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MMU - First Aid - Clinical Skill

First Aid for First Year Student Nurses

James Garvey

on 27 January 2016

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Transcript of MMU - First Aid - Clinical Skill

First Aid for
Student Nurses

The First Aider has an appropriate role within the workplace of contributing towards the health & safety of people at work and administering to the needs of employees if and when accidents occur.
The First Aider
1. When you find someone hurt or collapsed what is your first priority and what action do you take?
Unconsciousness: when something or someone interferes with the normal functioning of the brain.
The unconscious casualty is not aware of his surroundings
The Unconscious Casualty
Encourage casualty to cough
A wound is defined as an interruption of the
tissues of the body. This may internal or external and usually results in blood loss. This may range from life threatening haemorrhage to a haematoma (bruise)
Bleeding & Wounds
Causes of burns
Burns & Scalds
The Aims of First Aid
Preserve Life
Prevent the condition from deteriorating
Promote Recovery
Where can I transfer a casualty to?
S.A.F.E. Approach
S - Shout for Help
A - approach with caution
F - free from danger
E - evaluate the ABC
The Resuscitation Council UK 2010 Guidelines have been made to reflect the importance of chest compressions and to reduce the number and duration of pauses during chest compressions.
The British Heart Foundation
The BHF recently started a campaign to highlight the importance of compression only CPR for the lay public with no prior knowledge.
To recap:
Compressions at a rate of 100-120 per minute
Do not stop to check victim unless signs of life are detected (movement, coughing, speaking)
Include ventilation as a standard, particularly for those with a duty of care (Resus Council 2010).
Here are some success stories:
When obtaining help ask for an AED (Automated External Defibrillator)
Compress chest to a depth of 5-8cm and at a rate of 100-120min
Give each rescue breath over 1 second rather than 2 seconds
Do not discontinue CPR unless the victim starts to show signs of regaining consciousness, such as coughing, opening eyes, speaking or moving purposefully AND starts to breathe normally.
Describe the method you should use to gain a response from the unconscious victim?
What are you also observing for?
Describe agonal breathing
Here is an example
How would you open a person's airway and what actions would you take?
Explain the three observations techniques you would use to assess someone is breathing?
What is the maximum time to assess breathing?
What is the diagnosis if a victim is unresponsive and not breathing normally?
Chest compressions - where will you press with the heel of your hand?
Where is the sternum?
What is the rate of cardiac compressions per minute?
Adult Basic Life Support - flow chart
Recovery Position
The Resuscitation Council UK recommends the following sequence of the recovery position. No single position is perfect for all victims.
The position should be stable, near a true lateral position with the head dependent and with no pressure on the chest to impair breathing.
Causes of Unconsciousness
Pale, dizzy, slow pulse
Fits -
sometimes caused by high temperature
Red, dry skin, full bounding pulse,
paralysis, irregular pupils
F.A.S.T = Face, arms, speech, time
Head Injury
Concussion (shock)
Compression (stroke)
Pale, cold, clammy skin
weak rapid pulse, nausea, thirst
Heart Attack
Shock, crushing pains in chest
Difficulty in breathing, choking, asthma, strangulation.
Stiffening & relaxing of muscles
Aura, tonic, clonic, flaccid.
Hypogylcaemia - low blood sugar
Hyperglycaemia - high blood sugar
Give up to 5 back blows
Check to see if each back blow has relieved the airway obstruction.
The aim is to relive the obstruction with each blow rather than give all five at once.
If back blows fail give up to five abdominal thrusts.
Types of wound:

Gun Shot
Gun Shot
The aim is to stem the flow of blood
This is done by
applying pressure
to the wound (providing no foreign body in situ) and raising the limb -
A casualty who loses a lot of blood will exhibit the signs and symptoms of SHOCK
Skin is cold and clammy
Face is pale
Rapid pulse becoming weaker
Casualty may feel faint
May complain of thirst
Brreathing is poor
Dry heat - fire, hot objects, the sun
Electrical burns
Chemical burns - alkali or acid
Intense cold - liquid oxygen and nitrogen
Causes of Scalds
Moist heat - steam or boiling water, or other hot liquid
Signs & Symptoms:

- Pain at the site of burn or scald.
- Reddening or other discoloration of the area.
- There may be blisters.
- There may be charring.
- Shock
The most important factor to note is the extent of the burn (how much of the body surface is involved) which determines the seriousness of the situation
Wallace's Rule of 9

- Break Blisters
- apply creams, lotions or sprays
- use lint or fluffy dressings
Chemical Burns
To remove the chemical substance wash the
burnt part thoroughly with water for at least
20 minutes.
Remove contaminated clothing but be careful not to contaminate yourself.
Refer to a doctor or hospital immediately
Putting out fire on clothing
A disturbance in the way the body metabolises carbohydrates and sugars resulting in hypergylcaemia (high blood glucose)
Older people may develop type 2 diabetes
also known as late onset diabetes. This disturbance of blood glucose levels may be controlled by diet or a combination of diet and medication.
Have you ever experienced feeling dizzy, weak and anxious and you’re not sure why you’re experiencing those signs? Then, it eventually disappeared after you ate something? That could be
Hypoglycemia is a condition wherein the person has abnormally low blood sugar. “Hypo” meaning low and “glycemia” meaning glucose or sugar. Glucose is our body’s main source of energy. Although hypoglycemia is not a disease in itself, it can be a sign of a health problem. This is commonly associated with diabetes. However, there are other conditions that cause hypoglycemia in people who are not suffering from diabetes. Diet and medication can also cause low blood sugar.
Here are the early symptoms of hypoglycemia:
1. Confusion
2. Dizziness
3. Feeling shaky
4. Hunger
5. Headaches
6. Irritability
7. Pounding heart; racing pulse
8. Pale skin
9. Sweating
10. Trembling
11. Weakness
12. Anxiety
These symptoms can progress if left untreated. These can lead to:
1. Passing out
2. Poor concentration
3. Nightmares or bad dreams
4. Poor coordination
5. Feeling irritable
6. Numbness in mouth and tongue
7. Coma
8. Headache
Two types:

Minor Epilepsy:

The casualty may appear to suddenly start day dreaming, this may last a few seconds and they may not realise it has happened. Sometimes it may be accompanied by strange movements such as twitching the face, jerking of an individual limb or lip smacking, they may also let out a cry.
Major Epilepsy:

Three main phases:
- strange sensory stimulation, taste, smell or feeling
- muscle rigidity
- sudden violent jerking, eyes rolling, teeth clenching, drooling from the mouth, snoring, loss of bladder or bowel control.
- relaxation of the body, patient may not be fully alert for 20 minutes.

Assist the casualty to the floor if possible
Cushion the casualty's head to avoid injury
Move any objects out of the way
Take a note of the time.
Dial 999
If the fitting lasts for more than 3 mins
If the level of response doesn't improve within 10 mins
If a second fit occurs
If this is their first fit
If they have been seriously injured
If you are unsure
After the fit:

ABC - CPR if necessary
Recovery Position - monitor Airway and Breathing
Check levels of response regularly
Dial 999 if they don't improve within 10mins
If the victim collapses, commence CPR without delay.
What is an AED?
Automated External Defibrillator
An automated external defibrillator (AED) is a portable electronic device that automatically diagnoses the life-threatening cardiac arrhythmias of ventricular fibrillation and ventricular tachycardia in a patient,and is able to treat them through defibrillation, the application of electrical therapy which stops the arrhythmia, allowing the heart to re-establish an effective rhythm.
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