definition : emergency care provided for injury or sudden...
TRANSCRIPT
1
RLS
SA
Em
erg
ency F
irst A
id
2
RLS
SA
Em
erg
ency F
irst A
id
CPR
3
RLS
SA
Em
erg
ency F
irst A
idAction Plan
D anger
R esponse
A irway
B reathing
C PR
D efibrillation
S end for help
4
RLS
SA
Em
erg
ency F
irst A
idDRSABCD
Danger
Check for dangers to:
Yourself
Bystanders
Casualty
Walk 360o around the casualty
Use all 6 senses
Smell
Sight
Taste
Touch
Listen
Common Sense
5
RLS
SA
Em
erg
ency F
irst A
idDRSABCD
Response
Is the casualty responsive?
C an you hear me?
O pen your eyes
W hat‟s your name?
S queeze my hands and let go
If the casualty is not responsive, and fluid is suspected in the
airway, roll the casualty into recovery position
6
RLS
SA
Em
erg
ency F
irst A
idDRSABCD
Send for Help
Dial 000
Be prepared to give the following information
Location of the emergency (including nearby landmarks,
closest intersections etc..)
The telephone number from where the call is being made
What happened
How many persons require assistance
Condition of the casualty
What assistance is being given
Any other information requested
** Never hang up before the emergency services operator hangs
up **
7
RLS
SA
Em
erg
ency F
irst A
idDRSABCD
Airway
Open the airway
Tilt the casualty‟s head back to remove
tongue from the airway
Clear the airway
Check to see the airway is free from
obstructions
In an unconscious victim, care of the airway takes precedence
over ANY injury
8
RLS
SA
Em
erg
ency F
irst A
idDRSABCD
Breathing – Normal Breathing?*
Check for signs of life
consciousness, responsiveness, movement
and normal breathing
Look, Listen, Feel
Look - for rise and fall of the chest
Listen - for breathing noises
Feel - for rise and fall of chest
and for breath on cheek
* For drowning related emergencies give 2 rescue breaths prior to
commencing CPR
Watch for rise and
fall of the chest
9
RLS
SA
Em
erg
ency F
irst A
idDRSABCD
C PR - 30 : 2
If no signs of life are present give
30 chest compressions,followed by 2 breaths
Centre of the chest
♥ Compressions applied too high are ineffective
♥ Compressions applied too low may cause regurgitation &/or
damage to the vital organs
The centre of the chest (sternum) should be depressed by a
third of the chest depth
Push FIRM
Push FAST
10
RLS
SA
Em
erg
ency F
irst A
idDRSABCD
2 Breaths
Pistol gripTake a breath for
yourself
Breath into
patient
Watch for rise and
fall of chest
11
RLS
SA
Em
erg
ency F
irst A
idDRSABCD
12
RLS
SA
Em
erg
ency F
irst A
idDRSABCD
Automated External Defibrillator
Attach AED (if available) as soon as possible and follow the
prompts
13
RLS
SA
Em
erg
ency F
irst A
idDRSABCD - Defibrillators
14
RLS
SA
Em
erg
ency F
irst A
idDRSABCD
D – DangersCheck for dangers
R – ResponseCheck for response
No response
S - Send for helpCall 000
A – AirwayOpen AirwayClear the airway no
yesB – BreathingLook, Listen & Feel for breathing
Responsive? Breathing normally?
D – DefibrillationAttach AED (automated external defibrillator)
and follow prompts
Place in recovery position
Monitor vital signs
Provide oxygen
C – CPRGive 30 chest compressions
Followed by 2 breathsContinue until qualified help arrives
or normal breathing returns
For drowning related emergencies give 2 rescue
breaths prior to commencing CPR
15
RLS
SA
Em
erg
ency F
irst A
id
Mouth to mouth
Used when no pocket mask is available
Mouth to mask
Should always be used by First Aiders
Minimises transfer of communicable diseases
Provides mouth to mouth & nose resuscitation
Mouth to nose
Can be administered in deep water
Mouth to mouth and nose
Used to resuscitate infants
Mouth to mouth and nose
Breath is applied to both the mouth and nose
Done to infants
Mouth to neck stoma
Breath is applied to tube in neck
Rescue Breathing
16
RLS
SA
Em
erg
ency F
irst A
idTechniques
ADULTS CHILDREN INFANTS
Head Tilt: Full Full Neutral
Breath Size: Rise and fall of the chest
Compression
Depth:1/3 depth of the chest
Compression
Point:Visual – Centre of the chest
Compression
Method:2 Hands 1 or 2 Hands 2 Fingers
17
RLS
SA
Em
erg
ency F
irst A
idDRSABCD
CPR is the technique of rescue breathing combined with chest
compressions
The purpose of CPR is to temporarily maintain a circulation
sufficient to preserve brain function until specialised treatment is
available
CPR should be continued until:
Signs of life return
Qualified help arrives and takes over
It is impossible to continue
Danger returns
18
RLS
SA
Em
erg
ency F
irst A
idDRSABCD
ADULTSAged 8 years old
plus
30 compressions
2 breaths
5 cycles in 2 minutes
Almost 2 compressions per second
“Thirty & Two That’s All You Do”
CHILDRENAged 1 year old to 8
years old
INFANTSAged up-to 12
months
19
RLS
SA
Em
erg
ency F
irst A
idDRSABCD
Multiple rescuers
It is recommended that frequent rotation of rescuers
is undertaken to reduce fatigue
Approximately every 2 minutes
“Thirty & Two That’s All You Do”
20
RLS
SA
Em
erg
ency F
irst A
idDRSABCD - infant
D anger
The assessment for danger remains the same
R esponse
Make loud noises such as clapping
Blow air in the infants face
Run fingers along the arches of the feet
Place finger inside of hands
S end for Help
Call 000
A irway
Both mouth and nose should be cleared
Nose can be cleared using the „milking‟ technique
Open airway is achieved with head in neutral position
B reathing – Normal Breathing
Look, listen and feel
Check for signs of life
C PR
30 compressions followed by 2 breaths Mouth-to-mouth-and-nose rescue breathing
2 fingers on lower half of the sternum
21
RLS
SA
Em
erg
ency F
irst A
idDRSABCD
Vomit
A voluntary response
Abdominal muscular contraction occurs
Removal is often forceful and projectile
Often appears “chunky”
A good sign – something is working
Regurgitation
An involuntary response
The stomach distends
The contents ooze out
Often appears “frothy”
A bad sign – often caused by:
Over inflation
Insufficient head tilt
Not allowing enough time
between breaths
22
RLS
SA
Em
erg
ency F
irst A
idDRSABCD
If the casualty vomits or regurgitates during resuscitation they should
immediately be rolled onto their side and airway cleared. If no signs of life
are present, rescuer should continue with rescue breathing and
compressions.
If regurgitation is suspected you may be required to adjust:
Head tilt
Breath size
Breath frequency
23
RLS
SA
Em
erg
ency F
irst A
idDRSABCD - Choking
Choking can be present in a conscious or unconscious casualty
Varied severity
Some typical causes:
Relaxation of the airway muscles due to unconsciousness
Inhaled foreign body
Trauma to the airway
Anaphylactic reaction
May be gradual or sudden onset
Some of the signs in a conscious casualty:
Anxiety, agitation, gasping sounds, coughing, loss of voice, clutching at
neck with thumb and fingers
24
RLS
SA
Em
erg
ency F
irst A
idDRSABCD
Mild Obstruction
Breathing is laboured
Breathing may be noisy
Some escape of air can be felt from the mouth
Severe Obstruction
There may be efforts at breathing
There is no sound of breathing
There is no escape of air from nose &/or mouth
25
RLS
SA
Em
erg
ency F
irst A
idDRSABCD
The simplest way to determine the severity of a foreign
body airway obstruction is to assess for ineffective or
effective cough
Effective cough (Mild Airway Obstruction)
Give reassurance
Encourage to keep coughing
If obstruction is not relieved, rescuer should CALL 000
26
RLS
SA
Em
erg
ency F
irst A
idDRSABCD
Ineffective cough (Severe Airway Obstruction)
Conscious victim:
CALL 000
Perform up to 5 sharp back blows
Heel of hand between shoulder blades
Check for removal of obstruction between each back blow
If back blows aren‟t successful, perform up to 5 chest thrusts
Use CPR compression point
Similar to CPR compressions but sharper and delivered at a
slower rate
Check for removal of obstruction between each chest thrust
Continue to alternate between back blows and chest thrusts if
obstruction is not relieved
27
RLS
SA
Em
erg
ency F
irst A
idDRSABCD
Ineffective cough (Severe Airway Obstruction)
Unconscious victim:
CALL 000
If solid material is visible in the airway sweep it out using
your fingers
Commence CPR
28
RLS
SA
Em
erg
ency F
irst A
idDRSABCD
Assess Severity
Call ambulance
Give up to 5
Back Blows
If not effective
Give up to 5
Chest Thrusts
Encourage Coughing
Continue to check
victim until recovery
or deterioration
Call ambulance
Conscious
Effective Cough
Mild Airway Obstruction
Ineffective Cough
Severe Airway Obstruction
Unconscious
Call ambulance
Commence CPR
29
RLS
SA
Em
erg
ency F
irst A
idDRSABCD
Left Lateral Tilt
When a heavily pregnant women is lying on her back, the
foetus can compress a major blood vessel of the mother
(inferior vena cava).
This can be minimized by providing sufficient padding
under her right buttock, to provide an obvious pelvic tilt to
the left whilst leaving the shoulders flat on the floor.
“Mothers are always right, padding the right buttock”
30
RLS
SA
Em
erg
ency F
irst A
idDRSABCD
Talking in an untrained bystander
If you believe that there is a responsible bystander that you could use for 2-operator CPR and the casualty would benefit more from receiving 2-operator CPR, you have the choice of talking in an untrained bystander in the situation that you do not have a second trained person to assist.
There are many ways to approach talking in an untrained bystander. Some examples:
Ask whether the bystander is prepared to help
Establish whether they have any first aid experience
31
RLS
SA
Em
erg
ency F
irst A
idDRSABCD
Ask them to kneel on the opposite side and place hands on the ground and do what you are doing
Ask them to place their hands on top of yours to gauge the depth of compressions
Ask them to count the compressions for you
Ask them to place their hands on the patient and compress with you
When you believe they are ready, let them take over the compressions
Do not rush the change over
The experienced rescuer must always remain at the head
32
RLS
SA
Em
erg
ency F
irst A
id
First Aid
33
RLS
SA
Em
erg
ency F
irst A
id
Definition : Emergency care provided for injury or sudden
illness before medical care is available
The 5 P’s
Preserve life
Prevent further injury
Protect the unconscious
Promote recovery
Procure medical aid (access medical aid)
Aims
34
RLS
SA
Em
erg
ency F
irst A
idAims
Responsibilities of the first aid provider
Ensure personal health and safety
Maintain a caring attitude
Maintain composure
Maintain up to date knowledge and skills
35
RLS
SA
Em
erg
ency F
irst A
idApproach to an incident
Approach to an incident:
Primary survey
Assessment of vital signs
Secondary survey
This approach will:
Reduce risk to yourself or others becoming victims
Provided a more thorough examination
Prioritise the victims injuries so as to enable management in
order of severity
36
RLS
SA
Em
erg
ency F
irst A
idO H & S
Occupational First Aid Provider
Duties may include:
Provision of first aid
Maintenance of first aid kits and facilities
Identification of potential hazards
Maintenance of records & other tasks
37
RLS
SA
Em
erg
ency F
irst A
idO H & S
Duties of Employers
Employers are expected to make every reasonable effort
to provide a safe & healthy workplace. This involves the
provision of safe equipment, safe plant, safe procedures,
appropriate training and welfare facilities
Duties of Employees
Employees are expected to make every reasonable effort
to secure the health and safety of both themselves and
others at work
38
RLS
SA
Em
erg
ency F
irst A
idFirst Aid Kits
Pocket mask Gloves (disposable) Telephone numbers of
emergency services
First Aid manual Cotton bandages (various
sizes)
Triangular bandages
Adhesive tape Sterile wound dressings
(various sizes)
Sterile saline (for wound
irrigation)
Sterile eye pads Scissors Notebook
Alcohol swabs Accident report forms Pens
Additional Items (home or specialized kits)
Sun Screen Tweezers Vinegar
Asthma reliever &
spacer
Space blankets Band-Aids
39
RLS
SA
Em
erg
ency F
irst A
idCross Infection
Can be minimized by:
Attempting to avoid contact with blood and other bodily fluids
Use of protective devices such as disposable gloves & resuscitation masks
Being vigilant for sharp objects such as syringes or broken glass
Always washing hands thoroughly following, & if possible prior to the provision of first aid
Being immunized against communicable diseases such as hepatitis B
Seek medical advise in the case of exposure
40
RLS
SA
Em
erg
ency F
irst A
idLegalities
There is no legal obligation to act as a “Good Samaritan”. You may
have a moral obligation to help someone in need, otherwise you may
owe a duty of care.
Duty of Care
Common examples: Teachers Students
Employer Employees
Gym Instructor Gym Patrons
Motorist Other Motorists & Pedestrians
A duty of care is established:
If it is a legal obligation &/OR
Once first aid begins
41
RLS
SA
Em
erg
ency F
irst A
idLegalities
Negligence
For a First Aid provider to be found negligent (civil liability), the
following need to be considered:
Did the provider owe a duty of care to the casualty
Did the provider act outside their level of training (standard of care)
Did the provision of First Aid result in damage or loss to any
persons or property
Consent
Consent must be gained before initiating any first aid
Verbally ask for permission/consent
If a minor, ask parent or guardian
If unconscious, consent is assumed
42
RLS
SA
Em
erg
ency F
irst A
idReporting
All items included in reports must be factual, and not express
personal opinion
Example:
The casualty appeared intoxicated
INCORRECT
Vs.
The casualties breath smelt „fruity‟
CORRECT
43
RLS
SA
Em
erg
ency F
irst A
idImpact of Trauma & Counselling
As everyone deals with trauma in their own way it is very
important to complete your individual report immediately
Then follow this up with a debrief
Your employer will offer you counselling or there are alternatives
such as local hospital, police, grief counselling services (refer
yellow pages) or LSV. This should be done as soon as possible
44
RLS
SA
Em
erg
ency F
irst A
idVital Signs Survey
Vital Signs Survey
Checking the casualties vital signs at regular intervals (e.g., 1 minute)
Breathing rate and depth
(Average adult 10-20 breaths per minute)
(Average infant 30-50 breaths per minute)
Heart rate
(Average adult resting 60-90 beats per minute)
(Average child resting 70-110 beats per minute)
(Infants resting up to 150 beats per minute)
Responsiveness
Hearing, movement in the eyes
Able to answer questions, movement from limbs
45
RLS
SA
Em
erg
ency F
irst A
id
Secondary Survey
46
RLS
SA
Em
erg
ency F
irst A
idSecondary Survey
We are looking for:
B leeding
B urns
F ractures
O ther things - Signs & Symptoms
47
RLS
SA
Em
erg
ency F
irst A
idSecondary Survey - DOLOR
Assessment of responsive casualty (DOLOR)
Description
Ask the casualty to describe the problem
Onset & Duration
Ask the casualty when the problem arose & how it has
progressed
Location
Ask the casualty where on the body the problem is
Other Signs and Symptoms
Signs: Things you can see
Symptoms: Things the casualty can feel
Do you notice any other signs?
Is the casualty aware of any other symptoms?
Relief
Has anything provided relief? e.g, rest, position or medication
48
RLS
SA
Em
erg
ency F
irst A
idSecondary Survey
Head
Look and feel for bleeding and bumps
Check for fluid discharge from ears and nose
Check the eyes for any signs of injuries
Neck
Look at and feel the back of the neck gently
for tenderness & irregularities. If there are
any concerns of potential spinal injuries, do
not move the victim, unless they become
unresponsive or are in immediate life
threatening danger
ASSESSING Conscious / Unconscious casualty
head to toe examination
49
RLS
SA
Em
erg
ency F
irst A
idSecondary Survey
Back/Chest/Abdomen
Ask a responsive victim to inhale deeply and see if it causes discomfort
Look at & feel the chest, back and abdomen for irregularities & tenderness
Limbs
Look for an injury &/or deformity
Check from the extremities moving toward the trunk, feeling for irregularities
Check for altered strength and sensation
Check gloves after each section for bodily fluids
50
RLS
SA
Em
erg
ency F
irst A
idPrioritising Casualties
Treat unconscious casualties first because they are
unable to protect their airway or protect themselves
from external dangers
Triage – prioritise casualties in order of urgency of
management
Multiple casualties
51
RLS
SA
Em
erg
ency F
irst A
id
Medical Emergencies
52
RLS
SA
Em
erg
ency F
irst A
idFainting and Shock
Fainting is caused by an inadequate blood supply to the brain.
It‟s reduced in severity compared to shock.
Shock is caused by lack of oxygen supply to the vital organs.
53
RLS
SA
Em
erg
ency F
irst A
id
Causes of Fainting
Prolonged periods of standing
Emotional distress
Low fluids or food
Causes of Shock
Heart failure
Inadequate blood volume/blood loss
External or internal bleeding
Leaky or dilated vessels
Inadequate O² in blood
With Shock the body responds by:
Vasoconstriction
Increased heart rate
Increased breathing rate
Fainting and Shock
54
RLS
SA
Em
erg
ency F
irst A
idFainting and Shock
Signs & Symptoms – Fainting & Shock:
Tingling (poor circulation)
Light-headedness, dizziness
Nausea
Pale, cold clammy skin
Brief period of unresponsiveness (1 to 2 minutes)
Rapid, weak pulse & Rapid, shallow breathing
Altered responsiveness
Thirst
Weakness
Collapse
55
RLS
SA
Em
erg
ency F
irst A
idFainting and Shock
Management of Fainting and Shock
Primary survey
Lay victim down with legs elevated
Treat cause, if possible (i.e. bleeding)
Reassurance
Monitor & record vital signs
Provide oxygen, if able
Maintain thermal comfort
Seek medical assistance
56
RLS
SA
Em
erg
ency F
irst A
idEasy to remember treatment
If the face is pale raise the tail,
If the face is red raise the head,
If the face is blue they’re almost through.
The easiest way to remember the treatment of Fainting or Shock is:
57
RLS
SA
Em
erg
ency F
irst A
id
Blood Vessels
58
RLS
SA
Em
erg
ency F
irst A
idBlood Vessels
Blood Vessels – Types
ARTERIES : carry oxygenated blood through the body from the
heart to all other organs
VEINS : carry the carbon dioxide rich blood from the organs to
the heart
CAPILARIES : are the smallest blood vessels where the
exchange of the O² to the CO² happens
59
RLS
SA
Em
erg
ency F
irst A
idBlood Vessels
Bleeding
ARTERIES :
Rapid & profuse (usually spurts)
Bright red
VEINS :
Flows from wound at steady rate
Dark red
CAPILARIES :
Gently oozes from wound
60
RLS
SA
Em
erg
ency F
irst A
idBlood Composition
Plasma (50-60%)
♥ Contains salts, sugar, etc
Red blood cells (40-50%)
♥ Contain haemoglobin to carry oxygen
White blood cells
♥ Fight infection
Platelets
♥ Clotting agents
61
RLS
SA
Em
erg
ency F
irst A
id
Wounds
62
RLS
SA
Em
erg
ency F
irst A
idTypes Of Wounds
Abrasions
Scrapes on the surface of the skin with damage to small capillaries
Lacerations & Incisions
Cuts, usually caused by sharp objects such as a knife or piece of glass
Lacerations have ragged edges
Incisions have smooth edges
Avulsions
Where a flap of skin &/or flesh has been totally or partially removed
63
RLS
SA
Em
erg
ency F
irst A
idTypes Of Wounds
Puncture Wound
Occurs when a sharp, pointy
object has penetrated the flesh
Embedded Object
Wound with an embedded
object still in place
Amputation
Occurs when a body part has
been severed
64
RLS
SA
Em
erg
ency F
irst A
idMinor Wounds
Definition:
Superficial
Small surface area
(<2.5cm)
Bleeding ceases quickly
65
RLS
SA
Em
erg
ency F
irst A
idMinor Wounds
Seek medical attention if:
There is any doubt about the severity of the wound
The wound cannot be easily cleaned
Infection is a concern (there is a greater risk of infection with
large abrasions)
Stitches may be required
Tetanus immunisation may be necessary
66
RLS
SA
Em
erg
ency F
irst A
id
Management
Wash in clean, running water
Clean thoroughly, take special care with large abrasions to
ensure any debris is removed
Dry using sterile gauze
Cover with a clean dressing
Minor Wounds
67
RLS
SA
Em
erg
ency F
irst A
idMinor Wounds
Avulsions:
Flap of skin should not be
removed unless it‟s very small
Large flaps of skin or
appendages should be returned
to normal position before applying
the sterile dressing / bandage
68
RLS
SA
Em
erg
ency F
irst A
idMinor Wounds
Nose Bleeds
Nose bleeds may occur as a result of a direct trauma
or may occur spontaneously.
Management
Ask the casualty to firmly squeeze the fleshy part of the nose, below the bone
Position the casualty sitting upright, with their head slightly forward
Ask the casualty to breathe through their mouth and avoid swallowing any blood (can cause vomiting)
Seek medical aid if the bleeding time exceeds 10 minutes
It is best not to apply pressure to a suspected broken nose
69
RLS
SA
Em
erg
ency F
irst A
idMajor Wounds
Pressure
Elevation
Rest
If bleeding continues through the pad:
Apply another pad and bandage (over the original pad and
bandage)
Remove pad and bandage and replace if bleeding still continues
Apply pressure near the artery
Management
Conduct a primary survey & act accordingly
Apply direct pressure to the wound site
Apply a sterile dressing, followed by a pad & bandage where
possible
Elevate injured site if possible
Call the ambulance (if required)
Keep casualty still and reassure them
Monitor vital signs and treat for shock if required
Provide supplemental oxygen (if able)
Seek medical attention (if required)
70
RLS
SA
Em
erg
ency F
irst A
idMajor Wounds
Puncture Wounds
With a deep puncture wound, even though external bleeding
may be minimal, there is a risk that internal organs may have
been damaged. There is also a high risk of infection so
medical aid should be sought.
71
RLS
SA
Em
erg
ency F
irst A
idMajor Wounds
Embedded Objects
Sometimes objects are embedded at
the wound site. Where possible, these
objects should be left in place.
Attempting to remove the object can
cause further damage can exacerbate
the bleeding.
Management
Apply pressure to the wound site
Elevate the affected area
Apply a ring/donut bandage around the object
Dress around the wound without applying
pressure to the embedded object
72
RLS
SA
Em
erg
ency F
irst A
idMajor Wounds
Amputations
Management of the stump
Refer to general wound management
Management of the Severed Part
Wrap the body part in a clean, sterile, non-adhesive dressing if possible
Place the body part in a sealed plastic bag or container
Place the sealed body part in a container of icy water
Do not allow part to come into direct contact with ice or water
Seek urgent medical assistance
73
RLS
SA
Em
erg
ency F
irst A
idMajor Wounds
A crush injury involves changes in blood, decreased
volume of fluid in the blood vessel (hypovolemic shock),
and kidney failure. Generally the victim is protected from
these effects until the crush object is released.
Crush Injury
Management
ARC guidelines recommend if safe and physically
possible, all crushing forces should be removed
as soon as possible after the crush injury.
If a crushing force is applied to the head, neck,
chest or abdomen and is not removed promptly
death may ensue from breathing failure, heart
failure or blood loss.
DO NOT use a tourniquet for the first aid
management of a crush injury.
74
RLS
SA
Em
erg
ency F
irst A
idInternal Bleeding
Internal bleeding may be suspected, depending on:
Type of trauma the victim has undergone
Victim‟s past medical history (e.g., stomach ulcers)
Victim has signs and symptoms of shock
Pain and swelling in the affected area
Coughing up blood, „dark brown‟ blood in vomit or excretion of
blood from urinary or digestive system
75
RLS
SA
Em
erg
ency F
irst A
idInternal Bleeding
Management
Seek urgent medical aid
Conduct a primary survey and act accordingly
Lay casualty down, if possible, and raise legs slightly
Keep still and reassure
Thermoregulation
Provide supplementary oxygen (if able)
Monitor vital signs
Conduct a secondary survey (if appropriate)
Give nothing by mouth
76
RLS
SA
Em
erg
ency F
irst A
id
Burns
77
RLS
SA
Em
erg
ency F
irst A
idSources Of Burns
Flames
Hot objects
Hot air
Hot water and steam
Chemicals
Radiation
Electricity
Cold
78
RLS
SA
Em
erg
ency F
irst A
idWhen To Call 000
Ambulance is recommended for:
A flame burn the size of the casualty‟s palm
Any flame or scald burn involving the hands, face, perineum or genitals
Any chemical burns
Any electrical burns
Any burns with suspected respiratory tract involvement
Any infant or child with any type of burn
79
RLS
SA
Em
erg
ency F
irst A
idTypes Of Burns
Superficial Burn
Only the top layer of skin is involved (e.g. sunburn)
Partial Thickness Burn
The top layer and part of the next layer have been
burnt
Full Thickness Burn
Both outer layers have been damaged, and
possibly the subcutaneous tissue being affected
This can result in damage to fat, muscles, blood
vessels and nerve endings
80
RLS
SA
Em
erg
ency F
irst A
idTypes Of Burns
Superficial Partial Full
Redness Severe pain Painless
Pain Redness Cracked and dry appearance
Weeping from the burn White or charred appearance
Blistering
Summary Of Burns
81
RLS
SA
Em
erg
ency F
irst A
idGeneral Burns
Management
Assess for dangers including flames, chemicals and noxious
gas emissions.
First aid providers should not expose themselves or others to
any of these dangers
Remove victim to safe environment
Conduct a primary survey and act accordingly
Arrange medical aid (as appropriate)
Immediately cool the affected area with water for up to 20
minutes
Only the affected area should be cooled due to the risk of
overcooling the victim (greater concern with infants or children)
Do not use ice (as there is a possibility of sending a person
into shock)
82
RLS
SA
Em
erg
ency F
irst A
idGeneral Burns
Remove all rings, watches and other jewellery from the
affected area
Elevate burn limbs (where feasible)
Cover burn area with a clean, sterile, lint-free dressing
Provide oxygen (if able)
Do Not
Peel off adherent clothing
Burst blisters
Apply ointments or lotions
83
RLS
SA
Em
erg
ency F
irst A
idThermal Burns
Management of Burns caused by Flame or Scalding
Remove any covering of material, especially if no water for
flushing is available
Ensure no hot water is trapped within the victim‟s skin folds
(especially children)
Continue to cool the site, despite the application of dressing
84
RLS
SA
Em
erg
ency F
irst A
idInhalation
Inhalation of hot gases or flame can cause burns along
the respiratory tract that can result in swelling and possible
airway obstruction. In addition, inhalation of smoke and
toxic gases can result in breathing distress and a variety of
serious problems.
Management
Seek urgent medical aid
Conduct a primary survey and act accordingly
Provide supplemental oxygen (if able)
85
RLS
SA
Em
erg
ency F
irst A
idChemical Burns
Sources of Chemical Burns:
Household cleaning agents
Pool or spa chemicals
Gardening and farm sprays
Car batteries
Industrial chemicals
Both acid and base chemicals can damage body tissues,
causing them to release heat. Base burns are more serious
than acid burns as they can penetrate further into the body.
86
RLS
SA
Em
erg
ency F
irst A
idChemical Burns
Management
Avoid/neutralize any dangers
Brush any powdered chemical off victim
Flush with fresh, cool water for 20-30 minutes
Ensure that chemicals are not accessible by children
Always keep Material Safety Data Sheets with chemicals
87
RLS
SA
Em
erg
ency F
irst A
idElectric & Lightning Burns
Electrical burns can be caused by faulty, or misuse of, electrical
appliances. In some accidents, downed power lines are a potential
source of severe electrical burns.
Consider DANGER when dealing with electrical burns
Turn off power
If power lines are down, avoid coming closer than at least 8-10
meters to the lines
Do not attempt to move power lines, even with non-conductive
material, as at high voltage, electrocution is still possible
Lightning strikes cause a large number of deaths each year. If
caught outside in an electrical storm, stay clear of:
Tall trees or poles
Bodies of water
Metallic machinery and objects
Hilltops or open spaces as most lightening strikes occur here
88
RLS
SA
Em
erg
ency F
irst A
idElectric & Lightning Burns
Electrical burns are characterized by entry and exit wounds, which
may appear minimal. Electricity may have passed through and
damaged internal organs resulting in:
No breathing
Irregular or no heart beat
Damage to internal muscles and tissues
Fractures
89
RLS
SA
Em
erg
ency F
irst A
idElectric & Lightning Burns
Management
It is important to:
Avoid/Neutralise electrical and other dangers
Conduct a primary survey and act accordingly
Arrange medical aid, as required
Treat burn as appropriate
90
RLS
SA
Em
erg
ency F
irst A
id
Soft Tissue injuries
91
RLS
SA
Em
erg
ency F
irst A
idFractures
DEFINITION
A fracture is a break in a bone. Sometimes a fracture may be a single,
clean break or there may be a number of breaks.
Children often suffer a “greenstick” fracture, which is the splintering of a bone.
Fractures are usually defined as either:
CLOSED
Where the overlying skin is unbroken OR
OPEN
In which case there is an open wound at the fracture site the fracture can
also cause damage to underlying organs – this is known as a
COMPLICATED fracture. Serious internal bleeding can result from fractures of major bones such as the femur or pelvis.
92
RLS
SA
Em
erg
ency F
irst A
idFractures
CAUSES
Direct force
A bone is broken at the site of impact
Indirect force
A bone breaks some distance from the point of impact as a result of pressure
E.g. arm breaks from bracing a fall by putting hands out
Abnormal muscular contraction
A fracture can occur due to a “sudden” muscular contraction.
This is often associated with electrocution
RECOGNITION
Pain at or near the site of
fracture
Difficulty/inability to move
the injured part
Swelling
Deformity
Grating of bone
Tenderness
Possible shock
93
RLS
SA
Em
erg
ency F
irst A
idManagement Of Fractures
RESPONSIVE CASUALTY
Conduct a primary survey & act accordingly
The main aim is to prevent any movement at the site of the fracture
If unsure, keep the casualty still & comfortable and call the ambulance
Immobilise the joint above or below the fracture site, if possible
Splint in a position of comfort for the victim
Do not attempt to realign a badly deformed limb.
Where possible, an immobilized fractured limb should be elevated
Treat for shock
Support a fractured jaw with the hand
If necessary, pull the lower jaw forward to keep the airway open
First Aid Providers may need to Improvise
Tie shoelaces together to avoid feet moving when a fractured foot is suspected
Use a long sleeve t-shirt to support arm by pulling arm through top and over shoulder
Using a branch as a splint
UNRESPONSIVE CASUALTY
Arrange urgent medical assistance
Immediately place the victim in the
recovery (lateral) position
Conduct a primary survey & vital
signs survey, and act accordingly
Provide supplemental oxygen (if
able)
94
RLS
SA
Em
erg
ency F
irst A
idContusions & Bruises
Arise after trauma to a site
Trauma usually occurs as a result of a blow to the area
Underlying blood vessels are damaged & dark, purple discolouration arises at the site
Changes colour as it starts to heal (yellowish green) as the water material is naturally removed
95
RLS
SA
Em
erg
ency F
irst A
idSprains & Strains
Sprains:
Occur at the joint
Usually occurs as a result of stretching and possibly tearing of the ligaments or other tissues at the joint
Swelling at the site quickly follows the injury to the joint
This acts as a protective mechanism to stop further movement at the site
96
RLS
SA
Em
erg
ency F
irst A
idSprains & Strains
Strains:
Usually associated with muscles & tendons which attach the muscle to the bone.
Can be caused by overuse or putting excessive load on a muscle or muscle group.
It can also occur if muscles are not warmed up properly prior to strenuous use.
Varied severity
Mild discomfort with minor muscle
damage
Complete tearing of the muscle
resulting in loss of use
97
RLS
SA
Em
erg
ency F
irst A
idSprains & Strains
R I C E R / D
MANAGEMENT
R est
Ensure no further stress is placed on the injury
I ce
Apply an ice pack or cold compress to the injured site
Ice pack or cold compress should be wrapped in a damp cloth, rather than being applied directly to the skin
The pack/compress should be applied for 10-20 minsON/OFF
Ice should not be applied to the head, genitals or nipples
Ice can be applied for approx 48 hours after injury
98
RLS
SA
Em
erg
ency F
irst A
idSprains & Strains
C ompression
A compression bandage should be applied to the injured area
The bandage should not be so tight as to restrict circulation
E levation
The injured area should be elevated to minimise swelling and facilitate the healing process
D iagnosis or R eferral
Medical advice should be sought if you are at all unsure of the extent of the injury
99
RLS
SA
Em
erg
ency F
irst A
id
Spinal Injury
100
RLS
SA
Em
erg
ency F
irst A
idSpinal Injury
The spine consists of the spinal column and
the spinal cord.
The column is made up of a series of bones
called vertebrae, separated by cartilage known
as discs. These discs act as shock absorbers
during movement.
The spinal cord is made up of bundles of
nerves and passes through holes in the
vertebrae. It acts as a pathway for impulses
between the brain and the rest of the body,
and is also involved in reflex actions. Nerve
tracts run from the spinal cord, through the
gaps in the vertebrae to various parts of the
body.
DEFINITION
101
RLS
SA
Em
erg
ency F
irst A
idSpinal Injuries
Injuries to the spine may involve the body spinal column or the cord, or both.
Injuries to the spinal cord may arise through fractures in the vertebrae causing damage to the cord, which can be compressed or severed (partially or totally). Injury can worsen as a result of swelling and bleeding at the site.
There is also the potential to worsen some spinal injuries by inappropriate handling of the casualty.
102
RLS
SA
Em
erg
ency F
irst A
id
Spinal injuries are most often associated with motor vehicle and diving accidents, but can also be caused by a number of other mechanisms.
When assessing the casualty, the best indicator of a possible spinal injury is the history of the accident.
Spinal Injuries
103
RLS
SA
Em
erg
ency F
irst A
idSpinal Injuries
What happens to the spine when injured
C1-C7 Quadriplegic (neck down)
T1-T12 Paraplegic (with additional damage to nerves)
L1-L5 Paraplegic (waist down)
S1-S5 Sacral
CX1 – CX4 Coccyc
BREAKDOWN
104
RLS
SA
Em
erg
ency F
irst A
idSpinal Injuries
Depending on the extent
of the spinal injury this is
what area of the body can be
affected.
105
RLS
SA
Em
erg
ency F
irst A
idSpinal Injuries
Incidents with high likelihood of spinal injury
Victim falling, or having an object fall upon them, from a
distance greater than the casualty‟s height
Any penetrating injury, or injury involving major blunt force to
the head, neck or trunk
Any accident involving a pedestrian, cyclist, motorcyclist or
casualty thrown from a vehicle
Diving and surfing accidents
106
RLS
SA
Em
erg
ency F
irst A
idSpinal Injuries
History of the incident
Pain or discomfort in the neck or back region
Altered sensation, movement or strength in the limbs or trunk
Irregular bumps on the neck or back
Slow pulse rate (50-60bpm)
Diaphragmatic breathing
Erection in injured males (priapism). Also occurs in females
Does not necessarily mean no movement possible
RECOGNITION
107
RLS
SA
Em
erg
ency F
irst A
idSpinal Injury
If responsive:
Conduct Primary, Vital Signs and Secondary Surveys and act accordingly
Use double trapezius grip and log roll to move casualty
Arrange urgent medical assistance
Keep the casualty still and reassure them
Thermoregulation Minimise any movement of the
head and spinal column Manage any other injuries Provide supplemental oxygen (if
able)Avoid YES/NO questions
Ask WHEN, WHERE, HOW, WITH WHO questions
Avoid DOES, CAN, IF & IS questions
If unresponsive:
Arrange urgent medical assistance
Conduct a Primary Survey and act accordingly
Use jaw thrust method for Rescue Breathing if required
Support the victims head and neck, avoiding any twisting or forward movement of the neck (jaw thrust)
Thermoregulation Continually monitor vital
signs
108
RLS
SA
Em
erg
ency F
irst A
id
Bandaging
109
RLS
SA
Em
erg
ency F
irst A
idBandaging
How to make a collar and cuff sling
110
RLS
SA
Em
erg
ency F
irst A
idBandaging
How to make a donut bandage
111
RLS
SA
Em
erg
ency F
irst A
idBandaging
The Elevation sling
Place bandage with apex pointing to elbow
over the arm. Tuck in under the arm, then
twist both ends. Tie off the two ends on
the uninjured side.
112
RLS
SA
Em
erg
ency F
irst A
idBandaging
Lower Arm sling
Place bandage with apex to elbow over
patients chest. Bring opposite end over
patients arm and tie off on uninjured side.
Twist remaining bandage at elbow and tuck
in.
113
RLS
SA
Em
erg
ency F
irst A
idBandaging
Head bandage (pirate hat/scarf)
Place long edge of the bandage above the
eyebrows across the forehead. Pull down the
apex to the nape of the neck. Bring the two
long ends to the back criss-cross and tie off.
Tuck in the excess bandage in at the base of
the head.
114
RLS
SA
Em
erg
ency F
irst A
idBandaging
Hand bandage (glove)
Fold over the end of the bandage and place over knee. Place fist on
top of the bandage, bring loose end over the fist. Criss-cross the two
sides over the fist bringing the loose bit off the tie over the criss-cross
again and tie off.
115
RLS
SA
Em
erg
ency F
irst A
idBandaging
Fractures / breaks
Place the patients injured part on a splint, ask patient to assist in
supporting the limb in order to minimise the pain they are
experiencing. Using a long bandage (triangular), tie off above and
below the break leaving injured area exposed.
116
RLS
SA
Em
erg
ency F
irst A
idBandaging
Immobilisation
Place injured limb still in a comfortable position. Place a splint
between the limbs bring uninjured to injured. Using the natural
hollows place bandage in and under the limbs tying off the bandage
on the uninjured side. You can improvise by using patients shoe-
laces, belt, scarf, tie etc if bandages are in short supply.
117
RLS
SA
Em
erg
ency F
irst A
idBandaging
Pressure Immobilisation Technique (P.I.T.)
Note: it is a good idea to mark the bite site on the bandage with a
cross to assist medical personnel to locate where the bite is.
Commencing at the bite
site work your way down
to the fingers, leaving
fingernails exposed and
then work back up the
arm covering two-thirds
of the bandage at each
turn of the bandage.
Continue bandaging all
the way up to the
nearest lymph node.
118
RLS
SA
Em
erg
ency F
irst A
idBandaging
P.E.R. (pressure, elevation, rest)
Place pad on injured area, commence from bottom moving up over
lapping ends of roller bandage. Once completed tie off and elevate