Volunteer Marine Rescue TDM MF1007B. Volunteer Marine Rescue TDM MF10 07B.

Volunteer Marine Rescue

TDM MF1007B

Volunteer Marine Rescue

TDM MF10 07B

Apply First Aid

Introduction Emergencies Legal Obligations Managing the Scene Patient Care Air Way Management Respiratory Care C.P.R. Unconsciousness

Session 1

Please Note

“This is a Hands on Course”

During this first aid course you will be required to perform first aid techniques and procedures on other students.

These procedures will also be practiced on you by other course participants. Eg: bandaging, recovery position etc.

If you are concerned with these, please take this opportunity to discuss your concerns with your course facilitator now.

Obtaining Consent

• You should obtain consent from the individual before assistance is provided.

• It is assault to touch or interfere in any way if consent is not given.

• Consent is deemed not necessary if an individual is unconscious.

• In the case of a minor, obtain consent from parent or guardian.

Duty of care

Australian Law does not impose a duty on all persons to stop and render assistance

If you do stop, then you assume a duty of care to act carefully and competently

Queensland State Law does impose a duty to those involved in a road traffic crash to stop, render assistance as able and call for medical assistance

The VMR Worksite.

VMR Bases and Vessels are considered under the law to be workplaces and therefore workplace health and safety regulations apply.

Mariners and volunteers working on a commercial vessel have a legal obligation and responsibility to comply with workplace health and safety instructions from Unit Management and the Master of the vessel.

Legislation requires that VMR workers do not recklessly use or misuse anything provided for their use, and do not willfully risk the health and safety of themselves or others.

The volunteer rescuer is there to assist and must protect those being assisted.

Clause 39 provides an indemnity to individual

volunteers, either engaged in community work for

community organisations or as an office holder of

such an organisation, from liability in negligence for

their own actions. The conduct of the volunteer

must be in good faith, and without reckless

disregard for the safety of any other person.

Civil Liabilities Act

AQTF AND ARC GUIDELINES

All first aid and resuscitation techniques and

assessment processes meet AQTF (Australian

Quality Training Framework) and ARC

(Australian Resuscitation Council) guidelines.

Emergency Contact Numbers

000 Call this number for:• Ambulance• Fire• Police

112 From a mobile or call 000

131261 Call Poisons information centre call

What is first aid?

First Aid is emergency care

given to an injured or ill

patient before medical

assistance arrives.

Aims of First AID

PFO

UR

‘sPRESERVE LIFE

PROTECT THE UNCONSCIOUS

PREVENT DETERIORATION

PROMOTE RECOVERY

IMPORTANCE OF REASSURANCE

By easing anxiety and pain levels you help promote

recovery of the injured patient by:

• Decreasing the pulse rate

• By decreasing the pulse rate you slow blood loss

• By slowing blood loss you slow the shock process

LEGAL ISSUES

DUTY OF CARE CODE OF PRACTICE

NEGLIGENCE CONSENT

RECORDING CONFIDENTIALITY

NOTE

Any first aider is not expected to be an expert and a court would

consider: •the first aider's level of training,•what a prudent and reasonable

person could be expected to do with the same level of training and in the

same or similar circumstances

BARRIERS TO ACTION

• Presence of bystanders

• Uncertainty about the victim

• Nature of injury/illness

Are we competent to take over?

Friend v stranger, First Aid means First Aid

Some injuries are very unpleasant to see

BARRIERS TO ACTION

• Fear of Disease transmission

• Fear of doing something wrong

• know

• Can I catch something here?

• (some of us feel we will do the wrong thing

• some of us feel we may go too far)

• The worst we can do is nothing.

RESPONSIBILITIES OF THE FIRST AIDER

• COMMUNICATION

•Needs to be culturally

aware, sensitive, respectful

(Verbal and non verbal communication is

important when handling a casualty)

…..More Responsibilities

• Reporting

• Record Keeping

• Must be timely, Clear, concise, accurate

• Do’s: Use pen not pencil, sign and date, maintain confidentiality

• Don'ts: No correction fluid- cross out and initial changes

…SELF CARE AS a FIRST-AIDER

Debriefing is important

Working as a first aider in traumatic affects people differently

Seeking feedback from medical personnel about your experience can promote self-improvement and prepare you

better for future events

RECOGNISING EMERGENCIES

UNUSUAL NOISES

Screams, yells, moans, calls for help, breaking glass ,crashing metal, screeching tyres

UNUSUAL SIGHTS

Stalled vehicle with door open, overturned saucepan spilled medicine container, broken glass, fallen high-voltage lines

UNUSUAL SMELLS

Unusual strong smells, unrecognisable smells, obnoxious smells

UNUSUAL SIGNS AND SYMPTOMS OF BEHAVIOUR

Unconscious, difficult breathing, clutching chest or throat, slurred speech, confused, irritability, drowsiness, sweating usually, uncharacteristic colour of skin.

Survey the Scene

Are there any Dangers?

Traffic

Fire

Electricity (fallen power lines)

Fuel or Chemical spillage

Gas

Bad Weather

Unstable Structures

ASSESSING THE SITUATION – Safety Management

DETERMINE PRIORITIESD.R.A.B.C.D.Multiple Casualties

UTILISE BY-STANDERS

CALL FOR HELP Dial 000

GENERAL MANAGEMENT

D.R.S.A.B.C.D.

HAEMORAGE CONTROL

EMOTIONAL SUPPORT

PAIN RELIEF

CLIMATE PROTECTION

Risks to the Rescuer

• Environmental Dangers

• Cross Infection:Take precautions if necessary.

Use ‘barrier devices’ if possible.

• Manual HandlingFollow principles of safe moving and handling. Get assistance if necessary

ACTION AT AN EMERGENCY

AC

T Quickly

Calmly

Correctly

CASUALTY EXAMINATION

Response - C.O.W.S

• Can you hear me?• Open your eyes• What’s your name• Shake (give them a shake)

MOVING A CASUALTY

• Before moving the casualty consider • Whether you can handle the size and weight, without

injury to yourself or the casualty• What other help is available• Type and seriousness of injuries• Terrain to be crossed• Distance casualty has to be moved• If travel or motion sickness may make casualty worse

When lifting, remember to:

• Bend at the knees

• Keep your back straight and head up

• Keep in a balanced position

• Keep your centre of gravity low

• Hold the weight close to your body for stability

• Take small steps

• Work as a team - someone must take role of leader

Moving People ON YOUR OWN Follow principles of safe handling and get help if needed

The Arm Drag

The Ankle Drag

The Clothes Drag

Lifting a Casualty - General Management

Follow DRABCD.Manage all injuries and immobilise fractures.Tell casualty what you are intending to do.Seek casualty’s help and cooperation.Make sure casualty feels secure.Always use help to lift if it is available. Hold casualty firmly.Avoid risks where possible.

Gathering Patient Information

HISTORY

SIGNS

SYMPTOMS

EXTERNAL CLUES

CHECK:Handbag

Pockets

Briefcase

Hospital Cards

Medic Alert

Sig

ns Sight

Touch

Smell

Hearing

Sym

pto

ms

SensationsPAINTENDERNESSLOSS OF MOVEMENTLOSS OF SENSATIONCOLDHEATNAUSEAWEAKNESSDIZZINESSFAINTNESSLOSS OF CONSCIOUSNESSLOSS OF MEMORY

Check for INJURIES

TOP TO BOTTOM

HEAD

NECK & SPINE

TRUNK

ARMS

LEGS

Vital signs

• Pulse

• Breathing

• Conscious state

• Skin state

Normal Pulse

• Adults (60-80 BPM)

• Children (80-100 BPM)

• Infants (100-160 BPM)

Normal Breathing

• Adults 16-20 breaths per minute• Children (1-5 YO) 25-40 breaths per

minute• Children (6-12 YO) 16-25 breaths per

minute• Infants (1-12 mths) 25-40 breaths per

minute

UNCONSCIOUSNESS

An unconscious patient is one who does not respond to the spoken word.

There are three levels:

•Fully conscious (alert).

•semiconscious (can be roused).

•fully unconscious (no response).

UNCONSCIOUSNESSCauses:

• Trauma- Head/spinal

• Stroke

• Infections (meningitis)

• Epilepsy / Seizures

• Diabetic attack - Insulin

• Infant Convulsions

• Alcohol / Drugs

• Pretending

• Uraemia ( renal failure)

Combinations of different causes maybe present in an unconscious casualty

CARE FOR AN UNCONSCIOUS PATIENT

• Place in recovery position (See below).• Stop bleeding.• Loosen all tight clothing.• Leave in recovery position. Check for injuries.• Keep patient’s temperature normal.• Continue to monitor their A.B.C.• DO NOT attempt to give fluids.• DO NOT leave your patient. Send someone else for help.

Document for your own information and medical aid when it comes all history, signs and symptoms you find.

Be prepared to perform CPR if the patient goes into cardiac arrest (that is not breathing and heart stops beating).

Recovery Position

All unconscious patients must be placed in the recovery position irrespective of their injuries.

This is to ensure their airway is open so oxygen can get to their lungs.

Recovery Position

The first step is to raise the knee nearest to you.

Recovery Position

Place the patients arm nearest to you across their chest.

Extend their other arm away from their body.

Recovery Position

Carefully roll the patient on to their side, bring the head back so that the airway is clear.

Recovery Position

If a patient is pregnant and CPR has to be performed, place a pillow under her right buttock.

Recovery Position

All unconscious women in the late stages of pregnancy must be placed in the recovery position on their left side.

Airway Management

Obstructed Airway

Open Airway

Maximum Head Tilt & Jaw Support.

(except for Babies).

(Note tongue obstructing the airway)

Opening the Airway

Use Pistol Grip

Jaw Thrust Jaw Support

Noisy Breathing Always Means a

Partially Obstructed Airway.

Opening the Airway

Pul

se B

reat

hing Rate per Minute

Effort Sounds

Rate per minute Rhythm Volume

Airway Obstructions

Anatomical• Blocked by Anatomic

Structure.

• Tongue

• Swelling of the Throat

• Laryngeal Spasm

• Blocked by Foreign Material.

• Food or Vomit

• Toy

• Fluid

• Blood

Mechanical

Choking

Airway ObstructionsChoking

Choking occurs when the airway is totally or partially blocked by swollen tissues or a foreign body, or when food or other

material enters the windpipe instead of the gullet.

Symptoms and signs of choking• Inability to breath, speak, cry or cough.• Noisy breathing or wheezing.• Clutching at the throat.• Red or congested face with bulging neck veins.• Anxiety, restlessness.• Cyanosis (Bluish colouration of the skin).• Collapse and unconsciousness.

Choking

Airway ObstructionsIf a person cannot breath or cough, urgent care is required.

Quickly assist the victim to lie down.

Use the heel of your hand to give up to five sharp back blows between the shoulder blades.

Airway Obstructions

If the person is still unable to breathe, give up to four recovery chest thrusts in an attempt to expel the object.

Do not apply pressure below the ribs or the abdomen.

Choking

Airway Obstructions

An alternative way is to place the person on a chair, their chest resting on the back of the chair.

Give up to five back thrusts to dislodge the object.

Is no improvement commence CPR.

Choking

Do Not

Choking - Finger Probes

Finger probes are used only to remove visible foreign matter

Probe for matter that cannot be seen.

Probing may:

• Force the matter further into the airway, or

• Cause damage to the inside of the mouth and thus causing severe bleeding.

Oxygen Emergencies

SuffocationStrangulationFumes InhalationDrowningChokingElectrical injuriesAsthmaWinding

Breathing Emergencies

May be caused by:ChokingAsthmaElectrocutionShockNear drowningHeart attackInjury to the chest or lungsAllergic reactionDrugsPoisoning

Asthma Assist with prescribed medication

and management plan.

Rest and reassure the person.

Place the person in a comfortable position.

Observe the person constantly.

If medication is not working call an ambulance.

Care for Hyperventilation

• Remain calm.

• Reassure the person.

• Count each breath aloud.

• Encouraged the person to breathe slower.

• The person should visit a doctor or hospital to rule out any underlying problems.

SeizuresWhen to call an ambulance.

• If it lasts more than a few minutes• Repeated seizures• Injury• The person is pregnant• Person is diabetic• The person is an infant or child• Has no previous history of seizures• Occurs in water• person remains unconscious

DiabetesGlycaemia

Hypo Hyper

Onset: Rapid Slow

Respiration: Normal Laboured

Pulse: Normal Rapid

Skin: Pale /Sweaty Hot / Dry

Behaviour: Altered Normal

Care for respiratory distressGeneral care:

Emergency action principles

Specific care:• Calm the person and reassure • Assist casually into a comfortable position

• Assist with relevant medication

• Maintain the casualties normal body temperature

• Monitor the casualties of vital signs.

Respiratory arrest

The condition in which there is cessation of breathing

Key points of respiratory arrest

As a consequence of respiratory distress the following may occur:

• Unconsciousness

• Breathing stops

• Heart stops beating

• Body systems fail

Cardiac arrest

The condition in which the heart has stopped or is too weak to pump effectively enough to

provide a palpable pulse.

No response

No breathing

No pulse

CPR(Cardio Pulmonary Resuscitation)

EAR(Expired Air Resuscitation)

Methods:

Mouth to mouth Mouth to nose Mouth to mouth and nose Mouth to mask Mouth to Stoma

Check:

Clear airway Pistol grip Head tilted (not babies) Tight seal Chest rise

ECC(External Cardiac Compression)

Check:

Kneeling position Shoulders over Sternum Elbows straight 50-50 rhythm No jabs No rocking no interruptions



Mouth to Stoma

A person who has had a Laryngectomy must breathe through an opening in the front of their neck called a ‘Stoma’.

They are referred to as total or partial neck breathers.

Stoma


For a total neck breather support the jaw with the head tilted back to make it easier to seal your mouth over the stoma as shown and in the accompanying illustration.

Mouth to Stoma


Mouth to Stoma

For a partial neck breather seal the mouth and that nose to stop air escaping from the mouth or nose as shown in the accompanying illustration.


Adult

One operator

Over 8 years of age

Site Lower half of sternum

How Two hands

Depth Third of chest depth

Ratio 2 inflations 30 compressions

Cycle time Five cycles in two minutes


Child

One operator

1 to 8 years of age


How One hand





Baby

One operator

Under 1 year of age


How Two fingers





Regurgitation

If patient vomits during CPR:

• Stop CPR.

• Turn Patient into recovery position.

• Clear Airway of vomit.

• Return to supine position

• Continue CPR.

Head Injury(Unconscious Not Breathing)

Removal of Headgear

If the firstaider is the only one present and the person with headgear is UNCONSCIOUS and NOT BREATHING, the

airway takes precedence over ALL other injuries.

To enable CPR to be carried out, remove the headgear exercising great care not to move the neck unduly.

If a second person is available, one person supports the neck while the headgear is being removed.

DURATION OF C.P.R.

Once commenced, C.P.R. should continue until:

•Spontaneous circulation returns (E.A.R. continues)

•The patient recovers

•Trained help relieves you

•A Medical Officer pronounces life extinct

•It is physically impossible to continue

Time to Practice

recovery Position

Choking

CPR

Volunteer Marine Rescue TDM MF1007B. Volunteer Marine Rescue TDM MF10 07B.

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Transcript of Volunteer Marine Rescue TDM MF1007B. Volunteer Marine Rescue TDM MF10 07B.