Nina Elisabeth N Storvik Theres Arulf 1
Program Accident scene command and initial assessment Patient examination ABCDE -approach CPR Recovery position Bleedings Hypothermia - Frostbite Fractures Burns CO poisoning Remove helmet
Before going into the Arctic The first aider and the situation City vs. Remote area 3
Before going into the Arctic Getting outside help requires time Harsh conditions can pose at threat Equipment needed? Communications: Satellite phone vs beacon vs InReach 4
Seven steps for first aid response 1. Take charge of the situation 2. Approach the patient safely 3. Preform emergency rescue and urgent first aid 4. Protect the patient 5. Check for other injuries 6. Plan what to do 7. Carry out the plan This steps guides you in dealing with all injuries or accidents, but use common sense. 5
SAFETY Remember! In every situation, your own safety first! Stay and play? Load and go? 6
Patient examination You'll find what you're looking for! You need A strategy for examination A plan for treatment
Airways Breathing Circulation Disability Exposure Free airways? Breathing? Visible bleedings? Color of skin? Refill? Conscious? Neurological symptoms? Patient examination Prevent hypothermia KEEP THE PATIENT WARM!
Check response If unresponsive A Free airways? YES NO Establish free airways YES B Is he/she breathing? Check up to 10 seconds NO Call for help! Start CPR 9
The chain of survival 10
LIFELESS PATIENT Check response Open Airways Check breathing Call for help 30 chest compressions 2 rescue breaths 11
A - airways Check response Open Airways Check breathing Call for help 30 chest compressions Open airways Lift chin 2 rescue breaths Clean the mouth? 12
B - breathing Check response Open Airways Check breathing Call for help Look, listen and feel for NORMAL breathing 30 chest compressions 2 rescue breaths Check for up to 10 seconds Movement of chest/abdomen? Breathing sound? 13
Call for help Check response Open Airways Check breathing Call for help 30 chest compressions 2 rescue breaths 14
CPR 30 chest compressions Check response Open Airways Check breathing Call for help 30 chest compressions 2 rescue breaths 15
Chest compressions Open up clothing bare skin Place the heel of one hand in the center of the chest Place other hand on top Compress the chest Rate 100 per min Depth 5 6 cm Equal compression : relaxation
CPR 2 rescue breaths Check response Open Airways Check breathing Call for help 30 chest compressions 2 rescue breaths 17
Rescue breaths Keep airways free Pinch the nose Take a normal breath Place lips over mouth Blow until the chest rises Take about 1 second Allow chest to fall Repeat 18
Continue CPR 30 2 19
CPR, cardiopulmonary resuscitation Call for help 30 chest compressions 2 rescue breaths Continue 30:2 If breathing is impossible, give continuous compressions When possible change CPR operator every 2 min Start with 5 rescue breaths on children and on patient with suspected hypoxia. 20
DEFIBRILLATOR Turn it on and follow the instructions! 21
Check response If unresponsive A Free airways? YES NO Establish free airways YES B Is he/she breathing? Check up to 10 seconds YES NO Call for help! Start CPR B Observe breathing for 1 minute YES Recovery position Call for help! 22
RECOVERY POSITION 23
Check response If unresponsive A Free airways? YES NO Establish free airways YES B Is he/she breathing? Check up to 10 seconds YES NO Call for help! Start CPR B Observe breathing for 1 minute YES Recovery position Bleedings? Signs of circulation problem? YES Stop bleedings Call for help! 24
Signs of circulation problems Pale, cold and clammy skin Slow refill
BLEEDINGS Internal bleedings External bleedings 26
INTERNAL BLEEDINGS Where? Abdomen (spleen, liver and bowel-vessels) Chest (large vessels in lung/heart) Pelvis (when fractured) Thigh (when fractured) Head (Brain damage) Treatment Keep warm!!!! Low temperature would increase bleeding! Supine position The patient should not have anything to drink! Stabilize fractures Observe closely 27
EXTERNAL BLEEDINGS Arterial: Pulsating, high pressure, light red Venous: Steady, low pressure, dark red 28
EXTERNAL BLEEDINGS Main principles Press the bleeding site Raise the bleeding site higher than the heart Bandage with pressure Object in the wound? Keep warm!!! Supine position 30
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Check response If unresponsive A Free airways? YES NO Establish free airways YES B Is he/she breathing? Check up to 10 seconds YES NO Call for help! Start CPR B Observe breathing for 1 minute YES Recovery position Bleedings? Signs of circulation problem? YES Stop bleedings Call for help! Conscious? Neurological symptoms? Alert Voice responsive Pain responsive Unresponsive Patient examination head to toe Treat/prevent hypothermia!!! 33
Patient examination Head to toe examination Check for bleedings and other injuries
Frostbite COLD-RELATED INJURIES General hypothermia (3 levels) 35
HOW TO PREVENT FROSTBITE/HYPOTHERMIA Appropriate clothing for the activity Exposure time - humidity, wind-chill factor, wind velocity Extra clothing Keep in movement Wet skin/clothing Avoid dehydration and exhaustion eat and drink regularly Take care of yourself and the others Buddy check! Go to the toilet when you need Alcohol or drug intoxication 36
FROSTBITE Superficial Deep TREATMENT: Do NOT rub! Reheat slowly 37
GENERAL HYPOTHERMIA Mild Moderate Serious pale, cold skin Shivering, clumsy Change in mood, sometimes tired Reduced consciousness no shivering paradox heat feeling, may undress Unconscious, may appear dead very low breathing rate and pulse 38
TREATMENT HYPOTHERMIA AVOID further heat loss PROTECT against wind and humidity REMOVE wet clothing Treat other injuries Observe CPR (long time!) if necessary Treat very carefully Sleeping bag with other person. A great excuse! If conscious patient: Warm, sweet drink 39
The Hibler thermal pack vapor barrier insulation windproof barrier
Closed fractures FRACTURES Two general types Open fractures 42
FRACTURES Signs Pain Swelling Bruise Neurological symptoms (fractures in neck and back) Complications Bleeding Instability Soft tissue injury Pain Dislocation Open fracture 43
FRACTURES Treatment Stabilization: prevent more damage, decreases pain Observation: circulation around and below the fracture, temperature, color Fractures in thigh, pelvis and chest could give large internal bleedings. Bandage open wounds Ice 44
SPLINTING FRACTURES 45
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Fracture in head, neck and/or back Should always be suspected when there is high energy Should always be suspected when trauma to the head and head injury. Treat carefully! Stabilize and immobilize before transport. 47
BURNS Degrees and prognosis First degree Superficial and red Heals in 3-4 days without scars. Second degree Blisters, redness Heals in 14 days. Third degree Deep, open wounds/tissue damage Needs surgery First aid Cooling immediately; until pain disappears and minimum 20 min Burn dressing; Water-Jel Leave blisters till they puncture (good bandage) Keep bandage on till dry surface. 48
CO Inhalation Open fire- incomplete burning In closed room, tents, cabins Often when people are sleeping, difficult to notice. Symptoms Headache, dizzy, confused, tired Sick, vomit Reduced consciousness Cherry colored skin Treatment Air out the CO Get out in fresh air! Observe and treat complications CPR if necessary 49
Seven steps for first aid response S STOP T THINK O OBSERVE P - PLAN 1. Take charge of the situation 2. Approach the patient safely 3. Preform emergency rescue and urgent first aid 4. Protect the patient 5. Check for other injuries 6. Plan what to do 7. Carry out the plan This steps guides you in dealing with all injuries or accidents, but use common sense. 50
Check response If unresponsive A Free airways? YES NO Establish free airways YES B Is he/she breathing? Check up to 10 seconds YES NO Call for help! Start CPR B Observe breathing for 1 minute YES Recovery position Bleedings? Signs of circulation problem? YES Stop bleedings Call for help! Conscious? Neurological symptoms? Alert Voice responsive Pain responsive Unresponsive Patient examination head to toe Treat/prevent hypothermia!!! 51