First Aid/CPR/AED, American Red Cross participant’s manual

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Steps in the EMS system
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1. Recognize that an emergency exists 2. Decide to act 3. Activate the EMS system 4. Give care until help takes over
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Give appropriate care to an ill or injured person until:
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-You see an obvious sign of life, such as breathing – Another trained responder or EMS personnel take over -You are too exhausted to continue -The scene becomes unsafe
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When your call to EMS is answered:
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Give your name, location, address (?), phone number, number of victims, and victims’ conditions; do not hang up before the call taker does so
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Expressed consent
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When a conscious person who understands your questions and what you plan to do gives you permission to give care; step back and call for more advanced personnel if the person refuses care or withdraws consent at any time; if the conscious person is a child or infant, permission to give care must be granted by a parent or guardian if possible
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Implied consent
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The assumption of the law that a person who is unable to give expressed consent (unconscious, unable to respond, confused, mentally injured, or seriously ill) would have given consent if they could
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PPE
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Personal Protective Equipment
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When to call first in an emergency (if alone)
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-For any adult or child about 12 years or older who is unconscious -For a child or infant who you witnessed suddenly collapse -For an unconscious child or infant who is known to have heart problems
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When to care first in an emergency if alone (give 2 minutes of care, then call EMS)
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-For an unconscious child (12 years or younger) who you did not see collapse -For any drowning victim
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Types of non-emergency moves
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Walking assist Two-person seat carry
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Types of emergency moves
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Pack-strap carry Clothes drag Blanket drag Ankle drag
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Conducting interviews
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-Identify yourself and get the person’s consent to give care -Ask for their name -What happened? -Do you feel weird or uncomfortable anywhere? -Do you have any allergies? -Do you have any medical conditions or are you taking any medication?
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Shock
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A condition in which the circulatory system fails to deliver enough oxygen-rich blood to the body’s tissues and vital organs
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Signs of shock
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-Restlessness or irritability -Altered level of consciousness -Nausea or vomiting -Pale, ashen or grayish, cool, moist skin -Rapid breathing and pulse -Excessive thirst
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Agonal breath
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In an unconscious adult, irregular, gasping, or shallow breath; do not occur frequently in children
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Atherosclerosis
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When the arteries harden and narrow
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Signs of a heart attack
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-Chest pain, discomfort, or pressure -Discomfort in other areas of the upper body in addition to the chest -Trouble breathing -Skin similar to that in shock -Sweat -Dizziness -Nausea and vomiting -Fatigue, lose of consciousness
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Aspirin
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One of the medications that can help minimize damage from a heart attack
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Cardiac chain of survival
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-Early recognition and early access to EMS -Early CPR -Early defibrillation -Early advanced medical care
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Arrythmias
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Abnormal, chaotic activity of the heart
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CPR in adults
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100 bpm, two hands in center of sternum, push chest down at least two inches, two breaths per thirty chest compressions
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CPR in children
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100 bpm, two hands in center of sternum, push chest down about two inches, two breaths per thirty chest compressions
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CPR in infants
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100 bpm, two or three fingers in center of chest, push chest down about one and a half inches, two breaths per thirty chest compressions
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Ventricular fibrillation (V-fib)
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When the ventricles quiver (fibrillate) without any organized rhythm
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Ventricular tachycardia (V-tach)
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When the ventricles contract too quickly
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Most cases of cardiac arrest in infants and children may be caused by:
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-Airway and breathing problems -Traumatic injuries or accidents -A hard blow to the chest -Congenital heart disease -Sudden infant death syndrome
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AED’s in water
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-If a person is in water, remove them from the water before defibrillation -Remove wet clothing and dry the person’s chest -If it is raining, make sure the person is as dry as possible and sheltered from the rain -Avoid getting the AED or defibrillation pads wet
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ICD
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Implantable cardioverter-defibrillator; a mini AED; usually located below the person’s left collar bone (can be placed elsewhere); typically feel like a small lump under the skin
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AED’s with pacemakers or ICD’s
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Do NOT place defibrillation pads directly over the device; adjust pad placement if necessary. If unsure if the victim has such a device, follow the AED instructions
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AED’s with transdermal medication patches
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Remove patches with a gloved hand before defibrillation; NEVER place electrode pads directly over medication patches
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Anaphylaxis
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Also known as anaphylactic shock; air passages swell and restrict a person’s breathing; this is a life-threatening emergency
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Signals of breathing emergencies
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-Trouble breathing or no breathing -Slow or rapid breathing -Unusually deep or shallow breathing -Gasping for breath -Wheezing, gurgling, or making high-pitched noises -Unusually moist or cool skin -Flushed, pale, ashen, or bluish skin -Shortness of breathe -Dizziness or lightheadedness -Pain in the chest, or tingling of the hands, feet, or lips -Apprehensive or fearful feelings
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Signals of choking
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-Coughing, either forcefully or weakly -Clutching the throat with either one or both hands (universal sign of choking) -Inability to cough, speak, cry, or breathe -Making high-pitched noises while inhaling or noisy breathing -Panic -Bluish skin color -Losing consciousness if blockage is not removed
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Seizure
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A result of abnormal electrical activity in the brain and causes temporary, involuntary changes in body movement, function, sensation, awareness, or behavior
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Epilepsy
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A chronic seizure condition
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When caring for one experiencing a seizure
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Do not hold or restrain the person. Do not put anything in the person’s mouth. Remove any nearby furniture or other objects that may injure the person. Give care to the person as you would for someone who is unconscious
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Stroke
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Also called a “brain attack,” usually caused by a blockage in the arteries that supply blood to the brain. Some strokes have bleeding in the brain from a broken blood vessel or an aneurysm that has broken open.
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Mini-stroke
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When a person has the signals of a stroke, which then completely go away. That person is then at high risk of having a full stroke within the next two days.
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How to help prevent stroke
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-Control your blood pressure -Quit smoking -Eat a healthy diet -Exercise regularly -Maintain a healthy weight -Control diabetes
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Signals of a stroke
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-Weakness or numbness of the face, arm, or leg. Usually on only one side of the body -Facial droop or drooling -Trouble with speech -Loss of vision or dimmed/blurred vision in one or both eyes -Sudden severe headache -Dizziness, confusion, agitation, loss of consciousness, or other severe altered mental status -Loss of balance or coordination, trouble walking, or ringing in the ears -Incontinence
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FAST (for a stroke)
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Face: weakness, numbness, or drooping on one side of the face Arm: weakness or numbness in one arm Speech: slurred speech or difficulty speaking Time: try to determine when the signals began. If the person shows any signals of stroke, time is critical.
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Diabetes
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The inability of the body to change sugar (glucose) from food into energy. This process is regulated by insulin, a hormone produced in the pancreas. Type I diabetes usually begins in childhood and occurs when the body produces little or no insulin. Type II diabetes usually occurs in adults, but can occur in children. With this, the body does not produce enough insulin to meet the body’s needs, or the body becomes resistant to the insulin produced. Type I diabetics are insulin dependent, while Type II diabetics may become insulin dependent.
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Hyperglycemia
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Too much sugar in the blood
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Hypoclycemia
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Too little sugar in the blood
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How to treat diabetics
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If they are conscious and able to swallow, give them sugar in the form of several glucose tablets or glucose paste, a 12-ounce serving of fruit juice, milk, non-diet soft drink, or sugar dissolved in water.
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Heat cramps
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Least severe of the heat-related illnesses. They are painful muscle spasms, usually in the legs or abdomen.
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To care for heat cramps:
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Help the person move to a cool place to rest. Give an electrolyte- and carbohydrate-containing fluid such as a commercial sports drink, fruit juice, or milk. Water may also been given. Lightly stretch the muscle and gently massage the area. Salt tablets should not be given.
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Heat exhaustion
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More severe than heat cramps. Often affects athletes, firefighters, construction workers, and factory workers. It also affects those who wear heavy clothing in a hot, humid environment. Signals include cool, moist, pale, ashen or flushed skin; headache; nausea; dizziness; weakness; and exhaustion
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Treating heat exhaustion:
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Move the person into a cooler environment with circulating air. Loosen or remove as much clothing as possible. Apply cool, wet cloths such as towels or sheets. Give them cool amounts of cool fluid if he or she is able to swallow. They should not resume normal activities the same day.
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Heat stroke
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Least common but most severe heat-related illness. Usually occurs when people ignore the signals of heat exhaustion. It develops when the body systems are overwhelmed by the heat and begin to stop functioning.
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Signals of heat stroke
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Extremely high body temperature; red skin that can be either dry or moist; changes in consciousness; rapid, weak pulse; rapid, shallow breathing; confusion; vomiting; and seizures
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Frostbite
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The freezing of body parts exposed to the cold. Can result in loss of fingers, toes, hands, arms, feet, and legs
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Signals of frostbite
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Lack of feeling in the affected area, swelling and skin that appears waxy, is cold to the touch or is discolored (flushed, white, yellow, or blue). In more serious cases, blisters may form, and the affected area may turn black and show signs of deep tissue damage.
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Caring for frostbite
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Handle the area gently. If possible, remove wet clothing and jewelry from the affected area. Never rub the area. Do not attempt to warm the affected area if there is a chance that it might refreeze or if there is a medical facility nearby. To care for a more serious injury, gently soak it in water not warmer than about 105 degrees Fahrenheit. Keep the area in the water until normal color returns and it feels warm (about 20-30 minutes). Loosely bandage the area with a dry, sterile dressing. Do not break any blisters. Do not give ibuprofen or any nonsteriodal anti-inflammatory drugs.
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Hypothermia
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When the entire body cools because the ability to keep warm is failing. The person will die if not given the proper care.
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Signals of hypothermia
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-Shivering -Numbness -Glassy stare -Indifference -Loss of consciousness
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Treating hypothermia
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Gently move the person to a warm place. Remove wet clothing, dry the person, and put on dry clothing. Warm the body gradually. If the person is alert, give warm liquids that do not contain alcohol or caffeine. If the person is not breathing, perform CPR.
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Caring for an insect sting
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-Remove any visible stinger with a clean fingernail, a plastic card, or tweezers. In the case of a bee sting, if you use tweezers, grasp the stinger, not the poison sack. -Wash the site with soap and water -Cover the site and keep it clean -Apply a cold pack to the area to reduce pain and swelling -Activate EMS if the person has trouble breathing or shows other signs of anaphylaxis
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Closed wound
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A wound in which the skin’s surface is not broken; tissue damage and any bleeding occur below the surface
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Open wound
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A wound in which the skin’s surface is broken, and blood may come through the tear in the skin
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Signals of internal bleeding
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-Tender, swollen, bruised, or hard areas of the body, such as the abdomen -Rapid, weak pulse -Skin that feels cool or moist or looks pale or bluish -Vomiting blood or coughing up blood -Excessive thirst -An injured extremity that is blue or extremely pale -Altered mental state, such as the person becoming confused, faint, drowsy, or unconscious
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Caring for a closed wound
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Apply an ice pack to the area to decrease bleeding beneath the skin. Apply to the injured area for periods of about 20 minutes. Elevating the injured area may help reduce swelling, but do not elevate if this action causes more pain.
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Abrasion
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The most common type of open wound. Usually caused by something rubbing roughly against the skin. Any bleeding comes from capillaries, but they do not bleed much. Other terms include a scrape, a rug burn, a road rash, or a strawberry.
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Laceration
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A cut in the skin, commonly caused by a sharp object such as a knife, scissors, or broken glass. It can also occur when a blunt force splits the skin. Bleeding may be heavy, or there may be none at all.
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Avulsion
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A serious soft tissue injury. It happens when portions of the skin, and sometimes other soft tissues, is partially or completely torn away. It often damages deeper tissues, causing significant bleeding.
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Amputation
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A type of avulsion when a violent force completely tears away a body part, including bone. Sometimes bleeding is easier to control because the tissues close around the vessels at the injury site.
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Puncture
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Usually occur when a pointed object pierces the skin. They do not bleed much unless a blood vessel has been injured. If an object remains in the wound, it is called an embedded object.
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Dressings
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Pads placed directly over a wound to absorb blood and other bodily fluids and to prevent infection. They should be sterile.
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Occlusive dressing
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A bandage or dressing that closes a wound or damaged area of the body and prevents it from being exposed to the air or water.
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Bandage
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Any material that is used to wrap or cover any part of the body; used to hold dressings in place, apply pressure to control bleeding, protect and wound from dirt and infection, and provide support to an injured limb or body part
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Pressure bandage
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Any bandage applied snuggly to create pressure on a wound or injury
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Tourniquet
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A tight band placed around an arm or leg to constrict blood vessels in order to stop blood flow to a wound; it should only be used as a last resort; applied just above the wound
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Superficial burns
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-Involve only the top layer of skin -Cause skin to become red and dry, usually painful, and the area may swell -Usually heal within a week without permanent scarring
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Partial-thickness burns
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-Involve the top layers of skin -Cause skin to become red; usually painful; have blisters that may open and weep clear fluid, making the skin appear wet; may appear mottled; and often swells -Usually heal in 3-4 weeks and may scar
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Full-thickness burns
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-May destroy all layers of skin and some or all of the underlying structures-fat, muscles, bones, and nerves -The skin may be brown or black (charred) with the tissue underneath sometimes appearing white, and it can either be extremely painful or relatively painless -Healing may require medical assistance, scarring is likely
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Treating a severed body part
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Try to find the part and wrap it in gauze or any clean material. Put the part in a plastic bag and seal the bag. Keep it cool by placing it in a slurry of ice and water. Do not freeze it.
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Signals of a serious chest injury
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-Trouble breathing -Severe pain at the site of injury -Flushed, pale, ashen, or bluish skin -Obvious deformity, such as that caused by a fracture -Coughing up blood -Bruising at the site of a blunt injury -A “sucking” noise or distinct sound when the person breathes
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Signals of a serious abdominal injury
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-Severe pain -Bruising -External bleeding -Nausea -Vomiting (sometimes blood) -Weakness -Thirst -Pain, tenderness, or a tight feeling in the abdomen -Organs protruding from the abdomen -Rigid abdominal muscles -Other signals of shock
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Treating an open wound to the abdomen
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1. Put on PPE 2. Position the victim on their back with knees bent if this does not cause him/her pain 3. Do not apply direct pressure or push any organs back into the wound 4. Remove clothing from around the wound 5. Apply moist, sterile dressings directly over the wound (clean, warm tap water may be used) 6. Cover dressings loosely with plastic wrap if available
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RICE
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Rest Ice (or Immobilize) Compression (or Cold) Elevation
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Signals of an asthma attack
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-Trouble breathing or shortness or breath -Rapid, shallow breathing -Sweating -Tightness in the chest -Inability to walk without stopping for a breath -Feelings of fear or confusion
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Signals of anaphylaxis
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-The skin or area of the body that comes in contact with the substance usually swells and turns red -Difficulty breathing, wheezing, or shortness of breath -Tight feeling in the chest and throat -Swelling of the face, throat, or tongue -Weakness, dizziness, or confusion -Rash or hives -Low blood pressure -Shock

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