Transcript First Aid Essentials: Part One

First Aid Facts: Part One
First Aid for Engineers
August 27th, 2003
Outline
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Airway problems
Breathing problems
Circulation: bleeding and shock
Wounds
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Assessment and treatment
Special considerations
Burns
Facial, ear and eye injuries
Head, neck and spinal injuries
Abdominal and chest trauma
Bone, joint and muscle injury
Respiratory System Anatomy
Respiratory System Physiology
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Breathing allows CO2
to be expelled and O2
to be exchanged into
the blood.
Without an open
Airway breathing
cannot occur.
Air is drawn into the
body by negative
pressure in the pleural
cavity created by
muscular contraction
of the diaphragm
Airway evaluation
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If victim is talking, crying or coughing the
airway is open.
If the victim is unconscious and on their
back then the tongue is most likely blocking
the airway.
Two methods for opening the airway
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Head tilt, chin lift - no suspicion of spinal injury
Jaw thrust – known or suspicion of spinal injury
Chin Lift and Head Tilt
Jaw Thrust
Inspection of Airway
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Open Airway
Look for food or fluid
If no spinal injury then turn
victim to recovery position
If foreign object seen or
spinal injury then finger
sweep
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Wear a glove
Use a cloth to get liquid out
Recovery Position
Check for Breathing
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“can you speak?”
Look - chest movement
Listen – air movement
Feel - air on cheek
Inadequate breathing
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Less than 8 per minute
Blue lips
Increased effort with
breathing
Rescue Breathing
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Place your mouth over the
victims mouth and pinch the
nose closed.
Exhale into the victims mouth
slowly, filling their lungs with
the air from your lungs
Release and let the air come
back out, turn and watch the
chest fall.
Give one breath every 5
seconds in adults
If you are trained, use a
“mouth to device” protective
breathing apparatus
Obstructed Airway
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Will lead to cardiac arrest
Usually food, blood or vomit
Partial airway obstruction
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Cough present
Noises may be heard with respiration
May become blue
Complete obstruction
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Cannot cough, speak or breath
Heimlich Maneuver
If victim becomes unconscious
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Call EMS
Place victim on back and open airway
Look inside mouth – if cannot see
anything do not do a finger sweep
Try to give rescue breaths
If these do not go in reposition the head
and give another breath.
Perform abdominal thrusts
Circulatory System (plumbing)
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Heart (pump)
Arteries (large
outbound pipes)
Capillaries (oxygen
delivery location)
Veins (large drainage
pipes)
Blood (fluid)
Circulatory arrest:
Heart stops pumping
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Causes:
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Arrhythmia – electrocution, heart attack
No oxygen to heart – heart attack,
respiratory arrest (choking, seizure,
allergic reaction)
No blood to pump - Trauma
May respond to CPR
Brain damage occurs in 10 minutes
Bleeding
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Arterial
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Venous
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Pulsating
Rapid
Smoother
Flow
Slow
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External Bleeding
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Internal Bleeding
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Capillary
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Oozing
Obvious
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Bruising
Painful, tender,
rigid abdomen
Broken ribs or
bruised chest
Bloody or black
stools or vomit
Controlling Bleeding
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Wear Personal
Protection Equipment If
Available
Expose the wound to
see where bleeding is
coming from
Three Steps
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Direct Pressure
Elevation
Pressure point
Shock
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Definition
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No O2 to Tissue
Signs and Symptoms
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Change in mental
status
Skin Pale, Cold,
Clammy (low BP)
Nausea and vomiting
Rapid Pulse and Rapid
Breathing
Types of Shock
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Cardiogenic – pump failure
Hypovolemic – loss of fluid
Neurogenic – pipes enlarge, too large
for volume of fluid
Anaphylactic – loss of fluid and
enlarged pipes
Septic – loss of fluid and enlarged
pipes
Treatment of Shock
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Treat the Cause
Position with feet raised 1 foot above heart
Cover with warm blankets
Do not give anything to eat or drink
Reassure the victim
Use EpiPen if Anaphylactic Shock
Wounds - Anatomy of Skin
Types of wounds
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Incision - sharp strait wound
Avulsion – part of skin loose or torn
Puncture – deep, narrow wound
Abrasion – top layer of skin scraped off
Laceration – irregular cut from tearing
Amputation – part of body detached
Burn – partial or full thickness thermal or
chemical injury to skin.
Treatment for wounds
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Wash your hands and don gloves
Expose wound completely
Wash wound with water at medium faucet
flow
Remove debris with sterile tweezers
Cover with sterile gauze and if shallow
wound antibiotic ointment
Keep clean and dry – replace dressing daily
Watch for signs of infection
Wounds that require medical attention
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Bio or chemical hazards involved
Dirty or victim without recent tetanus shot
Arterial bleeding
Into deep subcutaneous fat
Bites
Amputations, Avulsions or Impaled objects
Facial wounds
Infected wounds
Special consideration
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When was your last Tetanus shot?
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If not within last 5-10 years, must have
new shot within 72 hours to prevent
tetanus
There is no cure for tetanus.
Impaled objects
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Never remove the object
Stop bleeding by placing pressure around
the object
Amputations
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Activate EMS
Wrap stump in bulky
dressing
Do not use tourniquet
Find and gently clean part
Wrap part in gauze and
place into plastic bag
Place bag in bag of ice
and transport with victim
Burns
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First Degree
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Second Degree
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Superficial (epidermis)
Heal without intervention
Partial thickness (into dermis)
Larger or sensitive areas require medical attention
Third Degree
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Full thickness (thru dermis into fat or muscle)
Require skin grafting in most cases
Three levels of Burns
Types of Burns
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Thermal
Chemical
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Always require medical
attention
Special consideration
with certain chemicals
Electrical
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Always require medical
attention
Go deep and travel
along the muscles
Assessing % BSA burned – Rule of nines
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Minor Burn
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Moderate Burn
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<50% 1st Degree
<10% 2nd Degree
>50% 1st Degree
10-30% 2nd Degree
<10% 3rd Degree
Severe Burn
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Larger BSA 2nd and 3rd
Degree
All Electrical Burns
Burns to face, hands, feet or
genitals
Most Chemical Burns
Inhalation burns
Treatment of Minor Burns
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Stop the Burn – cool water irrigation
Aloe Vera or other soothing lotion
Keep covered with sterile gauze
Take Aleve or Advil
Watch for signs of infection
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Fever or oozing
Increasing Redness, Swelling and Pain
Treating Moderate to Severe Burns
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Activate EMS
ABCDE’s
Stop the burning
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Remove clothing
Irrigate only smaller burns
Assess Depth (degree)
Assess Extent (% BSA)
Cover Areas with dry bandage damp
bandage can lead to hypothermia
Treat for Shock
Facial Injuries
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Most injuries to the
face requires medical
attention
A bloody nose or black
eye can be treated
with Ice, elevation of
head and gentle
pressure
Go to Babson Health
Center for evaluation
of minor injuries
Activate EMS for more
serious injuries
Eye Injuries
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All Eyeball injuries should be seen by an
ophthalmologist if they result in
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For Corneal injuries or chemical splashes
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Change in vision
Pain
Irrigate eye for 15 minutes
If chemical exposure – transport to nearest hospital
Do not try to remove an impaled object or replace an
explanted eyeball
Bandage both eyes, protect the injured one with a
paper cup, or damp gauze if the eyeball is exposed
Transport to the nearest hospital
Ear injuries
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Seek medical attention for
external ear injury
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High risk of infection
Seek medical attention for
blast injuries resulting in
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Decreased hearing
Blood or fluid coming from
the ear
Dental injuries
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Find missing tooth
Placed rolled up gauze in socket to
control bleeding
Clean tooth and replace into
socket if not too damaged
Place tooth in saliva soaked gauze
if unable to replace
Teeth replaced in < 1 hr. may
survive
Transport victim to Hospital
Head injuries
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Scalp wounds
bleed significantly
Skull fractures
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Painful at site
Unequal pupils
Skull deformity
Blood or fluid from
ears and eyes
Signs and Symptoms of Brain Swelling
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Altered level of
Consciousness
Memory Loss
Nausea and Vomiting
Headache
Unequal pupils or change in
vision
Seizures
Weakness or Paralysis
Leak of Blood or CSF from
ears
Treating head injuries
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Activate EMS
Monitor ABCD’s
Cover wounds with sterile dressing
Assume spine injury - immobilize neck
Apply pressure around to bleeding
scalp wounds
Watch for signs of brain swelling
Anatomy of the Spine
Signs and Symptoms of
Spinal Injury
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Pain with movement
Numbness
Tingling or weakness
Loss of bowel or
bladder control
Paralysis
Loss of strength
Treatment of Spinal Injury
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Seek Immediate medical attention
Do Not Move Victim unless absolutely
necessary
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To monitor ABC’s
To evacuate from immediate Danger
Stabilize before move if possible
Monitor ABCD’s until help arrives
Chest Trauma
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Vital Organs are protected by Ribs and
Sternum
Critical Injury to the chest can affect Airway,
Breathing and Circulation
Do not remove Penetrating objects
Do not lift off crushing object unless
breathing is significantly affected
Bandage and stabilize them for
transportation
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Sucking chest wounds are a special case
Sucking Chest Wounds
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Wounds which go thru the chest wall into lung
Requires Immediate attention to avoid lung collapse
Create “Valve Dressing”
Dressing for sucking Chest Wound
Abdominal Wounds
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Should always be evaluated by
professionals – call EMS
Monitor ABCD’s
Do not give anything to eat or drink
Treat for Shock
If intestines protruding cover with wet,
non-adherent dressing and Saran Wrap
Watch for Vomiting
Anatomy of Skeletal System
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Anatomy
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Bones
Cartilage
Ligaments
Tendons
Muscles
Types of Injuries
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Sprain
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Strain
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muscle
Dislocation
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tendon
Contusion
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ligament
joint
Fracture
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bone
Symptoms of Orthopedic injuries
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Sharp Pain
Swelling
Tenderness to are
Deformity to the
area
Bruising and
stiffness
Weak or poor
function
Treatment for minor injuries - RICE
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Rest – avoid using
Ice – 20 minutes every 2-3 hours
Compression – Wrap to keep swelling down
especially in joint
Elevation - Also to reduce swelling
Fracture/Dislocation Treatment
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Check ABC’s
Activate EMS
Treat for Shock
Look and feel extremity for CSM
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Circulation – pulses
Sensation
Movement
Stabilize across joint if need to move victim
Use RICE until help arrives
Practical Skills Exercise:
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Patient Assessment / SAMPLE history
/ Pressure Points
Bandages and Splints
Carries and Spinal Immobilization
Airway and Breathing
Review
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Gross Pictures to Follow
Grossest are “moulage” – not real
Please feel free to close yours eyes
What type of injury is this?
What would you do for it?
What type of injury is this?
What would you do for it?
What type of injury is this?
What would you do for it?
What type of injury is this?
What would you do for it?
What type of injury is this?
What would you do for it?
What type is this? What do you do for this?