Basic First Aid Concepts

Basic First Aid Concepts

Introduction

• Medical emergencies can occur in a medical environment.
• All staff should be prepared to handle emergencies.
• Physicians or nurses should be called first, as they are best qualified.
• Patient care techs may be first on the scene, requiring a cool head and quick, correct responses.
• Employers usually require healthcare workers to maintain current certification in First Aid and CPR.
• It is strongly suggested to attend First Aid and CPR training and maintain certification.

Choking

Steps and Rationale

1. Call for the nurse and stay with the client, or call 911 if alone.
   • Rationale: Allows you to get help while providing for the client's safety and comfort.
2. Ask if the client can speak or cough.
   • Rationale: Identifies signs of a blocked airway.
3. If the client cannot speak or cough, move behind the client and slide arms under the client's armpits.
   • Rationale: Puts you in the correct position to perform the procedure.
4. Place your fist with the thumb side against the abdomen midway between the waist and ribcage.
   • Rationale: Positions fist for maximum pressure with the least chance of injury to the client.
5. Grasp your fist with your other hand.
   • Rationale: Allows you to stabilize the client and apply balanced pressure.
6. Press your fist into the abdomen with quick inward and upward thrusts.
   • Rationale: Forces air from lungs to dislodge object.
7. Repeat until the object is expelled.
8. Assist with documentation according to current nursing practices.
   • Rationale: Accuracy is necessary because decisions regarding client's care may be based on your report. What you write is a legal record of what you did. If you don't document it, legally it didn't happen.

Seizures

Steps and Rationale

1. Call for the nurse and stay with the client, or call 911 if alone.
   • Rationale: Allows you to get help while providing for the client's safety and comfort.
2. Place padding under the head and move furniture away from the client.
   • Rationale: Protects client from injury.
3. Do not restrain the client or place anything in their mouth.
   • Rationale: Any restriction may injure the client during the seizure.
4. Loosen the client's clothing, especially around the neck.
   • Rationale: Prevents injury or choking.
5. After the seizure stops, position the client onto their side.
   • Rationale: Allows saliva to drain from the mouth so the client doesn't choke.
6. Note the duration of the seizure and the areas involved.
   • Rationale: Provides the nurse with necessary information to properly assess the client's condition and needs.
7. Assist with documentation according to current nursing practices.
   • Rationale: Accuracy is necessary because decisions regarding client's care may be based on your report. What you write is a legal record of what you did. If you don't document it, legally it didn't happen.

Falling or Fainting

Steps and Rationale

1. Call for the nurse and stay with the client, or call 911 if alone.
   • Rationale: Allows you to get help while providing for the client's safety and comfort.
2. Check if the client is breathing.
   • Rationale: Provides you with information necessary to proceed with procedure.
3. Do not move the client.
   • Rationale: Prevents further damage if the client is injured.
4. Talk to the client in calm and supportive manner.
   • Rationale: Reassures the client.
5. Apply direct pressure to any bleeding area.
   • Rationale: Slows or stops bleeding.
6. Take pulse and respiration.
   • Rationale: Provides the nurse with necessary information to properly assess the client's condition and needs.
7. Assist the nurse as directed.
8. Assist with documentation according to current nursing practices.
   • Rationale: Accuracy is necessary because decisions regarding client's care may be based on your report. What you write is a legal record of what you did. If you don't document it, legally it didn't happen.
9. Check client frequently according to current nursing practices.
   • Rationale: Assures client comfort and allows you to quickly report any change in client condition.

Fire

Steps and Rationale

1. Remove clients from the area of immediate danger.
   • Rationale: Clients may be confused, frightened, or unable to help themselves.
2. Activate the fire alarm.
   • Rationale: Alerts the entire facility of danger.
3. Close doors and windows to contain the fire.
   • Rationale: Prevents drafts that could spread the fire.
4. Extinguish small fire with a fire extinguisher if possible.
   • Rationale: Prevents the fire from spreading.
5. Follow all facility policies and leave the building, meeting in a predetermined location.
   • Rationale: Facilities have different methods of dealing with emergencies. You need to follow the procedures for your facility.

Basic Steps to Applying a Dressing to a Wound

Step 1: Removing the Dressing

• Removing the dressing may be painful if the wound has dried and adhered to the dressing.
• Moistening the dressing with saline (contact lens solution) can loosen it and decrease pain.
• Dressings that keep the wound moist are encouraged.

Step 2: Cleaning the Wound

• Clean the wound only with normal saline.
• Soap and water and other common cleaning agents are toxic to the body's natural healing processes.
• These agents can kill cells in the wound bed, wash away biochemicals needed for wound repair, and dry the wound, making it more painful.
• Normal saline removes excess bacteria while maintaining natural healing processes.

Step 3: Applying Topical Agents

• Topical agents can change the environment of the wound bed.
• Topical antibiotics or antiseptic agents decrease bacteria.
• Moisturizing agents like saline gels may be added if the wound is too dry.
• Mild enzymes can be added to assist the body in removing dead tissue.
• Apply topicals with a cotton tip applicator or wooden applicator stick directly to the base of the wound, coating it like "icing on a cake."

Step 4: Applying the Primary Dressing

• The primary dressing should keep the wound moist but not too wet.
• A dry wound can become painful, making dressing changes difficult.
• An overly wet wound can cause messiness and odor problems.
• The goal is to maintain a moist, clean wound bed.

Step 5: Applying the Secondary Dressing

• The secondary dressing fastens the primary dressing tightly to the body.
• It protects the wound from trauma and assists with excessive drainage.
• Note: Wound care becomes easier with practice as both the patient and caretaker become familiar with the process.