first aid Flashcards
bleeding
Minor & severe (can eventually lead to shock)
Types of bleeding:
Arterial: High pressure, blood from the heart. Spurting appearance.
Capillary: from small blood vessels. Oozing appearance.
Venous: low pressure blood travelling back to the heart. Flowing appearance.
Signs & symptoms
Bleeding
Event history (object that caused the bleeding can determine severity of the bleeding)
MOI can provide insights into potential location and severity of injuries.
Not all bleeding is visible. High velocity/blunt trauma = internal bleeding. To determine, check for shock (weak and rapid pulse).
Treatment
Direct pressure
Apply firm pressure over wound with an absorbent dressing (cloth, gauze, etc.) or gloved hand.
For severe bleeding, stopping the bleeding has priority over cleaning the wound.
Tie improvised tourniquet if bleeding cannot be controlled.
2. Elevate
Elevate wound above level of heart. This slows down blood flow to the wound and reduces bleeding.
3. Early evacuation
Call ambulance 995 immediately for severe bleeding or if signs of shock are observed.
4. Monitor vitals
Actively look out for signs of shock and treat it accordingly.
penetrating chest wound
Signs & symptoms
Difficulty breathing
Bleeding chest wound
Event history (of being stabbed)
Treatment
Protect uninjured lung for casualty by leaning them over to injured side.
If object removed, apply 3-sided chest seal.
If not, immobilise the object by placing roller bandages around it and tying them to the body. DO NOT remove the object, and don’t move as far as possible.
Apply direct pressure (around the object, if in-situ)
Early evac—call 995, be ready to handle cardiac arrest.
3-sided chest seal: cover wound with non-porous dressing and tape down 3 sides, letting air escape from last side. This prevents air from entering and thus the formation or worsening of pneumothorax.
drowning
Water entering the lungs and obstructing oxygen intake.
Casualties should be sent to hospital even if conscious due to secondary drowning (where water may have entered the lungs).
Signs & symptoms: Event history
Treatment
Maintain open airway
Lay casualty down in supine position if no spinal injury suspected
Cover with blanket/towel/provide warm drink if casualty is alert and conscious (keep warm)
Early evacuation (even if conscious, secondary drowning)
Monitor vitals (chance of cardiac arrest)
seizures
Seizure: involuntary, uncontrollable and abnormal body movements accompanied by loss of consciousness due to abnormal electrical activity in the brain.
Could be caused by physical damage to brain.
Upon seeing seizure, record start time of seizure and remain calm. DO NOT put objects into casualty’s mouth or restrain casualty.
Causes of seizure including but not limited to: alcohol/drugs, high fever, head injury, hypoglycaemia, infection
Signs & symptoms
Jerking movement of arms and legs
Altered consciousness during/after seizure
Event history
Medical history (of seizures)
Treatment
Maintain open airway: upon seizure end, put casualty in recovery position to allow secretions to drain and tongue to flop. Head-tilt-chin-lift is difficult as seizure makes stiff neck.
Note start and end time of seizure.
Early evacuation FOR ALL CASES!!
Reduce risk of secondary injury for casualty: remove surrounding objects, and use pillow
fainting
Fainting (disability)
Temporary loss of consciousness caused by lack of blood flow to the brain
Also known as syncope
Many causes, but most are not life-threatening
Life-threatening causes of fainting: stroke, heart rhythm problems
Signs & symptoms
Brief loss of consciousness
Giddiness
Pale skin
Event history (fainting)
Note: not all loss of consciousness = fainting!
Following conditions may be mistaken for fainting:
Cardiac arrest
Seizure
Heat injury
Hypoglycaemia
Treatment
Maintain open airway: head grip
Improve blood flow to brain: lift legs above heart level if appropriate
Treat any secondary injury
Early evacuation if:
Casualty does not regain consciousness after briefly fainting.
Casualty complains of weakness on one side of body/chest pain/shortness of breath etc.
No obvious cause of fainting
heat injury
When the body fails to regulate its own temperature.
Contributory factors:
Exposure to warm/humid weather
Poor physical conditioning
Dehydration
Heat injury exists as a spectrum —cramps - exhaustion - stroke. Without treatment, it will become more severe (towards stroke)
Drowsy casualties may not be able to maintain an open airway. Either sit them up or (if supine) perform head-tilt-chin-lift.
Signs & symptoms
Confusion (for heat stroke)
Caused by electrolyte imbalance
Muscle spasms
Commonly seen in large muscle groups like arms, thighs, abdomen
Giddiness/fever (not a key telltale sign)
Sweating/nausea
Event history (of being dehydrated/exposed to a warm/humid environment)
Treatment
Early evacuation (esp. Heat stroke) call ambulance asap!
Cool the casualty down
Bring them to sheltered area/provide shelter with umbrella etc.
Remove excess clothing if possible/appropriate
Offer casualty water/an isotonic drink if they are alert and conscious
Monitor vitals closely for signs of deterioration
Casualty may fall into cardiac arrest
6 points of cooling
2 at neck, 2 under armpits, 2 at inner thighs
Use ice packs, ice water or cool wet towels, place at cooling points if appropriate.
(optional) for casualties with muscle spasms, stretching
E.g quadriceps stretch, calf stretch, as long as stretch relieves area where muscle spasm is it’s appropriate
stroke
Signs & symptoms
FAST, any of FAS is enough to identify a stroke
F: facial drooping, one side of face drooping downwards
A: arm weakness, have cas lift both arms. If can, ask cas to close eyes. If one arm drifts down that’s arm weakness.
S: slurred speech. Speech is unclear, more like noise than actual words.
Treatment
Call an ambulance
Monitor vitals
cardiac arrest
Life-threatening condition that causes irregular heartbeat
Oxygen level in the blood decreases, causing brain damage
If situation is reversed immediately, chance of survival as high as 90%
Ventricular fibrillation: ventricles of the heart quiver instead of pumping normally
Signs & symptoms:
No pulse, no breathing
Common causes/MOI: drowning, choking, drug overdose, severe trauma, electrocution, stroke, smoke inhalation, severe allergy
Treatment
Airway management: head-tilt-chin-lift, unless suspected C-spine injury
Breathing: look for rise and fall of chest for no more than 10s. If breathing not present, start CPR (gasping/agonal breathing = no breathing)
CPR!!! Location: lower sternum. Fingers don’t touch chest wall.
Stop CPR when casualty regains signs of life, paramedics arrive to take over CPR, or AED is analysing heart rhythm
Recovery position: use on unconscious but breathing casualty, to allow secretions to drain and tongue to fall forward
heart attack
Buildup of fatty plague in coronary vessels, less blood and thus less O2 to the heart.
high cholesterol, high blood pressure, diabetes, smoking, and other risk factors.
Signs & symptoms
Shortness of breath
Perspiration
Severe chest pain
Medical history of heart attack
Treatment
Early evacuation
Heart attack casualties require prompt medical intervention.
Early restoration of blood flow to the heart muscles in the hospital increases casualty’s chances of survival.
Regulate breathing
Place casualty in a half sitting position for ease of breathing. Encourage casualty to breathe slowly and deeply. Ensure there is adequate air supply. Reassure casualty.
Medication (if available)
Assist casualty to administer medication to relieve chest pain.
Glyceryl trinitrate (GTN) relieves chest pain by relaxing and widening blood vessels in the heart and other organs.
Casualties must still seek immediate medical attention even after consuming GTN.
It may come in tablet or spray form and is to be administered under the tongue (sublingual)
Do not give medication to unconscious casualties.
c-spine injury
Caused by direct trauma or abnormal movements
High velocity trauma
Fall from height
Usually in conjunction with head injury
Signs & symptoms
Event history
Limb weakness
Neck pain
Treatment
Early recognition: recognise based on suspected trauma, neck pain. If unsure, proceed to secure anyway.
Open airway with jaw thrust, secure with head grip.
Call ambulance & monitor vitals
head injury
Caused by any trauma to the head, skull bone
Usually in conjunction with C-spine injury
Signs & symptoms
confusion/altered state of consciousness
Vomiting
Cerebrospinal fluid (CSF) discharge from nose/ears
Raccoon eyes: dark blue/purple bruises on upper/lower eyelids.
Battle sign: large bruise behind ears
Event history (of impact to head)
Treatment
Call ambulance, early evac.
Manage c-spine: secure with head grip if needed, principle is immobilise/prevent movement.
Treat secondary injuries and monitor vitals.
shock
Hypovolemic: caused by excessive loss of fluids
Anaphylactic: caused by severe allergic reaction
Cardiogenic: caused by sudden heart dysfunction (cardiac arrest, etc.)
Look for as secondary condition in any of these scenarios.
Signs & symptoms
Cold, pale, sweaty skin
Confusion, lightheadedness or feeling faint
Weak and rapid pulse
Treatment
Call ambulance
Elevate legs if no suspected spinal injury
Stop other external bleeding (hypovolemic!)
Perform CPR if needed
eye injury
Potential MOI:
Blunt trauma (e.g. punching, hit by ball)
Penetrating trauma (e.g. stabbing, hit by flying shrapnel)
Chemical injury (e.g. acid splash)
As the eye is situated close to other vital organs (e.g. brain, nose), look closely for other injuries when there is an eye injury.
Signs & symptoms
Eye pain and redness
Blurring or loss of vision
Foreign body in eye
Event history
Treatment
Remove irritant (if any)
For chemical injury: Irrigate affected eye under running water. Be careful not to let the water run into the unaffected eye. (some labs have dedicated eye irrigation tap)
Small foreign body on the surface of the eye: Irrigate the eye under water gently. If unable to remove under gentle irrigation, do not attempt further
Protect the eye: Cover the eye with gauze and tape
Evacuation: All eye injuries require specialist evaluation at the hospital.
Do not attempt to remove any foreign body with your hands or tweezers. You may injure the eye further.
airway burns + inhalation of fumes
Burns to face/mouth/throat
Can become worse rapidly and block airway
Advanced medical help required as no obvious treatment
Assume anyone in a fire suffers
Usually in conjunction with inhalation of fumes
Example: carbon monoxide in smoke impacts ability of red blood cells to carry oxygen to vital organs, can lead to death.
Signs and symptoms
Difficulty breathing due to swollen airway
Voice change
Singed nasal/facial hair
Soot in mouth
Facial flushing
Confusion
Event history (in a fire)
Treatment
Maintain open airway
For conscious casualties: sit upright, loosen clothing around neck
For unconscious casualties: head-tilt-chin-lift or jaw thrust to open airway
Move casualty to open area for easier breathing
Early evacuation & monitor vitals
Treat other injuries e.g. burns to face
altered state of consciousness
Potential MOI
1. Structural cause: Injuries that damage the brain directly
E.g. seizure, stroke, head injuries, heat injuries
- Systemic cause: Injuries that affect the brain function indirectly
E.g. fainting, hypoglycaemia, toxins (alcohol or drugs)
For all ASOC casualties, they may not be able to maintain an open airway.
Airway management:
Place casualty in recovery position to maintain open airway.
Recovery position prevents the tongue from sliding back and blocking the airway.
Signs & symptoms
Altered state of consciousness
Environmental assessment (drugs, beer bottles lying around)
Event history
Treatment
Early evacuation
For all drug overdose cases.
If patient unable to maintain A,B,C in alcohol intoxication.
Maintain open airway
Place casualty into recovery position if there are no external injuries.
Prevent and treat secondary injury
Remove drugs / alcohol from casualty and prevent further ingestion.
Keep casualty warm to prevent hypothermia.
Monitor vitals
Monitor vitals to detect for early signs of deterioration. Some drugs might only take effect after a period of time.
