efaw

© Nuco Training Ltd – January 2011

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Welcome

HSE approved

Emergency First Aid at Work



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6 Primary Survey

1 Introductions

2 What is First Aid?

3 Legislation

4 Responsibilities

5 Action in an

Emergency

7 Secondary

Assessment

8 The Respiratory

System

9 Resuscitation

10 Disorders of

Respiration

11 Disorders of the

Circulation

13 Epilepsy

15 Foreign Objects

12 Wounds and

Bleeding

14 Minor Burns and

Scalds

16 Course Closure



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Module 1

Introductions


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Housekeeping

Sign in

Health & Safety issues

Facilities

Mobile phones

Smoking arrangements

Course administration

Introductions


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HSE approved


• Must attend and successfully complete this

HSE Approved course – Emergency First Aid at Work, in

order to achieve your certificate

• Valid for a 3 year period

• Re-qualification is to attend and successfully complete

this same 1-Day course

• The Health and Safety Executive (HSE) are strongly

recommending that you complete a 3-hour refresher

course annually during your qualification period


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The course syllabus

HSE Approved - Emergency First Aid at Work

Module 1 Introductions

Module 2 What is First Aid?

Module 3 Legislation

Module 4 Responsibilities

Module 5 Action in an Emergency

Module 6 Primary Survey

Module 7 Secondary Assessment

Module 8 The Respiratory System

Module 9 Resuscitation

Module 10 Disorders of Respiration

Module 11 Disorders of the Circulation

Module 12 Wounds and Bleeding

Module 13 Epilepsy

Module 14 Minor Burns and Scalds

Module 15 Foreign Objects

Module 16 Course Closure


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The Assessment Process

Although there is no independent

assessment, your instructor will be

assessing your skills throughout

the course including:

Managing an incident – Primary Survey

Top-to-toe survey

Recovery position

CPR

Seizure

Choking

Major bleed control

Treatment for shock



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Module 2

What is First Aid?


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What is First Aid?

First Aid

is the initial or immediate

assistance given to someone who

has been injured or taken ill

before the arrival of qualified

medical assistance


9

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The Aims of First Aid


10

Preserve life

Prevent the injury from worsening

Promote recovery

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Any Questions?


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Module 3

Legislation


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Acts and Regulations

• Health and Safety at Work Act 1974

Requires employers to ensure, so far as reasonably practicable, the

health, safety and welfare of their employees This also extends to

non-employees such as outside contractors and members of the

public

• Health and Safety (First Aid) Regulations 1981

Employers are required to provide adequate personnel, training,

equipment and facilities to render FIRST AID to their employees

should they become injured or taken ill at work

• Management of the Health & Safety at Work Regulations1999

Require employers to make a suitable sufficient assessment of the

risks to health & safety of all their employees


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Provision

• Inexperienced workers or employees with

disabilities or particular health problems

• Employees who travel a lot, work remotely

or work alone

• Employees who work shifts or out of hours

• Premises spread out across buildings/floors

• Workplace remote from emergency medical

services

• Employees working at sites occupied by other

employers

• Planned and unplanned absences of First-Aiders

• Members of the public who visit the workplace



Category of Risk

Numbers

employed at any

location

Suggested number of First

Aid personnel

Lower Fewer than 25 At least 1 Appointed Person**

e.g. Shops, offices and libraries 25 – 50 At least 1 Emergency First Aider

(1-day EFAW)

More than 50 1 First Aider (FAW)

At least one per100 employees or part

thereof

Higher Fewer than 5 At least 1 Appointed Person**

e.g. Light engineering and assembly

work, food processing, warehousing,

extensive work with dangerous

machinery or sharp instruments,

construction, chemical manufacture,

work involving special hazards*

such as hydrofluoric acid or confined

spaces.

5 – 50

At least 1 First Aider *** (EFAW or FAW)

More than 50 1 First Aider (FAW)

At least one for every 50 employees or

part thereof

Ensure any injuries and illness that

might occur can be dealt with by the

First Aid personnel you provide

* Additional training

may be needed for

First Aiders to deal

with injuries

resulting from

special hazards.

** Where First Aiders

are shown to be

unnecessary, there is still

a possibility of an accident

or sudden illness, so you

should consider providing

qualified First Aiders

*** The type of injuries that

might arise in working with

those hazards identified, will

influence whether the First

Aider should be trained in

FAW or EFAW


provision

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First Aid Kits

17

There are many different sizes and types

according to the size and type of business you are in

Your Risk Assessment

of First Aid Needs

will identify your

particular requirements

which may vary from

one business to another


17

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First Aid kits

Minimum suggested contents: A guidance leaflet

20 adhesive dressings Individually wrapped and

assorted sizes

2 sterile eye pads

4 triangular bandages Individually wrapped and sterile

6 medium sterile wound dressings Individually wrapped and un-medicated

2 large sterile wound dressings Individually wrapped and un-medicated

6 safety pins

Disposable gloves

Other items are allowed that

are appropriate to your

business such as burns

dressings and ice packs.

No medicines, ointments etc


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Accident and Incident Reporting

• Date, time and place of incident

• Name and job of injured or ill person

• Details of the injury/illness and what First Aid

was given

• What happened to the person immediately

afterwards?

(e.g. – went back to work, went home,

went to hospital)

• Name and signature of the person reporting

the incident

• Must be kept in accordance with the

Data Protection Act 1998


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RIDDOR

Reporting of Injuries, Diseases and Dangerous Occurrences Regulations (RIDDOR)

Immediate reporting

• Deaths and major injuries including

amputations, loss of sight and most

fractures

Over 3-day injuries

• Within 10 days – any injury that causes an employee to

be off work or not able to perform their usual job for more than 3 days

• Work-related ill health within 10 days of a diagnosis


20

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Any Questions?


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Module 4

Responsibilities


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Responsibilities of the

Emergency First Aider

• Arrival at the scene

• Dealing with casualties

• Contacting the emergency

services

• Prioritise the First Aid treatment

• Clearing up process


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Casualty Communication

• Make and keep eye contact

• Tell the truth

• Use understandable language

• Be careful of what you say

• Be aware of body language

• Speak slowly, clearly and

distinctly

• Allow time for the casualty to

answer


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Contacting the

Emergency Services

When ringing

999 or 112 …… Remember LIONEL

L Location

I Incident

O Other services

N Number of casualties

E Extent of injuries

L Location - repeat


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Any Questions?


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Module 5

Action in an Emergency


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Arriving at the scene

S

T

E

P

U

P

Stop - Assess the situation

Traffic – Consider safety at all times

Environment – Consider your limitations

Protection – Yourself, your casualty and others

Unknown hazards – Gas, electricity, fire etc

Prioritise



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Module 6

Primary survey


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Primary survey

D anger

R esponse Shout for help

A irway

B reathing

C CPR for a non-breathing casualty

or

Circulation for a casualty who is breathing normally.

Treat bleeding, burns, breaks etc

If they are unresponsive, place them in the recovery position

and monitor their breathing


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Primary Assessment

D Danger

Make sure the area is safe before

you approach

R Response

Check to see if the casualty

responds to verbal command or a

pain stimulus

A Airway

Open the airway by tilting the

head back and lifting the chin

with two fingers

B Breathing

Look, listen and feel for normal

breathing for up to ten seconds

C CPR

Commence CPR if required

D R A B C

Shout for help!!

S

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Check for Dangers

The area must be safe before

you offer your casualty any

Treatment

Safe for you primarily,

not forgetting any bystanders

and of course your casualty

Failing to do this could result

in you having more casualties

to deal with, which could

include yourself!


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Check for a Response

Alert

Voice – “Are you alright?”

Place your hands on their

shoulders and gently shake them

Unresponsive

A

V

P

U

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Shout for Help

If you are on your own, you MUST

shout for help

Ideally, you should never leave your

casualty on their own

A bystander can be of a great

benefit to you

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Open the Airway

Open the airway by supporting

your casualty’s forehead with one

hand and tilting it back by placing

2 fingers under their chin and

gently lifting it

Support the head in this position in

order to perform a breathing check

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Check for Normal Breathing

Look, listen and feel for normal

breathing for no longer than

10 seconds.

Agonal gasping is best described as

infrequent, noisy gasps.

This is not normal breathing and they

should be treated as a non-breathing

casualty.


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Your Bystander

Your bystander can be of a

great help to you by……….

• Calling for an ambulance

• Managing crowds and hazards

• Fetching the First Aid kit and

defibrillator if you have one

• Consoling relatives and friends

• Helping you if they are trained to

do so

• Cleaning up

• A support for you


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Any Questions?


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Module 7

Secondary assessment



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History

Casualty Assessment

Signs Symptoms

Will help you

make a diagnosis


• Head and face

• Neck

• Chest and shoulders

• Arms

• Spine

• Pelvis

• Abdomen

• Extremities

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Top-To-Toe Survey



Top-To-Toe Survey


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Kneel beside the casualty,

remove any spectacles or

wristwatch and check their

pockets for bulky items

such as keys etc.

Recovery Position

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Place the arm nearest to you at right

angles to their body with arm bent

in the position it falls.

Do not attempt to force the arm into

an unnatural position

Recovery Position

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Bring the arm furthest away from

you across the chest and hold the

back of the hand against the

nearest cheek

Recovery Position

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With your other hand,

grasp the far leg just

above the knee and pull it

up but keep the foot on

the ground

Recovery Position

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Keep their hand pressed

against the cheek and pull

on the leg to roll the

casualty towards you and

onto their side

Recovery position

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Roll them gently over,

supporting their head

constantly

Recovery position

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Adjust the upper leg so

that both the hip and

knee are bent at right

angles

Adjust the hand under

the cheek if necessary

to keep the head tilted

Keep the airway open

and monitor their

breathing

Recovery Position

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Casualty in the

Recovery Position

51

Keep talking to them, keep them warm and continue to

monitor their breathing

If injuries allow, turn the casualty to the other side after

30 minutes to relieve pressure on their lower arm


http://picasa.google.com/support/bin/answer.py?answer=154010&hl=en



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Any Questions?


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Module 8

The Respiratory System


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Respiratory System

The air we breathe in roughly consists of:

78% Nitrogen

21% Oxygen

0.96% Argon

0.04% Other gases

From the oxygen we breathe in, we use

approximately a ¼ of it, as our system

can only accommodate so much

The rest is dispelled with when we

breathe out, along with other gases

including carbon dioxide.


The Respiratory System

Left Lung

Alveoli (air sacs)

Bronchioles

(small airways)

Pleura or membrane

Right lung

Bronchi

Trachea or windpipe

Oesophagus (gullet)

Larynx or voice-box

Pharynx or throat

Epiglottis

Nasal Cavity Nasal Cavity

Mouth

Diaphragm

…and through our mouth We are able to breathe through our nose… An average adult at rest

will breathe approximately

10 – 20 times each minute

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55 © Nuco Training Ltd – January 2011

55


Any Questions?


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Module 9

Resuscitation


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Principles of Resuscitation

• Start with chest compressions. This artificially

circulates the oxygenated blood around the body and

in particular, the vital organs. The heel of one hand

must be placed in the centre of the chest – the bottom

half of the sternum or breastbone. If in doubt of this

position because of outer clothing, then remove or

undo the outer clothing

• After 30 chest compressions, give your casualty 2

ventilations or breaths

The recognised methods for this action are either by

mouth to mouth or mouth to nose

Both breaths should not take longer than 5 seconds

• If you are unable or unwilling to give 2 breaths for

whatever reason, you must continue with chest

compressions without delay.


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Principles of Resuscitation

• Start with chest compressions. This artificially circulates

the oxygenated blood around the body and in particular,

the vital organs. The heel of one hand must be placed in

the centre of the chest – the bottom half of the sternum or

breastbone. If in doubt of this position because of outer

clothing, then remove or undo the outer clothing

• After 30 chest compressions, give your casualty 2

ventilations or breaths.

The recognised methods for this action are either by mouth

to mouth or mouth to nose.

Both breaths should not take longer than 5 seconds.

• If you are unable or unwilling to give 2 breaths for whatever

reason, you must continue with chest compressions

without delay.

Continue until

your casualty show signs of regaining consciousness

such as coughing, opening their eyes, speaking or

moving purposefully,

AND

they start to breathe normally again,

or the emergency services take over, or you become

exhausted



Check for

dangers Check for

a response

Shout for

help

Tilt the

head back Open the

airway

Check for

normal

breathing

Ring for an

ambulance

Give 30

chest

compressions

Open the

airway Give 2

breaths

Repeat

30 : 2

Resuscitation Protocol

Make this call

yourself if you

have no help

Take no longer

than 10 seconds

Continue until

medical help

takes over,

you become

too exhausted,

or your casualty

recovers

Depth of 5 - 6 cms

Speed of 100 - 120

per minute

Take no longer

than 5 seconds

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Not breathing

normally


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Early recognition

and call for help

Recognise those at

risk of cardiac arrest

and call for help in

the hope that early

treatment can

prevent arrest

Early CPR

Start CPR to buy

time until medical

help arrives

Early

defibrillation

Defibrillators give

an electric shock to

reorganise the

rhythm of the heart

Post

resuscitation care

Provide

professional help in

order to restore the

quality of life

The Chain of Survival


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Any Questions?


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Module 10

Disorders of Respiration



If your casualty is

choking….. Encourage them

to cough…..

If this doesn’t work,

give up to 5

back blows…..

If this doesn’t work,

give up to 5

abdominal thrusts…..

If this doesn’t work, repeat the process of

up to 5 back blows, followed by up to

5 abdominal thrusts…..

If there is no improvement

after 3 cycles, then you

must call for an ambulance

If successful, then

reassure them and seek

medical help if appropriate.

If this is successful,

then reassure them

and seek medical help.

Dealing with a Conscious

Choking Adult

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Dealing with an Unconscious

Choking Adult Support the casualty

to the floor…. Call for an ambulance

immediately….

Commence CPR with 30

chest compressions

If they are not effective check

the airway and remove any obstruction

before your next attempt. Do NOT interrupt CPR Continue CPR

30 COMPRESSIONS – 2 BREATHS

until professional help arrives,

the casualty recovers,

or you become exhausted

Try to give 2 effective breaths

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Any Questions?


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Module 11

Disorders of the Circulation


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Oxygenated

blood to

upper

body

Blood

to lungs

Oxygenated

blood

from lungs

Oxygenated

blood

to lower

body

Blood

returning

from lower

body

Blood

to lungs

Blood

returning

from

upper body

Oxygenated

blood

from lungs

The Circulatory System



Plasma

• The fluid component of the blood

Platelets

• Aid the blood to clot

Red cells

• Carry haemoglobin that binds

the oxygen

White cells

• Manufacture antibodies and fight

infection & bacteria

Blood

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Other conditions include, excessive vomiting, diarrhoea,

injury to the spinal cord, infection, burns - plus many more

Causes of Shock

Blood Loss

Head Trauma Heart Attack

Poisoning

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• A rapid weak pulse

• Pale, blue/grey, cold clammy

skin

• Nausea and thirst

• Rapid shallow breathing

Recognition of Shock

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Treatment for Shock

• Treat the cause

• Lay the casualty down

• Raise and support the

legs if injuries allow

• Loosen tight clothing

• Keep the casualty warm

• Dial 999/112

• No food or drink



• Central chest pain

• Pain down left arm possibly

• Breathlessness

• A rapid or irregular pulse

• Rapid breathing and a

shortness of breath

• Pale blue/grey, cold and

clammy skin

• Nausea and vomiting

Recognition of a Heart Attack

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• Silent Heart Attack

• Feeling of “indigestion”

• No severe pain

Recognition of a Heart Attack

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Treatment for a heart attack

• Make the casualty comfortable and warm

• Position the casualty in the

half-sitting position

• Monitor the casualty’s breathing

• Call 999/112

• Calm and reassure

• If casualty becomes

unconscious carry out the

procedure for BLS

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Anaphylactic Shock

Extreme Allergic Reaction

Food

Peanuts

Pulses (e.g. Lentils)

Tree nuts

Sesame

Fish

Shellfish

Dairy Products

Eggs

Fruit

Non-Food

Wasp Stings

Bee Stings

Natural; Latex (rubber)

Certain medicines or injections

Antibiotics (especially penicillin)

Aspirin

Non-steroidal anti-inflammatory

drugs (e.g. ibuprofen)

Possible Causes


A Major Allergic Reaction to the

Body • Anxiety

• Red, blotchy skin

• Swelling of the face and neck

• A rapid pulse

• Swelling of the mouth and tongue

Recognition of

Anaphylactic Shock

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Treatment for

Anaphylactic Shock

• Call 999/112

• Sit the casualty up if they are conscious

• Encourage them to use their own medication

if it is available

• Be prepared to open their airway

and resuscitate them

• Monitor their airway

and breathing

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Any Questions?


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Module 12

Wounds and Bleeding



Types of Wounds

Incision Clean cut as with

a knife blade

Laceration Rough tear as

with barbed wire

Abrasion Scrape as with a

gravel rash

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Types of Wounds

Contusion A blunt blow

causing bruising

Puncture A stabbing type

wound

Velocity Gun shot wound

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• Arterial

• Bright red oxygenated blood

• Spurts from the wound in time with

the heartbeat

• Venous

• Dark red blood will gush from the

wound or pool at the site of the

wound

• Capillary

• Oozing occurs at the site

Types of Bleeding

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Preventing Cross Infection

• Wear disposable gloves

• Where possible, wash hands before dressing a

wound

• Cover cuts and grazes on your hand

• Avoid touching the wound

• Try not to talk, sneeze or cough over the wound

• Place all soiled dressings and materials, including

gloves, in a suitably marked (orange/yellow)

plastic bag

• Put sharp items such as needles or syringes in

containers for disposal

84

Rescuers should take appropriate safety precautions

where feasible, especially if the casualty is known to

have a serious infection such as tuberculosis (TB)

or severe acute respiratory distress syndrome (SARS)

During an outbreak of a highly infectious condition

such as SARS, then protective precautions for the

rescuer are essential


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• Wear gloves

• Check wound for embedded objects

• Use sterile dressing

• Elevate and support injured

limbs

Treatment of Bleeding

If further bleeding occurs, apply a second dressing on top of the first If blood seeps through both, then remove both dressings, and apply a new dressing, making sure that pressure is applied accurately at the point of bleeding

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Any Questions?

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Check the wound for

anything embedded

Wounds with

Embedded Objects


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Apply dressings and pressure to

either side of the object


Wounds with

Embedded Objects

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Ask the casualty to assist if

they are able to do so

Wounds with embedded objects


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Apply a larger sterile

dressing over the top


Wounds with

Embedded Objects

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Secure the bandage


Wounds with

Embedded Objects

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Treat for shock as soon as

you can


Wounds with

Embedded Objects

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Site

Mouth

Appearance Cause

Ear

Nose

Anus

Uretha Bleeding from the bladder, kidneys.

Vagina Either fresh or dark blood Menstruation, miscarriage, disease or

injury to the vagina or womb.

Bleeding from Orifices

Bright red, frothy, coughed up. Vomited

blood, red or dark reddish brown

Bleeding in the lungs.

Bleeding in the stomach.

Fresh bright-red blood.

Thin, watery blood

Injury to ear, perforated eardrum.

Head injury.

Fresh bright red blood.

Thin, watery blood

Ruptured blood vessel in nostril.

Skull fracture.

Fresh bright-red blood.

Black tarry, offensive-smelling stool

Injury to anus or lower bowel.

Injury to upper bowel.

Urine with red or smoky appearance and

occasional clots


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Any Questions?


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Module 13

Epilepsy



Recognition of

Minor Epilepsy

• Sudden absence

• Staring blankly ahead

• Slight twitching

• Chewing and lip smacking

• Plucking at clothing

• Noises

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Treatment of

Minor Epilepsy

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• Make the casualty safe

• Sit them down, calm

and reassure them

• Monitor and discuss the

condition with them

• Establish a history if

there is one

• Establish if any

medication is being taken

• Refer to the doctor if it

is necessary to do so


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Recognition of major epilepsy

• A warning period

• The casualty becomes rigid

and often cries out

• Sudden collapse and

becomes unconscious

• Cyanosis may be present

and breathing may cease

• Convulsive movement

which can be violent

• Loss of bladder or

bowel control

• Clenched jaw and congestion

of the face



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Treatment of

Major Epilepsy

If

or

or

or

Dial 999/112

• Support or ease the casualty’s fall

• Make space around the casualty

• Ask bystanders to move away

• Protect the casualty’s head

• Record the duration of the seizure

• Do not restrain the casualty

• Do not put anything in their mouth

Unresponsive for longer than ten minutes

Seizure lasts for longer than five minutes

Repeated seizures

It’s their first seizure



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Any Questions?


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Module 14

Minor Burns and Scalds



Superficial burn • Only the outermost layer of skin is affected

• Redness, swelling and tenderness

• 5% or more must be sent to hospital

Partial thickness burn • Rawness and blisters

• 1% or more must be sent to hospital

• 9% will cause shock

Full thickness burn • The two layers of the skin, the epidermis

and dermis, are burnt

• Requires hospital treatment

Depth of Burns

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103

Wallace’s Rule Of Nines

9%

Back 18%

Front 18%

9% 9%

1%

18% 18%

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Treatment of Burns

• Flood the injured part

with cold water

(minimum of 10 minutes)

• Gently remove any

jewellery or wrist watches

• Cover the area with a

sterile dressing

break blisters

apply adhesive dressings

apply lotions, ointments or fats

attempt to remove anything sticking to the burn

DO NOT DO NOT

DO NOT

DO NOT



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Any Questions?


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Module 15

Foreign Objects


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• Nose

• Ear

• Eye

• Swallowed

• Others

Foreign Objects



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Module 16

Course Closure



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Any Questions?

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Course Closure

• Please check your names on the register in

respect of clarity for certification purposes

The name that is shown will be printed on

your certificate

• Collect your CPC Certificates before you leave

• Fill in appropriate Evaluation Forms

Have a safe journey home!


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All rights reserved. No part of this publication may be reproduced, stored in a retrieval system or

transmitted in any form or by any means without written permission from Nuco Training Ltd

This publication is supplied subject to the condition that it shall not, by any way of trade or

otherwise, be lent, re-sold, hired out or otherwise circulated without the prior consent of

Nuco Training Ltd


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