First Aid Facts: Part One

First Aid for Engineers

August 27th, 2003

Outline Airway problems Breathing problems Circulation: bleeding and shock Wounds

Assessment and treatment Special considerations Burns

Facial, ear and eye injuries Head, neck and spinal injuries Abdominal and chest trauma Bone, joint and muscle injury

Respiratory System Anatomy

Respiratory System Physiology

Breathing allows CO2 to be expelled and O2 to be exchanged into the blood.

Without an open Airway breathing cannot occur.

Air is drawn into the body by negative pressure in the pleural cavity created by muscular contraction of the diaphragm

Airway evaluation

If victim is talking, crying or coughing the airway is open.

If the victim is unconscious and on their back then the tongue is most likely blocking the airway.

Two methods for opening the airway Head tilt, chin lift - no suspicion of spinal injury Jaw thrust – known or suspicion of spinal injury

Chin Lift and Head Tilt

Jaw Thrust

Inspection of Airway

Open Airway Look for food or fluid If no spinal injury then turn

victim to recovery position If foreign object seen or

spinal injury then finger sweep Wear a glove Use a cloth to get liquid out

Recovery Position

Check for Breathing

“can you speak?” Look - chest movement Listen – air movement Feel - air on cheek Inadequate breathing

Less than 8 per minute Blue lips Increased effort with

breathing

Rescue Breathing

Place your mouth over the victims mouth and pinch the nose closed.

Exhale into the victims mouth slowly, filling their lungs with the air from your lungs

Release and let the air come back out, turn and watch the chest fall.

Give one breath every 5 seconds in adults

If you are trained, use a “mouth to device” protective breathing apparatus

Obstructed Airway

Will lead to cardiac arrest Usually food, blood or vomit Partial airway obstruction

Cough present Noises may be heard with respiration May become blue

Complete obstruction Cannot cough, speak or breath

Heimlich Maneuver

If victim becomes unconscious

Call EMS Place victim on back and open airway Look inside mouth – if cannot see

anything do not do a finger sweep Try to give rescue breaths If these do not go in reposition the head

and give another breath. Perform abdominal thrusts

Circulatory System (plumbing)

Heart (pump) Arteries (large

outbound pipes) Capillaries (oxygen

delivery location) Veins (large drainage

pipes) Blood (fluid)

Circulatory arrest:Heart stops pumping

Causes: Arrhythmia – electrocution, heart attack No oxygen to heart – heart attack,

respiratory arrest (choking, seizure, allergic reaction)

No blood to pump - Trauma May respond to CPR Brain damage occurs in 10 minutes

Bleeding

Arterial Pulsating Rapid

Venous Smoother

Flow Slow

Capillary Oozing

External Bleeding Obvious

Internal Bleeding Bruising Painful, tender,

rigid abdomen Broken ribs or

bruised chest Bloody or black

stools or vomit

Controlling Bleeding

Wear Personal Protection Equipment If Available

Expose the wound to see where bleeding is coming from

Three Steps Direct Pressure Elevation Pressure point

Shock

Definition No O2 to Tissue

Signs and Symptoms Change in mental

status Skin Pale, Cold,

Clammy (low BP) Nausea and vomiting Rapid Pulse and Rapid

Breathing

Types of Shock

Cardiogenic – pump failure Hypovolemic – loss of fluid Neurogenic – pipes enlarge, too large

for volume of fluid Anaphylactic – loss of fluid and

enlarged pipes Septic – loss of fluid and enlarged

pipes

Treatment of Shock

Treat the Cause Position with feet raised 1 foot above heart Cover with warm blankets Do not give anything to eat or drink Reassure the victim Use EpiPen if Anaphylactic Shock

Wounds - Anatomy of Skin

Types of wounds

Incision - sharp strait wound Avulsion – part of skin loose or torn Puncture – deep, narrow wound Abrasion – top layer of skin scraped off Laceration – irregular cut from tearing Amputation – part of body detached Burn – partial or full thickness thermal or

chemical injury to skin.

Treatment for wounds

Wash your hands and don gloves Expose wound completely Wash wound with water at medium faucet

flow Remove debris with sterile tweezers Cover with sterile gauze and if shallow

wound antibiotic ointment Keep clean and dry – replace dressing daily Watch for signs of infection

Wounds that require medical attention

Bio or chemical hazards involved Dirty or victim without recent tetanus shot Arterial bleeding Into deep subcutaneous fat Bites Amputations, Avulsions or Impaled objects Facial wounds Infected wounds

Special consideration

When was your last Tetanus shot? If not within last 5-10 years, must have

new shot within 72 hours to prevent tetanus

There is no cure for tetanus. Impaled objects

Never remove the object Stop bleeding by placing pressure around

the object

Amputations

Activate EMS Wrap stump in bulky

dressing Do not use tourniquet Find and gently clean part Wrap part in gauze and

place into plastic bag Place bag in bag of ice

and transport with victim

Burns First Degree

Superficial (epidermis) Heal without intervention

Second Degree Partial thickness (into dermis) Larger or sensitive areas require medical attention

Third Degree Full thickness (thru dermis into fat or muscle) Require skin grafting in most cases

Three levels of Burns

Types of Burns

Thermal Chemical

Always require medical attention

Special consideration with certain chemicals

Electrical Always require medical

attention Go deep and travel

along the muscles

Assessing % BSA burned – Rule of nines

Minor Burn <50% 1st Degree <10% 2nd Degree

Moderate Burn >50% 1st Degree 10-30% 2nd Degree <10% 3rd Degree

Severe Burn Larger BSA 2nd and 3rd

Degree All Electrical Burns Burns to face, hands, feet or

genitals Most Chemical Burns Inhalation burns

Treatment of Minor Burns

Stop the Burn – cool water irrigation Aloe Vera or other soothing lotion Keep covered with sterile gauze Take Aleve or Advil Watch for signs of infection

Fever or oozing Increasing Redness, Swelling and Pain

Treating Moderate to Severe Burns

Activate EMS ABCDE’s Stop the burning

Remove clothing Irrigate only smaller burns

Assess Depth (degree) Assess Extent (% BSA) Cover Areas with dry bandage damp

bandage can lead to hypothermia Treat for Shock

Facial Injuries

Most injuries to the face requires medical attention

A bloody nose or black eye can be treated with Ice, elevation of head and gentle pressure

Go to Babson Health Center for evaluation of minor injuries

Activate EMS for more serious injuries

Eye Injuries

All Eyeball injuries should be seen by an ophthalmologist if they result in Change in vision Pain

For Corneal injuries or chemical splashes Irrigate eye for 15 minutes If chemical exposure – transport to nearest hospital

Do not try to remove an impaled object or replace an explanted eyeball

Bandage both eyes, protect the injured one with a paper cup, or damp gauze if the eyeball is exposed

Transport to the nearest hospital

Ear injuries

Seek medical attention for external ear injury High risk of infection

Seek medical attention for blast injuries resulting in Decreased hearing Blood or fluid coming from

the ear

Dental injuries

Find missing tooth Placed rolled up gauze in socket to

control bleeding Clean tooth and replace into

socket if not too damaged Place tooth in saliva soaked gauze

if unable to replace Teeth replaced in < 1 hr. may

survive Transport victim to Hospital

Head injuries

Scalp wounds bleed significantly

Skull fractures Painful at site Unequal pupils Skull deformity Blood or fluid from

ears and eyes

Signs and Symptoms of Brain Swelling

Altered level of Consciousness

Memory Loss Nausea and Vomiting Headache Unequal pupils or change in

vision Seizures Weakness or Paralysis Leak of Blood or CSF from

ears

Treating head injuries

Activate EMS Monitor ABCD’s Cover wounds with sterile dressing Assume spine injury - immobilize neck Apply pressure around to bleeding

scalp wounds Watch for signs of brain swelling

Anatomy of the Spine

Signs and Symptoms of Spinal Injury

Pain with movement Numbness Tingling or weakness Loss of bowel or

bladder control Paralysis Loss of strength

Treatment of Spinal Injury

Seek Immediate medical attention Do Not Move Victim unless absolutely

necessary To monitor ABC’s To evacuate from immediate Danger Stabilize before move if possible

Monitor ABCD’s until help arrives

Chest Trauma

Vital Organs are protected by Ribs and Sternum

Critical Injury to the chest can affect Airway, Breathing and Circulation

Do not remove Penetrating objects Do not lift off crushing object unless

breathing is significantly affected Bandage and stabilize them for

transportation Sucking chest wounds are a special case

Sucking Chest Wounds

Wounds which go thru the chest wall into lung Requires Immediate attention to avoid lung collapse Create “Valve Dressing”

Dressing for sucking Chest Wound

Abdominal Wounds

Should always be evaluated by professionals – call EMS

Monitor ABCD’s Do not give anything to eat or drink Treat for Shock If intestines protruding cover with wet,

non-adherent dressing and Saran Wrap Watch for Vomiting

Anatomy of Skeletal System

Anatomy Bones Cartilage Ligaments Tendons Muscles

Types of Injuries Sprain

ligament

Strain tendon

Contusion muscle

Dislocation joint

Fracture bone

Symptoms of Orthopedic injuries

Sharp Pain Swelling Tenderness to are Deformity to the

area Bruising and

stiffness Weak or poor

function

Treatment for minor injuries - RICE

Rest – avoid using Ice – 20 minutes every 2-3 hours Compression – Wrap to keep swelling down

especially in joint Elevation - Also to reduce swelling

Fracture/Dislocation Treatment Check ABC’s Activate EMS Treat for Shock Look and feel extremity for CSM

Circulation – pulses Sensation Movement

Stabilize across joint if need to move victim Use RICE until help arrives

Practical Skills Exercise:

Patient Assessment / SAMPLE history / Pressure Points

Bandages and Splints Carries and Spinal Immobilization Airway and Breathing

Review

Gross Pictures to Follow Grossest are “moulage” – not real Please feel free to close yours eyes

What type of injury is this? What would you do for it?

What type of injury is this? What would you do for it?

What type of injury is this? What would you do for it?

What type of injury is this?What would you do for it?

What type of injury is this?What would you do for it?

What type is this? What do you do for this?