Advanced First Aid

Definition of advocate?

literally means to "speak in favor of" or "plead in another's behalf". As an Emergency Responder you must act as an ill or injured person's advocate putting their needs above your own, as long as it is safe to do so.

What is confidentiality?

means that you will share information about the event or the person's condition only with those who are directly involved in their care. Examples of these individuals include, other care providers, EMS personnel, hospital personnel, and any others involved in their care.

•Lacerations

• often caused by sharp objects, lacerations will have straight and/or jagged edges.

definition of sign

•A sign is something that you can actually see. Examples include bleeding, an obviously broken bone or swelling.

Internal bleeding steps

•Activate 9-1-1 •Monitor ABC's •Control external bleeding •Keep the person lying flat on their back •Monitor body temperature and keep warm with blankets •Provide supplemental oxygen per protocol

what are the three conditions that are essential to ensure that we get enough oxygen for our bodies?

•An open and clear airway •Adequate volume of air with each breath •Adequate rate of breathing Should an ill or injured person experience difficulty with any of these factors, breathing will be compromised.

Priorities of care for diabetes

•As always your first priority is ensuring adequacy of ABC's. •Place the person in the recovery position •If they are responsive it is appropriate to have them eat or drink something with sugar in it. •Activate 9-1-1 and provide supplemental oxygen per your protocol

What are the priorities of care when treating a seizure

•As for anyone experiencing a decrease in level of consciousness, the first priority of care in to ensure adequacy of ABC's. constant monitoring of the ABC's is imperative and steps must be taken to manage problems. •Place the person in the recovery position and provide reassurance. •Gather a SAMPLE history to report to the responding EMS crew members. •Stroke treatment is time sensitive so activation of 9-1-1 should be done as early as possible.

•The care for a complete airway obstruction includes the following steps

•Ask the person if they can speak, if they cannot breathe, cough, or speak a complete airway obstruction exists. •Stand directly behind the person and place one hand in the form of a fist directly above his belly button. Your fist should be thumb side against the person and held tightly. •Reach around with the other hand and grasp your fist, pulling it tightly against the person's abdomen. •Pull inward and upward sharply in separate and distinct thrusts. Continue these thrusts until the obstruction is relieved. •

Blood traveling from the right side of the heart goes where?

•Blood from the right side of the heart goes to the lungs where oxygen and carbon dioxide are exchanged.

Blood is carried back to the heart through vessels called what?

•Blood is carried back to the heart from the body through veins.

Dental Injuries

•Ensure a clear and open airway, broken teeth and blood can easily cause obstruction of the airway so remove them from the airway •Place the patient in the recovery position to minimize blood entering the airway by having the injured person spit the blood and teeth out •If possible, collect the knocked out teeth and place them in a cup of milk. If milk is not available it is acceptable to wrap them in a clean dressing for transport with the injured person.

Should you perform a primary assessment before or after the scene size-up?

Answer - the scene size-up is performed first to identify if there are any hazards present at the scene. Ask the class to describe the other things that should be determined during the scene size-up.

What does BSI stand for?

Body Substance Isolation

What to do if you don't know if a bone or muscle is injured?

Bones can suffer injury such as breaks and bruises. It is often times difficult to determine which type of muscle or bone injury a person has. It is for this reason that you will treat injuries to muscles as though a bone is also injured.

Which is the most efficient way to contact local resources in the event of an emergency, using a landline or a cell phone to call 911?

land line because the dispatcher will, in most cases, be able to determine your location by the number you are calling from.

What is used to describe the general cause of a person's injury? Of a person's illness?

- The mechanism of injury is used for injured people where the nature of illness is the term used for ill people.

skeletal system, how many bones?

200 bones •Support •Movement •Protection •Cell production

What is a DNR?

A DNR is typically initiated when a person has a terminal illness. Not all DNR orders are the same. The order will reflect the specific wishes of the person and family members. In order to honor a DNR the original order must be presented to you so that the specific wishes of the person can be read and understood. When in doubt you should activate 9-1-1 and, if safe to do so, begin care for the person. EMS professionals are well versed on how to handle these situations and take over when they arrive.

What is the log roll?

A log roll can be either an emergent or non-emergent move depending on the reason it is being used. It may be used to roll an ill or injured person from their back to their side allowing for airway drainage, control bleeding from their back, or to place them on a backboard. It can also be used to roll a person from a face down to a face up position. Ideally you would have 3 responders participate in rolling the person.

multi-casualty incident

A multiple-casualty incident or MCI is an incident with more than one ill or injured person.

What is a stair chair?

A stair chair is an assistive device used to carry ill or injured people down a flight or multiple flights of stairs. While these devices are not available for use in all settings they should be utilized when available. The ill or injured person is secured into the stair chair and responders position themselves at the front and rear of the chair grasping handles and moving the person either up or down stairs. It is important to familiarize yourself with the manufacturer's operating instructions prior to attempting to move someone in the stair chair.

What is abandonment?

Abandonment refers to a situation where a responder leaves an ill or injured person before someone with equal or higher training took over care.

How to care for respiratory difficulty

Activate 911 Remain calm and reassure Assist with position of comfort Loosen clothing Assist with medication Provide supplemental oxygen

The importance of good communication when lifting someone

All involved in the move should make eye contact as the person at the ill or injured person's head, or Head Man, communicates with everyone by stating that the person will be moved after a simple 1-2-3 count. By doing this the move will be coordinated and no one is caught unprepared.

Which of the four body cavities can hide enough blood to be life threatening?

All of the cavities with the exception of the head.

What is an advanced directive?

An advanced directive is a legal document that outlines a person's wishes regarding his own health care. Advanced directives are becoming more common as people are becoming more informed about end-of-life issues.

What organs could be injured when a person has an injury to the abdomen?

An injury to the abdomen could produce injury to the liver, intestines, pancreas, kidneys, spleen, stomach, or gall bladder.

What are you committed to as a Emergency Responder?

As an Emergency Responder you are committed to assist an injured or ill person who is in need. Accepting the roles and responsibilities of an Emergency Responder means that you must apply your emergency care knowledge and skills to the best of your ability.

What is an extremity lift?

At times a person must be lifted from the ground to a chair, couch, or some type of stretcher. This should only be done once it is determined that a neck or back injury is not suspected.

Bleeding from which type of vessel is most difficult to control?

Bleeding from arteries is most difficult to control due to the pressure in the vessels.

Respiratory difficulty: common causes

Common causes: Asthma Heart attack Chemical exposure Lung disease Allergic reaction

What is the intent of the course?

Crash Injury Management: Emergency Medical Services for Traffic Law Enforcement Officers". This was a standardized course designed to provide training in emergency medical care for first responders to traffic accidents. It was considered to be advanced first aid training.

Emotional Responses to Stress

Denial Fear Guilt Grief Anxiety Panic attacks Anger Depression

What is the name of the device that is designed to be applied directly to a wound to assist with bleeding control?

Dressings are designed to be placed directly over a wound to control bleeding. They are held in place by bandages.

How many workplace illnesses and injuries happen annually?

Each year there are over 4 million workplace injuries and illnesses in the US. An injury or illness can occur at any time in any environment and as an Emergency Responder you become part of the system to aid those stricken by illness or injury.

Clothes drag

Emergent move- •The responder will kneel at the ill or injured person's head •Grasp the person's clothing at the shoulders •Slowly raise the person's body off of the floor •Drag the person across the ground ensuring that they are being dragged along the long axis of the body

Physical Responses to Stress

Fatigue Nausea/vomiting Difficulty sleeping Chest pain Rapid heart rate Difficulty concentrating Nightmares Difficulty making decisions

What is the Good Samaritan Law?

Good Samaritan Laws exist in all fifty states and are designed to encourage the passerby to stop and render care to an ill or injured person by limiting the exposure to civil liability.

What are protocols?

Guidelines for providing emergency care are sometimes referred to as protocols and are developed in cooperation with the Medical Director. In the absence of protocols you should provide care based on the training that you will receive in this program.

Breach of duty

If you have a legal duty to render care and fail to do so, or do so in a reckless or grossly negligent manner, you could be considered in breach of duty. Examples of breach of duty include failing to provide appropriate care to someone in need.

What to do if you are exposed to pathogens?

If you suffer a direct exposure to a person's body fluid or blood you should immediately wash the area with soap and warm water. Every employer that has employees with a possible risk of exposure must perform an assessment of this risk and develop a written exposure control plan intended to minimize the risk. Become familiar with your employer's written exposure control plan as it will help you through the steps following an exposure.

What do you do if an ill person who is drunk says no to help?

Ill or injured people who refuse may be impaired due to their illness or injury, or from drugs, alcohol, or mental illness. You must not dismiss them as leaving an ill or injured person before he receives proper care could be considered abandonment.

Mental competency

In addition to being over the age of 18, a person must be mentally competent to legally grant consent. It is important to understand that people who are under the influence of drugs or alcohol, or are so badly injured that they do not fully understand their condition, may not be competent to refuse care. When in doubt, begin care and activate your emergency action plan or call 9-1-1. The EMS professionals will take over when they arrive.

Moving a patient

In most situations it is best to leave an ill or injured person in the position they are found. In most cases people are found in a position that is most comfortable for them. This is not to say that they are not in pain but are simply in the position that the pain is least in. Do not be in a hurry to move someone that is ill or injured. You should take time to evaluate the situation and his condition prior to moving him.

Jaw-thrust maneuver

In situations where you suspect that a person has a neck or back injury, the jaw-thrust maneuver should be used to open their airway. Follow these steps to perform a jaw-thrust maneuver: •Position yourself at the top of the person's head •Place your thumbs on their cheek bones while grasping the corners of their jaw with the first 3 fingers of each hand •With gentle pressure, pull upward at the corners of their jaw causing it to move forward Bringing the jaw forward lifts the tongue off the back of the throat opening the airway. This maneuver takes practice so if you find that you are unable to open an airway using it you should resort to the head-tilt/chin-lift maneuver regardless of neck or back injury.

Respiratory difficulty signs and symptoms

Increased respiratory rate Increased work of breathing Panicked look Obvious movement of the chest and abdomen Use of neck muscles

What are the signs and symptoms of respiratory difficulty?

Increased respiratory rate Increased work of breathing Panicked look Obvious movement of the chest and abdomen Use of neck muscles

Why is it important to state "1-2-3 lift"?

It is important to make eye contact and state a "1-2-3 lift" count in order to ensure that each responder lifts at the same time limiting the possibility of injury

Clearing the airway: If vomit is present position the person

It is normal for an ill or injured person to experience nausea and vomiting. As a responder you should be aware of this and be prepared for the possibility of vomiting. If the person vomits you must immediately log roll the person to their side allowing for the vomit to drain from the airway, minimizing the possibility for it to enter the airway.

ligaments

Ligaments are tough fiber-like tissues that connect two or more bones, typically a joint.

In order for you to perform an adequate airway and breathing check of an ill or injured person who is unresponsive, what position must the person be in?

Lying flat on their back, they should be placed in that position by performing a log roll if found on their side or face down.

Is it ever appropriate to help another person if it puts you at an unreasonable risk?

No, it is never appropriate to put yourself at risk on the scene of an emergency.

What I sone of the biggest differences between a child and an adult in the respiratory system?

One of the biggest differences between the child and adult respiratory system is the size of the airway. The child's airway is much smaller therefore prone to obstruction.

Extremity lift procedure

One responder kneels behind person grasping the wrists Second responder kneels beside the person grasping below the knees 1-2-3 lift

What is the highest level of EMS training for the individual who can be found on ambulances, fire engines, and helicopters across the nation?

Paramedic

What are pathogens?

Pathogens are germs that cause disease. Pathogens can be spread from person to person, and some of the most dangerous pathogens are carried in the blood.

How to place someone in the recovery position:

Position left arm straight above the head Right arm over chest Grasp the right shoulder and knee Roll toward you

Assessing airway and breathing:

Position yourself Listen for 5-10 seconds Observe the chest Consider moving the person

rescue breathing rates

Rate: Once every 3-5 secondsfor child Once every 5-6 secondsfor adult

What to do when giving care to minors?

Remember that a minor cannot legally refuse care. If a minor is refusing care you must call 9-1-1 for assistance. EMS professional are well versed in consent and refusal procedures and will know what to do in these situations.

What needs to be done during the secondary assessment?

S - signs and symptoms - where does it hurt? How does it feel? A - allergies - do you have any known allergies? M - medications - do you take any prescription or non-prescription medications? Have you been taking them as prescribed? P - past medical history - do you have any existing medical history? Has this ever happened before? L - last oral intake - when was the last time you had anything to eat or drink? E - events leading to the call - what were you doing when the incident occurred? Did you do something that caused this to happen?

What urge do you need to avoid?

Safety must always be your first priority. Resist the urge to rush into any scene until it has been determined to be safe by observing the entire scene to identify any immediate or potential hazards.

Expressed consent

Saying yes, nodding

The Assessment

Scene size up, Primary Assessment, Secondary Assessment,

Assessment of the Ill Person:

Scene size-up Primary assessment Secondary assessment Reassessment

self-splinting

Self-splinting Apply cold: Decrease bleeding Decrease swelling Decrease pain Manual stabilization

Signs of symptoms of diabetes

Signs and symptoms: Altered mental status Pale, moist skin Irritable or unusual behavior Fruity or sweet breath Unresponsiveness

Partial airway obstruction:

Signs: Difficulty speaking Coughing Care: Encourage forceful coughing May have to provide thrusts

Complete airway obstruction:

Signs: Inability to breathe Inability to cough Inability to speak

SETUP: what to do before entering a scene

Stop - Stand still and observe the scene for any potential hazards. •Environment - Observe the surroundings and look for any environmental hazards. •Traffic - look for any oncoming traffic and take steps to alert drivers that a hazard exists. •Unknown hazards - keep an eye out for potential hazards or ones that are not immediately obvious. •Protect yourself and the ill or injured - use appropriate barriers to protect you from exposure to blood or others bodily fluids. These barriers also help to protect the person you are caring for.

Signs and symptoms of a stroke

Sudden change in mental status Headache Vision problems Slurred speech Facial droop Paralysis (one side)

How can you manage stress?

Talk about it Eat a balanced diet Exercise Schedule time to relax Sleep Avoid alcohol

tendons

Tendons are the structures at the end of each muscle that attach directly to the bone.

What is the AVPU scale?

The A-V-P-U scale can be used to describe a person's mental status. A - alert - this means that a person is awake and talking V - verbal - this means that a person responds only when spoken to P - pain - this is when a person will only respond when a painful stimulus is performed, the sternum rub can be used to perform this stimulus. A sternum rub is when you firmly rub the knuckles of one hand up and down their sternum. U - unresponsive - this is when the person does not respond at all

What do the initial care people do? What do first aid providers do?

The Emergency Responder provides initial medical care for the victim with limited equipment. First aid providers perform a Primary Assessment of the patient and provide life saving interventions until higher trained individuals arrive.

Emergency Medical Services (EMS)

a formalized system of highly trained individuals and specialized resources designed to respond to, care for, and transport victims of sudden injury or illness.

rescue breathing

The Emergency Responder will follow these steps when providing rescue breaths to someone. •Carefully position the person on their back •Open their airway using the appropriate method •Look, listen and feel for breathing for 5-10 seconds, if no breathing is detected you will need to provide rescue breaths •Using a barrier device provide rescue breaths at a rate of on breath every 5-6 seconds for adults and one breath every 3-5 seconds for a child. Each breath should be about one second in duration •Observe the chest for rise and fall with each breath •Continue providing rescue breaths until the person begins breathing adequately on their own or until EMS arrives • If the chest does not rise when a breath is delivered, reposition the head and try again. If there is still no rise and fall, perform chest compressions to remove the blockage. If the person vomits, roll them onto their side or turn their head to allow the vomit to drain from the mouth. After the vomit is cleared return them to their back and continue rescue breaths.

Standard Precautions are meant to protect you from exposure to potentially infectious blood and bodily fluids from which types of ill or injured people?

The answer is ALL ill or injured people; you must consider all people to be a potential source of infection.

Which vessels are under higher pressure?

The arteries are under higher pressure as compared to that of veins.

What % oxygen do we breathe?

The body needs a constant supply of oxygen to survive. The air that we breathe all the time contains 21% oxygen and this is more than enough to meet the demands of the body.

Who does the Good Samaritan law NOT apply to?

The law does not protect those who are providing care as part of their normal job, such as an EMT or Paramedic responding in an ambulance.

Who is the medical director?

The physician who oversees the care delivered by EMS providers is the Medical Director.

How to preform the log roll

The procedure for performing a log roll includes: •One responder at the person's head to hold or stabilize the head and neck during the roll •A second responder should kneel at the person's side opposite the direction of the roll - assess the arms for obvious injury - raise and extend the person's arm which is on the same side of the direction to be rolled - position the arm straight up over their head •The third responder should kneel at the person's hips •Responders should grasp the person's shoulders, hips, knees, and ankles (if only one responder is at the person's side they should grasp the shoulder and hip) •The Head Man will make eye contact to the others and direct the roll following a 1-2-3 count - the person will be rolled until they are in a complete face-up position If the ill or injured person's head is turned in one direction or the other the "Head Man" should not initially try to turn the person's head with the body during the roll. They should allow the head to come into alignment with the body half way through the roll.

What is the recovery position used for?

The recovery position is used for responsive and unresponsive people who have no breathing or circulation problems and no head or neck injuries are suspected.

Head-tilt/chin-lift maneuver to open the airway

The tongue is the most common cause of airway obstruction, when a person is lying flat on their back the tongue tends to lie against the back of the airway thus obstructing it. To open the airway you should perform a head-tilt/chin-lift maneuver by following these steps: •Position yourself at the top of the person's head •Place the palm of one hand on the person's forehead and two fingers of the other hand under the bony part of their chin •With equal pressure on both hands, gently lift the chin and tilt the head backward Since the tongue is attached to the lower jaw, tilting the head back will lift the tongue off the back of the throat and open the airway.

Emergent moves

There are some situation where it is necessary to move an ill or injured person and move him quickly. •There is some sort of external threat - always keep in mind that the scene must be safe for you and others to approach. You should never put yourself at risk. •If the person is experiencing problems related to airway, breathing, circulation, or severe bleeding it may be necessary to move them as any of these issues can be life threatening. If you cannot get to the patient to provide care to them you will have to move them quickly to begin care.

Secondary assessment physical examination

To perform the physical examination use the BP-DOC tool to help you remember what to look for. B - blood - inspect the body for any bleeding P - pain - ask the person if they have any pain and where it is. You will then palpate for other areas that are painful as you perform the physical exam. D - deformities - observe for deformities of any kind such as angulated limbs, bumps, or swelling O - open wounds - observe for any open wounds C - crepitus - crepitus is a peculiar crackling or grating feeling or sound under the skin or in the joints. Recognizing this is especially important when examining an unresponsive person as they cannot tell you when something hurts. If crepitus is felt you can assume that there is an underlying bone or joint injury

Implied consent

When a parent or guardian is not present to consent for the ill or injured minor you may provide care based on a legal concept called implied consent. It is implied that if the parent or legal guardian had knowledge of the situation they would consent to care. Implied consent also applies for adults who are unconscious and in need of care. If they could communicate he would give you consent to provide care to him.

Special considerations when calling 911

When using a cell phone you may be connected to a dispatcher that is in a different town or county than yourself so you must be prepared to provide your exact location. In many workplaces it is necessary to dial a 9 or another number to get an outside line before dialing 9-1-1. it is important to thoroughly understand your emergency plan including the requirements to activate EMS so that delay in notification does not occur.

Common Responses to Stress

Withdrawal Inability to rest Antisocial behavior Increased use of alcohol Decreased appetite

Negligence

You are expected to provide "prudent and reasonable" care

How to do a proper clean up

You must first clean the equipment with warm water and soap. After cleaning with soap and water you will disinfect it with an appropriate disinfecting agent such as isopropyl alcohol.

Which is the best way to avoid injury holding a heavy object close or far from your body while lifting?

You should keep weight as close to your body as possible while lifting.

When is it necessary for you to remain at the emergency scene or with the injured or ill person at least until someone of higher training can take over?

You should remain with the person until EMS arrives as they are higher trained than yourself. In many cases, a person who initially refuses care will consent after EMS arrives on scene and their situation is explained by the EMS personnel.

multi casualty incident

Your role at the scene of a MCI may not involve caring for the ill or injured. There may be more important duties which include: •Evaluate the scene - estimate the number of ill or injured •Identify safety hazards - be especially cautious and take time to identify all hazards •Activate 9-1-1 •Provide as mush info as possible to the dispatcher so they can send the appropriate amount of resources •Remain clear if necessary and do not allow others to enter an unsafe scene If you are familiar with the building and its contents you may be very helpful as a resource for EMS once they arrive.

Crepitus

a peculiar crackling or grating feeling or sounds under the skin or joints

Emergency Responder

an individual who arrives first on the scene of an incident and takes action to save lives.

What are the two signs of deformity in a musculoskeletal injury?

angulation and swelling

Which problem requires the most immediate response — a partial airway obstruction or a complete obstruction?

complete airway obstruction requires an immediate response. If the airway is completely obstructed and air cannot flow into and out of the airway death will occur.

Protocols

emergency care guidelines developed in cooperation with the Medical Director; provide EMS personnel and some Emergency Responders with recommended procedures for emergency care.

What is a mandated reporter?

is someone who is legally obligated to report any suspicion of abuse or neglect. While most often thought of being related to children, abuse and neglect are a common problem among the elderly as well.

Duty of Care

is the requirement that a person act toward others and the public with watchfulness, attention, caution, and prudence that a reasonable person in a similar circumstances would use. If a person's actions do not meet this standard their acts may be considered negligent and any damages may be claimed in a lawsuit for negligence.

What is ethics?

is the study of the principles that define behavior as right, good, and proper.

"Emergency responder" defined

is used to describe the first level of training and certification for EMS personnel. Since September 11, 2001, this definition has broadened. Homeland Security Presidential Directive defines Emergency Responders as those individuals who in the early stages of an incident are responsible for the protection and preservation of life, evidence, and the environment. Simply put, an Emergency Responder is any individual with formal training who arrives first on the scene of an incident and takes action to protect bystanders and save lives.

What is consent?

is when a responder obtains permission from the ill or injured person before providing care.

If there is a problem with the primary assessment, must you still do your best to complete a secondary assessment before EMS arrives? Why or why not?

no, you may not ever get to the secondary assessment if there are problems that require addressing related to airway, breathing, or circulation. It is important not to get distracted from addressing these life-threatening problems as failure to properly address them may result in the person dying.

Is it appropriate to encourage a person to take his medication whether it has expired or not?

no, you should not assist a person or encourage them to take expired medications.

Who can you share information with?

other care providers, EMS personnel, hospital personnel, and any others involved in their care.

body mechanics

refers to the proper use of the body to facilitate moving and lifting with the goal of maximizing effectiveness and minimizing personal injury

definition of symptom

something that you cannot see but the person tells you. Examples include pain, nausea or dizziness.

EMS Systems include

sophisticated communications systems, ambulances, helicopters, fire and police resources, and a variety of skilled individuals who make the system function.

What are the two main types of muscle injuries?

strains and tears

When is "self-splinting" an acceptable method of stabilizing or immobilizing an injured extremity?

t is appropriate when EMS has been activated and no other injury to the person exists.

Which part of the body is responsible for regulating many of the body's involuntary functions?

the central nervous system

Emergency Medical Technician EMT

the most common level of training in the prehospital setting, EMT's can be found in nearly all areas of EMS. EMT's are trained to provide basic life support skills which may include a short list of medications. EMT training can range from 3 weeks to one year.

Medical Direction

the oversight given to EMS providers by a physician.

What is medical direction?

the oversight given to EMS providers by a physician.

Medical Director

the physician in charge of an EMS system.

What is the ideal position for anyone with altered mental status who does not have a suspected neck or back injury?

the recovery position as this will allow for drainage of the airway and facilitate maintaining an open airway.

Paramedic

this is the highest level of training in the prehospital environment, they can be found in nearly all areas of EMS including ambulances, fire departments, law enforcement agencies, lifeguard teams, and helicopters. Paramedics receive training in advanced procedures and can administer medications for a wide variety of medical conditions. Paramedic training can range from six months to two years.

Advanced Emergency Medical Technician AEMT

this level of training requires fewer hours of training than the Paramedic. The AEMT is trained to provide a limited set of advanced skills and fewer medications than the Paramedic. AEMT training can range from six months to one year.

Emergency Medical Responder EMR

this level requires the least amount of training and typically involves fifty to one hundred hours of training. In most systems the EMR is trained to provide basic life support care including the use of automated external defibrillator

Burn care

xtinguish any burning clothing but if there is resistance to removal leave it in place as the clothing may have melted to the skin. If the skin is unbroken, you may cool the burns with clean water. If the skin is broken, cover it with clean or preferably sterile dressings. Do not attempt to cool open burns with water as this could increase the risk of infection. Monitor the person's ABC's carefully because they may have breathed in hot air that could have burned their airway. If there are any indications that an airway burn may be present call 9-1-1 immediately. You should never apply anything to an open or closed burn such as ointments, lotions, or butter. This will only serve to keep the heat in. never break blisters on burned skin. For chemical burns, brush the chemical from the skin prior to flushing with water. For liquid chemical burns, flush the affected area with copious amounts of water for 15-20 minutes.

Should a head-tilt/chin-lift ever be attempted on a person with a suspected neck or back injury?

yes, if the airway cannot be opened by performing a jaw thrust the responder should resort to the head-tilt/chin-lift to open the airway regardless of whether the person has a suspected neck or back injury. Remember that if the airway is not opened the person will die.

Is the assessment different or the same for an unresponsive person compared to a responsive patient?

yes, it is different because the unresponsive person cannot tell you what is wrong with them. The responsive person can tell you where they are hurting and you can adjust your examination accordingly.

In what part of the SAMPLE history might you learn that the person you are caring for had a heart attack six months ago?

you will discover this information in the P - past medical history portion of the assessment.

Assuming that the scene is safe, what is your top priority when caring for a person who is actively convulsing from a seizure?

your top priority is to clear the area around the person to minimize the possibility of them injuring themselves.

Heat-related emergencies: •Priorities of care

•Ensure adequacy of the ABC's and remove them from the hot environment. •For heat exhaustion you should apply cool towels or cold packs to the arm pits, neck, and abdomen. •For heat stroke more aggressive cooling is indicated including pouring water on the person and aggressively fanning them, apply cold packs to the arm pits, neck, and groin. •If the person is unresponsive they should be placed in the recovery position.

what are the three layers of the skin?

•Epidermis - the outermost layer of the skin •Dermis - lies just beneath the epidermis and contains the sweat and oil glands, hair follicles, nerve endings and some blood vessels •Subcutaneous - the deepest layer of the skin and is made up of fatty tissue which provides shock absorption and insulation for the body

Splint steps

•Expose the injury site •Assess circulation, sensation, and movement of the hand or foot •Immobilize the injury site by using a splint •Immobilize the joint above and below the injury site •Reassess circulation, sensation, and movement

How can pathogens enter the body?

•Ingestion - this occurs when we eat or swallow something that is contaminated with pathogens. •Inhalation - this occurs when we breathe in airborne particles that contain disease-causing pathogens. •Absorption - this occurs when pathogens are allowed to be absorbed through contact with the skin. •Injection - this can occur when someone is poked or stuck with a contaminated needle or sharp object.

•Poison is anything that is harmful to the body and can enter the body in 4 ways.

•Ingestion is swallowing a poison •Injection can be by a bite or a sting •Absorption takes place when a poison is absorbed through the skin •Inhalation is when a poison is breathed in

What are proper body mechanics when lifting?

•Lift with your legs - keep your back as straight as possible and bend at your knees. •Position your feet properly - they should be on a firm, level surface positioned a comfortable width apart (shoulder-width). Be careful on unstable or slippery surfaces. •Avoid leaning - avoid leaning to either side when lifting with one hand, bend your knees to grasp the object and keep your back straight. •Minimize twisting - attempts to turn or twist while you are lifting can result in serious injury. •Keep weight close to you - keep the weight you are lifting as close to your body as possible, the farther the weight is from you the greater chance of injury.

Care for seizures

•Once the seizure has stopped perform your assessment. In most cases the person will remain unresponsive for several minutes as they slowly recover. This state is called the postictal state and in normal. •Place the person in the recovery position to allow for drainage of the airway and provide reassurance. A seizure can become a life threatening emergency if the convulsions last more than 5 minutes or if the person has difficulty breathing when the convulsions have stopped. Call 9-1-1 in these cases.

Nose bleed care

•Place a clean dressing over the nostrils while pinching them closed, hold firm pressure over the dressing •Have the person sit and lean slightly forward as pressure is held to the nostrils •Be patient, it may take some time for the bleeding to stop

PPE (Personal Protective Equipment)

•Protective gloves - these may be latex or non-latex and should be worn at all times when caring for an ill or injured person. •Eye protection - this may be in the form of safety glasses/goggles or a face shield •. Their function is to protect the eyes from being splashed with fluids. •Masks - -these generally cover the nose and mouth and protect from splashed fluids as well as from inhaled pathogens.

Normal pulse rate

•Rate - a normal pulse is between 60-100 beats per minute. To assess for rate palpate the pulse and count the number of beats you feel in 15 seconds then multiply that number by 4 to get an accurate minute rate.

What is shock?

•Shock results when the organs and cells of the body do not receive an adequate supply of oxygenated blood.

Eye Injury Care

•Small foreign objects or debris on the surface of the eye can be flushed out with clean water or an eyewash solution. •Injuries to the eye that are caused by splashing of chemicals should be cared for by flushing the effected eye with large amounts of tap water. Direct the flow of the water from the inside edge of the eye downward to avoid the water from entering the unaffected eye. •Heat burns to the eye should be cared for by placing moist dressings over both eyes. If an object is protruding from the eye, use dressings and bandages to stabilize the object. Place several gauze pads around the object and secure them in place with a bandage. Whenever possible, cover both eyes as this will prevent the movement of the protruding object as both eyes move together.

Burn type

•Superficial - affect only the surface of the skin and cause a reddening of the skin with mild to moderate pain. The most common type is a sunburn •Partial thickness - affect the deeper layers of the skin and are classified by the presence of blisters •Full thickness - affect all layers of the skin and can reach the muscles and bones. These burn are characterized by open charred skin.

Biting and stings

•The care provided to a person who has been bitten or stung depends on their signs and symptoms. A local reaction may be the only effect, this will include swelling and redness at the site. If more serious signs and symptoms are present such as difficulty breathing or AMS you must call 9-1-1 immediately. Keep the person comfortable and monitor the airway closely. If he feels dizzy/lightheaded place him in the recovery position. If breathing becomes inadequate you must provide rescue breathing. •

For which ill or injured person is the extremity lift ideally suited?

•The extremity lift is ideal for a person without a neck or back injury that must be lifted from the ground to a chair, coach, or some sort of stretcher

Open wounds

•The first priority of dealing with open wounds is to control blood loss. The first step to control bleeding is to apply direct pressure to the wound. Pressure may be applied with a gloved hand but it is preferred that you use something clean and absorbent such as a sterile dressing. If, after a few minutes, you have not been able to control the bleeding a tourniquet should be considered. We will discuss the use of a tourniquet in a few minutes.

Care for someone with an altered mental status

•The primary concern for a person with altered mental status is an open and clear airway. As a person becomes less responsive the ability to manage the airway diminishes so you will need to closely monitor airway and breathing status at all times.

What does the musculoskeletal; system provide?

•The shape of the body •The ability of the body to move •Protection of vital organs •Production of blood cells in the bone marrow

What is battery?

•You are not legally permitted to force care on anyone. Attempting to restrain or force care on someone could be considered battery.

How to treat shock

•Your priorities of care for shock should focus on maintaining the ABC's. ensuring an open and clear airway, adequate breathing, and adequate circulation are key to survival. You must assess for and control any obvious bleeding.

•Avulsions

•caused by a tearing away of the skin and other tissues

•Penetrations

•caused by sharp, pointed objects or projectile such as a bullet.

EMS System

•formalized system of highly trained individuals and specialized resources designed to respond to, care for, and transport victims of sudden illness or injury.

how to treat cold-related emergencies

•ies of care •After the ABC's are addressed you should prevent further heat loss of the person. The first step is to remove them from the cold environment if possible. •Remove any wet clothing, dry the skin, and cover them with warm blankets. •Handle them carefully and avoid giving food or fluids •For frostbite you should remove any constricting jewelry and wrap frostbitten areas with sterile dressings while awaiting EMS. •If EMS is not available, immerse frostbitten areas in warm water (100-105 degrees) for 20-30 minutes. This will be painful to the person so you must communicate this to them. •If there is any chance of re-freezing you should not attempt to re-warm the affected area. Do not rub or massage areas and do not burst blisters if present.

Allergic Reaction

•if the person carries a life-saving epinephrine auto-injector prescribed to him by a physician help him use it. If he is unable to assist you should administer it to him. Be aware that the effects of the epinephrine may be limited to a short time so seek medical attention immediately.

Definition of mechanism of the injury

•is a term used to describe the general cause of a person's injury. Examples include a vehicle collision, fall from a height or a twisted ankle.

•Superficial

•minor wounds affecting the outermost layer of skin and include minor cuts and scrapes.

•Amputations

•occurs when a body part or limb is forcibly cut or torn from the body.

•Abrasions

•often caused by forceful rubbing against a rough surface such as pavement.

•Capillaries

•the smallest of vessels that transport blood. The most common type of injury that damages the capillaries is a scrape or abrasion to the skin. Damage to capillaries typically causes bleeding that is bright red in color and oozes from the wound.

•Arteries

•these are vessels that transport oxygen-rich blood under high pressure to the organs and cells of the body. Arteries typically run deep in the body and close to bones for protection. Due to the pressure in the arteries there is significant risk of serious blood loss when they are damaged. Arterial blood is usually bright red in color and may be seen as spurting from the wound with each heart beat.

•Veins

•transport blood that is depleted of oxygen under low pressure from the organs and cells of the body back to the heart. Veins typically run close to the surface of the skin and often can be seen beneath the skin. The blood from veins is darker red in color and flows steadily from the vessel when damaged. Bleeding from veins is easier to control due to the lower pressure inside the vessel.