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First Aid

By: Mary Anne Mejia

First Aid Review


77.1702 (a) Each operator of a surface coal mine shall make arrangements with a licensed physician, medical service, medical clinic, or hospital to provide 24hour emergency medical assistance for any person injured at the mine.

(b) Each operator shall make arrangements with an ambulance service, or otherwise provide for 24hour emergency transportation for any person injured at the mine.

First Aid Scene Safety


Make sure the area is safe
What caused the injury or accident?

Ensure Personal Safety


Protect yourself with gloves, masks, before you act. You wouldnt work with toxic chemical without the proper protection would you?

First Aid Patient Assessment


Primary Survey
ABCs and severe bleeding Life Threatening conditions

Secondary Survey
DE Thorough Head to toe hands on examination for wounds, burns, musculoskeletal injuries and anything else that will require treatment.

First Aid Patient Assessment


A (Airway) Assess for unresponsiveness Open the Airway (Head tilt-Chin lift) B (Breathing) Look, Listen and Feel for Breathing If not breathing, give two normal breaths C (Circulation) Check Pulse at Carotid Artery (5-10 seconds) If no pulse, start chest compressions

First Aid Patient Assessment


D
Assess for Deformity Hands on; Head to toe Examination for all other injuries and conditions that will require treatment

E
Expose If you cant see it, you cant treat it

First Aid CPR and Rescue Breathing


ABCs Ratio
30 compressions to 2 breaths 1 breath every 5 seconds

Rate
Hard and Fast 12 breaths per minute

First Aid Control of Bleeding


Direct Pressure
95%

Elevation
97%

Pressure Points
99%

Tourniquet
Last resort 1%

First Aid Burns


Degree
First (Superficial) Second (Partial Thickness) Third (Full Thickness)

Treatment
Remove heat Prevent contamination Over Bandage; loosely

Burns Degrees of Burns


1. Third-degree burn a. Many layers of skin are burned.

b. There is severe discoloration.


c. Some skin may be charred. d. These burns can be life threatening.

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Third-Degree Burn
Full thickness burn with tissue damage
Third Degree Burn Damage extends deeper into tissues (epidermis, dermis, and hypodermis) causing extensive tissue destruction. The skin may feel numb.
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Heat Burn Treatment

Go through RAP ABCH first, then ask if burn

was caused by heat.

Determine degree and amount of burn.


If it is a third-degree burn or large second-

degree burn, use the ABCH, then treat for shock. skin may come with it.

Do not attempt to pull off the clothing because


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Heat Burn Treatment


Cut it off if attached to the skin. Apply a sterile dressing and elevate. Seek immediate medical attention. Burn is first-degree or small second-degree,

apply cold water/compress until pain stops.

If you must use ice, provide a barrier. Do not apply an ointment.


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Chemical Burn Treatment

Determine if burn was caused by a dry chemical. If so, brush it off, remove clothing, wash area

fifteen to twenty minutes.

If not caused by dry chemical, remove clothing

and jewelry, wash area for fifteen to twenty minutes.

Seek medical attention in both cases.


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Electrical Burn Treatment

If burn is not chemical, then its an electrical

burn.

Is victim in contact with electrical source, are

you at risk.

If yes, ask adult to turn off power.

May entail calling 911 to have then call

appropriate person.

Treatment same as heat burn.


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Electrical Burn Treatment

In all cases, monitor wound for signs of infection. Large wounds seek medical attention to reduce

risk of infection.

Serious burn, monitor for signs of shock.

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burns treatment

COOL! REMOVE

DRESS

dislocated kneecap

open fracture

Note the poor aseptic technique!

open fractured wrist

First Aid Musculoskeletal Injuries


Splinting
Immobilize the joint above and the joint below When in doubt, SPLINT

Elevate Apply cold compresses Do we ever want to attempt to "straighten out a broken bone or fracture?

First Aid Shock


Treat for Shock on all patients from the beginning. Shock can kill, even though the injuries wouldnt. Be calm and reassuring Keep the patient warm Elevate feet, if no back or head injuries.

eye / face laceration

finger laceration

Fingertip amputation

laceration

Poisons
Poisons can enter the body one of four ways:

1. Inhalation 2. Ingestion 3. Injection 4. Absorption

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Poisoning Treatment
Poisonous injections: i.e. Snakebites, Identify the snake, if possible. Then clean the bite with soap and

water and keep bite below heart level. Seek medical attention.

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Poisoning Treatment
If the poison is inhaled or swallowed;

Check "ABCH" and treat for shock.


Seek medical attention and call the

Poison Control Center

1-800-222-1222
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Insect Bite or Sting Treatment


If possible, try to catch the spider or

insect without risk to you. Check to see if the stinger is in the skin. If not, Clean the area, apply ice to reduce swelling.

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Insect Bite or Sting Treatment


If stinger is found, gently scrape the

stinger out of the wound using a plastic card or fingernail, pulling away from the wound to minimize amount of toxin released into the body. Do not squeeze stinger. Treat wound as a minor cut.
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Insect Bite or Sting Treatment


Next, check to see if the victim is allergic

to the bite. Look for signs of shock and swelling. If no, then seek medical attention or an adult for assistance. If yes, check ABCH, treat for shock, and immediately seek medical attention.
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Dog Bites

Here's How: Stay Safe. Secure the dog or the victim. Move one away from the other. If the dog's owner is around, instruct him or her to secure the dog. If not, move the victim to a safe location. Dogs may bite because their territory is threatened. Don't start any treatment until there is a reasonable expectation that the dog won't attack again. If you are not the victim, practice universal precautions and wear personal protective equipmentif available. Control any bleeding by following the appropriate steps. Avoid using a tourniquet unless there is severe bleeding that cannot be controlled any other way.

Once the bleeding is controlled, clean the woundwith soap and warm water. Do not be afraid to clean inside the wound. Be sure to rinse all the soap away, or it will cause irritation later. Cover the wound with a clean, dry dressing. You can put antibiotic ointment on the wound before covering. Watch for signs of infection: Redness Swelling Heat Weeping pus

Always call a physician to determine if you should be seen. Some dog bites need antibiotics, particularly if they are deep puncture wounds. Additionally, many municipalities have regulations for reporting dog bites and monitoring the dogs, and that is often initiated by contact with a doctor. Any unidentified dog runs the risk of carrying rabies. If the dog cannot be identified and the owner cannot show proof of rabies vaccination, the victim must seek medical attention. Rabies is always fatal to humans if not treated. The wound may need stitches. If the edges of a laceration are unable to touch, or if there are any avulsions, the wound will need emergency medical attention. Wounds on the face or hands should be seen by a physician because of the likelihood of scarring and loss of function.

Fracture
KEEPING A BROKEN BONE STILL

The victim will often have put the injured part in the position that is most comfortable for him and will generally be guarding the injury and keeping it still. If the victim has not done this, encourage him to keep still and help him into a comfortable position.
Once the victim is still you can help to steady and support the fracture using your hands. By helping the victim keep the injured part still you enable him to relax. The very act of relaxing the muscles reduces on the broken bones and often alleviates pain.

If you have to transport the victim yourself, or if it is going to be a while until help arrives, then you can immobilize the broken bone further with bandages or improvise with coats or blankets, for example. The key points to remember with any type of bandaging are: Not to tie the bandage too tightly. To pad around the site of the break. Do not move the injured part area unnecessarily. Place the dressing over the wound and build up padding along side the bone. Tie both the padding and the dressing in place, using firm pressure.

Remember that broken bones do swell and that you may need to loosen the bandage if the circulation below the site of the break becomes impaired. TREATMENT OF OPEN BREAKS
In the first instance, the wound should be protected using either a sterile dressing or an improvised dressing made from a piece of clean, dry, and non-fluffy material. If the bleeding is profuse, or you are going to have to wait some time for further help, this dressing should be held in place using the same principles as you would apply if there were a foreign object in the wound.

CHECKING FOR DAMAGE TO CIRCULATION With any bandaging, you run the risk of cutting off the circulation to the area below the site of the bandage. While this can in part be avoided by no tying bandages too tightly and by never using a tourniquet, the nature of wounds means that they swell and this can cause once satisfactory bandage to become too tight. There are a number of ways to check whether a bandage is cutting off the circulation:

If the skin below the site of the bandage becomes white, gray, or blue, or feels cold to the touch. If the victim complains of tingling, numbness or of a lack of circulation. If the pulse in the limb slows or stops. If the color does not quickly return to the skin after the skin is gently pinched or the nail compressed. If you noticed any of these signs, gently loosen, but do not remove, the bandage until the blood flow returns.

Choking
Choking occurs when a foreign object becomes lodged in the throat or windpipe, blocking the flow of air. In adults, a piece of food often is the culprit. Young children often swallow small objects. Because choking cuts off oxygen to the brain, administer first aid as quickly as possible. The universal sign for choking is hands clutched to the throat. If the person doesn't give the signal, look for these indications: Inability to talk Difficulty breathing or noisy breathing Inability to cough forcefully Skin, lips and nails turning blue or dusky Loss of consciousness

If choking is occurring, the Red Cross recommends a "fiveand-five" approach to delivering first aid: Give 5 back blows. First, deliver five back blows between the person's shoulder blades with the heel of your hand. Give 5 abdominal thrusts. Perform five abdominal thrusts (also known as the Heimlich maneuver). Alternate between 5 blows and 5 thrusts until the blockage is dislodged. The American Heart Association doesn't teach the back blow technique, only the abdominal thrust procedures. It's OK not to use back blows, if you haven't learned the technique. Both approaches are acceptable.

To perform abdominal thrusts (Heimlich maneuver) on someone else: Stand behind the person. Wrap your arms around the waist. Tip the person forward slightly. Make a fist with one hand. Position it slightly above the person's navel. Grasp the fist with the other hand. Press hard into the abdomen with a quick, upward thrust as if trying to lift the person up. Perform a total of 5 abdominal thrusts, if needed. If the blockage still isn't dislodged, repeat the five-and-five cycle. If you're the only rescuer, perform back blows and abdominal thrusts before calling 911 or your local emergency number for help. If another person is available, have that person call for help while you perform first aid.

If the person becomes unconscious, perform standard CPR with chest compressions and rescue breaths. To perform abdominal thrusts (Heimlich maneuver) on yourself: First, if you're alone and choking and you have a landline phone, call 911 or your local emergency number immediately. Then, although you'll be unable to effectively deliver back blows to yourself, you can still perform abdominal thrusts to dislodge the item. Place a fist slightly above your navel. Grasp your fist with the other hand and bend over a hard surface a countertop or chair will do. Shove your fist inward and upward. Clearing the airway of a pregnant woman or obese person:

Position your hands a little bit higher than with a normal Heimlich maneuver, at the base of the breastbone, just above the joining of the lowest ribs. Proceed as with the Heimlich maneuver, pressing hard into the chest, with a quick thrust. Repeat until the food or other blockage is dislodged or the person becomes unconscious. Clearing the airway of an unconscious person:

Lower the person on his or her back onto the floor. Clear the airway. If there's a visible blockage at the back of the throat or high in the throat, reach a finger into the mouth and sweep out the cause of the blockage. Be careful not to push the food or object deeper into the airway, which can happen easily in young children. Begin cardiopulmonary resuscitation (CPR) if the object remains lodged and the person doesn't respond after you take the above measures. The chest compressions used in CPR may dislodge the object. Remember to recheck the mouth periodically. Clearing the airway of a choking infant younger than age 1:

Assume a seated position and hold the infant facedown on your forearm, which is resting on your thigh. Thump the infant gently but firmly five times on the middle of the back using the heel of your hand. The combination of gravity and the back blows should release the blocking object. Hold the infant faceup on your forearm with the head lower than the trunk if the above doesn't work. Using two fingers placed at the center of the infant's breastbone, give five quick chest compressions. Repeat the back blows and chest thrusts if breathing doesn't resume. Call for emergency medical help. Begin infant CPR if one of these techniques opens the airway but the infant doesn't resume breathing.

If the child is older than age 1, give abdominal thrusts only.

To prepare yourself for these situations, learn the Heimlich maneuver and CPR in a certified first-aid training course.