Cycle First Aid by Steve Evans SRPara MCPara Liverpool Century RC Member
Cycle First Aid
Cycle First Aid Aims of First Aid • • • •
Preserve Life Prevent Condition Worsening Promote Recovery Send for Help Early 999 or 112
Systematic Approach C - Care – Be aware of danger to yourself “A dead rescuer is no good to anybody” and to the casualty and others • Moving traffic • Blind Bends • Spilt fuel • Create a NO smoking area
Systematic Approach C - Care R - Reconnaissance – You need to know how many Casualties there are, for each unconscious / seriously injured casualty you need an Ambulance ( 3 on the floor = 3 Ambulances )
Systematic Approach C– R– Inform – Dial 999 or 112 for the Ambulance Service or other Emergency Services if there is spilt fuel, threat of fire, trapped casualties, dangers to others
Systematic Approach C – R – I – Treat the casualties according to their needs remember your Priorities Catastrophic bleed, Airway, Breathing • Do NOT Move the Casualty unless their life is threatened
Common Injuries Head on - Head and Face, Potential Neck – check the damage to the cars windscreen, Chest or Abdominal, fractures to thigh bone, (handle bars) hand / thumb Side impact - Traumatic amputation of lower leg or fractures / dislocated ankle FOOSH - Fractured Clavicle/Shoulder, broken wrist/forearm Over Half of Cyclist who end up in hospital have Head injuries,50% Arm, 40% Leg, 5% Chest/abdomen. Road Rash
Common Injuries
Consider the Damage Look at the potential for injuries,internal and external
Priorities • Catastrophic (life Threatening ) Bleed • Airway – clear if blocked or open if not breathing, being aware of potential Neck Injury, Cover open chest wounds • Cervical Awareness – DO NOT Remove Helmet unless life is threatened • Breathing – if No then start resuscitation
The No 1 Cause of Death • The No 1 Cause of Death in Trauma is a blocked Airway • When Unconscious the tongue drops to the back of the Casualty’s throat blocking their airway • This is preventable by performing a Jaw Thrust or Chin Lift
Tongue Blocking Airway
Jaw Thrust
Criteria for Helmet Removal • A Blocked Airway that cannot be cleared in any other way • The Casualty's Chest or Abdomen is not rising and falling (Not Breathing) • The need for Resuscitation • Remember that it takes 2 Persons to remove a Helmet safely
Control Of Haemorrhage
Wound Types
Contusion (bruise) Laceration – tearing of the tissue Incision – clean cut with sharp knife Puncture – penetrating wound Graze / abrasion – Road Rash
Road Rash
Road Rash
These injuries look and feel painful Look beyond the gore Are there underlying injuries Fractures Internal Injuries/bleeding Head Injuries
Road Rash Treatment
Check for Underlying Injuries Wash out Dirt and Grit Cover with Clean dressing Needs scrubbing within a medical centre to prevent scaring and promote healing Moist dressings help the healing process Check for Infection later on,i.e. redness, hot to touch, swelling in Armpit or Groin
Body’s Reaction to Bleeding The body reacts three ways to control bleeding Blood clots Ends of vessels contract Blood pressure falls
Blood Loss P-
Posture / Position
E-
Expose / Examine
Foreign Objects
Splinter from the Velodrome track
Blood Loss P-
Posture / Position
E-
Expose / Examine
E-
Elevate
P-
Pressure
Pressure Points  Brachial – Upper arm, underneath the bicep muscle pressing against the upper arm bone
Pressure Points
Pressure Points Brachial – Upper arm, underneath the bicep muscle pressing against the upper arm bone Femoral – upper 3 rd of the groin pressing the femoral artery against the rim of the pelvis this will take 2 thumbs
Pressure Points Brachial – Upper arm, underneath the bicep muscle pressing against the upper arm bone Femoral – upper 3 rd of the groin pressing the femoral artery against the rim of the pelvis this will take 2 thumbs Apply for Max 10 mins then release for 1 minute to flush the build up of toxins then re-apply if required
Shock Signs & Symptoms
Pale, cool, clammy skin Ashen, cyanosed skin Fast weak pulse Rapid shallow breathing Nausea Feeling faint – lower level of consciousness
Shock-The Falling Lift Early – Disorientated / Confused Compensates by – Fast Pulse - Rapid Breathing - Pale cool Clammy Skin Feels Faint Late Sign – Cyanosed Late Sign - Unconsciousness
Shock - Treatment
Treat the possible cause Loosen tight clothing Rest – comfortable position Reassurance – Nil by Mouth Consider raising the legs – Not in Cardiac cases
Head Injuries Laceration to scalp Concussion – shaking of the brain Compression – Bleeding in skull Skull fracture – cranium / base
Levels of Consciousness • • • •
Alert and responsive Verbal - Responding to speech Pain - Responding to pain Unresponsive -No response
These are most important when dealing with severe head injuries
Compression Head Injury
Compression Head Injury Bleeding within the Skull compressing the brain Loss of Consciousness Unequal Pupils Flushed face Slow full bounding pulse Vomiting TREATMENT = 999 Ambulance Be Neck Injury Aware
Concussion
Shaking of the brain Loss of Consciousness – amnesia Vomiting Headache/dizziness = Hospital Broken helmet = more serious Treatment, Monitor the Patient for changes, take to hospital if concerned
Head Injury Treatment Gain history Monitor AVPU, Breathing, pulse Dress any wounds If Unconscious A.B.C.
Functions of the Skeleton Gives shape and support Protects internal organs Along side major bones are major blood vessels / nerves for protection
Classifications of Fractures Closed – the bone is fractured but there is no external wound Open – there is an external wound leading to the site of the fracture. The bone may be protruding Complicated – the ends of the bones have damaged underlying organs
Hand Injuries
FOOSH-Arm Injuries
Broken Collar Bone
Broken Collar Bone
Complications of Collar Bone injury • Damage to Underlying OrgansPunctured Lung causing difficulty in breathing • Damage to blood vessels- Arteries and veins leading to blood loss • Damage to nerves- loss of movement or sensation
Signs and Symptoms of Collar Bone Injury • • • • • •
Pain over the area of the break A bump may be felt or a step seen A reddish-purple bruise starts to appear The shoulder appears to sag or drop Inability to raise the arm due to pain People report a popping or snapping sound
Treatment of Collar Bone Injury • Look for Underlying problems, breathing or massive swelling • Apply a sling or at least support the injured side • Treat for shock • Give pain relief if available • Send to hospital for an X-Ray • Do not allow to ride any further
Leg Injuries
Signs & Symptoms of a fracture Swelling Loss of movement Irregularity Pain Deformity
Unnatural movement Crepitus Tenderness Shock
Fractures - Treatment Upper limbs – support in a comfortable position Lower limbs – do NOT move unless life is threatened Lower limbs – do NOT attempt to straighten limbs Treat for Shock
Strains & Sprains Strain – history of over stretching - sudden sharp pain - swelling possible cramps Sprain – history of twisting a joint - pain at joint - swelling possible discolouration
Strains & Sprains Treatment
Treatment for both R.I.C.E. Rest Ice – bag of frozen peas in a cloth Compress – not to tight Elevate – to the height of a stool
Spinal Injuries
The Spine
Spinal Injuries
Spinal Injuries - Causes
Sports accidents Road Traffic Collisions Falls Vertical Deceleration Injury Diving Accidents Head injuries Direct force injuries
Spinal Injuries – Signs & Symptoms
History is Vital May be no obvious signs of injury Lack of sensation Pins & Needles Inability to move limbs Back or Neck pain No symptoms present – damage yet to be done
Spinal Injuries - Treatment If you suspect a spinal injury The Casualty must Not be moved unless their life is threatened Keep the head still – Trauma Head hold Do not allow others to interfere Remember – there is no second chance
Trauma Head Hold
Spinal Injuries If there is Vomit or blood in the Casualty’s airway and it cannot be cleared. Then there is need for a Log Roll to be performed Log Rolls can only be performed safely with 4 persons, one to hold the head and control the rest of the group, there is a need to work as a team and roll the Casualty on to their side as one unit (Log)
Cardio Pulmonary Resuscitation
Priorities for CPR D - Danger R - Response S - Stop Life Threatening Bleeding A - Airway - be Neck Injury Aware B - Breathing NO dial 999 C - Compressions / Rescue Breaths (1 person to hold the head)
Trauma Head Hold
Hand Position - Adult
Adult Basic Life Support Notes The determinant for starting CPR is now a patient who is “Not breathing normally”. This indicates agonal or cheyne-stokes breathing where the heart has already Stopped. Agonal breathing is characterised by respiratory effort in short gasps, with absences in breathing up to 15-30 seconds in-between gasps. There is no longer an initial 2 ventilations. Once a decision to commence has been made, the rescuer starts with 30 compressions. There are no longer any pulse or circulation checks once CPR has started. The determinant for stopping resuscitation is a patient who is “Breathing normally”. The rescuer has the option to perform compressiononly CPR, at a rate of 100 compressions per minute. This is where the need for mouth-to-mouth would previously have prevented people from doing anything.
Effectiveness of Rescuer CPR Number of Compressions
Approved Compressions
1 min
81.5
92.9%
2 min
80.2
67.2%
3 min
80.6
39.2%
4 min
84.3
31.3%
5 min
77.4
18.0%
Hightower D: Annals of Emergency. Medic. (1995) Sept 26:3
ICE in your Mobile • It is recommended that you place In Case of Emergency (ICE) in your contacts within your Mobile phone • It is good practice as Emergency workers like Doctors , Nurses and Paramedic will be able to contact your family if you are Unconscious or Badly injured • Place Name, Number and relationship
Really Bad Cycling Injury Helmet Hair
Cycle First Aid by Steve Evans SRPara MCPara Liverpool Century RC Member