1

2
3
4
Good Samaritan Law = accept and expect no compensation for your actions,
do not act outside your scope of care or the generally accepted first aid
principles.

Duty to Act = You are required to administer aid up to your comfort and ability
level. (for a non-certified person, that only means to call 911/912,
emergency dispatch)

5
6
Risks! Infectious disease, being sued, being assaulted, personal traumatic
guilt or sadness

7
What is really going on here? Is he attacking the person or the snake? Did he
release the snake to hurt the down man? Did the down man release the
snake to hurt the man with the bat and he is defending himself?

8
DO NOT ENTER THE WATER FOR A DROWNING PERSON.
DO NOT ENTER THE WATER FOR A DROWNING PERSON.
DO NOT ENTER THE WATER FOR A DROWNING PERSON.
DO NOT ENTER THE WATER FOR A DROWNING PERSON.
DO NOT ENTER THE WATER FOR A DROWNING PERSON.
DO NOT ENTER THE WATER FOR A DROWNING PERSON.

9
10
Examples of Immediate Danger:
Your friend slips off a cliff at the beach, and cannot easily walk. You must
drag them up the beach to avoid the tide coming in.

An AUC student wrecks their scooter in front of the Starz Casino in the
middle of traffic. Cars are not stopping and continue to drive very close to
your friend who cannot easily move on their own due to their injuries.

11
Figure out where you are, what the basic complaint
is person unconscious, person bleeding,
person stung by bees. Etc.
Ensure safety sound and smells too!
Send or call for help.

12
13
14
15
Machineel also called the BEACH APPLE or the DEATH APPLE grows
in the Caribbean and Florida. Waxy apple. The bark, sap, leaves and
fruit are POISONOUS AND CAUSTIC.

Will burn your skin if you are under it in a rain storm, will burn eyes
and cause blindness!

16
Poison caused by dinoflagellate consumed by small fish, and then eaten
by bigger fish.

NO CURE. Supportive care only!

17
Low number of cases currently (2016) in St. Maarten, but bugs travel.

Can be transmitted sexually!

Rarely fatal, but permanent joint pain is common

Guillain-Barre = Weakness or paralysis that starts distally (limbs) and

moves proximally can be fatal. (This is opposite of Botulism which
starts at the head/face, and paralyzes outwards)

18
Jack-Spanaird Wasp rarely attacks, but attacking or falling into a nest
can be trouble. They are persistent do not dive into water.

Centipedes very painful sting relieved by heat. Usually not fatal.

Centipeded Rum contains the toxins, be aware.

Brown Widow spider Black Widows cousin, same symptoms muscle

twitching and local fever, possible necrosis, rarely fatal.

19
JELLYFISH Wetsuit, pantyhose avoid them, they travel in packs
treat the burn like a sunburn

FIRE CORAL Treat the resulting blisters like a chemical burn

SEA URCHIN Rarely a problem, watch the sting site for necrosis or
infection seek a doctor early if infected/necrosed

STONEFISH Rumored to have been spotted in the area normally only

found in the Indo-Australian ocean areas. DEADLY STING, no
antivenom!

20
Last unprovoked Shark Bite was 2010 Simpson Bay 2 Shark, small
bite to a mans calf.
99% of shark bites in and near St. Maarten for a 100 mile radius are
during shark feeding dives.

Stingray Almost all logged stings are from stepping on a ray in

shallow water. Remove the barb, soak in warm salted water, observe
for infection.

21
MOVE to a shaded or air conditioned place. DO NOT IMMEDIATELY DUNK
IN FREEZING WATER.

REMOVE tight, warm, or constrictive clothing. Loosen normal clothing.

Remove Rings if possible hand can swell and cause further injury

COOL use a tepid water spray, splash water to replace sweat (likely they will
not be able to sweat), add cool packs to the forehead/armpits/groin/back of the
knees.

RE-COVER Once they are cooled somewhat, they may begin to shiver.
Provide a loose blanket as needed, as shivering can be dangerous to a
recovering heat injured person.

Allow them to drink water. Use Sports Drinks as possible Gatorade is not
perfect, but better than pure water. Do NOT USE beer, wine, alcohol, soda,
tea!

22
MOVE to a warm place or near a fire or warm radiator. DO NOT
IMMEDIATELY DUNK IN HOT WATER.

REMOVE wet clothing. Loosen normal clothing. Remove Rings if possible

hand can swell and cause further injury

WARM add warm packs to the forehead/armpits/groin/back of the knees.

Avoid overheating. Hugging for body warm is acceptable, but not possibly not
efficient if you are alone

RE-COVER Provide a blanket as needed, as shivering can be dangerous to

a recovering cold injured person. Areas of frostbite/nip (RED or BLACK skin)
may feel like burning, but do not apply cold or water to them.

Allow them to drink water. Use Sports Drinks as possible Gatorade is not
perfect, but better than pure water. Do NOT USE beer, wine, alcohol, soda,
tea!

23
WATER!

Even with chemical burns, water is typically okay. Caustic Lye Soap can be
made worse with water but it is unlikely that you have a fire hose of vinegar!

The solution to pollution is dilution! Water water water, when in doubt, more
water.

Always cover with plastic if skin is missing. This protects from infection and
retains warmth so that the exposure does not incur a cold injury as well.

24
If you have no water and have cold milk use it on the burn.
Chocolate/flavoured milk is a bad idea due to the sugary syrups added, but
possibly better than nothing.

OLD WIVES TALES: Do not add butter to a burn. It will cause more harm.

It is not preferred to use alcohol to cool a burn with that said, if you have
nothing else cold beer or cold liquor can be helpful but liquor may cause a
large amount of pain.

Do not use cling gauze/paper towels/toilet tissue, it will stick and embed in the
burn, which will have to be scrubbed very painfully from the burn.

25
A standard soda can is about 350mL of fluid.

A standard cereal bowl is about 500mL of fluid when nearly full.

A 48 x 48 square panel of blood on a tile or hard surface is about 1500mL

(LIFE THREATENING)

Understand that absorbent materials beds, sand, carpets will lead to a

gross underestimate of blood loss. Take your assumption and double it until
proven otherwise.

26
Direct pressure, even in a nose bleed, will resolve most venous and small
arterial bleeds. You must be patient and hold very tight and firm pressure for
longer than you think in order to be effective.

Tourniquets are a LAST RESORT as noted above. You will likely be doing
harm by applying a tourniquet, and the saving of a life must out weight the
damage you are doing.
DO NOT USE A HOLLYWOOD LEATHER BELT TOURNIQUET! It will likely
not be effective. A cloth strap, at least 1 in width, tightened with a bar/lever of
some sort will be more effective and easier to retain constant pressure. Once
applied. NEVER REMOVE THE TOURNIQUET.

27
Arms around the waste, find the inferior border of the sternum/solar-celiac
plexus, make a fist slightly to the left, and drive it inward and upward into the
diaphragm. Repeat until the item is dislodged, a strong cough, or speech is
heard.

Too big for a bear hug? Place the person against the wall, use two hands like
CPR in the same place over the stomach, and drive in and upward into the
diaphragm. Alternatively, you can bend them over a chair corner, and drive the
chair corner into the same area with back pressure.

28
Same motion, be easier with a smaller person.

29
Strike hard! Make a loud thump but do not break bones the greater the
thump/resonance, the more likely the dislodgement of the object.

The thrusts are the same area as the Heimlich, but use about 2-3 fingers to
reduce your tendency to overpush.

30
The limit is your imagination. Your goal is to immobilize the broken bone ends
without more movement. If you have been successful, the pain will almost
always be reduced to a manageable level.

DO NOT UNDERESTIMATE BONE ENDS! They are sharper than glass, and
will cut thru anything stab you. Stab the injured person. Stab random
splinting materials! PAD THEM accordingly!

31
99% of seizures resolve without issue. Watch the breathing, because the
seizures that tend to progress to a systemic failure are due to hypoxia and lack
of breathing, and not from other seizure causes.

99% of seizure related injuries are due to driving and falls. Be protective of the
spine!

32
To protect the spine, keep the head in a natural forward facing position as
much as possible. Place a thin pad under the back of the head.

NEVER NEVER NEVER place anything in the mouth of a person having a

seizure. Especially your fingers.

33
Context clues like diabetic testing equipment lancets, test strips, BGL meter.
Insulin or 1cc syringes.

MEDICAL ALERT BRACELETS, NECKLACES, TATTOOS!

34
Do not tourniquet limbs or suck out venom. No longer a common modern
treatment outside of distant wilderness survival medicine.

35
Do not give Benadryl to a stranger. I would strongly suggest not giving
Benadryl to your children unless you are very comfortable with the medication.
I would seek medical attention immediately if you see ANYTHING that
resembles the above scenario.

Do not administer someone elses Epi-pen to the wrong patient can lead to
fatal complications that you cannot manage. You are welcome to assist
someone with their Epi-Pen if you are comfortable with doing so. Follow the
directions on the side of the device.

If you are comfortable helping someone with their asthma inhaler, then do so
in an emergency. Follow the directions on the bottle/package/inhaler. Do not
administer medications that are not prescribed to the person in distress!

36
It is common for a person in shock to be very thirsty, and it is common to want
to be helpful and give them water to drink. Depending on the illness or form of
shock, the person is likely to vomit from the stimulation of the stomach, which
will make them feel worse. Also, in traumatic hypovolemic shock, giving
volumes of fluid by mouth will cause the body to decompensate further, also
defeating the purpose of your care.

If you cannot resist giving water by mouth, wet a small cloth and let them suck
on it to relieve the thirst.

37
This truly falls on your judgement. If they will not respond to ANY stimulation
painful pinching or extreme noise, and they are breathing shallowly, and they
have vomited excessively, you are possibly dealing with alcohol poisoning that
should be managed by the Emergency Room. They are very experienced with
drunks here in St. Maarten, do not feel bad taking care of someone that is that
far intoxicated. At the very least, the saline infusions, oxygen, and anti-emetic
medications will reduce the hangover, so you are being helpful

Drugs we all hope no one uses them are all about tolerance and control.
Once the intoxicated user is a danger to you, others, or themselves, it is time
to call for help. In most cases, calming someone down, and helping them to
bed might be the best course of action, but do not put yourself in danger
because of someone elses decision to party a little too hard.

38
This is treated no different than anything else. Treat for shock if it is
tolerated. Lay them down or in the recovery position, elevate the feet, pad the
head, and cover them with a blanket.

If not tolerated, try to reduce the chance for damage. Keep them away from
stairs, knives, driving, etc. Do not put yourself in danger to protect them.

39
40
41
NO BREATHS needed. Just ensure an open airway and the compression of
the chest will lead to a bellows like action and allow for some passive
oxygenation at the lungs if the airway is unblocked.

Compress the chest at least 2 and up to 1/3rd of the depth of the chest. Push
to a rate of 100-120 beat per minute. A helpful song to remember is Staying
Alive by the Bee Gees or place a watch with a second hand in front of you
and attempt to compress 2 times per tick of the second hand.

ALLOW for a full recoil of the chest or you are absolutely doing nothing for the
person who is down.

Always remember, CPR is rarely definitive care, get HELP COMING fast!

42
NO BREATHS needed.

Compress the chest at least 2 and up to 1/3rd of the depth of the chest. Push
to a rate of 100-120 beat per minute. A helpful song to remember is Staying
Alive by the Bee Gees or place a watch with a second hand in front of you
and attempt to compress 2 times per tick of the second hand.

ALLOW for a full recoil of the chest or you are absolutely doing nothing for the
person who is down.

Always remember, CPR is rarely definitive care, get HELP COMING fast!

43
Once you get an AED, just turn it on. It will tell you what to do next. Everything
is made to be very simple, just listen and follow the commands.

Compressions are more important than the AED. Do not stop compressions to
go find an AED.

44
45
46
47
48
49
A heart attack can effect the young or old. Do not think because some
describes crushing chest pain, radiating to the left arm and they are 24 years
old, that they could not be having a heart attack.

Older women, diabetics, and people with several previous heart attacks may
not have the classic heart attack symptoms. They may only have the jaw
pain. Or a pain in between the shoulder blades with some nausea. Be aware
of this, and look for other signs or ask if they have heart problems. When in
doubt, call an ambulance if the person consents and let them do the
diagnosing.

Remember, time is muscle in the heart, and hearts do not regrow! Earlier
travel to a hospital may the difference between long term disability and a minor
procedure.

50
Remember, time is brain tissue, and brains do not regrow! Earlier travel to a
hospital may the difference between long term disability and a minor
procedure.

51
52