First Aid Unit 9 1. Introduction On your drive home you come upon an accident that has just...

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First AidUnit 9

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Introduction

On your drive home you come upon an accident that has just occurred. Are you legally responsible to stop and help the victims?

If you do provide first aid, can you be sued if the patient is paralyzed or dies?

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Introduction

You started first aid on the victims of the accident. You hear that there are sirens in the distance. Can you leave now because you hear that help is on the way?

One of the victims is bleeding very badly from his leg. He tells you not to touch him because he feels the bleeding is not that bad. You know this is a very serous injury. What do you do?

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Definition

First Aid – immediate care given to a victim of an accident or illness to minimize effect of injury or illness until trained medical professionals can take over Not full & complete treatmentNot limited to physical treatment of victim

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First Aid

Why provide first aid?Difference between life & deathDifference between recovery & permanent

disabilityHelp yourself & others in time of emergency

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Principles of First Aid

Basic Principles of First AidRemain calmAvoid panicEvaluate situation thoroughly (“scene safety”)Treatment you provide will vary depending on

type of injury or illness, environment, equipment and supplies on hand & availability of medical help

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Preparing To Administer First Aid

Recognize that an emergency existsUse senses to assist you

Hearing – screams, calls for help, breaking glass, changes in noises of machinery

Sight – empty medicine containers, damaged electrical wires, a stalled car, smoke, fire, blood

Smell – chemicals, natural gas, pungent fumes, unfamiliar odors

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After determining that emergency exists:Call for medical help immediately (9-1-

1)Time factor is critical Early EMS access increases survival rate

If instructing others to call:Describe situation, location, number of

victims

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After determining that emergency exists:Check scene to make sure it is safe to

approach (fuel spill, chemicals, power lines, fire, etc.)

Hundreds of untrained responders die every year because of their failure to check the scene

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After determining that emergency exists:Survey entire scene

What happenedDangers presentNumber of people involved

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If scene is NOT safe:Do NOT proceedCall for medical help immediatelyInform others in area of hazard

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Administering First Aid

Once you determine scene is safe:Approach victim(s)

Determine if victim is conscious Tap gently, call out to them

If victim is conscious find out what happened and where they are injured

Be brief; Assess orientation to person, place, time and incident (A & O x4)

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A & O x4Person

“What’s your name?” (Introduce self as well.)

Place“Do you know where you are?”

Time“What year is it?” “What day is it?” “What

month is it?”

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A & O x4Incident

“Can you tell me what happened?”

Obtain patient’s permission before touching them or rendering treatment of any kind.

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NEVER move a victim unless:The victim is in a dangerous area such

as an area filled with fire, smoke, flood waters, carbon monoxide, dangerous traffic where vehicles may not see victim

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IF you have to move the victim:Move victim quickly and carefullyNOTE: Victims have been injured more

severely by improper movement, so avoid all unnecessary movement

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If you are alone, make certain you speak to EMS before providing care for:Unconscious adultUnconscious child 8 years old or olderUnconscious infant

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If victim is unconscious, confused, or seriously ill and unable to consent to treatment, and no other relative is present, you can assume that you have permission to render aid.

Patients have the right to refuse care!

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If patient refuses care:Do NOT proceed!If possible have someone witness

refusalIf situation is life threatening, update

EMS immediately

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Triage

Triage: method of prioritizing treatmentIf you have two or more victims, triage

also determines who gets treated first, and who can wait for treatment

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Triage

Always care for life-threatening injuries FIRST!No breathing or difficulty breathingNo pulseSevere bleedingChest painAbdominal painVomiting or passing bloodPoisoning

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Triage

Always care for life-threatening injuries FIRST!Head injuriesNeck or Spinal injuriesOpen chest or abdominal woundsShockSecond or third degree burns

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Triage

If victim is conscious:Provide reassuranceTry to determine what happenedMechanism of injuryExamine the victim thoroughly

Always have a reason for what you doAsk the victim about pain & discomfort

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Triage

Check for other injuries:Broken bonesBurnsShockNote any abnormal signs/symptomsCheck vital signs (pulse/respiration/temp?)Note temperature, color & moistness of skinCheck & compare pupils

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Triage

Check for other injuries:Look for fluids or blood

draining from mouth, nose, or ears

Examine the body for cuts, bruises, swelling & painful areas

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Triage

Report any abnormalities to EMSObtain as much information as possible

(patient may have a change of status)Give information gathered to correct

authorities onlyLook for medical identification bracelets,

necklacesMental picture of surroundings

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Triage

Mental picture of surroundingsDo NOT give patient anything to eat or drink, unless

the situation absolutely warrants it (dehydration, hypoglycemia)

Protect victim from extreme cold or heatDo NOT diagnose victim or make predictions

about their outcomeMaintain confidentiality at all times

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Triage

Mental picture of surroundingsDo NOT touch any of the items unless it is vital to

the care of your victimEmpty medication bottlesAlcoholWeapons (do not touch unless there is a threat)ChemicalsWho is present (potential witnesses or suspects)SCENE SAFETY!

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Triage

Mass Casualty SceneHigh number of victimsYou will not be able to handle this situation on

your own.Call for help immediatelyBegin triage process (different than non-

mass casualty incident)

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Triage

Mass Casualty SceneDone quickly and efficientlyMass casualty triage requires training“Walking wounded”Triage Tag: white, green, yellow, red, black

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Triage

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First Aid Treatment

Bleeding & WoundsOpen or closed wound?Goal is to control bleeding and prevent

infection

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First Aid Treatment

BleedingPPEDirect pressureElevate above heartNever remove bandage

after it has been applied – NEVER

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First Aid Treatment

Types of WoundsAbrasion: skin is scraped off, bleeding is

usually minimalGood chance of infection

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First Aid Treatment

Types of WoundsAbrasion: treatment; clean and cover

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First Aid Treatment

Types of WoundsIncision: cut or injury caused by sharp objectEdges are usually clean, easily infected

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First Aid Treatment

Types of WoundsIncision: Treatment; control bleeding,

determine need for stitches, cover

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First Aid Treatment

Types of WoundsLaceration: tearing of tissue by excessive

force; edges not smooth or even

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First Aid Treatment

Types of WoundsLaceration: treatment, control bleeding,

determine if stitches are needed, cover wound

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First Aid Treatment

Types of WoundsPuncture: caused by sharp object; bleeding

usually is smallGood chance for infection

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First Aid Treatment

Types of WoundsPuncture: treatment; do NOT remove object.

Anchor object in place.

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First Aid Treatment

Types of WoundsAvulsion: tissue is torn or separated from

victim’s bodyBleeding is minimal, chance of infection

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First Aid Treatment

Types of WoundsAvulsion: treatment; control bleeding, clean,

place avulsed skin back, cover

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First Aid Treatment

Types of WoundsAmputation: body part is cut off and

separated from body

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First Aid Treatment

Types of WoundsAmputation: treatment; CONTROL

BLEEDING (tourniquet), retrieve body part, bag it

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First Aid Treatment

Types of WoundsAmputation: NEVER place an amputated

body part directly on ice. Keep body part cold (ice) and moist.

Transport body part with the victim

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First Aid Treatment

Types of WoundsTourniquet: apply tourniquet as last resort!Write time tourniquet was applied on

forehead

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First Aid Treatment

Control BleedingFirst priority in caring for wounds!It is possible for a person to bleed to death in

a short period of timeArterial bleed: spurts blood each time the

heart beats, can result in heavy blood loss; bright red blood; life threatening – must be controlled quickly

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First Aid Treatment

Control BleedingVenous bleed: slower, steadier, darker blood;

easier to controlObserve standard precautions

PPEUse thick layers of dressingsAvoid contact with blood as much as possibleWash hands as soon as possible

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First Aid Treatment

Control BleedingFour methods to control bleeding:

Direct pressureElevationPressure bandagePressure points

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First Aid Treatment


Direct pressureApply pressure directly to the wound using a gloved

(covered) hand and thick gauze (clean cloth)Apply pressure for 5-10 minutesIf blood soaks through ADD dressing to existing oneDo not disturb any formed clots

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First Aid Treatment


ElevationRaise injured part above level of heartContinue to apply direct pressureDo NOT elevate extremity if fracture is suspected

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First Aid Treatment


Pressure bandageDifference between “dressing” & “bandage”Applied to hold dressing in placeCHECK PULSE SITE DISTAL TO THE WOUND

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First Aid Treatment


Pressure pointsUsed when direct pressure,

elevation, and pressure bandage do not stopbleeding

Apply pressure to main artery and press it againstthe underlying bone to cutoff main blood supply

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First Aid Treatment


Pressure pointsTwo main arteries:

BrachialFemoral

When bleeding stopsslowly release pressure

If bleeding starts againrepeat process

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First Aid Treatment

Preventing InfectionCan develop in any woundSigns & Symptoms

SwellingHeatRednessPainFeverPusRed streaks leading from wound

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First Aid Treatment

TetanusBacterial spores are found in soil Can remain infectious for > 40 yearsBacteria affects outermost nerves and moves

inward toward the spineAfter 8 days tetanus short-circuits nerve signals and

block the relaxation of muscles

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First Aid Treatment

Tetanus

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First Aid Treatment

Objects imbedded in wounds:If near surface, gently remove using sterilized

tweezersClosed wounds:

Apply cold compressInternal injuries – can be life-threateningSigns & Symptoms:

Pain, tenderness, swelling, deformity, cold/clammy skin, rapid/weak pulse, hypotension, restlessness, vomiting

Get medical help immediately

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First Aid Treatment

ShockA clinical set of signs and symptoms that are

associated with an inadequate supply of blood to body organs, especially the brain and heart

Causes:

Excessive blood lossExcessive pain InfectionHeart attack or strokePoisoningLack of oxygen

Psychological traumaDehydration from burns, vomiting or diarrhea

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First Aid Treatment

Types of ShockAnaphylactic: allergic reactionCardiogenic: heart attack or cardiac arrestHemorrhagic: blood lossMetabolic: vomiting, diarrhea, electrolyte imbalanceNeurogenic: injury to brain or spinal cordPsychogenic: emotional distressRespiratory: trauma to respiratory systemSeptic: infection that has spread throughout body

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First Aid Treatment

Treatment of ShockReduce or eliminate that which is believed to be the

source of the shockControl bleedingOxygenPain controlEmotional supportRaise lower extremities (about 12 inches) if no fractureIf victim has difficulty breathing, raise shoulders and not

feetIf neck injury suspected – DO NOT MOVE PATIENT

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First Aid Treatment

Treatment of ShockMaintain body temperature

Prevent over heating or over coolingAvoid giving victim anything to eat or drink – use wet cloth

to moisten lips if needed

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First Aid Treatment

PoisoningCan happen at any ageCan occur by:

SwallowingInhalingInjectingContact with skin

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First Aid Treatment

PoisoningIf victim is unconscious:

Check for breathing (respiratory arrest)Call 9-1-1Position victim on their side

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First Aid Treatment

PoisoningIf poison has been swallowed:

Call 9-1-1Call poison control for first aid directions

(800) 222-1222Save container or label for rescuersTry to find out how much poison was swallowedIf victim vomits, save sample

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First Aid Treatment

PoisoningIf poison has been swallowed:

Call 9-1-1Call poison control for first aid directions

(800) 222-1222Save container or label for rescuersTry to find out how much poison was swallowedIf victim vomits, save sample

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First Aid Treatment

PoisoningIf poison has been inhaled:

REMOVE victim from areaCall 9-1-1Check for breathing (respiratory arrest)

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First Aid Treatment

PoisoningIf victim has been poisoned by contact:

Call 9-1-1Wash with LARGE amounts of water for 15-20 minutesRemove victim’s clothing and jewelry that may contain

poisonCall poison control for first aid directions

(800) 222-1222

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First Aid Treatment

PoisoningIf victim has been poisoned by injection:

Call 9-1-1If arm or leg affected, position extremity BELOW the level

of the heartRemove embedded stingers (scrape with card-like object)Do NOT use tweezers!Wash area with soap & waterApply cold pack/dressing

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First Aid Treatment

PoisoningIf victim has been poisoned by injection:

Call 9-1-1If arm or leg affected, position extremity BELOW the level

of the heartRemove embedded stingers (scrape with card-like object)Do NOT use tweezers!Wash area with soap & waterApply cold pack/dressing

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First Aid Treatment

BurnsCan be caused by:

FireHeatChemicals Radiation Electricity

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First Aid Treatment

Burns3 Types:

First degree:Least severeSuperficialEpidermis onlyReddened, discolored skinMild to moderate pain

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First Aid Treatment

Burns3 Types:

Second degree:Partial thicknessEpidermis & DermisBlisterRedness, swelling of skinSevere painSurface of skin can appear wet

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First Aid Treatment

Burns3 Types:

Third degree:Full thicknessMost severe type of burnAll layers of skin involved as well as underlying tissue

(muscle, organs, etc.)White, charred appearanceMay have extreme pain or may little to no pain at all, if

nerves are burnedCan be life-threatening (fluid loss, shock, infection)

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First Aid Treatment

BurnsTreatment:

Remove source of heatCool the skin areaCover the burn with clean (sterile if available) dressingRelieve painObserve for shock

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First Aid Treatment

Heat ExposureElevation of body temperature due to extented

exposure to heat source (example: sun, extreme workout, etc.)

Electrolytes can become imbalancedCan be life threateningWater, salt lost through respiration

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First Aid Treatment

Heat ExposureHeat Cramps:

Muscle pains and spasmsCaused by loss of salt and water through perspirationApply firm pressure to the cramped muscle to provide

reliefHave victim rest in cool areaSips of water or sport drink

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First Aid Treatment

Heat ExposureHeat Exhaustion:

Overexposure to heatMore severe than heat cramps – affect entire bodyVictim loses water and salt through extreme perspirationElectrolyte imbalanceCall 9-1-1Can be life threateningMove patient to cool areaLoosen, remove excessive clothingCool patient down STAT!

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First Aid Treatment

Heat ExposureHeat Exhaustion:

If victim is conscious give sips of waterThis condition can lead to heat stroke if not treated

quickly

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First Aid Treatment

Heat ExposureHeat Stroke:

Prolonged overexposure to high temperaturesTRUE MEDICAL EMERGENCYCall 9-1-1Body retains heat (105 – 106 degrees)Victim is not sweatingDry, hot, red skinRapid pulse (tachycardia)May lose consciousness

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First Aid Treatment

Heat ExposureHeat Stoke:

COOL VICTIM IMMEDIATELYHigh temperature can lead to seizuresCan go into cardiac arrest if not treated quicklyIf available place victim in cool bath tubPlace ice packs under armpits and in groin area, as well

as rest of the bodyObserve/treat shock

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First Aid Treatment

Cold ExposureHypothermia:

Sustained body temperature which is lower than normalNormal oral temperature 98.6 degrees Fahrenheit Move victim to warm area as soon as possibleRemove wet clothing (if applicable)WARM GRADUALLY!!!Warming that is done too quickly can cause irregular

heart rhythm and lower temperature of internal organs

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First Aid Treatment

Cold ExposureFrostbite:

Actual freezing of tissue fluids which damage skin and underlying tissue – can lead to tissue death

Common sites: fingers, toes, ears, nose & cheeksCan actually “burn” tissueImmerse affected body parts in WARM (not hot water)Blisters may form – do not puncture blisters – EVERNeeds medical attention as quickly as possibleObserve/treat for shock

First Aid Unit 9 1. Introduction On your drive home you come upon an accident that has just...

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Transcript of First Aid Unit 9 1. Introduction On your drive home you come upon an accident that has just...