CPR/FIRST AID

Providing First Aid Immediate care given to the victim of an accident or illness to minimize the effect of injury or illness until experts can take over Reasons for providing correct first aid

Basic Principles of Providing First Aid Remain calm and avoid panic Evaluate situation thoroughly Have a reason for anything you do Treatment you provide will vary depending on type of injury or illness, environment, others present, equipment or supplies on hand, and availability of medical help

First Steps Recognize that an emergency exists Use all senses to detect problems Sometimes signs of emergency are obvious and at other times they are less obvious

Next Steps Check the scene and make sure it is safe to approach What to observe If not safe, call for medical help If safe, approach the victim Call emergency medical services (EMS) as soon as possible

Next Steps (continued) If possible, obtain the victim’s permission before providing any care Triage if necessary Check for other injuries Obtain as much information as possible

General Principles Obtain qualified help as soon as possible Avoid any unnecessary movement of the victim Reassure the victim Use a confident, calm attitude to help relieve victim’s anxiety Avoid giving the victim anything to eat or drink

General Principles (continued) Protect the victim from cold or chilling, but avoid overheating Work quickly in an organized and efficient manner Do not make a diagnosis or discuss condition with observers at scene

General Principles (continued) Maintain confidentiality and protect the victim’s right to privacy while providing treatment Make every attempt to avoid further injury Provide only the treatment you are qualified to provide

Performing Cardiopulmonary Resuscitation (CPR) Cardio: the heart Pulmonary: the lungs Resuscitation: to remove from apparent death or unconsciousness Breathe for the patient and circulate blood

Performing Cardiopulmonary Resuscitation (CPR) (continued) Purpose: keep oxygenated blood flowing to the brain and other vital body organs Performed until the heart and lungs start working again or until medical help is available Clinical Death: when the heart stops beating the victim stops breathing Biological Death: death of body cells (usually 4-6 minutes after clinical death) .

Performing Cardiopulmonary Resuscitation (CPR) (continued) ABCDs for airway A stands for airway B stands for breathing C stands for circulation D stands for defibrillation Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Performing Cardiopulmonary Resuscitation (CPR) (continued) Evaluate victim’s condition before starting CPR Correct hand placement is essential before compressions are performed Various methods of CPR used Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Performing Cardiopulmonary Resuscitation (CPR) (continued) One-person rescue for adult victim Two-person rescue for adult victim CPR for infants CPR for children CPR for victims with obstructed airways Reasons for stopping CPR Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

15:3 Providing First Aid for Bleeding and Wounds Wounds involve injuries to the soft tissues Open: break in skin or mucous membranes Closed: no break in skin or mucous membranes, but injury occurs to underlying tissues Wounds can result in bleeding, infection, and/or tetanus Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Classifications of Open Wounds Abrasion Incision Laceration Puncture Avulsion Amputation

Open Wounds The most common accidents resulting in open wounds are falls, mishandling of sharp objects, accidents with tools or machinery, and car accidents. A closed wound (a contusion or internal bleeding) is a bruise that damages the underlying tissue without breaking the skin (as in a black eye).

There are at least five different types of open wounds: Abrasions An abrasion is a skin wound caused by rubbing or scraping the skin against a hard, rough surface. Bleeding in this type of wound is usually limited, but it is important that the skin be cleaned in order to guard against infection. Incisions An incision is a cut caused by a knife, the rough edge of metal, broken glass, a razor blade or some other sharp object. This type of wound generally bleeds rapidly and heavily. If the cut is deep, muscles, tendons and nerves may be damaged.

Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. Lacerations - A laceration is a jagged, irregular or blunt breaking or tearing of soft tissues, often resulting from mishandling tools and machinery and other accidents. Bleeding from a laceration may be rapid and extensive. Punctures - A puncture is a piercing wound that causes a small hole in the tissues. Such objects as nails, needles, ice picks and other pointed objects can produce puncture wounds. Even if external bleeding is slight, there may be serious internal bleeding resulting from internal damage to an organ (as in a gunshot wound). All puncture wounds require the attention of a health professional because of the danger of tetanus. Avulsions - An avulsion is a forcible tearing or partial tearing away of tissues. It occurs in such accidents as gunshot wounds, explosions, animal bites or other body-crushing injuries. Bleeding is heavy and rapid. If a body part (a finger, tooth or toe, for example) has been torn away in an accident, it should always be sent along with the victim to the hospital (placed on moistened gauze and cooled), since there is a possibility that it can be reattached. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. When should adolescents and adults get vaccinated against tetanus? Immunization experts recommend that the first dose of Tdap be given at age 11-12 as a booster during the routine adolescent immunization visit if the adolescent has finished the childhood DTaP schedule and has not already received a dose of Td or Tdap. Adults should continue to receive a booster dose of Td every ten years. Adults who will be having close contact with an infant should receive Tdap vaccine even if they’ve recently received Td vaccine If someone experiences a deep or puncture wound, or a wound contaminated with dirt, an additional booster dose may be given if the last dose was more than five years ago. It is important to keep an up-to-date record of all immunizations so that repeat doses don't become necessary. Although it is vital to be adequately protected against tetanus, receiving more doses than recommended can lead to increased local reactions, such as painful swelling of the arm. Who recommends this vaccine? The Centers for Disease Control and Prevention (CDC), the American Academy of Pediatrics (AAP), the American Academy of Family Physicians (AAFP), and the American College of Physicians (ACP) all recommend this vaccine. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Controlling Bleeding First priority because victim can bleed to death quickly Bleeding can come from arteries, veins, or capillaries Observe standard precautions

Controlling Bleeding (continued) Direct pressure Elevation Pressure bandages Pressure on pressure points Do not disturb clots Do not remove dressings Do not clean wound

Minor Wounds First priority – prevention of infection Wash your hands before caring for wound Put on gloves Wash the wound with soap and water Rinse the wound thoroughly Use sterile supplies Tell the victim to get medical help if any signs of infection appear

Signs of Infection Swelling Heat Redness Pain Fever Pus Red streaks

Tetanus Tetanus bacteria can enter an open wound Serious illness Get tetanus shot or booster as needed .

Objects Embedded in Wound If superficial, gently remove Objects embedded in tissues should be left and removed by physician

Closed Wounds Can occur anywhere on body If bruise, apply cold application to reduce swelling Observe for signs of internal bleeding Get medical help as quickly as possible Check breathing and treat for shock Avoid unnecessary movement of victim No food or fluids

Providing First Aid for Shock (It’s electrifying!) Also called hypoperfusion Shock: clinical set of signs and symptoms that are associated with an inadequate supply of blood to body organs, especially brain and heart Causes of shock

Providing First Aid for Shock (continued) Goals of treatment Positioning of victim Maintain body temperature Avoid food or drink Other principles of care

Signs and Symptoms of Shock Skin is pale or bluish-gray and cool or cold to the touch Diaphoresis Rapid and weak pulse Respirations rapid, shallow, and may be irregular Blood pressure very low or unobtainable .

Signs and Symptoms of Shock (continued) General weakness Anxiety and extreme restlessness Excessive thirst Nausea and/or vomiting Blurred vision or changes in appearance of eyes

15:5 Providing First Aid for Poisoning Can happen to anyone regardless of age Poison: any substance that causes a harmful reaction when applied or ingested Immediate action is needed First aid varies depending on type of poison, injury involved, and the method of contact

Ways Poisoning Occurs Swallowing various substances Inhaling poisonous gases Injecting substances Contacting the skin with poison

15:6 Providing First Aid for Burns Injury caused by fire, heat, chemical agents, radiation, and/or electricity Classifications of burns First-degree or superficial Second-degree or partial-thickness Third-degree or full-thickness

Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. Treatment Objectives Remove source of heat Cool the skin Cover the burn Relieve pain Observe for and treat shock Prevent infections Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Treatment Usually not required for first-degree burns All third-degree burns require treatment How to treat superficial or mild second-degree burns How to treat severe second-degree burns and third-degree burns .

Providing First Aid for Heat Exposure Overexposure to heat may cause a chemical imbalance in the body Occurs when water and salt are lost through perspiration Also occurs when body cannot eliminate excess heat Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. Heat Cramps Muscle pains and spasms Caused by exposure to heat Loss of water and salt from perspiration Apply firm pressure on cramped muscle to provide relief Encourage rest and move to cooler area Small sips of water or electrolyte solution (e.g., sports drink) Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. Heat Exhaustion Occurs when exposed to heat and there is loss of fluids through sweating Signs and symptoms First aid care Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. Heat Stroke Prolonged exposure to high temperatures Medical emergency – needs immediate care Body unable to eliminate excess heat Signs and symptoms First aid care Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

15:8 Providing First Aid for Cold Exposure Exposure to cold external temperatures can cause body tissues to freeze and body processes to slow down Needs immediate attention Degree of injury affected by wind velocity, amount of humidity, and length of exposure to cold .

Hypothermia When body temperature is less than 95 degrees Fahrenheit or 35 degrees Celsius Caused by prolonged exposure to cold Signs and symptoms Death can occur if body processes become too slowed down First aid care

Frostbite Actual freezing of tissue fluids with damage to the skin and underlying tissues Caused by exposure to freezing or below-freezing temperatures Early signs and symptoms Other signs and symptoms as progresses

Frostbite (continued) Objectives of first aid Common sites: fingers, toes, ears, nose, cheeks First aid care Assess for signs and symptoms of shock

Providing First Aid for Bone and Joint Injuries Variety of injuries can occur Frequently occur during accidents or falls Examples: fractures, dislocations, sprains, and strains May have more than one type of injury to bones and joints at the same time Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Fracture Break in the bone Closed or simple fracture Compound or open fracture Signs and symptoms Objectives of first aid

Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. Dislocation When the end of the bone is displaced from a joint or moved out of its normal position within a joint Tearing or stretching of ligaments, muscles, and other soft tissues also frequently occurs Signs and symptoms First aid care Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. Sprain Injury to the tissues surrounding a joint Common sites: ankles and wrists Signs and symptoms Frequently resemble fractures or dislocations – treat as fracture if in doubt First aid care Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. Strain Overstretching of a muscle Caused by overexertion or by lifting Frequent site: back Signs and symptoms First aid treatment Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Splints Devices used to immobilize injured part Types of splints Pneumatic or air splints Padded boards Traction splints Splints can also be made from cardboard, newspapers, pillows, boards, etc.

Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. Splints (continued) Need to be long enough to immobilize the joint above and below the injured area Should be padded Tied in place Apply as not to create pressure on area If open wound, control bleeding before applying splint Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. Splints (continued) Never attempt to reposition bone Splint before moving victim Observe precautions when using pneumatic splints Traction splints Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Circulation Check After Splint Verify that the splints are not too tight Check skin temperature Check color Note swelling or edema Numbness or tingling Check pulse If circulation impaired, immediately loosen

Slings Commercial slings Triangular bandages Use: support arm, hand, forearm, and shoulder Positioning of sling Check circulation Limit movement of limb

Slings (continued) If use knots Placement Padding Special considerations for shoulder injury

Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. Neck or Spine Injury Most dangerous types of injuries involving bones and joints Movement can result in permanent injury resulting in paralysis Avoid any movement of victim if at all possible Wait for backboard and adequate help to arrive for transfer Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

15:10 Providing First Aid for Specific Injuries Treatment for burns, bleeding, wounds, poisoning, and fractures is basically the same for all regions of body Injuries to specific body parts require special care Examples: eyes, ears, nose, brain, chest, abdomen, and genital organs

Eye Injuries Always involves danger of vision loss Usually best to avoid giving major treatment Obtain help of a specialist Foreign objects in the eye Blows to the eye Penetrating injuries that cut eye tissue

Ear Injuries Can result in rupture or perforation of eardrum Torn or detached tissue Ruptured or perforated eardrum Clear fluid or blood-tinged fluid draining from ear

Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. Brain Injuries Wounds and blows to head and skull can cause brain injury Obtain medical help as quickly as possible Signs and symptoms First aid care Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. Nose Injuries Nosebleeds are usually more frightening than serious Nosebleeds also called epistaxis Causes of nosebleeds First aid care Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Chest Injuries Usually medical emergencies Involve heart, lungs, and major vessels Sucking chest wound Penetrating injuries to the chest Crushing injuries to the chest

Abdominal Injuries Can cause damage to internal organs and bleeding in major blood vessels Intestines and other abdominal organs may protrude from open wound Medical emergency Bleeding, shock, and damage to organs can be fatal Signs and symptoms First aid care

Providing First Aid for Sudden Illness Can be difficult to determine exact illness Base care on signs and symptoms Obtain information from victim if possible Look for medical alert bracelets or necklaces or medical information cards

Heart Attack Also called coronary thrombosis, coronary occlusion, or myocardial infarction Occurs when there is blockage in one or more coronary arteries If heart stops, start CPR Signs and symptoms First aid care

Fainting Temporary reduction in supply of blood to brain Early signs and treatment If victim loses consciousness, try to prevent injury Obtain medical help if recovery not prompt, there are other injuries, or fainting reoccurs (can be sign of serious problem)

Diabetes Mellitus Metabolic disorder caused by lack of or insufficient production of insulin Diabetic coma Insulin shock

Applying Dressings and Bandages Dressings used as sterile covering and to control bleeding Materials used in dressings Dressings can be held in place with tape or a bandage Bandages used to hold dressings in place, to secure splints, and to support and protect body parts

Applying Dressings and Bandages (continued) Apply bandages snugly enough to control bleeding and prevent movement of dressing, but not so tight that they interfere with circulation Types of materials for bandages Applying dressings

Checkpoints for Circulation Check circulation after bandage applied Signs of poor or impaired circulation Swelling or edema Pale or cyanotic color Coldness to touch Numbness or tingling Poor or slow capillary refill Loosen bandage immediately if warranted .

Summary Proper first aid can save a life Provide only care you are qualified to provide Always reassure victim and avoid unnecessary stress and movement Obtain medical help as quickly as possible