First aidWhat School Staff Should Know

by

Julie Stevenson, RN

PCS Health Services

Definition of First aid

• Immediate care given to a sick or injured person to help prevent further deterioration.

•First Aid is often life-saving in nature.

•School staff is responsible for care until parent/guardian or paramedics arrive.

BEHAVIOR BASICS IN FIRST AID

• Stay calm, even if you are not.

• Monitor your surroundings for safety.

• Prioritize injuries.

• Call 911 if needed.

• Control the crowd.

• Only move the victim after injuries have been evaluated and it is safe to do so.

• Make decisions! Assume you are in charge until someone with more experience takes over.

Go bag

• Always keep a “Go Bag” with you.

• Include:• First Aid Manual/REDCROSS first aid app

• Student’s Emergency Care Plans

• Class roster with parent phone numbers

• Adhesive tape

• Band aids

• Different sized gauze pads

• Elastic wrap

• Cold packs

• Splints

• Scissors

• Gloves

Asthmaknown asthmatic having an attack

• Signs of distress may include labored breathing, flaring of nostrils, audible wheezing, cough, shortness of breath and anxiety.

• Asthmatic students who self carry, should always have their inhaler available. Encourage them to use it as directed in their Asthma Action Plan.

• Have the student lean forward with their elbows on their knees. This helps maximize the lung surface area.

• You should see quick improvement.

• If a school nurse is available, call her to come assess the student.

• Call 911 if difficulty breathing continues after treatment.

Asthmaattack with no known history

• Relax breathing, slowly have student breathe in through the nose and out through the mouth.

• Stay calm.

• Call for the nurse, if available.

• Have student lean forward with their elbows on their knees.

• If symptoms do not improve quickly, call 911.

Minor injuries

• For minor injuries like cuts and scrapes, the student can administer their own first aid with your supervision.

• Have the student wash the area with warm soapy water and then cover with a band aid. Follow school policy regarding the use of antiseptics and antibiotic ointment.

• If you are assisting the student, always follow Universal Precautions.

Serious wounds or cuts

• Apply direct pressure by pressing the wound with your finger or palm, preferably over a gauze pad.

• Raise and support the injured part so that it is above the level of the heart.

• If the wound continues to bleed, add more gauze without removing the original gauze pad.

• Call 911 if bleeding is not controlled.

• Monitor for symptoms of SHOCK.

• Always follow Universal Precautions.

Types of bleeding

1. Capillary

2. Venous

3. Arterial

Capillary bleeding

• Examples:

Scratch, scrape, abrasion; like a skinned knee or elbow.

Follow Universal Precautions when caring for ALL wounds.

Apply pressure with a gauze or clean cloth. Bleeding is easy to control with a small amount of pressure.

When bleeding stops, clean the wound and apply a band aid.

Venous bleeding

Examples:• Puncture wound, cut.

Apply continuous pressure with a gauze or clean cloth. May need to hold pressure for a few minutes until the blood clots.

When bleeding stops, clean the wound and apply a band aid or dressing. This type of wound may require stitches.

Arterial bleeding

• Examples:• Deep puncture wound, gunshot wound, wound

from trauma. A serious wound.

With this type of wound, it is common to see blood squirting out when the heart beats. This type of bleeding will need a lot of pressure applied to control the bleeding.

This type of wound will require medical attention.

remember• Always follow Universal Precautions

• Call 911 if necessary.

• Have a first aid kit/”Go bag” with needed supplies

• Apply pressure with the palm of your hand or fingers, using gauze or whatever you have available

• Never remove old gauze, just add more gauze or dressing material. Removing the old gauze can cause any clot that has formed to break loose.

• If the wound is on an extremity, and the bleeding is controlled, you can wrap the wound with an ace bandage or rolled gauze. Always wrap from the distal end to the proximal end (this helps promote blood return from the extremity). Assess distal extremity for good circulation (pink fingers and toes)

• Elevate the extremity and monitor for shock.

Symptoms of shock

• Feeling anxious

• Dizziness, light headedness

• Weak pulse

• Nausea

• Vomiting

• Altered consciousness

• Sweating and paleness

burns

Rinse the area under cool water for at least 10 minutes. (this will reduce pain, swelling and the risk of scarring)

Call 911 if the burn is on a child, the burn blisters, affects more than one part of the body, or if underlying tissue is visible.

Never put butter or cream on a burn. The oils will retain heat.

Never use ice on a burn, only cool water. The ice may cause further damage to the skin.

Never remove clothing that is STUCK to the burn as this can cause further damage to the skin.

Nosebleeds• Have student sit down

• Pinch nostrils together, lean forward and breathe through the mouth. Do not have student tilt their head back as this will cause the blood to go down their throat.

• Pressure should be applied for at least 10 minutes.

• After the bleeding has stopped, tell the student not to pick or blow their nose.

Head injury

• Students seem to bump their heads quite often and determining the seriousness of the injury can be difficult.

• Wounds to the head tend to be very bloody. This is because heads are very vascular. Control the bleeding with pressure to the area as discussed before.

• For a bump to the head, observe the student for a change in their level of consciousness.

• Ask them questions that they would generally be able to answer like their name, birthday, date, teachers name etc..

Head injury

• Students should be observed for a minimum of 30 minutes. Notify parent/guardian.

• Continue to monitor for changes. If the student c/o nausea, headache, becomes disoriented or vomits, call the parent to come pick the child up and have them evaluated by a medical professional.

• Call 911 if the students condition deteriorates.

headache

• Most headaches are minor.

• Asking some basic questions can help to determine what you need to do.• When did it start?• Where is the pain?• Are you hungry? You may need to let them

eat a snack• Did you sleep well last night?• If the student wears glasses, do they have

them at school?

headache

• Headaches are of concern if they strike suddenly and are severe, if they are accompanied by fever, stiff neck, mental confusion, double vision, numbness or difficulty speaking, or if they follow a head injury.

• Call 911 or have the parent take student for medical evaluation.

Stomach ache

• Asking some basic questions can help to determine what you need to do.• When did it start?• Where is the pain?• Are you hungry?• Do you need to use the restroom? **

If they have a greenish glow to their skin…they are about

to vomit!

If c/o lower right abdominal pain, it could be appendicitis and should be taken seriously.

Sore throat

• Could be sinus drainage irritating the back of the throat.

• White patches or pus filled pockets on the tonsils usually indicate strep throat.

• Seasonal allergies can cause a sore throat.

• If student looks sick or has fever over 100.4, then send to health room or call parent to pick up.

Human bite

• If a student was bitten by another student, control the bleeding and wash the wound thoroughly.

• Cover wound with a bandage.

• Notify parent and encourage medical evaluation.

• Fill out student injury report.

Insect bites and stings

• Bees, wasps, hornets, fire ants, mosquitoes and fleas are the most common.

• Swelling is caused by the venom injected into the skin.

• Try and remove the stinger by scraping it off with a firm edge. Try a credit card.

• To reduce pain and swelling, apply an icepack. Do not use directly on the skin.

Bee sting allergy

• Watch for signs of an allergic reaction: hives, cough, runny nose, tightness in throat, tingling in face or throat.

• For students with a history of a bee sting allergy, administer their Epipen per Allergy Action Plan.

• If signs of a reaction are present but an Epipen is not available, then call 911 immediately.

Splinters and blisters

• Wash with soap and water.

• Remove splinters that are easily accessible.

• Wash again and apply a band aid.

• If imbedded, clean the area, cover with a band aid and notify parent.

• Do not pop blisters, just cover with a bandage.

Dental injuries

• If a tooth is knocked out, handle the top only, never the root.

• Do not rub it or scrape it.

• Gently rinse the tooth in a bowl of water.

• Try to replace the tooth into the socket and have the student bite down gently on a moistened gauze.

• If unable to do that, then place tooth in milk or mild salt water solution.

Dental injuries

• Refer for immediate dental care.

• For a toothache, refer student to a dentist.

• If a student loses a tooth at school, have them rinse their mouth and place a rolled up gauze in the socket and have them bite down until the bleeding stops.

• Always have cute tooth holders…kids love those!

rashes

• The most common rashes seen at school are due to infection or allergy.

• Most rashes require a student to be evaluated by a physician for diagnosis before they can attend school.

• Impetigo, rheumatic fever/scarlet fever (caused by untreated strep infection), ringworm, scabies, and fifth disease are just a few things you may see in the school setting.

fractures

• If bleeding at the site, apply direct pressure at the site.

• Immobilize the area; keep the joint above and below the area immobilized.

• Apply ice or cold pack to area.

• Stabilize the area with a splint if possible.

• Observe for signs of shock and notify parent.

choking

• Classic signs are inability to talk, cough, or breathe.

• Universal sign for choking is placing the hands up to your throat.

• Send someone to call 911.

• Stand behind the student and place hands around the students stomach. Place fist above belly button and press inward and upward until item is dislodged.

• If child collapses then start CPR.

Dizziness/fainting

• Fainting- lay student down with feet elevated. Keep airway open.

• Dizziness- have person sit down with head low and take slow, deep breaths.

• Have student rest until recovered.

• Call parent.

seizures

• Many different types of seizures.

• Grand Mal/Tonic Clonic is the most often seen.

• Protect the person from injury (place a jacket or pillow next to their head. Remove items that may cause injury from the immediate area)

• Time the seizure

• Never put anything in the mouth of someone seizing.

• After the seizure, roll the person onto their side and monitor breathing. (recovery position)

• Call 911 if: no history of seizures, if seizure is unusual, if person has trouble breathing or if the seizure lasts longer than 5 minutes.

Things to think about

• Frequent visits to the health room usually mean something else is going on.

• Child may have anxiety issues. Some students just need a little hug or reassurance.

• Students with ADHD may use illness as a way to get out of class because they just cannot sit still.

• Try and keep students engaged in class. If students enjoy school, they will spend more time in class and less time asking to come to the health room.

Kids say the darndest things

• “When you become a mom, your hand becomes a thermometer”

• “My throat tickles because I swallowed an ant”

• “You get what you get, and you don’t pitch a fit”

• “My eyes are leaking!”

• I fell off the swing because I’m in the “nerd group”

• “I think I have a kitty infection, but don’t worry, its not the kind that says MEOW.

The end