First aid (NPLQ gen 10)

How long can you apply an icepack to a bruise for up to?

20 minutes

What temperature does the body go below in hypothermia?

35*C

What is a normal heart rate for adults?

60-100 bpm

What is a seizure?

A fit that occurs when normal brain activity is suddenly disrupted, due to illness or injury. Epilepsy - tendency to have recurrent seizures.

Penetrating chest injury

Air may be sucked into chest cavity causing lung to collapse. S=painful breathing thats rapid/uneven/shallow, acute pain, may hear air over wound, blue/grey skin, frothy coughed up blood, bubbling blood. T=call 999, sit them comfortably leaning towards injured side, do not try to cover wound, use direct pressure to control bleeeding. Can use recovery position (inj side down) and CPR if neede

How does anaphylaxis affect the ABC's?

Airway - swelling, stridor Breathing - wheeze, fatigue, confusion, difficulty Circulation - blood vessels dilate -> weak, floppy, faint, clammy, drowsy

What is an absence seizure and how do you treat?

Appear as if casualty is day dreaming and is common in children, lasts for just a few second and they are often unaware it happened. Signs: Jerk, twitch, pluck at clothes, swallowing repeatedly, lip smacking, look dazed Treatment: Support them with head above water, guide away from pool or danger, help them to sit or lie in quiet place, reassure, stay with them until fully alert

Consent

Ask casualty's permission before administering first aid. If no, call 999 if emergency help needed. If unconscious, consent not needed.

What are the treatments of anaphalaxis?

Ask if autoinjector with them. Administer own medication/ parents administer to child. Call 999 when using even if device helps. Sit up if hard to breath but if feels faint, lay down and raise legs. If no improvements in 5 mins then second dose administered. Monitor breathing

What are they key things to remember for secondary surveys?

Ask permission, must be after primary survey, ask if any pain and where?, protect privacy of casualty, wear gloves, don't move the casualty more than necessary, check about any medical conditions/medication. Talk through it with them to check still breathing if conscious. If the airway is ever a worry for unconscious casualty, return them to recovery position. If removing clothing, should be same sex as casualty.

What is a secondary survey?

Assess head to toe for any injuries - look for bleeding, bruising, protruding bones, fractures, casualty reaction and pain

Which side of the wrist do you measure pulse?

Base of thumb - radial pulse. Use pads of fingers, not your thumb.

What should you always check after seizures?

Be suspicious of cardiac arrest and assess them for normal breathing once seizures have ended.

Fainting treatment

Before fainting - reassure, advise them to breath deep but slow, lay them down and raise legs, loosen tight clothes, ask bystanders to leave area. Full faint - lay them down, raise legs (pale raise the tail), check airways and breathing is normal, call999 if not coming around quickly. After, give them sips of water

Stroke

Blood clot/ruptured blood vessel in brain FAST - can they smile/face drooped/keep arms up/understand you? Need just one of these! CALL 999 Slightly raise head and shoulders - pillow/float (red raise the head). Reassure, monitor constantly

Why shouldn't we warm up a casualty too quickly from hypothermia?

Blood drawn to surface of the boyd, causing blood pressure to fall, leading to shock

What happens during shock when there is a lack of circulating blood?

Blood is directed from skin -> more important areas, breathing increases to get more oxygen to the blood, heart rate increases to circulate this quicker.

What are the symptoms and signs of an asthma attack?

Breathing difficulties, wheezing, anxiety, difficulty speaking, pale and clammy, grey/blue lips

What are the treatments of shock?

Call 999, assist them to lie down, PALE RAISE THE TAIL, loosen tight clothing, treat burn/bleed if possible, DON'T GIVE THEM FOOD OR DRINK, keep them warm, reassure

Treatment of hypothermia

Call 999, handle them gently so heart does not stop, move to warm place (but not too sudden heat as could cause shock), remove wet clothing, assist them into comfortable seated position, wrap blankets around them (plastic bag up to neck and cover head if in remote place), sip warm drink and eat high E food e.g. chocolate. Maintain observation of breathing and consciousness, recovery position.

Treatment of head injury

Call 999, lay down and keep head inline in case spinal, treat other injuries, if unconscious recovery position and monitor breathing

How to treat a heart attack?

Call 999. Half sitting position (hold shoulders/ against wall, torpedo buoy under knees), loosen tight clothing, ask if medications to take, reassure, remove cause of stress, monitor casualty, subtly have AED ready and ready to do CPR. Are they allergic to aspirin? Could take aspirin 300mg

Sting

Can brush away with card/fingernail but don't tweezer, use a cold compress for up to 20 minutes, call 999 if in mouth and suck ice

Sunburn treatment

Casualty itchy tender skin, dizzy, shock symptoms, blisters, burns Move casualty to shade, give sips cold water, use cool water, call 999 if severe

What are the symptoms and signs of hyperventilation?

Caused by excessive breathing due to panic attack or before submerging, or with constant sinkers, reducing CO2 so no need to breath, then physical activity takes O2. Dizziness, feeling faint, cramps in hand and feet/pins and needles, tight chest, panic, rapid pulse Unnaturally fast deep breathing, flushed skin

What causes poisoning? And how do they enter the body?

Caused by gas/chemical release, drug abuse or alcohol abuse. Poison enters body via ingestion, inhalation nose or mouth, absorption in eyes or skin, injection into skin

Where do you check for injuries in secondary surveys?

Check for bleeding, bruising, swelling, deformity fracture, protruding bones, casualty reaction/pain 1)Breathing - shallow/regular/odour 2)Head - fluid (ears/nose), pupil dilation, skin colour, clamminess 3)Mouth - obstruction, vomit, teeth loose 4)Neck - medic alert, pulse (rate -100,strength,rhythm) 5)Chest rises and falls 6)Arms - needle marks, bracelet, movement wx pain 7)Abdomen - light pressure - tender? 8)Pelvis - incontinence -(don't rock/squeeze!) 9)Legs/feet - movement wx pain

How do you administer an adrenaline auto-injector?

Check the medication dose is correct, correct date on medication, is it damaged? Inject to mid upper outer thigh. Don't need to remove clothing but check nothing in pocket. Epipen - 3 seconds, Jext 10 seconds, Emerade 5.

What do you do after an accident?

Clean up, fill up, write up.

What are the signs of a seizure?

Collapse suddenly, breath out and stiffen, sink in pool without warning Muscles stiffen and back may arch Lips may go blue Limbs of body clench or jerk Eyes may role back Teeth may clench, may drool Noisy breathing like snoring Incontinence

Concussion v compression

Concussion is where a casualty may have an altered level of consciousness, be disorientated, confused, forgetful, go unconscious after blow to head Compression is a potentially fatal condition where there's pressure to brain from traumatic head injury (skull fracture) or bleed in brain. Need emergency help for both

Hypoglycemia treatments

Conscious - sit them down, give sugary drink or glucose tablet/chocolate/sugar sweets. (aim for 15-20g glucose eg 150ml glass non-diet fizzy/fruit juice or 3 teaspoons sugar) If responds - give them more, let them rest, advise need for further help If not responding, call 999 Unconscious - call 999, recovery position, monitor airway (don't give something by mouth if unconcious)

How do you treat an unconscious casualty?

DO YOU CALL 999????? Primary survey - DR ABC. If not breathing, give CPR. Treat major bleeding, remove/treat obvious causes of unconsciousness. Secondary survey if there had been an accident. Loosen clothing at neck, chest, waist. Protect from cold and wet. Recovery position if breathing normally. Monitor this. Keep paramedics updated. If then conscious, DONT give them food or drink.

Heat exhaustion signs and symptoms

Develops gradually due to loss of salt and water from body due to sweating/dehydration Symptoms: nausea, loss of appetite, headaches, confusion, dizzy; rapid, weakening pulse and breathing; muscle cramp Signs: sweating, pale clammy skin

Symptoms and signs of poisoning

Difficulty breathing, dizzy, nauseous, abdominal pain, confusion, head ache, evidence of substance, unusual smell in area/on breath, vomiting, burns and swelling, pale skin

What are the symptoms of shock?

Dizziness, confusion, disorientated, nauseous, thirst

What are the symptoms of a heart attack?

Dizziness, nausea, anxiety, crushing in chest, tingling in left arm (could be R of girls), feels like indigestion, feeling of impeding doom, weak pulse.

Signs and symptoms of head injury

Dizzyness, nausea, vomiting, ST memory loss, headache, possible seizures, pale/clammy/flushed, bloodshot eyes, dilated pupils, unusual breathing, bleeding/fluid from ear/nose, depression in skull

Embedded object in wound plus bleeding

Don't remove unless it's a splinter. Build up dressing around and pressure slightly away from wound

NOP content on first aid?

Employer required to make adequate first aid provision for employees, provide first aid training for approp no. of colleagues, inform employees of location of equipment/facilities/personnel, have links with emergency services, location of accident forms. Our role: follow training, inform officer of what kit was used so can be replaced, use PPE, record accidents accurately.

Dislocation symptoms and treatment

Feeling of nausea, shock, deformed inj area, may swell, reluctant to move affected joint. Tr - allow casualty to get in comfy position, support inj limb with padding/bandages, don't try to relocate joint, call 999. Do not allow casualty to eat or drink

How to treat burns?

Flood with cool running water for at least 20 mins, DON'T REMOVE STUCK CLOTHING, remove rings/watches before area swells, apply but not wrap with non adhesive sterile dressing. Can loosely put on clingfilm. Don't add creams! Call 999 if child/elderly, severe, inhaled smokes from chemical leak, area greater than palm (partial thickness, 1% of body surface area) or whole way round limb, covers feet/hands/face/neck/genitals, electrical burn

What are triggers of anaphalaxis?

Foods, medicines, insect stings, latex

External bleeding

Gloves, sit them down, call 999 if major, apply pressure with sterile dressing (if not then fingers or hands), 'can I put a bandage on you', 'will you apply pressure' (whilst u get bandage) 'can you take your hand off whilst I examine the bleed?' If cut on hand, pt grips small bandage and wrap another over clenched fist but leave out finger and thumb (pinch and if stays white then loosen), or have bandage lengthways and they hold with thumb Remove and reapply, don't layer dressings.

How do you recognise hyperglycemia?

Gradual and diabetic would usually recognise and manage it e.g. excessive thirst, increased need to urinate and drowsiness. Also may have fruity smell on breath. Call 999.

Need training for these, but what can yoy use for severe bleeding?

Haemostatic dressing, or tourniquet

Diabetic emergency types

Hypo - too little sugar Hyper - too much sugar

When to call 999 with a seizure?

If lasts longer than 5 mins, casualty has had a second seizure, injured themselves (esp head), first ever seizure, if they don't wake up after 10 mins recovery, if seizure is different or lasts longer than usual for them, if unsure, if in water (may have swallowed water)

When do you call 999 for asthma attacks?

If they go unconscious, attack is severe, attack lasts longer than normal, medication doesn't help (3 goes), distressed/exhausted

Fracture treatment

Keep them as still as possible Immobilise with a sling - support (down under, inj arm/wrist/ribs) or elevation (up and over, for inj arm/hand/shoulder and to minimise swelling). If fracture of lower body, use pads or blankets to support. Cover exposed wounds with sterile dressing

Nosebleed - causes, treatment

May be caused by bang on nose/violent sneezing/HBP/anti clotting meds. If blood thin and watery after head injury - serious! Sit with head tilted forward, ask them to breath through mouth, pinch fleshy bit under bridge. Ask them to try not to speak, swallow, sniff, cough. Apply pressure 10 mins at a time (must not check), if severe or more than 30, call 999

Heat exhaustion treatment

Move them to cool place, encourage them to sit water, tea, milk, or to rehydrate with isotonic sports drink. Assist them to lie down and raise legs. Cool skin but not get too cold e.g. use wet towel. If unconscious, place in recovery position and monitor breathing

How to treat hyperventilation?

Move to quiet area, reassure but be calm and firm, take slow breaths through nose (in nose, out mouth), small sips of water to distract/read something to you/breath with them slowly, call 999 if attack is prolonged

What is asthma?

Muscles of air passages go into spasm and narrow airway and mucus accumulates -> SOB and wheezing. Don't be responsible for inhalers.

Types of fractures

Open - bone broke through the skin, stick out, may bleed. Closed (simple) - bruise, swelling, deformity. Complicated - inj to maj vessel/organ/joint. Greenstick - bend in bone, children. Hard to move, painful, cracking at time of injury, bleeding/swelling.

Dental injuries - signs and treatment

Pain, difficulty speaking, bleeding, swelling, damage to tooth. Treatment: retrieve broken parts and store in cows milk, rinse mouth warm water, seek dentist. Tooth knocked out - pick tooth up by crown, rinse for max 10 seconds cold water, then place in socket. If not possible, rinse then wrap in cling film, or if no water available then store in cows milk, dentist. Bleeding socket - bite on sterile pad and maintain pressure. Check no other head injury

What are the signs of a heart attack?

Pale grey skin, coughing, blue tinge to lips, sweaty skin, find breathing difficult, clutching chest, sudden collapse

What are the signs of shock?

Pale, cold clammy skin, blueness of lips and extremities, weak rapid pulse, rapid/shallow breathing, unconscious POC - grey or yellowness to skin, grey/whiteish skin around mouth instead of blue lips

What are the priorities of first aid?

Preserve life Alleviate suffering Prevent situation from getting worse Promote recovery

What regulation requires these accidents to be reported to the healthy and safety executive? Death, major injuries, dangerous occurrences, incidences resulting in being off work 7+ days, diseases, taken direct to hospital.

RIDDOR (2013) - reporting of illness, disease and dangerous occurrences

Hypoglycaemia signs and symptoms

Rapid pulse, feel faint, limbs tremble, confusion, aggression, pale, sweating, shallow breathing, unconscious, seem drunk

How to treat an asthma attack?

Reassure, sit them comfortably e.g. on chair leaning forward or reverse on chair. Encourage use of inhaler, and spacer if have one. Use again if attack not eased. Remove from cause - dusty room/fumes. Don't take them outside.

Fainting - causes signs and symptoms?

Reduction in blood supply to brain due to injury, illness, fatigue, long periods in hot atmosphere/standing still Casualty may have nausea, blurred vision, stomach ache, yawn, sway, sweat visible. cold, clammy, shallow breathing, weak pulse

Treatment for poisoining

Remove cause, rinse mouth and sips of water, don't induce vomiting, treat injuries, 999, use face mask if CPR, tell emergency services any info about poison Swallowed corrosive substances - rinse mouth and give sips of water or milk.

Treatment of seizures out of water and once seizure is over

Remove objects that could cause injury, protect head, loosen clothing around neck, time seizure for time and duration After seizure let them rest until fully recovered even if alert, may fall asleep, make sure breathing and put in recovery position

Treatment for sprains and strains

Rest, ice (no longer than 20 mins), comfortable position, elevation RICE

Flail chest

Ribs fractured in several places and this section moves opposite to rest of chest when breathing. Breathing painful, shallow, fracture symptoms. Call 999, sit them leaning towards injured side, keep weight of arm off injury e.g. elevation sling. May need recovery position (again injured side down) and cpr.

Burns and scalds signs and symptoms

Serious burns may cause little pain as nerves damaged. Pain, shock, breathing difficulties if airways affected. Blistering, swelling, redness, clear fluid, signs of shock

Contents of first aid box?

Shears, bandages, sterile dressing, contents list, plasters, sterile (alcohol-free) wipes, foil blanket, safety pins, ice pack

What are the causes of shock?

Shock is a failure of the circulation, leading to an inadequate supply of blood to vital organs. Low blood volume, loss of bodily fluids (severe vomiting, diarrhoea, BURNS, blood loss, severe dehydration) , low cardiac output

Internal bleeding signs symptoms and treatment?

Skin pale/cold/clammy, confusion, restlessness, bruising (esp at point of impact/swelling), shock without loss of blood, thirst, weak but rapid pulse Lie casualty down, call 999, treat for shock

Treatments for minor bleeding injuries

Small cuts/grazes - wash with clean water, dry with sterile dressing, apply plaster or sterile dressing.

How to treat splinters

Small objects that pierce skin. Remove with tweezers if small, but if difficult/deep/large, leave where it is. Can cause infection. Wear protective gloves, clean area, use tweezers, pull out in same direction, gently squeeze site to clean wound, cover with dressing.

Cramp causes

Sudden, involuntary and painful contraction of a muscle. Caused by cold conditions, sudden exercise, injury to muscle, excessive loss of salt from severe sweating and dehydration

Severity of burns

Superficial - outer layer burnt, red, tender, swelling Partial thickness - outer layer and epidermis burnt - red and raw skin, blisters Full thickness - all layers skin burnt including nerves/fat/muscle/BV. Charred, waxy, pain may be absent if nerve endings involved

Treatments of seizures in water

Support their head and keep face clear of the water Make sure head doesn't hit you or the poolside If possible, support them in shallow water away from side until seizure over Once out they may fall into deep sleep Monitor breathing and reassure casualty, be prepared for CPR Call 999 as water may have been inhaled Do not restrain and only move if danger of injury or falling into water

Cramp signs, symptoms, treatment

Swimmer can't relax muscle, pain in a muscle, muscle feels hard and tight. Support casualty, stretch muscle carefully and gently straighten, get them to massage area, rest

What are the symptoms of anaphalaxis?

Swollen tongue, hoarse voice, difficulty swallowing, noisy breathing, persistent cough, drowsy/weak (as blood vessels dilate) abdominal pain, anaphylactic shock. Also more serious reactions with only swelling of hands/feet/face/skin, or red itchy rash, or widespread flushing of skin, or anxiety/panic

Symptoms v signs

Symptoms are what a patient tells you about how they feel, signs are something you see/hear/feel/smell

Treatment of eye injury

Take care if they are wearing contacts, advice not to rub, separate eyelids with finger and thumb, examine the eye, wash out with sterile solution/tap water, tilt head to bad eye side, if didnt work, apply pad to affected eye and close good eye to keep eye still. If chem injury, call 999, wash with continuous flow for 20+ minutes and tilt head.

Dressings

To control bleeding, prevent infection and absorb discharge. Large enough to cover skin beyond wound. Apply straight to wound, check circulation so not too tight, apply pressure around foreign bodies and not on top.

Where do you measure pulse of an infant?

Two fingers on inside of their upper arm.

Electric shock signs and treatment

Unconscious, spasm of respiratory muscles so breathing stops, cardiac arrest, burns at entry and exit points. Pain, see casualty jolt, signs of shock Turn off mains, not the plug! Don't touch with something metal or wet. Once isolated, call 999, treat burns after primary survey/for shock

What are varicose vein bleeds?

VVB - if a valve in leg fails then blood collects behind it and easily damaged by knock against something. Blood may squirt, alarming. Direct even pressure 10min/until bleeding stops. 999, lay them down. Can layer dressings for these bleeds. Recheck limb every 10 minutes.

Hygiene procedures

Wear protective gloves, wash hands before and after, your own wounds covered. Don't touch/cough in wound.

What is hypothermia? Signs?

When casualties core body temp is below 35*C, due to exhaustion, intoxication, immobilisation, immersion in cold water, cold weather condition Symptoms: cold, slow pulse, tired Signs: shivering, changes in behaviour, slurred speech, confusion, stiffening of muscle, pale cold skin, infants may become quiet.

What to remember about sharps bin?

Yellow bin, move bin to sharp not sharp to bin Auto injectors go in sharps bin

What types of causes of burns are there?

dry heat (hot surface, fire, friction), wet heat (steam), chemical, electrical, sunburn

What should a first aid box NOT contain?

medicines, sprays, creams, sharp scizzors, cotton wool, inhalers

Sprain v strain

sprain=Injury to ligaments, swelling, bruising, discolouration Strain=injury to muscles if over-stretched, localised bit intense pain, swelling if limb, severe cramp

How to treat small cuts/grazes?

wash, dry (sterile dressing), apply

How do you protect amputated part?

wrap it in a plastic bag/cling film, then soft cloth/bandage, and then ice/cold pack