Basic First Aider Student Handbook PDF

BASIC FIRST AIDER Student Handbook NHQ Training Directorate [email protected] Basic First Aider Student Handbook Choking Food or other objects that can become stuck in the mouth or throat can lead to choking. If the object isn’t cleared the patient can stop br...

BASIC FIRST AIDER Student Handbook NHQ Training Directorate [email protected] Basic First Aider Student Handbook Choking Food or other objects that can become stuck in the mouth or throat can lead to choking. If the object isn’t cleared the patient can stop breathing and become unresponsive which can eventually lead to a fatality. While many choking incidents are minor and can be cleared by the casualty themselves they can be very frightening for the individual concerned. Choking Adults & Children Recognition  Unable to cough or speak  Difficulty or unable to breathe  Grasping at the neck or throat  Pointing at the mouth or throat Treatment 1. Ask the casualty ‘Are you choking? 2. Encourage the casualty to cough 3. If the casualty cannot clear the obstruction themselves or they cannot cough or breathe, support them with one hand while leaning them forward and give up to five back blows between their shoulder blades. Visually check the casualties mouth between each back blow and remove any obstruction with your fingertips (do not sweep the casualties mouth) St John Wales Training Directorate, Version 1.0 - Page | 12 Basic First Aider Student Handbook 4. If step 3 is unsuccessful, give up to five abdominal thrusts. Stand behind the casualty, link your hands and form a fist below their ribcage, then pull sharply inwards and upwards. Check their mouth after each abdominal thrust. 5. Call 999/112 if casualty is still choking 6. Repeat steps 3 and 4 as required, checking the mouth after each step If the casualty becomes unresponsive at any point support them as they fall, protecting their head. Open their airway and check breathing. If the casualty is breathing place them into the recovery position. If they are not breathing perform CPR. Choking Infant Recognition Mild obstruction:  Able to cough but difficulty on breathing or making any noise Severe obstruction:  Inability to cough, make any noise or breathe  Eventual unresponsiveness Treatment 1. Lay the infant face down along your forearm and thigh and support the head. Give up to 5 back blows between the shoulder blades with the heel of your hand. 2. Turn the infant over so they are face up along your leg and check the mouth – do not sweep the mouth with your finger as this may push the object further down the throat. Pick out any obvious obstructions. 3. If choking persists give up to 5 chest thrusts which will be very similar to chest compressions. With the infant still lying on your leg place 2 fingertips on the lower half of their breastbone give up to five sharp thrusts, pushing inwards and downwards towards the infants head. 4. Recheck the infants mouth 5. Call 999/112 if obstruction has not cleared 6. Repeat black blows and chest thrusts cycles as until emergency help arrives or the obstruction has been cleared 7. Be prepared to resuscitate if infant becomes unresponsive. St John Wales Training Directorate, Version 1.0 - Page | 13 Basic First Aider Student Handbook 8. Always seek medical advice if chest thrusts have been administered Communication & Casualty Care Good communication skills are essential for all first aiders. When working with a casualty you must communicate effectively so that you can:  Build trust between yourself, the casualty and/or any bystanders  Provide the most appropriate care  Work with the emergency Services  Look after yourself and your casualty  Manage the situation safely Remember that not all communication is verbal so be aware of the messages you give to others through your body language. Dealing with a casualty Approach Approach the casualty in a calm and confident manner to reassure them and gain their trust.  Tell the casualty your name and that you are a first aider with St John Wales  Ask the casualty if you can treat them.  Explain what you are doing and why you are doing it  Be confident in your actions, but not overpowering  Appear calm and act in a logical manner  Be in control, gentle but firm Communication methods The way you communicate depends on who you are trying to communicate with for instance:  Infants can’t always tell you how they feel but parents are often able to understand their own toddler  A child might not understand some words, or may be overawed by the situation. Try to put them at ease by using simple language and explaining what you are doing.  Some casualties may not speak English as a first language. In such situations try to use a friend or relative to translate. If there are no translators available speak slowly and use body language to help explain where possible.  A casualty who has a hearing Dignity and Inclusiveness Always respect the casualty’s wishes and maintain their dignity while you work with them. For example if the casualties clothing has rolled up as a result of putting them in the recovery position cover them with a blanket to help maintain dignity. The casualty’s age, gender, race, religion, disability or sexual orientation should not affect the care that you provide or how you treat them. Gain Information Communicate with the casualty throughout treating them, asking simple questions such as ‘what did you have for lunch today?’ will help establish their last meal time whilst comforting the casualty. Always ensure you listen carefully to what the casualty is saying as this can give you clues as to what is wrong with them. St John Wales Training Directorate, Version 1.0 - Page | 14 Basic First Aider Student Handbook Personal Possessions Always take care of the casualties belongings. If possible, get their permission before removing items such as glasses, jewellery or clothing. If you need to search a casualties belongs for identification please ensure you do this in front of a witness. Consent Sometimes a casualty may resist or refuse you help. This could be for a number of reasons such as  The injury  Their beliefs  Shock as a result of the incident  The influence of alcohol or drugs  Mental health issues such as Dementia If a patient refuses treatment always respect their wishes and never argue of disagree with a casualty who refuses your help. Remember that your safety is the priority. St John Wales Training Directorate, Version 1.0 - Page | 15 Basic First Aider Student Handbook Primary Survey The primary survey is a quick way to establish if a casualty has any injuries or conditions which are life-threatening. You should perform the primary survey every time you attend to a casualty. It can remembered using the acronym DRABC. Danger – Before approaching any casualty, you must ensure that there is no danger to yourself. If possible you should move any potential sources of danger away from the casualty. Only as the very last resort should you move the casualty. Response – Check to see if the casualty is responsive. Call their name, say hello and shout a command such as “Open your eyes” or ask questions such as “Can you hear me?” Gently shake their shoulders or for a baby tap them on the foot. Do not shake them hard as you could make their injuries worse. If there is no response, shout for help and go on to the next stage. Airway – You will need to check if the casualty’s airway is open and clear. Kneel by the casualty and place one hand on their forehead. With the other hand place your index and middle fingertips under the point of their chin, lift and hold to keep their airway open. Breathing – Once you have opened the airway, you must check to see whether the casualty is breathing normally. Place your cheek just above the casualty’s mouth and nose. Look, listen and feel for their breathing for no more than 10 seconds. Look at their chest for movement, listen for sounds of breathing and feel for breath on your cheek. Circulation - Are there any signs of severe bleeding? St John Wales Training Directorate, Version 1.0 - Page | 16 Basic First Aider Student Handbook Resuscitation If a casualty is unresponsive and not breathing you will need to commence cardio pulmonary resuscitation (CPR) as soon as possible. When the heart stops it is possible to keep the blood flowing manually by performing chest compressions. Rescue breaths will help to put oxygen into the lungs and bloodstream. Adult CPR 1. Perform the primary survey. If there is no response and the casualty is not breathing start CPR. 2. Kneel beside the casualty, level with their chest 3. Place hand on the centre of the casualty’s chest. Place your other hand on top of this one. Interlock your fingers and keep them off the casualty’s ribs. There is no need to remove the casualty’s clothes to find the correct hand position. 4. Press straight down 5-6cm, keeping your elbows straight. Release the pressure fully but do not take your hands off their chest. 5. Give 30 times chest compressions at a rate of 100 - 120 compressions a minute. 6. Open the casualty’s airway by placing one hand on the forehead and two fingers under the chin. 7. Keep supporting the casualty’s chin with the fingertips of one hand. With your other hand, pinch the soft part of their nose 8. Take a breath and place your mouth over the casualty’s mouth making a good seal (use a face shield if you have one) 9. Breathe steadily into the casualty’s mouth for one second and check that their chest rises. 10. Keeping your hands in position, remove your mouth and let their chest fall 11. Give a second rescue breath 12. Continue giving 30 chest compressions and two rescue breaths until:  Professional help takes over  The casualty starts breathing normally  You become exhausted 13. If there is another first aider present, change over every two minutes with minimum disruption. Child CPR 1. Perform the primary survey. If there is no response and the child is not breathing start CPR. 2. Open the child’s airway by placing one hand on the forehead and two fingers under the chin. 3. Keep supporting the casualty’s chin with the fingertips of one hand. With your other hand, pinch the soft part of their nose. 4. Perform 5 initial rescue breaths. St John Wales Training Directorate, Version 1.0 - Page | 17 Basic First Aider Student Handbook 5. Take a breath and place your mouth over the child’s mouth making a good seal (use a face shield if you have one) 6. Breathe steadily into the child’s mouth for one second and check that their chest rises. 7. Keeping your hands in position, remove your mouth and let their chest fall 8. Give a further 4 rescue breaths. 9. Place the heel of one hand in the centre of the child’s chest and press down to one third of its depth. Release the pressure but do not remove the hand. 10. Continue 30 compressions at a rate of 100-120 compressions per minute. 11. Give 2 rescue breaths 12. Call 999/112 13. Continue CPR at a ratio of 30 compressions to 2 rescue breaths. 0 Infant CPR 1. Perform the primary survey. If there is no response and the baby is not breathing start CPR 2. Gently open the airway by tilting the head with one hand and lift the chin with one finger from the other hand. 3. Perform 5 initial rescue breaths. 4. Take a breath and place your lips over the baby’s mouth and nose. Blow steadily and gently for about 1 second until the chest rises. Watch the chest fall and perform a further 4 rescue breaths. 5. Give 30 chest compressions. Place the tips of your index and middle finger in the middle of the chest. Press down one third of the baby’s chest at a rate of 100-120 compressions per minute. 6. Give 2 rescue breaths. 7. Call 999/112. 8. Continue CPR at a rate of 30 compressions to 2 rescue breaths. St John Wales Training Directorate, Version 1.0 - Page | 18 Basic First Aider Student Handbook Unresponsive Casualty An unresponsive and breathing casualty should be placed into the recovery position which will help to maintain a clear airway and allow any fluid or vomit to drain away from the mouth which will prevent choking. Treatment 1. Carry out the primary survey sequence. If the casualty is unresponsive and breathing place them in to the recovery position. 2. Kneel beside the casualty. Remove spectacles and any bulky items from their pockets 3. Place the arm nearest to you at a right angle to the casualty’s body with their elbow bent and palm upwards. 4. Bring the arm further from you over their check holding their palm outwards. Then place the back of the casualty’s hand against their cheek nearest to you. 5. Using your other hand, grasp the leg furthest from you and pull their knee up. Make sure that their foot is flat on the floor. 6. Make sure the casualty’s hand remains pressed against their cheek to support their head and neck. Pull their leg towards you, keeping your hand on the outside of their leg, so the casualty rolls on their side. 7. Bring their upper leg towards their hip so that the knee and the hip are at right angles. 8. Gently tilt their head back to keep their airway open and, if necessary, adjust the hand under the cheek to support their head. 9. Dial 999 or 112. 10. Monitor the casualty’s vital signs 11. If the casualty is in the recovery position for a long time, turn them on their other side if injuries allow after 30 minutes. St John Wales Training Directorate, Version 1.0 - Page | 20 Basic First Aider Student Handbook Unresponsive Infant 1. Perform the primary survey. If the infant is unresponsive and breathing continue as follows. 2. Call 999/112. 3. Cradle the infant in your arms with the head tilted downwards. 4. Monitor vital signs (breathing, pulse and level of response). St John Wales Training Directorate, Version 1.0 - Page | 21