1. 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

2. 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

3. 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

4. Core Lessons Include: Emergency Scene Management
Shock, Unconsciousness & Fainting
Choking Adult
Cardiovascular Emergencies & 1-Rescuer Adult CPR
Severe Bleeding

5. What is First Aid? What is first aid? Who is a first aider?
What can a first aider do?

6. 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

7. 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

8. 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

9. 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

10. #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

11. Video on Emergency Scene Management
Video on ESM DVD #1
Pay close attention to what the male worker does when the client passes out.

12. 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

13. 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

14. 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

15. 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

16. 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:

17. 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

18. 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

19. 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!

20. Secondary Survey HISTORY
VITAL SIGNS (CONSIOUSNESS, BREATHING, PULSE, SKIN CONDITION/TEMP)
HEAD-TOE EXAMINATION
FIRST AID FOR INJURIES & ILLNESS FOUND

22. 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…

23. 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

24. 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.

25. SHOCK, UNCONSCIOUSNESS & FAINTING
Define:Unconsciousness
Define: Fainting
Causes of shock
Signs & symptoms of shock
First aid for shock

26. 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

27. 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

28. CAUSES OF SHOCK Breathing problems Severe bleeding Severe burns
Spinal cord injuries
Heart attack
Medical emergencies (diabetes, allergies)

29. 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

30. 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

31. 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?

32. CHOKING Safety measures to prevent on objects
Mild & severe airway obstruction
Effects of prolonged airway obstruction
Causes of choking
Signs of choking

33. 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

34. 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

35. CHOKING ADULT(CONSCIOUS)
As you watch the video, note the steps taken by the waitress. List the first aid procedures demonstrated in the clip

36. 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?”)

37. 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

38. 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

39. 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?

40. 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

41. 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!

42. CHOKING EXTRA Pregnant Women Choking DVD #7
Self Administered Choking DVD #8

43. CPR VIDEO
CPR Video #9
What are some of the signs and symptoms that would lead you to think this is a serious emergency?

44. 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

45. CARDIOVASCULAR & CPR Know about cardiovascular disease
Recognize angina/heart attacks and provide first aid
Recognize cardiac arrest
Perform one-rescuer CPR

46. 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?

47. 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

48. 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

49. 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

50. 5 Rights For Giving Medicines
The right medicine
The right person
The right amount
The right time
The right method

51. The Keystones to Survival
Help someone with heart problems:
Early recognition
Early access
Early CPR (if required)
Early defibrillation (if required)

52. Practice!
One-rescuer CPR – Adult
Listen for instructions

53. 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

54. Cardiac Arrest – AED Device
Using an AED
Video #10

55. 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

56. How do you know if someone is having a stroke?
Signs:
Facial droop
Arm drift
Speech
Time
Symptoms:
Weakness
Numbness
Vision problems
Headache
Dizziness

57. 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

58. 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.

59. Severe Bleeding

60. 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.

61. Objectives: Use dressings and bandages
Recognize major wounds and internal versus external wounds
Provide first aid

62. 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)

63. 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

64. 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

65. 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!

66. 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

67. The Triangular Bandage

68. 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

69. Practice Get a partner Collect one bandage from the back
Scenario: Listen for your instructions!

70. 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

71. 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

72. 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

73. 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

74. 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?

75. BURNS

76. 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.

77. Burn Caused by Heat

78. Burn Caused by Radiation

79. Electrical Burns

80. Burns Caused by Chemicals

81. Recognizing Burns

82. First Degree Burn Skin is pink to red Slight swelling Skin is dry
Tenderness to severe pain in the injured area

83. First Degree Burn

84. 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

85. Second Degree Burn

86. 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)

87. Third Degree Burn

88. 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

89. 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

90. 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

91. Poison, Bites & Stings

92. Objectives Prevent poisoning Recognize poisoning Provide first aid
Provide first aid for bites and stings

94. POISON
Any substance that can cause illness or death when absorbed by the body

95. Types of Poison Swallowed poisons Inhaled poisons Absorbed poisons
Injected poisons

96. 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

97. 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

98. 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

99. 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

100. 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.

101. 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

102. Injected poisons Follow the general guide
Put casualty at rest and keep affected limb below heart level – this delays circulation of the poison

103. Bites and Stings

104. 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

105. Snakebite Rattlesnakes are BC’s only poisonous snakes Signs & Symptoms
Burning sensation
Swelling and discolouration
Severe pain
Weakness
Chills
Sweating
Nausea
Vomiting

106. 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

107. 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

108. Ticks

109. 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

110. Leeches

111. 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