What are the main priorities for assessment and management of first aid patients? How should the major types of injuries and medical conditions be managed.
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Slide 1
What are the main priorities for assessment and management of
first aid patients? How should the major types of injuries and
medical conditions be managed in first aid situations? What does
the individual need to consider in administering first aid? First
Aid
Slide 2
What are the main priorities for assessment and management of
first aid patients? Summary of content: Setting priorities for
managing a first aid situation and assessing the casualty: -
situational analysis - priority assessment procedures - DRABCD -
STOP Crisis management: - CPR - bleeding - shock - neck and spinal
injury - moving the casualty - medical referral - care of the
unconscious casualty
Slide 3
Setting priorities for managing a first aid situation and
assessing the casualty The priority when assessing and managing
first aid patients is minimising the harm to: - yourself -
bystanders - the casualty When managing the first aid situation, it
is important that the circumstances and eventual outcomes for the
patient are improved as much as possible. Expediency and
appropriate care here positively affect the individuals quality of
life.
Slide 4
Setting priorities for managing a first aid situation and
assessing the casualty Situational Analysis There is a chance that
some stage in our life we may be confronted with the need to
resuscitate an individual in a number of different circumstances.
It is important that you are able to deal with this quickly,
effectively and without risk to yourself or others. To do so you
need to: Analyse the situation observe what has happened and ask
yourself: What's the best I can do for this person in terms of the
skills that I have? Plan how to deal with the situation prioritise
your intended actions, dealing with the most important issues
first. The main issue with situational analysis is that you don't
become a victim yourself in an effort to assist another person.
Always put your safety first.
Slide 5
Setting priorities for managing a first aid situation and
assessing the casualty Priority Assessment and Management
Procedures Scenarios: Scenario 1 Scenario: Petrol leaking,
dangerous wires, at least 4 casualties, injuries (for example,
broken bones, dislocations, bleeding, spinal injuries), possible
fatalities, other cars on the road. Dangers: Risk of explosions
(petrol and fire), other cars, danger of being electrocuted, broken
glass, unstable structures, fumes, etc Priority management DRABCD
Call ambulance Assess danger to self, bystanders, casualties. Other
Traffic - Warn other vehicles, put on Hazard lights, use a
bystander to warn oncoming traffic, park a car on the road a safe
distance from the crash Damaged Vehicle - be aware of airbags that
havent gone off, put on handbrake, put vehicle in gear, put bricks
or blocks against wheels to stop it rolling Fallen or Damaged
Overhead Power lines - Keep away from the cable do not move, call
emergency services. Fire Risk - keep bystanders/casualty/self well
away, no naked flames or smoking, switch off the ignition Check for
conciousness/unconciousness Airway management/CPR Control
bleeding
Slide 6
Setting priorities for managing a first aid situation and
assessing the casualty Scenario 2 Scenario panic, a variety of
swimmers, weak swimmers and non swimmers. Dangers wave size, being
caught in the rip as well, being pulled under by weak, non-swimmers
or panicking swimmers. Priority Management - Try to get assistance
from lifeguards - Assess danger you should only attempt a water
rescue if you are a strong swimmer and the water is not too deep
for you. - Consider the safest rescue options (for example, reach,
throw, wade, row, swim, etc) - Priotisation/Triage (in a situation
like this, this involve assisting those whose injuries/ condition
can be treated quickly) - If possible, paddle to the victims on a
board and with PFDs. The board and PFDs can be used to keep the
victims afloat until help arrives.
Slide 7
Setting priorities for managing a first aid situation and
assessing the casualty Scenario 3 Scenario broken glass, bleeding,
lacerations, panicking, crying, etc Dangers stepping in/being cut
by glass, being infected by blood, etc Priority Management - Call
the Ambulance - Assess dangers to self, casualties, bystanders -
Move casualties away from the glass if possible - DRABCD - Manage
bleeding
Slide 8
Setting priorities for managing a first aid situation and
assessing the casualty DRABCD D check for DANGER to you to other
people in the immediate area to the casualty R check for RESPONSE
is the casualty conscious? to check for consciousness ask
questions, squeeze their hand A check AIRWAY is the airway open and
clear of objects? clear and maintain the airway B check for
BREATHING is the chest rising and falling? can you hear or feel air
from the mouth or nose? if breathing is absent give two initial
breaths C give CPR if there are no signs of life unconscious, not
breathing and not moving, apply CPR CPR stands for cardiopulmonary
resuscitation CPR involves giving 30 compressions at a rate of
approximately 100 compressions per minute, followed by two breaths
D attach DEFIBRILLATOR (if available) follow voice prompts
Slide 9
Setting priorities for managing a first aid situation and
assessing the casualty STOP Stop Stop the person from moving. It
may be necessary to stop the sport or activity. Are there any
dangers? Talk Talk to the injured person. Ask them questions to
ascertain the type and severity of the injury. Questions may
include: What happened? Where does it hurt? Can you move the
affected area or body part? Observe Observe the patient and the
injured area. Look for facial expressions of pain, look for
swelling or deformity and feel for pain or tenderness. Ask yourself
questions such as: Does the patient look distressed? Is there
swelling, bleeding or bruising? Are there any deformities? Prevent
Prevent further injury by conducting a whole of body assessment and
treating the injury with appropriate first aid.
Slide 10
Setting priorities for managing a first aid situation and
assessing the casualty Whole of Body Assessment
Slide 11
Crisis Management Cardiopulmonary Resuscitation (CPR) Refer to
pages 13 & 14 of your exercise booklet and read through the
table.
Slide 12
Crisis Management Bleeding 1. Use DRABC action plan. 2. Apply
direct pressure by holding a pad or dressing firmly over the site.
3. Lay casualty down and elevate injury. 4. Rest the injured area.
5. Do not give patient anything by mouth, particularly asprin as
this tends to increase the rate of bleeding. 6. Loosen tight
clothing. 7. Seek medical advice.
Slide 13
Crisis Management Shock Is a condition where the body closes
off the blood supply to the extremities (arms, legs and skin) to
ensure enough oxygen reaches vital organs. Causes: - Blood loss. -
Fluid loss e.g. Dehydration. - Being involved in an accident.
Symptoms: - Paleness and cold clammy skin. - Weak rapid pulse. -
Rapid shallow breathing. - Nausea and faintness. Management: 1.
Utilise DRABCD action plan.5. Dress any wounds or burns. 2.
Reassure the patient.6. Loosen restrictive clothing, particularly
around the neck. 3. Seek medical advice.7. Keep casualty
comfortable. 4. In the absence of a fracture raise legs above the
level of the heart.
Slide 14
Crisis Management Neck and Spinal Injury Signs and Symptoms:
Loss of movement in the hands and/or legs. Pain in the neck and/or
back, tingling sensation in the hands or feet. Altered sensation,
movement or strength in the limbs or trunk. Irregular bumps on the
neck or back and slow pulse. Management Procedures: Reassure
patient. Loosen any tight clothing. Do not move them. Support head
and apply a cervical collar if one is available. Seek medical
attention. Monitor casualty closely until help arrives. If casualty
is unconscious, treat patient as if they have a neck and spinal
injury and use the DRABCD procedures.
Slide 15
Crisis Management Please refer to page 16 of your exercise
booklet and read through the following: Moving the Casualty
http://www.youtube.com/watch?v=VSyuBMEwfrk
http://www.youtube.com/watch?v=4UBIxtyoxok
http://www.youtube.com/watch?v=vMkDtw_5yaY
http://www.youtube.com/watch?v=MWs3rMXt2hA Medical Referral Care of
the Unconscious Casualty
Slide 16
How should the major types of injuries and medical conditions
be managed in first aid situations? Individuals can sustain a wide
range of injuries. It is important to be able to identify the
symptoms for each type of injury and be familiar with the
appropriate management techniques. You need to pay attention to the
environment, listen to the patient (if conscious) and assess the
injured area(s) to determine the best management technique. How
much do you Know??? Complete the Emergency Care Quiz on pages 18-19
of your work booklet,
Slide 17
Management of Injuries Cuts and Lacerations Abrasions, open
wounds and penetrating wounds. Signs and Symptoms Scraped skin
caused by a fall on a hard surface. Incisions or lacerations. Deep
wound from an object, e.g. From a bullet. Management DRABCD Control
bleeding using pressure. Cleanse thoroughly. Apply clean dressing.
Seek medical attention.
Slide 18
Management of Injuries Fractures These can be closed (under the
skin), open (through the skin) or complicated (where organs are
damaged). Signs and Symptoms Sound from the bone breaking.
Localised pain. Swelling and deformity. Tenderness. Loss of power.
Difficult to achieve normal range of motion. Management DRABCD
Control bleeding (if any) Immobilise with a sling or a splint.
Observe for shock and treat if necessary. Seek medical
attention.
Slide 19
Management of Injuries Dislocations Refers to the bone being
dislodged from the joint. Signs and Symptoms Swelling,
discolouration. Pain and deformity. Tenderness with an inability to
move. Management DRABCD Support the area. Apply ice. Elevate if
possible. Seek medical attention.
Slide 20
Management of Injuries Head Injuries and Concussion Trauma to
the head Signs and Symptoms Blurred Vision. Loss of memory,
headache. Change in size of the pupil. Bleeding from nose or ears.
Abnormal response to commands. Management DRABCD. Support the head
or neck. Keep airway open. If conscious lay in the lateral
position. Do not apply pressure to a bleeding head if a skull
fracture is suspected. Seek medical attention.
Slide 21
Management of Injuries Eye Injuries Signs and Symptoms
Irritation to the eye. Watering. Redness. Pain to the eye itself.
Inability to open. Management Rubbing and removal of embedded
objects must be avoided. Lay in the lateral position. Cover both
eyes. Seek medical attention.
Slide 22
Management of Injuries Nasal Injuries Signs and Symptoms Pain,
swelling, deformity and bruising. Management Instruct casualty to
breath through the mouth. Blowing the nose should be avoided.
Assume sitting position with head and shoulders leaning forward.
Apply pressure with the index finger and thumb to the soft part of
the nose just below the bone. Apply pressure for approx 10 minutes
or until bleeding stops. Seek medical attention.
Slide 23
Management of Injuries Burn Injuries These can be caused by
fire, chemicals, electricity and radiation. Signs and Symptoms
Severe pain, possible swelling. Redness, blistering and shock.
Management Remove the casualty from the danger or the danger from
the casualty. DRABCD. Hold burnt area under cold running water.
Remove jewellery and clothing only if it is not stuck to the skin.
Seek urgent medical attention. Do not brak blisters or apply
creams, lotions or adhesive dressings.
Slide 24
Management of Injuries Teeth Injuries Signs and Symptoms
Bleeding from the mouth. Dislodged tooth. Management If the tooth
has been loosened keep it in place and seek immediate dental
advice. If the tooth has been knocked out, re-implant and splint to
an adjacent tooth using aluminium foil. If not possible, place in
milk or clean with the casualties saliva and seek urgent dental
assistance. Most teeth can be saved if the root is not
handled.
Slide 25
Management of Injuries Electrocution Signs and Symptoms
Unconsciousness. Electrical wires may be visible. Management
DRABCD. Cool burnt area under running water. Seek urgent medical
advive.
Slide 26
Management of Injuries Chest Injuries These may range from
bruised or fractured ribs to lung injuries. Signs and Symptoms Pain
usually on breathing and coughing. Difficulty in breathing.
Tenderness when touched. Management Place in a comfortable
position. Encourage shallow breathing. Pad the injured area. Seek
urgent medical advice.
Slide 27
Management of Injuries Abdominal Injuries These are injuries to
the stomach and pelvis caused in such instances such as car crashes
and tackles in sport. Signs and Symptoms Shock, pain in the region.
Nausea or possible vomiting. Difficulty in breathing. Possible
blood in the urine or coming from the anus. Management DRABCD.
Loosen clothing in the area e.g. Belts. Lie patient on their back,
slightly elevate shoulders and bend the knees. Do not allow
casualty to consume food or drink. Seek urgent medical
attention.
Slide 28
Management of Injuries Activity Apply your new-found knowledge
to the case studies on pages 21-23 of your exercise work
booklet.
Slide 29
Management of Medical Conditions Heart Attack Signs and
Symptoms Shortness of breath, difficulty in breathing, excessive
perspiration, irregular heart beat, pain in the chest that can
extend down the neck and arm. Management Techniques DRABCD, seek
urgent medical assistance, loosen tight clothing.
Slide 30
Management of Medical Conditions Stroke Signs and Symptoms
Numbness in the face, arm or leg, slurred speech, disorientation,
blurred vision, loss of consciousness. Management Techniques
DRABCD, seek urgent medical assistance, make patient
comfortable.
Slide 31
Management of Medical Conditions Diabetes Signs and Symptoms
There are two medical conditions relating to diabetes,
hypoglycaemia and hyperglycaemia. The signs and symptoms of
hypoglycaemia (low blood sugar) include nausea, confusion,
sweating, rapid pulse, shallow breathing. Signs and symptoms of
hyperglycaemia (high blood sugar) include drowsiness, rapid pulse,
thirst, increased urination, breath has a fruity smell. Management
Techniques The management techniques for hypoglycaemia include
DRABCD, if unconscious do not give anything by mouth, if conscious
patient should be encouraged to eat or drink glucose e.g. fruit
juice, jelly beans. The management techniques for hyperglycaemia
include DRABCD, seek medical assistance if the patient is conscious
allow them to administer insulin.
Slide 32
Management of Medical Conditions Epilepsy Signs and Symptoms
Muscle spasms, rigid body, frothing at the mouth, loss of bladder
control, loss of consciousness. Management Techniques DRABCD, clear
obstacle that may cause injury e.g. tables and chairs, once the
seizure has finished, place in recovery position, monitor patient
and reassure them, seek medical assistance.
Slide 33
Management of Medical Conditions Asthma Signs and Symptoms
Breathlessness or difficulty in breathing, wheezing and coughing,
tightness in the chest, rapid pulse, paleness and sweaty skin.
Management Techniques The four-step Asthma First Aid is: Sit the
person upright and give reassurance do not leave them alone.
Without delay, give the person four separate puffs of your blue
reliever medication (Airomir, Asmol, Bricanyl, Epaq or Ventolin).
This should be taken one puff at a time via a spacer. Ask the
person to take four breaths from the spacer after each puff of
medication. Wait four minutes. If there is little or no
improvement, repeat steps 2 and 3. If there is still no
improvement, call an ambulance immediately. Dial triple zero (000).
Repeat steps 2 and 3 continuously while waiting for the ambulance
to arrive.
Slide 34
Management of Medical Conditions Anaphylaxes Signs and Symptoms
Difficulty breathing, swelling of the tongue, swelling/tightness in
the throat, difficulty talking/hoarse voice,wheezing or persistant
coughing, loss of conciousness and / or collapse, young children
may appear pale and floppy. Abdominal pain or vomting (when
associated with an allergic reaction to an insect sting or bite).
Management Techniques Adrenaline is given as an injection using an
autoinjector.
Slide 35
Management of Medical Conditions Poisoning Signs and Symptoms
Headache, drowsiness, vomiting, pain, rapid pulse, breath smells of
fumes. Management Techniques DRABCD, in most cases do not induce
vomiting, if possible consult poisoning information on product,
seek urgent medical assistance.
Slide 36
Management of Medical Conditions Bites and stings Snake bite
Signs and Symptoms Puncture marks, pain, swelling, headache, rapid
pulse, difficulty in breathing. Management Techniques DRABCD,
reassure the patient, apply a compression bandage over the site and
along the limb, immobilise the site, seek medical assistance.
Funnel-web spider Signs and Symptoms Puncture marks, pain,
sweating, difficulty in breathing, nausea, shock. Management
Techniques DRABCD, reassure the patient, apply a compression
bandage over the site and along the limb, immobilise the site, seek
urgent medical assistance. TBC.....
Slide 37
Management of Medical Conditions Redback spider Signs and
symptoms Pain, sweating, nausea, joint pain, rapid pulse.
Management Techniques DRABCD, reassure the patient, apply ice to
the bite site, seek medical assistance. Bee sting Signs and
symptoms Pain at site, swelling. Management Techniques Remove by
scraping away stinger (do not squeeze), apply ice to the bite site,
seek medical assistance if allergic reaction occurs.
Slide 38
Management of Medical Conditions Exposure to extreme heat can
result in hyperthermia Signs and Symptoms Cramps, exhaustion,
dizziness, nausea, headache, rapid pulse, unconsciousness.
Management Techniques Place patient in cool shaded area, give sips
of water, reduce body temperature by use of fan or wet towel, seek
medical assistance.
Slide 39
Management of Medical Conditions Exposure to extreme cold can
result in hypothermia Signs and Symptoms Shivering, fatigue,
slurred speech, slow reaction time, slow pulse, cold skin.
Management Techniques Remove wet clothing, wrap the patient in warm
clothing, blankets, sleeping bag etc., use body heat of another
person, do not try to raise body temperature too quickly, provide
warm drinks to sip, seek medical assistance.
Slide 40
What does the individual need to consider in administering
first aid? Summary of Content: Physical Environment - traffic
accidents - water environments - electricity Infection Control and
Protection - HIV/AIDS - blood-borne viruses (Hepatitis B and C)
Legal and Moral Dilemmas - legal implications e.g. OH&S - moral
obligations e.g. duty of care & responsible citizenship -
common sense versus heroics Support following first aid situations
- debriefing - counselling
Slide 41
Physical Environment The nature of the physical environment
may, in part have been responsible for the occurrence of the
accident in the first place. E.g. A drowning may have occurred as a
result of a rapidly rising water level. Or a traffic accident may
be due to an oil spill on the road. Whatever the circumstances, it
is important that protective measures be observed and strategies
put into place so that a further injury does not occur. Read
through the information and complete the relevant activities on
pages 28-32 of your exercise booklet.
Slide 42
Infection Control and Protection There is a risk of cross
infection (passing infection from one person to another) when
administering first aid. This is particularly so when giving CPR or
managing wounds. There are many illnesses that can be transferred,
some more serious than others e.g. Colds and influenza, HIV/AIDS,
glandular fever, measles, chicken pox, mumps, herpes and hepatitis
B and C to name a few. Administration of first aid requires
measures to be taken to avoid transmission of infection under any
circumstances. The first aider must apply hygienic practices and
create a barrier so that the infection cannot pass from one person
to another. YOU CAN NOT TELL JUST BY LOOKING AT SOMEONE IF THE HAVE
AN INFECTIOUS DISEAS OR NOT! The situations that cause most concern
are in relation to HIV/AIDS and blood-borne viruses such as
hepatitis B and C. Read through the information and complete the
activities on pages 32-33 of your exercise booklets.
Slide 43
Legal and Moral Dilemmas The legal and moral dilemmas of a
first aider giving first aid is of great concern as it can
implicate the practice of providing first aid to a casualty in
need. There are many questions raised in relation to when a first
aider is required by law to provide assistance and in fact if they
are legally required at all. Plus if you do, are you then liable
for any personal damage or further injury (that often happens)
whilst providing first aid and saving a casualtys life? What seems
truly difficult is the moral obligation to assist a fellow human
being in need, particularly when your life is at risk in the
situation too. The question raised is when are you morally
obligated? If you are not legally required to assist, are you then
expected to provide first aid from an emotional perspective? What
would a responsible citizen do? And if you were to assist, what
emotional impact would it have on you as an individual? Who is
there to support you following a first aid situation? To find out
more on the above issues, please read through the information on
pages 33 and 34 of your exercise booklets.
Slide 44
Support Following First Aid Situations Regardless of the
severity and the outcome of a first aid situation, the action of
providing another person or a group of people with first aid, can
have an emotional impact on you. Not everyone will be affected the
same after an incident. Some will be traumatised emotionally
(traumatic stress) straight away, whilst others may not feel the
entire emotional affects until days or even weeks later. This is
why it is integral that anyone involved in assisting during a first
aid situation is provided the opportunity to debrief and then
follow up their account with counselling. First aiders all need to
be given the opportunity to deal with their trauma after the
situation in their own way, however, it is important that a
supportive safety net has been created around them to ensure their
own health and well-being, particularly after a traumatic
experience. Please read through page 36 of your exercise
booklet.
Slide 45
END OF UNIT So, whats your perspective on moral obligations to
providing first aid now????