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.
Responsibilities of the First Responder: Safety Scene management Patient Assessment Patient Care Patient Transport
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
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
What have you been taught and what do you teach about CPR and rescue breathing?
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
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
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
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
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
Fractures Splint ONLY AFTER ABCs Do NOT delay transport for splinting in a patient who is unconscious or has uncontrolled bleeding
Altered mental status Slurred speech or difficulty speaking Facial droop Unequal pupil Unable to move half of body Difficulty swallowing Stroke: Signs & Symptoms (Continued)
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
Shock & Fainting What do you teach about fainting? What about shock?
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)
Common Causes of Allergic Reactions Insect Stings Foods Medications Plants
Four Routes of Poisoning INHALATION INJECTION INGESTION ABSORPTION Acid – Intentional Burns
Acid Burns ABCs !!! Rinse well with water –Even if no pain Acids and bases can cause damage without causing pain
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