First Aid/cpr

Front 1

Duty to Act

Back 1

A legal responsibility of certain people to provide a reasonable standard of care when called upon or presented with the opportunity to do so

Front 2

Negligence

Back 2

The failure to perform an action that a reasonable prudent person would do. Your performance will be based on what any other individual with similar education and experience would do under similar circumstances.

Front 3

In order to establish negligence, the court must decide that:

Back 3

1. There was a duty to act.
2. There was a breach of duty
3. Damage occurred
4. There was immediate cause – the injury that the patient suffered was caused by your actions or inactions.

Front 4

Act of Commission

Back 4

You do wrong from which serious medical complication develops.

i.e. perform some medical treatment not trained or certified to do

Front 5

Act of Omission

Back 5

You fail to do something that should have been done.

i.e. Fail to check for safety of different playing areas, check equip., failure to refer victim.

Front 6

What are the six Vital Signs?

Back 6

1. Blood Pressure
2. Pulse Rate
3. Respiration Rate
4. Pupils
5. Body Temperature
6. Skin Color

Front 7

Vitals

Blood Pressure

Back 7

Measured by a sphygmomanometer (B.P. cuff)

1. Systolic – pressure against walls as heart contracts –usually the “higher” pressure.
-Normal systolic pressure is 120 mm Hg.

2. Diastolic- residual pressure in arterial walls while the heart is between beats.
-Normal diastolic pressure is 80 mm Hg.
*Females usually 8-10 mm/hg lower.

Front 8

Vitals

Pulse Rate

Back 8

The wave of pressure in the blood generated by the pumping of the heart in one minute.
Normal-
Adult (60 – 80)(bpm)
Child (70-115)
Infant (80-140)

Front 9

Vitals

Respiration Rate

Back 9

One breath is the complete cycle of moving air in (inhalation) and out (exhalation).

Adults = 12-20
Children = 15-25
Infants = 20-40

Front 10

Vitals

Pupils

Back 10

Responsiveness to light:
Exposed to light – constrict (get smaller)
Remove light – dilate (get bigger)

*Constricted - drugs/narcotics, heat stroke
*Dilated -shock, heat exhaustion, hemorrhage drugs- cocaine, speed
*Unequal –head injury - stroke

Front 11

Vitals

Body Temp

Back 11

Assess skin temperature by placing the back of your
hand against the patient’s skin.

*Hot/dry - heat stroke
*Cool/moist (clammy) - heat exhaustion, shock

Core temp = 98.6 F
97-100 - low grade fever/virus
100-104 - bacterial/later stages viral

Front 12

Vitals

Skin Color

Back 12

Assess skin color in the nail beds, oral mucosa (inside the
mouth), and conjunctiva (inside the lower eyelid)

For infants/children, assess the soles of the feet or the palms of the hands.

Front 13

Vitals

What do the different skin colors mean?

Back 13

*Red (flushed)- heat stroke or carbon monoxide
*White (Pale) – poor perfusion – lack of effective blood flow reaching tissues.
*Yellow (Jaundiced) – improper liver function
*Blue-Gray (Cyanotic) – lack of oxygen reaching the cells, poor perfusion

Front 14

Cardiac arrest

Back 14

heart stops - no blood, no oxygen – No Pulse!!!

Front 15

Heart attack

Back 15

blockage in a vessel(s) of the heart – tissue damage occurs.

Front 16

Angina

Back 16

heart muscle not receiving proper oxygen – usually goes away with rest and/or nitroglycerin

Front 17

S/S of a Heart Attack

Nine of them...

Back 17

1. Things out of the ordinary (Feeling of impending doom) 2. Erratic/irregular pulse - rapid/slow
3. *Chest pain* - like someone standing on the chest
4. Sick to stomach (Nausea/Vomiting)
5. Headache
6. Denial - says its indigestion, panic attack etc.
7. Pain across back, chest, or arms
8. Sudden onset of sweating
9. Difficulty breathing

Front 18

Care for someone having heart attack

Back 18

1. Call 811/911
2. Get the person to relax (loosen tight clothing)
3. Talk to the person – calm them
4. Tell them help is coming
5. Cover if cold
6. Check and monitor vital signs
7. OPQRST Questions
8. Aspirin Therapy

Front 19

What is OPQRST?

Back 19

0– Onset,
P – Provocation,
Q – Quality,
R – Radiation,
S – Severity,
T - Time

Front 20

Ventricular Fibrillation

Back 20

v-fib - quivering heart -cannot move blood

total disorganized electrical activity in heart

Front 21

Ventricular Tachycardia

Back 21

v-tac – three or more beats in
a row at a rate of 100 beats or more per minute that
originates in the ventricles - cannot pump blood properly

Front 22

Asystole

Back 22

the stopping of all electrical activity in the heart.

1. Not corrected by defibrillation
2. Very unlikely to be resuscitated

Front 23

Two causes of Stroke are:

Back 23

Cerebral Infarction

and

Hemorrhage

Front 24

Cerebral Infarction

Back 24

Thrombus – blood clot forms in a cerebral vessel

Embolus – (an undissolved mass of material i.e. fat globule, blood clot, etc. breaks loose from another site in the body and lodges in a cerebral artery).

Front 25

Hemorrhage

Back 25

Cerebral Hemorrhage – one of the cerebral arteries
ruptures.

Subarachnoid Hemorrhage – one of the brain’s surface
vessels ruptures.

Front 26

S/S of Stroke

14!

Back 26

1.Decreased consciousness
2.Severe headache
3.Drooping eyelid and drooping mouth on one side
4.Paralysis or weakness
5.Respiratory distress
6.Slow, bounding pulse
7.Loss of bowel/bladder
8.Change in personality
9.Unequal pupils
10.Loss of vision, dimness
11.Difficulty speaking
12.Inability to speak
13.Nausea or vomiting
14.Possible seizures

Front 27

Emergency Care for a Stroke Victim

Back 27

1. Handle victim calmly and carefully
2. Don’t increase anxiety
3. Position victim on back with head and shoulders slightly raised
4. Monitor ABC’s
5. Keep victim warm
6. No food or drink

Front 28

Transient Ischmemic Attack (TIA)

Back 28

(MINI STROKES)
*as many as 75% of all thrombus strokes are preceded by one or more TIA(s). Symptoms of a TIA last for less than 24 hours and usually less than 1 hour. TIA’s do not cause nausea or vomiting, and headache is not often present. Most signs and symptoms are similar to those of a stroke.

Front 29

What are the 3 Types of Blood Vessels?

Back 29

Arteries = bright red (hard to control

Veins = dark red (easier to control)

Capillaries = not as bright as arteries (clots easily)

Front 30

How many liters of blood does the human body have?

Back 30

about 5 liters

Front 31

AVULSION

Back 31

a flap of skin that is torn or pulled loose

Front 32

CUT

Back 32

incision (smooth edges) / laceration (jagged edges)

Front 33

SCRAPE

Back 33

abrasion, road rash, rug burn, strawberry

Front 34

PUNCTURE

Back 34

does not usually bleed a lot, therefore easily
infected

Front 35

S/s – Internal Bruising

Back 35

1.Tender, swollen, or abdomen rigidity
2.Anxiety or restlessness
3.Rapid weak pulse
4.Rapid breathing
5.Skin is cool / moist, looks pale or bluish
6.Nausea / vomiting
7.Excessive thirst
8.Declining level of consciousness
9.Rest in comfortable position

Front 36

Treatment of Internal Bruising

Back 36

1. Get him/her to rest in a comfortable position
2. Minimize shock, keep victim from getting chilled/overheated
3. Reassure and comfort victim

Front 37

Dressings

Back 37

Pads placed directly on wound to soak up blood, keep germs out (should be sterile - usually loose to let air in)
If sterile dressing not available - use clean cloth, towel,handkerchief, tie, sock etc.

Front 38

Bandages

Back 38

(Band-Aid, triangular band, roller band) – material
used to wrap/cover any part of body, holds dressing in place; apply pressure which helps control bleeding, support injured part of body

Front 39

Roller Bandage

Back 39

when used to control bleeding, a bandage is called a pressure/roller bandage

Front 40

Care for external bleeding

Back 40

a.Obtain consent
b.Cover wound with sterile dressing
c.Secure bandage over dressing
d.Use overlapping turns to cover dressing completely
e.Tie or tape the bandage in place (try not to cover toes / fingers-check if too tight)
f.Check fingers for warmth color and feeling

Front 41

What happens if blood soaks thru bandages?

Back 41

Apply more dressing/bandage - *removing stops clotting*

Front 42

The musculoskeletal system is composed of:

4

Back 42

1. Muscles
2. Tendons
3. Bones
4. Ligaments

Front 43

Four main types of musculoskeletal injury:

Back 43

1. Fractures
2. Dislocation
3. Sprains
4. Strains

Front 44

Fractures

Back 44

disruption in the continuity of a bone

Closed – little or no movement or displacement of the broken bones.
Open (Compound) – enough movement that bone actually breaks through the surrounding tissues.

Front 45

Dislocation

Back 45

a complete displacement of a bone from a joint

Subluxation – a partial displacement of a bone from its joint (will go back to its normal position most of the time)

Front 46

Sprains

Back 46

Stretching or tearing of a ligament (inelastic band of tissue that connects bone to bone).

Front 47

Strains

Back 47

Stretching or tearing of a muscle or tendon (tough band of connective tissue that attaches muscle to bone.)

Front 48

Things to look for when you have an injured victim: DOTS

Back 48

1. Discoloration
2. Obvious deformity – could tell you if something is fractured or dislocated
3. Tenderness
4. Swelling

Front 49

Care for the injured individual

if the injury is not very
serious – RICE.

Back 49

1.Rest
2.Ice - First ask the victim if he/she is allergic to ice
3.Compression
4.Elevate the injured part -must be done w/o caused more harm
5.Always refer the injured victim to a physician
-liability issue
6.Monitor vital signs and treat for shock

Front 50

Five reasons for splinting

Back 50

1.Prevents further damage to muscle, spinal cord, peripheral nerves, and blood vessels by the broken bone ends
2.Prevents laceration of the skin by broken bones, converting a closed fracture into an open one
3.Prevents restriction of distal blood flow resulting from pressure of the bone ends on blood vessels
4.Prevents excessive bleeding into tissues at the fracture site
5.Prevents against shock by decreasing pain

Front 51

Rules 1-4 for splinting

Back 51

1.The clothing should be removed from the area of any suspected fracture or dislocation – w/o causing more harm
2.Note and record the circulatory and neurological status distal to the fracture site. (capillary refill)
3.In a fracture, the splint should immobilize the joint above andbelow the fracture
4.In a dislocation or sprain, the splint should immobilize the bone above and the bone below the injured joint

Front 52

Rules 5-8 for splinting

Back 52

5.During splinting minimal movement of the limb should be allowed
6.Cover all wounds with a dry, sterile dressing before applying the splint
7.Pad the splint to prevent local pressure
8.Do not move or transport the victim before splinting

Front 53

SHOCK

Back 53

-a state of collapse or depression of the cardiovascular system

Front 54

Review of the Circulatory System – 3 Components – Main Causes

Back 54

1.Working Pump – the heart is damaged so it fails to pump properly
2.Pipes – blood vessels dilate so that blood “pools” in the larger vessels, resulting in a diminished amount of fluid available to provide efficient circulation.
3.Fluid – blood is lost, so there is an insufficient volume of fluid in the circulatory system.

Front 55

7 Types of Shock

Back 55

1. Hypovolemic
2. Neurogenic
3. Anaphylactic
4. Septic
5. Cardiogenic
6. Metabolic
7. Psychogenic

Front 56

Hypovolemic shock

Back 56

Most common form.
---Brought on by a drop in blood volume or body fluids---
-usually caused by hemorrhage – blood loss – hemorrhagic shock
-dehydration from excessive sweating
-excessive vomiting/diarrhea
-excessive loss of fluid by diseased kidneys

Front 57

Neurogenic shock

Back 57

-blood vessels dilate markedly therefore not enough blood to fill them
-B.P. leads to decreased venous return which results in venous pooling (lack of blood flow back to the heart)
-loss of vasomotor tone – primary cause
-caused by deep anesthesia/spinal cord or brain damage/fever

Front 58

Anaphylactic shock

Back 58

-results from an allergic reaction (most severe form)
-antibodies come into contact with substance and release histamine (vasodilator)
-result in a great reduction in venous return leading to blood pooling
S/s – Difficult breathing, swollen tongue, mouth/throat (rash)

Front 59

Septic shock

Back 59

-caused by some form of serious illness and is caused by severe infection
-blood poisoning - system infection
-high fever

Front 60

Cardiogenic shock

Back 60

-Results from heart failure
-cardiac output itself falls too low to supply the body with adequate blood flow
-results in tissue deterioration and death

Front 61

Metabolic shock

Back 61

-loss of fluid from a change in biochemical equilibrium
-insulin shock/diabetic coma

S/s - vomiting/diarrhea

Front 62

Psychogenic shock

Back 62

-blood pressure falls and reduces blood flow to brain
-causes the person to faint (syncope)
-caused by strong emotional excitation
-standing in one position for extended time

Front 63

3 Stages of Shock

Back 63

1. Compensatory stage
2. Progressive 2nd stage
3. Irreversible 3rd stage

Front 64

Compensatory stage

Back 64

As BP begins to drop, HR mechanisms try to correct to normal circulation

Blood vessels constrict to increase BP, usually corrects itself within 24 hrs.

Front 65

Progressive 2nd stage

Back 65

a.Body can only compensate so much
b.In an attempt to keep organs supplied, blood is shunted away from the extremities to the heart and lungs
c.Result is that other tissues produce toxic byproducts – need medical intervention

Front 66

Irreversible 3rd stage

Back 66

a.Organs die or stop functioning
b.Blood shunted away from kidneys/liver to heart/brain
c.Blood vessels are no longer able to sustain the pressure needed to supply heart and brain

Front 67

S/s of Shock

8

Back 67

1.Skin color - pale
2.Dark skinned individuals - grayish color
3.Skin temp – cool clammy/heavy sweating?
4.Pulse – rapid/weak
5.Respiration Rate – shallow
6.Blood pressure – low
7.Pupils – dilated
8.Later stages – loss of consciousness

Front 68

Treatment of Shock

8

Back 68

1. Reassure victim
2. Elevate feet above the level of the heart and head to increase venous return from lower extremity to heart
3.Breathing difficulty – semi-reclining position
4.Control bleeding
5.Minimize pain – splinting fractures
6.Maintain body temperature
7.Traumatic situations – anti shock trousers
8.No food – why?
---complications if surgery is needed (anesthesia)

Front 69

Why are burns serious?

Back 69

1.Infection
2.Lead to fluid loss
3.Lead to a decreased ability to maintain normal body temperature
4.Shock due to pain from exposure to damaged nerves

Front 70

4 mechanisms of causes of burns

Back 70

1. Thermal
i.e. touching a hot stove
2. Electrical
i.e. coming in contact with exposed wires, lightning
3. Chemical
i.e. coming in contact with acid, chlorine, bleach
4. Radiation
i.e. staying in the sun too long

Front 71

Do's of burns

Back 71

DO:
a.Cool a burn by flushing with cool water (except for electrical)
b.Cover the burn with a dry clean cloth covering such as a sterile dressing.
c.Keep the victim comfortable and from being chilled or overheated.

Front 72

Don'ts of burns

Back 72

DON'T
a.Apply ice directly to any burn unless it is very minor.
b.Touch any burn with anything other than a sterile covering.
c.Remove pieces of cloth that stick to the burned area.
d.Break blisters
e.Use any kind of ointment on a severe burn.

Front 73

Three types of burns

Back 73

1st Degree or superficial burns

2nd Degree or partial thickness burns

3rd Degree or full thickness burns

Front 74

1st Degree or superficial burns

Back 74

a.Can be painful because nerves are exposed - swelling may occur.

b.Takes approximately 5-6 days to heal.

Front 75

2nd Degree or partial thickness burns

Back 75

a.Blisters with clear fluid inside. Can be painful. Swelling also may occur.

b.Takes approximately 3-4 weeks to heal.

Front 76

3rd Degree or full thickness burns

Back 76

a.Destroys all layers of the skin including muscles, nerves, and bones.

b.May not be painful because nerves are destroyed.

Front 77

Where do more than 90% of all poisonings take place?

Back 77

the Home

Front 78

General S/s of Poisoning

11

Back 78

1.Nausea, vomiting, diarrhea
2.Chest or abdominal pain
3.Sweating, changes in consciousness, seizures
4.Headache
5.Dizziness
6.Irregular pupil size
7.Burning/tearing of eyes
8.Abnormal skin color
9.Burns around the lips, tongue, or on the skin
10.Unusual odors, flames, smoke
11.Unusual behavior suggesting drug use

Front 79

S/s of Allergic reactions

4

Back 79

1.Breathing difficulty
2.Tightness in the chest
3.Rash, hives, or itching
4.Swelling in face, neck or tongue

Front 80

4 Types of Poisonings

Back 80

1.INGEST (swallow) – ex. Foods-certain mushrooms / shellfish, medicine, household items (cleaning products)
2.INHALE (breath in) – ex. Carbon monoxide (engine or car exhaust)
3.ABSORB (touch it) – Come in contact with skin or other membrane ex. Plants - poison ivy, poison oak
4.INJECT – Bites or stings ex. Insects, spiders (black widow and brown recluse), snakes

Front 81

activated charcoal

Back 81

For a victim who has swallowed a petroleum product (kerosene or gasoline) use activated charcoal after vomiting to counteract poison - vomiting removes only about half of the poison, PCC might have you try to counteract the remaining poison – using activated charcoal liquid / powder forms (looks like mud-might be hard to get victim to drink-use straw or cover).

Front 82

NEVER INDUCE VOMITING FOR:

Back 82

A victim who has swallowed a corrosive (acid) ex. Draino or caustic (alkali) ex. Strychnine, the substance
will burn the tissues esophagus/throat/mouth (again) if vomited

Front 83

What are epinephrine pens used for?

Back 83

used to dilate the bronchioles to help the patient breath easier

Front 84

HEAT / COLD EXPOSURE Factors:

6

Back 84

1.Activities
2.Clothing
3.Weather – wind and humidity
4.Length of exposure
5.Working / living conditions
6.Persons’ age and state of health

Front 85

Heat Related Emergencies

Back 85

1. HEAT CRAMPS - least severe
2. HEAT EXHAUSTION – more severe
3. HEAT STROKE - most severe, least common!!!

Front 86

HEAT CRAMPS

Back 86

painful spasms of skeletal muscles (usually legs / abdomen – could be warning) - 1st sign body overcome by heat

Front 87

S/s of Heat Cramps

Back 87

a.muscle twitching and spasms in arms, legs, or abdomen
b.wet and warm skin as a result of excess sweating
c.temperature, pulse, and respiratory rate should be normal or slightly elevated

Front 88

Treatment of Heat Cramps

Back 88

a. rest in a cool place
b. encourage to drink liquids
c. apply ice and gentle stretch or massage
d. monitor for S/s of heat exhaustion/stroke
e. do not drink salt water or take salt tablets

Front 89

Heat Exhaustion

Back 89

long exercise / work in sun - sitting in sun too long, prolonged sweating from strenuous activity in a hot environment resulting in
inadequate replacement of fluid losses

Front 90

S/s of Heat Exhaustion

Back 90

a.rapid strong pulse, heavy sweating
b. normal or slightly lowered body temperature
c. cool, moist, pale or red skin
d. headache, nausea, dizziness, weakness, exhaustion

Front 91

Treatment of Heat Exhaustion

Back 91

a. treat as if in shock
b. take out of hot environment
c. place on back with feet elevated
d. sponge or towel victim with cool water
e. remove as much clothing as possible
f. if conscious allow victim to drink fluids
g. if symptoms persist or no improvement within 30 minutes get help or transport to medical facility

Front 92

HEAT STROKE

Back 92

body systems overwhelmed by heat - they begin to stop
functioning

Front 93

S/s of Heat stroke

Back 93

a. rapid and weak pulse
b. no sweating
c. core temp above 103 F.
d. shallow breaths
e. red, hot and dry skin
f. changes in consciousness (dizziness, weakness, loss of
consciousness), seizures

CLASSIC - (lose ability to sweat)-affects elderly, chronically ill and obese
EXERTIONAL (retain ability to sweat) – strenuous work or play in a warm environment

Front 94

TREATMENT FOR HEAT EXHAUSTION / STROKE

Back 94

a.Get victim out of the hot environment
b.Cool body – use cool, wet cloths
c.Loosen tight clothing
d.If the victim is conscious give cool water, not too fast 4 ounces every 15 minutes
e.Minimize shock - keep lying down with legs up
f.Call EMS
g.Watch for changes in
h.Do not return to activity
i.If the victim vomits - stop giving fluids - sign they are
getting worse, put on side; watch for breathing problems,
keep victim lying down
j.Anything cold - ankles, armpits, groin, neck, to cool large blood vessels

Front 95

Why should we not use rubbing alcohol to cool someone with heat stroke/exhaustion/cramps?

Back 95

it will close pores and prevent heat loss***

Front 96

FROSTBITE

Back 96

literal freezing of the body parts exposed to cold (water in between bodies cells freezes and swells

Front 97

Treatment of Frostbite

Back 97

re-warming is necessary and needs to be done by a physician, if this is not possible, try rapid re-warming

Front 98

Rapid re-warming

Back 98

handle gently, put frostbitten part in warm (not hot) water (100-105 F thermometer / or hand), apply warm moist cloths and change them frequently for ear or facial injuries - if fingers / toes are frostbitten place cotton/gauze between them - after re-warming bandage area with dry, sterile dressing

Front 99

NO NOs of Frostbite treatment

5

Back 99

1.Don’t break any blisters
2.Don’t rub the part to warm-ice crystals can cause more damage
3.Don’t let area touch sides / bottom of container if soaking
4.Don’t allow victim alcohol / smoking
5.Don’t allow area to refreeze

Front 100

HYPOTHERMIA

Back 100

life threatening cold injury, thermal control is lost once body temp is below 95 F.

If below 80 F, coma or death

Front 101

Types of Hypothermia exposure:

Back 101

1.Acute exposure (mild hypothermia)
-six hours or less in duration victim loses heat rapidly, usually water immersion
2.Subacute exposure (profound hypothermia)
- exposure is 6 to 24 hours
3.Chronic exposure (profound hypothermia)
- long term cooling, more than 24 hours

Front 102

Mild hypothermia

Back 102

core temp above 90 F
Raise core temp by:
a.Use tub of hot water, leave victims arms and legs out
b.Place hot packs against the body’s areas of high heat loss
c.In Wilderness - have rescuer lie trunk to trunk with the victim in a sleeping bag

Front 103

Profound Hypothermia

Back 103

core temp. below 90 F
a.Do not re-warm victim if they can be transported within 12 hours, keep victim from getting colder (do not elevate feet causes cold blood to go to heart)
b.Do not jostle during transportation
c.Avoid CPR unless you are POSITIVE victim has no pulse
d.Example of slow faint pulse – someone with hypothermia

Front 104

S/s of Different Types of Hypothermia

Back 104

1.mild – numbness, shivering, slurred speech, memory lapses, fumbling hands, cold abdomen and backs

2.profound – shivering has stopped, decreasing levels of consciousness
-muscles become still and rigid
-skin has blue appearance
-no response to pain
-pulse and respiration drop
-pupils dilate

Front 105

Treatment of hypothermia

Back 105

1.Get victim out of cold environment
2.Have a source of heat - use barrier (warm gradually)
3.Add insulation beneath and around the victim (blankets, cloths, towels etc.)
4.Replace wet clothing
5.Handle victim gently

Front 106

DIABETES

Back 106

A condition which person’s body does not produce enough of the hormone insulin, causing too much sugar in blood

Front 107

Diabetic emergency

Back 107

person becomes ill due to imbalance of insulin and sugar in body

Front 108

2 Major Types Diabetes

Back 108

Type I Insulin Dependent Diabetes

Type II Non-Insulin Dependent Diabetes

Front 109

Type I Insulin Dependent Diabetes

Back 109

a.Body produces little/or no insulin
b.Usually starts in childhood
c.Need to inject insulin daily into body
d.Must regulate use of insulin

Front 110

Type II Non-Insulin Dependent Diabetes

Back 110

a.Body doesn’t produce enough insulin
b.Usually occurs in older adults

Front 111

HYPOGLYCEMIA

Back 111

insulin reaction - high insulin, low blood sugar (low sugar can make a person ill)

Front 112

HYPERGLYCEMIA

Back 112

- diabetic coma - low insulin, high blood sugar
MORE SERIOUS – happens when diabetics fail to take insulin

Front 113

S/s of Diabetic emergencies

Back 113

1.Rapid Pulse / Rapid Breathing
2.Feeling / Looking Ill
3.Changes in level of consciousness - dizziness, drowsiness, confusion

Front 114

Difference btw Insulin reaction and diabetic coma?

Back 114

***YOU DON’T NEED TO DIFFERENTIATE BETWEEN INSULIN
REACTION AND DIABETIC COMA – the treatment is the same

Sugar will not hurt!

Front 115

SEIZURES

Back 115

a sudden involuntary muscle contraction, usually due to uncontrolled electrical activity in the brain

Front 116

S/s of seizures

Back 116

1.Brief blackout or confused behavior (“petit mal” seizure)
2.Sudden falling – loss of consciousness
3.Drooling, frothing at the mouth
4.Vigorous spasms, twitching, jerking limbs, stiffening (“grand mal”)
5.Grunting, snorting
6.Loss of bladder or bowel movement

Front 117

Care for seizures

Back 117

First aid is aimed at protecting the victim from injury and getting medical help.
1.Do not restrain
2.Do not place anything in their mouth
3.Clear area of hard/sharp objects – chairs, tables
4.Do not try to make the victim “snap out of it”

Front 118

After the seizures stops....

Back 118

1.If you don’t suspect head/neck/spine injury – place in recovery position.
2.Protect the airway
3.Monitor the victim while recovering
4.Stay with the victim until consciousness is fully regained or you have medical help.

Front 119

What to look for in a head injury?

Back 119

a.depressions & bruising
b.fractures & lacerations
c.check pupils and if fluid is draining from nose, ears,
or mouth

Front 120

Don't move victim if...

Back 120

1.Any loss of consciousness or change in level of consciousness
2.Unequal pupils or fluid loss
3.Extreme pain or loss of sensation

Front 121

CONCUSSION

Back 121

immediate loss or transient impairment of the brain’s ability to function

Front 122

3 Mechanisms of concussions

Back 122

1.Direct blow – head contacts a fixed object or struck in the head by object
i.e. helmet/helmet
2.Indirect blow – sudden force that causes twisting or swirling of the brain within the skull.
3.Contrecoup – results from a blow to the opposite side.

Front 123

-2 sites of head/brain injury-

Back 123

1. pt. of impact
2. pt. opposite side where brain hits the skull

Front 124

Grade I Concussion

Back 124

mild - “bell rung” dazed/disoriented, memory loss at time of impact, no loss of consciousness

Front 125

Grade II Concussion

Back 125

moderate - loss of consciousness < 4 minutes
retrograde amnesia

Front 126

Grade III Concussion

Back 126

severe - unconscious > 4 minutes

Front 127

S/s of concussions

7

Back 127

1.deepening headache 2.blurred vision
3.nausea / vomiting 4.restlessness / confusion
5.unequal pupils 6.ringing in ears 7.unable to wake victim

Front 128

Treatment of concussions

Back 128

1.Keep quiet - do not leave alone
2.Awake @ 2 - 4 hours - observe for above symptoms to develop
3.No aspirin (thins blood)
4.If victim is unconscious assume a neck injury

Front 129

SKULL FRACTURE

Back 129

-spherical, 1/4 inch thick

-mechanism - direct blow

Front 130

Four Types of skull fracture:

Back 130

1.Depressed – fragments driven into membranes or brain itself
2.Linear – thin line - most common, least serious, most difficult to detect
3.Comminuted – egg shell – pt. of impact, cracks radiate from center
4.Basal – floor of skull – extensive damage

Front 131

S/s of Skull fracture

Back 131

-palpable deformity - pain / swelling
-discoloration under eyes – sunken (raccoon) – gradual
-bruising behind ear – gradual
-blood / fluid (CSF) - nose / ears /scalp - bleeding
-unequal pupils

Front 132

Treatment of Skull Fracture

Back 132

-do not stop flow (CSF out
nose/ears)
-check out flow for “halo sign”
-CSF will always form a pink ring target
-EMS transport to ER

Front 133

CERVICAL SPINE INJURIES

Unconscious

Back 133

UNCONSCIOUS - basic protocol -call EMS!! a.stabilize head/neck in position found
b.log roll if on stomach c.primary survey--how?
d.no ammonia inhalants

Front 134

CERVICAL SPINE INJURIES

Conscious

Back 134

CONSCIOUS- basic protocol
a.Make an observation b.Stabilize - head/neck in position found
c.Get a History
d.evaluate quickly short term, long term memory
e.evaluate clarity of their responses, state of mind
confused? head injury? happened before?

Front 135

INJURY REMOVAL

One Rescuer

Back 135

1.Clothes drag
2.Foot drag
3.Blanket drag
4.One person crutch

Front 136

INJURY REMOVAL

Two Rescuers

Back 136

1.Crutch method (buddy carry)
2.Seat carry
3.Extremity lift

** Remember--stabilize head and neck 1st!

Front 137

INJURY REMOVAL

Four Rescuers

Back 137

1.Log roll--if spinal injury, provide cervical traction.

2.Be sure to roll body in unison--use the backboard

Front 138

INJURY REMOVAL

Four-Six Rescuers

Back 138

1.Man lift - slide board feet head
2.Scoop stretcher

Front 139

WHY DO WE MOVE SOMEBODY?

Back 139

-when faced with immediate danger
-you have to get to another victim who may have a more serious problem
-you may have to remove in order to provide proper care

Front 140

Poison control center phone #

Back 140

[phone]

CHOP

Front 141

When is consent implied?

Three things

Back 141

1. Person's unconscious
2. Person's confused
3. Person's seriously ill and cannot grant consent

Front 142

Do you have to obtain consent when dealing with an infant or child?

Back 142

Consent is implied if parent or guardian is not present

Front 143

Without oxygen brain cells begin to die after how many minutes?

Back 143

Approximately four minutes

Front 144

Several bleeding to lower leg can be controlled by finger pressure to what artery?

Back 144

Femoral Artery

Front 145

How far do you tilt the head back for an adult?

Back 145

Enough to open airways (past neutral0

Front 146

How far do you tilt the head back for a child?

Back 146

Slightly past neutral

Front 147

How far do you tilt the head back for an infant?

Back 147

To neutral

Front 148

Rescue Breathing: Adult

Back 148

-1 breath every 5 seconds
-Breath should last 1 second

Front 149

Rescue Breathing: Child & Infant

Back 149

1 breath every 3 seconds

Front 150

How deep should chest compressions be with an infant?

Back 150

.5 to 1 inch

Front 151

How deep should chest compressions be with a child?

Back 151

1 to 1.5 inches

Front 152

How deep should chest compressions be with an adult?

Back 152

1.5 to 2 inches

Front 153

CPR: Adult

Back 153

30 compression & 2 breaths

Front 154

CPR: Child & Infant with one rescuer

Back 154

30 compression & 2 breaths

Front 155

CPR: Child & Infant with two rescuers

Back 155

15 compression & 2 breaths

Front 156

What is the rate for compression?

Back 156

100 compressions per minute