PADI RTO First Aid Student Manual

PADI RTO First Aid Student Manual

INTRODUCTION

Published and distributed by PADI Asia Pacific Pty Ltd (PADI RTO # 6729) Unit 3, 4 Skyline Place Frenchs Forest NSW 2086 Australia http://www.padirto.com/ © PADI 2019. All rights reserved. No part of this product may be reproduced, sold or distributed in any form without the written permission of the publisher. Product No. 70200AU (02/19) Version 1.1

i

PADI RTO

Table of Content Provide cardiopulmonary resuscitation - CPR I Provide basic emergency life support - BLS II Provide first aid - FA III Provide an emergency first aid response in an education and care setting - FA EDU IV Provide first aid in remote situations - FA REMO V Provide advanced first aid - AFA VI Provide advanced resuscitation - AR VII VIII Manage first aid services and resources - MFA

INTRODUCTION

ii

PADI RTO

INTRODUCTION

PADI RTO First Aid Student Manual Someone cuts his finger in a kitchen. At a gym, an older gentleman collapses from a heart attack. During a sporting event, a young boy faints from standing too long. Two automobiles collide, seriously injuring the occupants. A youngster floats motionless, face down in a swimming pool. A diner at the next table chokes on food, unable to breathe. Accidents happen every day. Some of these people just need a helping hand, while others will die or suffer serious permanent injury if not immediately attended to. Many things separate those who live and escape serious disability from those who die or suffer long after their misfortune: The individual’s fitness and health, the severity of the initial incident, the distance from medical care and often, just plain luck. No one can control these variables - be it at home, at the workplace or in any other environment. But there’s one variable you can control when you’re on the scene of any medical emergency: You. Often, life versus death or complete recovery versus long-term disability lies with a layperson first responder providing care between the emergency’s onset and the arrival of professional medical personnel. If you are there, you can provide that care. You can be an Emergency Responder. As a layperson, you can’t guarantee that a casualty will live or fully recover — there’s too much beyond anyone’s control — but you can feel confident that given the circumstances, everything that can be done will be done. If you’re not familiar with emergency care procedures, they can seem intimidating and complex. What do you do? For that matter, how do you know what to do first? Such questions may appear overwhelming, but actually, they’re not. If you can remember the memory device DRSABCDS, you’ll know what to do. This is because no matter what the nature of a medical emergency, you follow the same steps in the same order, providing basic care based on what you find. In the units of competency contained in this manual, you’ll learn that DRSABCDS prompts you to follow the necessary steps in the right order, so you do the right things at the right time. You’ll learn to apply first responder care following the same priorities used by medical professionals. The procedures, skills and knowledge presented in this manual are in line with the Australian Resuscitation Council (ARC) Guidelines. The Australian Resuscitation Council is a voluntary co-ordinating body which represents all major groups involved in the teaching and practice of resuscitation.

iii

PADI RTO

INTRODUCTION

Introduction Welcome to your PADI RTO First Aid Student Manual for training programs of the Health Training Package units of competency related to providing CPR and first aid (HLTAID). This manual contains a number of sections or training programs (each one related to a specific unit of competency) that are presented in sequence, all progressing on from each other. PADI RTO is a training organisation registered by ASQA and authorised to deliver the following untis of competency within its scope of registration: Overview Each training program contains three portions: Knowledge Development, Skills Development and Scenario Assessment. Knowledge Development covers the regulations, legal considerations, principles & procedures as well as basic physiology to help you understand the background and considerations you need to be aware of when providing CPR and first aid in the workplace. It is this information that you find in this student manual – the other portions are presented during face-to-face training. During Skills Development you will learn to provide CPR and first aid under the guidance of your Trainer. Scenario Assessment then allows you to further practice, demonstrate and apply the skills and knowledge you have learnt in ‘real-life’ scenarios under the supervision of your Trainer. • HLTAID001 Provide cardiopulmonary resuscitation • HLTAID002 Provide basic emergency life support • HLTAID003 Provide first aid • HLTAID004 Provide an emergency first aid response in an education and care setting • HLTAID005 Provide first aid in remote situations • HLTAID006 Provide advanced first aid • HLTAID007 Provide advanced resuscitation • HLTAID008 Manage first aid services and resources

iv

PADI RTO

INTRODUCTION Using this Manual Read through each section and make any notes for your own reference. Make sure that you follow ‘ important note ’ guidelines found at the start of sections where you need to ensure you completed any underlying prerequisite unit(s) of competency beforehand. You will notice in each section there are questions printed in black bold; these are the learning objectives (the information you are required to know). Look for the answers to these objectives within the topic to help you remember them and reference them again in the future. Each section has a set of Knowledge Review questions to answer. If you can’t recall the answer, go back and review the relevant topic. If you still cannot find the answer or need help better understanding the information, ask your Trainer to help explain and further clarify the information. The Knowledge Review questions are important as they help to confirm and reinforce the concepts contained in each unit of competency, and retain the information you have learnt during independent study. Therefore, if you had difficulties with any information, it is important to ask your Trainer to elaborate and further explain the information when you review the information with your Trainer. Your Trainer will then help you apply the information into your workplace environment during the face-to-face skills & scenario portions of your training program. Having completed all portions of the training program you will be required to complete a short multiple-choice exam (called Knowledge Assessment) on the information learnt during training. Your Trainer will then review and explain to you any question you missed in the Knowledge Assessment. Please make sure that the Knowledge Assessments are either emailed before the training commences or bring them with you to class. Please also ensure you make yourself familiar with the current PADI RTO Student Handbook. You may have received a link in the invitation email to enrol online or you can download it under the Students’ tab at http://www.padirto.com/ .

v

PADI RTO

HLTAID001 - PROVIDE CARDIOPULMONARY RESUSCITATION

Provide cardiopulmonary resuscitation Introduction Welcome to your training program HLTAID001 Provide cardiopulmonary resuscitation (CPR). This unit of competency will introduce you to: • State/Territory regulations, first aid codes of practice and workplace procedures • Legal, workplace and community considerations • Considerations when providing CPR • Basic anatomy and physiology State/Territory regulations, first aid codes of practice and workplace procedures This section provides you with basic knowledge about national guidelines along with State or Territory regulations and apply them to providing cardiopulmonary resuscitation (CPR) in the workplace, along with your own and your employer’s responsibilities in the workplace. You will also learn how to protect yourself when assisting others and how to ensure you can keep your skills current (refreshed). ARC Guideline relevant to the provision of CPR What are our legal responsibilities in the workplace? In the first instance we follow the Australian Resuscitation Council (ARC) guidelines on how we should undertake resuscitation. Furthermore, each Australian State or Territory has Workplace Health & Safety guidelines that may require certain industries or business types and sizes to provide specific first aid equipment and adequately trained staff to use it. It is the responsibility of each employer to review their local Workplace Health & Safety guidelines along with any relevant codes of practice and industry standards as part of their risk management plans for providing first aid in the workplace. Employers should also be familiar with industry standards for first aid kits and equipment relevant to their business. Note: your Trainer will review the relevant ARC guidelines with you.

Safe work practices to minimise risks and potential hazards What obligations do employers have to employees in the workplace? Employers and employees have a responsibility to adhere to legislation and local codes to minimise potential hazards. Legislations exist to help protect people from injury and illness in the workplace. It is the responsibility of both the employer and the employee to adhere to legislation and local codes of practice and to implement workplace policies and procedures to minimise potential hazards. Hazards may be obvious due to the nature of the workplace or subtle and unforeseen.

I-1

PADI RTO

HLTAID001 - PROVIDE CARDIOPULMONARY RESUSCITATION Infection control principles and procedures, including use of standard precautions What are four ways you can protect yourself against disease transmission? 1. Use barriers. These may be (but are not limited to) any of the following: gloves, ventilation masks or shields, eye or face shields including eyeglasses or sunglasses, goggles and face masks. 2. Always wash your hands or any other exposed area with antibacterial soap and water. Scrub vigorously, creating lots of lather. If water is not available, use antibacterial wipes or soapless liquids. 3. All blood and bodily fluids should be considered potentially infectious. Take precautions to protect yourself against them. Requirements for currency of skill and knowledge How can you practise and refresh your skills? ARC recommends that ‘all those trained in CPR should refresh their CPR skills at least annually’. You can also practise and refresh your skills by regularly: • Reviewing your student manual • Role-playing various first aid scenarios SafeWork Australia states: ‘Refresher training in CPR should be undertaken annually and first aid qualifications should be renewed every three years’.

Legal, workplace and community considerations In this section you will learn how to manage stress both during and after an emergency, along with the duty of care requirements and the need for respect and privacy when assisting others in the workplace.

I-2

PADI RTO

HLTAID001 - PROVIDE CARDIOPULMONARY RESUSCITATION

Awareness of potential need for stress-management techniques and available support following an emergency situation How can you care for yourself after you’ve provided emergency care in stressful situations? 1. Providing care under emergency situations can be very stressful. 2. To reduce your physical and emotional stress after providing emergency care: a. Try to relax after the incident. Lower your heartbeat and blood pressure by resting or walking slowly. Relaxing will reduce elevated adrenaline produced by your body to help you through the stress of providing emergency care. b. Avoid stimuli such as caffeine, nicotine or alcohol. c. Talk about the incident to others. Sharing your experience with others helps in processing thoughts and emotions, therefore reducing stress and anxiety. Talking about the incident can be a healing medicine. d. If you experience physical or emotional problems such as prolonged depression, sleeping disorders, persistent anxiety or eating disorders, seek the help of a health care professional. e. Spend time with others. Reach out – people care. Duty of care requirements What are the duty of care requirements in the workplace? Identification, elimination, prevention or minimisation of hazards is a priority in the workplace to prevent or minimise injuries. It is the responsibility of employers, employees, and possibly the Emergency Responder’s duty, to identify hazards and implement strategies to manage the risks involved. If your employer cannot provide specific information, check the Workplace Health & Safety websites in your State or Territory for guidance. Respectful b haviour towards a casualty As an Emergency Responder how should you approach casualties in a respectful way? Approach casualties (and fellow students during your training) in a calm, culturally aware, sensitive and respectful manner. Learn more about a specific culture in your work environment so you have a better understanding how to act appropriately. Encourage casualties and their representatives to communicate cultural issues that may impact their care. Being culturally aware means that you respond to the needs of all casualties regardless of their respective cultural backgrounds (race/ethnicity, faith/religion, gender, disability, sexual orientation, age, etc.) during training and in a “real-life” event.

I-3

PADI RTO

HLTAID001 - PROVIDE CARDIOPULMONARY RESUSCITATION Develop cultural awareness by reflecting on and examining your own and all casualties’ and fellow students’ values, beliefs and cultural identity. Raise awareness of similarities and differences, social disadvantages and provider inequalities. Develop cultural understanding through fostering relationships with different cultural groups. Recognise and continuously develop the skills, roles and functions needed to perform culturally sensitive assessments; to plan, implement and evaluate culturally sensitive emergency response; and challenge any possibly existing discrimination and prejudice. Own skills and limitations What is a Good Samaritan law? The provision of emergency care does raise legal issues. Emergency care can only be provided upon consent. If a casualty is unresponsive, then consent is assumed. Good Samaritan laws (or related, local laws) are enacted to encourage people to come to the aid of others. Generally, Good Samaritan principles impose no legal duty to help a stranger. For example, in New South Wales and Queensland the ‘Good Samaritan’ or volunteer is required to act with “reasonable care and skill” and to a standard that is appropriate to their level of training (and generally speaking that standard is low) while in the Northern Territory persons are required by Statute Law to “render assistance to any other in need”. ARC states: “The standard of care required of a person who has a duty of care to respond is higher. All responders who hold themselves out to have a skill must perform their tasks to a standard expected of a reasonably competent person with their training and experience. This does not mean a standard of care of the highest level.” [Refer current ARC Guideline 10.5 on legal and ethical issues related to resuscitation, available online at http://resus.org.au/ guidelines/ ]. Good Samaritan laws may or may not apply in your region; your Trainer will discuss local Good Samaritan laws applicable to your area. In general, what are the five ways you should act to be protected by most Good Samaritan laws? 1. Only provide care that is within the scope of your training 2. Act in good faith 3. Do not be reckless or negligent 4. Act as a prudent person would 5. Ask permission and gain consent from the casualty to help

I-4

PADI RTO

HLTAID001 - PROVIDE CARDIOPULMONARY RESUSCITATION

Consent How do you ask for permission to help a casualty? When an injured or ill responsive adult needs emergency care, ask permission before you assist the person. This also helps to reassure the casualty, noting that you are trained appropriately. Use the Responder Statement; say, “Hello? My name is . I’m an Emergency Responder. May I help you?” If the casualty agrees or doesn’t respond, you can proceed with emergency care. If a responsive adult becomes unconscious, most laws assume implied permission – meaning you can proceed with emergency care. You should check the laws in your region. If an injured or ill responsive adult refuses emergency care, do not force it on them. If possible, talk with the individual and monitor their condition by observation without providing actual care. You could, however, activate/call Emergency Medical Services (EMS) at this time. Privacy and confidentiality requirements What are the privacy and confidentiality requirements when providing emergency care in the workplace? You should respect that different genders, age groups or cultures have differing views on what is acceptable. You need to be flexible in your approach and adjust the care you provide accordingly. Remember to treat others with the dignity and respect that you would like you or your loved ones to receive. Casualty confidentiality is of the upmost importance, both legally & morally. It is important you keep any opinions to yourself (do not engage in gossip or offer opinions). When dealing with the appropriate authorities, state only facts and refrain from expressing your opinion. It is important that you adhere to privacy laws. Remember that personal information about the health of a worker is confidential; this includes any details on medical condition(s) along with any treatment provided, etc. You must not disclose any information without the person’s consent. Furthermore, do not ask health care professionals details about the health of a co-worker. Importance of debriefing Why is debriefing important following an incident in the workplace? A debriefing is designed to help people deal with their trauma, one incident at a time, by allowing them to talk about the incident after it happened, without judgment or criticism. This process is in place to prevent or reduce critical incident stress. Considerations when providing CPR In this section you will learn the important considerations when providing CPR in an emergency, including protecting the casualty’s airway and the important links in the Chain of Survival .

I-5

PADI RTO

HLTAID001 - PROVIDE CARDIOPULMONARY RESUSCITATION Airway obstruction due to body position How can the airway become obstructed due to body position? Positional asphyxia has been defined as asphyxia (stoppage of respiration) caused by an unusual position of the body which interferes with the breathing and thus with pulmonary ventilation. Effective respiration requires three critical elements, i.e. an open airway, adequate ventilations and a functional respiratory muscular pump. Appropriate duration and cessation f CPR Once an Emergency Responder has started CPR, for how long should they continue? Provide CPR for as long as possible. Normally it is recommended to continue CPR until the casualty responds or begins breathing normally, it is impossible to continue (e.g. exhaustion), a health care professional arrives and takes over, or a health care professional directs that CPR be stopped. Appropriate use of an AED What is the function of an AED? An Automated External Defibrillator (AED) is a sophisticated, battery-powered microprocessor-based device that incorporates a heart rhythm analysis and a shock-advisory system. AEDs are designed for lay rescuers like you. The AED connects to the patient via two chest pads. It analyses the patient’s heart rhythm automatically and detects when a shock is needed to restore a normal heart rhythm. The electrical shock causes a momentary disruption that can allow the normal heart rhythm to return. Early defibrillation is crucial in the Chain of Survival for any adult casualties who are not breathing normally. As an Emergency Responder you can aid a casualty by providing CPR to keep oxygenated blood flowing at a minimal level until you, a bystander or EMS personnel can defibrillate the casualty’s heart. During Skills Development you will learn how to use an Automated External Defibrillator (AED) which allows you to provide defibrillation to an adult casualty quickly. Because time is critical, being able to use an AED before Emergency Medical Services arrive can significantly increase chances for survival. Chain of Survival What are the Chain of Survival’s four links and which three involve you, the Emergency Responder? The Chain of Survival illustrates the four links of emergency care. The first three links or actions within the Chain of Survival involve you, the Emergency Responder. The remaining link involves Emergency Medical Services personnel or other health care professionals.

I-6

PADI RTO

Early Recognition and Send for Help As an Emergency Responder you must first recognise that an emergency exists. Once you’ve determined that an emergency exists, assess the scene to determine if it is safe for you to assist the casualty. You will learn proper scene assessment and primary assessment during Skills One and Two of this training program. Next, for a casualty with a life-threatening problem, you must first call EMS. This is the Call First concept. Early CPR A person who is not breathing normally needs CPR immediately. CPR is a skill you will learn in Skills Three and Four. Early CPR is an important way to provide emergency care until the arrival of EMS personnel. Early Defibrillation An Automated External Defibrillator (AED) is key to reviving an adult casualty suffering from a cardiac emergency involving ventricular fibrillation (abnormal, twitching heart). You will learn to use an AED in Skill Five of this training program. Early Professional Care and Follow-up EMS personnel can provide advanced casualty care such as artificial airways, oxygen, the use of cardiac drugs and defibrillation when AEDs are unavailable or may not be used by Emergency Responders in a local area. To complete the Chain of Survival , casualties move from your important, initial care to Emergency Medical Services’ care (and hospital care, if needed). What is the Cycle of Care (Emergency Action Plan or Resuscitation Chart) – DRSABCDS? ARC presents the Basic Life Support Flow Chart as DRSABCD.

HLTAID001 - PROVIDE CARDIOPULMONARY RESUSCITATION

I-7

PADI RTO

HLTAID001 - PROVIDE CARDIOPULMONARY RESUSCITATION Standard precautions

What standard precautions should we follow while providing emergency care? Always place a barrier between you and any moist or wet substance from another person; assume all blood and fluid are potentially infectious. Basic anat my and physiology This section covers the basic anatomy and physiology as it relates to CPR along with how to check for responsiveness in a casualty and how positional change can affect airway management. How to recognise a person is not breathing normally What are the priorities of care during respiratory failure? Respiratory problems require the immediate attention of Emergency Responders because without oxygen the brain begins to die within a few minutes. The two problems with the respiratory system that Emergency Responders learn to handle are: 1. respiratory failure 2. airway obstruction It’s important for you to first open the airways and check whether or not an unresponsive and unconscious casualty is breathing normally. How do you determine if a casualty is not breathing normally? Begin by opening the airway, using head tilt-chin lift manoeuver (more on this later). Next, place your ear over the casualty’s nose and mouth, and quickly scan for normal breathing: look toward their chest and see if it rises and falls; listen for signs of normal breathing; feel for their breath on your ear (your ear is very sensitive, so if the casualty is breathing, even lightly, you’ll probably feel it). You may also gently place your hand on the casualty’s chest to feel if it rises and falls. Casualties who are gasping or breathing abnormally and are unresponsive require resuscitation. There is a high incidence of abnormal gasping (agonal gasps) after cardiac arrest. Chest What is the general purpose of the respiratory system and how does it work? The chest contains two lungs, one lung on the right side of the chest, the other on the left side. The lungs are soft and protected by the ribcage. The general purpose of the respiratory system is to bring oxygen (O 2 ), into our body and to remove carbon dioxide (CO 2 ). Oxygen is a gas that provides us energy while carbon dioxide is a waste product or “exhaust” of the body. The diaphragm separates the chest cavity (containing the heart and lungs) from the abdominal cavity and performs an important function in respiration (breathing). Normal breathing is essential to maintaining life. When the diaphragm flattens and the ribs are lifted up and out, the volume of the lungs increase, pulling air into the body through the mouth or nose. Air entering the body is moistened and filtered.

I-8

PADI RTO

Once air enters the body, it travels around the tongue, down the throat or pharynx and past the epiglottis – a flap that prevents food or fluid from entering the lungs. Here, the pharynx divides into two passageways, one for food ( oesophagus ) and the other for air. The passageway for the air is called the trachea or windpipe. The trachea branches into the left and right bronchi , which lead into each of the two lungs. Response/consciousness How do we check for responsiveness in an injured person? Changes in the level of consciousness, or LOC, of a person who may have sustained an injury to the head are an important indicator of the way the brain is functioning. The scale used to measure this is commonly called “AVPU” for Alert, Verbal, responsive to Pain, or Unresponsive. Note: pain inducement is left for the health care professional to control and is not a measure of consciousness for the lay-person rescuer or Emergency Responder. Speak directly to the person. Ask: what is your name? What is the day / time? What happened? Upper airway anatomy and effect of positional change How does positional change effect the upper airway? For some casualties, merely opening the airway lifts their tongue away from the back of their throat allowing them to resume breathing. The tongue is the most common cause of airway obstruction in unresponsive casualties. You need to do this because in an unconscious person, the tongue often falls back and blocks the airway. Use the head tilt/chin lift method. For adults and children (1 to 8 years old): place one hand on forehead, tilt the head backwards, hold up the chin with thumb and fingers to open the mouth and pull the tongue and soft tissues away from the back of the throat. ARC suggests to use ‘pistol grip’ to lift the chin. For infants (less than 1 year old): keep the head neutral (maximum head tilt should not be used) and support the lower jaw at the point of the chin with the mouth maintained open.

HLTAID001 - PROVIDE CARDIOPULMONARY RESUSCITATION

I-9

PADI RTO

HLTAID001 - PROVIDE CARDIOPULMONARY RESUSCITATION

I-10

PADI RTO

HLTAID002 - PROVIDE BASIC EMERGENCY LIFE SUPPORT

Provide basic emergency life support * IMPORTANT NOTE * If you have not previously completed the prerequisite unit of competency HLTAID001 Provide cardiopulmonary resuscitation (CPR), you first need to review the Knowledge Development portion of that program and complete the related Knowledge Review questions. You find the information in the previous section of this manual. Only then should you start studying this section. Introduction Welcome to your training program HLTAID002 Provide basic emergency life support (BLS). Progressing on from the prerequisite unit of competency (CPR), this program will further introduce you to: • Basic anatomy and physiology • Principles and procedures for first aid management Basic anatomy and physiology In this section you will expand your knowledge of basic anatomy and physiology by learning additional fundamental knowledge about the circulatory system, the lymphatic system and the nervous system and their importance when providing basic emergency life support. The circulatory system What is the general purpose of the circulatory system? Most cells in the human body are not in direct contact with the external environment. The purpose of the circulatory system is to act as a transport service to provide these cells with the essentials of life. The circulatory system transports both blood and lymph. The heart, blood and blood vessels form the cardiovascular system, while lymph nodes, lymph and lymph vessels form the lymphatic system.

II-1

PADI RTO

HLTAID002 - PROVIDE BASIC EMERGENCY LIFE SUPPORT How many litres of blood are there in an average-sized adult body? An average-sized adult body contains approximately six litres of blood liquid and blood solids. Liquids make up 55% and solids the remaining 45%, including red blood cells, white blood cells and platelets. Blood transports oxygen, nutrients, carbon dioxide and waste products. Blood also defends us against disease and helps regulate body temperature. How big is the heart, what is its general shape and where is it located? The heart is pear-shaped in size, it is a muscular organ hardly bigger than your fist. Your heart does approximately 70 beats/minute = 2.5 billion beats/lifetime. The heart is located in the chest cavity, behind the breast-bone and between the lungs. The right side pumps blood to the lungs and the left side pumps blood to other body parts. What is the name of the heart cells that trigger its beating action? Pacemaker cells initiate a chain reaction that causes the heart to contract in waves; they are located in the top right portion of the heart. The top cells contract first, followed by the lower portion of the heart. If pacemaker cells are deprived of oxygen, abnormal rhythm (ventricular fibrillation) may occur. What is the name of the blood vessels that take blood away from the heart? During each heart contraction, blood surges into the arteries – the vessels that carry blood away from the heart. Arteries are strong and elastic. What is a pulse and blood pressure? As blood enters an artery after the heart contracts, it stretches. This stretching can actually be felt when an artery is near the surface of the skin. This feeling of the stretching of arteries is called a pulse. Contraction of the heart propels the blood through the arteries with considerable force. This force is called blood pressure. When an artery is cut, blood spurts out under pressure in regular intervals. Typically, arterial blood is bright red because it is oxygen-rich. What is the name of the one cell wide blood vessels located at the site of nutrient and waste exchange? As blood moves away from the heart through the arteries, the vessels get smaller and smaller. Eventually the arteries branch into a network of tiny vessels called capillaries. All the body’s cells are in close proximity to a capillary network. This close association between capillaries and cells allows for the exchange of materials. Since capillary walls are only one cell thick, gases and nutrients can easily diffuse into and out of the thin walls.   A small cut or abrasion anywhere on the skin is sure to damage a bed of capillaries. When capillaries are cut, the blood oozes slowly and typically stops quickly due to clotting. What is the name of the blood vessels that take blood to the heart? As the blood flows out of the capillaries on their way back to the heart the network forms larger vessels called veins. Veins return blood to the heart. When a vein is cut the blood flows from the wound steadily without rhythmic spurts. Typically, the blood from veins is dark red because it is oxygen poor.

II-2

PADI RTO

What is the name of the artery in the neck and wrist? Several arteries in the human body are important for Emergency Responders to know about. The carotid artery on each side of the neck is very close to the skin and typically easy to locate; it is a powerful artery since it is close to the heart, taking oxygen-rich blood to the brain. The radial artery near the wrist may be used to feel for a pulse. However, as you’ll learn, a casualty may not have a detectable carotid or radial artery pulse, but may still have a heartbeat. Feeling for a pulse may not be the best way to determine if a casualty has a heartbeat. During Skills Development you’ll learn the technique of quickly scanning the patient for responsiveness and normal breathing. Where are the artery pressure points on the leg and arm used to control severe bleeding? The two main pressure points can be found in the arms (this is the brachial artery that can be found by placing several fingers under the upper arm, several inches down from the armpit, then pressing inward until you feel a pulse) and the legs (this is the femoral artery that can be found on the inside of the thigh near the area of the groin). What arteries supply blood to the heart muscle? Coronary arteries supply blood directly to the heart. Heart attacks and cardiac arrest are two major problems. The lymphatic system

HLTAID002 - PROVIDE BASIC EMERGENCY LIFE SUPPORT

What are the two primary purposes of the lymphatic system? Like the cardiovascular system, the lymphatic system forms a vast network of vessels and is part of the body’s circulatory system. The two primary purposes of the lymphatic system are to transport returning fluids that have collected in tissues to the bloodstream and to filter out foreign particles, microorganisms and other tissue debris from the body. What are problems related to the lymphatic system? An injury to the abdomen may cause life- threatening internal bleeding from the spleen. Since a person with an infection may have inflamed, swollen and tender lymph nodes, you should be on the lookout for these indications during injury or illness assessment. The lymphatic system also removes injected venoms following a bite or sting from poisonous animals. Slowing the movement of lymph may reduce the spreading of venom from a poisonous bite or sting. As with any serious injury or illness, you provide initial care for the patient by alerting Emergency Medical Services.

II-3

PADI RTO

HLTAID002 - PROVIDE BASIC EMERGENCY LIFE SUPPORT The nervous system

What is the primary purpose of the nervous system? All mental and physical activity is controlled by the nervous system – a complex network of cells that communicate with one another. The division of labour that exists within the nervous system allows it to control the human body precisely and efficiently. What are the two main organs of the central nervous system? The two main organs of the central nervous system are the brain and the spinal cord. The brain is the human body’s controlling organ. The spinal cord extends from the brain and then on to a network of nerves throughout the body. Information transmitted to and from the brain include sensory information (touch, taste, sight, sound, smell), motor functions and involuntary functions along with levels of consciousness.

II-4

PADI RTO

What four different types of information are transmitted to and from the brain? 1. Sensory information 2. Motor functions 3. Involuntary functions 4. Levels of consciousness How is the central nervous system protected from injury? The brain and spinal cords’ delicate nerve cells are surrounded by protective tissue layers that help keep them safe from injury. Also, the skull protects the brain and spinal column vertebrae protect the spinal cord. A clear liquid called cerebrospinal fluid provides additional protection. Principles and procedures for first aid management Considerations when providing first aid for specified conditions This section introduces basic first aid procedures for conditions such as allergic reactions, (incl. anaphylaxis), bleeding control, cardiac arrest (incl. chest pain), choking and airway obstruction, respiratory distress (incl. asthma), shock, and stroke. It also introduces you to the basic principles for the management of these conditions when providing basic emergency life support. Allergic Reactions, incl. anaphylaxis

HLTAID002 - PROVIDE BASIC EMERGENCY LIFE SUPPORT

What are the indications of severe and mild allergic reactions? Severe allergic reactions (anaphylaxis or anaphylactic shock) are potentially life-threatening; they can occur rapidly – usually immediately after a person eats (e.g. peanuts, shellfish) or is stung or bitten by an insect, or has taken drugs (e.g. penicillin). Persons with severe allergic reactions may have hives or red blotchy skin, wheezing, chest tightness, stomach pain and complain of nausea, difficulty breathing, talking or swallowing (due to swollen face, lips, tongue or throat tissue). Their blood pressure may drop, leading to dizziness and fainting. Treat a severe allergic reaction as a medical emergency and follow primary care procedures. Mild allergic reactions include sneezing, itchy eyes, runny nose and skin rashes. Mild allergies are not life-threatening and are usually controlled with antihistamines. How do you manage severe allergic reactions that are potentially life-threatening? Remember your priorities of care (DRSABCDS). First, stop and assess the scene for danger. Was the casualty stung or eating? Consider your safety and form an action plan; check to see if an auto-injector is available – if so, assist the casualty in administering it. If auto-injector is not available, continue the Cycle of Care . Responsive casualties may prefer to sit up for easier breathing. Check their level of responsiveness and check for any indications of a pre-existing condition by looking for a medic alert tag and asking the casualty. Alert Emergency Medical Services (EMS) as appropriate and continue to support the casualty until EMS personnel arrives.

II-5

PADI RTO

PADI RTO HLTAID002 - PROVIDE BASIC EMERGENCY LIFE SUPPORT Bleeding control What is severe bleeding? Experience tells you that when the skin and underlying tissue is cut, scraped or punctured, there’s going to be blood. How much blood flows from the wound and how quickly it leaves the body is what determines whether it’s a minor problem or severe, life-threatening bleeding. As we’ve learnt, the human body contains about six litres of blood. Rapid loss of just one litre is dangerous and can lead to death. Because severe bleeding is life-threatening you, as an Emergency Responder, need to be able to recognise and manage this during a primary assessment. Severe bleeding management is the first S in the last step of the Cycle of Care (DRSABCDS). What are the basic principles for the control of severe bleeding? First, ensure safety for the casualty and yourself, the Emergency Responder – use barriers. Stop the bleeding to conserve the casualty’s own blood. Remember to reassure the casualty during first aid care and encourage rest. Transport casualty to the hospital or call Emergency Medical Services if they appear pale, sweaty, agitated and thirsty due to blood loss (these indications may be associated with internal bleeding). What are the three types of bleeding and how is each identified? In general, there are three types of external bleeding. In an emergency, it’s not critical for you to diagnose the exact type of bleeding. However, by knowing the differences you’ll be better able to judge how severe the bleeding is and how best to manage it. During Skill Development you’ll learn how to control severe bleeding using direct pressure and pressure points. Arterial Bleeding Bright red blood that spurts from a wound in rhythm with the heartbeat. This is the most serious type of bleeding since blood loss occurs very quickly. If a major artery is cut, death can occur within a minute Venous Bleeding Dark red blood steadily flowing from the wound without rhythmic spurts. This bleeding can also be life-threatening and must be controlled as quickly as possible. Capillary Bleeding Blood slowly oozing from the wound. This slow bleeding may stop on its own or is typically easy to handle with direct pressure. Any time a casualty has severe bleeding, use barriers, activate EMS immediately and quickly provide care to prevent excessive blood loss.

II-6

What is internal bleeding? It is difficult to recognise internal bleeding. However, Emergency Responders should always suspect internal bleeding when a person is injured. Injuries that commonly cause internal bleeding include those caused by a violent blunt force or when an object penetrates the skin and damages internal organs. Car accidents and falling from extreme heights may also cause internal bleeding. Unlike external bleeding, internal bleeding may also be due to medical conditions such as ulcers, haemophilia (a lack of ability to clot blood from a wound) or aneurysm (internal bursting of a blood vessel). Common signs of internal bleeding include anxiety and restlessness, rapid breathing, rapid and weak pulse, unconsciousness and pale tongue along with bleeding from a body opening such as the ears, mouth and nose. Three symptoms of internal bleeding include, pain and tenderness around the affected area, thirst and nausea. Unlike external bleeding, Emergency Responders can do little for a person with internal bleeding. If you suspect a casualty has internal bleeding, call EMS immediately, keep the patient comfortable and immobile (unless in harm’s way). Internal bleeding typically requires surgery. Cardiac conditions What are the indications of cardiac arrest and how do you manage them? Cardiac arrest symptoms are immediate and drastic and may include a sudden collapse, no normal breathing and a loss of consciousness. Other indications may precede sudden cardiac arrest, such as fatigue, fainting, blackouts, dizziness, chest pain, shortness of breath, weakness, palpitations or vomiting. If the casualty is not breathing normally begin CPR/defibrillation as soon as possible. Ensure you also alert EMS. Choking and airway obstruction How do you recognise upper airway obstruction? Airway obstruction may be partial or complete and may be present in the conscious or the unconscious casualty. Typical causes include relaxation of the airway muscles due to unconsciousness, inhaled foreign body, trauma to the airway, severe allergic reaction. During partial obstruction breathing is laboured and may be noisy, some escape of air can be felt from the mouth. During complete obstruction, there may be efforts at breathing or no sound of breathing, there is no escape of air from nose and/or mouth. How do you manage foreign body airway obstruction (FBAO, or choking)? Assess the severity, check if there is an effective cough. Effective cough (mild airway obstruction): encourage coughing to expel the foreign material and continue the Cycle of Care (DRSABCDS) and if the obstruction is not relieved the responder should call EMS. Ineffective cough (severe airway obstruction): if casualty is conscious, call EMS, give up to five back blows with the heel of one hand in the middle of the back between the shoulder blades – if this is not effective, give up to five chest thrusts. These are similar to chest compressions but sharper and delivered at a slower rate. If casualty is unconscious, call EMS and commence CPR.

HLTAID002 - PROVIDE BASIC EMERGENCY LIFE SUPPORT

II-7

PADI RTO

HLTAID002 - PROVIDE BASIC EMERGENCY LIFE SUPPORT Respiratory distress, incl. asthma What is hyperventilation and what are the indications? Hyperventilation is rapid breathing resulting from stress, deliberate over-breathing or other medical condition. The casualty may experience light headedness, air starvation, chest pressure, chest discomfort, panic, blurred vision and tingling. It is important to monitor the casualty and continue the Cycle of Care (DRSABCDS). What are two types of asthma attacks and how do you manage them? Asthma attacks can occur suddenly or develop over a period of time. Mild attack – difficulty breathing and wheezing. Reassure and monitor the casualty, encourage them to take a comfortable position. Severe attack – unable to speak, drowsy, unconscious, airway severely compromised, treat severe attack as a medical emergency. Follow the principles for primary assessment and care, tell casualty to breath slowly and help to take medication as prescribed, administer oxygen (if available) and keep reassuring the casualty. Continue the Cycle of Care (DRSABCDS). Shock What is shock and what causes it? Any injury or illness (serious or minor) that stresses the body may result in shock. Shock occurs when an injury or illness makes it difficult for the body’s circulatory system to provide adequate amounts of oxygenated blood to vital organs. During shock, the body begins to shut down. Shock is a life-threatening condition that is easier to prevent from getting worse than it is to manage or treat after it becomes severe. Shock management is the second S in the last step of the Cycle of Care (DRSABCDS). What conditions may cause shock? Some conditions that may cause shock are: severe bleeding, major trauma, severe burns, severe dehydration, heart attack, abnormal dilation of blood vessels (due to severe infection, allergic reaction, brain or spinal injury) or blocked blood flow to or from the heart.

II-8

PADI RTO

What are the nine indications of shock? Indications of shock may include: 1. rapid, weak pulse 2. pale or bluish tissue colour 3. moist, clammy skin – possibly with shivering 4. mental confusion, anxiety, restlessness or irritability 5. altered consciousness 6. nausea and perhaps vomiting 7. thirst, 8. dazed look, lacklustre eyes 9. shallow but rapid, laboured breathing. Even if you don’t recognise any of these indications, continue to manage for shock when you provide emergency care to an injured or ill casualty. Remember, it’s better to prevent shock than to let it complicate their condition. Stroke What is a stroke? A stroke can happen in two main ways. Either there is a blood clot or plaque that blocks a blood vessel in the brain that causes an ischaemic stroke; or a blood vessel in the brain breaks or ruptures causing an Haemorrhagic stroke. This deprives the brain of oxygen and causes cell death. Indications and damage depend on what part of the brain has been affected. Treat stroke as a medical emergency – call EMS and monitor the Cycle of Care (DRSABCDS). If the casualty is conscious sit upright leaning slightly forward and to the injured side, if innocuous put them into the lateral recovery position injured side down. What are five indications of stroke? 1. numbness, paralysis or weakness of face, arm or leg 2. speech difficulties 3. facial droop 4. unexplained headaches 5. sudden blurred or decreased vision in one eye, or both

HLTAID002 - PROVIDE BASIC EMERGENCY LIFE SUPPORT

II-9

PADI RTO

HLTAID002 - PROVIDE BASIC EMERGENCY LIFE SUPPORT

II-10

PADI RTO

HLTAID003 - PROVIDE FIRST AID

Provide First Aid * IMPORTANT NOTE * If you have not previously completed the prerequsite units of competency HLTAID001 Provide cardiopulmonary resuscitation (CPR) and HLTAID002 Provide basic emergency life support (BLS), you first need to review the Knowledge Development portions of those programs and complete the related Knowledge Review questions. You find the information in the previous sections of this manual. Only then should you start studying this section. Introduction Welcome to your training program HLTAID003 Provide first aid (FA). Progressing on from the prerequisite two units of competency (CPR, BLS), this program will introduce you to: • Considerations when providing first aid • Basic anatomy and physiology • Principles and procedures for first aid management Considerations when providing first ai This section will introduce you to the two types of assessment you can perform while assessing a casualty’s condition. What is meant by visual and verbal assessment of a casualty? A visual assessment is when you carefully observe the casualty and note what you see, e.g. is the person conscious or have they just lost consciousness; note the time; check them for a medical alert bracelet or necklace and check if they have any medication in the their hands or in the vicinity. A verbal assessment is when you ask questions and note the answers. Ask the person their name, the year and if they know where they are. Introduce yourself, ask if they are experiencing any pain on a scale from 1 to 10, with 10 being the worst the person ever felt. Ask the casualty if they know what happened, if they are experiencing any numbness or tingling in the hands, arms or legs or anywhere in the body; ask if they are experiencing nausea and also ask if they are taking any medication or have allergies to food or medication. Basic anatomy and physiology Considerations when providing first aid for specified conditions This section will introduce you to the skeletal and muscular systems and explain the key differences between tendons and ligaments and their relevance when providing first aid. The skeletal syst m What are three purposes of the skeletal system? The adult human body has more than 200 bones in an internal framework called the skeleton. Bones provide a rigid framework against which muscles can pull, give shape and structure to the body and support and protect delicate internal organs. Bones also store minerals, such as calcium and phosphorus that play vital roles in metabolic processes. In addition, the internal portions of many bones produce red blood cells and certain types of white blood cells. Cracked, broken and fractured bones and dislocations often require emergency care.

III-1

PADI RTO