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Contents Page WHAT IS FIRST AID? ......................................................................................................... 3 The Aims of First Aid.......................................................................................................... 3 Basic Materials for a First Aid Kit - Activity ......................................................................... 3 Basic Materials for a First Aid Kit ......................................................................................... 4 Accident Report Details ...................................................................................................... 4 RESPONSIBILITIES OF THE FIRST AIDER.............................................................................. 4 Prioritising Treatment Triage............................................................................................... 6 Summoning Help: LIONEL .................................................................................................. 6 Casualty Communication .................................................................................................... 6 PRIMARY ASSESSMENT ...................................................................................................... 7 If the Casualty Is Breathing ................................................................................................ 7 SECONDARY ASSESSMENT ................................................................................................. 7 Top to Toe: ...................................................................................................................... 9 TOP – TOE SURVEY........................................................................................................13 BREATHING AND CIRCULATION..........................................................................................14 Breathing .....................................................................................................................14 Circulation ....................................................................................................................15 RESUSCITATION ..............................................................................................................16 Why Apply a Defib?........................................................................................................16 The Chain of Survival .....................................................................................................18 Why is early Defib so important? .....................................................................................18 TYPES OF WOUND ............................................................................................................20 TYPES OF BLEEDING.........................................................................................................20 TREATMENT GENERAL OF BLEEDING ................................................................................20 GENERAL TREATMENT OF MAJOR BLEEDING......................................................................20 ASTHMA .........................................................................................................................21 CHOKING ........................................................................................................................21 HEART ATTACK ................................................................................................................22 SKULL FRACTURE AND CEREBRAL COMPRESSION .................................................................23 WHAT IS A FRACTURED..................................................................................................23 SKULL AND CEREBRAL COMPRESSION ................................................................................23 RECOGNITION FEATURES ...............................................................................................23 TREATMENT..................................................................................................................24 FUME, GAS AND SMOKE INHALATION .................................................................................24 TREATMENT..................................................................................................................24 2 of 24

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WHAT IS FIRST AID?
THE IMMEDIATE ASSISTANCE OR TREATMENT GIVEN TO SOMEONE INJURED OR SUDDENLY TAKEN ILL BEFORE THE ARRIVAL OF AN AMBULANCE, DOCTOR OR OTHER APPROPRIATELY QUALIFIED PERSON

The Aims of First Aid
• • • • Preserve life Prevent deterioration Promote recovery Obtain further medically qualified assistance if required

Basic Materials for a First Aid Kit - Activity What should be in a first aid kit? What should NOT be in a first aid kit?

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Basic Materials for a First Aid Kit
• • • • • • • • • • • Guidance Cards 20 Adhesive Dressings 6 Medium Sterile Dressings 2 Large Sterile Dressings 2 Extra Sterile Dressings 2 Sterile Eye Pads 6 Triangular Bandages 6 Safety Pins Disposable Gloves Plastic Face Shield Cleansing Wipes

Accident Report Details
• • • • • • • • Name Of Casualty Home Address Name Of Person Writing The Report When The Accident Happened Where The Accident Happened What Happened Treatment Given Method Of Disposal e.g. Hospital, Home or Return To Work

RESPONSIBILITIES OF THE FIRST AIDER
As a First Aider your ultimate responsibility is for yourself, followed closely by the casualty and other bystanders. You may have to make instant decisions and delegate duties based on limited knowledge of the situation. The following is information to help simplify and prioritise the order in which you will carry out your duties and also decide whether or not further medical aid is required. Complete the following exercise – there are at least six things to consider at each stage.

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Arriving at the scene

Dealing with the casualties

Dealing with the aftermath

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Prioritising Treatment Triage
B__________________ B__________________ B__________________ B__________________ This is commonly known as triage and is an excellent tool for determining priority of treatment

Summoning Help: LIONEL
Below is an excellent way of remembering what information you will be expected to give to the emergency services if they are required. L I O N E L __________________ __________________ __________________ __________________ __________________ __________________

Casualty Communication
As a first aider you should be aware that your casualty is going to be scared and possibly will not be aware of what is being said or done. Therefore any and all gestures, attitude and body language towards the casualty should be positive, as it is critical in gaining the casualties trust. • • • • • • • • Keep Eye Contact Tell The Truth Be Aware Of Body Language Speak Clearly and Slowly Use Their Name Allow Time For The Casualty To Answer Act In A Calm and Confident Manner After The Incident

Once the incident is over there are various tasks you must complete, some of these are, • Fill in accident report 6 of 24

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• • • • • Dispose of used kit in appropriate way Make area safe Contact family/friend if required Replenish first aid box Be aware of your own feelings

PRIMARY ASSESSMENT
Your primary assessment is the most important assessment you will carry out as it sets the tone for the treatment you will administer. It will also allow you to take immediate control of the incident instead of it taking control of you. • • • • • Danger Response Shout Airway Breathing Make the area safe Identify yourself, Ask questions If no response shout for help Open the airway, Check then Extend Look, Listen, Feel for breathing for 10 seconds

If the Casualty Is Breathing
• • • • • • • • Check for danger Check response Shout! Open the casualty’s Airway and check for Breathing. Examine the casualty for life-threatening injuries. Place casualty into the recovery position. Go and get help. Monitor and record casualty’s response, breathing and pulse when you return.

SECONDARY ASSESSMENT
Once we have established that the person is breathing we must then ascertain whether or not they have any further injuries before we put them into the recovery position. To do this we carry out what is called a top – toe survey, if at any time during the secondary assessment the person breathing becomes noisy or they start to have problems we must instantly put them into the recovery position. REMEMBER PRIORITIES • BREATHING • BLEEDING • BURNS • BONES 7 of 24

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The assessment is carried out as its name suggests starting at the top (head) and working down to the tail (legs). At all times during the assessment you must be communicating with the casualty, letting them know what is happening and what you are doing. You must do this even if you think the casualty is unconscious as the last sense we loose is our hearing and as we said earlier we must try and put the casualty at ease whatever the circumstances. Before you start the assessment you must first put on your gloves so as to prevent any cross infection, also remember as you carry out the assessment regularly check your gloves for signs of blood as you may not have been able to feel it. Once the top – toe has been completed and we do not suspect any further injuries we can place the casualties in the recovery position so as to aid breathing.

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Top to Toe:
Body Part Eyes What are you checking for?

Head

Ears

Mouth

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Body Part Neck What are you checking for?

Shoulders

Chest

Arms

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Body Part What are you checking for?

Wrist

Hands

Stomach

Hips

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Body Part Leg What are you checking for?

Ankle

Feet

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TOP – TOE SURVEY
PUT GLOVES ON HEAD AND FACE • • Ensure the mouth and nose is clear Carefully look at the face, scalp, ears, eyes, nose and mouth for any bleeding, bumps, swelling or depression. Examine the eyes for unequal pupils, look for any fluid drainage or blood particularly around the ears and nose. Smell the casualties breath for strong alcohol odour or fruity breath. Note the colour, temperature and state of the skin.

• • • NECK • • • •

Loosen clothing around the neck and look for any warning medallion. Look at the head, neck and cervical spine for any obvious injuries or swelling. Gently feel the cervical spine for deformity or tenderness. Ask a responsive casualty if he or she feels any pain or tenderness.

CHEST • • • • Look carefully for any signs of injury. Gently press on the ribs to determine if there is any tenderness. Do not press on bruises or breaks in the skin. Look for the normal rise and fall of the chest with the breathing process. Gently feel along both the collarbones and the shoulders for any deformity, irregularity or tenderness.

ABDOMEN • • Look first for any signs of obvious injury, including swelling and bruising. Next gently feel the abdomen. Ask the casualty if there is any pain or tenderness as you press over the abdomen and note any rigidity.

PELVIS • Feel both sides of the hips and gently move the pelvis to look for the signs of fracture.

EXTREMITIES 13 of 24

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BEGIN AT THE THIGH AND WORK DOWN TO THE FOOT • • • Look for lacerations, bruising, swelling, obvious deformities and bleeding. Feel along the calves and shins for tenderness and pain. Check pockets by pulling out the lining and remove any sharp objects. If possible, get a witness and make sure any items removed stay with the casualty.

NEXT, EXAMINE THE ARMS. • • • • • Look for lacerations, bruising, swelling obvious deformities and bleeding. Feel along the arms for tenderness and pain. Check the radial pulse, if unable to detect this then try the carotid pulse at the neck. Test the casualties’ ability to move both arms and each hand. Look for any needle marks on the forearms or any warning bracelet.

BREATHING AND CIRCULATION Breathing
To take a breath in, the muscles between the ribs contract to pull the ribs upwards and outwards. The diaphragm, a strong muscle underneath the rib cage, also contracts and flattens helping to enlarge the cheat cavity. This causes air to be drawn in through the mouth and or nose from where it travels through the air passage and down into the lungs, where it eventually comes into contact with the blood vessels and delivers oxygen. There is a small flap known as the epiglottis just where the food and air passage meet to stop air going into our stomach or food into our lungs. This flap gets confused sometimes hence we burp (air in the stomach) or cough, or choke when eating. To breath out, after a short pause both the muscles between the rib cage and the diaphragm relax and the air is expelled out through the same passage. The average breathing rate of an adult at rest is 16 times per minute, this is faster in children and babies.

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Air Route lottis

Epiglottis Oesophagus Oesop

Larynx ynx Trachea
chea

Bronchus chus
e oli Alveoli

Circulation
Once we have oxygen in the blood we need to get it pumped around the body to do this we need the heart. This acts as a pump and its function is to pump oxygenated blood around the body. In most people it beats continuously until we die. It beats on average 60-80 times a minute in an adult; this is quicker in both children and babies. There are certain things which can either speed up or slow down the heart rate such as, exercise, stress, alcohol, tea, coffee and smoking.

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Deoxygenated Blood Oxygenated Blood

RESUSCITATION
Unfortunately even as good as we are we may have to deal with an apparently dead person. After we have conducted our primary assessment we have decided that we cannot detect signs of breathing and / or circulation, WHAT NOW? • • • Cardio Pulmonary Resuscitation

You will find below a straightforward guide for what action you will need to take in various circumstances; this will act as a great training aid and revision tool for what you go through with your trainer in the lesson.

Why Apply a Defib?
Sudden Cardiac Arrest Sudden Cardiac Arrest (SCA) is due an electrical malfunction of the heart typically (but not always) associated with an abnormal heart rhythm known as .ventricular fibrillation.. It is a condition in which the heart’s electrical impulses suddenly become chaotic; causing an abrupt cessation of the heart’s pumping action. Instead of beating in a regular coordinated manner the heart begins to .quiver. and is unable to pump blood. Victims collapse and 16 of 24

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quickly lose consciousness, often without warning. Unless a normal heart rhythm is restored, death follows within a matter of minutes. The average survival rate is less than five percent. What causes sudden cardiac arrest? SCA is largely unpredictable. Many victims have no prior history or symptoms of heart disease. One common cause (but by no means the only cause) of sudden cardiac arrest is a .heart attack.. .Heart Attack. is not strictly a recognised medial term. Most doctors prefer the term .Myocardial infarction. or .MI.. A Myocardial infarction occurs when there is a blockage in the small arteries that feed blood to the heart muscle itself. This usually results in the characteristic .crushing. chest pain felt by victims as the heart muscles are starved of oxygen. This oxygen starvation can sometimes trigger the chaotic heart rhythm called ventricular fibrillation described above which causes the patient to collapse and suffer a sudden cardiac arrest. Sudden cardiac arrest can often occur in the early stages of a heart attack leading to collapse and death within a few minutes. How Do You Treat Sudden Cardiac Arrest? A person who has collapsed, is unresponsive and is not breathing normally may be suffering sudden cardiac arrest and needs to be treated very quickly. If you suspect a patient is in cardiac arrest you should call the emergency services immediately. For the best chance of survival effective treatment needs to be given within the first few minutes. This treatment should include CPR (cardiopulmonary resuscitation) which consists of manual chest compressions and rescue breaths and rapid defibrillation. Modern AEDs will accurately and quickly analyse the patient’s heart rhythm to determine if the patient is actually suffering from sudden cardiac arrest and will not allow a shock to be delivered unless the patient’s heart needs one. SCA is most often caused by the heart going into .ventricular fibrillation. (VF) A heart in ventricular fibrillation must be .defibrillated.. To defibrillate the heart .to stop the chaotic and unproductive quivering of VF an electrical shock must be applied. This electrical shock passes through the heart muscle and (if successful) resets the hearts electrical system enabling the normal heart rhythm to become re-established. Defibrillation administered within the first few minutes after collapse gives the patient the best chance of survival The likelihood of successful resuscitation decreases by approximately 7-10 percent with every minute that passes. After several minutes, very few resuscitation attempts are successful. Thus, the most important element in the treatment of SCA is providing rapid defibrillation therapy. CPR on its own is essential if a defibrillator is not immediately available. Although CPR can’t stop fibrillation it can extend the patients life long enough for a defibrillator to arrive. The very best chance of survival comes from a combination of the right basic training, good quality CPR and most importantly, rapid defibrillation within the first few minutes. Some AED defibrillator gives voice instructions on CPR so even untrained users can resuscitate a victim of sudden cardiac arrest.

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The Chain of Survival

Why is early Defib so important?
For every minute that passes your patient has a 10% less chance of survival

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TYPES OF WOUND
A good way to remember the types of bleeding is to use this acronym – PC GAIL P - uncture C - ontusion G - unshot A - brasion I - ncised L - aceration Small Entry Blunt Blow Bullet Into or Through Body Top Layers Of Skin Scraped Off Clean Cut Rough Tear

TYPES OF BLEEDING
It is important for us to be able to recognise the type of bleeding so as to try and ascertain what structure has been affected Arterial Venous Capillary Bright oxygenated blood spurts from the wound In time with the heart beat. Dark red vein walls are capable of great distension. May gush profusely. Oozing occurs at the site of all wounds. Blood loss Is usually slight.

TREATMENT GENERAL OF BLEEDING
• • • • • • • • • • Put on gloves Raise and support injured limbs. Check wound for foreign objects. Apply pressure with sterile pad. When you arrive at the scene, ask the casualty to apply pressure with their hand until you have gloves and dressing. Leave original pad in place apply sterile Dressing. If the bleeding doesn’t stop after two dressings remove and reposition new dressings Once the bleeding stops bandage firmly. Support injured part if necessary. Treat for shock. DIAL 999.

GENERAL TREATMENT OF MAJOR BLEEDING
• • • Apply direct pressure over wound or next to embedded object Raise the injury, unless you are not able to i.e. fracture Position the casualty for shock normally lying down

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ASTHMA
WHAT IS ASTHMA Asthma is a condition where the air passages go into spasm and there is an excretion of thick, sticky mucus in the lungs, which further reduces the air passages. SOME OF THE CAUSES OF ASTHMA • • • Can be allergy to animal fur or dust Nervous tension Exercise

RECOGNITION • • • • • Difficulty in breathing with long wheezy breathing out phases Distress and anxiety Blueness of the skin in some cases Casualty may not be able to talk Can become exhausted

TREATMENT • • • • • Remain calm sit the casualty down leaning slightly forward on a support e.g. table. ( do not make them lie down) Assist them to take there own inhaler ( do not administer on your own ) Monitor there condition, it should start to ease within 3 minutes, if not get the casualty to take another dose of the same inhaler If the symptoms disappear advise the casualty to see their own doctor If the attack is severe or medication has no effect within 5 minutes, or it is there first attack get the casualty to hospital immediately

CHOKING
WHAT IS CHOKING • Choking is either a full or partial blockage of the airway, which will inhibit inhalation and exhalation.

WHAT ARE SOME OF THE CAUSES OF CHOKING • • • • Food Toys Pen tops General foreign objects

WHAT ARE THE SIGNS, SYMPTOMS AND HISTORY OF CHOKING • • • • • • Difficulty in breathing Possible noisy breathing Flushed skin at first, can eventually turn pale with blue extremities Clutching the throat May have been seen eating, chewing pen top etc Ask them, if conscious they can still nod 21 of 24

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WHAT IS THE TREATMENT • • • Ensure it is choking you are dealing with If they are coughing just encourage them to cough, as this means they are still getting air in If they stop coughing this can mean the airway is fully blocked, in this situation you should use the following guidelines.

Adult Choking Sequence

HEART ATTACK
WHAT IS A HEART ATTACK • This is where a blood clot gets caught in the arteries of the heart, thus preventing the blood from reaching further.

WHAT IS THE CAUSE OF A HEART ATTACK • Blockage in the arteries of the heart

RECOGNITION FEATURES • • • • • • Severe chest pain, radiating from the heart down the left arm (first side the heart supplies) Shortness of breath Pale skin, possible blueness of the lips Irregular weak pulse Signs and symptoms of shock, including sweating and feeling sick Possible sense of impending doom

TREATMENT 22 of 24

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• • • • Reassure the casualty, put them into a comfortable position, usually half sitting, half lying Phone an ambulance immediately Treat for shock, with emphasis on reassurance Be prepared for the casualty to go unconscious

Heart Attack

SKULL FRACTURE AND CEREBRAL COMPRESSION WHAT IS FRACTURED A

SKULL AND CEREBRAL COMPRESSION
• This is where via a direct blow the skull has broken, in its self this is very dangerous but added to this the broken bone can be depressed, and put pressure on the brain or there can be a build up of blood in the area and this places pressure on the brain. As was mentioned this can be a potentially lethal situation known as cerebral compression

RECOGNITION FEATURES
• • • • • • • • • History of a blow to the head Hot flushed face Possibly a raised temperature Slow strong pulse Noisy slow breathing Unequal pupils in severe cases Intense headache Watery blood fluid coming out of the ear Confusion 23 of 24

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• • Weakness on one side of the body Possible change in personality

TREATMENT
• • • • Call for an ambulance Place in the most comfortable position usually lying down with head and shoulders raised possibly leaning to the ear with the fluid appearing Cover the ear with a sterile dressing If the casualty becomes unconscious place in the recovery position with ear releasing fluid facing the floor and check A.B.C

FUME, GAS AND SMOKE INHALATION
When treating anyone for the above we have to be very careful not to put ourselves in danger, we also have to make sure that we have identified all the casualties as it is possible to get more than one. Here is a list of the possible gasses and fumes which we may come into contact with and their recognition features. • • • • • SMOKE – irritation of the air passages, causing possible spasm’s, swelling and burning CARBON MONOXIDE – possible headaches, confusion, nausea, breathing difficulties, skin will go a cherry red colour. CARBON DIOXIDE unconsciousness. – breathlessness, headaches, dizziness, leading rapidly to

SOLVENTS – headaches, vomiting leading to unconsciousness. These can stop the heart. LIGHTER FUELS – can cause the heart to stop.

TREATMENT
• • • • Send for help (ambulance or fire) Remove casualty from danger, if possible Check A.B.C and act accordingly, if you have to give rescue breaths be careful of the casualty exhaling as this could contain some of the fumes, gasses or smoke. Treat any burns

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