Download Occupational First Aid Student Notes Aims of First Aid: To preserve

Aims of First Aid:
Occupational First Aid Student Notes
To preserve life
To prevent the condition worsening
To promote recovery
Responsibilities:
Assess the situation – Scene safe, get help and protect yourself, others, casualty from danger
Make a diagnosis
Provide treatment
Arrange for removal to hospital
Prevent cross infection in so far as possible
Make report for the Emergency Services
Emergency Services
Call 999 or 112
1. Phone number you are calling from
2. Location
3. Incident/Accident
4. Other Services
5. Number of casualties
6. Extent of the injury or illness
Patient Assessment:
Vital Signs:
Primary Survey
A = Airway – Trauma Patient? Consider C-spine
B = Breathing – Is the patient breathing? Look, Listen, Feel
C = Circulation – Signs of circulation or severe bleeding?
D = Disability – Levels of response:
A = Alert
V = Voice
P = Pain
U = Unresponsive
Secondary Survey
Breathing – Rhythm, Rate: Adult 12 – 20 per min, Child 15 – 30 per min, Infant 25 – 50 per min
Pulse – Rhythm, Rate: Adult 60 – 80 per min, Child 70 – 150 per min, Infant 100 – 160 per min
Skin – Colour, Temperature, Moisture
Capillary Refill – Circulation in hands & feet, should be less than 2 seconds
History of Casualty:
S = Signs and Symptoms
A = Allergies
M = Medications
P = Pertinent past history
L = Last oral intake
E = Events leading to injury or illness
Head to Toe Exam:
Head = DOTS, Eyes – Pupils Equal Round Regular Light, Mouth – odd breath odours, teeth,
Neck = DOTS of C spine area, medical ID jewellery
Chest = DOTS, equal expansion of chest and use of accessory muscles
Abdomen = DOTS
Lower back = DOTS of lumber’s spine area
Pelvis = DOTS, bodily fluids
Legs & feet = DOTS, pulses, CSM’s
Arms & hands = DOTS, pulses, CSM’s, medical ID bracelet, needle marks
Recovery Position:
1. Kneel beside the casualty, remove spectacles and bulky objects from the pockets
3. Position nearest arm right angles to body
4. Raise furthest leg and pull it up until foot is flat on the floor
5. Bring the back of furthest hand against cheek nearest you
6. Pull on far leg, roll him towards you, onto his side and adjust leg – knee is bent at right angles
8. Tilt heat back to ensure that the airway remains open
Chain of survival:
Cardiac Arrest
Causes:
Recognition:
Treatment:
Cardiopulmonary Resuscitation
Early Access = getting help; an ambulance and AED
Early CPR = supplies blood to heart & brain
Early Defibrillation = a shock may restore the heartbeat
Early Advanced care = specialised life support treatment
“The Heart Stops”
Heart Attack, Drowning, Poisoning, Electrocution, Major Injuries , Anaphylaxis
Unresponsive and not breathing
Chain of Survival
Adult CPR:
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Check Scene Safety
Check for Response (Gentle Tap and Shout)
No Response
Call for help – Dial 999 or 112, ask for a Cardiac Ambulance & AED
Open the Airway (Head tilt, Chin lift)
Check for breathing (Look, Listen, Feel, 5-10 sec.)
Not Breathing
Give two rescue breaths (1sec. Each)
Hand Position (two hands on centre of chest)
Give 30 Chest Compressions (takes 18-20 sec’s)
Depth of compression 4 – 5cm at a rate of 100 per min
Give two breaths (1sec. Each)
Continue CPR (30:2) until: AED becomes available
Casualty shows signs of life
EMS takes over
If you are too tired to continue
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Check Scene Safety
Check for Response (Gentle Tap and Shout) – No Response
Call for help – Alone do CPR for 2 mins then dial 999 or 112, Not alone ask them
Open the Airway – Head tilt, Chin lift (neutral position for Infant)
Check for breathing (Look, Listen, Feel, 5-10 sec.)
Not Breathing
Give two to five rescue breaths (1 sec. Each)
Child: one or two hands on centre of chest
Infant: two fingers just below nipple line
Give 30 Chest Compressions
Depth of compression 1/3 to 1/2 at a rate of 100 per min
Give two rescue breaths – 1 sec. Each
Do 5 cycles of 30:2 – takes approx. 2 mins
If alone phone for a cardiac ambulance now
Continue CPR until: Casualty shows signs of life, EMS takes over, You are too tired to continue
Child & Infant CPR:
Partial obstruction:
Treatment:
Airway Obstruction (Choking)
Good air exchange is still present
Encourage the casualty to Cough
Full obstruction:
Signs & Symptoms:
Poor air exchange
Difficulty breathing
Weak and ineffective cough
Unable to speak, cry, cough
Cyanosis – Skin, fingernail beds/lips bluish grey
Universal distress sign – Grasp throat
Airway Obstruction:
Pregnant or Obese – Do chest thrusts
Wheelchair bound – Kneel behind, remove sides
Adult or Child Choking:
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Check for safety
Ask the casualty are you choking? Unable to cough and speak
Give up to 5 back blows; Check effectiveness after each back blow
If Unsuccessful
Find Hand position just above belly button
Give up to 5 abdominal thrusts
Check for effectiveness after each abdominal thrust
Repeat back blows & abdominal thrusts until successful or casualty goes unconscious
If the casualty goes unresponsive
Call For Help – Dial 999 or 112
Start CPR checking the mouth for foreign body each time before giving a breath
Continue with CPR until help arrives
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Check for safety
Baby has ineffective cough or is making high pitched sounds
If Unable to cough, cry or breathe
Give up to 5 Back Blows (Position the baby head downwards)
Check effectiveness after each back blow
If Unsuccessful
Give up to five Chest Thrusts (Position the baby face upwards)
Find finger position (2 fingers just below nipple line)
Check for effectiveness after each chest thrust
Repeat back blows & chest thrusts until successful or baby becomes unconscious
If the Infant goes unresponsive
Call for Help – Dial 999 or 112
Open the Airway (head tilt, chin lift)
Attempt to ventilate – If the Breath does not go in reposition the head and try again
Attempt up to five rescue breaths
Start CPR checking the mouth for foreign body each time before giving a breath
Continue with CPR until help arrives
Infant Choking:
The Heart:
Electrical Activity:
Cardiac Arrest
Treatment:
Automated External Defibrillation
Heart is a muscle; 4 chambers coordinate blood flow.
Pacemaker cells emit electrical impulses; heart contracts.
Normal sinus rhythm
Heart disease can cause the heart to malfunction and causing:
Ventricular fibrillation (VF) or Ventricular tachycardia (VT)
CPR must be performed until defibrillator arrives
VF and VT can be corrected with defibrillation, but time is critical, for every minute that
defibrillation is delayed, casualty’s chance for survival decreases by 7% to 10%.
AED Electronic device: Analyses the heart rhythm
Determines and advises need to shock
Delivers electrical shock to the casualty in cardiac arrest
Re-establishes a heart rhythm that will generate a pulse
Common elements:
On/off button & Cable and pads (electrodes)
Analysis capability
Defibrillation capability
Prompts to guide you
Battery operation for portability
Using an AED:
1. Turn the unit on
2. AED pads to bare chest and the cable to the AED
3. Stand clear and analyse the heart rhythm
4. Deliver a shock if indicated
5. Perform CPR, 30:2 for 2 mins
6. Check casualty & repeat analysis
7. Shock & CPR steps as needed
Considerations:
Water – Remove casualty from water and dry the chest
Children – Under 8 years
Medication patches – Remove patches and wipe skin
Implanted devices – Pacemakers and defibrillators
Avoid placing electrode pads over devices
AED Maintenance:
Preventive maintenance checks are recommended by manufacturers.
Automatically perform periodic self-tests, but it should be checked daily to ensure proper operation
Check expiration and replacement dates on electrode pads and batteries
Arriving ambulance crews may choose to continue with your AED or attach their own unit
Definition:
Shock
Circulatory failure or collapse when the arterial blood pressure is too low to provide an adequate
supply of blood to the tissues. As a result of this, the vital organs such as the heart and brain are
deprived of oxygen. Permanent damage to body parts possible if untreated
Circulatory System
Failure:
Pump failure – Heart Attack or Angina
Blood loss – from internal or external injuries
Loss of Fluid – burns, dehydration, vomiting, diarrhoea
Pipe failure – poisoning, spinal injury, anaphylaxis
Sign & Symptoms:
Pale, cold and clammy skin
Nausea and vomiting
Unresponsiveness (when shock is severe)
Treatment:
1. Treat severe and life-threatening injuries
2. Position casualty on his or her back
3. Raise casualty’s legs 30 cm
4. Prevent heat loss, Insulate from the ground
5. Call 999/112 for an ambulance
6. Calm, reassure and monitor airway and breathing
Anaphylaxis:
Causes:
An allergic reaction to substances that enter body causing over production of histamine
Medications – penicillin, aspirin
Foods – peanuts, fish, wheat, dairy products
Insect stings
Plants
Signs & Symptoms:
Breathing difficulty, sneezing, coughing
Skin reaction, tightness in chest
Swelling of tongue, mouth, or throat
Blueness around lips and mouth
Dizziness, Nausea and vomiting
Treatment:
1. Call 999/112 for an ambulance
2. Check Airway and breathing; be prepared to start CPR
4. If casualty has own auto-injection, help with its use
5. Even if casualty appears to recover – must go to hospital
Rapid breathing
Altered mental status
Bleeding Types:
Wounds Type:
External Bleeding
Treatment:
Bleeding and Wounds
Capillary (oozing)
Venous (Dark red and flowing)
Arterial (Bright Red and spurting)
Abrasion – Top layer of skin, little blood loss – graze
Avulsion – Piece of skin torn loose/hanging from the body
Amputation – The cutting or tearing off of a body part
Incision – Cut with smooth edges such as a knife
Laceration – Cut/torn skin with jagged edges – barbed wire
Puncture – Object entering the body, high risk of infection
P = Position the patient – Lie or sit casualty down
E = Elevate the area
E = Expose and examine the wound – Wear Gloves
P = Pressure bandage
S = Shock treatment
Internal Bleeding
Causes:
Blunt Trauma, Crush Injury, Fracture, Ulcer
Signs & Symptoms:
DOTS, Vomiting or coughing up blood, Black or bright red stool
Treatment:
Serious Internal Bleeding – Call 999 and Treat for shock
Minor Internal Bleeding – Rest, Ice, Compression, Elevation
Fracture Types:
Musculoskeletal Injuries
Closed fracture – there is no laceration in the overlying skin
Open fracture – an open wound lies over the fracture
Complicated Fracture – injury to other important structures
Causes:
Direct force – falling on your back or struck by a blunt object
Indirect force – collar bone, spine
Muscular action – patella
Disease – osteoporosis
Signs & Symptoms:
Deformity, Open wounds, Tenderness, Swelling
Inability to use injured part, crepitus, heard bone break/ snap
Treatment:
1. Expose and Examine, stabilise injured part, prevent movement
2. Apply ice pack to reduce swelling and pain
3. Treat for shock, Call 999/112
4. If it is an open fracture: Cover wound and exposed bones without applying pressure on the bone
Sprain:
Signs & Symptoms:
Injury to the ligaments surrounding a joint – overstretching or a sudden twisting movement
Pain, swelling and inability to use limb
Treatment:
Rest the injured part
Ice apply an ice packs to the injured part for 10 minutes
Compression – wrap firmly with an elastic bandage
Elevate the injured part to reduce swelling
Dislocation:
Signs & Symptoms:
A strong force, an unnatural movement or a muscle contraction can cause dislocation
Pain, deformity, swelling and tenderness
Treatment:
Splint as found, provide the same care as for fracture
Do not attempt to put the joint back in place and Call 999/112
Skull Fracture:
Head and Spinal Injuries
1. Dome or vault of the skull can be fractured by a heavy blow leading to a depressed fracture
2. Indirect force, landing awkwardly from a fall or a blow to jaw, could fracture base of the skull
Signs & Symptoms:
Pain and Deformity at point of injury
Bruising under eyes or behind ears
Heavy scalp bleeding
Penetrating wound
Treatment:
1. Dial 999/112 for an ambulance
2. Stabilise head and neck to prevent movement
3. Monitor breathing and provide care if needed
4. Control bleeding by applying a sterile dressing
5. Apply pressure around edges of wound
Brain Injury
Concussion:
Signs & Symptoms:
Brain Injury
Compression:
Signs & Symptoms:
Treatment:
Nosebleeds
Treatment:
Broken Nose
Signs & Symptoms:
Treatment:
Spinal Injuries
Causes:
Blood or clear fluid from ears or nose
Changes in pupils
‘Soft spots’ in skull
Associated spinal injury
Temporary disturbance of brain activity – blow to head
Pale, cold, clammy skin
Rapid respirations and pulse
Sudden onset
Confused and memory loss
Pupils equal
Nausea may vomit
Build-up of pressure on brain caused by bleeding or swelling
Flushed, dry, hot skin
Noisy slow respirations
Slow, full & bounding pulse
Gradual onset
Unequal pupils
Go unconsciousness
1. Dial 999/112
2. Monitor ABC and Response Levels
1. Sit and lean the casualty head slightly forward
2. Pinch soft part of the nose together for 5-10 mins
3. Seek medical care if: Bleeding does not stop
Pain, swelling and possible crookedness
Bleeding and difficulty breathing through nostrils
Black eyes appearing 1 to 2 days after injury
1. same as for a nosebleed, apply ice pack to nose for 10 mins
3. Do not try to straighten a crooked nose
4. Seek medical care
Collision accidents – Road traffic accidents
Impact accidents – direct or indirect blows
Diving accidents – swimming pools
Sudden violent movements – sports injuries
Signs & Symptoms:
Inability to move arms/legs
Numbness, tingling, weakness in arms/legs
Deformity of Neck (C1-C7) Neck/back pain
Treatment:
1. Call 999/112
2. Stabilise head & neck; prevent movement
3. If unresponsive: Chain of Survival
Burns Types:
Burns
Dry Burns – hot surfaces, fire, friction
Scalds – hot liquids, hot fat or oil, steam
Cold Injury – freezing temperatures, refrigerants
Radiation Burns – sunburn, ultraviolet lamps
Chemical Burns – Acids, alkalis, cleaning products
Electrical Burns – Low voltage, Lightning, High voltage
Burn Depths:
Superficial – Redness, Mild swelling, Tenderness, Pain
Partial-Thickness – Blisters, Swelling, Weeping fluids, Pain
Full-Thickness – Leathery, waxy pearly grey, charred skin
Thermal Burns:
Do Not: Burst blisters or touch the burnt area
Apply any creams or ointments
Remove clothing that is stuck to the skin
Apply adhesive dressings
Superficial Burns
Treatment:
1. Wear disposable gloves
2. Cool burn with cold water for 10 minutes
3. Remove clothing or jewellery
Partial-Thickness Burns
Treatment:
1. Wear disposable gloves
2. Remove clothing or jewellery
3. Cool burn with water for 10 minutes
4. Cover burn with dry, non-adhesive, sterile dressing
5. Treat for Shock
Full-Thickness Burns
Treatment:
1. Call 9-9-9/112 for an ambulance
2. Wear disposable gloves
3. Remove clothing or jewellery
4. Cover burn with dry, non-stick, sterile dressing
5. Monitor airway and breathing, provide care as needed
6. Treat for shock
Chemical Burns:
Treatment:
Chemicals in the Eye
Treatment:
Results from caustic or corrosive substance: Acids, Alkalis, Organic compounds
1. Dry Chemical – Brush chemical off skin
3. Wet Chemical – Flush skin with water for 20 minutes
4. Remove contaminated clothing and jewellery – Gloves on
5. Cover the burn with a dry, sterile or clean dressing
6. Seek medical care
1. Flush with warm water for 20 minutes
2. Position head appropriately
3. Loosely bandage both eyes
4. Seek immediate medical care
Electrical Burns:
Thermal burn (flame)
Arc burn (flash)
True electrical (contact)
Treatment:
1. Make the scene safe – disconnect the power at fuse box or circuit breaker
2. Check ABC and Check for spinal injuries
4. Cover burns – entrance and exit wounds
5. Treat for shock
6. Call 9-9-9/112 for an ambulance
Heart Attack:
Signs & Symptoms:
Treatment:
Aspirin
Indication:
Contraindications:
Effect:
Side Effects:
Dose:
Route:
Angina:
Signs & Symptoms:
Sudden Illness
Blood supply to part of the heart muscle is reduced or stopped, heart muscle starts to die
Chest pressure, squeezing, dull ache or pain
Pain spreading to shoulders, neck, jaw, or arms
Dizziness, sweating, nausea or vomiting
Shortness of breath
1. Call 9-9-9 or 1-1-2
2. Help casualty into comfortable position: Half-sitting position, support head, back & under knees
4. If the Casualty becomes unconscious start Chain of Survival
Cardiac chest pain
Allergy
Stomach ulcers
Anticoagulant therapy or bleeding tendency
Under 16 years old
Reduces further clots and thrombus formation
Gastric irritation and bleeding
Severe bronchospasm
300mg
Orally to be chewed or dispersed in water
Record on Patient report – Do Not Keep Aspirin in the First Aid Kit
Brought on by physical activity, exposure to cold or emotional stress
Heart does not get enough oxygenated blood
Similar to heart attack, does not last longer than 10 minutes
Treatment:
1. Allow them to rest, if has GTN, help him/her take it.
2. If pain lasts longer than 10 minutes, call 9-9-9 or 1-1-2
Stroke:
Signs &Symptoms:
Part of blood flow to brain is cut off, caused by either a blocked or ruptured blood Vessel
Sudden, severe headache
Weakness or paralysis of face/one side of body
Difficulty in speaking
Dizziness or loss of balance
Blurred or decreased vision
Unresponsive
Assessment:
F –facial weakness
A –Arm weakness
S –Speech problems
T –Time to call 112/999
Treatment:
1. Check: Airway, Breathing, Call 112/999
2. Keep comfortable, if Unconscious – Recovery position
4. Do not give anything to eat or drink
Asthma:
Signs & Symptoms:
Air passages narrow and mucus builds up, resulting in poor oxygen exchange
Breathing is abnormally fast or slow, deep or shallow
Noisy breathing – wheezing, gurgling, crowing, cyanosis
Unable to speak in complete sentences
Casualty is very anxious
Treatment:
1. Position of comfort
2. Assist with asthma inhaler
3. If condition does not improve in 5 minutes call 9-9-9/112
Fainting
Signs & Symptoms:
Temporary loss of consciousness caused by a decreased blood flow to the brain
Sudden but normally brief unresponsiveness, Pale, sweating skin, slow pulse
Treatment:
1. Open airway, check breathing and provide care
2. Raise legs 30 cm, Loosen tight clothing
3. If casualty fell, check for injuries
4. Seek Medical Care if: Has repeated fainting episodes
Does not regain consciousness quickly
Faints for no apparent reason
Seizures:
Causes:
Resulting from abnormal stimulation of the brain’s cells
Alcohol withdrawal
Drug overdose
Electric shock
Fever
Infection
Heatstroke
Shock
Hypoglycaemia
Poisoning
Stroke
Signs & Symptoms:
Sudden falling
Unresponsiveness
Rigid body
Back arching and Jerky muscle movement
Treatment:
Protect from injury by moving away any objects
Loosen any restrictive clothing
When the seizure is finished, place in recovery position
Do not put anything in casualty’s mouth or restrain casualty
Call 9-9-9 if:
Unknown reason or longer than 5 minutes
Slow to recover, second seizure, or difficulty breathing
Pregnant or medical condition
Signs of illness or injury
Diabetes:
Insulin is either lacking or ineffective. It helps to regulate blood sugar levels, body cells become
starved of sugar:
Type I: Insulin dependent, juvenile onset
Type II: Non-insulin dependent, adult onset
Hypoglycaemia:
Causes:
Signs & Symptoms:
Very low blood sugar
Insufficient food, over exercise or excessive insulin
Anger
Confusion
Sudden hunger
Excessive sweating
Sudden onset
Pale colour
Poor coordination
Trembling
Seizures
Unresponsiveness
Hyperglycaemia:
Causes:
Signs & Symptoms:
Very high blood sugar
Insufficient insulin, overeating, inactivity or illness,
Drowsiness
Extreme thirst
Frequent urination
Gradual onset
Rapid breathing
Fruity/sweet Breath odour
Unresponsiveness
Vomiting, warm and dry skin
Treatment:
1. Give sugar (drink, snack, and sandwich)
2. Condition doesn’t improve in 15 mins, give sugar again
3. If still no improvement, call 9-9-9/112
Asphyxia:
Causes:
Oxygen cannot reach the tissues of Lungs due to an obstruction or damage to respiratory system
Paralysis of the respiratory nervous system
Compression to the chest
Lack of oxygen in the air
Compression of the neck
Suffocation and obstructed airway
Medical conditions
Poison:
Enter Bodies:
Any substance that impairs health or causes death (toxin)
By ingestion – things eaten or drunk
By inhalation – gases or fumes
By injection – stings, bites or needles
By absorption – chemicals, toxic vapours
By instillation – harmful substances splashed into eyes
Ingested Poisons
Signs & Symptoms:
Abdominal pain, cramping, nausea, vomiting, diarrhoea
Burns, stains, odour near or in mouth
Drowsiness or Unresponsiveness
Poison containers nearby
Treatment:
1. Wear PPE – gloves
2. Determine – Age & size of casualty, What and how much poison ingested, When it was taken
3. Call 9-9-9/112, Open airway, Check breathing
4. If breathing, place casualty in recovery position
5. Ensure you do not become contaminated
Heat Exhaustion:
Signs & Symptoms:
Loss of water and salt through heavy sweating
Heavy sweating , severe thirst, Headache, Nausea and vomiting
Treatment:
1. Stop activity and rest in cool place
2. Remove excess or tight clothing
3. Provide water or commercial sports drink
4. Have casualty lie down; raise legs about 30 cm
5. Apply cool, wet towels to casualty
6. Seek medical care if no improvement
Heatstroke:
Signs & Symptoms:
Body temperature is extremely high
Extremely hot/dry skin, Confusion, Seizures, Unresponsiveness
Treatment:
1. Stop activity and rest in cool place, Call 9-9-9
2. If unresponsive, Chain of survival
3. Rapidly cool patient with cool/wet towels, fanning and cold pack
Hypothermia:
Signs & Symptoms:
Body temperature falls more than 2°C
Mild – Uncontrollable shivering, Confusion or lethargy, Cold skin even under clothing
Severe – No shivering, Muscles stiff and rigid, Appear to be dead
Treatment:
1. Remove from cold
2. Prevent further heat loss: replace wet clothing, cover head, place blankets around casualty
3. Handle gently, rewarm gradually and lie casualty down
5. Give casualty warm, sugary beverages
6. Seek medical care