• Bleeding
• Bones
• Burns
• General
• Poison

Bleeding

Severe Bleeding

• Check whether there is an object embedded in the wound.  If you suspect there is something embedded, take care not to press on the object.   Instead press firmly on either side of the object and build up padding around it before bandaging to avoid putting pressure on the object itself.


• If there is nothing embedded, press on the wound with your hand, ideally over a clean pad, and  secure with a bandage.


• If the wound is on an arm or leg raise the injured limb above the level of the heart.

Nose Bleeds

Signs and Symtoms

• Nose bleeds may occur spontaneously or after sneezing, picking or blowing the nose.


• If bleeding occurs after an accident consider the possibility of a nose or skull fracture.


• Leakage of clear or straw-colored fluid from the nose may indicate a base of the skull fracture

Management

• Sit the patient down.


• Advise the patient to breathe through the mouth, with the head tilted forward.


• Get him or her to pinch the entire soft part of the nose for 10 - 20 minutes.


• If bleeding has not been controlled, repeat pressure and call 10177 for an ambulance.


• When the bleeding stops tell the patient not to blow his or her nose for a few hours, because this may restart the bleeding.

Back to top

Bones

How to deal with strains and sprains?

It’s difficult to differentiate between a sprain and a strain.  A sprain occurs at a joint and involves ligaments – most commonly a sprained ankle.   A strain is an injury to muscle or tendons and tends to occur when the muscle is stretched – for instance when playing sport.

Luckily the initial treatment for both injuries are the same – the RICE procedure:

• Raise the injured part.
• Ice – apply ice or a cold pad to the injured area.
• Compress the injury using a bandage or soft padding.
• Elevate the injured part.

Broken Bones(Fractures)

When a bone is broken it is said to be fractured.  This fracture may be through the full thickness of the bone or partially through it.   The fracture is usually as a result of an unusual force being applied to the bone. 

Fractures - Key points to remember are:

• Do not move the fractured limb unnecessarily.
• Stabilize the fracture.
• Support the limb and transport or call 10177 and ask for an ambulance.

Signs and Symtoms

• Deformity
• Swelling and discoloration
• Tenderness and pain – severe discomfort
• Altered sensation (e.g. pins and needles)
• Sound of breaking
• Exposed bone ends
• Constant pain
• Loss of normal function.

Managment

• Call 10177 and ask for an ambulance
• Control any bleeding using direct/ indirect pressure
• Immobilize fracture, ideally using padding around the limb
• Assist patient into a comfortable position
• Splinting of a large bone is not necessary in a metropolitan environment, and should only be done if help will be delayed

Head Injuries and Spinal Injuries

Head injuries involve injury to the brain (for example, bruising or bleeding), injuries to the skull (for example, fractures or breaks) and injuries to the face (for example, bruising, bleeding and fractures).   Spinal injuries involve injury to the backbone (from the upper neck to the lower back).  These have the potential to be life-threatening injuries. 

Signs and Symtoms

• Any bleeding from the head that is more than minor
• Loss of consciousness or altered state of awareness (not awake and talking to you) or ‘groggy’
• Confusion
• Nausea, vomiting
• Memory loss.

Management

• Safety, Response, Airway, Breathing, Circulation, Severe Bleeding (SRABCS)
• Call 10177 and ask for an ambulance.

Back to top

Burns

Burns are usually caused by heat, but can also result from extremely low temperatures (liquid gases and dry ice), electricity and chemicals.  Burns can cause skin loss and tissue damage, with a resultant risk of fluid loss and infection.

• Remove patient from danger.
• Call for an ambulance only for burns: larger than a patient’s hand; or if the burn involves the face, neck, hands, feet joints or genitals; or the patient is in significant pain; the patient is very old or very young; the patient has a significant chronic medical problem.
• Flood area with cold water (not ice cold) for up to 20 minutes (to reduce pain and damage).
• Do not remove clothing adhering to the skin.
• Remove restrictive jewelry if possible.
• Do not put any creams on the burn.
• Lightly cover with cling film or clean dressing to prevent infection.

Back to top

General

How to resuscitate (CPR) - Adults

• Place your hands on the centre of their chest and, with the heel of your hand, press down (4-5cm).  After every 30 chest compressions give 2 breaths.
• Pinch the person’s nose.  Place your mouth over their mouth and – by blowing steadily – attempt 2 rescue breaths each over one second.
• Continue with cycles of 30 chest compressions and 2 rescue breaths until emergency help arrives.

How to deal with choking

• Give up to 5 back blows between the shoulder blades with the heel of your hand.
• Check the mouth quickly after each one and remove any obvious obstruction.  If the obstruction is still present:
• Give up to 5 abdominal thrusts.  Place a clenched fist between the navel and the bottom of the breast bone and pull inwards and upwards.
• Check the mouth quickly after each one.  If the obstruction does not clear after three cycles of back blows and abdominal thrusts, dial 10177 (or 112) for an ambulance.

Shock

Signs and Symtoms

• The patient may:
  • Have pale, moist and cold skin
  • Have an increased breathing rate and become weak
  • Feel like vomiting
  • Be thirsty and request a drink
  • Be anxious, feel dizzy and their level of consciousness may decrease.

Management

• Safety, Response, Airway, Breathing, Circulation, Severe Bleeding (SRABCS)
• Call 10177 and ask for ambulance
• Reassure the patient and stay with them
• Keep him/ her warm
• Do not give anything to eat or drink.

Back to top

Poison

• Poisons enter the body through:
  • The mouth – ingested or swallowed
  • The lungs – inhaled or sniffed
  • The skin – absorbed or injected
  • The blood – injected or absorbed.
• Poisons may be
  • Solid
  • Liquid
  • Gas.
• And come in the form of
  • Medicines
  • Industrial products
  • Household substances.

Note:

If you are certain that the substance is corrosive (for example, bleach) and the patient is fully conscious and alert, then you may give a small amount of water or milk to drink.

If the substance is non-corrosive then giving fluids may increase the toxicity by making the substance pass from the stomach to the intestine where it is absorbed more rapidly and could increase the risk of vomiting.

Back to top