FAR-Modules mcq how to aid mcq and summer concept.

First Aid Response (FAR)
© Civil Defence College
(December 2018)

Table of Contents
Module 1 -Patient Assessment…………………………………………………….page 2
Module 2 -Incident Procedure ……………………………………………………page 52
Module 3 -CFR (not included)
Module 4 -Common Medical Emergencies ………………………………….page 81
Module 5 -Injury Management and Shock …………………………………page 133
Module 6 -Care of the Unconscious Patient ………………………………page 190
Module 7 -Burns & Electrical Injury Care …………………………………..page 219
Module 8 -Hypothermia & Hyperthermia ………………………………….page 251
Module 9 -Information management ………………………………………..page 272
Module 10 -Communications ……………………………………………………..page 293
Module 11 -The Well-being of the First Aid Responder ……………….page 312
First Aid Response

Patient Assessment
Module 1
First Aid Response
© Civil Defence College
(December 2018)

Learning Outcomes
Knowledge Objectives (by the end of this Unit,you will be able to…)
1.State the purpose of a Primary Survey and identify when it should be
conducted
2.State the purpose of a Secondary Survey and identify when it should be
conducted
3.Identify the key anatomical areas to be examined during a “Survey”
4.Describe the procedure for patient assessment –primary and secondary
5.State the 6 Vital Signs –circulation, breathing, blood pressure (cap refill),
skin colour, skin temperature, and conscious level
6.State the normal/abnormal characteristics of the 6 vital signs
7.Define the term ‘sign’ and ‘symptom’
8.Identify the components of a patient’s history based on the mnemonic
SAMPLE: Signs & Symptoms, Allergies, Medication, Pertinent medical
history, Last oral intake, Event (SAMPLE)

Learning Outcomes
Attitudinal Objectives (by the end of this Unit,you will be able to…)
1.Recognise and respond to the feelings the patient may experience
during examination in a non-judgemental and compassionate manner
2.Communicate with empathy during examination to patient/s as well as
with family members, friends and bystanders showing appreciation and
understanding for the effects of pain and fear
Skills Objectives (by the end of this Unit,you will be able to…)
1.Demonstrate how to conduct a Primary Survey
2.Demonstrate how to conduct a Secondary Survey
3.Demonstrate how to obtain a SAMPLE history
4.Demonstrate how to record the findings of patient assessment

•Primary Survey
1.Initial Response
2.Catastrophic Bleeding
3.Mechanism of Injury
4.Assess Responsiveness
5.ABCDE
•Secondary Survey
1.Vital Signs
2.Signs & Symptoms
3.SAMPLE History
4.Head-to-Toe Examination
Topics

**Scenario**
You are out on duty when a gentleman
approaches you and tells you that a member
of the public has collapsed!
Task:Write out the steps
you would take

What is it?
-Method used to identify
the presence of any life
threatening injuries
-We use a Primary Survey
with every patient we meet
-First step in the Care
Management of any
patient
What does it consist of?
1.Initial Response
2.Catastrophic Bleeding
3.Mechanism of Injury
4.Assess Responsiveness
5.ABCDE
Primary Survey

1. Initial Response
•Scene Safety
•Scene Survey
•Scene Situation
Question:
-What elements might
we be focusing on here?

Scene Safety
•Look and listen for Immediate dangers to yourself & others
•Any hazards at the scene?
•Is it safe to approach?
•Take standard infection control precautions and COVID-19
specific precautions.

Scene Survey
•Look at the incident –what happened?
•Examine the Mechanism of Injury
•Look at the position of the patients
•Number of patients
•Are there bystanders/onlookers?

Scene Situation
•Will you need additional help?
–Responders
–EMS (999/112)
•Establish priority patient/s
•Listen to information being provided
•Be calm and confident (the patient is relying
on you)
•Be caring, compassionate & non-judgemental

2. Catastrophic Bleeding
Q. What do we do if
there is a
catastrophic bleed?

3. Mechanism of Injury

Linking Mechanism of Injury to
suspected injuries of the head and spine
•Any trauma patient with altered level of consciousness
•Blunt trauma with associated injuries above the collar bones
•Penetrating trauma to head, neck and torso
•Falls from height
•Shallow water diving accidents
•Hangings
•Gunshot wounds

Suspected Head or Spinal Injury
Question:What do we do if
we suspect the casualty
may have suffered a
head or spinal injury?

•If the Mechanism of Injury suggests a spinal
injury you must control c-spine
C-Spine

4. Assess Responsiveness
•Shake & Shout
•Gently tap the patient’s shoulders and ask if
he/she can hear you
•Unresponsive? (999/112 & AED)
Open the Airway & check
for normal Breathing

5. ABCDE
AIRWAY
BREATHING
CIRCULATION
DISABILITY
EXPOSE AND EXAMINE

Airway
•The first step is to ensure the patient has an
adequate Airway
WHY?
No airway = no means of breathing
Result: Life threatening complications

Airway
Q. Does anyone know the most common cause of
an airway obstruction?
–The Tongue
Q. How do we fix an inadequate airway?
–Head-Tilt, Chin-Lift method
–Lifts the tongue from the back of
the mouth and opens the airway

Breathing
•After we have ensured the patient has an airway –
we need to ask a very important question:
Are they breathing?
NO
•We need to breathe for them
•Start CPR
•Call for help
YES –is it normal?
•Depth (shallow or deep)
•Speed (fast or slow)
•Regularity (regular or irregular)

Circulation
•Key Components:
–Pulse
•Have they a pulse?
NO
•No breathing + No Pulse
= CPR
YES –is it normal?
•Rate (fast or slow)
•Regularity (regular or irregular)
•Strength (strong or weak)

Circulation
•Key Components:
–Cap Refill
•Is it less than 2 seconds?
–Skin Colour and Temperature
•Pale?
•Flushed? (Red)
•Cyanosed? (Blue)

Disability
•Alert–is the patient alert?
•Voice–do you have to raise
your voice to get response from
patient?
•Pain–does the patient only
respond to a pain stimulus?
•Unresponsive–is the patient
completely unresponsive?
In order to assess a patients responsiveness
we use the AVPU scale

Expose & Examine
•The final step of the Primary Survey is to expose and
examine
•A common mistake people have is thinking this is only
for trauma patients, but we should do it for all patients
•What are we looking for?
–Deformities
–Open Wounds
–Tenderness
–Swelling
–Also looking out for rashes, sources of infection, etc.

PHECC CPGs
•FAR CPGs (2017)
–Primary Survey
CPGs
Page
16

Questions or Clarifications?

What is it?
-Method used to establish
any other injuries and look
for signs & symptoms
-We can classify it as either
‘Medical’ or ‘Trauma’
What does it consist of?
•Vital Signs
•Signs & Symptoms
•SAMPLE History
•Head-to-Toe
Examination
Secondary Survey

Vital Signs
•Circulation
•Breathing
•Blood Pressure (Cap Refill)
•Skin Colour
•Skin Temperature
•Conscious level

Assessing Pulse (Circulation)
Normal Rates:
60 to 100 Adult
Count for
30 seconds x 2
Radial Pulse

Assessing Pulse (Circulation)
Normal Rates:
60 to 100 Adult
Count for
30 seconds x 2
Carotid Pulse
•Don’t press too
hard!
•No to be used for
patients with
suspected head
or neck injuries

Pulse
Rate: Fast Slow
Rhythm: Regular Irregular
Quality: Strong Weak
Assessing Pulse (Circulation)
Q1. What might a rapid strong pulse be a
sign of?
Q2. What might a fast & weak pulse be a
sign of?
Q3. What would no pulse be a sign of?

Assessing Breathing (Resp. rate)
Normal Rates:
12 to 20 Adult Count for
30 seconds x 2

Assessing Breathing
Q1. What might a slow or fast breathing rate
be a sign of?
Q2. What might irregular breathing be a sign
of?
Breathing
Rate: Fast Slow
Rhythm: Regular Irregular
Quality: Deep Shallow
Quiet Noisy
Laboured Normal

Blood Pressure (Cap Refill)
Pressure is applied to the nail
bed until it turns white. This
indicates that the blood has
been forced from the tissue
Pink colour should return in less
than 2 seconds after pressure is
removed
1
2
Cap Refill
Cap Refill
Fast Refill Slow Refill
Palpable Pulse Non-Palpable Pulse

Skin Condition
•Colour –white (pale), red, blue, yellow,
black/blue, flushed
•Temperature –warm/cool, hot/cold
•Condition –clammy, sweaty, dry, wet
Book
Page
35

Conscious Level –AVPU
•Alert–is the patient alert?
•Voice–do you have to raise
your voice to get response
from patient?
•Pain–does the patient only
respond to a pain stimulus?
•Unresponsive–is the
patient completely
unresponsive?

Sign or a Symptom
Sign Symptom

Sign or a Symptom
Sign Symptom
•An indicator of the
patient’s condition
that you can see,
smell, feel or hear
(e.g. vomiting,
coughing, deformity)
•An indicator of the
patient’s condition
that they tell you and
that only they can feel
(e.g. nausea, back
pain, stomach-ache)

Sign or a Symptom
Mix & Match
1. “I feel sick” 8. Tightness of the chest
2. A fractured arm 9. Tenderness
3. Swelling 10. Patient says they feel unwell
4. Fatigue 11. Breathing rate of 10 p.min
5. Smell of alcohol off patient12. Wheezing
6. Abnormal breathing 13. Headache
7. Weak pulse 14. Bleeding
In 2’s –Picks out the Signs & Symptoms

SAMPLE History (Hx)
•S–signs and symptoms
•A–allergy
•M–medications taken or medications on
•P–past medical history
•L –last intake including drugs or alcohol
•E–events leading to and including event

•Head, Neck, and Cervical Spine
–Feel head and neck for deformity, tenderness, or
crepitus
–Checkfor bleeding & Askabout pain or tenderness
Page
38-40
Head-to-Toe Examination

•Chest
–Watch chest rise and fall with breathing.
–Feel for grating bones as patient breathes.
–Listen to breath sounds.
Page
41
Head-to-Toe Examination

•Abdomen
–Look for obvious injury, bruises, or bleeding.
–Evaluate for tenderness and any bleeding.
–Examine the area very gently.
Page
42
Head-to-Toe Examination

•Pelvis
–Look for any signs of
obvious injury,
bleeding, deformity
–Do not apply pressure
to the pelvis
Page
43
Head-to-Toe Examination

•Extremities –Arms& Legs
–Look for obvious injuries
–Feel for deformities
–Look for Medic alert tags
–Assess
-Cap Refill
Page
44
Head-to-Toe Examination

Take a SAMPLE history of your partner
Remember:
•Signs & Symptoms
•Allergies
•Medications
•Past Medical History
•Last Oral Intake
•Events Leading Up
Let’s Practice!
Role Play

Let’s Practice!
Role Play
1. Carry out a Primary
Survey on your partner
2. Carry out a Secondary Survey on your
partner including a full set of vitals
Remember:
•Empathy
•Compassion
•Calm & Caring Approach
•Understanding of
patient’s pain & fear

Assessment
Q. Describe the procedure for carrying out a
Primary Survey
Q. Describe the procedure for carrying out a
Secondary Survey
*Books Away!*
Group Work

Course Manual:
Complete Questions
on page 47
Assessment
*Try completing questions without help first!*
Assessment Sheet:
10 MCQ
questions
1
2

Summary
•Primary Survey
1.Initial Response
2.Catastrophic Bleeding
3.Mechanism of Injury
4.Assess Responsiveness
5.ABCDE
•Secondary Survey
1.Vital Signs
2.Signs & Symptoms
3.SAMPLE History
4.Head-to-Toe Examination

Incident Procedure
Module 2
First Aid Response
© Civil Defence College
(October 2015)

Learning Outcomes
Knowledge Objectives (by the end of this Unit,you will be able to…)
1.Outline the reasons and importance of making the 999/112 call
2.Describe the importance of scene safety for responders
3.State the First Aid Responder's personal responsibility related to
personal and scene safety
4.List the First Aid Responder’s role in the continuum of care
5.Outline how to apply the principles of standard infection control
precautions e.g. hand washing, glove use and disposal, clinical
waste disposal
6.List the Care Principles outlined in the PHECC CPG manual

Learning Outcomes
Attitudinal Objectives (by the end of this Unit,you will be able to…)
1.Demonstrate a calm, caring attitude, showing awareness of self-
protection and safety
Skills Objectives (by the end of this Unit,you will be able to…)
1.Demonstrate pre-approach checks
2.Demonstrate a safe approach
3.Demonstrate good glove disposal and hand washing technique

•Roles & Responsibilities of the First Aid
Responder
•Scene Safety, PPE & Infection Control
•Calling 112 (or 999)
•Patient Confidentiality
•Continuum of Patient Care
•Handover to EMS
Topics

Resources?

Q. What do you think are the
Roles & Responsibilities of the
‘First Aid Responder’
Question Time!
*Books Away!*
Group Work

Roles & Responsibilities
•Keep Calm
•Personal Safety, Scene safety and safety of others
•3 P’s –Preserve Prevent Promote
•Check & Maintain Airway, Breathing & Circulation
•Qualified to administer CPR
•Call 112/999 –or instruct someone else to do so
•Access the patients injury/illness
•Prioritise injuries/illness
•Prioritise patients
•Offer reassurance and care until EMS arrives
•Administer care within your training

Personal Safety
1.Make sure the scene is safe to enter
2.Look out for.....
•Fire or explosion risk
•Electrical Wiring
•Broken Glass or Fragments
•Smell of Gas
•Chemicals
•People
Personal Protective Equipment (PPE)

What forms of PPE can we use?
Personal Protective Equipment

Personal Protective Equipment

Scene Safety
Your safety
comes
FIRST!

Scene Safety
Why is Scene Safety so important?

Let’s Practice!
Demonstrate pre-approach checks and
effective scene safety

Infection Control
Q. How might we become infected as a result
of giving care?

Pathogens (Germs) –
Transmission
Transmission Method Contaminationvia
Droplet Coughing or sneezing
Direct Physical ContactTouching an Infected Person
Indirect Physical ContactTouching contaminated surface or clothing
Airborne transmission Small spores carried in the air

Infection Control
Q. What types of Infection Control measures
do you think we can implement?

Safe Removal of Gloves
Page
19
2 31
4 5 6

Hand Washing
The biggest cause
of infection
spreading is the
lack of, or no,
Hand Washing!

Clinical Waste Disposal

112/999
As a responder it is your
responsibility to contact
the emergency services
“It’s better to be looking at
them than for them!”

Let’s Practice!
Make the call to the Emergency Services
using your Red Card

PHECC CPGs
•FAR CPGs (2017)
–Care Principles
CPGs
Page
14/15

Safety of Patient and others
•Compassion to the Patient
•Remember their dignity
•Take control
•Reaction of Close family or Friends
•Offer Reassurance
•Explain to the patient what you are doing

Patient Confidentially
•All Medical information
•Disclosed onlyto Healthcare Professionals
•ACR’s/PCR’s stored appropriately

Continuum of Patient Care
Our role as Responders;
•Shared duty of care on scene
•Each responder accountable for his/her own actions
•Most qualified takes the lead
•Manage and treat the patient’s illness/injury
•Communicate effectively on scene
•Fill out patient care forms thoroughly & accurately
•Efficient handover to arriving EMS is essential

Handover to EMS
•Information you need to give
•Short and Concise
•ASHICE!
•Record Times
•Ambulatory Care Report (ACR)

Assessment Sheet:
10 MCQ
questions
Assessment
*Try completing questions without help first!*

Assessment
•Why is it important to call 112/999?
•Why is Personal & Scene Safety important?
•How should we apply the principles of
Infection Control?
•What is our role in the Continuum of Care?
*Books Away!*
Group Work

Summary
•Roles & Responsibilities of a Responder
•Personal Safety & Scene Safety
•Infection Control
•Calling 112/999
•Patient Confidentiality
•Continuum of Care
•Handover to EMS

Common Medical Emergencies
Module 4
First Aid Response
© Civil Defence College
(October 2015)

Learning Outcomes
Knowledge Objectives (by the end of this Unit,you will be able to…)
1.List the common medical emergencies (CMEs)
2.Identify the key manifestations (origin, nature and cause) of each CME
3.State the key signs and symptoms of each CME
4.Outline methods to assess patients for each CME
Attitudinal Objectives (by the end of this Unit,you will be able to…)
1.Demonstrate an ability to empathise with the regimes that patients may need to
follow for their underlying conditions and be able to describe the risks of
stereotyping
2.Demonstrate an ability to respond to the needs of patients who have failed to
adhere to their usual medication regimes in a non-judgemental and compassionate
manner showing appreciation for the effects of fear
Skills Objectives (by the end of this Unit,you will be able to…)
1.Demonstrate how to care for patients who have suffered a CME according to CPGs

Common Medical
Emergencies (CME’s)
1.Inadequate breathing (Asthma)
2.Low/high blood sugar (Diabetes)
3.Seizures
4.Poisoning/Overdose
5.Fainting
6.Cardiac Chest Pain (Angina)
7.Anaphylaxis

Resources?

What do we know!
•Asthma
•Diabetes
•Seizures
•Poisoning/Overdose
•Fainting
•Cardiac Chest Pain (Angina)
•Anaphylaxis

What do we want to know!
•Asthma
•Diabetes
•Seizures
•Poisoning/Overdose
•Fainting
•Cardiac Chest Pain (Angina)
•Anaphylaxis

Before we go any further…
Sign Symptom

1. Asthma
To understand Asthma, we
must first look at;
•Parts of the Respiratory
System
•Functions of the
Respiratory System
•Respiratory Arrest

Parts of Respiratory System
Page
48

Functions of Respiratory System
•Provide Oxygen and remove Carbon Dioxide
Group Work
Page
49

Respiratory Arrest
•No Breathing
•No Rise & Fall of Chest
•Skin colour changes
•Normal Breathing (age)
•Normal rhythm
•Effort normal
Adequate Air Exchange
Treatment
Respiratory Arrest
•Scene safety
•Help! 112/999
•Open airway
•CPR……..

PHECC CPGs
•FAR CPGs (2017)
–Asthma
CPGs
Page
20

Asthma –Video

Q1. What is Asthma?
Q2. How does Asthma originate?
Q.3 What is Bronchospasm?
Q.4 What effect does it have on the body?
Question Time!
*Books Away!*
Group Work

Asthma –Video

Q1. How is Asthma caused?
Q.2 What are the triggers?
Question Time!
*Books Away!*
Group Work

Page
49 &
50
Question Time!
Q. List the Signs & Symptomsof
someone with Inadequate Breathing?

PHECC CPGs
•FAR CPGs (2017)
–Glycaemic Emergency
CPGs
Page
29

Q1. What is Diabetes?
Q2. How does Diabetes originate?
Q.3 How is it caused?
Q.4 What effect does it have on the body?
Question Time!
Group Work
*Books Away!*

2. Diabetes

Signs & Symptoms
High Blood Sugar
•Gradual onset
•Sweet Breath
•Frequent urination
•Increased hunger & thirst
•Rapid breathing & pulse*
•Warm Dry Skin
*Rapid breathing & pulse can present as a symptom of both

Signs & Symptoms
Low Blood Sugar
•Sudden onset
•Poor coordination
•Unusual Behaviour
•Cool Clammy Skin
•Rapid breathing & pulse*
•Altered Level of Consciousness
*Rapid breathing & pulse can present as a symptom of both

Treatment of a Diabetic patient
•Make comfortable
•Offer sweet drink or food
•Patient may have their own
•Reassure & Monitor patient
•Advise to visit GP
•If required call 112/999
•Scene Safety
•ABC
•Call 112/999
•Breathing –Recovery Position
•Reassure and Monitor
Conscious Patient Unconscious Patient

PHECC CPGs
•FAR CPGs (2017)
–Seizure/Convulsion
CPGs
Page
32

3. Seizures
Has anyone experienced a seizure
or witnessed a seizure?

What is a Seizure?
•Sudden surge of electrical activity in the brain
•Usually affects how a person appears or acts for a
short time
•Seizures can be a symptom of many different
disorders that can affect the brain

Seizures –Causes?
•Epilepsy
•Low Blood Sugar
•High Temperature
•Stroke
•Infection
•Brain Tumour
•Poisoning
•Head injury
•Alcohol
•Drugs

Seizures –Epilepsy
1. Simple Partial (Minor)
2. Generalised –Tonic Clonic (Major)

Simple Partial Seizures
•Consciousness is not impaired
•The seizure is confined to either rhythmical twitching of
one limb or part of a limb
•Or unusual sensations, such as pins and needles in a
distinct part of the body

Generalised Seizure
•The most dramatic form is the tonic-clonic
convulsive seizure (still sometimes called a
"major" or "grand mal" seizure)
•The person becomes rigid, then falls to the
ground and there is jerking of all four limbs
•Breathing is laboured and there may be
incontinence of urine
•Not all of these features are always seen

Q1. What are Seizures?
Q2. How do Seizures originate?
Q.3 How are they caused?
Q.4 Name 2 types of Epileptic Seizures?
Question Time!
Group Work
Q.5 What effect does it have on the body?
Q.6 What are the signs & symptoms?
Q.7 How do we treat a patient suffering a seizure?

Seizures…
Page
127,
128

PHECC CPGs
•FAR CPGs (2017)
–Poisons
CPGs
Page
31

4. Poisoning/Overdose
Substances that have
the potential to destroy
life or harm health

Routes of entry of Poison?
•Ingestion
•Inhalation
•Injection
•Absorption
Page
152

Signs & Symptoms
•Nausea
•Vomiting
•Pain
•Breathing difficulties
•Seizure
•Confusion
•Unconsciousness
What are the signs & symptoms of Poisoning?

Treatment
•Scene Safety
•Call 112 (or 999)
•Identify source –Identification sheet
•Inhalation = fresh air
•Ingestion –DO NOTinduce vomiting!
•Check Level of consciousness AVPU
•Recovery Position –if necessary

Poisons
•Toxic Chemicals
Useful Number:
National Poisons
Information Centre,
Beaumont Hospital
Tel: 01-8092166
(24 hour service)
www.poisons.ie
Page
153-4

PHECC CPGs
•FAR CPGs (2017)
–Fainting
CPGs
Page
28

Has anyone ever fainted or seen
anyone faint?
5. Fainting

Cause?

Signs/Symptoms & Treatment
Signs & Symptoms?
•Slow Pulse
•Dizziness
•Pale, Cool Clammy Skin
•Blurred Vision
•Limb Weakness
•Sweating
Treatment?
•Lie patient down, raise legs
•Support & reassurance
•Move onlookers
•Sit patient up slowly
•Fresh Air
•If repeated incidents refer
patient to GP
Group Work

PHECC CPGs
•FAR CPGs (2017)
–Cardiac Chest Pain
CPGs
Page
25

Severe chest pain caused by a reduced blood flow to
the heart. It is a warning that there is a problem with
the blood supply to your heart.
6. Angina
Essentially, your heart
isn’t getting enough
oxygen-rich blood

Signs/Symptoms & Treatment
Signs & Symptoms?
•Chest Pain
•Pain spreading to the arms,
neck, jaw and around the
back
•Nausea
•Shortness of breath
•Extreme fatigue
•Weakness
•Abdominal pain
Treatment?
•Rest
•On medication for this?
•Reassurance
•Monitor vitals
•Be prepared to call 999/112
Group Work

PHECC CPGs
•FAR CPGs (2017)
–Anaphylaxis
CPGs
Page
27

Anaphylaxis is a serious, life-
threatening allergic reaction
7. Anaphylaxis
It can have a sudden
onset and rapid
progression

Signs/Symptoms & Treatment
Signs & Symptoms?
•Difficulty breathing
•Diminished consciousness
•Changes to your skin (red,
blotchy skin or itchy skin)
•Dizziness
•Swelling (lips, hands, feet)
•Confusion
•Weak & rapid pulse
Treatment?
•Treat as a medical
emergency! (999/112)
•On medication for this?
•Sit them down
•Reassurance
•Monitor vitals
Group Work

Let’s Practice!
1. Inadequate Breathing (Asthma)
2. Low/High Blood Sugar (Diabetes)
3. Seizures
4. Poisoning/Overdose
5. Fainting
Role Play
Remember:
•Empathy
•Compassion
•No judgement
•Understanding of
patient’s pain & fear
6. Angina
7. Anaphylaxis

Course Manual:
Complete Questions
on page 60 & 137
Assessment
*Try completing questions without help first!*
Assessment Sheet:
10 MCQ
questions
1
2

Assessment
•What effect does Asthma have on the body?
•How do you treat a conscious patient with Diabetes?
•List at least 5 causes of Seizures
•What are the signs & symptoms of Poisoning?
•What are the signs & symptoms of Fainting?
•Define Angina
•What is Anaphylaxis?
*Books Away!*
Group Work

Summary
•Common Medical Emergencies
–Asthma
–Diabetes
–Seizures
–Poisoning/Overdose
–Fainting
–Angina
–Anaphylaxis
•Signs & Symptoms of each
•Treatment of each

Injury Management & Shock
Module 5
First Aid Response
© Civil Defence College
(October 2015)

Learning Outcomes
Knowledge Objectives (by the end of this Unit,you will be able to…)
1.State the main types of serious bleeding injuries and causes using
CLIPS
2.State the main types of musculoskeletal injuries (fracture, sprains,
strains and dislocation) and causes
3.Explain hypovolaemic shock, causes and progression
4.Describe the care management of bleeding injuries –external and
internal
5.Describe the care management of a nose bleed
6.Describe the care management of musculoskeletal injuries
7.Describe the care management of suspected spinal injuries
8.Describe the care management of shock

Learning Outcomes
Attitudinal Objectives (by the end of this Unit,you will be able to…)
1.Demonstrate an ability to empathise with patients, their friends and
families when managing traumatic injury in a non-judgemental and
compassionate manner
Skills Objectives (by the end of this Unit,you will be able to…)
1.Demonstrate how to control external blood loss at various wound sites
2.Demonstrate how to manage a patient with internal blood loss
3.Demonstrate how to manage soft tissue injuries
4.Demonstrate how to immobilise a limb injury –any painful, swollen or
deformed limb
5.Demonstrate how to manage hypovolaemic shock
6.Demonstrate how to maintain active spinal motion restriction

1.Wounds & Bleeding
2.Musculoskeletal Injuries
3.Spinal Injuries
4.Shock
*Warning* –Some graphic pictures!
Topics

•Wounds & Bleeding
•Musculoskeletal Injuries
•Spinal Injuries
•Shock
What do we know!

1. Wounds & Bleeding
•Circulatory System
•Heart & Blood Vessels
•Functions of Blood
•Types of Bleeding
•Internal & External
Bleeding

Circulatory System
Contains….?
Heart
Arteries
Veins
Capillaries
Blood

Heart & Blood Vessels
4 Chambers
Top –Atriums (2)
Bottom –Ventricles (2)
Arteries
Veins
Capillaries

•What is the function of
our blood?
Functions of Blood?

Functions of Blood
•Maintain Body Temperature
•Transport:
–Oxygen to cells
–Nutrients to cells
–Waste Products away from cells
–Disease Fighting Cells
–Platelets for clotting
Page
89

•Three types of bleeding?
–Capillary (oozing)
–Venous (flowing)
–Arterial (spurting)
External Bleeding

•What effect does bleeding
have on the body?
Effect of Bleeding
•Pulse?
•Skin?
•Body Temperature?

•CLIPS!
–Contusions
–Lacerations
–Incisions
–Penetrations
–Special (i.e.
gunshot wounds)
Wounds –Types

Bleeding Control
•P –
•E –
•E –
•P –
•S –
CPGs
Page
35
Posture
Elevation
Examination
Pressure
Shock

•Wear gloves if
available
•Expose wound
•Cover with clean
cloth or gauze
•Apply direct
pressure
Care for
Serious External Bleeding

•Apply a pressure
bandage
•DO NOT remove any
blood-soaked
dressings
Care for
Serious External Bleeding

•Skin is not broken and blood is not seen.
•Recognising internal bleeding
–Bruising
–Painful, tender area
–Vomiting or coughing up blood
–Black or bright red stool
Internal Bleeding

Care for Internal Bleeding
•Care for minor internal bleeding
Follow the steps of the RICE procedure.
–Rest the injured area
–Use an Ice pack
–Compress the injured area
–Elevate an injured arm or leg if not broken
•Care for serious internal bleeding
–Call 112 (or 999)
–Care for shock by raising the casualty's legs
–If vomiting occurs, roll the casualty onto his or her side
–Monitor breathing

Pages
95-101
Group Work –Readings!
•Causes?
•Treatment?
•Other key info?
Group Work

•Amputations
−Call 112 (or 999)
−Control bleeding
−Care for shock
−Recover the amputated part and place it in a clean
plastic bag or cling film
−Lightly wrap the bagged amputated part in gauze
−Keep the part cool, but do not freeze
Special Wounds

•Embedded (Impaled) Objects
−Expose area
−Do NOT remove the object
−Control bleeding around the
object
−Stabilise the object
−Shorten the object only if
necessary
Special Wounds
© E. M. Singletary, M.D. Used with permission.

Dressings and Bandages
Dressings Bandages
Difference??

Dressings
•Functions
–Absorb blood
–Prevent infection
–Protect the wound
•Types
–Gauze pads
–Adhesive strips
–Trauma dressings
–Improvised dressings

Bandages
•Functions
–Hold dressing in place
–Apply pressure to
control bleeding
–Prevent or reduce
swelling
–Support and stabilize
an extremity or joint
•Types
–Gauze roller
bandages
–Elastic roller
bandages
–Triangular
bandages

Triangular Bandages

Practice Bandaging!

Let’s Practice!
Demonstrate how to manage and treat
a patient suffering from internal
blood loss
Remember:
•Empathy
•Compassion
•Calm & Caring Approach
•Understanding of
patient’s pain & fear
Role Play

2. Musculoskeletal Injuries

Functions of Skeleton?
Page
138,
139

Fracture
•Break or crack in a
bone

Types of Fracture
Complicated fracture
Closed Fracture Open Fracture

Cause of Fracture?
•Slip, Trip, Fall
•Assault
•Bone disease
•Motor Accident
•Sports Injury

Signs Symptoms
Signs & Symptoms –Fracture?

Signs & Symptoms –Fracture
Sign Symptom
•Swelling or Bruising
•Deformity
•Protruding bone
•Loss of
function/movement
•Pain
•Tenderness

Sprain v Strain?
What is a Sprain &
what is a Strain?

Dislocation

Treatment
•Scene Safety
•Call for help
•Do not move patient –unless necessary
•All patient get into a position of comfort
•Deal with bleeding
•Immobilise bone or joint as presented
•Check CSM both sides of injury
•Reassure and keep patient warm

R.I.C.E

PHECC CPGs
•FAR CPGs (2017)
–Limb Injury
CPGs
Page
38

Moving Patients with Fractures
•How or why do you think you’d move a patient
with a fracture?

Demonstration & Practice Time
1.Immobilise a limb
injury
2.Demonstrate Care
Management of
patient
Practice:
Remember:
•Empathy
•Compassion
•Calm & Caring Approach
•Understanding of
patient’s pain & fear

3. Suspected Spinal Injury
•FAR CPGs (2017)
–Spinal Injury Management
CPGs
Page
39

Let’s Practice!
Demonstrate how to maintain active
spinal motion restriction
High Risk Factors:
•Dangerous mechanism of injury
•Fall from height > 1metre
•Axial load to head or base of spine
•Impaired awareness
•Aged 65 or older
•Age ≤ 2 years incapable of verbal
communication
Role Play

•What is Shock?
4. Shock

Shock....
“An acute medical condition associated with a fall in blood
pressure, caused by such events as loss of blood, severe
burns, allergic reaction, or sudden emotional stress, and
marked by cold, pallid skin, irregular breathing, rapid pulse,
and dilated pupils”(Oxford English Dictionary)
“Shock is a life-threatening condition that occurs when
an insufficient supply of blood throughout the body
causes the cells of the body to be deprived of oxygen.
Shock can occur following a serious accident, illness or
injury”(First Aid Manual)

Shock
1.Heart
2.Blood vessels
3.Blood
Lack of ???? reaching body cells =SHOCK!
Problem with any one or more of…

How might the…..
…be damaged in the first place?
1. Heart
3. Blood Vessels
2. Blood
Group Work

Causes of Shock…..
SHOCK
Bleeding
Externally
Bleeding
Internally
Severe
Allergic
Reaction
Dehydration
Heart
Condition
Severe
Burns

This Module is focused on Internal and External
Bleeding as well as Injury Management
Shock
…therefore, we speak about Shock in terms of
Blood Loss
Hypovolaemic Shock!

Types of Shock
HypovolemicShock –Loss of Blood Circulation
CardiogenicShock –Heart not ‘working’ properly
ObstructiveShock-blood obstructed –Heart not working
DistributiveShock –Septic –Anaphylactic -Neurogenic
Page
93

1. Heart
3. Blood Vessels
2. Blood
What Signs or Symptoms might you
note on a patient with a damaged…..
Group Work

Signs & Symptoms of Shock
•Pale Face
•Rapid Shallow
Breathing
•Fast, Weak Pulse
•Clammy Skin
•Agitation
•Confusion
•Anxiety
•Disorientation
•Unconsciousness
•Weakness
•Dizziness

Treatment for Shock?
•A –Open Airway
•B –Check Breathing
•C –Check Circulation
•Deal with External Bleeding
•Raise Limbs (if possible)
•Keep Patient warm
•Loosen tight clothing
•Observe Vital Signs
•Reassure patient
Life Threatening Conditions –
call 112 (or 999) immediately

Let’s Practice!
Demonstrate how to manage and treat
a patient suffering from
hypovolaemic shock
Remember:
•Empathy
•Compassion
•Calm & Caring Approach
•Understanding of
patient’s pain & fear
Role Play

Course Manual:
Complete Questions
on page 96
Assessment
*Try completing questions without help first!*
Assessment Sheet:
10 MCQ
questions
1
2

Assessment
•State the main types of serious bleeding injuries and causes
using CLIPS
•State the main types of musculoskeletal injuries and their
causes
•Explain hypovolaemic shock and its cause
•Describe the care management of internal & external
bleeding
•Describe the care management of a nose bleed
•Describe the care management of a musculoskeletal injury
•Describe the care management of a suspected spinal injury
•Describe the care management of shock
Group Work

Summary
•Serious Bleeding –Internal & External
–CLIPS
•Musculoskeletal Injuries
–RICE
•Spinal Injuries
•Shock
–Hypovolaemic

Care of the Unconscious Patient
Module 6
First Aid Response
© Civil Defence College
(October 2015)

Learning Outcomes
Knowledge Objectives (by the end of this Unit,you will be able to…)
1.List the common causes of an altered level of consciousness
2.Describe the difference between each of the ‘AVPU’ levels
3.List the main signs and symptoms of concussion and outline the
reason for on-going observation post injury
4.List the main signs and symptoms of (cerebral) compression
5.Describe the management of a head injured patient
6.Describe the management of a suspected spinal injury
7.List steps to care for the general well-being of an unconscious
patient

Learning Outcomes
Attitudinal Objectives (by the end of this Unit,you will be able to…)
1.Demonstrate an ability to empathise with patients who may not appear to
be fully conscious in a non-judgemental and compassionate manner
2.Demonstrate an ability to respond to the needs of patients showing
appreciation for the effects of pain and fear
Skills Objectives (by the end of this Unit,you will be able to…)
1.Demonstrate how to assess a patient’s conscious level
2.Demonstrate how to examine a patient’s head
3.Demonstrate how to manage a patient’s airway using the head tilt/chin lift
4.Demonstrate how to provide advice to a patient with a suspected spinal
injury
5.Demonstrate how to care for an unconscious patient’s general wellbeing

1.Altered Level of Consciousness (ALOC)
2.AVPU Scale
3.The Nervous System
4.Concussion & Compression
5.Care Management for Head Injury
6.Head/Neck/Spinal Immobilisation
7.Care Management for Unconscious Patient
Topics

Resources?

Show What You Know!
Altered Level of Consciousness

Altered Level of Consciousness
•Interruption or alteration of a person’s
mental state
•Defined as any level of response in a
patient other than normal

Altered Level of Consciousness
•Causes
–Substance abuse
–Alcohol
–Epilepsy
–Shock
–Low blood sugar
–Stroke
–Lack of oxygen to the brain
–Trauma

Measuring ALOC
•Alert–is the patient alert?*
•Voice–do you have to raise
your voice to get response
from patient?
•Pain–does the patient only
respond to a pain stimulus?
•Unresponsive–is the
patient completely
unresponsive?
*Only ‘Alert’ state is NORMAL!*

Unconsciousness
•Unconsciousness is when a person is
unable to respond to people or other
stimuli and appear to be asleep
Alert???
Aware of where they are??

Causes of Unconsciousness
•Fainting
•Shock
•Head Injury
•Poisoning
•Epilepsy
•Diabetes
•Asphyxia
•Stroke
•Heart Attack
•Hypothermia
•Drug overdose
•Alcohol poisoning
•Severe blood loss
•Car Accident

Treatment for Unconsciousness
•A –Open Airway
•B –Check Breathing
•C –Check Circulation
•AVPU
•Observe Vital Signs
•Reassure the patient
Life Threatening Conditions –
call 112 (or 999) immediately!
How do we treat an Unconscious patient?

The Nervous System

Functions of Nervous System
•Information centre
•Voluntary & Involuntary movements
•Two Parts –Central & Peripheral
•Central –Brain & Spinal Cord
•Peripheral –nerves which connect to CNS

Concussion v Compression

Concussion v Compression
NFL's
concussion
crisis

Concussion v Compression
Concussion –Sudden Onset
Signs & Symptoms
•Temporary loss of consciousness
•Dizziness
•Nausea & Vomiting
•Headache
•Rapid Pulse
•Skin –clammy & cold
•Confusion
Compression –Slow Onset
Signs & Symptoms
•Severe Headache
•Slow & Noisy Breathing
•Dilation of one/both pupils
•High Temperature
•Weakness or Paralysis
•Irritable & disoriented
•Drowsiness
•Slow, Strong Pulse

Concussion
Treatment
•Referred to Hospital
•Recovery Position
•Monitor Vital Signs
•Regain consciousness –
remember AVPU
•Reassure patient
Compression
Treatment
•Call 112 (or 999)
•Recovery Position
•Monitor Vital Signs
•Reassure patient
Concussion v Compression
Pages
124 &
125

PHECC CPGs
•FAR CPGs (2017)
–ALoC
CPGs
Page
26

Questions or Clarifications?

•Sit patient down
•Ice pack
•Treat wound (if bleeding)
•Assess responsiveness –AVPU
•112 (or 999) if needed
Management of a Head Injury
How do we treat a head injured patient?
ABC’s, Vital Signs, Reassure, 112 (or 999)
What if they fall unconscious?

•112/999 immediately
•Immobilise head/neck/spine
•Head, Neck & Spine in straight
line!
•Reassurance
Management of a Head Injury
What if we suspect Trauma to the head?
Remember:
•Empathy
•Compassion
•Calm & Caring Approach
•Understanding of
patient’s pain & fear

PHECC CPGs
•FAR CPGs (2017)
–Spinal Injury Management
CPGs
Page
39

Let’s Practice!
Demonstrate how to manage and treat a
patient using inline techniques, with or
without spinal injury management devices,
to reduce spinal column motion.
Role Play
High Risk Factors:
•Dangerous mechanism of injury
•Fall from height > 1metre
•Axial load to head or base of spine
•Impaired awareness
•Aged 65 or older
•Age ≤ 2 years incapable of verbal
communication

Let’s Practice!
1. Assess a patient’s conscious level
2. Demonstrate how to examine a patient’s head
3. Demonstrate head tilt/chin lift technique
Role Play

Assessment Sheet:
10 MCQ
questions
Assessment
*Try completing questions without help first!*

Assessment
•List the common causes of an altered level of
consciousness
•Describe the difference between each of the ‘AVPU’ levels
•List the main signs and symptoms of concussion and
outline the reason for on-going observation post injury
•List the main signs and symptoms of (cerebral)
compression
•Describe the management of a head injured patient
•List key points in head/neck/spinal immobilisation
•List steps to care for the general well-being of an
unconscious patient
Group Work

Summary
•Altered Level of Consciousness (ALOC)
•AVPU Scale
•The Nervous System
•Concussion & Compression
•Care Management for Head Injury
•Head/Neck/Spinal Immobilisation
•Care Management for Unconscious Patient

Burns & Electrical Injury Care
Module 7
First Aid Response
© Civil Defence College
(October 2015)

Learning Outcomes
Knowledge Objectives (by the end of this Unit,you will be able to…)
1.List the causes/types of burn
2.Describe the severity of burns including reference to face, hands,
feet,flexion points and perineum (FHFFP) and circumferential burns
3.Describe the factors that indicate severity of a burned patient
4.Describe the burns potential of electrical injury
5.Describe physiological threats associated with burns
6.Describe the associated threats resulting from electrical injury
7.List the care management for burns including the importance of
standard infection control precautions
8.Outline why inhalation injuries are common following certain burns
injuries

Learning Outcomes
Attitudinal Objectives (by the end of this Unit,you will be able to…)
1.Demonstrate an ability to respond to the needs of patients who have
suffered from burns, electrical and related injury/illness showing
appreciation for the effects of pain and fear
Skills Objectives (by the end of this Unit,you will be able to…)
1.Demonstrate how to assess the extent of burns injuries
2.Demonstrate how to treat burns injuries using equipment listed on
CPGs
3.Demonstrate an awareness of safety considerations
4.Demonstrate the care management of burned patients

1.The skin
2.Causes/types of burns
3.Degrees & severity of burns
4.Impact of burns & common injuries
5.Electrical Injury and burns
6.Care management for burns & electrical
injury
*Warning* –Some graphic pictures!
Topics

Resources?

Burns & Electrical Injury
Suffered a
chemical
injury/burn

•What is the function of
our skin?
The Skin

The Skin
Consists of:
Functions…
•Protection
•Sensation
•Regulation
•Absorption
Pages
145

Burns or Scalds?
•What is the difference
between a burn and a scald?
Group Work

Burns or Scalds?
•Burn –dry heat
•Scald –wet heat
•Both are injuries to
Skin
When Muscles, Bone and
Blood Vessels are
damaged
–Thermal/Heat
–Electricity
–Chemicals
–Light
–Radiation
–Friction
How can a person be
burned?
What are the dangers
of being burned?

Types & Causes of Burns
Types Causes
1. DryBurn Contact with a hot object
2. Scald Contact with hot liquids, gas or steam
3. Chemical Burn Contact with domestic or industrial
chemicals
4. Electrical Burn Contact with an electric current
resulting in electricshock
5. Radiation Burn Extended exposure to UV light (sun) or
other radiationsources (e.g. sunburn)
6. Friction Burn Friction with abrasive materials or
surfaces

Important Parts of the Body
•FHFFP
F –Face, H –Hands, F –Feet, FP –Flexion Points
•Flexion Points: Any parts of the body at which you
flex, twist, bend
–Knees
–Hips
–Elbows
–Neck

Assessing a Burn
1.Depth
2.Area (%)
3.Age
4.Location
4 key points in determining the severity of a burn:
Q. Why is the age of the
person important?
Q. Why is the location
important?

Assessing a Burn –Depth
First Degree
Second Degree
Third Degree
A superficial or partial
thickness burn to a
FHFFP location
increases the severity of
the injury and extent of
medical assistance
required.
Key Point:

Assessing a Burn –Depth
–burn that goes all
the way around
the body part
Circumferential Burns:
•Compression
•Circulation problems
•Restriction of blood
supply
Dangers?

Assessing a Burn –Area
The Rule of Nines:
Page
147

Rule of Nines?
1.
2. 3.
4.
Groups: Calculate each
percentage burnPage
147

Treatment of Minor Burns
•Gloves on, Scene Safety
•Stop the burning process….
Why not?
Q. How should we
treat Minor Burns?
Group Work

Treatment of Major Burns
•Gloves on, Scene Safety
•Stop the burning process….
Q. How should we
treat Major Burns?
Group Work

PHECC CPGs
•FAR CPGs (2017)
–Burns
CPGs
Page
34

Questions or Clarifications?

Chemical Burns
Q. What types of Chemicals might
we come into contact with?
•Domestic cleaning products
•Acids
•Deodorant
•Bleach
•Disinfectant
•Fuel
•Paint thinner

Treatment of Chemical Burns
•Scene Safety & PPE
•Have a colleague check the chemical & advice
•ABC
•Safe comfortable position
•Flush area with clean water –20 minutes
•If appropriate remove contact lenses
•Patient may need emergency shower

Inhalation Injuries
•Carbon Monoxide
•Smoke
•Slurry gas poisoning
•Fuel gases
•Gas leak
•Slow onset
•Compromise airway
•Major organs affected
Q. What are the dangers/effects?

Electric Shock

Management of Electric Shock
•Do not touch patient
•Scene Safety –Turn off Power
•Use non-conducting object
–Dry wood or plastic
•Reassure patient

Treatment of Electric Shock
•Scene Safety –Turn off Power
•Call 112 (or 999)
•Check AcBC
•Treat for injuries (burns, cardiac arrest, breathing
difficulties)
•Shock
•Reassure and Monitor Vital Signs

Let’s Practice!
Demonstrate how to assess the extent
of burns injuries
Remember:
•Empathy
•Compassion
•Calm & Caring Approach
•Understanding of
patient’s pain & fear
Role Play

1. Demonstrate how to treat a burns & electrical injury
Remember:
•Empathy
•Compassion
•Calm & Caring Approach
•Understanding of
patient’s pain & fear
Role Play
Let’s Practice!

Assessment Sheet:
10 MCQ
questions
Assessment
*Try completing questions without help first!*

Assessment
•Why are standard infection controls important
when dealing with burns?
•List the causes/types of burn
•Describe the burns potential of electrical injury
•Describe the associated threats resulting from
electrical injury
•Why are inhalation injuries common following
certain burns injuries?
•List the care management for burns
Group Work

Summary
•The skin
•Causes/types of burns
•Degrees & severity of burns
•Impact of burns & common injuries
•Electrical Injury and burns
•Care management for burns & electrical
injury

Learning Outcomes
Knowledge Objectives (by the end of this Unit,you will be able to…)
1.State the normal range in body temperature
2.Describe common causes of overcooling (hypothermia)
3.Describe common causes of overheating (hyperthermia)
4.List the signs and symptoms of overcooling
5.List the signs and symptoms of overheating
6.Outline the additional requirements when checking vital signs
on a patient that has symptoms of overcooling
7.Describe basic treatment methods to avoid progression of a
heat related condition

Learning Outcomes
Attitudinal Objectives (by the end of this Unit,you will be able to…)
1.Demonstrate an ability to respond to the needs of patients who
have suffered from a heat related condition showing appreciation
for the effects of pain and fear
Skills Objectives (by the end of this Unit,you will be able to…)
1.Demonstrate how to care for patients with hypothermia
2.Demonstrate how to care for patients with hyperthermia

1.Body Temperature
2.Causes of Hypothermia
3.Causes of Hyperthermia
4.Signs & symptoms of Hypothermia &
Hyperthermia
5.Care management for Hypothermia &
Hyperthermia
Topics

Resources

Q1. What is Hypothermia
and what effect does it
have on the body?
What Do We Know…
*Books Away!*
Group Work
Q2. What is Hyperthermia
and what effect does it
have on the body?

Body Temperature
Page
161

Body Temperature
•Body heat is lost faster in cold water as opposed to
cold air
•Large amount of body heat is lost through your head
•Adult* Body naturally regulates temperature
–Sweating (too hot)
–Shivering (too cold)
*Babies and toddlers can’t yet

PHECC CPGs
•FAR CPGs (2017)
–Hypothermia
CPGs
Page
30

Hypothermia
•Body temperature falls below 35°C
•Body may shiver –effort to increase body
temperature
•Body begins to “shut down”
–Protect Heart & Brain
–Heart rate slows
–Brain activity slows
–Blood supply returns to core of body

Feeling cold
Mental Confusion
Drowsiness
Low energy
Apathy
Feeling afraid
Unable to think
Pale skin
Shivering
Weak pulse
Slow, shallow breathing
Slurred or mumbledspeech
Loss of consciousness
Muscle stiffness
Hypothermia
Signs & Symptoms?
Signs Symptoms
Group Work

Treatment of Hypothermia
•Identify reason for cooling
•Move patient out of cold & remove wet clothing
•Cover patient with blankets/clothing
–Layers if possible
–Cover head
•112/999
•Warm drink
•Reassurance
•Monitor vital signs

Treatment of Hypothermia
•Weak radial pulse
–Reason: Blood supply to the peripheries is reduced in
order to protect major organs
•Delayed or no cap refill
–Reason: Reduced blood supply to the peripheries.
May be no refill in more severe cases
Watch out for:
Take carotid pulse

Questions or Clarifications?

Hyperthermia
•Body temperature climbs above 38°C
•Causes
–Sun exposure
–Adverse reaction to drugs/medication
–Over-exertion
–Dehydration
–People at risk (Sports, Concerts, etc)

Nausea
Sickness
Headaches
Dizziness
Low energy
Weakness
Confusion
Sweating
Rapid Breathing
Fast,weak pulse
Hot, dry skin
Fainting
Muscle cramps
Reddened skin
Hyperthermia
Signs & Symptoms
Signs Symptoms
Group Work

Treatment of Hyperthermia
•Identify reason for overheating
•Avoid further exertion
•Fluids
•Tepid bath/shower
•Avoid alcohol
•112/999
•Reassurance
•Monitor vital signs
Q. How can we treat a patient
suffering from Hyperthermia?

Let’s Practice!
Demonstrate how to treat a patient suffering from:
1.Hypothermia (overcooling)
2.Hyperthermia (overheating)
Remember:
•Empathy
•Compassion
•Calm & Caring Approach
•Understanding of
patient’s pain & fear
Role Play

Assessment Sheet:
10 MCQ
questions
Assessment
*Try completing questions without help first!*

Assessment
•State the normal range in body temperature
•Describe common causes of hypothermia
•Describe common causes of hyperthermia
•List the signs and symptoms of overcooling
•List the signs and symptoms of overheating
•Outline the additional requirements when checking
vital signs on a patient that has symptoms of
overcooling
•Describe basic treatment methods to avoid
progression of a heat related conditions
Group Work

Summary
•Body Temperature
•Causes of Hypothermia
•Causes of Hyperthermia
•Signs & symptoms of Hypothermia &
Hyperthermia
•Care management for Hypothermia &
Hyperthermia

Learning Outcomes
Knowledge Objectives (by the end of this Unit,you will be able to…)
1.Explain the rationale for recording patient health information
2.Outline what information is required on the Ambulatory Care
Report (ACR) (or other patient care record) and how it should
be entered
3.Explain the essential elements of a verbal handover report to
other pre-hospital First Aid Response teams
4.Explain the management andstorage for ACRs or other patient
care/accident/incident record in line with relevant legislation

Learning Outcomes
Attitudinal Objectives (by the end of this Unit,you will be able to…)
1.Understand how recording data contributes to a high standard of
patient care
2.Explain why documentation should be completed in a timely
manner but should not distract from care and communication
with the patient
Skills Objectives (by the end of this Unit,you will be able to…)
1.Complete an ACR (or other patient care record) for a given
patient scenario
2.Demonstrate a “hand over” report to other member of the EMS

•Why we record information
•Ambulatory Care Report (ACR)
•Verbal handover report
•Demo filling out ACR
•Demo hand over to arriving EMS
Topics

•For what reasons do we
record patient & incident
information?
Why record information

Why record information
•Clinical
–Clinical responsibility
–In cases of life-threatening conditions patient care
will take precedence
–Patients record: documentation of out-of-hospital
events
–Time of occurrence of critical events (accurate
assessment of condition)

Why record information…
•Records
–Recording interventions and medications
administered to patients pre-hospital is an essential
clinical responsibility of all pre-hospital emergency
care practitioners
•Legal Protection
–Legal document
–Identifies the care that has been given
–A properly completed ACR will provide protection
and will be essential if called as a witness to court

Remember…..
Inaccurate documentation is potentially
damaging to patients, services and the
professional standing of the pre-hospital
emergency care practitioner

ACR

PCR

Information required
•Sections
–Incident Information
•Details of incident
•Patient Information
–Clinical Information
•Primary Survey
•Secondary Survey
–Medication Treatment
•Vitals
•Declined Treatment
Why is this important?

Copies
•Top Copy
–Travels with the patient
•given to arriving EMS
•Bottom Copy
–Stored locally by CDO
–Hand delivered to Civil Defence College for
storage at a later point

1. Your partner slipped and hurt their wrist.
You have treated the injury, now complete
an ACR to reflect your treatment. Take and
record vital signs for practice!
Role Play
Let’s Practice!

Handover…
•Important to let EMS take control once they
arrive
•Vital to hand over all information you have
gathered
•Recording the timing of events or medications
is very important
•Do not leave scene until told you can go
–Duty of care
–Abandonment!

Handover…
•What to do;
–Introduce the casualty to the EMS
–Give a summary of their condition, what you
found when you arrived and what treatment
you provided
–Ensure that your hand over is comprehensive,
but concise

Handover…
•ASHICE!
–A Age of patient
–S Sex of patient
–H History (what happened)
–I Injuries
–C Condition of patient
–E ETA

Handover…
•IMISTAMBO!
–I Identification of patient
–M Mechanism of injury
–I Injuries
–S Signs
–T Treatment
–A Allergies
–M Medication
–B Background
–O Other Information

2. Use your ACR/PCR to now complete a verbal
and physical handover of information to
the arriving EMS
Role Play
Let’s Practice!

Questions or Clarifications?

Assessment
•Give 3 reasons why do we record patient
information
•State 5 pieces of information that are recorded on
an ACR
•Why is this important not to be distracted by filling
out an ACR when treating a patient?
•Explain the essential elements of a verbal handover
report to arriving EMS
Group Work

Summary
•Why record patient information
•Key information to record
•Completing an ACR for a patient scenario
•Handover to EMS and what to do/say
•Demonstration of effective handover

Learning Outcomes
Knowledge Objectives (by the end of this Unit,you will be able to…)
1.Describe the principle barriers to effective patient and team
communication
2.State the personal qualities that make an effective communicator
3.Explain how to seek a patient’s consent for treatment
Attitudinal Objectives (by the end of this Unit,you will be able to…)
1.Whilst taking control of an emergency situation, demonstrate a
courteous approach toward the patient, their family and
bystanders
2.Outline the role of the First Aid Responder in the continuum of
patient care

Learning Outcomes
Skills Objectives (by the end of this Unit,you will be able to…)
1.Demonstrate the use of open questioning technique and obtain
important and relevant clinical information
2.Demonstrate communicating with the EMS services

•Types of communication
•Barriers to effective communication
•Being an effective communicator
•Patient consent
•Continuum of patient care
Topics

•How do we communicate
with…
–our patient?
–our team?
Communication
Group Work

Types of Communication
•Verbal
–Speaking & Listening
–Tone & Inflection
•Non-verbal
–Eye contact
–Touch
–Body Language
–Demeanour
–Gestures
•Written
–PCR’s
–Clear & concise
–Accurate

Types of Communication
•Verbal
–Essential part of quality patient care
–Find out what’s wrong with the patient
–You are a vital link between the patient and the
professional health care team
–Speaking clearly is essential
–Listening forms an important part

Barriers…
•Environmental conditions
–Weather
–Surrounding noise
•Culture/language barriers
•Physical barriers (COVID-19 PPE)
•Stereotyping/false assumptions
•Giving advice or false reassurance
What are the barriers to effective communication with……
Group Work

Barriers…
•Environmental conditions
–Weather
–Surrounding noise
•Culture/language barriers
•Physical barriers (COVID-19 PPE)
•No lead –poor teamwork
•Insufficient communication within the team
•Self-focusing behaviour
What are the barriers to effective communication with……
Group Work

Effective Communication
A Responder will be an effective communicator by……….
•Being confident and competent in their care of
the patient
•Showing respect for the patient at all times
•Continuously informing and reassuring the
patient
•Use open questioning technique

Effective Communication
Remember:
•Confident & Competent Care
•Compassion & Respect
•Inform & Reassure
•Understanding of patient’s pain
& fear

Patient Consent…
•Patients have the right to determine what
happens to them and their bodies
•For patients presenting as P or U on the AVPU
scale, implied consent applies
•Patients may refuse assessment, care, medication
and/or transport

Seeking Consent…
•Clearly identify yourself
•Reassure patient
•Calm and controlled voice, no panic!
•Explain potential actions to patient
–Let them know what you need to do to treat them
effectively (e.g. examine & touch a wound, cutting
clothing, etc.)
How should we go about seeking consent?

Family & Bystanders…
•Calm approach
•Assertive
•Identify yourself & your qualifications
•Direct bystanders to move away if causing
obstruction
•Ask for help from bystanders to clear area if needed
•Protect yourself
–Threat of violence: back away!
–Personal safety is paramount
Group Work
Q. How should we deal
with family & bystanders?

Continuum of Patient Care
Our role as Responders;
•Shared duty of care on scene
•Each responder accountable for his/her own actions
•Most qualified takes the lead
•Manage and treat the patient’s illness/injury
•Communicate effectively on scene
•Fill out patient care forms thoroughly & accurately
•Efficient handover to arriving EMS is essential

Let’s Practice!
You are on duty at a community event when you are
alerted to a member of the public who is unwell
Demonstrate a courteous approach to the patient, their
family and bystanders. Use open questioning to obtain
important and relevant information
Remember:
•Empathy
•Compassion
•Calm & Caring Approach
•Understanding of
patient’s pain & fear
Role Play

Questions or Clarifications?

Assessment
•Outline the role of a First Aid Responder in the
continuum of patient care
•Describe the principle barriers to effective patient
communication
•Describe the principle barriers to effective team
communication
•State the personal qualities that make an effective
therapeutic communicator
•Explain how to seek a patient’s consent for
treatment
Group Work

Summary
•Barriers to effective patient and team
communication
•Personal qualities of an effective communicator
•Seeking a patient’s consent for treatment
•Demonstration of good communication
•Demonstration of open questioning technique

Learning Outcomes
Knowledge Objectives (by the end of this Unit,you will be able to…)
1.List the role and responsibilities of the First Aid Responder
2.List the emotional reactions that a First Aid Responder may experiences
when faced with trauma, illness death and dying.
3.List the signs and symptoms of critical incident stress
4.State the possible steps that the First Aid Responder may take to
reduce/alleviate critical incident stress
5.Discuss the relevant legislation relating to the provision of first aid (such
as the Good Samaritan reference within the Civil Law Miscellaneous
Provisions Act 2011).
Attitudinal Objectives (by the end of this Unit,you will be able to…)
1.Understand the normal responses to trauma, illness, death and dying

1.Role & responsibilities of a First Aid
Responder
2.Emotional reactions
3.Critical incident stress
4.Alleviating critical incident stress
5.Good Samaritan
Topics

Q. What do you think are the
Roles & Responsibilities of the
‘First Aid Responder’?
Question Time!
Group Work

Roles & Responsibilities
•Keep Calm
•Personal Safety, scene safety and safety of others
•3 P’s –Preserve, Prevent, Promote
•Check & Maintain Airway, Breathing & Circulation
•Administer CPR if required
•Call 112 (or 999) –or instruct someone else to do so
•Access the patients injury/illness
•Prioritise injuries/illness
•Offer reassurance and care until EMS arrives
•Administer care within your training and CPG’s
•Gain consent if required

•What is Critical Incident Stress?
Critical Incident Stress

•You may have to deal with situations that
produce a high level of stress
–Injury or illness to infants and children
–Elderly patients
–Witnessing severe injury
–Death and violence
–Mass-casualty incidents
Critical Incident Stress

•It is caused by exposure to a traumatic event,
which extends beyond ordinary experiences
•It is a normal, but painful, response of normal
healthy people to an abnormal event
•Symptoms can be physical, emotional,
intellectual and or behavioural
•Most people recover from Critical Incident
Stress and remain healthy and productive
Critical Incident Stress

Emotional Reactions to trauma,
illness, death & dying
•Denial
–Refusing to believe that situation is happening
•Anger
–Becoming upset/angry due to grief-causing event
•Bargaining
–“if only” often accompanied by guilt
•Depression
–Expressing despair and hopelessness
•Acceptance
–Recognising that death and dying cannot be changed

Signs & Symptoms of Stress
•Irritability
•Inability to focus
•Difficulty sleeping
•Anxiety
•Change in
personality
•Stomach cramps
•Indecisiveness
•Guilt
•Loss of appetite
•Loss of interest in
work
•Isolation
•Anger
Page
23

Reducing stress…before duty
•Prepare –by training and practicing skills
•Prepare equipment –good working order
•Prepare yourself –be fit and healthy
•Gather relevant information about the event
•Follow directions of leaders
•Take breaks
•Do not take personal blame for tragedies
•Maintain a positive mental attitude
What can we do BEFORE duty?
Group Work

Reducing stress…after duty
•Take care of yourself
•Avoid alcohol –it worsens the stress reactions
•Eat good food and drink plenty of fluids
•Physical exercise helps to lower stress reactions
•Participate in operations review –debrief
•Learn what you can from the experience
•Talk about the incident with people you trust
What can we do AFTER duty?
Group Work

Good Samaritan
Civil Law (Miscellaneous Provisions) Act 2011;
•‘A volunteer shall not be personally liable in negligence for
any act done when carrying out voluntary work’
Does not apply if;
•the act was done by the volunteer in bad faith or with gross
negligence
•the volunteer knew or ought reasonably to have known that
the act was outside of their scope of practice or was contrary
to the instructions of the volunteer organisation concerned
Ref: http://www.irishstatutebook.ie/eli/2011/act/23/section/4/enacted/en/html

Questions / Discussion

Assessment
•List the role and responsibilities of a First Aid
Responder
•List 4 signs of stress
•List 4 symptoms of stress
•Describe the 5 emotional reactions to
trauma/illness/dying/death
•State 3 ways in which we can we help to alleviate stress
before duty
•State 3 ways in which we can we help to alleviate stress
after duty
Group Work

Summary
•Roles & Responsibilities of First Aid Responder
•Possible emotional reactions a Responder may
experience when faced with trauma, illness, death and
dying
•The signs and symptoms of critical incident stress
•Reducing stress before and after a duty
•Good Samaritan

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