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First Aid Training

Course designation…

HLTFA301B Apply First Aid


Formally Senior First Aid

1
Welcome to your First Aid Course

 Introductions
 Housekeeping
 Course delivery
 Exam
 Practical Assessments
 Course Evaluation
 Questions
 Any specific topics you would like covered

2
Course Format
 Conscious Casualty  Drowning
 Unconscious Casualty  Choking
 CPR and defibrillator  Poisoning
 Bandages and slings  Drug overdose
 Bites and Stings  Burns and scalds
 Diabetes  Strokes
 Seizures/fitting  Hyperventilation
 Triage  Hypothermia/Hyperthermia
 Record keeping  Safe manual handling
 Trauma

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What is First Aid?

 The initial care, given to a casualty, prior to


the arrival of professional medical assistance.

 What is your obligation to provide first aid?

4
PRINCIPLES OF FIRST AID
 LOOK AFTER NUMBER ONE - YOU

• Consider the danger to you, others and the casualty.

• Wear protective equipment such as gloves, masks


etc.

• Be careful not to get an injury helping, such as cuts


and abrasions if accessing a damaged vehicle, a
back injury whilst lifting or a needle stick.

• Promote a safe environment at an accident scene, at


work and at home.
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Danger
Response
Airway
Breathing
Compression
Defibrillation
Refer page 14 in your manual 6
First Aid Protocol

 Assess the scene…

 Assess the casualty…

 Assess what to do next…

Triple A Protocol
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IDENTIFY THE HAZARD

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ASSESS THE SCENE
 Protect yourself and others

 Protect the casualty

 Phone the Ambulance on 000 (112 Mobile


phones)

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DANGERS
 Traffic
 Unstable environment
 Fire or explosion
 Burns
 Chemical fumes
 Electrocution
 Needle stick injury
 Back injuries
 Equipment failure
 Biological
 Aggressive behaviour
 Body fluids especially blood
 Aggressive dog?
10
INFECTION CONTROL
In every first aid situation, you must assume that the
injured casualty has a disease.

 Before First Aid:


• Wash your hands
• Use Gloves
• Use a Resuscitation Mask

 During First Aid:


• Ensure gloves are worn and not torn
• Consider double gloving
• If you come in contact with body fluids, wash
immediately and seek medical advice
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Refer page 8 in your manual
Assess the Casualty- are they
alive ?
 Is the casualty responding ?

 Is the casualty breathing normally ?

 Is the casualty moving ?

 Are there signs of life ?

 If they respond, seek their permission to


provide first aid.
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Refer page 3 in your manual
Assess the Casualties

TRIAGE

What does it mean?

 The efficient use of resources so the most good can


be done for the most people.

 This would mean a casualty that had suffered a


cardiac arrest should only be given CPR if there are
no other seriously injured casualties that would
benefit from your life-saving treatment.

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ASSESS WHAT TO DO NEXT
 Commence treatment.

 Don’t move the patient unless they’re in danger or


you must move them to provide treatment.
 Arrange transportation to
hospital.
 Provide confidence and
reassurance.
 Build teamwork and avoid panic.

 Ensure you don’t injure yourself whilst providing


assistance.
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The Conscious and
Unconscious Casualty

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The Conscious Casualty
 What does the term ‘conscious’ mean ?

 Conscious means a person is in their normal


state of mind.

 Generally this is like you are now, able to


communicate and aware of your surroundings.

 In certain circumstances i.e. people with


medical conditions and/or disabilities you may
need to ask if there behavior is ‘normal’.

16
Consciousness
How do we determine the consciousness of a
patient?

C – can you hear me?


O – open your eyes.
W – what’s your name?
S – squeeze my hand

17
The Unconscious casualty
 Unconscious casualty means there is no
response from the casualty to your
communications with the casualty

 There are many causes of unconsciousness,

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Causes of Unconsciousness
 Alcohol (intoxication)
 Epilepsy (fitting/convulsions)
 Insulin (Diabetes)
 Overdose/Under dose (illicit and prescription drugs)
 Uraemia (renal failure is difficult to diagnose)
 Trauma (Shock)
 Infection
 Psychiatric / Pretending
 Stroke (CVA Cerebrovascular Accident / TIA Transient Ischemic Attack )
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Treating the Unconscious
Casualty

 Unless CPR is to be performed, all


unconscious, breathing casualties must
be placed in the lateral ‘recovery’ or ‘stable
side’ position.

 Preferably on their left side.

Let’s have a practice 


20
Examining the conscious and
unconscious casualty
 Once the casualty has been placed on their side, we
must treat any obvious life threatening injuries ie; any
major haemorrhage.

 As part of a secondary survey, all casualties require


a head to toes examination.

 When examining a conscious or an unconscious


casualty, use different methods. (remember to gain
permission from the conscious casualty and preserve the dignity
of the unconscious casualty)
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Examining the conscious and
unconscious casualty
 Once a head to toes examination has been
completed, complete the secondary survey.

 Look for symptoms such as cold clammy


skin, skin colour, heart rate.

 Look at the history of the situation…where


the casualty is lying, ask witnesses what
happened.
22
Examining the conscious and
unconscious casualty
 Does the casualty take any medication?

 Does the casualty have any allergies?

 When was there last meal?

23
Examining the conscious and
unconscious casualty
 It is important that throughout first aid
treatment that the first aider monitors and
records the casualties breathing, skin
condition and level of consciousness.

 This should be done every 3 to 5 minutes.

 This information establishes a trend and


could prove invaluable to ambulance and
paramedic staff on their arrival.
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Resuscitation

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Cardio-Pulmonary Resuscitation
 CPR is a technique involving rescue
breathing and the compression of the heart
(through external cardiac compression) ECC,
therefore pumping oxygenated blood around
the body.
 CPR when performed correctly, can preserve
brain functions until medical help arrives.
 CPR is used on a patient who has suffered a
cardiac arrest.

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Causes of Cardiac Arrest
 Heart condition

 Near Drowning

 Electrocution

 Trauma

 Blockage of coronary arteries

 Drug overdose

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Basic Life Support Chart
Danger – Check for danger, risks or hazards. Always ensure the safety
D of yourself, any bystanders and the casualty

Response – Check for a response. Is the casualty conscious /


R unconscious? Call 000 for the ambulance. From a Mobile:112

Airway – Is the Airway open? Look for signs of life. No signs of life will
A mean the casualty is unconscious, unresponsive, not breathing
normally, not moving.

B Breathing – Give 2 initial breaths, if not breathing normally.

Compressions – Give 30 chest compressions (At a rate of almost 2


C compressions per second) followed by 2 breaths

Defibrillation – Cardiac Arrest Casualties need urgent defibrillation to


D increase their chance of survival. Continue doing CPR until qualified
personnel arrive and take over care of the casualty or until signs of life
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return. Don’t delay getting help.
CPR TECHNIQUE
 2 Breaths followed by 30 Compressions

 When performing CPR on a child, use only


the air in your mouth.

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Breathing
 Five ways to perform Rescue Breathing -
1. Mouth to mouth resuscitation

2. Mouth to nose resuscitation

3. Mouth to mouth and nose resuscitation

4. Mouth to stoma resuscitation

5. Mouth to mask resuscitation

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Compressions
 Find the compression point by placing your hands in
the centre of the chest (lower half of the sternum)
 In infants the 2 finger technique should be used for
compressions
 In children and adults the rescuer should use the
heel of their hand while placing the other hand
securely over the top of the first.
 The compressions should equate to 1/3 of the chest
depth.
 The rate of compressions should be approximately
100 compressions per minute for all ages.

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VENTRICULAR FIBRILLATION (VF)
 Sudden cardiac arrest can occur any time and
without warning.
 Though the average age of these victims is 65, some
are in their 30’s or 40’s.
 Most victims experience an abnormal heart rhythm
called ventricular fibrillation (VF).
 When the heart is in this state, it cannot beat in an
organized fashion; the heart is unable to pump blood
to the body.
 Sudden cardiac death can occur in minutes unless
you act quickly.

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DEFIBRILLATION

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AED
 What is an AED?

• The automated external defibrillator (AED) is a


computerized medical device.
• It will check a person’s heart rhythm.

• It will recognize a rhythm that requires a shock.

• And it will advise the rescuer when a shock is


needed.
• The AED uses voice prompts, lights, and text
messages to tell the rescuer the steps to take.
Refer page 36 in your manual 34
HOW DOES IT WORK
 The AED can diagnose and restore a normal heart
rhythm to victims of sudden cardiac arrest due to
ventricular fibrillation (VF).

 In the unconscious victim, adhesive pads are placed


on the chest by trained individuals to deliver an
electrical shock.

 This shock (or series of shocks) is called


defibrillation, and it briefly stops all of the heart’s
electrical activity so the heart can resume normal
beating on its own.
35
Refer page 36 in your manual
DEFIBRILLATION

Remember…EVERY MINUTE COUNTS

 If defibrillation occurs in the first one or two minutes,


90% of sudden cardiac arrest victims in VF survive.

 If defibrillation is delayed for more than ten minutes,


the survival rate drops to 5% for sudden cardiac
arrest victims in VF.

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CPR TECHNIQUE
Let’s practice CPR 

Remember…2 breaths & 30 compressions

100 compressions per min

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Debriefing
 As soon as possible after an emergency situation,
document what had taken place.

 A diary note, write on the back of a time sheet if at


work.

 It doesn’t matter what you write on.

 This will help you put the events into perspective and if
asked, may help paramedics with the continued care of
the casualty.

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Head Injuries
 Head injuries can range from a simple bleeding
nose, or a tooth being knocked out to a heavy blow
to the head as a result of a fall, car accident or a
fight.

 A head injury can constitute a severe medical


emergency.

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Head Injuries
Symptoms...

 Memory impairment
 Bleeding from an open wound.
 Lack of coordination
 Deformity of the skull or face.  Headache or giddiness

 Become drowsy or vague.  Slurred speech


 Possible seizures
 Agitated or irritable.  Becomes unconscious

 Vomits or complains of nausea.

 Bleeding or discharge from the ear

 Changes in the size/shape of the pupils

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Head Injuries
Treatment…
Follow the Triple A Protocol and call an ambulance if required
If the casualty is conscious…
 Complete a thorough assessment and ensure the cervical spine
is not damaged.
 Keep the casualty lying down and at rest.
 Check carefully the neck, eyes and ears, and if bleeding or
discharge is found, place the casualty on the injured side to aid
the draining process.
 Dress any wounds and monitor

41
Head Injuries
Treatment cont…
Unconscious casualty…

Follow the Triple A Protocol… DR ABCD


 Manually support the head and neck and place the casualty on
their side. (Be very careful when turning the casualty over as there could be damage to
the cervical spine.)

 Maintain manual traction of the head and neck until the


ambulance arrives and takes over the care of the casualty.
 If there is fluid coming out of an ear, ensure that the casualty is
lying on that side to allow drainage.
 Treat any wounds and monitor.

42
Head Injuries
Treatment cont…

 Progressive Head Injury…should the casualty


show a decline in consciousness, they’re suffering
from a more serious brain injury, which requires
urgent medical intervention.
 Nose bleeds are common and can be controlled
by constant pressure to the soft part of the nose
for at least 10 minutes.
 Ice packs can be used.
 Don’t let the casualty blow their nose.
 Monitor the casualty

43
Head Injuries
Treatment cont…
Tooth Injury…
 If the tooth is knocked completely out, rinse gently
and put back in place – the correct way around 
 Another alternative is to place the tooth in a small
container surrounded by the casualties own saliva or
milk and seek medical or dental assistance.
 Apply firm pressure, using a sterile pad, to any
bleeding wound or tooth socket for at least 10
minutes.
44
Shock
Shock fits into 3 categories…

 Absolute fluid loss


- low blood volume

 Relative fluid loss


 Cardiac failure
- Cardiogenic Shock

45
Shock
 Shock can be bought about by physical or
mental trauma.
 Physical trauma may be the result of a shark
bite, car accident or industrial accident
causing blood loss.
 Mental trauma maybe as a result of bad
news, witnessing a bad accident etc., causing
arteries to dilate and decrease the relative
blood volume.
46
Shock
Signs and symptoms of shock include…
 low blood pressure (hypotension),
 over breathing (hyperventilation), a weak rapid pulse,
 cold clammy greyish-bluish (cyanotic) skin,
 decreased urine flow and mental changes (a sense of
great anxiety and foreboding, confusion and,
sometimes, combativeness).

 Depending on the underlying cause shock can be a


major medical emergency. It is common after serious
injury. Emergency care for shock involves keeping the
patient warm and giving fluids by mouth or, preferably,
intravenously.

47
Shock
Treatment…
Follow the Triple A Protocol… DR ABCD
 If you come upon a person in shock, the initial response should
be to call 000.
 Lay the person down in a safe place and try to keep them warm
and comfortable.
 Elevate the legs to increase the available blood flow to the vital
organs.
 Treat any injuries and monitor the casualty continuously.

 Confirm the ambulance has been called.

48
Faints
 Fainting can present similarly to shock, if the faint is
unwitnessed.

 The brain is being starved of oxygen due to the lack


of blood flow.

 People stand still for long periods of time eg; army


personnel standing at attention for long periods.

 Blood pools in the lower extremities which reduces


the supply available to the brain. Fainting occurs.

49
Faints
Signs and Symptoms…

 The casualty normally feels light headed prior to the


faint, may feel nauseated and anxious and appears
pale.

 The diagnosis may be confirmed by rapid return to


consciousness while lying flat.

 Occasionally, fainting may be associated with fitting.

 Brain damage or death may occur if the casualty is left


supported in an upright position
50
Faints
Treatment…

Follow the Triple A Protocol… DR ABCD

 Lie the casualty on their back with feet and


legs elevated.
 If the casualty is unconscious they must be
place in the stable side position.
 Pregnant women must be laid on the left
side to aid the return of blood back to the
heart.
 Assess the casualty for any injuries
resulting from a fall.
 Treat wounds and monitor.

51
Drowning
 Drowning is the process of experiencing respiratory
impairment from immersion in liquid.

 The most important and life threatening consequence


of drowning is the interruption of the oxygen supply to
the brain.

 Early rescue and resuscitation are the major factors


in survival.

52
Drowning
Treatment…
Follow the Triple A Protocol… DR ABCD
 Rescue and remove the casualty from the water or liquid.
Don’t put yourself in danger attempting a rescue.
 DRABCD… Assess the casualty, their airway and breathing
with the casualty on their side. This will allow for drainage of
any fluid and do away with the need to continually roll the
casualty back and forth.
 Commence CPR as required.
 Consider spinal injuries and the effects of hypothermia
 Seek urgent medical assistance.
53
Abdominal Injuries
Abdominal injuries fall into two groups…

 Trauma related abdominal injuries.


 Non – trauma related injuries.

Trauma related injuries…

Signs and symptoms…

 Pain in the stomach


 Feeling sick in stomach
 Nausea and vomiting
 Pale cold skin
 Evidence of bleeding or obvious injury

54
Abdominal Injuries
Treatment…
Follow the Triple A Protocol… DR ABCD
 Control bleeding using direct pressure and bandages.
 Consider internal bleeding. Look for pale cold clammy skin.
 If the casualty is in shock lay them down and elevate the feet.
 Flexing the knees may help reduce pain.
 Don’t allow the casualty to eat or drink.
 Assist the casualty to be comfortable.
 If stomach contents are visible, cover with plastic wrap, a non stick dressing or
a wet dressing. Do not push the contents back into the stomach.
 If an object is embedded in the abdomen, leave it in place and pad around it.
It may be plugging any blood loss and removal may do further damage to
surrounding tissue.

55
Abdominal Injuries
Non – trauma related injuries.
Signs and symptoms…

 Right lower abdominal pain, evidence of fever – appendix


 Right upper abdominal pain – gallstones
 Referred back pain – kidneys
 Severe tearing mid/upper abdominal pain – artery tear.
 Severe right or left lower abdominal pain in a female casualty –
possible ectopic pregnancy.
 Red flushed skin if infection is present.

56
Abdominal Injuries
Treatment…
Follow the Triple A Protocol… DR ABCD

 Assist the casualty into a comfortable position.


 Consider bending the knees to take pressure off the
muscles.
 Don’t allow the casualty to eat or drink.
 If the casualty is in shock (rapid weak pulse, cold clammy
skin) lay them down and elevate the feet.
 In the case of a female anatomy problem, such as an
ectopic pregnancy, maintain absolute confidentiality.

57
Bleeding
 Bleeding can be internal or external
and can be the result of trauma or it
can happen spontaneously resulting
from disease.

 If the bleeding is internal you may


not be able to see evidence or signs
of blood loss, however signs of
shock will be evident. (pale cold
clammy skin) with any form of blood
loss.

58
Bleeding
Internal bleeding which is visible may be
evident as…
Lungs – frothy bright red blood coughed up.
Stomach – dark type, coffee coloured blood.
Bowel – dark loose smelly stools.
Vaginal – usually red blood discharge.

59
Bleeding
Treatment for internal bleeding…

Follow the Triple A Protocol… DR ABCD

 Lie the casualty down.


 Elevate the feet.
 Keep the casualty warm.
 Knees may be flexed, which may help reduce
pain.
 Reassure the casualty.
60
Bleeding
Treatment for external bleeding cont…

Follow the Triple A Protocol… DR ABCD

 Inspect the wound for an embedded object.


 Direct, sustained pressure is the most effective way to control
bleeding.
 Apply a pad over the wound and secure with a bandage.
 If the initial dressing doesn’t stop the bleeding, apply another pad
and bandage over the first.
 If the bleeding doesn’t stop, remove the second pad and apply
another pad and bandage.
 Elevate the wound if possible.

61
Bleeding
Treatment for external bleeding cont…

Wounds involving Embedded Objects – knives, barbs,


stakes etc…
Don’t remove the embedded object.
It may be plugging the wound and
restricting the bleeding.
It may also cause more damage to
surrounding tissue.
Place a bulky pad around the object
and bandage firmly in place. 62
Bleeding
Treatment for external bleeding cont…

 Tourniquet – for the control of life threatening bleeding and


only as a last resort.

 Life threatening bleeding may involve the traumatic


amputation of a limb, eg; shark attack

 The tourniquet should be tight enough to stop the circulation of


blood to the injured limb and control the bleeding.

 Note the time of application and provide this information to the


paramedics on arrival.

 Monitor the casualty.

63
Bleeding
Treatment for external bleeding cont…

 In the event of the complete amputation of a finger or limb there may be


less blood evident than you would expect.
 This is due to the fact that the arteries recoil, spasm and self seal.
 Direct pressure maybe enough to control bleeding in these
circumstances. If not then use a tourniquet.
 Place the amputated body part in plastic bag and seal it completely,
ensuring it is watertight.
 Place the plastic bag inside another plastic bag and seal it.
 Place the plastic bags into a container of cool water, making sure no
water touches the amputated part and send with the casualty to hospital.

64
Anaphylaxis
 Most people will, at some time in their lives, experience
some form of allergic reaction.

 Anaphylaxis is the most severe form of allergic


reaction.

 It affects the respiratory and or the cardiovascular


systems.

 Anaphylaxis is a life threatening condition.

 The patient should be treated immediately.

Refer page 14 & 15 in your manual 65


Anaphylaxis
Causes…
Severe reactions to some foods, medications,
stinging insects and latex.

66
Anaphylaxis
Signs and symptoms…

 Red skin, welts and blotchy rashes over the skin.


 Swelling of the throat and tongue causing breathing
difficulties.
 Breathing sounds such as wheeze and stridor.
 Difficulty talking in sentences.
 Terrified, with a feeling of doom.
 Increased heart rate.
 Collapse and unconsciousness.

67
Anaphylaxis
Treatment…
Follow the Triple A Protocol and call for the
ambulance… DR ABCD
Once symptoms are confirmed administer the contents
of an EPIPEN (the casualty will be carrying one if they have known
allergies)

If in doubt and the casualty is displaying any of the


previously mentioned symptoms, accompanied by a
rapid deterioration, don’t hesitate to assist the
casualty to administer the EPIPEN injection.
68
Anaphylaxis
Administration…
 Remove the EPIPEN from it’s container.
 Hold firmly in closed fist with grey cap towards
your thumb.
 Remove the grey cap.
 With positive force, push the black end against
the thigh of the patient, (through clothing) until
a click is heard and felt.
69
Anaphylaxis
Administration cont…
 The needle will be injected automatically into
the thigh and the contents of the EPIPEN will
be injected into the muscle.

 Wait 10 seconds, remove


the EPIPEN and massage the area.

 Place used EPIPEN carefully back into it’s


container and seal for safety. 70
Anaphylaxis
 Once treatment has been administered
remain with the casualty and maintain their
airway. Monitor their condition continuously.

 The casualty may find it easier to breath if


they are sitting upright, unless they are dizzy
and confused (low blood pressure/shock)

 Confirm the ambulance has been called.

71
Asthma
 Asthma is a chronic (ongoing) respiratory
disorder in which the airways occasionally
constrict, become inflamed and are lined with
excessive amounts of mucus.

 Health experts don’t know exactly what


causes asthma. They do know that there are
hereditary and environmental influences.

 They do know what triggers asthma attacks.

72
Asthma
Asthma triggers…

Pollen Dust mites

Mould Pet fur

There are many triggers for asthma ranging from the above
examples to the common cold, exercise and cold night air.
73
Refer page 16 & 17 in your manual
Asthma
Symptoms…
 Wheeze – a high pitched noise.
 Coughing – this is usually dry and persistent.
 Can’t get their breath
 Tightness in the chest.
 Raised shoulders, neck muscles and rib
muscles become tight.

74
Asthma
Symptoms cont...
 Difficulty speaking more than a few words or
inability to speak because of wheezing or
breathlessness.
 Distress.
 With severe asthma the casualty may have
blueness around the mouth.

75
Asthma
Treatment cont…
 Relievers in a puffer are best delivered through a
spacer if one is available. Spacers can be improvised
using a paper or Styrofoam cup.

 The casualty should take one puff at a time, then take


four normal breaths between each puff. Wait four
minutes, give four more puffs.
 Whilst waiting for the ambulance, give four puffs every
four minutes.

76
Asthma
Treatment cont…

 No harm is likely to result from giving a


Reliever, in recommended doses, to
someone who doesn’t have asthma.

77
Fractures and Dislocations

78
Fractures and Dislocations
 What is a Dislocation?

 A dislocation is a partial or full separation of a joint.

 What is a Fracture ?

 A fracture is a break in the continuity of a bone or


cartilage.
Causes
 Direct force
 Indirect force
 Abnormal Muscular contraction
79
Fractures and Dislocations
Open or compound…

 This fracture involves


a situation where the
bone protrudes
through the skin OR
there is a wound
adjacent to the
fractured bone.

80
Fractures and Dislocations
Closed or simple fracture…
 The skin stays intact and there is no sign of external
bleeding. Bleeding occurs into the tissues.

81
Fractures and Dislocations
Complicated Fracture…
 A fracture that involves
damaged to vital organs
or major blood vessels.

82
Refer page 47 in your manual
Fractures and Dislocations
Sign & Symptoms…

 Pain  Protruding Bone


 External Bleeding  Open Wound
 Bruising/Contusion  Difficulty breathing
 Swelling  Pale, cold, clammy skin
 Tenderness  Crepitis
 Absent distal pulse  Shortening of limb
 Unable to weight bare  Deformity of limb
 Inability to move
Refer page 47 in your manual 83
Fractures and Dislocations
Complications…

 Infection

 Shock – blood loss

 Nerve and blood vessel damage

 Nausea

Refer page 47 in your manual 84


Fractures and Dislocations
Treatment…

Follow the Triple A Protocol… DR ABCD

 Control any bleeding and cover wounds


 If injury is painful but casualty can move the limb if they
wanted to – may mean fracture
 If injury is painful but casualty could not move the limb if they
wanted to – may mean dislocation
 Immobilise the injury with splints, bandages and slings
 Check circulation following splinting and bandaging
 Reassure the casualty
85
Sprains and Strains
 A sprain is a stretching or tearing of
ligaments. Ligaments are tough
bands of fibrous tissue that connect
one bone to another. Common
locations for sprains are your ankles
and knees.

 A strain is a stretching or tearing of


muscle or tendon. People
commonly call strains "pulled" Hamstring Muscle tear

muscles.
 Hamstring and back injuries are
among the most common strains.
86
Sprains and Strains
Symptoms…
 Pain and tenderness around joints or muscles.
 Swelling.
 Discolouration to injured part.
 Decreased function of the injured part.
 Inability to stand on leg without pain.

87
Sprains and Strains
Treatment…
 Follow the Triple A Protocol… DR ABCD

Follow the acronym R.I.C.E.

 R…Rest the injured area. Have the casualty lie still


and make them as comfortable as possible.

 I…Ice apply a cold compress, frozen peas rapped in a


cloth works well. Ice in a plastic bag rapped in a cloth.

If no cold pack or ice available, use a bandage


soaked in cold water.
88
Sprains and Strains
Treatment cont…
Rest
Ice
 C… Compression with the use of a roller bandage
and in conjunction with the ice will help reduce
bleeding and swelling.

 E… Elevation of the injured area above the level of


the heart if the injury permits will also help reduce
blood flow to the area and reduce pain.

89
Bandages & Slings

90
Types of bandages
 Crepe Bandages
 Conforming bandages
 Gauze bandages
 Triangular bandages

91
Bandages are used for…
 Holding dressings in place
 Helping to control bleeding
 Helping to immobilise fractures
 Pressure immobilisation for snake and spider
bites
 Hold cold packs in place
 Reduce swelling

92
Slings are used for…
 Support of injured arms or wrists
 Immobilisation of fractures
 Elevation to control external bleeding

What can be used as a sling?


 Shirts
 Belts
 Rope
 Jumper

93
Sling types
Upper arm sling
 Used for injuries to the upper arm, including collar
bone, shoulder or ribs

Lower arm sling


 Used for injuries to the lower arm, including wrist and
hand

Collar and cuff


 This sling can be used for hand injuries, or fracture of
the upper arm

Refer page 18 & 19 in your manual 94


BANDAGES & SLINGS
 Let’s have a go at some slings…

Refer page 18 & 19 in your manual 95


Snake & Funnel Web Spider
Bites

Refer page 20 to 25 in your manual 96


Snake & Funnel Web Spider
Bites
Any suspicion of a snake or funnel web spider
bite should be treated immediately particularly if
the victim is a child.
If the casualty has been in an area where snakes
or funnel web spiders may be eg; long grass,
damp wet gardens etc. and the casualty becomes
unwell, don’t discount the possibility of a bite.

97
Snake & Funnel Web Spider
Bites
Signs and symptoms…

Snake bite…

■ Paired fang marks.


■ Nausea and vomiting.
■ Blurred or double vision.
■ Limb weakness or paralysis.
■ Respiratory weakness or arrest.

98
Snake & Funnel Web Spider
Bites
Signs and symptoms…
Funnel Web Spider bite…
 Pain at the bite site.
 Profuse sweating.
 Abdominal pain
 Muscular twitching, breathing difficulties.

 Confusion leading to unconsciousness.


99
Snake & Funnel Web Spider
Bites
Treatment…
Follow the Triple A protocol… DR ABCD
 Lie the casualty down and don’t allow them to move.
 Life threatening effects may be seen in children in
minutes.
 Apply a pressure immobilisation bandage.
 Seek medical assistance.
 Bring transport to the casualty, preferably an
ambulance.

100
Snake & Spider Bites
 Appling a pressure immobilisation bandage.
• Place a pad over the bite site
• Firmly bandage from lower extremities and up to the
top of the limb.

 Splint the bandaged limb.

 Keep bitten area lower than the heart at all times.

 Once applied do not remove bandages.

 Application of the bandage slows the absorption of venom.

101
Pressure Immobilisation
As soon as possible, apply a broad
pressure bandage from below the
bite site, upward on the affected
limb (starting at the fingers or
toes, bandaging upward as far as
possible). Leave the tips of the
fingers or toes unbandaged to
allow the victims circulation to be
checked. Do not remove pants or
trousers, simply bandage over
the top of the clothing.

Images and text courtesy of Australian Venom Research Unit


www.avru.org
102
Pressure Immobilisation
Bandage firmly as for a sprained ankle,
but not so tight that circulation is
prevented. Continue to bandage
upward from the lower portion of the
bitten limb.

Apply the bandage as far up the limb


as possible to compress the
lymphatic vessels.

Images and text courtesy of Australian Venom Research Unit


www.avru.org

103
Refer page 20 to 25 in your manual
Pressure Immobilisation
Bind the splint firmly, to as much of the limb
as possible, to prevent muscle, limb and
joint movement. This will help restrict
venom movement. Seek urgent medical
assistance now that first aid has been
applied.

Images and text courtesy of Australian Venom Research Unit


www.avru.org

104
Refer page 20 to 25 in your manual
Other Bites and Stings
Other bites and stings include…

Bites…
Red Back Spider
White Tailed Spider and
other spiders

105
Other Bites and Stings
Red Back, White Tailed and other spider bites…

Signs and symptoms…


Immediate pain that becomes hot, red and swollen.
 Intense local pain which increases and spreads.

 Nausea, vomiting and abdominal pain.

 Profuse sweating, especially at the bite sight.

 Swollen glands under the armpits or in the groin.

106
Other Bites and Stings
Red Back, White Tailed and other spider bites…

Treatment…

Follow the Triple A Protocol… DR ABCD

Apply ice packs to the bite site to relieve the pain (apply for no longer
than 20 minutes at a time)

While the White Tail spider bite may cause severe inflammation and
has caused, contrary to popular opinion, very few cases of severe
local tissue damage, other causes of necrotic ulcers should be
investigated especially if you didn’t see the spider.

107
Other Bites and Stings
Tick bite…
Signs and symptoms…

 Local irritation, which is the most common


sign.
 Lethargy, muscle weakness and unsteady
gait.
 Double vision, breathing problems and
swallowing problems.
108
Other Bites and Stings
Tick bite…
Treatment…
Follow the Triple A Protocol… DR ABCD
 Using fine curved forceps or equivalent, lever the tick
out.
 Alternatively, a lasso of fine thread may be positioned
low around the mouth parts and steadily upward
traction applied opposite the direction of entry.
 After extraction apply antiseptic and seek medical
assistance if required.
109
Other Bites and Stings

Bee, Wasp, and Ant stings…

Signs and symptoms…

 Immediate and intense pain.

 Local redness and swelling.

 In allergic persons… itchy rash, facial swelling,


wheeze and possible collapse

110
Other Bites and Stings
Bee, Wasp, and Ant stings…

Treatment…

Follow the Triple A Protocol… DR ABCD

 Scrape a bee sting off sideways with a fingernail or sharp


edge.
 Apply ice.
 If the casualty has a known allergy, called Anaphylaxis, they
must have the EPIPEN administered immediately.
 If the casualty has a history of allergy, use the pressure
immobilisation bandage technique and seek urgent medical
assistance.
 Commence CPR if required. 111
Other Bites and Stings
Jelly Fish stings…

Signs and symptoms…

 An inconspicuous mark that may develop a red flare.


 White wheals with a surrounding red flare.
 Multiple whip like wheals on the skin.
 A frosted ladder pattern in the sting marks may be seen initially
followed by blistering or darkening of the sting pattern.
 Pain and general muscle aches.
 Cramps in the limbs, chest and abdomen.
 Irrational behaviour due to the pain and effects of the venom.
 Collapse and possible cardiac arrest in major stings.
112
Other Bites and Stings
Jelly Fish stings…
Treatment…
Follow the Triple A Protocol… DR ABCD
Tropical Jellyfish stings…

 Remove the victim from the water and restrain if necessary.


 Commence CPR if necessary.
 Liberally douse the sting area with vinegar. (Do not wash
with fresh water)
 If no vinegar available, pick off the tentacle remnants and
rinse with sea water.

113
Other Bites and Stings

Jelly Fish stings…

Treatment…

Follow the Triple A Protocol… DR ABCD


Non-tropical bluebottle stings…
 Pick off any adherent tentacles with fingers.
 Rinse the stung area with sea water.
 Place stung area in hot water – no hotter than the
casualty can comfortably tolerate.
 If local pain isn’t relieved with heat, or hot water is not
available, cold packs may be effective. 114
Other Bites and Stings
Other non – tropical minor jellyfish stings…
Follow the Triple A Protocol… DR ABCD
Treatment…
 Keep the casualty at rest.
 Don’t allow rubbing of the area.
 Pick of any adherent tentacles with fingers.
 Rinse stung areas with seawater (NOT freshwater)
 Apply cold packs for pain relief.
 If local pain is not relieved, or if generalised pain develops, or
the sting is large (half a limb or more) call an ambulance.
115
Other Bites and Stings
Blue Ringed Octopus and Cone Shell stings…

Signs and symptoms…

 A spot of blood at site.

 Numbness of lips and tongue

 Progressive weakness of
muscles of respiration.

 Inadequate, or cessation of
breathing
116
Other Bites and Stings
Blue Ringed Octopus and Cone Shell stings…

Treatment…

Follow the Triple A Protocol… DR ABC


 Apply a pressure immobilisation bandage if possible.

 Commence CPR if necessary.

 Seek urgent medical assistance.

117
Other Bites and Stings
Fish stings…

Depending on the fish, the casualties reaction to a sting


can range from mild discomfort to extreme pain.

The Reef Stonefish is the most


venomous fish in the world.
Most fish stings are protein
based and are controlled with
hot water.

118
Other Bites and Stings
Fish stings…

Signs and symptoms…

 Intense pain, swelling and an open wound.

 Bleeding

 Irrational behaviour and panic may occur.

119
Other Bites and Stings
Fish stings…
Treatment…
Follow the Triple A Protocol… DR ABCD
 Place the stung hand or foot in hot water. (water as hot as
the casualty can comfortably bear for 30 to 45 minutes)
 Should hot water not relieve the pain, the application of cold
packs may be effective.
 Seek medical assistance.
 Further advice is available from the Australian Venom
Research Unit on 03 94838204.

120
BURNS & SCOLDS
 Burn severity should be assessed and classified by
degree.
 The first-degree burn involves only the upper layers
of the epidermis and dermis.
 The second-degree burn penetrates slightly deeper
and produces blistering of the skin.
 First and second degree burns are considered partial
thickness burns.
 Third-degree or full thickness burns penetrate the
entire dermis. These burns may involve injury to
blood vessels, nerves, muscle tissue, bone, or
internal organs.
121
BURNS & SCOLDS

122
BURNS & SCOLDS
Signs and symptoms…

 Pain around the burnt area.

 Localised blistering to the skin.

 Red to black marks around the burnt area.

123
BURNS & SCOLDS
Treatment…

Follow the Triple A Protocol… DR ABCD

 Gentle running, cold or cool water is the treatment for all burns.
 Lots of it for at least 20 minutes.
 Cool chemical or bitumen burns for at least 30 minutes.
 Remove all rings and tight fitting clothing before swelling occurs.
 Cut off contaminated clothing. Don’t remove clothing contaminated
with chemicals, over the head. Cut them off.
 Elevate the injured area if possible to reduce swelling.

124
BURNS & SCOLDS
Treatment cont…

 Once cool, cover the burnt area with a loose and light
non-stick dressing, preferably a sterile or clean, dry
and lint-free material.

 Plastic cling wrap, a clean handkerchief, sheet or


pillowcase are suitable dressings.

 An emergency silver blanket could be used to help


prevent shock.

 Seek medical assistance.


125
BURNS & SCOLDS
Treatment cont…
Electrical burns…
 Are normally more severe than is initially
apparent.
 May have entry and exit burns.
 Cardiac arrest may also result from current
flow through the heart.
 Seek medical assistance.
126
BURNS & SCOLDS
Treatment cont…

Thermal burns…
 Stop, drop and roll the casualty if
they are is on fire.

 Smother flames with a blanket or


coat.

 Treat with cool gentle running


water.

 Seek medical assistance.


127
BURNS & SCOLDS
Treatment cont…

Thermal burns cont…

 Inhalation of flames or heated air can cause severe


damage to the airways resulting in swelling and possible
airway obstruction.

 Coughing or a hoarse voice indicates exposure.

 Frequent sips of cool water can help reduce the injury.

 Seek medical assistance.

128
BURNS & SCOLDS
Treatment cont…
Lightning burns…
 Burns from lightning can be as a direct strike which
will present as entry and exit burns with varying
degrees of severity.
 They can also be flash burns as a result of a
lightning strike close by. Presented as superficial
spidery patterned burns on the skin as the current
has flowed over the skin.
 Seek medical assistance.

129
BURNS & SCOLDS
Treatment cont…

Chemical burns…

 Acids and alkalis react with body tissue and cause a burn.

 Alkali burns are more serious than acid burns as the


penetrate more deeply.

 Don’t try and neutralise chemical burns as this will only


generate more heat.

 Flood the area with copious amounts of cool water.

 Seek medical assistance.

130
Burn Pictures

Bad scald Hot oil injection burn

Electrical
burns

131
Choking

132
Choking
We’ve all experienced choking, to varying degrees, at
some time in our lives.

Common causes of choking are…


 Obstruction of the airway by food.
 Children swallowing an object.
 Talking or laughing while eating.
 Running whilst eating or drinking.
 Not chewing food correctly.
 Swallowing foreign objects such as bones.
 Eating too quickly.
133
Choking
Partial obstruction…

 A partial obstruction occurs when something is


stuck in the casualties throat but is still able to
breathe, with some difficulty

 Food or beverage ‘goes down the wrong way’


causing us to panic whilst we try to cough it up.

 Generally this is over in a few seconds, or, until we


cough the item up

134
Choking
Partial obstruction…

Signs and symptoms…

 Breathing

 Can talk but with difficulty

 May have rattly voice

 More than likely coughing

135
Choking
Complete obstruction…
 A complete obstruction occurs when something is
lodged in the casualties throat/airway completely
blocking it and stopping any air movement.

 This is life threatening

 Person is quiet

 Requires urgent treatment

136
Choking
Complete obstruction…
Signs and symptoms…
 No air movement (no breathing)
 Unable to speak
 Unable to cough
 No breaths sounds
 Blue (cyanosis) around lips

 Collapses to floor without a sound


137
Choking
Complete obstruction…

Treatment…

Follow the Triple A Protocol… DR ABCD


 Up to five vigorous back blows between
shoulder blades with heel of hand
If unsuccessful…
 Up to five chest thrusts
If unsuccessful…
 Continue sequences of back blows and
chest thrusts until successful or
ambulance arrives.
 CPR may be required.
138
SPINAL INJURIES

139
SPINAL INJURIES
 The spine is made up of 33
vertebrae which protect the spinal
cord.
 Between each vertebrae is a disc
that acts as ‘suspension’.
 The spine has four regions, these
being:
 Cervical
 Thoracic
 Lumbar
 Sacrum
140
SPINAL INJURIES

Spinal injury types…


 Partial or full severing of the spinal cord
 Fractured vertebrae
 Bruising of the spinal cord
 Skull fractures
 Closed head injuries

141
SPINAL INJURIES
Signs and symptoms…
 Slowing/cessation of breathing

 Slowing of heart rate

 Quadriplegia – paralysis of all limbs (legs and


arms)

 Paraplegia – paralysis of the legs and lower parts


of the body
 Pain at injury site.

142
SPINAL INJURIES

Signs and symptoms cont…


 Loss of bowel and/or bladder functions.

 Pain or discomfort in neck and/or back.

 Altered sensation such as numbness, tingling,


weakness or burning sensation

 Slowing pulse.

 Lumps/deformity on neck and back.

143
SPINAL INJURIES
Treatment…

Conscious casualty…

Follow the Triple A Protocol… DR ABCD


 Manually immobilise the neck in position found. Unless
casualty is in a life threatening situation, leave them where
found eg; in the car seat. If wearing a crash helmet, leave
it on the casualty. Don’t move the head and/or neck
anymore than is essentially necessary.
 Treat any other injuries

 Monitor until help arrives


144
SPINAL INJURIES
Treatment cont…
Unconscious casualty
Follow the Triple A Protocol… DR ABCD
 Manually immobilise the neck immediately.
 If the patient is upright in a car seat, leave them there.
Gently lift their head back to open the airway and hold in this
position until help arrives.
 If the patient is prostrate on the ground, with as much
assistance as possible log roll the patient onto their side
keeping the head, neck and spine in alignment. (left side if
possible)
 Maintain an open airway
 Treat any other injuries
145
Seizures and Fitting
 An epileptic seizure is a transient symptom of abnormal,
excessive or synchronous neuronal activity in the brain.

 A seizure can take many forms. In a major seizure there


is sudden muscle spasms producing rigidity and the
casualty will fall down.

 The casualty will become unconscious which may be


associated with noisy breathing, salivation and urinary
incontinence.

 Jerking movements of the head, arms and legs occur.

 Seizures can however occur in casualties that don’t suffer


from epilepsy.
146
Seizures and Fitting
Treatment…

Follow the Triple A Protocol… DR ABCD


 Make the area around the casualty safe.

 Remove any dangerous objects or cover sharp


objects with pillows or blankets.

 Don’t try and restrain the casualty.

 Don’t place anything in his/her mouth.

 If possible, place the casualty on their side.


147
Seizures and Fitting
Febrile Convulsions may occur in young children
between the age of 1 and 4 years.

These convulsions are associated with a sudden rise


in body temperature (usually greater than 38
degrees)

It’s the sudden rise in temperature that triggers the


convulsion, not how high the temperature is.

148
Seizures and Fitting
Febrile Convulsion present similar to an epileptic seizure.

Treatment…

Follow the Triple A Protocol… DR ABCD

 Make the area around the casualty safe.

 Remove any dangerous objects or cover sharp objects


with pillows or blankets.

 Don’t try and restrain the casualty.

 Don’t place anything in his/her mouth.

 If possible, place the casualty on their side.


149
Seizures and Fitting
A person known to have a history of epileptic seizures
may not need urgent medical care unless the
active or jerking part of the seizure lasts for more
than 5 minutes, or another seizure occurs before
the casualty has fully recovered from the first.

Most casualties will feel tired after an attack. They


should be allowed to rest if this is the case.

150
CPR REVISION
 Let’s have another CPR practice.

 Complete 5 cycles each of 2 breaths & 30


compressions in two minutes.

151
Crush Injuries
 Crush injuries can occur in a wide variety of situations, from
car accidents, industrial accidents, trench cave-ins and
mining accidents.
 The injury can progress to crush injury syndrome if…
• A large area is involved such as the thigh.
• There is no circulation beyond the crush.
• Crushed for 60 minutes or more.
 Once the injury has developed into crush injury syndrome the
crushing force should not be removed until specialist medical
assistance is present.
 The premature removal of a crushing force in this situation
can lead to sudden blood loss and the delivery of toxins to
the body that can prove to be fatal.
152
Crush Injuries

Typical injuries from crushing accidents.

153
Crush Injuries
Treatment…

Follow the Triple A Protocol… DR ABCD


 Immediately remove the crushing force if possible.
 Treat any injuries and prevent blood loss.
 Keep the casualty comfortable and closely monitor
there condition and vital signs.
 The casualty can appear alert and relatively calm,
however their condition can deteriorate rapidly and
shock may set in.
154
Diabetes
 Hyperglycaemia – is a condition of high blood
sugar and is generally a condition with a slow
onset. It is not common for first aiders to be
confronted with this disorder.

 Hypoglycaemia – low blood sugar is the condition


that first aiders will generally be confronted with, it
is a condition that causes confusion, and can
cause unconsciousness and death.

155
Diabetes
Hypoglycaemia

Causes…
 Overdose of insulin

 Insufficient food

 Excessive exercise

 Alcohol consumption

156
Diabetes
Hypoglycaemia

Signs and symptoms…


 Confusion

 Pale sweaty skin

 Dizziness and weakness

 Shaking and trembling

 Irritable or inappropriate behaviour

 Could be unconscious 157


Diabetes
Hypoglycaemia

Treatment…

Follow the Triple A Protocol… DR ABCD

Conscious casualty…

 Make the casualty comfortable. If swallowing can


safely be achieved, give high energy foods or
sugar.

 The casualty will respond quickly if low blood


sugar levels are the cause. (you will not do harm if158
you give sugar or food to a hyperglycaemic
Diabetes
Hypoglycaemia

Treatment cont…
 The casualty may carry lollies in their pocket

 When the casualty recovers they may be a little


confused.

 Make sure they eat a normal meal as soon as


possible

159
Diabetes
Hypoglycaemia

Treatment cont…
Unconscious casualty…

Follow the Triple A Protocol…. DR ABCD


 Place the casualty in the stable side position and seek
medical assistance.

 Monitor the patient until help arrives.

160
Eye Injuries
There are five categories of eye injuries…

 Minor foreign bodies

 Major foreign bodies

 Burns to the eye

 Welding flash

 Smoke in the eyes

161
Eye Injuries
Treatment…
Follow the Triple A Protocol… DR ABCD
Never remove an embedded object from the eye.
 Remove an minor foreign object if present (only if on
the white of the eye).
 Use sterile water to wash the out the eye.
 With burns to the eye continue with running water for at
least 20 minutes.
 For an embedded object use a ring pad over the object
and bandage in place to prevent the object or the eye
from moving. (it helps to cover both eyes to prevent
movement) 162
Drug Overdose

 A drug overdose can be by accident or


intentionally with prescribed drugs or with
illicit drugs.

 Remember our roll as a first aider is not to


be a judge, but to preserve life.

163
Drug Overdose
Signs and symptoms…

 Signs and symptoms vary depending on the


drugs taken. In saying that, almost all cases
will result in unconsciousness and possibly
death.

164
Drug Overdose
Signs and symptoms cont…

 Vomiting  Drowsiness

 Pale, cold clammy skin  Syringes

 Breathing difficulties  Empty bottles, containers

 Abdominal pain  Decreased level of


consciousness

165
Drug Overdose
Treatment…
Conscious casualty…
Follow the Triple A Protocol…DR ABCD
■ Make the casualty comfortable.
■ Try and ascertain what drug the casualty has taken and when.
■ Be aware that certain drugs can cause delusions and behavioural problems.
■ Treat any associated injuries, such as self inflicted injuries or results of falls or
trauma.
■ If the casualty vomits, collect a sample and send with the casualty to hospital.
■ Send any medicine bottles, suicide notes or other relevant items as well.
■ Continually monitor the casualty and if required ring the Poisons Information
Centre on 131126
■ Monitor breathing and vital signs. Record.
166
Drug Overdose
Treatment…
Unconscious casualty…
Follow the Triple A Protocol…DR ABCD
■ Place the casualty on their side and call the
ambulance.
■ Follow the same procedures as with a
conscious casualty.

167
Poisoning
Poisoning can occur to a casualty in many ways and with
many different chemicals.

Poisons can enter the body in many different ways…


■ Ingestion… by eating or drinking poisonous substances.

■ Injection… through drug use.

■ Absorption… through the skin via contact with various


poisons.

■ Inhalation… breathing gas vapours or fumes into the


lungs.
168
Poisoning
Treatment…

Follow the Triple A Protocol…DR ABCD

■ Ensure you are wearing protective equipment, such as gloves, face


shield and a rubber apron and any other protective equipment required.

■ Immediately remove the casualties cloths if contaminated

■ Wash skin thoroughly. Be careful not to contaminate yourself.

■ If the casualty is unconscious, place them on their side and maintain an


open airway.

■ If CPR is required, ensure you clean the poison from the face of the
casualty and use a facemask for resuscitation.

■ Contact the Poisons Information Centre on 131 126 for advice on first aid
treatment. This can be done by a third person while you’re treating the
casualty
169
■ Monitor and record vital signs.
Electric Shock

Frayed and damaged electrical cables pose a real threat to any person that may come
in contact with them. All leads should be inspected and tagged, by a competent
person, every six months and they should also be inspected for damage before
and after use.

170
Electric Shock
It’s amperage that intensifies an electric shock
and not necessarily the voltage.

Signs and symptoms...

■ Burns
■ Cardiac arrest
■ Respiratory arrest
■ Maybe entry and exit burns

171
Electric Shock
Treatment…

Follow the Triple A Protocol… DR ABCD

■ Be extremely careful that there is no danger to


yourself or others as electricity cannot be seen.

■ Disconnect the electricity supply where possible.

■ If you are not absolutely sure that the power source


has been isolated, stay well clear until expert help
arrives.

172
Electric Shock
Treatment cont…

Follow the Triple A Protocol… DR ABCD

■ Commence CPR as required.

■ Treat any other injuries that may present.

■ Use cool running water on entry and exit burn


wounds.

173
Stroke
A stroke can happen when the following occurs…

 A blood vessel that supplies blood to the brain is blocked by a


blood clot.

This is called an ischemic stroke.

 A blood vessel breaks open, causing blood to leak into the brain.

This is called a hemorrhagic stroke.

 If blood flow is stopped for longer than a few seconds, the brain
cannot get blood and oxygen. Brain cells can die, causing
permanent damage.

174
Stroke
 To determine if a casualty has had a stroke an
assessment of three specific symptoms must be made.

 Follow the acronym F. A. S. T.

• F… Facial weakness – can you smile?

• A… Arm weakness – can you raise both arms?

• S… Speech problems – can the casualty speak clearly.

• T… Test all three symptoms.

175
Stroke
Other signs and symptoms of a stroke…

■ Confusion.

■ Loss of feeling or paralysis to one side of the body.

■ Face may be sagged on one side.

■ Garbled or no speech possible

■ May have a seizure.

■ Semi-conscious or unconscious.

176
Stroke
Treatment…

Follow the Triple A Protocol… DR ABCD

Conscious casualty…

■ Place them in a position that is comfortable to them.

■ As they may be confused we don’t want to make things


worse by getting the casualty to do something they’re
not comfortable with.

177
Stroke
Treatment…

Follow the Triple A Protocol… DR ABCD

Unconscious casualty…

■ Lay the casualty on their side with the facial droop facing
down.

178
Hypothermia
 Hypothermia is caused by over exposure to cold which
causes the core body temperature to drop below 35oC.

 This causes muscular and internal organ function to


become impaired and if not treated will lead death.

 A casualty can progress very quickly from being just


cold to being very cold due to a combination of wind,
wet clothing, cold water and snow.

 It’s vital for the bodies core temperature to remain


warm and stable, as any decrease in temperature, by
only a few degrees, can have devastating
consequences.
179
Hypothermia
Signs and symptoms…

■ Feeling cold ■ Confusion and clumsiness


■ Intense shivering ■ Lack of coordination
■ Muscle rigidity ■ Irrational behaviour
■ Exhaustion ■ Poor decision making
■ Decrease in conscious

180
Hypothermia
Signs and symptoms cont…

Mild hypothermia 34oC to 35oC

■ Maximum shivering, pale, cool skin, poor


coordination.
■ Slurred speech, usually responsive but with
apathy and slowed thinking and thoughts.

181
Hypothermia
Signs and symptoms cont…

Moderate hypothermia 30oC to 33oC


■ Most shivering ceases, increased muscle
rigidity, consciousness decreasing, pulse and
respiration slow and difficult to detect.
Severe hypothermia, below 30oC
■ Progressive loss of consciousness, cardiac
abnormalities develop, pupils fixed and dilated,
may appear dead.

182
Hypothermia
Treatment…

Follow the Triple A Protocol… DR ABCD

■ Remove the casualty from the cold or wet area.


■ Keep the casualty lying down and handle the
casualty very gently.
■ Remove wet clothing immediately and gently dry
the casualty.

183
Hypothermia
Treatment cont…

Follow the Triple A Protocol… DR ABCD

■ Slowly rewarm the casualty.


■ Cover with a blanket or warm dry clothes.
■ Give the casualty small sips of a sweet, warm
drink. Do not give an unconscious casualty
anything to eat or drink.
■ Place an unconscious casualty on their side.

184
Hypothermia
Important points to remember…
 When a person is hypothermic, they may show all the
signs of being dead.
 It is vitally important to actively resuscitate a casualty
who is hypothermic and not responding.
 The very cold condition slows down all the body’s
requirements for oxygen and when casualties are
resuscitated and slowly rewarmed, remarkable recoveries
have been achieved.
 It is important that the rewarming process is slow, as
rewarming a casualty quickly could mean instant death.

 Ideally the body’s core temperature should remain within


0.5oC of 37oC
185
Hyperthermia

 Hyperthermia is caused by over exposure to hot


conditions and is made worse when physical
exertion is involved.

 It’s onset is also quickened if the skin is exposed to


direct sunlight, and more so if the back of the neck
is exposed.

 A core body temperature above 40oC will lead to


unconsciousness and death.

186
Hyperthermia

Signs and symptoms…


■ Headache ■ Tiredness
■ Nausea ■ Dizziness
■ Seizures ■ Unconsciousness
■ Thirst may be a late
symptom

187
Hyperthermia

Signs and symptoms…

Heat Cramps…
 Are muscle cramps after prolonged exertion.
The body temperature is usually normal.

Heat Exhaustion…
 (37oC to 40oC) is recognised by pallor, or pale
skin colour, sweating, thirst, fainting and
moderately elevated body temperature.

188
Hyperthermia

Signs and symptoms…

Heat Stroke…

 (above 40oC core temperature) causes impaired


mental function and a very high body temperature,
which may lead to unconsciousness and death.
All body organs are affected.

189
Hyperthermia

Treatment…

Follow the Triple A Protocol… DR ABCD

Immediately move the casualty to a cool location


 Make the casualty as comfortable as possible.
 Remove their clothing (while preserving their dignity)
 Give frequent, very small sips of water if conscious.

Should the casualty become unconscious they must be


placed on their side.
190
Hyperthermia

Treatment cont…

Follow the Triple A Protocol… DR ABCD

Reduce the core body temperature


 Sponge the casualty with cool water.
 Cover with wet dressings and continue reducing the
core temperature.
 Fan the casualty to increase the cooling effect.
 Apply cold packs to the groin and armpits in severe
cases. 191
Hyperventilation
 Hyperventilation is bought about by an hysterical
reaction to a situation, stress and/or an emotional
upset.

 It’s basically an acute anxiety attack. It causes rapid


breathing and causes oxygen and carbon dioxide levels
in the body to be out of balance.

 If the attack is witnessed by the first aider, then a


diagnosis can usually be made with confidence.

192
Hyperventilation
Signs and symptoms…

 Severe anxiety and complete emotional upset.


 Tingling in the fingers, lips and/or feet.
 A feeling that they can’t get enough air.
 Normal skin colour.
 Chest pain usually develops and the victim may
think that they are having a heart attack as well.
 Light headedness.
 The hand, wrist or fingers can bend backwards.
193
Hyperventilation
Treatment…
Follow the Triple A Protocol… DR ABCD
Be assertive with the casualty
■ Provide calm and assertive reassurance to the
casualty.
■ Ensure the casualty regains composure.
Discourage the casualty from breathing fast
■ Instruct the casualty to only breath in and out
through their nose. This is difficult to continue and
requires the casualty to concentrate on something
else other than their emotional upset. 194
Hyperventilation

 The previous treatment of encouraging the


casualty to breath in and out of a paper bag is
no longer recommended.

195
Safe Manual Handling
 Because of the shape and construction of the
spinal column, which curves forward in the
neck and lumbar regions, the majority of back
injuries occur in the lower lumbar area
because it receives the greatest stress.

 Incorrect manual handling


places undue pressure on
the lower back.

196
Safe Manual Handling

197
Safe Manual Handling

The key to safe manual handling is…

Mental Preparation…

 What… the weight and size of the load.


 Where… the load is to be taken.
 How… lifting technique

198
Safe Manual Handling

The key to safe manual handling is…


Position…
 Stand as close to the load as possible.
 Feet apart and facing in the desired direction
to give a stable base.
 Bend the knees.
 Keep back in alignment with the shoulders
and pelvis.
 Hold your head straight.
 Grip the load securely. 199
Safe Manual Handling

The key to safe manual handling is…


Lifting…
 Use the thigh and leg muscles.
 Keep the load as close as possible to the
body and avoid twisting or jerking.

200
Summary

 First aiders obligation  Choking


 Triple A Protocol  Diabetes
 DR ABCD  Monitor and record
 Unconscious casualty  Anaphylaxis
 COWS  Asthma
 Cardiac Arrest  Burns
 CPR  RICE
 Injuries  FAST
 Bites and stings

201
Written Assessment
 Students to complete the theory assessment
 22 Multiple Choice
 18 True or False

 All criteria on the practical assessment must be met and a


minimum mark of 75% achieved in the written exam before you
can be deemed competent.

 Duration approx 1 hour

 Please ensure all assessments and administration paperwork is


handed back to the Trainer before leaving.

THANK YOU

202

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