First Aid

1
Chapter 9

• First Aid
• Secondary Assessment

2
Warm-up

• What its the ratio between chest compressions
  and breathes for adult, child, and infant two man
  CPR?

3
Lesson Objectives.

• Demonstrate how to perform a secondary
  assessment.
• Recognize and care for a victim of a sudden
  illness.
• Recognize and care for wounds.
• Recognize how to control external bleeding.
• Recognize and care for shock.
• Recognize and care for heat- and cold-related
  emergencies.

4
Secondary Assessment

• After completing the initial assessment and
  determining that there are no life-threatening
  conditions, perform a secondary assessment.
• During a secondary assessment , perform a quick
  head-to-toe examination for an adult
• Toe-to-head exam for an child/infant

5
Using SAMPLE to take a brief history pp.142-143

• S- signs symptoms
• A - allergies
• M- medications
• P- pertinent past medical history
• L- last oral intake
• E- events leading up to incident

6
SUDDEN ILLNESS

• Diabetic emergency
• Fainting
• A seizure

• A stroke
• Allergic reaction
• Poisoning

7
Sudden illness continued

• It is not important to know the cause or type of
  sudden illness because the care you provide will
  be the same with a few exceptions.
• If you think something is wrong, check the victim
  and look for a medical identification bracelet or
  necklace.
• The victims condition can worsen rapidly if care
  is not provided.

8
Diabetic Emergency

• Too much or too little sugar in their blood
• Often, diabetics know what is wrong and will have
  something to take
• Give sugar, preferably in liquid form

9
Seizures

• Provide care in the same manner as for an
  unconscious victim. Protect the victim from being
  injured, remove nearby objects that might cause
  injury.
• If there is fluid in the victims mouth (saliva,
  blood or vomit) roll victim on one side so that
  the fluids drain from the mouth.

10
Seizures continued

• If the victim is known to have periodic seizures,
  there is no need to summon EMS. Unless
• The seizure last more than 5 minutes
• Multiple seizure
• Appears to be injured
• Victim is pregnant
• Victim is diabetic
• Fails to regain consciousness
• Occurs in water

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Seizures in the Water

• Summon or have someone summon EMS
• Support the victim with his or head above water
  until seizure ends.
• Remove the victim from the water ASAP after the
  seizure.
• Place the victim face-up on the deck and perform
  an initial assessment and care.

12
Stroke

• Signs weakness/numbness of the face, arm or leg
  (usually on one side)
• To care think FAST
• Face- weakness on one side of face
• Arm-weakness/numbness in one arm
• Speech- slurred or troubled
• Time- time to summon EMS

13
Bites Stings p. 147

• Spider/scorpion
• Snakebites
• Marine Life
• Jellyfish
• Crabs
• Stingray

14
WOUNDS

• An injury to the bodys soft tissue, such as the
  skin, fat and muscles.
• Show video
• http//www.youtube.com/watch?vmjEcj8KpuJw

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Cuts, Scrapes, Bruises

• Blood- 60,000 miles of blood vessels
• Heart
• Arteries
• Veins
• Capillaries

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Stitches

• Uncontrollable bleeding
• Wounds that show muscle, bones, joints
• Large and deep puncture wounds
• Embedded objects
• Human / animal bites

18
Types of Wounds

• Contusion (bruise)
• Abrasion (scrape)
• Incision (cut / laceration)
• Avulsion
• Puncture

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Contusion (Bruise)

• Damage to soft tissues blood vessels causes
  bleeding under the skin
• At first it may appear red
• Turn purple

20
Scrape (abrasion)

• Most common type of wound caused by skin that has
  been rubbed or scrapped away
• Usually painful because scraping away of outer
  skin exposes nerve endings

21
Incision (cut / laceration)

• May be jagged or smooth edges
• Commonly caused by sharp objects
• Can also be caused by a blow from a blunt object

22
Avulsion

• A cut in which a portion of the skin or other
  soft tissue is partially / completely torn away
• May hang like a flap
• Severed (finger)

23
Puncture

• Caused when a pointed object pieces the skin
  (nail, tack, bullet)
• An object that remains embedded in the wound is
  called an impaled object

24
Caring for Soft Tissue Injuries

• Closed Wound (internal injuries)
• Apply something cold to control swelling
• Signals of Internal Bleeding
• Tender, swollen, bruised
• Rapid / weak pulse
• Skin (cool, moist, pale, bluish)
• Vomiting / coughing up blood
• Excessive thirst
• Confused, faint, drowsy or unconscious

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Caring for an Open Wound

• Control bleeding (sterile dressing-direct
  pressure)
• Raise / elevate above heart (if no broken bone is
  suspected)
• Apply bandage snugly over dressing (if bleeding
  does not stop apply additional dressing)
• If bleeding cannot be controlled, put pressure to
  supplying artery

26
Continued

• Call EMS
• Care for shock
• Wash hands after care

27
Shock

• Any serious injury or illness can result in
  shock.
• Shock is a natural reaction by the body.
• It usually means the victims condition is very
  serious.
• It is a life-threatening condition that occurs
  when the body is not getting enough blood flow.
  This can damage multiple organs. Shock requires
  IMMEDIATE medical treatment and can get worse
  very rapidly.

28
Signals of Shock

• Restlessness / irritability
• Altered consciousness
• Nausea
• Pale, cool, moist skin
• Rapid breathing
• Rapid pulse

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Caring for Shock

• Have victim lie down, elevate legs about 12
  (unless you suspect head, neck, back injuries)
• Call 9-1-1
• Control any external bleeding
• Help victim maintain body temperature
• Do not give food or drink
• Reassure victim

30
Special Situations

• Severed body parts
• Embedded objects
• Injuries to the mouth
• Animal and human bites
• Emergency childbirth

31
Severed Body Part

• Wrap the part completely in gauze or a clean
  towel.
• Wet the towel with cool water.
• Place the wrapped body part in a plastic bag
  seal it shut.
• Place the sealed bag in to another bag or bucket
  filled with ice.
• Take the bag with the amputated body part to the
  hospital with the victim.

32
Embedded Objects

• Do not remove it
• Place several objects around object to support it
• Eye-cover both eyes

33
Organs that Break Through the Abdomen

• Carefully remove clothing from around the move
• Cover organs with a moist, sterile / clean
  dressing
• Cover dressing with plastic wrap
• Place a folded towel / cloth to keep warm

34
Burns

35
Burns

• Are a specific type of soft tissue injury
• You can describe burns by their cause or by their
  depth (the deeper the burn, the more severe it
  is)
• A critical burn can be life-threatening

36
Burns are caused by

• Heat
• Chemicals
• Electrical current
• Radiation

37
What are Critical Burns?

• Burns involving trouble breathing
• Burns covering more than one body part
• Burns to the head, neck, hands, feet or genitals
• Burns (other than very minor) to child/elderly
• Burns resulting from chemicals, explosions or
  electricity

38
Critical Burns

• Life-threatening
• Seek immediate medical attention
• Often hard to tell how severe a burn is after it
  has happened
• Problem breathing

39
Types of Burns
40
Superficial (First Degree)

• Involve the first layer of skin
• Skin is red dry usually painful
• May be swollen
• Most sunburns are superficial
• Heals in 5-6 days without permanent scarring

41
Partial Thickness (Second Degree)

• Involves top layers of skin
• Skin is red blistered that may open seep
  clear fluid
• Usually painful often swells
• Usually heals in 3-4 weeks
• Scarring may occur

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Full Thickness (Third Degree)

• Destroys all layers of skin any/all underlying
  structures (fat, muscle/bones,nerves)
• Burns look brown/black (charred) with tissue
  underneath appearing white
• Can be either extremely painful or relatively
  painless (nerve endings destroyed)

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Care for Burns

• Stop the burning
• Put out flames or remove victim from source of
  burn
• Call fast-serious burns
• Cool the burn
• Use large amounts of water to cool
• Do not use ice

48
Care for Burns Continued

• Cover the burn
• Use dry, sterile dressings
• Loosely bandage them in place (dont put pressure
  on burn)
• Do not break blisters (unbroken skin helps
  prevent infection)

49
Minor Burns

• Wash area with soap water
• Keep clean
• Apply antibiotic ointment (Neosporin)
• Watch for infection

50
Severe Burns

• Lay victim down-unless trouble breathing
• Raise areas above heart
• Chill easily- cover

51
Special Kinds of Burns
52
Chemical Burns

• Chemicals (cleansers, lawn garden sprays, paint
  removers, bleach) come in contact with skin or
  eyes
• May cause severe burns (longer contact)
• Flush with large amounts of cool running water
• Remove clothing

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Electrical Burns

• Never go near a victim of an electrical burn
  until you are sure the power source is turned off
• Caused by
• Power lines
• Lightning
• Defective electrical equipment
• Electrical outlets

55
Electrical Burns continued

• Severity depends on how long the victim was in
  contact with power source strength type of
  current path it takes
• Often deep
• Two wounds-enter/exit

56
Radiation

• Sun-may blister
• Cool the burn
• Stay out of the sun
• Protective lotion (SPF-15)
• Antibiotic lotion-prevent infection

57
Donts of Burn Care

• Apply ice directly to any burn, unless its very
  minor
• Touch a burn w/ anything except clean covering
• Remove pieces of cloth that stick to burned area
• Try to clean a severe burn
• Break blisters
• Use any kind of ointment

58
Injury to Muscles, Bones Joints
http//www.youtube.com/watch?v_wxebhExcTk
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Skeletal System

• Over 200 bones
• Various sizes shapes
• Protect the body help the body move
• Hard dense have a rich supply of blood/nerves

60
Joints

• Consist of 2 or more bones held together by
  ligaments
• All joints have a normal range of motion
• When joints are forced beyond this range,
  ligaments stretch/tear

61
Muscular System

• 600 muscles-most attached by strong tissue called
  tendons
• The shortening lengthening of muscle make the
  body move
• Brain directs muscles to move through the spinal
  cord
• Injuries/diseases to the brain, spinal cord, or
  nerves can affect muscle control (stroke,
  parapalegic, Parkinsons)

62
Injuries

• Injuries to muscles, bones joints happen often
• Happen to people of all ages
• Happen at home, at work, and at play

63
Four Basic Types of Injuries

• Fractures
• Dislocations
• Strains
• Sprains

64
Fractures

• Complete break, chip or crack
• Closed
• Fractures can be life-threatening if they involve
  breaks in large bones, sever an artery, affects
  breathing

65
Fractures

• Open (compound)-bone breaks through the skin

66
Dislocations

• Is the movement of a bone at a joint from its
  normal position
• Usually more obvious than a fracture
• Usually tears ligament away from bone
• Forms a bump, ridge or hallow

67
Strains

• Stretching and tearing of muscles tendons
• Usually caused by lifting something heavy or
  working muscle too hard
• Usually involve neck, back, thigh, calf

68
Sprain

• Tearing ligaments at a joint
• Mild sprains may swell, but usually heal quickly
• Severe sprain can involve a fracture/dislocation
• Joints easily injured-(ankle, knee, wrist, finger)

69
How can you tell how bad the injury is?

• Pain (most common signal)
• Swollen, red or bruised
• Significant deformity-twisted or strangely bent
• Abnormal lumps or ridges
• Inability to use affected part normally
• Bone fragments sticking out of wound

70
Continued

• Feel bones grating, felt/heard a snap,pop at the
  time of injury
• Injured area is cold/numb
• Compare to uninjured leg or arm
• X-ray, MRI, CAT scan

71
Splinting

• Splint only when victim must be moved
• Only if you can do it without causing more pain
• Splint the injury in the position you find it
• Check circulation

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Types of Splints

• Soft splints
• Anatomic splints
• Slings
• Rigid splints

73
Sprains Strains

• General care (R.I.C.E.)
• Rest
• Immobilize
• Cold
• Elevate
• Cold then heat-reduces swelling and pain

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Special Situations
75
Head Spine Injuries

• 2 million each year
• Mostly males 15-30 years old
• Causes
• Motor vehicle accidents (44)
• Falls (22)
• Acts of violence (24
• Sports (8) 2/3 from diving

76
When to Suspect Head, Neck, Back Injuries

• A fall from a height greater than that of the
  victim (elderly person)
• Any diving mishap
• Unconscious person (unknown reason)
• Motor vehicle accidents where severe blunt force
  to the head, chest, abdomen, or pelvic area (gun
  shot wound)
• Victims helmet is broken (motorcycle, bike,
  football, industrial helmet)
• Lightning strike or when a victim is thrown

77
Signals of Head, Neck Back Injuries

• Change in consciousness
• Severe pain/pressure in the head, neck or back
• Tingling or loss of sensation (hands, fingers,
  feet toes)
• Partial / complete loss of movement
• Unusual bumps/depressions on head/spine
• Blood / fluids (ears / nose)

78
Signals continued

• Heavy external bleeding (head, neck, back)
• Seizures
• Impaired breathing / vision
• Nausea / vomiting
• Persistent headache
• Loss of balance
• Bruising (head, eyes, behind the ears)