Chapter 16First Aid

Defined

• First aid is the immediate care given to the victim of an accident or illness to minimize the effect of injury or illness until experts can take over

Reasons for providing correct first aid

• It can mean the difference between life and death for that person

• It can mean the difference between recovery and permanent disability

• You can help yourself, your family, your friends, even strangers in a time of emergency

EMERGENCY

• So, that brings us to an important question: “What is an emergency?”

• Dictionary Definition:• e·mer·gen·cy (-mûrjn-s)n. pl. e·mer·gen·cies– 1. A serious situation or occurrence that happens

unexpectedly and demands immediate action– 2. A condition of urgent need for action or

assistance

ACTIVITY• What do you think constitutes an emergency?• For, today’s assignment, please get a computer.• Look on reputable news websites for articles about

emergencies.– Google phrases like house fire, heart attack, stroke, car

accident, etc.• While reading those articles list words or phrases

from the article that you think illustrates that the events you are reading are an emergency.– Example, rushed to the hospital, CPR at the scene,

paramedics, injuries, etc.

ACTIVITY continued• In the end you need a list of at least 20 words

and phrases that indicate that a situation is an emergency. Title the page EMERGENCY.

• Your completed list is due at the end of the class period.

• Be sure to use your assigned computer number.• When finished with your computer:– Log Off– Return it to the Cart, pushing the computer in all the

way– PLUG IN the computer

DAY 2

• 1st - Review our lists from yesterday.• 2nd - Question: • How do you know when a situation is an

emergency?• Now, let’s begin discussing what to do in case

of an emergency.

Basic Principles of Providing Emergency Care

• Remain calm and avoid panic• Evaluate situation thoroughly• Have a reason for anything you do• Treatment you provide will vary depending

on:– Type of injury or illness– Environment– Others present– Equipment or supplies available to you– Availability of medical help

First Aid: First Steps• Recognize that an emergency exists– Remember our list of words for what constitutes an

emergency• Use all senses to detect problems– What do you see? Hear? Smell? Feel?

• Sometimes signs of emergency are obvious and at other times they are less obvious– Examples –

• someone bleeding where you can see it vs. someone bleeding internally

• a broken bone sticking out of the skin vs. a hairline fracture• a person passed out on the pavement vs. a walking, talking

patient in shock from a trauma

Next Steps

• Check the scene and make sure it is safe to approach– REMEMBER rule # 1 of providing First Aid is to

ALWAYS protect yourself. (from our Safety Unit)

• Quick glance of the area– Look for:• What has occurred• Potential Dangers present• Number of People involve

Next Steps• If the scene is not safe, call for help– Examples:

• Downed power lines• Fire• Gunman

• Do not approach an unsafe scene!!!• If it appears safe, then approach the victim• Call 911 ASAP except in the case of minor injuries– Example:

• Small cuts• Scraped knee• Need for band-aid

Next Steps

If possible, obtain the victim’s permission before providing any care – not necessary if they are not conscious

The first thing you should do when you get to the victim is to check for all injuries

Then, prioritize injuries – this means put them in order of need

Provide care based on these prioritiesREMEMBER ABC’s

AirwayBreathingCirculation

General Principles to considerAlways obtain qualified help

Meaning call 911 for ambulance, fire dept., police, etc. Avoid any unnecessary movement of the victimReassure the victim; Use a confident, calm attitudeAvoid giving the victim anything to eat or drinkConsider temperature – Cold? Hot? Be organized and efficient in your careMaintain victim’s privacy/confidentiality as much

as possibleOnly provide treatment you know how to doAvoid anything that may cause further injury/harm

ACTIVITY

• Complete the worksheet on the basics of first aid care (use your notes and a textbook)

• This worksheet is due at the end of class.

Quiz

QUIZ First Aid Week OneWill be Friday, 2/__/2015

DAY 3• We have:• Defined an emergency.• Researched emergencies.• Listed criteria that helps us to determine

when an event is in fact an emergency.• Defined first aid.• Listed basic principles and steps to consider

when providing first aid.• Now we are ready to begin looking at specific

types of illness/injuries and the first aid necessary for each.

Bleeding and Wounds

• What is a wound?– an injury to soft tissues.

• Types:– Open: break in skin or mucous membranes– Closed: no break in skin or mucous membranes,

but injury occurs to underlying tissues• Problems– Wounds can result in bleeding, infection,

and/or tetanus ( infection of the nervous system with the potentially deadly bacteria )

Classifications of Open Wounds

• Abrasion - scrape• Incision – caused by a sharp object, straight

like a surgical cut• Laceration – jagged, irregular edges

• Puncture – caused by pointed object (nail) • Avulsion – “chunk” of tissue (skin)

• Amputation – body part cut off, completely separated from the body

Types of wounds

Laceration Puncture

Types of wound

An Avulsion A Puncture

Types of wounds

AN INCISION

Pictures

• Let’s look at some pictures of wounds and see if we can identify the type.

• Please note, you will see these pictures again.

Activity

• Draw a picture of each of the 6 classifications of wounds.– Abrasion– Avulsion– Amputation– Laceration– Incision– Puncture

• Be sure to label each picture.• This is due at the end of class today.

Day 4

• Now that we have defined the types of wounds, we are ready to begin caring for wounds.

• I have a worksheet for you to fill in the blanks as we go through these notes. These worksheets will be due for a grade.

• To begin, get with a partner and fill in the wounds overview together from your notes from yesterday.

• Remember, all of your notes will be due when we have the test on First Aid. So, keep up with your notes.

Treatment of Wounds

• All treatment should be directed towards:–Controlling bleeding before it leads to death–Preventing infection and/or obtaining

treatment for it• Example:– tetanus shot–antibiotics

Controlling Bleeding

• First priority in wound care because a victim can bleed to death in a short period of time

• Bleeding can come from:– Arteries – Veins– Capillaries

ARTERIAL BLOOD

• Usually spurts from a wound• Can result in heavy blood loss• Bright red in color• Life-threatening, so it must be controlled

quickly

VENOUS BLOOD

• Is slower than arterial blood and has a steady flow

• Dark red or maroon in color• Easier to control than arterial blood• This is the type of bleeding you have after you

get blood drawn

CAPILLARY BLOOD

• Oozes from the wound slowly• Less red than arterial blood in color, but not

dark like venous blood• Clots very easily• Capillary is the easiest of all three to control

and to stop

Human subway system

Arteries and Veins capillaries

Controlling Bleeding Basic Rules

• Remember when dealing with blood to ALWAYS observe standard precautions

• Use some type of protective barrier like a thick layer of gauze

• If gauze is not available, use a clean cloth or linen material like a towel

• Do your best to avoid contact of the victim’s blood with your skin

• Wash your hands thoroughly ASAP after providing first aid to bleeding victim

First aid supplies for controlling bleeding

• Let’s look together at the different types of supplies we may use to help control bleeding.

– Bandaids, different sizes– 2x2 Gauze– 4x4 Gauze– Wrapping Gauze (Kerlix)– Stretch Gauze– Sterile Gauze Pads– Drain Sponges– Abdominal Pad– Prepackaged Dressing trays

DAY 5

• Yesterday, we learned more about wounds including types, classifications, and the beginnings of treatment.

• Today we will continue with treatment of wounds – fill in the blank notes from yesterday.

• We will begin by evaluating an emergency scenario.

ACTIVITY• Choose a partner.• You and your partner discuss the following

scenario and record your answers on a sheet of paper.

• Be sure to write both student’s names of the sheet of paper.

• Remember to take time to talk about all of your options before settling on an answer.

• We will discuss this together at the end of the activity.

ACTIVITY• You are hanging out with your friends at the mall.

You head to the food court to grab a bite to eat. You come upon a worker who has a box on one of the tables and is opening it with a knife. The knife gets stuck on the tape and when he tries to free it, he loses control of it and cuts his arm. The cut appears to be deep and is bleeding profusely. The blood is dark red. Think fast: You do not have gloves with you. You do not have any gauze in your pocket. Answer the following:

1. What can you grab to protect yourself?2. What can you grab to stop the bleeding?

NOTES

• Now, let’s get back to the notes worksheet from yesterday.

• We will pick up at the top of the back of the first page, labeled as page 3, Roman Numeral VI.

Four Main Methods of Controlling Bleeding

1.Direct pressure2.Elevation

3.Pressure bandages4.Pressure points

Direct Pressure• Apply pressure directly to the wound• Wear gloves (best case scenario)• Use a sterile dressing material – sterile gauze• If gauze is not available, then use a clean cloth

or linen type towel. It’s important to find something as clean as possible and the more absorbent, the better!

• If a major emergency it may be necessary to use your bare hands, but this should be avoided if at all possible.

Direct Pressure

• Apply pressure for 5 to 10 minutes or until bleeding stops – DO NOT keep raising the dressing to check!

• If blood soaks through the dressing, apply a second dressing over the first and continue direct pressure – DO NOT remove the first dressing

• Do not disturb, pick at, or try to remove the blood clot once they have formed

• DIRECT PRESSURE will usually stop most bleeding

ACTIVITY• Let’s practice direct pressure. • Each person take two pieces of 4x4 gauze. They

are thin, so be sure you get only two.• Situation:– You are home alone, cooking to surprise your parents

with dinner when they get off of work. You use the kitchen slicer to cut up some onions. As you slice them, you catch the side of your thumb of your dominant hand in the slicer – ouch! You have an avulsion. It is not too deep, but 1 cm chunk of your skin is left behind on the slicer! It is bleeding, dripping onto the tray of the slicer. You grab the first aid kit from on top the fridge and find 2 pieces of gauze.

• Using one piece of gauze, demonstrate for me how you will hold pressure.

ACTIVITY continued• It has been only 2 minutes, but the blood is

beginning to seep through your first piece of gauze. • Demonstrate for me what we will do next.• Ok the bleeding has now stopped. We haven’t

learned it yet, but what do you think you will do next?– Clean the wound with soap and water – not too hard,

because you don’t want to disturb the clot– Apply triple antibiotic ointment if available (Neosporin)– Cover with a bandaid– Order pizza instead, since this dinner now has a little

more flavoring that you planned!

Reminder

• Quiz tomorrow over front side of worksheet (marked at 1 and 2)

• Quiz will be multiple choice

Day 6

• We have identified the 4 main ways to control bleeding while performing first aid. The last class period before the quiz we talked about and practiced direct pressure.

• We even did a direct pressure activity, where each of you practice applying direct pressure.

• Next, we begin with Elevation.• Be sure to fill in the blanks on your notes

worksheet that you began with Mr. Griffin.

Elevation• Raise the injured part above the level of

the victim’s heart• Allow gravity to aid in stopping blood flow• Continue to apply direct pressure while

elevating• Do not elevate if fractures are present or

suspected – this may cause further damage to the limb

PRACTICE• Let’s practice elevation of a wound.• Pair up.• One of you is the victim, one the first aid

responder.• Victim – You were walking in your neighborhood

and decided to take a short cut through a neighbor’s yard. You tried to jump their fence, but misjudged the distance and cut your right leg badly on the fence. You had a sweatshirt wrapped around your waist, and are using it to hold pressure, but it is still bleeding badly.

PRACTICE

• First Aid Responder – You are walking by and see the victim. You notice how badly he/she is bleeding. They tell you they have been holding pressure for several minutes. The blood is dark red in color, but there is a lot of it.

• Decide what your first and second step should be.

• Show me. I’ll walk around checking each group.

• Good job, now let’s get back to our notes.

Pressure Bandage• Apply to hold dressing in place• Maintain direct pressure and elevation while applying

pressure bandage.• Apply additional dressing over dressing on wound• Use a roller bandage or similar material to hold dressing

in place – secure around the limb where wound is located (use what is available to you. A bandana makes an excellent pressure bandage.)

• Check color above and below bandage• Check pulse sites above and below bandage• Loosen or replace bandage as needed

Activity

• Let’s try putting a pressure bandage on Timmy (the mannequin).

• Choose a partner. One group of two can be at each of Timmy’s arm, and one group at each leg. So 8 of you will be able to help Timmy at once.

• Here are your supplies, 2 pieces of gauze and a strip of cloth to use as a pressure bandage.

• Timmy has a bad wound from a fall. You find him. Follow through the steps (direct pressure, elevation, and pressure bandage) and work to stop Timmy’s bleeding. GO!

DAY 7

• We have worked through 3 of the 4 ways of controlling bleeding.

• Today, we will explore the last one, pressure points, and then work at putting them all together.

• Then, we will learn about minor wounds and their care.

• Be sure to fill in the blanks on your notes.

Pressure Points

• Used when direct pressure, elevation, and pressure bandage do not stop severe bleeding

• Apply pressure to a main artery and press it against an underlying bone to cut off main blood supply to that area

• Should not be used any longer than absolutely necessary because it stops circulation to other parts of the limb

• Continue with direct pressure and elevation while applying pressure to pressure points

Pressure Points

• Two main pressure points– Brachial Artery on arm– Femoral Artery on leg

• When bleeding stops, slowly release pressure on pressure points while continuing to use direct pressure and elevation.

• Reapply pressure to pressure point if bleeding reoccurs• Always seek medical attention ASAP• For major wounds, make no effort to clean wound

because this may result in additional bleeding

Activity

• We can’t practice pressure points on each other, because we would be limiting circulation.

• Instead, let’s work together to find our brachial artery on our own arm and then let’s look at Timmy to see where the femoral artery would be.

• Next, let’s work through a complete scenario on Timmy as a group. Can I have volunteers. I need two first aid providers, a bystander, and an ambulance.

Scenario• Timmy has been hit by a car. The car drove off

after they hit him. He is laying in the road. He is bleeding dark red blood from his head, bright red blood from his left leg that is spurting out, and has multiple abrasions with red bleeding that is not spurting out all over his left arm. The two first aid responders are in cars nearby and jump out to help. One of them happened to have a first aid kit in their car that contained gauze, gloves, bandaids, bandages, and other many other supplies. The bystander has no first aid experience, but has a cell phone.

• Show us how to respond.

DAY 8• We are now finished with controlling bleeding. Yay!• What were the 2 main focuses of first aid for wounds?– Control bleeding– Prevent infection

• So, now that we have finished controlling bleeding, we need to talk about preventing infection.

• For major wounds, bleeding is the most important issue, but for minor wounds where life-threatening bleeding is not a part of it, then preventing infection becomes primary.

• Be sure to fill in your wound notes worksheet as we go through.

MINOR WOUNDS

• Defined as not having severe bleeding• First priority – prevention of infection when bleeding is

not an issue• Remember to wash your hands and put on gloves– The wound is minor, so you have time– Remember Rule # 1 – Protect YOURSELF

• Wash the wound with soap and water or wound treatment for infection such as hydrogen peroxide Wipe in a outward direction away from the wound

• Use sterile gauze if available

Minor Wound treatment• Discard gauze after each use and use clean gauze• Rinse wound thoroughly with cool water• Gently blot wound dry with sterile gauze when

available• Apply dressing and bandage– A dressing is an absorbent covering for a wound– A bandage is an outer covering or wrap that holds the

dressing in place– So, what’s a bandaid?

• Explain signs of infection for victim to monitor for and advise to seek medical attention if these occur

Signs of Infection

• Swelling • Heat• Redness• Pain• Fever• Pus

• Red streaks leading from the wound

Signs of Infection

Tetanus

• Tetanus bacteria can easily enter an open wound

• Serious illness• Get tetanus shot or booster as needed

Tetanus Side Effects

What if there is an object in the wound?

• Examples - splinters, small pieces of glass, small stones or gravel, etc.

• If object is at the surface of the skin, remove it gently with tweezers (wipe with alcohol if not sterile)

• If imbedded deeper in skin then leave for physician to remove– If in doubt, leave for a medical professional– Advise victim to not leave objects imbedded in

wounds, this can lead to serious infection later

PRACTICE

• Let’s practice placing dressings on wounds– First, let’s review washing your hands• How long – 20 to 30 seconds• Sing, Happy Birthday 2 times

– Next gloves– Then apply dressing• Tape with Gauze• Bandaid• Wrapping or stretch Gauze

Remember

• Quiz tomorrow over fill in the blank notes – You have already quizzed on the front side, this

quiz will be over the rest of the hand out

DAY 9

• Quiz – Wounds

• After the quiz,• We will learn about types of bandages

BANDAGESTriangular bandage – head/scalp recurrent wrap for headhttp://www.youtube.com/watch?v=Fc2-GnjVf8c Circular Bandage - head, arm, elbow, wrist, hand, leg, knee, foot, etc. Never use around neck or throathttp://www.youtube.com/watch?v=w0KTMrSG_uoSpiral Wrap Bandage - any extremity, start at the bottom of the limb and spiral upward

Never use on head or neck/throatFigure 8 Wrap Bandage – joint (ankle/wrist) http://www.youtube.com/watch?v=HcfYYKglxrcRecurrent Wrap Bandage – fingerhttp://www.youtube.com/watch?v=Te45hWRO9vE

PURPOSE

• Three purposes of a Bandage:– To hold a dressing in place– To provide pressure to help control bleeding– To help protect the dressing and wound from

germs that could cause infection

ACTIVITY

• STATIONS

Dressing applicationTriangular BandageCircular BandageSpiral Bandage

Figure 8 BandageRecurrent Bandage

Day 10

• Continue with stations and check-offs for each station.

DAY 11

• Now, you have learned all about wounds, dressings, and bandages. You have had the opportunity to practice each one of them.

• Today, we will review everything we have learned about first aid since the very beginning.

• STUDY GUIDE• Tomorrow, we will have a test over everything

we have learned.