First Aid Facts: Part One

1
First Aid Facts Part One

• First Aid for Engineers
• August 27th, 2003

2
Outline

• Airway problems
• Breathing problems
• Circulation bleeding and shock
• Wounds
• Assessment and treatment
• Special considerations
• Burns
• Facial, ear and eye injuries
• Head, neck and spinal injuries
• Abdominal and chest trauma
• Bone, joint and muscle injury

3
Respiratory System Anatomy
4
Respiratory System Physiology

• Breathing allows CO2 to be expelled and O2 to be
  exchanged into the blood.
• Without an open Airway breathing cannot occur.
• Air is drawn into the body by negative pressure
  in the pleural cavity created by muscular
  contraction of the diaphragm

5
Airway evaluation

• If victim is talking, crying or coughing the
  airway is open.
• If the victim is unconscious and on their back
  then the tongue is most likely blocking the
  airway.
• Two methods for opening the airway
• Head tilt, chin lift - no suspicion of spinal
  injury
• Jaw thrust known or suspicion of spinal injury

6
Chin Lift and Head Tilt
7
Jaw Thrust
8
Inspection of Airway

• Open Airway
• Look for food or fluid
• If no spinal injury then turn victim to recovery
  position
• If foreign object seen or spinal injury then
  finger sweep
• Wear a glove
• Use a cloth to get liquid out

9
Recovery Position
10
Check for Breathing

• can you speak?
• Look - chest movement
• Listen air movement
• Feel - air on cheek
• Inadequate breathing
• Less than 8 per minute
• Blue lips
• Increased effort with breathing

11
Rescue Breathing

• Place your mouth over the victims mouth and pinch
  the nose closed.
• Exhale into the victims mouth slowly, filling
  their lungs with the air from your lungs
• Release and let the air come back out, turn and
  watch the chest fall.
• Give one breath every 5 seconds in adults
• If you are trained, use a mouth to device
  protective breathing apparatus

12
Obstructed Airway

• Will lead to cardiac arrest
• Usually food, blood or vomit
• Partial airway obstruction
• Cough present
• Noises may be heard with respiration
• May become blue
• Complete obstruction
• Cannot cough, speak or breath

13
Heimlich Maneuver
14
If victim becomes unconscious

• Call EMS
• Place victim on back and open airway
• Look inside mouth if cannot see anything do not
  do a finger sweep
• Try to give rescue breaths
• If these do not go in reposition the head and
  give another breath.
• Perform abdominal thrusts

15
Circulatory System (plumbing)

• Heart (pump)
• Arteries (large outbound pipes)
• Capillaries (oxygen delivery location)
• Veins (large drainage pipes)
• Blood (fluid)

16
Circulatory arrestHeart stops pumping

• Causes
• Arrhythmia electrocution, heart attack
• No oxygen to heart heart attack, respiratory
  arrest (choking, seizure, allergic reaction)
• No blood to pump - Trauma
• May respond to CPR
• Brain damage occurs in 10 minutes

17
Bleeding

• Arterial
• Pulsating
• Rapid
• Venous
• Smoother Flow
• Slow
• Capillary
• Oozing

• External Bleeding
• Obvious
• Internal Bleeding
• Bruising
• Painful, tender, rigid abdomen
• Broken ribs or bruised chest
• Bloody or black stools or vomit

18
Controlling Bleeding

• Wear Personal Protection Equipment If Available
• Expose the wound to see where bleeding is coming
  from
• Three Steps
• Direct Pressure
• Elevation
• Pressure point

19
Shock

• Definition
• No O2 to Tissue
• Signs and Symptoms
• Change in mental status
• Skin Pale, Cold, Clammy (low BP)
• Nausea and vomiting
• Rapid Pulse and Rapid Breathing

20
Types of Shock

• Cardiogenic pump failure
• Hypovolemic loss of fluid
• Neurogenic pipes enlarge, too large for volume
  of fluid
• Anaphylactic loss of fluid and enlarged pipes
• Septic loss of fluid and enlarged pipes

21
Treatment of Shock

• Treat the Cause
• Position with feet raised 1 foot above heart
• Cover with warm blankets
• Do not give anything to eat or drink
• Reassure the victim
• Use EpiPen if Anaphylactic Shock

22
Wounds - Anatomy of Skin
23
Types of wounds

• Incision - sharp strait wound
• Avulsion part of skin loose or torn
• Puncture deep, narrow wound
• Abrasion top layer of skin scraped off
• Laceration irregular cut from tearing
• Amputation part of body detached
• Burn partial or full thickness thermal or
  chemical injury to skin.

24
Treatment for wounds

• Wash your hands and don gloves
• Expose wound completely
• Wash wound with water at medium faucet flow
• Remove debris with sterile tweezers
• Cover with sterile gauze and if shallow wound
  antibiotic ointment
• Keep clean and dry replace dressing daily
• Watch for signs of infection

25
Wounds that require medical attention

• Bio or chemical hazards involved
• Dirty or victim without recent tetanus shot
• Arterial bleeding
• Into deep subcutaneous fat
• Bites
• Amputations, Avulsions or Impaled objects
• Facial wounds
• Infected wounds

26
Special consideration

• When was your last Tetanus shot?
• If not within last 5-10 years, must have new shot
  within 72 hours to prevent tetanus
• There is no cure for tetanus.
• Impaled objects
• Never remove the object
• Stop bleeding by placing pressure around the
  object

27
Amputations

• Activate EMS
• Wrap stump in bulky dressing
• Do not use tourniquet
• Find and gently clean part
• Wrap part in gauze and place into plastic bag
• Place bag in bag of ice and transport with victim

28
Burns

• First Degree
• Superficial (epidermis)
• Heal without intervention
• Second Degree
• Partial thickness (into dermis)
• Larger or sensitive areas require medical
  attention
• Third Degree
• Full thickness (thru dermis into fat or muscle)
• Require skin grafting in most cases

29
Three levels of Burns
30
Types of Burns

• Thermal
• Chemical
• Always require medical attention
• Special consideration with certain chemicals
• Electrical
• Always require medical attention
• Go deep and travel along the muscles

31
Assessing BSA burned Rule of nines

• Minor Burn
• lt50 1st Degree
• lt10 2nd Degree
• Moderate Burn
• gt50 1st Degree
• 10-30 2nd Degree
• lt10 3rd Degree
• Severe Burn
• Larger BSA 2nd and 3rd Degree
• All Electrical Burns
• Burns to face, hands, feet or genitals
• Most Chemical Burns
• Inhalation burns

32
Treatment of Minor Burns

• Stop the Burn cool water irrigation
• Aloe Vera or other soothing lotion
• Keep covered with sterile gauze
• Take Aleve or Advil
• Watch for signs of infection
• Fever or oozing
• Increasing Redness, Swelling and Pain

33
Treating Moderate to Severe Burns

• Activate EMS
• ABCDEs
• Stop the burning
• Remove clothing
• Irrigate only smaller burns
• Assess Depth (degree)
• Assess Extent ( BSA)
• Cover Areas with dry bandage damp bandage can
  lead to hypothermia
• Treat for Shock

34
Facial Injuries

• Most injuries to the face requires medical
  attention
• A bloody nose or black eye can be treated with
  Ice, elevation of head and gentle pressure
• Go to Babson Health Center for evaluation of
  minor injuries
• Activate EMS for more serious injuries

35
Eye Injuries

• All Eyeball injuries should be seen by an
  ophthalmologist if they result in
• Change in vision
• Pain
• For Corneal injuries or chemical splashes
• Irrigate eye for 15 minutes
• If chemical exposure transport to nearest
  hospital
• Do not try to remove an impaled object or replace
  an explanted eyeball
• Bandage both eyes, protect the injured one with a
  paper cup, or damp gauze if the eyeball is
  exposed
• Transport to the nearest hospital

36
Ear injuries

• Seek medical attention for external ear injury
• High risk of infection
• Seek medical attention for blast injuries
  resulting in
• Decreased hearing
• Blood or fluid coming from the ear

37
Dental injuries

• Find missing tooth
• Placed rolled up gauze in socket to control
  bleeding
• Clean tooth and replace into socket if not too
  damaged
• Place tooth in saliva soaked gauze if unable to
  replace
• Teeth replaced in lt 1 hr. may survive
• Transport victim to Hospital

38
Head injuries

• Scalp wounds bleed significantly
• Skull fractures
• Painful at site
• Unequal pupils
• Skull deformity
• Blood or fluid from ears and eyes

39
Signs and Symptoms of Brain Swelling

• Altered level of Consciousness
• Memory Loss
• Nausea and Vomiting
• Headache
• Unequal pupils or change in vision
• Seizures
• Weakness or Paralysis
• Leak of Blood or CSF from ears

40
Treating head injuries

• Activate EMS
• Monitor ABCDs
• Cover wounds with sterile dressing
• Assume spine injury - immobilize neck
• Apply pressure around to bleeding scalp wounds
• Watch for signs of brain swelling

41
Anatomy of the Spine
42
Signs and Symptoms of Spinal Injury

• Pain with movement
• Numbness
• Tingling or weakness
• Loss of bowel or bladder control
• Paralysis
• Loss of strength

43
Treatment of Spinal Injury

• Seek Immediate medical attention
• Do Not Move Victim unless absolutely necessary
• To monitor ABCs
• To evacuate from immediate Danger
• Stabilize before move if possible
• Monitor ABCDs until help arrives

44
Chest Trauma

• Vital Organs are protected by Ribs and Sternum
• Critical Injury to the chest can affect Airway,
  Breathing and Circulation
• Do not remove Penetrating objects
• Do not lift off crushing object unless breathing
  is significantly affected
• Bandage and stabilize them for transportation
• Sucking chest wounds are a special case

45
Sucking Chest Wounds

• Wounds which go thru the chest wall into lung
• Requires Immediate attention to avoid lung
  collapse
• Create Valve Dressing

46
Dressing for sucking Chest Wound
47
Abdominal Wounds

• Should always be evaluated by professionals
  call EMS
• Monitor ABCDs
• Do not give anything to eat or drink
• Treat for Shock
• If intestines protruding cover with wet,
  non-adherent dressing and Saran Wrap
• Watch for Vomiting

48
Anatomy of Skeletal System

• Anatomy
• Bones
• Cartilage
• Ligaments
• Tendons
• Muscles

49
Types of Injuries

• Sprain
• ligament
• Strain
• tendon
• Contusion
• muscle
• Dislocation
• joint
• Fracture
• bone

50
Symptoms of Orthopedic injuries

• Sharp Pain
• Swelling
• Tenderness to are
• Deformity to the area
• Bruising and stiffness
• Weak or poor function

51
Treatment for minor injuries - RICE

• Rest avoid using
• Ice 20 minutes every 2-3 hours
• Compression Wrap to keep swelling down
  especially in joint
• Elevation - Also to reduce swelling

52
Fracture/Dislocation Treatment

• Check ABCs
• Activate EMS
• Treat for Shock
• Look and feel extremity for CSM
• Circulation pulses
• Sensation
• Movement
• Stabilize across joint if need to move victim
• Use RICE until help arrives

53
Practical Skills Exercise

• Patient Assessment / SAMPLE history / Pressure
  Points
• Bandages and Splints
• Carries and Spinal Immobilization
• Airway and Breathing

54
Review

• Gross Pictures to Follow
• Grossest are moulage not real
• Please feel free to close yours eyes

55
What type of injury is this? What would you do
for it?
56
What type of injury is this? What would you do
for it?
57
What type of injury is this? What would you do
for it?
58
What type of injury is this?What would you do
for it?
59
What type of injury is this?What would you do
for it?
60
What type is this? What do you do for this?