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First Aid image (Afflictions (Bone and joint Injuries (Slings image (If…
First Aid
Steps of first aid
Recognize that an emergency exists
Use all senses to detect problems
Listen for sounds such as screams, calls for help, breaking glass, screeching tires, or changes in machinery or equipment noises
Look for unusual sites like an empty medicine bottle, damaged electrical wires, a stalled care, smoke, fire, or a person lying motionless, blood, or spilled chemicals
Note any unusual, unfamiliar, or strange odors like chemicals, natural gas, or pungent fumes
Watch for unusual behaviors like difficulty breathing, clutching of the chest or throat, abnormal skin color, drowsiness, excessive sweating, signs of pain and any other symptom of distress
Sometimes signs of emergency are obvious and at other times they are less obvious
Car accident with victims in a car
Empty medicine container and a small child with slurred speech
After you have determined that an emergency does deed exists, you need to take appropriate action:
Check the scene and make sure it is safe to approach (scan the area and look for information)
What to observe (dangers present, number of people involved)
An infant thrown from the vehicle may be overlooked
Down wires
If not safe, call for medical help– never endanger your own life or the lives of bystanders
If safe, approach the victim
Determine if the victim is conscious, tap gently and call to him
If conscious, try to find out what happened and what is wrong
Never move an injured person unless the person is in danger (fire, smoke, flood, poisonous fumes, dangerous traffic)
Call emergency medical services (EMS) as soon as possible
Dial 911
Don’t hang up until all information is given
Give information: describe the situation, actions taken, exact location, telephone number you are calling from, assistance that is required, number of people involved, and the condition of the victim
After calling for help, if possible, obtain the victim’s permission before providing any care (REMEMBER EVERYONE HAS THE RIGHT TO REFUSE CARE)
If conscious they should give permission
If unconscious, confused, or seriously ill- it is implied consent
Check for other injuries
If a person has more then one injury, treat the more serious one first
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Obtain as much information as possible
Obtain qualified help as soon as possible and report all information obtained
Avoid any unnecessary movement of the victim
Reassure the victim, use a confident, calm attitude to help relieve victim’s anxiety
Avoid giving the victim anything to eat or drink
Protect the victim from cold or chilling, but avoid overheating
Work quickly in an organized and efficient manner
Do not make a diagnosis or discuss condition with observers at scene
Maintain confidentiality and protect the victim’s right to privacy while providing treatment
Make every attempt to avoid further injury
Provide only the treatment you are qualified to provide
If you are alone, call EMS immediately before providing care to any of the following:
An unconscious adult
An unconscious child who has reached puberty
An unconscious infant or child with a high risk for heart problems
Any victim for whom you have witnessed a cardiac arrest
If you are alone, shout help and start CPR, if needed for
An unconscious infant or child 1 year of age to puberty
Any victim of submersion or near drowning
Any victim with cardiac arrest caused by drug overdose
If no one arrives to call EMS, continue providing care by giving 5 cycles of CPR (2 minutes), then go to the nearest phone and call EMS, only to return quickly and resume what you were doing
Afflictions
Wounds involve injuries to the soft tissues
Open: break in skin or mucous membranes
Classification
Abrasion
Skin is scraped off, bleeding limited, but infection needs to be prevented
Incision
Cut or injury by a sharp object like a knife, scissors, razor blade. Edges are smooth and regular. Deep, bleeding can be heavy and can lead to excessive blood loss, damage to muscles, nerves and other tissues
Laceration
Tearing of tissues by the way of excessive force. Wound is often jagged with irregular edges. Bleeding can be heavy, contamination can lead to infection
Puncture
Sharp object like a pin, nail, or pointed instrument. Gunshot wounds can also cause a puncture. External bleeding limited but internal bleeding can occur, increase chance of infection
Avulsion
Tissue is torn and separated from the body (piece of torn tissue from ear, nose, hand or other). Important to save the body part while caring for wound
Amputation
Body part is cut off and separated from the body. Bleeding can be heavy and extensive. Preserve the body part by wrapping in a cool moist dressing (sterile water or saline if possible) Use a plastic bag kept cool or in ice water and transport with victim. Body part never directly on ice d/t freezing the tissue
Closed: no break in skin or mucous membranes, but injury occurs to underlying tissues (bruise or hematoma)
Can occur anywhere on body
If bruise, apply cold application to reduce swelling
Observe for signs of internal bleeding
Pain, tenderness, swelling, deformity, cold and clammy skin, weak pulse, a drop in blood pressure, uncontrolled restlessness, excessive thirst, vomited blood or blood in urine, or feces
Get medical help as quickly as possible
Check breathing and treat for shock
Avoid unnecessary movement of victim
No food or fluids
Wounds can result in bleeding, infection, and/or tetanus
First aid treatment is aimed at controlling the bleeding and preventing or obtaining treatment for infection
First priority because victim can bleed to death quickly
Bleeding can come from arteries, veins, or capillaries
Arterial blood spurts and results in heavy blood loss
Venous is slower, steadier and dark red or maroon
Capillary blood oozes
Observe standard precautions
Use the four direct methods for controlling bleeding and should be used in the order given
Direct pressure
Elevation
Pressure bandages
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Raise the injured part above the level of the victim’s heart while continuing to apply pressure
Sterile dressing (clean cloth) over wound for 5-10 minutes. Blood soaks through dressing so add or apply a second dressing over the first dressing if bleeding continues
Do not disturb clots
Do not remove dressings
Do not clean wound
Tetanus bacteria can enter an open wound
Serious illness most common in puncture wounds and wounds that involve damage to tissues underneath the skin
Get tetanus shot or booster as needed
Minor wounds
First priority – prevention of infection
Wash your hands before caring for wound
Put on gloves
Wash the wound with soap and water
Wipe in an outward direction, away from the wound and discard the wipe after each use
Rinse the wound thoroughly
Use sterile supplies
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Objects embedded in wound
If superficial, gently remove
Objects embedded deeply in tissues should be left for a certified physician to remove
Shock
Also called hypoperfusion
clinical set of signs and symptoms that are associated with an inadequate supply of blood to body organs, especially brain and heart
Causes of shock
Hemorrhage (excessive loss of blood)
Excessive pain
Infection
Heart attack
Stroke
Poisoning(chemical, drugs, gases,
Lack of oxygen
Psychological trauma
Dehydration (loss of body fluids) from burns, vomiting, or diarrhea
Types of shock
Anaphylactic
Hypersensitivity or allergic reaction to a substance like food, medication, insect bite
Cardiogenic
Damage to heart muscle from heart attack or cardiac arrest
Hemorrhagic
Severe bleeding or loss of blood plasma
Metabolic
Loss of body fluid from severe vomiting, diarrhea, or heat illness or a disruption of acid-base balance as occurs in DM
Neurogenic
Injury or trauma to brain or spinal cord
Psychogenic
Emotional distress such as anger, fear, or grief
Respiratory
Trauma to respiratory tract, or resp. arrest
Septic
Acute infection like toxic shock syndrome
When shock occurs the body attempts to increase blood flow to the brain, heart, and vital organs by reducing blood flow to other body parts- which leads to the s/s
Skin is pale or bluish-gray and cool or cold to the touch check nail beds and the mucous membranes around the mouth
Diaphoresis
Excessive perspiration- wet, clammy feeling when skin touched)
Rapid and weak pulse- difficult to feel- check carotid
Respirations rapid, shallow, and may be irregular
Blood pressure very low or unobtainable
General weakness as shock progresses the victim becomes listless, and confused eventually losing consciousness
Anxiety and extreme restlessness
Excessive thirst, nausea and/or vomiting
Blurred vision or changes in appearance of eyes
Sunken and have a vacant or confused expression
Pupils may be dilated or become large
Treatment
Goals of treatment- get medical help (4 goals)
Eliminating the cause of shock
Improve circulation, especially to brain and heart
Provide and adequate oxygen supply
Maintain body temperature
Positioning of victim needs to be based on the person’s injuries
Usually laying flat on back (can raise legs 12 inches)
If victim is vomiting or has bleeding injury to mouth or jaw position on side
Breathing problems- may be necessary to raise head and shoulders
Head and neck injury- Head and not neck lying flat with head raised slightly
Maintain body temperature- avoid overheating
Avoid food or drink
If person has c/o excessive thirst a moist, wet cloth can be used
Other principles of care- when caring for someone who needs first aid- always important to be observing for signs of shock
Poisoning
Can happen to anyone regardless of age
Poison: any substance that causes a harmful reaction when applied or ingested
Ingesting (swallowing), inhaling, injecting, or contacting the skin
If poison has been swallowed
Call poison control or a doctor immediately- If you can’t get a hold of someone call EMS
Save the label to give the information to someone
Estimate how much was taken and the time
IF vomit occurs, save a sample of the material
Methods to induce vomiting
Tickle the back of the throat or give warm saltwater to drink
DO NOT induce when: unconscious, who swallowed an acid or alkali, petroleum products, convulsing, or who have burns on the lips and mouth
If poisoned by inhalation of gases
Remove victim from area
Before entering the danger area, take a deep breath of fresh air and do not breath in while removing victim
Check for breathing and provide artificial respirations if needed
Obtain medial help immediately
If poisoned by contact with skin
Use large amounts of water to wash skin for 15-20 minutes
Remove clothing and jewelry
Call PC or a doctor
Obtain medical help
Contact with poisonous plants
Poison ivy, oak, sumac
Wash area thoroughly with soap and water
If rash or weeping sores start after 2-3 days, lotions like Calamine or Caladryl or paste made from baking soda and water, may help to relieve the discomfort
If condition is severe, obtain medical help
If poisoned by injection (insect, spider, or snake bite or stings the person)
Remove any embedded stinger by scraping the stinger away from the skin with the edge of a credit card or a tongue depressor -DO NOT use tweezers (can puncture venom sac, injecting more poison)
Wash area with soap and water
Apply a sterile dressing and a cold pack
Tick bite
Use tweezers to slowly pull the tick out of the skin, wash area, apply antiseptic, watch for s/s of infection, obtain medical help
Snake bite, spider bite
Wash the wound, immobilize the area, position it lower then the heart, do nut cut the wound or apply a tourniquet, monitor breathing and give artificial support as needed, obtain medical help
Immediate action is needed (can go into anaphylactic shock)
First aid varies depending on type of poison, injury involved, and the method of contact
If victim is unconscious check for breathing. Provide artificial respiration if not. If they are breathing, place person on their side
Burns
Injury caused by fire, heat, chemical agents, radiation, and/or electricity
Classifications of burns
First-degree or superficial
Less severe, involves only top layer of skin, last 5-6 days, skin reddened, feels pain. Common exposures: sunburn, steam, and exposure to a weak acid or alkali
Second-degree or partial-thickness
Epidermis and dermis. A blister or vesicle forms, skin mottled, swelling on surface, painful burn taking 3-4 weeks to heal. Excessive exposure to sun, artificial radiation, hot, boiling liquid
Third-degree or full-thickness
Most severe type, layers of all the skin involved, white or charred appearance, extremely painful, if nerve endings are destroyed it can be painless, can be life threatening due to fluid loss, infection, and shock. Exposure to flames, electricity contact and immersion in hot boiling liquids
Treatment
First aid treatment is directed towards
Remove source of heat
Cool the skin
Cover the burn
Relieve pain
Observe for and treat shock
Prevent infections
Medical treatment is not usually required for superficial and mild partial thickness burns unless:
Medical care should be obtained if more than 15% of the surface of an adult is burned or 10% for child
Burns affect face or respiratory tract
Difficulty breathing
Burns cover more then one body part
Partial thickness burn and is under 5 or over 60
Burns resulted from chemicals, explosions, or electricity
All third-degree burns require treatment
Rule of nine- is used to calculate the % of body surface burn
If an adult has burns on both legs, this would equal 18% of body surface
How to treat superficial or mild second-degree burns
Cool the area buy flushing it with large amounts of cool water
Do not use ice or ice water (causes body to lose heat)
After pain lessens, use a sterile, dry dressing to prevent infection (if nonadhesive is ready to use….use that
Elevate the affected part to reduce swelling
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DO NOT use cotton, tissues, ointment, powders, grease, butter unless instructed to do so by a doctor. DO NOT break or open any blisters that form
How to treat severe second-degree burns and third-degree burns
Call for medical help immediately
Cover area with thick sterile dressings
Elevate the affected area
If feet or legs burned do not allow the victim to walk
If clothing is burned into skin- do not attempt to remove
Watch for respiratory distress and or shock. Provide artificial support if needed
How to treat when chemicals splashed on skin
Large amounts of water to flush for 15-30 minutes
Gently remove any clothing, socks, shoes, or jewelry that contains the chemical
Continue flushing
How to treat eyes burned by chemicals or irritating gases
Flush the eyes with large amounts of water for 15-30 minutes
If one eye is injured, tilt head in the direction of the injury and begin flushing
Start at the inner corner of the ye and all the water to run over the surface of the eye to the outside
Monitor for s/s of schock
Heat exposure
Overexposure to heat may cause a chemical imbalance in the body
Occurs when water and salt are lost through perspiration
Also occurs when body cannot eliminate excess heat
Heat cramp
Caused by exposure to heat
Muscle pains and spasms caused by the loss of water and salt from perspiration
Treat it by applying firm pressure on cramped muscle to provide relief
Encourage rest and move to cooler area
Small sips of water or electrolyte solution (e.g., sports drink)
Heat exhaustion
Occurs when exposed to heat and there is loss of fluids through sweating
Signs and symptoms include pale clammy skin, profuse perspiration (diaphoresis), fatigue, weakness, headache, muscle cramps, nausea, and or vomiting, and dizziness, and or fainting.
First aid care
The body temperature is normal or just slightly elevated
Treat quickly can develop into a heat stroke
Moving the person into a cooler area
Loosening or removing excess clothing
Apply cool, wet cloths,
Lay the person down
Elevate the victim’s feet 12 inches
Give small sips of call water (4oz q 15 minutes)
Monitor for s/s of shock
Heat stroke
Prolonged exposure to high temperatures
Medical emergency - needs immediate care
Body unable to eliminate excess heat and internal body temp rises to 1050 F or higher
Signs and symptoms- normal defense for body like sweating is no longer working
Red, hot, and dry skin, pulse rapid, may lose consciousness,
First aid care
Cooling the body quickly by placing in tub of cool water
Sponge body with cool water
Ice or cold packs can be placed on wrists, ankles and axillary area and the groin
Be alert to shock and call 911
Cold exposure
Exposure to cold external temperatures can cause body tissues to freeze and body processes to slow down
Needs immediate attention or victim will die
Degree of injury affected by wind velocity, amount of humidity, and length of exposure to cold
Hypothermia
When body temperature is less than 95 degrees Fahrenheit or 35 degrees Celsius
Caused by prolonged exposure to cold, and the elderly are susceptible to hypothermia
Signs and symptoms
Shivering, numbness, weakness, or drowsiness, low body temperature, poor coordination, confusion, and loss of consciousness
Death can occur if body processes become too slowed down
First aid care
Move to warm area
Remove wet clothing
Slowly warm the victim by wrapping
If victim is conscious, give warm nonalcoholic, noncaffeinated liquids by mouth
Avoid warming the person to quickly d/t rapid warming can cause heart arrhythmias
Frostbite
Actual freezing of tissue fluids with damage to the skin and underlying tissues
Caused by exposure to freezing or below-freezing temperatures
Common sites: fingers, toes, ears, nose, cheeks
Early signs and symptoms include redness and tingling
Other signs and symptoms as progresses
Pale, glossy skin that is white or grayish-yellow in color, blisters, skin that is cold to touch, numbness and sometimes, pain that will gradually go away, incoherent, confused, lethargic, unconscious, death
Treatment
Objectives of first aid
Mmaintaining respirations, treating for shock, warming the affected parts and preventing further injury.
First aid care
Parts affected may be immersed in warm water
Parts should not be rubbed or massaged
Avoid breaking blisters
Do not use hot water above 104 degrees or heat from a stove, or heat lamp
Dry sterile dressings should be placed between toes or fingers to prevent them from rubbing
Assess for signs and symptoms of shock
Bone and joint Injuries
Variety of injuries can occur
Frequently occur during accidents or falls
Examples: fractures, dislocations, sprains, and strains
May have more than one type of injury to bones and joints at the same time
Fractures
Break in the bone
Closed or simple fracture-no break in skin
Compound or open fracture- open wound in skin
Signs and symptoms can vary and not all will be present in every victim
Deformity
Limited motion or loss of motion
Pain and tenderness at site
Swelling and discoloration
Protrusion of bone through skin
Person heard a break or a snap or felt a grating sensation
Abnormal movements within a part of a body
Objectives of first aid
Maintain respirations
Treat for shock
Keep the broken bone from moving
Prevent further injury
Use a device like a splint or sling to prevent movement
Obtain medical help
Dislocation
When the end of the bone is displaced from a joint or moved out of its normal position within a joint
Accompanied by tearing or stretching of ligaments, muscles, and other soft tissues
Signs and symptoms
Deformity
Limited or abnormal movement
Swelling
Dislocation
Pain and tenderness
A shortening of lengthening of the affected limb
First aid care
Same as those with fractures
No attempt to reduce the dislocation
Immobilize the affected part by using splints and slings
Obtain medical help
Sprain
Injury to the tissues surrounding a joint usually occurs when the part is forced beyond its normal ROM
Common sites: ankles and wrists
Signs and symptoms
Swelling
Pain
Discomfort
And sometimes impaired motion
Frequently resemble fractures or dislocations - treat as fracture if in doubt
First aid care
Apply a cold application to decrease swelling and pain
Elevate the affected part
Encourage the person to rest the affected part
Apply the elastic bandage to provide support for the affected area but avoid stretching the bandage too tightly
Obtain medical help if swelling is severe or if the or if there is any questions of a fracture
Strain
Overstretching of a muscle
Caused by overexertion or by lifting --Frequent site: back
Signs and symptoms
Sudden pain, swelling, and or brusing
First aid treatment
Encourage the person to rest
Recommend bed rest with a backboard under the mattres for a strained back
Apply cold applications to reduce swelling
After swelling decreases, apply warm, wet applications
Obtain medial help
Splints
Devices used to immobilize injured part
Types of splints
Pneumatic or air splints-
Padded boards-
Traction splints
Special devices that provide a puling or traction effect on the injured bone
Basic principles
Splints can also be made from cardboard, newspapers, pillows, boards, etc.
Need to be long enough to immobilize the joint above and below the injured area
Should be padded
Tied in place
Apply as not to create pressure on area
If open wound, control bleeding before applying splint
Never attempt to reposition bone
Splint before moving victim
Circulation check
Verify that the splints are not too tight
Check skin temperature
Check color
Note swelling or edema
Numbness or tingling
Check pulse
If circulation impaired, immediately loosen
Slings
Commercial slings have series of straps that extend around the neck and or thoracic region
Triangular bandages most common type of sling used for first aid
Use: support arm, hand, forearm, and shoulder
Positioning of sling hand is higher then the elbow which helps promote circulation, prevent swelling and decrease pain,
Check circulation , temperature, color, swelling, pain, numbness
Limit movement of limb
If use knots
Placement - knot should not be pressed against the one in the back but on either side of the spinal column
Padding - place under the knot to protect skin
Special considerations for shoulder injury
Keep arm next to the body
After sling has been applied, another bandage can be placed around the thoracic region to hold the arm against the body
Neck and spine injury
Most dangerous types of injuries involving bones and joints
Movement can result in permanent injury resulting in paralysis
Avoid any movement of victim if at all possible
Wait for backboard and adequate help to arrive for transfer
Specific injuries
Treatment for burns, bleeding, wounds, poisoning, and fractures is basically the same
Injuries to specific body parts require special care
Examples: eyes, ears, nose, brain, chest, abdomen, and genital organs
Eye
Always involves danger of vision loss
Best to avoid giving major treatment
Obtain help of a specialist-
Foreign objects in the eye- examples, what can happen to the eye, signs & symptoms, and then treatment
Blows to the eye
Penetrating injuries that cut eye tissue
Ear
Can result in rupture or perforation of eardrum
Torn or detached tissue
Ruptured or perforated eardrum
Clear fluid or blood-tinged fluid draining from ear
Brain
Wounds and blows to head and skull can cause brain injury
Seek medical help quickly as possible
Signs and symptoms
First aid care
Nose
Nosebleeds are usually more frightening than serious
Nosebleeds also called epistaxis
Causes of nosebleeds
First aid care
Chest
Usually medical emergencies
Involve heart, lungs, and major vessels
Sucking chest wound
Penetrating injuries to the chest
Crushing injuries to the chest
Abdominal
Can cause damage to internal organs and bleeding in major blood vessels
Intestines and other abdominal organs may protrude from open wound
Medical emergency
Bleeding, shock, and damage to organs can be fatal
Signs and symptoms
First aid care
Genital organs
Result of falls, blows, or explosions
Can cause severe pain, bleeding, and shock
First aid care
Sudden illness
Can be difficult to determine exact illness being experienced
Base care on signs and symptoms
Information from victim if possible
Look for medical alert bracelets or necklaces or medical cards
Heart attack
Known by other names as coronary thrombosis, coronary occlusion, or myocardial infarction
Occurs when there is blockage in one or more coronary arteries
If heart stops, start CPR
Signs and symptoms
First aid care
Cerebrovascular accident
Also called stroke, apoplexy, or cerebral thrombosis
Causes
Signs and symptoms
First aid care
Fainting
Temporary reduction in supply of blood to brain
Early signs and treatment
If victim loses consciousness, try to prevent injury
Obtain medical help if recovery not prompt, there are other injuries, or fainting reoccurs
Convulsion
Type of seizure-strong involuntary contraction of muscles
Causes
Progression of a convulsion
First aid care is directed at preventing self-injury
Diabetes mallitus
Metabolic disorder caused by lack of or insufficient production of insulin
Diabetic coma
Insulin shock
Differentiate between diabetic coma and insulin shock
First aid is not full and complete treatment, rather it is defined as the immediate care given to the victim of an accident or illness to minimize the effect of injury or illness until experts can take over
Can often mean the difference of life and death or recovery vs permanent disability
In ANY situation where first aid treatment is necessary it is essential that you:
Remain calm and avoid panic
Evaluate situation thoroughly
Have a reason for anything you do
Treatment you provide will vary depending on type of injury or illness, environment, others present, equipment or supplies on hand, and availability of medical help
Important for you to think about all theses factors and determine what action is necessary
Applying dressings and bandages
Dressings used as sterile covering and to control bleeding
Materials used in dressings
Dressings can be held in place with tape or a bandage
Bandages used to hold dressings in place, to secure splints, and to support and protect body parts
Apply bandages snugly to control bleeding and prevent movement of dressing, but not to interfere with circulation
Check circulation after application
Signs of poor or impaired circulation:
Swelling or edema
Pale or cyanotic color
Coldness to touch
Numbness or tingling
Poor or slow capillary refill
Loosen bandage immediately
Types of bandages consist of:
Roller gauze
Triangular
Elastic
Depends on the body part
Spiral
Figure-eight for joints
Recurrent or finger wrap
