Cpr and First Aid using Vistelar Principals for Proxemics

Cpr and First Aid using Vistelar Principals for Proxemics

Scene Safety for CPR and First Aid responders using Vistelar Principles

 

One of the first things people are taught in CPR and first aid classes is to assess the scene for safety and to size up the scene.  I feel like this is done in a very almost haphazard way for medical practitioners and laypeople because instructors just talk about look and make sure it’s safe, they don’t explain or have a template on what to look for.  Now if you are a first responder, firefighter, law enforcement, or security where you were entering an unsafe environment all the time you probably have a better grasp on this but for the layperson, I found that most people who are not like-minded often overlooked this very critical stage.

 

As one of Vistelar’s conflict management instructors I also teach CPR and first aid so when we talk about assessing the scene, I always tell them about Vistelar’s 10-5-2 proxemics and how it can apply to them.  At the end of every class, there are always a few people that say this was their biggest takeaway from the class and previous classes never taught them 10-5-2.  I wanted to share how I do this.

 

10 Feet Proxemics

Evaluate with an option to exit.

 

We started at 10 feet before we step on that stage we must make sure that stage doesn’t step on us, this quote can often be heard from Derek Washington another Vistelar trainer because just like in first aid we must treat the injured person as a carrier and use PPE (personal protection equipment) I feel we must also treat each injured person as someone who wants to cause us harm, so before I give them help I must ensure I do my due diligence and make sure it’s safe to enter, not just from the environment but also from the person needing help (we will discuss trauma-informed care in a few).   Before we decide to help and enter the scene, we need to stop at 10 feet from the victim, we make sure that we listen with all of our senses.  Most people use vision for about 70% of our sensory input and so we start by telling people to make sure you have a 720° view of the situation looking for obvious signs of danger such as other people, clues such as did the person fall from a ladder, is there more than one injured person this might tell us it’s a danger in the environment. Looking for obvious signs of bleeding and injury, signs of a struggle, etc.

 

So what’s the other 30%? Well, we have to look at our other senses such as hearing.  We want to listen for a snap, crackling, and popping (could indicate electrical shock dangers), do we hear other people screaming and moaning shouts of help, machinery running, motor vehicles in the area, hissing of gas leaking, etc. 

 

We also want to use our sense of smell.   Do we smell gasoline, smoke, and chemicals? 

 

If it is unsafe at 10 feet I can exit the scene and call 911.  If it’s safe I can enter about 5 feet from the victim.

 

5 Feet Proxemics

Communication with an option to evade.

 

I don’t rush to the person yet.  Have you ever seen a paramedic run into a scene?  They walk with purpose and assessing the scene as they enter it, also they can’t help if they get injured along the way or drop and break the medical equipment needed to save your life. 

 

So, at 5 ft I stop and use this as my communication distance.  Sir are you ok?  Can you hear me?  If responsive I can ask some basic questions before I get within contact distance.  If unresponsive to my verbalization I can then go to my other senses.  Also, at 5 ft I could see the other side of the body that I couldn’t see from 10ft.  Do I see a weapon close?  Do I see bleeding and can I tell what caused it?  Do I see a needle in their arm or a pill container close?  Do I smell anything different, may smell alcohol at this distance, smell for the items discussed at 10 feet due to windage, the strength of the odor, and other factors you may get more sensory input with smell at a closer distance.

 

If I feel its unsafe, I can evade and get to a safe distance and call 911, if I feel it’s safe, I can enter into 2 feet of the victim.

 

2 Feet Proxemics

Operate or escape to safety.

 

So, at 2 feet this is our contact stage or operating distance.  I am in Arkansas where hunting is pretty prevalent and when you shoot a big buck, bear, or any other wild animal we have to be careful as we approach and when we get to the contact distance we don’t jump on it and listen for breathing we poke it with an object like the barrel of a rifle to check for responsiveness before we get any closer.  A man was killed by a buck in Northwest Arkansas a few months back for failing to understand proxemics.

 

We check for responsiveness by tapping the shoulder and seeing if that causes any kind of movement or anything that may indicate he is not dead.  I do not personally recommend doing both shoulders and tapping them and yelling at them. Let me explain the trauma-informed care part I mentioned at the beginning.  We don’t know the reality this person is in.  Imagine you were sleeping and at 2 am someone jumped on your bed and was tapping you and startling you from a nice slumber, what would you do with a stranger directly on top of you?  I would probably punch them in the face.  With that said you don’t know if they are on drugs, if they were sexually assaulted before, or physically assaulted before, they could come responsive and go to a situation they were involved with in the past.

 

If they are nonresponsive and no chest rise for 5-10 seconds, we then start our cpr.  We want to create alert/sound alarm (a topic for a future write up) and activate ems and try and get an aed to you using verbal and nonverbal communication throughout the whole process.

 

If they are responsive, we can render the first aid we are trained to do.  If they become combative due to confusion, past trauma, or something else we must always be ready to escape the danger and go to a safe distance.

 

To summarize we must ensure our safety before rendering aid to someone else.  We must have a framework to teach responders to use.

 

Logan Lee is an active shooter instructor, self-defense instructor, verbal de-escalation instructor, firearms, cpr and first aid, advanced bleeding control, and many other topics.

 

www.141shootingrange.com

870-761-5043



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