First Aid: Ch. 12-15

Physical Examination of Head and Spinal Injuries If victim is unresponsive and no life-threatening condition, do not perform physical examination. If unresponsive victim may have spinal injury, do not move victim unless necessary. Do not depend on any specific assessment to decide if victim has spinal injury. Do not assume victim without specific symptoms does not have possible spinal injury.

First Aid: Skull FRacture DO THIS FIRST: Call 9-1-1 and stay with victim Put a breathing, unresponsive victim in the recovery position unless you suspect neck, back, hip or pelvic injury . Monitor breathing and be ready to give CPR. DO NOT clean wound, press on it or remove impaled object Cover the wound with a sterile Dressing. If there is significant bleeding, apply pressure only around the edges of the wound, not on the wound itself. Use a ring dressing to apply pressure around the wound. DO NOT apply pressure if you feel bone fragments move. DO NOT move victim unnecessarily because there maybe a spinal injury. ***** DO NOT raise the victims legs

First Aid: Brain Injuries Do THIS FIRST: Have the victim lie down Keep the victim still and protect them from becoming chilled or over heated Call 9-1-1 and monitor the victim’s condition until help arrives Support the head and neck, even in a responsive victim, if you suspect a spinal injury. ( Spinal Restriction) *** DO NOT let the victim eat or drink anything***

First Aid: Brain Injuries For an unresponsive victim DO THIS FIRST: Call 9-1-1. Monitor the victim’s breathing without moving the victim unless necessary. Suspect a spinal injury and restrict movement of the head and neck. Control serious bleeding and cover any wounds with a dressing.

First Aid: Spinal Injuries Do THIS FIRST: Ask responsive victim what happened. If they have any of the risk factors, explain they need to hold the head still to restrict spinal movement. With an unresponsive victim, check for risk factors for suspected spinal injury. Hold the victims head and neck with both handsin the position found to restirict movement of the head and spine. Monitor the victim’s breathing and be ready to give CPR if needed. Have someone call 9-1-1 ADDITIONAL CARE: Reassure a responsive victim and tell them not to move. Continue to stabilize the head and spin, and monitor the victim’s breathing until help arrives.

SKILL: SPINAL MOTION RESTRICTION Ask responsive victim what happened. If they have risk factors explain the need to hold the head still to restrict movement. Hold the victim’s head and neck with both hands in the position found to restrict movement. Monitor the victim’s breathing and be ready to provide basic life support. Have someone call 9-1-1. Reassure a conscious victim and tell them not to move. Continue to stabilize the head and spine and monitor the victim’s breathing until help arrives.

Skill: Rolling a victim with spinal injury(log Roll) Hold the victim’s head with hands on both sides over ears. The first aider at the victim’s head directs others to roll the body as a unit. Continue to support head in new position on side.

First Aid: Broken RIbs DO THIS FIRST: Help the victim to sit or stand in the position of easiest breathing. Support the ribs with a pillow or soft padding loosely bandaged over the area and under the arm Call 9-1-1 *** Monitor breathing while waiting for help. > If helpful, immobilize the arm with a sling and binder to prevent movement and ease pain.

First Aid: Flail Chest DO THIS FIRST: Help the victim sit in a comfortable position for easiest breathing. Splint the flail area with a small pillow or thick padding loosely bandaged in place (but not completely around the chest). Position the victim lying on the injured side to give more support to the area, unless this causes more discomfort or difficulty breathing. Call 9-1-1. **** ADDITIONAL CARE: If padding is not available to splint the flail area, support it with pressure frow your hand. Monitor the victim until help arrives

First Aid: Impaled Object DO THIS FIRST: Keep victim still in the position found. Stabilize the impaled object with bulky dressings. Call9-1-1. ** ALERT ** DO NOT give the victim anything to eat or drink. If you note air moving in or out of a penetrating chest wound, do not clock the air flow with a dressing.

First aid: Sucking chest wound DO THIS FIRST: Put a sterile dressing around the wound but do not block airflow into or out of the wound. Position victim lying down inclined toward the injured side, unless this causes more discomfort or difficulty breathing. Call9-1-1. ADDITIONAL CARE: Monitor the victim’s breathing until help arrives. Treat victim for shock.

First Aid: Closed Abdominal Injury DO THIS FIRST: Carefully position the victim on his or her back, and loosen any tight clothing. Bending the knees may relax the abdominal muscles, reducing the pain. Call 9-1-1. Treat victim for shock, monitor the victim’s breathing and be ready to give CPR if needed. *** ALERT *** If you suspect a spinal injury, do not move the victim from the position found. DO NOT give them anything to eat or drink.

First Aid: Open Abdominal Wound DO THIS FIRST: Lay victim on back and loosen tight clothing. Cover wound with moist, sterile dressing or dry non-adherent dressing. 3.Cover with large occlusive dressing. Call 9-1-1. Treat for shock. Monitor breathing and be ready to give CPR if needed. *** ALERT *** If you suspect a spinal injury, do not move the victim from the position found. DO NOT push protruding organs back inside the abdomen, but keep them from drying out with an occlusive dressing or plastic covering. DO NOT apply direct pressure on the wound.

First Aid for Pelvic Injuries DO THIS FIRST: Support the victim in the position found. Call9-1-1. If help is DELAYED, immobilize legs together. Treat for shock. Monitor breathing and be ready to give CPR, if needed.

Skill: Applying a Spiral Bandage Anchor starting end of the elastic bandage below the injured area, farther from the trunk. Wrap the bandage in spirals up the limb toward the center of the body. Secure the end of the bandage with clips or tape.

Skill: RICE for Wrist Injury Rest the injured wrist. Put ice or a cold pack on the injured area. Compress the injured area with an elastic bandage. Elevate the injured area. Use a sling to hold the wrist in place.

First Aid: Fractures DO THIS FIRST: Immobilize area (joints above and below). Call 9-1-1 for LARGE bone fractures or prepare for transport (hand & foot) Treat open wound: cover with sterile dressing and apply gentle pressure around the fracture area ONLY if needed to control bleeding. Apply RICE. Splint if help delayed. *** ADDITIONAL CARE *** Treat victim for shock. Monitor the victims breathing. Remove clothing and jewelry if they may cut off circulation due to swelling.

ALERT: Fractures DO NOT try to align the ends of a broken bone. DO NOT put pressure on bone ends when controlling bleeding. DO NOT give the victim anything to eat or drink

First Aid: Dislocation DO THIS FIRST: 1. Immobilize area in the position found. 2. Call9-1-1. ( hand and foot related dislocations can be splinted and prepared for transport to the ER.) 3. Apply RICE. (DO NOT use compression bandages or elevate the injured area if moving the joint causes pain) 4. Splint if help delayed. *** ALERT*** DO NOT TRY TO PUT DISPLACED BONE BACK IN PLACE DO NOT LET VICTIM EAT OR DRINK REMOVE TIGHT CLOTHING & JEWELRY MONITOR BREATHING/ TREAT FOR SHOCK

First Aid: Sprains DO THIS FIRST: 1. Immobilize area. 2. Apply RICE. 3. Use soft splint to immobilize joint. (Bandage, pillow or blanket) 4. Seek medical attention.

First Aid: Strains DO THIS FIRST: Apply RICE. Keepcoldpackonareafor20minutes(or10 minutes if it produces discomfort), then at least 30 minutes off; reapply for 20 (or 10) minutes, then remove again for 30 minutes. ADDITIONAL CARE: Seek medical attention if pain is severe or persistent, or if there is a significant or prolonged (3 days or more) impairment of function.

First Aid: Contusion DO THIS FIRST: First treat any injury that caused the bruising. Apply RICE. Do not massage the muscle. Keep the cold pack on the area for 20 minutes (or 10 minutes if it produces discomfort), then remove it for 30 minutes. Repeat the process for 24-48 hours as needed.

Muscle Cramps : Tightening of muscle Usually occurs from prolonged use but may have no apparent cause Most common in thigh and calf muscle Different from heat cramps May last a few seconds to 15 minutes May be prevented with flexibility exercises and stretches

First Aid: Muscle Cramp DO THIS FIRST: Have the victim stop the activity. Gently stretch out the muscle, if possible. Gently massage the muscle after active cramping stops, if this provides relief. Place a cold pack on the area for 20 minutes (or 10 minutes if it produces discomfort), then remove it for 30 minutes. ADDITIONAL CARE: Give the victim s ports drink with carbohydrates and electrolytes. Coconut water is also effective. If there is nothing else available give the victim water.

Skill: Applying An arm sling and binder Secure the point of the bandage at the elbow. Use a safety pin or tie the point at the elbow. Position the triangular bandage. (put across chest) Bring up the lower end of the bandage to the opposite side of the neck. Tie the ends. Pad under the knot. Tie a binder bandage over the sling and around the chest. ***** View NSC Power Point for images on each step. ****

Upper Arm Injuries DO THIS FIRST: Check for signs of circulation and sensation in the hand & fingers. Apply rigid splint along outside of arm. Tie above and below the injury . Support wrist with sling. Apply wide binder to support arm and immobilize it against chest. *** If you suspect a broken humerus.

The goal of splinting the upper arm is to stabilize the bone between the shoulder and the elbow by using a rigid splint on the outside of the arm The goal of splinting the shoulder is to stabilize the area from the trunk to the upper arm with a soft splint.

First aid: Shoulder injuries Use soft splint for shoulder injuries *** no not move the extremity*** Check for signs of circulation and sensation in hand and fingers. Call 9-1-1 circulation is cut off. Pad hollow areas between body and arm. Apply sling and binder to support arm and immobilize against chest: • If this causes pain use larger pillow between arm and chest

Elbow Injuries: Straight rigid splint If elbow straight, apply rigid splint from upper arm to hand. If more support needed, use binders around chest and upper arm and lower arm and waist.

Skill: Splinting the Forearm Support the arm above and below the injury. Check circulation. Position the arm on a padded rigid splint. If available, add a roller bandage under the fingers. Secure the splint. Check circulation once secured. Put the arm in a sling, and tie a binder over the sling and around the chest.

First Aid: Wrist Injuries Apply rigid splint on palm side of arm from forearm past fingertips. Tie above and below wrist. Leave fingers uncovered. Support forearm and wrist with sling, and apply binder around upper arm and chest.

First aid: Hand Injuries Place roll of gauze in palm. Bandage entire hand, leaving fingers exposed, if possible, to check circulation. Place rigid splint on palm side of hand. Pad area between hand and splint. Support further with sling and binder.

First aid: Hip Injuries Fractures and dislocations First aid similar to that for pelvic injuries Call 9-1-1. Do not move victim. ***If help may be delayed, splint to stabilize injury. ***

Stabilizing hips if care is delayed Immobilize leg and hip in position found. Pad between legs and bandage together (unless this causes more pain). Treat victim for shock, but do not elevate legs.

First aid: Upper Leg Injuries Fractures of femur Call 9-1-1. Keep victim from moving. If help may be delayed, splint to stabilize injury.

First aid: Upper Leg Injuries if care is delayed Check circulation and sensation in foot and toes. Put rigid splint on each side of leg: Pad body areas and voids. Inside splint should extend from groin past foot. Outside splint should extend from armpit past foot. Tie splints with cravats or bandages. Check circulation periodically

First aid: Knee Injuries Sprains and dislocations Do not transport yourself – call 9-1-1. Splint knee in position found. Apply soft splint by rolling blanket or placing pillow around knee . If knee is straight, make anatomical splint: Rigid splints provide additional support.

First Aid: Lower Leg Injuries Fractures of tibia or fibula Do not transport victim yourself: • Call 9-1-1. Immobilize leg from knee to ankle. Use soft splint, rigid splint or anatomic splint.

Skill: Anatomic Splinting of Leg 1. Check circulation. Gently slide 4 or 5 bandages or strips of cloth under both legs. Do not put a bandage over the injury site. 2. Put padding between the legs. Do not move the injured leg. 3. Gently slide the uninjured leg next to the injured leg. 4. Tie bandages(snug but not tight), starting in the middle, then at the lower leg and then at the top. Check circulation.

First aid: ankle injuries Goal is to immobilize ankle. Usually soft splint is best. Gently remove shoe to check for circulation, unless this causes significant pain: If circulation absent call 9-1-1. Continue to check after splinting.