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First Aid Facts: Part One. First Aid for Engineers August 27 th , 2003. Outline. Airway problems Breathing problems Circulation: bleeding and shock Wounds Assessment and treatment Special considerations Burns Facial, ear and eye injuries Head, neck and spinal injuries
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First Aid Facts: Part One First Aid for Engineers August 27th, 2003
Outline • Airway problems • Breathing problems • Circulation: bleeding and shock • Wounds • Assessment and treatment • Special considerations • Burns • Facial, ear and eye injuries • Head, neck and spinal injuries • Abdominal and chest trauma • Bone, joint and muscle injury
Respiratory System Physiology • Breathing allows CO2 to be expelled and O2 to be exchanged into the blood. • Without an open Airway breathing cannot occur. • Air is drawn into the body by negative pressure in the pleural cavity created by muscular contraction of the diaphragm
Airway evaluation • If victim is talking, crying or coughing the airway is open. • If the victim is unconscious and on their back then the tongue is most likely blocking the airway. • Two methods for opening the airway • Head tilt, chin lift - no suspicion of spinal injury • Jaw thrust – known or suspicion of spinal injury
Inspection of Airway • Open Airway • Look for food or fluid • If no spinal injury then turn victim to recovery position • If foreign object seen or spinal injury then finger sweep • Wear a glove • Use a cloth to get liquid out
Check for Breathing • “can you speak?” • Look - chest movement • Listen – air movement • Feel - air on cheek • Inadequate breathing • Less than 8 per minute • Blue lips • Increased effort with breathing
Rescue Breathing • Place your mouth over the victims mouth and pinch the nose closed. • Exhale into the victims mouth slowly, filling their lungs with the air from your lungs • Release and let the air come back out, turn and watch the chest fall. • Give one breath every 5 seconds in adults • If you are trained, use a “mouth to device” protective breathing apparatus
Obstructed Airway • Will lead to cardiac arrest • Usually food, blood or vomit • Partial airway obstruction • Cough present • Noises may be heard with respiration • May become blue • Complete obstruction • Cannot cough, speak or breath
Call EMS Place victim on back and open airway Look inside mouth – if cannot see anything do not do a finger sweep Try to give rescue breaths If these do not go in reposition the head and give another breath. Perform abdominal thrusts If victim becomes unconscious
Circulatory System (plumbing) • Heart (pump) • Arteries (large outbound pipes) • Capillaries (oxygen delivery location) • Veins (large drainage pipes) • Blood (fluid)
Circulatory arrest:Heart stops pumping • Causes: • Arrhythmia – electrocution, heart attack • No oxygen to heart – heart attack, respiratory arrest (choking, seizure, allergic reaction) • No blood to pump - Trauma • May respond to CPR • Brain damage occurs in 10 minutes
Arterial Pulsating Rapid Venous Smoother Flow Slow Capillary Oozing External Bleeding Obvious Internal Bleeding Bruising Painful, tender, rigid abdomen Broken ribs or bruised chest Bloody or black stools or vomit Bleeding
Controlling Bleeding • Wear Personal Protection Equipment If Available • Expose the wound to see where bleeding is coming from • Three Steps • Direct Pressure • Elevation • Pressure point
Shock • Definition • No O2 to Tissue • Signs and Symptoms • Change in mental status • Skin Pale, Cold, Clammy (low BP) • Nausea and vomiting • Rapid Pulse and Rapid Breathing
Types of Shock • Cardiogenic – pump failure • Hypovolemic – loss of fluid • Neurogenic – pipes enlarge, too large for volume of fluid • Anaphylactic – loss of fluid and enlarged pipes • Septic – loss of fluid and enlarged pipes
Treatment of Shock • Treat the Cause • Position with feet raised 1 foot above heart • Cover with warm blankets • Do not give anything to eat or drink • Reassure the victim • Use EpiPen if Anaphylactic Shock
Types of wounds • Incision - sharp strait wound • Avulsion – part of skin loose or torn • Puncture – deep, narrow wound • Abrasion – top layer of skin scraped off • Laceration – irregular cut from tearing • Amputation – part of body detached • Burn – partial or full thickness thermal or chemical injury to skin.
Treatment for wounds • Wash your hands and don gloves • Expose wound completely • Wash wound with water at medium faucet flow • Remove debris with sterile tweezers • Cover with sterile gauze and if shallow wound antibiotic ointment • Keep clean and dry – replace dressing daily • Watch for signs of infection
Wounds that require medical attention • Bio or chemical hazards involved • Dirty or victim without recent tetanus shot • Arterial bleeding • Into deep subcutaneous fat • Bites • Amputations, Avulsions or Impaled objects • Facial wounds • Infected wounds
Special consideration • When was your last Tetanus shot? • If not within last 5-10 years, must have new shot within 72 hours to prevent tetanus • There is no cure for tetanus. • Impaled objects • Never remove the object • Stop bleeding by placing pressure around the object
Amputations • Activate EMS • Wrap stump in bulky dressing • Do not use tourniquet • Find and gently clean part • Wrap part in gauze and place into plastic bag • Place bag in bag of ice and transport with victim
Burns • First Degree • Superficial (epidermis) • Heal without intervention • Second Degree • Partial thickness (into dermis) • Larger or sensitive areas require medical attention • Third Degree • Full thickness (thru dermis into fat or muscle) • Require skin grafting in most cases
Types of Burns • Thermal • Chemical • Always require medical attention • Special consideration with certain chemicals • Electrical • Always require medical attention • Go deep and travel along the muscles
Assessing % BSA burned – Rule of nines • Minor Burn • <50% 1st Degree • <10% 2nd Degree • Moderate Burn • >50% 1st Degree • 10-30% 2nd Degree • <10% 3rd Degree • Severe Burn • Larger BSA 2nd and 3rd Degree • All Electrical Burns • Burns to face, hands, feet or genitals • Most Chemical Burns • Inhalation burns
Treatment of Minor Burns • Stop the Burn – cool water irrigation • Aloe Vera or other soothing lotion • Keep covered with sterile gauze • Take Aleve or Advil • Watch for signs of infection • Fever or oozing • Increasing Redness, Swelling and Pain
Treating Moderate to Severe Burns • Activate EMS • ABCDE’s • Stop the burning • Remove clothing • Irrigate only smaller burns • Assess Depth (degree) • Assess Extent (% BSA) • Cover Areas with dry bandage damp bandage can lead to hypothermia • Treat for Shock
Facial Injuries • Most injuries to the face requires medical attention • A bloody nose or black eye can be treated with Ice, elevation of head and gentle pressure • Go to Babson Health Center for evaluation of minor injuries • Activate EMS for more serious injuries
Eye Injuries • All Eyeball injuries should be seen by an ophthalmologist if they result in • Change in vision • Pain • For Corneal injuries or chemical splashes • Irrigate eye for 15 minutes • If chemical exposure – transport to nearest hospital • Do not try to remove an impaled object or replace an explanted eyeball • Bandage both eyes, protect the injured one with a paper cup, or damp gauze if the eyeball is exposed • Transport to the nearest hospital
Ear injuries • Seek medical attention for external ear injury • High risk of infection • Seek medical attention for blast injuries resulting in • Decreased hearing • Blood or fluid coming from the ear
Dental injuries • Find missing tooth • Placed rolled up gauze in socket to control bleeding • Clean tooth and replace into socket if not too damaged • Place tooth in saliva soaked gauze if unable to replace • Teeth replaced in < 1 hr. may survive • Transport victim to Hospital
Head injuries • Scalp wounds bleed significantly • Skull fractures • Painful at site • Unequal pupils • Skull deformity • Blood or fluid from ears and eyes
Signs and Symptoms of Brain Swelling • Altered level of Consciousness • Memory Loss • Nausea and Vomiting • Headache • Unequal pupils or change in vision • Seizures • Weakness or Paralysis • Leak of Blood or CSF from ears
Treating head injuries • Activate EMS • Monitor ABCD’s • Cover wounds with sterile dressing • Assume spine injury - immobilize neck • Apply pressure around to bleeding scalp wounds • Watch for signs of brain swelling
Signs and Symptoms of Spinal Injury • Pain with movement • Numbness • Tingling or weakness • Loss of bowel or bladder control • Paralysis • Loss of strength
Treatment of Spinal Injury • Seek Immediate medical attention • Do Not Move Victim unless absolutely necessary • To monitor ABC’s • To evacuate from immediate Danger • Stabilize before move if possible • Monitor ABCD’s until help arrives
Chest Trauma • Vital Organs are protected by Ribs and Sternum • Critical Injury to the chest can affect Airway, Breathing and Circulation • Do not remove Penetrating objects • Do not lift off crushing object unless breathing is significantly affected • Bandage and stabilize them for transportation • Sucking chest wounds are a special case
Sucking Chest Wounds • Wounds which go thru the chest wall into lung • Requires Immediate attention to avoid lung collapse • Create “Valve Dressing”
Abdominal Wounds • Should always be evaluated by professionals – call EMS • Monitor ABCD’s • Do not give anything to eat or drink • Treat for Shock • If intestines protruding cover with wet, non-adherent dressing and Saran Wrap • Watch for Vomiting
Anatomy of Skeletal System • Anatomy • Bones • Cartilage • Ligaments • Tendons • Muscles
Types of Injuries • Sprain • ligament • Strain • tendon • Contusion • muscle • Dislocation • joint • Fracture • bone
Symptoms of Orthopedic injuries • Sharp Pain • Swelling • Tenderness to are • Deformity to the area • Bruising and stiffness • Weak or poor function