First Aid Notes

DRSABC

chief complaint? check history (SAMPLE) head to toe exam

• FAM: first aid management
• C: casualty
• FB: foreign body

1. call EMS immediately; tell not to move (in case of spinal inj)
2. primary survey
3. if breathing, place in Recovery unless spinal inj. suspected
4. if bleeding from head, apply direct pressure
5. monitor vitals every 2m

1. call EMS immediately; tell not to move
2. keep head still w/ folded clothing; do not leave monitor vitals every 2m

types: generalized, partial FAM: maintain airway, protect from +injury

• reassure C
• remove nearby hazards
• protect head w/ folded clothing/towel but do not restrict airway
• do not restrain C
• do not place anything between teeth/in mouth (can cause bleeding)
• wait until convulsions have stopped (postictal phase, often unresponsive)
• then can clear airway w/ finger sweep
• ensure airway is open, check for breathing + injuries
• comfort C until fully conscious
• Call EMS if:
  • unsure of care plan (some people have frequent seizures, may not go to hospital)
  • lasts longer than 5m
  • C not conscious after 5-10m
  • diabetes or injury
  • first seizure
  • life threatening condition

lie down; elevate legs (shock position) fresh air

check FAST types: ischemic (thrombus causes anoxia); hemorrhagic (rupture causes hemorrhage)

diabetes mellitus: siphoning of urine with a high glucose level type 1: insulin dependent

• almost no insulin; develops as child/teen
• regular injections needed

type 2: non-insulin

• insufficient insulin; linked with obesity; more common >40yo
• controllable with diet, exercise, medication

cannot speak, breathe, cough = complete FBAO (choking)

• mild: encourage to cough, until ineffective
• complete: Heimlich (artificial cough)
  • hold shoulders, stand behind C
  • (Abdominal) - put index finger 2 fingers above navel
  • (Chest) - slide arms from C's hips up, wrap chest
  • close fist around thumb (5-4-0 motion)
  • place above other hand, then wrap with other hand
  • thrust inwards (+ upwards, if abdominal)

1. position supine on firm flat surface
2. shout for help, EMS, AED
3. 30 chest compressions
4. open airway
   • head tilt, chin lift
   • check for visible FB
   • if FB visible - finger sweep:
     • insert finger along inside of cheek
     • dislodge FB with hooking motion do not force FB deeper into throat
   • if nothing seen: continue chest compressions
5. mouth to mouth ventilation (BCLS + AED providers)
   • 1st ventilation with MTM
   • if no resistance: check B/C, if none, start CPR
   • if resistance: reposition head, chin, 2nd ventilation
6. chest compressions (BCLS + AED providers)
   • 30 chest compressions
   • HTCL, check for FB
   • repeat step 4-6 until help arrives or C starts to speak/breathe/cough
7. (Trained healthcare provider) (? does this class qualify?)
   • start CPR 30:2 if no breath/pulse or not sure
   • has pulse but not normal breathing:
     • start rescue breaths 12/min
     • reassess
   • has pulse and breathing:
     • put in Recovery

• assure C, ask about history, inhaler?
• help to sit, get inhaler, breathe slowly
• if more severe after a few minutes, call EMS

• remove from trigger, help breathe slowly (nose in, mouth out), reassure
• ask about history

eg. carbon monoxide, from boiler

• S&S: headache, vertigo, nausea, vomit
• remove C do not enter space with fumes (?)
• open windows, turn off device
• emergency protocol

• S&S: hives, itching, swelling, wheezing, watery eyes, flushing

• elderly, pregnant
• cardiovascular disease, COPD (chronic pulmonary obstructive disease)
• infections, burns, diabetes, malignancy

• early: Pale, cold and clammy skin; Weakness and dizziness Rapid and weak pulse; Nausea and vomiting; Sweating
• late: Rapid, shallow breathing; Cyanosis (grey-blue skin) Restlessness and aggressive behavior Yawning and gasping for air; Unconsciousness
• bleeding: adult can lose .5L/20m ok - more, or faster, can cause shock

• treat any causal injuries
• Shock position
• call EMS
• loosen tight clothing for ventilation, keep warm
• monitor vitals, consciousness
• turn C's head if vomiting

If internal bleeding suspected:

• call EMS
• primary survey
• shock position unless there's a fracture
• loosen tight clothing
• do not leave, monitor vitals
• chest compressions and AED if not breathing
• reassure give nothing to consume by mouth

• apply direct pressure with gloved hand
  • place clean dressing ASAP
• apply bulky pad beyond wound edges
  • if bleeding continues, add a bandage on top
• do not disturb once bleeding is controlled

bright red, spurts; can quickly cause shock

dark red, steady flow; can quickly cause shock

steady ooze

• remove/cut clothing to expose wound
• apply direct pressure
• raise and support injury above C's heart, minimize blood loss

embed forein particles, cause infection

• call EMS; apply direct pressure
• do not remove object
• stabilize object with paddings + control bleeding
• rest injury in comfort

tissue is forcefully torn off

• call EMS; apply direct pressure
• apply tourniquet; record application time
• treat casualty for shock
• preserve amputated part
  • wrap in clean dry gauze/cloth
  • place in plastic bag, place bag in ice

• cover & secure exposed abdominal contents with plastic bag/wrap
• treat for shock, monitor vitals

• direct pressure
  • if skull fracture suspected, use ring pad
• lay down with head & shoulders raised

• bandage: should be neat, firm; tight enough to fit 1 finger start 3 rounds; figure 8, lower each round; broad bandage sling

child/teen injuries near joints may affect growth plates, should be evaluated

X should cover gauze + wound

donut; open arm sling; elevated arm sling; broad fold bandage

would; hand or foot; elbow or knee; ear, eye, head

apply promixal to wound and upper arm/thigh to compress artery against a long bone windlass tourniquet

immobilize bone, nearby joints, and soft tissue break apply in position found (don't straighten/move) secure starting at proximal stable part of limb check circulation every 30m radial pulse most reliable compare injured and uninjured limb warm fingers = circulation ok improvise with folded newspaper

temporomandibular joints

S&S similar to collarbone (but at shoulder)

flail chest = fracture at 2+ locations on ribcage

• call EMS
• supine position; support leg
• treat open wounds
• bring good leg alongside injured, immobilize both
• support ankles; slide one bandage under knees, one under ankles
• +2 bandages under knees; one above + below fracture site
• soft padding btw. calves, knees, ankles
• narrow fold figure 8 around ankles
• broad fold around knees
• broad fold - one above + below fracture
• tie knot on uninjured side

strain = torn muscle; sprain = torn ligament

S&S: entry & exit wounds; shock; full-thickness burns

• scene survey + primary survey
  • make sure scene is safe; call power company or authorities
  • if high V, can only keep others away
• remove from electrical source
• CCCC

S&S:

• stinging pain; discoloration, blistering, swelling
• HF acid <30% may have no pain up to 24h; causes severe burns + slow healing ulcers

• strong alkali
  • worst. penetrate quickly into tissues
  • e.g. caustic soda, sodium hydroxide: ammonia, cement, plaster
• acids
  • cause more visible immediate damage, but penetrate less
  • easier to wash out
  • e.g. sulphuric acid, hydrochloric

• reassure; cold compress 15m
• if reduced vision or discoloration, seek medical attention

confusion; mouth, throat burns (swallowed); difficulty breathing (inhaled) vomiting, abdom. pain, diarrhea; skin burns (absorbed); low O2 (injected)

• swallowed: call EMS; if not breathing, CPR
• absorbed through skin: call EMS; remove clothing; flush w/ cold water
• inhaled: lead to fresh air; call EMS
• splashed in eye: call EMS; flush w/ water 10m+
• injected: call EMS; remove stinger if possible

do not induce vomiting - will burn throat, mouth, lungs do not try to neutralize chemical

reduced blood to heart rest and administer glyceryl trinitrate (GTN)

• sublingual

no blood to heart

• gasping, sweatiness, nausea, vomit
• chest pain "crushing, dull, heavy, squeezing"
• pain radiates to arm, upper abdomen, jaw

• call EMS immediately
• assist in GTN admin. critera:
  • must have history of angina
  • GTN not expired
  • not allergic to GTN
  • no viagra past 24h
• half-sitting position, cushions under knees, back (Fowler's?)
• monitor vitals

normally 2s