First Aid Stage 2

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First Aid Stage 2

  1. 1. The Boys’ Brigade 99th Singapore CompanyA CCA from Canberra Secondary School First Aid Stage 2 Content:The 6 Modules under First Aid Stage 2 badgework are as follows:- Actions at Emergencies- Treatment of Strains and Sprains- Fractures & Immobilisations I (Theory and Upper Limbs)- Fractures & Immobilisations II (Lower Limbs and Spinal Injuries)- Handling Shock- Animal Bites, Insects Stings, BitesRank DateName Material adopted from First Aid Manual 8th Edition Page 1
  2. 2. The Boys’ Brigade 99th Singapore CompanyA CCA from Canberra Secondary SchoolModule 7: Actions at EmergenciesIn any emergency, you must follow a clear plan that will enable you to prioritise what set ofsteps is required to be employ to a casualty. Remember clearly the purpose of first aid:Preserve LifePrevent Condition from worseningPromote RecoveryTo help us do that, first aiders follows a standard 4 sequential profile. Material adopted from First Aid Manual 8th Edition Page 2
  3. 3. The Boys’ Brigade 99th Singapore CompanyA CCA from Canberra Secondary SchoolTo perform all these actions in a short time is difficult and often, first aider on site might onlybe able to perform very limited materials. Hence, the aim for a first aider in an emergency is to:- Assess the casualty- Maintain the Vital signs of the casualtyFortunately, a step-by-step guide is employed and we know it as Primary Survey. Material adopted from First Aid Manual 8th Edition Page 3
  4. 4. The Boys’ Brigade 99th Singapore CompanyA CCA from Canberra Secondary SchoolBesides Primary Survey, there is also Secondary Survey and further skills set which will bediscuss in greater details as you pursue a first aider certification. The measure of the wellbeing of your casualty is based on their vital signs. Vitals signs are as follows:Level of Response, Pulse, Breathing and Temperature.Hence, do note how to measure the above. Material adopted from First Aid Manual 8th Edition Page 4
  5. 5. The Boys’ Brigade 99th Singapore CompanyA CCA from Canberra Secondary SchoolRecovery PositionShould a casualty remain unconscious, the breathing and circulation are not compromised, nofurther treatment necessary, as first aid, we need to position the casualty in Recovery Position. Material adopted from First Aid Manual 8th Edition Page 5
  6. 6. The Boys’ Brigade 99th Singapore CompanyA CCA from Canberra Secondary SchoolModule 8: Treatment of Strains and SprainsLigaments, muscles and tendons are the softer structures and tissues surrounding our bonesand joints. Often, they are also the easiest to be injured by overstretched, partial or completetorn due to violent or sudden movement. During sporting activities, strains and sprains areoccurs frequently. As such the responsibility of a First Aider in situation as such revolvesReducing Swelling/Pain and obtaining medical aid if necessary. Under normal circumstances,strains and sprains are not life-threatening unless complication occurs.Recognition of Strains/SprainsPain and tendernessDifficulty in moving the injured part, especially if it is a joint.Swelling and bruising in the area.On the onset of strains/sprains, a suitable treatment is characterised as R I C E. R Rest Rest the injured part I Ice Apply Ice or cold compress C Compress Compress the injury E Elevate Elevate the injured partEven though many people have strains and sprains, how you asked yourself, why does it swell?Well, in terms of swelling occurs in injuries that has relationship with bleeding. Often, strainand sprains swellings as the soft tissues are damaged breaking certain blood vessels. As such,when blood comes out of the vessels, it cause a red colouration commonly noticed as bruises.Tenderness and swelling may set in depended on the position of injury.What if we do not treat strains and sprains properly?Should the soft tissue be overstretched, give it a few weeks, pain will go away which muchmedical attention. However, if the tissue is torn partially or totally, it can result in extremepain and lack of mobility/functionality of the injury site. Material adopted from First Aid Manual 8th Edition Page 6
  7. 7. The Boys’ Brigade 99th Singapore CompanyA CCA from Canberra Secondary SchoolHow do we handle a case strain/sprain using RICE?Below describe the steps relating to a sprain ankle. However, it can be modify to be applicableto most strain and sprain. Material adopted from First Aid Manual 8th Edition Page 7
  8. 8. The Boys’ Brigade 99th Singapore CompanyA CCA from Canberra Secondary SchoolAttached below are steps to use a roller bandage on ankle or wrist. Material adopted from First Aid Manual 8th Edition Page 8
  9. 9. The Boys’ Brigade 99th Singapore CompanyA CCA from Canberra Secondary SchoolModule 9: Fractures & Immobilisations I (Theory and Upper Limbs)Fracture is a break or crack in a bone as a reason of considerable force. It is as a result of director indirect force acting on the bone. A fracture can occur at any body part whereby bone ispresent. As such, there are numerous types of fracture. To simplify matters, there are broadlyclassified as Open or Closed Fracture, Stable or Unstable Fracture. Material adopted from First Aid Manual 8th Edition Page 9
  10. 10. The Boys’ Brigade 99th Singapore CompanyA CCA from Canberra Secondary SchoolRecognition of FracturesDeformity, swelling and bruising at the fracture sitePain and difficulty in moving the areaShortening, bening or twisting of a limbSigns of shock, especially if the fracture is to the thigh bone or pelvis (as there are major bloodvessel flowing near this region as fracture will mean breaking of such vessels)Difficulty in moving a limb normally or cannot move at allWound protruding with a bone endDespite many types of fractures, the aim and purpose for first aid remain relatively the same.- Prevent Movement at injury site.- Minimise blood loss and infection at injury site.- Arrange evacuation to hospital with comfortable support during transport.In this module, we are looking at handling injuries to the upper limbs, dislocated shoulder,upper arm, forearm, elbow, hand/fingers and ribcages.Almost all this required a sling which will be elaborate in the next few pages. But a familiarknot is required: Reef Knot Material adopted from First Aid Manual 8th Edition Page 10
  11. 11. The Boys’ Brigade 99th Singapore CompanyA CCA from Canberra Secondary SchoolArm SlingAn arm sling holds the forearm in a horizontal or slightly raised position, Itprovides support for an injured upper arm, wrist, or forearm, or a simple ribfracture and is ued for a casualty whose elbow can be bent. Material adopted from First Aid Manual 8th Edition Page 11
  12. 12. The Boys’ Brigade 99th Singapore CompanyA CCA from Canberra Secondary SchoolElevation SlingAn elevation sling is used to keep the forearm and hand raised in a higher position. This formof sling supports the forearm and hand with the fingertips touching the casualty’s shoulder. Inthis way, an elevation slins helps to control bleeding from wounds in the forearm or hand, tominimise swelling and to support the chest in complicated rib fractures. Material adopted from First Aid Manual 8th Edition Page 12
  13. 13. The Boys’ Brigade 99th Singapore CompanyA CCA from Canberra Secondary SchoolBelow summarises the usage of arm slings and elevations slings for different fractures andinjury that is common.Slings are used when the elbow is able to bend. The next page depicts the case wherebyelbow could not be bend. Material adopted from First Aid Manual 8th Edition Page 13
  14. 14. The Boys’ Brigade 99th Singapore CompanyA CCA from Canberra Secondary SchoolNote that even when transportation, the bandage 1,2, 3 does not fall on the injured elbow.Hence, remember to tie the broad bandage in a secure fashion.How will an elbow be injured?Well, besides direct impact that occurs in road-traffic-accidents, it is more than likely thatelbow injuries occur when a casualty attempts to break a fall. During a fall, upon a high impact,the force of the fall travels from the palm upwards to the elbow. Since elbow is the firststructure upwards, it is prone to damage. As such, an unstable fracture will occur which ischaracterised as stiff and difficult to straighten.Why should be check for circulation after immobilisation?After injury has occur, the blood vessels may not be in the normal position. Hence, eventhough the immobilisation might be possible in a comfortable position, the blood vesselsmight be hindered. Hence, check for pulse on the downstream of the limb or looking out forsigns of poor circulation is important to save the injured limb. Signs of poor circulation couldapply as slow refill of redness in fingernail beds and turning of purplish. Material adopted from First Aid Manual 8th Edition Page 14
  15. 15. The Boys’ Brigade 99th Singapore CompanyA CCA from Canberra Secondary SchoolThis part of the notes touch on cases whereby ribcage are fracture. Note that during a ribinjury, there will be lots of blood loss. At the same time, lung are jeopardise as a result. Hence,the type of dressing employed is special.Recognition of Chest InjuriesSharp Pain over site of fracturePain on taking deep breathShallow breathingOpen wound at chest. Sucking noise might be hear as air are suck into the chest cavity viawoundParadoxical BreathingNotice that the wound is cover on 3 sides and not 4 sides. This will allow air to escape on theloss side. Material adopted from First Aid Manual 8th Edition Page 15
  16. 16. The Boys’ Brigade 99th Singapore CompanyA CCA from Canberra Secondary SchoolModule 10: Fractures & Immobilisations II (Lower Limbs and Spinal Injuries)In this module, we are going to briefing touch on improvised slings and injuries to the lowerlimbs.In the event whereby there are no triangular bandages, we can still make use of materials thatare ready for usage. Here we present 4 types of materials are could be used. Material adopted from First Aid Manual 8th Edition Page 16
  17. 17. The Boys’ Brigade 99th Singapore CompanyA CCA from Canberra Secondary SchoolLower limb injuries can be broadly classified as injuries to pelvis (hip-bone), injury before kneeand injury after knee.Injury to pelvis can be as a result of indirect force. It is common for casualty of a car crash tosuffer pelvis fractures. As there are major organs, blood vessels in the pelvis region, injuries topelvis should be consider as severe and handled properly.Recognition of Pelvis Fracture/InjuriesInability to walk or even stand although legs appear uninjuredPain and tenderness in the region of hip, groin, or back that increases with movementblood at the urinary outlet, especially in a male casualtySigns of shock and internal bleedingIn such a case, help the casualty to lie on the back. Then place padding in between thestraighten legs near the ankle and knee. Tie using 2 bandages, 1 to immobilise the ankles, theother to lock the knee. Then at regular intervals, monitor the vital signs and record accordingly. Material adopted from First Aid Manual 8th Edition Page 17
  18. 18. The Boys’ Brigade 99th Singapore CompanyA CCA from Canberra Secondary SchoolFor injuries before the knee, we can visualised that the injuries occurs at the thigh region.Similarly, we should get the casualty to lie down on the flat surface. Then straighten the legsof the casualty gently. Then applying 4 bandages first at the ankles, second on the knees,thirdly above the site of injuries and lastly after the injury. A soft padding can be placed inbetween the legs for provide comfort for the casualty.Remember, to check to check for signs of shocks and reassure the casualty accordingly. Noticethat the knots are tied on the non-injured side. This rule of thumb is also applicable in othercases of fractures.In the event whereby both legs are injured, or whereby a splint is available, the similar stepshould be employed but instead the knots to be tied on the splint.A splint is a medical equipment structure that provides solid support for injured site. Animprovised splint could be any straight wooden pole, long branch, or even a broomstick. Material adopted from First Aid Manual 8th Edition Page 18
  19. 19. The Boys’ Brigade 99th Singapore CompanyA CCA from Canberra Secondary SchoolFor injuries after the knee, it is often associated with the injures/fractures over at the shinarea. While controlling bleeding, it is important to immobilise especially when the casualty nolonger have the ability to walk.Similar to injury before the knee, 4 bandages are required. There are place on first at theankles, second on the knees, thirdly above the site of injuries and lastly after the injury. A softpadding can be placed in between the legs for provide comfort for the casualty.It is noted that the first bandage uses a narrow bandage. It is a Figure-of-8 tie across the 2ankles to pull the ankle in place. As such, when there are injuries to the ankles, the knots tothis narrow bandage should be employ on the non-injured side.Up to now, you have learn from Module 9 to Module 10 the different immobilisation ondifferent portion of the body. There are lots of different knots and bandages coupled withdifferent technique which may sometimes apply to be difficult and confusing. However, thekey principle of immobilisation and first aid should be employed.Remember, you may not always have a first aid kit with all the bandages in place and all thepictures depicted here represent the ideal cases. Hence, it is up to your own reasoning todecide what is to be done. Material adopted from First Aid Manual 8th Edition Page 19
  20. 20. The Boys’ Brigade 99th Singapore CompanyA CCA from Canberra Secondary SchoolSpinal / Back injuriesFor Spinal or back injuries are not uncommon cases of injuries. It can occurs when the casualtysuffers from the following situations:- Falling from height- Falling awkwardly while doing gymnastics, trampolining, skateboarding- Diving into shallow pool and hitting the bottom- Thrown off a horse or motorbike- Sudden braking of a vehicleAs a first aider, we know that spinal injuries have major implication to mobility when thecasualty recovers. Hence, our purpose is to prevent further injury, maintain Casualty ABC andarrange for urgent evacuation to hospital.Should the casualty be conscious, the first thing you should suggest to the casualty is toreassure the casualty and advise the casualty not to move.Next, kneel behind the casualty’s head and grasp firmly on the casualty head. Keep in mindnot to cover the ears and stay within view of the casualty.Next, rest your elbow on your thigh to keep your arms steady.Alight the head, neck and spine to assume a neutral position, a position that is least harmfulhead position for a casualty suspected from a spinal injury. Material adopted from First Aid Manual 8th Edition Page 20
  21. 21. The Boys’ Brigade 99th Singapore CompanyA CCA from Canberra Secondary SchoolModule 11: Handling ShockShock is a life-threatening condition occurs when the circulatory system fails and as a result,vital organs like brain, heart are deprived of oxygen. It needs immediate action to preventpermanent organ damage and even death. To make matter worse, casualty that suffers fromshock also experiences fear and pain which could made the condition worse. Hence,communicating and reassuring the casualty suffering from shock is important.Unlike the shock we learn from our English language lesson, medically, it is describe as thefailure of delivering oxygen to vital organs. It could be due to loss of body fluid or blood whichlimits the amount of fluids active in the circulatory system. Typical cases of such are externalbleeding or internal bleeding. Hence, any case of shock can be in the form of allergic reactionsdue to foreign chemical present in the blood stream or in contact with the body that causesanaphylactic shock, a case of extreme allergic reaction.Regardless of the type of shock a casualty experience, their recognition signs are similar.Recognition of ShockInitially – Rapid Pulse; Pale, cold clammy skin; sweatingAs shock develops- cyanosis of lips, fingernail- weakness and dizziness- nausea, vomiting, thirst- rapid, shallow breathing- weak pulseAs brain ‘s oxygen supply weakens- restlessness and aggressiveness- Yawning and gasping for air- UnconsciousnessFinally, Heart may stop.As such, you aim as a first aider is to 1) Recognise shock 2) Treat Obvious signs of shock 3)Improve blood supply to brain, heart lung 4) Remove casualty urgently to hospital. Material adopted from First Aid Manual 8th Edition Page 21
  22. 22. The Boys’ Brigade 99th Singapore CompanyA CCA from Canberra Secondary SchoolA simple steps are describe below:It is noted that monitoring the vital signs are important. And there should be strictly NOconsumption of food, drink or smoke. Wetting of lips is however permitted. Material adopted from First Aid Manual 8th Edition Page 22
  23. 23. The Boys’ Brigade 99th Singapore CompanyA CCA from Canberra Secondary SchoolModule 12: Animal Bites, Insects Stings, BitesBites and Stings are by at large common when venturing into the wilderness or at the forestedareas. As far as possible, keeping a cautious state of mind can help to reduce the possibility ofgetting a bite or sting. However, in the event that such a case occurs, the principle is woundcare to prevent infection and monitor for signs of shocks.In cases of animal/insects stings or bites, which includes snake bites, it is important to identifythe animal or insects. This could be done by catching the animal/insect (dead or alive) orsimply taking a photo of the animal/insect.For a insect sting, the key principle is to relieve swelling/pain followed by evacuated tohospital if casualty show signs of shock. These are done by using ice pack compression whichcould easily relieve the pain. Should the stinger remains, do NOT use a tweezers as thepressing action will cause more venom to be injected. Instead, brush or scrape it off sidewaysusing fingernails or the blunt edge of a knife. Shock might occur for cases of multiple stings orallergic reactions. Hence, evacuation to hospital may be necessary.For snake bites, it is firstly important to recognise the snake as venomous or not. Typically,should the bite create 2 holes, snake is venomous. More than that, snake is likely to be non-venomous. In cases of venomous species, it is important to remember to reassure the casualtyand delay the spread of venom. This is done by asking the casualty to lie down and be calm.Do not attempt to apply a tourniquet, suck the venom out or slash the wound with a knife. Butrather keep the heart above wound and recognise the snake as far as possible.In case of a animal bite, the 3 objectives of first aid is to- Control Bleeding- Minimise risk of infection to both casualty and first aider, wound care.- Obtain medical aid if necessaryIn countries of known threats of bite-related diseases like rabies, special caution needs to beemploy and medical aid is therefore necessary when such cases arise.One point to note is that animals/insects do not just bite or sting without any rhythm reasons.Their signs of aggression are often an intrusion of their spaces. As such, keep the eyes open innature will help a lot in minimising such cases. Material adopted from First Aid Manual 8th Edition Page 23

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