First Aid Basics

Dr. Uma B.M.First Aid BasicsDefinition:

Care given to an injured person to stabilize and keep him / her safe until he / she can receive professional medical attention.General guidelinesRemain calm Communicate a calm and supportive attitude to the ill and injured.Never leave the injured unattendedHave someone else call the doctor and the childs parent.Do not move the injured. Do not allow him to walk Bring help to the patient.Other students who may congregate should be clearedEmergencies dealt withWound (deep/extensive)Bleeding (severe)Head, neck, or back injuryBroken boneAmputationAllergic reactionsBreathing difficultyInsect BiteDental Problems

Foreign bodiesChokingSeizureUnconsciousnessBurns (chemical, electrical, third degree)Electrical shock PoisoningDrowningSnake bite

First AidFirst aid is as easy as ABC airway, breathing and Circulation In any situation, apply the DRSABCD Action Plan.DRSABCD stands forDangerResponseSend for helpAirwayBreathingCirculationDefibrillation

BruiseBruise forms when a blow breaks blood vessels near your skin's surface, allowing a small amount of blood to leak into the tissues under the skin

What you need to do:If your skin isn't broken, you don't need a bandage,Elevate the injured area. Apply ice or a cold pack several times a day for a day or two after the injury. Rest the bruised area, if possible. Consider acetaminophen

CUTS/SUPERFICIAL ABRASION

Treatment Cleanse thoroughly with soap and water. Do not use hydrogen peroxide, alcohol, or other disinfectant.

Apply dry dressing (preferably sterile).

Determine individual's tetanus immunization status from school record.

BleedingExternal or Internal

External: Stop the bleedingClean wound thoroughlyApply an antibioticCover the woundChange the dressing.Do not remove old dressingGet stitches for deep woundsInternal Bleeding : Potentially life threatening

For low-risk wounds on the face or scalp, which have very extensive blood supply, closure within 24 hours is reasonable. For wounds in areas with less blood supply, such as fingers or toes, or for wounds at risk for infection, closure within 4-6 hours is warranted.

8Head neck and back injuryMost common cause is fall during playMost common symptom- BleedingWhat should be done?Stop bleeding. If required get it sutured.Observe for signs of internal head injury

Vomiting Drowsiness Disorientation, confusion, memory loss, LocBleeding from ears and/or nose, Marked swelling SeizuresSevere headache

Head injuryDo not insert anything into the childs mouth

Control bleeding by applying direct pressure over the wound

Do not wash the wound if you suspect skull fractures

Small cuts on face may bleed excessively. Apply direct pressure with clean dressings

If dressings get soaked apply new one on the old. Dont remove old ones

If above signs absent, treat for headache Treatment of Head injuryKeep the child lying and quietIf unconsious and neck injury suspected, Support head & turn entire body to one side (log roll)Do not turn head if neck injury is suspectedLoosen cloth around neckCheck for airway obstruction

Broken bonesComplaints of pain, tingling, and numbness

Feelings of cold

Swelling

Discoloration

Treatment:

Splint the extremity

Broken bones

OPEN FRACTURE Complete break or crack, or in bone in which the skin is broken.Child presents with

Possible deformityPain and tendernessBone piece sticking out of the woundInability to use the affected part normallyBleeding Injured area is cold and numb

Things to be done:

Unless there is danger to life, do not move from place of accident until affected limb has been properly supported or immobilized. Immobilize Support with pillows, blankets, broomstick,or uninjured limb,

Apply ice/cold pack for 15 minutes

DislocationInability to move the affected part normally

A bump, ridge, or hollow that does not normally exist in a nonfunctioning joint

Pain

Bruising

Swelling

Treatment

Determine cause

Keep him calm and warm

Do not attempt to put the part back in place

Support extremity with pillows, blankets, broomstick, uninjured limb, etc., to reduce pain

Amputation If amputation is complete : Dos Locate severed body part. Wrap part in clean sterile dressing.

Place in plastic airtight bag and lay bag in pan of water kept cool with ice packs.

Control bleeding

Donts Dont wash severed part

Do not put part directly on ice.

Never complete the amputation.

ALLERGIC REACTION

Overreaction of the bodys immune system to specific substances that it misidentifies as harmful

How do the kids present?

Rashes

Itching

Swelling

Red and hot skin

Watering of eyes, nose, Sneezing

Anaphylaxis- Severe Allergy Severe, sudden generalized reaction that is potentially life threatening.

Wheezing

Breathing difficulty

Choking

Swelling of body parts like lips, eyes.

Skin is flushed and dry or pale, cool, and clammy

Things to do for allergic reactionsIn mild cases

Keep the child away from allergen

Apply cold compress

Give antihistaminic medicinesIn severe casesIf wheezing ,make him sit in comfortable position

Loosen tight clothing and cover the person with a blanket.

Don't give the person anything to drink.

Get emergency treatment even if symptoms start to improve19Asthma call ambulance: Difficulty breathingInability to speak more than 3-5 word sentences. Fast or Slow breathingDisoriented & Bluish lips or nailThings to do:Make him sit comfortablyLoosen tight clothingDo NOT place a pillow under the person's head. This can close the airway.Do NOT give the person food or drink.

Bee and Wasp stings Local Reaction Intense pain

A whitish bump with a red dot in its center

Swelling at the site of the sting

Chills

Fever

Muscle cramps, joint pain

Severe Reaction

Apprehension

Rash (particularly on face)

Swelling of face and tongue

Difficulty breathing, wheezing, gurgling.

Skin feels moist and or appears flushed, pale or bluish

21Bee and wasp stingsTREATMENT

Remove stinger as quickly as possible. Apply cold compress to reduce pain and swelling. If the sting is on the arm or leg, keep extremity below the level of the heart.Give antihistaminics

ANIMAL BITE

What should be done?

Cleanse wound thoroughly with soap and water for 5 minutes. Cover wound with clean bandage (preferably sterile).Determine individual's tetanus immunization status.

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In Human bite determine Hepatitis B vaccination status If allergic symptoms, Give antihistaminics23

DENTAL PROBLEMSBaby teeth/ tooth loss

Rinse mouth with warm water. If bleeding, have individual bite on gauze for several minutes. Send tooth home with individual in sealed container (e.g., envelope or plastic bag).

Knocked out tooth

Try to locate the toothHold the tooth by its crown not the rootRinse the tooth gently with water. Do not scrubPlace the tooth in cold milk or waterControl bleeding by applying gentle pressureApply cold pack for 15 min on face over injured area

Dental ProblemsBroken/ displaced tooth

Broken braces Gently clean dirt from the injured area with warm water.Apply ice/cold pack -15 min on the face.(Do not apply ice directly to skin.)If sharp tooth cover with gauze prevents cutting lips or cheek. Save broken tooth fragments. If tooth has been pushed up into the gum, do not attempt to pull it into position or move it.

Cover ends of broken braces and wires with wax or a piece of gauze. If wire becomes stuck in the cheek or gum tissues, do not attempt to remove it. If appliance is loose or broken, save any broken pieces. Call parent and recommend follow-up dental careEar injuries

EaracheIf discharge is present, wipe from outer ear only.Allow free drainage. Call parent and recommend contact with health provider.

Ear Problems cont.Foreign object in ear:Do not attempt to remove object at school.Try using gravity to get the object out by tilting the head to the affected side Call parent and recommend contact with health provider.

Bug in ear/INSECT IN EAR

Place a few drops of oil in the ear to quiet the insect.Only if visible try to remove with tweezersRecommend follow-up medical careAVOID using oil to remove any object other than an insect, since oil can cause other kinds of objects to swell.Eye ProblemsForeign body:PainTearing Redness Scratchy feeling in eyeVision changes

Ask the child not to rub the eye Flush with lukewarm water. Turn head to the side and pour water from nose outward.If particle seems imbedded, do not attempt to remove it. If object remains, cover both eyes loosely with gauze or cloth to restrict eye movement.Eye ProblemsCHEMICAL BURNS

BRUISES/BLOWS

Determine type of chemical. If dry chemical, carefully brush off as much as possible, avoiding additional skin contact. Immediately flush eye with large quantities of cool water. Turn head to the side and pour water from nose outward. Do not allow chemical to wash into unaffected eye. If minor trauma apply ice/cold pack for 15 minutes to eye. (Do not apply ice directly to skin.)Patch both eyes to minimize eye movement, and refer for immediate medical care29Eye Problems (cont.)Conjuctivitis:

Change in vision Painful eyeFeels like foreign body in eye for over 1 hour Experiences flashing light or floaters in fieldRed, watery, swollen eyesThick yellow discharge

Do not put a patch over a possible eye infection. Exclude individual from school until condition has cleared up

Nose Problems

Nose BleedsBleeding, Swelling, Choking, BruisingThings to do:Make the child lean forward, make him breathe through mouthLoosen anything around neckPinch the side of nose against septum for 5 to 10 min for clot to form

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Nose Problems contForeign body in nose

PainSwellingFoul smell

What to do:Do not try to remove the object. Call the doctor

Foreign body in throatChokingAsk him are you chokingIf patient is unable to do all these he is chokedUniversal sign is Clutching of neckUnable to speakWeak ineffective coughHigh pitched sound or no sound while inhalingBreathing difficultyBlue lips

Things to do:Do not panicIf the child can breathe, Speak or cough do not interfereStay with the child, encourage to cough out the obstruction

Choking cont..Heimlich maneuverStand behind the childWrap arms around his waistMake fistPlace the thumb side above the navel, well below the breast boneGrasp your fist with other handProvide quick upward thrusts into the patients abdomenRepeat the thrusts until the patient coughs up the object

Finger Injuries ( cont)Crush InjuriesAmputated fingerFor minor injury, such as shutting door on finger, apply ice/cold pack for 15 minutes. (Do not apply ice directly to skin)

Gently clean the amputated part with water (preferably saline) Cover it in moist gauze wrap Or clean paper towelPut it in a watertight bag Place the bag on ice Do not put the amputated part directly in ice. You could further damage Replantation- not possible after 12 hrsFor hand or arm its with in 6 hrs

Lead pencil puncture wound

Lead contains graphite, it has no other harmful effect other than staining the skinComplete recovery is difficultWhat to do:If lead is superficially lodged remove by tweezers.Do not push tweezers beneath the skinWash with soap and water Determine the childs tetanus immunizationSeizure

SeizurePlace a cushion or blanket under the childs headDont place anything in the mouthTurn him to a sideDo not hold or restrain the childClear the area around the child from sharp objectsLoosen tight clothesDo not give food , drink, or medicines during seizureRemain with him during seizure and monitor the patient38Seizure cont.After the episodeAllow individual to sleep in a dark room as needed. (May last from 30 minutes to several hours.)Record the length of the seizure and activity during and after the seizure Check for injuries. See appropriate procedures for treatment.If individual remains unconscious after seizure is over, maintain open airway and continue to Keep individual comfortable

FaintingBlurred vision Light-headedness Nausea Sweating Loss of consciousness

Position individual on back on a flat surface. If other injuries are present, see appropriate procedures.If no injuries, elevate legs 8-12 inches. Loosen clothing around neck and waist. Apply cool, damp cloth to head. Continue to observe carefully. Recovery should occur in 2 minutes.

Sprains/StrainsSwellingTenderness Pain upon motion DiscolorationRICE StrategyRest and Keep individual warm and comfortable.Ice/cold pack for 15 minutes to the area. (Do not apply ice directly to skin.)Compression bandage- extend well beyond injury. Immobilize extremity. Support with pillows, blankets, broomstick, uninjured limb, etc.Elevate -If movement does not cause pain, elevate affected part

BURNSCHEMICALIf the chemical is in a dry or powder form, carefully brush it off the skin before flushing with water. Flush skin or eye immediately with large amounts of cool water. Continue flushing 30 minutes. If possible, remove outer clothing while burn is being flushed. If available, follow directions on chemical container.Electrical

Do not try to pull away the child until power source is switched offWear glovesCover the burnt area with a sterile dry non sticky dressingLook for second burnt area where electricity has left the bodyTreat for shock

Thermal burnsDosCool the burn. Hold - running water for 10-15 min until pain subsides. Cover with a sterile gauze bandageIf blister is broken, wash with soap and water and apply dry bandage

DontsDon't use ice. Don't apply egg whites, butter or ointments to the burn.. Don't break blistersDon't use fluffy cotton as bandagePOISONINGSINGESTED/SWALLOWEDNOTE: Ingested poisoning can occur from drug overdoses, medication errors, household and industrialDo not give any medication, food, or liquid until told to do so by the doctorDo NOT induce vomiting unless you are told to do so Do NOT try to neutralize the poison with lemon juice or vinegar, or any other substanceIf the poison has spilled on the person's clothes, remove the clothing and flush the skin with water

Common ailmentsFeverHeadacheOral temp 100 or moreHeadache, watery eyesCough, skin rash ,SorethroatVomiting diarrhoeaWhat to do:Take temperatureMake him lie downDont cover himApply cool compress on foreheadIsolate the child for benefit of othersEmergency care -when severe; persistent; severe with sudden onset;If no head trauma Ask to lie down for 20-30 minutes in darkened area. Check temperature. Place a cool cloth on the forehead to promote relaxation. If headache persists, call parent for follow-up medical care.

45DrowningClear airwayMouth to mouth breathingCardiac massage if heart sounds absentAll cases should be hospitalized

Snake biteFangmarks swelling/severe pain at the site Bloody discharge from wound, Burning sensation

Things to be done:

Wash wound with soap/water Immobilize the affected area Keep area slightly elevated Apply cool compress/wet cloth to affected part Apply a firm bandage 2-4 inches above bite toi. Prevent venom spreadingii. Take care of any bleeding Monitor for pulse, respiration and blood pressure

Diarrhea Excessive sweating Blurred vision Numbness/tingling sensation Increased thirst Vomiting Fever Loss of muscle co-ordinations Convulsions Rapid pulse Weakness/Dizziness/Fainting47Mouth/Jaw InjuriesMaintain open airway. If conscious, no neck injuries are suspected, prop him upleaning forwardto allow blood to drain.If lip penetrated, place a rolled dressing between the lip and gum and another dressing on the outer surface of the lip. Apply ice/cold pack for 15 minutes to reduce swelling and decrease painIf tongue is bleeding, apply a dressing with gentle pressure. Rinse mouth with cold water for 15minutesCPR Cardio Pulmonary Resusitation:What is it?Maneuver to revive breathing, & heart beatGive two breaths. To get the breath in, tilt their head back gently by lifting their chin. Pinch their nostrils closed, place your open mouth firmly over their open mouth and blow firmly into their mouth

CPRGive Compressions:30 compressions and two breaths Let chest rise completely between pushes. Check for breathing 5 repeats in 2 minutes until you get medical help or until the person responds.

How to give Compressions Place heel of one hand on the center of the chest at the nipple line. You can also push with one hand on top of the other. Press down about 2 inches. Make sure not to press on ribs.

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