NSC Advanced First Aid, CPR & AED – Flashcards
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Goals of First Aid
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1. Keep victim alive 2. Prevent victim's condition from getting worse 3. Help promote early recovery 4. Ensure victim receives appropriate medical care
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Consent
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Need to have victim's consent before using first aid
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Types of consent
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Expressed and Implied
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Expressed consent
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Responsive victim communicates consent, can include head nods
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Implied consent
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Unresponsive or child's parent not present or reached
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Refusing consent
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Victim can refuse consent - if they go unresponsive consent is now implied Get second witness to refusal
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Scope of care
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Set of first aid techniques learned in first aid course
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Standard of Care
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Care expected from any trained EMT under similar circumstances
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Abandoment
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If you leave victim and injury or illness becomes worse Justified reasons: Exhaustion, imminent danger, or replacement comes (equal or higher skill level)
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Confidentiality
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Only give victim's information to the treating medical professionals
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Infectious Diseases Transmitted
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1. Someone has infection 2. Infection leaves body 3. Infection reaches another person, enters body (through blood) 4. Second person develops infection
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Bloodborne Diseases
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1. HIV 2. Hep B (Has vaccine) 3. Hep C
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Protection against bloodborne diseases
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use gloves
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Steps in an Emergency
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1. Recognize the emergency 2. Check the scene 3. Check the victim 4. Call 9-1-1 5. Give first aid 6. Have victim seek medical attention
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10 Body Systems
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1. Respiratory 2. Cardiovascular 3. Nervous 4. Musculoskeletal 5. Integumentary 6. Gastrointestinal 7. Endocrine 8. Immune 9. Urinary 10. Reproductive
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Assessment
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1. Initial assessment 2. Secondary assessment 3. Monitor for change
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Initial Assessment
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Check for life-threatening conditions Move only if - immediate danger or cannot give lifesaving care
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How to check for responsiveness
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Tap on shoulder and ask "Are you okay?", doesn't respond then call 9-1-1 and provide care
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AVPU Scale
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Alert Verbal - Response to verbal Painful - Responses to pain Unresponsive
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Initial Assessment Steps
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1. Check for responsiveness and normal breathing 2. Unresponsive - Call 9-1-1, if unresponsive and not breathing provide BLS 3. Breathing - Check for severe bleeding and other threats 4. Care for life threatening conditions
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Recovery Position
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Keeps airway open, allows fluids to drain, prevents from inhaling stomach contents HAINES High Arm IN Endangered Spine Extend arms over victim's head, position arm closest to you over victim's chest, bend victim's leg closest to you at the knee, put forearm under victim's shoulder while supporting the neck and carefully roll, bend both legs and open mouth
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SAMPLE
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Signs and symptoms Allergies Medications Previous problems Last food or drink Events
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Physical Exam
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Head to toe DOTS Deformities Open injuries and wounds Tenderness Swelling
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Universal sign of choking
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Hands around the throat
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Choking care for Responsive Adult and Child
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1. Consent 2. 9-1-1 3. Stand behind with one leg in between theirs 4. Locate navel, create fist with hand above navel 5. Grasp fist with other hand and thrust inward and upward
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Choking care for Responsive Infant
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1. 5 back blows 2. Check for expelled object 3. 5 chest thrusts 4. Continue cycle, if alone call 9-1-1 after 1 minute
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Effects of blood loss
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causes a decrease in oxygen supply to the body; blood pressure drops; heart pumps faster to compensate for the decreased volume and BP; body will attempt to clot the blood to halt bleeding; usually requiring 6-7 minutes; uncontrolled, bleeding can result in shock and death
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Class 1 blood loss
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Up to 15%
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Class 2 blood loss
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15-30%
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Class 3 blood loss
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30-40% At 30% body can no longer compensate
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Class 4 blood loss
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>40%
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Types of External Bleeding
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1. Arterial 2. Venous 3. Capillary
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Controlling bleeding
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Apply direct pressure and raise above the head
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Symptoms of internal bleeding
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Abdomen - tender, swollen, bruised, hard Blood vomited or present in urine or stool Cool, clammy skin, pale, ashen, or bluish Thirst Confusion or lightheadness
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Shock - Severe blood loss
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Not enough oxygen-rich blood reaching organs, life-threatening, may develop quickly or gradually
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Common Types of Shock
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1. Hypovolemic 2. Cardiogenic 3. Neurogenic 4. Anaphylactic
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First Aid for Shock
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1. Check responsiveness 2. Call 9-1-1 3. Lie on back 4. Feet 6-12" above ground
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First Aid for Anaphylactic Shock
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1. Call 9-1-1 2. Help administer epi-pen
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What shouldn't you use to clean a wound?
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Never use alcohol, hydrogen peroxide, or iodine
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Types of Open Wounds
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Abrasions, Lacerations, Punctures, Avulsions, Amputations, Burns
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Scalp Wound W/O Fracture First Aid
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1. Replace any skin flaps, cover with dressing 2. Use direct pressure to control bleeding 3. Roller or triangle bandage around head to secure dressing
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Blow to Eye
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1. If eye is bleeding or leaking fluids - CALL 911 2. Cold pack with barrier (up to 15 min) 3. Lie still, cover uninjured eye 4. Seek medical attention
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Ear Injuries
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1. Clear fluid or watery blood from the ear could mean skull fracture - call 911 2. Help vic sit up, tilting affect ear lower to let blood or other fluid drain 3. Cover ear with loose sterile dressing - No pressure 4. Medical attention
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Teeth and Mouth Injuries
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Bleeding, control with direct pressure. Knocked out teeth can be replanted. Priority of first aid is keeping airway open and controlling bleeding
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Knocked out teeth
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1. Vic sit still, titled forward to allow blood to drain 2. Rinse with tap water or saline 3. Control bleeding by having vic bite down for 20-30 minutes on gauze 4. Save the tooth. Pick up by crown and place in milk 5. See dentist immediately
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Nosebleed First Aid
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1. Tilt head forward, mouth open 2. Pinch nostrils together just below the bridge for 10 min 3. Gasping or choking on blood call 911
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Function of skin (three things)
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Protection Regulates temperature Sensation
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What Happen With a Burn?
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May damage any layer of skin Can allow pathogens - risk of infection Fluid loss (2nd degree) Loss of body heat (severe burn) Damage to nerve endings
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Where are the majority of deaths by fires and burn at?
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The Home
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Heat Burns
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Caused by sun, flames, steam
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Assessing a Burn
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What type of burn is it? (1st, 2nd, 3rd) How extensive? What specific body area?
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Classifications of Burns
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1st degree 2nd degree 3rd degree
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1st degree
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Superficial burns Damage only the outer skin layer
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2nd degree
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Partial-thickness burn Damages deeper layers Blisters present Depending on size, may require medical attention
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3rd degree
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Full thickness burn Damages all layers
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What do you use for assessing burn size and severity?
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Rule of nines
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When do you call 911 for burns?
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Any 3rd degree burn that is larger than 50-cent piece Any 2nd degree that covers more than 10%, (5% in kids) 2nd and 3rd on face, genital, hand, feet Circumferential burns Chronic health disorders
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First Aid: Heat Burns
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1. Stop burning, cool area 2. Protect area 3. Provide supportive care 4. Ensure medical attention
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First Aid: 1st Degree Burns
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1. Stop burning 2. Cool burned area with cool water 3. Remove constricting items 4. Protect
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First Aid: 2nd Degree Burns
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1. Stop burning 2. Cool burned area with cool water 3. Large burns call 911 4. Remove constricting items 5. Nonstick dressing - keep loose
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First Aid: 3rd Degree Burns
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1. Stop burning 2. Cool burned area with cool water 3. Remove constricting items 4. Call 911 5. Treat for shock 6. Cover burn with nonstick dressing - keep loose *Do not cool burn if larger than 20% of the body or 10% for a child
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Smoke Inhalation
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Potential airway or lung injuries Airway swells Symptoms may not be obvious until 48 hours after exposure
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First Aid: Smoke Inhalation
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1. Get victim to fresh air 2. Call 911 3. Help victim into comfortable position for breathing, keep calm
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First Aid: Chemical Burns
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1. Check MSDS 2. Move away from fumes or ventilate area 3. Gloved hand, brush off any dry chemical 4. Flush area with running water. Flush until EMS arrive. 5. Remove clothing and jewelry 6. Call 911 for any chemical burn
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Electrical Burns and Shocks
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External injuries may include entrance and exit wounds Internal injuries caused by electricity flowing through body includes irregular heart rhythms or cardiac arrest
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First Aid: Electrical Burns
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1. Do not touch victim until area is safe. Unplug or turn off power. 2. Call 911 3. Unresponsive victim - Give BLS 4. Care for the burn 5. Treat for shock
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Head and Spinal Injuries
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May be life-threatening Damage or trauma to the brain and spine
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Assessment of Head and Spinal Injuries
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Mechanism of injury Focus on physical exam Recognize possibility of head/spinal injury
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Sign and Symptoms of Head/Spinal Injuries
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Lumps Changing levels of responsiveness (AVPU) Confusion Fluids Stiff neck Inability to move a body part Dizziness Unequal pupils Headache Tingling in hands/feet
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Physical Exam of Head/Spinal Injuries
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Unresponsive - NO exam -Do not move victim with possible spinal injury -Maintain spinal motion restriction to prevent head movement Responsive - Carefully assess -Need 2 people, one to hold head in place -Reveal problems call 911 -Don't assume lack of certain symptoms means no spinal injuries Assessment 1. Check victim's head 2. Check neck 3. Check feet sensation 4. Ask victim to point toes 5. Check strength (Can you push on my hands) 6. Check in hands too
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Skull Fracture
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Check for fractures before applying direct pressure to scalp bleeding (can push bone fragments back into brain) Life-threatening
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First Aid: Skull Fracture
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1. Call 911, Stay with victim 2. Put breathing unresponsive victims into recovery position, unless spinal injury suspected 3. Do not clean wound, press on it, or remove impaled object 4. Cover with sterile dressing 5. If bleeding use a ring dressing
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Brain Injury
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May occur with blow to head Likely with skull fracture Range of signs and symptoms, signs may progress 911 (immediately if nausea, vomiting, headache, seizures, vision or speech problems, changing levels of responsiveness present) Suspected spinal injury
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First Aid: Brain Injury
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1. Have victim lie down 2. Keep victim still and comfortable 3. Call 911 4. Support head and neck
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Concussion
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Temporary swelling of the brain Usually no head wound May have been "knocked out" and regain consciousness Second impact syndrome can be fatal
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Signs and Symptoms of a Concussion
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Headache Temporary confusion, altered mental status Memory loss Brief loss of responsiveness
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A&O (Alert and Oriented X4)
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Person (Do they know who they are?) Place (Where are they?) Time (What time of day is it?) Disposition (Do they know what happened?)
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First Aid: Concussion
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Difficult to determine seriousness Seek medical attention Call 911, keep victim still and give supportive care Victim should never continue the activity (possibility of second impact syndrome if they do)
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Spinal Injury
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Fracture of neck or back always serious Perform spinal motion restriction *Hold the head in the position you found them in (unless unresponsive then give CPR - keeping head in line with body)
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First Aid: Spinal Injury
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1. Ask a responsive victim what happened. Assess responsive victim. 2. Stabilize neck in position found 3. Monitor breathing - prepare for CPR 4. Send someone to call 911
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Log Roll
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1. Hold victim's head with both hands over ears 2. First aider at head directs the others to roll as a unit 3. Keep supporting head
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Lower Back Injuries
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Usually mechanical/pain May not damage spinal cord Usually not an emergency
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Chest, Abdomen, Pelvic Injuries
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Blunt force trauma or penetrating Can be life-threatening Shock Always call 911
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Common Causes of Chest Injuries
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Car crash Blow to chest Falling Sports
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Signs/Symptoms of Chest
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Breathing problems Severe pain Coughing blood Bruising and Swelling Deformity
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Pneumothorax
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Air escapes from injured lung, causing it to collapse Respiratory distress - Call 911
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Hemothorax
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Blood from injury builds up in the thoracic cavity - compressing the lung Shock 911
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Broken Ribs
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Typically from trauma Lower ribs and side weaker - more common injuries Sever pain, dislocation, swelling Injuries to lungs or underlying organs can be damaging as well Always call 911
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First Aid: Ribs
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1. Help victim sit into comfortable position 2. Support ribs with pillow, loosely bandage 3. Call 911
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Flail Chest
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Two or more ribs broken in two or more places From severe blow to the chest Paradoxical movement - flail segment moves in opposite direction
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First Aid: Chest Flail
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1. Comfortable position 2. Splint with pillow and bandage 3. Position victim lying on injured side 4. 911
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First Aid: Impaled Object
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1. Keep victim still 2. Stabilize with dressing 3. Bandage around and over object 4. Call 911
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Sucking Chest Wound
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Open wound in chest caused by penetrating injury Wound lets air move in and out of chest during breathing Can be life-threatening Can collapse both lungs
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First Aid: Sucking Chest Wound
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1. Put thin sterile dressing over wound 2. Cover dressing with plastic wrap to make air-tight seal, tape on three sides 3. Position victim inclined toward injured side 4. Call 911
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Abdominal Injuries
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Closed or open Blow to abdomen Internal or external bleeding Needs immediate medical attention
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Closed Abdominal Injuries
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Can be life-threatening Internal organs may have ruptures + severe bleeding
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First Aid: Closed Ab Injury
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1. Position comfortable, loosen tight clothing 2. Call 911 3. Treat for shock and monitor breathing
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Open Abdominal Injuries
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Visually injuries - internal organs Large wound creates evisceration - ab organs protrude, serious emergency
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First Aid: Open Ab Injury
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1. Victim on back 2. Cover would with dry non-inherent or moist sterile dressing 3. Cover with large occlusive dressing 4. 911 5. Treat for shock *Intestine Taco for exposed organs, Make pouch of large pad, Tape
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Pelvic Injuries
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Common in elderly Can cause internal bleeding and shock May also have spinal injury
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First Aid: Pelvic
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1. Victim lie on back 2. 911 3. Immobilize legs together 4. Treat for shock
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Bones, Joints, Muscle Injuries
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Most common injuries Caused by blow, impact, fall, sports
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Musculoskeletal Injuries
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Fractures Dislocation Sprains Strains Contusions Cramps
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Assessment (SAMPLE) for Musculoskeletal Injuries
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Initial assessment first - life threatening conditions Perform physical exam Mechanism of Injury Ask for history Do no move unnecessarily
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Signs and Symptoms for Musculoskeletal Injuries
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Compare injured arm or leg to opposite DOTS Pain Bleeding Discoloration/Bruising Abnormal sensation Inability to move Difference in temperature
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RICE
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Rest Ice Compression Elevation
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Rest
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Don't move Rest until medical help
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Ice
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Cold reduces swelling, pain, and bruising Put on as soon as possible (except for open wound) Plastic bag with ice-water with cloth barrier Apply for 20 min, remove for 30
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Compression
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Comfort and support Elastic roller bandages over injured area, ice pack, another loose ace bandage Can be used for 24-48 hours
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Elevation
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Helps prevent swelling Helps control internal or external bleeding Splint fracture first and elevate above the heart
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Fractures
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Bones completely broken or only cracked Bleeding can be severe with open Nearby organs can be damaged Closed and Open
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Closed Fracture
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Simple fracture Skin not broken
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Open Fracture
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Compound fracture Skin broken
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First Aid: Fractures
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1. Immobilize area (above and below the suspected fracture) 2. 911 3. Treat open wound 4. Apply RICE 5. Splint
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Joint Injury: Dislocation
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One or more bones moved out of normal position in joint Usually involves tearing of ligaments Pain, swelling, bruising, looks deformed Can damage nerves and cause serious bleeding
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Joint Injury: Sprains
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Bone remain in place but ligaments and other structures injured Overextended joint Ankles, knees, wrist common Swelling, pain, bruising Looks similar to a fracture Circulation check
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Joint Injury
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Both types can look like a fracture Treat as severe, call 911
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First Aid: Dislocations
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1. Immobilize/Splint 2. 911 3. RICE
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First Aid: Sprains
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1. Immobilize 2. RICE 3. Soft Splint 4. Medical attention
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Muscle Injuries
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Overexertion, careless, sudden move Strains, contusions, cramps Less serious than bone and joint Repeated injury can lead to chronic pain
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Strains
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Tearing of muscle or tendon Overexertion First Aid: RICE, cold pack 20 min on and 30 off
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Contusion
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Bruised muscle May result from a blow Pain, swelling, discoloration May persist First Aid: 1. Apply RICE, DO NOT massage 2. Cold pack, 20 on 30 off 3. Repeat 24-48 hours
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Muscle Cramps
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Tightness and overexertion Thigh and calf common Different from heat cramps Flexibility and stretches can reduce First Aid: 1. Stop activity 2. Stretch 3. Cold pack 20 on, 30 off 4. Gently massage
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Splinting
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Restricts movement Always splint if suspected fracture Reduces pain Minimizes swellings Can be improvised Check and treat life-threatening first Consider mechanism of injury and possibility of spinal injury
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Types of Splints
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Rigid Soft Anatomic
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Rigid Splint
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Board, plastic, metal, cardboard
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Soft Splint
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Pillow, folded blanket, or towel Triangular bandage formed into a sling
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Anatomic
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"Buddy Taping" Bandage uninjured leg, toe, or finger to injured one
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Securing Splints
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Bandages, strips of cloth, velcro strips Knots or tape (not on skin)
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Guidelines for Splinting
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Dress any open wound first Splint injury in position found Immobilize entire area (above and below) Place padding between skin and splint Do not secure over open would Elevate if possible, ice Check circulation
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Slings
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Prevent movement, provide elevation Splint first Splint in position found, slings may not be possible Cold packs can be used (20 on, 30 off) Do not cover fingers inside sling
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Hips
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Fractures and dislocations First Aid similar to pelvic injury Call 911 Do not move Anatomic splint legs, pad between Treat for shock, but do not elevate
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Upper Leg
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Femur fracture 911 Keep from moving Use anatomic splint
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Knees
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Strain, dislocation Call 911, do not transport yourself Soft splint Straight - use anatomic
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General Signs of Symptoms of Sudden Illness
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Ill, dizzy, confused, weak Skin color changes Sweating Breathing changes Nausea and vomiting
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General Care for Sudden Illness
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911 for unexplained illness Help victim rest, avoid getting chilled/overheated Reassure No food or drink Watch for changes
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Heart Attack
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Precursor to cardiac arrest Reduced blood flow to heart Can occur at any age
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Symptoms of Heart Attack
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Varies from slight discomfort to crushing pain No signs until collapse Signs and symptoms come and go before heart attack occurs Shortness of breath, jaw or back pain (left side), indigestion, nausea, vomiting Act quickly - early identification
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Aspirin and Heart Attack
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Chew one uncoated adult aspirin
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Nitroglycerin for Heart Attack
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Often prescribed for angina Assist victim who is prescribed Do not attempt if unresponsive
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First Aid: Heart Attack
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1. 911 2. Comfy position 3. Ask about meds 4. Encourage victim to chew one uncoated adult aspirin 5. Stay with victim, reassure
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Angina
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Chest pain caused by heart disease Pain lasts a few minutes People know if they have it Prescribed meds
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Stroke
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Interruption of blood flow to the brain 911, medical attention immediately (Can decrease permanent damage) Time is critical - know what time the symptoms started
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Cincinnati Prehospital Stroke Scale
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1. Ask victim to smile 2. Ask victim to close eyes and raise both arms out in front of body 3. Ask victim to repeat a sentence "You can't teach an old dog new tricks"
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First Aid: Stroke
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1. 911 2. Monitor 3. Lie on back, shoulders slightly raised 4. Loosen clothes 5. Turn victim's head on affected side
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Transient Ischemic Attack (TIA)
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Temporary interruption to blood flow to brain Similar signs as a stroke 911
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Respiratory Distress
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Difficulty breathing Distress does not go away
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First Aid: Respiratory Distress
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1. 911 2. Help into comfy position 3. If hyperventilating, ask to breathe slowly 4. Ask about meds 5. Stay with victim and monitor
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First Aid: Hyperventilation
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1. No other cause 2. Reassure 3. 911 if doesn't return to normal
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Chronic Obstructive Pulmonary Disease (COPD)
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Includes emphysema and chronic bronchitis May cause respiratory problems Follow first aid for respiratory distress
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First Aid: Fainting
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1. Monitor breathing, ready for CPR 2. Lay down, raise legs 6-12" off ground, loosen clothing 3. Check for possible injuries (head) 4. Reassure
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Types of Seizures
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1. Complex partial - person seems dazed, mumble or wander 2. Absence - person stares blankly, doesn't respond 3. Generalized tonic - convulsions, loses consciousness, muscle spasms 4. Febrile - caused by high fever in infants/children
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First Aid: Seizures
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1. Prevent injury 2. Loosen clothing (check for med ID) 3. Turn to one side if vomiting 4. After seizure, keep airway open 5. Be reassuring
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Altered Mental Status
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Changes in normal behavior Sign or results of injury or illness Common Causes: stroke seizures head injury fever poison diabetic emergency
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Diabetic Emergencies
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Hypoglycemia (Low blood sugar) Hyperglycemia (High blood sugar)
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First Aid: Hypoglycemia
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1. Confirm victim has diabetes. Look for medical ID 2. Give sugar 3. Give more sugar after 15 min if still feeling ill 4. 911 for unresponsive or significant symptoms
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First Aid: Hyperglycemia
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1. 911 2. Early signs - hard to tell if low or high blood sugar (give sugar, if doesn't improve 911) 3. Later stage - 911 immediately
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Poison
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Any substance that enters or touches the body with effects that injures Most accidental poisonings occur at home
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Poison Control Center
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800-222-1222 Provide info and treatment advice
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4 Ways Poison Enters the Body
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Swallow Injected Inhaled Absorbed
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Poison Care
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Unresponsive - 911 Responsive - PCC
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First Aid: Swallowed Poison
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1. Determine what was swallowed and how much 2. Responsive - PCC 3. Unresponsive - 911
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First Aid: Food Poisoning
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1. Have victim rest 2. Clear fluids 3. Seek medical attention
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First Aid: Inhaled Poisons/CO
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1. Get victim to fresh air 2. Call 911 3. Monitor and be ready for CPR 4. Unresponsive in recovery position
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First Aid: Animal Bites
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1. Clean w/o soap and water (unless bleeding) 2. Control bleeding 3. Cover with dressing and bandage 4. Health care provider
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Snake Bites - 4 common poisonous in US
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Rattesnakes Copperhead Cotton mouth Coral snake
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First Aid: Snake Bite
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1. Have victim lie down, calm down and keep bite lower than heart 2. Call 911 3. Wash bite 4. Wrap with ACE bandage - top down, snug 5. Remove constricting items
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Spider Bites - 2 common in US
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Black widow - red hourglass shape on abdomen Brown recluse - brown violin shape on back
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First Aid: Spider Bites
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1. Breathing problems (brown recluse bite) - 911 2. Keep bite below heart 3. Wash with soap and water 4. Ice pack, 20 on 30 off
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First Aid: Ticks
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1. Remove tick with tweezers close to skin, pull gently until tick lets go 2. Wash with soap and water 3. Antiseptic 4. Medical attention if flu-like symptoms begin
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Ticks - Diseases it Carries
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Rocky Mountain Spotted Fever Lyme Disease
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Marine Bites
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Stop bleeding Care for Shock Lifeguard 911
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Stings
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Can cause difficulty breathing, shock, muscle paralysis, seizures
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First Aid: Marine Stings
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1. Wash with vinegar for 30 sec 2. Remove any tentacles 3. No vinegar, use baking soda water mix 4. Reduce pain by soaking in hot water for 20 min 5. Pain returns - soak again 6. Call 911 if swelling around mouth, large area, difficulty breathing, or from box jelly sting
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Three Conditions of Negligence
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1. You had a duty to act 2. You breached that duty 3. Your actions or inactions caused damage or injury
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Respiratory System
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Gas exchange Possible emergencies: airway obstruction, airway swelling, punctured lung
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Cardiovascular System
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Primary Organs: Heart, blood, blood vessels Transport blood to lungs Regulates body temperature Fluid balance Emergencies: Any condition that affects respiratory, severe bleeding, stroke, heart attack
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Nervous System
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Brain, spinal cord, sensory receptors, nerves Function is sensory receptors gather info about environment and send to brain. Brain integrates and analyzes info and signals lead to actions. Emergencies: Head/spinal injury, stroke
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Signs of Infection
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Wound area is red, swollen, and warm Pain Pus Fever Red streaks or trails on skin (call health care provider immediately)
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When to Seek Medical Attention for a Wound...
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Severe bleeding Deep/large wound Face wounds Infected Bites Foreign objects in wound Puncture wounds Unknown tetanus Requires stitches (longer than 1 inch) Unsure about wound
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Puncture Wound
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High risk of infection Irrigate the wound, press around wound to help promote bleeding (helps push fluid out), dressing, medical attention
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Impaled Object
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Don't remove Dress wound around/over it Direct pressure around Stabilize and still Medical attention
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Avulsion
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Try to move into normal position Control bleeding Provide wound care If completely separate, treat as amputation
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Amputation
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Control bleeding, care for victim and wound Then recover and care for amputated part -wrap severed part in sterile dry dressing -place in plastic bag, sealed -Place in another container of ice -emergency personal
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Genital Wound
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Provide privacy Use direct pressure to control external bleeding
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Head and Face Wounds
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Possible neck or spinal damage Do not move head Scalp wound Never wrap around neck