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FIRST AID - MEDICAL CONDITIONS. HLTFA301B. Presenter Name Rank or Organisation Date. Learning Outcomes. MLO 1.1.8 Describe Management of Head, Neck and Facial Injuries MLO 1.1.9 Describe Management of Chest Injuries MLO 1.1.10 Describe the Management of Abdominal Injuries.
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FIRST AID - MEDICAL CONDITIONS HLTFA301B Presenter Name Rank or Organisation Date
Learning Outcomes • MLO 1.1.8 • Describe Management of Head, Neck and Facial Injuries • MLO 1.1.9 • Describe Management of Chest Injuries • MLO 1.1.10 • Describe the Management of Abdominal Injuries
Learning Outcomes • MLO 1.1.7 • Perform First Aid Treatment for Shock and Haemorrhage • MLO 1.1.11 • Treat Burns • MLO 1.1.12 • Treat Fractures, Dislocations, Spinal and Soft Tissue Injuries
Learning Outcomes • MLO 1.1.13 • Describe Management of Poisoning • MLO 1.1.14 • Manage Envenomation • MLO 1.1.15 • Describe Management of Environmental Injuries • MLO 1.1.16 • Describe Management of Illness, Injuries and Other Conditions
SHOCK Definition: “Shock is a lack of effective circulating blood volume in the body, where sufficient oxygen is not reaching the body’s vital organs.”
SHOCK Main Causes of Shock: • Loss of Blood: • Abdominal Emergencies:. • Loss of Body Fluids: • Allergies: • Heart Attack:. • Sepsis or Toxicity: • Spinal Injury: • Crush Injuries: • Witness:
SHOCK Signs & Symptoms:For a Conscious Casualty - • Drowsy, confused, restless, aggressive, faintness • Pale, Cool, Clammy Skin • Nausea & / or vomiting • Thirsty & dry mouth • Rapid, shallow breathing, rapid, weak pulse • Pupils dilate • Cyanosis – Blue colouration of fingers, lips, toes, nose • Progressive ‘shutdown’ of body’s vital functions • Collapse & / or unconsciousness
SHOCK IF CONSCIOUS: • Lie casualty down on back with legs elevated • Monitor vital signs • Reassure casualty • Maintain body temperature, but DO NOT overheat IF UNCONSCIOUS: • Recovery Position with support under the bent leg to elevate • Maintain body temperature, but DO NOT overheat • Recheck injuries & monitor vital signs
CARDIOVASCULAR Major Organs: 1. Blood Vessels - Arteries, Veins & Capillaries 2. Blood 3. Heart Major Functions: • Transports nutrients & oxygen • Removes waste products
BLEEDING Bleeding is the loss of blood from the blood vessels. • Can be External& obvious orlnternal& not so obvious. • Severe or continued bleeding may result in collapse leading to death. Classified depending on which vessel it comes from: • Arterial Bleed– Oxygen rich, bright red, spurts out, hard to control • Venous Bleed – Deoxygenated, dark red, flows out, easier to control • Capillary Bleed – Most common, slow, easy to control, dark red in colour
Signs and Symptoms • External Bleeding • Faintness or dizziness • Restlessness • Nausea • Thirst • Weak, rapid pulse • Cold, clammy skin • Pallor • Sweating • Progressive LOC (drowsy, irrational or unconscious) • Internal Bleeding • Pain • Tenderness • Rigidity of Abdominal Muscles
Management – External Bleed • Call 000 / Medic’s & Follow DRABCD • Lie casualty down if bleeding severe (Shock) • Remove or cut off clothing to expose wound • Apply firm Direct Pressure– get casualty to do this if possible • Elevatethe bleeding part & restrict movement • Apply a pad over wound & secure with a bandage • If bleeding not controlled, leave initial pad on & place 2nd on top • If bleeding continues replace the 2nd & apply a 3rd pad & bandage over top
Head, Neck and Facial Injuries • Wounds of the head, neck and face require special treatment • They are not handled the same as wounds or injuries to the lower body • Wounds to these areas will also bleed excessively, because this region is very vascular
Head Wound • If a casualty has suffered a blow to the head, his state of consciousness should be checked • If unconscious, the casualty should be treated as per the care of the unconscious • If Conscious, the casualty should obtain medical advice if he develops any of the following warning signs of a concussion
What are the Characteristics of a Head injury? Headache, Vomiting, Irritability, Drowsiness, Amnesia (an inability to remember clearly events before the injury), Stumbling or uncoordinated movement, or tingling or numbness in the limbs What are the Characteristics of a drunk person? Headache, Vomiting, Irritability, Drowsiness, Amnesia (an inability to remember clearly events before the injury), Stumbling or uncoordinated movement, or tingling or numbness in the limbs Don’t just assume people are drunk !
Management • Cover scalp lacerations with a dressing and bandage securely, avoiding undue pressure • Control bleeding or leakage of fluid from the ears, they should be covered with a dressing. No attempt should be made to plug the ears • Foreign bodies protruding from a head wound should not be removed (donut bandage applied) • Lips may be moistened, but the patient must not be allowed to eat or drink • If the casualty also has wounds to the jaw or face, or is vomiting, the casualty must be positioned, as to allow drainage of fluids and vomit.
Neck Wounds • Neck wounds may be superficial or involve other structures • Control any bleeding • First aiders MUST NOT apply a constricting circular bandage around the neck • If a fracture of the neck is suspected, the patient should be treated as per a spinal injury • The patient should be treated for shock, but not placed in the shock position • Evacuated to the nearest medical facility
Eye Injuries • Protect the eye from contamination by putting a sterile dressing loosely over both eyes • For penetrating wounds of the eye, build up around the area by using ring bandages or other padding • Chemical agents in the eyes should be flushed out at once with copious amounts of water 15 minutes • Grit can be flushed from the eye using eye wash or saline • All eye casualties are to be transferred to advanced medical care
Ear Injuries • It is important to remember that bleeding or fluid loss from the ears can be a serious sign of head injury • As with all other wounds, the bleeding can be controlled by direct pressure • All foreign body injuries are to seek advanced care by medical staff.
Nasal Injuries • It is important to remember that bleeding or fluid loss from the nose can be a serious sign of head injury • A simple bleed from the nose (epistaxis) can be managed by getting the casualty to gently pinch the nostrils closed with the head tilted forward and to hold that position for 10 minutes • Ice packs over the bridge of the nose and the back of the neck may be of some benefit • If bleeding persists, medical aid should be sought
Mouth and Teeth Injuries • Bleeding from the mouth area can normally be controlled by direct pressure • As with all mouth injuries, the airway has priority • If teeth are knocked out, they can be replaced if clean • If unclean, or uncertain of the correct placement of the teeth, the teeth should be stored in a clean container with the casualty’s own saliva, or milk • Evacuate the casualty to appropriate medical aid, which in some cases would be to a dental unit.
Introduction - Trunk Injuries • Injuries to the trunk region can create potential life-threatening complications to a casualty • The trunk of the body can be divided into three cavities • The thoracic, • The abdominal and • The pelvic cavities • With some injuries there will be external signs of bleeding or protruding organs • However, there may be internal injuries with serious internal bleeding. • These injuries will not always be obvious
Thoracic Trauma • Chest injuries can include • Fractured ribs • Flail chest • Sucking Chest Wound
Rib Fractures • Commonly caused by blunt trauma following a motor vehicle accident, explosion or impact with an object • Identifying a Rib Fracture • History of the blunt trauma • Pain at the site of the injury • Casualty’s difficult and painful breathing, as well as shallow breathing
Management • Assisting a conscious casualty into a comfortable sitting position, leaning towards the injured side • Securing the arm closest to the injured side by using padding and broad bandages • Applying a St John sling to this arm to offer further support • Placing an unconscious casualty into the lateral position with the injured side down supporting the injured area • Arrange for evacuation to medical aid
Flail Chest • Occurs when a number of ribs in the same area are broken so that part of the chest is ‘floating free’ • Damaged section is sucked in during inspiration and blown out during expiration • Casualty is also unlikely to be able to properly communicate with the first aider (single words only) • A flail chest is a life-threatening injury
Signs and Symptoms • Deformity and abnormal mobility of chest wall • (paradoxical breathing) • History of the trauma • Tenderness and chest pain • Difficulty and painful breathing - SOB • Irregular shallow respirations • Cyanosis • Coughing blood • Shock
Management • Position as Per Fractured Ribs for Both Conscious and Unconscious • Place a large bulky dressing over the injured area with a firm bandage • Support the injured area by securing the arm closest to the injury and by applying a sling if tolerated • Arranging for evacuation to medical aid
‘Sucking Chest Wound’ • Known as a ‘Open Pneumothorax’ which results from a Penetrating Injury • If a puncture is deep enough, the rib cage may be penetrated, allowing air to enter the chest through the wound • This causes the lung to collapse on the injured side • Pressure in the chest cavity may build up to such an extent that the heart is pushed to the side, resulting in impaired functioning of the opposite lung
Signs and Symptoms • Shortness of breath, with associated anxiety • Fast pulse and respiratory rate • Blood-stained froth is coughed up • Bloodstained bubbles around wound when casualty exhales • A sound of air being sucked into chest as the casualty inhales • Cyanosis • Loss of consciousness occurs • Shock
Management • Position as Per Fractured Ribs for Both Conscious and Unconscious • Provide an adequate airway and sustain respiration if needed • Cover the wound with a dressing such as a plastic sheet, and seal with tape on three sides only (not the bottom edge) • Treat for shock • Evacuate the casualty with the injured side down preferably in the lateral position if pain permits
Introduction to Abdominal Injuries • Organs in the Abdomen can easily be injured because there is no bone structure to protect them. • Some of these – liver, spleen, and stomach – tend to bleed easily and profusely, so injuries to them can be life threatening. • An injury to the abdomen can be opened or closed and both are as serious as each other
Abdominal Injuries • Anatomy and Physiology
Signs and Symptoms • Severe Pain • Nausea and / or Vomiting • Bruising and tenderness around the wound • Unnatural paleness • External bleeding / Protrusion of Intestines through the Abdominal Wall • Blood in the urine • Distension / Swelling • Shock
Management • Gently raise the casualty’s knees and support them. • The casualty’s head and shoulders are to be slightly raised. This position will be the most comfortable for a conscious casualty taking pressure off the abdominal muscles • Cover all abdominal wounds completely with moist and preferably sterile dressings to prevent contamination. • The shell dressing should be saturated with water before gently placing on the wound. This is to prevent the dressing from adhering to the organs • Do NOT try to push organs back into the abdomen • Do NOT apply direct pressure to wound
BURNS Burns are injuries to the skin and underlying tissues • Burns can damage: • Skin, • Muscle, • Bone, • Blood Vessels, • and Nerves
Causes of Burns • Heat • Extreme Cold • Chemicals • Corrosive Substances • Electricity • Friction • Radiation
Classification of Burns 1. SUPERFICIAL • Reddening • (like sunburn) • Painful • Blistering • Damage to outer layers 2. DEEP • White / blackened areas • Nil pain • Damage to all layers • plus underlying structures & tissues
General Management The aim is to stop burning process, cool the burn (thereby providing pain relief) and cover the burn. General Principles for managing burn: COOL, COVER, CARRY
General Management If Clothes are on FIRE: • STOPcasualty • DROPcasualty to ground & wrap in blanket, coat or rug (wool is best) • ROLLcasualty along ground until flames smothered
RADIATION BURNS • Radiation burns are caused by radiant energy – energy radiated from its source • Sunburn is the most common
THERMAL BURNS • Thermal Burns are those caused by Heat • Contact with an open flame or hot object • Scalding by steam or hot liquid, Blast (hot gas), Inhalation injury and Direct Contact.
INHALATION BURNS • This injury occurs when someone is trapped in an enclosed space with toxic gas or fumes from a fire or chemical leak. • These gases can produce a chemical burn causing an inflammatory response to a person's respiratory system. • Initially, inhalation injuries may be masked by other outer burns. • However, damage may appear within two to 48 hours after a burn injury.
ELECTRICAL BURNS • A high voltage electrical burn may be more serious than it appears. • It can be quite deep even when the surface skin shows no evidence of burning • High current flow can cause entry and exit wounds
CHEMICAL BURNS • Burns are often caused by chemicals used in industry but can also result from chemical agents used in the home. • A caustic chemical will continue to burn whilst in contact with the skin • Therefore it is important to remove the chemical from the skin as quickly as possible
FRICTION BURNS • A friction burn occurs when skin is scraped off by contact with some hard object, such as the road, the floor, etc. • It is usually both an abrasion and a heat burn. • Friction burn injuries are commonly seen following road traffic accidents in motorcycle • The incidence of friction burns is reasonably high but the majority of patients do not report to hospital for treatment, as most of them have only minor burns.
Management for All Burns • Call 000 / Medic’s and follow DRABCD. • COOL - the burnt area with cool running water at least 20 minutes. • COVER - the burn with a clean non-adherent, lint free, dressing to PREVENT infection. • Treat for shock. • Remove any constrictions e.g. jewellery if on limbs or neck. • Never remove burnt clothing if stuck to skin (cut around). • CARRY - wait till medical help arrives, for transport to hospital.