First Aid Level 2 - Bag 1

8/8/2019 First Aid Level 2 - Bag 1

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First Aid Training

Course designation

HLTFA301B Apply First AidFormally Senior First Aid


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Welcome to your First Aid Course

Introductions

Housekeeping

Course delivery

Exam

Practical Assessments

Course Evaluation

QuestionsAny specific topics you would like covered


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Course Format

Conscious Casualty

Unconscious Casualty

CPR and defibrillator

Bandages and slings

Bites and Stings

Diabetes

Seizures/fitting

Triage

Record keeping Trauma

Drowning

Choking

Poisoning

Drug overdose

Burns and scalds

Strokes

Hyperventilation

Hypothermia/Hyperthermia

Safe manual handling


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What is First Aid?

The initial care, given to a casualty, prior to

the arrival of professional medical assistance.

What is your obligation to provide first aid?


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PRINCIPLES OF FIRST AID

LOOK AFTERNUMBER ONE - YOU

Consider the danger to you, others and the casualty.

Wear protective equipment such as gloves, masksetc.

Be careful not to get an injury helping, such as cuts

and abrasions if accessing a damaged vehicle, a

back injury whilst lifting or a needle stick.

Promote a safe environment at an accident scene, at

work and at home.


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Danger

Response

Airway

Breathing

CompressionDefibrillation

Refer page 14 in your manual


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First Aid Protocol

Assess the scene

Assess the casualty

Assess what to do next

Triple A Protocol


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IDENTIFY THE HAZARD


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ASSESS THESCENE

Protect yourself and others

Protect the casualty

Phone the Ambulance on 000 (112 Mobile

phones)


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DANGERS Traffic Unstable environment

Fire or explosion

Burns

Chemical fumes Electrocution

Needle stick injury

Back injuries

Equipment failure

Biological Aggressive behaviour

Body fluids especially blood

Aggressive dog?


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INFECTION CONTROL

In every first aid situation, you must assume that theinjured casualty has a disease.

Before First Aid:

Wash your hands Use Gloves

Use a Resuscitation Mask

During First Aid:

Ensure gloves are worn and not torn Consider double gloving

If you come in contact with body fluids, washimmediately and seek medical advice



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Assess the Casualty- are they

alive ?

Is the casualty responding ?

Is the casualty breathing normally ?

Is the casualty moving ?

Are there signs of life ?

If they respond, seek their permission to

provide first aid.Refer page 3 in your manual


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Assess the Casualties

TRIAGE

What does it mean?

The efficient use of resources so the most good can

be done for the most people.

This would mean a casualty that had suffered a

cardiac arrest should only be given CPR if there areno other seriously injured casualties that would

benefit from your life-saving treatment.


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ASSESSWHAT TO DO NEXT

Commence treatment.

Dont move the patient unless theyre in danger oryou must move them to provide treatment.

Arrange transportation tohospital.

Provide confidence and

reassurance.

Build teamwork and avoid panic.

Ensure you dont injure yourself whilst providingassistance.


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The Conscious and

Unconscious Casualty


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The Conscious Casualty

What does the term conscious mean ?

Conscious means a person is in their normal

state of mind.

Generally this is like you are now, able to

communicate and aware of your surroundings.

In certain circumstances i.e. people withmedical conditions and/or disabilities you may

need to ask if there behavior is normal.


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Consciousness

How do we determine the consciousness of a

patient?

C can you hear me?

O open your eyes.

W whats your name?

S squeeze my hand


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TheUnconscious casualty

Unconscious casualty means there is no

response from the casualty to your

communications with the casualty

There are many causes of unconsciousness,


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Causes ofUnconsciousness

Alcohol (intoxication)

Epilepsy (fitting/convulsions)

Insulin (Diabetes)

Overdose/Under dose (illicit and prescription drugs)

Uraemia (renal failure is difficult to diagnose)

Trauma (Shock)

InfectionPsychiatric / Pretending

Stroke (CVA Cerebrovascular Accident / TIA Transient Ischemic Attack )


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Treating theUnconscious

Casualty

Unless CPR is to be performed, all

unconscious, breathing casualties must

be placed in the lateral recovery or stableside position.

Preferably on their left side.

Lets have a practice


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Examining theconscious and

unconscious casualty Once the casualty has been placed on their side, we

must treat any obvious life threatening injuries ie; any

major haemorrhage.

As part of a secondary survey, allcasualties require

a head to toes examination.

When examining a conscious or an unconsciouscasualty, use different methods. (remember to gainpermission from the conscious casualty and preserve the dignity

of the unconscious casualty)


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unconscious casualty

Once a head to toes examination has been

completed, complete the secondary survey.

Look for symptoms such as cold clammy

skin, skin colour, heart rate.

Look at the history of the situationwhere

the casualty is lying, ask witnesses what

happened.


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unconscious casualty

Does the casualty take any medication?

Does the casualty have any allergies?

When was there last meal?


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Resuscitation


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Causes ofCardiac Arrest

Heart condition

Near Drowning

Electrocution

Trauma

Blockage of coronary arteries

Drug overdose


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BasicLifeSupport Chart

DDanger Check for danger, risks or hazards. Always ensure the safety

of yourself, any bystanders and the casualty

RResponse Check for a response. Is the casualty conscious /

unconscious? Call 000 for the ambulance. From a Mobile:112

AAirway Is the Airway open? Look for signs of life. No signs of life will

mean the casualty is unconscious, unresponsive, not breathing

normally, not moving.

B Breathing Give 2 initial breaths, if not breathing normally.

C Compressions Give 30 chest compressions (At a rate of almost 2compressions per second) followed by 2 breaths

DDefibrillation Cardiac Arrest Casualties need urgent defibrillation to

increase their chance of survival. Continue doing CPR until qualified

personnel arrive and take over care of the casualty or until signs of life

return. Dont delay getting help.


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CPR TECHNIQUE

2 Breaths followed by 30 Compressions

When performing CPR on a child, use onlythe air in your mouth.


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Breathing

Five ways to perform Rescue Breathing -

1. Mouth to mouth resuscitation

2. Mouth to nose resuscitation

3. Mouth to mouth and nose resuscitation

4. Mouth to stoma resuscitation

5. Mouth to mask resuscitation


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Compressions

Find the compression point by placing your hands inthe centre of the chest (lower half of the sternum)

In infants the 2 finger technique should be used forcompressions

In children and adults the rescuer should use theheel of their hand while placing the other handsecurely over the top of the first.

The compressions should equate to 1/3 of the chest

depth. The rate of compressions should be approximately

100 compressions per minute for all ages.


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VENTRICULAR FIBRILLATION (VF)

Sudden cardiac arrest can occur any time andwithout warning.

Though the average age of these victims is 65, someare in their 30s or40s.

Most victims experience an abnormal heart rhythmcalled ventricularfibrillation (VF).

When the heart is in this state, it cannot beat in anorganized fashion; the heart is unable to pump blood

to the body. Sudden cardiac death can occur in minutes unless

you act quickly.


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DEFIBRILLATION


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AED

What is an AED?

The automated external defibrillator (AED) is a

computerized medical device.

It will check a persons heart rhythm.

It will recognize a rhythm that requires a shock.

And it will advise the rescuer when a shock is

needed.

The AED uses voice prompts, lights, and text

messages to tell the rescuer the steps to take.



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HOWDOESIT WORK

The AED can diagnose and restore a normal heartrhythm to victims of sudden cardiac arrest due toventricular fibrillation (VF).

In the unconscious victim, adhesive pads are placedon the chest by trained individuals to deliver anelectrical shock.

This shock (or series of shocks) is calleddefibrillation, and it briefly stops all of the heartselectrical activity so the heart can resume normal

beating on its own.

Refer page 36

in your manual


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DEFIBRILLATION

RememberEVERY MINUTE COUNTS

If defibrillation occurs in the first one or two minutes,90% of sudden cardiac arrest victims in VF survive.

If defibrillation is delayed for more than ten minutes,

the survival rate drops to 5% for sudden cardiacarrest victims in VF.


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Lets practice CPR

Remember2 breaths & 30 compressions

100 compressions permin

CPR TECHNIQUE


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Debriefing

As soon as possible after an emergency situation,document what had taken place.

A diary note, write on the back of a time sheet if atwork.

It doesnt matter what you write on.

This will help you put the events into perspective and ifasked, may help paramedics with the continued care of

the casualty.


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Head Injuries

Head injuries can range from a simple bleeding

nose, or a tooth being knocked out to a heavy blow

to the head as a result of a fall, car accident or a

fight.

A head injury can constitute a severe medical

emergency.


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Head Injuries

Symptoms...

Bleeding from an open wound.

Deformity of the skull or face.

Become drowsy or vague.

Agitated or irritable.

Vomits or complains of nausea.

Bleeding or discharge from the ear

Changes in the size/shape of the pupils

Memory impairment

Lack of coordination

Headache or giddiness

Slurred speech

Possible seizures

Becomes unconscious


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Head Injuries

Treatment

Follow the Triple A Protocol and call an ambulance ifrequired

Ifthecasualty is conscious

Complete a thorough assessment and ensure the cervical spineis not damaged.

Keep the casualty lying down and at rest.

Check carefully the neck, eyes and ears, and if bleeding ordischarge is found, place the casualty on the injured side to aid

the draining process. Dress any wounds and monitor


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Head Injuries

Treatment cont

Unconscious casualty

Follow the Triple A Protocol DR ABCD

Manually support the head and neck and place the casualty ontheir side. (Be very careful when turning the casualty over as there could be damage tothe cervical spine.)

Maintain manual traction of the head and neck until theambulance arrives and takes over the care of the casualty.

If there is fluid coming out of an ear, ensure that the casualty islying on that side to allow drainage.

Treat any wounds and monitor.


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Head Injuries

Treatment cont

Progressive Head Injuryshould the casualtyshow a decline in consciousness, theyre suffering

from a more serious brain injury, which requiresurgent medical intervention.

Nose bleeds are common and can be controlledby constant pressure to the soft part of the nosefor at least 10 minutes.

Ice packs can be used.

Dont let the casualty blow their nose.

Monitor the casualty


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Head Injuries

Treatment cont

Tooth Injury

If the tooth is knocked completely out, rinse gently

and put back in place the correct way around

Another alternative is to place the tooth in a smallcontainer surrounded by the casualties own saliva ormilk and seek medical or dental assistance.

Apply firm pressure, using a sterile pad, to anybleeding wound or tooth socket for at least 10minutes.


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Shock

Shock fits into 3 categories

Absolutefluid loss

- low blood volume

Relativefluid loss

Cardiacfailure- Cardiogenic Shock


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Shock

Shock can be bought about by physical or

mental trauma.

Physical trauma may be the result of a sharkbite, car accident or industrial accident

causing blood loss.

Mental trauma maybe as a result of bad

news, witnessing a bad accident etc., causingarteries to dilate and decrease the relative

blood volume.


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Shock

Signs and symptoms ofshock include

low blood pressure (hypotension),

over breathing (hyperventilation), a weak rapid pulse,

cold clammy greyish-bluish (cyanotic) skin,

decreased urine flow and mental changes (a sense ofgreat anxiety and foreboding, confusion and,sometimes, combativeness).

Depending on the underlying cause shock can be a

major medical emergency.It is common after seriousinjury. Emergency care for shock involves keeping the

patient warm and giving fluids by mouth or, preferably,intravenously.


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Shock

Treatment


If you come upon a person in shock, the initial response shouldbe to call 000.

Lay the person down in a safe place and try to keep them warmand comfortable.

Elevate the legs to increase the available blood flow to the vitalorgans.

Treat any injuries and monitor the casualty continuously.

Confirm the ambulance has been called.


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Faints

Fainting can present similarly to shock, if the faint is

unwitnessed.

The brain is being starved of oxygen due to the lack

of blood flow.

People stand still for long periods of time eg; army

personnel standing at attention for long periods.

Blood pools in the lower extremities which reducesthe supply available to the brain. Fainting occurs.


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Faints

Signs and Symptoms

The casualty normally feels light headed prior to the

faint, may feel nauseated and anxious and appears

pale.

The diagnosis may be confirmed by rapid return to

consciousness while lying flat.

Occasionally, fainting may be associated with fitting.

Brain damage or death may occur if the casualty is left

supported in an upright position


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Faints

Treatment


Lie the casualty on their back with feet andlegs elevated.

If the casualty is unconscious they must beplace in the stable side position.

Pregnant women must be laid on the leftside to aid the return of blood back to theheart.

Assess the casualty for any injuriesresulting from a fall.

Treat wounds and monitor.


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Drowning

Drowning is the process of experiencing respiratoryimpairment from immersion in liquid.

The most important and life threatening consequenceof drowning is the interruption of the oxygen supply tothe brain.

Early rescue and resuscitation are the major factors

in survival.


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Drowning

Treatment


Rescue and remove the casualty from the water or liquid.

Dont put yourself in danger attempting a rescue.

DRABCD Assess the casualty, their airway and breathingwith the casualty on their side. This will allow for drainage ofany fluid and do away with the need to continually roll thecasualty back and forth.

Commence CPR as required.

Consider spinal injuries and the effects of hypothermia

Seek urgent medical assistance.


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AbdominalInjuries

Abdominal injuries fall into two groups

Trauma related abdominal injuries.

Non trauma related injuries.

Trauma related injuries

Signs and symptoms

Pain in the stomach

Feeling sick in stomach Nausea and vomiting

Pale cold skin

Evidence of bleeding or obvious injury


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AbdominalInjuries

Treatment


Control bleeding using direct pressure and bandages.

Consider internal bleeding. Look for pale cold clammy skin.

If the casualty is in shock lay them down and elevate the feet.

Flexing the knees may help reduce pain.

Dont allow the casualty to eat or drink.

Assist the casualty to be comfortable.

If stomach contents are visible, cover with plastic wrap, a non stick dressing ora wet dressing. Do not push the contents back into the stomach.

If an object is embedded in the abdomen, leave it in place and pad around it.It may be plugging any blood loss and removal may do further damage tosurrounding tissue.


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AbdominalInjuries

Non trauma related injuries.

Signs and symptoms

Right lower abdominal pain, evidence of fever appendix

Right upper abdominal pain gallstones

Referred back pain kidneys

Severe tearing mid/upper abdominal pain artery tear.

Severe right or left lower abdominal pain in a female casualty possible ectopic pregnancy.

Red flushed skin if infection is present.


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Bleeding

Bleeding can be internal or external

and can be the result of trauma or it

can happen spontaneously resulting

from disease.

If the bleeding is internal you may

not be able to see evidence or signs

of blood loss, however signs of

shock will be evident. (pale coldclammy skin) with any form of blood

loss.


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Bleeding

Internal bleeding which is visible may be

evident as

Lungs frothy bright red blood coughed up.

Stomach dark type, coffee coloured blood.

Bowel dark loose smelly stools.

Vaginal usually red blood discharge.


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Bleeding

Treatment for internalbleeding


Lie the casualty down.

Elevate the feet.

Keep the casualty warm.

Knees may be flexed, which may help reducepain.

Reassure the casualty.


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Bleeding

Treatment forexternalbleeding cont


Inspect the wound for an embedded object.

Direct, sustained pressure is the most effective way to controlbleeding.

Apply a pad over the wound and secure with a bandage.

If the initial dressing doesnt stop the bleeding, apply another padand bandage over the first.

If the bleeding doesnt stop, remove the second pad and applyanother pad and bandage.

Elevate the wound if possible.


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Bleeding


Wounds involving Embedded Objects knives, barbs,

stakes etcDont remove the embedded object.

It may be plugging the wound and

restricting the bleeding.

It may also cause more damage tosurrounding tissue.

Place a bulky pad around the object

and bandage firmly in place.


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Bleeding


Tourniquet for the control of life threatening bleeding andonly as a last resort.

Life threatening bleeding may involve the traumaticamputation of a limb, eg; shark attack

The tourniquet should be tight enough to stop the circulation ofblood to the injured limb and control the bleeding.

Note the time of application and provide this information to theparamedics on arrival.

Monitor the casualty.


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Bleeding


In the event of the complete amputation of a finger or limb there may beless blood evident than you would expect.

This is due to the fact that the arteries recoil, spasm and self seal.

Direct pressure maybe enough to control bleeding in thesecircumstances. If not then use a tourniquet.

Place the amputated body part in plastic bag and seal it completely,ensuring it is watertight.

Place the plastic bag inside another plastic bag and seal it.

Place the plastic bags into a container of cool water, making sure nowater touches the amputated part and send with the casualty to hospital.


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Anaphylaxis

Most people will, at some time in their lives, experiencesome form of allergic reaction.

Anaphylaxis is the most severe form of allergic

reaction.

It affects the respiratory and or the cardiovascularsystems.

Anaphylaxis is a life threatening condition.

The patient should be treated immediately.

Refer page 14 & 15 in your manual


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Anaphylaxis

Causes

Severe reactions to some foods, medications,

stinging insects and latex.


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Anaphylaxis

Signs and symptoms

Red skin, welts and blotchy rashes over the skin.

Swelling of the throat and tongue causing breathing

difficulties.

Breathing sounds such as wheeze and stridor.

Difficulty talking in sentences.

Terrified, with a feeling of doom.

Increased heart rate.

Collapse and unconsciousness.


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Anaphylaxis

Treatment

Follow the Triple A Protocol and callfor the

ambulance DR ABCD

Once symptoms are confirmed administer the contents

of an EPIPEN (the casualty will be carrying one if they have knownallergies)

If in doubt and the casualty is displaying any of thepreviously mentioned symptoms, accompanied by a

rapid deterioration, dont hesitate to assist the

casualty to administer the EPIPEN injection.


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Anaphylaxis

Administration

Remove the EPIPEN from its container.

Hold firmly in closed fist with grey cap towardsyour thumb.

Remove the grey cap.

With positive force, push the black end againstthe thigh of the patient, (through clothing) until

a click is heard and felt.


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Anaphylaxis

Administration cont

The needle will be injected automatically intothe thigh and the contents of the EPIPEN will

be injected into the muscle.

Wait 10 seconds, remove

the EPIPEN and massage the area.

Place used EPIPEN carefully back into itscontainer and seal for safety.


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Anaphylaxis

Once treatment has been administered

remain with the casualty and maintain their

airway. Monitor their condition continuously.

The casualty may find it easier to breath if

they are sitting upright, unless they are dizzy

and confused (low blood pressure/shock)

Confirm the ambulance has been called.


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Asthma

Asthma is a chronic (ongoing) respiratorydisorder in which the airways occasionallyconstrict, become inflamed and are lined withexcessive amounts of mucus.

Health experts dont know exactly whatcauses asthma. They do know that there arehereditary and environmental influences.

They do know what triggers asthma attacks.


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Asthma

Asthma triggers

Pollen

Mould

Dust mites

Pet fur

There are many triggers for asthma ranging from the above

examples to the common cold, exercise and cold night air.Refer page 16 & 17 in your manual


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Asthma

Symptoms

Wheeze a high pitched noise.

Coughing this is usually dry and persistent.

Cant get their breath

Tightness in the chest.

Raised shoulders, neck muscles and rib

muscles become tight.


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Asthma

Symptoms cont...

Difficulty speaking more than a few words or

inability to speak because of wheezing or

breathlessness.

Distress.

With severe asthma the casualty may have

blueness around the mouth.


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Asthma

Treatment cont

Relievers in a puffer are best delivered through aspacer if one is available. Spacers can be improvisedusing a paper or Styrofoam cup.

The casualty should take one puff at a time, then takefour normal breaths between each puff. Wait four

minutes, give four more puffs.

Whilst waiting for the ambulance, give four puffs everyfour minutes.


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Asthma

Treatment cont

No harm is likely to result from giving a

Reliever, in recommended doses, tosomeone who doesnt have asthma.


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Fractures and Dislocations


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What is a Dislocation?

A dislocation is a partial or full separation of a joint.

What is a Fracture ?

A fracture is a break in the continuity of a bone or

cartilage.

Causes

Direct force

Indirect force

Abnormal Muscular contraction


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Open orcompound

This fracture involves

a situation where the

bone protrudesthrough the skin OR

there is a wound

adjacent to the

fractured bone.


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Closed or simplefracture

The skin stays intact and there is no sign of external

bleeding. Bleeding occurs into the tissues.


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Complicated Fracture

A fracture that involves

damaged to vital organs

or major blood vessels.



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Pain

External Bleeding

Bruising/Contusion

Swelling

Tenderness

Absent distal pulse Unable to weight bare

Inability to move

Protruding Bone

Open Wound

Difficulty breathing

Pale, cold, clammy skin

Crepitis

Shortening of limb

Deformity of limb

Sign & Symptoms



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Complications

Infection

Shock blood loss

Nerve and blood vessel damage

Nausea



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Treatment


Control any bleeding and cover wounds

If injury is painful but casualty can move the limb if they

wanted to may mean fracture

If injury is painful but casualty could not move the limb if they

wanted to may mean dislocation

Immobilise the injury with splints, bandages and slings

Check circulation following splinting and bandaging

Reassure the casualty


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Sprains and Strains

A sprain is a stretching or tearing ofligaments. Ligaments are toughbands of fibrous tissue that connectone bone to another. Commonlocations for sprains are your ankles

and knees.

A strain is a stretching or tearing ofmuscle or tendon. Peoplecommonly call strains "pulled"

muscles.

Hamstring and back injuries areamong the most common strains.

HamstringMuscle tear


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Sprains and Strains

Symptoms

Pain and tenderness around joints or muscles.

Swelling.

Discolouration to injured part.

Decreased function of the injured part.

Inability to stand on leg without pain.


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Sprains and Strains

Treatment


Follow the acronymR.I.C.E.

RRest the injured area. Have the casualty lie stilland make them as comfortable as possible.

IIceapply a cold compress, frozen peas rapped in a

cloth works well.Ice in a plastic bag rapped in a cloth.

If no cold pack or ice available, use a bandagesoaked in cold water.


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Sprains and Strains

Treatment cont

Rest

Ice

C Compression with the use of a roller bandageand in conjunction with the ice will help reduce

bleeding and swelling.

EElevation of the injured area above the level ofthe heart if the injury permits will also help reduce

blood flow to the area and reduce pain.


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Bandages & Slings


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Types ofbandages

Crepe Bandages

Conforming bandages

Gauze bandages

Triangular bandages


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Bandages areused for

Holding dressings in place

Helping to control bleeding

Helping to immobilise fractures

Pressure immobilisation for snake and spider

bites

Hold cold packs in place

Reduce swelling


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Slings areused for

Support of injured arms or wrists

Immobilisation of fractures

Elevation to control external bleeding

What can be used as a sling?

Shirts

Belts

Rope

Jumper


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Sling types

Upper arm sling

Used for injuries to the upper arm, including collar

bone, shoulder or ribs

Lower arm sling

Used for injuries to the lower arm, including wrist and

hand

Collar and cuff This sling can be used for hand injuries, or fracture of

the upper arm



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BANDAGES & SLINGS

Lets have a go at some slings


Snake & Funnel Web Spider


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Snake & FunnelWebSpider

Bites

Refer page 20 to 25 in your manual



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Bites

Any suspicion of a snake or funnel web spider

bite should be treated immediately particularly if

the victim is a child.

If the casualty has been in an area where snakes

or funnel web spiders may be eg; long grass,

damp wet gardens etc. and the casualty becomes

unwell, dont discount the possibility of a bite.



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Bites

Signs and symptoms

Snakebite

Paired fang marks.

Nausea and vomiting.

Blurred or double vision.

Limb weakness or paralysis.

Respiratory weakness or arrest.


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Bites

Treatment

Follow the Triple A protocol DR ABCD

Lie the casualty down and dont allow them to move.

Life threatening effects may be seen in children inminutes.

Apply a pressure immobilisation bandage.

Seek medical assistance.

Bring transport to the casualty, preferably anambulance.


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Snake & SpiderBites

Appling a pressure immobilisation bandage.

Place a pad over the bite site

Firmly bandage from lower extremities and up to thetop of the limb.

Splint the bandaged limb.

Keep bitten area lower than the heart at all times.

Once applied do not remove bandages.

Application of the bandage slows the absorption of venom.


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PressureImmobilisation

As soon as possible, apply a broadpressure bandage from below thebite site, upward on the affectedlimb (starting at the fingers or

toes, bandaging upward as far aspossible). Leave the tips of thefingers or toes unbandaged toallow the victims circulation to bechecked. Do not remove pants or

trousers, simply bandage overthe top of the clothing.

Images and text courtesy of Australian Venom Research Unitwww.avru.org

b l


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Bandage firmly as for a sprained ankle,but not so tight that circulation isprevented. Continue to bandageupward from the lower portion of the

bitten limb.

Apply the bandage as far up the limbas possible to compress the

lymphatic vessels.

Images and text courtesy of Australian Venom Research Unit

www.avru.org

Refer page 20 to 25 in your manual

P I bili ti


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Bind the splint firmly, to as much of the limb

as possible, to prevent muscle, limb and

joint movement. This will help restrict

venom movement. Seek urgent medical

assistance now that first aid has been

applied.

Images and text courtesy of Australian Venom Research Unit

www.avru.org

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First Aid Level 2 - Bag 1

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