Emergency Aid

On this page, I look at the most common First Aid emergencies and explain how to treat them. This is followed by instructions on how to perform CPR. Then there are lists for equipment that should be found in your First Aid Kit. Some organisations have slightly different ways of treating injuries, but this is a good middle of the road, information page.

Bleeding

Controlling bleeding is almost always very simple. Most external bleeding can be controlled by applying direct pressure to the open wound. Direct pressure permits normal blood clotting to occur.

Remember that a small amount of blood appears as a lot of blood. It is important for you to keep calm and do what is necessary for the victim.

When it is necessary to control bleeding, use the following methods:

Direct pressure with sterile bandage, if available

Elevation

Pressure points

The best all around method of controlling bleeding is applying pressure directly to the wound. This is best done by placing gauze or the cleanest material available against the bleeding point and applying firm pressure with the hand until a cover bandage is applied. The cover bandage knot should be tied over the wound unless otherwise indicated. The bandage supplies direct pressure and should not be removed until seen by a doctor.

If bleeding continues after the bandage has been put on, this indicates that not enough pressure has been applied. Use the hand to put more pressure on the wound over the bandage, or apply a second bandage. Do not remove original dressing. Either method should control the bleeding. Elevating the bleeding part of the body above the level of the heart will slow the flow of blood and speed clotting. Use elevation with direct pressure when there are no fractures or fractures have been splinted and it will cause no pain or aggravation to the injury.

Nosebleeds

Nosebleeds are more often annoying than life threatening. They are more common during cold weather, when heated air dries out the nasal passages. First aid for nosebleeds is simple:

Keep the victim quietly seated, leaning forward if possible.

Gently pinch the nostrils closed.

Apply cold compresses to the victim's nose and face.

If the person is conscious, it may be helpful to apply pressure beneath the nostril above lip.

Instruct victim not to blow his/her nose for several hours after the bleeding has stopped, or clots could be dislodged and start the bleeding again.

Nosebleeds that cannot be controlled through these measures may mean a problem, such as high blood pressure. The victim should see a doctor. Anyone who suffers a nosebleed after an injury should be examined for possible facial fractures. If a fractured skull is suspected as the cause of a nosebleed, do not attempt to stop the bleeding. To do so might increase the pressure on the brain.

Shock(Occurs to leaders when Cubs walk into the hall)

The state of shock may develop rapidly or it may be delayed until hours after the event that causes it. Shock occurs to some degree after every injury. It may be so slight as not to be noticed; or so serious that it results in death where the injuries received ordinarily would not prove fatal.

Some of the major causes of shock are as follows:

Severe or extensive injuries

Severe pain

Loss of blood

Severe burns

Electrical shock

Certain illnesses

Allergic reactions

Poisoning inhaled, ingested, or injected

Exposures to extremes of heat and cold

Emotional stress

Substance abuse

The signs and symptoms of shock are both physical and emotional. Shock may be determined by any or all of the following conditions:

Dazed look

Paleness in light skinned individuals and ashen (greyish) in dark skinned individuals

Nausea and vomiting

Thirst

Weak, rapid pulse

Cold, clammy skin

Shallow, irregular, laboured breathing

Pupils dilated

Eyes dull and lacklustre

Cyanosis (late stages of shock)

The brain suffers from a decreased blood supply and does not function normally; the victim's powers of reasoning, thinking, and expression are dulled. The victim may exhibit the following:

Weak and helpless feeling

Anxiety

Disorientation or confusion

Unconsciousness (late stages of shock)

First aid for the victim of physical shock is as follows:

Keep the victim lying down, if possible. Make sure that the head is at least level with the body.

Elevate the lower extremities if the injury will not be aggravated and there are no abdominal or head injuries. If in doubt, keep the victim flat.

Provide the victim with plenty of fresh air.

Loosen any tight clothing (neck, chest, and waist) in order to make breathing and circulation easier.

Handle the victim as gently as possible and minimise movement. Keep the victim warm and dry by wrapping in blankets, clothing, brattice cloth, or other available material. These coverings should be placed under as well as over the victim to reduce the loss of body heat. Keep the victim warm enough to be comfortable. The objective is to maintain as near normal body temperature as possible, not to add heat.

Do not give the victim anything by mouth. The victim's emotional well-being is just as important as his/her physical well-being. Keep calm and reassure the victim. Never talk to the victim about his/her injuries. Keep onlookers away from the victim as their conversation regarding the victim's injuries may be upsetting.

Fainting (Occurs to leaders when Scouts remember all of their camp kit.)

Fainting is a temporary loss of consciousness due to an inadequate supply of oxygen to the brain and is a mild form of shock.

Fainting may be caused by the sight of blood, exhaustion, weakness, heat, or strong emotions such as fright or joy, etc. Some people faint more easily than others.The signs and symptoms of fainting may be any or all of the following:

The victim may feel weak and dizzy, and may see spots.

The face becomes pale and the lips blue.

The forehead is covered with cold sweat.

The pulse is rapid and weak.

The breathing is shallow.

The first aid for fainting is as follows:

If the person feels faint, the initial response might be sitting with the head between the knees

Have the victim lie down with the head lower than the feet.

If the victim is unconscious for any length of time, something may be seriously wrong. Arrange for transportation to a medical facility.

Treat the victim for physical shock.

Maintain an open airway.

Do not give stimulants.

Stings

The signs and symptoms of insect bites and stings are as follows:

The stings of bees and the bites of mosquitoes, ticks, fleas, and bedbugs usually cause only local irritation and pain in the region stung or bitten.

Moderate swelling and redness may occur and some itching, burning, and pain may be present.

The first aid for insect bites and stings is as follows:

The sting area should be inspected to determine whether the stinger is still left in the body. If it is, remove it in order to prevent further injection of toxin. The sting should be carefully scraped off the skin, rather than grasped with tweezers, so as not to squeeze toxin into the body.

Application of ice or ice water to the bite helps to slow absorption of toxin into the blood stream. A paste of baking soda and water can also be applied to the bite.

The victim should be observed for signs of an allergic reaction. For people who are allergic, maintain an open airway and get the victim to medical help as quickly as possible.

Burns and Scalds

The first aid given to a burn victim largely depends on the cause of the burn and the degree of severity.

Emergency first aid for burns or scalds should primarily be exclusion of air from the burned area, relief of the pain that immediately follows burns, minimising the onset of shock, and the prevention of infection.

Never remove any clothing from the affected burn or scald area, taking this off will cause the skin to be removed create further problems like infections. Keep the patient covered, except the injured part, since there is a tendency to chill.

First aid dressings for burns and scalds should be free of grease or oil. The use of greases or oils in the treatment of burns makes it necessary to cleanse the burned or scalded areas with a solvent before medical treatment can begin. This delays the medical treatment and is very painful.

Be careful when dressing burns and scalds. Burned and scalded surfaces are subject to infection the same as open wounds and require the same care to prevent infection. Do not break blisters intentionally.

Never permit burned surfaces to be in contact with each other, such as: Areas between the fingers or toes, the ears and the side of the head, the undersurface of the arm and the chest wall, the folds of the groin, and similar places.

Cover bandages should be loose enough to prevent pressure on burned surfaces. As swelling often takes place after burn dressings have been applied, check them frequently to see that they are not too tight. Watch for evidence of shock and treat if it is present.

In cases of severe burns, remove the victim to the hospital as quickly as possible. The victim will probably require an anaesthetic so that ordinarily nothing should be given by mouth.

 

C.P.R

The CPR procedures should be learned and practised on a training mannequin under the guidance of a qualified instructor. The step by step procedure for cardiopulmonary resuscitation is as follows:

Establish unresponsiveness. Gently shake the victim's shoulder and shout, "Are you OK?" The individual's response or lack of response will indicate to the rescuer if the victim is just sleeping or unconscious

Call for help. Help will be needed either to assist in performing CPR or to call for medical help.

Position the victim. If the victim is found in a crumpled up position and/or face down, the rescuer must roll the victim over; this is done while calling for help

A.B.C. (Airway, Breathing, Circulation)

A-Airway. Open the airway. The most common cause of airway obstruction in an unconscious victim is the tongue.

Use the head-tilt/chin-lift manoeuvre to open airway. (This manoeuvre is not recommended for a victim with possible neck or spinal injuries.)

B-Breathing. Establish that they are not breathing. After opening the airway repeat check.

Turn your head toward the victim's feet with your cheek close over the victim's mouth (3 to 5 seconds).

Look for a rise and fall in the victim's chest.

Listen for air exchange at the mouth and nose.

Feel for the flow of air.

Sometimes opening and maintaining an open airway is all that is necessary to restore breathing.

Provide artificial ventilation.

If the victim is not breathing give two full breaths by mouth-to-mouth, mouth-to-nose-nose, or mouth-to-stoma ventilation

Allow for lung deflation between each of the two ventilations.

C-Circulation. Check for pulse. Check the victim's pulse to determine whether external cardiac compressions are necessary.

Maintain an open airway position by holding the forehead of the victim.

Place your fingertips on the victim's windpipe and then slide them towards you until you reach the groove of the neck. Press gently on this area (carotid artery) Check the victim's carotid pulse for at least five seconds but no more than ten seconds.

If a pulse is present, continue administering artificial ventilation once every 5 seconds or 12 times a minute. If not, begin CPR.

Perform cardiac compressions.

Place the victim in a horizontal position on a hard, flat surface.

Locate the bottom of the rib cage with the index and middle fingers of your hand closest to patient's feet.

Run your index finger up to or in the notch where the ribs meet the sternum (breastbone).

Place your middle finger in notch and index finger on sternum.

Place the heel of the other hand on the sternum next to the index finger in the notch in the rib cage.

Place the hand used to locate the notch at the rib cage on top and parallel to the hand which is on the sternum.

Keep the fingers off the chest, by either extending or interlocking them.

Keep the elbows in a straight and locked position.

Position your shoulders directly over the hands so that pressure is exerted straight downward

Exert enough downward pressure to depress the sternum of an adult 1 1/2 to 2 inches.

Each compression should squeeze the heart between the sternum and spine to pump blood through the body.

Totally release pressure in order to allow the heart to refill completely with blood.

Keep the heel of your hand in contact with the victim's chest at all times.

Make compressions down and up in a smooth manner.

Perform 15 cardiac compressions at a rate of 80-100 per minute, counting "one and, two and, three and,.....fifteen".

Use the head-tilt/chin-lift manoeuvre and give two full breaths (artificial ventilation).

Repeat cycle four times (15 compressions and 2 ventilations).

After the fourth cycle, recheck the carotid pulse in the neck for a heartbeat (5 to 10 seconds).

If breathing and heartbeat are absent, resume CPR (15 compressions and 2 ventilations).

Stop and check for heartbeat every few minutes thereafter.

Never interrupt CPR for more than five seconds, except to check the carotid pulse or to move the victim.

 

Pack First Aid Kit

The Troop First Aid Kit should be kept in a dust and damp proof box. It should be clearly labeled with a white cross on a green background (but the box itself can be any colour - perhaps a high visibility colour is best). In the Troop First Aid Kit you need to keep everything you may need for emergencies both on Troop Nights and when you are out on activities. You should keep a list in the box of what is in it so that stock can be replaced when it is used.

The following list is a guide as to what you should keep in your Troop First Aid Kit, and is by no means definitive.

Plasters: About 20, individually wrapped. You may wish to opt for the blue plasters suitable for use in a kitchen. It is a good idea to ask on health forms whether Scouts are allergic to plasters.

Bandages: Several, in different sizes.

Sterile Dressings: Several, in different sizes. These are particularly good as they are both the pad to put on the wound, and the bandage to strap the wound up with.

Triangular Bandages: About four. Don't forget you can always use neckers if supply becomes short.

Eye Pads.

Safety Pins.

Needle and Tweezers.

Tubigauze.

Antiseptic Wipes: You should use running water in preference if it is available. This is because antiseptic kills skin cells as well as germs. If you will not have a water supply during any activity, supply antiseptic wipes.

Plastic Bags: Useful for all sorts of things!

Tissues.

Disposable Gloves: To protect both the first aider and the casualty.

Scissors.

Dressing Tape: For holding dressings and bandages in place.

Notebook and Pencil.

You will also need your accident book along with a copy of your accident procedure document. That way, when something happens, it can be documented straight away and the necessary action taken.

Personal First Aid Kit

When camping, or walking, or going on any Scouting activity, you should all have personal first aid kits. These are kept in your own kit and are totally separate from the Troop First Aid Kit mentioned above.

Your personal first aid kit should be small but include everything you think you will need for emergencies. It is advised that you keep it in a small, waterproof, bag so that it is all kept together and is kept tidy.

The following are some of the things you may wish to keep in your Personal First Aid Kit:

Plasters: It is a good idea to keep some plasters of the brand you use at home in your personal kit, in case you cannot use the ones in the Troop Kit.

Pain Killers: On the camp permission and health form we ask the parents permission if we can allow their son/daughter to take their own pain killers, and under what circumstances. You should always tell a leader (preferably the first aider) if you take anything, what it is and how much you have taken.

Antiseptic Wipes.

A crepe or woven bandage.

Safety pins: Just a couple! For use with the bandage and to make a sling from your necker.

Tissues.

Sun Cream.

Sting Cream.

Any Medication: This includes asthma pumps and any other medication you take regularly or are likely to need. All such items should be clearly labelled with your name, what it is, what it is for, and the dose. Usually this is handed into the first aider before we leave for any activity - but putting it with your personal first aid kit will ensure you do not forget it!

50p: It may seem out dated to include money for a phone box in your kit, but you can never be sure that your mobile will work where you are!

Pencil and paper.

You should remember that everything you take, especially any tablets, should be clearly marked with your name and what they are. Unmarked packets and bottles should not be taken at all! Glass medicine bottles are not advised, but if there is no alternative then make sure the glass is well protected.

 

  For more information contact: 01974 298005