HLTAID003 PROVIDE FIRST AID LEARNER GUIDE TABLE OF CONTENTS FIRST AID COURSE ..........................................................................
Author: Basil Phillips
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TABLE OF CONTENTS FIRST AID COURSE ....................................................................................................................................................2 HOW TO USE YOUR LEARNER GUIDE ....................................................................................................................2 DISCLAIMER................................................................................................................................................................2 PRINCIPLES OF FIRST AID........................................................................................................................................3 LEGAL ISSUES IN FIRST AID ....................................................................................................................................3 CARDIOPULMONARY RESUSCITATION (CPR) .....................................................................................................17 FIRST AID ..................................................................................................................................................................19 INFECTION CONTROL..............................................................................................................................................41 WHEN ADMINISTERING FIRST AID THE RESPONDER MAY HAVE THE FOLLOWING EQUIPMENT AVAILABLE; ..............................................................................................................................................................42 OCCUPATIONAL HEALTH & SAFETY (OHS) AND MANUAL HANDLING ...........................................................43 REFERENCES AND USEFUL LINKS .......................................................................................................................44

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FIRST AID COURSE HLTAID003 Provide First Aid course conducted by SKILLED Group RTO, and is nationally recognised and valid for 3 years. An update should be attended annually to ensure you remain current in CPR The resuscitation and first aid practices in this course and detailed in this Learner Guide are based on the current guidelines from the Australian Resuscitation Council (ARC). Further reading can be found at www.resus.org.au Each State and Territory also has its own governing body which have their own Codes of Practice and Guidelines that outline the minimum requirements relating to First Aid Kits in the Workplace. It is important that you are aware of these within your own organisation.

HOW TO USE YOUR LEARNER GUIDE Your Learner Guide contains the basic first aid principles. This includes: • • • • •

Principles of first aid Legal issues Perform cardio pulmonary resuscitation – HLTAID001 Basic emergency life support – HLTAID002, and HLTAID003 Provide First Aid

You must be familiar with this guide and have completed all the theory questions prior to attending the 1 day face to face training session. Please bring this Learner Guide to the training session. You will be assessed on the practical demonstration component and once competent will receive a statement of attainment ‘HLTAID003 Provide First Aid’

DISCLAIMER The information contained in this Learner Guide and delivered during the face-to-face training session relates to the current accepted first aid practices in Australia. While all due skill and attention has been taken in collecting, validating and providing the attached information, SKILLED is not liable in any way for loss of any kind including damages, injuries, costs, interest, loss of profits or special loss or damage, arising from any error, inaccuracy, incompleteness or other defect in this information. In utilising this information the recipient and/or attendee of the ‘Apply First Aid’ course acknowledges that SKILLED makes no representations as to the accuracy or completeness of this information.

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PRINCIPLES OF FIRST AID First Aid is the term used to describe the initial care given to a sick or injured casualty prior to the arrival of trained medical assistance or other emergency services. First Aid can describe the provision of minor health assistance or it can describe interventions that are life-saving.

LEGAL ISSUES IN FIRST AID The following is a guide only. This will assist first aiders to understand the legal consequences of becoming involved in an incident. You should seek independent legal advice related to first aid if you have any specific issues. ‘Good Samaritans’ are protected from liability, who in good faith and without expectation of payment or reward, come to the assistance of a person who is apparently injured or at risk of being injured.

LEGAL CONSIDERATIONS RELATING TO FIRST AID CONSENT: Under Australian Law a person has control over their body and can bring a charge of assault, if touched without consent. An injured/ill person has the right to refuse advice/assistance from a First Aider, Paramedic, Nurse or Doctor. Before treating a casualty you must identify your qualifications and gain consent. For example, “I am a first aider, can I help you?” If the casualty is unconscious or seriously injured and unable to give consent, you can assume consent and commence treatment. If the casualty is under 18 years old, consent must be obtained from a parent or guardian. If neither is present, you can commence treatment.

DUTY OF CARE Under Australian Law a First Aider usually has no legal duty of care. Unless they are the designated work place first aider or employed in child care centres/schools. Once first aid treatment is commenced you then have a duty of care to continue within the scope of your first aid knowledge and skills. You may cease to administer first aid if: •

Qualified help arrives

The area becomes unsafe

You are physically unable to continue, or

The casualty recovers

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NEGLIGENCE In the unlikely event that a First Aider is sued for providing first aid assistance, negligence must be established in that: •

The first aider owed a duty of care

The relevant standard of care was breached

Further injury was sustained, and

If further injury was sustained had the first aider gone beyond their scope of training

If a further injury was sustained in the process of saving their life, duty of care has been undertaken and the first aider had acted in good faith. For example, if a first aider gives CPR to a casualty and a rib is broken, it is reasonable to expect that this may occur. The outcome of not performing CPR would be death.

RECORDING First aiders should make an accurate recording of any injury/illness and subsequent treatment. This will: •

Assist the medical personnel who take over the care of the casualty

Be required in the workplace, or

Assist if the incident is brought to court

Proper records will assist you to recall the incident if you are questioned about the treatment or injury at a later stage and should include information such as: •

Date, place and time of the incident

Casualties details

Witness details

Personnel involved- especially in a workplace

Emergency services involved, who called them and why

The treatment involved and supplies used- especially in a workplace

All details need to be correctly recorded and should be documented as soon after the incident as practicable. This will ensure that events are recorded accurately and do not rely on people’s memories.

In the workplace the reports are also used as a method to improve workplace health and safety and to replenish any supplies to the First Aid Kit. They can also be used as a platform to debrief all personnel involved in a major incident or accident to enable the discussion of what worked well, what could have been done better and what can be improved to next time.

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CONFIDENTIALITY Part of recording and reporting incidents is the collection of personal information about the casualty. Privacy legislation protects the information collected in this manner, any person including First Aiders must comply with both Commonwealth and any state/territory implemented legislative requirements.

If a person who undertakes first aider duties as part of their job function will also have to comply with their internal policies and procedures regarding the privacy of an individual’s information. Dependent on the type of organisation and the type of first aider duties that are being provided, there are different regulatory bodies that the first aider will need to comply with such as: •

Australia Medical Association (AMA)

Medical Record Advisory Units

Hospital System Units

Department of Human Services

ETHICAL ISSUES Ethical issues may arise when being a First Aider to a person with differing customs, traditions and values. These differences need to be handled in a respectful manner which allows a degree of trust to be maintained between First Aider and casualty. This is also important when treating children and the elderly who may be further distressed when being moved or handled by what they would consider to be a complete stranger. In dealing with a casualty be empathic, unbiased and non-judgemental. Do not think in stereotypes. Do not let your personal biases and opinions impact on the way you interact with the casualty, regardless of their race, culture, religion, gender, age, disability or even the way they look. It may be more appropriate for a female first aider to treat a

female from other cultures. Following are some simple strategies for talking to a casualty regardless of cultural background, disability and age: 1. Speak slowly and clearly. 2. Use short and simple sentences 3. Maintain normal volume, do not shout because they perhaps do not understand English or are elderly and may be deaf. Young children will respond particularly well to a calm voice that is not raised or anxious. 4. Use sign language to convey what you are going to do/are doing; keep it simple and slow and precise. 5. Avoid jargon.

6. Respond to expressed emotions in an empathetic manner, everyone has their own pain threshold and will respond differently to the sight of blood or when they are injured.

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FIRST AID PRIORITIES Emergency situations are non-routine situations where first aiders can be faced with numerous and varied problems. The DRSABCD (refer to Diagram Basic Life Support – Primary Survey on Page 8 for definition) approach, detailed below, prioritises the actions that must be followed in any emergency situation. First Aiders must: •

Identify themselves

Gain consent (when appropriate)

Respond to the casualty in a culturally aware, sensitive and respectful manner

Provide reassurance & information to the casualty

Maintain confidentiality & privacy

Utilise bystanders & available resources

Provide accurate information to emergency services

Be aware of WHS & infection control principles and

Seek clinical evaluation & debriefing

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Lungs The lungs help us breath. They take in oxygen from the air and expel carbon dioxide back into the air.

Brain The brain is the control centre for movement, sleep, hunger, thirst, and virtually every other vital activity necessary for survival

Heart The heart is a pump; it pushes blood around the body.

Stomach The stomach helps to digest food before it passes into the intestines

Liver The liver is like a chemical factory, adjusting food levels in the blood. It removes toxins from the blood and generates body heat.

Kidneys The kidneys filter waste from the blood and expels excess water and salts from the body in the form of urine.

Large Intestine Indigestible food goes to the large intestine. Water is adsorbed and the remaining waste becomes faeces

Small Intestine The small intestine is the longest section of the digestive system and where most digestion occurs

D – DANGER Before helping in an emergency you must quickly assess the surroundings for any danger that could cause further harm to you, any bystanders or the casualty(s). Hazards may include electricity, traffic or flammable gases. If any dangers are present then remove them if safe to do so, or if not possible, move the casualty(s) from danger (Refer to section “Moving an Injured Casualty”). Priority should be given to unconscious casualties in cases where there is more than one casualty. If the casualty(s) cannot be moved safely, or you cannot remove the danger you must call emergency services and wait for their assistance. After assessing the situation and ensuring the safety of yourself, bystanders and casualties, you must phone for help.

MOVING AN INJURED CASUALTY Move casualties only if necessary to remove them from danger. Moving an injured casualty is only recommended if it is to; •

Ensure the safety of rescuer and casualty

Protect the casualty from extreme environmental conditions

Make possible care of the airway, breathing and circulation

Make possible the control of excessive bleeding

When moving a casualty; •

Avoid bending or twisting the casualty’s neck and back

Use 3 – 4 people if possible to support the head, neck, torso, pelvis and limbs

A single rescuer may need to ankle drag or shoulder drag the casualty

Ensure the airway is protected above any other injury

Stay at the scene until emergency services arrive. Once the situation has been assessed, dangers controlled, and you have called for help, assess casualty(s) level of consciousness.

R - RESPONSE Response describes a person’s level of consciousness. Unconsciousness is defined as a state of not being awake and aware of, and casualty not responding to their surroundings. Assess response by; •

Using simple commands like “Can you hear me”, “Open your eyes”, “What is your name”, Squeeze my hand”

Call the casualty’s name if known

Squeeze shoulders firmly to elicit a response

Never shake infants or small children

A casualty who fails to respond, or who shows only a mild response is unconscious. An unconscious person has lost their normal protective reflexes and can receive permanent brain damage within 3-4 minutes or die quickly without proper medical attention. Priority should be given to unconscious casualties.

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S-SEND FOR HELP In any emergency it is essential to get emergency medical attention as soon as possible. Use other people around to assist if possible. Phone First – this is the advice for most emergency situations and cardiac arrests. This is because a person in cardiac arrest is likely to be in an abnormal heart rhythm which can be corrected with a defibrillator. The sooner the casualty has access to a defibrillator, the better their chances of survival. Phone Fast – This is the suggested approach for child cardiac arrests and in cases of airway obstruction or inadequate ventilation. Often phoning for help occurs at the same time as commencing resuscitation. To call for help dial; Triple Zero (000) – Primary emergency number. Use to call for help from all telephones (landline, mobile phones and payphones). 112 – Secondary emergency number. Use to call for help from a digital mobile phone. 106 – Secondary, text-based emergency number. Use to call by people who are deaf, or who have speech and hearing impairment. Service operates using a teletypewriter. When the operator answers you will be asked what service you need. You will then be directed to the appropriate service.

Further information you may be asked to provide; • Your exact location •

The telephone number you are calling from

The number of casualties

A brief description of injuries or illnesses

Information about other services that may be required

A – AIRWAY Signs and symptoms of airway obstruction •

Extreme anxiety




Loss of voice

Laboured, noisy breathing


Extreme perspiration

Rise in heart rate

CYANOSIS – late stage oxygen deprivation resulting in blue lips and fingernails

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FOREIGN BODY AIRWAY OBSTRUCTION (CHOKING) Choking may be indicated by the following signs and symptoms; •

Clutching the throat

Wheezing, gagging, coughing

Difficulty breathing, speaking or swallowing

Making a whistling or crowing sound, or no sound at all

Face, neck, ears, fingernails, lips turning blue

Collapsing or unconscious

If the casualty can still breathe and cough, a partial obstruction is indicated. Encourage the casualty to continue coughing to expel the foreign body and reassure the casualty. If their condition deteriorates and/or the foreign body is not expelled, emergency services should be called. In the case of a severe airway obstruction, if coughing does not remove the object or in the case of infant choking; •

Call 000 for an ambulance

Bend casualty well forward, or lay infant with head down on forearm or across lap

Give up to 5 sharp back blows, checking if obstruction has dislodged in between each back blow

If dislodged, ensure mouth is clear using finger sweep

If blockage is not cleared after 5 back blows; •

Give 5 chest thrusts (slower but sharper than CPR compressions)

Use 1 hand for adults and children, 2 fingers for infant

Check if obstruction has cleared after each chest thrust

Chest thrusts may be given to adults and children older than 1 year in the standing or sitting position. Infants should be placed head down, across the rescuers thigh

If blockage is not cleared after 5 chest thrusts; • Continue alternating 5 back blows with 5 chest thrusts until medical help arrives. If casualty becomes unconscious remove any visible obstruction from the mouth and commence CPR •

Refer to “Flow Chart for the Management of Foreign Body Airway Obstruction”

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B – BREATHING Once the airway has been opened and cleared, check if the casualty is breathing. LOOK for movement of the lower chest or upper abdomen LISTEN for escape of air from nose or mouth FEEL for movement of the chest or abdomen If casualty is breathing Place the casualty on their side in the recovery position and maintain the airway. Look for and control any major bleeding and observe casualty while waiting for an ambulance to arrive. If casualty is not breathing Check the airway has been cleared and opened. Commence CPR immediately starting with Compressions x 30 then Rescue Breathing x 2. This involves breathing your expired air into the casualty. This air contains approximately 15-18% oxygen, and is sufficient to maintain life until an ambulance arrives. You are not required to do any rescue breaths before commencing CPR. Rescue Breathing Technique •

Place casualty on their back

Open the airway using backward head tilt and jaw support

Block the nose

Give 2 breaths (using mouth-mouth, mouth-mask or mouth-nose technique)

Check for signs of life

Mouth to Mouth Take a breath, open your mouth as wide as possible and place it over the casualty’s mouth. Whilst maintaining an open airway, pinch the nostrils and blow to inflate the lungs. Look for rise of the chest during ventilations. Ensure correct head tilt, adequate air seal and ventilation. Mouth to Nose This technique may be used when the casualty’s jaw is clenched or injured, or in infants and small children. Close the mouth using your hand to support the jaw. Push the casualty’s lips together with your thumb. Take a breath and place your widely opened mouth over the casualty’s nose (or mouth and nose in infants). Mouth to Mask Mouth to mask resuscitation decreases the risk of cross-infection for the rescuer. Maintain a backward head tilt and chin lift. The narrow end of the mask is placed on the bridge of the casualty’s nose. Ensure a tight seal. Inflate lungs by blowing through the mouthpiece.

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CARDIOPULMONARY RESUSCITATION (CPR) RESUSCITATION DEFINITION “The preservation or restoration of life by the establishment and or maintenance of airway, breathing and circulation and related emergency care” Cardiopulmonary Resuscitation (CPR) describes the combination of Compressions with Rescue Breathing. The aim is to temporarily maintain the circulation of oxygen around the body and preserve brain function until specialised treatment is available.

COMPRESSION TO VENTILATION RATIO 30 compressions followed by 2 ventilations - 30:2


Signs of life return

Advanced life support team arrives

If exhaustion makes it impossible to continue

If decision to stop is made by an authorised person

The Australian Resuscitation Council (ARC) Guidelines state; •

Any attempt at resuscitation is better than no attempt at all

Interruptions to compressions should be minimised

Over ventilation should be avoided

A defibrillator should be attached and used as soon as possible

D – DEFIBRILLATION The heart is controlled by an electrical impulse. During a cardiac arrest, the normal electrical impulse is interrupted and irregular rhythm causes the heart to stop beating. Defibrillation is the administration of a brief electric shock to the heart with the aim of returning normal heart rhythm. Early defibrillation has been identified as a factor in improving the chances of survival in and out of hospital cardiac arrest. This is preferably delivered by trained people or health professionals after assessment of the situation. However the introduction of Public Access Defibrillators (PAD) via PAD programs is increasing and supports untrained bystanders to also perform defibrillation if required. •

If available the Automatic External Defibrillator (AED) should be applied to the casualty as soon as possible

Turn the AED on and follow the prompts

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FIRST AID ABDOMINAL INJURY The abdominal area contains the stomach, liver, pancreas and spleen. This area is not protected by bones therefore is at risk of injury. Casualties who suffer serious abdominal injury may have internal bleeding which can be life-threatening if not treated immediately. Signs and symptoms; •

Bleeding wound

Severe pain in abdominal area

Nausea or vomiting

Exposed organs

First aid management; 1. Call for an ambulance 2. Assist casualty into a comfortable position 3. Do not give the casualty anything to eat or drink 4. Control any bleeding – Refer to section Control of Bleeding 5. Do not attempt to replace exposed organs 6. Monitor the casualty’s airway, breathing and circulation 7. Commence CPR if required

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MINOR SKIN INJURIES Minor skin injuries often occur as the result of unanticipated trauma and may include:• • • •

Lacerations Cuts and Scrapes Bruising Splinters

In many situations the skins may only require protection from further injury and managing infection.

Lacerations, Cuts and Scrapes First Aid Management; a) Clean wound and surrounding area – done gently with mild soap if available b) Blot dry with sterile pad or clean dressing c) Protect it with sterile pad or clean dressing to absorb fluid and prevent from further contamination d) Secure with first aid tape to keep out of dirt and germs and minimise an infection Splinters Slender Pieces of Wood, Bone, Glass or Metal Objects that is under the skin

Signs and Symptoms: • • •

Selling Redness Pain

First Aid Management; a) b) c) d) e) f)

Sterilize needle or tweezers Wipe with sterile pad before use Loosen skin around the splinter with a needle Use the tweezers to remove the splinter If the splinter breaks or goes further within the skin seek medical attention Cover with sterile pad or adhesive bandage if required

Bruising Soft tissue injury that involves a break in blood vessel close to the surface of the body. This can be caused by a blow or force to the body. Bruising may be seen with either a strain or sprain. There may be no symptoms and signs present immediately, First Aid Management; a) An ice pack can help reduce the pain and swelling from occurring b) It can be applied for 10-20 minutes at a time c) If significant pain after 24 hours and swelling occurred, seek medical attention

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CHEST PAIN / CARDIAC ARREST Common underlying problems: 1. 2. 3. 4. 5. 6. 7.

Acute severe asthma Electrocution Head injury Near drowning Seizures Some allergies Poisoning / drug overdose

Signs and Symptoms: 1. 2. 3. 4. 5. 6.

Chest pain or discomfort Pain, pressure, heaviness or tightness in the chest, shoulders, neck, arms, jaw or back Nausea Dizziness Sweating Shortness of breath

These conditions can result in: 1. Airway obstruction – often caused by the tongue or foreign body 2. Respiratory arrest – absence of breathing 3. Circulatory arrest – absence of circulation

ANGINA An Angina attack is the result of a temporary lack of oxygen supply to the heart muscle, due to a reduced blood flow around the hearts blood vessels. Signs: 1. Pain or discomfort in the middle of the chest. 2. Pain may be accompanied by breathlessness and sweating. 3. Pressure or a feeling of tightness in the chest. 4. Radiating pain to the neck, jaw and left arm, or both arms. 5. Sometimes, radiating pain in the upper back and shoulders

The chances of survival from cardiac arrest are dependent on; 1. Early access to emergency services 2. Early basic life support 3. Defibrillation 4. Early advanced life support

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CONTROL OF BLEEDING Wear gloves or use an alternative barrier to avoid infection. All body tissues and fluids should be treated as potentially infectious. External Bleeding 1. Apply direct, sustained pressure on or near the wound using a sterile dressing 2. If no dressing is available, use a clean cloth or your hands to apply pressure 3. Small wounds should be washed, dried and treated with a mild antiseptic 4. Do not apply antiseptic to large, traumatic wounds 5. Where possible, apply a bandage to secure the dressing in place. Reinforce dressings when required without removing previous dressings. 6. Elevate the injured part if possible 7. Seek medical assistance 8. Reassure and calm the person to avoid increased heart rate, to reduce bleeding and the effects of shock Nose Bleeds 1. Sit the casualty down with their head forward and advise them to breathe through their mouth 2. Apply firm pressure to the soft part of the nose below the nasal bone for at least 10 minutes 3. Advise the casualty to avoid blowing their nose for as long as possible

Tooth bleeds If a tooth is knocked out or is dislodged: 1. Cleanse with saliva or milk and replace the tooth immediately. There is a 90% chance of successful reimplantation if the tooth is replaced within minutes. 2. Splint the tooth with cooking foil and ask the casualty to bite firmly down on the splint 3. If the tooth cannot be replaced have the casualty store it in their mouth or in a small amount of milk Internal Bleeding Internal bleeding can be difficult to detect and assess. Symptoms and signs may include pain, tenderness or swelling around area. Bleeding from body openings including vomiting blood, vaginal bleeding or rectal bleeding, is also a sign. First aid management; 1. Call for help immediately 2. Follow DRSABCD 3. Reassure casualty

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Shock Shock is a body response to injury or illness which results in impaired circulation and can be life-threatening if not managed immediately. Shock can be caused by loss of circulating blood volume, cardiac arrest, abnormal dilation of blood vessels or a blockage that prevents blood from flowing in and out of the heart. Signs and symptoms; 1. Dizziness, confusion 2. Muscle weakness, collapse 3. Thirst 4. Anxiety 5. Restlessness 6. Nausea, vomiting 7. Shortness of breath, rapid breathing 8. Cold feeling 9. Rapid pulse becoming weak or slow First aid management; 1. Control bleeding 2. Call for emergency medical assistance 3. Assist casualty to a comfortable position usually lying down 4. Provide oxygen if available 5. Keep casualty warm 6. Provide reassurance 7. Monitor and commence CPR if required

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ELECTRIC SHOCK First aid management; 1. Ensure safety of rescuer 2. Call 000 for help 3. Turn off power source before touching the casualty 4. If not possible, push casualty away from power source using a broom handle or other non-conducting object such as dry clothing 5. Avoid armpits as sweat can conduct electricity 6. Apply first aid as required 7. Burns are common 8. If unconscious and unresponsive, start CPR until medical team arrives

EXPOSURE TO HEAT AND COLD Hypothermia (Cold Injury) Hypothermia is indicated by a body temperature below 35 degrees. Casualties whose body temperature is falling generally progress into cardiac arrest with system and organ failure. Signs and symptoms; 1. Shivering or absence of shivering in severe cases 2. Pale, cool skin 3. Impaired coordination, increasing muscle stiffness 4. Slurred speech 5. Progressive loss of consciousness 6. Hypotension 7. Slow irregular pulse

First aid management; 1. Call for emergency medical assistance 2. Remove sources of cold e.g. remove from cold, windy environments, wet clothing 3. Keep casualty warm if possible i.e. blanket 4. Give warm oral fluids only if casualty is conscious

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Hyperthermia (Heat Exhaustion, Heat Stroke) Hyperthermia may be caused by exposure to hot environments, impaired metabolic activity or other impairment of the body’s normal temperature system. Signs and symptoms; 1. Fatigue 2. Headache 3. Nausea, vomiting 4. Discomfort, dizziness 5. Collapse, loss of consciousness and death in severe heat stroke

First aid management; Heat Exhaustion 1. Lie casualty down 2. Loosen and remove excessive clothing 3. Cool the skin with moisture and/or fanning 4. Give water to drink if casualty is conscious 5. Call for emergency medical assistance 6. Avoid hot environmental conditions

Heat Stroke 1. Call for help immediately 2. Follow DRSABCD 3. Remove hot environmental conditions 4. Cool the skin with moisture and/or fanning 5. Apply wrapped ice packs to neck, groin and armpits Dehydration Dehydration is caused by the body’s loss of fluids from prolonged exposure to heat and humidity. A prolonged period of dehydration will lead to shock in the very young and the elderly which can be fatal. Signs and symptoms; 1. Pale, clammy skin 2. Rapid breathing 3. Profuse sweating 4. Thirst 5. Loss of skin elasticity 6. Sunken eyes in children

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First aid management; 1. Rest in the shade 2. Remove unnecessary clothing 3. Cool water to drink 4. Give assistance when recovered

ENVENOMATION First aid management; Pressure Immobilisation – use for snake bites, funnel web and mouse spiders, blue ring octopus, cone shell and allergic reactions to any bite of sting. 1. Ice or cold pack – use for bee stings, scorpions, red back spider and ant bites 2. Hot fluid – use for stonefish, stingray and bluebottle stings 3. Vinegar – use for jellyfish stings

POISONING Poisoning may occur in a variety of circumstances such as: •


Skin (chemical contamination)

Eye (splash)

Inhaled (gas fumes), and


Signs and symptoms; •

Abdominal pain


Nausea, vomiting

Burning pains from mouth to stomach

Difficulty breathing

Tight chest

Blurred vision

Skin discolouration, blue lips

Sudden collapse

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First aid management; Follow DRSABCD If unconscious; Call 000 for ambulance If conscious; 1. Reassure casualty 2. Try to determine source of poisoning 3. Do not induce vomiting 4. Call 000 for ambulance 5. Call 13 11 26 for Poisons Information Centre

Drug and alcohol misuse Drug and alcohol misuse, either accidental or deliberate, may lead to intoxication or poisoning. When dealing with drug and alcohol misuse: •

DO NOT put yourself at risk

DO NOT approach the casualty if you don't feel it is safe

DO NOT be judgmental (you could provoke hostility)

First Aid Management 1. DRSABCD 2. Call 000 for an ambulance 3. Reassure casualty 4. Be aware of contaminated needles 5. Remove any potential weapons from the vicinity if possible 6. Seek information: a. Drug used & quantity b. Monitor c.

Check for any injuries/seizure

d. If possible keep a sample of vomit to send to the hospital e. Keep substances/containers for identification

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Suddenly cry out/out burst

Eyes rolling up

Fall to the ground

Blue face and neck

Displaying jerky, spasmodic muscular movements

Froth at the mouth

Bitting the tongue

Lose control of bladder and bowel


First aid management; 1. Check breathing and circulation Follow DRSABCD 2. Protect casualty from injury 3. Do not restrain or restrict movement 4. Do not place anything in the mouth 5. Place casualty on their side in the recovery position as soon as possible or during convulsion for infants For infants; 1. Always seek medical aid For children and adults 1. Manage injuries sustained 2. Do not disturb the casualty if they fall asleep 3. Continue to check for signs of life 4. Seek medical aid if seizure lasts for more than 5 minutes, another seizure quickly follows or the casualty is injured

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EYE INJURY First aid management; 1. Support head as still as possible 2. Ask casualty to try not to move or rub eyes 3. Flush infected eye with cool, flowing water 4. Place sterile dressing and bandage over eye 5. If it is a penetrating eye injury, place dressing around object and bandage around 6. Seek medical advice or call 000 for ambulance Do not; •

Touch the eye

Rub the eye

Remove any object penetrating the eye

Apply pressure when bandaging the eye

Ear Injury The ear has two functions which are hearing and balance. The eardrum is easily damaged by: •

Children inserting small objects




First aid management; Obstruction: 1. If an insect attempt to float it out with warm water 2. DO NOT INSERT ANYTHING IN THE EAR i.e. cotton bud Ruptured eardrum; 1. Cover affected ear 2. Seek medical advice


Localised pain

Difficult or impossible normal movement

Loss of power

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Discolouration and bruising

It’s sometimes difficult to tell the difference between fractures, dislocations, sprains and strains → if in any doubt treat as a fracture.

First aid management; 1. Follow DRSABCD 2. Control bleeding and cover wounds 3. Check for signs of a fracture 4. Ask casualty not to move the injured part 5. Immobilise fracture a. Bandage the injured part with wide bandages if available. Ensure bandages cover above and below the fracture b. Use a splint if available, using pads to naturally shape the body c.

Check that the bandage is not too tight, or loose every 15 minutes

d. Immobilise arm in a sling for a collar-bone fracture 6. Watch for signs of loss of circulation to hand or foot 7. Call 000 for ambulance Sprains and strains; 1. Follow DRSABCD 2. Follow RICE method; R

→ Rest


→ Ice


→ Compression


→ Elevation

3. Seek medical aid

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HEAD INJURY Signs and symptoms •

Altered, abnormal response to commands and touch

Wounds to scalp or face

Blood or clear fluid coming from the nose or ears

Unequal pupils

Blurred vision

Memory loss

First aid management; 1. Follow DRSABCD a. Ensure airway is maintained 2. Support head and neck a. In case spine is injured 3. Control bleeding a. Dress with a sterile dressing b. Apply direct pressure unless there is the possibility of a skull fracture c.

If blood or fluid is coming from the ear, secure a loose dressing over the ear and allow it to drain

d. Wear gloves to protect from infection e. Reinforce dressing as needed if bleeding continues 4. Lie casualty down with head and shoulders slightly raised 5. Call 000 for ambulance

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ASTHMA MANAGEMENT Asthma describes the condition of difficult breathing with associated distress. This occurs when the smaller airways become inflamed and swollen when exposed to certain aggravating factors. Asthma is common in children and there is a strong link between asthma and other allergies. Signs and symptoms; •

Wheezing (chest may be silent in very severe asthma)

Chest tightness, sometimes coughing

Difficulty speaking due to wheezing

Rapid breathing


Many individual’s with asthma carry an asthma action plan. This is an individually tailored plan that helps the casualty and carers recognise and respond appropriately to the asthma. If you are in contact with people who suffer from asthma ensure you are aware of their action plan. First aid management - If unconscious 1. Follow DRSABCD 2. Call 000 for ambulance First aid management – If conscious 1. Make casualty comfortable a. Usually sitting upright and forward b. Ensure adequate fresh air c.

Tell casualty to take slow, deep breaths

2. Help with administration of medication – use casualty’s normal medication if available. Otherwise, Ventolin or Bricanyl may be used a. Administer 4 puffs of a blue inhaler & use a spacer if available b. Take 4 breaths c.

If no improvement after 4 minutes give another 4 puffs

3. If attack continues a. Call 000 for ambulance b. For a severe attack keep giving 4 puffs every 4 minutes

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Epipen auto-injector pen • Contains one metered dose of Epinephrine, also known as Adrenaline •

Be familiar with the person’s individual action plan

Use the Epipen immediately if signs and symptoms of anaphylaxis occur

Grip the middle of the Epipen

The black or orange tip contains the needle – hold this away from the body except when injecting into the casualty

Unscrew the cap and slide the Epipen out of the carry tube

Hold the Epipen in your fist with your thumb closest to the grey or blue safety cap

Remove the grey or blue safety cap to activate the Epipen

Hold the Epipen at a 90 degree angle to the fleshy upper outer part of the thigh

Place the black tip gently on the thigh

Press the black tip hard into the thigh until a click is heard or felt. Hold there for 10 seconds

Remove the Epipen carefully, avoiding the now exposed needle. Epipen with an orange end automatically covers the needle after use.

Gently rub the thigh for about 10 seconds

The Epipen viewing window should now be red to indicate the medication was administered

Each Epipen can only be used once, even if there is still Epinephrine left in the syringe

IMPORTANT NOTE: You need to check the expiry date before using the Epipen or Anapen. If the Epipen or Anapen has expired, and the fluid is still clear, and is not cloudy or have substances floating in them, you are able to still use this.

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DIABETES Diabetes is a condition where there is an imbalance of sugar in the blood. The pancreas is the organ that produces insulin to regulate the level of blood sugar. Hypoglycaemia (Low blood sugar) This is the most common type where there is insufficient sugar in the bloodstream. Its onset is rapid. The casualty may become unconscious and if untreated death may follow in hours. Signs and symptoms; •







First aid management; 1. Call 000 If conscious: 1. give 5 jelly beans 2. 3 glucose tablets 3. 150 ml of sugared drink 4. Repeat after 5-10 minutes if no improvement If unconscious: 1. Place in the recovery position 2. Do not give Insulin injection 3. Do not give any food or drink Hyperglycaemia (High blood sugar) This is where there is too much sugar in the bloodstream. Signs and symptoms; •

Hot skin


Passing large amounts of urine

Breath has sweet smell


Unconsciousness progressing to coma

First aid management; 1. Seek medical attention 2. When in doubt treat for low blood sugar

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Important note:- Casualties with diabetes will generally recognise the symptoms themselves. For a casualty with high blood sugar you can allow them to self-administer insulin. However as a First Aider do not administer this yourself. You are able to provide assistance to the casualty if required.

STROKE A stroke is where there is a blocked or bleeding blood vessel to the brain. This should be treated to the same emergency as a cardiac arrest (heart attack). Signs and symptoms: •

F-A-S-T Facial weakness. Can the casualty smile? Arm weakness. Can the casualty raise both arms? Speech problems. Can the casualty speak clearly and understand what you says Time to act

First Aid management; 1. Call 000 if the casualty fails any one of the FAST test 2. Place in a comfortable position 3. Maintain airway (mucus) 4. Reassurance 5. Recovery position if unconscious

DROWNING Drowning occurs when there is submersion in liquid which causes lack of oxygen It is a common cause of accidental death. Do not attempt a rescue beyond your capabilities and where possible take a floatation device. Do not resuscitate in deep water. Signs and symptoms; •

Pale and bluish skin

Absent or laboured breathing


Decreased level of consciousness

No signs of life

First Aid management; 1. Call 000 2. Check airway and breathing 3. Give rescue breaths only if unable to remove victim from water 4. Commence CPR

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5. Recovery position when breathing restored 6.

Assess for spinal injuries and treat if required


Assess for hypothermia and treat if required

NEEDLE STICK INJURY The principal risk associated with needle-stick injuries is with blood borne viruses such as HIV (AIDS), Hepatitis B and Hepatitis C. Reduce the risk by: • Observing for danger (drug misuse/diabetics) •

Follow safety procedures if in the workplace

Never recap a used needle

Dispose of needles in puncture proof sharps approved container

If you do receive a needle-stick injury: •

Wash immediately

Report incident of in the workplace

Seek medical advice for testing and support

MENINGOCOCCAL DISEASE About Meningococcal Disease •

Acute bacterial infection

Death can occur within hours if not recognised and treated in time

Transmitted by saliva – sneezing, coughing, kissing, sharing food / drinks

Those most at risk include; o

Babies and children up to age 5 (up to 2/3 of cases)


Teenagers and young adults 15 – 25 years

Increased risk where children and young adults are in close contact

Increased risk during winter and early spring

Wide range of symptoms make it difficult to detect early

No common set of symptoms and no order

Many deaths have occurred due to delayed diagnosis

Early Signs and Symptoms; • Fever, cold shivers •

Cold hands and feet

Fatigue, lethargy, drowsiness

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Not all First Aid events are traumatic, however it is important to debrief as soon as possible as First Aiders are not immune from feelings of grief and fear. The intent of a debriefing is to offer psychological support after an event. People react to a traumatic incident differently and will most likely exhibit a range of emotional responses that may manifest much later after the event, these responses can include: • • • • • •

Lack of sleep Irritability for no apparent reason Depression Fear Flashbacks Headaches

These responses are normal to an abnormal situation such as a major incident or death of a casualty. First aiders are encouraged to seek help and to talk about their experiences when they are ready and to recognise any of the above responses sooner rather than later.

Self-evaluation will enable the first aider to assess their actions during and post the first aid they have provided. Some questions that a first aider could ask themselves are: • • • • •

How well did I manage the incident? Did I assess the injuries in a timely and efficient manner? Did I apply the correct first aid management technique? Did I manage the stress in a positive manner? Did I communicate in a way that was easily understood?

Self-evaluation is a tool that will promote deep understanding of strengths and areas for improvement. First aiders who carry out this technique often successfully handle the stress of traumatic events and can then constructively participate in an evaluation meeting with their supervisor or clinical director What do you need to self- evaluate? 1. Time ensure you allow about an hour to complete the self‐evaluation. 2. Quiet conduct the self‐evaluation in a quiet place without interruptions 3. Be objective Accept that not everything you have done was right. 4. Action plan - The self‐evaluation is a good opportunity to identify specific ways to improve your

performance Once the self‐evaluation has been carried out, seeking feedback from others is the next step to improve the first aiders’ knowledge and skills, ensure currency of treatments and used for ongoing improvement

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INFECTION CONTROL AN IMPORTANT NOTE FOR FIRST-AIDERS Infectious diseases are transmitted via a number of ways including exposure to infected blood or other body fluids, via airborne contaminants or via skin to skin contact. Infection Control describes actions taken to prevent cross-infection between people. When providing first aid it is important to avoid cross infection between the casualty and the rescuer. First aiders should assume that everyone is potentially infectious.


Wash and dry hands (before, if situation permits) and after performing first aid, especially in cases where there is an open wound or the possibility of being exposed to any blood or body fluids

Wear gloves when treating open wounds and change gloves between different people

If you are exposed to another person’s blood or body fluids, wash the area thoroughly with soap and water

MEDICAL EQUIPMENT When administering First Aid the responder may have the following equipment available; •

Home/office First Aid Kit

Car First Aid Kit

Fire blanket

Automated External Defibrillator

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OCCUPATIONAL HEALTH & SAFETY (WHS) AND MANUAL HANDLING WH&S is where all employees and managers have a responsibility to work safely, taking reasonable care for their own health and safety and of other persons who may be affected by their actions Manual Handling refers to the moving or “handling” of people or any inanimate object. When providing First Aid, it is important to follow safe manual handling procedures to avoid injury to yourself and the casualty.

APPROACHING A MANUAL HANDLING TASK Emergency situations are not routine therefore any manual handling required will not have been previously identified, assessed and controlled to reduce the risk of injury. First aiders should quickly assess any risks. Ask yourself; •

Is it absolutely necessary to move the casualty or object

If movement is necessary, can it be moved safely? Is the size, weight or shape a problem?

Also consider; • Can I move the casualty / object alone? •

Do I need equipment or assistance?

Is there enough room?

While performing manual handling always remember; • Never lift and twist •

Always use your legs to get you to the level of the load

Never bend, always squat

Keep your back as straight as possible

Hold heavy items as close as possible while lifting and carrying.

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REFERENCES AND USEFUL LINKS Anaphylaxis Australia; www.allergyfacts.org.au Asthma Foundation; www.asthma.org.au Australian Resuscitation Council; www.resus.org.au Australian Government, Department of Health and Ageing; www.health.gov.au Better Health, www.betterhealth.vic.gov.au Kidsafe WA; www.kidsafewa.com.au Meningococcal Education; www.meningococcal.com.au National Asthma Council; www.nationalasthma.org.au St John’s Ambulance; www.stjohn.org.au Victorian Centre for Early Defibrillation; www.vced.org.au

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