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2010 Lecture Guide First Aid
2010 Lecture Guide First Aid
Table of Contents
General Information Medical Emergencies
Introduction...............................................2 Difficulty Breathing....................................55
Responding to Emergencies.....................3 Asthma......................................................57
Legal Issues..............................................6 Allergic Reactions.....................................59
Protection from Infection............................7 Seizures....................................................61
Heart Attack...............................................9 Fainting.....................................................63
Stroke........................................................11 Diabetic Emergencies...............................64
Adult/Child Choking...................................13
Infant Choking...........................................15 Environmental Emergencies
Poisoning..................................................70
First Aid Assessment Heat-related Emergencies.........................74
Assessing a Victim....................................18 Cold-related Emergencies.........................77
Positioning a Victim...................................22 Bites & Stings............................................80
Moving a Victim.........................................23
Prevention and Planning
Injuries First Aid Kits..............................................87
Bleeding, Shock, Trauma..........................24 Maltreatment of Children...........................87
Head, Neck & Back Injuries......................34
Chest & Abdominal Injuries.......................42
Muscle, Bone & Joint Injuries....................45
Burns.........................................................50
The Lecture Guide is the primary resource to guide the Instructor through the lecture and move the
course along smoothly. The layout follows the layout of the Student Workbook, with similar topic head-
ings. Add statistics or points of interest to the Lecture Guide to customize your presentation.
1. The box under each topic heading indicates:
a. DVD Chapter to show at the beginning of the topic. Sometimes you will show multiple DVD
chapters, then pause to discuss or practice them.
b. DEMONSTRATE: The Instructor demonstrates on a manikin, student volunteer, or him or
herself.
c. PRACTICE: Skill for students to practice. A skill that is tested will say (Skill ) next to
it. Skill Check Option 1: Use Skill Sheets to check off each step of a skill as your
student successfully demonstrates it. Option 2: Use a Skill Summary to check off a
completed skill.
d. SUPPLIES: Equipment or supplies needed to teach each topic.
2. Some topics are optional depending on the needs of the workplace and students.
a. e.g. Applying a splint, infant choking care
3. A dotted line separates the topic introduction from the rest of the topic.
4. Gray shaded boxes that say ‘Senior’ are only taught with the workbook, “CPR, AED and First Aid
for the Senior Community.”
5. Gray shaded boxes that say ‘Child’ are only taught with the workbook, “CPR and First Aid for
Childcare Providers.”
6. Review ‘How Would You REACT?’ pages with your students. The questions have the correct an-
swers in bold. The scenarios will vary according to the details you give the students. Visit www.
emssafety.com/Login for suggested scenario responses. You may also substitute your own sce-
narios which apply more specifically to the needs of the students and workplace.
Basic First Aid Lecture Guide 1
Basic First Aid Introduction
Instructor Introduction
• Introduce yourself; give your qualifications and experience.
• Questions are welcome.
• Locations of bathrooms, exits, etc.
• Provide breaks during the course.
Why are you here?
• Your workplace or profession requires it
• You want to learn for your own knowledge
Why should you learn First Aid?
• > 123M visits to emergency department each year in U.S.
• > 1/3 of visits are for injuries.
• Overcome barriers to act:
o Fear of doing the wrong thing or hurting someone
o Fear of catching a disease
o Panic or not knowing what to do
• Goal: Respond safely, confidently and effectively in an emergency.
What will you learn today?
• Quickly recognize an emergency
• Assess a victim and recognize life-threatening conditions
• Know when to call 9-1-1
• First aid treatment for common illnesses and injury
• Things you can do to prevent an emergency
How will you learn?
• DVD, workbook, lecture, demonstration, hands-on practice, discussion
o Emphasize skills and confidence-building over lecture.
• Must pass skills and written test to receive a course completion card.
o Instructor’s job is to help you learn and pass this course.
o Card is valid for up to 2 years.
2 years is too long to remember everything in an emergency.
Must review and refresh your learning periodically.
o Receive access for 2 years to a digital workbook online.
Let Instructor know privately if:
• Any medical or physical conditions that may limit your participation
• Latex allergy (unless all classroom supplies are latex-free)
Follow state, local, and workplace regulations and policies.
• Some first aid treatments may be restricted by state, local, or workplace regulations.
o e.g. Epinephrine auto-injector; asthma inhaler
• Although you may be taught and tested on some treatments that are restricted in certain re-
gions, this does not authorize you to perform them while giving first aid.
• Learn your state, local, and workplace regulations.
2 Basic First Aid Introduction © 2011 EMS Safety Services, Inc.
Responding To Emergencies
DVD Ch: DEMONSTRATE: PRACTICE: SUPPLIES:
1, 2
Learning Objectives:
• Be able to recognize an emergency and evaluate a scene for safety.
• Know when and how to activate EMS and interact with EMS.
Key Concepts
• Emergency scenes can be dangerous.
• Rescuers can quickly become victims.
• Caution and common sense can save your life.
REACT to an Emergency
Recognize an emergency
• Screams, panic; seriously ill or injured person; victim or bystanders agitated or threatening
• Suspicious environment; collision or stopped vehicle; environmental hazard
• Remain calm; stay aware of your own safety.
• Consider resources and options.
Environment
Size up the scene from a safe distance. Common hazards include:
• Blood and body fluids: Use personal protective equipment on every scene.
• Traffic: Use your vehicle, hazard lights and bystanders to control traffic around the scene.
Watch for jagged metal and broken glass. Don’t turn your back to oncoming traffic.
• Fire or smoke: Stay low to avoid smoke inhalation, and focus on escaping. If possible, drag the
victim to safety. Never enter a smoke-filled environment.
• Wet, icy or unstable surface or structure: Slips, falls and vehicle movement can cause addi-
tional injuries to bystanders and rescuers. Avoid walking onto a frozen lake or pond if the stabil-
ity of the ice is unknown.
• Downed electrical wires: Do not enter the scene; maintain a safe distance. If downed lines are
near your car, stay inside the vehicle.
• Hazardous materials, chemicals and gases: Unusual smells, hissing sounds, liquids, hazard-
ous containers; dead birds, animals, and fish could indicate a biological or chemical hazard.
Leave the area and report it immediately.
• Open water, strong currents: Do not attempt a water rescue without professional training and
equipment. It only takes a foot of swift moving water to move a car downstream.
• Confined space: Could be a cave, sewer, drainage culvert, or someone’s garage. Look for
clues such as more than 1 victim with no apparent injury. Do not enter without training and
proper equipment.
• Hostile environment: Do the victim or bystanders appear agitated or threatening?
Tip Before you enter an emergency scene, consider how you will exit. Identify two possible exits.
Senior
• Give EMS a printed list of medications if available.
• If the person wears glasses or hearing aids, try to provide these before EMS transports the
person.
Sum it up
• Remain calm.
• Assess the scene from a safe distance.
• Check for hazards and resources before focusing on the victim.
• If the scene is not safe, do not enter; call 9-1-1.
• Do not become a victim.
Rescuer Stress
Learning Objectives
• Understand that there might be physical, mental, and emotional consequences to providing care
in an emergency.
Key Concepts
• It’s normal to feel stress after an incident.
• Each rescuer will respond differently to stress depending on:
o Experience
o Personality
o Seriousness of the incident
o Outcome
• Rescuer stress may cause changes in emotions, ability to concentrate, appetite, sleep, and
other physical symptoms.
DISCUSS:
• Has anyone here responded to a serious emergency?
• Will you discuss what emotions you felt after the emergency was over?
• How did you deal with the emotions?
Basic First Aid Lecture Guide Responding To Emergencies 5
Legal Issues
DVD Ch: DEMONSTRATE: PRACTICE: SUPPLIES:
3
Learning Objectives:
• Know the common elements of the Good Samaritan Law.
• Understand the need for consent, right to privacy and right to refuse care.
Key Concepts
• Some people have a duty to respond to an emergency.
• Other people respond voluntarily.
• Give your name, level of training, and the problem. Ask if you can help.
Types of Consent
• Expressed consent: Victim expresses desire for aid
• Implied consent: Consent is assumed (unresponsive person)
• Minor’s consent: A parent or legal guardian must give consent. If condition is life-threatening,
treat under implied consent.
Right to Privacy
• Do not give out the victim’s information to coworkers or bystanders.
• Give information to EMS responders and to the person in charge of workplace safety.
Sum it up
• A designated first aid responder has a duty to act when at work.
• Once you begin care, do not leave the victim until help arrives.
• Request consent before giving care.
• Do not provide treatment that you are not trained to give.
Instructor Note: Skip this chapter if you will be certifying your students in the annual Bloodborne
Pathogens awareness training in Section 3 of this Instructor Manual.
Learning Objectives:
• Understand how to help prevent BBP exposure and what to do if you are exposed.
• Demonstrate the skill of disposable glove removal.
Key Concepts
• The OSHA Bloodborne Pathogens Standard requires the employer to help protect you from
exposure to BBP.
• Use precautions with every emergency to protect yourself.
• Hand washing is an important part of infection control.
Bloodborne Pathogens
• Bloodborne pathogens are disease-causing microorganisms in blood.
• Most serious: HIV, Hepatitis B, Hepatitis C
• May be transmitted during an emergency when giving first aid, handling contaminated sharp
objects, cleaning a blood spill.
Universal Precautions
Universal Precautions & Body Substance Isolation provide protection.
• Assume all blood and body fluids are infectious, except sweat.
• Take precautions with all victims, even children.
• Use personal protective equipment.
o Disposable gloves, gown, mask, goggles or face mask, CPR barrier
o Choose the right equipment for each emergency.
o Wash hands thoroughly immediately after glove removal.
o Wash with soap and water for at least 20 seconds.
o If hands not visibly soiled and running water is not available, use hand sanitizer, then
wash ASAP.
Tip If you don’t have a biohazard bag or container, place the contaminated items in a leak-proof
plastic bag and seal it. Dispose of it according to your workplace policy.
Heart Attack
DVD Ch: DEMONSTRATE: PRACTICE: SUPPLIES:
5
Learning Objectives:
• Know how to recognize a heart attack and the proper rescuer actions.
• Understand the importance of early activation of EMS.
Key Concepts
• Heart disease is the leading cause of death in the U.S.
• Heart attack can lead to cardiac arrest.
• More than 1.25 million Americans have a first or recurrent heart attack every year.
• About 70% of the deaths from heart attack occur before the victim reaches the hospital.
• Call 9-1-1 early for any signs of heart attack.
Sum it up
• Heart attack victims often deny or ignore symptoms, or say there is another cause.
• Be alert to less common symptoms in women, diabetics, and older people.
• Fast recognition of heart attack symptoms gives the best chance of survival.
• Clot-busting medications can dissolve the clot.
• Only effective in the first few hours of a heart attack.
10 Heart Attack © 2011 EMS Safety Services, Inc.
Stroke
DVD Ch: DEMONSTRATE: PRACTICE: SUPPLIES:
6
Learning Objectives:
• Know how to recognize a stroke and the proper rescuer actions.
• Understand the importance of early activation of EMS and early treatment at a hospital.
Key Concepts
• Stroke is the 3rd leading cause of death in the U.S.
• 800,000 strokes each year in the U.S.
• Call 9-1-1 early for any signs of stroke.
What is a stroke?
• A stroke is like a heart attack occurring in the brain.
• Caused by a clot or bleed in the brain.
• Symptoms may be minor or severe.
• Many survivors are permanently impaired and struggle with daily activities.
Time is critical.
• Treat most strokes with clot-busting medication (fibrinolytic therapy).
o Same as with a heart attack.
o Only effective in the first few hours of a stroke.
• Early recognition of stroke can make the difference between life and death or between complete
recovery and lifelong disability.
STRoke Assessment
Use STR to quickly recognize common signs of a stroke.
• Smile: Ask person to smile.
o Both sides of face should move equally.
• Talk: Ask person to repeat a common phrase.
o Listen for slurred or incorrect words.
• Reach: Ask person to close eyes and raise arms.
o Look for arm drift or weakness on one side.
Sum it up
• Recognize the signs and symptoms of stroke.
• Do not wait to see if the symptoms will disappear (TIA).
• Call 9-1-1 and get help early for the best chance of survival and recovery.
Learning Objectives:
• Recognize choking in the adult or child.
• Demonstrate choking management of a responsive victim.
• Understand rescuer actions if the victim becomes unconscious.
Key Concepts
• Choking is a preventable emergency.
• Most choking incidents occur in children younger than 5 years.
• Treatment is the same for an adult or child.
• Act quickly, because severe choking will result in death if not treated.
Recognize choking
• Choking is often confused with other emergencies.
o e.g. Heart attack, asthma, seizure, drug overdose
• Consider what the person was doing to help recognize choking:
o Talking or drinking alcohol while eating
o Eating too fast or not chewing food completely
o Wearing dentures while eating (difficult to tell if food is chewed)
o Walking or running while eating or chewing gum
• Universal sign of choking: 1 or both hands at the throat.
Mild Obstruction
• The airway is partially blocked.
• If the person can forcefully cough or speak, do not interfere.
• Forceful coughing is the best way to relieve an obstruction.
o Ask, “Are you choking?”
o If can cough or speak, encourage coughing.
o Watch for progression to a severe obstruction.
o Send someone to call 9-1-1 if coughing is prolonged.
Senior
If the victim is in a wheelchair:
• Perform abdominal thrusts if you can quickly access the right location.
o May depend on wheelchair style, size and sitting position of victim.
• Perform chest thrusts if you cannot perform abdominal thrusts.
Child
To perform abdominal thrusts on a small child, the rescuer may need to kneel down behind the child
to get into the right position.
Chest Thrusts
If pregnant or too large to reach around the abdomen, use chest thrusts.
• Stand behind the person and reach under the arms and around the chest.
• Place one fist in the center of the chest.
o Same location as chest compressions
• Grasp the fist with your other hand.
• Perform continuous backward thrusts.
Key Concepts
• An infant cannot communicate to you that he or she is choking.
• Forceful coughing is the best way to relieve an obstruction.
Mild Obstruction
• If can forcefully cough or cry, monitor breathing.
• Watch for progression to a severe obstruction.
• Call 9-1-1 if coughing is prolonged.
Unresponsive Infant
If the victim becomes unresponsive, perform CPR.
1. Look for the object in the mouth after each set of compressions.
o If seen, remove the object. Do not ‘blind sweep’ the mouth.
2. Continue CPR.
3. If you are alone, call 9-1-1 after 2 minutes of CPR.
Sum it up
• Prevent choking before it becomes an emergency.
QUESTIONS SCENARIOS
Home
1 Possible hazards at an emergency scene may
include:
a. Fire or smoke
You are talking with your wife when she suddenly
b. Blood or body fluids
slumps in her chair. She cannot maintain her posi-
c. Traffic
tion in the chair and does not make sense when
d. Unstable structures
she speaks. How would you REACT?
e. All of the above
True False
True False
School
True False
Work
5 If a victim has difficulty speaking or weakness on
one side of the body, he or she should:
Learning Objectives:
• Understand the scene size-up, initial assessment, and on-going assessment, and how to perform
them.
• Identify common situations in which EMS should be activated.
• Demonstrate the initial assessment of a victim.
• Know how to prioritize life-threatening conditions.
Key Concepts
• Ensure your own safety.
• Assess a victim in the position found.
• Treat life-threatening conditions first.
Scene Size-up
• Size-up the scene for safety before you enter.
o If not safe, call 9-1-1 and follow dispatcher instructions.
• Size-up the victims.
o How many, general condition, possible cause of injury or illness.
• Suspect serious injury if:
o Vehicle, motorcycle, bicycle accident
o Fall from greater than standing height
o Explosion or gunshot
• Identify available resources.
o Bystanders, first aid kits, personal protective equipment, cell phones
Initial Assessment
1. Assess response:
• Approach the victim from the side and gather a general impression.
Appears unresponsive:
• If appears unresponsive, tap the shoulder and shout, “Are you okay?”
• If no response, have someone call 9-1-1 (activate EMS), get the first aid kit and AED.
• Go call yourself if you are alone with an adult victim.
Responsive:
• Gain consent. Give your name and training, and ask if you can help.
• Ask questions to determine what happened. What is the chief complaint?
18 Assessing a Victim © 2011 EMS Safety Services, Inc.
2. Assess Breathing
Unresponsive: Scan the chest for breathing.
• If no breathing or only gasping, begin standard CPR if you are trained.
o Give continuous chest compressions if you are not trained.
• If breathing, continue assessment and closely monitor breathing.
Responsive: Check for the quality, rate and effort of breathing.
• Listen for noisy breathing. Is the airway clear?
• Is the person working hard to breathe?
• Can the person speak? Is the person speaking in broken sentences?
• Is breathing fast or slow?
3. Assess Head-to-Toe
• Look head-to-toe for obvious signs of injury
o e.g. Bleeding, bruising, burns, twisted limbs
o Smell for chemicals which might indicate poisoning.
• Assess appearance
o Color, sweating, temperature, movement, position
Assess temperature with the back of your gloved hand on the person’s forehead.
Normal skin is warm, dry, and good color.
• Treat life-threatening conditions first.
o Prioritize problems with response, airway, breathing, circulation.
o If you find a life-threatening condition, stop the assessment and give care. (e.g. Control
bleeding with direct pressure.)
Tip Check the victim’s cell phone for an ICE contact: In Case of Emergency. It will usually be a fam-
ily member or close friend.
Senior Caregiver
Assessment:
• Make movements slow and deliberate.
• May be difficult to differentiate between new problem and symptoms from a chronic medical
condition.
o e.g. Is mental confusion from hypoglycemia or from a previous stroke?
o Interview family members to find out.
• May deny symptoms because does not want to risk losing independence.
o May not want to be a bother.
o May not want to go to the hospital.
Child
Assessment:
• If more than 1 child, go to the quiet one first. May be unresponsive.
• Get down to child’s level.
• Take your time with the assessment.
o Speak slowly and clearly.
o Make movements slow and deliberate.
o Ask a young child to point to where it hurts.
Infants: The most difficult to assess, because they cannot communicate verbally.
• Be alert for signs of listlessness or exhaustion, which indicate severe distress.
• Support the head of infants younger than 4 months.
Age 1-5: Easily scared by strangers.
• Do not remove clothing, and avoid any unnecessary touching.
• Use observation to help your assessment.
Age 6-12: When injured or stressed, may behave younger than their actual age.
• Be honest if something is going to hurt.
• Work slowly, avoiding any surprises.
• Give a simple explanation of what you are going to do.
On-Going Assessment
Reassess the scene and your victim while you wait for professional responders to arrive:
1. Ensure the scene is still safe.
2. Reassess and continually monitor responsiveness and breathing.
3. Observe for changes in mental status (victim becomes confused or unresponsive).
4. Calm and reassure the victim.
Positioning a Victim
DVD Ch: DEMONSTRATE: PRACTICE: SUPPLIES:
11 Tripod position
Learning Objectives
• Identify when to use the recovery position.
• Describe different positions for various conditions.
Key Concepts
• Move a victim only if immediate danger or needs essential care.
• Use different positions for different conditions.
Unresponsive Victim
Unresponsive Victim
• The airway can become blocked by the tongue, vomit, blood or mucus.
• The recovery position keeps the airway open and allows fluids to drain.
• Use the recovery position when:
o A person is unresponsive and has vomit, fluid or blood in the mouth.
o A lone rescuer has to leave to get help.
• Log roll a victim into the recovery position.
o Roll without twisting the spine.
o Position should be stable, with the person unlikely to roll further forward or back.
• If an unresponsive victim is face down, carefully log roll the victim face up.
22 Positioning a Victim © 2011 EMS Safety Services, Inc.
Modified H.A.IN.E.S. recovery position
• There are many different types of recovery position.
• Use this recovery position especially if you suspect neck or back injury.
• End with the victim lying on his side, head supported by his raised arm.
Place a pregnant victim on her left side.
• Allows blood to flow more freely.
• Avoids problems from the weight of the baby pressing down on nerves and blood vessels.
Responsive Victim
Shock position: lying face up
• Use if signs of shock, dizzy or faint
Sum it up
• Use the recovery position for an unresponsive person if you must leave to get help, or to keep
the airway open and allow fluids or vomit to drain.
• Do not move a trauma victim unless absolutely necessary for essential care.
o e.g. CPR, placing a blanket under a victim to insulate from heat or cold, bleeding control,
or airway management
Moving a Victim
DVD Ch: DEMONSTRATE: PRACTICE: SUPPLIES:
Learning Objectives
• Know when a person should and should not be moved.
• Identify the “drag and carry” methods for movement of a victim.
Key Concepts
• Use good lifting techniques to protect yourself.
• Only move a victim for essential care such as CPR or airway management, or if there is immedi-
ate danger.
• Pull or drag the victim in the direction of the long axis of the body.
Emergency Drags
• Ankle Drag: Pull by the ankles.
• Shoulder Pull: Kneel down behind the head and reach under the armpits. Stand and drag to
safety. Use for short distances over rough surfaces.
• Blanket Drag: Log roll the victim onto a blanket, wrap the blanket, and drag to safety.
• Clothes Drag: Grab the neck and shoulders of the shirt or jacket and support the head with
your forearms. Make sure the clothes don’t press on the throat.
Emergency Carries
• Human Crutch: Support the injured leg and help the person walk on the good leg.
• Pack Strap Carry: Pull the person’s arms over your shoulders, cross at your chest and hold the
wrists.
• Seat Carry: 2 rescuers link both arms to form a seat, and the victim holds your shoulders.
o Alternate: Link 1 arm to form a seat, and link the other arm behind the victim’s back.
Sum it up
• Only drag or carry a person when necessary.
• Generally wait for professional responders to arrive and move the victim.
Learning Objectives
1. Identify the different types of bleeding.
2. Demonstrate how to stop bleeding and apply a bandage.
Key Concepts
• Minor wounds often stop bleeding without intervention.
• Severe, uncontrolled bleeding is life threatening.
• Can die of blood loss in just a few minutes.
• Control of severe bleeding is a critical treatment that can save a life.
• Firm, direct pressure on a wound will control most bleeding.
• Apply direct pressure until the bleeding has stopped or trained rescuers arrive.
External Bleeding
The body contains an average of 10 pints of blood.
• Can usually lose 1 pint with no negative effects.
o The amount for a blood donation.
• Loss of 2 pints may result in shock.
• Loss of 5-6 pints usually results in death.
! Children and the elderly have less tolerance for blood loss, and may go into shock sooner than a
non-elderly adult.
Types of Wounds
• Laceration: A cut or torn wound.
o e.g. Piece of glass, machinery accident
o Often has jagged edges.
• Puncture: Usually a deep wound with minimal bleeding.
o e.g. Nail, animal bite
o Greatest chance of infection.
o May cause internal bleeding.
• Abrasion: A painful scraping away of skin.
• Avulsion: Skin or tissue completely or partially torn from the body.
o Usually severe bleeding.
Severe Bleeding
The priority is to stop the bleeding. Do not attempt to clean the wound.
1. Scene safety, get the first aid kit and AED, put on personal protective equipment.
2. Lay the victim down.
3. Remove any clothing over the wound so you can see where the bleeding is coming from,
and if there is anything embedded in the wound.
4. Apply continuous, firm direct pressure.
a. May take more than 10 minutes.
b. Add dressings; don’t replace.
5. Treat for shock (lay flat and maintain body temperature).
6. After bleeding has stopped, apply a pressure bandage if needed to secure dressings in
place and maintain pressure.
a. Especially if you are the only rescuer and you must leave to get help.
b. Wrap an elastic or roller bandage around the limb and secure in place.
c. Don’t wrap so tightly that it creates a tourniquet effect.
Senior
If a person takes blood thinning medication, it may take much longer to control bleeding, even with
a minor wound.
Applying a Tourniquet
1. Apply a tourniquet to the limb at least 2” above the injury, but not over a joint.
2. Tighten the rod just to the point that bleeding stops, and secure it.
3. Record the time that you put it on.
4. Notify EMS that a tourniquet was applied, and the time.
Shock
• Life-threatening condition that occurs when the body’s organs and tissues don’t receive enough
oxygenated blood.
• Caused by severe injury or sudden illness.
• Immediate first aid can prevent shock or stop its progression.
• Goals of first aid care:
o Treat any obvious cause of shock
o Improve blood flow to the brain, heart and lungs
o Get emergency medical help
• Do not delay calling for emergency help.
Treatment of Shock
Do not give food or drink to a victim of severe bleeding, shock or trauma. Surgery may
be required.
! Signs of shock are not always obvious, especially in children. Suspect shock in cases of
severe bleeding.
Internal Bleeding
• Internal bleeding is concealed within the body and may not be obvious.
o Common with car accidents, falls, knife and gunshot wounds
o Can be life-threatening
• Common causes: Injury to internal organs; fractures; medical condition
• Goals of treatment: Prevent shock; get EMS responders on scene ASAP.
• Bruised, tender, swollen or hardened skin or tissues, especially in the abdominal area and
suspected fracture sites
• Chest or abdominal pain
• Bleeding from a body opening: Mouth, nose, ear, rectum, vagina, urethra
• Blood in vomit: Bright red or coffee ground appearance
• Blood in stool: Dark tarry or bright red
• Blood in urine: Red, pink or tea-colored
• Signs of shock
Traumatic Injuries
Trauma is a wound or injury caused by sudden external force or violence.
• Major trauma can result in shock, respiratory failure, and death.
• Motor vehicle accidents are the most common cause of injury-related death.
• Gunshot wounds are the 3rd leading cause.
Treatment of Amputation
a. Check for entrance and exit wound. 4. Do not disturb potential crime scene
evidence.
b. Control bleeding.
c. Treat for shock.
d. Keep the victim still.
Crush Injuries: Occur from blunt force applied for an extended period.
• Tissues are not being supplied with blood while under compression.
• Common injuries: fractures, lacerations, bruising, bleeding
• Injury scenes can be dangerous; consider secondary collapse.
Tip Don’t clean a wound with a cotton ball or anything fluffy that may leave deposits.
Senior
A skin tear is a tearing away of the skin from the tissue below.
• Common in older persons with drier, thinner, and less elastic skin.
• Result of a bump, fall, or even vigorous washing and drying of skin.
• Common on hands, arms and lower legs.
• Treat as an avulsion: replace torn skin if possible.
Risk factors for skin tears: impaired vision, limited mobility, malnutrition, use of corticosteroids,
dementia, loss of pain perception.
Nosebleeds
• Very common, but rarely life threatening.
• Usually caused by dryness.
Treatment of Nosebleeds
1. Sit in a chair and tilt the head slightly forward. 3. Apply ice pack wrapped in a moist cloth
2. Pinch the nostrils for about 10 minutes. to nose. Breathe through the mouth.
• The victim feels dizzy or weak. • The nosebleed is associated with hyper-
tension.
True False
School
True False
Work
Learning Objectives
• Describe the signs, symptoms, and treatment of head injury.
• Understand that protective gear and seat belts can prevent head injuries.
• Identify the causes, signs and symptoms of neck and spine injuries.
• Describe treatment of neck and spine injuries.
• Identify the common causes, signs and symptoms of eye injuries.
• Describe the treatments for penetrating trauma & chemicals in the eye.
• Understand the proper treatment when a tooth is knocked out.
• Know when an emergency visit to the dentist is necessary.
Head Injuries
Key Concepts
• With any head injury, assume the person also has a neck injury.
o Stabilize the head and neck as a unit to prevent further injury.
• Treat the victim in the position found.
• All head injuries should be evaluated by a physician.
Overview
Inside the skull, the brain is surrounded by cerebrospinal fluid (CSF).
• Cushions the brain from bumps of everyday activities.
• The fluid may not be able to absorb a hard blow.
• An external object can also damage the brain (penetrating head injury).
• 1.7 million traumatic brain injuries each year; 52,000 die.
Common Causes:
• Car, motorcycle, bicycle accidents
• Fall from a height greater than standing
• Physical assault
• Electrical shock or lightning strike
• Sports activities: diving, contact sports
34 Head, Neck & Back Injuries © 2011 EMS Safety Services, Inc.
External Head Injuries
Most blows to the head result in external injuries.
• Scalp lacerations bleed profusely.
• A hematoma is a large swelling on the scalp after a blow.
o The scalp’s veins leak blood into the tissue just beneath the skin.
o Will last for several days or even weeks.
• A black eye is the result of bleeding around the eye and under the skin.
o Most are not serious.
o Avoid any pressure on the eye itself.
o If there is bleeding within the eye, seek emergency medical care.
• Trauma to the nose is usually caused by blunt injury.
• Consider a facial fracture if facial irregularity.
Parents and sports coaches should be familiar with the signs of a concussion.
• A person who has had a prior concussion has an increased risk of serious brain injury and even
death in subsequent brain injuries.
• Coaches must know when to remove players from a game or practice.
• Parents must be alert to signs of head injury.
Basic First Aid Lecture Guide Head, Neck & Back Injuries 35
Signs and Symptoms of Head Injury
Senior
Falls are the leading cause of traumatic brain injury (TBI).
• People > 75 have the highest rate of injury and death from TBI.
• Reduce risk for falls.
• Recognize TBI after a fall.
• Get medical help.
Child
Shaken Baby Syndrome
• When an infant or toddler is shaken, the brain bounces back and forth inside the skull.
• Causes brain bruising, swelling, and possible brain damage or death.
• Usually younger than 2 years old.
• Can occur with as little as 5 seconds of shaking.
36 Head, Neck & Back Injuries © 2011 EMS Safety Services, Inc.
DISCUSS: How can you protect yourself and your family from head injury?
• Make sure your helmet fits properly.
• Know the signs and symptoms of concussion.
• Always wear a seatbelt; place infants and small children in child car seats.
• Keep firearms unloaded and locked away securely.
• Install child safety gates at the top and bottom of stairs.
• Use non-slip mats in tubs and showers.
• Install window guards to prevent falling out of windows.
• Wear a hard hat at work when indicated.
Sum it up
• Early response to a head injury could save a life.
• If a person has signs and symptoms of a brain injury, call 9-1-1.
The spinal cord is a group of nerve tracts extending along the back.
• Originates in the brain and ends in spinal nerves that go to the various parts of the body.
• Protected by the spine, a series of bones that extends from the base of the skull to the tailbone.
• All the information going from the brain to the limbs and back travels through the spinal cord.
When the spinal cord is damaged it can result in:
• Loss of movement, sensation, breathing and bladder control
• Immediate death
12,000-20,000 spinal cord injuries each year in the US; up to 50% will die.
• Males sustain 80% of SCI.
• >50% of SCI victims are between 15 to 35 years old.
High-risk Incidents:
• Motor vehicle accidents
• Severe blunt trauma
• Penetration injuries
• Diving and sports injuries
• Head injuries, falls
• Lightning strikes
• The victim is unresponsive for an unknown reason
Basic First Aid Lecture Guide Head, Neck & Back Injuries 37
Signs and Symptoms of Neck / Spine Injury
Sum it up
• The initial care of a spinal injury may affect the rest of the person’s life.
• If there is a chance of spinal injury, assume there is one.
Eye Emergencies
Key Concepts
• When treating an eye injury, do not apply pressure to the eye.
• Most eye injuries are preventable.
Overview
• 1 million new eye injuries each year; 43% occur in the home.
• The leading causes include:
o Household chemicals
o Yard and workshop debris
o Sports accidents
o Fireworks
o Battery acid
o Over-exposure to UV radiation
o Inappropriate games and toys with inadequate supervision
• About 40,000 sports-related eye injuries each year; 90% are preventable.
• > 700,000 work-related eye injuries each year in the U.S.
o 90% are preventable with proper safety eyewear.
38 Head, Neck & Back Injuries © 2011 EMS Safety Services, Inc.
• Gently flush the area with lukewarm water.
• If flushing does not help:
o Lay a swab across the top of the eyelid.
o Fold the lid over the swab and flush with lukewarm water, or use wet sterile gauze.
Do not try to remove something directly over the cornea.
• If you are unable to remove it, seek medical care.
• Do not rub the eye.
• Do not apply ointments or creams.
Corneal Abrasions
• A corneal abrasion is a scratch on the surface of your eye.
• It can be caused by dust, dirt, a fingernail, or even a contact lens.
• Often described as a continual feeling that something is in the eye.
• Usually very painful.
• You may notice redness, tears, blurred vision, or sensitivity to light.
• Must be evaluated by a physician and may require antibiotics.
Sum it up
• Eye injuries are the most common preventable cause of blindness.
• Wear protective eyewear when needed in the home, garden, work, and during sports.
Dental Emergencies
Key Concepts
• 5 million teeth are knocked out each year.
• If a tooth is knocked out or broken, be careful not to inhale or swallow the tooth or blood.
Tip If a tooth is lost, have a chest x-ray to see if the tooth was inhaled or swallowed.
Jaw Injury
A jaw fracture is suspected if there is:
• Pain
• Swelling
• Limited opening of the mouth
• A new malocclusion (poor bite)
• Double vision
• Facial numbness
To reduce pain:
• Close the mouth and splint the jaw with a gauze roll (or a towel, shirt or necktie).
• Do not interfere with the airway or over-tighten.
Basic First Aid Lecture Guide Head, Neck & Back Injuries 41
• Remain alert for airway complications.
• Apply an ice pack wrapped in a moist cloth.
• Seek professional medical attention promptly.
If there is airway obstruction or uncontrollable bleeding, activate EMS.
Sum it up
• Most dental trauma is preventable:
o Use mouth guards or face shields.
o Wear a seat belt.
o Don’t chew on ice or hard candy.
• See a dentist within 30 minutes if a permanent tooth is knocked out.
• If airway obstruction, activate EMS.
Learning Objectives
• Know how to recognize and treat chest and abdominal wounds.
• Understand that any pregnancy-related illness, complication or injury should be evaluated by a
physician.
Broken Ribs
• A rib fracture is painful but rarely life-threatening.
• Complications:
o Sharp bone ends can cause a punctured lung or lacerated liver.
o Observe for internal bleeding or respiratory distress.
• Bruising • Deformity
• Pain with a deep breath • Paradoxical movement
• Tenderness when palpating the injured o The flail segment moves in the oppo-
area site direction of the rest of the chest.
• Swelling
Abdominal Wounds
Open abdominal wound:
• Usually caused by a penetrating injury.
• May expose internal organs.
• Do not remove objects impaled in the abdomen.
• Do not attempt to push abdominal organs back in.
Closed abdominal injury:
• Usually caused by blunt trauma injury.
• Consider spine immobilization.
• Watch for signs of internal bleeding.
Common Causes:
• Automobile accidents
• Knife or gunshot wounds
• Medical problems related to the stomach and intestines
Basic First Aid Lecture Guide Chest and Abdominal Emergencies 43
Signs and Symptoms of Abdominal Wound
Pregnancy-Related Emergencies
• Treatment of pregnancy-related emergencies is extremely complex.
• Position pregnant victims on their left side.
• Activate EMS at any sign of sudden illness or injury.
Treatment of Appendicitis
Sum it up
• A sucking chest wound is a life-threatening situation.
• Do not remove objects impaled in the abdomen.
44 Chest and Abdominal Emergencies © 2011 EMS Safety Services, Inc.
Muscle, Bone and Joint Injuries
DVD Ch: DEMONSTRATE: PRACTICE: SUPPLIES:
14 Splint application
Sling / swathe (optional)
Splint, sling, swathe
(optional)
Splint, binding or wrap
Triangular bandages
Learning Objectives
• Define fracture, dislocation, sprain and strain.
• Describe assessment and treatment of muscle, bone & joint injuries.
• Demonstrate splint and sling application (optional).
• State the meaning of the acronym RICE.
Key Concepts
• The human body is made up of more than 600 muscles and 200 bones.
• Types of musculoskeletal injury: fractures, dislocations, sprains, strains and contusions
• A First Aid provider treats fractures, dislocations, severe sprains and strains the same.
! Compare the injured side to the uninjured side to determine deformity and swelling.
Basic First Aid Lecture Guide Muscle, Bone and Joint Injuries 45
Treatment of Fracture
Child
• Children fall frequently, but most falls do not result in a fracture.
• A child’s bones are softer than an adult’s bones.
• Fractures in children usually heal faster than fractures in adults.
• The fracture of a growth plate (area at the end of a long bone where new bone tissue
grows) may require physician follow-up to make sure there are no complications when it
heals.
Applying a Splint
Apply splints to suspected fractures, dislocations and severe sprains.
• To immobilize the joints above and below the injury.
• Should not increase pain.
• Allows transport with less pain and risk of further injury.
• Made from rigid materials or “buddy taped” to another body part.
• Usually wait for EMS personnel to splint the injury.
46 Muscle, Bone and Joint Injuries © 2011 EMS Safety Services, Inc.
7. Carefully apply the splint. Secure the splint above and below the injury, not directly over it.
8. Recheck temperature and sensation below the injury site.
Types of Splint
• Flexible splint: SAM splint
• Improvised splint: stick, magazine, blanket
• Anatomic splint: splint one body part to another
R.I.C.E. Technique
Sprains, Strains and Contusions
• A contusion is bruising resulting from a direct blow.
• A sprain is a stretching or tearing of ligaments or other structures in a joint.
• A strain is a stretching or tearing of muscle or tendon.
• Common injury sites include the shoulder, elbow, finger, hip and ankle.
• Mild sprains and strains will usually heal within 2 weeks.
• If a sprain remains swollen and painful for several days, consult a physician.
Ice: Apply an ice pack wrapped in a thin moist cloth for 20 minutes, 3-4 times a day for the first 2-3
days.
Elevate: Raise the injured area above the heart, if it does not increase the pain.
Basic First Aid Lecture Guide Muscle, Bone and Joint Injuries 47
Do not apply ice directly onto bare skin.
Do not apply heat to a new injury because it will increase swelling and bruising.
To treat a severe ankle sprain, place a horseshoe-shaped soft pad with the opening facing up
Tip on the outer ankle before applying a compression wrap. This will prevent swelling in the outer
ankle.
! People with decreased sensation, diabetes or vascular disease should consult their doctor
before applying ice.
Muscle Cramps
• The muscle is locked into an involuntary contraction or spasm.
• Cause is unknown but may involve muscle fatigue, overexertion, dehydration, exercising in
extreme heat, pregnancy, or inadequate stretching.
Sum it up
• Immobilize a suspected fracture, and wait for EMS personnel to splint it.
• Use RICE to reduce pain and swelling.
Senior
Falls and Fractures
Key Concepts
• Falls are serious for anyone, but can be especially serious for older persons.
• More than 1 in 3 people over age 65 fall every year.
o Up to 5% of these falls result in fractures.
• Over 2 million people are treated in emergency departments each year for fall-related
injuries.
48 Muscle, Bone and Joint Injuries © 2011 EMS Safety Services, Inc.
Signs and Symptoms of Hip Fracture
May be confused with a hip dislocation, which can occur after hip replacement surgery.
• The leg may be turned inward or outward in an unnatural position.
• Treat a suspected dislocation and fracture the same.
Pelvic fracture
• There may be no visible deformity, but extreme pain when trying to roll, walk, or even
move the legs.
• Call 9-1-1 (activate EMS).
Compression fracture of the spine
• The collapse of one 1 or more vertebral bones can occur with no apparent cause.
o It can be very painful or may have no symptoms at all.
o Get medical care for evaluation, pain management, and osteoporosis treatment.
• If unable to move or walk or if pain is severe, call 9-1-1.
• If the vertebral fracture is caused by an injury such as a fall:
o Call 9-1-1 (activate EMS).
o Keep the person calm and still.
o Do not move the person.
Osteoporosis
• A disease that causes a gradual loss of bone density.
• Results in extremely fragile bones that break under minimal stress.
• Women lose bone density faster than men.
• 50% of all women and 25% of all men over age 50 will sustain a fracture due to osteopo-
rosis.
Prevent osteoporosis to prevent fractures.
• See a healthcare provider to:
o Evaluate you for osteoporosis.
o Clear you to perform weight bearing activities and exercises to strengthen your
bones.
Basic First Aid Lecture Guide Muscle, Bone and Joint Injuries 49
o Evaluate your medications to see if they contribute to osteoporosis or falls.
o Evaluate your nutritional status.
• Take care of yourself.
o Stop smoking.
o Avoid excessive alcohol consumption.
o Eat a healthy and adequate diet.
Sum it up
• A fall can be serious and affect the rest of your life.
o Many people develop a fear of falling and become less active.
o Less activity leads to osteoporosis and loss of strength and mobility.
o Osteoporosis can lead to increased risk of fracture during a fall.
o Decreased strength and mobility leads to higher risk for falls.
o A fall can result in a loss of function or independence, and produce a fear of fall-
ing.
• Follow the fall prevention tips at the end of the workbook to prevent falls.
• See a healthcare provider to evaluate you for osteoporosis.
• See a physical therapist to improve your strength and mobility.
Burns
DVD Ch: DEMONSTRATE: PRACTICE: SUPPLIES:
15
Learning Objectives
• Identify the types and severity of burns.
• Describe the assessment and emergency treatment of burns.
Key Concepts
• Cool thermal burns with water.
o Helps stop the spread of a burn.
• About 4,500 fire and burn deaths per year.
• About 20,000 more are injured from fire and burns.
• Smoke alarms decrease your risk of dying in a fire by 50%.
Thermal Burns
• Ensure scene safety.
• Stop the heat source.
• Death often results from smoke rather than heat or flames.
• Hypothermia may occur in large burns due to decreased ability to retain heat.
o Prevent further heat loss by covering the victim with a clean white sheet.
50 Burns © 2011 EMS Safety Services, Inc.
Treatment of Minor Burns
• Do not try to remove jewelry and clothing that has been burned into the skin.
• Do not apply ice directly onto the skin.
• Do not break blisters.
Senior
• Seniors are more at risk for burns due to:
o More difficulty differentiating between hot and cold
o Decreased pain perception
• The young and the elderly have the most difficulty recovering from severe burns.
• Unexplained or suspicious burns could be an indication of abuse.
Child
• The young and the elderly have the most difficulty recovering from severe burns.
• Unexplained or suspicious burns could be an indication of abuse.
Electrical Burns
1. Scene safety: turn off the power supply.
2. Call 9-1-1 (activate EMS).
3. Provide CPR or treat for shock if needed.
4. Look for entrance and exit wounds, and treat thermal burns.
All victims of electrical burns need to be evaluated by a physician!
True False
Work
5 The signs and symptoms of a fracture may in-
clude:
Learning Objectives
• Recognize the signs and symptoms of a respiratory emergency, and know how to respond.
• Describe the appropriate emergency treatment for severe asthma.
Key Concepts
• Sudden, severe difficulty breathing is a medical emergency.
• Recognition of the emergency and prompt activation of EMS is critical. Delay can be fatal.
• Approximately 25 million Americans suffer from asthma.
• A person with a history of severe asthma attacks may wear medical alert jewelry and carry a
quick-relief inhaler.
Senior
COPD is a group of lung diseases, including chronic bronchitis and emphysema, which
limit the flow of air into and out of the lungs.
• 80% of all cases are caused by heavy, long-term cigarette smoking.
• COPD cannot be cured; symptoms can be controlled.
o Quit smoking
o Exercise
o Proper diet
o Adequate rest
o Stress management
When surveying the scene, quickly look for clues to the cause of the problem:
Tip • Partially eaten food
• Asthma inhaler present
• Poisons present (e.g. opened chemical containers or pill bottles)
• Drug paraphernalia
• Medications stored in a disorganized way
• Oxygen tank
• Accident scene
When assessing the victim, quickly try to determine the cause of the breathing difficulty:
• What happened to cause the problem?
• Is there a history of severe allergy or asthma?
• Are there other symptoms of heart attack or stroke?
1. Activate EMS (call 9-1-1). 3. Keep the person calm and still.
2. Position of comfort, usually sitting up.
Senior
Pneumonia
• A respiratory condition that destroys lung tissue & causes fluid build-up around the lungs
• Reduces the lungs’ ability to get oxygen, so a person breathes faster to compensate.
• Very serious illness for older adults or people with chronic illness
• > 52,000 people die of pneumonia each year in the U.S.
• If you suspect pneumonia, see your doctor right away.
• Pneumonia is preventable with vaccination.
Asthma
• A chronic disease in which the main air passages of the lungs become inflamed.
• Many asthmatics carry inhaled medication that can quickly open airways.
• By treating attacks early, the severity of the attack is usually reduced.
• Asthma attacks are usually brought on by triggers:
o e.g. Odors, exercise, stress, smoke, pollution, allergens, respiratory infection.
• Avoid the triggers of asthma attack (except exercise).
• Suspect asthma in a person with a history of asthma attacks.
Senior
• Some people develop asthma later in life.
• Take action to control asthma triggers.
• Tell your doctor if you have symptoms of asthma.
o Certain medications can provoke asthma.
o There are alternatives to most medications that may not cause an asthma attack.
• Ask your doctor for an asthma treatment plan.
• Keep an updated list of current medications and dosages.
• Tell your friends and relatives how to help you in case of an asthma attack.
• Get a flu shot each year.
o Respiratory infections are a common trigger for asthma.
Make sure the victim is fully alert before assisting with an inhaler.
Make sure the person is using his or her own prescription quick-action inhaler, and it has not
!
expired.
A person with asthma should follow his or her healthcare provider’s instructions for use of an
inhaler if they differ from these instructions.
In some regions a first aid provider is not allowed to help administer asthma medication. Follow
your state, local and workplace regulations for the use of prescribed asthma medications.
Child
• If you are a caregiver of an asthmatic child, make sure the parents leave the child’s medica-
tions with you, along with specific instructions.
• Follow your state guidelines for storage and use of medications.
Sum it up
• If you suspect a respiratory emergency, call 9-1-1 without delay.
• Control asthma with medicine and avoiding triggers.
Learning Objectives
• Identify the signs and symptoms of an allergic reaction.
• List 5 common allergens.
• Demonstrate the correct use of an epinephrine auto-injector.
Key Concepts
• An allergy is an overreaction of your body’s immune system to a substance.
• 50 million Americans suffer from allergies.
• The quicker the onset of symptoms, the more severe the reaction.
• Allergic reactions get worse with each exposure.
• A person with a severe allergy may wear medical alert jewelry.
Common Allergens
• Inhaled: Pollen, mold spores, dust, pet dander, smoke, pollution
• Swallowed: Shellfish, dairy products, drugs, eggs, nuts, chocolate
• Injected: Bee sting venom
• Poisons: Can be inhaled, swallowed or injected
Anaphylactic Shock
• The most severe result of an allergic reaction.
• Causes swelling in the airways and a sudden drop in blood pressure.
• It is life threatening and requires immediate emergency medical care.
• Death can occur within minutes.
• Suspect anaphylaxis when signs and symptoms involve more than one body system (respira-
tory, cardiovascular, skin, gastrointestinal)
Epinephrine
• People with known severe allergies may carry an epinephrine auto-injector.
• Epinephrine is the most commonly used drug for emergency treatment of anaphylaxis.
• The sooner it is administered, the more effective it is in stopping the reaction.
1. Carefully remove the safety cap and press the tip firmly against the outside of the thigh, be-
tween the hip and knee.
2. Hold for 10 seconds, then pull straight out.
3. Rub the injection site for about 10 seconds.
4. Record the time of the injection.
5. Dispose of the auto-injector safely, or give to EMS when they arrive.
!
The person should follow his or her healthcare provider’s instructions for use of an epinephrine
auto-injector if they differ from these instructions.
Follow your state, local, and workplace guidelines and regulations for use of an epineph-
rine auto-injector as a first aid treatment.
Key Concepts
• A seizure is an abnormal electrical discharge in the brain.
• About 10% of the U.S. population will have a seizure during their lifetime.
• Almost 3 million Americans have epilepsy, the most common cause of seizure.
o Condition in which the person has repeated seizures.
o Usually controlled by medication.
• If someone tells you he thinks he is going to have a seizure, believe him.
Types of Seizure
• May affect only one part of the body, or may affect the whole body.
• Symptoms displayed will depend on the cause of the seizure and the part of the brain that is af-
fected.
o A petite mal seizure can appear as a staring episode (day-dreaming).
o A grand mal seizure has more dramatic symptoms, and commonly requires first re-
sponder intervention.
Child
Febrile seizures
• Triggered by a rapidly increasing body temperature usually to over 102°.
• Most common before age 2, but seen in children up to age 5.
• About 3-5% of children between 9 months and 5 years of age have at least one febrile
seizure.
• Most febrile seizures do not cause any harm.
1. Place the victim face up on the floor; remove nearby objects and furniture.
2. Protect the victim’s head from injury with a small pillow or other soft object such as a
blanket or jacket.
a. Ensure that you do not close the victim’s airway or restrict movement by raising
the head too high.
3. Try to loosen any tight clothing, especially around the neck.
4. Ask spectators to leave.
5. Time the seizure.
6. Do not restrain or put anything in the person’s mouth.
7. Do not move the victim unless he or she is in a dangerous location.
Treatment of Fainting
Senior
Fainting
• Don’t ignore fainting.
• May be a sign of a more serious medical condition.
• May indicate the need for medication adjustment.
• Can cause serious injury if you fall.
Postural Hypotension
• A drop in blood pressure (hypotension) that occurs with a sudden change in posture.
o Change from sitting to standing.
o Change from lying down to sitting or standing.
• More common in older people.
• Can make you feel dizzy, lightheaded, or even faint.
• Lasts from a few seconds to a few minutes, depending on the cause.
Vertigo
• A sense of movement or rotation of a person or their surroundings.
o High risk for falls.
o Get medical care to determine the cause.
Sum it up
• After a seizure or fainting, assess response, breathing, circulation and appearance.
• Stay with the person until he or she is responsive, alert, and speaking.
• People who lose consciousness may vomit.
• Ensure airway remains unobstructed.
• Activate EMS. A physician should determine the cause of all first time or repeated seizures.
Diabetic Emergencies
DVD Ch: DEMONSTRATE: PRACTICE: SUPPLIES:
19
Learning Objectives
• Identify the signs and symptoms of low blood sugar.
• Describe the treatment for diabetic emergencies.
Key Concepts
• Diabetes is a disease that decreases a person’s ability to process sugar.
o Most of the food we eat is broken down into glucose for energy.
Do not give chocolate in a diabetic emergency because it does not contain enough sugar.
Tip A person who has had a diabetic emergency should be evaluated by a physician to check medi-
cation dosage.
Exercise, diet, and medications are the basis of diabetes management.
Sum it up
• Do not ignore the early symptoms of low blood sugar.
o Shaky, nervous, irritable, confused
• Provide care before it becomes an emergency.
• Give sugar in all diabetic emergencies.
o You can quickly improve symptoms of low blood sugar.
o There is little risk of worsening the condition of a person with high blood sugar.
Instructor Note: This topic is only for the CPR and First Aid for Childcare Providers and the Senior
Community Student Workbooks.
Senior/Child
Learning Objectives
• Describe the signs, symptoms, and emergency treatment of dehydration.
• Understand when a person may be at risk for dehydration.
Key Concepts
• Children and older people dehydrate more quickly than younger adults.
• Severe dehydration can lead to seizures, permanent brain damage, shock and even death.
Dehydration occurs when the body does not have as much water and fluids as it should.
• Our bodies lose fluid every day from sweat, urine, and feces.
• Fluids are replaced through normal eating and drinking.
• Dehydration occurs when fluid loss exceeds fluid intake.
Causes of Dehydration:
• Losing too much fluid from vomiting or diarrhea, excessive urination, excessive sweating,
fever
o Excessive sweating may occur during extended exercise or on a hot day.
o Fever causes more water to evaporate from the body.
• Not drinking enough fluids due to:
o Loss of appetite or decreased alertness from illness
o Nausea
o Sore throat or mouth sores
• May be a combination of both.
Senior
• Older people dehydrate more quickly than younger adults.
• People with chronic illness are also at higher risk.
o Uncontrolled diabetes produces excessive urine output.
o Doctor may test your blood sugar to check for undiagnosed diabetes.
• Decreased sense of hunger or thirst, so don’t realize you need to drink more.
• If the doctor prescribed water pills or fluid restriction, ask the doctor how much to drink
when the weather is hot.
Mild/Moderate Dehydration
• Dry or sticky mouth
• Less active, sleepy
• Low urine output
• Dark-colored urine (concentrated)
Severe Dehydration
• Very dry mouth
• No tears
• No urine output
• Skin is loose and wrinkled
• Very sleepy, drowsy, lethargic or unresponsive
• Sunken eyes
• Skin is cool and blotchy (mottled) on arms, hands, legs and feet
• Rapid heart rate
• Severe weakness, dizziness or lightheadedness
• Dizziness when you get up
• Signs of shock
Treatment of Dehydration
Mild Dehydration
1. Drink fluids as tolerated. Frequent, small amounts are better tolerated than a large
amount at one time.
2. Treat the cause of dehydration. Follow healthcare provider’s advice for medications and
management of diarrhea and vomiting.
a. Mild diarrhea: Bland foods, clear liquids as tolerated.
b. Mild vomiting: Stop eating solid foods. Wait 2-3 hours, then try to drink clear flu-
ids in small amounts.
a. Severe diarrhea and vomiting: Discontinue fluids and solid foods. Call physician
or take person to emergency department. May require IV fluids and hospitaliza-
tion.
Moderate/Severe Dehydration
1. Assess response, breathing, and appearance.
2. Call 9-1-1 (activate EMS).
Mild/Moderate Dehydration
• Dry mouth with few tears when crying
• Fussy, less active, not wanting to play
• Infants: wet fewer than 6 diapers per day
• Children: fewer trips to the bathroom to urinate
• Dark-colored urine (concentrated)
Severe Dehydration
• Very dry mouth
• Cry without tears
• Skin is loose and wrinkled
• Very sleepy, drowsy, or unresponsive
• Sunken eyes
• Sunken fontanelles in an infant (the soft spot on the top of the head)
• Skin is cool and blotchy (mottled) on arms, hands, legs and feet
• Rapid heart rate for age
• Signs of shock
Treatment of Dehydration
Mild Dehydration
1. Drink fluids as tolerated. Frequent, small amounts are better tolerated than a large
amount at one time.
2. Treat the cause of dehydration. Follow healthcare provider’s advice for medications
and management of diarrhea and vomiting.
a. Mild diarrhea: Bland foods, clear liquids as tolerated.
b. Mild vomiting: Stop eating solid foods. Wait 2-3 hours, then try to drink clear
fluids in small amounts.
c. Severe diarrhea and vomiting: Discontinue fluids and solid foods. Notify par-
ents or guardians, call physician, or take child to emergency department. May
require IV fluids and hospitalization.
Moderate/Severe Dehydration
1. Assess response, breathing, and appearance.
2. Call 9-1-1 (activate EMS).
Senior/Child
Prevent dehydration before it occurs
• Recognize conditions that may cause dehydration and ensure adequate fluid intake.
• If a person is sick, treat the symptoms to reduce water loss and encourage fluid intake.
o Illness with sore throat may cause pain when drinking fluids
o Illness with fever increases water loss through evaporation
o Diarrhea and vomiting are common causes of diarrhea.
Tip If vomiting or diarrhea seems to be caused by a new medication, talk to your doctor. There
are often many choices of medications that are effective but have fewer side effects.
Sum it up
• Make sure to get enough fluids whether ill or physically active.
• When a person is dehydrated due to sweating or hot weather, be alert to heat-related illness.
• Get medical care when ill to stop the progression to severe dehydration.
• Dehydration that is recognized and treated early usually has a good outcome.
Poisoning
DVD Ch: DEMONSTRATE: PRACTICE: SUPPLIES:
20
Learning Objectives
• Describe the signs, symptoms, and emergency treatment of poisoning.
• Know when to call the poison control center and when to activate EMS.
Key Concepts
• A poisoning occurs when exposure to a substance results in bodily harm.
• Poison control centers receive over 4 million calls each year.
• About 91% of poisonings occur at home.
• Poisons can be swallowed, inhaled, absorbed through the skin, or injected.
A rescuer must recognize that a poisoning may have occurred and act fast!
• Look for clues to a poisoning.
o e.g. Empty bottles, opened containers, disturbed plants
• Try to identify the poison, how much and when it was taken.
Heat Emergencies
DVD Ch: DEMONSTRATE: PRACTICE: SUPPLIES:
21
Learning Objectives
• Describe the signs, symptoms, and emergency treatment for heat exhaustion and heat stroke.
Key Concepts
• Heat-related emergencies are a true medical emergency.
• They usually result from heavy exercise, work, or play in hot weather.
• They also occur when people spend a prolonged amount of time in the heat, such as during a
heat wave.
• > 1,500 people die from excessive heat each year in the U.S.
1. Stop activity and move to a cool location. 3. Gently stretch and massage muscles.
2. Drink sports drink or juice.
Heat Exhaustion
• Dizziness
1. Stop activity and lie down in a cool location. 4. Drink sports drink or juice if tolerated.
2. Remove clothing. a. No nausea, vomiting, seizure, or
3. Cool the person (cool water bath, spray, confusion.
fan) b. Responsive, coherent, able to
hold a glass without help.
Heat Stroke
• The body is unable to regulate its temperature.
• Body temperature rises rapidly.
• Can lead to brain damage or death if not treated quickly.
Senior
• Older people are more prone to heat illness due to physical changes in the body:
o Fewer sweat and oil glands in the skin result in less effective heat loss through
evaporation.
o Decreased blood circulation to the skin results in less heat radiation through the
skin.
o A temperature that does not seem too hot to others could cause heat illness in an
older person.
• Scene size-up should include the temperature of the home.
• An environment that is too warm or a person dressed too warmly could also indicate a
heat-related emergency.
Child
• Do not leave a child alone in a car on a hot day.
• When the outside temperature is 93° F, the temperature inside a car can reach 123° F in
just 20 minutes.
Sum it up
• Heat exhaustion can quickly progress to heat stroke.
• Heat stroke can lead to brain damage or death if not treated promptly.
• Recognize and care for heat-related illness before it becomes life-threatening.
76 Heat Emergencies © 2011 EMS Safety Services, Inc.
Cold Emergencies
DVD Ch: DEMONSTRATE: PRACTICE: SUPPLIES:
22
Learning Objectives
• List actions that can help prevent a cold-related emergency.
• Describe the signs, symptoms and treatment of hypothermia and frostbite.
Key Concepts
• Your body loses heat in water up to 25 times faster than in air.
• Cases have been recorded in temperatures as high as 65° F.
Hypothermia
• Hypothermia is abnormally low body temperature.
• Immersion in cold water is the most common cause of hypothermia.
• Hypothermia is a serious, life-threatening condition.
Treatment of Hypothermia
Do not give alcohol (may cause heat loss) or coffee (may cause dehydration).
Do not apply direct heat if you are near medical care.
Do not immerse in warm water because it will warm the person too quickly.
Frostbite
• Frostbite is the actual freezing of body tissues.
• Caused by prolonged exposure to cold.
• Children are more at risk, because they lose heat more rapidly than adults.
Treatment of Frostbite
Do not rewarm with direct heat (over a stove, open flame or heating pad)
Do not rub frostbitten skin.
Do not rewarm the part if it may refreeze.
Senior
Seniors are more susceptible to cold emergencies.
• Decreased ability to sense a change in temperature.
o The body is supposed to sense a change in temperature, then respond by generat-
ing heat (shivering) or dissipating heat (sweating).
o Temperature may need to change by 10° F before can sense the change.
o Loss of muscle mass results in less shivering in cold temperatures to keep the body
warm.
o Weight loss and less fat under the skin results in less insulation against the cold.
• People with medical conditions that impair sensation, blood flow or movement are at in-
creased risk for hypothermia.
Sum it up
• Immersion in cold water is the most common cause of hypothermia.
• Take precautions to prevent a cold-related emergency.
Drowning
DVD Ch: DEMONSTRATE: PRACTICE: SUPPLIES:
Instructor Note: This topic is only for the CPR and First Aid for Childcare Providers Student Workbook.
Learning Objectives
• Know how to respond safely to a drowning emergency.
• Understand that a small child should never be left alone when there is a chance of drowning.
Key Concepts
• About 4,000 people die each year from unintentional drowning.
• Drowning is the leading cause of injury death in children age 1-4, and the 2nd leading cause of
death in children under age 14.
• Nonfatal drowning can result in severe brain damage with impaired memory, learning, and basic
functioning.
• Drowning is preventable.
Water Safety
Water safety is especially important in a home with small children.
• Drowning can occur quickly and in very little water.
o e.g. Bucket, toilet, bathtub with just 1” of water.
• Always closely supervise a child who is near any water.
! Drowning victims commonly vomit during CPR. Carefully log roll the victim to the side, sweep
the mouth clear, roll back, and continue CPR.
Sum it up
• The speed of response is critical for a drowning victim.
o Giving immediate chest compressions and rescue breaths may possibly revive a drown-
ing victim without the use of an AED.
• All drowning victims should be seen by a physician. Even if they seem fully recovered, compli-
cations may develop later.
Learning Objectives
• Know which insects and snakes are poisonous.
• Know the proper treatment for bites and stings.
• Call 9-1-1 if there is severe bleeding, the animal remains a danger, or the animal may have
rabies.
• Get medical care for further wound cleaning, stitches, rabies vaccination, signs of infection,
or care of bites to the face, neck or hands, deep puncture wounds, or large lacerations.
Human Bites
• Can be as dangerous as animal bites due to possibility of infection.
• May occur when very young children are playing, during a fight, in a mental institution, or in a
prison.
• A physician should always evaluate human bites.
Basic First Aid Lecture Guide Bites and Stings 81
Snakebites
Key Concepts
• 7,000 - 8,000 venomous snakebites each year in the U.S.
• Most snakes are not poisonous.
Treatment of Snakebites
1. Scene safety. Call 9-1-1 if you suspect the bite is from a venomous snake.
2. Keep the victim calm and still, with the bite area lower than the heart. Decrease activity.
3. Wash the wound gently with soap and running water.
4. Remove jewelry and constrictive clothing; swelling can progress rapidly.
5. Wrap an elastic bandage around the entire bitten arm or leg, starting furthest from the heart.
a. Use overlapping turns.
b. Wrap snugly but still allow a finger to slip under the bandage.
c. Check temperature and sensation below the wrap to make sure it is not too tight.
6. Get medical help immediately. Antivenom must be given within a few hours.
7. Mark the border of the swelling/redness every 15 minutes with a pen.
Treat all unknown snakes as poisonous. Consider the need for a tetanus shot.
1. If stung by a bee, quickly scrape off the stinger with your fingernail or a straight-edged ob-
ject.
2. Speed is important; 90% of the venom is delivered within 20 seconds.
3. Wash with soap and water.
4. Apply an ice pack wrapped in a moist cloth for 10 minutes on, then 10 minutes off.
5. Consider over-the-counter medications for itching, pain & inflammation.
6. See your physician if the swollen area is large, if the sting site is in the mouth or nose, or if
you develop mild nausea, intestinal cramps or diarrhea.
Anaphylaxis
• Difficulty breathing or wheezing • Facial, throat or tongue swelling; difficulty
• Hives and rash swallowing
• Shock
Bark scorpion
• Scorpions in the U.S. are found mostly in the southwest.
• Only the bark scorpion (found primarily in Arizona, New Mexico and on the California side of the
Colorado River) is dangerous to humans.
• Scorpions only sting when provoked.
! Children under 10 and older people are more at risk to develop serious symptoms.
Antivenom is available for scorpion stings or black widow bites.
Tick Bites
Key Concepts
• Found in the woods, shrubbery, high grasses, gardens, marshes & beaches.
• Most tick bites are harmless; some transmit life-threatening diseases.
• Check for ticks on parts of the body that bend, on top of the head, behind the ears, on the neck
and hairline, where clothing presses on the skin.
Do not use petroleum jelly, alcohol, or a hot match to kill the tick.
Do not handle the tick with your bare hands.
Sum it up
• Most bites and stings are preventable.
o Teach children to treat dogs with caution.
o Keep your hands and feet out of areas you can’t see.
o Use insect repellant.
• If a bite victim develops serious symptoms, seek medical help immediately.
QUESTIONS SCENARIOS
Home
1 Someone having difficulty breathing will probably
choose to:
True False
School
Work
Maltreatment of Children
DVD Ch: DEMONSTRATE: PRACTICE: SUPPLIES:
Instructor Note: This topic is only for the CPR and First Aid for Childcare Providers Student Workbook.
Learning Objectives
• Recognize the signs of child maltreatment.
• Know how to report it if needed.
Key Concepts
• Child maltreatment is when a child or young person is being harmed physically, emotionally,
sexually, or through neglect of basic needs.
• There are > 3 million reports of child abuse or neglect each year in the U.S.
o Almost 800,000 children are actual victims of maltreatment.
• Teachers, caregivers, and healthcare professionals are usually required by law to report their
suspicions to child protective services, social services, or local police.
Types of Maltreatment
Physical abuse: The willful infliction of physical injury to a child.
• Shaken baby syndrome is a leading cause of brain injury in infants.
Emotional or psychological abuse: A deliberate attempt to make a child feel worthless and incompe-
tent.
• e.g. Rejecting, isolating, terrorizing, ignoring, or corrupting
Sexual abuse: The rape, molestation, prostitution, or sexual exploitation of a child.
• May also be the employment or coercion of a child to engage in, assist in, or simulate sexually
explicit conduct.
• The incidence of sexual abuse increases with child age.
Neglect: Depriving a child of basic physical needs.
• e.g. Shelter, warmth, supervision, safety, medical care
• The most common form of child maltreatment.
Basic First Aid Lecture Guide First Aid Kit Contents / Maltreatment of Children 87
Warning Signs of Abuse
Child:
• Unexplained or suspicious injuries
• Multiple healing injuries
• Untended medical conditions
• Delayed physical or emotional development
• Frequent absence from school
• Extremes in behavior (e.g. Overly compliant, angry, aggressive)
• Sudden change in school performance
• Sudden refusal to participate in sports or change for gym
• Does not want to go home
• Frightened of certain adults
• Lack of adult supervision
• Steals or begs for food or money
• Poor hygiene or inadequate clothing for the weather
• Drug or alcohol abuse
• Self-destructive or depressed
• History of running away or suicide attempt
• Sophisticated sexual behavior or knowledge
• Reports abuse or neglect
Parent or Caregiver:
• Gives implausible explanation for injury
• Unconcerned or indifferent about the child
• Considers the child bad, worthless, or a burden
• Constantly criticizes or blames the child
• Uses or recommends harsh punishment
• Expects perfection that the child cannot achieve
• Extremely protective or secretive about the child
• Drug or alcohol abuse
• History of being abused as a child
Sum it up
• Accusation of child abuse is very serious.
• Try to rule out causes other than abuse, but do not delay reporting your suspicions.
• Do not count on someone else to report signs of abuse or neglect.
• Know your local and state guidelines, and post telephone numbers for reporting.