Duke of Edinburgh Award Expedition First Aid Preparation Mrs Desveaux School Nurse

Aim Good preparation to prevent accidents and injury Suggested contents of a First Aid Kit Basic First Aid procedures Calling the emergency services

Potential First Aid Situations Blisters Cuts and bruises Insect bites Sprains and strains Burns / sunburn Fainting Dehydration / heat exhaustion/ fatigue Fractures Unconsciousness

Prevention of accidents / injury Appropriate footwear which has been well broken in and supports ankles helps prevent blisters and twisted ankles. Good tread helps prevent falls. Two layers of socks, a thin inner pair and a thick outer walking sock reduces friction on feet and absorbs sweat to keep feet dry, both helping to prevent blisters. If the weather is very hot trainers with a good tread and one layer of socks is better to prevent excessive sweating and softening of the feet. When resting or in camp removed trainers to allow feet to breath and skin to harden again.

Prevention of accident/injury Wear a strong sunscreen and hat to prevent sunburn and renew frequently. Also advisable to wear mosquito repellant Drink plenty of fluids to prevent dehydration and graze on snacks to keep energy levels up, get plenty of sleep. Get plenty of sleep and an early start to avoid exhaustion from tiredness or the full strength of the sun. Take care around camping stoves and open flames.

First Aid Kit Disposable gloves – 4 pairs Hand sanitizer Antiseptic wound cleansing wipes, spray or liquid and cleansing pads. Scissors and tweezers Waterproof plasters assorted sizes Plaster strip 6cm x 1 m to cut to size Adhesive tape Sterile gauze pads (40cm x 40cm)x6 Triangular bandages x3 Elastic bandages x 3 (5cm, 7.5cm, 10.5cm) Safety pins x6 Cotton wool Antiseptic cream or powder Antihistamine cream Antihistamine tablets (optional) Freezegel (optional) Paracetamol 500 mg tablets x10 Glucose sweets ( or normal boiled sweets, a quick source of sugar) After sun cream Oral rehydration salts x 2 sachets A large freezer bag Specialist blister plasters- Compeed (optional).

Practical discussion and demonstrations Blisters Cuts and bruises Sprains and strains Burns / sunburn Fainting Dehydration / heat exhaustion Fractures Unconsciousness

Wounds and bleeding Minor cuts, scratches and grazes Treatment: Wash and dry your own hands or use hand sanitiser. Cover any cuts on your own hands and put on disposable gloves. Clean the cut, if dirty, under running water or use an antiseptic wipe. Pat dry with a sterile dressing or clean lint-free material. If possible, raise affected area above the heart. Cover the cut temporarily while you clean the surrounding skin with soap and water or an antiseptic wipe and pat the surrounding skin dry. Cover the cut completely with a sterile dressing or plaster.

Severe Bleeding Put on sterile gloves Apply pressure with a non fluffy pad until a sterile dressing available and elevate limb above heart, being careful if a broken bone is suspected Treat for shock Apply a sterile dressing and check circulation beyond dressing Dial 114 (122) or send for help to previous check point ( follow expedition organisers instructions). If blood seep through first bandage cover with a second. If blood seeps through second then remove and replace with a fresh dressing.

Wounds and Bleeding: Severe bleeding

Minor burn or scald Treatment: For minor burns, hold the affected area under cold water or any other safe cooling liquid available for at least 10 minutes or until the pain subsides. Remove jewellery etc. Clean and cover the burn with a non fluffy dressing, checking the circulation beyond the dressing and observing fot signs of swelling. If a minor burn is larger than a postage stamp it requires medical attention. All deep burns of any size require urgent hospital treatment. Clothing on fire Treatment •Stop the casualty panicking or running – any movement or breeze will fan the flames •Drop the casualty to the ground •If possible, wrap the casualty tightly in a coat, curtain or blanket (not the nylon or cellular type), rug or other heavy-duty fabric. The best fabric is wool •Roll the casualty along the ground until the flames have been smothered. On all burns: •Do not use lotions, ointments and creams •Do not use adhesive dressings •Do not break blisters.

Insect bites or stings. If sting still present flick of with a finger nail, do not squeeze. Clean area with an antiseptic wipe Apply antihistamine cream If necessary for multiple stings/ bites or excessive swelling take an antihistamine tablet.

Sprains and Strains Ligament injury-sprain Muscle and tendon injury- strain May be a stretch, tear or complete rupture Recognition – pain, tenderness, swelling, bruising, difficulty in moving affected part RICE- Rest, ice, compression and elevation. For an ankle injury on a hike, do not remove the shoe, bandage over the shoe, immerse in cold water then elevate and rest limb. If able to walk, assist person to walk to camp, otherwise call for help. If pain severe and movement affected arrange for casualty to be seen at hospital. Otherwise advise to rest and seek medical attention if required.

Fractures Suspected fracture- pain, bruising, swelling, tenderness, deformity. For arms and wrists it may be possible to immobilise, apply a sling and walk to camp, assess the individual situation and follow instructions of the expedition organiser. For leg injuries, immoblise the limb, cover any open wounds, observe and treat shock. Do not give any food or fluids and send for help.

Choking Give up to five back blows Check the mouth and remove any obvious obstruction If obstruction still present give up to five chest thrusts. If the obstruction does not clear after three cycles of back blows and abdominal thrusts then call 114 ( 112) and be prepared to commence CPR.

CPR Repeat the compressions 30 times, at a rate of 100-120 per minute (about the speed of the song 'Nelly the Elephant'). Continue resuscitation, 30 compressions to 2 rescue breaths Do not stop unless: ◦emergency help arrives and takes over ◦they show signs of recovery such as coughing, opening eyes, speaking or moving purposefully and breathing normally ◦you become so exhausted that you cannot carry on

Calling for Assistance Two members of group to return to previous check point. Rest of group to stay with the casualty. Follow instructions issued by expedition organisers as help will be nearby. If necessary Telephone - SAMU 114 State your name and that you are acting in the capacity of a first aider Telephone number Exact location, roads, landmarks, access points etc Type of emergency/injury Name and age and sex of casualty Details of any hazards

Quick tips Wear gloves to protect yourself and the casualty Wash hands or use hand sanitizer before tending a wound To stop bleeding- apply pressure and elevate limb above level of heart For burns flood area with water or other harmless cooling liquid for 10 minutes For sprains and strains – RICE rest, ice , compression & elevation For dehydration and heat exhaustion give plenty of water and if necessary an isotonic drink Shock and fainting- lie casualty down, reassure, raise legs above heart. For suspected fractures or serious injuries do not move the casualty or allow to eat or drink. Place an unconscious casualty in the recovery position

The Duke of Edinburgh Award Have a safe and happy expedition