LESSON 2 Review: ESM (Responsive Casualty): Head & Spinal Injuries F I R S T A I D T R A I N I N G LESSON 2 Review: ESM (Responsive Casualty): Head & Spinal Injuries Unresponsive Casualty Shock Unconsciousness & Fainting Positioning the Casualty First Aid Presentation – © St John Ambulance Canada

REVIEW VIDEO CLIP: ESM Responsive Casualty

HEAD & SPINAL INJURIES History Signs & Symptoms Care & Handling F I R S T A I D T R A I N I N G HEAD & SPINAL INJURIES First Aid Presentation – © St John Ambulance Canada TITLE SLIDE Insert your information directly into the text boxes provided to customize your presentation History Signs & Symptoms Care & Handling

Head & Spinal Injuries: HISTORY The history will help you determine the potential for a head/spinal injury: Look for evidence at the scene Listen to what the casualty and bystanders tell you about the incident

Head and Spinal Injury Signs and Symptoms Obvious head injuries Fluids from the ears Pain at the injury site Headache or dizziness Numbness, tingling or paralysis

Head and Spinal Injury: risks Dangers of improper handling Life-long disability Death Principles of management Warn not to move Support the head and neck Reassure the casualty

POSITIONING THE CASUALTY Semi-Sitting Position F I R S T A I D T R A I N I N G POSITIONING THE CASUALTY First Aid Presentation – © St John Ambulance Canada TITLE SLIDE Insert your information directly into the text boxes provided to customize your presentation Position Found Semi-Sitting Position Recovery Position Shock Position

Positioning the Casualty Potential head or spinal injury = original position stabilizing head and neck (if you have a “life over limb situation” use the HAINES recovery position: high arm in endangered spine) Troubles Breathing = semi sitting position (relieves chest pressure) Unconscious with no other injuries = recovery position Conscious with no other injuries = shock position (elevate legs 30cm)

PRACTICAL: In Partners Recovery Position Demonstration: Students partner up and try it (both) Demonstrate the correct position you would use if your partner were suffering from a heart attack. Demonstrate with your partner the position you would use if a head/neck injury was suspected.. Demonstrate how you would position a conscious casualty with no other injuries during ongoing casualty care.

ESM: EMERGENCY SCENE MANAGEMENT (Unresponsive) F I R S T A I D T R A I N I N G ESM: EMERGENCY SCENE MANAGEMENT (Unresponsive) First Aid Presentation – © St John Ambulance Canada TITLE SLIDE Insert your information directly into the text boxes provided to customize your presentation Signs & Symptoms Scene Survey Primary Survey Secondary Survey/Ongoing Casualty Care

3 KEY STEPS OF ALL FIRST AID SCENARIOS Scene Survey (same for all) Primary Survey (differs based on scenario) Secondary Survey/Ongoing Casualty Care (until medical help arrives)

Decreasing consciousness UNRESPONSIVE CASUALTY Signs Casualty does not respond to voice or touch Decreasing consciousness Indicates the casualty is getting worse May result in an airway emergency Always a serious emergency

UNRESPONSIVE CASUALTY: Scene Survey Assess hazards Take charge of the situation Offer help & obtain consent (approach in line of vision!) Find out history of the scene… how & where injury occurred (mechanism) by: Looking for evidence Signs: Something you see, feel, smell or hear (e.g. pale skin, bleeding) Symptoms: Sensations the casualty feels and may describe to you (e.g. pain, nausea, dizziness) Asking questions (casualty & witnesses)

Scene Survey Continued Assess responsiveness Send someone for help (call 911 and let them know we have: info on casualty, injury, location…) Do not hang up until dispatcher tells you to. Support head & neck if injury is suspected

Primary Survey (CAB-D – not ABCs) In a primary survey, you must check for the priorities of first aid but with UNRESPONSIVE it changes to CABD: Circulation - if not breathing, begin compressions (30) - If casualty is breathing, check skin color, skin temperature, internal & external bleeding Airway - different if responsive or unresponsive - use the head tilt–chin lift to open airway Breathing - look, feel, listen - should be 10-20 breaths per minute (count # in 15 seconds) - if absent: give 2 breaths Defibrillate - continue compressions on an unconscious casualty until an AED or medical help arrives During primary survey, the casualty should stay in the position found (whenever possible and especially if spinal injuries are suspected)

Secondary Survey/Ongoing Casualty Care Secondary Survey: obtain medical history and information of the casualty Treat for shock (loosen clothing, cover with blanket, reassure casualty) Monitor (check ABCs again) Record events & report incident to medical experts. When medical help arrives, you should be prepared to report on: What happened The suspected injuries What first aid has been provided

VIDEO CLIP: ESM Unresponsive Casualty

PRACTICAL: IN GROUPS OF 3 Get into groups of 3 and follow the procedures identified for a UNRESPONSIVE CASUALTY First Aider #1: You are walking down the stairs at school and your friend complains that they aren’t feeling well. Suddenly, they collapse and fall to the bottom of the stairs. The friend is unconscious and you suspect that they may have a spinal injury. First Aider #2: You are at home with your older brother and he is up on a ladder, changing a light-bulb. He falls and is lying face up. He is not responsive. First Aider #3: You are at the mall, you see a crowd and commotion near the elevator. As you approach, you see an elderly woman who is lying on the ground. You ask the person who she is with what happened: She was feeling dizzy and was eased to the floor. She is unconscious.

SHOCK, UNCONSCIOUS & FAINTING Shock: Signs & Symptoms F I R S T A I D T R A I N I N G SHOCK, UNCONSCIOUS & FAINTING First Aid Presentation – © St John Ambulance Canada TITLE SLIDE Insert your information directly into the text boxes provided to customize your presentation Shock: Signs & Symptoms Shock: First Aid Fainting

SHOCK Shock is a circulation problem in which body tissues are not receiving enough blood. If severe, shock can lead to unconsciousness or even death. Any injury or illness can be accompanied by shock.

Signs & Symptoms of Shock Signs of shock include: Skin is pale, cool, clammy Lips turn bluish Shallow irregular breathing Changes in level of consciousness Weak rapid pulse Symptoms of shock - casualty may be: Restless, anxious, disoriented, confused, afraid, dizzy, thirsty (do NOT give water!)

Loosen tight clothing at neck, chest, and waist Keep casualty warm First Aid for Shock Reassure casualty Loosen tight clothing at neck, chest, and waist Keep casualty warm Moisten lips for thirst but DO NOT GIVE WATER! Place casualty in best position for illness/injury Monitor ABCs closely Continue with ongoing casualty care

FAINTING Causes of Fainting: A brief loss of consciousness caused by a temporary shortage of oxygen to the brain. Causes of Fainting: Fatigue, hunger, lack of fresh air Fear & anxiety Long periods of sitting or standing Severe pain

Act Quickly!! (you may be able to prevent it) Warnings of Fainting Paleness and sweating Dizzy or feeling sick Act Quickly!! (you may be able to prevent it)

If fainting occurs… Treat casualty as unresponsive (ABCs)

Video Clip: Shock, Unconscious & Fainting