Basic First Aid Guidelines and Principles

Terry Slattery, ATC

Instructor/Head Athletic Trainer

Theodore Roosevelt High School

ke_tslattery@kentschools.net

Overview

Emergency Action StepsEmergency Action PlansRecognizing and Responding to an

EmergencyPrevention of Disease TransmissionBasic First Aid Skills

In any emergency or non-emergency situation, always follow the three Emergency Action Steps to help minimize the confusion and provide a structure for appropriate care

Emergency Action Steps

1. CHECK

2. CALL

3. CARE

• CHECK the scene:– Is it safe?

– What happened?

– How many people are involved?

– Is there immediate danger involved?

– Is anyone else available to help?

• CHECK for life-threatening conditions, such as:– Unconsciousness

– No breathing or trouble breathing

– No signs of life (breathing or movement)

– Severe bleeding

Emergency Action Steps - CHECK

CHECK the scene for safety CHECK the ill or injured person

Emergency Action Steps - CALL

• Land Line – Land line:

• Directly to local EMS dispatch

• Displays address to EMS

• Phone location and access

• Know how to access outside line

• Best option to use

• Cell Phone– Cell phone:

• Directly to least busy cell tower

• Answered by State Highway Patrol

• Transferred to local EMS

• Slight delay

CALL 9-1-1 or local emergency number When in doubt….CALL for help!

Calling for help is something anyone can do

Emergency Action Steps - CALL

EMS Dispatch Information1. Location?2. Telephone #?3. Caller’s name?4. What happened?5. How many victims?6. Victim(s) condition?7. Help being given?8. Answer dispatcher questions clearly and

concisely as possible

Notes:• Do not hang up first. Let EMS dispatcher tell you

when or leave phone off hook• Never assume 911 has been called• Assign bystanders clear directions

– AED, First Aid supplies– Meet EMS– Retrieve forms/info– Alert parents, admin, supervisor, etc– Crowd/scene control

Emergency Action Steps - CALL

• When to call 9-1-1 for an Adult (>12-yrs old): Incomplete listing Unconscious Trouble breathing or breathing in a strange way Not breathing No signs of circulation Persistent chest pain Severe bleeding that does not stop Deep burn to face and neck Pressure or pain in the abdomen that does not go away Vomiting blood or passing blood Multiple seizures or seizures that last longer than 5 minutes Possible head, neck or back injuries Apparent poisoning Broken bone with obvious deformity or broken thru skin Sudden severe headache or slurred speech

Emergency Action Steps - CALL

• When to call 9-1-1 for a Child or Infant (<12-yrs old) Sudden silence No breathing Difficulty breathing No signs of circulation Non-responsive to stimuli Upper torso deep burn Apparent poisoning

Call 9-1-1 if Fire or explosion Downed electrical lines Presence of poisonous gas Swiftly moving or rapidly rising water Motor vehicle accidents Persons who cannot be easily moved

Emergency Action Steps - CALL

Emergency Action Steps - CARE Care for the ill or injured person

• Do no further harm…do not move unless absolutely needed Act as a “reasonable, prudent, person” to the best of your

ability or training level• Good Samaritan Law• Obtain consent to help if conscious• Know expectations of your contract vs volunteer

Monitor the “ABCs” – Airway, Breathing and Circulation Protect yourself and others

• Follow universal precautions (gloves,barriers,hand washing, etc.)• OHSA Standards• For copy of OSHA Bloodborne Pathogens Standard (CFR

1910.1030) see link: http://www.osha.gov/SLTC/etools/hospital/hazards/bbp/bbp.html

A little education goes a long way!

Time for a 10 minute break!

CPR or UPS video clip here

Emergency Action Plan (EAP)• Must be structured, yet flexible enough to be easily

followed1. Posted

2. Practiced

3. Practical

• OSHA resources• http://www.osha.gov/SLTC/etools/evacuation/index.html

• http://www.osha.gov/SLTC/etools/evacuation/docs/eap_checklist.pdf

• Examples Roosevelt Athletics (Athletic Health Care)

Theodore Roosevelt High School

Kent City Schools

Transportation Services??

Emergency Action Plan (EAP)

Basic First Aid Skills

Checking an Ill or Injured Person– Conscious vs Unconscious– Adult vs Child or Infant– Head to Toe Assessment– Give Care

Basic First Aid Skills Recognizing and Caring for Shock

• Decrease of oxygenated blood to the vital organs of the body • Signals of Shock

• Restlessness/irritability

• Altered level of consciousness

• Nausea or vomiting

• Rapid breathing and pulse

• Pale or ashen, cool, moist skin

• Excessive thirst

• Care for Shock• 9-1-1

• Elevate legs 8-12” if no head, neck, back injury

• Maintain body temperature

• Do not give anything to eat or drink

Soft Tissue Injuries• Closed Wounds = PRICE = Protection, Rest, Ice, Compression, Elevation

• Contusions = bruise, protect

• Internal bleeding = vomit/pass blood, tender abdomen, EMS

• Open Wounds = Stop bleeding, sterile dressing, bandage, protect• Abrasion = clean, staph/MRSA issues

• Laceration = stitches or not?

• Avulsion = preserve avulsed area and transport with victim

• Puncture = do not remove item, easily infected

Basic First Aid Skills

Bleeding and Wound Care• Use a protective barrier (Universal Precautions)

• To stop/slow external bleeding1. Direct pressure

2. Elevation

3. Pressure point

4. Tourniquet (last resort)

• Wash/irrigate/clean wound if possible

• Cover wound with dressing and bandage

• Refer for proper medical care

Basic First Aid Skills

Burns• Can damage one or more layers of skin, fat, muscle, bone

• 1st degree = superficial, red skin

• 2nd degree = blisters

• 3rd degree = charred, black, deep

• Burn type and tx options • Heat = cool area with cold water, cover loosely with sterile dressing

• Chemical = flush with cool water

• Electrical = turn off power source, cover with sterile dressing, refer

• Radiation (sun) = remove from source, cool, cover lightly

• Lightning• Have a warning plan

• Do not rely on “flash-to-bang” method

Basic First Aid Skills

Bone and Joint Injuries• Fracture

• Obvious deformity = splint/keep in position found in, do not straighten

• No obvious deformity = error on side of caution, movement means nothing

• Open vs. Closed = thru skin or not

• Dislocation = completely out of joint, do not reduce, support

• Subluxation = popped out and then back in, support

• Sprain = stretch of ligament, PRICE, Dr. referral

• Strain = stretch of muscle/tendon, PRICE, Dr. referral

Basic First Aid Skills

Head, Neck and Back Injuries:• Always suspect there is head, neck, back injury

• Numbness or tingling in both arms or legs

• Partial or complete loss of strength and movement

• Care for:• Call EMS

• Do not move

• Stabilize head/neck in position found

• Monitor ABCs

Basic First Aid Skills

Heat-Related Emergencies• Heat Cramps = muscle spasm, dehydration, fluids

• Heat Exhaustion = cool, moist, pale skin, disoriented, electrolytes

• Heat Stroke = red, hot, dry skin, Medical Emergency

Cold-Related Emergencies• Hypothermia = body temp, apathy, weakness, warm body

• Frostbite = freezing of tissue cells, gradual warm, do not rub

Basic First Aid Skills

Sudden Illnesses• Fainting = treat for shock, quick recovery• Diabetic Emergency = hyper/hypo, tx as directed,

glucagon pen, fast absorbing sugar• Seizure = do not resist, protect head, let run course,

slow recovery, EMS if first one or >5 min.• Stroke = F.A.S.T. = Face, Arm, Speech, Time• Poisoning = 800-222-1222, collect bottle/substance• Allergic Reactions = Epi-pen, benydryl, EMS, ice• Asthma = inhaler, EMS

Basic First Aid Skills

Splinting• Splint in position found• Immobilize the joint above and below injury• Check distal circulation

• Anatomic splints = affix to another body part• Soft splints = pillow, folded blanket, sling• Rigid splints = vacuum, air, board, metal

Basic First Aid Skills

Basic First Aid Skills

Cardiopulmonary Resuscitation (CPR)• Function is to sustain circulation to vital organs

• New CPR standards (2006)• Simplified to be less intimidating to learn and/or perform

• No pulse check

• 30:2 compression/ventilation rate for Adult, Child, Infant (15:2 old)

• See chart for specifics

CPR Skill Comparison Chart

Skill Components Adult CPR Child CPR Infant CPR

Hand Position Two hands in center of chest (on lower ½ of

sternum)

One or two hands in center of chest (on lower

½ of sternum) dependant on victim

size

Two or three fingers on lower half of chest (one

finger width below nipple line)

Chest Compression Depth

1 ½” to 2” 1” to 1 ½” ½” to 1”

Breaths

Until the chest rises (full breath)

About 1 second per breath

Until the chest rises (less than full breath) About 1 second per

breath

Until the chest rises (less than full breath) About 1 second per

breath

Compression to Breath Cycle

30 compressions 2 breaths

30 compressions 2 breaths

30 compressions 2 breaths

Rate of Compressions

30 compressions in about 18 seconds

(100 compressions per minute)

30 compressions in about 18 seconds

(100 compressions per minute)

30 compressions in about 18 seconds

(100 compressions per minute)

Automated External Defibrillator (AED)• Device that analyzes the hearts electrical rhythm

• Sudden Cardiac Arrest vs Standard Heart Attack (MI)

• Public access = early defibrillation = > saves• 10% < chance of survival for every minute of not breathing, no circulation

• Precautions• Electrical conductors: water, metal, touch, etc.

• Most pads specific to adults (55 lbs/8 yrs/3rd grade)

• Easy to use• Open lid and follow directions

• Becoming “Expected Standard of Care” in public facilities

• If have AED must have policy/procedure/training protocols

Basic First Aid Skills

Common Sense RulesCheck – Call - Care

Act as a reasonable prudent person to the best of your training level

If conscious and breathing…do not move!

Follow your gut instinct!

Document everything you do!

Call 9-1-1 if any doubt

If you think it is wrong it probably is!