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Emergency

First Aid

David Olley


This Handbook is ideal for use in support of a properly structured first aid course. It will also prove invaluable as ongoing reference for someone who has completed a course

emergency

first aid

AED Airway Angina Asthma Basic life support Bleeding Bruising Burns Choking CPR Cross infection Diabetes Eye injury Face shield/mask First Aid response Fractures Grazes Heart attack Internal bleeding Minor cuts Nosebleed Poisons Primary survey Record-keeping Recovery position Secondary survey Seizure Shock Stroke Unconscious casualty Wounds Wound dressing

Š2015 Safety Publishing Ltd. All rights reserved. No part of this publication may be reproduced in any form or by any means without the written permission of Safety Publishing Ltd

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Emergency First Aid

Standard Infection Control Cross infection occurs when bacteria or viruses that cause infection are passed from

one person to another. In a First Aid situation this may be from the casualty to the first aider or first aider to the casualty, so it is a good idea to minimise any risk. Although the risk of catching disease from a patient is low, it is something that anyone who is likely to offer first aid hould be aware of.

Blood Born Pathogens Pathogens are microorganisms that cause disease. Blood-borne pathogens are viruses or bacteria that are present in human blood and body fluids and which can infect and cause disease in humans. The two most important of these are Human Immunodeficiency Virus (HIV) and the Hepatitis B virus (HBV).

How are they spread? The most common way is through sexual transmission or IV drug use. However, any contact with infected body fluids or blood could potentially carry the risk of infection. Having the correct information can allay irrational fears about exposure to HIV and HBV. On the other hand, treating these potential infections too lightly may lead you to ignore appropriate protective measures. Protecting yourself It is important to understand what the potential problems might be and what measures you can take to protect yourself from exposure. Attitude Your attitude is a vital part of protecting yourself. Having the correct attitude means taking Universal Precautions. This means that you treat all human blood and body fluids as infectious. Personal protective equipment Personal protective equipment (PPE) may include clothing and equipment worn by an individual when undertaking activities which could result in exposure to blood-borne pathogens. ▪ PPE always starts with gloves but could include aprons and pocket masks. ▪ Gloves and aprons protect your clothing and hands from coming into contact with blood. Vinyl or nitrile gloves are preferred to latex as there is a possibility of a serious allergic response to latex ▪ Pocket mask refers to any one of several types of devices that may be used whilst performing CPR or rescue breathing.


Emergency First Aid Safe working practice ▪ Treat all blood and body fluids as if they were infectious. ▪ Wear appropriate personal protective equipment. ▪ When performing rescue breathing us a pocket mask equipped with a one-way valve. ▪ Contain spills immediately, then cleanup and disinfect the area. ▪ Clean up contaminated sharps or broken glass with tongs, forceps or a brush and dustpan. ▪ Handle all waste as if it contains sharps or infectious material. ▪ After removing PPE wash hands and other affected areas with soap and warm water. ▪ Place all potentially infectious materials and contaminated items in closable containers or bags, clearly marked as infected waste or biohazard. If you think you have been exposed ▪ Flush the area with warm water then wash vigorously with soap and water. ▪ If you have an open wound, squeeze gently to make it bleed. ▪ Seek emergency medical treatment following an exposure incident. ▪ Seek counselling regarding the risk of HIV or HBV infection and any other follow up treatment that may be needed.

Accident Records All accidents and incidents that occur in the workplace should be reported and recorded. A book for this purpose can be bought from most stationers or first aid equipment suppliers. The records and the way they are kept should comply with the Data Protection Act 1988 and 2003 The record may be completed by anyone but should include: ▪ the date, time and location of the incident ▪ the personal details of the injured party ▪ details of the injury or illness and what first aid treatment was given ▪ what happened to the casualty after treatment (went home, hospital etc.) the name and signature of the person completing the record

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Emergency First Aid

Summoning Help 999 or 112 are the free 24-hour numbers to call for emergency help. When you get through the operator will ask you which service you require. (An Garda Siochaná, Fire Service, Ambulance Service or Coast Guard) If you ask for an ambulance they will then take details of why you need help. The initial questions are to prioritise just how urgent the problem is. In particular they will ask you if the person you’re calling about is unconscious, has breathing difficulties or chest pain as these may be life-threatening and need the fastest response. ▪ Try to stay calm and to pass on to ambulance control as much information about the casualty’s condition as you can. ▪ Only pass on information you know to be true, guesses or assumptions may mean you are given inaccurate advice. ▪ Give as much information about your location as possible to help the ambulance crew find you. ▪ Don’t hang up until the ambulance controller tells you to. ▪ In an emergency the controller is trained to talk you through procedures or to remind you to do checks that you may not have thought of. This can be ▪ reassuring at a very tense time.

Stay calm, stay focused and stay on the line

112 The EU Emergency Phone Number These days most people carry a mobile telephone and it is likely that the emergency call would be made from this. If this is the case then dialling 112 instead of 999 may have some advantages. ▪ Over 70 countries including all of Europe use 112 as an emergency number. ▪ If your mobile doesn’t have a signal, when you dial 112 it will automatically search for and use any other mobile service which does have a signal. ▪ If your P.A.Y.G. mobile is out of credit it will still call 112. ▪ With most modern mobiles if you have to call from someone else’s phone which ▪ is locked, it will still call 112 even without the password. ▪ 112 will work just as well as 999 from a land line telephone.


Emergency First Aid

The Initial Response The first aider should not be expected to deal with complex casualties or incidents, but to provide an initial response where first aid is required. In some circumstances such as minor wounds or injuries the first aid given may be the only treatment that the casualty receives. Where injuries or illnesses are more serious first aid may be followed by treatment from ambulance paramedics, doctors or hospital staff. Assess the situation ▪ Identify potential hazards to the health and safety of yourself, the casualty and others. ▪ Where appropriate, attempt to minimise these hazards. ▪ Assess the casualty’s vital signs and physical condition in accordance with established first aid procedures. Apply basic first aid techniques ▪ Apply first aid management in accordance with established first aid procedures. ▪ Conduct primary survey to establish the presence of life-threatening conditions. ▪ Respond to results of primary survey and give basic life-support as appropriate. ▪ Control blood loss, look for and treat shock. ▪ Conduct secondary survey to establish the presence or otherwise of further illness or injury. ▪ Treat injuries as appropriate according to established first aid procedures. ▪ Reassure and make the casualty comfortable as appropriate. ▪ Seek assistance from others as necessary. Communicate details of the incident ▪ Request medical assistance at the appropriate time using available communications. ▪ Accurately convey details of the casualties condition and treatment given to the emergency services or relieving personnel. ▪ Assist where appropriate in the preparation of accident investigation. Priorities for first aid treatment The priorities for first aid treatment can be remembered by the initials D.R.A.B.C. Danger: Are you, the casualty or others in danger? Response: Is the casualty responsive? Airway: can they breathe? Breathing: are they breathing normally? Circulation: are they bleeding or in shock?

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Emergency First Aid

Emergency Response Plan In any emergency it helps to have a clear plan of action. This helps you to prioritise your actions and to ensure that things are not missed. The plan will need to cover the following steps:

Make the area safe if possible. Do not take risks.

Yes

DANGER To yourself,the casualty or others No

RESPONSE? Shout and shake No

Find and treat other injuries Yes Control serious bleeding Treat shock Call for medical attention

Shout “HELP” Send for AED

Think about possible C spine injury.

AIRWAY Open with head tilt - chin lift

BREATHING NORMALLY? Yes Quick check No

START CPR Give 30 chest compressions CONTINUE CPR Continue at 30:2 until arrival of AED or ambulance

Secondary survey Recovery position Treat other injuries Call for medical attention


Emergency First Aid

Patient Assessment To maintain life a person needs oxygen to be supplied to every cell in the body. This oxygen comes from the atmosphere around us so to take it in we need to be able to breathe effectively and to circulate the oxygen effectively to the cells. With this in mind we need to know: Can they breathe? - Airway Are they breathing normally? - Breathing Is the oxygen being transported effectively? - Circulation

Primary Survey

A airway

Can they breath? If they are unconscious, open the airway with head tilt /chin lift. If they are conscious, treat conditions such as choking

B breathing

Are they breathing normally? If they are unconscious and not breathing normally, first call 999 for help then start CPR. If they are unconscious and breathing normally, examine them for other injuries and place them carefully into the recovery position.

C

Are they bleeding or in shock? Control any serious bleeding and circulation look for and treat the effect of blood loss or shock. Call 999 for an ambulance

Secondary Survey The secondary survey is undertaken to discover the extent of the casualty’s injuries or illness, or to assess the effectiveness of treatment given during the primary survey. There are three elements to the secondary survey: ▪ History / Mechanism Of Injury (M.O.I.) ▪ Signs ▪ Symptoms History / mechanism of injury This refers to what happened or how it happened and will give important information or clues as to what may be wrong. The information may be given by the casualty or by witnesses at the scene. There may also be physical clues at the scene. Signs A sign is something that you find for yourself using your own senses. It may be something that you see, feel, hear or smell. Symptoms Symptoms are the feelings that the casualty experiences due to the accident injury or Illness. The most common symptom described by the casualty following injury is probably pain.

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Emergency First Aid

Examining the Casualty Examining the casualty just means looking carefully at them. It is important that the casualty is examined for signs of obvious injury, and for their general appearance and demeanour. The results of the examination put together with the history and the symptoms described by the casualty are often enough to suggest what might be wrong with them and also to suggest an appropriate course of action. It is often suggested that the first aider should perform a formal top to toe examination at some stage. This often involves feeling and pressing on the casualty’s chest, abdomen, neck and lower spine as well as their limbs, looking for abnormalities and irregularities. This approach can be potentially difficult, misleading and dangerous for the following reasons: ▪ A first aider will never have felt enough normal bodies to know what is abnormal, and therefore could never exclude the possibility of injury, based on their top to toe examination. It would not be safe to do so, so if the history suggests injury then they have to assume it. ▪ By pressing on an injured spine or abdomen, they could cause pain or physical harm to the casualty. Bleeding ▪ Have a good look at the casualty from top to bottom looking for obvious signs of bleeding. ▪ Look for signs of hidden bleeding such as bruising or swelling. ▪ Pale cold skin or signs of shock? ▪ Have they got blood on their clothing? ▪ Control any serious bleeding as a priority. Head and neck ▪ Are there any signs of injury to the head such as lumps, bruising or bleeding? ▪ Swelling or bruising around the eyes? ▪ Blood, or pale coloured liquid leaking from the ears or nose? ▪ Does the accident suggest a neck injury? If so assume it. Torso and limbs ▪ Are there any obvious signs of injury? ▪ Does the casualty seem to have trouble breathing? ▪ Do they experience pain on breathing or coughing? ▪ Does the history of the incident suggest a blow or crushing injury to the torso? ▪ Are their arms and legs the correct shape and pointing in the right direction? ▪ Are they showing signs of bleeding or shock with no obvious external bleeding? Pockets and clothing ▪ Is there any information that might explain their situation? ▪ Look particularly for medical information on lockets or bracelets. ▪ Are they carrying medication? ▪ Remove any sharp or bulky items from their pockets before moving them to avoid potential injury.


Emergency First Aid

Levels of Consciousness Unconsciousness can be defined as a reduction in activity in the nervous system that leads to changes in the casualty’s responses to the world around them. The management of the unresponsive casualty may be the most important thing that a first aider will learn. Any casualty who is unconscious is in grave danger due to the absence of the cough and swallow reflexes which guard the airway. Anything in their mouth could block the airway. This may include food, blood, saliva and vomit, but most commonly their own tongue. The level of consciousness may be estimated using the AVPU scale.

A alert

Fully conscious and aware Eyes open spontaneously

V verbal

Appears sleepy with eyes May make uncoordinated closed. Eyes open to speech movements or sound. Speech may be Reflexes are intact slurred

P pain

Appears deeply asleep with Does not open eyes to speech eyes closed Functioning reflexes

U

Reflexes are intact and normal

Appears deeply asleep with Does not respond to any Stimulus unresponsive eyes closed Does not open eyes Functioning reflexes

Causes of Unconsciousness Direct injury to the brain such as: ▪ head injury ▪ haemorrhage ▪ stroke ▪ brain abscess

Indirect injury to the brain such as: ▪ infections ▪ drugs, including alcohol ▪ extremes of temperature ▪ heart attack ▪ diabetes ▪ shock ▪ asphyxia

Treatment of Unconsciousness ▪ ▪ ▪ ▪ ▪

Perform a primary survey to establish airway and breathing. Perform a secondary survey to find and treat (if required) other injuries. Place the casualty carefully into the recovery position to maintain the airway. Send for medical help. Continue to observe and monitor.

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Emergency First Aid

The Recovery Position The aim of the recovery position is to maintain and protect the airway by placing the casualty in a position on their side with the head lower than the chest. This allows the tongue to full forward and allows drainage of blood, saliva or stomach contents from the mouth, by gravity. It reduces the risk of the lungs being damaged by corrosive stomach contents due to the absence of the swallow and cough reflex. ▪ Remove the casualty’s glasses, if worn. ▪ Check their pockets for bulky or sharp objects that may be a problem if they lay on them.

Place the arm closest to you up and out of the way, with the elbow bent and the palm facing upwards, but don’t force it.

Bring the across the the back alongside face.

furthest hand body and hold of the hand the casualty’s

Reach across to the furthest leg and pull the knee up, keeping the foot flat on the floor.

Keeping their hand against the face to support the head, pull gently on the knee to roll the casualty toward you.

Once the casualty is fully over, pull up on the knee to prevent them from rolling back.

Adjust the head to keep the airway open. Adjust their hand under the cheek to keep their head tilted back.


Emergency First Aid

Chain of Survival The chain of survival demonstrates the steps that are necessary to increase the casualty’s chance of surviving sudden cardiac arrest. Their chances will be greatly improved when all of the links are in place.

Early access

Early CPR

Early defib

Advanced care

Early access ▪ Early access to the rescue services or to someone with a defibrillator. Early CPR ▪ To buy time until the arrival of the defibrillator. ▪ CPR alone is unlikely to reverse SCA but it will help to keep the organs oxygenated until the heart can be restarted. Early Defib ▪ Chances of survival decrease by around 10% per minute. ▪ Early defibrillation has to be the target. Early ACLS ▪ If someone has been so ill that their heart has stopped, then there is always the possibility it could happen again. ▪ Proper ongoing care or advanced cardiac life support techniques may be able to prevent this.

Compression Only Resuscitation Cardio pulmonary resuscitation means combining chest compressions with rescue breathing. If for any reason the rescuer does not feel confident in performing full CPR or if there is blood or vomit on the casualties face or around their mouth and the rescuer is not comfortable in performing rescue breaths then they should start compression only resuscitation immediately. They should maintain compressions at 100 – 120 compressions a minute until help arrives or until the casualty recovers.

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Emergency First Aid

Approach with CARE ▪ Make sure that there is no danger to yourself, the casualty or bystanders. ▪ Deal with danger if appropriate but do not take chances with your own safety. The Initial Response

Check RESPONSE ▪ Check initially in the position that you find them. ▪ Speak loudly to them. ▪ Use their name or ask them to open their eyes. ▪ If no response, shake them gently by the shoulder. If they respond: ▪ Leave them in the position that you found them. ▪ Check to find out what might be wrong. ▪ Observe and reassess regularly. If they do not respond: ▪ Shout loudly for help.

Shout “HELP” ▪ If you are alone, shout for help loudly to try to attract attention but do not leave the casualty. ▪ If someone is nearby ask them to phone an ambulance. ▪ Send for an AED if available

Open the AIRWAY ▪ Undo anything tight around the neck and remove their glasses, if worn. ▪ Place one hand on the forehead and two fingers of the other hand under the bony part of the jaw. ▪ Gently rotate the head backward and lift the jaw. ▪ This lifts the tongue and straightens the airway.

Check for NORMAL BREATHING ▪ Place your ear over the casualty’s nose and mouth, looking down towards the feet. ▪ Check for no more than 10 seconds. ▪ Look–for movement. ▪ Listen–for breathing. ▪ Feel–for breath on the cheek.


Emergency First Aid

If they ARE breathing normally ▪ Examine them carefully for any immediately life-threatening injury, such as severe bleeding, and treat if possible. ▪ Turn them carefully into the recovery position as soon as it is practical to do so.

If they ARE NOT breathing normally ▪ Ensure that an ambulance is called and that an AED has been sent for if there is one available. Try to call yourself without leaving the casualty. ▪ If you have a speaker phone, switch it on ▪ Calling ambulance control means that they can locate the nearest AED and arrange for it to be sent if necessary. They can also offer advice on diagnosis and treatment and if necessary, talk you through the procedure. ▪ Start CPR with 30 chest compressions

Deliver CHEST COMPRESSIONS Chest compressions should be performed with the casualty lying flat on their back on a firm surface. It should not be necessary to undress them or expose the chest unless they are wearing very heavy outer clothing

Place the heel of one hand in the centre of the chest, on top of the breastbone

Place the heel of the other hand on top of the first. Keep your fingers from pressing on the chest wall

Position yourself with your shoulders directly above their chest, with your arms straight and your elbows locked

▪ Push straight down on their chest to a depth of 5 to 6 cm ▪ Release the pressure completely between compressions, keeping your hand in contact with the chest. ▪ Keep movements smooth and not jerky. ▪ Erratic or violent movements may injure the casualty and will not pump blood efficiently. ▪ Compress the chest at a rate of 100 to 120 compressions per minute. ▪ It is important to maintain the quality, rate and depth of the compressions Your performance is liable to deteriorate as you get tired. For this reason it is recommended that if another rescue is available and can perform chest compressions, you should change over every two minutes.

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Emergency First Aid

Deliver RESCUE BREATHS Air in the atmosphere contains about 21% oxygen. When we breathe we only use what we need, about 4%, so the air that we breathe out still contains around 17% oxygen. This is more than enough to maintain life in our casualty. Take no more than 10 seconds to deliver two rescue breaths

Use the fingers of the hand performing the head tilt to pinch the nose closed. Take a normal breath.

Seal your lips around their mouth and blow steadily until the chest rises. Each breath should be sufficient to cause the chest to rise as in normal breathing

Release the nose and keeping the airway open let them breathe out. Re-seal your lips and give another rescue breath. Give two breaths in total.

Each breath should take about one second to deliver. Watch the chest as the breath is delivered to ensure that it rises. Do not interrupt compressions by more than 10 seconds to deliver the two breaths. Following the second breath, immediately replace your hands on the chest and continue CPR with a further 30 chest compressions. ▪ Continue with chest compressions and rescue breathing in a ratio of 30:2. Do not stop unless: ▪ You are sure the casualty has recovered, they open their eyes, move, are breathing normally. ▪ You are directed to stop by a qualified practitioner ▪ You become too exhausted to continue. ▪ ▪ ▪ ▪


Emergency First Aid

Cardio pulmonary resuscitation (CPR) CPR means combining chest compressions with rescue breathing ▪ Give 30 chest compressions followed by two rescue breaths. ▪ Ratio 30:2. Continue until: ▪ The casualty shows obvious signs of recovery, such as opening their eyes or coughing. ▪ Someone else takes over from you. ▪ You are alone and too exhausted to continue.

Compression only resuscitation If you are unable or unwilling to give rescue breaths, start compression only resuscitation. ▪ Give chest compressions to a depth of 5 to 6 cm and at a rate of 100 to 120 compressions a minute. ▪ Continue chest compressions without a break, stopping to check the casualty only if they show obvious signs of recovery.

Regurgitation/vomiting Regurgitation is common during resuscitation attempts. If it occurs: ▪ Turn the casualty on to their side, facing away from you. ▪ Support their weight on your legs to prevent them from rolling back. ▪ Ensure that their head faces down and that their open mouth is at the lowest point, to ensure drainage. ▪ If necessary remove debris from the mouth with your fingers. ▪ Place the casualty on to their back, open the airway and check for normal breathing. ▪ Resume CPR immediately if required.

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Emergency First Aaid

When the AED Arrives An AED can be used safely by almost anyone, so its use is not restricted to trained rescuers. However training is preferred to improve performance, leading to a better outcome. When using an AED keep interruptions to chest compressions to a minimum. Do not stop to check the casualty or discontinue CPR unless they show obvious signs of recovery, such as opening their eyes, speaking or starting to breathe.

The AED The appearance of individual AEDs may vary from maker to maker but they will all have similar layouts and properties. The essence of AED design and use is simplicity and so you should be able to use any AED in exactly the same sequence. One type of AED may be used for illustration but the instructions apply equally to all.

Activate the AED ▪ Some AEDs will automatically switch on when you open the lid. ▪ With others you may have to press the “ON“ button. ▪ Attach leads to the AED if necessary.

Attach the pads ▪ Remove the pads from any outer packing. ▪ Look carefully at the instructions on the pads. ▪ Peel off any backing paper and stick the pads onto the casualty’s chest as shown. ▪ One pad should be placed below the right collar bone, next to the breastbone. ▪ The other pad should be placed below the left armpit, on the side of the chest wall, over the lower ribcage. ▪ It is not important which way round the pads are placed.

Pad placement ▪ The casualty’s chest should be exposed to enable correct pad placement. ▪ If the chest is wet it may prevent the pads from sticking and making a good contact. Towel dry is usually sufficient. ▪ Excessive chest hair may also prevent effective contact. The area where the pads are to be placed should be quickly shaved if necessary. ▪ Do not delay defibrillation if a razor is not immediately available. ▪ It is important that the left side pad is placed well back to the side of the rib cage. ▪ If it is too close to the front, current travelling from pad to pad will travel across the front of the chest, missing the heart. ▪ With the pad placed well to the side the current will travel from pad to pad through the heart muscle.


Emergency First Aid Analyse ▪ Keep clear during analysis ▪ Ensure that nobody touches the casualty whilst the AED is analysing the heart rhythm as this may lead to inaccurate results. ▪ Do not stop chest compression for more than 10 seconds during analysis. ▪ Follow voice prompts

No shock indicated ▪ If the voice prompts direct you to start CPR, start chest compression and rescue breathing immediately. ▪ Maintain CPR for two minutes or until prompted to stop. ▪ Continue to follow voice prompts.

Shock indicated ▪ Ensure that everybody is clear of the casualty. ▪ Press the shock button as directed. ▪ After the shock is delivered continue CPR for two minutes, or until directed to stop. ▪ Allow the AED to analyse. ▪ Continue to follow voice prompts.

AED Safety An AED is like any other electrical appliance in that certain safety precautions should be observed to minimise the risk of injury to the operator, assistants or even the casualty. ▪ Keep the electrodes (pads) separate: do not allow them to touch when the machine is switched on. This could complete the circuit and could be dangerous. ▪ Never connect the pads to anyone except a casualty in suspected cardiac arrest: A live AED should never be connected to anyone for demonstration or training purposes. ▪ Be aware of patches on the skin: some medications, particularly GTN may be administered via skin patches. Avoid placing the electrodes directly over the patch.

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Emergency First Aid

AED safety - continued â–Ş Be aware of implants: Devices such as pacemakers or cardioverters may be implanted under the skin. Their presence is often marked by a scar or bump. They are most commonly found high on the left side of the chest and so are not often a problem for pad placement. â–Ş Be aware of inflammable environments: Because of the risk of sparks the casualty may have to be removed from an area containing inflammable vapours, before a shock is given. â–Ş Risk of shock to others: if the pads are making good contact then there is very little risk of shock to others, even in a wet or conductive environment, as long as they are not in direct contact with the casualty. Current will travel from one pad to the other and not into the surrounding area.

Resuscitation of Children People are often worried about performing basic life support techniques on children. The most important thing is to do something rather than to hesitate trying to remember different protocols or worrying about doing harm. If in doubt children should receive the same treatment as adults. The only change is that the chest should be compressed to one third depth. If you can remember the differences however then the following changes may be beneficial.

Open the airway with head tilt/ chin lift. Check for normal breathing. Take no more than 10 seconds.

If they are not breathing normally start with 30 chest compressions. Continue CPR (30:2) for two minutes before calling for an ambulance

Continue CPR until the arrival of the AED or ambulance crew. If unable to ventilate, perform compression only CPR,


Emergency First Aid

Hygiene / Personal Protection Although delivering rescue breathing and chest compressions offers little threat of cross infection to the rescuer, many will find the idea of mouth-to-mouth rescue breathing distasteful and there is a perceived threat from HIV or hepatitis. If this is the case one alternative would be compression only resuscitation, or the rescuer may use one of a number of barrier methods to deliver rescue breathing. It is often suggested that a simple handkerchief or something similar placed over the casualty’s face will form a barrier but this is unlikely to be particularly effective. Similarly, there are available simple plastic sheets with some form of opening which may be placed over the casualty’s face allowing the rescuer to blow through the opening. These are to be preferred to a handkerchief but are still not particularly effective. The best form of barrier for delivering rescue breathing would be a pocket mask designed for the purpose. These have the advantage of allowing mouth to nose ventilation as well as mouth-to-mouth ventilation. They will usually also include some form of one-way valve. Some may have a fixture allowing the expired air to be enriched with oxygen. The mask should be placed over the casualty’s nose and mouth whilst the rescuer blows through the one-way valve.

Keeping the airway open with head tilt and chin lift, the facemask is placed over the casualty’s nose and mouth.

The rescuer then blows through the one-way valve. The casualty’s expired air is deflected from the rescuer by the valve.

The mask may be held in place more easily using both hands in an “over the top” position with the rescuer at the head of the casualty

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Emergency First Aid

Foreign Body Airway Obstruction

Recognition The problem often occurs whilst eating. They will often stand up and clutch their neck. They will look anxious or distressed.

Treatment Encourage them to cough. If they are coughing do not slap them on the back as this may encourage the object to drop further into the throat.

Back blows Bend them forward supporting them on the shoulder. Give up to 5 blows with the heel of the hand between the shoulder blades.

Abdominal thrusts Stand behind the casualty and reach with your arms around the upper abdomen,between the belly button and the point of the breastbone.

Abdominal thrusts Make a fist with one hand and place the fist, thumb end first, against the soft part of their abdomen, just below the point of the breastbone. Grasp your fist with your other hand.

Abdominal thrusts Pull sharply backward and upward, bending from the elbows, at an angle of about 45째 to the horizontal. Repeat up to 5 times, checking for breathing after each thrust.


Emergency First Aid Seek medical attention If your efforts to relieve the obstruction have been successful it is still important that the casualty receives medical attention, particularly if they have suffered a serious obstruction and have required abdominal thrusts.

Treatment – child ▪ Follow the general guidelines for obstructed airway in an adult. ▪ Moderate the force required for back blows and abdominal thrusts. ▪ If not effective dial 999/112 for an ambulance. Treatment – infant If the infant is unable to cry or breathe: ▪ Lay them down supported on your thigh, supporting the head with the hand. ▪ Make sure the head is lower than the body. ▪ Give five blows in the middle of the baby’s back using the heel of the other hand. ▪ If the obstruction is relieved, it is not necessary to give all five blows. ▪ Check the baby’s mouth and remove any foreign material found. ▪ If back blows are unsuccessful, give five chest thrusts. ▪ Place two fingers on the breastbone about a fingers width above the point where the ribs meet. ▪ Give up to 5 sharp downward thrusts, similar to chest compressions but sharper and at a slower rate. ▪ The aim is to relieve the obstruction, not necessarily to give all five chest thrusts. ▪ Check the baby’s mouth for any foreign objects which should be removed. ▪ If necessary repeat the sequence of back blows and chest thrusts three times, and if still unsuccessful take the baby with you to the telephone call an ambulance.

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Emergency First Aid

Choking Summary Signs of Choking?

Prevent leaving

No

Effective Cough?

Yes

Severe obstruction

Unresponsive?

Mild obstruction

Give up to 5 back blows

Dial 999 /112 for an ambulance

Encourage cough

Obstruction not relieved?

Start Chest compressions

Continue to monitor for deterioration to ineffective cough or relief of obstruction

Give up to 5 abdominal thrusts

Continue CPR at 30:2 until the obstruction is relieved and casualty is breathing normally

Alternate 5 back blows and 5 abdominal thrusts


Emergency First Aid

Shock Shock is a condition that results from a failure of the circulation to supply oxygen and nutrients to the tissues and to remove waste products from them. Blood is responsible for transport within the body. It transports oxygen and fuel to the cells and takes waste products away from them. If we have an inefficient circulation or insufficient blood then it will not be able to perform these tasks and the affected cells will be damaged or could die. This could lead to organ failure and the death of the casualty. We call this condition shock.

Shock– causes Fluid loss – may be due to blood loss or loss of fluids in burns and some forms of illness such as severe diarrhoea and vomiting. Heart failure – due to a failure of the pumping action of the heart to produce sufficient circulation. Often a result of heart attack. Nervous – caused by stimulation of certain parts of the nervous system. May be associated with pain, fear or grief or may follow damage to the central nervous system. Allergic – due to a very severe acute allergic response, often referred to as anaphylaxis.

Shock – recognition ▪ Appropriate history (cause) ▪ Pale, cold clammy skin ▪ Cyanosis (blue tinge to the face, particularly the lips) ▪ Rapid shallow breathing

▪ ▪ ▪ ▪ ▪

Rapid weak pulse Cold and shivery Thirst or dry mouth Confused or disorientated Dizzy, nausea, vomiting

Shock– treatment Treat the cause where possible. Reassure. Lay them down and elevate their limbs if their injuries permit. Keep them warm. Give them nothing to eat or drink but moisten their lips if they complain of thirst. ▪ Do not offer alcohol. ▪ Discourage smoking. ▪ Get urgent medical attention. ▪ ▪ ▪ ▪ ▪

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Emergency First Aid

Bleeding and Blood Loss Blood loss refers to blood lost from the circulatory system. It may be lost from the body – external bleeding, or it may be retained inside the body – internal bleeding. Bleeding is controlled because blood congeals and forms blood clots. It is the blood clot which blocks the hole and stops the bleeding. The first aid treatment of bleeding is designed to encourage this to happen by slowing down the flow of blood. This involves the use of ▪ Direct pressure ▪ Elevation In a healthy person it takes up to 10 minutes for blood clots to form, so treatment should always be maintained for at least this period of time

Personal protection Before dealing with the bleeding injury it is advised that the first aider takes basic precautions against blood-borne viruses such as HIV and hepatitis. This should include wearing gloves from the first aid kit.

Wounds In external bleeding the blood escapes from an abnormal break in the surface of the tissues – a wound. The problems associated with wounds are that blood gets out and that dirt and infection get in.

Control of bleeding Remember SEEP to control bleeding

S Sit E Expose E Elevate P Pressure

Sit or lay the casualty down (if their injuries permit) Remove or cut clothing to gain good access to the injury If the wound is on a limb and other injuries permit, elevate the wound above the level of the heart Apply direct pressure to the bleeding point using your hand or a wound dressing


Emergency First Aid

Control of bleeding ▪ Apply pressure directly over the bleeding point, using your fingers or a pad. ▪ Pressure should be maintained for at least 10 minutes, to allow a blood clot to form. ▪ Maintaining the pressure, elevate the bleeding point above the level of the casualty’s heart. ▪ Maintain direct pressure and elevation until bleeding is controlled or until a dressing and bandage become available.

Application of wound dressing

Apply without touching the face of the dressing, to keep it clean. Use the long rolled part of the bandage to hold the dressing in place.

Take care to cover all four edges of the dressing. Retain the short end of the bandage.

Tie off by tying the two ends of the bandage together. If blood soaks through the dressing, apply another dressing on top of the first

Check circulation After applying a bandage make sure it is not too tight by checking the circulation below the bandage site. Remember that injuries swell, so you may have to go back and check again from time to time. Tell the casualty to look out for signs of swelling or puffiness below the site as well as for numbness or pins and needles. If you can feel a pulse below the injury it means that the blood supply is adequate

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Emergency First Aid

Internal bleeding Internal bleeding occurs when blood is lost from the blood vessels but retained within the body, usually within one of the body cavities such as a skull, thorax, abdomen and large muscles. It may follow injury such as a fractured bone or penetrating wound, or possibly occurs as a result of a medical condition such as a bleeding stomach ulcer. Internal bleeding may remain concealed or may subsequently be revealed by visible blood issuing from one of the body openings such as the mouth, nose or ears.

Internal bleeding– recognition The signs and symptoms of internal bleeding will depend on: ▪ Where the blood is escaping from. ▪ Where the blood is being retained. ▪ How much blood has escaped from the circulatory system. ▪ The dangers from internal bleeding may result from serious blood loss leading to blood loss shock, or from pressure build-up due to blood being trapped in a confined space. Signs and symptoms may include: ▪ Pain, both at the site of bleeding and where the blood is being retained. ▪ Changes in level of consciousness, particularly where the blood is trapped inside the head. ▪ Swelling and bruising (later) at the sight of bleeding. ▪ Tenderness, particularly with abdominal bleeding. ▪ Blood appearing at one or more of the body’s natural openings (revealed internal bleeding) ▪ Signs and symptoms of blood loss shock with no obvious external blood loss.

Internal bleeding– treatment There is no definitive first aid treatment to control or stop internal bleeding. This will often require emergency surgery and possibly blood replacement therapy. ▪ ▪ ▪ ▪

Urgent medical attention is life-saving so dial 999/112 for an ambulance. Assess the casualty’s level of response. Place an unconscious casualty into the recovery position. Be prepared to offer life support as required.


Emergency First Aid

Graze Grazes are often caused by a sliding fall onto a rough or dirty surface. They are usually contaminated by dirt and grit. They should be washed thoroughly under a running tap, if possible, to remove dirt contamination. It is often less painful to allow the casualty to do this themselves.

Bruise Bruises are caused by bleeding into or underneath the skin. They may be caused by minor bleeding at the site of an impact or may indicate more serious internal injury. The treatment of bruising is to elevate the injury and apply an ice pack, where possible or where injuries allow. This reduces blood flow to the injury and results in less swelling It is important to look at how the injury was caused and to be alert for more serious internal bleeding. Sometimes, bruising from deeper injuries may not become visible for hours or even days following the injury. If you suspect the possibility of internal injury then you must seek medical advice urgently

Minor cuts and wounds Minor cuts and wounds can be treated quite simply: Wash them carefully with clean water. Apply a clean dry dressing such as a Band-Aid. If clean water isn’t available, it may be possible to use non-alcohol-based cleansing wipes from the first aid kit. Tell the person to observe the injury and if it shows signs of infection, such as redness or swelling, they should seek medical advice

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Emergency First Aid

Splinters

Small pieces of wood or wire that are embedded in the skin can be carefully removed, Clean the area with soap and water before removal is attempted

Grasp the end of the splinter firmly with clean forceps. Pull the splinter out in a straight line, in the opposite direction to the way it entered.

Squeeze the wound firmly to produce a small drop of blood. Apply a small dressing or adhesive plaster.

Embedded Foreign Bodies An embedded foreign body is any object in or on a wound that cannot be simply flicked or wiped off. Do not attempt to remove an embedded foreign body, as this may cause increased damage to the casualty. The object may also be acting as a plug for the wound and helping to control blood loss. If necessary pressure can be applied around or to either side of the foreign body with your hands or with dressings. The general principle is to apply the dressing around the foreign body rather than on top of it. Casualties with large foreign bodies should be left in the position that you find them and medical help should be summoned urgently. If the object is small it should be well padded and supported before the casualty is moved. It may be necessary to reduce the size of the object before the casualty can be moved safely and this is a job best performed by the emergency services.


Emergency First Aid

Nosebleeds Nosebleeds occur when the blood vessels in the nose are damaged or rupture spontaneously. Although nosebleeds are usually unpleasant rather than dangerous, they can occasionally lead to serious blood loss if not controlled. Recurring nosebleeds with no obvious cause should be investigated. Sit the casualty down with the head leaning well forward. Help or encourage the casualty to pinch the soft part of the nose, just below the bony part, for at least 10 to 15 minutes to allow for blood clot formation. If not successful refer the casualty for medical attention, maintaining pressure on the nose. If successful, as is usual, till the casualty not to sniff hard, blow their nose, or do anything which may disturb the blood clot for at least six hours.

Eye injury For small particles of dust or grit that are loose in the eye, wash out with eyewash or tap water. For anything more serious or even if you only suspect a more serious injury, cover the affected eye with a soft clean pad held gently by the casualty or bandaged lightly into place. To avoid moving the affected eye tell the casualty to keep the other eye closed. Take them for medical attention.

If they spill corrosive chemical into the eye it must be removed with copious amounts of water. Irrigate the eye until you are sure that all of the chemical is removed. Wear protective gloves if they are available. Be careful that the water runs away from the affected eye and not into the good eye. Call for an ambulance as soon as you can, but do not delay starting the irrigation.

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Emergency First Aid

Burn Injury Burns are injuries which normally affect the surface of the body, usually causing damage to the skin and tissue that immediately underlies it. They are commonly assessed for severity by their size and by how deep into the tissues they go. Anything other than minor or superficial burns will require medical assessment and treatment.

Burns by depth

Superficial Affects only the surface layers. Heals quickly with little or no scarring or infection.

Intermediate May be very painful. May cause serious fluid loss in large burns, so shock often a problem.

Deep Delayed healing. Causes serious scarring and infection problems . Often requires surgery.

General treatment for burns Deal with the source of the heat. Remove the casualty from the source or the source from the casualty. Cool the burn with clean cold water for 10 to 15 minutes. Remove jewellery, watches or anything which may form a constriction or band around the burnt area and which may become a problem should the burn cause swelling later. ▪ Cover the burn with a clean non-fluffy dressing. ▪ ▪ ▪ ▪

Do not ▪ Burst blisters ▪ Use fats ointments or creams ▪ Use adhesive dressings or tapes Seek medical attention for: ▪ Any deep or charred burn ▪ Any electrical burn ▪ Any burn affecting the face or genitalia

▪ Any burn if the casualty is a child ▪ Any burn encircling a limb


Emergency First Aid

Suspected Fracture A fracture is broken or cracked bone. There is very little first aid treatment for fractures, the aim is to prevent the fracture causing further damage. We achieve this by keeping the injury still, or immobilisation.

Fracture – recognition ▪ The casualty may have heard or felt the bone break. ▪ There is usually pain at the site, which may be severe. ▪ There is usually tenderness at the site. ▪ Swelling and bruising. ▪ The affected limb may be the wrong shape. ▪ The casualty may have problems in moving the affected limb.

Fracture – treatment ▪ Move the casualty as little as possible. ▪ Keep the affected part in the position that you find it. ▪ Use soft materials such as pillows to keep the affected parts still. ▪ Cover any wounds and control any blood loss. ▪ Look for and treat shock. ▪ Take or send the casualty to hospital.

Spinal injury The major threat from a fracture of the spinal vertebrae is damage to the spinal cord which runs immediately behind them. This damage may cause a loss of feeling or movement below the fracture site, that may be permanent. There may be little or no sign of injury although the casualty may complain of a loss of feeling or movement, or strange sensations such as burning or pins and needles in the arms and legs. First aid treatment is designed to limit movement and to prevent further damage.

If you suspect spinal injury: ▪ Do not move the casualty unless it is to save their life. ▪ In the unconscious casualty, protection of the airway takes priority. ▪ Keep their head and neck supported at all times. ▪ Talk to the casualty and tell them to keep their head still.

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Emergency First Aid

Seizure / Epilepsy A seizure is most often caused by an abnormal electrical disturbance in the brain. It can cause changes in body movement or function, sensation, awareness or behaviour and can last from just a few seconds to a condition which will not stop. There are many different types of seizure with many different causes. Probably the most common type of seizure that would require first aid attention is called the tonic / clonic seizure.

Seizure – Recognition ▪ Possible known history of seizures. ▪ They may appear uneasy or nervous immediately prior to the fit. ▪ They may fall to the ground with a loud cry. ▪ Breath holding or irregular breathing. ▪ Cyanosis / congestion of the face. ▪ Muscle rigidity, followed by uncontrolled movements of limbs and trunk. ▪ Sometimes teeth grinding. ▪ Sometimes the lips or tongue may be bitten and there may be flecks of foam or blood on the lips.

Assess the situation – are they in danger of injuring themselves? Remove any nearby objects that could cause injury.

A

assess

C

cushion head injury.

T

time

Check the time – if the seizure lasts longer than five minutes, you could call an ambulance.

I

identify

Look for a medical bracelet or ID card – it may give you information about the person’s seizures and what to do

Cushion the head (with a pillow or clothing) to protect them from

O over

Once the seizure is over, put them into the recovery position. Stay with them and reassure them as they come round

N never

Never try to restrain the person, put something in their mouth or try to give them food or drink

Call an ambulance if: ▪ It is their first seizure. ▪ They remain unconscious for more than 10 minutes.

▪ The seizure lasts for more than five minutes. ▪ They have repeated seizures.


Emergency First Aid

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Asthma Asthma is a condition which affects the lungs. In an acute asthma attack the tiny pipes which carry air to the air sacs, or alveoli, become narrowed due to inflammation and muscle spasm of the wall of the pipe. This leads to difficulties in passing air through the pipe, causing a feeling of tightness in the chest and difficulty in breathing. As the air is forced through the narrow pipes it causes a whistling sound and this whistling or wheezing is quite characteristic. Most asthma sufferers will have been diagnosed by their doctors and will be receiving treatment in the form of drugs which suppress the condition (avoidance) and drugs which relax the spasm of the air pipes (treatment) These drugs are usually given in the form of an inhaler or puffer which squirts a mist of drug into the mouth. It is then inhaled into the lungs. If a patient is having an acute attack, they require a drug which will relax the spasm. This will be in a blue inhaler. Asthma – recognition ▪ Known history of the condition. ▪ Severe respiratory distress. ▪ Coughing. ▪ Noisy whistling or wheezing respirations, particularly on breathing out. ▪ Cyanosis (blue lips/complexion)

Asthma – treatment ▪ Place the casualty at rest. ▪ Sitting down and leaning forward resting on something is often comfortable. ▪ Encourage them to use their own medication as appropriate. ▪ Summon medical help if they do not recover quickly.

Asthmatic Bronchiole

Normal Bronchiole


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Emergency First Aid

Stroke Stroke is a condition in which the blood supply to part of the brain is interrupted, leading to localised brain injury and possible death of brain cells.

Stroke – recognition ▪ May be severe headache or sudden loss of consciousness. ▪ General feeling of being unwell. ▪ Paralysis or weakness affecting one side of the body ▪ There may be drooping of the eye or mouth on the affected side. ▪ There may be difficulty speaking or forming sentences. Stroke is a medical emergency that responds well to urgent medical treatment. To aid in early diagnosis remember the FAST test.

Act FAST Ask them to smile. Does the face look lopsided? Is the eye or mouth drooping on one side?

F

face

A

arms

Ask them to raise both of their arms above their head. Can they raise them equally?

S

speech

Can they speak clearly and understand what you say?

T

time

Time to call for an ambulance!

If the patient fails any one of the tests call an ambulance immediately. Prompt medical care can reduce further damage to the brain and help the person o recover more completely.

Stroke – treatment ▪ ▪ ▪ ▪ ▪ ▪

Reassure Lay them down with the head slightly raised Place them in the recovery position if they are or if they become, unconscious Call urgently for medical attention Continue to monitor their condition until the arrival of medical assistance Be prepared to offer life support as appropriate


Emergency First Aid

Anaphylaxis Anaphylaxis is an extreme and severe allergic reaction that may develop very rapidly following exposure to the substance to which the sufferer is sensitive. This may include nuts, fish and shellfish, dairy products and eggs. Non-food causes may include insect stings, antibiotics and latex. The reaction affects the whole body may start within minutes of exposure or may be delayed by several hours Anaphylaxis– recognition ▪ Swelling/puffiness of the face. ▪ General flushing of the skin. ▪ Swelling of the mouth and tongue. ▪ Difficulty in swallowing or talking. ▪ Alteration of heart rate. ▪ Widespread blotchy skin rash (hives) ▪ Severe asthma. ▪ Feeling of weakness. ▪ Indications of shock. ▪ Abdominal pain. ▪ Nausea and vomiting.

Anaphylaxis– treatment ▪ Call 999/112 for an ambulance. ▪ Pass on any information you may have on the casualty’s medical history or condition. ▪ If the casualty is carrying an auto injector of adrenaline (EpiPen or Jext injector) and is able to use it, then help them to do so. ▪ If you have been trained to use it, then inject the casualty* ▪ If the casualty has problems breathing place and a half sitting position. If they feel find or show signs of shock lay them down. ▪ If they become unconscious place in the recovery position. * although the use of an auto injector is usually restricted to those who have received appropriate training, in a potentially life-saving situation anyone may use one by following the instructions on the pack.

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Emergency First Aid

Diabetes This is a condition where the sufferer has a problem in burning up sugar due to the lack of the chemical insulin. This may lead to an imbalance in the sugar levels in the blood. Diabetes can start very slowly and may go unnoticed for a long time. Because of the slow onset it is seldom a problem for first aiders, as the condition progresses the sufferer will seek medical advice from their doctor. Blood sugar level that is too low, (hypoglycaemia) may be caused when a diabetic inject insulin and then fails to eat enough sugar to counteract the effect. As this condition is the most immediately dangerous it is the aspect that first aiders should be most familiar with. Hypoglycaemia – recognition ▪ History of diabetes. ▪ Receiving insulin or other hypoglycaemic drug. ▪ They may suddenly become confused, disorientated or even aggressive ▪ May follow physical exertion ▪ Pale or grey in appearance. ▪ Profuse sweating. ▪ Rapid and strong pulse. ▪ Diminishing level of consciousness.

Hypoglycaemia –treatment If conscious ▪ Sit them down ▪ If they have their own supply of sugar or glucose then help them to take it. ▪ Otherwise give them some sugar, about 10g of glucose would be appropriate. ▪ This could be a glass of non-diet soft drink or 2 or 3 spoons of sugar in a glass of water. ▪ Response is usually swift. If so give them more sugar and keep them at rest. ▪ If they have a blood testing kit available assist them to monitor their blood glucose levels. ▪ If their condition fails to improve suspect other causes and call an ambulance. ▪ Continue to monitor their condition. If unconscious ▪ Place them in the recovery position. ▪ Refer to medical help urgently, with history if available.


Emergency First Aid

Chest Pain Chest pain is a symptom which must always be taken seriously. It may be caused by a minor problem such as indigestion or by a major and potentially dangerous problem such as heart attack. From a first aid perspective it is always safer to assume the worst and hope for the best. Remember, it is much better to over treat indigestion than to under treat heart attack. Heart related chest pain that may result from angina or heart attack. Other causes of acute chest pain may include pulmonary embolism, pneumothorax, injury to the chest wall and some types of acute chest infection such as pneumonia or pleurisy.

Angina Angina is a condition caused by narrowing or spasm of the coronary arteries,the pipes that deliver freshly oxygenated blood to the heart muscle. This leads to less blood and therefore less oxygen reaching the heart muscle. There may be sufficient blood to feed the muscle when the heart is beating norm Ally, but when the heart rate increases due to exertion or excitement the Plaque build-up causing demand for blood increases with it, narrowing of the artey leading to demand outstripping supply. This can cause cramp -like pain in the chest, often bought on by exercise and which improves with rest

Heart attack Heart attack occurs when a blood clot forms in a coronary artery, blocking it and depriving part of the heart muscle of blood and therefore oxygen That part of the heart muscle which is deprived of oxygen may subsequently die. This is called Blocked Coronary a myocardial infarction or MI Artery The severity of the heart attack will depend on the position of the blood clot and therefore how much heart muscle is affected. It may range from mild chest pain to sudden death. Some people who suffer a heart attack may exhibit no symptoms at all

Death of heart muscle

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Emergency First Aid Heart attack (continued) Heart-attack responds very well to early treatment, so it is beneficial to keep the delay in calling an ambulance to a minimum. Do not be persuaded by the casualty that it is not serious, or that it will go away. If you have any reason to suspect a heart attack either to yourself or to someone you are with then treat it appropriately and call urgently for medical attention. Angina and heart attack–recognition Sign symptoms in recognition of both of these conditions are very similar. From a first aid point of view it can be extremely difficult to tell the difference and in most cases it is not strictly necessary. ▪ Central chest pain, often described as squeezing or crushing in nature, or as a ▪ feeling of pressure in the chest. ▪ Pain may spread upward to the neck until one or both arms, most commonly to ▪ the left. ▪ May look pale or grey. ▪ May be sweating profusely. ▪ May complain of shortness of breath. ▪ May feel dizzy or weak. In addition, angina pain often starts with exercise or exertion and goes away with rest whilst heart-attack pain can start at any time and does not usually improve with rest. Angina pain may respond to GTN medication whilst heart-attack pain often does not. Anyone with central chest pain which does not improve with rest should be assumed to be having a heart attack.

Angina and heart attack–treatment Rest –place the casualty at physical rest to reduce the load on the heart. A well supported half sitting position with the legs slightly elevated is usually comfortable but be guided by the casualty. Reassure – anxiety or fear makes a heart beat faster and work harder. Reassurance is vital and can be life- saving. Refer – call 999 or 112 immediately. Treatment starts as soon as the paramedic arrives and early treatment is life-saving. Resuscitate – monitor the casualty continuously, be prepared to start CPR if required and send for a defibrillator should one be available.


Emergency First Aid

Poisons A poison is defined as any substance it irritates, damages or impairs the function of the body’s tissues Sufferers tend to be exposed to poison in one of four ways: ▪ Ingestion or swallowing ▪ Inhalation of gases or vapours ▪ Injection, either accidental or intentional ▪ Absorption through the skin or membranes

General treatment for poisons Although there are specific treatments for particular types of poisoning, it is probably true to say that the general procedure for dealing with poisoning cases follows the same steps. ▪ Remove the source ▪ Treat the effect ▪ Get medical help ▪ Collect and pass on as much history/evidence as possible

Absorbed poisons This type of poisoning most often occurs accidentally as a result of chemical spillage etc. It is rare in the work environment due to the use of appropriate personal protective equipment. ▪ The contaminated area should be flooded with water to dilute and remove as much chemical as possible. ▪ Give life support is required (being aware of your own safety) and get the casualty to medical help with as much information as possible.

Injected poisons Poisons may be injected both accidentally and intentionally. The most common type of intentional injection of poison would be intravenous drug abuse. This is rare in a work environment. Accidental injection could include standing on a spike or nail, which could cause infection. All puncture wounds require medical attention and the casualty may need antibiotics and possibly tetanus protection. In the event of an overdose of intravenous drugs the first aid should be aware that the risk to themselves from various sources may be increased. The casualties friends may also be under the influence of drugs and may resent interference from the first-aider. There will also be an increased risk of blood-borne viruses such as HIV or Hepatitis C.

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Emergency First Aid

Inhaled poisons Accidentally inhaled poisons may result from fire or industrial processes. There is a particular risk to rescuers from poisonous gas that may not be immediately obvious. Many dangerous fumes are colourless, odourless and tasteless in the presence may not be noticed until it is too late so great care must be taken when approaching the victim of apparent inhalation poisoning. Vapours , such as those given off by some solvents will close may be inhaled intentionally to produce intoxication. Users may become very violent if you attempt to prevent them or to remove the substance, so again, care must be taken. The best treatment for almost all inhalation poisoning is to remove the casualty to fresh air, if it is safe to do so. Summon help urgently as the casualty will almost certainly benefit from being given oxygen. In some situations where there is a known risk, selected persons may be trained to act as rescuers and in the use of breathing apparatus whilst others may be trained to administer oxygen. Where this is the case these personnel should be summoned urgently.

Swallowed poisons Swallowed poison is probably account for more cases of poisoning than all others combined. They may be accidental or intentional. They may result from swallowing a toxic substance or from swallowing a larger than normal amount of a normally nonpoisonous material such as alcohol or some types of medicine. Swallowed poisons occur in two forms, corrosive and systemic. The treatment will vary in each case

Corrosive The mode of action is to burn the tissues and the main danger results from chemical burns to the mouth and throat that may lead to swelling and obstruction of the airway. Treatment should be to limit the damage by washing out the mouth and encouraging the casualty to take continuous sips of a bland liquid. Under no circumstances should you attempt to induce vomiting as this may lead to further burning. Offer life support as appropriate, remembering to use personal protective measures as required. Get the casualty to medical help urgently and pass on as much history as possible. Protect the airway of the unconscious breathing casualty by placing them into the recovery position.

Systemic The have an effect on the body’s systems and include such things as alcohol and some medicines. They are often taken intentionally and the effect is dose-related. They have to be digestive and so there is often a time delay between ingestion and effect. The best treatment for overdose or accidental poisoning by mouth is the general treatment for poisoning. ▪ Support and maintain ABC ▪ Get them to medical help with as much information as possible


Emergency

First Aid ▪ Contain simple, accurate and up-to-date information ▪ Conforms to all latest guidelines ▪ Filled with clear easy to follow instructions ▪ Ideal for all short first-aid courses ▪ Ideal as an ongoing reference book

Emergency first aid ireland page tunrn revision  
Emergency first aid ireland page tunrn revision  
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