FIRST AID TRAINING

1
FIRST AID TRAINING

• KIRKWOOD COMMUNITY COLLEGE
• HEALTH SCIENCE

2
FIRST AID TRAINING

• Power Point 1

3
LEARNING OUTCOME

• the student should be able to identify their role
  in providing first aid

4
PURPOSE OF FIRST AID

• provide temporary assistance in medical emergency
  situations until professional rescuers arrive and
  assumes responsibility for the victim

5
LEGAL ASPECTS

• Good Samaritan Law minimizes the fear of legal
  consequences, but protects only those acting in
  good faith without gross negligence or willful
  misconduct

6
LEGAL ASPECTS

• Do no further harm to the victim

7
LEGAL RESPONSIBILITY

• Legal responsibility varies from state to state
  as to who stops and renders first aid. Know your
  state law

8
What is the state law of Iowa?

• How would you find this information out?
• Who can you call in you local community?
• What is Iowas law?
• No legal responsibility in Iowa unless it is
  part of your job description

9
LEGAL RESPONSIBILITY

• once you render first aid to a victim, you have a
  legal obligation to continue until professional
  rescuers arrive
• to discontinue would be considered abandonment

10
MORAL OBLIGATION TO RENDER FIRST AID

• When designated by employment
• When a pre-existing responsibility exists,
  examples
• parent/child
• driver/passenger
• student/teacher

11
CONSENT FOR FIRST AID

• Permission from a conscious victim is required to
  avoid assault charges and termed consent
• Permission from an unconscious victim is not
  obtainable from the victim. Therefore, we assume
  the victim would want first aid. This action is
  termed implied consent

12
TRIAGE

• is the action of sorting victims of disaster in
  order to determine who needs immediate care and
  transportation to the hospital, or could be
  delayed
• disaster any situation that taxes emergency
  resources

13
GET HELP!!!!

• call 9-1-1 for professional rescuers
• give your location
• describe nature of emergency (fire, explosion,
  drowning, fall, motor vehicle accident, etc.)
• tell them number of victims involved
• describe seriousness of injuries
• advise of hazardous material involvement

14
TWO COMPONENTS OF VICTIM ASSESSMENT

• Primary Observation designed to identify any
  life threatening problems and stabilize them
  immediately
• Secondary Observation designed to detect
  obvious injuries or clues to illness and injury
  through a head-to-toe observation, gather history
  from victim or bystanders inspect surroundings

15
KEY COMPONENTS OF PRIMARY OBSERVATION

• A AIRWAY
• B BREATHING
• C CIRCULATION
• LEVEL OF CONSCIOUSNESS

16
AIRWAY

• is it open functional? If not, correct.
  Consider cause or mechanism of injury. (Use
  head-tilt, chin-lift if no injury jaw-thrust
  maneuver if there is head/neck injury)
• airway may be obstructed

17
BREATHING

• can victim speak?
• look, is the chest rising and falling?
• listen, do you hear air going in and out of
  airway?
• feel, do you feel air touching your cheek?

18
CIRCULATION

• to determine a heartbeat. Is breathing,
  coughing or movement present? If NOT, assume no
  heartbeat and start CPR
• control severe bleeds with pressure dressing
  immediately

19
LEVEL OF CONSCIOUSNESS

• is the victim oriented to person, place and time?
• the brain requires a constant supply of oxygen
  from the heart to remain oriented
• blood losses will affect oxygen supply and
  interfere with orientation
• breathing disorders will decrease oxygen supply
  also interfering with orientation

20
HISTORY OF EVENT

• chief complaint. What hurts?
• obtain history about the condition of the victim
  from victim, family, friends or bystanders. What
  happened?
• find out events that lead to chief complaint.
  What were they doing?
• note the ENVIRONMENT (drugs, alcohol, weapons,
  falls, motor vehicle accidents, surrounding
  temperature,etc.)

21
VITAL SIGNSHEARTBEAT

• is there breathing, coughing and movement? This
  would indicate the heart is beating when present
• when absent, compressions of heart must begin to
  circulate blood to vital organs

22
VITAL SIGNSBREATHING

• is victim breathing or NOT?
• is the breathing pattern fast, slow, deep,
  shallow, labored, noisy?
• if NOT breathing, artificial breathing must be
  administered

lungs
23
ARTIFICIAL BREATHING

• mouth to mouth ventilation or use other
  artificial breathing assistive devices
• artificial breathing for an adult should take
  place once every 5 seconds (20/minute)

24
VITAL SIGNSTEMPERATURE

• is skin hot, cold, warm?
• a hot to the touch or cold to the touch body
  indicates abnormality

25
VITAL SIGNSSkin/mucous membrane color

• Pink? Adequate oxygen levels
• White (pale)? Peripheral blood shunted to core
  of body to self protect major organs
• Gray (ashen)? Indicates decreasing oxygen level
  in blood, body systems begin suffering
• Blue (cyanotic)? Indicates excessive amount of
  blood not carrying oxygen, body systems in
  critical state
• Red (flushed)? Harmful levels of carbon monoxide
  or increased carbon dioxide levels

26
HEAD-TO-TOE OBSERVATION

• must be consistent and deliberate each time
  performed
• should be done for each victim when condition
  allows to make sure nothing is missed
• may be omitted if the primary observation
  components airway, breathing and heartbeat are
  compromised

27
HEAD NECK

• Observe for
• bleeding (open wounds)
• deformities of facial structures (fractures)
• c/o pain/numbness/tingling of extremities
  (possible neck injury)
• pupil size and response to light (changes could
  indicate head injury)
• mouth for missing/broken teeth or bleeding

28
CHEST

• Observe for
• equal rising and falling on both sides of chest
  during breathing
• deformity of chest wall (indicating possible rib
  fractures)
• bleeding, indicating open chest wound
• complaint of chest pain from injury/disease
• abnormal breathing patterns
• coughing/bloody sputum

29
ABDOMEN

• Observe for
• hardness of abdomen indicates problem
• bleeding, indicating open wound
• complaints of pain
• bruising, a SERIOUS indicator of injury
• vomiting (save for professional personnel to
  observe for content possible blood)
• Abdominal cavity has body organs suspended
  within. There is great potential for blood loss
  if connecting tissue is torn

30
PELVIS

• Observe for
• obvious swelling (pelvic trauma has a potential
  to bleed profusely due to big blood vessels in
  the pelvic cavity)
• obvious deformity, rotation, shortening of lower
  leg(s) may indicate hip fracture
• complaints of pain
• signs symptoms of shock
• bleeding, indicating open wound

31
EXTREMITIES

• Observe (arms legs) for
• obvious deformity or visible bone, indicates
  possible fracture
• shortening of one extremity to another, indicates
  possible fracture/dislocation
• obvious bleeding indicates open wounds
• complaint of marked tenderness/pain over injury
  site or false movement indicates possible
  fracture
• complaint of loss of feeling below injury site,
  indicates nerve damage

32
EXTREMITIES

• Observe for P-M-S
• pink skin color and warm temperature below
  injury?
• movement, is it present or absent below injury
  site?
• sensation to touch, is it present or absent below
  injury site?
• PMS checks must be done before after
  splinting and bandaging extremity injuries

33
SPINE

• Observe for
• complaint of pain over spine strong indicator of
  spine injury
• complaint of numbness, tingling, and/or inability
  to move strong indicator of spine injury
• DO NOT MOVE VICTIM UNLESS IMMINENT DANGER IS
  PRESENT

34
MEDICAL ALERT IDENTIFICATION

• Check for
• bracelets, necklaces other forms of medical
  alert IDs that could provide valuable
  information for professional team about
  pre-existing health conditions

35
HEAD-TO-TOE OBSERVATION

• OMIT SECONDARY OBSERVATION WHEN
• patient is unable to maintain an open airway
• patient is not breathing on their own
• there is no heartbeat
• your hands will be full doing CPR, and the
  secondary is not essential until later or never,
  depending on the circumstances

36
Quizlet 1

• You neighbor is painting his house from a ladder.
  You hear him cry out and hear the ladder hit the
  cement. When you arrive you find him on his
  back, his right arm is deformed and he is not
  moving.
• What is your assessment of the situation?
• In what order would you manage this victim?
• ABC
• Airway
• How do you determine he is breathing?
• Breathing
• Jaw thrust or chin thrust and why
• Circulation
• Where do you check for a pulse on an adult?
• Call 911
• What should you do with his arm?
• Straighten it out?
• Leave it alone?
• When can you leave the victim?

37
FIRST AID TRAINING

• KIRKWOOD COMMUNITY COLLEGE
• HEALTH SCIENCE

38
FIRST AID TRAINING

• Power Point 2

39
LEARNING OUTCOME

• identify types of bleeding wounds and shock, and
  the appropriate first aid interventions

40
WOUNDS SHOCK

• Average adult body contains 6 liters of blood
  (approximately 6 quarts)
• rapid loss of 1 quart blood (1000cc) from adult
  can lead to shock and death
• rapid loss of 1-cup blood (250 cc) from child can
  be deadly
• rapid loss of 2-Tablespoons blood (30 cc) from
  infant can be deadly

41
SHOCK

• Definition
• inadequate tissue/cell perfusion causing body
  cells and systems to begin death due to a loss of
  body fluids and oxygen within the blood vessels

42
TISSUE PERFUSION

• Definition
• is the process of providing all living cells with
  a constant supply of oxygen and nutrients, and
  removing waste products from the cells
• this process is essential for a healthy life

43
CAUSES OF SHOCK

• trauma - blood loss
• illness - body fluid losses of vomit, diarrhea,
  fever (perspiration)
• heart disease - causing blood flow disruptions
  rhythm disturbances
• gastrointestinal diseases - disrupt electrolyte
  balance and destroy cells, organs, systems

continued
44
CAUSES OF SHOCK

• respiratory disease - causing disruption of the
  oxygen supply to cells
• allergic reactions - causing serious breathing
  spasms vasodilatation
• head injury - causing central nervous
  system inability to command properly
• spine injury - may result in loss of ability for
  blood vessels to constrict causing
  (vasodilatation)

45
MAJOR TYPES OF SHOCK

• Hypovolemic (hemorrhagic)
• Cardiogenic
• Anaphylactic
• Fainting

46
HYPOVOLEMIC SHOCK
Circulatory System

• Causes
• blood loss
• dehydration, other body fluid losses due to fever
  (sweating), vomiting, major burns, serious
  respiratory crises
• diarrhea

Full
Fluid loss
47
HYPOVOLEMIC SHOCKSigns Symptoms

• restlessness/irritability
• altered level of consciousness
• weak/rapid pulse
• pale/moist skin
• rapid breathing
• nausea vomiting
• dull, sunken appearing eyes
• big pupils
• obvious injuries (bruising/bleeding)

48
TREATMENT FORHYPOVOLEMIC SHOCK

• manage A-B-Cs call 9-1-1
• apply direct pressure to bleeds (barriers)
• elevate part if bleeding continues
• consider pulse pressure points if bleeding
  continues
• add dressings dont remove soaked ones
• prevent body heat loss chills
• if not contraindicated, elevate legs 12

49
DO NOT ELEVATE LEGS WHEN

• the victim is unconscious or may have had a
  stroke (will increase pressure in the brain)
• chest pain is present (will increase workload to
  heart)
• there is a spine injury (may cause further
  injury)
• breathing problems are present (will make this
  condition worse)
  

50
CARDIOGENIC SHOCK

• Causes
• heart pump failure that in turn reduces or
  starves the cells of oxygenated blood

51
CARDIOGENIC SHOCK

• Signs Symptoms
• severe cyanosis (blue-purple coloring of skin)
• one or more signs symptoms of heart attack
  (shortness of breath, anxiety, chest
  pressure/tightness, jaw pain, upper extremity
  pain, nausea, indigestion, light headed/dizzy,
  wet cool skin,etc.)

52
TREATMENT FORCARDIOGENIC SHOCK

• manage A-B-Cs first
• recognize the emergency call 9 -1-1 immediately
• keep patient in sitting position while conscious
  with legs dangling over the edge until they
  become unconscious
• be prepared to perform CPR

53
ANAPHYLACTIC SHOCK

• Causes
• exposure to allergens such as
• insect/bee stings
• certain medications (penicillin tetanus
  frequent offenders)
• certain foods (shellfish, berries, nuts)
• pollens/dust/molds
• (Vary per individual)

54
ANAPHYLACTIC SHOCK
Bronchial tubes

• Signs Symptoms
• redness, swelling at site of a bite or sting
• severe hives/itching
• swelling of face, throat, eyes hands
• coughing, wheezing, breathing difficulties
• POSSIBLE DEATH IN 30 SECONDS TO 30 MINUTES

55
TREATMENT FORANAPHYLACTIC SHOCK

• manage A-B-Cs
• recognize emergency call 9-1-1 immediately
• if victim carries a bee sting kit or allergy kit,
  assist victim in the administration of injectable
  epinephrine
• be prepared to do CPR

56
FAINTING

• Causes
• interruption of blood flow to the brain
• blood pools in lower extremities when standing
  for long periods of time
• psychological disturbance
• fainting is often the only sign of heart problems
  in the elderly, therefore an elderly victim
  should always be seen by a physician to rule out
  heart problems after fainting

57
FAINTING

• Signs Symptoms
• dizziness
• skin color is pale
• skin cool and moist to the touch
• may complain of nausea
• black outspell

58
TREATMENT FOR FAINTING

• break fall if possible to prevent injuries
• if there are no obvious injuries, place victim on
  back with legs elevated 12
• loosen tight clothing around neck
• wipe forehead with cool/wet cloth
• turn vomiting victim onto side
• after a long rest, assist victim to a slow
  upright position if there are no injuries after
  regaining consciousness

59
Quizlet 2

• You are watching your daughter perform at her
  first junior high chorus concert. She suddenly
  starts to weave back and forth and then collapses
  to the ground.
• What is your assessment of the situation
• What type of shock has occurred?
• Why did it occur?
• What is the treatment ?

60
CAUSES OF BLEEDING

• Injuries/Trauma penetrating injury that breaks
  through skin with sharp objects
• blunt injury that does not break through the skin
  
• Diseases ulcers, aneurysms, cancers

61
CLASSIFICATION OF BLEEDING WOUNDS

• Open Wounds skin is broken
• Closed Wounds skin is intact

62
OPEN WOUNDS

• (external) visible blood outside of the body
  skin is broken

63
ARTERIAL BLEED

• spurting bright red blood. Most dangerous, must
  be stopped. Could be life threatening

64
VENOUS BLEED

• flowing blue/red blood that responds to direct
  pressure to stop. Pressure may be necessary 6-10
  minutes before clotting takes place

65
CAPILLARY BLEED

• oozing dark red blood. May clot spontaneously or
  rapidly with pressure. MOST COMMON type of bleed

66
TYPES OF WOUNDS

• abrasion
• incision
• laceration
• puncture
• avulsion
• amputation

67
ABRASION

• skin scrape, floor burn, road rash often embedded
  with dirt. This wound is typically a capillary
  bleed prone to infections

68
INCISION

• smooth edged cut made by a sharp object (knife,
  scissors) and bleeds easily

69
LACERATION

• a jagged, irregular break in skin edge created by
  a sharp object through trauma, and bleeds freely

70
PUNCTURE

• piercing through the skin (knife, nail, pen,
  etc.) Minimal bleeding until removed
• DO NOT REMOVE
• angle depth of instrument determines what
  organ(s) are affected

71
AVULSION

• flap type skin injury that bleeds freely and has
  small portion of the skin still attached to the
  body

degloved
72
AMPUTATION

• detachment of a body part or portion of the part
  (finger, toe, arm, leg, ear, etc.)

Partial amputation
Complete amputation
73
TREATMENT OF OPEN WOUND INJURIES

• Minor wounds
• wash hands with 3-5ml soap for 10-15 sec.
• use protective barrier gloves, plastic wrap or
  bag
• cleanse wound gently with soap water, rinse
  thoroughly and dry
• cover wound with clean dressing apply direct
  pressure
• apply bandage to secure dressing. Avoid it being
  too tight (P-M-S checks)

74
TREATMENT OF OPEN WOUND INJURIES

• Major wounds
• manage A-B-Cs first
• apply clean dressing to wound apply direct
  pressure. Dont remove soaked dressings, add
  more dressings so clots are not disturbed
• elevate part if bleeding continues
• may need to apply pressure to a pulse point above
  the bleed site

75
ARTERIAL PULSE PRESSURE POINTS
Pressure Points

• if direct pressure and elevation of a part has
  not stopped a bleed, find the pulse point between
  the wound and heart closest to the wound and
  apply pressure at that point

76
TREATMENT OF OPEN WOUND INJURIES

• Major wounds
• seek medical attention for all major wounds (may
  need a tetanus update, may need to have the
  wound closed, there could be bone injury also)
  Sutures must be done within 6-8 hours after
  injury
• all bites from animal or human should be seen by
  a physician. Identify the animal and its owner
  whenever possible, and notify the authorities so
  animal can be contained

77
MANAGING AMPUTATED PARTS

• manage A-B-Cs call 9-1-1
• apply direct pressure to stump
• wrap body part in a dry, clean cloth
• place wrapped part into a plastic bag and seal
• place sealed bag into icy cold water
• DO NOT PUT AMPUTATED PART DIRECTLY INTO WATER OR
  ON ICE

78
CLOSED WOUNDS

• Blunt injuries (internal) blood not visible, but
  bleeding is active inside of the body skin is
  intact. This type of bleeding is often most
  serious

tire tracks on abdomen
79
CONTUSION

• bruising caused by blunt injury

80
HEMATOMA

• blood pooling under the skin resulting in blue
  colored mass hematoma (blood tumor)

81
TREATMENT OF CLOSED WOUND INJURIES

• manage A-B-Cs and call 9-1-1
• note how injury happened and be concerned when
  things look bad
• treat for shock
• treat problems appropriately when identified in
  observation
• apply ice to closed wounds with a barrier between
  ice skin to prevent frostbite

82
WOUNDS REQUIRING IMMEDIATE ATTENTION

• arterial bleeding
• deep wounds into muscle, bone joints or open
  gaping
• all puncture wounds, dirty wounds or wounds with
  embedded objects
• blunt injuries that produce a large bruise, or
  swelling
• bites, human or animal

83
COMPLICATIONS OF WOUND INJURIES

• infection - invasion of disease-producing
  organisms into the body
• tetanus - an infectious disease caused by
  bacteria found in the soil, air, skin or feces
  producing a powerful toxin affecting the brain
  and spinal cord

84
SIGNS SYMPTOMS OF WOUND INFECTION

• redness, swelling, pain of affected area
• affected area hot to the touch
• drainage (pus) from wound foul smell
• possible fever, chills
• possible red streaks from affected area towards
  heart (SERIOUS SIGN, requires immediate medical
  attention)

85
SIGNS SYMPTOMS OF TETANUS

• Muscle spasms following a dirty wound
• Extreme body rigidity (Lock Jaw)
• No known antidote available
• Prevented by vaccination

86
Quizlet 3

• You and a friend are hiking in the woods. You
  friend slips off of the trail and falls down a
  hill, landing along side a tree. When you reach
  your friend, she is awake and complaining of
  chest pain and finds it hard to breathe. Her
  skin is cool and damp and she appears pale.
• What is your assessment of the situation?
• Identify the type of trauma that occurred
• Blunt force-no evident bleeding
• Why does it hurt to breathe?
• Possible broken ribs/internal bleeding
• Why is the skin pale and damp?
• Going into shock
• What steps are taken to treat a patient in shock?
• Your friend complains of being thirsty. Is this
  a concern?

87
BANDAGING

• bandages hold dressings in place
• dressings are placed directly over wounds to
  control bleeding and/or prevent further
  contamination. Whenever possible, dressings
  should be sterile. When sterile is not
  available, dressings should be clean

88
ROLLER BANDAGES

• long strips of material or prepared gauze rolls
  in varying widths lengths used in wrapping
  extremity and head wounds
• may be used to secure splints

89
TRIANGULAR BANDAGES

• cravat, triangular in shape
• can be used as an arm sling with second wrapped
  around chest wall keeping arm close to chest
• ideal for splinting simple rib fractures

90
PRINCIPLES OFBANDAGING

• P-M-S checks below injury site before after
  bandaging
• apply secure enough to hold dressing in place,
  but not too tight to disrupt circulation
• do not include fingers toes unless they are the
  wounded parts. You want to see their color
  feel their temperature
• wrap towards heart during application
• use figure 8 techniques with roller bandages

91
FIRST AID TRAINING

• KIRKWOOD COMMUNITY COLLEGE
• HEALTH SCIENCE

92
FIRST AID TRAINING

• Power Point 3

93
LEARNING OUTCOME

• identify injuries to specific body areas,
  fractures, joint and muscle injuries and the
  appropriate first aid interventions

94
SKULL FRACTURES

• open fractures indicate that the bone has broken
  through the skin may or may not be visible

95
SKULL FRACTURES

• closed fractures indicate the bone has been
  broken, but the skin is intact

Closed fracture
96
CAUSES OF SKULL FRACTURES

• trauma to the head from
• motor vehicle accidents
• falls
• blows to the head

97
HEAD INJURIES

• Signs Symptoms of Skull Fractures
• pain at site of injury
• deformity soft spot
• drainage from ears nose (CSF)
• unequal pupil size
• CONSIDER the mechanism of injury to assess
  seriousness

98
CONCUSSION

• a temporary impairment of brain function due to
  injury to the skull

99
CAUSES OF CONCUSSIONS

• blow to the head due to a fall, motor vehicle
  accident, industrial accident, weapon, etc.
• shaking the head causes severe bruising of the
  brain and tearing of the blood vessels creating
  theShaken Baby Syndrome. This condition is
  often the cause of death for infants

100
CONCUSSION

• Signs Symptoms
• loss of consciousness
• severe headache
• short term memory loss
• seeing stars sensation
• dizziness
• double or blurred vision
• projectile vomiting

101
DEGREE OF CONCUSSION

• Mild - no loss of consciousness
• Moderate - unconscious less than 5 minutes
• Severe - unconscious more than 5 minutes

102
BRAIN CONTUSION

• bruising on or in the brain
• very serious

103
BRAIN CONTUSIONEPIDURAL BLEED

• on top of brain, just below skull. The space
  between skull brain is minimal. Any bleeding
  in this space is serious, causing pressure on the
  brain

b l o o d
brain
104
BRAIN CONTUSIONSUBDURAL BLEED

• takes place within the brain often results in
  neurological disabilities or death

brain
B l o o d
105
SIGNS SYMPTOMSBRAIN CONTUSION

• Epidural Bleeds
• initial blow to the head possible brief period
  of unconsciousness
• seeing stars sensation, headache, dizziness,
  projectile vomiting, visual disturbances
  initially
• hours or days later, the patient suddenly becomes
  unconscious
• unequal pupil size

106
TREATMENTHEAD INJURIES

• A-B-Cs (jaw thrust maneuver)
• cover bleeding wounds (dont plug-up nose or ear
  bleeding/drainage)
• Call 9-1-1 for prolonged unconsciousness
• Always assume a neck/spine injury with any head
  or face injury until ruled out by x-ray

107
COMPLICATIONS OF HEAD CONTUSIONS

• Need immediate medical attention
• headache lasting more than 48 hours
• nausea vomiting more than 2 episodes back to
  back, or projectile vomiting
• drowsiness (victim should be awakened frequently
  assess their level of orientation)
• visual disturbances (blurred/double)
• unsteady gait
• speech problems
• seizures

108
EYE INJURIES

• Blunt Trauma
• Penetrating Injuries
• Foreign Objects

109
EYE INJURIES

• CAUSES OF BLUNT EYE TRAUMA
• fists (altercations)
• snowballs
• baseballs/softballs
• doors, etc.

110
TREATMENTBLUNT EYE TRUAMA

• have victim sit semi-upright
• close both eyes
• seek medical attention immediately
• DO NOT place any weight onto globe of eye
• DO NOT place ice on the eye

111
PENETRATING EYE INJURIES

• CAUSES
• pens
• ice picks
• knives
• bullets
• roofing staples
• pool sticks, etc.

staple
112
TREATMENTPENETRATING EYE

• place victim in semi-sitting position
• close both eyes of victim
• NO pressure on the eye
• dry gauze pads over both eyes
• seek medical attention immediately
• victim cant see when both eyes are covered, keep
  them informed

113
FOREIGN OBJECTS

• dust
• dirt
• metal
• splinter
• rust
• pens/pencils
• glass, etc.

114
TREATMENTFOREIGN OBJECTS

• DO NOT rub the eye
• flush eye with tepid water from inner corner to
  outer corner of eye until object is free (use
  gentle water flow)
• may invert eyelid onto Q-tip, and gently flush
  object
• if still in, close both eyes seek medical
  attention
• keep patient informed as they cant see

115
TREATMENTEMBEDDED OBJECT

• DO NOT remove the embedded object
• place paper cup over short object to protect
  object from being bumped and moved
• have patient close unaffected eye
• cover both eyes to reduce eye movement
• seek medical attention immediately
• keep patient informed about happenings

116
CHEMICAL BURNS

• Acid
• destroys eye within 30 min. appears beefy red
• flush immediately with tepid, gentle flow water,
  from inner to outer corner of eye 20 minutes
  minimum
• Call 9-1-1

• Alkali
• destroys eye in 30 seconds appears milky
  white
• flush immediately with tepid, gentle flow water,
  from inner to outer corner of eye 20 minutes
  minimum
• Call 9-1-1

117
CHEMICAL BURN TOTHE EYE
acid
alkali
118
NOSEBLEEDS

• Two Types
• anterior - involving the superficial vessels in
  front portion of nose
• posterior - involving larger vessels in back
  portion of nose (could be life threatening bleed)

119
CAUSES OF NOSEBLEEDS

• trauma
• sinus infections/allergies
• hypertension (high blood pressure)
• dry air conditions

Patient applies squeezing pressure
120
TREATMENT NOSE BLEEDS

• keep patient quiet
• sit upright/lean slightly forward to avoid
  swallowing of blood
• pinch nostrils for minimum of 5 minutes
• apply ice to forehead above nose
• seek medical attention if bleeding after 6-10
  minutes
• question patient about anticoagulant drugs (drugs
  that affect clotting time)
• treat for shock

121
DENTAL INJURIES

• a tooth completely knocked out of socket
• place in whole milk
• take patient tooth to dentist immediately
• DO NOT touch the root of the tooth

missing
If no dentist is available, rinse tooth with
water and replace in socket and align with
adjacent teeth
122
DENTAL INJURIES

• partially extracted teeth
• get to dentist immediately, if not
• rinse with water and align tooth to adjacent
  teeth and push back into place

123
CHEST INJURIES

• Types of chest injuries
• open - chest wall is open - skin broken
• penetrating (could be ribs breaking through or
  foreign object such as bullet, knives, etc.)
• sucking wounds
• closed - chest wall is closed
• no obvious bleeding noted
• major injuries can be involved though. The
  largest blood vessels are in the middle of the
  chest

124
BLUNT TRAUMATO CHEST

• may cause serious injuries to the organs beneath
  the impact
• examples (steering wheel to chest on impact,
  fists to face or chest, kicked by someone or
  other weapons, etc.)

125
PENETRATING TRAUMATO CHEST

• may cause serious injuries beneath site of
  penetration
• consider length of instrument penetrating
  movement within body
• examples (bullets, knives, picks, pens, etc.

126
CRUSHING INJURYTO CHEST

• squeezes body, bones or organs to the point of
  bursting or prevents the body system the ability
  to function
• Example (any heavy weight on chest impairs the
  action of breathing)

127
SIGNS SYMPTONSOF CHEST INJURIES

• chest pain -shortness of breath
• open wounds -chest deformity
• pale/ashen color -paradoxical movement
• sucking sounds -signs of shock
• asymmetrical chest wall movement
• coughing up of blood

128
TREATMENT CLOSED CHEST INJURIES

• ABCs - stabilize any vital sign problems
• Call 9-1-1 immediately
• allow sitting position unless there are
  accompanying injuries that prevent it
• to immobilize major rib injuries, consider the
  use of pillow over the affected area
• to immobilize simple rib fractures, use a sling
  swathe
• NEVER bind the chest to inhibit breathing

129
TREATMENT OPENCHEST INJURIES

• open wounds should be sealed quickly with
  cellophane wrap or plastic baggie, etc. large
  enough not to get sucked into wound secured
  with tape on 3 sides only
• any chest wound has potential to become a life
  threatening problem
• Call 9-1-1 immediately

130
TREATMENT EMBEDDED OBJECTS IN CHEST

• stabilize any embedded foreign objects to
  minimize movement of the object and further
  injuries
• DO NOT remove the embedded object

131
ABDOMINAL INJURIES

• open injuries there is an entry from outside
  the body into the abdominal cavity
• closed injuries blunt injury to abdominal
  cavity that may result in serious abdominal organ
  contusions lacerations, large small blood
  vessel tears that result in major blood losses

132
CAUSES OF ABDOMINAL INJURIES

• impaled objects
• objects that enter the abdomen by accident or
  assault remain in the abdomen (knives, bullets,
  pens, ice picks, etc.)
• penetrating injuries
• objects that enter the abdomen causing injury,
  and if pulled out, suffer major bleeding
  (bullets, knives, pens, ice picks, motor vehicle
  parts, etc.)

133
CLOSED ABDOMINALINJURIES (BLUNT INJURY)

• Causes
• blows with fists or other instruments during
  altercations
• falls onto blunt objects
• motor vehicle accidents

134
SIGNS SYMPTOMS

• history of injury
• pain, cramping , nausea, possible vomiting
• guarded positioning/hardened abdomen
• evidence of blood in urine /or stool
• evisceration (abdominal organs exposed)
• signs of shock pale/ashen color, cool skin,
  moist skin, rapid breathing

135
TREATMENTABDOMINAL INJURIES

• check correct A-B-C problems, call 9-1-1
• keep victim quiet, warm and in position of
  comfort
• give patient nothing to eat or drink
• patient may vomit, save emesis
• cover eviscerated organs with sterile, moist,
  non-clinging dressing bulky dry dressing
• do not remove or allow movement of impaled objects

136
FRACTURES

• defined as
• break in the bone cortex
• closed fractures have no break in the skin
• open fractures have a break in the skin

fracture
fracture
137
DISLOCATION

• defined as
• displacement of bones at a joint

Elbow photo
Elbow x-ray
138
SPRAIN/STRAIN

• sprain defined as
• temporary dislocation of joint usually involving
  ligament injury
• strain defined as
• pulled muscle

Sprained right ankle
swollen
139
CAUSES OF BONES JOINT INJURIES

• sporting injuries
• motor vehicle accidents
• falls
• altercations, etc.

140
SIGNS SYMPTOMSOF BONE INJURIES

• pain /or swelling over site of injury
• obvious deformity /or false motion
• joint deformity with dislocations
• crepitus (grating sensation as fractured bones
  ends rub together)
• possible open wound with bone protrusion
• history of injury

141
TREATMENTFRACTURE/DISLOCATIONS

• manage A-B-Cs before fractures
• remove clothing around injury site
• control bleeds with pressure dressings
• do not push protruding bone(s) under skin
• P-M-S, check skin color, temperature movement
  below injury
• splint as found, include joint above below
• recheck P-M-S, skin color, temperature movement
  below injury

142
TREATMENTMUSCLES INJURIES

• Ice to injury site 24-48 hours after injury
  (place barrier between ice skin)
• Compress injury site with ace wrap for support
  (not too tight) P-M-S checks
• Elevate affected part to reduce swelling
• Apply heat to site 48 hours after injury
• Seek medical attention if pain/swelling persists

143
SPINE INJURIES

• Causes of spine injuries
• motor vehicle accidents
• falls
• diving accidents
• rodeo stunts
• gymnastic, etc.

144
SIGNS SYMPTOMSSPINE INJURY

• mechanism of injury suggestive of spine injury
• complaints of numbness, tingling, weakness or
  burning sensation in arms/legs
• loss of bowel or bladder control
• complaint of pain directly over a section of the
  spine
• not breathing

145
TREATMENTSPINE INJURIES

• A-B-Cs (jaw-thrust maneuver to open airway with
  spine injuries)
• Call 9-1-1
• allow no patient movement (move patient only if
  imminent danger is present)
• keep patient warm

146
TREATMENTSPINE INJURIES

• assign someone to keep head aligned with body (a
  blanket rolled shaped like a horseshoe around
  head secured to a backboard works well) Do not
  use any weights on sides of head

147
SPLINTING

• a splint is a supportive device applied to
  immobilize a fracture or restrict movement of an
  injured part
• splinting minimizes further surrounding tissue,
  vessel and nerve damage that the broken bone ends
  could do when not stable

148
TYPES OF SPLINTS

• pillow
• rigid boards, rolled newspaper/magazine
• professional padded, vacuum, ladder, and traction

vacuum
padded rigid
traction
149
CREATIVE SPLINTS

• when professional splints are not available,
  consider using
• rolled up magazine or newspaper
• a board or other flat firm object
• a pillow
• buddy tape affected extremity to an adjacent
  one with padding between. The unaffected finger,
  toe, or leg becomes the splint for the injured
  buddy body part

150
PRINCIPLES OF SPLINTING

• apply splints before moving victim
• P-M-S checks (pink/warm skin, movement, sense of
  touch below fracture)before splint
• include joints above below injury site
• secure splint with cravats or roller bandages
• keep fingers toes exposed for assessment
• splint injury as found, do not straighten
• cover open fractures with sterile or clean
  dressings

continued
151
PRINCIPLES OF SPLINTING

• hand /or finger fractures should be placed in
  position of function (cupped around roller
  bandage or something similar)
• remove jewelry, clothing, shoes, or socks when
  part of the injury site
• recheck P-M-S
• elevate fracture extremities after splinting
• apply ice to closed fracture site, with cloth
  barrier between ice skin

152
LEARNING OUTCOME

• identify skills in moving and rescuing victims

153
MOVING VICTIMS

• do not move a victim until you have provided
  appropriate first aid for the injuries identified

154
MOVING VICTIMS

• exceptions of moving before treatment of
  injuries
• existing fire or imminent danger of fire
• when it is impossible to gain access to other
  victims in a vehicle in need of life-saving care
• DO NOT enter an area of explosives or hazardous
  materials regardless of situation to avoid injury
  to self

155
ONE PERSON

• Emergency moves
• Drags pull direction of long axis of body
• shoulder/clothing drag tug clothing at
  neck/shoulder area, stabilize head in forearms
  used for short/rough surfaces
• blanket drag - pull blanket from behind the
  victims head

156
ONE PERSON

• Emergency moves
• ankle drag - pull victim by ankles the fastest
  method for short distances on smooth surface
• one person assist - assist victim to walk if able

157
ONE PERSON

• Emergency moves
• Carries
• firemans carry - victim carried over your
  shoulder if injuries permit

158
ONE PERSON

• Emergency moves
• Carries
• pack-strap carry - for longer distances when
  firemans carry might be unsafe

159
TWO PERSON

• Emergency moves
• two person assist - help person to walk

160
TWO PERSON

• Emergency moves
• two handed seat carry

161
TWO-THREE PERSON

• Emergency moves
• four handed grip - easiest when no equipment

162
TWO-THREE PERSON

• Emergency move
• chair carry

163
TWO-THREE PERSON

• Emergency moves
• two handed grip extremity carry
• hammock carry - 3 - 6 people on alternate sides
  of victim linking hands together beneath victim

164
MOVING VICTIMS

• Principles of Moving Victims
• immobilize protect injuries before moving
• maintain firm footing with feet, shoulders width
  apart, one foot slightly in front of the other,
  knees bent slightly, your arms close to your
  body, avoid twisting, keep back straight with
  hips below shoulders. Let the leg muscles work,
  not your back
• keep motion(s) smooth
• know physical capabilities. Need help? Get it,
  for safety of all!

165
WATER RESCUE

• drowning is 3rd leading cause of accidental death
• your goal will include not becoming the next
  victim and doing what you can do safely to help
  the victim

166
WATER RESCUE

• Principles of attempting water rescue
• Reach
• long stick, lightweight pole, or any object that
  will extend to victim
• secure yourself before reaching out to victim
• if bystander is nearby, have them hold onto you
  will you reach out to victim

167
WATER RESCUE

• Principles of attempting water rescue
• Throw
• attach a rope to anything that floats (ring buoy,
  life jacket, floating cushions, short pieces of
  wood, empty plastic jugs, etc.)
• throw object beyond victim so wind/current allows
  floating object to come back to victim
• lean backwards as you pull victim to safety to
  avoid getting pulled into water yourself

168
WATER RESCUE

• Principles of attempting water rescue
• Row
• if victim is beyond reach rowboat/sailboat are
  available, you may attempt this type of rescue if
  you have the skill (a paddle/oar craft is slower
  safer than a motor driven craft
• consider elements of danger
• victim should be pulled into boat over the back,
  NOT the side

169
WATER RESCUE

• Principles of attempting water rescue
• Go
• an assessment must be made by rescuer weighing
  the risk vs. reward to the victim
• this should be last resort, not first
• know your capabilities

170
WATER RESCUE

• After a water rescue
• protect victim yourself against cold
• be prepared to start mouth to mouth resuscitation
  and/or CPR
• seek medical attention for victim and yourself

171
ICE RESCUE

• attempt to reach victim with an object
• form a human chain, lying flat to distribute
  weight on the ice
• seek medical attention for victim immediately
  after rescue
• remove cold/wet clothing cover with dry warm
  blankets after rescue
• DONT become the next victim

172
LEARNING OUTCOME

• identify poisoning, alcohol, and drug emergencies
  and first aid interventions

173
Poisons, Alcohol Drugs

• poison defined as
• any substance that will cause a reaction that
  damages tissue, alters organ and system functions
  or may even cause death

Recreational Drugs/Alcohol
174
INGESTED POISONS

• swallowed (accidental or intentional)

Drano
175
INHALED POISONS

• the act of breathing subjects the respiratory
  system to inhaled poisons

Carbon monoxide
176
ABSORBED POISONS

• through the skin by coming in contact with a
  poison

Poison ivy
177
INJECTED POISONS

• through skin puncture that could be a bite from
  an animal or reptile, a sting from an insect or
  recreational drug injection

Ouch!
178
INGESTED POISONS

• Signs Symptoms
• nausea, vomiting, diarrhea, abdominal cramping
• obvious mouth burns, stains, odors
• obvious containers/evidence of poisons

179
TREATMENT INGESTED POISONS

• manage A-B-Cs and call 9-1-1
• determine what, amount time ingested
• contact Poison Control Center
• Mercy Medical Center [phone]
• St. Lukes [phone]
• University of Iowa 1-800-272-6477
• follow directions of poison center that may
  include inducing vomiting using Syrup of Ipecac

180
INGESTED POISONS

• When NOT to induce vomiting
• seizure activity
• unconsciousness or drowsiness
• pregnancy
• heart problems
• when corrosives, petroleum or strychnine products
  have been ingested

181
INHALED POISONS

• Signs Symptoms
• headache
• dizziness/weakness
• visual disturbances
• hoarseness, tightness in throat,difficulty
  swallowing, coughing, wheezing
• cardiac respiratory failure
• INHALED POISONS OFTEN ODORLESS, BEWARE!!

182
TREATMENTINHALED POISONS

• dont become the next victim
• manage A-B-Cs
• remove patient from environment if possible
• call 9-1-1, 100 oxygen is needed for victim

183
ABSORBED POISONS

• Signs Symptoms
• redness of skin
• blisters/rashes
• swelling
• itching
• known contact with poison ivy/oak or other
  poisonous substance

184
TREATMENTABSORBED POISONS

• wash exposed area immediately with mild soap
  tepid water (avoid strong water pressure)
• baking soda compresses to affected areas or
  poison ivy or oak 4 times/day
• hot baths (releases natural antihistamines)
• seek medical attention in severe cases

185
INJECTED POISONS

• Signs Symptoms
• obvious markings (insect bites, bees, ticks,
  snake bites, etc. or needle tracks anywhere on
  the body) DO THOROUGH EXAM
• localized pain/burning
• swelling/redness
• possible nausea, vomiting, weakness
• tightness in throat, difficulty breathing
• possible respiratory/cardiac arrest

186
TREATMENTINJECTED POISONS

• manage A-B-Cs
• identify poison
• pull off ticks with tweezers or fingers grasping
  close to skin (dont twist it)
• call 9-1-1 for drug injected poisons or snake
  bites

tick
This bite resulted in Lyme disease
187
MOOD ALTERING SUBSTANCES

• alcohol a depressant, even though there is an
  initial up feeling. Abuse of alcohol causes
  physical psychological disorders that affect
  personal professional relationships

188
MOOD ALTERING SUBSTANCES

• drugs may be stimulants (uppers) or they may
  be depressants (downers)

189
UPPERS

• stimulate central nervous system
• gives feeling of well being/reduce fatigue
• may cause hyperactivity, restlessness and
  belligerence when high dosages are used
• frequently abused uppers
• caffeine, cocaine, amphetamines, anti-asthmatic
  drugs, vasoconstrictors, etc.

190
DOWNERS

• depress central nervous system
• cause drowsiness
• relieve anxiety
• relaxing
• frequently abused downers
• marijuana, barbiturates, tranquilizers,
  narcotics, anticonvulsants, etc.

191
MOOD ALTERING DRUGS

• Signs Symptoms
• possible alcohol odor on breath
• possible lack of coordination
• possible drowsiness
• possible slurred speech
• possible hyperactivity or combativeness
• possible nausea/vomiting
• possible flushed face (red)

192
TREATMENTDRUG ABUSE

• manage A-B-Cs/call 9-1-1
• manage injuries/shock resulting from abuse
  (victims abusing drugs/alcohol are frequent ER
  patients)
• be prepared for vomiting save for hospital
• observe environment for pills, alcohol, drug
  paraphernalia, etc.

193
FIRST AID TRAINING

• KIRKWOOD COMMUNITY COLLEGE
• HEALTH SCIENCE

194
FIRST AID TRAINING

• Power Point 4

195
LEARNING OUTCOME

• identify burns, cold, and heat related
  emergencies and first aid interventions

196
HEAT BURNS

• Causes
• hot liquids, vapor or steam
• hot flames
• contact with hot coals, pipes, utensils, stoves,
  etc.
• radiant heat
• solar heat
• The hotter the source, the more serious the burn
  injury

197
SUPERFICIAL BURNS

• epidermis or outer layer of skin involved
• once referred to as a first degree burn
• skin will appear very red. A good example of
  this is the typical sunburn

198
PARTIAL THICKNESS BURNS

• includes entire outer skin layer below
• once referred to as second degree burns
• in addition to redness, the skin will blister,
  swell and be very painful

199
FULL THICKNESS BURNS

• includes all layers of skin underlying fat,
  muscle bone

continued
200
FULL THICKNESS BURNS

• once called third degree
• skin will be charred (black), white, or red
• no pain in full thickness burns, nerves
  destroyed, areas adjacent very painful (2nd
  degree)

201
BURN ASSESSMENT

• Factors influencing seriousness of burn
• size depth of burn
• age of victim
• body parts involved in burn
• previous medical history
• temperature of burning agent

202
SIZE DEPTH OF BURN

• the greater the size of the involved burn and the
  deeper the burn penetrates, the more serious the
  situation

203
SIZING UP THE BURN

• call 9-1-1 when burn involves
• face (possible inhalation)
• hands feet (may result in muscle contractures)
• genitalia area (may result in serious infections)
  

204
AGE INFLUENCE ON BURN RECOVERY

• a victim less than 5 years old will not tolerate
  serious burns because they will not have
  developed body systems mature enough to battle
  serious burns
• a victim older than 60 years of age will not
  tolerate serious burns, because the advanced
  maturity of the body systems may not be able to
  cope with the injury

205
PREVIOUS MEDICAL HISTORY

• history of cardiac problems may compromise
  cardiovascular circulation
• history of respiratory problems may reduce
  adequate oxygen supply to affected areas
• history of diabetes will complicate recovery from
  burns

206
TREATMENT/HEAT BURNS

• put out fire (wrap body in blanket if flames)
• manage A-B-Cs
• remove clothing unless stuck, cut around this
  area to avoid pulling off body tissue
• remove all jewelry
• cool superficial partial thickness burns with
  tepid water

continued
207
TREATMENT/FULL THICKNESS BURNS

• cover full thickness burns with sterile dressing
  or clean cloth
• call 9-1-1
• no ointments, butter or other home remedies
• do not break blisters
• do not wrap snug bandages over dressings
• maintain body temperature, do not allow the
  victim to get cold

208
CHEMICAL BURNS

• most serious are the caustic or corrosive actions
  of chemicals that include
• alkali-(examples Drano - ammonia) alkali burns
  faster and deeper than acid. Most alkali burns
  can penetrate and burn within 30 seconds of
  contact

Drano
209
CHEMICAL BURNS

• most serious are the caustic or corrosive actions
  of chemicals that include
• acid-(examples bleach, vinegar) acid burns are a
  little slower to penetrate and are noticed at
  approximately 30 minutes after contact

210
TREATMENTCAUSTIC OR CORROSIVES

• Caustic or Corrosive
• flush area with gentle flow water15 minutes
  minimum. Do not use pressure water source
  (forces chemical into body)