First Aid Training

1. First Aid Training Course designation… HLTFA301B Apply First Aid Formally Senior First Aid

2. Welcome to your First Aid Course • Introductions • Housekeeping • Course delivery • Exam • Practical Assessments • Course Evaluation • Questions • Any specific topics you would like covered

3. Course Format • Conscious Casualty • Unconscious Casualty • CPR and defibrillator • Bandages and slings • Bites and Stings • Diabetes • Seizures/fitting • Triage • Record keeping • Trauma • Drowning • Choking • Poisoning • Drug overdose • Burns and scalds • Strokes • Hyperventilation • Hypothermia/Hyperthermia • Safe manual handling

4. What is First Aid? • The initial care, given to a casualty, prior to the arrival of professional medical assistance. • What is your obligation to provide first aid?

5. PRINCIPLES OF FIRST AID • LOOK AFTER NUMBER ONE - YOU • Consider the danger to you, others and the casualty. • Wear protective equipment such as gloves, masks etc. • Be careful not to get an injury helping, such as cuts and abrasions if accessing a damaged vehicle, a back injury whilst lifting or a needle stick. • Promote a safe environment at an accident scene, at work and at home.

6. Danger • Response • Airway • Breathing • Compression • Defibrillation Refer page 14 in your manual

7. First Aid Protocol • Assess the scene… • Assess the casualty… • Assess what to do next… Triple A Protocol

8. IDENTIFY THE HAZARD

9. ASSESS THE SCENE • Protect yourself and others • Protect the casualty • Phone the Ambulance on 000 (112 Mobile phones)

10. DANGERS • Traffic • Unstable environment • Fire or explosion • Burns • Chemical fumes • Electrocution • Needle stick injury • Back injuries • Equipment failure • Biological • Aggressive behaviour • Body fluids especially blood • Aggressive dog?

11. INFECTION CONTROL In every first aid situation, you must assume that the injured casualty has a disease. • Before First Aid: • Wash your hands • Use Gloves • Use a Resuscitation Mask • During First Aid: • Ensure gloves are worn and not torn • Consider double gloving • If you come in contact with body fluids, wash immediately and seek medical advice Refer page 8 in your manual

12. Assess the Casualty- are they alive ? • Is the casualty responding ? • Is the casualty breathing normally ? • Is the casualty moving ? • Are there signs of life ? • If they respond, seek their permission to provide first aid. Refer page 3 in your manual

13. Assess the Casualties TRIAGE What does it mean? • The efficient use of resources so the most good can be done for the most people. • This would mean a casualty that had suffered a cardiac arrest should only be given CPR if there are no other seriously injured casualties that would benefit from your life-saving treatment.

14. ASSESS WHAT TO DO NEXT • Commence treatment. • Don’t move the patient unless they’re in danger or you must move them to provide treatment. • Arrange transportation to hospital. • Provide confidence and reassurance. • Build teamwork and avoid panic. • Ensure you don’t injure yourself whilst providing assistance.

15. The Conscious and Unconscious Casualty

16. The Conscious Casualty • What does the term ‘conscious’ mean ? • Conscious means a person is in their normal state of mind. • Generally this is like you are now, able to communicate and aware of your surroundings. • In certain circumstances i.e. people with medical conditions and/or disabilities you may need to ask if there behavior is ‘normal’.

17. Consciousness How do we determine the consciousness of a patient? C – can you hear me? O – open your eyes. W – what’s your name? S – squeeze my hand

18. The Unconscious casualty • Unconscious casualty means there is no response from the casualty to your communications with the casualty • There are many causes of unconsciousness,

19. Causes of Unconsciousness • Alcohol (intoxication) • Epilepsy (fitting/convulsions) • Insulin (Diabetes) • Overdose/Under dose (illicit and prescription drugs) • Uraemia (renal failure is difficult to diagnose) • Trauma (Shock) • Infection • Psychiatric / Pretending • Stroke (CVA Cerebrovascular Accident / TIA Transient Ischemic Attack )

20. Treating the Unconscious Casualty • Unless CPR is to be performed, all unconscious, breathing casualties must be placed in the lateral ‘recovery’ or ‘stable side’ position. • Preferably on their left side. Let’s have a practice 

21. Examining the conscious and unconscious casualty • Once the casualty has been placed on their side, we must treat any obvious life threatening injuries ie; any major haemorrhage. • As part of a secondary survey, all casualties require a head to toes examination. • When examining a conscious or an unconscious casualty, use different methods. (remember to gain permission from the conscious casualty and preserve the dignity of the unconscious casualty)

22. Examining the conscious and unconscious casualty • Once a head to toes examination has been completed, complete the secondary survey. • Look for symptoms such as cold clammy skin, skin colour, heart rate. • Look at the history of the situation…where the casualty is lying, ask witnesses what happened.

23. Examining the conscious and unconscious casualty • Does the casualty take any medication? • Does the casualty have any allergies? • When was there last meal?

24. Examining the conscious and unconscious casualty • It is important that throughout first aid treatment that the first aider monitors and records the casualties breathing, skin condition and level of consciousness. • This should be done every 3 to 5 minutes. • This information establishes a trend and could prove invaluable to ambulance and paramedic staff on their arrival.

25. Resuscitation

26. Cardio-Pulmonary Resuscitation • CPR is a technique involving rescue breathing and the compression of the heart (through external cardiac compression) ECC, therefore pumping oxygenated blood around the body. • CPR when performed correctly, can preserve brain functions until medical help arrives. • CPR is used on a patient who has suffered a cardiac arrest.

27. Causes of Cardiac Arrest • Heart condition • Near Drowning • Electrocution • Trauma • Blockage of coronary arteries • Drug overdose

28. Basic Life Support Chart

29. CPR TECHNIQUE • 2 Breaths followed by 30 Compressions • When performing CPR on a child, use only the air in your mouth.

30. Breathing • Five ways to perform Rescue Breathing - • Mouth to mouth resuscitation • Mouth to nose resuscitation • Mouth to mouth and nose resuscitation • Mouth to stoma resuscitation • Mouth to mask resuscitation

31. Compressions • Find the compression point by placing your hands in the centre of the chest (lower half of the sternum) • In infants the 2 finger technique should be used for compressions • In children and adults the rescuer should use the heel of their hand while placing the other hand securely over the top of the first. • The compressions should equate to 1/3 of the chest depth. • The rate of compressions should be approximately 100 compressions per minute for all ages.

32. VENTRICULAR FIBRILLATION (VF) • Sudden cardiac arrest can occur any time and without warning. • Though the average age of these victims is 65, some are in their 30’s or 40’s. • Most victims experience an abnormal heart rhythm called ventricular fibrillation (VF). • When the heart is in this state, it cannot beat in an organized fashion; the heart is unable to pump blood to the body. • Sudden cardiac death can occur in minutes unless you act quickly.

33. DEFIBRILLATION

34. AED • What is an AED? • The automated external defibrillator (AED) is a computerized medical device. • It will check a person’s heart rhythm. • It will recognize a rhythm that requires a shock. • And it will advise the rescuer when a shock is needed. • The AED uses voice prompts, lights, and text messages to tell the rescuer the steps to take. Refer page 36 in your manual

35. HOW DOES IT WORK • The AED can diagnose and restore a normal heart rhythm to victims of sudden cardiac arrest due to ventricular fibrillation (VF). • In the unconscious victim, adhesive pads are placed on the chest by trained individuals to deliver an electrical shock. • This shock (or series of shocks) is called defibrillation, and it briefly stops all of the heart’s electrical activity so the heart can resume normal beating on its own. Refer page 36 in your manual

36. DEFIBRILLATION Remember…EVERY MINUTE COUNTS • If defibrillation occurs in the first one or two minutes, 90% of sudden cardiac arrest victims in VF survive. • If defibrillation is delayed for more than ten minutes, the survival rate drops to 5% for sudden cardiac arrest victims in VF.

37. CPR TECHNIQUE Let’s practice CPR  Remember…2 breaths & 30 compressions 100 compressions per min

38. Debriefing • As soon as possible after an emergency situation, document what had taken place. • A diary note, write on the back of a time sheet if at work. • It doesn’t matter what you write on. • This will help you put the events into perspective and if asked, may help paramedics with the continued care of the casualty.

39. Head Injuries • Head injuries can range from a simple bleeding nose, or a tooth being knocked out to a heavy blow to the head as a result of a fall, car accident or a fight. • A head injury can constitute a severe medical emergency.

40. Head Injuries Symptoms... • Bleeding from an open wound. • Deformity of the skull or face. • Become drowsy or vague. • Agitated or irritable. • Vomits or complains of nausea. • Bleeding or discharge from the ear • Changes in the size/shape of the pupils • Memory impairment • Lack of coordination • Headache or giddiness • Slurred speech • Possible seizures • Becomes unconscious

41. Head Injuries Treatment… Follow the Triple A Protocol and call an ambulance if required If the casualty is conscious… • Complete a thorough assessment and ensure the cervical spine is not damaged. • Keep the casualty lying down and at rest. • Check carefully the neck, eyes and ears, and if bleeding or discharge is found, place the casualty on the injured side to aid the draining process. • Dress any wounds and monitor

42. Head Injuries Treatment cont… Unconscious casualty… Follow the Triple A Protocol… DR ABCD • Manually support the head and neck and place the casualty on their side. (Be very careful when turning the casualty over as there could be damage to the cervical spine.) • Maintain manual traction of the head and neck until the ambulance arrives and takes over the care of the casualty. • If there is fluid coming out of an ear, ensure that the casualty is lying on that side to allow drainage. • Treat any wounds and monitor.

43. Head Injuries Treatment cont… • Progressive Head Injury…should the casualty show a decline in consciousness, they’re suffering from a more serious brain injury, which requires urgent medical intervention. • Nose bleeds are common and can be controlled by constant pressure to the soft part of the nose for at least 10 minutes. • Ice packs can be used. • Don’t let the casualty blow their nose. • Monitor the casualty

44. Head Injuries Treatment cont… Tooth Injury… • If the tooth is knocked completely out, rinse gently and put back in place – the correct way around  • Another alternative is to place the tooth in a small container surrounded by the casualties own saliva or milk and seek medical or dental assistance. • Apply firm pressure, using a sterile pad, to any bleeding wound or tooth socket for at least 10 minutes.

45. Shock Shock fits into 3 categories… • Absolute fluid loss - low blood volume • Relative fluid loss • Cardiac failure - Cardiogenic Shock

46. Shock • Shock can be bought about by physical or mental trauma. • Physical trauma may be the result of a shark bite, car accident or industrial accident causing blood loss. • Mental trauma maybe as a result of bad news, witnessing a bad accident etc., causing arteries to dilate and decrease the relative blood volume.

47. Shock Signs and symptoms of shock include… • low blood pressure (hypotension), • over breathing (hyperventilation), a weak rapid pulse, • cold clammy greyish-bluish (cyanotic) skin, • decreased urine flow and mental changes (a sense of great anxiety and foreboding, confusion and, sometimes, combativeness). • Depending on the underlying cause shock can be a major medical emergency. It is common after serious injury. Emergency care for shock involves keeping the patient warm and giving fluids by mouth or, preferably, intravenously.

48. Shock Treatment… Follow the Triple A Protocol… DR ABCD • If you come upon a person in shock, the initial response should be to call 000. • Lay the person down in a safe place and try to keep them warm and comfortable. • Elevate the legs to increase the available blood flow to the vital organs. • Treat any injuries and monitor the casualty continuously. • Confirm the ambulance has been called.

49. Faints • Fainting can present similarly to shock, if the faint is unwitnessed. • The brain is being starved of oxygen due to the lack of blood flow. • People stand still for long periods of time eg; army personnel standing at attention for long periods. • Blood pools in the lower extremities which reduces the supply available to the brain. Fainting occurs.

50. Faints Signs and Symptoms… • The casualty normally feels light headed prior to the faint, may feel nauseated and anxious and appears pale. • The diagnosis may be confirmed by rapid return to consciousness while lying flat. • Occasionally, fainting may be associated with fitting. • Brain damage or death may occur if the casualty is left supported in an upright position