EMERGENCY CARE esac First Aid, CPR, and AED Peel Thee CMC) nc ae Medical Writer ee Me aa] Wictele-clg Eee) ly MD, FAAOS — WT ele 7 ConeM ere eM Cao Ness American College of EHEH Emergency Physicians” Pee sc ak aeEg World Headquarter Jones Barbet Learning Wallstreet Bulingon, MA 01803, falo@plearning com ‘ow earring com Subantial discounts on bulk quanti of Jones & Bara Learning publications areavalcble to corporations, professional asociatons, nd ater qualfed organisations Por detail pec csstnt infomation, contac he special sles depattvent Jones Se Butt, Learning va theaboveconbt information 0! sndan eral 10 spe- Salalevpearnng.con, Jones Baett Learning bocks and products ate avaable trough most bookslores and ealine Sooktellers Ta contact Jones & Bartlet Lean 1g dicey, call 800-822-0004, Ly 97848-4000, or vst us Webste, sr eating com roduction Credits CChazas, Board of Ducetors Clayton Jones (Chef Execuve Oficer Ty Fela resident Jates Homer SVP, Eltoton-Chef: Mchse! Johnson SVP, Chel Operating Ocer:Don Jones. J SVP, Chef Technolgy Officer: Dean Fosella SVP, Chief Markeung ice alison Mt Fendewgst Execinive Publisher: Kimberly Bopp Execulve Vie Presiden JB Lean, Lawrence D. Newel ‘Poof les, Public Safe Gronp: Matthew Mansclcs ExeciveAqulshons Edkor “EN: Chine Emerton Director of Ses, Public Salty Grovp: Paty Einstein AACS Ch Eaton Ofc: Ma WW Wistng Diner, Dearmento Pulations Mari Fox. PHD Managing Rarkara X Scotese ‘Asstt ea Editor: Gayle Mursy AOS Boro iccory 2011-2012 Preuene Danl). Bry, ND Fre Peary Johe Foe ND Sand Vie Preet Joes} ob MD FocProicn be} Calg aD Treasrer reek Aer, Feralas Grafs anew NP, MB {ely Ov halen, MD Mite evn? tack MD Wifoed en, MD Minder: Keer MD, MPH Seg 4 Meace ID fee teen ND Sion DE Ras MD Nici N She Mb Dal D Tesch MD Banat ive Si, Ete. atc Keren Hack ACHE. CAP af) Assorinte Ebr Onis MacDonald Produeton Manage: Jeney L. 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Courier compotion Covet Painting: Courier Corporation ‘Addonal paotogaphic and llutationscredes appear ox page270, which consitutesa coutinuton othe copyright page {Copyright ©2013 by Jones & Bart Leaning, LLC, an Ascend Leaering Company Al igs rexrved Ma pave mei powcr bythe coppght may be reproliuced ore in ny form ldronde oe ethan, hotoeopying recoding of hy anyinformation storage an reeeval sem, seo! writen permsion frome copyright ose “Theft ald, CPR, and AED procedures an! prvocolsin this book are kased on the mot curreatyecemmendations of esporaible medial sources The Jmerian Ace of Othopatdie surgeons ani the publisher, however. make no juarautecasto ad assume mo vesponsiblt er, theorresiness sul ieieney, oreamplaenes of ch information arrecommendaions Oiler adsl sty estes mar e teuied eer pariculareeratares Reviewed bythe Amérkan Callege of Energeney Physicians: The Amérian Collegeof Emery Physkcans (ACEP) makés every eff vo ensue tha fs eviwersareknowlelgable content exper Reters ave neserthes acbised that te statements and opinions expres inthis publiction se po sia secmntencnn atin me public are should note concruel os iCal Clipe policy, ACEP isn response and expect fisclaimsalllabity for damages of any Find arsngouto use ceferce to, elizceo2, of yrformanceol such ilorination. The mtr contained bein are net intended eatublich policy, proven, or atandard ol care, To cantact ACER wey to: PO Bon 619811, Dalle, TX 75261-99115 tle: 800-795-1892, 0r 972-5500 Some nage inthis hock Festare mls, These model donot recessny enor, represent of partic inthe avis represented in Ihe bray of Congress Catologingt-Publication Data First ad, CPR and AEDessentias Seven M, Thygeson ;Amencan Aealemy of Othopsedi Surrons land Amersn Calley of Emergency hysieans— ed eV edo: Fists and CPR essa Aon Thygersn, Sth ed 2007 Related ed of: Advanced fus aid, CPR, end AED. eh ed, Inelides ides ISBNO78-1-4496-2600-4 |. Thygerson, Alin L, Fist sd and CPR essentials 1, American Atadeiny of Onhop Surgions, Ul, American College of Eergéney Fhysicans. IV. Tile V. Tle Advanced frst ae, CP and AED. TONING 1 Fist Aid. 2 Cardiopalmosary Reouoctation.3. Clete Countenhock 4, tinergaicies, WA292] LC chesfction not sgn slears2 aden) 1033475 fous Frinted inthe Unted Sats Ammericn BIN W987 esa 3D Bahan dengan hak ciptaBackground Information Action at an Emergency Finding Out What's Wrong cPR Automated External Defibrillation Shock Bleeding Wounds Burns Head and Spinal Injuries © 66666086 6 @ 34 48 57 67 74 89 104 Chest, Abdominal, and Pelvic Injuries. Bone, Joint, and Muscle Injuries Extremity Injuries Sudden Illnesses. Poisoning Bites and Stings Cold-Related Emergencies Heat-Related Emergencies Rescuing and Moving Victims 130 140 149 159 183 195 221 232 240charter QB) ercraroune intormaton Why Is First Ald Important? Whe Needs First Aid? What Is First Aid First Aid Supplies First Aid and the Law cnepter QB) Action at an emergency Emergencies What Should Be Done? ‘Seeking Medical Care How te Call EMS. ‘Scene Size-uo Disease Precautions charter @ Finding Out What's Wrong Victim Assessment Overview Primary Check ‘Secondary Check SAMPLE History What to Do Until Medical Help Is Available Triage: What to Do With Multiple Victims chai “O cpr Heart Attack and Cardiac Arrest Caring for Cardiac Arrest Performing CPR Airway Obstruction cnorter@ ‘Automated External Defibrillation Public Access Defibrillation How the Heart Works Care for Cardiac Arrest ‘About AEDs 48 40 50 50 Using an AED 51 Special Considerations 51 AED Manufacturers 34 chapter e Shock 57 Shock Causes of Shock 37 ‘The Progression of Shock 50 ‘Care for Shock 60 Chapter 8 Bleeding 6 Bleeding «7 Extemal Bleeding 67 Internal Bleeding 70 crane @ Wounds 14 ‘open Wounds 14 ‘Amputations 73 Blister ei Impaled (Embedded) Objects 283 ‘Closed Wounds a4 Wounds That Require Medical Ca 84 Dressings and Bandages, as Chapter 6 Buns es Types of Burns 29 Chapter ® Head and Spinal Injuries 104 Head injuries 104 Scalp Wounds 104 Skull Fracture 105 Brain injuries 106 Types of Brain Injury 106Eye injuries Penetrating Eye Injuries Blows to the Eye Cuts of the Eve or Lid Chemical in the Eyes Eye Avulsion Loose Objects in the Eye Light Burns to the Eye Ear injuries Nose Injuries Nosebleeds Broken Nose Objects in the Nose Dental Injuries Objects Caught Between the Teeth Bitten Lip or Tongue Loosened Tooth Knocked-Out Tooth Broken Tooth Toothache Spinal Injuries Recognizing Spinal Injuries Care for a Spinal injury chapter @ Chest Injuries Closed Chest Injuries Open Chest Injuries Abdominal Injuries Closed Abdominal Injuries Open Abdominal Injuries Pelvie Injuries Chest, Abdominal, and Pelvic Injuries Chapter @ Bone, Joint, ond Muscle Injuries Bone Injuries Fractures Joint Injuries Dislocations Sprains Muscle Injuries Strains Cramps Contusions caster €B) Extremity Injuries Extremity Injuries Assessment Types of Injuries 108 108 10 1" mm 13 13 113 na 14 14 115 117 117 7 7 WT 7 120 120 120 120 121 130 130 130 133 133 134 134 135 140 140 140 144 144 4s. 145 145, 145 146 149 149 149 150 Contents RICE Procedure for Bone, Joint, ond ‘Muscle Injuries R= Rest Is lee C= Compression E= Elevation Splinting Extremities Types of Splints Splinting Guidelines Slings cnapter QB) suse tinesses Unexplained Change in Responsiveness Heart Attack Angina ‘Stroke (Brain Attack) Asthma Hyperventilation Chronic Obstructive Pulmonary Disease Fainting Seizure Diabetic Emergencies Emergencies During Pregnancy Chapter 6 Poisoning Polson What Isa Poison? Ingested (Swallowed) Poisons Alcohol Emergencies Alcohol Intoxication Drug Emergencies Carbon Menoxide Poisoning Plant-Induced Dermatitis: Poison Ivy, Poison Oak, and Poison Sumac cnr Bites and stings Animal Bites Snake Bites Insect Stings Spider and Insect Bit Marine Animal injuries vaste Cold-Related Emergencies Cold-Related Emergencies Freezing Cold injuries Hypothermia 150 150 150 151 152 154 154 155. 156 159 159 159 162 163 167 169 169 170 12 15 179 183 183 183 184 185 185 188 188 189 195. 195 199 203 206 212 221 221 221 228Contents cherter Heat-Releted Emergencies Heat-Related Emergencies Heat Illnesses cvorter @ Rescuing end Moving Victims Victim Rescue Water Rescue lee Reseve Electrical Emergency Rescue Hazardous Materials incidents Motor Vehicle Crashes Fires 2a2 232 232 240 240 240 2a 243 244 2aa 245 Tareatening Dogs Farm Animals Confined Spaces ‘Triage: What to Do With Multiple Victims Finding Life-Threatened Victims Moving Victims Emergency Moves Nonemergency Moves. ‘Appendix A Medication Information Answer Key Index Image Credits 246 246 246 246 247 247 2a8 248 255 258 260 270ECSI EMERGENCY CARE & SAFETY INSTITUTE Welcome to the Emergency Care & Safety Institute Welcome to the Emergency Care & Safety Institute (ECSN), brought to you by the American Academy of Orthopaedic Surgeons (AOS) and the American Col- lege of Emergency Physicians (ACEP) ECSI is an internationally renowned organi- zation that provides training and certifications that meet job-related requirements as defined by regulatory authorities such as OSHA, The Joint Commission, and state offices of EMS, Education, ‘Transportation, and Health, Our courses are deliv- ered throughout a range of industries and markets worldwide, including colleges and universities business and industry, government, public safety agencies, hospitals, private training companies, and secondary school systems ECSI programs are offered in association with the AAOS and ACEP. AAOS, the world’s largest medical organization of musculoskeletal specialists is known as the original name in EMS publishing with the first EMS textbook ever in. 1971, and ACEP is widely recognized as the leading name in all of emergency medicine. AACS About the AAOS The AAOS provides education and practice manage- ment services for orthopaedic surgeons and allied health professionals. The AAOS also serves as an advocate for improved patient care and informs the public about the science of orthopaedics. Founded in 1933, the not-for-profit AAOS has grown from a small organization serving less than 500 members to the world’s largest medical organization of musculoskel- etal specialisis, The AAOS now serves about 36,000 members internationally. HBB American Collegeof HEBE Emergency Physicians’ About ACEP ACEP was founded in 1968 and is the world’s oldest and largest emergency medicine specialty organization Taday it represents more than 28,000 members and is the emergency medicine specialty society recognized as the acknowledged leader in emergency medicine ECSI Course Catalog Individuals seeking training from ECSI can choose from among various traditional classroom-based Courses oralternative online courses stich as @ Advanced Cardline Life Support Automaied Extemal Defibrillation (AED) Bloodborne and Airhorne Pathogens Babysitter Safety Driver Safety CPR (Layperson and Health Care Provider Levels) @ Emergency Medical Responder @ First Aid (Multiple Courses Available) @ Oxygen Administration, and more! ECSI offers a wide range of textbooks, instruc tor and student support materials, and interactive technologs, including online courses. ECSI student manuals are the center of an integrated teaching and learning system that offers resources to better support instructors and train students, The instructor supple ments provide practical hands-on, time-saving tools like PowerPoint presentations, DVDs, and web-based distance learning resources. Technology resources provide interactive exercises and simulations to help students become prepared for any emergency. Documents atesting to ECSI’s recognitions of sa isfactory course completion will be issued to those who successfully meet the course requirements, Weittea acknowledgement of a participant’s successful course completion is provided inthe form of a Course Completion Card, sted by the Emergency Care & Salty Institute Visit www.ECSinstitute.org today! Bahan dengan hak ciptaThis concise student manual is designed to give laypersons the education and confidence they need to effectively provide emergency care. Features that reinforce and expand on essential information include Flowcharts Pose a central ques tion and organize treatment options Dy inary oriiness type. EC eu Perera Chapter at a Glance Guides students throug) the topics covered in the chapter ‘Skill Drills Provide step- bystep explanations and visual summaries of imoor- tant skils for first aiders.FYI Boxes ince ‘ydualeifrmation Featedto the vis a+ esses ascasse in that section ncn rover: thn tips andi actors. Has ‘Answer questions com- _mon to first aiders. Resource Preview ‘hotos enable ine stugent to visualize common signs and treatment options. a _shouldnot take wnile d= ‘ministering treatment. Bahan dengan hak cipta‘Emergency Care | Wrap-ups Those decision = “ables provide eauecinet summary ol whet igs frst — 2iders shoud look forand what treatment hey should srovide forthe emergency presented in the text jeady for Review : ‘thoraugh summary atthe key points in the chapter. ee ten Prep Kit End-ofchapter actiies tenloreimpor tant concentsand improve comprehension. ‘Vital Vocabulary List of the Key terms and defi tions fom the chapter. peacoat Usenet a fulz shidants onthe chap followed critical thinking i lepecae concise auestons that allow stu ants to apply wnat they've : learnee. Bahan dengan hak ciptaBackground Information > Why Is First Aid Important? tis better to know first aid and not need it than to need it and not cote know it, Everyone should be able to perform first aid, because most am reople will eventually find themselves in a situation requiring it for ny Ss Eee mother person or for th s. First aid agnose (this Important? what medical doctors do), but they can susp ihe problem is : then give first aid Who Needs First Aid? What Is First Aid? > Who Needs First Aid? A : First Aid Supplies ease and cancer continue to be critical health jems in the United States, injuries—both unintentional and nntentional—constitute 2 major threat to public health. This threat has been called the neglected epide Death statistics do not alway First Aid and the Law lect the extent or severity of the juured do not njury problem. Most people who The scope of injuri their injuries best be appreciated! if thought of as: Deaths from injuries and hospita ramid mos’ available dava have been, are only the tip of er number of injuries seen in emergency department 1 physician offices. Aneven greaternumber of injuries are treated by staiders, This supports the need for first ald training Each year, one in four p co need m e experience a nonfatal injury serious or to restrict activity for at least 1 day edical6 First Aid, CPR, and AED Essentials More sports-related nonfatal injuries are ureated in hospital emergency departments than any other type of unintentional injury OSHA Regulations (Standards-29CFR 1810.151) Medical Services and First Aid~General Industry: ‘In the absence of infirmary, clinic, or hospital in near proximity to workplace which is used for the treatment of allinjured employees, a person or persons shall be adequately trained to render fist aic, Adequate first aid supplies shell be readily availabe.” A delay of as little ay 4 minwes when a per son's heart stops can mean death, Therefore, what a bystander does can mean the difference between life and death. Fortunately, most injuries do not require lifesaving efforts. During their entire lifetimes, most people will see only one or two situations involv- ing life-threatening conditions, Most injuries do net require lifsaving efforts EIEN. Knowing what todo forless severe injuries demands greater attention during first aid instruction. Each year, the injuries of millions of Americans go unreported. For many of them, the injury causes temporary pain and inconvenience, for others, how ever, the injury leads to disability, chronic pain, and ‘a profound change in lifestyle, Given the size of the injury and sudden illness problem, everyone should be prepared to deal with an emergency. ea ee LC AAR a teeIhjurosrsoting indeath Injury pyramid. > What Is First Aid? Firs id is the immediate care given to an injured or suddenly ill person. First aid does not take the place of proper medical care. It consists only of giving tem- porary help until proper medical care, if needed, is obtained or until the chance for recovery without medical care is ensured. Most injuries and illnesses do not require medical care Properly applied, first aid might mean the differ- ence between life and death, between rapid recovery and along hospitalization, or between atemporary and 2 permanent disability. First aid involves more than doing things for others; talso includes ieatments that people can give themselves. Recognizing a serious medical emergency and knowing how to get help could be crucial in saving 2 life, Recognition of an emergency can be delayed because neither the victim nor bystanders know basic symptoms (for example, « heart attack victim might ‘wait hoursafter the onset of symptoms hefore seeking help). Moreover, too many people do not know first aid; even if they do, they might panic in an emergency. > First Aid Supplies ‘The supplies in a first aid kit should be customized to include those items likely 19 be used on a regular basis Avkit for the ome is often different than one for the Chapter 1 Background information e What level of care is a first alder expected to give? The level of care is also known by the term "stan dard of care.” A first aider cannot pravice the same level of care as a physician or an emergency med cal technician, To meet the standaré of care for a Victim, a first aider must: () do what is expected of. someone with first ald training and experience work: ing under similar conditions, and (2) treat the victim to the best of his or her ability. if the firt aid you provide is not up to the expected standard, you may be neld lable for your actions. workplace. A home kit may contain personal medica tionsand asmaller number of items. A workplace kt will need more items (such as bandages) and will nt inchude personal medications. lists the basic items that should be stocked in a workplace first aid kit, Although a first aid kit may have some medica- tions, such as antihistamines and topical ointments, there might be local requirements that restrict the use ofthese items by first aiders without prior written approval. For example, teachers, activity leaders, and bus drivers in certain areas might not be able to admin- ister these items to children without specific written permission signed by'a child’s parent or guardian, > First Aid and the Law Legal and ethical issues concern all first aiders, For example, isa first aider required to stop and give care atan ancomobile crash? Cana child witha broken arm be treated even when the parents cannot be contacted for their consent? These and many other legal and ethical questions confront first aiders. A first aider can be sued. Do not become overly concerned about being sued—it rarely happens, Ways to minimize the risk of a suit include @ Obtaining the victim's consent before touch- ang him or her. © Following this hook’s guidelinesand not exceeding your training level @ Explaining any first aid you are about to give % Once starting to care fora vietim, stay with thai person. You are legelly bound to remain with the victim until care is turned over to an equally or better trained person.6 First Aid, CPR, and AED Essentials Se sae std Meme, Minimum Quantity Adhesive strip bandages(I" x 3°" 20 Triangular baneages® (muslin, 4 36'-40" x 36-40" x $2'-56") Sterile eye pads (2% 27 2 Sterile gauze pads (4" x 4”) 6 ‘Sterile gauze pads (3° x 3°)" 6 Sterile gauze pads 2" 2¢ 6 Sterile nonstick pads (3° 4") 6 Sterile traume pads (5* x 9°)" 2 Sterile trauma pads (8" x 10°) 1 3 Sterile conforming roller gauze (2 width) Sterile conforming roller gauze 3 lls (45° width) Watersroof tape (1"x 5 yards) troll rolls Porous adhesive tape (2° x Syd)* 1 roll Elastic roller bendages (4 and 6") 1 of each Antiseptic skin wipes, individually 10 packets wropped™ Heme Minimum Guantity Antibiotic ointment, individual 6 packets packets* Dsposable (medical exam) gloves 2 pairs per size (various sizes)* Moutirtotarrier device (either a face mask witha one-way valve ‘ra disposable face shield) Dsposabie instant cold packs Sealable plastic bag: (quart size) Padded malleable splint (SAM Splint, 4" 36") Emergency blanket, Scissors 1 Tweezers 1 Hand sanitizer (6196 ethyl bottle alcohel) Biohazard waste bag (2.5 gallon cepactty) Mini flashlight and batteries 1 List of local emergency telepone 1 numbers: Fist aid guide 1 ‘tem meets the ANSI/ISEA 23081-2009 minimum standard for the workplace first ad hit. Optional items and siges may be added based on the potential hezerds, Consent Afirsa aid without the vietin’s consent is unlawful Expressed Consent Consent mus. be obtained from every alert, mentally competent (able to make a rational di which would indicate expressed consent ider must have the victim's consent (permission) before giving firs aid, Touching another person without his or her consent is unlawful (known as battery) and could be grounds fora lawsuit. Likewise, giving first ssion) person of legalage. Tell the victim that you have frst aid training and explain what you will be doing, The victim may sive permission verbally or with a nod of the head, Implied Consent Implied consent involves an unresponsive vietim with a life-threatening condition, It is assumed oF implied that an unresponsive victim would consent to lilesav- ing interventions. An alert victim who doesnot resist the administrations of a first aider is also assumed to have given implied consent Children and Mentally Incompetent Adults Consent must be obtained from the parent or guardian ofa child victim, as legally defined by the state. The same is true foran aduk who is mentally incompetent ‘When life-threatening situations exist and a parent or legal guardian is not available for consent, first aidshould be given based on implied consent, Do not withhold firs aid from a minor just to obtain consent froma parent or guardian, Psychiatric emergencies present difficult problems of consent. Under mos: conditions, a palice officer isthe only person with the authority to restrain and transport a person against that person's will. A first aider should not intervene anless directed to do so by police officer or unless it is obvious that the victim is about to do life-threatening harm to himself or herself or to others. Refusing Help Although it seldom happens, a person might reluse assistance for countless reasons, such as religious grounds, avoidance of possible pain, or the desire to be examined by aphysictan rather than by a first air. Whatever the reason for refusing medical care. or even, no reason is given, the alert and mentally competent adult can reject help. Generally, the wisest approach is for you to inforen the victim of his or her medical condition, what you propose to do, and why the help is necessary. If the Vietim understands the consequences and still refuses treatinent, thete is litle else you can do. Call 9-1-1 and, while awaiting arrival: © Try again wo persuade the victim to accept care and encourage others at the scene to persuade the victim, A victim could change his or her mind after a short time © Make certain you have witnesses. A vietim could refuse consent and then deny having done so, © Consider calling for law enforcement assis- tance, In most locations, the police can place 4 person in protective custody and require hhim or her to go toa hosptal vandonment Abandonment means leaving a victim after starting to give help without first ensuring that the victim will receive continued care at the same level or higher. Once you have responded to an emergency, you must not leavea victim who needs continuing first aid untill another competent and trained person takes respon- sibility for the victims, This might seem obvious, but there have heen casesin which critically ill or injured victims were left unattended and then died. Thus, a first aider must stay with the victim unl another equally or beer trained person takes over Chapter 1 Background information e How can | avoid a lawsuit resulting from giving first aid? Before giving first aid, get the victim’s consent or permission. Then provide good care, keeo within ‘your training level, be nice to the victim, nave wit nesses, and afterward, write down what you did, names of witnesses, and who took over the victims care fram you. Negligence Negligence means not following the accepted stan- dards of care, resulting in further injury to the victim. Negligence involves 1. Having duty to act (required to give firs: aid) 2. Breaching that duty (either by giving no care or by giving substandard care) 3, Causing injury and damages 4, Exceeding your level of training Duty to Act No one is required to give first aid unless a legal duty o.act exists, For example, you do not have to help a stranger unless you have a legal obligation to that person, or you were involved in the events that led to the vietimis injuries, regardless of who was at fault The decision to help in an emergency is usually an ethical (moral) one, Duty to act could apply in the following situations © When employment requires it, Ilyour employer designates you as the person responsible for providing first aid to meet Occupational Safety and Health Administra Lion (also known as OSHA) requirements and you are called 10 an injury scene, you have a dy to act, Examples of occupations that involve a legal obligation to give first aid Include law enforcement officers, park rangers, athletic trainers, lifeguards, flight atiendants, and fire lighters. @ When on duty (and sometimes when off duty). Some states requize certain people who are licensed by the sate to give emergency care regardless of their on- or off-duty status. In other words, these people are considered to be always on duty. Other states require them toact when on duty hut not generally6 First Aid, CPR, and AED Essentials when they are off duty, unless they are in uniform or have other visible insignia and appear to be on duty—in which case these people must respond. © When a preexisting responsibility exists. You ‘might have a preexisting relationship with other persons that makes you responsible for them, which means thet you mist give Firat aid should they need it. For example, a parent has a preexisting responsibility for a child, and a driver for a passenger. Breach of Duty A breach of duty happens when a first aider fails ta provide the type of care that would be given by a person having the same or similar training, There are two ways to breach one’s duty: acts of omission and acts of commission, An act of omission is the failure to do what a reasonably prudent person with the same or similar training would do in the same or similar circumstances. An act af commission is doing some- thing that a reasonably prudent person would not do ‘under the same or similar circumstances, Forgetting to put on a dressing is an act of omission; cutting a snake-bite site is an act of commission Injury and Damages Inflicted In addition to physical damage, injury and damage can include physical pain and sullering, mental anguish, medical expenses, and sometimes loss of earnings and earning capacity Confidentiality Firstaiders might lear confidential information. Itis important that you be extremely cautions about reveal> ing information you learn while caring for someone. ‘The law recognizes that people have the right to pri vacy. Do not discuss what you know with anyone other than those who have a medical need to know. ‘The exception to this is when state laws require the reporting of certain incidents, such 2s rape, abuse, and gunshot wounds, Good Samaritan Laws Good Samaritan laws encourage people to assist oth- ers in distress by granting them immunity against lawsuits. Although the laws vary from state to state, Good Samaritan immunity generally applies only when the rescuer is (I) acting during an emergency; (2) acting in good faith, which means he or she has good intentions; G) acting without compensation; and (4) not guilty of malicious misconduct or gross negligence toward the victim (deviating, from rational first aid guidelines Although Good Samaritan laws primarily cover health care providers, many states have expanded them io include laypersons serving as first aiders, In fact, some states have several Good Samaritan laws that cover different types of people in various situ- ations, Many legal experts believe Good Samaritan laws have given first aiders a false sense of security. These laws will not protect first aiders who have caused further injury to a vietim, Good Samaritan laws are not 2 protection for poorly given first aid or for exceeding the scope of your traming. Fear of lawsuits has made some people hesitant of becoming involved in emergency situations. First aiders, how- ever, are rarely sued> Ready for Review © Everyone should be able to perform first aid because mast people will eventually find themselves in a situation requiring, it for another person or for themselves. © First aid is the immediate care given to an injured or suddenly ill person. First aid does not take the place of proper medical care © The supplies ina first aid kit should be customized to include those items likely to be used on a regular basis. © Legal and ethical issues concern all first aiders. © A first aider must have the victim's consent (permission) before giving first aid. © First aiders might learn confidential informa- Udon. Ibis importane that you be extremely cautious about revealing information you learn while caring for someone. © Varying from state to state, Good Samaritan. Jaws encourage people to assist others in distress by granting them immunity against lawsuits. > Vital Vocabulary abandonment Failure to continue first aid until relieved by someone with the same or a higher level of training act_of commission Doing something thai a reason- ably prudent person would not do under the same or similar circumstances. act ofomission Failure to do what a reasonably pru- dent person with the same or similar training would do in the same or similar circumstances hattery Touching 2 person or providing first aid with- out consent. breach ofduty Whena first aider fails to provide the type of care that would be given by a person having the same or similar training, consent An agreement by a patient or victim to accept treatment offered as explained by medical personnel or first aiders, duty_to.aet A person's responsibility to provide vic- tim care expressed consent Permission for care that a victim ‘gives verbally orwith a head nod. first aid Immediae care given to an injured or sud- denly ill person. Good Samaritan laws Laws that encourage people to voluntarily help an injured or suddenly ill person by minimizing the liability for errors made while rendering emergeney care in good faith implied consent An assumed consent given by an unconscious adult when emergeney lifesaving treat ‘ment is required negligence Deviation from the accepted standard of care that results in further injury to the victim. Bahan dengan hak cipta» Assessment in Action Toward the end of the ski season you heat chat a ski reson in a neighboring state isalmost vacant of skiers, and the resort is offering reduced ees during week- days, You decide to take advantage of reduced &ki fees and take a few days olf wo go skiing, As you ski down the mountain on a run with trees bordering on beth sides, you come across a man lying motionless in the snlow near a tree he may have crashed into. No other skiers are in sight and you are alone, As you approach the victim, you see no obvious injuries. You have no first aid supplies, Your first aid certification is stil current. Directions: Circle Yesif you agree with the statement; circle No if you disagree Yes No | You have so stop to help the man, Yes No 2. You have implied consent to help this man. Alter tapping on the man’s shoulder to see if he 15 OK, he remains unre- sponsive hut breathing. You can leave and assuume that the ski pairol will be coming shortly, 4, You decide to help, Before assessing the vietim, you roll him over, causing him to slide down the hill and hit a tree, Good Samaritan laws protect you even if you cause farther harm to the victim, Yes No 3. Yes No >» Check Your Knowledge — Directions Circle Yes i you agree with the statement; carele No if you disagree Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No No No No 1. Because an ambulance can arrive ‘within minutes in most locations, most people do not need to learn first aid. 2. Correct first aid can mean the differ- ence between life ancl death. 3. During your lifetime, you are likely to encounter many life-threatening emergencies 4, Allinjured victims need medical care 5. Belore giving first aid toan alert, com- petent adult, you must get consent (permission) from the victim, 6. If you ask an injured adult if you can help, and she says “No,” you can ignore het and proceed to provide care 7. People who are designated as ist aid ersby their employers must give first aid to injured employees while on the job. 8. First aiders who help injured victims: are rarely sued. Sood Samaritan laws provide a degree ‘of protection for firs aiders who actin good faith and without compensation. 10. Youare required to provide first aid to any injured or suddenly ill person you encounter. Bahan dengan hak ciptaRea ae Emergency” > Emergencies ave distinctive characteristics. They are: at « pance » Dangerous—people’s lives, well-being, or property are heated > Emergencies » Unusual and rare events—the average Emergencies n will probably anter fewer than a halla dozen setious emergencies in a me Be Done? Different from one anether—each presentsa different set of problems, P Seeking Medical Ufgirseeaihey happen suiadenlyand wulion: warnig: Care ® Urgent—if the emergency is not dealt with immediately, the situation will escalate D> Howto Call EMS > What Should Be Done? Victims would benefit if bystanders could following: 1. Recognize the emergency 2. Decide to help. 3. Call 9-1-1 if emerz 4. Check the victim. 5. Give first ald medical service is needed. Bahan dengan hak cipta6 First Aid, CPR, and AED Essentials: fic It is not always clear at first glance whether an emergency exists. Recognize the Emergency To help in an emergency, the bystander first has to notice that something is wrong. Noticing that some. thing is wrong is related to four factors END: © Severity Severe, catastrophic emergencies such as a motor vehicle crash involving an overturned car or several vehicles attract attention. © Physical disance. The closera bystander Is to an emergency situation, the more likely he or she will notice it ® Relationship. Knowing the victim increases the likelihood of noticing an emergency: For example, you would notice your child’s in- juries before you might notice the same injuries ona steanger @ Time exposed. Evidence indicates that the longera bystander is aware of the situation, the more likely he or she will notice it as an emergency. Decide to Help At some time, everyone will have to decide whether to help another person, Unless the decision to act in an emergency is considered well in advance of an actual emergency, the many obstacles that make it dif- ficult or unpleasant for a bystander to help a stranger ave almost certain to impede action, One important strategy that people use to avoid action is to refuse Gonsciously or unconsciously) to acknowledge the emergency. Many emergencies do not look like the ones portrayed on television, and the uncertainty of the real event can make it easier for the bystander to avoid acknowledging the emergency Making a quick decision 10 get ivolved at the time of an emergency is more likely to occur if the bystander has previously considered the possibility of helping others. Thus, the most important time to ake the decision to help is before you ever encounter ‘an emergency, Deciding to help is an attitude about emergencies and about one’sability to deal with emer- sgencies, [bisa attiude that takes time to develop and isaffected by a number of factors. | 9-1-1 if EMS Is Needed Wrong decisions about calling 9-1-1 can be made. Examples include a delay in calling 9-1-1 until callers are absolutely sure that an emergency exists, or deciding to bypass EMS and to transport the vietim to medical care in a private vehicle. Such actions can endanger a victim, Fortunately, most injuries and sudden illnesses do not require mecical care—only first aid. Check the Victim You must decide whether li threatening conditions exist and what kind of help a victim needs, See the chapter ertitled Finding Out What's Wrong for details Give First Aid Often the most critical life support measures are effec tive only ifstared immediately by the nearest available person, That person usually will be a layperson—a bystander > Seeking Medical Care Knowing when to call 9-1-1 for help from EMS is important. To know when to call, you must be able to ell the difference between a minor injury or ill ness and a life-threatening one. For example, upper abdominal pain can be indigestion, ulcers, or an early sign of a heart attack. Wheezing could be related to a person’ asthma, for which the person can use his or her prescribed inhaler for quick relief, or itcan be as serious asa severe allergic reaction from a bee sting. Not every cut needs stitches, ner does every bura require medical care. It is, however, always best to err on the side of caution, According to the American College of Emergency Physickans (ACEP), if the answertw any of the following questions is “yes,” or if you are unsure, call 9-1-1 for help. ® Isthe victim's condition life threatening? ® Could the condition get worse and become life threatening on the way ta the hospital? © Does the victim need the skills or equipment of EMS? © Could the distance or traffic conditions cause a delay in getting the victim to the hospital? © Isa spinal injury suspected? ACEP also recommends immediate transport to the hospital emergency department, by EMS or by private vehicle, for the following conditions that are ‘warning signs of more serious conditions: © Chest pain lasting 2 minutes or more © Uncontrolled bleeding (ee the following lise of wounds needing immediate medical care) Any sudden or severe pain Coughing or vomiting blood Difficulty breathing, shortness of breath Sudden dizziness, weakness, fainting Changes in vision Difficulty speaking Severe or persistent vomiting or diarrhea Change in mental status (for example, confusion, difficulty arousing) Suicidal or homicidal feelings © Wounds needing immediate medical care include (see the chapter entitled Wounds for additional wounds needing medical care) those in which: — Bleeding from a cut does not slow during the first 15 minutes of seady direct pressure — Signs of shock occur. — Breathing is difficuk because of cut to the neck or chest A deep cut to the abdomen causes moder ate to severe pain. — There isa cut to the eyeball — Accut amputates or partially amputates an extremity. When a serious situation occurs, call 9-1-1 first. Do not call your doctor, the hospital, a friend, relatives, or neighbors for help before you call 9-1-1. Calling anyone else first only wastes time. IF the situation is not an emergency, call your doc- tor. However, if you have any doubi abaut whether the situation is an emergency, call 9-1-1 Chapter 2. Action at an Emergency 6 > How to Call EMS In most communities, to receive emergency assistance of any kind, call 9-1-1 Check to see sf this istrue in yourcommunity. Emergency telephone numbers are usually listed on the inside front cover of telephone directories. Keep these numbers near or on every telephone, Dial 0 the operator) if you do net know the emergency number. When you call 9-1-1, speak slowly and clearly Be ready to give the dispatcher the following information 1. The victim's location, Give the address, names of intersecting roads, and other landmarks, if possible. This information is the most important thing you can give. Also, tell the specific location of the victim, (For ‘example, “in the basement” or “in the backyard.”) 2. The phone number you are calling from andl your name, This allows dispaichers io detect false reports, thus minimizing their fre- quency, and it allows a dispatch center without the enhanced 9-1-1 system to call back if disconnected or for additional information if needed 3. What happened. State the nature of the emergency. (For example, “My husband fell offa ladder and is not moving”) 4, Number of persons needing help and any special conditions, (For example, “There was For help. call 9-14 or the local emergency number.6 First Aid, CPR, and AED Essentials ‘car crash involving two cars. Thee people are trapped.”) 5. Vietim’s condition, (For example, “My husband's head is bleeding”) List any first aid yout have tried (such as pressing on the site of the bleeding). Do not hang up the phone unless the dispatcher instructs you to do 50, Enhanced 9-1-1 systems can track a call, but some communities lack this technol- ogy. Also, the EMS dispatcher could tell you how best ‘o care for the victim, IFyou senel someone else to cal have the person report back to you so you can be sure the call was made. > Scene Size-up I you are at the scene of an emergency situation, do a 10-second scene'size-up looking for three things: (1) hazards that could be dangerous to you, the vietim(s), or bystanders; (2) the cause of the injury or illness; and @) the number of victims. As you approachan emergency scene, scan the area for imme- diate dangersto yourself or to the vievim If the scene is dangerous, stay away and call 9-1-1. You are not being cowardly, merely realistic Never attempt a rescue that you have nat been specifi- trained to do. You cannot help another person if you also become a victim. Dea 10 ecand sane size up by bohing for rea Hinge >. Cause of jury or natre oa vetim's audeon those 8. Number of vim Scene size-up, The scene size-up includes evaluating the scene for hazardous conditions The second step isto try to determine the cause of the inmrry, Forexample, ifthe emergency department physician knows that ¢ victim was thrown against a sicering wheel, he or she will check for liver, spleen, and cardiac injuries, Be sure to tell EMS personnel about your findings so they can identify the extent of any injuries. Finally, determine how many people are involved. There could be more than one victim, so look around and ask about others involved. > Disease Precautions First alders must understand the risks from infectious diseases, which can range in severity from mild to lle threatening. First aiders should know how to reduce the risk of contamination to themselvesand to others, An infeetious disease is a medical condition caused by the growth and spread of small, harmful organisms within the body. A communi isa disease that can spread from one person to another Immunizations, protective techniques, and handwash- ing can minimize the risk of infection. Because there are so many different infectious diseases to be con- cerned about, the Centers for Disease Control and Prevention (CDC) developed a set of standard precau- tions, which advise you to assume that all victims are infected and ean spread an organism that poses risk for transmission of infectious diseases. These protec tive measuresare designed io prevent first aiders from coming inwo direct contact with Infectious agents,Handwashing Handwashing is one of the simplest yet most elective ways to contiol disease transmission. Even if you wearing gloves, you should wash your hands before, if possible, and definitely after every victim contact. The longer the germs remain with you, the greater their chance of infecting you. The proper procedure for washing your hands is 2s follows 1. Use soap and warm water, if possible. All types of soap are acceptable when washing vwith water 2. Rub yonr hands together for 15 to 20 see conds to work up a lather. Wash all surfaces well, including wrists, palms, hacks of hhands, and fingers. Clean the dirt from under your fingernails, 3. Rinse the soap from your hands. 4. Dry your hands completely with a clean towel if possible (this helps remove the germs) Iftowels are not available, however, itis okay to allow your hands to air dry. If soap and water are not available, use an alcohol-based hand sanitizer to clean your hands ‘Apply the gel to one hand and rub hands together, covering all surfaces of hands and fingers, until the hands are dry. If your mucous membranes (Gor example, your eyes, nose, or mouth) are splashed by a bloody fluid, immediately flush the area with arin Use a waterless handwashing solution if there is no running water availabe. Chapter 2. Action at an Emergency Se Personal Protective Equipment Personal protective equipment (PPE) includes exam gloves, mouth-to-barrier devices, eye protection, and gowns, PPE provides a barrier between the first aider and infectious diseases. Exam Gloves Exam gloves are Uhe most common type of PPE and should always be worn when there is any possibility of exposure to blood or body fluids. All first aid kits should contain several pairs of gloves. Because some rescuers have allergic reactions to latex, latex-free gloves should also be available, You might consider putting ona second pair of gloves over the first if there is major, significant external bleeding orbody fluid. If the gloves: cut or torn, replace them. Mouth-to-Barrier Devices Mouth-to-barrier devices are recommended GATED. A though there are no documented cases of disease transmission to rescuers as a result of per- forming unprotected mouth-to-mouth resuscitation on a victim with an infection, you should use a barrier device such asa pocker mask when providing CPR. Other Personal Protective Equipment Other PPE includes eye protection and gowns and aprons. OSHA requires these to be available in some workplaces, especially for health care workers. These are not required for fist alders and usually will net be available. Figure 6 Pocket face mas, one-way valve.So First Aid, CPR, and AED Essentials Che ning Up After an Emergency ‘When cleaning up blood or other body fluids, protect yourself and others against disease transmission by following these steps: 1. Wear heavier gloves than lightweight latex or vinyl 2. Ifyou have been trained in the correct procedures, use absorbent barriers to soak up blood oF other infectious materials Clan the spill area using soap and water. Alter cleaning, disinfect with a bleach and water solution at a 1:10 dilution, Isopropyl alcohol also can be used to disinfect. These solutions can corrode pr discolor certain fabrics, leathers, vinyl, or other synthetic materials, 3, Discard contaminated materials in an appropriate waste disposal container. Uyouhave been exposed to blood or body Maids 1. Use soap and water to wash the parts of your body that have been contaminated 2. Ifthe exposure happened at work, repont the incident ta your supervisar. Otherwise, contact your personal physician. If the exposure was significant, seek medical care. Early action can prevent the development of certain infections. The best protection agains disease is using the sseguards described here, By following these guide- lines, first aiders can decrease their chances of con- Lracting bloodborne illnessesy Ready for Review © Emergencies are dangerous, umastl, rare, unforeseen, and must be dealt with before the situation becomes worse. © A bystander is a vital link between EMS and the victim, © Victims would benefit if bystanders could quickly and reliably do the following — Recognize the emergency. = Decide to help. — Call 9-1-1 if EMS is needed. Check the victim. — Give first axd. © Knowing when to call 0-1-1 is important. To dosso, you must be able to tell the difference between a minor injury or illness and a life-threatening one. © Inmost communities, call 9-1-1 to receive emergency assistance. © The sight of blood and the cries of victims can be upsetting, but itis essential that first aiders remain slertand working at an injury scene. © If you are at the scene of an emergency situation, do a 10-second scene size-up ooking for hazards, the cause of the injury or illness, and the number of victims. © First aiders should take precautions to protect against infectious diseases. © There are few incidents that i jolve emo- tional stress like the life-and-death situations that you might face > Vital Vocabulary eaten te ar dieters sean eee ee from person to person, or from animal to person. infectious disease A medical condition caused by the growth of small, harmful organisms within the body personal protective equipment (PPE) Equipment, such as exam gloves, used to block the entry of an organism into the body. scene size-up Steps taken when approaching an emergency sene, Steps include checking for haz- ards, noting the cause of the injury or illness, and determining the number of vietims. standard precautions Protective measures that have traditionally heen developed by the Centers far Disease Control and Prevention (CDC) for use in dealing with obgets, blood, body fluids, or other potential exposure risks of communicable disease. Bahan dengan hak cipta> Assessment in Action You ate walking from house to house in an unfamiliar neighborhood collecting donated clothing for a local charitable organization. You find no one home ata par- ticular house but hear a loud explosion in the garage You decide to see what happened. Upon entering the sarage you find a teenage boy lying on the ground. There is astrong gasoline odor. You have a cellular telephone with you. Directions: Circle Yesif you agree with the statement circle No if you disagree Yes No 1 This scene could be dangerous, Yes No 2. You should not be concemed about other possible victims. Yes No 3. In most communities, 9-1-1 can be used to contact EMS, Yes No 4. Ifyou do not know the exact address of the emergency, be prepared io give a description of the location as best as you ean, > Check Your Knowledge Directions: Circle Yes if you agree with the statement; circle No if you disagree. Yes Yes Yes. Yes Yes Yes Yes No No No No No No No 1. A wene sunvey should he done hefore giving first aid to an injured victim. 2. Fora severely injured victim, call the vietim’s doctor before calling for an ambulance. 3. Dial 0 (for the telephone operator) if you do not know the emergency tele- phone number 4, First aiders should assume that blood and all body fluids are infectious. 5. If you are exposed to blood while on the job, report it to your supervisor, and if off the job, to your personal physician. 6. First aid kits should contain exam gloves. 7. Wash yourhands with soap and water after giving first aid 8. Exam glovescan be made of almost any ‘material as long as they fit the hand well. Bahan dengan hak ciptaFinding Out What's > Victim Assessment Overview During emergency situations when panic exists, knowing what to do and what net to do is crucial. A victim assessment is a sequence of actions that helps determine what is wrong and thus helps provide ieee Re eoeerieut safe and appropriate first aid, Becoming lamiliar with the process of ee ‘ctim assessment will enable you to act quickly and decisively in hectic emergency situations. Victim assessment is an important first, Primary Check aid skill. requires an understanding of each assessment step as well as decision-making skills. Secondary Check out what is wrong with @ person will be influenced by whether the victim is suffering from an illness or an injury, whether SAMPLE History the victim is responsive or unresponsive, and whether life-threatening, ions exist. A key point isto conduct a primary check first and to What to Do Until care for any problems you uncaver before going on withthe assessment. Medical Help Is Different problems and conditions requice different approaches Byailable for determining what is wrong. Not all parts of an assessment apply to every vietim, and the sequencing can vary depending on the vic Triage: What to tim’ problem, Most victims do not require a complete assessment. Do With Multiple For example, a vietim who cut a finger while whittling a stick will Victims not require a complete assessment, but a victim who slipped and fell 20 feet down.a mountainside and cut a finger will, becanse other inj ies might be present and the flowchart give a previsw of the sequence lor the different types of victim you may encounter6 First Aid, CPR, and AED Essentials: eee Injured Vietim Responsive. Without Significant CO! + Primary check + Primary check + Examine chief + Secondary check complaint using pos + SAMPLE history Unresponsive + Primary check + Secondary check using the DOS parts of 00TS SANPLE history from others With Significant Col + Primary check + Secondary check sing DOTS + SAMPLE history Suddenly I Victim Responsive + Primary check + SAMPLE history Unresponsive Using the DOS. parts of DOTS SAMPLE history from others + Examine chief ‘complaint COI = cause of injury: also known as mechanism of injury. DOTS = deformity, open wounds, tenderness, swelling ‘SAMPLE = symptoms, allergies, medications, pertinent history, last oral intake, and events leading up to the illsess or injury Avvietim assessment can provide important infor mation about a problem and help you determine how ‘o ureat it and whether medical care is needed, If the vietim requires medical care, pass what you found dur- ing the assessment to the emergency medical service (EMs) personnel or health care providers. Call 9-1-1 forany vietim with a significant cause of injury (COD or nature of illness, and for any unresponsive victim. You should check the victim systematically. You can do this by performing these five steps: 1. Perform a scene size-up (see the chapter entitled Action at an Emergency) 2. Perlorm a primary check 3, Perform a secondary check, also known asa physical exam or head-to-toe exam, 4, Obtain the victim’s SAMPLE history: 5. Perform a reassessment ‘The scene size-up helps determine the salety of the scene and the general condition of the victim. It is followed by the primary check, in which the first sider idemtifies and treats immediate life-threatening conditions involving problems withthe victim's breath- ing and severe bleeding, Victtms with immediate life- threatening, conditions can die within minates unless their problems ate quickly recognized and treated, A secondary check, consisting of a physical examination, follows the primary check. These pro: cedures can reveal information that will help identify the injury or illness, its severity, and what first aid is needed. Detailed information is gained about the victim's injury (eg, a painful ankle or bleeding nose) or chief complaint (eg, chest pain or itchy skin) Performing the secondary check right after the primary checkand before doing the SAMPLE history. allowsan injury to be found and cared for sooner than ifthe SAMPLE history comes before the secondary check. In some cases, especially when caring fora stranger, performing the SAMPLE history before the secondary check invelves a conversation with the stranger, which may case the victim's anxiety about having a first aider conduct a secondary check. Also, in cases of illness, performing the SAMPLE history before the secondary check can indicate which part of the secondary check should he performed first > Primary Check The second part of a victim assessment sequence is always the primary check. The purpose of the primary check is to identify life-threatening conditions so you can immediately take action to treat the conditions. The primary check includes checking the victim's responsiveness, checking circulation, checking for breathing, and checking for severe bleeding, irst Impression of the Victim While approaching the victim, form an immediate first impression of the victim. This also has beenPeon eect (AYPU scale). Cees reese teen Eee Cinta) aon Senor Beene rea Ceencicuy Coreen Pee tia ul)) Eau}6 First Aid, CPR, and AED Essentials referred to as a general impression, look test, oF gut reaction, Botk the scene size-up and your first impre sion of the victim should help determine 1. Does the victim appear to have an injury oF an illness? If you are unable to determine whether the victim is ill or injured, treat the situation as though he or she were injured. Impressions ean come from such things as the victim's position and the victim's breath- ing sounds, Is the victim obviously responsive or unresponsive? 3. Isthe victim obviously breathing adequately or normally? Talking? 4. Are there signs of obwious bleeding —blood spurting, blood-scaked clothing, blood pooled on the ground oF Hloor? 5. Is there a chance of exposure to the victim's blood or ether body fluids Iso, be sure to use standard precautions before making physical contact with the victim: 2, 6. Is there any danger to you, the victim, or bystanders at the scene? Check Responsiveness Shorlly after reaching the victim, you should have 8 good idea of whether the victim is responsive or unresponsive, If the victim is motionless, genily tap the victim's shoulder and ask loudly, “Are you okay? Beyond this point, how and in wha’ order you conduct the checks will largely depend on the answer to the above question, IF the victim answers, moans, or moves, the vic- tim is responsive, Ifthe vietim does not respond, call 9-1-1 to activate EMS. In the unresponsive victim, look for regular breathing by taking quick look at the chest to see if it risesand falls. If you cannot see any chest movement and cannot hear any sounds (except occasional gasping) of air coming from the nose and mouth, this indicates the vicuin is not breathing, Do not mistake occasional gasping for breathing—it is not! Take immediate stepsto begin CPR, starting with 30 chest compressions followed by two breaths (1 see- cond each), See the chapter entitled CPR for directions on how to perform CPR. A victim's level of responsiveness can range from fully responsive (Conscious) to unresponsive {anconscious), Not all responsive victims are fully alert, and they may respond to different levels of suimulation Verbal First Aid: What to Say to a Victim Use these guidelines for gaining rapport and calming slerl and responsive injured and ill victims: 1. Avoid negative statements that could add to a victim's distress and anxiety. 2. Your first words toa victim are very important because they set the tone of your interaction, 3. Do not ask unnecessary questions uniess it aids treatment or satisfies the victim's need to talk 4. Tears and/or laughter can be normal. Let the victim know this if such responses seem to make him or ner fee! embarrasseo, 5, Stress the positive. For example, instead of, "You will not have any pain,” say, "The worst is over.” 6, Do not deny the obvious. For exemple instead of saying, "There is nothing wrong," say, “You've had quite a fall and probably don't feel too well, but we're going to look at you.” Use the vietim’s name while providing frst ald For analen vietim, hegin by introducing yourself Tell the vietim that you are trained in first aid and ask permission to help, Foran alert, responsive victim, you can evaliate the victim’ ability © remember by asking: ® Person—What is your name? ® Place—Do you know where you are? © Time—What is the month and year? ® Event—What happened? For a motionless victim, tap his o her shoulder and ask, “Are you okay?” If there is no response, check for breathing, Foran unresponsive victim, the steps resemble the same stepsused when beginning to perlorm cardiopul- monary resuscitation (CPR)—RAP-CAB—although ‘most unresponsive victims do not need CPR (see the chapter entitled CPR) Forany motionless person, check responsiveness by gently tapping the victim’ shoulder and shou ting, “Are you okay?” Speak loudly enough to wake the victim he or she 1s seeping Gtep A If there is no response, sctivate FMS by calling 9-1-1 Gtep @ P Alter calling to activate EMS, you should position the victim onto his or her back on a flat, firm surface. 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reached a page that is unavailable for viewing or reached your viewing limit for this book.aa You have either reached a page that is unavailable for viewing or reached your viewing limit for this book.aa You have either reached a page that is unavailable for viewing or reached your viewing limit for this book.aa You have either reached a page that is unavailable for viewing or reached your viewing limit for this book.aa You have either reached a page that is unavailable for viewing or reached your viewing limit for this book.AK Abandonment, 5.2 Abdomen ‘quadrants of, 134 secondary check, 26,27 Abdominal injuries cchapterassessment, 139 chapter review, 138 clesed injuries, 134, 136, 137, 138 impaled objects, 134, 130 open injuries, 134-135, 136, 137, 138 protrading organs, 134-135, 136, 137, 138 recognizing, importance of, 133-124 vital vocabulary, 138 Abrasions, 74,73, 87 Absotbed poisoning, 183 Acetaminophen insect tings, 204, 205 spider bites, 206, 208 Acids chemical burns, 95 poisonings, 184, 185 Act ol commission, 5.2. Act of omission, 6.7 AED. See automated external defibrillator (AED) ‘Agonal respirations, 21 Airway. chest injuries, 150 CPR, 36 RAP-CAB [or unresponsive victim, 21, 22 way obstruction adalts, 40, 41, 42 children, 40, 41,42 defined, 40,47 infants, 40,42 review of, 42 signs 0, +0 unresponsive victims 40 Alcohol incoxication, 185, 187-188, 192 Aleohol based hand sanitizer 13. Alkalis ‘chemical burns, 95 poisonings, 184, 185 Allergies insect ange, 204, 205, 205 SAMPLE history, 30 Amputation care for, 79-81, 86 defined, 74,76, 87 Anaphylaxis care for, 1-62, 66 detined, 66 review of 65 shock, cause of, 58, 59 signs and aympioms, 60 Anatomic splints, 154 “Anemone stings, 219,216 Angina pectoris care for, 162, 163, 179 defined, 162, 181 recognizing, 162, 179 Animal bres care for, 98, 217 overview of, 195-196, 197 rabies, 108, 166, 108, 210 recognizing, 198, 217 Ankle drag, 248 Anterior nosebleed, 115, 128 Antivenom ‘lack widow spider bites, 207 snake bites, 200, 219 {Awe (ash) burns 97 Arm dit, 166, 167 Anerial bleeding, 67.68, 73 Aspirin hear attack, 161, 164, 179 inset stings, 204, 203 spider bites, 206, 208 Assessment of vietims chapter assessment, 33 chapter review, 32 priinty cheek, 18, 20-23, 32 rechecking, 31 SAMPLE history, 28,19, 30,32 secondary check, 18 1S, 23-30, 32 sequence of, 17-18, 19,32 triage, 31,32 vital vocabulary, 32 Asihma care lor, 168-168. 180 elized, 167, 181 recognizing, 167-168 triggers of, 16T, 168 ‘Automated external dfibrilator (AED) cardiac arrest, using for. 50 chapter assessment, 56 chapter review, 56 components of, 50-51 defined, +8, 36 hean function, 48-49, 50 maintenance, 53- rmanafactures, 54 publ locations of 48, 49 skillchecklist, 93 special considerations for use, 51, 33-54 using, 51, 52 vital vneabuaey, 58 Bahan dengan hak ciptaAvulsions eyes, 113, 126 skin, 74, 73,87 B Babinski reflex, 24 Bacittacin, 78 Back, examining, 26, 28 Baking soda paste, 204 Bandages defined, 78,87 elastic, 85, 151-152, 153, 202, 217 types of, 85, Bark scorpions, 210 Barracuda bites, 214, 218 Battery, defined, 4,7, Battle’ sign, 105, 106, 128 Bites and stings animal bites, 195-198, 217, 219 chapter assessment, 219 chapter review, 219 infection, potential for, 77 Insect stings, 205-208, 218 ‘marine animal injuries, 212, 234-217, 218, 219 snake bites, 199-203, 217,219 spider and insect bites, 205-212, 218 vital vocabulary, 219 Slack widow spider bites, 200-207, 209, 218 Blanket pull, 248 Banker (with mo poles) stretcher, 49 Manket-and-pole improvised stretcher, 248-240 252 Bleack solution, for cleaning, 14 Bleeding chapter assessment, 73 chapter review, 73 checking for, 21 exiernal, 67-70, 71, 72, 73 internal, 70-71, 72 vital vocabulary, 73 Blisters burns, 90.93, 95 care for, 81-83 Blood average amount in adults, 67 cleaning alter anemergency, 14 exiernal bleeding, protection from, 68, 69 loss, ascause of shock, 57, 58, 59 Blood vessels, and shock, 57, 58, 59 Board-improvised stretcher, 249, 252 Body temperature. See also hypothermia highest recorded. with recovery. 233, lowest recorded, with full recovery, 220 Bone injuries chapter assessment, 8 chapter review, 8 fractures (See Iractures) vital vocabulary, 148 index @ Brain atiack, See stroke ‘Brain injuries acquired injuries, 108 concussions, 106-107, 126, 128 contusions, 108, 128 coup-conrecoup injuries, 108 described, 106 diffuse axonal injuries, 1085 penetrating inure, 108, signs requiring further care, 108 Breach of dury, 5.2, Breathing, abnormal sounds, checking lor, 21, 22 checking for, with cardine arrest, 35 ches! injeries, 130 difficulty astra), 168 aifficully (heart attack), 161 RAP-CAB for unresponsive victim, 21, 22 rescue breaths, with CPR, 36 Brown recluse spider bites, 206, 207-208, 209, 218, Burns care for, 99-99, 96, 102 chapter assessment, 103, chapter review, 103 chemical, 89, 95, 97. 98, 102, 103 depth of,90, 91, 103 electrical, 89-90, 67, 98-101, 102, 103 extent of, 90-91, 92, 93 light burns to the eye, 113, 126 respiratory involvement, 91-92 severity, calculating, 92 thermal, 89, 99-97, 103 types of, 89-80, 103 vital vocabulary, 103, 1 c {Cainmine lotion, 190, 19, 192 Galling9-1-), 9-11, eng Capillaty bleeding, 67-68,73 apillagy rll tex, 12 Cae ae oes carbon monoxide, defined, 188, 193 ate foe Wet, 189, 182 recognising, 188-189, 192 ardiacartest AED use, 50 caring for, 34-35, 47 defined, 34,47 Cardiopulmonary resuscitation (CPR) adult CPR. 35-36, 37, 48 aduls, children, and infants defined, 35 airway obstruction 40-12, 47 tiewny Geena 36 breathing. checking for, 35 cardiac arrest, 34-35, 47 changes in procedure, 43 chapter assessment, 47 Bahan dengan hak cipta@ First Aid, CPR, and AED Essentials chapter reviews chest compressions, child CPR, 35-30, 38 defined, 34-35, 47 heart attack, described, 34, 47 infant CPR, 35-36, 39 rescue breaths, | responsiveness, checking for, 39 review of, 42 review of, using RAP-CAB steps, 45-46 vital vocabulary, 47 Cat bites, 195 Cause of injury ned, 18, 32 extremity injuries, 150 no significant canes, 26, 20 secondary check, 23-24 significant causes, 24-20, 27-28 Cerebrospinal fluid (CSF), 105, 106 Chain of survival, 34-35, 47 Chairearry, 251 Chemical burns ‘care for, 99,95, 97, 98 ‘causes of, 95 defined, 89, 103, eyes, in, 111,113, 126 Chest, examining, 25-26, 27 Chest compressions in CPR defined, 35,47 duration of performing, 35 hhand position, 35 rate for, 35-36 Chest injuries ‘chapter assessment, 159 chapter review, 138 clesed injures, 130-131, 132, 157,138 flail ehest, 131, 138 impaled objects, 132, 133, 137 open injuries, 122, 133, 137, 138 rib fractures, 130-131, 132, 137, 138 sucking chest wound, 132, 133, 137, 138 vital vocabulary, 138 CCheet pain, eauses of, 161, 162, 163 Childven ‘AED use, 93 aleway obstruction, 40,41, 42 consent issues, 4-5 EPR, 35-36, 38 Choking, universal sign of, 40 Chronic bronchitis, 170 Chronic obstructive pulmonary disease (COPD), 169-170, 180 Cineionats Prehospptal Stroke Scale, 166 36, 47 Circulation. See also CSM (Circulation, Sensation, Movemend assessment cchest compressions in CPR, 35-36, 47 chest injuries, 150 ‘exiremity injtty, checking pulse beyond, 142 presnure bandages, 70 RAP-CAB for unresponsive victim, 21, 22 Classic heatstroke, 234 ‘Cleaning after an emergency, 1 ‘Clenched-fist injuries fight bite”), 78, 198 Closed abdominal injuries, 134, 136, 137, 138, ‘Closed chest injury, 130-131, 132, 137, 138 ‘Closed fracture, 140, 141, 148 Closed wounds, 8¢ old applications. Seeice packs Cold related emergencies chapter assessment, 23 chapter review, 23) Frostbite, 221, 222-225, 230, 231 frostaip, 221-223, 231 hypothermia, 225-220, 230,231 vital vocabulary, 231 (Cold-water immersion, 241, 245 Colloidal oatmeal bath, 190, 191, 192 ‘Communicable disease, 12. 15. Compression, in RICE procedure, 151152, 153 Concussions ‘care for, 126 defined, 106, 128 recovery from, 107 symptoms of. 107 Confidentiality, § Confined spaces, resexe from, 246 ‘Consent for treatment chiléren and mentally incompetent adults, 45 delined, £7. expressed consent, 4,2 implied consent, ‘Contact (plant) dermatitis, 189-191, 192 Contact lenses, 114 Coatusions ‘brain, 108, 128 defined, 150, 1357 muscles, 146, 147 ‘COPD (chronic obstructive pulmonary disease), 169-170, 180 Copperhead snakes, 199, 200 Coral snakes, 199, 200, 201, 202, 217 ‘Cottonmeuth (water moccasin) snakes, 199, 200 ‘Coup-contrecoup injury, 108 (CPR. See cardiopulmonary resuscitation (CPR) Cradle carry, 249 ‘Gramps, heat, 232-233, 238, 239 Cramps, muscular care for, 146, 147 defined, 145-40, 148 recognizing, 146, 147 Crepitus, 141, 148, Growing bresths, 21 (CSF (cerebrespinal fluid), 105, 106 ‘CSM (Circulation, Sersatlon, Movemend assessment extremities, secondary check of, 26 extremity injuries, 150 fractures, 142. 143-144 Cyanosis, 21, 29 Bahan dengan hak ciptaD Death alcohol intoxication, 187 animal-related, 195, 196 cardiac arrest, 3+ injury pyramid, 3 leading causes of, in U.S..2 snake bites, 199 triage category, 31,247 Defibillaion. Seals automated external defibrillator (AED) cardiacarrest, 39 defined, 48, 56 Deformity, checking for, 24, 25, 32. See also DOTS (Detormity, Open wounds, Tenderness, Swelling) Dehydration, severe, 233 Delayed care tage category, 31, 247 Dental injuries bien lip ortongue, 117, 127 Ipvoken tooth, 120 care of, 19 knocked-out tooth, 117-118, 120, 127 loosened tooth, 117 “objects caught between the teeth, 137 toathache, 120, 127 Diabetes described, 175, 181 hyperglycemia, care for, 176, 177, 178, 180 hyperglcemia, recognizing 176, 177, 178, 180,181 hypoglycemia. care for, 175-177. 178, 180 hypoglycemia, recognizing, 176, 177, 178, 180 types of, 175-176 Diffuse axonal injury, 108 Direct pressure for external bleeding, 68, 69, 72 Disease precautions cleaning up afieran emergency handwashing, 12 personal protective equipment,13.15, Aypes of diseases, 12.15. Dislocations care for, 144-145, 147 defined, 150, 157 recognizing, 144, 147 Dogs bites, 195, 196 rescue irom, 246 DOTS (Deformity, Open wounds, Tenderness, Swelling) exiremity injuries, 149 fractures, 131, 197 injary signsand symptoms, 24,25, 32 Doughnut-shaped (ting) bandage, 70 Dressings burns, 94, 95 éelined, 75, 87 types of, 85, wounds, covering, 77-78 Drowning Vietim, care for, 24, 242 Drowsiness, alter a head injury, 108 Drug emergencies, 188, 192 Duty o ac, 5-6, 4 index @ E Ea xarining, 25,27 jaan Elastic bandages described 85 extremity injures, 151-152, 153, shale bites, 202,217 eee cate 99,100,102 dered, 89-90, 103 inter tissue damage, 9, 101 source of, 99 typer of 27, 98 Electrical emergency sce, 20 Elevation, in RICE procedure, 132,133 Enibedéed sbjects Sex impaledemeded objects Eregecies asin cating chapet review, 3 disease precautions, 12-14 13 cihesgendes, caratteriaicgo 9 EMS, procedure for caling. 11 feeetae er Oil mela care, seeking, 10-11 at tal vocabulary, 15 Eneieeeadielserice 5) calling procedure fr, I-12 rechecking victim before arrival of, 31 Enpliysema 17D Eplepy, 172 Seals seizures Epinephrine auc injectors anaphylaxis, 61-62, 66 inset ngs 204,203,206 Brent kading fo las oF injury, or SAMPLE history, 30 Eyerionl eatstoke, 234 Expresed consent 2 External bleeding care for, 8-70, 71,72 pes of 67-68, 73 Enemies, examining, 26,28 Exes cay. 231 Extremty injuries assessment of, 149-150 ceainttee is lapertview 57 RCE procedure, 190-193 stings 159,157 Spliting, 154-156, 15; yper of 130,15 al vocabulary, 157 bye injuries lows to the eye 110,126 care of, 12 haa the eyes, 11,113,126 contact lenses, 14 usa dhe eye ar le 11, 126 eye avulsion, 113, 126 58 Bahan dengan hak cipta@ First Aid, CPR, and AED Essentials impaled (embedded) objects, 8+ light burns, 113, 126 loose objects in, 113, L14, 126 penetrating, 108, 110, 126 sympathetic eye movernent, 111 Eyes problems afer head injuries, 108 secondary check, 29,20, 27 F Facial droop, 165, 156 Fainting ‘care for, 170, 171, 172, 180 described, 170, 181 psychogenic shock, 59, 64 recognizing 170, 171, 180 Farm animals, rescue from, 246 ight bite’ (clenched fis injury), 78, 198 Fire ant stings, 203,205, Fire fighters carry Fires, rescue from, 245-246 First aid chapter assessment, § chapter review, Z defined, 3,2 expected level ofcare, 3 legal issues, 3-6. OSHA regulations, 2 supplies for, 3.4 taining, importance of, vital vocabulary, First impression ofthe vietim, 18, 20, 32 First-degreeuperficial) burns, 00, 83-04, 96,102, 103 Hail chest, 131, 138 Fash (are) burs, 97 Foreign objects eyes. in nose. in, 117 Four-handed seat carry, 251 Fractures, See als splints care for, 41-144, 147 defined, 140, 148, 150, 157 nose. 115. 126 recognizing, 141, 147, 148 types of, 149, Lal, 148 Frostbite ‘ere for, 223-225, 230 defined, 221, 231 recognizing 222-225, 230 Frostnip, 221-222, 231 Full-thickness (hird-degree) burns, 90, 91, 93,95, 102,103 s 14, 126 G Gangrene, 222 Garter snakes, 203 Gaseous poisons, 183 Gasoline poisoning, 183, ‘Gasping breaths, 21 Gestational diabetes, 176 Give Me9 fer Stroke (Walk, Talk, Reach, See, Feel), 105, Gloves extemal bleeding, protection from, 68, 69 ‘open wounds, 76 PPE,13 Glucose levels hyperglycemia, 176, 177, 178, 180, 181 hypoglycemia, 170, 176-177, 178, 180, 181 responsiveness, changein, 150 Good Samaritan laws, 8,2 ‘Gurgling breaths, 21 H HAINES (High Arm IN Endangered Spins) recovery postion, 23 Hammock carry, 252 Hand postion for CPR, 35 Handwashing. 12 Hazardous materials incidents, 244,245 Head, examining, 24-25, 27 Head injuries brain injuries, 106-108, 126, 128 care of, 109 chapter assessment, 129 chapter review, 128 responsiveness, change in, 160 scalp wounds, 104-105, 126 seconclary check, 24 skull fractures, 104, 105-108, 125, 128 vital wesbulaey, 128 Head tit-chin lift method of opening airway, 36 Headache, 108 Heart blood citation, 48-49 slectrieal activity, 40, 50 shock, cause of, 57, 58, 59 Heart atack cardiac axes, differentiating from, 160 care for, 161-162, 179 defined, 4, 47 described, 159-160, 181 medical care, not seeking, 163 medleal care, seeking, 161, 163, 164, 179 recognizing, 160-161, 179, Heat apalications, 151 Heat cramps, 232-233, 238, 239 Heat edema, 236 Heat exnausion, 233-234, 237,238 Heat index, 234,235 Heat rash, 236 Hent syncope, 236 eatrehted emergencies chapter assessment, 239 chapter review, 239 heat cramps. 232-233, 238,238 heat exhaustion, 233-234, 237, 238, heat illnesses, 236 Bahan dengan hak ciptahreatstroke, 233, 234-236, 237, 238 vital vocabulary, 239 Heatstroke ‘eae for, 233, 235-236, 237, 238 classic or exertional recognizing, 233, 234-235, 238 responsiveness, change in, 160 Heimlich maneuver, 40,42 HELP (heat escape lessening position), 241,243 Hemorrhage, defined, 67,73 Hemorthagic stroke, 165 Hobo spider bites, 206, 208, 218 Hognose snakes, 203, Honeybee stings, 203, 204, 205 Hornet stings, 203, 204, 205 Haman bies, 198,217 Human cratch, 249 Hydrecorusone cream, 204, 203 Hydrogen peroxide, 77 Hyperglycemia cate for, 176, delined, 177, 181 recognizing, 176, 177,178, 160 Hyperventilation, 169, 180 Hypoglycemia care for, 176-177, 178, 180 defined, 181 fainting, 170 recognizing, 176, 177, 178, 180 Hypothermia ‘cae for, 226, 228, 229, 230 defined, 225, 231 mild ated severe, differentiating, 225-226, 228 recognizing, 225, 226, 228, 230 responsiveness, change in, 160 7178, 180 I ‘ibuprofen Insect stings, 204, 205 spar bites, 208, 208 toe packs. See isp RICE (Rest, Tee, Compression, Elevation) procedure exivemity injuries, 151 hreatstroke, 236, 237, 238 homemade, 151 insect sings, 204 RICE procedure, 150-151, 153, spaler bites, 206, 207, 209 lee rescue, 241,244 ness, sudden angina, 162-163, 179.181 asthma 167-169, 180, 181 chapter assessment, 182 chapter review, 181 COPD, 169-170, 180 diabetic emergencies, 175-178, 180, 181 fainting, 170-172, 180, 181 hheart atack, 159-162, 163, 164, 179, 181 index 6 hyperventilation, 169, 180 pregnancy, emergencies during, 179, 180 responsiveness, change in, 158, 160 seizures, 172-174, 180, 181 stroke, 163, 165-167, 179, 181 vital vocabulary, 181 Immediate care triage category, 31, 247 Impaled/embedded objects abdomen, 134, 136 care for, 83-84, 86 chest, 132, 133, 137 fs, in, 84 head injures, 100 puncture wounds, 74, 75, 87 Implanted devices, and AED use, 53,54 Implied conser Incisions, 74, 75, 87 Innis AED use, 33, airway obstruction, 40, 42 CR, 35-35, 3 Infection brain, 108 dlisease precautions, 12-1415 septi shock, 59 wounds, 18-79 Infectious disease, defined, 12 Ingested poisons care for victims, 184-185, 186, 192, 193 dleseribed, 183, 184, 193 recognizing, 184. 186 Inkaled poisoning, 183 Inshalers, forasthma, 168-169, 180 Injected poisoning, 183 Injuries Seealso specific types of injuries exposing to check, 29 pyramid of severity, 2.3 Insect bites mosquitoes, 210 leks, 210-212, 213, 218 Insect stings allergic reaction, 204, 205, 206 cere for, 203-208 recognizing, 203, 218 Internal bleeding care for, 70-71, 72 recognizing, 70 Ischemic stroke, 165 Isopropyl alcohol Cleaning after an emergency, wounds, 77 5 Jellyfish stings, 214, 25, 216, 218 Joiat injuries: Seealso splints chapter assessment, 148 chapter review, 148 dislocations, H4—145, 147 Bahan dengan hak ciptae@ First Aid, CPR, and AED Essentials sprains, 145, 147, 148 vial vocabulary, 148 K Kerosene poisoning, 183 Knot method of tick removal, 211 L Lacentions 18, 11, 126 skin, 74,75.87 LAF (Look And Fee) for signs of inury, 24 Last orl intake, for SAMPLE history, 30 Legal and ethical issues fbandonencat, 5.2 breach of duty, 6.2 confidentiality consent, 4-5. dury toact, 5-6, Good Samaritan laws 8.2 injury and damages inflicted, ¢ lawsuits, avoiding, 3,5 negligence, 5.2 relusal of hp, 3 Lifting, principles of Lip, ten, 117,127 Liquid poisons, 183 lyme disease, 211 M Marine animal injuries mmavine anisaals that sting, 214-215, 216, 218, 219 sharks, 212, 214, 218, stingrays, 215, 216, 217, 218 Medical care, secking, Swe also 9-1-2, calling abdominal injuries, 134, 135, angina, 163,179) Drain injures, fier, 108, ‘chest injuries, 131, 132, 133 deciding to call 1-1, 10-11 diabetic emergencies, 176, 177, 178, 180 dislocations, 145 fainting, 171, 172 fractures, 143 frosthite, 223, 224 heart attack, 161, 163, 164, 179 hestrelated emergencies, 133, 234,235, 237, 238 hypothermia, 226, 228, 230 ingested poisoning victims, 18, 180, 192 insect sings, 205, 205 pregnancy, emergencies during, 179, 180 RAP-CAB for unresponsive vielim, 20,22 seizures, 173, 174, 180 shark bites, 214,216 snake bites, 202 spider bites, 207,208, 209 stoke, 166, 19 ‘wounds, 78, 84-85 Medical emergencies. Se ilness, sudden Mesical identification tags, 29-30 Medication patches, and AED use, 53 Medications, in SAMPLE history, 30 Mental incompetence, and consent issues, 4-9 Mobility, after head injures, 103 Moray cel bies, 214, 218 Moeqio bites, 210 Motor vehicle crashes, rescue from, 244-245 Mouth, See also dental injures bitten lip or tengue, 117, 127 examining, 25,27 Moutheio-barrier devices, 3 Mouth-to-breathing device reseue breaths, 36 Mouth-lo-nese rescue breaths, 36 Mouth-io-stoma rescue breaths, 36 Moving victims See aso rescuing ard moving victims emergency moves, 248-252 Isang, principles of, 247 honemergency mores, 208-249, 252 reasons lo, 247 Feasons to not mow a vetim, 248 Moscle injuries chapter assessment, 148 chapter review, 18 contusions, 146, 147 cramps, 145-146, 147, 148 strains, 15, 197 vital vocabulary, 48 Myoeaidial infarction (MD. See hear attack N Naproxen, 205 Nature of illness, defined, 18, 32 Nausea, after head injary, 108 Nebulizers, 168 Neck, examining, 25,27 Negligence, 5.2 Nematocyst, 214, 218 Neosporin, 77,78, Nearogenic shock, 58, 58 9.11, calling See lzo medical care, seeking confined spaces, rescue from, 246 deeiding.to call, 0-11 fires, 245 information te give dispatcher, 11-12 motor vehicle crashes, 244 Niteoglyeerin angina, 102, 103, 178 hear attack, 161-162, 164 Nose, examining 25,27, Nose finarios broken nose, 115, 126 nosebleeds, 114-113, objects inthe nose, 117 16, 126, 128 Bahan dengan hak cipta° Open abdominal injuries, 134-135, 136, 137, 138 Openches injury, 132, 133, 137, 138 Open fractures, 140, Mi, 142-143, 148 Open wounds. See eso dressings cee for, 76 checking for, 24.25, 32 cleaning, 76-77, covering, 77-78, 87 infection, 78-79 metlical care, seeking. 78 types of, 74-76, 86, 87 OSHA regulations for first aid, 2. P Facemaker cells ofthe heart, 49 Facermakere, and AED we, Fackestrap carry, 250 Tartlalthickness(second-depes) burns, 90, 93, 94-95, 102, 103 ast medical history for SAMPLE history, 32 Foks pelvic iajures, 135, 137, 139 scsonslary check 26,28 Fenetrating injuries brain, 108 eyes, 108, 10, 126 Ferfusion wrangle, 57-58 TERRL (Pupils, Equal, Round, Reactive to Light) 25,26 Fersonal protective equipment (PPE, 13,15, 68,69, 76 Figayback ear), 259 Hi vipers, 199-202, 203, 217,219 Fant (contact) dermatitis, 189-191, 192 Tocket face masks, 12 Foison Help, phone number for, 184, 186, 192, 193 Toison ivy, 189-191 Foison oak, 189-191 Foison sumac, 189-191 Poisoning aleohol emergencies, 185, 187-188, 192 carbon monoxide poisoning, 188-189, 192, 193 chapter assessment, 194 chapterreview, 193 common household poisons, 183, drug emergencies, 188, 192 Ingested posons, 183, 14-189, 180, 192, 195 plant (contact) dermatitis, 189-191, 192 poison, defined, 183,193 poisons, dilating, 184 vital vocabslary, 193 Folysporin, 17 Tortuguese man-ofsar tings, 214, 216, 218 Fositioning the victim chest injuries, 130 HAINES recovery position, 23 TIELP (heat escape lessening pasta), 241, 20) primary check, 21, 23, index @ recovery position, 20, 22, 23, 185 shock, 6 ipod position, 23, 108 Postericr nosebleeds, 115, 128 Povidore iodine, 77 PPE (personal protective equipmen Pregnancy emergencies during, 179, 180 sestational diabetes, 176 Pressure bardage, 68, 69, 70, Prickly beat, 236 Primary check bleeding, 21 breathing, 21 defined, 17, 32 first mpreseton, 18, 20,32 positioning the vieiim, 21, 23 responsiveness, 20-21, 22 sequence of, 18, 19 when to interrupt, 23 Protruding organ injury, 134135, 136, 197,138 Psychogenic shack, 58, 64, 170, 181. See also fainting Pump failure, as cause of shock, 57,3 Puncture wounds animals, 195, 198 described, 74,75. 77. 87 marine animals, 212, 214, 216, 217, 218 pit vipers, 200 Pupils, examining, 25, 26,27 195, 196, 198, 219 Raccoon eyes,” 105, RAP-ABC (Responsiveness, Activate EMS, Position, Airway, Breathing, Circulation) responsive vieim, 21 RAP-CAB (Kesponsiveness Activate EMS, Position, Circulation, Airway, Breatbing) adult CPR, 44, 45-46 basic Hie support, 4548 unzesponsivevietin, 20-21, 22 Rattlesnakes, 198, 200, 203 *Reachthrow-row-yo" for water escue, 240-241, 42 Rechecking victims, 3 Recovery position, Refusal of help, Rescue breaths, with CPR, 36 Rescuing and moving victims chaper assessment, 25+ chapter seview, 253 confined spaces, 246 dogs, rescte from, 240 clectical emergeney rescue, 248 emergency moves, 248-252 farm animals, rose frm, 246 fires, 245-246 hazardous materials incklens, 254,245 ice rescue, 241, 244 23, 185 Bahan dengan hak cipta@ First Aid, CPR, and AED Essentials motor vehicle creshes, 244-245 moving victims, reasons for, 247 rnonemergency moves, 248-248, 252 triage, 240-247.187, vial vocabulary, 253 water rescue, 240-241, 242, 243, Respiratory system ‘burns, 91-92 shock, 59 Responsiveness ‘hacking for, 20-21, 22 cor, 35 unexplained change in, 159, 160, Rest, in RICE procedure, 150 Rib fractures, 130-131, 132, 137, 138 RICE (Rest, les, Compression, Elevation) procedare contusions, 146 described, 130153, dislocations. 144 ‘external blesding, 72 sprains 145 strains, 145 Rigid splits, 154 Ring oughnu-shaped) banda Rocky Mountain spotted fever, 211 ule of 15s for ow blood glucose, 176 ule of nines for burns, 91 Rae ofthe hana (pale, 91, £2, 93 "Rule of thirds" for extremity injuries, 149 s Sal heat-related illnesses, 233, 234 imusce cramps, 140 SAMPLE (ymptoms. Allergies, Medications, Past medical Fistor, Las orl intake, Events leading up to illness or injury) hicory defined, 15,32 deseribed, 30 sequence of assessment, 18, 19 Sealp wounds, 104-105, 136 Scene size-up, 12,15 Scorpion bites, 209,210, 218 Secorslary check cause of injury, 23-24 clues, additional, 30 defined, 18,32 goal of, 23 Thead andl spinal injury, 24 key signs are symptoms, 24,25, 32 medical ID tags, 28-30 reliably of, 24 sequence of 18,19 special considerations, 28 Vietim with no significant cause of injury, 26,29 vietim with significant cause of injury, 24-26, 27-28 second-degree (parial-thicknese) burns, 90, 93, 94-95, 102, 103 Soisures care for, 173, 174, 180 causes of, 172 defined, 172, 181 head injury, 108 recognizing, 172-173, 174, 180 responsiveness, change in, 160 stalus epilepticus, 175, 181 Seli-splints, 154 Semi-sitting position, 23 Septie shock, 59 Shark bates, 212, 214, 218 Shivering, and hypothermia, 226, 228, 230, shock caring for, 60-64 ccaseee of, 37-50, 65 chapter assessment, 65 chapter review, 6 defined. 57, 66 moving victims, 64 progression of, 50-60 responsiveness, changein, 160 review of, 65 vital vocabulary, 66 shoulder drag, 248 Signs, defined, 24, 32 Silver based antibiotic eream (Silvadene) burns, 94 wounds, 78 Skin color, temperature, and moisture, 29 Skull fractures caring for, 105-106, 125 caring for wounds with, 104, 105 defined, 105, 128 recognizing, 105, 106, 128 Slings, 156, 157 Snake bites ‘antivenom, 200, 219 incidence of, 199) rnonpoisonous snakes, 201, 203 ‘venomous snakes, 199-203, 217, 219 Snoring 21 Soft aplins, 154 Solid poisons, 183 speech head injury, 108 stroke victims, 165, 166 Spider bites black widow spiders, 206-207, 209, 218 Drown recluse spiders, 206, 207-208, 209,218 hobo spiders, 206, 208, 218 tarantulas, 208, 200 Spinal injuries ‘cave for, 121-122, 125, 127 ‘causes, 120, 121 chapter assessment, 129 chapter review, 128 checking for, in a responsive vietim, 122-123 checking for, in an unresponsive victim, 124 Bahan dengan hak ciptadrowning victim, care for, 241 positioning she viet, 21,23 Fecognizing, 120-121, 122-124, 127 secondary check, 24 victims, moving, 248 victims, not moving, 122 vital vocabulary, 128 splints applying, 155-156 delined, 154, 157 types of, 154 Sprains cae for, 145, 147 delined, 145, 148, 150, 157 recognizing 145, 147 Spray poisons, 183 Standard precautions, 12.15, Status epilepticus, 173, 181 Stingray injuries, 215, 216, 217, 218 Stings. Seebites and stings STOP (Supir, seizures, stoke, shock, Temperature, Cxygen Poisoning, pressure on brain) reasons for change in responsiveness, 159, 160 Strains cae for, 145, 147 defined. 150, 157 recognizing 145, 147 stroke acquired brain irjury, 108 cere for, 166, 178 eseribed, 193, 165, 181 recognizing, 165-166, 167, 172 responsivencss, change i, 160 types of, 165 Sucking chest wound, 132, 133, 137, 138 Superficial (first-degree) burns, 96, 93-94, 96, 102, 103 Sutures, 78, 85 Swathe, 156, 157 ‘welling, checking lor, 24, 25, 32 sympioms. defined, 24,32 SAMPLE history, 30 syncope, 170, 181. See alo fainting T Taran bites, 208, 209 Teeth, See dental injuries Tenderness, checking for, 24,25, 32 ‘endinitis, 130, 157 Tetanus animal bites, 195, 198 ‘Thermal barns Seealso burns defined, 89, 103 electrical, 97 Third degre (ull-thickness) burns, 90, 91,93, 85, 102, 103 Tk bites, 210-212, 213, 218 index @ ‘Tongue airway obstruction, 40 bitten, 147, 127 ‘Triage described, 31, 32, 246, 253 victim classification, 247 Tripod position, 23, 168 ‘True electrical inpuries, 97,98, LO Tumors, brain, 108 Two-handed seat carry, 250 “Two-perton acelsi, 250, v Venous bleeding, 67, 68, 73 Ventricular fibrillation (V-ib), #9, 50 Ventricular tachycardia (V-tach), 49, 50 Vision problems, alter head injuries, 108 Vomiting head injury, 108 poisoning victims, 185 Ww Walking wounded, as triage category, 31,247 ‘Wasp stings, 203, 204, 205 Water AED use, 53 chemical burns, 97, 98 cold, for burns, 93, 04 Water moceasin Cottonmouth) snakes, 199, 200 Wor rescue cold-water immersion, 241, 243 drowning, 241, 242 reach-throw-tow-go, 240-241, 242 Wheezing, 21 Wind chill chart, 227 Wounds amputations, 74 blisters, 81-83 chapter review, 87 cleaning, 76-77 closed, 8¢ slressingsand bandages, 77-78, 8, high-risk, 77, 78 impaled (embedded) objects, 83-84, 86 infection, 78-79 medical care, requiring, 84-85 ‘open, 74-79, 86, 87 scalp, 104-105, 126 vital vocabulary, 87 wound care, myths about, 79 9-81, 86, 87 < Yellow jacket stings, 203, 204, 205 Bahan dengan hak ciptaaa You have either reached a page that is unavailable for viewing or reached your viewing limit for this book.