WFA Certification

CPR

1. 30 compressions (100 per min; 2 in) 2. 2 Rescue breaths (blow for 1 second) Regular pads when older than 8 or more than 55 pounds.

Autoinjector

1. Locate outside middle thigh 2. Pull off safety cap 3. Hold 90 angle to thigh 4. Push tip in for 10 seconds 5. Massage area

Avulsion

A portion of skin is partially or completely torn away Care for it like an open wound

Open Abdominal Injuries

Apply moist, sterile dressings then cover with plastic or foil wrap

Serious Abdominal Pain

Fever (102); Specific pain; tenderness; regidity; pain when walking; blood in vomit (coffee), feces (black), urine (red); N/V; Shock Dont give anything by mouth

Strains

Overstretched muscles or tendons

Rib Injuries

Pain on inspiration, discoloration Sling and swathe, keep breathing even if painful, bulky jacket or pillow for comfort

SAMPLE History

Signs and Symptoms Allergies Medications Past medical history LOI Events

Sling and Swathe

Sling - Triangular bandage under the injured arm and over the uninjured shoulder keeping the wrist higher than elbow Swathe - Bind injured body part to chest with folded triangle bandage

Hyponatremia

Sodium levels in blood is too low - Headache, fatigue, cramps, nausea, sweating - Clear urine, recent - Normal temp - Normal or slightly elevated pulse/breathing Water intoxication: Severe, disorientation, DICHead Appears as heat exhaustion, but do not give water until they pee

Dislocation

Splint Reduction - Put joint back in normal position (stop if increase in pain) Shoulder - (Stimson technique) Lay down with weight pulling on the wrist for 30 min; Sling and swathe Finger - Keep it partially bent while pulling on it and pressing the joint back in. Do not tape on joint

Angulated Fracture

Straighten using in-lie traction to reduce pain: Pull along line of bone, move back in place; No force, stop if painful, once

High Altitude Cerebral Edema (HACE)

Swelling of brain Ataxia (loss of coordination); Headache, personality changes, seizure/Coma Descend (Rapid); Medicine (acetazolamide, dexmethasone)

Area of Burn

TBSA - Total Body Surface Area Rule of Palmar Surface: The palm is 1%

Stingray

Tap or ocean water

Seizure

Unusual sensation (aura), irregular breathing, drooling, upward rolling of eyes, rigid body Do not immerse in cold water

Scorpion of Black Widow

Wash, wound gel, bandage, cold pack

Choking

1. 5 back blows 2. 5 abdominal thrusts

Checking an Injured Adult

1. Are you okay? 2. 911 3. Head tilt, chin life 4. Check breathing for 10 seconds 5. Scan for bleeding If child, give 2 minutes of care before calling 911. Give breaths first unless you saw them collapse.

Care for Burn

1. Stop source 2. Manage ABCDEs - Treat for shock and hypothermia 3. Cool or flood for 20 min (leave blisters intact) 4. Dress with wound gel (and redress twice a day) 5. Cover with gauze (Do not pack with ice) 6. Elevate and move around

AED

1. Turn on 2. Wipe chest 3. Attach pads 4. Plug in connector 5. Stand clear 6. Analyze 7. Shock 8. CPR (2 min/5 cycles)

Acute Mountain Sickness (AMS)

6500 to 8000 feet (if lower, probably dehydration or heat illness). Can progress to HACE or HAPE Headache, LOA, N/V, Insomnia, Lassitude (exhaustion) Descend; Asperin

National Poison Control Center (PCC)

800-222-1222

Assisting Drowning Victims

Reach, Throw, Row, Go Stride position - Leg opposite of your throwing arm is forward; throw upstrem

Partial Thickness Burn

Red, Painful, swollen, blisters about an hour after cooling

Superficial burn

Red, painful, swollen skin

Wound Cleaning

Remove large materials before washing Use 1 quart of DI water (boiled, filtered) to make a high pressure stream Hold syringe about 2 in above and perpendicular Do not use H2O2, Alochol, or iodine Wash skin around laceration before irrigating

RICE Method

Rest, Immobilize, Cold, Elevate 20 min; let warm for 10 to 15 min and repeat

Bleeding

Serious: Spurts from arteries or smooth, rapid bleeding from veins Cover wound with sterile dressing and apply direct pressure (If needed, use anything to press into wound including fingers) Cover head bleeding with bulky dressing and press lightly

Abrasions

Shallow, dirty when skin has been scraped away Within 10 min, apply thick layer of wound gel and cover with a sterile dressing, then bandage After 10 min, scrub wound and irrigate. Then apply thin layer of wound gel

Mild to Moderate Hypothermia

Shivering, umbles (fum, grum, mum, stum) Worsens, uncontrollable shivering, confusion, impaired judgement Give carbs, any fluid, place hot water bottle near heart or armpits or groin

Mild Brain Injury

Short term (<3 min) LOC, amnesia, blurry vision, Nausea, Headache, Dizziness, Lethargy, neck pain Monitor and check every 2 hours

Caring for a Near Drowning Person

Check ABCDEs 2 rescue breaths if not breathing; Do not attempt to clear lungs

Chest Injuries

Check for DOTS, deviated windpipe (trachea), abnormal breathing, bleeding (bubbling), gurgling, guarding

Lightning Injuries

Check: Burns, Trauma, Dazed, Breathing, Pulse Care: CPR Evacuate fast

Friction Blisters

Clean around site; Sterile needle to open blister; leave roof of skin intact; wash with soap and water; apply dressing that limits friction Build a donut by cutting a hole in the center of moleskin and fill with wound gel

Sucking chest wound

Cover hole with occlusive dressing with 3 sides taped Remove dressing if trouble breathing to avoid tension pneumothorax. If this does not remedy, use finger to release trapped air.

Laceration

Cuts through the skin with rugged edges 1. Close with strips or tape - Clip hair, but do not shave 2. Apply wound gel or transparent (microthin) film dressing but not both 3. Cover with sterile dressing and bandage Microthin film dressings can be left in place until healing is complete Do not close wounds more than 1/2 inches, exposed bone, dirty, or animal bites

Giardia

Diarrhea > 10 days Smelly smelling poop

Focused Spine Assessment

Discontinue immobilization if - Reliable - Positive CSM - Grip and lift legs - Deny pain

Drowning Victims

Distressed: Breathe, call for help, reach for stuff Active: Struggles, no supporting kick, vertical, no progress, unable to reach for stuff Passive: Basically dead

Impaled Objects

Do not remove unless you need to do CPR Secure with bulky dressing; apply gentle pressure and immobilize by bandaging around it

Frostbite

Do not rub Put in 105 F water Loosely bandage with dry sterile dressing Put cotton between fingers and toes

Ear Problems

Do not use force to remove an object, but use water (or oil for insects) 50% water:Alcohol

Check

Establish control and recognize; check safety; obtain consent; check for clues; move if needed

Chafing

Excess friction in groin area Apply lubricating oil or ointment (petroleum jelly or cooking oil) or baby powder or cornstarch

Remove Helmet

Face mask blocks access to airway; Chin strap does not allow for an open airway; does not hold head securely; prevents immobilization

Spinal Injuries

Falls on butt or head or taller than the person, chin forced to chest, rotation, jerking, deceleration, helmet breaks, lightning Pain or tenderness, altered sensations in extremities, respiratory difficulty, loss of bowel control, shock Jaw thrust!

High Altitude Pulmonary Edema (HAPE)

Fluid collects in air space of lungs Dry cough, SOB; chest pain; frothy sputum (reddish) Descend (1000 to 1500); Rapid

Group First Aid Kit

Gauze, Bandage, tape, alcohol pads, povidine-iodine pads, moleskin, triangle bandage, safety pin

Evacuation with brain injury

Go fast Carry Maintain open airway H.A.IN.E.S Position - High arm in endangered spine Elevate head

Heat Exhaustion

Heat stress, water and electrolyte loss, and inadequate hydration - Pale, flushed skin - N/V - Decreased urine (yellow) - Elevated heart rate and respiratory - Dizziness when standing - Same as Heat Cramps, but also wet down and allow them to sleep - Recovery can take 24 hours

Heat attack

Heavy pressure center chest pain; radiating pain on jaw or left shoulder; nausea; SOB; fatigue Do not walk; 2-4 chewable low does aspirins (81 mg) (or one 325 mg); Nitroglycerin if strong pulse under tongue

Non-Life-Threatening Allergic Reactions

Hive, rash, itching Administer antihistamines

Anaphylaxis

Inject with epinepherine into the thigh (EpiPen and Auvi-Q). Give second dose. Do not use if cloudy Swollen lips; Shock (pale, cool, sweaty); difficulty breathing; N/V

Sprains

Injuries to ligaments

Open fracture

Irrigate and dress; in-line traction; splint

Nosebleeds

Lean forward and pinch bridge of nose for 10 min After 20 min, pack with gauze soaked with nasal spray Don't blow nose for 10 days

Heat Cramps

Lest severe - muscle spasms in legs and abdomen - Give electrolyte drink or water but no salt tablets - Lightly stretch muscle

Diabetic Emergency

Light-headed, irregular pulse, dry red skin, pale moist skin Give sugar; Insulin

Confined Space

Limited access and not intended for continuous occupancy SCBA - Self Contained Breathing Apparatus Don't use AED and O2

Stomachache

Lower abdominal discomfort; Cramping; N/V; Diarrhea Hydrate and bland diet

Teeth Problems

Make temporary filling by mixing zinc powder oxide and eugenol or wax or gum Store tooth in mouth, milk, or 0.9% saline solution

Rigid Splint

Tie rigid splint with triangle bandages

Burns - Evacuate Fast

Trouble breathing; partial 10% or more; circumferential or covering body part; head, face, neck, hands, feet, genitals; full thickness more than 5%; chemicals or electricity or explosion; elderly or young

Jellyfish

Vinegar for 30 seconds, or baking soda slurry; then hot water immersion

Stings

Wasps do not lose their stinger so grasp stinger and not venom sac

Diarrhea

Watery stools; gastroenteritis (stomach flu) Mild - Water or sports drink; bland diet Persistent - Carbohydrate electrolyte solution; 1 teaspoon of salt and 8 of sugar for a quart of water (1/4 every hour)

Immersion Foot

When feet have been exposed for > 12 hours or even 3. Peeling skin, swollen, waxy Soak in warm (102-105 F) for 5 min; Elevate

Soft Splint

Wrap a soft objects around injured area. Tie with triangle bandages

Personal First Aid Kit

Bandages, gauze, tape, moleskin, soap/sanitizer, wound gel, scissors, gloves, CPR breathing mask, tweezers

Stroke

Blood flow is cut off to part of the brain Face, Arm, Speech, Time

Heat Stroke

Body produces heat faster than it can be shed - Temp of 105 (104 oral) - Disoriented, bizzare personality - Elevated heart rate and respiratory - Seizure - Rapidly cool

Suspect possible airway complications with

Burns to the face and neck, soot in mouth or nose, singed facial hair, a dry cough

Altitude Illness

At high altitudes, we do not have enough O2 in blood because of low air pressure

Pneumothorax

Air escaping lung and collecting in chest Trouble breathing and anxiety

Primary (Initial) Assessment - ABCDEs

Airway - HTCL if unconscious Breathing - Quality (no more than 10 seconds) Circulation - Bleeding Disability - Spinal injury Environment/Expose - Signs and symptoms

Fracture

Muscles appear to be spasming; injured are feels unstable; one spot hurts a lot. Compare to other side Splint using padding Wrap jaw around head Collarbone/Upper arm - Swing and swathe Always use padding Pelvis/Hip - Rigid litter (stretcher) Watch for shock

Snakebite

Necrosis at site. Apply elastic (pressure immobilization) bandage to slow spread of venom from lymph nodes (should be able to slip a finger under) Keep below heart Do not apply ice or suction Do not walk

Severe Hypothermia

No shivering, muscle rigidity, stupor or coma, decrease pulse/breathing, stops complaining, <90F Handle gently, CPR is no breathing (3 min) before moving; Hypothermia wrap; do not give food

Tourniquets

Only if blood loss is uncontrolled by direct pressure - Multiple patients/injuries; needs to be moved quickly 1. Tie band of soft material (1-2 in wide) 2 in above wound 2. Tie a short stick into material and twist it until bleeding stops 3. Note the time

Splint

Only if it does not cause more pain; Position of function (arms across heart)

Shock

Organs do not get enough blood Early: Rapid, weak heart rate; rapid, shallow respiratory rate; pale, cool, clammy (if allergy: pink and warm); N/V; Thirsty Later: LOC decreased, unconsciousness Lie down; open airway; do not give fluids if vomiting or head injury (sips if delayed more than 2 hours)

Full thickness

Painless, pale(scalding), charred

Secondary (Focused) Assessment

Physical Exam - Look for DOTS (Deformity, Open injury, tenderness, swelling); CSM; Skin Consciousness - AVPU; A+O Vital Signs - Breathing: 12-20 (regular and unlabored); Heart rate - 60 to 100 (strong and regular); Skin - pink, warm, and dry

Anatomic Splint

Place several triangular bandages above and below injured area. Tie legs together

Care for Spine Injury

Place thickest part of collar between chin and chest Move everything slowly and stop if there is pain FOAM - Free of any movement Strap on head last Observe for 24 hours

Lightning Safety

Plan turnaround time 5 seconds = 1 mile 30-30 rule: Seek location when storm is 6 miles away and stay for 30 minutes after Downhill Uniform cover Avoid: Flood zones Squat on insulating material Do not lie down Cover ears and eyes if tingling; Keep people 100 feet away

Serious Brain Injury

Prolonged unconsciousness; skull fracture (drepression, raccoon eyes, battles sign), inability to move, eyes unresponsive, pupils, mental status, LOC, N/V HR slows down (<40), then speeds up Erratic respiratory rate