Hlt page the drsabcd action plan detail danger

	HLTAID003 Provide First Aid Course Code: HLT54115

Assessment Instructions

Achieving competency

Reassessment

If you receive a Not Yet Satisfactory result for this Assessment Task, it will be due to you not satisfying the requirements of one, multiple or all aspects of the task. Your Assessor will provide you with feedback as to where you did not meet the requirement. You will have one other opportunity to resubmit your assessment work addressing the areas as identified in your assessor feedback.

Extensions may be granted by your trainer under exceptional circumstances and will only be granted for a maximum of two (2) weeks.

Adjustment in assessment

WHAT IS FIRST AID?

INFECTION CONTROL

Infection Control refers to a series of actions taken to minimise or control the spread of diseases. An infectious disease is transmitted only by a specific kind of contact. Examples are measles, chicken pox, and the common cold.

Waste Management The waste contaminated with body fluid (blood, vomit) produced o
during the First Aid scenario should be dealt with as soon as possible. They should be disposed into an infectious waste bin but if this is not possible, it should be double bagged before disposing of it in a lidded waste bin

o A duty of care exists;
o The First Aider breached their duty of care (i.e. did something that was outside the scope of their training); and
o The First Aider made the person worse as a result of their actions
o
A Duty of Care can be breached by either action or inaction (i.e. if you do nothing and the person in your care gets worse).

An employer is vicariously liable for its employees’ acts “in the course of employment”.

Treatment without consent will be justified when:
 There is a necessity to act when it is not practicable to communicate with the casualty, and  The treatment is reasonable (i.e. what a reasonable person, given the level of training completed, would do in the circumstances)

 Use ink – not pencil
 Clearly record:
o Casualty details - spelling, legal name
o Details of the scenario
o Summary of signs and symptoms
o Summary of management
o Summary of outcome i.e. what happened to the casualty
o Signed off - usually a copy is to be provided to the casualty
o If there are errors put a line through it and initial it
 Storage
Confidentiality is a must when storing these reports. The only people who have access to this are the casualty, the First Aider and in a workplace and the designated HR personnel. For any other access, the casualty’s permission must be sought in writing.

The DRSABCD Action Plan assists you to prioritise your actions, including the primary assessment of the casualty for any life-threatening conditions and what management to put in place.

It should be where you start at any scenario and so it is very important that you are familiar with the Action Plan. Your trainer will review the DRSABCD Action Plan further with you.

3. If there is no response to any of the above, the casualty is deemed as unconscious and you move on to sending for help and checking that the airway is clear.

If there is a response you move on to collecting history, signs and symptoms and managing the outcome of your investigations.

Send for help and check Collect history, signs and symptoms

the airway is clear and manage the outcome

BREATHING
Check for normal breathing using the “look, listen, feel” method for at least 10 seconds. Look for consistent rise and fall of the chest, and hear and feel consistent breaths.

Gasping or occasional gasps often referred to as agonal breathing are not normal breathing.

For example, after a car accident and the driver, still in the seat, is slumped forward with their chin on their chest. This will compromise the airway and their ability to breath and result in positional asphyxia.

The management is to open and clear their mouth. Then hold their
chin in a “pistol” grip to raise their chin to tilt their head, or from
behind with each of your hand holding their head firmly on both sides, tilt their head. This will open the airway.

1. Kneel beside casualty, one knee level with head and the other with casualty’s chest. 2. Locate lower half of sternum (breastbone) in the centre of chest.

Adult / Child (over 1 year)
1. Place heel of hand on lower half of sternum (breastbone) and place heel of
other hand on top of first
2. Interlock fingers of both hands and raise fingers to ensure that pressure is not applied over casualty’s ribs, upper abdomen or bottom part of sternum.

4. Repeat to complete 30 compressions at a rate of approximately 100 per minute.

Note: During CPR (combining chest compressions with rescue breathing), you would expect to achieve 5 sets of 30 compressions and 2 breaths (30:2) in about 2 minutes
Change over between First Aiders during CPR
When two First Aiders are present or if a second person arrives to help:

 You can stop giving CPR when:
o The casualty begins breathing and is responsive o More qualified help arrives
o You are physically unable to continue

What to do when the casualty starts breathing
1. Turn the casualty to the recovery position
2. Call for an ambulance or medical aid as soon as possible (if not done already)
3. Assess casualty for bleeding and other injuries noting tenderness, swelling, wounds or deformity in the following order:

o If breathing is present, leave in the Recovery Position and monitor o If breathing is still absent, turn onto back and recommence CPR

THE RESPIRATORY SYSTEM
The primary function of the respiratory system is to supply the blood with oxygen in order for the blood to deliver oxygen to all parts of the body.

During expiration, the diaphragm relaxes, and the volume of the thoracic cavity decreases, while the pressure within it increases. As a result, the lungs contract and air is forced out. The ambient air we breathe in consists of about 20.8% oxygen.

The gaseous exchange uses up about 5%. Therefore, the expired air has about 15% oxygen in it. This amount of oxygen breathed into the casualty’s lungs, combined with compressions during CPR will preserve the circulation of air and blood around the body while waiting for medical aid to arrive.

DEFIBRILLATION
What is a defibrillator?

It is a machine that can analyse the heart rhythm and decide to deliver a jolt of biphasic electricity to stop the arrhythmia. This in turn will allow normal sinus rhythm to resume. A fully automated external defibrillator is known as an AED and a semi- automated as an SAED but the term AED is most commonly used.

o One pad to casualty’s right chest wall—below collarbone (ensure pad adheres to skin) o One pad to casualty’s left chest wall—below left nipple (ensure pad adheres to skin). Note: If implant is identified, place pad at least 5 cm away from site— do not place pad on top of pacemaker or implant site.

You will be required to demonstrate implementing the DRSABCD Action Plan which includes:

It is a proven fact that the Chain of Survival can improve survival rate up to 80%.

 Even in the case of a successful rescue the casualty still needs to be assessed and monitored. Hence the need to call Triple Zero (000).

CHOKING
A person chokes when the airway is partly or completely blocked. The person usually has trouble breathing, but if the blockage is a complete blockage they cannot breathe at all.

Signs and symptoms

o Clutching the throat
o Coughing, wheezing, gagging
o Having difficulty breathing, speaking or swallowing
o Trying to cry but making strange sounds or no sound at all
o Making a whistling or crowing noise
o Turning blue in the face, neck, lips, ears or fingernails
o Collapsing or being unconscious
o
The simplest way to assess the severity of an airway obstruction is to check whether a cough is effective or ineffective.

Signs and symptoms

These may develop progressively depending on the severity of the injury, continuation of fluid loss or the lack of effective management. They can include:
• Cold, clammy skin
• Faintness or dizziness

WOUNDS & BLEEDING

A wound is a break in the continuity of the tissues of the body. It may bleed and it may become infected.

External Bleeding
Management
1. DRSABCD
2. Lie casualty down if the bleeding is severe
3. Remove or cut clothing to expose the wound
4. Apply firm direct pressure or instruct casualty to do so if possible
5. If casualty is unable to apply pressure, apply pressure using a pad or your hands (use gloves if available)
6. Raise and rest the injured part when possible
7. Apply a pad over the wound if not already in place and secure with bandage - ensure pad remains over the wound
8. If bleeding continues, leave initial pad in place and apply a second pad over the first and secure with a bandage
9. If bleeding continues replace second pad only
10. Seek medical aid

3. Note the time of application – write this on the casualty in pen as after 30 minutes, release the bandage and check for bleeding

 If there is no bleeding, remove the bandage
 If bleeding recommences, apply direct pressure
 If direct pressure is unsuccessful, reapply the constrictive bandage and recheck in 30 minutes again
4. Call Triple Zero (000) for an ambulance

The casualty should also be advised of the signs and symptoms of infection including localised pain, redness, swelling, offensive discharge, not healing. In this case they should seek medical aid.

How to clean a minor wound e.g. a graze
Collect appropriate equipment from the First Aid kit:

You can do this by placing pads around the object, and securing the pads with a bandage taking care not to put pressure on the object.

AMPUTATIONS

Signs and symptoms of internal bleeding:
• Pain
• Tenderness
• Rigidity of abdominal muscles
• Coughing up red, frothy material
• Shock - pale, cold, clammy skin
Management
1. Lie casualty down or if casualty is coughing up frothy blood half sitting will be more comfortable
2. Raise the legs or bend the knees
3. Loosen tight clothing
4. Call Triple Zero (000) for an ambulance
5. DO NOT give the casualty anything to eat or drink
6. Reassure the casualty, manage shock

CRUSH INJURIES

In an asthma attack the lining of the lungs and airway become inflamed and swollen. Excess mucus is produced, causing the person to have great difficulty in breathing which in turn creates great distress. Usually it is the expiration (breathing out) phase that is difficult and varying volume of wheeze is audible. The reduction in the volume of the wheeze or cessation does not necessarily mean that the casualty is recovering.

Factors triggering an asthma attack may include exercise, respiratory infections, allergies (to pollen, foods, bee stings etc.), exposure to sudden changes in weather conditions especially cold air, anxiety, smoke. Although asthma is treatable and usually can be managed, there is no known cure. There are two types of medication – relievers and preventers.

Preventers reduce the inflammation in the airways and reduce symptoms and exacerbations. Examples are Pulmicort and Flixotide.

There are also combination medications like Seretide and Symbicort which is a preventer plus a symptom controller.

You will be required to demonstrate the administration of a reliever medication using a volumatic spacer.

ALLERGIC REACTIONS