First Aid for Public Safety Personnel study guide

More advanced classes require that you know and be able to properly use more advanced vocabulary.

If you have at first taken a lower level class and then move to higher level you can’t be complacent and think that you already know everything. A member of the public can call any wound a cut, but a person training in Emergency Response, Title 22 or lifeguard training should know the difference between an avulsion, laceration, puncture or abrasion.

As a lifeguard you might have referred to burns as first, second, and third degree, but in a higher level class such as First Aid for Public Safety Personnel (Title 22) or Emergency Response you need to know the difference between superficial, partial thickness and full thickness.

Blood from a wound can come from capillaries, arteries or veins. Do you know the kind of bleeding from each?

Will you care for, (or not care for) this wound with a bandage, pressure bandage, tourniquet, dressing, universal dressing, occlusive dressing?

What is a normal heart rate, what is compensating, and what is the rate of compressions for various kinds of CPR?

Are you familiar with specific vocabulary such as tissues, muscle, tendon, nerve, ligament, palpate, hypoxia, anaphylaxis, stimulant, depressant, hallucinogen, narcotic, synergistic, diastolic, systolic, placenta, amniotic, cervix, crowning, prolapsed cord, circulatory, respiratory, nervous, endocrine, esophagus, femur, patella, cranial, clavicle, larynix, epiglottis, stoma, auscultation, defibrillation, fibrillation, distal, proximal, embolism, transient ischemic, BSI, DOTS, AVPU, SAMPLE, DNR, LOC, START, SIDS, rule of nines?

Re-reading the glossary at the end of the text can really improve your chances of passing a test.

This page has the main points of overhead projections for my use while teaching the American Red Cross First Aid for Public Safety Personnel (Title 22) class, and for my students to review.

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First Responder Characteristics

Controls fears

Presents professional appearance

Maintains skills and knowledge

Stays healthy

Recognizes and keeps victim’s needs as priority

Primary Responsibilities of First Responders

Gain access to victims

Identify life-threatening conditions

Summon more advanced medical personnel when necessary

Provide care

Assist more advanced medical personnel

Secondary Responsibilities of First Responders

Control and direct bystanders

Keep records

Reassure others at scene

Medical Oversight

Direct medial control

Indirect medical controls

Protocols

Standing orders

Warning Signs of Stress

Inability to concentrate

Difficulty sleeping/nightmares

Anxiety

Guilt

Loss of interest in work

Critical Incident Stress

Can build-up over days, weeks, months, or years

May require counseling

At the Scene, Evaluate-

Problems

Dangers

Number of victims

Behavior of victims/bystanders

Need for additional assistance

Ensure Your Safety By-

Wearing proper gear

Doing what you are trained to do

Summoning additional resources

Possible Dangers at an Emergency Scene

Traffic

Fire

Electricity

Water/ice

Hazardous material

Unstable structures/vehicles

Natural disasters

Multiple victims

Hostile situations

and see: checking the scene for safety

Conditions Necessary for Disease Transmission

Sufficient quantity of pathogen to cause disease

Person vulnerable to the disease

Transmission at correct entry site

How Pathogens Enter the Body

Indirect Contact

Airborne

Vector-borne

more details at: Bloodborne Pathogens quick facts

Exposure Control Plan

Schedules and methods for implementing OSHA standard

Procedures for evaluating exposures

Immunizations

Standard Precautions (BSI) to Prevent Disease Transmission

Personal hygiene practice

Engineering controls

Work practice controls

Legal Considerations

Standard of care

Duty to act

Competence

Consent

Advance directives/DNR orders

Refusal of care

Battery

Abandonment

Negligence

Good Samaritan Laws

Confidentiality

Preserving evidence

Obtain Consent Before Providing Care

State level of training

Explain what you observe

Explain what you plan to do

Four Components of Negligence

Breach of Duty

Cause

Damage

Major Body Systems

Circulatory

Nervous

Musculoskeletal

Integumentary

Basic Guidelines for Moving a Victim

Bend at knees and hips

Lift with you legs, not your back

Take short steps

Move forward when possible

Look where you are walking

Protect victim’s head, neck, and back

Moves

Emergency Moves

Fire fighter’s carry

Clothes drag

Blanket drag

Shoulder drag

Pack-strap carry

Non-urgent moves

Direct lift

Extremity lift

Direct carry

Draw sheet method

Assessment-Scene Size-Up

Mechanism of injury/nature of illness

Number of victims

Resources needed

Assessment-Initial Assessment

Assess level of consciousness

Assess airway

Assess breathing

Assess circulation (pulse, severe bleeding, and skin characteristics)

Assessment-Physical Exam

Identify signs and symptoms

Check victim from head to toe

Look and palpate (feel) for signs of injury- (DOTS)

Deformity

Open injuries

Tenderness

Swelling

Levels of Consciousness-AVPU

Verbal – only responds to verbal commands

Painful – Only responds to painful simulus

Unresponsive – does not respond

Assessment-SAMPLE History

Allergies

Medications

Pertinent past history

Last oral intake

Events leading to injury or illness

Measuring Blood Pressure

Systolic: Reflects pressure in arteries when heart is working/contracting

Diastolic: Reflects pressure in arteries when heart is resting/refilling

Asthma

Triggered by-

Allergic reaction to pollen/food/a drug/insect stings

Emotional stress/physical activity

Signs and Symptoms

Struggling to breathe

Wheezing when exhaling

Emphysema

Caused by-

Smoking; usually develops over many years

Signs and symptoms

Shortness of breath

Possible coughing, cyanosis, or high fever

Advanced cases: Restlessness, confusion, weakness

Hyperventilation

Triggered by-

Fear/anxiety

Injury to head/severe bleeding/illness

Asthma

Exercise

Signs and symptoms

Shallow, rapid breathing

Dizziness

Anaphylaxis (severe allergic reaction)

Triggered by-

Food/insect stings/a drug

Signs and Symptoms

Tightness in chest/throat

Swelling of face/neck/tongue

Care for Respiratory Distress

Keep victim from getting chilled or overheated

Reduce heat; add moisture

If authorized, help victim take any medications

Summon more advanced medical personnel

Monitor vital signs

Key Points of Respiratory Arrest

Commonly caused by illness, injury, or choking

Often preceded by respiratory distress

Body systems will progressively fail

Give Rescue Breaths

Children-1 every 3 seconds

Infants-1 every 3 seconds

Airway Obstruction

Tongue

Swollen tissues of mouth and throat

Mechanical – Airway blocked by foreign object

Food

Toy

Fluids

Airway Obstruction

Partial

Victim can still move air to and from lungs; can cough, speak, breathe

Complete

Victim is unable to speak, breathe, cough; no air movement

The Heart

Left atrium – receives blood from lungs

Right ventricle – pumps blood to lungs

Left ventricle – pumps blood to body

Major Functions of Blood

Maintains constant body temperature

Transports oxygen, nutrients, and wastes

Care for External Bleeding

Pressure bandage

If necessary-

Summon more advanced medical personnel

Care for Internal Bleeding

Apply ice or cold pack

If serious injury-

Do no further harm

Monitor ABCs and vital signs

Have victim rest in a comfortable position

Keep victim from getting chilled or over-heated

Reassure victim

Provide care for other conditions

Signs and Symptoms of Shock

Rapid/weak pulse

Rapid breathing

Pale, ashen, or bluish/cool/moist skin

Excessive thirst

Nausea and vomiting

Drowsiness/loss of consciousness

Body Compensates for Blood Loss

Pulse feels weak

Breathing rate increases

Superficial blood vessels contract

Body sweats

LOC deteriorates

Body dies

Wounds

Open

open wound types:

Laceration (cut)

Avulsion (portion of the skin torn away)

Puncture

Types of Burns

Partial-thickness (second-degree)

Full-thickness (third-degree)

Critical Burns

Burns covering more than one body part

Burns on the head, neck, hands, feet, or genitals

Any partial- or full-thickness burns to children or the elderly

Burns from chemicals, explosions, or electricity

Care for thermal (heat) Burns

Cool burned area with cool water

Cover burned area with a sterile dressing

Take steps to minimise shock

Keep the victim from getting chilled or overheated

Applying a Roller Bandage

Secure end of bandage

Completely cover dressings

Don’t cover fingers or toes

Apply additional dressings if necessary

Signs and Symptoms of Chest Injury

Severe pain

Obvious deformity

Discoloration of skin

Coughing up blood

Care for Serious Chest Injury

Position victim to aid breathing

If ribs are broken, bind arm to injured side

Cover sucking chest wound

Administer oxygen

Monitor breathing and pulse

Care for Serious Abdominal Injury

Do not put pressure on protruding organs or try to put them back inside

Position victim on back

Remove clothing around wound

Cover loosely with moist, clean dressing

Cover dressing with plastic wrap

Cover with folded towel to maintain warmth

Administer oxygen

Summon more advanced medical personnel

Position victim on back

Bend knees slightly

Administer oxygen if available

Minimize shock

Summon more advanced medical personnel

Care for Serious Pelvic Injury

Minimize movement

Control bleeding

Administer oxygen, if available

Minimize shock

Care for Open Wound to Genitalia

Control bleeding

Common Signs and Symptoms of Musculoskeletal Injuries

Bruising and swelling

Significant deformity

Discoloration

Bone protruding from wound

Inability to use affected part normally

Grating bones

Heard a napping or popping sound

Cause of injury, such as fall from height suggests that the injury may be severe

Care for Muscle and Bone Injuries

Immobilize

Cold: apply a plastic bag of ice (with a thin barrier between the ice and skin)

Elevate above heart level unless it causes more pain

Emergency Care for Muscle and Bone Injuries

Control life-threatening injuries

Allow victim to rest in comfortable position

Apply cold to reduce pain and swelling

Support area above and below injury

Cover open wounds with sterile dressing

Do not re-position protruding bones

When To Suspect a Head, Neck, or Back Injury

Any motor vehicle collision

A person found unconscious for unknown reasons

Any injury that penetrates the head or trunk

A motor vehicle crash involving a driver or passengers not wearing safety belts

Any person thrown from a motor vehicle

Any injury in which a victim’s helmet is broken

Times to suspect a spinal injury (symptoms, causes, signs of spinal injury) has a much longer list

Signs and Symptoms of Serious Head, Neck, and Back Injuries

Severe pain/pressure in head/neck/back

Tingling/loss of sensation/movement in extremities

Unusual lumps/depressions on head/spine

Blood/fluids in the ears/nose

Profuse external bleeding of head/neck/back

Seizures

Impaired breathing/vision

Nausea/vomiting

Persistent headache

Loss of balance

When Not To Use In-line Stabilization

When victim complains of pain, pressure, or muscle spasms on initial head movement

When rescuer feels resistance when attempting to move head

Ways To Prevent Head, Neck, and Back Injuries

Wear helmets and protective eyewear

Safeguard against falls

Take safety precautions in sports and recreation

Avoid improper drug use

Inspect equipment

Think and talk safety

General Signs and Symptoms of Medical Emergencies

Headache/lightheaded/dizzy/weak

Nausea/vomiting

Change in breathing/pulse/skin temperature, color, moisture

Altered Mental Status Can Result From

Infection

Poisoning, including substance abuse or misuse

High or low blood sugar or insulin reactions

Head injury

Any condition that results in decreased blood flow to the brain

Conditions resulting from mental, emotional, or behavioral disorders

Care for a Victim of an Altered Level of Consciousness

Elevate legs

Do ongoing assessment

Check airway; put unconscious victims in recovery position

Loosen any restrictive clothing

Do not give victim anything to eat

Have suction equipment available

Summon more advanced medical personnel

Reassure victim

Causes of Seizures

Infection

Chronic medical conditions

Poisoning

Low blood sugar

Head injury

Any condition causing decreased level of consciousness

Pregnancy complications

To Care for a Seizure Victim

Do not try to stop seizure or restrain victim

Protect victim from injury

Protect victim’s modesty

Manage airway by rolling victim onto his or her side

Remove nearby objects and protect victim’s head

Do not place anything between teeth

When seizure is over, do physical exam and care for any injuries found

Hypoglycemia

Too little sugar

Sugar is used rapidly

Also called insulin reaction

Signs and Symptoms of Diabetic Emergencies

Rapid breathing and pulse

Feeling and looking ill

Those at Greatest Risk for Heat-related Illness

Those involved in strenuous activity in a hot environment

Those with preexisting health problems

Those using illicit drugs or medications

Those who have had a heat-related illness in the past

Heat Illnesses includes warnings about dehydration.

Signs and Symptoms of Heat-related Illness

Cool, moist, pale, or ashen skin (earlier stages)

Dry, red, hot skin (later stages)

Nausea

Exhaustion

Progressive loss of consciousness

Rapid, weak pulse (later stages)

Rapid, shallow breathing (later stages)

High body temperature (later stages)

Care for Heat Exposure

Give small amounts of cool water to conscious victim

Have victim lie down in a cool or shady area and elevate legs if possible

Loosen or remove clothing

Apply cool, wet towels or cold packs to wrists, armpits, groin, and legs

Fan victim

Factors Affecting Normal Body Temperature

Humidity

Wind

Clothing

Intensity of activity

Body’s ability to adapt (physical fitness level)

Those at Greatest Risk for Cold Exposure

Those without adequate equipment, clothing, or training for cold environment

Those with health problems

Those using illicit drugs, medications, or alcohol

see more at: Cold illness and injuries (hypothermia, frostbite and prevention)

Signs and Symptoms of Hypothermia

Shivering

Numbness

Decreasing level of consciousness

Poor coordination

Difficulty speaking

Rigid posture

Care for Hypothermia

Reassure victim

Handle victim gently

Remove victim from cold environment

Have victim stop all activity and rest

Remove wet clothing

Place victim in dry blankets or clothing and wrap in plastic if available

Protect from any further heat loss

Frostbite

Most common form of frostbite

Skin is frozen, underlying tissues are not

Involves loss of feeling and sensation

Person feels tingling sensation when rewarmed

Deep frostbite

Skin is white and waxy

Skin is firm when palpated

Swelling and blisters may be present

When rewarmed, skin appears red with areas of purple and blue

To Prevent Overexposure Emergencies

Take frequent breaks

Replenish body with food and fluids

Reduce work intensity

Wear clothing appropriate for task and environment

Actions Indicating a Behavioral Emergency

Possessing a weapon(s)

Threatening harm to others or self

Being verbally abusive

Speaking in a nonsensical manner

Withdrawing deeply

Hallucinating

To Calm a Victim of a Behavioral Emergency

Acknowledge that victim appears upset

Get in front of victim and at eye level

Avoid unnecessary contact

Do not threaten, challenge, or argue with victim

Involve others that victim trusts

Encourage victim to discuss whatever is troubling him/her

How Poisons Enter the Body

Injection

Inhalation

Absorption

Clues of Poisoning

Flames or smoke

Containers that are open or out of place

Plants partially eaten or disturbed

Poisoning Severity

How and when it entered the body

Victim’s size, weight, and age

General Principles for Poisoning Emergencies

Remove victim from source of poison

Conduct initial assessment

Conduct physical exam and SAMPLE history

Summon more advanced medical personnel

Contact Poison Control Center (PCC) as per local protocols

Do not give anything to eat or drink

When Not to Induce Vomiting for Ingested Poisons

Victim is having a seizure

Victim is pregnant

Victim has ingested corrosive substance or petroleum product

Victim is known to have heart disease

Guidelines for Initial Snakebite Care

Wash wound if possible

Immobilize affected part

Minimize victim’s movement

Keep affected part lower than heart

Summon more advanced medical personnel

Human Bites

Require professional medical care immediately

Need to be washed with soap and water

Can bleed if severe; control severe bleeding

Depressants

Alter consciousness

Promote sleep

Depress respiration

Relieve pain

Relax muscles

Impair coordination and judgment

Care for Substance Misuse and Abuse

Care as you would for poisoning

Signs and Symptoms of Anaphylaxis

Itching

Rash

Weakness

Nausea/vomiting

Dizziness

Trouble breathing

Care for Anaphylaxis

Position victim in the most comfortable position that aids breathing

Administer supplemental oxygen

Have victim use anaphylaxis kit if one is available

Anaphylaxis quick FAQs

The Labor Process

Stage One – Preparation

Time period: From first contraction until uterus is fully dilated

Stage Two – Delivery of the Baby

Crowning occurs

Delivery of the baby

Stage Three – Delivery of the Placenta

Occurs within 30 minutes after birth

Placenta separates from uterine wall and exits through vagina

Stage Four – Stabilization

Recovery and stabilization of mother

Lasts approximately 1 hour

Uterus contracts to control bleeding

Assessing Labor

Amniotic sac ruptured?

Contractions?

Are they close together?

Are they strong?

Bloody discharge?

Urge to bear down?

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see also:

What the AED says as you use it

CPR quick facts

AED quick facts

How to pass a Red Cross written test

Why did they change CPR?

Bloodborne Pathogens quick facts

fast, basic neurological exam

Oxygen administration quick facts

cultural issues in first aid

wilderness first aid outline

injuries quick facts

first aid Secondary Assessment

Times to suspect a spinal injury (symptoms, causes, signs of spinal injury)

causes of fainting, altered mental status, sudden altered mental status, unconsciousness

Seizures, causes of and basic care for

Concussion signs and symptoms, prevention

(Note to on-line users not in my classes: this is a study sheet. It is not complete instruction in first aid or any topic named in the webpage title, or in the main points of overhead projections at this page.)

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Mary Donahue

Mary Donahue welcomes you to her home page

First Aid for Public Safety Personnel study guide