First Aid for Child Care - Welcome to Jason Roosevelt

Report
• Jason Roosevelt
• Certified for 14 years
– Adjunct Faculty at Phoenix College
• Teaching for 8 years
– ASHI/AHA CPR instructor trainer
• Teaching for 8 years
• Fire Communications Lead
– 8 Years
 If you are the first on the scene of accident
that results in an injury or serious illness,
you may be the only link between a victim
and emergency medical care. Your role is
to take action, whether by providing first
aid, seeking medical help or calling 911.
Your actions may improve the victims
chance of recovery.
 The following slides will provide specific
information from The American Safety &
Health Institute (ASHI) on basic first aid
procedures.
• The important of this training is for the first
person on the scene of an accident or
emergency illness to know the steps to
keep the patient alive:
• HELP UNTIL QUALIFIED HELP
ARRIVES!
• At work, injuries, and illnesses kill more
than two million people in the world each
year.
• 1 death every fifteen seconds.
• 6000 people a day.
• By focusing on safe practices and making
healthy choices we can prevent this
horrible tally of injury, illness, disease, and
death.
• Once injury or sudden illness has
occurred, providing effective first aid can
make the difference between life and
death, rapid vs. prolonged recovery, and
temporary vs. permanent disability.
• This program focuses on what you must
know and do in order to maintain your
composure and provide confident,
effective first aid care.
• METHOD: Physical skill demonstration by
student in classroom and assessed by ASHI
authorized instructor
• Demonstrate Proper Removal of Contaminated
Gloves
• Perform the Emergency Action Steps for an
Unresponsive and Responsive Victim
• Place a Victim in a Recovery Position
• Control Severe Bleeding and Manage Shock
• Manually Stabilize an Injured Limb
• Manually Stabilize a Suspected Spinal Injury
• Infectious Illnesses
– There have been no documented cases
where use of training manikins has
been responsible for transmission of
bacterial, fungal, or viral diseases.
– ASHI authorized instructors routinely
and thoroughly clean and disinfect
training manikins.
– To prevent spread of infectious
illnesses, both instructors and students
should clean their hands often, using
alcohol-based hand sanitizers or soap
and water.
• Infectious Illnesses
Please do not participate if:
– Your hands, mouth, or lips have skin
lesions.
– You are ill.
• To prevent injury during skill practices:
– Avoid awkward or extreme postures of
the body.
– Do not practice moving simulated
victims if you have a history of back
problems.
– Practice of these moves may aggravate
previous back injuries.
• Reason for Learning
– Common legal issues are an important
element of care and a frequent concern
of First Aid Providers.
• Always identify yourself prior to requesting
permission to treat them.
- By treating the
patient to the best of your ability, treating
within your level of your training, are
neither reckless or negligent and are
acting in good faith, reduces the chance
you will be sued.
– This does not protect you from gross
negligence.
– “Act as any prudent person would.”
Good Samaritan Principle and Laws
•
•
•
•
Legal principle/law based on Biblical story.
Prevents a rescuer who has voluntarily helped a
stranger in need from being sued for
'wrongdoing.'
Designed to encourage people to help in
emergencies.
Generally protect you from liability as long as
you:
•
Are reasonably careful
•
Act in “good faith” (not for reward)
•
Do not provide care beyond your skill
level
• Good Samaritan Laws and Principles
– Different from state to state, province to
province, and country to country.
– You should be familiar with Good Samaritan
laws in the state where you live and in other
states or countries where you work or travel.
• Obtain Consent
• Consent means permission
– A responsive adult must agree to receive first
aid care.
– Expressed Consent means responsive victim
gives his or her permission to receive care.
– Implied Consent means that permission to
perform first aid care on an unresponsive victim
is assumed.
• Special Consent Situations
– Children
• Consent must be obtained from a parent or
guardian prior to administering any care.
– DO NOT delay treatment if a parent or
guardian can not be located.
– Mentally Challenged
• Attempt to obtain verbal consent. If not able
to communicate effectively, follow implied
consent rules.
– Intoxicated or Under the Influence
• If a person has an altered level of
consciousness, or is too intoxicated to make
rational decisions, implied consent applies.
When Caring for Older Persons
• An elderly person suffering from a disturbance in
normal mental functioning, like Alzheimer's disease,
may not understand your request for consent.
• Expressed consent must be gained from a family
member or legal guardian.
• When life-threatening situations exist and a family
member or legal guardian is not available for consent,
care should be given based on implied consent.
Prevention
• No evidence of a single successful lawsuit in the
United States against a person providing first aid in
good faith.
• Still, it’s necessary to use common sense.
– Never attempt skills that exceed your training.
– Don't move a victim unless their life is in danger.
– Call for an ambulance immediately, even if you
decide not to give first aid.
– Always ask a responsive victim for permission before
giving care.
– Once you have started first aid don't stop until
qualified help arrives.
• Refusing Treatment
– A conscious, mentally competent adult has the
right to refuse treatment.
– Try to persuade the patient to accept treatment.
• Confidentiality - Keep all patient
information confidential.
• Abandonment – DO NOT leave your
patient prior to transfer of care to another
trained person.
A 5-year-old child suddenly turns blue and
stops speaking while eating. No parent or
legal guardian is present.
1.Do you need permission to care for the child?
2.Why or why not?
3.What is the legal term for this?
A 37-year-old trips and falls. His right forearm
is painful, swollen, and looks broken.
1.Do you need permission to care for the victim?
2.Why or why not?
3.What is the legal term for this?
• Your safety must be your first priority.
– You can’t help anyone if you become injured.
• Make sure the scene of the accident or
illness is safe before you enter.
• If the scene is not safe then wait for
trained help with the proper equipment
and/or personnel to safe make it safe.
• NOTE: First Aiders must be aware of the
risks associated with emergency medical
care.
• Diseases can be air borne or blood borne.
• Any body fluid can carry diseases.
Reasons for Learning
• Bloodborne pathogens are viruses or
bacteria that are carried in blood and can
cause disease in people.
• Risk of getting disease while giving first aid
is extremely low.
• Observing universal precautions for
victims of all ages will make it lower.
• The best prevention of transmitting any
disease is the use of “Protective Barriers”.
• The use of gloves, face masks and eye
protection is recommended.
• These items should be part of any First Aid
Kit.
• After treating any patient you should
always wash your hands.
• One of the most effective ways of
preventing transmission of a disease is to
wash your hands after restroom.
• Cover all cuts, scrapes, hangnails, rashes,
etc.
• Minimize splashing of body fluids
• Handle sharp objects with caution
• Not handle food, cigarettes, make-up, etc.
when around bodily fluids
• Use bleach 1:10 solution to clean up any
spills or bodily fluids
– 1oz bleach to each 10oz of hot water
• Universal Precautions is a way to
limit the spread of disease by
preventing contact with blood and
body fluids.
– To “observe universal precautions”
means that whether or not you think the
victim’s blood or body fluid is infected,
you act as if it is.
– Observe universal precautions for
victims of all ages.
Personal protective equipment
– A barrier between you and
victim’s blood or body fluid.
– Wear disposable, protective
gloves when performing first
aid. If a glove is damaged, don't
use it!
– Goggles or safety glasses with
side protection should be used
to help protect your eyes.
– If you find yourself in a first aid
situation without standard
personal protective equipment,
improvise.
• Use an alcohol-based hand rub to clean your
hands and other exposed skin after providing first
aid.
– If an alcohol-based hand rub is not available,
wash with soap and water.
– Decontaminate all surfaces, equipment and
other contaminated objects as soon as possible
• Workers designated by employers to give
first aid must be provided appropriate
personal protective equipment and receive
additional training on how to eliminate or
reduce exposure and what to do if
exposed to blood or other potentially
infectious materials (OSHA Standard
1910.1030).
You are called to attend to a 45-year-old
coworker who is bleeding profusely from
the neck after being struck with a pry bar
thrown from the intake chute of a rock
crusher. The victim is slumped in a
corner of the lower platform of the
machine with the pry bar in his lap.
1. Should you “observe universal
precautions”? Why or why not?
2. What protective equipment should you
wear/use?
Responding to
Emergencies
• Experience has led to the development
of 3 simple steps
– Assess – Whenever you recognize an
emergency, you should:
• Assess the emergency scene for safety. Is
it safe to approach the victims? If not safe,
alert EMS for help. Look for additional
bystanders for assistance and make them
aware of any safety concerns
• If you can approach, assess the victim(s) for
life-threatening conditions. Assess victims
for breathing, circulation or hemorrhaging
(severe bleeding)
• Experience has led to the
development of 3 simple steps
– Alert –
• EMS for medical assistance if
necessary
– Attend – Complete a “head to toe”
exam and provide necessary care until
advanced medical help arrives and
takes over.
• Emergency rescue is a procedure for moving a
victim from a dangerous location to a place of
safety
• In most cases, a First Aid Provider should
not move an injured person.
– Emergency services personnel are the best
trained and equipped to do this, and you
should use them.
– However, in a life-threatening emergency or
catastrophic disaster, there may not be time
to wait for professional help.
– In these cases, it may be necessary to
perform an emergency move.
• Fire or danger of explosion
• Danger of asphyxia due to lack of Oxygen
or presence of gas
• Serious traffic hazard
• Risk of drowning
• Exposure to cold / heat
• Possibility of injury from collapsing walls or
building
• Electrical injury or potential injury
• Pinning by machinery
•
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Avoid unnecessary disturbances
Ensure open airway
Control Bleeding
Check for Injury
Immobilize injured parts before moving
Transport
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Pulling the Victim
Lifting the Victim
Supporting the Victim
Chair Carry
Two Man Carry
Blanket Lift
Three Man Hammock Carry
Drags
• Drag victim in the direction of the long axis
of the body to protect spine as best as
possible.
• Never pull victim sideways or pull head
away from neck and shoulders.
Sparks from a grinding operation has caused
an explosion and fire, knocking a nearby
coworker off a suspended scaffold. The
12-foot fall has knocked the worker
unconscious. The scene is not safe. and
there is no time to wait for professional
help.
1. Should you perform an emergency
move?
2. If no, why?
3. If yes, how?
• Call 9-1-1 or your number local emergency
when you suspect any type of serious
injury or illness.
• When in doubt, CALL 911 !!!
• Know your location, phone number and
what the exact emergency is.
Paramedics and Emergency Medical
Technicians are trained to prioritize
their patients and make the
transportation decision based on the
patient s injuries.
Triage
• If there is more than one victim at the
scene of an emergency, the first aid
providers should prioritize or classify the
injured victims. This process is called
triage. It is the best way to help and
provide care that would benefit the
greatest number of victims. The first aid
provider(s) should classify the victim’s
priority status into one of four groups:
Triage • Life-threatening injuries or illnesses that may
be corrected or treated successfully.
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Respiratory arrest or obstruction
Suspected heart attack
severe bleeding
unconscious or unresponsive
severe head injuries
open chest wound
suspected spinal injury
abdominal wounds
severe burns or severe shock
• Assessment Time is critical. The first aid provider
should assess victims in a rapid manner.
– Less than 1 minute
Triage • Not life-threatening injuries.
– Example: (moderate blood loss, moderate
burns, fractures, eye injuries or other illnesses
or injuries in which the victim appears to be
stable.
Triage –
• Victims who appear to be stable or are
able to move to a specified site for
classification.
• This group should be identified by
announcing “ anyone able to walk, please
move to (a specified area) or a safe
location”
Triage –
• Victims who have exposed brain matter,
have been decapitated, have severed
trunk or have been incinerated.
• This also includes victims who have been
in cardiac arrest for over 20 minutes
– With exception to those that are in cardiac
arrest due to severe hypothermia or cold water
drowning
Reasons for Learning
• The Emergency Action Steps are intended
to help the First Aid Provider spot and
care for life-threatening problems in a
responsive or unresponsive victim.
• A First Aid Provider should perform these
steps quickly - in a minute or less.
• Assess Scene
– If scene is unsafe or at anytime
becomes unsafe, GET OUT!
• Assess Victim
– Not moving? No response?
• Alert
– If no response, alert EMS (Call 9-1-1)
or activate Emergency Action Plan.
• Attend to the ABCs
• A – Airway
– Patent?
– Obstructions
• B – Breathing
– Rate, Rhythm and Quality
• C – Circulation
– Rate, Rhythm and Quality
– Skin Condition
• Color, Temperature or Condition
• D – Defibrillation
– For those trained in CPR with AED
• Airway should be open and free of
obstructions (patent)
• Use Head Tilt-Chin Lift or Jaw Thrust to
open airway
• Only remove obstructions you can see
– NO BLIND FINGERSWEEPS
– A=AIRWAY. Open Airway
• Tilt head, lift chin.
• Respiration should be free of any
wheezing, snoring or gurgling
– Open Airway to assist
• If choking, perform appropriate
intervention
• Normal adult breathing should be 12-20
times per minute. (Once every 3-5
seconds)
• Normal child/infant breathing should be 20
times per minute
• Perform rescue breathing if necessary
• B=BREATHING. Check Breathing
– Look, listen, and feel for at least 5 seconds, but
no more than 10.
– If victim is not breathing normally or you are
unsure, perform CPR.
– If breathing normally…
• Circulation includes pulse and skin
condition
• Normal adult pulse should be 60-100
• Normal child/infant pulse should be 100
• Pulseless, START CPR
• Pulse rate below 30, START CPR
• Observe skin conditions, treat for shock or
environmental problems as necessary.
• C=CIRCULATION
– Look for blood pumping or pouring out of a
wound.
– Control it with direct pressure.
– Look for normal tissue color. Use your exposed
wrist to feel for body temperature.
• Only way to reverse the fibrillation of the
heart.
• Part of CPR
• Life Saving
• Continue to Attend to the ABCDs
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Keep airway open.
Assure normal breathing. Control bleeding.
Monitor tissue color and temperature.
Help maintain normal body temperature.
If it’s available and you are properly trained,
give emergency oxygen.
•
When Caring for Children
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Caring for children is very stressful. You must
remain calm.
In the child daycare setting, see your Facility
Emergency Action Plan for details regarding
alerting EMS, notifying parents, and
supervising other children during a medical
emergency.
•
When Caring for Older Persons
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Remain alert for special hazards due to chronic
illness in older persons.
In home-care or assisted living settings, look around
carefully.
Victim may be contaminated with infectious body
fluids such as urine, feces, vomit, or weeping
wounds.
Furniture, wheelchairs, walkers, and medical
devices may also be contaminated.
Observe Universal Precautions. Use Personal
Protective Equipment!
•
You are called to help a sick woman in the front office.
The woman is lying on the floor and appears lifeless.
Her lips are bluish. You squeeze her shoulder and say
“Are you okay?” There is no response.
1.
2.
•
What should you do first?
Then what?
You are called to help a sick child on the playground.
The child’s lips are blue, he is short of breath and
cannot stop coughing.
1.
2.
What should you do first?
Then what?
• Reason for Learning
– Recovery positions prevent an unconscious
victim’s tongue and secretions from blocking
the airway and causing death.
•
First used in hospitals to protect
unconscious patient’s airway from
being blocked by tongue or
secretions as the individual
“recovered” following surgery.
–
Has since become an important
technique in first aid.
•
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Place an unresponsive, uninjured victim
who is breathing normally on his or her
side.
Especially if victim is having difficulty
with secretions, is vomiting or if you
must leave victim alone to get help.
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Make sure body position is stable so the
victim does not roll onto the face or back.
Make sure there is no pressure on chest that
could make it harder to breathe.
Because blood flow in the lower arm may be
impaired, turn victim to opposite side if he or
she is in recovery position for more than 30
minutes.
Check breathing regularly.
•
As a rule, you should not move an
injured victim. However, there are times
you may have to;
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When victim is lying flat on his or her back and
has debris, blood, or secretions in the mouth that
might block airway.
When you must leave victim alone to get help.
When victim is lying on a very hot or very cold
surface, and you need to get a blanket under
them to maintain a normal body temperature.
•
Use HAINES position for injured victim
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HAINES stands for “High Arm IN Endangered
Spine” and is a modified recovery position.
When using HAINES position, there is less neck
movement and less risk of spinal cord damage.
Roll victim to side so that head rests on extended
arm.
Bend both legs at knees to stabilize victim.
• HAINES Position
•
Prevention
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Choking on vomit is a cause of severe brain
damage and death for victims of accidental
alcohol and drug overdose.
These problems may be prevented when victim is
placed on his or her side, because fluid can drain
easily from mouth.
Never leave an unresponsive person, including
one “passed out” from excessive alcohol or drug
use, alone while lying flat on his or her back.
•
You are attending to an unresponsive
victim who fell 17 feet through a roof
opening onto a concrete floor. The victim
is lying face up on his back. You see
blood pouring from his mouth and hear
gurgling. EMS has been alerted. The
scene is safe. Bystanders tell you not to
move the victim.
–
What should you do? Why?
– Signs and Symptoms
– Level of Consciousness
– Primary Complaint
– Check Vital Signs
• ABC’s
• Respiration
• Pulse
• Skin Condition
• Eyes
– Allergies
– Allergies to foods, medications, insects or other
things
– Look for medical alert bracelets
– Ask victim if they may have been exposed to an
allergen
– Medications
– Is the victim taking any medications
– Under the influence ?
– Pre-existing Medical History
– Look for medical alert bracelets, necklace etc.
– Ask victim about any medical conditions that
may relate to their current problems
– Last Meal
– Ask victim when they ate last, and when did
they eat?
– Events
– What events led up to the illness or injury
– What were they doing when the problem started
• Normal: 98.6 F ( 37 C) )
• Over 100 F is abnormal
– Heat Stress
– Heat Stroke
– Febrile Seizure
• Under 97 F is dangerous
– Hypothermia
– Frostbite
• Temperature
– Hot
– Warm
– Cool
• Color
– Pink
– Red
• Heat, Burn or Carbon Monoxide
– Pale
• Shock
– Ashion
• Lack of Oxygen/Shock
– Cyanotic
• Lack of Oxygen
• Condition
– Dry
– Clammy
• Moist
– Diaphoretic
• Sweaty
• Capillary Refill
– Normal is less than 2 seconds
– Press the fingernail and count until pink returns.
• More than 2 seconds is a sign of shock
• For dark pigmented patients, you can check the
fingernail beds, mouth inside the mouth, and/or
eyelids for change.
• “PERL” is normal
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P - Pupils are:
E – Equal and
R – Reactive to
L – Light
– Unequal size – possible head injury
– Un-reactive –
• Constricted – Drugs or other disease
• Dilated – Drugs, possible head injury
– Unconscious ?
• Normal Adult Blood Pressure range for an
adult is 100/60 to 140/100
• ???/xxx Is the systolic pressure
– Pressure exerted in the artery when the heart
contracts
• xxx/??? Is the diastolic pressure
– Pressure of the vessels when heart is at rest
• “Perfect Pressure” is 120/80
• Low blood pressure can cause shock,
dizziness, decreased consciousness
• High blood pressure can cause chest pain,
stroke or dizziness or decreased
consciousness
• Breathing Condition
– Rate - # of times per minute
– Rhythm – Normal or erratic
– Quality – Shallow, normal or deep
• Agonal ?
– Slow, long and gasping respirations
» BREATHING EMERGENCY
• Snoring or gurgling ?
– Use airway maneuvers
• Wheezing ?
– Asthma or Allergic Reaction
» Treat Accordingly
• Normal Respiratory Rates
– Adult – 12-20
– Child – 15-30
– Infant – 25-50
• “every 3 to 5 seconds”
• Any person not breathing at least 10 times
per minute, start rescue breathing or CPR
as necessary.
• Normal Pulse
– Adult – 60-100
– Child – 80-120
– Infant – 100-120
• Elevated Pulse is a sign of shock. Treat
accordingly
• Low Pulse can be from variety of ailments.
Treat symptoms.
• Pulse Under 30, START CPR.
• A normal adult is aware of who they are,
where they are, current time, and recent
events or what happened.
• A patient may be:
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ALERT & ORIENTED
CONFUSED
DISORIENTED or
UNCONSCIOUS
• Adult/Child (AVPU)
– Awake and Alert (Awake)
– Responds to Talking (Verbal)
– Responds to gently shaking shoulder and
shouting (Tactile)
– Responds to Pinch inside of upper arm (Painful)
– Does not respond (Unresponsive)
• Infant (AVPU)
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Awake and Alert (Awake)
Responds to Talking (Verbal)
Responds to gently flicking bottom off foot
Responds to Pinch inside of upper arm (Painful)
Does not respond (Unresponsive)
MOBILITY AND MOVEMENT
• Normal Movement
– Pain Free and without restriction
– Painful
• Possible strain, sprain, dislocation or
fracture
• Unable to move
– Paralysis from injury
– Paralysis from stroke
REACTION TO STIMULI
• Awake
• Responds to Verbal Stimuli
– Are you OK?
• Responds to Tactile Stimuli
– Gentle Shaking/Tapping
• Responds to Painful Stimuli
– Pinch
• Unresponsive
– Breathing?
• Be aware of paralysis and injuries
• AMA recommends anyone with a medical
condition, such as diabetes, heart
problems, allergies, etc. wear or carry
medical alert identification.
Consists of air passages
lungs passages, lungs,
muscles, and nerves.
• Purpose:
– To provide a constant supply of
oxygen and release carbon
dioxide.
• Breathing is centrally controlled by
the brain.
• Respiration can be:
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Absent
Slow or Fast
Deep or Shallow
Gasping, Labored or Choking
• Treat as needed
• Normal Breathing
– Does the patient appear to be breathing
normally?
– Rate is not important as quality
– Skin color and overall appearance should be
considered
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Choking
Asthma
Drowning
Poisoning
Suffocation
Smoke Inhalation
Drug Overdose g
Electrical shock
• A disease in which air passages in lungs
become narrower from swelling and extra
mucus.
• This limits airflow into and out of lungs and
causes wheezing and/or shortness of
breath.
• Asthma attacks (or episodes) can be
caused by tobacco smoke, dust mites,
furred and feathered animals, certain
molds, chemicals, and strong odors.
•
Signs and Symptoms
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Can be very mild to life-threatening.
Constant coughing, especially worse at night
and early morning.
Anxiety.
Sudden onset of wheezing.
Chest tightness.
Shortness of breath.
Extreme difficulty breathing.
Bluish color to lips and face.
Pounding heart.
Sweating.
Altered mental status.
•
•
An asthma attack or episode can quickly
get worse.
If victim is unable to administer
prescribed medication without
assistance, you should help administer
the prescribed dose in the correct
manner.
•
Metered Dose Inhaler
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Delivers specific amount of medicine.
Remove cap and shake inhaler.
Hold inhaler upright. Tilt head back slightly and
breathe out.
Press down on inhaler to release medicine; start to
breathe in slowly for 3 to 5 seconds.
•
Metered Dose Inhaler (cont)
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Hold breath for 10 seconds to allow medicine
to go deeply into lungs.
Repeat as directed.
There are many different types and brands of
inhalers that require different techniques (i.e.;
spacers, dry powder inhaler, etc.).
Assist the victim with his or her medication as
prescribed.
Nebulizer
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•
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Turns liquid medicine into a mist for
inhaling.
Place air compressor on sturdy surface.
Put medicine into nebulizer cup.
Assemble nebulizer cup and mouthpiece.
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Nebulizer (cont)
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Connect tubing to air compressor and nebulizer
cup.
Turn on air compressor.
Take slow, deep breaths. If possible, hold each
breath for 2-3 seconds to help medicine get into
lungs.
Continue until nebulizer cup is empty (about 10
minutes).
•
Alert EMS if the victim has any of the
following:
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No improvement 15-20 minutes after initial
treatment with medication.
Constant coughing.
Difficulty breathing with chest and neck pulled in.
Stooped body posture.
Struggling or gasping.
Trouble walking or talking.
Child stops playing and can’t start activity again.
Lips or fingernails are grey or blue.
Comfort, calm, and reassure while awaiting EMS.
• Anaphylaxis is a sudden, severe allergic
reaction that involves the whole body.
• Swelling of the lips, eyelids, throat, and
tongue can block airway.
• It is critical for anyone with a history of
anaphylaxis to keep epinephrine autoinjectors on hand at all times.
Signs and Symptoms:
Rapid onset
• Anxiety.
• Hives/itching.
• Sensation of heart pounding.
• Nausea/vomiting.
• Abdominal pain/cramping.
• Diarrhea.
• Epinephrine Auto-Injector
– An auto-injector is a drug delivery system that
is a pressure-activated injector for use in the
rapid administration of epinephrine
(adrenaline).
– Each auto-injector is designed for a single use
and is pre-filled with a precise dose of
prescribed medication.
Storage
– Epinephrine auto-injectors should be
stored at room temperature until
marked expiration date, at which time
unit must be replaced.
– Auto-injectors should not be
refrigerated as this could cause device
to malfunction.
•
Storage (cont.)
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–
–
Auto-injectors should not be exposed to
extreme heat or direct sunlight.
Heat and light shorten the life of the product
and can cause the medication to break down.
To be effective, solution in the auto-injector
should be clear and colorless.
If solution is brown, replace unit immediately.
First Aid
•
•
•
If victim has a history of allergic exposure
and carries a lifesaving epinephrine autoinjector prescribed by a physician, help
the person use it.
If the victim is unable, you should
administer it.
Waiting for paramedics may significantly
increase risk of death.
•
•
•
•
Beneficial effect is relatively short.
Auto-injector is for emergency use only
and not a replacement or substitute for
medical care.
Some allergic reactions can be so severe
that a single dose of epinephrine may not
reverse the symptoms.
Victim may carry an epinephrine autoinjector with 2-doses-in-1 device
(Twinject).
− Epinephrine
Auto-injector*
−
–
–
–
–
–
Directions for use:
Unscrew yellow or
green cap off carrying
case and remove autoinjector from storage
tube.
Grasp unit with black
tip pointing downward.
Form fist around unit
(black tip down).
With your other hand,
pull off gray safety
release.
Hold black tip near
outer thigh.
−
Directions for use: (cont)
–
–
–
–
–
Swing and jab firmly into outer thigh until it clicks so
that unit is at a 90° angle to thigh.
Auto-injector is designed to work through clothing.
Hold firmly against thigh for approximately 10
seconds.
The injection is now complete. Window on autoinjector will show red.
Remove unit from thigh and massage injection area
for 10 seconds.
−
•
•
•
•
•
Directions for use: (cont)
Carefully place used auto-injector
(without bending the needle), needle-end
first, into storage tube.
Screw cap of storage tube back on
completely and send it with victim to
hospital.
Most of liquid (about 90%) stays in autoinjector and cannot be reused.
Correct dose of medication has been
delivered if red flag appears in window.
Comfort, calm, and reassure while
awaiting EMS.
•
•
•
•
DO NOT ever put thumb, fingers, or hand
over black tip.
DO NOT remove gray safety release until
ready to use.
DO NOT use if solution is discolored or
red flag appears in clear window.
DO NOT place patient insert or any other
foreign objects in carrier with autoinjector, as this may prevent you from
removing auto-injector for use.
•
While attending a school field trip, an 8-year-old
child with a history of asthma and allergy to
peanuts complains of an itchy feeling in his
mouth after eating ice cream. Ten minutes later,
the child can’t stop coughing. His lips and face
start swelling, and he develops a rash over his
entire body. The child has been prescribed an
epinephrine auto-injector, but it is in his
backpack on the bus.
–
What should you do?
How to Open the Airway
•To open the airway, place one hand on the forehead, two fingers
under the chin, and tilt the head back to where the chin points to
the sky
• DO NOT USE THIS TECHNIQUE IF YOU SUSPECT SPINAL
INJURY
• For suspected spinal injuries
• Place thumbs on cheek bones, index and
middle fingers at the angle of the jaw.
• Press down on the cheek bones, then
press out on the jaw to open the airway.
• The anatomy of the infants airway is much
smaller and can be occluded by tilting the
head back too far.
• Position the infants head into a “sniffing
position”
Foreign Body Airway
Obstruction
• Refer to Basic Life Support Procedures.
• Facts
– Atmospheric air contains approximately 21%
oxygen
– Your body consumes approximately 5% oxygen
when you breathe
– Air you provide during rescue breathing and
CPR contains approximately 16% oxygen
– 1 Breath every 3-5 seconds
• Follow normal breathing rate guide
•
•
•
•
•
•
Heart
Arteries
Veins
Arterioles
Venules
Capillaries
• Pulse Location
– Carotid: the neck
– Brachial: the upper arm
– Radial: the wrist
• Pulse Quality
–
–
–
–
Absent
Slow or Fast
Weak or Pounding
Irregular or Regular
• A condition in which the heart is
generating any no longer blood flow.
• There will be no pulse or respiration.
• Brain - 4 - 6 minutes
• Heart - 4 - 6 minutes
• Kidney - 45 - 90 minutes
(Acute Myocardial Infarction)
• When an artery in the heart becomes
partially or totally blocked, it reduces stops
to a portion or blood flow of the heart
muscle.
• Substernal Pain
• Squeezing, Pressure or Heaviness in the
Chest
• Pain MAY Radiate to Jaw, Left arm or
Both arms
• Pain NOT relieved by rest
• Cool, Clammy Skin
• Shortness of Breath
• Nausea
• Feeling of Impending Doom
• THE HEART ATTACK PATIENT MAY
DENY ANY AND ALL SYMPTOMS OF A
HEART ATTACK
(Angina Pectoris)
• The signs and symptoms of a Heart Attack
usually brought on by stress and/or
exercise.
• Without heart permanent damage to the
heart.
• Is usually relieved by rest or nitroglycerin.
•
•
•
•
•
•
•
Call 911
Oxygen (if available)
Position of Comfort (usually sitting)
Keep Calm
Loosen tight clothing
Nothing to eat or drink
Nitroglycerin as directed
• Be ready to perform CPR on any patient
complaining or showing symptoms of
cardiac problems
.....
• Is a red sticky fluid that carries oxygen to
the body and removes waste products.
• The normal adult has six liters of blood.
• A newborn infant has about 300 ml.
• Clotting of blood normal takes six to seven
minutes.
Types of Bleeding
• Arterial – Bright red and spurting
– Most serious.
– Life threatening
• Venous – Dark red and steady flow
– Result of deep cut that opens a vein.
– Bleeding must be controlled
• Capillary – Dark red and oozing
– Smallest and most numerous vessels in the
body
– Slow bleeding
• Direct Pressure
– Clean, dry cloth or bandage material
– Add more dressings to control bleeding as
needed. Do not remove soaked dressings.
– Apply bandage material
• Pressure Bandage
• Elevation
– Raise above the level of the heart
• Pressure Points
– Locate pressure point and apply pressure
• Tourniquet
– Last resort
– Can cause tissue damage
Direct Pressure
Elevation
Pressure Points
• Brachial Artery
– Put Thumb on outside of arm, fingers on inside
of middle upper arm and Squeeze….
• Femoral Artery
– Place heel of hand directly over femoral artery
(located between upper leg and pubic area),
lean forward keeping arm straight and apply
pressure.
Pressure Bandage with Pressure Points
• USE ONLY AS A LAST RESORT !!!!!!!!!
• Apply as close to the wound as possible
• Once applied Never loosen
• Get Help at Once!!
• Can be life threatening
• Call 911 if lasts over 30 min
• Can be from high blood pressure, trauma
or various other reasons
• Do not swallow blood
– Can cause vomiting
• Pinch the nostrils
– Between the nares and bridge
• Keep patient in sitting position
• Lean patient’s head forward
• Apply a cold compress to the nose
– Also back of neck if possible
• The signs and symptoms of shock with no
or minimal external bleeding.
• May be life threatening.
• Needs fast entry into the EMS system and
treatment at a hospital.
• Several Causes including trauma and
disease.
– Rectal Bleeding, Blood in urine, vomiting blood,
vaginal bleeding (non-menstrual)
– Blood from rectum, mouth, vagina or blood in
urine
– Bruise or contusion
– Rapid pulse
– Cool and/or moist skin
– Painful, tender or hard spot on abdomen
• Closed soft tissue injuries can be as little
as a bruise or damage to a vital organ.
• Minimal care can be given in the field for a
closed soft tissue injury, keep the patient
calm and have them transported to the
hospital for further evaluation.
– Bruises, Contusions, Lacerated liver or
Fractured spleen
• The key steps in treating a closed softtissue injuries are:
– Protect the wound from further injury
– Avoid rough handling
– There may be a closed fracture
• Open soft tissue injuries can be life
threatening injuries.
• Proper initial care is critical.
• You must remove the clothing from the
injury site for proper bleeding control
– Unless clothing is melted to the skin or wound
• NEVER REMOVE AN IMPALED OBJECT
– Unless occluding the airway
– Use bandages and materials to stabilize the
object
• The key steps in treating an open softtissue injuries are:
– Stop the bleeding:
• Direct pressure - the most efficient
• Elevation - elevate the injured extremity
• Pressure point - apply pressure on the
appropriate pressure point
• Protect the wound from further damage
• Bandage the wound
– Control bleeding
– Do Not scrub body part
– Wrap in clean cloth, place in sealed plastic bag
and place in bag containing ice
– Get help as soon as possible
• Expose the wound
• Apply direct pressure with dressing
– Do not remove soaked dressings
• Secure the dressing with a bandage
• Check distal pulse
Expose the Wound
Apply Direct Pressure with Bandage
Secure the dressing with a bandage
Check the distal pulse
• Shock is a condition which causes failure
of the circulatory system to provide
sufficient perfusion to parts of the body.
•
•
•
•
•
•
•
•
•
•
•
Restlessness and anxiety
Weak and rapid pulse
Cold and clammy skin
Profuse sweating
Pale or cyanotic face
Breathing is shallow, labored, rapid, possibly
irregular, or gasping
Eyes dull or lusterless with dilated pupils
Marked thirst
Nausea or vomiting
Falling blood pressure
Possible fainting
Shock Signs and Symptoms
•
Early:
–
•
Victim appears uneasy, restless, or worried.
Later on:
–
–
–
–
–
–
–
–
Changes in responsiveness.
Cool wet skin from heavy sweating.
Pale or bluish tissue color.
Shivering.
Intense thirst.
Nausea, vomiting.
Shallow or gasping breathing.
Below normal body temperature.
•
•
•
•
•
•
•
•
Maintain a clear airway
Control bleeding
Give oxygen (if available)
Elevate lower extremities
Keep patient calm
Prevent loss of body heat
Keep victim lying down
Do not give anything by mouth
• RNCHAMPS
•
•
•
•
•
•
•
•
Respiratory
• Asthma or Obstruction
Neurogenic
• Spinal Injuries
Cardiogenic
• Heart Failure
Hypovolemic
• Loss of blood
Anaphylactic
• Allergic Reaction
Metabolic
• Loss of Fluids
Psychogenic
• Fainting
Septic
• Infection
• Respiratory compromise
• Obstruction or other restriction
– Asthma, COPD, Emphysema
• Wheezing/difficulty exhaling
• Increased pulse rate
• Coughing
• Anxiety
• Distended or Bulging neck veins
• Shoulders hunched and chest pulled up by
breathing effort
• Sit Upright
• Supportive Care
– Inhaler or Nebulizer as directed
• Damage to the spinal cord causing dilated
blood vessels
• Slow heart rate
• Low Blood Pressure
• Signs of Neck Injury
• Keep still, elevate legs only if no trauma
• Keep Warm
• Treat ABC’s
• Inadequate Heart Function
• Chest Pain, Shortness of Breath, Nausea
& Vomiting
• Weak Pulse
• Be prepared for CPR
• Sitting Upright
• Oxygen if available
• Nitroglycerin as directed
•
•
•
•
•
Loss of Blood
Control Bleeding as soon as possible
Life Threatening
Treat ABC’s First
Cool Clammy Skin, Rapid and Weak
Pulse, Change in mental status
• Elevate legs, cover to keep warm, provide
oxygen
• Nothing to eat or drink
•
•
•
•
•
•
•
•
Allergic reactions
Reactions to environment
Life Threatening
Itching, Hives, Narrowed Airway, Vascular
dilation, swelling and edema
Cyanosis
Treat airway problems first
Supportive Care
Call 911
– Consider Epi Pen if available.
• ONLY IF TRAINED
• Caused by excessive vomiting or diarrhea
• Similar to hypovolemia
• Treat signs and symptoms
• Caused by temporary vascular dilation
• Can be triggered by bad news, emotional
problems, or any other sudden “shock” to the
system.
• May cause fainting or temporary loss of
consciousness
• Lay flat, elevate legs, remove from situation,
keep warm
• Normally Psychogenic Shock is self correcting.
• Maintain a clear airway.
• Assess for any injury that may have occurred
as the patient fell.
• Caused by infection
• Symptoms will include pale skin, low blood
pressure, warm skin and elevated heart
rate.
• Keep warm, elevate legs, provide
supportive care
• DO NOT MOVE A PATIENT WITH A
HEAD INJURY, ALWAYS SUSPECT A
SPINAL INJURY.
• Head injuries may make a patient
unconscious, confused, or violent.
• Bleeding from the ears or nose may be
relieving internal pressure) cerebrospinal
fluid (pressure).
• A late pupils sign may be unequal pupils.
• Open or Closed Injuries
• Signs & Symptoms
–
–
–
–
–
–
–
–
–
–
Raccoon Eyes
Battle Signs
Decreased Mental Status
Sleepiness
Nausea or Vomiting
Dizziness
Bleeding from Eyes, Ears or Nose
Clear fluid from ears
Unequal pupils
Slow to react
Raccoon Eyes
Battle Signs
• Maintain the A,B,C’s
• Control Bleeding:
• Avoid excessive pressure on a suspected
skull fracture.
• Do not try to stop bleeding from the ears
nose if you suspect that it’s cerebrospinal
fluid.
• Patient may vomit
• Be ready to manage the airway.
• Seizures may be caused by many
conditions:
– Head injuries, drugs, diabetes, or epilepsy.
• A seizure is the involuntary contractions of
the skeletal muscles.
• Two types of seizures are:
– Petite Mal and Grand Mal.
– Febrile
• DO NOT TRY TO RESTRAIN A PATIENT
HAVING A SEIZURE .
• Protect the patient from hurting
themselves during the seizure.
• Do Not Force anything into the patient’s
mouth.
• Monitor the patient’s breathing.
Strokes
Cerebral-Vascular Attack
Strokes
• “Brain Attack”
• Blockage or Rupture of a blood vessel in
the brain
• Life Threatening
• Call 911
• Sit Upright
• Nothing by mouth
Fractures and Dislocations
• Bones, joints, and muscles give the body
shape, allow movement, and protect vital
internal organs.
• Strains and sprains are injuries to muscles
and joints; dislocations and fractures are
injuries to joints and bones.
• It is difficult to tell a dislocated bone from a
broken (fractured) one.
• A fall on level ground can cause a minor
fracture, while a high-speed motor vehicle
accident can cause severe fractures
involving many bones.
Fractures and Dislocations
• Fractures can cause total disability. In rare
cases, they can cut vital organs and/or
arteries and cause death.
• If an injured extremity is blue or extremely
pale, alert EMS or activate your
Emergency Action Plan immediately.
• Most often, these injuries are non-lifethreatening.
Fractures
• Basically there are two types of Fractures:
– Open - the skin has where been broken
– Closed - where the skin has not been broken
• Both types of fractures can result in
serious blood loss.
• DO NOT MOVE a patient until his fracture
has been splinted. Moving the patient may
cause further soft tissue injuries.
Fractures – Closed Injury
• Signs and Symptoms:
–
–
–
–
–
–
–
–
–
No open wound.
Sharp pain.
Swelling.
Deformity.
Tenderness.
Bruising.
Joint locked into position.
Anxious, pale, clammy, weakness/fainting.
Nausea/vomiting.
Fractures – Open Injury
• Signs and Symptoms:
–
–
–
–
–
–
–
–
–
Open wound.
Bleeding wound may have bone sticking out.
Substantial blood loss from open fractures is possible.
Gunshot Wound (often causes open fractures).
Pain.
Swelling.
Deformity.
Anxious, pale, clammy, weakness/fainting.
Nausea/vomiting.
Fractures
• May hear a bone snap
• Pain & tenderness, difficulty moving
injured body part
• Swelling and discoloring
• Grating Sound
• Exposed Bone
• Report of grating sensation
• Shortening of injured leg/arm
• Unusual angle or position of body part
FRACTURE
Dislocations
• Dislocations - a deformity at a joint
• NEVER TRY TO STRAIGHTEN A
DISLOCATION!!
• Keep the patient from moving until the joint
has been splinted.
Dislocations
Dislocated Finger
Dislocated Knee
ICE
•
Apply ice or a cold pack to
decrease pain, bleeding, and
swelling.
– Limit application to 20 minutes or less.
Immobilize
•
Manually Stabilize Injured Limb
– Gently place your hands above and
below the injury to limit movement and
prevent further injury while awaiting
EMS
Don’ts
•
•
•
•
•
DO NOT move victim if you think that
there may be a head, neck, or back
injury.
DO NOT attempt to straighten a painful,
swollen, or deformed arm or leg.
DO NOT attempt to push bone back
under skin.
DO NOT allow a victim with leg, ankle, or
foot injury to bear weight on it.
DO NOT remove shoes or boots unless
there is severe bleeding from foot.
Sprains &
Strains
Sprains & Strains
• Sprains and strains are injures to the
muscles and/or ligaments around a joint.
• It takes a X-ray to determine if it is a
sprain, strain, fracture, or dislocation.
• Treat all sprains and strains as if they were
fractures. Properly splint the injury.
First Aid for Sprains & Strains
R–I–C–E
R – Rest, try not to use
the affected extremity
I - Ice, apply a cold pack.
Do not apply ice directly
to skin.
C - Compress, use an
elastic or conforming
wrap - not too tight.
E - Elevate, above heart
level to control internal
bleeding.
Child Care
•
When Caring for Children
–
–
–
–
Fractures in young children are different than
those in adults because bones are softer and
more able to bend.
Instead of breaking completely through when
an injury occurs, bone may buckle and crack.
This is called a “greenstick fracture” (like
breaking a fresh, green branch).
First aid treatment is generally the same as for
adults.
Elder Care
•
When Caring for Older Persons
–
–
Loss of normal bone density, mass, and
strength make the bones of older persons
more brittle and more likely to fracture.
First aid treatment is generally the same as for
adults.
Prevention
•
Prevention (children)
–
–
–
Sports and recreation are the leading causes
of injury-related visits by children to
emergency rooms.
Forearm fractures account for 40 to 50 percent
of all childhood fractures.
Supervision of children, first aid training for
coaches, and the use of protective devices
may help to prevent serious injury.
Prevention
•
Prevention (older people)
–
–
–
Injuries from falls in older people are a major
public health problem in modern societies with
aging populations.
Many states and local areas have education
and/or home modification programs to help
older people prevent falls.
Check with your local government's health
department or division of elder affairs to see if
there is a program in your area.
Wrap Up Scenario
•
You are attending to a 37-year-old
accidental shooting victim with an open
fracture of the lower left leg. The victim
is responsive and in significant pain.
Broken bone ends are visible in the
wound, which is bleeding – although not
severely. The scene has been secured
and there is no threat from the weapon.
EMS has not been alerted.
–
What should you do?
Spinal Injuries
• Reasons for Learning
– Spinal cord injury is a devastating condition that
affects young and healthy people around the
world.
– Males are four times more likely to suffer spinal
injury than females.
– Proper first aid can prevent further injury as well
as major physical and emotional burdens.
Spinal Injuries
• Spinal injury is often caused by motor
vehicle collisions, gun shot wounds, falls,
and sports injuries.
• Injuries to the spine cause damage to the
bones of the spine, the spinal cord, or to
tissues and blood vessels surrounding the
spinal cord.
Spinal Injuries
• Injuries to the spine block the brain's ability
to communicate with other parts of body
• If you suspect a victim could possibly have
a spinal injury, assume the individual
does!
Spinal Injuries
• DO NOT TRY TO MOVE A PATIENT
WITH A SUSPECTED SPINAL INJURY.
• Have patient remain still and wait for
trained help to arrive.
• Only reposition the head if the patient is
not breathing using the Jaw Thrust
maneuver.
• Maintain a inline position
• Monitor the rate of breathing of the patient.
Spinal Injuries
• Signs and Symptoms:
–
–
–
–
–
–
–
–
–
Altered level of consciousness.
Spinal pain, pressure, or tenderness.
Obvious injury to the neck, head, or back.
Multiple injuries, including pain, swollen,
deformed limbs.
Numbness, tingling, burning, or loss of
sensation in the hands, fingers, feet or toes.
Weakness or paralysis in any part of the body.
Loss of bladder or bowel control.
Bullet or stab wound to head, neck or chest.
Dove headfirst into shallow water.
Spinal Injuries
• Assume a spinal injury has occurred when
victim:
– Has been exposed to physical force
and has any of the previous signs and
symptoms.
– Was in a motor vehicle (car, truck,
motorcycle, ATV) or bicycle crash
(occupant or pedestrian).
– Fell from greater than a standing height
– Has been exposed to physical force
and appears drunk or older than 65.
Spinal Injuries
Caution
• Pain and loss of function usually
accompany a spinal injury but the absence
of pain does not mean that the victim has
not been significantly injured.
Spinal Injuries
•
Manually Stabilize Suspected Spinal Injury
–
–
–
–
Tell responsive victim not to move.
Place your hands on both sides of victim’s head to
stabilize it.
Keep head, neck, and spine in line.
Comfort, calm, and reassure.
Spinal Injuries
•
Protect Airway
–
–
If victim is or becomes unresponsive and has
debris, blood or difficulty breathing from
secretions in the mouth or you must leave to
get help:
Use HAINES position to protect airway.
Spinal Injuries
•
•
•
•
•
•
DO NOT ask injured victim to move in
order to try to find a pain response.
DO NOT move injured victim to test for a
pain response.
DO NOT move injured victim to perform a
physical assessment.
DO NOT bend, twist, or lift victim’s head
or body.
DO NOT move injured victim before
medical help arrives unless the airway is
in danger.
DO NOT remove a helmet if a spinal
injury is suspected.
Spinal Injuries
•
When Caring for Children
–
–
–
Spinal injury in children is rare, but risk is greatest
when child has multiple injuries or chest injuries.
Distress and discomfort may make it difficult to
restrict spinal motion in a child.
Do your best to manually restrict child’s head in the
position in which it was found.
Spinal Injuries
•
Prevention
–
–
–
DO wear seat belts.
DO NOT drink and drive.
DO NOT dive headfirst into swimming pools,
lakes, rivers, or ocean surf, especially when
you do not know the depth of water or when
water is not clear.
Spinal Injuries
•
You are attending to an 18-year-old
coworker who fell backwards
approximately 12 feet from the top of a
shelving unit onto a concrete floor. The
victim is responsive and is complaining
of a burning sensation in his hands. He
says he is okay and wants to “walk it
off”.
– What should you do?
• The key reasons for splinting:
– Reduce the chance of damage to nerves, or
blood vessels muscles.
– Prevention of a closed fracture from becoming
an open fracture.
– Reduce pain.
– Reduce risk of paralysis from a spinal injury.
• Multiple types of materials could be used
as splinting material.
• Some samples are:
–
–
–
–
–
Cardboard
Wood
Air splints
Pillow
Folded newspaper
• The key steps in treating a fracture or
dislocation are:
– Remove the clothing covering the fracture.
– Do not try to replace protruding bones.
– Splint in position found
• Unless no pulses are present in extremity
– Note circulation and nerve status.
– Use padded splints or pad the splint.
– Immobilize the fracture and joints above and
below the fracture.
– Always splint fractures before moving the
patient.
– Recheck circulation and nerve status after
splinting.
• First Degree – Superficial
–
–
–
–
–
Skin becomes reddened
Very tender to touch
Overexposure to sun
Light contact with hot objects
Scalding by hot water or steam
• Second Degree – Partial Thickness
–
–
–
–
Blisters and very painful
Results from a very deep sunburn
Contact with hot liquids
Flash burns from gasoline etc.
• Third Degree – Full Thickness
– Skin is dry, pale, white, or can be black and charred
and is painless
– Caused by flame, ignited clothing, immersion in hot
water, contact with hot objects, or electricity.
• Thermal burns are caused by the sun, fire,
hot liquids or objects, and hot gases.
• Electrical burns are caused by contact
with electrical wires, current, or lightning.
• Chemical burns are caused by contact
with wet or dry chemicals.
• Burns on the face, hands, feet, and
genitals can be particularly serious.
Types of Burns
•
•
If victim is on fire, tell him or her to STOP,
DROP, and ROLL.
If victim is in contact with electricity, shut
off the power.
–
–
–
–
Do not touch victim or any wires.
Do not touch (or allow your clothing to touch) a
wire, victim, or vehicle that is possibly
energized.
Do not approach within eight feet of it.
NEVER attempt to handle wires yourself
unless you are properly trained and equipped.
• The percentage of burns is measured
using a rule called the rule of 9’s.
• Each body part can be measured with a
multiple of 9.
• The following are considered Critical
Burns:
– Burns/smoke around the mouth or nose
– Burns involving the face, hands, or feet
– Third degree burns covering more than 10% of
the body
– Second degree burns covering more than 30%
of the body
Second Degree Burns
Third Degree Burns
Moderate burns are:
– Third degree burns of 2% to 10% of the body
– Second degree burns of 15% to 30% of the
body
– First degree burns of 50% to 75% of the body
• STOP THE BURNING PROCESS
– Cool with copious amounts of cool water on
thermal or liquid chemical burns
• No ICE !
•
•
•
•
•
•
• Do not use water
The burned areas should be covered with a clean,
dry dressing.
Do not break blisters
Do not apply ice directly to skin
Do not apply any home remedies or ointments
NEVER USE GREASE (BUTTER) ON A BURN!
Watch for symptoms of smoke/heat inhalation
•
First Aid: Major Burns
–
–
–
–
–
Expose.
Cut and gently lift away any clothing covering
burned area.
If clothing is stuck to burn, do not remove it.
If victim’s skin is in contact with a liquid
chemical, immediately flush chemical off with
large amount of water.
Remove jewelry if possible (burns cause
swelling).
•
First Aid: Major Burns
– Separate fingers or toes with dry,
sterile, non-adhesive dressings.
– Leave burn blisters intact.
– Lightly cover the burn area with a dry
sterile bandage or clean sheet if the
burned area is large.
– Continue to ATTEND to the ABCs.
•
First Aid: Minor Burns
–
–
–
–
Expose the burn.
Cool heat burns with cold water as quickly as
possible, and continue cooling at least until
pain is relieved.
After cooling, cover the burn with a dry, sterile
bandage or clean dressing.
Protect the burn from pressure and friction.
•
First Aid: Minor Burns
– Immediate cooling of minor burns will
reduce swelling, infection, and depth of
injury. It will allow faster healing with
less scarring.
– DO NOT pop burn blisters.
– DO NOT apply ointment, butter, ice,
medications, cream, oil, spray, or any
other substance to a burn.
• Dry Chemicals must be brushed off before
flooding the affected area with running
water.
• ALL chemicals, wet or dry, in contact with
the skin should be washed off (flooded)
with large amounts of water.
• Contaminated clothing must be removed.
(Flood with water as they remove the
clothing)
• ALL chemicals, wet or dry, in contact with
the eyes should be washed off (flooded)
with large amounts of water.
• At a minimum flush both eyes for 20
minutes and then transport to the hospital
for further treatment.
• Electrical burns can be more serious than
they appear to be. Most damage is hidden
under the skin.
• Respiratory and cardiac problems are
common with electric shock.
• DO NOT TOUCH THE PATIENT UNLESS
YOU KNOW THE POWER IS OFF!!
•
Once the power is off, ASSESS, ALERT,
and ATTEND to the ABCs.
–
–
–
Victim may need CPR and defibrillation.
Burns may be present at points where the
current entered and exited the body.
All victims of electric shock require medical
assessment because the extent of injuries may
not be apparent.
Electrical Burns
•
When Caring for Children
– Minor burns in children are extremely
common.
– Severe burns in children can result in
prolonged suffering, disability,
disfigurement, and impaired physical
and mental development.
– First aid for burns in children is the
same as with adults.
•
When Caring for Older Persons
– Age and chronic disease contribute to
a higher frequency of complications
and death in older adults who suffer
burn injuries.
– First aid for burns in older persons is
the same as with adults.
•
Prevention
–
–
–
Hot water scalds are twice as common as
thermal burns in young children and typically
occur when toddlers reach up and pull a pot of
hot water off the stove and onto themselves.
Turn handles inward. Closely supervise young
children.
Many fire-related injuries and deaths occur
from children under 5 years old playing with
matches or lighters and often start in a
bedroom. Keep matches and lighters in a
secured drawer or cabinet.
Extra caution must be exercised when working
near energized power lines. Keep a safe
distance between power lines and ladders,
tools and work materials.
•
You are attending to a victim burned
from a flash fire and explosion while
painting the inside of a recently
fabricated 1300-gallon steel tank. The
fire is out, and the scene is safe. The
victim has moderate and major (second
and third degree) burns on his thighs,
hands, arms, and chest.
– What should you do?
• Inhaled Poisons Toxic fumes (gases)
• Skin Exposures to Poisons - Plants or
chemicals
• Swallowed - Plants or Poisons chemicals
•
Swallowed Poisons
–
–
–
–
–
–
Drugs (prescription, illegal, over-the-counter).
Alcohol.
Household cleaning products, make-up.
Pesticides, paints, solvents.
Contaminated foods.
Poisonous plants (plants and plant parts can
cause harm).
Most Frequently Involved Substances
(Children < 6 Years)
Cosmetics and personal care
products
Cleaning substances
Analgesics
Foreign bodies
Topicals
Cough and cold preparations
Plants
Pesticides
Vitamins
Antimicrobials
Antihistamines
Arts/crafts/office supplies
Gastrointestinal preparations
Hormones and hormone antagonists
Electrolytes and minerals
Most Frequently Involved
Substances
(Adults > 19 Years)
Analgesics
Sedatives/hypnotics/antipsychotics
Cleaning substances
Antidepressants
Bites/envenomations
Alcohol
Cardiovascular drugs
Food products, food poisoning
Cosmetics and personal care
products
Pesticides/Chemicals
Hydrocarbons
Fumes/gases/vapors
Anticonvulsants
Antihistamines
Stimulants and street drugs
•
Skin Contact
– Corrosives (Alkalis, acids,
hydrocarbons)
– Poisonous plants (poison ivy, oak,
sumac)
• Be careful not to expose yourself to the
Toxic Environment.
• Once the patient is removed the from
contaminated area:
– Verify breathing and circulation
– CPR may be necessary
– Get trained help
•
CARBON MONOXIDE CAUSES MORE POISONING
DEATHS THAN ANY OTHER SUBSTANCE. IT IS
PRODUCED DURING THE INCOMPLETE BURNING
OF ORGANIC FUELS. CARBON MONOXIDE IS A
COLORLESS, ODORLESS, TASTELESS GAS;
WHICH MAKES ITS DETECTION IN THE AIR
DIFFICULT AND THUS INCREASE THE HAZARD.
USUALLY THE VICTIM DOES NOT REALIZE WHAT
IS HAPPENING UNTIL IT IS TOO LATE.
• REMOVE THE PATIENT FROM THE EXPOSURE
SITE
• PROVIDE PATIENT WITH 100% OXYGEN OR
EXPOSE HIM TO FRESH AIR
• MONITOR THE PATIENT FOR FURTHER
RESPIRATORY DISTRESS
• RUN ENGINES OUTDOORS OR
WITH DOORS/ WINDOWS OPEN
• KEEP WINDOWS CRACKED
WHERE YOU SLEEP
• DO NOT USE ENGINE EXHAUST
FOR HEAT
•
– SENSE OF PRESSURE IN THE HEAD
– ROARING/ RINGING SENSATION OF THE EARS
– PATIENT IS CONFUSED AND UNABLE TO THINK
CLEARLY
– DRUNK APPEARANCE
– OFTEN VOMITING
– INCONTINENT
– CONVULSIONS
– BOUNDING PULSE
– CHERRY RED LIPS
– DILATED PUPILS
– COMA
NOTE: YOU SHOULD CONSIDER CARBON
MONOXIDE POISONING WHENEVER CONFRONTED
WITH A GROUP OF PEOPLE WITH DIFFERENT
SYMPTOMS WHO ARE SHARING
ACCOMMODATIONS.
• Be careful not to expose yourself to the
Toxic Environment.
• Poisonous Plants
– Poison Ivy
– Poison Oak
– Poison Sumac
• Once the patient is removed the from
contaminated area:
–
–
–
–
Verify breathing and circulation
Decontaminate as necessary
CPR may be necessary
Get trained help
• Ingestion or contact with certain plants ma
cause symptoms such as:
–
–
–
–
–
–
–
–
Skin Irritation
Eye Irritation
Mouth Irritation
Pain
Breathing Problems
Allergic Reactions
Stomach and Intestinal Problems
Death
• Save part of plant for comparison
• Plants have oils or sap that of absorbed
can cause rash, sores or dermatitis.
• Poison Ivy and Poison Oak
– Wild Vine/Shrub
– Red Stemmed
– 3 leaves
• Leaves of 3 don’t touch me
• Poison Sumac
– Shrub/Tree
– Clear, watery sap that turns black when
exposed to air
– Grey/Brown Bark
• Treatment
–
–
–
–
–
Calamine lotion
Cortisone Cream
Aveeno or oatmeal bath or compress
Cool Compress
Diphenhydramine 25-50mg
• It is important to try to find exactly what and
how much the patient has swallowed.
• Verify breathing and circulation
• Call 9-1-1 or Poison Control 1-800-222-1212
–
–
–
–
–
Age
Weight
Amount
Type
How long ago ingested
• DO NOT INDUCE VOMITING
• DO NOT flush toilet or discard vomit
• Gather bottles
Prevention
–
–
–
Store all medicines, household products, and
personal care products in locked cabinets that
are out of reach of small children.
Identify poisonous plants in your house and
yard, and place them out of reach of children
or remove them.
Make sure visitors to your home keep their
medicines out of the reach of children.
Prevention
• Never mix household and chemical
products together. A poisonous gas may
be created when mixing chemicals.
• Do not burn fuels or charcoal or use
gasoline-powered engines in confined
spaces such as garages, tents, or poorly
ventilated rooms.
• Place carbon monoxide monitors near
the bedrooms in your house.
•
A 3-year-old girl was found at home
playing with a bottle of a children’s
cough and cold medicine. One hour later
she fell asleep. Approximately 11 hours
later, she is found blue and
unresponsive.
–
What should you do?
• Bee Stings: Critical if the patient is
allergic to bee stings
• In the allergic patient this can be life
threatening
– Epi Pen
• If patient is allergic to bees call 9-1-1
• Swelling may not happen for up to 24
hours
• Wash with Soap and Water
• Remove Stinger with credit card
– No tweezers
• Ice and Cortisone Cream
• Swelling and pain are normal
– (may not happen for up to 24 hour
•
•
•
•
•
Wash with Soap and Water
Ice
Tylenol or Advil
Not normally life threatening
Contact Poison Control for directions
• Normal sign is minor swelling and pain
• Flu like symptoms
• Very dangerous to the very young and the
elderly
• Anti-venom is available
• Seek Medical Attention
•
•
•
•
Normal sign is minor swelling and pain
Flu like symptoms
Ulcerated sore
Needs treatment at a hospital
Brown Recluse
Hobo
• Usually from fights
• The human mouth is full of germs and
bacteria
• The wound needs to be properly cleaned
and treated
• Watch for signs of infection
• Most dog bites are to the face
• Dog bites bleed heavily due to the facial
blood supply and the tearing forces
applied to the skin
• The bite may be as simple as a few
puncture wounds or it may be life
threatening bleeding
• Make the sure scene is safe
• Apply direct pressure to the wound
• Patient should be taken to the hospital for
further care to prevent infection
• Animal control or the police department
must be notified so they can the check dog
for rabies
•
•
•
•
40,000-50,000 bites – annually
Over 8,000 are poisonous snake bites
Fewer than 10 deaths reported annually
Anti-venom is available
• Occurs in less than 30% of bites
• Minimal in 30 – 40% of bites
• Significant in only 30% of bites
• Signs & Symptoms
–
–
–
–
–
Swelling
Discoloration
Labored breathing
Progressive general weakness
Convulsions
• Make sure the scene is safe
• Keep the patient calm
• Have the patient transported to the
hospital for further treatment
• DO CUT THEWOUND NOT THE WOUND
OPEN!!
• Keep wound BELOW the heart
• Ice packs to wound
• Use tourniquets sparingly
• Restrict Movement
• Heat Emergencies
–
–
–
–
Cramps
Heat
Heat Exhaustion
Heat Stroke
• Cold Emergencies
– Hypothermia
– Frostbite
• Exposure to hot, humid environment or
excessive exercising in heat can
overwhelm body's ability to cool itself
down.
• Two main heat illnesses are heat
exhaustion and heat stroke.
• These conditions have common
characteristics ranging from mild to
severe.
• With rapid cooling and medical treatment,
the survival rate approaches 90%.
• Heat Cramps
– Painful muscle spasms
– Moist Sweaty Skin
– Treatment –
• Remove from heat
• Rest, water or fluids with salts
• Heat Exhaustion
– Working in a hot environment, patient is weak, dizzy or
faints.
– Temperature below 104
– Nausea and Vomiting
– Pale, cool and sweaty skin
– Treatment
• Treat for shock and transport to the hospital
• Ice packs in arm pits, groin and behind neck
• Limit fluids to prevent vomiting
• Heat Stroke
–
–
–
–
–
–
–
Life Threatening
The body is overheating from the inside
Hot to touch, Bright Red Skin
NO SWEATING
Change in mental status
Vomiting
Temperature above 105
– Treatment
• Cool as rapidly as possible
– Ice Packs to Neck, Armpits and Groin
• Call 911
When Caring for Children and Older
Persons
• Young children and elderly with chronic
diseases (or those who cannot get out of
the heat) are at great risk for heat stroke
and death.
• First aid treatment is the same in all heat
emergencies - cool the victim down!
Prevention
•
•
When working in the heat, take rest
periods in a cool environment, and drink
plenty of fluids.
NEVER leave a child alone in a motor
vehicle in the heat, even to run a quick
errand. The passenger compartment can
quickly turn into a fatal oven!
•
After a long day working in a 90F (32C) heat wave,
you spot your coworker, a 41-year-old welder,
collapsed beside his vehicle. You squeeze the victim’s
shoulder and ask, “Are you okay?” There is no
response. You shout for help and tilt the victim’s head
back to open the airway. The victim is breathing fast
and shallow. His face is hot, red, and very sweaty.
You can see the man’s heartbeat pounding in his
neck. His body suddenly begins twitching and jerking.
–
What should you do?
• Hypothermia
– General cooling of the body
– Body temperature decreased to 95 F (35 C)
or less.
•
•
Early Symptoms
– Frostbite.
– Pale and cold skin.
– Weakness and loss of coordination.
– Altered Mental Status.
– Uncontrollable shivering.
Late Symptoms
– No shivering.
– Slow (or absent) breathing or heartbeat.
• Treatment
• Get inside and out of wind.
• Remove wet or constricting clothes,
replace with dry.
• Cover with warm blankets.
• Cover head and neck to help retain body
heat.
• Place victim near a heat source and
place containers of warm, but not hot,
water in contact with the skin.
• Comfort, calm, and reassure the victim
until EMS arrives.
Prevention
•
•
All deaths from exposure to extreme cold
are preventable.
Early recognition of signs and symptoms
of frostbite and hypothermia, along with
awareness of key risk factors, can help
minimize both injury and death.
• Frostnip
– patients skin blanches white
• Frostbite - freezing of parts of the body
– Superficial
• skin is white and waxy
• underlying skin is soft
– Deep
• the skin is frozen
• Frostnip
– local rewarming with warm hands
– Do Not Rub!
• Superficial Frostbite
– local rewarming, may be painful, may need
hospital care
– Do Not Rub!
• Deep Frostbite –
– Must be taken to hospital,
– Very painful and may lose extremity
•
•
•
DO NOT rub or massage the affected
area.
DO NOT disturb blisters on frostbitten
skin.
DO NOT give alcoholic beverages. They
do not help and may be harmful.
•
It’s been a long day working outside in the cold and
you feel exhausted. It’s so cold, it’s hard for you to
stop shivering. Your feet feel numb. On the way to
your truck you slip and fall on the ice. When you try to
stand, you slip and fall again. You feel drunk, but don’t
even drink. Fortunately, your coworker – a trained
First Aid Provider -- finds you lying in the parking lot.
She recognizes the emergency and alerts 911 on a
cell phone. In this rural location, and with the icy
roads, EMS may be significantly delayed.
–
What should she do?
• Too much or too little sugar in the body
– Symptoms: cool clammy skin, weak dizzy
– First Aid: give sugar in form of candy or drink
– ONLY IF ABLE TO SWALLOW
– NOT IF UNCONSCIOUS
• Orange Juice with Sugar
• Soda
• Glucose Tabs or Paste
• Knocked out tooth:
– Place in container of whole milk if tooth can be
replaced in 30 min.
– Rinse tooth in cold water and place back in
socket, then go to dentist ASAP:
Eye Injuries
Eye Injuries
• Requires emergency care
• Penetrating Object in the Eye
– Protect the eye with padding around the object
– Place paper cup or cone over object to keep it
from being disturbed
– Cover undamaged eye also to prevent
movement of the injured eye
• Chemical in Eye
– Flush with warm water
• Loose Object
– Remove with flushing if possible or wet gauze
– Use Caution
• Open Chest Wound With Impaled Object
– DO NOT remove an impaled object
• Bandage and Stabilize
• Minimize Movement
– Impaled Knife, etc.
• Open Chest Wound Without Impaled
Object
– Cover wound to prevent outside air from
entering the wound
– Use plastic wrap with tape on 3 sides to prevent
air from leaking
– GSW or Stabbing
• CALL 911 IMMEDIATELY
• Closed Chest Wound
– Blow to chest area
– Bruised or Fractured Ribs
• Cover chest with pillow to hold
pressure on wound
– Stabilized wound
– Watch for signs of shock
Every home or business
should have one
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
Gloves
Eye protection
Pocket mask
2 x 2 sterile gauze pads
4 x 4 sterile gauze pads
8 x 10 sterile gauze pads
Roller bandage 4”
Triangular bandage
Instant ice Pack
Antiseptic towelettes
Tape 1”
Antibiotic Ointment
Betadine prep pads
Hydrocortisone cream
Eye wash
Sting kill pads
Multiple adhesive bandages (band aids)
Questions,
Comments, Etc?
TEST
1. A responsive adult must agree to
receive first aid care. This is known as:
a)
b)
c)
d)
Refusal
Consent
Objection
Obligation
1. A responsive adult must agree to
receive first aid care. This is known as:
a)
b)
c)
d)
Refusal
Consent
Objection
Obligation
2. To “observe universal precautions”
means:
A. Whether or not you think the victim’s blood or
body fluid is infected, you act as if it is.
B. To quickly look for life-threatening conditions.
C. To reassure and comfort the victim.
D. To obtain Implied Consent.
2. To “observe universal precautions”
means:
A. Whether or not you think the victim’s blood
or body fluid is infected, you act as if it is.
B. To quickly look for life-threatening conditions.
C. To reassure and comfort the victim.
D. To obtain Implied Consent.
3. When dragging a victim in an
emergency, DO NOT:
A. Use your legs and keep the weight as close to
your body as possible.
B. Protect the spine as best as possible.
C. Know your physical ability and respect your
limitations.
D. Pull the victim sideways or pull the head away
from the neck and shoulders.
3. When dragging a victim in an
emergency, DO NOT:
A. Use your legs and keep the weight as close to
your body as possible.
B. Protect the spine as best as possible.
C. Know your physical ability and respect your
limitations.
D. Pull the victim sideways or pull the head
away from the neck and shoulders.
4. The Emergency Action Steps for an
UNRESPONSIVE victim include all the
following EXCEPT:
A. Assessing the scene and victim.
B. Alerting EMS or activating your emergency
action plan.
C. Opening the airway.
D. Asking if it’s okay to help.
4. The Emergency Action Steps for an
UNRESPONSIVE victim include all the
following EXCEPT:
A. Assessing the scene and victim.
B. Alerting EMS or activating your emergency
action plan.
C. Opening the airway.
D. Asking if it’s okay to help.
5. The Emergency Action Steps for a
RESPONSIVE victim include all the
following EXCEPT:
A. Assessing the scene and victim.
B. Assuming it is okay to help.
C. Alerting EMS or activating your emergency
action plan.
D. Helping victim maintain normal body
temperature.
5. The Emergency Action Steps for a
RESPONSIVE victim include all the
following EXCEPT:
A. Assessing the scene and victim.
B. Assuming it is okay to help.
C. Alerting EMS or activating your emergency
action plan.
D. Helping victim maintain normal body
temperature.
6. A responsive adult victim has given
you permission to provide first aid care.
The victim is awake, talking and
complains of feeling weak and dizzy.
You should:
A. Place victim in recovery position using the
HAINES method.
B. Call 9-1-1 or activate your emergency action
plan.
C. Give the victim an alcoholic beverage.
D. Apply cool, wet cloths to the victim’s skin.
6. A responsive adult victim has given
you permission to provide first aid care.
The victim is awake, talking and
complains of feeling weak and dizzy.
You should:
A. Place victim in recovery position using the
HAINES method.
B. Call 9-1-1 or activate your emergency
action plan.
C. Give the victim an alcoholic beverage.
D. Apply cool, wet cloths to the victim’s skin.
7. You are attending to a victim who is
unresponsive from an overdose of pain
medicine. EMS has been alerted. You
have opened the victim’s airway by
tilting the head and lifting the chin.
Why?
A. Without an open airway, the unresponsive
victim will die.
B. To manually stabilize a suspected spinal
injury.
C. To reassure and comfort victim.
D. To observe Universal Precautions.
7. You are attending to a victim who is
unresponsive from an overdose of pain
medicine. EMS has been alerted. You
have opened the victim’s airway by
tilting the head and lifting the chin.
Why?
A. Without an open airway, the unresponsive
victim will die.
B. To manually stabilize a suspected spinal
injury.
C. To reassure and comfort victim.
D. To observe Universal Precautions.
8. You are attending to a seriously injured,
unresponsive victim who is lying face
up on the pavement. You hear gurgling,
and the victim vomits. You should:
A. Wait for EMS providers to arrive and explain
what happened.
B. Quickly place the victim in the recovery
position using the HAINES method.
C. Tell the injured victim not to move.
D. Perform a series of abdominal thrusts until the
victim’s stomach is empty.
8. You are attending to a seriously injured,
unresponsive victim who is lying face
up on the pavement. You hear gurgling,
and the victim vomits. You should:
A. Wait for EMS providers to arrive and explain
what happened.
B. Quickly place the victim in the recovery
position using the HAINES method.
C. Tell the injured victim not to move.
D. Perform a series of abdominal thrusts until the
victim’s stomach is empty.
9. You are attending to a responsive
accident victim who has blood gushing
out of a large wound in the leg. To
control the bleeding you should:
A. Wash wound with clean, running tap water for
5 minutes until bleeding stops.
B. Apply direct pressure with absorbent pad until
bleeding stops.
C. Apply triple antibiotic lotion or cream and
cover the wound with an adhesive bandage.
D. Apply a tourniquet.
9. You are attending to a responsive
accident victim who has blood gushing
out of a large wound in the leg. To
control the bleeding you should:
A. Wash wound with clean, running tap water for
5 minutes until bleeding stops.
B. Apply direct pressure with absorbent pad
until bleeding stops.
C. Apply triple antibiotic lotion or cream and
cover the wound with an adhesive bandage.
D. Apply a tourniquet.
10. An injured victim is shivering and wet
from heavy sweating. His tissue color is
pale and he is pleading for something
to drink. You should:
A. Give warm salty water.
B. Give cool, clean tap water.
C. Give nothing to drink; remove any blood
soaked dressings.
D. Give nothing to drink; cover him with a blanket
to maintain normal temperature.
10. An injured victim is shivering and wet
from heavy sweating. His tissue color is
pale and he is pleading for something
to drink. You should:
A. Give warm salty water.
B. Give cool, clean tap water.
C. Give nothing to drink; remove any blood
soaked dressings.
D. Give nothing to drink; cover him with a
blanket to maintain normal temperature.
11. You are caring for a coworker with a
painful, blistered burn on the arm from
a hot liquid. You should:
A. Cool it with cold water as quickly as possible
and continue cooling until pain is relieved.
B. Quickly pop each blister, then apply cold
butter until the pain is relieved.
C. Apply triple antibiotic ointment to the burn and
cover it with an adhesive bandage.
D. Apply ice directly to the burn and keep it there
until pain is relieved.
11. You are caring for a coworker with a
painful, blistered burn on the arm from
a hot liquid. You should:
A. Cool it with cold water as quickly as
possible and continue cooling until pain is
relieved.
B. Quickly pop each blister, then apply cold
butter until the pain is relieved.
C. Apply triple antibiotic ointment to the burn and
cover it with an adhesive bandage.
D. Apply ice directly to the burn and keep it there
until pain is relieved.
12. You are attending to a responsive
adult who tripped and fell. She has
sharp pain, swelling, and deformity in
her right leg. EMS has been alerted.
You should:
A. Tap and shout, “Are you okay?”
B. Manually stabilize the injured leg.
C. Firmly snap the dislocated bone ends back
into place.
D. Apply a pressure bandage around the entire
length of the extremity.
12. You are attending to a responsive
adult who tripped and fell. She has
sharp pain, swelling, and deformity in
her right leg. EMS has been alerted.
You should:
A. Tap and shout, “Are you okay?”
B. Manually stabilize the injured leg.
C. Firmly snap the dislocated bone ends back
into place.
D. Apply a pressure bandage around the entire
length of the extremity.
13. You are caring for a responsive victim
that was thrown from a motorcycle. He has
given you permission to provide first aid
care and complains of a burning sensation
in his fingers. He is wearing a helmet and
has no severe bleeding. You should:
A. Tell him to sit up so you can check for a pain
response.
B. Place your hands on both sides of the helmet to
keep his head, neck and spine in line.
C. Remove his helmet and perform a physical
assessment.
D. Place him in the recovery position.
13. You are caring for a responsive victim
that was thrown from a motorcycle. He
has given you permission to provide
first aid care and complains of a
burning sensation in his fingers. He is
wearing a helmet and has no severe
bleeding. You should:
A. Tell him to sit up so you can check for a pain
response.
B. Place your hands on both sides of the
helmet to keep his head, neck and spine in
line.
C. Remove his helmet and perform a physical
assessment.
D. Place him in the recovery position.
14. You are assisting a person with
asthma in taking his/her prescribed
medication. There is no improvement
from the medicine after 20 minutes, and
the person seems to be struggling to
breathe. You should:
A. Instruct the person to double the prescribed
dose and try again.
B. Be patient. Wait for the medication to take
effect.
C. Perform a physical assessment.
D. Alert EMS or activate your emergency action
plan.
14. You are assisting a person with
asthma in taking his/her prescribed
medication. There is no improvement
from the medicine after 20 minutes, and
the person seems to be struggling to
breathe. You should:
A. Instruct the person to double the prescribed
dose and try again.
B. Be patient. Wait for the medication to take
effect.
C. Perform a physical assessment.
D. Alert EMS or activate your emergency
action plan.
15. You are caring for a victim who has
been stung by a wasp and is severely
allergic to them. The victim has an
epinephrine auto-injector but is having
trouble handling the device due to her
constant coughing. Her lips and face
appear swollen. You should:
A. Help the victim use the device. If she is
unable, administer it yourself.
B. Comfort, calm, and stay with victim until the
swelling goes down.
C. Attempt to raise the victim’s blood sugar level
as quickly as possible.
D. Leave the victim alone to provide privacy and
minimize embarrassment.
15. You are caring for a victim who has
been stung by a wasp and is severely
allergic to them. The victim has an
epinephrine auto-injector but is having
trouble handling the device due to her
constant coughing. Her lips and face
appear swollen. You should:
A. Help the victim use the device. If she is
unable, administer it yourself.
B. Comfort, calm, and stay with victim until the
swelling goes down.
C. Attempt to raise the victim’s blood sugar level
as quickly as possible.
D. Leave the victim alone to provide privacy and
minimize embarrassment.
16. You are attending to a victim of
suspected heat exhaustion. All of the
following are correct, EXCEPT:
A. Have the victim lie down in a shady cool
place.
B. Loosen or remove excess clothing.
C. Give a cool sports drink to replace lost fluid,
salts and minerals.
D. Cover head and neck to help retain body heat.
16. You are attending to a victim of
suspected heat exhaustion. All of the
following are correct, EXCEPT:
A. Have the victim lie down in a shady cool
place.
B. Loosen or remove excess clothing.
C. Give a cool sports drink to replace lost fluid,
salts and minerals.
D. Cover head and neck to help retain body
heat.
17. You are called to attend to a coworker
who collapsed while working in a hot
warehouse. The victim is unresponsive.
His skin is hot and wet. EMS has been
alerted. You should:
A. Spray or pour water on the victim and fan him.
B. Comfort, calm, and stay with the victim until
fully recovered.
C. Apply heat packs to the victim’s neck, groin,
and armpits.
D. Administer the victim’s prescribed medication.
17. You are called to attend to a coworker
who collapsed while working in a hot
warehouse. The victim is unresponsive.
His skin is hot and wet. EMS has been
alerted. You should:
A. Spray or pour water on the victim and fan
him.
B. Comfort, calm, and stay with the victim until
fully recovered.
C. Apply heat packs to the victim’s neck, groin,
and armpits.
D. Administer the victim’s prescribed medication.
18. You are caring for a coworker who is
complaining that his fingers are numb after
a long day working outside in the winter
cold. His fingers look pale and they feel
very cold and hard. There is a medical
clinic not too far away. You should:
A. Put his fingers in warm 100°F to 105°F (38° to
40°C) water.
B. Place a sterile dressing between his fingers and
seek medical attention.
C. Place hot water near, but not in contact with the
skin.
D. Instruct the victim to briskly rub the affected area.
18. You are caring for a coworker who is
complaining that his fingers are numb after
a long day working outside in the winter
cold. His fingers look pale and they feel
very cold and hard. There is a medical
clinic not too far away. You should:
A. Put his fingers in warm 100°F to 105°F (38° to
40°C) water.
B. Place a sterile dressing between his fingers and
seek medical attention.
C. Place hot water near, but not in contact with the
skin.
D. Instruct the victim to briskly rub the affected area.
19. You are attending to a responsive
victim of hypothermia. The victim has
been moved inside. Wet clothes have
been replaced with dry and you have
covered the victim with warm blankets.
Next, you should:
A. Place the victim near a heat source and place
containers of warm water in contact with the
skin.
B. Briskly massage the victim’s arms and legs.
C. Give a cool sports drink.
D. Give a warm alcohol drink.
19. You are attending to a responsive
victim of hypothermia. The victim has
been moved inside. Wet clothes have
been replaced with dry and you have
covered the victim with warm blankets.
Next, you should:
A. Place the victim near a heat source and
place containers of warm water in contact
with the skin.
B. Briskly massage the victim’s arms and legs.
C. Give a cool sports drink.
D. Give a warm alcohol drink.
20. You have been called to provide first
aid for a coworker who is complaining
of a headache and nausea after inhaling
a chemical cleaning product. The scene
is safe and other than the symptoms
described, the victim seems fine. You
should:
A. Encourage the victim to go back to work.
B. Induce vomiting with syrup of ipecac.
C. Administer a whole adult aspirin tablet (325
mg.).
D. Call the Poison Center.
20. You have been called to provide first
aid for a coworker who is complaining
of a headache and nausea after inhaling
a chemical cleaning product. The scene
is safe and other than the symptoms
described, the victim seems fine. You
should:
A. Encourage the victim to go back to work.
B. Induce vomiting with syrup of ipecac.
C. Administer a whole adult aspirin tablet (325
mg.).
D. Call the Poison Center.
21. When life-threatening situations exist
and the parent or legal guardian is not
available, first aid care for a child
should be given based on:
A.
B.
C.
D.
Refusal
Implied Consent
Objection
Obligation
21. When life-threatening situations exist
and the parent or legal guardian is not
available, first aid care for a child
should be given based on:
A.
B.
C.
D.
Refusal
Implied Consent
Objection
Obligation
22. You are assisting a child with asthma
in taking prescribed medication. Ten
minutes later the child is bent over and
can’t stop coughing. You should:
A. Double the prescribed dose of medication and
have the child try again.
B. Be patient. Wait for the medication to take
effect.
C. Perform a physical assessment.
D. Alert EMS or activate your emergency action
plan.
22. You are assisting a child with asthma
in taking prescribed medication. Ten
minutes later the child is bent over and
can’t stop coughing. You should:
A. Double the prescribed dose of medication and
have the child try again.
B. Be patient. Wait for the medication to take
effect.
C. Perform a physical assessment.
D. Alert EMS or activate your emergency
action plan.
• 23. You been called to provide first aid
for a 3-year old child who was
discovered on the floor of the bathroom
drinking from an open bottle of skin
care lotion. Other than crying loudly
when you quickly take the bottle away,
the child appears fine. You should:
A. Administer sips of lemon juice or vinegar to
neutralize the product.
B. Administer 25–50 grams of activated charcoal
in a glass of water to dilute the product.
C. Administer ½ ounce syrup of ipecac to help
the child vomit out the product.
D. Call the Poison Center.
• 23. You been called to provide first aid
for a 3-year old child who was
discovered on the floor of the bathroom
drinking from an open bottle of skin
care lotion. Other than crying loudly
when you quickly take the bottle away,
the child appears fine. You should:
A. Administer sips of lemon juice or vinegar to
neutralize the product.
B. Administer 25–50 grams of activated charcoal
in a glass of water to dilute the product.
C. Administer ½ ounce syrup of ipecac to help
the child vomit out the product.
D. Call the Poison Center.
24. The Emergency Action Steps for a
RESPONSIVE victim include all the
following EXCEPT:
A. Assessing the scene and victim.
B. Opening the airway.
C. Alerting EMS or activating your emergency
action plan.
D. Helping the victim maintain normal body
temperature.
24. The Emergency Action Steps for a
RESPONSIVE victim include all the
following EXCEPT:
A. Assessing the scene and victim.
B. Opening the airway.
C. Alerting EMS or activating your emergency
action plan.
D. Helping the victim maintain normal body
temperature.
• 25. This was the best First Aid Class
you have ever had.
A. True
B. False
• 25. This was the best First Aid Class
you have ever had.
A. True (Of Course)
B. False
Survey Information
• Please be sure to either complete a survey
today and return it to your instructor, or
you may also visit the ASHI website at
http://ashinstitute.org/quality.htm
and choose the RATE OUR PROGRAM
link.
Training Center Name: Mt Lemmon Fire
District
Class Title: Basic First Aid and CPR/AED
for the Lay Person

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