PAEDIATRIC-2013 - First Aid Training Excellence
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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
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
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
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
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
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
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
Unconscious casualty:
Place into recovery position
Ensure open airway
Sent to hospital
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