First Aid

1. First Aid What are the main priorities for assessment and management of first aid patients? How should the major types of injuries and medical conditions be managed in first aid situations? What does the individual need to consider in administering first aid?

2. What are the main priorities for assessment and management of first aid patients? Summary of content: • Setting priorities for managing a first aid situation and assessing the casualty: - situational analysis - priority assessment procedures - DRABCD - STOP • Crisis management: - CPR - bleeding - shock - neck and spinal injury - moving the casualty - medical referral - care of the unconscious casualty

3. Setting priorities for managing a first aid situation and assessing the casualty The priority when assessing and managing first aid patients is minimising the harm to: - yourself - bystanders - the casualty When managing the first aid situation, it is important that the circumstances and eventual outcomes for the patient are improved as much as possible. Expediency and appropriate care here positively affect the individual’s quality of life.

4. Setting priorities for managing a first aid situation and assessing the casualty Situational Analysis There is a chance that some stage in our life we may be confronted with the need to resuscitate an individual in a number of different circumstances. It is important that you are able to deal with this quickly, effectively and without risk to yourself or others. To do so you need to: • Analyse the situation – observe what has happened and ask yourself: ‘What's the best I can do for this person in terms of the skills that I have?’ • Plan how to deal with the situation – prioritise your intended actions, dealing with the most important issues first. • The main issue with situational analysis is that you don't become a victim yourself in an effort to assist another person. Always put your safety first.

5. Setting priorities for managing a first aid situation and assessing the casualty Priority Assessment and Management Procedures Scenarios: Scenario 1 Scenario: Petrol leaking, dangerous wires, at least 4 casualties, injuries (for example, broken bones, dislocations, bleeding, spinal injuries), possible fatalities, other cars on the road. • Dangers: Risk of explosions (petrol and fire), other cars, danger of being electrocuted, broken glass, unstable structures, fumes, etc • Priority management – DRABCD • Call ambulance • Assess danger – to self, bystanders, casualties. • Other Traffic - Warn other vehicles, put on Hazard lights, use a bystander to warn oncoming traffic, park a car on the road a safe distance from the crash • Damaged Vehicle - be aware of airbags that haven’t gone off, put on handbrake, put vehicle in gear, put bricks or blocks against wheels to stop it rolling • Fallen or Damaged Overhead Power lines - Keep away from the cable – do not move, call emergency services. • Fire Risk - keep bystanders/casualty/self well away, no naked flames or smoking, switch off the ignition Check for conciousness/unconciousness Airway management/CPR Control bleeding

6. Setting priorities for managing a first aid situation and assessing the casualty Scenario 2 Scenario – panic, a variety of swimmers, weak swimmers and non swimmers. • Dangers – wave size, being caught in the rip as well, being pulled under by weak, non-swimmers or panicking swimmers. • Priority Management - Try to get assistance from lifeguards - Assess danger – you should only attempt a water rescue if you are a strong swimmer and the water is not too deep for you. - Consider the safest rescue options (for example, reach, throw, wade, row, swim, etc) - Priotisation/Triage (in a situation like this, this involve assisting those whose injuries/ condition can be treated quickly) - If possible, paddle to the victims on a board and with PFDs. The board and PFDs can be used to keep the victims afloat until help arrives.

7. Setting priorities for managing a first aid situation and assessing the casualty Scenario 3 • Scenario – broken glass, bleeding, lacerations, panicking, crying, etc • Dangers – stepping in/being cut by glass, being infected by blood, etc • Priority Management - Call the Ambulance - Assess dangers to self, casualties, bystanders - Move casualties away from the glass if possible - DRABCD - Manage bleeding

8. Setting priorities for managing a first aid situation and assessing the casualty DRABCD D check for DANGER • to you • to other people in the immediate area • to the casualty R check for RESPONSE • is the casualty conscious? • to check for consciousness ask questions, squeeze their hand A check AIRWAY • is the airway open and clear of objects? • clear and maintain the airway B check for BREATHING • is the chest rising and falling? • can you hear or feel air from the mouth or nose? • if breathing is absent give two initial breaths C give CPR • if there are no signs of life – unconscious, not breathing and not moving, apply CPR • CPR stands for cardiopulmonary resuscitation • CPR involves giving 30 compressions at a rate of approximately 100 compressions per minute, followed by two breaths D attach DEFIBRILLATOR (if available) • follow voice prompts

9. Setting priorities for managing a first aid situation and assessing the casualty STOP Stop Stop the person from moving. It may be necessary to stop the sport or activity. Are there any dangers? Talk Talk to the injured person. Ask them questions to ascertain the type and severity of the injury. Questions may include: • What happened? • Where does it hurt? • Can you move the affected area or body part? Observe Observe the patient and the injured area. Look for facial expressions of pain, look for swelling or deformity and feel for pain or tenderness. Ask yourself questions such as: • Does the patient look distressed? • Is there swelling, bleeding or bruising? • Are there any deformities? Prevent Prevent further injury by conducting a whole of body assessment and treating the injury with appropriate first aid.

10. Setting priorities for managing a first aid situation and assessing the casualty Whole of Body Assessment

11. Crisis Management Cardiopulmonary Resuscitation (CPR) Refer to pages 13 & 14 of your exercise booklet and read through the table.

12. Crisis Management Bleeding • Use DRABC action plan. • Apply direct pressure by holding a pad or dressing firmly over the site. • Lay casualty down and elevate injury. • Rest the injured area. • Do not give patient anything by mouth, particularly asprin as this tends to increase the rate of bleeding. • Loosen tight clothing. • Seek medical advice.

13. Crisis Management Shock Is a condition where the body closes off the blood supply to the extremities (arms, legs and skin) to ensure enough oxygen reaches vital organs. Causes: - Blood loss. - Fluid loss e.g. Dehydration. - Being involved in an accident. Symptoms: - Paleness and cold clammy skin. - Weak rapid pulse. - Rapid shallow breathing. - Nausea and faintness. Management: 1. Utilise DRABCD action plan. 5. Dress any wounds or burns. 2. Reassure the patient. 6. Loosen restrictive clothing, particularly around the neck. 3. Seek medical advice. 7. Keep casualty comfortable. 4. In the absence of a fracture raise legs above the level of the heart.

14. Crisis Management Neck and Spinal Injury Signs and Symptoms: • Loss of movement in the hands and/or legs. • Pain in the neck and/or back, tingling sensation in the hands or feet. • Altered sensation, movement or strength in the limbs or trunk. • Irregular bumps on the neck or back and slow pulse. Management Procedures: • Reassure patient. • Loosen any tight clothing. • Do not move them. Support head and apply a cervical collar if one is available. • Seek medical attention. Monitor casualty closely until help arrives. • If casualty is unconscious, treat patient as if they have a neck and spinal injury and use the DRABCD procedures.

15. Crisis Management Please refer to page 16 of your exercise booklet and read through the following: • Moving the Casualty http://www.youtube.com/watch?v=VSyuBMEwfrk http://www.youtube.com/watch?v=4UBIxtyoxok http://www.youtube.com/watch?v=vMkDtw_5yaY http://www.youtube.com/watch?v=MWs3rMXt2hA • Medical Referral • Care of the Unconscious Casualty