Street Angels First Aid Training INSTRUCTOR ELLIS KING

Street Angels First Aid Training INSTRUCTOR: ELLIS KING

Administration

Learning Outcome ü By the end of this course you will have gained the basic skills and knowledge to demonstrate that you can work as an Emergency First Aider in the workplace. ü All the skills and knowledge gained on this course will be broken down into smaller objectives throughout the day. ü The qualification you will be working toward is the Emergency First Aid at Work (FAW)

General Structure Information Demonstration Practical

The Importance of First Aid Research conducted back in the mid part of the 90’s by Hussain and Redmond demonstrated that first aid could have prevented deaths in up to 39% of people who died from a medical emergency before reaching hospital.

Objectives of First Aid (The Three P’s) 1. Preserve Life 2. Prevent further injury/condition deteriorating 3. Promote recovery At all times follow the principal of DO NO HARM

In a Nutshell First aid is: Immediate but temporary care

The Priorities of First Aid Airway Breathing Circulation

Primary Survey Danger Response Airway Remember DR ABC Breathing Circulation

Airway • Inspect for any potential blockages Inspect Clear • Clear any blockages which may be present • Ensure that the airway is clear and open Open

Breathing Look, listen and feel for a maximum of 10 seconds for normal breathing

Circulation If normal breathing is present, circulation is also present Be sure to check for, and control any major bleeding

The Practical Bit DR. ABC

The Secondary Survey ü The secondary survey consists of: ü A more detailed examination of the casualty ü Making a diagnosis via: o History and external clues o Signs o Symptoms ü Treating what you find ü The recovery position

History and External Clues ü History: o The amount of force involved o Casualties age and state of health o The environment o Are they suffering from any illnesses? ü External clues: o Warning Bracelets o Medicines/inhalers

Signs ü The empirical bit. What can you see, feel, hear or smell? : o Bleeding o Bruising o Swelling o Deformity o Vomit o Noisy breathing o Alcohol

Symptoms ü What the casualty can tell you: o Pain o Loss of sensation o Dizziness o Nausea o Loss of movement o Faintness o Anxiety

The Recovery Position ü Used for an unconscious casualty who is breathing It: o Prevents the tongue from blocking the throat o Aids drainage

Further Study Austin. M, (2014) First Aid Manual, 10 th Edition, Published by: Dorling Kindersley (DK), London.

Any Questions?

Take a Break

Basic Life Support CARDIOPULMONARY RESUSCITATION (C. P. R)

Cardiac Arrest Relationship between survival rate and time to defibrillation 11% 1% 22% 66% 5 Mins 10 Mins 15 Mins 20 Mins

Head tilt/chin lift Unresponsive Shout for help Shake and shout Open the airway Not breathing normally? Hands in centre of chest Call 999 Check for max 10 seconds 30 chest Compressions 2 rescue breaths & 30 chest compressions

Chest Compressions 1. Rate = 100 -120 Per minute 2. Depth = 5 -6 cm 3. Ratio = 30 compressions/2 ventilations Note – if done correctly this only provides a maximum of 30% normal cardiac output

Ventilation with a Pocket Mask ü Advantages o Eliminates direct contact o Allows for adequate lung ventilation o Can be attached to supplementary oxygen

Final Thoughts ü If you start C. P. R the patient may, or may not, be successfully resuscitated. If you do not start their chance of survival will diminish by 20% per minute ü Don’t let your C. P. R skills get rusty, after all a friends life may depend upon them

The Practical Bit DR. ABC

Any Questions?

Further Study ü Austin. M, (2014) First Aid Manual, 10 th Edition, Published by: Dorling Kindersley (DK), London. ü https: //www. youtube. com/watch? v=s. Er. VV 0 ks 2 YA ü https: //www. youtube. com/watch? v=to. St. Et. Tx 5 zo

Choking

Obstruction by a Foreign Body ü Signs and symptoms o Universal distress signal for choking o Victim can not speak or make any sound o Cyanotic skin o Exaggerated but ineffective breathing sounds o Collapse

Techniques to Relieve Choking 1. Finger sweep 2. Coughing 3. Back slaps 4. Abdominal thrusts

Finger Sweep ü Used to clear the airway manually ü Do not force the foreign body further down the airway ü Only go as far as you can see ü Only use your fingers

Coughing ü Most effective way if the airway is partially blocked ü Calm the casualty down ü Ask them to cough ü Don’t continue asking if they cannot expel the foreign body

Back Slaps ü Used to create an artificial cough ü Delivered between the shoulder blades with the flat of your hand in an upwards motion

Abdominal Thrusts ü Used if the patient develops poor air exchange or if the airway is completely blocked ü Purpose is to create an artificial cough ü Abdominal thrusts can be performed whilst patient is sitting, standing or laying down

Mild or Severe Mild: o Patient speaks and answers yes o Patient is able to speak, cough and breathe Severe: o Patient is unable to speak o Patient is unable to breathe, sounds wheezy, silent coughing o May be unconscious

Adult Choking Assess Severity Severe airway obstruction Unconscious start C. P. R Conscious start 5 back blows and 5 abdominal thrusts Mild airway obstruction Encourage to cough, continue to monitor

The Practical Bit DR. ABC

Any Questions?

Further Study Austin. M, (2014) First Aid Manual, 10 th Edition, Published by: Dorling Kindersley (DK), London.

Take a Break

Unconsciousness

Unconsciousness “A state of complete or partial unawareness, or lack of response to stimuli. ” ü Results from an interruption of the brains normal activity ü Prone to secondary injury

Causes FISH SHAPED Fainting Stroke Intoxication Heart attack Shock Asphyxia/Asthma Head injury Poisoning Epilepsy Diabetes

Head Injuries

Types of Head Injury ü Scalp ü Skull ü Brain: o Concussion o Compression

Concussion Results from the brain being shaken

Concussion Signs and symptoms: o Unconscious for a short period o Memory loss o Dizziness or nausea Treatment: o A. B. C’S and monitor o If recovered within 3 minutes watch closely, if not seek medical help

Compression Bruising or bleeding into the cranial cavity causing an increase of pressure on the brain

Compression Signs and symptoms: o Deteriorating levels of response o Apparent full recovery followed by a deterioration o Unequal pupils/weakness on one side o Slow/full pulse

Pupil Response Dilated – O O Constricted – o o Unequal – O o

Treatment of Compression Conscious: o Support in a comfortable position o Monitor o Seek urgent help Unconscious: o A. B. C’s o Recovery Position o Monitor o Seek urgent medical help

Stroke

Stroke What? o Disruption of blood flow to the brain o Caused by a clot or bleed

Stroke Signs and symptoms: o Headache o Confusion o Weakness/paralysis o Speech problems

Stroke FACE ARMS SPEECH TIME

Stroke Treatment: o A. B. C’s o Head and shoulders raised o Recovery position? o Seek medical help o Rest and reassure

Heart Conditions

The Coronary Arteries

Signs and Symptoms ü A persistent crushing/vice like central chest pain may radiate to the jaw/arms ü Ashen skin (sweating) ü Rapid, weak or irregular pulse ü Rapid breathing ü Faintness or giddiness ü Sense of impending doom ü Not relieved by GTN

Angina ü Supply of oxygen is insufficient ü Normally caused by a narrowing of the arteries ü Usually occurs on exertion or stress

Signs and Symptoms ü Chest pain (cramp/indigestion) ü Shortness of breath ü Sweating/nausea ü Increased pulse rate ü Feeling of weakness ü Anxiety

Treatment ü Aim to ease the strain on the heart ü Sit casualty down, and encourage them to rest ü Reassure ü Help administer GTN ü Send for help ü If pain persists suspect heart attack

Heart Attack ü Occurs when a portion of the cardiac muscle is deprived of oxygen and dies (cardiac infarction) ü The larger the blockage, the larger the attack ü Possible causes include: o Embolism o Blood clot

Treatment ü Put patient at ease ü Minimise the work of the heart ü Sit casualty at rest – Half sitting, head and shoulders supported and knees bent ü Seek urgent medical attention ü Monitor ü Be prepared to resuscitate

Asthma

Asthma ü What? o “Reversible airway obstruction” ü Signs: o Difficulty breathing o Wheezing o Tight chest ü Treatment: o Help self-medicate o Rest and reassure o Seek medical help

Epilepsy

Epilepsy ü What? o Disturbance of the brains normal activity ü Why? o o o Head injury Disease Lack of oxygen Some Poisons 60% are unknown ü Treatment: o o Protect from further harm Loosen clothing Keep people away Encourage to attend hospital ü Do not: o Use force o Put anything in the mouth

Diabetes

Diabetes ü What? o Body fails to regulate blood sugar levels ü Why? o Normally regulated by insulin from the pancreas o Variations of insulin lead to a build up of glucose ü Two types: o Hyperglycaemia (little or no insulin) o Hypoglycaemia (too much insulin and/or little sugar)

Signs and Symptoms HYPER HYPO ü Hours to days ü Minutes ü Skin ü Breath ü Associated symptoms ü Behaviour o Dry/flushed o Sweet/fruity o Nausea o Vomiting o Extreme thirst o Restless/drowsy o Pale/sweating o Normal o Hunger o Headache o Dizziness o Appears drunk

The Big Giveaway

Treatments HYPER HYPO ü A. B. C’s ü Urgent medical help ü If alert give sugar ü If in doubt give sugar ü Never give anything by mouth if not conscious ü Advise to seek medical help

Assessing Levels of Consciousness Alert Voice Pain Unresponsive

General Treatment ü Treat the A. B. C’s ü Recovery position ü Treat the obvious cause ü Observations every 10 minutes ü Protect from the elements ü Nil by mouth ü Care of eyes ü Do not leave unattended/seek help

Final Thoughts ü Ensure the airway is clear ü Keep checking the response level ü Examine the casualty thoroughly (secondary survey)

Any Questions?

Take a Break

Wounds and Bleeding

Incision

Laceration

Abrasion

Arresting External Bleeding ü A. B. C’s ü Sit casualty down ü Quickly examine the wound – GLOVES! ü Apply direct pressure and elevate ü Apply a sterile dressing – maximum of two ü Rest and reassure ü Treat for shock

Foreign Bodies ü Small objects and contamination may be removed ü Never attempt to remove objects which are embedded ü Control bleeding by applying pressure around the site ü Stabilise any foreign body

Any Questions?

Burns and Scalds

Superficial Burns

Partial Thickness Burns

Full Thickness Burns

General Treatment of Burns ü Stop the burning process ü Remove rings and constricting clothing ü Immerse of douse in water for at least 10 minutes ü Take care not to cool the whole casualty ü Cover in cling film to protect it from infection

Do Not ü Burst blisters ü Apply lotions or creams ü Touch the burn ü Use fluffy dressings

Any Questions?

Fractures and Dislocations

Closed Versus Open

Fractures: Signs and Symptoms ü Pain ü Deformity ü Shortening/bowing ü Swelling ü Guarding/loss of use ü Tender ü Bruising ü Grating/crepitus

Treatment ü Expose the entire extremity ü Arrest any bleeding ü Dress open wounds ü Check the circulation ü Keep the casualty still ü Steady and support the limb

Do Not ü Press down on protruding bone ends ü Attempt to push exposed bone ends back beneath the skin ü Move the casualty unnecessarily ü Let the casualty eat or drink

Dislocation ü Displacement of a bone end from its joint ü Signs and symptoms o Pain o Loss of motion o Deformity ü Danger lies in the compromise of the nerve and blood supply

Any Questions?

Shock

Shock A temporary or permanent collapse of the circulatory system, leading to a lack of oxygenation of the tissues

Introduction ü Normal oxygenation (perfusion) requires: o A functioning pump o Adequate fluid volume o Intact tubing o Adequate air exchange ü Damage to one, or more, of these will lead to inadequate tissue perfusion which leads to shock

Low Volume Shock ü The most common type ü Due to loss of body fluid: o Blood Haemorrhage o Plasma Burns o Electrolyte Diarrhoea and Vomiting o Water Sweating

Signs and Symptoms ü Restlessness and anxiety ü Thirsty ü Pale, cold and clammy skin ü Rapid, weak pulse ü Rapid, shallow breathing ü Weakness and giddiness ü Nausea and possible vomiting ü Altering levels or consciousness

General Treatment of Shock ü A. B. C’s first ü Control any external bleeding ü Lay down-head low/feet raised ü Keep them warm ü Loosen tight clothing ü Monitor ü Seek urgent medical help

Do Not ü Leave the casualty unattended ü Let them eat, drink or smoke ü Try to warm them with direct heat ü Move the casualty unnecessarily ü Waste time

Any Questions?

Rules and Regulations

Action After an Accident After every accident/treatment, what should the first aider do? ü Record the incident in an accident book ü Report this to management ü Replenish the first aid kit

Recording ü Following an accident the following should be recorded in an Accident Book: o Full name/address/occupation or casualty o Date the entry was made o Date/time of incident o Place and circumstances o Details of injury and treatment given o Signature of person making the entry ü As of Dec 31 st 2003 the Accident Book must comply with the data protection act

Accident Book

Reporting ü Governed by the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations (RIDDOR) 1995 ü The reporting of accidents and ill health at work is a legal requirement ü Identifies where and how accidents happen and allow for investigation of serious accidents

RIDDOR ü What needs reporting: ü Who to: o Death or major injury o Environmental Health Department o Over seven-day injury o Health and Safety Executive o Disease o Dangerous Occurrence

Replenish Any items used from the first aid kit

First Aid Kits ü Must cater for whatever is considered to be ‘’reasonably practical’’ ü Stored in a suitable/clearly marked container ü Must conform to legal requirements ü Readily accessible ü Checked and replenished regularly

Minimum Contents 1 – First aid guidance leaflet 4 – First aid dressing (12 x 12 cm) 1 – First aid dressing (18 x 18 cm) 2 – Triangular bandage 12 – Safety pins 2 – Eye dressings 20 – Plasters 20 – Sterile wipes 1 – Microporous tape (2. 5 cmx 5 m) 6 – Nitrile gloves (pair) 3 – Finger dressing 1 – Face shield 1 – Foil blanket 1 – Burn dressing (10 x 10 cm) 1 – Clothing cutters 1 – Conforming bandage

Non-permitted Items ü Tablets and medication of any kind ü Antiseptics of any kind ü Creams and sprays of any kind ü Eye baths

Any Questions?