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 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. 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 life 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 allegic, follow the Anaphylaxis Action Plan. Including the use of an adrenaline auto-injector 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
