MEDICAL TRAINING IN POWER POINT (1).pptx

MEDICAL TRAINING

1. MEDICAL EMERGENCY RESPONSE

2. PLEASE SCAN THE QR CODE PRE TEST QUIZ

3. TRAINER PROFILE NAME : Razak Bin Majid POSITION : Trainer EDUCATION : Executive Master SHE from UNISEL H/P : 019-4944324 Competency: SHO Registered Person (8408) Authorize Gas Tester (DOSH) Train The Trainer (NIOSH & HRDF) Scaffolder (DOSH) Train The Trainer (Forklift) Traffic Management Supervisor Train The Trainer (BOFA) Lifting Supervisor ISO 45001-2018 Lead Auditor Trained Ergonomic ISO 14001-2015 ISO 39001- 2012

4. In case of EMERGENCY Please use nearest exit to the assembly area Please do not run Please do not use the elevator Use the nearest staircase Safety Briefing 4

5. Facilities Washroom (Every floor) Surau (First Floor) Cafeteria Smoking (Ground Floor) Reminder Silence hand-phone during training session Important Things

6. OBJECTIVES ( At the end of this course, participant will be able to: Clear communication channels during coordinating responses. Control an accident scene while preventing further injury to rescuer or patient Conduct an initial and secondary assessment of patients Give proper care for common injuries and illnesses Coordinate with external medical service. Documentation and Reporting Develop and implementation where the personnel or organization able to have a well-documented ERP which consist the outline on procedure to be taken during emergency.

7. “The purpose of this course is to train emergency medical responders, people like you, who will often be the first trained individuals with/without a duty to provide care at the scene of an emergency. The course content and activities will prepare you to better recognize emergencies, make decisions, and provide care. This course teaches the skills you will need to manage emergency situations until more advanced medical personnel, such as EMTs and Paramedics arrives”

8. Definition of the term “Emergency Medical Response” Emergency Medical Responders  ( EMRs ) are people who are specially trained to provide out-of-hospital care in medical emergencies, typically before the arrival of an ambulance . EMR is often the first medically trained person to arrive on the scene of an emergency EMR have the knowledge and skills necessary to provide immediate lifesaving interventions while awaiting additional emergency medical services (EMS) resources to arrive.

9. The Medical Emergency – roles & responsibilities Maintain your body in a healthy physical and mental condition. Maintain equipment in a ready state. Respond promptly and safely to the scene of an accident or sudden illness. Ensure the scene is safe from hazards. Protect yourself. Protect the incident scene and patients from further harm.

10. The Medical Emergency – roles & responsibilities Summon appropriate assistance. Gain access to patients Perform patient assessment Administer emergency medical care Provide reassurance to patients and family members Move patients only when necessary

11. The Medical Emergency – roles & responsibilities Seek and then direct help from bystanders, if necessary. Control activities of bystanders. Assist ERTs and paramedics, as necessary. Maintain continuity of patient care. Document you care. Keep you knowledge and skills up to date.

12. EMERGENCY ACTION PRINCIPLES Elements of Surveying the Scene Survey the Scene Once you recognized that an emergency has occurred and decide to act, you must make sure the scene of the emergency is safe for you, the victim/s, and any bystander/s Scene safety Mechanism of injury or nature of illness Determine the number of patients and additional resources Identify yourself as first aider and get consent to give care

13. The first aider is alone, CALL FIRST, that is, activate medical assistance or arrange transfer facility before providing care for: An unconscious adult victim or child 8 years old or older. An unconscious infant or child known to be at a high risk for heart problems. The first aider is alone, provide 1 minute of care, then CALL FAST for: An unconscious victim less than 8 years old. Any victim of submersion or near drowning. Any victim of arrest associated with trauma. Any victim of drug overdose. EMERGENCY ACTION PRINCIPLES

14. EMERGENCY ACTION PRINCIPLES CALL First and CALL Fast Activate Medical Assistance and Transport Facility In some emergency, you will have enough time to call for specific medical advice before administering first aid. But in some situations, you will need to attend to the victim first. Both trained and untrained bystanders should be instructed to Activate Medical Assistance as soon as they have determined that an adult victim requires emergency care “Call First”. While for infants and children a “Call Fast” approach is recommended.

15. EMERGENCY ACTION PRINCIPLES Do a Primary Survey In every emergency situation, you must first find out if there are conditions that are an immediate threat to the victims life Check for Consciousness Check for Airway Check for Breathing Check for circulation

16. EMERGENCY ACTION PRINCIPLES Do a Secondary Survey It is a systematic method of gathering additional about injuries or condition that may need care. Interview the victim Check vital signs Perform head-to-toe examination

17. UNDERSTANDING THE CHAIN OF SURVIVAL The term chain of survival provides a useful metaphor for elements of emergency cardiovascular care system-of-care concept. The chain of survival shows that actions that must take place to give the cardiac arrest victim the best chance of survival. Each link is independent, yet connected to the links before and after. If any link is broken the chance for a good outcome is decreases.

18. CHAIN OF SURVIVAL ELEMENTS

19. CHAIN OF SURVIVAL Merujuk kepada beberapa Tindakan yang dilakukan dengan betul untuk mengurangkan kematian yang berkaitan dengan jantung terhenti

20. Call 911 After determining that there is an injury needing advance care; if unconscious tap and shout. 01 Question you will need to answer Nature of the emergency Where are you? How many are hurt? Ages of who is/are hurt Who are you? Has treatment started?

21. Begin CPR Most adult cardiac arrests (CA) victims heart is in ventricular fibrillation (VF) – Abnormal chaotic heart rhythm that prevents the heart from pumping blood. CPR will not usually stop VF but plays an important part in pushing oxygenated blood to the brain and heart and prolonging VF so that an AED will be useful. CPR can double or triple the victims survival rate For every passing minute without CPR, rate of surviving drops 7-10%. With CPR there is only a 3-4% drop each minute 02

22. Use an AED The use of the AED will stun the fibrillating heart, if the heart is still viable the normal pacemakers in the heart will begin firing and start a normal rhythm. If used within 5 min, chances of survival is 49 – 75%. Using an AED is simple 03

23. Advanced Care - EMS Response time is 7-8 minutes – CPR is extremely important. 04 Integrated post-cardiac arrest care 05

24. REASON OF OSHA AMENDMENT & FMA REPEALED TUJUAN PINDAAN AKKP & PEMANSUHAN AKJ

25. Akta bagi kawalan risiko berkaitan kerja atau berbangkit dengan aktiviti kerja berhubung dengan ; Memastikan Keselamatan , Kesihatan dan Kebajikan orang yang sedang bekerja Melindungi orang lainselain daripada pekerja terhadap risiko keselamatan dan Kesihatan pekerjaan Menggalakkan persekitaran pekerjaan yang sesuai dengan fisiologi dan psikologi pekerja Bersifat self regulation

26. Akta bagi kawalan kilang yang berhubung dengan ; Keselamatan , Kesihatan dan Kebajikan orang yang berada di dalam kilang Pendaftaran dan pemeriksaan jentera Perkara perkara berkaitan kilang dan jentera Bersifat prescriptive

27. Konsep perundangan KKP secara pengaturan kendiri (self  regulation) Penggubalan peraturan seiring perkembangan teknologi terkini Percanggahan peruntukan dua akta boleh diseragamkan Meraktifikasi ILO konvensyen (C155) Mengatasi loopholes Akta 514 Meningkatkan keberkesanan penguatkuasaan undang-undang .

28. Akta 139 dan 514 Akta 139 (FMA) Akta 514 (OSHA) Berusia 28 tahun , tidak   pernah dipinda Mengandungi 67 seksyen dan 3 jadual 8 peraturan , 2 perintah Dipinda kepada 92 seksyen   dan 5 jadual B erusia 55 tahun, kali  terakhir dipinda pada 2006 Mengandungi 70 seksyen dan 3 jadual 13 peraturan Akta dimansuhkan   keseluruhan AKKP sedia ada AKKP ( Pindaan ) 2022 Potong Pindaan Tambahan 67 Seksyen 3 Jadual 2 Seksyen 35 Seksyen 27 Seksyen 2 Jadual Jumlah Seksyen : 92 Seksyen dan 5 Jadual AKJ ( Pemansuhan ) 2022 Akta akan dimansuhkan semua

29. PRIVISION UNDER FMA (1967) MIGRATED INTO THE OSHA (AMENDMENT) 2022 Installation of machinery Pemasangan jentera Licensed person Orang berlesen Notice of occupation place of work Notis menduduki tempat kerja Director General Special Order Perintah Khas Ketua Pengarah Inspection of machinery Pemeriksaan jentera Special Scheme Inspection (SSI) Skim Pemeriksaan Khas Certificate of fitness for machinery Perakuan kelayakan jentera

30. MAJOR IMPROVEMENT IN OSHA (AMENDMENT (2022) Application Pemakaian OSH Coordinator OSH-C OSH Training Keperluan Latihan KKP Risk Assessment Pentaksiran Risiko Right of employee Hak pekerja Duties of principal Kewajipan Majikan & Prinsipal Occupational health services Perkhidmatan Kesihatan Pekerjaan Machinery Integrity Integriti Jentera Regulate OSH practitioners Kawal selia Pengamal KKP Empower NCOSH Memperkasa MNKKP Licensed person Orang berlesen (OBL) Increasing the penalty Peningkatan Penalti

31. Pemakaian Terpakai kepada semua tempat kerja kecuali Perkhidmatan domestic ATM Pekerjaan di atas kapal 1 Pindaan S1(2) Tertakluk kepada subseksyen (3), Akta ini hendaklah terpakai bagi semua tempat kerja di seluruh     Malaysia     termasuk perkhidmatan   awam   dan  pihak berkanun S1(3) Tiada apa-apa jua dalam Akta ini terpakai bagi pekerjaan yang dinyatakan dalam Jadual Pertama .

32. Pentaksiran Risiko 2 Peruntukan spesifik kewajipan majikan menjalankan pentaksiran risiko dan langkah kawalan risiko di tempat kerja . Kenalpasti bahaya Analisis risiko Kawalan risiko Kewajipan untuk menjalankan pentaksiran risiko dan melaksanakan Langkah-Langkah kawalan 18B. Tiap-tiap   majikan , orang yang bekerja   sendiri atau prinsipal hendaklah menjalankan pentaksiran risiko berhubung dengan risiko keselamatan dan kesihatan yang kepada mana-mana orang yang terjejas dengan mungkin Jika pentaksiran risiko menunjukkan bahawa kawalan risiko dikehendaki untuk menghapuskan atau mengurangkan risiko keselamatan   dan  kesihatan ,  majikan ,  orang  yang  bekerja sendiri atau prinsipal itu hendaklah melaksanakan kawalan itu . Bagi maksud seksyen ini , “ pentaksiran risiko ” ertinya proses membuat penilaian risiko kepada keselamatan dan kesihatan yang timbul daripada bahaya semasa bekerja dan menentukan langkah-langkah yang wajar bagi pengawalan risiko .

33. Kewajipan Prinsipal Menambahbaik takrifan sedia ada seperti definisi “ majikan ” “ pekerja ” bagi menjelaskan lagi hubungan antara pekerja dan majikan . 3 “ Majikan ” ertinya mana mana orang yang membuat suatu kontrak perkhidmatan untuk mengambil kerja mana mana orang sebagai pekerja “ Pekerja ” ertinya mana mana orang yang telah membuat suatu kontrak perkhidmatan dengan seoarang majikan “ Kontrak Perkhidmatan ” ertinya apa apa perjanjian sama ada secara lisan atau bertulis dan sama ada secara nyata atau tersirat yang menurutnya seseorang bersetuju untuk menggaji seseorang yang lain sebagai pekerja dan orang yang lain itu bersetuju untuk berkhidmat dengan majikannya sebagai pekerja dan termasuklah suatu kontrak perantisan .

34. Kewajipan Majikan Memperkenalkan tanggungjawab tambahan kepada “ majikan ” Keperluan membangun & melaksanakan pelan kecemasan ditempat kerja 3 1 5 . (1) Adalah menjadi kewajipan tiap-tiap majikan untuk memastikan , setakat yang praktik keselamatan kesihatan dan Kesihatan dan Kebajikan semasa bekerja semua pekerjaannya . (2) Tanpa menjejaskan keluasan makna subseksyen (1) perkara yang diliputi oleh kewajipan itu termasuklah terutamanya :- Pe ngadaan dan penyenggaraan loji dan sistem kerja yang setakat yang praktik , selamat dan tanpa risiko kepada Kesihatan” Pembangunan dan pelaksanaan tatacara bagi berurusan dengan kecemasan yang boleh timbul semasa pekerjaannya sedang bekerja Bagi memastikan wujud tatacara atau pelan bagi mengurangkan kesan akibat kemalangan yang berlaku

35. Kewajipan Prinsipal Memperkenalkan tanggungjawab tambahan kepada “ majikan ” Keperluan membangun & melaksanakan pelan kecemasan ditempat kerja 3 18. (1) Hendaklah menjadi kewajipan tiap -tap prinsipal untuk mengambi l , setakat yang boleh dipraktikkan , apa-apa Langkah sebagaimana yang perlu untuk memastikan keselamatan dan Kesihatan : mana-mana kontraktor yang diguna khidmat oleh principal aoabila sedang bekerja Mana-mana subkontraktor atau subkontraktor tidak langsung apabila sedang bekerja ; dan Mana-mana pekerja yang diambil kerja oleh kontraktor atau subkontraktor apabila sedang bekerja Bagi memastikan wujud tatacara atau pelan bagi mengurangkan kesan akibat kemalangan yang berlaku (2) Kewajipan yang dikenakan ke atas principal dalam subseksyen (1) hendaklah hanya terpakai jika kontraktor , subkontraktor atau pekerja yang disebut daalam subseksyen itu bekerja dibawah arahan prinsipal mengenai cara kerja itu dijalankan

36. Hak pekerja Menambahbaik hak pekerja mengambil kira Article 13, ILO C155 Hak pekerja untuk mengasingkan diri dari tempat kerja sekiranya terdapat bahaya hampir pasti yang mengancam KKP mereka . 4 26A. (1) Seseorang pekerja , selepas memberitahu majikannya atau wakilnya yang dia mempunyai justifikasi yang munasabah untuk mempercayai terdapat suatu bahaya hampir pasti berlaku di   tempat   kerjanya ,   hendaklah   mempunyai hak untuk mengeluarkan dirinya daripada bahaya atau kerja itu jika majikan itu gagal untuk mengambil apa-apa t indakan untuk menghapuskan bahaya itu . (2)  Seseorang   pekerja   yang  mengeluarkan   dirinya   daripada bahaya mengikut subseksyen (1) hendaklah dilindungi daripada akibat tidak wajar dan tidak boleh didiskriminasikan . Bagi maksud seksyen ini , “ bahaya hampir pasti berlaku ” ertinya suatu risiko kematian yang serius atau kecederaan badan yang serius kepada mana-mana orang yang disebabkan oleh mana-mana loji , bahan , keadaan , aktiviti , proses, amalan , tatacara atau bahaya tempat kerja .

37. Perkhidmatan Kesihatan Pekerjaan Pengadaan perkhidmatan bagi perlindungan kesihatan pekerja semasa bekerja ; Penggalakan kesihatan dan kesejahteraan di tempat kerja ; Pencegahan penyakit dan keracunan pekerjaan . 5 Perkhidmatan Kesihatan Pekerjaan (1) Jika Menteri mendapati bahawa dalam mana-mana tempat kerja atau kelas atau jenis tempat kerja — kes penyakit telah terjadi yang dia mempunyai sebab untuk percaya mungkin disebabkan oleh jenis proses atau keadaan lain kerja ; oleh sebab perubahan dalam mana-mana proses atau dalam bahan yang digunakan dalam mana-mana proses atau , oleh sebab pengenalan apa-apa proses baru atau bahan baru bagi kegunaan dalam sesuatu proses, mungkin terdapat risiko kesan buruk kepada kesihatan orang yang diambil kerja dalam proses itu ; atau (d) mungkin terdapat risiko kesan buruk kepada kesihatan orang yang diambil   kerja   dalam   mana-mana  pekerjaan   yang  dinyatakan   dalam Jadual Ketiga , atau daripada apa-apa bahan atau benda yang dibawa ke industri itu untuk digunakan atau dikendalikan dalamnya atau daripada apa-apa perubahan keadaan dalam industri itu , dia boleh membuat peraturan-peraturan menghendaki supaya perkiraan bagi perkhidmatan kesihatan pekerjaan .

38. Melantik OSH-C Keperluan melantik pekerja untuk bertindak sebagai Penyelaras Keselamatan dan Kesihatan Pekerjaan (OSH-C) Untuk membantu majikan penyelaras pematuhan perundangan KKP dan program KKP di tempat kerja 6 SEKSYEN BAHARU 29A PENYELARAS KESELAMATAN DAN KESIHATAN PEKERJAAN 29A (1) Seseorang majikan yang tempat kerjanya TIDAK termasuk dalam mana-mana kelas atau jenis tempat kerja sebagaimana yang disiarkan   dalam   Warta  di  bawah   subseksyen   29(1)  hendaklah melantik salah seorang daripada pekerjanya untuk bertindak sebagai Penyelaras Keselamatan dan Kesihatan Pekerjaan (OSH-C) jika dia mengambil kerja lima atau lebih pekerja di tempat kerjanya . Majikan yang telah melantik seorang Pegawai Kesihatan (SHO) walaupun tempat kerja tidak Perintah SHO, tidak perlu melantik OSH-C

39. PINDAAN SEKSYEN 29: PEGAWAI KESELAMATAN DAN KESIHATAN (SHO) AKTA 514 (SEBELUM PINDAAN) AKTA 514 (SELEPAS PINDAAN) Pegawai keselamatan dan kesihatan S.29. (1) Seksyen ini hendaklah terpakai bagi apa-apa kelas atau jenis industri yang ditentukan oleh Menteri melalui perintah yang disiarkan dalam Warta. (2) Seseorang penghuni suatu tempat yang baginya seksyen ini terpakai hendaklah mengambil kerja seorang orang kompeten untuk bertindak sebagai pegawai keselamatan dan kesihatan di tempat kerja . ………..… S.29(4) diganti Pegawai keselamatan dan kesihatan S.29. (1) Seksyen ini hendaklah terpakai bagi apa-apa kelas atau jenis tempat kerja yang ditentukan oleh Menteri melalui perintah yang disiarkan dalam Warta. (2) Seseorang penghuni suatu tempat yang baginya seksyen ini terpakai hendaklah melantik seorang orang kompeten untuk bertindak sebagai pegawai keselamatan dan kesihatan di tempat kerja . ………….. S.29 (4) Seseorang hendaklah dilantik sebagai pegawai keselamatan dan kesihatan hanya untuk satu tempat kerja pada satu-satu masa, melainkan jika dibenarkan selainnya oleh Ketua Pengarah ;

40. Keperluan Latihan KKP 7 SEKSYEN BAHARU 31A KURSUS LATIHAN KESELAMATAN DAN KESIHATAN PEKERJAAN (1)  Menteri boleh , melalui perintah yang disiarkan dalam   Warta , menghendaki   mana-mana   kelas   atau   perihal   orang   untuk menghadiri kursus latihan keselamatan dan kesihatan pekerjaan sebagaimana   yang  dinyatakan   dalam   perintah   itu yang  dijalankan oleh seorang penyedia latihan berdaftar . (2) Majikan mana-mana orang yang dikehendaki untuk menghadiri apa-apa   kursus   latihan   di  bawah   subseksyen   (1)  hendaklah memastikan yang  orang itu telah   menyelesaikan   kursus latihan tersebut sebelum membenarkan orang itu untuk melaksanakan apa - apa kerja yang baginya latihan itu diperlukan . Ketua Pengarah boleh , mengeluarkan arahan untuk pekerja yang ditetapkan mengikuti kursus ulangkaji . Keperluan “ kelas atau perihal orang” untuk menghadiri kursus KKP yang ditetapkan . Memastikan pekerja yang ditetapkan diberi latihan sebelum melakukan aktiviti kerja .

41. Kawal selia pengamal KKP Pendaftaran , pemantauan dan akauntabiliti pengamal KKP (Orang Kompeten , Penyelia , Firma Kompeten ) diseragamkan dibawah perundangan M eningkatkan komitmen dan tahap profesionalisme pengamal KKP Kawal selia dan Tindakan undang-undang boleh dilakukan Bahagian VIIA, Peruntukan bagi Orang Kompeten dan Penyedia Latihan S.31C Permohonan Pendaftaran S.31E Pembaharuan Pendaftaran S.31C Permohonan Pendaftaran S.31F Pembatalan Pendaftaran

42. Integriti Jentera 8 Memasukkan elemen pengurusan integriti jentera , pemeriksaan jentera , Perakuan Kelayakan dan Skim Pemeriksaan 9 Orang berlesen (OBL) Peruntukan bagi membolehkan Orang Berlesen dilantik bagi menjalankan pemeriksaan loji dan pengeluaran Perakuan Kelayakan . Meningkatkan pengurusan loji oleh industri . Menangani isu backlog pemeriksaan jentera . Bahagian VIA : Pemberitahuan Menduduki Tempat Kerja , Pemasangan dan Pemeriksaan Loji. PEMBERITAHUAN TEMPAT KERJA DAN AKTIVITI Pemeriksaan Berkala Kilang dimansuhkan PENETAPAN LOJI YANG PERLUKAN PERAKUAN KELAYAKAN PEMASANGAN LOJI PERAKUAN KELAYAKAN PEMERIKSAAN BERKALA LOJI Akan ditetapkan dalam Peraturan Jentera Berperakuan yang sedang digubal . SKIM PEMERIKSAAN KHAS Peraturan berkaitan Skim Pemeriksaan Khas dikekalkan dan ditambah baik PERINTAH KHAS PENGARAH

43. Kawal selia Penyeliaan Pendaftaran , pemantauan dan akauntabiliti pengamal KKP (Orang Kompeten , Penyedia Latihan, Firma Kompeten ) diseragamkan dibawah perundangan . Meningkatkan komitmen dan tahap profesionalisma pengamal KKP. 10 Bahagian VIIA. Peruntukan bagi Orang Kompeten dan Penyedia Latihan. Permohonan Pendaftaran Kesahan Pendaftaran Pembaharuan Pendaftaran Pembatalan Pendaftaran Tujuan Peruntukan : Membolehkan kawal selia dilakukan dan tindakan perundangan diambil jika mereka gagal melaksanakan tanggungjawab

44. Memperkasa MNKKP Meningkatkan keberkesanan MNKKP. Keanggotaan maksimum 25 orang ( kerajaan , majikan , pekerja , NGO, ahli akademik dan profesional ) Selaras dengan perkembangan kompleksiti industri . 11

45. Wakil AKKP 1994 (ahli) Pindaan AKKP (ahli) Majikan 3 (organisasi yang mewakili majikan) 5 (organisasi yang mewakili majikan) Pekerja 3 (organisasi yang mewakili pekerja) 5 ( organisasi yang mewakili pekerja ) Kementerian Jabatan ≥ 3 5 (termasuk KP Kesihatan & wakil Kementerian atau Jabatan) Organisasi / Badan Profesional ≥ 3 termasuk 1 wanita ≥ 3 termasuk 1 wanita ( Organisasi / Badan Profesional ) Agensi KSM Bukan ahli (pemerhati) KSU KSM, KP JKKP, ED NIOSH, KE PERKESO Jumlah 12 < ahli < 15 ( termasuk Pengerusi & Timb . Pengerusi) 22 < ahli < 25 ( termasuk Pengerusi, Timb . Pengerusi & Setiausaha )

46. Peningkatan Penalti   Penalti Sedia ada Penalti Pindaan   Penalti Am RM10K RM100K - Penjara : 1 tahun Kewajipan Majikan, Prinsipal RM 50K RM 500K Penjara : 2 tahun Penjara : 2 tahun Kewajipan Pekerja RM 1K RM 2K Penjara : 3 bulan Penjara : 3 bulan Orang Kompeten - RM 100K Tidak mematuhi Notis RM 50K RM 500K Penjara : 5 tahun Penjara : 2 tahun Setiap hari kesalahan berterusan – RM 500 Setiap hari kesalahan berterusan – RM 2K Perbandingan dengan Lain-lain Akta tempatan ( Akta 127, Akta 520) yang mempunyai konsep perundangan yang sama menetapkan penalti maksima RM500K Akta KKP luar negara juga mengenakan denda yang tinggi . 12

47. Hazards A hazard is a source or a situation with the potential for harm in terms of human injury or ill-health, damage to property, damage to the environment, or a combination of these. Two categories Health hazards : occupational illnesses Safety hazards : physical harm, injuries Hazard identification Hazard identification is part of the process used to evaluate if any particular situation, item, thing, etc. may have the potential to cause harm. The term often used to describe the full process is risk assessment: Identify hazards and risk factors that have the potential to cause harm Analyse and evaluate the risk associated with that hazard Determine appropriate ways to eliminate the hazard, or control the risk when the hazard cannot be eliminated Understanding hazards, hazard identification and management

48. HAZARD SYMBOLS

49. Hazard management Hazard management is essentially a problem-solving process aimed at defining problems (identifying hazards), gathering information about them (assessing the risks) and solving them (controlling the risks). Understanding hazards, hazard identification and management

50. When you have identified the hazards, you need to assess the risk created by each hazard. The risk is the likelihood that the hazard will cause injury, illness or disease in the way that it is used or occurs in the workplace, and the severity of the injury, illness or disease that may results. HAZARD MANAGEMENT STEPS Assessing the risk 02 Identifying the Hazard 01 This is the fundamental step in hazard management. SOME WAYS TO IDENTIFYING HAZARDS: Workplace inspections Incident reporting Register of injuries Consultation with employees

51. It is important to know if your risk assessment was complete and accurate. It is also essential to be sure that changes in the workplace have not introduces new hazards or changed hazards that were once ranked as lower priority to a higher priority. HAZARD MANAGEMENT STEPS Evaluate, Monitor and Review 04 Hazard Control 03 It is not enough to just find and rate the hazards, After founding the hazard it is important to eliminate or control the hazard before the injury or illness of people due to hazard.

52. Roles and responsibilities of the ERT members It is a nominated team identified from the staff who have been specially trained to provide immediate response during any (Code Red or Orange) emergency situation as per the defined protocol. WHAT IS ERT (EMERGENCY RESPONSE TEAM)?

53. ERT MEMBERS The team comprises of; Deputy COO – Team Leader Assistance COO Security Director & Manager, Supervisors Case Management / Executive on Duty Patient Services Director Engineering & Facility Management Director EFMD HVAC Engineer Environmental Services Director & Manager Nursing Coordinator The team comprises of; ICU Coordinator Clinical Engineering Supervisor Environmental Health and Safety Manager / Officer Executive on Duty Electrician on Duty Plumber on Duty / Supervisor

54. Roles and Responsibilities of the ERT Members

55. Assessing the situation and activating the emergency response plan Quickly gather information about the nature , scope and impact of the emergency , and decide whether to activate the emergency response plan . Notify the relevant authorities and request their assistance if needed; Police Fire department Ambulance Evacuating and protecting the employees and assets Ensure the safety and well-being of the employees and visitor: Directing them to the nearest exit / safe area Provide with first aid / medical attention Secure the premises and equipment, and prevent any further damage or loss Roles and Responsibilities of the ERT Members

56. Communicating and managing the crisis Establish a crisis communication who can provide accurate and timely information to the media , customers , partners and other stakeholders . Monitor the situation and update the emergency response plan as needed, and external agencies to resolve the crisis. Recovering and restoring the operations Evaluate the aftermath of the emergency and assess the extent of the damage and disruption. Implement the recovery and restoration plan ; Repairing / replacing the damage facilities and equipment Restoring data and systems Resuming the normal operations Providing counselling and support to the affected employees. Roles and Responsibilities of the ERT Members

57. Workplace consultation and communication Health and Safety management system components NEXT SLIDE : PLAY THE VIDEO

58. Health and Safety management system components

59. Type of Medical Emergencies in the workplace

60. Definitions and Classification (Open & Closed) A wound is an injury, especially one in which the skin or another external surface is torn, pierced, cut, or otherwise broken. Wounds can be classified into two main types .These are open and closed wounds. In the category open and closed wounds the wounds are then summarised again into more specific categories. Traumatic Injuries Bites & Stings Allergic Reactions Gastrointestinal Problems

61. Open Wounds Some types of open wounds include: Incisions – caused by a clean, sharp-edge object such as a knife, a razor or a glass splinter. Lacerations – rough, irregular wounds caused by crushing or ripping forces. Abrasions (grazes) – a superficial wound in which the topmost layers of the skin are scraped off, often caused by a sliding fall onto a rough surface Puncture wounds – caused by an object puncturing the skin, such as a nail or needle. Penetration wounds – caused by an object such as a knife entering the body. Avulsion wounds – this is a wound that occurs due to the integrity of any tissue is compromised

62. Close Wounds Closed wounds are like open wounds and have numerous amount of types. However closed wounds have less than open. But are just as dangerous. Explained below are the main types of closed wounds: Contusions (bruise) – caused by blunt force trauma that damages tissues under the skin. Hematoma – caused by damage to a blood vessel that in turn causes blood to collect under the skin Crushing Injuries – caused by a great or extreme amount of force applied over a long period of time. Image above shows a person suffering from contusions.

63. Nature of the Injuries Wounds can be divided into three main groups to emphasis their seriousness, these groups are: Minor Cuts and Scrapes Puncture Wounds Major wounds

64. How to Treat Minor Cuts and scrapes Puncture wounds Wash the affected area thoroughly with soap and water removing any foreign material, which may cause infection. Cover with a sterile bandage. Wash the wound area daily and reapply a clean dressing until it is completely healed. However when washing sterile area do not scrub as you will damage the wound more. Puncture wounds are difficult to clean. If the object has penetrated the bone, it is especially risky. Flush the area thoroughly with water, cleaning well and on a number of occasions. Elevate the wound, and if signs of infection manifest (redness, swelling, persistence pain, pus or fever), contact a health professional

65. How to Treat Major Wounds For severe bleeding, apply constant pressure to the wound with a sterile dressing. Hold for up to twenty minutes. If there is a foreign object in the wound don’t press directly, but apply pressure along the wound area. If broken bones or dislocations are suspected, do not move the affected limb. If you are sure there are no broken bones or dislocations, you can gently elevate and support the part while keeping pressure on it. This action should minimize bleeding. Then get Medical Help.

66. General ways to teat any wound The following are the 5 basic steps for treating a cut or wound : STOP THE BLEEDING CLEAN THE WOUND APPLY ANTIBIOTIC COVER THE WOUND SEEK IMMEDIATE PROFESSIONAL MEDICAL ATTENTION IF THE WOND.. 01 02 03 04 05

67. 1 2 3 4 5 STOP THE BLEEDING Apply gentle Pressure with sterile gauze or clean cloth Elevate the wound above the heart Do not lift the gauze or cloth the check if the bleeding has stopped; this can restart bleeding. If blocked spurting / continues to flow despite pressure& elevation, seek immediate professional medical assistance CLEAN THE WOUND Rinse the wound with clean water Do not use soap, iodine, alcohol or hydrogen peroxide; this can irritate the wound If dirt or debris remain in the wound after raising, use sterile tweezers to gently remove the dirt/debris; if this falls, seek professional medical attention to remove the dirt/debris APPLY ANTIBIOTIC Once the wound has stopped bleeding and has been rinsed clean, apply a thin layer of antibiotic cream or ointment to the wound. If a rash results from use of the antibiotic, discontinue use of the ointment and seek professional medical attention. COVER THE WOUND Keep the wound covered with an adhesive bandage or sterile gauze as it heals; this will keep the wound clean and prevent infection. Change the wound covering twice daily and keep the wound clean. SEEK IMMEDIATE PROFESSIONAL MEDICAL ATTENTION IF THE WOND Is more than ¼ inch deep or is gasping Has a jagged edge or fat/muscle tissue is visible. Become imitated or infected (has increased redness, swelling, drainage or pain) Is deep or dirty or it has been more than 5 years since your last tetanus shot.

68. Signs & Systems of Wounds Redness or excessive swelling in the wound area Throbbing pain or tenderness in the wound area Red streaks in the skin around the wound or progressing away from the wound Pus or watery discharge collected beneath the skin or draining from the wound Tender lumps or swelling in your armpit, groin or neck Foul odour from the wound Generalized chills or fever

69. Medical Emergencies – Traumatic Injuries Soft Tissue Injuries Eye Injuries Burns Sprains, Strains & Fractures

70. Medical Emergencies – Soft Tissue Injuries Broadly categorized as either “closed” or “open” Damage to the skin, cells and blood vessels May result in extensive injuries to the internal organs and bones

71. Medical Emergencies – Soft Tissue Injuries Contusions Hematomas Abrasions Lacerations Avulsions Amputations Penetrations / Punctures Blisters Crush Injuries

72. Medical Emergencies – Soft Tissue Injuries Treatment The basic care for any soft tissue injury is the proper use of wound dressings and bandages The functions of the dressings and bandages are to stop bleeding, to protect wounds from further damage, and to prevent further contamination

73. Fractures, Dislocations, Sprains & Strains Injuries to the bones, muscles and connective tissues result when excessive or abnormal force is applied to the musculoskeletal system There are three basic mechanisms by which this force can be applied: Direct Force Indirect Force Twisting Force Medical Emergencies

74. Fractures, Dislocations, Sprains & Strains It will not be your responsibility to diagnose exactly what type of injury has occurred The fact is that any painful, swollen and deformed extremity will receive the same emergency medical care Medical Emergencies

75. Medical Emergencies – Fractures When a bone is broken or is simply cracked Can produce severe bleeding Very painful Potential for long-term disability Classified as “open” or “closed”

76. Open Fracture When the skin overlying a painful, swollen and deformed extremity is broken, then the condition is termed – an open fracture Closed Fracture If there is no break in the continuity of the skin, then the condition is termed – a closed fracture Definition (Open & Closed)

77. Classification (Open Fracture) Type 2 Type 1 Type 3A Type 3B Type 3C

78. TYPE 1 (OPEN FRACTURE ) Small less than 1cm Clean puncture through which a bone spike protrudes out Minimal soft tissue damage No crushing Not comminute (low-energy fracture)

79. TYPE 2 (OPEN FRACTURE ) More than 1cm No skip flap Minimal soft tissue damage Moderate crushing or communication (low-energy fracture)

80. TYPE 3A (OPEN FRACTURE ) Large wound more than 10cm Extensive muscle devitalization High energy Comminute

81. TYPE 3B (OPEN FRACTURE ) Large wound Cannot be covered by soft tissue Severely comminute Extensive muscle devitalization High energy Requires a flap for bone coverage and soft tissue closure Periosteal stripping

82. TYPE 3C (OPEN FRACTURE ) High energy Increased risk of amputation and infection Any grade 3 with major vascular injury requiring repair regardless the wound.

83. Grades of soft tissue injury correlates with infection and fracture healing WHY USE CLASSIFICATIONS

84. Types of Bleeding VENOUS BLEEDING ARTERIAL BLEEDING CAPILLARY BLEEDING

85. General Management of wounds (All Infected Wounds and with Foreign Bodies)

86. Chest Injuries Open or closed All victims should have their airway, breathing, and circulation checked. A responsive victim should sit up or be placed with injures side down. In a closed chest injury, the skin is not broken Chest and Abdominal Injuries Rib fractures The upper four ribs are protected by the collarbone and shoulder blades. The lower two ribs, “floating ribs”, have freedom to move Broken ribs usually occur along the side of the chest

87. Recognizing Rib Fractures Sharp pain (deep breath, coughing or moving) Victim holds injured area Victim reports being hit where there is pain. Area is tender Shallow breathing Gently press inward on both sides of the chest at the same time to assess for a rib fracture. Chest and Abdominal Injuries Care for Rib Fractures Help victim find a comfortable position Stabilize the ribs with a pillow or similar object Give pain medication Seek medical care

88. Flail Chest Flail chest involves several ribs in the same area broken in more than one place. Paradoxical movement is when the area over the injury moves in a direction opposite to that of the rest of the chest wall during breathing. Chest and Abdominal Injuries Recognizing Flail Chest Paradoxical chest motion takes place Breathing is very painful and difficult Bruising may occur

89. Care for Flail Chest Support the chest Apply hand pressure Place victim on injured side with blanket underneath Monitor breathing Seek medical care Chest and Abdominal Injuries Open Chest Injuries An open chest injury is when the skin has been broken and the chest wall is penetrated

90. Impaled Object in the Chest An impaled object penetrates the chest wall Causes air and blood to escape into the space between lungs and chest wall Lung collapse Can lead to shock and death Chest and Abdominal Injuries Recognizing An open chest injury is when the skin has been broken and the chest wall is penetrated

91. TRAIINNG EVALUATION