1. Emergency Aid I Resuscitation Resuscitation –Adult CPR First Aid First Aid –Primary Survey –Secondary Survey –Recovery position –Summoning help –Dressings & Slings –Clearing up Scenario Scenario –Putting theory into practice

2. Plan of action 8 hours training (approx.) 8 hours training (approx.) –3 x 2 hours 1 hour CPR 1 hour CPR 1 hour first aid 1 hour first aid –1 x 2 hours Revision & scenarios Revision & scenarios Exam Exam

3. What is First Aid? Preserve Life Preserve Life –Don’t forget yours!! Prevent deterioration Prevent deterioration –Treat the obvious Promote recovery Promote recovery –Treat the less obvious

4. Primary Survey Check for Danger Check for Danger To yourself, your patient and everyone else To yourself, your patient and everyone else Check Responses Check Responses Shake & shout Shake & shout Shout for ‘help’ Shout for ‘help’ Open Airway Open Airway Head tilt & chin lift Head tilt & chin lift Check for normal Breathing Check for normal Breathing Look, listen & feel Look, listen & feel Call/send for an Ambulance Call/send for an Ambulance Start CPR Start CPR

5. CPR 30 Chest compressions 30 Chest compressions Place hands in centre of chest Place hands in centre of chest Push chest down (4-5 cm) Push chest down (4-5 cm) At a rate of 100 per minute At a rate of 100 per minute 2 breaths 2 breaths 1 second in, 2 seconds out 1 second in, 2 seconds out

6. Practical Let’s have a go at CPR Let’s have a go at CPR

7. Choking Partially Obstructed. If there is some movement of air when they try to breath. If there is some movement of air when they try to breath. Encourage them to cough Encourage them to cough Completely Obstructed Lean them forward Lean them forward 5 back slaps (up to) 5 back slaps (up to) 5 abdominal thrusts 5 abdominal thrusts If they become Unconscious Start CPR immediately Start CPR immediately

8. Making a diagnosis Signs Signs –What you can see (blood, breaks etc.) Symptoms Symptoms –What the patient feels (where it hurts) History History –What has happened (ask patient and bystanders)

9. Secondary Survey A secondary survey is what you do once you know they are breathing normally. A secondary survey is what you do once you 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 happened and do you hurt anywhere’. If they are conscious you can ask them ‘what happened and do you hurt anywhere’. Whilst constantly reassuring, check for lumps, bumps, dents, deformity & wet patches. Whilst constantly reassuring, check for lumps, bumps, dents, deformity & wet patches. Keep ABC in mind when doing secondary survey. Keep ABC in mind when doing secondary survey.

10. Secondary Survey Check head Check head –Dents, lumps, bruising & fluids from ear, nose & mouth Check neck & upper spine Check neck & upper spine –Unevenness, swelling, numbness & inability to move may suggest a fracture Check shoulders and chest for fractures & bleeding or strange sounds Check shoulders and chest for fractures & bleeding or strange sounds Check stomach area for swelling & hardness Check stomach area for swelling & hardness

11. Secondary Survey Gently check pelvis for unnatural movement Gently check pelvis for unnatural movement Check legs for signs of bleeding or irregularity Check legs for signs of bleeding or irregularity Check arms for signs of bleeding or irregularity Check arms for signs of bleeding or irregularity Watch out for medi-alerts Watch out for medi-alerts Be careful of needles Be careful of needles

12. Secondary Survey Keep talking/reassuring Keep talking/reassuring –Your patient can hear you –Members of the public will know what you are doing

13. Practical This is practice!!! This is practice!!! –Constantly explain to the casualty what you are doing

14. Reasons for Unconsciousness F I S H S H A P E D

15. Fainting Fainting Imbalance of heat Imbalance of heat Shock Shock Heart Attack Heart Attack Stroke Stroke Head Injury Head Injury Asphyxia Asphyxia Poisons Poisons Epilepsy Epilepsy Diabetes Diabetes

16. Fainting Phew!!! Phew!!! –Unless they hit something on the way down they will recover quickly. –The pulse should be strong and bounding –Caused by lack of oxygen to the brain. –Lay them down, loosen tight clothing & raise the legs.

17. Imbalance of heat Hypothermia (too little heat) Hypothermia (too little heat) –Cold to touch –Confused –Unsteady –Slow pulse & breathing –Remove from cold environment –Warm them up at the rate they cooled –Call for an ambulance

18. Imbalance of heat Hyperthermia (too much heat) Hyperthermia (too much heat) –Heat exhaustion – profuse sweating profuse sweating Signs & symptoms of shock Signs & symptoms of shock Treat as for shock Treat as for shock 1 tsp of salt in 1 litre of water to sip slowly 1 tsp of salt in 1 litre of water to sip slowly –Heat stroke Patient will be hot, red and dry Patient will be hot, red and dry Call for an ambulance Call for an ambulance Remove outer clothing Remove 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.

19. Imbalance of heat Infant convulsions (febrile) Infant convulsions (febrile) –Remove outer clothing –Remove nappy (it usually has a plastic lining) –Sponge them from head to foot with tepid water to reduce temperature. –Call an ambulance –Don’t forget mum!!

20. Shock Shock is ‘Lack of Oxygen to the vital organs’. Many conditions will cause patients to suffer from shock 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 up Patient will be nauseas so expect them to throw up Call for an ambulance Call for an ambulance

21. Shock - treatment T – Treat the cause R – Rest – lay the casualty down A – Assistance or Ambulance W – Warmth – keep the casualty warm L – Loosen tight clothing E – Elevate the legs R - Reassure

22. Shock - anaphylactic Severe allergic reaction to a trigger. Swelling, blotchy skin, difficulty breathing, patient distressed. Swelling, blotchy skin, difficulty breathing, patient distressed. Sit the casualty down & lean forward Sit the casualty down & lean forward Loosen tight clothing Loosen tight clothing Reassure Reassure Assist patient to administer medication if they have any. Assist patient to administer medication if they have any. Call for an ambulance Call for an ambulance Be prepared to start CPR Be prepared to start CPR

23. Heart Attack AKA Myocardial Infarction (MI) Due to a blockage in one of the arteries in the heart Due to a blockage in one of the arteries in the heart Severe crushing chest pain – may move down an arm, up the neck & into the jaw. Severe crushing chest pain – may move down an arm, up the neck & into the jaw. Pain does not go away with rest Pain does not go away with rest Call for an ambulance immediately Call for an ambulance immediately If conscious – sit in ‘W’ position If conscious – sit in ‘W’ position If unconscious and breathing – put in recovery position, monitor ABC If unconscious and breathing – put in recovery position, monitor ABC If unconscious and not breathing – Start CPR If unconscious and not breathing – Start CPR Chain of Survival starts!!! Chain of Survival starts!!!

24. Chain of survival

25. Angina Pectoris Due to a narrowing in one of the arteries in the heart Due to a narrowing in one of the arteries in the heart Severe crushing chest pain – may move down an arm, up the neck & into the jaw Severe crushing chest pain – may move down an arm, up the neck & into the jaw If pain does not go away with rest assume it is a heart attack. If pain does not go away with rest assume it is a heart attack. Will probably have a history of Angina & is likely to have medication, if so, assist them to take it. Will probably have a history of Angina & is likely to have medication, if so, assist them to take it. Even with history it may still be a heart attack Even with history it may still be a heart attack Treat as for heart attack Treat as for heart attack Call for an ambulance Call for an ambulance

26. Stroke AKA - CVE (Cerebral Vascular Event) Due to a blocked or burst blood vessel in the brain Due to a blocked or burst blood vessel in the brain Patient will be confused Patient will be confused Paralysis on one side of the body is common Paralysis on one side of the body is common The patient will probably be able to hear clearly The patient will probably be able to hear clearly Patient may soil themselves, have slurred speech & be dribbling. Patient may soil themselves, have slurred speech & be dribbling. Call for an ambulance, lay them down with head and shoulders slightly supported, monitor ABC Call for an ambulance, lay them down with head and shoulders slightly supported, monitor ABC

27. Head Injury Concussion Blow to the head causing brain to shake inside the skull. (causes the brain to try to ‘re-boot’). Blow to the head causing brain to shake inside the skull. (causes the brain to try to ‘re-boot’). Pale, nauseous & unsteady. Pale, nauseous & unsteady. Should seek medical advise Should seek medical advise

28. Head Injury Compression 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 brain A bleed inside the skull putting pressure on the brain Patient will be flushed, breathing may become slow and noisy, pupils may be un-equal. Patient will be flushed, breathing may become slow and noisy, pupils may be un-equal. Patient can deteriorate rapidly Patient can deteriorate rapidly Patient may have suffered from concussion which later develops into compression Patient may have suffered from concussion which later develops into compression Call for an ambulance, check for obvious head injuries, lay them down with head and shoulders raised and supported, reassure, monitor ABC Call for an ambulance, check for obvious head injuries, lay them down with head and shoulders raised and supported, reassure, monitor ABC

29. Asphyxia Drowning, suffocation, CO poisoning etc. Drowning, suffocation, CO poisoning etc. Remove from cause (but don’t put yourself in danger) Remove from cause (but don’t put yourself in danger) Perform DR ABC Perform DR ABC Call an ambulance etc. Call an ambulance etc.

30. Poisoning Drugs, alcohol, medication etc. Drugs, alcohol, medication etc. Ingestion – eaten/drunk Ingestion – eaten/drunk Inhaled – breathed in Inhaled – breathed in Injection – syringe, bite or sting Injection – syringe, bite or sting Absorbed – chemicals Absorbed – chemicals

31. Poisoning Make sure you don’t poison yourself Make sure you don’t poison yourself DO NOT induce vomiting DO NOT induce vomiting Find out which poison was used and how much Find out which poison was used and how much Call ambulance Call ambulance Monitor ABCs Monitor ABCs Use a mask/shield if you do CPR Use a mask/shield if you do CPR Place in recovery position Place in recovery position

32. Epilepsy Protect the head but let them get on with it!! Call an ambulance if… It’s their first fit It’s their first fit It lasts more than 5 minutes It lasts more than 5 minutes If they have repeated fits If they have repeated fits Lets face it, how do you know any of the above until after the fit! Call for an ambulance immediately, you can always cancel it.

33. Diabetes Hypoglycaemia – Lack of sugar Hypoglycaemia – Lack of sugar –May act drunk –Give something sugary if they are conscious –If the condition improves give them some food –If not, call for an ambulance Hyperglycaemia – Excess sugar Hyperglycaemia – Excess sugar –Smell of pear drops on breath –Give sugar if not sure as it will do no immediate harm –Call for an ambulance & monitor ABC

34. Spinal Injury Someone with a suspected spinal injury should not be moved if at all possible Someone with a suspected spinal injury should not be moved if at all possible If you can stay with your patient, monitor them closely and get ready to turn them if they vomit If you can stay with your patient, monitor them closely and get ready to turn them if they vomit If you have to leave them, place them in the recovery position carefully If you have to leave them, place them in the recovery position carefully Airway takes priority Airway takes priority

35. Bleeding Contusion Contusion –A bruise – can be quite extensive Laceration Laceration –A jagged cut e.g. barbed wire. Incision Incision –A clean cut from something sharp (knife, glass) Puncture Puncture –A small hole but possibly a lot of internal damage

36. Bleeding Position Position –Sit or lie the patient down Expose Expose –Have a look Elevate Elevate –Raise injury above the heart (if possible) Pressure Pressure –Direct pressure – indirect as a last resort

37. Internal Bleeding Lungs Lungs –Frothy blood in mouth Stomach Stomach –Dark ‘coffee coloured’ blood in vomit Kidneys Kidneys –Blood stained urine Large intestine Large intestine –Black sticky tarry substance in stools

38. Bleeding (all) Treat if possible (PEEP) Treat if possible (PEEP) Place in recovery position if loosing consciousness Place in recovery position if loosing consciousness Treat for shock and monitor Treat for shock and monitor Call ambulance or send to hospital Call ambulance or send to hospital

39. Burns and scalds Dry heat – fire, hot objects Dry heat – fire, hot objects Scald -Steam, hot water/oil Scald -Steam, hot water/oil Electrical – Entry & exit burns Electrical – Entry & exit burns Chemical – bleach etc. Chemical – bleach etc. Friction – rope burn Friction – rope burn Radiation – sun burn Radiation – sun burn Cold – dry ice, liquid gases Cold – dry ice, liquid gases

40. ‘Hot’ Burns and scalds Remove clothing if not stuck to skin Remove clothing if not stuck to skin Cool with clean fresh water for up to 15 minutes Cool with clean fresh water for up to 15 minutes Treat for shock etc. Treat for shock etc. Us a dressing that won’t stick (cling film) Us a dressing that won’t stick (cling film) DO NOT burst blisters DO NOT burst blisters

41. ‘Cold’ Burns Skin will stick to cold objects, do not pull away Skin will stick to cold objects, do not pull away Treat for shock etc. Treat for shock etc. Us a dressing that won’t stick (cling film) Us a dressing that won’t stick (cling film) DO NOT burst blisters DO NOT burst blisters

42. Fractures Simple - nothing else involved Simple - nothing else involved Greenstick – in young people, not all the way through the bone Greenstick – in young people, not all the way through the bone Complicated – Involves other body system Complicated – Involves other body system Closed – Skin not broken Closed – Skin not broken Open – Skin broken Open – Skin broken

43. Dislocations Occur when a strain has been put on a joint Occur when a strain has been put on a joint May also include a fracture May also include a fracture Do not try to put it back!! Do not try to put it back!!

44. Fractures/dislocations Recognition History (bones tend not to just break) History (bones tend not to just break) Swelling Swelling Uneven when compared to healthy side Uneven when compared to healthy side

45. Fractures/dislocations Treatment Immobilise Immobilise Cover any open wound with sterile dressing Cover any open wound with sterile dressing Send to hospital Send to hospital

46. Sprains & Strains Sprains Sprains –Wrenching/tearing of ligaments Strains Strains –Overstretching of tendons/muscles Symptoms are similar to a fracture, can be more painful, advise them to go to hospital

47. Sprains & Strains Treatment - RICE Rest Rest Ice Ice Compression Compression Elevate Elevate

48. Asthma Difficulty in breathing out Difficulty in breathing out A Chronic condition – they know they’ve got it. A Chronic condition – they know they’ve got it. Sit them down, lean them forwards and reassure Sit them down, lean them forwards and reassure Help them to take their medication – do not use a friends!! Help them to take their medication – do not use a friends!! Call an ambulance if they don’t get better Call an ambulance if they don’t get better

49. Drowning Remove them form water if safe to do so. Remove them form water if safe to do so. Perform primary survey Perform primary survey Always send them to hospital Always send them to hospital

50. Recovery Position The recovery position is a position in which a breathing casualty should be left whilst help is summoned. The recovery position is a position in which a breathing casualty should be left whilst help is summoned. It should be:- It should be:- 1.Stable 2.Have no weight on the Chest 3.Have the head positioned so that fluid can drain away If a patient has an injury they should be laid so that they are lying on the injury. This will help prevent movement of the injury and make sure blood doesn’t move into the ‘good’ side of the body. If a patient has an injury they should be laid so that they are lying on the injury. This will help prevent movement of the injury and make sure blood doesn’t move into the ‘good’ side of the body.

51. Practical Let’s have a go at the recovery position Let’s have a go at the recovery position

52. Calling an ambulance Dial 999 or 112 Dial 999 or 112 Have details ready Have details ready Patient – as much information as you have Patient – as much information as you have Position – where you are (exact location) Position – where you are (exact location) Problem – what’s wrong Problem – what’s wrong Never be afraid to call an ambulance, let them decide what to do once you have given them all the details Never be afraid to call an ambulance, let them decide what to do once you have given them all the details Never call an ambulance ‘for a laugh’ Never call an ambulance ‘for a laugh’

53. Slings 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 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. Make sure it is big enough (double the size of the 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. Be careful when unwrapping it. The pad should be kept sterile so don’t touch it. Be careful when unwrapping it. The pad should be kept sterile so don’t touch it. Wrap the strapping around the limb so that the sides of the pad are closed. Wrap the strapping around the limb so that the 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 re-fill’ Check circulation below the wound using ‘capillary re-fill’

54. Slings and dressings If something is sticking out of the wound, put some dressings around the object and cover the whole area. If something is sticking out of the wound, put some dressings around the object and cover the whole area. Do not try to remove the object Do not try to remove the object Do not apply any pressure on the object. Do not apply any pressure on the object.

55. Slings and dressings Slings – AKA triangular bandages. Slings – AKA triangular bandages. Used to support an arm so that it is comfortable. Used to support an arm so that it is comfortable. Elevated or Support sling. Elevated or Support sling. Us the one that keeps the patient’s arm in the position they want it in. Us the one that keeps the patient’s arm in the position they want it in.

56. Slings and dressings Dressings are used to keep wounds sterile and to help stop bleeding. Dressings are used to keep wounds sterile and to help stop bleeding. Slings are used to prevent movement and to keep the patient comfortable. Slings are used to prevent movement and to keep the patient comfortable. If they are going by ambulance the paramedics may remove all the dressings and slings. If they are going by ambulance the paramedics may remove all the dressings and slings.

57. Practical Let’s have a go at slings & dressings Let’s have a go at slings & dressings

58. Cleaning up Make sure any accident books have been filled in. Make sure any accident books have 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 sure the appropriate people are told so that they can fix it. If there was an obvious cause, make sure the appropriate people are told so that they can fix it.

59. Summary DR ’help’ ABC DR ’help’ ABC Keep calm and always reassure! Keep calm and always reassure! Call for help Call for help

60. Practical Let’s have a go at dealing with a scenario Let’s have a go at dealing with a scenario Has anyone seen any incidents? If so, lets practice what could have been done. Has anyone seen any incidents? If so, lets practice what could have been done.