Apply First Aid

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HLTFA311A. Be prepared for an emergency. . Learn first aid, you could save a life.. 1. Copyright NFA Jan 2013 Version 4. Welcome . Basic Housekeeping. Schedule. Break. Location of toilets. Location of emergency exits. ID: 540345 Download Presentation

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Apply First Aid




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Presentations text content in Apply First Aid

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Apply First AidHLTFA311A

Be prepared for an emergency. Learn first aid, you could save a life.

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Welcome

Basic HousekeepingScheduleBreakLocation of toiletsLocation of emergency exitsMobile phones

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Course Content

ElementAssess the situationApply first aid proceduresCommunicate details of the incidentEvaluate own performance

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Aims of first aid

Ensure that the scene is safePreserve the lifeProtect the unconsciousPrevent progression of the injuryProvide comfort/promote recoveryPhone for an ambulance.

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Legal Considerations

Duty to ActNegligenceConsentRecording

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Primary Survey

Danger ResponseSend for helpAirwayBreathingCompressionsDefibrillation

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Basic Life Support

D

DangerEnsure the scene is safe

Unsafe

Check for and remove hazards/risks

R

Check for a response

No

Yes

A

Unconscious

Open and clear airway, look listen and feel for breathing

Conscious : Manage injuries/illnessMonitor , rest and reassure

B

Not breathing normallyCommence chest compressions

Breathing normally Manage patient in the recover position

C

30 chest compressions followed by 2 breathsContinue until responsiveness or normal breathing returnsIf unwilling /unable to perform rescue breaths continue chest compressions

D

Defibrillate: Attach AED- follow voice prompts Continue CPR

S

Send for help - call 000

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Danger

Once an emergency has occurred you need to ensure the safety of all of those at the scene by checking for hazards The groups that you need to consider are shown in order of priority below:Yourself Bystanders The PatientDon’t become an innocent victim

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Response

Check the Patient for a response Call out to the patient “what is your name?”Gently tap on the patient on the shoulder and ask “can you hear me?”If no response - patient is unconscious , manage the airway

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Send for Help - Call 000

Phone Fast /Emergency service controllerName/contact detailsExact locationType of incidentStatus of the patientHazardsDo not hang upStay with the patient until help arrives

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Airway

Ensure the airway is open and clear If the airway is obstructed, remove any visible foreign bodies

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Airway Management

AIRWAY OPEN

AIRWAY OBSTRUCTED

AIRWAY CLOSED

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Breathing

Keep the airway open and check for normal breathingLook, Listen and Feel for no more than 10 seconds for normal breathingLook – to see if the chest risesListen – for the sound of normal breathingFeel – for air against your cheek

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Breathing

If Breathing Normally: Roll into the recovery positionPregnant women onto their left sideObserve and reassess the patient for continued breathing regularlyMaintain an open airway with head tilt and jaw supportNo head tilt for infantsIf Breathing AbsentSend someone for the AED (if available)Commence CPR

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Recovery position

The unconscious patient who is breathing normally must be placed in the recovery position. This lifesaving position helps to maintain an open and clear airwayEncourage the jaw and tongue to relax and fall forwardPromote free drainage so that fluids such as vomit and saliva will not obstruct the airwayPatients may be either turned towards or away from the First AiderEnsure the neck and head is gently tilted back with the face slightly downward and supported by the patients own handWith an unconscious patient care of the airway takes precedence over any injuryCare of the spinal patientSpinal patients must be moved with caution. The neck and head must be supported and the body in correct alignment. Use of the log roll technique is recommended.Advanced stages of pregnancyPlace the patient on her left side to avoid distress to the foetus.

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Breathing

Sounds of gurgling, sighing or coughing may be present – this is regarded as not breathing normal and is an indication of a patient in cardiac arrest, immediately commence chest compressions

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Sudden Cardiac Arrest

Sudden Cardiac Arrest occurs when the heart stops suddenly beating due to an electrical malfunction of the heart muscle. This disrupts the normal heart rhythm, resulting in the loss of consciousness, loss of pulse and loss of life in minutes.

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Sudden Cardiac Arrest

The heart may begin to vibrate or quiver in an irregular manner, this is called fibrillation. The heart is unable to pump oxygen rich blood through the heart. When this blood is not supplied to the brain you lose consciousnessThe only way to start a fibrillating heart and restore normal rhythm is to defibrillation

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Chain of Survival

Early recognition and early accessEarly CPREarly defibrillationEarly advanced medical care

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CPR

CPR is only performed on a person who is in Cardiac Arrest Sudden cardiac arrest is not a heart attackPrimary need to get heart beating again ASAP orMimic action of heart beating to send blood out to the tissues (perform Chest compressions)

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CPR

Cardiopulmonary resuscitation (CPR) is a combination of chest compressions and rescue breathing

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Chest Compressions

Give 30 compressionsCompress 1/3 chest depthGive 2 breaths continue with 30 compressions (5 cycles every 2 minutes)

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Summary

30 chest compressions2 breathsRate 100 compressions per minuteEach cycle is 30 compressions : 2 breathsCompress ⅓ of the chest depthHand position – centre of the chestAdult – 2 handsChild – 2 handsInfant – 2 fingers

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Summary

Only stop CPR if:the scene becomes unsafequalified help arrives and takes oversigns of life returnyou become physically unable to continue CPRan authorised person pronounces life extinct

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Summary

UnconsciousNo normal breathing Patient is in CARDIAC ARREST-PERFORM CPRAny attempt at resuscitation is better than no attempt

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Summary

Chest compressions onlyIf the First Aider is unable/unwilling to perform rescue breaths chest compressions only is advised as residual oxygen supplies in the body will be circulated in the body.Compressions should be continued at a rate of 100 per minute Multiple First AidersIn the presence of multiple First Aiders, Call the ambulance first.Obtain any necessary emergency equipment such as defibrillator.Regular rotation is recommended to reduce fatigue; Every 2 minutes.

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Defibrillation

Defibrillation is the definitive treatment for Cardiac

ArrestAn AED (Automated External Defibrillator) delivers a controlled electric shock to the patient’s heartThe AED is an automated electronic device used to restore a normal heartbeat. Asystole the absence of any heart beat. CPR holds off asystole

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Defibrillation

Ventricular Fibrillation: Heart irritability where the heart cells are not ‘firing off’ in an organised manner. Blood circulation is impaired and can result in death

Ventricular tachycardia: Heart irritability where the heart cells are stimulated prematurely resulting in a fast abnormal heart beat. The heart is unable to refill and the patient will become unconscious with no heart beat

.

Asystole is characterised by the absence of any cardiac activity

VF or VT can be reversed provided there is rapid intervention with CPR and defibrillation. If treatment is delayed the chance of survival is reduced by less than 10% for each minute the heart is stopped

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CPR artificially keeps the heart beating and circulates O2 blood, the heart must be defibrillated to return the electrical conduction system back to normal so the heart can beat spontaneously

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Defibrillation

Ensure CPR is continuedTurn on AEDFollow the AED instructionsShave chest hair and dry moisture with towel if requiredCheck for any implanted medical devicesPlace pads on chest and ensure firm contactEnsure no one is touching patient when shock is delivered

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Defibrillation

An AED should only be applied when a patient is unconscious and not breathing Each minute that defibrillation is delayed reduces the patient’s chances of survival by about 10 % The sooner the shock is administered, the greater the likelihood of the patient’s survivalIt is virtually impossible to save a patient with cardiac arrest without a defibrillator

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Practical Assessment with AED

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Choking Flow chart

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Choking

Choking occurs the upper airway is obstructed by swollen tissue or a foreign body, or when food or other material enters the trachea instead of the oesophagus.

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Partial Obstruction

Signs and Symptomsdifficulty in breathingwheezingsnoring soundpersistent coughcyanosis (blue skin colour)in children and infantsflaring of the nostrilsin-drawing of the tissues above the sternum and in between the ribsManagementEncourage patient to cough to expel foreign material Do not give any back blows because this could cause the patient to inhale the object and my result in a severe airway obstruction

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Choking

Must often occurs while eating and involves the inhalation of food down the trachea during a meal.Coughing is the body’s reflex action to dislodge a foreign object

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Complete Obstruction

Signs and Symptomsunable to breathe, speak or coughagitated and distressedmay grip the throatbluish skin colourrapid loss of consciousness

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Complete Obstruction

ManagementAttempt five sharp back blows between the shoulder bladesIf unsuccessful attempt five chest thrustsContinue alternating, call 000 and be prepared to commence CPR.

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Shock

Shock is a sudden or slow /steady loss of blood volume and/or pressure due to illness, pain or trauma.It is the bodies defensive response to protect the vital organs – heart, lung, kidneys and brainShock is caused by many factors the most significant is pain.

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Shock

Initial shockPale cold clammy skin.Weak, Rapid pulse.Rapid breathing.As shock progressesFaintness or dizzinessNauseaAnxietyRestlessness.Thirst.Drowsiness, confusion.Cyanosis in extremities.Finally collapse and unconsciousness, due to progressive ‘shutdown’ of body’s vital functions

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Major Functions of Blood

Transports oxygen, nutrients and wastesProtects against diseaseMaintains constant body temperature

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Signs of External Bleeding

Capillary

gentle ooze form wound

Venous

flows from wound at a steady rate

dark red in colour

Arterial

rapid and profuse

bright red in

colour

as it is under pressure usually spurts

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Control Bleeding

Direct pressureElevationRest

QAS 56

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Internal Bleeding Management

Call 000 and closely monitor airway, breathing and circulation regularly.Rest and reassure patientRaise legs if injuries permit.Do NOT give any food or drink.First aiders cannot control internal bleeding but early recognition and calling 000 can save lives

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Practical session - bandaging

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Asthma

People with asthma have very sensitive airways, and when they are exposed to certain triggers, their airways narrow making it difficult for them to breathe.The inside lining of the airways becomes red and swollen Extra mucus is often producedThe muscles around the airways constrict

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Asthma

Shortness of breath especially when speakingWheeze may or may not be presentDry, irritating, persistent coughRapid breathingTightness in the chestCyanosis around the lips and ear lobesTiredness, exhaustionCollapse

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Asthma Management

Get patient to have 1 puff of reliever medicationPatient then takes 4 breathsRepeat until patient has had 4 puffs (with 4 breaths between puffs)Wait 4 minutesIf no improvement give another 4 puffsIf no improvement call 000Continue with 4 puffs x 4 breaths x 4 minutes until ambulance arrives

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Anaphylaxis

The most severe and sudden form of allergic reactionOccurs when there is exposure to an allergen to which a person is sensitive to

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Anaphylaxis

Is potentially life threatening and should be treated as a medical emergencyAnaphylaxis results when a generalised allergic reaction affects the respiratory(breathing) and/or cardiovascular (heart and blood pressure) system. Blood vessels dilate and blood pressure falls, airway is constricted resulting in breathing difficulty.

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Mild to Moderate allergic reaction

Symptoms of a mild to moderate allergic reaction can include: swelling of the lips, face and eyes hives or welts tingling mouth abdominal pain and/or vomiting (these are signs of severe allergic reaction to insects)

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Severe allergic reaction

Signs of anaphylaxis (a severe allergic reaction): • difficulty breathing or noisy breathing• swelling of the tongue• swelling/tightness in the throat• difficulty talking and/or a hoarse voice• wheezing or persistent coughing• loss of consciousness and/or collapse• young children may appear pale and floppy

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First Aid Management

Lay person flat, do not stand or walk. If breathing difficult allow to sit not standPrevent further exposure to triggerGive Adrenaline auto injector Phone ambulance 000 or 112 (mobile)Contact family/emergency contact Administer asthma medication to assist breathingFurther adrenaline doses may be given if no response after 5 minutes (if another adrenaline auto injector is available)If in doubt whether it is anaphylaxis use the adrenaline auto injector

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Heart Attack

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Angina/Heart Attack/Cardiac arrest

Angina is caused by constriction of the blood vessels supplying the heart muscle with blood. The chest pain is due to a reduction of blood flow to the muscle of the heart causing a lack of oxygen to the muscle.Heart Attack occurs when a coronary artery is suddenly blocked by a blood clot and the heart muscle is damaged due to lack of oxygen.Cardiac arrest is a condition in which the heart stops beating and pumping effectively

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Heart Attack

Signs and Symptoms: Pale, cool skinChest pain or discomfort, usually in the centre of the chest, may spread or radiate to the shoulders, neck jaw and/or armsSweatingRapid, shallow respirations or difficulty breathingNausea and/or vomitingCollapse

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Heart Attack

Management:Treat situation as life threatening.Advise patient to rest usually sitting. This will ease the strain on the heart. Call 000 – “Every minute counts” Assist patient to take medication, e.g. anginine , GTN Spray, give aspirin if directed Be prepared for sudden unconsciousness.Reassure and monitor PatientBe prepared to commence CPR.  

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QAS 133

Consists of:BonesMusclesLigamentsTendons

Musculoskeletal System

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Sprains and Strains

SprainThe stretching and tearing of ligaments and other soft tissue structures at a joint

StrainThe stretching and tearing of muscles and tendons, occurs between the joints

QAS 141

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How to Manage - RICER

Rest – the patient and the injured limb Ice- the injury, this will help reduce inflammation and pain by causing blood vessels to constrictCompression- and support the injury with firm elastic bandage after the ice pack has been removedElevation- the injured limb to help reduce the swelling and pain Refer – to medical help if required

QAS 140

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Dislocation

A dislocation occurs when there is displacement of one or more bones at a joint such as shoulder,hip,elbow,fingers or toes.

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QAS 137

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Signs and Symptoms sudden pain in the affected joint loss of power and movement deformity and swelling of the joint tenderness may have some temporary paralysis of the injured limbHow to Managesupport limb in position of comfort apply RICER seek medical helpany attempt to reduce a dislocation is only to be made by a doctorIf you are unsure if the injury is a dislocation, manage as a fracture and gently immobilise in the position found

Dislocations

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Type of Fractures

- Complicated -May involvebody organsand tissue.

- Open -

Bone protrudes through skin or wound leading to site of the fracture.

- Closed -

Bone remains within the skin.

No wound leading to site of the fracture.

QAS 134

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Signs and Symptoms

SignsSwellingDiscolourationDeformityAngulation

SymptomsPainLoss of powerTendernessNumbness Crepitus –bone ends grating against each other

QAS 135

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How to Manage

The main aim of fracture treatment is to support or immobilise to: Minimises pain Prevents further damage Minimises bleeding Prevents a closed fracture becoming an open fracture.Support: Leave injured limb in the position found and pack around to give support.Immobilise: • Use Splint, Sling or bandage to prevent movement.• Stabilise joint above and below fracture site.• Apply triangular or broad bandages above and below fracture site.• Check circulation every 10mins

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Mechanism of Head Injuries

Direction of Impact

QAS 95

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Concussion

Concussion or “Brain Shake” is atemporary loss or altered state ofconsciousness followed by completerecovery. Subsequent declinesuggests a more serious brainInjury.

QAS 96

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Cerebral Compression

This may be caused by trauma to the head, or by a blood clot formed within the skull

Cerebral compression is a condition which occurs when pressure within the brain increases

QAS 97

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Can occur following:Motor vehicle accidentsDiving into shallow waterA fall from a ladder or roofSporting accidentsFall in the elderlyHeavy object falling on top of a person

Spinal Injury

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The most important indicator of a head, neck and spinal injury is the history of the incident and the mechanism of the injury

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history of incidentunnatural posturePatient may complain of pain at the site of injurytingling, burning, unusual, or absent feeling in limbsabsence of pain in limbsinability to move arms and/or legspenile erectionDifficulty breathing Loss of bladder or bowel movementonset of shock

Signs and Symptoms

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If conscious Keep the patient calm and still as possible Do not move patient unless absolutely necessary, use log roll technique• Call 000• Support the head and neck in the neutral position until ambulance arrives• Rest, reassure and keep the patient warm• Closely monitor patient for response and breathing

How to Manage

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If unconsciousApply DRABCDHandle gently with no twisting, and minimal movement of the head and neckTurn Patient onto their side to protect airway (log roll),ensure when that spinal alignment is maintained

How to Manage

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Care of the airway takes precedence over any other injury (including neck and spinal injury)

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The body’s reaction to heat and cold

QAS 120

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Hyperthermia

QAS 121

Symptoms and Signs

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Move Patient to cool, shaded, ventilated area.Lie flat with legs elevated.Loosen and remove excess clothing.Cool by: fanning spraying with water applying wrapped ice packs to neck, groin and armpits draping wet sheet over body or fanning.Give cool water to drink, if fully conscious.Seek medical help or Call 000 if in doubt

How to Manage

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Progression of Hypothermia

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Signs and Symptoms

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Confusion Slurring of speechBehaviour changesHeat rate slowsLoss of consciousness

Pale skinCold to touchShiveringSevere hyperthermia there is no shiveringDifficulty in coordinating

QAS 122

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If conscious Seek shelter – protect from wind chill Wrap in blankets/ sleeping bag or space blanket and cover head• Handle gently to avoid heart arrhythmias• Keep horizontal to avoid changes in blood supply to brain• Replace wet clothing with dry• Give warm, sweet drinks if consciousCall 000IF NOT SHIVERING and help is delayed:• Apply heat packs to groins, armpits, and side of neck.• Body-to-body contact can be used.If unconscious • Apply DRSABCD

How to Manage

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How to Manage

DO NOT re-warm too quickly – can cause heart arrhythmiasDO NOT use radiant heat (eg fire or electric heater), may send cold blood from the body to the heart and brain too quickly• DO NOT rub or massage extremities - dilates blood vessels in skin so body heat is lost.• DO NOT give alcohol – lowers the body’s ability to retain heat DO NOT place in hot bath as lethal arrhythmias could occur , monitoring and resuscitation if needed may be difficult.

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Burns and Scalds

Burns are injuries that damage and kill skin cells, caused by heat or extreme coldBurns are most commonly caused by exposure to flames, hot objects, hot liquids, chemicals or radiation. Scalds are caused by contact with wet heat such as boiling fluids or steam. Electrical burns are less common, but have the potential to be more serious as the depth of the burn is usually greater than is apparent, and cardiac irregularities may occur.

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Superficial reddening (like sunburn)outer layer of skin onlyPartial thickness blisteringdamage to deeper layers of skinFull thicknesswhitish, or blackened areasdamage to all layers of skin, plus underlying structures and tissues

Types of Burns

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Apply DRSABCD - Ensure your own safety• Cool affected area with water for as long as necessary – up to 20mins Hydrogel products are an alternative if water is not availableCall 000• Remove rings, watches, jewellery from affected area as they restrict circulation when swelling occurs• Cut off contaminated clothing – do not remove clothing contaminated with chemicals over the head or face• Cover the burned area with a loose, non-adherent dressing (sterile non-adherent dressing, plastic cling wrap, wet handkerchief, sheet or pillow case) to protect and minimise infection Elevate burnt limb if possible

How to Manage

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Rule of Nines- estimates the surface area of a burn

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Shock from loss of blood or plasmaInfectionBreathing problemsCirculation restricted or cut off.

Complications of Burns

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Use ice to coolOver cool the burn injuryTouch the burn injuryRemove clothing stuck to burn areaPrick or break blistersUse any oil, butter or ointmentUse cotton wool,towels,cotton blankets or adhesive dressingsGive any alcohol

Do Not

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IngestionInhalation

InjectionAbsorption

Poisons enter the body

Via

QAS 106

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How Poisons Act

Central nervous systemOxygen displacementDamage internal organsDamage to the cells

QAS 105

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Apply DRSABCD• Call Poisons Information Centre for advice 131126 or Call 000• Monitor Vital Signs Identify type and quantity of poison• Establish the time of poisoning.• DO NOT induce vomiting.• DO NOT give anything by mouth

How to Manage

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Bites and Stings – Category 1

Management – Pressure ImmobilisationSnake/Sea Snake, Funnel Web Spider, Blue Ringed Octopus, Cone ShellComment – Pressure Immobilization is used to slow the movement of venom

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Bites and Stings – Category 2

Management – Ice/Cold CompressBee, Wasps, Ant, Red Back Spider, White Tail spider, bush tick, common jellyfishComment – Ice/Cold Compress relieves pain and swelling by reducing flow of blood to the bite site. Apply Pressure Immobilisation if allergic to bite/sting

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Bites and Stings – Category 3

Management – Heat/Hot WaterStonefish, Bull Rout, Stingray, Non tropical Bluebottle, other spine fishComment – Heat/Hot water is an effective treatment for minimising pain

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Bites and Stings – Category 4

Management – VinegarTropical Jellyfish, Box Jellyfish, IrukandjiComment – Vinegar inactivates the discharge of stinging capsules which prevents further injection of venom. Vinegar cannot relieve pain from venom already injected

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Stroke occurs when the blood supply to part of the brain is disrupted, resulting in damage to brain tissue.• This is caused by either a blood clot blocking an artery (cerebral thrombosis) or a ruptured artery inside the brain (cerebral haemorrhage)• The signs and symptoms of a stroke may vary, depending on which part of the brain is damaged

Stroke -Brain Attack

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Sudden severe headacheSudden nausea and/or vomitingConfused emotional mental state that could be mistaken for drunkennessBlurred vision, unequal pupilsParalysis, weakness or loss of coordination ,loss of balance , generally on one side of the body but can be both sidesDifficulty talking, understanding or swallowing Urinary incontinenceGradual or sudden loss of consciousnessMay have seizures

Signs and Symptoms

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Fast Test

FAST is a simple way of remembering the signs of a stroke:• Facial weakness – Can the Patient smile? Has their mouth or eye drooped?• Arm weakness – Can Patient raise both arms?• Speech – Can Patient speak clearly and understand what you say?• Time to act fast - Call 000

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If Patient fails any one of the FAST tests act FAST and call 000Adopt position of comfortEnsure airway does not become obstructedReassurance – talk to the Patient even if unconsciousUnconscious – place in recovery position

How to Manage

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TONIC-CLONIC SEIZURESProtect from harmPlace something soft under headLoosen tight clothingRoll into recovery position when seizure subsidesReassure until fully recoveredCall 000, if necessaryDO NOT put anything in the patient's mouthDO NOT restrain the patientDO NOT move the patient unless in danger

How to Manage - Epilepsy/Seizure

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Febrile convulsions occur when a child has a high temperature.The growing brains of small children are more sensitive to fever than are more mature brains When the normal brain activity is upset a convulsion or fit can occur.Febrile convulsions may occur in children aged six months to six years Manage as for Seizure/Epilepsy PLUS:• Remove excess clothing• Apply moist cloth to forehead (no ice).• DO NOT allow shivering to occur• DO NOT put in cold bath

Febrile Convulsions

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Diabetes is a condition which is caused by an imbalance of sugar, or glucose, in the blood. Diabetic emergencies appear in two forms:Hypoglycaemia – or low blood sugar is an imbalance where the tissues especially the brain cells, become starved of essential sugar. The onset is rapid.Hyperglycaemia, or high blood sugar is an imbalance of blood sugar, which usually requires the affected person to supplement their insulin by periodic injections.:

Diabetes

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Both conditions (Hypo and Hyperglycaemia) aremanaged the same way by first aiders

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Hypoglycaemia

Signs and Symptoms:Pale skinProfuse sweatingHungerConfused or aggressiveRapid and strong pulseMay appear to be drunkSeizuresUnconsciousness

ManagementIf conscious give either a:sweet drink (not diet drink), jelly beans or sweets, glass of fruit juice, orteaspoon of sugar or honeyThe patient will normally respond well and rapidly to this treatmentEncourage patient to have more sugary food or drink until they feel betterIf patient dies not improve or worsens call 000 DO NOT attempt to give insulin injection Give nothing by mouth to a unconscious diabetic

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Hyperglycaemia

Signs and Symptoms:Hot, dry skinExcessive thirstFrequent need to urinateSmell of acetone (nail polish remover) on the breathDrowsiness and extreme tiredness,fatigueUnconsciousness, progressing to coma (diabetic coma)Weight loss

ManagementDefinitive treatment for high blood sugar requires medical expertise.When in doubt if the patient has low or high blood sugar, treat as for low blood sugar. DO NOT attempt to give insulin injection Give nothing by mouth to a unconscious diabetic

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Minor Eye InjuriesInjuries where the eye has been struck by a foreign object, or has a small object adhering to its surface, causing irritation. It is characterised by a bloodshot eye, irritation, and an urge to rub the eye.How to Manageirrigate the eye and wash the object out if this fails, touch the corner of a clean wet cloth to the object and lift it off the surface refer to medical aid if vision is affected cover the affected eye if appropriateavoid ‘pushing’ the object around the eye’s surface only use eye-drops if prescribed by a doctor

Eye Injuries

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Assessment

Multiple choice testPractical scenarios

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