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2

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CPR

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idAction Plan

D anger

R esponse

A irway

B reathing

C PR

D efibrillation

S end for help

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idDRSABCD

Danger

Check for dangers to:

Yourself

Bystanders

Casualty

Walk 360o around the casualty

Use all 6 senses

Smell

Sight

Taste

Touch

Listen

Common Sense

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Response

Is the casualty responsive?

C an you hear me?

O pen your eyes

W hat‟s your name?

S queeze my hands and let go

If the casualty is not responsive, and fluid is suspected in the

airway, roll the casualty into recovery position

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Send for Help

Dial 000

Be prepared to give the following information

Location of the emergency (including nearby landmarks,

closest intersections etc..)

The telephone number from where the call is being made

What happened

How many persons require assistance

Condition of the casualty

What assistance is being given

Any other information requested

** Never hang up before the emergency services operator hangs

up **

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Airway

Open the airway

Tilt the casualty‟s head back to remove

tongue from the airway

Clear the airway

Check to see the airway is free from

obstructions

In an unconscious victim, care of the airway takes precedence

over ANY injury

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Breathing – Normal Breathing?*

Check for signs of life

consciousness, responsiveness, movement

and normal breathing

Look, Listen, Feel

Look - for rise and fall of the chest

Listen - for breathing noises

Feel - for rise and fall of chest

and for breath on cheek

* For drowning related emergencies give 2 rescue breaths prior to

commencing CPR

Watch for rise and

fall of the chest

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C PR - 30 : 2

If no signs of life are present give

30 chest compressions,followed by 2 breaths

Centre of the chest

♥ Compressions applied too high are ineffective

♥ Compressions applied too low may cause regurgitation &/or

damage to the vital organs

The centre of the chest (sternum) should be depressed by a

third of the chest depth

Push FIRM

Push FAST

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2 Breaths

Pistol gripTake a breath for

yourself

Breath into

patient

Watch for rise and

fall of chest

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Automated External Defibrillator

Attach AED (if available) as soon as possible and follow the

prompts

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idDRSABCD - Defibrillators

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D – DangersCheck for dangers

R – ResponseCheck for response

No response

S - Send for helpCall 000

A – AirwayOpen AirwayClear the airway no

yesB – BreathingLook, Listen & Feel for breathing

Responsive? Breathing normally?

D – DefibrillationAttach AED (automated external defibrillator)

and follow prompts

Place in recovery position

Monitor vital signs

Provide oxygen

C – CPRGive 30 chest compressions

Followed by 2 breathsContinue until qualified help arrives

or normal breathing returns

For drowning related emergencies give 2 rescue

breaths prior to commencing CPR

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Mouth to mouth

Used when no pocket mask is available

Mouth to mask

Should always be used by First Aiders

Minimises transfer of communicable diseases

Provides mouth to mouth & nose resuscitation

Mouth to nose

Can be administered in deep water

Mouth to mouth and nose

Used to resuscitate infants

Mouth to mouth and nose

Breath is applied to both the mouth and nose

Done to infants

Mouth to neck stoma

Breath is applied to tube in neck

Rescue Breathing

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idTechniques

ADULTS CHILDREN INFANTS

Head Tilt: Full Full Neutral

Breath Size: Rise and fall of the chest

Compression

Depth:1/3 depth of the chest

Compression

Point:Visual – Centre of the chest

Compression

Method:2 Hands 1 or 2 Hands 2 Fingers

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CPR is the technique of rescue breathing combined with chest

compressions

The purpose of CPR is to temporarily maintain a circulation

sufficient to preserve brain function until specialised treatment is

available

CPR should be continued until:

Signs of life return

Qualified help arrives and takes over

It is impossible to continue

Danger returns

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ADULTSAged 8 years old

plus

30 compressions

2 breaths

5 cycles in 2 minutes

Almost 2 compressions per second

“Thirty & Two That’s All You Do”

CHILDRENAged 1 year old to 8

years old

INFANTSAged up-to 12

months

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Multiple rescuers

It is recommended that frequent rotation of rescuers

is undertaken to reduce fatigue

Approximately every 2 minutes

“Thirty & Two That’s All You Do”

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idDRSABCD - infant

D anger

The assessment for danger remains the same

R esponse

Make loud noises such as clapping

Blow air in the infants face

Run fingers along the arches of the feet

Place finger inside of hands

S end for Help

Call 000

A irway

Both mouth and nose should be cleared

Nose can be cleared using the „milking‟ technique

Open airway is achieved with head in neutral position

B reathing – Normal Breathing

Look, listen and feel

Check for signs of life

C PR

30 compressions followed by 2 breaths Mouth-to-mouth-and-nose rescue breathing

2 fingers on lower half of the sternum

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Vomit

A voluntary response

Abdominal muscular contraction occurs

Removal is often forceful and projectile

Often appears “chunky”

A good sign – something is working

Regurgitation

An involuntary response

The stomach distends

The contents ooze out

Often appears “frothy”

A bad sign – often caused by:

Over inflation

Insufficient head tilt

Not allowing enough time

between breaths

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If the casualty vomits or regurgitates during resuscitation they should

immediately be rolled onto their side and airway cleared. If no signs of life

are present, rescuer should continue with rescue breathing and

compressions.

If regurgitation is suspected you may be required to adjust:

Head tilt

Breath size

Breath frequency

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idDRSABCD - Choking

Choking can be present in a conscious or unconscious casualty

Varied severity

Some typical causes:

Relaxation of the airway muscles due to unconsciousness

Inhaled foreign body

Trauma to the airway

Anaphylactic reaction

May be gradual or sudden onset

Some of the signs in a conscious casualty:

Anxiety, agitation, gasping sounds, coughing, loss of voice, clutching at

neck with thumb and fingers

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Mild Obstruction

Breathing is laboured

Breathing may be noisy

Some escape of air can be felt from the mouth

Severe Obstruction

There may be efforts at breathing

There is no sound of breathing

There is no escape of air from nose &/or mouth

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The simplest way to determine the severity of a foreign

body airway obstruction is to assess for ineffective or

effective cough

Effective cough (Mild Airway Obstruction)

Give reassurance

Encourage to keep coughing

If obstruction is not relieved, rescuer should CALL 000

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Ineffective cough (Severe Airway Obstruction)

Conscious victim:

CALL 000

Perform up to 5 sharp back blows

Heel of hand between shoulder blades

Check for removal of obstruction between each back blow

If back blows aren‟t successful, perform up to 5 chest thrusts

Use CPR compression point

Similar to CPR compressions but sharper and delivered at a

slower rate

Check for removal of obstruction between each chest thrust

Continue to alternate between back blows and chest thrusts if

obstruction is not relieved

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Ineffective cough (Severe Airway Obstruction)

Unconscious victim:

CALL 000

If solid material is visible in the airway sweep it out using

your fingers

Commence CPR

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Assess Severity

Call ambulance

Give up to 5

Back Blows

If not effective

Give up to 5

Chest Thrusts

Encourage Coughing

Continue to check

victim until recovery

or deterioration

Call ambulance

Conscious

Effective Cough

Mild Airway Obstruction

Ineffective Cough

Severe Airway Obstruction

Unconscious

Call ambulance

Commence CPR

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Left Lateral Tilt

When a heavily pregnant women is lying on her back, the

foetus can compress a major blood vessel of the mother

(inferior vena cava).

This can be minimized by providing sufficient padding

under her right buttock, to provide an obvious pelvic tilt to

the left whilst leaving the shoulders flat on the floor.

“Mothers are always right, padding the right buttock”

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Talking in an untrained bystander

If you believe that there is a responsible bystander that you could use for 2-operator CPR and the casualty would benefit more from receiving 2-operator CPR, you have the choice of talking in an untrained bystander in the situation that you do not have a second trained person to assist.

There are many ways to approach talking in an untrained bystander. Some examples:

Ask whether the bystander is prepared to help

Establish whether they have any first aid experience

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Ask them to kneel on the opposite side and place hands on the ground and do what you are doing

Ask them to place their hands on top of yours to gauge the depth of compressions

Ask them to count the compressions for you

Ask them to place their hands on the patient and compress with you

When you believe they are ready, let them take over the compressions

Do not rush the change over

The experienced rescuer must always remain at the head

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First Aid

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Definition : Emergency care provided for injury or sudden

illness before medical care is available

The 5 P’s

Preserve life

Prevent further injury

Protect the unconscious

Promote recovery

Procure medical aid (access medical aid)

Aims

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Responsibilities of the first aid provider

Ensure personal health and safety

Maintain a caring attitude

Maintain composure

Maintain up to date knowledge and skills

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idApproach to an incident

Approach to an incident:

Primary survey

Assessment of vital signs

Secondary survey

This approach will:

Reduce risk to yourself or others becoming victims

Provided a more thorough examination

Prioritise the victims injuries so as to enable management in

order of severity

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idO H & S

Occupational First Aid Provider

Duties may include:

Provision of first aid

Maintenance of first aid kits and facilities

Identification of potential hazards

Maintenance of records & other tasks

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Duties of Employers

Employers are expected to make every reasonable effort

to provide a safe & healthy workplace. This involves the

provision of safe equipment, safe plant, safe procedures,

appropriate training and welfare facilities

Duties of Employees

Employees are expected to make every reasonable effort

to secure the health and safety of both themselves and

others at work

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idFirst Aid Kits

Pocket mask Gloves (disposable) Telephone numbers of

emergency services

First Aid manual Cotton bandages (various

sizes)

Triangular bandages

Adhesive tape Sterile wound dressings

(various sizes)

Sterile saline (for wound

irrigation)

Sterile eye pads Scissors Notebook

Alcohol swabs Accident report forms Pens

Additional Items (home or specialized kits)

Sun Screen Tweezers Vinegar

Asthma reliever &

spacer

Space blankets Band-Aids

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idCross Infection

Can be minimized by:

Attempting to avoid contact with blood and other bodily fluids

Use of protective devices such as disposable gloves & resuscitation masks

Being vigilant for sharp objects such as syringes or broken glass

Always washing hands thoroughly following, & if possible prior to the provision of first aid

Being immunized against communicable diseases such as hepatitis B

Seek medical advise in the case of exposure

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idLegalities

There is no legal obligation to act as a “Good Samaritan”. You may

have a moral obligation to help someone in need, otherwise you may

owe a duty of care.

Duty of Care

Common examples: Teachers Students

Employer Employees

Gym Instructor Gym Patrons

Motorist Other Motorists & Pedestrians

A duty of care is established:

If it is a legal obligation &/OR

Once first aid begins

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Negligence

For a First Aid provider to be found negligent (civil liability), the

following need to be considered:

Did the provider owe a duty of care to the casualty

Did the provider act outside their level of training (standard of care)

Did the provision of First Aid result in damage or loss to any

persons or property

Consent

Consent must be gained before initiating any first aid

Verbally ask for permission/consent

If a minor, ask parent or guardian

If unconscious, consent is assumed

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All items included in reports must be factual, and not express

personal opinion

Example:

The casualty appeared intoxicated

INCORRECT

Vs.

The casualties breath smelt „fruity‟

CORRECT

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As everyone deals with trauma in their own way it is very

important to complete your individual report immediately

Then follow this up with a debrief

Your employer will offer you counselling or there are alternatives

such as local hospital, police, grief counselling services (refer

yellow pages) or LSV. This should be done as soon as possible

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idVital Signs Survey

Vital Signs Survey

Checking the casualties vital signs at regular intervals (e.g., 1 minute)

Breathing rate and depth

(Average adult 10-20 breaths per minute)

(Average infant 30-50 breaths per minute)

Heart rate

(Average adult resting 60-90 beats per minute)

(Average child resting 70-110 beats per minute)

(Infants resting up to 150 beats per minute)

Responsiveness

Hearing, movement in the eyes

Able to answer questions, movement from limbs

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Secondary Survey

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idSecondary Survey

We are looking for:

B leeding

B urns

F ractures

O ther things - Signs & Symptoms

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Assessment of responsive casualty (DOLOR)

Description

Ask the casualty to describe the problem

Onset & Duration

Ask the casualty when the problem arose & how it has

progressed

Location

Ask the casualty where on the body the problem is

Other Signs and Symptoms

Signs: Things you can see

Symptoms: Things the casualty can feel

Do you notice any other signs?

Is the casualty aware of any other symptoms?

Relief

Has anything provided relief? e.g, rest, position or medication

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idSecondary Survey

Head

Look and feel for bleeding and bumps

Check for fluid discharge from ears and nose

Check the eyes for any signs of injuries

Neck

Look at and feel the back of the neck gently

for tenderness & irregularities. If there are

any concerns of potential spinal injuries, do

not move the victim, unless they become

unresponsive or are in immediate life

threatening danger

ASSESSING Conscious / Unconscious casualty

head to toe examination

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idSecondary Survey

Back/Chest/Abdomen

Ask a responsive victim to inhale deeply and see if it causes discomfort

Look at & feel the chest, back and abdomen for irregularities & tenderness

Limbs

Look for an injury &/or deformity

Check from the extremities moving toward the trunk, feeling for irregularities

Check for altered strength and sensation

Check gloves after each section for bodily fluids

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idPrioritising Casualties

Treat unconscious casualties first because they are

unable to protect their airway or protect themselves

from external dangers

Triage – prioritise casualties in order of urgency of

management

Multiple casualties

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Medical Emergencies

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Fainting is caused by an inadequate blood supply to the brain.

It‟s reduced in severity compared to shock.

Shock is caused by lack of oxygen supply to the vital organs.

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Causes of Fainting

Prolonged periods of standing

Emotional distress

Low fluids or food

Causes of Shock

Heart failure

Inadequate blood volume/blood loss

External or internal bleeding

Leaky or dilated vessels

Inadequate O² in blood

With Shock the body responds by:

Vasoconstriction

Increased heart rate

Increased breathing rate

Fainting and Shock

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Signs & Symptoms – Fainting & Shock:

Tingling (poor circulation)

Light-headedness, dizziness

Nausea

Pale, cold clammy skin

Brief period of unresponsiveness (1 to 2 minutes)

Rapid, weak pulse & Rapid, shallow breathing

Altered responsiveness

Thirst

Weakness

Collapse

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Management of Fainting and Shock

Primary survey

Lay victim down with legs elevated

Treat cause, if possible (i.e. bleeding)

Reassurance

Monitor & record vital signs

Provide oxygen, if able

Maintain thermal comfort

Seek medical assistance

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idEasy to remember treatment

If the face is pale raise the tail,

If the face is red raise the head,

If the face is blue they’re almost through.

The easiest way to remember the treatment of Fainting or Shock is:

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Blood Vessels

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Blood Vessels – Types

ARTERIES : carry oxygenated blood through the body from the

heart to all other organs

VEINS : carry the carbon dioxide rich blood from the organs to

the heart

CAPILARIES : are the smallest blood vessels where the

exchange of the O² to the CO² happens

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Bleeding

ARTERIES :

Rapid & profuse (usually spurts)

Bright red

VEINS :

Flows from wound at steady rate

Dark red

CAPILARIES :

Gently oozes from wound

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Plasma (50-60%)

♥ Contains salts, sugar, etc

Red blood cells (40-50%)

♥ Contain haemoglobin to carry oxygen

White blood cells

♥ Fight infection

Platelets

♥ Clotting agents

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Wounds

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Abrasions

Scrapes on the surface of the skin with damage to small capillaries

Lacerations & Incisions

Cuts, usually caused by sharp objects such as a knife or piece of glass

Lacerations have ragged edges

Incisions have smooth edges

Avulsions

Where a flap of skin &/or flesh has been totally or partially removed

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Puncture Wound

Occurs when a sharp, pointy

object has penetrated the flesh

Embedded Object

Wound with an embedded

object still in place

Amputation

Occurs when a body part has

been severed

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idMinor Wounds

Definition:

Superficial

Small surface area

(<2.5cm)

Bleeding ceases quickly

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Seek medical attention if:

There is any doubt about the severity of the wound

The wound cannot be easily cleaned

Infection is a concern (there is a greater risk of infection with

large abrasions)

Stitches may be required

Tetanus immunisation may be necessary

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Management

Wash in clean, running water

Clean thoroughly, take special care with large abrasions to

ensure any debris is removed

Dry using sterile gauze

Cover with a clean dressing

Minor Wounds

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idMinor Wounds

Avulsions:

Flap of skin should not be

removed unless it‟s very small

Large flaps of skin or

appendages should be returned

to normal position before applying

the sterile dressing / bandage

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Nose Bleeds

Nose bleeds may occur as a result of a direct trauma

or may occur spontaneously.

Management

Ask the casualty to firmly squeeze the fleshy part of the nose, below the bone

Position the casualty sitting upright, with their head slightly forward

Ask the casualty to breathe through their mouth and avoid swallowing any blood (can cause vomiting)

Seek medical aid if the bleeding time exceeds 10 minutes

It is best not to apply pressure to a suspected broken nose

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idMajor Wounds

Pressure

Elevation

Rest

If bleeding continues through the pad:

Apply another pad and bandage (over the original pad and

bandage)

Remove pad and bandage and replace if bleeding still continues

Apply pressure near the artery

Management

Conduct a primary survey & act accordingly

Apply direct pressure to the wound site

Apply a sterile dressing, followed by a pad & bandage where

possible

Elevate injured site if possible

Call the ambulance (if required)

Keep casualty still and reassure them

Monitor vital signs and treat for shock if required

Provide supplemental oxygen (if able)

Seek medical attention (if required)

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Puncture Wounds

With a deep puncture wound, even though external bleeding

may be minimal, there is a risk that internal organs may have

been damaged. There is also a high risk of infection so

medical aid should be sought.

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Embedded Objects

Sometimes objects are embedded at

the wound site. Where possible, these

objects should be left in place.

Attempting to remove the object can

cause further damage can exacerbate

the bleeding.

Management

Apply pressure to the wound site

Elevate the affected area

Apply a ring/donut bandage around the object

Dress around the wound without applying

pressure to the embedded object

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Amputations

Management of the stump

Refer to general wound management

Management of the Severed Part

Wrap the body part in a clean, sterile, non-adhesive dressing if possible

Place the body part in a sealed plastic bag or container

Place the sealed body part in a container of icy water

Do not allow part to come into direct contact with ice or water

Seek urgent medical assistance

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A crush injury involves changes in blood, decreased

volume of fluid in the blood vessel (hypovolemic shock),

and kidney failure. Generally the victim is protected from

these effects until the crush object is released.

Crush Injury

Management

ARC guidelines recommend if safe and physically

possible, all crushing forces should be removed

as soon as possible after the crush injury.

If a crushing force is applied to the head, neck,

chest or abdomen and is not removed promptly

death may ensue from breathing failure, heart

failure or blood loss.

DO NOT use a tourniquet for the first aid

management of a crush injury.

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Internal bleeding may be suspected, depending on:

Type of trauma the victim has undergone

Victim‟s past medical history (e.g., stomach ulcers)

Victim has signs and symptoms of shock

Pain and swelling in the affected area

Coughing up blood, „dark brown‟ blood in vomit or excretion of

blood from urinary or digestive system

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idInternal Bleeding

Management

Seek urgent medical aid

Conduct a primary survey and act accordingly

Lay casualty down, if possible, and raise legs slightly

Keep still and reassure

Thermoregulation

Provide supplementary oxygen (if able)

Monitor vital signs

Conduct a secondary survey (if appropriate)

Give nothing by mouth

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id

Burns

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idSources Of Burns

Flames

Hot objects

Hot air

Hot water and steam

Chemicals

Radiation

Electricity

Cold

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idWhen To Call 000

Ambulance is recommended for:

A flame burn the size of the casualty‟s palm

Any flame or scald burn involving the hands, face, perineum or genitals

Any chemical burns

Any electrical burns

Any burns with suspected respiratory tract involvement

Any infant or child with any type of burn

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idTypes Of Burns

Superficial Burn

Only the top layer of skin is involved (e.g. sunburn)

Partial Thickness Burn

The top layer and part of the next layer have been

burnt

Full Thickness Burn

Both outer layers have been damaged, and

possibly the subcutaneous tissue being affected

This can result in damage to fat, muscles, blood

vessels and nerve endings

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Superficial Partial Full

Redness Severe pain Painless

Pain Redness Cracked and dry appearance

Weeping from the burn White or charred appearance

Blistering

Summary Of Burns

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Management

Assess for dangers including flames, chemicals and noxious

gas emissions.

First aid providers should not expose themselves or others to

any of these dangers

Remove victim to safe environment

Conduct a primary survey and act accordingly

Arrange medical aid (as appropriate)

Immediately cool the affected area with water for up to 20

minutes

Only the affected area should be cooled due to the risk of

overcooling the victim (greater concern with infants or children)

Do not use ice (as there is a possibility of sending a person

into shock)

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Remove all rings, watches and other jewellery from the

affected area

Elevate burn limbs (where feasible)

Cover burn area with a clean, sterile, lint-free dressing

Provide oxygen (if able)

Do Not

Peel off adherent clothing

Burst blisters

Apply ointments or lotions

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Management of Burns caused by Flame or Scalding

Remove any covering of material, especially if no water for

flushing is available

Ensure no hot water is trapped within the victim‟s skin folds

(especially children)

Continue to cool the site, despite the application of dressing

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Inhalation of hot gases or flame can cause burns along

the respiratory tract that can result in swelling and possible

airway obstruction. In addition, inhalation of smoke and

toxic gases can result in breathing distress and a variety of

serious problems.

Management

Seek urgent medical aid

Conduct a primary survey and act accordingly

Provide supplemental oxygen (if able)

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Sources of Chemical Burns:

Household cleaning agents

Pool or spa chemicals

Gardening and farm sprays

Car batteries

Industrial chemicals

Both acid and base chemicals can damage body tissues,

causing them to release heat. Base burns are more serious

than acid burns as they can penetrate further into the body.

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Management

Avoid/neutralize any dangers

Brush any powdered chemical off victim

Flush with fresh, cool water for 20-30 minutes

Ensure that chemicals are not accessible by children

Always keep Material Safety Data Sheets with chemicals

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Electrical burns can be caused by faulty, or misuse of, electrical

appliances. In some accidents, downed power lines are a potential

source of severe electrical burns.

Consider DANGER when dealing with electrical burns

Turn off power

If power lines are down, avoid coming closer than at least 8-10

meters to the lines

Do not attempt to move power lines, even with non-conductive

material, as at high voltage, electrocution is still possible

Lightning strikes cause a large number of deaths each year. If

caught outside in an electrical storm, stay clear of:

Tall trees or poles

Bodies of water

Metallic machinery and objects

Hilltops or open spaces as most lightening strikes occur here

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Electrical burns are characterized by entry and exit wounds, which

may appear minimal. Electricity may have passed through and

damaged internal organs resulting in:

No breathing

Irregular or no heart beat

Damage to internal muscles and tissues

Fractures

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Management

It is important to:

Avoid/Neutralise electrical and other dangers

Conduct a primary survey and act accordingly

Arrange medical aid, as required

Treat burn as appropriate

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Soft Tissue injuries

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DEFINITION

A fracture is a break in a bone. Sometimes a fracture may be a single,

clean break or there may be a number of breaks.

Children often suffer a “greenstick” fracture, which is the splintering of a bone.

Fractures are usually defined as either:

CLOSED

Where the overlying skin is unbroken OR

OPEN

In which case there is an open wound at the fracture site the fracture can

also cause damage to underlying organs – this is known as a

COMPLICATED fracture. Serious internal bleeding can result from fractures of major bones such as the femur or pelvis.

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CAUSES

Direct force

A bone is broken at the site of impact

Indirect force

A bone breaks some distance from the point of impact as a result of pressure

E.g. arm breaks from bracing a fall by putting hands out

Abnormal muscular contraction

A fracture can occur due to a “sudden” muscular contraction.

This is often associated with electrocution

RECOGNITION

Pain at or near the site of

fracture

Difficulty/inability to move

the injured part

Swelling

Deformity

Grating of bone

Tenderness

Possible shock

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RESPONSIVE CASUALTY

Conduct a primary survey & act accordingly

The main aim is to prevent any movement at the site of the fracture

If unsure, keep the casualty still & comfortable and call the ambulance

Immobilise the joint above or below the fracture site, if possible

Splint in a position of comfort for the victim

Do not attempt to realign a badly deformed limb.

Where possible, an immobilized fractured limb should be elevated

Treat for shock

Support a fractured jaw with the hand

If necessary, pull the lower jaw forward to keep the airway open

First Aid Providers may need to Improvise

Tie shoelaces together to avoid feet moving when a fractured foot is suspected

Use a long sleeve t-shirt to support arm by pulling arm through top and over shoulder

Using a branch as a splint

UNRESPONSIVE CASUALTY

Arrange urgent medical assistance

Immediately place the victim in the

recovery (lateral) position

Conduct a primary survey & vital

signs survey, and act accordingly

Provide supplemental oxygen (if

able)

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Arise after trauma to a site

Trauma usually occurs as a result of a blow to the area

Underlying blood vessels are damaged & dark, purple discolouration arises at the site

Changes colour as it starts to heal (yellowish green) as the water material is naturally removed

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Sprains:

Occur at the joint

Usually occurs as a result of stretching and possibly tearing of the ligaments or other tissues at the joint

Swelling at the site quickly follows the injury to the joint

This acts as a protective mechanism to stop further movement at the site

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Strains:

Usually associated with muscles & tendons which attach the muscle to the bone.

Can be caused by overuse or putting excessive load on a muscle or muscle group.

It can also occur if muscles are not warmed up properly prior to strenuous use.

Varied severity

Mild discomfort with minor muscle

damage

Complete tearing of the muscle

resulting in loss of use

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R I C E R / D

MANAGEMENT

R est

Ensure no further stress is placed on the injury

I ce

Apply an ice pack or cold compress to the injured site

Ice pack or cold compress should be wrapped in a damp cloth, rather than being applied directly to the skin

The pack/compress should be applied for 10-20 minsON/OFF

Ice should not be applied to the head, genitals or nipples

Ice can be applied for approx 48 hours after injury

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C ompression

A compression bandage should be applied to the injured area

The bandage should not be so tight as to restrict circulation

E levation

The injured area should be elevated to minimise swelling and facilitate the healing process

D iagnosis or R eferral

Medical advice should be sought if you are at all unsure of the extent of the injury

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Spinal Injury

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The spine consists of the spinal column and

the spinal cord.

The column is made up of a series of bones

called vertebrae, separated by cartilage known

as discs. These discs act as shock absorbers

during movement.

The spinal cord is made up of bundles of

nerves and passes through holes in the

vertebrae. It acts as a pathway for impulses

between the brain and the rest of the body,

and is also involved in reflex actions. Nerve

tracts run from the spinal cord, through the

gaps in the vertebrae to various parts of the

body.

DEFINITION

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Injuries to the spine may involve the body spinal column or the cord, or both.

Injuries to the spinal cord may arise through fractures in the vertebrae causing damage to the cord, which can be compressed or severed (partially or totally). Injury can worsen as a result of swelling and bleeding at the site.

There is also the potential to worsen some spinal injuries by inappropriate handling of the casualty.

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Spinal injuries are most often associated with motor vehicle and diving accidents, but can also be caused by a number of other mechanisms.

When assessing the casualty, the best indicator of a possible spinal injury is the history of the accident.

Spinal Injuries

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What happens to the spine when injured

C1-C7 Quadriplegic (neck down)

T1-T12 Paraplegic (with additional damage to nerves)

L1-L5 Paraplegic (waist down)

S1-S5 Sacral

CX1 – CX4 Coccyc

BREAKDOWN

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Depending on the extent

of the spinal injury this is

what area of the body can be

affected.

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Incidents with high likelihood of spinal injury

Victim falling, or having an object fall upon them, from a

distance greater than the casualty‟s height

Any penetrating injury, or injury involving major blunt force to

the head, neck or trunk

Any accident involving a pedestrian, cyclist, motorcyclist or

casualty thrown from a vehicle

Diving and surfing accidents

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History of the incident

Pain or discomfort in the neck or back region

Altered sensation, movement or strength in the limbs or trunk

Irregular bumps on the neck or back

Slow pulse rate (50-60bpm)

Diaphragmatic breathing

Erection in injured males (priapism). Also occurs in females

Does not necessarily mean no movement possible

RECOGNITION

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If responsive:

Conduct Primary, Vital Signs and Secondary Surveys and act accordingly

Use double trapezius grip and log roll to move casualty

Arrange urgent medical assistance

Keep the casualty still and reassure them

Thermoregulation Minimise any movement of the

head and spinal column Manage any other injuries Provide supplemental oxygen (if

able)Avoid YES/NO questions

Ask WHEN, WHERE, HOW, WITH WHO questions

Avoid DOES, CAN, IF & IS questions

If unresponsive:

Arrange urgent medical assistance

Conduct a Primary Survey and act accordingly

Use jaw thrust method for Rescue Breathing if required

Support the victims head and neck, avoiding any twisting or forward movement of the neck (jaw thrust)

Thermoregulation Continually monitor vital

signs

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Bandaging

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How to make a collar and cuff sling

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How to make a donut bandage

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The Elevation sling

Place bandage with apex pointing to elbow

over the arm. Tuck in under the arm, then

twist both ends. Tie off the two ends on

the uninjured side.

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Lower Arm sling

Place bandage with apex to elbow over

patients chest. Bring opposite end over

patients arm and tie off on uninjured side.

Twist remaining bandage at elbow and tuck

in.

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Head bandage (pirate hat/scarf)

Place long edge of the bandage above the

eyebrows across the forehead. Pull down the

apex to the nape of the neck. Bring the two

long ends to the back criss-cross and tie off.

Tuck in the excess bandage in at the base of

the head.

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Hand bandage (glove)

Fold over the end of the bandage and place over knee. Place fist on

top of the bandage, bring loose end over the fist. Criss-cross the two

sides over the fist bringing the loose bit off the tie over the criss-cross

again and tie off.

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Fractures / breaks

Place the patients injured part on a splint, ask patient to assist in

supporting the limb in order to minimise the pain they are

experiencing. Using a long bandage (triangular), tie off above and

below the break leaving injured area exposed.

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Immobilisation

Place injured limb still in a comfortable position. Place a splint

between the limbs bring uninjured to injured. Using the natural

hollows place bandage in and under the limbs tying off the bandage

on the uninjured side. You can improvise by using patients shoe-

laces, belt, scarf, tie etc if bandages are in short supply.

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Pressure Immobilisation Technique (P.I.T.)

Note: it is a good idea to mark the bite site on the bandage with a

cross to assist medical personnel to locate where the bite is.

Commencing at the bite

site work your way down

to the fingers, leaving

fingernails exposed and

then work back up the

arm covering two-thirds

of the bandage at each

turn of the bandage.

Continue bandaging all

the way up to the

nearest lymph node.

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P.E.R. (pressure, elevation, rest)

Place pad on injured area, commence from bottom moving up over

lapping ends of roller bandage. Once completed tie off and elevate