First Aid Basics

• The text covers first aid and emergency medical care basics

Introduction to First Aid

• First aid is the immediate care for someone injured or ill
• It can include self-help and home care when medical help is unavailable
• First aid is scientifically accepted

Value of First Aid Training

• Self-help skills are improved
• Improves your ability to help others
• Increases preparation for disasters
• Increases safety awareness

Objectives of First Aid

• Aims to alleviate suffering
• Works to prevent further injuries
• Works to prolong life and save limbs

Role of the First Aider

• Bridges the gap between the victim and the physician
• The first aid provider must ensure personal and patient safety
• They must consider risks like communicable diseases and scene safety
• Other considerations include the need for proper positioning and emergency vehicles
• Reflective clothing, hazardous materials, aggressive casualties, violent patients, and electrical hazards must be considered
• They must gain access to the victim
• They must determine any threats to the patient's life
• They must summon advanced medical care
• The first aid provider must assess and provide care
• They assist advanced personnel
• It's important to record all findings and care given

Characteristics of a Good First Aider

• Gentle: avoid causing pain
• Resourceful: uses available resources effectively
• Observant: notices important signs
• Tactful: avoids alarming the victim
• Empathetic: provides comfort
• Respectable: maintains a professional, caring attitude

Hindrances in Giving Emergency Care

• Includes unfavorable surroundings
• Includes the presence of crowds
• Includes pressure from the victim or relatives

Introduction to Emergency Medical Care

• Emergency is an unforeseen situation requiring immediate action
• It an immediate risk to health, life, property, and the environment

Types of Emergency

• Danger to life where it can affect a single person through medical emergencies and trauma
• Emergencies can also affect a large number of people, like in natural disasters
• Dangers to health
• Dangers to property
• Dangers to the environment

Emergency Management Definition

• Emergency management is traditionally care for patients with urgent and critical needs
• It's now considered what the patient or family perceives as an emergency

Emergency Care

• Emergency care is the immediate care given at the injury or illness scene
• It is typically by trained professionals

Universal Access in Emergency Situations

• 3-digit universal access replaces old seven-digit numbers for medical, police, or fire assistance
• In the US, 9-1-1 dispatch centers have enhanced capabilities using computer-aided dispatch (CAD)
• CAD helps identify the caller's location by tracing the phone number
• This is used to find the nearest emergency units
• In the Philippines, 117 is used as the Universal Access number

Modern EMS (Emergency Medical Services)

• The EMS is a network of professionals providing medical care for sudden injuries or illnesses
• It includes professionals with various training levels and responsibilities

Federal Agencies (HAZMAT)

• Occupational Safety and Health Administration (OSHA) addresses workplace safety
• Environmental Protection Agency (EPA) protects the environment and human health

Continuum of Care

• Out-of-hospital care is the first phase
• The second phase is emergency department care
• Definitive care is the third

EMS Related Agencies

• First Responders are a part of the EMS
• Law enforcement, including police and departments of public safety are also part of EMS
• Fire Departments
• Regional Organizations
• Departments of Health

First Aid Kit and Supplies Basic Equipment

• Basic equipment includes a spine board
• It also includes a short board
• Sets of splints
• Poles and blankets

Basic Suggested First Aid Kit Contents

• Rubbing alcohol, Povidone Iodine, Cotton, Gauge Pad
• Tongue Depressor and Penlight
• Band-aids and Gloves
• Scissor and Forceps
• Triangular Bandage and Elastic roller bandage
• Occlusive dressing and Plaster
• Tweezers

Core Competencies in Emergency Nursing

• Assessment skills
• Critical thinking skills are key
• Knowledge of emergency care
• Technical skills
• The ability to communicate

Emergency Dispatchers

• Answer emergency calls via 1-1-7
• They are called emergency dispatchers
• Communication Specialists (COMSPEC) or Medical Communicators (MEDCOM)

Emergency Dispatchers Responsibilities

• They collect caller information while alerting emergency services
• They must answer calls quickly, within 90 seconds in over 95% of cases
• Emergency dispatchers must dispatch appropriate responding emergency units within 90 seconds

First Responders

• They are the first to arrive at the scene
• Police officers, security guards, or fire department members are often first responders
• First responders are citizens whose duty it is to help
• First Responders are trained in basic assessment
• They should know simple airway management and oxygen administration
• They should also know how to control bleeding, and perform CPR and defibrillation

Emergency Medical Technician-Basic (EMT-B)

• Have completed primary training for prehospital care
• EMT-Bs often work in ambulances
• They may be part of a security detachment at malls or work in the field as soldiers
• Their skills cover airway maintenance, oxygen administration, bleeding control, CPR, and defibrillation
• They are capable of patient assessment and limited medication administration
• Training includes basics of illnesses and prehospital patient management during transport

Emergency Medical Technician-Intermediate (EMT-I)

• Also known as EMT-I
• Their knowledge and skills include higher-level patient assessment
• This includes the use of advanced airway management techniques
• Cardiac arrest management skills like ECG interpretation
• Drug administration
• Venue therapy
• Intraosseous infusions

Emergency Medical Technician- Paramedic

• It is the highest level of prehospital EMS provider
• requires career professionals with extensive training
• Paramedic programs are often 1,000 hours long
• Includes expanded training in managing ill and injured patients
• Comprehensive patient management
• Paramedics can also administer advanced airway management and use intravenous methods
• They can administer expanded medication and cardiac arrest management
• They closely follow physician's instructions and written protocols for patient care

When to Decide Calling EMS

• Call if the victim has a life-threatening condition such with issues relating to their airway, breathing or circulation
• Other conditions include if the person is unresponsive

Conditions to Call EMS

• Chest pain/pressure
• Severe bleeding
• Head/Spine injuries
• Poisoning/drug overdose
• Seizures
• Severe burn
• Drowning/near-drowning
• Threatened suicide
• Imminent childbirth

Situations to Call EMS

• Fires and explosions
• Vehicle crashes
• Downed electrical wires
• Chemical spills, gas leaks, or unknown substances, especially if rapidly moving or rising

Scope and Practice of Emergency Nursing

• It is demanding due to diverse conditions unique to the ER
• ERNs must have specialized education, training, and experience

Nursing Interventions in ER Care

• The nurse must accomplish things interdependently
• They must coordinate with a licensed physician
• Medical interventions are based on assessment data
• Emergency health staff must work as a team
• ED patients have a wide variety of potential problems

Issues in Emergency Nursing Care

• ERNs must establish priorities and continuously assess incoming patients
• ERNs must support families, supervise allied health individuals and educate
• Issues include legal and occupational health risks
• A need for holistic care must be balanced with a fast-paced, technology-driven environment

Legal Issues

• Consent is an approval of care by a patient
• Expressed/Actual Consent is consent from a competent person
• Implied Consent may be applied by the ER head if patient can't give consent i.e unconscious
• Parental Consent is when the parent or guardian gives consent for minors

Refusing Consent

• Patients can accept or refuse medical care as part of their rights
• Refusal Medical Assistance refers to non-emergency situations where EMT assistance may not be necessary
• Refusal Against Medical Advice is a phrase used when patient denies life saving care that may pose imminent harm

Considerations for Refusing Consent

 - Try actions to persuade individuals with treatment
 - Spend time talking to the patient
 - Consult medical direction
 - Contact family to help convince an individual
 - Call law enforcement if necessary
 - Try to determine why someone refuses 
 - A patient must to legally consent (legal age or emancipated minor)
 - A patient must be legally competent
 - Patients must sign a “release form” - for liability

Guidelines for Refusing Consent

• Do not treat intoxicated individuals
• Do not treat individuals under the infleunce of drugs
• Do not treat those with altered mental states

Legal Issues in Emergency Care

• Includes acting properly in a given situation
• Providing care
• Includes a duty to act
• Requires the first aid giver to perform their job
• One may also be held liable for acting inappropriately

Patient Abandonment

• Can take place when you leave a patient after initiating care
• Includes if the patient has not been transferred to an expert
• Confidentiality relates to patient history
• Patient record must not be shared with others

Good Samaritan Law

• Protects those that are not guilty of gross negligence

General Guidelines for Emergency Care

• First only act if you are trained
• Next get the victim's consent
• Do not moe the victim unnecessarily
• Call for professional help
• Continue care until medical personal arrive

Steps for Special Situations

• Keep giving medical care until help arrives
• Use medical identification such as signs for allergies or epilespy
• Note organ donors
• Carefully note the conditions of crime scenes

Golden Rules of Emergency Care: What to Do

• Obtain consent
• Think the worst
• Provide support
• Respect physical privacy
• Be calm
• Give care to the most serious parts
• Assist in medical care
• Keep individuals away

Golden Rules of Emergency Care: What NOT to Do

• Do not leave individuals alone
• Do not make claims
• Do not allow injuries to be seen

Center for Disease Control Recommendations

• Take precautions during first aid
• Note all victims
• Use appropriate PPE

Steps for Body Substance Isolation

• Hand washing
• Gloves and eye protection
• Mask and gown
• Follow protection standards

Guidelines in ER Care

• Take action rapidly to start
• Note needed materials
• Ask for help but intervene and never cause further harm

Steps in Emergency Action Principles

1. For a concious individual survay the scene
2. Acitvate medical assistance
3. Provide medical transport

Scene Survey Guidelines

• Make sure the scene is safe
• Identify what individuals are in need of care
• Get consent to give care

Medical Assistance Guidelines

• Note your name
• Note number of persons involved
• Determine victim and conditions
• Provide medical attention if able

Primary Survey

• Check the level of resposiveness

Airway Guidelines

• Keep it open
• Use trauma treatment

Guidelines for Breathing

• Use breathing support
• Listen for chest

Guidlines for Circulation

• Note the pulse
• Note any cappilary refill

Action Steps for Disability

• Note neurological disabiliy

Steps to Expose

• Check for wounds

Seconday Survey steps

• Ask individuals their names
• Check victims names
• Note any allergies or previous illnesses

Physical Exam

• Check for deforminies and contusions
• Check the burn areas