1. Basic Principles of First Aid Betty Fitzpatrick, RN, NCSN Regional School Nurse Consultant/Liaison

2. 2 First Aid  First Aid vs. Emergency  Child’s view  Your view  Teacher’s View  Parent’s View  Principal’s View

3. 3 911: To Call or Not To Call  Do you have the information and equipment you will need?  Is the situation getting worse?  Have you notified the principal?  Have you documented your care appropriately?  Can you reach the student’s family?

4. 4 911: To Call or Not To Call  When the student is having increasing trouble breathing or has stopped breathing  Severe blood loss, uncontrolled  Loss of consciousness  First seizure, or lasts longer than 5 minutes  When you have used an epi-pen  Severe burn

5. 5 Do you know CPR?

6. 6 For Most Injuries, Ice Can Be Your Best Friend  Ice applications:  Blue gel or chemical packs; Freezer Ziplok bags with frozen sponge, washcloth, or ice cubes; Popsicle for the mouth  Use a thin layer of cloth or paper towel between ice and the skin.  Apply 10-15 minutes every 30-60 minutes for pain or swelling  Do not use for burns!

7. 7 Cuts and Scrapes  Control bleeding using firm pressure and universal precautions  Clean thoroughly with soap and water  Dress with gauze or a Band-aid  Have a cut evaluated for stitches if:  longer than 1/4-1/2 inch  fat or tissue protruding from cut  on the face  gaping open

8. 8 Bleeding  Always wear gloves (carry them with you)  Apply direct, firm pressure, using gauze or a clean cloth  Elevate the area, if possible (above the heart)  Hold firm pressure for 7-10 minutes, without stopping to “check”  After bleeding controlled, clean the wound and apply a dressing

9. 9 Arterial & Uncontrolled Bleeding  Arterial blood is bright red, and spurts with each heartbeat--Blood from a vein will be darker red, and flow steadily  If bleeding is arterial, or is uncontrolled after 10 minutes of firm pressure, have someone call 911  If anything is protruding from the wound, leave it, and tape a dressing to hold it in place

10. 10 Nosebleeds  Very common in children  Have the student lean forward, not back  Apply firm pressure--7-10 minutes  Pinch the nostrils not bridge of nose  Afterwards, do not let the child blow!  Prolonged or recurrent nosebleeds should be reported to parents for possible medical attention

11. 11 Fractures, Sprains and Dislocations  A fracture is a broken bone  A sprain is an injury to the ligaments around a joint  A dislocation is when a bone slips out of it’s socket.  It takes an X-ray to tell the difference

12. 12 Do you have x-ray vision?

13. 13 Fractures, Sprains and Dislocations  Remember “PRICE”  P is for Protect: Splint in position found  R is for Rest: Avoid further movement  I is for Ice: To minimize swelling and pain  C is for Compress: Ace bandage, check often  E is for Elevate, above the heart

14. 14 Head Injuries  For minor head injuries  Rest and Ice  Back to class  Recheck in clinic in 1-2 hours for:  Increasing headache pain  Vision problems  Memory loss

15. 15 Head Injuries Symptoms that would indicate a more severe head injury, requiring medical attention are:  Loss of consciousness  Clear fluid from nose or ear  Vision or speech problems, unequal pupils  Inability to arouse from sleep  Vomiting 3 or more times  Unsteady gait, neck pain

16. 16 Neck and Spinal Injuries  Always suspect a neck or spinal injury if the child:  Has fallen more than 10 ft  Has a bad head injury  Does not get up quickly  Tells you he has neck or back pain

17. 17 Neck and Spinal Injuries  Do not move him if you suspect spinal injury  Someone else should call 911 while you stay with the child  If he vomits, roll him to one side, “like a log”, keeping his neck and back straight

18. 18 Allergic Reactions  Insect sting, food, medication, latex  Remember the Three R’s:  Recognize symptoms  React quickly  Review what caused the reaction, and how well the emergency plan worked

19. 19 Allergic Reactions  Signs of a severe reaction are:  Intense itching, hives  Facial swelling, especially eyes and lips  Cough, hoarseness, or difficulty swallowing  Wheezing, more severe respiratory difficulty  Check emergency plan, follow directions  Give epi-pen immediately, if ordered  Call 911, observe for breathing problems

20. 20 Shock  Shock can result from a severe injury, illness, or infection  The child may be disoriented, confused, or unconscious  Skin will be pale and clammy  Shock results when the body sends blood and oxygen to the most vital organs

21. 21 Shock Call 911  Have child lie down and elevate or prop legs 12 inches or more  Keep the child warm and calm  Observe for further problems with breathing or circulation  Do not give child anything to eat or drink

22. 22 Burns  First aid is cold water  Helps control pain, stop burning process  Do not use ice  Dress with a clean bandage  Leave blisters intact  If the burn is on the hand or face, or is larger than the palm of the hand:  Call parents to seek further medical attention

23. 23 Seizures  A seizure is an episode of abnormal electrical activity in the brain  May vary from staring spells, to movement of one extremity, to a generalized or grand mal seizure  First aid for a child having a seizure is to prevent injury and observe for complications. A seizure management plan should be completed and on file

24. 24 Seizures  It is helpful to check the time, so you can tell parents or EMS how long it lasted  Do not put anything in the child’s mouth, but do speak calmly to him  When the seizure is over, the child will usually be sleepy. Turn him to one side  Call 911 if it is the first seizure or lasts longer than 5 minutes

25. 25 Eye Injuries  Foreign Bodies or Splashes  Flush with large amounts of water for 15-20 minutes  Cover the eye with a gauze dressing  Don’t let the child rub, Call parents  For a penetrating eye injury  Keep student lying flat  Cover with a metal shield, or “cup”  Call 911

26. 26 Heat Emergencies  Heat Cramps  Move student to a cool place  Give fluids (water)  May try a gentle massage of cramped area  Heat Exhaustion: Headache, nausea, faintness, skin pale and clammy  Move to a cool place, lie down  Give sips of water (4 oz. every 15 minutes)  Apply cool, wet cloths, fan  Notify parents

27. 27 Heat Emergencies  Heat Stroke is a medical emergency: skin is red, hot, dry; high fever; disoriented; may have seizures, unconsciousness  Transport to air-conditioned room  Call 911, notify parents  Sponge with water and apply cold packs  Do not give fever reducers  Avoid exposure to extreme temperatures for several days

28. 28 Dental Injuries  Broken or knocked out teeth  Notify parents, child should see dentist or ER within 1 hour if possible  If bleeding, apply pressure  If tooth is knocked out, find tooth, place in a cup of milk or “Save a Tooth”, send with child  Do not rub or clean tooth  Rinse mouth with cool water

29. 29 Bee Stings and Insect Bites  intense itching  trouble breathing  hives  wheezing  hoarseness  paleness  difficulty swallowing  facial swelling Remove Stinger by flicking it with a driver’s license or credit card Apply ice or cold compress Use Epi-Pen if you have one for this child, call 911

30. 30 Tick Removal  Remove the tick by pulling straight out with tweezers or your fingers  Wash with soap and water  Inform parent or caregiver  This is NOT an emergency and does not need to be treated immediately  Provide follow-up information that includes seeing a doctor if the child develops a rash, fever, or headache and possibly joint pain a week to 30 days after a tick bite

31. 31 Splinter Removal  Use Clean tweezers  If you see the object sticking out of the skin grasp and gently pull out the same direction it went in  No digging or doing anything invasive  Wash with soap and water

32. 32 Bumps and Bruises  Apply ice for 20 minutes  Elevate the area if possible  Do not break or open blood blisters

33. 33 Sunburn  Avoid direct sun between 10 a.m. and 3 p.m.  Recommend students bring sunscreen from home to outdoor events  Treat sunburn with cool compress  Encourage extra fluids

34. 34 Reporting Accidents  All accidents that require medical attention should be reported to the school office.  Your County Student Accident Form should be completed by the person who witnessed the accident and the caregiver  This documentation should be completed the same day and reported within 24 hours

35. 35 Georgia Poison Center  When to call them:  For any ingestion of a non-food item  For a chemical splash or burn  For an animal bite  And the numbers are:  404.616.9000  1.800.282.5846

36. 36 Questions? Contact your school nurse