First Aid
Settings and Practice
Agoura Hills DRT
March 16, 2011
Bill Novik
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First Aid Settings
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Movies in the Park
Concerts in the Park
Relay for Life
The Great Race
The Big One
Little Ones (personal incidents)
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General Operating Procedures
• Incident command structure – IC
– Sign-in and –out, report if leaving/returning area
• Work in teams
• PPE – Personal Protective Equipment
• Perform only to level of (CERT) training
– CERT level 1, First responder – level 3
– Water (ice), soap, sugar
• Supplies – canopies, chairs, cots, backboard, two
medical kits, soap, towels, ice, “grab-and-go” bag, radios
(HAM or FRS), AED(?)
• How to become more involved in DRT – jump in, be selfstarting, you’re not far behind anyone
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Typical Incidents
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Lost children
Requests for OTC drugs
Bee stings
Sprains / Strains / Breaks
Scrapes / Scratches
Heat Exposure
Diabetes
Shock / Hypoperfusion
Heart Attack
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General First Aid Protocol
• Introduce self and level of training
• Obtain permission to treat
– under age 18
• Record name of victim (or gender and
age) and injury
• Do at least a quick, overall, visual head-totoe assessment
• Get information about nature and cause of
injury (SAMPLE)
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General First Aid Protocol
• Tell the victim what you observe, what you will
do, and what you are doing
• Get assistance if serious injury (immediateRPM) or are uncomfortable
• Call for professional responders if needed
(probably through IC)
• Keep track of time for important events
• Write a report for major incidents (w/i 24 hours)
• Recommend professional follow-up if
appropriate
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Bee Stings
• Remove stinger quickly
– Scrape with edge of credit card, tweezers or fingernail
– Tweezers
– Do not squeeze the venom sac
• Wash with soap and water
• Apply ice (not directly to skin)
• Ask about known allergic reactions
– If unknown, have person stay at first-aid or with
someone who can help
– can develop an allergy even if immune before
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Sprains / Strains / Breaks
• Signs and Symptoms
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Severe fall or collision
Slow capillary refill in child or infant
No pulse below injury
Loss of sensation
Inability to move without pain or discomfort
Painful, swollen, deformed
• Action
– RICE: Rest, Immobilize, Cold (20 minute cycle), Elevate
– Immobilize / Splint
• Soft – blanket, towel, pillow, sling
• Rigid – board, metal strip, cardboard
• Anatomic - arm to chest, leg to leg, digit to digit
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Sprains / Strains / Breaks
• Action: Splint
– Do not splint if professionals responding
– Splint only if can be done without causing more pain
or discomfort
– Splint injury in position you find it
– Splint injured area and joints above and below injury
– Check for proper circulation and sensation before and
after splinting
– Elevate splinted part if possible
– Extra half tie to hold the tie (surgeon’s knot)
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Scrapes / Scratches
• Minor bleeding usually stops within 10 minutes
• Blood loss
– More than 2 pints – trouble
– One liter – deep trouble
• Action
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Follow BSI (body substance isolation) precautions
Controlling bleeding more important than washing
Direct pressure (white on white on red)
Elevate injured area above level of heart, if not painful
Pressure points
• Brachial artery – upper arm
• Femoral artery – inner thigh
– Monitor ABC (check for cause of injury or for other injuries)
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Bandaging Tips
• Start at narrower point working toward thicker
part
• Wrap at an angle
• Leave a flap to fold over after first wrap and
wrap two times to anchor
• Half twist over wound to add pressure
• Tie off with bow over wound for more pressure
• Tie off tips
– a) Pull free end of bandage under limb for tie
– b) Tear end of bandage down middle for tie
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Heat Exposure
• Signs and Symptoms
– Cool, moist, pale, ashen skin (red in early stages)
– Headache
Nausea
– Dizziness and weakness
Exhaustion
• Signs and Symptoms – Serious Heat Exposure
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Change in level of consciousness
Vomiting
Sweating stops
Rapid, weak pulse
Rapid, shallow breathing
Red, hot, dry or moist skin High temperature
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Heat Exposure
• Action
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Check ABC
Summon advanced aid for serious heat exposure
Lie down in cool/shady spot with legs elevated
Loosen/remove clothing
Cool packs to body (wrist, ankles, armpits, groin)
Fan victim
Small amounts of water to conscious victim
(sip every 3-4 minutes)
– Prepare to do CPR if later stage heat-related illness
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Diabetes
• Signs and Symptoms
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Change in level of consciousness
Dizziness, drowsiness, confusion
Irregular breathing
Rapid or weak pulse
Feeling and looking ill
Flushed, hot, dry skin
Sweet breath odor
Restless, agitated
• Action
– If conscious and can take food or fluids, give sugar
• Candy, fruit juice, non-diet soda, table sugar or sugar water
– If not better in five minutes after sugar, summon advanced aid
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Shock / Hypoperfusion
Inability for circulatory system to provide oxygen
• Signs and Symptoms
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Restless/irritable
Pale, ashen, cool, moist skin
Rapid breathing (>30 breaths/minute)
Rapid (100-200 beats/min), weak pulse (drop in blood pressure)
Excessive thirst
Changes in level of consciousness
Nausea
Action
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Monitor ABC and treat
Rest comfortably, reassure victim
Keep from getting chilled or overheated
Control bleeding
Elevate legs 12 inches (but do no further harm)
No food or drink
Immediately call for advanced care as cannot be fixed by first aid alone
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Heart Attack
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Signs and Symptoms
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Persistent chest pain/discomfort
Mild discomfort to unbearable crushing sensation
Chest pressure, squeezing, tightness, aching, constricting, heavy
Center of chest or spread to shoulder, arm, neck, or jaw
Lasts longer than ten minutes
Difficulty breathing (rapid breathing)
Pulse may be fast or slow
Skin may be pale, ashen, bluish, moist
Action
– Convince victim to stop and rest
– Obtain information from victim
• When pain started
• Does anything lessen pain
• Where does it hurt
What brought it on
What does it feel like
– Comfort victim
Call for care
– Assist with prescribed medications
Monitor vital signs
– Prepare to give CPR if heart stops beating
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Practice
• Scenario – Great Race but paramedics/ambulance not at scene (no
band-aid situations)
• Treat everyone and everything as real as possible
• Select an Incident Commander
• Become aware of available supplies
• Use supplies – do it real
– Reuse previously used supplies if available
– Don’t activate cold packs, pour water, or cut clothing
– Put supplies back – in good condition
• Interact (talk) with victim. Some will give you more information if you
talk with them or ask questions
• Victims will give you feedback / guidance
• If something is truly real, indicate so by saying “real, real, real” or by
repeatedly tapping head. Shout out!
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