Brief Summary
This video provides essential first aid guidance for various injuries and medical emergencies. It covers chest injuries, fractures, burns, cardiac arrest, strokes, anaphylaxis, diabetes, and seizures. Key takeaways include the importance of quick assessment, appropriate immediate actions, and knowing when to seek professional medical help.
- Protecting vital organs in chest injuries and knowing how to improvise a chest seal.
- Stabilising fractures and dislocations, using the RICE method for sprains and strains.
- Recognising different types of burns and applying correct cooling and covering techniques.
- Differentiating between cardiac arrest, heart attack, and stroke, and performing CPR when necessary.
- Managing anaphylaxis with epinephrine auto-injectors and understanding diabetic emergencies.
- Ensuring safety during seizures and providing post-seizure care.
Introduction to Chest Injuries
The chest cavity protects vital organs like the heart and lungs, shielded by ribs, the diaphragm, and intercostal muscles. Chest injuries can disrupt this protection, making quick action crucial. Identifying the injury mechanism early, such as in a car accident causing blunt chest trauma, significantly improves survival chances.
Sucking Chest Wound
A sucking chest wound can lead to a collapsed lung. For example, a construction worker with a puncture wound to the chest may experience air or blood entering the pleural cavity, causing breathing issues. Treatment involves creating a semi-occlusive dressing using plastic and tape, securing three sides and leaving one open as a one-way valve to allow air to escape but prevent re-entry. If spinal injuries are suspected, do not move the patient.
Open Pneumothorax
Penetrating chest trauma can be immediately life-threatening, especially if the wound communicates with the chest cavity, causing an open pneumothorax and potentially collapsing the affected lung. Normally, the lungs fill the pleural cavity on inhalation, aided by the intercostal muscles and diaphragm. In open pneumothorax, a wound creates an open passage between the external environment and the pleural cavity, leading to lung collapse due to loss of negative pressure.
Treatment of Open Pneumothorax
Treatment involves applying a chest seal with a valve to expel blood and air during exhalation, allowing negative pressure to be created and the lung to re-inflate. The Russell chest seal is a state-of-the-art dressing designed by trauma experts, featuring a valve that opens with a small positive pressure gradient and closes with even a small negative pressure, even in the presence of blood. It's latex-free and uses a hydrogel-based dressing for adherence on hairy or sweaty skin.
Improvised Chest Seal
If a chest seal isn't available, an improvised one can be made using everyday products like glove wrappers. The plastic should overlap the wound area by at least 1.5 inches to ensure it doesn't leak. Tape the plastic on all four sides using duct tape if medical tape isn't available. Centre it over the wound, ensuring it's stuck down to prevent air from entering the chest space. Check the patient 360° for additional wounds and repeat the process if necessary.
Fractured Ribs
Fractured ribs are incredibly painful, especially when breathing. Support the chest with a pillow or rolled-up jacket and stabilise the ribs with tape, but never wrap the tape completely around the chest as it may restrict breathing. Signs of a rib fracture include guarding the area, sharp pain when coughing, and an increased respiratory rate. Steps should be taken to relieve pain and symptoms before taking the person to the emergency department for X-rays and evaluation.
Abdominal Injuries
Abdominal injuries, particularly bowel evisceration, can be life-threatening. If part of the bowel protrudes through a wound, prevent infection by covering it with a wet sterile dressing and securing it with cling wrap. Never try to push the bowel back in; it must be handled in a sterile hospital environment. Keep the patient in a semi-sitting position if possible and get them to advanced care quickly.
Internal Abdominal Injuries
Unlike the chest and pelvic areas, the abdomen has no bones to protect it, so any injury can cause serious damage to internal organs like the liver, spleen, or stomach. Hollow organs tend to rupture, while solid organs tear and bleed. Signs include bruising, bleeding, pain, inability to stand, and nausea or vomiting. Treatment involves placing the patient at total rest, usually on their back or affected side with knees raised, ensuring clothing is loose, and providing reassurance.
Protruding Organs
If internal organs protrude outside the body, do not touch them or try to push them back in. Instead, have the person lie flat with their knees bent and cover the organs with a moist sterile dressing that won't stick. Do not allow the patient to eat or drink, and get immediate medical help as soon as possible. The first aider's job is to stabilise the patient until professional help arrives.
Pelvic Injuries
The pelvis protects vital organs and blood vessels. Pelvic injuries result from high-impact accidents and can lead to severe pain, bruising, and swelling. The patient may feel a strong urge to urinate, indicating internal trauma. Stabilise the pelvis with heavy padding like rolled blankets to minimise movement, but avoid applying downward or outward pressure. Advanced techniques should only be performed by trained professionals.
Managing Pelvic Injuries
Pelvic injuries typically involve substantial force, and rupture of blood vessels or organs can be fatal. Always stabilise the pelvis to prevent further movement or injury and never attempt advanced stabilisation techniques without proper training. Be cautious during transport to minimise movement and stress on the injury. The image illustrates the anatomy of the pelvis and highlights common areas affected by pelvic injuries, showing stress or damage to the pelvic structure.
Fractures: Identification and Classification
When managing fractures, the goal is to stabilise the injury, minimise further damage, and ensure the patient receives appropriate care. Common signs include severe pain, swelling, visible deformity, difficulty moving the limb, and crepitus. Fractures are classified into closed (bone doesn't break through skin) and open (bone breaks through skin), with open fractures being more dangerous due to infection risk.
Fractures: Management and Treatment
Begin by exposing the injured limb, carefully removing clothing to assess the injury. Dress open wounds with sterile bandages to prevent infection, using a ring bandage for exposed bones. Splint the limb to immobilise it, ensuring you immobilise the joints above and below the fracture site. Check circulation, motor function, and sensation before and after applying the splint. Elevate the limb gently to reduce swelling and arrange for transport to medical care.
Fractures: Scenario Example
In a scenario where a soccer player falls and can't move their arm, remove their jersey sleeve to assess the injury. If there's no bleeding, gently splint the arm, immobilising the wrist and elbow. After checking their fingers for circulation, elevate the arm with support and get them to a nearby clinic for X-rays and further care. Staying calm and following these steps ensures the patient's safety and comfort.
Splinting: Introduction and Objectives
A splint is used to hold an extremity stable in a traumatic event where an orthopedic injury is suspected, such as a fracture or dislocation. Splints reduce pain and prevent further orthopedic or soft tissue injury. When splinting a long bone fracture, immobilise the joint above and below. For a joint injury, immobilise the long bone above and below. Splinting is an objective-based practice, and you can improvise splints if needed.
Splinting: Signs and Symptoms of Orthopedic Injury
Signs and symptoms of an orthopedic injury include pain at the site, severe bruising, a false joint where the arm or leg bends where it shouldn't, reduced movement distal to the injury, and an open fracture where bone ends are visible. Crepitus and the patient reporting a snap, crackle, or pop during the event are also indicators. Official diagnosis requires imaging in a hospital.
Splinting: Process and Application
The first step in splinting is to check the patient's circulation, motion, and sensation distal to the injury. Pinch the finger to check capillary refill, assess motion, and check for numbness. Stabilise the injury, size the splint to the uninjured extremity, and apply the splint under or over the injury. Wrap the splint onto their arm, reducing motion of the joint above and below for long bones, and the long bone above and below for joint injuries.
Splinting: Post-Application and Splint Types
After applying the splint, recheck the patient's circulation, motion, and sensation. If reduced, reassess the splint to ensure it's not too tight. Seek definitive care as quickly as possible. A Sam splint is recommended for its versatility and compactness. Carry roller gauze or Coban to secure the splint and a triangular bandage to create a sling. Improvise a splint if necessary, but commercial products are more comfortable and quicker to apply.
Bone Fractures: Types and Mechanisms
Bones can break depending on the mechanism of injury, bone strength, and force applied. An open or compound fracture occurs when the bone forces through the skin, leading to excessive bleeding and infection risk. Different types of fractures include transverse, stable, complicated, fracture dislocation, green stick, spiral, compression, stress, impacted, oblique, comminuted, evulsion, and segmental fractures.
Dislocations: Identification and Management
Dislocations occur when a joint is forced out of its normal position, resulting in visible deformity and pain. Identification involves looking for visible deformity, swelling, inability to move the joint, and severe pain. Do not attempt to relocate the joint; immobilise the limb in the position found, apply a splint if necessary, and transport the patient to advanced medical care.
Dislocations: Scenario Example and Key Actions
In a scenario where a relative dislocates their elbow, reassure them and stabilise the injury without trying to straighten the arm. Gently place it in a sling for support and comfort, then arrange for transportation to the nearest hospital. Dislocations require expert care, so focus on immobilisation and safe transport.
Sprains and Strains: Overview and Identification
Sprains involve damage to ligaments, while strains involve damage to muscles or tendons. Both share similar signs: pain and tenderness, swelling and bruising, and difficulty moving the joint or muscle. Sprains are typically associated with sudden movements involving twisting or impact on a joint, while strains are related to repetitive movements, overuse, or improper stretching.
Sprains and Strains: Scenario Example and Key Differences
In a soccer game, a player twisting their ankle during a pivot likely has a sprain, while another clutching their hamstring after sprinting likely has a strain. Recognising whether it's a sprain or strain helps determine the next steps, such as immobilising the area or advising rest and recovery.
The RICE's Method for Sprains and Strains
The RICE's method is effective for managing sprains, strains, and soft tissue injuries. Rest involves stopping any activity that stresses the injured area. Ice reduces swelling and numbs pain, applied for 20 minutes at a time. Compression involves wrapping the injured area snugly with a bandage. Elevation raises the injured area above heart level. Splint immobilises the injured joint or muscle.
RICE's Method: Scenario Example and Key Benefits
If a child twists their ankle playing soccer, encourage them to rest, apply an ice pack wrapped in a towel for 20 minutes, gently wrap the ankle with an elastic bandage, elevate the ankle on a cushion, and immobilise the ankle with a splint if needed. The RICE's method provides immediate relief, promotes recovery, and prevents further injury.
Sprains and Strains: Notes and Good Practices
Sprains frequently occur in joints like the ankle, wrist, and knee, while strains are common in muscles like the hamstrings, lower back, or shoulders. Monitor circulation during compression or splinting, avoid applying heat to a fresh injury, encourage gentle movement during recovery, and seek medical advice for severe injuries.
Burns: Types and Causes
Burns are classified based on their source: thermal burns from extreme heat or cold, chemical burns from corrosive substances, electrical burns from electrical current, and radiation burns from UV light or radioactive materials. Each type requires specific care to address its unique challenges.
Burns: Classification and Immediate Treatment
Burns are categorised into first-degree (superficial), second-degree (affecting epidermis and dermis), and third-degree (full thickness). Treatment focuses on minimising damage and preventing infection. Stop the burning process, cool the burn with cool running water for 10-20 minutes, cover the burn with a sterile non-stick dressing, relieve pain with over-the-counter pain relief, and seek medical attention for larger or severe burns.
Burns: Additional Points and Good Practices
Chemical burns require immediate flushing with water for at least 20 minutes. Electrical burns may appear minor but often cause internal damage. Avoid popping blisters. Use only clean sterile materials to dress burns, never apply heat or homemade remedies, and monitor the patient for signs of shock.
Inhalation Burns: Identification and Action
Inhalation burns occur when the respiratory system is exposed to extreme heat, smoke, or toxic fumes. Look for burns or soot around the mouth and nose, difficulty breathing, singed nasal hairs, changes in voice, and black or soot-coloured sputum. Prioritise getting the patient to fresh air and seek emergency medical care immediately.
Burn Cautions: What Not to Do
Do not apply ice or freezing water directly to burns, pop blisters, apply home remedies, remove clothing stuck to the burn, apply heat, touch the burn with bare hands, or attempt to neutralise chemical burns with other chemicals. Ensure the electrical source is turned off before touching the patient, do not delay seeking medical care, avoid overcompression with bandages, monitor for shock, avoid contaminating the burn, and be cautious with inhalation burns.
Cardiac Arrest vs. Heart Attack: Understanding the Difference
Cardiac arrest occurs when the heart suddenly stops beating, requiring immediate CPR and an AED. A heart attack is caused by a blockage in blood flow to the heart muscle, with symptoms including chest pain, shortness of breath, and nausea. Recognising the symptoms of each is crucial for effective intervention.
Cardiac Arrest and Heart Attack: Recognising Symptoms
In cardiac arrest, the patient collapses suddenly and becomes unresponsive with no pulse or breathing. In heart attacks, symptoms are often more gradual, including persistent chest pain, radiating pain, shortness of breath, nausea, and sweating.
Cardiac Arrest: Immediate Action
In cardiac arrest, check for responsiveness and breathing. If there's no pulse or breathing, call emergency services immediately. Begin CPR with 30 chest compressions followed by two rescue breaths. If an AED is available, follow the prompts.
Heart Attack: Management and Care
Managing a heart attack involves reducing stress on the heart and seeking immediate medical help. Call emergency services, keep the patient calm and seated, loosen tight clothing, and give them aspirin if they aren't allergic. Monitor the patient closely and provide reassurance.
Heart Attack Symptoms in Women
Heart attack symptoms in women are often more subtle and may differ from classic chest pain. They may experience unusual fatigue, pain in the back, neck, jaw, or arms, shortness of breath, nausea, vomiting, cold sweats, or indigestion. It's important to take these symptoms seriously and seek medical attention right away.
Cardiac Emergencies: Notes, Cautions, and Good Practices
Cardiac arrest requires immediate CPR and an AED, while heart attacks benefit from aspirin and rest. Never give food, drink, or medication (apart from aspirin) to someone experiencing a heart attack unless instructed by medical professionals. In cardiac arrest, do not delay CPR while waiting for the AED. Ensure the scene is safe, delegate tasks to bystanders, and remain calm.
Stroke: Understanding and Identifying
A stroke occurs when blood flow to the brain is interrupted, either due to a blockage (ischemic stroke) or bleeding (hemorrhagic stroke). Recognising a stroke involves observing key signs using the FAST method: Facial drooping, Arm weakness, Speech difficulty, and Time to call emergency services. Additional symptoms include sudden confusion, severe headaches, blurred vision, dizziness, and paralysis.
Stroke: Risk Factors and Early Recognition
Risk factors for stroke include advancing age, family history of heart disease, diabetes, high blood pressure, high cholesterol, smoking, poor physical fitness, obesity, and stress. Use the FAST method to quickly identify symptoms: ask the person to smile, lift both arms, and listen to their speech.
Stroke: Management and Action
Managing a stroke requires calmness and quick action. Call emergency services immediately, keep the patient seated and calm, and if they are unconscious, place them in the recovery position. Monitor their breathing and start CPR if it stops. Transport to a hospital is essential for specialised care.
Stroke: Notes, Cautions, and Good Practices
Speed is critical; use the FAST method to quickly identify symptoms. Never give food, drink, or medications to a stroke patient unless instructed by medical professionals. Avoid moving the patient unnecessarily. Ensure the scene is safe, collect as much history as possible, and stay calm.
Aneurysm: Understanding and Responding
An aneurysm is a weakened area in the wall of a blood vessel that bulges or balloons under pressure. Rupture can lead to severe internal bleeding. Cerebral aneurysms often present with a sudden intense headache, while aortic aneurysms cause sharp pain in the chest, abdomen, or back. If you suspect a ruptured aneurysm, call emergency services immediately, keep the patient calm and still, monitor their breathing, and be prepared to perform CPR.
Anaphylaxis: Understanding and Identifying
Anaphylaxis is a life-threatening allergic reaction caused by an exaggerated immune response to an allergen. Common allergens include shellfish, peanuts, medications, and insect stings. Symptoms include breathing difficulties, swelling of the face, lips, tongue, or throat, skin reactions, nausea, abdominal cramps, dizziness, confusion, or fainting.
Anaphylaxis: Management and Action with EpiPen
Managing anaphylaxis requires swift action. Ensure the scene is safe, call emergency services, and remove the allergen if possible. If the patient has an epinephrine auto-injector, assist them in using it. Reassess the patient's condition and transport them to a hospital for observation and further treatment.
EpiPen: How to Use
The EpiPen is an auto-injector that administers adrenaline for anaphylaxis. Remove it from its case, set the patient down, remove the safety cap, and push the auto-injector into the thigh. Hold it there for 3 seconds and then remove it. Stay until emergency services arrive. If unconscious, place them in the recovery position. Give the used EpiPen to emergency services.
Anaphylaxis: Notes, Cautions, and Good Practices
Act immediately, as time is critical. Epinephrine is the first and most effective treatment. Avoid giving the patient food, drink, or medications other than epinephrine. Do not delay calling emergency services. Educate those with severe allergies about carrying their auto-injectors, incorporate epinephrine injector training into first aid courses, and stay calm.
Diabetes: Understanding the Condition
Diabetes disrupts the body's ability to regulate blood sugar levels due to issues with insulin. Type 1 diabetes requires lifelong insulin injections, while type 2 diabetes is characterised by a gradual decline in insulin production. Recognising the symptoms early is key to managing this condition.
Hypoglycemia: Identifying Low Blood Sugar
Hypoglycemia (low blood sugar) occurs when the body lacks sufficient glucose or has an excess of insulin. Symptoms include irritability, confusion, cold and clammy skin, a rapid heartbeat, and drowsiness. If untreated, it can result in severe complications, including death.
Hyperglycemia: Identifying High Blood Sugar
Hyperglycemia (high blood sugar) occurs when glucose levels in the blood are excessively high, often due to insufficient insulin. Symptoms include excessive urination, headaches, weight loss, dizziness, warm dry skin, and a fruity odour on their breath. If not managed promptly, it can lead to coma or death.
Diabetic Emergencies: Management and Treatment
If unsure whether the patient is experiencing hypo- or hyperglycemia, place them in the recovery position and rub glucose sugar inside the mouth. For hypoglycemia, provide sugary food or drinks if conscious. Call for professional medical assistance and transport the patient to a hospital. Avoid administering insulin without medical supervision and never give fluids to an unconscious patient.
Seizures: Understanding and Identifying
Seizures result from sudden disruptions in the brain's electrical activity, causing uncontrolled movements and loss of consciousness. Recognising a seizure involves observing jerking movements, frothing at the mouth, or eyes rolling back. Understanding the cause is vital, as seizures can stem from serious issues like brain injuries or infections.
Seizures: Immediate Action and Safety
When someone is experiencing a seizure, focus on keeping them safe. Never restrain their movements; instead, gently roll them onto their side to prevent choking. Place a soft object under their head to cushion it and move any harmful objects nearby. Never insert anything into their mouth.
Seizures: Post-Seizure Care and Recovery
After the seizure ends, check the person's breathing and pulse. If they're breathing, place them in the recovery position. Offer reassurance as they regain consciousness, cover them with a blanket, and stay with them until they recover fully or medical help arrives. Call emergency services if the seizure lasts longer than 5 minutes or if a second seizure follows immediately.
Seizures: Notes, Cautions, and Good Practices
Seizures can have many causes, so medical evaluation is essential. Prioritise airway protection during and after the seizure. Avoid crowding the person and never attempt to stop the seizure or restrain them. Look for medical alert bracelets or IDs to determine possible triggers and record the seizure's duration.
Seizures: Workplace Scenario and Response
When a person has a seizure, ensure the area around them is safe by removing sharp objects. Protect their head by cupping your hands to provide cushioning. Assess whether EMS has been activated and check if the person is breathing. If not breathing, start CPR and call for an AED. If breathing, place them in the recovery position to keep their airway open.
Seizures: Postictal State and Recovery Position
During the postictal state, assess for breathing and recovery signs. Elevate the arm closest to you over their head, bring the furthest leg away, and cross their legs. Roll the patient onto their side, lift their head, and bend their arm up underneath their head. Bring their knee up as a kickstand. Cover them with a sheet, coat, or blanket if they show signs of shock.
Seizures: Important Considerations and Reminders
A seizure patient is low on oxygen, confused, and may be combative. Don't try to hold them down during a seizure; just support and protect them. Assess them for more serious situations like cardiac arrest while awaiting EMS. Remember to complete the questionnaires to deepen your understanding of the material covered.
