first aid treatment presenation for 30082014.pdf

8/11/2019 First Aid Treatment Presenation for 30082014.pdf

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First Aid Treatment

DR. MOHAMED JOWHAR

PEGAWAI PERUBATAN, UKM

PUSAT KESIHATAN

UNIVERSITI KEBANGSAAN MALAYSIA


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Being a First Aider

Doing Your Best

A casualty may not respond as you hoped, some

conditions are inevitably fatal, even with the best medical

care.

Assessing Risk

First do no harm,

Calculated risk,

Do not use treatments that are not sure about, just for the

sake of doing something.


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GIVING CARE WITH CONFIDENCE

Being in control both of your own reaction & of theproblem,

Acting calmly &logically,

Being gentle but firm, Speaking to casualty kindly but in

clear& purposeful way.

Building up Trust,

Talking to relatives,

Coping with children


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Looking after yourself

Personal safety -Do not put yourself at risk,

The fight or flight response- increase heart rate&

breathing, sweating,

Staying calm-remember first aid procedures.

Feelings after an accident

Satisfaction & pleasure,

Confusion & doubt,

Anger & sadness.


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Recordingfirst aid treatment

name, address, occupation, date& time,

place & circumstance of accident,

details concerning & treatment given

Actions at an EmergencyAssess the situation,

Make the area safe,

Give emergency aid,

Get help from others.


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Topics for today Discussion

Fever

Common Cold-Upper Respiratory Tract Infection (Flu)

Dyspepsia/Gastritis/Peptic Ulcer

Diarrhea

Dysmenorrhoea (Peroid Pain)

Headache

Back Pain

Sport Injury

Bruising /Abrasions/ Lacerations

Head Injury

Eye injury

Severe Bleeding

Burns

Shocks

observe Unconscious patient

Anxiety /Hyperventilation/Panic Attack

Acute Asthma Attack

Anaphalytic Reaction

Ebola Virus


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Confused

Sleepy

Boring

Alert


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FEVER Oral Temperature >37.2.C, Ear drum T >37.7.C,

Is a sign of disease and occurs in response to infection (mainly

viral)

Abrupt onset of fever with chill and rigor is a feature of some

disease.

Treatment

Paracetamol 500mg 2 tablets 3-4x/day

High fever- Tepid sponging for first 30minutes combined withParacetamol.

Adequate fluid intake/increased fluid 2-3Litre/day-frequent

small drinks of light fluids/water

Dress in light clothing, do not over heat with too many clothes


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Common Cold-Upper Respiratory Tract

Infection (Flu)

Tiredness

Running nose, Sneezing

Sore throat

Slight Fever

OthersHeadache, Hoarseness, Cough

Treatments

Rest

Drink ample amount of Water Stop Smoking

Steamed Inhalation-with Menthol

Medicines-Paracetamol, cough syrupBena Expectorant


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Dyspepsia/Gastritis/Peptic Ulcer

More common in Male, Smoking, Stress, Medication with pain

killers, H.pylori infection

Dyspepsia( Indigestion)

Pain or discomfort centered at upper abdomen

Heartburn due to acid regurgitation

Water brash

Gastritis

Pain m/b severe, +/- vomiting, related with meal

Peptic Ulcer (Gastric Ulcer/Duodenal Ulcer)

Ulcer in Stomach or in Early part of Small Intestine


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Treatment

Stop smoking, alcohol and coffee drinking

avoid unnecessary use of pain killer

Avoid spicy and pickled foods

Small and frequent intake of easily digestable food at the

time of disease

Followed by of regular meals

Antacidseg., gelucil, zellox & relcers syrups


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Diarrhea

Frequent passage of loose/watery stools

BacterialDiarrhoea.Acute Gastroenteritis,

Viral DiarrhoeaRota Virus in children

Antibiotic Reactioneg., Penicillins

Irritable bowel syndrome (Chronic Diarrhoea)spicy food, milk

Awareness for Signs of Dehydration

Sunken eyes, skin turger, peripheral pulse, Blood Pressure

Fluid ReplacementORS, Increased fluid intakecoconut water, fruit juice,

Health Education


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Dysmenorrhea (Period Pain)

Period pain in reproductive age of femaleLow midline abdominal pain

Varies from to dull to severe cramping pain

Usually lasts for 24hrs up to 2-3 Ds

Asso with nausea and sometimes vomiting


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Period Pain Management

Promote life style-exercise, stopped smoking and alcohol,

relaxation techniques

Place hot water bottle over painful area

Avoid extreme cold

Medicationeg., Ponstan


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HeadacheTension Headache

Tension or muscle contraction headache

Lasts for hours and recurs each day

Associated with cervical dysfunction and stress or tension

Migraine

sick headache-10%, > in female

Pain usually half of the head, +/- eye pain

Classic Migraine-Headache, vomiting and aura

Common Migraine- Without aura

ManagementExplanation and reassurance

Advise stress reduction-relaxation, meditation

Avoid trigger factors-food (chocolate, cheese, nuts, coffee), moving

round, watching TV

Medication


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Back Pain

Mechanical back pain 72%

Pain at rest, relieve at activity- Inflammation

Pain provoked by activity, relieved with rest- Mechanical dysfunction

Pain with standing/walking, relieve on sitting- Spondylolisthesis

Stiffness at rest, pain with or after activity, relief with rest-Osteoarthritis

Treatment

No bed rest-normal daily activity in 2 days

Regular simple analgesics (PCM)

Swimming


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Sports Injury/MVA

Musculoskeletal Injury/Pain(PRICE)

Protect

Rest

Ice

Compression

Elevation


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Bruising /Abrasions/ Lacerations

Bruising (contusion) -caused by a blunt force trauma

that damages tissueunder the skin, bleeding in

subcutaneous or deeper tissue while leaving the skin

basically intact.

Abrasions (grazes)-superficial wounds in which the

topmost layer of the skin(the epidermis) is scraped off,

common with motor vehicle accident.

Lacerations - Lacerations, irregular tear-like wounds

caused by someblunt trauma.
http://en.wikipedia.org/wiki/Biological_tissuehttp://en.wikipedia.org/wiki/Skinhttp://en.wikipedia.org/wiki/Blunt_traumahttp://en.wikipedia.org/wiki/Blunt_traumahttp://en.wikipedia.org/wiki/Skinhttp://en.wikipedia.org/wiki/Biological_tissue


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Management

RICE- Rest, Ice, Compression, Elevation (large

Bruises/Haematomas)

Clean /remove all ground- in dirt, metal,clothing and other

material(Abrasions/Lacerations)

Scrub out dirt with sterile water

Clean with Acraflavine solution,apply protective

dressing(some wound may left open

Immobilise a joint that may be affected by a deep wound( eg.

Arm sling)

Analgesic- Paracetamol/Ponstan


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Head injury

Control bleeding- put glove , replace skin flap,

Non fluffy pad over wound

Secure dressing with bandage

Help casualty to lie down-head & shoulders

slight raise

Dial ambulance


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Eye injury

Support casualtys head-hold head on your

knees , Keep eye still

Give eye dressingdressing , keep uninjured

eye close

Send to hospital


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Severe bleeding-Eg.MVA

Apply pressure to wound-direct pressure towound , pad before bandage

Raise & support injured part-raise above heart

Wound bandage-secure bandage firmly, check

circulation

Dial for Ambulance

Treat for shock , monitor casualty-vital signs-

level of response, pulse, breathing


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Burns

Cool Burn-pour cold liquid/water for 10mins

Watch for smoke inhalation- difficult

breathingRemove any constrictions-put glove, do not

apply lotion, ointment, do not touch , do not

remove sticks to burn

Cover Burn-dressing

Send to Hospital


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Unconscious patient Completely unresponsive to any stimulus.

1.Blackouts{episodic (transient) loss of consciousness}- dizziness, weakness

2.Epilepsysteps-- aura, initial rigid tonic phase, convulsion, drowsy, with tongue

biting, incontinence urine/faeces

3.Syncopetransient loss of consciousness but with warning symptoms and rapid

return of alertness following a brief period of unconsciousness(seconds to 3

minutes)

(1) Vasovagal attack- with standing, dizzy, faintness, blurred vision, sweating

4.Chocking- suddenly cyanosed, while eating meat, speechless, grasps throat

5 D tt k bl k t dd l f ll i di t l t i iddl d


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5.Drop attack- blackouts, suddenly falls, immediately get up again- middle aged

women, Dx- vertebrobasilar insufficiency, Parkinsons disease and Epilepsy

6.Heart Attack- reduce blood flow to brain

7.Cardiac arrhythmias- elderly, sudden blackout in heart block,sick sinus

syndrome,ventricular tachycardia

8. Vertebrobasilar insufficiency- stroke, TIA-Transient Ischaemic attack(minor

stroke),

Hypoglycemia- lightheadedness,sweating, shaking,on Diabetics with insulin/oral

drugs

9. Head injuriesBrain injuries of Concussion, contusion, lacerations, skull fracture

10.Shock- reduce blood flow to brain

11. Poisoning

12.Meningitis


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Management

Keep the patient alive by maintaining airway and breathing and circulation(ABC)

Get the History from witness

Examine patient- Assess by checking level of response to stimuli using AVPU cod

A- Alert?, V- respond to Voice?, P- respond to Pain?, U- Unresponsive to any

stimulus

Check for ABC- open Airway using jaw thrust method, check Breathing,

Circulation, prepare to give chest compressions and rescue breaths

Bleeding- Apply direct pressure to the wound

Head injury should be treated as neck injury/spinal injury- use log- roll technique

Arrange removal of casualty to hospital if necessary, call to PK/Ambulance

Level of Response


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Level of Response

Eyes- Observe for reaction while testing other responses

Open spontaneously 4

Open to speech 3

Open to painful stimulus 2

No response 1

Speech - When testing responses, speak clearly & directly close to casualty ears

Response sensibly to questions 5

Seems confused 4

Uses inappropriate words 3

Incomprehensible sounds 2

No response 1

Movement -Apply painful stimulus, pinch ear lobe or back of hand

Obey commands 6

Points to pain 5

Withdraws from painful stimulus 4

Bends limbs in response to pain 3Straighten limbs in response to pain 2

No response 1

COMA SCORE = E+M+V

MINIMUN 3/15 , MAXIMUN 15/15

IF 8-10: TAKE CARE- MONITOR THE AIRWAY


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Asthma Attack-Action

Allow Casualty to use reliever(blue) inhaler-S/s-difficulty

breath/speak , wheeze, grey-blue lips & skin, exhaustion

Make casualty comfortable-sitting forwards & supporting

upper body by leaning arms

Encourage casualty to breath slowlyif attack not ease within

1-3min,encourage to take another dose inhaler to breath

slowly& deeply

For adults/children > 6 years old- 6-12 puff in every

20minutes(first hour)

One puff actuation at atime,4-5 normal breaths each time


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Anaphylactic Shock

Causes- Bee stings, food reactions- peanuts/fish, drugs

Treatment

1.Call Ambulance-pass info.-causes of allergy

2.Help to relieve symptoms-anxiety, puffy eyes, impaired

breathing , shock

3.Monitor Casualty-response , pulse, breath


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Before give medicine

Ask-

1.any drug allergy previously ?

2.Any disease?


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ADR Adverse drug Reaction)

DRUG SHOULD BE PRESCRIBED ONLY

WHEN THERE IS VERY GOOD

INDICATION FOR ITS USE.

CONFIDENCE COURAGE TO TELL

PATIENT WHEN A DRUG IS NOT

REQUIRED.


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Anxiety /Hyperventilation/Panic Attack

Anxiety-worry about various life circumstances

Hyperventilation-lightheadedness, dizziness, aerophagy,

hand spasm, sweating, palpitation

Panic Attack(Discrete period of intense fear ordiscomfort)-SOB, unsteady feeling, palpitation, shaking,

uncontrolled fear of doing something, +/- chest pain and

numbness


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Carta Alir Rawatan Di Kolej


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MANGSA

AHLI BSMM

RAWATAN AWAL DI TEMPAT

KEJADIAN

SERIUSRAWATAN LANJUT DI

BILIK RAWATAN

YA

MASAMASA

LAIN TELEFON DR.

ONCALL

WAKTU

BEKERJA

BAWA KE PUSAT

KESIHATAN UKM

RAWATAN OLEH DOKTOR

TIDAK

Carta Alir Rawatan Di Kolej

PENGGUNAAN UBAT-UBATAN


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Zellox suspension - sakit gastric,minum sebanyak 15ml( 2 -3penutup botol) x

3kali/hari.

Tab Actal/ GELUSIL- sakit gastric, 2bijix3 kali/hari,

Panadol- sakit kepala, badan sakit, demam-500mg 2 biji x3-4 kail/hari,

Ponstan 250mg - sakita kepala,badan, senggunggut dan sakit lain-con: terseliuh, 2

biji x 3 kal

Ultracarbon/Eucarbon- Keracunan makanan ringan& cirit- birit, 1 bijix3

kali/hari,

ORS(Oral Rehydration Solution) - 250ml air masak/mineral bagi sebungkus,

Menzza cream -sakit otot, sendi,terseliuh & kekejangan otot- sapukan

Burnol plus cream - luka kecil, ruam,melecet dan gigitan serangga-sapukan

Flavine/Acraflavine lotion - antiseptic,luka sahaja

Calamine lotion- alergi kulit,ruam& kulit gatal


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Ebola Virus


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first aid treatment presenation for 30082014.pdf

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