Chapter 9Chapter 9First AidFirst Aid

Considerations for Responding to Injuries and Illnesses

Recognize that an emergency has occurred

Decide to act

Help make decisions in an emergency situation, consider the following: Should I provide care where the victim was found, or

move him or her to the first aid room? Is the safety of the victim or others compromised? Is there a risk of further injury to the victim? Is there a risk of exposing the victim or others to

pathogens (e.g., by leaving a trail of blood or body fluids)?

Should I summon EMS personnel? When should I recommend that the victim see a health

care provider to seekfurther medical treatment?

Secondary Assessment

Take a Brief History

Head-to-Toe Examination for an adult

Toe-to-Head for child

Children get down at eye level, speak slowly and in a friendly manner, use simple words and ask questions that the child can easily understand. Look for signs and symptoms that indicate

changes in LOC

Using SAMPLE to take a Brief History “S”igns or “S”ymptoms: bleeding, skin that is cool and moist,

pain, nausea, headache, and difficulty breathing What happened?, Where do you feel any pain or discomfort? Do you have any

numbness or loss of sensation?

“A ”llergies: Do you have any allergies to medications, food, environmental elements, such as pollen or bees What type of reactions do you usually have?

“M”edications: Do you have any medical conditions or are you taking any medications? Have you taken any medications in the past 12 hours?

Pertinent past “M”edical history: Have you experienced any recent falls, accidents or blows to the head? Have you ever been in any medical, surgical or trauma incidents? Have you recently been ill?

“L”ast oral intake: find out what the victim most recently took in by mouth as well as the volume or dose consumed. This includes food, drinks and medication.

“E”vents leading up to the incident: What the victim was doing before and at the time of the incident.

Checking a Conscious Person

Head-to-examination Tell the victim what you are going to do

Visually inspect victim’s body looking carefully for any bleeding, cutes, bruises, and obvious deformities

Look for medical identification necklace or bracelet

Do NOT ask the victim to move any areas in which he/she has discomfort or pain

Areas to check: The Head: scalp, face, ears, eyes, nose and mouth

for cuts, bumps, bruises, and depressions or changes in consciousness

Skin Appearance and Temperature: coloring face and lips, moist or dry skin

Neck: move from side-to-side, pain, discomfort or inability to move

Shoulders: shrug

Chest and abdomen: difficulty breathing or pain when breathing

Arms: check one at a time, move hand and fingers

Legs: check one at a time, move foot and toes

If victim is unable to move or experiencing dizziness or pain

Help the victim rest in a comfortable position

Keep the victim from getting chilled or overheated

Reassure the victim

Determine whether to summon EMS

Continue to watch for changes in level of consciousness

If any life-threatening conditions develop

when performing the secondary

assessment, stop the assessment and

provide appropriate care immediately!

Sudden Illness Check for a tag “medical information”

Types of sudden illness: A diabetic emergency

Fainting

A seizure

A stroke

An allergic reaction

Signs and symptoms of sudden illness

Changes in (LOC)

Nausea or vomiting

Difficulty speaking or slurred speech

Numbness or weakness

Loss of vision or blurred vision

Changes in breathing; the person may have trouble breathing or may not be breathing normally

Changes in skin color

Sweating

Persistent pressure or pain

Diarrhea

Seizures

Paralysis or inability to move

Severe headache

General care steps for sudden illness

Care for any life-threatening conditions first

Monitor the victim’s condition and watch for changes in LOC

Keep the victim comfortable and reassure him/her

Keep the victim from getting chilled or overheated

Do not give the victim anything to eat or drink unless the victim is fully conscious and is not in shock

Care for any other problems that develop “vomiting”

Diabetic emergency Illness because too much or too little sugar in

blood

If conscious and can safely swallow food or fluids give him/her sugar “preferably in liquid form” Juices or non-diet soft drinks are GREAT

Summon EMS if: Unconscious or loses consciousness

Unable to swallow

Victim does not get better in 5 min after taking sugar

Cannot find sugar to give

Fainting Is not usually harmful, and the person will

usually quickly recover.

Lower the person to the ground or other flat surface and position the person on his/her back.

Do not give the victim anything to eat or drink

Seizures Provide care to person who has a seizure in the

same manner as for any unconscious victim. Protect victim from being injured

Remove any nearby objects that may cause injury

Protect head by placing soft cushion under it

Roll to side if fluid in mouth “vomit, blood, saliva” If in water support victim with his/her head above

water until the seizure ends

Let the seizure to run its course because attempting to restrain the person can cause further injury

Summon EMS for a Seizure when:

Occurs in water

Lasts more than 5 minutes

Multiple seizures no sign of slowing down

Appears to be injured

The person is pregnant

The person is diabetic

Fails to regain consciousness

The person is elderly and may have suffered a stroke

This is the first person’s first seizure

No need to summon EMS if victim has PERODIC seizures

Stroke May have weakness or numbness on one side of the face,

arm, or leg

Difficulty taking or being understood when speaking

Have blurred vision

Experience sudden severe headache

THINK FAST Face: weakness on one side of the face ask to smile

Arm: weakness on one side ask to raise one arm

Speech: Slurred speech or trouble speaking have them repeat a sentence to you

Time: time to summon EMS note the time signs/symptoms began

Wounds Injury to the body’s soft tissue: skin, fat and

muscles

Germs can get into the body through a scrape, cut, puncture or burn and cause infection

Closed wound Occurs beneath the surface of the skin (simplest= contusion)

Internal bleeding may occur when the skin’s surface is NOT broken and damage to soft tissue and blood vessels happens below the surface.

Caring for internal bleeding: summon EMS if: Severe pain or cannot move a body part without pain Force that caused the injury was great enough to cause serious

damage An inured arm or leg is blue or extremely pale Excessive thirst, becomes confused, faint, drowsy or unconscious Vomiting blood or coughing up blood Skin that feels cool or moist, or looks pale or bluish Rapid, weak pulse Tender, swollen, bruised or hard areas of the body , such as

abdomen

Open Wound Break in the skin can be as minor as a scrape of the

surface layers or as severs as a deep penetration

4 main types

1. Abrasion: skin has been rubbed or scraped away (scrape, road rash) clean wound to prevent infection

2. Laceration: cuts bleed freely, and deep cuts can bleed severely can damage nerves, large blood vessels and other soft tissue

3. Avulsion: cut in which a piece of soft tissue or even part of the body, “finger”, is torn loose or torn off entirely

4. Puncture: do not bleed a lot and can easily become infected

External Bleeding

Control any bleeding.

*Place a sterile dressing over the wound.*Apply direct pressure until bleeding stops

Clean the wound thoroughly with soap (if available) and water. If possible, irrigate an abrasion with clean, warm running tap water for about 5 minutes to remove any dirt and debris.

If bleeding continues, use a new sterile dressing and apply more pressure.

After bleeding stops, remove the dressing and apply antibiotic ointment, if one is available, the victim has no known allergies or sensitivities to the medication and local protocols allow you to do so.

Cover the wound with a sterile dressing and bandage (or with an adhesive bandage) to keep the wound moist and prevent drying.

Wash your hands immediately after providing care.

Major wound: external bleeding

Activate the EAP, summon EMS personnel and follow the general procedures for injury or sudden illness on land.

Cover the wound with a sterile gauze dressing and apply direct pressure using the flat part of your fingers. A large wound may require more pressure; use pressure from your full hand with gauze dressings to try to stop the bleeding. For an open fracture, do not apply direct pressure over the broken bones, but instead pack sterile gauze around the area to control bleeding and prevent infection.

If the dressing becomes saturated with blood while you are applying pressure, do not remove it. Instead, place additional dressings over the soaked bandage and reapply direct pressure. Then cover the dressings with a bandage to hold them in place.

Keep the victim warm and position the victim on his or her back.

Care for other conditions, including shock.

Wash your hands immediately after providing care.

ShockNatural body reaction usually means victim’s condition is VERY

serious

Signs/Symptoms

Restless or irritability

Altered LOC

Pale or ashen, cool, moist skin

Nausea or vomiting

Rapid breathing and pulse

Excessive thirst

Minimize the effects by:

Call EMS

Watch for changes in LOC

Control any external bleeding

Keep victim from getting chilled or overheated

Have victim flat on back

Cover victim with blanket

Comfort and reassure the victim

DO NOT GIVE FOOD OR DRINK

Care for wounds Tooth: place in milk do not scrub tooth and touch

only the crown (white part) if no milk place in clean water

Abdomen: remove clothing, do not attempt to put the organs back into abdomen, cover with moist sterile dressing and cover with plastic wrap, place blanket over to keep warm

Nosebleed: lean forward, pinch nostrils for about 10 minutes or until bleeding stops

Severed body parts: wrap bandage wound to prevent infection wrap the severed body parts in sterile gauze, place in plastic bag, put it on ice do NOT freeze it

Continue. . . Scalp injuries: often bleed heavily, put

pressure on the area around wound, if spongy do NOT apply pressure

Embedded Objects: object that remains in the wound keep it there, place sterile dressings around object to keep it from moving

Caring for Burns Stop burning by removing from source

Cool burned area with large amounts of cool, running water

Cover the burned area loosely with sterile dressing

Minimize shock

Comfort and reassure the victim.

Chemical: flush area for about 20 min flush affected eye from the nose outward and downward

Insect Stings See if stinger is still in the skin: if so scrap the stinger

away from the skin with plastic card

Wash the wound

Cover the site and keep it clean

Apply a cold pack to reduce pain and swelling

Watch for allergic reaction

Care for life threatening conditions

Monitor the victim’s conditions look for changes in LOC and keep victim comfortable

Heat and Cold Related injuries

Heat cramps: painful muscle spasms that usually occur in legs and abdomen

Heat exhaustion: body’s cooling system is becoming overwhelmed Cool, moist, pale, flushed skin

Headache, nausea, dizziness

Weakness

Heavy sweating

Heat stroke: body’s system’s are overwhelmed can be life-threatening Red, hot, dry skin

Changes in LOC

vomiting

Cold-Related Emergencies

Hypothermia: victim’s entire body cools because its ability to keep warm fails. Victim will die if care is NOT provided.

Summon EMS Move victim to warm place gently Remove any wet clothing Warm the victim slowly by wrapping ALL exposed

body surfaces especially head (most heat leaves throught the head)

Frostbite: body parts freeze having been exposed to the cold. Never rub area Do not warm areas if it might refreeze Separate toes and fingers with dry, sterile gauze

Injuries to muscles, bones, and joints

Fractures: complete break, a chip or a crack in a bone.

Closed: the skin over the broken bone is intact

Open: There is an open wound in the skin over the fracture

Dislocations: the movement of a bone away from its normal position at a joint

Sprains: tearing of ligaments at a joint

Strains: stretching and tearing of muscles or tendons

Difficult to know which it may be. It is not necessary to know what type of injury because the care is the same!

Care for muscle, bone, and joint injuries

Summon EMS

Support the inured area above and below the site of the injury

Check for circulation and sensation below the injured area

Immobilize and secure the injured area if the victim must be moved and it does not cause further pain or injury

Recheck for circulation and sensation below the injured area

RICE General care for all musculoskeletal injuries

Rest: avoid any movements or activiites that cause pain

Immobilize: stabilze the injured area in the position in which it was found.

Cold: apply ice or a cold pack for periods fo 20 minutes. Repeat if needed

Helps to reduce swelling and eases pain and discomfort

Elevate: above the level of the heart helps slow the flow of blood, helping reduce swelling

Immobilizing Splints: is a tool or device used to immobilize

an injury. Splint the injury in the position in which the

injured area was found.

Splint the injured area and the joints or bones above and below the injury site.

Check for circulation and sensation before and after splinting.

Immobilizing muscle, bone, and joint injuries

Anatomic Splints: The person’s body is the splint. Example: an arm can be splinted to the chest, or an injured leg to the uninjured leg.

Soft Splints: soft materials; folded blanket, towel, pillow or folded triangular bandage can be used to form a splint.

Rigid Splints: Boards, folded magazines or newspapers or metal strips that do not have sharp edges can serve as splints.