BASIC FIRST AID AMERICAN SAFETY HEALTH INSTITUTE Joe

BASIC FIRST AID AMERICAN SAFETY & HEALTH INSTITUTE Joe Cooke EMT-CT Jim Ogden EMT-CT

BASIC FIRST AID • FIRST AID: is the immediate care given to the injured or suddenly ill person. It is the temporary assistance that is rendered until competent medical care, if required, arrives and takes over. • Properly applied first aid can save lives, reduce recovery time, and quite possibly be the difference between temporary or lifelong disability for the victim.

BASIC FIRST AID • GOOD SAMARITAN LAW INFORMATION – A. – B. – C. – D. Act in good faith are neither reckless or negligent act as a prudent person would, and only provide care that is within the scope of your training

BASIC FIRST AID • Three step-model for emergency response – 1. ASSESS • • a. b. c. d. is the scene safe Are there bystanders to help make them aware of any existing danger assess victims for life threats

BASIC FIRST AID – 2. ALERT • • • Notify EMS for assistance if necessary Give complete details of the incident Number of victims type of injuries any special hazards such as live power lines

BASIC FIRST AID – ATTEND • Complete head-to-toe exam • Provide emergency care until trained help arrives

BASIC FIRST AID • CHECK FOR RESPONSIVENESS • NO RESPONSE • • • Call EMS Check airway check for breathing and circulation Provide CPR or rescue breathing if necessary Control bleeding if necessary Care for shock

BASIC FIRST AID • RESPONSIVE • • • Introduction/request for consent Control bleeding if necessary Complete a head-to-toe exam Provide first aid if appropriate Care for shock Call EMS if necessary

BASIC FIRST AID • CALL EMS IF VICTIM: • • Is or becomes unconscious Has chest pain or pressure Has difficulty breathing Is bleeding severely Has pain or pressure in the abdomen Passing/vomiting blood Has slurred speech, severe headache or seizures

BASIC FIRST AID • Continued • Has a head, neck or back injury • Has possible broken bones • Has been poisoned

BASIC FIRST AID • GENERAL PRINCIPLES OF TRIAGE – Process of sorting multiple victims by the severity of their injuries • Critical - Life threatening injuries or illnesses that may be treated successfully • Serious - Not life-threatening • “Walking Wounded” - People who have minor injuries and can move on their own • Fatally injured or dead - No chance for survival

BASIC FIRST AID • MOVING A VICTIM • A victim should never be moved from the emergency scene unless remaining at that location is life-threatening. Ideally, EMS should respond to the emergency scene. When emergency moves are made make sure that you move the victim far enough so that no additional moves are required. The most critical time in the move is the beginning of the move.

BASIC FIRST AID • HEAD-TO-TOE EXAM • Assess scene for safety • Check ABC’s • Tell victim what you are doing and ask for permission to provide care • If treating an impact injury, maintain C-spine control

BASIC FIRST AID • SAMPLE – S = Signs and Symptoms • • • Level of consciousness Primary complaint Pulse rate Skin Condition Eyes

BASIC FIRST AID • SAMPLE (Continued) – A = Allergies • • • Foods Medications Insects Any other known allergies Look for Medic Alert Bracelet or Necklace Ask victim if they have been exposed

BASIC FIRST AID • SAMPLE (Continued) – Medications • Taking any prescribed medications • Over the counter drugs • Illegal substances

BASIC FIRST AID • SAMPLE (Continued) – P = Pre-Existing Medical History • Look for medical alert bracelets, necklace, etc… • Ask victim or family members about any medical conditions that may relate to their current problems

BASIC FIRST AID • SAMPLE (Continued) – L = Last Meal • When they ate last • What they ate

BASIC FIRST AID • SAMPLE (Continued) – E - Events • What events led up to the illness or injury • In medical situations, ask about the last several days

BASIC FIRST AID • STANDARD PRECAUTIONS & BSI – Standard Precautions • A means that should be employed to prevent infection via blood-borne pathogens such as HIV and HBV as well as other known blood-borne pathogens • All blood and certain body fluids that may contain blood should be considered potentially infectious, and precautions should be taken to protect yourself against them

BASIC FIRST AID • BSI – To reduce the risk of infection, you should: • Always place a barrier between you and someone else’s body fluids (Ex. , Latex or Vinyl gloves, eyewear…) • Cover all cuts, scrapes, hangnails, rashes, etc. • Minimize the splashing of body fluids • Handle any sharp objects with caution • Not handle food, cigarettes, make-up…when around body fluids

BASIC FIRST AID • BSI (Continued • Ensure that body fluid spills are cleaned up and the area is properly disinfected • Wash hands or any exposed area immediately and thoroughly after you provide care or clean a spill • Spills should be cleaned with a 10% bleach solution (1/4 cup bleach to 1 gallon of water freshly made)

BASIC FIRST AID BLEEDING EMERGENCIES – Body holds approximately 6 quarts of blood – Loss of one quart can lead to death or severe shock

BASIC FIRST AID • TYPES OF BLEEDING – Capillary bleeding • Oozing type of bleed – Venous bleeding • steady flow • dark in color – Arterial bleeding • spurting bleeding • bright red in color

BASIC FIRST AID • THE BLEEDING CONTROL SEQUENCE – Direct pressure • Pressure bandage – Elevate – Pressure Point • Femoral artery • Brachial artery

BASIC FIRST AID • BLEEDING CONTROL (Continued) – Tourniquet • Last resort (almost never needed) • Decision to sacrifice the limb to save the life

BASIC FIRST AID • INTERNAL BLEEDING – Signs and symptoms • Blood loss from mouth, rectum, vagina or blood in urine • Bruise of contusion • Rapid pulse rate • Cool and /or moist skin • Nausea and vomiting • Painful, tender, or hard spot on abdomen or chest

BASIC FIRST AID • BLEEDING (Continued) – Penetrating Object • Do Not Remove except from cheek • Bandage around object to stabilize it in place – Severed Body Part • Control bleeding • Keep severed part cool and dry then transport with victim for possible re-attachment – Bites (Animal/Human) • Clean well and seek medical attention

BASIC FIRST AID • SHOCK – A condition in which the body’s circulatory system fails to deliver an adequate supply of blood to all parts of the body. When the body’s organs do not receive an adequate supply of blood, they fail to function properly

BASIC FIRST AID • SIGNS OF SHOCK • • • Anxiety, Restlessness or Irritability Altered level of consciousness Rapid pulse rate Rapid breathing Pale, cool, moist skin Lackluster eyes, dazed look Weak, Helpless feeling Thirst Nausea

BASIC FIRST AID • CARE FOR SHOCK • Keep the victim lying down, if possible • Try to make the victim comfortable • Speak in a comforting and reassuring tone to relieve stress or anxiety • Control any external bleeding (if necessary) • Elevate legs 10 -12 inches… unless you suspect spinal damage or broken bones • Cover victim. Maintain body temperature. If possible, provide barrier between victim and ground

BASIC FIRST AID • CARE FOR SHOCK (Continued) • Don’t give victim anything to eat or drink • Provide victim with plenty of fresh air • If victim is nauseous or begins to vomit, place the victim on his/her left side • If EMS has not been called, make sure a call is made to activate the EMS

BASIC FIRST AID • BURN CARE • 2 million burn injuries each year • 6000 people die from burn related injuries per year • 1 st degree/superficial • Top layer of skin is red and dry, usually painful • 2 nd degree/partial thickness • Top layer of skin is burned, will be red and have blisters. Very painful

BASIC FIRST AID • BURN CARE (Continued) • 3 rd degree/full thickness • All layers of the skin are involved • Usually very little pain at the center of the burn, pain increases in the outlying areas

BASIC FIRST AID • ELECTRICAL BURNS • May severely damage underlying tissue • Victim may have two wounds, entrance and exit • Never go near a victim who has been electrically burned until you are sure the power is shut off and the scene is safe • General first aid care for an electrical burn: • Turn power source off • Check breathing and circulation, provide appropriate cardiac care (if necessary)

BASIC FIRST AID • ELECTRICAL BURNS (Continued) • Do not move victim unless necessary (spinal trauma may result from electrical burns) • Cover burn with dry sterile dressing • Seek medical attention

BASIC FIRST AID • CHEMICAL BURN • May be cause by a number of substances (Chlorine, battery acid, etc. ) • Require immediate care • First Aid Care for Chemical burns • • Wash away chemical with flowing water Flush for at least 20 minutes Remove contaminated clothing and jewelry If dry chemical, brush away chemical before flushing

BASIC FIRST AID • CHEMICAL BURN (Continued) • Contact EMS and/or poison control center • Watch the victim for delayed reactions • Chemical in one eye • rinse contaminated eye from nose outward so the water does not get into the un-injured eye

BASIC FIRST AID • SMOKE INHALATION • Smoke may irritate or damage airway or irritate the eyes • Move victim to a safe area • Check breathing and circulation/provide necessary care • Place victim in a semi-seated or reclined position • Call EMS

BASIC FIRST AID • DO’S AND DON’TS FOR BURN CARE – Do • Watch for signals and changes in breathing and consciousness • Keep victim from getting chilled or overheated • Seek medical attention if appropriate – Don’t • Apply any home remedy or ointments • apply ice directly on the skin

BASIC FIRST AID • DO’S AND DON’TS (Continued) • Break blisters • Remove pieces of clothing or any other item stuck to burn • Apply a moist dressing to a burn • Don’t give victim anything to eat or drink unless he/she is fully conscious (best not to give anything at all unless there will be an extended time to treatment

BASIC FIRST AID • FIRST AID FOR THERMAL BURNS – 1 st degree burn • Cool the burned area. Immerse in cold water or apply cold cloths • Cover with clean dry dressing • Elevate burned limbs above heart level • Treat for shock if necessary – 2 nd degree burn • Treatment is the same as for 1 st degree burns

BASIC FIRST AID • THERMAL BURNS (Continued) – 3 rd degree burn • • • Call EMS immediately (Do Not Apply Water) Cover with clean dry dressing Elevate burned limbs above heart level Treat for Shock Special precautions must be taken when dealing with children. Burns that may not appear to be severe for an adult may be life threatening for children

BASIC FIRST AID • FIRST AID FOR STRAINS AND SPRAINS – Types of Muscle Injuries • Muscle Strain – When muscle is stretched beyond its normal range of motion resulting in muscle fiber tear • Muscle Contusion – Results from a blow. Known as a bruise • Sprain – When joint is twisted beyond normal range. Severe sprain requires advanced medical attention

BASIC FIRST AID • GENERAL FIRST AID FOR STRAINS AND SPRAINS • I-C-E – I = Ice • Apply cold pack. Do not place ice directly on skin – C = Compress • Use an elastic or conforming wrap, not to tight – E = Elevate • Above the level of the heart to control internal bleeding

BASIC FIRST AID • DISLOCATIONS AND FRACTURES • Signs and Symptoms • • • Deformity Swelling and discoloration Grating sound Pain Inability to move injured area Exposed bone (compound fracture)

BASIC FIRST AID • First Aid care for dislocations and fractures – I-A-C-T • I = Immobilize area – Splints, pillows, jackets, blankets, magazines • A = Activate EMS (911) – Or transport victim to a medical center • C = Care for Shock • T = Treat any additional secondary injuries

BASIC FIRST AID • HEAD, NECK OR SPINAL INJURY – More than 2 million injuries in America each year. Many result in disabling conditions each year. – You must always suspect head or spinal trauma when the victim has been injured as a result of: • An automobile accident • Being thrown from any motorized vehicle • A fall from a height greater than the victims own height

BASIC FIRST AID • Head, Neck or Spinal Injury (Continued) • • • A penetration wound such as a gunshot A severe blow to the head, neck or back A diving accident A lightning strike Any serious impact injury

BASIC FIRST AID • Along with the actual cause of injury, certain signals suggest head or spinal trauma. They include: • • • A change in consciousness Difficulty breathing Impaired vision Inability to move a body part Headache Vomiting

BASIC FIRST AID • Continued • Loss of balance • Tingling or numbness in hands, feet and/or toes

BASIC FIRST AID • MEDICAL EMERGENCIES/SUDDEN ILLNESS – General emergencies of unknown cause • Signs and Symptoms – – – Pale or flushed skin Cold sweats Dizzy, light-headed, weak, confused Nausea or vomiting Diarrhea Severe headache

BASIC FIRST AID • • • Paralysis Slurred speech Seizure Breathing difficulty Persistent pain or pressure Changes in consciousness

BASIC FIRST AID • GENERAL FIRST AID CARE • Help victim rest comfortably • Interview victim/bystanders • • 1. 2. 3. 4. Are you allergic to anything? Are you on medication? When did you last eat? What led up to this problem? • Look for medical alert tags • Reassure victim • Watch for signals and changes in breathing and consciousness

BASIC FIRST AID • Don’t give the victim anything to eat or drink • Diabetic emergencies are an exception • Keep victim from getting chilled or overheated • Seek medical attention if appropriate • If the victim faints, position them on back and then elevate the legs 8 to 10 inches. (Do not elevate if you suspect spinal or head injury • If the victim vomits, place them on the left side with head resting on arm (Recovery Position)

BASIC FIRST AID • SPECIFIC TYPES OF MEDICAL EMERGENCIES – Asthma • Signs and Symptoms – – – Wheezing/ Difficulty exhaling Increased pulse rate Anxiety Distended/bulging neck veins Coughing Shoulders hunched and chest pulled up by breathing effort

BASIC FIRST AID • First Aid for Asthma – – Calm victim/give reassurance Assist victim with any prescribed medication Make victim comfortable Contact EMS if signs and symptoms remain the same or get worse – Nebulizer

BASIC FIRST AID • Diabetic Emergency – One of the leading causes of death in the United States • Signs and Symptoms – Same as general medical emergencies – Unconsciousness of unknown origin – If the person tells you they are diabetic, ask about last meal – True medical emergency

BASIC FIRST AID • First Aid for Diabetic Emergency – Interview victim/check for responsiveness and med. Alert tag – Conscious - Give sugar – Unconscious - Call EMS/Monitor breathing and circulation – No response to sugar - Call EMS immediately and monitor breathing and circulation – Responds to sugar - Continue to monitor victim until you are sure that they are all right and all the signs and symptoms of diabetic emergency are gone

BASIC FIRST AID • Seizures – Can be the result of injury, disease, fever, or infection – Can range from mild black-outs to severe uncontrolled muscular contractions • First Aid for Seizures – Clear the area of any objects that can harm the victim – Do not hold or restrain victim or place anything in victim’s mouth

BASIC FIRST AID – Cushion the victim’s head with pillow, blanket, etc. – Place victim on his/her side after seizure activity subsides. This act will help to prevent choking – Activate EMS if: • You are uncertain about cause of seizure • The seizure lasts more than a few minutes or there are repeated seizures • The victim is pregnant • The victim does not regain consciousness • The seizure occurs while victim is in water • The victim is injured

BASIC FIRST AID • Severe Allergic Reaction – Also know as Anaphylactic shock – Is life-threatening reaction of the body to a substance to which the victim is extremely allergic • Cause of an allergic reaction include: – An insect bite or sting – An ingested substance (foods such as spices, nuts, shellfish, or medication such as penicillin

BASIC FIRST AID – An inhaled substance (dust, pollen or chemicals) – An injected substance (Antitoxins or drugs such as penicillin – An absorbed substance (certain chemicals when in contact with skin, can result in a severe allergic reaction) • Signs and Symptoms – – – A rash, skin burning, itching and hives A feeling of tightness in the chest and throat Noisy and /or difficult breathing Nausea Swelling of face, neck, lips, and/or tongue

BASIC FIRST AID – Fainting, coma – Confusion – Dizziness

BASIC FIRST AID • Stroke – Also called brain attack – Caused by blockage or hemorrhage in the brain – Will require prompt medical care • Signs and Symptoms – – – Severe headache Numbness usually on one side (most often right side) Paralyses Unconsciousness Trouble speaking

BASIC FIRST AID • First Aid Care for Stroke – Check for Responsiveness: • No Response: • a. Call EMS • b. Assess for breathing and circulation. Provide necessary care – If breathing and circulation are present: • a. Place victim on his/her side • b. Make sure EMS is activated • c. Comfort and reassure victim • d. Continue to monitor breathing and circulation

BASIC FIRST AID • Poisoning – A substance (liquid, gas or solid) that when absorbed, swallowed, inhaled or injected into the body can cause tissue damage and organ damage. – Regardless of the type of poisoning, you must always call the POISON CONTROL CENTER for specific first aid care

BASIC FIRST AID • Signs and Symptoms of Poisoning – – – Abdominal cramping or pain Nausea and/or vomiting Diarrhea Burns, stains and odor in and around the mouth Change in consciousness (drowsiness…unconsciousness) Poison plants, poison containers, poisonous gases in the area

BASIC FIRST AID • General First Aid Guide for Poisoning Emergencies – Assess the scene for clues and safety – Get victim away from poison if necessary – Assess victim response (level of consciousness, breathing and circulation) – Provide care for any life-threatening conditions – If the victim is conscious, attempt to get more information – Alert the Poison Control Center or your local emergency system. Bring any empty container, plant, etc. , to the phone for verification

BASIC FIRST AID • POISONOUS PLANTS • FOODBORNE ILLNESS • BITES AND STINGS • Bees/Wasps/Hornets • Marine Life Stings and Care • Spiders – Black Widow – Brown Recluse • Tick Bites

BASIC FIRST AID • Snake Bites – – Rattlesnake Coral snake Cottonmouth Copperhead – First Aid Care for Snake Bites • Call the Poison Control Center or EMS • Do not attempt to suck the venom out of the victim • Keep the affected limb below heart level • Calm and reassure victim

BASIC FIRST AID • HEAT OR COLD RELATED EMERGENCIES – Heat Related Emergencies • Heat Cramps – Signs and symptoms • Painful muscle cramps • Moist, cool skin • Heavy sweating – Treatment • Move to cool place

BASIC FIRST AID • Give water or saline solution • Massage muscle • Heat Exhaustion – Signs and Symptoms • Cold and clammy • Heavy sweating • Weak pulse • Shallow Breathing • Nausea • Stomach cramps • Weakness, Fatigue • Headache

BASIC FIRST AID – Treatment • Move to cool place • Elevate legs • Remove sweat-soaked clothing • Apply cool packs • Give water • Monitor • Heat Stroke – Signs and symptoms • Hot, dry, red skin • Confusion or unconsciousness

BASIC FIRST AID • Little or no sweating • Full, rapid pulse – Treatment • Move to cool place • Immediately cool victim by fanning and applying cool water • Remove any excess clothing • CALL EMS • LIFE-THREATENING

BASIC FIRST AID – Cold related emergencies • Most often affects ears, nose, hands and feet • Frostbite – Signs and symptoms • White and waxy skin appearance. May feel frozen on surface but underlying tissue is still soft. • Frozen – Signs and symptoms • Hard skin that will look blotchy white to yellow-gray or blue-gray

BASIC FIRST AID – Treatment • Remove victim from cold environment • Transport victim immediately to a medical facility • Do not allow the victim to smoke. Smoking will further constrict the blood vessels, hindering the body’s own heating abilities • Do not rewarm area if there is any chance of refreezing • Only rewarm the area if medical authorities advise you to do so. If you are advised to rewarm, place affected body part in warm water, being sure that it is not touching the bottom or sides of container.

BASIC FIRST AID • Add warm water (100 to 105 degrees F. ) as needed. You should be able to put your hand in water without feeling discomfort. Once area thaws, bandage with a sterile dressing and place padding between fingers or toes. • SEEK MEDICAL ATTENTION!

BASIC FIRST AID • Hypothermia – General cooling of the body • Mild Hypothermia – Signs and Symptoms • Shivering, slurred speech • Stumbling or staggering • Usually the victim is conscious and can talk – Treatment • Remove from cold environment • Have a source of heat (warm water, fireplace…)

BASIC FIRST AID • Replace wet clothing with dry • Provide a hat, blankets, coats. Insulate victim • Seek medical attention • Severe Hypothermia – Signs and Symptoms • Body core temperature below 90 Degrees F. • Shivering has stopped • Muscles have become stiff and rigid • Shin has a bluish appearance • Skin does not react to pain • Pulse and respiration slow down

BASIC FIRST AID • Pupils will be dilated • Victim may appear dead – Treatment • Call EMS • Keep victim from getting colder • Rewarming in the field is not recommended for victims with severe hypothermia • Be careful when moving victim. Treat victim as though he/she could break • While checking vitals, make sure you do a thorough pulse check before determining the need for CPR

BASIC FIRST AID • SPECIFIC BODY INJURIES AND CARE – Abdominal Injury – Eye Injury – Blister Care – Chest Wound – Nose Bleed Care

BASIC FIRST AID • THAT’S ALL