First Aid for the Workplace, Schools and the Community

First Aid

According to the Center of Disease Control and Prevention (CDC), many sports-related injuries in children and young adults require visits to the emergency room every year.

Responsible coaching is a major factor in

preventing and reducing the risk of injuries.

Injuries

- Injuries are one of the nation’s most important health problems.

- Many injuries are preventable. - The five leading causes of injury-related deaths:

- Motor vehicle crashes - Falls - Poisonings - Drownings - Choking

Injury Prevention

- Check the studio/facility area before and after class. - Follow sport specific safety guidelines - Ensure athletes have pre-participation medical approval

(physical exam). For the studio, this may be an option, but is highly recommended.

- Obtaining parental permission releases - Having a written emergency action plan. (see next slide) - Properly selecting and fitting sports and safety equipment,

inspecting it routinely, and ensuring athletes use it correctly and consistently.

- Warning athletes of potential risks and how to prevent injuries.

Emergency Action Plan

An Emergency Action Plan refers to having a

written plan that specifies what to do in the event of an emergency, whether a natural disaster, or a sudden illness or injury.

Head, Neck, and Back Injuries

If you think the athlete has a head, neck or back

injury - Call. Or have someone else call 9-1-1 - Minimize movement of the head, neck, and back. - Place your hands on both sides of the victims' head and

support the athlete’s head as you find it. - Tell him to respond verbally to any question you ask and

to avoid nodding or shaking the head. - If the head is sharply turned to one side, do not try to

align it. Support the head as you find it.

Head, Neck and Back Injuries

- Maintain an open airway. - Have the victim remain in the position in which you

found them. - Monitor the ABC’s (Airway, Breathing, Circulation). - If the person is wearing a helmet, DO NOT remove it or

any attached face masks or shields unless necessary to access the airway.

Video: Muscle, Bone and Joint Injuries

FAQ’s

Q: If I suspect that a person has a head, neck or back injury and the person starts to vomit, what do I do?

A: If the person begins to vomit, position them onto one

side to keep the airway clear. To minimize movement of the victim’s head, neck and back, two responders should place the person in this position, if possible. One responder should help move the person while the other

keeps the head, neck and back in line.

Basic Types of Injuries

There are two basic types of injuries

Soft Tissue (layers of the skin, fat, and muscle)

Musculoskeletal

(muscles, bones, and joints)

Soft Tissue Injuries

- Soft tissue injuries include layers of the skin, fat and muscle.

- Injuries may damage the soft tissues at or near the skin’s surface or deeper in the body.

- A physical injury that damages the layers of the skin is called a wound.

- Wounds are typically classified as open or closed.

Soft Tissue Injuries

- A CLOSED wound, the soft tissue damage occurs beneath the surface of the skin, leaving the outer layer intact. - A closed wound may bleed internally. - The least severe of closed wounds is a bruise, also called a contusion.

- To care for a closed wound – - Apply direct pressure. - Elevate the injured body part if it does not cause pain. - Apply ice or a cold pack (place a gauze pad or towel between the

source of cold and the person’s skin and ice for twenty minutes)

Soft Tissue Injuries

- In an OPEN wound, the break in the skin can be as minor as a scrape on the surface layers or as severe as a deep penetration.

- There are four types of open wounds – - Abrasions - Lacerations - Avulsions or amputations - Punctures

Soft Tissue Injuries

Abrasions – a wound consisting of superficial damage to the skin.

Soft Tissue Injuries

Lacerations – a tear in the skin which results from an injury.

Soft Tissue Injuries

Avulsions– where the extremity is pulled off rather than cut off

Amputations – Surgical removed of all or part of a limb.

Soft Tissue Injuries

Punctures – an injury that creates a small hole or wound in the skin.

A wound with 4 stitches

Soft Tissue Injuries

- To care for a minor open wound - - Use a barrier between your hand and the wound (use

disposable gloves). - Apply direct pressure for a few minutes to control any

bleeding. - Wash the wound thoroughly with soap and water. If

possible, soak the wound for 5 minutes with clean running water.

- Apply triple antibiotic ointment or cream to a minor wound (only if the person has no known allergies or sensitivities to the medication).

- Cover the wound with a sterile dressing and a bandage (or with an adhesive bandage).

Controlling Bleeding

VIDEO – “Controlling Bleeding”

Key Point: - Remember that shock can develop from a

serious injury that results from severe external or internal bleeding.

Controlling Bleeding CHECK the scene for safety, then check the injured victim. CALL 9-1-1 if

necessary. CARE for an victim who is bleeding – 1. Cover the wound with a dressing and press firmly against the wound

with a gloved hand. 2. Elevate the injured area above the level of the heart if you do not

suspect a broken bone.

3. Cover dressings with a roller bandage. If BLEEDING does not STOP

4. Apply additional dressings.

FAQ’s

Q: Why do we no longer use pressure points or elevation to stop bleeding?

A: More emphasis is being placed on direct pressure as the most effective method of controlling bleeding. The scientific evidence does not support use of pressure points or elevation to control external bleeding.

Q: How do I care for a nose bleed? A: Have the person sit and lean slightly forward. Pinch the nose together

for about 10 minutes. Apply an ice pack to the bridge of the nose. If bleeding does not stop, apply pressure on the upper lip just beneath the nose and seek advanced medical care.

Burns

Key Points: - Burns are a special type of soft tissue injury. - Burns can damage one or more layers of skin and the layers of fat,

muscle and bone beneath. - Burns are caused by:

- Thermal (HEAT) - Chemicals - Electricity - Radiation

Burns - Burns are classified by their depth. The deeper the burn, the more

severe it is. - The three levels of burns are:

- Superficial (First degree) - Partial thickness (Second Degree) - Full thickness (Third Degree)

- A critical burn requires medical attention. These burns can be

considered life threatening.

Burns

- Call 9-1-1 if the person has – - Trouble breathing. - Burns covering more than one body part or a large surface area. - Suspected burns to the airway. - Burns to the head, neck, hands, feet, or genitals. - Has a full thickness burn and is younger than age 5 or older than

60. - Burns resulting from chemicals, explosions or electricity.

Burns

- Thermal - Remove source of heat. - Cool the burn by using cold running water. - Cover the burn loosely with a sterile dressing.

Burns

- Chemical - Brush off chemicals that cause burns using gloved hands

and then flush the area with tap water. - If an eye is burned, flush the affected eye. Make sure

that the affected eye is lower than the unaffected eye as you flush.

- If wet chemicals get on the skin, flush the affected area with large amounts of cool water.

Burns - Electrical

- Be sure the person is no longer in contact with the power source before making contact with them.

- Turn off the power source and care for life threatening conditions

- Call 9-1-1 if the electrical burn is due to a fallen power line.

- Electrocution can cause cardiac and breathing emergencies. Be prepared to give CPR or use a AED and care for shock and thermal burns.

Burns

- Radiation - Care for sunburns as you would any other burns. - Cool the burn and protect the areas from further

damage by keeping it out of the sun. Video - BURNS

FAQ’s

Q: Can I put ointment or other medication on a burn? A: No, do not put any kind of ointment or gel on anything other than a

very minor burn. Ointments do not relive pain and can also seal in heat.

Q: Is it better to use ice or ice water on a burn rather than tap water? A: No, do not use ice or ice water except on small superficial (minor)

burns, such as a finger burned from touching a hot stove. Q: if the person’s clothing is burned onto him or her, should I try to

remove it? A: No, do not try to remove any clothing that is sticking to the person

because you could further expose the wound to infection.

Injuries to Muscles, Bones, and Joints

Key Points: - Injuries to muscles, bones and joints often occur as

a result of accidents, such as falls, vehicle crashes or forced impact with equipment or machinery.

- A person with an injured lower extremity should not bear weight until advised by a medical professional.

- If an injured extremity is blue or extremely pale, call 9-1-1 as this might indicate a life-threatening condition.

Injuries to Muscles, Bones, and Joints

There are four types of muscle, bone and joint injuries:

- Fracture: a break or disruption in bone tissue. - Dislocation: a displacement or separation of a bone

from its normal position at a joint. - Sprain: a partial or complete tearing or stretching of

ligaments and other tissues at a joint. - Strain: a stretching and tearing of a muscle.

Injuries to Muscles, Bones, and Joints

The general care for injuries to muscles, bones, and joints includes the following: RICE - REST: Do not move or straighten the injured area - IMMOBILZE: Stabilize the injured area in the position

found. - COLD: Ice the injured area (20 minutes) - ELEVATE: Do not elevate the injured part if it causes

more pain.

VIDEO – “Injuries to Muscles, Bones, and Joints Overview”

Splinting

Splinting is a method of immobilizing an injured extremity and should ONLY be used if you have to move or transport a person to seek medical attention and if splinting does not cause more pain.

If you have to splint –

- Splint an area in which you found it - Splint the injured area above and below the injury site - Check for circulation (feeling, warmth, and color) before

and after splinting.

Splinting

Splinting - see handout on how to splint. There are several types of splinting –

- Soft Splints: folded blankets, towels, pillows and slings. - Rigid Splints: Boards, metal strips and folded magazines

or newspapers. - Anatomic Splints: Splinting an uninjured body part to an

injured body part. Video: Splinting

Splinting

Practice the skill: 1. An anatomic splint 2. A Soft Splint 3. Sling (Shoulder Injury) 4. Rigid Splint

FAQ’s

Q: Why is it better to leave the person’s shoe on when splinting an ankle?

A: The shoe can act as a splint and minimize swelling. Also,

removing the shoe may require manipulating the ankle and should only be done by medical professionals

Sudden Illness

- It is important to know the cause or type of sudden illness because the acre you give will be the same with few exceptions

- There are several types of sudden illness: - Fainting, diabetic emergency, seizure, stroke, poisoning,

and allergic reaction.

Sudden Illness

- Some illness develop over time, while others can strike without notice

- General guidelines: - Monitor breathing and consciousness - Help the person rest in the most comfortable position. - Keep the person from getting chilled or overheated. - Reassure the person - Give any specific instructions as needed.

Video: “Sudden Illness”

Sudden Illness

Fainting - Characterized by a temporary loss of consciousness that

could be a signal of a more serious underlying condition. - It is caused by temporary reduction of blood flow to the

brain such as when blood pools in the legs and lower body. - It is usually self-correcting condition. When the person collapses,

normal circulation to the brain resumes. - As long as the person recovers quickly and has no lasting signals, you

may not need to call 9-1-1.

Sudden Illness

Diabetic Emergency - The condition in which the body does not produce

enough insulin or does not use the insulin effectively.

- If the person is conscious and able to shallow, give

them sugar in the form of fruit juice, candy, a non-diet soft drink.

Sudden Illness

Seizures - When injury, disease, fever, poisoning or infection disrupts

normal functions of the brain, the electrical activity of the brain becomes irregular. This irregularity can cause a sudden loss of body control known as a seizures.

- If a person is having a seizure, protect them from injury by removing nearby objects

- Protect the person’s head. - Call 9-1-1 if the seizure last more than 5 minutes, the person

has repeated seizures, the person is injured, has diabetes or is or pregnant.

Sudden Illness

Stroke The blockage if blood flow to a part of the brain.

Signals of a Stroke - Weakness or numbness on one side including the face, arm,

or leg. - Difficulty speaking or slurred speech - Sudden dizziness - Blurred vision or sudden severe headaches

Sudden Illness

Stroke Think FAST:

- FACE (weakness on one side of the face) - ARM (weakness or numbness in one arm) - SPEECH (Slurred speech or trouble getting the words

out) - TIME (Time to call 9-1-1 if you see any of these signals.

Sudden Illness

Poisoning - Poisoning enters the body in four ways

- Inhalation - Swallowed - Absorption - Injection

- If life threatening, call 9-1-1 and the Poison Control Center (800)222-1222.

Sudden Illness

Allergic Reaction - Insect bites or stings or contact with certain drugs,

medications, foods or chemicals can cause allergic reaction. - If a person is having a severe allergic reaction, use the action

steps: CHECK, CALL, CARE. - The person may have an epinephrine to treat severe allergic

reaction called anaphylaxis.

Anaphylaxis

Background: Every year in the United States, between 400

and 800 deaths are caused by severe allergic reaction. These reactions bring on a condition called anaphylactic shock, also know as anaphylaxis.

A person can die from anaphylaxis within 1

minute of being exposed to an antigen (a foreign substance that brings on the allergic reaction.

Anaphylaxis

Allergic Reactions: - Allergic reactions are cuased by the activity

of the immune system. - The body recognizes and protects itself from

antigens (foreign substances) by producing antibodies, which fight antigens.

- Antigens are found in the liver, bone marrow, spleen and lymph glands.

- The immune system recognizes the antigens and releases chemicals to fight these foreign substances and eliminate them from the body.

Anaphylaxis

Common Antigens:

- Food (nuts, peanuts, shellfish, strawberries)

- Insect Sting

- Medication

- Latex

- Animal dander

- Antobiotics

- Pollen

Anaphylaxis

Signals of Anaphylaxis

- Anaphylaxis usually occurs suddenly, within seconds or minutes after contact with the substance

- The skin or area of the body that comes in contact with the substance usually swells and turns red.

Anaphylaxis

Signals of Anaphylaxis

- Swelling, itching or hives

- Red, watery eyes

- Runny nose

- Coughing, wheezing or difficulty breathing

- Troat tightness or closing

Anaphylaxis

Signals of Anaphylaxis

- Difficulty swallowing

- Nausea or vomiting

- Stomach cramps

- Change of voice

- Sense of doom

- Change of skin color

- Dizziness, fainting or loss of consciousness

Anaphylaxis

Signals of Anaphylaxis - Trouble breathing can progress to an

obstructed airway as the lips, tongue, throat and larynx (voice box) swell.

- Low blood pressure and shock may accompany these situations.

- Death from anaphylaxis may occur because the person’s breathing is severely restricted.

Anaphylaxis

Care for Anaphylaxis

- Check the person’s airway and breathing.

- Call 9-1-1 if the person is having trouble breathing or if the person complains that their throat is closing.

- Help the person into the most comfortable position for breathing.

- Monitor the ABC’s. (Review handout)

Anaphylaxis

Epi-Pen - Epinephrine mimics the response of

nervous system. - It quickly contricts blood vessels to

improve blood pressure. - Improves breathing and alleviate the

wheezing. - Stimulates the heartbeat. - Works to reverse the swelling and hives.

Anaphylaxis

Epi-Pen - Epinephrine mimics the response of

nervous system. - It quickly contricts blood vessels to

improve blood pressure. - Improves breathing and alleviate the

wheezing. - Stimulates the heartbeat. - Works to reverse the swelling and hives.

Anaphylaxis

Epi-Pen (Side Effects) - Increased heart rate - Pale skin - Dizziness - Chest pain - Headache - Nausea and vomiting - Excitability and anxiousness

FAQ’s Q: What type of care do I give for someone who has fainted? A: Position the person on flat surface. If possible, elevate the person’s legs 8 to 12

inches. Do not give the person anything to eat or drink. Do not splash water on the person or slap their face.

Q: Should I give sugar to someone who is having a diabetic emergency? A: Yes, If the person is fully conscious and able to shallow. DO NOT give liquids or

food to a person who is not fully conscious and unable to swallow. Q: Should I try to hold down someone who is having a seizure? A: No, do not try to hold down a person who is having a seizure. Your primary care

objective is to protect the person from any further injury. Keep the person from striking any nearby objects and keep their airway open.

Q: Should I give a person showing signals of shock something to eat or drink? A: No, do not give the person anything to eat or drink, even though he or she is

likely to be thirsty. The person’s condition may be severe enough to require surgery, in which case it is better if the stomach is empty.

Heat Related Emergencies

Environmental conditions that could lead to heat related emergencies. - Doing strenuous activities outside on a hot day. - Working in a hot room with little air circulation. - Not drinking enough water while working in a

warm environment. - Working in a building where the cooling system

fails.

Heat Related Emergencies

Heat Cramps and Heat exhaustion (early stage) - Heat Cramps are conditions associated with

overexposure to heat. Heat Stroke (late stage) - Heat stroke develops when the body’s systems are

overwhelmed by heat and stop functioning. Heat stroke is a life-threatening condition.

- Young children and the elderly are more susceptible to extremes is temperatures.

VIDEO: Heat-Related Emergencies

Heat Related Emergencies

Heat Cramps are conditions associated with overexposure to heat.

Topics: 1. Heat exhaustion (early stage) 2. Heat Stroke (late stage) 3. Heat Related Article 4. Slide Show

http://www.medicinenet.com/low_blood_pressure_hypotension_pictures_slideshow/article.htm

Heat Related Emergencies

Heat exhaustion (early stage) - It is a milder form of heat-related illness that can

develop after several days of exposure to high temperatures and inadequate or unbalanced replacement of fluids.

- Those most prone to heat exhaustion are elderly people, people with high blood pressure and people working or exercising in a hot environment.

- Can take place when climate changes from cold to hot relatively quickly. The body needs time to acclimate itself to the weather change.

Heat Related Emergencies

Warning signs of heat exhaustion include: • Heavy sweating • Paleness • Muscle Cramps • Tiredness/weakness • Dizziness • Headache • Nausea / Vomiting • Fainting

Heat Related Emergencies

More Symptoms: - The skin may be cool and moist. - The victim's pulse rate will be fast and weak,

and breathing will be fast and shallow. - If heat exhaustion is untreated, it may

progress to heat stroke, which is a medical emergency. Seek medical attention and call 911 immediately if: – symptoms are severe, or – the victim has heart problems or high blood

pressure

Heat Related Emergencies

Heat exhaustion treatment:

- Cooling measures that may be effective include:

- Cool, non-alcoholic beverages - slowly ingested, preferable water

- Rest

- cool shower, bath, or sponge bath

- an air-conditioned environment

- Lightweight clothing

Heat Related Emergencies

What is HEAT STROKE? – Heat stroke is a form of hyperthermia, an abnormally elevated body temperature with accompanying physical and neurological symptoms.

– Unlike heat cramps and heat exhaustion, two other forms of hyperthermia that are less severe, heat stroke is a true medical emergency that can be fatal if not properly and promptly treated.

Heat Related Emergencies

- The body normally generates heat as a result of metabolism, and is usually able to dissipate the heat by either radiation of heat through the skin or by evaporation of sweat.

- However, in extreme heat, high humidity, or vigorous physical exertion under the sun, the body may not be able to dissipate the heat and the body temperature rises, sometimes up to 106 F (41.1 C) or higher.

- Another cause of heat stroke is dehydration. - A dehydrated person may not be able to sweat fast enough

to dissipate heat, which causes the body temperature to rise.

Heat Related Emergencies

Those most susceptible individuals to heart strokes include: – Infants – The elderly (often with associated heart

diseases, lung diseases, kidney diseases, or who are taking medications that make them vulnerable to dehydration and heat strokes)

– Athletes – Individuals who work outside and physically

exert themselves under the sun.

Heat Related Emergencies What are heat stroke symptoms and signs? Symptoms of heat stroke can sometimes mimic those of heart

attack and heat exhaustion. Sometimes a person experiences symptoms of heat exhaustion before progressing to heat strokes.

Signs and symptoms of heat exhaustion include: • Nausea • Vomiting • Fatigue • Weakness • Headache • Muscle cramps and aches • Dizziness

Heat Related Emergencies However, some individuals can develop symptoms of heat stroke

suddenly and rapidly without warning. Different people may have different symptoms and signs of heatstroke.

But some more common symptoms and signs of heat stroke

include: • high body temperature • The absence of sweating, with hot red or flushed dry skin • Rapid pulse • Difficulty breathing • Strange behavior • Hallucinations • Confusion • Agitation • Disorientation • Seizure, and/or coma

Heat Related Emergencies How do you treat a heat stroke victim? • Victims of heat stroke must receive immediate treatment to

avoid permanent organ damage. First and foremost, cool the victim. – Get the victim to a shady area, remove clothing, apply cool or tepid

water to the skin (for example you may spray the victim with cool water from a garden hose), fan the victim to promote sweating and evaporation, and place ice packs under armpits and groin.

– Monitor body temperature with a thermometer and continue cooling efforts until the body temperature drops to 101 to 102 F

– Always notify emergency services (911) immediately. If their arrival is delayed, they can give you further instructions for treatment of the victim.

Heat Related Emergencies • How can heat stroke be prevented?

– The most important measures to prevent heat strokes are to avoid becoming dehydrated and to avoid vigorous physical activities in extreme hot and humid weather.

– If you have to perform physical activities in hot weather, drink plenty of fluids (such as water and sports drinks), but avoid alcohol, caffeine, and tea which may lead to dehydration.

– Your body will need replenishment of electrolytes (such as sodium) as well as fluids if you sweat excessively or perform vigorous activity in the sunlight for prolonged periods.

– Take frequent breaks to hydrate yourself. Wear hats and

light-colored, lightweight, loose clothes.

FAQ’s

Q: Can a heat-related emergency occur on a cold day? A: Yes, if the person has been exercising or performing a stress-related

activity that may cause the body to lose fluids. Q: Should you give a sports drink to a person who is suffering from

heat cramps or heat exhaustion? A: It is okay to give a person experiencing heat cramps or heat

exhaustion small amounts of a sports drink, as long as they are conscious and able to shallow. However, cool water can also be given.

Cold Related Emergencies

- The environment does not have to be extremely cold for a person to suffer a cold-related emergency, especially if the person is wet or if it windy.

- Young children are susceptible to cold-related emergencies because their body temperature regulating system is not fully developed.

- The elderly can experience a cold-related emergency inside when exposed to lower temperatures over a period of time, as their temperature regulating mechanisms are sometimes impaired.

VIDEO: Cold-Related Emergencies

FAQ’s Q: What is the difference between frostbite and hypothermia? A: Frostbite is the condition when the body tissue freezes after being

exposed to the cold environment. Hypothermia is the condition when the body cools because the body’s ability to regulate temperature fails. The person may die if not given prompt medical care.

Q: Should I rub a frostbitten body pert to warm it up? A: No, never rub a body part that may be frostbitten. Rubbing can cause

extensive, painful soft tissue damage. Do not attempt to re-warm the frostbitten area if there is a chance that it might re-freeze or if you are close to a medical facility.

Q: Should I give fluids to drink that contain alcohol or caffeine to a person

who is in a cold environment? A: Alcohol and caffeine interferes with the body’s normal response to cold

and makes a person more susceptible to hypothermia.