Unit G Emergency Care Skills

2HV07.01 Acquire Certification in Cardiopulmonary Resuscitation

2HV07.01 Acquire Certification in Cardiopulmonary Resuscitation

A. Principles of providing first aidB. Basic facts about CPRC. Performing CPR, one-person rescue D. Performing CPR, two person rescueE. Performing CPR, infants and childrenF. Obstructed airway, conscious adultG. Obstructed airway, unconscious victimH. Use of AED

2H07.02 Provide Basic First Aid

A. Bleeding and WoundsAbrasion

skin scraped off, bleeding limited

Puncture

Caused by sharp object (pin, nail, etc.)

External bleeding minimal, may lead to infection or tetanus

Laceration

A tearing of tissues from excessive force,

jagged edges, bleeding may be

heavy. Deep lacerations may become infected

Incision

A cut with sharp object such as a knife, scissors, razor blade, etc., if cut is deep, bleeding can be

heavy, also can have damage to muscles and nerves

Avulsion

Tissue torn or separated from the body, bleeding is

heavy, important to preserve the body

part because a surgeon may be able

to reattach it.

Amputation

Body part cut off or separated from the body, bleeding can be extensive, important to preserve separated part for reattachment.

Wrap part in cool, moist dressing (sterile water or saline

preferred) and place in plastic bag. Keep bag cool or in ice water and transport with the

victim. (Don’t place the body part in direct contact with the

ice.)

Arterial & VenousArterial bleeding is bright red in

color and life

threatening

Venous bleeding is slower and dark

red.

Control Bleeding

1. Direct Pressure2. Elevation3. Pressure Bandage4. Pressure points

Use protective barrier to control bleeding (gloves)or thick layers of dressings. Avoid direct contactwith blood. Wash hands after providing first aid.

InfectionSigns and symptoms of wound infection:

• Swelling• Heat• Redness• Pain• Fever• Pus• Red Streaks

Infection

Tetanus- bacterial infection, most common in puncture wounds, be sure to find out when victim last had tetanus shot, advise to consult medical professional about tetanus booster.

Closed Wounds

• If a bruise, apply cold

• Signs of internal bleeding-pain, tenderness, swelling, deformity, cold and clammy skin, rapid and weak pulse, uncontrolled restlessness, excessive thirst, vomiting blood, blood or urine in feces.

Shock

When caring for bleeding/wounds, or any other injury or illness, be alert for signs of shock.

Clinical set of signs and symptoms associated with inadequate supply of blood to body organs, especially the brain and heart.

[ If not treated shock can lead to death, even when the victim’s injuries are not life threatening.]

Shock

Caused by:

• Hemorrhage• Excessive pain• Infection• Heart attack• Poisoning by chemicals, drugs or gases• Lack of oxygen• Psychological trauma• Dehydration from burns, vomiting, or diarrhea

Symptoms

• Skin pale or cyanotic• Skin cool to touch

• Diaphoresis• Pulse rapid and weak

• Respirations rapid and shallow• Hypotension

• Victim weak, listless, confused and eventually unconscious• Victim anxious and extremely restless

• Victim may complain of excessive thirst• Victim may experience nausea and vomiting

• Victim may complain of blurred vision – as shock progresses, eyes may appear sunken and have vacant, confused expression,

pupils dilate

Get medical help right away. If possible:

1. Eliminate the cause of shock

2. Improve circulation to the brain and heart

3. Provide oxygen4. Maintain body

temperature

Positioning patient depends on injuries:

If neck or spinal injury suspected:

-do not move the victim

How would you position the following victims?

• Victim has a broken arm, no other apparent injuries.

• Victim is vomiting and bleeding profusely from a lacerated tongue.

• Victim has broken ribs and is dyspneic.

Shock

Cover the patient with blankets or additional clothing. Blankets may also be placed between the ground and the victim.

Avoid giving the patient anything to eat or drink. A wet cloth may be used to moisten the lips and mouth.

If help wont arrive for more than an hour and dehydration is evident, provide fluids.

Poisoning• If poison is ingested, call a poison

control center (PCC) or physician immediately. If not available call EMS.

• Save the label or container of the substance taken.

• If it is helpful to know-estimate how much was taken and the time the poisoning occurred.

• If the victim vomits, save a sample.• If the victim is unconscious check

for breathing. Provide rescue breathing is the victim is not breathing. If victim is breathing, turn victim on his-her side.

Poisoning• DO NOT induce vomiting if:- The victim is unconscious- The victim swallowed acid of

alkali- The victim swallowed petroleum- The victim is convulsing- The victim has burns on the lips

or mouths

                     

• If the poison control center tells you to induce vomiting:

- Give syrup of ipecac- Tickle the back of the victims

throat- Administer warm salt water

Poisoning• Vomiting only removes half of the poison, so you

may need to administer activated charcoal to counteract the remaining poison.

• If poisoning is due to gas inhalation…remove victim from area

Carbon Monoxide Poisoning• Odorless and colorless gas• Before entering the area,

take a deep breath and don’t breathe the gas while removing the victim from the area

• After the rescue, check for breathing and administer CPR if needed

• Obtain medical help immediately

Chemicals or Poisons that come in Contact with Skin

• Wash with large amounts of water

• Remove clothing or jewelry that contains the substance

• If poisonous plant, wash with soap and water- use Calamine or Caladryl (or paste made from baking soda and water.)

• Obtain medical help

For insect bite, sting or snakebite…

• If possible, hold part below level of the heart

• Remove the stinger and wash the area with soap and water

• Apply sterile dressing and cold pack

• Monitor the victim and give CPR if needed

• Watch for allergic reaction• Treat for shock

BURNS

First Degree Burns• Involves only the

epidermis• Heals in 5-6 days• No scarring• Skin red, mild swelling• Victims feels pain• Usually cause by the

sun, hot objects or steam, or exposure to weak acid-alkali

Second Degree Burns• Epidermis and dermis• Blister or vesicle forms• Skin red an mottle with

swelling • Surface appears wet• Very painful• Usually cause by the

sun, sunlamp, contact with hot or boiling liquids, contact with fire

Third Degree Burns• Injury to all layers and

underlying tissue• Area has white or charred

appearance• Can be extremely painful or

painless (if nerve endings destroys)

• Usually caused by flames, prolonged contact with hot objects, contacts with electricity, immersion in hot or boiling liquids

Treatment• Remove source of heat• Cool affected skin area• Cover the burn• Relieve pain• Observe pain• Observe and treat for shock• Medical care should be obtained in more than

15% of adult body burned (10% of a child)

Treatment• DO NOT apply cotton,

tissues, ointment, powders, oils, grease, butter, or other substances to the burned area unless you are instructed to do so by a physician

• DO NOT break open blister• Call for help immediately if

3rd degree burns• Dehydration can occur

quickly with burns• Be alert for signs of shock• Remain calm and reassure

burn victim

BONE AND JOINT INJURIES

Fractures• A break in a bone• Closed or simple- does not

break the skin• Compound or open-

accompanied by open wound• Common signs and symptoms

include deformity, limited (loss of) motion, pain and tenderness at fracture site, swelling and discoloration, protrusion of bone ends

• Victim may have heard a snap or feel a grating sensation

• Treatment includes immobilizing above and below fracture, treat for shock

Dislocation• When the end of bone moves

out of the joint• Usually accompanied by

tearing-stretching of ligaments

• Signs and symptoms include deformity, limited of abnormal movement, swelling, discoloration, pain, tenderness, shortening or lengthening of affected arm or leg

• Treatment similar to fractures- immobilize affected area, do not attempt to reduce the dislocation

Sprain• Injury to tissues surrounding

a joint when the part is forced beyond its normal ROM

• Ligaments, tendons and other tissues stretched or torn

• Usually ankle or wrist• Symptoms similar to

fracture and dislocation• Treatment includes

application of cold, elevation of affected part, and rest

Strain• Overstretching of

muscle- frequently the back

• Signs-symptoms include sudden pain, swelling and-or bruising

• Treatment aimed at resting affected muscle

SUDDEN ILLNESS

Heart Attack• Blood supply to heart is

blocked• If heart stops beating CPR

must be performed• Signs/symptoms- chest pain

or pressure, pain radiating to shoulders, arms, neck or jaw

• Shortness of breath• Cyanosis• Victim weak and

apprehensive• Nausea, vomiting, loss of

consciousness• Encourage victim to relax,

place in comfortable position, and obtain medial help

Cerebrovascular Accident (Stroke)• Either a clot in a cerebral

artery or hemorrhage of a blood vessel in the brain

• Signs/symptoms- numbness, paralysis, pupils unequal size, mental confusion, slurred speech, nausea, vomiting, difficulty breathing and swallowing, and loss of consciousness

• Remember that although the patient/victim may be unable to speak or may be unconscious, he/she may be able to hear and understand what is going on

Fainting• Temporary reduction of blood

supply to the brain• Victim regains consciousness

after being in a supine position

• Signs- dizziness, extreme pallor, diaphoresis, coldness of the skin, nausea, numbness and tingling of hands and feet

• When signs occur, help the victim sit with the head at the level of the knees

• If victim loses consciousness, try to prevent injury, loosen clothing, maintain open airway

Convulsion• Seizure• Occurs in conjunction with

high body temperature, head injuries, brain disease, and brain disorders such as epilepsy

• Body muscles become rigid followed by jerking movements

• During seizure, victim may stop breathing, bite their tongue, lose bladder and bowel control, and injure body parts

• Face and lips develop a bluish color

• Victim loses consciousness

Diabetic Coma• Caused by an increase in the

level of glucose in the bloodstream

• A result of an excess intake of sugar, failure to take insulin, or insufficient production of insulin

• Signs: Confusion, weakness or dizziness, nausea or vomiting, rapid, deep respirations, flushed skin, and fruity smelling breath

• Victim will lose consciousness and die if not treated

• Obtain medical treatment as quickly as possible

Insulin Shock• Caused by an excess amount

of insulin (low level of glucose in bloodstream)

• A result of failure to eat or too much insulin

• Signs: Muscle weakness, mental confusion, restlessness or anxiety, diaphoresis, pale, moist skin, hunger pains, palpitations

• If victim conscious, give sweetened drink or sugar

• Avoid giving victim hard candy if confused

• If victim loses consciousness, get medical help

Dressing and BandagesDressing= sterile covering over

wound or injured partBandages= materials to hold

dressing in place, secure splints, and support body parts

• Roller gauze bandages• Triangular bandage• Elastic (Ace) bandages

After bandage applied, check to be sure it is not too tight

(Check circulation by pressing lightly on nail beds lightly on nail beds to make them turn white. Color should return to nail beds immediately.)