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SD-draft-OFA (10/03/15)

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Shaun Durkin

on 6 August 2015

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Transcript of SD-draft-OFA (10/03/15)

Quotation 1
Patient Assessment
Respiratory Emergencies
Wounds and Bleeding
Define
respiration
List the component parts of the respiratory system
List the functions of the respiratory system
List the percentage of oxygen in inspired and expired air
State the signs and symptoms of a patient with respiratory difficulties
List the signs of adequate air exchange
List the signs of respiratory arrest
Define
asthma
Define f
oreign body airway obstruction
Explain the functions of a barrier device
Describe
the correct use of a
face shield
or
facemask
Describe the steps in the management of a foreign body airway obstruction in the responsive and unresponsive adult (child and infant where appropriate)
Demonstrate
an open airway using the head tilt technique
Demonstrate
rescue breathing using mouth-to-mouth, mouth-to-mask or mouth-to-nose (infants only) techniques
Recognise the signs of choking in an adult (child and infant where appropriate) and take the appropriate steps to clear the airway obstruction
Demonstrate
the relief of a foreign body airway obstruction in an unresponsive adult (child and infant where appropriate)
Demonstrate
the treatment of the patient with respiratory difficulties
Demonstrate
the treatment of the patient in respiratory arrest
List the components of the circulatory system
List the functions of blood
Differentiate between arterial, venous and capillary bleeding
State the effects of severe bleeding
List wound types
Demonstrate the control of bleeding using posture, expose, examination and elevation, pressure and shock (PEEPS)
Outline the management of head, eye and facial injuries
Outline the management of internal bleeding
Outline the management of crush injuries
Outline the benefit of tying a reef knot
Demonstrate the application of pre-packed sterile dressings to various body sites
Demonstrate the application of bandages to various body sites
Demonstrate using a triangular bandage the narrow fold, broad fold, arm sling and elevation sling
Demonstrate the treatment of a nose bleed
Demonstrate the procedure to clean a simulated minor wound
Demonstrate the treatment of surface injuries to the head, ear and face using items from a first aid kit
€66 per candidate
Garry MacSweeney / Tony Doyle / Judy Morrissey
FETAC 5N1207
First Aid in the Workplace
Altered Levels of Consciousness
Shock
Anaphalactic Shock
Nervous System
Unconsciousness
Concussion
Fainting
Seizures
Diabetes
Recovery Position
Occupational First Aid
Cardiac First Response
Describe the links in the chain of survival for adult (child and infant where appropriate)
Explain the importance of calling the emergency services
Retrieve an automated external defibrillator (AED)
Explain the importance of early cardio pulmonary resuscitation (CPR) and defibrillation
Describe when to start CPR
Describe when to use an AED
List the 4 major life threatening emergencies
Define heart attack, stroke, cardiac arrest and foreign body airway obstruction
List the signs of heart attack, stroke, cardiac arrest and foreign body airway obstruction
Explain the functions of an AED
Outline the conditions in which an AED is use
List the safety precautions for use of an AED
List the special considerations for use of an AED
List the steps of one-rescuer adult CPR (child and infant where appropriate)
Describe the appropriate actions to take for each AED voice prompt
List the obvious signs of death and describe when resuscitation is not indicated
Describe the legal implication for those who attempt to provide pre-hospital emergency care
Describe the clinical indemnity issues for those who attempt to provide pre-hospital emergency care
Describe the importance of the pre-hospital emergency care continuum emphasising the integration of all pre-hospital emergency responders
List the steps to be taken prior to aspirin (acetylsalicylic acid) 300mg tablet administration for cardiac chest pain
Assess responsiveness
Demonstrate the techniques of airway, breathing and circulation assessment in an adult (child and infant where appropriate)
Perform one-rescuer adult CPR (child and infant where appropriate)
Demonstrate safe defibrillation with an AED (adult only) with minimal delay and interruption in CPR
Demonstrate how to troubleshoot the most common problems that might be encountered whilst using an AED
Demonstrate the recovery position
Demonstrate the steps in aspirin (Acetylsalicylic Acid) 300mg tablet administration for a patient suspected of having cardiac chest pain
Musculoskeletal Injuries
Functions of the Skeleton
Fracture
Dislocation
Soft Tissue Injuries
Burns & Scalds, Chemicals, Poison and Electric Shock
Skin
Burns & Scalds
Treatment of Chemical Burns
Poison
Electric Shock
Heat Illness
Heat Exhaustion
Heatstroke
Sunstroke
Hypothermia
Stings and Bites
FETAC Accreditation
Component Specification

Learning Outcomes grouped into 8 units
Skills Demonstration (80%)
Examination Theory (20%)
Describe a
primary
and
secondary
survey
State the normal
respiration rates
for an adult at rest
List the methods to obtain a
breathing rate
State the normal
pulse rates
for an adult at rest
List the methods to obtain a pulse rate
Outline the methods to assess the
skin colour, temperature, condition
Differentiate between hot, cool and cold skin temperature
Differentiate between a
sign
and
symptom
Explain the need to search for additional medical identification
Outline the reason for forming a general impression of the patient
Assess levels of consciousness including using the
alert, verbal, pain, unresponsive (avpu) scale
Assess the patient for external bleeding
Outline the
airway, cervical spine, breathing and circulation (acbc) approach
to a trauma victim
Explain how the mechanism of injury may lead to a risk of
spinal injury
Describe the requirements for an
explicit handover
between occupational first aiders and other health care practitioners including documentation as appropriate
Demonstrate a primary and secondary survey
Demonstrate assessment of breathing
Demonstrate assessment of a pulse
Demonstrate manual in-line stabilisation of the head in a suspected spinal injury
Assessment
Pulse – 60-100 in Resting Adult
Breathing 12-20 in Resting Adult
Level of Consciousness AVPU
Skin Colour
Skin Temperature
Search for additional medical information
Any Bleeding
Signs and Symptoms
A SIGN is information you can find out

A SYMPTOM is something the person complains of
The Vital Signs
PULSE: the number of heartbeats in one minute (normal 60-100)
BREATHING: the number of breaths taken in one minute (12-20)
LEVEL OF CONSCIOUSNESS (Alert / Voice / Pain / Unresponsive)
Making a diagnosis
History
Symptoms
Signs
Diagnosis
History
ALLERGIES: has the person any allergies?
MEDICATION: is the person taking any medications?
PAST MEDICAL HISTORY: has the person had to go to the doctor or hospital in the last week? Does the person have any known medical conditions?
LAST MEAL: when did you last the person had anything to eat?
EVENT: what happened ?
How To Make A Diagnosis
History (A.M.P.L.E.)

Signs – Information you can find out yourself – pulse, breathing rate, level of consciousness, colour.

Symptoms – whatever the person complains of – e.g. pain, numbness, nausea, dizziness, double vision
Spinal Injury
Suspect if ...
Fall from Height
Road Traffic Accident
Crush Injury
Sports Injury – Diving, Rugby, Skiing, Horse Riding
Penetrating Injury along Spine/Neck
Other Trauma

Signs & Symptoms of a Spinal Injury
Pain
Abnormal Sensation –Tingling, Pins & Needles, Burning Pain
Numbness
Weakness or Paralysis in Limbs below injury
Primary Survey
Medical:-

A: Airway
B: Breathing
C: Circulation
D: Disability
E: Expose & examine any bleeding
Trauma:-

A. Airway
c. cervical spine
B. Breathing
C: Circulation
D: Disability
E: Expose & examine any bleeding
Scene Safety
Are there any hazards for me or others?
Do I need any special assistance – fire brigade, gardai?
What happened here? Is it going to happen to me if I get involved here?
Primary Adult Survey
Trauma
Take standard infection control precautions
Consider pre-arrival information
Scene Safety Scene Survey Scene Situation
Control Catastrophic external Haemorrhage
Mechanism of injury suggestive of spinal injury?
If yes, control cervical spine
If no, assess for responsiveness
If no diall 999/112 request AED
If yes, open airway with head tilt chin lift
If airway obstructed go to FBAO CPGs
Airway open – check breathing
If no commence CPR
If yes – Treat all life threatening injuries only
Consider expose/examine
Vital signs – pulse resps., and AVPU
If necessary - Formulate Red Card Information-999/112
Maintain care until handover to appropriate practitioner
Secondary Survey
Medical
Primary Survey
Record vital signs
If patient actually unwell, formulate Red Card info – 999/112
Maintain care until handover to appropriate practitioner
If patient unwell, focussed medical history of presenting complaint
S.A.M.P.L.E.
Check for medications carried or medical alert jewellry
Formulate Red Card info – 999/112.
Maintain care until handover to appropriate practitioner
Secondary Survey
Trauma
Primary Survey –
Obvious minor injury – Treat as necessary
Examination of obvious injuries
Record Vital signs
SAMPLE History
Complete head to toe survey as history dictates
Check for medications carried or medical alert jewellery
Formulate Red Card info – 999/112
Maintain care until handover to appropriate practitioner
Handover Report
Casualty’s Name and age (approx)
Casualty’s address
History of incident
Description of injuries
Vital Signs – any changes
Treatment given
What is First Aid?
The immediate treatment given for any injury, or sudden illness before the arrival of an ambulance, doctor or any other qualified person.
What is Occupational First Aid?
Occupational first Aid refers to First Aid in the Workplace
Safety Health & Welfare at Work Act 2005
Duties of the Employer – link to RehabCare Safety Statement
Contents of First Aid Box for 11 – 25 persons
Responsibilities of the First Aider
To assess safety
To identify the nature of the illness or injury
To give treatment
To arrange removal to hospital if needed
To remain with the person
To give a report when handing over
List the
role
and
responsibilities
of the Occupational First Aider (OFA)
Describe the OFA's responsibility related to personal safety
Discuss the roles and responsibilities of the OFA towards others at the scene of an incident including the patient and bystanders
Describe the importance of
scene safety
for the rescuers
Assess for scene safety
Apply the principles of s
tandard infection control precautions
such as hand washing, glove use and disposal, clinical waste disposal
Explain the importance, necessity and legality of patient
confidentiality
With reference to the First Aid Regulations and Guide: define the terms 'first aid' and 'occupational first aider'; describe the duties of an employer, identify the contents of a first aid box for 11-25 persons and the minimum conditions and facilities of a first aid room
State the procedure for the activation of
emergency services
List possible
emotional reactions
that an OFA may experience when faced with trauma, illness, death and dying
List the signs and symptoms of
post traumatic stress
State possible steps that the OFA may take to help reduce and or alleviate stress
Describe the role of post traumatic stress management
Emergency Services 999/112
Always give the following information:
Name and telephone number
Give exact location
Type and seriousness of incident
Number of casualties
Condition of casualties
Any hazards
Don’t hang up the phone until you are told to do so
If mobile is switched off, switch on and without entering a code you can dial 112
If mobile is switched on you can diall 112 without taking the lock off
If the ‘sim’ card is missing from the mobile, you can still diall 112
If you have no credit you can diall 112
Use Anywhere in Europe
Emotional Reactions to Trauma / Illness / Death / Dying
Anger
Guilt
Fear
Sadness and Depression
Hyper arousal/Numbing
Avoidance
Some signs of stress:
Poor concentration
Poor memory
Anger
Anxiety
Depression
Sweating/dry mouth
Digestive problems
Restlessness/Tired
Sleep Difficulties
Drinking/Smoking
Over eating
Loss of appetite
Self neglect
Loss of interest in sex
Where to find help:
Staff de-briefing session
By consulting your GP or Company Doctor
Your Employee Assistance Programme
Professional Counselor
Define Respiration
Respiration is the exchange of gases, oxygen and carbon dioxide, which takes place in the lungs and cells of the body.

FUNCTION:
(1) Take in oxygen
(2) Remove carbon dioxide
Signs of Respiratory Arrest
Colour pale or grey/blue
No chest rise
Unconscious no response
No movement or sign of life
Signs of Adequate Air Exchange
Normal breathing between 12-20 per minute

Good normal colour with relaxed breathing

What is Asthma?
Asthma is narrowing of the airways causing breathlessness.
Persistent ticklish coughing
Wheeze
When is Asthma Serious?
If persons colour is bad - grey, blue, very pale
If person has difficulty speaking
If person is very distressed
Treatment for Asthma
Ensure A, B, C
Reassure and calm the casualty
Position casualty up-right, leaning forward.
Ensure a good air supply.
Monitor vital signs.
Assist with own medication.
Arrange for medical assistance if breathing is distressing casualty, if colour is blue, or if casualty is finding it difficult to speak.
The Components of the Circulatory System
Heart
Blood Vessels
Blood
Functions of the Blood
Transportation of Gases
Regulation of temperature
Protection (immunity)
Nutrition
Blood Vessels
ARTERY – Blood from an artery is bright red and is under pressure – very serious bleeding
VEIN – blood from vein is darker red and will have a steady flow of blood
CAPILLARY – low pressure bleeding/oozing – not serious
Types of Wounds
Contusion – bruising
Laceration – tear, like with barbed wire
Incision – knife, glass, paper cut
Puncture Wound – dog bite, stand on nail
Abrasion – scraping cut like bad graze
Body's Response to Blood Loss
½ Litre loss - little or no effect
2 Litres loss – Pulse quickens, pale, sweaty, un-cooperative, weakness
3 Litres loss – rapid pulse greater than 110, rapid breathing, reduced level of consciousness. Heart will stop if not transfused quickly.
Self Protection at the Accident
Always wear gloves when dealing with blood, or body fluids….
Saliva
Urine
Vomit
Wash Hands
Control of External Bleeding
P Position sitting or lying
E Elevate
E Expose and Examine
P Pressure with bandage
Treatment of Serious Eye Injury
Call 999 / 112 for ambulance
Support & monitor A B C’s
Provide support for the casualty’s head
Tell casualty not to move good eye
Give the casualty a sterile dressing to hold on the eye
Treatment of Facial Injuries
Dial 999 / 112 for ambulance
Support & monitor A B C’s
Watch for blood / saliva in mouth (airway)
Cold compress on broken nose or cheekbone
Give patient soft cold compress to hold on lower jaw
Treatment for Suspected Internal Bleeding
Ensure ABC
Elevate lower limbs if possible
Monitor vital signs
Reassure
Prevent chilling
Arrange urgent removal to hospital
Place in recovery position if person loses consciousness.
Crush Injury
If a person has been crushed for less than 15 minutes the weight may be removed.

However, where crushing has been going on for more than 15 minutes then do not remove weight. Prolonged crushing may cause toxins to be released.

WAIT FOR AMBULANCE/DOCTOR
Nosebleed
CAUSE:
picking, infection, bang on nose.

You want to- safeguard breathing, to prevent inhalation of blood and to stop bleeding.

TREATMENT:
Sit Down, lean forward. Breathe through mouth. Tell person not to speak. Pinch fleshy part of nose just below bridge. Release after 10 minutes. Repeat if not stopped. Repeat up to 3 times.
If not stopped then send to hospital.
What is Shock?
Shock is failure of the cardiovascular system to adequately supply the cells and tissues of the body with oxygen.
What Can Cause Shock?
Blood Loss
Heart Failure
Severe allergic reaction
Loss of body fluids (burns, D+V)
Massive infection
Damage to Spinal Nerves
Signs and Symptoms of Shock
Face – pale
Skin – cold clammy
Pulse – rapid
Breathing – faster
Anxious, agitated
Thirst
Feeling of doom
Weakness, falling level of consciousness
Treatment of Shock
Scene Safety. Phone 999/112 Urgent.
AcBc
Elevate Legs
Monitor Vital Signs
Treat Cause of Shock
Keep Warm/Reassure
Immobilise any Fractures
Reassure
Vital Signs
Pulse/heart rate - normal 60-100
Breathing rate – normal 12-20 per min
Level of Consciousness –
Alert -
Responds to voice
Responds to pain
Unresponsive
Others Signs
Colour – normal, pale, grey, blue
Skin Temperature – whether warm or cool or cold
Sweating or not sweating
Monitoring Vital Signs
If Vital signs are within normal limits and person is alert and appears normal, feels warm and not cold and sweaty then they are probably ok.

However, if Vital Signs are outside the normal ranges, if skin is cold and sweaty if person is unconscious then you must phone 999/112 immediately
The Nervous System
Involves the Brain, the Spinal Cord and the Nerves
Carries signals to and from all parts of the body
Stores and interprets information
Controls movement, Consciousness and Breathing
What is Unconsciousness?
Unconsciousness is an abnormal state in which the body's control mechanisms are lost or impaired
Causes of Unconsciousness
Faint
Head Injury
Heart Attack
Severe Bleeding
Shock
Hypothermia
Asphyxia
Poison
Drugs/Alcohol
Epilepsy
Diabetes
Stroke
Infantile Convulsion
You must always consider your own safety and that of other bystanders before going in to help a victim in a first aid situation
For your own safety:
You should always be able to avail of gloves in case you suddenly need to deal with serious bleeding
You must advise anyone helping you to wear gloves
Use a face mask when administering rescue breaths
Approaching a scene:
Walk briskly, bringing First Aid Bag, Blanket.
Put on your Gloves
Check that the Scene is Safe
Confidentiality
You must not repeat any personal details you come across during a First Aid Situation.
People may confide in you at a time when they are vulnerable
You are legally forbidden to divulge anything except what needs to be reported to medical staff.
Who is an Occupational First Aider?
General Application (First Aid) Regulations 2007
Legislation and a Good Samaritan
First Aid Responsibilities
Personal Safety and Scene Safety
What is Concussion?
Concussion is caused by shaking of the brain
It comes on immediately and people usually recover from it
Symptoms vary from being dazed to being 'knocked-out (unconscious)
What is Compression?
Compression is caused by pressure on the brain.
This could be caused by swelling of the brain, by bleeding into the brain, or by a stroke.
This could result from a knock to the head, or if a stroke, person could just become unwell with no history of being hit on the head
Shock
Management of a Head Injury
Ensure A c, B, C
Treat all life threatening injuries
Consider spinal injury and treat
If Unconscious- place in the recovery position
Monitor vital signs
Head to toe survey
Prevent chilling
The Recovery Position
The purpose of the Recovery Position is to safeguard the persons airway.
The two most likely causes to block a persons airway are their tongue or vomit.
By placing them in the Recovery Position, the airway is protected from vomit or the tongue
Caution – with a person who might have a neck or spinal injury
Treatment of a Person with Altered Levels of Consciousness
Once you are happy that the person is breathing adequately, you must place the person in the RECOVERY POSITION
Phone 999 OR 112. Remain with the person and continue to monitor their vital signs. Be prepared to resuscitate if necessary
Define Diabetes
Diabetes is 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
2 Types of People with Diabetes
Those who take Diabetic tablet daily

Those who must inject Insulin daily
What Causes a Person with Diabetes to Become Unwell?
Missing a Meal
Careless with medication/food balance
Delay in eating
Tummy bug causing them to be vomit food
Too much exercise
Alcohol
Person with Diabetes unwell (mild)
Confusion
Lethargy
Sleepy
Bizarre behaviour
May appear drunk or spaced out
May be wearing information medallion or bracelet
Person with Diabetes unwell (serious)
Unconscious
May be wearing information medallion or bracelet
May have epileptic type seizure
Fast Pulse
Breath may smell
Treatment for Person with Diabetes (conscious)
Establish A, B, C
Help person to sit down
Give sugary drinks
Chocolate
Sweet foods
Seek medical help
Treatment for Person with Diabetes
(unconscious - very urgent)
Establish A, B, C
Call Ambulance 999/112
Place patient in recovery position
Monitor vital signs
Prevent chilling
Look for other causes
Urgent removal to hospital – do not try to give food or drink unless fully awake
129-130
119-121
Nervous System
Unconsciousness
Concussion
Compression
123-126
Fainting
A temporary reduction in blood flow to the brain
Reaction to pain or fright
Emotional upset
Exhaustion
Lack of food
Long periods of standing
Treatment for Fainting
Ensure A c, B, C
Raise lower limbs if slow to feel better
Ensure plenty of fresh air
Obtain a good history. Reason for faint, could there be other cause?
Loosen any tight clothing
Treat any injuries

If unconsciousness persists, call for the ambulance
Fainting
126
Define Epilepsy
Epilepsy is a tendency to recurrent seizures originating in the brain
Types of Seizure
Partial Seizure

Generalised seizure
First Aid for Generalised Seizure
Note the time
Clear a space around the person
Protect the head to prevent head/facial injury
Remove glasses if worn
Loosed tight neckwear
Loosed chest and leg safety straps on wheelchairs
Reassure others and explain what you are doing
First Aid for Generalised Seizure
Turn the person on their side if not already (Recovery Position)
Check that vomit or dentures are not blocking the throat
Wipe away any excess saliva from the mouth
Reassure the person and tell them what has happened
First Aid for Generalised Seizure
Check for signs of injury and apply First Aid if necessary
Observe the person and stay with them until recovery is complete (they may need assistance to return to their routine)
Provide privacy and offer assistance if there has been incontinence
Record appropriately
127-129
Recovery Position
131-136
Injuries from Seizures
Most seizures happen without warning, last only a short time and stop without any special treatment.
Injuries can occur, but most people do not come to any harm in a seizure and do not usually need to go to hospital or see a doctor.
Your main role is to supervise during seizure and especially following a seizure until person has returned to their normal self. Recovery position while sleepy following seizure.
pages 6-14
Transmission of infection:
Direct Contact (hands, ground, dirty glass)
Airborne Infection (coughing, breathing)
Blood (Hepatitis, HIV)
pages 14-15


One person dies each week in Ireland from Asthma


Diall 999/112 if you think person's asthma is serious
Full transcript