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First Aid Study Guide

 

March, 2003

 

 

Ø       The four basic steps of the EMS system are

 

1.                   Recognize that an emergency exists

2.                   Decide to act

3.                   Call the local emergency telephone number for help

4.                   Provide care until help arrives

 

Ø       The Good Samaritan law provides legal protection to people who provide emergency care to ill or injured persons. 

 

Ø       The greatest risk of infection occurs when you touch blood or other body fluids directly.  Use protective gloves, wash hands with warm water and soap.

 

Ø       Animals pass diseases through bites.  For example, infected dogs, cats cattle, and some wild animals can transmit rabies.

 

Ø       The worst thing to do is nothing.

 

Ø       When they are available, use protective barriers, such as disposable gloves, when giving care for a bleeding wound.  Afterward, wash your hands thoroughly with soap and warm running water as soon as possible, even if you wore gloves.

 

Ø       The three basic steps to take in an emergency are:

 

1.                   Check the scene and the victim

2.                   Call 9-1-1 or your local emergency number

3.                   Care for the victim

 

Ø       Do not move a seriously injured victim unless there is an immediate danger.  If you must move a victim, do it as quickly and carefully as possible.

 

Ø       The first thing you do is to check to see if the victim is conscious.

 

Ø       Talk to the victim and reassure them

 

Ø       One of the most dangerous threats to a seriously injured victim is unnecessary movement.

 

Ø       Calling for help is often the most important action you can take to help the victim.

 

Ø       Call 911 when a victim is or becomes unconscious, or when he has injuries to the head, neck or back.

 

Ø       A victim who is breathing very slowly, heavily or rapidly or gasping for breath might not be getting enough air or may stop breathing.  A victim who is making shrill, gurgling or choking noises may be in similar danger.

 

Ø       In general, the best guideline is: when in doubt . . . call

 

Ø       When you call 911 do not hang up the phone until the dispatcher you are talking to does, remember that they are trained and may be able to help you with the victim.

 

Ø       Before giving first aid you must get permission from the victim.  If the victim is a child, get permission from the parent. If no parent is available, them permission is implied if the injury is life threatening.

 

Ø       Do Not give care to a conscious victim who refused help.

 

Ø       Permission is implied if a victim is unconscious or unable to respond.

 

Ø       You should check to see if an unconscious victim is:

 

1.                   Has an open airway

2.                   Is breathing

3.                   Shows signs of circulation

4.                   Is bleeding severely

 

Ø       An easy way to recall what you need to check is to remember ABC: Airway (open the airway), Breathing (check for breathing), and Circulation (check for signs of circulation and severe bleeding).

 

Ø       To check the pulse in an adult or a child, feel at the front of the neck for the Adam’s apple and slide your fingers into the groove next to it in the side of the neck.

 

Ø       To check for breathing, watch the chest to see if it rises.

 

Ø       If vomiting occurs, roll the victim on the side, and clear the mouth of any matter.

 

Ø       4-6 minutes: Brain damage possible.

 

Ø       Hyperventilation occurs when a person breathes faster than normal (rapid and shallow).  It is often the result of fear or anxiety.

 

Ø       Asthma and exercise also can trigger hyperventilation.

 

Ø       Allergic reactions can also cause breathing problems.  The person may also carry medication to reverse the reaction and may ask you to help them to use it.

 

Ø       A person who is having trouble breathing may breathe more easily in a sitting position.

 

Ø       If a choking person is coughing forcefully, let him or her try to cough up the object.  A person who is getting enough air to cough or speak is getting enough air to breathe.  Stay with the person and encourage him or her to continue coughing.  Try to reassure the victim and reduce anxiety.

 

Ø       Clutching the throat with one or both hands is universally recognized as a distress signal for choking.

 

Ø       A person who cannot speak, cough forcefully, or breathe is choking.  Give quick upward thrusts to the abdomen, just above the navel, until the airway is cleared.

 

Ø       To give rescue breathing, tilt the head back, lift the chin, and pinch the nose shut.  Breathe into the victim’s mouth.

 

Ø       When giving rescue breathing, give one breath about every 5 seconds.  Look for the chest to rise, give slow breaths to avoid air going into stomach.

 

Ø       After 10 to 12 breaths, recheck the pulse to make sure the heart is still beating.

 

Ø       Continue rescue breathing until one of the following happens:

 

1.                   The victim begins to breathe without your help.

2.                   The victim has no pulse (begin CPR).

3.                   Another trained rescuer takes over for you.

4.                   You are too tired to go on.

 

Ø       You may need to perform rescue breathing on a victim with a stoma, an opening in the front of the neck.  To check for breathing, look, listen, and feel for breaths with your ear over the stoma.  To give rescue breathing, seal your mouth around the stoma and breathe into the victim.

 

Ø       If you suspect a head, neck, or back injury, try not to move the victim’s head and neck.  Try to open the airway by using the jaw-thrust maneuver.

 

Ø       To give abdominal thrusts to an unconscious victim, place the heel of your hands just above the navel with your fingers pointing toward the victim’s head and give quick, upward thrusts.

 

Ø       If an unconscious victim is pregnant, give chest thrusts.  Kneel to one side of the victim, place the heel of one hand in the center of the breastbone and give quick, downward thrusts.

 

Ø       Stop giving abdominal or chest thrusts at once if the object comes out or the victim begins to breathe or cough.

 

Ø       The major signal of a heart attack is pain or discomfort in the chest that does not go away.

 

Ø       Any chest pain that is severe, lasts longer than 10 minutes, or persists even during rest requires medical care at once.

 

Ø       Heart attack pain is most often felt in the center of the chest, behind the breastbone.  It may spread to the shoulder, arm, or jaw.

 

Ø       Signals of a Heart Attack:

 

1.                   Persistent chest pain or discomfort: victim has persistent pain or pressure in the chest that is not relieved by resting, changing position, or oral medication.  Pain may range from discomfort to an unbearable crushing sensation.

2.                   Breathing difficulty: victim’s breathing is noisy.  Victim feels short of breath.  Victim breathes faster than normal.

3.                   Changes in pulse rate: Pulse may be faster or slower than normal or may be irregular.

4.                   Skin appearance: Victim’s skin may be pale or bluish in color.  Victim’s face may be moist, or victim may sweat profusely.

 

Ø       If a victim is not breathing and has no pulse, he or she needs CPR.  CPR a combination of chest compressions and rescue breathing.

 

Ø       When to stop CPR:

 

1.                   If another trained person takes over CPR for you.

2.                   If EMS personnel arrive and take over care of the victim.

3.                   If you are exhausted and unable to continue.

4.                   If the scene becomes unsafe.

 

Ø       To find the correct hand position for CPR, find the notch at the lower end of the victim’s breastbone where the ribs meet the breastbone.  Place the heel of one hand above this notch.  Place your other hand directly on top of it.

 

Ø       With your hands in place, position yourself so that your shoulders are directly over your hands and your elbows are locked.  Press the chest down the release it, keeping a smooth, even rhythm.

 

Ø       When you press down on the breastbone, the weight of your upper body creates the force you need to compress the chest.

 

Ø       You should do about 15 compressions in about 10 seconds.  Give 2” deep compressions.

 

Ø       Two slow breaths for every 15 compressions, or 2 breathes every 10 seconds.

 

Ø       Encourage a choking child who is coughing forcefully to continue coughing.

 

Ø       If the victim is breathing, place him or her in the recovery position while keeping the victim’s airway open.

 

Ø       If a child is choking and cannot speak, give quick, upward thrusts to the abdomen, just above the navel, until the object is forced out.

 

Ø       If a pulse is present but the child is still not breathing, give 1 breath about every 3 seconds.  Give 1½ “ deep compressions.

 

Ø       If you are unable to breathe air into the child, the airway is probably blocked.  Give 5 chest compressions.

 

Ø       If at any time you find that your rescue breaths will not go in, use the same technique that you used for CPR.  Give 5 chest compressions. (test question implies to blocked airway, not breathing -–give chest compressions.)

 

Ø       If a child is not breathing and has no pulse, give cycles of 5 compressions and 1 breath.

 

Ø       To clear a blocked airway, you will need to repeat a series of 5 back blows and 5 chest thrusts.

 

Ø       To give rescue breaths to an infant, seal your mouth over the infant’s mouth and nose.

 

Ø       Even when you are giving rescue breathing properly, the child may vomit.  If this happens, roll the child onto one side and wipe the mouth clean.

 

Ø       Germs can get into the body through a scrape, cut, or puncture and cause infection.

 

Ø       An injury to the soft tissues is commonly called a wound.

 

Ø       Scrapes, cuts, and punctures are open wounds.

 

Ø       Avulsions are open wounds in which a piece of skin, soft tissue, or even part of the body such as a finger, is torn loose or is torn off entirely.

 

Ø       Dressings are pads placed directly on the wound.  They come is various sizes.  Some have surfaces that won't stick to a wound.

 

Ø       A bandage is any material used to wrap or cover any part of the body.  Often used to hold a dressing in place.

 

Ø       When a roller bandage is used to help control bleeding, it is commonly called a pressure bandage.

 

Ø       If blood soaks through bandages, put on more dressings and bandages.  Do not remove blood soaked ones.

 

Ø       Control bleeding by placing a clean covering, such as a sterile dressing, over the wound and applying pressure; or use your hand – next step is a pressure point on the body where you can squeeze the nearby artery against the bone underneath.

 

Ø       In an infant, check for a pulse by pressing your first two fingers against the bone on the inside of the infant’s upper arm between the elbow and the shoulder.  Brachial artery.

 

Ø       Arterial blood is usually bright red – Venous blood is dark red.

 

Ø       Veins are damaged more often because they are closer to the skin’s surface.

 

Ø       Capillaries are tiny blood vessels near the skin.

 

Ø       If possible, elevate the wound above the level of the heart.

 

Ø       Signals of Shock:

 

1.                   Restlessness or irritability.

2.                   Altered consciousness.

3.                   Pale, cool, moist skin.

4.                   Rapid breathing.

5.                   Rapid pulse.

 

Ø       Caring for shock involves the following simple steps:

 

1.                   Have the victim lie down.  Helping the victim rest in a more comfortable position may minimize any pain.

2.                   Help the victim maintain normal body temperature.  If the victim is cool, try to cover him to avoid chilling.

3.                   Try to reassure the victim.

4.                   Elevate the legs about 12 inches unless you suspect head, neck or back injuries or possible broken bones involving the hips or legs.  If you are unsure of the victim’s condition, leave him/her lying flat.

 

 

Ø       If a splinter is in the eye, you should not attempt to remove it.

 

Ø       If part of the body has been torn or cut off, try to find the part and wrap it in sterile gauze or any clean material.  Put the wrapped part in a plastic bag.  Keep the part cold by placing the bag on ice, if possible, but do not freeze.

 

Ø       Nose injuries; in most cases, you can control bleeding by having the victim sit with the head slightly forward while pinching the nostrils together.

 

Ø       If the injury knocked out one or more of the victim’s teeth, control the bleeding and save any teeth so that they can be reinserted.

 

Ø       It is important for the tooth to be replaced within 30 minutes to an hour after injury

 

Ø       Pick up the teeth by the chewing edge (crown), not the root.  Do not rub or handle the root part of the teeth.  If possible, place the teeth back in the socket in its normal position.  Bite down gently and / or hold the tooth in position with a sterile gauze pad, a tissue, or a clean cloth.

 

Ø       Preserve the tooth by placing it in a closed container of cool, fresh milk until it reaches the dentist.  If milk is not available, use the victim’s saliva.

 

Ø       A penetrating chest injury is called a sucking chest wound.  Your number one concern is the victim’s breathing.

 

Ø       To care for a sucking chest wound, cover the wound with a dressing that does not allow air to pass through it.  Tape the dressing in place, except for one corner that should stay loose.

 

Ø       To care for a burn, first stop the burning.

 

Ø       Cool the burned area with large amounts of cool water.

 

Ø       Then cover the burn with dry, clean dressings to help prevent infection.

 

Ø       Don’t put any kind of ointment on a burn unless it is a very minor burn.

 

Ø       For minor burns and burns with open blisters that aren’t bad enough to need medical care, wash the area with soap and water.  Keep it clean.  Put on an antibiotic ointment, such as Neosporin.  Watch for signals of infection.

 

Ø       Don’t remove pieces of cloth that stick to the burned area.

 

Ø       For chemical burns to the skin or eyes, flush the burn with large amounts of cool running water until the ambulance arrives.  Have the victim take off any clothes with the chemical on them.

 

Ø       For dry chemical burns, dust off as much as possible with gloved hands, a brush or towel.

 

Ø       Never go near a victim whom you think has been injured by electricity until you are sure the power is turned off.  If a power line is down, wait for the fire department or the power company.

 

Ø       The four basic types of injuries to muscles, bones and joints are fractures, dislocations, strains and sprains.

 

Ø       A dislocation is a separation of a bone from its position at a joint.

 

Ø       A sprain is the partial or complete stretching or tearing of the special soft tissue bands that hold bones together at a joint, called ligaments.  In short, injuries to joints are usually sprains.

 

Ø       A strain is a stretching or tearing of muscles or the strong fibers that attach muscle to bone, called tendons; injuries to the soft tissue between joints, the muscles and tendons, are strains.

 

Ø       Splint an injury in the position you find it.

 

Ø       First apply cold, then heat to a strain or a sprain.

 

Ø       When a person has a head injury, the best care you can give is to minimize movement of the victim’s head and spine.

 

Ø       General care for head and spine injuries:

 

1.        Minimize movement of the head and spine.

2.        Maintain an open airway.

3.        Check consciousness and breathing.

4.        Control any external bleeding.

5.        Keep the victim from getting chilled or overheated.

 

Ø       In case of a seizure, care for the person until help arrives by protecting the person from injury and keeping the airway clear.

 

Ø       Do NOT try to stop the seizure.  Do NOT hold or restrain the person.  Do NOT try to place anything between the victim’s teeth.

 

Ø       If the victim of a diabetic emergency is conscious, give him or her food or fluids containing sugar.

 

Ø       To care for fainting, place the victim on his back, elevate the feet, and loosen any restrictive clothing, such as a belt, tie, or collar.

 

Ø       If you suspect that the victim’s condition is caused by some form of poisoning, call your Poison Control Center.

 

Ø       The signals of poisoning include nausea, vomiting, diarrhea, chest or abdominal pain, breathing difficulty, sweating, changes in consciousness, and seizures.  Other signals of poisoning are burns around the lips or tongue or on the skin.

 

Ø       Do NOT induce vomiting if they have swallowed a corrosive substance (an acid or alkali) or a petroleum product such as kerosene or gasoline.

 

Ø       If someone is stung by an insect, remove the stinger.  Scrape it away from the skin with your fingernail or a plastic card, such as a credit card, or use tweezers.

 

Ø       Apply a cold pack to the area to reduce the pain and swelling.

 

Ø       Snake bites:  If you know the victim can’t get professional medical care within 30 minutes, consider suctioning the wound using a snakebite kit.

 

Ø       To care for someone bitten by a snake, wash the wound and immobilize the injured area, keeping it lower than the heart, if possible, call 9-1-1 or the local emergency number.  DO NOT apply ice to a snakebite.  DO NOT cut the wound.  DO NOT apply a tourniquet.  DO NOT use electric shock.

 

Ø       If the wound is minor, wash it with soap and water.

 

Ø       Heat exhaustion: Its signals include cool, moist, pale, or flushed skin, headache, nausea, dizziness, weakness, and exhaustion.

 

Ø       Heat Stroke: Heat stroke is a serious medical emergency.  The signals are red, hot, dry skin; changes in consciousness; rapid, weak pulse; and rapid, shallow breathing.

 

Ø       Do Not let the conscious victim drink too quickly.  Give about one glass (4 ozs.) of water every 15 minutes.

 

Ø       Frostbite is the freezing of body parts exposed to the cold.

 

Ø       The signals of frostbite include lack of feeling in the affected area and skin that appears waxy, is cold to the touch, or is discolored (flushed, white, yellow, or blue).

 

Ø       Never rub affected area.  Warm the area gently by soaking the affected part in water no warmer that 105 degrees.  Loosely bandage the area with a dry, sterile dressing.

 

Ø       Signals of hypothermia include shivering, numbness, glassy stare, apathy, and loss of consciousness.

 

Ø       For a hypothermia victim, rewarm the body gradually by wrapping the victim in blankets or putting on dry clothing and moving him to a warm place.

 

Ø       A child involved in a motor vehicle accident and found in a car seat should be left in the seat if the device has not been damaged.

 

Ø       Sometimes a severe blow or penetrating injury to the abdomen can cause organs to be exposed or protrude.  In this case, carefully position the victim on his back.  Do not apply any pressure to the organs and do not attempt to push the organs back inside.  Remove any clothing from around the wound and apply moist, sterile dressings or a moistened clean cloth loosely over the wound.

 

Ø       Wounds that break through the abdomen can cause the organs to push out.  Carefully remove clothing from around the wound.  Cover the organs with a moist sterile or clean dressing and cover the dressing with plastic wrap.  Place a folded towel or other cloth over the dressing to keep the organs warm.

 

Ø       Signals of Internal Bleeding:

 

1.       Tender, swollen, bruised or hard areas of the body, suck as the abdomen

2.       Rapid, weak pulse

3.       Skin that feels cool or moist or looks pale or bluish

4.       Vomiting or coughing up blood

5.       Excessive thirst

6.       Becoming confused, faint, drowsy or unconscious

 

Ø       Some closed wounds can be extremely serious.  The victim may be bleeding internally and need emergency medical help as soon as possible.  Help the victim rest in the most comfortable position.  Keep the victim from getting chilled or overheated.  Reassure and comfort the victim.