Chapter 16 First Aid
Providing First Aid Section 1
Objectives Define first aid
Question Read section 1, pages (5 minutes) What is first aid? What type of people require first aid?
16:1 Providing First Aid Immediate care given to the victim of an accident or illness to minimize the effect of injury or illness until experts can take over Reasons for providing correct first aid
Basic Principles of Providing First Aid Remain calm and avoid panic Evaluate situation thoroughly Have a reason for anything you do Treatment you provide will vary depending on type of injury or illness, environment, others present, equipment or supplies on hand, and availability of medical help
First Steps Recognize that an emergency exists Use all senses to detect problems Sometimes signs of emergency are obvious and at other times they are less obvious
Next Steps Check the scene and make sure it is safe to approach What to observe If not safe, call for medical help If safe, approach the victim Call emergency medical services (EMS) as soon as possible (continues)
Next Steps ( continued ) If possible, obtain the victim’s permission before providing any care Triage if necessary Check for other injuries Obtain as much information as possible before you proceed
General Principles Obtain qualified help Avoid any unnecessary movement of the victim Reassure the victim Use a confident, calm attitude to help relieve victim’s anxiety Avoid giving the victim anything to eat or drink (continues)
General Principles ( continued ) Protect the victim from cold or chilling, but avoid overheating Work quickly in an organized and efficient manner Do not make a diagnosis or discuss condition with observers at scene (continues)
General Principles ( continued ) Maintain confidentiality and protect the victim’s right to privacy while providing treatment Make every attempt to avoid further injury or harm Provide only the treatment you are qualified to provide
Cardiopulmonary Resuscitation Section 2
Objectives Describe the basic principles of cardiopulmonary resuscitation for one-person rescue, two-person rescue, infants, children, and obstructed airway victims.
16:2 Performing CPR Cardiopulmonary resuscitation (CPR): Cardio: _________ Pulmonary: ________ Resuscitation: to remove from apparent ________________ When performing CPR, you breathe for the patient and circulate ___________ (continues)
Performing CPR ( continued ) Purpose: keep oxygenated blood flowing to the brain and other vital body organs Performed until the ____ and ____ start working again or until medical help is available Clinical versus biological death (continues)
ABCDs of CPR A stands for ____________ B stands for ____________ C stands for ____________ D stands for ____________ (continues)
Airway Open airway head-tilt/chin lift method 1. Put one hand on _________ 2. Put fingertips of other hand under bony part of ____ near the _____ 3. Tilt head back without closing the ________ Prevents ______from falling back and _____ air passage If victim has suspected neck or upper spinal cord injury, try to open airway by lifting the _____ without tilting the _____ back. If difficult to keep the jaw lifted with one hand, use ___________
Breathing Breath into the victims ______ or ______ Supplies needed _________ Important to pinch the victim’s _____shut and make a tight seal around the victim’s _____ with your mouth to avoid loss of ______ Each breath should take about one second and the _____ should rise ______ or forceful breaths should be avoided Can force air into the ____ and _____ causing gastric distension Can cause serious complications such as vomiting, aspirating fluids into the lungs and even cause ______
Circulation Apply pressure to certain area of ______ Heart is compressed between _____ and ______ Blood is squeezed out of heart and into _______ _____ is supplied to the body cells
Defibrillation Common cause of cardiac arrest is ___________ ________, and arrhythmia, or abnormal electrical ________ pattern of the heart When the heart is fibrillating, it does not ______ blood effectively Defibrillator is a machine that delivers and ________ _______ to the heart to try to restore the normal electrical pattern and rhythm. ________ ________ __________(AEDs) are available for use by trained first responders, emergency medical technicians, and even citizens
Defibrillators (cont) After _______ pads are positioned on the victims chest, AED determines the heart ______, recognizes abnormal rhythms that may respond to defibrillation, and sounds an audible or visual warning telling the operator to push a “______” button. Some AEDs are fully automatic and even administer the shock Anytime a shock is administered with an AED, it is essential that no one is ________ the victim Rescuer should state “_____ _____ _______” Look carefully to make sure no one is in _____ with the victim before pushing the _____ button Serious injuries, such as _____ _______, can occur if shocked by the AED
Performing CPR Evaluate victim’s condition before starting CPR: Check if patient is conscious, as “___ ___ ___?” If unconscious, check for _______ If not ______, place victim on back Open the ______ by using the head-tilt/chin lift or jaw-thrust maneuver Call out for help, or ask someone to call 911 (continues)
Performing CPR ( continued ) ___________ for chest movement _________ for breathing ___________ for movement of air from the nose or mouth If not breathing, give ____ breaths Make sure breaths are effective Then check the carotid pulse Where is the carotid pulse? (continues)
Correct hand placement Adults: Hand is placed on the lower half of the sternum between the nipples Use the middle finger of hand to closest to victim’s feet to follow the ribs up to where ribs meet sternum at the substernal notch Keep middle finger on notch and position index finger next to it Place heel of opposite hand (closest to victim’s head) on sternum next to index finger Prevents danger of incorrectly applying pressure on the xiphoid process
Administering Chest Compressions After positioning your hands on the sternum, straighten your arms and align your shoulders directly over your hands Push straight down on the victim’s sternum with a hard fast motion On an adult, the sternum should be compressed 1 ½ to 2 inches After each compression, allow the chest to recoil completely Deliver compressions at a rate of 100 compressions per one minute Proper administration of compressions will produce adequate blood flow and improve the victim’s chance of survival
Various methods of CPR used Adult, child or infant One-person adult rescue for adult 30 compressions followed by 2 ventilations (30:2 ratio)
(continues) Performing CPR ( continued ) Two-person adult rescue for adult 30 compressions by one rescuer followed with 2 ventilations by the second rescuer (30:2 ratio) CPR for infants (birth to one year) 30 compressions followed by 2 ventilations for one rescuer (30:2 ratio) 15 compressions followed by 2 ventilations for two rescuers (15:2 ratio)
Performing CPR ( continued ) CPR for children (1 year to puberty) 30 compressions followed by 2 ventilations for one rescuer (30:2 ratio) 15 compressions followed by 2 ventilations for two rescuers (15:2 ratio) CPR for choking victims Reasons for stopping CPR
16:3 Providing First Aid for Bleeding and Wounds Wound is an injury to soft tissues Open: break in skin or mucous membranes Closed: no break in skin or mucous membranes, but injury occurs to underlying tissues Wounds can result in bleeding, infection, and/or tetanus
Classifications of Open Wounds Abrasion Incision Laceration Puncture Avulsion Amputation
Controlling Bleeding First priority because victim can bleed to death quickly Bleeding can come from arteries, veins, or capillaries Observe standard precautions (continues)
Controlling Bleeding ( continued ) Direct pressure Elevation Pressure bandages Pressure on pressure points Do not disturb clots Do not remove dressings Do not clean wound
Minor Wounds First priority—prevention of infection Wash your hands thoroughly before caring for wound Put on gloves Wash the wound with soap and water Rinse the wound Use sterile supplies
Signs of Infection Swelling Heat Redness Pain Fever Pus Red streaks
Tetanus Tetanus bacteria can easily enter an open wound Serious illness Get tetanus shot or booster as needed
Objects Embedded in Wound Examples such as splinters, pieces of glass, or small stones If superficial, gently remove Objects embedded in tissues should be left and removed by physician
Closed Wounds Can occur anywhere on body If bruise, apply cold application to reduce swelling Observe for signs of internal bleeding Get medical help Check breathing and treat for shock Avoid unnecessary movement No food or fluids
16:4 Providing First Aid for Shock Also called hypoperfusion Shock: clinical set of signs and symptoms that are associated with an inadequate supply of blood to body organs, especially brain and heart Causes of shock
Types of Shock See Table 16-1 in text Anaphylactic Cardiogenic Hemorrhagic Metabolic Neurogenic (continues)
Types of Shock ( continued ) Psychogenic Respiratory Septic
Signs and Symptoms of Shock Skin is pale or bluish-gray and cool or cold to the touch Diaphoresis Rapid and weak pulse Respirations rapid, shallow, and may be irregular Blood pressure very low or unobtainable (continues)
Signs and Symptoms of Shock ( continued ) General weakness Anxiety and extreme restlessness Excessive thirst Nausea and/or vomiting Blurred vision or changes in appearance of eyes
Treatment for Shock Goals of treatment Positioning of victim Maintain body temperature Avoid food or drink Other principles of care
16:5 Providing First Aid for Poisoning Can happen to anyone Poison: any substance that causes a harmful reaction to the outside or inside of the body Immediate action is needed First aid varies depending on type of poison, injury involved, and the method of contact
Ways Poisoning Occurs Ingesting various substances Inhaling poisonous gases Injecting substances Contacting the skin with poison
First Aid for Poisoning If poison has been swallowed Methods to induce vomiting If poisoning by inhalation of gases If poisoning by contact with skin Contact with poisonous plants If poisoning by injection
16:6 Providing First Aid for Burns Injury caused by fire, heat, chemical agents, radiation, and/or electricity Classifications of burns Superficial Partial-thickness Full-thickness
Treatment Objectives Remove source of heat Cool the skin Cover the burn Relieve pain Observe for and treat shock Prevent infections
Treatment Usually not required for superficial and mild partial-thickness burns Rules for when to treat All full-thickness burns require medical treatment How to treat superficial and mild partial-thickness burns (continues)
Treatment ( continued ) How to treat severe partial- or full-thickness burns How to treat when chemicals splashed on skin How to treat eyes burned by chemicals or irritating gases
16:7 Providing First Aid for Heat Exposure Overexposure to heat may cause a chemical imbalance in the body Occurs when water and salt are lost through perspiration Also occurs when body cannot eliminate excess heat
Heat Cramps Muscle pains and spasms Caused by exposure to heat Loss of water and salt Apply firm pressure on cramped muscle to provide relief Provide rest and move to cooler area Small sips of water or electrolyte solution (e.g., sports drink)
Heat Exhaustion Occurs when exposed to heat with loss of fluids through sweating Signs and symptoms First aid care
Heat Stroke Prolonged exposure to higher than normal temperatures Medical emergency—needs immediate care and attention Body unable to eliminate excess heat Signs and symptoms First aid care
16:8 Providing First Aid for Cold Exposure Exposure to cold temperatures can cause body tissues to freeze and body processes to slow down Needs immediate attention Degree of injury affected by wind velocity, amount of humidity, and length of exposure to cold
Hypothermia When body temperature is less than 95ºF (35ºC) Caused by prolonged exposure to cold Signs and symptoms Death can occur if body processes become too slowed down First aid care
Frostbite Freezing of tissue fluids with damage to the skin and underlying tissues Caused by exposure to freezing or below-freezing temperatures Early signs and symptoms Other signs and symptoms as frostbite progresses (continues)
Frostbite ( continued ) Objectives of first aid Common sites: fingers, toes, ears, nose, cheeks First aid care Assess for signs and symptoms of shock and treat as needed
16:9 Providing First Aid for Bone and Joint Injuries Frequently occur during accidents or falls with variety of injuries Examples: fractures, dislocations, sprains, and strains May have more than one type of injury to bones and joints at the same time
Fracture Break in the bone Closed or simple fracture Compound or open fracture Signs and symptoms Objectives of first aid
Dislocation When the end of the bone is displaced from a joint or moved out of its normal position within a joint Tearing or stretching of ligaments, muscles, and other soft tissues also frequently occurs Signs and symptoms First aid care
Sprain Injury to tissues surrounding a joint Common sites: ankles and wrists Signs and symptoms Sprains frequently resemble fractures or dislocations— treat as fracture if any doubt First aid care
Strain Overstretching of a muscle Caused by overexertion or by lifting Frequent site: back Signs and symptoms First aid treatment
Splints Devices to immobilize injured parts Types of splints Pneumatic or air splints Padded boards Traction splints Splints can also be made from cardboard, newspapers, pillows, boards, etc. (continues)
Splints ( continued ) Need to be long enough to immobilize the joint above and below the injured area to prevent movement Should be padded Tied in place Apply as not to create pressure on affected area If open wound, control bleeding before applying splint (continues)
Splints ( continued ) Never attempt to reposition bone Splint before moving victim Observe precautions when using pneumatic splints Traction splints
Circulation Check After Splint Verify that the splints are not too tight Check skin temperature Check color Note swelling or edema Numbness or tingling Check pulse If circulation impaired, immediately loosen the ties
Slings Commercial slings Triangular bandages Use: support arm, hand, forearm, and shoulder Positioning of sling Check circulation Limit movement of limb (continues)
Slings ( continued ) If using knots Placement Padding Considerations for shoulder injury
Neck or Spine Injury Most dangerous types of injuries involving bones and joints Movement can result in permanent injury resulting in paralysis Avoid any movement of victim if at all possible Wait for backboard and adequate help to arrive for transfer
16:10 Providing First Aid for Specific Injuries Treatment for burns, bleeding, wounds, poisoning, and fractures is basically the same Injuries to specific body parts require special care Examples: eyes, ears, nose, brain, chest, abdomen, and genital organs
Eye Injuries Always involves danger of vision loss Best to avoid giving major treatment Obtain help of a specialist Foreign objects in the eye Blows to the eye Penetrating injuries that cut eye tissue
Ear Injuries Can result in rupture or perforation of eardrum Torn or detached tissue Ruptured or perforated eardrum Clear fluid or blood-tinged fluid draining from ear
Brain Injuries Wounds and blows to head and skull can cause brain injury Seek medical help quickly as possible Signs and symptoms First aid care
Nose Injuries Nosebleeds are usually more frightening than serious Nosebleeds also called epistaxis Causes of nosebleeds First aid care
Chest Injuries Usually medical emergencies Involve heart, lungs, and major vessels Sucking chest wound Penetrating injuries to the chest Crushing injuries to the chest
Abdominal Injuries Can cause damage to internal organs and bleeding in major blood vessels Intestines and other abdominal organs may protrude from open wound Medical emergency Bleeding, shock, and damage to organs can be fatal Signs and symptoms First aid care
Injuries to Genital Organs Result of falls, blows, or explosions Can cause severe pain, bleeding, and shock First aid care
16:11 Providing First Aid for Sudden Illness Can be difficult to determine exact illness being experienced Base care on signs and symptoms Information from victim if possible Look for medical alert bracelets or necklaces or medical cards
Heart Attack Known by other names as coronary thrombosis, coronary occlusion, or myocardial infarction Occurs when there is blockage in one or more coronary arteries If heart stops, start CPR Signs and symptoms First aid care
Cerebrovascular Accident Also called stroke, apoplexy, or cerebral thrombosis Causes Signs and symptoms First aid care
Fainting Temporary reduction in supply of blood to brain Early signs and treatment If victim loses consciousness, try to prevent injury Obtain medical help if recovery not prompt, there are other injuries, or fainting reoccurs
Convulsion Type of seizure—strong involuntary contraction of muscles Causes Progression of a convulsion First aid care is directed at preventing self-injury
Diabetes Mellitus Metabolic disorder caused by lack of or insufficient production of insulin Diabetic coma Insulin shock Differentiate between diabetic coma and insulin shock
16:12 Applying Dressings and Bandages Dressings used as sterile covering and to control bleeding Materials used in dressings Dressings can be held in place with tape or a bandage Bandages used to hold dressings in place, to secure splints, and to support and protect body parts (continues)
Applying Dressings and Bandages ( continued ) Apply bandages snugly to control bleeding and prevent movement of dressing, but not to interfere with circulation Types of bandages consist of: Roller gauze Triangular Elastic
Methods to Wrap Bandages Depends on the body part Spiral Figure-eight for joints Recurrent or finger wrap
Checkpoints for Circulation Check circulation after application Signs of poor or impaired circulation: Swelling or edema Pale or cyanotic color Coldness to touch Numbness or tingling Poor or slow capillary refill Loosen bandage immediately
Summary Proper first aid can save a life Provide only care you are qualified to provide Always reassure victim and avoid unnecessary stress and movement Obtain medical help as needed