First Aid

First AidBy: Mary Anne MejiaFirst Aid Review77.1702

(a) Each operator of a surface coal mine shall make arrangements with a licensed physician, medical service, medical clinic, or hospital to provide 24-hour emergency medical assistance for any person injured at the mine.

(b) Each operator shall make arrangements with an ambulance service, or otherwise provide for 24-hour emergency transportation for any person injured at the mine.

First AidScene SafetyMake sure the area is safeWhat caused the injury or accident?Ensure Personal Safety Protect yourself with gloves, masks, before you act.You wouldnt work with toxic chemical without the proper protection would you?

3First AidPatient AssessmentPrimary SurveyABCs and severe bleedingLife Threatening conditionsSecondary SurveyDEThorough Head to toe hands on examination for wounds, burns, musculoskeletal injuries and anything else that will require treatment.

4First AidPatient AssessmentA (Airway)Assess for unresponsivenessOpen the Airway (Head tilt-Chin lift)B (Breathing)Look, Listen and Feel for BreathingIf not breathing, give two normal breathsC (Circulation)Check Pulse at Carotid Artery (5-10 seconds)If no pulse, start chest compressions

5First AidPatient AssessmentDAssess for DeformityHands on; Head to toe Examination for all other injuries and conditions that will require treatmentEExposeIf you cant see it, you cant treat it

6First AidCPR and Rescue BreathingABCsRatio30 compressions to 2 breaths1 breath every 5 secondsRateHard and Fast12 breaths per minute

7First AidControl of BleedingDirect Pressure95%Elevation97%Pressure Points99%TourniquetLast resort 1%

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First Aid BurnsDegreeFirst (Superficial)Second (Partial Thickness)Third (Full Thickness)TreatmentRemove heatPrevent contaminationOver Bandage; loosely

1213Burns Degrees of BurnsThird-degree burn layers of skin are burned.There is discoloration.Some skin may beThese burns can beManyseverecharred.life threatening.Firsd Aid Skills1314Third-Degree Burn

Third Degree BurnDamage extends deeper into tissues (epidermis, dermis, and hypodermis) causing extensive tissue destruction. The skin may feel numb.Full thickness burn with tissue damageFirsd Aid Skills1415Heat Burn TreatmentGo through RAP ABCH first, then ask if burn was caused by heat.Determine degree and amount of burn.If it is a third-degree burn or large second-degree burn, use the ABCH, then treat for shock.Do not attempt to pull off the clothing because skin may come with it.Firsd Aid Skills1516Heat Burn TreatmentCut it off if attached to the skin.Apply a sterile dressing and elevate.Seek immediate medical attention.Burn is first-degree or small second-degree, apply cold water/compress until pain stops.If you must use ice, provide a barrier.Do not apply an ointment.Firsd Aid Skills1617Chemical Burn TreatmentDetermine if burn was caused by a dry chemical.If so, brush it off, remove clothing, wash area fifteen to twenty minutes.If not caused by dry chemical, remove clothing and jewelry, wash area for fifteen to twenty minutes.Seek medical attention in both cases.Firsd Aid Skills1718Electrical Burn TreatmentIf burn is not chemical, then its an electrical burn.Is victim in contact with electrical source, are you at risk.If yes, ask adult to turn off power.May entail calling 911 to have then call appropriate person.Treatment same as heat burn.Firsd Aid Skills1819Electrical Burn TreatmentIn all cases, monitor wound for signs of infection.Large wounds seek medical attention to reduce risk of infection.Serious burn, monitor for signs of shock.Firsd Aid Skills19

COOL!

REMOVEDRESS123burns treatmentdislocated kneecap

dislocated

normalopen fracture

Note the poor aseptic technique!open fractured wrist

First AidMusculoskeletal InjuriesSplintingImmobilize the joint above and the joint belowWhen in doubt, SPLINTElevateApply cold compressesDo we ever want to attempt to "straighten out a broken bone or fracture?

24First Aid ShockTreat for Shock on all patients from the beginning.Shock can kill, even though the injuries wouldnt.Be calm and reassuringKeep the patient warmElevate feet, if no back or head injuries.

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First AidRequirement: A Mine MUST have 1 person on every shift capable of performing emergency first aid. With proof thereof.eye / face laceration

finger laceration

Fingertip amputation

laceration

31PoisonsPoisons can enter the body one of four ways: Inhalation Ingestion Injection AbsorptionFirsd Aid Skills31Use overhead with MLR 4a Poisons and Bites flowchart on it to illustrate each area.Next slide will start on left side with poison ivy (Absorption).

33Poisoning TreatmentPoisonous injections: i.e. Snakebites,Identify the snake, if possible.Then clean the bite with soap and water and keep bite below heart level.Seek medical attention.Firsd Aid Skills3334Poisoning TreatmentIf the poison is inhaled or swallowed;Check "ABCH" and treat for shock.Seek medical attention and call the Poison Control Center1-800-222-1222Firsd Aid Skills34Poison Control number is nationwide.

36If possible, try to catch the spider or insect without risk to you.Check to see if the stinger is in the skin.If not, Clean the area, apply ice to reduce swelling.Insect Bite or Sting TreatmentFirsd Aid Skills3637Insect Bite or Sting TreatmentIf stinger is found, gently scrape the stinger out of the wound using a plastic card or fingernail, pulling away from the wound to minimize amount of toxin released into the body.Do not squeeze stinger. Treat wound as a minor cut.

Firsd Aid Skills3738Insect Bite or Sting TreatmentNext, check to see if the victim is allergic to the bite.Look for signs of shock and swelling.If no, then seek medical attention or an adult for assistance.If yes, check ABCH, treat for shock, and immediately seek medical attention.Firsd Aid Skills38

Here's How:Stay Safe. Secure the dog or the victim. Move one away from the other. If the dog's owner is around, instruct him or her to secure the dog. If not, move the victim to a safe location. Dogs may bite because their territory is threatened. Don't start any treatment until there is a reasonable expectation that the dog won't attack again.If you are not the victim, practiceuniversal precautionsand wearpersonal protective equipmentif available.Control any bleedingby following the appropriate steps. Avoid using atourniquetunless there is severe bleeding that cannot be controlled any other way.Dog BitesOnce the bleeding is controlled,clean the woundwith soap and warm water. Do not be afraid to clean inside the wound. Be sure to rinse all the soap away, or it will cause irritation later.Cover the wound with a clean, dry dressing. You can put antibiotic ointment on the wound before covering. Watch for signs ofinfection:RednessSwellingHeatWeeping pusAlways call a physician to determine if you should be seen. Some dog bites need antibiotics, particularly if they are deep puncture wounds. Additionally, many municipalities have regulations for reporting dog bites and monitoring the dogs, and that is often initiated by contact with a doctor.Any unidentified dog runs the risk of carrying rabies. If the dog cannot be identified and the owner cannot show proof of rabies vaccination, the victimmustseek medical attention. Rabies is always fatal to humans if not treated.Thewound may need stitches. If the edges of a laceration are unable to touch, or if there are any avulsions, the wound will need emergency medical attention. Wounds on the face or hands should be seen by a physician because of the likelihood of scarring and loss of function.

KEEPING A BROKEN BONE STILL

The victim will often have put the injured part in the position that is most comfortable for him and will generally be guarding the injury and keeping it still. If the victim has not done this, encourage him to keep still and help him into a comfortable position.

Once the victim is still you can help to steady and support the fracture using your hands. By helping the victim keep the injured part still you enable him to relax. The very act of relaxing the muscles reduces on the broken bones and often alleviates pain.FractureIf you have to transport the victim yourself, or if it is going to be a while until help arrives, then you can immobilize the broken bone further with bandages or improvise with coats or blankets, for example.The key points to remember with any type of bandaging are:Not to tie the bandage too tightly.To pad around the site of the break.Do not move the injured part area unnecessarily.Place the dressing over the wound and build up padding along side the bone.Tie both the padding and the dressing in place, using firm pressure.Remember that broken bones do swell and that you may need to loosen the bandage if the circulation below the site of the break becomes impaired.TREATMENT OF OPEN BREAKS

In the first instance, the wound should be protected using either a sterile dressing or an improvised dressing made from a piece of clean, dry, and non-fluffy material. If the bleeding is profuse, or you are going to have to wait some time for further help, this dressing should be held in place using the same principles as you would apply if there were a foreign object in the wound.

CHECKING FOR DAMAGE TO CIRCULATIONWith any bandaging, you run the risk of cutting off the circulation to the area below the site of the bandage. While this can in part be avoided by no tying bandages too tightly and by never using a tourniquet, the nature of wounds means that they swell and this can cause once satisfactory bandage to become too tight. There are a number of ways to check whether a bandage is cutting off the circulation:If the skin below the site of the bandage becomes white, gray, or blue, or feels cold to the touch.If the victim complains of tingling, numbness or of a lack of circulation.If the pulse in the limb slows or stops.If the color does not quickly return to the skin after the skin is gently pinched or the nail compressed.If you noticed any of these signs, gently loosen, but do not remove, the bandage until the blood flow returns.

Choking occurs when a foreign object becomes lodged in the throat or windpipe, blocking the flow of air. In adults, a piece of food often is the culprit. Young children often swallow small objects. Because choking cuts off oxygen to the brain, administer first aid as quickly as possible.The universal sign for choking is hands clutched to the throat. If the person doesn't give the signal, look for these indications:Inability to talkDifficulty breathing or noisy breathingInability to cough forcefullySkin, lips and nails turning blue or duskyLoss of consciousnessChokingIf choking is occurring, the Red Cross recommends a "five-and-five" approach to delivering first aid:

Give 5 back blows. First, deliver five back blows between the person's shoulder blades with the heel of your hand.Give 5 abdominal thrusts. Perform five abdominal thrusts (also known as the Heimlich maneuver).Alternate between 5 blows and 5 thrusts until the blockage is dislodged.The American Heart Association doesn't teach the back blow technique, only the abdominal thrust procedures. It's OK not to use back blows, if you haven't learned the technique. Both approaches are acceptable.

To perform abdominal thrusts (Heimlich maneuver) on someone else:Stand behind the person. Wrap your arms around the waist. Tip the person forward slightly.Make a fist with one hand. Position it slightly above the person's navel.Grasp the fist with the other hand. Press hard into the abdomen with a quick, upward thrust as if trying to lift the person up.Perform a total of 5 abdominal thrusts, if needed. If the blockage still isn't dislodged, repeat the five-and-five cycle.If you're the only rescuer, perform back blows and abdominal thrusts before calling 911 or your local emergency number for help. If another person is available, have that person call for help while you perform first aid.If the person becomes unconscious, perform standard CPR with chest compressions and rescue breaths.To perform abdominal thrusts (Heimlich maneuver) on yourself:First, if you're alone and choking and you have a landline phone, call 911 or your local emergency number immediately. Then, although you'll be unable to effectively deliver back blows to yourself, you can still perform abdominal thrusts to dislodge the item.Place a fist slightly above your navel.Grasp your fist with the other hand and bend over a hard surface a countertop or chair will do.Shove your fist inward and upward.Clearing the airway of a pregnant woman or obese person:Position your hands a little bit higher than with a normal Heimlich maneuver, at the base of the breastbone, just above the joining of the lowest ribs.Proceed as with the Heimlich maneuver, pressing hard into the chest, with a quick thrust.Repeat until the food or other blockage is dislodged or the person becomes unconscious.Clearing the airway of an unconscious person:Lower the person on his or her back onto the floor.Clear the airway. If there's a visible blockage at the back of the throat or high in the throat, reach a finger into the mouth and sweep out the cause of the blockage. Be careful not to push the food or object deeper into the airway, which can happen easily in young children.Begin cardiopulmonary resuscitation (CPR) if the object remains lodged and the person doesn't respond after you take the above measures. The chest compressions used in CPR may dislodge the object. Remember to recheck the mouth periodically.Clearing the airway of a choking infant younger than age 1:Assume a seated position and hold the infant facedown on your forearm, which is resting on your thigh.Thump the infant gently but firmly five times on the middle of the back using the heel of your hand. The combination of gravity and the back blows should release the blocking object.Hold the infant faceup on your forearm with the head lower than the trunk if the above doesn't work. Using two fingers placed at the center of the infant's breastbone, give five quick chest compressions.Repeat the back blows and chest thrusts if breathing doesn't resume. Call for emergency medical help.Begin infant CPR if one of these techniques opens the airway but the infant doesn't resume breathing.If the child is older than age 1, give abdominal thrusts only.

To prepare yourself for these situations, learn the Heimlich maneuver and CPR in a certified first-aid training course.