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First Aid

First Aid. Chad Peters, MS, ATC. Recognizing and Responding to an Emergency. Whats Out of the Ordinary Sights, appearances, behaviors, odors, noises Examples? Ask Questions. Overcoming Barriers. Why don’t people act? Presence of other people “Some one else can help”

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First Aid

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  1. First Aid Chad Peters, MS, ATC

  2. Recognizing and Responding to an Emergency • Whats Out of the Ordinary • Sights, appearances, behaviors, odors, noises • Examples? • Ask Questions

  3. Overcoming Barriers • Why don’t people act? • Presence of other people • “Some one else can help” • Being unsure of the ill person’s condition • Fear • Catching Disease • Doing Something Wrong • Law Suit • Unsure when to call 911 • How do we over come these?

  4. Good Samaritan Laws • Protect citizens who act the same way a “reasonable and prudent person” would if they were in same situation. • Act in good faith • Not be deliberately negligent or reckless • Act within the scope of his or her training • Not abandon the person

  5. Obtaining Consent • Prior to giving care, you MUST get consent • To obtain consent: • State your name • Tell the person you are trained in 1st Aid • Ask the person if you can help • Explain what you think is wrong and what you are going to do • DO NOT give care to some one who refuses • DO call 911 anyway • Unconscious = Implied Consent, as well as child or infant with out parent

  6. Preventing Disease Transmission • Avoid contact with bodily fluids • Assume everyone is infected with something • This also includes clothing and surfaces • Cover your own open wounds and lesions • Remove jewelry prior to putting on gloves • Avoid touching your own mouth, nose, or eyes • Have gloves, goggles, breathing barriers available

  7. Cleaning Up Blood Spills • Use something to absorb such as paper towels or towels • Bleach and Water (1 ½ cup to one gallon of water solution) or other product. • Use biohazard bag or container if saturated • Most Common Blood Borne Pathogens • Hep B, Hep C, HIV

  8. Emergency Action Steps • CHECK • Scene • What Happened • # People Involved • Immediate Danger • Any available to help? • Unconscious? • Breathing • Bleeding

  9. Emergency Action Steps • Call • 911 • On campus – call campus safety - 3229 • Dial 7 on campus • Land line • If you are not sure whether or not you should call, CALL

  10. 911 Calls... • Must give dispatcher following information • Type of emergency situation • Type of suspected injury • Present condition of athlete • Current assistance being given (CPR, ect) • Location • telephone • cross streets • how to enter facility

  11. Assessment Procedures • Primary Survey • ABCs • Bleeding/Shock • Secondary Survey • Vitals • Signs & Symptoms

  12. Unconscious Person • Note Body Position • Determine level of consciousness • ABCs • Neck & Spine • Do not remove helmet (face mask o.k. • Establish Airway • If prone and no breathing, role over (supine) • If prone and breathing, do not role over • When consciousness gained, log roll to spine board • Maintain Vitals until EMS arrives • Person is stabilized, 2ndary survey

  13. External Bleeding • Direct Pressure • Elevation • Pressure points • Brachial/Femoral

  14. Shock • Can occur with any injury • Most likely in • severe bleeding • internal injury • fractures • Definition • Not enough blood available to circulatory system

  15. Dilation of blood vessels & imbalance of osmotic pressure • Shock if untreated can cause DEATH • Risky Conditions • extreme fatigue • extreme temperature • extreme dehydration • illness

  16. Handling Shock • Signs & Symptoms • Skin • Moist, pale, cool, clammy skin • Weak & rapid pulse • Increased & shallow breathing • decreased b.p. • extreme thirst

  17. Treating Shock • Maintain body temperature • Elevate Feet • Unless head & neck • If psychogenic, do not allow athlete to see injury • Do not over react, but confident & in control.

  18. VITALS • Pulse • 60-80 in adults • Account for activity • 80-100 in children • Respiration • 12 in adults • 20-25 in children • Blood Pressure • Temperature • Skin Color

  19. Blood Pressure • Systolic over diastolic • 120/80 • Temperature • 98.6 • Skin Color • Pupils • shock, heatstroke, hemorrhage • stimulants

  20. State of Consciousness • Movement • Head Injury • Stroke (cerebrovascular accident) • Abnormal Nerve Response • Nerve damage • blocked artery • spinal cord injury • head injury

  21. Moving an Injured Person • When to move an injured person? • You are faced with immediate danger • Need to move to another person who may have more serious injuries • When you need to provide proper care and cannot do so where you are located. • See pages 8 and 9 for methods of how to move some one.

  22. Skill Card – Checking Injured Person • Show Injury Cycle Hand Out

  23. The Physics of Injury • Muscle/tendon injuries • injured by excessive tension • muscle/fascia injuries occur during eccentric contraction • tendons are strong -- 8700 to 18,000 lb./sq. inch. • strains occur most often at the musculotendinous junction (MTJ) • MTJ strains -- most common soft tissue sports injuries

  24. Mechanical Forces of Injury • Three types of force • Tensile • tendons resist tensile force • Compressive • bones resist compressive force • Shear • ligaments resists tensile force Compressive Tension Shear

  25. Critical Force • Critical Force: • Defined: How much force can tissue withstand • Varies for each type of tissue • May vary within the same tissue, depending upon: • age • temperature • skeletal maturity • gender • body weight

  26. The Physiology of Injury • The inflammatory process • Whenever damaged, the body reacts with a predictable sequence of physiologic actions, commonly called “swelling.” • begins during the first few minutes following an injury

  27. The Physiology of Sports Injury • Normal signs/symptoms include • swelling • pain • reddening of skin • increased local temperature • loss of function • several specific stages: • Acute inflammatory phase • Resolution (Healing) phase • Regeneration & Repair

  28. Intervention Procedures • Controlling the inflammatory process • cryotherapy (crushed ice bags, aerosol coolants, ice cups, ice water baths, commercial cold packs) • After the acute phase, application of heat is appropriate (hydrocolator packs, warm towels, and ultrasound).

  29. Pain and Acute Injury • Everyone copes with pain differently. • Pain is as much psychological as physiological. • Pain results from sensory input received through the nervous system and indicates location of tissue damage. • Messages concerning sensory information that travel quickly through nervous system are given higher priority than pain messages that travel more slowly. • Pain is not a useful indicator of injury severity.

  30. Injuries at Work • Leading causes of injury related death at work • Motor Vehicle accidents • Homicides • Falls • Accidents with machinery • Injuries from falling objects • Electrocutions

  31. Types of Open Wounds

  32. Care for Open Wound • 1. Stop Bleeding • Direct Pressure with gauze (if available) • Stack gauze, do not remove it. • Pressure points in severe cases (arteries) • Clean with soap and water, irrigate with water, 5 min if possible • Ointment (neosporin, triple antibiotic, etc.) • Cover with band aide or other non stick product. • Stitches? • ½ inch long or skin does not naturally come together.

  33. Pressure Points

  34. Burn Care • Types • Superficial, or 1st degree • Involves top layer, red, dry skin, painful • Partial thickness, or 2nd degree • Involves top layers of skin, swelling, blisters, heals in 3 to 4 weeks, scarring possible • Full thickness, or 3rd degree • May destroy all layers of skin and underlying structures, such as muscle, fat, bones, and nerves • Skin brown and charred, healing may need assistance

  35. Critical Burns • Cause trouble breathing • Covering more than one body part or large surface area • Head, neck, hands, feed, or genitals • Burns to the airway • Children and elderly • Resulting from chemicals, explosions, or electricity • All the above are life threatening,

  36. Burn Care • Thermal • Must act quickly to cool skin with cool water • After checking scene, of course! • Chemical • If Powder, brush off prior to rinsing • If liquid, rinse with water until EMS arrives or symptoms cease. • Electrical • Do not touch until sure power source is removed • 911

  37. Infection

  38. Examples of Staph Infections www.spapex.org/spapex/ impetigobulloso.jpg

  39. Staph Infection

  40. MRSA

  41. Special Situations • Embedded object in eye • Do not attempt to remove embedded object • Use cup or something similar to protect the eye • Cover both eyes to avoid movement • Severed Body Part • Wrap in gauze, place over ice, 911! • Nosebleed • Pressure, lean forward to allow clotting • Find out why bleeding, dry air or injury • Teethe • If misplaced, try to correct • If knocked out, place in milk or water and get to dentist quickly.

  42. Acute and Chronic Injuries • Acute injury - “injury characterized by rapid onset, resulting from a traumatic event” • Acute injuries typically involve trauma followed by pain, swelling and loss of function. • Critical force -- “magnitude of a single force for which the anatomical structure of interest is damaged”

  43. Acute and Chronic Injuries • Chronic injury - “injury characterized by a slow, insidious onset, implying a gradual development of structural damage” • Chronic injuries develop over time and are often associated with repetitive, cyclic activities, such as running. • These injuries are commonly called “overuse injuries.” Common sites include the Achilles tendon, patellar tendon and the rotator cuff.

  44. Soft Tissue and Skeletal Injury • Soft tissue includes: • muscle, • fascia, • tendon, • joint capsule, • ligament, • blood vessels • nerves

  45. Majority of injuries involve: Bruises (contusions) Sprains Strains Skeletal injuries involve bony structures Soft Tissue and Skeletal Injury

  46. Standard Nomenclature of Athletic Injuries (AMA) 1968. Sprains - injuries to ligaments (three levels) 1st degree: Slightly torn ligament 2nd degree: Significantly torn ligament 3rd degree: Completely torn ligament Strains - injuries to tendon, muscle or musculotendinous junction (Same 3 levels as above) Contusions - commonly called a bruise Connective Tissue Injury

  47. Fractures - break or crack in bone -- two types: closed and open Stress fracture - break or crack in a bone which develops over a relatively long time period Dislocations - the displacement of contiguous surfaces of bones comprising a joint -- two types: subluxation - partial Luxation or dislocation - total displacement Connective Tissue Injury

  48. Care of musculoskeletal injuries • Severe injuries must be splinted until extent of injury is determined • Splinting always consists of the joint above and below the injury • RICE • Rest, Ice, Compression, Elevation • Or the ARC Version • Rest, Immobilize, Cold, Elevate

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