Transcript FIRST AID
FIRST AID Introduction to Medical Careers Primary Assessment – Responsive Person • Look for any immediately life-threatening problems • Introduce yourself • See if there are and diminished levels of • responsiveness, • Altered mental status • Difficulty Breathing • Scan for serious bleeding Primary Assessment – Responsive Person • Check tissue color • Normal is pink • Paleness = blood loss or shock • Bluish = lack of oxygen • Feel forehead for skin temperature • Normal skin feels warm and dry • Cool, wet can indicate shock • ONGOING ASSESSMENT: continue to monitor the person for responsiveness, breathing, skin color and temp Secondary Assessment • When no life-threatening problems, do a secondary assessment • An organized approach to gather more information about an ill or injured person • Use DOTS and SAMPLE • If a secondary assessment reveals any specific problems, provide the indicated care. Secondary Assessment DOTS • what to look for in a physical assessment • • • • Deformities Open injuries Tenderness Swelling SAMPLE • what to ask • • • • • • Signs and symptoms Allergies Medications Past medical problems Last oral intake Events leading to the problem Secondary Assessment Palpation: examine by touch how done: • give statement • maintain communication • done in position found in • begin at neck • look for fluid, deformity, pain Sign see, hear, feel ex – vomiting Symptom they tell you ex – nausea BLEEDING Pints of blood in the body - 10-12 shock -2-3 pints lost death -4-5 pints lost What is a blood vessel? Something that carries blood What are the vessel types? Artery Vein Capillary BLEEDING ARTERY from heart to the body under pressure thick walls spurts oxygenated bright red BLEEDING VEIN from body to heart no pressure thin walls trickles without oxygen dark red BLEEDING CAPILLARY network within muscle exchange between oxygenated or deoxygenated cell thick walls oozes STOP THE BLEEDING • Control the bleeding first. • Use direct pressure to stop the bleeding • Cover with gauze. Re-cover if necessary. • Don’t take off dressing to look. • Use pressure bandage if direct pressure is not working • Use elevation • Spurting blood = Artery • Oozing blood = Vein • Dispose of waste in biohazard bag or container. WOUNDS & BANDAGING • do not remove debris from major wounds • clean if possible • Bandage once the bleeding is under control • impaled objects need to be left in & secured • check circulation – distal to the injury • gun shot/stab wounds-- cover chest to maintain pressure SHOCK What is shock? Inadequate supply of oxygen to vital organs/body tissue Signs/Symptoms uneasy, restless, or worried cool, pale, and sweaty tissue confused rapid weak pulse through pain in chest SHOCK • What to do: • Activate EMS • Maintain normal body temperature • Keep patient lying down or treat in position found • Do not give food or drink even if patient asks • Keep person as comfortable and calm as possible • Continue ongoing assessment Internal Bleeding • A significant blow • Hard to detect • Signs of shock and mechanism of injury are the earliest indications of internal bleeding may have occurred. Amputation • Complete detachment of a body part • Control severe bleeding • Call EMS • Wrap severed part in a sterile or clean cloth • Place in tightly sealed plastic bag • Cool the bag indirectly with ice or a chemical cold pack • Calm, Comfort, Reassure • Ongoing Assessment Impaled Objects • General rule: to not remove an impaled object • Acts like a plug • Activate EMS • Prevent movement of body part and impaled object • Eye • Activate EMS • Stabilize object • Cover both eyes….why? • Calm, Comfort, and reassure Open Chest Injuries • May allow oxygen to be drawn into the chest • Activate EMS • Stop any bleeding but don’t seal the wound • Calm, Comfort, Reassure • Ongoing Assessment Open Abdominal Injury • Evisceration: abdominal organs protrude through an open wound • Activate EMS • Position of comfort • Cover any protruding organs with thick, moist dressing • Do not apply direct pressure • Calm, comfort, reassure • Ongoing assessment Head, Neck, or Back Injury • Spinal Injury • Signs and Symptoms • Mechanism • wound on head/scalp • blood/clear fluid from nose & ears • Deformity • bruising around eyes/ears • Numbness, tingling, or paralysis anywhere in the body Head, Neck, or Back Injury • Spinal Injury • What to do: • Call EMS • Immobilize head, neck, and back manually • Do not move the patient • Treat for shock • Ongoing assessment Head, Neck, or Back Injury • HEAD INJURY aka “Concussion” or TBI • Signs / Symptoms • • • • • • • • Headache Nausea Dizzy Blurred vision Not all there Emotional state changed Unequal pupils Bright lights or loud noises bother Head, Neck, or Back Injury • HEAD INJURY aka “Concussion” or TBI • What to do: • • • • Activate EMS system for serious head injury, or if in doubt Monitor signs and symptoms. Call parents. Notify EMS if signs/symptoms get worse Swollen, Painful, or Deformed Limb • Strains: stretching or tearing of muscles or tendons • Sprains: tearing injuries of ligaments • Dislocation: separation of bone ends at a joint • Fractures: break in the bone • Commons Signs/Symptoms • Swelling, pain, discoloration • Point tenderness, deformity • Inability to move or doesn’t want it moved Swollen, Painful, or Deformed Limb • Care • • • • • Call EMS Immobilize Fracture / Dislocation Check for circulation, movement, and sensation Calm, Comfort, Reassure Ongoing assessment Splinting 3 rules of splinting: 1. Splint as is 2. Fingers and toes showing for circulation 3. Splint one joint above and one joint below to stabilize the injured area BURNS • Signs / Symptoms • First degree: redness of skin, no blistering (sunburn) • Second degree: redness of skin with blistering (scald burns, hot liquid) • Third degree: deep burn, black & charred, white or tan skin (flame or hot metal) • Pain • Difficulty breathing • Shock BURNS Epidermis- top layer of skin Dermis- second layer of skin Full thickness burns • stop burning • apply sterile dressing Partial thickness burns • if skin is unbroken, cool with water & apply a dry dressing Don’t • apply gels • remove stuck on clothing • Apply ice Burns Electrical Burns Chemical Burns • Call EMS • Turn off electricity • May have to do CPR and use an AED • Treat burn(s) • Flush area with large amounts of water • If powder: brush off first Minor Injuries Nosebleed Injured Tooth • Sit straight up or head tilted forward • Pinch the nose • May use a nose plug • Break, dislocate, or knock out • Knocked out: re-implant ASAP • Control bleeding • To save: • Cup with saliva • Others: • Milk, saline solution, Sav-a-tooth Cutoff for FA Test #1 Sudden Illness • Suspect when, without warning, a person suddenly appears weak, ill, or in severe pain • The most common warning signs of serious illness: • Altered mental status • Breathing difficulty or shortness of breath • Pain, severe pressure, or discomfort in the chest • Severe abdominal pain Altered Mental Status • Is a warning sign of a serious problem & considered a medical emergency • Activate EMS • Comfort position • Calm & reassure • Ongoing assessment Fainting • Unexpected drop of blood pressure and blood flow to the brain • Causes: anxiety, fear, pain, stress, standing in place too long, or rapid movements • Treatment • Lay the person flat • Raise feet 6-12 inches • Or keep person seated forward and place head between knees Stroke • Brain attack • Occurs when the blood supply to a portion of the brain is suddenly interrupted • A blocked or ruptured artery in the brain which stops the adequate flow of blood to a portion of the brain • Stroke? blockage of blood and O2 to the brain • Aneurysm? ruptured blood vessel Stroke •Signs / Symptoms • Numbness or weakness of face, arm, or leg; especially one sides • Confusion • Change in the ability to speak or be understood • Changes in sight and balance • A severe, sudden headache Stroke • Quick test: FAST • Face droop: ask the person to smile • Arm drift: ask the person to hold up both arms • Speech difficulty: ask the person to speak a simple sentence • Time to activate EMS: if a person has trouble with any of these tasks, call EMS STROKE • What to do: • Calm, Comfort, and Reassure • Insure that family & bystanders do not make inappropriate comments. Hearing is the last sense to fail • Call 9-1-1 • If patient is unconscious, place on affected side to allow fluids to drain from mouth • Minimize movement and continue ongoing assessment until help arrives What Is Diabetes? Disease in which the body cannot effectively use sugar for energy. A disorder of the pancreas The pancreas stops making insulin, an essential hormone in the body. Insulin is the key that allows glucose to enter the cells. Glucose is used by every cell in the body for energy INSULIN Without insulin, glucose cannot enter the cell. Glucose stays in the bloodstream, creating high levels of blood sugar. Diabetes • Type I • body no longer produces insulin • most commonly effects children & young adults • Type II • body no longer utilizes insulin • commonly occurs as we age & become inactive (genetic involvement) • Gestational • women who are pregnant & have high blood pressure SIGNS/SYMPTOMS OF LOW BLOOD SUGAR • Weakness or tiredness LOW • Shaking • Headache • Anxious, Pale • Pale, cool, and sweaty skin LOW Treatment of Hypoglycemia Treatment : responsive person • Provide • Glucose tablets--start with 2 • Juice • Regular soda pop (not diet) • If longer than 1 hour until next meal or snack, give small snack containing protein (cheese crackers or milk) • DO NOT GIVE INSULIN!!! • • • Calm, Comfort, and Reassure Ongoing assessment If no response to sugar in 10-15 minutes, call EMS & provide additional glucose or sugar Hypoglycemia •Treatment for Unresponsive • Quickly activate EMS • Do not give anything to eat or drink • Provide any required supportive care • Ongoing assessment (ABC’s) SEIZURES • Brief episodes of disorderly electrical activity in the brain which affects its normal functions and produces changes in a person’s movements, behavior, or consciousness. DID YOU KNOW? ¤ 2,000,000 people in the U.S. have some form of Epilepsy. ¤ 300,000 of those are under age 18. ¤ 100,000 new cases are reported each year. ¤ In 70% of cases, the cause is unknown. ABSENCE SEIZURES • Very brief, last only a few seconds, and look like a blank stare, or daydreaming. The person is completely unaware of his surroundings. They begin and end suddenly. TONIC-CLONIC SEIZURES • Person blanks out, falls, stiffens, then jerks uncontrollably for a minute or two. Seizure • Typically occur without warning • May have an aura/smell/noise before seizure • Signs/Symptoms • Jerking movements • Breathing may seem absent • Can lose control of bowel or bladder • May vomit FIRST AID FOR SEIZURES • Protect person from injury • Move objects away • Do not restrain • If possible, roll the person onto his/her side to allow saliva to drain • Do not put any thing in her/his mouth • Calm, comfort, reassure • Ongoing assessment SEIZURES • Activate EMS if the person: • Is injured or vomits • Has no history of seizure • Continues to seize for more than 5 minutes • Has more than one seizure (one right after the next) Breathing Difficulty, Shortness of Breath • A medical emergency • Caused by an underlying medical illness such as asthma, allergic reaction, heart failure, or lung disease • S/S: coughing, wheezing, or other unusual breathing sounds; bluish lips or fingers • Treatment: • • • • Call EMS Comfortable position Calm, comfort, & Reassure Ongoing assessment WHAT IS ASTHMA? • Narrowing of the airway • A reversible, obstructive lung disease caused by an excessive reaction of the airways to certain stimuli or “triggers” • cold/change in temp • Exercise • allergies 100 0 1st Qtr 3rd Qtr Eas We No ASTHMA IS NOT • Contagious- Usually genetic • Infectious- It is a chronic disease 3 Components of an Asthma Attack 1. Bronchospasm The smooth muscles that wrap around the windpipe (bronchi) tighten, reducing the size of the airway. normal Asthma attack Components of an Asthma Attack 2. Inflammation The mucosal lining of the windpipe becomes inflamed and swells, thereby reducing the size of the airway even further. 3. Mucus Increased mucus production takes up more space; now the airway is very constricted. Possible Early Warning Signs • The person may cough, especially after activity. • The person may complain of not being able to take a deep breath • The person may have a high pitched wheeze • The person may feel fatigued • He or she may complain of a heavy feeling in the chest, may press on their in chest compensating for the pressure. ASTHMA • Signs/symptoms • Treatment • 1. Labored breathing • 2. Wheezing sound when exhaling • 3. High pitched cough • 4. Weakness • 5. Chest tightness • 1. Assist with medication • 2. Activate EMS if not getting better or no history of asthma • 3. Calm them down • 4. Monitor vitals* WHEN DO YOU CALL 911 • Wheezing or coughing increases after taking medications • Medication doesn’t help within 5 minutes • Difficulty breathing -retractions seen https://www.youtube.com/watch?v=F4YlUXsvFRA -hunched over position • Child has trouble walking or talking, or stops playing and cannot start again • Lips or fingernails appear “blue” ALLERGIC REACTIONS What is an allergy? over reaction by the body to a substance that is normally harmless Causes of allergies (5 I’s) ingestion inhalation injection insects interaction S/S• Itching or swelling of the lips, tongue, mouth or throat • Hoarseness, hacking cough, shortness of breath, wheezing • Hives, itchy rash and/or swelling about the face or extremities • Nausea, abdominal cramps, vomiting, and/or diarrhea ANAPHYLAXIS Life-Threatening Allergies Allergic Reactions Types of life-threatening allergies usually seen in persons: • Insects, Bees •Peanuts and Tree Nuts • Latex or Rubber • Foods Anaphylaxis Symptoms Itching Wheezing Shallow respirations Loss of consciousness • Throat “closing off” • Rapid onset • Sweating • Weakness • Feelings of apprehension • Tingling in mouth, face, or throat ALLERGIC REACTION • What to do: • Call 9-1-1 if onset is rapid (within 1 hour) • Epi-pen or other medication • Calm, comfort, reassure • Continue with ongoing assessement until help arrives What is an “Epi-pen”? • Many people with Anaphylaxis carry an “epipen” with them at all times. • An “Epi-pen” contains a single dose of epinephrine (adrenalin) that when given, will open the airways for approximately 15 minutes and allow them to breathe. • This is only temporary relief. You must also call 911 when a person has an Anaphylaxis reaction. Pain, Severe Pressure, or Discomfort in the Chest • Acute coronary syndrome (ACS) occurs when there is reduced blood flow to the tissues of the heart • Heart Attack • Signs/Symptoms • Pain, pressure, or discomfort in the chest • Women: indigestion, weakness, or fatigue • Shortness of breath, nausea, lightheadedness • Pain in the arms or back • Pale, cool, and sweaty skin Pain, Severe Pressure, or Discomfort in the Chest • Treatment: • Activate EMS • Get AED • Comfortable position • Calm, comfort, and reassure • Ongoing assessment Poisoning • Any substance that can enter the body and create a harmful reaction in the body • Ingested: • prescribed medications, personal care products, household cleaning products • Inhaled: • Carbon monoxide, natural gas, solvent fumes, and chemical vapors Poisoning • Signs / Symptoms • • • • • • • • • • Abdominal pain or cramping Nausea Vomiting Altered mental status Headache Dizziness Difficulty breathing Burns on hands or around mouth, odor of breath Information with witnesses Suspicious circumstances, such as empty containers Poisoning • What to Do: • Ingested • Activate EMS if showing any life-threatening signs • Call Poison Control Center: • 800-222-1222 (NATIONWIDE) • Never induce vomiting unless Poison Control Center tells you – save vomit for EMS • Save bottles/containers for EMS Poisoning • What to Do: • Inhaled • Perform SETUP • Move patient to fresh air – when safe • Contact Poison Control Center • Absorbed • Call Poison Control Center • Dry Powder - brush off dry powder and flush with gallons of water for at least 20 mins. • Liquid - flush with gallons of water for at least 20 mins Severe Abdominal Pain • May be a warning sign of a serious illness • Signs and Symptoms • Appears suddenly or is a new experience for the person • Intense pain • Abdomen may be rigid or tender to the touch • Nauseated and vomit • Treatment • Activate EMS • Find a comfortable position • Calm, comfort, and reassure Heat Emergencies • Occur when a body’s normal temperature-reducing mechanisms get overwhelmed and become inefficient or stop working • Heat Exhaustion • Signs/Symptoms • • • • • • Heavy sweating Pale, cool, sweaty skin Nausea and vomiting Headache Dizziness Feeling weak Heat Emergencies • Heat Exhaustion • Treatment: • Move to a cool place • Loosen or remove excess clothing • Cool person off • Drink fluids Heat Emergencies • Heat Stroke • Body temp rises because the body’s cooling system is overwhelmed or shut down • Signs/Symptoms • • • • Warm, even hot to the touch Heavy sweating may be present…may have red and completely dry skin Confused and trouble communicating May become unresponsive and could have a seizure • Treatment: • EMS…medical emergency • Cool ASAP Cold Emergencies • Hypothermia • Generalized cooling of the body • Occurs when body temp is below 95° F • Signs/Symptoms • Pale, cold skin • Uncontrollable shivering • Loss of coordination • Treatment • • • • • Remove wet clothing and cover with something warm & dry Activate EMS Move to a warm place Cover head and neck to retain body heat Rewarm near a heat source Cold Emergencies • Frostbite • Skin and underlying body tissue freezes • Most common: fingers, toes, earlobes, cheeks, and nose • Prevent freezing by simple skin-toskin rewarming technique • Signs of freezing • Loss of feeling in affected part • Firm, pale, cold, numb skin • Treatment • • • • Warm place Activate EMS Remove wet clothes Do not rub or massage affected area • Remove jewelry • Place clean pads between fingers & toes • Wrap with clean towel or pad Stinging Insects • If a stinger is present in the skin, remove it as quickly as possible • S/S: local pain, redness, swelling, itching • Treatment • General: wash site with soap & water • Cover with band-aid • Use local cooling to help reduce swelling & pain • Watch for allergic reaction Snake Bites • Venomous snakebite is a medical emergency • Person sit and stay calm • Activate EMS • Remove any constricting items from the affected limb • Control any bleeding with clean pad & direct pressure • Do not apply a tourniquet, cold compresses, or try to suck out the venom • Keep person warm, reassure, and quiet Marine Animal Stings • Sea Anemones or Jellyfish • Wash wound with vinegar for at least 30 sec to deactivate the venom • Take hot shower or bath for 20 mins to ↓ pain • Monitor ABCs Animal and Human Bites • Control bleeding with direct pressure • Wash area with lots of water • Seek professional medical attention • Can cause bacterial infection Plan of Action • Homework a) List the disasters most likely to affect your household. • Homework b) What are the escape routes from your home? i. Draw a picture of your family’s house ii. Draw arrows to show two (2) exits from each room iii. Draw a meeting place outside near the home iv. If you can’t return home or are asked to evacuate, what is your meeting place outside your neighborhood? i. What if your best route there? ii. If that is impassable, then how do you get there? •Homework c) Make a list of supplies you will need to last at least three (3) days i. Must include at least 15 items d) Homework is due: _____________