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Kampala Police 2010-11 FIRST AIDER ToT. Purpose of this course In Uganda, Police are often the frontline for trauma care.

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Presentation on theme: "Kampala Police 2010-11 FIRST AIDER ToT. Purpose of this course In Uganda, Police are often the frontline for trauma care."— Presentation transcript:

1 Kampala Police FIRST AIDER ToT

2 Purpose of this course In Uganda, Police are often the frontline for trauma care

3 Police can make a difference Without an ambulance or specialized medical equipment you can save lives Goal is to empower cadets with knowledge to save lives

4 Stress that you do not need to be a doctor, have an ambulance or other equipment to save lives! Police can make a difference

5 Course Objectives Increase your medical knowledge Learn the highest-yield first aid techniques that save lives Demonstrate proficiency in performing and teaching these skills

6 Course Outline Safety Anatomy DR. ABCs & High-yield first aid Common medical and injury scenarios Skills station Post test

7 ROLES AND RESPONSIBILITY OF THE FIRST AIDER

8 Qualities of the First Responder: Observant. Resourceful. – –Use materials available at the time, improvise and implement necessary ones. Dexterous (skillfully and cleverly done). Humanitarian. – –Able to work beyond social, tribal and religious boundaries. Perseverance. – –Able to work without giving up until qualified help arrives. Sympathetic. Explicit. – –Be clear with your instructions to the casualty and or bystanders.

9 Responsibilities of the First Responder: Safety Scene management Patient Assessment Patient Care Patient Transport

10 Anatomy

11 Respiratory System

12 Inhalation Air Flows Into Lungs

13 Exhalation Air Flows Out of Lungs

14 Away from the Heart High Pressure Back to the Heart Low Pressure

15 Arterial Capillary Venous

16 Carotid Pulse (find yours)

17 Femoral Pulse (find yours)

18 Radial Pulse (find yours)

19 Nervous System

20 Spinal Column

21 Scene Management and Safety

22 Personal Safety is #1 Universal precautions

23 Infectious Diseases What diseases can you contract from exposure to blood and body fluids? HIV Hepatitis B and C Others? What are the chances of contracting HIV from a needlestick from an HIV infected victim? What should you do if you are exposed to bodily fluids? You cannot get cancer from blood/fluid contact with a victim

24 Scene Safety: Assess the scene

25 Scene Safety: Secure the scene Turn off ignition & secure brake Use patrol car to protect the scene

26 Scene Safety: Secure the scene Protect the bystanders

27 Scene Safety: Assess Casualties

28 Scene Management: Get help

29 High-Yield First Aid Casualty Management & Initial Assessment

30 A irway B reathing C irculation Don’t Panic, use ABCs D anger R esponse. Personal and scene safety “Are you alright?”

31 How does a road traffic accident or any other trauma kill a person?

32 Airway Assessment A irway

33 Without an open airway, a patient can die within seconds ABCs for All Victims A irway

34 Open the Airway -Clear nose and mouth -Lift Chin ABCs for All Victims Check if patient is conscious: “Are you ok?” Victim Does NOT Respond Victim Responds A irway

35 Without chin lift, jaw thrust With chin lift, jaw thrust Adrian et al, Anesthesiology June Volume 90 - Issue 6 - pp

36

37 Breathing Assessment B reathing

38 ABCs for All Victims Look Listen Feel If patient not breathing, keep airway open & transport ASAP! B reathing

39 Adequate Breathing: Normal Rates  Adults  Children  Infant 12-20/min /min /min.

40 Circulation Assessment C

41 ABCs for All Victims If bleeding: Apply pressure Elevate wound Wrap with bandage C irculation

42 Arterial Capillary Venous

43 Methods for bleeding control C irculation

44 Pressure, Pressure & more Pressure!!!

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46

47 Severe Bleeding A bleeding patient can lose all of their blood in ONE MINUTE and die DIRECT PRESSURE is best DO NOT USE TOURNIQUETS Unless amputation AND unable to control bleeding with pressure alone A tourniquet WILL cause irreversible damage and possibly kill the limb

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50 Artery Compression Technique

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52

53 Carotid Pulse

54 Femoral Pulse

55 Radial Pulse

56 Infants: Check brachial pulse.

57 A irway B reathing C irculation Don’t Panic, recall ABCs

58 BASIC LIFE SUPPORT, CPR & Rescue Breathing

59 What have you been taught and what do you teach about CPR and rescue breathing?

60 Old Teaching: If patient not breathing, classic teaching has been to give rescue breaths Trauma 1 st Responder Teaching If not breathing  make sure airway open, no breaths, and transport ASAP B reathing Swenson et al. NEJM, July 2010

61 C irculation Current Teaching: If victim does not have a pulse, start chest compressions at 100 per minute Trauma 1 st Responder Teaching If no pulse transport ASAP (after ABCs) DO NOT DELAY TRANSPORT FOR CPR

62 C irculation Trauma 1 st Responder Teaching If no pulse and not breathing transport ASAP (after ABCs) CPR and rescue breathing will not hurt as long as it does not delay transport! 30 chest compressions : 2 breaths

63 Lifting and Moving Lifting and MovingVictims

64 Secure victim in car Drive at a reasonable speed – –Will not likely make a difference in transport time If unconscious use the recovery position Transport Key Points

65 Recovery Position: if unconscious

66 Emergency Move Blanket Drag

67 Emergency Move – Clothes Drag

68 Emergency Move - Back Pack Carry

69 Emergency Move – Direct Carry

70 Body Roll

71

72 Take positions to log roll patient. Leader at head directs.

73 Secure victim in car Drive at a reasonable speed – –Will not likely make a difference in transport time If unconscious use the recovery position Transport Key Points

74 Special Injury Considerations

75 Soft-Tissue Injuries

76 Impaled Object

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81 Internal Bleeding

82 Abdominal Evisceration

83 Burns

84 Burns

85 Burns

86 Burn Care Stop the burning process with waterStop the burning process with water Remove smoldering clothing & jewelryRemove smoldering clothing & jewelry ABCsABCs Cover burn with dry, sterile dressingCover burn with dry, sterile dressing NO ointments/creamsNO ointments/creams Don’t break blistersDon’t break blisters Seek medical attentionSeek medical attention

87 Musculoskeletal Injuries

88 Types of Musculoskeletal Injuries

89 Fractures Move the limb as little as possible Use cardboard, cotton, and tape or cloth ties keep limb clean, still, and stable ABC Initial Assessment Patient talking & Bleeding Controlled Patient unable to talk or Bleeding Uncontrolled Take to hospital immediately!!! SAFETY

90 Fractures Splint ONLY AFTER ABCs Do NOT delay transport for splinting in a patient who is unconscious or has uncontrolled bleeding

91

92 Improvised Splints

93 Making cardboard splint

94 Splint for Injured Forearm

95 Injuries to the Head and Spine

96 Nervous System

97 Spinal Column

98 Mechanisms of Spinal Injury

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100 If possible, get others to help, and maintain control of the neck, do not need special collar Transport victim onto carrier by log-rolling Transport: Possible spine injury

101

102 Secure patient and transport.

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106 Skull Fractures and Concussions What do you teach about managing these conditions?

107 Common Medical Emergencies

108

109 Heart Attack

110 CHOKING ABCs !!! (check mouth if unconscious) If ABLE to speak or cough, then not complete obstruction –Encourage coughing –Heimlich if failed If UNABLE to speak/cough attempt then Heimlich

111 CHOKING: Heimlich Maneuver Position yourself behind patient. Position yourself behind patient.

112 Place thumb-side of fist in middle of abdomen, between navel and rib cage.

113 Heimlich Maneuver

114 Infant choking - conscious

115 Deliver 5 chest thrusts.

116 Infant choking - Unconscious

117 Perform tongue-jaw lift & remove visible objects.

118 Drowning What do you teach about managing a drowning victim?

119 Diabetes  High Blood Sugar  Need insulin  If too much medication can have low blood sugar  If too little medication, high blood sugar  Can cause fits, loss of consciousness or confusion

120 STROKE

121  Altered mental status  Slurred speech or difficulty speaking  Facial droop  Unequal pupil  Unable to move half of body  Difficulty swallowing Stroke: Signs & Symptoms (Continued)

122 Fits (Seizures) Not Contagious! Put patient in recovery position ASAP ABCs Transport ASAP SAFETY Make sure victim is clear of obstacles that could cause injury

123 Shock & Fainting What do you teach about fainting? What about shock?

124 Gabon Viper Puff Adder Snake Bites  Coin coverage and blackstones are ineffective  One review in Gulu, 108 snake bite patients, none received antivenom, all survived  Do not cut and suck  Immobilization, cleaning of limb and immediate transport are key (Below the heart, light compression wrap)

125 Common Causes of Allergic Reactions Insect Stings Foods Medications Plants

126 Four Routes of Poisoning INHALATION INJECTION INGESTION ABSORPTION Acid – Intentional Burns

127 Acid Burns ABCs !!! Rinse well with water –Even if no pain Acids and bases can cause damage without causing pain

128

129 Obstetrics and Gynecology

130 Anatomy Perineum Vagina Cervix Pubic Bone Uterus

131 Anatomy Amniotic Sac Umbilical Cord Placenta

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138 Multiple-CasualtyIncidents

139 Tasks for Mass Casualty  Extrication  Triage  Staging  Treatment  Transportation  Supply  Command

140 Mass Casualty: STEP 1 Triage officer announces that all patients that can walk should get up and walk to a designated area for eventual secondary triage. Color coding © Lou Romig MD, Used with permission.

141 Mass Casualty: STEP 2 If no breathing and no pulse, leave aloneIf no breathing and no pulse, leave alone If no breathing but has pulse, evaluate ABCs and consider for immediate transportationIf no breathing but has pulse, evaluate ABCs and consider for immediate transportation If breathing and has pulse, also evaluate ABC and prepare for transportIf breathing and has pulse, also evaluate ABC and prepare for transport © Lou Romig MD, Used with permission.

142 Death Do not decide if a patient is dead at the scene!Do not decide if a patient is dead at the scene! This must be done at a health facility!This must be done at a health facility! Live patients have been transported to the morgueLive patients have been transported to the morgue

143 QUICK REVIEW

144 Police can make a difference Without an ambulance or specialized medical equipment you can save lives Goal is to empower cadets with knowledge to save lives

145 You do not need to be a doctor, have an ambulance or other equipment to save lives! Police can make a difference

146 Personal Safety is #1 Universal precautions

147 A irway B reathing C irculation Don’t Panic, recall ABCs

148 A irway Chin lift & jaw thrust Adrian et al, Anesthesiology June Volume 90 - Issue 6 - pp

149 ABCs for All Victims Look Listen Feel If patient not breathing, transport ASAP! B reathing

150 C irculation Pressure, Pressure & more Pressure!!!

151 CPR If no pulse and not breathing trauma victim transport ASAP (after ABCs) CPR and rescue breathing will not hurt as long as it does not delay transport! 30 chest compressions : 2 breaths

152 Secure victim in car Drive at a reasonable speed – –Will not likely make a difference in transport time If unconscious use the recovery position Transport Key Points


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