First Aid at Work Book (A4) First edition January 2013 (Reprinted August 2014) ISBN 978-1-907751-88-2 Second edition January 2016 ISBN 978-1-910964-16-3 Page number and previous content Page number and updated content 2 Doctors ABCD 2 Doctor ABCD 5 First-aid equipment The content will be dependent on the assessment of first-aid needs that should be conducted. In December 2011 the British Standards Institute launched the new workplace First Aid Kit (BS 8599). 5 5 First-aid equipment The content will be dependent on the assessment of first-aid needs that should be conducted. In December 2011 the British Standards Institute launched the new workplace First Aid Kits (BS 8599-1). 5 7 Incident recording and reporting After any first-aid incident it is important that the incident is recorded and reported in full. Ultimately the employer is responsible for the reporting of accidents; however, as the first aider, you should be clear on your role within this process. The accident book should be completed in full and populated with clear and concise information; there may also be the necessity to inform the relevant authority (re RIDDOR). In cases where a defibrillator has been 7 Incident recording and reporting After any first-aid incident it is important that the incident is recorded and reported in full. Ultimately the employer is responsible for the reporting of accidents; however, as the first aider, you should be clear on your role within this process. The accident book should be completed in full and populated with clear and concise information; there may also be the necessity to inform RIDDOR. In cases where a public access AED has been used, dependant on local authority policies, there may be a requirement to report the event using a
used, regardless of whether shocks were given or not, then the Event Report Form (ERF) requires completing in full and the white copy to be sent to the Resuscitation Council (UK) as soon as possible. The address of which can be found at the bottom of the Form. prescribed audit reporting chain. 8 Primary Survey Having conducted a scene survey and established that the immediate area is safe from any dangers, you can now approach the casualty. When approaching the casualty an initial casualty assessment should be conducted; this initial casualty assessment is called a primary survey. The primary survey is a systematic process of approaching, identifying and dealing with immediate and or life-threatening conditions. The primary survey can be remembered by the acronym DRSABCD (or the easy way to remember, Doctors ABCD). 8 Primary Survey Having conducted a scene survey and established that the immediate area is safe from any dangers, you can now approach the casualty. When approaching the casualty an initial assessment should be conducted; this initial assessment is called a primary survey. The primary survey is a systematic process of approaching, identifying and dealing with immediate and or life-threatening conditions. The primary survey can be remembered by the acronym DRABCD (or the easy way to remember, Doctor ABCD).
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11 Secondary Survey Head-to-toe survey If the casualty is breathing a secondary survey should be carried out. Inform the casualty what you are doing at all stages. If the casualty is responsive ask them to tell you if they feel any pain during the head-to-toe survey. 11 Secondary Survey Head-to-toe survey If the casualty is breathing normally a secondary survey should be carried out. Inform the casualty what you are doing at all stages. If the casualty is responsive ask them to tell you if they feel any pain during the head-to-toe survey. 12 Recovery position The casualty is now in the recovery position 12 Recovery position The casualty is now in the recovery position + Check breathing regularly, and be prepared to carry out CPR. 13 The Principles of Resuscitation Basic life support (BLS) comprises of the following elements: Initial assessment (primary survey) Airway maintenance Chest compressions Rescue breathing (expired air ventilation) 13 The Principles of Resuscitation Basic life support (BLS) and automated external defibrillation (AED) comprises of the following elements: Initial assessment Airway maintenance and breathing Cardiopulmonary Resuscitation (CPR) and Automated External Defibrillation (AED) 14 Complete 30 compressions and 2 rescue breaths until: 1. qualified medical assistance takes over 2. the casualty shows signs of regaining consciousness such as coughing, opening eyes, speaking or moving and starts to breathe normally 3. you become physically exhausted and cannot continue 14 Complete 30 compressions and 2 rescue breaths until: 1. A health professional tells you to stop 2. You become exhausted 3. The casualty is definitely waking up, moving, opening their eyes and breathing normally 15 Adult basic life support 15 Adult basic life support and automated external defibrillation
15 Compression-only CPR If you are not trained, the casualty has extensive facial injuries or you are unwilling to give rescue breaths then chest compressions only may be administered. If chest compressions only are given, these should be continuous at a rate of 100 120 compressions per minute. 15 Compression-only CPR If you are untrained or unable to give rescue breaths then compression-only CPR may be administered. If compression-only CPR is given, then this should be continuous at a depth of 5-6 cm and at a rate of 100 120 compressions per minute. 16 Infant and child CPR The age definition of an infant can best be defined as from birth to 1 year old. The age definition of a child can best be defined as from 1 year old to the onset of puberty. 16 Infant and child CPR The age definition of an infant can best be defined as from birth to less than 1 year of age. The age definition of a child can best be defined as from 1 year old to the onset of puberty.
18 helpful hint; The use of an AED is not recommended for infants aged less than 1 year 18 Removed and not replaced
19 A choking adult or child (airway obstruction) Someone who is choking will have either a partial or complete obstruction of the airway. The severity of the blockage will determine the difficulty in breathing. 19 A choking adult or child (airway obstruction) Someone who is choking will have either a mild or severe airway obstruction. The severity of the blockage will determine the difficulty in breathing. 19 With a complete obstruction the casualty may show the above signs but also the skin colour may develop a blue/grey tinge; the casualty will get progressively weaker and eventually will become unconscious. 19 BACK BLOWS Lean the casualty forward (supporting the upper chest with one hand). Administer a maximum of 5 sharp back blows with the other hand. If, after 5 sharp back blows, the obstruction still remains, then administer abdominal thrusts. ABDOMINAL THRUSTS Stand behind the casualty, lean them forward and place your hands around their stomach. Make a clenched fist with one hand and place the thumb of the clenched fist above the navel. Cup the clenched fist with the other hand and pull inwards and upwards in one motion. Repeat this procedure up to a maximum of 5 times. 19 With a severe airway obstruction the casualty may show the above signs but also the skin colour may develop a blue/grey tinge; the casualty will get progressively weaker and eventually will become unconscious. 19 BACK BLOWS Stand to the side and slightly behind the casualty Support the chest with one hand, lean the casualty forward and administer a maximum five sharp blows between the shoulder blades with the heel of your other hand If the back blows are ineffective then give up to 5 abdominal thrusts ABDOMINAL THRUSTS Stand behind the casualty and put both arms round the upper part of the abdomen, lean the casualty forward With one hand clench your fist and place it between the naval and the ribcage Grasp this hand with your other hand and pull sharply inwards and upwards, repeat this process up to a maximum of 5 times Assess the casualty s condition, if the obstruction is still not relieved call for an ambulance (999/112) and continue with cycles of up to 5 back blows and up to 5 abdominal thrusts until qualified medical assistance takes over If the casualty becomes unresponsive commence CPR 20 Treatment, 2nd point Contact the emergency services immediately 20 Treatment, 2nd point immediately 20 20
20 Action for a choking infant flow diagram 20
22 Treatment of bleeding (General), 6th point Dress the wound with a sterile dressing and elevate the injured part if possible Last point Contact the emergency services (999/112) and monitor the casualty 23 Wounds with embedded foreign objects, 6th point Contact the emergency services, monitor the casualty and if required treat for shock 23 Amputations, Treatment, 3rd point Contact the emergency services (999/112) 22 Treatment of bleeding (General), 6th point Dress the wound with a sterile dressing Last point and monitor the casualty 23 Wounds with embedded foreign objects, 6th point, monitor the casualty and if required treat for shock 23 Amputations, Treatment, 3rd point Bottom of page new text Helpful Hint Haemostatic dressings A haemostatic dressing can be used when direct pressure cannot control severe external bleeding or the wound is in a position where direct pressure is not possible. Training is required to ensure the safe and effective application of these dressings. Tourniquet A tourniquet can be used when direct wound pressure cannot control severe external bleeding in a limb. Training is required to ensure the safe and effective application of a tourniquet. 24 Treatment for shock, 7th point Contact the emergency services (999/112) Treatment for anaphylaxis, 1st point Contact the emergency services (999/112) 25 Generalised seizures, Treatment, last point If it is their first seizure contact the emergency services (999/112) 28 Superficial burn, Treatment, 3rd point Immerse in tepid running water (not freezing) for the minimum of 10-20 minutes (the longer the better). 24 Treatment for shock, 7th point Treatment for anaphylaxis, 1st point 25 Generalised seizures, Treatment, last point If it is their first seizure call for an ambulance (999/112) 28 Superficial burn, Treatment, 3rd point Cool the area of the burn with water for a minimum of 10 minutes
6th point Place a dry sterile dressing or if unavailable then apply clingfilm around the injury 28 Partial-thickness burn, Treatment, 4th point Remove clothing and then flush the area of the wound with tepid water for the minimum of 10-20 minutes 7th point Place a dry sterile dressing or if unavailable then apply clingfilm around the injury 28 6th point Dress the burn with a loose sterile dressing or if unavailable then place a layer of clingfilm over the burn** Partial-thickness burn, Treatment, 4th point Remove clothing and then flush the area of the wound with water for a minimum of 10 minutes 7th point Dress the burn with a loose sterile dressing or if unavailable then place a layer of clingfilm over the burn** 29 Full-thickness burn, Treatment, 4th point Remove clothing and then flush the area of the wound with tepid water for the minimum of 10-20 minutes 7th point Place a dry sterile dressing or if unavailable then apply clingfilm around the injury 29 Chemical burns to the eye, Treatment Wash chemical from the eye for a minimum of 10 minutes with fresh running water. Ensure chemical does not run into the other eye. Cover with a sterile pad and seek medical attention. 31 Types of fractures (top of page) Treatment, 4th point Contact the emergency services 32 Treatment (General), 2nd point Contact the emergency services 33 Treatment of Conscious Casualty, 1st point Contact the emergency services 33 Treatment of Unconscious Casualty, 3rd point Contact the emergency services 29 Full-thickness burn, Treatment, 4th point Remove clothing and then flush the area of the wound with water for a minimum of 10 minutes 7th point Dress the burn with a loose sterile dressing or if unavailable then place a layer of clingfilm over the burn** 29 Chemical burns to the eye, Treatment Irrigate the eye immediately using continuous large volumes of clean water. Seek medical attention. 31 Types of fractures (top of page) Treatment, 4th point 32 Treatment (General), 2nd point 33 Treatment of Conscious Casualty, 1st point 33 Treatment of Unconscious Casualty, 3rd point
34 Fractures in Children (Greenstick), Treatment, 5th point Call the emergency services 34 Dislocations, Treatment, 3rd Point Contact the emergency services 35 Flail Chest, Treatment, 3rd point Contact the emergency services immediately. 35 Penetrating Chest Wound, Treatment, 1st point Contact the emergency services. Put on your gloves. Do not remove any embedded objects. Apply pressure to the wound. Try and place the casualty into a half-sitting position, or lateral position (lying on their side, injured side down). Place a plastic dressing, taped down on three sides onto the wound. (This prevents further air getting in but does not impede air from escaping.) Treat for shock. Monitor the casualty s airway and be prepared to carry out basic life support. 34 Fractures in Children (Greenstick), Treatment, 5th point 34 Dislocations, Treatment, 3rd Point 35 Flail Chest, Treatment, 3rd point immediately 35 Penetrating Chest Wound, Treatment, 1st point. Put on your gloves. Do not remove any embedded objects. Try and place the casualty into a half-sitting position, or lateral position (lying on their side, injured side down). Do not apply a dressing, leave the open chest wound exposed to freely communicate with the external environment or cover the wound with a non-occlusive dressing if necessary. Control localised bleeding with direct pressure. Treat for shock. Monitor the casualty s airway and be prepared to carry out basic life support. 36 REMEMBER! It is important to phone 999/112 immediately 36 REMEMBER! it is important to call for an ambulance (999/112) immediately 36 Heart Attack, Treatment, 1 st point Phone 999/112 immediately. 36 Heart Attack, Treatment, 1 st point immediately 36 Helpful Hint The administration of a 300mg aspirin is recommended for a casualty suffering from a heart attack. The aspirin should be chewed, as it will reduce blood clotting. 37 Treatment, 1 st point Call 999/112 immediately Helpful Hint IMPORTANT Contact the emergency services as soon as possible. The speed of 36 Helpful hint The administration of 150-300mg of chewable aspirin is recommended for a casualty with chest pain due to a suspected heart attack 37 Treatment, 1 st point immediately Helpful Hint IMPORTANT Call for an ambulance as soon as possible. The speed of treatment
treatment can have a major impact on the casualty s recovery. 38 Hypoglycaemia, Treatment Sit the casualty down, calm and reassure. For suspected hypoglycaemia, give a sugary drink or sugary food (e.g. glucose sweets). If the condition improves offer further sugary drinks or foods. If there is no improvement in the casualty s condition then call 999/112. Monitor the condition. If the casualty becomes unconscious carry out basic life support. 38 Hyperglycaemia, Treatment, 3 rd point If they have not been previously diagnosed then call 999/112 39 Poisons, Treatment (General), 1 st point Dial 999/112 39 Asthma Treatment (General), 2nd point Ensure use of medication (reliever inhaler) and get the casualty to follow own personal action plan. 4 th point If the attack is prolonged contact the emergency services 39 Helpful Hint If it is the casualty s first attack or they are hyperventilating then contact the emergency services immediately and be prepared to carry out basic life support. can have a major impact on the casualty s recovery. 38 Hypoglycaemia, Treatment Sit the casualty down, calm and reassure. For suspected hypoglycaemia, ask the casualty to take glucose tablets equating to 15-20g glucose. If glucose tablets are not available, use other dietary forms of sugar (jelly babies/non-diet fizzy drink). If there is no improvement in the casualty s condition then call for an ambulance (999/112). Monitor the condition. If the casualty becomes unconscious carry out basic life support. 38 Hyperglycaemia, Treatment, 3 rd point If they have not been previously diagnosed then call an ambulance (999/112) 39 Poisons, Treatment (General), 1 st point 39 Asthma Treatment (General), 2nd point If the casualty is experiencing difficulty in breathing assist them with the administration of their prescribed bronchodilator.** If the attack is prolonged call for an ambulance (999/112) 39 Helpful hint If it is the casualty s first attack or they are hyperventilating then call for an ambulance (999/112) immediately, and be prepared to carry out basic life sup port. 40 Blunt Abdominal Trauma (BAT) Treatment, 1 st point Contact the emergency services immediately 40 New Helpful Hint ** First aiders should be trained in the use of inhalers and spacers in order to assist a casualty in the administration of their prescribed bronchodilator Blunt Abdominal Trauma (BAT) Treatment, 1 st point immediately 40 Penetrating Abdominal Trauma (PAT), Treatment, 1st point 40 Penetrating Abdominal Trauma (PAT), Treatment, 1st point
Contact the emergency services immediately 41 Treatment (General), 5 th point Contact the emergency services 42 Frostbite, Treatment, 4th point Contact the emergency services or seek medical attention immediately. 43 Heatstroke, Treatment, 2nd point Contact the emergency services. 44 2 nd point Person responsible for checking YOUR First-aid container content: 3 rd point Location of nearest First-aid container (to where you work): immediately 41 Treatment (General), 5 th point and request other emergency services if required 42 Frostbite, Treatment, 4th point immediately. 43 Heatstroke, Treatment, 2nd point 44 2 nd point Person responsible for checking YOUR first-aid kit content 3 rd point Location of nearest first-aid kit (to where you work): Version 1 April 2016