Pasadena Lapidary Society. Basic Field Trip First Aid

Transcription

1 Pasadena Lapidary Society Basic Field Trip First Aid

2 Contents NOTES Subject Page General... Wound Care... Bleeding... Head Injuries... Eyes, Nosebleeds, Blisters. Stings and Snake Bites... Spider Bites Scorpions and Ticks... Burns.. Heat Emergencies.. Fractures. Strains and Sprains.. Notes Prepared by Mark Nelson, EMT Emergency Medical Technician Instructor L.A. County Sheriff San Dimas Mountain Rescue Team Page 2 Page 19

3 NOTES General Considerations This Guide is produced for the purposes of assisting participants in a rock-hounding field trip apply basic first aid to minor injuries. It is not intended to be a substitute for a proper basic first aid course or qualified medical attention. Preventing medical emergencies means getting yearly doctor s exams and regular exercise. Protect your health by determining whether you re at risk for any life-threatening conditions, and follow your doctor's suggestions to reduce any risk factors that can be dangerous to your health. All medicines should be kept in child-proof containers and well out of the reach of children. All poisonous materials should be stored out of reach of children in child-proof containers. Learn how to be safe at home in the kitchen, bathroom and yard where many accidents occur. Drive carefully and appropriately to weather and traffic conditions. Children should be secured in child-safety seats. Your local police and fire department can help ensure you have installed the seat correctly. All passengers in motor vehicles should wear safety belts. Never operate a vehicle if under the influence of alcohol or drugs. Read warning labels on all medications to see if they impair your ability to drive or operate machinery. How can I be prepared for medical emergencies? The initial minutes after an injury or medical crisis frequently are the most important. The key is knowing what to do, remaining calm and making a decision to act. Page 18 Page 3

4 Keep a list of emergency phone numbers by the phone. Include numbers for: police, fire, poison control ( ), local hospital, ambulance service (911 in most areas), and your family physician. Keep and maintain a well-stocked first-aid kit at home, at work and in your vehicle. This will help you handle medical situations. A source for a guide to assemble your own home and field trip first aid kit is listed on www. EmergencyCareforYou.org. Keep a list of all your medications in your wallet, including drug names, strength, dosage form, regimen, and name and contact information for the doctor who prescribed them. Also list all allergies, especially to medications and latex, which is used in many medical gloves worn by health care workers. Also keep a list of emergency contacts, such as family members. It is recommended that people program their cell phones with ICE (In Case of Emergency) to list the name and phone number for someone who knows you and your medical history well. Wear your medical-alert bracelet or necklace if you have a condition that emergency responders need to know about (examples: asthma, bee sting allergy, epilepsy). Take a first-aid class. This will not only help you stay calm and focused, but will also help you to help yourself and those around you in the event of an emergency. Wound Care - Proper Care For Wounds Minor Wounds Most cuts are minor, but it's still important to properly care for them. If you delay care for only a few hours, a wound can build up enough bacteria to cause a serious infection and increases your risk of a noticeable scar. Page 4 Suspect back or neck injury if victim is unconscious or has head injury, neck pain, or tingling in arms or legs. If neck or back injury suspected, DO NOT move victim unless necessary to save victim's life. Observe for shock. DO NOT give victim anything to eat or drink. Control any bleeding through direct pressure, but DO NOT elevate affected area. Immobilize and support affected bone in position found. DO NOT try to push protruding bone back into body or let victim move or use affected area. If bone is protruding, cover with clean cloth once bleeding is controlled. Immobilize injured area, and, if no open wound present, apply ice pack wrapped in clean cloth. Immobilizing Fractured Bone: Check for sensation, warmth, and color of toes or fingers below suspected break. Place padded splint under area of suspected break: Use board, rolled newspaper or magazines, broomstick, or rolled blanket for splint. Wrap splint in cloth or towels for padding. Bind splint to limb using neckties, cloth, belts, or rope. DO NOT bind directly over break Recheck often for sensation, warmth, and coloring. If fingers or toes turn blue or swell, loosen binding. For arm or shoulder injury, place splinted arm in sling, with hand above elbow level. Bind arm to victim's body by wrapping towel or cloth over sling and around upper arm and chest; tie towel or cloth under victim's opposite arm. Page 17

5 First Aid for Fractures and Sprains A fracture is a break or crack in a bone that can be caused by an accident, fall, or blow. Symptoms include a snapping sound as bone breaks, bone protruding from skin, detectable deformity of bone, abnormal movement of bone, grating sensation during movement, pain and tenderness, difficulty in moving or using the affected part, swelling, and discoloration. A sprain refers to stretched or torn tendons, ligaments, and blood vessels around a joint and can be caused by an accident, fall, or blow. Symptoms of a sprain include pain, tenderness, swelling, and discoloration in the joint area. A muscle strain refers to stretched or torn muscle. It can be caused by excessive physical effort or improper posture during activity. Symptoms include pain, stiffness, and possibly swelling in the affected area. Sprain or Strain: Have victim rest, with affected area elevated. Apply cold compress or ice pack wrapped in cloth to affected area. If pain or swelling continue for more than 2 days, consult a doctor. It is sometimes difficult to tell the difference between a fracture and a sprain or strain until an X-ray has been performed. If you cannot tell, treat it as a fracture. Fracture: SEEK MEDICAL ATTENTION IMMEDIATELY. Call for EMS, or transport victim to emergency room after immobilizing affected area. Wait for EMS and DO NOT attempt to transport victim if you suspect head, back, or neck injury; if there's a visible deformity of bone; or if the victim cannot be splinted or transported without causing more injury. Page 16 For most simple wounds it is recommended to follow these three guidelines: 1. Clean the cut with soap and water. 2. Treat the cut with an antibiotic ointment to prevent infection and to keep it moist to decrease scarring. 3. Protect the cut by covering it with a clean bandage. Serious Wounds Sometimes it's hard to determine what wounds can be treated at home and which require a trip to the emergency department. These guidelines identify which wounds need emergency medical care: Wounds that will not stop bleeding after five minutes of applying direct pressure. Long or deep cuts that need stitches. Cuts over a joint. Cuts that may impair function of a body area such as an eyelid or lip. Cuts that remove all of the layers of the skin like those from slicing off the tip of a finger. Cuts from an animal or human bite. Cuts that have damaged underlying nerves, tendons, or joints. Cuts over a possible broken bone. Cuts caused by a crushing injury. Cuts with an object embedded in them. Cuts caused by a metal object or a puncture wound. Call 911 or emergency services immediately if: Bleeding from the cut does not slow during the first 15 minutes of steady direct pressure. Signs of shock occur. Breathing is difficult because of a cut to the neck or chest. A deep cut to the abdomen causes moderate to severe pain. A cut to the eyeball. A cut amputates or partially amputates an extremity. Page 5

6 Bleeding Listed below are some general principles of emergency care that apply to the majority of minor open wounds. If possibly serious, seek medical attention immediately. Note: (In order to avoid health risks, please be sure to put on latex or nitrile gloves. If either is not available, try to find a clean, plastic bag to cover your hands.) Control Bleeding - Start with direct pressure of direct pressure and elevation. When necessary, use pressure points. Do NOT use a tourniquet. Clear the wound surface - You may need to expose the wound (and cut the clothing if needed). Wash the wound with soap and water. Apply an antibiotic ointment if available. Cover the wound with a sterile gauze dressing and bandage Prevent Further Contamination - Use a sterile dressing, if possible. When none is available, use the cleanest cloth material at the scene. Bandage the Dressing in Place - Do not remove blood-soaked cloth. Put additional material over it. After the bleeding has stopped change the dressing. Reassure the patient - will decrease patient's pulse rate and blood pressure and may reduce bleeding rate. Serious Wounds - (Do not clean the wound; simply remove foreign matter from its surface and rinse with clean water. Proper wound cleaning for serious wounds often is best done by medical staff.) Brush large debris away with a sterile dressing. Heat Exhaustion Symptoms Normal, low, or only slightly elevated body temperature. Cool, clammy, pale skin. Sweating. Dry mouth. Thirst. Fatigue. Weakness. Feeling dizzy. Headache. Nausea. Vomiting can occur. Muscle cramps. Weak or rapid (abnormal) pulse. First Aid for Heat Exhaustion Move to a cool place indoors or in the shade. Lie down. Loosen clothing. Drink fluids, such as cool or cold water. Add 1/2 teaspoon of salt to 1 quart of water. Sip this. Or drink sport drinks with salts and electrolyes - such as Gatorade. Have salty foods, such as saltine crackers, if you tolerate them. Massage and stretch cramped muscles. Heat Stroke These signs and symptoms can occur suddenly with little warning: Very high temperature (104ºF or higher). Hot, dry, red skin. No sweating. Deep breathing and fast pulse. Then shallow breathing and weak pulse. Confusion. Hallucinations. Convulsions. Loss of consciousness. Call EMS. Before Emergency Care Arrives Move the person to a cool place indoors or under a shady tree. Place the feet higher than the head to avoid shock. Remove clothing. Either wrap the person in a cold, wet sheet; sponge the person with towels or sheets that are soaked in cold water; or spray the person with cool water. Fan the person. Put ice packs or cold compresses on the neck, under the armpits, and on the groin area. Once the person's temperature gets to 101ºF do not lower the temperature further. Don't give fever reducing medicine. Don't use rubbing alcohol. Page 6 Page 15

7 Heat Emergencies Sweat evaporates from the skin to cool the body. If this personal cooling system does not work right or fails to work, heat exhaustion or a heat stroke can occur. Prevention - The Best First Aid Treatment Use caution when you are in the sun. When your body loses liquid, muscles get tired and the body becomes weak. This can shorten your mineralcollecting experience! Drink liquids before you think you need them. At the first sign of heat exhaustion, get out of the sun. If you can, avoid midday heat. Do not do vigorous activity during the hottest part of the day (11:00 a.m. to 4:00 p.m.). Drink lots of liquids, especially if your urine is dark yellow. Drink water or sport drinks with electrolytes such as Gatorade. Do not stay in or leave anyone in a closed, parked car during hot weather. Don't drink liquids with alcohol or caffeine. Wear light, loose-fitting clothing, such as cotton, so sweat can evaporate. Wear a wide-brimmed hat with vents. Use an umbrella for shade. If you feel very hot, try to cool off. Open a window. Use a fan. Go to an air-conditioned place. Check with your doctor about sun exposure if you take: Water pills, mood-altering medicines and some antibiotics, such as tetracycline. Heat exhaustion is a warning that the body is getting too hot. With a heat stroke, body organs start to overheat. They will stop working if they get hot enough. If it is not treated, a heat stroke can result in death. Page 14 Animal and Human Bite Wounds. If a wound is not bleeding heavily, wash it with soap and water. Washing should take at least 5 minutes. Avoid scrubbing because it can injure tissues. Allowing a wound to bleed a little helps remove bacteria left in the tissues. Rinse the wound thoroughly with running water. Control bleeding. Cover with a sterile dressing, but do not seal the wound tightly with tape or a butterfly bandage. Seek medical attention because of the danger of infection, need for further cleaning, the possible need for a tetanus shot, and for sutures to close the wound. Wounds with high Infection Risk - such as animal bites, very dirty or ragged wounds or puncture wounds. Prevent infection by applying a dry, sterile dressing. Seek medical care for wound cleaning and possible tetanus immunization. If in a remote location hours away from medical care, clean the wound, if possible, and control bleeding. Head Injuries Expect a lot of bleeding because of the many blood vessels in the head and scalp. Whenever head wounds occur, suspect spinal injury and skull fracture. Control bleeding. If a skull fracture is suspected, apply pressure around the edges of the wound rather than at its center. Elevate the head and shoulders to help control bleeding. Check the pupils for even dialation. Do not remove an embedded object. Instead, stabilize it in place with bulky dressings. Page 7

8 Eye Injuries Penetrating Injuries Do not remove an imbedded object from an eye. Protect the eye with a paper cup or paper cone to prevent the object from being driven further into the eye. Cover both eyes to stop movement of the damaged eye due to sympathetic movement. Blows to the Eye Apply a cold pack for about 15 minutes to reduce pain and swelling. A bleeding in the eye or blurred vision could signal internal eye damage. Seek medical care immediately if this should happen. Nosebleeds - most nosebleeds can be stopped by these simple procedures: Keep the victim in a sitting position to reduce blood pressure. Keep the head tilted slightly forward so that blood can run out the front of the nose and not down the back of the throat. Pinch both nostrils together for 10 to 15 minutes. Remind the victim to breathe through the mouth and to spit out any accumulated blood. If bleeding persist, have the victim gently blow the nose t remove any clots and excess blood, and to minimize sneezing. This allows new clots to form. Then, pinch the nostrils together for another 10 to 15 minutes. Seek medical care if bleeding does not stop. Blisters To treat a small blister formed by rubbing, cover it with an adhesive bandage. This will protect the blister from further injury and relieve the pain. Blisters that become broken should be washed with soap and warm water. Dry the injured area and swab it with 70% rubbing alcohol. Keep clean and dry. When walking is again needed, apply a product such as moleskin to the affected area. Cover the burn with a sterile gauze bandage. Don't use fluffy cotton, or other material that may get lint in the wound. Wrap the gauze loosely to avoid putting pressure on burned skin. Bandaging keeps air off the burn, reduces pain and protects blistered skin. Take an over-the-counter pain reliever. These include aspirin, ibuprofen (Advil, Motrin, others), naproxen (Aleve) or acetaminophen (Tylenol, others). Use caution when giving aspirin to children or teenagers. Though aspirin is approved for use in children older than age 2, children and teenagers recovering from chickenpox or flu-like symptoms should never take aspirin. Talk to your doctor if you have concerns. Minor burns usually heal without further treatment. They may heal with pigment changes, meaning the healed area may be a different color from the surrounding skin. Watch for signs of infection, such as increased pain, redness, fever, swelling or oozing. If infection develops, seek medical help. Avoid re-injuring or tanning if the burns are less than a year old doing so may cause more extensive pigmentation changes. Use sunscreen on the area for at least a year. Cautions: Don't use ice. Putting ice directly on a burn can cause a burn victim's body to become too cold and cause further damage to the wound. Don't apply butter or ointments to the burn. This could cause infection. Don't break blisters. Broken blisters are more vulnerable to infection. Page 8 Page 13

9 BURNS Mineral collecting often involves camping and being out in the sunshine. Burns don t have to ruin your enjoyment if treated properly. First-degree burn The least serious burns are those in which only the outer layer of skin is burned, but not all the way through. The skin is usually red, with swelling, and pain sometimes is present. Treat a first-degree burn as a minor burn unless it involves substantial portions of the hands, feet, face, groin or buttocks, or a major joint, which requires emergency medical attention. Second-degree burn When the first layer of skin has been burned through and the second layer of skin (dermis) also is burned, the injury is called a seconddegree burn. Blisters develop and the skin takes on an intensely reddened, splotchy appearance. Second-degree burns produce severe pain and swelling. If the second-degree burn is no larger than 3 inches (7.6 centimeters) in diameter, treat it as a minor burn. If the burned area is larger or if the burn is on the hands, feet, face, groin or buttocks, or over a major joint, treat it as a major burn and get medical help immediately. For minor burns, including first-degree burns and second-degree burns limited to an area no larger than 3 inches (7.6 centimeters) in diameter, take the following action: Cool the burn. Hold the burned area under cool (not cold) running water for 10 or 15 minutes or until the pain subsides. If this is impractical, immerse the burn in cool water or cool it with cold compresses. Cooling the burn reduces swelling by conducting heat away from the skin. Don't put ice on the burn. Page 12 Injuries From Insects and Snakes Bee Stings Bee, wasp and hornet stings are usually more painful and alarming than dangerous. An initial sharp pain is often followed by mild swelling and soreness, which can be relieved by first aid. However, some people are allergic to these poisons, and can rapidly develop anaphylactic shock, a very serious condition. Multiple stings can have a dangerous cumulative effect. Stings in the mouth or throat, causing swelling which may obstruct the airway, should be taken very seriously. Treatment of a Sting in the Skin Remove the stinger, if still present, with tweezers - being careful not to squeeze the venom sac. Wash with soap and water. Apply a cold compress to relieve pain and minimize swelling. Advise the casualty to see their own medical practitioner if pain and swelling persist or increase over the following 24 to 48 hours. Snake Bites Snakes seek food from creatures smaller than themselves. They will avoid contact with humans and will seek an opportunity to escape such an encounter. All snakes will act to defend themselves if cornered and strike or bite and if they believe that the human is a threat to them. Avoid reaching under rocks or bushes without checking first. Watch where you place your hands and feet. While you are looking for rock specimens, check also for these reptiles. A snake bite is often not a serious injury, but can be very frightening. It is vital to reassure the casualty to remain calm, as the spread of venom, in the case of a poisonous snake, can be delayed if the casualty keeps still and calm. The snake, if killed, or a note of its appearance should be kept so that that correct anti-venom can be given, if necessary. Page 9

10 Treatment of Snake Bites All snake bites are wounds. Wash the wound thoroughly with soap and water. Bandage as you would any wound. Monitor the injury site for infection. In the case of a poisonous snake bite lay the casualty down, telling them to keep calm and still. After washing the wound, secure and support the injured part. DO NOT apply a tourniquet, cut the wound with a knife, or attempt to suck out the venom. Call the closest emergency care facility and let them know you have a suspected snake bite. Transport the injured person safely to the nearest emergency care facility. In the case of very remote locations with a confirmed poisonous snake bite, call 911 and request air transportation to the nearest emergency care facility. Spider Bites (Black Widow, Brown Recluse and Tarantula) If possible, catch the spider intact and confirm its identity. Even if the body is crushed, save it for identification. Clean the bitten area with soap and water or alcohol. Place an ice pack over the bite to relieve pain. Keep the victim quiet and monitor breathing. Seek immediate medical care. An antivenin for black widow bites is available. Black Widow Brown Recluse Tarantula Page 10 Scorpion Sting A scorpion sting can be painful, but is rarely lifethreatening. It will normally cause immediate pain and burning around the sting site. Sometimes this is followed by numbness or tingling. Severe cases may include paralysis, spasms or respiratory difficulties. First aid consists of monitoring breathing, cleaning the sting site with soap and water or rubbing alcohol, and applying an ice pack over the sting site. Ticks Ticks survive by drinking the blood of mammals. To get to their food they crawl to the ends of bush and tree branches, waiting to the chance to catch a ride with a passing food source. Unlike other insect stings, which are hit-and-run offenses, a tick likes to hang around at the scene of the crime by burrowing its head in its victim s skin. After a day of mineral collecting it is a good idea to do a bug body and clothing scan. If you find one attached to your skin, follow these tips for treating tick bites and removing ticks. 1. Use tweezers and grasp the tick as close to the skin surface as possible and gently lift the tick to tent he skin. Hold until the tick lets go. Do not twist or jerk the tick, since this may result in incomplete removal. 2. First aid consists of cleaning the site with soap and water or rubbing alcohol, and applying an ice pack over the sting site. Calamine lotion helps relieve itching. 3. Keep the area clean and watch for signs of infections or unexplained symptoms of severe headaches, fever or rash. If these symptoms occur seek medical care immediately. Page 11