Ed.1 April 14
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Housekeeping ● ● ● ● ● ● ● ●
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Fire alarm/exits Toilets Smoking Drinks Breaks Lunch Questions Talking over others.
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Housekeeping
As a courtesy to others please set your phone to SILENT MODE.
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Key to Highfield PowerPoint™ presentations KEY
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KEY TASK 1
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D The last point on a slide is denoted by a full stop. 5
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Module Guide
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Introduction
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Wounds and bleeding
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Responsibilities of the first aider
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Shock
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Assessing an incident
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Seizures
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Managing an unresponsive casualty
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Dealing with minor injuries
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The respiratory system
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Other Injuries
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Module
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Introduction NEXT
The emergency first aider ● To become a qualified emergency first aider learners will have to have successfully passed a one day formal training course that is accredited through an awarding organisation (AO) ● The emergency first aid at work qualification is valid for a three year period.
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What is first aid?
The immediate care given to a person who has been injured, or who has become ill, prior to the arrival of qualified medical assistance
For all first-aid treatment you should wear disposable gloves.
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Introduction
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Responsibilities of the First Aider NEXT
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What are the main aims of first aid?
Preserve life ● Administer immediate effective first aid to a casualty in order to save life
Prevent the condition from worsening ● Recognising and treating the cause will assist with preventing the condition from worsening
Promote recovery ● Administer ongoing treatment and offer constant support until the arrival of qualified medical assistance
Remember! If you have not contacted the emergency services then they will not arrive! 12
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Consent
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Before commencing treatment of a casualty the emergency first aider should ask for and receive the casualty’s consent to treatment. If the casualty is unable to give their consent due to their injuries or because they are unresponsive you can assume their consent to treatment.
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The responsibilities of the emergency first aider ● ● ● ● ● ● ●
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Ensuring first-aid equipment is fit for purpose Arriving at the scene Ensuring the scene is safe Contacting the emergency services Prioritising the treatment of casualties Clearing up after an incident Incident reporting and recording.
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First-aid equipment The content of the first-aid kit will be dependent on the assessment of first-aid needs that should be conducted. Below is the recommended content from the British Standards Institute (BSI).
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First aid at work provision
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First Aid Kit
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Arriving at the scene When arriving at the scene: ● ● ● ●
always try to remain calm take charge of the situation conduct a scene survey ensure the safety of yourself, bystanders and others ● gather information from bystanders and the casualty ● fully brief the Emergency Services.
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Arriving at the scene When arriving at the scene:
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Contacting the emergency services ● First aiders will either contact the emergency services themselves or instruct a bystander to do so ● Contacting them at the earliest opportunity is paramount The number for contacting the emergency services is:
999/112
● When contacting the Emergency Services, it is important that the information given is clear, concise and sufficient ● This can be achieved by remembering the acronym LINE. 20
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Prioritising the treatment of casualties After conducting a primary survey and contacting the emergency services, casualties should be placed in an order of priority and treated accordingly. This order is as follows: If dealing with multiple casualties it is often the quietest who require treatment first.
Breathing Bleeding Bones/Burns Other Conditions
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In certain circumstances these priorities can be changed
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Clearing up after an incident ●Ensure that all used bandages and used items such as personal protective equipment (PPE) are placed in a yellow clinical waste bag, or similar ●Ensure that the area where any blood or other bodily fluids have been spilt is thoroughly cleaned ●Restock the first-aid kit and replace any other equipment that may have been used during the incident ●Record and report the incident.
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Incident recording and reporting
● After any first-aid incident it is important that it is recorded and reported in full ● The accident book should be completed in full and populated with clear and concise information; there may also be the necessity to inform RIDDOR.
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Minimising infection It is important that as a first aider you do not transmit infections to your casualty or indeed contract infections from your casualty. To assist in minimising the risk of infection and crosscontamination there are various precautions that can be taken such as: ●having good personal hygiene ●ensuring that barrier devices are used ●covering any open cuts or sores ●minimising contact with blood or bodily fluids ●changing gloves between casualties ●washing hands thoroughly after removing gloves. 24
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Barrier devices
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Barrier devices are essential equipment and help to eradicate the spread of infection and cross-contamination. Barrier devices, as their name suggests, place a barrier between the first aider and the casualty
Barrier devices include: ●nitrile powder-free gloves ●face shields ●pocket masks.
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Assessing an Incident NEXT
Assessing an incident
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Upon arrival at an incident a scene survey must be conducted to ensure the safety of the casualty, any bystanders and the first aider. The scene survey should be conducted by remembering the acronym CLAP. ontrol the situation ook for potential hazards ssess the situation rotect and prioritise.
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Scene survey – remember CLAP ontrol the situation Stop, take a deep breath and take charge of people and vehicular traffic
ook for potential hazards Look for anything that could cause further harm to the casualty, bystanders or, more importantly, yourself within the immediate area
ssess the situation Gather as much information about what has occurred from the casualty and from bystanders and try to make a diagnosis (history, signs and symptoms)
rotect and prioritise Ensure protection is worn (gloves), and that casualties are prioritised (breathing, bleeding, bones/burns and other conditions). Try to gain assistance from a bystander and contact emergency services.
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Primary survey The primary survey is a systematic process of: • approaching • identifying • dealing with immediate and/ or lifethreatening conditions
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The primary survey can be remembered by the acronym DRSABCD (or the easy way to remember, Doctors ABCD).
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Doctors ABCD
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Primary survey
Prior to approaching the casualty, ensure the scene is safe to do so.
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Primary survey
If possible, approach the casualty from the feet as this prevents hyperextension of the neck from a responsive casualty. When checking for a response use the AVPU scale.
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Are you alright?
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AVPU scale
The ‘P’ in the acronym AVPU is sometimes referred to as ‘Pain’ depending on the scales used. Examples of this would include pinching the ear lobes or fingertips.
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Primary survey
If you are on your own do not leave the casualty at this stage.
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for help
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Primary survey
With an unresponsive casualty open the airway using the head-tilt-chin-lift method.
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Primary survey
After opening the airway look, listen and feel for normal breathing for no more than 10 seconds. If the casualty is not breathing call 999/112
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Agonal Gasps Present in 40% of cardiac arrest victims. After a cardiac arrest a casualty may be barely breathing or taking NOISY infrequent gasping breaths. This is not to be confused with normal breathing.
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Primary survey
Casualty not breathing – commence CPR (30 compressions 2 breaths) Casualty breathing – carry out secondary survey
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Compression-only CPR If you are unable, not trained, or are unwilling to give rescue breaths, give chest compressions only. These should be continuous at a rate of 100-120 per minute to a depth of 5-6 cm.
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Primary survey
If available an automated external defibrillator (AED) should be used alongside CPR.
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Interactive activities
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Secondary survey (Head-to-toe survey)
If the casualty is breathing, a secondary survey should be carried out. Inform the casualty what you are doing at all stages. If the casualty is responsive ask them to tell you if they feel any pain during the headto-toe survey ●Head and face ●Neck ●Chest and shoulders ●Arms and hands ●Spine ●Pelvis ●Abdomen ●Legs and feet. 40
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Head-to-toe survey
Head and face ● Look at the casualty’s head and face for any obvious signs of injury or trauma ● Remove spectacles if the casualty is wearing them. Gently feel around the head, face and scalp for any bleeding, swelling or depressions ● Look at the casualty’s ears for signs of bleeding or the presence of cerebrospinal fluid (CSF).
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Head-to-toe survey Neck ● Loosen any restrictive clothing such as ties or collars ● Gently feel around the cervical spine area and back of the neck to check for any bleeding, swelling or deformity and also check for medical necklaces
Chest and shoulders ● Gently feel around the shoulders to check for signs of deformity and bleeding ● Check the chest for normal breathing movement (rise and fall) and check for any bleeding.
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Head-to-toe survey
Arms and hands ● Check along the arms; feel for signs of deformity, swelling and bleeding ● Check the wrists for medical bracelets
Spine ● Try to check as much of the spine as possible without moving the casualty; feel for tenderness and deformity as well as signs of bleeding.
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Head-to-toe survey
Pelvis ● Check the hips and pelvis for deformity, unnatural positioning or bleeding
Abdomen ● Gently check the abdomen for signs of bleeding, swelling or unnatural softness.
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Head-to-toe survey
Legs and feet ● Check the legs and feet for bleeding, unnatural positioning, swelling and deformity ● Check the pockets of skirts or trousers for objects that may cause discomfort or pain should the casualty be moved.
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The recovery position
If you suspect a spinal injury (unless breathing is compromised) the casualty should be left in the position found.
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Placing the casualty in the recovery position helps to: ●maintain a clear airway ●assist with natural breathing ●clear the airway of excretions such as vomit if the casualty is breathing, but unresponsive
Kneel to the side of the casualty; remove glasses, watches and any large objects from side pockets
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The recovery position
When placing a pregnant woman into the recovery position she should be placed onto her left hand side, as this prevents compression of the inferior vena cava.
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Place the arm nearest to you at a right angle to the casualty and allow it to rest in a natural position
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The recovery position
Bring the other arm across the casualty’s chest and secure the back of their hand onto their nearest cheek.
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The recovery position
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Bring the arm furthest away from you across the chest and hold the back of the hand against the NEXT nearest cheek.
The recovery position
With your free hand grasp the casualty’s clothing around the knee and draw the leg up ensuring the foot remains on the ground.
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The recovery position
Keeping the casualty’s hand on their cheek to control the head movement, pull their leg towards you so the casualty turns onto their side.
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The recovery position
Adjust the casualty’s upper leg so that the knee and lower leg are at right angles to the hip, making a stable base.
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The recovery position
Check that the airway is open and adjust the hand under the cheek to maintain the airway.
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The casualty is now in the recovery position
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Module 6
Wounds and Bleeding NEXT
Types of bleeding Internal bleeding ● This is when blood escapes from the circulatory system, but remains inside the body. Sometimes signs of internal bleeding can be visible such as when the casualty coughs up blood or vomits blood, but most of the time internal bleeding is not apparent External bleeding ● This is where blood escapes from the circulatory system to the outside of the body, for example from a wound.
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Types of bleeding (continued) Arterial bleeding ● This is a bleed from an artery and will be bright red in colour (oxygenated blood); the blood will pump from the wound in time with the casualty’s heartbeat Venous bleeding ● This is a bleed from a vein, the blood will be a dark red in colour (deoxygenated blood) and will gush or flow from the wound Capillary bleeding
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● This is a bleed that is red in colour and slowly oozes from the wound or from underneath the skin, e.g. bruising. NEXT
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Wounds with embedded foreign object
Contact the emergency services, monitor the casualty and if required treat for shock. If you have not contacted the emergency services then they will not arrive! 87
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Shock
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Minor burns and scalds Every year there are large numbers of people who suffer from a minor burn or scald injury which can be caused by many things such as: ●radiation (sunlight, sunbeds, X-rays) ●direct heat (fire, iron, kettle, cooker, machinery) ●electricity, domestic supply, appliances (high and low voltage) ●extreme cold (freezing temperatures, frozen objects) ●chemicals (domestic, industrial) ●inhalation of toxic fumes (from a fire) ●scalds (hot liquids, fats, steam).
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Minor burns and scalds Recognition ● Pain at the site of the injury ● Redness, tenderness and swelling ● Possible blistering.
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Minor burns and scalds Treatment ● Remove the source of the burn if possible ● Put on your disposable gloves ● Remove clothing and then flush the area of the wound with tepid water for a minimum of 10-20 minutes ● Remove restrictive clothing or jewellery as swelling may occur ● Do not remove anything that is stuck to the burnt skin ● Seek medical attention immediately
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For electrical burns ensure that the source has been disconnected.
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Minor burns and scalds Treatment ● Remove the source of the burn if possible ● Put on your disposable gloves ● Remove clothing and then flush the area of the wound with tepid water for a minimum of 10-20 minutes ● Remove restrictive clothing or jewellery as swelling may occur ● Do not remove anything that is stuck to the burnt skin ● Seek medical attention immediately
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