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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.
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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.
T r a i n e r G u i d e : S E S S I O N 9
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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.
T r a i n e r G u i d e : S E S S I O N 9
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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T r a i n e r G u i d e : S E S S I O N 9
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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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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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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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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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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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).
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Falls (cont.)
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ACTIVITY: Identifying Fall Risks
Show Slide #26: ACTIVITY: Identifying Fall Risks• Groupings:individualorteamsofstudentsworkinginsame
home.• Readdirectionsaloud.• Askforvolunteerstosharepotentialfallrisksandplansto
managethoserisks.
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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.
Description of Risk* Plans to Manage Risk
* Remember to think about the individual's behavior, daily living skills, environment, and lifestyle choices.
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*Remember to think about the individual’s health, behavior, daily living skills, environment, and lifestyle choices.
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Fires
• Thisinformationrelatestoasessionoutcomeandmayappearonthequiz.
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.
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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.
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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.
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Responding to a Fire (cont.)
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ACTIVITY: Identifying Fire Risks
Show Slide #35: ACTIVITY: Identifying Fire Risks• Groupings:individualsorteamsofstudentsworkinginsame
home.• Readdirectionsaloud.• Askforvolunteerstosharepotentialfirerisksandplansto
managethoserisks.
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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.
Description of Risk* Plans to Manage Risk
* Remember to think about the individual's behavior, daily living skills, environment, and lifestyle choices.
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*Remember to think about the individual’s health, behavior, daily living skills, environment, and lifestyle choices.
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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.
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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.
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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”
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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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Exercises for Preventing Back Problems (cont.)
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.
• Thisinformationrelatestoasessionoutcomeandmayappearonthequiz.
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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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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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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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
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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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Appendix 9-C (cont.)
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Appendix 9-C (cont.)
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Appendix 9-C (cont.)
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Appendix 9-C (cont.)
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