First aid

First aid

First aid consists of the immediate attention given to a sick, injured or injured person at the scene of events, before the arrival of specialized personnel or being transferred to a center care or hospital.

They are urgent therapeutic measures that are applied to victims of accidents or sudden illnesses. The purpose of first aid is to relieve the pain and anxiety of the injured person or patient and prevent the worsening of the state of it.

Sequence of care

For example, if a person is found unconscious or suspected of having received an electric shock or electrocution, the person who will treat them must be sure that the same thing will not happen to them. You should check that the area is safe. If there is someone else at the scene of the accident, you must give them instructions to request emergency services, giving the following information:

1. The phone number you're calling from, if you know it.
2. The location of the victim's location.
3. The kind of urgency the victim is experiencing.
4. The kind of help that is being provided.
5. His name.
6. What other help you need: firefighters, police,

Then the patient is assessed.

1. Primary patient assessment.
2. Rationale of conscience: the victim will be asked how he is, how he is. If he answers, it is an unequivocal symbol that he breathes and has a pulse. If you do not answer, pinch slightly on your shoulders; if you react, follow the previous behavior. In case of death, call emergency services as soon as possible. A quick way to value consciousness is to determine whether or not it responds:
   • Alert. He's awake, he talks.
   • Verbal. Answer the call, when we raise the voice and call it How is it?
   • Pain. Respond to the pain, pinch and react with gestures or grunted.
   • Unconscious. He doesn't answer.
3. Neurological assessment through the Glasgow scale: motor response assessment.

   • He's got his eyes open.

     • Never. 1
     • Just the painful stimulus. 2
     • With verbal stimulation. 3
     • Spontaneously. 4

     Verbatim response

     • No answer. 1
     • Not understandable. 2
     • Incoherence. 3
     • He speaks disoriented. 4
     • Talk straight. 5

     Motor response

     • No answer. 1
     • Extension to the stimulus. 2
     • Abnormal flexibility. 3
     • Remove from painful stimuli. 4
     • Locate the painful stimulus. 5
     • He obeys orders. 6

   Review of the scale:

   • 15 points: patient in normal condition.
   • 15-14 points: generalized trauma.
   • 13-9 points: polytraumatism.
   • Inferior to 9 points: severe head injury.

4. Review of breathing. We will approach the victim's mouth with the cheek and try to feel the breath while looking at the chest (if he breathes he will move). It is important to note that in case there is breathing, it will be necessary to explore the pulse, as it may or may not have it.
   • See: We look at the chest, whether it rises or not. If it rises and goes down, breathe.
   • Listen: With the ear we hear the sound of breathing.
   • Feel: With the index and half fingers we feel the carotid pulse (on the side of the trachea) of the victim.
5. Activate the medical emergency or emergency system.
6. Pulse rating. There are multiple places to look for it, divided into two groups:

   • Central pulse

     Carotid arteries, located on both sides of Adam's walnut in a small depression, in the throat. To feel it press slightly with the index fingers and greater, never with the thumb (we would feel our own pulse). The femoral arteries, located in the inguinal region, at the root of the thigh. We'll feel the pulse on our fingers.

     Peripheral pulse

     Other places to identify the pulse can be the radial arteries, on the outer face of the wrist. Less recommended since in case of accident and loss of knowledge, blood is redistributed to vital organs, and not to the extremities so sometimes this method can be misleading

In case of not finding a pulse, start the heart massage, that is cardiopulmonary RCP reanimation.

According to new European Resuscitation Council (ERC) guidelines published in 2010, pulse is not a criterion for deciding whether to start CPR. Instead, breathing is more important because it is easier to check if a person is breathing. These Guidelines further state that trained rescuers should also provide ventilations with a compression-to-breath (CV) ratio of 30:2. For untrained rescuers, phone-guided chest compressions-only CPR is encouraged.

Wounds and bleeding

An injury is considered to be any loss of continuity of the skin, mucous membranes or body tissues, caused by trauma or accident or by a surgical act. As a consequence of tissue damage, there is a risk of infection and the possibility of injury to organs or parts adjacent to the injured area such as: muscles, nerves, blood vessels, etc. In these situations it is necessary to have knowledge of first aid in order to apply the necessary care measures as the situation requires.

Blood is found circulating inside the blood vessels (arteries, veins and capillaries), which transport it throughout the body. When one of these blood vessels ruptures, the blood leaks out, causing bleeding, which can be internal or external. It is important to know the care that should be given in the event of a hemorrhage, since the consequences of poor management can cause hypovolemic shock.

Wounds

Wounds are injuries that cause loss of soft tissue integrity. They are produced by external agents, such as a knife, or internal agents, such as a fractured bone; They can be open or closed, mild or complicated. The main risks of a wound are infection and hemorrhagic shock.

Signs and Symptoms: pain, bleeding, destruction, soft tissue damage, erythema of the area.

General classification of wounds

• Open wounds: In this type of wounds the separation of soft tissues is observed. They are the most susceptible to infection.
• Closed wounds: These are those in which the separation of tissues is not observed, are usually caused by blows; the bleeding accumulates under the skin (hematoma), cavities or viseras.
• Simple wounds: They are wounds that affect the skin, without causing damage to important organs. Example: surface scrap or cuts
• Intricate wounds: They are extensive and deep wounds with abundant bleeding; there are usually muscle injuries, blood vessels and internal organs.

Classification according to the element that produces them

• Contuses: They are produced by stones, sticks, punches or hard objects. They produce a lot of pain and in them a hematoma is observed, these wounds are presented by the resistance of the bone to the blow, causing the injury of soft tissues. They are usually referred to as “morning.”
• Cutting or incised wounds: They are produced by sharp objects such as cans, glass, knives, which can dry muscles, tendons and nerves. The edges of the wound are clean and linear, the bleeding can be low, moderate or abundant.
• Puncture wounds: They are produced by objects with tip, such as nails, needles, sticks etc. The injury is painful, the low hemorrhage and the entry hole is unnotorious. Tetanus is one of the complications of this type of wound.
• Cortounzantes: The last two wounds can be mixed, according to the mechanism and object that causes the wound, and there is a Cortopunzante wound.
• Lacerated wounds: Produced by object of dentured edges (screws or cans). There is tearing of tissues and the edges of the wounds are irregular.
• Scratch or abrasions: Produced by friction or skin friction with hard surfaces. Very well known as “rasmillions”; they are very painful and their greatest risk is infection. Example: The fall of a child's knees.
• Avulsive wounds: They are those where the tissue of the victim's body is separated and torn. A cutter or lacerated wound can become avulsive. Bleeding is abundant, example; dog bite.
• Pervading wound: Produced by an element that enters the body reaching cavities and/or can damage internal organs. They can be produced by ridges, sticks. There may be a commitment to the abdomen.
• Herida Perforante: They occur when the object passes through the body. They are produced by firearms. The projectile is introduced into the body producing serious internal injuries. There may be a chest commitment.
• Amputation: It is the total loss of a part of the body or limb.

General considerations for wound management

• All wounds require first aid.
• Always wash your hands with soap before and after first aid care in wounds, to avoid infections.
• Identify the type of wound.
• If there is bleeding, check if it is capillary, venous or arterial.
• Do not place liquids or strange elements such as creams, oils, toothpaste etc; on the wound.
• Do not apply antibiotic powders or creams, can cause wound infection.
• Do not use cotton or tissues or paper towels, as they leave remains in the area that can cause Infection.

Bleeding

Hemorrhage is defined as the uncontrolled leakage of blood from any blood vessel. They can appear anywhere on the body. The amount of blood lost will depend on the bleeding blood vessel: vein or artery. The latter is obviously more serious, since a large volume of blood can be lost in a few minutes, producing shock and risk of death.

Types of bleeding

• External: Output of blood to the outside of the body. Your commitment can be assessed
• Internal: The damage caused by bleeding cannot be evaluated, so internal bleeding should be considered serious.
• Exteriorized: they occur inside and take contact with the outside by natural holes.

Characteristics of bleeding according to the affected blood vessel

Depending on the damaged vessel that produces the output of blood, we can distinguish the following characteristics in a hemorrhage or bleeding.

• Arterial: The blood flows under pressure, is pulsable, bright red, goes away from the body, is the most severe bleeding.
• Venosa: Dark red color, sprout without strength, blood flows continuously.
• Capilar: The flow is slow, in droplets.

Hemorrhage Complications

Arterial hemorrhage is the most dangerous, because if it is not controlled in time, it can cause Shock due to significant loss of blood in a short time, acute debilitation, death

Goals of bleeding treatment

• Control the bleeding
• Prevent and reduce shock effects
• Reduce pollution risks
• Transfer to the hospital

Hypovolemic shock

The loss of large volumes significantly affects the transport of oxygen and nutrients throughout the body, which leads to this medical emergency, which if not corrected, the loss of volume can cause Cardiorespiratory Arrest.

Signs and symptoms:

• Cold and sticky skin
• Confusion
• Decrease or absence of urinary expenditure
• General weakness
• Pale skin (pallidez)
• Rapid breathing
• Sweating
• Wet skin
• Loss of knowledge

General Considerations for the Management of Bleeding

• Evacuate the victim, conscience, breathing and pulse
• Ask for help, call an ambulance
• Identify the vessel from which the bleeding comes
• Wash your hands, if possible protect your hands with gloves if you have them
• Remove or cut the clothes by exposing the injured site and identify the type of bleeding by cleaning the injury with a cloth
• Control the bleeding with a clean dressing or cloth over the bleeding site.
• Direct pressure
• Raise the limb
• If the bleeding does not stop, apply a second deposit or clean cloth on top of the first and apply again pressure
• If it is external arterial bleeding, apply compression in the nearest artery, over injury
• Slowly and slowly the pressure on the artery by stopping the bleeding
• Place a compressive bandage once the bleeding is controlled
• Do not use turnstile unless it is an extreme emergency

Burns

They are a specific type of soft tissue injury produced by physical, chemical, electrical or radiation agents.

They are produced by exposure to fire, hot metals, radiation, caustic chemical substances, electricity or, in general, any source of heat (for example, the sun). Burns are classified based on the depth of tissue damage and the extent of the affected area. A first degree burn, which only affects the superficial layer of the skin, is characterized by redness. A second degree burn presents formation of blisters (blisters), and a third degree burn affects the subcutaneous tissue, muscle and bone producing necrosis. The severity of a burn also depends on its extent. This is measured in percentages of the body surface. Severe burns produce shock and extensive fluid loss. A patient with third degree burns that occupy more than 10% of the body surface area should be hospitalized as soon as possible.

Mnemonics

In those cases of emergency, it is convenient to keep in mind certain mnemonic rules that allow you to easily remember the order of action. An example of a mnemonic rule can be the following - PAS:

• Protect (P): Protects the victim and the rest of the people (including the helper himself) from the focus that causes the damage.
• Alert (A): Ask for help (emergency telephone number: 112 in Spain and 911 in the United States and Mexico. )
• Help (S): Implement the necessary relief measures to keep the victim alive. Leave the rest of the actions to the professionals.

First aid kit

Every home, school, public place, workplace, and automobile should have a first-aid kit that contains what is necessary to save a life and avoid complications caused by an accident.

A first-aid kit should contain healing material and medicines that do not pose a risk to people, however, you should always ask yourself before administering them about a possible allergy or negative reaction to any medicine or substance.

It is important that the first-aid kit is out of the reach of children, is kept in a cool, dry place, and that the expiration date of the medications is checked periodically to replace them if necessary.

The first-aid kit must include:

• Directory of nearby health personnel, Red Cross, ambulances and health services, firefighters and toxicological information center, etc.
• Antiseptic solution
• Antiseptic cloths
• Burning treatment
• Eye patch with adhesive
• Solution for eye wash
• Esparadrapo
• Adhesive fabric or Micropore
• Sterilized gas
• Clean bandages of at least three sizes
• Clean scissors, not oxidized
• Thermometer
• Oxygen water
• Neutral soap
• Battery lamp
• Minimum two pairs of latex gloves or sterile gloves
• Isodine or Betadine (puma and solution)
• Plastic bags
• Mask for insuffration
• Férulas