Emergency Aid I

1. Emergency Aid I • Resuscitation • Adult CPR • First Aid • Primary Survey • Secondary Survey • Recovery position • Summoning help • Dressings & Slings • Clearing up • Scenario • Putting theory into practice

2. Plan of action • 8 hours training (approx.) • 3 x 2 hours • 1 hour CPR • 1 hour first aid • 1 x 2 hours • Revision & scenarios • Exam

3. What is First Aid? • Preserve Life • Don’t forget yours!! • Prevent deterioration • Treat the obvious • Promote recovery • Treat the less obvious

4. Primary Survey • Check for Danger • To yourself, your patient and everyone else • Check Responses • Shake & shout • Shout for ‘help’ • Open Airway • Head tilt & chin lift • Check for normal Breathing • Look, listen & feel • Call/send for an Ambulance • Start CPR

5. CPR • 30 Chest compressions • Place hands in centre of chest • Push chest down (4-5 cm) • At a rate of 100 per minute • 2 breaths • 1 second in, 2 seconds out

6. Practical • Let’s have a go at CPR

7. Partially Obstructed. If there is some movement of air when they try to breath. Encourage them to cough Completely Obstructed Lean them forward 5 back slaps (up to) 5 abdominal thrusts If they become Unconscious Start CPR immediately Choking

8. Making a diagnosis • Signs • What you can see (blood, breaks etc.) • Symptoms • What the patient feels (where it hurts) • History • What has happened (ask patient and bystanders)

9. Secondary Survey • A secondary survey is what you do once you know they are breathing normally. • Also known as top to toe survey. • If they are conscious you can ask them ‘what happened and do you hurt anywhere’. • Whilst constantly reassuring, check for lumps, bumps, dents, deformity & wet patches. • Keep ABC in mind when doing secondary survey.

10. Secondary Survey • Check head • Dents, lumps, bruising & fluids from ear, nose & mouth • Check neck & upper spine • Unevenness, swelling, numbness & inability to move may suggest a fracture • Check shoulders and chest for fractures & bleeding or strange sounds • Check stomach area for swelling & hardness

11. Secondary Survey • Gently check pelvis for unnatural movement • Check legs for signs of bleeding or irregularity • Check arms for signs of bleeding or irregularity • Watch out for medi-alerts • Be careful of needles

12. Secondary Survey • Keep talking/reassuring • Your patient can hear you • Members of the public will know what you are doing

13. Practical • This is practice!!! • Constantly explain to the casualty what you are doing

14. F I S H S H A P E D Reasons for Unconsciousness

15. Fainting Imbalance of heat Shock Heart Attack Stroke Head Injury Asphyxia Poisons Epilepsy Diabetes Reasons for Unconsciousness

16. Fainting • Phew!!! • Unless they hit something on the way down they will recover quickly. • The pulse should be strong and bounding • Caused by lack of oxygen to the brain. • Lay them down, loosen tight clothing & raise the legs.

17. Imbalance of heat • Hypothermia (too little heat) • Cold to touch • Confused • Unsteady • Slow pulse & breathing • Remove from cold environment • Warm them up at the rate they cooled • Call for an ambulance

18. Imbalance of heat • Hyperthermia (too much heat) • Heat exhaustion – • profuse sweating • Signs & symptoms of shock • Treat as for shock • 1 tsp of salt in 1 litre of water to sip slowly • Heat stroke • Patient will be hot, red and dry • Call for an ambulance • Remove outer clothing • Cover with a wet sheet (and keep it wet) • Fan them vigourously.

19. Imbalance of heat • Infant convulsions (febrile) • Remove outer clothing • Remove nappy (it usually has a plastic lining) • Sponge them from head to foot with tepid water to reduce temperature. • Call an ambulance • Don’t forget mum!!

20. Shock Shock is ‘Lack of Oxygen to the vital organs’. Many conditions will cause patients to suffer from shock • Skin – pale, cold and clammy • Breathing - rapid & shallow • Pulse - rapid & weak • Patient will be nauseas so expect them to throw up • Call for an ambulance

21. Shock - treatment T – Treat the cause R – Rest – lay the casualty down A – Assistance or Ambulance W – Warmth – keep the casualty warm L – Loosen tight clothing E – Elevate the legs R - Reassure

22. Shock - anaphylactic Severe allergic reaction to a trigger. • Swelling, blotchy skin, difficulty breathing, patient distressed. • Sit the casualty down & lean forward • Loosen tight clothing • Reassure • Assist patient to administer medication if they have any. • Call for an ambulance • Be prepared to start CPR

23. Heart Attack AKA Myocardial Infarction (MI) • Due to a blockage in one of the arteries in the heart • Severe crushing chest pain – may move down an arm, up the neck & into the jaw. • Pain does not go away with rest • Call for an ambulance immediately • If conscious – sit in ‘W’ position • If unconscious and breathing – put in recovery position, monitor ABC • If unconscious and not breathing – Start CPR • Chain of Survival starts!!!

24. Chain of survival

25. Angina Pectoris • Due to a narrowing in one of the arteries in the heart • Severe crushing chest pain – may move down an arm, up the neck & into the jaw • If pain does not go away with rest assume it is a heart attack. • Will probably have a history of Angina & is likely to have medication, if so, assist them to take it. • Even with history it may still be a heart attack • Treat as for heart attack • Call for an ambulance

26. Stroke AKA - CVE (Cerebral Vascular Event) • Due to a blocked or burst blood vessel in the brain • Patient will be confused • Paralysis on one side of the body is common • The patient will probably be able to hear clearly • Patient may soil themselves, have slurred speech & be dribbling. • Call for an ambulance, lay them down with head and shoulders slightly supported, monitor ABC

27. Head Injury Concussion • Blow to the head causing brain to shake inside the skull. (causes the brain to try to ‘re-boot’). • Pale, nauseous & unsteady. • Should seek medical advise

28. Head Injury Compression • Similar to stroke but with history of head injury • A bleed inside the skull putting pressure on the brain • Patient will be flushed, breathing may become slow and noisy, pupils may be un-equal. • Patient can deteriorate rapidly • Patient may have suffered from concussion which later develops into compression • Call for an ambulance, check for obvious head injuries, lay them down with head and shoulders raised and supported, reassure, monitor ABC

29. Asphyxia • Drowning, suffocation, CO poisoning etc. • Remove from cause (but don’t put yourself in danger) • Perform DR ABC • Call an ambulance etc.

30. Poisoning • Drugs, alcohol, medication etc. • Ingestion – eaten/drunk • Inhaled – breathed in • Injection – syringe, bite or sting • Absorbed – chemicals

31. Poisoning • Make sure you don’t poison yourself • DO NOT induce vomiting • Find out which poison was used and how much • Call ambulance • Monitor ABCs • Use a mask/shield if you do CPR • Place in recovery position

32. Epilepsy Protect the head but let them get on with it!! Call an ambulance if… • It’s their first fit • It lasts more than 5 minutes • If they have repeated fits Lets face it, how do you know any of the above until after the fit! Call for an ambulance immediately, you can always cancel it.

33. Diabetes • Hypoglycaemia – Lack of sugar • May act drunk • Give something sugary if they are conscious • If the condition improves give them some food • If not, call for an ambulance • Hyperglycaemia – Excess sugar • Smell of pear drops on breath • Give sugar if not sure as it will do no immediate harm • Call for an ambulance & monitor ABC

34. Spinal Injury • Someone with a suspected spinal injury should not be moved if at all possible • If you can stay with your patient, monitor them closely and get ready to turn them if they vomit • If you have to leave them, place them in the recovery position carefully • Airway takes priority

35. Bleeding • Contusion • A bruise – can be quite extensive • Laceration • A jagged cut e.g. barbed wire. • Incision • A clean cut from something sharp (knife, glass) • Puncture • A small hole but possibly a lot of internal damage

36. Bleeding • Position • Sit or lie the patient down • Expose • Have a look • Elevate • Raise injury above the heart (if possible) • Pressure • Direct pressure – indirect as a last resort

37. Internal Bleeding • Lungs • Frothy blood in mouth • Stomach • Dark ‘coffee coloured’ blood in vomit • Kidneys • Blood stained urine • Large intestine • Black sticky tarry substance in stools

38. Bleeding (all) • Treat if possible (PEEP) • Place in recovery position if loosing consciousness • Treat for shock and monitor • Call ambulance or send to hospital

39. Burns and scalds • Dry heat – fire, hot objects • Scald - Steam, hot water/oil • Electrical – Entry & exit burns • Chemical – bleach etc. • Friction – rope burn • Radiation – sun burn • Cold – dry ice, liquid gases

40. ‘Hot’ Burns and scalds • Remove clothing if not stuck to skin • Cool with clean fresh water for up to 15 minutes • Treat for shock etc. • Us a dressing that won’t stick (cling film) • DO NOT burst blisters

41. ‘Cold’ Burns • Skin will stick to cold objects, do not pull away • Treat for shock etc. • Us a dressing that won’t stick (cling film) • DO NOT burst blisters

42. Fractures • Simple - nothing else involved • Greenstick – in young people, not all the way through the bone • Complicated – Involves other body system • Closed – Skin not broken • Open – Skin broken

43. Dislocations • Occur when a strain has been put on a joint • May also include a fracture • Do not try to put it back!!

44. Fractures/dislocations Recognition • History (bones tend not to just break) • Swelling • Uneven when compared to healthy side

45. Fractures/dislocations Treatment • Immobilise • Cover any open wound with sterile dressing • Send to hospital

46. Sprains & Strains • Sprains • Wrenching/tearing of ligaments • Strains • Overstretching of tendons/muscles Symptoms are similar to a fracture, can be more painful, advise them to go to hospital

47. Sprains & Strains Treatment - RICE • Rest • Ice • Compression • Elevate

48. Asthma • Difficulty in breathing out • A Chronic condition – they know they’ve got it. • Sit them down, lean them forwards and reassure • Help them to take their medication – do not use a friends!! • Call an ambulance if they don’t get better

49. Drowning • Remove them form water if safe to do so. • Perform primary survey • Always send them to hospital

50. Recovery Position • The recovery position is a position in which a breathing casualty should be left whilst help is summoned. • It should be:- • Stable • Have no weight on the Chest • Have the head positioned so that fluid can drain away • If a patient has an injury they should be laid so that they are lying on the injury. This will help prevent movement of the injury and make sure blood doesn’t move into the ‘good’ side of the body.