Basic first aid


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Basic first aid

  1. 1. Basic First Aid Northwest Fire District Feb 2010
  2. 2. Discussion Objectives Basic Airway Management and CPR How to use O2 Chest Pain Management Choking Management Shock Management Eye Injuries Impales Objects
  3. 3. Objectives Cont… Bleeding Control Burn Management Heat Related Emergencies Cold Related Emergencies CO Poisoning
  4. 4. Basic Airway Management and CPR Basic airway anatomy  Upper airway  Tongue  Oropharynx  Nasopharynx  Laryngopharynx  Nares  Mouth  Epiglottis  Larynx
  5. 5. Basic Airway Management and CPR  Lower airway anatomy  Vocal Cords  Trachea  Lungs  Bronchi  Bronchioles  Alveoli  Diaphragm
  6. 6. Basic Airway Management and CPR Level of consciousness (LOC) and ABCD’s  Are they conscious and maintaining their own airway?  Yes – support ABC’s  No – perform jaw thrust for trauma victim or head tilt chin lift for non trauma victim
  7. 7. Basic Airway Management and CPR  Common causes of airway obstruction  Tongue (due to unconsciousness)  Soft tissue swelling  Blood or vomit  Direct injury  Teeth
  8. 8. Basic Airway Management and CPR  Common sounds of an obstructed airway include:  Snoring – Due to obstruction of the upper airway by the tongue  Gurgling – Due to obstruction of the upper airway by liquids  Wheezing – Narrowing of the lower airways  Silent – Complete airway obstruction
  9. 9. Basic Airway Management and CPR  Are they breathing? Look, listen, and feel!  Yes – Is it adequate?  Use a non-rebreather at 15 LPM O2  No to either question – Assist  Use a BVM at 15 LPM O2  Provide 2 rescue breaths before checking pulse
  10. 10. Basic Airway Management and CPR Is there a pulse?  Yes – Continue to support respirations and reassess for pulse every 2 minutes  No – Perform 30 chest compressions after every 2 breaths
  11. 11. Basic Airway Management and CPR  Attach AED as soon at it arrives at the scene (after one round of CPR – Child under age 8 or 55 lbs)  Follow AED commands  After delivery of shock (if indicated) immediately resume CPR  Do NOT check for a pulse until after 2 minutes of CPR  Only 1 shock will be deliverd  Minimize interruptions in CPR
  12. 12. Basic Airway Management and CPR  Insert airway adjunct (oral airway) if no gag reflex is present  Measure from corner of mouth to tip of ear  Insert upside down until it stops  Rotate 180 degrees and continue to insert until the adjunct rests against the teeth
  13. 13. Basic Airway Management and CPR  Cricoid pressure (Sellick’s Maneuver)  Gentle pressure  Releasing pressure could precipitate vomiting  Reduces gastric inflation by closing the esophagus and bringing the trachea in-line  BURP method (Backward Upward Rightward Pressure)  Similar to criciod pressure
  14. 14. Basic Airway Management and CPR  Single rescuer adult and child CPR ages 1 and up get 30:2 compression to ventilation ratio  Two rescuer CPR age under 8 gets 15:2 compression to ventilation ratio  Child breaths every 2-3 seconds  Adult breaths every 4-5 seconds  Compression rate of 100 per minute  Bee Gees “Stayin’ Alive”  Queen “Another One Bites the Dust”
  15. 15. How to Use O2 Open tank Select O2 delivery device Set flow rate to 15 LPM Connect tubing to the tank Fill oxygen reservoir
  16. 16. Chest Pain Management REST!!!! Apply O2 via non-rebreather Request EMS Prepare an AED in case of sudden cardiac arrest Dispatcher may request you to administer 324 mg of Aspirin if the patient has no allergies
  17. 17. Chest Pain Management Signs and symptoms of a heart attack (Myocardial Infarct)  Chest discomfort, pressure, squeezing, fullness or pain  Discomfort in other areas of the upper body such as pain or discomfort in one or both arms, the back, neck, jaw or stomach  Shortness of breath may occur with or without chest discomfort  Other signs may include breaking out in a cold sweat, nausea or lightheadedness
  18. 18. Choking Management Heimlich maneuver until person becomes unresponsive or limp Place supine on hard surface Look in mouth for obstruction Blind finger sweep for adults only Remove object if it can be seen Give rescue breath  If it does not go in reposition head and try again  If it does not go in continue on to next step
  19. 19. Choking Management While still supine on hard surface, give 5 abdominal thrusts adult/child  Infant use 5 back blows and 5 chest thrusts alternately  Pregnant or obese – Use chest thrusts instead of Heimlich / abdominal thrusts Repeat steps until rescue breaths make chest rise Once chest rise is achieved, check pulse  If pulse present – Rescue breathing only  If absent – CPR
  20. 20. Shock Management Signs of shock  Fast, weak pulse (rate 110 per minute or greater)  Low blood pressure (hypotension); systolic less than 90 mmHg.  Pale  Sweaty  Fast breathing (respirations 30 per minute or greater)  Anxiety, confusion, or unconsciousness (diminished mental state)
  21. 21. Shock Management  Elevate legs  Keep warm!!!
  22. 22. Eye Injuries Substance in eye  Irrigate with sterile saline solution or sterile water Blunt injuries  Cover both eyes
  23. 23. Impaled Objects Do not remove object unless it interferes with CPR or airway Stabilize in place with large bulky dressings
  24. 24. Bleeding Control Types of bleeding  Arterial bleeding  Bright red in color  Difficult to control  Profuse and spurting due to high pressure from the heart as it contracts  Venous bleeding  dark red/maroon in color  Usually easy to control because the veins are under low pressure  Venous bleeding in the neck can suck in air an air embolism
  25. 25. Bleeding Control Types of bleeding  Capillary bleeding  Slow and oozing due to their small size and low pressure  Easy to control in most cases.
  26. 26. Bleeding Control Elevate extremity Add gauze and apply pressure dressing Use tourniquet as last resort  Once applied do not remove  Extremity will most likely need to be amputated due to complete stoppage of blood flow
  27. 27. Burn Management Thermal Burns - Burns are the third leading cause of accidental death in the United States  Superficial burns (first degree)  Involve only the epidermal layer of skin  They are painful, dry, red, and blanch with pressure  Such injuries generally heal in three to six days without scarring
  28. 28. Burn Management Thermal Burns  Partial-thickness (second degree)  Involve the epidermis and portions of the dermis  Painful, red, weeping, usually form blisters, and blanch with pressure  Scarring is possible
  29. 29. Burn Management Thermal Burns  Full-thickness burns (third degree)  Extend through and destroy the dermis  Usually painless  Skin appearance varies from waxy white to leathery gray, to charred and black  The skin is dry and inelastic, and does not blanch with pressure  Scarring is severe with contractures; spontaneous healing is not possible.
  30. 30. Burn Management Thermal Burns  Fourth degree burns  Life-threatening injuries that extend through the skin into underlying tissues, such as fascia, muscle, or bone
  31. 31. Burn Management Thermal Burns  Management  Remove from danger and stop the burning process  Apply sterile burn sheet, or dry sterile gauze if no burn sheet available  Consider inhalation and airway burns  Apply high flow O2 if indicated
  32. 32. Burn Management Chemical Burns  Brush off excess chemical  Irrigate with sterile water (if chemical does not react with water) until burning process is stopped  Cover with sterile burn sheet  If chemical reacts with water call HAZ-MAT team, obtain MSDS, or call poison control  Potassium  Sodium
  33. 33. Burn Management Electrical Burns (mostly internal injuries)  Stop the burning process  Neutralize the heat source  Remove smoldering clothing  Prepare AED and anticipate cardiac arrest  Apply sterile burn sheet to burns
  34. 34. Heat Related Emergencies Heat Cramps  Painful, brief muscle cramps that occur during exercise or work in a hot environment  Remove from environment and hydrate
  35. 35. Heat Related Emergencies Heat Exhaustion Often pale with cool, moist skin, sweating profusely, muscle cramps or pains, feels faint or dizzy may complain of headache, weakness, thirst, and nausea. Core (rectal) temperature elevated (usually more than 100F) and the pulse rate is increased Rest in a cool, shaded area Give cool fluids such as water or sports drinks Loosen or remove clothing Apply cool water to skin Do not use an alcohol rub
  36. 36. Heat Related Emergencies Heat Stroke  Unconscious or markedly abnormal mental status (dizziness, confusion, hallucinations, or coma)  Flushed, hot, and dry skin  Rectal (core) temperature of 105F or more  Call EMS immediately  Move the person to a cooler environment, or place him or her in a cool bath of water, or moisten the skin with lukewarm water and use a fan to blow cool air across the skin  Give cool beverages by mouth only if the person has a normal mental state and can tolerate it
  37. 37. Cold Related Emergencies Frostbite – occurs when tissues freeze  Superficial frostbite  May experience burning, numbness, tingling, itching, or cold sensations in the affected areas  Deep frostbite  Swelling and blood-filled blisters are noted over white or yellowish skin that looks waxy and turns a purplish blue as it re-warms and may even appear blackened and dead  Keep the affected part elevated in order to reduce swelling  Move to a warm area to prevent further heat loss  Remove all constrictive jewelry and clothes because they may further block blood flow  Give the person warm fluids to drink
  38. 38. Cold Related Emergencies  Deep frostbite  Apply a dry, sterile bandage, placing cotton between any involved fingers or toes (to prevent rubbing), and take the person to a medical facility as soon as possible  Never re-warm an affected area if there is any chance it may freeze again  Do not rub the frozen area, friction created by this technique will only cause further tissue damage
  39. 39. Cold Related Emergencies Hypothermia – Core body temperature of less than 95F  Below 95F  Shivering is seen, pulse, breathing rate, and blood pressure all decrease, may experience some clumsiness, apathy, confusion, and slurred speech  Below 89.9F  Shivering stops, victim may be in a stupor, heart rhythm may become irregular  Below 82.4F  Reflexes are lost and cardiac output continues to fall, risk of dangerously irregular heart rhythms increases, and brain activity is seriously slowed, pupils are dilated, and the victim appears comatose or dead
  40. 40. Cold Related Emergencies Hypothermia treatment  Check ABC’s  Because the victim’s heartbeat may be very weak and slow, the pulse check should ideally be continued for at least 1 minute before beginning CPR  Rough handling of these victims may cause deadly heart rhythms  Remove all wet clothes and move the person inside  The victim should be given warm fluids if he or she is able to drink  Cover the person’s body with blankets and aluminum-coated foils, and place the victim in a sleeping bag  Avoid actively heating the victim with outside sources of heat such as radiators or hot water baths  Strenuous muscle exertion should be avoided
  41. 41. CO Poisoning Carbon monoxide (sometimes referred to as CO) is a colorless, odorless gas produced by burning material containing carbon  Carbon monoxide binds to hemoglobin several hundred times more strongly than oxygen  Carbon monoxide is the leading cause of accidental poisoning deaths in America  Concentrations as little as 0.04% (400 parts per million) carbon monoxide in the air can be fatal
  42. 42. CO Poisoning Signs and symptoms of CO poisoning  Headache  Hallucinations  Dizziness  Nausea or vomiting  Flu-like symptoms  Chest pain  Shortness of breath on exertion  Seizure  Flushed skin  Altered mentation
  43. 43. CO Poisoning Treatment  Move all family members and pets to fresh air away from the source of carbon monoxide (CO)  Apply high flow O2  Treatment in hyperbaric chamber may be necessary  Monitor for cardiac arrest
  44. 44. CO Poisoning Effects of CO related to PPM  35 ppm (0.0035%) Headache and dizziness within six to eight hours of constant exposure  100 ppm (0.01%) Slight headache in two to three hours  200 ppm (0.02%) Slight headache within two to three hours  400 ppm (0.04%) Frontal headache within one to two hours  800 ppm (0.08%) Dizziness, nausea, and convulsions within 45 minutes, Insensible within two hours  1,600 ppm (0.16%) Headache, dizziness, and nausea within 20 minutes, death in less than two hours  3,200 ppm (0.32%) Headache, dizziness and nausea in five to ten minutes, death within 30 minutes  6,400 ppm (0.64%) Headache and dizziness in one to two minutes, death in less than 20 minutes.1  12,800 ppm (1.28%) Unconsciousness after 2-3 breaths, death in less than three minutes.
  45. 45. Questions??????