1. Scoutmaster and Assistant Scoutmaster Outdoor Skills Training
First Aid

2. Goals By the end of this session, participants will be able to:
Shape their attitudes and approach to first-aid situations
Define first aid and explain what a first aid plan is
Describe a systematic approach to first aid
Assemble a first-aid kit that includes items for specific injuries
Explain the considerations for first aid in pre-trip planning

3. Disclaimer I acknowledge: Many of you have had first aid training
There may be different ways to do things
But…..
We’re going to go over what BSA wants us to teach our Scouts

4. What is First Aid?
The first help given to a victim of an accident or other health emergency.
First Aid should:
Stop life-threatening dangers
Protect an injured or ill person from further harm
Get proper medical help for the victim

5. Systematic Approach to Teaching First Aid
As the Scouts work on the requirements for Tenderfoot, Second Class, and then First Class we build upon their first aid skills
This is not necessarily the way we approach a victim, but it is a good way to build the skills of the Scout

6. Tenderfoot Requirements
Requirement 11 Identify local poisonous plants; tell how to treat exposure to them Requirement 12a. Show how to care for someone who is choking

7. Tenderfoot Requirements
Requirement 12b.
Show first aid for the following:
Simple cuts and scrapes
Blisters on the hand and foot
Minor (thermal/heat) burns or scalds
Bites or stings of insects and ticks
Venomous snakebite
Nosebleed
Frostbite and sunburn

8. Poisonous Plants Oily sap from the plant causes a reaction on the skin
It usually takes 10 – 20 minutes on the skin to cause the rash
Prevention—wash the skin with soap and water if you have a known exposure
Don’t forget the sap can be on clothes and shoes

9. Poisonous Plants Rash: Red rash with blisters
May be oozing a clear to straw colored liquid
First Aid:
Wash the sap off the skin
Change clothes and shoes and wash
Calamine lotion is a drying agent that may help to relieve itching

10. Choking Universal symbol for choking: First Aid:
Ask, “Are you choking?”
If the person can speak, cough, or breathe:
Encourage them to keep coughing and trying to get the object up
Have someone call for help

11. Choking
If they cannot breathe, speak or cough and are still conscious:
Abdominal Thrusts (Heimlich Maneuver)
Back blows
Firmly strike the palm of the hand between the shoulder blades 5 times

12. Choking If the person becomes unconscious:
Lower them gently to the floor
Perform abdominal thrusts
Straddle the patients thighs
Use the palm of one hand with your other hand on top
Place hand above the belly button
Use upward, quick thrusts

13. Simple Cuts & Scratches
Wash with soap and water
Apply antiseptic to prevent infection
Keep the wound clean with an adhesive bandage (Band-aid)
Clean and rebandage small wound daily

14. Blisters on Hands and Feet
Pockets of fluid that form as a defense against friction on the skin
Prevention:
Wear work gloves (community service projects, when using saw, ax, etc.)
Wear proper fitting shoes or boots
Change socks when they become sweaty or wet
Pay attention to warnings (hot spots)

15. Blisters on Hands and Feet
When you feel a “hot spot”:
Stop
Cut a piece of moleskin or molefoam slightly larger than the reddened area
Can build up layers to protect and take pressure off the area
Alternately, create a “doughnut” with the moleskin. Build layers up around the area.

16. Blisters on Hands and Feet
First Aid for a blister:
A gel pad, used to treat burns, can be applied directly over a blister with moleskin around it
If you need to continue hiking, you may want to drain the blister
Wash the skin with soap and water
Sterilize a needle (over a flame or with alcohol)
Pierce the skin at the edge of the blister and apply light pressure to push fluid out; be careful to leave the layer of skin over the blister
Put doughnut of moleskin around blister
Apply antibiotic ointment and cover the top with a bandage

17. Minor Burns/Scalds (1st degree)
First Aid
Remove the heat source
Run under cool water or apply cool compresses
Prevention of sunburn:
Apply sunscreen
Reapply if sweating or swimming
Wide brimmed hat
Long sleeves/long pants

18. Bee and Wasp Stings
Scrape away stinger with edge of credit card or knife
Apply an ice pack
Know whether or not the person is allergic to bee stings

19. Tick Bites Prevention First Aid Wear long pants and long-sleeve shirt
Button your collar
Tuck pants in boots or socks
First Aid
Grasp the tick as close to the skin as possible with tweezers
Gently pull until it comes loose
Wash the area with soap and water
Apply antiseptic

20. Chigger Bites Prevention First Aid
Chiggers are small, red mites that live in tall grass, forests and along streams/lakes
Chigger bites are extremely itchy!
Prevention
Same as for Ticks and Insect Repellant
First Aid
Remove chiggers by gently rubbing
Use calamine lotion or finger nail polish

21. Spider Bites Black Widow Spider bite may cause:
Redness and sharp pain at site
Sweating
Nausea and vomiting
Stomach pain and cramps
Muscle pain and Spasm

22. Spider Bites Brown Recluse Spider may cause:
Pain, redness and swelling in 2-8 hours (usually not right away)
An open sore will likely develop
Fever
Chills
Nausea and vomiting
Joint pain
Faint rash

23. Spider Bites First Aid for all spider bites:
Wash the area with soap and water
Apply cold pack
Seek medical attention

24. Snake Bite Prevention First Aid for Non-venomous Snake
Watch where you put your hands when gathering firewood or rocks
Use hiking stick to poke among stones and brush ahead of you while walking through areas where snakes are common
First Aid for Non-venomous Snake
Wash with soap and water
Apply antiseptic

25. Venomous Snakebites Get victim to medical care as soon as possible
Remove rings or jewelry from the extremity
If the victim has to wait to seek medical care have them lie down and position the affected extremity lower than the rest of the body
Keep reassuring the victim
Treat for shock
Do NOT cut the victim, suction, or apply ice
Timber Rattlesnake
Northern Copperhead

26. Nosebleed Have the victim sit up and lean forward
Pinch the nostril shut
Apply a cool, wet cloth over the bridge of the nose
If severe:
Treat for shock
Seek medical attention

27. Frostbite Most often occurs on ears, nose, fingers, feet
May cause grayish-white patches on the skin
May feel painful, then numb
Prevention
Keep skin covered

28. Frostbite First Aid Get victim indoors, if possible
Place palm of hand over ear or cheek
Place fingers under clothing in armpit
Place victim’s feet on skin of your abdomen
DO NOT RUB the skin
Can run the affected area under warm (not hot) water
Have the victim exercise affected fingers or toes
Seek medical attention

29. Second Class Requirements
Requirement 6a
Show what to do for “hurry” cases of stopped breathing, serious bleeding, and ingested poisoning
Requirement 6b
Prepare a personal first aid kit to take with you on a hike

30. Second Class Requirements
Requirement 6c
Demonstrate first aid for the following:
Object in the eye
Bite of a suspected rapid animal
Puncture wound from a splinter, nail, and fishhook
Serious burns
Heat exhaustion
Shock
Heat stroke, dehydration, hypothermia, and hyperventilation

31. Hurry Cases
What is a “hurry” case? A “hurry” case is when a victim suffers from an immediate threat to their life. Action must be taken within minutes to save the victim.

32. Hurry Cases What are the “hurry” cases? Stopped breathing
Severe bleeding
Ingested poisoning
Stopped heartbeat (First Class Requirement)

33. Stopped Breathing Open the Airway
Position the victim on his or her back
Use the head tilt, chin lift method
Look in the mouth for any obstructions that can be removed

34. Stopped Breathing Look, listen and feel for breathing
Look for the chest to rise and fall
Listen for the sound of moving air
Feel for the breath on your cheek

35. Stopped Breathing Give rescue breaths
Place barrier device over the victims mouth
Pinch the nostrils
Seal your mouth over the victims mouth (mouth and nose of a small child)
Blow a slow breath into the victim; enough to see the chest rise
Repeat every 5 seconds for over 9 years old; every 3 seconds for under 9 years old

36. Stopped Breathing If the chest doesn’t rise and fall
Reposition the head
Check again for any obstructions
Try the breaths again
If still not able to make the chest rise, begin abdominal thrusts
Continue rescue breathing until the victims breathes on their own, help arrives, or you are too physically exhausted to continue

37. Severe Bleeding Put on protective equipment, if available
Latex gloves and eye protection
Apply direct pressure over the wound with a sterile dressing and the palm of your hand
You can secure the dressing with a gauze wrap or elastic bandage if you have one
Check periodically for circulation (feeling, warmth, and color)
Loosen the bandage when necessary

38. Severe Bleeding Elevate the extremity if possible
If the bandage becomes soaked with blood, do NOT remove it. Place an additional bandage over the first and continue to apply pressure
Have the victim lie down
Treat for shock
Remove any blood or body fluids that has come in contact with your skin with soap and water. Change contaminate clothing.

39. Ingested Poisoning Victim will be sick, maybe unconscious
Most clues will be found at the scene
Gather empty bottles/containers
Estimate how much may have been ingested
Call Poison Control Center and 911.
Do not give victim anything by mouth or induce vomiting unless told to do so by Poison Control
Treat victim for shock
Monitor Breathing

40. Prepare a Personal First Aid Kit
Adhesive Bandages—6
Sterile gauze pads, 3-by-3-inch—2
Adhesive tape
Moleskin, 3-by-6-inch
Soap
Antiseptic
Scissors
Non-latex gloves
Mouth barrier device
Eye protection
Pencil and paper
Tweezers (not in Scout Handbook)
Triangular bandage (not in the Scout Handbook)

41. Personal First Aid Kit Make it practical for the Scout
Encourage them to bring their personal first aid kits on all outdoor scout activities (and any others where they may have a day pack or fanny pack)
Periodically review the contents of their first aid kits when appropriate for the event to which you are going

42. Object in the Eye
Have the person blink the eyes; tears may help flush out the object
Wash your hands with soap and water
Try to flush the eye with clean running water
You may try to remove the object with a moistened cotton swab
Do NOT rub the eye
Do NOT try to remove any object that is embedded in any portion of the eye

43. Animal Bite Control any bleeding
If not bleeding, wash the area thoroughly with soap and water
Cover the wound with a sterile dressing
Seek medical care

44. Animal Bite
Suspect rabies in any animal, especially if they are acting uncharacteristically
Try to get a description of the animal and note when the animal was last seen
Do NOT put yourself at risk for injury by trying to capture the animal
Notify police, animal control, or rangers about the animal

45. Splinters
Remove splinters with tweezers sterilized over a flame or in boiling water
May also use a sterilized needle if necessary
Wash the area with soap and water
Apply antiseptic
Apply adhesive bandage

46. Puncture Wounds
Puncture wound can be dangerous because they allow germs to enter the wound and are hard to clean

47. Puncture Wounds
Remove bits of glass or other objects you can see with tweezers sterilized over a flame or in boiling water
Wash the area with soap and water
Apply antiseptic
Apply sterile bandages
Seek medical attention

48. Fishhook
If medical personnel are available, let them remove the fishhook. If not:
Push the hook further until the barb comes through the skin
Snip off the barb
Ease the shank of the hook back out the point of entry
Wash the area, apply antiseptic and bandage

49. When blisters form, there is deeper damage to the skin
Second-Degree Burns
When blisters form, there is deeper damage to the skin
Remove heat source
Run under cool water or use cool compresses
Dry area and protect with a sterile bandage
Do NOT pop blisters
Do NOT apply butter, cream, ointments or sprays
Seek medical care

50. Third-Degree Burns This is the deepest and most severe type of burn
Skin will be charred or burned away
Because nerves are damaged, the victim may not feel pain

51. Third-Degree Burns
Stop the burning process! May use cool compresses but do not immerse large areas in cool water (may cause shock)
Do NOT try to remove clothing that is sticking to the area
Do NOT apply creams, ointments or sprays
Cover the area with a sterile gauze or clean sheet if the area is large
Treat for shock
Seek immediate medical attention

52. Shock What is shock? When does it occur?
When the circulatory system is unable to provide enough blood to all parts of the body
When does it occur?
May occur with any injury or stress to the body

53. Symptoms of Shock Restlessness or irritability Weakness
Confusion or fear
Dizziness
Moist, clammy, cool, and/or pale skin
Quick, weak pulse
Shallow, rapid, and irregular breathing
Nausea
Vomiting
Extreme thirst

54. Shock Treat every victim for shock!
Most victims have some degree of shock but symptoms are not always apparent early
Sometimes early first aid for an injury may prevent shock
Sometimes early treatment for shock will prevent shock

55. Shock
Eliminate the causes of shock by restoring breathing and circulation, controlling bleeding, relieving severe pain, and treating wounds
Call for emergency aid
Have the victim lie down
Raise the victim’s legs about 12 inches (only if you don’t suspect head, neck, back, hip or leg injuries)
Keep the victim warm with blankets, coats or sleeping bags

56. Shock Do not leave the victim alone
Continue to reassure the victim in a calm voice (fear and uncertainty may make shock worse)
A person who appears to be unconscious may still be able to hear you—keep letting them know you are there and you are getting help

57. Heat Related Injuries Prevention Drink plenty of fluids
Rest in the shade when you feel too warm or get muscle cramps
Do the heaviest physical activity in the morning or evening
Wear loose, light-colored clothing
Shade your head with a hat

58. Heat Exhaustion
Occurs when the body’s cooling system becomes overworked.
Symptoms
Pale skin that is clammy from heavy sweating
Nausea
Fatigue/weakness
Dizziness/lightheadedness
Headache
Muscle cramps
Rapid Pulse

59. Heat Exhaustion Have the victim lie in a cool, shady place
Elevate the feet
Remove excess clothing
Cool the victim by applying cool,
wet cloths to body and fanning
If he is alert, have the victim sip
on a glass of cool water
If recovery is not rapid, get medical attention

60. Heat Stroke
Occurs when the body’s cooling system is overworked and stops functioning. The victims body temperature will soar to a life-threatening level

61. Heat Stroke Symptoms Very hot skin
Red skin, can be dry or a little damp from sweat
Rapid pulse
Noisy breathing
Confusion, irritability, unwillingness to accept treatment
Unconsciousness

62. Heat Stroke Call for medical help immediately!
Move the victim to a shady or air-conditioned area
Cool the victim any way you can
Remove outer clothing
Cover with cool wet towels, clothing, etc. and fan
Place in a steam, bathtub of cool water, or in front of an air conditioner in house or car
Wrap icepacks with a thin barrier and place in armpits, along neck, and in groin

63. Heat Stroke Keep the victim lying down and comfortable
Raise the victims head and shoulders a little
If the person is able to drink, give small amounts of cool water
Monitor the victim closely
They may vomit
They may require rescue breathing

64. Dehydration
Occurs when more water is lost from the body than is taken in
Water is lost from the body from breathing, sweating, digestion, and urination
Prevention
Drink plenty of fluids (summer and winter)
Urine should be clear
Plan in advance to have proper amount of drinking water

65. Dehydration
Symptoms
Increased thirst
Dry lips
Headache
Body aches, muscle cramps
Dark urine
Heat exhaustion, heat stroke, and hypothermia can all be caused in part by dehydration

66. Hypothermia Occurs when more body heat is lost than can be generated.
Wind, precipitation, hunger, dehydration, and exhaustion all increase the risk
Prevention
Wear proper clothing for the weather
Don’t forget the hat!
Eat proper food for energy
Drink plenty of fluids

67. Symptoms of Hypothermia
Feeling cold and numb
Fatigue
Anxiety
Uncontrollable shivering
Slurred speech
Confusion, making bad decisions
Irritability
Stumbling and/or falling down
Loss of consciousness

68. Hypothermia Take the victim into the shelter of a building or tent
Remove all wet clothing
Wrap the victim in dry clothing, blankets, sleeping bag
If conscious, have the victim drink warm fluids (avoid caffeine and alcohol)

69. Hypothermia
Wrap water bottles filled with warm water and place in armpits and groin
Do NOT rewarm the victim too quickly (like immersing in warm water). This may cause an irregular heart rhythm
Monitor the victim. Be ready to provide other first aid

70. Hyperventilation
Occurs when breathing is too rapid and too much carbon dioxide is removed from the bloodstream
Symptoms
Victim feels like he or she is suffocating
Dizziness
Disoriented
Increasingly fearful
Tingling in fingers, toes, lips

71. Hyperventilation Talk quietly to the victim
Encourage the victim to calm down and breath slowly
Have the patient take some slow breaths in a paper bag
Seek medical care—breathing fast may be a sign of other conditions (asthma, diabetes, etc.)

72. First Class Requirements
Requirement 8a
Demonstrate bandages for a sprained ankle and for injuries of the head, the upper arm, and the collarbone.
Requirement 8b
Show how to transport by yourself, and with another person, a person
From a smoke-filled room
With a sprained ankle, for at least 25 yards

73. First Class Requirements
Requirement 8d
Tell the five most common signals of a heart attack.
Explain the steps (procedures) in cardiopulmonary resuscitation (CPR)

74. Bandages
Sprained Ankle
Head
Upper Arm
Collarbone

75. Rescue from a Smoke-Filled Room
Must be done quickly
Cannot put yourself at risk
How to move a victim in that environment:
Grab the victim by their clothing and drag them toward you
Roll the victim onto a coat, blanket, tablecloth, etc. and drag them out
Get behind the victim, reach under his arms, grab his wrists and drag him out

76. Transport a Victim with Sprained Ankle
Walking Assist
One-Person Carry
Four-handed Seat Carry
Two-person Carry

77. Heart Attack 5 Most Common Symptoms
Uncomfortable pressure, squeezing, fullness in the chest
May spread to shoulders, arms, and neck
Unusual Sweating
Nausea
Shortness of Breath
A feeling of Weakness

78. CPR for Heart Attack Check for Response
Tap the victim on the shoulder
Are you OK?
Activate the Emergency Response System and get an AED

79. CPR for Heart Attack Open the Airway Head tilt--chin lift
Look, listen and feel for 5-10 secs
If not adequate breathing, give 2 rescue breaths
Watch for the chest to rise and fall
If chest doesn’t rise, reposition the head (airway) and attempt 2 more breaths

80. CPR for Heart Attack Begin Chest Compressions
30 compressions, then 2 breaths
Rate of 100 per minute
Keep interruptions to 10 seconds or less
Continue until:
Scene is unsafe
More qualified help arrives
Cannot physically continue