Basic First Aid Training: Basic First Aid Training SRSA training team Darfur Sudan December 2004 - March 2005 Introduction: Introduction Aim of training course - Timings for course ; Introduction Period 1 - Break Period 2 - Break Conclusion Key subjects to be covered: Key subjects to be covered 1. KNOWLEDGE OF BASIC LIFE SUPPORT 2. ASSESSMENT OF LIFE THREATENING SITUATIONS 3. PRIORITISE TREATMENT OF CASUALTIES 4. BASIC AND ESSENTIAL TREATMENT OF INJURIES 5. SAFE EVACUATION OF CASUALTIES Aims and objectives: Aims and objectives The aim and objective of this course is that the participants will be able to carry out the following actions without supervision Give basic life support Assess life threatening situations Prioritise casualties Give basic and essential treatment of injuries Safely evacuate casualties 1. KNOWLEDGE OF BASIC LIFE SUPPORT : 1. KNOWLEDGE OF BASIC LIFE SUPPORT First aid is the treatment of the sick and injured before professional medical help can be given. The aims of first aid are to prevent death or further injury, to counteract shock and to relieve pain. Unconsciousness, severe bleeding or burns require immediate treatment. Serious trauma is most likely from road traffic accidents, gunshots, stab wounds, fire, or blasts from bombs and land mines. 2. ASSESSMENT OF LIFE THREATENING SITUATIONS : 2. ASSESSMENT OF LIFE THREATENING SITUATIONS Evaluate the three S´s: Safety Scene Situation Safety – evaluate all possible threats and ensure that none still exist. Scene – evaluate the scene to determine what happened. Situation – assess if you have to deal with several casualties Practical assessment of situation: Practical assessment of situation 3. PRIORITISE TREATMENT OF CASUALTIES : 3. PRIORITISE TREATMENT OF CASUALTIES DANGER CHECK FOR CONSCIOUSNESS PRIORITY 4. BASIC AND ESSENTIAL TREATMENT OF INJURIES : 4. BASIC AND ESSENTIAL TREATMENT OF INJURIES A – Airway: Clear it if blocked B – Breathing: Mouth to mouth resuscitation if victim not breathing C – Circulation: Stop bleeding by applying direct pressure, prevent shock, CPR Burns Fractures A - Airway: A - Airway Check for breathing: put your face close to the casualty’s mouth, and look, listen and feel for breathing: Look for chest movements. Listen for sounds of breathing. Feel for breath on your cheek. How to open the airway: Non trauma patients: Chin lift Trauma patients: Jaw thrust maneuver Chin lift and Jaw thrust: Chin lift and Jaw thrust The recovery position: The recovery position Unconscious casualties should be placed in the recovery position to prevent the tongue blocking the throat and allows liquid to drain from the mouth. This is best learned through practical exercises. B - breathing: B - breathing Artificial breathing: Raise the chin slightly, pinch the nose and give 2 quick breaths (1-5 seconds/breath) in to the casualty´s mouth. Evaluate effect by look, listen and feel. C - circulation: C - circulation Bleeding is classified according to the type of blood vessel that is damaged: artery or vein. Arterial bleeding: Spurting of bright red blood (richly oxygenated) under pressure Venous bleeding: Slow, steady bleeding at low pressure, dark red blood (poorly oxygenated) Severe external bleeding: Severe external bleeding The rapid loss can lead to shock or death in a very short period of time so it must be controlled speedily! Bleeding at the face and neck may obstruct the airway. Remember that shock may well develop and the casualty may loose consciousness. Your aims are: to control the bleeding to prevent shock Control of bleeding: Control of bleeding Treatment of bleeding: Treatment of bleeding Remove or cut clothing Apply direct pressure over the wound If the wounding body (i.e. knife or bullet ) is still incarcerated in the wound, do not extract it Raise and support an injured limb Apply a clean pad or sterile dressing, bandage it in place firmly Secure and support the injured part Look for help and check periodically the circulation Casualty treatment: Casualty treatment It may help to lay the casualty down. This will reduce blood flow to the site of injury, and minimize shock. Chest injuries and abdominal injuries: Chest injuries and abdominal injuries Chest injuries: Clear airway if obstructed Seal open sucking wounds with hand or other airtight material DO NOT try to remove any objects that might be sticking out of the wound Abdominal injuries: Cover wound with dressings Lay patient on back, with knees up and head and shoulders raised DO NOT remove debris from the wound DO NOT push in protruding intestines DO NOT give food, drink or painkillers Checking of pulse: Checking of pulse The preferred method to detect the pulse of a casualty, is on the neck. 1. Feel for the Adam’s apple with two fingers; slide your fingers back towards you into the gap between the Adam’s apple and the strap muscle, and feel for the carotid pulse. 2. Feel for ten seconds before deciding that the pulse is absent. 3. If it is, proceed with C.P.R CPR: CPR CARDIO PULMONARY RESCUSITATION – CPR If pulse is present and breathing not active , administer ventilations for one minute (ten ventilations), before checking again the carotid pulse. If pulse is absent , proceed CPR (15/2 compressions/ventilations) - no stop. If pulse is present check for breathing, ensure free airway. CPR technique (1 or 2 First-Aiders): CPR technique (1 or 2 First-Aiders) 1. Identify the correct position for the hands – follow from the level of the lowest rib, measure upwards a distance of 2 fingers along the chest bone. Place the ball of the hand on this postion and add the other hand on top. 2. Give 15 chest compressions. Return to the head and give 2 ventilations, then 15 further compressions If there are two first-aiders; the one giving chest compressions should set the rythm by counting out loud the pace. Correct CPR position: Correct CPR position Shock: Shock Clinical shock occurs when there is reduced blood circulating through the body. The main cause of shock is substantial loss of blood, which results in an inadequate supply of oxygen to the body tissues. A person suffering from shock needs immediate attention! Recognition: there may be pallor, cold and clammy skin, rapid and weak pulse, pain, thirst, confusion, restlessness and irritability - possibly leading to collapse and unconsciousness. Place the casualty in a semi-prone position with the legs elevated Ensure free airway Keep the casualty warm Act calmly and reassuringly Do not give anything to drink Burns: Burns The main causes of burns are: Fire, dry heat, corrosive substances and friction Wet heat, hot liquids and vapors 1. Extinguish the burn with large amount of liquid, 10 minutes or more. 2. Check airway, breathing, pulse. Be prepared to resuscitate. 3. Gently remove any rings, watches, belts, shoes, or smoldering clothing 4. Cover the injury with a sterile burns sheet or other suitable material. Use a clean plastic bag for a burned hand or foot. Do not drain any blister! Fractures: Fractures Fracture recognition: Difficulty in moving a limb Pain at or near the site of injury Local distortion, swelling and bruising Shortening, bending, or twisting of the limb Signs of shock Closed fracture treatment: Do not move the casualty until the injured part is secured and supported Support the injured part Immobilize joints above and below a fracture site with a splint Open fracture treatment: Cover the wound and apply pressure to control the bleeding If bone is protruding, build up pads of soft, non fluffy material around the bone Do not press down directly on a protruding bone end Immobilize as for a closed fracture, elevate the injured part Check the circulation beyond the bandaging every 10 minutes Upper limb fractures: Upper limb fractures Support the arm against the trunk with a sling and, if necessary, bandaging. In case of fractured collar bone, dislocated shoulder, severe shoulder sprain, fractured upper arm, injuries around the elbow, and to the forearm and wrist proceed as follows: Sit the casualty down; gently steady and support the injured site across the chest Ask him/her to support the arm Support the arm in a sling and secure the limb to the casualty’s chest Transport the casualty in a sitting position Stabilization of upper limb fractures: Stabilization of upper limb fractures Lower limb fractures: Lower limb fractures Injuries to the hip, thigh or lower leg: Lay the casualty gently down: ask another helper to steady and support the injured limbs Immobilize the limb by splinting it to the uninjured limb Gently bring the casualty’s sound limb alongside the injured one Stabilization of lower limb fractures: Stabilization of lower limb fractures 5. SAFE EVACUATION OF THE CASUALTY FROM DANGER AREA : 5. SAFE EVACUATION OF THE CASUALTY FROM DANGER AREA Remember! Never move a casualty with suspected spinal injury unless assisted by medical personnel. Exceptions: Life-threatening situation At a mass-casualty incident If the original position of the casualty prevents you from establishing and ensuring a free airway Proceed with extreme caution if you suspect a neck or spinal injury! Human crutch: Human crutch Dragging method: Dragging method Concluding remarks: Concluding remarks Any questions ?: Any questions ?