MSERT Stage I

5 things that can prevent people from getting involved in an emergency

1) Bystander Effect

2) Unpleasant Injuries or Illnesses

3) Fear of catching a disease

4) Fear of doing something wrong or causing more harm

5) Stigma or Bias

Bystander Effect

The assumption that someone else will get involved so you don’t have to

4 Roles of a First Aider

1) Recognize the Emergency

2) Protect yourself and others

3) Access help

4) Act according to your skills and training

Emergency Medical Services System

A network of community resources and trained personnel organized to give emergency care in cases of injury or sudden illness

When to call EMS

A person is unresponsive or has an altered mental state

A person is not breathing normally

A person has persistent chest pain or pressure

A person has life-threatening bleeding

A person has a seizure

A person has a head, neck, back, or pelvis injury

A person has an apparent mental health emergency

A person has an apparent mental health emergency

A person is not easily accessible or cannot be transported safely

Examples of PPE

Safety glasses, goggles, face masks, CPR breathing barriers, gloves

What questions should you ask when checking the scene?

Is the scene safe? Are there any hazards? What happened? How did it happen? How many ill or injured people are there? Is there someone that can help you?

Primary Assessment

1) Check whether the person is responsive

2) Check the person’s airways, breathing, and circulation

Signs of an open airway

Speaking, moaning, or crying indicates an open airway

How should you open the airway of an unresponsive person?

Perform a head-tilt/chin-lift

How long should you check for breathing for?

5-10 seconds

Signs of normal breathing

Air is moving in and out of the lungs, the chest is rising and falling

Agonal Respiration

A reflexive pattern of gasping for air that is indicative of lack of oxygen; treat the person as if they aren’t breathing

What three conditions are considered top priority emergencies?

Unresponsiveness, difficulty breathing, and life-threatening bleeding

Check, Call, Care

Check for responsiveness and breathing

Call 911 if an individual is unresponsive or has a life threatening condition

Care for any life-threatening conditions

What should you do after providing care and while waiting for EMS?

Monitor the person’s breathing, level of responsiveness, and overall condition

Help the person rest in a comfortable position

If necessary, roll the person into the recovery position

Keep the person from getting chilled or over heated

Reassure the person

Who should be put into a recovery position?

A person that is unresponsive or has an altered level of responsiveness (Ideally without a spinal injury)

What should you remember when putting someone into the recovery position?

Support and protect the head while rolling

Try to roll the person as one unit

Roll the person so that they stay safely on their side (hand supporting their head so they don’t aspirate)

Check the ABCs after you complete the roll

When can you help a person take their medication?

The person is responsive, the scene is safe, and the person has expressed a need for help finding or preparing their medication

Giving/Administering Medication

Directly delivering medicine to the person, either putting it in their mouth, spraying it into their mouth/nose, or injecting it.

When can you administer medication?

If it is a life-saving medication like an inhaler, epinephrine, or narcan

Steps of a Secondary Assessment

1) SAMPLE

2) Check the Vital Signs

3) Perform an Injury Check

SAMPLE

Signs and symptoms

Allergies

Medications

Past Medical History

Last oral intake (food or drink)

Events leading up to the emergency

What should you check for when checking vital signs?

Level of Responsiveness

Breathing

Skin

Level of Responsiveness

Is the person alert, sleepy, or confused? Is the level of responsiveness changing?

Checking Breathing (Vital Signs)

Is the breathing fast or slow? Shallow or deep? Painful?

Checking Skin (Vital Signs)

Is the skin wet or dry? Clammy? An unusual color or temperature?

What is the difference between a Focused Exam and a Hand On Check?

Both are used to check for injuries during secondary assessment.

Focused Exam is for responsive patients that can answer questions, Hands-On Checks ar for unresponsive but breathing patients

Focused Examination Steps

1) Explain the purpose of the exam is to identify injuries

2) Ask the person if anything hurts or feels uncomfortable

3) If the person indicates an area of pain or concern, look at the area for signs of injury

4) Ask focused questions about how the person feels

How should you perform a Hands-On Check?

Starts by examining the head for injuries, and works downwards, palpating the body for injuries and abnormalities. Focus on the chest, abdomen, and legs before checking the arms

Symptoms of Shock

Anxiety or Confusion

Cool, clammy skin that may be a different color than usual

Weakness

Excessive Thirst

Rapid Breathing

Drowsiness or loss of responsiveness

Nausea and vomiting

How should you treat someone whose airway is completely blocked?

Alternate between two of the three: Back blows, abdominal thrusts, or chest thrusts

If they become unresponsive, stop treating them for choking and begin CPR

NOTE: abdominal thrusts cannot be used on pregnant people

How can you tell if someone’s airway is completely blocked?

The person is unable to cough or speak and they cannot breathe

How should you care for a choking baby?

1) Sit/kneel with the baby face down on your forearm, holding the jaw but keeping the mouth clear

2) Deliver 5 back blows

3) Flip the baby over, supporting the head

4) Place 2 fingers in the middle of the chest and deliver 5 compressions

5) Repeat until the object comes out or the baby begins to cry; if the baby becomes unresponsive, begin CPR

Heart Attack

Occurs when the heart cannot get enough oxygen because of a blockage in one of the arteries that feed it

Symptoms of Heart Attacks

Pain/Pressure/Tightness in the chest, heaviness in the chest, pain radiating from the chest to the arms, shoulders, back, jaw, and or/neck

Shortness of breath, nausea/vomiting, feelings of impending doom, skin/lips/fingers are an abnormal color, unresponsiveness, cool/sweaty skin

Soft Symptoms of Heart Attacks

Unfocused/mild chest discomfort, extreme fatigue, flu-like symptoms, gastric discomfort, dizziness/light-headedness

How should you treat for a heart attack?

Have the person rest quietly, and if possible, have them chew either 1 regular-strength ASA tablet or 2-low dose tablets

What are ASA tablets?

Acetylsalicylic Acid Tablets can be chewed to help treat heart attacks

Stroke

Occurs when the blood flow to part of the brain is interrupted

Symptoms of Strokes

Sudden/Severe headaches, Dizziness/Confusion, Unresponsiveness, Temporary loss of responsiveness, Sudden loss of bowel/bladder control, vision problems

FAST

Face: Facial numbness or weakness, look for facial drooping, have the person smile

Arms: Arm numbness or weakness, ask them to close their eyes and put out both arms, look for sagging

Speech: Abnormal speech/slurring

Time: call EMS

How many bandages should you put on external bleeding before using a tourniquet?

2

Life-Threatening External Bleeding

Bleeding that is difficult to stop or control

In what situations should you use a tourniquet?

The bleeding can’t be controlled by direct pressure, you can’t access the wound, or you must move the person and can’t maintain direct pressure

Symptoms of Internal Bleeding

Bruising/pain in the injured area, Soft tissues that are tender/swollen/hard, Blood in saliva/vomit, Severe thirst, Nausea/Vomiting, Anxiety

Can you give food or water to someone with suspected internal bleeding?

Absolutely not

Steps to using an AED

1) Have someone call 911 and bring an AED

2) Take off the person’s clothing so that there’s nothing on their chest

3) Check for water by tapping on the ground (dry person if needed)

4) Apply pads

5) Clear the body before shocking

How far away should AED pads be from a pacemaker?

2.5cm/1in

Symptoms of an Asthma Attack

Gasping for air, wheezing/coughing, rapid or shallow breathing, Inability to say more than a few words without pausing to breath, tightness in the chest

How can you treat an asthma attack?

If you suspect an environmental trigger, move the person away from the trigger

Help the person use their inhaler

Steps to help Someone take an inhaler

1) Shake the inhaler and remove the cap

2) Have the person breathe out as much air as possible

3) Have the person bring the inhaler to their mouth and press down on the top of the inhaler

4) Hold for one breath

Symptoms of Anaphylaxis

Rash, skin swelling, high pitched breathing, dizziness, lack of alertness, vomiting

Steps to give an epi pen

1) Blue to the sky orange to the thigh, remove the cap

2) Push the injector to the outside of the thigh for 5-10 seconds

3) Rub the injection site for 30secs.

4) If the person’s condition doesn’t improve in five minutes, repeat the dose

When should you call EMS for a burn patient?

The burns make it difficult for them to breathe, the burns were caused by chemicals/explosions/electricity, the burns are full thickness (Blackened/charred) or involve a large amount of blistered or broken skin, The burns cover the face or neck or hands or a large surface area

How should you treat a burn?

1) Cool the affected area with water or a cool compress (NOT AN ICE PACK) for at least 10 minutes

2) Remove clothings/jewelry from the burn site, but don’t try to take off anything stuck to the skin

3) Cover the burn loosely with a dry dressing

How should you treat chemical burns?

1) Remove any clothes that might have the chemical on them, brush any dry chemical powder off the skin

2) Flush with cool running water for at least 15 minutes

How long can you keep an ice pack on for treating a bruise?

20 minutes on per hour

How to treat nosebleeds

1) Have the person sit with the head slightly forward

2) Pinch the person’s nostril for 10-15 minutes

What can you put a knocked out tooth in?

Egg whites, coconut water, whole milk, gauze with the person’s saliva

How long should you rinse the eyes after getting chemicals in them?

15 minutes

How should you treat someone whose eyes have been flash burned?

1) Move the person away from the source of light

2) Cover the eyes with a cool, wet cloth

3) Get the person to medical attention

How to treat an impaled object?

1) Leave the object in place

2) Stabilize the object without putting direct pressure on it

3) Secure the object in place with dressings

Symptoms of chest injuries

Deformity/swelling, shallow breathing, bruising, coughing up blood

If the chest is penetrated, you may hear a sucking sound coming from the wound with each breath

Treatment of Chest Injuries

1) If the wound is bleeding a lot, apply pressure. Do not apply dressing or pressure for minor bleeding

2) If there isn’t a penetrating chest injury, give the person something bulky to hold against their chest

Note: If a chest dressing becomes saturated with blood switch it out so it doesn’t prevent air from escaping

How should you treat someone with organs protruding out of their abdomen?

1) Don’t apply direct pressure or try to push the organs back into the abdomen

2) Cover the protruding organs with moist, sterile dressings

3) Loosely cover the dressings with plastic wrap

4) Give the person a blanket or a towel to keep them warm

When should you suspect a head/neck/spine/pelvis injury?

A fall from any height greater than the person’s height; A diving injury; A person found unresponsive for unknown reasons; A strong blow to the lower jaw, head, or torso; A person has been struck by lightning or electrocuted

Symptoms of a head/neck/spine injury

Pain or pressure in the head/neck/back; blood or fluid draining from the ears/nose; unusual bumps or depressions; bruises around the eyes and behind the ears; seizures; impaired breathing or vision; nausea/vomiting; unequal pupil sizes; loss of movement in a body part; loss of bladder control; changes in LOR; dizziness; loss of balance

Symptoms of a Pelvic Injury

Deformity/swelling; pool of blood under the skin/bruising; inability to move the lower legs or hips; inability to walk or stand; a shorter/twisted/bent leg; broken bone sticking out of the skin; snapping/popping sound; grating sound of bone; muscle cramps; signs of shock

How should you treat a head/neck/spine injury?

Call EMS, ensure the head and neck is supported in the position you found them in

How should you treat a pelvic injury?

Call EMS; place padding between the legs and keep them still

Concussion

A subset of traumatic brain injuries

Concussion Symptoms

Drowsiness; foggy mindset; temporary memory loss; slower reaction times; neck pain; headache; LOR; dizziness; loss of balance; vision issues; sensitivity to light/noise; seizure; irritability; personality cahnges

Concussion Symptoms in Children & Babies

Changes in playing, sleeping, or eating habits; excessive crying; lack of interest in toys

Strain

The stretching or tearing of muscles or tendons

Sprain

The stretching or tearing of ligaments at a joint

Dislocation

The movement of a bone out of its normal position at a joint

Fracture

A chip, crack, or break in a bone

RICE Method

Rest

Immobilize

Cool the area for 20minutes/hour

Elevate: raise the injury

General Steps for Splints

1) Check for normal temperature and skin color below the injured area before and after immobilizing the limb

2) Immobilize the injured part in the position you found it in

3) Make sure the splint is long enough to extend above and below the injury

Regular Sling

1) Have the person hold the injured arm across the body

2) Slide a triangular bandage under the injured arm

3) Bring the bottom end of the bandage over the shoulder of the injured side and tie the ends together behind the neck

4) Secure the arm to the body with another bandage

Tube Sling

1) Have the person support the arm of the injured side/shoulder

2) Place a triangular bandage over the arm, tuck the lower edge under the arm and secure at the elbow

3) Tie the bandage’s together

4) Secure the arm to the body with another bandage

What is the order of preference for sugar sources?

Oral glucose tablets, chewable candy, fruit juice, fruit strips, milk

Symptoms of Diabetic Emergencies

Changes in LOR; confusion; rapid breathing; cool skin; appearance of intoxication; seizures

How to treat diabetic emergencies?

1) Have the person ingest sugar

2) If their condition doesn’t improve in ten minutes, call EMS and administer more sugar

Febrile Seizures

Seizures that occur in children/babies that are caused by high fevers

When should you call EMS after someone has a seizure?

The seizure lasts more than a few minutes, you don’t know the person’s medical history, the person has several seizures in a row, the person is unresponsive for an extended period of time

How should you treat someone having a seizure?

1) Protect the person’s head from injury by moving away objects and supporting their head with a soft object

2) Roll the person into the recovery position

Symptoms of Heat Stroke

Dry, hot skin; seizures; unresponsiveness; severe headache; irritableness; rapid, shallow breathing

How to treat heat stroke

1) Call EMS and get an AED

2) Remove the person from the hot environment and loosen tight clothing

3) Immerse the person’s forearms in cool water, pour water on their clothing and press cool towels to their chest, fan the person, and apply ice packs to the person’s armpits and chest

4) Provide a cool drink if the person is alert

Superficial Frostbite

Hardened skin, skin that looks paler than the area around it, pain or stinging in the area which is followed by numbness

Deep Frostbite

Skin and underlying tissues are hard to the touch, Skin that is white/blue/black/mottled, Complete loss of feeling in the affected area

How to Treat Frostbite

1) Remove anything that could restrict blood flows to the affected area

2) ONLY Thaw the area if you’re sure it won’t freeze again. Use warm water or body heat. DO NOT RUB THE SKIN. Once you’ve started warming them back up, you have to keep them warm

3) Protect the skin with loose, dry dressings; leave any blisters intact

4) Elevate any thawed extremities above the heart

5) Rehydrate the person and encourage them to seek medical attention

Cold Stressed

Shivering, Responsive, Normal Breathing

Mild Hypothermia

Shivering, Responsive, Normal Breathing, Complaining of cold, Impaired Movement

Moderate Hypothermia

Impaired movement, Not Complaining of Cold, Not Shivering, may be unresponsive, may have abnormal breathing

Severe Hypothermia

Not complaining of cold, Not moving, Not shivering, Unresponsive, Abnormal breathing

How to Treat Cold Stress

1) Add dry clothing to the person to reduce heat loss

2) Give the person a high-calorie food or dink

3) Increase heat production (have them exercise)

How to Treat Mild Hypothermia

1) Keep the person horizontal; no standing or walking for at least 30 minutes

2) Insulate the person or apply a vapor barrier

3) Apply heat to the person’s upper trunk

4) Give the person a high calorie food or dink

5) If symptoms don’t improve in 30 minutes, call EMS

How to Treat Moderate Hypothermia

1) Keep the person horizontal

2) Do not give the person food or dink

3) Insulate the person or apply a vapor barrier

4) Apply heat to the person’s upper trunk

5) Call EMS