FIRST AID IN THE SCHOOL SETTING

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• FIRST AID IN THE SCHOOL SETTING
• By
• Sara Bonnet, R.N.

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Definition of First Aid

• Immediate care to sick or injured individual
  given to prevent further damage
• First aid is often life-saving in nature
• School staff is responsible until the
  parent/guardian or paramedics arrive.

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Behavior Basics in First Aid

• Stay Calm, even if you are faking it
• Prioritize injuries
• Call 911 if needed
• Crowd control
• Only move victim when injuries have been
  evaluated and it is safe to do so
• Make decisions! Do things!
• Assume you are in charge until another more
  qualified person takes over.

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Reporting

• For ALL major events, i.e. accidents, illness,
  seizures, stings and allergic students, notify
  administration.
• The parent/guardian must be notified.
• The teacher needs to complete an accident report
  in the office.
• If the nurse was not available email her to
  follow up.

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AsthmaKnown Asthmatic having an attack

• Signs of distress will be labored breathing
  flaring of nostrils, audible wheezing, cough,
  shortness of breath which results in rapid
  breathing.
• Asthmatic students who carry an inhaler should
  have it immediately available, especially in PE.
• If the student has an inhaler, remind him/her use
  it. Do this as soon as the asthma attack is
  identified.
• Have the student lean forward with elbows on
  knees, this maximizes the lung surface area
• Quick improvement should be noted
• Call 911 if difficulty breathing continues after
  treatment and the student has trouble talking.
• Have the student transported to the health office
  if further evaluation is needed.

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AsthmaKnown Asthmatic having an attack

• So in reviewhave the student
• use the rescue inhaler
• cough to loosen the mucus in the airways
• relax breathing/keep everyone calm around the
  student
• if symptoms do not improve quickly--seek medical
  attention

Call 911 if breathing does not improve after
treatment.
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AsthmaAttack with no known history

• Cough to loosen the mucus in the airways
• Relax breathing/keep everyone calm around the
  student
• If symptoms do not improve quickly--seek medical
  attention
• Even if the episode seems to improve, move
  student to the health office,

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911 Calls for Asthma

• Call if life is threatened
• Call 911 as soon as the need is identified
• .then contact the office staff
• The office staff will contact the administration
  and support staff who need to know
• Do not waste time looking for any individual to
  get permission to call 911
• Remember, the nurse could be tied up, her roll is
  to have Asthma Action Plans on the asthmatic
  students and prevent as many of these incidents
  as possible.
• The health aide can follow an asthma action plan

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Minor Injuries

• For minor cuts and scrapes the student can
  administer his/her First Aid with your
  supervision.
• Wash hands and always wear gloves
• If wound is dirty, gently clean with warm water
  and soap followed with antiseptic
• Cover with band aid or larger adhesive dressing
• Topical antibiotic ointment can be used to
  prevent infection

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Serious wounds or cuts

• Apply direct pressure by pressing the wound with
  your thumb preferably over a clean pad
• Raise and support the injured part so that is is
  above the heart
• If wound continues to bleed, add more dressing
  without removing original pad
• Watch for shock and treat

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Symptoms of Shock

• Anxiousness
• Dizziness, light headedness
• Weak, thready pulse
• Stupor
• Nausea
• Vomiting
• Sweating and pallor

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Caring for Shock

• Lie student down
• Elevate legs
• Continue pressure if bleeding
• Call 911
• Notify parent and office

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Nosebleeds

• Sit student down (do not lie down)
• Pinch nostrils, lean forward and breathe through
  the mouth
• Pressure should be applied for at least 10
  minutes
• No nose blowing

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Head Injury

• Remember that heads are very vascular therefore
  head cuts tend to be very bloody
• Observe for levels of consciousness (oriented to
  person, place and thing)
• Should observe for minimum of 30 min.
• Always notify a parent recommend medical care if
  change in status

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Head Injury

• If severe injury, keep student lying down and
  quiet with head and shoulders slightly elevated
• Suspect associated neck injury and immobilize
• Refer for medical care may need to call 911

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Headache

• Most headaches are minor and can be treated with
  a pain reliever
• Ask about hunger (breakfast etc.)
• When did it start and where is pain
• Headaches are of concern if they strike suddenly
  and severely Accompanied by fever, stiff neck,
  mental confusion, double vision, numbness or
  difficulty speaking
• Notify parent if pain persists or the child
  looks sick

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Stomachache

• Ask about where pain is and if they feel like
  vomiting?
• How long have they had stomachache, do they need
  to use bathroom
• Did they have breakfast
• Let student sit quietly and notify parent if no
  improvement

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Sore throat

• Anything else hurt headache, stomachache, feels
  feverish, etc.
• Does student look sick? If so send home even in
  absence of symptoms

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Bites

• Animal bites are most likely caused by domestic
  animals (cats and dogs)
• Cat bites have higher risk of infection
• If bite breaks skin, treat as minor wound wash
  thoroughly with soap and water
• Apply antibiotic ointment and cover
• Notify parent

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Human Bites

• More dangerous than animal bites with greater
  risk of infection
• Stop bleeding by applying pressure
• Wash wound thoroughly
• Apply antibiotic ointment and cover
• Notify parent and refer to doctor for evaluation

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Insect bites and Stings

• Bees, wasps, hornets, yellow
• jackets, fire ants, mosquitoes and fleas are
  most troublesome insects
• Swelling is caused by venom injected into skin
  at time of bite.
• Try to remove stinger by scraping or brushing off
  with a firm edge
• To reduce swelling and pain apply cold pack
• Be sure all cold packs are covered and not placed
  directly on skin

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Bee Sting Allergy

• Watch for signs of allergy (welts, cough,
  tightness in throat, runny nose)
• For students who have a history of bee sting
  allergy (Health Concerns List) or tell you they
  have, administer bee sting kit medication if
  available.
• If not call 911 and parent.

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Splinters and Blisters

• Wash area with soap and water
• Protruding, minor splinters may be removed,
  easily accessible
• Wash again, apply band aid
• If imbedded, clean area, cover with band aid and
  refer to medical care
• For blisters, do not open

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Dental Injuries

• If a tooth is knocked out, handle the top part
  only, not the roots
• Do not rub or scrape it to remove dirt
• Gently rinse tooth in bowl of water
• Try to replace the tooth in the socket then bite
  down gently on moistened gauze
• If unable to replace tooth, place in milk or warm
  mild saltwater solution continued

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Dental injury

• Refer for immediate dental care
• For a toothache refer student to dentist
• Over-the -counter pain relievers may help until
  child can get to dentist

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Skin Rashes

• Most commonly seen rashes in schools are due to
  either infection or other systemic illness
• Call the nurse about any suspicious looking rash.
• Commonly Seen Rashes in Schools
• Contact Dermatitis, Impetigo, Scabies, Eczema,
  Ringworm, Herpes Simplex (cold sore)

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Seizures

• Maintain a clear airway by turning child on one
  side with head low to encourage gravity drainage
  of secretions
• Position student to prevent injury by falling or
  knocking against objects.
• Do not try to place object in mouth

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Seizures

• Observe and be able to describe the duration and
  focal elements of the seizure
• Call 911 only if seizure lasts longer then 5
  minutes
• Always notify a parent if seizure occurs at
  school
• Student will usually be sleepy a lethargic after
  a seizure (post-ictal state)

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Fractures

• If bleeding at the site, stop bleeding by using
  direct pressure directly on the wound with
  sterile or clean bandage
• Immobilize the area Keep the joint above and
  below the fracture immobilized
• Apply cold wrapping ice or cold pack inin in
  cloth. Observe for signs of shock
• Notify parents immediately

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Choking

• Classic signs - cannot talk, cough or breath
• Unable to communicate and is anxious
• Universal sign
• Send someone to call 911 and
• perform Heimlich Maneuver

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EYE

• Foreign Body
• Flush eye with cool water for 5 minutes
• If unable to flush out object and /or pain
  persists notify parent and advise immediate
  medical care
• Penetrating Injury
• Do NOT wash eye or attempt to remove embedded
  object. Cover with sterile compress
• Keep student quiet-move via stretcher
• Call parent to seek immediate medical care
• Blows
• Ask about blurred vision or pain
• Apply cold/cool compress

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Fainting/Dizziness

• Fainting lay person down with feet
  elevated.Keep airway open.
• Dizziness- have person assume sitting position
  with head low and take deep slow breaths or lie
  down.
• Have student rest until recovered. Call parent,
  send home accompanied.

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Complete

• CONGRATULATIONS on
• completing your required First Aid course!!
• The hope is youll never need to use all this
  information, but now youre prepared. First Aid
  instructions are located in your 1st Aid box
  teacher notebook.
• Now complete the brief post test Emergency
  Checklist you received at the in-service youre
  home free. Thanks much!