UETTDRRF10 -Provide First Aid In An ESI Envirnment

Your primary assessment in an emergency situation: DRSABCD

Staying calm in an emergency situation is not easy.

The action plan DRS ABCD will help you stay focussed on providing the best support for a casualty:

Click on this link to Shock verdict for a practical and amusing video demonstration of
DRS ABCD.
What is CPR?

The need for cardiopulmonary resuscitation (CPR) arises when a person's breathing or heartbeat has
stopped or is abnormal. The supply of oxygen to the brain and vital organs is interrupted and this can lead
to severe damage or even death.

Whenever someone is seriously ill or injured or in need of urgent medical help, you will need to call Triple
Zero 000 immediately to organise professional care.

CPR is a technique to help you as a first aider to save a life. By giving compressions you simulate the
person's heart beat and keep their circulation going. And by giving a rescue breath, you provide the
casualty with oxygen that allows the casualty's cells to metabolise energy to perform vital functions such as
muscle movement. This includes the body's most precious involuntary muscle: the heart.

CPR will help you to keep a casualty's organs alive until the arrival of advanced medical care. Find out more
about CPR: ANZCOR Guideline 8 - Cardiopulmonary Resuscitation (CPR)

Take some time to reflect on the individual steps of the DRS ABCD:

 Dangers? What dangers can you think of in emergency situations?

Dangers for you as a first aider? How can you protect yourself? Dangers for the casualty?

 Response? Is the casualty responsive?

What does the response look like?

 Send for help What are the main numbers for Emergency Services?
How would you organise help in your workplace?

 Airway? Is the airway open?

What can block the airway? How can you clear it?

 Breathing? Check for breathing (LOOK, LISTEN and FEEL)

Look for rise and fall of the chest Listen for breathing sounds?
Feel the chest for movement

The casualty is not breathing or not breathing normally:

 CPR Start CPR if no normal breathing is detected

Start with 30 chest compressions, followed by 2 rescue breaths

 Defibrillator
Attach the Automated External Defibrillator (AED) as soon as possible andfollow instructions.
Checking vital signs

It is important to check Level of response. If a person is unconscious, the first step is to check their mouth
for any item blocking the airway. These items could include their tongue, food or vomit. If blockages are
found, gently roll the person onto their side, into the recovery position. Clear any blockages using your
fingers, then check for breathing. If no blockages are found, roll the person onto their back and check for
breathing. Listen for the sound of the breath, look for the movements of the chest or feel for the breath on
your cheek.

It is not essential to search for a pulse when a person is found with no signs of life. It can be difficult to find
a person's pulse sometimes and time can be wasted searching. If CPR is necessary, it must be started
without delay.

Where there is more than one casualty, always give priority to the unconscious casualty.

C.O.W.S will help you remember

Determine a casualty's level of consciousness via a gentle touching and loud talking. Do not shake the
casualty. Casualty examination for first aid follows a plan which is known by the acronym 'COWS'.

This is used to remind first aid providers of some simple steps that will help to determine a casualty's ability
to respond. These steps are:

 C an you hear me?

 O pen your eyes
 W hat's your name?
 S queeze my hand

If the casualty is conscious and they express no pain, observe their behaviour for any distress, unusual
position or posture and any body-swelling.

Convey details of casualty's condition

S stands for SEND. It is critically important to have emergency service's attend the site as quickly as
possible. When you make the phone call, the operator and will ask you for details such as:

 location of casualty-providing the exact address is best, but if you aren't sure of this, give some
landmarks or nearest cross streets, and some directions.
 the number of casualties effected
 the nature and extent of illness or accident -include the physical condition of the casualty, and any
relevant signs and symptoms (see below for more details)
 the number of the phone you are using
 your name.

If you are carrying out first as you call, put your phone on loud speaker so you can continue to use your
hands. Then hold the line to answer any further questions and provide any other relevant details, such as
damaged power lines.
When providing details of the casualty's condition, include the following

 Colour-What colour is the casualty's skin?

 Conscious state-Is the casualty conscious?

 Breathing-Is the casualty breathing? If not, have rescue breaths and CPR commenced?

 Bleeding-Is the bleeding controlled? Is it bright red spurting blood or dark red flowing blood?

 Pupils-Are the pupils of equal size and reacting to light?

 Shock-Are there signs of shock (pale, sweaty, nauseous, cold)?

 Movement-Does the casualty have coordinated movement?

 Can the casualty feel and move limbs, if conscious?

 Anything abnormal (such as bruising, a bone sticking out or swelling).

First Aid Treatment:- Electric shocks and Burns

Electric shocks are caused by contact with live electricity that sends an electric current through the body.
Sometimes the electricity can cause a burn, often where the electricity entered or exited the body. Electric
shocks can cause little more than a fright and some pain, or they can be severe enough to knock someone
unconscious and stop their heart and leave severe burning to the skin.

When should I call an ambulance or go to the emergency department?

An electric shock can be life threatening. Call an ambulance on triple zero (000) if someone has had an
electric shock and:

 lost consciousness, even for a second

 they are breathing very fast or very slow
 their heartbeat is very fast, or very slow, or irregular

Even if you can't see a physical injury, an electric shock might cause internal damage. Even for a mild
electric shock, you still need medical attention to assess whether it's affected the heart. Always take
someone who has been shocked to the nearest emergency department for assessment.

What should I do while waiting for an ambulance?

If someone near you receives an electric shock, do not put yourself in danger:

 look first, don't touch - the person may still be in contact with the electricity, and if you touch them,
you will receive an electric shock
 switch off the electricity at the mains, remove fuses, turn off all powerpoints and unplug all cords
before approaching the person
  if that's not possible, use material that does not conduct electricity, such as a dry wooden broom
handle, to separate the person from the electricity source
 take particular care if the victim is in contact with water, which carries electricity

When it is safe, check if the person is conscious and breathing. Gently touch and talk to the person. If there
is no response, start CPR.

If there is an electrical burn, you can treat it in the same way as you would any other burn. Put the burnt
area under running water for at least 20 minutes then cover with a sterile gauze bandage, if available, or a
clean cloth. Don't use a blanket or towel, because loose fibers can stick to the burns.

There should be an Emergency Burns Kit at every work site. These kits contain a varity of burn dressings.
Each burn dressing satchel is clearly marked to indicate where to apply the dressing on the body of the
casualty.

What are the symptoms of an electric shock or burn?

The signs and symptoms of an electric shock depend on the type of current, how high the voltage is, how
long the person was in contact with electricity, and their overall health.

The symptoms of an electric shock are:

 difficulty breathing or no breathing at all

 a weak, erratic pulse or no pulse at all
 burns
 loss of consciousness
 cardiac arrest
What causes electric shocks or burns?

Common causes include:

 Chemicals
 Electricity
 Hot Water
 Friction

First Aid Treatment:- What to do to treat Severe Bleeding

1. Help the patient to lie down, particularly if the bleeding is severe.

2. Remove or cut the patient's clothing to expose the wound.

3. Ask the patient to apply direct pressure over the wound, or as close to the point of the
bleeding as possible. If the patient is unable to apply pressure, use a pad or your hands.

4. Squeeze the wound edges together if possible.

5. Apply a pad over the wound if not already in place.

6. Secure the pad by bandaging over it. Ensure the pad remains over the wound.

7. If bleeding is still not controlled, leave the initial pad in place and apply a second pad and
secure it with a bandage.

8. If bleeding continues through the second pad, replace the second pad leaving the first pad in
place, and rebandage.

9. Do not give the severely bleeding patient any food or drink, and call triple zero (000) for an
ambulance.

10. Check every 15 minutes that the bandages are not too tight and that there is circulation
below the wound.

Call for and Amulance and continue to check the patient's breathing

What are the symptoms of severe bleeding?

As well as the obvious sign of blood coming from a wound, signs and symptoms of severe bleeding include:

• weak, rapid pulse

• pale, cool, moist skin

• pallor, sweating
 • rapid, gasping breathing

• restlessness

• nausea

• thirst

• faintness, dizziness or confusion

• loss of consciousness.

First Aid Treatment:- Bites and Stings

Bee stings, wasp stings and ant stings

Bee, wasp stings and ant bites are the most common triggers of anaphylaxis caused by insect stings.

Wasps are generally more aggressive than bees and are attracted to food and sugary drinks. Check open
food and drink containers when you are outdoors before you eat or drink from them.

Take these steps if you are stung by a bee:

 do not use tweezers to remove the sting; bees leave behind a sac of venom, and if you try to use
tweezers you will release more venom from the sac
 if the stinger is still in the skin, gently try to remove it by scraping it carefully from the side with the
edge of a firm object, such as a finger nail or credit card - flicking the sting out as soon as possible to
reduce the amount of venom injected
 when you have removed the sting, wash the affected area with soap and water and dry the area
gently

Wasps and bull ants rarely leave their sting in the skin. Use a cold pack and soothing cream to relieve a
minor reaction, and take a oral antihistamines to treat the itch.

If the pain is persistent and continues, see your doctor. You may need cortisone tablets to settle the
swelling.

Ticks

Allergic reactions to ticks range from mild (with large local swelling and inflammation at the site of a tick
bite) to severe (anaphylaxis).

To prevent allergic reactions to ticks do NOT forcibly remove the tick. Disturbing the tick may cause the tick
to inject more allergen-containing saliva. The options are to:

 leave the tick in place and seek medical assistance; or

 freeze tick (using a product that rapidly freezes and kills the tick) and allow it to drop off
Ticks can attach to your skin when you're out and about in the bush.

To protect yourself from ticks, wear light coloured clothing, tuck your trousers into your socks and spray an
insect repellent containing diethyltoluamide (DEET) or picaridin onto your skin, shoes and socks.

After returning from a tick area, thoroughly check the whole body of all members of the party (especially
children) for ticks. Pay particular attention to the back of the head and neck, groin, armpits and back of the
knees. You can have more than one tick.

If you are not allergic to ticks, kill it first with an ether-containing spray such as Wart-Off Freeze® or
Elastoplast Cold Spray® and then remove it as soon as possible.

If you are allergic to ticks, do NOT forcibly remove the tick. Kill it first with an ether-containing spray such as
those mentioned above and then have it removed by a doctor or go to the Emergency Department.

DO NOT:

 grasp the tick by the body,

 apply methylated spirits or fingernail polish, or
 use a lighted match, or cigarette

Once the tick is out, apply antiseptic cream to the bite site. Tick bites can remain slightly itchy for several
weeks. If the tick isn't fully removed, you should look out for signs of infection - redness, pain around the
wound site, pus or clear liquid coming from the wound, and a high temperature over 38°C.

See your doctor if you develop a reaction around the bite site, or if you feel generally unwell or experience
muscle weakness or paralysis after a tick bite.

Mosquito bites

Mosquitoes cause itchy bites but severe allergic reactions are rare. Some types of mosquitoes can spread
serious diseases .

See your doctor if you develop a rash, flu-like symptoms such as fever, chills, headaches, joint and muscle
pains (swelling or stiffness), fatigue, depression and generally feel unwell.

Most mosquito bites can be managed by washing the area with soap and water and applying an antiseptic.
Cold packs may help with local pain and swelling. To lessen your chance of being bitten by mosquitoes (and
midges), cover up as much skin as possible and stay inside in the early morning or at dusk. Use an insect
repellent when you are out and about and there are mosquitoes around.

Scorpion and centipede stings

Take these steps if stung by a scorpion or a centipede:

 apply an ice pack to the sting or bite site

 clean the wound with antiseptic or wash with soap and water to help prevent secondary infection
  use a painkiller

Caterpillar stings to the skin

Take these steps if stung by a caterpillar:

 remove visible caterpillar hairs with tweezers

 apply and remove adhesive tape to the area to remove the finer caterpillar hairs
 do not scratch or rub the area, this may cause the hairs to penetrate deeper into the skin

Itching

Itching is a common irritation of the skin that makes a person want to scratch the itchy area. It can occur
anywhere on the body, and can be very frustrating and uncomfortable. Itching may occur on a small part of
the body, for example around the area of an insect bite, or it can affect the whole body, such as with an
allergic reaction.

Sometimes spots or rashes may be present around the area that is itchy, or they may cause the itchiness
itself.

It is quite common to find that after you've scratched an itch, that the itch becomes more persistent
(itchier) and you get into a cycle of itching and scratching. This can be painful and can sometimes lead to an
infection if the skin is broken. If itching persists for more than 48 hours, see your doctor.

To relieve itching, take the following steps:

 try not to scratch the area - keep your nails short to prevent breaking the skin if you do scratch
 a cool bath or shower may help to soothe the itching - gently pat yourself dry with a clean towel,
but do not rub or use the towel to scratch yourself
 avoid perfumed skin care products
 try to wear loose cotton clothing, which can help prevent you overheating and making the itch
worse - avoid fabrics which irritate your skin, like wool or scratchy fabrics
 an ice pack may relieve the itching but should not be placed directly against the skin - you can make
an ice pack by using a bag of frozen peas wrapped in a clean cloth
 there are medicines available to ease the symptoms of itching - speak to a pharmacist for further
advice and to make sure any medicines you take are suitable for you
 if you are in pain, get advice on medicines from a pharmacist or doctor

Snake bites

It can be difficult to know if a bite from a snake is dangerous or not. This article explains the best first aid
treatment depending on the type of snake involved.

Note: All snake bites must be treated as potentially life-threatening. If you are bitten by a snake, call
triple zero (000) for an ambulance.
It’s also important to be aware that bites from snakes can cause a severe allergic reaction (anaphylaxis) in
some people. Learn more about first aid treatment for severe allergic reactions in the ‘anaphylaxis’ section
below.

About snake bites

Australia has about 140 species of land snake, and around 32 species of sea snakes have been recorded in
Australian waters.

About 100 Australian snakes are venomous, although only 12 are likely to inflict a wound that could kill
you. These include Taipans, Brown snakes, Tiger snakes, Death Adders, Black snakes, Copperhead snakes,
Rough Scaled snakes as well as some sea snakes.

Most snake bites happen when people try to kill or capture them. If you come across a snake, don't panic.
Back away to a safe distance and let it move away. Snakes often want to escape when disturbed.

Different types of snake bites

Dry bites

A dry bite is when the snake strikes but no venom is released. Dry bites will be painful and may cause
swelling and redness around the area of the snake bite.

Because you can’t tell if a snake’s bite is a dry bite, always assume that you have been injected with venom,
and manage the bite as a medical emergency. Once medically assessed, there is usually no need for further
treatment, such as with antivenoms. Many snake bites in Australia do not result in envenomation, and so
they can be managed without antivenom.

Venomous bites

Venomous bites are when the snake bites and releases venom (poison) into a wound. Snake venom
contains poisons that are designed to stun, numb or kill other animals.

Snake identification:

Identification of venomous snakes can be made from venom present on

clothing or the skin using a ‘venom detection kit’. For this reason, do not
wash or suck the bite or discard clothing.

Do not try to catch or kill the snake to identify it, because medical services
do not rely on visual identification of the snake species.

Antivenom is available for all venomous Australian snake bites.

What are the symptoms of a venomous bite?

 severe pain around the bite, this might come on later

  swelling, bruising or bleeding from the bite
 bite marks on the skin (these might be obvious puncture wounds or almost invisible small scratches)
 swollen and tender glands in the armpit or groin of the limb that has been bitten
 tingling, stinging, burning or abnormal feelings of the skin
 feeling anxious
 nausea (feeling sick) or vomiting (being sick)
 dizziness
 blurred vision
 headache
 breathing difficulties
 problems swallowing
 stomach pain
 irregular heartbeat
 muscle weakness
 confusion
 blood oozing from the site or gums
 collapse
 paralysis, coma or death (in the most severe cases)

In Australia, there are about 2 deaths a year from venomous snake bites.

First Aid Treatment:- What to do to treat snake bites

For all snake bites, provide emergency care including cardiopulmonary resuscitation (CPR) if needed. Call
triple zero (000) for an ambulance. Apply a pressure immobilisation bandage and keep the person calm and
as still as possible until medical help arrives. If you can’t use a pressure bandage, because the bite is on the
trunk or stomach, apply and keep constant firm pressure.

It is import that you do not move the casuality. Walking will increase bloodflow throughout the body,
which will in turn spead the venom to the heart and brain. Keep the casualty still and as relaxed and calm
as possible.

Avoid washing the bite area because any venom left on the skin can help identify the snake.

DO NOT apply a tourniquet, cut the wound or attempt to suck the venom out.

First Aid Treatment:- Anaphylaxis

Anaphylaxis is a severe allergic reaction to a substance and potentially life threatening. It should always
be treated as a medical emergency, requiring immediate treatment. Most cases of anaphylaxis occur after
a person with a severe allergy is exposed to the allergen they are allergic to (usually a food, insect or
medication).
What are the symptoms of a mild to moderate allergic reaction?

 Swelling of face, lips and eyes

 Hives or welts
 Tingling mouth
 Abdominal pain, vomiting (these are signs of anaphylaxis for insect allergy)
 Difficulty breathing

First Aid Treatment - What to do to treat a mild to moderate allergic reaction?

1. For insect allergy - flick out sting if visible

For tick allergy - freeze dry tick and allow to drop off

2. Stay with person and call for help

3. Locate adrenaline (epinephrine) autoinjector

4. Phone family/emergency contact

Mild to moderate allergic reactions (such as hives or swelling) may not

always occur before anaphylaxis (severe allergic reaction).

First Aid Treatment - What to do to treat a mild to Anaphylaxis (Severe Allergic Reaction)

Action For Anaphylaxis (Severe Allergic Reaction)

1. Lay person flat

Do NOT allow them to stand or walk
If unconscious, place in recovery position
If breathing is difficult allow them to sit

2. Give adrenaline autoinjector

3. Phone ambulance - 000

4. Phone family/emergency contact

5. Further adrenaline doses may be given if no response after 5 minutes

6. Transfer person to hospital for at least 4 hours of observation If in doubt give adrenaline
autoinjector
What are the symtoms of a person in Shock (not electrical shock)

Shock is a critical condition brought on by the sudden drop in blood flow through the body. Shock may
result from trauma, heatstroke, blood loss, an allergic reaction, severe infection, poisoning, severe burns or
other causes. When a person is in shock, his or her organs aren't getting enough blood or oxygen. If
untreated, this can lead to permanent organ damage or even death.

Signs and symptoms of shock vary depending on circumstances and may include:

 Cool, clammy skin

 Pale or ashen skin
 Bluish tinge to lips or fingernails (or gray in the case of dark complexions)
 Rapid pulse
 Rapid breathing
 Nausea or vomiting
 Enlarged pupils
 Weakness or fatigue
 Dizziness or fainting
 Changes in mental status or behaviour, such as anxiousness or agitation

First Aid Treatment:- What to do to treat a person is in shock

Call 000. Then immediately take the following steps:

 Lay the person down and elevate the legs and feet slightly, unless you think this may cause pain or
further injury.

 Keep the person still and don't move him or her unless necessary.

 Begin CPR if the person shows no signs of life, such as not breathing, coughing or moving.

 Loosen tight clothing and, if needed, cover the person with a blanket to prevent chilling.

 Don't let the person eat or drink anything.

 If the person vomits or begins bleeding from the mouth, and no spinal injury is suspected, turn him
or her onto a side to prevent choking.

-------------- END OF DOCUMENT -------------------------------