Emergency First Aid

First Aid is designed to preserve the life of the injured person, stop impact of damaging factors and avoid
further complications.

The isolator officer on duty is responsible for the protection of the guardhouse and timely reaction to
any incident in the cell. The officer on duty shall check the situation of the cells with a 5-minute intervals
through cell/doors.

In order to determine the state of health of the person placed in the cell, the officer on duty enters the
cell. Risk assessment is necessary prior entering the cell, during which attention is paid to the behavior
of individuals in the past and the number of personnel in the isolation ward at the time. Prior entering
the cell, the officer on duty calls other officer of the isolator. (Applies to all scenarios)

Scenario 1 Unconscious condition

Scene 1. During one of these inspections, the officer on duty saw the separately placed detainee,
in an unconscious state in the cell. Prior entering the cell officer on duty should call other worker in
the isolator and then enter the cell.

The goal – determination of life-threatening injuries and condition.

Initial examination / evaluation DREBC control

Time 1-2 minutes

 D- Danger
 R- Response
 A- Airways
 B- Breathing
 C- Circulacion

R- Checking response

When the officer on duty approaches the injured person, first of all, he/she needs to slightly tap him/her
on the shoulder and shake while at the same time fixing the head, loudly ask – Are you OK? Open your
eyes, talk to me, can you hear me? (Checking response). It is possible to slightly pinch the person in
the upper part of the chest (pain response), then visual and tactile examination of the body (from head
to foot) takes place in the course of 10-15 seconds. Head examination should be performed with
stretched and straightened fingers. Fasteners and belt must unfastened.
 A- Opening airways

The injured person is lying on his/her back. We put our left hand on his forehead and push it
backwards as much as possible, while putting two fingers of the right hand on his/her chin moving it
back and forth, and then pulling down the chin carefully. If necessary oral cavity is cleaned with the
index finger.

In the event of head and spine injuries pulling head backwards is inadmissible. This time, we are
pulling down the chin carefully without pulling the head backwards.

B- Breathing examination

Breathing examination is performed with ear and cheek as close as possible to the injured
person’s mouth and nose. Our eyes are focused on the chest.

C- Circulation (pulse) examination

Pulse examination is performed by putting middle and index fingers on the carotid artery.
 Cardiopulmonary resuscitation

Cardiopulmonary arrest is a combination of two life-threatening events: breathing and heartbeat

stop. Cardiopulmonary resuscitation supplies oxygen to the cells in the body to restore its normal
functioning. Cardiopulmonary resuscitation is the combination of rescue breathing and chest
compression 2-30, where 2 is mouth-to-mouth breathing and 30 is chest compression. The frequency of
compressions in adults is 80-100 compressions per minute.

Time is playing crucial factor here (on average in 5-7 minutes irreversible changes occur in the brain
cells), therefore the guard must act quickly in order to save life.
The guard is standing on his/her knees from the right side and next to the person's chest. The person
should be on his or her back on a firm surface. (floor)
Guard finds the ending of the breast bone and places index finger of the right hand above it vertically,
then puts left hand index and middle fingers next to it and places palm of the right hand on the middle finger
so that the fingers are parallel to the ribs. The left hand is placed on the right hand from the top.

Hands should be straight in the elbow joint and the pressure should be made vertically at an equal pace.
2 mouth-to-mouth breathing after 30 compressions.
Effective resuscitation features include: spontaneous breathing, pulse at the carotid artery, skin color
improvement, narrowing the pupil to the light, the appearance of spontaneous movement of the limbs

Cardiopulmonary resuscitation continues until arrival of an emergency or restoration of breathing and

pulsation.

Scenario 2. Foreign body in the upper respiratory tract

Two detainees are placed in the cell

Scene 1 Detainee called officer on duty from one of the cells about his cellmate not feeling well. The
officer on duty enters the cell in order to determine detainee’s state of health. Risk assessment is
necessary prior entering the cell, during which attention is paid to the behavior of individuals in the
past and the number of personnel in the isolation ward. Prior entering the cell, the officer on duty calls
other officer of the isolator. (Applies to all scenarios)

According to the assessment of the officer on duty, the detainee is choking as his airway is being
blocked by solid foods.

Scene 2. Injured person – pale face, cyanosis around lips, fearful face, bulging eyes, widened nostrils
and veins on the neck, fingers of both hands are held in the neck area.
Scene 3. Action of officer on duty is to perform Heimlich maneuver. He stands behind the injured
person, makes him put the legs on a shoulder level, places fist of the right hand in the area between
navel and stomach, about 4-5 cm. from the navel. Left hand needs to be placed on the wrist of the right
hand. The person is tipped forward and the police officer starts abdominal thrusts upwards about 4-7
times. Then the guard observes the face of the injured person and asks whether he/she can breathe, can
he/she cough.

If no breathing is observed the maneuver is continued.

Despite positive outcome of the procedure, it is necessary to transfer the detainee to the medial facility
for further examination.

Scenario 3. Mental disorder

Scene 1 Loud shouting, noise, breaking sound is heard from the cell.

Scene 2 Risk assessment is necessary prior entering the cell by the officer on duty, during which
attention is paid to the behavior of individuals in the past and the number of personnel in the isolation
ward by that time. Prior entering the cell, the officer on duty calls other officer of the isolator.
Scene 3 Detainee is anxious, aggressive, shouts, insults those around him/her, does not understand
where (s)he is, and inadequately answers to the questions. Gradually, establishing verbal contact
becomes difficult, (s)he experiences visual and auditory hallucinations.

Scene 4. Officer is trying to calm detainee down, to protect the people around him from possible
aggression as well as detainee from self-injuries

At the same time, the second employee calls an ambulance crew to transfer detainee to the relevant
specialist at the clinic.

Scenario 4. Epileptic convulsions

Only one detainee is placed in the cell

When a person with epilepsy is placed in the isolation ward, the isolator servant should have
information on what kind of epileptic episodes is this person experiencing, how often and when the
last episode took place, as well as what kind of medication he takes.

The isolator servant is informed that detained person has epilepsy and he/she might have an epileptic
episode any time. Thus, the detained person needs to be placed in a cell with a low bed.

Scene 1. Cell detainee felt mood deterioration, darkening of the face color (Epileptic aura). He managed
to call the guard and fell after shouting, went pale (gray), with rolling eyes. He/she has expressed muscle
spasm, trismus, rigidity and jerking of limb muscles. Foaming discharge from mouth (sometimes
bloody, due to tongue biting)

Scene 2. The police officer adequately assesses the situation, prior entering the cell he/she calls other
employee of the isolator and warns to call the ambulance crew. He quickly folds the blanket and puts
it under the head of lying injured person in order to avoid self-injury (secondary injury) after seizure
ends the mouth should be cleaned and the body is turned to the side.

It is categorically forbidden to open the mouth, tightly hold head and limbs.

Scenario 5. Hypoglycemic condition – low sugar levels in the blood

Two detainees in the cell

Detainee has a pancreatic diabetes. He receives drug treatment. Prior to detention he received his
medicine.

Scene 1. Detained person explains to the guard from the cell window that he does not feel well (general
weakness, excessive sweating, tremor, vague consciousness). He relates the mentioned condition with
the fact that he has not eaten since taking the medication. Detained person asks the guard to bring
sweetened liquid as soon as possible.
Scene 2. Officer on duty immediately calls other servant of the isolator. Risk assessment is necessary
prior entering the cell, during which attention is paid to the behavior of individual in the past and the
number of personnel in the isolator. Officer on duty enters the cell and gives sweetened water to the
detainee, after which condition of detained person improves clearly.

Scene 3. Other servant at the isolator calls the emergency center at the same time.