FIRST AID FIRST AID IN THE NATURE IN THE NATURE Bc. Marie Bártová, Bc. Marie Bártová, Institute of Nursing Theory and Institute of Nursing Theory and Practice Practice Charles University, 1st Medical Charles University, 1st Medical Faculty Faculty Prague 2006 Prague 2006
FIRST AID IN THE NATURE
Feb 12, 2016
FIRST AID IN THE NATURE. Bc. Marie Bártová, Institute of Nursing Theory and Practice Charles University, 1st Medical Faculty Prague 2006. CONTENTS. Bleeding Shock Heat related injuries Fractures Drowning. B L E E D I N G. M INOR CUTS, SCRATCHES w ash and dry your own hands - PowerPoint PPT Presentation
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FIRST AID FIRST AID IN THE NATUREIN THE NATURE
Bc. Marie Bártová, Bc. Marie Bártová, Institute of Nursing Theory and PracticeInstitute of Nursing Theory and PracticeCharles University, 1st Medical FacultyCharles University, 1st Medical Faculty
Prague 2006Prague 2006
First Aid, Institute of Nursing Theory and Practice
CONTENTSCONTENTS
- BleedingBleeding
- ShockShock
- Heat related injuriesHeat related injuries
- FracturesFractures
- DrowningDrowning
B L E E D I N GB L E E D I N G
MMINOR CUTS, SCRATCHESINOR CUTS, SCRATCHES- wwash and dry your own handsash and dry your own hands- ccover any cuts on your own hands over any cuts on your own hands and put onand put on disposable glovesdisposable gloves- cclean the cutlean the cut- raise affected area above the heartraise affected area above the heart- ccover the cut with a sterile over the cut with a sterile dressing or plastedressing or plasterr
First Aid, Institute of Nursing Theory and Practice
BLEEDING BLEEDING II
SEVERE BLEEDINGSEVERE BLEEDING- lay the victim down (fainting), elevate the lay the victim down (fainting), elevate the
bleeding areableeding area- remove any obvious loose debris or dirt from a remove any obvious loose debris or dirt from a
woundwound- apply pads and bandages apply pads and bandages - maintain pressure maintain pressure - if bleeding continues place another cloth over if bleeding continues place another cloth over
the first onethe first one- get medical help and take steps to prevent shockget medical help and take steps to prevent shock
Marie Bártová
STEPS TO PREVENT SHOCK"- immobilize the injured body part - lay the victim flat- raise the feet about 12 inches- cover the victim with a coat or blanketDo not place the victim in this position if there has been a head, neck, back, or leg injury or if the position makes the victim uncomfortable. Get medical help as soon as possible.
Marie Bártová
Call immediately for emergency medical assistance if: - the bleeding can't be controlled, or is associated with a serious injury- the wound might need stitches- embedded gravel or dirt cannot be removed easily with gentle cleaning- internal bleeding or shock is suspected- signs of infection develop including increased pain, redness, swelling, discharge, swollen lymph nodes, fever, or red streaks spreading from the site toward the heart. (This is usually treated with topical or oral antibiotics. If untreated, an infection can cause a skin abscess or other complications.) - the injury involves an animal or human bite- you are not up-to-date on tetanus immunization (within 5-10 years).
First Aid, Institute of Nursing Theory and Practice
BLEEDING BLEEDING IIIIDO NOT:DO NOT:- apply a tourniquet apply a tourniquet
to control bleeding to control bleeding if not neccessary if not neccessary
- pull out any embedded pull out any embedded object from a woundobject from a wound
- try to clean a large try to clean a large woundwound
- remove a dressing if it becomes soaked with blood remove a dressing if it becomes soaked with blood - peek at a wound to see if the bleeding is stoppingpeek at a wound to see if the bleeding is stopping- try to clean a wound after you get the bleeding under try to clean a wound after you get the bleeding under
control control
Marie Bártová
Stopping bleeding with a tourniquetWhen there is severe bleeding where a major artery has been severed, pressure may be insufficient and a tourniquet may be necessary. Tourniquets are an effective way of stopping bleeding from an extremity. They do, however, stop circulation to the affected extremity and should ONLY be used when other methods, such as pressure dressings, have failed (or are likely to fail). Pressure from tourniquets must be relieved periodically to prevent damage to the tissue from lack of oxygen ! !
First Aid, Institute of Nursing Theory and Practice
S H O C KS H O C K „„Acute circulatory failure with inadequate or Acute circulatory failure with inadequate or
inappropriately distributed tissue perfusion resulting inappropriately distributed tissue perfusion resulting in generalized cellular hypoxia.„in generalized cellular hypoxia.„
CAUSE OF SHOCKCAUSE OF SHOCK- traumatrauma- severe infectionsevere infection- allergic reactions etc.allergic reactions etc.
TYPES OF SHOCKTYPES OF SHOCK- cardiogenic shockcardiogenic shock - - problems with the heartproblems with the heart- septicseptic shock shock – endotoxins cause vasoconstriction– endotoxins cause vasoconstriction- distributive shock distributive shock - anaphylaxis- anaphylaxis- hypovolemic shockhypovolemic shock - - loss of circulating voluloss of circulating volummee
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Types of shock1) Cardiogenic ShockBlood flow decreased due to an intrinsic defect in cardiac function – either the heart muscle, or the valves are dysfunctionalClassical example is acute anterior myocardial infarction, when the amount of damaged ischaemic muscle may be so great that the heart cannot pump anymore. The decreased contractility causes a decrease in stroke volumeTypical haemodynamic picture: - decreased cardiac output and blood pressure- high left ventricular filling pressures (backward failure)- increased systemic vascular resistance (from vasoconstriction, which is a sympathetic compensatory response to the low blood pressure)- increased heart rate (sympathetic compensatory response to the low blood pressure)- other features of cardiogenic shock such as the cool peripheries, decreased urine output and sweating can also be explained by the sympathetic compensatory response. 2) Hypovolemic shock - result of intravascular blood volume depletionCommon causes: - haemorrhage- vomiting- diarrhoea- dehydration- third-space losses during major operationsPrimary abnormality is a decrease in preload. The decreased preload causes a decrease in stroke volume.Typical haemodynamic picture: - decreased cardiac output and blood pressure- low left ventricular filling pressures (because the ventricle is empty)- increased SVR (from vasoconstriction, which is a sympathetic compensatory response to the low blood pressure)- increased heart rate (sympathetic compensatory response to the low blood pressure)- other features of hypovolaemic shock are similar to those seen in cardiogenic shock and include cool peripheries, decreased urine output and sweating that can also be explained by the sympathetic compensatory response. 3) Distributive Shock - occurs when the peripheral vascular dilatation causes a fall in SVRMost common causes: - septic shock- anaphylactic shock- acute adrenal insufficiency- neurogenic shock.Cardiac output is often increased but the perfusion of many vital organs is compromised because the blood pressure is too low and the body loses it’s ability to distribute blood properly4) Septic shock - is associated with sepsis which is the presence of pathogenic organisms in the blood or tissues. Septic shock is also associated with septicemia, usually by Gram-negative (endotoxic shock) bacteria, but also Gram-positive and rarely fungi.
First Aid, Institute of Nursing Theory and Practice
SHOCK SHOCK II
SIGNSSIGNS- ppale face ale face - ccold, clammy skin old, clammy skin - ffast, shallow breathing ast, shallow breathing (hyperventilation)(hyperventilation)- rrapid, weak pulseapid, weak pulse- hypotensionhypotension- the eyes may seem to stare, the eyes may seem to stare, pupils
dilatated- yyawningawning/s/sighingighing/delirium//delirium/unconsciousnessunconsciousness
First Aid, Institute of Nursing Theory and Practice
SHOCK SHOCK IIII
TREATMENTTREATMENT- lay the casualty down, raise
and support the legs- check for signs of circulation (if absent
begin CPR)- keep the person warm and comfortable- if the person vomits, turn him on the side
– recovery position- do not give the anything to eat or drink
First Aid, Institute of Nursing Theory and Practice
H E A T R E L A T E D I N J U R I E S
- HypothermiaHypothermia- HyperthermiaHyperthermia
- BurnsBurns
First Aid, Institute of Nursing Theory and Practice
HYPOTHERMIA
CONDITIONS LEADING TO HYPOTHERMIA:
- cold temperatures, wetness - fatigue, exhaustion, dehydration- alcohol intake (vasodilation -
increased heat loss)
TYPES - mild 35—32 ◦C- moderate 32—30 ◦C- severe less than 30 ◦C
TREATMENT:TREATMENT:- reduce heat lossreduce heat loss- add fuel & fluids add fuel & fluids
(carbohydrates, hot liquids)(carbohydrates, hot liquids)- add heatadd heat
„Exists when the body core temperature is below 35 ◦C“
Marie Bártová
FROSTBITE TREATMENT:1. Get out of cold2. Warm your hands (tuck under your arms), nose/ears/face – cover with dry , glowed hands3. Don´t rub the affected area4. If there´s any chance of refreezing, don´t thaw out the affected areas (already twowed out – wrap them – don´t let refreez)5. Get emergency medical help if numbness remains during warming. If it´s not possible warm frosbitten parts in warm-NOT HOT- water
First Aid, Institute of Nursing Theory and Practice
HYPERTHERMIA
SIGNS:- mental state change, perspiration - headache, tachypnea, dizziness
FORMS OF HS:- non-exertion heat stroke (CHS)
- high environmental temperatures (elderly)
- exertion heat stroke (EHS) - physical exercise in high environmental temperatures (healthy adults)
TREATMENT:TREATMENT:Cooling techniques:Cooling techniques:- Surface cooling methods Surface cooling methods
(undress the victim, ice packs)(undress the victim, ice packs)- Internal cooling methods (i.v Internal cooling methods (i.v
drugs, cool fluids)drugs, cool fluids)
„Occurs when the body’s ability to thermoregulate fails, and core temperature exceeds the one that is normally maintained by homeostatic mechanisms“ Heat stroke (HS) - a systemic inflammatory response with a core temperature above 40.6 ◦C
Marie Bártová
Predisposing factorsThe elderly are at an increased risk for heat-related illness because of underlying illness, medication use, declining thermoregulatory mechanisms and limited social support. There are several risk factors:lack of acclimatisation, dehydration, obesity,alcohol, cardiovascular disease, skin conditions(psoriasis, eczema, scleroderma, burn, cysticfibrosis), hyperthyroidism, phaeochromocytomaand drugs (anticholinergics, diamorphine, cocaine, amphetamine, phenothiazines, sympathomimetics, calcium channel blockers, beta-blockers).
First Aid, Institute of Nursing Theory and Practice
BURNS
SIGNS:SIGNS:- skin rednessskin redness- swellingswelling- painpain
TREATMENT:TREATMENT:- cool the burncool the burn- ccover the burn over the burn
with a sterile with a sterile gauze bandagegauze bandage
- ttake pain relieverake pain reliever if neccessaryif neccessary
FIRST-DEGREE BURNFIRST-DEGREE BURN - o- outer layer of uter layer of skinskin (epidermis) is burned(epidermis) is burned
First Aid, Institute of Nursing Theory and Practice
BURNS I
SIGNS:SIGNS:- blistersblisters- severe painsevere pain- swellingswelling
TREATMENT:TREATMENT:- cool the burncool the burn- ccover the burn over the burn
with a sterile with a sterile gauze bandagegauze bandage
- ttake pain relieverake pain reliever if neccessaryif neccessary
SECOND-DEGREE BURNSECOND-DEGREE BURN – first and – first and second layer of skin (epidermis) is burnedsecond layer of skin (epidermis) is burned
DO NOTDO NOT::
- pputut the the ice directly on a burn
ice directly on a burn ((frostb
itefrostb
ite))
- break blisters
break blisters (ris
k of (ris
k of infection
infection))
Marie Bártová
Hold the burned area under cold running water for at least 5 minutes, or until the pain subsides. If this is impractical, immerse the burn in cold water or cool it with cold compresses. Cooling the burn reduces swelling by conducting heat away from the skin. Don't put ice on the burn.
Marie Bártová
Don't use fluffy cotton, which may irritate the skin. Wrap the gauze loosely to avoid putting pressure on burned skin. Bandaging keeps air off the burned skin, reduces pain and protects blistered skin.
Marie Bártová
These include aspirin, ibuprofen (Advil, Motrin, others), naproxen (Aleve) or acetaminophen (Tylenol, others). Never give aspirin to children or teenagers.
First Aid, Institute of Nursing Theory and Practice
BURNS II
SIGNS:SIGNS:- dry, white/black dry, white/black
areasareas- signs of shock signs of shock
TREATMENT:TREATMENT:- make sure the victim is no make sure the victim is no
longer in contact with longer in contact with smoldering materialssmoldering materials
- don´t immerse severe large don´t immerse severe large burns in cold waterburns in cold water
- check for signs of circulationcheck for signs of circulation- cover the area of the burn cover the area of the burn
(c(cool, ool, moinst, sterile bandage)
THIRD-DEGREE BURNTHIRD-DEGREE BURN – involve all – involve all layers of skin (fat, muscle and even bone can layers of skin (fat, muscle and even bone can be affected)be affected)
First Aid, Institute of Nursing Theory and Practice
F R A C T U R E S
SIGNSSIGNS- local bruising and local bruising and
tenderness in the tenderness in the effected area effected area
- skin stretch marksskin stretch marks- localized swelling localized swelling - fforming hematomasorming hematomas- painpain- impaired functionimpaired function
TYPESTYPES- Closed FractureClosed Fracture - - no no
broken skinbroken skin- Compound FractureCompound Fracture - -
bone penetrate through bone penetrate through the skin from the insidethe skin from the inside (risk of infection)(risk of infection)
„„AA fractured bone is a bone which has had fractured bone is a bone which has had its tissueits tissue b broken. A fractured is aroken. A fractured is a name of name of ththe e type of the break type of the break eexperiencedxperienced““
Marie Bártová
Butterfly FractureThis type of fracture has slight comminution at the fracture site which looks largely like a butterfly. The fracture site has butterfly fragments. Closed FractureWhen there is a closed fracture there is no broken skin. The bones which broke do not penetrate the skin (but may be seen under the skin) and there is no contusion from external trauma. Comminuted Bone Fracture A comminuted fracture has more than two fragments of bone which have broken off. It is a highly unstable type of bone fracture with many bone fragments.Complete Bone FractureThis is where the bone has been completely fractured through it's own width. This is opposite from a hairline fracture or incomplete bone fracture where there is only a "crack" and not a complete break.Complex FractureThis type of fractured bone severely damages the soft tissue which surrounds the bone. Compound Bone FractureWhen this occurs, the bone breaks and fragments of the bone will penetrate through the internal soft tissue of the body and break through the skin from the inside. There is a high rise of infection if external pathogenic factors enter into the interior of the body. Compression FractureThis type of bone fracture generally occurs after a fall where the vertebral column is compressed and then under the extreme pressure cracks or breaks. This type of bone fracture may also be referred to as a Impact Fracture.Double FractureWith this type of broken bone there is multiple fractures on the same bone or two bones which are fractured at the same time (ie - tibula and fibula). This type of trauma generally requires internal fixation of the fractured bones. It is also known as a Segmental Fracture. Fissure FractureThis bone fracture has minimal trauma to the bone and surrounding soft tissues. It is a incomplete fracture with no significant bone displacement and is considered a stable fracture. In this type the fracture the crack only extends into the outer layer of the bone but not completely through the entire bone. It is also known as a Hairline Fracture. Fracture-DislocationThis type of fracture is complicated with a dislocation of the joint proximal to the fracture site. Fragmented FractureDuring this fracture the trauma will result in many broken bones leaving many pieces of bone within the patient. Greenstick FractureThe pathology of this type of fracture includes a incomplete fracture in which only one side of the bone has been broken. The bone usually is "bent" and only broken of the outside of the bend. It is mostly seen in children and is considered a stable fracture due to the fact that the whole bone has not been broken. As long as the bone is kept rigid healing is usually quick. Hairline FractureThis bone fracture has minimal trauma to the bone and surrounding soft tissues. It is a incomplete fracture with no significant bone displacement and is considered a stable fracture. . In this type the fracture the crack only extends into the outer layer of the bone but not completely through the entire bone. It is also known as a Fissure Fracture. Incomplete FractureThis occurs when the bone breaks but the ends do not completely separate leaving the bone with a "crack" which does not extend the complete width of the bone. This is opposite from a complete bone fracture where the broken bone ends are completely severed from each other. Impact FractureThis type of bone fracture generally occurs after a fall where the vertebral column is compressed and then under the extreme pressure cracks or breaks. This type of bone fracture may also be referred to as a Compression Fracture. Impacted FractureType of fracture where the ends of the broken bones are wedged together. Multiple FracturesIn this type of fractured bone there are several fracture lines on one bone. It can also mean several fractures in one patient but on separate bones but generally due to the same injury. Generally due to traumatic injuries, this will be evident in a patient who has a fractured pelvis and clavicle due to a fall or hit by a car. Oblique FracturesThese types of fractures are one of rarest forms. They are a oblique break in the bone which is very unstable (break at an angle). They can be easily diagnosed as spiral fractures. Open Bone FractureThis type of fracture classified as when a broken bone protrudes to the exterior of the body giving rise to soft tissue injuries of the muscles, tendons and ligaments. There is a high risk of injection to the internal tissues. Segmental Fracture With this type of broken bone there is multiple fractures on the same bone or two bones which are fractured at the same time (ie - tibula and fibula). A bone break in which several large pieces of bone have broken away from the broken bone. This type of fracture easily becomes an open fracture. It is also known as a Double Fracture. Simple FractureA simple bone fracture is one of the better types of fractures as there is only bone damage with little or no soft tissue damage and the broken bone ends do not penetrate the skin. Spiral FracturesIn this pattern a bone has been broken due to a twisting type motion. It is highly unstable and may be diagnosed as a oblique fracture unless a proper x-ray has been taken. The spiral fracture will look like a corkscrew type which runs parallel with the axis of the broken boneStable FractureA stable fracture is a broken bone which is generally transverse, oblique, greenstick or a hairline fracture which is somewhat secure. Transverse Bone FractureIn this type of fracture the bone has been broken giving rise to a transverse break or fissure within the bone at a right angle to the long portion of the bone.. It is most often caused by direct traumatic injuries. Unstable FractureAn unstable fracture is generally a broken bone which is comminuted, oblique or a spiral fracture requiring external or internal fixation.
First Aid, Institute of Nursing Theory and Practice
FRACTURES I
TREATMENTTREATMENT- stop any bleedingstop any bleeding- immobilize the injured area (a splint)immobilize the injured area (a splint)- apply ice pack to limit swelling apply ice pack to limit swelling - help relive painhelp relive pain- treat for shock (head slightly lower than treat for shock (head slightly lower than
the trunk, elevate legs) the trunk, elevate legs) - call emergency call emergency
Marie Bártová
CALL FOR EMERGENCY SERVICE IF:- the person is unresponsive (CPR?)- there is a heavy bleeding- gentle pressure or movement cause pain- the limb or joint appears deformed- the bone has pierced the skin- injured extremity is numb or bluish- you suspect brek bone in the neck, head, back,hip, pelvis, upper leg
First Aid, Institute of Nursing Theory and Practice
D R O W N I N GD R O W N I N G„A process resulting in primary respiratory
impairment fromsubmersion/immersion in a liquid medium“
LIFE SUPPORT LIFE SUPPORT (Eropean Resuscitation Council 2005)(Eropean Resuscitation Council 2005)::- quick removal of quick removal of the drowning victim from the water- open airway - pprompt initiation of rescue breathing for 1 min- <5 min to land - continue rescue breaths - >5 min from land - continue rescue breaths for 1 min - chest compression after the victim is removed from
water
Marie Bártová
There is no need to clear the airway of aspiratedwater. The majority of drowning victims aspirateonly a modest amount of water, and this isabsorbed rapidly into the central circulation.
Marie Bártová
Regurgitation during resuscitationIf regurgitation occurs, turn the victim’s mouth tothe side and remove the regurgitated material using directed suction if possible. If spinal cord injury is suspected, log-roll the victim, keeping the head,neck and torso aligned, before aspirating the regurgitated material. Log-rolling will require several rescuers
First Aid, Institute of Nursing Theory and Practice
REPETITIONREPETITION
1.1. How do you act if a severe bleeding wound How do you act if a severe bleeding wound dressing becomes soaked with blood?dressing becomes soaked with blood?
2.2. Name 3 signs of shock. Name 3 signs of shock. 3.3. What age group is in greater risk of What age group is in greater risk of non-
exertion heat stroke? 4. What burn degree is characterized by blisters? 5. Explain what is compound ompound bbone one ffractureracture??6.6. How do you carry out rescue breathing in a How do you carry out rescue breathing in a
drowning victim after his removal from water? drowning victim after his removal from water?
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