairsafetylicensehelpstoensurethatnooneisinjuredandthatpeersaredemonstratingrespectfulbehavior.

Aswepreparetoassistanindividualtouseawheelchair,herearesomecriticalpointstoconsider:

• Self-mobilization:Doesthisindividualwantyourassistance?Cantheindividualmovehimselforherself?Ifyes,encouragehimtotransporthimselfasmuchaspossible.

• Individual sitting position:Beforestarting,checktoseethattheindividualisseatedaccordingtotheirindividualplan.– Aretheindividual’shipssupposedtobeallthewaybackinthewheelchair?– Doestheseatbeltneedtobeattached?– Arefootrestsinplace?Shouldtheindividual’sfeetbeonthefootrests?– Aretheindividual’shandsonthearmrestsorinhisorherlap,awayfromthewheels?

• Brakes:Arethebrakeslockedpriortoassistinganindividualintooroutofawheelchair?

• Holding on:Areyouholdingbothpushhandlesonthewheelchairfirmly?

• Starting and stopping:Areyoustartingandstoppingslowly,takingcornersslowly,andmaintainingasteadypacewhilemoving?Thisistoavoidjostlingtheindividualorthrowinghimorheroffbalance.

• Surface levels:Areyoualertforchangesinsurfacelevels;forexample,doorjambsorthefloorofanelevator?Hittingahalf-inchriseatstandardwheelchairspeedcanbendthefrontcastersandthrowtheindividualforward.

• Opening doors:Areyouopeningdoorsbystoppingthewheelchair,openingthedoorbyhandandslowlybringingthewheelchairthrough?Neveropendoorsbypushingwiththefrontofthewheelchair.Thiscandamagethewheelchair’sfootrests,theindividual’sfeet,orthedoor.Ifthedoordoesnotstayopenonitsown,holditwithonehandoryourbackside.Donotletthedoorbangthesideofthewheelchair.

• Inclines and ramps:Areyouensuringthattheindividual’sweightisalwayspushingbacktowardyouonupwardslopes?Theindividual’sweightshouldalwaysbepushingbacktowardyouonupwardslopes.Goinguphillmeanspushingtheindividual;togodownhill,turnthechairaroundandwalkbackwards.Inthismanner,theindividual’sweightwillpushbacktowardyou.

• Curbs:Areyouusingthelargewheelstorollovercurbs?– Up curbs—Stopatthecurb,raisethefrontcastersbypressingdownonthefootlever,rollthefrontcastersontothesidewalk,androllthelargewheelsoverthecurbbyliftingslightlyonthepushhandlesasyoupushforward.

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Safely Transporting an Individual in a Wheelchair (cont.)

Show Slide #43: Medical Emergencies• AmedicalemergencyisanunexpectedeventcallingforFirstAid,

followedbypromptmedicalattention.• Allemergenciescallforapromptresponse,eithercalling911orcalling

PoisonControlandgettingadvice.• Thisinformationrelatestoasessionoutcomeandmayappearonthe

quiz. Outcome: Define a medical emergency.

Medical Emergencies

Show Slide #44: Emergency Action Review times when 911 or the Poison Control Center should be called.• Alwayscall911iftheindividual:

— Hasbleedingthatcan’tbecontrolled— Isorbecomesunconscious,notrelatedtoaseizure— Hasnopulse— Hastroublebreathingorisbreathinginastrangeway— Haschestpainorpressure— Hassevereinjuries,suchasbrokenbones— Ischoking(notbreathingandnotcoughing)— Hasinjuriestothehead,neckorback— Hasgoneintoshock— Hasaseizurelastingfiveminutesorcontinuousseizures— Sufferselectricalshock— Isdrowningorneardrowning— Hasparalysis,numbnessorconfusion— Sufferssevereburnsthatcovermorethanonepartofthebodyoron

thehead,neck,hands,feetorgenitals• Otherreasonstocall911:

— Fireorexplosion— Downedelectricalwires— Swiftlymovingorrapidlyrisingwater— Presenceofpoisonousgas— Vehiclecollisionswithinjuries— Shooting

• Whenyoucall911,tellthem:— Whoyouare— Whereyouare— Whathashappened

• Stayonthephoneuntilthedispatchertellsyoutohangup.



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Medical Emergencies

ADSPisconstantlymakingdecisions,andoneofthemostseriousdecisionsistodeterminewhenmedicalattentionisnecessary.

Amedicalemergencyisanunexpectedeventcallingforfirstaid,followedbypromptmedicalattention.

Someemergenciescallforanimmediateresponsetoprotectlife.

Allemergenciescallforapromptresponse,eithercalling911orcallingthePoisonControlCenter(1-800-222-1222)andgettingadvice.

Emergency Action: Callingforhelpisoftenthemost

importantactionaDSPcantaketohelptheindividualinneedofaid.

ALWAYS Call 911 if the individual:• Hasbleedingthatcan’tbecontrolled• Isorbecomesunconsciousnotrelated

toaseizure• Hasnopulse• Hastroublebreathingorisbreathingin

astrangeway• Haschestpainorpressure• Hassevereinjuriessuchasbroken

bones• Ischoking(notbreathingandnot

coughing)

• Hasinjuriestothehead,neck,orback• Hasgoneintoshock• Hasaseizurelastingfiveminutesor

continuousseizures• Sufferselectricalshock• Isdrowningorneardrowning• Hasparalysis,numbness,confusion• Sufferssevereburnsthatcovermore

thanonepartofthebodyoronthehead,neck,hands,feet,orgenitalsIfanindividualappearstohavebeen

poisoned,firstcallthePoisonControlCenterat1-800-222-1222.

Call 911 if any of the following circumstances apply:• Fireorexplosion• Downedelectricalwires• Swiftlymovingorrapidlyrisingwater• Presenceofpoisonousgas• Vehiclecollisionswithinjuries• Shooting

When you call 911, tell them:• Whoyouare• Whereyouare• Whathashappened• Whenithappened

Stay on the phone until the dispatcher tells you to hang up.

– Down curbs—Alwayscomedowncurbsfacingbackwardswiththelargewheelscomingfirst.Maintainsomeupwardpressureonthepushhandlesasyoupullthewheelchairtowardyou.

TheaboveguidelinesarefromThe North Dakota Staff Training manual,pp.77–78),1995

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Safely Transporting an Individual in a Wheelchair (cont.)


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Medical Emergencies (cont.)

Show Slide #45: What to Do Until Medical Help Arrives• Untilmedicalhelparrives:

— Staycalm— Staywiththeperson— Maintainairway— Controlbleeding— Treatforshock— Haveacurrentmedicalhistoryreadytogivetotheparamedics

Show Slide #46: First Aid and Supplies• FirstAidisrequiredbyCommunityCareLicensingregulationsand

isagreatskilltohave.• TheRedCrossandotherorganizationsoffertheclasses.• FirstAidtechniquesinclude: — Abdominalthrusts,alsoknownastheHeimlichmaneuver — Rescuebreathing — CPR• Everycommunitycarefacilitymusthavethefollowingsuppliesat

acentrallocationinthehome.Makesureyouknowwherethesesuppliesarelocatedandhowtousethem.

— CurrenteditionofFirstAidManual — SterileFirstAiddressings — Bandagesorrolledbandages — Adhesivetape — Scissors — Tweezers — Thermometer — Antisepticsolution



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What to Do Until Medical Help ArrivesYou’vedonetherightthingcallingfor

help.Wheneveryouareconcernedaboutaninjuryormedicalcondition,callingforassistanceistherightthingtodo.Whileyouarewaitingforassistance,therearesomeveryimportantthingsyoucandotogivetheindividualthebestpossiblechancetorecover.

Untilmedicalhelparrives:• Stay calmsothatyoucanreassure

theindividualandnotaddtotheirfearandconcern.

• Stay with the person.• Maintain the individual’s airway,if

necessarybytiltingtheheadback.• Control bleeding,byapplication

ofpressureoruseofatourniquetifnecessary.

• Treat for shockbyhavingthepersonliedownandbylooseningclothing,coveringwithablanket,andseekingmedicalattention.

• Have a current medical history readytogivetotheparamedicsincluding,ataminimum:-Name,dateofbirth,currentaddress,andphonenumber

-Currentmedications-Listofallergies-Insuranceinformation(forexample,Medi-Calcard)

-Informationaboutwhathappenedandwhen

-Physician’snameandtelephonenumber

Itisagoodideatohaveall healthinformation,includingacopyoftheindividual’shealthhistoryandconsent-to-treatmentforms,inaseparatefolder,availableforDSPstogivetoemergencypersonnel.

First AidFirstAidisemergencycaregiven

immediatelytosomeonewhoishurt.FirstaidtrainingisrequiredbyCommunityCareLicensingregulations.TheRedCrossandotherorganizationsofferfirstaidclasses.

Firstaidtechniquesinclude:• Abdominalthrusts,alsoknownasthe

Heimlichmaneuver• Rescuebreathing• Cardio-pulmonaryresuscitation(CPR)

First Aid SuppliesEveryCommunityCareFacility(CCF)

musthavethefollowingminimumsuppliesatacentrallocationwithinthehome:• AcurrenteditionofaFirstAidmanual

approvedbytheAmericanRedCross,theAmericanMedicalAssociation,orastateorfederalhealthagency

• Sterilefirstaiddressings• Bandagesorrolledbandages• Adhesivetape• Scissors• Tweezers• Thermometer• Antisepticsolution• Gloves

ItisimportantthateveryDSPknowswherethesesuppliesareinthehomeandhowtousethem.

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Medical Emergencies (cont.)


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Environmental Emergencies: Fire, Earthquake, and Flood

Show Slide #47: The 4 “P”s• Wecanrarelypredictenvironmentalemergencies,butwecandoourbestto

prepareforthem.• Thisinformationrelatestoasessionoutcomeandmayappearonthequiz. Outcome: Give examples of environmental emergencies.• Someenvironmentalemergenciesareinternal,suchaswhenafireoccurs

withinthehome.• Otherenvironmentalemergenciesareexternal,suchasearthquakes,floods,

tornadoes,toxicspills,orothereventsthatinterferewithessentialservices.

Responding to Disasters• Onceadisasteroccurs,thereare4questionsthatmustbeasked:

1. ArethereinjuriesthatrequireFirstAidandmedicalattention?2. Doesthehomehavetobeevacuated,orisitsafetooccupy?3. Aretheresourcesoffoodandwater?4. Hasthedisasterinterferedwithpublicutilities,suchasgas,electricityand

communications?• Reviewthe“4P’s,”whatDSPscandotorespondwellduringanenvironmental

emergency.

Disaster Preparation• 1st P: Prepare

— Everyhomeneedstohavecriticalsuppliesonhandbecauseofthedisruptiontoservicesthatenvironmentaldisasterscreate.ReviewthebulletsintheStudentGuide.



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Environmental Emergencies: Fire, Earthquake, and Flood

Wecanrarelypredictwhenadisasteroraccident,suchasafire,earthquakeorflood,will

occur,butwecandoourbesttopreparefortheseenvironmentalemergencies.HowDSPsreactinanemergencydependsupontheirabilitytoidentifypossiblerisks,theirskillinfollowingtheemergencyplan,andtheirabilitytoremaincalminthefaceofuncertainty.

Someenvironmentalemergenciesareinternal,aswhenafireoccurswithinthehome.Othersareexternal,aswhenanearthquake,flood,tornado,toxicspill,orothereventoutsidethehomeinterfereswithpower,water,foodsupplies,orotheressentialservices.

Someexternalemergenciesmaycauseinternalemergencies,aswhenaflooddamagesahomeoranearthquakecausesafire.

Externaldisasters,maycauseproblemswithtravel,communications,andbasicutilityservices,includinggas,water,andelectricity.Theyputagreatdealofstrainonemergencyservices,includingmedicalcare.

Responding to DisastersOnceadisasteroccurs,therearefour

questionsthatmustbeasked.• ArethereinjuriesthatrequireFirstAid

andmedicalattention?• Dotheindividualshavetoevacuate

(leave)orisitsafetostayinthehome?

• Arefoodandwateravailable?• Hasthedisasteraffectedpublic

utilities,suchasgas,electricity,andcommunications?

Toincreasetheirabilitytorespondwellduringanenvironmentalemergency,aDSPneedstofollowthe“4Ps”:

• PREPARE …havetherightthingsavailable.

• PLAN …decidewhowilldowhat.• PRACTICE …holddisasterdrills.• PERFORM …completetheright

actioninanemergency.

P R E P A R E

Everyhomeneedstohavecriticalsuppliesonhandincasethereisanenvironmentaldisaster.Inadditiontofireextinguishersandsmokedetectorsthateveryhomeshouldhave,eachhouseholdneeds:• Firstaidkitandfirstaidbook.• Adjustablewrenchforturningoffgas

andwater.• Battery-poweredradioandflashlight

withplentyofextrabatteries.• Bottledwatersufficientforthenumber

ofindividualsandstaffinthehome(1gallonperpersonperday).

• Aone-weekfoodsupplyofcannedanddriedfoodsforeachindividualandstaffmember.NOTE: Theseshouldbereplacedregularly:watereverysixmonthsandcannedgoodsonceayear.Containersshouldbedated.

• Non-electriccanopener.• Portablestoveandfuel,suchas

butaneorcharcoal.• Matches(NOTE:Donotlightifthereis

anysmellofgas).• Creditcardsandcash.• Anextrasetofkeys.

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Environmental Emergencies: Fire, Earthquake, and Flood (cont.)

Disaster Preparation (cont.)

• 1st P: Prepare (cont.)— Everyhomeneedstohavecriticalsuppliesonhandbecauseofthedisruptionto

servicesthatenvironmentaldisasterscreate.ReviewthebulletsintheStudentGuide.

• 2ndP:Plan— Again,CommunityCareLicensingrequiresallcommunitycarefacilitiestohavea

DisasterPlan.— ReferstudentstoAppendix9-Btoseewhatablankdisasterplanlookslike.— DSPsshouldassistincreatingandrefiningtheDisasterPlan.

• 3rd P: Practice— DSPsshouldknowhowtodothefollowingthingssothattheywillbepreparedin

caseofanenvironmentalemergency:– Turnoffgas,waterandelectricity.– Providefirstaid.– Getindividualstheassistancetheyneed.– Communicatewithotherstaff.

• 4th P: Perform— Itisalwaysadvisabletostaycalm.— Reviewthestepsthatoneshouldtakeafteranearthquake.



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• AcurrentpostedDisasterPlan,withinformationaboutrelocation,PoisonControl,andphysiciannamesandtelephonenumbers.Inaddition,DSPsmusthavethefollowingitemsforeachindividuallivinginthehomeincluding:

• Listofcurrentmedicationsbeingtakenandprescribingphysician.

• Currentlyprescribedmedicationsonhand.

• Emergencyinformation(forexample,name,dateofbirth,homeaddress,andphonenumber;name,address,andphonenumberofadministrator;Medi-Calorothermedicalinsurancenumbers;knownallergiesandfoodsensitivities;andname,address,andphonenumberofrelativesorclosestfriends).

• Medi-Calorotherinsurancecard.• Signedconsent-to-treatmentform,with

phonenumberoftheregionalcenterorotherplacementagency.

• Otherpersonalandhealth-relatedinformationinareadilyaccessibleform.

• Achangeofclothing,raingear,andsturdyshoes.

• Blanketsorsleepingbag.• Anyneededadaptiveequipment

orassistivedevice(forexample,wheelchair,extrapairofglasses).

P L A N

CommunityCareLicensingrequiresallfacilitiestohaveaDisasterPlan(seeAppendix9-B).DSPsshouldassistinwritingthehomedisasterpreparednessplan.AssistinginwritingtheplanmakesitmorelikelythatDSPswillunderstandthereasonforactionstheyshouldtakeandmayalsoresultinidentifyingstrategiesforabetterplan.

P R A C T I C E

EachDSPshouldknowhowtorespondappropriatelytoanexternaldisaster,andpracticeisthewaythisisaccomplished.Knowingyouneedtoturnoffthegasisonlyusefulifyouknowhowtodothisandhavethetoolstocompletethetask.DSPsshouldknowhowto:• Turnoffgas,water,andelectricity.• Providefirstaid.• Getindividualstotheassistancethey

need.• Communicatewithotherstaff.

P E R F O R M

Thetypeandstrengthofanexternaldisasterwilldeterminehowtorespond.Itisalwaysagoodideatostaycalm.Forexample,inanearthquake,howtoresponddependsonwhereyouarewhentheearthquakeoccurs.Ifyouareinsideabuilding,stayawayfromwindows,standinadoorway,orcrouchunderasturdydeskortable.Ifyouareoutside,standawayfrombuildings,trees,andtelephoneandelectricalwires.Ifyouareinacar,driveawayfromunderpassesoroverpasses,stopinasafearea,andstayinthecar.

Afteranearthquake,oneshould:• Checkforinjuriesandprovideany

neededfirstaid.• Checkforgas,water,electrical,or

otherbreaks.Turnoffutilitieswheredangerexists(forexample,ifyousmellgas,turnoffgasnearmeter).

• Checkforbuildingdamage(forexample,aroundchimneysandfoundations).

• Cleanupdangerousspills(forexample,glassorwater).

• Turnonyourradioandlistenforinstructions

• Usethetelephoneonlyifneededtocallforimmediatehelp.

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Environmental Emergencies: Fire, Earthquake, and Flood (cont.)


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ACTIVITY: Disaster Planning and ResponseShow Slide #48: ACTIVITY: Disaster Planning and Response• Groupings:pairsorsmallgroups.• Assigneachgroupaparticulartypeofdisaster: — Earthquake — Flood — Fire — Tornado — Toxicspillintheneighborhood• Youdonothavetoassignalloftheabovedisasterstogroupsandcan

includeothersifyouwouldlike.• Giveeachgroupapieceofchartpaperandmarkers.• Directions: DeterminethebestwaytoPrepare,Plan,andPracticefor

thedisaster.Chartyourteamdecisionsonthewallchartpaperandbepreparedtopresenttheplantothelargegroup.Otherteamswillcritiquetheplan,somakesureyou’vecoveredeverything.

• Askteamstoreportbacktothelargegroup,andaskforcommentsandsuggestionsfromthestudents.

• Eachteam,regardlessofthedisasterassigned,shouldincludethefollowingintheirrecordedanswers:

— Prepare:SuppliesaslistedinStudentGuidePostedDisasterPlanItemsandinformationforindividualsinthehomeaslistedinStudentGuide

— Plan:Addresswhowill-DirectevacuationandpersoncountHandlefirstaidCommunicatewithemergencyservicesandothersProvideorsecuretransportationTurnoffutilities

— Practice:Planmightincludedescribingvariousdisasters,settingdatesandtimesfordrills,etc.



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A C T I V I T Y

Disaster Planning and Response

Directions: Using the disaster the teacher has given you, write down what you would do to Prepare, Plan, and Practice.

PrepareWhatdoyouneedtohaveonhand?

PlanWhatstepswillyoutakeintheeventofthisdisaster?(Besuretobespecific;forexample,whowilldowhat?)

PracticeDescribetheplanforDSPsandconsumerstopracticesteps.

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Summary• Askstudentstoturnbacktothe“What Do You Want to Know?”

activityatthebeginningofthesession.Givestudents5minutestothinkaboutwhattheylearnedandanswerthethirdquestion.

• Askforvolunteerstosharetheiranswers.

Show Slide #49: Practice and Share• DirectstudentstoPracticeandSharedirections.• Readthedirectionsandmakesurestudentsunderstandthe

assignment.

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P R A C T I C E A N D S H A R E

ReviewtheDisasterPlanforthehomewhereyouworkanddothefollowing:• Istheplanuptodate?Ifnot,tellyouradministrator.• Locatetheemergencyexits.• Doesthehomehavean“ABC”fireextinguisher?Isitcharged?Ifnot,tellyour

administrator.

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Quiz: Risk Management: Environmental Safety

Show Slide #50: Quiz Time• Givestudents20minutestotakethequiz.

Show Slide #51: Quiz Answers• Discussquestionsandanswersasaclass.• Remindstudentstomarkthecorrectanswerssotheycanusethe

correctedquizzesasastudyguideforthetestaftertraining.

Answers 1. B2. C3. A4. B5. C6. C7. A8. C9. B10.C

End of Session 9



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Session 9 Quiz

Risk Management: Environmental Safety

1. What is one way to prevent poisoning from household chemicals:A)Don’tstoreANYpoisonouschemicals

inthehomeB)Keepallpoisonousproductsinlocked

cabinetsC)Tellindividualsinthehomenotto

touchpoisonousproductsD)Placepoisonousproductsonashelf

2. WhatisthefirstthingaDSPmustdoifthey think an individual may have been poisoned?A)MaketheindividualvomitB)CallthehomeadministratorC)CallthePoisonControlCenterD)Askaneighborforhelp

3. What is one thing a DSP can do to prevent some falling accidents?A)Usearubbermatorabenchinthe

showerB)LeavebooksandtoysonstairwaysC)AllowspillstoairdryD)Keepwiresandhosesalongwalkways

4. If an individual who has fallen appears to have been seriously injured or is bleeding, what should the DSP do?A)TellanotherDSP;movetheindividual

toanearbychairorsofaB)Call911forassistance;donotmove

theindividualC)Asktheindividualiftheywouldlike

somehelpD)Asktheindividualhowtheyfell

5. Which activity will help prevent injury fromfires?A)Placeallcardboardboxesinapilein

thegarageB)AllowsmokinganywhereinthehouseC)Checksmokedetectorsmonthlyand

replacebatteriestwiceayearD)Keepextrawoodandpaperinthe

fireplace

6. What should a DSP do if they smell smokeordiscoverafire?A)Takesomeindividualsout,thengo

backforothersB)Stopandgetimportantpapersand

personalbelongingsC)Helpallindividualsoutofthehome;

meetinadesignatedmeetingplaceD)Leaveatonce;otherswillfollowthe

DSP

7. What can a DSP do to prevent drowning?A)Helpindividualslearnaboutwater

safetyB)AllowdivinginshallowwaterC)Leavewaterinopenbucketswhereit

canbeeasilyseenD)Servealcoholatpoolparties

8. Which item below is a principle of good body mechanics?A)Bendfromthewaisttopickupheavy

objectsB)ReachdownintodeeptubsandbinsC)Keepthenaturalcurveofthespine

whenliftingD)Twistsharplyatthewaist

9. A “medical emergency”:A)Isaseriousaccidentthatoccursaway

fromthefacilityB)Isanunexpectedeventrequiring

firstaid,followedbypromptmedicalattention

C)Iswhenanindividual’sdoctorcallsunexpectedly

D)Isaneventonlytobehandledbythehomeadministrator

10. Which of the following is an environmental emergency?A)ChokingB)TakingthewrongmedicationC)AnearthquakeD)Fallingfromaladder

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Appendices

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Appendix 9-A

Safety for Infants and Toddlers

Safety for Infants1. Nevershakeababy!2. Neverleaveaninfantaloneonabed,

changingtableorotherhighobject.3. Alwaysputcribrailsupwhenstepping

orturningawayfromtheinfant.4. Placeababydowntosleeponhisor

herbackorontheside,withthelowerarmforwardtostopinfantfromrollingover.

5. Placeababyonafirmmattressanddonotusefluffyblanketsforcomfortersunderthebaby.Donotletababysleeponawaterbed,sheepskin,pillow,orothersoftmaterial.

6. Coverelectricaloutletswithchildproofcovers.

7. Makecertainthatwiresandcordsfromlamps,appliances,etc.arenothangingwhereachildcouldeasilypullthem,causingsomethingtofall.

8. Keepgatesinfrontofstepsandstairs.9. Keepallmedicine,household

cleaners,andanyothertoxicsubstanceoutofthereachofchildren,inalockedcabinet.

10.Keepchildprooflatchesonalldrawersandcabinetstopreventaninfant,toddler,orsmallchildfromopening.

11.Keepallplasticbagsawayfrominfantsandsmallchildren.

12.Keepneedles,safetypins,coins,beadsandothersmallobjectsawayfrominfantsandsmallchildren.

13.Nevergiveaninfantoryoungchildfoodsthatareeasilychokedon,suchaspopcorn,peanuts,grapes,rawvegetables,marshmallows,hotdogsorotheritemswhichmayobstructachild’sairway.

14.Placehotcoffeepotorotherhotiteminthecenterofthetableoutofachild’sreach.Donotplacehotitemsonatablewithatablecloth,unlessthechildissupervised.

15.Neverleaveachildaloneinabathtub,ornearotherbodiesofwater,suchasafishpondorswimmingpool.Achild’ssmallinflatableplasticpoolcanalsobedangerousifthechildisnotsupervised.

16.UseasunscreenwithanSPFof15orhigherwhentakinganinfantorchildoutdoors.

17.Alwaysplaceaninfantinacarseat,whichhasbeenproperlyinstalled.Placeinfantcarseatinbackseat.

18.Neverleaveachildalonenearalightedstove,fireplace,barbeque,burningcandleorlamp.

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Safety for Toddlers and Preschoolers 1. Keepalltoolsoutofthereachof

children.2. IfyouhaveVenetianblindswithcords

cuttheloopinordertoavoidthechildgettinghisorherneckcaughtinit.

3. Keepmatchesandlightersoutofreach.

4. Alwaysturnthehandlesofpotsandpanstowardsthebackofthestove.

5. Learnwhichplantsarepoisonousandkeepyoungchildrenawayfromthem.

6. Becertainchildrenaresecuredwithaseatbeltwhenseatedincarriagesandstrollers.

7. Neverleaveachildaloneinacarriage,strollerorshoppingcart.

8. Neverleaveachildaloneinthehouseoraparkedcar.

9. Childrenweighingupto60poundsoruptosixyearsofageshouldrideinacarseat.

10.Neverplaceachildinthefrontpassengerseatwithpassengersideairbags.

11.Discardoldrefrigerators,freezers,orstovesorhavethedoorsremovedfromthem.

12.Neverhavefirearms(loadedorunloaded)whereachildcanreachthem.

Safety for School Age Children Amongschool-agedchildren,motor

vehicleaccidentsaretheleadingcauseofdeath,followedbypedestrianinjuries.Ahighpercentageofnon-fatalinjuriesareduetofalls.Considerationforkeepingschool-agedchildrensafeinclude:

1. Useseatbeltsatalltimesinautomobiles.

2. Useappropriatelyfittinghelmetsonallchildrenridingbicycles.

3. Educatechildrenaboutthedangerofgoingintothestreet.Setboundaries.Usedooralarmsorotherdevicesinhomeofchildrenwhomaynotunderstandandrunintothestreet.

4. Alwayshaveadultsupervisionwhenchildrenareswimming.

5. Teachchildrenaboutappropriateinteractionwithstrangers(gettingintocars,answeringdoors,etc.).

Appendix 9-A (cont.)

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EAppendix 9-B

Disaster Plan for Residential Care Facilities

I. ASSIGNMENTS DURING AN EMERGENCY (USE REVERSE SIDE IF ADDITIONAL SPACE IS REQUIRED)

III. FACILITY EXIT LOCATIONS (USING A COPY OF THE FACILITY SKETCH [LIC 999] INDICATE EXITS BY NUMBER)

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY CALIFORNIA DEPARTMENT OF SOCIAL SERVICES

EMERGENCY DISASTER PLAN FOR

ADULT DAY PROGRAMS, ADULT

RESIDENTIAL FACILITIES, RESIDENTIAL

CARE FACILITIES FOR THE CHRONICALLY

ILL AND SOCIAL REHABILITATION FACILITIES

INSTRUCTIONS:

Post a copy in a prominent location in facility, near telephone.Licensee is responsible for updating information as required.Return a copy to the licensing office.

NAME OF FACILITY

SIGNATURE

NAME(S) OF STAFF TITLE ASSIGNMENT

DATE

ADMINISTRATOR OF FACILITY

TELEPHONE NUMBERFACILITY ADDRESS (NUMBER, STREET, CITY, STATE, ZIP CODE)

( )

( )

AS ADMINISTRATOR OF THIS FACILITY, I ASSUME RESPONSIBILITY FOR THIS PLAN FOR PROVIDING EMERGENCY SERVICES ASINDICATED BELOW. I SHALL INSTRUCT ALL CLIENTS/RESIDENTS, AGE AND ABILITIES PERMITTING, ANY STAFF AND/ORHOUSEHOLD MEMBERS AS NEEDED IN THEIR DUTIES AND RESPONSIBILITIES UNDER THIS PLAN.

1.

2.

3.

4.

5.

6.

1.

3.

2.

4.

DIRECT EVACUATION AND PERSON COUNT

HANDLE FIRST AID

TELEPHONE EMERGENCY NUMBERS

TRANSPORTATION

OTHER (DESCRIBE)

VIII. AFFIRMATION STATEMENT

II. EMERGENCY NAMES AND TELEPHONE NUMBERS (IN ADDITION TO 9-1-1)

IV. TEMPORARY RELOCATION SITE(S) (IF AVAILABLE, SUBMIT LETTER OF PERMISSION FROM RENTER/LEASEE/MANAGER/PROPERTY OWNER)

VI. FIRST AID KIT (LOCATION)

V. UTILITY SHUT—OFF LOCATIONS (INDICATE LOCATION(S) ON THE FACILITY SKETCH [LIC 999])

VII. EQUIPMENT

FIRE/PARAMEDICS

RED CROSS

PHYSICIAN(S)

HOSPITAL(S)

DENTIST(S)

ELECTRICITY

WATER

GAS

LIC 610D (10/03) (PUBLIC)

POLICE OR SHERIFF

OFFICE OF EMERGENCY SERVICES

POISON CONTROL

AMBULANCE

CRISIS CENTER

OTHER AGENCY/PERSONLONG TERM OMBUDSMAN

TELEPHONE NUMBER

TELEPHONE NUMBER

( )

SMOKE DETECTOR LOCATION (IF REQUIRED)

FIRE EXTINGUISHER LOCATION (IF REQUIRED)

TYPE OF FIRE ALARM SOUNDING DEVICE (IF REQUIRED)

LOCATION OF DEVICE

NAME ADDRESS

NAME ADDRESS

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Appendix 9-C

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Appendix 9-C (cont.)

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Documents

Trainer Resource Guide - California Department of ... 1, Session 9: RISK MANAGEMENT: ENVIRONMENTAL SAFETY TRAINER RESOURCE GUIDE T-3 • Remember what you learned in Session 3: Preventing