- Before giving care, you must obtain consent
- Explain who I am, my level of testing, what I plan to do, and if I can help
- Implied concent is when a person is unconcious or unable to respond.
- Obtain concent from a parent if the injured person is a child
- For interview someone SAMPLE
- Signs and Symptoms
- Allergies
- Medications
- Past Medical History
- Last ate or drank
- Events leading up to incident
- Examples of sudden illnesses
- seizure
- stroke
- diabetic emergency
- breathing emergecies
- poisoning
- Call 911 for
- unresponsive or altered level of responsiveness
- breathing problems
- chest pain
- severe bleeding or burns
- painful, swollen, deformed areas, open wound or fracture
- sudden illness
- until help arrives
- make sure scene is safe
- care for life-threatening conditions
- help the person rest and watch for changes in responsiveness and breathing
-
Seizures
- Move hazards out of the way
- NEVER hold them down nor put anything in their mouth
- Check for responsiveness
- shout "Are you okay?"
- then tap shoulders
- then check for breathing
-
Breathing Emergencies
- Anaphylaxis
- States have various laws about helping administer epi pens
- Sometimes a second dose of the epi pen is advised
- Make sure it's the vicitm's own epi pen
-
Heat related illnesses
1. Heat cramps
- Move to a cool place
- Slowly rehydrate
- Electolyte drink, coconut water, milk, or water (in order)
- NEVER administer salt tablets
2. Heat Exhaustion
- Cool moist pale ashen skin
- headache, dissiness, exhaustion
- Loosen or remove clothing
- Apply cool wet cloths
- fan and mist with water
- Electolyte drink, coconut water, milk, or water (in order)
3. Heat Stroke (life threatening, worst)
- symptoms
- High body temp
- Change in body
- vision
- confusion
- skin dry or moist
- rapid weak pulse
- rapid breathing
- vomiting
- seasures
- treat
- immerse neck down with cool water
-
Open and closed wounds
- open wounds have broken the skin
- Open wounds
- Abrasion
- Laceration
- Avulsions
- Puncture
- Nose bleed
- sit slightly forward to avoid swallowing blood
- pinch nostrils together for 10 minutes
- Before securing a bandage, check below the injury for feeling, warmpth and color
- Bandage beyond wounded area on both sides by an inch
- Tie knot in bandage directly over wound for added pressure
- Check below area again for feeling, warmpth, and color
-
Muscle, bone, joint Injuries
- Fractures
- Dislocations
- Sprains (stretching or tearing of ligament or joint)
- Strains (stretching or tearing of muscles or tendons)
-
Whenever you wrap a limb, it's vital to check for circulation before your wrap and again after
-
Head, Neck, Spine Injuries
- Encourage verbal answers instead of head nods
- This type of injury should be assumed under certain conditions (car accident, broken helmet, fall from above standing height, etc)
-
Sudden Illness and Febrile (relating to fever) Seizure
- Febrile Seizure (in babies)
- Symptoms
- Blank Stare
- Confusion
- More that I didn't write down
- Can be caused by a rapid rise in body temperature
- In infants and children, a fever can indicate a specific health problem such as an ear infection
- You can't stop a seizure, but you can
- Prevent injury
- Ensure airway is open after seizure ends
- protect the airway
- cool the body with a luke warm sponge, but not too much or too rapidly, which could cause another seizure
-
Stroke
- Caused when blood to the brain is cut off or bleeding to the brain
- Note the time it begins and call 911 right away
- How do you know? All you need is one of these signs
- Face (ask to smile)
- Arms (ask to raise arms)
- Speech (ask to repeat "the sky is blue" and listen for slurring)
- Time to call 911
-
Diabetes
- It is caused by imbalance of sugar and insulin
- Hypoglycemia is too little sugar
- Hyperglycemia is too much sugar
- Signs of a diabetic emergency
- Changes in mood and levels of responsiveness
- Rapid breathing
- Feeling / looking ill
- dizziness
- headaches or confusion
- Hyperglycemia generally comes on more slowly than hypoglycemia
- If victim is awake and able to follow simple commands, give the 15-20 grams of glucose tablets, candies, fruit juice, fruit strips, non-diet soft drinks, or milk
- If unable to swollow, stop giving food or drink and call 911
-
Cold
- Frostbite
- Freezing of body parts exposed to cold temperatures
- Symptoms
- Lack of fellling in area
- Swollen or discolored skin that appears waxy or cold to the touch
- Blisters
- Pain near frostbitten area
- Gently warm the area but do NOT rub
- Gently soak in warm, not hot water
- Bandage the area
- Do not warm a body part if there is a chance it will re-freeze
- Hypothermia
- The entire body cools
- Symptoms
- Shivering
- Numbness
- Glassy stare
- loss of consciousness
- Treatment
- Gradually move to warm place
- Warm with blankets
- Cover the head
- always call 911
- Do NOT give alcohol or caffine
-
Burns
- Make sure the scene is safe
- Types
- Superficial burn
- heals within a week
- Partial- thickness burn
- Causes redness, blisters,
- Full -thickness burn
- Charred or waxy
- Heat or thermal and radiation burn:
- Cool with large amounts of cold, running tap water
- do this before interviewing the victim
- leave blisters intact and cover the burn loosely with sterile gauze
- using gloves, remove jewelry or clothing that isn't stuck to skin
- removing rings is especially important in case the hand swells
- Chemical burn
- It will continue to burn so long as it is on the skin
- flush with tap water for 20 minutes at least
- If chemicals in eye
- Flush with water, keep the affected eye lower than the non-affected eye
- Be careful when cooling large burns to not cause hypothermia
- Electrical burn
- look for entry and exit wound
- If a burn is on a hand, throat, feet, or genatles, 911 always needs to be called
-
Severe external bleeding
- Tourniquet
- Do not remove a tourniquet once it is applied
- Note the time that it is applied to relay to EMS
- Apply tourniquet 2 inches above wound
- Use Hemostatic dressings for neck or torso as a last result
- Shock
- Symptoms
- Restlessness, irritability or altered level of responsiveness
- Nausea or vomiting
- Pale, ashen or grayish skin that is cool and moist
- Treatment
- Call 911, lay injured person flat on the floor and cover them with a blanket, reassure
-
Heart Attack
- Symptoms
- Tightness, pressure or pain in chest
- Discomfort in shoulder, arm, neck, jaw, stomach, or back
- Shortness of breath
- Nausea or vomiting
- Pale skin
- Sweating
- anxiety
- back or jaw pain
- Unexplained fatigue
- Treatment
- 2-4 62 mg (low-dose) asprin if the person or 1 regular chewed 325mg
- is not alergic
- No stomach ulcers
- Loosen tight or uncomfortable clothing
- Cardiac chain of survival
- Recognize signs and symptoms and Call 911
- Early cpr
- Early Defibrillation
- Early EMS
- Integrated post-cardiac arrest care
-
CPR
- 12 or older is an "adult" for CPR
- Critical numbers are 30 (chest compressions) and 2 (breaths)
- Push 2 inches deep (at least) and 100 compressions per minute (push hard and fast)
- Minimize interruptions between compression cycles
- Continue CPR until obvious signs of life, an AED becomes available, 5 sets of CPR have been done and a trained responder is available to switch, to exhausted to continue, or the scene becomes unsafe
- if you need to leave the scene to call 911, place the person in the recovery position
-
AED
- Pads should not touch each other
- AEDs are safe to use near water, even in rain
- but if they are in a pool or puddle, move them and dry chest using pads in AED kit (it is important that the chest is dry)
- If they have an implanted medical device (pacemaker / implanted defibrillator / medication patch), avoid placing pads directly over the device (put pad an inch away) (typically located below right collar bone and feel like a lump under the skin)
- Remove medical patches if present (with gloved hand) before applying AED
- Safe to use on metal (such as bleachers) so long as the pads aren't touching the metal
-
Choking
- Alternate 5 back blows with 5 abdominal thrusts
- If you are unable to reach around the choking person or the choking person is pregnant, give chest thrusts instead
- Continue until object is forced out, person can cough forcefully, talk or breathe, or they become unresponsive.
- If person can cough, encourage them to continue coughing
- If they become unconscious, lower them to the ground and do CPR. Support their head while they are lowered
- if you can see an obstruction in their mouth when opening the airway, sweep it out with a finger
- Remember never do more than 2 rescue breaths
-
Child CPR
- If child pads are not avaliable, use adult pads but make sure they don't touch
- child pads are for 0-8 year olds or less than 55 lbs
- 30 compressions (about 2 inches) and 2 rescue breaths
-
Infant CPR
- If you come across and unresponsive child alone
- shout for help, provide care for 2 minutes (5 cycles of cpr) before calling 911 and getting an AED
- Infants are 1 year old or younger
- Make sure they are on firm flat surface
- Push hard and fast with 2 fingers at center of chest just below nipple line at depts of 1, 1/2"
- Don't extend the head too far when opening the airway
- hold their head back gently with your other hand
- Make seal over infants nose and mouth for rescue breaths
- Never give more than 2 rescue breaths in one cycle of CPR, even if the chest doesn't rise
- To check responsiveness, speak loudly and say their name, then tap foot and shout again and look for normal breathing
-
Infant Choking
- Symptoms
- High pitched noises while inhaling
- Noisy breathing
- Bluish skin
- Losing consciousness
- Treatment
- 5 back blows
- 5 chest thrusts
- repeat cycle until infant can cough, breath, or the object is forced out
4 key actions
- Recognize emergency
- Decide to take action
- Activate EMS System
- Give care until help arrives
Action Order: Check, Call, Care Nitro gloves are preferred
SAMPLE
Signs and symptoms Allergies Meds Pertinent Medical History Last Ate or Drank
Sudden Emergencies: Seizure Stroke Diabetic Emergency Breathing Emergencies Poisoning -Look for Changes in levels of responsiveness
Seizures Never restrain, never put anything in their mouth For infant: (Febrile seizure) protect airway If fever, cool the baby, but not too much or too rapidly. Anaphylaxis Confirm history of allergies Face swelling, Difficulty breathing Treat: Epinephrine auto injector (check own prescribed) Second dose of epin. After 10 minutes
Heat Related Illnesses
- Heat Cramps (Least severe)
- Treat:
- Move out of heat
- Apply cooling wet cloths
- Coconut water, milk or water
- NEVER salt tablets
- Heat Exhaustion (needs attention)
- Heat Stroke (Life threatening)
Stroke
FAST - Facial drooping, Arm weakness, Speech difficulties and Time to call emergency services Symptoms: Drooping smile, slurred speech, drifting arm (if asked to raise both) Diabetes Hypoglycemia - too little sugar in blood Hyperglycemia - too MUCH sugar in blood Even if you’re unsure, it’s always okay to give 12 oz fruit juice, milk or non diet soft drink
Frostbite
Do not rub, handle skin gently Soak in luke-warm water / warm with skin to skin contact Do not warm if there is a chance body part will refreeze Do not give caffeine (will dehydrate body)
Recovery Position
Lying on side, one arm up, other arm under head
