the nbo scout training team bsa crew 911
TRANSCRIPT
The NBO Scout Training Team
BSA Crew 911
www.scoutcpr.org
Introduction to WFAB…
Course Information…
Certification Requirements
Certification Length
Purpose of Certification
Course Outline
Course Schedule
2
What are three things that have to happen at any accident or injury sceneAn accident or injury has to occur!
“Someone” has to recognize that a accident or injury has occurred!
YOU must decide to ACT!
What is Delayed Care?
3
A Delayed Care Situation is when professional help is more than 30 minutes away… Rural Areas
Construction Sites
The Wilderness
Natural Disasters
Terrorist Acts3A
Some Delayed Care Activities…
Sailing – Mountaineering
Kayaking – Backpacking
Rafting – Hiking
Skiing – Camping
Canoeing – Horse Back Riding
Ballooning - Caving3B
A Delayed Care Situation is also when there is no easy way…
To Call for Help
For emergency personnel to reach the victim
To transport the victim to medical care.
3C
Emergency Action Steps!
4
CHECK… CALL… CARE…
Check The Scene and then the Victim…
Check for Available Resources
Never put yourself in danger!… dead or injured heroes are no help to anyone!
4A
CHECK… CALL… CARE…
Make a plan… carry out the plan.
Get Help!
In a delayed care situation, you have to think, plan then choose.
4B
CHECK… CALL… CARE…Provide Care…
Care FIRST for life-threatening conditions
Monitor the patient
Provide care for the conditions you find…4C
Check the Scene…
Take Charge
List Tasks to be Performed
Followership/Leadership
Approach Safely!
Do emergency moves if needed
5
Check the Patient…
Do Urgent First Aid
Initial Assessment
Protect the Patient
Prioritize Care
Check for Other Injuries
6
Check for Available Resources…
Number of people that can help
Communications
Food Supply - Water Supply
Shelter
Supplies
Transportation 7
Call for Help…
Plan what to do
Get Help!
Calling – Distress Signals
Sending for Help
Leaving a patient alone
Transporting a patient8
Care in a Delayed Care Situation…
Remain Calm
Do No Further Harm!
Monitor the patient
Every 15 minutes at least
Continuously for Serious Injuries
9
Injury Prevention…
10
Cause and Prevention of Injuries…
Reasons why injuries occur
Bad Judgment using equipment
Bad Judgment of ability
Environmental conditions
Equipment Failure10A
Risk and Safety
Risk is a number, a statistic.
Safety is a judgment call.
11
Being Prepared…
Four types of preparation…
Mental preparation
Physical preparation
Group preparation
Material preparation
12
The Ten Essentials…
Map of the area – Compass
Flashlight with batteries & bulb
Extra Food – Extra Clothing
Sunglasses and Sunscreen
Pocketknife – Matches
Candle – First Aid Kit 13
Other important items…
Full Water Bottles
Ground Insulations
Shelter – Emergency Blanket
Singling device – Duct Tape
Special environmental concerns
14
First Aid Kit…
Include plenty of sterile absorptive material
Water tight compartments
Specific to the area
No prescription drugs
First Aid Directions
First Aid Report Forms 15
Observations…
Circumstances
Extent of Injuries
Introduce yourself
Obtain consent
If victim is conscious do a physical exam and SAMPLE
history16
SAMPLE History…
S - Signs/Symptoms
A – Allergies
M – Medications
P – Pertinent Past History
L – Last food or fluid intake
E – Events proceeding17
General Principles of a Physical ExamDo NO FURTHER HARM!
Be complete and systematic
Use direct observation
Compare body parts
One person does the exam
Make multiple observations
Record what you find!18
Observe DOTS…
D – Depressions
O – Obvious deformity
T – Tenderness
S - Swelling
19
Vital Signs…
Pulse – Breathing
Skin Color – Temperature
Pupil Reaction
Level of Consciousness LOC
Sensation
Ability to Move20
Level of Consciousness…
A – Alert
V – Verbal
P – Painful response only
U – Unresponsive
21
Disease Transmission…
22
Route of disease transmission…
Direct – Touching body fluids
Indirect – Touching bandages or contaminated equipment
Airborne – Inhalation
Vector borne – By an animal bite or insect sting
22A
Steps to prevent Disease…
Wear Gloves – Wash you Hands!
Dispose of soiled stuff properly
Cover cuts and scrapes
Avoid touching your eyes
Use a CPR mask
If you are exposed… See your Doctor
23
Wound Care…
24
Steps to control Severe bleeding…Well aimed Direct Pressure
Elevation above the heart
Pressure Bandage
Pressure Point
Do not become discouraged!
24A
Preventing Wound Infection…Wash your hands – use gloves
Wash the wound area
Do not attempt to close large wounds
Cover with a sterile dressing
Change dressing daily
Maintain Immunizations 25
Water Sterilization…
Remove the big stuff
Boil for at least 1 minute
Rinse container with boiling water – and let sit for 1 minute
Pour out rinse water and put the boiled water into the container
Cover container – Let it cool 26
Eye Injuries…
Lodged Objects…
Clean water rinse from nose to ear
Lift object out gently with gauze
Embedded Object
Stabilize object as found
Do not attempt to wash it out
Evacuate on a stretcher27
Head, Neck and Back Injuries
28
Causes of Head Neck and Spinal InjuriesDirect Blow to the spine
Blow to the head
Falls on the buttocks
Falls from higher than victims height
Broken helmet - Driving mishap
Unconsciousness, reason unknown
Lightning strike – Severe Blunt Force
28A
Signs and Symptoms of spinal injury…Change in Consciousness
Problems with breathing or vision
Inability to move a body part
Ongoing Headache – pain/pressure
Nausea and vomiting
Loss of balance
(more)29
Signs and Symptoms of spinal injury…Bleeding of the head neck or back
Burse behind ears or under eyes
Blood or fluid from the ears or nose
Unusual bumps or depressions
Very Slow Pulse
Unequal pupils – Unequal response to light or a moving object
29A
Types of head injuries…
Skull Fracture
Brain Injury:
Concussion
Bleeding within the skull
30
First Aid Goals – Head Injuries…Prevent further injury
Assess seriousness
Watch closely for changes
Patient may walk out IF…
Injuries appear minor
Patient is able to walk steadily
The terrain is safe31
First Aid Goals – Spinal Injuries…
Prevent further injury
Assess the cause and seriousness
Monitor Vital Signs
Evacuate Professionally as soon as possible
32
Chest Injuries…
Two common types:
Penetrating
Rib Fractures
33
Chest Injuries First Aid Goals…
Assess seriousness
Prevent further injury
Help increase ease of breathing
Watch closely for changes
Evacuate Immediately33A
Abdominal Injuries…Open Injury
Possible protruding intestines
Care for as other wounds except use an occlusive dressing on
organs
Closed Injury
Bruising, rigidity or tenderness
Care by monitoring closely, treat for shock, evacuate 34
Extremity Injuries… Fractures
Open or Closed
Pain and reluctance to use
Possible deformity
Tenderness
Swelling, instability and bruising
First Aid… Immobilize to reduce pain and prevent further injury
35
Extremity Injuries… DislocationsOccur at joints
Pain
Loss of ability to use joint
Deformity, limb looks shorter
Tenderness and Swelling
Joint seems locked in place
First Aid… Immobilize in place36
Extremity Injuries… Sprains & StrainsStrain – over stretched muscle
Sprain – torn ligament
Pain, aggravated by motion
Localized tenderness and swelling
Difficult to distinguish from fracture
First Aid… RICE and Immobilize 37
Extremity Injuries… First Aid Goals
Assess seriousness
Prevent further injury
RICE…
R – REST
I – Ice or cold pack
C – Compression
E - Elevation38
Splinting
39
Splinting… General Principles
Determine location of injury and assess circulation, sensation and movement.
If an open injury, stop bleeding. Rinse bone ends with large amounts of sterile water
If severely bent and NOT AT A JOINT, firmly by gently straighten limb
Remove rings, watches, etc.39A
Splinting… General Principles (cont)Prepare a splint… pad well
Tie splint on securely
Neatness counts
Observe area below splint for feeling, warmth and color at least once every 30 minutes
If available, apply RICE
40
Burns
41
Causes of Burns
Heat
Chemicals
Electricity
Radiation and Explosions
41A
Types of burns…
Superficial
Partial Thickness
Full Thickness
41B
First Aid Goals… Burns
Rule of 9’s – Prevent further injury
Treatment of thermal burns:
Cool the Burn
Wash with sterile water
Remove jewelry
Apply antibiotic ointment
Elevate, treat for shock42
Shock
43
Shock… Early Stages
Patient is aware, restless, anxious
Skin is pale, cool, clammy
Heart and respiration rate is rapid
Patient is thirsty or nauseous
43A
Shock… Later Stages
Patient is lethargic, apathetic or unconscious
Skin is gray, cool and damp
Heart rate is weak and irregular
Respiration is very low or shallow and irregular
Eyes are dull and dilated
44
Shock… First Aid Goals
Ensure patient is breathing
Stop any obvious causes
Maintain Body Temperature
Treat patient gently
Replace lost fluids
Raise Legs is injury allows
Monitor continuously - Evacuate45
Shock… Delayed Care SituationsIf patient will be able to get to a hospital in a few hours, do NOT give food or fluids
If longer, give sips fluid at a rate of 4 oz to an adult over a 20 minute period
For a child, 1/2 the amount
Do not give fluids if unconscious or if there is a head or abdominal injury 46
HYPOTHERMIA
47
Mild Hypothermia
Complains of cold
Uncontrolled shivering
Decreased fine motor coordination
Disagreeable or apathetic
Core Temperature still above 90 Deg F
First aid – END Exposure!47A
Moderate to severe HypothermiaIncreasing lethargy and confusion
May or may not be shivering
Slurred speech
Stiff, stumbling walk
Unresponsive or unconscious
Pulse and respiration may be undetectable
Core Temperature below 90 Deg F48
First Aid for Moderate to severe Hypothermia
End Exposure
Replace wet clothing
Rewarm slowly – body core first
Use Hypothermia Wrap if possible
49
Heat Related Injury
50
Effects of excessive heat
Heat Cramps and fainting:
Rest in a cool place
Heat Exhaustion:
Skin is pale and damp
Nausea, weakness, dizziness, thirst, headache
Cool, fluids in small sips, recovery may take 24 hours
51
Effects of excessive heat-Heat StrokeLifethreatening condition
Exertional heat stroke
Classic heat stroke
Reduce body temperature
Cool with wet cloths
Monitor for rebound
If Conscious, give small sips of water
Evacuate by stretcher 51A
Sudden Illness
52
Sudden Illness…
Difficulty Breathing
Chest Pain
Unconsciousness
Allergic Reactions
Seizures
Diabetic Emergency52A
Snake bites… Pit Vipers, Coral Snakes
First Aid:
Keep patient calm
Clean the wound
Immobilize limb below heart
Travel slowly – Rest frequently
DO NOT cut and suck, use a tourniquet, cold or electrical shock
53
Insect stings and bites
generally localized
Stings to inside of mouth or nose may cause breathing problems
Anaphylactic shock is lifethreatening
Ask patient if they have had a reaction before
Remove stinger by scraping
Apply cold for swelling54
Spider bites
Two common spiders in the US
Brown Recluse
Black Widow
Seek medical help if pain is severe or if there is breathing difficulty
55
Tick bites
Can carry disease
Remove ticks by:
Grasp tick close to skin
Pull out with steady pressure
Clean and disinfect bite and hands
DO NOT use petroleum jelly or burn the tick 56
Other Miseries
Blisters
Dental Emergencies
Diarrhea from Contaminated water
Fainting
Headache
Disease from wild animals
Lightning 57
Putting it all together!
58
Carrying out the plan…
The action portion of the plan takes place after:
All first aid has been given
The plan has been formulated
The equipment assessed
The party is ready
Patient Monitoring
Altering the plan 58A
The NBO Scout Training Team
BSA Crew 911
www.scoutcpr.org
Questions?