Volunteer Marine Rescue

TDM MF1007B

Volunteer Marine Rescue

TDM MF10 07B

Apply First Aid

Session 1

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Introduction Emergencies Legal Obligations Managing the Scene Patient Care Air Way Management Respiratory Care C.P.R.

Unconsciousness

Please Note

“This is a Hands on Course”

During this first aid course you will be required to perform first aid techniques and procedures on other students.

These procedures will also be practiced on you by other course participants. Eg: bandaging, recovery position etc.

If you are concerned with these, please take this opportunity to discuss your concerns with your course facilitator now.

Obtaining Consent

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You should obtain consent from the individual before assistance is provided.

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It is assault to touch or interfere in any way if consent is not given.

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Consent is deemed not necessary if an individual is unconscious.

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In the case of a minor, obtain consent from parent or guardian.

Duty of care

Australian Law does not impose a duty on all persons to stop and render assistance If you do stop, then you assume a duty of care to act carefully and competently Queensland State Law does impose a duty to those involved in a road traffic crash to stop, render assistance as able and call for medical assistance

The VMR Worksite.

VMR Bases and Vessels are considered under the law to be workplaces and therefore workplace health and safety regulations apply. Mariners and volunteers working on a commercial vessel have a legal obligation and responsibility to comply with workplace health and safety instructions from Unit Management and the Master of the vessel. Legislation requires that VMR workers do not recklessly use or misuse anything provided for their use, and do not willfully risk the health and safety of themselves or others. The volunteer rescuer is there to assist and must protect those being assisted.

Civil Liabilities Act

Clause 39 provides an indemnity to individual volunteers, either engaged in community work for community organisations or as an office holder of such an organisation, from liability in negligence for their own actions. The conduct of the volunteer must be in good faith, and without reckless disregard for the safety of any other person.

AQTF AND ARC GUIDELINES All first aid and resuscitation techniques and assessment processes meet AQTF (Australian Quality Training Framework) and ARC (Australian Resuscitation Council) guidelines .

Emergency Contact

000

Numbers

• • •

Call this number for: Ambulance Fire Police 112 From a mobile or call 000 131261 Call Poisons information centre call

What is first aid?

First Aid is emergency care given to an injured or ill patient before medical assistance arrives.

Aims of First AID

‘s

P RESERVE LIFE P ROTECT THE UNCONSCIOUS P REVENT DETERIORATION P ROMOTE RECOVERY

IMPORTANCE OF REASSURANCE By easing anxiety and pain levels you help promote recovery of the injured patient by:

•

Decreasing the pulse rate

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By decreasing the pulse rate you slow blood loss

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By slowing blood loss you slow the shock process

LEGAL ISSUES

DUTY OF CARE NEGLIGENCE RECORDING CODE OF PRACTICE CONSENT CONFIDENTIALITY

NOTE

Any first aider is not expected to be an expert and a court would consider: •the first aider's level of training, •what a prudent and reasonable person could be expected to do with the same level of training and in the same or similar circumstances

BARRIERS TO ACTION

• Presence of bystanders Are we competent to take over?

• Uncertainty about the victim • Nature of injury/illness Friend v stranger, First Aid means First Aid Some injuries are very unpleasant to see

BARRIERS TO ACTION

• Fear of Disease transmission • Can I catch something here? • Fear of doing something wrong • know • • • (some of us feel we will do the wrong thing some of us feel we may go too far) The worst we can do is nothing.

RESPONSIBILITIES OF THE FIRST AIDER • COMMUNICATION •Needs to be culturally aware, sensitive, respectful (Verbal and non verbal communication is important when handling a casualty)

…..More Responsibilities

• Reporting

• Must be timely, Clear, concise, accurate

• Record Keeping

• Do’s: Use pen not pencil, sign and date, maintain confidentiality • Don'ts: No correction fluid cross out and initial changes

…SELF CARE AS a FIRST AIDER

Debriefing is important Working as a first aider in traumatic affects people differently Seeking feedback from medical personnel about your experience can promote self-improvement and prepare you better for future events

RECOGNISING EMERGENCIES UNUSUAL NOISES Screams, yells, moans, calls for help, breaking glass ,crashing metal, screeching tyres UNUSUAL SMELLS Unusual strong smells, unrecognisable smells, obnoxious smells UNUSUAL SIGHTS Stalled vehicle with door open, overturned saucepan spilled medicine container, broken glass, fallen high-voltage lines UNUSUAL SIGNS AND SYMPTOMS OF BEHAVIOUR Unconscious, difficult breathing, clutching chest or throat, slurred speech, confused, irritability, drowsiness, sweating usually, uncharacteristic colour of skin.

Survey the Scene Are there any Dangers?

Traffic Fire Electricity (fallen power lines) Fuel or Chemical spillage Gas Bad Weather Unstable Structures

ASSESSING THE SITUATION – Safety Management

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DETERMINE PRIORITIES D.R.A.B.C.D.

Multiple Casualties

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UTILISE BY-STANDERS

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CALL FOR HELP Dial 000

GENERAL MANAGEMENT

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D.R.S.A.B.C.D.

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HAEMORAGE CONTROL

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EMOTIONAL SUPPORT

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PAIN RELIEF

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CLIMATE PROTECTION

Risks to the Rescuer

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Environmental Dangers

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Cross Infection:

Take precautions if necessary.

Use ‘barrier devices’ if possible.

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Manual Handling

Follow principles of safe moving and handling. Get assistance if necessary

ACTION AT AN EMERGENCY

Quickly Calmly Correctly

CASUALTY EXAMINATION

Response - C.O.W.S

• C

an you hear me?

• O

pen your eyes

• W

hat’s your name

• S

hake (give them a shake)

MOVING A CASUALTY

•

Before moving the casualty consider

• Whether you can handle the size and weight, without injury to yourself or the casualty • What other help is available • Type and seriousness of injuries • Terrain to be crossed • Distance casualty has to be moved • If travel or motion sickness may make casualty worse

When lifting, remember to:

• Bend at the knees • Keep your back straight and head up • Keep in a balanced position • Keep your centre of gravity low • Hold the weight close to your body for stability • Take small steps • Work as a team - someone must take role of leader

The Ankle Drag The Clothes Drag Moving People ON YOUR OWN Follow principles of safe handling and get help if needed The Arm Drag

Lifting a Casualty - General Management

 Follow DRABCD.

 Manage all injuries and immobilise fractures.

 Tell casualty what you are intending to do.

 Seek casualty’s help and cooperation.

 Make sure casualty feels secure.

 Always use help to lift if it is available.  Hold casualty firmly.

 Avoid risks where possible.

Gathering Patient Information

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HISTORY

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SIGNS

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SYMPTOMS

EXTERNAL CLUES

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CHECK:

Handbag Pockets Briefcase Hospital Cards Medic Alert

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Sight

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Touch

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Smell

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Hearing

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Sensations

PAIN TENDERNESS LOSS OF MOVEMENT LOSS OF SENSATION COLD HEAT NAUSEA WEAKNESS DIZZINESS FAINTNESS LOSS OF CONSCIOUSNESS LOSS OF MEMORY

Check for INJURIES

TOP TO BOTTOM

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HEAD

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NECK & SPINE

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TRUNK

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ARMS

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LEGS

Vital signs

• Pulse • Breathing • Conscious state • Skin state

Normal Pulse

• Adults (60-80 BPM) • Children (80-100 BPM) • Infants (100-160 BPM)

Normal Breathing

• Adults 16-20 breaths per minute • Children minute (1-5 YO) 25-40 breaths per • Children (6-12 YO) 16-25 breaths per minute • Infants (1-12 mths) 25-40 breaths per minute

UNCONSCIOUSNESS

An unconscious patient is one who does not respond to the spoken word.

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There are three levels: Fully conscious (alert).

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semiconscious (can be roused).

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fully unconscious (no response).

• • • • • • • • •

UNCONSCIOUSNESS

Causes: Trauma - Head/spinal Stroke Infections (meningitis) Epilepsy / Seizures Diabetic attack - Insulin I nfant Convulsions Alcohol / Drugs Pretending Uraemia ( renal failure) Combinations of different causes maybe present in an unconscious casualty

CARE FOR AN UNCONSCIOUS PATIENT

• • • Place in recovery position (See below).

• Stop bleeding.

• Loosen all tight clothing.

• Leave in recovery position. Check for injuries.

• Keep patient’s temperature normal.

• Continue to monitor their A.B.C.

DO NOT DO NOT

attempt to give fluids.

leave your patient. Send someone else for help.

Document for your own information and medical aid when it comes all history, signs and symptoms you find.

Be prepared to perform CPR if the patient goes into cardiac arrest (that is not breathing and heart stops beating).

Recovery Position

All unconscious patients must be placed in the recovery position irrespective of their injuries.

This is to ensure their airway is open so oxygen can get to their lungs.

Recovery Position

The first step is to raise the knee nearest to you.

Recovery Position

Place the patients arm nearest to you across their chest.

Extend their other arm away from their body.

Recovery Position

Carefully roll the patient on to their side, bring the head back so that the airway is clear.

Recovery Position

If a patient is pregnant and CPR has to be performed, place a pillow under her right buttock.

Recovery Position

All unconscious women in the late stages of pregnancy must be placed in the recovery position on their left side.

Airway Management

Obstructed Airway

(Note tongue obstructing the airway)

Open Airway Maximum Head Tilt & Jaw Support.

(except for Babies).

Opening the Airway

Jaw Thrust Jaw Support Use Pistol Grip

Opening the Airway Noisy Breathing Always Means a Partially Obstructed Airway.

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Rate per Minute Effort Sounds

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Rate per minute Rhythm Volume

Airway Obstructions

Choking Anatomical • Blocked by Anatomic Structure.

• Tongue • Swelling of the Throat • Laryngeal Spasm Mechanical • Blocked by Foreign Material.

• Food or Vomit • Toy • Fluid • Blood

Airway Obstructions

Choking Choking occurs when the airway is totally or partially blocked by swollen tissues or a foreign body, or when food or other material enters the windpipe instead of the gullet.

Symptoms and signs of choking • • • • • • • Inability to breath, speak, cry or cough.

Noisy breathing or wheezing.

Clutching at the throat.

Red or congested face with bulging neck veins.

Anxiety, restlessness.

Cyanosis (Bluish colouration of the skin).

Collapse and unconsciousness.

Airway Obstructions

If a person cannot breath or cough, urgent care is required.

Choking Quickly assist the victim to lie down.

Use the heel of your hand to give up to five sharp back blows between the shoulder blades.

Airway Obstructions

Choking If the person is still unable to breathe, give up to four recovery chest thrusts in an attempt to expel the object.

Do not apply pressure below the ribs or the abdomen.

Airway Obstructions

Choking An alternative way is to place the person on a chair, their chest resting on the back of the chair.

Give up to five back thrusts to dislodge the object.

Is no improvement commence CPR.

Choking - Finger Probes

Finger probes are used only to remove visible foreign matter Do Not Probe for matter that cannot be seen.

Probing may: • Force the matter further into the airway, or • Cause damage to the inside of the mouth and thus causing severe bleeding.

Oxygen Emergencies

        Suffocation Strangulation Fumes Inhalation Drowning Choking Electrical injuries Asthma Winding

Breathing Emergencies

May be caused by:           Choking Asthma Electrocution Shock Near drowning Heart attack Injury to the chest or lungs Allergic reaction Drugs Poisoning

Asthma

 Assist with prescribed medication and management plan.

 Rest and reassure the person.

 Place the person in a comfortable position.

 Observe the person constantly.

 If medication is not working call an ambulance.

Care for Hyperventilation

• Remain calm.

• Reassure the person.

• Count each breath aloud.

• Encouraged the person to breathe slower.

• The person should visit a doctor or hospital to rule out any underlying problems.

Seizures

When to call an ambulance.

• If it lasts more than a few minutes • Repeated seizures • Injury • The person is pregnant • Person is diabetic • The person is an infant or child • Has no previous history of seizures • Occurs in water • person remains unconscious

Diabetes

Glycaemia Onset: Respiration: Pulse: Skin: Behaviour: Hypo Rapid Normal Normal Pale /Sweaty Hot / Dry Altered Hyper Slow Laboured Rapid Normal

Care for respiratory distress

General care: Emergency action principles Specific care: • Calm the person and reassure • Assist casually into a comfortable position • Assist with relevant medication • Maintain the casualties normal body temperature • Monitor the casualties of vital signs.

Respiratory arrest

The condition in which there is cessation of breathing Key points of respiratory arrest As a consequence of respiratory distress the following may occur: • Unconsciousness • Breathing stops • Heart stops beating • Body systems fail

Cardiac arrest

The condition in which the heart has stopped or is too weak to pump effectively enough to provide a palpable pulse.

 No response  No breathing  No pulse

CPR

(Cardio Pulmonary Resuscitation) EAR (Expired Air Resuscitation) Methods:      Mouth to mouth Mouth to nose Mouth to mouth and nose Mouth to mask Mouth to Stoma Check:      Clear airway Pistol grip Head tilted (not babies) Tight seal Chest rise

CPR

(Cardio Pulmonary Resuscitation) ECC (External Cardiac Compression) Check:        Kneeling position Shoulders over Sternum Elbows straight 50-50 rhythm No jabs No rocking no interruptions

CPR

(Cardio Pulmonary Resuscitation) Mouth to Stoma A person who has had a Laryngectomy must breathe through an opening in the front of their neck called a ‘Stoma’.

They are referred to as total or partial neck breathers.

Stoma

CPR

(Cardio Pulmonary Resuscitation) Mouth to Stoma For a total neck breather support the jaw with the head tilted back to make it easier to seal your mouth over the stoma as shown and in the accompanying illustration.

CPR

(Cardio Pulmonary Resuscitation) Mouth to Stoma For a partial neck breather seal the mouth and that nose to stop air escaping from the mouth or nose as shown in the accompanying illustration.

CPR

(Cardio Pulmonary Resuscitation) Adult One operator Site How Over 8 years of age Lower half of sternum Two hands Depth Ratio Third of chest depth 2 inflations 30 compressions Cycle time Five cycles in two minutes

CPR

(Cardio Pulmonary Resuscitation) Adult One operator Site How Over 8 years of age Lower half of sternum Two hands Depth Ratio Third of chest depth 2 inflations 30 compressions Cycle time Five cycles in two minutes

CPR

(Cardio Pulmonary Resuscitation) Child One operator Site How 1 to 8 years of age Lower half of sternum One hand Depth Ratio Third of chest depth 2 inflations 30 compressions Cycle time Five cycles in two minutes

CPR

(Cardio Pulmonary Resuscitation) Baby One operator Site How Under 1 year of age Lower half of sternum Two fingers Depth Ratio Third of chest depth 2 inflations 30 compressions Cycle time Five cycles in two minutes

CPR

(Cardio Pulmonary Resuscitation)

Regurgitation If patient vomits during CPR:

•Stop CPR.

•Turn Patient into recovery position.

•Clear Airway of vomit.

•Return to supine position •Continue CPR.

Head Injury

(Unconscious Not Breathing)

Removal of Headgear If the firstaider is the only one present and the person with headgear is UNCONSCIOUS and NOT BREATHING , the airway takes precedence over ALL other injuries.

To enable CPR to be carried out, remove the headgear exercising great care not to move the neck unduly.

If a second person is available, one person supports the neck while the headgear is being removed.

DURATION OF C.P.R.

Once commenced, C.P.R. should continue until: • • • • • Spontaneous circulation returns (E.A.R. continues) The patient recovers Trained help relieves you A Medical Officer pronounces life extinct It is physically impossible to continue

Time to Practice

recovery Position Choking CPR