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St. John Ambulance Saving Lives
Objective: To train each student to the level of Emergency or Standard first aid Motivation: As a student, you play a vital role within your community’s emergency medical system, as well as in the workplace
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Requirements for Certification
It is your responsibility to attend all instructional sessions It is your responsibility, throughout the course,to show progress toward the attainment of specific first aid skills & knowledge by participating in the hands-on practical exercises & completing the Student Reference Guide activities
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Requirement for Certification
Your first aid/CPR skills will be checked throughout the course during each practical lesson Your first aid/CPR theoretical content will be evaluated by a knowledge based evaluation. The pass mark is 50% on each section Successful completion= An Emergency/Standard level first aid certificate & pocket card Certification is valid for 3 years
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Core Lessons Include: Emergency Scene Management
Shock, Unconsciousness & Fainting Choking Adult Cardiovascular Emergencies & 1-Rescuer Adult CPR Severe Bleeding
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What is First Aid? What is first aid? Who is a first aider?
What can a first aider do?
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What is First Aid? First Aid is emergency help given to an injured or suddenly ill person using readily available materials. The objectives of a first aider are as following: Preserve a life Prevent the illness or injury from becoming worse Promote Recovery First Aiders do not treat or diagnose, but suspects injuries & gives first aid
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What Can A First Aider Do?
A first aider gives first aid, but can also do much more. In an emergency, a first aider can also: Protect the casualties belongings Keep unnecessary people away Reassure family or friends Clean up the emergency scene & work to correct any unsafe conditions
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Good Samaritan Act In Canada (except Quebec), & most of the US, you do not have a legal duty to help a person in need, unless it is part of your job in the work place. Ex. Life Guard Using Good Samaritan principles however, you are encouraged to help others and are covered by the act in emergency situations
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Good Samaritan Act You must abide by the following principles:
Identify yourself as a first aider and get CONSENT Use reasonable skill and care in accordance of your knowledge You are not negligent in what you do You do not abandon the person
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#1 RULE The number one rule in giving first aid is to “ensure safety”
Emergency scenes can be dangerous and you have to ensure your safety You must ensure that your actions do not put anyone else in danger
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Video on Emergency Scene Management
Video on ESM DVD #1 Pay close attention to what the male worker does when the client passes out.
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Emergency Scene Management
A sequence of 4 actions that ensures safe and appropriate first aid is given: Scene Survey Primary Survey Secondary Survey On-going casualty care
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LET’S REVIEW ESM Conducting a scene survey Primary survey
Turn to your partner & tell them what you know about: Conducting a scene survey Primary survey Secondary survey Ongoing casualty care
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1) SCENE SURVEY Ask what happened. Ensure Safety! Remove hazards
If casualty is conscious, warn him/her not to move Identify yourself & offer help Support the head and neck Assess responsiveness Activate EMS
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2) PRIMARY SURVEY A,B,C’s Airway- Assess the airway (open airway, ensure airway is clear Breathing- Check for effective breathing. If needed, assess rate and quality Circulation- Check skin for signs of shock. Perform a Rapid Body Survey
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3) Secondary Survey The secondary survey is a step-by step way of gathering information to form a complete picture of the casualties overall condition Only do a secondary survey if there is more than one injury Follow these steps:
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Secondary Survey Steps
The history (Ask Questions! Ex. Symptoms, allergies, medications, last meal etc) The vital signs (breathing, level of consciousness, pulse, skin colour, temperature) Head to toe examination First aid for injuries found
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4) GIVE ONGOING CARE Loosen tight clothing at neck & waist
Reassure the casualty Place in recovery position ( if there are no signs of a head or spinal injury) Cover to maintain warmth Re-assess ABC’s & record your findings Continue to reassure the casualty
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LET’S TRY IT! STEP 1: SCENE SURVEY Take charge of the situation
Call out for help Assess hazards, ensure safety Find out the history of the emergency Identify yourself as a first aider & offer to help Assess responsiveness Begin Primary survey! Go!
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Secondary Survey HISTORY
VITAL SIGNS (CONSIOUSNESS, BREATHING, PULSE, SKIN CONDITION/TEMP) HEAD-TOE EXAMINATION FIRST AID FOR INJURIES & ILLNESS FOUND
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HOW TO TURN A CASUALTY FACE UP
You should give first aid in the position in which the casualty is found as much as possible, but sometimes you have to turn them over to assess for life-threatening injuries and to give proper aid. If there is no suspected head or spinal injuries…
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Casualty Face Up Cont. Extend the arm closest to you over the head
Tuck the far arm against the casualty’s side Cross the far foot over the nearest foot Support the head and neck. Firmly grip the clothing at the waist. Roll casualty over. Position casualty for giving first aid
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VIDEO ON SHOCK DVD Video #4
Notice what happens to the human body when they go into shock – this will help identify someone who is truly in shock.
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SHOCK, UNCONSCIOUSNESS & FAINTING
Define:Unconsciousness Define: Fainting Causes of shock Signs & symptoms of shock First aid for shock
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SHOCK Shock is a circulation problem where the body’s tissues don’t get enough oxygenated blood- inadequate circulation to the body tissues Medical shock is life-threatening because the brain & other organs cannot function properly Shock can progress to unconsciousness and even death
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SHOCK REVIEW! What is shock?
A condition of inadequate circulation to the body tissues Results when the brain other vital organs are deprived of oxygen The development of shock may be rapid or gradual
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CAUSES OF SHOCK Breathing problems Severe bleeding Severe burns
Spinal cord injuries Heart attack Medical emergencies (diabetes, allergies)
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SIGNS & SYMPTOMS of SHOCK
Restlessness Decreased consciousness Pale skin at first, later, bluish grey Bluish/purple colour to lips, tongue, earlobes, fingernails Cold and clammy skin Profuse sweating Vomiting Shallow, irregular breathing, gasping Weak, rapid pulse or absent radical pulse
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FIRST AID FOR SHOCK Give prompt first aid for any injury or illness
If conscious, elevate feet 12 inches (shock position) Unconscious but breathing= recovery position Heart attack, asthma, breathing problems= semi-sitting position Suspected head/spinal cord injury= support head and leave in position found Loosen tight clothing at chest, neck and waist Cover to preserve body heat Monitor ABC’s
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CHOKING CONSCIOUS VIDEO
Choking Conscious Video DVD #5 How many abdominal thrusts and back blows does the first aider give the patient? And does she alternate between the two techniques or not?
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CHOKING Safety measures to prevent on objects
Mild & severe airway obstruction Effects of prolonged airway obstruction Causes of choking Signs of choking
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CHOKING When the airway is partly or completely blocked & airflow is reduced or cut off Partially blocked airway= good air exchange, poor air exchange Completely blocked airway= NO air exchange
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COMMON CAUSES OF CHOKING
Food or some other object stuck in the throat Tongue of an unconscious person falling to the back of the throat Blood or vomit collects in the throat
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CHOKING ADULT(CONSCIOUS)
As you watch the video, note the steps taken by the waitress. List the first aid procedures demonstrated in the clip
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CHOKING ADULT (CONSCIOUS)
STEP 1: Begin ESM. Perform a scene survey STEP 2: Stand by & Encourage coughing STEP 3: Perform a Primary Survey. Identify the degree of airway obstruction (ask the casualty “are you choking?”)
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CHOKING ADULT (CONSCIOUS)
STEP 4: Give Abdominal Thrusts Stand behind the casualty. Find the top of the hip bones with each hand Make a fist & place it midline, thumb side against the abdomen, just above the other hand Grasp the fist with the other hand. Thrust inward & upward forcefully
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CHOKING ADULT Cont. If casualty becomes unconscious…
Ease the casualty on the floor (ON THEIR BACK) Support the head and neck as you ease the casualty to the floor
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CHOKING ADULT VIDEO (UNCONSCIOUS)
As you watch the video, note: Choking Adult Unconscious DVD #6 How does the first aid for choking change once the casualty has lost consciousness?
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CHOKING ADULT (UNCONSCIOUS)
Send a bystander to get medical help Open the mouth & look for obstruction Open the airway & check for normal breathing If casualty is not breathing normally try to ventilate If chest does not rise, reposition the head, ventilate again
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CHOKING ADULT (UNCONSCIOUS)
If chest still does not rise, begin compressions- give 30 chest compressions If you are successful in clearing the airway give 2 ventilations & check for normal breathing Continue with primary survey Give on-going casualty care until medical help arrives Let’s PRACTICE!
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CHOKING EXTRA Pregnant Women Choking DVD #7
Self Administered Choking DVD #8
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CPR VIDEO CPR Video #9 What are some of the signs and symptoms that would lead you to think this is a serious emergency?
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CPR---ADULT CASUALTY Check Breathing for 10 seconds- No Breathing?
Breathe into casualty TWICE (1 second per breath) Chest Compressions- 30 times- push hard & fast If AED is available, use it at this time Give 2 more breaths Continue with 30 compressions and 2 breaths until help arrives
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CARDIOVASCULAR & CPR Know about cardiovascular disease
Recognize angina/heart attacks and provide first aid Recognize cardiac arrest Perform one-rescuer CPR
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Think-Pair-Share What do you think of when someone mentions cardiovascular disease? What do you think causes this? What are signs and symptoms of someone having a stroke? What is the difference between a heart attack and a stroke?
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The Facts (4-1) High blood pressure (hypertension) – blood pressure is always excited and fast Atherosclerosis – a build-up of fatty deposits that makes arteries narrow Angina – chest pain caused by the heart not getting enough oxygen
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The Facts continued Heart attack – happens when heart muscle dies from lack of oxygen Cardiac arrest – when the heart stops pumping Stroke/TIA – brain tissue dies as a result of the brain not getting enough oxygen
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Angina/Heart Attack The pain may feel like: Other signs include:
Heaviness Tightness Squeezing Pressure Crushing Indigestion Aching jaw Sore arms Other signs include: Denying anything is wrong Fear Pale skin Nausea Vomiting Sweating Shortness of breath Fatigue Shock Unconsciousness Cardiac arrest
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5 Rights For Giving Medicines
The right medicine The right person The right amount The right time The right method
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The Keystones to Survival
Help someone with heart problems: Early recognition Early access Early CPR (if required) Early defibrillation (if required)
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Practice! One-rescuer CPR – Adult Listen for instructions
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PROCEDURES Begin ESM: Scene survey Assess responsiveness
Call for medical help Primary survey: ABCs Pinch nostrils and give 2 ventilations Place hands on chest for compressions (best place is horizontally along the armpits and vertically along the neck/airway) Cycles of 30 compressions and 2 ventilations
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Cardiac Arrest – AED Device
Using an AED Video #10
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STROKES What causes a stroke?
A blood clot blocking an artery in the brain Causes brain tissue to die Caused by hardened arteries which narrow with time Can also be caused by a ruptured artery
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How do you know if someone is having a stroke?
Signs: Facial droop Arm drift Speech Time Symptoms: Weakness Numbness Vision problems Headache Dizziness
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TIA Transient Ischemic Attack (TIA) – caused by lack of oxygen to part of the brain. Leaves no permanent damage, but may warn of future strokes. Has the same signs and symptoms as a stroke
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ASPRIN VS NON ASPRIN Any signs of injury below the neck – Heart Attack, you can give an Aspirin. Any signs of injury above the neck – Stroke DO NOT give Aspirin.
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Severe Bleeding
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BANDAGE AND BLEEDING VIDEO
Bandage Video # 12 Severe Bleeding Video #13 Identify some principles of controlling severe bleeding. How do these affect the scenario? WARNING: Be prepared to close your eyes if you are sensitive to graphic scenes.
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Objectives: Use dressings and bandages
Recognize major wounds and internal versus external wounds Provide first aid
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What’s the diff? Open wound vs (cut)
External bleeding vs (blood pouring out) Arterial bleeding vs (artery - lots of blood) Closed wound (skin covers the wound) Internal bleeding (bruising) Venous bleeding (veins - not a lot of blood)
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OMG UR BLEEDING I’m a 1st aider, can I help u?
Apply direct pressure to the wound Place the casualty at rest to reduce the pulse rate
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Dressings Sterile (or as clean as possible)
Large enough to cover the wound completely Highly absorbent Compressible, thick, and soft Non-stick and lint-free
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Bandages Any material that is used to hold a dressing in place, maintain pressure over a wound, support a limb, immobilize, or secure a splint Apply firmly to control bleeding Check circulation – not too tight! Do not use as padding or dressings!
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The Triangular Bandage
Whole: use as a sling or to hold a large dressing in place Broad: hold splints in place or apply even pressure Narrow: secure dressings or splints or immobilize ankles and feet Ring: control bleeding without applying direct pressure
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The Triangular Bandage
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Internal Bleeding Possible causes: a severe blow or penetrating injury to chest, neck, abdomen, or groin; major limb fractures Signs: blood coming from ear canal, bloodshot eyes, black eye, coughs up bright red frothy blood, bright red or brown blood is in vomit, blood is in stool as black tarry or as normal red, blood is in urine as red or smoky brown
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Practice Get a partner Collect one bandage from the back
Scenario: Listen for your instructions!
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Scenario Your casualty: Has effective breathing
Has blood spurting from a 5cm gash inside their left forearm. There are no foreign objects in the wound. Feels faint Does not have other injuries
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Bleeding ESM Scene survey: take charge, call out for help, assess hazards, make area safe, learn about the casualty, identify yourself as a first aider Primary Survey: assess ABCs Expose bleeding and assess injury Send a bystander for medical help
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Tell the casualty to apply direct pressure over the wound
Tell the casualty to apply direct pressure over the wound. Make them comfortable. Replace their hand with dressings and continue to apply direct pressure Continue primary survey: check for shock, check for hidden external and internal bleeding
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Check for impaired circulation below the injury (nail bed test)
Bandage the dressings in place Place injured arm on casualty’s chest and check circulation again Give ongoing care
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Video Amputations DVD #14
When positioning the injured part, what does the first aider do with a complete amputation that’s different from with a partial amputation?
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BURNS
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Burns- Facts Injury to the skin & other tissues caused by heat, radiation, or chemicals Burns are the leading cause of injury at home Young children or elderly seniors are especially at risk for being burned, and at these ages, could be more serious.
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Burn Caused by Heat
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Burn Caused by Radiation
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Electrical Burns
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Burns Caused by Chemicals
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Recognizing Burns
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First Degree Burn Skin is pink to red Slight swelling Skin is dry
Tenderness to severe pain in the injured area
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First Degree Burn
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Second Degree Burn Skin looks raw and is mottled red in colour
Skin is moist and ranges in colour from white to cherry red Blisters that contain clear fluid Extreme pain
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Second Degree Burn
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Third Degree Burn Skin is pearly white, tan coloured, or charred black
Skin is dry and leathery You may see blood vessels and bones under the skin Little or no pain (nerves are destroyed)
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Third Degree Burn
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First Aid for Heat Burns
Begin an ESM Primary Survey Cool the burn right away by immersing it in cool water. If you cannot do this, pour the cool water on the area or cover it with a cool cloth Cool the burn until the pain has lessened. This will reduce the temperature of the burn, reduce tissue damage, swelling or blistering & relieve pain
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First Aid for Heat Burns Cont.
Loosen or remove anything on the burned area that is tight (jewellery and tight clothing) Do this as soon as you can before the injury swells Don’t remove anything that is stuck
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First Aid for Heat Burns Cont.
When the pain lessens, loosely cover the burn with a clean, lint free dressing. If the area is large use a sheet Secure the dressing with tape but be sure there is no tape on the burned area Give ongoing casualty care- arrange for medical help and monitor the casualty for signs of shock
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Poison, Bites & Stings
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Objectives Prevent poisoning Recognize poisoning Provide first aid
Provide first aid for bites and stings
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POISON Any substance that can cause illness or death when absorbed by the body
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Types of Poison Swallowed poisons Inhaled poisons Absorbed poisons
Injected poisons
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Steps Phone the Poison Information Centre
Get a scene history = what poison was taken, how much, how the poison entered the body, when the poison was taken
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Signs & Symptoms Swallowed = nausea, abdominal cramps, diarrhea, vomiting, discoloured lips, burns Absorbed = reddening of the skin, blisters, swelling, burns Injected = irritates the point of entry, may cause allergic or behavioral reaction Inhaled = problems with breathing, coughing, chest pain, headache, dizziness, unconsciousness, cardiac arrest
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General First Aid for Poison
Begin ESM – do a scene survey For responsive casualties, call Poison Information Centre For unresponsive casualties, call medical help Do primary survey If breathing is stopped, begin CPR Check for poison around the mouth first Use a barrier device if available Put casualty in the recovery position Give ongoing care
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Swallowed Poisons Begin ESM – scene survey
Do not dilute a swallowed poison unless told to by medical help Conscious casualty – wipe poisonous or corrosive residue from face and rinse or wipe mouth Never induce vomiting except on advice of the Poison Information Centre
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Inhaled Poisons Begin ESM – do scene survey. Assess hazards (possible present of gas or vapour). Ensure your own safety. Move casualty to fresh air Unresponsive – call for medical help Primary survey and ABCs. Not breathing? Begin CPR. Use a face mask if the poison could affect you.
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Absorbed Poisons Begin ESM – do scene survey
Do primary survey and give first aid Flush affected area with large amounts of cool water (brush off before flushing) Remove contaminated clothing Wash affected skin with soap and water Give ongoing casualty care
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Injected poisons Follow the general guide
Put casualty at rest and keep affected limb below heart level – this delays circulation of the poison
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Bites and Stings
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Animal Bites Start ESM – do scene survey. Protect yourself with gloves
Do primary survey and give first aid Examine wound for broken skin Bleeding – allow moderate bleeding to cleanse wound Wash wound with antiseptic soap, apply dressing and bandage Broken skin – get medical help
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Snakebite Rattlesnakes are BC’s only poisonous snakes Signs & Symptoms
Burning sensation Swelling and discolouration Severe pain Weakness Chills Sweating Nausea Vomiting
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Snakebite First Aid Begin ESM – do scene survey Do primary survey
Place casualty in semi-sitting position and keep affected limb below heart level Flush bite with soapy water. Do not apply cold compresses or ice Immobilize the limb Give ongoing casualty care and seek medical help
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Insect Bites and Stings
Begin ESM – do scene survey, primary survey, and ABCs. Examine sting site, looking for the stinger. Remove it by scraping. For irritation, apply rubbing alcohol to sting or a paste of baking soda and water. For serious reactions that affect breathing or cause swelling of airway, help casualty take their own medication
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Ticks
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Ticks Scene survey. Remove the tick with tweezers. Grasp it as close to the skin as possible and pull away with steady pressure. Avoid squishing an engorged tick. Keep the tick and bring it to medical help Clean the area with soapy water and apply an antiseptic Get medical help if there are any signs of infection
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Leeches
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Leeches Scene survey Detach leaches by using a fingernail to push the head end (the skinny end) of the leech off of the skin. Then use a fingernail to push the larger end off. Some bleeding will occur. Cleanse the wound and apply dressing if required Get medical help if there is any sign of infection later
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