Bechtel Environmental, Safety, and Health (BESH) Preparing to Respond Bechtel First Response Training Session I

Bechtel Environmental, Safety, and Health (BESH)

PreparingPreparing to Respond to Respond

Bechtel First Response TrainingSession I

Slide 2Bechtel Environmental, Safety, and Health (BESH)

Safety is Our ValueSafety is Our Value

“We measure safety performance by the number

of incidents. But let’s be clear…

it’s really not about incident rates…it’s about people.

People who have faces, names, families, hopes, and dreams.”

-Riley BechtelAugust 15, 2001


Preparing to Respond:Preparing to Respond: Enabling Learning Enabling Learning ObjectivesObjectives

Workplace emergency defined

Preparedness as strategy First response resources Universal precautions Legal aspects Barriers to action Communicating an

emergency Safety & Health

professional roles


Emergency DefinedEmergency Defined

Emergencies may be natural or man-made and include the following:

Fires Toxic gas releases Chemical spills Radiological accidents Explosions Floods Hurricanes Tornadoes Civil disturbances Workplace violence resulting in

bodily harm and trauma


Preparedness as a StrategyPreparedness as a StrategyEssential activities for preparing to respond to an incident

1. Plan

2. Organize

3. Train

4. Equip

5. Exercise

6. Evaluate & improve


Preparedness as a StrategyPreparedness as a Strategy

Eventuality consciousness and preparedness should be kept at a high level

Ensure team members receive proper training and members understand their roles

– Employees should become conversant with the correct actions during an emergency situation

– Needs for improvements in emergency response may be identified and rectified


Emergency & First Response ResourcesEmergency & First Response Resources

Site map– Alarms

– Telephones

– Eye wash stations

– AEDs

– Emergency Response Field Bags and other equipment

– First Aid/Nurses’ Office

– Safety Office

– Evacuation routes

– Tornado shelter

Fire procedure and fire extinguishers


General Principles to Responding to an General Principles to Responding to an EmergencyEmergency

Protect yourself, call 911, tell dispatcher your location, do NOT hang up until the dispatcher tells you to, follow all instructions given by emergency personnel

Medical Emergency Protect yourself, begin first aid, call 911, call

Security, have another person meet EMS at gate to escort back to victim

Criminal Acts Protect yourself, for acts IN PROGRESS call

911, for acts NOT in progress call Security

Fire Alarm or Actual Fire Protect yourself, call Security, use nearest

safe exit, call 911, stay 500 feet away, do NOT return until “All Clear” is given

Natural Disaster/Inclement Weather Protect yourself, seek appropriate shelter,

stay away from windows, pull shades/curtains, avoid large rooms, wait for “All Clear” signal

Hazardous Materials & Chemical Spills Protect yourself, notify supervision to call the

Safety Spill Response


Emergency Response Field BagEmergency Response Field BagBuilding a trained First Responder’s field bag

– 12 pr exam gloves– 2 surgical masks with face

protectors– 2 paper gowns– 3 CPR barrier devices– Oxygen & nasal canula &

rebreather mask & tubing– Ambu-bag– Vitalbook, notebook & 4 black

pens– Stethoscope– Blood pressure cuff– Glucometer & testing strips– Glucose & hard candy– Epinephrine injection pen– Arm splint & leg splint– 4 cold packs– 4 hot packs– Burn gel towel– Roll of medical easy-rip tape– Bandage scissors– 6 sting wipes– 24 alcohol prep pads– 2 small paper bags– 2 hand towels (1 in each bag)– box kleenex– 2 absorbent pads (chucks)

– 4 ABD pads– 4” sterile roller gauze– Heavy duty scissors– pen light– 2 rolls of 2” CoBan– 2 rolls of 6” CoBan – Heat blanket– Bottle of water– Aspirin– Benadryl (diphenhydramine)– Ammonia salts– 1 L sterile saline– 2 bottles eye wash– Calcium gluconate– 4 gallon-sized ziplock bags– Black permanent marker– Roll of caution tape– BIOHAZARD garbage bag– First-aid quick reference booklet– This list, with telephone numbers on

the backside


Universal PrecautionsUniversal Precautions

Please refer to Bechtel Core Process 305: Bloodborne Pathogens– Certified First Aid Responders

should receive annual blood-borne pathogen training as specified by OSHA 29 CFR 1910.1030

a set of precautions designed to prevent transmission of blood-borne pathogens when providing first aid or health care

blood and certain body fluids of all patients are considered potentially infectious for HIV, HBV and other blood-borne pathogens

Personal Protective Equipment (PPE) - Universal precautions involve the use of protective barriers


Legal Aspects of Legal Aspects of Providing Emergency CareProviding Emergency Care

Good Samaritan laws vary from jurisdiction to

jurisdiction Once a responder begins rendering

aid, he must not leave the scene until it is necessary to call for needed medical assistance, a rescuer of equal or higher ability takes over, or continuing to give aid is unsafe

Responder is not legally liable as long as the responder acted rationally, in good faith and in accordance with their level of training


Key Legal VocabularyKey Legal Vocabulary

Abandonment - failure to provide care for the patient once it has been initiated

Assault - an action that places a person in immediate fear of bodily harm

Battery - touching another person without their consent

Consent - granting permission to treat Expressed Consent - when a competent,

adult patient gives permission to be treated HIPAA - Health Insurance Portability and

Accountability Act of 1996, a Privacy Rule that provides federal protections for personal health information

Implied Consent - when a patient is unable to give expressed consent, the law assumes that they would desire to have life-saving treatments rendered

Negligence - failure to administer the same degree of care that a reasonable person would exercise under the same circumstances

Standard of Care - what a reasonable and prudent person would do under similar circumstance


Understanding the Effects of StressUnderstanding the Effects of StressBarrier to action

Response time is critical Emergent incidents and situations can

create strong emotions of fear, anxiety, and panic

Reflection and Mental Preparation is Key to Managing Fear and Panic

– Reflect on your past or likely pattern of behavioral reactions

– Identify and rehearse steps, both mental and concrete, that will aid you in minimizing your weaknesses

Responders will organize after emergency to debrief and discuss lessons learned

Crisis counseling may be hosted to assist those who were witness to the emergency, if indicated


Communication of an Communication of an EmergencyEmergency

1. Your name

2. The location of the emergency

3. State your emergency, listen attentively for questions

Chief complaint/Incident type (# of patients)

Conscious? Yes/no or alert Breathing? Yes/no or difficult Is there chest pain? Is there severe bleeding? Is it spurting? Is this a life or death emergency?

4. Stay at the scene, if safe, until Safety & Health Services and/or EMS services arrives – Safety and RN will contact Security


SafetySafety & & HealthHealth Team Roles Team Roles

– Engage EMS (if not already, if deemed necessary by Occupational Health RN or Safety Professional)

– Notify Security to await arrival of ambulance and/or fire department and provide escort to emergency location

– Assume command of scene– Stabilize patient until EMS takes

control of the scene– Set up barriers around the scene– Take photos of the scene– Interview scene witnesses– Complete accident investigation

with local Police and/or Fire Department


SafetySafety & & HealthHealth Team Roles Team Roles (continued)(continued)

– Report to Bechtel Managers and others– Place phone calls to employee’s

emergency contacts– Complete OSHA reporting – Host Emergency Response Debriefing

(ERD)– Host Critical Incident Stress Debriefing

(CISD), as needed and appropriate – Share lessons learned with Supervisors

(if applicable)– Direct media to Community Relations– Complete additional reporting

documentation– Implement safety measures from

lessons learned


Preparing to Respond Review QuestionsPreparing to Respond Review Questions

1. What is an essential activity in planning for an emergency?Plan, Organize, Train, Equip, Exercise, Evaluate & improve

2. What are three examples of emergency resources?See slide 7

3. What is the key to avoiding panic? Preparation and reflection

4. What are Universal Precautions?a set of precautions designed to prevent transmission of blood-borne pathogens when providing first aid

5. Who addresses the media?Community Relations


We value yourWe value your Safety Safety and and HealthHealth

Questions?Questions?Speak with your Project Nurse or

Safety Professional


Learn More about Learn More about Preparing to Preparing to RespondRespond

Bechtel Core Process 305: Blood-borne Pathogens

Centers for Disease Control (CDC.gov)

National Institute for Occupational Safety & Health (NIOSH.org)

National Safety Council (NSC.org)

Occupational Safety & Health Administration (OSHA.gov) – How to Plan for Workplace Emergencies

and Evacuations– Best Practices Guide: Fundamentals of a

Workplace First-aid Program

U.S. Department of Health and Human Services (HHS.gov)

Documents

Bechtel Environmental, Safety, and Health (BESH) Preparing to Respond Bechtel First Response Training Session I