LESSON 2.1 Minor Wound Management Process

Transcription

1 LESSON 2.1 Minor Wound Management Process How do we make use of the four different kinds of first aid items such as gauze, melolin, padding (triangular bandage), and plaster to cover up the wounds? Cleaning of Wound S/N Steps of Cleaning Wound 1 Put on a pair of gloves. 2 Wash the wound with sterile water. 3 Use the tweezer to take a gauze out. 4 Use the gauze to blot the wound. We can either wipe it down once, then fold the dirty part inwards and wipe it another time and so on, or wipe the wound in circular motion from the inner part to the outer part of the wound. Note: 5 If there are dirt around the wound area that cannot be washed away by sterile water, inform the casualty that you will be using alcohol swab to clean the surface of his/her skin due to stubborn stains. Note: Covering of Wound The four types of first aid items available: Plaster: Gauze: Melolin: Pressure pad (triangular bandage): 1

2 References es_swabs_medical_wond_dressing.jpg 2

3 LESSON 2.2 Management of Hard and Soft Tissues What are the various hard and soft tissues injuries? How do we treat hard and soft tissues injuries? Identification of Hard and Soft Tissue Injuries Hard Tissue Injuries Fracture Fractures are breaks in bone tissue. This includes chipped or cracked bones. Fractures can also be open or closed. Open Fracture Involves an open wound Bone is exposed Occurs when limb is severely bent Serious as it carries the risk of infection and severe blood loss Can cause shock Closed Fracture More common than closed fracture Occur without causing a break in the skin Carry the risk of internal bleeding if bone s ends damage the tissues and blood vessels Symptoms of Fracture - Swelling and/or bruising around affected joint - Deformity - Pain in the injured area - Loss of function in the injured area Dislocation - Dislocation is a displacement or separation of a bone from its normal position - Caused by severe force - Dislocation is generally more obvious than close fracture as it often causes an abnormal lump - Symptoms of Dislocation o Severe pain o Swelling and bruising around affected joint o Deformity Soft Tissue Injuries Strains - Stretching and tearing of muscles or tendon - Caused by over exertion or uncoordinated movement Sprains - Partial or complete tearing of ligaments - Occurs when bones are forces beyond their normal range of motion 1

4 Symptoms of Strains and Sprains - Pain and tenderness - Difficulty in moving the injured part - Swelling and bruising to the affected area Cramps Cramps are sudden painful spasm in the muscles. It usually occurs during sleep. It can also develop after a strenuous activity due to the buildup of chemical waste in the muscles. Other causes may include: - Exercise soon after a meal - Chilled muscles due to weather - Sudden vigorous activity - Poor muscular coordination - Loss of body fluids and salt Treatment of Hard and Soft Tissue Injuries Cramps Dislocation Immobilization using triangular bandages - Gently stretch the contracted muscles - Straighten knee and pull the foot up towards the shin Sprain Fractures Strain R - REST I - ICE to relieve pain, swelling, and bruising for not more than 15 minutes C COMPRESS by bandaging the injured part for at least 2 hours E ELEVATE the injured part to further reduce swelling 2

5 Open Arm Sling Purpose: Shoulder, elbow (bend), and wrist fracture/ dislocation, and upper arm and lower arm fracture Apex Injured side Reef knot Place the triangular bandage against the chest with Apex towards the elbow Bring the other end of the bandage to the other shoulder Secure the sling with a reef knot on the opposite side of the injury Twist the end and tuck it in, to secure the elbow region Add-ons for Shoulder and elbow fracture/dislocation cases: Get a second triangular bandage and open it up First fold Second fold, also known as a broad bandage 3

6 Reef knot tied against the body Immobilize the Open Arm Sling with a broad bandage to prevent movement Add-ons for upper arm fracture cases: The injured area should be avoided to prevent worsening of injury Immobilize the Open Arm Sling with 2 broad bandages, 1 below the injured area and the other above the injured area Add-ons for wrist and lower arm fracture cases: Place a splint on the injured site Take a triangular bandage and open it up First fold 4

7 Second fold Third fold also known as narrow bandage Use the narrow bandage and place the middle of it at the bottom of the wrist area Form a cross at the top of the arm Bring it back up and tie a reef knot to secure the splint Elevation Sling Tie an Open Arm Sling and immobilize the fracture with a Broad Bandage Purpose: Collarbone and finger fracture Place the arm on the uninjured site Place a Triangular bandage on the elevated arm, with Apex towards the elbow Tuck in the hand first 5

8 Tuck in the rest of the bandage Do a fold to secure the elbow region Twist at the elbow region Bring the rest to the back of victim and secure it with a reef knot Fold a broad bandage and tie an immobilizer with a reef knot against the body of the uninjured side Add-ons for finger fracture: Place a pad over the affected finger Elevate the affected arm Tie an elevation sling and immobilize the arm with a broad bandage 6

9 Immobilization for Elbow Fracture (Unable to Bend cases) Place a Broad Bandage across the chest Place a 2nd Broad Bandage below the elbow Place a 3rd Broad Bandage around the wrist region 7

10 Images from Singapore Red Cross Academy References 8

11 First Aid Bronze LESSON 2.3 Primary Survey When met with a critical emergency, when every crucial second matters, what would you do? Emergency Action Plan No matter how careful you are, emergencies can occur at any place or time. When this happens, your role as the first responder or aider is very crucial. In such situation, you need to stay calm and perform the emergency action plan. 1

12 First Aid Bronze Primary Survey It is the first part of the Emergency Action Plan & it consist of 6 steps. D R S A B C 1. Check for Danger - Look at all 6 directions (Up, Down, Left, Right, Front, Back) 2. Check for Responsiveness [AVPU] - Alert: Eyes are open - Voice: Able to answer question - Pain: Move or respond to tapping of shoulder - Unresponsive: No response or movement 3. Shout for Help - Ambulance Get an AED - Get a First Aid Kit 2

13 First Aid Bronze 4. Open the Airway - Head-Tilt-Chin-Lift maneuver - 1 hand on the forehead, the other hand supporting by the side of the jaw. 5. Check for Breathing - Look, Listen & Feel Look at the chest if there is any movement Listen for breathing sound Feel for warm air against your cheek - Up to 10 Seconds - Gasping is considered not breathing. 6. Commence CPR Locating hand position - Maintain Head-Tilt-Chin-Lift - Run your middle finger from the lower margin of casualty s rib cage to sternal notch - Place index finger next to middle finger - Place the heel of your palm of the other hand beside then nail of your index finger 3

14 First Aid Bronze Chest Compression - Interlace fingers and lift fingers off the casualty s chest - Straighten your arms and lock elbows - Position your shoulder directly over the casualty s chest - Use your body weight to compress down to a depth of at least 5 cm and count 1 and 2 and 3 and 4 and 5 and 1 and 2 and 3 and 4 and 10 and 1 and 2 and 3 and 4 and 15 1 and 2 and 3 and 4 and 20 1 and 2 and 3 and 4 and 25 1 and 2 and 3 and 4 and 30 Mouth to Mouth Breathing - After every 30 compression, deliver 2 ventilations - Maintain Head-Tilt-Chin-Lift - Pinch nose and give 2 quick ventilations ( ml/sec per breath) - Watch out for chest rise and release the pinch after each breath - Continue good quality CPR (30 compression: 2 ventilation, is 1 cycle) Reasons to stop CPR: - Ambulance team arrives to take over - AED is in use - Casualty starts to breathe - Another rescuer arrives and take over - You become exhausted 4

15 First Aid Bronze Notes: 5

16 LESSON 2.4 Primary And Secondary Survey How do you carry out primary and secondary survey? Which injuries should you treat first? In managing medical emergencies, treating the injuries of casualties is not the only thing you have to take note of. Ensuring the safety of your casualty and YOURSELF (as a first aider), being able to prioritise which injuries are more life-threatening to attend to quickly, and being able to continuously monitor and assess the casualty s condition after treatment of lifethreatening injuries are important things to take note in the treatment process of the casualty. What is Primary Survey? Across 4. After opening the airway, check for 6. The next step to do if the casualty is unconscious and there is no breathing Down 1. Assess the scene for 2. Assess casualty for 3. for help 5. Doing Head Tilt Chin Lift is to open the 1

17 Priority of Treatment As a first aider, when you encounter a casualty with several injuries, it is essential to decide on which injury to treat first. This will allow the casualty to be By rule of thumb, the priority of treatment of injuries is: 1) Life threatening emergencies (such as unconsciousness) 2) Bleeding wounds and fractures (such as lacerations and closed forearm fracture) 3) Minor injuries (such as abrasions) Activity! Here are several injuries. Identify the type of injuries and match the injuries to the priority of treatment. Picture of injury Type of injury Minor injury Priority of Treatment 1 Fracture 2 Life threatening Profuse bleeding wounds 3 4 2

18 What is the Secondary Survey? Objective of Secondary Survey: Continuously monitor the casualty s condition and find any non-life threatening conditions requiring treatment. Activity! Find the words that describe the secondary survey in the Word Search. H C O M P A R E H D F P Y C O K B M H U E C D R J Y E D L V X A H X K U W E K C A E I E M R I W P R M E S V C I T O I S I E T B F K Y N W R N N O R A V G Y E K E R R Q D E I V A G Y Y Y A C G A H C U 3

19 How to conduct a Head to Toe survey? H _ N _ S C Back A _ Abdomen H Pelvis L _ F _ 4

20 Head: - Using both hands (with gloves on), gently run your hands across the skull, pressing in gently but firmly, starting at the forehead and working around to the back of the head. - Feel for any dents, look for blood or fluid and watch for signs of discomfort. - If it is a trauma injury, check both ears and nose for blood or fluid. Neck: - Start at the sides of the neck and gently press in. Watch carefully for signs of pain. - Move around until you reach the spine, moving as far down the neck as possible without moving the casualty, if he is lying on his back. - If there is pain, tenderness or deformity here, stop the survey immediately and wait for help. Shoulder: - Expose the shoulders if possible, look for obvious deformity, especially around the collar bones. - Try pressing along the line of the collar bone, watching for deformity or pain. - Place a hand on each shoulder, and gently push down, looking to ensure that one side does not move more than the other. Chest: - Look for sections of the chest which are out of line with the rest of it, or which are moving differently to the rest of the chest whilst breathing. - Look for obvious wounds on the chest. - Gently press on the chest. The best way to do this is to imagine the chest divided into four quarters running neck to stomach. Place one hand (balled into a fist) and press down one on the left and one on the right in each quarter (avoiding breasts if applicable). Watch for one side moving differently to the other, or pain being caused. NOTE: The chest is ideally done exposed, although you should be aware of the sensitivity of females to this, and if you are able to keep breasts covered, it is advisable to do so. Back: - If the casualty is lying on his side, or front, you can also feel down his spine. - If he is lying on his back, skip this part of the check, and leave it for the ambulance crew. -If you are not confident, do not conduct the check! 5

21 Arms: Hands: - Run both hands down on the inside and outside of one arm at a time, looking for deformity or pain. - Run both hands down one hand at a time, looking for deformity or pain. Abdomen: - Gently push both sides of the abdomen simultaneously, using the palms of your hands. - Check if the abdomen feels hard or if there is pain caused by the pushing. Pelvis: - Place a hand on each hip and first gently compress the hips together with both hands (there should be very little movement, and little to no pain). - If there is no pain or movement, gently push down on the hips in a "rocking" motion to see if there is any movement. - If the patient has moderate to severe pain when the hips are compressed, or the hips move when compressed, do not rock the hips. Legs: - Run both hands down the inside and outside of each leg simultaneously (avoiding the groin area on the inside). - Look for any shortening or rotation of one leg compared to the other. Feet: - Take each foot, check that it can be moved normally and has no obvious injuries. 6

22 Notes: 7

23 Reference Cadet Guide: Page 2 Laceration picture: 19.jpg Unconscious casualty: Closed fracture: Abrasion: Page 4 Human Body Outline: Slides: Slide

24 First Aid Bronze LESSON 2.5 Unconscious Choking When a casualty turns unconscious with his airway blocked, you have only a few minutes to save him from death, what would you do? Why unconscious choking did occurs? When someone is choking, the casualty s airway is blocked, preventing the casualty from breathing. After a prolong amount of time, the casualty will fall unconscious due to the lack of oxygen in the body while the foreign object is still blocking the airway. If this is not treated as soon as possible, due to the lack of oxygen to the brain and body, it will eventually lead to death within a couple of minutes. Steps of Unconscious Choking S S C A B 1. Support casualty - Gentle & quickly support the casualty to supine position 2. Shout for Help - Ambulance Get an AED - Get a First Aid Kit 1

25 First Aid Bronze 3. Chest Compression - Straighten your arms and lock elbows - Position your shoulder directly over the casualty s chest - Use your body weight to compress down to a depth of at least 5 cm and count 1 and 2 and 3 and 4 and 5 and 1 and 2 and 3 and 4 and 10 and 1 and 2 and 3 and 4 and 15 1 and 2 and 3 and 4 and 20 1 and 2 and 3 and 4 and 25 1 and 2 and 3 and 4 and Open the Airway - Head-Tilt-Chin-Lift maneuver - Look for foreign object - If visible, Use your index finger to sweep it out - Do NOT blind sweep 5. Check for Breathing - Look, Listen & Feel Look at the chest if there is any movement Listen for breathing sound Feel for warm air against your cheek - Up to 10 Seconds - Gasping is considered not breathing. 2

26 First Aid Bronze If breathing not present: Mouth to Mouth Breathing - Deliver 2 ventilations - Maintain Head-Tilt-Chin-Lift - Pinch nose and give 2 quick ventilations ( ml/sec per breath) - Watch out for chest rise and release the pinch after each breath - If chest does not rise after 1 st ventilation, Reposition head and give 2 nd ventilation After 2 ventilation - If chest rises, check for breathing. If breathing not present, repeat from step 3 onwards - If chest does not rise, suspect still choking and repeat from step 3 If breathing is present: Check for Secondary Survey - Check for injuries Put to Recovery Position Monitor for vital signs (Breathing & Level of Consciousness) Notes: 3

27 LESSON 2.6 Delegation of Trio What are the three roles you can play when working as a trio to manage a casualty? How is each role important? When you are working as a first aid team during a first aid duty, and your team meets a casualty, are all of you going to fight to give treatment to the casualty? How will you be able to maximize the abilities of your manpower to make sure the casualty gets the best and fastest treatment? Let s have a look! What are the 3 roles? Definition Definition Definition The Giver is similar to the logistics IC role; he will be in charge of the First Aid items in the first aid bag. The Provider is the one who is the first responder to the casualty. The Recorder, is the one who is recording down the casualty s details. 1

28 What are the functions of the 3 roles? 2

29 How are the 3 roles linked to the 4 Ps of First Aid? Preserve Life Prevent condition from worsening Promote recovery Provide comfort and relief Notes: 3