Basic Principles of First Aid

Betty Fitzpatrick, RN, NCSN

Regional School Nurse Consultant/Liaison

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First Aid

First Aid vs. Emergency Child’s view Your view Teacher’s View Parent’s View Principal’s View

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911: To Call or Not To Call

Do you have the information and

equipment you will need?

Is the situation getting worse?

Have you notified the principal?

Have you documented your care

appropriately?

Can you reach the student’s family?

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911: To Call or Not To Call

When the student is having increasing trouble breathing or has stopped breathing

Severe blood loss, uncontrolled Loss of consciousness First seizure, or lasts longer than 5

minutes When you have used an epi-pen Severe burn

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Do you know CPR?

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For Most Injuries, Ice Can Be Your Best Friend

Ice applications: Blue gel or chemical packs;

Freezer Ziplok bags with frozen sponge, washcloth, or ice cubes; Popsicle for the mouth

Use a thin layer of cloth or paper towel between ice and the skin.

Apply 10-15 minutes every 30-60 minutes for pain or swelling

Do not use for burns!

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Cuts and Scrapes

Control bleeding using firm pressure and universal precautions

Clean thoroughly with soap and water Dress with gauze or a Band-aid Have a cut evaluated for stitches if:

longer than 1/4-1/2 inch fat or tissue protruding from cut on the face gaping open

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Bleeding

Always wear gloves (carry them with you) Apply direct, firm pressure, using gauze or a

clean cloth Elevate the area, if possible (above the

heart) Hold firm pressure for 7-10 minutes, without

stopping to “check” After bleeding controlled, clean the wound

and apply a dressing

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Arterial & UncontrolledBleeding

Arterial blood is bright red, and spurts with each heartbeat--Blood from a vein will be darker red, and flow steadily

If bleeding is arterial, or is uncontrolled after 10 minutes of firm pressure, have someone call 911

If anything is protruding from the wound, leave it, and tape a dressing to hold it in place

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Nosebleeds

Very common in children Have the student lean forward, not back Apply firm pressure--7-10 minutes Pinch the nostrils not bridge of nose Afterwards, do not let the child blow! Prolonged or recurrent nosebleeds

should be reported to parents for possible medical attention

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Fractures, Sprains and Dislocations

A fracture is a broken bone A sprain is an injury to the ligaments

around a joint A dislocation is when a bone slips out of

it’s socket. It takes an X-ray to tell the difference

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Do you have x-ray vision?

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Fractures, Sprains and Dislocations

Remember “PRICE”

P is for Protect: Splint in position found R is for Rest: Avoid further movement I is for Ice: To minimize swelling and

pain C is for Compress: Ace bandage, check

often E is for Elevate, above the heart

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Head Injuries

For minor head injuries Rest and Ice Back to class

Recheck in clinic in 1-2 hours for: Increasing headache pain Vision problems Memory loss

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Head Injuries

Symptoms that would indicate a more severe head injury, requiring medical attention are:

Loss of consciousnessClear fluid from nose or ear Vision or speech problems, unequal

pupils Inability to arouse from sleepVomiting 3 or more timesUnsteady gait, neck pain

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Neck and Spinal Injuries

Always suspect a neck or spinal injury if the child:

Has fallen more than 10 ft Has a bad head injury Does not get up quickly Tells you he has neck or back

pain

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Neck and Spinal Injuries

Do not move him if you suspect spinal injury

Someone else should call 911 while you stay with the child

If he vomits, roll him to one side, “like a log”, keeping his neck and back straight

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Allergic Reactions

Insect sting, food, medication, latex Remember the Three R’s:

Recognize symptoms React quickly Review what caused the reaction,

and how well the emergency plan worked

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Allergic Reactions

Signs of a severe reaction are: Intense itching, hives Facial swelling, especially eyes and lips Cough, hoarseness, or difficulty

swallowing Wheezing, more severe respiratory

difficulty Check emergency plan, follow directions

Give epi-pen immediately, if ordered Call 911, observe for breathing problems

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Shock

Shock can result from a severe injury, illness, or infection

The child may be disoriented, confused, or unconscious

Skin will be pale and clammy Shock results when the body sends

blood and oxygen to the most vital organs

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Shock

Call 911 Have child lie down and elevate or prop legs

12 inches or more

Keep the child warm and calm

Observe for further problems with breathing or circulation

Do not give child anything to eat or drink

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Burns

First aid is cold water Helps control pain, stop burning

process Do not use ice Dress with a clean bandage

Leave blisters intact If the burn is on the hand or face, or is

larger than the palm of the hand: Call parents to seek further medical

attention

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Seizures

A seizure is an episode of abnormal electrical activity in the brain

May vary from staring spells, to movement of one extremity, to a generalized or grand mal seizure

First aid for a child having a seizure is to prevent injury and observe for complications. A seizure management plan should be completed and on file

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Seizures

It is helpful to check the time, so you can tell parents or EMS how long it lasted

Do not put anything in the child’s mouth, but do speak calmly to him

When the seizure is over, the child will usually be sleepy. Turn him to one side

Call 911 if it is the first seizure or lasts longer than 5 minutes

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Eye Injuries

Foreign Bodies or Splashes Flush with large amounts of water for

15-20 minutes Cover the eye with a gauze dressing Don’t let the child rub, Call parents

For a penetrating eye injury Keep student lying flat Cover with a metal shield, or “cup” Call 911

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Heat Emergencies

Heat Cramps Move student to a cool place Give fluids (water) May try a gentle massage of cramped area

Heat Exhaustion: Headache, nausea, faintness, skin pale and clammy Move to a cool place, lie down Give sips of water (4 oz. every 15 minutes) Apply cool, wet cloths, fan Notify parents

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Heat Emergencies

Heat Stroke is a medical emergency: skin is red, hot, dry; high fever; disoriented; may have seizures, unconsciousness Transport to air-conditioned room Call 911, notify parents Sponge with water and apply cold

packs Do not give fever reducers Avoid exposure to extreme

temperatures for several days

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Dental Injuries

Broken or knocked out teeth Notify parents, child should see dentist or

ER within 1 hour if possible If bleeding, apply pressure If tooth is knocked out, find tooth, place in

a cup of milk or “Save a Tooth”, send with child

Do not rub or clean tooth Rinse mouth with cool water

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Bee Stings and Insect Bites

intense itching trouble breathing hives wheezing

hoarseness paleness difficulty swallowing facial swelling

•Remove Stinger by flicking it with a driver’s license or credit card•Apply ice or cold compress •Use Epi-Pen if you have one for this child, call 911

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Tick Removal

Remove the tick by pulling straight out with tweezers or your fingers

Wash with soap and water

Inform parent or caregiver This is NOT an emergency and does not need to

be treated immediately Provide follow-up information that includes

seeing a doctor if the child develops a rash, fever, or headache and possibly joint pain a week to 30 days after a tick bite

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Splinter Removal

Use Clean tweezers

If you see the object sticking out of the skin

grasp and gently pull out the same direction it

went in

No digging or doing anything invasive

Wash with soap and water

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Bumps and Bruises

Apply ice for 20 minutes

Elevate the area if possible

Do not break or open blood blisters

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Sunburn

Avoid direct sun between 10 a.m. and 3 p.m.

Recommend students bring sunscreen from

home to outdoor events

Treat sunburn with cool compress

Encourage extra fluids

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Reporting Accidents

All accidents that require medical attention should be reported to the school office.

Your County Student Accident Form should be completed by the person who witnessed the accident and the caregiver

This documentation should be completed the same day and reported within 24 hours

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Georgia Poison Center

When to call them: For any ingestion of a non-food item For a chemical splash or burn For an animal bite

And the numbers are: 404.616.9000 1.800.282.5846

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Questions?

Contact your school nurse