First Responder First Aid

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First Responder First Aid

• Capt Mikesell

2
Class Outline

• What questions does a first responder need to
  ask?
  
• ABCc of first Aid
• Fractures/ contusions/ lacerations
• Climate injuries
• Insect/animal bites/poisons
• Food/choking

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What does a first responder need to ask?

• Check for a response
• AVPU
• A Awake, Alert, Oriented xs three(time person
  and place)
  
• V verbal, (can the patient give you a verbal
  response)
  
• P Pain (sternal rub, nail bed, check corneal
  response, arm flop)
  
• U Unresponsive (No reaction verbally physical
  any physical withdrawal from pain)

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So what does that mean

• Known buddy? Ask him or her about the things you
  know and determine the level of consciousness
  from their response
  
• If they can communicate you ask them whats wrong
  and go through your checklist (dont forget
  orientation times three). Check first for
  bleeding or obvious deformities (patient may not
  know where or exactly what is wrong with due to
  nerve and or brain damage)
• Assess injuries and treat as needed

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If unresponsive(ABCs)

• Check Airway
• Check Breathing
• Check for pulse (Carotid)
• STOP THE BLEEDING

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Types of Bleeding

• Whether the victim thinks they are bleeding or
  not CHECK!!
  
• Feel for wet spots
• Arterial bleeding will pulsate and spray (bright
  Red) (Life threatening emergency!!!) (without
  stopping or slowing the bleeding they will bleed
  out in 15-30 minutes) (for a severe arterial
  laceration its possible the victim could bleed
  out in less than five minutes)
• Venous bleeding (steady constant flow) (not as
  serious but can be life-threatening)
  

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Arterial Bleeding

• Apply pressure directly to the wound
• Find the artery above the wound and apply
  pressure (this allows the blood to coagulate
  ahead of the injury)
  
• Apply pressure dressing to wound once bleeding
  has been stopped or slowed
  
• Elevate the artery above the heart if possible
  (Icing the area will help slow the blood as
  well)
  
• Tourniquets may be applied above the wound but
  below the closest joint (a tourniquet is not
  always as effective as simply applying pressure
  with your fingers) When a tourniquet is applied
  mark the time if possible
• If a person is found with arterial bleeding it is
  essential they get to a medical facility ASAP

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Venous bleeding

• Apply pressure directly to the wound
• Pressure dressing if necessary
• Elevate above the heart
• Ice the area if possible and necessary to slow
  the bleeding
  

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If unresponsive(ABCs)

• Check Airway
• Check Breathing
• Check for pulse (Carotid)
• STOP THE BLEEDING

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Unresponsive

• Airway Head tilt and chin lift. (Look, listen
  and feel) 5-10 seconds.
  
• Breathing Attempt to give 2 rescue breaths.
  Make each breath over 1 second and make visible
  chest rise. If no chest rise, reposition head to
  open airway and attempt to ventilate again.
  After 2 rescue breaths, check for pulse.
• Circulation check for carotid pulse for 5-10
  seconds. If no pulse begin CPR.
  

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Rescue Breathing

• If patient has a pulse but is not breathing, or
  not breathing adequately, begin rescue breathing.
  
  
• Approximately 8-12 breaths per minute, or 1
  breath every 6-10 seconds. Make each breath over
  1 second. Each breath should cause visible chest
  rise.
• Continue rescue breathing until help arrives or
  until patient starts breathing spontaneously.
  Recheck pulse every 2 minutes.
  
• If patient starts breathing spontaneously, place
  pt on their side in the rescue position to
  prevent vomit from choking them (common side
  effect)

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Fractures

• Compound-Open wound associates with the break
  (High risk for infection)
  
• Simple- Occurs beneath the skins surface (no
  visible bone)
  
• Burst bone at site of injury fragments (Usually
  vertebral fracture)
  

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Compound fractures

• Immobilize the joint
• Elevate above the heart
• Slow or stop the bleeding
• Elevate and ice if possible to control swelling
• Check for a pulse below the injury site to
  ensure that blood flow is not compromised With
  pulse Recheck every 15 minutes (If there is no
  pulse you have less than an hour to keep the
  limb) THIS IS AN IMMEDIATE MEDIVAC

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Simple fractures

• Check for obvious deformity
• Check for pulse below the break
• Immobilize the injury
• Elevate and ice if possible to control swelling
• Medevac according to severity

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Why can fractures be so dangerous?

• Compartment Syndrome- The swelling or bleeding at
  the injury site increases pressure on the blood
  vessels compromising circulation to the
  extremity. This condition causes severe
  unrelenting pain, and if untreated leads to loss
  of the affected limb.
• Osteomylitis- Often caused by untreated compound
  fractures (infection of the bones)
  
• Extremely hard to cure

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Contusions/Lacerations

• Contusion- Severe bruising with or without
  discolorations (Localized pain usually associated
  with a traumatic event, discoloration, swelling)
  
• Lacerations- Severe cuts (usually resulting in
  moderate to severe loss of blood)
  

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Contusions

• Contusions to the ribs require assessment of the
  lungs (check for shortness of breath)
  
• Ice and rest
• Head contusion must be reassessed every two hours
  for increasing cranial pressure
  

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Lacerations

• Stop the bleeding
• Disinfect the wound (attempt to irrigate the
  wound)
  
• Elevate and apply ice if possible
• Reassess and move on

19
Climate injuries

• Hypothermia- climate injury where body
  temperature drops to 95 degrees or below and the
  bodys systems are effected by the change
  
• Heat Exhaustion- Climate injury where the core
  body temperature climbs above the normal temp and
  the bodys systems are effected by the changes
  
• Heat stroke- climate induced injury where the
  core body temperature rises above 105 degrees and
  usually results in body shut down (can be fatal
  within 10-15 minutes of onset)

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Hypothermia

• Causes dehydration, exposure to elements (Can be
  normal temperatures when water is involved)
  
• Signs
• Shivering occurs when core body temp drops over 2
  degrees and stops after 2 degrees (not a good
  thing)
  
• Numbness in extremities
• Slowed circulation/ breathing
• Loss of cognitive skills
• Euphoria (If your cold your alive)

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Treatment of hypothermia

• Re-warm the body core temperature
• Immersion of effected body temperature into water
  
  
• Apply heat to body trunk and vital areas
• Do not use dry heat
• Best re-warming source for us is your buddy
• Do not expose to extreme temperatures
• Immediate medevac and IV

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Heat Exhaustion

• Causes Dehydration, exposure to elements,
  physical exertion Can occur when temperatures
  are moderate or even cold
  
• Symptoms
• Dizziness
• Weakness
• Fainting
• Nausea vomiting headaches
• Cold clammy skin

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Treatment

• -Remove excess layers of clothing
• -Lie down feet up
• -Drink water slowly or increase electrolytes
  (stop the cramping)
  

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Heat Stroke

• Causes Dehydration, exposure to elements,
  physical exertion Can occur when temperatures
  are moderate or even cold
  
• Symptoms
• High body temp
• Loss of any signs of sweat
• Decreased levels of consciousness
• Signs of shock (elevated heart rate, change in
  level of consciousness)

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Treatment of Heat Stroke

• Primary- lower core body temp
• Remove clothing
• Ice patient (cool water if ice isnt available to
  armpits, groin, neck and head)
  
• Cover with wet t-shirts or towels
• Start electrolyte replacement immediately
• Medevac essential

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Frostbite

• Temporary or permanent skin tissue damage caused
  by prolonged temperature of 23 degrees fare
  height and below
  
• Signs
• -Numbness, tingling and burning, pain, pain fades
  and disappears, discoloration

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Treatment of frostbite

• Re-warm effected areas as quickly as possible
• Do not rub the area
• Immerse the effected area in a bath fo up to an
  hour at a time
  
• If no water is available stick the effected area
  in a body heat zone (arm pit/ groin/ thighs)

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Insect bites/animal bites and poisons

• Insect bites- allergic reaction caused by insect
  bite to skin
  
• Animal bites- Come on figure this one out
  yourselves
  
• Poisons- allergic reaction to naturally occurring
  plant/ vegetation or as a result of animal
  (snake/spider) bites.

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Insect bites

• Worst case scenario Anaphylactic shock
  (shortness of breath, tightness of throat, facial
  swelling, increased heart rate,decreased blood
  pressure, hives, itching)
• Treatment for anaphylaxis 1) epinephrine or
  epi-pen (check for special meds the person might
  be carrying) usually this will have happened to
  the victim before
• 2) Benadryl if possible without choking
• 3) Call medevac
• Minor localized reaction including redness
  itching, swelling
  

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Prevention/treatment

• DEET
• Antihistamines (stop itching to prevent
  inflammatory response)
  
• Topical ointments
• Watch the area for days after for signs and
  symptoms of infection
  
• If tick bite look for swelling skin
  discoloration and or rings up to 7 days after the
  bite
  
• (Tick) Swollen joints local to the area and or
  overall signs of fatigue that are unusual need to
  be followed up immediately (treated with
  antibiotics)

31
Animal Bites

• Skin broken by teeth of an animal possibly
  causing infection leading to rabies, cat scratch
  fever, cellulitis or other possible bacterial
  infections.

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Prevention/treatment

• This isnt a petting zoo (stay away from
  animals!)
  
• Tetanus shot current within the last five years
• Irrigate the wound
• Stop bleeding if necessary (includes compression
  and elevation)
  
• Get follow up ASAP

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Food and Choking

• If your choking because of the food your
  eating..your a dumbass
  
• No seriously look up the Heimlich maneuver and
  apply as needed
  
• Dont eat it unless it comes wrapped up. Save the
  survival crap until after you have been trained
  accordingly