Emergency Aid IEmergency Aid I

• ResuscitationResuscitation– Adult CPRAdult CPR

• First AidFirst Aid– Primary SurveyPrimary Survey– Secondary SurveySecondary Survey– Recovery positionRecovery position– Summoning helpSummoning help– Dressings & SlingsDressings & Slings– Clearing upClearing up

• ScenarioScenario– Putting theory into Putting theory into

practicepractice

Plan of actionPlan of action

• 8 hours training (approx.)8 hours training (approx.)– 3 x 2 hours3 x 2 hours

• 1 hour CPR1 hour CPR

• 1 hour first aid1 hour first aid

– 1 x 2 hours1 x 2 hours• Revision & scenariosRevision & scenarios

• ExamExam

What is First Aid?What is First Aid?

• Preserve LifePreserve Life– Don’t forget yours!!Don’t forget yours!!

• Prevent Prevent deteriorationdeterioration– Treat the obviousTreat the obvious

• Promote recoveryPromote recovery– Treat the less Treat the less

obviousobvious

Primary SurveyPrimary Survey

• Check for DangerCheck for Danger• To yourself, your patient and everyone To yourself, your patient and everyone

elseelse

• Check ResponsesCheck Responses• Shake & shout Shake & shout

• Shout for ‘help’Shout for ‘help’• Open AirwayOpen Airway

• Head tilt & chin liftHead tilt & chin lift

• Check for normal Breathing Check for normal Breathing • Look, listen & feelLook, listen & feel

• Call/send for an AmbulanceCall/send for an Ambulance• Start CPRStart CPR

CPRCPR

• 30 Chest compressions30 Chest compressions• Place hands in centre of chestPlace hands in centre of chest

• Push chest down (4-5 cm)Push chest down (4-5 cm)

• At a rate of 100 per minuteAt a rate of 100 per minute

• 2 breaths2 breaths• 1 second in, 2 seconds out 1 second in, 2 seconds out

PracticalPractical

• Let’s have a go at CPRLet’s have a go at CPR

ChokingChoking

Partially ObstructedPartially Obstructed..

• If there is some If there is some movement of air movement of air when they try to when they try to breath.breath.

• Encourage them to Encourage them to coughcough

Completely ObstructedCompletely Obstructed

• Lean them forwardLean them forward

• 5 back slaps (up to)5 back slaps (up to)

• 5 abdominal thrusts5 abdominal thrusts

If they become If they become UnconsciousUnconscious

• Start CPR Start CPR immediatelyimmediately

Making a diagnosisMaking a diagnosis

• SignsSigns– What you can see (blood, breaks etc.)What you can see (blood, breaks etc.)

• SymptomsSymptoms– What the patient feels (where it hurts)What the patient feels (where it hurts)

• HistoryHistory– What has happened (ask patient and What has happened (ask patient and

bystanders)bystanders)

Secondary SurveySecondary Survey

• A secondary survey is what you do once you A secondary survey is what you do once you know they are breathing normally.know they are breathing normally.

• Also known as top to toe survey.Also known as top to toe survey.

• If they are conscious you can ask them ‘what If they are conscious you can ask them ‘what happened and do you hurt anywhere’. happened and do you hurt anywhere’.

• Whilst constantly reassuring, check for lumps, Whilst constantly reassuring, check for lumps, bumps, dents, deformity & wet patches.bumps, dents, deformity & wet patches.

• Keep ABC in mind when doing secondary Keep ABC in mind when doing secondary survey.survey.

Secondary SurveySecondary Survey

• Check head Check head – Dents, lumps, bruising & fluids from ear, nose & Dents, lumps, bruising & fluids from ear, nose &

mouthmouth

• Check neck & upper spineCheck neck & upper spine– Unevenness, swelling, numbness & inability to Unevenness, swelling, numbness & inability to

move may suggest a fracturemove may suggest a fracture

• Check shoulders and chest for fractures & Check shoulders and chest for fractures & bleeding or strange soundsbleeding or strange sounds

• Check stomach area for swelling & hardnessCheck stomach area for swelling & hardness

Secondary SurveySecondary Survey

• Gently check pelvis for unnatural movementGently check pelvis for unnatural movement

• Check legs for signs of bleeding or Check legs for signs of bleeding or irregularity irregularity

• Check arms for signs of bleeding or Check arms for signs of bleeding or irregularity irregularity

• Watch out for medi-alertsWatch out for medi-alerts

• Be careful of needlesBe careful of needles

Secondary SurveySecondary Survey

• Keep talking/reassuringKeep talking/reassuring– Your patient can hear youYour patient can hear you– Members of the public will know what Members of the public will know what

you are doingyou are doing

PracticalPractical

• This is practice!!!This is practice!!!– Constantly explain to the casualty what Constantly explain to the casualty what

you are doingyou are doing

Reasons for Reasons for UnconsciousnessUnconsciousness

• FF

• II

• SS

• HH

• SS

• HH

• AA

• PP

• EE

• DD

Reasons for Reasons for UnconsciousnessUnconsciousness

• FaintingFainting

• Imbalance of heatImbalance of heat

• ShockShock

• Heart AttackHeart Attack

• StrokeStroke

• Head InjuryHead Injury

• AsphyxiaAsphyxia

• PoisonsPoisons

• EpilepsyEpilepsy

• DiabetesDiabetes

FaintingFainting

• Phew!!!Phew!!!– Unless they hit something on the way Unless they hit something on the way

down they will recover quickly.down they will recover quickly.– The pulse should be strong and boundingThe pulse should be strong and bounding

– Caused by lack of oxygen to the brain.Caused by lack of oxygen to the brain.– Lay them down, loosen tight clothing & Lay them down, loosen tight clothing &

raise the legs.raise the legs.

Imbalance of heatImbalance of heat

• Hypothermia (too little heat)Hypothermia (too little heat)– Cold to touch Cold to touch – ConfusedConfused– UnsteadyUnsteady– Slow pulse & breathingSlow pulse & breathing

– Remove from cold environmentRemove from cold environment– Warm them up at the rate they cooledWarm them up at the rate they cooled– Call for an ambulanceCall for an ambulance

Imbalance of heatImbalance of heat

• Hyperthermia (too much heat)Hyperthermia (too much heat)– Heat exhaustion – Heat exhaustion –

• profuse sweatingprofuse sweating• Signs & symptoms of shock Signs & symptoms of shock • Treat as for shockTreat as for shock• 1 tsp of salt in 1 litre of water to sip slowly1 tsp of salt in 1 litre of water to sip slowly

– Heat strokeHeat stroke• Patient will be hot, red and dryPatient will be hot, red and dry• Call for an ambulanceCall for an ambulance• Remove outer clothingRemove outer clothing• Cover with a wet sheet (and keep it wet)Cover with a wet sheet (and keep it wet)• Fan them vigourously.Fan them vigourously.

Imbalance of heatImbalance of heat

• Infant convulsions (febrile)Infant convulsions (febrile)– Remove outer clothingRemove outer clothing– Remove nappy (it usually has a plastic Remove nappy (it usually has a plastic

lining)lining)– Sponge them from head to foot with Sponge them from head to foot with

tepid water to reduce temperature.tepid water to reduce temperature.– Call an ambulanceCall an ambulance– Don’t forget mum!!Don’t forget mum!!

ShockShockShock is ‘Lack of Oxygen to the vital organs’.Shock is ‘Lack of Oxygen to the vital organs’.

Many conditions will cause patients to suffer from Many conditions will cause patients to suffer from shockshock

• Skin – pale, cold and clammy Skin – pale, cold and clammy • Breathing - rapid & shallow Breathing - rapid & shallow • Pulse - rapid & weak Pulse - rapid & weak

• Patient will be nauseas so expect them to throw Patient will be nauseas so expect them to throw upup

• Call for an ambulanceCall for an ambulance

Shock - treatmentShock - treatmentT – Treat the causeT – Treat the cause

R – Rest – lay the casualty downR – Rest – lay the casualty down

A – Assistance or AmbulanceA – Assistance or Ambulance

W – Warmth – keep the casualty warmW – Warmth – keep the casualty warm

L – Loosen tight clothingL – Loosen tight clothing

E – Elevate the legsE – Elevate the legs

R - ReassureR - Reassure

Shock - anaphylacticShock - anaphylacticSevere allergic reaction to a trigger.Severe allergic reaction to a trigger.• Swelling, blotchy skin, difficulty breathing, Swelling, blotchy skin, difficulty breathing,

patient distressed.patient distressed.• Sit the casualty down & lean forwardSit the casualty down & lean forward• Loosen tight clothingLoosen tight clothing• ReassureReassure• Assist patient to administer medication if Assist patient to administer medication if

they have any.they have any.• Call for an ambulanceCall for an ambulance• Be prepared to start CPRBe prepared to start CPR

Heart AttackHeart Attack

AKA Myocardial Infarction (MI)AKA Myocardial Infarction (MI)

• Due to a blockage in one of the arteries in the heartDue to a blockage in one of the arteries in the heart• Severe crushing chest pain – may move down an arm, up Severe crushing chest pain – may move down an arm, up

the neck & into the jaw.the neck & into the jaw.• Pain does not go away with restPain does not go away with rest• Call for an ambulance immediatelyCall for an ambulance immediately• If conscious – sit in ‘W’ positionIf conscious – sit in ‘W’ position• If unconscious and breathing – put in recovery position, If unconscious and breathing – put in recovery position,

monitor ABCmonitor ABC• If unconscious and not breathing – Start CPRIf unconscious and not breathing – Start CPR• Chain of Survival starts!!!Chain of Survival starts!!!

Chain of survivalChain of survival

Angina PectorisAngina Pectoris

• Due to a narrowing in one of the arteries in the Due to a narrowing in one of the arteries in the heartheart

• Severe crushing chest pain – may move down an Severe crushing chest pain – may move down an arm, up the neck & into the jawarm, up the neck & into the jaw

• If pain does not go away with rest assume it is a If pain does not go away with rest assume it is a heart attack.heart attack.

• Will probably have a history of Angina & is likely Will probably have a history of Angina & is likely to have medication, if so, assist them to take it.to have medication, if so, assist them to take it.

• Even with history it may still be a heart attackEven with history it may still be a heart attack• Treat as for heart attackTreat as for heart attack• Call for an ambulanceCall for an ambulance

StrokeStrokeAKA - CVE (Cerebral Vascular Event)AKA - CVE (Cerebral Vascular Event)

• Due to a blocked or burst blood vessel in the Due to a blocked or burst blood vessel in the brainbrain

• Patient will be confusedPatient will be confused• Paralysis on one side of the body is commonParalysis on one side of the body is common• The patient will probably be able to hear The patient will probably be able to hear

clearlyclearly• Patient may soil themselves, have slurred Patient may soil themselves, have slurred

speech & be dribbling.speech & be dribbling.• Call for an ambulance, lay them down with Call for an ambulance, lay them down with

head and shoulders slightly supported, head and shoulders slightly supported, monitor ABCmonitor ABC

Head InjuryHead Injury

ConcussionConcussion

• Blow to the head causing brain to Blow to the head causing brain to shake inside the skull. (causes the shake inside the skull. (causes the brain to try to ‘re-boot’).brain to try to ‘re-boot’).

• Pale, nauseous & unsteady.Pale, nauseous & unsteady.

• Should seek medical adviseShould seek medical advise

Head InjuryHead InjuryCompressionCompression

• Similar to stroke but with history of head injury Similar to stroke but with history of head injury • A bleed inside the skull putting pressure on the A bleed inside the skull putting pressure on the

brainbrain• Patient will be flushed, breathing may become Patient will be flushed, breathing may become

slow and noisy, pupils may be un-equal.slow and noisy, pupils may be un-equal.• Patient can deteriorate rapidlyPatient can deteriorate rapidly• Patient may have suffered from concussion which Patient may have suffered from concussion which

later develops into compressionlater develops into compression• Call for an ambulance, check for obvious head Call for an ambulance, check for obvious head

injuries, lay them down with head and shoulders injuries, lay them down with head and shoulders raised and supported, reassure, monitor ABCraised and supported, reassure, monitor ABC

AsphyxiaAsphyxia

• Drowning, suffocation, CO poisoning Drowning, suffocation, CO poisoning etc.etc.

• Remove from cause (but don’t put Remove from cause (but don’t put yourself in danger)yourself in danger)

• Perform DR ABCPerform DR ABC

• Call an ambulance etc.Call an ambulance etc.

PoisoningPoisoning

• Drugs, alcohol, medication etc.Drugs, alcohol, medication etc.

• Ingestion – eaten/drunkIngestion – eaten/drunk

• Inhaled – breathed inInhaled – breathed in

• Injection – syringe, bite or stingInjection – syringe, bite or sting

• Absorbed – chemicals Absorbed – chemicals

PoisoningPoisoning

• Make sure you don’t poison yourselfMake sure you don’t poison yourself

• DO NOT induce vomitingDO NOT induce vomiting

• Find out which poison was used and how Find out which poison was used and how muchmuch

• Call ambulanceCall ambulance

• Monitor ABCsMonitor ABCs

• Use a mask/shield if you do CPRUse a mask/shield if you do CPR

• Place in recovery positionPlace in recovery position

EpilepsyEpilepsyProtect the head but let them get on with it!!Protect the head but let them get on with it!!

Call an ambulance if…Call an ambulance if…• It’s their first fitIt’s their first fit• It lasts more than 5 minutesIt lasts more than 5 minutes• If they have repeated fitsIf they have repeated fits

Lets face it, how do you know any of the above Lets face it, how do you know any of the above until after the fit! Call for an ambulance until after the fit! Call for an ambulance immediately, you can always cancel it.immediately, you can always cancel it.

DiabetesDiabetes

• Hypoglycaemia – Lack of sugarHypoglycaemia – Lack of sugar– May act drunkMay act drunk– Give something sugary if they are consciousGive something sugary if they are conscious– If the condition improves give them some foodIf the condition improves give them some food– If not, call for an ambulanceIf not, call for an ambulance

• Hyperglycaemia – Excess sugarHyperglycaemia – Excess sugar– Smell of pear drops on breathSmell of pear drops on breath– Give sugar if not sure as it will do no Give sugar if not sure as it will do no

immediate harmimmediate harm– Call for an ambulance & monitor ABCCall for an ambulance & monitor ABC

Spinal InjurySpinal Injury

• Someone with a suspected spinal Someone with a suspected spinal injury should not be moved if at all injury should not be moved if at all possiblepossible

• If you can stay with your patient, If you can stay with your patient, monitor them closely and get ready to monitor them closely and get ready to turn them if they vomit turn them if they vomit

• If you have to leave them, place them If you have to leave them, place them in the recovery position carefullyin the recovery position carefully

• Airway takes priorityAirway takes priority

BleedingBleeding

• ContusionContusion– A bruise – can be quite extensiveA bruise – can be quite extensive

• LacerationLaceration– A jagged cut e.g. barbed wire.A jagged cut e.g. barbed wire.

• IncisionIncision– A clean cut from something sharp (knife, glass)A clean cut from something sharp (knife, glass)

• PuncturePuncture– A small hole but possibly a lot of internal A small hole but possibly a lot of internal

damagedamage

BleedingBleeding

• PositionPosition– Sit or lie the patient downSit or lie the patient down

• ExposeExpose– Have a lookHave a look

• ElevateElevate– Raise injury above the heart (if possible)Raise injury above the heart (if possible)

• PressurePressure– Direct pressure – indirect as a last resortDirect pressure – indirect as a last resort

Internal BleedingInternal Bleeding

• LungsLungs– Frothy blood in mouthFrothy blood in mouth

• StomachStomach– Dark ‘coffee coloured’ blood in vomitDark ‘coffee coloured’ blood in vomit

• KidneysKidneys– Blood stained urineBlood stained urine

• Large intestineLarge intestine– Black sticky tarry substance in stoolsBlack sticky tarry substance in stools

Bleeding (all)Bleeding (all)

• Treat if possible (PEEP)Treat if possible (PEEP)

• Place in recovery position if loosing Place in recovery position if loosing consciousnessconsciousness

• Treat for shock and monitorTreat for shock and monitor

• Call ambulance or send to hospitalCall ambulance or send to hospital

Burns and scaldsBurns and scalds

• Dry heat – fire, hot objectsDry heat – fire, hot objects

• Scald -Scald - Steam, hot water/oilSteam, hot water/oil

• Electrical – Entry & exit burnsElectrical – Entry & exit burns

• Chemical – bleach etc.Chemical – bleach etc.

• Friction – rope burnFriction – rope burn

• Radiation – sun burnRadiation – sun burn

• Cold – dry ice, liquid gasesCold – dry ice, liquid gases

‘‘Hot’ Burns and scaldsHot’ Burns and scalds

• Remove clothing if not stuck to skinRemove clothing if not stuck to skin

• Cool with clean fresh water for up to Cool with clean fresh water for up to 15 minutes15 minutes

• Treat for shock etc.Treat for shock etc.

• Us a dressing that won’t stick (cling Us a dressing that won’t stick (cling film)film)

• DO NOT burst blistersDO NOT burst blisters

‘‘Cold’ BurnsCold’ Burns

• Skin will stick to cold objects, do not Skin will stick to cold objects, do not pull awaypull away

• Treat for shock etc.Treat for shock etc.

• Us a dressing that won’t stick (cling Us a dressing that won’t stick (cling film)film)

• DO NOT burst blistersDO NOT burst blisters

FracturesFractures

• Simple - nothing else involvedSimple - nothing else involved

• Greenstick – in young people, not all Greenstick – in young people, not all the way through the bonethe way through the bone

• Complicated – Involves other body Complicated – Involves other body systemsystem

• Closed – Skin not brokenClosed – Skin not broken

• Open – Skin brokenOpen – Skin broken

DislocationsDislocations

• Occur when a strain has been put on Occur when a strain has been put on a jointa joint

• May also include a fractureMay also include a fracture

• Do not try to put it back!!Do not try to put it back!!

Fractures/dislocationsFractures/dislocations

RecognitionRecognition

• History (bones tend not to just break)History (bones tend not to just break)

• SwellingSwelling

• Uneven when compared to healthy Uneven when compared to healthy sideside

Fractures/dislocationsFractures/dislocations

TreatmentTreatment

• ImmobiliseImmobilise

• Cover any open wound with sterile Cover any open wound with sterile dressingdressing

• Send to hospitalSend to hospital

Sprains & StrainsSprains & Strains

• SprainsSprains– Wrenching/tearing of ligamentsWrenching/tearing of ligaments

• StrainsStrains– Overstretching of tendons/musclesOverstretching of tendons/muscles

Symptoms are similar to a fracture, Symptoms are similar to a fracture, can be more painful, advise them to can be more painful, advise them to go to hospitalgo to hospital

Sprains & StrainsSprains & Strains

Treatment - RICETreatment - RICE

• RestRest

• IceIce

• CompressionCompression

• ElevateElevate

AsthmaAsthma

• Difficulty in breathing outDifficulty in breathing out• A Chronic condition – they know A Chronic condition – they know

they’ve got it.they’ve got it.• Sit them down, lean them forwards Sit them down, lean them forwards

and reassure and reassure • Help them to take their medication – Help them to take their medication –

do not use a friends!!do not use a friends!!• Call an ambulance if they don’t get Call an ambulance if they don’t get

betterbetter

DrowningDrowning

• Remove them form water if safe to Remove them form water if safe to do so.do so.

• Perform primary surveyPerform primary survey

• Always send them to hospitalAlways send them to hospital

Recovery PositionRecovery Position

• The recovery position is a position in which a The recovery position is a position in which a breathing casualty should be left whilst help is breathing casualty should be left whilst help is summoned.summoned.

• It should be:-It should be:-1.1. StableStable2.2. Have no weight on the ChestHave no weight on the Chest3.3. Have the head positioned so that fluid can drain awayHave the head positioned so that fluid can drain away

• If a patient has an injury they should be laid so that If a patient has an injury they should be laid so that they are lying on the injury. This will help prevent they are lying on the injury. This will help prevent movement of the injury and make sure blood movement of the injury and make sure blood doesn’t move into the ‘good’ side of the body.doesn’t move into the ‘good’ side of the body.

PracticalPractical

• Let’s have a go at the recovery positionLet’s have a go at the recovery position

Calling an ambulanceCalling an ambulance

• Dial 999 or 112Dial 999 or 112• Have details readyHave details ready• Patient – as much information as you havePatient – as much information as you have• Position – where you are (exact location)Position – where you are (exact location)• Problem – what’s wrongProblem – what’s wrong

• Never be afraid to call an ambulance, let Never be afraid to call an ambulance, let them decide what to do once you have them decide what to do once you have given them all the detailsgiven them all the details

• Never call an ambulance ‘for a laugh’ Never call an ambulance ‘for a laugh’

Slings and dressingsSlings and dressings

• Sterile dressings – these will be in a first aid kit.Sterile dressings – these will be in a first aid kit.• Make sure it is big enough (double the size of the Make sure it is big enough (double the size of the

wound). It will be tightly wrapped so if it’s as big as wound). It will be tightly wrapped so if it’s as big as the wound when in it’s packet it will be big enough.the wound when in it’s packet it will be big enough.

• Be careful when unwrapping it. The pad should be Be careful when unwrapping it. The pad should be kept sterile so don’t touch it.kept sterile so don’t touch it.

• Wrap the strapping around the limb so that the Wrap the strapping around the limb so that the sides of the pad are closed.sides of the pad are closed.

• Not too loose and not too tight.Not too loose and not too tight.• Check circulation below the wound using ‘capillary Check circulation below the wound using ‘capillary

re-fill’ re-fill’

Slings and dressingsSlings and dressings

• If something is sticking out of the If something is sticking out of the wound, put some dressings around wound, put some dressings around the object and cover the whole area.the object and cover the whole area.

• Do not try to remove the objectDo not try to remove the object

• Do not apply any pressure on the Do not apply any pressure on the object. object.

Slings and dressingsSlings and dressings

• Slings – AKA triangular bandages.Slings – AKA triangular bandages.

• Used to support an arm so that it is Used to support an arm so that it is comfortable.comfortable.

• Elevated or Support sling.Elevated or Support sling.

• Us the one that keeps the patient’s Us the one that keeps the patient’s arm in the position they want it in. arm in the position they want it in.

Slings and dressingsSlings and dressings

• Dressings are used to keep wounds Dressings are used to keep wounds sterile and to help stop bleeding.sterile and to help stop bleeding.

• Slings are used to prevent movement Slings are used to prevent movement and to keep the patient comfortable.and to keep the patient comfortable.

• If they are going by ambulance the If they are going by ambulance the paramedics may remove all the paramedics may remove all the dressings and slings.dressings and slings.

PracticalPractical

• Let’s have a go at slings & dressingsLet’s have a go at slings & dressings

Cleaning upCleaning up

• Make sure any accident books have Make sure any accident books have been filled in.been filled in.

• Get all body fluids cleaned up.Get all body fluids cleaned up.

• Replenish the first aid kit.Replenish the first aid kit.

• If there was an obvious cause, make If there was an obvious cause, make sure the appropriate people are told sure the appropriate people are told so that they can fix it.so that they can fix it.

SummarySummary

• DR DR ’help’’help’ ABC ABC

• Keep calm and always reassure!Keep calm and always reassure!

• Call for helpCall for help

PracticalPractical

• Let’s have a go at dealing with a Let’s have a go at dealing with a scenarioscenario

• Has anyone seen any incidents? If so, Has anyone seen any incidents? If so, lets practice what could have been lets practice what could have been done.done.