Responding to Injuries
An article in the May 2020 series, The Healthy Church
In the Bible
He who quarries stones is hurt by them, and he who splits logs is endangered by them (Ecclesiastes 10:9).
Now Ahaziah fell through the lattice in his upper chamber in Samaria, and lay sick (2 Kings 1:2).
There is … no medicine for your wound, no healing for you. ~ Jeremiah 30:13
The injured you have not bound up ... (Ezekiel 34:4).
I will ... bind up the injured ... (Ezekiel 34:16a).
He went to him and bound up his wounds, pouring on oil and wine. Then he set him on his own animal and brought him to an inn and took care of him (Luke 10:34).
In the News
Miami Gardens, Florida, March 11, 2020 - An SUV plowed into a food pantry outside a church in Miami Gardens. One woman was killed and eight other persons were injured. News stories did not specify how the injured were first treated, but they were taken to hospitals.[1]
Pittsburgh, Pennsylvania, October 27, 2018 - A gunman entered a synagogue during Sabbath services and opened fire. Eleven persons were killed. Many more did not die because several synagogue members, as well as the first responders, used Stop the Bleed training they had received earlier in the year.[2]
Warren County, Ohio, February 2, 2020 - A church bus carrying more than 30 children to Sunday School was hit at an intersection by an SUV. The driver of the bus was killed and several children were injured. Persons at the scene transported injured children to local hospitals while members of nearby churches took the uninjured children to their destination.[3]
Chico, California, May 24, 2019 - While her mother was in a meeting in the church, a 6-year-old girl played outside on the church"s playground. She was ejected from a spinning playground fixture called the "Bumblebee" and landed on the lid of the septic tank. The lid broke and she fell into the tank. The playground monitor and one of the older children rescued the girl from the tank and took her into a restroom to be cleaned. The church closed off that part of the playground.[4] Three months earlier, in Rockport, TX, a 2-yearold girl fell into a septic tank at an RV park and died.[5]
On the Web, December 11, 2018 - The Injury Claim Coach is only one of many lawyer groups providing information on how to sue churches and other non-profits for injuries and/or offering to assist in filing such lawsuits.[6]
Accidents Happen
No matter how safe we make the church, school, or home, there is always a chance that an accident will happen. We try to make that chance as small and unlikely as possible, especially for more serious injuries. However, there are some injury causes that are outside our control, and not all of them are accidents. Among these are non-church vehicles, individual carelessness, the injured person"s health conditions, severe weather, and violent aggression. Therefore being careful includes being ready for the injuries that do occur.
The news stories are of several ways people have been injured at church or in church-related activities. In one of the stories, the incident could be described as "an accident waiting to happen" because of the proximity of the playground to the septic tank.[4] This is an example of a hazard which was overlooked, not recognized. It illustrates the value of having a safety expert (such as a risk abatement specialist from your insurance provider) assist in a church safety assessment.
Injuries often carry liability of insurance claims and lawsuits. There are lawyers out there looking for clients to file suit against churches, synagogues, mosques, and other non-profit groups for injury claims.[6]
When a person or persons are injured, there are a few immediate considerations. These include existing danger, type of injury, severity of injury, and number of injuries. To these we can add the relative availability of healthcare facilities and professional services. After an injury we should review the incident to consider how to make the church a safer place.
Existing Danger
When responding to an injury, be aware of continuing danger. Two considerations are the safety of the responders and bystanders and the safety of the injured person. One situation is injured persons in a burning car or building. Getting injured persons out comes before treating any injuries they have. Another situation is during an active shooter incident. Everyone"s safety depends first on protecting them from the shooter, then on treating the injuries. Sometimes we can improvise cover or concealment to allow us to stop bleeding - but not always. There are other dangers associated with the underlying causes of injury, such as a severe windstorm or earthquake, where getting injured people to safety is the first priority.
Type of Injury
This is obvious. The type of injury determines the treatment. In First Aid training we are taught how to treat each of several injuries. We can briefly categorize them as cuts, bruises, sprains, fractures, concussions, eye injuries, allergic reactions, poisoning, burns, heat stress, and cold stress. There are sub-categories within each of these.
Taking just four of these, there are basic goals in treatment.
Cuts - Stop the bleeding. Clean the wound. Protect the wound.
Burns - Cool the burn. Carefully clean, if you can (depending on the severity). Protect the burn.
Allergic Reactions - Administer an Epi-Pen or diphenhydramine (same stuff as Benadryl) - these are antihistamines which block or reduce the allergic reaction. If the person goes into anaphylactic shock, call 911. The advantage of an injectable antihistamine plus adrenaline (epinephrine) is that it can be injected when a person is unable to swallow.
Eye Injuries - If foreign matter get into eyes, wash out with clean running water. Cover eye. Get medical care. If serious, such as damage from blow or from caustic substance, call 911.
Heat and Cold Stresses - Heat stress in summer and cold stress in winter are seasonal injuries. This includes heat stroke, hypothermia, and frostbite. In spite of our efforts, some people became stressed with the cold or heat. If not treated soon enough, they can result in permanent injury or death.
Severity of Injury
Some minor injuries can be treated then and there without seeking further medical care. However, the patient should be advised on care, such as keeping a cut clean. No matter how minor the injury, there should be at least a note of it in the security log. This is evidence of immediate and proper treatment. Also, follow up with the injured person to find out how the injury is healing. If it is infected, see to it that they get medical attention.
There is a continuum of severity of injury. For example, cuts can vary from mere scratches to severe bleeding. Gunshot wounds often result in severe bleeding needing immediate action. Fortunately for the synagogue in Pittsburgh, several people there were trained to stop severe bleeding.[2]
Concussions are often unrecognized at the moment of injury. If someone has suffered a head blow, always suspect a concussion until it can be ruled out. It may take several minutes, or even another day, before the symptoms show, so don"t assume there is no concussion if the victim seems OK at first. The long-term effects of a concussion can be serious and debilitating.
Burns also vary in severity. Know the difference of degree and how to treat them. A first-degree burn, the mildest, usually just has red skin. Second-degree burns cause blisters or searing (such as a white mark left by the edge of a hot iron). Third degree burns go through the skin leaving charred flesh, peeling skin, etc. If you can stomach it, read the descriptions of those burned by the eruption of the White Island volcano in New Zealand. You"ll hope you never have to see that in the church, but severe burns can result from a gas explosion.
The first thing to do for a burn is to cool it down. Remove the person from the source of heat. Use cold water, ice, chilled gel packs, etc. to cool the burn. Gently clean it if you can. Be careful to not further injure the area. If it is more than a first-degree burn, get medical help.
Number of Injuries
Some incidents many result in several injuries. For example, the driver and passengers in a vehicle accident, people in front of a toppled bookcase, and shooting victims. The Church Safety Team needs to practice responding to mass casualty incidents. Triage [tree-AWZH] is deciding who needs to be treated first and who can wait. For example, treat severe bleeding or a heart attack before a broken leg.
Availability of Facilities and Services
Keep a list of emergency services and medical facilities. Actually, have these in the emergency contact lists on key Safety Team members" mobile phones and the church phone.
Follow-up
After an injury incident, review the report(s) and debrief those who responded. For a minor kitchen cut, this would be very brief. A review and evaluation considers what caused the injury, the nature and severity of the injury or injuries, and the response. Possible outcomes of a review are commendation for a good response, notes on improving the response, how incidents may be prevented (if they can), calculating the liability of the church, and noting what supplies need to be replenished and what training is needed.
There Is More
This is one of the four articles in the series The Healthy Church. The others are "Proactive Response" (Make the Church a Safe and Healthful Place), "Have a Heart" (Responding to Heart Attacks, Strokes, Choking, and Seizures), and "Make Yourself Ready" (Equip and Train for Medical Response).
References
- Joel Franco, Reinaldo Llerena, and Franklin White, "Woman killed, 8 injured following crash in Miami Gardens," WSVN, March 11, 2020 [https://wsvn.com/news/local/miami-dade/woman-killed-8-injured-following-crash-in-miami-gardens/].
- Dr. Matthew D. Neal, "OP-ED: 'Stop the Bleed' training saved lives in Pittsburgh," Observer-Reporter, November 7, 2018 [https://observer-reporter.com/op-ed-stop-the-bleed-training-saved-lives-in-pittsburgh/article_d3a7a240-e1df-11e8-8f61-afc2d163d383.html].
- Ed Richter, "Investigation continues into Sunday crash that killed church bus driver with children onboard," Dayton Daily News, February 3, 2020 [https://www.daytondailynews.com/news/local/investigation-continues-into-sunday-crash-that-killed-church-bus-driver-with-children-onboard/8ZTqHsts1d1Hel95qqNaTL/].
- Luna Nas, "Girl Falls in Septic Tank at Chico Church," Action News Now, May 26, 2019, Updated: May 27, 2019 [https://www.actionnewsnow.com/content/news/Girl-falls-in-septic-tank-at-Chico-Church-510457651.html].
- Eric Levenson and Artemis Moshtaghian, "2-year-old girl dies after falling into septic tank at Texas RV park," Fox2Now, February 22, 2020 [https://fox2now.com/news/2-year-old-girl-dies-after-falling-into-septic-tank-at-texas-rv-park/].
- Charles R. Gueli, "Church Injury Claims: How to Prove Liability and Get Fair Compensation," Injury Claim Coach, Updated & Reviewed December 11, 2018 [https://www.injuryclaimcoach.com/church-liability-insurance.html].