Transcript nationalfirstaid.com.au

Apply First Aid
HLTFA311A
Be prepared for an emergency.
Learn first aid, you could save a life.
Copyright NFA Jan 2013 Version 4
1
Welcome
• Basic Housekeeping
– Schedule
– Break
– Location of toilets
– Location of emergency exits
– Mobile phones
Copyright NFA Jan 2013 Version 4
2
Course Content
Element
1. Assess the situation
2. Apply first aid procedures
3. Communicate details of the incident
4. Evaluate own performance
Copyright NFA Jan 2013 Version 4
3
Aims of first aid
•
•
•
•
•
•
Ensure that the scene is safe
Preserve the life
Protect the unconscious
Prevent progression of the injury
Provide comfort/promote recovery
Phone for an ambulance.
Copyright NFA Jan 2013 Version 4
4
Legal Considerations
• Duty to Act
• Negligence
• Consent
• Recording
Copyright NFA Jan 2013 Version 4
5
Primary Survey
Danger
Response
Send for help
Airway
Breathing
Compressions
Defibrillation
Copyright NFA Jan 2013 Version 4
6
Basic Life Support
D
R
Danger
Ensure the scene is safe
No
B
C
D
Check for and remove hazards/risks
Check for a response
S
A
Unsafe
Yes
Send for help - call 000
Unconscious Open and clear airway, look listen and
Conscious : Manage injuries/illness
Monitor , rest and reassure
feel for breathing
Not breathing normally
Commence chest compressions
Breathing normally
Manage patient in the recover position
30 chest compressions followed by 2 breaths
Continue until responsiveness or normal breathing returns
If unwilling /unable to perform rescue breaths continue chest compressions
Defibrillate: Attach AED- follow voice prompts
Continue CPR
Copyright NFA Jan 2013 Version 4
7
Danger
• Once an emergency has occurred you need to
ensure the safety of all of those at the scene by
checking for hazards
• The groups that you need to consider are shown
in order of priority below:
– Yourself
– Bystanders
– The Patient
Don’t become an innocent victim
Copyright NFA Jan 2013 Version 4
8
Response
• Check the Patient for a response
• Call out to the patient “what is your name?”
• Gently tap on the patient on the shoulder and
ask “can you hear me?”
If no response - patient is unconscious ,
manage the airway
Copyright NFA Jan 2013 Version 4
9
Send for Help - Call 000
•
•
•
•
•
•
•
•
Phone Fast /Emergency service controller
Name/contact details
Exact location
Type of incident
Status of the patient
Hazards
Do not hang up
Stay with the patient until help arrives
Copyright NFA Jan 2013 Version 4
10
Airway
• Ensure the airway is open and clear
• If the airway is obstructed, remove any visible
foreign bodies
Copyright NFA Jan 2013 Version 4
11
Airway Management
AIRWAY OPEN
AIRWAY OBSTRUCTED
AIRWAY CLOSED
Copyright NFA Jan 2013 Version 4
12
Breathing
•
•
•
•
•
Keep the airway open and check for
normal breathing
Look, Listen and Feel for no more than 10
seconds for normal breathing
Look – to see if the chest rises
Listen – for the sound of normal breathing
Feel – for air against your cheek
Copyright NFA Jan 2013 Version 4
13
Breathing
If Breathing Normally:
– Roll into the recovery position
– Pregnant women onto their left side
– Observe and reassess the patient for continued
breathing regularly
– Maintain an open airway with head tilt and jaw support
– No head tilt for infants
If Breathing Absent
– Send someone for the AED (if available)
– Commence CPR
Copyright NFA Jan 2013 Version 4
14
Recovery position
The unconscious patient who is breathing normally must be placed in
the recovery position. This lifesaving position helps to maintain an open and clear
airway
Encourage the jaw and tongue to relax and fall forward
Promote free drainage so that fluids such as vomit and saliva will not obstruct the
airway
Patients may be either turned towards or away from the First Aider
Ensure the neck and head is gently tilted back with the face slightly downward and
supported by the patients own hand
With an unconscious patient care of the airway takes precedence over any injury
Care of the spinal patient
Spinal patients must be moved with caution. The neck and head must be supported
and the body in correct alignment. Use of the log roll technique is recommended.
Advanced stages of pregnancy
Place the patient on her left side to avoid distress to the foetus.
Copyright NFA Jan 2013 Version 4
15
Breathing
Sounds of gurgling, sighing or coughing may
be present – this is regarded as not breathing
normal and is an indication of a patient in
cardiac arrest, immediately commence chest
compressions
Copyright NFA Jan 2013 Version 4
16
Sudden Cardiac Arrest
• Sudden Cardiac Arrest occurs when the heart
stops suddenly beating due to an electrical
malfunction of the heart muscle. This disrupts
the normal heart rhythm, resulting in the loss of
consciousness, loss of pulse and loss of life in
minutes.
Copyright NFA Jan 2013 Version 4
17
Sudden Cardiac Arrest
• The heart may begin to vibrate or quiver in an
irregular manner, this is called fibrillation. The
heart is unable to pump oxygen rich blood
through the heart. When this blood is not
supplied to the brain you lose consciousness
• The only way to start a fibrillating heart and
restore normal rhythm is to defibrillation
Copyright NFA Jan 2013 Version 4
18
Chain of Survival
 Early recognition and early access
 Early CPR
 Early defibrillation
 Early advanced medical care
Copyright NFA Jan 2013 Version 4
19
CPR
• CPR is only performed on a person who is in
Cardiac Arrest
• Sudden cardiac arrest is not a heart attack
• Primary need to get heart beating again ASAP
or
• Mimic action of heart beating to send blood out
to the tissues (perform Chest compressions)
Copyright NFA Jan 2013 Version 4
20
CPR
Cardiopulmonary resuscitation (CPR) is a
combination of chest compressions and
rescue breathing
Copyright NFA Jan 2013 Version 4
21
Chest Compressions
• Give 30 compressions
• Compress 1/3 chest depth
• Give 2 breaths continue with 30 compressions
(5 cycles every 2 minutes)
Copyright NFA Jan 2013 Version 4
22
Summary
•
•
•
•
•
•
•
•
•
30 chest compressions
2 breaths
Rate 100 compressions per minute
Each cycle is 30 compressions : 2 breaths
Compress ⅓ of the chest depth
Hand position – centre of the chest
Adult – 2 hands
Child – 2 hands
Infant – 2 fingers
Copyright NFA Jan 2013 Version 4
23
Summary
Only stop CPR if:





the scene becomes unsafe
qualified help arrives and takes over
signs of life return
you become physically unable to continue CPR
an authorised person pronounces life extinct
Copyright NFA Jan 2013 Version 4
24
Summary
• Unconscious
• No normal breathing
• Patient is in CARDIAC ARREST-PERFORM CPR
Any attempt at resuscitation is better
than no attempt
Copyright NFA Jan 2013 Version 4
25
Summary
Chest compressions only
If the First Aider is unable/unwilling to perform rescue breaths chest
compressions only is advised as residual oxygen supplies in the body will be
circulated in the body.
• Compressions should be continued at a rate of 100 per minute
Multiple First Aiders
• In the presence of multiple First Aiders, Call the ambulance first.
• Obtain any necessary emergency equipment such as defibrillator.
• Regular rotation is recommended to reduce fatigue; Every 2 minutes.
Copyright NFA Jan 2013 Version 4
26
Defibrillation
•Defibrillation is the definitive treatment for Cardiac
Arrest
•An AED (Automated External Defibrillator) delivers a
controlled electric shock to the patient’s heart
•The AED is an automated electronic device used to restore
a normal heartbeat.
•Asystole the absence of
any heart beat.
CPR holds off asystole
Copyright NFA Jan 2013 Version 4
27
Defibrillation
Ventricular Fibrillation: Heart irritability where the heart cells are not ‘firing off’ in
an organised manner. Blood circulation is impaired and can result in death
Ventricular tachycardia: Heart irritability where the heart cells are stimulated prematurely
resulting in a fast abnormal heart beat. The heart is unable to refill and the patient will
become unconscious with no heart beat.
Asystole is characterised by the absence of any cardiac activity
VF or VT can be reversed provided there is rapid intervention with CPR and defibrillation. If
treatment is delayed the chance of survival is reduced by less than 10% for each minute
the heart is stopped.
CPR artificially keeps the heart beating and circulates O2 blood, the heart must be
defibrillated to return the electrical conduction system back to normal so the heart can
beat spontaneously.
Copyright NFA Jan 2013 Version 4
28
Defibrillation
• Ensure CPR is continued
• Turn on AED
• Follow the AED instructions
• Shave chest hair and dry moisture with towel if
required
• Check for any implanted medical devices
• Place pads on chest and ensure firm contact
• Ensure no one is touching patient when shock is
delivered
Copyright NFA Jan 2013 Version 4
29
Defibrillation
• An AED should only be applied
when a patient is unconscious and
not breathing
• Each minute that defibrillation is delayed reduces
the patient’s chances of survival by about 10 %
• The sooner the shock is administered, the greater
the likelihood of the patient’s survival
It is virtually impossible to save a patient with
cardiac arrest without a defibrillator
Copyright NFA Jan 2013 Version 4
30
Practical Assessment
with AED
Copyright NFA Jan 2013 Version 4
31
Choking Flow chart
Copyright NFA Jan 2013 Version 4
32
Choking
• Choking occurs the upper airway is
obstructed by swollen tissue or a foreign body,
or when food or other material enters the
trachea instead of the oesophagus.
Copyright NFA Jan 2013 Version 4
33
Partial Obstruction
Signs and Symptoms
•
•
•
•
•
•
difficulty in breathing
wheezing
snoring sound
persistent cough
cyanosis (blue skin colour)
in children and infants
– flaring of the nostrils
– in-drawing of the tissues above the sternum and in between the ribs
Management
• Encourage patient to cough to expel foreign material
• Do not give any back blows because this could cause the patient
to inhale the object and my result in a severe airway obstruction
Copyright NFA Jan 2013 Version 4
34
Choking
• Must often occurs while eating and involves
the inhalation of food down the trachea
during a meal.
Coughing is the body’s reflex action
to dislodge a foreign object
Copyright NFA Jan 2013 Version 4
35
Complete Obstruction
Signs and Symptoms
• unable to breathe, speak or cough
• agitated and distressed
• may grip the throat
• bluish skin colour
• rapid loss of consciousness
Copyright NFA Jan 2013 Version 4
36
Complete Obstruction
Management
• Attempt five sharp back blows between the
shoulder blades
• If unsuccessful attempt five chest thrusts
• Continue alternating, call 000 and be prepared
to commence CPR.
Copyright NFA Jan 2013 Version 4
37
Shock
• Shock is a sudden or slow /steady loss of
blood volume and/or pressure due to illness,
pain or trauma.
• It is the bodies defensive response to protect
the vital organs – heart, lung, kidneys and
brain
• Shock is caused by many factors the most
significant is pain.
Copyright NFA Jan 2013 Version 4
38
Shock
Initial shock
•
•
•
Pale cold clammy skin.
Weak, Rapid pulse.
Rapid breathing.
As shock progresses
•
•
•
•
•
•
•
Faintness or dizziness
Nausea
Anxiety
Restlessness.
Thirst.
Drowsiness, confusion.
Cyanosis in extremities.
Finally
•
collapse and unconsciousness, due to progressive ‘shutdown’ of body’s vital functions
Copyright NFA Jan 2013 Version 4
39
Major Functions of Blood
• Transports oxygen, nutrients and wastes
• Protects against disease
• Maintains constant body temperature
Copyright NFA Jan 2013 Version 4
40
Signs of External Bleeding
-
Arterial
rapid and profuse
bright red in colour
as it is under pressure
usually spurts
Venous
- flows from wound at a
steady rate
- dark red in colour
Capillary
- gentle ooze form wound
Copyright NFA Jan 2013 Version 4
41
Control Bleeding
• Direct pressure
• Elevation
• Rest
Copyright NFA Jan 2013 Version 4
QAS 56
42
Internal Bleeding Management
• Call 000 and closely monitor airway, breathing
and circulation regularly.
• Rest and reassure patient
• Raise legs if injuries permit.
• Do NOT give any food or drink.
First aiders cannot control internal bleeding but early
recognition and calling 000 can save lives
Copyright NFA Jan 2013 Version 4
43
Practical session - bandaging
Copyright NFA Jan 2013 Version 4
44
Asthma
• People with asthma have very sensitive airways, and
when they are exposed to certain triggers, their
airways narrow making it difficult for them to
breathe.
• The inside lining of the airways
becomes red and swollen
• Extra mucus is often produced
• The muscles around the airways
constrict
Copyright NFA Jan 2013 Version 4
45
Asthma
•
•
•
•
•
•
•
•
Shortness of breath especially when speaking
Wheeze may or may not be present
Dry, irritating, persistent cough
Rapid breathing
Tightness in the chest
Cyanosis around the lips and ear lobes
Tiredness, exhaustion
Collapse
Copyright NFA Jan 2013 Version 4
46
Asthma Management
• Get patient to have 1 puff of reliever medication
• Patient then takes 4 breaths
• Repeat until patient has had
4 puffs (with 4 breaths between
puffs)
• Wait 4 minutes
• If no improvement give
another 4 puffs
• If no improvement call 000
• Continue with 4 puffs x 4 breaths x 4 minutes
until ambulance arrives
Copyright NFA Jan 2013 Version 4
47
Anaphylaxis
• The most severe and
sudden form of allergic
reaction
• Occurs when there is
exposure to an allergen
to which a person is
sensitive to
Copyright NFA Jan 2013 Version 4
48
Anaphylaxis
• Is potentially life threatening and should be
treated as a medical emergency
• Anaphylaxis results when a generalised
allergic reaction affects the
respiratory(breathing) and/or cardiovascular
(heart and blood pressure) system. Blood
vessels dilate and blood pressure falls, airway
is constricted resulting in breathing difficulty.
Copyright NFA Jan 2013 Version 4
49
Mild to Moderate allergic reaction
•
•
•
•
Symptoms of a mild to moderate allergic
reaction can include:
swelling of the lips, face and eyes
hives or welts
tingling mouth
abdominal pain and/or vomiting (these are
signs of severe allergic reaction to insects)
Copyright NFA Jan 2013 Version 4
50
Severe allergic reaction
Signs of anaphylaxis (a severe allergic reaction):
• difficulty breathing or noisy breathing
• swelling of the tongue
• swelling/tightness in the throat
• difficulty talking and/or a hoarse voice
• wheezing or persistent coughing
• loss of consciousness and/or collapse
• young children may appear pale and floppy
Copyright NFA Jan 2013 Version 4
51
First Aid Management
•
Lay person flat, do not stand or walk.
If breathing difficult allow to sit not stand
• Prevent further exposure to trigger
• Give Adrenaline auto injector
• Phone ambulance 000 or 112 (mobile)
• Contact family/emergency contact
• Administer asthma medication to assist breathing
• Further adrenaline doses may be given if no response
after 5 minutes (if another adrenaline auto injector is
available)
If in doubt whether it is anaphylaxis use the adrenaline
auto injector
Copyright NFA Jan 2013 Version 4
52
Heart Attack
Copyright NFA Jan 2013 Version 4
53
Angina/Heart Attack/Cardiac arrest
• Angina is caused by constriction of the blood
vessels supplying the heart muscle with blood.
The chest pain is due to a reduction of blood
flow to the muscle of the heart causing a lack of
oxygen to the muscle.
• Heart Attack occurs when a coronary artery is
suddenly blocked by a blood clot and the heart
muscle is damaged due to lack of oxygen.
• Cardiac arrest is a condition in which the heart
stops beating and pumping effectively
Copyright NFA Jan 2013 Version 4
54
Heart Attack
Signs and Symptoms:
• Pale, cool skin
• Chest pain or discomfort, usually in the centre of
the chest, may spread or radiate to the
shoulders, neck jaw and/or arms
• Sweating
• Rapid, shallow respirations or difficulty breathing
• Nausea and/or vomiting
• Collapse
Copyright NFA Jan 2013 Version 4
55
Heart Attack
Management:
• Treat situation as life threatening.
• Advise patient to rest usually sitting. This will ease
the strain on the heart.
• Call 000 – “Every minute counts”
• Assist patient to take medication, e.g. anginine ,
GTN Spray, give aspirin if directed
• Be prepared for sudden unconsciousness.
• Reassure and monitor Patient
• Be prepared to commence CPR.
Copyright NFA Jan 2013 Version 4
56
Musculoskeletal System
Consists of:
Bones
Muscles
Ligaments
Tendons
Copyright NFA Jan 2013 Version 4
QAS 133
57
Sprains and Strains
Sprain
Strain
The stretching and
tearing of ligaments
and other soft tissue
structures at a joint
The stretching and
tearing of muscles
and tendons, occurs
between the joints
Copyright NFA Jan 2013 Version 4
QAS 141
58
How to Manage - RICER
Rest – the patient and the injured limb
Ice- the injury, this will help reduce inflammation and pain by
causing blood vessels to constrict
Compression- and support the injury with firm elastic
bandage after the ice pack has been removed
Elevation- the injured limb to help reduce the swelling and
pain
Refer – to medical help if required
Copyright NFA Jan 2013 Version 4
QAS 140
59
Dislocation
A dislocation occurs when there is
displacement of one or more bones at a joint
such as shoulder,hip,elbow,fingers or toes.
Copyright NFA Jan 2013 Version 4
QAS 137
60
Dislocations
Signs and Symptoms
•
•
•
•
•
sudden pain in the affected joint
loss of power and movement
deformity and swelling of the joint
tenderness
may have some temporary paralysis of the injured limb
How to Manage
• support limb in position of comfort
• apply RICER
• seek medical help
• any attempt to reduce a dislocation is only to be made by a doctor
If you are unsure if the injury is a dislocation, manage as a fracture
and gently immobilise in the position found
Copyright NFA Jan 2013 Version 4
61
Type of Fractures
- Closed -
- Open -
Bone remains within
the skin.
No wound leading to
site of the fracture.
Bone protrudes through
skin or wound leading to
site of the fracture.
- Complicated May involve
body organs
and tissue.
Copyright NFA Jan 2013 Version 4
QAS 134
62
Signs and Symptoms
Signs
Symptoms
Swelling
Discolouration
Deformity
Angulation
Pain
Loss of power
Tenderness
Numbness
Crepitus –bone
ends grating
against each
other
Copyright NFA Jan 2013 Version 4
QAS 135
63
How to Manage
The main aim of fracture treatment is to support or immobilise to:
• Minimises pain
• Prevents further damage
• Minimises bleeding
• Prevents a closed fracture becoming an open fracture.
Support:
• Leave injured limb in the position found and pack around to give
support.
Immobilise:
• Use Splint, Sling or bandage to prevent movement.
• Stabilise joint above and below fracture site.
• Apply triangular or broad bandages above and below fracture site.
• Check circulation every 10mins
Copyright NFA Jan 2013 Version 4
64
Mechanism of Head Injuries
Direction of Impact
Copyright NFA Jan 2013 Version 4
QAS 95
65
Concussion
Concussion or “Brain Shake” is a
temporary loss or altered state of
consciousness followed by complete
recovery. Subsequent decline
suggests a more serious brain
Injury.
Copyright NFA Jan 2013 Version 4
QAS 96
66
Cerebral Compression
Cerebral compression is a condition
which occurs when pressure within the
brain increases
This may be caused by trauma to
the head, or by a blood clot formed
within the skull
Copyright NFA Jan 2013 Version 4
QAS 97
67
Spinal Injury
Can occur following:
• Motor vehicle accidents
• Diving into shallow water
• A fall from a ladder or roof
• Sporting accidents
• Fall in the elderly
• Heavy object falling on top of a person
The most important indicator of a head, neck and
spinal injury is the history of the incident and the
mechanism of the injury
Copyright NFA Jan 2013 Version 4
68
Signs and Symptoms
•
•
•
•
•
•
•
•
•
•
history of incident
unnatural posture
Patient may complain of pain at the site of injury
tingling, burning, unusual, or absent feeling in limbs
absence of pain in limbs
inability to move arms and/or legs
penile erection
Difficulty breathing
Loss of bladder or bowel movement
onset of shock
Copyright NFA Jan 2013 Version 4
69
How to Manage
If conscious
• Keep the patient calm and still as possible
• Do not move patient unless absolutely necessary, use log roll
technique
• Call 000
• Support the head and neck in the neutral position until
ambulance arrives
• Rest, reassure and keep the patient warm
• Closely monitor patient for response and breathing
Copyright NFA Jan 2013 Version 4
70
How to Manage
If unconscious
• Apply DRABCD
• Handle gently with no twisting, and minimal
movement of the head and neck
• Turn Patient onto their side to protect airway (log
roll),ensure when that spinal alignment is maintained
Care of the airway takes precedence over any other
injury (including neck and spinal injury)
Copyright NFA Jan 2013 Version 4
71
The body’s reaction to heat and cold
Copyright NFA Jan 2013 Version 4
QAS 120
72
Hyperthermia
Symptoms and Signs
Muscular Cramps Heat Exhaustion
 Heavy Sweating
 Rapid Onset
 Pain
 Muscle spasms
Heat Stroke
 Shock
 Sweating stops
 Dizziness /
weakness
 Cool / moist skin,
sweating
 Rapid rise in body
temperature
 Altered state of
consciousness
 Nausea
 Body system fail
Copyright NFA Jan 2013 Version 4
QAS 121
73
How to Manage
•
•
•
•
Move Patient to cool, shaded, ventilated area.
Lie flat with legs elevated.
Loosen and remove excess clothing.
Cool by:
•
•
•
•
fanning
spraying with water
applying wrapped ice packs to neck, groin and armpits
draping wet sheet over body or fanning.
• Give cool water to drink, if fully conscious.
• Seek medical help or Call 000 if in doubt
Copyright NFA Jan 2013 Version 4
74
Progression of Hypothermia
Copyright NFA Jan 2013 Version 4
75
Signs and Symptoms
•
•
•
•
• Confusion
• Slurring of
speech
• Behaviour
changes
• Heat rate slows
• Loss of
consciousness
Pale skin
Cold to touch
Shivering
Severe
hyperthermia there
is no shivering
• Difficulty in
coordinating
Copyright NFA Jan 2013 Version 4
QAS 122
76
How to Manage
If conscious
• Seek shelter – protect from wind chill
• Wrap in blankets/ sleeping bag or space blanket and cover head
• Handle gently to avoid heart arrhythmias
• Keep horizontal to avoid changes in blood supply to brain
• Replace wet clothing with dry
• Give warm, sweet drinks if conscious
• Call 000
IF NOT SHIVERING and help is delayed:
• Apply heat packs to groins, armpits, and side of neck.
• Body-to-body contact can be used.
If unconscious
• Apply DRSABCD
Copyright NFA Jan 2013 Version 4
77
How to Manage
• DO NOT re-warm too quickly – can cause heart
arrhythmias
• DO NOT use radiant heat (eg fire or electric heater),
may send cold blood from the body to the heart
and brain too quickly
• DO NOT rub or massage extremities - dilates blood
vessels in skin so body heat is lost.
• DO NOT give alcohol – lowers the body’s ability to
retain heat
• DO NOT place in hot bath as lethal arrhythmias
could occur , monitoring and resuscitation if
needed may be difficult.
Copyright NFA Jan 2013 Version 4
78
Burns and Scalds
Burns are injuries that damage and kill skin cells, caused by
heat or extreme cold
– Burns are most commonly caused by exposure to flames,
hot objects, hot liquids, chemicals or radiation.
– Scalds are caused by contact with wet heat such as boiling
fluids or steam.
– Electrical burns are less common, but have the potential to
be more serious as the depth of the burn is usually greater
than is apparent, and cardiac irregularities may occur.
Copyright NFA Jan 2013 Version 4
79
Types of Burns
• Superficial
– reddening (like sunburn)
– outer layer of skin only
• Partial thickness
– blistering
– damage to deeper layers of skin
• Full thickness
– whitish, or blackened areas
– damage to all layers of skin, plus underlying
structures and tissues
Copyright NFA Jan 2013 Version 4
80
How to Manage
• Apply DRSABCD - Ensure your own safety
• Cool affected area with water for as long as necessary – up to 20mins
Hydrogel products are an alternative if water is not available
• Call 000
• Remove rings, watches, jewellery from affected area as they restrict
circulation when swelling occurs
• Cut off contaminated clothing – do not remove clothing contaminated
with chemicals over the head or face
• Cover the burned area with a loose, non-adherent dressing (sterile nonadherent dressing, plastic cling wrap, wet handkerchief, sheet or pillow
case) to protect and minimise infection
• Elevate burnt limb if possible
Copyright NFA Jan 2013 Version 4
81
Rule of Nines- estimates the
surface area of a burn
Copyright NFA Jan 2013 Version 4
82
Complications of Burns
• Shock from loss of blood or plasma
• Infection
• Breathing problems
• Circulation restricted or cut off.
Copyright NFA Jan 2013 Version 4
83
Do Not
Use ice to cool
Over cool the burn injury
Touch the burn injury
Remove clothing stuck to burn area
Prick or break blisters
Use any oil, butter or ointment
Use cotton wool,towels,cotton
blankets or adhesive dressings
• Give any alcohol
•
•
•
•
•
•
•
Copyright NFA Jan 2013 Version 4
84
Poisons enter the body
Via
Ingestion
Injection
Inhalation
Absorption
Copyright NFA Jan 2013 Version 4
QAS 106
85
How Poisons Act
•
•
•
•
Central nervous system
Oxygen displacement
Damage internal organs
Damage to the cells
Copyright NFA Jan 2013 Version 4
QAS 105
86
How to Manage
• Apply DRSABCD
• Call Poisons Information Centre for advice
131126 or Call 000
• Monitor Vital Signs
• Identify type and quantity of poison
• Establish the time of poisoning.
• DO NOT induce vomiting.
• DO NOT give anything by mouth
Copyright NFA Jan 2013 Version 4
87
Bites and Stings – Category 1
• Management – Pressure Immobilisation
• Snake/Sea Snake, Funnel Web Spider, Blue
Ringed Octopus, Cone Shell
• Comment – Pressure Immobilization is used to
slow the movement of venom
Copyright NFA Jan 2013 Version 4
88
Bites and Stings – Category 2
• Management – Ice/Cold Compress
• Bee, Wasps, Ant, Red Back Spider, White Tail
spider, bush tick, common jellyfish
• Comment – Ice/Cold Compress relieves pain
and swelling by reducing flow of blood to the
bite site. Apply Pressure Immobilisation
if allergic to bite/sting
Copyright NFA Jan 2013 Version 4
89
Bites and Stings – Category 3
• Management – Heat/Hot Water
• Stonefish, Bull Rout, Stingray, Non tropical
Bluebottle, other spine fish
• Comment – Heat/Hot water is an effective
treatment for minimising pain
Copyright NFA Jan 2013 Version 4
90
Bites and Stings – Category 4
• Management – Vinegar
• Tropical Jellyfish, Box Jellyfish, Irukandji
• Comment – Vinegar inactivates the discharge
of stinging capsules which prevents further
injection of venom. Vinegar cannot relieve
pain from venom already injected
Copyright NFA Jan 2013 Version 4
91
Stroke -Brain Attack
• Stroke occurs when the blood supply to part of the brain
is disrupted, resulting in damage to brain tissue.
• This is caused by either a blood clot blocking an artery
(cerebral thrombosis)
or a ruptured artery inside the brain
(cerebral haemorrhage)
• The signs and symptoms
of a stroke may vary, depending on
which part of the brain is damaged
Copyright NFA Jan 2013 Version 4
92
Signs and Symptoms
• Sudden severe headache
• Sudden nausea and/or vomiting
• Confused emotional mental state that could be mistaken
for drunkenness
• Blurred vision, unequal pupils
• Paralysis, weakness or loss of coordination ,loss of balance ,
generally on one side of the body but can be both sides
• Difficulty talking, understanding or swallowing
• Urinary incontinence
• Gradual or sudden loss of consciousness
• May have seizures
Copyright NFA Jan 2013 Version 4
93
Fast Test
FAST is a simple way of remembering the signs
of a stroke:
• Facial weakness – Can the Patient smile? Has
their mouth or eye drooped?
• Arm weakness – Can Patient raise both arms?
• Speech – Can Patient speak clearly and
understand what you say?
• Time to act fast - Call 000
Copyright NFA Jan 2013 Version 4
94
How to Manage
• If Patient fails any one of the FAST tests act
FAST and call 000
• Adopt position of comfort
– Ensure airway does not become obstructed
• Reassurance – talk to the Patient even if
unconscious
• Unconscious – place in recovery position
Copyright NFA Jan 2013 Version 4
95
How to Manage - Epilepsy/Seizure
TONIC-CLONIC SEIZURES
•
•
•
•
•
•
Protect from harm
Place something soft under head
Loosen tight clothing
Roll into recovery position when seizure
Reassure until fully recovered
Call 000, if necessary
subsides
DO NOT put anything in the patient's mouth
DO NOT restrain the patient
DO NOT move the patient unless in danger
Copyright NFA Jan 2013 Version 4
96
Febrile Convulsions
• Febrile convulsions occur when a child has a high
temperature.
• The growing brains of small children are more sensitive to
fever than are more mature brains
• When the normal brain activity is upset a convulsion or fit can
occur.
• Febrile convulsions may occur in children aged six months to
six years
• Manage as for Seizure/Epilepsy PLUS:
• Remove excess clothing
• Apply moist cloth to forehead (no ice).
• DO NOT allow shivering to occur
• DO NOT put in cold bath
Copyright NFA Jan 2013 Version 4
97
Diabetes
• Diabetes is a condition which is caused by an imbalance of
sugar, or glucose, in the blood.
• Diabetic emergencies appear in two forms:
– Hypoglycaemia – or low blood sugar is an imbalance
where the tissues especially the brain cells, become
starved of essential sugar. The onset is rapid.
– Hyperglycaemia, or high blood sugar is an imbalance of
blood sugar, which usually requires the affected person to
supplement their insulin by periodic injections.
:
Both conditions (Hypo and Hyperglycaemia) are
managed the same way by first aiders
Copyright NFA Jan 2013 Version 4
98
Hypoglycaemia
Signs and Symptoms:
Management
•
•
•
•
•
•
•
•
•
Pale skin
Profuse sweating
Hunger
Confused or aggressive
Rapid and strong pulse
May appear to be drunk
Seizures
Unconsciousness
•
•
•
If conscious give either a:
– sweet drink (not diet drink),
– jelly beans or sweets,
– glass of fruit juice, or
– teaspoon of sugar or honey
The patient will normally respond well
and rapidly to this treatment
Encourage patient to have more sugary
food or drink until they feel better
If patient dies not improve or worsens
call 000
DO NOT attempt to give insulin
injection
Give nothing by mouth to a
unconscious diabetic
Copyright NFA Jan 2013 Version 4
99
Hyperglycaemia
Signs and Symptoms:
• Hot, dry skin
• Excessive thirst
• Frequent need to urinate
• Smell of acetone (nail polish
remover) on the breath
• Drowsiness and extreme
tiredness,fatigue
• Unconsciousness, progressing to
coma (diabetic coma)
• Weight loss
Management
• Definitive treatment for high
blood sugar requires medical
expertise.
• When in doubt if the patient
has low or high blood sugar,
treat as for low blood sugar.
DO NOT attempt to give insulin
injection
Give nothing by mouth to a
unconscious diabetic
Copyright NFA Jan 2013 Version 4
100
Eye Injuries
Minor Eye Injuries
• Injuries where the eye has been struck by a foreign object, or has a small
object adhering to its surface, causing irritation.
• It is characterised by a bloodshot eye, irritation, and an urge to rub the
eye.
How to Manage
• irrigate the eye and wash the object out
• if this fails, touch the corner of a clean wet cloth to the object and lift it
off the surface
• refer to medical aid if vision is affected
• cover the affected eye if appropriate
– avoid ‘pushing’ the object around the
eye’s surface
– only use eye-drops if prescribed by a
doctor
Copyright NFA Jan 2013 Version 4
101
Assessment
Multiple choice test
Practical scenarios
Copyright NFA Jan 2013 Version 4
102