ABC of First Aid

Asthma &
Anaphylaxis
International
Emergency Numbers
' #  

Dr Audrey Sisman
 Contents
Essential First Aid
Unconscious ........................................ ..2
DRSABCD ........................................... ..3
Basic Life Support Flow Chart ............... 3
CPR ....................................................... 4
Choking / Positional asphyxia................ 6
Drowning ............................................... 7
Trauma
Soft Tissue Injury & Fracture ................. 8
Upper Limb Injury .................................. 9
Lower Limb / Pelvic Injury.................... 10
Bleeding............................................... 12
Shock................................................... 14
Crush Injury ......................................... 14
Burns ................................................... 15
Electric Shock ...................................... 16
Multiple Casualties/ Prioritising............ 16
Chest ................................................... 17
Abdomen ............................................. 18
Eye ...................................................... 19
Head Injury .......................................... 20
Spinal Injury ......................................... 21
Medical Emergencies
Heart Conditions .................................. 22
Asthma ................................................ 23
Croup/ Epiglottitis ................................ 24
Faint..................................................... 24
Seizure/ Epilepsy ................................. 25
Febrile Convulsion ............................... 25
Diabetes .............................................. 26
Stroke .................................................. 27
Hyperventilation ................................... 27
Heat Exposure ..................................... 28
Cold Exposure ..................................... 29
Bites and Stings................................... 30
Poisons ................................................ 32
Allergy/ Anaphylaxis ............................ 33
Asthma & Anaphlaxis
Why Asthma is Dangerous .................. 34
Asthma Medications & Devices ........... 34
Asthma Facts & Information ................ 35
Allergy & Anaphylaxis Facts ................ 36
About Anaphylaxis ............................... 37
Risk Assessment
Manage Anaphylaxis Risks.................. 38
Anaphylaxis Action Plans .................... 39
Assessing Hazards & Minimise Risk ... 40
Risk Assessment Matrix ...................... 40
Risk Rating Table................................. 41
Asthma Risk Assessment .................... 42
Asthma Action Plans............................ 43
Education & Child Care
Regulations, Codes & Proceedures .... 44
National Child Care Legislation ........... 44
Communication Plans & Privacy ......... 45
Normal Clinical Values for Children ..... 46
AED for Child Care .............................. 46
Understanding Child Care Law............ 47
General First Aid
Principles of First Aid ........................... 48
Legal Issues ........................................ 48
Communication/ Reports ..................... 49
Record Keeping / Self-Help ................. 49
Safe Work Practices ............................ 50
Needlestick Injury / Hygeine ................ 50
First Aid Kits Contents ......................... 50
Basic Anatomy & Physiology ............. ..51
Casualty Assessment .......................... 52
Asthma/Anaphylaxis Managment Plan 53
Risk Assessment Form ........................ 54
First Aid Incident Report Form ............. 55
World Map  Inside Back Cover
Emergency Numbers 
2 | Essential First Aid
means call your countrys emergency number Essential First Aid | 3

Unconsciousness is a state of unrousable, unresponsiveness, where the

casualty is unaware of their surroundings and no purposeful response can be obtained. Basic Life Support & AED ABC Publications
NO RESPONSE NO Breathing or Follow Basic Life Support Chart
Assess hazards and use
D
Abnormal Breathing
Dangers? strategies to minimise risk.
Breathing Normally Recovery Position, Call , monitor Follow safe workplace practices
Causes of an unresponsive (unconscious), breathing state:
Combinations of different
causes may be present in
 
(pg 25 )
  (Diabetes pg 26) 


 (head/spinal pg 20,21)
(meningitis)

R Response? HAS RESPONSE

an unconscious casualty eg Conduct Secondary Survey

head injury and diabetes.  (Poisons pg 32) (pg 27)
If necessary
!!(renal failure) NO RESPONSE  Call for help
NB.The sense of hearing is usually the last sense to go, so be careful what you say near an unconscious casualty.
 Stop Bleeding
All unconscious casualties must be handled gently and every effort made to avoid any twisting  Cool Burns
or forward movement of the head and spine.
(An unconscious, breathing woman in advanced pregnancy should be placed on her left side). S Send for help. Call   Support the Head, Neck & Spine
 Support Fracture(s)
 Pressure Immobilise
The recovery position:
 Assist with medication(s)

A
 Maintains a clear airway - allows the tongue to fall forward.
 Facilitates drainage and lessens the risk of inhaling  Airway
foreign material (eg saliva, blood, food, vomit).
 Permits good observation and access to the airway.
 Avoids pressure on the chest which facilitates Recovery position
breathing.
 Provides a stable position and minimises injury to casualty.
Airway management
takes priority over
spinal injury
B NO Breathing or
abnormal breathing
Breathing
Normally
& monitor
Secondary Survey

Send or go for AED

Call 
C Compressions
Start CPR
Shock
Switch on
Follow voice
30 x Compressions prompts

CPR No Shock
30:2 Shock Advised
Step 1 Step 2 Step 3 Advised
Raise the casualtys furthest Stabilise the casualty by Carefully tilt the head
2 x Rescue Breaths
if able & willing
arm above the head. "# $%'* slightly backwards
Place the casualtys nearest when resting on the ground. and downwards. This AED
arm across the body.
Bend-up the casualtys nearest
leg.
Tuck the casualtys hand
under their armpit.
Ensure the casualtys
facilitates drainage of
saliva and/or stomach
contents and reduces
D 

use AED
Analyses
Rhythm

 or
With one hand on the shoulder head is resting on their the risk of inhalation
and the other on the knee, roll
casualty away from you.
outstretched arm. which may cause
pneumonia.
In an EMERGENCY CALL
4 | Essential First Aid
means call your countrys emergency number Essential First Aid | 5

CPR HAZARDS! Compressions ~'> >Q ^ |CPR CPR

 Biohazards $+$"
 { |}J~ ;<=

 30 Compressions
Dangers QXYZ
 Chemicals spills, fumes, fuel Q|}''<=
 Electricity power-lines  Place heel of one hand in centre of casualtys chest
Protect yourself   

 (which is the lower half of the sternum)
- use antiseptics  Fire, explosion  Place other hand on top, arms straight and press down
and barrier  Unstable structures on sternum at least 5 cm in adults
protection:  Slippery surfaces  Allow complete recoil of chest after each compression
 Broken glass  Keep compressions rhythmical at a rate of 100 per min
gloves, mask,  Sharp metal edges
goggles.  !}  <
@=
 Needle stick
 Aggressive behaviour 2 Rescue Breaths (RB)  2 breaths over 2 secs
"
 ?
Response 

 SPEAK LOUDLY Dont shout
"
Hello, can you hear me? Are you all right? \ into the stomach causing
your eyes. Squeeze my hands. regurgitation.

 Infants perform mouth to
NB. Approach a collapsed casualty with caution, they 
 JQ^"; 
could be anxious, irrational or aggressive, so be ready to puff of air from cheeks.
step back if necessary. Take a breath. Use resuscitation mask or
 Turn head after each RB. barrier protection if possible
Drowning. Assess victim on the back with head Close casualtys nostrils
 Listen and feel for air If unwilling or unable to give
and shoulders at the same level. This decreases the < ; @=?
exhaled from mouth. RB, do chest compressions
Mouth to mouth (good seal).
likelihood of regurgitation and vomiting. The casualty  Avoid inhaling re-expired air. only.
Send for help. Call  should not be routinely rolled onto the side to assess
airway and breathing.
Blow"
?
CPR >
Q
Q| Same ratio
for infant,
30:2 >$~'>; Q
^ <~'=|}
> ;  
$$
 ;? child, adult
Airway 
 $; ;?
Use pistol grip to achieve chin lift.
Chin lift
Head Watch that your knuckle doesnt
tilt compress neck and obstruct airway
and breathing.
If foreign material is present, roll
 Change rescuers every 2 mins to reduce fatigue. Stop CPR when:
 Do compression-only CPR, if unwilling or unable  Casualty responds or begins breathing normally
To clear foreign material  Exhaustion you cant continue.
to give rescue breaths (RB).
 Continue CPR until responsiveness or normal  Health professional arrives and takes over.
breathing returns.  Health professional directs that CPR be ceased
D
 {<
#{@$= 
casualty onto the side and clear reverse abnormal heart rhythms. Not all heart rhythms are reversible


@ Use AED when casualty is unconscious, not breathing normally.
sweep method. Spinal injury and infants(<1yr): Keep head in a When there are 2 rescuers, continue CPR while one rescuer
neutral position (i.e. minimise backward head tilt) organises and attaches AED pads:
 The airway takes precedence over any other injury including a possible spinal injury. Switch on AED & follow voice prompts of the AED.
 
  ;$
; "
<= Place pads on bare, dry chest - remove clothing, jewellery,
medication patches, wipe chest dry, avoid piercings and pace-
 G ; J
$
makers, remove chest hair with razor or scissors.
Breathing  G $ 
 "Do not use an AED on infants (< 12 months)
 O  
 "No contact.{]

 

 ?
Abnormal or NO Breathing? O@

Take up to 10  An infant is under 12 months old "No conduction.{]
 
; 


$  conductive material"+
;?
seconds to  A child is 1-8 years
after the airway has been cleared and opened,  An adult is over 8 years "No explosion. {]

#?
check for the rescuer must immediately commence chest
breathing Children under 8, use with child pads if available, otherwise use adult pads. If pads touch
compressions then rescue breathing (CPR).
each other, position one pad on the front and the other pad on the back of the chest. Check

;
$
$ +
continue with compression only CPR. manufactures instructions. Choose appropriate AEDs for child care. (pg 46)
NB. No harm to rescuers has occurred while using an AED in the wet
]^? @;

_+
Chain of survival: is the key to improving the survival rate from cardiac arrest. Time is the
sounds of gurgling, sighing or coughing may be present, but
this is ineffective breathing and CPR should be commenced. essence. The 4 steps required are: 1) Call  Early 2) Begin CPR immediately
3){@$4) Advanced cardiac life support by paramedics
6 | Essential First Aid
means call your countrys emergency number Essential First Aid | 7

Choking Inhalation of a foreign body can cause partial or complete airway obstruction. Drowning
Drowning is the process of experiencing respiratory impairment from immersion in liquid.
Partial Airway Obstruction (Effective cough): Interruption of oxygen to the brain is the most important consequence of drowning so early
SIGNS & SYMPTOMS FIRST AID rescue and resuscitation are the major factors in survival. Drowning can be fatal or non-fatal.
 >
   

  DO NOT attempt to save a
 Z coughing SIGNS & SYMPTOMS
>
 > O 

 drowning casualty beyond your
 {@
$   Q
 swimming ability.
 ]$   {]
$$; >   $ 
^

!
  Remove casualty from water as soon
 > cough is effective
(blue skin colour) 
 > If blockage doesnt clear 
$  as possible.
 $Rescue Breathing in
A Drowning Victim water if trained to do so (requires a
Complete Airway Obstruction (Ineffective cough): "=#
SIGNS & SYMPTOMS FIRST AID impossible.
 !$$ +  {
$$;?  Cardiac compressions in water are
speak or cough  > 
  $;? $ @
 Z
 

 J  {
  
? not be attempted.
     > 
  $;?
 ><$
=  $$;  
 FIRST AID
On land or boat:
 Q
consciousness
obstruction not relieved.

 > .
Call 
 Assess the casualty on the back with
 

+>Q (pg 4).
Back blows are delivered standing or {]
$

 head and body at same level.
lying using the heel of the hand  Do NOT routinely roll the casualty onto
internal injury.
between the shoulder blades. the side to assess airway and breathing.
Vomiting and regurgitation often occur during  Commence CPR if required (pg 4)
Lay an infant face Chest thrusts are delivered standing or
resuscitation of a drowned casualty. After rolling  Roll into recovery position if vomiting or
down across the lap. 
; ;@
If after 5 back
blows the airway is still
casualty onto their side to clear the airway, regurgitation occurs.
surface is required. Chest thrusts
are sharper and slower than chest reassess condition. If not breathing, promptly roll
 {]
distended
compressions (CPR). Check the casualty on to their back and continue with
obstructed, use chest thrusts. Check stomach by external compression.
airway after each chest thrust. resuscitation. Avoid delays or interruptions to
airway after each back blow. The aim  Treat for Hypothermia (pg 29) - often
CPR. Do not attempt to expel
is to relieve the obstruction with each Chest Thrusts associated with immersion.
water "
 


 

An obstruction in the airway will cause
resistance when giving Rescue Breaths.
A foreign body in the airway can be
removed later, if it is blown further into
the airways during CPR.
Positional Asphyxia Is where an airway is obstructed due to body position. If it is
accumulates in upper airway.   oxygen if available and trained.
 All immersion casualties, even if
seemingly minor, must be assessed in
hospital as complications often follow.
Back blows
on infant
Rescuing a Drowning Victim

+;@ 
person, the restrained person must be continuously monitored.
To prevent positional asphyxia
 Avoid face-down restraint unless absolutely necessary and reposition as soon as possible.
" Never sit or lean on the abdomen.
 Identify persons at risk: Psychosis and Drug over dose can lead to cardiac rhythm  If conscious: throw a buoyant aid (life jacket, surf board) or drag from water using an

$$ @
?Obesity @
$  umbrella, rope, towel, stick.
face-down position. Physically disabled $ @
?  If unconscious: Turn casualty face up and remove from water.
 Pay close attention to a person saying they cant breathe, gurgling or gasping sounds,  Consider possibility of spinal injury remove from water gently, maintaining spinal alignment
lips and face turning blue, increased resistance or sudden tranquility. as much as possible.
8 | Trauma
means call your countrys emergency number Trauma | 9

Soft Tissue Injury & Fracture Arm Slings: Use a triangular

bandage or improvise. Upper
Sprain:#;  ?
Strain: ;   @$? 
Soft Tissue
Injury

Dislocation: Displacement of bone ends in a joint. Slings and splints
can assist with
Fracture (#):^$+@ support and
Closed: Fractured bone doesnt penetrate skin. immobilisation. If
Open: Fracture is exposed through open wound or penetrates skin. casualty is at rest
Complicated: Vital organ, major nerve or blood vessel is damaged by a broken bone. and comfortable
The Signs & Symptoms and First Aid for a fracture and soft tissue injury are very similar. these may not be
necessary.
SIGNS & SYMPTOMS FIRST AID
  Control external bleeding or cover wound (pg 12)

 Q@; Improvise:
   Support or Immobilise + R.I.C.E.R. By using a belt or
 Q ElevationSling
Elevation Sling buttons on shirt
Medical Assistance: X-rays are the only sure way of The radius
 {  
diagnosing the type of injury. always
 ;
 {

Call if: Deformity as blood vessels and
nerves can be damaged.
attaches to
the thumb.
  
Open Fracture: Risk of blood loss and
Fracture
F
Fr actture M
Management:
anagementt: infection.
The main aim of fracture treatment $
 % '

is to support or immobilise an  X(pg 52, 56)
injured part which: Rigid Splint: Rolled up newspaper,
  $ placed under the fracture, tied either end
fracture becoming an open fracture. with triangular bandages.
Support: G    ? Arm Sling
Immobilise: !Splint, Sling or bandage to prevent movement. Fractured
  $$$; ? humerus:
   $$$$; ? Notice
deformity
  >  }(pg 11).
  DO NOT elevate a suspected fracture until it has been immobilised.
Note: If medical help is close by and the casualty doesnt need to be moved, a splint may
not be required to immobilise a fracture. However, where a casualty needs to be moved,
especially over rough terrain or long distances a splint will help to immobilise a fracture.
Soft Tissue Management: Do No HARM No Heat: No Alcohol: No Running: No Massage. Finger Splints: Immobilisation reduces
R.I.C.E.R. Method used to treat soft tissue injuries (sprains/ strains) and fractures. pain. After splinting, apply an elevation Collar
sling to minimise swelling.
Rest: Rest casualty and injured part; this prevents further damage and reduces bleeding. & Cuff Sling
Ice:Q +" ;$$?;
for 10 - 20 mins do not place ice directly on skin. Ice pack or frozen peas can be placed Pain in: Could be: Management:
over a bandage. Continue to cool injury three times/day for 2-3 days after the injury. O {   ; 
Shoulder O    J position of comfort.
Compression@ $ ?

injured part and reduces bleeding and swelling. ;  $
Elevation:Q $   $?
; "; Upper Arm O   J suits casualty.
blood and reduces swelling.
Refer: Refer casualty to a doctor, in case there is other injury eg fracture. Record incident.     
Fore Arm/ O  J J elbow to reduce swelling
 Degree of pain is not a good indicator of injury type since pain tolerance varies in individuals. Wrist O $
 Never manipulate a dislocation - there may be an associated fracture.   ;   
 When in doubt, always treat an injury as a fracture. O J is a fracture or soft tissue
 Check circulation (pg 11) after immobilisation ie after bandaging, splinting, sling. Hand injury, treat as for fracture
O J 
 May need to slowly adjust position of limb if no circulation is present. J (pg 8)
10 | Trauma
means call your countrys emergency number Trauma | 11

  FIRST AID  

Pelvic Injury:
 Call
 Reassure casualty
Immobilising Lower limb:
 A body splint is an effective way
Fracture site.
Bandaging and splints
to immobilise lower limb fractures. may be required if
 Control any external bleeding.
 The key to immobilising leg the casualty needs to
 G ";  $
 @ $ be transported. Use
supported. triangular bandages,
 Place padding between legs and on either side around the feet.
 Place padding in natural hollows broad bandages,
of hips (eg blanket, towel, pillow). belts, clothing or
 Figure-of-eight bandage around ankles and between legs.
 Stabilise joints above and below sheets to tie legs
feet. together. Tie-off on
 Apply broad bandage above knees. fracture site.
uninjured leg, above
SIGNS &  Dont attempt to move casualty.  Position all bandages before tying
SYMPTOMS and below fracture
 Discourage attempts to urinate. off. Position splint underneath limb to site.
    Maintain body temperature.  Apply broad bandages above and support & immobilise fracture.
groin region  Monitor vital signs (pg 52, 56) below injured area.
Splints$@
 ;  Tie bandages off on uninjured
" $%*
+Uses uninjured, adjoining body part to
movement
@aim is to prevent further injury by side of body.
$ ?G;$+@
 $; immobilizing the fracture. The casualty will usually  If using a rigid splint (eg stick)
commonly strapped together as body splints.
  (pg 14) support and immobilize the injury in the most ensure splint doesnt extend " 
*
+ Folded blankets, towels, pillows
comfortable position and a splint will not usually be further than length of legs. "  %*
+ Boards, sticks, metal strips, folded
Consider internal
required, especially if an ambulance is available. Do  Position splints under the injured magazines and newspapers
bleeding from
]
+   limb to provide support.
bladder, uterus,
bowel damage.
to maintain circulation. For suspected fractured  Pad over splint to make more Checking Circulation:
pelvis always consider spinal injury. Do not move the comfortable.  >  $;  +
casualty unless necessary. " Check circulation there may be impaired circulation.
Left leg appears A 1.5 litre blood loss   $ $;
shorter and is rotated can result from a
SIGNS AND SYMPTOMS that level of injury. Compare to other side. If colder, there
outwards. closed fracture of the
a bandage is too tight: may be impaired circulation.
Notice swelling over ] $>   Z@  ; ?>   
femur. In this case a 3
hip due to internal   
 return within a few seconds.
litre blood loss could
bleeding. This is the   ;J$  > $; ;  ;
result in shock (pg 14)
typical position of the below injury absent, circulation may be impaired.
and death.
leg with a fractured
This type of injury is
hip (fractured neck of
@ Pain in: Could be: Management:
femur) and is common
accidents. O O  
in the elderly after a Hip/groin ; 
Hip Injury minor fall. {  J adopt position of
Thigh Injury comfort.
R.I.C.E.R. for a O       ;  
R.I.C.E.R. Thigh < =$< = injury is a fracture or
sprained ankle:
Rest: Casualty Support knee soft tissue injury, treat
in position O { as for fracture (pg 8).
doesnt move ankle Knee
of comfort. >  
Ice: Cool injured area fracture after it has
Compression: Use a Do not try to been immobilised.
straighten Lower Leg/ O $O @$ 
crepe bandage Ankle {J X
Elevation: Place foot knee if avoid further injury.
higher than hip painful. O JJ  >  
Ankle Injury Refer and record Knee Injury Foot {J immobilisation (above).
 12 | Trauma
means call your countrys emergency number Trauma | 13

Bleeding Embedded Object: eg knife, glass, stick or metal. Bleeding

Bleeding (haemorrhage) can be external and obvious or internal (within the body) and often FIRST AID
not seen.  {]
 $ $  ; ?
$% %according to the type of blood vessel damaged:  Build up padding around the object.
Arterial Bleed - damaged artery; bright red blood; spurting
 Apply sustained pressure over the pad (indirect pressure).
Venous ^$";
 ^@ ?
Capillary - tiny blood vessels; bright red blood; oozing
 {]
  $?
Types of wounds associated with bleeding are:
$G  $$
   {]
 $ Z $?
 Elevate, immobilise, restrict movement of the limb.
 Advise casualty to remain at rest.
Major External Bleeding:

 $ 
 Call
casualty. Internal Bleeding: Signs, symptoms and management as for Shock (pg 14)
{+   +
easiest, most effective way to stop bleeding.  Suspect internal bleeding if a large blunt Concealed:
Apply direct or indirect pressure on or near force @+ Spleen, liver, pancreas, brain (no
the wound as appropriate. from a height; or a history of stomach ulcers, bleeding visible).
early pregnancy (ectopic pregnancy) or Revealed:
penetrating injury. Lungs Cough up frothy pink sputum.
 Internal bleeding may be concealed or revealed. Stomach Vomit brown coffee grounds
FIRST AID  If a casualty is coughing up frothy blood, allow or red blood.
 > {+ $? casualty to adopt position of comfort normally Kidneys/ Bladder Blood stained urine.
Direct Pressure half-sitting. Bowels Rectal bleeding: bright red or
 !$$?
and Elevation  First aiders cant control internal bleeding but black and tarry.
 Direct Pressure Method:
   $$(pg 13)
early recognition and calling can save lives. Uterus - Vaginal bleeding.
TOURNIQUET: Used to control
   $@
pressure until bleeding stops.
life-threating bleeding (eg 
traumatic amputation of a limb). FIRST AID
  X  ;   
 !LAST RESORT.    $; $?
pad (sterile dressing, tea towel or handkerchief).
 !;$<  Y ;?
  ^@  ?   $       ?
wide).
  If bleeding continues - apply another pad and a  X  }'<
 high above wound.
tighter bandage. be required after exercise, hot weather or if casualty has high
     blood pressure or takes aspirin or warfarin tablets - maintain
  $++
visible. pressure for at least 20 minutes).
immobilise the part, advise casualty to rest

  $?  $ '?

  >
 ]    ?
  Q  ? write time of application on   $; ;  ?
  X(pg 52, 56) casualty.
  #$?  > 
pressure over wound.
Amputation Manage amputated limb as for major external bleeding (pg 12).
  {]
 + +? Amputation of a limb may require a tourniquet (pg 12) to control life-threatening bleeding.
  If major bleeding continues - remove all pads {]
    {]
;  ;  ?
to locate a bleeding point, then apply a more direct joint or wound.    Z  ; $?
pressure over the bleeding point.  {]
    $;;   
 
 (pg 14) if required. until casualty receives specialist (The part should not be in direct contact with ice).
care.   ;   ?
14 | Trauma
means call your countrys emergency number Trauma | 15

Shock Shock is a loss of effective blood circulation resulting in tissue/ organ Burns Burns may result from: heat<"++=+cold, friction,
damage and is life threatening. chemical (acid, alkali), electrical or radiation (sunburn, welders arc).
CAUSES FIRST AID
 {]
$ ?
Loss of blood volume:^"   DRSABCD
 {]
$$?
Loss of blood pressure: Heart/ pump failure  Cool affected area with water for as long
 {]
++
or abnormal blood vessel dilatation. as necessary - usually 20 mins.
powders (except hydrogel).
 #$  Remove rings, watches, jewellery from
bleeding  {]
   
 X   affected area.
substances.
 $   Cut off contaminated clothing do not
 {]
 \" $ 
  "  remove clothing contaminated with
(towels, tissues, cotton wool).
 Y The total blood volume in the body is chemicals over the head or face.
 Y   about 6 litres. Blood loss of >1 litre  Elevate burnt limb if possible.
Seek medical help for:
   > $  $ 
abnormal (20%) may result in shock. Rapid  Cover burnt area with a loose, non-stick
  #<=   $  O  $ 
dilatation of blood loss leads to more severe dressing (sterile non-adherent dressing,
 ^J   Infant, child or elderly.
blood vessels shock. plastic cling wrap, wet handkerchief,
 Burns to hands, face, feet, major joints, or
sheet, pillow case). genital area.
SIGNS & SYMPTOMS  {]
;  ?
FIRST AID  ^ Z _?
 ++  >#$(pg 12)  Hydrogel products are an alternative if  Burns encircling limbs or chest.


 O
 > 
  +
water is not available.  Burns associated with trauma.
 Q+ ;$ ? lying down
-
/;''
 <'%(pg 14)
 ] J  #$
 >   Maintain body temperature
 Q  ?  Reassure
 Q+;   X(pg 52, 56).
 Q+ $<   $  < 
internal abdominal bleeding). and/ or delay surgery).
NB. In early stages of blood loss, children
may have a normal pulse rate, but pallor is
the warning sign. If Unconscious: '*$' Partial Thickness Burn Full Thickness Burn
DRSABCD (pg 3) (1st degree) (2nd degree) (3rd degree)
Reddening (like sunburn) Red and Blistering White or blackened
Painful Very Painful Not painful
Crush Injury A heavy, crushing force to part of the body usually causing Flame:
+{Q+>Q+QGG    " "; 
extensive tissue damage from internal bleeding, fractures, ruptured organs, or an impaired
blood supply.
$+    X> 
Inhalation: (See also pg 32, Poisons) "  
FIRST AID Crush Injury Syndrome:  ; ;$;$ {]

 {Q^>{  ;? Is a complication of crush injury $ # ;  Q+
 >
   $?
usually involving a thigh or pelvis
(ie not a hand or foot).
G   >   
# #$> 
 >#$ (pg 12). Toxins released from damaged =+"  $ ^  ;  
{]
   (pg 12) to manage a crush tissue may cause complications $; ;{ $ $  ; 
injury.
 X  ?
but the risk of sudden death   > 
following removal of a crushing Bitumen:^    ; ;~'{]

 > ? force is extremely small.  _$  ; $+ $ 
X(pg 52, 56)
NB - the casualtys condition may deteriorate quickly
It is recommended to remove the
crushing force as soon as safe

 ;>
Electrical:^     ;  
due to extensive damage. and possible.

injuries (pg 16) Call
16 | Trauma
means call your countrys emergency number Trauma | 17

Electric Shock Chest Major chest injuries include fractured rib, <
(multiple rib fractures,
Electric shock may cause: "*
@
"=%@
"$' 
"$=+sucking chest wound. A fractured
rib or penetrating injury may puncture the lung.
FIRST AID
 ]!QO
O!QGO]{ Fractured Rib/ FIRST AID
BYSTANDERS. Position casualty in position

 >


;
<$

Flail Chest: of comfort; half-sitting, leaning
toward injured side, if other
box or main circuit breaker) SIGNS & SYMPTOMS injuries permit.
 X

? Holding chest Encourage casualty to breathe
 >>Q
(pg 4). Pain at site with short breaths.
 @$
(pg 15). Pain when breathing
Place padding over injured area.
Rapid, shallow breathing Bandage and sling may help to
Bruising immobilise the injury.
Tenderness If bandages increase discomfort,
^
<"  loosen or remove them.
DO NOT touch casualtys skin before electrical source is disconnected.
punctured lung) Apply a Collar & Cuff sling to
BEWARE: Water"metal materials can conduct electricity from casualty to you.
Flail Chest section arm on injured side.
 POWER LINES are in contact with a vehicle
or a person, there should be no attempt at removal or
of chest wall moves in
opposite direction during
Call for an ambulance
Monitor for internal bleeding/
breathing.
resuscitation of the casualty until the situation is declared shock (pg 13, 14)
 (pg 14)
safe by electrical authorities. "If Unconscious: Recovery
 Q10 m@<$+ position, injured side down.
pool of water, cable).
 
 
;  Z
Protect yourself and others.
Sucking Chest Wound:
SIGNS & SYMPTOMS FIRST AID
Multiple Casualties/ Prioritising You may be faced with the  
 ^ @

 
 +
leaning toward injured side.
;

?; @+
 

;
   $+$; 
remember the goal is for the greatest good for the greatest number of people. In all
when casualty breathes. around the wound.
cases remember the principles of safety to yourself, bystanders and casualty.  ^$
$$   ;
+; 
PRIORITIES: }|+|; around wound when casualty pad taped on 3 sides: This allows air to escape
breathes. from pleural cavity and prevents lung collapse
1  G!]>]>!
@? ;
the casualty into the recovery position may be all thats required initially.
 >
 
$
frothy sputum.
(pneumothorax).

 > for an ambulance .
Moderate bleeding (< 1 litre)   (pg 14).  X$J (pg 13, 14).
 $<}=
2  Crush injury 3 Spinal injury
 Shock Multiple fractures
  ;
  Burns (10-30% of body)
 $;

 

 Burns to 30% of body
4  \


 Head injury, showing

deterioration 5  $  +
massive head or torso injuries

Remember: A casualty is always in a changing, non-static condition. This is especially

important in head and abdominal injuries in which deterioration can occur.
18 | Trauma
means call your countrys emergency number Trauma | 19

 Eye Types of eye injuries:"$'"X ;%"[


 \'"
;]
An injury to the abdomen can be an open or closed wound. Even with a closed wound the
rupture of an organ can cause serious internal bleeding (pg 13, 14), which results in shock Burns: FIRST AID
(pg 14). With an open injury, abdominal organs sometimes protrude through the wound. Chemical - acids, caustic soda, lime
UV -_" +;$  QQ
;  ;
FIRST AID (the eyes are red and feel gritty hours later) sterile eye (saline) solution for 20 -30 mins.

 >
   $; ;
Heat -"  O     ?
Contact Lenses: DO NOT remove if the    ?
under head and shoulders and support
 $>   G <=?
under bent knees.   ?
  ;G
 If unconscious, place in recovery
initially protect the eye but if a chemical or
position, legs elevated if possible.  If chemical burn+{]
 Z; 
foreign body tracks under the lens, severe
 >#$;;  other chemicals as this can create heat.
injury may occur.
dressing, plastic cling wrap or aluminium
foil. Foreign body:+ +++ 
  ;  $< Plastic cling wrap has been placed over an
tightly). open abdominal wound and secured with FIRST AID
surgical tape.  ;  $ 
 Q ?
 X(pg 52, 56). (saline) solution or gentle water pressure from hose/ tap.
  (pg 14).   + ; +
gently lift particle off using a moistened cotton bud or the
 {]
  $;$$ corner of a clean handkerchief.
cavity.  <{]
  
 {]
   irrigate only)
wound.     + ;  
 {]
  $;;  @ no pressure is placed over injured eye.
(may cause spasm).  ?
 {]
<   {]
;  $?
surgery for wound repair).
Penetrating Injury:
FIRST AID
 G  "
 Q 

 >
   
 $ $?
    
   +$ 
this will cause movement of injured eye.
 >  +$  $
anxious.
 {]
$$?
 {]
  $?

Direct Blow: $;   @  $  

of the eye socket or retinal detachment.
FIRST AID QQ  ; 
 $  
20 | Trauma
means call your countrys emergency number Trauma | 21

Head Injury Spinal Injury

^"  ear may indicate a The key to managing a spinal cord injury: Protect airway & minimise spinal movement
ruptured eardrum or skull fracture:
Conscious:

Cervical
  ;
;"  ? SIGNS & SYMPTOMS FIRST AID
{]
 $?  $?     ${]
AIRWAY management takes priority   of patient - leave this to the experts.
body.   ?
over ALL injuries, including spine.


Spinal Column
 ] $;? >

Thoracic
ALL cases of unconsciousness, even
if casualty was unconscious only  !$?     ?
$"+ $$?  !?  Q  ?
If casualty didnt lose consciousness,   (pg 14).  X$ ?
but later develops any of the following
signs and symptoms (below), urgent QUICK CHECK Conscious Casualty:
medical advice must be sought.  > ; @ Support the head and
Lumbar
Monitor all casualties closely for the me? neck in a conscious
@   ? casualty with neck pain.
 > @? Do not remove helmet
All head injuries should be suspected
as a spinal injury until proven  >      ? and ask casualty to
otherwise.  >    ;  remain still.
and point them away?
 {  ; ?
FIRST AID
SIGNS & SYMPTOMS  >     J?
Check DRSABCD (pg 3)
Headache or giddiness
Conscious: NB. If the casualty has neck or back pain-
Nausea or vomiting
   _ $$? treat as a spinal injury. The pain may be
Drowsy or irritable
 Q + ? due to an unstable vertebral fracture which
Slurred speech
 $" + may result in spinal cord damage if handled
Blurred vision
cover with a dressing (do not plug). incorrectly.
Confused or disorientated.
 >$; (pg 12). Unconscious casualty:
Loss of memory Suspect spinal injury with:
 {]
 ? Turn casualty onto their side,
Swelling and bruising around eyes. motor vehicle accidents, motor bike and
 {]
  <  maintaining head, neck, and spinal
Bleeding into corner of eyes. cyclists, diving, falls from a height, minor
bleeding within skull). alignment. Maintain an open airway.
Bruising behind ears. falls in the elderly and sports injuries such
 $$;+;? (Log roll technique). Use safe manual
; " $ as rugby and horse riding.
  ? handling techniques to avoid injuring yourself.
from nose or ear.
Unconscious: Unconscious: eg ask for assistance; bend your knees.
Loss of power in limbs.
 Q;   ? Any person found unconscious is potentially spinal injured until proven otherwise - turn
Loss of co-ordination.
Seizure
 > 
 X}'<pg 52, 56).
casualty onto their side and maintain an open airway.
Unequal pupils REMEMBER, airway management takes priority over spinal injury.
 >$; ?
G +$"? Helmet Removal: Helmets could
  J$ ? FIRST AID
 ;; $? be preventing further spinal or head  Q;   
Concussion: Brain Shake is a
temporary loss or altered state of
 $? injuries. If a full-face (motorcycle)
helmet is impeding proper airway

 >
 X}'(pg 52, 56)
consciousness followed by complete Cerebral Compression: Brain swelling or bleeding management in an unconscious  >$; 
recovery. Subsequent decline within the skull shows deteriorating signs and casualty and/ or you intend to perform   J$ 
(see signs and symptoms above) symptoms (above). This is a serious brain injury and CPR, the helmet needs to be removed  ;; $
suggests a more serious brain injury. could be life threatening.  ? ;   $
removal to the experts.
22 | Medical Emergencies
means call your countrys emergency number Medical Emergencies | 23

Heart Conditions Angina is a cramping of the heart muscle; relieved

by rest, with no permanent muscle damage.
Asthma Asthma is a disorder of the airways that can cause respiratory distress.
Spasm, <
 and increased mucus production in the airways causes breathing
Heart attack is caused by a blocked coronary artery, @ ? $;$  ; +
resulting in muscle damage which may lead to exercise, emotional stress, pollen, dust-mite, food preservatives, smoke, fumes or cold and
complications such as cardiac arrest. " ? ; ;?
Cardiac arrest is a condition in which the heart
stops beating and pumping effectively. The damage SIGNS & SYMPTOMS FIRST AID
caused by a heart attack may cause abnormal rhythms Mild:  Sit casualty comfortably upright.
(Venticular Fibrillation) which result in cardiac arrest.  Dry persistent cough  Calm and reassure - stay with casualty
 Wheeze  Follow casualtys Asthma Action Plan
Some abnormal rhythms can be reversed by an AED.  Breathless but speaks in sentences
Cardiac arrest is fatal without basic life support (pg 3). or give
 Chest tightness  Reliever Medication (4 puffs - 1 puff
Severe: (Call ambulance straight away) ]%;;


Heart attack and Angina are heart conditions  $ <$ =
which present with similar signs and symptoms.  Borrow an inhaler if necessary
 Wheeze inaudible (no air movement)
 If no improvement, repeat after 4 mins
SIGNS & SYMPTOMS+
 Central chest pain$$>  
 Y
 Cyanosis (blue lips)
 Skin pale and sweaty  Call if no improvement
 #$<GJ=
 Exhaustion
 Breathlessness@ \  $  Anxious/ Distressed  Keep giving 4 puffs every 4 mins until
 Indigestion type pain in the upper abdomen (referred pain from the heart)  Rapid pulse ambulance arrives or casualty improves
 Pain spreading to the "_]"`"'%"
 
 @? $each puff.
 Collapse (respiratory arrest)
 Heaviness or weakness in left arm  If Collapse:
 Dizzy Young Children may also demonstrate:
NB. Casualties having a heart attack may present with  Severe coughing and vomiting  Commence DRSABCD (pg 3)
 Nauseous  Stop eating or drinking
breathlessness alone while others may have heaviness
 Pale and sweaty  Restless or drowsy Rescue breaths may require more force
in the arm or believe they have indigestion.
 Irregular pulse  Muscles in throat and between ribs suck in  ;;?;"; 
steady pressure until chest begins to rise.
Allow time for chest to fall during expiration.
FIRST AID
 STOP and REST in position of comfort (usually sitting). Using Puffer - with spacer If no spacer available
 Q  Are you on prescribed heart medication?
- Do you have angina? Can you take Aspirin?
     $;  $
treat as for @{@{{@=}"=~  "/@* %
%"

  prescribed heart medication<$
]=?
 +give another dose of heart medication. SHAKE
1 PUFF
4 BREATHS
ANGINA should be relieved by rest and medication (tablets or spray). REPEAT X 4
 3 doses of medication over 10 mins, the pain has not diminished, Reliever Medication: Shake inhaler, remove cap and Shake inhaler, remove cap. Put
then the condition should be considered a HEART ATTACK Blue - grey colour. put inhaler upright into spacer.inhaler between teeth and seal
Salbutamol puffers are the Place spacer between teeth with lips.
Warning signs: most common (eg Ventolin, and seal with lips. Administer 1 puff as casualty
{]_


Pain lasts > 10 mins

Pain gets suddenly worse
>
]
Call  Monitor vital signs
Asmol, Airomir) also
Terbutaline (eg Bricanyl - Administer 1 puff and ask inhales slowly and steadily.
Slip inhaler from mouth. Ask
casualty to breath in and out for
supplied in a turbuhaler)
It is not harmful to give 4 breaths through the spacer. casualty to hold breath for 4 sec
# Repeat until 4 puffs have been or as long as comfortable.
Aspirin (300mg) if directed salbutamol to someone
by emergency services. Vital Signs who does not have given. Breathe out slowly, away from
Before directing you to give Aspirin, (pg 52, 56) Prepare for CPR asthma. Wait 4 mins and repeat if there inhaler.
emergency services will want to know if: Adults can use Symbicort is no improvement. Repeat until 4 puffs have been

 given.
> Warfarin (blood thinning medication) in emergency: follow
SMART action plan, Call if casualty does not
>   Asthma or Stomach ulcers Wait 4 mins and repeat if no
available from Asthma respond to medication. Say it
improvement
Foundation is an asthma emergency
24 | Medical Emergencies
means call your countrys emergency number Medical Emergencies | 25

Croup/ Epiglottitis Seizure/ Epilepsy A seizure is caused by abnormal electrical activity in

Croup and Epiglottitis are infections of the upper airways (larynx, pharynx and trachea) the brain. Types of seizure include brief lapses of attention (absence seizure) trance-like
and occurs in young children. Both conditions start with similar signs and symptoms but wandering (partial-complex seizure) and rigidity followed by jerking (tonic-clonic seizure).
epiglottitis progresses to a life-threatening state. Croup: Viral infection A seizure can occur in a person with "** "%\' "
 " 

affecting upper airways in Fever<$ = Hypoglycaemia <$=PoisoningAlcohol
SIGNS & SYMPTOMS FIRST AID Drug Withdrawal.
CROUP: infants and children
 DO NOT examine FIRST AID
 > < 5 yrs. Slow onset, usually SIGNS & SYMPTOMS
childs throat this    $
 ^   follows a cold or sore throat Tonic-Clonic Seizure
may cause complete or protect head with cushion/ pillow.

Mild
 ]$  and lasts 3-4 days. Can also   <;$
blockage. ] ?
    affect adults. taste, smell, sound or sight).
 >Q ?  {  
    >  ?
  Epiglottitis: Bacterial avoid injury.
" $
 % '
  >
worse if child is upset. infection of the epiglottis  {]
   _  ?
" =;'* (tonic phase lasts few secs).
 ? <"$ =  QQ$?
  ;?
causing upper airway  $<  X(pg 52, 56).

EPIGLOTTITIS:  Q  ; 
Severe

" 
]]  Call obstruction. It occurs in phase lasts few mins).
the 4 - 7 yr age group and  ^  J supervision at end of seizure.
" '
%
' 
"  ]%
 >+ 
    ? has a rapid onset over 1-2  #   if:
 Z  ?
 G hrs. 
 $ $
" 

   Z  ;?
"  
*
' care until ambulance This is an emergency stained saliva.
arrives. and requires urgent  G$$;? >  $?
" <'% Z  ;?
ambulance transport to  ^  
the hospital. Z @ ? 
 _@Z ?
{@  {; ;? >   _ $?
@  A person known to have epilepsy may not require
ambulance care and may get upset when one is called.
differentiate
between ~='*
and ~* 



- further tests are
usually required.
 Call 
not sure
if you are

 (Normal body temperature = 37C)

Faint Febrile convulsions are associated with a high body temperature (>38C). It is the rate of rise
Fainting is a sudden, brief loss in temperature, not how high it gets, which causes the convulsion. They occur in 3% of all
of consciousness caused by children between the age of 6 mths and 6 yrs.
SIGNS & SYMPTOMS FIRST AID
$"; $  {ZZ  ?  G " SIGNS & SYMPTOMS FIRST AID
with full recovery. It often occurs  ]   ;  (Similar to epilepsy + fever)  XZ J
in hot conditions with long  ; left side.  O Epilepsy.
periods of standing; sudden  Q   Q   +"   PLUS:
postural changes (eg from consciousness within  ;?     Q# 
sitting to standing); pregnancy  ^ 
a few seconds of lying  DO NOT give food or drink
(lower blood pressure); pain  ^  forehead
"? to unconscious.    +$
or emotional stress (eg sight  {]
; 
 ;  >   ? recovery position after seizure  O  
of blood). There could be  X     to occur
underlying causes, which may Q#  ^   {]
 $
embarrassment. medical assessment clothing  G ;
need medical assessment.
26 | Medical Emergencies
means call your countrys emergency number Medical Emergencies | 27

 
 Stroke
{$$$;   $? The blood supply to part of the brain is disrupted, resulting in damage to brain tissue.

$ Hypoglycaemia (Low blood sugar) or Hyperglycaemia This is caused by either a blood clot blocking an artery (cerebral thrombosis) or a ruptured
(High blood sugar). Both conditions, if left untreated, result in altered states of artery inside the brain (cerebral haemorrhage).
consciousness which are medical emergencies. The signs and symptoms of a stroke vary, depending on which part of the brain is damaged.
SIGNS & SYMPTOMS - Both conditions share similar signs and symptoms: SIGNS & SYMPTOMS FIRST AID
"@**
;%'%] '%
%/ '  > Z    FAST tests, act
"*%;
 "*%*'"'  Y 
 ! Z 
fast and Call
 
HYPOglycaemia (LOW) HYPERglycaemia (HIGH)
 ^   Q 
DIFFERENCES

 +;  +

 {  Q  
 Fast progression  Slow progression
    X$ 
 Y   $ < =
 {@ ;;  #$

$ 

   X(pg 52, 56)
     
side of body.
 Z   ]  New drugs and medical procedures can limit or
 G$
 $ reduce damage caused by a stroke.
 $J$;?
 Z  Therefore, prompt action is essential for optimum

$Y? recovery.
 Y+;;$  ! 
measures. TIA (Transient Ischaemic Attack) is a mini-stroke
FAST is a simple way of with signs and symptoms lasting < 60 mins.
FIRST AID Hypoglycaemia can occur if a remembering the signs of a The risk of a stroke subsequent to a TIA is high,
Both conditions (Hypo and Hyperglycaemia) are person with diabetes: stroke: therefore early recognition and treatment is vital.
 ;$@? 
     Facial weakness Can the
Conscious:  O  casualty smile? Has their mouth or
 ;J$+  #$   eye drooped?
teaspoons of sugar or honey, glass of fruit juice faster than normal  Arm weakness Can casualty
(not diet or low sugar type).  ^ raise both arms?
 Repeat if casualty responds eg. diarrhoea and vomiting  Speech Can casualty speak
 ; high carbohydrate food:  # clearly and understand what you
sandwich, few biscuits, pasta or rice meal. stress say?
 > 
if no improvement within a few minutes of The reason sugar is given to
giving sugar (could be hyperglycaemia or another diabetics with an altered state of
 Time to act fast - Call  Cerebral haemorrhage Cerebral thrombosis
medical condition). consciousness is that most will be
Unconscious: hypoglycaemic. The symptoms 


  of hypoglycaemia progress more Hyperventilation syndrome is the term used to describe the signs and symptoms resulting
 > 
 {]
  $
rapidly and must be addressed
quickly.
from stress-related or deliberate over-breathing. The increased depth and rate of breathing
upsets the balance of oxygen and carbon dioxide which results
SIGNS & SYMPTOMS
 ]
Y]$   If the casualty is hyperglycaemic,  Q$  in diverse symptoms and signs.
the small amount of sugar given  G   NB. Other conditions
$@;@ 
@ FIRST AID which may present with
raise blood sugar levels and will do toes.  >Q ? rapid breathing:
no harm.  ^    ; $    
   - count breaths aloud.  Y 
@?  #    Y
Dont give diet or diabetic food/ drink  > 
 # medical condition.
;  @; $ <= 
 >   DO NOT use a bag for  {$
Fruit Juice Sugar Jelly Beans this doesnt correct low blood sugar.
 Q  rebreathing.  
28 | Medical Emergencies
means call your countrys emergency number Medical Emergencies | 29

Heat Exposure Normal body temp = 37C Cold Exposure

Exposure to cold conditions can lead to hypothermia (generalised cooling of the body) or
Heat Exhaustion: occurs when the body cannot lose heat fast enough. Profuse 

 (localised cold injury).
; ;$ $  " 
decreased blood volume (mild shock). If not treated quickly, it can lead to heat-stroke. Hypothermia: is a condition where the body temperature drops below 35C
 Y $ + $ ?
Heat Stroke: occurs when the bodys normal cooling system fails and the body     ; cold, wet and windy, especially in the young
temperature rises to the point where internal organs (eg brain, heart, kidneys) are damaged: and elderly   " alcohol or drugs.
Blood vessels near the skins surface dilate in an attempt to release heat, but the body is   $ + $;   
so seriously dehydrated that sweating stops (red, hot, dry skin). Consequently, the body require less oxygen. Hypothermia protects the brain from the effects of hypoxia so
temperature rises rapidly because the body can no longer cool itself. resuscitation should be continued until the casualty can be rewarmed in hospital.
This is a life-threatening condition. MILD Hypothermia MODERATE Hypothermia SEVERE Hypothermia
Heat Exhaustion 35 34C 33 30C <30C
Organs cook at 42C FIRST AID  X#       ! 
(Mild Moderate Hyperthermia)
 X +  ++$   X   >  
 ^
~*>'*> Heat Stroke shaded, ventilated area.    >     @#
SIGNS & SYMPTOMS
 ;
(Severe hyperthermia)
 ^
'*>
 <
with legs elevated.
 Gexcess
  
  ; 
 $ 
 ;  }
 ;$ hard to
detect
 
 >
 Pale, cold, clammy skin SIGNS & SYMPTOMS clothing.
 Y   NO Sweating  Cool by:  X
FIRST AID
 X 


 Red, hot, dry skin
 ] 
; ;;
ice packs to neck, groin and " {]
;too quickly- can

 >
 shelter protect from wind chill.
 O    $ ;  cause heart arrhythmias.  Ygently to avoid heart arrhythmias.
 ]   $J  over body and fanning. " {]
 radiant heat <@  horizontal to avoid changes in blood
 Q   J   cool water to drink if or electric heater) - re-heats too supply to brain.
<  "   Z  fully conscious. quickly.  Q; ; ?
loss (pg 14)  !     " {]
 $massage  blankets/ sleeping bag or space
Progresses to
Profuse sweating may occur 
 > if in doubt extremities- dilates blood vessels in
skin so body heat is lost.
blanket and cover head.
 warm, sweet drinks if conscious.
" {]
alcohol dilates O]
YQ]
blood vessels in skin and impairs  heat packs to groins, armpits, trunk
Breeze or fan shivering. and side of neck.
Heat radiates from the
body, especially the head " {]
  hot bath  Body-to-body contact can be used.
into the surrounding air as monitoring and resuscitation if
During breathing, cold air O!]>]>!
$@ ?  DRSABCD (pg 3) - Check breathing/ pulse
is inhaled and warm air is
exhaled for 30- 45 secs as hypothermia slows down
Frostbite: is the freezing of body everything.
Heat Exhaustion and Heat Stroke are tissues and occurs in parts exposed to the  no signs of life commence CPR while
Heat is lost through usually caused by over-exertion in hot,
evaporation (sweat) on cold. re-warming casualty.
; " ?
the skin
SIGNS & SYMPTOMS +;#  $
Heat is lost through FIRST AID
convection ie warm
air around the body is  
  $$ 
replaced with cold air Q;; $ (rewarming can
Heat is - worse on windy days be very painful){]
 $ 
conducted
from the  {]
  {]
$$
 
 NEVER thaw a part if there is any chance of it being re-frozen. Thawing and refreezing
!!
Frost bite results in far more tissue damage than leaving tissue frozen for a few hours.
Body heat can be lost quickly in high, exposed areas
30 | Medical Emergencies
means call your countrys emergency number Medical Emergencies | 31

Bites/ Stings (Both found in tropical waters) Bites/ Stings

LAND TYPE FIRST AID $-_ '%\_
ANIMALS
SIGNS & SYMPTOMS
FATAL

Snakes Pressure Immobilisation Technique (PIT) SIGNS & SYMPTOMS

(see next page for PIT)  immediate skin pain  Mild sting followed 5-40 mins later by:
Funnel web Spiders
 Frosted pattern of skin marks  generalised pain
Red back spiders/ others COLD COMPRESS/ ICE PACK  >  ] ++;
Bees  Cardiac Arrest  >JRespiratory arrest
Wasps
(Anti-venom available) (No anti-venom)
Scorpion
FIRST AID

SEA
Ants Red Back Spider {Q^>{Q ;Call 
Q { $$
O; VINEGAR~'
TYPE FIRST AID
CREATURES rinse with seawater (NOT freshwater)  +>Q
Sea Snakes
Blue-Ringed Octopus Pressure Immobilisation Technique (PIT) Non-Serious Bite/ Sticks:
(see next page for PIT)
Cone Shell Fish stings: $$ ; ^;  ;
FATAL

Tropics

VINEGAR Liberally apply vinegar for 30 secs (vinegar neutralises Red Back Spider:$] 
stinging cells) then pick off tentacles. If no vinegar available,
$-_X

 
 
   


  Bee/Wasp/ Ant/ Tick:G<$ =Q
'%\_X
SEAWATER. Do not use fresh water because it can cause stinging   
cells to discharge.    +; #(pg 33)
Bluebottles { O  ;? Q    
Fish Stings: Stingray HOT WATER - Use cold compress if no pain relief with
 +
 hot water Pressure Immobilisation Technique (PIT): This method is used to treat a variety of
: Bullrouts $O ;$^  > 
Potentially Fatal Bite/ Sting:

Snakes Funnel web Spider Blue-Ringed Octopus Cone Shell

1. Apply a pressure
SIGNS & SYMPTOMS: similar for all 4 species with death from Respiratory Arrest
within minutes to hours.
bandage over the bite area 2. Apply a second 3. Splint the bandaged
<@  ]
 bandage@ limb, including joints either
Painless bite{^ {@ ;; @$; toes extending upwards side of bite site.
^ @ $] Y  bandage and skin). covering as much of limb as Q $?

J $    ;> > DO NOT wash bite site possible. DO NOT elevate limb.
X\$ ^  ^ 
(If only one bandage pants/ shirts as undressing >  (pg 11)
FIRST AID:
 {Q^>{  {]
; $<= available: start from causes unnecessary DO NOT remove bandage
 {]
 $ @J; movement and splint once it has been
 Q 
 > 
  $
  
 {]
 $
 {]
   (pg 12)
far up limb as possible
covering the bite).
X\$ applied.

 Q +  {]

@ PIT (Pressure Immobilisation Technique)
""# 
priority over PIT species is made from venom on skin.  !

!

 $
"
"
%
32 | Medical Emergencies
means call your countrys emergency number Medical Emergencies | 33

Poisons A poison is any substance which causes harm to body tissues. Allergy/ Anaphylaxis Anaphylaxis is a life-threatening allergic reaction
A toxin is a poison made by a living organism (eg animal, plant, micro-organism). which can be triggered by nuts (especially peanuts), cows milk, eggs, wheat, insect
A venom#;  $<++@ =?
13 11 26 - Poisons Information Centre Free Call, 24/7, Australia wide.
Poisons can be ingested (swallowed), absorbed, inhaled or injected. The effect of a
poison will depend on what the substance actually is and how much has been absorbed.
stings/bites (bee, wasp, ant, tick), and certain drugs (eg Penicillin).
The airways rapidly swell and constrict, interfering with breathing, and the blood vessels
widen, leading to shock (pg 14). Casualties need an immediate injection of adrenaline.
People who know they are at risk may wear a medical alert bracelet and carry their own
injectable adrenaline. FIRST AID
Ingested: Swallowed substances can be broadly categorised into corrosive eg dish SIGNS & SYMPTOMS  G
"+;?$ 
washer detergents, caustics, toilet/ bathroom cleaners and petroleums or non-corrosive @
;
Can be highly variable and
eg plants, medications (tablets/ liquids) and illicit drugs. Some drugs make people drowsy  <;=
may include:
or unconscious, others can cause panic or aggression others cause dangerous dehydration.
Adverse drug experience - (bad trip) indicated by FIRST AID
Mild to moderate Allergic  Call 
" Administer oxygen if available
reaction:
confusion, hallucination, overcome by crowds, possibly  
  ;++   $ 
violent. Keep yourself safe, seek assistance. To help:  (from container/ bottle). @
(pg 23)
 Y <+ =
Stay calm yourself and talk calmly Reassure the person  $  ?  Further adrenaline should be given if no improvement



Rest the person Reduce stimuli, move slowly, take to a  {]

unless advised. after 5 mins
 Abdominal pain, vomiting
quiet placeEncourage happy, positive, simple thoughts.  {]
give anything by mouth
(severe if reaction to insects)  >
DRSABCD (pg 3).
SIGNS & SYMPTOMS of a corrosive unless advised.  Severe Allergic Reaction If in doubt give the autoinjector
substance:  
 J$  Drinking too much water can cause (Anaphylaxis):
^
J
 ]
J serious problems Mild allergy may not precede anaphylaxis Use adrenaline when symptoms become severe. EpiPen

  {@ $ ; and Anapen are auto-injecting pens containing a measured
 {@ J$ 
FOR ALL POISONING: dose of adrenaline (Epinephrine). It can take only 1- 2 mins
Unconscious  Z 
 {Q^>{ for a mild allergic reaction to escalate to anaphylaxis.
 {@ J 
  $  +;;   Y;X 
contamination from around the mouth.  Swelling/tightness in throat
 >>
 ! $?
 {]
use Syrup of Ipecac to induce 
advice or Call
 X(pg 52, 56)
 Persistent dizziness
 "<  =
vomiting unless advised by Poisons  J   >   
Information Centre. notes with casualty to hospital. Swelling
Absorbed:  ;   How to Use an EpiPen: How to Use an Anapen:
hospital. 1.
Chemical splash from eg pesticide, weed killer. 2.
FIRST AID 1. 2.
 {]
$ ;++ ?
   ?
 O;  ; 
Pull off Black needle Pull off grey safety cap
Inhaled: Toxic fumes from gas, burning solids or liquids. Inhaled poisons include: shield. from red button.
carbon monoxide (car exhausts); methane (mines, sewers); chlorine (pool chemicals,
cleaning products); fumes from paints, glues, and industrial chemicals. 3. 4.
FIRST AID O@  Push orange end hard into
SIGNS & SYMPTOMS X   EpiPen and pull off outer thigh so it clicks and
^ $Y  G   blue safety-release. hold for 10 secs
] {ZZ>  Remove Epipen and
#$
> 
Injected: As a result of a bite or sting (pg 30, 31) or may be injected with a needle.
massage injection site for
10 secs @ Press red button so it
against outer mid-thigh clicks and hold for 10secs.
The most common type of drug overdose via injection are narcotics which cause respiratory (with or without clothing)Remove Anapen and
depression (slow breathing), respiratory arrest (no breathing) or unconsciousness. Seek NB. When the orange needle end is withdrawn from massage injection site for
urgent medical assistance if breathing is slow or abnormal. The most common injection the thigh, the needle is automatically protected. 10secs
 ++$;+$;@?]^?] $ BEWARE of needle protruding from end after use.
carriers of Hepatitis B, C, and/ or HIV (AIDS).
34 | Asthma & Anaphylaxis
means call your countrys emergency number Asthma & Anaphylaxis | 35

Why Asthma is Dangerous { ; ;>2 is

trapped in the lungs during
-
Asthma in the workplace some occupations have higher risks of asthma
The extra mucus that is produced during an asthma attack, can an asthma attack. Occupational Asthma<=
form a mucus plug in the air sacs (alveoli) in the lungs. The Flour, dust: (cooks, bakers, farmers) Sawdust: (builders, carpenters)
mucus plug prevents the casualty from exhaling. This causes Animals: (vets, lab technicians) Detergents: (cleaners) Resins,
 >2 (carbon dioxide) in the lungs and blood solvents, solder: (repairers, builders, electricians, Spray painters)
which leads to acidosis. Acidosis is life threatening and needs
advanced medical management, in hospital. When a persons Managing Workplace Asthma - How to reduce the risk
asthma cant be controlled with reliever medication it is critical PPE (Personal Protective Equipment) Re-deploy
that they receive urgent hospital care before carbon dioxide levels workers to lower risk area or duties Have Emergency
build to an irreversible level.  $@@
Inhalation Exhalation  Seek less toxic alternatives Provide emergency asthma

" '!
(! management training
* Metered Dose Inhaler = puffer Autohaler
$ 
Manage asthma in aged care
EMERGENCY
^ +^ J

Salbutamol brands are Ventolin, Airomir, Asmol.

Names
Terbutaline brand is Bricanyl. How to help people with asthma who have special
Speed Fast acting. needs and circumstances
Purpose Relax airway muscles. "Wheelchairs. Keep person in wheelchair; upright as
Ventolin & Asmol Puffer. Airomir Autohaler. possible. (Unconscious - DRSABCD)
Device
^
$  "In-bed asthma attack. Raise the bed head or use
Ventolin puffer & spacer
)
 pillows or cushions to support upright.
+^;

Asmol A
Accuhaler
^ O#+ ++ "In shower or bath. Maintain client in bath or shower (on seat if
Names possible) support sitting up. Empty the bath water. Keep client
Alvesco, Tilade, Intal Forte, Singulair
Speed Slow acting. Can take weeks for full effect. warm. Preserve clients dignity - cover.
NOT FOR EMERGENCY

Purpose Reduces the sensitivity to asthma triggers. "='

% '
. Use communication aids to reassure
Device Puffer, Accuhaler, Turbuhaler,Tablet. and to give explanations.
Symptom Controllers "Intellectual disability. Develop and maintain regular routines.
Names #


Speed Slower acting than relievers. About 30 minutes. Exercise Induced Asthma (EIA)
Purpose Relax airway muscles lasts up to 12 hours. At rest breathing is mostly through the nose. During exercise, air
A
Device Turbuhaler, Accuhaler is breathed through the mouth and air that enters the lungs

'!
 Preventer plus a Symptom Controller + @?

Name Seretide asthma attack.
Purple

Without spacer With Spacer

Speed Slower acting Exercise is an excellent activity for everyone including
Purpose Prevention plus control of symptoms asthmatics as it helps to improve overall health and lung
Device Accuhaler or MDI (Puffer). Taken twice a day. function. Exercise is one trigger that should not be avoided. Therefore it is

'!
 Can be used in emergency for ADULTS important to manage EIA so people with asthma can continue to participate in
Name Symbicort most sports.
Reliever is fast acting
Adult use only

Speed
Red & White

Purpose Prevention plus control of symptoms Children may need a Managing EIA
Device 

$
X{<
=? spacer with a mask Take reliever 5-20 minutes before exercise Warm-up before exercise Warm-
Symbicort may be used for casualties over 12, 

$
  down after exercise Always carry blue reliever medication in case needed
CAUTION when prescribed. Max 6 doses at a time. Max in-breath. This may not Tips for coaches: ! \


<If symptoms occur
12 doses per day of Symbicort#. be possible in emergency
#
during match: Stop playing & take reliever. Resume activity if symptom free. If
SMART action plan for Symbicort use as a reliever is
symptoms recur: take reliever, do not play again on same day.) ; 
available from Asthma Foundation Note: Spacers are for single person use only.
Spacers to warm-up / warm-down   @Display
  
 
Help medication to reach the lungs.
Protect the throat from irritation.
Help coordinate breath with puff.
asthma posters and brochures in club rooms Check with Australian Sports Anti-
replaced. Used spacer can be given to casualty.
Doping Authority 1 for info on banned medications
Personal spacers should be washed every month.
Use warm soapy water; air dry; do not rinse. 1
Australian Sports Anti-Doping Authority (ASADA) http://www.asada.gov.au/substances/
36 | Asthma & Anaphylaxis
means call your countrys emergency number Asthma & Anaphylaxis | 37

Allergy/Anaphylaxis Facts 
 " + There are two basic categories of anaphylaxis:
Ige mediated and idiopathic. Ige mediated
Anaphylaxis is the most severe form of allergic reaction. Anaphylaxis can cause
symptoms such as swelling of the tongue and throat and this can lead to breathing anaphylaxis is a result of the immune system releasing large quantities of histamine and
@
? Many substances can cause anaphylaxis, but the most common are Food, other chemicals which causes the typical signs of anaphylaxis. Idiopathic anaphylaxis is not
Medicine and Insects. Anaphylaxis is a medical emergency. fully understood, but also causes severe life threatening reactions.
What happens in an anaphylactic reaction?
Causes of death from anaphylaxis Allergens Ige antibody
Anaphylaxis Facts - Australia " {

 an allergy prone person runs across an
 60% medications Allergies in Australia are very common, affecting allergen (peanuts for example), their immune system
 20% insects about 1 out of 5 people. produces large amounts of peanut Ige antibody. As a
 10% unknown Death from anaphylaxis is rare. result of this their body is sensitised to peanuts.
 5% food About 12 die each year from anaphylaxis  These Ige molecules attach themselves to mast cells.
 5% other (latex, hair dye, etc) X]
 $
???


 " The second time this person comes into contact with
Medications: IF anaphylaxis is fatal then death usually occurs very peanuts, the peanut Ige antibodies trigger the mast cells
soon after contact with the trigger. to release granules of powerful chemical mediators, such
< 5 min after injected medication as histamine and cytokines into the blood stream
< 15 min after insect stings  These chemical mediators (histamine etc) cause
< 30 min after food Histamine etc
 Vasodilation
What does adrenaline do?  Fluid loss into tissues
Adrenaline:  Smooth muscle contraction
 Reverses vasodilation  Increased mucus secretion
Insect stings/ticks:  Reduces swelling  This causes the common anaphylaxis signs & symptoms
Ants, Bees and Wasps are the most likely  Increases heart output  Redness, rashes and welts
insects to cause anaphylaxis. Ticks also  $ @

Anaesthetics and injected medications cause anaphylaxis in some people; most  ;+  $ @

such as antibiotics are the most  Prevents mast cells from  Shock
reactions to tick occur when attempting to
common drugs to cause anaphylaxis. remove the tick. releasing chemicals  Cardiac arrest
Some over-the-counter medications such Give Adrenaline Early
"(NSAIDS)  If the mast cell response is slowed down quickly, with early use of
can cause anaphylaxis. Some alternative adrenaline, the amount of histamine and mediators released by the
and complementary medicines are based mast cells is greatly restricted, to the point where adrenaline can
$
";  effectively reverse the effects these chemicals have.
known allergens.   ; $<"

See ASCIA for info on ticks: www.allergy.org.au
leaking into the tissues) can result in severe shock leading to
Food: Food is the most common cause of anaphylaxis in children cardiac arrest.

@ # ?
 It is very important to give the adrenaline autoinjector if the signs
Any food can cause anaphylaxis but and symptoms of the casualty suggest anaphylaxis.
 If you are in doubt - give the autoinjector.

these 9 Foods are the most common
Peanuts  Dairy O O " Call . The reaction could return when the effects of adrenaline

]

 wear off after about 20 minutes
 Eggs What is an autoinjector? Autoinjectors contain a pre-measured dose
What does all this mean? Most allergic reactions do not cause death. However when
anaphylaxis is life threatening it develops very rapidly and requires immediate treatment
with adrenaline. First Aiders and carers must learn to identify signs of anaphylaxis and be
? +@ 
medication is pushed out. Each Autoinjector can only be used once.
EpiPen & Anapen are different BRANDS of autoinjector. Both brands contain
adrenaline. Each brand has different operating instructions! It is much better to
take a few seconds to read the instructions and administer the medication correctly than
to rush and make mistakes in a panic. In the past rescuers have injected themselves.
prepared to act quickly Dont make the same mistake. %

'


38 | Risk Assessment
means call your countrys emergency number Risk Assessment | 39

Manage Anaphylaxis Risks Anaphylaxis Action Plans ASCIA has Action Plans and many
other resources: www.allergy.org.au
There are four sectors that need to consider the risks of anaphylaxis.
ASCIA is a professional medical organisation, comprised mostly of scientists and specialist
1. Children in care.
 +G{>++ + 
 @ ?
 Y ><Y=+O{>?
2. Schools. Primary and Secondary ASCIA provide useful information Personal Action Plans should be stored with medication.
3. Workplaces. All workplaces, including the workers in child care employment. and resources about Allergy and They contain:
4. Voluntary organisations, especially those working with minors. This includes Anaphylaxis and also produce " Individuals details - name, age
> $+   >   + J +^> $? ASCIA Anaphylaxis Action " Emergency contact details
Each of these sectors should have an anaphylaxis policy and an anaphylaxis Plans. Action plans provide " Extra instructions
management plan (pg 53) and communication plan (pg 45) in place. For the Child Care important information to help all " General signs and symptoms
sector there are stringent legal requirements that impose obligations on the child care stakeholders reduce the risks of " Doctors signature - this is a medical document
centres, the employees and the parents. anaphylaxis. " Instructions for using either Anapen or EpiPen
Case study. Action Plans must be supplied to child care centres and schools$  
Voluntary Organisations - Duty-of-Care who is diagnosed with Anaphylaxis.
 Billy, was a member of a local football
   In a workplace, although it is not compulsory to provide an action plan in a workplace
club and known to be allergic to wasps.
duty-of-care responsibility when running environment it is strongly recommended and employers should encourage workers to inform
 While playing football away from the
activities. @;$  #  
home ground, some wasps were
When a duty-of-care relationship exists there ; @$?
attracted to a plate of cut up oranges.
is responsibility to
 Billy was stung on the hand when he ate BDUJPO!QMBO!GPS
1. Do what a reasonable person would do Child details
2. In similar circumstances
one of the pieces of orange.
 Billys adrenaline autoinjector was in his
Date of birth www.allergy.org.au B o b qi zm b yjt This is a sample
Anaphylaxis
3. With the same level of training For use with EpiPen adrenaline autoinjectors
sports bag, in the dressing room. action plan for
Name:
Date of birth: ! N J M E ! U P ! N P E F S BU F ! B M M F S H J D ! S F B D U J P O!
 An ambulance was called, and Billy was Child photo  Swelling of lips, face, eyes Epipen.
 Hives or welts
rushed to hospital.  Tingling mouth
 Abdominal pain, vomiting (these are signs of a severe allergic
 The subsequent investigation revealed What child is Photo
reaction to insects)
BDUJPO
the football club anaphylaxis policy Allergic to
!

 For insect allergy, flick out sting if visible. Do not remove ticks. What to do for
helped Billy survive.  Stay with person and call for help
 Locate EpiPen or EpiPen Jr mild reaction
Parent/carer  Give other medications (if prescribed) ....................................
Confirmed allergens:
Dose: ..........................................................................................
Details  Phone family/emergency contact

Mild to moderate allergic reactions may

>iVi`i>>>
Organisations should Signed by Family/emergency contact name(s):
Watch for any oneviv}}v
>>
What to do for
" Conduct a risk assessment. Doctor Work Ph:
! B O B Q I Z M B Y J T ! ) T F W F S F ! B M M F S H J D ! S F B D U J P O *! anaphylaxis
" Develop a policy Home Ph:
Mobile Ph:
 Difficult/noisy breathing
 Swelling of tongue
" Have communication plan Instructions Plan prepared by:  Swelling/tightness in throat
Dr:  Difficulty talking and/or hoarse voice
printed on Signed:  Wheeze or persistent cough If in doubt...
Date:  Persistent dizziness or collapse
A Risk Assessment should be part of the planning for every activity. Some risks can be plan and on Ipx!up!hjwf!FqjQfo  Pale and floppy (young children) give the
anticipated. For example a child playing sport could have an anaphylactic attack if they were autoinjector 1 2 ! B D U J P O! autoinjector
1 Lay person flat. Do not allow them to stand or walk.
allergic to insect stings. The mid-outer thigh If breathing is difficult allow them to sit.
is the BEST site for 2 Give EpiPen or EpiPen Jr
For privacy, Action
Form fist around PLACE ORANGE
EpiPen and END against outer 3 Phone ambulance*- 000 (AU), 111 (NZ), 112 (mobile)
Example: FASTEST absorption of PULL OFF BLUE mid-thigh (with or
4 Phone family/emergency contact
Plans should be
SAFETY RELEASE. without clothing).
5 Further adrenaline doses may be given if no response after
medication. 3 4
 Billys club knew he was anaphylactic from questions on the registration form.

ASCIA 2013. This plan was developed by ASCIA

5 minutes (if another adrenaline autoinjector is available)
If in doubt, give adrenaline autoinjector displayed discreetly
 The club policy encouraged members to Let People Know, so Billys team mates PUSH DOWN REMOVE EpiPen.
After giving adrenaline:
U
iVi
*,vii>i}vvi
to enable rescuers
knew about his anaphylaxis and they all knew where his autoinjector was located.
HARD until a click Massage Ui>>i`V>viii>>>>>
is heard or felt injection site for
The difference between to recognise
EpiPen is generally prescribed for adults and children over 5 years.
and hold in place 10 seconds.

 A communication plan was developed which included an awareness program. for 10 seconds. EpiPen Jr is generally prescribed for children aged 1-5 years.
*Medical observation in hospital for at least 4 hours is recommended after anaphylaxis.
EpiPen Action Plan and
 Information posters for conditions like anaphylaxis, asthma, epilepsy and diabetes an Anapen Action Plan is
Instructions are also on the device label
and at www.allergy.org.au/health-
Additional information
Note: This is a medical document that can only be completed and signed by the patient's
individuals and their
set of signs and
professionals/anaphylaxis-resources

were on the clubroom notice boards and articles were printed in the club newsletter.
treating medical doctor and cannot be altered without their permission.
the instructions on how
 The communication plan made sure


%

% were to use each device symptoms.
all aware that Billy was anaphylactic and they were all properly trained. A copy of the Action Plan should be stored with medication.
 The policy required that an Anaphylaxis trained person was present at every activity. Throughout this book the word parent includes legal guardian
40 | Risk Assessment A sample Risk Assessment Plan is
available from www.acacqa.gov.au means call your countrys emergency number Risk Assessment | 41

Assess Hazards and Minimise Risk *,*

$-  : A risk rating table can be customised to meet needs of an organisation
Hazard Assessment is required for child care and most other workplaces. Use the matrix to Activity must not proceed while any risk is rated VERY HIGH

Risk rating & Action

VERY HIGH
evaluate the consequence of hazards, then develop strategies to reduce the level of risk.
Risk Assessment Matrix Consequence (C) ; YY;  
HIGH $@X<=
Hazard (eg Anaphylaxis) 1=Slight 2=Minor 3=Moderate '*+ 5=Severe
Risk management plan must be in place before activity begins
Death or MEDIUM
No treatment 1st aid 1 or 2 1st aid >2 Hospital 1 or 2
Hospital >2
No further action required
LOW
5 = Almost certain LOW MEDIUM HIGH VERY HIGH VERY HIGH
Is expected during activity
How to use the template to complete risk assessment. Two worked
4 = Very Likely #?# ;?
Likelihood (L)

LOW MEDIUM HIGH VERY HIGH VERY HIGH

Expected more often than not # 1 Sharing lunch, for an anaphylactic child who is allergic to food (eg egg products). After
3 = Likely the strategy is put in place the residual risk is MEDIUM. The risk rating table (above) shows a
LOW MEDIUM HIGH HIGH VERY HIGH
Will occur on occasion MEDIUM risk activity can proceed provided the risk management plan is in place.
2 = Unlikely # 5 Working alone outdoors. Although it is unlikely that the worker will get stung, the
LOW LOW MEDIUM HIGH HIGH   $ ?
 YY?
$ ; YY
May occur but more likely not to
\$  $$ @+ 
1 = Very Unlikely LOW LOW LOW LOW LOW practicable steps have been taken to control the risk.
Practically impossible to occur
Risk Assessment for Anaphylaxis Risk Rating Residual Risk Person responsible
Instructions to use this matrix: 1. Look up Likelihood score 2. Look up

Refer matrix above

Refer matrix above

Refer matrix above

Consequence
Strategy

Consequence
Consequence score 3. Read Risk from table.

Likelihood

Likelihood
Type

Risk

Risk
In schools and child care strategies must be
No. Activity Hazard developed in consultation with parents. Name Done

Each workplace should develop a set of strategies

that is suitable for that workplace

#1 BYO Lunches Children share lunches. Possible Develop and implement No Sharing policy. Eat inside under
Room
contamination. 3 5 VH 
  
  
  2 3 M
Child Day Care Centre

Coordinator
Individual Anaphylaxis Plan in room. Send info in newsletter.
2 Cooking activity Exposure to allergen. Hidden ingredient.      
   
Accidental cross contamination of ingredients parents to determine safe ingredients/brands. Separate utensils Activity
3 5 VH 1 3 L
for different foods. Correct labelling & storage of ingredients. Coordinator
Develop and initiate cleaning policy. Invite parents to assist.
3 Excursion Exposure to trigger, communication Advise all workers of childs allergy. Ensure medication and Activity
@ +  4 5 VH
copy of emergency action plan is with child. Take mobile
2 5 H Coordinator/
medication. 
  
 
  ! 
Manager
immediately available. Approved by Parent and Manager.
4 Catering for Accidental cross contamination of food Use only approved caterer. Advise caterers to prepare food Activity
function platter, supplied by caterers for in-service 3 3 H separately, supplied on labelled platters. Nominate person to 2 4 H Coordinator/
training receive food. Advise all participants of risk and precautions. "
#

Workplace

#5 Outdoor worker  <= Uniform protects ankles. Inspect meters before approaching. Safety
working alone works alone as a meter reader 2 5 H
Carry mobile phone / radio as required. Establish monitored
2 5 H @
default SMS reporting. Utilise GPS monitoring. Carry
medication on person. Wear medi-alert. Supervisor

6 Power line tree Worker allergic to bees Advise all co-workers. Medication immediately available.
"
#

clearing 2 5 H 
 

$ 

%

 2 5 H
Manager
present. Establish alternative communication path if required.
42 | Risk Assessment
means call your countrys emergency number Risk Assessment | 43

Asthma Risk Assessment

se sm Asthma Action Plans
Common Asthma Triggers Possible Risk
k Management Strategies
t Asthma Management Plans and Asthma Action Plans are an integral part of an asthma
"Pollens from grasses, trees, shrubs
bs Consider removing problem plants around schools, child policy and communication plan. There are a great variety of Asthma Action Plans available. A
care centres and work places. sample of some of the range is presented here.
What to
"Weather Changes especially sudden cold Careful planning of night time activities, camps, working or Wh

changes; moving from hot to cold. overtime, plan for unexpected delays. Preheat rooms. Wheeze
You ma
y or ma
y

[PVU 7SHU heard

is usually
___
______
[OTH(J
___

"Moulds are affected by wind rain and

______
(Z by:___
PPE* when gardening, potting or working with mulches. Complet
ed

Date: ___
__/___
__/___
___

ths by
your loca
l doctor
Cough
ugh m
A dry co
temperatures. Can be present in garden ION PLAN
6 mon
wed in
ASTHMA AC ID label
Scheduled cleaning of bathrooms, commercial laundries; Name / IEVER
To be revie

ASTHMA ACT
TION PLAN h
Name:
Stop REL UHM[LY
TLKPJH[PV^LSS Chest tig
ILPUNdoctoH`Z
r  chil

mulches and wood chips.

An older
use nontoxic cleaners. Doctor:
Green: Feell l Good
Take this ASTH
MA ACTIO N PLAN with you when
you visit your
MVYFFFFFF
FK

Continu
e chest pa
CONTA CT DETAIL
S
in
When We H[PVU! VENTER
Shortnes
EMERG ENCY
Feel Good Orange : Sho TLKPJ
;,9nd
rt Wi
PRE
S CT DETAIL
,=,5 DOCTO RS CONTA Name
Take 79
Red: Bad

ing
ei
"Animal dander and saliva Consult with parents before introducing a pet day. Cats, t
no short win Short Wind Short Wind NAME Phone
Feels lik

Improv
d ise: Relationship

Increase
DATE
t
no cough t
tight chest Bad Short Wi fore exerc DUE
nd Be
A CHECK -UP
NEXT ASTHM e
Continu
dogs, horses, rodents, even insects, can trigger asthma. t
no whistle
breathing t
whistle brea
t
short wind
thing (wheeze) t
short wind
t
fast
all the time
cough (se
e back
of page
)
(almost no sympto
ms)
RELIEVER U ALWAYS
TLKPJH[PV[V
CARRY YOUR cking
Su
RELIEVER WITH

Peak ow* (if young

used) above:
YOU

when walking brea thing ee ze, L Asthma under control

FFFFW\MM
Z In
My medicati or playing t
ll - a cold, wh WHEN WEL HK H`
we LZ

ASTHMA ACTION PLAN

whistle breathin un OTHER [PT
) er
on: In old
CTIONS
g a lot When
the ing INSTRU exercise
ation: __ with Improv e, what to do before

"Chemicals & cosmetics Develop a dress code policy. Avoid highly scented
.............................
s, trigger avoidanc
r) medic ter is:__________
..................................
e
My medicati t
cannot talk ue puffe Your preven __
(e.g. other medicine
Continu
rug
..................................
.................................. )
(NAME & STRENGTH ..................................
..................................
.......................

on: VER (bl ______

Take of __
times every day VENTER RELIE ____ ..................................
..........................
PRE.................
..................................
..................................
St ..................................
......

Short Wind ___ puffs Take

blets this ASTHMA ACTION PLAN with you when you visit your doctor
puffs/taTake
______
__ ................................. ..................................
..................................

Danger Pla
Take __ ______ with your inhaler ..................................
The ch
deodorant. Include cleaning staff in communication plan. day. ................................. .................................. ......................
Use a spacer

ncer 3 to 4 times a __Your__relieve
..................................
______
..................................
Myys S
Alwa t
sit ____r is: ..................................
..................................
(NAME) ..................................
..................................

ym
use 4 puffs when up
............... .................
ab .................................. .................................. ......
spa TER: __ .................................. ..................................
Aserthwith
spac ic
m your ort needed e PREVEN Take
puffs
NAME g or shortness
of breath
DOCTORS CONTACT DETAILS EMERGENCY CONTACT DETAILS
.................................
..................................
................. ..................................
..................................

Continu
..................................

puffer if youa Acti Always carry t
have 4 puff symptoms like

wheezing, coughin .................

on Pla with your blue puffe s of blue puffer When: You have DATE Name
waking up with
asthma,
Symbic
r wait a short time and htness, ath, NEXT ASTHMA CHECK-UP DUE 3 times per week, Use a spacer
with your inhaler

"Foods & Additives 7

 8
99

 <
 
 r e.g. more than activities) Phone 
have one
ort M
n you and use/BitNFwhe chest tig
rsens - ly, shortness of bre
g more relieve
ainte ____ n worse (needin ring with usual
na have short wind you
____
If wo Asthma getting than usual, asthma is interfe Relationship
and
nce An ____ t
send someon L more ms (if used) between
t
quick WHEN NOT WEL
____ sympto Peak ow*
doctor
d Relie %BUF ____ e to hea athing bre athing Contact your
Norm
ver Th
@@@@ ____
____
for__help lth bre
clinic reased effort of the
__ with INSTRUCTIONS
................
erapy @@@@ : s)

triggers. Alert cooking staff, catering suppliers.

..................................
dicationter:
@@@@ ____ OTHER ing extra medicine
______
.................................. )
al mo @@@@ ____ inc r) me Imp rov medicines, when to stop taking .................................. (NAME & STRENGTH
@@@@ ____ ffe taking preven ____ WHEN WELL (e.g. other
day (almost ......

de 6TVB @@@@
t
@@if@@@@ (blue pu __________
Keep sary. Asthma under
times everycontrol no symptoms) ALWAYS CARRY YOUR RELIEVER WITH YOU
t ..................................
..................................

as neces
M
CFT
U
1&' you@@@@ still have LIEVER day) blets
..................................
.........................
..................................

Take RE _ puffs of ____

..................................
MY SY 
@@@@
@@@@ @@@@ bad short win Take
8 times
apuffs/ta .................................
Peak ow* (if used) above: ..................................
...... .................................. ..................................
......
MBICO
RT AS
@@@@
@@ take @@@@
4 more puff(1s 
@@ d, Take __ __ urs (6-
to 4 ho ur doctor. __ _da ys ..................................
..................................
..................................
..................................
..................................

____for_

4ZNC @@@@ Your preventer is: OTHER INSTRUCTIONS ................. ................. ...................................................................................................................................

every 3
.................................. .....
THM @@@@ .................................. ..................................
______ puffs/tablets
(NAME & STRENGTH)
puffsJDPSU
puffs with your inhaler
spacer proving see yo
@@ @@@@ ................................. ..................................
A TR
Asth t
keep@@usin least  Use a spacer
(e.g. other medicines, trigger avoidance, what to do before exercise)

"Dust & Dust Mites S

Schedule cleaning to reduce dust levels during open
.................................. ..................................
____r__
@@@@
ation at


4Z 
H EATM @@@@ ................. .................
-NJO @@@@ Take times every day ................. .................
NCJDP ma g the blue
................................. (NAME) ............................................................

03
ENT @@@@
@@@@ If not
im _ of relieve is:
R medic
.................................. .................................. ..................................
......

______ Your
you feel better
QIPOpuff
...............
SU

puffs are
IS:  ..................................
F
@@ er until RELIEVE
(1 Use a spacer with your inhaler .................................. .................
................................................................................................................................................................................
@@ STEROID:
.................

H @@@@ ................. .................
MY RE
IF OV
-up
puffs
or the hea @@@@ Take @@ @@@@ roids use Your puffs
@@@@oral ste Take
reliever is: .................................
..................................
...... ..................................
.......................................................................................................................................
..................................
..................................

GULA
R TR ER A wor ker lth@@@@@@@@@@@@ While taking @@@@ ..................................
(NAME)
................. ................................................................................................................................................................................

com y@@ ..................................

ttimes. Vacuum frequently. Use damp cloth for dusting. es ty breathing,

5BLF EATM t


. PERI @@ a da Take puffs ..................................
.................
................................. .....................................................................................................................


ENT Z
B TUINB OD OF 2 @@ @@@@ times
4 @@ increasing difcul your inhaler


JOIB EV
TZ to 3 within 3 hours, 
Use a spacer with
When: You have symptoms like wheezing, coughing or shortness of breath g reliever again
...............................................................................................................................................................................
ERY OPU
JN 3 DA Asth @@@@
BOE

MBUJPO DAY: QSPWJOH NQUPNT
B YS: @@@@ ,Use a spacer with your inhaler (needin symptoms)
T

JO
UI t

*
BN SF
HF ma e @@
tightness
 Asthma is severenight with asthma and

03
Dr Comment GET WORSE
................................................................................................................................................................................
at


JOIB F
NPS
VT UUJOH
X merg d chest aking, waking often Peak ow* (if
used) between
JOIBMB JOH
NPSF
U - marke IF SYMPTOMS
OJOH
ficulty spe
MBUJPO doctor today
RELIE T

JO
UI UJPOT IBO
 s:
PSTF
0
3
SIGN If severe
ency
athe, dif
; Contact your

"Exercise is a common asthma trigger andd

VER: F
FWF
B
EB
4ZNC more CTIONS
ng to bre
................ s) week, waking up with asthma,
OJOH
I shou Z
S OF Asthma getting
................. worseOTHER (needing INSTRU reliever e.g. more than 3 times per
taking extra medicine
JDPSU
S WHEN NOT WELL ..................................

A
Allow time for people to warm up AND warm down. Aim Use Sy FWFSZ ld: AN AS
struggli it ) more symptoms than usual, (e.g. other medicine ng this
s, when to stop
.................
mb
EBZ FMJFWFS t
4ZN THM ter:.................................. (NAME Y. Wa & STRENGTH asthma is interfering with usual activities)
Keep taking preven
MEDIATEL bri
ico

$POUJO
QUPNT A EM e lips day
for re
lief puffs rt 1
of my inhala puffs VF
UP t
&YUS
HFUUJO blu
ERGE ffe r) IM oth.........
.................................. er times every Prednis Please olone/predniso
h you wh
ne: en
Peak ow* (if used) for .................................. and
g between
.. days

I shou asthma tion when 1-64


J

VTF
N
Z
SFH
FNF
E
JDVMUZ
H
XPS
TF
RV NCY: Keep putaking
(blue................
R ................. puffs/ta blets.................
preventer:
, take an .................
......................................................................................................................
nutes................. Takepla
nOTHER wit
ur docto
.... each mornin
.................r
ld alw ever UP
SFM OIpuffs BMB VMBS
F t

-JUUM JDLMZ RELIEVE
Take
4 mi.................
in................. ................. L.
(NAME & .................
STRENGTH) ....................... ................. ..................................
it yo INSTRUCTIONS Contact ...... doctor
.................your

affects about 50% of people with asthma.

symp
JFWF
T UJPO
4ZNCJD F
PS
O
CSFB of t ITA vis .................
ays ca toms need puffs WFSZE UIJ pu ffs Take en puffs/tablets HO SP times every day yo u tal ..................................

to control asthma rather than avoid exercise.

P
J provem
.................................
arest
...........................................................

TQFB Take 4
.................
ed ZNQUP BZ
USF SFMJFWF NQ OH
PS ................. (e.g. other medicines,
spi................. when to stop
................. taking extra medicines)
or the ho
rry my PSU
X no im................. with your inhalerne
.................
S
JOIB SPWFNFOU

.................


4UBSU
B BUNFO
OR or the..................................
NT IFOF .................................. ......

nutes. If e...................................................................
Symb LJOH Use a spacer ..................................

DPVST WFS
O U
MBUJPO GSPN

blu ..................................
DOCT k or.................
................................................................................................................................................................................
MY AS
THM
icort
Turbuh

$POUBD F
PG
Q
SFEOJTP
FFEF
E
T
4ZNC
JDPSU
for 4 mi to yourYour reliever
Use
to spyoureainhaler .................
is:a.................
spacer with
le
(NAME)
............. ..................................
..................................
................................................................................................................................................................................
..................................
.......................
t

*
DB A IS aler IF I HA d go ab ..................................
O
UBL
F
QBSU
STAB
LE IF:
U
NZ
E
PDUPS MPOF
VE 4 puffs
an
breTake e, un
ath................. Your reliever
................ puffs LY
is: '000'
ON.................
.................

lance,
.......................................................................................................................................
................. ..................................
2003
.................
October 96475
..................................
................................................................................................................................................................................
XJUIP
JO
OP I SHOU ANY OF ng to GE NT am bu (NAME)
..................................
......
..................................
.................................. MIU
......
VU
BT COUR gli NCE Take UR ................................. an ................. ..................................
If strug
THE .................


"/% UINB
T SNBM
SE
S
LD DI ABOV
BULA itin puffs g for .................
..................................................................................................................... ..................................
.................

ZNQUP QIZTJDBM
B
................. ...............................................................................................................................................................................
E OF SAY A
AL 00 wa
.................................. . ..................................
P ED
PR I AM 0 FO E DA
call an AM ..................................
r or wh ile nu tes ..................................
ry 4 mi

Parents of children with asthma, who

.................
t
*
*
EP
t

NT
DUJWJUZ

HAVI NG inhaler
AMBU ER SIGNSlips
R AN with your
EP
OP N
NIIS V NG ctoa spacer
*PPE = Personal Protective Equipment 5BLF
to the do
SO  Use
eve

Examples using the risk assessment matrix

................................................................................................................................................................................
U
XBL

Y
 OLO
LON A SE ffs your ................................................................................................................................................................................
NE puwith
the way
CFDB E TA ,  Use-a4
F
V Q
B 
NH
P TAB WHIHIL VERE LANC ffe r spacer inhaler

blue pu
VTF
P BL
BLET ILE
G
BTUI U
OJHIU
PS
JO UBCMFU
T
QFS
S

TS:
S: ST
S
LE
LE I AM AM W ASTH
MA AT ANDOn
E
giv e breathing proble
ms,
NB
UIF
N
EBZ
G TA
AR AI e to ency (severe
reliever has
. continu
OTHE ____ PS




N

NHH
Q RT T MY TING TACK Asthma emerg very quickly,
R INST PSOJO ____
QSSF
FEEO ASTH FO ms get worse
H
____ OJT
JTP t
4JU
V MA FIR R THE AM IF SYMPTOMS GET WORSE Asthma is severe (needing reliever again within 3 hours, increasing difculty breathing,

attend school or child care facilities are

E

EB PMP
MPO S sympto
DANGER SIGN little or no effect)
____ RUCT ____ BZZTT
0
03 OFF

QSJHI waking often at night with asthma symptoms)

Child care centre has three children with asthma enrolled. The Asthma management
____ IONS ____ ____ U
BOE ST AI BULA
____ : ____ __ t
5
t

5BL
T

TUBZ
DB D PL NCE below:
____ ____ ____ F
F

JO

JOIB MN AN: Peak ow (if used) Peak ow* (if used) between and
____ ____ ____ ____ MBUJPO Keep taking preventer:......................................................................................................................
____ ____ ____ *G
UIF
____
____
____
____ ____ __ SF
JT
OP

4Z

PG
NCJDP
(NAME & STRENGTH)
nce immediately OTHER INSTRUCTIONS ;asth Contact your doctor
ma.org.autoday
____
DIAL 000 FOR
____
JNQS Call an ambula onal
____ ____ PG
4Z SU
8B Take ................................. puffs/tablets............................................................ timesemerge every day ncy (e.g. other medicines, when to stop taking
www.nati extra medicines)

required to provide the school or centre

____ ____ ____ NCJDP PW
P FN JU
 this is an asthma
____ __ IF I NE FOU
UB o
N Say that

plans supplied to the centre identify triggers: grass pollens; hair spray, cosmetics and food
SU
VQ r as often as
needed Prednisolone/prednisone:

AMBULANCE
____ ED M t
*G
t


*G
P

PO
UP
B
LF
BO JOVUFT taking relieve
____ INHA ORE OMZ
MZ

7F
7FOUP NB YJNVN PUI FS
JOIB 

................................................................................................................................................................................
Keep
330
33
330
301_E
301 __ LATION THAN
PGUFO MJO
JT
B
PG

MBUJPO
 Use a spacer with your inhaler Take ........................................................................ each morning for .................................... days
1
_EN
ENG
NG_Ac
_A I mus S (TOT 12 SY
BT
OF WBJMBCMF JOIBMB

Actition
Ac
Acttitiio
tio ion t AL) IN MBICO FEFE UJPOT Your reliever is:
the sa see my do
onPl
nP
n .......................................................................................................................................
Pllan
Pl
Pla
la
a
an
an_
n_FA
n_FFA.in RT t
4
t


4UBSU
B
VOUJ
UBLF
 under 12 years. (NAME) ................................................................................................................................................................................

with an up-to-date action plan for asthma.

A
A.i.ind
A. indd
in
ind
nd
n dd 1
dd ANY UJM
IF

QV nded for children
me da ctor or DAY,
DPVST MQ
BSS T
BT * Peak flow Take not recomme

<X  =?

................................. puffs ...................................................................................................................
y go to EJSFD F
PG
Q JWFT

................................................................................................................................................................................
hosp UFE

X SFEO
E JTP
ital t


t
& IJMF
X MPOF
U ................................................................................................................................................................................
&WFO
J BJUJOH BCMFU  ................................................................................................................................................................................
G
NZ
T
GP

S
UI T
BT
Use a spacer with your inhaler
*
TIP ZNQUP F
BNC

The action plan must be completed by

VME
TF NT
BQ VMBOD ................................................................................................................................................................................
TFSJP F
N QF BS
UP
F
VT
BT Z
EPD TFUUMF

Workplace; $$ "?
 UINB
B UPS
JN
RVJDL
NFEJB MZ


UUBDL UFMZ
B Asthma emergency (severe breathing problems,
GUFS
B

DANGER SIGNS symptoms get worse very quickly, reliever has

 <=?

little or no effect)

 YY?
$(pg 41)  @ 11/11/
DIAL 000 FOR
AMBULANCE
Call an ambulance immediately
Say that this is an asthma emergency
Peak ow (if used) below:

management must both approve the strategies before work can proceed.
09 9:1
5:5 Keep taking reliever as often as needed www.nationalasthma.org.au
6 AM
* Peak
P k flow
fl nott recommended
d d ffor
or children
hild under
d 12 years
years.

Example of Risk Assessment for Asthma Risk Rating Residual Risk Person responsible
Consequence

Consequence
Refer page 40
Likelihood

Likelihood
Strategy
Activity,
(pg 40)

(pg 40)
Type

Risk

Risk
No. infrastructure or Hazard Name Done
In schools and child care facilities, strategies must be
environment
developed in consultation with parents

1 Lawn Mowing Grass pollens known trigger 4 3 H Arrange for gardening to be conducted on weekends. 2 3 M Manager
Child Care

2 Hair spray, cosmetics, Child care workers trigger asthma in sensitive children Perfume and cosmetics policy. Communication plan to ensure
3 2 M 1 2 L Manager
deodorant, perfumes   
 
 

3 MSG, sulphites, Snack foods and lunches may contain ingredients that Food policy, no sharing policy. Treat alternatives provided by Coordinator/
4 3 H 2 5 H
salicylates trigger asthma parents. Communication plan. Manager
4 Employees triggered Cleaning and vacuuming disturb dust. Communicate with cleaners. Arrange cleaning to be done after Manager/
4 4 VH 2 4 H
Work

by dust work. Budget for carpet replacement with alternative coverings. "
#

5 " %
4 Occupational asthma caused by wood dust "
#

5 4 VH Dust extraction system. PPE. Positive pressure masks. 2 4 H
Supervisor
44 | Education & Child Care
means call your countrys emergency number Education & Child Care | 45

Regulations, Codes and Procedures Communication Plans

First Aiders in the workplace need to have knowledge of and comply with, state and A Communication Plan is an essential part of
territory regulations+@codes of practice (also called compliance codes) and managing anaphylaxis or asthma risks to identify- Stakeholders:
workplace procedures?;
;
 ; " Who needs to know (the stakeholders) In an 
environment the
comply. " The roles of each of the stakeholders stakeholders will include
" What information is needed  First Aiders
Regulations control a wide range of activities in the workplace such as " How the information will be distributed  Employers

@

  Co-workers
" Where medication will be located

 $
@  Managers / supervisors
A card system can assist children to summon  Caterers
Codes of Practice give approved methods of how to comply with regulations for example help. The colour of the card, visible from a
 @ 


  In a school setting stakeholders will
" G; 
;@(pg 50) # ;@ Medical Alerts communicate to re rescuers include
required for workplace CTIC
 Carers & Parents
HYLA  O@
" Describes how to conduct a hazard assessment (pg 40) ANAP N CY
G E
" There are many Codes of Practice/Compliance Codes covering a wide range of workplace EMER 0
 Teachers (also Relief &
L 0 0
health and safety issues CAL UR
GE Temporary) and Teachers Aids
I N G AS
B R
O
S
R IST
NT  Speciality teachers including
J C
E EQT
R AN
Workplace Policy & Procedures are instructions written by an employer on how to perform AUTO
I N
U CE Sport, Drama, Music, Cooking and
IRE
tasks safely. Some examples of tasks that should have a P&P D Teachers on Yard Duty

 
 ;  Food industry staff including
In a factory the stakeholders will include
  #
 canteen and caterers
 Management  Administration, Cleaning staff,
 Union representatives
National Child Care Legislation  O@@
Maintenance, and Bus Drivers
 


> @ 
$; 
 @
medications in child care settings. These are regulations 90 to 95.
90 Medical Conditions Policy.

This regulation requires education and
care services to have a written policy
about medical conditions.
 Health & Safety representatives  School Camp Providers
 Canteen staff / Catering contractors  Volunteers
92 Medication Record  Co-workers / Supervisors   
This regulation is about medication records which
must record the following details:
) ! Privacy is important. Personal information must be stored securely. The
information can only be revealed to authorised people. The communication
Authorisation to administer plan should explain who would have access to this information. In a school this would
Medication Dosage Name of 
 #?; ;

@
?
91 Medical conditions policy must child Method Time and Date A workplace must provide opportunity for new employees to reveal life threatening conditions
be provided to parents. Name of who administered during the induction process. The employer must act on the information when it is supplied.
This policy is very important for  _<see reg An employee may choose NOT to reveal anaphylaxis, asthma or other medical conditions.
children with medical conditions such 95) Signatures This will be more likely to happen if an employee senses they will be teased or bullied about
as asthma, diabetes and anaphylaxis. their condition.
93 Administration of medication. 94 Exception to authorisation requirement A communication plan should explore ways to encourage employees to inform key people
anaphylaxis or asthma emergency. Medication $
# $@ ; 
Medication must be authorised. It workers. When co-workers know how to use an autoinjector, and know where it is located,
may be administered to a child without an
must be recorded. In an emergency  @?
authorisation in case of anaphylaxis or asthma
medication can be authorised verbally .
!  and newsletters to raise awareness about medical conditions in the
emergency. In such case notify parent and
by parent or if unable to be contacted school, club house or workplace. Employees are more willing to reveal important medical
emergency services as soon as practicable. information if they feel the information will be used respectfully, in a supportive environment.
$?

95 Procedure for administration of medication Seek permission

Medication must be Administered from its original container, with childs name on it Always seek permission from an employee before passing on medical information that has been
in date Instructions must be followed. The dosage of the medication and the identity @?
  $;#how the information will
of the child must be checked by another person (Family Day Care do not need to check be circulated, why the information will be circulated and who the information will be provided to.
with another person) This information can be included on the medical form, at commencement of employment.
46 | Education & Child Care
means call your countrys emergency number Education & Child Care | 47

 !!  !" Understanding Child Care Law

Generally children and infants have different heart rates and respiration rates from The Australian Commonwealth National Child Care Regulations.
adults. These differences vary, depending on many conditions. Government makes laws that apply ^ >; 
Adults 12-5 y 5-1 y <1 y to the whole of Australia (for example recognised it would be desirable to have
In adults it is generally accepted that Pulse/min 60-100 80-120 95-150 100-180 taxation law.) uniform child-care regulations across Australia.
 Normal heart rate (at rest) is about 72 Breaths/min 12-20 20-25 25-35 40-30 State Governments make laws that only
>;  
 Normal breathing rate is about 15 Temp oC 36-37 36-37 36-37 36-37 apply to a state (for example health or legal jurisdiction to create this legislation, so
 Normal temperature is about 37oC. Table shows approximate range of normal clinical values by age education.) + 
>
Local Governments make laws that action to pass the same legislation in each
Children and babies usually have about the same only apply to a council (for example use
temperature (37oC) as adults of incinerators.)
The Australian constitution prohibits
Heart rate (pulse) and breathing rates are fastest in
the Commonwealth government from
infants and younger children and slow down as the child
passing laws about things not authorised
 ?>>;
coordinate implementation of National Child
Care Legislation.
Since the introduction of the National Child
Care Regulations the Child Care law in all
?AEDs are not recommended
in The Constitution. Education and States will now be very similar to other States
for use on infants (under 12 months) is because the
health are matters for State legislation. but may have important
devices are not reliable when checking if the heart rhythm
is a normal rhythm. The faster heart rate of infants can cause the AED to give a false differences.
reading. National Laws are not one single act of the WHO is COAG?
Commonwealth Parliament but are the same The Council
There are a number of other differences between smaller children and
legislation passed separately in each state. of Australian
adults.

Cartilage in the trachea is not fully developed at birth which means ]G;"
<>=;
the airway is very soft and pliable and very easy to obstruct. with existing State laws. An example of created to oversee policy reforms which
Infants skull bones are not fully knitted together, which can make this is laws about who can administer an require cooperative action by Australian
them more vulnerable to head injury. autoinjector.  "   ?
Proportionally an infants head is much larger than an adult. A babys head is relevant State may change the wording of the > ]O<]

nearly 20% of total body surface area, while an adult head is only about 10%. A burn to an National Law for that particular state. O;=>>

infants face is even more serious than a burn to an adult face. National Child Care Law and Regulations.
So even though National Child Care
Infants do not have fully developed temperature regulatory systems which means infants National Child Care Regulations apply
Regulations are intended to be the same +Y+ 
are more susceptible to hypothermia and hyperthermia. Children can become dehydrated
very quickly, especially if they are vomiting or have episodes of diarrhoea. across Australia they still vary from state to & family day care but do not apply to
state. You need to check what the law is in schools. Regulations for schools are
AED* for child care ; your state. the responsibility of each of the State
{@$$

; 

$ ;  Education departments.
is over the age of 8 years old. Victorias Ministerial Order 90 is a
For children under 8, use with paediatric (child) pads if available. If child pads are not 
 ? 
available use adult pads. If the pads cannot be placed without touching States have similar legislation (pg 44)
each other, position one pad on the front of the casualtys chest and the WHO is ACECQA? The Australian Childrens
  $  ?@$

 
>

 
the size of the shock to the size of the casualty. Check manufactures <>>=;$ >
instructions. national leadership in promoting continuous

'%;

'%
 They are not improvement in early childhood education and
reliable when checking infant heart rhythms. care and school age care in Australia.
Care should be taken when purchasing an AED for an education or care
setting to select a device that is suitable for the age group.
{|
#{@$(pg 5) >> 
;;;???

48 | General First Aid
means call your countrys emergency number General First Aid | 49

Principles What is First Aid? Its the immediate care of an injured or Communication
of First Aid suddenly sick casualty until more advanced care arrives.
 @     ?
X  $ + @
{ 
%
+ culturally appropriate ways of communicating that are courteous and clear. It may sometimes
 Preserve life This includes the life of rescuer, bystander and casualty. be necessary to communicate through verbal and non-verbal communication and you may
 Protect from further harm Ensure the scene is safe and avoid harmful intervention.    " ?
@
 Prevent condition worsening Provide appropriate treatment. needs to maintain respect for privacy and dignity and pay careful attention to client consent
 Promote recovery Act quickly, provide comfort and reassurance, get help, call
Helping at an emergency may involve:
.  @?
  >  Reports
@ While waiting for help and if time permits, make a brief written report to accompany the

;  +$ @  ? casualty to hospital. This will reduce time spent at the scene for ambulance crew and further
Reasons why people do not help: assist medical and nursing staff with initial patient management. A report can be written on a
O ;O!$   spare piece of paper and should include the following:
 ]  <$++$ $ = Date, time, location of incident
of bystanders (embarrassed to come forward or take responsibility) Casualty details]+{^+? The back inside page

~X
@%*

  $?{@ Contact person for casualty - Family member, friend. Form, which can be torn
@? ;$@ +    What happened - Brief description of injury or illness.  %'%

%
appropriate care, even if you dont know what the underlying problem is. Remember, at an First aid action taken What you did to help the casualty. incident.
emergency scene, your help is needed. Other health problems Diabetes, epilepsy, asthma, heart problems, operations.
Getting Help: Medications/ allergies Current tablets, medicines.
Call 
$ +@? from a mobile phone fails, call 112.
 $ _;  ;  #location
When casualty last ate or drank Tea, coffee, water, food.
Observations of Vital Signs - Conscious state, pulse, breathing, skin state, pupils.
First aiders name/ phone number in case medical staff need any further information.
   phone number from which you are calling?>_
What has happened?How many casualties?>  <=
?
; ; @ 
Record Keeping
dispatch the ambulance and paramedics. DO NOT hang-up until you are told to do so or In the workplace, it is important to be aware of the correct documentation and record
   @?$ 
you that the call has been made and that the location is exact.
+  @;   @ ?
Every organisation has its own procedures and documentation so familiarize yourself with
the correct process.
Legal Issues All documentation must be legible and accurate and must contain a description of the illness
No Good Samaritan or volunteer in Australia has ever been successfully sued for the or injury and any treatment given. Thorough and accurate medical records are essential in
 ?_ any court case or workers compensation issue.
 _;   #@ ;?Duty of care: In addition:
In a workplace there is an automatic duty of care to provide help to staff and customers, <=] "   
which means you are required to provide help to your best ability at your work place. In the  @
 +    $@?Consent: Where
$+;  $@?   78"9; 

refuses help, you must respect that decision. When the casualty is a child, if feasible seek Each person reacts differently to traumatic events and in some instances strong emotions
 J ? J @ may affect well being and work performance. Symptoms may appear immediately or
sometimes months later after an event and may develop into chronic illness.
aid should be given. In a child care situation, parents must notify the centre if the child has
There is no right or wrong way to feel after an event. It is important for all people who have
any medical conditions and also provide medications and instructions. Consent forms are been involved in an incident take part in a debrief. Workplaces must provide opportunity
signed at enrolment. In an emergency, parents or a doctor can also provide authorisation $@?  
over the phone. (see also reg 94 on pg 44) =%

+ Personal information about the + $$@ ; 
  @?
    ?+$$  @
and treatment provided. First aiders should only disclose personal information when performance may assist with self-improvement and prepare you better for any future events.
handing-over to medical assistance eg paramedics. Currency requirements @ Some Reactions/ Symptoms>{@ 
skills & knowledge$; ?@@   {@ {$${ {
candidate was assessed as competent on a given date. The accepted industry standard #  # OJ#$ 
 @ 
% and 1 year for    O;O $Y  $Y
CPR.  ;@ ? X  
50 | General First Aid
means call your countrys emergency number General First Aid | 51

Safe Work Practices and Manual Handling Basic Anatomy and Physiology
 <+ =_ @ The Skeleton protects vital organs,
Anatomy: The science of the structure of the body
aider protects him/herself from injury eg using correct manual handling techniques; bending provides anchor points for muscles,
Physiology: The science of the functions of the body
the knees and using leg muscles to protect against back injury. Knowing your own skills and and a structure to the body. Bone
limitations and asking for help when required will help prevent injury. Always adhere to safe Normal breathing is breathing in and out regularly
marrow is an important source of
; ? ;< ; @= about every 3-5 seconds. If a person is not
blood cell production. Fractures
there is a legal obligation to use supplied Personal Protection Equipment (PPE). breathing normally, their body will not have enough
of major bones can cause major
Needle Stick Injury FIRST AID oxygen to supply the brain and other organs
internal bleeding and impair blood
The risk of catching a serious infection (Hepatitis B, C  Z$  ? cell replacement
and HIV) from needle stick injury is very low. ;  ;$?
Reduce the risk of needle stick injury:   ?
]$  
] bottle or sharps container.
   
;  
Y^;;   hospital for analysis.
; $J$" 
<% $

!
 $ 

!,%

 ,   Sternum
Hygiene Minimise the risk of cross infection to yourself, bystanders and casualty by Liver Ribs
taking standard precautions to control infection:
Stomach
Prior to treatment: During treatment: After treatment:
   ;   ! J  >   +  Large intestines
and water, or rinse with mask, if available immediate vicinity.
antiseptic. when performing   +
 >    resuscitation. bandages and disposable gloves
Small intestines
with a waterproof dressing  {]
  +       ; 
before putting on gloves. sneeze or breath and water, even if gloves were used.
 $? over a wound.  Q@? Air between
 {      Bladder
=

 ]*
%
Hip joint the linings of
object when wearing ; $" ? from Worksafe Vic Compliance code
gloves .  {]

(ball and socket) the lungs (the
^@ 1 The Skeletonpleura) causes a
 ! more than one^@ 1
eye protection. casualty without Bronchioles pneumothorax -
Disposable gloves 2
 > washing hands are small tubes collapsed lung
Individually wrapped sterile adhesive strips 10
likely to produce infection. and changing Windpipe that carry air into
gloves. Large sterile wound dressings 1
(Trachea) the lungs
Medium sterile wound dressings 1
First Aid Kits Non-allergenic tape 1 The Heart has four
 G@workplaces, vehicles
Plastic bags for disposal 2 chambers. Valves
and in the home in a clean, dry, dust-free
Resuscitation mask or shield 1 inside the heart control
location.
 X @accessible and Rubber thread or crepe bandage 2  ;$";?
The heart is located
signage clearly indicates their location. Safety pins 5 Heart The aorta is the main
near the centre of the
 Check kits regularly for completeness and Scissors 1 artery taking blood
chest.
valid dates. Small sterile wound dressings 1 out to the organs and
 >;vary depending on the number of Sterile coverings for serious wounds 1 Diaphragm tissues.
employees, and the industry you work in. High Sterile eye pads (packet) 2 When we breathe-in the diaphragm contracts and
risk industries may need extra modules. Sterile saline solution 15 ml 2 the muscles between the ribs contract. To breathe- Coronary arteries. A
 List 
%  in workplace kits. Triangular bandages 2 out we relax these muscles. If there is pressure on heart attack is caused
 !State and Territory legislation@ Tweezers
aid kits are required in all workplaces.
1 the abdomen (eg a person sitting on abdomen), by the coronary
   
 ? #
@





this can prevent air exhaling when the person arteries becoming
relaxes. This can cause positional asphyxia blocked
52 | General First Aid

Casualty Assessment When dealing with a person who is ill or Asthma/Anaphylaxis Management Plan
injured, you need a clear Plan of Action:
School/Employer:
Radial pulse 1.Start with a Primary Survey (DRSABCD), (pg 3)
Phone:
;  $@
life-threatening conditions. Student/Employee name:
2.If there are no life-threatening conditions which Date of birth Age: Year level/Department:

@<$+
Severely allergic to:
response) then proceed to Secondary Survey.
7! 7= is a systematic check of the casualty involving    J
"'
"-
"='X% to help identify any problems that may have Storage Location of Medication:
been missed. Parent/carer/next-of-kin information 1 Parent/carer/next-of-kin information 2
 If the casualty is unconscious, the secondary survey is conducted in the recovery
Name: Name: a
position. You may need to look for external clues and ask bystanders some questions. apted to
Relationship: ationship:
Relationship: la n c a n be ad
  
conscious start with questions followed by examination. Remember to gement
p
clude:
introduce yourself, ask for consent to help and ask their name. is mana and should in
Thphone:
Home phone: Home
me p la c e rk p la c e
work n of wo en
Questions Examination Work phone: Locatio work undertak
ork phone:
Work
y p e o f la c e
 T rkp
What happened? Vital Signs: are indicators of body function and provide ut of wo on ce
Mobile:  Layo tion of medicati ency assistan
Mobile:
Do you feel pain or numbness a guide to the casualtys condition and response to  L o c a
it y o f e merg lone
abil ga
anywhere? treatment. Address:  Avail hood of workin
Address:
Can you move your arms and  Likeli
 Conscious State: There are 3 broad levels
legs? >

!
  <$
$=
Do you have any medical 
|
++ Medical practitioner contact: Phone:
conditions? confused, drowsy.
Do you take any medications? Emergency care to be provided at school/work: Q? 
 Pulse: The carotid pulse in the neck is the best pulse
Do you have any allergies? to check. Feel for rate, rhythm, force, irregularities. 


When did you last eat?
(Bystanders may be helpful)
External Clues
Medical Alert: casualties
with medical conditions such
as diabetes, epilepsy or severe
allergy usually have a bracelet,
Q
remove the risk if possible: otherwise reduce the risk
pendant or card to alert people of
their condition.
Medications: People on
regular medication usually carry
Normal pulse rates: Adults: 60-80 /min The anaphylaxis management plan has been put together with my knowledge and input
Children: 80-100/min Communication plan actioned: Review date:
 Breathing: Look, listen and/or feel for breathing rate,
depth and other noises eg wheezing, noisy breathing. Signature of parent/employee: Date:
Normal breathing rates: Adults 16-20 breaths/min Signature of principal/supervisor: Date:
Children: 25-40 breaths/min
(Check pulse/ breathing for 15 secs then x by 4 to RISK 
Y
get rate/min. Use a watch) Music Music teacher to be aware, there should be no sharing of wind instruments. e.g. Music
 Skin State: Look at face and lips. recorders. Speak with the parent about providing the childs own instrument. teacher
Red, hot skin fever, heat exhaustion, allergy Canteen Staff (or volunteers) trained to prevent cross contamination of safe foods Canteen
Cool, pale, sweaty shock, faint, pain, anxiety Child having distinguishable lunch order bag manager
^
<=;$
+ +" Restriction on who serves the child when they go to the canteen
it with them. Photos of the at risk children in the canteen
chest, collapsed lung, heart failure, hypothermia Encourage parents of child to view products available
Carotid pulse Pupils: Unequal, reactive to light {J >{

?;;;???

Head to Toe: Sunscreen Parents of children at risk of anaphylaxis should be informed that sunscreen is Principal
  

$
 offered to children. They may want to provide their own.
begin. Excursions Plan an emergency response procedure prior to the event. Excursion
 G$
+
+
 
  J  
? planner
areas. Distribute laminated cards to all attending teachers, detailing the following:
   ;;? Location of event, Map reference (Melway), Nearest cross street.
 #
; 
$
  Procedure for calling ambulance advise: allergic reaction; requires adrenaline.
Prior to event, check that mobile phone reception is available and if not,
stage eg Im just going to move your arm. consider other form of emergency communication eg radio.
NB. The pulse is not checked  
$ \{
during CPR hurt when I move your arm? This and other resources available from: http://www.education.vic.gov.au/school/teachers/health/Pages/anaphylaxisschl.aspx
 Risk Assessment Form First
means call your countrys emergency number
Aid Incident Report Form
Date
responsible
(Complete this form as best as you can and give copy to paramedic and keep record in accordance with WHS procedures)
Person

J

 

  

  

Name Date: / / Time: Location:

Casualty Details: Department:

Name: {^JJ M/F

Date:
Residual

Risk
use matrix
Risk

Consequence Home Address:

Likelihood
Postcode:
explain steps to remove the risk or reduce the risk to

In schools and child care centres strategies must be

Family Contact Name: Phone ]@ 

Elimination / control measures

Work department: Supervisor name: ]@ 

developed in consultation with parents

Management:: ]@ 

an acceptable level.

Work safe: ]@ 

Strategy

What Happened (a brief description):

First Aid Action Taken:

Signature:
Position:
Risk
use matrix

Comments:
Rating
Risk

Consequence
Likelihood Ambulance called: yes Time: Referred to:
Current Medications:
describe what could go wrong

Known health issues

USE WITH RISK ASSESSMENT MATRIX

no
no Diabetes yes
Known Allergies:
Epilepsy yes
Venue and safety information reviewed: yes
Attached: yes
Hazard

Asthma yes
Anaphylaxis yes Last ate or drank: What?
(pg 40)

Heart yes When?

Medications given
 
What Time Dose
Plan prepared by:
In consultation with:
Communicated to:
enter the activity or
Activity

location

cut here

-
Casualty Examination: mark location of injuries on diagram and
$"$  +$ ++;+$ ?

Verbal Secondary Survey

W-H-A-M-M-M-E-D
What happened
Hurt - where does it hurt
Allergy
Medications
Medical conditions - alerts
Move your arms and legs
Eat or drink last
Document the answers

Observations
of Vital Signs:
Time
Conscious State
Fully Conscious
Drowsy
Unconscious
Pulse rate:
description:
Breathing rate:
description:
Skin State Colour:
Temp:
Dry/Clammy:
Pupils

R L

First Aiders Details:

(In case the hospital needs to contact you for more information regarding the incident).

Name:(Print)__________________________________________________

Phone: Signature:
cut here
ABC of First Aid Asthma &
Anaphylaxis is divided into
seven main colour coded sections:
ABC of
1. Essential First Aid
2. Trauma First Aid
Asthma &
3. Medical Emergencies
4. Asthma & Anaphlaxis
5. Risk Assessment
6. Education & Childcare
7. General First Aid
Anaphylaxis
In conjunction with an approved
 
 
    
emergency situations.

  
     
guidelines and is written for Australian
conditions.
  
  
 
competency units:
HLTAID001: Provide CPR
HLTAID002: Provide Basic Emergency
Life Support
HLTAID003: Provide First Aid
HLTAID004:    

aid response in an
education and care setting
22024VIC: Course in Emergency
Management of Asthma in
 

22099VIC: Course in First Aid
Management of Anaphylaxis