❤️‍🩹First Aid Unit 14 – First Aid: Patient Care Principles for Nurses

Key First Aid Concepts

• Aims to preserve life, prevent further injury, and promote recovery through immediate care
• Involves assessing the situation, calling for help, and providing appropriate interventions
• Follows a systematic approach (ABCDE) to prioritize care: Airway, Breathing, Circulation, Disability, Exposure
• Emphasizes the importance of personal safety and protection (using gloves, masks, and other protective equipment)
• Requires knowledge of basic anatomy and physiology to recognize signs and symptoms of injuries and illnesses
• Includes both physical and psychological support to the patient and bystanders
• Necessitates effective communication with the patient, bystanders, and emergency services
  • Use clear and concise language
  • Provide reassurance and comfort

Patient Assessment Techniques

• Primary survey (ABCDE approach) rapidly identifies and addresses life-threatening conditions
  • Airway: Check for obstruction and ensure a clear airway
  • Breathing: Assess respiratory rate, depth, and effort; look for chest rise and fall
  • Circulation: Check pulse rate, strength, and regularity; assess skin color and temperature
  • Disability: Evaluate the patient's level of consciousness (AVPU scale: Alert, Verbal, Pain, Unresponsive)
  • Exposure: Examine the patient for visible injuries or signs of illness while maintaining privacy and preventing hypothermia
• Secondary survey involves a head-to-toe examination to identify non-life-threatening injuries or illnesses
• Vital signs monitoring includes measuring blood pressure, pulse rate, respiratory rate, and temperature
• SAMPLE history gathering: Signs/Symptoms, Allergies, Medications, Past medical history, Last meal, Events leading to the incident
• Focused physical examination based on the patient's chief complaint or mechanism of injury
• Ongoing reassessment to monitor changes in the patient's condition and response to interventions

Emergency Response Protocols

• Scene safety: Ensure the safety of the rescuer, patient, and bystanders; control hazards if possible
• Activating emergency medical services (EMS) by calling the appropriate number (911 in the United States)
• Providing a clear and concise report to EMS, including location, nature of the emergency, number of patients, and any hazards
• Following the chain of command and working collaboratively with other first responders (paramedics, firefighters, law enforcement)
• Implementing triage in mass casualty incidents to prioritize care based on the severity of injuries and available resources
• Documenting the incident, including patient information, interventions provided, and any changes in the patient's condition
• Participating in debriefing sessions to review the response, identify areas for improvement, and address any emotional impact on the rescuers
• Maintaining confidentiality of patient information in accordance with legal and ethical guidelines

Common Injuries and Treatments

• Bleeding control: Apply direct pressure, elevate the affected limb, and use pressure points or tourniquets if needed
  • For severe bleeding, pack the wound with hemostatic gauze and apply a pressure dressing
• Fractures and sprains: Immobilize the affected area, apply ice to reduce swelling, and elevate the limb
  • Use splints or slings to support the injured extremity and prevent further damage
• Burns: Cool the burn with running water, cover with a sterile dressing, and monitor for signs of shock
  • Avoid breaking blisters or applying creams or ointments
• Head injuries: Monitor the patient's level of consciousness, pupil size and reactivity, and motor function
  • Suspect a spinal injury if the mechanism of injury suggests it and immobilize the patient accordingly
• Chest pain: Have the patient rest in a comfortable position, administer aspirin if not contraindicated, and monitor vital signs
• Shortness of breath: Assist the patient in finding a comfortable position (often sitting upright), administer oxygen if available, and monitor respiratory status
• Allergic reactions: Remove the trigger if possible, administer epinephrine if prescribed, and monitor for signs of anaphylaxis
  • For severe reactions, assist with the patient's epinephrine auto-injector and call EMS immediately

Life-Saving Interventions

• Cardiopulmonary resuscitation (CPR) for patients in cardiac arrest
  • Perform chest compressions at a rate of 100-120 per minute and a depth of at least 2 inches
  • If trained and willing, provide rescue breaths at a ratio of 30 compressions to 2 breaths
• Automated external defibrillator (AED) use for patients in ventricular fibrillation or pulseless ventricular tachycardia
  • Follow the AED's voice prompts for proper pad placement and shock delivery
• Choking management using abdominal thrusts (Heimlich maneuver) for conscious adults and children
  • For unconscious patients, alternate between chest compressions and foreign body airway obstruction (FBAO) removal attempts
• Naloxone administration for suspected opioid overdose
  • Administer intranasally or intramuscularly and monitor for improvement in respiratory status
• Epinephrine administration for anaphylaxis using an auto-injector or ampule and syringe
  • Inject into the outer thigh and repeat every 5-15 minutes if symptoms persist
• Glucose administration for hypoglycemia using oral glucose gel, tablets, or sugary beverages if the patient is conscious and able to swallow
  • For unconscious patients, administer glucagon intramuscularly if available
• Cooling measures for heat stroke, including removing the patient from the hot environment, applying cool water, and using ice packs on the neck, armpits, and groin

Wound Care and Bandaging

• Cleaning the wound with clean water or saline solution to remove dirt and debris
  • Avoid using hydrogen peroxide or alcohol, as they can damage healthy tissue
• Applying pressure with a clean dressing to control bleeding
• Covering the wound with a sterile dressing to prevent infection and promote healing
  • Use non-adherent dressings for burns or wounds with significant drainage
• Securing the dressing with tape, gauze, or a bandage wrap
  • Ensure the bandage is snug but not too tight to avoid impairing circulation
• Elevating the affected limb to reduce swelling and promote comfort
• Monitoring the wound for signs of infection (increased pain, redness, swelling, discharge, or fever)
• Changing the dressing regularly (at least daily) or when it becomes soiled, wet, or loose
• Referring the patient for further medical evaluation if the wound is deep, extensive, or shows signs of infection

Medication Administration in First Aid

• Assisting patients with their prescribed medications, such as inhalers for asthma or nitroglycerin for chest pain
  • Ensure the medication is prescribed to the patient and is not expired
• Administering over-the-counter pain relievers (acetaminophen or ibuprofen) for minor pain or fever
  • Follow the recommended dosage and check for any contraindications or allergies
• Providing oral glucose or sugary beverages for patients with hypoglycemia
• Administering epinephrine for anaphylaxis using an auto-injector or ampule and syringe
  • Inject into the outer thigh and repeat every 5-15 minutes if symptoms persist
• Applying topical creams or ointments for minor burns, insect bites, or rashes
  • Follow the product's instructions for application and monitor for any adverse reactions
• Documenting the medication administered, including the name, dose, route, time, and patient response
• Consulting with medical control or poison control for guidance on medication administration in uncertain situations

Legal and Ethical Considerations

• Duty to act: Providing care within the scope of one's training and certification while ensuring personal safety
• Good Samaritan laws: Protecting rescuers from liability when providing care in good faith and without expectation of compensation
• Informed consent: Obtaining the patient's permission before providing care, if the patient is conscious and able to make decisions
  • For minors or incapacitated patients, obtain consent from a parent, guardian, or designated decision-maker
• Abandonment: Ensuring continuity of care until the patient is transferred to another provider or refuses further care
• Negligence: Adhering to the standard of care and avoiding actions that may cause harm to the patient
• Documentation: Accurately recording the patient's condition, interventions provided, and any changes in status
  • Maintain confidentiality of patient information in accordance with privacy laws (HIPAA)
• Scope of practice: Providing care within the limits of one's training and certification, and not exceeding those boundaries
• Ethical principles: Respect for patient autonomy, beneficence (doing good), non-maleficence (avoiding harm), and justice (fair distribution of resources)

Practical Skills and Simulations

• Hands-on practice of essential first aid skills, such as CPR, AED use, and wound care
  • Use manikins, training devices, and simulated scenarios to develop proficiency
• Simulation exercises to reinforce decision-making, prioritization, and communication skills
  • Participate in mock scenarios with varying levels of complexity and realism
• Skill assessments to demonstrate competency and identify areas for improvement
  • Complete written exams, practical skill evaluations, and scenario-based testing
• Debriefing sessions to reflect on performance, discuss challenges, and share insights
  • Engage in constructive feedback and self-evaluation to enhance learning and retention
• Continuing education and recertification to maintain and update skills and knowledge
  • Attend refresher courses, workshops, and conferences to stay current with the latest guidelines and best practices
• Interprofessional collaboration to foster teamwork and communication among healthcare providers
  • Participate in simulations and drills with other first responders, nurses, and physicians to improve coordination and patient outcomes
• Psychological first aid training to support patients and bystanders experiencing emotional distress
  • Learn techniques for active listening, empathy, and crisis intervention to provide comfort and reduce anxiety