Participate In Workplace Health and Safety What is followed to ensure safe workplace policies and procedures? The Work Health and Safety Act 2011 – Provides the framework for the protection of the health, safety, and welfare of workers at work as well as others affected by the work undertaken at the workplace. What is a hazard? Anything (including work practices or procedures) that have the potential to harm the health or safety of a person. What is the risk management process? Hazard identification Risk assessment Risk control Review control measures What type of hazards can be seen in the workplace? - Physical = manual tasks, radiation Chemical = acids, heavy metals, and dusts Biological = micro-organisms including bacteria and viruses Mechanical/electrical = slips, trips and falls Psychosocial = fatigue, stress, and violence Why are risk assessments important? A risk assessment is necessary to prevent accidents and to maintain workplace safety. It involves an analysis of the hazard in terms of the likelihood of it creating a workplace injury or illness. They help to: - Create awareness of hazards and risks Identify who may be at risk Determine if existing control measures are adequate or if more should be done Prevent injuries or illnesses when done at the design or planning stage Prioritise hazards and control measures What are the hierarchy of controls? Control Elimination: the hazard is removed completely Substitution: where the hazard is replaced by another process Engineering controls: removing or isolating a hazard through technology Administrative controls: policies aimed at limiting exposure to a hazard including guidelines, policies, procedures Personal protective equipment: clothing and equipment designed to be a barrier between the worker and the hazard Example of control in practice Where a health care facility has chosen not to purchase latex gloves to eliminate the risk of employees developing allergies / allergic reactions to latex materials Replacing floors with a more slip-resistant surface to avoid slips and falls Using ceiling-mounted systems to transfer a person from bed to bathroom. The equipment rather than the health care worker takes the load of the lift In high-risk psychiatric areas, staff members must work in pairs when providing care to discourage the person from threatening the carers The use of gloves and masks and eye shields when caring for the person with infective/viral respiratory disorder, e.g., SARS What is a residual risk? A risk that remains even after all the controls have been implemented. It is not possible to eliminate or completely control all hazards, part of a risk analysis is knowing that a level of risk may be considered acceptable if it is unlikely to occur or if it does occur, it will have minimal impact What are new and emerging hazards? - Presence of bodily fluids from an infected wound Excessive noise from new building works adjacent to the health facility Evidence of worker fatigue or burnout Violent or aggressive behaviour What are examples of emergency situations? - Critical medical or surgical emergencies Events requiring evacuation Fires and explosions Hazardous substances and chemical spills Security emergencies = intruders What are emergency signals and alarms? - Machinery malfunction alarms Fire alarms Evacuation alarms or announcements Beepers on mobile phones What do incident / accident reports need to always include? - Date, time, place Name and address of person / persons involved Witnesses Where and when it occurred The tasks or work that was being performed Description of the incident, injury, or symptoms Any treatment provided How can you complete an incident or accident form correctly? - Clear info so that it can be understood – easy to read and written legibly Concise info – only including relevant info Complete info – all required details Objective info – free of emotions and personal bias Info must be correct accurate and able to be verified What are the safe housekeeping practices in work areas that must be followed? - Maintaining a clear, clean, and tidy work area to improve health and safety Prevention of accident, injury, and illness in the workplace Maintaining equipment and notifying supervisors about any equipment that is not working Keeping walkways and traffic areas clear Using a spill kit to clean spills Participating in WHS training Observing safety signs and knowing what they mean What are the three categories of offences for failing to comply with a WHS duty? - Category 1 = most serious breaches, where a duty holder recklessly exposes a person to the risk of death or serious injury Category 2 = failure to comply with a WHS duty that exposes a person to risk of death, serious injury or illness Category 3 = failure to comply with a WHS duty What is the difference between a general induction and a specific induction? General = provides an overview of the general safety obligations, policies, and procedures of the organisation. Specific = identifies specific hazards and risks relevant to the employee’s position or location and instructs the employee in the safe system if work for the completion of tasks or in the use of equipment or materials. What can stress and fatigue be caused by in the workplace? - Shift work Time pressures Staff shortages - Dealing with behaviours of concern Emotional trauma when caring for palliative patients Exposure to infectious diseases or sharps What are physical signs of stress? - Eating more, or less Chest pain, rapid heartbeat Skin conditions such as eczema Loss of sex drive Nausea, dizziness Diarrhoea or constipation Sleeping too much or too little Frequent colds What are psychological signs of stress? - Depression and anxiety Procrastinating or neglecting responsibilities Inability to concentrate Constant worrying Feeling overwhelmed Moodiness, irritability, or anger Loneliness and isolation Using alcohol, cigarettes, or drugs to relax How can one manage their stress levels? - Talking to others about emotions Seeking professional support through counselling Undertaking regular exercise Maintaining a balanced diet Limiting alcohol and other drugs Getting adequate sleep Breathing exercises Relaxing Reflecting What is Gibb’s reflective cycle? - Description Feelings Evaluation Analysis Conclusion Action plan COMPLY WITH INFECTION PREVENTION AND CONTROL POLICIES AND PROCEDURES What are the 5 pathogenic micro-organisms? - Bacteria Viruses Fungi Protozoa Rickettsia What is direct contact? - Occurs through touch when physical contact transfer pathogens from an infected source to a susceptible host. E, g needlestick injury What is indirect contact? - Occurs when a pathogenic micro-organism is transferred via an object when an infected source touches it and a susceptible host then touches the same object. E.g., tap What is airborne transmission? - Occurs from coughing, sneezing, or talking. The pathogenic micro-organism is so small it is able to linger like an aerosol in the air for long periods allowing it to attach to dust or other droplets for transfer What is droplet transmission? - Occurs when the pathogenic micro-organism is transmitted through saliva / mucus after being expelled from the source via coughing, sneezing, or talking. The droplets are unable to travel more than a meter or so and therefore close proximity is requiring for transmission. What are standard precautions? Are the basic practices used for all patients or residents – regardless of whether a known infection exists. Includes: - Hand hygiene Aseptic technique Respiratory hygiene and cough etiquette Disinfectant and sterilisation Safe handling and disposal of sharps Correct waste management Appropriate handling or linen PPE What are additional precautions? Used when a known or suspected infection exists. Used in addition to standard precautions. Includes: - Hand hygiene Negative pressure room Gown / apron N95 mask Goggles Signage Patient-dedicated equipment Visitor information Surgical mask What is a hospital-acquired infection? - An infection acquired in the health care facility, that the resident or patient was free of, and not incubating, at the time of admission. What is the difference between a routine hand wash and a clinical hand wash and surgical hand wash? Routine: used by everyone in everyday life. In the health care setting this includes washing hands before and after patient contact, between tasks and after removing gloves. It should be 40 – 60 seconds Clinical: used by health care workers before commencing a dressing or procedure on a resident / patient, or before opening sterile equipment. It should last a minimum of 60 seconds. Surgical: Completed prior to surgery or invasive procedure. Takes between 2 – 5 minutes. Cleans under the nails with a nail stick and extending beyond the hands to elbows. What are the five moments of hand hygiene? - Before touching a patient Before a procedure After a procedure or body fluid exposure risk After touching a patient After touching a patient’s surroundings How long should hand rub procedure take? 20 – 30 seconds What are the procedures for respiratory hygiene and cough etiquette? - Cover the mouth and nose with a tissue when coughing, sneezing, or blowing the nose Always use tissues and dispose of them immediately in the waste after use If tissues are not available, sneeze or cough into inner elbow instead of hands Always practice correct hand hygiene afterwards Do not touch the eyes, nose, or any mucous membranes with contaminated hands What are the 3 types of cleaning in the health care setting? - Cleansing Disinfecting Sterilising What is the difference between cleansing, disinfecting and sterilisation? Cleansing: using warm water and mild detergent to clean equipment Disinfection: The removal or elimination of pathogenic micro-organisms with the use of chemical solutions Sterilisation: The complete removal of and destruction of all micro-organisms from equipment What are the processes for handling, transporting, and processing linen? All linen should be changed regularly and if soiled must be contained in an appropriately identified impervious bag for transportation to laundry or for disposal as per facility guidelines. The two main aims are to prevent contamination of clean linen and transfer of micro-organisms to other residents or patients. Contaminated linen should be placed immediately into the appropriate linen skip and removed from the area in a timely manner. Transporting clean linen should be done on a trolley. What is the difference between general and clinical waste? General waste = considered as domestic waste, recyclable waste such as cardboard boxes, and uncontaminated linen. Clinical waste = any waste that has the potential to cause or spread disease. This type of high-risk waste is disposed of in sharps containers or colour-coded bins with appropriate labelling. What are the 7 types of wastes? - Infectious Pathological Chemical Pharmaceutical Genotoxic or carcinogenic Radioactive General What is a risk assessment? The process of gauging the danger associated with an identified hazard so the nature of the risk can be understood How do you remove a spill? Place a safety sign to alert others. Use PPE. Visible fluid should be soaked up using a disposable cloth or paper towels which should then be immediately placed in the contaminated waste bag. The affected area should be washed with hot soapy water, and if only a small spill should be then left to dry. Larger spills may need to be wiped down with bleach as per facility guidelines. PPE should be removed, and hand hygiene should be performed. The manager on duty should be informed and all appropriate documentation should be completed. How do you prepare a specimen? Use a leak-resistant bag with separate compartments for the request form and specimen. If they are leaking, then they may not be accepted or processed. What is the first step when it comes to a needlestick injury? Immediately clean the wound and observe facility protocol. What are ADLs? - Feeding Bathing Dressing Toileting Mobility Continence What is a clean zone? An area identified for non-contaminated items only. E.g., patient’s room, treatment room, equipment and storage areas, administration areas and kitchen. What is a contaminated zone? An area identified for contaminated items only. E.g., bathroom and toilet areas, the laundry, and the cleaning areas for processing dirty equipment. RECOGNISE HEALTHY BODY SYSTEMS What are the anatomical terms? - Superior: towards the upper part of the body Inferior: towards the lower part of the body Medial: towards the midline of the body Lateral: Away from the midline of the body Proximal: Close to the origin of the body part Distal: Further from the origin of the body part Superficial: At the body surface Deep: More internal body What are the body systems? - Cardiovascular Respiratory Musculoskeletal Endocrine Nervous Special sense Gastrointestinal Urinary Reproductive Integumentary Lymphatic and immune system What is the structural organisation of the body from atom to organ system? Atom, molecule, organelle, cell, tissue, organ, organ system, organism What are the four types of tissues and their functions? - Epithelial: protects the outer body and lines internal organs, its structure allows for secretion, absorption, and filtration Connective: supports the body and connects other tissues Nervous: Sends and receives electrochemical impulses from one part of the body to another Muscle: Involved in voluntary and involuntary movements. What is the function of the cardiovascular system? - Transportation of oxygen, carbon dioxide and nutrients Clotting of open wounds Regulation of body temperature What is an artery? Thick-walled blood vessel that takes oxygenated blood away from the heart What is a vein? Thin-walled blood vessel that returns deoxygenated blood back to the heart What is a capillary? Small vessel that join arterioles and venules. Nutrients and oxygen are passed through capillaries into the cells of the body and waste products such as carbon dioxide are removed. What is atherosclerosis? Abnormal build-up of fat, cholesterol, and other substances in the inner lining of their arteries What are signs of a cardiac or coronary artery disease? - Fatigue Shortness of breath Pain, numbness, weakness or coldness in legs or arms Pain in chest, neck, jaw, throat or left arm Irregular heartbeat Light headedness Dizziness What is the function of the respiratory system? To supply oxygen to and remove carbon dioxide from the cells of the body What are the organs of the upper respiratory tract? - Nose Mouth Pharynx Larynx Epiglottis Trachea What are the organs of the lower respiratory tract? - Bronchi Lung Bronchioles Alveoli Diaphragm What are the signs and symptoms of a respiratory disorder? - Cyanosis Fatigue Loss of appetite Cough Dyspnoea Shortness of breath What are the 5 functions of the musculoskeletal system? - Store minerals Provide support for the body Protect organs Provide movement Produce blood cells What is cartilage? Connective tissue that provides support as bones do but is softer and more flexible. What is a joint? When two or more bones meet and are classified as immovable, freely moveable. What are signs and symptoms of someone with a musculoskeletal disorder? - Pain or swelling Loss of mobility Deformity What are the primary glands in the endocrine system? - Pituitary Pineal Thyroid Parathyroid Thymus Adrenal glands What does the endocrine system do? Regulates the human body by releasing chemical messengers called hormones. What major processes are controlled by hormones? - Reproduction Growth and development Fluid balance Metabolism What is the function of the nervous system? Controls and coordinates all voluntary and involuntary activities of the body through functional units known as neurons. What are the structures of the nervous system? - Central nervous system = brain and spinal cord Peripheral nervous system = cranial and spinal nerves What makes up the special senses system? - Vision, hearing, smelling, and taste What are the 3 layers of the eye? - Outermost layer is the sclera Middle layer is the vascular region = choroid, ciliary body, and lens Innermost layer is the retina What are the 3 major areas of the ear? - - Outer ear: contains the pinna which directs sound waves into the ear. The soundwaves reach the tympanic membrane or eardrum and cause it to vibrate Middle ear: contains three small bones (malleus, incus, and stapes) which transmit the vibratory motion from the ear drum to the oval window of the inner ear. The eustachian tube connects the middle ear to the throat and plays a role in equalising pressure within the ear Inner ear: Includes fluid called perilymph, the cochlear which contains the mechanisms of hearing, along with the vestibule and semicircular canals which are involved in balance. What types of cells allow humans to smell? Olfactory cells What do tastebuds contain that allow people to taste things? Chemoreceptors What are the 5 types of tastes? - Unami Salty Sour Sweet Bitter What is the function of the gastrointestinal system? Enables food to be converted into simpler molecules so that it can be absorbed into the blood for cell energy and function. What is the alimentary tract? It is 9 – 10m muscular tube which extends from the mouth to the anus! What are the accessory organs of the GIT? - Tongue Salivary glands Pancreas Live Gall bladder What is the function of the urinary system? To filter wastes from the blood to produce urine for elimination What are 2 other words used instead of urination? Voiding and micturition What are the 3 main functions of the kidneys? - Filtration reabsorption Secretion What are the structures of the male reproductive system? - Penis Testicles What are the structures of the female reproductive system? - Ovaries Uterus Fallopian tube Vagina What makes up the integumentary system? - Skin Hair Nails Sweat glands What are the layers of the skin called? - Epidermis Dermis Hypodermis What is a burn? An injury to any layer of skin and are caused by extreme heat or cold, contact with electricity, chemicals, friction, or radiation. What is the function of the lymphatic system? Assisting in fighting infections by removing debris and draining excess fluid from the body’s tissues. Where can lymph nodes be found? Neck, armpits, abdomen, and groin What is the function of the immune system? Allows the body to defend itself against foreign substances. What are the body’s line of defences? Firs line: body’s natural barriers = intact skin and mucous membranes Second line: body’s responses = inflammatory response, phagocytes engulf and destroy pathogens Third line: act directly on invading micro-organisms = b lymphocytes secrete antibodies that bock foreign substances What is homeostasis? The ability to maintain a relatively stable internal state that persists despite changes in the world outside. What are examples of homeostasis? - Temperature regulation: vasodilation, vasoconstriction Fluid balance: kidneys decrease urine output when dehydrate and conversely increase output when there is too much fluid Glucose maintenance: release pf insulin reduces glucose concentration COMMUNICATE AND WORK IN HEALTH OR COMMUNITY SERVICES What is verbal communication, provide examples. Involves the use or words and the way that they are delivered. Includes tone of voice, use of pauses, rate of speech. Communicating verbally is important when trying to obtain information What is nonverbal communication, provide examples. Refers to messages that are no expressed in words. Including facial expressions, eye contact, posture, gestures, touch, proxemics, and appearance. How can you communicate service information in a clear manner and confirm understanding? - Making appropriate eye contact throughout interaction Keeping the language simple using vocabulary familiar to the patient’s age and educational level Speak clearly and at a moderate pace Keep messages clear and concise Demonstrations Encouragement Seeking feedback What is assertion? Being able to stand up for your own or another person’s rights in a calm and positive way, without being aggressive or passive. What is a conflict of interest? A situation in which someone in a position of trust has competing professional or personal interests. These competing interests can make it difficult to carry out tasks in an impartial way What is mandatory reporting? The legislative requirement imposed on selected classes of people to report suspected cases of child abuse and neglect to government authorities. ASSIST WITH MOVEMENT What is The Work Health and Safety Act 2011? Describes the responsibilities of employers and employees in assessing risks posed by hazards in the workplace and determining how best to modify or eliminate work process to control or eliminate risk. What are aids that can help lift or transport a patient? - Slide sheet Bed ladder / rope ladder / bed triangle Transfer belt Swivel and transfer boards Raised toilet seat Mechanical lifters Wheelchairs and commode chairs Walking frames, crutches, and walking sticks How can you appropriately prepare the environment when assisting in movement? Ensure that the environment is clear, this means making sure that the bedside area is clear, and the bed height is right for the procedure. Make sure that the bed brakes are on, the floors do not have any tripping hazards and that the route is clear from any obstructions What are the stages of a pressure ulcer? - Stage 1: discolouration of the upper layer of skin Stage 2: experience some pain. The sore area of the skin has broken through the top layer and some of the layer below Stage 3: Sores will have progressed to being completely broken through the top two layers and into the fatty tissue below Stage 4: extends below the subcutaneous fat into deep tissues like muscles and tendons. Stage 5: the unstageable stage. Excessive tissue damage TRANSPORT INDIVIDUALS How is someone’s mobility classified? - Ambulant: capable of walking independently – with a walking stick or with minimal assistance Non-ambulant: require a wheelchair or trolley / bed as they can only partially or non-weight bear ASSIST WITH NURSING CARE IN AN ACUTE CARE ENVIRONMENT What is the nursing process? Assessment, diagnosis, planning, implementation, evaluation What is nursing history? Data collected about a client’s physical, cognitive, social, and emotional history. What are the SMART goals? - Specific Measurable Attainable Realistic Time based What is the chart used to gauge an individual’s consciousness? Glasgow coma scale What are the 3 main types of wound dressings? - Film dressings Foam dressings Gels PROVIDE NON-CLIENT CONTACT SUPPORT IN AN ACUTE CARE ENVIRONMENT What is a health care record? The primary source of information about a patient’s health and wellbeing. What types of health records are there? - Integrated progress notes Admission forms Discharge and transfer forms X-rays and images Obs charts How do you store health care records? - Documents need to remain private and confidential and must at all times be stored in a secure space for access by authorised personnel only - Records must be correctly stored and eventually destroyed by authorised personnel to make sure that info of a sensitive nature is not made public Kept for 7 years after the patient’s death How do you dispose of health care records? - Needs to be in a way that provides confidentiality and privacy Any confidential paperwork is placed in a locked bin and shredded before being sent for recycling. They can also be pulped or burned What is the thing that you use to take someone’s bgl? Glucometer RESPOND EFFECTIVELY TO BEHAVIOURS OF CONCERN What is Maslow’s hierarchy of needs? - Self-actualisation Esteem needs Social needs Safety needs Physiological needs List 10 different BOC Anxiety, confusion, anger, grief, manipulation, intoxication, aggression, self-harming, wandering and violence Name 6 different reasons why clients may display BOC - Environment Psychological Physical Psychiatric Medical causes Neurological What are 3 legal and 3 ethical considerations when working with clients with BOC? Legal - Anti-discrimination act Privacy act 1988 WHS act Ethical - Duty of care Mandatory reporting Confidentiality What is the ABC model? - Antecedent Behaviour Consequence What is debriefing? Providing a summary update of condition or situation to affected or concerned people. WORK WITH DIVERSE PEOPLE What is cultural identity? The feeling of belonging in a group. It can include: - Nationality Location Ethnicity Social class Gender Religious and spiritual beliefs Explain what attitudes, values and beliefs are? Attitudes: a way of thinking or feeling about certain ideas or issues Values: A measure of the worth or importance a person attaches to something Beliefs: A feeling that something is true. How can you act to improve your own self and social awareness? - Develop empathy. Develop emotional intelligence. Participate in informal and formal learning. Access resource materials and networks What is ethnocentrism? The belief that your own group or culture is better or more important than others. What are the 4 steps you can take when promoting understanding across diverse groups? - Step 1: define the problem by identifying issues that may be causing conflict. Step 2: examine cultural interpretation by considering the impact of cultural differences. Step 3: Resolve the conflict by gaining commitment and addressing any difficulties. - Step 4: Evaluate and monitor changes to check the conflict no longer applies. WORK WITH PEOPLE WITH MENTAL HEALTH ISSUES What are barriers to communication? - Attitudes Stigma Myths What are mental health legislations? - Mental health act 2007 (NSW) Australian Human Rights Commission Act 1986 Disability Discrimination Act 1992 Privacy Act 1988 DELIVER CARE SERVICES USING A PALLIATIVE APPROACH What is palliative care? Care that improves the quality of life of patients and their families, through prevention and relief of suffering by assessment and treatment of pain and other problems, physical, psychological, and spiritual. Is a curative approached used in palliative care? No. A holistic and comfort-care approach is used so that the individual can be supported so that they can experience the best quality of life possible. What is quality of life? Includes an individual’s physical, social, psychological, and spiritual needs and can only be determined by the individual. What is an advanced care directive? It is a plan that allows individuals to write down their goals and preferences for end of life, or any treatments that they would refuse. What is a power of attorney? A person who has been given the power to make decisions on the patient’s behalf regarding managing assets and financial affairs in the event that they are unable to do so. What is hospice care? Represents a compassionate approach to palliative care whilst enhancing the QOL. Can be received at a facility or in their own home. This allows the person to spend their final days in a familiar and comfortable environment with their loved ones. What are the signs of impending death? - Increased anxiety, restlessness, and confusion Shallow and irregular breathing = Cheyne-stokes Noisy breathing Speech becomes difficult. Pulse become rapid or weak. Extremities become cold. Skin may be pale, clammy, and mottled. Involuntarily void or defecate. Eyes stare and become glazed Loss of consciousness What are the signs of a clinical death? - Pupils may not respond to light. Jaw may drop. Eyes remain open. No pulse or respiration Body becomes cold. Blood pools with purple discolouration at lowest parts of the body After 2 – 4 hours body becomes rigid Fluid may leak from natural body openings ORGANISE PERSONAL AND WORK PRIORITIES AND DEVELOPMENT What are key performance indicators? A measure value that demonstrates how effectively objectives and goals are being met First Aid Summary Sheet INTRODUCTION TO FIRST AID KEY WORDS AED – Automated External Defibrillation BLS – Basic Life Support DRS ABCD – Danger, Response, Send for help, Airways, Breathing, CPR, Defibrillation Signs – Characteristics of an injury that you can see, feel or hear Reassurance – The act of providing information that is comforting and builds trust Casualty – The injured or ill person Bystander – The people who are in the immediate vicinity of the incident First aider – The person providing first aid Professionals – Trained professional can include but aren’t limited to paramedics, firemen, police, doctors and nurses WHAT IS FIRST AID? - First aid is the immediate care of an ill or injured person, using available resources, and until medical or other professional assistance arrives. AIMS OF FIRST AID - Preserve life Prevent further injury Protect the unconscious Promote recovery Provide reassurance DUTY OF CARE - In Australia, there is no legal obligation to offer someone first aid unless a duty of care has already been established. E.g. Voluntary employment as a first aider Once you begin first aid care, you have a duty to provide the care to the best of your ability and knowledge until your own safety becomes endangered, the casualty no longer requires or refuses your assistance, or you have been relieved by a more qualified person. CONSENT - The act of giving permission and before you provide care to a casualty you must obtain for their consent. If the casualty is unresponsive (unconscious) or, due to their injury or illness is unable to give consent, their consent is implied. AED – Automated External Defibrillation BLS – Basic Life Support DRS ABCD – Danger, Response, Send for help, Airways, Breathing, CPR, Defibrillation Signs – Characteristics of an injury that you can see, feel, or hear Reassurance – The act of providing information that is comforting and builds trust Casualty – The injured or ill person Bystander – The people who are in the immediate vicinity of the incident First aider – The person providing first aid Professionals – Trained professional can include but are not limited to paramedics, firemen, police, doctors, and nurses WHAT IS FIRST AID? - First aid is the immediate care of an ill or injured person, using available resources, and until medical or other professional assistance arrives. AIMS OF FIRST AID - Preserve life Prevent further injury Protect the unconscious Promote recovery Provide reassurance DUTY OF CARE - In Australia, there is no legal obligation to offer someone first aid unless a duty of care has already been established. E.g., Voluntary employment as a first aider Once you begin first aid care, you have a duty to provide the care to the best of your ability and knowledge until your own safety becomes endangered, the casualty no longer requires or refuses your assistance, or you have been relieved by a more qualified person. CONSENT - The act of giving permission and before you provide care to a casualty you must obtain for their consent. If the casualty is unresponsive (unconscious) or, due to their injury or illness is unable to give consent, their consent is implied. If the casualty is under 18 years of age, consent should be sought (wherever possible) from their parent or legal guardian. REASSURANCE - The process of providing information that is comforting, it builds trust and increases confidence in your ability to provide first aid. - You can offer reassurance to the casualty by letting the casualty know what you are doing and when professional help is on its way. Offering reassurance is an important aspect of first aid care and will assist in reducing fear and anxiety. CONFIDENTIALITY - When offering first aid it is important that you keep any information confidential. Information about the nature of the accident or the condition of the casualty should only be conveyed to emergency services and / or the workplace supervisor. CULTURAL AWARENESS - It is important for the first aider to respond to the casualty in a culturally aware, sensitive, and respectful manner. If you are uncertain about the cultural needs or expectations of the casualty, ask for their advice. This may include difference in language, the use of plain English, gender roles, role boundaries and health care preferences. REPORTING & RECORDING - It is required under WHS law that employers keep a register of injuries in the workplace, First Aid personnel are required to complete documentation and report on any first aid incident events. The information contained in the record needs to be relevant, factual, and accurate to the best of your ability. MEDICATIONS - In medical emergency, it is advised to provide assistance to the casualty with selfmedication. Any assistance with medication should be performed in line with State or Territory legislation, workplace policies and any available medical or pharmaceutical instructions. TAKING CARE OF YOURSELF AND OTHERS o o o o o o In any first aid situation it is essential that you take precautions to ensure your own safety and the safety of others. In some first aid situations there may be the potential risk of illness or injury to the first aider or bystanders. Risks or illness or injury may result from: Exposure to blood and other body substances Acts of aggression An unsafe scene for example, oncoming traffic in a road accident Bystanders placing themselves and others at risk of injury Moving objects causing back, neck or shoulder injuries Presence of smoke, fire, or poisonous fumes STANDARD PRECAUTIONS - Standard precautions are a set of guidelines that aim to protect people from accidental exposure to blood or other bodily substances. GENERAL PRINCIPLES: - Wear gloves Use other PPE such as face shields, masks, or goggles Encourage the casualty to treat themselves, E.g., Apply pressure to their own bleeding wound Dispose if waste materials and sharps in the correct container Avoid accidental injuries to yourself, E.g., Cuts from broken glass Wash your hands with soap and water or waterless hand wash EXPOSURE TO BLOOD AND OTHER BODY FLUIDS: - Wash affected skin surfaces with liquid soap and water If eyes are contaminated – rinse thoroughly with water or normal saline If blood or other body fluids get in the mouth, spit it out and rinse the mouth with water several times If clothing is contaminated, remove clothing and shower if necessary Follow any other workplace policies Seek medical advice immediately following an exposure and attend any follow up treatment or monitoring MOVING THE CASUALTY - - - The condition of the casualty can be worsened by movement, increasing pain, injury, blood loss and shock. If movement is necessary and help is available, the most experience rescuer should take charge and maintain the casualty’s body in strict spinal alignment. Moving the casualty unnecessarily can also pose risks for the first aider. Incorrect lifting and moving techniques can result in severe back, neck, and shoulder injuries. Moving the casualty should only take place if you are unable to provide life saving measures in the current position or if there are any immediate threats to life such as fire and explosion. CAR ACCIDENT: Best to avoid any unnecessary removal of casualties from vehicles. If it is safe to do so, provide first aid to casualties in the vehicle. Only remove the casualty if you are unable to provide life saving measures in the current position or if there are immediate threats to life such as fire and explosion MOTORBIKE ACCIDENT: Motorbike helmets can provide support to the head, neck and spine and can help prevent further injury, Helmets should only be removed to maintain an open airway or to provide CPR If the helmet must be removed it is better if this is done by a paramedic or another trained person STAGES OF FIRST AID MANAGEMENT Initial approach Prioritise DRS ABCD Send for help call 000 Secondary assessment Communicate details Finalise the incident - - - - - INITIAL APPROACH Stay calm Assess for any immediate dangers Ensure the area is safe Introduce yourself to the casualty and others State that you would like to offer help and gain their permission to provide assistance Conduct a quick assessment of the scene PRIORITISE DRS ABCD The DRS ABCD Action Plan will help you assess if a casualty is in a life-threatening situation and in need of immediate Basic Life Support (BLS) or other life saving measures SEND FOR HELP Stay calm, do not should, speak slowly and clearly Answer the operator’s questions Give details of where you are, including street number, nearest cross street and locality Stay focused and stay relevant Follow any instructions and DO NOT hang up the phone until directed to SECONDARY ASSESSMENT Head-to-toe approach General signs and symptoms to look for are: Bleeding or bruising Fractures and deformity Rashes Swelling Pain, tingling, numbness Bite or sting marks Burns Reduced movement Reduced strength COMMUNICATION DETAILS: Handing over to emergency services personnel Continue first aid until the paramedic is ready to take over the care of the casualty Provide as much info as possible, including info that may have been given to you by the casualty or bystanders If requested to do so, stay, and assist the emergency services personnel Workplace record and report forms All employers are required by law to keep a register of injuries that occur in the workplace If you are responsible for first aid at work, you will be required to record the incident according to your workplace procedures FINALISE THE INCIDENT: Clean up the immediate area, but only if it is appropriate to do so Take action to prevent any further accidents from happening Complete workplace injury or illness forms Reorder and re-stock any first aid kits and supplies - Seek opportunities to talk about the situation with family / friends / colleagues Seek or refer someone to counselling or debriefing after the accident CALLING FOR HELP - - If a person in unable to speak English they can call 000 from a fixed line and say either ‘police’, ‘fire’ or ‘ambulance’. Once connected they should stay on the line and a translator will be arranged If you are deaf or have a speech or hearing impairment: call 106 for a text-based service COMMUNICATING INCIDENT DETAILS - Provide the following information Nature of the accident Time you arrived at the scene Types of first aid provides Casualty’s response to first aid Duration of any CPR Type and amount of medication taken Any completed workplace records and report forms FIRST AID KIT - Basic items of the first aid kit: Emergency numbers Gloves for protection Scissors for cutting tape, clothing, and bandages Bandages of different sizes for stopping bleeding and for fractures sprains, bites, and stings Tape for securing pads for bleeds First Aid reference book Sterile water or normal saline Band-Aids for covering small wounds Waterless hand wash Other equipment which may include bandages and pads of different sizes, a face mask, tweezers, and thermal blanket BASIC LIFE SUPPORT CHAIN OF SURVIVAL Early recognition and call for help Early CPR Early defibrillation Post resuscitation care DRS ABCD ACTION PLAN Danger Response Send for help Airways Breathing CPR Defibrillation - - - DANGER Always check for danger. Make sure the area is safe for you, bystanders, and the casualty Response Check for a response using the touch and talk technique. “Can you hear me?” Grasp and squeeze both shoulders firmly Send for help Shout for help or send someone to call 000 at the earliest possible stage - Airways Head tilt and chin lift technique Place one hand on the casualty’s forehead and gently tilt the head back With your fingertips under the point of the casualty’s chin, lift the chin to open the airway Keeping the airway open, look, listen, and feel for breathing Airway management for infant An infant’s airway can easily become obstructed by an excessive backward head tilt or jaw thrust Therefore, the infant’s head should be kept in a neutral position - Breathing Look, listen and feel technique Look for the rise and fall of the upper abdomen or chest Listen at the casualty’s mouth Feel for air escaping the casualty against your cheek Decide if breathing is normal, not normal, or absent - Commence CPR 30 compressions, 2 breaths = 30:2 Compressions must be paused briefly to allow for the rescue breaths to be given - Adult Two hands over the centre of the chest To 1/3 chest depth 100 compressions per minute - Child One or two hands over the centre of the chest 1/3 chest depth 100 compressions per minute - - Infant Two fingers over the centre of the chest 1/3 chest depth 100 compression per minute - Defibrillation AED guides rescuer through the right steps. AIRWAY OBSTRUCTION AND CHOKING DROWNING - Remove casualty from water DRS ABCD 000 If airway is blocked or the person vomits, roll the casualty on their side Clear the airway Reassess breathing Monitor the casualty closely All drowning casualties should go to hospital in an ambulance, even if recovery occurs, as complications can develop RECOVERY POSITION - Placing the casualty on their side maintains an open airway The casualty should be placed on their left side but if a chest injury is apparent casualty should be placed injured side down. Two ways to place a person on their side: normal and then a log roll BITES AND STINGS PRESSURE IMMOBILISATION TECHNIQUE - DO NOT USE FOR REDBACK SPIDER BITES Objective is to attempt to slow the flow of lymphatic fluid located in the affected arm or leg - DRS ABCD 000 Lay the casualty down and at complete rest Remove jewellery from the affected limb Apply a firm, elasticised broad bandage (10-15 cm wide) with even tension to the affected limb. Commence bandaging at the toes or fingers (leave them exposed) and bandage the entire limb regardless of where the venomous bite has occurred. A bandage that is too loose will be ineffective, one that is too tight may cause tissue damage Keep the limb still by immobilising using a splint, sling, or another method Provide reassurance Keep the casualty at complete rest until medical help arrives - REDBACK SPIDER - DO NOT USE PIT DRS ABCD Apply an ice pack to the bite site. Monitor the casualty closely over time Provide reassurance If the casualty is a small child or the pain is severe call, see medical assistance INSECT BITES AND STINGS - DRS ABCD Gently remove the bee sting using a sidewards scraping motion Apply an ice pack to the bite site to help with the pain / discomfort Observe signs of an allergic reaction If present manage the casualty for suspected allergic reaction If the person become unresponsive provide BLS 000 TICK BITES - DO NOT disturb, squeeze, or scratch the tick Kill the tick where it is using an ether-containing spray / rapid freezing spray Remove the tick as soon as possible Inspect all skin areas and folds of skin for more ticks If you suffer any symptoms – seek urgent medical assistance If the casualty becomes unresponsive provide BLS If allergic, follow the Anaphylaxis Action Plan. Including the use of an adrenaline autoinjector if symptoms of anaphylaxis occur MARINE BITES AND STINGS FISH SPINE STINGS - DRS ABCD 000 Place the affected limb in hot water to help relieve pain – do not burn the skin If heat does not relieve the pain, or hot water is not available you can try using an ice pack Transport to, or seek urgent medical assistance DO NOT USE PIT JELLYFISH - - Non-tropical DRS ABCD and remove the casualty from the water (if safe to do so) Seek help from the Lifeguard if available Pick off tentacles then wash sting site with sea water Place the affected limb in hot water for 20 minutes – do not burn the skin If hot water does not relieve pain, apply a cold pack or ice in a dry plastic bag DO NOT USE VINEGAR Tropical DRS ABCD and remove casualty from the water (if safe to do so) 000 Pour or spray large amounts of vinegar over the sting site for 30 seconds (if unavailable use sea water) Gently remove tentacles ensure this is safe Apply a cold pack or ice in a dry plastic bag for relief. Ensure no fresh water meets the sting site Monitor and prepare to provide BLS The casualty who initially appears stable but experience severe symptoms in the following minutes, may suffer Irukandji Syndrome and need urgent medical attention BLUE-RINGED OCTOPUS AND CONE SHELL - Often painless bite or scratch Small amount of blood may be visible at the bite site Numbness of the lips or tongue Progressive weakness or paralysis Difficulty swallowing or breathing Inadequate or no breathing BLEEDING AND WOUNDS EXTERNAL BLEEDING *Bleeding from the nose and/or ear may be related to a head injury *DO NOT apply pressure over an embedded object OR remove an embedded object Direct pressure method - DRS ABCD, if required call 000 Use standard precautions Place a pad or covering that is absorbent over the bleeding site Apply firm direct pressure Immobilise the area to restrict movement Maintain pressure until bleeding stops Apply a firm roller bandage to hold the pad in place and apply additional pressure to the bleeding area If bleeding continues, apply additional pad and bandage to original dressing - If the severe bleeding from a lower limb – lie the casualty down Immobilise the area to restrict any movement Encourage the casualty to remain at rest Reassure the casualty Assess for and manage shock NOSEBLEED - Sit the casualty down with their head leaning forward Get the casualty to pinch the soft part of their nose (below the bone) Maintain pressure for 10 to 20 mins Apply a cold pack to the neck, nose, or forehead If bleeding continues after 20 mins, seek medical advice INTERNAL BLEEDING *DO NOT apply pressure over internal organs *DO NOT give anything to eat or drink Signs and symptoms may include: - Pain, tenderness, or swelling Shock Bleeding from an opening of the body o Coughing or vomiting blood o Blood-stained urine o Bleeding from the vagina or anus o Blood-stained or black faeces - DRS ABCD 000 - Rest the casualty in a position of comfort Assess for and manage shock Provide reassurance WOUNDS - Control bleeding and if required call 000 Wash hands and war gloves (if possible) Clean the wound (depending on type
