Chapter 9
First Aid
Considerations for Responding to
Injuries and Illnesses

Recognize that an emergency has occurred

Decide to act

Help make decisions in an emergency situation, consider the following:

Should I provide care where the victim was found, or move him or
her to the first aid room?

Is the safety of the victim or others compromised?

Is there a risk of further injury to the victim?

Is there a risk of exposing the victim or others to pathogens (e.g., by
leaving a trail of blood or body fluids)?

Should I summon EMS personnel?

When should I recommend that the victim see a health care
provider to seekfurther medical treatment?
Secondary Assessment
 Take a Brief History
 Head-to-Toe Examination for an adult
 Toe-to-Head for child
 Children get down at eye level, speak slowly and in
a friendly manner, use simple words and ask questions
that the child can easily understand.
 Look for signs and symptoms that indicate changes in
LOC
Using SAMPLE to take a Brief History

“S”igns or “S”ymptoms: bleeding, skin that is cool and moist, pain, nausea,
headache, and difficulty breathing


“A”llergies: Do you have any allergies to medications, food, environmental
elements, such as pollen or bees


What type of reactions do you usually have?
“M”edications: Do you have any medical conditions or are you taking any
medications?


What happened?, Where do you feel any pain or discomfort? Do you have any numbness or loss of sensation?
Have you taken any medications in the past 12 hours?
Pertinent past “M”edical history: Have you experienced any recent falls,
accidents or blows to the head? Have you ever been in any medical, surgical
or trauma incidents?

Have you recently been ill?

“L”ast oral intake: find out what the victim most recently took in by mouth
as well as the volume or dose consumed. This includes food, drinks and
medication.

“E”vents leading up to the incident: What the victim was doing before and
at the time of the incident.
Checking a Conscious
Person
 Head-to-examination
 Tell the victim what you are going to do
 Visually inspect victim’s body looking carefully for
any bleeding, cutes, bruises, and obvious deformities
 Look for medical identification necklace or bracelet
 Do NOT ask the victim to move any areas in which
he/she has discomfort or pain

Areas
to
check:
The Head: scalp, face, ears, eyes, nose and mouth for cuts,
bumps, bruises, and depressions or changes in consciousness
 Skin Appearance and Temperature: coloring face and lips,
moist or dry skin
 Neck: move from side-to-side, pain, discomfort or inability to
move
 Shoulders: shrug
 Chest and abdomen: difficulty breathing or pain when
breathing
 Arms: check one at a time, move hand and fingers
 Legs: check one at a time, move foot and toes
If victim is unable to move or
experiencing dizziness or pain
 Help the victim rest in a comfortable position
 Keep the victim from getting chilled or overheated
 Reassure the victim
 Determine whether to summon EMS
 Continue to watch for changes in level of
consciousness
If any life-threatening
conditions develop when
performing the secondary
assessment, stop the
assessment and provide
appropriate care
immediately!
Sudden Illness
 Check for a tag “medical information”
 Types of sudden illness:
 A diabetic emergency
 Fainting
 A seizure
 A stroke
 An allergic reaction
Signs and symptoms of sudden illness
Changes in (LOC)
Changes in skin color
Nausea or vomiting
Difficulty speaking or slurred
speech
Sweating
Numbness or weakness
Persistent pressure or pain
Loss of vision or blurred vision
Diarrhea
Changes in breathing; the
person may have trouble
breathing or may not be
breathing normally
Seizures
Paralysis or inability to
move
Severe headache
General care steps for
sudden illness
 Care for any life-threatening conditions first
 Monitor the victim’s condition and watch for changes
in LOC
 Keep the victim comfortable and reassure him/her
 Keep the victim from getting chilled or overheated
 Do not give the victim anything to eat or drink unless
the victim is fully conscious and is not in shock
 Care for any other problems that develop “vomiting”
Diabetic emergency
 Illness because too much or too little sugar in blood
 If conscious and can safely swallow food or fluids give
him/her sugar “preferably in liquid form” Juices or
non-diet soft drinks are GREAT
 Summon EMS if:
 Unconscious or loses consciousness
 Unable to swallow
 Victim does not get better in 5 min after taking sugar
 Cannot find sugar to give
Fainting
 Is not usually harmful, and the person will usually
quickly recover.
 Lower the person to the ground or other flat surface
and position the person on his/her back.
 Do not give the victim anything to eat or drink

Seizures
Provide care to person who has a seizure in the same
manner as for any unconscious victim.
 Protect victim from being injured
 Remove any nearby objects that may cause injury
 Protect head by placing soft cushion under it
 Roll to side if fluid in mouth “vomit, blood, saliva”
 If in water support victim with his/her head above water
until the seizure ends
 Let the seizure to run its course because attempting to
restrain the person can cause further injury
Summon EMS for a Seizure when:

Occurs in water

Lasts more than 5 minutes

Multiple seizures no sign of slowing down

Appears to be injured

The person is pregnant

The person is diabetic

Fails to regain consciousness

The person is elderly and may have suffered a stroke

This is the first person’s first seizure
No need to summon EMS if victim has PERODIC
seizures
Stroke

May have weakness or numbness on one side of the face, arm, or leg

Difficulty taking or being understood when speaking

Have blurred vision

Experience sudden severe headache

THINK FAST

Face: weakness on one side of the face ask to smile

Arm: weakness on one side ask to raise one arm

Speech: Slurred speech or trouble speaking have them repeat a sentence
to you

Time: time to summon EMS note the time signs/symptoms began
Wounds
 Injury to the body’s soft tissue: skin, fat and muscles
 Germs can get into the body through a scrape, cut,
puncture or burn and cause infection
Closed wound

Occurs beneath the surface of the skin (simplest= contusion)

Internal bleeding may occur when the skin’s surface is NOT broken
and damage to soft tissue and blood vessels happens below the surface.

Caring for internal bleeding: summon EMS if:

Severe pain or cannot move a body part without pain

Force that caused the injury was great enough to cause serious damage

An inured arm or leg is blue or extremely pale

Excessive thirst, becomes confused, faint, drowsy or unconscious

Vomiting blood or coughing up blood

Skin that feels cool or moist, or looks pale or bluish

Rapid, weak pulse

Tender, swollen, bruised or hard areas of the body , such as abdomen
Open Wound
 Break in the skin can be as minor as a scrape of the surface
layers or as severs as a deep penetration
 4 main types
1.
Abrasion: skin has been rubbed or scraped away (scrape,
road rash) clean wound to prevent infection
2.
Laceration: cuts bleed freely, and deep cuts can bleed
severely can damage nerves, large blood vessels and other
soft tissue
3.
Avulsion: cut in which a piece of soft tissue or even part of
the body, “finger”, is torn loose or torn off entirely
4.
Puncture: do not bleed a lot and can easily become infected
External Bleeding

Control any bleeding.
*Place a sterile dressing over the wound.
*Apply direct pressure until bleeding stops

Clean the wound thoroughly with soap (if available) and water. If
possible, irrigate an abrasion with clean, warm running tap water for
about 5 minutes to remove any dirt and debris.

If bleeding continues, use a new sterile dressing and apply more pressure.

After bleeding stops, remove the dressing and apply antibiotic ointment,
if one is available, the victim has no known allergies or sensitivities to the
medication and local protocols allow you to do so.

Cover the wound with a sterile dressing and bandage (or with an
adhesive bandage) to keep the wound moist and prevent drying.

Wash your hands immediately after providing care.
Major wound: external bleeding

Activate the EAP, summon EMS personnel and follow the general
procedures for injury or sudden illness on land.

Cover the wound with a sterile gauze dressing and apply direct pressure
using the flat part of your fingers. A large wound may require more pressure;
use pressure from your full hand with gauze dressings to try to stop the
bleeding. For an open fracture, do not apply direct pressure over the broken
bones, but instead pack sterile gauze around the area to control bleeding and
prevent infection.

If the dressing becomes saturated with blood while you are applying
pressure, do not remove it. Instead, place additional dressings over the
soaked bandage and reapply direct pressure. Then cover the dressings with a
bandage to hold them in place.

Keep the victim warm and position the victim on his or her back.

Care for other conditions, including shock.
Shock
Natural body reaction usually means victim’s condition is VERY serious
Signs/Symptoms
Minimize the effects by:

Restless or irritability

Call EMS

Altered LOC

Watch for changes in LOC

Pale or ashen, cool, moist skin

Control any external bleeding

Nausea or vomiting

Keep victim from getting chilled
or overheated

Rapid breathing and pulse

Have victim flat on back

Excessive thirst

Cover victim with blanket

Comfort and reassure the victim
DO NOT GIVE FOOD OR DRINK
Care for wounds

Tooth: place in milk do not scrub tooth and touch only the
crown (white part) if no milk place in clean water

Abdomen: remove clothing, do not attempt to put the organs
back into abdomen, cover with moist sterile dressing and cover
with plastic wrap, place blanket over to keep warm

Nosebleed: lean forward, pinch nostrils for about 10 minutes or
until bleeding stops

Severed body parts: wrap bandage wound to prevent infection
wrap the severed body parts in sterile gauze, place in plastic bag,
put it on ice do NOT freeze it
Continue. . .
 Scalp injuries: often bleed heavily, put pressure on the
area around wound, if spongy do NOT apply pressure
 Embedded Objects: object that remains in the wound
keep it there, place sterile dressings around object to
keep it from moving
Caring for Burns
 Stop burning by removing from source
 Cool burned area with large amounts of cool, running
water
 Cover the burned area loosely with sterile dressing
 Minimize shock
 Comfort and reassure the victim.
Chemical: flush area for about 20 min flush affected eye
from the nose outward and downward
Insect Stings

See if stinger is still in the skin: if so scrap the stinger away from
the skin with plastic card

Wash the wound

Cover the site and keep it clean

Apply a cold pack to reduce pain and swelling

Watch for allergic reaction

Care for life threatening conditions

Monitor the victim’s conditions look for changes in LOC and
keep victim comfortable
Heat and Cold Related injuries

Heat cramps: painful muscle spasms that usually occur in legs and
abdomen

Heat exhaustion: body’s cooling system is becoming overwhelmed


Cool, moist, pale, flushed skin

Headache, nausea, dizziness

Weakness

Heavy sweating
Heat stroke: body’s system’s are overwhelmed can be lifethreatening

Red, hot, dry skin

Changes in LOC

vomiting
Cold-Related Emergencies

Hypothermia: victim’s entire body cools because its ability to
keep warm fails. Victim will die if care is NOT provided.
 Summon EMS
 Move victim to warm place gently
 Remove any wet clothing
 Warm the victim slowly by wrapping ALL exposed body
surfaces especially head (most heat leaves throught the head)

Frostbite: body parts freeze having been exposed to the cold.

Never rub area

Do not warm areas if it might refreeze

Separate toes and fingers with dry, sterile gauze
Injuries to muscles, bones,
and joints
 Fractures: complete break, a chip or a crack in a bone.
 Closed: the skin over the broken bone is intact
 Open: There is an open wound in the skin over the fracture
 Dislocations: the movement of a bone away from its
normal position at a joint
 Sprains: tearing of ligaments at a joint
 Strains: stretching and tearing of muscles or tendons
Difficult to know which it may be. It is not necessary to know
what type of injury because the care is the same!
Care for muscle, bone, and joint injuries
 Summon EMS
 Support the inured area above and below the site of the injury
 Check for circulation and sensation below the injured area
 Immobilize and secure the injured area if the victim must be
moved and it does not cause further pain or injury
 Recheck for circulation and sensation below the injured area
RICE
 General care for all musculoskeletal injuries
 Rest: avoid any movements or activiites that cause
pain
 Immobilize: stabilze the injured area in the position in
which it was found.
 Cold: apply ice or a cold pack for periods fo 20
minutes. Repeat if needed
 Helps to reduce swelling and eases pain and discomfort
 Elevate: above the level of the heart helps slow the
flow of blood, helping reduce swelling
Immobilizing
 Splints: is a tool or device used to immobilize an
injury.
 Splint the injury in the position in which the injured
area was found.
 Splint the injured area and the joints or bones above
and below the injury site.
 Check for circulation and sensation before and after
splinting.
Immobilizing muscle, bone, and
joint injuries
 Anatomic Splints: The person’s body is the splint.
Example: an arm can be splinted to the chest, or an
injured leg to the uninjured leg.
 Soft Splints: soft materials; folded blanket, towel,
pillow or folded triangular bandage can be used to
form a splint.
 Rigid Splints: Boards, folded magazines or
newspapers or metal strips that do not have sharp
edges can serve as splints.