1.WELCOME Public First AidCertificate Course (English) PCFA/ 10 / 11

2. Important to know

Course Ref. No. :PCFA/ 10 / 11 (English)

Venue :Room 403, St. John Tower,

2 MacDonnell Road, H.K.

Date Morning Afternoon Total Hours (30 hours) 9.8.10(Mon) 0900- 1300 hours 1400 1730 hours 7.5 10.8.10(Tue) 1400 1700 hours 7 11.8.10(Wed) 1400 1800 hours 8 12.8.10(Thur) 1400 1730 hours 7.5 3. Important to know

Examination :

Date :

Time :7:30 p.m. -10:30 p.m.

Venue :/F., St. John Tower,

2 MacDonnell Rd.,H.K.

4. Examination

Eligible to sit for exam. :

at least80% (24 hours) attendance in class

in class

Parts Description Time Required 1 Written examination 30 itemsMultiple-Choice Questions 30 min. 2 Bandaging Bleeding woundand fracture (draw-slots) About 20 min. 3 Cardio-Pulmonary Resuscitation (CPR) Adult CPR About 10 minutes 5. Preparations for Examination Parts ofExam. (Time) Preparations 1 Written examination (30 min.) Stationery : 2 blackball pens, correction ink HKID card 2 Bandaging (15-20 min.) Roller bandage : 2 and 3 X 2 each size Bandage clips X 4 no. Gauzes : 6 pieces Triangular bandages :at least 6 pcs. Pads / towels : large and small X 2 each 3 Cardio-pulmonary Resuscitation (about 10 min.) Face shield (provided by HKSJ) 6. Thank for your cooperation

Participate actively in class activities and choose one classmate ofsame sexas a partner to practise bandaging if possible.

Keep the classroom clean

without eating or drinking in class.

3.Change your mobile phone tovibratory modeandavoid engaging in mobile phone conversationwhen lecturing is in progress.

4.Notto take video or photos in class ; buy one DVD ($15)

5.Bring and use your own bandage pack .

7. Thank for your cooperation

6. Do not attend lecture(s) if you werepregnant or

had fever, persistent cough, skin infection and/or running nose .

Proper handwashing is advised.

7. Buy and use aface shieldduring the practical session of CPR.

8. Wear a shirt / T-shirt with a collar and

buttons to protect own privacy

during the practical session of CPR.

9. Observe any adverse changes of weather

a. H.K. tropical cyclone warning signals and

b. Rainstorm signals : amber, red, black

For enquiries, please dial 2539 8027

8.

Lecture One

Principles of

Mr. W.Y. TANG 9. Learning Objectives

Upon completion of this session, participants will

be able to :

Define first aid.

List 3 aims of first aid.

List 4 main responsibilities of a first aider.

Explain DRABC.

Define signs and symptoms and give 4 examples for each.

Provide psychological support to a casualty.

Differentiate between primary survey and secondary survey.

10. Learning Objectives

8.Arrangean unconscious casualty in recovery position.

9.List 2 advantages of recovery position.

10. List 2 contraindications of recovery position.

11. Use a triangular bandage to:

- tie and untie a reef knot

- make a ring pad

- apply

a. an arm sling

b. an elevation sling

12. Check circulation of the fingers after applying a sling.

13. Use improvised slings

11.

What ?

Initialassistance or

treatment

Whom?

a. The injured person

b. suddenly ill person

When?

Before the arrival of

ambulance or medical aid

How?

Make use ofmaterials and persons available on the spot

12. 3 Aims of First Aid

To save life

To prevent

the condition

from getting worse

To promote recovery

13. First Aiders

Being qualified

.Holder ofa valid

certificatefrom

. Competence :ASK

. Reassessed

every 3 years

Negligence breach of duty of care, foreseeable,

causation, harm/damage

14.

Knowledge

Self : abilities, limitations (experiences), vaccination

First aid, PPE, leadership, cooperation, responsibility,

stress coping, decision making

AffectionSkills

Emotion, sensitivity, sympathyTrained -

Empathy, considerate, supportiveAct quickly , gently

Trust and respect othersResponsive

First Aiders 15. 4 Main Responsibilities of A First Aider

Assessment (Danger)

Diagnosis (Response, ABC, Condition)

First Aid

(Use Personal Protective Equipment)

Disposal, Record and Report

16. DO FIRST 1.Physical Care: D anger R esponseA irwayB reathingC irculation H aemorrhage S hockF ractureLife- threatening 999 17. 2. Psychological Care Casualty First Aider Upset, tearful, angry,frightened,distressed Psychological support Help to regain confidence Early referral Positive feeling Negative feeling Coping skills Share& consult others 18. 1. Safe Environment 2. NatureofAccident /Illness 3.Casualty 4. Self-Competence Assessment 19. Assessment

Safe environment

-Safety: casualty, first aider and onlookers

- Danger : actual, potential

e.g. fire, poisoning, electrocution,

machine, drowning etc.

- In traffic accident :

. Wear high-visibility jacket

. Warning triangle : > 45m away

. Keep hazard lighting flashing

. Aware of slipperyand oily road surface

. Never cross a motorway to attend a casualty

19.4.2010 20. Assessment

2. Nature of accidentor

state of physical / mental illness

21. Assessment

3. Casualty- number, age and gender

. special attention to :

a. pregnant women

b. self-harm (suicide) person

c. dying

d. badly injuredor ill

4. Self-Competence

- if alone, not approach

the scene,dial 999 or 992 (fax)

*Triagedone by the emergency services

22.

Approaching

The Casualty

23.

Approach

Face the casualty

Build and maintaintrust

- self-identification

- greet by name

- crouch or kneel down

-talk with the parents before touching the child

- explain and reassure

- get consent; inform actions to be taken

- treat with dignity and respect wishes

- allow position of comfort

Approaching The Casualty 24. Approaching The Casualty

Communication skills:

-V oice: calm and confident; no shout

-S peed: not too fast

-Language: same and simple,

interpreter if needed

-Instructions: simple and short

-Eye contact , not stare

25. Approaching The Casualty

Communication skills (contd):

- Use affirming nods and mmms

- Use simple hand gestures and

movements

- Touch the shoulder, arm or hold hand

- Not interrupt the casualty

- Answer questions honestly

- Summarize the given information to

show understanding

26. Approaching The Casualty

If the casualty refuses help :

- Thecasualtys right

-Notargue or disagree;explain actions

intended

- Dial 999 and report facts

- Stay at a safe distance and observe until

allowed

NO 27.

Using By-standers

28. Using By-standers

1. Attitude

- calm, firm and gentle manner

2. Seek help

- invite by-standers to:

Phone -dial 999 for ambulance, inform

tel. no., location, type and severity of

emergency, casualties, hazards;

emphasize toreturn & report (P.21-23)

first aid

29. Using By-standers

Seek help(contd)

- invite by-standers to :

get first aid equipment

provide physical care, psychological support

make the area safe

maintain the casualtys privacy

not let people crowd the scene

transport the casualty

30.

Prevention of

Cross Infection

31. Prevention of Cross Infection

First aider

i.Beforework

. i.e.inspectthewound

a.Wash and dry hands properly or use alcohol gel(P.17)

b. Inspect own hands for a cut or graze

c. Cover open wound

with water-proof dressings

32. Prevention of Cross Infection

First aider

d. Wearpersonal protective equipment (PPE)

e.g. gloves (P.18)

. latex-free ornitrile(blue or purple)

to prevent from acquiring

blood-borne diseasese.g. AIDS, hepatitis B or C,

syphilis, malaria

. mask

. face shield

. plastic glasses

. plastic apron etc.

33. Prevention of Cross Infection

First aider (contd)

ii.During wok :

.Do not touch :

a. the bleeding wound with bare hands

b. clean or sterile dressing that covers thewound

. Do not breathe, cough, sneeze over a wound

. Ask the casualty tohelp oneself

e.g. apply direct pressure on the dressing

. Use a clean plastic bag to cover hands if no gloves

available

.Change glovesafter attending one casualty

34. Prevention of Cross Infection

First aider

iii. After work :

. Remove gloves turn it inside out

. Dispose used gloves, soiled dressings, waste

safely >plastic orbiohazard bag ; useyellow

sharps container for sharps

. Use soap and water to wash hands or use

alcohol gelto rub handswith attention to

palms, dorsums, fingers, thumbs, nails andwrists

35.

Diagnosis

36. Diagnosis

I. Priority

- more than one casualty :

. Attend unconscious or badly injured casualty

first

-treat casualtiesin position foundunless in danger

-For driver :

support the head and neck

37. Diagnosis Primary Survey Secondary Survey DRABCHSF CPR

History

Signs and Symptoms

Physical exam.

External clues

38. Primary Survey

Primary survey

- must be donebefore leaving acasualty

. level of consciousness (R)

AVPU code

. airway (A)

. breathing (B)

. circulation (C )

* No breathing and pulse :

initiate cardio-pulmonary

resuscitation (CPR)

39. The Falling Back of the Tongue Risk of Unconsciousness Blocked Airway (A) 40. Head Tilt Chin Lift To Open Airway 41. Breathing (B)

Check breathing :look, listen, feel

Note: rate, depth, ease, noise

Chest wall movement rise and fall

Normal rate of breathing :

. Adult : 12 - 16 breaths/min.

(average 16 breaths/min. )

. Children : 20 - 30 breaths/min.

. Baby : 20 30 breaths/min.

Depth - shallow or deep

Easiness, breathing sounds

** No spontaneous breathing :

give rescue breaths

Face Shield 42. Circulation (C)

1.Check pulse

rate, strength (strong / weak), rhythm (regularity), tension

a. Adult :(P.53)

. site : carotid pulse,brachial pulse, radial pulse, femoral pulse

. rate : normal pulse rate: 60 80 beats / min.

b. Child: similarto adult

c. Baby: brachial pulse, rate is much faster,

about 100 140 beats / min.

2. Signs of circulation: any breathing, coughing, body/limbs

movement

If 1 & 2 were absent, doexternal cardiac compression

43. Secondary Survey

1.History AMPLE

-a llergy

-m edication

-p revious medical condition

-l ast meal

-e vent history

Information from the casualty,

eye-witness, relatives

44. Secondary Survey

2.Signs:

- Look : bleeding

Feel : cold/hot

Listen : wheeze, stridor

Smell : alcohol, urine,

faeces, acetone

3. Symptoms

-sensations described

e.g. nausea, pain, dizzy,

thirst, cold (P.51)

45. Secondary Survey

4. Physical examination:

Before :

-consentof the casualty

During :

- wear gloves

- head-to-toe survey (P.49-51)

- expose body parts & maintain privacy

and warmth

- remove / cut garment along the seams carefully

- do it systematically

- look, listen, feel, smell

- use both hands

- move with minimal disturbance

Cut or remove clothingP.232 46. Secondary Survey

4. Physical examination (contd)

During:

- compare one side with the other

-examine the painful part last

- check for swelling, tenderness, bleeding or

abnormalities

-not remove helmetif untrained to do so (P.233)

After :record, check comfort

47. Head-to-Toe Survey

Head8. Shoulders and clavicles

Ears9.Chest

Eyes10.Abdomen

Nose11.Hip and pelvis

Mouth12.Lower legs

Face13.Feet

Neck14.Forearm, hands, spine

48. Secondary Survey (contd)

-External clues:

a. Medical follow-up

card

b. Warning bracelet

e.g. epilepsy, diabetic,

allergy

c. Drugs

e.g. steroid, warfarin, insulin,

aspirin, TNG, phenytoin,

reliever inhalerfor asthma

d. Syringes

e. Needle marks, sweets

49. Examples of DrugsKept by a CasualtyAlways ask abystanderto act aswitnesswhen searching the casualtys bag for clues.Medicines e.g. glyceryl trinitrate foranginaand phenytoin for epilepsy A warning bracelet states medical condition andmay give a phone no. for information about the casualtys medical history. Auto-injector Contains epinephrine (adrenaline), for people at risk of anaphylactic shock. 50. WarningCard I am a Diabetic If you find me confused with strange behaviour, it may be due to disturbed blood sugar level.If I can drink, please give me a cup of sugary drink.If I remains confused after 10 15 minutes, please send me to hospital immediately or inform my relatives by phone. If I cannot swallow, or become comatose, please dial 999 and send me to hospital without delay or informmy relatives. Thank you very much for your help. Name :Tel. : Address : s Follow up hospital : Dr. :Next of Kin :Tel. : Oral drug : Dose : Frequency & Time : Insulin & Dose : Frequency & Time : Other : 51.

First Aid

52. First Aid

Dial 999 before starting first aid

- use resources available

- not move the casualty unnecessarily

- give first aid on the spot

2.Injuries

- bleeding wound

. control bleeding - dressings

and bandage with elevation

- fracture, sprain, strain

. immobilization

. rest, ice,compression/comfortable

supportand elevation (R.I.C.E.)

Bruise 53. First Aid

3. Illness

- Stroke / shock: A,B,C

- Coma : recovery position

- Heart attack : A,B,C

- Hyper/hypothermia : lower / increase temp.

- Epilepsy : protect and observe

4. Cardiac / respiratory arrest - CPR

54. First Aid

Self-administered drugs- ensure :

1. Appropriate to the condition

2. Not out of date

3. Taken as doctors advised

4. Precautions strictly followed

5. Recommended dose

6. Record name, date, time, method and frequency

Never buy, borrow, give drug or antidotesby first aiders

Never giveaspirinfor a personnarrow-fold bandage (3) 1 2 74. Triangular Bandage

• Reef knot

• - left cross right , right cross left

• flat surface at its back, U-shape, easy to untie, safe, not slip, comfortable

• Rules for application

• -Must stand in frontof the casualty and observe response

• Explain and reassure the casualty before application

• Support the injured part

• Expose finger nails for inspection

• Pad reef knotabove the clavicle , not acting on bone

• Check circulation every 10 minutes

75. Triangular Bandage Uses Whole piece Arm /elevation sling, ring pad, the headBroad-fold bandage Immobilize fracture - clavicle, upper arm, forearm,wrist (elbowcan bend) , hand,fingers,flailchest - upper arm, elbow or forearm (elbowcannot bend) - pelvis, thigh, knee(pad), leg Narrow-fold bandage Immobilize feet : fracture pelvis, thigh, leg Control severe bleeding : palm 76. Reef Knot L R LeftCross Right Right Cross Left L R Untie a reef knot Reef Knot (U-shape) 77. Ring Pad

• Narrow fold bandage

• Size of ring

• Form loop

Tuck tail Ring pad 78. Arm Sling, P.251 1. Unfold triangular bandage 2. Keep theapex2 3 inches away from the elbow 3. Pad reef knotabove the clavicle 4. Twist the apex backwards Direct one end ofbandage to the injured side Expose all fingers 79. Elevation Sling 1 2 3 4 5 6 Hold hand Tuck the apex under the upper arm3 Pull backward, keep it under the scapulaPad reef knot just above the clavicle Tidiness 80. Slings Reef knot Injured side Injured side Reef knot Expose nails Arm Sling Elevation Sling Use Support theupper arm, elbow, forearm and wrist Hand and fingers Injured arm position Bend the elbowbetween 80-90 degreesCrossthe chest with injured fingers almosttouching the shoulder Knot On the injured side,at the hollowjustabove the clavicle On theun injured sideabove the clavicle 81. Check Circulation (Every 10 Min.) After Applying A Sling

• Temperature : warm or cold

• Pulse : present ofradial pulse

• Sensation : numbness ortingling sensation

• Fingers movement

• Capillary refill test

• .Apply pressure on a nail bed

• . Colour changes from pink to white

• . Release pressure

• . Normal : rapid return of pink colourwithin 2 seconds

• 6.Swelling and cyanosis

• * If the circulation is affected, remove bandage and reapply again

82. Four Improvised Slings (P.253) Jacket Corner Check Circulation Button-Up Jacket Support wrist on lower button Anchor using a safety pin Place handin loop Check circulation 1 2 3 4 Protect elbow Unfasten button Long-Sleeved Shirt Belt or Thin Garment 83. References

• St. John Ambulance, St. Andrews Ambulance

• Association, British Red Cross. (2009).First Aid

• Manual . (9 thed., P.12-31,37-53, 64-65, 72-73,

• 232- 233, 242, 249-253). London : Dorling

• Kindersley.

• (2007)

• ( 13-34 40-41,195-198

• 201-203 ) :