Transcript Document

Cycle First Aid
by Steve Evans SRPara MCPara
Liverpool Century RC Member
Cycle First Aid
Cycle First Aid
Aims of First Aid
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Preserve Life
Prevent Condition Worsening
Promote Recovery
Send for Help Early 999 or 112
Systematic Approach
C - Care – Be aware of danger to
yourself “A dead rescuer is no good
to anybody” and to the casualty and
others
• Moving traffic
• Blind Bends
• Spilt fuel
• Create a NO smoking area
Systematic Approach
C - Care
R - Reconnaissance – You need to know
how many Casualties there are, for
each unconscious / seriously injured
casualty you need an Ambulance ( 3 on
the floor = 3 Ambulances )
Systematic Approach
C–
R–
Inform – Dial 999 or 112 for the
Ambulance Service or other
Emergency Services if there is spilt
fuel, threat of fire, trapped
casualties, dangers to others
Systematic Approach
C –
R –
I –
Treat the casualties according to their
needs remember your Priorities
Catastrophic bleed, Airway, Breathing
• Do NOT Move the Casualty unless their
life is threatened
Common Injuries
 Head on - Head and Face, Potential Neck –
check the damage to the cars windscreen,
Chest or Abdominal, fractures to thigh
bone, (handle bars) hand / thumb
 Side impact - Traumatic amputation of
lower leg or fractures / dislocated ankle
 FOOSH - Fractured Clavicle/Shoulder,
broken wrist/forearm
 Over Half of Cyclist who end up in hospital
have Head injuries,50% Arm, 40% Leg,
5% Chest/abdomen.
 Road Rash
Common Injuries
Consider the Damage
Look at the potential for
injuries,internal and external
Priorities
• Catastrophic (life Threatening ) Bleed
• Airway – clear if blocked or open if not
breathing, being aware of potential Neck
Injury, Cover open chest wounds
• Cervical Awareness – DO NOT Remove
Helmet unless life is threatened
• Breathing – if No then start resuscitation
The No 1 Cause of Death
• The No 1 Cause of Death in Trauma is
a blocked Airway
• When Unconscious the tongue drops
to the back of the Casualty’s throat
blocking their airway
• This is preventable by performing a
Jaw Thrust or Chin Lift
Tongue Blocking Airway
Jaw Thrust
Criteria for Helmet Removal
• A Blocked Airway that cannot be
cleared in any other way
• The Casualty's Chest or Abdomen is
not rising and falling (Not Breathing)
• The need for Resuscitation
• Remember that it takes 2 Persons to
remove a Helmet safely
Control Of Haemorrhage
Wound Types
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Contusion (bruise)
Laceration – tearing of the tissue
Incision – clean cut with sharp knife
Puncture – penetrating wound
Graze / abrasion – Road Rash
Road Rash
Road Rash
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These injuries look and feel painful
Look beyond the gore
Are there underlying injuries
Fractures
Internal Injuries/bleeding
Head Injuries
Road Rash Treatment
Check for Underlying Injuries
Wash out Dirt and Grit
Cover with Clean dressing
Needs scrubbing within a medical centre to
prevent scaring and promote healing
 Moist dressings help the healing process
 Check for Infection later on,i.e. redness,
hot to touch, swelling in Armpit or Groin
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Body’s Reaction to Bleeding
The body reacts three ways to control
bleeding
Blood clots
Ends of vessels contract
Blood pressure falls
Blood Loss
P - Posture / Position
E - Expose / Examine
Foreign Objects
Splinter from the Velodrome
track
Blood Loss
P - Posture / Position
E - Expose / Examine
E - Elevate
P - Pressure
Pressure Points
 Brachial – Upper arm, underneath
the bicep muscle pressing against
the upper arm bone
Pressure Points
Pressure Points
 Brachial – Upper arm, underneath
the bicep muscle pressing against
the upper arm bone
 Femoral – upper 3rd of the groin
pressing the femoral artery against
the rim of the pelvis this will take
2 thumbs
Pressure Points
 Brachial – Upper arm, underneath the
bicep muscle pressing against the upper
arm bone
 Femoral – upper 3rd of the groin pressing
the femoral artery against the rim of
the pelvis this will take 2 thumbs
 Apply for Max 10 mins then release for
1 minute to flush the build up of toxins
then re-apply if required
Shock Signs & Symptoms
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Pale, cool, clammy skin
Ashen, cyanosed skin
Fast weak pulse
Rapid shallow breathing
Nausea
Feeling faint – lower level of
consciousness
Shock-The Falling Lift
 Early – Disorientated / Confused
 Compensates by – Fast Pulse
- Rapid Breathing
- Pale cool Clammy Skin
 Feels Faint
 Late Sign – Cyanosed
 Late Sign - Unconsciousness
Shock - Treatment
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Treat the possible cause
Loosen tight clothing
Rest – comfortable position
Reassurance – Nil by Mouth
Consider raising the legs – Not in
Cardiac cases
Head Injuries
 Laceration to scalp
 Concussion – shaking of the brain
 Compression – Bleeding in skull
 Skull fracture – cranium / base
Levels of Consciousness
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Alert and responsive
Verbal - Responding to speech
Pain - Responding to pain
Unresponsive -No response
These are most important when dealing with
severe head injuries
Compression Head Injury
Compression Head Injury
 Bleeding within the Skull compressing the
brain
 Loss of Consciousness
 Unequal Pupils
 Flushed face
 Slow full bounding pulse
 Vomiting
 TREATMENT = 999 Ambulance
 Be Neck Injury Aware
Concussion
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Shaking of the brain
Loss of Consciousness – amnesia
Vomiting
Headache/dizziness = Hospital
Broken helmet = more serious
Treatment, Monitor the Patient for
changes, take to hospital if concerned
Head Injury Treatment
 Gain history
 Monitor AVPU, Breathing,
pulse
 Dress any wounds
 If Unconscious A.B.C.
Functions of the Skeleton
 Gives shape and support
 Protects internal organs
 Along side major bones are major
blood vessels / nerves for protection
Classifications of Fractures
 Closed – the bone is fractured but
there is no external wound
 Open – there is an external wound
leading to the site of the fracture.
The bone may be protruding
 Complicated – the ends of the bones
have damaged underlying organs
Hand Injuries
FOOSH-Arm Injuries
Broken Collar Bone
Broken Collar Bone
Complications of Collar Bone
injury
• Damage to Underlying OrgansPunctured Lung causing difficulty in
breathing
• Damage to blood vessels- Arteries
and veins leading to blood loss
• Damage to nerves- loss of movement
or sensation
Signs and Symptoms of Collar
Bone Injury
• Pain over the area of the break
• A bump may be felt or a step seen
• A reddish-purple bruise starts to
appear
• The shoulder appears to sag or drop
• Inability to raise the arm due to pain
• People report a popping or snapping
sound
Treatment of Collar Bone
Injury
• Look for Underlying problems,
breathing or massive swelling
• Apply a sling or at least support the
injured side
• Treat for shock
• Give pain relief if available
• Send to hospital for an X-Ray
• Do not allow to ride any further
Leg Injuries
Signs & Symptoms of a fracture
 Swelling
 Loss of
movement
 Irregularity
 Pain
 Deformity
 Unnatural
movement
 Crepitus
 Tenderness
 Shock
Fractures - Treatment
 Upper limbs – support in a
comfortable position
 Lower limbs – do NOT move unless
life is threatened
 Lower limbs – do NOT attempt to
straighten limbs
 Treat for Shock
Strains & Sprains
 Strain – history of over stretching
- sudden sharp pain
- swelling possible cramps
 Sprain – history of twisting a joint
- pain at joint
- swelling possible discolouration
Strains & Sprains Treatment
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Treatment for both
R.I.C.E.
Rest
Ice – bag of frozen peas in a cloth
Compress – not to tight
Elevate – to the height of a stool
Spinal Injuries
The Spine
Spinal Injuries
Spinal Injuries - Causes
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Sports accidents
Road Traffic Collisions
Falls
Vertical Deceleration Injury
Diving Accidents
Head injuries
Direct force injuries
Spinal Injuries – Signs & Symptoms
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History is Vital
May be no obvious signs of injury
Lack of sensation
Pins & Needles
Inability to move limbs
Back or Neck pain
No symptoms present – damage yet to be
done
Spinal Injuries - Treatment
If you suspect a spinal injury
 The Casualty must Not be moved unless
their life is threatened
 Keep the head still – Trauma Head hold
 Do not allow others to interfere
 Remember – there is no second chance
Trauma Head Hold
Spinal Injuries
 If there is Vomit or blood in the Casualty’s
airway and it cannot be cleared. Then there
is need for a Log Roll to be performed
 Log Rolls can only be performed safely with
4 persons, one to hold the head and control
the rest of the group, there is a need to
work as a team and roll the Casualty on to
their side as one unit (Log)
Cardio Pulmonary
Resuscitation
Priorities for CPR
DRSABC-
Danger
Response
Stop Life Threatening Bleeding
Airway - be Neck Injury Aware
Breathing NO dial 999
Compressions / Rescue Breaths
(1 person to hold the head)
Trauma Head Hold
Hand Position - Adult
Adult Basic Life Support
Notes
The determinant for starting CPR is now a patient who
is “Not breathing normally”. This indicates agonal or
cheyne-stokes breathing where the heart has already
Stopped. Agonal breathing is characterised by
respiratory effort in short gasps, with absences in
breathing up to 15-30 seconds in-between gasps.
There is no longer an initial 2 ventilations. Once a
decision to commence has been made, the rescuer
starts with 30 compressions.
There are no longer any pulse or circulation checks
once CPR has started. The determinant for stopping
resuscitation is a patient who is “Breathing normally”.
The rescuer has the option to perform compressiononly CPR, at a rate of 100 compressions per minute.
This is where the need for mouth-to-mouth would
previously have prevented people from doing anything.
Effectiveness of Rescuer
CPR
Number of
Compressions
Approved
Compressions
1 min
81.5
92.9%
2 min
80.2
67.2%
3 min
80.6
39.2%
4 min
84.3
31.3%
5 min
77.4
18.0%
Hightower D: Annals of Emergency. Medic. (1995) Sept 26:3
ICE in your Mobile
• It is recommended that you place In
Case of Emergency (ICE) in your
contacts within your Mobile phone
• It is good practice as Emergency
workers like Doctors , Nurses and
Paramedic will be able to contact your
family if you are Unconscious or Badly
injured
• Place Name, Number and relationship
Really Bad Cycling Injury
Helmet Hair
Cycle First Aid
by Steve Evans SRPara MCPara
Liverpool Century RC Member