Adult First Aid - CEUworks.com · unconscious victim is implied and a first aider should not hesitate to treat an unconscious victim. Consent of a parent or guardian is required to

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Adult First Ai

For Professionals

Stephen D. Woodin, EMT-P 5th Edition

CEUworks.com

Safety Services (813) 855-1225 Fax (813) 818-0019 P.O. Box 990 Flagler Beach, FL 32136 www.CEUworks.com

Chances are, you are here, reading this book, for one of a number of reasons:

1. You are employed by a facility and are in need of continuing education. This course will update/renew your training for the subject you need.

2. You are wanting to improve your educational training information, and are taking this course for professional development.

3. You desire to start working in the medical field. You have a burning desire to work with and help people, to improve the quality of life of the aged population.

Keeping your continuing education up

to date in todays’ busy lifestyle is a challenge for even the most organized individual. This course will help you meet the training requirements for continuing education.

This module is designed to be sent to

you via fax. We will wait up to 90 days for you to read the material then complete the test at the end of the course. When you fax your answers back to us, we will score your course, then fax your course completion certificate to you free of charge.

This course counts as 4 hours of continuing education for the licensed professional.

YOUR success is OUR

success! 5th Edition Copyright © 2008 by Safety Services

INTRODUCTION P.O. Box 990 Flagler Beach, FL 32136 www.CeuWorks.com All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form, by any means, electronic, mechanical, photocopying, recording, or otherwise, without prior written permission from the publisher. Printed in the United States of America

This content contained herein is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for continuing professional education or hands on training. Although some of the information contained in this publication relates to medical topics and issues, no information in the publication should be construed as medical advice. Use of AEDs requires medical direction from a qualified physician. The publisher does not guarantee the accuracy of the information and assumes no risk or liability as a result of any reliance on it.

Adult First Aid Copyright © 2008 Safety Services/www.CEUworks.com

Page 1

Stephen Woodin, EMT-P

Stephen Woodin, a Florida certified Firefighter & Paramedic has be involved in EMS and safety/medical related education since 1989. He has

written and developed over 30 training courses including CPR, First aid, HIV/Infection Control, and various continuing education courses for licensed professionals. Steve has an extensive background in course development, digital media, including internet webmaster, digital video editing, printing, and graphic arts.

Stephen is currently the President

of Safety Services & has been in business since 1994. Safety Services currently has 500+ instructors nationwide. Safety Services creates and markets instructor products and materials to instructors that need high quality training materials for their training curriculums. Please feel free to contact Stephen by phone at (813) 855-1225, if you have any questions about this or any other course that we offer. You can also do training online from our website at: www.CEUworks.com. The use of this book… This book is a culmination of intense reasearch, organization, and the help of many, many individuals & company friends. Of those individuals, this author would like to thank those who helped make this book a reality. Much

ABOUT THE AUTHOR thanks to our printer who without fail comes through for us everytime. The use of this book is authorized by Safety Services and its’ authorized training partners. Only instructors authorized by Safety Services International, Inc. with the accompanying instructor manual may use this book and its’ contents for training sessions. Unauthorized use of this book by companies or individuals for training sessions will be prosecuted to the fullest extent of the law. If you would like to use this book for your training sessions, please feel free to contact Safety Services International, Inc. for licensing information. We have wholesale prices available for groups. Safety Services International, Inc. can be contacted during business hours M-F 8:00am-5:00pm EST. (813) 855-1225. Upon completion of this course, the student will have met the requirements for issuance of the course certificate. We can Fax your certificate to you at no additional cost. Additional copies of your certificate or wallet cards can be purchased from our website at www.CEUworks.com. We welcome your comments, and hope that you get from this material all that is available from this course. Please submit your comments to us via fax at (813) 818-0019 or from our website.


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The time to learn First Aid is before

you need to use it. Each year 64 million Americans sustain injuries that require medical attention or restrict their activities for more than half a day. The following material could save the life of someone dear to you! We suggest you scan the material to get an overview of the various areas covered, them spend time reviewing each topic in detail. If you own or work in an adult living facility or you are a home based elderly care center then you should have in place and review every so often your policies and procedures for emergencies. When to call 911 or your local EMS number if different, and when it is appropriate to call the family of an injured resident. You should know and put into practice the rules for DOEA and other licensing bodies in your area, if you are unsure call your inspector and ask! COURSE OBJECTIVES The goal of this course & every instructor that teaches this course is to make sure each student participating in this course, feels comfortable and confident in their skills to perform first aid on an adult if warranted. Now keep in mind that not everyone can stand the sight of blood, and not everyone will recall the exact steps to take but remember that doing anything for the person will be better than doing nothing at all! Always keep in mind if you do nothing more than promptly call 911, or your local EMS system, you have

performed the first and most vital step in first aid and that is calling for more advanced professional help. Reviewing this book and these procedures will keep your skills sharp and ready for anything that may possibly happen either at work or at home. Be safe and have fun with this course.

INTRODUCTION

In this course, you will learn…

Understanding personal safety Personal Protection and

Bloodborne diseases Basics of choking and prevention Identification of life threatening

injuries How to treat and manage bleed

and wounds How to treat and manage broken

bones Identify and manage bites and

stings from insects and animals How to treat and manage injuries

specific to parts of the body How to identify signals of a heart

attack COURSE OVERVIEW How to identify signs and symptoms of a stroke Basics of the Good Samaritan laws

PRETEST

Read each statement below and choose the best response by circling the letter beside the desired response. 1. Bleeding from the eyes and unequal

pupils are signs of a skull fracture. A. True B. False 2. Risk factors for stroke include heredity

and age, as well as a previous history. A. True B. False

Adult First Aid

Copyright © 2008 Safety Services/www.CEUworks.com

Page 3

3. Luckily there is a vaccine you can get that will prevent the transmission of HIV, Hepatitis A, Hepatitis B, & Hepatitis C.

A. True B. False 4. Signs & symptoms of an allergic

reaction include pain, difficulty or noisy breathing, and bleeding.

A. True B. False 5. Symptoms of fainting include light

headedness, pale skin, & sweating. A. True B. False 6. If a tooth is knocked out during a first

aid incident, you should put the tooth in a glass of milk and have the person get to a dentist as soon as possible.

A. True B. False Answers: 1. A, 2. A, 3. B, 4. B, 5. A, 6. A DO NOT SUBMIT THE ANSWERS TO THIS PRETEST TO US FOR SCORING. THESE ARE HERE TO TEST YOUR PREVIOUS KNOWLEDGE OF THIS COURSE INFORMATION.

com(HeshosafempeUnrefor haIt ibocomweflui

other bodily fluids could splash into the eyes, nose or mouth, then you should wear goggles, or some form of protective eyewear, and a mask to cover the mouth and nose. It is always better to over-treat then to under-treat when it comes to personal protection. When you get complacent you will get exposed. Included with personal safety is watching out for things that will harm you physically. This includes the upset person that can cause bodily harm, electrical hazards, chemical spills, low oxygen environments, moving vehicles, and falling hazards. P

Adu

UNIVERSIAL RECAUTIONS

Because of the current municable disease situation patitis B, Hepatitis C, HIV/AIDS) you uld always think of your personal ety FIRST. No one (including your ployer) will watch out for YOUR rsonal safety as well as YOU! iversal precautions (sometimes erred to as Body Substance Isolation, BSI) is used in the healthcare field and s become the thing to do for everyone. s a mindset that treats all blood and dily fluids as if they had a

municable disease. This means aring gloves to protect against bodily ds. If there is a chance that blood or

If you choose not to use "safety items" that are supplied by your job for whatever reason, and you contract a communicable disease such as HIV, or Hepatitis, chances arwill not cover your mtreatment.

lt First Aid Copyright © 2008 Safety Services/www.CEUworks.com

Fig. 1.1 Left to right: Gloves should ALWAYS be worn to protect the provider from infectious materials such as Hepatitis B, and HIV/AIDS. If there is a possibility that blood or other bodily fluids could be splashed into the eyes, nose, or mouth, then goggles or protective glasses should be worn and mouth or mouth and nose barrier should be used to protect the provider from exposure.

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e Workers Comp edical bills for

Duty to Act No one is required to render first aid under normal circumstances. Even a physician could ignore a stranger suffering a heart attack if he chose to do so. Exceptions include situations where a person’s employment designates the rendering of first aid as a part of described job duties. Examples include lifeguards, law enforcement officers, park rangers, and industry safety officers. A duty to provide first aid also exists where an individual has presumed responsibility for another person’s safety, as in the case of a parent-child or driver-passenger relationship. While in most cases there is no legal responsibility to provide first aid care to another person, there is a very clear responsibility to continue care once you start. You cannot start first aid and then stop unless the victim no longer needs your attention, other first aiders take over the responsibility from you, or you are physically unable to continue care. Need for consent In every instance where first aid is to be provided, the victim’s consent is required. It should be obtained from every conscious, mentally-competent adult or adult guardian of an injured child. The consent may be either oral or written. Permission to render first aid to an unconscious victim is implied and a first aider should not hesitate to treat an unconscious victim. Consent of a parent or guardian is required to treat a child, however emergency first aid necessary to maintain life may be provided without such consent.

It is important to remember that an adult or the parent of a child victim has the right to refuse care. Regardless of the reason, if the person tells you that they

LEGAL & ETHICAL CONSIDERATIONS

do not want you to touch them or motions for you to not put your hands on them you must respect the victim’s decision. You cannot force care on a person who does not want it regardless of their condition! However, if the person is not conscious, you can help them under “implied consent”. Implied consent means that if they had been conscience they would have wanted you to help them.

Legal Concerns Some well-meaning people hesitate to provide first aid because they are concerned about being sued. This need not be a concern!

Legislators in almost every state in the country have passed GOOD SAMARITAN LAWS which are intended to protect good people who offer first aid help to others. Most of the Good Samaritan Acts are very similar in their content and usually provide tow basic requirements which must be met in order for the first aider to be protected by these provisions:

• The first aider must not deliberately cause harm to the victim.


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• The first aider must provide the level & type of care expected of a reasonable person with the same amount of training & in similar circumstances.

There should be little, if any, concern about legal consequences related to providing first aid. You need only have the victim’s consent and then offer the level of care for which you are trained to give. The Good Samaritan Act has been established in almost all states.

Heart attacks are among the leading cause of adult deaths in the United States. Over 255,000 adults die each year from heart related problems. It is important to know the signs and symptoms to be able to identify a family member or coworker that might be

require Cardiopulmonary Resuscitation (CPR). CPR provides vital oxygen through rescue breathing and maintains circulation through chest compressions. Proper training is required to perform CPR with hands-on training in a classroom setting. Because any heart attack can lead to cardiac arrest, it is therefore vital for first aiders to be able to recognize the early warning signs of a heart attack. Early recognition of heart problems is essential for the victim to receive prompt professional EMS attention. A heart attack victim whose heart is still beating has a much better chance of survival than a victim whose heart has stopped!

HEART ATTACK

Most heart attack victims who die

succumb within 2 hours after having their heart attack. Many of these victims could be saved if bystanders recognize the symptoms of a heart attack, bring to the victims’ side & use an AED if necessary,

and get professional

assistance through the EMS system by calling 911.

Indeed, many victims of heart attacks think they are

experiencing heartburn or other minor discomfort

Fig. 2.1 Left to Right: When the electrical energy in the heart muscle starts to go “haywire”, helpcould be as close as the new AED’s (automated external defibrillator) that are common now inmost public buildings. The heart is the main muscle that is responsible for movement of theblood and oxygen to the cells throughout the body. CPR is the process of mechanically addingoxygen to the blood and circulating the oxygenated blood to the brain cells to prevent damage.

suffering from a heart attack. A heart attack happens when one or more of the blood vessels that supply blood to the heart become blocked. When this occurs, cells in the heart begin to die when they cannot get oxygenated blood for vital nourishment. If a large part of the heart is deprived of blood, the heart stops beating and the victim suffers Cardiac Arrest! When a victim’s heart stops beating, they

when in fact their life is in jeopardy! The most significant sign of a heart attack is chest pain or discomfort. The victim may describe it as pressure, a feeling of tightness in the chest, aching, crushing, fullness or tightness, constricting or heavy pain. The pain may be located in the center of the chest although it is not uncommon for the pain to radiate to one or both shoulders,


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arms, the neck, jaw, or back. In addition to pain, victims may experience sweating, nausea, or shortness of breath. Many victims deny they may be having a heart attack. Others may have their condition worsened by fear of dying. With all victims in need of assistance it is important for the rescuer to constantly reassure the victim and keep them as calm and relaxed as possible. The psychological value of reassurance is as important in first aid as any treatments. First Aid Actions for Heart Attack:

• Recognize the signs & symptoms of a heart attack.

• Comfort & reassure the victim. • Have the victim stop whatever they

were doing and sit or lie down. • Call 911 or your local EMS agency

immediately. • If the victim becomes unconscious,

be prepared to perform CPR. (if you are trained to do so)

• Use an AED (Automatic External Defibrillator) if available and you are trained in its use.

All of us can reduce the risk of heart attack with proper lifestyle. By controlling high blood pressure, limiting cholesterol in the diet, watching weight, exercising regularly, stop smoking, and minimizing stress. Healthy living = A longer, happier, healthier life. Primary Survey In every emergency situation, there is a logical order to be followed.

First, it is important to carefully assess the scene of an emergency BEFORE any further steps are taken. The purpose of this assessment is to assure it is safe to approach the victim to provide first aid care. For example, an unconscious victim might be lying on a live power line. If a

rescuer were to touch the victim before the power could be shut off, the rescuer would become a victim as well! Always be sure it is safe before you attempt to help a victim!

VICTIM ASSESSMENT

Adult First Aid Copyright © 2008 Safety Ser

Fig. 3.1 After determining that the scene is safe, kneel beside the victim and gently shake and shout, “Are you OK?”. Then call out for help or call 911 if you are alone.

Once you determine it is safe for you to help a victim, you should immediately determine if the victim has any life threatening conditions. Begin by Checking to see if the victim is responsive. Kneel and ask, “ARE YOU OK?”. If there is no response, you must immediately call for help! Recent studies have conclusively shown that victims who are not breathing and do not have a heartbeat have a substantially greater chance for survival if they receive prompt advanced medical care in a hospital or by trained rescue personnel. Only after a call is placed for emergency medical services does a volunteer attempt to further help an unconscious victim. If there are bystanders on the scene, summon someone to your side to provide assistance. If the victim is on his stomach, first place the victim’s arm

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closest to you at his head. Then turn him over by placing one hand on the victim’s hip and the other hand at the victim’s shoulder. Turn the body in a smooth, even straight line so as to not cause further injury in the event of existing spinal cord injury. With the victim now on his back, open the victim’s airway by placing the heel of your hand on the victim’s forehead and the tips of your fingers under the bony part of the jaw. Push down on the forehead while lifting up the chin until the jaw is pointing straight up. Now place your ear over the victim’s mouth and look, listen & feel for breathing for 5 to 10 seconds. Look at the chest to see if it is rising. Listen for sounds of breathing and feel for air coming from the victims mouth or nose. If the victim is not breathing, rescue breathing is required immediately!

R

escue breathing

will provide

vital oxygen

to a victim

who cannot breath

on their own. After

giving a victim two breaths, the pulse is checked at the Carotid Artery to ascertain if the victim has a heartbeat. This artery is located on the side of the neck and is found by first positioning the fingers on

the victim’s Adam’s Apple, then sliding the fingers down into the soft groove on the side of the neck. The pulse is checked for 5 to 10 seconds. CPR is a combination of very simple steps. These steps are:

Fig. 3.2 Left to Right: Open the airway by using the head-tilt Chin-lift maneuver. Take 5-10 seconds to look, listen, and feel to determine if the victim is breathing. If the victim is not breathing, give 2 rescue breaths, then check for a pulse in the carotid artery in the neck. Check the pulse for 5-10 seconds. If the victim has no pulse, then begin CPR.

Important: While this book identifies life threatening conditions requiring rescue breathing or CPR, these skills require intensive classroom skill development and practice and cannot be effectively presented or taught in this book. The author strongly encourages everyone to enroll in a CPR course.

Adult First Aid Copyright © 2008 Safety Service

Fig. 3.3 The carotid artery is used in the adult victim to check for a heartbeat or pulse. Absence of a pulse is an indication that they do not have a heartbeat.

• Breath for the victim if they are not breathing.

• Give them a heartbeat if they do not have a pulse. This is done by doing manual chest compressions.

• If the person is in need of CPR they are not breathing and they do not have a pulse, they are considered dead.

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These initial steps of checking the airway, breathing and circulation (pulse), together with a check for major bleeding, constitute the primary survey, which looks for life-threatening conditions. In every instance where first aid is to be provided, it is important to always ask a conscious victim for permission to help them. If a victim is unconscious, it is presumed they have provided consent for you to assist them. Obstructions in the Airway (Note: Emergency treatment of airway obstructions is taught as part of CPR training and only through classroom practice can the necessary skills be mastered.) The mechanics of handling airway obstructions are presented in this book are for background insight only. If an individual is signaling that they are choking - but can speak or cough forcibly - there is an exchange of air, although it

might be diminished,

you should encourage

the victim to continue

coughing while you

monitor them. On the other hand, if a victim is choking, but

cannot

• Stand behind the victim

Fig. 3.6 After you have the proper stance, and permission to help, find the navel, grab your first hand with your second hand, then pull both in & up. Do this firmly with the intention to get the object out. Choking is considered a “life-threatening” situation. No time should be wasted in performing the Heimlich maneuver.

• Wrap your arms around the victim’s waist

Fig. 3.4 The universal sign ofchoking is one hand or two handsaround the neck in a clutchingfashion.

Adult First Aid Copyright © 2008 Safety S

speak or cough, an airway obstruction exists which must be treated immediately! The treatment for an obstructed airway in a conscious victim involves use of the Heimlich Maneuver, is considered a true emergency, & is performed as follows:

Fig. 3.5 To perform the Heimlich maneuver on an adult, it isimportant that you are prepared in the event that the victim goesunconscious. Don't drop them! Be sure to get a good open footstance. If the victim goes unconscious, you will be able to controltheir fall to the ground. Be careful not to hurt your back.

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• Make a fist with one hand and

place the thumb side of the first against the victim’s abdomen, just above the navel and well below the lower tip of the breastbone, grasp

your fist with your other hand with elbows out, press your fist into the victim’s abdomen with quick. upward thrusts.

Each thrust is a distinct, separate attempt to dislodge the foreign object. Repeat thrusts until foregoing object is cleared or victim becomes unconscious. Emergency treatment of airway obstructions in an unconscious victim is taught in CPR classes. Secondary Survey The secondary survey is a head to toe exam to look for any other problems with the body other than those found in the primary survey. You will be looking for scrapes, scratches, bumps, buries, bleeding, and broken bones among others. It is imperative to remember that if you find any complications with the primary survey that a secondary may not be performed until the primary survey complications are resolved or fixed. Treat all injuries as you find them. When performing the secondary survey, the person should be conscious and talking to you, and you should be speaking each step to them as your perform it. Starting at the head run your hands through the hair and look at your hands to see any visible blood. Look at the face for any abnormalities. Look at the neck to see if the windpipe is in line. Press on the collarbones to make sure they are intact. Look at the chest and make sure both sides are rising equally. If not then make a mental note to tell EMS when they arrive. Gently press on the abdomen for any tenderness or rigidity. Gently press the pelvis together to ensure that it is intact. Gently squeeze each arm with 2 hands working from the shoulder down to the hand checking for any broken

bones. Move to the legs and as you did with the arms check the legs working from the hip down to the feet. Ask the person to move their fingers and toes. If you do not find any problems and they are not complaining of any pain then most likely they are all right. Watch them carefully for the next few hours and if they start developing problems seek medical attention. BLEEDING AND WOUNDS

Bloodborne Pathogens The material printed in this section is current at the time of this writing. Because of the fast paced and ever-changing research being done to find a cure for the bloodborne diseases we can not guarantee the validity of the information provided even 30 days after this material is written. Bloodborne pathogens are

disease-causing

microorganisms that may be present in

human blood. They may be

transmitted with any exposure to blood. Two

significant viruses are Hepatitis B


Fig. 4.1 The biohazard symbol is a universal logo that warns of potentially infectious materials. All potentially infectious materials should be placed in containers lined with red bags that display the biohazardous logo.

Virus (HBV) and Human Immunodeficiency Virus (HIV). A number of other Bloodborne


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viruses exist but for our purposes here we will only discuss HIV, and HBV. The HBV attacks the liver. HBV is very infectious and can cause:

• Active hepatitis B-a flu-like illness that can last for months.

• A chronic carrier state. The person may have no symptoms, but can pass HBV to others who they come into contact with.

• Cirrhosis, liver cancer, and death. Fortunately, vaccines are available to prevent HBV infection. Even if you are vaccinated against HBV, you still must treat all blood and bodily fluids as if they are infectious. This practice is known as “Universal Precaution”. HIV is the virus that causes the end result called AIDS (Acquired Immune Deficiency Syndrome). HIV attacks the bodies immune system, making the body less able to fight off infections, such as the common cold. In most cases, these infections eventually prove to be fatal. At present there is no known cure or vaccine for Aids.

• Use protective equipment whenever possible to prevent contact with bodily fluids while giving first aid.

• Keep open wounds covered with dressings to prevent blood contact.

First Aid Kit

Everyone should have a well-stocked first aid kit handy at home, in the care and in the workplace. The contents of your kit will vary depending upon the number of people it is designed to protect as well as special circumstances where it will be used. For example, a first aid kit in a factory where there may be danger of flying debris getting into the eye should certainly have a sterile eyewash solution in its kit. If a family member is a known diabetic, your kit at home should have a glucose or sugar solution. When

assembling your first aid kit, whether for use in the home, car or at work, you should consider possible injuries you are likely to encounter and then select kit contents to treat

those conditions. It’s also important


Fig. 4.2 Every home and car should have a well stocked first aid kit. There should be adequate materials to handle every emergency.
to check your
kit periodically to restock items that have been used and to replace items that are out of date. It’s also advisable at home and at work to have both a stationary kit, stored in a cabinet or drawer, as well as a compact portable kit that can be taken quickly to the site of an emergency.

Recommended Contents for a First Aid Kit


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• Activated Charcoal (poisoning emergencies)

• Adhesive tape • Adhesive strip bandages-assorted

sized • Alcohol wipes • Antacid • Antibiotic ointment • Baking soda • Calamine lotion • Chemical ice packs • Chemical hot packs • Cotton balls • Cotton swabs • Disposable latex or vinyl gloves • Elastic bandages • Face mask for CPR • Gauze pads-various size • Hydrogen Peroxide • Hypoallergenic tape • Non-adhering dressing(Telfa) • Safety pins • Paper (cone shaped) drinking cups • Scissors • Roller gauze-self adhering • Hand Soap • Space blanket • Sam splint • Syrup of Ipecac • Tweezers • Thermometers-oral & rectal • Waterproof tape • Triangular bandages

Fig. 4.3 Above: Syrup of ipecac is a solution that will promote vomiting in the event of an accidental poisoning, it should only be given on the advice of poison control.

• All first aid kits should have several pairs of rubber, vinyl, or latex gloves available. Use these gloves in every situation involving blood or bodily fluids.

• If gloves are not available, use the most waterproof material available or extra gauze or other absorbent materials to form a barrier.

• Whenever available use a mouth barrier called a face shield or face mask device when doing rescue breathing. Every first aid kit should have one. While saliva is not considered a high risk fluid, there may be blood in the mouth.

A person who is exposed to blood or other bodily fluids should:

• Wash the exposed area immediately with soap and running water. Scrub vigorously with lots of soapy lather.

• Report the incident promptly, according to your workplace policies. “If it didn't get reported and it isn’t on paper it didn’t happen!”


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• Get medical help, treatment and counseling. If your workplace is covered by OSHA’s Bloodborne Pathogens Standards, ask about getting a confidential medical evaluation, testing and treatment.

• Ask about HBV globulin if you have not had the HBV vaccine. It can provide short term protection.

Bleeding Major bleeding may be a life-threatening condition requiring immediate

attention. Bleeding may be external or

internal. Bleeding comes from one of 3 types of vessels in the body, Arteries, veins, or capillaries. Arteries are major blood vessels which carry oxygen-rich blood from the heart

throughout the body. Blood from arteries is bright red in color and spurts from the wound. Arterial bleeding requires immediate attention and is potentially life threatening!

Fig 4.4: CPR face barriers are a handy, usually key-chain type device that allows you to breath into the victim, butkeeps the victims body fluids on their side of the mask.

Veins which carry blood back to the heart to be oxygenated. Venous bleeding is dark red, almost maroon in color, and runs steadily from the wound. If left untreated, venous bleeding can be potentially life threatening. Ccapillaryies are the smallest of our body’s blood vessels. Blood from capillaries is red and oozes from the wound. Bleeding from capillaries are hardly ever life threatening in small areas of the body. This type of bleeding would be the same as the scraped knee or elbow that we received as children. Capillary bleeding however, can be life threatening if large surface areas of the body are affected from injuries such as “road rash” from a vehicle crash. Capillary bleeding usually has a higher risk of infection than other types of bleeding. First aid for bleeding is intended to:

• Stop the bleeding • Prevent infection • Prevent shock

How to Control Bleeding:

• Apply direct pressure on the wound.

• Use a dressing, if available. If a dressing is not available, use a clean rag, towel, piece of clothing or your hand alone. Important: Once pressure is applied, keep it in place.

• If dressings become soaked with

blood, apply new dressings over

Fig. 4.4 The above diagram is the route the blood takes from the heart to the lungs, back to the heart, then out to the various parts of the body


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the old dressings. The less a bleeding wound is disturbed, the easier it will be to stop the bleeding!

• A bandage, such as a roll of gauze, is used to hold a dressing in place.

Pressure should be used in applying the bandage. After the bandage is in place, it is not important that the dressings you will use are sterile! Use whatever you have at hand and work fast! A slow pulse rate, or bluish fingertips or toes, signal a bandage may be impeding circulation.

Fig. 4.6 Left to Right: proper bandaging of a wound simply means that the bandage applies enough pressure to help control bleeding, yet not so tight as to restrict circulation. Bandaging the head, forearm, and the ankle/foot. Try overlapping the roll cling so that no skin can be seen through the bandaging materials when you are completely finished. Neatness does not count.

• If bleeding continues, and you do not suspect a fracture, elevate the wound above the level of the heart and continue to apply direct pressure.

• If the bleeding still cannot be controlled, the next step is to apply pressure at a pressure point.

For wounds of the arms or hands, pressure points are located on the inside of the wrist (radial artery-where a pulse is checked) or on the inside of the upper arm (bronchial artery). For wounds of the legs, the pressure point is at the crease in the groin (femoral artery). Steps 1 and 2 should be continued with the use of the pressure points.

• The final step to control bleeding is to apply a pressure bandage over the wound.

Note the distinction between a dressing and a bandage:

• A dressing may be a gauze square applied directly to a wound.

Signs and symptoms of internal bleeding are:

• Bruised, swollen, tender or rigid abdomen.

• Bruises on the chest or signs of fractured ribs.

Fig. 4.5 Pressure points are the points at which a vessel passes over a bone. Applying pressure to these points helps the control of large bleeding wounds.


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• Blood in the vomit. • Wounds that have penetrated the

chest or abdomen. • Bleeding from the rectum or

vagina. • Abnormal pulse, and difficulty

breathing. • Cool moist skin.

First aid in the field for internal bleeding is limited. If the injury appears to be a simple bruise, apply cold packs to slow bleeding, relieve pain and reduce swelling. If you suspect more severe internal bleeding, carefully monitor the person and be prepared to perform CPR if required (and you are trained to do so). You should also reassure the victim, control external bleeding, and care for shock (shock is covered in the next section). Loosen tight fitting clothing and place the victim on their left side so fluids can drain from the mouth and not become an airway obstruction. Wounds A wound is an area that has a break in the skin. There are several types of wounds that can cause severe bleeding. These include Lacerations, incisions, aversions, and amputations. A laceration is a rough jagged opening in the skin such as when a piece of glass cuts the skin. It is usually caused by the skin being torn open. These types of wounds most commonly have the biggest and most visible scars when healed. Incisions are a smooth type of cut such as when a surgeon makes a cut with a scalpel. These wounds heal more quickly and with less scarring than lacerations.

Avulsions are almost like amputations but the affected body part is still attached by a piece of skin. Aversions can affect any part of the body away from the main trunk. Avulsion can happen to the hands, fingers, arms, legs, toes, ears, nose, lips, and any other body part that can be caught in machinery, or other moving gadgets. Amputations are the complete removal of a limb or other body part away from the trunk. Sometimes it is necessary to remove surgically body parts that are dead or too badly damaged from trauma to the body. Amputations can be caused

by limbs or other body parts being caught in machinery

or other moving

objects. Any wound no

matter what the cause, if

bleeding and if left

Adult First Aid Copyright © 2008 Safety Servi

Fig. 4.6 Bleeding is controlled first by direct pressure with a gauze pad and pressure directly on the wound. This will help to slow the bleeding. Direct pressure is followed with a pressure bandage applied over the open wound.
unattended can cause severe shock or even death. All bleeding wounds should be treated promptly and properly to prevent serious illness or death. Shock Shock is common with may injuries, regardless of their severity. The first hour after an injury is most important because it is during this period that
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Page 15

symptoms of shock appear. If shock is not treated, it can progress to cause death! Shock is failure of the cardiovascular system to keep adequate oxygenated blood circulating to the vital organs of the body, namely the heart, lungs and brain, Any type of injury can cause shock. Signs and symptoms of shock include: Confused behavior, very fast or very slow pulse rate, very fast or very slow breathing, trembling and weakness in the arms or legs, cool and moist skin, pale or bluish skin, lips and fingernails and enlarged pupils. Putting a victim in a lying-down position improves circulation. If the victim is not suspected of having head or neck injuries, or leg fractures, elevate the legs. If you suspect head or neck injuries, keep the victim lying flat. If victim is experiencing trouble breathing, place them in a semi-reclining position. Maintain the victim’s body temperature by covering with a blanket or sheet, but do not allow them to become overheated. Human Bites Biting occasionally occurs among adults, usually in long term care, when they become confused about where they are or among adults who are fighting. Many of these bites are minor and more of an

emotional wound than a physical one. However, the human mouth contains a large number of bacteria which can cause infection if introduced into another’s blood through a bite. The likelihood of infection from a human bite is greater than that of an animal bite. First Aid Actions

• Wearing gloves for protection, wash the wound with soap and water. Bites that do not break the skin are not serious.

• If the bite breaks the victim’s skin, they might need a tetanus shot or antibiotics.

Animal Bites Animal bites carry a high risk of infection and require professional attention promptly! Infection may develop hours, or days, after an animal bite. Certain species of wild animals have a higher incidence to carry rabies than others. If a person is bitten by a wild or stray animal, after treating the injury, animal control should be notified so the animal may be caught and put into quarantine to be checked for rabies. Signs and symptoms of infection are:

BITES AND STINGS • Pain & tenderness or pus at the

wound site,

Adult First Aid Co

Fig. 5.1 Left to Right: Some species of animals have a higher tendency to carry rabies than others. In the wild, the rat, squirrels, and raccoons, as well as possums have been known to carry rabies. If you are bitten by a wild or stray animal, treat the injury for bleeding, then notify animal control so that the animal may be caught and quarantined to be checked for rabies.

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• Redness, • Swelling, • Red streaks in the skin around the

wound • Possibly swollen glands closest to

the wound site. First aid care for animal bites includes:

• Washing the wound well with soap and water, if there is no heavy bleeding.

• Cover the wound and seek professional attention. A serious wound should be cleaned only by trained medical personnel.

Insect Bites Insect bites and stings can be life-threatening to people with a severe allergy to the insect’s venom. Signs and symptoms of allergic reaction include pain, swelling of the throat, redness or discoloration at the site of the bite, itching, hives, decreased consciousness and difficult or noisy breathing. First aid calls for being alert for signs of allergic reaction or shock and seeking medical attention as quickly as possible for these victims!

If a stinger remains in the victim, you should try to remove it carefully without tweezers, try scraping with the edge of a credit card. Be careful not to squeeze the stinger as this will inject more venom into the victim. Once a stinger has been removed, the wound should be washed well with soap and water. Cold compresses will help relieve pain and swelling. The stung area should be kept lower than the heart to slow circulation of the venom. Remember, in all cases of insect bites, watch for signs of allergic reaction and if they appear, seek professional medical attention without delay! Snake and Spider bites In the U.S. of the 40,000 to 50,000 annually bitten by snakes, over 7,000 are poisonous snakes. Amazingly, only a dozen die each year. Of the many different snake species, only four (4) in the U.S. are poisonous: Rattlesnake, Copperhead, Water moccasin, and the Coral snake. The first three are called pit vipers and have three common characteristics:

• Triangular, flat head wider than its neck

• Elliptical pupils (such as that of the cat)

• Heat sensitive “pit” located between each eye and nostril

The coral snake is small and very colorful, with a series of bright red, yellow, and black

Fig. 5.2 Left to Right: The wasp is a common insect that will sting if provoked. The red ant, also called fire ants, bites are painful and cause localized swelling. The common yellow jacket, these insects are VERY aggressive and will actually chase anyone that comes close to the nest.
bands around its

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body. Every other band is yellow. A black snout makes the coral snake. Signs and symptoms of pit viper bites are:

• Severe burning at the site of the snake bite.

• Two small puncture wounds. These are caused from the fangs that inject the venom.

• Swelling. Usually happens within 5 minutes of bite and can involve the entire extremity.

• Discoloration and blood filled blisters.

• In severe cases, Nausea, vomiting, sweating, and weakness.

• No venom injected in about 25% of the poisonous snakebite victims, only fang and tooth wounds.

Most snake bites occur within a few hours of medical facilities where antivenin is available. Bites showing no sign of venom injection require only basic first aid for puncture wounds and minor bleeding. Two spiders, the black widow and the brown recluse can be deadly if bitten.

Black widows are usually found thought the world. A red hourglass shape in the underside identifies the female (the one that bites). Females have a glossy black body. By volume, black widow spider venom is more deadly than the rattlesnakes, but is injected in much lesser volumes. The signs and symptoms of the black widow spider bite is as follows:

•

• •

•

Adult First Aid Copyright © 2008 Safety Services/

Fig. 5.3 Although the former treatment for snake bites was to apply a constricting band to prevent the spread of venom, treatment now includes the use of cold packs and bandage the site to prevent the spread of venom and keep the site clean. Treatment should include being seen at a hospital. Identifying the type of snake is also very important.

A sharp pinprick of the spiders bite may be felt. Most times victims are not

Fig. 5.4 The black widow shown above with the trademark red “hourglass” shape (circled). This spider can be deadly to those with suppressed immune systems or the very young. Otherwise, this type of bite is VERY painful and should be treated as an emergency.

even aware the bite has occurred. Faint red bite marks appear. Muscle stiffness and cramps, usually affecting the abdomen when the bite is to the lower part of the body. Affecting the back, chest and arms when the bite is to the top upper part of the body. Headache, chills, fever, heavy sweating, dizziness, nausea, vomiting, and severe abdominal pain.

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The brown recluse spider has a brown, possible purplish, violin shaped figure on its back. Brown recluse spider bites are rarely fatal but can case major tissue damage. Signs and symptoms are: The initial pain may be slight even

enough to be over-looked. A blister at the sight, along with redness,

pain, swelling after several hours. Fewer, weakness, vomiting, joint pain,

and a rash may occur. An ulcer forms within a week. Gangrene

may develop in some cases. Treatment for snake and spider bites include:

• Seek medical attention as soon as the bite has occurred or as soon as you notice any signs and symptoms.

• Treat for shock. • Use ice packs to reduce swelling

and slow the spread of the poison. • Clean affected area with soap and

water.(do not delay medical attention for this step)

• If severe signs and symptoms are present call 911 or your local EMS agency.

Head Injuries There are several types of injuries

to the head. These include scalp wounds, skull fractures, concussions, and contusions. Scalp wounds bleed profusely because of the scalp’s rich blood supply. Visualize the wound for location and size and to see any skull indentation. Skull fractures (small cracks in the skull bone) often occur as a result from a major trauma to the head. These could include falls from a tree, blow to the head from a baseball, baseball bat, or being hit by a motor vehicle. These injuries can be open or closed. Signs and symptoms include:

• Pain at the site of injury. • Severe headache. • Bleeding from the ears or the

nose. • Discoloration under the eyes. • Unequal pupils.

Eye Injuries Be extremely careful and gentle when treating eye injuries. Floating objects in the eye which can be visualized may be flushed from the eye with water. If the object cannot be removed in this manner, the victim should seek medical attention. Never attempt to remove objects imbedded in the eye! First

SPECIFIC BODY INJURIES

Fig. 6.1 Above: Due to the large amount of vessels in the head, a very small cut can appear to be larger than it is. Fig. 6.2 Below: Skull fractures are usually caused from blunt trauma to the head. Prompt treatment is requiredby EMS.

Adult First Aid Copyright © 2008 Safety Services/www.CEUworks.co

Fig. 6.3 If the eye has a foreign body in it try to flush the eye from the nose outward to remove the object. If there is a chemical splashed into the eyes, flush with copious amounts of water.

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aid care for these injuries consists of bandaging both eyes and seeking professional care promptly! An inverted paper cup covered with a bandage is appropriate for treatment until the victim is transported to the hospital. For chemical burns of the eye, wash the eye with copious amounts of water for 15 to 30 minutes. Then wrap a bandage around both eyes and seek professional help. Eyes are delicate and sight is precious! Prompt professional attention to eye injuries is required to preserve sight! Nose Injuries

they may cause increased pressure on injured tissue. All uncontrolled nosebleeds require prompt medical attention! Dental Emergencies The following procedures serve as guidelines for providing for temporary relief for dental emergencies. It is important to consult with a dentist as soon as possible.

Knocked out tooth:

• If the tooth is dirty rinse it gently with running water to clean it. Do not scrub it or remove any tissue fragments.

Fig. 6.4 nosebleeds are somewhat troublesome, but not life threatening. Direct pressure to the nose will stop bleeding. If the bleeding does not stop after several minutes, medical attention is required. Fig. 6.5 Contrary to modern belief, nosebleeds are treated by pinching the nostrils together and having the victim lean FORWARD for several minutes.

Severe nosebleed can be most frightening. It can also lead to shock if enough blood is lost! Many cases of nosebleed can be controlled simply by having the victim sit down, pinch the nostrils shut and lean forward (to prevent blood from running into the throat). Once the bleeding has been stopped, talking, walking and blowing the nose may disturb blood clots and allow the bleeding to resume. The victim should rest quietly until it appears the bleeding remains stopped. If it is suspected that the victim has suffered head, neck or back injuries do not attempt to control the blood flow as

B

Adult First Aid Copyright © 2008 Safety Service

Fig. 6.5 Top to bottom: If a tooth is broken or knocked out, place the tooth in a glass of milk and seek medical attention at a dentist.

• Place the tooth in a cup of whole mile or a special tooth preserving solution.

• If you can get to the dentist within 30 minutes there is a good chance that the tooth can be saved. Don’t forget to bring the tooth.

roken tooth: • Gently clean dirt from the injured

area with warm water. Place a cold compress on the face, in the area of the injured tooth, to decrease any swelling that may occur. Seek a dentist immediately.

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Bitten lip or tongue: • Control bleeding by gently holding

pressure on the site of injury. If persistent bleeding occurs contact EMS.

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also involve loss of fluids through the damaged skin. Second degree burns are usually the most painful because nerve endings are usually intact, despite severe tissue damage. Third degree burns are the deepest. They may look white or charred, & extend through all skin layers. Victims

A

ENVIRONMENTALEMERGENCIES

urns

The severity of a burn depends pon its size, depth and location. Burns re most severe when located on the ce, neck, hands, feet and genitals. Also, hen they are spread over large parts of e body or when they are combined with ther injuries. Burns result in pain, fection and shock. They are most erious when the victims are very young r very old.

evdn

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of third degree burns may have severe pain or no pain at all if the nerve endings are destroyed. First aid actions for burns: First degree flush with cool running water, apply moist dressings & bandage loosely. Second degree apply dry dressings and bandage loosely. Do not use water (long term) as it may increase risk of shock. Third degree same treatment as second degree. All victims of serious burns should seek professional help quickly!

Burns can be caused not only by hot liquids but also by

caustic chemicals. In these cases, it is

important to remove

ing on cloth

dul

Fig. 7.1 Left to Right: First degree burns are usually the equivalent of a sunburn. A second degree burn may have open or closed blisters. A third degree burn will be black and charred with little or no pain. A third degree burn can be life threatening if enough of the body surface is affected. Surgery usually always is necessary to treat a third degree burn.

First degree burns are the least ere. They are characterized by ess or discoloration, and mild lling. Overexposure to the sun is a mon cause of first degree burns.

Second degree burns are more ous. They are deeper than first ree burns, look red or mottled and e open or closed blisters. They may

which chemicals have spilled and flush the affected are with copious amounts of water for 15 to 30 minutes. After all of the chemical substance is rinsed off, treat the burn by its severity, ffirst, ssecond, or, tthird degree. If the burns are caused by contact with an electrical source, the first and most important thing is to make sure that the power is off! After the breaker or

t First Aid Copyright © 2008 Safety Services/www.CEUworks.com

Page 21

fuse has been shut off treat the burn the same as a chemical or heat burn. ALWAYS REMEMBER PERSONAL SAFETY! In some instances severe electrical shock can cause unconsciousness or cardiac arrest. If the person does not respond check ABC’s and call 911 or your local EMS agency. Start CPR or rescue breathing immediately (only if you have been trained in CPR in a classroom setting.) Poisoning Over a million cases of poisoning occur in the United States each year, most involving young children. Prevention

of poisoning should be the concern of every parent with young children. Substances likely to cause poisoning should be kept away from inquiring youngsters! Since various poisons cause different symptoms, and because treatments vary depending upon the substance ingested, the first step in the event of poisoning is to call the local poison control center! Do not wait for

need to be monitored carefully for signs of shock or impaired consciousness. Every household should keep syrup of ipecac and activated charcoal on hand for possible use in poisoning emergencies, however they should not be given unless instructed to do so by the poison control center. Both of these items are available at your local drug store. The number for the poison control center should be posted by the phone in the event of an emergency. The number for the Florida Poison Control Center is 1-800-222-1222. Use this number anytime you have a possible accidental poisoning or call 911 or your local EMS agency. Heat Emergencies Heat emergencies are very common in southern states, due to the almost year-round tropical climate that is common to our state. Never under estimate heat while working, playing or sunbathing. It does not take long for the body to be over heated and suffer from a heat related problem. There are three types of heat emergencies you may be required to treat. These include heat exhaustion, heat cramps, and the most severe requiring immediate medical attention, heat stroke. Heat Exhaustion

Fig. 7.2 Top to Bottom: If household chemicals are present, they should be in a locked cabinet or out of the reach of reach of any small children or adults who may confuse them with types of medication. Many household type plants are poisonous if chewed or ingested. Check with your local poison control center or library for books listing of common plants that may be poisonous. Contact poison control if ingested.

symptoms to occur! Identify the nature of the poison and receive specific care instructions from the professional staff at the center! All poisoning victims

Heat exhaustion is the least serious of the heat emergencies. It is caused by fluid loss which in turn causes blood flow to decrease in vital organs, resulting in a form of shock. The victims body temperature will remain normal. Signs and Symptoms may include:

• Cool, pale, and moist skin.


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• Dilated pupils(wide large pupils). • Headache. • Nausea and vomiting. • Dizziness.

First Aid Actions Get the victim out of the heat and into a cool place. Place them in the shock position (lying on back with legs elevated 8-12 inches). Remove or loosen tight fitting clothing. Cool by fanning or place cold packs under the arms, legs, and in groin area or cover the victim with wet towels or sheets. If conscious give water to drink every 15 minutes. While heat exhaustion is not a life threatening emergency it can progress to heat stroke, which is life threatening, if let unattended. Heat Cramps Heat cramps are muscular pain and spasms due to heavy exertion. They usually involve abdominal or leg muscles. It is generally thought this condition is caused from fluid loss and low salt level due to profuse sweating. First Aid Actions Get the victim to a cool place. If they can tolerate it, give half of a glass of water every 15 minutes. Heat cramps can usually be avoided by increasing fluid intake when active in hot weather. Heat Stroke This is the most serious type of heat emergency. It is life threatening and requires immediate and aggressive action on the part of the first aider. Heat stroke occurs when the bodies heat regulating mechanism fails. The body temperature rises so high that

brain damage, and death, may result unless the body is cooled quickly. The signs and symptoms are:

• Victims skin is hot, dry and red. • Very high body temperature up to

105 degrees. First Aid Actions The main thing to remember is that heat stroke is life threatening and prompt action by trained EMS is required. First and foremost call 911 or your local EMS agency. Cool the victim in the quickest manner possible. Remove the victim from the heat and into a cool environment. Place the victim into a bathtub of cool water (not full of ice!), then wrap in cool wet sheets and apply ice or cold packs to the under arms, legs, and groin area. Do not give the victim anything by mouth and treat for shock. Hypothermia Signs and symptoms of this dangerous condition which can become life-threatening are:

• shivering • dizziness • numbness • confusion • weakness • impaired judgment • impaired vision • drowsiness

Hypothermia victims pass through 5 stages, with each stage more serious and leading to death! The following stages are listed from least to worst.

• Shivering • Apathy • Loss of consciousness


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• Decreasing pulse and breathing rate

• Death First Aid Actions Seek professional help, get victim out of the cold, and if they are in wet clothing remove it and get them into dry clothing. Warm the body slowly! Give nothing to eat or drink unless victim is fully conscious as this can become an airway obstruction. If trained, monitor Airway, Breathing & Circulation and if necessary perform CPR! Contact 911 or your local EMS agency.

F bdclficgsgtba T

slightly, but will not have full range of motion.

First Aid Actions

• Broken bones except for spinal and pelvic fractures are seldom life threatening.

• Ask the victim

A

MUSCLE, JOINT & BONE

ractures

A fracture is a partial or complete reak in a bone caused by a twist or irect blow. Fractures are common in hildren, even though the bones and

igaments of healthy children are more lexible than those of the adult. These njuries are especially worrisome in hildren because any damage to the rowth plate of a bone can cause hortening of the bone and irregular rowth. Fractures often cause damage to

he surrounding muscles, nerves, and lood vessels causing bleeding, swelling, nd pain.

he signs and symptoms of fractures are: • Pain and tenderness. The victim

will complain of pain at the site. • Swelling. • Deformity. The break in the bone

will often move into an unnatural shape or bend in a manner that is not normal.

• Loss of use. The victim might be able to move the injured part

what happened.determine possible inyou should

• Immobilizethe injury whatever available. injured par

• Place ice injured parpain and sw

• Make arravictim tranfacility. If your local E

• Give the vdrink.

• Treat for sh

dult First Aid Copyright © 2008 Safety Services/www.CEUworks.co

Fig. 8.1 Fractures are complete or partial breaks in a bone. Visible signs are swelling, bruising, deformity, and possible breaks in the skin. Compare shape of suspected limb to opposite limb.

This will help you if there are any other juries and what actions take. the injury by packing with jackets, pillows, or soft material you have You want to keep the t from moving. packs along side the

t. This will help reduce elling.

ngements to have the sported to a medical necessary, call 911 or MS agency. ictim nothing to eat or

ock.

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Sprains A sprain is a twisting of a joint along with tearing of the supportive muscles and ligaments. It is sometimes difficult to distinguish between a fracture and a sprain because the symptoms are often similar. Any victim with a suspected fracture or sprain needs to have an X-ray at a medical facility. First Aid Actions

• Rest, ice and elevation are helpful for treating soft tissue injuries. The best results are accomplished if first aid treatment is started soon after the injury.

• Rest. Have the victim rest and try not to use the injured part.

• Ice. Apply a cold pack to the injured area for periods of 15 to 20 minutes. Applications of the cold packs help reduce swelling, pain and bruising.

• Elevate the injured part above the level of the heart. This helps slow the bleeding to the injured part and helps reduce pain and tenderness.

Dislocations A dislocation is the separation of a bone from a joint. In children, it is commonly seen in fingers and elbows. It takes only a small amount of force for the bone of a child to be dislocated. This is why adults are cautioned to not pull on the forearm or hand of a child. A simple tug to prevent a child from stepping from a curb into traffic or to keep them from falling can cause a dislocation. Infants and children should never be lifted by their arms or hands. They should always be lifted from under their armpits. Fractures, dislocations, sprains, and strains are hard for the lay person to

tell apart. The only way to tell these injuries apart is by having X-rays done at a medical facility. For this reason, treatment for any of these injuries are treated as though the injury was a break.

MEDICAL EMERGENCIES

Stroke A stroke occurs when the blood flow to the brain is interrupted long enough to cause damage. This may be caused by a clot formed in an artery in the brain or carried to the brain in the bloodstream, a ruptured artery in the brain or by compression of an artery in the brain, as found with brain Every year 55,0

a new or rec• Stroke is

death, keach yea

• Stroke is disability.are permof stroke.

Adult First Aid Copyright © 2008 Safety Services/www.CEUworks

Fig. 9.1 Stroke is caused by a blockage due to a blood clot or cholesterol that has lodged itself in a small vessel in the brain. Referred to by some medical professionals as a “Brain Attack”.

tumors.

00 Americans experience urrent stroke. the 3rd leading cause of illing 150,000 Americans r. the leading cause of adult Three Million Americans anently disabled because

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Why is stroke a medical emergency?

During a stroke, reduced blood flow to the brain starves the brain cells of essential oxygen and nutrients. Within minutes, cells in the center of the stroke die, however, stroke specialists believe that many cells in the surrounding area of the brain can be saved by prompt medical treatment. Recent stroke research indicates that:

• Restoration of blood flow can rescue brain tissue.

• New drugs may protect brain cells if given quickly following a stroke.

Therefore, early intervention is necessary and every minute following stroke can affect the ability of damaged brain cells to recover and regain function. What are the risk factors for stroke? Everyone is at risk for stroke. However, certain conditions can increase one’s risk for stroke. These risk factors fall into two categories, controllable and non-controllable. Non-Controllable risk factors include:

• AGE- The risk of having a stroke doubles each decade past age 55.

• Race- African Americans and Hispanics have a greater risk of death and disability from stroke.

• Diabetes- Although diabetes is treatable, having it makes a person more likely to have a stroke.

• Heredity- Stroke risk is greater for people with a family history of stroke.

• Previous Stroke- The risk of stroke is greater for someone who has had a previous stroke.

Controllable risk factors, if modified or treated, can decrease one’s risk of stroke. They include both medical disorders and lifestyle factors:

• High Blood Pressure • High cholesterol levels • Carotid artery disease • SMOKING • Lack of exercise • Obesity • Excessive alcohol consumption

First aid consists primarily of recognizing signs and symptoms and seeking professional attention. If you recognize the symptoms of stroke in yourself or others, CALL 911 (or your local EMS Agency) immediately. It’s critical for someone who experiences stroke symptoms to seek emergency treatment. Signs and symptoms of a stroke include:

• Weakness and numbness of the face, arm, or leg, often on only one side of the body.

• Dizziness • Confusion • Headache • Ringing in the ears • A change of mood • Difficulty speaking • Unconsciousness • Pupils of uneven size • Difficulty in breathing & swallowing • Loss of bowel and bladder control

If you suspect a person is having a stroke, have them stop whatever they are doing and rest. Your first initial step is to


Page 26

call 911 or your local EMS agency. It’s critical for someone who experiences stroke symptoms to seek immediate emergency medical treatment without delay. Reassure the victim and place them into a comfortable position. Do not give anything by mouth. If the victim vomits, roll them into the recovery position and allow the foreign materials to drain. Observe the victim while waiting for EMS to arrive. If trained in CPR, monitor the Airway, Breathing, and Circulation and be prepared to perform CPR or rescue breathing if necessary. Prompt medical attention increases the chances for survival, successful rehabilitation, and recovery. If you would like more information about strokes and their treatment, and effects on the body, please contact the National Stroke Association at 1-800-STROKES. Diabetic Emergencies Sugar is required in the body for nourishment. Insulin is a hormone that helps the body use the sugar. When the body does not produce enough Insulin, body cells do not get the needed nourishment and diabetes results. People with this condition take Insulin to keep their diabetes under control. Diabetics are subject to two very different types of emergencies: Insulin reaction (or insulin shock) This condition occurs when there is too much insulin in the body. This condition rapidly reduces the level of sugar in the blood and brain cells suffer. Insulin reaction can be caused by taking too much medication, by failing to eat, by heavy exercise and by emotional factors.

Signs and symptoms if insulin shock are:

• Fast breathing. • Fast pulse. • Dizziness. • Weakness. • Change in the level of

consciousness. • Difficulty in vision. • Headache • Numb hands or feet. • Hunger.

Diabetic coma This condition occurs when there is too much sugar and too little insulin in the blood and body cells do not get enough nourishment. Diabetic coma can be caused by eating too much sugar, by not taking prescribed medications, by stress and by infection. Diabetic coma develops more slowly than Insulin shock. Sometimes over a period of days. Signs and symptoms of diabetic coma are:

• Drowsiness. • Confusion. • Deep and fast breathing. • Thirst. • Dehydration. • Fever. • A change in the level of

consciousness. • Peculiar sweet or fruity-smelling

breath (often being confused with the smell of alcohol).

First Aid Actions Looking for the signs and symptoms listed above will help to distinguish the two diabetic emergencies. In addition, if the patient is conscious, you


Page 27

can ask two very important questions which will help determine the nature of the problem: 1. Ask “Have you eaten today?” Someone who has eaten, but has not taken prescribed medication may be in a diabetic coma. 2. Ask “Have you taken your medication today?” Someone who has not eaten, but did take their medication, may be having an insulin reaction. Distinguishing between the two types of diabetic emergencies can be difficult. (always look for an identifying bracelet which may reveal a person’s condition) Of the two conditions, insulin shock is a true emergency which requires prompt action! A person in insulin shock needs sugar quickly! If the person is conscious, give sugar in any form; candy, fruit juice, or a soft drink! Sugar give to a person in an insulin shock can be life-saving! If the person is suffering from diabetic coma, the sugar is not required but will not cause them further harm. Monitor victims carefully. Call 911 or your local EMS agency. Be prepared to perform CPR or rescue breathing if necessary and you are properly trained. Seizures Seizures are fairly common occurrences, but are very misunderstood. Seizures are the bodies way of attracting attention to itself to get help. They may be caused by many different types of conditions such as insulin shock, sudden onset of high fever, viral infections, head injuries (trauma) and drug overdose. When seizures reoccur with no identifiable cause, the person is said to have epilepsy.

Signs and symptoms of seizures are:

• A warning aura (halo around lights) or a sensation before the onset of a seizure.

• Many times when a victim knows that they are going to have a seizure they will move themselves to a safe location and lay on the floor, as to not cause any injuries to themselves during a fall.

Seizures can range from mild (petite mal) to severe (gran mal). Mild or petite mal seizures can take place and end in a matter of seconds. These seizures can look like the person is in a daze or “daydreaming”. Severe seizures, grand mal, may involve uncontrollable muscle spasms, rigidity, loss of consciousness, loss of bladder and bowel control, and breathing that stops temporarily. May epileptics carry a card or medical bracelet that identifies their condition. First Aid Actions Call 911 or your local EMS agency IMMEDIATELY! Prevent the person from injuring themselves by moving any furniture away from and prevent them from banging their head on the floor. Do not attempt to restrain them in anyway, allow them to seize freely. Do not put anything in the mouth it could cause airway obstruction. Wait for the seizure to subside then loosen their clothing and check for ABC’s. If vomiting occurs, turn them onto their side and allow fluids to drain. Stay with the person until they are fully conscious or professional rescuers arrive. Be prepared to perform CPR or rescue breathing if necessary.


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Fainting Fainting is a mild form of shock. It is a sudden and temporary loss of consciousness due to a brief lack of oxygen and blood to the brain. Fainting is not caused by an injury. It is the nervous system reaction to fear, hunger, pain, or a strong emotional upset. Occasionally, prolonged standing in the hot weather will cause fainting. The signs and symptoms of fainting are:

• Lightheadedness. • Seeing spots or unusual images. • Nausea. • Pale skin color. • Sweating.

First Aid Actions If the victim is on the verge of fainting:

• Lay the victim down on their back to prevent fainting.

• Apply a cool wet cloth to the face. • If the victim has already fainted: • Elevate the victims legs. • Open their airway and check for

ABC’s. • Check for injuries that might have

resulted from the fall. • Give nothing to eat or drink by

mouth. A victim who has fainted recovers quickly, often in 1 to 2 minutes. Fainting is generally not serious and usually be traced to a triggering event. You should call 911 or your local EMS agency if the victim fails to recover quickly and remains unconscious.

Asthma Asthma is the most chronic disease of childhood today. The U.S. Public health service estimates that there are more than 2.5 million children who suffer from asthma. According to the American Lung Association, asthma is on the increase in both children and Adults, due primarily to increased exposure to environmental pollutants and irritants. A victim with asthma experiences sporadic breathing difficulties called “attacks”. During these attacks, the lining of the airways throughout the lungs swell, narrowing, and therefore partially obstructing these passages. The lungs increase their normal production of mucus secretions which can further narrow the airways. Additionally, the muscles surrounding the chest tighten, making breathing difficult. During a severe attack, exhaling is more difficult than inhaling and a victim might have a feeling of suffocation. Asthma attacks can vary in length and intensity. Some victims might experience an annoying cough lasting for several days, weeks or even months, while other victims might have such difficulty that they can not even finish a sentence. A victim that has asthma may have the following signs and symptoms:

• Coughing. • Wheezing. • Chest tightness and shortness of

breath. • Increased pulse and respiratory

rate.


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First Aid Actions

• Help the victim sit in a straight up position in a quiet area.

• Give asthma medication as prescribed.

• Monitor the victims pulse and respiratory rate.

• Keep the victim at rest until there is improvement.

• The victim should be seen by a health care provider if:

• The victim is unable to speak easily.

• The victims lips have a blue discoloration.

• The victim has flaring of the nostrils, and is working very hard to breathe.

Emphysema Emphysema results from the destruction of the alveolar walls in the lungs. It is more common in men than in women and more common in rural settings. The major factor contributingg to emphysema in our society is cigarette smoking. Continued exposure to noxious substances, such as cigarette smoke, results in the gradual destruction of the walls of the lungs. This process decreases the usable surface area of the lungs, thus decreasing the area for gas exchange in the lungs. The loss of this area results in an increased ratio of air to tissue in the lungs. Additionally, the number of capillaries or small blood vessels in the lungs are decreased, thus increasing resistance blood flow, which causes blood in the lungs to back up increasing the pressure of those vessels. Increased pressure in the blood vessels of the lungs may ultimately lead right to heart failure,

and death. Emphysema also causes weakening of the walls of the smallest lung areas called the bronchioles. When these areas of the lungs are destroyed, the lungs loose their capacity to recoil and air becomes trapped in the lungs. Thus, residual volume increases, while vital capacity remains relatively normal. The carbon dioxide level becomes chronically elevated, forcing the body to depend on the carbon dioxide level instead of the oxygen level to control breathing. Patients with emphysema are more likely to have acute respiratory infections, such as pneumonia, and to heart irregularities. Chronic emphysema patients ultimately become dependent on inhalers, other drugs, and eventually oxygen to aid in the breathing process. Treatment for these people, and everyone who is suffering from breathing problems, is to call 911 or your local EMS number. Prompt treatment is essential to prevent further problems and possible death. To finish this training program, close this internet window, and go on to the

next step in the instructions.


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Documents

Adult First Aid - CEUworks.com · unconscious victim is implied and a first aider should not hesitate to treat an unconscious victim. Consent of a parent or guardian is required to