AFA Flashcards
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The cell is ?
the fundamental unit of
structure and function
Glucose penetrates the cell membrane
with the help of
insulin.
glucose can
penetrate these cells without insulin
Brain cells
Anterior
anything towards the front of
the body.
Posterior
anything towards the back
of the body
Lateral
body parts farthest from
the midline
Midline
an imaginary line dividing the
body into two mirror image halves
Medial
body parts closer to the midline
There are 206 bones in the normal skeleton. They:
• Protect internal body organs. • Provide shape or a framework to keep the body supported. • Produce red blood cells. • Provide storage for mineral salts, such as calcium.
Irregular bones
categories, such as vertebrae and the
jawbone do what
They serve complex roles in
muscle attachment and movement
The periosteum serves as a…
protective
sheath for the bone and provides an
anchoring surface for the tendons
The cranium encloses the brain and…
protects it from injury. It also serves as
an attachment for muscles
The spine is composed
of 33 bones, called vertebrae. Vertebrae
as classified from top-to-bottom are:
- Cervical (7)
- Thoracic (12)
- Lumbar (5)
- Sacral (5)
- Coccyx (4)
The shoulder girdle is composed of the:
- clavicles (collarbones), and
* scapulas (shoulder blades).
Each pelvic bone has three parts:
- the ilium,
- the ischium, and
- the pubis.
Normal respiration requires
five conditions:
- A supply of normal air
- A clear airway
- The mechanical bellows function of
the rib cage and diaphragm must be
intact and contain at least one
functioning lung - The control system, including the brain,
must be intact and able to respond to
changing carbon dioxide levels in the
blood stream - An adequate blood supply with proper
circulation by the heart
There are three key signs of normal
breathing:
• the rise and fall of the chest or abdomen, • evidence of air moving in and out of the lungs, and • a regular rate and rhythm.
The mechanics of breathing are under
the autonomic control of the…
brain
Average resting respiratory rates for
various ages
Age Average rate (breaths / minute) Infant (up to oneyear)30 to 50 Toddler (one tofour years)20 to 30 Child (five to 12years)12 to 20 Adult 12 to 20
The circulatory system has two major fluid
transportation systems:
- the cardiovascular system, and
* the lymphatic system
The cardiovascular system consists of:
- the heart, and
* blood vessels.
The circulatory cycle is made up of two
independent systems:
- pulmonary circulation, and
* systemic circulation.
Average resting pulse rates
Age Pulse rate (beats per minute) Infant (up to one year) 80 to 160 Toddler (one to four years) 80 to 120 Child (five to 12 years) 60 to 110 Adult 60 to 100
The most dependable site to take
a pulse is
either side of the larynx
One major function of the spleen is to
act as a storage reservoir for blood cells
A clot will usually form within
five minutes
after a blood vessel wall has been
damaged. If blood does not clot, a patient
may bleed to death from injury
The central nervous system consists
of two joined organs
the brain and
the spinal cord
The brain consists
of three parts
- the cerebrum,
- the cerebellum, and
- the brain stem.
Damage to the cerebellum results in
the loss of muscular coordination.
The skin is the largest organ of the human
body. It serves three main functions:
• Protects the body from the environment. • Maintains nerves that convey information about the environment to the brain. • Regulates body temperature.
The liver rids the body of harmful substances in the
blood and stores
nutrients
The appendix is a small, blind pouch near
the junction of the
large and small
intestines, in the lower right quadrant
The pancreas has two main functions:
• It secretes into the blood the hormones
insulin and glucagon which are
important in the control of blood sugar
level
• It secretes into the duodenum digestive
enzymes and pancreatic juices which
aid in digestion
The gallbladder is a pear-shaped sac
attached to the underside of the
liver in the upper right quadrant
Kidneys regulate…
fluid volume and other
substances in the blood, and remove
wastes from the blood
The CSP recommends hepatitis vacine…
A and B
(and C when available) vaccination for all
ski patrollers
Equal and
reactive
Normal
Non-reactive
Glass eye or
contact lens
Fixed and dilated
Brain hypoxia
Unequal
Head injury or
stroke, congenital
Fixed and
constricted
Drug abuse or
severe brain
damage
Small, pinpoint
Drug usage or
disease
Change from
constricted to
fixed and dilated
Worsening condition
Blue
Cyanosis
Lack of oxygen
Pale, cool and
clammy
Circulatory problems (shock, internal bleeding) Heat exhaustion Hypoglycemia (insulin shock)
Dry, warm,
flushed
Hyperglycemia
diabetic coma
Cold waxy
Hypothermia
Severe frostbite
Red
Frostbite
Burn
Yellow
Hepatitis/liver
dysfunction
Flushed
Heat stroke
Crushing chest injury
Onset
How did the pain start?
Was it sudden, gradual,
or an ongoing chronic
problem?
Quality
How would you describe the pain? (Burning, shooting pain, numbness, throbbing, etc.)
Time
When did the pain
begin? How long has it
been present? Is it
intermittent or constant?
Step 1. Scene survey Triage
• Note the time • Are there any further dangers to myself, the patients or any others? • What is the mechanism of injury (what happened)? • Is there more that one person injured? Yes
Step 2. Conduct voice triage.
Begin sorting patients by calling out, "Canadian Ski Patrol, if you can walk, come to the sound of my voice." If you need assistance, you can ask the "green" to help. They may also provide useful information about the locations of other patients.
Step 3. Follow a systematic route. Triage
- Start where you stand.
- Start with the closest patients.
- Work outward in a systematic fashion.
Step 4. Triage and tag each patient
green, red, yellow or black
Red- critical,life-threatening injuries
Yellow - serious, Not immediately life-threatening
Green - minor, May need treatment
Black - dead or non-salvageable
Step 5. Document triage results
Identify the locations of patients.
• Deploy resources effectively.
• Estimate the number of patients by
degree of severity
Triage pitfalls
• No team plan, organization, or goal. • Indecisive leadership about where to start and what to do. • Too much focus on one injury or person. • Treatment rather than triage.
Hypoxia is a condition resulting from a
decrease in the level of
oxygen available
to the cells
Hypoxia may be caused
by CRASH
C Cardiac R Respiratory A Altered level of consciousness S Shock H Head injury
Inadequate respiration refers to
insufficient amounts of oxygen exchange
in the lungs
the body’s major stimulus to
breathing becomes lower oxygen levels in a person with…
Chronic obstructive pulmonary disease (COPD)
The flowmeter normally controls the
output of oxygen to be delivered
from one to
15 litres per minute (lpm).
do not
administer oxygen using units equipped
with a positive
pressure resuscitator
Always ensure a clear airway before
administering
oxygen
Administering oxygen to
a breathing patient
- Explain the procedure to the patient.
- Place mask over their face.
- Recheck and adjust the flowmeter.
- Secure the equipment for transport.
- Monitor vitals and maintain airway
continually. - Be prepared to do artificial respiration
in case of respiratory arrest.
If the patient cannot tolerate wearing the
face mask
have them hold the mask close
to their face until they can put the mask
on.
Oxygen can be administered to a nonbreathing
patient using a
pocket face
mask or a bag-valve mask resuscitator
Signs and symptoms of airway
and breathing problems
• an absence of, or irregular movement of the chest wall and abdomen, • abnormal breathing sounds (whistling or high-pitched wheezing), • irregular respiration rate or rhythm, and • cyanosis (blueness of the skin).
Signs and symptoms
of circulatory problems
- cyanosis (blueness of the skin),
- increased respiratory rate,
- abnormal pulse rate and character,
- shallow breathing,
- pale, cool and clammy skin,
- absent radial or carotid pulse, and
- drop in blood pressure.
There are two classes of airway
obstructions
- mild airway obstructions, and
* severe airway obstructions
To treat a mild airway obstruction,
do the following:
- Prevent further injury;
- Identify yourself as a trained first aider;
- Offer assistance and ask permission;
- Do not attempt abdominal thrusts;
- Never interfere with the patient’s efforts
to clear the airway; - Stay with the patient until breathing
is normal; - Monitor vital signs;
- Encourage the patient to try and
dislodge the object by coughing; - If the condition persists, activate EMS;
10.If the patient becomes unresponsive,
treat the situation as a severe airway
obstruction.
Signs and symptoms of a severe airway
obstruction include
• inability to speak, breathe or cough;
• absence of chest movement or
air exchange; and
• increased cyanosis.
AR rates
Infant one every three
seconds (20/min.)
Child one every three
seconds (20/min.)
Adult one every five
seconds (12/min.)
A patient who has breathing difficulty will
usually move into a position where
breathing is easiest. Typically, this
position will be either
sitting or reclining
Typical closed chest injuries include
- rib fractures,
- flail chest,
- pneumothorax.
Signs and symptoms of fractured
ribs include:
• Leaning toward the injured side with a hand over the fracture area in an effort to ease pain and immobilize the chest. • A crackling sensation over the fracture site (subcutaneous emphysema) may be detected • Unwillingness or inability to take a deep breath. • Complaining of local pain and tenderness • Pain when moving the rib cage when breathing or coughing.
Rib fracture treatment
- Administer oxygen, if available.
- Make the patient as comfortable
as possible. - Transport the patient quickly and safely
to medical aid.
Signs and symptoms of a flail
chest include
- shortness of breath,
- swelling over the injury site,
- shock,
- muscle splinting of the injury site,
- possible paradoxical movement,
- severe pain when inhaling or exhaling
Flail chest treatment
- Administer oxygen asap.
- If the patient is experiencing difficulty
breathing and particularly if cyanosis (blueness) is present, assist breathing with oxygen and assisted ventilations. - Help the patient get in a comfortable position and transport him/her to medical aid. Activate EMS and treat as a load and go. Continue to monitor vital
signs. - Do not apply bulky padding or dressings to the flail segment so long as the patient is splinting the chest wall with the chest muscles or unless there
is substantial bleeding.
Signs and symptoms of a pneumothorax
include:
reduction of normal respiratory movements on the affected side,
• a fall in blood pressure,
• weak and rapid pulse,
• a sudden sharp chest pain.
Pneumothorax Treatment
- Administer oxygen, if available,
- Activate EMS and treat as a load and
go. Monitor vital signs. As a first aid
provider, you cannot provide surgical
release of the air from the chest cavity
Signs and symptoms of a sucking (open) chest
wound may include
• increasing difficulty in breathing, • frothy blood at the mouth or site of wound, • rapid, weak pulse, • cyanosis, • falling blood pressure, • localized chest pain.
Open chest injury Treatment
• If there is significant external bleeding, direct pressure to the chest wound with a hand and/or a non-occlusive dressing should be applied. • If a dressing becomes saturated and the patient is deteriorating, the dressing should be checked to prevent it sealing the chest wound. Transport the patient: • in a position of comfort, • in a position that will not impair breathing, • administer oxygen, if available, • monitor vital signs, • activate EMS and treat as a load and go.
Shock is the medical condition that
develops as a result of an imbalance
between the
delivery of oxygen and the
consumption of oxygen at the cellular
level
Shock increased pulse rate
The pulse rate increases in an attempt
to move more oxygenated blood to the
cells
Shock Increased respiration rate
It is an attempt to increase the blood
oxygen levels and increase elimination
of carbon dioxide (CO2) via the lungs.
Shock Pale, cool, clammy skin; delayed
capillary refill; cool extremities
The body attempts to maintain blood flow to the heart, brain, lungs and kidneys by sacrificing blood flow to the digestive organs and the extremities. This is achieved by constricting the arterioles and redistributing blood flow. The result is pale, moist skin, cool extremities and ultimately absent peripheral pulses
Shock High anxiety, restlessness
and aggression
It is due to reduced oxygen supply to the brain. Do not mistake this behavior for lack of consent
Shock General weakness, dizziness
and nausea
It is due to reduced oxygen supply to
the brain.
Shock Thirst
It is due to an attempt at restoring
blood volume. This volume could also
be lost through dehydration. Drinking
fluids will not restore blood volume.
Shock Decreased pulse strength
The volume of blood ejected by the heart becomes less. This decrease results in decreased pulse strength. The heart may not be refilling adequately, or it may not be emptying effectively, or there may not be enough blood to maintain the filling pressure
Shock Drop in blood pressure
It may be caused by either a
combination of blood loss, loss of
peripheral vasoconstriction and/or
failure of the cardiac pump.
Shock Decreased level of consciousness
It is due to a decrease in blood flow
and oxygen supply to the brain
Shock treatment
Stop external bleeding. Blood cannot be replaced in our environmental setting. • Activate EMS and treat as a load and go. • Administer oxygen at high flow rate. • Keep the patient warm. • Lay the patient down. • Treat the patient gently. • Give nothing by mouth. • Closely monitor the patient. Record vital signs and history. • Reassure the patient. Do the following, as required: • Assure adequate breathing, assist ventilations. • Move patient to recovery position in case of vomiting.
There is not much to do as a first aid
provider in the case of internal bleeding.
As soon as signs and symptoms appear,
do the following:
Activate EMS and treat as a load and
go.
• Treat for shock (don’t wait for it
to happen).
skull fracture Signs and symptoms
• Depressed fractures may result in a portion of the skull pressing into the brain. • Fractures of the base of the skull frequently result in bleeding from the ears, nose or mouth. Make sure this blood is not a result of laceration of the surrounding skin. • The clear, straw-coloured fluid which surrounds the brain - cerebrospinal fluid - may leak from the ears or nose as a result of a skull fracture. This type of injury should be suspected if a patient has sustained a severe impact to the jaw.
Consussion Typical Symptoms
• Headache • Feeling dazed or "slow" • Dizziness • Seeing stars or flashing lights • Ringing in the ears (tinnitus) • Sleepiness • Loss of field of vision, double vision, blurred vision, light sensitivity • Nausea
Consussion Look for the following
Memory or orientation problems: • General confusion • Memory loss • Unaware of time, date, place • Repeatedly asks the same questions
Concussion Signs
Poor coordination or balance. • Vacant stare or glassy-eyed. • Vomiting. • Slurred speech. • Slow to answer questions or follow directions. • Easily distracted, poor concentration. • Displaying unusual or inappropriate emotions (e.g. laughing, crying, swearing.) • Personality changes.
Consussion treatment
- Maintain an open airway. Be prepared to administer assisted ventilations if the patient’s condition deteriorates.
Activate EMS. - Administer oxygen if available.
- Be on the alert for the development of more serious internal head injuries,
they are a load and go. - Treat as for C-spine injury. Because head injuries are more likely to lead to
an unresponsive patient, monitor carefully and be prepared to tilt the
backboard to enable fluids to drain from the mouth and throat. - Maintain normal body temperature.
- Do not give any fluids.
- Your record keeping can be critically important in the case of head injuries.
Inform medical authorities of the following:
• Time and details of the incident.
• Presence or absence of signs and symptoms of spinal disabilities or external head injury.
• Duration of unresponsiveness,
if any.
• Pay particular attention to any change in vital signs and the pupils.
Check them every five minutes.
A patient who has lost consciousness should be kept under medical supervision for 24 hours following the injury.
Impaired or unequal reaction to light
Intracranial pressure
Fixed and dilated
Severe damage to the central functions of
the brain
One pupil dilated and one pupil normal
Damage is limited to one side of the brain
Fixed, constricted pupils
Drug abuse or severe irreparable brain
damage
Constricted pupils that later become fixed
and dilated
Worsening condition
Signs and symptoms of spinal injury
may include:
• great anxiety and reluctance for a conscious patient to voluntarily move their head or spine, • muscular stiffness/rigidity alongside the spinal column (self splinting), • pain in the midline of the neck or back, • TIC (Tenderness, Instability, Crepitus) along the spine, • loss of movement in any extremity, • numbness, tingling or burning sensation in any extremity, • sudden onset of breathing difficulty since the incident, • a mechanism of injury with a high probability for spinal injury.
The Canadian C-Spine Rule
Inclusion criteria are
• Greater than 16 years old. • Awake, alert, oriented (may not recall the details of the event) Glasgow Coma Scale =15. • Normal vital signs. • No pre-existing vertebral disease. • Acute, blunt injury less than 4 hours ago. • No penetrating spinal trauma. • No paralysis. • Not already immobilized.
CCSR High risk factors are
- Age > 65 years.
- Dangerous mechanisms.
- Numbness/tingling in extremities.
CCSR Dangerous mechanisms are
• Vertical fall from elevations greater than 1 meter with an abrupt stop. • Axial load to the head. • High speed collision with an abrupt stop. • Vehicle/snowrider collisions.
CCSR Low risk factors
• Low speed collision. • Sitting on the ground/snow. • Ambulatory at any time at the scene. • No neck/back pain at scene when asked. • No pain during midline palpation. No intoxication No evidence of distracting injury that might mask spinal injury pain
