Welcome to your: Emergency First Aid Course Your Instructor is: Mr. Tom Gourley Emergency Medical Supplies.
Download ReportTranscript Welcome to your: Emergency First Aid Course Your Instructor is: Mr. Tom Gourley Emergency Medical Supplies.
1 Welcome to your: Emergency First Aid Course Your Instructor is: Mr. Tom Gourley Emergency Medical Supplies 2 Introduction • Trainer Introduction • Course register • Health & Safety – Fire drill etc. • Course Format Areas Covered in this Session 3 • • • • • • • • • Human Anatomy What is first aid Aims of first aid The Responsibilities of the First Aider Delegation / Confidence / Communication Incident / Casualty priorities Multiple casualties Staying Safe during First Aid DANGER Telephone the Emergency Services 999 4 Human Anatomy (remind/revise) 1. Trachea 1 2. Lungs 3. Heart 4. Liver 5. Stomach 2 6. Pancreas 7. Large intestine 8. Small intestine 3 4 7 5 6 8 © 2002 Abertay Nationwide Training Circulatory System 5 Veins Aorta Action of muscles around these thin walled vessels squeezes blood through them, and one-way valves keep it from flowing back towards the heart Largest artery in the body Arteries Strong muscular, elastic walls enable arteries to expand with each surge of blood away from the heart and towards tissues © 2002 Abertay Nationwide Training 6 Circulatory System 7 The Heart Functions of the Blood 8 • • • • • Transportation of gases Nutrition Regulation Protection Excretion 9 Pulse Points Carotid Brachial Radial Femoral © 2002 Abertay Nationwide Training The Respiratory System 10 Tongue Respirtory Centre (Brain) Epiglottis Trachea Lung Bronchioles Diaphragm Alveoli © 2002 Abertay Nationwide Training 11 Define Respiration Respiration is the exchange of gases, oxygen and carbon dioxide, which takes place in the lungs and cells of the body. Take in oxygen Remove carbon dioxide What is First Aid 12 • The treatment given for any injury, or sudden illness before the arrival of an ambulance, doctor or any other qualified person. © 2002 Abertay Nationwide Training The Aims of First Aid 13 • To Preserve life • To Prevent the condition getting worse • To Promote recovery © 2002 Abertay Nationwide Training Responsibilities of First Aider 14 • Incident Management - Assess the situation / get help • Casualty Care - Protect casualty and others from Danger • Assess the casualty • Identify casualty’s injury / Illness • Provide treatment • Arrange transport • Remain with the casualty • Prevent cross infection © 2002 Abertay Nationwide Training Approach and Action 15 • Assess the situation • Telephone for help • Assess any further danger – Can you cope – Do you need assistance • Begin Treatment © 2002 Abertay Nationwide Training 16 Primary Assessment Danger your present environment Responses of your casualty Airway Breathing Circulation Road Traffic Accidents 17 Speed Kills Make the accident site safe © 2002 Abertay Nationwide Training 18 Levels of Response (AVPU) Alert responds appropriately / aware of place / time Verbal responds in some manner to voice Pain responds in some manner to painful stimuli Unresponsive Does not respond to painful stimuli © 2002 Abertay Nationwide Training 19 Airway • Before opening the airway (check) for any obstructions and remove (clear) them if possible • By tilting the head back and lifting the chin forward, the tongue is drawn away (open) from the back of the throat. Suspected Spinal injuries will differ, majority are conscious. • In an unconsciousness casualty the tongue may fall back to block the airway. Airway 20 OPEN AIRWAY © 2002 Abertay Nationwide Training Breathing Rates 21 Average Breathing Rates Adults 12 – 20 times per minute Infants and young children 20 - 30 times per minute © 2002 Abertay Nationwide Training Inspired and Expired Air 22 Inspired Air Other Gases 1% Expired Air © 2002 Abertay Nationwide Training Carbon Dioxide 4% Other Gases 1% Breathing 23 IF ABSENT BREATHE FOR YOUR CASUALTY ! Look, Listen & Feel up to 10seconds © 2002 Abertay Nationwide Training Self Protection 24 ALWAYS WEAR GLOVES When dealing with blood or body fluids © 2002 Abertay Nationwide Training Staying Safe during First Aid 25 • Blood and Bodily Fluid – HIV – Hepatitis B – Always wear protective gloves and goggles when dealing with blood and body fluids • Environmental Hazards – Traffic – Electrical Wires – Gas Leak © 2002 Abertay Nationwide Training Emergency Services 999 26 Always Give the Following Information: Name and telephone number • Give exact location • Type of incident • Seriousness of incident • • • • Number of casualties Condition of casualties Any hazards DON'T HANG UP THE PHONE UNTIL YOU ARE TOLD TO DO SO ! © 2002 Abertay Nationwide Training 27 Multiple Casualties Assess Danger Remove Danger Assess Casualties responses Assess Casualties A.B.C 4 X B’s © 2002 Abertay Nationwide Training Immediate Care Conditions 28 • • • • • Lack of Airway Lack of Breathing Lack of Pulse Suspected Spinal Injury Shock © 2002 Abertay Nationwide Training Life Threatening Conditions 29 • • • • Asphyxia Bleeding Cardiac arrest Shock © 2002 Abertay Nationwide Training Principles of Resuscitation 30 • For life to be sustained,: – A constant supply of oxygen must be maintained and delivered to the brain and other vital organs by circulating the blood. • The “pump” that maintains this circulation: – Is the heart. If the heart stops (cardiac arrest) urgent action must be taken if death is to be prevented. © 2002 Abertay Nationwide Training 31 Lay Rescuer CPR Guidelines • Establish that the casualty is unresponsive – Dial 112/999 ask for cardiac ambulance • Open the Airway – Head tilt/chin lift or, if trauma is suspected, jaw thrust. – Check for normal breathing. – (look, listen, feel) • If normal breathing is absent – Give 2 slow breaths (2 seconds per breath) – Ensure adequate chest rise, and allow exhalation between breaths. 32 Lay Rescuer CPR Guidelines • Check for signs of circulation – Normal breathing, coughing, or movement in response to the 2 breaths – If signs of circulation are present but there is no normal breathing, provide rescue breathing – 1 breath every 6 seconds, about 10 breaths per minute • If no signs of circulation are present, – Begin cycles of 15 chest compressions (about 100 compressions per minute) followed by 2 slow breaths Circulation 33 IF NO PULSE PRESENT COMMENCE CARDIAC MASSAGE ! © 2002 Abertay Nationwide Training Speed is Essential 34 • CPR if Commenced within 3 Minutes of Arrest can Prevent Permanent Brain Damage • Buys Time to Allow Successful Defibrillation by Trained personnel © 2002 Abertay Nationwide Training The Chain of Survival 35 Early Access © 2002 Abertay Nationwide Training Early CPR Early Defibrillation Early Advanced Cardiac Care 36 © 2002 Abertay Nationwide Training Making a Diagnosis 37 Secondary Survey Monitor Vital Signs Breathing Pulse Skin Colour Temperature Level of response Complete Top to Toe Survey Complete Definitive Treatments Top to Toe Survey 38 1. Head 2. Neck 4. Shoulders 3. Chest 6. Abdomen 5. Upper Limbs 7. Pelvis Lower Back 8. Lower Limbs © 2002 Abertay Nationwide Training Sequence of examination. 39 External Clues If casualty is Unconscious Look for Clues © 2002 Abertay Nationwide Training Treatment Priorities 40 • • • • • • • ABC Maintain airway (Recovery position) Bleeding Treat large wounds and burns Immobilise bone and joint injuries Other injuries / Conditions Regularly monitor casualty ABC © 2002 Abertay Nationwide Training Reporting 41 • • • • • • • • • Casualty’s name Casualty’s address History of the incident Description of any injuries Any unusual behavior Treatment given Breathing Pulse Response level © 2002 Abertay Nationwide Training Patient Interview 42 • • • • • • S A M P L E © 2002 Abertay Nationwide Training Symptoms Allergies Medications Past Medical History Last Meal Events Dressings & Bandages: Uses 43 • Dressings – Control bleeding – Reduce infection • Bandages – – – – Direct pressure Securing dressings etc Reduce swelling, support limbs Restrict movement © 2002 Abertay Nationwide Training Rules for Applying Dressings 44 • • • • • • Wear disposable gloves If possible, wash hands Correct size Place pad directly onto wound Avoid touching wound Try not to cough or sneeze © 2002 Abertay Nationwide Training General Rules for Bandaging 45 • • • • Explain and reassure Posture Support Your positioning – – – – Natural hollows Apply bandages firmly Exposure of digits Check circulation © 2002 Abertay Nationwide Training Preventing Cross Infection 46 • Always wash your hands – Before dressing a wound • Wear disposable gloves • Avoid touching the wound • Do not sneeze or cough – When treating a wound • Place soiled dressing in suitable bag – Seal and destroy by incineration © 2002 Abertay Nationwide Training The Choking Casualty 47 Recognition • Cannot Breathe • Cannot Speak • Cannot Cough • May Clutch Throat © 2002 Abertay Nationwide Training 48 Effects of Fume Inhalation Carbon monoxide Vehicle exhausts, chimneys – headache, confusion – aggression, nausea – vomiting, incontinence – dusky skin, red tinge – unconsciousness Carbon dioxide Deep enclosed spaces – Breathlessness – headache – Hypoxia – confusion – unconsciousness Smoke Fires – coughing – swollen air passages – unconsciousness – soot around nose – burns Solvents & Fuels Glues, lighter fluid – headache, vomiting – stupor – unconsciousness – death Treatment for Asthma 49 • Ensure A, B, C • Reassure the patient. • Position patient up-right – Leaning forward. • • • • Ensure a good air supply. Monitor vital signs. Assist with medication. 999? © 2002 Abertay Nationwide Training Medical Assistance for Asthma 50 Seek medical assistance if: • First attack or is severe • Inhaler has no effect after 5-10 minutes • Casualty is getting worse • Breathlessness makes talking difficult • Exhaustion • Unconsciousness – ABC, Resuscitate if necessary © 2002 Abertay Nationwide Training Causes of Shock 51 • • • • • • Blood loss Heart attack Allergic reaction Loss of body fluids Massive infection Damage to spinal nerves © 2002 Abertay Nationwide Training Shock - First Signs 52 RECOGNITION: – (adrenaline causes) • • • • Rapid pulse Pale gray skin Cold clammy skin Sweating © 2002 Abertay Nationwide Training 53 © 2002 Abertay Nationwide Training Treatment for Shock 54 Blood Loss 2-3 pints MODERATE LOSS 2 to 3 pints (20% - 30%) Pulse Skin Colour slightly raised cold and sweaty pale Pupils dilating, but equal Breathing Consciousness History Peripheral Temp. General Condition slightly raised light headed, faint constant observation and monitoring of vital signs to determine medical progress cool becoming unstable 55 Blood Loss over 3 pints SEVERE LOSS over 3 pints (30% and over) Pulse Skin Colour Pupils Breathing Consciousness History Peripheral Temp. General Condition fast, light, thready cold and clammy pale - cyanosed dilated and equal, slow to react to light deep sighing - air hunger apathetic, low pain threshold may become thirsty and suffer from blurred vision cold poor, could prove fatal Causes of Fainting 56 • Temporary reduction of blood flow to the brain • Reaction to pain or fright • Emotional upset • Exhaustion • Lack of food • Long periods of standing © 2002 Abertay Nationwide Training Recognition of Fainting 57 • • • • Brief loss of consciousness Fall to the floor Slow pulse Pallor © 2002 Abertay Nationwide Training Treatment for Fainting 58 • • • • • Raise and support lower limbs Fresh air, open window As they recover reassure casualty Assist casualty to sit up Treat any injuries If unconsciousness persists Call for the ambulance 59 © 2002 Abertay Nationwide Training Anaphylactic Shock Anaphylactic Shock 60 • • • • The name given to a major Allergic reaction within the body; Causes: Specific drugs Stings Ingestion of certain foods (peanuts) Chemical released into the blood stream causing the blood vessels to dilate thus restricting the airway. Severe Allergies 61 • • • • • • • Anxiety Blotchy skin Swelling of face Swelling of neck Puffiness around eyes Breathing difficulties Rapid pulse © 2002 Abertay Nationwide Training Treatment of Severe Allergies 62 • Relieve Breathing • Epi-pen 999 © 2002 Abertay Nationwide Training Heart Attack Treatment 66 Your aims are; • Make casualty comfortable • Phone for ambulance • Monitor vital signs • Reassure • Prepare to resuscitate if necessary © 2002 Abertay Nationwide Training First aid priorities 71 • Control blood loss – Pressure, Elevation • Minimise shock • Protect from infection • Hospital The nature of the wounding force determines the type of wound and influences its treatment. © 2002 Abertay Nationwide Training Types of Bleeding 72 • Arterial • Venous • Capillary Always wear protective gloves and goggles when dealing with blood and body fluids © 2002 Abertay Nationwide Training Wound Types 73 Contusion Laceration Incised Puncture © 2002 Abertay Nationwide Training Bleeding Control 74 Pressure Elevation Shock Infection 999 © 2002 Abertay Nationwide Training Internal Bleeding 75 • • • • • Bruising / Rigid abdomen Tender abdomen Guarding stomach Symptoms of shock Bleeding from orifices © 2002 Abertay Nationwide Training Internal Bleeding 76 • • • • • Lungs Stomach Kidneys Upper / Lower Bowel Fractured base of skull © 2002 Abertay Nationwide Training Treatment - Internal Bleeding 77 • A, B, C • Treat for shock – Elevate lower limbs if possible – Place in the recovery position if patient becomes unconscious – Reassure – Monitor vital signs – Urgent removal to hospital © 2002 Abertay Nationwide Training 78 Scalp & Head Wounds Treatment; • Displace skin flaps (Split wounds) • Apply direct pressure (Sterile dressing, secure) • Lay casualty down slightly raised head & shoulders • Unconscious ABC (Recovery position) Lots of blood, Possible underlying injury 79 Minor Wounds • Minor wounds may need medical help – Dog bite, – Infected – Embedded object etc. • Minor bleeding • Foreign bodies • Bruises HYGIENE Bleeding from Orifices 80 • • • • • • Mouth Ear Nose Anus Urethra Vagina © 2002 Abertay Nationwide Training 81 Various Injuries • Palm wounds • Bleeding varicose veins • Wounds at joint creases Eye Injury 82 • Provide support for the casualty’s head • Give the casualty a sterile dressing to hold on the eye • Arrange removal to hospital © 2002 Abertay Nationwide Training 83 Types of Head Injury All Head Injuries Are Serious; • Wounds to the scalp • Fracture of the skull • Concussion • Cerebral compression 84 © 2002 Abertay Nationwide Training Fractured Skull Recognition of Concussion 85 • • • • Brief or partial loss of consciousness Nausea, Dizziness on recover Memory loss Cerebral Compression 86 • • • • Noisy slow respiration's Slow, full and bounding pulse Flushed face Diminished level of response – going into unconsciousness • Unequal or dilated pupils • Intense headache 87 © 2002 Abertay Nationwide Training Fractured Skull Causes of Unconsciousness 88 F Fainting S Stroke H Heart Attack I Infantile convulsion A Asphyxia P Poison E Epileptic Fit S Shock H Head injury D Diabetes Types of Muscles 89 Voluntary Biceps etc. Tendons Involuntary Operate vital organs Heart etc. © 2002 Abertay Nationwide Training 90 Soft Tissue Injuries Soft Tissue Injuries - Sprains 91 Sprains are injuries due to: • Stretching or tearing ligaments or other tissues at a joint. • Caused by a sudden twist or stretch of a joint beyond it’s normal motion © 2002 Abertay Nationwide Training Soft Tissue Injuries - Sprains 92 • • • • The Symptoms of a Sprain are: Pain on movement Swelling Tenderness Discoluration © 2002 Abertay Nationwide Training Soft Tissue Injuries - Strains 93 • A strain is an injury to a muscle or tendon caused by over-exertion. • In severe cases muscles or tendons are torn and the muscle fibres are stretched. © 2002 Abertay Nationwide Training 94 Soft Tissue Injuries - Strains The Symptoms of a strain are; • Intense pain • Moderate swelling • Painful movement • Difficult movement • Sometimes, discolouration Soft Tissue injuries Treatment (RICER) 95 • Rest the injured part. • Apply Ice or cold compress. – (15-20mins) • Compress the injury. • Elevate the injured part. • Rehabilitate / Recuperation IF IN DOUBT - TREAT AS A FRACTURE ! © 2002 Abertay Nationwide Training 96 Rehabilitation Stop moaning I haven’t started yet… Functions of the Skeleton 97 • • • • Support Movement Protection Produce blood cells © 2002 Abertay Nationwide Training Definition of a Fracture 98 Definition; • A broken or cracked bone CAUSES: TYPES Direct force Open/Closed Indirect force Stable/Unstable Muscular action Greenstick Disease © 2002 Abertay Nationwide Training Simple Fracture 99 Simple: This is a clean break or crack in the bone © 2002 Abertay Nationwide Training Comminuted Fracture 100 Comminuted: This is a type of fracture that produces multiple bone fragments © 2002 Abertay Nationwide Training Green-Stick Fracture 101 Green stick: A split in a young, immature bone. Most common in children © 2002 Abertay Nationwide Training Open Fracture 102 The exposed bone is Vulnerable to contamination Open: In a open fracture, part of the bone breaks through the skin causing bleeding © 2002 Abertay Nationwide Training Wound Closed Fracture 103 Closed: The surrounding skin is unbroken. © 2002 Abertay Nationwide Training Open Fractures 104 • • • • • • • Cover wound, apply dressing Place padding over and around the wound Secure dressing and padding Immobilise injured part 999 Treat casualty for shock N.B. Nothing to eat or drink © 2002 Abertay Nationwide Training Closed Fractures / Dislocations 105 • • • • Support injured part Secure injured part 999 Circulation – (10 minutes) • N.B. Traction in extreme locations © 2002 Abertay Nationwide Training Assessment of Injuries 106 • History: (Ask the casualty what happened) – Violent blow or fall – Snapping sound – Sharp pain • Compare: – One side of the body against another • Visualise: – Try and imagine what happened • X-ray: – Injury may not be obvious © 2002 Abertay Nationwide Training Assessment of injuries 107 Recognition; • Difficulty moving limbs • Pain made worse by movement • Distortion • Coarse grating at bone ends • Shock (Femur, Ribcage, Pelvis) • Shortening, bending or twisting © 2002 Abertay Nationwide Training Dislocations 108 • • • • • • Partial or full displacement of bones at a joint Tears ligaments Associated fracture External wrenching force Violent muscle contraction Do not attempt to replace joint © 2002 Abertay Nationwide Training Injuries to the face and jaw 109 • • • • • Maintain airway Possible spinal injury Possible head injury Reduce swelling Hospital treatment The Human Spine 110 • Spinal Cord – Composed of nerve fibres Cervical 7 • Intervertebral discs – Padding or cushioning Thoracic 12 – Gristle Lumbar 5 4 coccyx (fused) © 2002 Abertay Nationwide Training Sacrum 5 (fused) Spinal Injuries 111 Three things are required; • A high index of suspicion. • Acute observation. • Dexterous and gentle handling. © 2002 Abertay Nationwide Training Spinal Injury 112 Your aims are; • To prevent further injury • Arrange removal to hospital © 2002 Abertay Nationwide Training Treatment of Spinal Injuries 113 • Call for an ambulance. – do not attempt to treat casualty on your own • • • • Support head and neck. Instruct casualty not to move. Reassurance. Do not move casualty unless in extreme danger. IF IN DOUBT TREAT AS A SPINAL INJURY Principles of Lifting 114 • • • • • • • • Assess the Task - Area - Load Bend the knees Broad stable base Back straight (Not necessarily vertical) Firm grip with palm of hand Arms in line with trunk Weight close to center of gravity Turn feet in direction of movement “LIFT WITH THE LEGS” Types and Causes of Burns 115 • • • • • • • Dry Burn Scald Electrical Burn Chemical Burn Radiation Friction Burn Cold Burn • • • • • • • Fire- Domestic appliances Hot liquids - Steam Low and high voltage - Lightning Industrial & Domestic chemicals Sunburn - Exposure to radiation Fast moving belts – Machinery Bare skin contacting ice etc. Burns 116 Superficial Partial Thickness Full Thickness © 2002 Abertay Nationwide Training Treatment of Minor Burns 117 Your Aim Is; • Halt the burning process • Relieve the swelling • Relieve the pain • Minimise risk of infection • Seek medical advice © 2002 Abertay Nationwide Training Treatment of Severe Burns 118 Your Aim Is To Ensure; • Scene safety • A, B, C • Halt the burning process, • Relieve pain • Treat for shock – Resuscitate if necessary – Treat associated injuries – Minimise the risk of infection – Arrange urgent removal to hospital © 2002 Abertay Nationwide Training Heat Exhaustion 119 • Recognition – Wet / sweaty appearance, Fatigue / Pale look – Headaches with possible cramps • Treatment – Remove from offending environment – Fan / cool patient – Provide cool drink – Advise to see doctor or dial 999 if they deteriorate © 2002 Abertay Nationwide Training Heat Stroke 120 • Recognition – – – – Hot dry red skin Rapid Lowered level of consciousness Nausea and/or vomiting Body temperature above 40ºC (104ºF) • Treatment – – – – Remove from offending environment Dial 999 for an Ambulance Cool patient with cold, wet sheets Nothing by mouth Hypothermia 121 General cooling of body Mild Hypothermia – Shivers - Cool body – < 98.6 temperature Severe Hypothermia – No Shivers – Sluggishness – Lowered level of consciousness © 2002 Abertay Nationwide Training Hypothermia 122 • Treatment – Remove from offending environment – Remove wet clothing – Insulate with blanket or covers • Mild – Offer hot drink • Severe – Activate EMS – Provide source of heat © 2002 Abertay Nationwide Training Define Diabetes 123 • A condition in which the body fails to regulate the concentration of sugar in the blood. • Diabetics are prone to two main problems: – – Hypoglycemia Hyperglycemia 124 Signs and Symptoms Hypoglycemia - Low blood glucose Colour Skin Consciousness pale profuse sweating and cold irritable, confused or may be unconscious, fits may be present in later stages Pulse rapid and weak Breathing normal to rapid Onset Treatment sudden, may be minutes sugar 125 Signs and Symptoms Hyperglycemia - high blood glucose Colour flushed Skin dry Consciousness restless, drowsy or lethargic behaviour Pulse rapid and full Breathing deep and sighing, possible sweet smell - acetone Onset gradual, hours to days Treatment insulin Hypoglycaemia - Treatment 126 Conscious Patient; • Establish A, B, C • Help patient to lie or sit down • Give sugary foods, drinks etc. • Advise to See their Doctor © 2002 Abertay Nationwide Training Hypoglycaemia - Treatment 127 Unconscious Patient • Establish A, B, C • Place patient in recovery position • Monitor vital signs • Prevent chilling • Look for other causes • Urgent removal to hospital © 2002 Abertay Nationwide Training Hyperglycaemia - Treatment 128 • • • • • Establish A, B, C Place patient in recovery position Monitor vital signs / Prevent chilling Look for other causes Urgent removal to hospital © 2002 Abertay Nationwide Training Define Epilepsy 129 Definition: • A condition that causes brief disruptions in the normal electrical activity of the brain. © 2002 Abertay Nationwide Training 130 Forms of Epilepsy • Absence Seizures – A minor form of epilepsy – Resembles daydreaming. • Seizures – A major form of epilepsy. – The patient experiences fits with a period of unconsciousness. 131 Risk Assessment Hazard means anything that can cause harm (e.g chemicals, electricity, working from ladders etc). Risk is the chance high or low, that somebody will be harmed by the hazard. • Look for Hazards • Who might be harmed • Evaluate the risk • Record your findings • Review Assessment 132 Risk Assessment Risk Assessments must be suitable and sufficient. You must be able to show that: • A proper check was made • You asked who might be affected • You dealt with all obvious significant hazards, taking into account the number of people who could be involved • The precautions are reasonable, and the remaining risk is low Risk Assessment 133 RISK ASSESSMENT SHEET Company Name……………….Completed by………………..Date…….. Activity Hazards Persons exposed Likelihood Severity Weight Lifting Weights falling onto fatigued body Weight Lifter 1. Most Unlikely 2. Unlikely 3. Likely 4. Most Likely 1. Trivial Injury 2. Slight Injury 3. Serious Injury 4. Major Injury or Death Rating Bands Action Required Rating Bands Action Required 1 & 2 Minimal Risk Maintain Control Measures 6 & 8 Medium Risk Improve Control Measures 3 & 4 Low Risk Review Control Measures 9, 12 & 16 Improve Controls immediately and consider stopping work To establish RISK Rating, multiply LIKELIHOOD by the SEVERITY Risk