DOE Outdoor First Aid

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DANGER Always STOP and THINK about the danger To yourself To the patient To the group Ask yourself: What can kill me? What can harm me? What can kill group members? What can harm members? What can kill the patient? What can harm the patient? Leadership!!!!

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Patient Management Assign roles Leader First Aider Carer Recorder

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The Recorder Time of the incident Initial findings of first aider Patients name What happened Patients condition Treatment being given The Carer Looks after the patient’s emotional needs gives support keeps them informed The carer can also support and help the first aider

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EFFECTIVE LEADERSHIP The leader needs to stand back and delegate as much as possible Protect your group from immediate danger and keep them together Give clear instructions Decision time Rest awhile? Walk out? Evacuation?

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A D B S C R Patient Management

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Patient Management DR. ABCS D anger R esponse A irway B reathing C irculation S evere Bleeding

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Diarrhoea Large, loose smelly stools Management Attend to patients possible embarrassment Don’t give fruit, dried food, milk, alcohol, or any solid, fatty, or highly seasoned foods Do give plenty of liquids 200ml hourly of boiled water or electrolyte drink Pay attention to personal hygiene Medications Rest

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EYES, foreign bodies Management Don’t rub the eye Automatic blinking and watering of the eye often moves object to the corner of the eye allowing it to be removed If object can’t be removed easily: First, flush the eye Don’t try to remove the object as this can damage the cornea Cover the eye with a soft pad, lightly secured Arrange evacuation If the object has pierced the eye, fluid will leak out. Permanent loss of sight may follow. Keep patient lying down flat on their back, and head up slightly. Very gently cover the eye and arrange evacuation

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EAR, foreign bodies If a person has an insect or other foreign body in their ear: Lean their head to the side, and gently pour warm water into the ear. This should float the insect out. Have the patient see a doctor on returning home to make sure that no tiny fragments are still present, and that the eardrum has not been damaged. DO NOT probe, or poke anything inside the ear

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Care of the Unconscious Patient Causes of unconsciousness include: Head injury, choking, stroke, epilepsy, diabetes, meningitis, heat stroke, hypothermia etc IMPORTANT Never leave an unconscious person unattended on their back. WHY? The normal reflexes that protect the airway of the conscious person will fail. The unconscious person cannot cough, swallow or gag. Always have someone checking that the unconscious patient is breathing, listening for gurgling noises in the throat, and watching for vomit in the mouth

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The Recovery Position In the outdoors, the best way to protect the airway from becoming blocked is to put the patient in the recover position. on side no pressure on chest unable to roll over onto face head positioned so tongue cannot fall across back of throat, any vomit or fluid will drain out of mouth and not into lungs

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Shock Shock is the name given to the condition when the circulatory system fails to provide sufficient oxygen to every part of the body. There are different types of shock but the results are the same. Shock is a serious condition that needs to be recognized and managed quickly Assessment A person in the early stage of shock will exhibit some or all of the following signs: pale, cool skin nausea and vomiting fast and weak pulse rapid breathing dizziness anxiety

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Treating Shock The aim is to keep blood circulating though the vital organs Check and monitor the ABCs. Reassure the patient Lie the patient on insulated ground, with the head and body flat and the feet and legs raised just above the level of the heart Keep the patient warm to try to maintain normal body temperature Do not give anything to drink at first. Moisten the lips of the very thirsty patient

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Severe External Bleeding A torn, major blood vessel, where there is severe blood loss is immediately life threatening Assessment A person who has experienced severe blood loss will exhibit signs of shock. In assessing the injury expose the wound and look for impaled, embedded objects. Try to note and record the amount of blood lost Management Your first priority is to stop the blood loss. There are 3 methods for controlling bleeding: Direct pressure Indirect pressure Tourniquets LAST RESORT ONLY

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Direct Pressure Key points: Apply pressure around an embedded object Large wounds may need to be packed with dressing material Maintain firm pressure until a clot forms Reassure patient, lie them down with bleeding limbs elevated Place another dressing pad on top of first if needed After 5 minutes slowly release pressure – reapply if needed Apply a compression bandage Treat for shock Check for circulation – may need to loosen bandage Consider splinting a limb with a major wound

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Fractures In the outdoors fracture management consists of: Supporting and immobilising the fractured bone Minimising the patient’s pain Ensuring an adequate blood supply to any fractured limbs Protecting an open fracture from infection If you come across a fracture in an urban area, with an ambulance readily available, you need only to keep the patient still. You should not move the broken limb or apply a splint.

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Assessment For Fractures a cracking sound as the bone is injured pain and swelling deformity – a fractured limb may be bent or twisted, or may be shorter than the opposite limb a ‘grating’ noise or feeling when the fracture is moved the signs and symptoms of shock A person who has suffered a significant accident or injury should be checked for fractures. A person with a fracture will exhibit some or all of the following signs:

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Fractured Arm (between elbow and wrist) Assessment If the fracture involves the wrist there may be general swelling, making it difficult to decide if a sprain or fracture. If in doubt treat as a fracture. Management Remove watches, jewellery, rings Give pain relief if needed Straighten the arm if necessary to restore circulation Apply a splint to immobilise the fracture Apply a sling to support the arm and to immobilise the elbow Extended care and evacuation guidelines Evacuation will depend on the severity of the fracture and the degree of pain and shock. Some patients will be able to walk out with assistance. Others will need evacuation

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Slings

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Fractured Leg (knee to ankle) Assessment The general signs and symptoms of a fracture will usually be present. If the ankle is fractured there may be general swelling, and it can be difficult to tell if a fracture or sprain. Treat as a fracture if in doubt. Management Remove clothing from injured leg Remove the boot, to check circulation to the foot If circulation is compromised, straighten the leg Give pain relief if needed Apply splinting from mid thigh to the foot. Ensure the lower leg, knee, and ankle are all immobilised. Arrange an evacuation

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Splinting a fractured knee

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