First Responder Test - Learning Objectives & Procedures PDF

**Learning objectives First responder** **Purposes and indications for the use of the recovery position** - Unconscious patients who have not suffered trauma should be in the recovery position - Help keep airway open - Allow secretions to drain from the mouth **AED acronym Meaning**...

**Learning objectives First responder** **Purposes and indications for the use of the recovery position** - Unconscious patients who have not suffered trauma should be in the recovery position - Help keep airway open - Allow secretions to drain from the mouth **AED acronym Meaning** - Automated, external defibrillator **What does BSI mean** - Body substance isolation **What is Standard Precautions aka BSI** - Assume that all patients are potentially infected with blood born pathogens - Always wear approved gloves, have 2 gloves on you at all times. **Best practices for using standard body substance isolation and precautions (infectious disease)** - Treat all blood and other bodily fluids and potentially other infectious material as known-to be infectious with a blood born disease - If items are infected spray with cavalcade and follow the directions provided by manufacturer - If blood or pathogens get on your uniform, dry clean it **Identify the role and responsibilities of the first responder** When other people arrive at the scene hand off patient to someone of equal and higher training than you. Give them a handoff report - Respond promptly and safely to the scene - Ensure the scene is safe from hazards - Protect yourself - Summon appropriate assistance - Gain access to patients - Perform patient assessment - Administer emergency medical care - Document your care **A First Responder** - The first medically trained person to arrive on the scene of an emergency **The meaning of acronym DOTS** - Deformities - open wounds - tenderness or pain - swelling **The meaning of acronym SAMPLE** - signs and symptoms - Allergies - Medications - Pertinent past medical history - Last oral intake - Events leading up to injury or illness **Vital assessment** - Respiration - Pulse - Capillary refill - Blood pressure - Skin condition/color - Pupil size and reactivity - Level of responsiveness **Pulse vital signs** - Determine rhythm and quality - In a normal adult resting pulse is 60 -- 100 bpm **Assessing vital signs (respiration)** - Respiration - Normal adult resting respiratory rate is 12-20 breaths per minute - Count patients breaths for 1 minute - Check breathing rate and quality **Primary assessment** To identify immediate life threats to the patient - Form a general impression - Assess the level of responsiveness - Perform a rapid scan - Identify immediate and threat to the patient - Form a general impression - Assess level of responsiveness using AVPU scale **Secondary assessment** - Is done to assess non life threatening conditions - Look and feel for signs of injury - Assess the patient for deformities, open injuries, tenderness and swelling **AVPU scale acronyms meaning** - Awake and alert - Responsive to verbal - Responsive to pain - Unresponsive **Consent of mental ill patients** - If the person appears to be a threat to themselves or others they should be placed under medical care - Application for authorization of temporary involuntary hospitalization (A Section 12) **Consent for minors** - Minors are not considered for speaking for themselves under the law - Emergency treatment must wait till parent or legal guardian give consent - If you can't get permission fast enough give care **What is implied Consent?** - Patient does not specifically refuse emergency care - The law assumes that if in the right state of mind, they would consent to emergency care if they were conscious, and allows you to treat these people - Do not hesitate to treat an unconscious person **Informed consent** - Patient understands who you are, what you want to do and what has happened and allows you to treat them - Give them a reason to believe that you know what you are doing - The presence of the uniform says we have been trained - Person can change their mind to consent at any given time - Patient lets you know verbally or non verbally that he or she is willing to accept treatment - Must be of legal age - Must be able to make a rational decision - You ask, they answer accurately and appropriately **Conditions present for negligence** - Duty to act - Breach of duty - Resulting injuries - Proximate cause **Breach of duty** - Providing improper/insufficient care or providing care that you are not trained or authorized to provide **What is negligence** - When a patient sustains further injury or had, bc the care administer did not meet the standard of care - Cops are not covered by the Good Samaritan law **Two criteria for standard of care** - Treat the patient the best to your ability - You must provide care that a reasonable prudent person with similar training would provide under similar circumstances **What is standard of care?** - The way you must act or believe **Duty to Act** - You must proceed promptly to the scene and render emergency medical care within the limits to your training and available equipment **Communications with a visually impaired patients** - Tell the patient what is happening - Identify noises, describe situation that is happening - Find patients name and use it through treatment - If patient has a service animal try to keep them together - Not necessary to talk louder - do NOT should **Communications with a hearing impaired patient** - Identify yourself - Face the patient so they can see your lips and face - Speak slowly and distinctly - Do NOT shout - Watch their face for understanding and uncertainty - Repeat and rephrase your comments in clear simple language - If all else fails write down your question **MOLST Protocols** - Check if order is valid - Box D and E must be fully complete for it to be valid - If expired, it is not valid - If valid, and section A states "do not resuscitate" then do not resuscitate - If form is not current or valid begin resuscitation - Patient can revoke the document **MOLST** - Is a medical order form that relays instructions between health professionals about a patients care **MOLST acronym meaning** - Medical orders for life sustaining treatment **Comfort care/DNR form** - Mass is moving away from this form - You should confirm identity - Confirm that the CC/DNR is from Ma - Confirm that the order verification form is current and valid - If the form is valid and the patient is in cardiac arrest, do NOT resuscitate - If the patient wants it to be revoked, sign date and write revoked **Law enforcement exceptions to HIPPA** - To respond to a request to protected health information for purposes of identifying or locating a suspect, fugitive, material witness or missing person **Confidentiality** - Information that only should be shared on with other medical personnel who are directly involved in the patients care. - Most patient information is confidential, such as: 1. Patient circumstances 2. Patient history 3. Assessment findings 4. Patient care giving **why do we use the recovery position** - To prevent secretions from entering your airway **Stress:** - You can't train your mind against stress **Two ways to open an airway** 1. Head tilt chin lift maneuver (push their forehead, lift their head) 2. Jaw thrust maneuver **CAB acronym meaning** - Circulation, breathing and, airway **Airway Management** - Airway care and rescue breathing **Therapy animal** - Provide psychological or physiological therapy to individuals other then their handlers - Unlike service dogs, they are encouraged to interact with a variety of people while on duty - Not protected under ADA **Developed mentally disabled patients** - Ask family or caretaker about their typical level of communication - Speak slowly using short sentences or familiar words - You might need to repeat yourself - Ask about their triggers **Communicating with children** - Have them hold a familiar object - Explain what is happening - Tell the child your first name - Get on their level, squat , kneel or sit next to the, to establish eye contact **Communicating with elderly people** - Give them time to answer - Assess them carefully - Don't assume they have physical or mental impairments **Who does the Good Samaritan law protect** - Citizens **Comfort animal** - They are crisis response animals that act during active crisis and emergency situations - They are certified to handle disaster response **Emotional support animal** - They are prescribed by mental health professionals - Provide comfort and support of their owners when needed - They do not have the same protections as service animals **Service animal** - Refers to any Animal trained to help a person who has a disability, such as visual or hearing impairment, mental illness, seizures [.] mobility impairment and diabetes - Only question you can ask the person is what service does it provide - Have a right to accompany their owner wherever they go **Signs and Symptoms of a stroke** - Dizziness - Patient may be alert, confused, unresponsive or unable to speak - Facial droop - Numbness/paralysis on one side of the body - The signs and symptoms may vary depending on the portion of the brain that is affected **FAST acronym meaning** - Face, arm, speech, time - Facial droop -- have patient show teeth and smile - Normal -- both sides of the face move equally - Abnormal -- one side of the face does not move as well as the other **Treatment of hypothermia** **Hypothermia signs and symptoms** - Feeling cold and shivering - Decreased consciousness - Sleepiness - Lack of coordination - Mental confusion - Slowed reactions - Unconsciousness Progresses if patient stops shivering **Hypothermia** - When the persons body is not able to produce enough energy to keep internal temp - Body temp drops less then 95 degrees - The patients skin will be white and waxy - The skin may be firm or frozen - Swelling and blisters may be present - Remove any jewelry on patient - Cover extremities with dry clothes **Superficial frostbite** - Warming must be done fast - The affected body part becomes numb and them turns bright red in color - Eventually the area looses its color and changes to pale white - Loss of feeling or sensation - Do NOT warm area by rubbing - Depending on the temperature and wind velocity frostbite can occur quickly **Frostbite body parts most susceptible** Can result when exposed parts of the body are exposed to a cold environment - Face - Ears - Fingers - Toes **Prevention/treatment of frostbite** - Prevent it before it happens - Pat don't rub and gradually warm them up - On coming traffic - Unstable surfaces - Leaking gasoline - Downed electrical lines - Potential for violence - Fire or smoke - Hazardous material - Needles - People **Overdosing and treatment** - They aren't breathing - Naloxone (Narcan) - Rescue breathing - - Small pupils - Not arousable - Not speaking - Breath slow and stopped (less than 8 time per minute) - No response to sternum rub - May hear chocking sounds or a gurgling/ snoring noise - Small pupils - Drowsy but arousable - Speech is slurred - Drowsy but breathing (8 or more breaths per minute) - Responds to sternum rubs - Observe them - Provide basics life support - Keep patient from hurting anyone - Provide reassurance **Treatment for anaphylactic shock** - Help them use Epi pen - Maintain patience - Administer oxygen if available - Elevate patients legs - Remove all allergen if possible - Monitor patients vitals - If patients heart stops begin CPR - Arrange for rapid transport - Itching - Hives - Swelling - sever respiratory distress - Loss of consciousness - Rapid weak pulse - Rapid shallow breathing - Vessels dilate or get large and blood pressure goes down **Heart conditions** - The heart must receive a constant supply of oxygen or it will die - The heart receives its oxygen through a complex system of coronary arteries - The arteries may narrow because of atherosclerosis - Progressive atherosclerosis can cause angina pectoris, heart attack and cardiac arrest **Cardiac arrest** 1. Complete cessation of the heartbeat 2. CPR and Defibrillation is your first emergency treatment **Congested heart failure** - gurgling, swollen ankles - Rapid shallow breathing - Moisture or gurgling in respiratory - Profuse sweating - Anxiety **Treatment of congested heart failure** - Place them in a sitting position - Administer oxygen - Get help - Arrange for prompt transport **Signs and symptoms of congested heart failure** - Breathing difficulty - Rapid, shallow breathing - gurgling respiration - Profuse sweating - Swollen ankles - Anxiety **The cause of Angina** - Oxygen demand exceeds supply - Chest pain caused by not enough blood flow and oxygen to the heart muscles - Usually related to exertion of physical/ emotional stress - Described as heavy pressure or discomfort **The cause of a heart attack** - When one or more of the coronary arteries is completely blocked **Signs and symptoms Angina/ heart attack** - The patient suffers immediate and severe pain - The pain may radiate from chest to the arms/shoulders or to the jaw - Short of breath, weak, sweating, nauseated and may vomit - If blocked area is critical, the heart may stop completely causing cardiac arrest **Treatment of Angina/Heart Attack** - Talk to the patient to relieve his or her anxiety - Do NOT have the patient walk or exert themselves - Place the patient in the most comfortable position - Ask patient if they are already being treated for a heart condition and has nitroglycerin - If nitroglycerin is prescribed to them, help them in taking 1 does of nitro according to the dosing directions - Be prepared to give CPR - If an AED is available have it brough to the patient and have it ready to use **Signs and symptoms** - A sign is something the patient and other can see - A symptom is something the patient can feel **How are seizures caused?** - By sudden episodes of uncontrolled electrical impulses in the brain - Epilepsy - Trauma - Head injury - Stroke - Shock - Decreased level of oxygen - High fever - Infection - Poisoning - Overdose of drugs and alcohol - Brain tumor or infection - Diabetic emergencies - Complications of pregnancy **Treatment of a seizure** - Usually, the seizure will be over by the time you arrive at the scene - If it has not ended, focus on protecting the patient from injury - Never place anything in the patients mouth - If an object was places in the mouth, remove it - Place something soft under the patients head if possible to prevent further injury - Once seizure stops, make sure to open the airway and place patient in recovery position - If the patient does not resume breathing, begin CPR, if pulseless begin CPR - After seizure if necessary, calm the patient and move the patient to a more comfortable and private place **What are the three types of seizures?** - Generalized seizure - Febrile Seizure - Absence seizure **Generalized seizure** - Produce shaking movements - Involving entire body - Lasts 1 to 2 minutes - Usually levees patient unconscious **Febrile Seizure** - Generalized seizures caused by a sudden high fever - Occurs in infants and young adults **Absence seizures** - Results in only a brief laps of consciousness - Patient may blink, stare vacantly, or jerk one part of their body - Monitor the patients CAB's **When a person is exposed to excess heat, the body's mechanism for regulating temperature can be overwhelmed resulting in:** - Heat exhaustion **Heat cramps** - Involuntary spasms in the muscles - Often occur after exercise, especially in hot weather - May experience body cramps **Treatment to heat cramps** - Move them to a cool place (air conditioned cruiser) - Have the patient lie down in a comfortable position **Heat exhaustion treatments** - Move person to a cooler place and treat them for shock - Unless patient is unconscious, nauseated or vomiting, give cool fluids by mouth - Monitor cabs - Cool patient with icepacks in axillary and groin areas **Heat Exhaustion** - Persons body is **wet** - When person is exposed to temp greater than 80 degrees - Can result in vigorous exercise at lower temps **Signs and Symptoms of Heat exhaustion** - Profuse sweating - Lightheadedness - Dizziness - Nausea - Weak pulse - Low blood pressure **Heat stroke** - The body is **dry,** does not produce sweat anymore - Occurs when the body is subjected to more heat than it can handle and the normal mechanism for getting rid of excessive heart are overwhelmed - Their body temp rises and the brain is affected, mental status changes will happen **Signs and symptoms of a Heat Stroke** - Flushed, dry skin that feels hot to the touch - Semi consciousness or unconscious - Internal temp as high as 106 degrees **Heat stroke Treatment** - Manage the patients CABs - Remove the patients clothes down to underwear and bra - Soak patient with water if possible - **How to control bleeding** 1. Direct pressure 2. Elevation 3. Tourniquet 4. Pressure point **Dressings for bleeding control** - It is an object that is places directly on the wound to control bleeding and prevent further contamination - Once in place, apply firm, direct manual pressure on it to stop any bleeding - If bleeding continues after dressing applied, put more gauze pads over the original dressing **Bandaging for bleeding control** - Make sure the dressing completely covers the wound and extends beyond all sides - Wrap bandage tightly enough to control bleeding, not to tight that it cuts off circulation - Check circulation regularly, if pulse is absent remove bandage and reapply - Secure the bandage so it doesn't slip off **Face and scalp wound bleeding control** - Apply direct pressure - Direct pressure compresses the blood vessels against the skull and stops the bleeding - Move the head as little as possible and stabilize the neck - Monitor their breathing and airways, protect the spine **Nose bleeds for bleeding control** - Have patient sit down and tilt the head forward, endless they are in shock - Pinch nostril together for at least 5 minutes **Eye injuries for bleeding control** - Cover the entire eye with a dry gauze pad - Have patient lie on their back **Neck wounds for bleeding control** - Use direct pressure - Once bleeding is control, dress the neck **Chest and back wounds for bleeding control** - Put patient in a comfortable position - If lung is punctured, air can escape and the lung will collapse - Cover the chest wound with an airtight material on all sides - Seal wound on all 3 sides - Use a commercial occlusive dress **Impaled objects for bleeding control** - Apply stabilizing dress - If object is protruding do not remove it - Support the object so it cannot move - Place gauze or towels on either side of the object and secure them with additional gauze **Levels of burns** - Superficial burn (first degree) - Partial thickness burn (second degree) - Full thickness burn (third degree) **Types of Burns** - Thermal burns - Respiratory burns - Electrical burns - Chemical burns **Superficial burns** - First degree - Reddened and painful skin - The injury is confined to the outmost layers of skin - The person experiences minor to moderate pain **Partial thickness burns** - Second degree - Does not damage the deepest layers of the skin - Blistering present - Fluid loss and moderate to severe pain **Full thickness burn** - Third degree - Damage is done to all layers of the skin - Pain is absent bc the nerve endings have been destroyed - Lose large quantities of body fluids and are susceptible to shock and infection **Cause and treatment of Thermal burns** - Caused by heat - Place the burned area in clean, cold water - Cover burn with dry, sterile dressing or burn sheet - Don't break blisters - With large burns must be treated for shock and transported to the hospital **Cause and treatment of Raspatory burn** - A burn to any part of the airway - Breathing problems can develop rapidly or slowly - Administer oxygen if you are trained to use it - Prepare to perform CPR **Respiratory signs and symptoms** - Burns around the face and nose hairs - Soot in the mouth or noise - Pain while breathing - Loss of consciousness bc of fire **Chemical burns cause and treatment** - Strong Substances causes them - The longer the chemical remains in contact with the skin, the more damage it causes - Remove as much of the chemical as possible - Brush away and dry chemical - Flush with water for at least 10 minutes - Cover the area with a dry sterile dressing **Chemical burns to the eyes** - Can cause extreme pain and severe injury - Flush the eyes with water for at least 20 minutes - Loosely cover the injured eyes with gauze **Electrical burns cause** - Occur when the electrical current enters the body at one point, travels through the body tissues and organs and then exists at the point of ground contact - Causes internal damage - May experience irregularities of cardiac rhythm or full cardiac arrest and death - Make sure person is still not in contact with electrical power source before you touch - Call for assistance from the power company or fire department - single entrance but multiple exit wounds, have to look all over the person's body **Cause of diabetes** - the bodies inability to process and use glucose - the pancreas does not produce insuline - the body produces insulin which enables glucose to move into individual cells **Insulin shock (hypoglycemia)** - happens when the body has enough insulin but not enough blood glucose - may appear drunk **signs and symptoms of insulin shock** - pale, moist, cool skin - rapid, weak pulse - dizziness or headache - confusion or unconsciousness - sweating - hunger **Diabetes treatment (besides insulin)** - juice with or without added sugar - candy - cake/ frosting - ice-cream - glucose tablets - packet of sugar **Acute abdomen pain cause** - caused by irritation - result from an infection or the presence of blood in the abdominal cavity - pain can be referred to other parts of the body - if organs are out of body do NOT place them back inside **Acute abdomen pain sign and symptoms** - may feel hard as a board - nausea - vomiting - fever - diarrhea **Acute abdomen pain treatment** - monitor vital signs - treat symptoms of shock - keep patient comfortable **Abdominal aortic aneurysm causes and treatment** - often complains of lower back pain - when the aorta begins to leak or rapture - Place the patient in comfortable position - Treat the patient for shock - Handle these patients gently **Classifications of poisoning** - Ingestion - Inhalation - Injection - Absorption **Ingested poisons** - More than 80% of all cases of poisonings are caused by ingestion **Signs and symptoms of ingested poisonings** - Diarrhea, vomiting, nausea - Abdominal pain - Abnormal or decreased respiration - Loss of consciousness - Seizures **Inhaled poisonings** - Some toxic substance is breathed in or absorbed through the lungs - Toxic substances (carbon monoxide) are very irritating if not poisonous, is breathed in or absorbed through the lungs - Other toxic gases (chlorine and Ammonia) are very irritating to the respiratory tract **Inhaled poisonings signs and symptoms** - Respiratory distress - Dizziness - Headache - Cough - Hoarseness - Confusion - Chest pain **Carbon Monoxide causes** - Improperly vented heating appliances - Smoke (burning buildings) - Motor vehicle running with block exhaust (snow/enclosed garage) **Signs and symptoms of carbon monoxide** - Headache - nausea - flulike symptoms - disorientation - unconsciousness **Treatment for inhaled poisonings** - remove patient from the source of gas - if patient is not breathing, begin rescue breathing - arrange for prompt transportation **The two major causes of poisonings by injection are** - animal bites and stings - toxic injection **Signs and symptoms of animal bites and stings and toxic injection** - obvious injury (bite or sting mark) - tenderness - swelling - red streaks radiating from injection site - weakness - dizziness - Localized pain - Itching **Types of head injury** - In closed head injury where bleeding and swelling are within the skull, this puts pressure on the brain, leading to brain damage and death - An open head injury usually profusely bleeding - Brain tissue or bone may be visible **Injuries to the head** - Confusion - Unusual behavior - Unconsciousness - Nausea and vomiting - Blood from the ear - Seizures - Paralysis - Bumps and bruises - Unequal pupils **Injuries to the head treatments** - Immobilize the head in a neutral way - Maintain an open airway with the jaw thrust maneuver - If trained to use, support the patients breathing with oxygen - Monitor circulation, be prepared to perform CPR **Injuries to the face cause** - Motor vehicle crashes (person hits face on steering wheel) - Assault - Falls - Airway obstruction is the primary danger in sever facial injuries - If patient has face injuries, suspect neck injuries **Injuries to the face treatment** - Immobilize the head in a neutral position - Maintain an open airway with the jaw thrust - Support breathing - Monitor circulation - Control bleeding by covering any wound with a dry, sterile dressing and apply direct pressure - Look for and stabilize other serious injuries - Arrange for prompt transport **Injuries to the spine** - A displaced vertebra, swelling, or bleeding, may put pressure on spinal cord and damage it - The spinal cord could be severed - Could result in death due to inability to breath **Signs and symptoms of a spinal injury** - Extreme weakness, numbness, paralysis or loss of movement - Loss of sensation or movement, or a tingling/ burning sensation in any part of the body below the neck - Priapism in males - Loss of bladder or bowel control **Treatment for spinal injury** - Place the head and neck in a neutral position - Stabilize the head and prevent movement - Maintain an open airway with the jaw thrust maneuver - If trained use oxygen by keeping the airway open **Injuries to the chest (Flail chest)** - If **3** or more ribs are broken in at least **2** places, the injured portion of the chest wall does not move with the rest of the chest - Decreases the amount of oxygen and carbon dioxide exchanged in the lungs **Treatment to a flail chest** - Support the patients breathing using a bag valve mas and supplemental oxygen - Monitor and support CABs **the first stage of labor** - Pregnancy is full term at **39 weeks** - Pregnant women's body prepares for birth - Initial contractions - The water breaks - The bloody show occurs' - Infants head does not appear during contractions **The second stage of labor** - The birth of the infant - You will see the infants head crowning during contractions - There is no time for transport **The third stage of labor** - You must help with stabilizing the condition of the mother and infant and delivering the placenta **Understand what defines mechanisms of injury (MOI)** - cause of injury **Too much insulin =** insulin shock **In order for if someone is bleeding out** - Direct pressure - Elevation - Tourniquet - Pressure point **If someone strikes you with a baseball bat to the arm what would be an underlying issue?** - Fracture to your bones **How are burns classified** - By depth **Why on a Third degree burn do you you not feel pain?** - it burns off all the nerve in a persons body endings