Health Unit - Brentsville District High School

Health Unit

• ECSI review: First Aid, CPR, disaster preparedness

• Summatives: Compression only CPR, fitness goal setting, knowledge quiz/test, Opioid assignment

• Fitness plan/portfolio

Bellringer• Complete the 3rd quarter fitness summative

– Turn in when complete

• SMART goal must be Specific, Measurable, Achievable, Relevant, and Time bound.

X I want to get faster

X I want to lose weight

✓I will lose 5 pounds by April 30

✓I will earn a score of 61 pacers the next time we test

Chapter 1

Introduction

Understanding Injuries

• Most injuries and sudden illnesses do not result in death, but rather result in: – Hospitalization

– Treatment in an emergency department or from a general practitioner

– Treatment from a first aid provider

Importance of First Aid

• It is better to know first aid and not need it that need it and not know it.

• Goals of first aid:

– Preserving life

– Alleviating suffering

– Preventing further illness or injury

– Promoting recovery

First Aid Competencies

• Recognizing, assessing, and prioritizing the need for first aid

• Providing care by using appropriate knowledge, skills, and behaviors

• Recognizing limitations and seeking additional care when needed

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Role of the First Aid Provider

1. Recognize the emergency.

– Factors that help a first aid provider recognize an emergency include the following:

• The severity of the injury or illness

• How close you are to the emergency scene and the length of time you are at an emergency scene

• A person’s distressed appearance or panic-stricken behavior

• Previously knowing and recognizing the injured or ill person

• Scene conditions (ie, sights, smells, sounds)


2. Decide to help.

– Excuses some people use for not helping:

• It is harmful—eg, “I could be injured, infected with a disease, or sued. I could hurt the person.”

• Obstacles are in the way—eg, “I don’t know how to help. The scene is unsafe. I don’t like smelling or seeing blood, vomit, or burned skin.”


3. Before helping, take the appropriate actions.

– Size up the scene.

– Ask if you may help.

– Seek medical care, if needed.

– Prevent disease transmission.


4. Find what is wrong with the person.

– Before giving first aid, you must determine what is wrong with the person—“find it, fix it.”

– Most cases involve checking only a person’s chief complaint.


5. Give first aid.

– Based upon what you found, give first aid until one of the following events occur:• Emergency medical services (EMS) takes over

• You take the person to a medical facility

• It is determined the person needs only first aid and home care

Chapter 2

Before Helping, Take the Appropriate Actions

Scene Size-Up

• You should perform a scene size-up every time you respond to an emergency.

• As you approach the scene, ask yourself:

– Are dangerous hazards present?

– How many people are involved?

– What is wrong?

– What happened?

– Are bystanders available to help?

Scene Size-Up: Scenario

You see your middle-aged neighbor shoveling snow off his driveway. When he is about halfway finished, he walks to the front steps of his house and sits down with a distressed look on his face. You walk over and ask if he is okay. He replies, “I think I pulled a muscle in my chest.” You see that he is breathing rapidly and appears pale and anxious.

Scene Size-Up: Agree or Disagree?1. Emergency scenes can be unsafe.

2. Every time you approach an emergency scene, perform a scene size-up.

3. Most emergency scenes involve multiple people.

4. Move bystanders aside; they are not helpful.

5. While approaching a person, you should have a first impression of whether the person is injured or ill.

6. While approaching a person, you should have a good idea of whether the person is responsive or unresponsive.

When to Call 9-1-1

• According to the American College of Emergency Physicians (ACEP), you should call 9-1-1 for help if you answer “yes” to any of the following questions:

– Is the condition life-threatening?

– Could the condition get worse on the way to the hospital?

– If you move the person, will it cause further injury?

– Does the person need the skills or equipment of EMS?

– Would distance or traffic cause a delay in getting the person to the hospital?

When to Call 9-1-1

– Difficulty breathing– Chest or upper abdominal

pain lasting 2 minutes or more

– A fast heartbeat at rest– Fainting (passing out) or

unresponsiveness– Difficulty speaking, or

numbness or weakness of any part of the body

– Sudden dizziness– Changes in mental status,

unusual behavior, or difficulty walking

– Sudden vision changes– Bleeding that will not stop

with direct pressure– Broken bones visible

through an open wound, or a broken leg

• ACEP recommends the immediate transport of people with the following conditions:

When to Call 9-1-1

– Drowning

– Choking

– Severe burn

– Allergic reaction

– Extremely hot or cold body temperature

– Poisoning or drug overdose

– Sudden, severe headache

– Any sudden or severe pain

– Severe or persistent vomiting or diarrhea

– Coughing or vomiting of blood

– Behavioral emergencies

• ACEP recommends the immediate transport of people with the following conditions (cont’d):

How to Call 9-1-1

• When calling 9-1-1, speak slowly and clearly. • Be ready to give the following information:

– The person’s location– The phone number you are calling from and your name– A brief account of what happened– Number of people needing help and any special conditions– Description of a person’s condition and what is being done

• Listen to what the dispatcher tells you to do.• Stay with the person needing help until EMS arrives.

Seeking Medical Care:Scenario

While hiking a canyon, you notice a nearby hiker suffer a serious fall. You need to call for medical help. How would you go about doing this?

Seeking Medical Care:Agree or Disagree?

1. When unsure about an injury or sudden illness, call 9-1-1 or seek medical care.

2. When calling 9-1-1 with a cell phone, the call taker can see the exact address of the caller.

3. For most bloody nose incidents, call 9-1-1.

4. Over 98% of the population in the United States and Canada are covered by some type of 9-1-1 service.

5. Call 9-1-1 for a person who is vomiting blood.

Legal Aspects of First Aid

• Legally you may not have to help another person, but most people believe it is a moral obligation.

• Good Samaritan laws provide protection against lawsuits. The following conditions must be met:

– You are acting with good intentions.

– You are providing care without expectation of compensation.

– You are acting within the scope of your training.

– You are not acting in a grossly negligent manner.

Negligence

• Negligent actions include:

– Giving substandard care

– Withholding care when you have a legal duty to act

– Causing injury or harm

– Exceeding your level of training

– Abandoning the person

Consent

• Always obtain consent (permission) before giving first aid.

• Types of consent include:

– Informed

– Implied

– Children

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Legal Aspects of First Aid:Agree or Disagree?

1. Before giving first aid to an alert, competent adult, you must get consent.

2. If you ask an injured adult if you can help and he or she says “No,” you can still give first aid.

3. People designated as first aid providers by their employers must give first aid while on the job.

4. First aid providers can be sued.

5. Good Samaritan laws provide protection against lawsuits for those acting with good intentions and without compensation.

Cleaning a Blood Spill

1. Wear PPE.

2. Wipe up blood with paper towels.

3. Spray or wash the area with 1 part liquid bleach in 9 parts water and let it air dry.

4. Dispose of materials in a biohazard container. If one is not available, double-bag in plastic bags.

5. When finished, wash your hands.

How to Wash Your Hands

• Wash your hands before and after giving first aid:1. Wash your hands with

soap and running water.

2. Rub all hand surfaces together for 15 to 20 seconds.

3. Rinse off the soap with running water.

4. Dry your hands with a clean towel or a paper towel.

Disease Prevention: Scenario

You are providing first aid for an injured person when you notice a tear in your gloves. Blood from the injured person’s wound has seeped through the tear and over your hand.

Disease Prevention:Agree or Disagree?

1. When giving first aid, wear disposable gloves to prevent contact with blood and body fluids.

2. When possible, wear latex-free gloves.

3. You do not need to wash your hands after giving first aid if you have been wearing gloves.

4. Use an alcohol-based hand cleaner when soap and water are not available.

5. Clean a blood spill by spraying or washing the area with one part water in nine parts liquid bleach.

Finding What is Wrong

• For an alert and breathing person:1. Call 9-1-1 for severe bleeding.

Control bleeding. 2. Check the person from head to

toe, looking, asking, and feeling for:

• D = Deformity• O = Open wounds• T = Tenderness (pain)• S = Swelling

3. Determine chief complaint.4. Check for a medical identification

tag.

Courtesy of the MedicAlert Foundation®. © 2006, All Rights Reserved. MedicAlert® is a federally registered trademark and service mark.


• For an alert and breathing person (cont’d):5. Perform a SAMPLE history. Ask about:

• S = Signs and symptom (chief complaint)

• A = Allergies

• M = Medications

• P = Pertinent past medical history

• L = Last oral intake

• E = Events leading up to the illness or injury

For an unresponsive person, a bystander or family member may be able to answer these questions.


• For an unresponsive person:

1. Use RAB-CAB to remember what to do:

• R = Check for responsiveness.

• A = Activate EMS.

• B = Breathing or only gasping?

2. If not breathing or only gasping, begin cycles of CPR:

• C = 30 chest compressions

• A = open airway

• B = 2 breaths

3. Continue CPR until an AED and/or EMS arrives.

Finding What is Wrong: Scenario

While walking through a movie theater’s parking lot, your friend stumbles and suddenly collapses onto the ground. His eyes roll back, his body goes rigid, and his arms and legs begin to jerk uncontrollably.

Finding What is Wrong:Agree or Disagree?

1. Always do a complete head-to-toe physical exam on an injured person.

2. “Unresponsive” refers to a person who can open his or her eyes, talk, or move.

3. Use DOTS to remember what to look for during a physical head-to-toe exam.

4. Use SAMPLE to help recall what to ask about the person’s medical history.

5. Look for a medical identification tag for all injured and suddenly ill people.

Chapter 3

Injury Emergencies

Bleeding Control

• Avoid contact with blood by putting on disposable exam gloves.

• To control bleeding:– Place a gauze dressing over

the wound. If not available, use your gloved hand.

– Apply direct pressure.– If the dressing becomes

blood-soaked, add more dressings onto the first one and press harder and wider over the wound.

Tourniquets

• If direct pressure fails to control bleeding on an arm or a leg, apply a manufactured tourniquet 2 to 3 inches (5 to 7 cm) above the wound.– Tighten the tourniquet

until the bleeding stops, then secure it in place.

• Manufactured tourniquets appear to be better than those that are improvised.

Tourniquets

• If a manufactured tourniquet is not available, apply an improvised tourniquet.– Wrap a band of soft material twice around the arm or leg

and about 2 to 3 inches (5 to 7 cm) above wound.

– DO NOT use narrow materials, elastic materials, or bungee-type devices.

– Tie a half or overhand knot on the arm or leg and place a short, rigid object over it. Then, tie a square knot over the rigid object.

– Twist the rigid object until the bleeding stops.

– Tie or tape the rigid object in place to keep the tourniquet from unwinding.

Hemostatic Dressings

• Apply a hemostatic dressing if:– Direct pressure is not

effective in controlling bleeding.

– A tourniquet is not available, is ineffective, or cannot be applied.

• Apply a hemostatic dressing in combination with direct pressure followed by a pressure bandage (eg, roller bandage).

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Bleeding Control: Scenario

A knife slipped and sliced into the forearm of a 35-year-old male butcher at a supermarket butcher shop. He is holding a blood-soaked cloth over the injury, and you see blood on the floor and a display case. He said the blood was shooting out of his arm.

Bleeding Control: Agree or Disagree?

1. Most cases of bleeding require more than direct pressure to stop it.

2. While trying to stop bleeding, remove and replace blood-soaked dressings.

3. If a bleeding arm wound is not controlled through direct pressure, apply pressure to the brachial artery.

4. If direct pressure fails to control an arm or leg’s severe bleeding, apply a tourniquet.

5. If direct pressure fails, raise the arm or leg.

6. Once bleeding has been stopped, pressure bandages can maintain control if needed.

Shallow Wounds: What to Do1. Gently wash inside and around the wound with

running water, with or without soap.2. Flush with pressurized water.3. Pat the area dry. 4. If bleeding restarts, apply direct pressure.5. Apply a thin layer of antibiotic ointment over the

wound .6. Cover the wound with a sterile or clean dressing and

bandage.

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Severe Wounds: What to Do

1. For a wound with a high risk of infection, clean as best you can.

2. Cover with a sterile or clean dressing held in place by a bandage.

3. Care for shock; keep the person from getting chilled or overheated.

Wound Care: Scenario

You find a coworker in the storage room with a blood-soaked cloth covering his hand. He said that glass from a broken bottle caused the wound. You take a quick look and see a jagged, gaping, open wound.

Wound Care: Agree or Disagree?

1. Gently wash a shallow wound with soap and warm running water.

2. Soak a wound in water to clean it.

3. After cleaning a shallow wound, cover it with antibiotic ointment before putting on a dressing.

4. Apply alcohol or hydrogen peroxide to a wound.

5. Seek medical care for wounds more than 1 inch long or one in which the edges do not fall together.

6. Wounds with a high risk for infection should receive medical care for proper cleaning.

Nosebleeds: What to Do

1. If nose was hit, suspect a broken nose.

2. Have the person sit leaning slightly forward.

3. Pinch the nostrils shut for 10 minutes.

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Nosebleeds: What to Do

4. If bleeding has not stopped after 10 minutes: – Have the person gently blow his or her nose to get rid of

ineffective blood clots. – Pinch the nostrils together again for 10 minutes. – Try other methods, such as applying an ice pack or

spraying decongestant spray in nostrils.

5. If bleeding reoccurs, seek medical care.

Nosebleeds: Scenario

Sean played a practical joke on one of his coworkers, startling him. In reaction, the coworker jumped up, hitting his nose against Sean’s elbow, causing a nosebleed. You pinch his nostrils shut, but his nose continues to bleed.

Nosebleeds: Agree or Disagree?

1. Position the person in a sitting posture.

2. Keep the head tilted slightly backward.

3. Pinch the nostrils shut for 10 minutes.

4. All nosebleeds require medical care.

Tooth Injuries: What to Do

1. Attempt to reimplant the tooth:– DO NOT touch the root of the tooth.– If the tooth is dirty, rinse it in a bowl of water.– Replace the tooth into its socket.

2. If unable to reimplant, store the tooth in one of the following until a dentist is available:– Hank’s Balanced Salt Solution– Egg white– Coconut water– Whole milk

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Tooth Injuries: What to Do

3. If none of the previously mentioned solutions are available, have the person spit saliva in a small container into which the tooth can be placed.

4. Seek a dentist as soon as possible.

Tooth Injuries: Scenario

Your friend was struck in the mouth by a pipe that was loosely suspended from a cable. He has spit out two of his front teeth, which are lying on the ground.

Tooth Injuries: Agree or Disagree?

1. Place a knocked-out tooth in mouthwash or rubbing alcohol until you reach a dentist.

2. Before attempting to reinsert a knocked-out tooth, scrub the tooth.

3. Only a dentist should attempt to reinsert a knocked-out tooth.

4. Never put an aspirin on an aching tooth or gums.

5. Have the person spit saliva into a small container and place the knocked-out tooth in it until you reach a dentist.

Eye Injuries: What to Do

• Blow to the eye

1. Apply an ice pack around the eye for 15 minutes. DO NOT place the pack on the eye.

2. Have the person keep the eyes closed.

3. Seek medical care.

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• Loose object in the eye

1. Have the person blink the eye several times.

2. Pull the upper eyelid out and over the lower lid.

3. Gently irrigate with clean, warm water.

4. Lift the eyelid up and over a cotton swab. If object is seen, remove it with the corner of a wet gauze pad.

5. If successful, medical care is usually not needed.


• Object stuck in the eye1. DO NOT remove the object.2. For a long object, place padding around the object to

stabilize, and place a paper cup over the object.3. For a short object, place a donut-shaped pad around the

eye, and wrap a bandage around the head to hold it in place.

4. Cover both eyes. 5. Keep the person flat on his or her back.6. Call 9-1-1 as soon as possible.


• Chemical in the eye1. Hold the eye wide

open; flush with warm water for at least 15 minutes.

2. The eyes may need to be loosely bandaged.

3. Contact the poison control center. • If not available, seek

medical care as soon as possible or call 9-1-1.


• Cut on the eyeball

1. DO NOT apply pressure to the injured eye.

2. Cover both eyes with gauze pads, and lightly wrap a bandage around the head.

3. Call 9-1-1 or drive the injured person to a medical facility as soon as possible.

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• Burns caused by light

1. Cover both eyes with moist, cool cloths.

2. Give pain medication if needed.

3. Seek medical advice.

Eye Injuries: Scenario

You are having a part of your house remodeled. One of the construction workers working on the project unintentionally pulls the trigger of a nail gun he is using. A nail becomes impaled (embedded) in the eye of another worker.

Eye Injuries: Agree or Disagree?

1. Tears will sufficiently flush out chemicals in the eye.

2. To rinse a chemical out of the eye, pour water into the eye for about 5 minutes.

3. To rinse a chemical out of the eye, hold the eye open and flood the eye with water for 20 minutes.

4. Use tweezers to remove small objects in the eye.

5. For a cut to the eyeball, cover both eyes with dressings and immediately obtain medical care.

6. For a long object stuck in the eye, protect it from being bumped and stabilize against movement.

Impaled (Embedded) Object: What to Do

• Sliver

1. Remove with tweezers.

2. Wash the area with soap and water.

3. Apply antibiotic ointment.

4. Apply an adhesive bandage.

Impaled (Embedded) Object: What to Do

• Large object 1. DO NOT remove or move the

object.

2. Stabilize the object with bulky dressings or padding placed around the base of the object.

3. If bleeding, apply direct pressure around the base of the object.

4. If necessary, reduce the length or weight of the object by cutting or breaking it.

5. Call 9-1-1.

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Impaled (Embedded) Object:Scenario

Your husband is helping to remodel a part of your house. While working on setting up some wall framing, he fires an air-powered nail gun. The nail penetrates into his left index and middle fingers.

Impaled (Embedded) Object: Agree or Disagree?

1. Remove an embedded object to prevent infection.

2. Prevent an embedded object from moving by placing bulky padding around the base of the object.

3. Use tweezers to remove a sliver in the skin.

4. For a long, embedded object in an eye, use a paper cup or similar item over the eye for protection.

5. Allow a person with an embedded object in the eye to see by leaving the uninjured eye uncovered.

Amputations: What to Do

1. Call 9-1-1.2. Control the bleeding.

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Amputations: What to Do

3. Care for the amputated part:– Wrap the part in a moistened sterile gauze or clean cloth.– Put the wrapped part in a waterproof container.– Keep the part cool by placing the wrapped part in a

container of ice.– DO NOT bury the part in ice or allow it to directly touch

the ice. DO NOT submerge it in water.

4. If the amputated part was not found, ask others to search for it and, if located, to take it to the medical facility where the person is going.

Avulsions: What to Do

1. Gently move the skin back to its normal position.

2. Cover with a sterile or clean dressing and apply pressure.

3. If bleeding continues, apply a tourniquet or a hemostatic dressing, if available.

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Amputations and Avulsions: Scenario

Your neighbor is mowing tall, wet grass when it begins to back up at his mower’s discharge opening. He reaches into the discharge chute to try to brush away a clump of grass, and his fingers are struck by the mower’s blade. Two fingers are cut off. You find him sitting on the lawn, firmly holding what remains of his fingers.

Amputations and Avulsions: Agree or Disagree?

1. Recover any amputated part, regardless of size, and take it with the person to the nearest hospital.

2. Cut off a partially attached body part because it will not survive.

3. Wrap an amputated part in a moistened, sterile gauze dressing, enclose it in a waterproof container, and keep it cool.

4. Keep an amputated part buried in ice or cold water.

5. Be prepared to apply a tourniquet if the bleeding does not stop by applying direct pressure.

Head Injuries: What to Do

If you suspect a skull fracture:

1. Apply a sterile or clean dressing over the wound and hold it in place with gentle pressure.

2. Control bleeding by pressing on the edges of the wound.

3. Call 9-1-1.

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Head Injuries: Scenario

At work, you are called to help a carpenter who fell from a ladder. A bystander says that, though responsive now, he was motionless for a couple of minutes. He complains about a severe headache and dizziness. There is swelling on the back of his head. You see no blood on him or in the surrounding area.

Head Injuries: Agree or Disagree?

1. To control bleeding with a suspected skull fracture, press around the edges and not directly on the wound.

2. Do not remove an impaled object from a skull.

3. A person whose head is injured may also have a spine injury.

4. Move any skin flap back to its normal position.

5. A person with a suspected concussion does not require medical care—only rest.

Spinal Injuries: What to Do

1. Call 9-1-1. Wait for trained rescuers with proper equipment.

2. DO NOT attempt to move the person.

3. Apply spinal stabilization.

4. Cover the injured person to prevent heat loss.

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Spinal Injuries: Scenario

At a construction site, a worker has fallen from a 15-foot ladder. He is complaining about back pain and cannot wiggle his toes, nor can he feel you pinching his toes on either foot.

Spinal Injuries: Agree or Disagree?

1. Consider a spinal injury whenever an older person falls.

2. Consider a spinal injury whenever the person is involved in a high-speed vehicle collision.

3. Being able to wiggle fingers and toes could indicate a spinal injury.

4. Trouble breathing is a reliable sign of a spinal injury.

5. Stabilize a person with a suspected spinal injury with your hands until EMS arrives.

Chest Injuries: What to Do

• For all chest injuries, look for:

– DOTS: Deformity, Open wound, Tenderness, Swelling

– Abnormal breathing rate and/or sounds

– Guarding

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• Rib fracture1. Help the person find a comfortable position.

2. Stabilize the chest by:– Having the person hold a pillow or other similarly soft

material against the area, or

– Placing arm on the injured side in a sling and binder.

3. DO NOT apply tight bandages around the chest.

4. Give pain medication.

5. Have the person cough and take deep breaths a few times every hour to prevent pneumonia.

6. Call 9-1-1.


• Flail chest

1. Stabilize the chest by:

– Placing a pillow or similarly soft material against area or arm on the injured side in a sling and binder, and

– Placing the person on his or her injured side with a blanket or similarly soft material underneath the person.

2. DO NOT apply tight bandages around the chest.

3. Call 9-1-1.


• Penetrating object

– Stabilize the object in place with bulky dressings or clothes.

– DO NOT try to remove the object.

– Call 9-1-1.

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• Open chest wound

1. Leave the wound exposed to air without a dressing or any airtight material.

2. DO NOT allow a blood-soaked dressing to become a barrier or obstruction if a dressing and direct pressure are used to stop bleeding.

3. Call 9-1-1.

Chest Injuries: Scenario

A worker was struck by a piece of reinforcing bar at a building under construction. The bar penetrated the worker’s chest. You are called over to help, and you see that the iron rod has been removed. Air is passing in and out of the man’s chest with each breath he takes.

Chest Injuries: Agree or Disagree?

1. Stabilize a broken rib by taping a person’s chest as tight as possible.

2. Stabilize an impaled object in the chest with bulky padding to prevent it from moving.

3. Do not apply an airtight material to seal off an open chest wound.

4. Have the person with a chest injury sit up.

5. Stabilize a broken rib by holding a pillow or blanket over the injured area.

Abdominal Injuries: What to Do

• Penetrating object1. DO NOT remove a

penetrating object.

2. Stabilize the object against movement.

3. Call 9-1-1.


• Protruding organs1. DO NOT try to push

protruding organs back into the abdomen.

2. DO NOT touch organs.

3. Cover them with a moist, clean dressing.

4. Call 9-1-1.


• Hard blow to abdomen

– Roll the person onto one side and expect vomiting.

– Monitor for signs of possible internal injuries.

– Call 9-1-1.

Abdominal Injuries: Scenario

A repairman falls while carrying replacement glass for a broken window. The new glass breaks into several jagged pieces. You find him lying on his back with a blood-soaked shirt. You see a lacerated abdomen with several loops of bowel protruding through the wound. The man says that a piece of glass caused the wound.

Abdominal Injuries: Agree or Disagree?

1. Gently push protruding organs back into the abdominal wound.

2. Keep the dressing covering protruding intestines dry.

3. Remove a penetrating object from the abdomen.

4. Stabilize an impaled object in place using bulky dressings or cloths.

5. For a blow to the abdomen when internal injuries are suspected, place the person on his or her side with the legs pulled up toward the abdomen.

Bone Injuries: What to Do

1. If EMS will arrive soon, hold the injured part.

2. If EMS is delayed or if you are transporting the person a long distance, use the RICE procedure and stabilize the part with a splint.

3. DO NOT try to straighten an injured extremity.

4. Call 9-1-1 for a blue or extremely pale extremity.

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Bone Injuries: Scenario

While cleaning leaves out of a rain gutter, your neighbor falls off the roof of her house and lands into a section of bushes. She complains about pain in her left lower leg. You look at the leg and feel it. It is beginning to swell and when compared with the uninjured leg, the injured one has a slight bend in it. The house is about 20 miles from the nearest hospital.

Bone Injuries: Agree or Disagree?

1. Check for DOTS to locate a possible broken bone.

2. If EMS is delayed, use the RICE procedure on a suspected broken bone.

3. If you are transporting a person with a suspected broken bone to a medical facility, apply a splint to stabilize the part.

4. If a bone is sticking out through the skin, try to push the bone ends back beneath the skin surface.

5. Try to straighten a crooked or bent broken bone.

Joint Injuries: What to Do

• Dislocation

1. Call 9-1-1.

2. Hold the part when transporting a short distance or until EMS arrives.

3. If EMS is delayed or if you are transporting a long distance:

• Use the RICE procedure.

• Use a splint to stabilize the part.

4. DO NOT try to reduce or reset a dislocation.

Joint Injuries: What to Do

• Sprain

1. Most sprains do not require medical care.

2. If recuperation seems long, consult a physician.

3. Use the RICE procedure.

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Joint Injuries: Scenario

During a city league basketball game, a player turns his ankle. He hobbles with difficulty and pain off the court. By the time he takes off his shoe, swelling has started to form on the ankle’s outer side.

Joint Injuries: Agree or Disagree?

1. Use the RICE procedure to treat sprains and dislocations.

2. When using an ice pack, place it directly on the skin.

3. Apply an elastic bandage to help control swelling in a joint.

4. Seek medical care for dislocated joints.

5. Try to reset or reduce dislocations.

Muscle Injuries: What to Do

• Cramp1. Try one or more of these methods to relax the muscle:

• Gently stretch the affected muscle.

• Press on the muscle.

• Apply an ice pack to the muscle.

• Drink lightly salted cool water or a commercial sports drink.

2. DO NOT give salt tablets.

• Bruises and strains

1. Use the RICE procedure.

Muscle Injuries: Scenario

While sprinting toward the finish line, a high school runner suddenly stops and with pain showing on her face. She hobbles her way off the track. Her coach asks what happened, and she complains about pain in her upper leg and believes that she has “pulled” a muscle.

Muscle Injuries: Agree or Disagree?

1. Give a sports drink to help treat a muscle cramp.

2. Use the RICE procedures for muscle bruises.

3. For muscle injuries, apply an ice pack for 5 minutes.

4. The rest part of the RICE procedure refers to getting 7 to 9 hours of sleep.

5. A thin cloth should be placed between an ice pack and a person’s skin.

Thermal Burns: What to Do

• Stop the burning by removing the person from the heat source.

• Remove clothing and jewelry from the burn area. – DO NOT try to remove stuck clothing.

• Seek medical care for the following:– Burns on face, neck, hands, feet, or genitals

– Breathing difficulty

– Blistering or broken skin

– Large area of skin or tissue burned

– All third- and large second-degree burns

First-Degree Burns: What to Do

1. Immerse the burned area in cool or cold water for at least 10 minutes.

2. Give ibuprofen.

3. Have the person drink as much water as possible without becoming nauseous.

4. Keep the burned arm or leg raised.

5. After burn has been cooled, apply aloe vera gel.

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Second-Degree Burns: What to Do

• Small second-degree burns

1. Follow Steps 1 through 4 for first-degree burns, with the following additions:• After burn has been

cooled, apply a thin layer of antibacterial ointment.

• Cover the burn with a loose, dry, nonstick, sterile or clean dressing.

• Large second-degree burns

1. Follow Steps 1 through 4 for first-degree burns, with the following additions:• Apply cold, but monitor,

as it may cause hypothermia.

• Call 9-1-1.

Third-Degree Burns: What to Do

1. Cover the burn with a dry, nonstick, sterile or clean dressing.

2. Call 9-1-1.

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Thermal Burns: Scenario

Your roommate is boiling water in the kitchen. She reaches across the stove for a cup and the sleeve of her blouse touches the gas flame and ignites, sending fire racing up her arm. Her screams bring you racing into the kitchen. After putting the fire out, you check her and find that she has burns on about 5% of her arm.

Thermal Burns: Agree or Disagree?

1. Apply butter or petroleum jelly on a burn.

2. Apply ice or ice water on a burn.

3. Run cold water over first- and small second-degree burns.

4. Cover first-degree burns with a sterile dressing.

5. Break blisters from a burn to shorten the healing time.

Electrical Burns: What to Do

• If the person is still in contact with electricity:

1. Call 9-1-1 to have the electricity turned off.

2. DO NOT touch or move power lines or the person.

3. DO NOT try to move electrical wires or devices with a wooden pole or handle.

4. Keep people away from the area.

Electrical Burns: What to Do

• If the person is not in contact with electricity and danger to rescuer has passed:

1. Check breathing, and if absent, begin CPR.

2. Call 9-1-1 immediately.

3. Cover burn wounds with sterile dressings.

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Electrical Burns: Scenario

You call an electrician to your home to resolve some electrical issues that have been occurring. You leave him as he begins to work on a live electrical circuit-breaker box. When you come back to check on him, you find him on floor not moving.

Electrical Burns: Agree or Disagree?

1. If an electrocuted person is in contact with an outdoor electrical wire, try to move the wire or the person with a wooden object.

2. For an electrocuted person inside a building, turn off the electricity at the fuse box, circuit-breaker, or outside switch box, or unplug the appliance.

3. After an unresponsive, electrocuted person has been rescued, check for breathing.

4. Care for both entrance and exit wounds.

5. All electrocuted people need medical care.

Chemical Burns: What to Do

• Once the area is safe:1. Brush a dry or powder chemical

off the skin with a gloved hand or piece of cloth before flushing with water.

2. Flush the burn with large amounts of cool running water for at least 20 minutes or until EMS arrives.

3. Call 9-1-1 immediately for all chemical burns.

4. DO NOT try to neutralize the chemical.

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Chemical Burns: What to Do

• Once the area is safe (cont’d):5. For a chemical in an eye:

• Tip the head so the affected eye is below the nose.

• Wash the eye with warm water from nose out to the side of the face for at least 20 minutes.

Chemical Burns: Scenario

You are helping a coworker replace a battery when it explodes, showering his arms with battery acid.

Chemical Burns: Agree or Disagree?

1. When washing chemicals off the body, flush continuously with water for at least five minutes.

2. When washing chemicals off the body, use high pressure water.

3. Try to neutralize a chemical so it does not cause more damage.

4. Brush dry powder chemicals from the skin before flushing.

5. Taking off clothing covering the affected area can be done while flushing the body with water.

Blisters: What to Do

• Hot spot and a blister that is closed and not very painful

1. Depending upon availability and the blister’s location, apply one of the following:

• Blister bandage (Blist-O-Ban)

• Surgical tape (Micropore paper tape)

• Elastic tape (Elastikon)

2. Trim and round the edges of the tape to prevent it from peeling off.

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• Blister that is closed and very painful

1. Clean the blister and a needle with an alcohol pad.

2. Make several small holes at the base of the blister with the needle. Gently press the fluid out.

3. Apply paper tape.

4. Cover paper tape with elastic (Elastikon) or adhesive tape.

5. Trim and round the edges of the tape.

6. Watch for signs of an infection.


• Blister that is very painful and open or torn

1. Use scissors to carefully trim off the dead skin.

2. Place a blister pad (Spenco 2nd Skin) over the raw skin.

3. Cover the blister pad with paper tape.

4. Cover paper tape with elastic (Elastikon) or adhesive tape. Trim and round the edges of the tape.

5. Watch for signs of an infection.

Blisters: Agree or Disagree?

1. Apply paper tape to relieve a hot spot.

2. For an open or torn blister, apply a blister pad once the blister roof has been removed.

3. Drain the fluid out of a very painful, closed blister.

4. Apply an adhesive strip (Band-Aid) over a blister.

5. Regardless of cause (ie, friction, burn, frostbite, poison ivy), treat all blisters the same.

Wed/Thurs 3/6 and 3/7

• Ace Wrapping (how to)

• Burns

• Ch 4: Sudden Illnesses (Asthma, anaphylaxis, heart attack, stroke, diabetes, shock, heat/cold emergencies)

• Next Class (Monday): CPR and Heimlich.

– Assessment: Chest compressions

Bellringer: write ? And answer

1. What is implied consent?

2. What does "RICE" stand for?

3. What are the 3 "degrees" of a burn

4. When would you call 911 for a burn?

5. How would you know if a wound was infected?

1st block bellringer

• What is heat exhaustion?

– How do you treat it?

• What is heat stroke?


• What is hypothermia?


Chapter 4

Sudden Illnesses

Asthma: What to Do

• Help the person use his or her physician-prescribed quick-relief (rescue) inhaler:1. Shake the inhaler several times and apply a spacer if

available.2. Hold the inhaler upright and have the person place his or

her lips around the inhaler or spacer.3. While the person breathes in slowly and deeply, depress

the inhaler.4. If using a spacer, press down on the inhaler and have the

person wait 5 seconds before breathing in.5. Tell the person to hold his or her breath for 10 seconds

and to breathe out slowly.6. A second dose may be given in 30 to 60 seconds.

Asthma: What to Do

• Call 9-1-1 if:

– The person does not improve.

– Repeated attacks occur.

– A severe or prolonged attack occurs.

Asthma: Scenario

You and your wife have just gone to bed when your wife begins to have trouble breathing due to her asthma. She is breathing heavily, deeply, and rapidly and is sitting up in bed. She has taken her asthma medications, but they are having little effect. Today’s weather conditions had high pollen indexes.

Asthma: Agree or Disagree?

1. Help the person having an asthma attack use his or her rescue inhaler.

2. Have the person lie on his or her back.

3. Have the person breathe slowly and deeply through the nose and quickly through the mouth.

4. When using an inhaler, tell the person to hold his or her breath for about 10 seconds after breathing in the medication.

5. All asthma attacks require calling 9-1-1.

Severe Allergic Reactions (Anaphylaxis): What to Do

• Call 9-1-1 if a person shows signs of a severe allergic reaction (trouble breathing; swelling of the tongue, throat, or face).

• If the person has his or her own physician-prescribed epinephrine auto-injector, you may need to help him or her self-administer it.

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Severe Allergic Reactions (Anaphylaxis): What to Do

• If the person can swallow, give an antihistamine.

– It is not lifesaving because it takes too long to work, but it can help prevent further reactions.

Severe Allergic Reactions: Scenario

You are at a local park and see a teenage girl lying on the grass crying. She says that her throat is “getting big,” and she is having trouble breathing. One of her friends thinks she may have been stung by a bee. Another friend has run across the park to get the girl’s mother. When the mother arrives, she tells you that her daughter is allergic to bee stings and that she has her daughter’s epinephrine auto-injector in her purse.

Severe Allergic Reactions: Agree or Disagree?

1. Epinephrine is the best treatment for saving a person experiencing a life-threatening allergic reaction.

2. Press an epinephrine auto-injector into the person’s upper arm to activate it.

3. An antihistamine is not life-saving because it takes too long to work, but it can help prevent further reactions.

4. State laws do not prohibit using another person’s epinephrine auto-injector to save a life.

5. When a person cannot use an epinephrine auto-injector on himself or herself, you should give the person an injection.

Heart Attack: What to Do

1. Call 9-1-1 immediately.

2. Have the person sit, with knees raised, and lean against a stable support.

3. Loosen any tight clothing.

Heart Attack: What to Do

4. Ask if the person takes any chest pain medication, and, if so, help him or her take it.

5. If the person is alert, is able to swallow, is not allergic to aspirin, and has no signs of stroke, help the person take one adult aspirin or two to four low-dose baby aspirins.

6. Monitor breathing. If the person becomes unresponsive and stops breathing, begin CPR.

Heart Attack: Scenario

An obese man complains of a crushing pain in his chest. He is sweating and has trouble catching his breath. He says that the pain has lasted about an hour, and he has taken three nitroglycerin tablets without relief. He reports that he is 67 years old.

Heart Attack: Agree or Disagree?

1. Call 9-1-1 immediately for anyone with central chest discomfort lasting more than five minutes.

2. Treat women with chest pain differently, as they have slightly different heart attack signs than men.

3. Help a person with chest pain walk around to increase his or her heart rate and blood pressure.

4. Give aspirin to any person experiencing a heart attack.

5. If breathing stops, give CPR.

Stroke: What to Do

1. Call 9-1-1.

2. If responsive, position the person on his or her back with head and shoulders slightly raised.

3. If the person is unresponsive, place on his or her side.

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Stroke: Scenario

You are shopping at the grocery store when an older man suddenly collapses and falls to the floor in front of you. You ask if he is okay. His reply is garbled, and you are unable to understand what he is trying to say. You notice that one side of his face is drooping. You suspect he has had a stroke.

Stroke: Agree or Disagree?

1. When a stroke is suspected, immediately call 9-1-1.

2. Never give CPR chest compressions to a non-breathing person who has had a stroke.

3. Give the person a glass of water to drink.

4. Gently place the person in a comfortable position with head and shoulders slightly raised.

5. Place an unresponsive, breathing person on their side.

Fainting: What to Do

• Check breathing. If stopped, call 9-1-1 and give CPR.

• If the person is breathing:

1. Keep the person flat on his or her back. Feet can be raised 6 to 12 inches if it does not cause pain.

2. Monitor breathing; if it stops, give CPR.

3. Loosen tight clothing.

4. If the person fell, check and treat any injuries.

5. Wipe the person’s forehead with a cool, wet cloth.

Fainting: What to Do

• Seek medical care if:

– There are repeated episodes.

– The person fainted for no apparent reason.

– The person does not regain responsiveness quickly.

– The person has diabetes, has seizures, is pregnant, has a loss of bowel or bladder control, or is over age 50.

Fainting: Scenario

You are attending your nephew’s high school basketball game when you notice a middle-aged man suddenly collapse onto the person sitting next to him. He is breathing and becomes responsive a minute later.

Fainting: Agree or Disagree?

1. Place an ammonia inhalant capsule or bottle of smelling salts near the nostrils of a person who faints.

2. Splash water on a person’s face to revive him or her.

3. If you believe a person is about to faint, prevent him or her from falling to avoid injury.

4. If a person who fainted is not breathing, give CPR until EMS arrives.

5. Raise a person’s legs while they are lying down.

Diabetic Emergencies: What to Do

If the person is responsive, alert, and can swallow:

1. The person may be able to tell you what to do.

2. If the person has a blood glucose meter, allow him or her to check his or her blood glucose.

3. Use the Rule of 15 when:

• Testing is not possible.

• Testing shows a low blood glucose level.

• Profuse sweating or shaking occurs in a person with diabetes.

Diabetic Emergencies: What to Do

If the person is responsive (cont’d):

– The Rule of 15 works as follows:

• Have the person eat 15 grams of sugar.

• Wait 15 minutes for the sugar to get into the blood.

• Recheck the blood glucose level. If it is still low, or if no testing is available, give the person 15 more grams of sugar to consume.

• If there is still no improvement, call 9-1-1 as soon as possible.

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Diabetic Emergencies: Scenario

In your carpool after work, the driver is driving fast, has been weaving, and almost crossed some traffic lanes. When he stops to let the first rider out, he just sits in the car, staring at the steering wheel. He then slumps over onto the steering wheel. His skin is cold and sweaty. You are aware that the driver has diabetes.

Diabetic Emergencies: Agree or Disagree?

1. A person with diabetes can often tell you what is wrong or how you can help him or her.

2. When unsure about a person’s blood glucose level, give sugar.

3. Allow a person with a blood glucose monitor to check his or her blood glucose.

4. Give sugar to a person with diabetes only if he or she can sit up and swallow.

5. If not improving within 15 minutes of taking sugar, recheck their blood glucose; if low, give more sugar.

Seizures: What to Do

1. Move nearby objects to avoid injury.

2. Place something soft under the head such as a rolled towel. DO NOT use a pillow.

3. Time the seizure from start to finish.

4. Keep bystanders away.


Call 9-1-1 for any of the following:

– Seizure lasting longer than 5 minutes

– Series of seizures following one another

– The person has breathing difficulties after the seizure

– The person has diabetes or is pregnant

– Seizure happened in water

– This is the person’s first known seizure

– The seizure is injury-related

– Slow recovery


After the seizure:

– Keep the airway open by placing the person on his or her side and head on a rolled towel.

– Monitor breathing and if it stops, give CPR.

– Allow the person to sleep.

– Stay with the person until he or she is alert.

Seizures: Scenario

A coworker slumps over in her chair and then onto the floor. She is having a seizure; her eyes are rolled back, her body is rigid, and she is shaking from head to foot. Her head is pounding on the concrete floor. She is pregnant and to everyone’s knowledge, this is her first seizure. The seizures lasts for almost 10 minutes.

Seizures: Agree or Disagree?

1. Have bystanders form a circle around a person having a seizure.

2. Move nearby objects away from the person.

3. Hold the person down to prevent injury.

4. Place a sturdy stick between the teeth to prevent biting the tongue.

5. If a seizure lasts more than five minutes, call 9-1-1.

6. After a seizure, place the person on his or her side to maintain an open airway.

Shock: What to Do1. Treat injuries.

2. If responsive and breathing normally, keep the person flat on his or her back. If there is no sign of injury, consider raising the feet 6 to 12 inches.

3. If unresponsive, roll the person onto his or her side.

4. Prevent the loss of body heat.

5. If the person does not improve, call 9-1-1.

Shock: Scenario

Following a motor-vehicle crash, you check on the driver and passengers of one of the vehicles. You see no external bleeding on the driver, but you are unsure about internal injuries. The driver lifts his shirt and you see a large red mark on his abdominal skin where the steering wheel hit him. He was not wearing a safety belt. He complains of being nauseated and says he feels like vomiting.

Shock: Agree or Disagree?

1. All unresponsive people should have their breathing checked; if not breathing, CPR should be started.

2. Give a person in shock something to drink.

3. Help a responsive person move around to help blood flow throughout the body.

4. Place an unresponsive person on his or her side.

5. Rub the person’s arms and legs vigorously to improve blood circulation.

Pregnancy Complications: What to Do

• Ask the woman if she might be pregnant.

• Severe stomach pain or cramps:

– If pain persists or labor is suspected, seek immediate medical care.

• Seizure

– See the “Seizures” section.

– Call 9-1-1 immediately.

Pregnancy Complications: What to Do

• Vaginal bleeding

– Have the woman place a sanitary pad or a towel to absorb blood. DO NOT pack the vagina.

– Call 9-1-1 immediately.

• Sudden leakage of fluid

– Seek immediate medical care.

• Morning sickness

– Treat the vomiting.

– If vomiting persists, seek medical care.

Pregnancy Complications: Scenario

You are shopping at the grocery store when you notice a pregnant woman who suddenly looks alarmed. You ask her if she is okay. She tells you she is within weeks of delivering her baby and her water just broke.

Pregnancy Complications:Agree or Disagree?

1. Stomach pain could indicate that labor has started.

2. Seizures do not happen during pregnancy.

3. For blood coming from the vagina, give the woman a towel to absorb the blood.

4. When a pregnant woman’s water breaks, it may indicate the beginning of labor.

5. A pregnant woman with recurring vomiting should be seen by a physician.

Chapter 5

Environmental Emergencies

Animal Bites: What to Do

1. Stop bleeding by applying direct pressure over the wound.

2. For a shallow wound:

– Wash inside and around with soap and running water.

– Flush the inside with clean running water.

– Cover the wound with a thin layer of an over-the-counter antibiotic ointment and a sterile dressing.

3. Severe bites should be cleaned at a medical facility.

Wild Animal Bites

• DO NOT try to capture the animal.

• DO NOT kill the animal. If you must kill it, DO NOT hit or shoot its head (brain).

• Preserve the head (brain) for a medical exam.

• Contact the local health department.

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Animal Bites: Scenario

A mail carrier is heard crying for help while being attacked by a large dog. The dog’s owner calls off the dog and takes it inside the house. You run up the street and help the mail carrier over to a nearby yard. You find several severe bite marks on his legs and arms.

Animal Bites: Agree or Disagree?

1. Apply an ice pack to a possible bruise from an animal or human bite that does not break the skin.

2. Severe animal or human bites should be cleaned at a medical facility.

3. Apply an over-the-counter antibiotic ointment over a severe animal or human bite.

4. Wash around the outside, but never the inside, of a shallow animal or human bite wound.

5. You do not need to report a bite from someone’s pet to the police or animal control.

Snakebites: What to Do

For all native North American snakes:

– Get the person and bystanders away from the snake.

– Encourage the person to rest, stay calm, and be still.

– DO NOT try to capture or kill the snake.

– Remove any rings, jewelry, or tight clothing from the bitten body part.

– Gently wash the bite with soap and running water. Apply a sterile dressing.

– Call 9-1-1 or transport the person to a medical facility.

Pit Viper Bite: What to Do

1. Call 9-1-1. You do not need to capture or kill the snake.

2. When possible, carry the person. If alone and capable, walk slowly.

3. DO NOT apply a pressure bandage.

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Pit Viper Bite: Cautions

• DO NOT cut the person’s skin to drain venom.

• DO NOT use mouth suction or a suction device.

• DO NOT apply cold packs or ice packs.

• DO NOT give alcohol.

• DO NOT apply electrical shock.

• DO NOT use a tourniquet.

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Coral Snake Bites: What to Do

1. Apply a wide elastic bandage using overlapping turns.

2. Start wrapping at the end of the bitten arm or leg and wrap upward, covering the limb’s entire length.

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Coral Snake Bites: What to Do

3. Use similar tightness as when wrapping a sprained ankle. You should be able to slip a finger under the wrapping.

4. Stabilize the bitten arm or leg as you would stabilize a broken bone and keep it below heart level.

Snakebites: Scenario

You are vacationing with your family at a cabin in the woods. One morning, your uncle walks out of the cabin and sees a rattlesnake. He picks up the snake and it bites him. Your uncle walks back into the cabin, washes his hand at the kitchen sink, and sits down on the couch.

Snakebites: Agree or Disagree?

1. Seeking medical care is the best thing you can do for a snake bite.

2. Apply an ice pack to a bite to inactivate the venom.

3. Use a suction pump to remove venom.

4. Apply a tourniquet to stop venom from spreading through the body.

5. Wash a bite with soap and running water and cover it with a dressing.

Insect Stings: What to Do

1. Immediately scrape the stinger and venom sac off the skin with a fingernail or plastic card, or brush it off with your hand.

2. DO NOT squeeze the venom sac.

3. Wash the area with soap and water.

4. Apply an ice pack for up to 20 minutes, placing a paper towel or thin damp cloth between the skin and the ice.

5. Give pain medication.

6. Apply hydrocortisone cream and give an antihistamine to relieve itching and swelling.

Insect Stings: What to Do

• If the person is allergic to insect stings or has signs of a severe allergic reaction within 30 minutes: 1. Call 9-1-1.2. Help the person self-administer

epinephrine.3. Monitor breathing, and if it stops,

give CPR.4. For a sting in the throat or mouth

that causes swelling, have the person suck on ice or flush with cold water.

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Insect Stings: Scenario

You are at a garden shop when you hear one of the shop’s employees complaining about her face swelling and a feeling of tightness in her throat. She says a bee stung her and she is having some breathing difficulty. She has a medical-alert bracelet indicating an allergy to insects and has medication for such an emergency.

Insect Stings: Agree or Disagree?

1. Use a physician-prescribed epinephrine kit on a person with a severe allergic reaction to an insect sting.

2. Place an ice pack over an insect sting site.

3. Remove an embedded stinger by scraping or brushing it off.

4. Encourage a person who has been stung to move around to stay alert and awake.

5. For a sting on an arm or leg, apply a wide band between the sting site and the heart.

Spider Bites: What to Do

1. Clean with soap and water.

2. Apply an ice pack to the area.

3. Seek medical care.

4. Tarantula spiders can flick their hairs. Remove the hairs with sticky tape, wash with soap and water, and apply a hydrocortisone cream.

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Spider Bites: Scenario

While resting on your outside patio, you feel a sharp pinprick on your arm and look down. You see a glossy black spider move across the patio. About 15 minutes later, a dull, numbing pain develops in your back. You look at your arm and see two tiny red spots. Abdominal cramping starts about an hour later and steadily gets worse.

Spider Bites: Agree or Disagree?

1. Do not worry about venomous spider bites and scorpion stings; they usually do not require medical care.

2. Most spiders that bite humans are never seen.

3. Scorpions sting and do not bite.

4. Clean the affected area with soap and water.

5. Apply heat to the area to draw the venom out of the skin.

Tick Bites: What to Do

To remove the tick:

1. Use tweezers or one of the specialized tick-removal tools to grasp the tick as close to the skin as possible.

2. Pull upward with steady, even pressure.

3. DO NOT twist or jerk the tick.

4. Lift the tick to tent the skin surface. Hold in this position until the tick lets go (about 1 minute).

5. Pull tick away from the skin. Try not to pull hard enough to break the tick apart.


• DO NOT use any of the following ineffective methods to remove the tick: – Petroleum jelly

– Fingernail polish

– Rubbing alcohol or gasoline

– Touching with a blown-out hot match, hot needle, or hot paper clip

• DO NOT grab a tick at the rear of its body.

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Once the tick is removed:1. Wash your hands and the area with soap and water.

Apply rubbing alcohol to further disinfect the area.

2. Apply an ice pack to reduce pain.

3. Apply calamine lotion to relieve itching.

4. Submerge the tick in alcohol, place in a sealed bag with its contents labeled and dated, and keep it in a refrigerator for one month to show a physician should a rash, fever, or flulike symptoms develop.

5. If a rash, fever, or flulike symptoms occur in 3 to 30 days after the tick’s removal, seek medical care.


If mouth parts broke off and remain in the skin:

1. Remove the parts with tweezers.

2. If unable to remove the parts easily, leave them alone and let the skin heal.

Tick Bites: Scenario

You live in tick country and have made it a practice to do a daily tick check of your children; however, you’ve been busy the past week and failed to do the inspections. At the end of the week, your 8-year-old comes to you and shows a dark spot that didn’t come off during a shower. You look closely and see that it is a tick attached to the skin.

Tick Bites: Agree or Disagree?

1. Cover an embedded tick with petroleum jelly.

2. Remove an attached tick by touching it with a blown-out but hot match, needle, or paper clip.

3. Use tweezers or a specialized tick-removal tool to remove a tick.

4. Pull an embedded tick upward with steady, even pressure until the skin surface tents; hold it in that position until the tick lets go.

5. Seek medical care for a rash or fever that occurs 3 to 30 days after the removal of a tick.

Heat Cramps: What to Do

1. Have the person rest in a cool area.

2. Give lightly salted cool water (dissolve 1/4 teaspoon [1.25 mL] salt in 1 quart [about 1 L] of water) or a commercial sports drink. DO NOT give salt tablets.

3. Gently stretch the muscle.

Heat Exhaustion: What to Do

1. Move the person to a cool place.

2. Remove excess clothing.

3. Spray or douse cold water on the person’s skin and vigorously fan.

4. If the person is able to swallow, give a commercial sports drink, fruit juice, or lightly salted water; if none of these options are available, give cold water.

5. Call 9-1-1 if improvement does not occur within 30 minutes.

Heat Stroke: What to Do

1. Move the person to a cool, shaded area.

2. Remove clothing, down to the person’s underwear.

3. Cool the person quickly by any means possible. The following methods are given in the order of effectiveness:

– Whole-body cold-water immersion

– Evaporative cooling

– Placing ice packs against the armpits, groin, and neck

4. Monitor the person frequently.

5. Call 9-1-1 as soon as possible.

Heat-Related Emergencies:Scenario

During a football team’s 2-hour practice in late August, the coach has the defense running sprints without rest breaks for the last 20 minutes of practice. One of the players suddenly falls to the ground. He has extremely hot skin, is sweating, and appears disorientated.

Heat-Related Emergencies: Agree or Disagree?

• For muscle cramps:1. Give the person a soda.

2. Gently stretch the painful area.

3. Call 9-1-1.

• For heat stroke:4. Give several salt tablets, if available.

5. Call 9-1-1.

6. The best cooling method is whole-body cold-water immersion.

7. Do nothing besides moving the person to a cool place and waiting for EMS to arrive.

Mild Hypothermia: What to Do

1. Remove wet clothing only when in a warm shelter.

2. Prevent heat loss. Add insulation (eg, blankets) and cover with a vapor barrier (eg, tarp, trash bags).

3. Apply heat to chest, armpits, and back (in that order). Use large electric pads, electric blankets, or warm water bottles. Place insulation between the skin and heat source to prevent burning the skin.

4. Give warm, sugary drinks to support shivering.

Severe Hypothermia: What to Do

1. Handle the person very gently.

2. Keep in flat (horizontal) position.

3. Prevent heat loss.

4. Monitor breathing and if it stops, give CPR.

5. Call 9-1-1.

6. Provide rewarming if possible.

Hypothermia: Scenario

You are out for a walk when you notice some commotion by a local pond. You make your way over and learn that a young woman fell through the ice of the pond while attempting to rescue her dog. Several bystanders formed a human chain and pulled her to safety. She is awake; has cold, pale skin; and has intense, uncontrollable shivering.

Hypothermia: Agree or Disagree?

1. Use a vapor barrier (eg, tarp) to trap body heat.

2. Do not give fluids containing sugar.

3. Check for breathing in an unresponsive person with hypothermia.

4. Keep the person with severe hypothermia in a flat (horizontal) position.

5. Rewarm by applying heat to the chest, armpits, and back using large electric pads or blankets with insulation.

Frostbite: What to Do

1. Get the person to a warm place. DO NOT let the person use a frozen extremity.

2. DO NOT thaw the part if:

– Medical care is less than 2 hours away.

– The affected area has thawed.

– Shelter, warm water, and a container are not available.

– A risk of refreezing exists.

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If travel time is more than 2 hours, use the wet, rapid, rewarming method:

1. Place frostbitten part in warm water. Put your hand into the water for 30 seconds to test that it is warm but not hot enough to burn. For facial or ear injuries, apply warm, moist cloths.

2. Give the person ibuprofen to help control the severe pain during rewarming.

3. Rewarming usually takes about 20 to 40 minutes or until the part becomes soft and pliable to touch. Air dry the area; DO NOT rub.


Once part is thawed:

1. Place bulky, dry, clean gauze on the affected part and between the toes and the fingers.

2. Slightly elevate the affected part above heart level.

3. Apply aloe vera gel to promote skin healing.

4. Give ibuprofen to limit pain and inflammation.

5. Give fluids if the person is alert and can swallow.

6. Seek medical care as soon as possible.

Frostbite: Scenario

You are on a vacation with some friends. One of your friends has been in the woods in below freezing temperatures all day. After coming back to the cabin, she complains that her toes are numb. They look gray and feel hard and cold. A medical facility is 15 minutes away.

Frostbite: Agree or Disagree?

1. If a person has hypothermia and frostbite, first treat the hypothermia.

2. Try to rewarm frostbite regardless of the person’s location.

3. Rewarm frostbite in a warm water bath for about 30 minutes.

4. Stop rewarming when the frostbitten part feels soft and pliable.

5. Break any blisters that have appeared.

Swallowed Poisoning: What to Do

1. Try to determine:

– Person’s age and weight

– Person’s condition

– What poison was swallowed

– When the poison was taken

– How much was taken

Swallowed Poisoning: What to Do

2. Call the National Poison Control Center hotline. Follow their directions.

3. Place the person on his or her left side to delay the poison from moving into the intestines and to prevent inhalation of vomit, if vomiting occurs.

4. Monitor breathing, and if it stops, give CPR.

Swallowed Poisoning: Scenario

You find your two-year-old son vomiting. You notice that the top of a nearby medicine bottle is off. The label on the bottle reveals that the medicine belongs to your visiting mother. You realize that your son must have swallowed some of her medicine.

Swallowed Poisoning:Agree or Disagree?

1. For most swallowed poisons, induce vomiting by giving syrup of ipecac.

2. For most swallowed poisons, have the person drink as much water as possible.

3. For a responsive person who swallowed a poison, call the National Poison Control hotline.

4. For an unresponsive person who swallowed a poison, call 9-1-1.

5. Place a poisoned person on their left side.

Inhaled Poisoning: What to Do

1. Try to determine:

– What substance was inhaled

– When the exposure occurred

– How long the substance was inhaled

– The person’s condition

2. Call 9-1-1 as soon as possible.

3. Place the person in a sitting or reclining position, or in whatever position best facilitates breathing.

4. Monitor breathing, and if it stops, give CPR.

Inhaled Poisoning: Scenario

A man and his son were found unresponsive inside their zipped-up tent at the group camping site you are staying at. They were discovered by other campers. A charcoal grill was found inside the tent; the grill apparently had been brought inside to provide warmth after it had been used outside for cooking.

Inhaled Poisoning:Agree or Disagree?

1. Immediately move a person exposed to an inhaled poison; you can assess the danger to yourself later.

2. Check an unresponsive person’s breathing because he or she may need CPR.

3. Even if a person with inhaled poisoning appears to have recovered, he or she needs medical care.

4. Place a person sitting up because it allows for better breathing than when lying down.

5. Only enter a dangerous scene involving toxic fumes or gas if you are properly equipped and trained.

Poison Ivy, Oak, and Sumac: What to Do

If within five minutes of an exposure:

1. Gently wipe skin with rubbing alcohol. DO NOT rub it in. DO NOT use packaged alcohol wipes.

2. Next, or if rubbing alcohol is not available, wash the skin with lots of cold running water. DO NOT scrub skin.

3. DO NOT use gasoline.

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Poison Ivy, Oak, and Sumac: What to Do

For mild itching:

1. Apply any of the following:

• Colloidal oatmeal bath

• Baking soda paste (1 teaspoon [5 mL] water mixed with 3 teaspoons [15 mL] baking soda)

• Calamine lotion

• Aluminum acetate solution (Burow’s solution)

• Physician-prescribed medication

2. DO NOT apply an over-the-counter hydrocortisone, as it is too weak.

Poison Ivy, Oak, and Sumac: Scenario

While weeding a vacant lot, you pull up a batch of weeds with shiny leaves in clusters of three. You finish the job about an hour later. The next morning, your arms are itching, and you notice a rash beginning to appear.

Poison Ivy, Oak, and Sumac: Agree or Disagree?

1. Calamine lotion can help relieve itching.

2. Allergic reactions to poison ivy, oak, or sumac are irritating but never require medical care.

3. Apply petroleum jelly to the affected area.

4. Soaking in an oatmeal bath can help reduce itching.

5. If you have contacted a poison ivy plant just a few minutes ago, immediately wash and rinse the area with lots of cold running water.

Marine Animal Injuries: What to Do

• For a bleeding wound from a bite, rip, or puncture:

1. Monitor breathing.

2. Control bleeding.

3. Wash wound with soap and water.

4. Flush the area with water under pressure.

5. Treat for shock.

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• For stings:

1. Wash tentacles off with ocean water.

2. For only Hawaiian box jellyfish and Portuguese man-of-wars, soak the area in vinegar for 30 seconds.

3. Remove clinging tentacles with tweezers or by scraping with a credit card or razor blade.

4. For jellyfish stings in North America and Hawaii, soak the area in non-scalding hot water for 20 minutes.

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• For a venomous bite:

1. Monitor breathing.

2. Control bleeding.

3. Apply pressure bandage on entire arm or leg.


• For a puncture (by spine):

1. Soak the area in hot water for 30 to 90 minutes or until pain subsides.

2. Remove pieces of debris with tweezers.

3. Wash the wound with soap and water.

4. Flush the area with water under pressure.

5. Treat the wound.

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Marine Animal Injuries: Scenario

You and a friend are swimming in a bay in New England and decide to go farther out where the water is cooler. While heading back to shore, your friend feels something latch around his arm. He quickly pushes it off and continues to swim to shore. When you get to the beach, your friend tells you his arm is burning and stinging and you see a rash on his arm. A lifeguard who is stationed nearby says it looks like your friend has received a jellyfish sting.

Marine Animal Injuries: Agree or Disagree?

1. Care for a marine animal sting by pouring hydrogen peroxide on the affected area.

2. Some marine animal bites and stings can cause an allergic reaction.

3. Using vinegar to care for a jellyfish sting is controversial partly because what works for one species may worsen the sting of another species.

4. Treat a shark bite the same as you would a dog bite.

5. For a sea snake bite to an arm or leg, apply a pressure bandage over the entire extremity.

Friday 3/8 and Monday 3/11• Turn in any late work from first aid

• CPR instruction (adult, child, infant)

• AED

• Choking: Heimlich maneuver

• Assessment: Chest compressions

• NEXT CLASS (Tues/Wed) YOU NEED EARPHONES WITH AN AUX CONNECTION OR YOUR OWN LAPTOP OR TABLET WITH EARBUD CONNECTIONS

Bellringer• Get a paper, fold in 4 quarters

• Go to page 99-101

• In each "Square" put a step for CPR

1. RESPONSIVE?

2. ACTIVATE

3. BREATHING?

4. COMPRESSIONS

5. AIRWAY

6. BREATHS

7. Infant CPR

8. AED

Chapter 6

CPR and AED

Difference Between a Heart Attack and Cardiac Arrest

• Heart attack: heart muscle tissue dies because its blood supply is severely reduced or stopped.

– This often occurs because of a clot in one or more coronary arteries.

• Cardiac arrest: a person’s heart stops beating

– Sudden cardiac arrest is a leading cause of death.

Performing CPR

• RAB-CAB

– R = Check for Responsiveness.

– A = Activate EMS by calling 9-1-1, and get an AED.

– B = Check for Breathing. (Place the person in the recovery

position.)

– C = Give chest Compressions.

– A = Open the Airway.

– B = Give Breaths.

Adult and Child CPR

• R = Responsive?

– Tap the person on the shoulder and shout, “Are you okay?”


– Shout for help.

– Call 9-1-1 or the local emergency number.

– Get an AED.

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Adult and Child CPR

• B = Breathing?

– Observe the chest for movement; take 5 seconds but no more than 10 seconds.

Adult and Child CPR

• C = Compressions

– Place the heel of one hand on the center of the person’s chest and on the lower half of his or her breastbone.

– Place your other hand on top of the first one with fingers interlocked.

– Push hard, fast, and smoothly.

Adult and Child CPR

• A = Airway

– Open the airway.

– Place your hand on the person’s forehead; apply pressure to tilt the head back.

– Place two fingers of your other hand under the bony part of the person’s jaw and lift.

– Tilt the head backward.

Adult and Child CPR

• B = Breaths

– Give 2 breaths.

– If you see chest rise, give 30 chest compressions.

– If the first breath does not make the chest rise, retilt the head and give a second breath.

– Each time before giving a breath, open the mouth and look for an object; if seen, remove it.

Adult and Child CPR

• Continue cycles of 30 chest compressions and 2 breaths until an AED arrives.

• When an AED becomes available, use it as soon as possible.

Adult and Child CPR: Scenario 1

While walking your dog, you pass a house where an older man who was mowing his lawn has just collapsed. His panicked wife has not yet called 9-1-1 for help. The man is unresponsive and not breathing.

Adult and Child CPR: Scenario 2

As the designated first aid provider at your office, you receive a phone call urgently telling you about an employee who was found collapsed on the workroom floor. You run down the hallway to the workroom and find two employees looking at the person but doing nothing. They seem relieved to see you and move off to the side for you to get next to the person.

Adult and Child CPR: Number the Steps

• Number the following steps in the correct order for giving CPR to an adult:

1. Call 9-1-1.

2. Give 30 compressions at the same beat as the Bee Gee’s song “Stayin’ Alive.”

3. Open airway with head tilt–chin lift.

4. Pinch the nose shut and give 2 breaths (1 second each).

5. Check for no breathing or only gasping.

6. Tap the person’s shoulder and shout, “Are you okay?”

Infant CPR

• R = Responsive?

– Tap infant’s foot and shout his or her name.

– Shout for nearby help.


– If you are alone, DO NOT call 9-1-1 until after giving 5 sets of CPR.

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Infant CPR

• B = Breathing?

– Observe the infant’s face and chest movement.

• C = Compressions

– Place the pads of 2 fingers on the breastbone, with 1 touching and both below the nipple line.

– Give 30 chest compressions.

Infant CPR

• A = Airway

– Open the infant’s airway using the head tilt–chin lift maneuver.

• B = Breaths

– Cover the infant’s mouth and nose with your mouth and make an airtight seal.

– Give 2 breaths.

Infant CPR

• Continue CPR until one of the following occurs:

• The infant begins breathing

• EMS arrives and takes over

• You become physically exhausted and unable to continue

Infant CPR: Scenario 1

A babysitter placed an infant in its crib to sleep. When its mother came home, the infant would not wake up or respond to the mother’s shouting. The mother finds that the baby is not breathing.

Infant CPR: Scenario 2

You accompany your child to the birthday party of one of their friends. You are talking with some of the other parents at the party while the children play in the backyard pool. Suddenly one of the older children shouts that Jack, an infant, is in the shallow end of the pool. His mother quickly pulls him to the side of the pool and finds that he is not breathing.

Infant CPR: Number the Steps

• Number the following steps in the correct order for giving CPR to an infant.

1. Call 9-1-1 after giving 5 cycles of CPR if not already done.

2. Give 30 chest compressions (rate of 100 beats per minute).

3. Continue giving cycles of 30 compressions and 2 breaths until an AED arrives, the infant starts breathing, or EMS takes over.

4. Check for breathing.

5. Open the airway.

6. Cover the infant’s mouth and nose with your mouth, and give 2 breaths, each lasting 1 second.

7. Tap the infant’s foot and shout his or her name.

Compression-Only CPR

• Understanding compression-only CPR helps to increase untrained bystander involvement

• Compression-only CPR is easy to teach, remember, and perform

• Steps to remember:

– Ask another person to call 9-1-1

– Push the center of the chest hard and fast, at the rate of 100–120 compressions per minute (or to the Bee Gees song “Stayin’ Alive”

Compression-Only CPR

– Continue chest compressions without stopping until help arrives or as long as possible. If another person is available, trade off about every 2 minutes.

Adult and Child Choking

• Ask, “Are you choking?” Shout for help.

• Wrap your arms around the person’s waist and locate the navel with a finger.


• Make a fist with the other hand and place the thumb side of the hand just above the navel and below the breast bone.

• Grasp the fist with the other hand and thrust the fist into the abdomen.


• If the person becomes unresponsive or a person is found unresponsive, provide CPR with the addition of a step:

– Give 30 chest compressions.

– Give 2 breaths. If the first breath does not cause the chest to rise, retilt the head and attempt a second breath.

– Continue sets of 30 chest compressions and 2 breaths.

Infant Choking

• Give up to 5 separate and distinct back blows.

• Give up to 5 separate and distinct chest thrusts.

Infant Choking

• Continue alternating the 5 back blows and 5 chest thrusts without interruption until one of the following occurs:

– The infant stops responding or can breathe, cough, or cry.

– EMS or a person who is trained takes over.

Automated External Defibrillator (AED)

• An AED is an electronic device that analyzes the heart rhythm and, if necessary, delivers an electric shock, known as defibrillation, to the heart of the person in cardiac arrest.

• What does this shock do?

– A normal and healthy heart has its own pacemaker that regulates the heart beat. The shock stops all electrical activity of the heart so the pacemaker can take over again.


• About AEDs:– Many different models

exist. Follow the displays, controls, and options for the model you are using.

– The AED enables first aid providers and other rescuers to deliver early defibrillation with only minimal training.


• Using an AED

1. Turn on the AED

2. Attached the pads to the person’s bare, dry chest, as shown on the pads.

3. Stay clear of the person. Make sure no one is touching the person and say “Clear!” Allow the AED to analyze the rhythm and follow prompts.

– The AED will either direct you to push the Shock button or will direct you to begin CPR.

4. Give 5 sets of CPR unless the person moves, begins to breathe, or wakes up. Repeat steps 3 & 4 until the person moves, begins to breathe, or wakes up.

COMPRESSON ASSESSMENT

• WHILE YOU ARE WAITING YOUR TURN

• CREATE A 10-15 WORD CROSSWORD PUZZLE

– MAKE the questions on the bottom, and the answer key is the crossword part

Chapter 7

Emergency Rescues, Moves, and Priorities

Emergency Rescues: What to Do

• Water

– Try the following in the order listed:

1. Reach with a pole.

2. Throw anything that floats.

3. Row, if a boat is available.

4. Go, if trained in swim rescue.

• Ice

1. Reach with a pole.

2. Throw a line.


• Electricity

– Indoors

1. Turn off the electricity.

– Outdoors1. High-voltage electricity

requires trained personnel.

• Motor-vehicle crash

1. Park in a safe place.

2. Turn on flashers.

3. Place flares or reflectors 250 to 500 feet behind the crash.


• Fire

1. Get people out of the area.

2. If it is a small fire, use a fire extinguisher if you can easily escape.

• Hazardous materials

1. Stay out of the area.

2. If outside, stay upwind.

• Confined space

1. Only those with proper training and equipment should enter the area.

Emergency Rescues: Scenario

You are fishing at a lake. Several swimmers and others in canoes are also enjoying the lake. One swimmer decides to swim to the other side of the lake but begins to struggle about 30 feet off shore.

Emergency Rescues:Agree or Disagree?

1. Throw an empty 5-gallon water container to a distressed person in deep water.

2. The first thing to do in case of a fire is to use a fire extinguisher and try to put out the fire.

3. Move downed power lines away from a person by using a broom handle or other wooden object.

4. Move away from strong, unusual odors or clouds of vapor.

5. Do not attempt rescues from collapsed structures unless you have the proper training and equipment.

Emergency Moves

• One-rescuer moves

– Human crutch

– Cradle carry

– Pack-strap carry

– Piggyback carry

– Firefighter’s carry

– Shoulder drag

– Ankle drag

– Blanket drag

• Two-rescuer moves

– Two-person assist

– Two-handed seat carry

– Extremity carry

– Chair carry

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Prioritizing Multiple People

• When many people are injured, use a process called triage to distinguish among:

– Those needing immediate care for one of the three “killers”—closed airway, severe bleeding, and shock

– Those who can wait for care until after others have been triaged

– Those who are deceased (dead)

Conducting Triage

1. Conduct a voice triage by calling out, “If you can walk, come to me.”

– Place people who can walk in the “delayed” category.

– Direct them to a designated safe area; have them sit down and stay together.

Conducting Triage

2. Start surveying each person who did not get up and walk.

– Begin with the person closest to you.

– Quickly get to each person and sort each by his or her need for care (immediate, delayed, dead).

– DO NOT stop to treat anyone during triage except to quickly open the airway and control severe bleeding.

Prioritizing Multiple People: Scenario

At a busy intersection, you see a crash involving a truck and a minivan. The truck’s driver says the minivan ran a red light, and he was unable to stop before hitting it. He tells you there are several people in the minivan and they all look seriously hurt. You open the minivan’s sliding door and see three people. One appears to be unresponsive; another is under the dashboard and yelling for help; and the third person is staring blankly and trying to talk.

Prioritizing Multiple People: Agree or Disagree?

1. Take up to five minutes per person when sorting multiple people for medical care.

2. Remove an impaled object stuck in an arm or leg if found during triage.

3. Splint a suspected broken arm if found during triage.

4. Separate the people who are able to walk on their own and keep them together.

5. Do not start CPR or cool a burn during triage.

Health Unit - Brentsville District High School

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Transcript of Health Unit - Brentsville District High School