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Cardiopulmonary Resuscitation (CPR)/First Aid
Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 2
Providing First Aid
Immediate care given to the victim of an accident or illness to minimize the effect of injury or illness until experts can take over
Reasons for providing correct first aid
Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 3
Basic Principles ofProviding First Aid
Remain calm and avoid panic Evaluate situation thoroughly Have a reason for anything you do Treatment you provide will vary depending
on type of injury or illness, environment, others present, equipment or supplies on hand, and availability of medical help
Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 4
First Steps
Recognize that an emergency exists Use all senses to detect problems Sometimes signs of emergency are
obvious and at other times they are less obvious
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Next Steps
Check the scene and make sure it is safe to approach
What to observe If not safe, call for medical help If safe, approach the victim Call emergency medical services (EMS)
as soon as possible
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Next Steps(continued)
If possible, obtain the victim’s permission before providing any care
Triage if necessary Check for other injuries Obtain as much information as possible
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General Principles
Obtain qualified help as soon as possible Avoid any unnecessary movement of
the victim Reassure the victim Use a confident, calm attitude to help
relieve victim’s anxiety Avoid giving the victim anything to eat
or drink
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General Principles(continued)
Protect the victim from cold or chilling, but avoid overheating
Work quickly in an organized and efficient manner
Do not make a diagnosis or discuss condition with observers at scene
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General Principles(continued)
Maintain confidentiality and protect the victim’s right to privacy while providing treatment
Make every attempt to avoid further injury Provide only the treatment you are
qualified to provide
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Performing Cardiopulmonary Resuscitation (CPR)
Cardio: the heart Pulmonary: the lungs Resuscitation: to remove from apparent
death or unconsciousness Breathe for the patient and circulate blood
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Performing Cardiopulmonary Resuscitation (CPR) (continued)
Purpose: keep oxygenated blood flowing to the brain and other vital body organs
Performed until the heart and lungs start working again or until medical help is available
Clinical versus biological death
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Performing Cardiopulmonary Resuscitation (CPR) (continued)
“CABD’s” of CPR (per 2010 guidelines)
C stands for circulation A stands for airway B stands for breathing D stands for defibrillation
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Performing Cardiopulmonary Resuscitation (CPR) (continued)
Evaluate victim’s condition before starting CPR
Correct hand placement is essential before compressions are performed
Compression rate of at least 100 per minute
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Performing Cardiopulmonary Resuscitation (CPR) (continued)
One-person rescue for adult victim Two-person rescue for adult victim CPR for infants CPR for children CPR for victims with FBAO
– (Foreign Body Airway Obstruction)
Reasons for stopping CPR
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Performing Cardiopulmonary Resuscitation (CPR) (continued)
Reasons for stopping CPR– The scene becomes unsafe and you have to
evacuate yourself and your victim– Physically unable to continue– Persons with more training than yourself
accept responsibility for victim and take over their care
– The victim shows signs of life
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Providing First Aid for Bleeding and Wounds
Wounds involve injuries to the soft tissues General classifications of wounds
– Open: break in skin or mucous membranes– Closed: no break in skin or mucous
membranes, but injury occurs to underlying tissues
• Wounds can result in bleeding, infection, and/or tetanus
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Classifications of Open Wounds
Abrasion Incision Laceration Puncture Avulsion Amputation
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Classifications of Open Wounds
Abrasion Incision Laceration Puncture Avulsion Amputation
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Classifications of Open Wounds
Abrasion Incision Laceration Puncture Avulsion Amputation
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Classifications of Open Wounds
Abrasion Incision Laceration Puncture Avulsion Amputation
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Classifications of Open Wounds
Abrasion Incision Laceration Puncture Avulsion Amputation
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Classifications of Open Wounds
Abrasion Incision Laceration Puncture Avulsion Amputation
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Classifications of Open Wounds
Abrasion Incision Laceration Puncture Avulsion Amputation
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Controlling Bleeding First priority because victim can bleed to
death quickly Bleeding can come from arteries, veins,
or capillaries Observe standard precautions
– Handwashing before/after care– Gloves – Goggles– Mask
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Controlling Bleeding(continued)
Direct pressure Elevation Pressure bandages Pressure on pressure points Do not disturb clots Do not remove dressings Do not clean wound
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Minor Wounds
First priority – prevention of infection Wash your hands before caring for wound Put on gloves Wash the wound with soap and water Rinse the wound thoroughly Use sterile supplies Tell the victim to get follow up medical
help - ALWAYS
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Signs of Infection
Swelling Heat Redness Pain Fever Pus Red streaks
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Signs of Infection
Swelling Heat Redness Pain Fever Pus Red streaks
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Tetanus
Tetanus bacteria can enter an open wound
Serious illness Get tetanus shot or booster as needed
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Objects Embedded in Wound
If superficial, gently remove Objects embedded in tissues should be
left and removed by physician
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Closed Wounds
Can occur anywhere on body If bruise, apply cold application to
reduce swelling Observe for signs of internal bleeding Get medical help as quickly as possible Check breathing and treat for shock Avoid unnecessary movement of victim No food or fluids
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Providing First Aidfor Shock
Also called hypoperfusion Shock: clinical set of signs and symptoms
that are associated with an inadequate supply of blood to body organs, especially brain and heart
Causes of shock
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Providing First Aidfor Shock (continued)
Goals of treatment Positioning of victim Maintain body temperature Avoid food or drink Other principles of care
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Types of Shock
Anaphylactic Cardiogenic Hemorrhagic Metabolic Neurogenic
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Types of Shock
Anaphylactic Cardiogenic Hemorrhagic Metabolic Neurogenic
Hypersensitive or allergic reaction to a substance such as food, medications, insect stings or bites, or snake bites
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Types of Shock
Anaphylactic Cardiogenic Hemorrhagic Metabolic Neurogenic
Damage to heart muscle from heart attack or cardiac arrest
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Types of Shock
Anaphylactic Cardiogenic Hemorrhagic Metabolic Neurogenic
Severe uncontrolled bleeding leading to life-threatening condition(Hypovolemic Shock)
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Types of Shock
Anaphylactic Cardiogenic Hemorrhagic Metabolic Neurogenic
Loss of body fluid from severe vomiting, diarrhea, or a heat illness, disruption in acid-base balance, as occurs in diabetes
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Types of Shock
Anaphylactic Cardiogenic Hemorrhagic Metabolic Neurogenic
Injury and trauma to brain and/or spinal cord
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Types of Shock(continued)
Psychogenic Respiratory Septic
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Types of Shock(continued)
Psychogenic Respiratory Septic
Emotional distress, such as anger, fear or grief
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Types of Shock(continued)
Psychogenic Respiratory Septic
Trauma to respiratory tract; respiratory distress, or arrest (chronic disease, choking)
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Types of Shock(continued)
Psychogenic Respiratory Septic
Acute infection that infects the entire body by entering the bloodstream
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Signs and Symptomsof Shock
Skin is pale or bluish-gray and cool or cold to the touch
Diaphoresis (excessive sweating) Rapid and weak pulse Respirations rapid, shallow, and
may be irregular Blood pressure very low or unobtainable
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Signs and Symptomsof Shock (continued)
General weakness Anxiety and extreme restlessness Excessive thirst Nausea and/or vomiting Blurred vision or changes in appearance
of eyes
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Providing First Aidfor Poisoning
Can happen to anyone regardless of age Poison: any substance that causes a
harmful reaction when applied or ingested Immediate action is needed First aid varies depending on
type of poison, injury involved, and the method of contact
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Ways Poisoning Occurs
Swallowing various substances Inhaling poisonous gases Injecting substances Contacting the skin with poison
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First Aid for Poisoning
If poison has been swallowed Methods to induce vomiting If poisoned by inhalation of gases If poisoned by contact with skin Contact with poisonous plants If poisoned by injection
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First Aid for Poisoning
If poison has been swallowed– Call Poison Control Center 1-800-222-1222– Call EMS: If warranted or delayed response
from Poison Control Center– Save container (label) for EMS– Estimate amount of ingestion if possible– Save emesis (if any) for testing– Induce vomiting ONLY if told to do so by EMS
or Poison Control Center
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First Aid for Poisoning
Methods to induce vomiting– Syrup of Ipecac (follow dosing instructions)
followed by 1-2 glasses of water– Warm salt water– Stimulate gag reflex– NOTE: Vomiting removes about one half of
the ingested poison
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First Aid for Poisoning
If poison has been swallowed– Do NOT induce vomiting if victim:
• Is unconscious• Swallowed acid or alkali• Swallowed petroleum products• Is convulsing (seizure)• Has burns on lips or in mouth
– Activated Charcoal may be recommended to neutralize poison
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First Aid for Poisoning
If poisoned by inhalation of gases– Remove victim from area immediately– Carbon monoxide
If poisoned by contact with poison– Use large amounts of water to wash the skin
for at least 15-20 minutes– Remove clothing, jewelry that may have come
in contact with poison
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First Aid for Poisoning
If poisoned by injection (insect/snake)– If extremity is affected LOWER the extremity
BELOW the level of the heart– Insect bite: Remove stinger by scraping the
stinger with edge of credit card or similar device
– Insect bite: DO NOT ATTEMPT TO REMOVE STINGER WITH FINGERS OR TWEEZERS – you will likely inject more poison by squeezing stinger
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First Aid for Poisoning
If poisoned by injection (insect/snake)– Insect bite: Wash area with soap and water
– Ticks: Use tweezers and slowly pull tick away from skin
– Snakebite: Wash wound with soap and water and immobilize the area
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First Aid for Poisoning
If poisoned by injection (insect/snake)– Snakebite: Wash wound with soap and water
and immobilize the area– Snakebite: Do NOT cut the skin (and suck
out the poison)– Snakebite: Do NOT apply tourniquet– Snakebite: Monitor respirations closely and
provide artificial ventilations if needed– Snakebite: Get medical help quickly
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Providing First Aidfor Burns
Injury caused by fire, heat, chemical agents, radiation, and/or electricity
Classifications of burns– First-degree or superficial (redness)– Second-degree or partial-thickness (blister)– Third-degree or full-thickness (burned tissue)
(Some burn scales include a 4th degree, which is a more specific “3rd” degree.)
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Treatment Objectives
Remove source of heat Cool the skin Cover the burn Relieve pain Observe for and treat shock Prevent infections – cover with cleanest
cloth and soak with cool/cold water (seek medical attention)
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Treatment
First Degree Burns Usually not required for first-degree burns Removing source of heat Cool area down (water) Light coat of antibiotic ointment Cover is needed (shade) Assess and treat for signs of shock (Pain)
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Treatment
Second Degree Burns Second degree burns will blister DO NOT rupture blister! Remove source of heat Cool area with cool water Cover (dressing) Assess and treat for shock (Very painful!)
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Treatment
Third Degree Burns Third degree burns involve extensive
tissue, muscle and possibly bone damage. Remove source of heat Cover (dressing) Assess and treat for shock Pain may be less (damaged nerves)
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Treatment
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Chemical Burns
Chemicals splashed on skin or eyes– Flush affected area with large amounts of
water for 15-30 minutes or until medical help arrives
– For eyes: turn victim towardaffected eye to prevent chemical from going intounaffected eye.
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Providing First Aidfor Heat Exposure
Overexposure to heat may cause a chemical imbalance in the body
Water & salt are lost through perspiration Also occurs when body cannot eliminate
excess heat Life-threatening
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Heat Cramps
Muscle pains and spasms Caused by exposure to heat Loss of water and salt from perspiration Apply firm pressure on cramped muscle to
provide relief Encourage rest and move to cooler area Small sips of water or electrolyte solution
(e.g., sports drink)
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Heat Exhaustion
Occurs when exposed to heat and there is loss of fluids through sweating
Signs and symptoms– Pale, clammy skin– Diaphoresis– Fatigue– Headache– Muscle cramps– Nausea/Vomiting
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Heat Exhaustion
First aid care– Move victim (if safe to do so) to cooler area– Lay victim down, raise feet– Remove excess clothing– Apply cool, wet clothes– Small sips of water– Do not dry sweat from victim’s body
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Heat Stroke
Prolonged exposure to high temperatures Medical emergency Needs immediate care! Body unable to eliminate excess heat
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Heat Stroke
Signs and symptoms– Red, hot DRY skin– Rapid, but strong pulse– Victim may lose consciousness– Seizures
First aid care– Cool body quickly
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Heat Stroke
First aid care– Cool body quickly– Tub of cool water– Ice or cold packs to wrists, ankles, axillary
areas and groin– Assess and treat for shock– Seek medical help immediately
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Providing First Aidfor Cold Exposure
Exposure to cold external temperatures can cause body tissues to freeze and body processes to slow down
Needs immediate attention Degree of injury affected by wind velocity,
amount of humidity, and length of exposure to cold
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Hypothermia
When body temperature is less than 95 degrees Fahrenheit or 35 degrees Celsius
Caused by prolonged exposure to cold Elderly more prone to hypothermia than
younger persons
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Hypothermia
Signs and symptoms– Shivering– Numbness– Drowsiness– Poor coordination– Confusion– Loss of consciousness
Death can occur if body processes become too slowed down
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Frostbite
Actual freezing of tissue fluids with damage to the skin and underlying tissues
Caused by exposure to freezing or below-freezing temperatures
Early signs and symptoms– Redness and tingling of affected areas– Pain to affected areas
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Frostbite
Other signs and symptoms as progresses– Pale, glossy skin– White or grayish colored skin– Blisters– Loss of all sensation– Confusion– Lethargy– Unconsciousness
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Frostbite(continued)
Objectives of first aid– Gradual warming of tissues– Do not rub or massage affected areas– Assess and treat for shock
Common sites: fingers, toes, ears, nose, cheeks
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Providing First Aidfor Bone and Joint Injuries
Variety of injuries can occur Frequently occur during accidents, falls,
and among athletes Examples: fractures, dislocations, sprains,
and strains May have more than one type of injury to
bones and joints at the same time
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Fracture
Break in the bone Closed or simple fracture
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Fracture
Break in the bone Compound or open fracture
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Fracture
Break in the bone Signs and symptoms
– Not always obvious– Pain– Deformity– Swelling– Tenderness– Discoloration– Protrusion of bone through skin
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Dislocation
When the end of the bone is displaced from a joint or moved out of its normal position within a joint
Tearing or stretching of ligaments, muscles, and other soft tissues also frequently occurs
Signs and symptoms First aid care
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Dislocation
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Sprain
Injury to the tissues surrounding a joint Common sites: ankles and wrists Signs and symptoms Frequently resemble fractures or
dislocations – treat as fracture if in doubt First aid care
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Sprain
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Strain
Overstretching of a muscle Caused by overexertion or by lifting Frequent site: back Signs and symptoms First aid treatment
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Splints
Devices used to immobilize injured part Types of splints
– Pneumatic or air splints– Padded boards– Traction splints
Splints can also be made from cardboard, newspapers, pillows, boards, etc.
Splints
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Pneumatic - Air
Traction
Padded
Pneumatic - Vacuum
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Splints(continued)
Need to be long enough to immobilize the joint above and below the injured area
Should be padded Tied in place Apply as not to create pressure on area If open wound, control bleeding before
applying splint
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Splints(continued)
Never attempt to reposition bone Splint before moving victim Observe precautions when using
pneumatic splints (overinflating) Traction splints – Only trained personnel
are to apply traction splints
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Circulation Check After Splint
Verify that the splints are not too tight Check skin temperature Check color Note swelling or edema Numbness or tingling Check pulse If circulation impaired, immediately loosen
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Slings
Commercial slings Triangular bandages Use: support arm, hand, forearm,
and shoulder Positioning of sling Check circulation Limit movement of limb
Slings
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Slings(continued)
If use knots– Placement – “short end” of triangular bandage
should extend back and under the elbow of the injured arm
– Padding
Special considerations for shoulder injury
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Checkpoints for Circulation
Check circulation after bandage applied Signs of poor or impaired circulation
– Swelling or edema– Pale or cyanotic color– Coldness to touch– Numbness or tingling– Poor or slow capillary refill
Loosen bandage immediately if warranted
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Neck or Spine Injury
Most dangerous types of injuries involving bones and joints
Movement can result in permanent injury resulting in paralysis
Avoid any movement of victim if at all possible
Wait for backboard and adequate help to arrive for transfer
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Eye Injuries
Always involves danger of vision loss Usually best to avoid giving
major treatment Obtain help of a specialist Foreign objects in the eye Blows to the eye Penetrating injuries that cut eye tissue
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Ear Injuries
Can result in rupture or perforation of eardrum
Torn or detached tissue Ruptured or perforated eardrum Clear fluid or blood-tinged fluid draining
from ear
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Nose Injuries
Nosebleeds are usually more frightening than serious
Nosebleeds also called epistaxis Causes of nosebleeds First aid care
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Abdominal Injuries
Can cause damage to internal organs and bleeding in major blood vessels
Intestines and other abdominal organs may protrude from open wound
Medical emergency Bleeding, shock, and damage to organs
can be fatal Signs and symptoms First aid care
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Seizures
Strong involuntary contraction of muscles Electrical storm of the brain – uncontrolled
nerve impulses Causes – tumor, trauma, febrile, genetic
medical condition (epilepsy) Progression of a convulsion (aura) First aid care is directed at preventing
self-injury
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Seizures
Time seizure Clear area Do not place anything in mouth Place victim on side protect airway
(prevent aspiration) Loss of bowel/bladder control Reassure victim once seizure ceases
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Diabetes Mellitus
Metabolic disorder caused by lack of or insufficient production of insulin
Diabetic coma (sustained hyperglycemia, low insulin production)
Insulin shock (high level of insulin, low sugar)
Differentiate between diabetic coma and insulin shock
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Summary
Proper first aid can save a life Provide only care you are qualified
to provide Always reassure victim and avoid
unnecessary stress and movement Obtain medical help as quickly as possible
Thank goodness we are DONE!!!!!
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