20. Emergency Medical Assistance (16 hrs.)

1. 20. Emergency Medical Assistance (16 hrs.) TCLEOSE LEARNING OBJECTIVES 05/03/2002

2. Objectives • Unit Goal: 20.1. The student will know the procedures and skills necessary to provide emergency medical assistance pending arrival of medical support. • 20.1.1. Discuss the legal aspects of providing emergency medical assistance. • 20.1.2. Identify the essential principles of patient assessment. • 20.1.3. Identify and demonstrate emergency aid procedures to control bleeding. • 20.1.4. Identify and demonstrate emergency aid procedures for burns. • 20.1.5 Identify and demonstrate the emergency aid procedures for treatment of shock. • 20.1.6. Identify and demonstrate the emergency aid procedures for broken bones and severe sprains. • 20.1.7. Identify and demonstrate the emergency aid procedures for poisoning. • 20.1.8. Identify and demonstrate the emergency aid procedures for illness related to exposure to the elements. • 20.1.9. Identify and demonstrate the emergency aid procedures for breathing emergencies. • 20.1.10. Identify and demonstrate the emergency aid procedures for victims of diabetic emergencies, strokes, and seizures. • 20.1.11. Identify the basic elements of and demonstrate CPR. • 20.1.12. Identify and explain emergency aid procedures for childbirth. • 20.1.13. Identify universal precautions for preventing transmission of communicable diseases. • 20.1.14. Identify methods of preparation of a patient for transportation. • 20.1.15. Identify factors associated with treatment of different cultures in emergency medical assistance.

3. Instructor may use the American Red Cross Community First Aid and Safety Course, Traffic Safety Association First Aid Course, or any other first responder emergency medical care course which satisfies the learning objectives.

4. Suggested reading: Bergeron, J. David & Bizjak, Gloria. (1991). Brady First Responder (3rd ed.).

5. Instructor must include a discussion of symptoms with each block of instruction.

6. Unit Goal: 20.1. The student will know the procedures and skills necessary to provide emergency medical assistance pending arrival of medical support.

7. 20.1.1. Discuss the legal aspects of providing emergency medical assistance.

8. Legal aspects:

9. Good Samaritan law - act as a reasonable and prudent person under the same circumstances CPRC 74.151.

10. PC 9.34 (b). Protection of life or health

11. TC 550.023. Duty to give information and render aid.

12. 20.1.2. Identify the essential principles of patient assessment.

13. Assessment principles:

14. Make sure location is safe for you and patient.

15. Conduct primary survey

16. Airway (ensure open airway)

17. Breathe (maintain airway, rescue breathing)

18. Circulate (bleeding)

19. 20.1.3. Identify and demonstrate emergency aid procedures to control bleeding.

20. Controlling bleeding:

21. Cover wound with dressing and apply direct pressure.

22. Elevate injured limb above heart.

23. Apply bandage and additional dressing, as necessary

24. Use arterial pressure if direct pressure fails to stop bleeding.

25. Get medical help.

26. 20.1.4. Identify and demonstrate emergency aid procedures for burns.

27. Treating burns: • Stop the burning • Cool the burn - use large amounts of cool water • Cover the burn - dry, sterile dressings or clean cloth • Get medical help

28. 20.1.5. Identify and demonstrate the emergency aid procedures for treatment of shock.

29. Treating shock: • Have victim lie down • Control bleeding • Elevate legs (unless head, neck, spinal injuries, hip or leg injuries are suspected) • Reassure victim • Do not give food or drink • Get medical help

30. 20.1.6. Identify and demonstrate the emergency aid procedures for broken bones and severe sprains.

31. Treating broken bones and severe sprains: • Determine the type and location of injury • Swelling • Bruising • Inability to move affected part normally • Protruding bone • Victim feels bone grating or heard a snap or pop at time of injury • Cold feeling or numbness at site of injury • Immobilize affected part • Splint, if necessary • Get medical help

32. 20.1.7. Identify and demonstrate the emergency aid procedures for poisoning.

33. Treating poisoning: • Chemical poisoning by contact • flush with water • Chemical poisoning by ingestion • Identify the poison • Check breathing, pulse, and level of consciousness • Contact Poison Control Center - do not give anything to eat or drink unless told to by medical personnel • Get medical help • Snake bite - poisoning by injection • Wash wound • Keep bitten part still and lower than the heart • Get medical help

34. 20.1.8. Identify and demonstrate the emergency aid procedures for illness related to exposure to the elements.

35. Heat related illness • Get victim out of the heat • Loosen tight clothing • Remove perspiration soaked clothing • Apply cool, wet cloths to the skin • Cool the victim • If conscious, give water to drink • Get medical help if vomiting, unable to drink, or if victim loses consciousness

36. Cold related illness • Care for life threatening problems • Move victim to a warm place • Remove wet clothing and dry victim • Warm victim slowly • Get medical help

37. 20.1.9. Identify and demonstrate the emergency aid procedures for breathing emergencies.

38. Choking • Place thumbside of fist against middle of abdomen, just above naval • Grasp fist with other hand • Give quick, upward thrusts

39. Rescue breathing • Tilt head back and lift chin • Pinch nose shut • Give two slow breaths checking to see if chest gently rises. Use abdominal thrust (up to 5 times) to clear airway, if obstructed, and sweep out mouth • Check for pulse • Give one slow breath every 5 seconds for one minute (12 breaths) • Recheck pulse and breathing about every minute • Continue rescue breathing as long as pulse is present but person is not breathing

40. Recommended Courses: American Red Cross: or Traffic Safety Council Heimlich Maneuver

41. NOTE: Use chest thrusts for pregnant victim. Discuss use of face shield or mask. Discuss one rescuer and two rescuer methods.

42. 20.1.10. Identify and demonstrate the emergency aid procedures for victims of diabetic emergencies, strokes, and seizures.

43. Diabetic coma - transport to medical facility immediately.

44. Insulin shock • Conscious patient – • administer sugar, granular sugar, honey, lifesavers or other candy placed under the tongue, or orange juice. • Unconscious patient • Avoid giving liquids • Provide a sprinkle of sugar under tongue • Turn head to side or place on side • Transport to medical facility

45. Stroke • Maintain an open airway • Keep patient at rest • Protect all paralyzed parts • Provide emotional support • Head, neck, and shoulders slightly elevated. Turn head slightly to side for drainage • Do not allow patient to become overheated • Do not administer anything by mouth • Monitor patient - shock or respiratory or cardiac arrest are possible • Get medical help

46. Seizures • Place patient on floor or ground • Loosen restrictive clothing • Do not try to hold patient during convulsions. Protect the patient from injury. • After convulsions have passed, keep patient at rest. Position head for drainage in case of vomiting. • Protect the patient from embarrassment. • If this is patient's first attack, alert EMS. If patient is aware of problem, ask if you can call doctor for him. Patient has the right to refuse further care.

47. 20.1.11. Identify the basic elements of and demonstrate CPR.

48. Elements of CPR: • Clear the airway • Breathe for victim • Maintain circulation by chest compression

49. Recommended Course: • American Heart Association, American Red Cross • NOTE: Instructor must identify differences in adult and infant CPR.

50. 20.1.12. Identify and explain emergency aid procedures for child birth.