First Aid 11

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A m e r i c a n

Heart

A s s o c i a t i o n

earn c ul ire

0

Hear tsaver

F i r s t A i d

S T U D E N T W O R K B O O K

Ed/ tors

Louis Gonzales, BS, LP,Senior Science Editor

Michael W. Lynch, NREMT-P, Content Consultant

Senior Managing Editor

Sue Bork

Special Contributors

Michae l A.

Buldra

Tony Fernandez, MS, NREMT-P

Susan Fuchs , MD

John Gos fo rd , BS, EMT-P

Theresa Hoadley, RN, PhD, TNS

Sco t t La rson , EMT

Mary Mast, RN

Dav id Par ish , MD, MPH

Ada m J . S inger, M D

Mark A. Terry, MPA, NREMT-P

First Aid Subcommittee

2010-2011

Rita Herr ington,

FNR

Chair

Louis Gonzales, BS, LP,Immed iate Past Chair,

2006-2009

Kostas Al ibert is , CCEMT-P

Nate Charlton, MD

Jeffrey D. Ferguson, MD, NREMT-P

Pete r Fromm, MPH, RN

Michael Hendricks, EMT

He len McCracken , RDH, MS

George Murphy, EMT-P, MPH

Jeane t te Prev id i , RN-BC, BSN, MPH

Wil l iam Smith , MD

Je f f Wo od in , NREMT-P

2011

Am er i c an H ear t As s oc ia t i on

ISBN

978-1-61669-018-2

Pr in ted in the Uni ted States of Amer ica

Fi rs t Amer ican Hear t Assoc ia t ion Pr in t ing March 2011

10 9 8 7 6 5 4 3 2 1

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First Aid Subcomm ittee 2009-2010

Rita Herr ington, FNR Chair

Louis Gonzales, BS, LP,Immediate Past Chair,

2006-2009

Nate Char l ton , MD

Jeffrey D. Ferguson, MD, NREMT-P

Pete r Fromm, MPH, RN

Michae l Hendr icks , EMT

Chr is topher Ho ls tege , MD

He len McCracken , RDH, MS

Jeane t te Prev id i , RN-BC, BSN, MPH

Norda Ra tc l i f f , APRN-BC, NP

Karyl Re id , RN, MSN, CPNP

Paul Satter lee, MD

Ad am J. Singer, M D

Wi l l iam Smith , MD

Je f f Wood in , NREMT-P

To f ind out about any updates or correct ions to th is text , v is i t w w w . h e a r t . o r g / c p r, navigate

to the page for th is cours e, and cl ick on Up dat es .

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1. Rescuer Duties 3

Deciding to Provide First Aid 3

Asking to Give First Aid

4

Supp lying the First Aid Kit 4

2. Victim and Rescuer Safety

5

Assessing the Scene

5

Washing Hands 6

Universal Precautions

7

Exposure to Blood 9

Taking Off Gloves (*Skill You W ill Dem onstrate) 9

3. Phoning for Help

1 0

When to Phone for Help

11

How to Phone for Help

12

4. Finding the Problem (*Skill You Will Dem onstrate) 13

5. After the Emergency

15

Sample First Aid Kit

16

Review Questions: First Aid Basics 17

1. Breathing Problems 19

General Breathing Problems

19

Asse mb ling and Using an Inhaler 20

How to Help Someone With Breathing Problems 21

2. Choking in an Adult

22

Mild vs Severe Choking 22

How to Help a Choking Adult 23

How to Help a Choking Adult Who Stops Responding 25

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3. Allergic Reactions 26

Using Epinephrine Pens ( Skill You Will Dem onstrate) 26

Mild vs Severe Allergic Reactions 27

4. Heart Attack 28

5. Fainting 29

6. Diabetes and Low Blood Sugar 30

7. Stroke 32

8. Seizure 32

9. Shock 34

Review Questions: Medical Emergencies 35

1. Bleeding You Can See 37

How to Stop Bleeding ('Skill You Will Dem onstrate) 37

Bandag ing ( Skill You Will Dem onstrate) 39

Using Tourniquets 40

2. Wounds 41

Bleeding From the Nose 42

Bleeding From the Mouth 43

Tooth Injuries 44

Eye Injuries 45

Penetrating and Puncturing Objects 45

Amputation 46

3

Bleeding You Can t See 47

4. Head, Neck, and Spine Injuries 48

5. Broken Bones and Sprains 50

Splinting

fSkill

You May Dem onstrate; Option al Practice) 51

6. Burns and Electrical Injuries 52

Burns 53

Electrical Injuries 54

Review Questions: Injury Emergencies 55

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1. Bites and Stings

Animal and Human Bites

Snakebites

Insect, Bee, and Spider Bites and Stings

Poisonous Spider and Scorpion Bites and Stings

Ticks

2.

Heat-Related Emergencies

Heat Cramps

Heat Exhaustion

Heat Stroke

3. Cold-Related Emergencies

Frostbite

Low Body Temperature (Hypothermia)

4. Poison Emergencies

Scene Safety for Poison Emergencies

Removing Poisons

Other First Aid for Poison Emergencies

Review Questions: Environmental Emergencies

First Aid Skills Summ ary

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Welcome to the American Heart Associat ion Heartsaver First Aid Course. This course provides

a framework for learning basic ski l ls that may save a l i fe or prevent further in jury. As cofounder

of the Nat ional First Aid Science Advisory board, the AHA is dedicated to decrease death and

d isab i l i ty when an emergency happens. The AHA be l ieves tha t YOU can make a d i f fe rence. We

thank you most sincerely for taking th is course.

Our thanks go to the many volunteers and staf f who made th is course possible. There are not

words to express the grat i tude fe lt for their passion, expert ise, and count less hours of work.

Rita Herrington, FNP

First Aid Subcomm ittee Chair

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What Y o u

Will

L e a r n

In th is course you' l l learn the basics of f i rst a id. An important part of

f i rst a id is learning how and when to get help.

T h e

F i r s t A i d You wil l learn f i rst a id basics throu gh th is Stude nt W ork boo k and

L e a r n i n g

P r o c e s s

the video for the cou rse. After each sec t ion of the cou rse, you wil l

answer a few wr i t ten rev iew quest ions and d iscus s the answers wi th

your instructor.

During the course you' l l pract ice some ski l ls. I f you demonstrate that

you can do the ski l ls taught in the course, you' l l receive a Heartsaver

Fi rs t A id course comple t ion card.

U s i n g

T h i s

S t u d e n t Use th is Student W orkboo k in the fo l lowing ways :

W o r k b o o k _

Before the course:

Read th is Student Workbook.

Look at the pictures.

Take notes about your group's pol ic ies and procedures. For

example, i f you work in a faci l i ty that has establ ished pol ic ies

and procedures fo r emergencies, rev iew these documents and

take notes about how this information wi l l apply to you.

During the course:

Use the Student Wo rkboo k to understand the important in for

mat ion and ski l ls taught in the course.

Af te r the course:

Review the ski l ls f requent ly.

Look at the act ion tables and ski l ls summaries in the Student

Workbook. Th is wi l l he lp you remember f i rs t a id .

H o w

Often

T r a i n i n g Review your Student Wo rkboo k and Quick Reference Guide o f ten to

I s N e e d e d

keep your ski l ls f resh. You need to retake th is cours e every 2 years

to get a new course comple t ion card.

I f you have a latex al lergy,

tell

you r e me r g e n c y r e s po n s e program superv isor and your

instructor before yo u s tar t the c o u r s e .

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What Y o u Will L e a r n You 'll learn the basic s of f irst aid .

D e f i n i t i o n s a n d First a id is the immediate care that you give someone with an i l lness

K e y

F a c t s

or in jury before som eone with more adv anc ed tra in ing arr ives and

takes over.

First a id may help someone recover more completely or more quickly

and may mean the dif ference between l i fe and death.

Most of the t ime you' l l g ive f i rst a id for minor i l lnesses or in juries.

You may also give f i rst a id for a more serious i l lness or in jury, such

as a heart at tack or major b leeding.

T o p i c s C o v e r e d Rescue r Dut ies

Vict im and Rescuer Safety

Phoning for Help

Finding the Problem ( Skill You Wil l Demonstrate)

Af te r the Emergency

1.

R e s c u er

Dut ies

W h at Y o u

Will

L e a r n

In th is sect ion we' l l cover

Deciding to Provide First Aid

Asking to Provide First Aid

Supplying the First Aid Kit

Deciding to Provide First Aid

D e f i n i t i o n s a n d Som e peo ple may be required to perfo rm f irst a id whi le wo rkin g. For

K e y

F a c t s

exa mp le, law enforc em ent of f icers, f i ref ighters, f l ight at tend ants, l i fe

guards, and park rangers may have a duty to give f i rst a id when they

are working. I f they are of f-duty, they can choose whether or not to

provide f irst a id.

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A c t i o n :

D e c i d i n g t o

P r o v i d e

F i r s t

A i d

Providing f irst a id may be part of your job descript ion. I f so, you must help

whi le you ' re work ing . However, when you ' re o f f -du ty , you can choose whether

or not to provide f irst a id.

Asking to Give First Aid

D e f i n i t i o n s a n d Before you provide f irst a id, i t 's imp ortant to ask the i ll or in jured perso n i f you

K e y F a c t s may help.

A c t i o n

Step Act ion

1

If the perso n resp ond s, introdu ce yourse lf as a f i rst a id provider

before you touch him. Ask i f you may help him.

2

I f the person agrees, you may give f i rst a id.

3

If the person refuses your help, phon e your em ergen cy respo nse

number (or 911) and stay with him unt i l someone with more

advanced tra in ing arr ives and takes over.

4

I f the person is confused or cannot answer, assume that he

would want you to he lp .

Supplying the First Aid Kit

The f irst a id ki t contains suppl ies that you might need in an emergency.

Not a l l f i rst a id ki ts contain the same suppl ies. Your company wil l decide

what the f i rst a id ki t should have in i t . At the end of th is sect ion, you' l l f ind a

sample l ist of suppl ies for a f i rst a id ki t . This l ist is f rom the American Nat ional

Standards Inst i tute (ANSI), but i t is only 1 example of what a company might

decide to include in a ki t .

Keep the suppl ies in a sturdy, watert ight container that is clearly labeled.

Know where the f irst a id ki t is.

Replace what you use so the kit wi l l be ready for the next emergency.

Check the kit at the beginning of each work period for expired suppl ies and

to make sure i t is complete and ready for an emergency.

D e f i n i t i o n s a n d

K e y F a c t s

A c t i o n :

S u p p l y i n g t h e

F i r s t

A i d K i t

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2. V ic t im and R e s c u e r Safe ty

Y o u

Will

L e a r n In th is sect io n we ' l l cove r

Assess ing the Scene

Washing Hands

Universal Precaut ions

Exposure to B lood

Taking Off Gloves ( Skill You Wil l Demonstrate)

D e f i n i t i o n s a n d You may have to give f i rst a id in dan gero us places . The i ll or in jured person may

K e y

F a c t s

be in a room with pois ono us fum es, on a busy street, or in a parkin g lot .

Before doing anything else, make sure the scene is safe for you and the in jured

person. Keep looking around to make sure that the scene stays safe. You can't

help anyone i f you're in jured yourself .

A c t i o n : As you approac h the scene, cons ider the fo l lowing

A s s e s s

t h e S c e n e

Danger : Look out for danger to you and danger to the in jured person. Move the

injured person only i f she's in danger or i f you need to move her to provide f irst

a id or CPR if you know how. Move her i f you can do so safely.

Help: Look fo r peop le who can he lp you and look fo r te lephones. Have some

one phone your emergency response number (or911) . Phone for help yourself i f

no one else is around.

W h o : Who's in jured? Figure out how many people are hurt and see i f you can

te l l what happened.

Wh e r e : Where are you? Be specif ic. The emergency response team (or 911)

dispatcher wi l l want to know your address, f loor, or locat ion in the bui ld ing or

on the property.

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Figure 1. Here are examples of ways to move an III or injured person.

F Y l

Whe n you g ive f i rs t a id , know your l imi ts . Don ' t bec om e another v ic t im.

Sometimes your wish to help can put you in danger. For example, i f you are not

a good swimmer, be very care fu l when t ry ing to save someone who 's drowning.

Washing Hands

Def in i t ions a n d Wash ing your hands we l l is one o f the most importan t p ro tect ions you have.

K e y

F a c t s

Alw ays use soa p and wate r if your hands are visib ly d irty and after taking off

g loves.

A c t i o n s f o r

W a s h i n g H a n d s

Well

Step

Act ion

1

Wet your hands with clean running water (warm if avai lable) and

app ly soap.

2

Rub hands together and rub al l surfaces of hands and f ingers for at

least 20 seconds.

3

Rinse hands with lots of running water.

4 Dry your hands using a paper towel or a ir dryer. I f possible, use your

paper towel to turn of f the faucet.

6

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Figure 2.Wash your hands well

with soap and lots of water after

taking off your gloves.

Use a hand sanit izer i f you can't wash your hands with soap and water. Rub

your hands well to loosen germs and then al low the sanit izer to a ir dry.

e f i n i t i o n s a n d

e y

F a c t s

This sect ion is based on recommendat ions o f the Centers fo r Disease Cont ro l

and Prevent ion (CDC). Universal precaut ions are intended to protect you and

your coworkers. For best protect ion, you should treat everyone's b lood as i f i t

were in fected.

Body f lu ids, such as b lood, sa l iva , and ur ine , can somet imes carry germs

that cause diseases. Personal protect ive equipment (PPE) protects you. PPE

inc ludes

Gloves to pro tect your hands f rom b lood and o ther body f lu ids

Eye protect ion, i f the in jured person is b leeding, to protect your eyes from

blood and o ther body f lu ids

Mask to pro tect you when you g ive breaths

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A c t i o n s f o r

U n i v e r s a l

P r e c a u t i o n s

Step

Act ion

1

Wear persona l p ro tect ive equ ipment whenever necessary.

2

Place a l l d isposab le equ ipment tha t has touched b lood or body

f lu ids contain ing blood in a biohazard waste bag (or as required by

your workp lace).

3

To d ispose o f the b iohazard waste bag, fo l low your com pany 's p lan

for d ispos ing o f hazardous waste .

4

Wash your hands well with soap and lots of water af ter properly tak

ing off your g loves.

Figure 3 .Wear protective gloves

whenever you give first aid and

wear eye protection if the ill or

injured person is bleeding.

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Latex a l lerg ies are common and can be serious. Some rescuers and i l l or

in jured people may be al lergic to latex. Use protect ive gloves that don't contain

latex, such as vinyl g loves, whenever possible.

If you or the il l or injured person has a latex allergy, do not use gloves that c o n

tain latex.

D e f i n i t i o n s a n d Blo odb orn e diseases are caus ed by germ s. A rescuer may catc h a disease if

K e y

F a c t s

germ s in som eon e else's b loo d or bod y f lu ids enter the rescuer's body, of ten

through the rescuer's mouth or eye or a cut on the sk in . To be safe, rescuers

shou ld wear pe rsona l p ro tec t i ve equ ipmen t -g loves and eye sh ie lds (gog

g les)- to keep f rom touch ing the in ju red person 's b lood or body f lu ids.

Three examples o f b loodborne d iseases are

Hum an im mun odef ic iency v i rus (HIV), the v i rus tha t causes A IDS

Hepat i t is B

Hepat i t is C

A c t i o n s :

E x p o s u r e t o B l o o d

Step

Act ion

1

I f you are wearing gloves, take them off .

2

Immediately wash your hands and the contact a rea wi th soap and

lots of water.

3

I f body f lu ids have splat tered in your eyes, nose, or the inside of

your mouth, r inse these areas with lots of water.

4

Tell your com pany 's em ergency response p rogram superv isor

what happened as soon as poss ib le . Then contact a hea l thcare

pro fess iona l .

Taking Off Gloves (*Skill You Will Dem onstrate)


K e y

F a c t s

W hen you give f irst a id, the outsid e of your g loves may tou ch b lood or othe r

body f lu ids. Take your g loves off without touching the outside of the gloves with

your bare hands.

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A c t i o n :

T a k i n g O f f G l o v e s

Step

Act ion

1

Grip 1 glove on the o utside of the glove near the cuff and peel i t

down unt i l i t comes off inside out.

2

Cup i t with your other (g loved) hand.

3

Place 2 f ingers of your bare hand inside the cuff of the glove that is

st i l l on your hand.

4

Peel that g love off so that i t comes off inside out, with the f i rst g love

inside it.

5

I f there is b lood on the gloves, d ispose of the gloves properly.

Put them in a biohaza rd was te bag or as required by your

workp lace .

If you do n ot have a biohaza rd was te bag , put the gloves in a

plast ic bag that can be sealed before you dispose of i t .

6

Wash your hands after you give f i rst a id so that you don't spread

germs.

Figure

5 . Proper removal of protectivegloveswithout touching the outside of the gloves.

F Y l

Use wate rless hand sanit izers only if you do not have imm edia te acc ess to

soap and water. Wash your hands with soap and lots of water as soon as

you can.

3 . Pho ning for Help

What

Y o u

Will L e a r n

In th is sec t ion we ' l l cove r


How to Phone for Help

D e f i n i t i o n s a n d The Am er ican Heart Assoc ia t ion adu l t Cha i n of Survivalshow s the m ost

K e y

F a c t s

imp ortant act ion s neede d to treat l i fe-threatening em ergenc ies in adu lts. The

f irst l ink in th is adult Chain of Survival is to recognize the emergency and phone

an emergency number to get he lp . Th is sect ion wi l l teach you how and when

to phone.

1 0

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Every place of business should have a plan for emergency response. This te l ls

workers who, how, and somet imes when to phone for he lp in an emergency.

Figure

6 . The AHA adult Chain of Survival. The first link in the adult chain is to rec og

nize the emergency and phone for help. This is followed by early CPR with emphasis on

compressions, rapid AED use, effective advanced care, and coordinated care afterward.


D e f i n i t i o n s a n d Your com pany may have som e inst ruct ions about when you shou ld phone the

K e y

F a c t s

eme rgency response number (or911) . In th is Student Workbook you' l l learn

when to phone for help in specif ic emergencies.

A c t i o n :

A s s e s s

W h e n t o

P h o n e f o r H e l p

As a general ru le, you should phone the emergency response number (or 911)

and ask for help whenever

Someone is seriously i l l or in jured

You are not sure what to do in an emergency

Here are som e exam ples of som eon e wh o is seriously i ll or in jured. The perso n

Does not respond to voice or touch

Has chest d iscomfort

Has signs of stroke

Has a problem breathing

Has a severe in jury or burn

Has a seizure

Sudden ly can ' t move a part o f the body

Has received an electr ic shock

Has been exposed to po ison

I f someone t r ies to commit su ic ide or is assau l ted , phone the emergency

response number (or 911) regardless of the person's condit ion.

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Important

Answering al l of a dispatcher's quest ions is important to gett ing help to you as

fast as possible. Do not hang up unt i l the dispatcher te l ls you to. Answering the

dispatcher's quest ions won't delay the arr ival of help.

F Y l :

E m e r g e n c y

D i s p a t c h e r s

When you phone for help, the emergency dispatcher may be able to te l l you

how to do CPR, use an AED, or g ive f i rst a id.

4. F inding the P roblem (*Ski ll You

Will

Demonst ra te )

W h at Y o u In th is sec t ion we ' l l cove r the step s of f inding the pro blem .

Will

L e a r n

D e f i n i t i o n s a n d After you che ck the scen e to be sure i t is safe, you mu st f ind out wh at the

K e y

F a c t s

prob lem is before you give f i rst a id. Learn to look for prob lem s in order of

importance. First look for problems that may be l i fe threatening. Then look for

o ther prob lems.

1 3

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Som eone who respo nds mov es, speak s, b l inks, o r o therwise reacts to you

whe n you tap h im and ask, Are you OK ? Som eone wh o does n ' t res pon d

does nothing when you tap him and ask i f he's OK.

A person who gasps usual ly appears to be drawing air in very quickly. He may

open h is mouth and move the jaw, head, or neck. Gasps may appear fo rce fu l

or weak, and some t ime may pass between gasps s ince they usua l ly happen

at a slow rate. The gasp may sound l ike a snort , snore, or groan. Gasping is

not regular or normal breathing. I t is a sign of cardiac arrest in someone who

doesn ' t respond.

A c t i o n :

The fo l low ing steps wi l l help you f ind out wh at the prob lem is. They are l isted in

F i n d t h e P r o b l e m order of imp ortan ce, with the mo st imp ortan t step l isted f i rst .

1. When yo u arr ive a t the scene, c h e c k

the s c e n e to be s u r e it iss a f e .

A s

you walk toward the i l l or in jured person, t ry to look for signs of the cause of

the prob lem.

2 . Check whether the person respond s.

Tap the perso n and s ho ut , Are

yo u

O K ?

A person who responds and is awake may be ab le to answer your ques

t ions.

Tel l the person you're there to help, ask permission to help, and ask

what the prob lem is .

A person may only be able to move, moan, or groan when you tap him

and shout . I f so phone or send someone to phone your emergency

response number (or 911) and get the f i rst a id ki t and AED.

3 .

Next,

c h e c k i f the person is breathing. If the person isn't breathing or is

only gasping, begin CPR and use an AED if you know how.

I f you don't know CPR and you aren't learning i t today, g ive Hands-Only

CPR. To learn about Hands-Only CPR, go to

handson lycpr .org .

4 . Next, look for any obvious s igns of injury,

s u c h

as b leeding , broken

bones , burns , or bites . (You wil l learn about each of these problems later.)

5 .

Finally,

look for medical information jewelry. This te l ls you i f the person

has a ser ious medica l cond i t ion .

F Y l

The mu scles at the back of the throat re lax in a person wh o doe s not res pon d.

When the muscles re lax, the tongue may fa l l back and block the airway. A per

son wi th a b locked a i rway cannot breathe.

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Figure 8. Check if the person responds. Tap him and shout, Are you OK ?

Figure 9.Look for medical information jewelry.

5 . Af ter the

E m e r g e n c y

a t Y o u

Will

L e a r n In th is sect ion we' l l cover privacy and what you sho uld do after the em ergency .

As a f i rst a id rescuer you wil l learn private th ings abo ut your cow ork ers , suc h

e y

F a c t s

as their me dical con dit io n. Give al l inform ation abo ut an i ll or in jured perso n to

EMS rescuers and your company 's emergency response program superv isor .

You may also need to f i l l out a report for your company.

You must no t share th is in format ion wi th o ther coworkers. Keep pr iva te th ings

private.

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A c t i o n s :

P r i v a c y

Give al l information about an i l l or in jured person to EMS rescuers.

Fi l l out the company's report or forms.

Protect the il l or injured person's privacy.

S a m p l e F i r s t

Aid Kit

The fo l lowing table l ists sample f i rst a id ki t contents. This is a ki t that fo l lows

ANSI s tandards. Di f fe rent workp laces may have d i f fe rent requ i rements.

Item

Minimum

S ize

or Volume

Quantity per

P a c k a ge

U n it P a c ka g e

Size

L is t ofimportant loca l emergency te lephone

n u m b e r s , including pol ice,fire depar tment ,

E M S , and poison contro l cen ter *

A b s o r b e n t c o m p r e s s

32 s q. in.

1

1

A d he s i v e

b a n da g e 1 in.

x

3 in. 16 1

A d he s i v e tape

2.5 yd. (total)

1 or 2

1 or 2

Antibiot ic treatment

0.14

f l . oz.

6

1

A n t i s e p ti c s w a b

0.14f l . oz.

10

1

Ant isept ic w ipe

1 in. x 1 in.

10

1

Ant isept ic

towelette

24 s q. in.

10

1

Ban dag e co m pre ss (2 in .)

2 in. x 36 in.

4

1

B a n d a g e

c o m pre ss (3 in.)

3 in. x 60 in.

2

1

B a n d a g e

co m pre ss (4 in.)

4 in. x 72 in.

1

1

Bur ndr e s s i n g

4 in.

x

4 in.

1

1 or 2

Bur ntreatment

1/32 oz.

6

1

C P R

barrier

1

1 or 2

C o l d p a c k

4 in. x 5 in.

1

2

E y e

c ove r i n g ,

with

me a n s of a t ta c h me n t

2.9 sq . in.

2

1

E y e / s k i n

w a s h

4 fl . oz. tota l

1

2

G lo v e s

2 pairs

1

or

2

R o l le r bandage (4 in.)

4 in. x 4 yd .

1

1

R o l le r bandage (2 in.)

2 in. x 4 yd .

2

1

Ster i le pad

3 in.

x

3 in.

4

1

Tr iangular bandage

40 in.

x

40 in. x

56 in.

1

1

H e a r ts a ve r FirstA i d Q u i c k R e f e r e n c e Gu i de *

I tems meet the ANSI

Z308.1-2009

s tandard , except those marked wi th an aster isk .

1 6

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R e v i e w Q ues t i on s :

F i r s t

A id

B a s i c s

Quest ion

Your Notes

1. When you are provid ing f irst a id

you shou ld

a. wear personal protect ive

equipment (PPE).

b. only wear PPE if the person is

someone you do not know.

c. not be concerned about PPE if

you wash your hands.

d.

use cloth gloves to protect

your hands.

2 .

When you phone for he lp , you

should stay on the l ine with the

dispatcher unt i l

a . peop le wi th more advanced

train ing arr ive.

b. the dispatcher te l ls you i t 's OK

to hang up.

3 .

After g iving fi rst a id, you

a. can ta lk about what happened

wi th anyone you want .

b . cannot d iscuss anyth ing wi th

coworkers; you must keep

p r i

vate th ings private.

c. can speak to a reporter ab out

the incident.

d . can d iscuss the inc ident wi th

your immedia te coworkers on ly .

continued)

1 7

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continued)

Quest ion

Your Notes

4 . You shou ld wash your hands fo r

at least

a.

10

seconds .

b. 15 seconds .

c . 20 seconds.

d .

3 minutes.

5 . When assess ing the scene, you

shou ld consider wh ich o f the fo l

lowing: (circle all that apply)

a. Danger to yourself and others

b. How many people are in jured

or ill

c. Where the locat ion is

d.

Where the nearest te lephone is

6 . You shou ld replace any suppl ies

you use from the f irst a id ki t .

True False

Answers :

sru i g

'HV

-

9

'o

-fr 'q e 'q

m

Z^ V

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What Y o u

Will

L e a r n

D e f i n i t i o n s a n d At any t ime, especia l ly dur ing medica l emergenc ies, som eone may

K e y

F a c t s

need CPR . See i f the perso n need s CPR . If he doe s, g ive CPR . If

you don ' t know how, g ive Hands-Only CPR.

T o p i c s C o v e r e d Breathing Problem s

Choking in an Adult

Al lergic React ions

Heart At tack

Fainting

Diabetes and Low Blood Sugar

Stroke

Seizure

Shock

1 . Brea th ing P rob l ems

W h at Y o u In th is sect io n we ' l l cove r

Will L e a r n General Breathing Problem s

Assembling and Using an Inhaler

How to He lp Someone With Breath ing Prob lems

General Breathing Problems


K e y

F a c t s

Someone may deve lop mi ld or severe b lockage o f the a i r passages.

Someone having a heart at tack, having a stroke, or experiencing cer

ta in in juries may also have breathing problems.

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S i g n s You can te l l i f som eon e is having troub le breathing if the person

Is breathing very fast or very slowly

Is having trouble with every breath

Has noisy

breathingyou

hear a sound or whist le as the air enters or

leaves the lungs

Can only make sounds or speak no more than a few words at a t ime in

between breaths, a l though the person is t rying to say more

Many peop le wi th medica l cond i t ions, such as asthma, know about the i r cond i

t ions and carry inhaler medicine that can make them feel better with in minutes

of using i t . Sometimes people have so much trouble breathing they need help

using their inhalers. You may need to help them.

Assemb ling and Using an Inhaler

D e f i n i t i o n s a n d Inhalers are ma de up o f 2 par ts : the medic ine cham ber and the mo uthp iece . A

K e y

F a c t s

spac er can be attach ed that ma kes i t easier for the person with the breathing

problem to inhale al l the medicine.

When someone has t roub le breath ing , she may pan ic . For th is reason, you

should be ready to assemble the inhaler and help her use i t .

Figure 10.

The parts of an inhaler: medicine canister, mouthpiece, and spacer.

A c t i o n s Fol low these step s to asse mb le and use an inhaler:

Step

Act ion

1 Shake the medic ine .

2

Put the medicine into the medicine chamber.

3

Remove the cap f rom the mouthp iece.

continued)

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continued)

Step

Act ion

5

Phone the your emergency response number (or 911) i f

The person has no medicine

The person does not get better af ter using her medic ine

The person's breathing gets worse , the person has trouble

speaking, o r the person s tops respond ing

6

Stay wi th the person unt i l someone wi th more advanced t ra in ing

arrives and takes over.

7

See i f the person needs CPR. I f he does, g ive CPR. I f you don't

know how, g ive Hands-Only CPR.

2. Choking in an Adul t


Mild vs Severe Choking

How to He lp a Choking Adu l t

How to He lp a Choking Adu l t Who Stops Respond ing

D e f i n i t i o n s a n d Ch oking is wh en foo d or anothe r obje ct gets stuc k in the airway in the throat.

K e y

F a c t s

The objec t stop s air f rom gett ing to the lungs.

Some choking is mild and some is severe. I f i t 's severe, act fast . Get the object

out so the person can breathe.

Mild vs Severe Choking

Use the fo l lowing table to f igure out i f someone has mild or severe choking and what you should do:

I f someone

The block in the

a i rway i s

And you

should

Can make sounds

Can cou gh loudly

Mild

Stand by and let her

cough

If wo rried abo ut her

breath ing , phone your

emergency response

number (or 911)

continued)

What Y o u

Will L e a r n

2

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continued)

If s om e on e

The block in the

airway is

And you should

Can not breathe or

Has a cou gh that has

no sound or

Ca nnot ta lk or ma ke

a sound or

Makes the chokin g

sign

Severe

Act quickly

Fol low the steps to

help a choking adult

F Y l : If som eon e is cho king , he mig ht use the cho king sign (holding the neck with

T h e

C h o k i n g S i g n one or both hands).

Figure 12. The choking sign:

holding the neck with one or

both hands.

How to Help a Choking Adult

D e f i n i t i o n s a n d Wh en som eone has severe cho king, g ive th rusts s l igh tly above the be l ly bu t ton .

K e y

F a c t s

These thrusts are som et imes ca l led the He iml ich maneuver. L ike a cou gh, each

thrust pushes air f rom the lungs. This can help remove an object that is b lock

ing the airway.

2 3

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A c t i o n : Fol low these steps to help a cho king adult :

H e l p a C h o k i n g

A d u l t

S tep

Act ion

1

If you th ink someo ne is chok ing, ask, Are you chok ing? If he nods

yes , te l l h im you are going to help.

2

Get behind h im. Wrap your arms around h im so tha t your hands

are in front.

3

Make a fist with 1 hand.

4 Put the thumb side of your f ist s l ight ly above his bel ly button and

wel l be low the breastbone.

5 G r a s p

the fist

with

your other hand and g ive qu ick upward th rusts

in to h is abdomen.

6 G i v e th r u s ts unt i l the object is forced out and he can breathe,

c o u g h ,

or ta lk, or unt i l he stops responding.

A c t i o n :

If som eon e is cho king and is in the late stage s of pregn ancy or is very large

H e l p a C h o k i n g and you can 't wr ap your arm s fu l ly aroun d the wais t , g ive thrus ts on the ches t,

L a r g e P e r s o n o r instead o f th rusts on the abd om en.

P r e g n a n t W o m a n

Fol low the same steps except fo r the locat ion where you p lace your arms and

hands. Put your arms under the armpits and your hands on the lower half of the

breastbone. Pul l stra ight back to give the chest thrusts.

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Figure 14.Chest thrusts on a choking large

person or pregnant woman.

F Y l

Any person wh o has received thrus ts shou ld te l l her healthcare provider.

How to Help a Choking Adult Who Stops Responding

D e f i n i t i o n s a n d If you give som eon e thrusts but can 't rem ove the objec t b lock ing the airway,

K e y

F a c t s

the person wi l l s top respond ing.

I f the person stops responding, fo l low these steps:

A c t i o n

Step

Act ion

1

Check i f he needs CPR. Give i t i f needed and i f you know how. I f


2

Continue CPR unt i l he speaks, moves, or breathes or unt i l someone

with more advanced tra in ing arr ives and takes over.

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3 . A l lerg ic

Re a c t io ns


Using Epinephrine Pens( Skill You Wil l Demonstrate)

Mild vs Severe Al lergic React ions

D e f i n i t i o n s a n d Ma ny al lergic react ions are mi ld . Some react ions tha t seem mi ld can become

K e y F a c t s

severe with in min utes.

People can be al lergic to many th ings, including

Many foods, such as eggs, nu ts , choco la te

Insect st ings or b ites, especial ly bee or wasp st ings

W h a t Y o u

Will

L e a r n

F Y l

So m e states and organ izat ions perm it f i rst a id rescuers to help peo ple use their

ep inephr ine pens. Peop le who carry ep inephr ine pens usua l ly know when and

how to use them.

You may help give the in ject ion i f you are approved to do so by your state regu

lat ions and by your company.

Using Epinephrine Pens (*Skill You Will Dem onstrate)

D e f i n i t i o n s a n d An epinep hrine pen wil l help som eon e with a severe al lergic react ion breathe

K e y F a c t s

mo re easi ly. I t conta ins a sma ll am oun t of me dicine that can be in jected throu gh

clothing. I t usual ly takes several minutes before the medicine starts to work.

The epinephrine in ject ion is g iven in the side of the th igh.

A c t i o n s f o r a n

E p i n e p h r i n e

P e n

Step

Act ion

1

Get the prescr ibed ep inephr ine pen.

2

Take off the safety cap. Fol low the instruct ions on the pen.

3

Hold the epinephrine pen in your f ist without touching either end

because the need le comes out o f one end.

4

Push the end with the needle hard against the side of the person's

t h igh , about halfway between the hip and knee. Give the in ject ion

through clothes or on bare sk in.

5

Hold the pen in place for about 10 seconds.

6

Remove the needle by pul l ing the pen stra ight out.

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continued)

Step

Act ion

4

I f he can't use i t h imself , and i f you're al lowed, use the epinephrine

pen to give him an in ject ion.

5

Rub the in ject ion spot for about 10 seconds .

6

After using the epinephrine pen, d ispose of i t properly.

7

Note the t ime of the in ject ion.

8



F Y l

If pos sible, save a sam ple of wh at caus ed the reac t ion.

Important

I t 's imp ortant to d ispo se of needles correc t ly so that no one gets stuc k. Fol low

your com pan y 's sharps d isposa l po l icy . If you do n ' t k now w hat to do, g ive the

need le to someone wi th more advanced t ra in ing than you have.

4 .

Heart

A t tack

What Y o u In th is sect io n we ' l l cover how to recognize and provid e f irst a id for heart

Will

L e a r n

a t tacks

D e f i n i t i o n s a n d Heart d isease is the single biggest caus e of death in the United States.

K e y

F a c t s

The f irst minutes of a heart at tack are the most important. This is when the

person is l ikely to get worse and may die. Also many of the treatments for heart

at tack wi l l be most successful i f they are given quickly.

S i g n s o f a Hear t Signs of a heart at tac k may include

A t t a c k

C h e s t

d i s c omf or t . Mo st heart at tack s involve disc om fort in the center of the

chest tha t lasts more than a few minutes or tha t goes away and co me s back.

I t can feel l ike uncomfortable pressure, squeezing, fu l lness, or pain. I f someone

has an uncomfortable feel ing in the chest, th ink heart at tack.

Discomfor t in other a r e a s of the upper body. Symptoms can inc lude pa in or

d iscomfort in one or bo th arms, the back, neck, jaw, or abdomen.

S h o r t n e s s

of breath. Th is may occur wi th or wi thout chest d iscomfort .

O th e r s igns may inc lude co ld sweat , nausea, or l igh t -headedness.

8

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in W o m e n , W om en , the elderly, and peop le wit h diabe tes are more l ikely to have the less

h e E l d e r l y , a n d typic al signs of a heart at tack , such as an ach e in the ches t, hear tburn , or

indige st ion. The y ma y have an unc om forta ble feel ing in the back , jaw, neck ,

or shoulder. They may also complain of shortness of breath or have nausea

or vomit ing .

Man y peop le wo n ' t adm it tha t the i r d isco mfo rt may be caused by a heart

at tack. People of ten say

I 'm too healthy,

I don ' t want to bother the doctor ,

I don ' t wan t to fr igh ten my wi fe , o r

I ' l l feel sil ly if it isn't a heart attack.

I f you suspect someone is having a heart at tack, act quickly. Don't hesitate,

even if the person is uncom fortab le adm it t ing h is d iscom fort .

Fol low these step s if som eon e has any of the signs of a poss ible heart at tack :

Step

Act ion

1

Make sure the person stays calm and rests.

2

Phone or have someone phone your e m e r g e n c y r e s po n s e n u mb e r

(or 911).

3

Ask someone to get the f i rst a id ki t and AED if avai lable.

4

I f the person has no al lergy to aspir in, no serious bleeding, and no

signs of a stroke, give him an aspir in (e ither 2 low-dose aspir in or 1

regular).

5



I t 's best i f the person doe sn't drive himself to the hosp ita l . Stay with him unt i l

someone wi th more advanced t ra in ing arr ives and takes over.

5 . Fa in t ing

Y o u

In th is sect ion we' l l cover what fa int ing is and how to provide f irst a id for i t .

L e a r n

2 9

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Faint ing is a short period when a person stops responding for less than a m in

ute and then seems f ine. This is usual ly caused by not enough blood going to

the brain. Seconds before fa int ing, he may feel d izzy.

Fa in t ing o f ten occurs when the person

Stands without moving for a long t ime, especial ly i f the weather is hot

Has a heart condit ion

Sudden ly s tands a f te r squat t ing or bend ing down

Rece ives bad news

A c t i o n s

Fol low these step s if a person is d izzy but st i l l resp ond s:

Step

Act ion

1

Make sure the scene is safe.

2

Help the person lie f lat on the floor.

3

I f the person doesn ' t improve or s tops respond ing, phone your

e m e r g e n c y r e s po n s e number (or 911).

I f a person fa ints and then starts to respond:

Step

Act ion

1

Ask the person to cont inue to l ie f lat on the f loor unt i l he can sit up

and feels normal.

2

If the person

fel l ,

look for in juries caused by the

fal l .

3

Phone your e m e r g e n c y r e s po n s e number (or911).

6 . D iabe tes and Low B l ood

Sugar

What Y o u In th is sect ion we ' l l cove r how to recogn ize and provid e f irst a id for low bloo d

Will

L e a r n sugar in a person with diabe tes.

Def in i t ions a n d Diabetes is a diseas e that af fects levels of sugar in the blo od . Too m uc h or too

K e y

F a c t s

l i tt le sugar caus es prob lem s. In th is cou rse, we 're going to add ress low bloo d

sugar, wh ich can cause someone 's behavior to change.

Some diabet ics take insul in. Too much insul in can also cause low blood sugar.


K e y

F a c t s

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Low blood sugar can occur i f a person with diabetes has

Not eaten or is vomit ing

Not eaten enough food for the level of act iv i ty

In jected too much insul in

Signs of low blood sugar can appear quickly and may include

A change in behavior, such as confusion or irr i tabi l i ty

S leep iness or no t respond ing

Hunger, th irst , or weakness

Sweat ing , pa le sk in co lor

A seizure (see the sect ion on seizures)

Fo l low these s teps if som eone is respond ing and show s s igns o f low

blood sugar:

Step

Act ion

1

I f the person can sit up and swallow, g ive him something that c o n

ta ins sugar to eat or drink.

2

Have him sit quiet ly or l ie down.

3

Phone or have someone phone your emergency response number

(o r

911).

The fo l lowing l is t shows what to g ive a person wi th d iabetes who has low b lood

sugar. Give foods that contain sugar, such as

Fruit juice

Milk

Sugar

Honey

A regular soft drink

I t 's important to make sure that whatever you give has sugar in i t . Diet foods

and dr inks don ' t have sugar; choco la te doesn ' t have enough sugar.

I f someone with low blood sugar is unable to si t up and swallow, don't g ive him

anything to eat or drink.

3 1

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7.

St roke

What You

In th is sect ion we' l l coverhow to recogn ize and provide f irstaid for s t roke.

Will L e a r n

Def in i t ions a n d

St rokes occur when b lood s tops f lowing

to a

part

of the

brain. This

can

happen

K e y

F a c t s

ifthere isb leed ing or a b locked b lood vesse l in the bra in .Thes igns of a s t roke

are usual ly very sudden.

New t rea tments can reduce the damage f rom as t roke and improve recovery.

However, they must beg iven wi th in the f i rst hours af ter the f i rst s igns of s t roke

appear.

As a

result ,

it's

impor tan t

to

recogn ize

the

s igns

of a

s t roke qu ick ly

and

get medical care fast.

S i g n s The

warn ing s igns

of

s t roke

are

Sudden numbness or weaknessof theface ,arm, or leg,especial lyon one

sideof the body

Sudden confus ion, t roub le speaking,

or

t roub le understand ing

Sudden t roub le see ingin one or both eyes

Sudden t roub le wa lk ing , d izz iness, loss

of

ba lance

or

coord inat ion

Sudden, severe headache wi th no known cause

A c t i o n s

Fo l low these s teps

if you

th ink som eone

is

having

a

stroke:

Step

Act ion

1

Make sure

the

scene

is

safe.

2 Phone

or ask

s o me o n e

to

phone your emergency response number

(or 911)and get the f irstaid kit and an AED ifavai lable.

3

Notethe t ime w hen thes igns of s t roke f i rs t appeared.

4 See if the person needsCPR. If he does, g iveCPR. If you don ' t

know how, g ive Hands-OnlyCPR.

8. Se izure

What You

In th is sect ion we' l l coverhow to recogn ize and provide f irstaid for seizures.

Will

L e a r n

2

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A seizure is abno rma l e lectr ical act iv i ty in the brain. M ost seizures stop with in a

e y

F a c t s

few min utes. A me dical con dit ion cal led epi lepsy often caus es seizures. Not a l l

seizures are due to epi lepsy. Some seizures happen when the heart suddenly

stops beat ing. Seizures can also be caused by

Head in jury

Low b lood sugar

Heat-re lated in jury

Po isons

The person may bite his tongue during a seizure. You can give f i rst a id for that

in jury af ter the seizure stops. After a seizure i t is not unusual for the person to

be confused or get sleepy.

During some types of seizures, the person may

Lose muscle cont ro l

Fal l to the ground

Jerk arms, legs, or other parts of the body

Stop respond ing

Dur ing a se izure you shou ld fo l low these s teps:

Step

Act ion

1

Make sure the scene is safe.

2

P r o te c t th e p e r s o n by

Mo ving furniture or other objec ts out of the way

Placing a sma ll pad or tow el unde r the person's head i f i t 's easy

to do so

3

Phone or have someone phone your company 's e m e r g e n c y

r e s p o n s e number (or911).

After a seizure, fo l low these steps:

Step

Act ion

1

S e e i f the personn e e d s C P R .If he does, g ive CP R. I f you do n't


2

S t a ywith

th e p e r s o n unt i l someone wi th more advanced t ra in ing

arrives and takes over.

3

I f the person is vomit ing or has f lu ids in h is mouth and you th ink

the person doesn't have a head, neck, or spine in jury, roll him to

his s ide.

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continued)

Quest ion

Your Notes

2 . Signs of a severe al lergic reac

t ion include trouble breathing,

swell ing of the face and tongue,

and the person may stop

respond ing.

True False

3 . A person wi th a

is usual ly awake and can ta lk

but may have an uncomfortab le

feel ing, such as pain or pres

sure,

in the chest.

a. stroke

b. seizure

c. heart attack

4 . The wa rning signs of

inc lude sudden numbness or

weakness o f the face, a rm, or

leg, especial ly on one side of

the body.

a. fa int ing

b. stroke

c. heart at tack

d.

seizure

5 . If som eone wi th low b lood sugar

is responding and can sit up

and swal low, g ive her someth ing

that contains sugar to eat or

drink.

True False

Answers : ^1 9 'q P

'o

'ami

Z

'o

V

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Part 3: Injury Emergencies

W h a t Y o u

You'l l learn how to provide f irst a id for in jury emergencies.

Will L e a r n


At any t ime, especia l ly dur ing in ju ry emergencies, someone may

K e y

F a c t s

need CPR. See i f the person needs CPR. I f he does, g ive CPR. I f


T o p i c s C o v e r e d Bleeding You Can See

Wo u n d s

Bleeding You Can't See

Head,

Neck, and Spine In juries

Broken Bones and Spra ins

Burns and Electr ical In juries

1.

B l eed ing You Ca n S ee

h a t Y o u

i l l

L e a r n


How to Stop Bleeding ( Ski l l You Wil l Demonstrate)

Bandag ing

( Skill

You Wil l Demonstrate)

Using Tourniquets

D e f i n i t i o n s a n d Bleed ing often looks wo rse than i t is. W hen a large bloo d vessel

K e y

F a c t s

is cu t or t o rn , the person can lose a lot of b lood with in minutes.

How ever, you can stop mo st b leed ing with press ure. If the in jured

person can help you, ask him to put d irect pressure on the wound

while you put on your personal protect ive equipment (PPE).

A dressing is wound covering used to stop bleeding. I t helps prevent

infect ion. A dressing can be a gauze pad or any other clean piece of

cloth or even a gloved hand.

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F Y l : Sma ll wo un ds heal better and with less infect ion i f an ant ib iot ic o intm ent or

Multiple D r e s s i n g s cream is used. App ly ant ib io t ic o in tment or cream and then a c lean dress ing,

a n d A n t i b i o t i c but only if the w ou nd is a small scra pe or surface cut and only i f the person

C r e a m s doe sn't have any al lergies to the ant ib io t ic.

Important: If the cut or scrap e is minor, wa sh the area with lots of clean wa ter to get the

Minor

C u t s

a n d w ou nd clean before app lying the dress ings. You' l l use less direct pressure to

S c r a p e s

s

^

0

p

^

n e

b leeding for a minor cut or scrape than for a major cut or scrape.

Bandaging (*Skill You Will Demo nstrate)

D e f i n i t i o n s a n d A band age is materia l used to prote ct or cover an in jured bod y part . A band age

K e y

F a c t s

may a lso he lp keep pressure on the wo und .

A c t i o n

Step

Act ion

1

Make sure the scene is safe. Get the f i rst a id ki t and wear PPE.

2

Use direct pressure, with gauze pads/dressings i f avai lable, to stop

any b leed ing.

3

Apply the bandage over the dress ings.

3 9

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Using Tourniquets

D e f i n i t i o n s a n d If an arm or leg has severe bleeding and you can 't sto p the bleedin g with direct

K e y

F a c t s

pressure , you can use a tourn ique t.

The best tourn iquets are premade, or manufactured, ones. I f you don ' t have

one, you can make a tourn iquet ou t o f a p iece o f c lo th and a wind lass, essen

t ia l ly a st ick-l ike object used to t ighten the tourniquet.

I f you apply the tourniquet correct ly, i t wi l l cause pain as i t stops the bleeding.

A c t i o n :

The fo l lowing s teps app ly to a prema de tourn ique t :

U s e a P r e m a d e

Step

Act ion

1

Mak e sure the scene is sa fe . Phone your eme rgency response

number (or 911) . Wear PPE.

2

Place the tourniquet 2 inches above the in jury, i f possible.

3

Tighten the tourniquet unt i l the bleeding stops.

4

Note what t ime you put the tourn iquet on .

5

Get medical help as soon as possible.

6

Leave the tourn iquet on unt i l someone wi th more advanced t ra in ing

takes over.

Important On ce you have the tourn ique t in p lace , leave i t a lone unt i l som eon e with more

advanced tra in ing arr ives and takes over.

A c t i o n : If you need to ma ke a tourn ique t, fo l low the step s in th is table. Then app ly the

M a k e

a n d U s e a tourn iquet the same way as you wo u ld fo r a prem ade one.

T o u r n i q u e t

S tep

Act ion

1

Make sure the scene is safe. Wear PPE.

2

Fold a cloth or bandage so that i t 's long and at least 1 inch wide.

3

Wrap the bandage 2 inches above the in jury, i f possible.

4

Tie the ends of the bandage around a st ick (or something similar to

a st ick).

5

Turn the st ick to t ighten the tourniquet.

6

Continue t ightening unt i l the bleeding stops.

continued)

0

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continued)

Step

Act ion

7

Secure the st ick so the tourniquet stays t ight.

8

Note what t ime the tourn iquet was p laced.

9

Get medical help as soon as possible.

F Y l

Important

Figure

1 9 .

A tourniquet applied to a leg.

Most f i rst a id ki ts have a tr iangular bandage. This is ideal for

tourn iquet .

Leave al l dressings on as you add more.

2 .

W o u n d s

What

Y o u

Will

L e a r n


Bleed ing From the Nose

Bleed ing From the Mouth

Tooth Injuries

Eye Injuries

Penet ra t ing and Punctur ing Objects

Ampu ta t ion

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Bleeding From the Nose

D e f i n i t i o n s a n d W ith nose bleed s i t 's som etim es hard to te l l how mu ch bleeding there is

K e y

F a c t s

because the in ju red person o f ten swal low s som e o f the b lood . Th is may cause

the person to vomit .

A c t i o n s Fol low these steps wh en giving f i rst a id to a person with a nos eble ed:

Step

Act ion

1

Make sure the scene is safe. Get the f i rst a id ki t . Wear PPE.

2

P r e s s both s i d e s of the nostr i ls whi le the p e r s o n si ts and leans

forward.

3

Place c o n s t a n t

pr e s s ur e

on both sides of the nostr i ls for a few

minutes unt i l the bleeding stops.

4 I f b leeding cont inues, press harder.

5 Phone your emergency response number (or 911) i f

You can 't stop the bleeding in abo ut 15 minutes

The bleeding is heavy, such as gush ing b lood

The person has troub le breathing

Important

People are somet imes mis in formed about the best way to s top a noseb leed.

The correct way to he lp someone wi th a noseb leed is to fo l low the s teps out

l ined in the table.

F igure 20. Press on both sides

of the nostrils.

Nasal bone

9b

Pinch soft part

of nose here

2

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K e y

F a c t s

A person wi th a mouth in ju ry may have broken, loose, o r knocked-out tee th .

Th is can be a choking hazard .

A c t i o n s f o r T o o t h Fol low these step s wh en giving f i rst a id to a perso n wi th a too th in jury:

I n j u r i e s

Step

Act ion

1


2

Check the mouth for any missing teeth, loose teeth, or parts of

teeth.

3

Clean the wound with sal ine or clean water.

4

I f a tooth is loose, have the person bite down on a piece of gauze to

keep the tooth in p lace and cal l a dent ist .

5

I f a tooth is chipped, gent ly clean the in jured area and cal l a dent ist .

6

Apply pressure wi th gauze to s top any b leed ing a t the empty too th

socket .

7

I f a tooth has come out, put the tooth in a cup of milk or clean water

and immediately take the in jured person and tooth to a dent ist or

emergency depa r tmen t .

8

Tell the person to ta lk with a dent ist i f a tooth changes color af ter an

injury.

Important Hold the too th by the cro wn , not the root (the part that wa s in the gum s). There

may be l igaments on the tooth that wi l l help reattach the tooth.

Keep the too th out o f the mouth .

Figure

2 2 . Hold the tooth by

the crown.

4

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A c t i o n s Fol low these step s wh en giving f i rst a id to a person with an in jury from a pun c

turing or penetrat ing object:

Step

Act ion

1


2

Phone or ask someone to phone your e m e r g e n cy r e s po n s e

number (or

911).

3

Stop any b leeding you ca n se e .

4

Try to keep the in jured person from moving.

Important Leave penetra t ing obje cts in.

I f a person is in jured and a sharp object, such as a nai l or a knife, remains part ly

stuck in the body, leave i t in the body. Taking i t out may cause more damage.

Amputation

D e f i n i t i o n s a n d If a part of the body, suc h as a f inger, toe, han d, or foot is cut of f (amp utated),

K e y

F a c t s

save the bod y part beca use do cto rs may be able to reattach i t . You can pre

serve a detached body part at room temperature, but i t wi l l be in a better

condit ion to be reattached i f you keep i t cool.

A c t i o n s

Fo l low these s teps to pro tect an am puta ted part :

Step

Act ion

1

Rinse the amputated part with clean water.

2

Cover or wrap the amputa ted part wi th a c lean dress ing.

3

I f i t wi l l f i t , p lace the amputated part in a watert ight p last ic bag.

4

Place that bag in another container with ice or ice and water; label i t

with the in jured person's name, date, and t ime.

5

Make sure i t is sent to the hospita l with the in jured person.

6

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o f H e a d Sus pec t a head in jury i f an in jured person

Does not respond or on ly moan s or move s

Acts s leepy or confused

Vomits

Compla ins o f a headache

Has trouble seeing

Has trouble walking or moving any part of the body

Has a seizure

The bone s of the spine prote ct the spinal c o r d . The spinal cord carr ies

me s -

e y

F a c t s

f o r S p i n e sages between the brain and the body,

d N e c k

I f the spine is damaged, the spinal cord may be in jured. The person may not be

able to move her legs or arms and may lose feel ing in parts of the body. Some

peop le ca ll th is a broken back.

You may cause further in jury to the spinal cor d i f you be nd, twis t , or turn the

person's head or neck. When you give f i rst a id to someone with a possible

spine in jury, you must not bend, twist , or turn the head or neck unless i t 's nec

essary to provide CPR or i f you need to move the person out of danger.

I f she is vomit ing or has f lu ids in her mouth, wear PPE and rol l her to the side.

o f a N e c k o r Su spe ct that the spine bones are broken if an in jured person

Injury

a | s 6 5 Q r Q | d e r

Was in a car or b icycle crash

Has fa l len from a height

Has t ingl ing or weakness in the extremit ies

Has pain or tenderness in the neck or back

Appears to be intoxicated or not fu l ly a lert

Has other painful in juries, especial ly of the head and neck

f o r H e a d ,

Fol low these steps wh en giving f i rst a id to a person with a poss ible hea d, neck,

k , a n d

S p i n e

or spin e in jury:

Step

Act ion

1 Make sure that the scene is safe.

2

Phone or ask someone to phone your emergency response number

(or 911) and get the first aid kit.

3

Min imize movement o f the head and neck.

4 9

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F igure 24 . Hold the head and neck

to minimize movement.

5 . Broken

B o n e s

and Spra ins

What

Y o u In th is sect io n we ' l l cove r how to recognize and provide f irst a id for broken

Will L e a r n bones and spra ins.

Joint sprains happen when jo ints move in direct ions they're not supposed to go.

Without an x-ray, i t may be impossible to te l l whether a bone is broken. But

you wi l l per form the same act ions even i f you don ' t know whether the bone is

broken.

S i g n s

There may be swe ll ing and the jo int may turn sl ight ly b lue if i t is spra ined .

A c t i o n s Fol low these step s wh en giving f i rst a id for a person with a poss ible broken

bone or sprain:

Step

Act ion

1

Make sure that the scene is safe. Get the f i rst a id ki t . Wear PPE.

2

Cover any open wound wi th a c lean dress ing.

3

Put a plas t ic bag f i l led with ice and water on the in jured area with

a towel between the ice bag and the skin for up to 20 minutes.

4 Phone or ask someone to phone your emergency response number

(or 911) if

There is a large open w ou nd

The in jured part is abno rma lly ben t

You're not sure wh at to do

5

I f an in jured body part hurts, the person should avoid using i t unt i l

checked by a healthcare provider.


K e y

F a c t s

5 0

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F Y l

You sho uld be able to put a few f ingers betw een the spl int and the in jured bod y

part . Do not t ie the spl int too t ight ly. This might cause further pain. I f you use

something hard for the spl int , pad the inside of the spl int with cloths or dress

ings,

i f poss ib le , to keep the person comfortab le .

Important

If the in jured part is b leed ing, app ly direct pressure to stop the bleed ing and

app ly a dress ing to the wound before app ly ing the sp l in t .

A c t i o n s : If you do n't have anythin g to use as a spl int , a person can use his other arm to

S e l f - S p l i n t i n g hold the in jured one in place. Fol low these step s to self -spl int an arm :

a n A r m

Step

Act ion

1 Make sure the scene is safe.

2

Have the in jured person place his hand across his chest and hold i t

in p lace with his other arm.

Important

Leave bent and defo rm ed bod y parts in their bent or defo rm ed pos it ions as you

apply the spl int . I f a broken bone has come through the

sk in ,

cover the wound

with a clean dressing, and spl int as needed.

6 .

B ur n s

an d

E lec t r i ca l

In jur ies

What

Y o u In th is sec t ion we ' l l cover how to provid e f irst a id for burns and electr ical

Will

L e a r n injuries.

2

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Burns are in juries that can be cau sed by con tact with heat, e lectr ic i ty, or c h e m i -

e y

F a c t s

f o r

B u r n s

cals. Heat burns can be cau sed by conta ct with f ire, a hot surface, a hot l iquid,

or s team.

Use cool water on burns. Ice can damage burned areas. I f someone with a burn

gets too co ld , she can get hypothermia ( low body temperature) .

f o r

B u r n s

Follow these steps to give f i rst a id to a person with a small burn:

Step

Act ion

1


2

I f the burn area is small , cool i t immediately with

co ld ,

but not ice-

co ld , water. Run cold water on the burn unt i l i t doesn't hurt .

3

You may cover the bum with a dry, nonst ick steri le or clean

dress ing.

F igure 27. If possible, hold the

burned area under cold running

water.

Important

Phone or send someone to phone your emergency response number (or 911) i f

There is a f ire

The person has a large burn

You are not sure what to do

5 3

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Important If som eone is on f ire, put the f i re out: Have that person stop , dro p, and roll;

then cover the person with a wet b lanket to put the f i re out. Once the f ire is out,

remove the wet b lanket.

A c t i o n s f o r Fol low these steps to give f i rst a id to a person with a large bur n:

L a r g e

B u r n s

Step

Act ion

1

Make sure the scene is safe. Get the f i rst a id ki t . Phone your emer

gency response number (or

911).

2

If the person is on fire, put the fire out.

3

Remove jewelry and clothing that is not stuck to the sk in.

4

Cover the person with a dry blanket.

5

Check for signs of shock.

F Y l

Cover the person wi th a dry b lanket to keep the person warm because once the

skin has burned, the person can no longer control body temperature wel l and

often gets co ld .

Electrical Injuries

D e f i n i t i o n s a n d Electr ic i ty can burn the bod y on the inside and outsid e. Electr ic i ty can stop

K e y

F a c t s

breathing or caus e a dead ly abno rma l heart rhy thm .

S i g n s

Electr ic i ty may leave only small ma rks on the body. No one can te l l how mu ch

damage there is inside the body based on the marks on the outside.

A c t i o n s

Fol low these steps for g iving f i rst a id for an electr ical in jury:

Step

Act ion

1 Make sure the scene is safe. Get the f i rst a id ki t and AED. Wear

PPE.

2

Phone or send someone to phone your emergency response num

ber (or 911).

3

When i t is safe to touch the in jured person, see i f he needs CPR. I f

he does, g ive CPR. If you do n ' t kno w how, g ive Han ds-On ly C PR.

4

A healthcare provider should check everyone who has an electr ical

injury.

4

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F Y l :

Stay clear of the in jured person as long as he's in co nta ct with a pow er sourc e

T o u c h in g S o m e o n e that is on. Electr ic i ty can travel f rom the sou rce throu gh the in jured person to

With

a n E l e c t r i c a l

v o u

u m

0

f f

the main power switch only i f you know how and can safely do so.

I n j u r y On ce the pow er is of f , you may touc h the in jured pers on.

High Voltage

I f the electr ical in jury is caused by high voltage, such as a fa l len power l ine,

electr ic i ty can travel through everything that touches the power l ine or source

(even a wooden st ick). Wait unt i l the power has been turned off to enter the

area and provide help.

Important

Man y peo ple have heard abo ut d if ferent o intm ents for burn s. The only th ing you

should put on a burn is cool water and clean dressings unless you are given

other instruct ions by a healthcare provider.

R e v i e w Q ues t i on s :

Injury

E m e r g e n c i e s

Quest ion

Your Notes

1. To help stop bleeding that you

can see, put f i rm pressure on a

dressing or bandage over the

bleeding area.

True False

2 . Mark an X by the correct

response.

A person wi th a noseb leed

should lean

forward .

backward .

3 . Mark an X by the correct

response.

If a large stick or a knife has

been pushed in to someone 's

body, you shou ld

remove i t as quickly as

poss ib le .

leave it in and get help.

continued)

5 5

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continued)

Quest ion

Your Notes

4 . If som eon e fa l ls do wn and then

becomes s leepy or confused,

vomits , o r compla ins o f a head

ache, the person may have a

head injury.

True False

5 . As soon as a person twis ts h is

ankle, apply a heat ing pad or

heat pack over the in jured area

for 20 minutes to help reduce

swell ing.

True False

6 . To give first aid for a sm all b urn

on the arm, coo l the burn wi th

a. lukewarm water.

b. ice dire ctly on the sk in.

c. co ld , but not ice-cold, water.

A n s we rs :

o

g 'es|ej -g'e nji 'in

\ \

a A e e i 'PJEMJOJ

'an j j .

\.

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Y o u

L e a r n

You'l l learn how to provide f irst a id for environmental emergencies.

At any t ime, especia l ly dur ing env i ronmenta l emergen cies, som eone

e y

F a c t s

may need CPR . If he doe s, g ive CPR . If you don 't kno w how , give

Hands-Only CPR.

C o v e r e d Bites and St ings

Heat-Re la ted Emergencies

Cold-Re la ted Emergencies

Poison Emergencies

1. B i t es

an d

St ings

Y o u

l n

th is sect ion we' l l cover

L e a r n An ima l and Hum an Bi tes

Snakeb i tes

Insect, Bee, and Spider Bites and St ings

Poisonous Sp ider and Scorp ion B i tes and St ings

Ticks

nimal and Hum an Bites

D e f i n i t i o n s a n d Altho ugh man y bites are minor, so m e may break the sk in . When a

K e y

F a c t s

b ite breaks the sk in , the wound can b leed and may become in fected

from the germs in the biter 's mouth. Bites that do not break the skin

are not usual ly serious.

Be sure to stay away from an animal that is act ing strangely.

A c t i o n s

Follow these steps to give f i rst a id to a person with an animal or

human b i te :

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e y

F a c t s

Ticks are found on an imals and in wooded areas. They a t tach themselves to

exposed body parts . Many t icks are harmless. Some carry ser ious d iseases.

I f you f ind a t ick, remove i t as soon as possible. The longer the t ick stays

attached to a person, the greater the person's chance of catching a disease.

f o r

T i c k

Step

Act ion

1


2

Grab the t ick by i tsmouth or head as close to the skin as pos

s ib le wi th tweezers or a t ick-remo ving dev ice .

3

Li f t the t ick straight out without twist ing or squeezing i ts body. I f

you l i f t the t ick unt i l the person's skin tents and wait for several sec

onds, the t ick may let go.

4

W a s h the bite with running water (and soap, i f avai lable).

5

See a healthcare provider i f you are in an area where t ick-borne dis

eases occur. I f possible, p lace the t ick in a plast ic bag and give i t to

the healthcare provider.

Some peop le have heard about o ther ways to remove a t ick . The correct way to

remove a t ick is to fo l low the act ions in the table.

2 .

H e a t - R e l a t e d


Y o u

L e a r n


Heat Cramps

Heat Exhaust ion

Heat Stroke

e y

F a c t s

Most heat -re la ted emergencies are caused by v igorous exerc ise .

Heat cramps are pa in fu l muscle spasms, most o f ten in the ca lves, a rms, s tom

ach muscles, and back.

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S i g n s

Signs o f heat cramps inc lude muscle cramps, sweat ing , and headache.

A c t i o n s f o r Heat

C r a m p s

Step

Act ion

i


Have the person with heat cramps rest and cool of f .

3

Have the person dr ink someth ing tha t conta ins sugar and e lect ro

lytes, such as ju ice or a sports drink, or water i f the others aren't

avai lable.

F Y l Once heat cram p sym ptom s stop, the person can exerc ise aga in . St re tch ing,

ic ing,

and massaging painful muscles may be helpful.

A bag with ice and water and w rap pe d in a tow el m ay be appl ied to the sore

muscle for up to 20 minutes i f the person can to lerate i t .

Important Mild heat-re lated signs are a wa rning that the perso n's con dit io n may get wo rse

un less you take act ion . Symptoms o f heat -re la ted emergencies o f ten increase i f

lef t untreated.

Heat Exhaustion

D e f i n i t i o n s a n d Heat exha ust ion is a serious con dit ion that of ten turns into heat stroke . I t of ten

K e y

F a c t s

occu rs when som eone exerc ises in the heat and swe ats a lo t.

S i g n s S igns o f heat exhaust ion inc lude swe at ing , nausea, d izz iness, vom it ing , muscle

cramps, feel ing fa int , and fat igue.

A c t i o n s Fol low these steps for heat exh aust io n:

Step

Act ion

1



(or 911).

3

Have the person l ie down in a cool p lace.

4

Remove as much o f the person 's c lo th ing as poss ib le .

5

Cool the person with a cool water spray.

continued)

2

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continued)

Step

Act ion

6

I f cool water spray is not avai lable, p lace cool damp cloths on the

neck, armpit , and groin area.

7

Have the person dr ink someth ing tha t conta ins sugar and e lect ro

lytes, such as ju ice or a sports drink, or water i f the others aren't

avai lable.

Heat stroke is a very serious co nd it io n. I t looks similar to heat exha ust ion but i t

e y

F a c t s

is l i fe threa tening . You need to act quickly.

The key signs of heat strok e are con fusi on, passing out, d izziness, and seizures.

Other s igns o f heat s t roke inc lude nausea, vomit ing , muscle cramps, fee l ing

faint , and fat igue.

f o r Heat

Step

Act ion

1

Make sure the scene is safe. Get the f i rst a id ki t and AED. Wear

PPE.

2

Phone or ask someone to phone your e m e r g e n c y r e s po n s e

number (or

911).

3

Put the person in coo l water , up to her nec k i f possible.

4



Beg in coo l ing the person immedia te ly . Every minute coun ts .

I f you can't put the person in cool water up to her neck, cool her with a cool

water spray.

Stop coo l ing the person once her behavior is normal aga in . Cont inued

c o o l

ing cou ld lead to low body temperature (hypothermia) .

Only put water on the person's sk in.

I f the person can drink, g ive her something to drink. Sports drinks are the

best.

I f the person can ' t d r ink, wa i t fo r someone wi th more advanced t ra in ing to

arrive and take over.

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Body Temperature (Hypothermia)

Hypo thermia occurs when body tempe rature fa l ls . Hypo thermia is a ser ious

e y

F a c t s

cond i t ion tha t can cause death . A person can deve lop hypothe rmia even when

the temperature is above freezing.

Sh iver ing pro tects the body by producing heat . Sh iver ing s tops when the body

becom es ve ry co ld .

The skin is coo l to the tou ch .

Shivering (shivering stops when the body temperature is very low).

The person may become confused or drowsy.

Persona l i ty may change or the person may behave as i f unconcerned about

the cond i t ion .

Muscles become st i f f and r ig id and the skin becomes ice cold and blue.

As the body temperature cont inues to drop

The person s tops respond ing

The person 's breath ing s lows

It may be hard to te l l whether the person is breathing

The person may appear to be dead

Step

Act ion

1

Get the person out of the

co ld .

2

Remove wet clothing and pat the body dry. Put dry clothes on the

person and cover the person with a blanket.

3


(or 911) and get the first aid kit and AED, if available.

4

Wrap the person up wi th anyth ing you haveclo th ing , towels ,

newspapers, e tc . Cover the head but no t the face.

5

See i f the person needs CPR. I f so, g ive CPR. I f you don't know

how, g ive Hands-Only CPR.

P lace a person wi th low body tempe rature near a heat source and p lace co n-

e w a r m i n g ta iners of wa rm , but not hot, wa ter in con tact with the

sk in .

I t is important to

get the person to medical care as soon as possible.

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Step

Act ion

1


2

Help the person take of f contaminated c loth ing and jewel ry .

3

Quickly help the person to a safe ty s h o w e r or eyewash stat ion i f

he responds and can move.

4

B r u s h

off any dry powder or so l id substances f rom the sk in wi th

your g loved hand.

5

R i n s e the contaminated areas with a lot of water for at least 20

minutes or unt i l someone with more tra in ing arr ives and takes over.

F igure 28. Brush off any

dry powder or solid sub

stances from the person's

skin with your gloved hand

If only one eye is af fected make sure the eye with the poison in i t is the lower

eye as you r inse. Make sure you do not r inse the poison into the unaffected eye.

Figure 2 9 . Help the person

wash his eyes and face under

water flowing from a faucet

or hose. Or use an eyewash

station.

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Other First Aid for Poison Emergencies

D e f i n i t i o n s a n d W orksites shou ld have an MS DS (Materia l Safety Data Sheet) for each

c h e m i -

K e y

F a c t s

ca l a t the work s i te . You shou ld know where the MSD S is a t your work s i te . The

MSD S prov ides a descr ip t ion o f how a speci f ic po ison can be harm fu l .

Unfortunately the MSDS usual ly provides l i t t le information about f i rst a id

act ions. Some of the f i rst a id act ions l isted in the MSDS or on the label of the

po ison may be outdated.

You wil l prob ably receive addit ion al t ra in ing on the MS DS during the Rig ht to

Kno w t ra in ing your work p lace prov ides.

A c t i o n s

Step Act ion

1

Make sure the

s c e n e

is

s a f e .

Get the first aid kit. Wear PPE.

2 Send someone to phone your e m e r g e nc y

r e s po n s e

number (or

911).

3

Tell the d ispat cher the nam e of the po i s o n , i f possible.

4 R e m o v e t he po i s o n , i f possible.

5

Move the person from the scene of the poison i f you can.

6 Help the person move to an area with fresh air, i f possible.

7 Send someone to get the Materia l Safety Data Sheet (MSDS), i f

avai lable.

Important

If you give CPR to a poiso ning vic t im , use a ma sk for g iving breaths if pos sible.

This precaut ion is especial ly important i f the poison is on the l ips or mouth.

Some d ispatchers may connect you to a po ison cont ro l center . Give on ly those

ant idotes that the poison control center or d ispatcher te l ls you to. The f irst a id

instruct ions on the poison i tself can be helpful but may be incomplete.

F Y l

W hen you cal l the em ergen cy respo nse number, t ry to have the fo l low ing infor

mat ion ready:

What is the name of the poison? Can you describe i t i f you cannot name it?

How much po ison d id the person touch, b reathe, o r swal low?

Abo ut how o ld is the person? What is the person 's approx ima te w e ight?

When d id the po ison ing happen?

How is the person feel ing or act ing now?

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A.4

4k

Figure

3 0 . Look for symbols

of poison s, such as these,

nearby.

Q ues t i on s :

E n v ir o n m e n t a l


Quest ion

Your Notes

1. Someone who has been b i t ten

by an insect or bee may have

a severe al lergic react ion and

should be watched for at least

minutes.

a. 10

b. 20

c. 30

d .

60

2 . Wh en someon e has a b i te be

sure to wash the bi

First Aid 11

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