DOC'S FIRST AID GUIDE
By
Kathleen A. Handal, M.D.
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"Invaluable e-book ... valuable resources that make a contribution to improving family health and safety ... concise guide takes out all of the guess work, telling the reader exactly what to do and what not to do when first aid situations arise."
Sari Fine Shepphird, Ph.D. Psychologist & Author
"Key is on the cover-Read it before you need it ... Helps decide what you can do at home and when you need to seek more advanced help."
Claire Merrick
"Very valuable and accessible contribution to the education needed for first aid responses."
Delores Rogers
"Replaces that old heavy reference book."
Stephanie Herold
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Published by DocHandal, LLC at Smashwords.
Copyright © 2009, by Kathleen A. Handal, M.D.
All rights reserved. This book may not be reproduced in part or in whole by any process without written permission from the author, Kathleen A. Handal, M.D. Thank you respecting the work of this author.
ISBN-13: 978-0-615-32737-2
This ebook is licensed for your personal enjoyment only. This ebook may not be resold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each person you share it with. If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy. Thank you for respecting the hard work of this author.
DocHandal, LLC publishes first aid and safety materials in a variety of electronic formats. Discounts for bulk orders and customized editions may be available from the publisher.
Visit http://www.DocHandal.com for more information.
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DISCLAIMER: This is a guide until medical assistance is obtained. The author does not represent that every acceptable first aid/medical procedure is contained herein or those abnormal or unusual circumstances may not warrant or require additional procedures. This material is not designed to take the place of first aid training by qualified instructors or evaluation by a physician. DocHandal recommends formal first aid & CPR training for everyone.
The information within this guide is a compilation of general medical first aid reflecting the current knowledge and accepted emergency practice in the United States at the time this guide was published (November 2010). The reader is urged to stay informed of changes in emergency care procedures.
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ABOUT THE AUTHOR
Kathleen Handal, MD is a nationally and internationally known emergency medicine “Doc”. She authored “The American Red Cross First Aid & Safety Handbook” which was written for the lay audience.
Doc believes physicians have a responsibility to teach and share medical common sense. Her website, www.Dochandal.com, serves as a base for her many consumer education endeavors. A frequent host and co-host on talk-radio health shows, she has also appeared on CNN and the Today Show. Her “Medical Emergencies in the Workplace” video won a bronze medal in the International Cindy Competition and was a Telly Award finalist. She has co-authored a series of medical textbooks.
As part of her dedication to public education, she wrote, directed and produced "Trauma Run", a nationally distributed video for grades 2-6. The video, produced in Spanish and English, teaches children how to respond to a medical emergency when no adults are available.
In “Doc’s ER Guide” she gives valuable insight into how an emergency room operates, so you’ll know how to get the best care possible. It’s like having Doc Handal at your side when you need her the most.
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Acknowledgments
Many thanks to Brian Coonce, Barbara O'Neill-Maguire, BSN, RN, OCN, Rocio Marin, Barbi Neary, RRT and all my ER patients over the years for their many and varied contributions, not the least of which was patience and trust.
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CONTENTS
READ THIS BOOK BEFORE YOU NEED IT!
AUTOMATED EXTERNAL DEFIBRILLATOR (AED)
For Impaled Objects - Object Stuck In Body Part
BONE / JOINT / MUSCLE INJURIES
RUPTURED EARDRUM / EAR DRAINAGE
5. EMERGENCY FIRST-AID TECHNIQUES
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The steps a rescuer takes during the first few minutes of a medical emergency are critical - they can mean the difference between temporary or permanent disability or between life and death. That's why first-aid knowledge and training are so important. They prepare you to intervene calmly and effectively in a medical emergency.
In this book you'll find easy-to-follow instructions on how to help in the more common medical emergencies. You'll learn what to do and what not to do if you're the first one on the scene. So familiarize yourself with this material before an incident occurs. And keep in mind that reading this information is no substitute for formal instruction and practice. Not every possible medical emergency situation is presented in this guide.
Before you become a rescuer, be aware of your own sensitivities and physical limitations. If you are not cut out for hands-on help at the scene of a medical emergency, you can still help. The fact that you know how to get help and can communicate effectively will make a difference.
It's also important to exercise compassion and understanding for the victim's situation. Your job is to stay calm and to reassure the victim without making false promises. Always remember to give the victim as much privacy as possible, including asking observers to act as a screen by facing out from the situation. Again, thinking ahead about this and the role you might play will make a difference in ensuring the effectiveness of your assistance.
READ THIS BOOK BEFORE YOU NEED IT!
In this book you will see how to:
Size up the situation
Set priorities
Check and maintain Airway, Breathing and Circulation (ABCs), the actions of CPR and the Automated External Defibrillator (AED)
Administer first aid for specific emergencies
Create an Emergency Info Sheet
Put together a First Aid Kit, using Doc Handal's First Aid Kit Checklist
Note: Any word in blue text within this book can be referenced from the Table of Contents.
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First aid is serious. Dedicate some time to learning how to help. Any time you spend doing this is time well spent. Make sure you have a first aid kit at home, in your car and at work. Familiarize yourself with its contents. Replace and update supplies as needed. You want to be ready to act quickly and correctly in a medical emergency.
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Your first step in a medical emergency must be to look around and ask yourself "Is the scene safe for me?" before attempting a rescue. Too often well-intentioned rescuers become victims themselves when they risk their safety to help others. Don't think that rushing in will make you a hero. If the area is unsafe, go for help or put on the personal protective equipment (PPE) that will permit you to assist safely.
Keep in mind that blood and some body fluids may contain infectious matter so ALWAYS take Universal Precautions, like wearing gloves or a CPR barrier mask, to protect you. Barrier devices should be kept in your First Aid Kit.
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After you've determined that it is safe for you to enter the area, approach the victim. As you do, look for signs of life. Determine if the victim is breathing. Tap the victim on the shoulder and ask, "Are you OK?" (Saying 'OK' is internationally understood.).
If spine or neck injury is suspected, don't move the victim unless there's a threat of fire, explosion, or other life-threatening danger. If a victim is face down turn the victim face up. If a spine injury is suspected, use the Log-Roll Technique to turn the victim.
If the victim does not respond CALL FOR MEDICAL HELP and start checking the ABCs.
If the victim responds, identify yourself as willing to assist. Find out what is wrong and take steps to help the victim. Always treat the more serious injuries first. It's important to stay calm and assure the victim while you're performing first-aid measures.
How you call for help should be another consideration. In most cases, the victim will need some type of emergency medical help, be it from Emergency Medical Technicians (EMTs), the company nurse, or a physician at the hospital. If you're not alone, tell someone else to go for medical assistance while you help the victim. In an emergency it's important to remember that every minute counts.
When alone, in certain circumstances, intervention is your priority. However, it is usually best to call Emergency Medical Services (EMS) – 911 in the USA/Canada, 999 in United Kingdom, 000 in Australia – before you intervene, especially if you witness a collapse or come across an unresponsive victim.
When you call EMS, remember that there are certain things a dispatcher will need to know in order to get help to you quickly:
The address and location of the emergency (including cross streets and specific directions to the exact location of the emergency).
Your name, phone number, and the number of a nearby phone.
A description of what happened and how many people need help. (It's also a good idea to check the victim for medical information jewelry and to report findings to the dispatcher.)
Stay on the phone until the dispatcher tells you it's okay to hang up. Remain calm and listen carefully—the dispatcher may give you valuable first-aid instructions for aiding the victim until help arrives.
When seconds count, an Emergency Info Sheet (EIS) is a great timesaver. Take the time now to fill in the emergency numbers. Make a copy of this call sheet and post it next to the telephones in your work area and at home. Having this information handy will help you obtain emergency medical assistance quickly.
In addition, make sure your cell phone directory includes the entry ICE (In Case of Emergency). ICE is the person you want called if you're ill or injured. Emergency personnel are trained to look for this number when they need to gather information about a victim.
Anyone involved in the care of an ill or injured person can be at risk of acquiring an infectious disease, such as Hepatitis, Tuberculosis, Acquired Immune Deficiency Syndrome (AIDS), or Meningitis. Identifying a person as having a communicable disease can be difficult or impossible; therefore, rescuers must presume everyone is a risk. Always take protective measures to avoid coming in contact with another person's body fluids (blood, urine, sputum, secretions). Protective measures should also be taken during cleanup and disposal of materials used to care for the victim.
To reduce the risk of infection, follow these guidelines:
Always cover all your open skin areas.
Wear the appropriate PPE such as: gloves, mask, CPR barrier mask (when giving rescue breathing), and goggles.
If possible, place a barrier between you and another person's body fluids.
Minimize the splashing of body fluids.
Wash hands and any exposed area with soap and water immediately after providing care, even if you were wearing gloves!
Handle sharp objects with caution.
Wear a mask if there's a risk of exposure to airborne disease.
Dispose of contaminated PPE in an appropriate container.
Contact your Primary Care Physician (PCP) immediately if you come in direct contact with another’s body fluids, especially if you have concerns.
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If a person is unresponsive and not breathing you need to start CPR right away. Gasping is not breathing! By unresponsive I mean appears lifeless, doesn’t move or respond when shoulder is tapped. Yell for someone to call EMS and get an AED. An AED applied fast may restart the heart. Don’t worry, AEDs are user friendly and I’ve included instructions on how to operate one.
Understand that when a victim's heart has stopped pumping blood (cardiac arrest), permanent brain damage can begin in four to six minutes, so you must act fast.
Cardiac arrest can strike at any age and may be caused by many conditions, including heart attack, suffocation, allergic reaction, drowning, choking, or electric shock.
In October 2010, guidelines on what a rescuer should do when CPR is needed changed. If you are untrained in CPR the new guidelines state that you should start chest compressions immediately and follow instructions when given by an EMS dispatcher. If you are CPR trained and able you should begin with chest compressions and then add rescue breathing, following current CPR guidelines. Research has shown that when chest compressions are given immediately to a cardiac arrest (unresponsive/not breathing) victim the chance of survival is improved.
I’m going to explain how to perform Chest-Compression-Only CPR on an adult for those of you who have never taken a CPR class. And then, since I always recommend formal training in CPR, I’m going to review the basics of what is covered in a CPR class for those who have taken one.
If you’ve never taken a CPR class you should still read the CPR Basics section. Being familiar with this information will be helpful in case an EMS dispatcher ever has to guide you through these lifesaving techniques.
NOTE: Healthcare providers, such as nurses and paramedics, learn more detailed instructions than what is covered in this book.
Be sure you are safe.
Tap and shout "Are you OK?" to assess responsiveness and look to see if the person is breathing---gasping is NOT breathing.
If unresponsive, have someone call EMS and get an AED while you start chest compressions.
Position the victim flat on a firm surface with head at the same level as the heart. Open chest clothing.
Kneel facing the victim's chest. Using your hand nearest the victim's legs, locate the center of the chest, between the nipples on the victim's breastbone.
Place the heel of your other hand on top of the hand on the chest. With shoulders back, straighten your arms, lean directly over the person, and lock your elbows.
Use straight-down pressure through both arms to push the breastbone down toward the spine, at least 2 in./5 cm. Push hard and fast at rate of 100 compressions a minute (100/min.). Allow chest to recoil between compressions. Don’t stop compressions unless absolutely necessary.
You may be directed by an EMS dispatcher to perform rescue breaths.
If a CPR barrier mask isn't available and you have any worries about giving rescue breathing or consider the victim at high risk for disease transmission say so. Your own safety is a priority.
NOTE: CPR on infants and children has better outcomes when chest compressions are combined with rescue breathing. This is best learned in a CPR class.
Remember, proper functioning of the heart and lungs is basic to life. Monitoring responsiveness, which includes determining whether the person is breathing and their heart is pumping, takes priority over other illnesses and injuries. Because, let’s face it, if you’re not breathing and your heart isn’t beating, stabilizing a fractured bone isn’t going to make much difference.
A trained lay rescuer, that’s someone who has taken a CPR class, should provide, at a minimum, chest compressions. Rescue breaths can be added at a ratio of 30 compressions to 2 breaths. So if you find someone who is unresponsive, start right in with chest compressions and provide rescue breaths as you’ve been trained.
It’s correct to think chest Compression, Airway and Breathing (C-A-B) instead of Airway, Breathing and Circulation (A-B-C) when it comes to an unresponsive victim. However, if you’re monitoring someone who is having a seizure, for example, monitoring the person’s breathing is most important. Use your common sense and prioritize when it comes to monitoring a victim.
Remember, CPR involves the use of chest compressions and rescue breathing. During CPR, the trained rescuer attempts to maintain a steady flow of oxygen and blood for the victim, whose lungs and heart have stopped functioning.
It is best administered by a trained person. Remember: