Health and safety and responses to emergencies in a care setting

M3: Discuss health, safety or security concerns arising from a specific incident or emergency in a health or social care setting.

D2: Justify responses to a particular incident or emergency in a health and social care setting.

Incidents can occur wherever and whenever. It is important that you know how to deal with incidents because it could save a person’s life.

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One incident that could occur is aggressive and dangerous encounters. This could happen in a care home where the patient has a mental illness or dementia, so it could lead to them being abusive towards staff. When working in a care home, staff members should be aware of what triggers the aggressive behaviour for each individual so it will prevent you from making it happen. When dealing with aggressive behaviour, your priority should be your own safety because the patient could easily hit you so you should respond to this quickly, keeping yourself safe. The way a carer should respond to this is by firstly calling for help because if you stay on your own with the patient, they could physically hurt you so it is important to have someone there as a witness in case something does happen.

This should be the first priority because it is not safe staying on your own and if you don’t do this response it could be a risk to you and also no one will be there to witness anything if the patient does hurt you. Having someone else there may calm the situation down. If no one is available to come you the second thing you should do is move back from the patient and try to calm them down, but this will not always work, if the patient doesn’t calm down or gets angrier then you should immediately move away from the situation so the patient can calm down on their own this is important because if you don’t move away it could make them angrier and cause them to lash out. As a carer you should know when to walk away from the situation to stop it from escalating.

After you have walked away, the last step should be to report it to the senior staff members or the manager so they could log it in the report book this is because all staff members will be aware of that person and if it happens again they will maybe be prepared and will know it’s happened before. It is important to inform everyone about this so they are aware when they are caring for that person.

The first thing and the most important thing to do is call for help. This is because you cannot stay on your own as the patient may not listen to you. It is always best to have someone else so you have a witness. The extra member of staff may be able to calm the situation down by talking to the patient. If you are on your own it will be quite intimidating and scary, as you may not know how to deal with it so it is easier to have someone else with you. These responses should be done in that order and effectively because it is a safer way to deal with the individual and also it will keep other people safe in the care home. You should record it because if you don’t it means no one will be aware of it unless you tell them but it is formal and a legislation to record it as it is proof. If family members, ask to see their record they will be aware of it and know all details about it. It is easy for carers to forget details about the incident so it is important to record it.

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A concern that could arise from aggressive and dangerous encounters is the patients could hurt themselves if they do get angry and violent. This is dangerous and it could cause serious injuries depending on what they do. You should inform other residents to stay away from this patient to keep themselves safe. This is because patients may try to speak to the aggressive resident. This might influence the responses because normally you would walk away if they are being aggressive however, if they are going to hurt themselves you should not walk away as the carer will need to try stopping them. You should call for help because you will not be able to deal with it yourself and make sure no sharp objects are around the patient or any other objects that could potentially hurt them.

This should be a quick response to deal with the situation because having sharp objects around that particular resident can be a massive risk, so if you quickly respond to it then it could reduce the incident from escalating. It will change the responses to the emergency because the patient will be a threat to you and to everyone else within the care home. The patient should be moved away from everyone else and should be accompanied by a carer. This is because it will give them a chance to calm down without creating a scene and it will not put other residents at risk as it could scare them. It is important to not let them be alone as anything could happen so leaving them with a carer is important as they can keep an eye on the patient and make sure they do not do anything to harm themselves.

A critical incident like falling unconscious can happen anytime in a care home with the elderly patients. For example, if they have diabetes or low sugar, it can cause them to be unconscious, as their body will need sugar. In addition, if the place is too hot they can fall unconscious from dehydration. It is important to look out for symptoms to prevent it from happening. Symptoms like headaches, dizziness, slurred speech, confusion and a fast heartbeat. If a patient says they have any of these symptoms, you should not ignore it as it could lead to a serious injury. Having a seizure or a stroke can happen at any time, which can also cause unconsciousness; in this case, it is a care home with elderly residents who go out on a trip out to a shopping centre.

So if an elderly patient has a seizure/stroke whilst walking in a shopping centre they will fall unconscious so it is important to respond to this situation straight away. The first thing you should do is check if they are breathing, if they are not which they won’t be if they are unconscious. The reason why you have to check if they are breathing first is because there are different procedures you have to take for example if they are breathing you should put them in a recovery position but if they are not breathing you need to perform CPR on the individual. Emergency services (999) should be called immediately so they can provide medical help. Whilst waiting for them it is important to keep performing CPR until they arrive because it could potentially save the residents life. It is important to follow this response effectively because the emergency services are professionals who know how to deal with this situation so they can provide better care.

The steps for CPR are:

* Place the heel of your hand on the breastbone at the centre of the person’s chest. Place your other hand on top of your first hand and interlock your fingers.

* Position yourself with your shoulders above your hands.

* Using your body weight (not just your arms), press straight down by 5–6cm on their chest.

* Repeat this until an ambulance arrives.

This is for people who have not been fully trained on how to perform CPR.

The people that have had training for CPR and are dealing with this situation they should do CPR with rescue breaths. The steps for this are:

* Place the heel of your hand on the centre of the person's chest, then place the other hand on top and press down by 5–6cm at a steady rate, at approximately 100 compressions per minute.

* After every 30-chest compressions, give two breaths.

* Tilt the casualty's head gently and lift the chin up with two fingers. Pinch the person’s nose. Seal your mouth over their mouth and blow steadily and firmly into their mouth. Check that their chest rises. Give two rescue breaths.

* Continue with cycles of 30 chest compressions and two rescue breaths until they begin to recover or emergency help arrives.

(NHS CHOICES, 14/07/2015)

You should also keep calling the patient because they may respond and also to reassure them that they are in safe hands. If you did not do this response you would not know if the patient is able to respond and also the patient may feel like they’re on their own so it is important to keep talking to them so they know they are in safe hands. You should always remain calm when dealing with a situation like this and make sure your priority is the person’s life you are trying to save. The reason for this is because if you are under pressure and worrying it may distract you from helping the person and it could lead to you not performing CPR effectively. If people are surrounding the environment, you must tell them to move away and keep the area clear.

It is important to respect the patient’s dignity because other people in the shopping centre may be overlooking to see what is happening. Always put a blanket or something over them to make sure nothing is exposed. This is because it may embarrass the patient once they are conscious and could make them feel uncomfortable if they find out everyone has been looking at them. Once the ambulance has come it is then their responsibility to take over and save the person. Once you get back to the care home it is important to record the accident because it is a legislation that should be followed correctly. You should also record it because all staff members will be aware of what caused it and how it happened which means they can be prepared in case it happens again. The most important response is to make sure the airway is clear; this is because it will stop them from breathing and it also means you will not be able to perform CPR if the patient’s airway is blocked. These responses should be followed correctly and effectively because it could safe the patients life.

A concern that could arise from an elderly patient falling unconscious is theft during the emergency. Because the patient has fell unconscious in a shopping centre on a trip, your attention will be on the patient and trying to save them so it will require you to put your things down. This will make it easy for someone to steal your things which will create a bigger emergency as the person may not be found and could potentially steal your valuable items. This thief could be a stranger who is walking past the incident. This is a concern that would need different responses because it will be difficult to deal with a patient and a theft. You should ask someone to keep an eye on your things whilst you look after the patient, this way no one can steal your things.

All onlookers should be asked to move away however, in this case a person who is looking could save valuable items from being stolen and also the thief could be caught. A shopping centre is a busy place so if your attention is on the patient a stranger could come and steal your valuables. The responses will change because you will be dealing with 2 incidents instead of one. To prevent any thefts, you should keep your things close to you or call someone to guard your items. This will stop people from thinking they can steal items. Getting someone to guard your items and to be aware of thief’s can be a good thing because it means your items will be protected however, it could also be a bad thing because it could make the patient feel uncomfortable when they are conscious because they may feel embarrassed.

Another concern that could occur is the patients may hurt themselves when they fall unconscious. It could lead to them hurting their head, which can cause serious head injuries for example a blood clot in the brain. This will require further assistance and responses that are more complicated that the professionals will deal with so 999 should be called immediately. You should try to stop any severe bleeding to stop the emergency from escalating.

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