• Those nearest to someone with life-threatening injuries are in the best position to provide first care.

• 1. Most essential actions

     1. Moving someone away from ongoing danger

     2. stopping life-threatening bleeding

     3. positioning the injured so they can breathe

     4. keeping them warm

     5. Providing comfort

  2. CERT volunteers are to to be a part of medical disaster operations

1. Identify life-threatening conditions resulting from trauma including

   1. Severe bleeding

   2. low body temperature

   3. Airway blockage

2. Apply correct life saving techniques

3. Provide basic first-aid care for non-life-threatening injuries.

1. Do I feel safe at this spot?

2. Should I leave a move to a safer location, or am I able to stay an start providing care immediately.

3. If I leave, can I take anyone with me?

CERT volunteers should first ensure they are wearing the appropriate and proper Personal Protective Equipment (PPE). For a detailed list of PPE, please reference Unit 1.

1. If the patient is conscious, be sure he or she can see you.

2. Identify yourself by giving your name and indicating the organization with which you are affiliated.

3. Always request permission to treat an individual.

   1. If the individual is unconscious it is assumed that the patient has given "implied consent", and you may be able to treat her/him.

   2. Ask a parent or gaurdian to treat a child if possible.

4. Whenever possible, respect cultural differences.

5. Always be mindful and respectful of the privacy of a patient's medical condition.

1. The average person has approximately five liters of blood.

2. Severe blood loss can lead to irreversible shock.

3. If you lose about 2.5 L of blood death may be unavoidable.

   1. Bleeding must be under control as soon as possible.

4. Indications of life-threatening bleeding include:

   1. Spurting/steady bleeding

   2. Blood is pooling;

   3. Blood is soaking through overlying clothes

   4. Blood is soaking through bandages

   5. amputation

Stage-Blood Loss-Heart Rate-Blood pressure-Breath rate-symptom

1. -<15% Bood volume-   100 bpm; normal-Patient appears normal-increased heart rate.

2. -<15%-30% blood volume- >100bpm- Slightly low-agitated or anxious as vital signs rise.

3. -<30-40% blood volume- >120 bpm- Low-Unable to compensate patient appears confused.

4. - > 40% blood volume-        >140 bpm- Critical-maybe Irreversible shock; lethargic, damage to vital organs. 

1. Arterial Bleeding: Artery Blood will spurt

2. Venous Bleeding: Vein Blood will flow

3. Capillary Bleeding: Capillary blood will ooze

1. Find the source(s) of the bleeding

2. If you have something to put between your hands and blood use it.

3. Apply firm steady direct pressure.

4. Keep pressure applied until EMS take over or bleeding stops.

Things to keep in mind:

1. Try to provide a barrier against the blood.

2. Do not use the same gloves on more than one person.

3. If barrier becomes blood soaked replace it.

4. Do not place bulky layers between hands and wound.

5. Correctly applied pressure may not be comfortable for the injured.

How to use a Tourniquet:

1. Place as high as possible on the injured limb - closest to the torso (you can place it over clothing)

2. Pull the strap through the buckle

3. Twist the rod tightly until bleeding stop/slows significantly (may be very painful)

4. Secure the rod.

5. If bleeding does not stop, place a second tourniquet.

6. leave in place until EMS takes over care.

Main signs of shock

1. Rapid & shallow Breathing

2. Capillary refill of greater than to seconds;

3. Failure to follow simple commands, "squeeze my hand"

To keep a person warm.

1. Remove wet clothing.

2. Place something between the injured person and the ground

3. Wrap the injured person with dry layers

4. Shield the injured person from the wind with your body or surrounding objects.

If patient is unconscious and you suspect there is an airway obstruction, clear the airway using the jaw thrust obstruction.

To perform this maneuver on an adult, kneel above the persons head and:

1. Put one hand on each side of the patients head 

2. Thumbs near the corners of mouth pointed towards chin.

3. using the elbows for support

4. Slide the finger into position under the angles or the patients jawbone with moving the head or neck.

5. Thrust the jaw upward without moving the head or neck to lift the jaw and open the airway.

A dialogue for providing comfort.

1. Share names an ask basic questions for example;

   1. How can I help?

   2. What do you need?

   3. What happened?

2. You can also provide comfort to the patient by supplying information about:

   1. What you currently know about what happened without speculating

   2. What is being done to assist them

   3. What is going to happen next

3. What can you do?

   1. Keep them warm.

   2. Offer a hand to hold.

   3. maintain eye contact

   4. Be patient and understanding

   5. If you have to move on to provide aid to another person, let him or her know.

The first step in treating burns is to conduct a thorough size-up.

1. What caused the burn?

2. is the danger still present?

3. When did the burning cease?

The objective of the first-aid treatment of burns are to;

1. Prevent Hypothermia

2. Manage Pain

3. Reduce the Risk of infection

Heat, chemicals, electrical current, or radiation may cause burns. The severity of a burn depends on the:

1. Temperature of the burning agent

2. Period of time the patient was exposed

3. Area of the Body that was affected

4. Size of the area burned

5. Depth of the burn

Burn classifications

Depending on the severity, burns may effect all three layers of skin

1. The epidermis, or outer layer of skin, contains nerve endings and is penetrated by hairs.

2. The dermis, or middle layer of skin, contains blood vessels, oil glands, hair follicles, and sweat glands.

3. The subcutaneous layer, or innermost layer, contains blood vessels and overlies the muscles.

Burn classification chart:

1. Superficial - Epidermis- Reddened dry skin, pain, swelling

2. Partial thickness- Partial destruction of epidermis- Reddened blistered skin, wet appearance, pain, swelling.

3. Full thickness- complete destruction of epidermis and dermis; Possible subcutaneous damage-whitened, leathery, or charred (brown or black), painful or relatively painless.

Dress the burn

1. Cover loosely with dry, sterile dressings to keep air out, reduce pain, and prevent infection,

2. Wrap fingers and toes loosley and individually when treating severe burns to the hand and feet.

3. Loosen clothing near the affecte area,Remove jewelry if necessary document what you removed.

4. Do not apply antiseptics, ointements, or other remedies.

5. Do not remove shreds of tissue, break blisters, or remove adhered particles of clothing.

it is best to defer treatment to trained medical professionals.

1. Protect yourself from contact with the substance.

2. Be sure to remove any affect clothing or jewelry.

3. If the irritant is dry, gently brush away as much as possible.

4. Use lots of cool running water to flush the chemical from the skin.

5. Apply a cool wet compress to relieve pain

6. Cover the wound loosely with a dry, sterile, or clean cloth, so that the cloth will not stick to wound.

When a foreign object impales a patient, you should,

1. Immobilize the affected body part.

2. Not attempt to move or remove an object, unless it is obstructing the airway.

3. Try to control bleeding at the entrance wound

4. Clean and dress the wound making sure to stabilize the impaled object.

5. Wrap bulky dressings around the object to keep it from moving.

1. Open Fracture

   1. a broken bone with some kind of wound that allows contaminates to enter around the fracture site.

2. Closed Fracture

   1. a broken bone with no associated wound. First aid treatment for closed fractures may require only splinting.

3. Displaced Fracture, If the limb is angled.

   1. described by the degree of displacement of the bone fragments.

4. Nondisplaced Fracture, if limb isn't angled.

Treating an Open Fracture

Do not

4. 1. Do not draw the exposed bone ends back into the tissue

   2. Do not irrigate the wound

You should

4. 3. Cover the Wound

   4. Splint the fracture

   5. Place a moist 4 by 4-inch dressing over the bone end to keep it from drying out.

1. An injury to the ligaments around a joint that is so severe that it permits separation of the bone form its normal position.

2. Treat a suspected dislocation like a close fracture.

3. immobilize the joint

a Sprain involves stretching or tearing of ligaments in a joint. 

1. Partial dislocation

2. The bone either remains in place or is able to fall back into place after injury

3. Treat the injury as a closed fracture.

Common signs of a sprain are:

1. Tenderness at the site of the injury.

2. Selling and or bruising

3. Restricted use or loss of use

Splinting

The most common procedure for immobilizing an injury.

Makeshift splints

1. Cardboard is the most common type of material.

2. Soft materials

   1. Towels

   2. Blankets

   3. pillows

   4. bandaging materials

   5. soft clothes

3. Rigid materials

   1. A board

   2. Metal strip

   3. Folded magazine

   4. Newspaper

   5. rigid item

Hypothermia

Caused by exposure to cold or by trauma.

Primary signs and symptoms of hypothermia are:

1. A body temperature of 95 F 37 C or lower

2. Redness or blueness of the skin

3. Numbness accompanied by shivering

In later stages, hypothermia will be accompanied by

1. Slurred speech

2. Unpredictable behavior

3. Listlessness

Treatment of Hypothermia

1. Removing wet clothing

2. Placing something between the injured person and the ground

3. Wrapping the injured person with dry layers

4. shielding the injured person from the wind

5. not attempting to use massage to warm affected body parts

6. placing an unconscious patient in the recovery position

Frostbite

symptoms of frostbite

1. Skin discoloration (red, white, purple, black)

2. Burning or tingling sensation

3. Partial or complete numbness

Treatment of frostbite

1. Warm patient slowly

   1. Rapid warming could cause chilled blood to flow to the heart, shocking it, and potentially stopping it.

2. Immerse injured area in warm (not hot) water - 107.6 F

3. Do not allow the body part to re-freeze

4. Do not attempt to use massage to warm body parts

   1. Ice crystals form in the tissue rubbing could cause damage.

5. Carefully, lightly, wrap affected body parts in dry, sterile dressing.

Heat related injury treatment

1. Take the patient out of the heat.

2. Cool the body slowly with cool, wet towels or sheets. 

   1. put the patient in a cool bath.

3. Have a hear stroke patient drink water, slowly

   1. Half a glass of water every 15 minutes.

4. If patient is experiencing vomiting, cramping, or is losing consciousness, do not administer food or drink,

If allergic reaction is so severe that it compromises the airway (anaphylaxis)

1. Calm the individual

2. Find and help administer the patients epi-pen

3. Do not administer medicine aside from the epi-pen