Transcript PAEDIATRIC-2013 - First Aid Training Excellence

Paediatric First Aid Course
Introduction to
your course
work book
House Rules
 Mobile phones switched off
 Toilets
 Break times
 Start and finish times
Competence assessment
 CPR practical session
 Incident training
 Certificates
Paediatric First Aid
 Write down in your own words why you have
chosen or asked by your employers to attend
this course.
 From a personal point of view, what would
you like to achieve / learn on the course
What is First Aid?
First Aid is the immediate
assistance or treatment given to
someone injured or suddenly
taken ill before the arrival of a
ambulance, doctor or other
appropriately qualified person
First Aid and the
Law
Acts and Regulations
 Health & Safety at Work Act 1974
 Health & Safety (First Aid) Regulations 1981
 Reporting of Injuries, Diseases & Dangerous
Occurrences Regulations 1995 (RIDDOR)
Risk assessment of First Aid needs
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To consider
Workplace hazards and risks
Size of the organization
History of accidents
Nature & distribution of work force
Remoteness for medical services
Needs of travelling, lone or remote workers
Working on shared or multi-occupied sites
Annual leave and other absences of First Aiders
The Aims of First Aid
 Preserve life
 Prevent the injury from worsening
 Promote recovery
Role and Responsibilities
First Aider must always
 Assess
 Danger
 Prioritise
 Ask
 Treat/Transfer
Managing casualties
P3
Your trainer will now
explain how oxygen
is transferred around
the body
P3
Multiple casualties
 From the following list decide who
needs your attention first.
 Remember you can only deal with one
casualty at a time.
 Please give reasons for your answers.
P3
 Screaming child  Shock
 Nose bleed
 Arterial bleed
 Broken leg
 Asthma attack
 Quiet child on the
floor
 Choking
 Anaphylactic shock
P3
 Quiet child on floor
 Arterial bleed
 Choking
 Nose bleed
 Anaphylactic shock
 Broken leg
 Asthma attack
 Shock
 Screaming child
P3
Triage
Breathing
over
Bleeding
over
Burns
over
Bones
P3
Primary Assessment
D: Danger
R: Response
A: Airway
B: Breathing
C: Circulation
P3
P4
Cardio-Pulmonary
Resuscitation
Adult
Child
Baby
P4
Cardio Pulmonary Resuscitation
Danger
Response
Airway
Breathing
Compressions
P4
P5
Adult
Unresponsive
Shout for help
Open airway
Not breathing normally
Call 999
30 chest compressions
2 rescue breaths
30 compressions
P6
P6
Problems during resuscitation
P9
Hygiene Considerations
During Resuscitation
P9
Paediatric
CPR
Unresponsive
Shout for help
Open Airway
Not breathing normally
5 rescue breaths
30:2
Call 999
(x 3 cycles)
2 Rescue breaths
30 compressions
P10
CPR
Child
 30 compressions : 2 inflations
 3 cycles of 30:2 = 1 minute
 At least a 1/3rd depth of chest
 1 hand
 100 – 120 rate per minute
P10
CPR
Infant
 30 compressions : 2 inflations
 3 cycles of 30:2 = 1 minute
 At least a 1/3rd depth of chest
 2 fingers
 100 – 120 rate per minute
P12
Assessing casualties
Primary assessment
Secondary assessment
Recovery position
A practical session
Secondary Assessment
P14
P14
Unconsciousness
Causes
Fainting
Stroke
Heart attack
Shock
Head injuries
Hypoxia
Poisoning
Epilepsy
Diabetes
P15
The AVPU Code
To check response:
A
Alert
V
Responds to Voice
P
Responds to Pain
U
Unresponsive
P15
The Recovery Position
P15
Choking
P16
Children & babies
Causes of airway obstruction
 Inhalation of vomit
 Foreign object e.g. toy, peanut
 Submersion in water
 Infection of the lungs or throat
 Injuries to the head, neck or chest
 Cot death
P16
 Often stand up very quickly
clutching throat
 Congested face, veins
prominent in face and neck
 Coughing
 Difficulty breathing
 May have been eating
P16
Choking Adult Treatment
Assess severity
Severe airway obstruction
Ineffective cough
Mild airway obstruction
Effective cough
Unconscious
Start CPR
Conscious
5 back blows
5 Abdominal thrusts
Encourage to cough
Monitor for deterioration
 Encourage the casualty to cough
 Up to 5 sharp back slaps
 Up to 5 abdominal thrusts
 Repeat cycle
 Unconscious CPR
Choking Paediatric Treatment
Assess severity
Ineffective cough
Effective cough
Unconscious
Open airway
5 breaths
Start CPR
Conscious
5 back blows
5 thrusts*
* Chest for
infants/abdominal for
child > 1
Continue to check for deterioration
to ineffective cough
or relief of obstruction
P16
 Encourage to cough
 Up to 5 sharp back slaps
 Up to 5 abdominal thrusts
 Unconscious CPR
P16
 Up to 5 sharp back slaps
 Up to 5 chest thrusts
 Unconscious CPR
P17
Obtaining medical assistance
In pairs write a list of
information the 999
operator may ask
you for
Conditions that affect the
breathing
Causes of breathing
problems
Workshop
Make a list of all of the
conditions that could affect
your casualties breathing
Hypoxia
Blockage
Febrile convulsions
Sickle cell anemia
Lack of O²
Poisoning
Compression of chest
Suffocation
Gas/smoke
Paralysis
Electrical injury
Carbon monoxide
Fits
P19
Anaphylactic shock
 Major allergic reaction
 Bee stings
 Peanuts, foods
 Drugs
P19
Anaphylactic shock
Anxiety
Red blotchy skin
Swelling of the face and neck
Puffiness around the eyes
Impaired breathing
A rapid pulse
P19
Anaphylactic shock
Treatment
 Calm and reassure
 Get help
 Help the casualty to sit up if conscious
 Recovery position if unconscious
 Help them to take their Epipen
P19
Asthma
Where the air passages to the lungs go into spasm
causing the lining of the airways to swell.
The casualty then finds it difficult to breathe
Causes of attack
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Pollen / Dust / Cigarette smoke
Allergens such as pet hair
Exercise
P20
Asthma recognition
Difficulty breathing
Wheezing
Distress and anxiety
Difficulty in speaking
Grey blue skin
Dry, tickly cough
May become exhausted
P20
Asthma treatment
 Calm and reassure casualty
 Sit them down, leaning forward supported
 Plenty of fresh air
 Allow him to use medication
 If attack is prolonged or medication does
not relieve attack, seek medical help
P20
P22
P22
Section 7
What sudden illnesses
or conditions can affect
the circulatory system?
P22
Shock
 What is it?
 Causes
P22
Causes of shock
 Severe bleeding
 Loss of body fluids
 Loss of serum
 Severe pain
 Acute heart attack
 Abdominal emergencies
P22
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Shock Recognition
Pale or grey skin
Cold, clammy skin
Feel faint or giddy
Feels sick or may vomit
Feels thirsty
Anxious or restless
Yawn or gasp for air
Rapid, weak pulse
Shallow, rapid breathing
May lose consciousness
P22
Shock Treatment
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Deal with the injury or cause
Lay casualty down, raise legs if possible
Head low and turned to one side
Loosen tight clothing
Moisten lips if thirsty
Keep casualty warm
Transfer to hospital
P22
Incised
Laceration
Puncture
Contusion
Abrasion
Arteries
Veins
Capillaries
P22
Types of bleeding
Arterial
Severe. Bright red oxygenated blood spurts
from wound with each heartbeat
Venous
Dark red. Blood may escape from the body as
quickly as an arterial bleed, may gush
profusely
Capillary
Oozing occurs at the site of all wounds, blood
loss is usually slight
P22
 Pale skin with cold clammy skin
 Rapid weak pulse
 Shallow fast breathing
 Feels sick or may vomit
 Feels cold and thirsty
 Confused/distressed
 Obvious injury
P23
Internal bleeding
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Recognition
Cold, clammy skin
Rapid, weak pulse
Pain
Thirst
Confusion, restlessness
Possible collapse
Pattern bruising
Bleeding from orifices
P23
Treatment of severe bleeding
 Direct pressure
 Elevate the injury
 Apply a sterile dressing
 Transfer to hospital
P23
Practical
Dressings and Bandages
P24
P25
P27
P27
Poisons
A poison is a substance which, if taken
into the body in sufficient quantity, may
cause temporary or permanent damage
P28
Workshop
P28
Poisons
How can a poison enter the body?
Ingested
Inhaled
Instilled
Injected
Absorbed
P28
Poisons
The affects of poisons
 Cause confusion, fits and unconsciousness
 Burn lips, mouth and food passages
 Affect the normal action of the heart
 Cause vomiting & diarrhea
 Damage blood preventing oxygen reaching
the tissues
 Inhaled poisons can cause severe respiratory
distress
P28
P30
P30
Burns and Scalds
Causes
 Friction
 Dry heat
 Electric current
 Acids and alkalis
 Intense cold
 Radiation
 Scalds are caused by moist heat, water, steam
P30
Classification of Burns
Superficial: Redness, swelling, tenderness
Partial thickness: rawness of skin and blisters
Full thickness: scorching, damage to nerves, fat
tissue and muscles
P30
P30
Medical Attention
Must be sought for:
 Full thickness burns
 Burns to face, hands, feet or genital area
 Burns that extend all around a limb
 Partial thickness burns greater than
1% of body surface = palm of casualties hand
P30
Electricity
P31
P31
P31
P31
Fractures
P32
P32
P32
Open Fracture
Fractured ends of the bone
protrude through the skin
P32
Closed Fracture
When the skin is not broken
P32
Complicated Fracture
Leads to further damage and injury
to major organs or blood vessels.
P32
P32
Fractures
Recognition features
 Casualty may hear the bone snap
 Pain
 Tenderness
 Swelling, bruising
 Loss of power
 Grating sound on movement
 Deformity
P32
P32
Bones, Muscles and Joints
Provides support, protects vital
organs and allows movement
Sprains, Strains & Dislocations
 Sprain is an injury to a ligament at a joint
 Strain is an injury to a muscle or tendon
 Dislocation is the dislodging of a bone head
at a ball and socket joint
P33
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Treatment
Rest
Ice
Comfortable Position
Elevation
P33
Disorders of the Brain
P34
P34
The AVPU Code
To check response:
A
Alert
V
Responds to Voice
P
Responds to Pain
U
Unresponsive
Concussion
• History of blow to the head
• Brief or partial loss of
consciousness
• Dizziness or nausea
• Loss of memory
• Mild headache
• Monitor and sent to hospital
P34
Compression
 May be disorientated, confused, unconscious or
weeping
 Progressive loss of consciousness
 Strong pulse
 Weakness or paralysis of mouth, face and one
side of the body
 Flushed face with hot, dry skin
 Pupils unevenly dilated
P34
Treatment
 Monitor and record levels of response
 Calm and reassure
 Ensure privacy
 Carry out the general management
and treatment for unconsciousness
 Arrange for urgent transfer to hospital
P34
Skull fracture
P34
Skull fracture
Could lead to compression
 A wound or bruise to the head
 A soft area or depression of the scalp
 Deterioration in level of response
 Clear fluid or watery blood coming form the
nose or ears
 Blood in white of the eye
 Distortion of the face or head
 Monitor & seek medical attention
P34
Treatment
 Monitor and record levels of response
 Calm and reassure
 Ensure privacy
 Carry out the general management
and treatment for unconsciousness
 Arrange for urgent transfer to hospital
P34
Observation of head injuries
Eyes
Skin
Breathing
Consciousness
Pulse
P35
The Spinal Column
Spinal injuries are
rare in children and
infants but we
should still have an
awareness of the
recognition features
P36
Spinal Injuries
Recognition features
Damage to spinal bones:
 Pain at injury site
 Step or twist in spine
 Tenderness
Damage to the cord:
 Loss of control or one or more limbs
 Abnormal sensations, tingling
 Disorientation or bewilderment
 Difficulty in breathing
P36
How should we manage a
suspected spinal injury?
P36
Spine Cord Injury
Management skills
 Management using two people
 Head tilt and chin lift
P36
 Diabetes
 Affects of heat and cold
 Poisoning
 Foreign bodies
 Electrical injuries
 Bites and stings
 Febrile convulsions
 Sickle cell
 Meningitis
P37
P37
P37
P37
P38
P38
P38
P38
P38
P39
Diabetes
Recognition of Hypoglycemia
 Pallor of skin
 Profuse sweating
 Casualties pulse is rapid
 Breathing is shallow
 Limbs may tremble
 Confused or abnormally aggressive, can be
mistaken for someone who is drunk
 Faintness or unconsciousness
P39
Treatment of Hypoglycemia
Conscious casualty:
Give a sweetened drink with 2 or tablespoons
of sugar, or other sweet substance
 If the casualty improves dramatically ensure
he gets more sugar, as the problem was an
excess of insulin
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Unconscious casualty:
 Place into recovery position
Ensure open airway
Sent to hospital
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P39
Diabetes
Recognition of Hyperglycemia
 Hot red face
 Dry skin
 Acetone smell on the breath
 May be wearing a medic alert bracelet
 May be carrying a testing kit
 Confused or abnormally aggressive, can be
mistaken for someone who is drunk
 Faintness or unconsciousness
P39
Diabetes
Treatment of Hyperglycemia
 Calm and reassure
 Loosen tight clothing
 Advise to seek medical assistance
 Place into recovery position if unconscious
P39
Major epilepsy
Disturbance in the normal electrical activity
of the brain
 May have an “Aura” or warning period
 Sudden loss of consciousness, falls to the floor and
becomes rigid
 Flushed or livid face and neck
 Commences convulsions, may lose control of
bladder or bowel
 Relaxes and becomes unconscious
 Recovers after a few minutes
P40
Treatment
 Try to support or ease the fall of the casualty, lay
him down
 Clear the space around the casualty
 Loosen tight clothing, put something soft under
the head
 DO NOT move, restrain, try to wake or put
anything in the casualties mouth
 When convulsion has finished place into the
recovery position, check for other injuries
 Advise casualty to see a doctor
P40
Effects of heat and cold
Heat exhaustion
Caused by a loss of salt and water from
excessive sweating
Hypothermia
Body temperature falls below 35C
Heat stroke
A failure of the “thermostat” in the brain causes
this condition
P41
P42
P42
P42
How to recognise Heat
Exhaustion
P43
P43
P43
Hypothermia
P44
How to recognise
Hypothermia
P44
P44
The Aftermath
 Report to the HSE
 Record in the accident

book
Replenish first aid
supplies
P47
Accident details
 Name of casualty
 Home address
 Name of person writing the report
 When the accident happened
 Where the accident happened
 What happened
 Treatment given
 Method of disposal
P47
First Aid containers
Workshop
P48
P48
First Aid Containers
Contents
 Disposable gloves
 Guidance card
 20 individually wrapped sterile dressings
 2 sterile eye pads
 4 individually wrapped triangular bandages
 6 safety pins
 6 medium sized individually wrapped sterile dressings
 2 large sized individually wrapped sterile dressings
P48
Question and Answer
Session