Basic First AidBasic First AidBasic First AidBasic First Aid

What is First Aid?What is First Aid?What is First Aid?What is First Aid? Webster’s says: “Emergency Webster’s says: “Emergency

treatment for injury etc, before treatment for injury etc, before regular medical care is available”regular medical care is available”– Tends to relate best to injuries rather than Tends to relate best to injuries rather than

illnessillness

What does this mean for us?What does this mean for us?

Why should people know First Aid?Why should people know First Aid?

Basic Life Support / CPRBasic Life Support / CPRA Critical Partner to A Critical Partner to

First Aid TrainingFirst Aid Training

Basic Life Support / CPRBasic Life Support / CPRA Critical Partner to A Critical Partner to

First Aid TrainingFirst Aid Training

CPR SkillsCPR Skills– Adult CPRAdult CPR– Choking skillsChoking skills– Child and InfantChild and Infant– Automated External DefibrillatorAutomated External Defibrillator

Words to Live By…Words to Live By…Words to Live By…Words to Live By…

If you remember NOTHING else:If you remember NOTHING else:– SAFETYSAFETY

AM I SAFE? AM I SAFE? IS MY PATIENT SAFE?IS MY PATIENT SAFE? Are Bystanders/other rescuers safe?!Are Bystanders/other rescuers safe?!

– KNOW WHEN YOU ARE IN OVER YOUR KNOW WHEN YOU ARE IN OVER YOUR HEADHEAD

**

Assessment In Action…Assessment In Action…In a nut shell!In a nut shell!

Assessment In Action…Assessment In Action…In a nut shell!In a nut shell!

Recognize the EmergencyRecognize the Emergency Decide whether to HelpDecide whether to Help

– NOTE! You have not “entered” the NOTE! You have not “entered” the scene yet!scene yet!

Scene SafetyScene Safety Call EMS if neededCall EMS if needed

– Still haven’t touched the Still haven’t touched the victim/patient yet!victim/patient yet!

Assess the VictimAssess the Victim– OK now you can touch them!OK now you can touch them!

Provide CareProvide Care

**

Recognizing the EmergencyRecognizing the EmergencyRecognizing the EmergencyRecognizing the Emergency

One of the largest barriers to lending One of the largest barriers to lending aid…aid…

Some ObviousSome Obvious– Smashed guardrail, broken glass, tire Smashed guardrail, broken glass, tire

marksmarks Some well hiddenSome well hidden

– Sleeping on the beachSleeping on the beach– Someone ‘Acting Strange’Someone ‘Acting Strange’

Why should I help?Why should I help?Why should I help?Why should I help? Good Samaritan ActGood Samaritan Act

– Protection from law suits for Protection from law suits for rendering aidrendering aid

Duty to Respond for WorkDuty to Respond for Work– Office Response TeamOffice Response Team

EthicalEthical– If not you, then who?If not you, then who?– What if it was Grandma?What if it was Grandma?

NOTE: No one can FORCE you to render aid when your safety is at risk!!! There may be circumstances when you

should NOT render aid!

When NOT to Help!When NOT to Help!When NOT to Help!When NOT to Help!

Unable to access victimsUnable to access victims Your safety is at riskYour safety is at risk

– Risk of fire, explosionRisk of fire, explosion You have kids in the car!You have kids in the car! You are ‘medicated’ or otherwise You are ‘medicated’ or otherwise

impairedimpaired

The list goes on…The list goes on…

SAFETYSAFETYSAFETYSAFETY RoadwaysRoadways Power LinesPower Lines Poisons Poisons

/Chemicals/Chemicals Fire ExplosionFire Explosion Other PeopleOther People ““Mechanism”Mechanism” Number of injuredNumber of injured HazardsHazards

Remember! You are NO good to anyone if you Remember! You are NO good to anyone if you become injured while trying to render aid!become injured while trying to render aid!

Infection ControlInfection ControlInfection ControlInfection Control

When to call 911- The Short ListWhen to call 911- The Short ListWhen to call 911- The Short ListWhen to call 911- The Short List Unconscious or Less than Fully Unconscious or Less than Fully

ConsciousConscious Trouble BreathingTrouble Breathing

– Includes asthma, allergic reactionsIncludes asthma, allergic reactions Chest Pain, Signs of Stroke or other Chest Pain, Signs of Stroke or other

Medical EmergenciesMedical Emergencies When you cannot safety transport the When you cannot safety transport the

injuredinjured– Able to wear seatbeltAble to wear seatbelt– Able to stand and get self into a carAble to stand and get self into a car

Bleeding you cannot controlBleeding you cannot control When you’re in over your head!When you’re in over your head!

– Can always get a second opinion!Can always get a second opinion!

How to Call 911How to Call 911How to Call 911How to Call 911

From CampusFrom Campus From “The Real Word”From “The Real Word” From a Cell PhoneFrom a Cell Phone

Information Desired By DispatchersInformation Desired By Dispatchers– Type of emergency and specific locationType of emergency and specific location– Number of victims/patientsNumber of victims/patients– Any threats to responders (ie fire, blocked Any threats to responders (ie fire, blocked

roads)roads)– Any care given, and any trained rescuersAny care given, and any trained rescuers– Your name and call back numberYour name and call back number

Emergency Medical Services:Emergency Medical Services:The Players…The Players…Emergency Medical Services:Emergency Medical Services:The Players…The Players… First ResponderFirst Responder

– Often Police / Law Enforcement Officers and Often Police / Law Enforcement Officers and Fire FightersFire Fighters

EMTEMT– Many Firefighters are becoming EMT certifiedMany Firefighters are becoming EMT certified– Minimal training level to operate an Minimal training level to operate an

ambulanceambulance– Trained to handle any emergency at a basic Trained to handle any emergency at a basic

levellevel ParamedicParamedic

– Advanced Care ProviderAdvanced Care Provider– Medications, IV’s, Advanced ProceduresMedications, IV’s, Advanced Procedures

How long till help arrives?How long till help arrives?How long till help arrives?How long till help arrives? Typical Urban ResponseTypical Urban Response

– First Responder and Advanced Paramedic First Responder and Advanced Paramedic

Ambulance arrival on scene in under 6 minutesAmbulance arrival on scene in under 6 minutes

– Typically a full time response serviceTypically a full time response service

Typical Suburban ResponseTypical Suburban Response

– First Responder arrival within 6-8 minutesFirst Responder arrival within 6-8 minutes

– Ambulance arrival under 12 minutesAmbulance arrival under 12 minutes

Typical “Rural” ResponseTypical “Rural” Response

– Varies greatly by geographyVaries greatly by geography

– Often First Responders within 10-12 minsOften First Responders within 10-12 mins

– Often ambulance is greater than 15-20 minutesOften ambulance is greater than 15-20 minutes Maybe as long as 60 minutes and up!Maybe as long as 60 minutes and up!

To move or not to move…To move or not to move…To move or not to move…To move or not to move… Common sense is needed Common sense is needed

here…here… Minor injuries, the patient will Minor injuries, the patient will

make this decision for you.make this decision for you.

More serious cases:More serious cases: There may be cases where an There may be cases where an

immediate danger exists to immediate danger exists to the victim of serious accident the victim of serious accident or injuries.or injuries.

Other than these immediate Other than these immediate life threats, victims should not life threats, victims should not be moved except by EMSbe moved except by EMS– (We’ll cover back woods stuff (We’ll cover back woods stuff

later)later)

Spinal injurySpinal injurySpinal injurySpinal injury Special Care:Special Care:

– When spinal cord / neck When spinal cord / neck injury is suspected:injury is suspected:

– Stabilize the neck Stabilize the neck manuallymanually

– This rescuer is now This rescuer is now engaged and must stay engaged and must stay with this patient.with this patient.

– Consider some form of Consider some form of mechanical stabilization mechanical stabilization (i.e. shoes, sandbag)(i.e. shoes, sandbag)

– These are the cases we These are the cases we do not want to move!do not want to move!

Significant Mechanisms of InjurySignificant Mechanisms of InjurySignificant Mechanisms of InjurySignificant Mechanisms of Injury Falls (2-3x victim’s height)Falls (2-3x victim’s height) Vehicle collisions involving: Vehicle collisions involving:

– ejectionejection– roll-overroll-over– high speedhigh speed– pedestrianpedestrian– motorcyclemotorcycle– bicyclebicycle

Unresponsive or altered mental status Unresponsive or altered mental status Penetrations (head, chest, abdomen)Penetrations (head, chest, abdomen)

When moving is necessary-When moving is necessary-When moving is necessary-When moving is necessary-

Rescue DragRescue DragRescue DragRescue Drag

When dragging patient headfirst, head When dragging patient headfirst, head can tilt and twistcan tilt and twist

Attempt to stabilize as best as possibleAttempt to stabilize as best as possible

– Consider a feet first drag in a straight line.Consider a feet first drag in a straight line.– If a turn is necessary, make it a gradual turnIf a turn is necessary, make it a gradual turn

Any move endangers a neck injury and Any move endangers a neck injury and may threaten the victim’s airwaymay threaten the victim’s airway

The AssessmentThe AssessmentThe AssessmentThe Assessment

For serious injured victims:For serious injured victims:–Ensure ABC learned in CPREnsure ABC learned in CPR–Focus on open airwayFocus on open airway

For Minor to Moderate InjuriesFor Minor to Moderate Injuries–Have the victim assist in Have the victim assist in

exposing the injury and exposing the injury and investigateinvestigate

–WEAR GLOVES!!WEAR GLOVES!!

Shock affects Shock affects are major are major functions of the functions of the bodybody

loss of blood loss of blood flow to the flow to the tissues and tissues and organsorgans

Shock must be treated for Shock must be treated for in all accident casesin all accident cases

* SHOCKSHOCKSHOCKSHOCK

Cuts and BleedingCuts and BleedingCuts and BleedingCuts and Bleeding Common SenseCommon Sense Most common form of First Aid Most common form of First Aid

needed!needed!

1.1. Control BleedingControl Bleeding2.2. Evaluate for Further careEvaluate for Further care

•MinorMinor

•Clean WoundClean Wound

•Antibiotic Antibiotic Cream/BandageCream/Bandage

•Monitor for infectionMonitor for infection

•MajorMajor

•Control BleedingControl Bleeding

•BandageBandage

•Transport Safely to Transport Safely to ERER

BleedingBleedingBleedingBleeding TypesTypes

– ArterialArterial– VenousVenous– CapilaryCapilary

Treatment:Treatment:– Direct PressureDirect Pressure– ElevationElevation– Pressure PointPressure Point– IceIce– Back Woods: Back Woods:

TourniquetTourniquet

Cleaning WoundsCleaning WoundsCleaning WoundsCleaning WoundsShallow woundsShallow wounds 1. Wash inside with1. Wash inside with

soap & watersoap & water2. Irrigate with 2. Irrigate with

pressurized waterpressurized water3. Apply antibiotic 3. Apply antibiotic

ointmentointment4. Cover with4. Cover with

sterile dressingsterile dressing

High risk woundsHigh risk wounds1. Seek medical care1. Seek medical care

for cleaningfor cleaning2. Remote location - 2. Remote location -

cleancleanas best you canas best you can

Physician Care Needed?Physician Care Needed?Physician Care Needed?Physician Care Needed?

CleanClean high risk wounds high risk wounds Close Close open woundsopen wounds

– 1. Cosmetic, wide, gaping,1. Cosmetic, wide, gaping,underlying structure injuredunderlying structure injured

– 2. Closure times =2. Closure times = extremities within 6 hoursextremities within 6 hours head & trunk within 24 hourshead & trunk within 24 hours

TetanusTetanus booster needed? booster needed?

Does it need stitches?Does it need stitches?Does it need stitches?Does it need stitches?

General Guide for Stitches:General Guide for Stitches:

– Joints or flexing areasJoints or flexing areas

–Cosmetic: Face or areas Cosmetic: Face or areas where patient appearance is where patient appearance is of concernof concern

–Wounds larger than 2cm (1/2 Wounds larger than 2cm (1/2 inch) and of significant depth inch) and of significant depth

To Stitch or not to stitch?To Stitch or not to stitch?To Stitch or not to stitch?To Stitch or not to stitch?

YESYES– FACEFACE– Deep jagged Deep jagged

cutcut– Near EyeNear Eye

To Stitch or not to Stitch…To Stitch or not to Stitch…To Stitch or not to Stitch…To Stitch or not to Stitch…

Maybe?!Maybe?! ShallowShallow

– No cosmetic No cosmetic concernconcern

– Limited flexLimited flex– Moderate-Minor Moderate-Minor

infection riskinfection risk

Scrape/cut on forearmScrape/cut on forearm

BurnsBurnsBurnsBurns

Time to be concerned:Time to be concerned:– SizeSize: 1: 1° burns° burns larger than twice the size of the larger than twice the size of the

patient’s hand or 2patient’s hand or 2°° burns (or worse) burns (or worse) ≥ ≥ the size the size of the patient’s handof the patient’s hand

– TypeType: Chemical, Steam Electrical should all be : Chemical, Steam Electrical should all be evaluated immediately.evaluated immediately.

– LocationLocation: Face/lungs, Chest, Circumferential: Face/lungs, Chest, Circumferential TreatmentTreatment

– Cool the Burn!Cool the Burn!– No ointments, goops, butter or lotions!No ointments, goops, butter or lotions!– Treat small burns like other wounds- antibiotic Treat small burns like other wounds- antibiotic

cream after wound has been cooledcream after wound has been cooled– Any burn meeting the above criteria should be Any burn meeting the above criteria should be

evaluated in ERevaluated in ER

InfectionInfectionInfectionInfection

Minor wounds can become major Minor wounds can become major problems!problems!

Signs of Infection:Signs of Infection:– RednessRedness– SwellingSwelling– HeatHeat– Puss or oozingPuss or oozing– Red StreaksRed Streaks

Sprains Strains and Automobiles…Sprains Strains and Automobiles…Sprains Strains and Automobiles…Sprains Strains and Automobiles…

22ndnd Most frequently used First Aid Most frequently used First Aid Skill!Skill!

Can you tell if an injury is a broken Can you tell if an injury is a broken bone or a sprain?bone or a sprain?

HEARTSAVER FACTS FIRST AID

Fracture: Closed Lower Leg (an easy call!)

Sprains Strains and AutomobilesSprains Strains and AutomobilesSprains Strains and AutomobilesSprains Strains and Automobiles Often minimal outward signs to tell Often minimal outward signs to tell

if a broken bone exists.if a broken bone exists.

Safest Treatment is to immobilize, Safest Treatment is to immobilize, and safely transport to medical and safely transport to medical facility for further evaluation.facility for further evaluation.

Splinting-Splinting-Splinting-Splinting- Any device, manufactured or Any device, manufactured or

improvised that limits (or improvised that limits (or eliminates!) movement above and eliminates!) movement above and below the injured sight.below the injured sight.

Two rules to splinting:Two rules to splinting:– Keep it simpleKeep it simple– Keep it simpleKeep it simple

Serious InjuriesSerious InjuriesSerious InjuriesSerious Injuries

Suspected thigh fractureSuspected thigh fracture

SuspectedSuspected

Head injuriesHead injuries

Multiple injuriesMultiple injuries

Loss of ConsciousnessLoss of Consciousness

– Behaving oddlyBehaving oddly

– Sleepy, unable to keep self awakeSleepy, unable to keep self awake

Serious CasesSerious CasesSerious CasesSerious Cases

Trouble BreathingTrouble Breathing

DiabetesDiabetes

SeizureSeizure

Allergic ReactionsAllergic Reactions

PoisoningPoisoning

Heat IllnessesHeat IllnessesHeat IllnessesHeat Illnesses

Heat strokeHeat stroke Extremely hot skinExtremely hot skin Altered mental Altered mental

statusstatus

Heat exhaustionHeat exhaustion Profuse sweatingProfuse sweating Flu-like symptomsFlu-like symptoms

Types of HypothermiaTypes of HypothermiaTypes of HypothermiaTypes of HypothermiaMildMild(above 90° F) (above 90° F)

• shiveringshivering• cold abdomencold abdomen

SevereSevere (below 90° F) (below 90° F)

• no shiveringno shivering• rigid muscles rigid muscles • altered mental statusaltered mental status

Frostbitten Ear

Frostbite: 2nd Degree

Back Woods First Aid…Back Woods First Aid…Back Woods First Aid…Back Woods First Aid…

BlistersBlisters TicksTicks Poison IvyPoison Ivy Transporting the InjuredTransporting the Injured

BlistersBlistersBlistersBlisters

Over use / rubbing Over use / rubbing injuryinjury

Why NOT to break Why NOT to break blister?blister?

Moleskin!Moleskin!Moleskin!Moleskin! Or other padding…Or other padding… Treatment can begin prior to full Treatment can begin prior to full

blown blisterblown blister

Poison Ivy Blister

Poison Oak Dermatitis and Blister

Tick

HEARTSAVER FACTS FIRST AID

Tick: Engorged and Embedded

Delayed EMS ResponseDelayed EMS ResponseDelayed EMS ResponseDelayed EMS Response

What happens when you are What happens when you are waayyy up north?waayyy up north?– To Move or not to move decisionsTo Move or not to move decisions

How the heck are we gonna get this person How the heck are we gonna get this person out of here!out of here!

Risk-Benefit EquationRisk-Benefit Equation– Likelihood of Risk X HarmLikelihood of Risk X Harm

After the emergency…After the emergency…After the emergency…After the emergency… Wash your hands!Wash your hands! Follow up care or monitor the Follow up care or monitor the

injuryinjury

Talk about it!Talk about it!– It’s good to talk about stressful It’s good to talk about stressful

experiences!experiences!– RNs, MDs, EMTs- talk with someone RNs, MDs, EMTs- talk with someone

who knows what it’s likewho knows what it’s like– Talk with someone who will listenTalk with someone who will listen

The First Aid KitThe First Aid KitThe First Aid KitThe First Aid Kit

Keep it Simple!Keep it Simple!– Few BandaidsFew Bandaids– Short roll of tapeShort roll of tape– Gauze padsGauze pads– Roller bandageRoller bandage– Ace WrapAce Wrap– GLOVESGLOVES– Ice PackIce Pack

First Aid KitsFirst Aid KitsFirst Aid KitsFirst Aid Kits

Simple kits available for ~$10Simple kits available for ~$10– Pro: simple, comes with case, one stop Pro: simple, comes with case, one stop

and doneand done– Con: often get poor quality suppliesCon: often get poor quality supplies

Fancy Day Trip to Month long Fancy Day Trip to Month long excursion kits availableexcursion kits available– Pro: One stop and donePro: One stop and done– Con: Definitely comes with TONS of Con: Definitely comes with TONS of

stuff you’ll never needstuff you’ll never need