First Aid; Helping you save lives
The Canadian Red Cross/Lifesaving Society updates its standards and procedures every few years based on the successes of first responders. Unfortunately this means that there is a lot of "old ideas" surrounding how to best help a victim. To the best of our knowledge these instructions are in keeping with today's standards. These instructions and videos are to serve as reminders only and are not a substitute for taking a Standard First Aid Course. We are not liable for the accuracy or the use of this information. Please enjoy this webpage and contact Coach Matt to enroll in a Swimming Lesson or Standard First Aid Course here in the GTA (Brampton, Ontario).
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- While wearing gloves, pick off any obvious dirt or debris from the surface of wound.
- Don't remove any large or deeply embedded objects.
- Don't probe the wound or attempt to clean it at this point.
- Don't reposition displaced organs. If the wound is abdominal and organs have been displaced, don't try to push them back into place.
- Your principal concern is to stop the bleeding.
- Apply pressure directly on the wound. Use a sterile bandage (a Bandage is a dressing –clean absorbent material– and a compress), clean cloth or even a piece of clothing and adhesive tape. If nothing else is available, use your hand. Maintain pressure until the bleeding stops.
- Hold continuous pressure for at least 20 minutes without looking to see if the bleeding has stopped.
- Don't remove the gauze or bandage. If the bleeding continues and seeps through the gauze or other material you are holding on the wound, don't remove it. Instead, add more absorbent material on top of it.
- Squeeze a main artery if necessary. If the bleeding doesn't stop with direct pressure, apply pressure to the artery delivering blood to the area of the wound. Pressure points of the arm are on the inside of the arm just above the elbow and just below the armpit. Pressure points of the leg are just behind the knee and in the groin. Squeeze the main artery in these areas against the bone.
- Immobilize the injured body part once the bleeding has stopped. Leave the bandages in place and get the injured person to the emergency room as soon as possible.
- Call 911
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Burns
To distinguish a minor burn from a serious burn, the first step is to determine the degree and the extent of damage to body tissues. The three classifications of burns (first-degree burn, second-degree burn and third-degree burn) will help you determine emergency care.
The least serious burns are those in which only the outer layer of skin is burned. The skin is usually red, with swelling and pain sometimes present. The outer layer of skin hasn't been burned through. Treat a first-degree burn as a minor burn unless it involves substantial portions of the hands, feet, face, groin or buttocks, or a major joint.
Second-degree Burn
When the first layer of skin has been burned through and the second layer of skin (dermis) also is burned, the injury is called a second-degree burn. Blisters develop and the skin takes on an intensely reddened, splotchy appearance. Second-degree burns produce severe pain and swelling.
Third-degree Burn
The most serious burns are painless, involve all layers of the skin and cause permanent tissue damage. Fat, muscle and even bone may be affected. Areas may be charred black or appear dry and white. Difficulty inhaling and exhaling, carbon monoxide poisoning, etc. may occur if smoke inhalation accompanies the burn.
Treatment of First & Second-degree Burns
For minor burns, including first-degree burns and second-degree burns limited to an area no larger than 3 inches (7.5 centimeters) in diameter, take the following action. If the second-degree burn is no larger than 3 inches (7.5 centimeters) in diameter, treat it as a minor burn. If the burned area is larger or if the burn is on the hands, feet, face, groin or buttocks, or over a major joint, treat it as a major burn and get medical help immediately):
- Cool the burn. Hold the burned area under cold running water for at least five minutes, or until the pain subsides. If this is impractical, immerse the burn in cold water or cool it with cold compresses. Cooling the burn reduces swelling by conducting heat away from the skin. Don't put ice on the burn.
- Cover the burn with a sterile gauze bandage. Don't use fluffy cotton, which may irritate the skin. Wrap the gauze loosely to avoid putting pressure on burned skin. Bandaging keeps air off the burned skin, reduces pain and protects blistered skin.
- Take an over-the-counter pain reliever.
Minor burns usually heal without further treatment. They may heal with pigment changes, meaning the healed area may be a different color from the surrounding skin. Watch for signs of infection, such as increased pain, redness, fever, swelling or oozing. If infection develops, seek medical help. Avoid re-injuring or tanning if the burns are less than a year old (doing so may cause more extensive pigmentation changes). Use sunscreen on the area for at least a year.
Caution
Don't use ice. Putting ice directly on a burn can cause frostbite, further damaging your skin.
Don't apply butter or ointments to the burn. This could prevent proper healing.
Don't break blisters. Broken blisters are vulnerable to infection.
Treatment of Third-degree Burns For major burns, dial 911 or call for emergency medical assistance. Until an emergency unit arrives, follow these steps:
- Don't remove burnt clothing. However, do make sure the victim is no longer in contact with smoldering materials or exposed to smoke or heat.
- Don't immerse large severe burns in cold water. Doing so could cause shock.
- Check for signs of circulation (breathing, coughing or movement). If there is no breathing or other sign of circulation, begin cardiopulmonary resuscitation (CPR).
- Elevate the burned body part or parts. Raise above heart level, when possible.
- Cover the area of the burn. Use a cool, moist, sterile bandage; clean, moist cloth; or moist towels.
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Choking
Know as the Heimlich maneuver, Abdominal Thrusts can be used to clear an object blocking the airway in conscious adults and children ages 1 to 8. It lifts the diaphragm and forces air from the lungs to push the object that blocks the airway up and out.
- Ask, "Are you choking?" The person may use the choking sign. Do not interfere if he or she can speak, cough, or breathe.
- If not able to speak, cough, or breathe ask "Would you like my help?" and "Are you pregnant?"
- You do not need to call 911, unless they go unconscious.
- If they are not pregnant: reach around the person's waist from behind. Make a fist. Place it above the navel, but below the rib cage. Grasp your fist with your other hand. Press your fist into person's abdomen and give 5 quick, upward thrusts.
- If they are pregnant: reach around the person's chest from behind. Make a fist. Place it on the breast bone directly between the breasts. Grasp your fist with your other hand. Give 5 quick, thrusts straight in.
- Repeat thrusts until the object is forced out or the person becomes unconscious. If the object is removed with success, the person should see a doctor as soon as possible.
- If the person becomes unconscious, lay them down on their back and shout for help, have someone call 911. (If you are alone call 911 right away even if it means you have to leave the victim).
- Look inside the victims mouth and remove any foreign objects.
- Do the ABC's (see CPR) Each time you open the airway to give rescue breaths, check the person's mouth for the object and remove it if you can. Do CPR as needed, until the object blocking the airway is forced out or until medical help takes over.
- Even when the object is removed with success, the person should see a doctor as soon as possible.
For Children Ages 1 to 8
- For a conscious child, give abdominal thrusts as for adults. Don't be too forceful.
- For an unconscious child, do the ABC's (see CPR) and remeber: each time you open the airway to give rescue breaths, check the person's mouth for the object and remove it if you can. Do CPR as needed, until the object blocking the airway is forced out or until medical help takes over.
For Babies Up to 1 Year Old
- Do not interfere if the baby coughs strongly, cries, or breathes okay.
- If the baby is conscious, and can not breathe hold the baby's head (face down) in one hand. Straddle the baby over your forearm. Rest your forearm on your leg for support. Keep the baby's head lower than the rest of his or her body.
- With the heel of your free hand, hit the baby on the back between the shoulder blades 5 times. Use quick, forceful motions. Repeat this procedure 3 to 4 times. If the object still blocks the airway, go to step 4.
- Turn the baby over (face up). Cradle the baby on your forearm. Support the head with one hand. Keep the baby's head lower than the rest of his or her body. Rest your arm on your leg for support. Place 2 fingers 1/2 inch below and in between the nipples on the baby's chest. Give 5 quick downward thrusts. Depress the sternum 1/2 to 1 inch with each thrust.
- Repeat steps 3 and 4 until the object is removed or the baby is unconscious.
- Once baby is unconscious lay on his or her back.
- Shout for help. Have someone call 911. If no one is there to make the call for you, give first aid for 1 minute, stop to call 911, then resume rescue efforts.
- Look into the babies mouth to. Remove the object, if visible.
- Tilt the head back and lift the jaw. Give 2 slow rescue puffs of air. If the air does not go in tilt the head back again and try another rescue puff.
- Place 2 fingers 1/2 inch below and in between the nipples on the baby's chest. Give 30 chest compressions
- Repeat steps 8 to 10 as needed.
- Don't give up. Continue first aid until medical help takes over or until the object is removed. Even if object is removed, get medical care right away.
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Cardiopulmonary resuscitation (CPR) is a lifesaving technique used to treat many emergencies including: irregular or absent breathing, irregular or absent heart rate, and for unconscious victims with a sealed air way.
ADULT CPR
Assess the situation before starting CPR
- Is the person conscious or unconscious?
- If the person appears unconscious, tap or shake his or her shoulder and ask loudly, "Are you OK?"
- If the person doesn't respond and two people are available, one should call 911 or the local emergency number and one should begin CPR. If you are alone and the victim is an adult , call 911 before beginning CPR (because it may have been a heart attack) - unless you think the person has become unresponsive because of suffocation (such as from drowning). In this special case, begin CPR for one minute and then call 911.
- If an AED is immediately available, deliver one shock if advised by the device, then begin CPR.
- Think ABC — Airway, Breathing and Circulation — to remember the steps explained below. Move quickly through Airway and Breathing to begin chest compressions to restore circulation.
Airway: Clear the airway
- Put the person on his or her back on a firm surface.
- Kneel next to the person's neck and shoulders.
- Open the person's airway using the head-tilt, chin-lift manoeuvre. Put your palm on the person's forehead and gently tilt the head back. Then with the other hand, gently lift the chin forward to open the airway.
- Check for normal breathing, taking no more than five or 10 seconds: Look for chest motion, listen for breath sounds, and feel for the person's breath on your cheek and ear. Gasping is not considered to be normal breathing. If the person isn't breathing normally and you are trained in CPR, begin mouth-to-mouth breathing. If you believe the person is unconscious from a heart attack and you haven't been trained in emergency procedures, skip mouth-to-mouth rescue breathing and proceed directly to chest compressions to restore circulation.
Breathing: Breathe for the person
- Rescue breathing can be mouth-to-mouth breathing or mouth-to-nose breathing if the mouth is seriously injured or can't be opened.
- With the airway open (using the head-tilt, chin-lift manoeuvre) pinch the nostrils shut for mouth-to-mouth breathing and cover the person's mouth with yours, making a seal.
- Prepare to give two rescue breaths. Give the first rescue breath — lasting one second — and watch to see if the chest rises. If it does rise, give the second breath. If the chest doesn't rise, repeat the head-tilt, chin-lift manoeuvre and then give the second breath.
- Begin chest compressions to restore circulation.
Circulation: Restore blood circulation with chest compressions
- Place the heel of one hand over the center of the person's chest, between the nipples. Place your other hand on top of the first hand. Keep your elbows straight and position your shoulders directly above your hands.
- Use your upper body weight (not just your arms) as you push straight down on (compress) the chest 2 inches (approximately 5 centimetres). Push hard and push fast — give two compressions per second, or about 120 compressions per minute.
- After 30 compressions, tilt the head back and lift the chin up to open the airway. Prepare to give two rescue breaths. Pinch the nose shut and breathe into the mouth for one second. If the chest rises, give a second rescue breath. If the chest doesn't rise, repeat the head-tilt, chin-lift manoeuvre and then give the second rescue breath. That's one cycle. If someone else is available, ask that person to give two breaths after you do 30 compressions.
- If the person has not begun moving after five cycles (about two minutes) and an automatic external defibrillator (AED) is available, apply it and follow the prompts. The American Heart Association recommends administering one shock, then resuming CPR — starting with chest compressions — for two more minutes before administering a second shock. If you're not trained to use an AED, a 911 operator may be able to guide you in its use. Trained staff in many public places are also able to provide and use an AED. If an AED is not available, go to Step 5 below.
- Continue CPR until there are signs of movement or until emergency medical personnel take over.
The procedure for giving CPR to a child age 1 through 8
is essentially the same as that for an adult. The differences are as follows
- If you're alone, perform five cycles of compressions and breaths on the child (this should take about two minutes) before calling 911 or your local emergency number or using an AED.
- Use only one hand to perform heart compressions.
- Breathe more gently.
- Use the same compression-breath rate as is used for adults (30 compressions followed by two breaths). This is one cycle. Following the two breaths, immediately begin the next cycle of compressions and breaths.
- After five cycles (about two minutes) of CPR, if there is no response and an AED is available, apply it and follow the prompts.
- Continue until the child moves or help arrives
INFANT CPR
Most cardiac arrests in infants occur from lack of oxygen, such as from drowning or choking. If you know the infant has an airway obstruction, perform first aid for choking. If you don't know why the infant isn't breathing, perform CPR.
- To begin, assess the situation. Stroke the baby and watch for a response, such as movement, but don't shake the child.
- If there's no response, follow the ABC procedures below and time the call for help as follows:
- If you're the only rescuer and CPR is needed, do CPR for two minutes (about five cycles) before calling 911 or your local emergency number.
- If another person is available, have that person call for help immediately while you attend to the baby.
- Place the baby on his or her back on a firm, flat surface, such as a table. The floor or ground also will do.
- Gently tip the head back by lifting the chin with one hand and pushing down on the forehead with the other hand.
- In no more than 10 seconds, put your ear near the baby's mouth and check for breathing: Look for chest motion, listen for breath sounds, and feel for breath on your cheek and ear.
- If the infant isn't breathing, begin mouth-to-mouth breathing immediately.
Breathing: Breathe for the infant
- Cover the baby's mouth and nose with your mouth.
- Prepare to give two rescue breaths. Use the strength of your cheeks to deliver gentle puffs of air (instead of deep breaths from your lungs) to slowly breathe into the baby's mouth one time, taking one second for the breath. Watch to see if the baby's chest rises. If it does, give a second rescue breath. If the chest does not rise, repeat the head-tilt, chin-lift maneuver and then give the second breath.
- If the chest still doesn't rise, examine the mouth to make sure no foreign material is inside. If the object is seen, sweep it out with your finger. If the airway seems blocked, perform first aid for a choking infant.
- Begin chest compressions to restore circulation.
Circulation: Restore blood circulation
- Imagine a horizontal line drawn between the baby's nipples. Place two fingers of one hand just below this line, in the center of the chest.
- Gently compress the chest to about one-third to one-half the depth of the chest.
- Count aloud as you pump in a fairly rapid rhythm. You should pump at a rate of about 100 to 120 pumps a minute.
- Give two breaths after every 30 chest compressions.
- Perform CPR for about two minutes before calling for help unless someone else can make the call while you attend to the baby.
- Continue CPR until you see signs of life or until a professional relieves you.
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Hypothermia
A condition in which a person's temperature drops below that required for normal function. Normally the body temperature is maintained near a constant level. However, when exposed to cold, the body's internal heating mechanisms may be unable to replenish the heat that is being lost to the surroundings. Hypothermia is the opposite of hyperthermia which is present in heat exhaustion and heat stroke.
Hypothermia is defined as any body temperature below 36-35°C (95 ºF). It is subdivided into different degrees: mild (35-37°C) moderate (32–35 °C), severe (32ºC or lower). This is in contrast with hyperthermia or fever which is defined as a rectal temperature of greater than 37.8 °C (100.0 °F).°C) moderate (32–35 °C), severe (32ºC or lower). This is in contrast with hyperthermia or fever which is defined as a rectal temperature of greater than 37.8 °C (100.0 °F).
Stage 1 (Mild)
Body temperature drops by 1–2 °C (1.8–3.6 °F) below normal temperature.
- Mild to strong shivering
- Loss of coordination
- FatigueMild to strong shivering
- Loss of coordination
- Fatigue
Stage 2 (Moderate)
Body temperature drops by 2–4 °C (3.8–7.6 °F) below normal temperature (32–35 °C or 91–94.8 °F).
- Shivering becomes more violent
- Disorientation, confusion, lapses in memory, may appear intoxicated
- Decreased consciousness
- Blurred vision and hallucinations
Stage 3 (Sever)
Body temperature drops below approximately 32°C (89.6°F).
- Shivering is reduced or stops
- Overwhelming desire to sleep
- Loss of consciousness
- May think they are warm and remove clothing
Treatment
- Remove victim to a dry sheltered place
- Handle gently (avoid jolting the victim)
- Do not rub the victim's skin
- Remove wet clothing and dry victim
- Warm (heating to quickly can induce shock) the victim's core (head, neck and torso)
- Phone EMS (911) if the victim is unconscious, confused or does not improve quickly.
Prevent it
Appropriate clothing helps to prevent hypothermia. Wearing cotton in chilly weather is a particular hypothermia risk as it holds water (continuing to draw heat away from the body). Even in dry weather, cotton clothing can become damp from perspiration, and chilly after the wearer stops exercising. Synthetic and wool fabrics provide far better insulation when wet and dry more quickly. Some synthetic fabrics are even designed to wick perspiration away from the body, such as liner socks.
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