First Aid Tips

[paramedicdeb]

Well I have been asked to post 1st aid tips for the general public. So as I have time I will post the whole 1st aid course in short form of course with the latest up to date guidelines so you will have to come back from time to time to review. If you don't understand something I have posted please do not hesitate to ask and I will respond as soon as I can. I welcome any feedback and suggestions. I will start from the begining and work all the way through to the end of the standard 1st aid guidelines. One thing you will have to remember is that this will be based on Canadian Occupational Health and Safety guidelines and may change from country to country so please do some research of your own to enhance these tips. Enjoy....Deb 

[paramedicdeb]

Tip #1 (Emergency Scene Management)

First Aid = giving help to a sick or injured person using readily available materials
Good Samaritan Law = volunteering to give 1st aid with no compensation provides coverage for you if you obtain consent from the patient.
Consent = verbal (nod, voice response, etc.) or implied (person does not respond when you talk to them) idePut onntify yourself and ask for consent.
A = Airway
B = Breathing
C = Circulation
(these are the essentials to sustain life no A-B-C's no life)

Scene Survey
The 1st priority in giving first aid to anyone is protecting yourself from any harm.
Always survey the scene to make sure there is no danger to yourself, either remove the danger or call for help.
Call for help as soon as you recognize you need help in any event call as soon as you find someone unresponsive to your voice or touch.
Put on protective barrier devices to protect yourself from infectious disease.
Barrier devices are things like latex gloves, gowns, masks, airway devices.
Remember Hepatitis can live in dried blood for 7-10 days and in a moist enviroment for up to 30 days.
Hand washing is the number one way to prevent transmission of disease and infection.
Identify yourself and obtain persons consent.
Leave the person in the position you find them if you can if you have to open the airway or other life saving tecniques then move the person in position.
If the person responds to you they have an open Airway, are Breathing and have Circulation make sure it is effective to sustain life.
Look for any serious bleeding (squirting bright red blood, steady flowing dark red blood) control the bleeding with pressure.
If the person does not respond to you, open the airway using the head tilt chin lift
Look (chest rise) - Listen (breath) - Feel (air movement) for breathing up to 10 seconds.
If the person is not breathing then CPR protocols need to be implemented and will be discussed at another 1st aid tip time.
If the person is breathing and not responsive do a quick search of the body and make sure there is no life threatening bleeding that needs controlling.
Put the person in the recovery position to maintain an open airway and clear any fluids that may come out.
Reassess the A B C's keep the person warm and handover to help when it arrives or take to hospital if no help available to transport.
Number one rule in 1st aid is using your common sense: if it looks like it will hurt or cause more damage don't do it, if it looks like it will benefit the person do it! 

Next topic discussion will be on shock, unconsciousness & fainting stay tuned.

[sweetgrandma]

Very good post! Thanks paramedicdeb! Please post more to educate us!

[dr_mathew]

Excellent! But explanation on certain terms is needed in order for a layperson to be able to understand this. E.g. "recovery position" etc.

Great effort paramedicdeb!

[paramedicdeb]

Tip #2
"Bleeding"
Bleeding comes in three different stages all can be life threatening if not controlled and treated properly whether it is severe bleeding emptying the body of the fluid it needs to survive or minor bleeding that is untreated open wound and infection sets in. All can cause the body to go into shock and shock can kill. I will elaborate on shock at a different time. Now a definition of bleeding types, signs & symptoms and treatment measures to control the bleeding situation you are dealing with. We only have 4-5 liters of blood in the body so severe bleeding can deplete our resources very fast. So acting quickly is top priority in dealing with the ABC's of life.

Severe Bleeding
Color is bright red (oxygenated blood) arterial bleeding
Bleeding is severe squirting with each heart beat.
Open wound present usually large wound that has severed and artery
Treatment is direct pressure to the area that is bleeding immediately to control the bleeding, then apply a pressure dressing with lots of bulky padding to absorb the blood, be sure not to cut off the circulation below the injury site, assess by feeling the temperature of the other limb/body part and looking for color in comparision. Always reassess and make sure the dressing is applying pressure to the area and should not move around, if the blood soaks through the dressing then add more dressing and more pressure to the area do not remove the dressing next to the wound as you may remove the blood clot the body is trying to make to help stop the bleeding. If the bleeding will still not stop or be controlled you may use pressure points for bleeding in the limbs, just find the brachial pulse point underneath the bicep of the arm or the femoral pulse point in the groin area (you do not have to find the pulse just find the area) and put pressure to the area this will compress the artery on the bone it crosses and help control bleeding as well. With good direct pressure, pressure dressing and possible pressure point control as well as paying close attention to the ABC's and any signs and symtpms of shock you will be preventing a certian death of the patient.

Moderate Bleeding
Color is dark red (de-oxygenated blood) venous bleeding
Blood comes out in a steady flow.
Open wound present that has severed veins.
Bleeding is not as severe as arterial bleeding but can lead to shock and depletion of blood & fluids in the body rapidly and needs to be controlled as soon as possible.
Treatment is the same as for severe bleeding above.

Minor Bleeding
Color is dark red (de-oxygenated blood) capillary bleeding
Blood oozes out of wounds that are mostly abrasions at the surface of the skin affecting the capillaries.
Bleeding is not severe and can be dealt with after close attention to the ABC's has been dealt with as a 1st priority.
Treatment is the same as previous but in these situation cleaning of dirt in and around the wound is recommended with soap and water if available and covering the wound with a dressing to prevent infection, if an antibiotic cream is available and the patient is not allergic to it then it may also be applied to the wound. Remember when cleaning the wound to wipe away from the edges and not across the wound to prevent any further contamination of the wound.

With any bleeding note if there is a protruding object and do not remove or apply pressure to the object but stabilize the object with bulky dressings and apply pressure around the wound to control bleeding. Do not give the patient anything to eat or drink but you may moisten the lips if they complain of thirst. We do not want to compromise a clear airway with any substances.

Internal Bleeding
Signs and symptoms are different as there is no open wound to identify the bleeding.
You may see bruising, discolorations, the patient may tell you there was blunt trauma in an area where you may suspect internal bleeding. There may also be coughing up of blood, blood in the urine or feces, distention and ridgid areas, blood coming from the nose, ears, or mouth.
Always monitor the ABC's, put the patient in a position of comfort, do not stop bleeding from the nose, or ears if a closed head injury is suspected due to build up of pressure on the brain, just apply loose bulky dressings to absorb the blood.
If the bleeding is an isolated nose bleed tilt the head forward and pinch the soft cartridge on the bridge of the nose until the bleeding subsides, do not let the patient blow their nose for at least 2 hours and sometimes a cold pack to the back of the neck aids in stopping the blood. Note that some nose bleeds can be life threatening and if it is not controlled then they must seek further medical attention to stop the bleeding althou this is not very common it does happen.

I hope this covers all your 1st aid needs in the event of a bleeding situation. More to come as I get more time.
Enjoy
paramedicdeb

[paramedicdeb]

SHOCK
Shock is a condition of inadequate perfusion to the body tissues, in other words it is lack of circulation of oxygenated blood to the body.
Shock can accommidate any illness or injury.
Shock can be life threatening and comes in many different forms but in general the signs and symptoms are the same for all the types and I will generalize them in this discussion.
THe vital organds (heart, lungs and brain are very greedy and will shut down the rest of the body functions in order to survive thus the reason the signs and symptoms below may be seen in cases of shock)
Shock has three stages:
1. Compensatory (the body is able to compensate for the changes)
2. Decompensatory (the body is no longer able to compensate for the lack of oxygen and the blood pressure drops)
3. Irreversable (death is imminent)
Shock is generally caused by the following conditions but not limited to.
Pump Failure (Heart is unable to circulate properly) "eg. Congestive Heart Failure"
Fluid Loss (Loss of blood and body fluids that carry the oxygen to the cells) "Blood loss due to trauma"
Psycogenic (Dilation of the vascular system or veins and arteries) "Common Faint"
Neurogenic (loss of connection of the nerves in order for the proper function this is the one condition that signs and symptoms may not be presented different) "Neck injury"
Allergic Reaction "Anaphylaxis" (body's abnormal response to a organism that would not effect most people) "Bee sting"
Signs and Symptoms
Anxiety & Restessness (first signs and symptoms noticed in shock)
Altered Level of consciousness (brain very sensitive to lack of oxygen)
Increased respirations (bodys response to wanting more oxygen for the vital organs)
Increased pulse rate (bodys response to circulate more oxygen to the cells)
Bluish tinge to the lips, mucous membranes and nail beds (lack of oxygen)
Pale - cool - Clammy skin (skin's response to the lack of oxygen)
Nausea &/or Vomiting (body's respone to expell food substance to concentrate on oxygen demands)
Any trauma and or illness present based on patient's condition
Decreased blood pressure (late sign and second stage of shock)
Treatment Priorities
The best treatment for shock is to stop the condition causing the shock first.
Stop any bleeding, treat any wounds, concentrate on the ABC's of life
Calm and reassure the patient
Keep the patient at rest.
Position the patient for the condition if no injuries permit and the patient is condition alows put the patient on their back and raise their feet 12 inches or so to increase the blood supply to the vital organs.
Monitor the patient's condition closely and the ABC's ar of course top priority.
Get medical attention as soon as possible.
Reassess the patient often and treat any illness and injuries as the condition presents.

That is shock in a nut shell....enjoy
paramedicdeb

[ministar]

Excellent post paramediceb!!
I would like to know how to manage burn cases.

[paramedicdeb]

BURN INJURIES
Burns can be disabilitating, scarring, disfiguring, mentally and physically challenging for the patient, life threatening when burns and/or smoke inhalation to the airway occur, as well as a cause to cut off circulation when circular burns are involved.
The most suseptible to burn injuries are children and the elderly.
The most common side effects of burns are contamination and infection due to the breakage of the skin which is the barrier to all organisms that enter the body and when broken then the barrier is no longer in affect.
Burns can cause swelling of tissues and this can be immediate or after a period of time.
Also remember with the skin barrier broken the temperature regulation is also affected so be careful to watch for shock and maintain normal body temperature.

Burns are causes by several different mechanisms of injury such as:
Heat sources (eg. steam, fire)
Radiation sources (eg. sunlight)
Friction sources (eg. rug or floor skids)
Electrical sources (eg. arcing, live wires)
Chemical sources (eg. acids)

There are three different classifications of burns:
1. 1st degree burns also call partial thickness burns (skin will be intact, redness is apparent, pain is often associated with the burn, burn affects the top layer of the skin only)
2. 2nd degree burns also call partial thickness burns (skin may not be intact and/or blisters may be present, skin appears white and waxy in appearance, and pain may be quite severe, burn affects the top layer of skin as well as the fatty tissue layer)
3. 3rd degree burn, also call full thickness burns (skin will appear charred, broken open, burn affects all levels of the skin and down to the nerve tissue may also affect bone levels "I have only seen this called a 4th degree in one piece of documentation when it affects the bone", there is usually little or no pain as due to the depth of the burn past the nerve endings but the burns may also be accomidated by 1st & 2nd degree burns.

The seriousness of the burns depends on these factors:
Degree of burn, amount of body surface burned "size", the area the burn is located on the body, and the age of the patient that has been burned.

Treatment for all burns is the same:
Make sure the scene is safe to enter this is especially important when dealing with electricity do not become a victim yourself.
Maintain the ABC's of life.
Top priority is to stop the burning process with cool water, wet lint free sheets or some other method, remember not to cool the body temperature to a hypothermic (generalized cooling of the body) state as this can happen rapidly with the skin barrier (temperature regulatory mechanism) gone. Remove any burning clothing, items as the cooling process is done as long as they are not embedded into the burned area.
Maintain body temperature. Treat for shock.
Do not touch burns, breath on them, apply oils or butter to them or remove any clothing or jewerly that is embedded in the burn.
Do not break blisters.
Cover the burns with a lint free dressing to avoid contamination and infection. Use loose dressings as to not restrict circulation if swelling occurs.
Do not apply butters, oils or creams to the burned area.
Seek medical attention as soon as possible.

Special circumstances:
-If the burn is due to the sun also watch for heat stroke/exhaustion and replace fluids if nausea and vomiting occurs seek medical attention, there are some special after sun lotions you can get at the drugstore to help relief the pain but use only if allowed by your countries 1st aid guidelines and recommendations.
-If the burn is caused by electrical shock remember to make sure the source of electricity is shut off prior to touching the patient, look for an entrance and exit wound, monitor patient for cardiac arrest and look also for broken bones that may occur through the pathway of the electricity trying to ground out of the body.
-If the burns are caused by a dry chemical brush off any loose powder first being sure you are not going to get burned yourself by wearing gloves or some other protective device to isolate the chemical and then flush the burn until the burning process stops.
-If the burn is involving the eyes immediately flush the eye(s) for at least 20 minutes remove contacts and dispose of if the patient is wearing them, if the burn only affects one eye make sure you are not flushing the chemical to the uncontaminated eye.
If the burn is caused by an arc welding flash to the eyes it may be painful for the patient several hours after the cause, use cool compresses and rest to relieve the pain if there is any doubt of visual deficits then seek medical attention immediately.

Remember one thing all injuries are 100% avoidable and proper safety can help to avoid these incidents from happening, usually accidents happen to the new worker within the first 6 months or being on the job, due to the untrained or not properly trained worker, unattended children, decreased perception and disease processes of the elderly and most of all people who are in a rush to do something and are just plain careless.

Enjoy this segment of first aid tips by yours truely.....
Paramedicdeb
 

[mdmjane]

Excellent post paramediceb!!

Totally agree!! But for a layperson like me, I need some time digesting those jargons used.
Thanks alot Paramediceb!! 

[paramedicdeb]

Sorry for the jargon I was trying to keep it as layperson as I can and that is pretty much how it is worded in the first aid courses I teach to the layperson. If you need clarification on anything just ask I will respond when I can.
Just remember these are just guidelines to deal with emergency situations and no way shape or form replace first aid training and medical care that may be needed in any situation.
Paramedicdeb
 

[mdmjane]

Congrats paramedicdeb for the awards you receive!! I think this topic of yours deserve another award! Thank you for the effort you have put in in educating us! I hope in future you will post more topics like this and teach us what to do during emergencies   

[paramedicdeb]

Thank you for your kind words and I will post more as soon as I get some time, just remember as I have said before hands on class room training is where you learn the skills to help you deal with any situation that arrives and gives you the confidence to deal with emergency situation posting can just give you and overview of what is the basics of emergency care and it not training just some guidelines for you. Enjoy.
Paramedicdebb

[mdmjane]

Anymore tips? I enjoy this thread very much

[tony1111]

Have been waiting long for new tips

[amanda]

paramedicdeb-- your effort on posting this useful thread is much appreciated. still bumping for more tips....