The NBO Scout Training Team

BSA Crew 911

www.scoutcpr.org

Introduction to WFAB…

Course Information…

Certification Requirements

Certification Length

Purpose of Certification

Course Outline

Course Schedule

2

What are three things that have to happen at any accident or injury sceneAn accident or injury has to occur!

“Someone” has to recognize that a accident or injury has occurred!

YOU must decide to ACT!

What is Delayed Care?

3

A Delayed Care Situation is when professional help is more than 30 minutes away… Rural Areas

Construction Sites

The Wilderness

Natural Disasters

Terrorist Acts3A

Some Delayed Care Activities…

Sailing – Mountaineering

Kayaking – Backpacking

Rafting – Hiking

Skiing – Camping

Canoeing – Horse Back Riding

Ballooning - Caving3B

A Delayed Care Situation is also when there is no easy way…

To Call for Help

For emergency personnel to reach the victim

To transport the victim to medical care.

3C

Emergency Action Steps!

4

CHECK… CALL… CARE…

Check The Scene and then the Victim…

Check for Available Resources

Never put yourself in danger!… dead or injured heroes are no help to anyone!

4A

CHECK… CALL… CARE…

Make a plan… carry out the plan.

Get Help!

In a delayed care situation, you have to think, plan then choose.

4B

CHECK… CALL… CARE…Provide Care…

Care FIRST for life-threatening conditions

Monitor the patient

Provide care for the conditions you find…4C

Check the Scene…

Take Charge

List Tasks to be Performed

Followership/Leadership

Approach Safely!

Do emergency moves if needed

5

Check the Patient…

Do Urgent First Aid

Initial Assessment

Protect the Patient

Prioritize Care

Check for Other Injuries

6

Check for Available Resources…

Number of people that can help

Communications

Food Supply - Water Supply

Shelter

Supplies

Transportation 7

Call for Help…

Plan what to do

Get Help!

Calling – Distress Signals

Sending for Help

Leaving a patient alone

Transporting a patient8

Care in a Delayed Care Situation…

Remain Calm

Do No Further Harm!

Monitor the patient

Every 15 minutes at least

Continuously for Serious Injuries

9

Injury Prevention…

10

Cause and Prevention of Injuries…

Reasons why injuries occur

Bad Judgment using equipment

Bad Judgment of ability

Environmental conditions

Equipment Failure10A

Risk and Safety

Risk is a number, a statistic.

Safety is a judgment call.

11

Being Prepared…

Four types of preparation…

Mental preparation

Physical preparation

Group preparation

Material preparation

12

The Ten Essentials…

Map of the area – Compass

Flashlight with batteries & bulb

Extra Food – Extra Clothing

Sunglasses and Sunscreen

Pocketknife – Matches

Candle – First Aid Kit 13

Other important items…

Full Water Bottles

Ground Insulations

Shelter – Emergency Blanket

Singling device – Duct Tape

Special environmental concerns

14

First Aid Kit…

Include plenty of sterile absorptive material

Water tight compartments

Specific to the area

No prescription drugs

First Aid Directions

First Aid Report Forms 15

Observations…

Circumstances

Extent of Injuries

Introduce yourself

Obtain consent

If victim is conscious do a physical exam and SAMPLE

history16

SAMPLE History…

S - Signs/Symptoms

A – Allergies

M – Medications

P – Pertinent Past History

L – Last food or fluid intake

E – Events proceeding17

General Principles of a Physical ExamDo NO FURTHER HARM!

Be complete and systematic

Use direct observation

Compare body parts

One person does the exam

Make multiple observations

Record what you find!18

Observe DOTS…

D – Depressions

O – Obvious deformity

T – Tenderness

S - Swelling

19

Vital Signs…

Pulse – Breathing

Skin Color – Temperature

Pupil Reaction

Level of Consciousness LOC

Sensation

Ability to Move20

Level of Consciousness…

A – Alert

V – Verbal

P – Painful response only

U – Unresponsive

21

Disease Transmission…

22

Route of disease transmission…

Direct – Touching body fluids

Indirect – Touching bandages or contaminated equipment

Airborne – Inhalation

Vector borne – By an animal bite or insect sting

22A

Steps to prevent Disease…

Wear Gloves – Wash you Hands!

Dispose of soiled stuff properly

Cover cuts and scrapes

Avoid touching your eyes

Use a CPR mask

If you are exposed… See your Doctor

23

Wound Care…

24

Steps to control Severe bleeding…Well aimed Direct Pressure

Elevation above the heart

Pressure Bandage

Pressure Point

Do not become discouraged!

24A

Preventing Wound Infection…Wash your hands – use gloves

Wash the wound area

Do not attempt to close large wounds

Cover with a sterile dressing

Change dressing daily

Maintain Immunizations 25

Water Sterilization…

Remove the big stuff

Boil for at least 1 minute

Rinse container with boiling water – and let sit for 1 minute

Pour out rinse water and put the boiled water into the container

Cover container – Let it cool 26

Eye Injuries…

Lodged Objects…

Clean water rinse from nose to ear

Lift object out gently with gauze

Embedded Object

Stabilize object as found

Do not attempt to wash it out

Evacuate on a stretcher27

Head, Neck and Back Injuries

28

Causes of Head Neck and Spinal InjuriesDirect Blow to the spine

Blow to the head

Falls on the buttocks

Falls from higher than victims height

Broken helmet - Driving mishap

Unconsciousness, reason unknown

Lightning strike – Severe Blunt Force

28A

Signs and Symptoms of spinal injury…Change in Consciousness

Problems with breathing or vision

Inability to move a body part

Ongoing Headache – pain/pressure

Nausea and vomiting

Loss of balance

(more)29

Signs and Symptoms of spinal injury…Bleeding of the head neck or back

Burse behind ears or under eyes

Blood or fluid from the ears or nose

Unusual bumps or depressions

Very Slow Pulse

Unequal pupils – Unequal response to light or a moving object

29A

Types of head injuries…

Skull Fracture

Brain Injury:

Concussion

Bleeding within the skull

30

First Aid Goals – Head Injuries…Prevent further injury

Assess seriousness

Watch closely for changes

Patient may walk out IF…

Injuries appear minor

Patient is able to walk steadily

The terrain is safe31

First Aid Goals – Spinal Injuries…

Prevent further injury

Assess the cause and seriousness

Monitor Vital Signs

Evacuate Professionally as soon as possible

32

Chest Injuries…

Two common types:

Penetrating

Rib Fractures

33

Chest Injuries First Aid Goals…

Assess seriousness

Prevent further injury

Help increase ease of breathing

Watch closely for changes

Evacuate Immediately33A

Abdominal Injuries…Open Injury

Possible protruding intestines

Care for as other wounds except use an occlusive dressing on

organs

Closed Injury

Bruising, rigidity or tenderness

Care by monitoring closely, treat for shock, evacuate 34

Extremity Injuries… Fractures

Open or Closed

Pain and reluctance to use

Possible deformity

Tenderness

Swelling, instability and bruising

First Aid… Immobilize to reduce pain and prevent further injury

35

Extremity Injuries… DislocationsOccur at joints

Pain

Loss of ability to use joint

Deformity, limb looks shorter

Tenderness and Swelling

Joint seems locked in place

First Aid… Immobilize in place36

Extremity Injuries… Sprains & StrainsStrain – over stretched muscle

Sprain – torn ligament

Pain, aggravated by motion

Localized tenderness and swelling

Difficult to distinguish from fracture

First Aid… RICE and Immobilize 37

Extremity Injuries… First Aid Goals

Assess seriousness

Prevent further injury

RICE…

R – REST

I – Ice or cold pack

C – Compression

E - Elevation38

Splinting

39

Splinting… General Principles

Determine location of injury and assess circulation, sensation and movement.

If an open injury, stop bleeding. Rinse bone ends with large amounts of sterile water

If severely bent and NOT AT A JOINT, firmly by gently straighten limb

Remove rings, watches, etc.39A

Splinting… General Principles (cont)Prepare a splint… pad well

Tie splint on securely

Neatness counts

Observe area below splint for feeling, warmth and color at least once every 30 minutes

If available, apply RICE

40

Burns

41

Causes of Burns

Heat

Chemicals

Electricity

Radiation and Explosions

41A

Types of burns…

Superficial

Partial Thickness

Full Thickness

41B

First Aid Goals… Burns

Rule of 9’s – Prevent further injury

Treatment of thermal burns:

Cool the Burn

Wash with sterile water

Remove jewelry

Apply antibiotic ointment

Elevate, treat for shock42

Shock

43

Shock… Early Stages

Patient is aware, restless, anxious

Skin is pale, cool, clammy

Heart and respiration rate is rapid

Patient is thirsty or nauseous

43A

Shock… Later Stages

Patient is lethargic, apathetic or unconscious

Skin is gray, cool and damp

Heart rate is weak and irregular

Respiration is very low or shallow and irregular

Eyes are dull and dilated

44

Shock… First Aid Goals

Ensure patient is breathing

Stop any obvious causes

Maintain Body Temperature

Treat patient gently

Replace lost fluids

Raise Legs is injury allows

Monitor continuously - Evacuate45

Shock… Delayed Care SituationsIf patient will be able to get to a hospital in a few hours, do NOT give food or fluids

If longer, give sips fluid at a rate of 4 oz to an adult over a 20 minute period

For a child, 1/2 the amount

Do not give fluids if unconscious or if there is a head or abdominal injury 46

HYPOTHERMIA

47

Mild Hypothermia

Complains of cold

Uncontrolled shivering

Decreased fine motor coordination

Disagreeable or apathetic

Core Temperature still above 90 Deg F

First aid – END Exposure!47A

Moderate to severe HypothermiaIncreasing lethargy and confusion

May or may not be shivering

Slurred speech

Stiff, stumbling walk

Unresponsive or unconscious

Pulse and respiration may be undetectable

Core Temperature below 90 Deg F48

First Aid for Moderate to severe Hypothermia

End Exposure

Replace wet clothing

Rewarm slowly – body core first

Use Hypothermia Wrap if possible

49

Heat Related Injury

50

Effects of excessive heat

Heat Cramps and fainting:

Rest in a cool place

Heat Exhaustion:

Skin is pale and damp

Nausea, weakness, dizziness, thirst, headache

Cool, fluids in small sips, recovery may take 24 hours

51

Effects of excessive heat-Heat StrokeLifethreatening condition

Exertional heat stroke

Classic heat stroke

Reduce body temperature

Cool with wet cloths

Monitor for rebound

If Conscious, give small sips of water

Evacuate by stretcher 51A

Sudden Illness

52

Sudden Illness…

Difficulty Breathing

Chest Pain

Unconsciousness

Allergic Reactions

Seizures

Diabetic Emergency52A

Snake bites… Pit Vipers, Coral Snakes

First Aid:

Keep patient calm

Clean the wound

Immobilize limb below heart

Travel slowly – Rest frequently

DO NOT cut and suck, use a tourniquet, cold or electrical shock

53

Insect stings and bites

generally localized

Stings to inside of mouth or nose may cause breathing problems

Anaphylactic shock is lifethreatening

Ask patient if they have had a reaction before

Remove stinger by scraping

Apply cold for swelling54

Spider bites

Two common spiders in the US

Brown Recluse

Black Widow

Seek medical help if pain is severe or if there is breathing difficulty

55

Tick bites

Can carry disease

Remove ticks by:

Grasp tick close to skin

Pull out with steady pressure

Clean and disinfect bite and hands

DO NOT use petroleum jelly or burn the tick 56

Other Miseries

Blisters

Dental Emergencies

Diarrhea from Contaminated water

Fainting

Headache

Disease from wild animals

Lightning 57

Putting it all together!

58

Carrying out the plan…

The action portion of the plan takes place after:

All first aid has been given

The plan has been formulated

The equipment assessed

The party is ready

Patient Monitoring

Altering the plan 58A

The NBO Scout Training Team

BSA Crew 911

www.scoutcpr.org

Questions?