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Chain of Survival
In order for a person to
survive
Early
Access “112”
Early
First Aid/CPR
You
Early
Defibrillation
EMS on
Scene
Early
Advanced Care
Hospital
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Basic First Aid
What Is First Aid?
The immediate care
given to an injured or suddenly ill person.
DOES NOT
take the place of proper medical treatment.
Legal Considerations
Implied Consent involves an unresponsive victim in a life-threatening condition.
It is assumed or “implied” that an unresponsive victim would consent to lifesaving help.
Only perform First Aid assistance for which you have been trained.
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Scene Survey
When confronted with an accident or illness
on duty it is important to assess the situation
to determine what kind of emergency situation you are dealing with, for your safety, the victim’s safety and that of others.
Do a quick survey of the scene that includes looking for three elements:
Hazards that could be dangerous to you, the victim, or bystanders.
The cause (mechanism) of the injury or illness.
The number of victims.
Note: This survey should only take a few seconds.
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Initial Assessment
Goal of the initial assessment:
Visually determine whether
there are life-threatening or other serious problems that require
quick care.
Determine if victim is conscious - by tap and shout. Check for ABC as indicated:
A = Airway Open? – Head-tilt/Chin-lift.
B = Breathing? – Look, listen, and feel.
C = Circulation? – Check for signs of circulation.
Note: These step-by-step initial assessment should not be changed. It takes less than a minute to complete, unless first aid is required at any point.
Breathing
Bleeding
Shock
Burn
Choking
Heart Attack
Fractures
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Victim Assessment Sequence
Assessment Sequence Components:
If victim is responsive
Ask
them what injuries or difficulties they are experiencing.
Check and
provide first aid for these complaints as well as others that may be involved.
If victim is not responsive (Unconscious or incoherent).
Observe for obvious signs of injury or illness:
Check from head to toe
Provide first aid/CPR for injuries or illness observed.
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Bleeding Control
Control Methods For External Bleeding:
Direct pressure stops
most bleeding.
Wear medical exam gloves (if possible)
Place a sterile
gauze pad or a clean cloth over wound
Elevation injured part to help reduce blood flow.
Combine with direct pressure over the wound (this will allow you to attend to other injuries or victims).
If bleeding continues, apply pressure at a pressure point to slow blood flow.
Pressure point locations:
Brachial (Top of elbow)
Femoral (Inside upper thigh)
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Bleeding Control Cont.
Control Methods For Internal Bleeding:
Signs of
internal bleeding:
Bruises or contusions of the skin
Painful, tender, rigid,
bruised abdomen
Vomiting or coughing up blood
Stools that are black or contain bright red blood
What to Do:
For severe internal bleeding, follow these steps:
Monitor ABC’s (Airway Breathing Circulation)
Keep the victim lying on his/her left side. (This will help prevent expulsion of vomit from stomach, or allow the vomit to drain and also prevent the victim from inhaling vomit).
Treat for shock by raising the victim’s legs 8” – 12”
Seek immediate medical attention
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Shock
Shock refers to circulatory system failure that happens
when insufficient amounts of oxygenated blood is provided for
every body part. This can be as the result of:
Loss of blood due to uncontrolled bleeding or other circulatory system problem.
Loss of fluid due to dehydration or excessive sweating.
Trauma (injury)
Occurrence of an extreme emotional event.
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Shock Cont.
What to Look For
Altered mental status
Anxiety and
restlessness
Pale, cold, and clammy skin, lips, and nail beds
Nausea
and vomiting
Rapid breathing and pulse
Unresponsiveness when shock is severe
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Shock Cont.
What to Do
After first treating life-threatening injuries
such as breathing or bleeding, the following procedures shall
be performed:
Lay the victim on his or her back
Raise the victim’s legs 8” – 12” to allow the blood to drain from the legs back to the heart.
Prevent body heat loss by putting blankets and coats under and over the victim
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Burns
Burn injuries can be classified as follow:
Thermal (heat)
burns caused by:
Flames
Hot objects
Flammable vapor that ignites
Steam or hot
liquid
What to Do:
Stop the burning
Remove victim from burn source
If open flame, smother with blanket, coat or similar item, or have the victim roll on ground.
Determine the depth (degree) of the burn
Слайд 13
Facilities Planning & Management
UW-Eau Claire
Burns Cont.
Chemical burns
The result
of a caustic or corrosive substance touching the skin
caused by:
Acids (batteries)
Alkalis (drain cleaners- often more extensive)
Organic compounds (oil products)
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Burns Cont.
What to Do:
Remove the chemical by flushing
the area with water
Brush dry powder chemicals from the
skin before flushing
Take precautions to protect yourself from exposure to the chemical
Remove the victim’s contaminated clothing and jewelry while flushing with water
Flush for 20 minutes all chemical burns (skin, eyes)
Cover the burned area with a dry, sterile dressing
Seek medical attention
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Burns
Burns have been described as:
First-degree burns (Superficial)
Only the
skin’s outer layer (epidermis) is damaged.
Symptoms include redness,
mild swelling, tenderness, and pain.
Usually heals without scarring.
What to Do:
Immerse in cold water 10 to 45 minutes or use cold, wet cloths.
Cold stops burn progression
May use other liquids
Aloe, moisturizer lotion
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Burns Cont.
Second-degree burns (Partial Thickness)
Epidermis and upper regions
of dermis
are damaged.
Symptoms include blisters, swelling, weeping of fluids, and severe pain.
What to Do:
Immerse in cold water / wet pack
Aspirin or ibuprofen
Do not break blisters
May seek medical attention
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Burns Cont.
Third-degree burns (Full Thickness)
Severe burns that penetrate
all the skin layers, into the underlying fat and
muscle.
Symptoms include: the burned area appears gray-white, cherry red, or black; there is no initial edema or pain (since nerve endings are destroyed)
What to Do:
Usually not necessary to apply cold to areas of third degree
Do not apply ointments
Apply sterile, non-stick dressings (do not use plastic)
Check ABC’s
Treat for shock
Get medical help
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Burns Cont.
Electrical Burns
A mild electrical shock can
cause serious internal injuries.
There are three types of electrical injuries:
Thermal burn (flame) – Objects in direct contact with the skin are ignited by an electrical current.
Mostly caused by the flames produced by the electrical current and not by the passage of the electrical current or arc.
Arc burn (Flash) – Occurs when electricity jumps, or arcs, from one spot to another.
Mostly cause extensive superficial injuries.
True Electrical Injury (contact) – Occurs when an electric current truly passes through the body.
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Burns Cont.
What to Do:
Make sure the scene is
safe
Unplug, disconnect, or turn off the power.
If that is
impossible, call the power company or EMS for help.
Do not contact high voltage wires
Consider all wires live
Do not handle downed lines
Do not come in contact with person if the electrical source is live
Check ABCs. (Airway Breathing Circulation)
If the victim fell, check for a spinal injury.
Treat the victim for shock by elevating the legs 8” – 12” if no spinal injury is suspected.
Seek medical attention immediately.
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Choking
What is it?
Obstruction in the airway.
General Precaution
If someone
is coughing, leave the person alone.
Do not perform
the Heimlich Maneuver.
Keep eyes on that person.
Ask the person if he/she needs help.
Signs and Symptoms
Person is not able to breath or talk due to obstruction, choking sign given, distressed, and panic.
Hands wrapped around the neck is universal sign for choking.
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Choking Cont.
What to Do:
Perform Heimlich Maneuver if
you are properly trained
Conscious Victim:
Approach from behind and wrap arms around the victim’s waist.
Place one fist just above the victim’s navel with the thumb side against the abdomen.
Second hand over the fist.
Press into the victim’s abdomen with one upward thrust
Repeat thrust if necessary.
Try to pop the obstruction out with swift thrusts in and up.
Continue until the obstruction is relieved or victim collapses.
Have someone call for help.
Note: Always stay calm.
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Choking Cont.
What to Do:
Unconscious Victim:
Ask someone to
call 112 for help
Lower victim to floor on back
or left side and perform Heimlich Maneuver
Open airway with tongue-jaw lift
Look inside mouth – if you cannot see anything, do a finger sweep
Try to give two full rescue breaths
If these do not go in, reposition the head and give another breath
Perform abdominal thrusts
Continue until successful or help arrives
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Fractures
There are two categories of fractures:
Closed (Simple) fracture
The
skin is intact and no wound exists anywhere near
the fracture site.
Open (Compound) fracture
The skin over the fracture has been damaged or broken.
The wound may result from bone protruding through the skin.
The bone may not always be visible in the wound.
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Fractures Cont.
What to Look for:
General signs and Symptoms:
Tenderness
to touch.
Swelling.
Deformities may occur when bones are broken,
causing an abnormal shape.
Open wounds break the skin.
A grating sensation caused by broken bones rubbing together
can be felt and sometimes even heard.
Do not move the injured limb in an attempt to detect it.
Loss of use.
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Signs and Symptoms of Injury
14-
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Fractures Cont.
Additional signs and symptoms include:
The history of
the injury can lead to suspect a fracture whenever
a serious accident has happened.
The victim may have heard or felt the bone snap.
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Foreign Body in the Eye
Eye
When on the
pupil or embedded in the white of the eye
Never
try to remove the object
Cover the injured eye with a clean pad
Bandage both eyes
Take the victim to the hospital
When floating on the white of the eye
Advise the victim not to rub the eye
Have them sit down facing a light so that you can see into the eye clearly
Using your finger or thumb gently pull the eyelids of the injured eye apart
When you see the foreign body wash it out with clean water
If the foreign body has not moved, try to lift it off with a moist swab or the dampened corner of a tissue or handkerchief.
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Basic First Aid for Wounds
Open Wounds
A break in
the skin’s surface that results in external bleeding and
may allow bacteria to enter the body that can cause infection
Abrasion
The top layer of skin is removed with little or no blood loss
Scrape
Laceration
A cut skin with jagged, irregular edges and caused by a forceful tearing away of skin tissue
Incisions
Smooth edges and resemble a surgical or paper cut
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Basic First Aid for Wounds Cont.
Open Wounds Cont.
Punctures
Deep,
narrow wounds such as
a stab wound from a nail or a knife in the skin and underlying organs
Avulsion
Flap of skin is torn loose and is either hanging from the body or completely removed
Amputation
Cutting or tearing off of a body part such as a finger, toe, hand, foot, arm, or leg
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Basic First Aid for Wounds Cont.
What to Do:
Wear
gloves (if possible) and expose wound
Control bleeding
Clean wounds
To prevent
infection
Wash shallow wound gently with soap and water
Wash from the center out / Irrigate with water
Severe wound?
Clean only after bleeding has stopped
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Basic First Aid for Wounds Cont.
Wounds Care
Remove small
objects that do not flush out by irrigation with
sterile tweezers.
If bleeding restarts, apply direct pressure.
Use roller bandages (or tape dressing to the body)
Keep dressings dry and clean
Change the dressing if it gets wet or dirty.
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Basic First Aid for Wounds Cont.
Signs of Wound
Infection:
Swelling, and redness around the wound
A sensation of warmth
Throbbing
pain
Fever / chills
Swollen lymph nodes
Red streaks
Tetanus (lock jaw), should receive injection in first 72 hours.
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Dressings and Bandages
The purpose of a dressing is
to:
Control bleeding
Prevent infection and contamination
Absorb blood and fluid drainage
Protect
the wound from further injury
What to Do:
Always wear gloves (if possible)
Use a dressing large enough to extend beyond the wound’s edges.
Cover the dressing with bandages.
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Dressings and Bandages Cont.
Bandage can be used to:
Hold
a dressing in place over an open wound
Apply direct
pressure over a dressing to control bleeding
Prevent or reduce swelling
Provide support and stability for an extremity or joint
Bandage should be clean but need not be sterile.
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Amputation
What to Do:
Control the bleeding
Treat the victim for
shock
Recover the amputated part and whenever possible take it
with the victim
To care for the amputated body part:
The amputated part does not need to be cleaned
Wrap the amputated part with a dry sterile gauze or other clean cloth
Put the wrapped amputated part in a plastic bag or other waterproof container
Keep the amputated part cool, but do not freeze
Place the bag or container with the wrapped part on a bed of ice
Seek medical attention immediately
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External Bleeding
If an adult looses more than 1
liter of blood or a child looses as little
as 1/3 of that amount loss is considered severe.
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Checking for Spinal Injuries
Spinal Injuries
Head injuries may indicate
that there are possible spinal injuries
It may have been
moved suddenly in one or more directions, damaging the spine.
What to Look For
General signs & symptoms
Painful movement of the arms or legs
Numbness, tingling, weakness, or burning sensation in the arms or legs
Loss of bowel or bladder control
Paralysis of the arms or legs
Deformity (odd-looking angle of the victim’s head & neck
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Checking for Spinal Injuries Cont.
What to Do:
Stabilize the
victim against any movement.
Check ABCs. (Airway Breathing Circulation)
Unresponsive Victim:
Look
for cuts, bruise, and deformities.
Test response by pinching the victim’s hand, and bare foot.
If no reaction, assume the victim may have spinal damage.
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Checking for Spinal Injuries Cont.
Responsive Victim
Upper Extremity Checks:
Victim
wiggles fingers.
Victim feels rescuer squeeze fingers.
Victim squeeze rescuer’s hand.
Lower
Extremity Checks:
Victim wiggles toes.
Victim feels rescuer squeezes toes.
Victim pushes foot against rescuer’s hand.
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Stroke (Brain Attack)
What is Stroke?
Tissue damage to area
of the brain due to disruption in blood supply,
depriving that area of the brain of oxygen.
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Stroke (Brain Attack) Cont.
Signs and Symptoms of Stroke:
Weakness
or numbness of the
face, arm, or leg (usually on one side of the body)
Blurred or decreased vision, especially in one eye.
Problems speaking or understanding
Unexplained, severe headache
Dizziness, unsteadiness, or sudden fall
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Bites and Stings
Insect stings and bites
What to Look
For:
Check the sting site to see if a stinger
and venom sac are embedded in the skin.
Bees are the only stinging insects that leave their stingers and venom sacs behind.
Scrape the stinger and venom sac away with a hard object such as a long fingernail, credit card, scissor edge, or knife blade.
Reactions are generally localized pain, itching, and swelling.
If Allergic reaction (anaphylaxis) occurs can be life threatening.
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Bites and Stings Cont.
Insect stings and bites Cont.
What
to Do:
Ask the victim if he/she has had a
reaction before.
Wash the sting site with soap and water to prevent infection.
Apply an ice pack over the sting site to slow absorption of the venom and relieve pain.
Because bee venom is acidic, a paste made of baking soda and water can help.
Seek medical attention if necessary.
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Bites and Stings Cont.
Tick bites
Tick can remain embedded
for days without the victim’s realizing it.
Most tick bites
are harmless, although ticks can carry serious diseases.
Symptoms usually begin 3 to 12 days after a tick bites.