Unit E Master Outline



Terminology List

1.

1. Abrasion

2. Amputation

3. Avulsion

4. Bandages

5. Burn

6. Cardiopulmonary resuscitation

7. Cerebrovascular accident

8. Convulsion

9. Diabetic coma

10. Diaphoresis

11. Dislocation

12. Dressing

13. Fainting (syncope)

14. First aid

15. Fracture

16. Frostbite

17. Heart attack (myocardial infarction)

18. Heat cramps

19. Heat exhaustion

20. Heat stroke

21. Hemorrhage

22. Hypothermia

23. Incision

24. Infection

25. Insulin shock

26. Laceration

27. Poisoning

28. Puncture

29. Shock

30. Sprain

31. Tetanus

32. Wound

33. Xiphoid process

Name ________________________________________ Date _________________________

2H07.02A PROVIDING FIRST AID FOR BLEEDING WOUNDS

MASTERY

YES NO

1. Surveyed the scene/secured environment ____ ____

2. Practiced standard precautions throughout procedure ____ ____

3. Performed primary survey; checked for consciousness verbal response, ABC's ____ ____

4. Reassured victim, identified self, got consent to help ____ ____

5. Cared for wound by:

a. Applying direct pressure ____ ____

b. Using a sterile dressing ____ ____

c. Pressing firmly against wound ____ ____

6. Elevated wound above level of heart if no fx suspected ____ ____

7. Applied pressure bandage to injury ____ ____

8. Checked to be sure bandage was not too tight by checking distal pulse or capillary refill ____ ____

9. Applied pressure to appropriate pressure point if wound still bleeding until bleeding controlled ____ ____

10. Reassured victim ____ ____

11. Activated EMS system; called 911 and stated:

a. Where emergency was located ____ ____

b. Phone number calling from and caller's name ____ ____

c. What happened ____ ____

d. How many victims needed help ____ ____

e. Condition of victim ____ ____

f. Help being given ____ ____

g. Hang up last ____ ____

12. Rechecked bleeding, reassured victim ____ ____

13. Treated for shock

a. Placed in supine position unless contraindicated ____ ____

b. Elevated lower extremities if no possibility of fracture or spinal injuries ____ ____

c. Covered victim with blanket ____ ____

d. Left serious injuries exposed for observation ____ ____

14. Performed secondary survey

a. Interviewed the victim ____ ____

b. Checked vital signs ____ ____

c. Head-to-toe exam; visually inspected, then asked victim to slowly more each body part if no pain occurs

- Head ____ ____

- Neck ____ ____

- Shoulders ____ ____

- Chest and abdomen ____ ____

- Arms ____ ____

- Hips and legs ____ ____

15. Rechecked ABC's and bleeding site(s) ____ ____

16. Reassured victim until EMS arrived ____ ____

---------------------------------------- TOTAL ____ ___

Mastery = 100% Yes

Non-Mastery = Below 100%

Date ____________ Evaluator ___________________

Comments:

Name ________________________________________ Date _________________________

2H07.02B PROVIDING FIRST AID FOR BONE/JOINT INJURIES

MASTERY

YES NO

1. Surveyed the scene/secured environment ____ ____

2. Practiced universal precautions throughout procedure ____ ____

3. Performed primary survey; checked for consciousness, verbal response, ABC's ____ ____

4. Reassured victim; identified self, got consent to help ____ ____

5. Activated EMS system: called 911 and stated:

a. Where the emergency was located ____ ____

b. Phone number calling from and caller's name ____ ____

c. What happened ____ ____

d. How many and condition of victims needing help ____ ____

e. Condition of victim ____ ____

f. Help being given ____ ____

g. Hung up last ____ ____

6. Performed secondary survey:

a. Interviewed the victim ____ ____

b. Checked vital signs ____ ____

7. Covered open wounds with appropriate dressing and bandage to control bleeding if needed ____ ____

8. Treated for shock:

a. Placed in supine position unless contraindicated ____ ____

b. Elevated lower extremities if no possibility of fractures or spinal injuries ____ ____

c. Covered victim with blanket ____ ____

d. Left serious injuries exposed for observation ____ ____

9. Completed secondary survey: Head-to-toe exam: visually inspected, then asked victim to slowly move each body part if no pain occurs ____ ____

10. Splinted fracture/dislocation according to injury

a. Minimal movement of injury ____ ____

b. Checked distal circulation with pulse or capillary refill ____ ____

c. Splinted injury in position found ____ ____

d. Applied cravats properly

- Location and tightness ____ ____

- Knots on outside of splint ____ ____

- At least one fingernail/toe left visible ____ ____

e. Immobilized bones/joints above & below fracture site ____ ____

f. Slung/swathed if appropriate ____ ____

g. Rechecked distal circulation after completion of splinting ____ ____

h. Applied ice/cold packs to fracture site or surrounding area (not over open fracture site) ____ ____

11. Rechecked ABC's and injury sites ____ ____

12. Reassured victim until help arrived ____ ____

---------------------------------------- TOTAL ____ ____

Mastery = 100% Yes

Non-Mastery = Below 100%

Date ____________ Evaluator ______________________

Comments:

Name ________________________________________ Date _________________________

2H07.02C APPLYING DRESSINGS AND BANDAGES

MASTERY

YES NO

1. Assembled equipment ____ ____

2. Washed hands and put on gloves ____ ____

1. Applied dressing

a. Obtained correct size dressing ____ ____

b. Opened package without touching dressing ____ ____

c. Used pinching action to pick up dressing ____ ____

d. Touched only one part of outside ____ ____

e. Held dressing over wound and lowered onto wound ____ ____

f. Secured dressing with tape or bandage ____ ____

2. Applied spiral wrap with roller gauze

a. Placed sterile dressing on wound ____ ____

b. Held bandage with loose end coming off bottom ____ ____

c. Started at bottom of limb and moved upward ____ ____

d. Anchored bandage correctly ____ ____

e. Circled area with spiral motion ____ ____

f. Overlapped each turn with ½ width of bandage ____ ____

g. Ended with 1 or 2 circular turns around limb ____ ____

h. Secured with tape, pins, or by tying ____ ____

5. Checked circulation in area below bandage ____ ____

6. Loosened bandage immediately if any signs of impaired circulation noted ____ ____

7. Obtained medical help for victim as soon as possible ____ ____

8. Removed gloves and washed hands ____ ____

---------------------------------------- TOTAL ____ ____

Mastery = 100% Yes

Non-Mastery = Below 100%

Date ____________ Evaluator ______________________

Comments:

Principles of Providing First Aid

Immediate care that is provided to the victim of injury or illness to minimize the adverse effects until experts take over.

Proper first aid can mean the difference between life and death.

When you encounter an emergency:

REMAIN CALM

▪ Avoid panic

▪ Evaluate the situation

▪ What you will do depends on the type of injury, environment, others present, etc. – so THINK before you act

The first step is to be alert to the signs of an emergency:

Once you determine an emergency exists, take steps to help the victims:

1. Check the scene and make sure it is safe to approach.

2. IF the scene is not safe, call for medical help – do not endanger yourself or others.

3. IF the scene is safe, approach the victim and determine consciousness by gently tapping and calling to him/her.

4. Never move an injured victim unless the victim is in danger.

5. Call the EMS as soon as possible – 911.

6. Be prepared to describe location, telephone number (where you are calling from), assistance required, # of people involved, etc.

7. Try to obtain victim’s permission before providing care. (If parent is present and victim a child, get parent’s permission.)

8. If person refuses care, do not proceed. If possible, have someone witness the refusal of care.

9. Always attend to life threatening emergencies first.

10. If victim conscious, breathing and able to talk, reassure the victim and try to determine what happened.

11. Check for injuries – examine the victim thoroughly and note any abnormal signs or symptoms.

12. Report abnormalities when EMS arrives.

13. Obtain as much information as possible regarding the incident and give the information to the correct authorities.

General Principles of First Aid

← Obtain qualified assistance as soon as possible

← Report all information obtained to proper authorities

← Avoid unnecessary movement of the victim

← Reassure the victim

← If the victim is unconscious or vomiting, do not give him or her anything to eat or drink

← Protect the victim from cold or chilling, but avoid overheating the victim

← Work quickly, but in an organized and efficient manner

← Do not make a diagnosis or discuss the victim’s condition with observers at the scene

← It is essential to maintain confidentiality and protect the victim’s right to privacy while providing treatment

← Make every attempt to avoid further injury

← PROVIDE ONLY THE TREATMENT THAT YOU ARE QUALIFIED TO PROVIDE

Providing First Aid for Bleeding and Wounds

Wound

▪ Injury to soft tissue

▪ Open: Break in the skin or mucous membrane

▪ Closed: No break in skin, injury to underlying tissues

▪ Opening wounds can result in bleeding, infection, or tetanus

▪ First aid directed toward controlling bleeding and preventing infection

Abrasion - skin scraped off, bleeding limited

Incision – cut with sharp object such as knife, scissors, razor blade, etc., if cut is deep, bleeding can be heavy, also can have damage to muscles and nerves.

Laceration – tearing of tissues from excessive force, jagged edges, bleeding may be heavy. Deep lacerations may become infected.

Puncture – Caused by sharp object (pin, nail, etc.) External bleeding minimal, may lead to infection or tetanus.

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.)

Control Bleeding

First Priority – Control the bleeding!

Arterial bleeding is bright red in color and life threatening.

Venous bleeding is slower and dark red.

Control bleeding by:

1. Direct pressure

2. Elevation

3. Pressure bandage

4. Pressure points

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

Infection

Signs and symptoms of wound infection:

▪ Swelling

▪ Heat

▪ Redness

▪ Pain

▪ Fever

▪ Pus

▪ Red streaks

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.

Object in wound? If on the surface, remove with tweezers. If object embedded, let a physician remove it.

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 or illness 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 oxygen

4. 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 when treating for shock?

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

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

← Victim has broken rips and is dyspneic

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 won’t arrive for more than an hour and dehydration is evident, provide fluids.

Poisoning

If poison ingested, call a poison control center (PCC) or physician immediately. If not available, call the EMS.

Save the label or container of the substance taken.

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 if the victim is not breathing. If victim is breathing, turn victim on his/her side.

If the poison control center tells you to induce vomiting:

( Give syrup of ipecac.

( Tickle the back of the victim’s throat.

( Administer warm salt water.

DO NOT induce vomiting if:

▪ The victim is unconscious.

▪ The victim swallowed acid or alkali.

▪ The victim swallowed petroleum.

▪ The victim is convulsing.

▪ The victim has burns on the lips or mouth.

Vomiting only removes ½ 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 & cold pack

• Monitor the victim and give CPR if needed

• Watch for allergic reaction

• Treat for shock

Providing First Aid for Burns

← Caused by fire, heat, chemicals, radiation or electricity.

First-degree (superficial)

← Involves only the epidermis

← Heals in 5-6 days

← No scarring

← Skin red, mild swelling

← Victim feels pain

← Usually caused by the sun, hot objects or steam, or exposure to weak acid/alkali

Second-degree (partial thickness)

← Epidermis and dermis

← Blister or vesicle forms

← Skin red and mottled with swelling

← Surface appears wet

← Very painful

← Usually caused by sun, sunlamp, contact with hot or boiling liquids, contact with fire.

Third-degree (full thickness)

← Injury to all layers and underlying tissue

← Area has white or charred appearance

← Can be extremely painful or painless (if nerve endings destroyed

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

Treatment for burns:

• Remove source of heat

• Cool affected skin area

• Cover the burn

• Relieve pain

• Observe and treat for shock

Medical care should be obtained if more than 15% of adult body burned. (10% of a child)

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 blisters. (Why?)

Call for help immediately if 3rd-degree burns.

Dehydration can occur quickly with burns.

Be alert to signs of shock.

Remain calm and reassure burn victim.

Bone and Joint Injuries

Fracture

• Break in a bone

• Closed or simple – does not break the skin

• Compound or open – accompanied by open wound on skin

Main facts regarding fractures

1. Signs and symptoms vary

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

3. Victim may have heard a snap or feel a grating sensation

4. Treatment includes immobilizing above and below fracture, treat for shock

Dislocation

• When the end of a bone moves out of the joint

• Usually accompanied by tearing/stretching of ligaments

• Signs and symptoms include deformity, limited or 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 affect muscle

Providing First Aid for Sudden Illness

Heart Attack

← Also called coronary thrombosis, coronary occlusion, or myocardial infarction

← Blood supply to heart is blocked

← If heart stops beating, CPR must be performed

← Signs and symptoms may include – chest pain or pressure, pain radiating to shoulders, arms, neck or jaw

← Shortness of breath

← Cyanosis

← Victim weak and apprehensive

← May also have nausea, vomiting, diaphoresis, loss of consciousness

← Encourage the victim to relax, place him/her in a comfortable position, and obtain medical help

Cerebrovascular Accident (Stroke)

← Also called CVA, apoplexy, or cerebral thrombosis

← Either a clot in a cerebral artery or hemorrhage of a blood vessel in the brain

← Signs/symptoms include numbness, paralysis, pupils unequal in size, mental confusion, slurred speech, nausea, vomiting, difficulty breathing and swallowing, and loss of consciousness.

Always remember that although the patient 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

← Early signs – dizziness, extreme pallor, diaphoresis, coldness of the skin, nausea, numbness and tingling of hands and feet

← When symptoms noticed, help the victim sit with the head at the level of the knees

← If the 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 the 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

← When victim regains consciousness, he/she may be confused, disoriented and complain of headache

← First aid directed toward preventing self injury – remove dangerous objects, provide pillow under the head

← Do NOT place anything between the victims teeth

← Do NOT use force to restrain or stop muscle movement

← When the convulsion is over, allow the victim to rest

← Obtain medical help if seizure lasts more than one minute or injury occurs

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

Dressings and

Dressing = sterile covering over wound or injured part

Bandages = 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 nailbeds to make them turn white. Color should return to nailbeds immediately.)

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▪ Screams

▪ Calls for help

▪ Breaking glass

▪ Screeching tires

▪ Empty medicine bottle

▪ Damaged electrical wires

▪ Smoke or fire

▪ Blood

▪ Spilled chemicals

▪ Difficulty breathing

▪ Clutching chest or throat

▪ Abnormal skin color

▪ Confusion

▪ Drowsiness

▪ Distress

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