Transcript Basic First Aid - Salesianum School

Basic First Aid
What is First Aid?
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Webster’s says: “Emergency treatment
for injury etc, before regular medical
care is available”
– Tends to relate best to injuries rather than illness
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What does this mean for us?
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Why should people know First Aid?
Basic Life Support / CPR
A Critical Partner to
First Aid Training
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CPR Skills
– Adult CPR
– Choking skills
– Child and Infant
– Automated External Defibrillator
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Words to Live By…
If you remember NOTHING else:
– SAFETY
AM I SAFE?
 IS MY PATIENT SAFE?
 Are Bystanders/other rescuers safe?!
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– KNOW WHEN YOU ARE IN OVER YOUR
HEAD
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Assessment In Action…
In a nut shell!
Recognize the Emergency
 Decide whether to Help
– NOTE! You have not “entered” the scene
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yet!
Scene Safety
 Call EMS if needed
– Still haven’t touched the victim/patient yet!
 Assess the Victim
– OK now you can touch them!
 Provide Care
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Recognizing the Emergency
One of the largest barriers to lending aid…
 Some Obvious
– Smashed guardrail, broken glass, tire marks
 Some well hidden
– Sleeping on the beach
– Someone ‘Acting Strange’
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Why should I help?
Good Samaritan Act
– Protection from law suits for rendering aid
 Duty to Respond for Work
– Office Response Team
 Ethical
– If not you, then who?
– What if it was Grandma?
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NOTE: No one can FORCE you to render aid when your
safety is at risk!!! There may be circumstances when you
should NOT render aid!
When NOT to Help!
Unable to access victims
 Your safety is at risk
– Risk of fire, explosion
 You have kids in the car!
 You are ‘medicated’ or otherwise
impaired
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The list goes on…
SAFETY
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Roadways
Power Lines
Poisons /Chemicals
Fire Explosion
Other People
“Mechanism”
Number of injured
Hazards
Remember! You are NO good to anyone if
you become injured while trying to render
aid!
Infection Control
When to call 911- The Short List
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Unconscious or Less than Fully Conscious
Trouble Breathing
– Includes asthma, allergic reactions
Chest Pain, Signs of Stroke or other Medical
Emergencies
When you cannot safety transport the
injured
– Able to wear seatbelt
– Able to stand and get self into a car
Bleeding you cannot control
When you’re in over your head!
– Can always get a second opinion!
How to Call 911
From Campus
 From “The Real Word”
 From a Cell Phone
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Information Desired By Dispatchers
– Type of emergency and specific location
– Number of victims/patients
– Any threats to responders (ie fire, blocked
roads)
– Any care given, and any trained rescuers
– Your name and call back number
Emergency Medical Services:
The Players…
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First Responder
– Often Police / Law Enforcement Officers and Fire
Fighters
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EMT
– Many Firefighters are becoming EMT certified
– Minimal training level to operate an ambulance
– Trained to handle any emergency at a basic level
Paramedic
– Advanced Care Provider
– Medications, IV’s, Advanced Procedures
How long till help arrives?
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Typical Urban Response
– First Responder and Advanced Paramedic Ambulance
arrival on scene in under 6 minutes
– Typically a full time response service
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Typical Suburban Response
– First Responder arrival within 6-8 minutes
– Ambulance arrival under 12 minutes
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Typical “Rural” Response
– Varies greatly by geography
– Often First Responders within 10-12 mins
– Often ambulance is greater than 15-20 minutes
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Maybe as long as 60 minutes and up!
To move or not to move…
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Common sense is needed here…
Minor injuries, the patient will
make this decision for you.
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More serious cases:
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There may be cases where an
immediate danger exists to the
victim of serious accident or
injuries.
Other than these immediate life
threats, victims should not be
moved except by EMS
– (We’ll cover back woods stuff later)
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Spinal injury
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Special Care:
– When spinal cord / neck
injury is suspected:
– Stabilize the neck
manually
– This rescuer is now
engaged and must stay
with this patient.
– Consider some form of
mechanical stabilization
(i.e. shoes, sandbag)
– These are the cases we
do not want to move!
Significant Mechanisms of Injury
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Falls (2-3x victim’s height)
Vehicle collisions involving:
– ejection
– roll-over
– high speed
– pedestrian
– motorcycle
– bicycle
Unresponsive or altered mental status
Penetrations (head, chest, abdomen)
When moving is necessary-
Rescue Drag
When dragging patient headfirst, head
can tilt and twist
 Attempt to stabilize as best as possible
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– Consider a feet first drag in a straight line.
– If a turn is necessary, make it a gradual
turn
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Any move endangers a neck injury and
may threaten the victim’s airway
The Assessment
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serious injured victims:
– Ensure ABC learned in CPR
– Focus on open airway
 For
Minor to Moderate Injuries
– Have the victim assist in
exposing the injury and
investigate
– WEAR GLOVES!!
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SHOCK
Shock affects are
major functions of
the body
loss of blood flow
to the tissues and
organs
Shock must be treated for in
all accident cases
Cuts and Bleeding
Common Sense
 Most common form of First Aid needed!
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Control Bleeding
2. Evaluate for Further care
1.
•Minor
•Major
•Clean Wound
•Control Bleeding
•Antibiotic
Cream/Bandage
•Bandage
•Monitor for infection
•Transport Safely to ER
Bleeding
Types
– Arterial
– Venous
– Capilary
 Treatment:
– Direct Pressure
– Elevation
– Pressure Point
– Ice
– Back Woods: Tourniquet
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Cleaning Wounds
Shallow wounds
1. Wash inside with
soap & water
2. Irrigate with
pressurized water
3. Apply antibiotic
ointment
4. Cover with
sterile dressing
High risk wounds
1. Seek medical care
for cleaning
2. Remote location - clean
as best you can
Physician Care Needed?
Clean high risk wounds
 Close open wounds
– 1. Cosmetic, wide, gaping,
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underlying structure injured
– 2. Closure times =
 extremities
within 6 hours
 head & trunk within 24 hours
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Tetanus booster needed?
Does it need stitches?
 General
Guide for Stitches:
– Joints or flexing areas
– Cosmetic: Face or areas where
patient appearance is of concern
– Wounds larger than 2cm (1/2
inch) and of significant depth
To Stitch or not to stitch?
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YES
– FACE
– Deep jagged
cut
– Near Eye
To Stitch or not to Stitch…
Maybe?!
 Shallow
– No cosmetic
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concern
– Limited flex
– Moderate-Minor
infection risk
Scrape/cut on forearm
Burns
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Time to be concerned:
– Size: 1° burns larger than twice the size of the
patient’s hand or 2° burns (or worse) ≥ the size of the
patient’s hand
– Type: Chemical, Steam Electrical should all be
evaluated immediately.
– Location: Face/lungs, Chest, Circumferential
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Treatment
– Cool the Burn!
– No ointments, goops, butter or lotions!
– Treat small burns like other wounds- antibiotic cream
after wound has been cooled
– Any burn meeting the above criteria should be
evaluated in ER
Infection
Minor wounds can become major
problems!
 Signs of Infection:
– Redness
– Swelling
– Heat
– Puss or oozing
– Red Streaks
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Sprains Strains and Automobiles…
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2nd Most frequently used First Aid Skill!
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Can you tell if an injury is a broken
bone or a sprain?
HEARTSAVER FACTS
Fracture: Closed Lower Leg (an easy call!)
FIRST AID
Sprains Strains and Automobiles
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Often minimal outward signs to tell if a
broken bone exists.
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Safest Treatment is to immobilize, and
safely transport to medical facility for
further evaluation.
Splinting
Any device, manufactured or improvised
that limits (or eliminates!) movement
above and below the injured sight.
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Two rules to splinting:
– Keep it simple
– Keep it simple
Serious Injuries
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Suspected thigh fracture
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Suspected
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Head injuries
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Multiple injuries
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Loss of Consciousness
– Behaving oddly
– Sleepy, unable to keep self awake
Serious Cases
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Trouble Breathing
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Diabetes
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Seizure
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Allergic Reactions
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Poisoning
Heat Illnesses
Heat stroke
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Extremely hot skin
Altered mental status
Heat exhaustion
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Profuse sweating
Flu-like symptoms
Types of Hypothermia
Mild
(above 90° F)
• shivering
• cold abdomen
Severe
(below 90° F)
• no shivering
• rigid muscles
• altered mental status
Frostbitten Ear
Frostbite: 2nd Degree
Back Woods First Aid…
Blisters
 Ticks
 Poison Ivy
 Transporting the Injured
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Blisters
Over use / rubbing injury
 Why NOT to break blister?
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Moleskin!
Or other padding…
 Treatment can begin prior to full blown
blister
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Poison Ivy Blister
Poison Oak Dermatitis and Blister
Tick
FIRST AID
HEARTSAVER FACTS
Tick: Engorged and Embedded
Delayed EMS Response
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What happens when you are waayyy up
north?
– To Move or not to move decisions
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How the heck are we gonna get this person out
of here!
Risk-Benefit Equation
– Likelihood of Risk X Harm
After the emergency…
Wash your hands!
 Follow up care or monitor the injury
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Talk about it!
– It’s good to talk about stressful
experiences!
– RNs, MDs, EMTs- talk with someone who
knows what it’s like
– Talk with someone who will listen
The First Aid Kit
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Keep it Simple!
– Few Bandaids
– Short roll of tape
– Gauze pads
– Roller bandage
– Ace Wrap
– GLOVES
– Ice Pack
First Aid Kits
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Simple kits available for ~$10
– Pro: simple, comes with case, one stop and
done
– Con: often get poor quality supplies
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Fancy Day Trip to Month long excursion
kits available
– Pro: One stop and done
– Con: Definitely comes with TONS of stuff
you’ll never need