Health Education Course, Chapter 3 - First Aid
Creating and Maintaining a Safe Classroom
A SAFE CLASSROOM:
The best first aid is to avoid setting up dangerous possibilities. Look around your classroom to determine if there are sharp objects or objects hanging loose from walls or the ceiling.
Ensure there is an escape route from the classroom and that the children are not trapped inside.
Run drills in order to practice what children should do should there be an emergency: fire, earthquake, hurricane, tornado, civil unrest
Keep a list of emergency rescue service numbers next to the telephone and in your pocket, wallet or purse.
Have medical supplies and a first-aid kit in your classroom
Identify areas where hazards exist and provide background information
Provide an indication of the extent of the hazard
Delineate some areas of protection needed
Suggest accident procedures to be followed
Suggest a lesson plan(s) in each area so that students are involved in the safety plan.
Help students take responsibility
Procedures
KEEP CALM. Remaining calm while helping the victim will help he/she to keep calm and cooperate. If the victim becomes anxious or excited the extent of the damage from the injury could be increased.
PLAN QUICKLY WHAT YOU NEED TO DO. Learn basic procedures, or have your first aid manual available, so you can care for the victim.
SEND FOR PROFESSIONAL HELP. Reaching help quickly could save a life. Know your local emergency telephone numbers.
BE AN ENCOURAGEMENT TO THE INJURED PERSON. Let the victim know that help is on the way and try to make them as comfortable as possible. Showing care and concern for the victim can give them hope during their circumstances.
Burns
- Never put butter or greasy ointments on a burn. They seal heat into the wound and may cause infection.
- Always seek medical attention, especially if:
- Burn covers more than one body part
- Burn is located on any sensitive area of the body (hands, face, feet, etc.)
- Burn is third degree
- Burn is caused by chemicals
First Degree Burn:
First degree burns damage the outer layer of skin.
CHARACTERISTICS:
- redness
- mild pain
- swelling
TREATMENT:
- Immediately submerge the affected part in cold water.
- Hold it under cold running water, or place cold, wet cloths on it until the pain decreases.
- Cover with a clean, dry gauze dressing for protection.
Second Degree Burns
Second degree burns go through to the second layer of skin.
CHARACTERISTICS:
- blisters
- rough, red skin
- swelling
- extreme pain
Treatment
- Immerse in cold water or have cold, wet cloths applied to it immediately.
- Gently blot area dry. Do not rub. Rubbing may break the blister, opening it to infection.
- Cover wound with dry, sterile bandage.
- If burn is located on arm or leg, keep limb elevated as much as possible.
Second degree burns should heal within a few weeks.
Third Degree Burns
Third degree burns are less painful than second degree burns because the nerve cells in the affected tissue are actually destroyed, but the damage is greater. The burn goes through to the third layer of skin.
CHARACTERISTICS:
- whitish or charred appearance
TREATMENT:
- Do not remove any clothing near or at the site of the burn
- Do not apply cold water or medication to the burn.
- Place clean, dry cloths (i.e. strips of a clean sheet) over the damaged area.
- If burns are on arms or legs, keep the limbs elevated above the level of the heart.
- If victim has burns on face, check frequently to make sure he is not having difficulty breathing.
- Get victim to a hospital at once.
Chemical Burns:
- Remove clothing on or near the burn area. Never pull clothing over the head with a chemical burn. You may need to cut the clothing.
- Wash the area thoroughly with low pressure water for at least 20 minutes.
- Apply a clean dressing to the area.
- Get medical attention as soon as possible.
Cuts and Abrasions
CUTS:
- Cleanse area thoroughly with soap and warm water, carefully washing away any dirt.
- Apply direct pressure to wound until bleeding stops.
- Put sterile bandage on wound.
- If cut is deep, get to a doctor as quickly as possible.
ABRASIONS (SCRATCHES):
- Wash thoroughly with soap and warm water.
- If it bleeds or oozes, bandage it to protect it from infection.
SIGNS OF A INFECTED WOUND:
- swelling
- redness
- pain
- may cause fever
- presence of pus
Dislocations
The most common dislocations occur in the shoulder, elbow, finger, or thumb.
LOOK FOR THESE SIGNS:
- swelling
- deformed look
- pain and tenderness
- possible discoloration of the affected area
IF A DISLOCATION IS SUSPECTED...
- Apply a splint to the joint to keep it from moving.
- Try to keep joint elevated to slow bloodflow to the area
- A doctor should be contacted to have the bone set back into its socket.
Fractures
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Nosebleeds
CAUSES:
- nose injury
- strenuous activity
- high blood pressure
- exposure to high altitudes
- blowing your nose too hard
WHAT TO DO IF A CHILD GETS A NOSEBLEED:
- have him/her down
- Lean slightly forward to prevent blood from running into the throat.
- Place cold, wet cloths on your nose to constrict the blood vessels in the nose and stop the bleeding.
- If blood is coming from only one nostril, press firmly at the top of that nostril.
- If both nostrils are bleeding, pinch nostrils together for at leat 10 minutes.
- If bleeing continues, apply pressure for another 10 minutes.
- If the bleeding is the result of direct injury to the nose, only gentle pressure should be applied.
- If heavy bleeding persists or if nosebleeds recur frequently, consult a physician.
Poisoning from Plants and Chemicals
From Plants
POISON IVY, POISON OAK, AND POISON SUMAC
Make certain that the irritation is from a plant rather than an animal or fire. Please ask the child questions!
SIGNS:
- rash
- blistering
- swelling
- burning
- itching
TREATMENT:
- Remove any contaminated clothing.
- Wash the affected area of skin thoroughly with soap and cool water to remove any poisonous residue. Be sure the water used to clean the area does not spread poison by running over other parts of your body. Using a washcloth could also spread the poison.
- Rinse the area with rubbing alcohol.
- Apply calamine lotion to the area to relieve itching and burning.
- If the victim develops a fever for several days or experiences an excessive amount of inflammation, irritation, oozing, or itching, he/she should be treated by a doctor.
From Chemicals
If a child has swallowed poison, do not try to make the child vomit as this may make the child more ill.
If poison is on the child's skin or clothes, remove the clothing and pour large amounts of water over the skin. Wash the skin thoroughly several times with soap.
If a child gets poison in her or his eyes, splash clean water in the eyes for at least 10 minutes.
Take the child immediately to a health centre or hospital. If possible, bring a sample of the poison or medicine or its container with you. Keep the child as still and quiet as possible.
Strains and Spains
SIGNS OF A STRAIN:
- affected joint begins to swell immediately
- joint may also turn black and blue due to the escaped blood from torn blood vessels
- victim will experience excruciating, shooting pains at the time of the injury because many nerves are injured in a sprain
TREATMENT:
- RICE treatment
- REST--Avoid using the affected part to avoid further discomfort or injury. Gradually rebuild your exercise program once the injury has healed.
- ICE--Apply ice (bags with crushed ice, cold packs, etc.) to the injured area for the first 24 to 48 hours to prevent or reduce swelling.
- COMPRESSION--Wrap an elastic bandage around the injured area to secure the ice in place. Do not wrap it so tightly that the circulation is cut off. After 10-15 minutes, loosen the bandage and remove the ice. Ice may be reapplied for 15-20 minutes every one or two hours for the first six hours after the injury. As long as the injury is swelling, continue to apply ice 3-4 times a day.
- ELEVATION--Elevate the injured area above the level of the heart to slow the bloodflow to the injury.
- Thermotherapy (applying moist heat) promotes healing but should not be applied to a muscle or ligament injury for at least 24 hours because heat will increase the swelling. After the swelling has gone, you should alternate applying cold compresses and moist heat to the injury.
- To treat the injury with warm, wet packs, place a water-dampened towel in a microwave oven for about 30 seconds. Check to make sure the towel is not too hot before placing it on the skin. If a microwave oven is not available, run a towel under very hot tap water, wring it out, and apply it to the injury.
- A sprained arm should be placed in a sling.
Most sprains take at least 6-8 weeks to heal.
DIFFERENCE IN SPRAINS AND STRAINS:
- SPRAIN--involves injury to the ligaments around a joint
- STRAIN--involves injury to a muscle or tendon
TREATMENT:
- At the time of the injury, begin the RICE treatment.
- For lower back strain, rest will often bring relief to the strained muscle. If not, alternate cold compresses with moist heat, allowing a time of rest between the treatments.
Asphyxiation
Asphyxiation is a loss of consciousness due to the presence of too little oxygen or too much carbon dioxide in the blood. The victim may stop breathing for a number of reasons (i.e. drowning, electric shock, heart failure, poisoning, or suffocation). The flow of oxygen throughout the body stops within a matter of minutes if a person's respiratory system fails. Heart failure, brain damage, and eventual death will result if the victim's breathing cannot be restarted.
RESCUE BREATHING
RESPIRATORY RESTORATION
A person suffering from asphyxiation should be given rescue breathing. Before you begin rescue breathing, be certain that the victim has actually stopped breathing.
- Kneel beside the victim, place your ear near his nose and mouth, and watch his chest carefully. You should feel and hear the breaths and see his chest rise and fall if he is breathing.
IF HE IS NOT BREATHING...
- Provide an open airway. Carefully place the victim on his back and open his mouth. If any material is blocking the airway, it must be cleared out.
- Tilt the victim's head back by placing the heel of one hand on his forehead and the other hand under the bony part of his chin to lift it slightly.
- Straddle his thighs, placing one palm slightly above the navel but well below the breastbone. Cover this hand with the other and interlace the fingers.
- Without bending your elbows, press sharply on the victim's abdomen 6-10 times.
- Turn the victim's head to one side and sweep out any contents in his mouth with your fingers.
- If the victim's breathing is not restored after removing the object, reposition his head in the head-tilt/chin-lift position and continue breathing for him as long as is necessary or until help arrives.
- If there are no signs of breathing , pinch the victim's nostrils closed. Seal your mouth over the victim's mouth and blow two full breaths. A rising chest indicates that air is reaching the lungs. If the stomach is expanding instead, the victim's neck and jaw are positioned improperly. Gently push on the victim's abdomen with the palm of your hand until the air is expelled, because the extra air in the stomach may cause vomiting.
- Look, listen, and feel again for signs of breathing. If the victim is still not breathing on his own, contnue blowing into his mouth one breath every five seconds until help arrives.
INFANTS:
If you are working with infants or a small child, position your mouth so that you can blow through the child's nose and mouth at the same time. Give two puffs, using your mouth and cheeks for breathing air into the infant's lungs (to keep from overinflating the lungs). Administer one breath every 3-4 seconds.
Bleeding
EXTERNAL BLEEDING:
- Apply direct pressure. Place a clean, folded cloth over the injured area and firmly apply pressure. If blood soaks through, do not remove it. Instead, cover that cloth with another one and continue to apply pressure to the wound for 7-10 minutes. If the bleeding is from the ear, place a clean bandage over the ear, lay the victim on his side, and allow the blood to drain out through the bandage.
- Elevate the injury. Position the wounded part of the body above the level of the heart if possible while you apply direct pressure.
- Know the pressure points. If direct pressure and elevation do not sufficiently slow the bloodflow, find a pressure point. Large arteries found close to the skin's surface supply blood to the head and to each arm and leg. The most common pressure points used during first aid are located in the upper arms and in the creases above the upper legs. Apply pressure to the closest pressure point to the wound so that the artery is pressed between your fingers and the bone directly behind the artery. If using the pressure point on a leg, you may need to use the heel of your hand instead of your finger.
- Resort to a tourniquet. On very rare occasions everything listed above may fail. To prevent the victim from dying, you should apply a tourniquet. Once a tourniquet is applied, it should not be loosened or removed until the victim has reached medical help. Use a tourniquet ONLY if everything listed above has failed. If you use a tourniquet, write down somewhere on the victim the time it was applied, so medical personnel wil know how long it has been in place.
INTERNAL BLEEDING:
Internal bleeding results when blood vessels rupture, allowing blood to leak into body cavities. It could be a result of a direct blow to the body, a fracture, a sprain, or a bleeding ulcer. If a victim receives an injury to the chest or abdomen, internal bleeding should be suspected. He will probably feel pain and tenderness in the affected area.
Other symptoms to watch for:
- cold, clammy skin
- pale face and lips
- weakness or fainting
- dizziness
- nausea
- thirstiness
- rapid, weak, irregular pulse
- shortness of breath
- dilated pupils
- swelling or bruising at the site of injury
The more symptoms that are experienced, the more extensive the internal bleeding is.
WHAT TO DO FOR THE VICTIM:
- Check for an open airway and begin rescue breathing if necessary.
- Call for medical help as soon as possible and keep the victim comfortable until help arrives.
- The victim may rinse his mouth with water, but DO NOT give a victim of internal bleeding anything to drink.
Convulsions
A convulsion (violent, involuntary contraction or muscle spasm) can be caused by epilepsy or sudden illness. Convulsion, or seizures, are not likely to cause death unless the victim stops breathing. The victim should be check by medical personnel.
SYMPTOMS:
- victim's muscles become stiff and hard, followed by jerking movements
- he may bite his tongue or stop breathing
- face and lips may turn a bluish color
- may drool excessively or foam at the mouth
WHAT TO DO:
- Clear all objects away from the victim and place something soft under his head
- Do not place anything between his teeth or in his mouth
- Do not give the victim any liquids
- If the vicitm stops breathing, check to see that the airway is open and begin rescue breathing
- Stay calm and keep the victim comfortable until help arrives.
Most convulsions are followed by a period of unconsciousness or another convulsion.
Electric Shock
- Remove the victim from the source of electricity before you touch him. Either turn off the master switch to disconnect the power, or use a nonmetal, dry object such as a stick to pull the wire or electrical source away from the victim's body.
- If he is not breathing, begin rescue breathing immediately; a victim whose heart has stopped breathing needs CPR.
- If the person is unconscious, but is breathing and has a heartbeat, you should place him in the recovery position and monitor his breathing and heart rate until medical help arrives.
Heatstroke
- Cool the body of a heatstroke victim immediately.
- If possible, put him in cool water; wrap him in cool wet clothes; or sponge his skin with cool water, rubbing alcohol, ice, or cold packs.
- Once the victim's temperature drops to about 101 F, you may lay him in the recovery position in a cool room.
- If the temperature begins to rise again, you will need to repeat the cooling process.
- If he/she is able to drink, you may give him some water.
- DO NOT GIVE A HEATSTROKE VICTIM ANY KIND OF MEDICATION.
- You should watch for signs of shock while waiting for medical attention.
Choking
If you are working with infants and children, ensure that you keep marbles, beads, thumbtacks, and other small objects out of their reach and prevent them from walking, running, or playing with food or toys in their mouths.
If you observe a "conscious" child choking:
- -Ask, "Are you choking?"
- -If the victim can speak, cough, or breathe, DO NOT INTERFERE.
- -If the victim CANNOT speak, cough, or breathe, give subdiaphragmatic abdominal thrusts (the Heimlich maneuver) until the foreign body is expelled or the victim becomes unconscious. (Or in case of extreme obesity or late pregnancy, give chest thrusts.)
The Heimlich Maneuver for CHOKING
A choking victim can't speak or breathe and needs your help immediately. Follow these steps to help a choking victim:
- From behind, wrap your arms around the victim's waist.
- Make a fist and place the thumb side of your fist against the victim's upper abdomen, below the ribcage and above the navel.
- Grasp your fist with your other hand and press into their upper abdomen with a quick upward thrust. Do not squeeze the ribcage; confine the force of the thrust to your hands.
- Repeat until object is expelled.
UNCONSCIOUS VICTIM, OR WHEN RESCUER CAN'T REACH AROUND VICTIM:
- Place the victim on back. Facing the victim, kneel astride the victim's hips. With one of your hands on top of the other, place the heel of your bottom hand on the upper abdomen below the rib cage and above the navel. Use your body weight to press into the victim's upper abdomen with a quick upward thrust. Repeat until object is expelled. If the Victim has not recovered, proceed with CPR.
- The Victim should see a physician immediately after rescue.
- Don't slap the victim's back. (This could make matters worse.)
The Heimlich Maneuver for CHOKING INFANTS
A choking victim can't speak or breathe and needs your help immediately.
Follow these steps to help a choking infant:
An infant or child can choke on food or toys that are small enough to enter the windpipe. If your child has swallowed something but can breathe and is able to cough or speak, it is best not to interfere because he or she will likely cough it out. If your child cannot breathe, cough or speak, take immediate action. Call 911 for help and then start treatment. The method of treatment varies with the child's age:
For an infant (younger than 1 year):
- Place the baby's face down on your lap with the head lower than the body.
- With the heel of your hand, hit your baby high between the shoulder blades four times.
- If the object does not come out, turn your baby over and compress (push on) the chest over the breast bone four times.
- If your child is still not breathing, open the mouth to see if you can remove the object with your finger.
- Try mouth-to-mouth breathing, and keep repeating this whole process until help arrives.
- For an older, larger child (older than 1 year), use the Heimlich maneuver to try and remove a foreign object:
- Put the child on his back on the floor or a table.
- Place the heel of one hand between his belly button and the breast bone in the middle of his abdomen. Put your other hand on top of the first hand and press inward and upward six to 10 times in rapid succession.
- Check the child's mouth quickly for the object, and try to remove it if it is visible.
- Try mouth-to-mouth breathing and then repeat the Heimlich maneuver. Keep trying until help arrives.
- The Heimlich maneuver can be done on a very large child in the standing or sitting position (from behind).
If the Victim Becomes Unconscious:
-Position victim on back, arms by side.
-Call out "Help!", or if others respond, call 911.
-Perform tongue-jaw lift and finger sweep to try to remove the foreign body.
-Open airway (head-tilt/chin-lift), and attempt rescue breathing.
-If unsuccessful, give 6-10 subdiaphragmatic abdominal thrusts (the Heimlich maneuver).
-Repeat sequence: perform finger sweep, open the airway, attempt rescue breathing, perform abdominal thrusts -- until successful.
-After obstruction is removed, begin the ABC's of CPR if necessary.
-BE PERSISTENT. Continue uninterrupted until obstruction is relieved or advanced life support is available. When successful, have the victim examined by a physician as soon as possible.
Teeth Knocked Out
Treatment: If your child's baby tooth has been knocked out because of an accident, leave the tooth out. Baby teeth are not put back into place (reimplanted) because it may damage the permanent tooth that is forming.
If your child's permanent tooth is knocked out, quick action is needed to give the tooth its best chance of successfully being reimplanted. Here are the steps needed:
- Look for the tooth and pick it up by its crown (the white part), not the root.
- Carefully rinse the tooth with water. Remember to put the stopper into the sink! Do not scrub the root or you may remove important tissue that will be needed for the tooth to reconnect to the bone and gums.
- If possible, place the tooth into its socket. If that is not possible, keep the tooth moist in a glass of milk or water.
- Transport your child and the tooth to your dentist immediately. Your dentist will reimplant the tooth and put on a splint to anchor it in place. Teeth have the best chance of reattaching if they are reimplanted within an hour of being knocked out.
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Last edited by Fred Mednick on Mar 17, 2006 12:18 pm US/Central.