1. If Not You….Who Chapter 1

2. Definition of EMS and First Aid (EMS) Emergency Medical System is a network of Police, Fire and Medical Personnel as well as other community resources. First Aid: Emergency treatment administered to an injured or sick person before professional medical care is available. CPR: Cardio Pulmonary Resuscitation AED: Automated External Defibrillator

3. Video: “Introduction”

4. Video: Deciding to Act/Taking Action” What were some examples in the video of people using their senses to recognize the emergency situation?

5. Everyone should know first Aid Your role in the EMS system includes 4 steps Recognizing an emergency Decide to act Activate the EMS System Give care until help arrives

6. Step 1: Recognizing an Emergency Unusual Sights blood smoke or fire broken items people milling around

7. Recognizing and Emergency Unusual Appearance or Behaviors a person who is noticeably uncomfortable a person who is clutching their chest or throat a person who is unconscious a person who appears to be confused or drowsy for unknown reasons a person who is having trouble breathing

8. Recognizing an Emergency Unusual Odors unusual odor of a person’s breath gasoline Natural Gas Smoke An unrecognizable smell

9. Recognizing an Emergency Unusual Noises Screaming Sudden silence for infants or children An explosion Items falling Glass breaking Tires screeching Metal Crashing Changes in Machinery sound (i.e., pitch, tone )

10. Recognizing and Emergency By recognizing an emergency, and taking immediate action, you give an ill person the best chance for survival Emergencies can often be recognized by unusual sights appearances behaviors odors noises

11. Step 2: Deciding to Act Reasons people give for not helping are called Barriers to Action Some Barriers to Action Include: The presence of other people Uncertainty about the person’s condition Fear of catching a disease Thinking that someone else will take care of it Fear of doing something wrong Fear of being sued Being unsure of when to call 911

12. Overcoming Barriers There are ways a person can overcome barriers when dealing with emergency situations. Get trained in First Aid/CPR/AED Avoid contact with bodily fluids or blood Training and practice to build confidence which enables you to take charge of a situation until help arrives Be aware of the Good Samaritan Law

13. Good Samaritan Law Established to encourage individuals to render emergency care and assistance at accident scenes “…Provides civil immunity for individuals who in good faith render emergency care at the scene of an accident or an emergency.” P.L.1963,c. 140 (C.2A:62A-1 et seq.)

14. How do you know your safe? Act in good faith Do not be negligent Act within scope of training Obtain consent before giving care Consent for an adult: What if they say no? Consent for a minor: Ask a parent or guardian Implied consent: Person is confused, unconscious, or seriously ill

15. Step 3: Activate the EMS Calling 9-1-1 is the most important and often the most forgotten step in the process. When calling 9-1-1 take the following steps State your name Tell person you are trained in first aid Ask the person if you can help Explain what you think may be wrong (i.e. broken arm, severe bleeding, burn) Explain what you plan to do

16. Prevent Disease Transmission Avoid contact with blood or bodily fluids Avoid touching objects that may be soiled with blood or bodily fluids Use barriers: gloves, eye protection (if necessary), face shield

17. Removing Disposable Gloves Partially remove the first glove by pinching the glove at the wrist, being careful to touch only the glove’s outside surface. Pull the glove toward the fingertips without completely removing it. The glove is now partially inside out. With the partially gloved hand, pinch the exterior of the second glove. Pull the second glove toward the fingertips until it is inside out and then remove it completely. Grasp both gloves with your free hand, touching only the clean interior surface of the glove. Discard the gloves in an appropriate container. Wash your hands thoroughly with soap and water.

18. Let’s practice… Glove Removal

19. Step 4: Give Care Until Help Arrives If you find yourself in an emergency situation, you should always follow the 3 basic emergency action steps. 1. Check Check the scene for safety, check the person for life- threatening conditions 2. Call Call 911 3. Care Care for person until help arrives

20. Emergency Action Steps Chapter 2

21. CHECK THE SCENE Is it safe? One victim is better than two What happened? How many people are involved? Is there immediate danger involved? Is anyone else available to help? When you reach the person, what is wrong?

22. CALL 911 Make sure you have the address of where you are Provide any information that the call taker requests DO NOT HANG UP before the dispatcher does

23. CARE Do no further harm Monitor person’s breathing and consciousness Help person rest in the most comfortable position Keep person from getting chilled or overheated Reassure the person Give any specific care needed (bandaging, splinting, etc.)

24. Emergency Action Steps (EAP’s) 1. Check: the scene and the person 2. Call: 9-1-1 3. Care: for the person

25. What are some types of injuries that would be considered potentially life- threatening?

26. Life Threatening Illness or Injuries Unconsciousness Not breathing or having trouble breathing Choking Persistent Chest Pain No signs of life (normal breathing or movement) Severe bleeding Shock Seizures

27. Checking and Ill or Injured Person Chapter 3

28. Video: Checking a Conscious Adult The following video demonstrates how to check a conscious adult and a conscious child

29. Checking a Conscious Adult For the Purpose of First Aid Care 12 years or older considered an adult 1-12 is considered a child Under the age of 1 year old is considered an infant Get consent before providing care Tell person your name If there is no obvious injury or illness, conduct interview of person and bystanders

30. Interview- Questions to ask What is your name? What happened? Do you feel pain or discomfort? Do you have any allergies? Do you have any medical conditions or are you taking any medication? Is there anyone I should call?

31. Check the person from Head to Toe Do not move areas where there is pain or discomfort Check person’s head, face, ears, nose, mouth Look for cuts, bruises, bumps or depressions Watch for changes in consciousness Watch for changes in person’s breathing Notice how skin looks and feels (cold, warm, flush, bluish, pale, ashen) Look over the body (ask about any areas that hurt) Look for medical ID tag

32. Checking an Unconscious Adult Check the scene, check the person for life-threatening conditions Tap the person’s shoulder, “Are you okay?” If you find the person unconscious and 9-1-1 has been called, find out if there are other conditions that threaten the person’s life. Always check an unconscious person to see 1. Has an open airway 2. Shows signs of life: movement, breathing 3. Is bleeding severely An easy way to remember what you need to check is to Check ABCs Airway Breathing Circulation ( and severe bleeding)

33. Checking the Airway and Breathing Open the airway by lifting the chin and opening the mouth Look, Listen, and Feel for breathing for no longer than 10 seconds. Bring your cheek towards person’s mouth, looking at the their chest Signals of Breathing Look for chest to rise and fall Listen for breathing Feel for breath on your cheek

34. Checking Circulation (blood flow) Adult- check at carotid artery (neck) Children- check carotid artery (neck) Infant- check brachial artery (inside upper arm)

35. What is shock?

36. Definition of shock: Shock is a life-threatening condition in which not enough blood is being delivered to all parts of the body and can result from injury or illness. Shock is likely to develop after severe internal or external bleeding. A person showing signs of shock needs immediate medical attention Body systems and organs can begin to fail

37. Signs of Shock Restlessness or Irritability Altered level of consciousness Nausea or vomiting Pale, ashen, cool, or moist skin Rapid breathing and pulse Excessive thirst

38. Care for Shock Call 911 (assuming you have already checked the scene for safety) Have person lie down is most comfortable position Control External bleeding by elevating legs approximately 12 inches Except if you suspect any broken bones in lower legs or hips, or head, back, neck injury Try to maintain normal body temperature Do not give person anything to eat or drink Reassure person, continue to monitor ABCs

39. Video Demonstration and Skills Checking an unconscious adult (over 12) Checking an unconscious child(1-12) Checking and unconscious infant(under 1)

40. Rolling an unconscious person who is face down Tap person on shoulder, “are you ok?” Kneel down next to the person (their face should be looking away from you) Place the person’s arm that is closest to you over their head This arm is going to support their head as they roll Place one hand on the person’s hip that is farthest away from you While supporting their head and neck, gently roll the person towards you Look, listen and feel for breath (10 seconds)

41. Chapter 2 and 3 Review Emergency Action Steps Check Check the scene for safety, check the person for life-threatening conditions Call Call 911 Care Care for person until help arrives Check a conscious adult by 1. Conducting interviews 2. Checking from head to toe

42. Breathing Emergencies Chapter 4

43. When to Care First It is necessary to care first for a Child or Infant when 1. The individual is not breathing 2. Does not have a history of heart disease 3. The collapse was unwittnessed You should give care for about 2 minutes before calling 9-1-1. Care first situations are likely to be caused by breathing emergencies All other unconscious emergencies you should CALL first

44. Breathing Emergencies Airway: The pathway from your nose and mouth to the lungs A breathing emergency happen when air can no travel freely and easily to the lungs. Breathing emergencies are life-threatening because the greatly cut down the amount of Oxygen to the body. Without Oxygen brain cells die and the heart stops breathing The 2 main breathing emergencies are Respiratory Distress and Respiratory Arrest

45. Respiratory Distress/Arrest Respiratory Distress: A condition when breathing becomes difficult. It is the most common breathing emergency. Respiratory Arrest: Breathing stops

46. Causes of Respiratory Distress Choking Asthma Heart Attack Injury to the head, neck, chest, lungs, abdomen Allergic Reactions Electrocution Drugs Poisoning

47. Signals of Breathing Emergencies Slow or rapid breathing Deep or shallow breathing Gasping Wheezing or gurgling Moist or cool skin Flushed, pale, ashen or bluish skin color Shortness of breath Dizziness or lightheadedness Pain in the chest, tingling in the hands, feet or lips Normal breathing is quiet and easy. A person should not have to struggle to breathe.

48. Conditions that might cause Breathing Emergencies Asthma: A condition that narrows air passages. Emphysema: A disease that involves damage to the lungs air sacs. Bronchitis: A condition that causes the bronchial tubes to become swollen or irritated. Hyperventilation: This occurs when a person breathes faster and more shallower causing the body to not take in enough oxygen. Anaphylactic Shock: The person’s airway swells and restricts the person’s ability to breathing. Choking: When the airway become blocked by a foreign object

49. Common Causes of Choking Adults Trying to swallow large pieces of food Drinking alcohol before or during meals Wearing Dentures Talking or laughing during eating Walking, playing or running with food in your mouth Children Trying to swallow large pieces of food Talking or laughing during eating Walking, playing or running with food in your mouth Swallowing Small Objects Infants Swallowing small objects A less than fully developed airway The infant has not fully developed his eating skills

50. Conscious Choking Adult/Child Check the Scene Check the Victim: If the person is coughing, encourage them to continue. Call 9-1-1 Back Blows and Abdominal Thrusts Give 5 back blows: Stand slightly behind the victim. Place one arm diagonally across the victim's chest for support and lean him forward. With the heel of your other hand, strike the victim firmly between the shoulder blades. Give 5 abdominal thrusts: Place the thumb side of your fist just above the victim's belly button. Grab your fist with your free hand. Pull quick, upward thrusts to dislodge the object.

51. Conscious Choking Infant Check the Scene Check the Victim Call 9-1-1 Blows and Thrusts Carefully hold the infant face down on your forearm, your hand supporting its head and neck Strike the infant directly between the shoulder blades with the heel of your other hand 5 times Turn the infant over and position two fingers in the center of the chest Give 5, 1/2 to 1 inch deep chest thrusts Repeat Blows and Thrusts until the object is forced out, the infant starts breathing, or the infant becomes unconscious.

52. Rescue Breathing Adults ( no movement or breathing) Check the injured or ill person. Look, listen and feel for no longer than 10 seconds 1. First, tilt the victim's head back and lift the chin up, then pinch the nose shut. 2. Take a breath and make a complete seal over the victim’s mouth 3. Blow in to make the chest cavity rise 4. If breath does not go in, re-tilt the head to make sure airway is open Each rescue breath should last about 1 second

53. Rescue Breathing Child (pulse but no breathing) Check the person: Look, listen, feel 1. Give 1 rescue breath ever 3 seconds Pinch nose shut Make a seal over the mouth Blow air in to make chest rise Children are smaller than adults so do not tilt head back as far. 2. After 2 minutes: check for signs of life and pulse for no longer than 10 seconds

54. Cardiac Emergencies Chapter 5

55. Cardiovascular Disease Cardiovascular Disease: An abnormal condition that affects the heart and blood vessels An estimated 61 million Americans suffer from some form of cardiovascular disease About 950,000 Americans die of Cardiovascular Disease each year The two main components of cardiovascular disease are coronary heart disease and stroke

56. Coronary Heart Disease The most common type of heart disease Coronary Heart Disease occurs when fatty deposits containing cholesterol clog the arteries supplying the heart. This damage to the heart can lead to a heart attack

57. Heart Attack When damage to the heart causes it to stop working effectively, the person experiences a heart attack. A heart attack can cause 1. An irregular heart beat 2. Improper circulation 3. Normal breathing to be disrupted 4. The heart to stop beating When the heart stops beating it is called cardiac arrest

58. Signals of a Heart Attack Chest discomfort or pain Upper body pain. Chest to your shoulders, arms, back, neck, teeth or jaw. Stomach pain. May feel like heartburn. Shortness of breath Anxiety. Lightheadedness. Sweating Nausea and vomiting

59. Care for a Heart Attack Recognize the signals Cal 9-1-1 Convince the person to stop what they are doing and rest Try to obtain information about the person Comfort the person Assist with prescribed medication Offer an aspirin if medically appropriate Monitor Their condition Be prepared to give CPR and to use AED

60. When the Heart Stops Beating Cardiac Arrest is a condition when the heart stops beating or beats too ineffectively to circulate blood. Unlike a heart attack, cardiac arrest can happen suddenly and without warning signs. When cardiac arrest happens, breathing stops. The absence of signs of life is the main signal of cardiac arrest. No signs of life mean no pulse and no breathing.

61. Early CPR and Defibrillation Even though a person is not breathing and shows no other signs of life, body cells can still live for a short time. This person is in immediate need of CPR and defibrillation. CPR is a combination of chest compressions and rescue breathing while defibrillation is delivering an electrical shock to the heart aimed at disrupting the electrical rhythm.

62. When Seconds Count! CPR TIME LINE 0-4 mins. brain damage unlikely 4-6 mins. brain damage possible 6-10 mins. brain damage probable over 10 mins. probable brain death

63. Cardiac Chain of Survival CPR at best provides about 1/3 of the normal blood flow to the brain so advanced medical care is needed as soon as possible A person in cardiac arrest will have the greatest chance of survival if the following 4 steps happen. They are called the Cardiac Chain Of Survival 1. Early recognition and access- call 9-1-1 ASAP. Usually the most forgotten step 2. Early CPR- help circulate Oxygen to vital body organs 3. Early defibrillation- each minute defibrillation is delayed the chance of survival drops 10% 4. Early advanced medical care- Paramedics and EMT can give advanced care and transport person to hospital

64. Video Segment Cardiac Chain of Survival Rescue Breathing: Adult, Child, Infant CPR Adult

65. Conscious Choking Adult/Child Check the Scene Check the Victim Call 9-1-1 Back Blows and Abdominal Thrusts Give 5 back blows: Stand slightly behind the victim. Place one arm diagonally across the victim's chest for support and lean him forward. With the heel of your other hand, strike the victim firmly between the shoulder blades. Give 5 abdominal thrusts: Place the thumb side of your fist just above the victim's belly button. Grab your fist with your free hand. Pull quick, upward thrusts to dislodge the object.

66. Conscious Choking Infant Check the Scene Check the Victim Call 9-1-1 Blows and Thrusts Carefully hold the infant face down on your forearm, your hand supporting its head and neck Strike the infant directly between the shoulder blades with the heel of your other hand 5 times Turn the infant over and position two fingers in the center of the chest Give 5 1/2 to 1 inch deep chest thrusts Repeat Blows and Thrusts until the object is forced out, the infant starts breathing, or the infant becomes unconscious.

67. Rescue breathing Adults ( no movement or breathing) Check the injured or ill person. Look, listen and feel for no longer than 10 seconds 1. First, tilt the victim's head back and lift the chin up, then pinch the nose shut. 2. Take a breath and make a complete seal over the victim’s mouth 3. Blow in to make the chest cavity rise Each rescue breath should last about 1 second

68. Rescue breathing child ( pulse but no breathing) Check the person: Look, listen, feel 1. Give 1 rescue breath ever 3 seconds Pinch nose shut Make a seal over the mouth Blow air in to make chest rise Children are smaller than adults so do not tilt head back as far. 2. After 2 minutes, check for signs of life and pulse for no longer than 10 seconds

69. CPR: ADULTS No signs of Life Check The Scene, Check the Person Call 9-1-1 Look, Listen, and Feel for no longer than 10 seconds Step 1:CPR Give cycles of 30 chest compressions and 2 rescue breaths Adults: Two hands in the center of the chest( lower half of the sternum) Step 2: When to Stop CPR Continue CPR until- Scene become s unsafe You find a sign of life AED is ready to use You are too exhausted to continue Another trained responder arrives and takes over What to do next: Use AED as soon as one becomes available

70. Unconscious Choking Adult Has a pulse but breaths do not go in Step 1 Tilt head further back and give 2 rescue breaths Step 2 If chest does not rise give 2 rescue breaths Step 3 Look for an object Step 4 Remove object if one is seen Step5 Try 2 rescue breaths What to do next If breaths do not go in, continue steps 2-5 If breaths go in, Check for signs of life and give care based on condition found

71. CPR: Child No signs of Life Check the Scene, Check the Person Call 9-1-1 Look, Listen and feel for no longer that 10 seconds Step 1: CPR Give cycles of 30 chest compressions and 2 rescue breaths Child: One or two hands in center of chest on lower half of the sternum Step 2: When to Stop CPR: Continue CPR until- Scene become s unsafe You find a sign of life AED is ready to use You are too exhausted to continue Another trained responder arrives and takes over What to do next: Use AED as soon as one becomes available

72. Unconscious Choking Child Has a pulse but breaths do not go in Step 1 Tilt head further back and give 2 rescue breaths Step 2 If chest does not rise give 2 rescue breaths Step 3 Look for an object Step 4 Remove object if one is seen Step5 Try 2 rescue breaths What to do next If breaths do not go in, continue steps 2-5 If breaths go in, Check for signs of life and give care based on condition found

73. CPR: Infant No signs of Life Check the Scene, Check the Person Call 9-1-1 Look, Listen and feel for no longer that 10 seconds Step 1: CPR Give cycles of 30 chest compressions and 2 rescue breaths Infants: Two or three fingers on lower half of chest( 1 finger below the nipple) Step 2: When to Stop CPR Continue CPR until- Scene become s unsafe You find a sign of life AED is ready to use You are too exhausted to continue Another trained responder arrives and takes over What to do next: Use AED as soon as one becomes available

74. Unconscious Choking Infant Has a pulse but breaths do not go in Step 1 Tilt head further back and give 2 rescue breaths Step 2 If chest does not rise give 2 rescue breaths Step 3 Look for an object Step 4 Remove object if one is seen Step5 Try 2 rescue breaths What to do next If breaths do not go in, continue steps 2-5 If breaths go in, Check for signs of life and give care based on condition found

75. Chest Compressions Adult/Child For chest compressions to be most effective, the person should be on his or her back and on a firm surface. To perform CPR on an adult: 1. Find the person’s sternum, straighten arms and lock elbows. 2. Kneel over the person 3. Give compressions by pushing sternum down 1 ½ to 2 inches 4. Push straight down with the weight of the upper body 5. After each compression, allow the chest to return to its normal position. 6. Give 30 compressions in 18 seconds 7. After 30 compressions give 2 rescue breaths

76. CPR SKILL COMPARISONS

77. Using An AED As we mentioned earlier in the unit, most people in sudden cardiac arrest need an electrical shock called defibrillation. Each minute defibrillation is delayed, the chances of survival drop by about 10 %. The AED should be used as soon as it is available and safe to do so. Cardiac Chain of Survival 1. Call 9-1-1 2. Begin CPR: CPR should only be stopped when the AED is ready to analyze.

78. AED Precautions Do not touch the person while the AED is analyzing. Prior to shocking, make sure everyone stands clear. Do not touch the person while the device is defibrillating. Do not use alcohol to wipe the person’s chest. Do not defibrillate a person around flammable materials. Do not use the AED in a moving vehicle. Do not use the AED if the person is in contact with water. Do not use the Adult AED and/or electrodes on a child under the age of 8 or under 55 pounds. Do not use the AED on a person wearing a nitroglycerin patch or any other patch on the chest. Do not cell phones within 6 feet of the AED

79. Special AED Situations Wet Environments Never use the AED in or around water. If a person is wet, dry the chest before attaching pads. Implantable Devices Pacemakers or other implanted cardio devices. Do not place the AED pads directly over the implanted device. It may interfere with the shock. Nitroglycerin Patches Nitroglycerin can be absorbed by the responder so it should be removed by a gloved hand before defibrillation. Other patches such as nicotine patches look the same so you should not take time to decipher.

80. AED: Adults Step1 Turn on AED Step 2 Wipe chest dry Step 3 Attach pads to bare chest Step 4 Plug in connector if necessary Step 5 Make sure no one is touching the person and say “EVERYONE STAND CLEAR” Step 6 Push analyze button and let AED analyze heart rhythm Step 7 If shock advised make sure no one is touching victim and say “ EVERYONE STAND CLEAR” and push shock button What to Do Next After shock: give 5 cycles or about 2 minutes of CPR If no shock advised, give 5 cycles or about 2 minutes of CPR

81. AED: Children For an AED, a child is considered to be below 55 pounds and between the ages of 1 and 8. Most cardiac arrests in children are not sudden. The most common causes of cardiac arrest are due to the following: 1. Airway or breathing problems 2. Traumatic injuries: accidents, drowning 3. Hard blow to the chest 4. Congenital heart disease 5. SIDS: Sudden Infant Death Syndrome

82. AED: Child Step1 Turn on AED Step 2 Wipe chest dry Step 3 Attach pads to bare chest. Make sure you are using pediatric AED pads. Step 4 Plug in connector if necessary Step 5 Make sure no one is touching the person and say “EVERYONE STAND CLEAR” Step 6 Push analyze button and let AED analyze heart rhythm Step 7 If shock advised make sure no one is touching victim and say “ EVERYONE STAND CLEAR” and push shock button What to Do Next After shock: give 5 cycles or about 2 minutes of CPR If no shock advised, give 5 cycles or about 2 minutes of CPR

83. AED Pad Placement Adult/ Larger ChildSmaller Child/Infant Place one pad on the upper right chest and the other pad on the lower left side. AED pads can never touch. If the chest area is too small, place one pad on the chest and one pad on the back

84. Soft Tissue Injuries Chapter 7

85. Injuries Injuries are one of our nation’s most important health problems 5 leading causes of injury are: Motor Vehicle Accidents Falls Poisoning Drowning Choking

86. Wounds Soft tissue is the layers of skin, fat and muscle beneath the skin’s outer layer An injury to the soft tissue is commonly called a wound. The two classifications of wounds are 1. Open Wounds: skin is broken 2. Closed Wounds: skin is not broken Both types of wounds may produce bleeding which can vary from minor to life-threatening

87. Types of Closed Wounds 1. Contusion 2. Internal Bleeding 3. Concussions

88. Contusion The simplest closed wound is a bruise which develops when the body is bumped or hit. The medical term for a bruise is a contusion The force of the blow damages the soft tissue layers causing internal bleeding. This bleeding seeps into surrounding tissues caused the area to swell and change colors

89. Internal Bleeding Typically result of blunt trauma (i.e. motor vehicle accident, fight, injury in sport) Signs of Internal Bleeding: Tender, swollen, bruised, or hard areas of the body, such as abdomen Rapid, weak pulse Skin that feels cool or moist or looks pale or bluish Vomiting or coughing blood Excessive thirst Becoming confused, drowsy, faint, or unconscious

90. Concussions Concussion- closed head injury. Injury to the brain caused by a blow or blunt trauma May result in headache, dizziness, tinnitus, nausea, vomiting, memory loss, vision difficulties

91. Care for Closed Wounds Bruise- ice, monitor symptoms Internal bleeding- Call 911, monitor symptoms for shock or possible loss of consciousness Concussion- call 911, get to advanced medical care asap, monitor symptoms

92. Types of Open Wounds Abrasion: most common type of injury, often caused by something rubbing against the skin Laceration: a cut in the skin caused by a sharp object (i.e. broken glass, knife, or from blunt trauma Avulsion: an injury in which a portion of the skin is partially or completely torn away Puncture: caused by a pointed object, such as a nail Embedded object: an object that may have caused the puncture wound and is protruding out of the skin (i.e. nail, stick, pen)

93. Care For Open Wounds Cover wound with sterile dressing Apply direct pressure to wound to help stop bleeding Cover dressing with bandage If wound continues to bleed through dressing, apply additional dressing over existing dressing and add more bandages

94. Special Situations Severed Body PartsEmbedded Objects Wrap the severed part in sterile gauze and put it in a bag on ice Placer several bandages around the embedded object to keep it from moving. Never remove an embedded object

95. Video Controlling Bleeding

96. Burns Have 2 Classifications Heat SourceDepth 1. Thermal (Heat)- Fire, hot pan 2. Chemical- may be wet or dry chemical, i.e. instant ice pack or ice melt (granulated), oven cleaner, drain cleaner 3. Electrical- electricity 4. Radiation (Sun)- sunburn 1. Superficial- 1 degree 2. Partial Thickness- 2 nd degree 3. Full thickness- 3 rd degree

97. Burns: Depth First Degree (superficial)- Involves only top layer of skin Skin is red and dry, usually painful and the area may swell Usually heals within a week without permanent scarring

98. Burns: Depth Second Degree (partial thickness): Involves the top layers of skin Skin is red; usually painful; has blisters that may open and weep clear fluid making the skin appear wet; may appear mottled and often swells Usually heals in 3-4 weeks and may scar

99. Burns: Depth Third Degree (full thickness): May destroy all layers of skin and some or all of the underlying structures Skin may be brown or black with the tissue underneath appearing white; pain level varies depending on nerve damage Healing may require medical assistance; scarring is likely

100. Burn Severity

101. Care For Thermal Burns Check the scene for safety (fire, down power lines, etc.) Stop the burning be removing the person from the source of the burn Check for life-threatening conditions Cool the burn with large amounts of cold running water * Cover the burn loosely with sterile dressing

102. Care for Burns- Continued Prevent Infection Take steps to minimize shock Keep person from getting chilled or overheated *DO NOT apply running water to possible dry chemical burn

103. Care For Burns- What not to do! DO NOT apply ice or ice water except on small, superficial burn and for no more than 10 minutes. DO NOT touch a burn with anything other than a sterile dressing/bandage DO NOT remove pieces of clothing tat may be stuck to a burn DO NOT try to clean a sever burn DO NOT break blisters DO NOT use any ointment on a severe burn

104. Care For Chemical Burns Remove clothes that may be contaminated Dry chemicals: brush the chemical off with a gloved hand, then flush the area with tap water under pressure Wet chemicals: flush the burn with large amounts of cold running water If chemical is in eye: have person flush eye out with large amounts of running water

105. Care For Electrical Burns Check the scene: Never go near a person who is in contact with electricity Call 911 Turn off power at its source and care for life-threatening injuries Be prepared to give CPR Care for shock and thermal burns Definite need for advanced medical care

106. Video Care for Burns

107. Nose Injuries Usually caused by blunt trauma Care- have person pinch the end of their nose with dressing/gauze and lean forward You may also apply ice to the bridge of the nose. NEVER APPLY ICE DIRECTLY TO THE SKIN

108. Tooth Injuries If person’s tooth is knocked out: Control bleeding by rolling up a piece of gauze and placing where the tooth was With a gloved hand, pick up the tooth by the crown (white part) Place the tooth in milk to save the tooth Person should see Dentist asap

109. Injuries to Muscles, Bones and Joints Chapter 8

110. Types of Injuries to Muscles, Bones or Joints 1. Fractures 2. Dislocations 3. Sprains 4. Strains

111. A complete break, a chip or crack in the bone. Closed fractures are when the skin is not broke and in open fractures, the skin is broken Fractures

112. Dislocations Movement of the bone at a joint away from its normal condition

113. Sprains and Strains SprainStrain Tearing of a ligament at a joint Stretching and tearing of muscles and tendons

114. Caring for Muscle, Bone or Joint Injuries The RICE method is recommended for treating injuries to the muscles, bones and joints Rest- Do not move or straighten the injured are Immobilize-Stabilize the injured area in the position it was found Cold-apply ice for 20 minutes. Never apply ice directly to skin Elevate- elevate only if it does not cause more pain

115. Video First Aid for muscles, bones and joints

116. Splinting Splint only if it is necessary to move the person Splint only if you can do so without causing more pain Splint the injury in the position you found it Splint the bones and joints above and below the injury Check for circulation(feeling, warmth and color) before and after splinting. Make sure splint is not too tight.

117. Types of Splints 1. Anatomic Splints: Person’s body is the splints 2. Soft Splints: folded blanket, towel, pillow or triangular bandage sling 3. Rigid Splints: boards, folded magazines or metal strips 4. The ground: An injured leg stretched out on the ground. After you have splinted the injury, apply ice.

118. Head, Neck, Back Injuries Signals of head, neck, back, injury Caring for head, neck, back injuries Involved in a motor vehicle accident Fell from a greater distance than standing height Complains of head, neck, back pain Has tingling or weakness in the extremities Is not fully alert Call 9-1-1 Minimize movement of the head, neck and spine by placing hands gently on both sides of person’s head Hold the head in line with body in the position you found the victim Monitor breathing and airway until EMS arrives

119. Sudden Illnesses Chapter 9

120. Signs of Sudden Illness Changes in consciousness Nausea or vomiting Difficulty speaking or slurred speech Numbness or weakness Loss of vision or blurred vision Changes in breathing Changes in skin color Sweating Persistent pressure or pain Seizures Paralysis or inability to move Severe headache

121. Caring for Sudden Illness Do no further harm Check the scene Call 9-1-1 Care for life-threatening conditions If person vomits and is unconscious, lie them on their side Help the person rest comfortably Keep the person from getting chilled or overheated Reassure the person Watch for changes in consciousness If the person is conscious ask if they take any medications or have any special medical conditions

122. Diabetic Emergencies Caused by too much or too little sugar in a person’s blood Care for Diabetic Emergencies Call 9-1-1 If the person is conscious and can swallow, give them sugar preferably in a liquid form If the person is conscious but unable to swallow, DO NOT PUT ANYTHING IN THEIR MOUTH If the person is unconscious care is the same for any individual

123. Seizures Sometimes a person who becomes suddenly ill may have a seizure Care for a Seizure Don not try to stop the seizure Do not hold or restrain the person Do not put anything in the person’s mouth Protect the person from being injured Remove nearby dangerous objects Protect the person’s head by placing a thin cushion underneath it

124. Stroke Stroke are the third leading killer in the United States A stroke, also called a “brain attack” is caused when blood flow to the brain is cut off or when there is bleeding into the brain. Risk Factors High Blood Pressure Cigarette Smoking Diet Diabetes

125. Strokes Continued Sudden Signals of a StrokeCare for a Stroke Difficulty talking or slurring speech Blurred or dimmed vision Sudden or severe headache, dizziness or confusion Call 9-1-1 Look at your watch and note when symptoms started If person is unconscious, make sure they have an open airway Stay with person and monitor ABC’s until EMS arrives

126. Heat or Cold Related Emergencies Chapter 11

127. Heat-Related Illnesses 1. Heat Cramps: Least severe of the heat-related emergencies Care: Rest in a cool place and give water, lightly stretch 2. Heat Exhaustion and Heat Stroke: more severe than heat cramps. Heat Cramps to Heat Exhaustion to Heat Stroke is the progression if symptoms are ignored. Care Get the person out of the heat loosen any tight clothing Apply cool damp cloths periodically Give cool water

128. Cold-Related Illnesses Frostbite and Hypothermia are two types of Cold-related illness. Frostbite: freezing of a body part that has been exposed to the cold Care for Frostbite Handle the area gently Never rub the area Warm the area by soaking it in warm water Loosely bandage the area with a sterile dressing If fingers and toes are frostbitten, place cotton or gauze between them