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First Aid

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First Aid 101!

Wound Dressing :

First, carefully inspect the injury. If there are punctures that penetrate into the fat, consider the possibility that there is gravel under the skin.

Check the stability of any areas of deeper skin injury by stretching the edges. Decide whether this will be a permanent dressing, or just a temporary patch until you get to the doctor.

Initial cleaning:
Wash the wound thoroughly. Most likely, the only source of water will be your water bottle. In this case, you may need to be conservative with the water: squirt, scrub, squirt again, scrub again.

If you don't have complete dressing materials with you, or if you can't get the wound clean, plan on re-cleaning and dressing the wound after you return to civilization.


Scrub the wound until the dirt is removed. In sliding, bouncing abrasions, the dirt is harder to remove and may require aggressive scrubbing. If you plan to care for the wound at home, you must get the wound completely clean.
It's easiest to scrub immediately after the injury. A couple of hours later, the wound will be more sensitive.

If you need a "scrub brush," the seam of your biking shirt sleave can help remove stubborn dirt. A benzalkonium chloride towellette is a good antiseptic cleaning tool. Wrinkle it up, so the edges can remove dirt.


If you're on a short ride and the wound isn't bleeding, you could defer thorough cleaning until you're in the shower. A few minutes in the water will soften up the blood and dirt. The warm water tends to numb up abrasions and lacerations, so they're easier to clean. Then take a rough washcloth and scrub the hell out of those scrapes. They need to be pink -- no brown dirt color remaining!

Apply antibiotic ointment (if you have it). Neosporin is a sample brand. Smear a thick coating of the antibiotic liberally over the entire wound area.
The antibiotic ointment protects the wound from dryness. It helps keep the bandage from sticking to your wound. And of course, it kills germs to reduce the infection risk.

Even if the bandage is only temporary, the antibiotic ointment can help dissolve road tar and soften any remaining dirt, so it will be easier to clean later.


Creating the dressing:
Place a non-stick pad over the wound. It should be large enough that it can slide or shift a bit without uncovering the wound. Telfa and Adaptic are sample brands.

If additional padding is needed, put gauze pads over the non-stick pad to provide thickness, or use a padded roll gauze (sample brand Kerlix) to cushion the area.

Secure the dressing with a kling roll gauze. Extend the gauze an inch or two beyond the borders of the dressing. The wrap should be snug but not tight. As you wrap, vary the angle of application so that not all passes are perfectly circular -- angle the wrap so it crosses the wound at a 30 degree angle one direction then straightens as it wraps around, then wrap around again in a full straight circle, come back the other direction at 30 degrees and straighten as you wrap around, make another straight circle, etc.


If the injury is over an area that will move, such as the elbow or knee, apply the gauze while the joint is half-way bent (about 45 degrees off of straight). To keep the dressing from creeping as the joint is moved, be sure to wrap the full width of the roll gauze circularly above the joint and below the joint.

Secure the kling roll gauze with a self-adhering elastic (sample brand Coban) wrap. Extend the borders of the elastic wrap a couple of inches beyond the kling wrap. If you don't have Coban, a standard elastic wrap ("Ace") will do, although it tends to migrate around a lot more.
Tape can be used to hold the dressing, but doesn't provide dust and moisture protection like Coban. And it tends to pull loose as you continue biking. I almost never use any tape in dressings, because it just doesn't work.

After finishing the Coban wrap, you're ready to continue biking.
If you're not absolutely certain the wound is clean, it will need a "re-do" when you get back. Decide whether you're heading for the doctor, or taking care of the wound yourself.

If you're planning home-care of a wound that remains dirty, hit the shower. Scrub the wound mercilessly with an abrasive sponge or washcloth. Expect to make it bleed again, but be sure you've gotten it clean. Then redress it with fresh material.

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Continuation....

Fractures and Splinting!

Initial Care for Fractures:

If you can, carefully cut away all clothing near the fracture site. You need to make sure the fracture hasn't broken the skin and you may be able to use the cut away material to aid in splinting. If you find an open fracture, protect the wound from contamination as you would any other.

No matter how soon you expect to get medical help, you should immobilize all fractures to prevent additional injuries due to accidental movement or muscle spasms. Immobilization can be achieved many ways; the key points being not to worsen the situation while immobilizing and making sure to also immobilize the joints above and below any limb fracture.

In general, don't try to reposition fractured limbs. Unless you know what you are doing, you could sever an artery or nerve. If out on the trail with help a long way off, practicality may necessitate slight repositioning in order to accommodate make-do splinting. In such situations if a limb has no pulse or is turning purple, repositioning may relieve some unnatural pressure which is pinching off an artery, however the rescuer must consider that a mishandled attempt could result in a jagged bone end severing the compressed artery, making a bad situation much worse!

To put this tricky situation in perspective, Brady's Emergency Care, 6th Edition states: "Angulations make splinting and transport more difficult. They can pinch or cut through blood vessels and are painful for the patient. They must, however, be repositioned so they can be splinted. Not to splint would be more dangerous."

DO NOT try to straighten angulations of the wrist, ankle or shoulder or attempt to straighten any dislocated joint!

When splinting using sticks or other "found" objects, try make padding between the injured limb and splint using a jacket, shirt filled with grass, anything which can be reasonably secured and can help fill in the gaps between the limb and the splint material. Don't get carried away with this concept, but if you can handily make something up without delaying the splinting process, it will be more comfortable to the patient.

Long bone fractures in the legs and arms can benefit from mild traction when splinting. For arm fractures where you have help during splinting, one person can grasp the arm above and below the fracture site and apply a smooth, steady pull until your helper can apply the splint. If you encounter a firm resistance, crepitus or the patient experiences a significant increase in pain, do not attempt traction. Do the best you can to splint in the position found. Once you successfully apply traction, do not release it until the splint is securely supporting the limb, otherwise the retracting bone end will cause additional tissue damage and possibly injure a nerve or artery.

A fractured forearm should be splinted from the hand through the elbow and can be secured across the chest with a sling if more comfortable for the patient. Upper arm fractures should be immobilized from shoulder through the elbow and can be secured against the body.

Traction for leg injuries is more difficult, and the risk of injury resulting from a failed traction attempt is even greater. Do not attempt leg traction until your helper is ready to apply a splint. Legs should be secured to splints using several ties from the ankle to the pelvis, but not directly over the fracture. If a long smooth board is available (e.g., a fence board), it can be secured all the way up to the armpit to improve stability.

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You can also visit the thread below for additional info on first aid.
Medyo mahaba na kasi kung i-post ko rin dito.
http://www.2wheeltouring.net/stories/firstaid.htm

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Eto para sa stroke :

START - during strokes or if you see someone fainting. According to Medical Therapists, they can totally reverse the effects of a stroke if the patient is given medical attention in the first 3 hours after a stroke.

S - immediately when you see someone faint (and still concious) ask the person if he or she can "smile" check if the lips moves or any deformations in the face
T - "talk", make the person talk, ask questions
A - "Arms" ask the person if he or she can feel anything when you pinch his arms or legs (or if they are numb)
R - "raise" ask the person if he or she can raise her arms and legs
T - "Tongue" ask the person to stick his or her tongue out and move it sideways
If the person cannot do any of these 5 items, most likely the person suffered a stroke. He or she must be rushed to the nearest hospital to get medical attention.

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First Aid – is an immediate care given to a person who has been injured or suddenly taken ill. It includes self-help and home care if medical assistance is not available or delayed

ROLES AND RESPONSIBILITIES OF THE FIRST AIDER

Bridge that fills the gap between the victim and the physician. It is not intended to compete with, nor take the place of the services of the physician. It ends when the services of a physician begin.

Ensure safety of him/her and that of the bystanders.
Gain access to the victim.
Determine any threats to patient’s life.
Summon advanced medical care as needed.
Provide needed care for the patient.
Record all finding and care given to the patient.

OBJECTIVES OF FIRST AID

To alleviate suffering.
To prevent added/further injury or danger.
To prolong life.

CHARACTERISTICS OF A GOOD FIRST AIDER
1. Gentle should not cause pain.
2. Resourceful should make the best use of things at hand.
3. Observant should notice all signs.
4. Tactful should not alarm the victim.
5. Empathic/Comforting should be comforting.
6. Respectable should maintain a professional& caring attitude.

HINDRANCES IN GIVING FIRST AID
Unfavorable surroundings.
The presence of crowds.
Pressure from victim or Relatives.

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FIRST AID EQUIPMENT AND SUPPLIES



Suggested First Aid Kit Contents (Basic)



· Rubbing Alcohol

· Gloves

· Povidone Iodine

· Cotton

· Gauge Pads

· Penlight

· Band Aid

· Scissors

· Forceps

· Bandage Triangular

· Elastic roller bandage

· Occlusive dressing

· Plaster





Cloth materials commonly used in First Aid



· Dressing/Sterile cloth material any sterile cloth material used to cover the wound.

· Bondage any clean cloth material sterile or not use to hold the dressing in place.





GUIDELINES IN GIVING EMERGENCY CARE



GETTING STARTED

1. Planning of action

2. Gathering of needed materials

3. Remember the initial response as follows :

A – Ask for help

I – Intervene

D – Do no further harm

4. Instruction to helper/s

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EMERGENCY ACTION PRINCIPLES



1. SURVEY THE SCENE.

· Is the scene safe?

· What happened?

· How many people are injured?

· Are there bystanders who can help?

· Identify yourself as a first aider.

· Get consent to give care





2. DO PRIMARY SURVEY OF THE VICTIM.

· Check responsiveness (if unresponsive, consent is implied)

· Protect spine if necessary.



Check for:



A- Airway

B- Breathing

C- Circulation



3. ACTIVATE MEDICAL ASSISTANCE.

· Depending on the situation:

- Phone first or phone fast

- A bystander should make the telephone call for help (if available)

- A bystander will be requested to call for a physician.

- Somebody will be asked to arrange for transfer facility.



Information to be remembered in activating medical assistance:

- What happened?

- Location

- Number of persons injured.

- Extent of injury and first aid given.

- The telephone number from where you are calling.

- Persons who activated medical assistance must identify him/herself and drop the phone last.



4. DO SECONDARY SURVEY OF THE VICTIM.

Interview the victim

- Ask the victim’s name

- Ask what happened.

- Assess the SAMPLE history



S – Signs/Symptoms

A – Allergies

M – Medications

P – Past medical history

L – Last meal intake

E - Events prior to injury

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Check the vital signs

- Determine radial or carotid pulse (pulse rate)







Adult


60/90 min



Child


80/100 min



Infant


100/120 min



- Determine breathing (respiration rate)







Adult


12/20 min



Child


18/25 min



Infant


25/35 min



- Determine skin appearance

→ Look at the victim’s face and lips

→ Record skin appearance, temperature, moisture, and color.



● Do head to toe examination looking for DCAP-BTLS (Deformity, Contusion, Abrasion, Puncture, Burn, Tenderness, Laceration, Swelling)



- Check and compare pupils of both eyes,

- Dilated pupils – involve bleeding and state of shock.

- Constricted pupils – may mean stroke or drug overdose.

- Unequal pupil – may suspect head injury or stroke.

- Check for fluid or blood in ears, nose or mouth.

- Gently feel the sides of the neck for signs of injury.

- Check and compare both collar bones and shoulder.

- Check the chest and rib cage

- Check the patient’s abdomen for tenderness by pressing lightly with flat part of your fingers.

- Check the hipbone by pressing slowly downward and inward for possible fracture.

- Check one leg at a time

- Check one arm at a time

- Check the spinal column by placing the victim into the side lying down position and press gently from the cervical region down to the lumbar for possible injury.

- Record all the assessments including the time.

- Keep the patient lying down, his/her head level with his/ her feet.

- Keep the patient warm and guard against chilling.

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Wound - is a break in the continuity of a tissue of the body either internal or external.



TWO CLASSIFICATION OF WOUND



1. Closed wound

Causes:

· Blunt object result in contusion (bukol) or bruises (pasa)

· Application of external forces.



Signs and symptoms

· Pain and tenderness (lamog)

· Swelling

· Discoloration

· Hematoma

· Uncontrolled restlessness

· Thirst

· Symptoms of shock

· Vomiting or cough of blood

· Passage of blood in the urine or feces

· Sign of blood along mouth, nose and ear canal











First Aid Management



· IIce application

· C- Compression

· E- Elevation

· S – Splint



2. Open wound

Classification of Open Wound



P- Puncture (Tusok) Penetrating pointed instruments such as nails, ice picks, daggers, etc.



A - Abrasion (gas-gas, galos) Scrapping or rubbing against rough surfaces.



L – Laceration (punit) Blunt instruments such as shrapnel’s, rocks, broken glasses, etc.



A – Avulsion Explosion, animal bites, mishandling of tools, etc.



I – Incision Sharp bladed instruments such as blades, razors, etc.

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FIRST AID MANAGEMENT



Wound with severe bleeding



· C – Control bleeding or direct pressure

· C – Cover the wound with dressing and secure with a bandage

· C – Care for shock

· C – Consult or refer for proper physician

Elastic Bandage – to control bleeding



Wound with bleeding not severe (home care)



· Clean the wound with soap and water

· Apply mild antiseptics

· Cover wound with dressing and bandage



Reminders:



1. All wounds must be thoroughly inspected and covered with a dry dressing to control bleeding and prevent further contamination.

2. Once bleeding is controlled by compression, the limb should be splinted to further control bleeding, stabilize the injured part, minimize the victim’s pain and facilitate the patient’s transport to the hospital.

3. As with closed soft tissue injuries, the injured part should be elevated to just above the level of the victim’s heart to minimize severity.

4. Amputated body parts should be saved, wrap in dry gauze, placed in a plastic bag, kept cool and transported with the patient.

5. Don’t induce further bleeding to clean the wound.

6. Don’t use absorbent cotton as a dressing.

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