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Page 1: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

Chapter 15

First Aid

Page 2: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

15:1 Providing First Aid

• Immediate care given to the victim of an accident or illness to minimize the effect of injury or illness until experts can take over

• Reasons for providing correct first aid

Page 3: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

Basic Principles of Providing First Aid

• Remain calm and avoid panic

• Evaluate situation thoroughly

• Have a reason for anything you do

• Treatment you provide will vary depending on type of injury or illness, environment, others present, equipment or supplies on hand, and availability of medical help

Page 4: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

First Steps

• Recognize that an emergency exists

• Use all senses to detect problems

• Sometimes signs of emergency are obvious and at other times they are less obvious

Page 5: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

Next Steps

• Check the scene and make sure it is safe to approach

• What to observe

• If not safe, call for medical help

• If safe, approach the victim

• Call emergency medical services (EMS) as soon as possible

(continues)

Page 6: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

Next Steps(continued)

• If possible, obtain the victim’s permission before providing any care

• Triage if necessary

• Check for other injuries

• Obtain as much information as possible before you proceed

Page 7: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

General Principles

• Obtain qualified help

• Avoid any unnecessary movement of the victim

• Reassure the victim

• Use a confident, calm attitude to help relieve victim’s anxiety

• Avoid giving the victim anything to eat or drink

(continues)

Page 8: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

General Principles(continued)

• Protect the victim from cold or chilling, but avoid overheating

• Work quickly in an organized and efficient manner

• Do not make a diagnosis or discuss condition with observers at scene

(continues)

Page 9: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

General Principles(continued)

• Maintain confidentiality and protect the victim’s right to privacy while providing treatment

• Make every attempt to avoid further injury or harm

• Provide only the treatment you are qualified to provide

Page 10: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

15:2 Performing CPR

• Cardiopulmonary resuscitation (CPR):– Cardio: the heart

– Pulmonary: the lungs

– Resuscitation: to remove from apparent death or unconsciousness

• When performing CPR, you breathe for the patient and circulate blood

(continues)

Page 11: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

Performing CPR(continued)

• Purpose: keep oxygenated blood flowing to the brain and other vital body organs

• Performed until the heart and lungs start working again or until medical help is available

• Clinical versus biological death

(continues)

Page 12: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

Performing CPR(continued)

• ABCDs of CPR– A stands for airway

– B stands for breathing

– C stands for circulation

– D stands for defibrillation

(continues)

Page 13: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

Performing CPR(continued)

• Evaluate victim’s condition before starting CPR:– Check if patient is conscious

– If unconscious, check for breathing

– If not breathing, place victim on back

– Open the airway by using the head-tilt/chin lift or jaw-thrust maneuver

(continues)

Page 14: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

Performing CPR(continued)

• Look for chest movement

• Listen for breathing

• Feel for movement of air from the nose or mouth

• If not breathing, give two breaths

• Make sure breaths are effective

• Then check the carotid pulse

(continues)

Page 15: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

(continues)

Performing CPR(continued)

• Correct hand placement is needed before performing chest compressions

• Various methods of CPR used

• One-person adult rescue for adult– 30 compressions followed by 2 ventilations (30:2 ratio)

Page 16: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

(continues)

Performing CPR(continued)

• Two-person adult rescue for adult– 30 compressions by one rescuer followed with

2 ventilations by the second rescuer (30:2 ratio)

• CPR for infants (birth to one year)– 30 compressions followed by 2 ventilations for one

rescuer (30:2 ratio)

– 15 compressions followed by 2 ventilations for two rescuers (15:2 ratio)

Page 17: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

Performing CPR(continued)

• CPR for children (1 year to puberty)– 30 compressions followed by 2 ventilations for one

rescuer (30:2 ratio)

– 15 compressions followed by 2 ventilations for two rescuers (15:2 ratio)

• CPR for choking victims

• Reasons for stopping CPR

Page 18: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

15:3 Providing First Aid for Bleeding and Wounds

• Wound is an injury to soft tissues– Open: break in skin or mucous membranes

– Closed: no break in skin or mucous membranes, but injury occurs to underlying tissues

– Wounds can result in bleeding, infection, and/or tetanus

Page 19: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

Classifications of Open Wounds

• Abrasion

• Incision

• Laceration

• Puncture

• Avulsion

• Amputation

Page 20: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

Controlling Bleeding

• First priority because victim can bleed to death quickly

• Bleeding can come from arteries, veins, or capillaries

• Observe standard precautions

(continues)

Page 21: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

Controlling Bleeding(continued)

• Direct pressure

• Elevation

• Pressure bandages

• Pressure on pressure points

• Do not disturb clots

• Do not remove dressings

• Do not clean wound

Page 22: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

Minor Wounds

• First priority—prevention of infection

• Wash your hands thoroughly before caringfor wound

• Put on gloves

• Wash the wound with soap and water

• Rinse the wound

• Use sterile supplies

Page 23: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

Signs of Infection

• Swelling

• Heat

• Redness

• Pain

• Fever

• Pus

• Red streaks

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© 2009 Delmar, Cengage Learning

Tetanus

• Tetanus bacteria can easily enter an open wound

• Serious illness

• Get tetanus shot or booster as needed

Page 25: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

Objects Embedded in Wound

• Examples such as splinters, pieces of glass, or small stones

• If superficial, gently remove

• Objects embedded in tissues should be left and removed by physician

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© 2009 Delmar, Cengage Learning

Closed Wounds

• Can occur anywhere on body

• If bruise, apply cold application to reduce swelling

• Observe for signs of internal bleeding

• Get medical help

• Check breathing and treat for shock

• Avoid unnecessary movement

• No food or fluids

Page 27: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

15:4 Providing First Aid for Shock

• Also called hypoperfusion

• Shock: clinical set of signs and symptoms that are associated with an inadequate supply of blood to body organs, especially brain and heart

• Causes of shock

Page 28: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

Types of Shock

• See Table 15-1 in text

• Anaphylactic

• Cardiogenic

• Hemorrhagic

• Metabolic

• Neurogenic

(continues)

Page 29: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

Types of Shock(continued)

• Psychogenic

• Respiratory

• Septic

Page 30: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

Signs and Symptoms of Shock

• Skin is pale or bluish-gray and cool or cold to the touch

• Diaphoresis

• Rapid and weak pulse

• Respirations rapid, shallow, and may be irregular

• Blood pressure very low or unobtainable

(continues)

Page 31: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

Signs and Symptoms of Shock(continued)

• General weakness

• Anxiety and extreme restlessness

• Excessive thirst

• Nausea and/or vomiting

• Blurred vision or changes in appearance of eyes

Page 32: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

Treatment for Shock

• Goals of treatment

• Positioning of victim

• Maintain body temperature

• Avoid food or drink

• Other principles of care

Page 33: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

15:5 Providing First Aid for Poisoning

• Can happen to anyone

• Poison: any substance that causes a harmful reaction to the outside or inside of the body

• Immediate action is needed

• First aid varies depending on type of poison, injury involved, and the method of contact

Page 34: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

Ways Poisoning Occurs

• Ingesting various substances

• Inhaling poisonous gases

• Injecting substances

• Contacting the skin with poison

Page 35: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

First Aid for Poisoning

• If poison has been swallowed– Methods to induce vomiting

• If poisoning by inhalation of gases

• If poisoning by contact with skin

• Contact with poisonous plants

• If poisoning by injection

Page 36: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

15:6 Providing First Aid for Burns

• Injury caused by fire, heat, chemical agents, radiation, and/or electricity

• Classifications of burns– Superficial

– Partial-thickness

– Full-thickness

Page 37: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

Treatment Objectives

• Remove source of heat

• Cool the skin

• Cover the burn

• Relieve pain

• Observe for and treat shock

• Prevent infections

Page 38: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

Treatment

• Usually not required for superficial and mild partial-thickness burns

• Rules for when to treat

• All full-thickness burns require medical treatment

• How to treat superficial and mild partial-thickness burns

(continues)

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© 2009 Delmar, Cengage Learning

Treatment(continued)

• How to treat severe partial- or full-thickness burns

• How to treat when chemicals splashed on skin

• How to treat eyes burned by chemicals or irritating gases

Page 40: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

15:7 Providing First Aidfor Heat Exposure

• Overexposure to heat may cause a chemical imbalance in the body

• Occurs when water and salt are lost through perspiration

• Also occurs when body cannot eliminate excess heat

Page 41: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

Heat Cramps

• Muscle pains and spasms

• Caused by exposure to heat

• Loss of water and salt

• Apply firm pressure on cramped muscle to provide relief

• Provide rest and move to cooler area

• Small sips of water or electrolyte solution (e.g., sports drink)

Page 42: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

Heat Exhaustion

• Occurs when exposed to heat with loss of fluids through sweating

• Signs and symptoms

• First aid care

Page 43: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

Heat Stroke

• Prolonged exposure to higher than normal temperatures

• Medical emergency—needs immediate care and attention

• Body unable to eliminate excess heat

• Signs and symptoms

• First aid care

Page 44: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

15:8 Providing First Aidfor Cold Exposure

• Exposure to cold temperatures can cause body tissues to freeze and body processes to slow down

• Needs immediate attention

• Degree of injury affected by wind velocity, amount of humidity, and length of exposure to cold

Page 45: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

Hypothermia

• When body temperature is less than 95ºF (35ºC)

• Caused by prolonged exposure to cold

• Signs and symptoms

• Death can occur if body processes become too slowed down

• First aid care

Page 46: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

Frostbite

• Freezing of tissue fluids with damage to the skin and underlying tissues

• Caused by exposure to freezing or below-freezing temperatures

• Early signs and symptoms

• Other signs and symptoms as frostbite progresses

(continues)

Page 47: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

Frostbite(continued)

• Objectives of first aid

• Common sites: fingers, toes, ears, nose, cheeks

• First aid care

• Assess for signs and symptoms of shock and treat as needed

Page 48: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

15:9 Providing First Aidfor Bone and Joint Injuries

• Frequently occur during accidents or falls with variety of injuries

• Examples: fractures, dislocations, sprains, and strains

• May have more than one type of injury to bones and joints at the same time

Page 49: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

Fracture

• Break in the bone

• Closed or simple fracture

• Compound or open fracture

• Signs and symptoms

• Objectives of first aid

Page 50: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

Dislocation

• When the end of the bone is displaced from a joint or moved out of its normal position within a joint

• Tearing or stretching of ligaments, muscles, and other soft tissues also frequently occurs

• Signs and symptoms

• First aid care

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© 2009 Delmar, Cengage Learning

Sprain

• Injury to tissues surrounding a joint

• Common sites: ankles and wrists

• Signs and symptoms

• Sprains frequently resemble fractures or dislocations—treat as fracture if any doubt

• First aid care

Page 52: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

Strain

• Overstretching of a muscle

• Caused by overexertion or by lifting

• Frequent site: back

• Signs and symptoms

• First aid treatment

Page 53: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

Splints

• Devices to immobilize injured parts

• Types of splints– Pneumatic or air splints

– Padded boards

– Traction splints

• Splints can also be made from cardboard, newspapers, pillows, boards, etc.

(continues)

Page 54: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

Splints(continued)

• Need to be long enough to immobilize the joint above and below the injured area to prevent movement

• Should be padded

• Tied in place

• Apply as not to create pressure on affected area

• If open wound, control bleeding before applying splint

(continues)

Page 55: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

Splints(continued)

• Never attempt to reposition bone

• Splint before moving victim

• Observe precautions when using pneumatic splints

• Traction splints

Page 56: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

Circulation Check After Splint

• Verify that the splints are not too tight

• Check skin temperature

• Check color

• Note swelling or edema

• Numbness or tingling

• Check pulse

• If circulation impaired, immediately loosen the ties

Page 57: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

Slings

• Commercial slings

• Triangular bandages

• Use: support arm, hand, forearm, and shoulder

• Positioning of sling

• Check circulation

• Limit movement of limb

(continues)

Page 58: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

Slings(continued)

• If using knots– Placement

– Padding

• Considerations for shoulder injury

Page 59: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

Neck or Spine Injury

• Most dangerous types of injuries involving bones and joints

• Movement can result in permanent injury resulting in paralysis

• Avoid any movement of victim if at all possible

• Wait for backboard and adequate help to arrive for transfer

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© 2009 Delmar, Cengage Learning

15:10 Providing First Aidfor Specific Injuries

• Treatment for burns, bleeding, wounds, poisoning, and fractures is basically the same

• Injuries to specific body parts require special care

• Examples: eyes, ears, nose, brain, chest, abdomen, and genital organs

Page 61: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

Eye Injuries

• Always involves danger of vision loss

• Best to avoid giving major treatment

• Obtain help of a specialist

• Foreign objects in the eye

• Blows to the eye

• Penetrating injuries that cut eye tissue

Page 62: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

Ear Injuries

• Can result in rupture or perforation of eardrum

• Torn or detached tissue

• Ruptured or perforated eardrum

• Clear fluid or blood-tinged fluid draining from ear

Page 63: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

Brain Injuries

• Wounds and blows to head and skull can cause brain injury

• Seek medical help quickly as possible

• Signs and symptoms

• First aid care

Page 64: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

Nose Injuries

• Nosebleeds are usually more frightening than serious

• Nosebleeds also called epistaxis

• Causes of nosebleeds

• First aid care

Page 65: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

Chest Injuries

• Usually medical emergencies

• Involve heart, lungs, and major vessels

• Sucking chest wound

• Penetrating injuries to the chest

• Crushing injuries to the chest

Page 66: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

Abdominal Injuries

• Can cause damage to internal organs and bleeding in major blood vessels

• Intestines and other abdominal organs may protrude from open wound

• Medical emergency

• Bleeding, shock, and damage to organs can be fatal

• Signs and symptoms

• First aid care

Page 67: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

Injuries to Genital Organs

• Result of falls, blows, or explosions

• Can cause severe pain, bleeding, and shock

• First aid care

Page 68: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

15:11 Providing First Aidfor Sudden Illness

• Can be difficult to determine exact illness being experienced

• Base care on signs and symptoms

• Information from victim if possible

• Look for medical alert bracelets or necklaces or medical cards

Page 69: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

Heart Attack

• Known by other names as coronary thrombosis, coronary occlusion, or myocardial infarction

• Occurs when there is blockage in one or more coronary arteries

• If heart stops, start CPR

• Signs and symptoms

• First aid care

Page 70: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

Cerebrovascular Accident

• Also called stroke, apoplexy, or cerebral thrombosis

• Causes

• Signs and symptoms

• First aid care

Page 71: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

Fainting

• Temporary reduction in supply of blood to brain

• Early signs and treatment

• If victim loses consciousness, try to prevent injury

• Obtain medical help if recovery not prompt, there are other injuries, or fainting reoccurs

Page 72: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

Convulsion

• Type of seizure—strong involuntary contraction of muscles

• Causes

• Progression of a convulsion

• First aid care is directed at preventing self-injury

Page 73: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

Diabetes Mellitus

• Metabolic disorder caused by lack of or insufficient production of insulin

• Diabetic coma

• Insulin shock

• Differentiate between diabetic coma and insulin shock

Page 74: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

15:12 Applying Dressings and Bandages

• Dressings used as sterile covering and to control bleeding

• Materials used in dressings

• Dressings can be held in place with tape or a bandage

• Bandages used to hold dressings in place, to secure splints, and to support and protect body parts

(continues)

Page 75: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

Applying Dressings and Bandages(continued)

• Apply bandages snugly to control bleeding and prevent movement of dressing, but not to interfere with circulation

• Types of bandages consist of:– Roller gauze

– Triangular

– Elastic

Page 76: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

Methods to Wrap Bandages

• Depends on the body part– Spiral

– Figure-eight for joints

– Recurrent or finger wrap

Page 77: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

Checkpoints for Circulation

• Check circulation after application

• Signs of poor or impaired circulation:– Swelling or edema

– Pale or cyanotic color

– Coldness to touch

– Numbness or tingling

– Poor or slow capillary refill

• Loosen bandage immediately

Page 78: © 2009 Delmar, Cengage Learning Chapter 15 First Aid

© 2009 Delmar, Cengage Learning

Summary

• Proper first aid can save a life

• Provide only care you are qualified to provide

• Always reassure victim and avoid unnecessary stress and movement

• Obtain medical help as needed