Fa (e) lect 1 (9 aug 2010  4 full days) n
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Fa (e) lect 1 (9 aug 2010 4 full days) n

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    Fa (e) lect 1 (9 aug 2010  4 full days) n Fa (e) lect 1 (9 aug 2010 4 full days) n Presentation Transcript

    • WELCOME Public First Aid Certificate Course (English) PCFA / 10 / 11
    • Important to know
      • Course Ref. No. : PCFA / 10 / 11 (English)
      • Venue : Room 403, St. John Tower,
      • 2 MacDonnell Road, H.K.
      Date Morning Afternoon Total Hours (30 hours) 9.8.10 (Mon) 0900- 1300 hours 1400 – 1730 hours 7.5 10.8.10 (Tue) 1400 – 1700 hours 7 11.8.10 (Wed) 1400 – 1800 hours 8 12.8.10 (Thur) 1400 – 1730 hours 7.5
    • Important to know
      • Examination :
      • Date :
      • Time : 7:30 p.m. - 10:30 p.m.
      • Venue : /F., St. John Tower,
      • 2 MacDonnell Rd., H.K.
    • Examination
      • Eligible to sit for exam. :
      •  at least 80% (24 hours) attendance in class
      • in class
      Parts Description Time Required 1 Written examination 30 items Multiple-Choice Questions 30 min. 2 Bandaging Bleeding wound and fracture (draw-slots) About 20 min. 3 Cardio-Pulmonary Resuscitation (CPR) Adult CPR About 10 minutes
    • Preparations for Examination Parts of Exam. (Time) Preparations 1 Written examination (30 min.) Stationery : 2 blackball pens, correction ink HKID card 2 Bandaging (15-20 min.) Roller bandage : 2” and 3” X 2 each size Bandage clips X 4 no. Gauzes : 6 pieces Triangular bandages : at least 6 pcs. Pads / towels : large and small X 2 each 3 Cardio-pulmonary Resuscitation (about 10 min.) Face shield (provided by HKSJ)
    • Thank for your cooperation …
      • Participate actively in class activities and choose one classmate of same sex as a partner to practise bandaging if possible.
      • Keep the classroom clean
      • without eating or drinking in class.
      • 3. Change your mobile phone to vibratory mode and avoid engaging in mobile phone conversation when lecturing is in progress.
      • 4. Not to take video or photos in class ; buy one DVD ($15)
      • 5. Bring and use your own bandage pack .
    • Thank for your cooperation …
      • 6. Do not attend lecture(s) if you were pregnant or
      • had fever, persistent cough, skin infection and/or running nose .
      • Proper handwashing is advised.
      • 7. Buy and use a face shield during the practical session of CPR.
      • 8. Wear a shirt / T-shirt with a collar and
      • buttons to protect own privacy
      • during the practical session of CPR.
      • 9. Observe any adverse changes of weather
      • a. H.K. tropical cyclone warning signals and
      • b. Rainstorm signals : amber, red, black
      • For enquiries, please dial 2539 8027
      • Lecture One
      • Principles of
      Mr. W.Y. TANG
    • Learning Objectives
      • Upon completion of this session, participants will
      • be able to :
      • Define first aid.
      • List 3 aims of first aid.
      • List 4 main responsibilities of a first aider.
      • Explain “DRABC”.
      • Define signs and symptoms and give 4 examples for each.
      • Provide psychological support to a casualty.
      • Differentiate between primary survey and secondary survey.
    • Learning Objectives
      • 8. Arrange an unconscious casualty in recovery position.
      • 9. List 2 advantages of recovery position.
      • 10. List 2 contraindications of recovery position.
      • 11. Use a triangular bandage to:
      • - tie and untie a reef knot
      • - make a ring pad
      • - apply
      • a. an arm sling
      • b. an elevation sling
      • 12. Check circulation of the fingers after applying a sling.
      • 13. Use improvised slings
      • What ?
      • Initial assistance or
      • treatment
      • Whom?
      • a. The injured person
      • b. suddenly ill person
      • When?
      • Before the arrival of
      • ambulance or medical aid
      • How?
      • Make use of materials and persons available on the spot
    • 3 Aims of First Aid
      • To save life
      • To prevent
      • the condition
      • from getting worse
      • To promote recovery
    • First Aiders
      • Being qualified
      • . Holder of a valid
      • certificate from …
      • . Competence : ASK
      • . Reassessed
      • every 3 years
      • Negligence – breach of duty of care, foreseeable,
      • causation, harm/damage
      • Knowledge
      • Self : abilities, limitations (experiences), vaccination
      • First aid, PPE, leadership, cooperation, responsibility,
      • stress coping, decision making
      • Affection Skills
      • Emotion, sensitivity, sympathy Trained -
      • Empathy, considerate, supportive Act quickly , gently
      • Trust and respect others Responsive
      First Aiders
    • 4 Main Responsibilities of A First Aider
      • Assessment (Danger)
      • Diagnosis (Response, ABC, Condition)
      • First Aid
      • (Use Personal Protective Equipment)
      • Disposal, Record and Report
    • DO FIRST 1. Physical Care : D anger R esponse A irway B reathing C irculation H aemorrhage S hock F racture Life- threatening 999
    • 2. Psychological Care Casualty First Aider Upset, tearful, angry, frightened, distressed  Psychological support  Help to regain confidence  Early referral Positive feeling Negative feeling  Coping skills  Share & consult others
    • 1. Safe Environment 2. Nature of Accident / Illness 3.Casualty 4. Self-Competence Assessment
    • Assessment
      • Safe environment
      • - Safety : casualty, first aider and onlookers
      • - Danger : actual, potential
      • e.g. fire, poisoning, electrocution,
      • machine, drowning etc.
      • - In traffic accident :
      • . Wear high-visibility jacket
      • . Warning triangle : > 45m away
      • . Keep hazard lighting flashing
      • . Aware of slippery and oily road surface
      • . Never cross a motorway to attend a casualty
      19.4.2010 周志鴻攝
    • Assessment
      • 2. Nature of accident or
      • state of physical / mental illness
    • Assessment
      • 3. Casualty - number, age and gender
      • . special attention to :
      • a. pregnant women
      • b. self-harm (suicide) person
      • c. dying
      • d. badly injured or ill
      • 4. Self-Competence
      • - if alone, not approach
      • the scene, dial 999 or 992 (fax)
      • * Triage done by the emergency services
      • Approaching
      • The Casualty
      • Approach
      •  Face the casualty
      •  Build and maintain trust
      • - self-identification
      • - greet by name
      • - crouch or kneel down
      • - talk with the parents before touching the child
      • - explain and reassure
      • - get consent; inform actions to be taken
      • - treat with dignity and respect wishes
      • - allow position of comfort
      Approaching The Casualty
    • Approaching The Casualty
      • Communication skills:
      • - V oice : calm and confident; no shout
      • - S peed : not too fast
      • - Language : same and simple,
      • interpreter if needed
      • - Instructions : simple and short
      • - Eye contact , not stare
    • Approaching The Casualty
      •  Communication skills (cont’d):
      • - Use affirming nods and “mmms”
      • - Use simple hand gestures and
      • movements
      • - Touch the shoulder, arm or hold hand
      • - Not interrupt the casualty
      • - Answer questions honestly
      • - Summarize the given information to
      • show understanding
    • Approaching The Casualty
      • If the casualty refuses help :
      • - The casualty’s right
      • - Not argue or disagree; explain actions
      • intended
      • - Dial 999 and report facts
      • - Stay at a safe distance and observe until
      • allowed
      NO
      • Using By-standers
    • Using By-standers
      • 1. Attitude
      • - calm, firm and gentle manner
      • 2. Seek help
      • - invite by-standers to :
      •  Phone - dial 999 for ambulance, inform
      • tel. no., location, type and severity of
      • emergency, casualties, hazards;
      • emphasize to return & report (P.21-23)
      •  first aid
    • Using By-standers
      • Seek help (cont’d)
      • - invite by-standers to :
      •  get first aid equipment
      •  provide physical care, psychological support
      •  make the area safe
      •  maintain the casualty’s privacy
      •  not let people crowd the scene
      •  transport the casualty
      • Prevention of
      • Cross Infection
    • Prevention of Cross Infection
      • First aider
      • i. Before work
      • . i.e. inspect the wound
      • a. Wash and dry hands properly or use alcohol gel ( P.17)
      • b. Inspect own hands for a cut or graze
      • c. Cover open wound
      • with water-proof dressings
    • Prevention of Cross Infection
      • First aider
      • d. Wear personal protective equipment (PPE)
      • e.g. gloves (P.18)
      • . latex-free or nitrile (blue or purple)
      • to prevent from acquiring
      • blood-borne diseases e.g. AIDS, hepatitis B or C,
      • syphilis, malaria
      • . mask
      • . face shield
      • . plastic glasses
      • . plastic apron etc.
    • Prevention of Cross Infection
      • First aider (cont’d)
      • ii. During wok :
      • . Do not touch :
      • a. the bleeding wound with bare hands
      • b. clean or sterile dressing that covers the wound
      • . Do not breathe, cough, sneeze over a wound
      • . Ask the casualty to help oneself
      • e.g. apply direct pressure on the dressing
      • . Use a clean plastic bag to cover hands if no gloves
      • available
      • . Change gloves after attending one casualty
    • Prevention of Cross Infection
      • First aider
      • iii. After work :
      • . Remove gloves – turn it inside out
      • . Dispose used gloves, soiled dressings, waste
      • safely –> plastic or biohazard bag ; use yellow
      • sharps container for sharps
      • . Use soap and water to wash hands or use
      • alcohol gel to rub hands with attention to
      • palms, dorsums, fingers, thumbs, nails and wrists
      • Diagnosis
    • Diagnosis
      • I. Priority
      • - more than one casualty :
      • . Attend unconscious or badly injured casualty
      • first
      • - treat casualties in position found unless in danger
      • - For driver :
      • support the head and neck
    • Diagnosis Primary Survey Secondary Survey DRABC HSF CPR
      • History
      • Signs and Symptoms
      • Physical exam.
      • External clues
    • Primary Survey
      • Primary survey
      • - must be done before leaving a casualty
      • . level of consciousness (R)
      • AVPU code
      • . airway (A)
      • . breathing (B)
      • . circulation (C )
      • * No breathing and pulse :
      • initiate cardio-pulmonary
      • resuscitation (CPR)
    • The Falling Back of the Tongue Risk of Unconsciousness Blocked Airway (A)
    • Head Tilt Chin Lift To Open Airway
    • Breathing (B)
      • Check breathing : look, listen, feel
      • Note : rate, depth, ease, noise
      • Chest wall movement – rise and fall
      •  Normal rate of breathing :
      • . Adult : 12 - 16 breaths/min.
      • (average 16 breaths/min. )
      • . Children : 20 - 30 breaths/min.
      • . Baby : 20 – 30 breaths/min.
      •  Depth - shallow or deep
      •  Easiness, breathing sounds
      • ** No spontaneous breathing :
      • give rescue breaths
      Face Shield
    • Circulation (C)
      • 1.Check pulse
      • rate, strength (strong / weak), rhythm (regularity), tension
      • a. Adult : (P.53)
      • . site : carotid pulse, brachial pulse, radial pulse, femoral pulse
      • . rate : normal pulse rate : 60 – 80 beats / min.
      • b. Child : similar to adult
      • c. Baby : brachial pulse, rate is much faster,
      • about 100 – 140 beats / min.
      • 2. Signs of circulation : any breathing, coughing, body/limbs
      • movement
      • If 1 & 2 were absent, do external cardiac compression
    • Secondary Survey
      • 1. History – “AMPLE”
      • - a llergy
      • - m edication
      • - p revious medical condition
      • - l ast meal
      • - e vent history
      • Information from the casualty,
      • eye-witness, relatives
    • Secondary Survey
      • 2. Signs :
      • - Look : bleeding
      • Feel : cold/hot
      • Listen : wheeze, stridor
      • Smell : alcohol, urine,
      • faeces, acetone
      • 3. Symptoms
      • - sensations described
      • e.g. nausea, pain, dizzy,
      • thirst, cold (P.51)
    • Secondary Survey
      • 4. Physical examination :
      • Before :
      • - consent of the casualty
      • During :
      • - wear gloves
      • - head-to-toe survey (P.49-51)
      • - expose body parts & maintain privacy
      • and warmth
      • - remove / cut garment along the seams carefully
      • - do it systematically
      • - look, listen, feel, smell
      • - use both hands
      • - move with minimal disturbance
      Cut or remove clothing P.232
    • Secondary Survey
      • 4. Physical examination (cont’d)
      • During:
      • - compare one side with the other
      • - examine the painful part last
      • - check for swelling, tenderness, bleeding or
      • abnormalities
      • - not remove helmet if untrained to do so (P.233)
      • After : record, check comfort
    • Head-to-Toe Survey
      • Head 8. Shoulders and clavicles
      • Ears 9. Chest
      • Eyes 10. Abdomen
      • Nose 11. Hip and pelvis
      • Mouth 12. Lower legs
      • Face 13. Feet
      • Neck 14. Forearm, hands, spine
    • Secondary Survey (cont’d)
      • - External clues :
      • a. Medical follow-up
      • card
      • b. Warning bracelet
      • e.g. epilepsy, diabetic,
      • allergy
      • c. Drugs
      • e.g. steroid, warfarin, insulin,
      • aspirin, TNG, phenytoin,
      • reliever inhaler for asthma
      • d. Syringes
      • e. Needle marks, sweets
    • Examples of Drugs Kept by a Casualty Always ask a bystander to act as witness when searching the casualty’s bag for clues. Medicines e.g. glyceryl trinitrate for angina and phenytoin for epilepsy A warning bracelet states medical condition and may give a phone no. for information about the casualty’s medical history. Auto-injector Contains epinephrine (adrenaline), for people at risk of anaphylactic shock.
    • Warning Card I am a Diabetic If you find me confused with strange behaviour, it may be due to disturbed blood sugar level. If I can drink, please give me a cup of sugary drink. If I remains confused after 10 – 15 minutes, please send me to hospital immediately or inform my relatives by phone. If I cannot swallow, or become comatose, please dial 999 and send me to hospital without delay or inform my relatives. Thank you very much for your help. Name : Tel. : Address : s Follow up hospital : Dr. : Next of Kin : Tel. : Oral drug : Dose : Frequency & Time : Insulin & Dose : Frequency & Time : Other :
      • First Aid
    • First Aid
      • Dial 999 before starting first aid
      • - use resources available
      • - not move the casualty unnecessarily
      • - give first aid on the spot
      • 2. Injuries
      • - bleeding wound
      • . control bleeding - dressings
      • and bandage with elevation
      • - fracture, sprain, strain
      • . immobilization
      • . rest, ice, compression/comfortable
      • support and elevation (R.I.C.E.)
      Bruise
    • First Aid
      • 3. Illness
      • - Stroke / shock : A,B,C
      • - Coma : recovery position
      • - Heart attack : A,B,C
      • - Hyper/hypothermia : lower / increase temp.
      • - Epilepsy : protect and observe
      • 4. Cardiac / respiratory arrest - CPR
    • First Aid
      • Self-administered drugs - ensure :
      • 1. Appropriate to the condition
      • 2. Not out of date
      • 3. Taken as doctor’s advised
      • 4. Precautions strictly followed
      • 5. Recommended dose
      • 6. Record – name, date, time, method and frequency
      • Never buy, borrow, give drug or antidotes by first aiders
      • Never give aspirin for a person <16 years old – risk of Reye’s syndrome (P.24) – rare, acute varicella or viral URI in childhood, may affect GIT, the liver and the brain, fatal
      • Disposal
    • Disposal
      • While waiting for ambulance after first aid:
      • Do not move the casualty ; immobilize the fractured or badly injured part before moving
      • Stay with the casualty; obtain more information
      • e.g. names of next of kin, add., tel. no. etc.
      • Give psychological support – casualty / relatives
      • Answer questions – not vague, misleading or
      • exaggerate answers
      • Provide shelter
    • Disposal
      • While waiting for ambulance :
      • Allow any position of comfort
      • No eating or drinking , moisten lips instead but allow self-administer drugs if needed
      • No smoking
      • Check vital signs (temp., pulse, resp., level of
      • consciousness, every 10 minutes; record (timed), compare,
      • and analyze findings and monitor the condition
      • - Keep warm
      • Care of personal belongings and clothing etc.
      • Identify the weapon / evidence needed by the Police
      • Others
      • Proper disposal of all waste safely esp. sharp objects
    • Keeping Notes
      • Casualty’s name, age, contact details
      • History of the incident or medical history
      • Brief description of any injuries
      • Any unusual / change behaviour
      • Any treatment (includes drugs, time) given
      • Vital signs (timed) – LOC, breathing rate, pulse
      • First aider’s contact details
      • Collected information : confidential
      • Give it to medical staff / nurses
      • Transportation
    • Transport and Transfer
      • Disposal of a casualty
      • Home if no unconsciousness
      • Private practitioner
      • Family doctor
      • Clinic
      • Ambulance to hospital
      • . report, assistance
      • Methods of Transportation
      • By one person / two persons
      • Equipment : wheel chair / chair , blanket, stretcher
      • Recovery Position
    • Recovery Position
      • Indications – a casualty :
      • loss of consciousness plus
      • . without fracture of limbs, the neck and
      • spine
      • . with spontaneous breathing and heart
      • beat (pulse)
    • Recovery Position
      • Contraindications / Do not move the casualty if
      • Fracture of limbs, the neck and/or spine
      • No assistants nearby if fracture case
      • No vital signs
    • Recovery Position
      • Advantages
      • Prevent falling back of the tongue
      • Allow free drainage of vomitus, blood or oral secretions
      • Prevent aspiration of vomitus / secretions
    • Recovery Position
      • Method
      • Kneel beside the casualty
      • Remove spectacles, hair clips,
      • bulky objects in the pockets
      • Straighten both legs
      • Bend the elbow that is nearest to you at right angle to the casualty’s body with the palm facing upwards
    • Recovery Position
      • Method (Cont’d)
      • bring the opposite arm across the casualty’s chest ; keep the back of the hand nearest to his face on your side
      • Grasp the far leg just above the knee and pull it up, keeping the foot flat on the ground
      • Steady the casualty’s hand pressed against his cheek, pull on the far leg, roll the casualty towards your side
    • Recovery Position
      • Method (Cont’d)
      • Tilt the head back to keep the airway open
      • Adjust the upper leg : bend the hip and knee at right angles
      • Turn the casualty to the opposite side if no other injuries if lying in such position for over 30 minutes (P.65)
    • Recovery Position
      • Observation
      • Check breathing, pulse, level of consciousness (LOC) every 10 minutes
      • Maintain the airway patent
      • Check the upper arm which should not be pressing on the lower arm
    • Summary
      • Definition of first aid
      • 3 aims of first aid
      • 4 main responsibilities of a first aider
      • “ DRABC”
      • Signs and symptoms with examples
      • Psychological need of a casualty
      • 7. Primary and secondary survey
      • Recovery position
      • 2 advantages of recovery position
      • 10. 2 contraindications of recovery position
      • Demonstration & Practice
      • Recovery Position
      • Triangular bandage
      • Slings
    • Recovery Position (P.64-65) Bend elbow Hand support the face
    • Triangular Bandage
      • Size : 1 sq. meter (m), cut diagonally
      • Parts : point (apex), ends, 2 sides, base
      • Use : whole piece of cloth as slings, secure
      • dressing or immobilize limbs
      • . broad-fold bandage – 2 folds
      • . narrow-fold bandage – 3 folds
    • Triangular Bandage Point Side End Side End Base End End Base Point broad-fold bandage (2) -> narrow-fold bandage (3) 1 2
    • Triangular Bandage
      • Reef knot
      • - ‘left cross right , right cross left’
      • flat surface at its back, U-shape, easy to untie, safe, not slip, comfortable
      • Rules for application
      • - Must stand in front of the casualty and observe response
      • Explain and reassure the casualty before application
      • Support the injured part
      • Expose finger nails for inspection
      • Pad reef knot above the clavicle , not acting on bone
      • Check circulation every 10 minutes
    • Triangular Bandage Uses Whole piece Arm /elevation sling, ring pad, the head Broad-fold bandage Immobilize fracture - clavicle, upper arm, forearm, wrist (elbow can bend) , hand, fingers, flail chest - upper arm, elbow or forearm (elbow cannot bend) - pelvis, thigh, knee(pad), leg Narrow-fold bandage Immobilize feet : fracture pelvis, thigh, leg Control severe bleeding : palm
    • Reef Knot L R Left Cross Right Right Cross Left L R Untie a reef knot Reef Knot (U-shape)
    • Ring Pad
      • Narrow fold bandage
      • Size of ring
      • Form loop
      Tuck tail Ring pad
    • Arm Sling, P.251 1. Unfold triangular bandage 2. Keep the apex 2 – 3 inches away from the elbow 3. Pad reef knot above the clavicle 4. Twist the apex backwards Direct one end of bandage to the injured side Expose all fingers
    • Elevation Sling 1 2 3 4 5 6 Hold hand Tuck the apex under the upper arm 3 Pull backward, keep it under the scapula Pad reef knot just above the clavicle Tidiness
    • Slings Reef knot Injured side Injured side Reef knot Expose nails Arm Sling Elevation Sling Use Support the upper arm, elbow, forearm and wrist Hand and fingers Injured arm position Bend the elbow between 80-90 degrees Cross the chest with injured fingers almost touching the shoulder Knot On the injured side, at the hollow just above the clavicle On the un injured side above the clavicle
    • Check Circulation (Every 10 Min.) After Applying A Sling
      • Temperature : warm or cold
      • Pulse : present of radial pulse
      • Sensation : numbness or tingling sensation
      • Fingers movement
      • Capillary refill test
      • . Apply pressure on a nail bed
      • . Colour changes from pink to white
      • . Release pressure
      • . Normal : rapid return of pink colour within 2 seconds
      • 6. Swelling and cyanosis
      • * If the circulation is affected, remove bandage and reapply again
    • Four Improvised Slings (P.253) Jacket Corner Check Circulation Button-Up Jacket Support wrist on lower button Anchor using a safety pin Place hand in loop Check circulation 1 2 3 4 Protect elbow Unfasten button Long-Sleeved Shirt Belt or Thin Garment
    • References
      • St. John Ambulance, St. Andrew’s Ambulance
      • Association, British Red Cross. (2009). First Aid
      • Manual . (9 th ed., P.12-31,37-53, 64-65, 72-73,
      • 232- 233, 242, 249-253). London : Dorling
      • Kindersley.
      • 香港聖約翰救護機構 (2007) 。 急救證書課程
      • 手冊 。 ( 第二版,第 13-34 、 40-41,195-198
      • 201-203 頁 ) 。香港 : 香港聖約翰救護機構。