Assessment+and+management+of+first+aid+patients.

What are the main priorities for assessment and management of first aid patients?

Setting priorities for managing a first aid situation and assessing the casualty: // Situational analysis: // - every situation that requires the administering of first aid is different - a scenario could involve water, traffic or electricity. - our senses of sight and hearing can give us a clue as to what happened or to be able to identify possible dangers that may exist near by. Examples of these include: falling rocks, smoke, live electrical wires etc. - also need to take into account how many people might be injured and the severity of each injury in order to decide what priorities are needed for the first aid that will need to be administered - A simple way to remember this is using the acronym COWS: C- Can you hear me? O- Open your eyes W- Whats your name? S- Squeeze my hand Priority assessment and management procedures - priorities for the assessment of a casualty include checking for a response, opening the airway, checking for breathing and circulation. Also just the simple task of placing the casualty into the recovery position, and opening their airways by making sure the tongue or any other foreign substance isn’t blocking the airway. - obtaining medical assistance as quickly as possible is a priority - head-to-toe (secondary survey) is also important; it helps in the assessment and management (in priority) of secondary signs and symptoms of injury

DRSABCD (Danger, Send for Help, Response, Airway, Breathing, Compressions, Defibrillation) - check for **danger**: to you, to others, to casualty - check for **response**: is casualty conscious or unconscious? - call 000 or 112 (for no reception) for **help** e.g. police, ambulance or fire brigade - check **airway**: is airway clear of objects and open? - check for **breathing**: is chest rising and falling? Can you hear or feel air from mouth or nose? - give **CPR**- involves giving 30 compressions at a rate of approximately 100 compressions per minute followed by two breaths -**DEFIBRILLATION**- if available and follow voice prompts

-an important acronym for first aid because it informs the person what to do when confronted with a situation that requires this kind of first aid

STOP (Stop, Talk, Observe, Prevent further injury) -a standard and systematic way of approaching any sports injury and follows the initial assessment of DRABCD -asking questions, observing the casualty and listening to the feedback given before taking further action

// Cardiopulmonary resuscitation (CPR) // -a possible life saving first aid which is a combination of mouth to mouth resuscitation and chest compressions that allows the delivery of oxygen and artificial blood circulation to a person who is in cardiac arrest Steps involved in cpr: Check for danger –approaching with care and not endangering yourself Look for a response –check if the casualty is conscious, touch them gently as if trying to wake them up, if no response, get help Dial triple 0 – ask for ambulance Check the airway- do not move the person, gently tilt the head back, open their mouth and look inside. If found any fluid/objects etc. gently roll them onto their side, tilt their head back, open their mouth and remove the foreign matter. Check for breathing- look, listen and feel for any signs of breathing. If they are breathing, gently roll them onto their side, if not proceed to mouth-to-mouth Use mouth-to-mouth- roll them onto their back and open airway, close their nostrils with your finger and thumb, put your mouth over their mouth and blow, give to full breaths into their mouth, ensure there is no air leak and check to see that as you do this the chest is rising and falling Cardiac compressions- put the heel of one hand on the lower half of the person’s ‘breastbone’ put your other hand on top of the first hand and interlock fingers. Press down firmly and smoothly 30 times. And follow with 2 breaths. Aim for a compression rate of 100 per minute.

Maintain CPR- repeat the cycle of 30 compressions then 2 breaths. Continue until professional help arrives.

Bleeding:

 * Pressure on the wound


 * Raise injury above heart level


 * Blood pressure drops in response to bleeding


 * External bleeding: capillaries, veins or arteries


 * Needs to be managed by pressure, elevation, and immobilisation


 * Don’t remove embedded object


 * Apply pressure around the object (doughnut)


 * Be aware of blood infection


 * Internal Bleeding


 * Pain and swelling around affected area


 * Can occur by direct force

Shock
Shock happens when not enough blood and oxygen can get to your organs and tissues. It causes very low blood pressure and may be life threatening. It often happens along with a serious injury.

Losing about 1/5 or more of the normal amount of blood in your body causes Hypovolemic shock. Blood loss can be due to: Other types of shock Symptoms of shock include Shock is a life-threatening medical emergency and it is important to get help right away. Treatment of shock depends on the cause.
 * Bleeding from cuts
 * Bleeding from other injuries
 * Internal bleeding, such as in the gastrointestinal tract
 * Septic
 * Cardiogenic
 * Neurogenic
 * Confusion or lack of alertness
 * Loss of consciousness
 * Sudden and ongoing rapid heartbeat
 * Sweating
 * Pale skin
 * A weak pulse
 * Rapid breathing
 * Decreased or no urine output
 * Cool hands and feet


 * Hardness


 * Follow DRSABCD for instance


 * Expose wound by cutting clothing


 * Apply direct pressure to the wound by using a sterile dressing or pad


 * Add another dressing if bleeding doesn’t stop.


 * After bleeding stops, firmly bandage the dressing pad to hold it firmly.


 * Raise and rest the injured part where possible.


 * Call or refer for medical advice.


 * Watch for sign of shock and unconsciousness.

Neck and spinal

 * Moving a person with neck or spinal injury you could cause more damage to the nerves in the cord and can sometimes cause death.
 * If you are not sure if the person has a neck or spinal injuries then still don’t move them.

The main goal is to keep the person immobile and safe until medical help arrives.
 * 1) You or someone else should call 911.
 * 2) Hold the person's head and neck in the position in which they were found. DO NOT attempt to reposition the neck. Do not allow the neck to bend or twist.
 * 3) Do not allow the person to get up and walk unassisted.

IF THE PERSON IS UNRESPONSIVE
 * 1) Check the person's breathing and circulation. If necessary, begin rescue breathing and [|CPR].
 * 2) DO NOT tilt the head back when attempting to open the airway. Instead, place your fingers on the jaw on each side of the head. Lift the jaw forward.

IF YOU NEED TO ROLL THE PERSON Do not roll the person over unless the person is vomiting or choking on blood, or you need to check for breathing.
 * 1) Two people are needed.
 * 2) One person should be located at the person's head; the other at the person's side.
 * 3) Keep the person's head, neck, and back in line with each other while you roll him or her onto one side.


 * DO NOT bend, twist, or lift the person's head or body.
 * DO NOT attempt to move the person before medical help arrives unless it is absolutely necessary.
 * DO NOT remove a helmet if a spinal injury is suspected.

Moving the casualty
In an emergency, you may have to hoist, carry, or  drag an injured person away from a position of danger. In some instances, you will be able to do this using a Neil Robertson stretcher, an Army litter, or by using an improvised stretcher; in other cases you will have to move the casualty by using the fireman’s carry, the tied-hands crawl, the blanket drag, the pack-strap carry, the chair carry, or some type of arm carry. Sometimes, it is necessary to move the patient with all possible speed, without regard to the severity of the injuries.

Referral
The recommendation of a medical or paramedical professional. If you get a referral to ophthalmology, for example, you are being sent to the eye doctor. In HMOs and other managed care schemes, a referral is usually necessary to see any practitioner or specialist other than your primary care physician (PCP), if you want the service to be covered. The referral is obtained from your PCP, who may require a telephone or office consultation first. The term "referral" can refer both to the act of sending you to another doctor or therapist, and to the actual paper authorizing your visit.

__Head injuries: __ - If the casualty suffered a severe head injury, such as a diving accident or major car crash - Any signs of loss of consciousness as a result of the injury - Any complaints regarding loss of vision, eg. Blurriness - Amnesia for events before or after the injury - Continuous headaches - Any vomiting episodes since the injury - Any seizures since the injury - Altered behaviour, particularly in infants and young children - Any suspicion of a skull fracture or penetrating head injury, such as clear fluid from the nose or ears - Visible trauma to the head  __Amputations:__ - If there are severe amputations to limbs, extremities or other body parts - If there’s profuse bleeding - Any pains related to the amputation(s) - loss of consciousness of the casualty - dizzy or lightheaded - less alert – person may be unable to respond and can be confused - emotional shock/stress experienced by person
 * __Examples of when medical referral is required:__**

__Spinal injuries:__ - If you have been injured above the collarbone on either side of the body - If you have been injured in a high speed motor vehicle accident - If you are feeling pain in your back that has been ongoing or has been consistent. - Neurological problems, such as weakness, numbness or tingling in the leg(s) or arm(s). - Abdominal pain that accompanies the back pain
 * External links:**


 * [|http://books.google.com.au/books?id=j7Zo-ebZpucC&pg=PT91&lpg=PT91&dq=%E2%80%A2%09Setting+priorities+for+managing+a+first+aid+situation+and+assessing+the+casualty&source=bl&ots=0GqR31ZqL1&sig=lm0T8PtA85W-czfmge880cJ6mjI&hl=en&ei=E-P5S-vFMY-9cYyC4eYL&sa=X&oi=book_result&ct=result&resnum=5&ved=0CBYQ6AEwBA#v=onepage&q=%E2%80%A2%09Setting%20priorities%20for%20managing%20a%20first%20aid%20situation%20and%20assessing%20the%20casualty&f=false]
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 * http://www.stjohnnsw.com.au/publications/Posters/post_drabcd.pdf