Scoutmaster and Assistant Scoutmaster Outdoor Skills Training

1
Scoutmaster and Assistant Scoutmaster Outdoor
Skills Training

• First Aid

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Goals

• By the end of this session, participants will be
  able to
• Shape their attitudes and approach to first-aid
  situations
• Define first aid and explain what a first aid
  plan is
• Describe a systematic approach to first aid
• Assemble a first-aid kit that includes items for
  specific injuries
• Explain the considerations for first aid in
  pre-trip planning

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Disclaimer

• I acknowledge
• Many of you have had first aid training
• There may be different ways to do things
• But..
• Were going to go over what BSA wants us to teach
  our Scouts

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What is First Aid?

• The first help given to a victim of an accident
  or other health emergency.
• First Aid should
• Stop life-threatening dangers
• Protect an injured or ill person from further
  harm
• Get proper medical help for the victim

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Systematic Approach to Teaching First Aid

• As the Scouts work on the requirements for
  Tenderfoot, Second Class, and then First Class we
  build upon their first aid skills
• This is not necessarily the way we approach a
  victim, but it is a good way to build the skills
  of the Scout

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Tenderfoot Requirements

• Requirement 11
• Identify local poisonous plants tell how to
  treat exposure to them
• Requirement 12a.
• Show how to care for someone who is choking

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Tenderfoot Requirements

• Requirement 12b.
• Show first aid for the following
• Simple cuts and scrapes
• Blisters on the hand and foot
• Minor (thermal/heat) burns or scalds
• Bites or stings of insects and ticks
• Venomous snakebite
• Nosebleed
• Frostbite and sunburn

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Poisonous Plants

• Oily sap from the plant causes a reaction on the
  skin
• It usually takes 10 20 minutes on the skin to
  cause the rash
• Preventionwash the skin with soap and water if
  you have a known exposure
• Dont forget the sap can be on clothes and shoes

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Poisonous Plants

• Rash
• Red rash with blisters
• May be oozing a clear to straw colored liquid
• First Aid
• Wash the sap off the skin
• Change clothes and shoes and wash
• Calamine lotion is a drying agent that may help
  to relieve itching

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Choking

• Universal symbol for choking
• First Aid
• Ask, Are you choking?
• If the person can speak, cough, or breathe
• Encourage them to keep coughing and trying to get
  the object up
• Have someone call for help

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Choking

• If they cannot breathe, speak or cough and are
  still conscious
• Abdominal Thrusts (Heimlich Maneuver)
• Back blows
• Firmly strike the palm of the hand between the
  shoulder blades 5 times

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Choking

• If the person becomes unconscious
• Lower them gently to the floor
• Perform abdominal thrusts
• Straddle the patients thighs
• Use the palm of one hand with your other hand on
  top
• Place hand above the belly button
• Use upward, quick thrusts

13
Simple Cuts Scratches

• Wash with soap and water
• Apply antiseptic to prevent infection
• Keep the wound clean with an adhesive bandage
  (Band-aid)
• Clean and rebandage small wound daily

14
Blisters on Hands and Feet

• Pockets of fluid that form as a defense against
  friction on the skin
• Prevention
• Wear work gloves (community service projects,
  when using saw, ax, etc.)
• Wear proper fitting shoes or boots
• Change socks when they become sweaty or wet
• Pay attention to warnings (hot spots)

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Blisters on Hands and Feet

• When you feel a hot spot
• Stop
• Cut a piece of moleskin or molefoam slightly
  larger than the reddened area
• Can build up layers to protect and take pressure
  off the area
• Alternately, create a doughnut with the
  moleskin. Build layers up around the area.

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Blisters on Hands and Feet

• First Aid for a blister
• A gel pad, used to treat burns, can be applied
  directly over a blister with moleskin around it
• If you need to continue hiking, you may want to
  drain the blister
• Wash the skin with soap and water
• Sterilize a needle (over a flame or with alcohol)
• Pierce the skin at the edge of the blister and
  apply light pressure to push fluid out be
  careful to leave the layer of skin over the
  blister
• Put doughnut of moleskin around blister
• Apply antibiotic ointment and cover the top with
  a bandage

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Minor Burns/Scalds (1st degree)

• First Aid
• Remove the heat source
• Run under cool water or apply cool compresses
• Prevention of sunburn
• Apply sunscreen
• Reapply if sweating or swimming
• Wide brimmed hat
• Long sleeves/long pants

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Bee and Wasp Stings

• Scrape away stinger with edge of credit card or
  knife
• Apply an ice pack
• Know whether or not the person is allergic to bee
  stings

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Tick Bites

• Prevention
• Wear long pants and long-sleeve shirt
• Button your collar
• Tuck pants in boots or socks
• First Aid
• Grasp the tick as close to the skin as possible
  with tweezers
• Gently pull until it comes loose
• Wash the area with soap and water
• Apply antiseptic

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Chigger Bites

• Chiggers are small, red mites that live in tall
  grass, forests and along streams/lakes
• Chigger bites are extremely itchy!
• Prevention
• Same as for Ticks and Insect Repellant
• First Aid
• Remove chiggers by gently rubbing
• Use calamine lotion or finger nail polish

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Spider Bites

• Black Widow Spider bite may cause
• Redness and sharp pain at site
• Sweating
• Nausea and vomiting
• Stomach pain and cramps
• Muscle pain and Spasm

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Spider Bites

• Brown Recluse Spider may cause
• Pain, redness and swelling in 2-8 hours (usually
  not right away)
• An open sore will likely develop
• Fever
• Chills
• Nausea and vomiting
• Joint pain
• Faint rash

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Spider Bites

• First Aid for all spider bites
• Wash the area with soap and water
• Apply cold pack
• Seek medical attention

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Snake Bite

• Prevention
• Watch where you put your hands when gathering
  firewood or rocks
• Use hiking stick to poke among stones and brush
  ahead of you while walking through areas where
  snakes are common
• First Aid for Non-venomous Snake
• Wash with soap and water
• Apply antiseptic

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Venomous Snakebites

• Get victim to medical care as soon as possible
• Remove rings or jewelry from the extremity
• If the victim has to wait to seek medical care
  have them lie down and position the affected
  extremity lower than the rest of the body
• Keep reassuring the victim
• Treat for shock
• Do NOT cut the victim, suction, or apply ice

Timber Rattlesnake
Northern Copperhead
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Nosebleed

• Have the victim sit up and lean forward
• Pinch the nostril shut
• Apply a cool, wet cloth over the bridge of the
  nose
• If severe
• Treat for shock
• Seek medical attention

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Frostbite

• Most often occurs on ears, nose, fingers, feet
• May cause grayish-white patches on the skin
• May feel painful, then numb
• Prevention
• Keep skin covered

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Frostbite

• First Aid
• Get victim indoors, if possible
• Place palm of hand over ear or cheek
• Place fingers under clothing in armpit
• Place victims feet on skin of your abdomen
• DO NOT RUB the skin
• Can run the affected area under warm (not hot)
  water
• Have the victim exercise affected fingers or toes
• Seek medical attention

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Second Class Requirements

• Requirement 6a
• Show what to do for hurry cases of stopped
  breathing, serious bleeding, and ingested
  poisoning
• Requirement 6b
• Prepare a personal first aid kit to take with you
  on a hike

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Second Class Requirements

• Requirement 6c
• Demonstrate first aid for the following
• Object in the eye
• Bite of a suspected rapid animal
• Puncture wound from a splinter, nail, and
  fishhook
• Serious burns
• Heat exhaustion
• Shock
• Heat stroke, dehydration, hypothermia, and
  hyperventilation

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Hurry Cases

• What is a hurry case?
• A hurry case is when a victim suffers from an
  immediate threat to their life. Action must be
  taken within minutes to save the victim.

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Hurry Cases

• What are the hurry cases?
• Stopped breathing
• Severe bleeding
• Ingested poisoning
• Stopped heartbeat (First Class Requirement)

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Stopped Breathing

• Open the Airway
• Position the victim on his or her back
• Use the head tilt, chin lift method
• Look in the mouth for any obstructions that can
  be removed

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Stopped Breathing

• Look, listen and feel for breathing
• Look for the chest to rise and fall
• Listen for the sound of moving air
• Feel for the breath on your cheek

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Stopped Breathing

• Give rescue breaths
• Place barrier device over the victims mouth
• Pinch the nostrils
• Seal your mouth over the victims mouth (mouth and
  nose of a small child)
• Blow a slow breath into the victim enough to see
  the chest rise
• Repeat every 5 seconds for over 9 years old
  every 3 seconds for under 9 years old

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Stopped Breathing

• If the chest doesnt rise and fall
• Reposition the head
• Check again for any obstructions
• Try the breaths again
• If still not able to make the chest rise, begin
  abdominal thrusts
• Continue rescue breathing until the victims
  breathes on their own, help arrives, or you are
  too physically exhausted to continue

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Severe Bleeding

• Put on protective equipment, if available
• Latex gloves and eye protection
• Apply direct pressure over the wound with a
  sterile dressing and the palm of your hand
• You can secure the dressing with a gauze wrap or
  elastic bandage if you have one
• Check periodically for circulation (feeling,
  warmth, and color)
• Loosen the bandage when necessary

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Severe Bleeding

• Elevate the extremity if possible
• If the bandage becomes soaked with blood, do NOT
  remove it. Place an additional bandage over the
  first and continue to apply pressure
• Have the victim lie down
• Treat for shock
• Remove any blood or body fluids that has come in
  contact with your skin with soap and water.
  Change contaminate clothing.

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Ingested Poisoning

• Victim will be sick, maybe unconscious
• Most clues will be found at the scene
• Gather empty bottles/containers
• Estimate how much may have been ingested
• Call Poison Control Center and 911.
• Do not give victim anything by mouth or induce
  vomiting unless told to do so by Poison Control
• Treat victim for shock
• Monitor Breathing

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Prepare a Personal First Aid Kit

• Adhesive Bandages6
• Sterile gauze pads, 3-by-3-inch2
• Adhesive tape
• Moleskin, 3-by-6-inch
• Soap
• Antiseptic
• Scissors

• Non-latex gloves
• Mouth barrier device
• Eye protection
• Pencil and paper
• Tweezers (not in Scout Handbook)
• Triangular bandage (not in the Scout Handbook)

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Personal First Aid Kit

• Make it practical for the Scout
• Encourage them to bring their personal first aid
  kits on all outdoor scout activities (and any
  others where they may have a day pack or fanny
  pack)
• Periodically review the contents of their first
  aid kits when appropriate for the event to which
  you are going

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Object in the Eye

• Have the person blink the eyes tears may help
  flush out the object
• Wash your hands with soap and water
• Try to flush the eye with clean running water
• You may try to remove the object with a moistened
  cotton swab
• Do NOT rub the eye
• Do NOT try to remove any object that is embedded
  in any portion of the eye

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Animal Bite

• Control any bleeding
• If not bleeding, wash the area thoroughly with
  soap and water
• Cover the wound with a sterile dressing
• Seek medical care

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Animal Bite

• Suspect rabies in any animal, especially if they
  are acting uncharacteristically
• Try to get a description of the animal and note
  when the animal was last seen
• Do NOT put yourself at risk for injury by trying
  to capture the animal
• Notify police, animal control, or rangers about
  the animal

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Splinters

• Remove splinters with tweezers sterilized over a
  flame or in boiling water
• May also use a sterilized needle if necessary
• Wash the area with soap and water
• Apply antiseptic
• Apply adhesive bandage

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Puncture Wounds

• Puncture wound can be dangerous because they
  allow germs to enter the wound and are hard to
  clean

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Puncture Wounds

• Remove bits of glass or other objects you can see
  with tweezers sterilized over a flame or in
  boiling water
• Wash the area with soap and water
• Apply antiseptic
• Apply sterile bandages
• Seek medical attention

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Fishhook

• If medical personnel are available, let them
  remove the fishhook. If not
• Push the hook further until the barb comes
  through the skin
• Snip off the barb
• Ease the shank of the hook back out the point of
  entry
• Wash the area, apply antiseptic and bandage

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Second-Degree Burns

• When blisters form, there is deeper damage to the
  skin
• Remove heat source
• Run under cool water or use cool compresses
• Dry area and protect with a sterile bandage
• Do NOT pop blisters
• Do NOT apply butter, cream, ointments or sprays
• Seek medical care

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Third-Degree Burns

• This is the deepest and most severe type of burn
• Skin will be charred or burned away
• Because nerves are damaged, the victim may not
  feel pain

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Third-Degree Burns

• Stop the burning process! May use cool
  compresses but do not immerse large areas in cool
  water (may cause shock)
• Do NOT try to remove clothing that is sticking to
  the area
• Do NOT apply creams, ointments or sprays
• Cover the area with a sterile gauze or clean
  sheet if the area is large
• Treat for shock
• Seek immediate medical attention

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Shock

• What is shock?
• When the circulatory system is unable to provide
  enough blood to all parts of the body
• When does it occur?
• May occur with any injury or stress to the body

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Symptoms of Shock

• Restlessness or irritability
• Weakness
• Confusion or fear
• Dizziness
• Moist, clammy, cool, and/or pale skin

• Quick, weak pulse
• Shallow, rapid, and irregular breathing
• Nausea
• Vomiting
• Extreme thirst

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Shock

• Treat every victim for shock!
• Most victims have some degree of shock but
  symptoms are not always apparent early
• Sometimes early first aid for an injury may
  prevent shock
• Sometimes early treatment for shock will prevent
  shock

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Shock

• Eliminate the causes of shock by restoring
  breathing and circulation, controlling bleeding,
  relieving severe pain, and treating wounds
• Call for emergency aid
• Have the victim lie down
• Raise the victims legs about 12 inches (only if
  you dont suspect head, neck, back, hip or leg
  injuries)
• Keep the victim warm with blankets, coats or
  sleeping bags

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Shock

• Do not leave the victim alone
• Continue to reassure the victim in a calm voice
  (fear and uncertainty may make shock worse)
• A person who appears to be unconscious may still
  be able to hear youkeep letting them know you
  are there and you are getting help

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Heat Related Injuries

• Prevention
• Drink plenty of fluids
• Rest in the shade when you feel too warm or get
  muscle cramps
• Do the heaviest physical activity in the morning
  or evening
• Wear loose, light-colored clothing
• Shade your head with a hat

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Heat Exhaustion

• Occurs when the bodys cooling system becomes
  overworked.
• Symptoms
• Pale skin that is clammy from heavy sweating
• Nausea
• Fatigue/weakness
• Dizziness/lightheadedness
• Headache
• Muscle cramps
• Rapid Pulse

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Heat Exhaustion

• Have the victim lie in a cool, shady place
• Elevate the feet
• Remove excess clothing
• Cool the victim by applying cool,
• wet cloths to body and fanning
• If he is alert, have the victim sip
• on a glass of cool water
• If recovery is not rapid, get medical attention

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Heat Stroke

• Occurs when the bodys cooling system is
  overworked and stops functioning.
• The victims body temperature will soar to a
  life-threatening level

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Heat Stroke

• Symptoms
• Very hot skin
• Red skin, can be dry or a little damp from sweat
• Rapid pulse
• Noisy breathing
• Confusion, irritability, unwillingness to accept
  treatment
• Unconsciousness

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Heat Stroke

• Call for medical help immediately!
• Move the victim to a shady or air-conditioned
  area
• Cool the victim any way you can
• Remove outer clothing
• Cover with cool wet towels, clothing, etc. and
  fan
• Place in a steam, bathtub of cool water, or in
  front of an air conditioner in house or car
• Wrap icepacks with a thin barrier and place in
  armpits, along neck, and in groin

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Heat Stroke

• Keep the victim lying down and comfortable
• Raise the victims head and shoulders a little
• If the person is able to drink, give small
  amounts of cool water
• Monitor the victim closely
• They may vomit
• They may require rescue breathing

64
Dehydration

• Occurs when more water is lost from the body than
  is taken in
• Water is lost from the body from breathing,
  sweating, digestion, and urination
• Prevention
• Drink plenty of fluids (summer and winter)
• Urine should be clear
• Plan in advance to have proper amount of drinking
  water

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Dehydration

• Symptoms
• Increased thirst
• Dry lips
• Headache
• Body aches, muscle cramps
• Dark urine
• Heat exhaustion, heat stroke, and hypothermia can
  all be caused in part by dehydration

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Hypothermia

• Occurs when more body heat is lost than can be
  generated.
• Wind, precipitation, hunger, dehydration, and
  exhaustion all increase the risk
• Prevention
• Wear proper clothing for the weather
• Dont forget the hat!
• Eat proper food for energy
• Drink plenty of fluids

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Symptoms of Hypothermia

• Feeling cold and numb
• Fatigue
• Anxiety
• Uncontrollable shivering
• Slurred speech

• Confusion, making bad decisions
• Irritability
• Stumbling and/or falling down
• Loss of consciousness

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Hypothermia

• Take the victim into the shelter of a building or
  tent
• Remove all wet clothing
• Wrap the victim in dry clothing, blankets,
  sleeping bag
• If conscious, have the victim drink warm fluids
  (avoid caffeine and alcohol)

69
Hypothermia

• Wrap water bottles filled with warm water and
  place in armpits and groin
• Do NOT rewarm the victim too quickly (like
  immersing in warm water). This may cause an
  irregular heart rhythm
• Monitor the victim. Be ready to provide other
  first aid

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Hyperventilation

• Occurs when breathing is too rapid and too much
  carbon dioxide is removed from the bloodstream
• Symptoms
• Victim feels like he or she is suffocating
• Dizziness
• Disoriented
• Increasingly fearful
• Tingling in fingers, toes, lips

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Hyperventilation

• Talk quietly to the victim
• Encourage the victim to calm down and breath
  slowly
• Have the patient take some slow breaths in a
  paper bag
• Seek medical carebreathing fast may be a sign of
  other conditions (asthma, diabetes, etc.)

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First Class Requirements

• Requirement 8a
• Demonstrate bandages for a sprained ankle and for
  injuries of the head, the upper arm, and the
  collarbone.
• Requirement 8b
• Show how to transport by yourself, and with
  another person, a person
• From a smoke-filled room
• With a sprained ankle, for at least 25 yards

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First Class Requirements

• Requirement 8d
• Tell the five most common signals of a heart
  attack.
• Explain the steps (procedures) in cardiopulmonary
  resuscitation (CPR)

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Bandages

• Sprained Ankle
• Head
• Upper Arm
• Collarbone

75
Rescue from a Smoke-Filled Room

• Must be done quickly
• Cannot put yourself at risk
• How to move a victim in that environment
• Grab the victim by their clothing and drag them
  toward you
• Roll the victim onto a coat, blanket, tablecloth,
  etc. and drag them out
• Get behind the victim, reach under his arms, grab
  his wrists and drag him out

76
Transport a Victim with Sprained Ankle

• Walking Assist
• One-Person Carry
• Four-handed Seat Carry
• Two-person Carry

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Heart Attack

• 5 Most Common Symptoms
• Uncomfortable pressure, squeezing, fullness in
  the chest
• May spread to shoulders, arms, and neck
• Unusual Sweating
• Nausea
• Shortness of Breath
• A feeling of Weakness

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CPR for Heart Attack

• Check for Response
• Tap the victim on the shoulder
• Are you OK?
• Activate the Emergency Response System and get an
  AED

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CPR for Heart Attack

• Open the Airway
• Head tilt--chin lift
• Look, listen and feel for 5-10 secs
• If not adequate breathing, give 2 rescue breaths
• Watch for the chest to rise and fall
• If chest doesnt rise, reposition the head
  (airway) and attempt 2 more breaths

80
CPR for Heart Attack

• Begin Chest Compressions
• 30 compressions, then 2 breaths
• Rate of 100 per minute
• Keep interruptions to 10 seconds or less
• Continue until
• Scene is unsafe
• More qualified help arrives
• Cannot physically continue