What are the main priorities for assessment and … Option 1... · Web viewBandages have a multitude of uses, ranging from applying pressure to bleeding wounds, to stabilising joints

Preliminary PDHPE First Aid Nicole Goh

What are the main priorities for assessment and management of first aid patients? Principles of First Aid Preserve life Protect from danger

Prevent the condition from worsening Promote recovery

Setting priorities for managing a first aid situation and assessing the casualty- SITUATIONAL ANALYSIS

Triage: Prioritising patients based on the severity of their conditions or injuries are treated first Generally, an unconscious victim takes priority

Reverse Triage: When the less wounded are treated in preference to the more severely wounded, because they are more likely to survive

This is usually the case for water scenarios and drownings

- PRIORITY ASSESSMENT PROCEDURES Follow DRSABCD and call 000 Remain calm and answer questions posed by the responder

Order of Assessment:1. DRSABCD2. Bleeding3. Burns4. Fractures5. Other injuries

- DRSABCD

- STOP

1


Describe the “STOP” technique of injury assessment and management. (3 Marks) Used when it’s been established that there is no threat to life Injury management and assessment of injuries (esp. sporting injuries)

STOP the person from moving Check for “danger”TALK to the injured person Ask questions to ascertain type and severity of injury

eg. What happened? Where does it hurt?OBSERVE the patient and injured area Look for swelling or deformity

Feel for pain or tendernessPREVENT further injuries Conduct whole body assessment and treat injury with

appropriate first aid1. Severe injury Get help2. Less severe injury RICER3. Minor injury Play on

Plan and conduct appropriate assessment and management procedures in response to a range of first aid scenariosOutline how bandages, slings and splints are used in the treatment of injuries. (3 Marks) Bandages and slings are particularly used in scenarios where bleeding has occurred; immobilise

joints if there has been a fracture or injury to any of the major limbs. Bandages have a multitude of uses, ranging from applying pressure to bleeding wounds, to

stabilising joints and to making slings. For example, the basic arm sling can be used to support an injured forearm whilst a collar and cuff sling is particularly useful for upper arm fractures. Especially in scenarios where bleeding to the hand has occurred, the collar and cuff sling is useful in elevating the injured hand.

Splints are mainly used to immobilise broken limbs due to fractures. After bleeding wounds have been attended to, a splint can be applied to the limb by using a rigid object such as rolled-up newspaper or a heavy stick and taping it to the limb.

Crisis management- CARDIOPULMONARY RESUSCITATION (CPR)

Commenced if the victim shows no sign of life and is:o Unconscious and unresponsiveo Not movingo Not breathing manually

Performed to maintain sufficient circulation of oxygenated blood to prevent brain damage 30 chest compressions : 2 breaths (or 100 compressions a minute) Tilt persons head well back (though not for an infant or injured) and open mouth 1/3 chest depth

- BLEEDING Bleeding is the loss of blood from any of the body’s blood vessels Artery: Bright red blood spurting out in time with the heart beat Capillary: Bright red blood oozing out Vein: Dark red blood flowing out of the body Caused by cuts, contusions, lacerations and abrasions

DRSABCD Apply direct pressure by holding a pad or dressing firmly over the site

2


Lay the casualty down and elevate the injury Rest the injured area Loosen tight clothing

- SHOCK Shock is a condition where the body closes off the blood supply to extremities (arms and legs) Can lead to a collapse of the circulatory system

Causes Symptoms Treatment Loss of blood from a wound Loss of fluids Heart attack Trauma in an accident

Paleness Cold and clammy skin Weak, rapid pulse Rapid, shallow breathing Nausea and faintness

DRSABCD Reassure the patient Raise legs above heart

level if no injuries Keep casualty comfortable

According to the symptoms, especially the young girl’s restlessness, confusion and anxious state, it’s highly likely that she’s gone into shock due to the trauma of witnessing the accident. First, DRSABCD should be carried out to ensure that the area is safe before attempting to treat her for shock. If possible, the young girl should be directed somewhere, away from the site of the accident as being in the vicinity may cause her condition to worsen. Once made comfortable and it’s been determined that she doesn’t have any injuries herself, she should be laid down with her legs raised above her heart level. The responder should constantly reassure her and keep her warm with blankets or other clothing items to maintain her body temperature.

- NECK AND SPINAL INJURY Symptoms Treatment Pain at or below the site of injury Loss of movement Lack of movement at the site of injury Tingling in hands or feet

DRSABCD Reassure them Support their head and apply a cervical collar if

available Do not move them and monitor closely Treat for shock

- MOVING THE CASUALTY Unless essential, a casualty should not be moved Such conditions include:

o Smoke-filled roomo Due to rising water levelso From a building in danger of collapsing

If the casualty has to be moved, use the following guidelines:o Work through the DRSABCD regimeo Seek their help when you move themo Ensure fractures have been immobilised and other injuries (eg. burns) have been treatedo Use your leg muscles and keep you back straight if they need to be liftedo Hold them firmly and communicate with the injuredo Stop as often as necessaryo Minimise movement of neck and spinal cord

- MEDICAL REFERRAL A patient should always be sent to hospital if the following happened:

3


o CPR was requiredo Patient was unconscious at any timeo Conditions such as a heart attack or spinal injury were suspected

- CARE OF THE UNCONSCIOUS CASUALTY Roll into the recovery position when breathing returns Support their head and neck to ensure air can enter the lungs Attend to any other injuries they may have Protect them from the elements (eg. rain or cold) Keep them warm

How should the major types of injuries and medical conditions be managed in first aid situations?

Management of injuries

Identify signs and symptoms, and primary management for each injury and medical conditionInjury Signs and Symptoms Primary ManagementCuts and lacerations Abrasions

Open wounds Penetrating wounds

Scraped skin caused by a fall on a hard surface

Incisions or lacerations Deep wound from an object

(eg. bullet)

Control bleeding using pressure

Cleanse thoroughly (if possible)

Apply clean dressing Seek medical attention

Fractures Open Closed Complicated (organs)

Sound from bone breaking Pain at the site Swelling and deformity Tenderness Difficult to achieve normal

range of movement

DRSABCD Control bleeding Immobilise with sling or

splints Observe for shock Seek medical attention

Dislocations Bone dislodged from

the joint

Swelling and deformity Discolouration Pain and tenderness Inability to move

DRSABCD Support Apply ice Elevate if possible Seek medical attention

Head injuries and concussion

Blurred vision Loss of memory Headache Change in size of one pupil Bleeding from nose or ears Abnormal responses to

commands

DRSABCD Support head or neck Keep airway open Lay in lateral position if

conscious Do not apply pressure to a

bleeding head if skull fracture is suspected

Seek medical attentionEye injuries Irritation to the eye

Watering and redness Pain to the eye

DO NOT rub or remove embedded objects

Lay in lateral position

4


Inability to open Cover both eyes Seek medical attention

Nasal injuries Pain Swelling and deformity Bruising

Breathe through mouth DO NOT blow nose Assume sitting position with

head and shoulders leaning forward

Apply pressure to the soft part of the nose for approx. 10 minutes

Burn injuries Fire Electrical Chemical Radiation

Severe pain Redness and blistering Possible swelling

Remove casualty from danger DRSABCD Hold burnt area under cold

running water for 20 minutes Remove clothing if not stuck Do not apply creams, lotions

or adhesive dressingsTeeth injuries Bleeding from mouth

Tooth dislodged Keep tooth in socket if

possible If not, place is in milk or clean

with casualty’s saliva and seek urgent dental assistance

Electrocution Unconscious Electrical wires may be

visible

DRSABCD Cool burnt area under

running water Seek medical attention

Chest injuries Bruised or fractured ribs Lung injuries

Pain, usually on breathing and coughing

Difficult breathing Tenderness when touched

Place in comfortable position Encourage shallow breathing Pad injured area Seek medical advice

Abdominal injuries Injuries to the stomach

and pelvis

Shock Pain in region Nausea or possible vomiting Difficulty breathing Possible blood in urine

DRSABCD Loosen clothing Lie patient on their back Slightly elevate shoulders and

bend knees Do not consume food or

drink

Management of medical conditions

Explain the nature of the identified medical conditions

Medical Condition What is it? Signs and Symptoms Management TechniquesHeart attack Discomfort in middle of chest DRSABCD

5


Heart ceases to function due to inadequate blood supply

Irregular pulse Shortness of breath Shock

Seek urgent medical help

Stroke Sudden blockage of

blood to the brain

Slurred speech Pupils may be of irregular size Loss of movement Possible seizures and loss of

consciousness

DRSABCD Seek urgent medical help

Diabetes Body is unable to

produce or regulate insulin

Hypoglycaemia (Low Blood Sugar) Rapid pulse Trembling Hunger Aggression

Hyperglycaemia (High Blood Sugar) Rapid pulse Thirst Increased urination

DRSABCD Seek urgent medical help Do not attempt to give

glucose or drink to an unconscious patient

If conscious, administer glucose and drink; allow self-administration of insulin

Epilepsy Seizures triggered by

abnormally high discharge of electrical activity to the brain

Serious seizures (grand mal) Rigid body and tightened jaw Some mouth frothing Possible loss of bladder control Loss of consciousness

DRSABCD Place in recovery position Remove dangerous objects During sleep, ensure airway

is fully openAsthma Breathing difficulties

due to constriction of the airways in the lungs

Tightness in chest Fast, shallow breathing Increase in pulse rate Wheezing noises

Reassure and assist with medication

Monitor breathing Provide water to drink Encourage controlled

breathing and relaxationAnaphylaxes Severe and sudden

allergic reaction

Breathing difficulties Swollen tongue, face, lips, eyes Hives or body redness Vomiting, abdominal pain Wheeze or persistent cough

DRSABCD Remove the trigger Implement management

plan if known Seek medical attention

Poisoning Can be absorbed via

swallowing, injection, inhalation or absorbed through the skin

Blurred vision Vomiting Breathing difficulties Tight chest

DRSABCD Call 13 11 26 Seek medical attention Do no induce vomiting

Bites and stings Snakebite Bee and Wasp Funnel-web spider Bluebottles

Puncture marks Double vision Tightness in chest Faintness

Sharp pain at site of bite Possible swelling

DRSABCD Apply a pressure

immobilisation bandage over the site and beyond

Do not elevate Seek medical help

Remove sting by scraping or flicking (do not squeeze)

Apply ice Seek medical advice

6


Intense pain at site of bite Cold skin and shivering Sense of numbness

Localised sting marks Vomiting Breathing difficulties

DRSABCD Reassure the person Apply pressure bandage over

bitten area and extend down the limb

DRSABCD Immerse the area in hot

water to alleviate pain Seek medical attention

Exposure to heat and cold Heat exhaustion:

Dehydration caused by working in hot, humid conditions

Heatstroke: Extreme dehydration; rapid rise in internal body temperature

Hypothermia: Exposure to low temperatures

Rapid, weak pulse Clammy, pale skin Extreme thirst Fatigue Loss of coordination

Disorientation leading to unconsciousness

Hot and dry skin Lack of sweat

Shivering Slow response to instructions Weak pulse Slurred speech

DRSABCD Rest in cool, shaded area Provide cool water Apply ice to cool the body Seek medical assistance

DRSABCD Seek urgent medical help Cool body with wet towels Provide plenty of water

DRSABCD Protect from the elements Remove wet clothing and

provide warm blankets Provide warm fluids Seek medical attention

Outline the management that should take place after an epilepsy seizure has occurred. (5 Marks) Check for any injuries sustained during the seizure If unable to roll the patient onto side during the seizure, should be done immediately after Patient’s jaw should be pushed slightly forward at an angle to assist with breathing during

recovery and to ensure they do not swallow their tongue or have the tongue blocking the airways Monitor patient closely until they have fully recovered, which can take up to 20 minutes, and at

this point, they should be fully awake and aware of their surroundings. Another seizure may occur or other scenarios such as vomiting may also occur Embarrassment after they gain consciousness due to a loss of bladder control Reassure In the event of vomiting, when the seizure has lasted more than five minutes or if a second

seizure quickly follows the first, one should seek immediate medical attention by calling 000.

What does the individual need to consider in administering first aid?

Physical environment

Analyse the particular safety issues associated with each physical environment and formulate specific self-protective strategies that should be observed

- TRAFFIC ACCIDENTS 7


Potential Dangers: o Oncoming traffico Fallen electricity wireso Flammable liquids such as petrolo Glass and debris

Protective Strategies: o Provide a protective barrier; park a vehicle between the accident and oncoming traffico Turning hazard lights ono Turn ignition off if the engine is still runningo Lighting the area with low beam if accident has occurred at night Increases safety

and raises awareness of the accident Only then should the rescuer attempt the remainder of DRSABCD The casualty should not be removed from the vehicle if possible, unless:

o Evidence of increasing shock and the casualty is upright in the caro Casualty is unconscious and adequate airway cannot be maintainedo Casualty’s position prevents access to control bleedingo There is danger of fire

- WATER ENVIRONMENT Potential Dangers:

o Own physical limitations such as own ability to swimo Changes in weather conditions; dangerous rips and currentso Hazardous objects under the water that are not visible to the observero Desperation of a drowning person and their potential to cause difficulty

Protective Strategies: o Sending for help immediatelyo Using ropes, branches and other flotation devices where possibleo Not placing yourself at risk if you’re unsure if you can perform the rescue safely

- ELECTRICITY Has an immense potential for danger as it’s often not visible Visible when wires are exposed or if wires are in contact with conductive material Electrocution can occur: Sufficient to cause severe burns and instant death Potential Dangers:

o The deadly nature of electricity and how it’s conductedo Examine the situation and assess the potential for harm

Protective Strategies: o Not touching cars or objects that in contact with fallen power lineso Turn power off at the source (if possible)o Remove live power cords with non-conducting material (eg. stick) if power cannot be

turned off immediately

Infection control and protection

Describe the procedures to be taken to reduce the risk of contact with body fluids and in the event of contact with body fluids in first aid settings

- HIV/AIDS

8


HIV virus causes AIDSo Can be transmitted through the exchange of blood or body fluids from an infected to

a non-infected person (highest con. of HIV virus are in blood)o Can be passed from person to person during CPR or attending to woundso However, this type of infection is usually passed from one person’s bloodstream to

another person’s bloodstreamo It is not usually passed through saliva as it usually gets destroyed by stomach juices

To prevent transmission:o Assume every casualty is infectedo Use disposable plastic gloveso Cover face of unconscious person with face mask if performing CPRo Cover sores, grazes, cuts etc. of any nature that exposes victim’s bloodo Wash hands and any surfaces of the body that have made contact with the casualty

with soap and warm water ASAP after performing treatment

- BLOOD-BORNE VIRUSES (HEPATITIS B AND C) Hepatitis: Disease that causes varying degrees of inflammation and subsequent damage to

the liver; comprises of three viruses: hepatitis A, B and C Must be transmitted from an infected person to a non-infected person Hepatitis B: Present in blood, semen and vaginal secretions

o Transmitted by sharing needles, unprotected sex, and ear piercingso Can be transmitted during first aid; especially if blood is involvedo Contracting hepatitis B carries risk of serious illness (eg. cancer due to damage to the

liver cells; cirrhosis of the liver) Hepatitis C: Transmitted through blood-to-blood contact; sharing needles

o Has the potential to cause extensive liver damage

Legal and moral dilemmas- LEGAL IMPLICATIONS (EG. OHS) First aider could be expected to:

o Use reasonable care in assessing priorities of the situation based on their level of training

o Take steps to call for further medical assistanceo Keep casualty stabilised until medical assistance arriveso Follow established treatment and management protocolso Not misrepresent themselves or take unnecessary riskso Use common sense and act in accordance with their level of training

- MORAL OBLIGATIONS (EG. DUTY OF CARE, RESPONSIBLE CITIZENSHIP) Duty of Care: Under common law, some people may be required to act a certain way in medical

situationsEg. Medical and paramedical professionals, lifeguards, teachers and child care workers

Responsible Citizenship: Help and provide assistance to the best of our ability

9


First aiders have obligations to render treatment appropriate to their level of training, until:o Another trained first aider takes overo Higher qualified help takes overo Area becomes unsafeo Become physically unable to continue

Consent: Must be obtained from conscious victims over 18 years old If the victim is unconscious or is unable to give consent, then first aid treatment can commence

Support the following first aid situations- DEBRIEFING

Involved obtaining information about the circumstances of the incident that resulted in first aid being administered

An account of the nature of the incident may be required Police officers, ambulance officers or accident investigation personnel may ask for recounts During debriefing, it’s important to:

o Take your time and ensure everything is recountedo Make all descriptions as accurate as possibleo Remain impartial and describe the incident exactly as it occurred

For example, if a person was to witness a traffic accident and thus became the first responder to the scene, this person would have to recount the details of how the accident occurred if possible. If other bystanders assisted in helping casualties with injuries such as bleeding, shock or if CPR was administered, all those that were involved would have to be debriefed to determine to what extent and the level of skill of first aid that was administered to the injured. This information could be particularly useful for ambulance and hospital staff later on.

- COUNSELLING Those involved in emergency procedures where there were fatalities or serious injuries may need

counselling after the event due to trauma Watching life slip away can lead to depression, anxiety and inability to cope Counselling helps to dispel feelings of blame and inadequacy that may result from responding to

an emergency situation

For example, a serious accident where first aid responders attempted to resuscitate a patient but were unsuccessful or in scenarios where people witness someone’s life slip away, this can be highly traumatic and affect people emotionally leading to depression, anxiety and the inability to cope. Other events that may require counselling include situations were serious injuries were experienced such as organs protruding or open fractures. While witnessing such injuries is already traumatic as it is, being unable to help in such situations due to inadequate experience may also affect people mentally. However, in these cases, counselling helps to dispel any feelings of blame and inadequacy, thus help people to cope with and overcome any complications that arose from responding to or witnessing a first aid situation.

1. Recommend the priorities for managing first aid AND assessing casualties in the below situation. (7 Marks)

10


In car accidents such as the one seen in the diagram, it’s important to carry out DRSABCD, especially the danger aspect before attempting to attend to any casualties and further manage the situation. Firstly, the crash may lead to a large amount of debris such as glass covering the scene and thus, may make it dangerous for responders to get to any casualties without being hurt themselves. Furthermore, since it’s a road accident, responders should be on the lookout for oncoming traffic and only enter the situation once it’s been deemed to be safe.

In situations such as these, triage would most likely be used to prioritise the victims if there are multiple casualties but limited amount of help. That is, an unconscious victim would take priority and hence a responder would have to follow DRSABCD to ensure that they’re still alive.

After providing first aid to the unconscious, bleeding would be the next injury to assess and treat as blood loss can lead to other complications such as shock. Due to the nature of the crash in the diagram and the possible embedding of glass, bleeding may be a major issue. If the victim is conscious, the responder should ask the victim to apply pressure and elevate their wound if possible. That way, if there are limited responders and the victim is conscious enough to attend to their own wound, the responder can then help other casualties that may be in more need or are unable to tend to their injuries such as young children.

As a part of this situation, fractures may also be common, especially neck and spinal injuries due to the whiplash motion during a crash. If there is a suspected neck injury, a cervical collar should be applied if it’s available and the patient should not be moved until the ambulance and more professional help arrives.

In addition, while a person involved in the crash may not have any visible injuries, they should be treated for shock as the event can be quite traumatic. In all victims, both injured and non injured, it’s necessary to treat for shock as soon as possible as it can lead to a collapse of the circulatory system and as a result, will make the situation more difficult as CPR may be required to resuscitate the victim. Overall, managing the situation is dependent upon the number of casualties, the severity of their injuries and the number of capable first aid responders to the scene. If there are limited responders, it would be necessary to prioritise the casualties using triage and hence accordingly: DRSABCD, bleeding, fractures and shock.

11

Documents

What are the main priorities for assessment and … Option 1... · Web viewBandages have a multitude of uses, ranging from applying pressure to bleeding wounds, to stabilising joints