HLTAID004 Learning Resource Booklet

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PROVIDE AN EMERGENCY RESPONSE IN AN EDUCATION AND CARE SETTING

HLTAID004

Learning Resource Booklet | 15/04/2015 careersaustralia.edu.au

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CONTENTS

LEARNING RESOURCE BOOKLET ................................................................................... 12

Learning Objectives ..................................................................................................... 12

Student Instruction ...................................................................................................... 12

Section 1: Overview ..................................................................................................... 13

First Aid ..................................................................................................................... 13

Aim of first aid ........................................................................................................ 13

First aid management .................................................................................................. 14

First aid must take into account ................................................................................. 14

Australian Resuscitation Council (ARC) Guidelines ............................................................ 15

ARCs purpose ......................................................................................................... 15

State/Territory regulations and workplace procedures ...................................................... 15

Regulatory authorities .............................................................................................. 16

The Guide to the Education and Care Services National Law and the Education and Care Services National Regulations 2011 ........................................................................... 18

First Aid Code of Practice .............................................................................................. 20

First aid kits ............................................................................................................ 21

Legal and ethical requirements ...................................................................................... 21

Duty of care ............................................................................................................ 21

Good Samaritan ...................................................................................................... 22

Negligence .............................................................................................................. 23

Consent .................................................................................................................. 23

Privacy and confidentiality requirements ..................................................................... 23

Privacy Act ............................................................................................................. 23

Confidentiality policies .............................................................................................. 24

Respond in a culturally aware, sensitive and respectful manner towards a casualty .............. 24

Documentation & report details of incident to workplace supervisor as appropriate .............. 24

Verbal reporting ...................................................................................................... 24

Written reports ........................................................................................................ 24

Workplace written reports ......................................................................................... 25

Documenting your treatment .................................................................................... 25


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Example injury report form ....................................................................................... 26

Notifiable incidents .................................................................................................. 28

Following an emergency situation .................................................................................. 28

Evaluation of own performance ................................................................................. 28

Signs and symptoms of stress ................................................................................... 28

Psychological impacts ............................................................................................... 29

Importance of debriefing .......................................................................................... 29

In the workplace stress management ...................................................................... 29

Outside the workplace stress management .............................................................. 30

Seek assistance from the emergency response services ................................................... 30

Australian emergency call service numbers ................................................................. 30

Making the call ........................................................................................................ 31

Making the casualty comfortable ................................................................................... 32

Identify, assess and manage immediate hazards to health and safety of self and others ....... 32

Emergency scene assessment ................................................................................... 32

Examples of dangers to be aware of when assessing safety .......................................... 33

Infection control .......................................................................................................... 34

Infectious diseases .................................................................................................. 34

Standard precautions ............................................................................................... 34

In the workplace procedures ..................................................................................... 35

In the workplace for healthcare providers: .................................................................. 35

Providing first aid .................................................................................................... 36

Accidental contamination .......................................................................................... 36

Contaminated items ................................................................................................. 36

Cleaning spills ......................................................................................................... 36

Manual handling .......................................................................................................... 36

Identify and assess the risks ..................................................................................... 36

Consider ................................................................................................................. 37

Steps for correct lifting or moving a load .................................................................... 37

Moving the injured ....................................................................................................... 37

Safety .................................................................................................................... 38


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Moving techniques ................................................................................................... 38

Spinal immobilisation ............................................................................................... 39

Aim to maintain casualties head aligned with body avoiding side to side movements ........... 39

Types of spine boards or stretcher ............................................................................. 39

Recognise an emergency situation ................................................................................. 40

Observations ........................................................................................................... 41

Priorities in an emergency ........................................................................................ 41

Emergency action Plan (Queensland Ambulance Services, 2014, p6) .............................. 42

Section 2: Basic Anatomy & Physiology .......................................................................... 43

Basic anatomy and physiology ...................................................................................... 43

Response/consciousness ........................................................................................... 43

Breathing ............................................................................................................... 44

Body systems .......................................................................................................... 44

11 Main systems ..................................................................................................... 45

SECTION 3: EMERGENCY ASSESSMENT ......................................................................... 51

Management of an emergency situation ......................................................................... 51

Danger ................................................................................................................... 51

Response ................................................................................................................ 51

Send for Help .......................................................................................................... 52

Casualty assessment .................................................................................................... 52

History ................................................................................................................... 52

Observations ........................................................................................................... 53

Secondary survey - .................................................................................................. 53

Levels of consciousness ............................................................................................ 55

The conscious casualty ................................................................................................. 55

The unconscious breathing casualty ............................................................................... 55

Management ........................................................................................................... 56

Airway ................................................................................................................... 56

Method for turning victim onto their side .................................................................... 57

The unconscious non - breathing casualty ....................................................................... 57

Section 4: CPR ............................................................................................................ 58


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Cardiac arrest ......................................................................................................... 58

Chain of survival ...................................................................................................... 58

Cardiopulmonary resuscitation - (CPR) ....................................................................... 59

Compression-ventilation ratio .................................................................................... 59

Steps of resuscitation ............................................................................................... 59

Chest compressions only .......................................................................................... 60

Multiple rescuers ..................................................................................................... 60

Duration of CPR ....................................................................................................... 60

Risks ...................................................................................................................... 60

CPR ....................................................................................................................... 61

Section 5: First Aid - Trauma ........................................................................................ 66

Abdominal injuries ....................................................................................................... 66

Causes ................................................................................................................... 67

Signs or Symptoms .................................................................................................. 67

Management ........................................................................................................... 67

Basic wound care (Major & minor skin injuries) ............................................................... 68

Types of wounds ..................................................................................................... 68

Management - minor skin injuries .............................................................................. 69

Management - Major skin Injuries .............................................................................. 69

Bandages during first aid .............................................................................................. 70

Roller bandage ............................................................................................................ 70

Used for: ................................................................................................................ 70

How to apply: ......................................................................................................... 70

Making an arm sling ..................................................................................................... 71

Bleeding ..................................................................................................................... 72

External bleeding ......................................................................................................... 72

Management ........................................................................................................... 72

Direct Pressure ........................................................................................................ 72

Indirect Pressure ..................................................................................................... 72

Tourniquet .............................................................................................................. 72

Internal bleeding ......................................................................................................... 73


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Management ........................................................................................................... 73

Nose bleed (Epistaxis) .................................................................................................. 73

Burns ......................................................................................................................... 74

Types ..................................................................................................................... 74

Aim ........................................................................................................................ 74

Steps ..................................................................................................................... 74

General management procedures .............................................................................. 75

Chest injuries .............................................................................................................. 77

Types of chest injuries ............................................................................................. 77

Management ........................................................................................................... 78

Choking and airway obstruction ..................................................................................... 78

Signs & symptoms for conscious casualty ................................................................... 79

Unconscious casualty ............................................................................................... 79

Techniques to clear FBAO ......................................................................................... 79

Management of conscious casualty ............................................................................ 80

Management Unconscious Casualty ............................................................................ 81

Management of airway obstruction flow chart .............................................................. 81

Crush injuries.............................................................................................................. 81

Management ........................................................................................................... 82

Ears & Eye injuries....................................................................................................... 82

Ear injuries ................................................................................................................. 82

Causes of Ear Injuries .............................................................................................. 82

Symptoms .............................................................................................................. 83

Management ........................................................................................................... 83

Eye injuries ................................................................................................................. 84

Management ........................................................................................................... 84

Fractures & Dislocation ................................................................................................. 85

Fractures .................................................................................................................... 85

Causes ................................................................................................................... 85

Signs and symptoms ................................................................................................ 85

Management ........................................................................................................... 85


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Dislocation .................................................................................................................. 86

Symptoms .............................................................................................................. 86

Management ........................................................................................................... 87

Head injuries .............................................................................................................. 87

Management ........................................................................................................... 87

Needle stick injuries ..................................................................................................... 88

Management ........................................................................................................... 88

Soft tissue injuries, including strains and, sprains ............................................................ 88

Causes ................................................................................................................... 88


Symptoms of a strain can include: ............................................................................. 89

Management ........................................................................................................... 89

Spinal injury ............................................................................................................... 89


Principles of management of a suspected spinal injury are: ........................................... 91

Managing a spinal injury for the conscious casualty...................................................... 92

Managing a spinal injury for the unconscious casualty .................................................. 92

Section 6: First Aid - Medical ......................................................................................... 93

Allergic reaction .......................................................................................................... 93

Causes of allergic reactions ....................................................................................... 93

Symptoms .............................................................................................................. 93

Management ........................................................................................................... 94

Anaphylaxis ................................................................................................................ 94

Most Common substances can cause anaphylaxis ........................................................ 94

Symptoms and signs are highly variable and may include: ............................................ 95

Management ........................................................................................................... 95

Different types of adrenaline auto injectors ................................................................. 96

How to use an EpiPen ............................................................................................. 97

Asthma ...................................................................................................................... 98

Triggers for asthma can include ................................................................................. 98

Asthma signs and symptoms ..................................................................................... 98


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Signs of a severe asthma attack ................................................................................ 98

Young children ........................................................................................................ 99

Managing an Asthma Attack ...................................................................................... 99

With Spacer .......................................................................................................... 100

Without Spacer ..................................................................................................... 101

Different types of bronchodilators ............................................................................ 103

Cardiac conditions, including chest pain ........................................................................ 104

Heart ................................................................................................................... 104

Angina ................................................................................................................. 104

Pulmonary oedema ................................................................................................ 105

Congestive cardiac failure ....................................................................................... 105

Heart attack .............................................................................................................. 105

Sign and symptoms ............................................................................................... 105

Management ......................................................................................................... 106

Diabetes ................................................................................................................... 107

Type 1 diabetes ..................................................................................................... 107

Symptoms of Type 1 Diabetes ................................................................................. 107

Type 2 diabetes: ................................................................................................... 107

Management ......................................................................................................... 108

Seizures, including epilepsy ........................................................................................ 109

A seizure may be associated with ............................................................................ 109

Symptoms ............................................................................................................ 109

Generalised seizures .............................................................................................. 110

Partial seizures ...................................................................................................... 110

Febrile convulsions ................................................................................................ 110

Management of a Seizure ....................................................................................... 110

Seizure in the water ............................................................................................... 111

Shock ...................................................................................................................... 112

Condition which may result in Shock ........................................................................ 112

Hypovolemic Shock ................................................................................................ 112

Cardiogenic Shock ................................................................................................. 112


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Distributive Shock (abnormal dilation of blood vessels) .............................................. 112

Obstructive Shock (blockage of blood flow in and out of heart) .................................... 112

Symptoms ............................................................................................................ 113

Signs ................................................................................................................... 113

Management ......................................................................................................... 113

Stroke ...................................................................................................................... 113

Recognition ........................................................................................................... 114

FAST .................................................................................................................... 114

Other common symptoms of strokes include; ............................................................ 114

Management ......................................................................................................... 115

Section 7: First Aid - Environmental ............................................................................. 116

Drowning .................................................................................................................. 116

Symptoms ............................................................................................................ 116

Management ......................................................................................................... 116

Dehydration .............................................................................................................. 117

Causes ................................................................................................................. 117

Symptoms ............................................................................................................ 117

Management ......................................................................................................... 118

Hyperthermia ............................................................................................................ 118

Heat induced illness may be caused by ..................................................................... 118

Factors that may contribute to heat induced illness .................................................... 118

Recognition ........................................................................................................... 119

Management ......................................................................................................... 119

Hypothermia ............................................................................................................. 119

Common causes .................................................................................................... 120

Symptoms ............................................................................................................ 120

Management ......................................................................................................... 120

Section 8: First Aid - Envenomation ............................................................................. 122

Pressure immobilisation treatment (PIT) ....................................................................... 122

Management ......................................................................................................... 122

Pressure bandage application .................................................................................. 123


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Please Note ........................................................................................................... 124

Snake bites ............................................................................................................... 125

Snake identification ............................................................................................... 125

Types of Venous Australian Snakes .......................................................................... 125

Effects Snake bites ................................................................................................ 125

Signs and symptoms .............................................................................................. 126

Management ......................................................................................................... 126

Spider bites .............................................................................................................. 127

Tick, bee, wasp and ant stings .................................................................................... 128

Marine stings ............................................................................................................ 130

Box Jelly Fish ........................................................................................................ 131

Irukandji .............................................................................................................. 131

Blue Bottle ............................................................................................................ 133

Blue Ringed octopus .............................................................................................. 133

Cone Shell ............................................................................................................ 134

Stone fish ............................................................................................................. 135

Sting ray .............................................................................................................. 135

Section 9: First Aid Poisoning ................................................................................... 137

Poisoning and toxic substances ................................................................................... 137

Symptoms ............................................................................................................ 137

Management ......................................................................................................... 138

Common substances causing poisoning .................................................................... 141

Prevention ............................................................................................................ 143

Skills assessments requirements ................................................................................. 146

Section 10: References .............................................................................................. 147


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LEARNING RESOURCE BOOKLET

Assessment: HLTAID004 Provide an emergency first aid response in an education and care setting - assessments one (1) to Four (4)

Due Date:

Learning Objectives

At the completion of this unit students will have an understanding of:

Provide first aid response to infants, children and adults

Apply appropriate emergency first aid procedures

Communicate details of the incident

Reflect on incident and own performance

Student Instruction

HLTAID004 read sections 1-9 of the learning resource and complete all four (4) assessments.

Check list

Section Section Title

Section 1 & 2 Read sections 1 & 2 of the learning resource booklet and complete assessment 1 before progressing.

Section 3 & 4 Read sections 3 & 4 of the learning resource booklet and complete assessment 2.

Section 5 & 6 Read sections 5 & 6 of the learning resource booklet and complete assessment 3 before progressing.

Section 7 & 9 Read sections 7 - 9 of the learning resource booklet and complete assessment 4.

Practical on-site assessment

HLTAID004 required to undertake practical assessment on-site.


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Section 1: Overview First Aid

Help given to a sick or injured person until full medical treatment is available, Oxford Dictionary

Aim of first aid

Preserve life includes the life of the casualty, bystanders and rescuer

Protect the casualty from further harm

Provide pain relief use of ice packs etc.

Prevent the condition from worsening ensure the treatment you provide will not make the casualties condition worse

Provide reassurance and promote recovery of the casualty

(Mckie 2011, p.6)

Preserve life

Protect casualty

Provide pain relief

Prevent the

condition from

worsening

Promote recovery


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First aid management

First aid must take into account

(Queensland Ambulance Services 2014, p1)

Workplace - policies & procedure, safe work practices, industry/site regulations, code of practice, WHS requirements, legislative requirements for State/territory

When first aid is delivered - location & nature of the incident, associated risks - hazards, location of emergency services

Australian Resuscitation council guidelines (ARC) Guidelines from Australian national peak clinical bodies Education & care services national law (as required)

The age, culture, ability or disability of the casualty Legal, social & community responsibilites - stress management techniques, duty of care, respectful behaviour, consent, confidentiality, debriefing, currency of skill & knowledge

Considerations - safety, use of available equipment & resources, duraction & cessation of CPR, use of defibrillator, infection control & any difference between adults & children


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Australian Resuscitation Council (ARC) Guidelines

In 1976 a voluntary coordinating board was formed to promote uniformity and standardisation in resuscitation and for the provision of first aid. Guidelines have been developed and can be accessed via the following link: http://www.resus.org.au/policy/guidelines/index.asp

ARCs purpose

State/Territory regulations and workplace procedures

Organisations are required by law to have first aid procedures in place. First aid compliance comes under the relevant state or territory OH&S Act.

State OH&S Act Link

ACT Occupational Health & Safety Act 1989

Work safe Australian Capital Territory

New South Wales Occupational Health & Safety Act 2000

Work cover New south Wales

Northern Territory Work Health (Occupational Health and Safety) Regulations

Work safe Northern Territory

Queensland Workplace Health and Safety Act 1995

WorkCover Queensland

Develops and publishes guidelines

Reviews and updates guidelines

Reviews world literature and research

in resuscitation

Act as a resource for authoritative material

on resuscitation


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South Australia Occupational Health, Safety and Welfare Act 1986

Safe work South Australia

Tasmania Workplace Health and Safety Act 1995

Work safe Tasmania

Victoria Occupational Health & Safety Act 2004

Work safe Victoria

Western Australia Occupational Safety and Health Act 1984

Work safe Western Australia

First Aid policies and procedures for workplace or industry must include emergency plans, safe work practices for risk & hazard assessment, infection control & first aid procedures in accordance with ARC & clinical peak bodies.

A workplace first aider must be able to:

Locate and have access to policies and procedures for safety requirements and the provision of first aid for the organisation

Workplace first aid requirements and arrangements will vary depending on:

Number of people at the workplace

The size of the workplace

The location of the workplace

The nature of work at the workplace

The type of hazards at the workplace

(Queensland Ambulance Services 2014, p1)

Safe Work Australia was established by the Safe Work Australia Act 2008 with the primary role of improving work health and safety and workers compensation arrangements across Australia. Safe Work Australia consists of representatives of the Commonwealth, state and territory governments, the Australian Council of Trade Unions, the Australian Chamber of Commerce and Industry and the Australian Industry Group. It performs its functions in accordance with strategic and operational plans agreed annually by the Select Council on Workplace Relations.

(Safe Work Australia Act, 2008)

Regulatory authorities

The National Quality Framework (NQF) establishes higher standards for all education and care services in Australia for children to age 13 years. The program sets levels of safety and quality to benefit all children and their families who use approved education and care services.

The Australian Childrens Education and Care Quality Authority (ACECQA) oversees the implementation of the NQF and works with regulatory authorities in each state and territory as they introduce and administer the new NQF system.


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http://www.acecqa.gov.au/nqf-acecqa

A regulatory authority in each state and territory regulates and assesses childrens education and care services.

http://www.acecqa.gov.au/regulatory-authorities1

Under the Education and Care Services National Law ACECQA must publish a list of approved first aid qualifications, anaphylaxis management training and emergency asthma management training.

For the purposes of the Law, the 'qualifications' on the list are either national or state accredited units of competency.

The list of approved first aid qualifications, anaphylaxis management training and emergency asthma management training replaces the state and territory government first aid requirements for educators from 1 January 2012.

http://www.acecqa.gov.au/first-aid-qualifications-and-training

The National Regulations also outline the mandatory requirements for services in relation to these qualifications. Further information relating to First Aid Qualifications, Anaphylaxis Management Training and Asthma Management Training can be found in regulation 136 Part 4.4 Staffing arrangements, Division 6 First aid qualifications.

Below is a summary of the different requirements for centre-based, school-based and family day care services.

Centre-based services - regulation 136 (1)

The approved provider of a centre-based service must ensure that the following persons are in attendance at any place where children are being educated and cared for by the service, and immediately available in an emergency, at all times that children are being educated and cared for by the service:

a. At least one (1) educator who holds a current approved first aid qualification b. At least one (1) educator who has undertaken current approved anaphylaxis management

training c. At least one (1) educator who has undertaken current approved emergency asthma

management training.

Services must have staff with current approved qualifications on duty at all times and immediately available in an emergency. One staff member may hold one or more of the qualifications.


Premises on school site - regulation 136(2)

If children are being educated and cared for at service premises on the site of a school, suitably qualified staff must be in attendance at the school site and immediately available in an emergency.

Services must have staff with current approved qualifications on duty at all times and immediately available in an emergency. One staff member may hold one or more of the qualifications.


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Family day care - regulation 136(3)

The approved provider of a family day care service must ensure that each family day care educator and family day care educator assistant engaged by or registered with the service:

a. Holds a current approved first aid qualification; and b. Has undertaken current approved anaphylaxis management training; and c. Has undertaken current approved emergency asthma management training.

Each family day care services staff member, including educator assistants, must hold all three qualifications.


The Guide to the Education and Care Services National Law and the Education and Care Services National Regulations 2011

ACECQA website has published the Guide to the Education and Care Services National Law and

the Education and Care Services National Regulations 201, URL address:

http://files.acecqa.gov.au/files/National-Quality-Framework-Resources-Kit/2014/NQF02%20Guide%20to%20ECS%20Law%20and%20Regs_web.pdf

Relevant to first aid, the guide to the National Law includes the law in relation to:

Incidents,

Injury

Trauma and illness

Serious incidents

Infectious diseases

First aid kits

Medical conditions

Administration of medications

The guide to the National Law: Incidents Injury, Trauma and Illness, Serious Incidents and

Infectious diseases.

Incidents, injury, trauma and illness

Education and Care Services National Law: Section 174 Education and Care Services National Regulations 201: Regulations 8587, 168, 177178, 183

An approved service must have in place policies and procedures in the event that a child is injured, becomes ill, or suffers a trauma. These procedures should be followed and must include the requirement that a parent be notified, as soon as possible and within 24 hours, in the event of an incident, injury, illness or trauma relating to their child (including the death of a child).

The National Regulations require that an incident, injury, trauma and illness record be kept, and


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that the record be accurate and remain confidentially stored until the child is 25 years old.

Information should be recorded as soon as possible, and within 24 hours after the incident, injury, trauma or illness. A sample Incident, injury, trauma and illness record is included on page 164. This may be adapted for use by individual services, or providers may develop their own.

(Guide to the National Law and National Regulations, 2014, p 60)

Serious incidents

National Law: Section 174, National Regulations: Regulation 12, 87

The National Law requires the regulatory authority to be notified of any serious incident at an approved service.

A serious incident means:

The death of a child while attending a service, or following an incident while attending a service.

Any incident involving serious injury, trauma or illness of a child while being educated and cared for at an education and care service which a reasonable person would consider required urgent medical attention from a registered medical practitioner, or for which the child attended or ought reasonably to have attended a hospital.

This might include, for example:

Whooping cough,

A broken limb

An anaphylactic reaction.

An incident at the service premises where the attendance of emergency services was sought, or should have been sought.

If a child:

Appears to be missing or cannot be accounted for

Appears to have been taken or removed from the service premises in a way that breaches the national regulations, or

Is mistakenly locked in or locked out of any part of the service premises.

Medical attention includes a visit to a registered medical practitioner or attendance at a hospital.

Emergency services may include ambulance, fire brigade, police and state emergency services.

A serious incident should be documented as an incident, injury, trauma and illness record as soon as possible and within 24 hours of the incident.


(Guide to the National Law and National Regulations, 2014, p 60)


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Infectious diseases

National Regulations: Regulations 4, 88

An approved service must take reasonable steps to prevent the spread of infectious diseases at the service, and ensure that the parent or emergency contact of each child enrolled at the service is notified of the occurrence of an infectious disease as soon as possible. The service must have policies and procedures in place about dealing with infectious diseases.

For family day care services, the service need only notify the parents of children being educated and cared for at the residence or venue where there is an occurrence of an infectious disease.

The National Health and Medical Research Council (NHMRC) publication, Staying Healthy:

Preventing infectious diseases in early childhood education and care services provides detailed information on infections and diseases which are required to be notified to the local public health department. It also provides information about exclusion periods for infectious diseases.

Notifying all families of the occurrence of an infectious disease should be done in a manner that is not prejudicial to the rights of any child or staff member. For example, There is a case of chicken pox in the toddler room rather than John has chicken pox. This might be done through a notice at the entrance to the service.

Cases of some infectious diseases are required to be notified to the local public health department.

Public health staff can provide valuable advice, support and resources to help manage outbreaks of illness, such as diarrhoea. Services should also notify families of exclusion periods for infectious conditions, such as in a policy document, through a poster displayed in the centre or in a family handbook.

(Guide to the National Law and National Regulations, 2014, p 60- 61)

First Aid Code of Practice

Safe Work Australia first aid in the workplace code of practice

http://www.safeworkaustralia.gov.au/sites/SWA/about/Publications/Documents/693/First%20aid%20in%20the%20workplace.pdf

Safe Work Australia released the new First Aid in the Workplace Code of Practice in 2012. It

provides support and guidance regarding different issues in work, health and safety ensuring

compliance with the Work Health and Safety Act (the WHS Act). All states with the exception of

Western Australia (WA) and Victoria (VIC) have adopted this Code. However WA and VIC are

expected to adopt the code of practice in the future.


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Code of Practice on first aid in the workplace provides guidance for:

Risk management

The number of first aiders required in a workplace

The training first aiders must receive

Who can provide the training

First aid kit content and location

Other first aid equipment such as automatic defibrillators (AED),

Procedures (record keeping & first aid requirements when managing an emergency)

(Safe Work Australia 2012)

First aid kits

Under state and territory legislation fully stocked first aid kits must be made accessible within a workplace. It is vital to ensure quick access to kits in the event of an injury within the workplace. The kits should be clearly labelled, maintained and regularly checked for current contents. The kit should contain basic equipment for administering first aid and workplace specific content will be based on a workplace risk assessment.

(Safe Work Australia 2012, pp.9-10)

Legal and ethical requirements

Duty of care

The term duty of care is used to describe any legal responsibilities and requirements for people to act in a certain way. As a first aider, when providing first aid to a casualty you have a duty to use the knowledge and skills that you obtained in your first aid training. If you decide to provide assistance to a casualty, you have a duty to provide care to the best of your abilities until the scene becomes unsafe, another trained first aiders takes over, qualified help arrives, the casualty shows signs of recovery or you become physically unable to continue.

(Mckie 2011, p.10-11)

It is important first aiders should not administer first aid management beyond their level of training and own capabilities and ensure they act in good faith and without recklessness to provide safe and effective first aid.

It is imperative to maintain currency of skills and knowledge of first aid practices and be aware of changes to legislation, policy and procedures and ARC guidelines in relation to first aid.

(Queensland Ambulance Services 2014, p.2)

WA http://www.vwa.vic.gov.au/__data/assets/pdf_file/0003/8706/First_aid_CC.pdf

VIC http://www.workcover.nsw.gov.au/newlegislation2012/general-risk-management/Pages/first-aid.aspx


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Within a workplace first aiders and staff have a duty of care in a workplace emergency. They should act within their own capabilities to; provide treatment and administer first aid in accordance to policies and procedures, report the incident and self-evaluate and debrief to improve on response for future incidents.


Good Samaritan

Good Samaritans and Volunteers

A Good Samaritan is defined in legislation as a person acting without expecting financial or other reward for providing assistance. Volunteers are generally defined as a member of a Volunteer organisation performing voluntary community work.

(ARC guidelines 10.5 2012, p.1)

Lay persons or Volunteers acting as Good Samaritans are under no legal obligation to assist a fellow being, that is, they have no legal duty to rescue. However in The Northern Territory, persons are required by Statute law to render assistance to any other in need.

If the decision is to assist, a standard of care appropriate to their training (or lack of training) is expected. Rescuers need not fear litigation if they come to the aid of a fellow human in need. No Good Samaritan or Volunteer in Australia, or probably elsewhere, has ever been successfully sued for consequences of rendering assistance to a person in need. Legal protection is provided as all Australian States and Territories have enacted Statutes which provide some measure of protection for the Good Samaritan and/or the Volunteer.

(ARC guidelines 10.5 2012, pp.1-2)

Further information on this can be found at the following link

http://resus.org.au/download/section_10/guideline-10-5-%20july-2012.pdf

To ensure protection from civil liability it is important:

The person acts in good faith

The persons action was without expectation or reward

They are not responsible for the injury in relation to the assistance provided

They exercised reasonable care and skill

They were not significantly impaired by alcohol or drugs

They was no false representation of their skill or expertise

(Mckie 2011, p.11)


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Negligence

Is a breach of duty which has legal as well as ethical repercussions? A person may be deemed negligent if the following factors are present:

1. There was a duty of care between the first aider and the casualty

2. Reasonable care and skill was not exercised by the first aider

3. The first aider breached the relevant standard of care

4. As a result of an act or omission of the first aider the casualty sustained damage

(Mckie 2011, p.11)

Consent

Consent is defined as permission for something to happen or agreement to do something, Oxford Dictionary Normally, the consent of an injured or ill person (parent or guardian of a minor) should be obtained before any assistance is rendered. The consent of a childs parent or (legal) guardian should likewise be obtained. To treat without consent potentially constitutes medical trespass (assault) and the victim could recover damages without requirement of proof of injury, causation or negligence.

(ARC guidelines 10.5 2012, p.2)

However if the injured person is unconscious, the law allows for implied consent. Implied consent occurs when the first aiders is unable to communicate with the victim. Most commonly, this is because the victim is unconscious or otherwise unresponsive. If the injured person is under 18 the consent of the parent or legal guardian should be obtained (where possible). (Mckie 2011, p.11) Further information on consent can be found at the following link: http://resus.org.au/download/section_10/guideline-10-5-%20july-2012.pdf

Privacy and confidentiality requirements

Extreme care should be taken to ensure all information and documentation regarding the casualty remains confidential. It is imperative to abide by the privacy act and also relevant confidentiality policies. The first aider should only release information to authorised personnel.

Privacy Act

The Privacy Act 1988 is an Australian law which regulates the handling of personal information about individuals. This includes the collection, use, storage and disclosure of personal information, and access to and correction of that information.

(The Privacy Act, 1988)


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Confidentiality policies

It is imperative to adhere to confidentiality policies. Each State and Territory will have a specific policy in regards to confidentiality. An example of these policies is the Queensland Government (Queensland Health) Health services Act 1991, Part 7: confidentiality guidelines. This policy can be found at: http://www.health.qld.gov.au/foi/docs/conf_guidelines.pdf

(Health Service Act, 1991)

Respond in a culturally aware, sensitive and respectful manner towards a casualty

It is crucial to be aware and respectful to the casualties customs, traditions and beliefs. Always ensure you have obtained consent to examine or provide treatment to a casualty. Maintain the casualties privacy and dignity. You should observe and respect the casualties right not to be touched or treated.

(Mckie 2011, p.9)

Documentation & report details of incident to workplace supervisor as appropriate

Verbal reporting

This may be required when transferring information to:

A supervisor

A parent/caregiver

Emergency services

First aider's are required to give an accurate verbal report and convey any details of the first aid provided and the casualtys response to the treatment. Ensure you give a quick, accurate handover so any appropriate further treatment can be initiated without delay. You will also need to advise your supervisor of the situation, as well as the childs primary caregiver and the parents/family members. The families should be informed of any incidents that could have an effect on their child.

(Queensland Ambulance Services, 2014, p.4)

Written reports

No matter how minor the incident it is always important to make notes or fill in a casualty report. These notes or reports will help you recall an incident at a later date. You will be asked to provide a report on the casualty, what happened, any changes, your care and how they responded to your care and procedures.

Important details to include would be:

The date, time and location

A description of the incident and injury

What first aid was provided?


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The casualtys vital signs (heartbeat, breathing, etc.)

Your details

An incident report form will be completed for the education and care service. The degree of seriousness of the incident will determine what reports you need to complete. Refer to your state/territory regulators for more details. The National Regulations (Regulations 87 3) required documentation (incident, injury, trauma and illness record) to be completed. You will need to maintain confidentiality about the incident, as per the statutory and organisational policies.

Workplace written reports

All incidents within the workplace are required to be reported. This includes seemly insignificant incidences including near misses or dangerous occurrences where there is no apparent injury.

When reporting an incident ensure you are attentive to:

Policies and procedures,

State or territory legislation

Privacy and confidentiality requirements

Guidelines and timeframes

Records of incidents must be kept for at least five (5) years from the date of the incidents.


Documenting your treatment

Accurate record of treatment

The date and time of incident

Brief personal details (name, address, date of birth)

History of illness/ injury

Observation( signs, symptoms and vital signs)

First aiders assessment of the injury/illness

Signature of first aider

Name of first aider

(Mckie 2011, p.14)


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Example injury report form


27


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Notifiable incidents

As per The Work Health and Safety Act (WHS) incidents deemed to be dangerous or serious must be reported to relevant state work health and state authorities or regulators such as work cover.

A notifiable incident as outlined in the WHS Act is:

The death of a person

A serious injury or illness, or

A dangerous incident

A notifiable incident arises from conduct undertaken at a workplace. Notifiable incidents may relate to any person engaged in activities at the place of work regardless of whether this person is an employee or a contractor. A member of the public regulators must be notified immediately of notifiable incidents.

(The WHS Act, 2011)

Following an emergency situation

Evaluation of own performance

First aiders should always be aware of their skills and limitations. Evaluating your own performance can provide you with valuable opportunities for self-improvement. When involved in a critical incident it is extremely important to recognise there may be ongoing psychological impacts for all involved: yourself, other rescuers as well as children if involved in the incident. It may be beneficial for the first aider to talk to the paramedics who attend the incident.


Signs and symptoms of stress

It is an entirely normal reaction to feel stressed following a first aid response. It is important to pursue available support following a first aid response and to implement appropriate stress management techniques. If you experience difficulty dealing with ongoing emotions in relation to the first aid event, should seek professional health assistance.

Some signs and symptoms of stress following a first aid event include:

Physical Fatigue, headache, insomnia, muscle aches, stiff neck, heart palpitations, chest pains, abdominal cramps, cold extremities, flushing/ sweating, frequent colds

Mental Decreased concentration/ memory, indecisiveness, mind racing/ going blank, loss of sense of humour

Emotional Anxiety, nervousness, depression, anger, frustration, worry, fear, irritability, impatience, short temper

Behavioural Pacing, fidgeting, nervous habits, crying, yelling, swearing, blaming, throwing things, altered eating patterns, smoking, binge drinking, feeling anti-social towards others



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Psychological impacts

Where an adult or child has been exposed to a traumatic situation, it is sometimes psychologically damaging (and increases trauma in the long term) for them to relive the whole experience. Children will need to have someone to talk to about it. Psychological first aid is now being used in preference to critical incident stress debrief (CISD), allowing the rescuer the ability to focus on their current situation and look at going forward, rather than reliving the traumatic event. Psychological first aid is also recommended for anyone having suffering a traumatic event, emergency or disaster. You do not need to be medical professional to use this technique. Just concentrate on being practical, gentle and kind. According to the Australian Red Cross:

Psychological first aid is not prescriptive. However, there are basic elements to providing psychological first aid that have been drawn from the literature on risk and resilience, research, field experience and expert agreement. The core principles of psychological first aid are to promote:

Safety Calm Connectedness Self-efficacy and group efficacy Hope Help

Source: Australian Red Cross, Psychological First Aid www.redcross.org.au/default.aspx

Importance of debriefing

People react differently to traumatic events and what may be a minor event to one person may constitute significant trauma for another. Strong emotions following an incident may affect an individuals health, well-being and work performance. Symptoms of emotional of an emotional response to a first aid event may appear immediately or in some cases months or years after the original event. In some circumstances, symptoms develop into a chronic illness and require extensive and long-term treatment.

If an incident occurs in the workplace, a debriefing session should be conducted without delay. A debriefing session should be initiated and conducted by a supervisor allowing for an opportunity for discussion and evaluation. The session should be recorded for future improvement and referral. It is important for the supervisor to recognise whether the first aider is suffering emotionally as a result of the incident. It is the supervisors responsibility to implement a plan/referral to ensure that the first aider receives the required emotional support and treatment. Where multiple people are involved in a critical incident, the supervisor should initiate a group discussion, meeting or debriefing (Queensland Ambulance Services, 2014, p.5).

It is important to allow time for those involved to recover from an incident. In stepping forward and offering first aid you have assisted the casualty in dire circumstances. The wise words of the great humanitarian Albert Schweitzer said the purpose of life is to serve and show compassion and the will to help others. (Mckie 2011, p.9)

In the workplace stress management

In workplaces there should be at least one (1) worker in every section of the workplace who has specialist critical incident stress management training.


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Critical incident stress management strategies in the workplace include:

Preparing workers for a possible critical incident in the workplace

Demobilisation (rest, information and time out RIT)

Defusing (immediate small group support)

Debriefing (powerful event group support)

(Better Health Channel, Vic Government, 2011)

Outside the workplace stress management

Stress management opportunities outside the workplace include:

Debriefing - with paramedics or colleagues

Recognising the importance to having time out

Consulting professional service for support services

(Better Health Channel, Victorian Government, 2014)

For further information on stress management support available for go to beyond blue

http://www.beyondblue.org.au/

Seek assistance from the emergency response services

If there is available assistance at the emergency scene the first aider can employ help to call the ambulance and obtain appropriate resource such as masks, gloves and defibrillators, depending on the severity of the situation. If there is no assistance at hand the first aider will have to call for help and source resources to the best of their ability.

The phone first, concept is recommended by the Australian Resuscitation council especially for suspected cardiac arrest. In cases of severe bleeding the first aider is advised to identify and immediately control any severe bleeding. Severe bleeding is defined as spurting or uncontrolled blood flow; this is a life-threatening condition that must be addressed as quickly as possible.

Australian emergency call service numbers

Triple Zero (000) The primary emergency service number should be used to access emergency assistance from all telephones. To make a call from a mobile on this number you must have reception.


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112 The International standard emergency number can be dialled from a digital mobile phone in areas of GSM network coverage. While a sim card or pin is not required to make a call, phone carriage (from any carrier) must be available to make the call.

106 Text based emergency call service is of assistance to those people who are deaf or have a hearing or speech impairment. This service operates using a teletypewriter service and does not accept voice calls or SMS message.

(An Australian Government Initiative, 2014)

Making a call to an emergency services

http://relayservice.gov.au/making-a-call/emergency-calls/

Making the call

From a safe place dial the emergency service number

Always ask for the service you need - police, fire or ambulance.

You will need to state or confirm your location. This will help route the call to the closest emergency services operator as quickly as possible.

Don't hang up. Wait for a reply from the emergency service.

Be ready to explain the emergency

When a call is made to an Ambulance Service a trained emergency medical dispatcher will ask the caller a number of questions. Remain calm while answering these questions and ensure that your responses are clear and concise. The questions are likely to include the following:

What is the exact location of the incident/accident?

What is the phone number from which you are calling?

What has happened?

How many people are sick/hurt?

What is the nature of the casualtys injuries?

Are you with the casualty now?

How old is the casualty?

Is the casualty conscious?

Is the casualty breathing?


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Identify Hazards

A hazard anything likely to cause an injury or illness

A RISK - likelihood and consequence

of an injury or illness from a

hazard

Identify Risks

For a Hazard there may be one or more risk factors e. chemical - poses toxic risk if contact

is made with, it may also be highly flammable/ give off harmful fumes

Prioritise Take action, use safety precautions, remove, control & minimise hazards and associated risks. Inform and direct others in order to

make the area safe

Review controls

Safety is an ongoing process. Ensure control are working, if safe proceed. Make any

adjustment or improvements to controls if hazards or risks are still present, check again

and proceed

Emergency medical dispatcher will provide you with first aid instructions and dispatch the paramedics. Do not end the call until you are told to do so by the emergency medical dispatcher.

(Queensland Ambulance Services, 2013)

Making the casualty comfortable

Ensure the casualty is as comfortable as physically possible. Covering the casualty to keep them warm or providing pain relief using bandages and slings, hot or cold packs etc.


If you are operating first aid equipment that is readily available you should comply with the manufacturers instructions. If first aid resources are not available at the scene you should improvise using appropriate items to achieving casualty comfort and safety.

Ensure you consistently monitor and reassure the casualty. The first aider should respond to any changed in the casualties condition in accordance with first aid principles


Identify, assess and manage immediate hazards to health and safety of self and others

Personal safety is of utmost importance when delivering first aid. To ensure the scene is safe consider:

Quickly identifying hazards

Conducting risk assessment for hazards

Employing risk assessments measures to determine what action is required to make the scene safer

Determine whether it is safe to proceed

Emergency scene assessment



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Examples of dangers to be aware of when assessing safety

Hazards Risks they may pose Examples to minimise risk/s

Aggressive behaviour

Being attacked Get help, remain calm, be reassuring, dont continue if they remain aggressive

Body fluids Being infected Personal protective equipment (PPE), gloves, eye wear, aprons etc.

Chemical fumes/ biological

Being poisoned Wait for professionals to declare the area safe, use PPE, shut down power, consult safety data sheet (SDS) to identify the substance

Environment (e.g. Storms, snow, wind, rain)

Falling or tripping

Being struck by falling or flying objects

Too hot or cold

Protect the area with a cover, move to a safer area

Fallen power lines Electrocution Contact authorities to shut down power, use non-conductive materials to remove casualty

Fire Being Burnt

Risk of explosion

Falling or collapse of building

Being trapped

Smoke

Extinguish fire if you are trained and it is safe to do so, remove sources or casualty to a safe are, call fire and emergency services & wait for them if unsafe

Lifting or moving heavy objects or casualties

Back injuries Safe manual handling, ask others for help, use devices such as back boards

Machinery Being injured by equipment

Failure of equipment

Shut down or shield dangerous moving parts

Needle stick injuries

Being stuck by needle and being contaminated

Relocate: move away from needles, advise others of danger, dont pick up

Traffic Being hit by a vehicle Move to a safer location, put up warning signs, position vehicles, have other direct traffic, slow vehicles down or stop



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Infection control

Precaution should always be taken when providing first aid to ensure your safety and the safety of others.

Infectious diseases

Infectious diseases are diseases which can be transmitted from one person to another.

Infectious agents (also called pathogens) are biological agents that cause disease or illness to their hosts Infection requires three main elementsa source of the infectious agent, a mode of transmission and a susceptible host.

Main modes for transmission of infectious agents are

Contact (including blood borne),

Droplet (sneezing or coughing)

Airborne (ventilation and air-conditioning systems)

(Australian guidelines for the Prevention and control of infection in Health care, 2010)

Standard precautions

Includes:

Hand hygiene

Use of personal protective equipment (PPE)

Appropriate handling and disposal of sharps

Appropriate handling and disposal of waste

Cleaning techniques

Managing spills of blood and body substances

(Safe Work Australia, 2012)

infectious diseases

Contact

Droplet Airborne


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In the workplace procedures

To protect individual workplaces you should adopt the following procedures:

Proper hand hygiene practices

Correct handling and disposal of sharps

Correct cleaning of surfaces and reusable equipment

Appropriate management of spills and soiled laundry

Appropriate handling and disposal of waste

Appropriate use of personal protective equipment, for example, using resuscitation masks for cardiopulmonary resuscitation


http://www.healthtranslations.vic.gov.au/bhcv2/bhcarticles.nsf/pages/First_aid_basics

In the workplace for healthcare providers:

The World Health Organisation (WHO) has published a guide to hand washing based upon current best practice in reducing infections.

http://www.who.int/gpsc/5may/Guide_to_Implementation.pdf?ua=1

SAVE LIVES: Clean Your Hands is an initiative that aims to ensure an ongoing global, regional, national and local focus on hand hygiene in health care. It encourages health-care workers to clean their hands

1. Before touching a patient

2. Before clean/aseptic procedures

3. After exposure to body fluid

4. After touching a patient

5. After touching patient surroundings

Clean your

hands

before touching a

patient

before clean/aseptic proceudres

After body fluid exposure

After touching a patient

After touching a paitent

surroundings


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Providing first aid

If required to deliver first aid where possible you should wash your hands with soap and water or apply alcohol based hand rub. Where available wear PPE, such as eye protection, a mask or protective clothing to protect you from any splashes from blood or body substances.

At the completion of first aid wash your hands with soap and water or apply alcohol based hand rub.


Accidental contamination

If any part of the body that comes in contact with blood or body substances you should immediately wash skin with soap and water. Prompt medical advice should be obtained in the event of: contact with blood or body substances contact with a person known to have a contagious illness or a sharps injury. All first aiders should be offered hepatitis B virus vaccination.


Contaminated items

Waste disposal should comply with state or local government requirements. Ensure you comply with organisational workplace policies and procedures. Contaminated sharps including scissors and tweezers should be disposed of in a rigid-walled, puncture-resistant sharps container by the person using them.

Cleaning spills

Cleaning should commence to remove any blood or body substances as soon as possible after an incident. Protection such as gloves, PPE: eye protection, plastic aprons and masks should be worn. Contaminated surfaces should be cleaved with warm soapy water.


Manual handling

Manual handling involves the active use of force by a person to lift, lower, push, pull, carry, move, hold or retain a person. Most injuries occur to the back as the spinal column is not designed to withstand abnormal flexion under load. Injuries are often the result of poor manual handling and therefore can often be avoided by following correct procedures.

(Active first aid 147, Qld ambulance 9)

Identify and assess the risks

Is manual handling essential?

What options are available?

Is the right person involved?


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Consider

The weight, size and shape of the casualty, the distance the casualty is to be carried, the height the casualty will have to be lifted. Take into account lifting techniques, observe your personal limitations and employ available help or mechanical devices

(Mckie 2011, p.148)

Steps for correct lifting or moving a load

Assess the situation

Position legs apart on foot level with the load

Keep back straight, look up and keep your head straight

Bend from hips, avoid twisting the body

Bend the knees

Keep the casualty close to your body

Keep carrying distance short

Avoid changing grip or jerking the load

Deposit the load by bending the knees and keeping the back straight

If pushing or pulling let the legs do the work

(Mckie 2011, p.148)

Moving the injured

If possible do not move the casualty as movement may increase pain, injury, blood loss and cause their condition to deteriorate. There are reasons for the need to move the injured casualty and these include:

To ensure the safety of yourself and the casualty

To protect from extreme weather conditions

Difficult terrain making it impossible to treat

Weight Size & shape

Distance

Height


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To prepare for evacuation from a remote area (e.g. Helicopter)

To care for airway of casualty by turning them on their side or back for CPR

To gain access to casualty to control severe bleeding

To conduct a basic triage for a multiple casualty incident


If more than one (1) first aider is present the most experienced first aider should take charge and clearly explain the method of movement to the casualty (if conscious) as well as to the assistants.

Safety

Ensure safety

Inform the casualty of your intentions an uniformed casualty may suddenly attempt to grab onto something

Use available resources such as spine board, stretchers, blankets

Use resources as per manufactures requirements

Follow manual handling safe practices

Avoid bending or twisting the casualties neck and spine

If three (3) or more people are available have them assist with the support of the head and neck, chest, pelvis and limbs

Moving techniques

Emergency Moves

Clothing drag

Blanket/ sheet drag

Bent arm drag

Dragging the casualty by their clothing

Dragging the casualty using a blanket or sheet

Reach under the casualtys armpits from behind, grasp the forearms or wrists and drag

Non- emergency Moves

Direct ground lift

Extremity lift

Blanket lift

Draw sheet method

Log roll

2-3 rescuers to lift with a stretcher

Not if spinal injury suspected, short distances

Not for head/spinal injury casualties

Roll casualty from bed to stretcher

Trained



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Spinal immobilisation

Aim to maintain casualties head aligned with body avoiding side to side movements

Manual stabilisation

Standing behind an upright/lying/kneeling casualty

Hold casualties head firmly, stabilise arms by locking elbows together or resting elbows on the ground

Cervical collars

To be used by those trained in application methods

Should only be removed by trained personnel who can clinically assess the neck of a spinal injury

Adverse effects associated with their use (discomfort, pain, restriction mouth, difficulty swallowing, compromising airway)

Spinal boards

Rigid boards placed under casualty

Casualty should be adequately immobilised prior to moving them

Can be uncomfortable so do not leave casualties on for an extended period of time

Types of spine boards or stretcher

Short backboard Spinal injury suspected

Casualty in seated position

Long backboard Spinal injury suspected

Rapid extrication required

Provides secondary support to short backboard

Flexible stretchers Not for spinal injuries

For limited space, stairs, cramped corners etc.

Basket stretchers Rescue situation

Winching casualty with helicopter

Scoop (orthopaedic) stretcher

Not for spinal injuries

Lift patient from ground without changing their position

Good for confined spaces

Can be placed with casualty onto a wheeled stretcher for transfer


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Stair chair Casualties that can sit up

Useful for stairs or narrow passageways

Transfer to ambulance stretcher once ambulance arrives

Portable/ folding stretchers

For use to when going downstairs, navigating rough terrain, moving from a narrow spot

Easily loaded on/ off ambulance

Basic/breakaway with folding wheels

Wheeled stretchers

2 basic types;

I person special wheels to roll in with

2 person lift in/ carry into narrow spaces with a rescuer on each side, it has adjustable height and angles and additional equipment can be attached

Children/Infants

Following traffic accident if possible conscious infants/children should be left in seat or capsule

Remove the child from car whilst still in seat

(Queensland Ambulance Services, 2014)

Recognise an emergency situation

Medical Emergency

Sudden illness

Example heart attack

Requires immediate

medical attention

Injury

damage to body from a violet force

eg. broken arm

If serious enough can be considered

an emergency situation


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Observations

Examples

Sound of someone in distress

Spilled chemical container

Unusual behaviour (e.g. panic)

Casualty with signs and symptoms

Priorities in an emergency

Early recognition is a key step in initiating early management of an emergency situation.

In all emergencies, the rescuer should:

Assess the situation quickly

Ensure safety for the rescuer, casualty and bystanders (this may mean moving the casualty)

Send for help (call an ambulance)

If the casualty is unresponsive and not breathing normally, follow the