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The NBO Scout Training Team BSA Crew 911 www.scoutcpr.org Introduction to WFAB… Course Information… Certification Requirements Certification Length Purpose of Certification Course Outline Course Schedule 2 What are three things that have to happen at any accident or injury scene An accident or injury has to occur! “Someone” has to recognize that a accident or injury has occurred! YOU must decide to ACT! What is Delayed Care? 3 A Delayed Care Situation is when professional help is more than 30 minutes away… Rural Areas Construction Sites The Wilderness Natural Disasters Terrorist Acts 3A Some Delayed Care Activities… Sailing – Mountaineering Kayaking – Backpacking Rafting – Hiking Skiing – Camping Canoeing – Horse Back Riding Ballooning - Caving 3B A Delayed Care Situation is also when there is no easy way… To Call for Help For emergency personnel to reach the victim To transport the victim to medical care. 3C Emergency Action Steps! 4 CHECK… CALL… CARE… Check The Scene and then the Victim… Check for Available Resources Never put yourself in danger!… dead or injured heroes are no help to anyone! 4A CHECK… CALL… CARE… Make a plan… carry out the plan. Get Help! In a delayed care situation, you have to think, plan then choose. 4B CHECK… CALL… CARE… Provide Care… Care FIRST for lifethreatening conditions Monitor the patient Provide care for the conditions you find… 4C Check the Scene… Take Charge List Tasks to be Performed Followership/Leadership Approach Safely! Do emergency moves if needed 5 Check the Patient… Do Urgent First Aid Initial Assessment Protect the Patient Prioritize Care Check for Other Injuries 6 Check for Available Resources… Number of people that can help Communications Food Supply - Water Supply Shelter Supplies Transportation 7 Call for Help… Plan what to do Get Help! Calling – Distress Signals Sending for Help Leaving a patient alone Transporting a patient 8 Care in a Delayed Care Situation… Remain Calm Do No Further Harm! Monitor the patient Every 15 minutes at least Continuously for Serious Injuries 9 Injury Prevention… 10 Cause and Prevention of Injuries… Reasons why injuries occur Bad Judgment using equipment Bad Judgment of ability Environmental conditions Equipment Failure 10A Risk and Safety Risk is a number, a statistic. Safety is a judgment call. 11 Being Prepared… Four types of preparation… Mental preparation Physical preparation Group preparation Material preparation 12 The Ten Essentials… Map of the area – Compass Flashlight with batteries & bulb Extra Food – Extra Clothing Sunglasses and Sunscreen Pocketknife – Matches Candle – First Aid Kit 13 Other important items… Full Water Bottles Ground Insulations Shelter – Emergency Blanket Singling device – Duct Tape Special environmental concerns 14 First Aid Kit… Include plenty of sterile absorptive material Water tight compartments Specific to the area No prescription drugs First Aid Directions First Aid Report Forms 15 Observations… Circumstances Extent of Injuries Introduce yourself Obtain consent If victim is conscious do a physical exam and SAMPLE history 16 SAMPLE History… S - Signs/Symptoms A – Allergies M – Medications P – Pertinent Past History L – Last food or fluid intake E – Events proceeding 17 General Principles of a Physical Exam Do NO FURTHER HARM! Be complete and systematic Use direct observation Compare body parts One person does the exam Make multiple observations Record what you find! 18 Observe DOTS… D – Depressions O – Obvious deformity T – Tenderness S - Swelling 19 Vital Signs… Pulse – Breathing Skin Color – Temperature Pupil Reaction Level of Consciousness LOC Sensation Ability to Move 20 Level of Consciousness… A – Alert V – Verbal P – Painful response only U – Unresponsive 21 Disease Transmission… 22 Route of disease transmission… Direct – Touching body fluids Indirect – Touching bandages or contaminated equipment Airborne – Inhalation Vector borne – By an animal bite or insect sting 22A Steps to prevent Disease… Wear Gloves – Wash you Hands! Dispose of soiled stuff properly Cover cuts and scrapes Avoid touching your eyes Use a CPR mask If you are exposed… See your Doctor 23 Wound Care… 24 Steps to control Severe bleeding… Well aimed Direct Pressure Elevation above the heart Pressure Bandage Pressure Point Do not become discouraged! 24A Preventing Wound Infection… Wash your hands – use gloves Wash the wound area Do not attempt to close large wounds Cover with a sterile dressing Change dressing daily Maintain Immunizations 25 Water Sterilization… Remove the big stuff Boil for at least 1 minute Rinse container with boiling water – and let sit for 1 minute Pour out rinse water and put the boiled water into the container Cover container – Let it cool 26 Eye Injuries… Lodged Objects… Clean water rinse from nose to ear Lift object out gently with gauze Embedded Object Stabilize object as found Do not attempt to wash it out Evacuate on a stretcher 27 Head, Neck and Back Injuries 28 Causes of Head Neck and Spinal Injuries Direct Blow to the spine Blow to the head Falls on the buttocks Falls from higher than victims height Broken helmet - Driving mishap Unconsciousness, reason unknown Lightning strike – Severe Blunt Force 28A Signs and Symptoms of spinal injury… Change in Consciousness Problems with breathing or vision Inability to move a body part Ongoing Headache – pain/pressure Nausea and vomiting Loss of balance (more) 29 Signs and Symptoms of spinal injury… Bleeding of the head neck or back Burse behind ears or under eyes Blood or fluid from the ears or nose Unusual bumps or depressions Very Slow Pulse Unequal pupils – Unequal response to light or a moving object 29A Types of head injuries… Skull Fracture Brain Injury: Concussion Bleeding within the skull 30 First Aid Goals – Head Injuries… Prevent further injury Assess seriousness Watch closely for changes Patient may walk out IF… Injuries appear minor Patient is able to walk steadily The terrain is safe 31 First Aid Goals – Spinal Injuries… Prevent further injury Assess the cause and seriousness Monitor Vital Signs Evacuate Professionally as soon as possible 32 Chest Injuries… Two common types: Penetrating Rib Fractures 33 Chest Injuries First Aid Goals… Assess seriousness Prevent further injury Help increase ease of breathing Watch closely for changes Evacuate Immediately 33A Abdominal Injuries… Open Injury Possible protruding intestines Care for as other wounds except use an occlusive dressing on organs Closed Injury Bruising, rigidity or tenderness Care by monitoring closely, treat for shock, evacuate 34 Extremity Injuries… Fractures Open or Closed Pain and reluctance to use Possible deformity Tenderness Swelling, instability and bruising First Aid… Immobilize to reduce pain and prevent further injury 35 Extremity Injuries… Dislocations Occur at joints Pain Loss of ability to use joint Deformity, limb looks shorter Tenderness and Swelling Joint seems locked in place First Aid… Immobilize in place 36 Extremity Injuries… Sprains & Strains Strain – over stretched muscle Sprain – torn ligament Pain, aggravated by motion Localized tenderness and swelling Difficult to distinguish from fracture First Aid… RICE and Immobilize 37 Extremity Injuries… First Aid Goals Assess seriousness Prevent further injury RICE… R – REST I – Ice or cold pack C – Compression E - Elevation 38 Splinting 39 Splinting… General Principles Determine location of injury and assess circulation, sensation and movement. If an open injury, stop bleeding. Rinse bone ends with large amounts of sterile water If severely bent and NOT AT A JOINT, firmly by gently straighten limb Remove rings, watches, etc. 39A Splinting… General Principles (cont) Prepare a splint… pad well Tie splint on securely Neatness counts Observe area below splint for feeling, warmth and color at least once every 30 minutes If available, apply RICE 40 Burns 41 Causes of Burns Heat Chemicals Electricity Radiation and Explosions 41A Types of burns… Superficial Partial Thickness Full Thickness 41B First Aid Goals… Burns Rule of 9’s – Prevent further injury Treatment of thermal burns: Cool the Burn Wash with sterile water Remove jewelry Apply antibiotic ointment Elevate, treat for shock 42 Shock 43 Shock… Early Stages Patient is aware, restless, anxious Skin is pale, cool, clammy Heart and respiration rate is rapid Patient is thirsty or nauseous 43A Shock… Later Stages Patient is lethargic, apathetic or unconscious Skin is gray, cool and damp Heart rate is weak and irregular Respiration is very low or shallow and irregular Eyes are dull and dilated 44 Shock… First Aid Goals Ensure patient is breathing Stop any obvious causes Maintain Body Temperature Treat patient gently Replace lost fluids Raise Legs is injury allows Monitor continuously - Evacuate 45 Shock… Delayed Care Situations If patient will be able to get to a hospital in a few hours, do NOT give food or fluids If longer, give sips fluid at a rate of 4 oz to an adult over a 20 minute period For a child, 1/2 the amount Do not give fluids if unconscious or if there is a head or abdominal injury 46 HYPOTHERMIA 47 Mild Hypothermia Complains of cold Uncontrolled shivering Decreased fine motor coordination Disagreeable or apathetic Core Temperature still above 90 Deg F First aid – END Exposure! 47A Moderate to severe Hypothermia Increasing lethargy and confusion May or may not be shivering Slurred speech Stiff, stumbling walk Unresponsive or unconscious Pulse and respiration may be undetectable Core Temperature below 90 Deg F 48 First Aid for Moderate to severe Hypothermia End Exposure Replace wet clothing Rewarm slowly – body core first Use Hypothermia Wrap if possible 49 Heat Related Injury 50 Effects of excessive heat Heat Cramps and fainting: Rest in a cool place Heat Exhaustion: Skin is pale and damp Nausea, weakness, dizziness, thirst, headache Cool, fluids in small sips, recovery may take 24 hours 51 Effects of excessive heat-Heat Stroke Lifethreatening condition Exertional heat stroke Classic heat stroke Reduce body temperature Cool with wet cloths Monitor for rebound If Conscious, give small sips of water Evacuate by stretcher 51A Sudden Illness 52 Sudden Illness… Difficulty Breathing Chest Pain Unconsciousness Allergic Reactions Seizures Diabetic Emergency 52A Snake bites… Pit Vipers, Coral Snakes First Aid: Keep patient calm Clean the wound Immobilize limb below heart Travel slowly – Rest frequently DO NOT cut and suck, use a tourniquet, cold or electrical shock 53 Insect stings and bites generally localized Stings to inside of mouth or nose may cause breathing problems Anaphylactic shock is lifethreatening Ask patient if they have had a reaction before Remove stinger by scraping Apply cold for swelling 54 Spider bites Two common spiders in the US Brown Recluse Black Widow Seek medical help if pain is severe or if there is breathing difficulty 55 Tick bites Can carry disease Remove ticks by: Grasp tick close to skin Pull out with steady pressure Clean and disinfect bite and hands DO NOT use petroleum jelly or burn the tick 56 Other Miseries Blisters Dental Emergencies Diarrhea from Contaminated water Fainting Headache Disease from wild animals Lightning 57 Putting it all together! 58 Carrying out the plan… The action portion of the plan takes place after: All first aid has been given The plan has been formulated The equipment assessed The party is ready Patient Monitoring Altering the plan 58A Questions? The NBO Scout Training Team BSA Crew 911 www.scoutcpr.org