• First Aid: Guide to Basic Rules and Procedures

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    First aid is emergency care provided for injury or sudden illness before emergency medical treatment is available. The first-aid provider in the workplace is someone who is trained in the delivery of initial medical emergency procedures, using a limited amount of equipment to perform a primary assessment and intervention while awaiting arrival of emergency medical service (EMS) personnel.

    Contents

    What's inside a First Aid Kit?

    First Aid Kits often vary in size and contents based on their intended purpose, however almost every First Aid Kit should include the following items:

    • Band-aids / Adhesive bandages
    • Gauze pads and medical tape
    • Scissors, cold pack
    • Wound bandage / compress
    • Eye pads / eye wash solution
    • First aid / burn cream
    • Antibiotic ointment
    • Face shield or barrier mask for providing CPR
    • Forceps / tweezers
    • Disposable thermometers
    • First aid instruction booklet

    A well-stocked first-aid kit can help you respond effectively to common injuries and emergencies. Keep at least one first-aid kit in your home, office and one in your car. Store your kits in easy to retrieve locations that are out of the reach of young children.

    Protect yourself with universal precautions

    Universal Precautions, also known as Standard Precautions, provide a way to limit the spread of disease by preventing contact with blood borne pathogens. Blood borne pathogens include but are not limited to Hepatitis B Virus (HBV), Hepatitis C Virus (HCV)and Human Immunodeficiency Virus (HIV).

    In order to follow Universal Precautions correctly, you should always consider a victim's blood and body fluids to be hazardous material and treat them as if they are infectious. To reduce the risk of infection you must always wear disposable gloves when giving first aid and use a face shield or mask when performing CPR.

    Remember to remove your gloves properly: Without touching the bare skin, grasp the inside palm of your gloves with the fingers of the opposite hand and pull gloves off inside out. Repeat this procedure with the second hand and dispose of the gloves in an appropriate manner.

    After removing your gloves, wash your hands well with soap and water and then apply an alcohol based hand sanitizer.

    Life threatening situations require emergency action steps

    When confronted with a potentially life threatening situation it is important to keep calm and follow these emergency action steps before attending to a victim.

    1. Assess the situation. Evaluate the area before jumping into action. If the scene is unsafe or becomes unsafe, get out immediately! Move the victim only if absolutely necessary. If a person is in contact with electricity DO NOT touch them until the source of electricity has been shut off.
    2. Send an Alert. Call 911 or activate the emergency action plan for your facility. It is very important that help can be dispatched as soon as possible.
    3. Attend to the victim. Check for any life threatening conditions. Tap them on the shoulder and ask "are you OK?". If an unconscious person is face-down: roll face-up, supporting the head, neck and back in a straight line. Next, open the airway by gently tilting the head and lifting the chin. Place your ear around the victim's airway while looking at his/her chest for movement. Do this for no longer than 10 seconds. If the victim is not breathing, immediately begin CPR. If the victim is breathing, maintain an open airway and monitor for any changes in condition.

    Choking (Victim is responsive)

    1. Verify the victim is choking. Quickly ask, "are you choking?" If the victim nods yes, or is unable to talk, speak, or cough - act quickly.
    2. Give 5 Back Blows. Bend the person forward at the waist and give 5 back blows between the shoulder blades with the heel of one hand.
    3. Give 5 Abdominal Thrusts. Place a fist with the thumb side against the middle of the person's abdomen, just above the navel. Cover your fist with your other hand. Give 5 quick, upward abdominal thrusts.
    4. Continue Care. Repeat sets of 5 back blows and 5 abdominal thrusts until the object is forced out, the person can cough forcefully or breathe, or the person becomes unresponsive.

    Choking (Victim is unresponsive)

    1. Lay the victim down on his/her back and begin chest thrusts as you would with CPR. Each time the airway is opened look for the object in the victim's throat and if you can see it, remove it being careful not to lodge the object further into the victim's throat.
    2. Continue chest thrusts until EMS / Paramedics arrive, or the victim shows signs of breathing / responsiveness.

    Minor Wounds

    Minor wounds include abrasions, lacerations, punctures and incisions. The most significant issues to consider with any open wound are control of bleeding and infection. Before providing care, put on protective gloves or use a barrier between you and the victim to reduce the chance of disease transmission while assisting the injured person.

    1. If bleeding, apply direct pressure with a clean cloth or absorbent pad dressing until bleeding stops.
    2. Wash the affected area with an antibacterial soap to remove any foreign matter.
    3. Cover the dressing with an adhesive bandage or gauze wrap.
    4. Check for circulation beyond the injury (check for feeling, warmth, and color).

    If the bleeding does not stop: apply more dressing and bandages and continue to apply additional pressure. Take steps to minimize shock and call 911 or the local emergency number if you have not already done so. Be sure to wash your hands thoroughly with soap and water after providing care.

    Shock

    Shock develops when not enough blood flows to the vital organs of the body. Victims with shock may stop responding. Common causes of shock are: severe bleeding, heart attack or other heart problems, severe allergic reaction, nervous system injuries, severe burns, and dehydration. A victim who is experiencing shock may exhibit any of the following: dizziness, fainting or feeling weak, shallow breathing, anxiety, restlessness, agitation, or confusion. Someone in shock may feel cool and clammy to the touch, have pale or greyish skin, complain of thirst, and even nausea or vomiting.

    You can help minimize shock by laying the victim flat on their back with the feet slightly elevated if possible. Keep the victim warm by covering him/her with a blanket, but prevent overheating. Ensure an open airway and adequate breathing for the person. Monitor the victim and administer CPR if necessary.

    Severe Bleeding

    For more serious wounds, rip or cut away clothing until wound is visible. Place an absorbent pad directly over the wound and apply firm, direct pressure. Ask the victim to assist if they are able. Next, wrap a conforming bandage securely over the pad to maintain pressure and hold the gauze in place. The bandage should be loose enough so a finger can slip under the bandage.

    If the bleeding continues, apply more pads as the first dressings become soaked with blood and maintain firm, direct pressure. Do not remove the first dressings, just continue to add more if soaking through continues. Take steps to minimize shock using the steps above until emergency medical teams arrive.

    Burns

    Burns can cause tremendous damage to the body, including extreme pain, scarring massive infection, organ failure and even death. Burns on the face, hands, feet, and genitals can be particularly serious.

    Thermal burns are caused by sun, fire, hot liquids or objects and sometimes hot gases.

    Chemical burns are caused by contact with wet or dry chemicals.

    Electrical burns are caused by contact with energized electrical components or lightening.

    If a victim is on fire, tell him/her to STOP, DROP, and ROLL. Never touch someone in contact with electricity until the source of electricity has been shut off.

    Minor Burns

    Signs and symptoms of minor burns include pain, redness, swelling and blisters. To treat minor burns, first expose the burn and cool with cold water and continue until pain is reduced. After cooling, cover with a dry, sterile bandage or clean dressing and protect the burn from friction and pressure. DO NOT pop blisters or apply any ointment or other substance.

    Major Burns

    A major burn will exhibit dry/leathery, white or blacked, charred skin. When dealing with a victim of sever burns follow emergency action steps discussed earlier and call 911 or local emergency number. Follow steps to reduce shock.

    Chemical Burns

    Flush the affected area with cool running water for at least 15 minutes. Remove all clothing that has been contaminated. Monitor the victim for shock and seek medical assistance. If chemical burn is in the eyes, flush continuously with water and seek medical attention immediately.

    Bites and Stings

    Bites and stings that could require first aid care can occur from a wide variety of sources. Most cause only minor discomfort and can easily be treated. However bites and stings from venomous snakes, insects or animals can cause intense pain and swelling. Bites from humans and animals such as dogs, cats, bats, etc., can cause severe injury and infection, including tetanus and rabies.

    Some people have severe allergic reactions to bites or stings that can be life threatening. In these cases, the most important first aid measure is rapid access to advanced emergency medical care. General signs and symptoms associated with bites and stings include redness, swelling, pain, itching, nausea, and breathing problems.

    To treat most minor bites and stings: remove any jewelry and constrictive clothing and wash the affected are with soap and clean water. To avoid risk of infection, do not close the wound. Proceed to cover the area with an adhesive bandage or gauze wrap. Do not apply any ointments or medicine on the wound. Apply ice if needed to reduce pain and swelling.

    Eye Injuries

    Eye injuries can range from minor irritations to severe sight threatening. Injuries are frequently caused by objects in the eye, burns, and blunt force injuries. Any of these conditions or situations can lead to permanent loss of
    vision.

    If an object is impaled in the eye, CALL 911 and DO NOT attempt to remove the object. Do not allow the victim to rub or apply pressure to the injured eye. Lightly cover both eyes with a gauze pad or clean cloth to minimize movement of the injured eye.

    If the injury is a black eye, you may apply ice to cheek and area around eye, but not directly on the eyeball itself.

    You can help prevent eye injury by wearing protective eye wear during risky activities. Always wear safety glasses with side shields anytime you might be exposed to flying particles, objects or dust. Wear goggles when working with or around chemicals or concentrated cleansing products.

    Nosebleeds

    1. Sit upright and lean forward. By remaining upright, you reduce blood pressure in the veins of your nose. This discourages further bleeding. Sitting forward will help you avoid swallowing blood, which can irritate your stomach. Have the victim spit out blood that collects in the back of the throat or mouth.
    2. Pinch the nose firmly. Use your thumb and index finger to pinch your nostrils shut. Breathe through your mouth. Continue to pinch for 5 to 10 minutes. Pinching sends pressure to the bleeding point on the nasal septum and often stops the flow of blood.
    3. To prevent re-bleeding, don't pick or blow your nose and don't bend down for several hours after the bleeding episode. During this time remember to keep your head higher than the level of your heart.

    Heat Exhaustion & Heat Stroke

    Causes of heat exhaustion include exposure to high temperatures, particularly when combined with high humidity, and strenuous physical activity. Without prompt treatment, heat exhaustion can lead to heatstroke, a life-threatening condition. Fortunately, heat exhaustion is preventable.

    Heatstroke occurs if your body temperature continues to rise. At this point, emergency treatment is needed. In a period of hours, untreated heatstroke can cause damage to your brain, heart, kidneys and muscles. These injuries get worse the longer treatment is delayed, increasing your risk of very serious complications.

    Heat Exhaustion

    Signs and symptoms of heat exhaustion include cool, moist skin with goose bumps when in the heat, heavy sweating, faintness, dizziness, fatigue, weak and rapid pulse, low blood pressure upon standing, muscle cramps, nausea, and headache.

    Victims experiencing heat exhaustion should stop all activity and be moved to a cooler environment where they should drink cool water or sports drinks. Contact emergency medical personnel if signs or symptoms worsen or if they don't improve within one hour. Seek medical attention immediately if body temperature reaches 104F or higher.

    Heat Stroke

    A body temperature of 104F or higher is the main sign of heat stroke. In heat stroke caused by hot weather, skin will feel hot and dry to the touch, and victim may lack the ability to perspire. Skin may turn red as body temperature rises. Other symptoms include nausea and vomiting, rapid breathing, increased heart rate, headache and confusion.

    If you think a person may be experiencing heat stroke, call 911 or local emergency services number immediately. Help the person move to a cooler environment and remove excess clothing. Place ice packs or cold, wet towels on the victim's head, neck, armpits, and groin. Mist him/her with water and move air across the victim with a fan if possible.

    Poison

    Call local poison control center or 911 for immediate medical attention. Labels on antidotes may be inaccurate! Do not follow them unless instructed by a physician. Never administer anything by mouth (milk, water, ipecac, ect.) until you have consulted with a medical professional.

    If the poison is on the skin, flush skin with water for 15 minutes, then wash and rinse with soap and water. If poison is in the eye, flush with lukewarm water for 15 minutes. Adults can stand under the shower with eyes open. always consult medical professionals after any eye injury has occurred.

    Stroke

    Notice the signs of stroke. Use the Think F.A.S.T. assessment:

    • Face: Ask the person to smile. Does one side of the face droop?
    • Arm: Ask the person to raise both arms. Does one arm drift downward.
    • Speech: Ask the person to repeat a simple sentence (such as, "The sky is blue."). Is the speech slurred? Can the person repeat the sentence correctly?
    • Time: CALL 911 immediately if you see any signs of stroke. Try to determine the time when signals first appeared. Note the time of onset of signals and report it to the call taker or EMS personnel when they arrive.

    References

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