1. FIRST AID IN THE NATURE Bc. Marie Bártová, Institute of Nursing Theory and Practice Charles University, 1st Medical Faculty Prague 2006

2. First Aid, Institute of Nursing Theory and Practice CONTENTS -Bleeding -Shock -Heat related injuries -Fractures -Drowning

3. B L E E D I N G MINOR CUTS, SCRATCHES - wash and dry your own hands - cover any cuts on your own hands and put on disposable gloves disposable gloves - clean the cut - raise affected area above the heart - cover the cut with a sterile dressing or plaster

4. First Aid, Institute of Nursing Theory and Practice BLEEDING I SEVERE BLEEDING -lay the victim down (fainting), elevate the bleeding area -remove any obvious loose debris or dirt from a wound -apply pads and bandages -maintain pressure -if bleeding continues place another cloth over the first one -get medical help and take steps to prevent shock

5. First Aid, Institute of Nursing Theory and Practice BLEEDING II DO NOT: -apply a tourniquet to control bleeding if not neccessary -pull out any embedded object from a wound -try to clean a large wound -remove a dressing if it becomes soaked with blood -peek at a wound to see if the bleeding is stopping -try to clean a wound after you get the bleeding under control

6. First Aid, Institute of Nursing Theory and Practice S H O C K „Acute circulatory failure with inadequate or inappropriately distributed tissue perfusion resulting in generalized cellular hypoxia.„ „Acute circulatory failure with inadequate or inappropriately distributed tissue perfusion resulting in generalized cellular hypoxia.„ CAUSE OF SHOCK -trauma -severe infection -allergic reactions etc. TYPES OF SHOCK -cardiogenic shock - problems with the heart -septic shock – endotoxins cause vasoconstriction -distributive shock - anaphylaxis -hypovolemic shock - loss of circulating volume

7. First Aid, Institute of Nursing Theory and Practice SHOCK I SIGNS -pale face -cold, clammy skin -fast, shallow breathing (hyperventilation) -rapid, weak pulse -hypotension -the eyes may seem to stare, -the eyes may seem to stare, pupils dilatated -yawning/sighing/delirium/unconsciousness

8. First Aid, Institute of Nursing Theory and Practice SHOCK II TREATMENT - -lay the casualty down, raise and support the legs - -check for signs of circulation (if absent begin CPR) - -keep the person warm and comfortable - -if the person vomits, turn him on the side – recovery position - -do not give the anything to eat or drink

9. First Aid, Institute of Nursing Theory and Practice H E A T R E L A T E D I N J U R I E S -Hypothermia -Hyperthermia -Burns

10. First Aid, Institute of Nursing Theory and Practice HYPOTHERMIA CONDITIONS LEADING TO HYPOTHERMIA : - -cold temperatures, wetness - -fatigue, exhaustion, dehydration - -alcohol intake (vasodilation - increased heat loss) TYPES - -mild 35—32 ◦C - -moderate 32—30 ◦C - -severe less than 30 ◦C TREATMENT: -reduce heat loss -add fuel & fluids (carbohydrates, hot liquids) -add heat „Exists when the body core temperature is below 35 ◦C“

11. First Aid, Institute of Nursing Theory and Practice HYPERTHERMIA SIGNS: - -mental state change, perspiration - -headache, tachypnea, dizziness FORMS OF HS: - -non-exertion heat stroke (CHS) - high environmental temperatures (elderly) - -exertion heat stroke (EHS) - physical exercise in high environmental temperatures (healthy adults) TREATMENT: Cooling techniques: -Surface cooling methods (undress the victim, ice packs) -Internal cooling methods (i.v drugs, cool fluids) „Occurs when the body’s ability to thermoregulate fails, and core temperature exceeds the one that is normally maintained by homeostatic mechanisms“ Heat stroke (HS) - a systemic inflammatory response with a core temperature above 40.6 ◦C

12. First Aid, Institute of Nursing Theory and Practice BURNS SIGNS: -skin redness -swelling -pain TREATMENT: -cool the burn -cover the burn with a sterile gauze bandage -take pain reliever if neccessary FIRST-DEGREE BURN - outer layer of skin (epidermis) is burned

13. First Aid, Institute of Nursing Theory and Practice BURNS I SIGNS: -blisters -severe pain -swelling TREATMENT: -cool the burn -cover the burn with a sterile gauze bandage -take pain reliever if neccessary SECOND-DEGREE BURN – first and second layer of skin (epidermis) is burned DO NOT: - put the ice directly on a burn (frostbite) - break blisters (risk of infection)

14. First Aid, Institute of Nursing Theory and Practice BURNS II SIGNS: -dry, white/black areas -signs of shock TREATMENT: -make sure the victim is no longer in contact with smoldering materials -don´t immerse severe large burns in cold water -check for signs of circulation -cover the area of the burn (cool, moinst, sterile bandage) THIRD-DEGREE BURN – involve all layers of skin (fat, muscle and even bone can be affected)

15. First Aid, Institute of Nursing Theory and Practice F R A C T U R E S SIGNS -local bruising and tenderness in the effected area -skin stretch marks -localized swelling -forming hematomas -pain -impaired function TYPES -Closed Fracture - no broken skin -Compound Fracture - bone penetrate through the skin from the inside (risk of infection) „A fractured bone is a bone which has had its tissue broken. A fractured is a name of the type of the break experienced“

16. First Aid, Institute of Nursing Theory and Practice FRACTURES I TREATMENT -stop any bleeding -immobilize the injured area (a splint) -apply ice pack to limit swelling -help relive pain -treat for shock (head slightly lower than the trunk, elevate legs) -call emergency

17. First Aid, Institute of Nursing Theory and Practice D R O W N I N G „A process resulting in primary respiratory impairment from submersion/immersion in a liquid medium“ LIFE SUPPORT (Eropean Resuscitation Council 2005) : -quick removal of -quick removal of the drowning victim from the water - -open airway -p -prompt initiation of rescue breathing for 1 min - -<5 min to land - continue rescue breaths - ->5 min from land - continue rescue breaths for 1 min - -chest compression after the victim is removed from water

18. First Aid, Institute of Nursing Theory and Practice REPETITION 1.How do you act if a severe bleeding wound dressing becomes soaked with blood? 2.Name 3 signs of shock. 3.What age group is in greater risk of 3.What age group is in greater risk of non-exertion heat stroke? 4. 4.What burn degree is characterized by blisters? 5.ompound bone fracture? 5.Explain what is compound bone fracture? 6.How do you carry out rescue breathing in a drowning victim after his removal from water?

19. First Aid, Institute of Nursing Theory and Practice THANK YOU ! barfofka@email.cz consultations: Monday 15.30pm – 16.00pm