First Aid

1. First Aid Steele Canyon High School ENS Department

2. First Aid Overview and Objectives • Basic review of common health issues that you may encounter in day to day life • Sensible approach to understanding causative factors • Care and treatment of various disease processes • A tiny bit of humor added along the way…

3. Allergic Reaction/Anaphylaxis • An allergic reaction is an inflammatory process triggered by allergens.. Common allergens include animal dander from cats or dogs, airborne allergens like pollen, and various drugs such as penicillin and sulfa. • Allergies • Symptoms of allergic reactions include hives, tongue or facial swelling, sneezing, itchy eyes, nausea, vomiting, and rashes. Allergic reactions may range from mild, to life-threatening conditions such as anaphylaxis. in which the mouth and tongue may swell to a point that makes it difficult to breathe. • Physicians diagnose allergic reactions based on clinical signs and symptoms. • Allergic reactions are treated with medications like antihistamines and steroids. • For life-threatening allergic reactions, may have epinephrine pens available. The best treatment for allergic reactions is to avoid the allergen if at all possible • Immediate medical care (call 911) for serious symptoms of an allergic reaction, such as chest pain, chest tightness, difficulty breathing, rapid heartbeat, swelling in the throat or mouth, dizziness or unconsciousness, flushing with hives, or wheezing.

4. Allergic Reaction Scary enough to look at… Imagine if it was on YOUR face!

5. Allergic Reaction/Anaphylaxis • Anaphylaxis is a severe, potentially life-threatening allergic reaction. It can occur within seconds or minutes of exposure to something you're allergic to, such as a peanut or the venom from a bee sting. • The flood of chemicals released by your immune system during anaphylaxis can cause you to go into shock; your blood pressure drops suddenly and your airways narrow, blocking normal breathing. Signs and symptoms of anaphylaxis include a rapid, weak pulse, a skin rash, and nausea and vomiting. Common triggers of anaphylaxis include certain foods, some medications, insect venom and latex. • Anaphylaxis requires an immediate trip to the emergency department and an injection of epinephrine. If anaphylaxis isn't treated right away, it can lead to unconsciousness or even death.

6. Anaphylaxis Life Threatening disease process…to both children and adults!

7. Allergic Reaction/Anaphylaxis • Anaphylaxis symptoms usually occur within minutes of exposure to an allergen. Sometimes, however, anaphylaxis can occur a half-hour or longer after exposure. Anaphylaxis symptoms include: • Skin reactions, including hives along with itching, and flushed or pale skin (almost always present with anaphylaxis) • A feeling of warmth • The sensation of a lump in your throat • Constriction of the airways and a swollen tongue or throat, which can cause wheezing and trouble breathing • A weak and rapid pulse • Nausea, vomiting or diarrhea • Dizziness or fainting

8. Allergic Reaction/Anaphylaxis • What to do in an emergency If you're with someone who is having an allergic reaction and shows signs of shock caused by anaphylaxis, act fast. Signs and symptoms of shock caused by anaphylaxis include pale, cool and clammy skin, weak and rapid pulse, trouble breathing, confusion, and loss of consciousness. Even if you're not sure symptoms are caused by anaphylaxis, take the following steps immediately: • Call 911 or emergency medical help. • Get the person in a comfortable position and elevate his or her legs. • Check the person's pulse and breathing and, if necessary, administer CPR or other first-aid measures. • Help give medications to treat an allergy attack, such as an epinephrine autoinjector or antihistamines, if the person has them.

9. Assessing ANY Situation and Rescues Is anyone in danger? If yes, can the danger be easily managed? If it cannot, call for the emergency help and protect the scene.Move the quietest victim first (Usually this is a telling sign) Gently shakes the shoulders and ask him or her a question. If there is a response, treat any life-threatening condition before checking the next person. If there is no response, check the airway. REALLY???

10. Assessment and Actions **An unconscious person is always at risk of the airway becoming blocked by the tongue. There is also the possibility of choking on vomit. If there is mouth or internal injuries, a person may a choking on blood. Most unconscious people are safest if placed in the recovery position while waiting for help to arrive. This position keeps the airway open and allows liquids to drain from the mouth. ASSESSING A VICTIM If somebody is unconscious (not responsive) but breathing, your priorities are: to ensure that they stay breathing by keeping the airway; unblocked and regularly looking, listening, and feeling for breaths; to treat any life-threatening injuries such as serious bleeding; and to call for an emergency help.

11. Assessment and Action HOW TO MOVE AN ADULT INTO THE RECOVERY POSITION 1. Kneel beside the victim. Ensure the airway is open by lifting the chin and tilting the head. Make sure both legs are straight, then place the arm nearest to you straight from the victim’s body.2. Bring the arm furthest away from you across the victim’s chest and hold the back of the hand against the cheek nearest to you.3. With your other hand, grasp the far leg just above the knee and pull it up, keeping the foot flat on the ground.4. Keeping the victim’s hand pressed against his or her cheek, pull on the far leg and roll the victim toward you and on to his or her side. 5. Tilt the head back so that the airway remains open. Call for emergency help if this has not already been done. Check the breathing regularly

12. Assessment and Action

13. Assessment and Action SPINAL INJURY If the victim has been involved in an accident that involved a lot of force, such as a fall, tackle, strike from a blunt force object, or automobile accident, the back or neck may be injured. The priority in an unconscious person will always be ABC. If you suspect a person may have a neck or back injury, or other broken bones, you may wish to adjust the recovery position to minimize movement. Gently move the head to a position where vomit or blood can drain out. If you are concerned about breathing the person must be moved into a safer position.

14. Assessment and Action The priorities for an unconscious child are to ensure that the child stays breathing by keeping the airway clear, and to call 911. If an unconscious child is breathing, do a quick check for life-threatening injuries and treat if necessary, then turn the victim into the recovery position.HOW TO MOVE A CHILD INTO THE RECOVERY POSITION 1. Kneel beside the child. Ensure the airway is open by lifting the chin and tilting the head. Make sure both legs are straight, then place the arm nearest to you to straight out from the child’s body, with the elbow bent and the palm placing upward.2. Bring the arm furthest away from you across the child’s chest and hold the back of the hand against the cheek nearest you.3. With your other hand, grasp the child’s far leg just above the knee and pull it up, keeping the foot flat on the ground.4. Keeping the child’s hand pressed against her cheek, pull on the far leg and roll the child toward you and to her side. 5. Tilt the head back so that the airway remains open.

15. Assessment and Action

16. Bleeding Control • Severe bleeding requires direct, firm pressure to the affected area. • If possible, elevate the any bleeding extremity above the level of the heart. • Do NOT remove any imbedded object , unless it interferes with breathing or respirations. • Remember gloves are a protective barrier…that are a must to use. • ANY bloody or body fluids you come in contact with should be washed away with soap and water immediately.

17. Bleeding Control

18. Burns Burns can be Awful…painful…disfiguring…life changing! • Many avenues provide ways you can get burned. Certainly by heat and fire, radiation, sunlight, electricity or chemicals. • There are 3 degrees of burns: • 1st, 2nd, and 3rd degree.

19. Burn- 1st Degree • First-degree burns are red and painful. A sunburn is an excellent example. Occasionally, they swell a little. 1st degree burns “blanch” or turn white when you press on the skin. Damaged skin over the burn may peel away after 1 or 2 days, which makes you look like a lizard. • Treatment.  Soak the burn in cool water (NOT ice). Apply a skin care product like aloe vera cream or an antibiotic ointment. Protect the burned area with a dry gauze bandage or clean clothing. Over-the-counter pain relievers, such as Tylenol or Motrin can to help with the pain. Remember, sunscreen!

20. Burn- 1st Degree • Red • Painful • Minimally invasive • Treatment • Stop the burn • Cool the burn • Cover the burn

21. Burn-2nd Degree • Second-degree burns  are thicker burns, have associated blistering and are VERY painful. Multiple skin layers are damaged, the skin is very red or even splotchy, and it may swell significantly.    • Treatment. Soak the burn in cool water for 15 minutes. If the burned area is small, put a cool, clean, wet cloths on the burn , then apply an antibiotic cream, or other creams as prescribed by your doctor. Cover the burn with a clean, dry nonstick dressing held in place with gauze or tape. Check with your doctor's office to make sure you are up-to-date on tetanus booster. • Change the dressing every day. Remembering to wash your hands with soap and water before any dressing change . Be gentle as you wash the burn and put antibiotic ointment on it. Watch for signs of infection, such as increased pain, redness, swelling or pus. If you see any of these signs, see your doctor right away. Avoid breaking any blisters that form. • Burned skin itches as it heals. Keep your fingernails cut short and don't scratch the burned area. Burned areas will be sun sensitive for up to one year.

22. Burn- 2nd Degree • Red • Loss of skin • Blistering • Fluid filled • Painful

23. Burns- 3rd Degree • Third-degree burns cause damage to all layers of the skin. The burned skin looks white or charred black. These burns may cause little or no pain because the nerves in the skin are damaged. Treatment.  For third-degree burns, go to the hospital right away. Don't take off any clothing that is stuck to the burn. Don't soak the burn in water or apply any ointment (do NOT use any home remedies…that involve food... No lemon juice, mayonnaise, Crisco, ice cubes,etc.). You can cover the burn with a sterile bandage or clean cloth until you receive medical assistance.

24. Burn-3rd Degree Multiple skin layers involved Charring Minimal pain Scarring extensive Do not walk through fire!

25. Bruises Bruises ( Contusion, Ecchymosis, Hematoma) • A bruise is a mark on your skin caused by blood trapped under the surface. In trauma, injury crushes small blood vessels but does not break the skin. Those blood vessels break open, leaking blood under the skin’s surface. • Bruises are often painful and can become swollen. There are skin, muscle and bone bruises. Bone bruises are the most serious. • Healing can take months for fading to occur, but most last only about two weeks. Initially reddish in color, then turning bluish-purple, and finally greenish-yellow before returning to normal. Ice minimizes the injured area. Elevation above your heart is also helpful. Any bruise appearing to be infected, should be check by a physician.

26. Bruises People on blood thinners should be especially cautious with bruising!

27. Choking • ChokingFood or small objects can cause choking if they get caught in your throat and block your airway. This prohibits oxygen from traveling to your lungs and brain. When your brain goes without oxygen for more than four minutes, bad things begin to happen. • Young children are especially high risk for choking. They choke on common foods like hot dogs, nuts, grapes, and on many small items like toy pieces and coins. Keep small objects out of their reach and supervise them when they eat. 

28. Choking…maybe not…. • Not choking, but very messy! Supervise your children when they eat!!

29. Choking • To remove a lodged or stuck object in the throat, do NOT stick your fingers in anyone’s mouth UNLESS you can see the object clearly. • Removing or clearing an airway obstruction is best performed by utilizing the Heimlich Maneuver, which forces air from the stomach upwards to clear the object from the airway.

30. Choking Rescue Techniques- Heimlich for Adults • To perform the Heimlich maneuver:Stand behind him or her. Form a fist with one hand and place your fist, thumb side in, just below the person’s rib cage in the front. Grab your fist with your other hand. Keeping your arms off the person’s rib cage, give four quick inward and upward thrusts. You may have to repeat this several times until the obstructing object is coughed out. • If you're the only rescuer, perform the Heimlich maneuver before calling 911 for help. If another person is available, have that person call for help while you perform the Heimlich maneuver.

31. Choking Rescue Techniques- Heimlich for Adults • Hands locked above the belly button. • Pressing upwards into the diaphragm. • Continue until the foreign body becomes dislodged.

32. Choking Rescue Techniques- Heimlich for Unconscious Adults • Heimlich maneuver on an unconscious person:If the person is lying down or unconscious, straddle him or her and place the heel of your hand just above the waistline. Place your other hand on top of this hand. Keeping your elbows straight, give four quick upward thrusts. You may have to repeat this procedure several times until the obstructing object is coughed out.

33. Choking Rescue Techniques- Heimlich for Unconscious Adults • Heel of your hand above the waistline. • Elbows straight • Deliver 4 upward thrusts • Repeat as necessary

34. Choking Rescue Technique-Heimlich on Children • Heimlich maneuver on a child:Stand behind the child. With your arms around his or her waist, form a fist with one hand and place it, thumb side in, between the ribs and waistline. Grab your fist with your other hand. Keeping your arms off the child's rib cage, give four quick inward and upward thrusts. You may have to repeat this several times until the obstructing object is coughed out.

35. Choking Rescue Technique-Heimlich on Children

36. Choking Rescue Technique-Heimlich on Infants • Heimlich maneuver on an  infant:Place the infant face down across your forearm (resting your forearm on your leg) and support the infant’s head with your hand. Give four forceful blows to the back with the heel of your hand. You may have to repeat this several times until the obstructing object is coughed out.  If this does not work, turn the baby over. With two fingers one finger width below an imaginary line connecting the nipples, give four forceful thrusts to the chest to a depth of 1 inch. You may have to repeat this several times until the obstructing object is coughed out.

37. Choking Rescue Technique-Heimlich on Infants

38. Cuts and Scrapes • Stop the bleeding. Minor cuts and scrapes usually stop bleeding on their own. If they don't, apply gentle pressure with a clean cloth or bandage. Hold the pressure continuously for 5 to 10 minutes. Don't keep checking to see if the bleeding has stopped because this may damage or dislodge the fresh clot that's forming and cause bleeding to start again. If the blood spurts out or continues to flow after continuous pressure, seek medical assistance. • Clean the wound. Rinse out the wound with clear water. Soap can irritate the wound, keep it out of the actual wound, if possible. Any dirt or debris remaining in the wound after washing, must be removed, or it will become an infection, or create a bigger scar. Use tweezers cleaned with soap and water to remove the particles. If debris remains deep in the wound after cleaning, see your doctor. Areas around the wound can be washed with soap, water and a cloth. No need for hydrogen peroxide, iodine or an iodine-containing cleanser, as these irritate living cells. If you choose to use them, don't apply them directly in the wound.

39. Cuts and Scrapes • Abrasions come in all sizes and shapes… They only look bad, and are not life threatening!

40. Cuts and Scrapes • Apply an antibiotic. After you clean the wound, apply a thin layer of an antibiotic cream or ointment like Neosporin or Polysporin to help keep the surface moist. These don't make the wound heal faster, but they deter infection and allow the healing process to close the wound more normally. • Cover the wound. Bandages can help keep the wound clean keeping bacteria out. After the wound has healed enough to make infection unlikely, exposure to the air will increase wound healing. • Change the dressing. Change the dressing at least daily or whenever it becomes wet or dirty. If you're allergic to the adhesive used in most bandages, switch to adhesive-free dressings or sterile gauze held in place with paper tape, gauze roll or a loosely applied elastic (ACE) bandage. These supplies generally are available at pharmacies. (Do NOT hold dressings in place with rubber bands, hairclips, or shoelaces).

41. Cuts and Scrapes • Get stitches for deep wounds. A wound that cuts deeply through the skin or is gaping or jagged-edged and has fat or muscle exposed usually requires stitches or staples, A strip or two of surgical tape may hold a small cut together, but if you can't easily close the largest part of the wound, you must see your doctor as soon as possible. Proper closure within a few hours. • Watch for signs of infection. See your doctor if the wound isn't healing or you notice any redness, drainage, warmth or swelling. • Get a tetanus shot. Doctors recommend you get a tetanus shot every 10 years. If your wound is deep, dirty and your last shot was more than five years ago, your doctor may recommend a tetanus booster. Booster are usually required within 48 hours of the injury.

42. Cut and Scrapesand a Gnarly Head Laceration!Definitely needs sutures…Definitely needs a head CT..Definitely won’t be growing hair here for quite some time!

43. Diabetic Emergencies • Diabetes mellitus is a medical condition in which the body is unable to effectively regulate the amount of sugar in the blood. The pancreas, an organ in the body) normally produces a hormone called insulin that regulates blood sugar level. In a person suffering from diabetes this does not happen effectively and as a result blood sugar levels become too high (this is known as hyperglycemia). Most diabetics control the condition through a combination of diet and injections of insulin. Too much insulin can lead to a condition known as hypoglycemia (low blood sugar).

44. Diabetic Emergencies • HYPOGLYCEMIA Low blood sugar level has a quick and serious effect on the brain. Most commonly it is caused by somebody with diabetes either taking too much insulin, or taking the right amount of insulin and then either not eating enough or burning off sugar through vigorous exercise.

45. Diabetic Emergencies SIGNS AND SYMPTOMS History of diabetes (sometimes a diabetic suffering a hypoglycemia attack is often confused or aggressive and may not admit to having a diabetes) Hunger Feeling faint or dizzy Strange behavior: confusion, aggression, or even violence Pale, cold, sweaty skin Rapid loss of unconsciousness Shallow breathing Evidence of diabetes, e.g. medic alert, sugar solution, or syringe in pocket Evidence of recent heavy exercise or drinking

46. Diabetic Emergencies TREATMENT If the person is unconscious, watch the airway and breathing, respond 911. If the person is fully conscious, help him to sit down or to lie down with the shoulders raised. Give something high in sugar and easy to consume, such as chocolate or a sugary drink. If this marks an improvement, give more. If the condition does not improve, seek medical advice. Stay with the person until he recovers. If the condition continues to deteriorate or does not improve, call 911.

47. Diabetic Emergencies • CONFUSION WITH OTHER CONDITIONS • It is not unusual for diabetes to be mistaken for other common situations such as drunkenness, substance abuse. The treatment in all these situations is to monitor and maintain the airway. Use the recovery position if the person becomes unconscious, and seek medical advice or call emergency help. • Do not make assumptions as to the cause of the problem. Somebody who is drunk may also be suffering from head injury; the syringe in a person’s coat may be for diabetic medication or for drug abuse. While you do not need to know the cause the medical staff do and any clues that you can hand over could be potentially life-saving. Please do not hide important information from caregivers.

48. Drinking and Driving- Doesn’t make you a better, more carefree driver!

49. Drinking and Driving- She had NOT been drinking…but the person who hit her had!!

50. Drinking and Driving Pardon me Mr. Fireman… Can I park my 3 ton helicopter here… I’ll just be a minute!!