RLSSA Emergency First Aid

Transcription

1 1

2 CPR 2

3 Action Plan D anger R esponse S end for help A irway B reathing C PR D efibrillation 3

4 DRSABCD Danger Check for dangers to: Yourself Bystanders Casualty Walk 360 o around the casualty Use all 6 senses Smell Sight Taste Touch Listen Common Sense 4

5 DRSABCD Response Is the casualty responsive? C an you hear me? O pen your eyes W hat s your name? S queeze my hands and let go If the casualty is not responsive, and fluid is suspected in the airway, roll the casualty into recovery position 5

6 DRSABCD Send for Help Dial 000 Be prepared to give the following information Location of the emergency (including nearby landmarks, closest intersections etc..) The telephone number from where the call is being made What happened How many persons require assistance Condition of the casualty What assistance is being given Any other information requested ** Never hang up before the emergency services operator hangs 6 up **

7 DRSABCD Airway Open the airway Tilt the casualty s head back to remove tongue from the airway Clear the airway Check to see the airway is free from obstructions In an unconscious victim, care of the airway takes precedence over ANY injury 7

8 DRSABCD Breathing Normal Breathing?* Check for signs of life consciousness, responsiveness, movement and normal breathing Look, Listen, Feel Look - for rise and fall of the chest Listen - for breathing noises Feel - for rise and fall of chest and for breath on cheek Watch for rise and fall of the chest * For drowning related emergencies give 2 rescue breaths prior to commencing CPR 8

9 DRSABCD Push FIRM Push FAST C PR - 30 : 2 If no signs of life are present give 30 chest compressions,followed by 2 breaths Centre of the chest Compressions applied too high are ineffective Compressions applied too low may cause regurgitation &/or damage to the vital organs The centre of the chest (sternum) should be depressed by a third of the chest depth 9

10 DRSABCD 2 Breaths Pistol grip Take a breath for yourself Breath into patient Watch for rise and fall of chest 10

11 DRSABCD 11

12 DRSABCD Automated External Defibrillator Attach AED (if available) as soon as possible and follow the prompts 12

13 DRSABCD - Defibrillators 13

14 DRSABCD D Dangers Check for dangers R Response Check for response No response S - Send for help Call 000 C CPR Give 30 chest compressions Followed by 2 breaths Continue until qualified help arrives or normal breathing returns For drowning related emergencies give 2 rescue breaths prior to commencing CPR D Defibrillation Attach AED (automated external defibrillator) and follow prompts A Airway Open Airway Clear the airway B Breathing Look, Listen & Feel for breathing Responsive? Breathing normally? no yes Place in recovery position Monitor vital signs Provide oxygen 14

15 Rescue Breathing Mouth to mouth Used when no pocket mask is available Mouth to mask Should always be used by First Aiders Minimises transfer of communicable diseases Provides mouth to mouth & nose resuscitation Mouth to nose Can be administered in deep water Mouth to mouth and nose Used to resuscitate infants Mouth to mouth and nose Breath is applied to both the mouth and nose Done to infants Mouth to neck stoma Breath is applied to tube in neck 15

16 Techniques ADULTS CHILDREN INFANTS Head Tilt: Full Full Neutral Breath Size: Rise and fall of the chest Compression Depth: 1/3 depth of the chest Compression Point: Visual Centre of the chest Compression Method: 2 Hands 1 or 2 Hands 2 Fingers 16

17 DRSABCD CPR is the technique of rescue breathing combined with chest compressions The purpose of CPR is to temporarily maintain a circulation sufficient to preserve brain function until specialised treatment is available CPR should be continued until: Signs of life return Qualified help arrives and takes over It is impossible to continue Danger returns 17

18 DRSABCD ADULTS Aged 8 years old plus CHILDREN Aged 1 year old to 8 years old INFANTS Aged up-to 12 months 30 compressions 2 breaths 5 cycles in 2 minutes Almost 2 compressions per second Thirty & Two That s All You Do 18

19 DRSABCD Multiple rescuers It is recommended that frequent rotation of rescuers is undertaken to reduce fatigue Approximately every 2 minutes Thirty & Two That s All You Do 19

20 DRSABCD - infant D anger The assessment for danger remains the same R esponse Make loud noises such as clapping Blow air in the infants face Run fingers along the arches of the feet Place finger inside of hands S end for Help Call 000 A irway Both mouth and nose should be cleared Nose can be cleared using the milking technique Open airway is achieved with head in neutral position B reathing Normal Breathing Look, listen and feel Check for signs of life C PR 30 compressions followed by 2 breaths Mouth-to-mouth-and-nose rescue breathing 20 2 fingers on lower half of the sternum

21 DRSABCD Vomit Regurgitation A voluntary response Abdominal muscular contraction occurs Removal is often forceful and projectile Often appears chunky A good sign something is working An involuntary response The stomach distends The contents ooze out Often appears frothy A bad sign often caused by: Over inflation Insufficient head tilt Not allowing enough time between breaths 21

22 DRSABCD If the casualty vomits or regurgitates during resuscitation they should immediately be rolled onto their side and airway cleared. If no signs of life are present, rescuer should continue with rescue breathing and compressions. If regurgitation is suspected you may be required to adjust: Head tilt Breath size Breath frequency 22

23 DRSABCD - Choking Choking can be present in a conscious or unconscious casualty Varied severity Some typical causes: Relaxation of the airway muscles due to unconsciousness Inhaled foreign body Trauma to the airway Anaphylactic reaction May be gradual or sudden onset Some of the signs in a conscious casualty: Anxiety, agitation, gasping sounds, coughing, loss of voice, clutching at neck with thumb and fingers 23

24 DRSABCD Mild Obstruction Breathing is laboured Breathing may be noisy Some escape of air can be felt from the mouth Severe Obstruction There may be efforts at breathing There is no sound of breathing There is no escape of air from nose &/or mouth 24

25 DRSABCD The simplest way to determine the severity of a foreign body airway obstruction is to assess for ineffective or effective cough Effective cough (Mild Airway Obstruction) Give reassurance Encourage to keep coughing If obstruction is not relieved, rescuer should CALL

26 DRSABCD Ineffective cough (Severe Airway Obstruction) Conscious victim: CALL 000 Perform up to 5 sharp back blows Heel of hand between shoulder blades Check for removal of obstruction between each back blow If back blows aren t successful, perform up to 5 chest thrusts Use CPR compression point Similar to CPR compressions but sharper and delivered at a slower rate Check for removal of obstruction between each chest thrust Continue to alternate between back blows and chest thrusts if obstruction is not relieved 26

27 DRSABCD Ineffective cough (Severe Airway Obstruction) Unconscious victim: CALL 000 If solid material is visible in the airway sweep it out using your fingers Commence CPR 27

28 DRSABCD Assess Severity Effective Cough Mild Airway Obstruction Ineffective Cough Severe Airway Obstruction Encourage Coughing Continue to check victim until recovery or deterioration Call ambulance Conscious Call ambulance Give up to 5 Back Blows If not effective Give up to 5 Chest Thrusts 28 Unconscious Call ambulance Commence CPR

29 DRSABCD Left Lateral Tilt When a heavily pregnant women is lying on her back, the foetus can compress a major blood vessel of the mother (inferior vena cava). This can be minimized by providing sufficient padding under her right buttock, to provide an obvious pelvic tilt to the left whilst leaving the shoulders flat on the floor. Mothers are always right, padding the right buttock 29

30 DRSABCD Talking in an untrained bystander If you believe that there is a responsible bystander that you could use for 2-operator CPR and the casualty would benefit more from receiving 2-operator CPR, you have the choice of talking in an untrained bystander in the situation that you do not have a second trained person to assist. There are many ways to approach talking in an untrained bystander. Some examples: Ask whether the bystander is prepared to help Establish whether they have any first aid experience 30

31 DRSABCD Ask them to kneel on the opposite side and place hands on the ground and do what you are doing Ask them to place their hands on top of yours to gauge the depth of compressions Ask them to count the compressions for you Ask them to place their hands on the patient and compress with you When you believe they are ready, let them take over the compressions Do not rush the change over The experienced rescuer must always remain at the head 31

32 First Aid 32

33 Aims Definition : Emergency care provided for injury or sudden illness before medical care is available The 5 P s Preserve life Prevent further injury Protect the unconscious Promote recovery Procure medical aid (access medical aid) 33

34 Aims Responsibilities of the first aid provider Ensure personal health and safety Maintain a caring attitude Maintain composure Maintain up to date knowledge and skills 34

35 Approach to an incident Approach to an incident: Primary survey Assessment of vital signs Secondary survey This approach will: Reduce risk to yourself or others becoming victims Provided a more thorough examination Prioritise the victims injuries so as to enable management in order of severity 35

36 O H & S Occupational First Aid Provider Duties may include: Provision of first aid Maintenance of first aid kits and facilities Identification of potential hazards Maintenance of records & other tasks 36

37 O H & S Duties of Employers Employers are expected to make every reasonable effort to provide a safe & healthy workplace. This involves the provision of safe equipment, safe plant, safe procedures, appropriate training and welfare facilities Duties of Employees Employees are expected to make every reasonable effort to secure the health and safety of both themselves and others at work 37

38 First Aid Kits Pocket mask Gloves (disposable) Telephone numbers of emergency services First Aid manual Adhesive tape Cotton bandages (various sizes) Sterile wound dressings (various sizes) Sterile eye pads Scissors Notebook Alcohol swabs Accident report forms Pens Triangular bandages Sterile saline (for wound irrigation) Additional Items (home or specialized kits) Sun Screen Tweezers Vinegar Asthma reliever & spacer Space blankets Band-Aids 38

39 Cross Infection Can be minimized by: Attempting to avoid contact with blood and other bodily fluids Use of protective devices such as disposable gloves & resuscitation masks Being vigilant for sharp objects such as syringes or broken glass Always washing hands thoroughly following, & if possible prior to the provision of first aid Being immunized against communicable diseases such as hepatitis B Seek medical advise in the case of exposure 39

40 Legalities There is no legal obligation to act as a Good Samaritan. You may have a moral obligation to help someone in need, otherwise you may owe a duty of care. Duty of Care Common examples: Teachers Students Employer Employees Gym Instructor Gym Patrons Motorist Other Motorists & Pedestrians A duty of care is established: If it is a legal obligation &/OR Once first aid begins 40

41 Legalities Negligence For a First Aid provider to be found negligent (civil liability), the following need to be considered: Did the provider owe a duty of care to the casualty Did the provider act outside their level of training (standard of care) Did the provision of First Aid result in damage or loss to any persons or property Consent Consent must be gained before initiating any first aid Verbally ask for permission/consent If a minor, ask parent or guardian If unconscious, consent is assumed 41

42 Reporting All items included in reports must be factual, and not express personal opinion Example: The casualty appeared intoxicated INCORRECT Vs. The casualties breath smelt fruity CORRECT 42

43 Impact of Trauma & Counselling As everyone deals with trauma in their own way it is very important to complete your individual report immediately Then follow this up with a debrief Your employer will offer you counselling or there are alternatives such as local hospital, police, grief counselling services (refer yellow pages) or LSV. This should be done as soon as possible 43

44 Vital Signs Survey Vital Signs Survey Checking the casualties vital signs at regular intervals (e.g., 1 minute) Breathing rate and depth (Average adult breaths per minute) (Average infant breaths per minute) Heart rate (Average adult resting beats per minute) (Average child resting beats per minute) (Infants resting up to 150 beats per minute) Responsiveness Hearing, movement in the eyes Able to answer questions, movement from limbs 44

45 Secondary Survey 45

46 Secondary Survey We are looking for: B leeding B urns F ractures O ther things - Signs & Symptoms 46

47 Secondary Survey - DOLOR Assessment of responsive casualty (DOLOR) Description Ask the casualty to describe the problem Onset & Duration Ask the casualty when the problem arose & how it has progressed Location Ask the casualty where on the body the problem is Other Signs and Symptoms Signs: Things you can see Symptoms: Things the casualty can feel Do you notice any other signs? Is the casualty aware of any other symptoms? Relief Has anything provided relief? e.g, rest, position or medication 47

48 Secondary Survey ASSESSING Conscious / Unconscious casualty head to toe examination Head Look and feel for bleeding and bumps Check for fluid discharge from ears and nose Check the eyes for any signs of injuries Neck Look at and feel the back of the neck gently for tenderness & irregularities. If there are any concerns of potential spinal injuries, do not move the victim, unless they become unresponsive or are in immediate life threatening danger 48

49 Secondary Survey Back/Chest/Abdomen Ask a responsive victim to inhale deeply and see if it causes discomfort Look at & feel the chest, back and abdomen for irregularities & tenderness Limbs Look for an injury &/or deformity Check from the extremities moving toward the trunk, feeling for irregularities Check for altered strength and sensation Check gloves after each section for bodily fluids 49

50 Prioritising Casualties Multiple casualties Treat unconscious casualties first because they are unable to protect their airway or protect themselves from external dangers Triage prioritise casualties in order of urgency of management 50

51 Medical Emergencies 51

52 Fainting and Shock Fainting is caused by an inadequate blood supply to the brain. It s reduced in severity compared to shock. Shock is caused by lack of oxygen supply to the vital organs. 52

53 Fainting and Shock Causes of Fainting Prolonged periods of standing Emotional distress Low fluids or food Causes of Shock Heart failure Inadequate blood volume/blood loss External or internal bleeding Leaky or dilated vessels Inadequate O² in blood With Shock the body responds by: Vasoconstriction Increased heart rate Increased breathing rate 53

54 Fainting and Shock Signs & Symptoms Fainting & Shock: Tingling (poor circulation) Light-headedness, dizziness Nausea Pale, cold clammy skin Brief period of unresponsiveness (1 to 2 minutes) Rapid, weak pulse & Rapid, shallow breathing Altered responsiveness Thirst Weakness Collapse 54

55 Fainting and Shock Management of Fainting and Shock Primary survey Lay victim down with legs elevated Treat cause, if possible (i.e. bleeding) Reassurance Monitor & record vital signs Provide oxygen, if able Maintain thermal comfort Seek medical assistance 55

56 Easy to remember treatment The easiest way to remember the treatment of Fainting or Shock is: If the face is pale raise the tail, If the face is red raise the head, If the face is blue they re almost through. 56

57 Blood Vessels 57

58 Blood Vessels Blood Vessels Types ARTERIES : carry oxygenated blood through the body from the heart to all other organs VEINS : carry the carbon dioxide rich blood from the organs to the heart CAPILARIES : are the smallest blood vessels where the exchange of the O² to the CO² happens 58

59 Blood Vessels Bleeding ARTERIES : Rapid & profuse (usually spurts) Bright red VEINS : Flows from wound at steady rate Dark red CAPILARIES : Gently oozes from wound 59

60 Blood Composition Plasma (50-60%) Contains salts, sugar, etc Red blood cells (40-50%) Contain haemoglobin to carry oxygen White blood cells Fight infection Platelets Clotting agents 60

61 Wounds 61

62 Types Of Wounds Abrasions Scrapes on the surface of the skin with damage to small capillaries Lacerations & Incisions Cuts, usually caused by sharp objects such as a knife or piece of glass Lacerations have ragged edges Incisions have smooth edges Avulsions Where a flap of skin &/or flesh has been totally or partially removed 62

63 Types Of Wounds Puncture Wound Occurs when a sharp, pointy object has penetrated the flesh Embedded Object Wound with an embedded object still in place Amputation Occurs when a body part has been severed 63

64 Minor Wounds Definition: Superficial Small surface area (<2.5cm) Bleeding ceases quickly 64

65 Minor Wounds Seek medical attention if: There is any doubt about the severity of the wound The wound cannot be easily cleaned Infection is a concern (there is a greater risk of infection with large abrasions) Stitches may be required Tetanus immunisation may be necessary 65

66 Minor Wounds Management Wash in clean, running water Clean thoroughly, take special care with large abrasions to ensure any debris is removed Dry using sterile gauze Cover with a clean dressing 66

67 Minor Wounds Avulsions: Flap of skin should not be removed unless it s very small Large flaps of skin or appendages should be returned to normal position before applying the sterile dressing / bandage 67

68 Minor Wounds Nose Bleeds Nose bleeds may occur as a result of a direct trauma or may occur spontaneously. Management Ask the casualty to firmly squeeze the fleshy part of the nose, below the bone Position the casualty sitting upright, with their head slightly forward Ask the casualty to breathe through their mouth and avoid swallowing any blood (can cause vomiting) Seek medical aid if the bleeding time exceeds 10 minutes It is best not to apply pressure to a suspected broken nose 68

69 Major Wounds Management Conduct a primary survey & act accordingly Apply direct pressure to the wound site Pressure Elevation Rest Apply a sterile dressing, followed by a pad & bandage where possible Elevate injured site if possible Call the ambulance (if required) Keep casualty still and reassure them Monitor vital signs and treat for shock if required Provide supplemental oxygen (if able) Seek medical attention (if required) If bleeding continues through the pad: Apply another pad and bandage (over the original pad and bandage) Remove pad and bandage and replace if bleeding still continues Apply pressure near the artery 69

70 Major Wounds Puncture Wounds With a deep puncture wound, even though external bleeding may be minimal, there is a risk that internal organs may have been damaged. There is also a high risk of infection so medical aid should be sought. 70

71 Major Wounds Embedded Objects Sometimes objects are embedded at the wound site. Where possible, these objects should be left in place. Attempting to remove the object can cause further damage can exacerbate the bleeding. Management Apply pressure to the wound site Elevate the affected area Apply a ring/donut bandage around the object Dress around the wound without applying pressure to the embedded object 71

72 Major Wounds Amputations Management of the stump Refer to general wound management Management of the Severed Part Wrap the body part in a clean, sterile, non-adhesive dressing if possible Place the body part in a sealed plastic bag or container Place the sealed body part in a container of icy water Do not allow part to come into direct contact with ice or water Seek urgent medical assistance 72

73 Major Wounds Crush Injury A crush injury involves changes in blood, decreased volume of fluid in the blood vessel (hypovolemic shock), and kidney failure. Generally the victim is protected from these effects until the crush object is released. Management ARC guidelines recommend if safe and physically possible, all crushing forces should be removed as soon as possible after the crush injury. If a crushing force is applied to the head, neck, chest or abdomen and is not removed promptly death may ensue from breathing failure, heart failure or blood loss. DO NOT use a tourniquet for the first aid management of a crush injury. 73

74 Internal Bleeding Internal bleeding may be suspected, depending on: Type of trauma the victim has undergone Victim s past medical history (e.g., stomach ulcers) Victim has signs and symptoms of shock Pain and swelling in the affected area Coughing up blood, dark brown blood in vomit or excretion of blood from urinary or digestive system 74

75 Internal Bleeding Management Seek urgent medical aid Conduct a primary survey and act accordingly Lay casualty down, if possible, and raise legs slightly Keep still and reassure Thermoregulation Provide supplementary oxygen (if able) Monitor vital signs Conduct a secondary survey (if appropriate) Give nothing by mouth 75

76 Burns 76

77 Sources Of Burns Flames Hot objects Hot air Hot water and steam Chemicals Radiation Electricity Cold 77

78 When To Call 000 Ambulance is recommended for: A flame burn the size of the casualty s palm Any flame or scald burn involving the hands, face, perineum or genitals Any chemical burns Any electrical burns Any burns with suspected respiratory tract involvement Any infant or child with any type of burn 78

79 Types Of Burns Superficial Burn Only the top layer of skin is involved (e.g. sunburn) Partial Thickness Burn The top layer and part of the next layer have been burnt Full Thickness Burn Both outer layers have been damaged, and possibly the subcutaneous tissue being affected This can result in damage to fat, muscles, blood vessels and nerve endings 79

80 Types Of Burns Summary Of Burns Superficial Partial Full Redness Severe pain Painless Pain Redness Cracked and dry appearance Weeping from the burn White or charred appearance Blistering 80

81 General Burns Management Assess for dangers including flames, chemicals and noxious gas emissions. First aid providers should not expose themselves or others to any of these dangers Remove victim to safe environment Conduct a primary survey and act accordingly Arrange medical aid (as appropriate) Immediately cool the affected area with water for up to 20 minutes Only the affected area should be cooled due to the risk of overcooling the victim (greater concern with infants or children) Do not use ice (as there is a possibility of sending a person into shock) 81

82 General Burns Remove all rings, watches and other jewellery from the affected area Elevate burn limbs (where feasible) Cover burn area with a clean, sterile, lint-free dressing Provide oxygen (if able) Do Not Peel off adherent clothing Burst blisters Apply ointments or lotions 82

83 Thermal Burns Management of Burns caused by Flame or Scalding Remove any covering of material, especially if no water for flushing is available Ensure no hot water is trapped within the victim s skin folds (especially children) Continue to cool the site, despite the application of dressing 83

84 Inhalation Inhalation of hot gases or flame can cause burns along the respiratory tract that can result in swelling and possible airway obstruction. In addition, inhalation of smoke and toxic gases can result in breathing distress and a variety of serious problems. Management Seek urgent medical aid Conduct a primary survey and act accordingly Provide supplemental oxygen (if able) 84

85 Chemical Burns Sources of Chemical Burns: Household cleaning agents Pool or spa chemicals Gardening and farm sprays Car batteries Industrial chemicals Both acid and base chemicals can damage body tissues, causing them to release heat. Base burns are more serious than acid burns as they can penetrate further into the body. 85

86 Chemical Burns Management Avoid/neutralize any dangers Brush any powdered chemical off victim Flush with fresh, cool water for minutes Ensure that chemicals are not accessible by children Always keep Material Safety Data Sheets with chemicals 86

87 Electric & Lightning Burns Electrical burns can be caused by faulty, or misuse of, electrical appliances. In some accidents, downed power lines are a potential source of severe electrical burns. Consider DANGER when dealing with electrical burns Turn off power If power lines are down, avoid coming closer than at least 8-10 meters to the lines Do not attempt to move power lines, even with non-conductive material, as at high voltage, electrocution is still possible Lightning strikes cause a large number of deaths each year. If caught outside in an electrical storm, stay clear of: Tall trees or poles Bodies of water Metallic machinery and objects Hilltops or open spaces as most lightening strikes occur here 87

88 Electric & Lightning Burns Electrical burns are characterized by entry and exit wounds, which may appear minimal. Electricity may have passed through and damaged internal organs resulting in: No breathing Irregular or no heart beat Damage to internal muscles and tissues Fractures 88

89 Electric & Lightning Burns Management It is important to: Avoid/Neutralise electrical and other dangers Conduct a primary survey and act accordingly Arrange medical aid, as required Treat burn as appropriate 89

90 Soft Tissue injuries 90

91 Fractures DEFINITION A fracture is a break in a bone. Sometimes a fracture may be a single, clean break or there may be a number of breaks. Children often suffer a greenstick fracture, which is the splintering of a bone. Fractures are usually defined as either: CLOSED Where the overlying skin is unbroken OR OPEN In which case there is an open wound at the fracture site the fracture can also cause damage to underlying organs this is known as a COMPLICATED fracture. Serious internal bleeding can result from fractures of major bones such as the femur or pelvis. 91

92 Fractures CAUSES Direct force A bone is broken at the site of impact Indirect force A bone breaks some distance from the point of impact as a result of pressure E.g. arm breaks from bracing a fall by putting hands out Abnormal muscular contraction A fracture can occur due to a sudden muscular contraction. This is often associated with electrocution RECOGNITION Pain at or near the site of fracture Difficulty/inability to move the injured part Swelling Deformity Grating of bone Tenderness Possible shock 92

93 Management Of Fractures RESPONSIVE CASUALTY Conduct a primary survey & act accordingly The main aim is to prevent any movement at the site of the fracture If unsure, keep the casualty still & comfortable and call the ambulance Immobilise the joint above or below the fracture site, if possible Splint in a position of comfort for the victim Do not attempt to realign a badly deformed limb. Where possible, an immobilized fractured limb should be elevated Treat for shock Support a fractured jaw with the hand If necessary, pull the lower jaw forward to keep the airway open First Aid Providers may need to Improvise Tie shoelaces together to avoid feet moving when a fractured foot is suspected Use a long sleeve t-shirt to support arm by pulling arm through top and over shoulder Using a branch as a splint UNRESPONSIVE CASUALTY Arrange urgent medical assistance Immediately place the victim in the recovery (lateral) position Conduct a primary survey & vital signs survey, and act accordingly Provide supplemental oxygen (if able) 93

94 Contusions & Bruises Arise after trauma to a site Trauma usually occurs as a result of a blow to the area Underlying blood vessels are damaged & dark, purple discolouration arises at the site Changes colour as it starts to heal (yellowish green) as the water material is naturally removed 94

95 Sprains & Strains Sprains: Occur at the joint Usually occurs as a result of stretching and possibly tearing of the ligaments or other tissues at the joint Swelling at the site quickly follows the injury to the joint This acts as a protective mechanism to stop further movement at the site 95

96 Sprains & Strains Strains: Usually associated with muscles & tendons which attach the muscle to the bone. Can be caused by overuse or putting excessive load on a muscle or muscle group. It can also occur if muscles are not warmed up properly prior to strenuous use. Varied severity Mild discomfort with minor muscle damage Complete tearing of the muscle resulting in loss of use 96

97 Sprains & Strains MANAGEMENT R I C E R / D R est Ensure no further stress is placed on the injury I ce Apply an ice pack or cold compress to the injured site Ice pack or cold compress should be wrapped in a damp cloth, rather than being applied directly to the skin The pack/compress should be applied for mins ON/OFF Ice should not be applied to the head, genitals or nipples Ice can be applied for approx 48 hours after injury 97

98 Sprains & Strains C ompression A compression bandage should be applied to the injured area The bandage should not be so tight as to restrict circulation E levation The injured area should be elevated to minimise swelling and facilitate the healing process D iagnosis or R eferral Medical advice should be sought if you are at all unsure of the extent of the injury 98

99 Spinal Injury 99

100 Spinal Injury DEFINITION The spine consists of the spinal column and the spinal cord. The column is made up of a series of bones called vertebrae, separated by cartilage known as discs. These discs act as shock absorbers during movement. The spinal cord is made up of bundles of nerves and passes through holes in the vertebrae. It acts as a pathway for impulses between the brain and the rest of the body, and is also involved in reflex actions. Nerve tracts run from the spinal cord, through the gaps in the vertebrae to various parts of the body. 100

101 Spinal Injuries Injuries to the spine may involve the body spinal column or the cord, or both. Injuries to the spinal cord may arise through fractures in the vertebrae causing damage to the cord, which can be compressed or severed (partially or totally). Injury can worsen as a result of swelling and bleeding at the site. There is also the potential to worsen some spinal injuries by inappropriate handling of the casualty. 101

102 Spinal Injuries Spinal injuries are most often associated with motor vehicle and diving accidents, but can also be caused by a number of other mechanisms. When assessing the casualty, the best indicator of a possible spinal injury is the history of the accident. 102

103 Spinal Injuries BREAKDOWN What happens to the spine when injured C1-C7 T1-T12 L1-L5 S1-S5 Quadriplegic (neck down) Paraplegic (with additional damage to nerves) Paraplegic (waist down) Sacral CX1 CX4 Coccyc 103

104 Spinal Injuries Depending on the extent of the spinal injury this is what area of the body can be affected. 104

105 Spinal Injuries Incidents with high likelihood of spinal injury Victim falling, or having an object fall upon them, from a distance greater than the casualty s height Any penetrating injury, or injury involving major blunt force to the head, neck or trunk Any accident involving a pedestrian, cyclist, motorcyclist or casualty thrown from a vehicle Diving and surfing accidents 105

106 Spinal Injuries RECOGNITION History of the incident Pain or discomfort in the neck or back region Altered sensation, movement or strength in the limbs or trunk Irregular bumps on the neck or back Slow pulse rate (50-60bpm) Diaphragmatic breathing Erection in injured males (priapism). Also occurs in females Does not necessarily mean no movement possible 106

107 Spinal Injury If responsive: Conduct Primary, Vital Signs and Secondary Surveys and act accordingly Use double trapezius grip and log roll to move casualty Arrange urgent medical assistance Keep the casualty still and reassure them Thermoregulation Minimise any movement of the head and spinal column Manage any other injuries Provide supplemental oxygen (if able) Avoid YES/NO questions Ask WHEN, WHERE, HOW, WITH WHO questions Avoid DOES, CAN, IF & IS questions If unresponsive: Arrange urgent medical assistance Conduct a Primary Survey and act accordingly Use jaw thrust method for Rescue Breathing if required Support the victims head and neck, avoiding any twisting or forward movement of the neck (jaw thrust) Thermoregulation Continually monitor vital signs 107

108 Bandaging 108

109 Bandaging How to make a collar and cuff sling 109

110 Bandaging How to make a donut bandage 110

111 Bandaging The Elevation sling Place bandage with apex pointing to elbow over the arm. Tuck in under the arm, then twist both ends. Tie off the two ends on the uninjured side. 111

112 Bandaging Lower Arm sling Place bandage with apex to elbow over patients chest. Bring opposite end over patients arm and tie off on uninjured side. Twist remaining bandage at elbow and tuck in. 112

113 Bandaging Head bandage (pirate hat/scarf) Place long edge of the bandage above the eyebrows across the forehead. Pull down the apex to the nape of the neck. Bring the two long ends to the back criss-cross and tie off. Tuck in the excess bandage in at the base of the head. 113

114 Bandaging Hand bandage (glove) Fold over the end of the bandage and place over knee. Place fist on top of the bandage, bring loose end over the fist. Criss-cross the two sides over the fist bringing the loose bit off the tie over the criss-cross again and tie off. 114

115 Bandaging Fractures / breaks Place the patients injured part on a splint, ask patient to assist in supporting the limb in order to minimise the pain they are experiencing. Using a long bandage (triangular), tie off above and below the break leaving injured area exposed. 115

116 Bandaging Immobilisation Place injured limb still in a comfortable position. Place a splint between the limbs bring uninjured to injured. Using the natural hollows place bandage in and under the limbs tying off the bandage on the uninjured side. You can improvise by using patients shoelaces, belt, scarf, tie etc if bandages are in short supply. 116

117 Bandaging Pressure Immobilisation Technique (P.I.T.) Note: it is a good idea to mark the bite site on the bandage with a cross to assist medical personnel to locate where the bite is. Commencing at the bite site work your way down to the fingers, leaving fingernails exposed and then work back up the arm covering two-thirds of the bandage at each turn of the bandage. Continue bandaging all the way up to the nearest lymph node. 117

118 Bandaging P.E.R. (pressure, elevation, rest) Place pad on injured area, commence from bottom moving up over lapping ends of roller bandage. Once completed tie off and elevate 118