2014 ASPA AEC Manual list of changes - Page 1

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1 ASPA Advanced Emergency Care Manual 11 th Edition January 2014: Changes from the 10 th Edition of 2012 (Minor changes/additions have been made throughout the Manual but in general only more significant changes have been noted below.) Chapter/Section Description Contributors Page 2 Acknowledgments updated. Preface New Preface added. Table of Contents Updated. 1.2 The Role of the Ski Edited and new text added. Patrol First Aider 1.3 Remote Area First New section added. DJ, Aid Considerations 1.4 Medico-Legal Edited and new text added. Aspects of First Aid 2.2 Respiratory System Introduction minor changes Mechanics of Breathing addition of new paragraph Mechanics of Breathing and Inspiration - edits and addition of new text to clarify the physiology behind the mechanics of breathing. 2.3 Circulatory System Minor changes and additions The Heart additions to clarify cardiac structure and function Pelvis Addition of new final sentence. 2.6 Digestive System Clarification of terminology The Bladder and New section added. Urethra 3 Approach to the Casualty Minor changes, additions and edits (including raising awareness of using all appropriate forms of PPE as required) Moving the Casualty new section added to reflect A Guideline 2 Managing an Emergency (November 2012) and Guideline 3 Recognition and first aid management of an unconscious victim (November 2012) Specific Examination - reference to springing the pelvis removed and instructions for examining the pelvis updated Transport of the Unconscious Casualty new instructions regarding the placement of the casualty s head (with a cross-reference to Transport of the Head-Injured Casualty. 4 Life Support Chapter updated for consistency with A Guideline 6 Compressions (December 2010), with the techniques of rescue breathing (or ventilations) and compressions forming key components of BLS/CPR, and to emphasise ensuring that the airway is both open and clear The Chain of Survival new section added Lateral Recovery Position - new instructions regarding the placement of the casualty s head (with a cross-reference to Transport of the Head-Injured Casualty Oropharyngeal Airways addition of new text explaining the risks associated with the use of OPAs and clarifying the circumstances in which they can be used in accordance with ASPA guidelines. New Figures 44 and 45: Measuring the OPA to select the correct size. New Figure 46: Inserting an OPA whilst providing jaw thrust. 4.6 Cardiopulmonary Resuscitation ( CPR ) A recommendations re the rate of compressions inserted Chest Compressions section updated for consistency with A Guideline 6. Detailed instructions and figure related to locating specific compression points deleted and text simplified to finding the lower half of the sternum/centre of the chest. Instructions inserted regarding compressions in children and infants and minimizing interruptions to compressions. New, DJ, Photos: LG, KC, 2014 ASPA AEC Manual list of changes - Page 1

2 5 Respiratory System Emergency Management 6 Circulatory System Emergency Management 7 Injuries to the Nervous System Figure 52: Chest compression techniques in children and infants The Technique of Rescue Breathing new paragraphs added regarding optimal delivery of ventilations and casualties who many require rescue breathing but not CPR Mouth-to-Mask text inserted to clarify optimal technique. New Figure 53: Mouth-to-mask technique (front view) Bag-Valve-Mask Resuscitator - text inserted to clarify optimal technique. New Figures 55: Use of the Bag-Valve-Mask resuscitator with two patrollers (front view) and 56: Use of the Bag-Valve-Mask resuscitator with two patrollers (side view) CPR with Two Patrollers - text inserted to clarify optimal technique and changeover of patrollers Effectiveness of CPR reference to ALS removed Asthma section updated to reflect A Guideline First Aid for Asthma (August 2011) Hazards of Oxygen Supplementation references to lubricants, static electricity and cracking an oxygen cylinder removed Management of External Bleeding Direct Pressure section updated for consistency with A Guideline Principles of Control of Bleeding for First Aiders (November 2008) Vascular Dilatation section on anaphylactic shock updated to reflect new sections on this topic. New Sections Signs and Symptoms of Anaphylactic (Allergic) Shock and Management of Anaphylactic Shock (incorporating some of the previous material on anaphylaxis) edited for consistency with A Guideline Anaphylaxis First Aid Management (February 2009). Chapter re-organisation and re-writing of several sections Head Injuries reorganized into a new Introduction and specific injuries Introduction re-written and expanded for consistency with A Guideline Head injury (November 2012) General Signs and Symptoms of Brain Injuries and General Principles of Management of Brain Injuries updated Concussion re-written and expanded Contusion/Cerebral Oedema/Raised Intracranial Pressure expanded and updated Intracranial Bleeding (Haematoma) updated and expanded. New paragraph on Intracerebral haemorrhage. New Section Unconsciousness inserted for consistency with A Guideline Head injury (November 2012). 7.3 Principles of First Aid Management of the Head Injured and Unconscious Casualty new expanded introductory section. New Section Transport of the Head-Injured Casualty this presents a summary of current recommendations from the literature re head placement during transport and suggestions for ski patrol practice, whilst acknowledging that this ultimately depends on local protocols and circumstances Brief Neurological Assessment ( AVPU ) reference to gently touching the eyelashes as indicative of the presence of a gag reflex has been removed as this is inaccurate. 7.4 Spinal Injuries: Introduction new explanatory paragraphs added and section expanded for consistency with A Guideline Management of suspected spinal injury (July 2012) Symptoms and Signs of Spinal Injury - section updated for,,,,,,, 2014 ASPA AEC Manual list of changes - Page 2

3 8 Fractures, Dislocations and Sprains 9 Management of Limb Injuries 10 Practical Application of Slings and Splints 11 Pain and Inhalational Pain Relief 12 Injury due to Temperature Extremes consistency with A Guideline Management of Management sub-section on Transport updated for consistency with A Guideline Management of Disrupted Acromio-Clavicular Joint new Figure 123: Disruption of the left acromio-clavicular joint Dislocated Shoulder new text added re spontaneous reductions Pelvic Fractures reference to springing the pelvis removed and section expanded to provide additional information about the identification and management of pelvic fractures. Figure 153: Dislocated knee correction of description to The tibia (bottom) is dislocated anteriorly with respect to the femur. Figure 155: Knee fracture correction of description to medial tibial plateau Fractured Fibula alone expanded information concerning complications. 9.4 Compartment Syndrome reference inserted to this occurring where a plaster/other cast is too tight Stiff Neck Cervical Collars additional paragraph added explaining the principles of manual in-line stabilisation for consistency with A Guideline Management of New Section Pelvic Binders Spine Board (Supine Position) reference inserted to casualties who are found to have neck pain upon palpation and for consistency with A Guideline additional instructions inserted into points 7 and 8, including ideally placing some padding under the head to optimise the neutral position Control of Pain - PQRSTA mnemonic deleted Administration of Penthrane new sentences emphasising importance of inhaling via the mouth and exhaling via the nose Advantages, Disadvantages and Contraindications (Penthrane) additional information regarding the use of a cutaway face mask with the analgiser. Clarification of contraindications (references to renal problems and pre-eclampsia removed as these are unlikely to be encountered in the ski patrol setting). Safety precautions and new Figure inserted Administration of Entonox minor changes/clarifications Advantages, Disadvantages and Contraindications (Entonox) clarification of contra-indications Standard Operating Procedure for S4 Drugs clarification of the legislative authority for ski patrollers to obtain, carry and administer Penthrane and Entonox and the specific regulations applicable in each State Cold Injuries clarification re freezing and non-freezing cold injuries and addition of diabetes; as a potential contributing factor Management of Hypothermia re-ordering of dot points to flow more logically and clarification of handling of hypothermic casualties Heat Cramps clarification of fluid administration for casualties.,,,,,,,,,,, 13 Medical Conditions, 2014 ASPA AEC Manual list of changes - Page 3

4 14 Poisoning, Bites and Stings 15 Other Injuries due to Trauma 13.2 Diabetes small updates throughout section Angina updated information concerning Management Acute Myocardial Infarction (Heart Attack: AMI ) Extensive revision and updating, including the introduction to the Section, Signs and Symptoms and Management Poisoning introduction updated for consistency with A Guideline Emergency Management of a Victim who has been Poisoned (July 2011). Clarification that vomiting should not be induced in the casualty in any circumstances Signs and Symptoms of Poisoning, General Management Principles, Management of Ingested Poisons and Management of Inhaled Poisons updated for consistency with A Guideline Emergency Management of a Victim who has been Poisoned (July 2011) Snake Bite updated for consistency with A Guideline Australian Snake Bite (July 2011) and Pressure Immobilisation Technique (August 2011) Tick Bite updated for consistency with A Guideline Envenomation Tick Bites and Bee, Wasp and Ant Stings (July 2012) Bee, Wasp and Ant Stings - updated for consistency with A Guideline Envenomation Tick Bites and Bee, Wasp and Ant Stings (July 2012) Other Stings updated to refer to relevant A Guidelines. Electrical Injuries: Management updated for consistency with A Guideline 2 Managing an Emergency (November 2012) and to refer to respiratory paralysis following a lightning strike Amputations updated Crush Injuries updated for consistency with A Guideline Emergency Management of a Crushed Victim (March 2013). Eye Injuries: Foreign Bodies reference to covering both eyes removed Dental Trauma suggestion to consider additional personal protective equipment Avalanche Casualties topic re-organised into sections. Updated for consistency with A Guideline Resuscitation in Special Circumstances (November 2011) Harness Suspension Trauma new section inserted for consistency with A Guideline Harness Suspension Trauma First Aid Management (July 2009).,,, 16 Childbirth New Section 16.5 Emergency Assistance with Childbirth, providing the contact numbers for each State. 17 OHS and Infection Control 18 Practical Application Minor changes and corrections., of Knots 19 Glossary Minor changes and clarifications. List of Contributors = Dr Guy Buchanan = Dr Rowena Christiansen = Dr James Cooper KC = Kirsten Campbell LG = Linda Godfrey DJ = Douglas James = Dr Donald Kuah = Dr Mark Zagorski (Reviewer for Chapters 14 and 17: Dr Stephen Webber.) 2014 ASPA AEC Manual list of changes - Page 4

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The development of this workbook was undertaken by trainers and developers within SAMPLE

The development of this workbook was undertaken by trainers and developers within SAMPLE FOREWORD This publication is one of a number of workbooks produced by The Australian Medical Association (WA) Inc as a resource for the health sector. It is utilised within AMA Recruitment and Training