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Welcome to your:

Emergency First Aid Course

Your Instructor is:

Mr. Tom Gourley

Emergency Medical Supplies

Introduction
Trainer Introduction Course register Health & Safety
Fire drill etc.

Course Format

Areas Covered in this Session


Human Anatomy What is first aid Aims of first aid The Responsibilities of the First Aider Delegation / Confidence / Communication Incident / Casualty priorities Multiple casualties Staying Safe during First Aid DANGER Telephone the Emergency Services 999

Human Anatomy (remind/revise)


1. Trachea 2. Lungs 3. Heart
1

4. Liver
5. Stomach 6. Pancreas

2 4 7

7. Large intestine
8. Small intestine

5 6

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Circulatory System
Veins
Action of muscles around these thin walled vessels squeezes blood through them, and one-way valves keep it from flowing back towards the heart

Largest artery in the body

Aorta

Arteries

Strong muscular, elastic walls enable arteries to expand with each surge of blood away from the heart and towards tissues
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Circulatory System

The Heart

Functions of the Blood


Transportation of gases Nutrition Regulation Protection Excretion

Pulse Points
Carotid Brachial Radial Femoral

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The Respiratory System


Tongue Epiglottis Respirtory Centre (Brain)

Trachea
Lung Diaphragm Alveoli
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Bronchioles

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Define Respiration
Respiration is the exchange of gases, oxygen and carbon dioxide, which takes place in the lungs and cells of the body.

Take in oxygen Remove carbon dioxide

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What is First Aid


The treatment given for any injury, or sudden illness before the arrival of an ambulance, doctor or any other qualified person.

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The Aims of First Aid

To Preserve life To Prevent the condition getting worse To Promote recovery

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Responsibilities of First Aider


Incident Management - Assess the situation / get help Casualty Care - Protect casualty and others from Danger Assess the casualty Identify casualtys injury / Illness Provide treatment Arrange transport Remain with the casualty Prevent cross infection

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Approach and Action


Assess the situation Telephone for help Assess any further danger
Can you cope Do you need assistance

Begin Treatment

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Primary Assessment

Danger your present environment Responses of your casualty Airway


Breathing

Circulation

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Road Traffic Accidents

Speed Kills

Make the accident site safe


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Levels of Response (AVPU)


Alert responds appropriately / aware of place / time Verbal responds in some manner to voice Pain responds in some manner to painful stimuli Unresponsive Does not respond to painful stimuli

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Airway
Before opening the airway (check) for any obstructions and remove (clear) them if possible By tilting the head back and lifting the chin forward, the tongue is drawn away (open) from the back of the throat. Suspected Spinal injuries will differ, majority are conscious. In an unconsciousness casualty the tongue may fall back to block the airway.

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Airway

OPEN AIRWAY
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Breathing Rates

Average Breathing Rates


Adults
Infants and young children

12 20 times per minute 20 - 30 times per minute

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Inspired and Expired Air


Inspired Air
Other Gases 1%

Expired Air

Carbon Dioxide 4%

Other Gases 1%

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Breathing

IF ABSENT BREATHE FOR YOUR CASUALTY !

Look, Listen & Feel up to 10seconds


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Self Protection

ALWAYS WEAR GLOVES


When dealing with blood or body fluids

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Staying Safe during First Aid


Blood and Bodily Fluid
HIV Hepatitis B Always

wear protective gloves and goggles when dealing with blood and body fluids

Environmental Hazards
Traffic Electrical Wires Gas Leak

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Emergency Services 999


Always Give the Following Information:

Name and telephone number Give exact location Type of incident

Seriousness of incident Number of casualties Condition of casualties Any hazards

DON'T HANG UP THE PHONE UNTIL YOU ARE TOLD TO DO SO !


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Multiple Casualties

Assess Danger Remove Danger

Assess Casualties responses


Assess Casualties A.B.C 4 X Bs

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Immediate Care Conditions


Lack of Airway Lack of Breathing Lack of Pulse Suspected Spinal Injury Shock

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Life Threatening Conditions


Asphyxia Bleeding Cardiac arrest Shock

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Principles of Resuscitation
For life to be sustained,:
A constant supply of oxygen must be maintained

and delivered to the brain and other vital organs by circulating the blood.

The pump that maintains this circulation:


Is the heart. If the heart stops (cardiac arrest)

urgent action must be taken if death is to be prevented.

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Lay Rescuer CPR Guidelines


Establish that the casualty is unresponsive
Dial 112/999 ask for cardiac ambulance

Open the Airway


Head tilt/chin lift or, if trauma is suspected, jaw

thrust. Check for normal breathing. (look, listen, feel)

If normal breathing is absent


Give 2 slow breaths (2 seconds per breath) Ensure adequate chest rise, and allow exhalation

between breaths.

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Lay Rescuer CPR Guidelines


Check for signs of circulation
Normal breathing, coughing, or movement in

response to the 2 breaths If signs of circulation are present but there is no normal breathing, provide rescue breathing 1 breath every 6 seconds, about 10 breaths per minute

If no signs of circulation are present,


Begin cycles of 15 chest compressions (about 100

compressions per minute) followed by 2 slow breaths

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Circulation

IF NO PULSE PRESENT COMMENCE CARDIAC MASSAGE !

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Speed is Essential
CPR if Commenced within 3 Minutes of Arrest can Prevent Permanent Brain Damage Buys Time to Allow Successful Defibrillation by Trained personnel

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The Chain of Survival

Early Access

Early CPR

Early Defibrillation

Early Advanced Cardiac Care

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Making a Diagnosis

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Secondary Survey

Monitor Vital Signs


Breathing Pulse Skin Colour Temperature Level of response

Complete Top to Toe Survey Complete Definitive Treatments

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Top to Toe Survey


2. Neck 1. Head 4. Shoulders 3. Chest 6. Abdomen

5. Upper Limbs

7. Pelvis Lower Back 8. Lower Limbs

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Sequence of examination.

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External Clues

If casualty is Unconscious Look for Clues


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Treatment Priorities
ABC Maintain airway (Recovery position) Bleeding Treat large wounds and burns Immobilise bone and joint injuries Other injuries / Conditions Regularly monitor casualty ABC

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Reporting
Casualtys name Casualtys address History of the incident Description of any injuries Any unusual behavior Treatment given Breathing Pulse Response level

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Patient Interview
S A M P L E
Symptoms Allergies Medications Past Medical History

Last Meal
Events

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Dressings & Bandages: Uses


Dressings
Control bleeding Reduce infection

Bandages

Direct pressure Securing dressings etc Reduce swelling, support limbs Restrict movement

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Rules for Applying Dressings


Wear disposable gloves If possible, wash hands Correct size Place pad directly onto wound Avoid touching wound Try not to cough or sneeze

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General Rules for Bandaging


Explain and reassure Posture Support Your positioning

Natural hollows Apply bandages firmly Exposure of digits Check circulation

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Preventing Cross Infection


Always wash your hands
Before dressing a wound

Wear disposable gloves Avoid touching the wound Do not sneeze or cough
When treating a wound

Place soiled dressing in suitable bag


Seal and destroy by incineration

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The Choking Casualty


Recognition Cannot Breathe Cannot Speak Cannot Cough May Clutch Throat

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Effects of Fume Inhalation


Carbon monoxide Vehicle exhausts, chimneys Smoke Fires coughing swollen air passages unconsciousness soot around nose burns

headache, confusion aggression, nausea vomiting, incontinence dusky skin, red tinge unconsciousness

Carbon dioxide Deep enclosed spaces Breathlessness headache Hypoxia confusion unconsciousness

Solvents & Fuels Glues, lighter fluid headache, vomiting stupor unconsciousness death

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Treatment for Asthma


Ensure A, B, C Reassure the patient. Position patient up-right
Leaning forward.

Ensure a good air supply. Monitor vital signs. Assist with medication. 999?

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Medical Assistance for Asthma


Seek medical assistance if: First attack or is severe Inhaler has no effect after 5-10 minutes Casualty is getting worse Breathlessness makes talking difficult Exhaustion Unconsciousness
ABC, Resuscitate if necessary

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Causes of Shock
Blood loss Heart attack Allergic reaction Loss of body fluids Massive infection Damage to spinal nerves

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Shock - First Signs


RECOGNITION:
(adrenaline causes)

Rapid pulse Pale gray skin Cold clammy skin Sweating

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Treatment for Shock

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Blood Loss 2-3 pints


MODERATE LOSS 2 to 3 pints (20% - 30%) Pulse Skin Colour Pupils Breathing slightly raised cold and sweaty pale dilating, but equal slightly raised light headed, faint constant observation and monitoring of vital signs to determine medical progress cool becoming unstable

Consciousness
History Peripheral Temp. General Condition

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Blood Loss over 3 pints


SEVERE LOSS over 3 pints (30% and over)
Pulse Skin Colour Pupils Breathing Consciousness History Peripheral Temp. General Condition fast, light, thready cold and clammy pale - cyanosed dilated and equal, slow to react to light deep sighing - air hunger

apathetic, low pain threshold


may become thirsty and suffer from blurred vision cold poor, could prove fatal

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Causes of Fainting
Temporary reduction of blood flow to the brain Reaction to pain or fright Emotional upset Exhaustion Lack of food Long periods of standing

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Recognition of Fainting
Brief loss of consciousness Fall to the floor Slow pulse Pallor

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Treatment for Fainting


Raise and support lower limbs Fresh air, open window As they recover reassure casualty Assist casualty to sit up Treat any injuries

If unconsciousness persists Call for the ambulance

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Anaphylactic Shock

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Anaphylactic Shock
The name given to a major Allergic reaction within the body; Causes: Specific drugs Stings Ingestion of certain foods (peanuts) Chemical released into the blood stream causing the blood vessels to dilate thus restricting the airway.

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Severe Allergies
Anxiety Blotchy skin Swelling of face Swelling of neck Puffiness around eyes Breathing difficulties Rapid pulse

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Treatment of Severe Allergies


Relieve Breathing Epi-pen

999
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Heart Attack Treatment


Your aims are; Make casualty comfortable Phone for ambulance Monitor vital signs Reassure Prepare to resuscitate if necessary

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First aid priorities


Control blood loss
Pressure, Elevation

Minimise shock Protect from infection Hospital


The nature of the wounding force determines the type of wound and influences its treatment.

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Types of Bleeding
Arterial Venous Capillary Always

wear protective gloves and goggles when dealing with blood and body fluids

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Wound Types

Contusion

Laceration

Incised

Puncture

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Bleeding Control

Pressure Elevation Shock Infection

999
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Internal Bleeding
Bruising / Rigid abdomen Tender abdomen Guarding stomach Symptoms of shock Bleeding from orifices

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Internal Bleeding
Lungs Stomach Kidneys Upper / Lower Bowel Fractured base of skull

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Treatment - Internal Bleeding


A, B, C Treat for shock
Elevate lower limbs if possible Place in the recovery position

if patient becomes unconscious Reassure Monitor vital signs Urgent removal to hospital

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Scalp & Head Wounds


Treatment; Displace skin flaps (Split wounds) Apply direct pressure (Sterile dressing, secure) Lay casualty down slightly raised head & shoulders Unconscious ABC (Recovery position)

Lots of blood, Possible underlying injury

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Minor Wounds
Minor wounds may need medical help
Dog bite, Infected Embedded object etc.

Minor bleeding Foreign bodies Bruises

HYGIENE

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Bleeding from Orifices


Mouth Ear Nose Anus Urethra Vagina

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Various Injuries
Palm wounds Bleeding varicose veins Wounds at joint creases

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Eye Injury
Provide support for the casualtys head Give the casualty a sterile dressing to hold on the eye Arrange removal to hospital

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Types of Head Injury


All Head Injuries Are Serious; Wounds to the scalp Fracture of the skull Concussion Cerebral compression

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Fractured Skull

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Recognition of Concussion
Brief or partial loss of consciousness Nausea, Dizziness on recover Memory loss

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Cerebral Compression
Noisy slow respiration's Slow, full and bounding pulse Flushed face Diminished level of response
going into unconsciousness

Unequal or dilated pupils Intense headache

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Fractured Skull

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Causes of Unconsciousness

F I

Fainting

S Stroke H Heart Attack

Infantile convulsion

A
P E

Asphyxia Poison Epileptic Fit

S Shock

H Head injury

D Diabetes

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Types of Muscles
Voluntary
Biceps etc. Tendons

Involuntary
Operate vital organs Heart etc.

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Soft Tissue Injuries

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Soft Tissue Injuries - Sprains


Sprains are injuries due to: Stretching or tearing ligaments or other tissues at a joint. Caused by a sudden twist or stretch of a joint beyond its normal motion

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Soft Tissue Injuries - Sprains


The Symptoms of a Sprain are: Pain on movement Swelling Tenderness Discoluration

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Soft Tissue Injuries - Strains


A strain is an injury to a muscle or tendon caused by over-exertion. In severe cases muscles or tendons are torn and the muscle fibres are stretched.

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Soft Tissue Injuries - Strains


The Symptoms of a strain are; Intense pain Moderate swelling Painful movement Difficult movement Sometimes, discolouration

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Soft Tissue injuries Treatment (RICER)


Rest the injured part. Apply Ice or cold compress.
(15-20mins)

Compress the injury. Elevate the injured part. Rehabilitate / Recuperation

IF IN DOUBT - TREAT AS A FRACTURE !


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Rehabilitation

Stop moaning I havent started yet

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Functions of the Skeleton


Support Movement Protection Produce blood cells

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Definition of a Fracture
Definition; A broken or cracked bone CAUSES: TYPES Open/Closed Stable/Unstable Greenstick

Direct force
Indirect force Muscular action

Disease

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Simple Fracture

Simple: This is a clean break or crack in the bone

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Comminuted Fracture

Comminuted: This is a type of fracture that produces multiple bone fragments

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Green-Stick Fracture

Green stick: A split in a young, immature bone. Most common in children

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Open Fracture
The exposed bone is Vulnerable to contamination

Wound

Open: In a open fracture, part of the bone breaks through the skin causing bleeding

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Closed Fracture

Closed: The surrounding skin is unbroken.

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Open Fractures
Cover wound, apply dressing Place padding over and around the wound Secure dressing and padding Immobilise injured part 999 Treat casualty for shock N.B. Nothing to eat or drink

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Closed Fractures / Dislocations


Support injured part Secure injured part 999 Circulation
(10 minutes)

N.B. Traction in extreme locations

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Assessment of Injuries
History: (Ask the casualty what happened)
Violent blow or fall Snapping sound Sharp pain

Compare:
One side of the body against another

Visualise:
Try and imagine what happened

X-ray:
Injury may not be obvious

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Assessment of injuries
Recognition; Difficulty moving limbs Pain made worse by movement Distortion Coarse grating at bone ends Shock (Femur, Ribcage, Pelvis) Shortening, bending or twisting

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Dislocations
Partial or full displacement of bones at a joint Tears ligaments Associated fracture External wrenching force Violent muscle contraction Do not attempt to replace joint

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Injuries to the face and jaw


Maintain airway Possible spinal injury Possible head injury Reduce swelling Hospital treatment

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The Human Spine


Spinal Cord
Composed of nerve fibres
Cervical 7

Intervertebral discs
Padding or cushioning Gristle

Thoracic 12

Lumbar 5 Sacrum 5 (fused)

4 coccyx (fused)
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Spinal Injuries
Three things are required; A high index of suspicion. Acute observation. Dexterous and gentle handling.

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Spinal Injury
Your aims are; To prevent further injury Arrange removal to hospital

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Treatment of Spinal Injuries


Call for an ambulance.
do not attempt to treat casualty on your own

Support head and neck. Instruct casualty not to move. Reassurance. Do not move casualty unless in extreme danger.

IF IN DOUBT TREAT AS A SPINAL INJURY

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Principles of Lifting
Assess the Task - Area - Load Bend the knees Broad stable base Back straight (Not necessarily vertical) Firm grip with palm of hand Arms in line with trunk Weight close to center of gravity Turn feet in direction of movement

LIFT WITH THE LEGS

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Types and Causes of Burns


Dry Burn Scald Electrical Burn Chemical Burn Radiation Friction Burn Cold Burn

Fire- Domestic appliances Hot liquids - Steam Low and high voltage - Lightning Industrial & Domestic chemicals Sunburn - Exposure to radiation Fast moving belts Machinery Bare skin contacting ice etc.

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Burns
Superficial

Partial Thickness

Full Thickness
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Treatment of Minor Burns


Your Aim Is; Halt the burning process Relieve the swelling Relieve the pain Minimise risk of infection Seek medical advice

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Treatment of Severe Burns


Your Aim Is To Ensure; Scene safety A, B, C Halt the burning process, Relieve pain Treat for shock
Resuscitate if necessary Treat associated injuries Minimise the risk of

infection Arrange urgent removal to hospital

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Heat Exhaustion
Recognition
Wet / sweaty appearance, Fatigue / Pale look Headaches with possible cramps

Treatment
Remove from offending environment Fan / cool patient Provide cool drink Advise to see doctor or dial 999 if they deteriorate

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Heat Stroke
Recognition

Hot dry red skin Rapid Lowered level of consciousness Nausea and/or vomiting Body temperature above 40C (104F)

Treatment

Remove from offending environment Dial 999 for an Ambulance Cool patient with cold, wet sheets Nothing by mouth

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Hypothermia
General cooling of body
Mild Hypothermia
Shivers - Cool body < 98.6 temperature

Severe Hypothermia
No Shivers Sluggishness Lowered level of

consciousness

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Hypothermia
Treatment
Remove from offending

environment Remove wet clothing Insulate with blanket or covers

Mild
Offer hot drink

Severe
Activate EMS Provide source of heat

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Define Diabetes
A condition in which the body fails to regulate the concentration of sugar in the blood. Diabetics are prone to two main problems:

Hypoglycemia Hyperglycemia

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Signs and Symptoms


Hypoglycemia - Low blood glucose

Colour Skin Consciousness

pale profuse sweating and cold irritable, confused or may be unconscious, fits may be present in later stages rapid and weak normal to rapid sudden, may be minutes sugar

Pulse Breathing Onset Treatment

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Signs and Symptoms


Hyperglycemia - high blood glucose

Colour flushed Skin dry Consciousness restless, drowsy or lethargic behaviour Pulse rapid and full Breathing deep and sighing, possible sweet smell - acetone Onset gradual, hours to days Treatment insulin

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Hypoglycaemia - Treatment
Conscious Patient; Establish A, B, C Help patient to lie or sit down Give sugary foods, drinks etc. Advise to See their Doctor

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Hypoglycaemia - Treatment
Unconscious Patient Establish A, B, C Place patient in recovery position Monitor vital signs Prevent chilling Look for other causes Urgent removal to hospital

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Hyperglycaemia - Treatment
Establish A, B, C Place patient in recovery position Monitor vital signs / Prevent chilling Look for other causes Urgent removal to hospital

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Define Epilepsy
Definition: A condition that causes brief disruptions in the normal electrical activity of the brain.

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Forms of Epilepsy
Absence Seizures
A minor form of epilepsy Resembles daydreaming.

Seizures
A major form of epilepsy.

The patient experiences fits with a period of

unconsciousness.

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Risk Assessment
Hazard means anything that can cause harm (e.g chemicals, electricity, working from ladders etc). Risk is the chance high or low, that somebody will be harmed by the hazard. Look for Hazards Who might be harmed Evaluate the risk Record your findings Review Assessment

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Risk Assessment
Risk Assessments must be suitable and sufficient. You must be able to show that:

A proper check was made


You asked who might be affected

You dealt with all obvious significant hazards, taking into account the number of people who could be involved The precautions are reasonable, and the remaining risk is low

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Risk Assessment
RISK ASSESSMENT SHEET
Company Name.Completed by..Date..
Activity
Weight Lifting

Hazards
Weights falling onto fatigued body

Persons exposed
Weight Lifter

Likelihood
1. Most Unlikely 2. Unlikely 3. Likely 4. Most Likely

Severity
1. Trivial Injury 2. Slight Injury 3. Serious Injury 4. Major Injury or Death

Risk

Rating Bands
1 & 2 Minimal Risk 3 & 4 Low Risk

Action Required
Maintain Control Measures Review Control Measures

Rating Bands
6 & 8 Medium Risk 9, 12 & 16

Action Required
Improve Control Measures Improve Controls immediately and consider stopping work

To establish RISK Rating, multiply LIKELIHOOD by the SEVERITY