The Basics of First Aid
A basic first aid manual covering procedures for cuts, lacerations, fractures, burns, heat stroke, hypothermia, seizures, concussions, fainting, bleeding, shock, choking,breathing problems, diabetes, CPR and AEDs.
Shared by: robvajko
2009 The Basics of First Aid “First Aid is defined as any and all emergency care given to an injured or sick person prior to the intervention of any professional medical treatment.” Rob Vajko 1/1/2009 www.nationalsafetyinc.com The Basics of First Aid Defining “First Aid” First Aid is defined as any and all emergency care given to an injured or sick person prior to the intervention of any professional medical treatment. The purpose of first aid 1. 2. 3. 4. 5. To preserve and sustain the life of the casualty To Stabilize the patient To prevent contamination To aid in better and more rapid recovery To aid in the safe transportation of the patient to a hospital of doctor Points to be clear on 1. The administrator of first aid is NOT A DOCTOR. The role of the first aider is to help keep the patient alive, as comfortable as possible in order to facilitate the doctor’s job when he or she arrives. 2. The first aider should NEVER give up on a patient and terminate life-saving endeavors. Only a doctor should declare a patient dead and stop life-saving procedures. 3. Though first aid training is recommended and advisable, you should not allow lack of training and/or experience keep you from trying to administer first aid. Your efforts may save a life. Page 2 © National Safety, Inc. www.nationalsafetyinc.com Part One – Scene Assessment, Safety and Personal Protective Equipment Being aware of safety issues can make the difference between saving the patient and becoming another one of the victims. Instances are too numerous to mention of people who have rushed to help someone else only to become a victim as well. Confined Space deaths, for example, count more deaths by rescuers than by the original victim. Seeing someone collapse, rescuers rush to his assistance without realizing that the reason for the collapse of the victim had to do with an oxygen deficient environment or an elevated level of some fatal gas. The rescuers end up becoming victims as well. Emergencies are, by their very nature, volatile situations and, as such the danger of further injury is increased. Obvious, immediate dangers include such things as downed power lines, floods, traffic, potential collapses in the immediate vicinity, violence by others, unstable ground to name only a few. You need to be aware of which situations you and others around you can control and which ones you will need the help of emergency personnel (Police, Power Company, Hazmat team, etc…) REMEMBER: You cannot help someone else if you become a victim yourself! Beyond the obvious and immediate dangers, there is also the issue of blood borne pathogens and other issues related to bodily fluids and infectious diseases (Hepatitis, HIV, etc…). PPE (Personal Protective Equipment) such as disposable gloves, CPR Barriers and eye protection may be necessary. Just because these dangers are not immediate (the effects may take years to show themselves) or visible does not diminish the threat. You need to protect yourself from contamination. Page 3 © National Safety, Inc. www.nationalsafetyinc.com Part Two – Providing First Aid The ABCs of First Aid The ABCs stands for… • Airway Make sure that the airway is clear. Tilt the head back, lift the chin so that the Jaw is thrust forward in order to make sure the airway is clear. • Breathing Look and listen for signs of breathing. Try to feel for breath. Allow 3 to 5 seconds. • Circulation Feel for a pulse using the second and third fingers and running them along the outer edge of the windpipe in the neck. Because this artery supplies a massive amount of blood to the brain, this is usually the easiest pulse to detect. Taken 5 to 10 seconds. Additional things to pay attention to: • • • • Notice the color of the persons’ skin. Blue, grey or purple colors usually indicate illness. Try to smell for alcohol on the breath Listen for groaning noises or rasping in the breathing. Listen for coughing or spluttering Page 4 © National Safety, Inc. www.nationalsafetyinc.com General First Aid Procedure ALWAYS CALL 911 FIRST (or have someone else call if more than one person is present) Page 5 © National Safety, Inc. www.nationalsafetyinc.com Normal Vital Signs: • • • • Breathing: 12-20 breaths per minute for adults or 20-25 times per minute for children Pulse: 60-80 beats per minute (adults) or 80-100 beats per minute for children Body Temperature: 98.6o F Blood Pressure: 120 over 80 Other issues to keep in mind • • • Always call 911 first. If you are alone with the patient than call 911 yourself. If others are present have them call 911 Do not move the patient unless it is absolutely necessary for survival. Professional medical personnel will arrange for transport. There may be more than just one injury that needs to be treated Page 6 © National Safety, Inc. www.nationalsafetyinc.com Part Three – Treating Specific Problems Treating Bleeding External Bleeding • For minor cuts and wounds - Clean and dress the injury. • For major bleeding - Apply constant and direct pressure to the bleeding and elevate the injured area if at all possible. DO NOT apply a tourniquet except as a last resort and only for 15 minutes or less as a tourniquet could, if not properly used, result in the loss of the limb. Internal Bleeding If a person is pale, has a rapid pulse, a weak pulse, labored breathing, cold and clammy skin and/or is sweating excessively, they may have internal bleeding. • • • If conscious, treat the patient for shock (See section on shock below). Keep the patient on his or her back with raised legs. Keep the patient warm until professional medical help arrives. Treating severed limbs or body parts 1. Immediately wash the severed part with clean water to prevent contamination 2. Pack it in a plastic bag and put it on ice 3. Get the patient and the severed part to the hospital immediately. Page 7 © National Safety, Inc. www.nationalsafetyinc.com Treating Burns There are three possible degrees of burns. The degree of severity will determine the method of treatment. • First Degree – Though there may be intense pain, the skin is only reddened and there are no blisters. First degree burns do not require professional medication treatment. Simply cool the area with cool water (DO NOT USE ICE! Ice will actually cause further burn). Blot it gently apply burn jel or burn cream and cover with a sterile dressing. Second Degree – Skin develops blisters and may be wet, shiny or “weeping”. Do not touch or cover the burn area. Try to sit the patient up (if possible, try to keep the burn area above heart level, especially for arms or legs) and watch for difficulty breathing. Get the patient immediate medical attention. Third Degree – The skin is very badly burnt. The epidermis (the upper layer of skin) and possibly the dermis (the lower layer of skin) has been destroyed. Burn area will often appear white, almost purple or black because of the dead skin. Third degree burns are often much less painful than first or second degree burns because the nerves themselves have been damaged or destroyed. Treatment for third degree burns should be the same as for second degree burns. Do not cover as contact with the affected area may cause further damage and increase the risk of infection. • • Electrical Burns – Special care and treatment should be sought for electrical burns as the damage may not be very evident on the surface but may actually have caused deep muscle damage and even kidney damage. Chemical Burns – Immediately flush the affected area with large amounts of water. Do not try to neutralize the chemical by adding other chemicals. What may work in a beaker or a test tube may actually cause further damage when on the skin. Additional note regarding burns: You will want to make sure that the patient has had a recent tetanus shot (within the last 5 years) as burns are highly susceptible to the tetanus infection. Page 8 © National Safety, Inc. www.nationalsafetyinc.com Treating Shock The body goes into shock when the vital organs aren’t receiving enough fresh, oxygen-rich blood. It is important to recognize and diagnose shock as early as possible in order to keep the patient from getting into serious and potentially life-threatening trouble. Symptoms of shock include: • • • • • • • • • • • • Low blood pressure Vacant stares, bewildered look Excessive thirst Vomiting Rapid, irregular and/or shallow breathing Restlessness Pale, cold or clammy skin Extreme and sudden fatigue Nausea Weak or rapid pulse Fainting Anxiety Different types of shocks Anaphylactic Shock is the usually brought on by an allergic reaction. This allergic reaction may be caused by a certain type of food, a insect bite or sting and by inhaling something toxic to the person in question. Psychogenic shock, usually referred to as “Shell Shock”, is the result of extreme emotions of fear, anger or grief. The mind, unable to cope, goes into a state of shock that can result in any number of physical conditions and symptoms. Hypovolemic Shock: This shock is cause by dehydration, bleeding, vomiting, diarrhea or any other condition that results in an extreme loss of fluids. This decrease of fluids causes a drop in blood volume. This decreased blood volume can result in damage to internal organs What to do for shock • • • • Loosen clothing to allow patient to breathe better and facilitate circulation Do not give the patient anything to eat or drink Cover the patient with a warm blanket Lay the patient on his or her back with legs elevated Page 9 © National Safety, Inc. www.nationalsafetyinc.com Treating Fractures A fracture is a break or splinter in a bone. It can be caused by violent impact or by any number of diseases that cause bone decay. There are several different classifications of fractures: 1. Greenstick fracture – which is a simple crack in the bone. They can be determined by a doctor using an x-ray machine. 2. Closed or “simple” fracture – in which the broken bone has not pierced through the skin. 3. Open or “compound” fracture – in which the broken bone has pierced or torn the skin resulting in an open wound. 4. Comminuted or “multiple” fracture – in which the bone is broken in more than one place. Closed fractures may not be immediately visible and may be difficult to diagnose. If in doubt, treat it as a fracture. To treat a fracture: 1. Try to avoid moving or jarring the limb 2. Support the limb with a splint (stick, rolled newspaper, etc… secured with rope, strips of cloth, tie, etc… to keep the limb completely rigid. 3. Make sure that the splint isn’t too tight by checking for a pulse at the extreme of the limb in question. The absence of a pulse would indicate that the splint is too tight. 4. Apply ice or frozen vegatables (frozen peas work well) to keep the swelling down but not for more than 20 minutes at a time. 5. Do not try to set the bone or repair the fracture. Page 10 © National Safety, Inc. www.nationalsafetyinc.com Treating Choking incidents Chocking, or airway obstructions, are caused when the windpipe is obstructed by a foreign object. The obstruction can be partial where the windpipe isn’t completely blocked and the patient can still breathe but with some difficulty or it can be complete where the windpipe is completely blocked and the patient cannot be allowed any oxygen at all. The purpose of first aid for chocking is to get the person to expel the foreign object and clear the windpipe. Coughing, slaps on the back or abdominal thrusts will often do the trick. If not, then the Heimlich maneuver may be necessary. Avoid using the Heimlich maneuver unless absolutely necessary as it can be painful and may even injure the person. Use it only when the person cannot talk, cough or breathe. How to do the Heimlich maneuver (The following information is taken from the Heimlich institute website at www.heimlichinstitute.org) The Heimlich Maneuver® for CHOKING ADULTS A choking victim can't speak or breathe and needs your help immediately. Follow these steps to help a choking victim: 1. From behind, wrap your arms around the victim's waist. 2. Make a fist and place the thumb side of your fist against the victim's upper abdomen, below the ribcage and above the navel. 3. Grasp your fist with your other hand and press into their upper abdomen with a quick upward thrust. Do not squeeze the ribcage; confine the force of the thrust to your hands. 4. Repeat until object is expelled. UNCONSCIOUS VICTIM, OR WHEN RESCUER CAN'T REACH AROUND VICTIM: Place the victim on back. Facing the victim, kneel astride the victim's hips. With one of your hands on top of the other, place the heel of your bottom hand on the upper abdomen below the rib cage and above the navel. Use your body weight to press into the victim's upper abdomen with a quick upward thrust. Repeat until object is expelled. If the Victim has not recovered, proceed with CPR. The Victim should see a physician immediately after rescue. Don't slap the victim's back. (This could make matters worse.) Page 11 © National Safety, Inc. www.nationalsafetyinc.com The Heimlich Maneuver for CHOKING INFANTS A choking victim can't speak or breathe and needs your help immediately. Follow these steps to help a choking infant: Lay the child down, face up, on a firm surface and kneel or stand at the victim's feet, or hold infant on your lap facing away from you. Place the middle and index fingers of both your hands below his rib cage and above his navel. Press into the victim's upper abdomen with a quick upward thrust; do not squeeze the rib cage. Be very gentle. Repeat until object is expelled. If the Victim has not recovered, proceed with CPR. The Victim should see a physician immediately after rescue. Don't slap the victim's back. (This could make matters worse. The Heimlich Maneuver for CHOKING (ONESELF) When you choke, you can't speak or breathe and you need help immediately. Follow these steps to save yourself from choking: Page 12 © National Safety, Inc. www.nationalsafetyinc.com 1. Make a fist and place the thumb side of your fist against your upper abdomen, below the ribcage and above the navel. 2. Grasp your fist with your other hand and press into your upper abdomen with a quick upward thrust. 3. Repeat until object is expelled. Alternatively, you can lean over a fixed horizontal object (table edge, chair, railing) and press your upper abdomen against the edge to produce a quick upward thrust. Repeat until object is expelled. See a physician immediately after rescue. Page 13 © National Safety, Inc. www.nationalsafetyinc.com Treating Breathing Problems There are numerous complications that can arise when a body isn’t getting adequate amounts of oxygen. Asthma, hyperventilation and panic attacks are three of several conditions that can result in breathing problems. Asthma Asthma is a chronic disease that causes the airways to constrict, become inflamed or accumulates excessive amounts of mucus. These attacks may be triggered by a number of different factors including cigarette smoke, pollen, cold air, warm air, pet dander and any number of other airborne particulates. Additionally the triggers may be brought on because of emotions or excursions. Asthma can be severe and, in extreme cases, the attacks can be fatal. Helping someone who is having an asthma attack • Help the sufferer sit upright as it is easier for them to breathe in this position than if they are laying down. • Try to calm them. Talk with a soothing voice. Do not panic and add to the emotional stress that the sufferer is already experiencing. Any additional stress will just make matters worse. • Get them to take their medication. Help them if they can’t take it for themselves. Shake the inhaler and give them one good puff. Have them hold the breath in for 4 seconds or so followed by 4-5 normal breaths. Repeat this procedure up to four times. If, after 4 minutes there is no improvement you should repeat the procedure. • If there is still no improvement in the sufferers condition, call 911 and stay with them until help arrives. Panic Attacks Panic attacks are characterized by a sudden sense of fear or anxiety that can leave the person with labored breathing along with a host of other symptoms. There is usually no visible or explainable reason for the onset of this attack and the patient often believes that they are having a heart attack the first time that it happens. The reasons why a person may have a panic attack can be biological, hormonal, hereditary or psychological. They are not usually dangerous and when the person can be kept calm, they usually subside without leaving any physical effects. Helping someone who is having a panic attack • Help the sufferer sit upright as it is easier for them to breathe in this position than if they are laying down. • Try to calm them. Talk with a soothing voice. Do not panic and add to the emotional stress that the sufferer is already experiencing. Any additional stress will just make matters worse. • Try to help them slow their breathing by having them breathe with you. Pause for a couple of seconds at the end of each breath and hold it in before walking through the cycle again. Page 14 © National Safety, Inc. www.nationalsafetyinc.com Hyperventilation Hyperventilation is brought about when fear or intense emotions cause a person to breathe too heavily. The increase of oxygen in the body causes the carbon dioxide concentration in the blood to drop below its normal level which in turn raises the pH levels and results in a constriction of the blood vessels to the brain. Symptoms of hyperventilation may include tingling, lightheadedness, dizziness, headaches and chest pains. The patient may feel that they are having a heart attack. Helping someone who is hyperventilating • The treatment for hyperventilation is similar to the treatment for a panic attack except that, initially, it is helpful to have the person loosely hold a paper bag over their nose and mouth while breathing. This helps the person increase the amount of carbon dioxide he or she is breathing in, thereby bringing the level back to normal. • Help the sufferer sit upright as it is easier for them to breathe in this position than if they are laying down. • Try to calm them. Talk with a soothing voice. Do not panic and add to the emotional stress that the sufferer is already experiencing. Any additional stress will just make matters worse. • Try to help them slow their breathing by having them breathe with you. Pause for a couple of seconds at the end of each breath and hold it in before walking through the cycle again. Page 15 © National Safety, Inc. www.nationalsafetyinc.com Treating Concussions Concussions are caused when a sudden impact to the head occurs. This sudden impact can cause the brain to “bounce around” in the skull resulting in bruising and swelling of the brain. As with any injury to the brain sensory input and output can be temporarily damaged and must therefore be dealt with immediately. Symptoms of a concussion may include the following: • • • • • • • • • • • • Speech impairment Blurred vision Confusion Disorientation Inability to concentrate or focus Headaches Dizziness Seizures Bleeding from the ears Dilated pupils Paralysis of any of the limbs or of either side of the face Loss of consciousness How to treat someone with a suspected concussion: • • • Lay the patient down on his or her back with legs elevated over the head and loosen all clothing. Apply a damp cloth to face and neck DO NOT GIVE THEM ANYTHING TO DRINK, even if they ask for it. Although most concussions do not require any additional medical treatment except rest, it is important to note two very important facts related to concussions: 1. Trauma to the brain kills over 50,000 people each year. Many of these patients exhibited no immediate symptoms and the injury seemed to be a minor one. This means that it is better to be safe and to have a patient checked out by a professional if there is the least doubt. 2. Damage from concussions can be cumulative. It is therefore essential to keep the head protected by using hard hats, bump caps and helmets. It is also essential to use seatbelts while driving. Page 16 © National Safety, Inc. www.nationalsafetyinc.com Treating Seizures A seizure is essentially a short in the communication between the body and the brain. It is important to note that not all seizures result in convulsions (unlike what most people tend to believe). There are two classifications of seizures. The first type can be either simple or complex (see below): Partial seizures (also called “focal seizures”) A. Simple partial seizures – the patient remains conscious and still has control of his or her motor skills B. Complex partial seizures – the patient looses consciousness either right away or after a while. 2. Generalized seizures which happen when abnormal activity is present on both sides of the brain. 1. How to treat someone who is having a seizure: First of all, it must be clear that there are a number of myths or beliefs about seizures that must be addressed. 1. It is not true that a person having a seizure can swallow his tongue. Most likely this misconception arose because the patient wasn’t turned onto one side to keep his airway clear (see below). DO NOT attempt to pry the patients mouth open or try to hold the tongue down. 2. Do not try to hold the patient down or to try to stop his movements. This only increases the possibility of injury to the patient and to you. 3. Do not attempt artificial respiration except if the patient stops breathing after the seizure (this is extremely unlikely however). So, now that we know what not to do, what is it that we should do? 1. Basically all that you can do is to keep the person comfortable and safe till the seizure runs its course. 2. Time the seizure as this information might be important to the doctor. 3. Clear the area around the person to keep him or her from striking anything that might cause injury. 4. Roll them on their side to help clear the airways and help them breathe. 5. Remain calm and reassure the patient. 6. Stay with them until the seizure has ended. Additionally, you will want to try to find a way to get the person home without them having to drive themselves (offer to drive them, call someone who can come get them or call a taxi). Page 17 © National Safety, Inc. www.nationalsafetyinc.com Treating Diabetes Emergencies as they relate to diabetes are either of the hyperglycemic or the hypoglycemic nature. Hypoglycemia has to do with low blood sugar and this imbalance usually hits fairly rapidly and most often when the person is active. Symptoms of hypoglycemia include excessive sweating, seizures, losing consciousness or falling asleep suddenly, disorientation, rapid pulse, confusion or sudden onset of hunger. How to treat someone with hypoglycemia. 1. Give the patient something sweet in order to raise the sugar level (only if the patient is conscious). 2. Call 911 immediately if the person is unconscious or goes into a seizure. Note to those who are hypoglycemic: 1. Always carry something sweet with you (candy, fruit, etc…) or glucose tabs (available in drugstores) 2. Glucagon is an injectable medication which rapidly raises blood sugar levels. Keep some handy and train a family member in how to administer the shot. 3. Be aware of the onset of this problem. Know when to pull off the road if you are driving; know when to make sure others around you know what is happening so that they can take appropriate action. Hyperglycemia has to do with high blood sugar and this imbalance usually is slower to hit. Symptoms of hyperglycemia include excessive thirst, blurry vision, fatigue or drowsiness and a strong smell similar to nail polish remover on breath. If the person loses consciousness there is a possible onset of a diabetic coma which can be extremely dangerous. How to treat someone with hyperglycemia. 1. Call 911 or get them to the emergency room if unconscious or if a blood test of the blood sugar levels shows abnormally high levels. 2. If the person is conscious and able to administer an insulin shot to himself, allow him to and aid if they ask for your assistance. Do not administer an insulin shot to an unconscious person. 3. Do not feed them anything as most food and drink has at least some sugar in it and may further aggravate the situation. Page 18 © National Safety, Inc. www.nationalsafetyinc.com Treating eye injuries As hard as we may try to remove all hazards and protect ourselves, eye injuries can and will occur. Knowing what to do when the injury occurs is crucial. Often time is of the essence. Treating a person who has something in his eye. 1. Do not rub the eye or allow the patient to rub his eye. Rubbing will further irritate. 2. Wash hands thoroughly with soap and water to remove any possibility of further contamination 3. Flush the eye using an approved eye wash 4. If you can see the object try to remove it with a clean, lint-free cloth. Pull the top eyelid over the bottom eyelid to try to use the bottom eyelashes to pull the item free. 5. If you cannot get the object out, seek immediate medical attention. Treating a chemical Splash or other chemical exposure 1. If the injured person is wearing contact lenses, remove the lenses immediately to keep the lens from trapping the chemical in the eye. 2. Flush the eye for 15 minutes straight to dilute and remove the chemical from the eye. 3. Seek immediate medical attention and, if possible, bring the bottle or the MSDS sheet with you. Treating cuts or punctures to the eye 1. Protect the eye and seek immediate medical attention. Keep the bandage from touching the eye using a eye cup or the cut out bottom of a paper cup. 2. Do not rinse, apply pressure or give the patient aspirin, ibuprofen or other anti-inflammatory drugs which might thin the blood and increase bleeding. Treating a blow to the eye 1. Gently apply a cold wash cloth or compress to help reduce swelling. Do not apply pressure. 2. If the patient has blurred vision or other visual problem, seek medical attention. Page 19 © National Safety, Inc. www.nationalsafetyinc.com Treating light burns Unlike other eye injuries, injuries related to lasers, welding and other radiant light sources may not be immediately detected. It may take several hours before the eye starts to feel irritated, as if there were sand in the eye. It may get severely bloodshot, or red, or it may swell. This may be as long as 12 hours after the exposure to the light. If this happens, cover the eye to avoid further irritation and get medical attention. In any and all cases, you are better off getting professional medical help as soon as possible. Many eye injuries may not look that severe at first but could potentially result in permanent damage including permanent loss of vision. Page 20 © National Safety, Inc. www.nationalsafetyinc.com Treating Heat Related Disorders and Dehydration The human body is extremely sensitive to changes in temperature and even minor changes can adversely affect it. A rise of less than 7oF above normal body temperature can result in death. The body normally handles heat by sweating to cool the body off. It is therefore critical to make sure that the body remains hydrated, especially in areas of elevated temperature and extreme activity. Heat related disorders include heat rash, heat syncope, heat cramps, heat exhaustion, heat stress, heat stroke and dehydration. Dealing with heat rash – Heat rash is usually due to moist clothing remaining in contact with the skin. Even once the skin has been cleaned and dried, the rash may persist for up to 3 weeks afterwards. To avoid heat rash try to wear moisture wicking clothing that pulls the moisture away from the skin. No special treatment is necessary for heat rash. It will eventually clear up on its’ own. Dealing with heat syncope – Heat syncope is generally not very serious. It is a dizziness that comes from overheating while sitting in the sun. Simply move the person to a shaded area and cool them down and the problem should go away. Give them plenty of liquids a little at a time to make sure that they aren’t getting dehydrated. Dealing with heat cramps – Heat cramps are caused by dehydration. When the muscles are low in sodium and fluids they may cramp up or spasm. Rehydration will usually remedy the problem (see below). Dealing with dehydration - First it must be noted that it is much simpler to make sure that the body stays hydrated than it is to try to rehydrate a body that has become dehydrated. Drinking plenty of liquids (avoid caffeinated or alcoholic beverages) is key to keeping the body hydrated. Symptoms of dehydration may include fatigue, cramping, dizziness, confusion, extreme thirst, headaches, fainting, and convulsions. To help a victim of dehydration give them small doses of liquids (electrolyte replacement drinks and/or tablets are a great way to rehydrate because they replace the needed electrolytes as well as the liquids) at regular intervals; too much to fast could cause the person to vomit and actually lose even more liquids, so give small doses a little at a time. Move the person to a cooler location. The urine of a well hydrated person will run clearish (as opposed to dark yellow). Dealing with heat exhaustion or heat stress - When dehydration continues, the lack of fluids in the body can cause the constriction of the blood vessels which will may result in lightheadedness, dizziness, exhaustion, cramping, fatigue, increased respiration, etc… Rehydration should remedy the problem. If left untreated, however, it could potentially lead to heat stroke which can be fatal (see below) Page 21 © National Safety, Inc. www.nationalsafetyinc.com Dealing with heat stroke – As we have already mentioned, heat stroke can be fatal. If the body temperature gets too elevated the brain can overheat. Death can result in as little as 30 minutes so it is imperative to get them help immediately. Heat stroke can be: 1. Slow (fluid depleted heat stroke) which comes about when dehydration is ignored. Eventually, the lack of fluids in the body causes the body to overheat, leading to heat stroke. 2. Fast (fluid intact) which comes about, not as a result of fluid depletion but as a result of extreme heat when the body isn’t able to cool itself down adequately or fast enough. In either case, heat stroke symptoms may include any of the following symptoms: • • • • • • • Flushed or hot skin Hallucinations Dizziness Disorientation Seizures Unusual behavior Heavy breathing The most important step, in treating someone with heat stroke, is to lower the body temperature. Move the person to a cooler area and remove all non-breathable clothing. Pour cool water (not too cold or the body could potentially go into shock) on wrists, neck and ankles. Fan them to speed up sweat evaporation. If ice packs are available, put them at the neck (the main artery at the neck will drive the cooled blood to the rest of the body faster). Monitor the patient’s temperature. When their body temperature falls below 102o stop cooling them and start to give them small sips of liquid (see rehydration procedures above). Page 22 © National Safety, Inc. www.nationalsafetyinc.com Treating hypothermia At the opposite end of the temperature spectrum is hypothermia. While hyperthermia is overheating of the body, hypothermia is when the body temperature gets too low. Hypothermia can set in with as little as a 3o drop in body temperature (while the normal body temperature is 98.6o F, hypothermia can set in when the body temperature drops below 96o). Hypothermia is a serious medical emergency that must be dealt with immediately. If a person starts to feel cold, complain of being cold, starts to act confused or disoriented or if they start to shiver, especially if they have been in or come from a cold environment, suspect hypothermia and take the appropriate action. Call 911 and try to keep the person warm using blankets, heat and even by sharing your own body heat. Do not try rubbing their arms and legs. If the cause of hypothermia has to do with the person being wet (if they fell through the ice, for example) then the wet clothing must be removed and the person must be dried off immediately. Then you will need to get heat to them (your own body heat if needed) to warm their core. Blankets, while useful in retaining body heat cannot, of themselves provide heat so it is imperative that some source of heat be present to raise the body temperature of the victim before the cold blood is forced to the heart. Use warm liquids if available. At the hospital heated blankets, warm IVs and other methods may be used to raise the body temperature. Page 23 © National Safety, Inc. www.nationalsafetyinc.com Appendix One Understanding the legal issues involved The Good Samaritan Laws Most states now have some form of a Good Samaritan law that provides immunity from liability for any person who tries to help someone in distress. This law applies also to attempted first aid. Though these laws do not prevent a lawsuit from being generated, either by the patient or by relatives, it does protect you, as the first aider, from being found liable. Good Samaritan laws do not apply to professional health care workers who are getting paid to rescue. Professionals are assumed to have been properly trained and to have the necessary knowledge to do their jobs correctly. They can be held accountable for their mistakes. A complication of this exemption may apply to you if you accept any kind of remuneration for the actions that you took. If you are somehow rewarded monetarily or otherwise for providing first aid, you may no longer be able to fall under the Good Samaritan law if legal proceedings are initiated against you. Because of this it is usually advisable not to accept gifts or rewards for any first aid acts taken. CPRinstructor.com is a great online resource to determine what the Good Samaritan laws are In your state. Page 24 © National Safety, Inc. www.nationalsafetyinc.com Appendix Two CPR and AED Awareness Each year as many as 325,000 people die from Sudden Cardiac Arrest (Also known as Sudden Cardiac Death or SCD). More people die from SCA than from breast cancer, prostate cancer, AIDS, house fires, handguns and traffic accidents combined. Sudden Cardiac Arrest is not the same as a heart attack. If we speak of a heart attack in terms of “plumbing” then SCA would be “electrical”. A heart attack occurs when one or more arteries get blocked for whatever reason preventing the blood from flowing properly. SCD, on the other hand, is essentially an electrical short that causes the heart to “flutter” or quiver (known as “ventricular fibrillation”). While most frequent in adults in the mid-30s to mid-40s it can also affect children (around 2 for every 100,000 children each year). A recent study done by the American Heart Association (Download it here) found the following: • • • • Only about 6 percent of out-of-hospital sudden cardiac arrest victims survive. Fewer than 1/3 of cardiac arrest victims receive CPR. Effective CPR can DOUBLE or TRIPLE survival rates. Few Americans are confident they could actually perform CPR and use an AED to help save a life in an emergency cardiac situation. The good news is that a few easy steps can make an enormous difference in reducing these numbers. “For victims of a sudden cardiac arrest, a bystander who performs immediate CPR and defibrillation with an AED could make a life or death difference.” (Quoted from the American Heart Association website here.) So what can be done? 1. Get CPR Training and get your employees trained as well. The Red Cross can even come out to your facility to conduct training. Find out more on their website. 2. Make sure there is an Automatic External Defibrillator (AED) available and make sure you and your employees are trained on it. (Defibtech and Zoll both make a great AED that requires very little training and which can even be used by someone who has never been trained. Turn it on and it will talk you through the process. IT WILL NOT ADMINISTER A SHOCK UNLESS IT DIAGNOSES VENTRICULAR FIBRILLATION. It is virtually impossible to accidentally hurt someone by using it when you shouldn’t. To find out more about these AEDs, click here). Page 25 © National Safety, Inc. www.nationalsafetyinc.com Being prepared will make all the difference! Performing CPR 1. If the patient is not breathing, tilt their head back and cover their mouth with yours. Blow until you see their chest rise. Breathe this way twice for two seconds each. 2. If the patient still shows no signs of life (sputtering, coughing, etc…) begin chest compressions directly between the nipples. Most people do not compress hard enough. Push hard, using the heel of your hand with the other hand over it. Pump at the rate of 100 compressions per minute (use the song “Staying alive” by the BeeGees to get the correct beat). Again, most people do not pump fast enough. 3. Breaths to pumps should ideally be 2 breaths to 15 pumps. Many AEDs (Automatic External Defibrillators) on the market today will actually monitor the strength and depth of the compression for you and let you know if you are not doing it hard enough or fast enough. This can make the difference between life and death for inexperienced personnel. Consider having an AED like the Zoll AED Plus. Page 26 © National Safety, Inc. www.nationalsafetyinc.com Appendix three Purchasing a first aid kit The type and size of the first aid kit that you will need will, of course, vary depending on the size of the group that will be using the first aid kit and whether or not it is to be permanently mounted or not. First Aid Cabinets XL First Aid Industrial Cabinet Large Industrial First Aid Cabinet Medium Industrial First Aid Cabinet Small Industrial First Aid Cabinet Standard Business First Aid Cabinet Food Service First Aid Cabinet Besides first aid cabinets, there are a variety of first aid kits, some in backpacks, fanny packs, plastic cases, steel cases and more… She the whole selection of first aid kits here. Page 27 © National Safety, Inc.