人员急救技术

nullBasic First AidBasic First AidPresented by Department of Environmental Protection Bureau of Deep Mine Safety Revised 12/99Securing the sceneSecuring the scene 1. Electrical hazards 2. Chemical hazards 3. Noxious & Toxic gases 4. Ground hazards 5. Fire 6. Unstable equipmentBefore performing any First Aid, Check for:Chain of SurvivalChain of SurvivalEarly Access”911” Early CPR or First Aid YouEarly Defibrillation EMS on sceneEarly Advanced Care HospitalIn order for a person to survive:Pay attention to: HISTORY; what happened; from the casualty or bystanders SYMPTOMS; what only the casualty can tell you SIGNS; what you can see for yourself Universal Precautions for Airborne & Bloodborn PathogensUniversal Precautions for Airborne & Bloodborn PathogensHIV & HepatitisTuberculosisGloves & Respiratory Barrier devise are a must to prevent transmission of diseasesnullDURING TREATMENT avoid coughing, breathing, or speaking over the wound avoid contact with body fluids use a face shield or mask with one-way-valve when doing active resuscitation use only clean bandages and dressings avoid treating more than one casualty without washing hands and changing gloves AFTER TREATMENT clean up both casualty and yourself clean up the immediate vicinity dispose of dressings, bandages, gloves and soiled clothing correctly wash hands with soap and water Fundamentals of First AidFundamentals of First AidActivate EMS System “911” 1. ABC (airway-breathing-circulation) 2. Control bleeding 3. Treat for Shock(medical emergencies) 4. Open wounds & Burns 5. Fractures & Dislocations 6. TransportationABC’sABC’sCauses of Respiratory/Cardiac ArrestElectricalDrowningToxic - Noxious gases SuffocationHeart AttackTraumaDrugsAllergic reactionsReaction TimeReaction TimeIf CPR/Artificial respiration is administered Chance of brain damage 0 to 4 minutes - 4 to 6 minutes - 6 to 10 minutes- 10 minutes + -Recovery rate of victim if has atrificial respiation done immediately Oxygenated blood flow must get to brainA-B-C’sA-B-C’sUse chin lift/head tiltLook.-listen-feel for breathingAttempt to VentilateVentilate Every 5 secondsEstablish responsivenessCheck pulseRecovery positionCardio Pulmonary ResuscitationCardio Pulmonary ResuscitationShould be certified to perform this procedure If done improperly, could harm victim Courses available through Deep Mine Safety at no cost to mining industryAirway ObstructionsAirway ObstructionsopenclosedobstructedTongueHeimlich Maneuver for Conscious Airway ObstructionHeimlich Maneuver for Conscious Airway ObstructionTypes of BleedingTypes of BleedingVeinsCapillarySpurtingSteady flowOozingArteryInternal InjuriesTypes of WoundsTypes of WoundsControl of BleedingControl of BleedingDirect PressureElevationCold ApplicationsPressure bandagePressure PointsPressure Points Where the artery passes over a bone close to the skinTemporal Facial CarotidSub-clavian Brachial Radial UlnarFemoral Popliteal PedalTourniquetTourniquetAbsolute last resort in controlling bleeding,Remember Life or the limbOnce a tourniquet is applied, it is not to be removed , only by a doctorShockShockShock affects are major functions of the body loss of blood flow to the tissues and organsShock must be treated for in all accident casesTreatment for ShockTreatment for ShockLie victim down if possible Face is pale-raise the tail Face is red-raise the head Loosen tight clothing Keep victim warm and dry Do not give anything by mouth No stimulantsnullHEAT EXHAUSTION HEAT EXHAUSTION is caused by exertion accompanied by heat and high humidity. It particularly affects the very young and the elderly. SIGNS AND SYMPTOMS pale, clammy skin profuse and prolonged sweating cramps in the limbs and/or abdomen nausea and/or vomiting headache lethargy CARE AND TREATMENT complete rest in the shade, no further exertion cool casualty by sponging with tepid water when nausea passes, give cool water to drink (cautiously) ensure casualty has assistance when recovered nullHEAT STROKE Heat stroke is potentially fatal. In this condition, the body's temperature regulation center in the brain has been rendered inoperable, and the temperature continually rises, causing eventual brain damage. Immediate active intervention is necessary to avoid coma and death. SIGNS AND SYMPTOMS flushed, hot, dry skin the casualty has ceased sweating rapid, strong pulse (sometimes irregular) irrational or aggressive behavior staggering gait visual disturbances vomiting collapse and seizures coma - death CARE AND TREATMENT urgent ambulance transport complete rest in shade remove casualty's clothing cool casualty with any means possible be prepared to resuscitate as required nothing by mouth - dehydration is required by intravenous fluids administered by a doctor or ambulance crew nullHYPOTHERMIA HYPOTHERMIA is a potentially fatal condition that especially affects the elderly. The body's core temperature has been lowered to the extent that the brain function is impaired and the heart's activity is about to be compromised. Urgent first aid intervention is required. SIGNS AND SYMPTOMS pale, cold skin - no capillary return when fingernails are pressed slow pulse, sometimes skipping a beat slow, shallow respirations blurred, or double, vision casualty is silent, appears asleep, difficult to rouse; may be unconscious casualty experiences a sense of 'wellbeing' absence of shivering If very cold, may have non-reacting pupils and appear 'death-like' CARE AND TREATMENT urgent ambulance transport warm casualty slowly, wrap in 'space blanket' or similar if wet, leave less bulky clothing on and warm slowly once casualty commences shivering, reassess heating nothing by mouth until fully recovered be prepared for sudden collapse and resuscitation Diabetic emergenciesDiabetic emergenciesInsulin Shock (Hypoglycemia) Result of insufficient sugar- Fast onset Cold clammy skin, pale, rapid respiration's and pulse, incoherent Treat by giving sugar bases productsDiabetic coma (Ketoacidosis) Too much sugar or insufficient insulin- Slow onset Warm, dry skin, slow respirations, smell of rotten fruit on breath True medical emergency, activate EMS system immediately Find out if victim has past diabetic historySnake & Spider bitesSnake & Spider bitesRattlesnakeCopperheadBlack WidowBrown RecluseLimit activity Constricting bandage above Cold application Advanced medical attention BurnsBurnsThermal burnsCool applicationCool application Don’t break blistersDry sterile dressing, treat for shocknullSevere Burns and Scalds Treatment: Cool the burn area with water for 10 to 20 minutes. Or use Burn Jel. Lay the casualty down and make him as comfortable as possible, protecting burn area from ground contact. Gently remove any rings, watches, belts or constricting clothing from the injured area before it begins to swell. Cover the injured area loosely with sterile unmediated dressing or similar non fluffy material and bandage. Don't remove anything that is sticking to the burn. Don't apply lotions, ointments, butter or fat to the injury. Don't break blisters or otherwise interfere with the injured area. Don't over-cool the patient and cause shivering. If breathing and heartbeat stop, begin resuscitation immediately, If casualty is unconscious but breathing normally, place in the recovery position. Treat for shock. Send for medical attention. nullMinor Burns and Scalds Treatment: Place the injured part under slowly running water, or soak in cold water for 10 minutes or as long as pain persists. Gently remove any rings, watches, belts, and shoes from the injured area before it starts to swell. Dress with clean, sterile, non fluffy material. Don't use adhesive dressings. Don't apply lotions, ointments or fat to burn/ scald. Don't break blisters or otherwise interfere. If in doubt, seek medical aid. nullChemical Burns Treatment: Flood the area with slowly running water for at least ten minutes. Gently remove contaminated clothing while flooding injured area, taking care not to contaminate yourself. Continue treatment for SEVERE BURNS Remove to hospital. Fractures & DislocationsFractures & DislocationsMust treat for bleeding firstDo not push bones back into placeDon’t straighten break Treat the way you found itnull IF A DISLOCATION IS SUSPECTED... 1. Apply a splint to the joint to keep it from moving. 2. Try to keep joint elevated to slow bloodflow to the area 3. A doctor should be contacted to have the bone set back into its socket.The most common dislocations occur in the shoulder, elbow, finger, or thumb. DislocationsLOOK FOR THESE SIGNS: 1. swelling 2. deformed look 3. pain and tenderness 4. possible discoloration of the affected area SplintsSplintsMust be a straight line breakCan be formed to shape of deformityBe careful of temperature changenull PROPER CARE: 1. While waiting on help to arrive, keep the victim lying down in the recovery position 2. Control any bleeding, and be sure that he is breathing properly. 3. Do not give the victim any liquids to drink. 4. If the victim becomes unconscious for any amount of time, keep track of this information so that you can report it when medical help arrives. Head InjuriesA sharp blow to the head could result in a concussion, a jostling of the brain inside its protective, bony covering. A more serious head injury may result in contusions, or bruises to the brain. OTHER SYMPTOMS TO LOOK FOR IF YOU SUSPECT A VICTIM MAY HAVE A BRAIN INJURY: 1. clear or reddish fluid draining from the ears, nose, or mouth 2. difficulty in speaking 3. headache 4. unequal size of pupils 5. pale skin 6. paralysis of an arm or leg (opposite side of the injury) or face (same side of the injury) Neck & Spinal InjuriesNeck & Spinal InjuriesCARE AND TREATMENT ABC extreme care in initial examination — minimal movement urgent ambulance transport apply cervical collar treat for shock treat any other injuries maintain body heat if movement required, 'log roll' and use assistants always maintain casualty's head in line with the shoulders nullLifting techniquesTwo person carry Lift & roll 4 person straddlenull