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first aid and emergencies, wounds shock hemorrhage

First aid and emergencies

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Emergency First Aid•
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First Aid and Emergencies INTRODUCTION First aid management is the care given to sick and injured person. First aid is the first and quick help given to any individual experiencing either a minor or actual disease or injury, given to protect life, prevent the condition from deteriorating. Definitions of First Aid Management 1.First aid is the initial, quick and temporary care given to the victim of accident/injured/sick person until the medical professional arrives. 2.First aid is the first assistance or support given to a casualty or a sick person for injury or any sudden illness before the arrival of an ambulance, a qualified paramedical or medical person or before arriving at a facility that can provide professional medical care.
BASIC PRINCIPLES OF FIRST AID The basic principles of first aid are:  Safe response in crisis/situation for well-being of the victim, bystander and helper/assistance.  Minimize further injury to the victim by fixing/stabilizing the situation.  Use suitable technique and first aid procedure.  Move the victim carefully, to reduce pain, to stabilize the condition.  Reassure and instruct the victim.
 Communicate with a bystander and emergency first aider. AIMS OF FIRST AID MANAGEMENT The aims of first aid management include 5Ps. Aims of First Aid - P5  Life Preservation  Protection of victim  Pain relief  Prevent or control On worsening of the condition of the patient.  Provide psychological support and reassure SCOPE OF FIRST AID
The scope of first aid comprises of three main components, i.e., diagnosis, treatment and disposal of cases. Diagnosis  First aider should know how the accident or sudden injury/damage has happened.  First aider can gather this information from the victim if the victim is able to speak or from the witnesses or bystanders. This is known as the history of the incident.  Next step in diagnosis is to watch the victim for symptoms like fainting, thirst, pain or shivering bleeding and cyanosis.  Look for the signs, which are different from normal conditions. Signs are the most accurate information or indicators, therefore diagnosis should be based Fil on signs. Treatment
 In treatment, the first aider should eliminate the cause of the condition as soon as possible, to prevent worsening of the condition.  Special care should be given to the victim, with severe bleeding, shock, unconsciousness and failure of breathing. Disposal 1.In disposal, the victim must be examined by the doctor on the spot. If this is not possible, the vic tim should be transported to the hospital/home de pending on the condition of the patient. 2.The family members of the victims should be informed immediately, and make arrangements for transportation of the victim. GOLDEN RULES FOR FIRST AID
Fundamental rule of first aid says “Do first of all, rapidly discreetly without quarrel or frenzy.” First Aid Rules  Firstly do emergency care, without any panic or confusion.
 Check the victim for major damage or bleeding and injuries.  Stop bleeding as soon as possible.  Reassure the victim and give comfortable position, keep him warm.  Check victim for ABC (airway, breathing, circulation)  Open airway by tilting the head of victim.  In case of respiratory arrest (no breathing signs), start with manual breathing or artificial breathing.  Give chest compressions, if carotid pulse is absent.  Do important that is essential to save life.  Treat victim for shock.  Do not permit crowd to gather around.  Carefully remove/loosen the clothes, keep body warm.  Arrange for transportation to send the victim to nearby hospital.
ADDRESSING THE EMERGENCY SITUATIONS Every situation is unique and need handling differently, main four steps should be followed: 1.Quick assessment: Evaluate the condition of the victims/patients:  Assess the consciousness level, respiratory pat-terns.  Check ABC (airway breathing and circulation).  Provide comfortable/recovery position to the patient.  Initial assessment shall focus on life- threatening illness and after stabilizing the victim detailed assessment can be conducted till the healthcare facility is accessed or patient is transported. 2.Call for help: Once evaluation is done for the scene and victims, call for help. Inform help needed like what happened, number of injured persons, kind of injuries are there and provide details of location.
3.Provide first aid: Do not give anything to eat or drink if the victim is drowsy, unconscious, nauseated, severely injured. Provide psychological support and reassure the victim. 4.Inform the police: If serious accident/damage has occurred. FIRST AID KIT First aid kit is a very important tool for providing emergency care to victims. It should be available at home, school, occupational places, buses/cars, and factories, to keep ready for any kind of mishap/emergency situation. The material inside first aid kit will be different according to the needs and duties performed. First aid kit 1.Cotton roll 2.Dressing pads
3.Triangular bandages 4.Roller bandages of different sizes 5.Pair of tweezers 6.Bunch of safety pins 7.Different scissors 8.Adhesive tape 9.Tongue depressor 10. Splints 11. Thermometer 12. Matchbox 13. Mackintosh 14. Clean sheet 15. Kidney tray 16. Torch 17. Small notepad and pencil 18. Soap 19. Airway 20. Rubber catheter 21. Tourniquet 22. Petroleum jelly tube
23. An antiseptic (mild) 24. Baking soda, salt, potassium permanganate, milk of magnesia 25. Medicine dropper 26. Solution such as Dettol, Savlon, spirit, boric acid, iodine, acriflavine, hydrogen peroxide, carbolic acid, gentian violet 1% solution 27. BP apparatus 28. Stethoscope 29. Glucose, sweet candy or sugar FIRST AIDER A first aider is a person who can provide emergency care to the victim at the time of accidents or any kind of mishap. A first aider should know what is best and what is needed. Qualities of first aider:  Good observer
 Tactful  Resourceful  Discriminate  Cool and calm  Good thinker  Good decision maker  Confident  Good leader FIRST AID MANAGEMENT OF VARIOUS EMERGENCY CONDITIONS WOUNDS Any disruption/breakage in the skin or the body surface due to physical means is known as a wound. Types of Wound  Penetrating wound: Penetrating wounds are the wounds, that break the full thickness of the skin.
 Non-penetrating wound: Nonpenetrating wounds are the wounds that do not break skin integrity.  Miscellaneous wound: The types of miscellaneous wound are:  Thermal wound: Injuries from extreme heat and cold is known as thermal wound. For example, burn, sunburn and frostbite.  Chemical wound: When injuries are caused by coming in contact with chemicals like strong acid or base or due to inhalation of chemical material.  Bites and stings: It is caused due to bites of humans, rodents, cats, dogs, snakes, scorpions and ticks.  Electrical wound: Injuries results from the passage of high voltage electric current.
First Aid for Wound Management Management of minor wounds:  Clean the wound under running water with soap.  Apply constant, firm and direct pressure on the wound till the bleeding stops.  If bleeding stops, immediately apply antibiotic ointment after cleaning.  Cover the wound with a bandage. Management of major wounds:  Firstly call for medical help.  Apply constant firm and direct pressure on the wound with a clean cloth and bandage till bleed-ing stops.  If the bandage soaks with bleeding, do not separate that bandage from the wound.  Apply more pressure and bandages on the wound. Pressure bandage may be applied. In
this case, monitor peripheral pulse for blood cir-culation assessment.  Take medical help to clean and close the wound. BLEEDING AND HEMORRHAGE Haemorrhage or bleeding is defined as an abnormal flow Of blood from an artery, vein and capillary due to injury or rupture. It can be internal or external. Types of Haemorrhage Haemorrhage can be categorized in different manner: According to Rupture of Blood Vessel 1.Arterial bleeding: Arterial blood is bright red in Colour. Arteries carry oxygenated blood
away from the heart to the tissues. They pump out blood with each contraction of heart. Arterial bleeding is difficult to control immediately and may lead to death. 2.Venous bleeding: Venous blood is dark red in Colour, carries deoxygenated blood and flow of blood is constant and steady. 3.Capillary bleeding: Blood in the capillary is red in color, comes from small blood vessels, flows very slowly. Capillary bleeding is not very serious, most of times blood stops without any medical aid or treatment. According to Body Surface 1.External bleeding: When bleeding can be seen on the body surface after trauma or injuries. 2.Internal bleeding: After any injury or trauma, when bleeding cannot be seen on body
surface, it is inside the body cavities such as skull, chest and abdomen.
First Aid Nursing Management for Haemorrhage/Bleeding For Internal Haemorrhage  Lay the victim in comfortable position.  Immobilize the victim.  Reassure the casualty/victim.  Provide blanket to keep body warm, according to weather.  Do not allow the victim to take anything by mouth.  Check ABC, if victim is unconscious.  Keep the victim in side-lying position to prevent aspiration if he/she is unconscious.  Raise his/her leg 8-12 inches by pillow to treat shock.  Immediately take him/her to the hospital for medical facility. For External Hemorrhage
 Check the body surface to find location of bleeding.  If any foreign body is visible, remove that to prevent further injuries.  Clean the wound with clean cloth.  Provide comfortable position to victim.  Put a clean/sterile gauge on wound and press firmly for 10 minutes to stop bleeding.  If bleeding continues after 10 minutes, then raise that body part above the level of heart to decrease blood flow to the injured part.  Keep victim warm and recheck circulation every 20-30 minutes.  Raise legs of the victim 8-12 inches, to treat shock.  Immediately transport him/her to nearby hospital for medical facility. How to Control Bleeding?
 Direct pressure: Apply direct pressure on wound.  Elevation: Elevate the bleeding part above the heart level, to decrease blood flow.  Pressure point: Apply direct pressure on pressure point. (femoral, popliteal, carotid, facial, temporal, brachial, radial or ulnar, palmer arch pressure point).  Applying a tourniquet: To stop bleeding or to cut off circulation. SHOCK Condition in which the blood circulation towards vitals organs is depleted and vitals fall below normal is called shock. It is a life-threatening condition because it decrease the function of vital
organs, if it is not treated immediately it will lead to death. Causes of Shock  Various cardiac problems like cardiac failure or heart attack  Any kind of allergic reactions  Severe hemorrhage due to injuries and accidents (may be internal and external)  Loss of fluid from body due to severe diarrhea and vomiting  Electrical shock  Severe burn and dehydration  Bacterial infection  Extreme heat and cold exposure  Any gas poisoning, bites and stings
Sign and Symptoms of Shock  Cold and clammy skin  Pale and cyanosis  Pulse is weak and rapid  Low BP (blood pressure)  Fainting/dizziness and level of consciousness reducer  Diminished vision  Increased breathing pattern  Dilated pupils  Nausea/vomiting First Aid Management for Shock  Firstly reassure the victim.  Provide comfortable position to victim.  Elevate foot end side to improve blood supply to heart and reduce blood flow to extremities  In case of head injury, reduce the pressure by raising fr the head slightly.
 If breathing problem is observed, then raise head and shoulder by providing comfortable position victim.  Loosen the tight clothing around neck, chest and waist. It helps in circulation and assist in breathing,  Provide blanket to victim, to keep body warm.  Stop bleeding by pressure and immobilize fracture part to treat cause of shock.  Check pulse, respiration and level of consciousness.  If pulse and breathing stops, immediately establish airway.  Start resuscitation as possible.  Keep the victim in recovery position.  Transport to the nearest hospital without any delay. In Case of Electric Shock  Switch off supply of main power from fuse box before helping victim.
 Stand 6 feet away from source so that current cannot come towards firstaider.  Must stand on dry wooden board to cut off electric current, use wooden stick or pole while handling the victim. Specific Nursing Considerations for Shock Management Follow DRSABCD and manage other severe injuries: D-Danger-Firstly ensure that area should be safe. R-Response-Check response of victim by asking his/her name, press their shoulders. S-Send for help. A- Airway - Open the mouth of patient. B-Breathing-Check for breathing by looking, listening and feel.
C-CPR-Start CPR, 30 chest compressions should be followed by 2 breaths. D- Defibrillation