First Aid Training

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Activate an established Emergency Medical Services (EMS) system such as 911, or local fire/rescue squad.

Evaluate the scene.

Consider whether or not the rescuers are trained and equipped to safely render assistance.

Protect themselves from injury or infection.

Keep calm

Act quickly

Call station or group as appropriate to activate EMS if necessary.

• Number of Patients.
• General condition of patients.
• Mechanism (type) of injury.
• Patient(s) level of consciousness.

Causes or symtoms of shock: Mechanism consistent with a serious injury such as a gun shot wound, fall from a great height, major burn, crushing accidents, etc.

If the patient's state-of-health has been compromised, for example, prolonged exposure to the elements, dehydration, malnourishment, etc.

Safely and quickly to a medical treatment center.

The sooner a victim arrives at a place where medical attention is available, the better.

Notify Station so that appropriate medical resources can be activated.

If Possible, avoid moving the patient until that is examined and all injuries are protected by properly applied splints, dressing, etc.

If head or neck injury is suspected, immobilized prior to movement.

Seek assistance before moving a patient.

For a conscious patients, always explain the move procedure in advance.

Patient movements should be careful, deliberate, and the minimum required.

Almost all patients are transported laying down.

Shock is a depressed physiological or mental state.

The symptoms usually precede the signs.

• Causes:
• Trauma
• Allergic reactions
• Hypothermia
• Drugs
• Toxins
• Heart Attack
• Illness such as diabetes
• Emotional

• Symtoms include:
• Restlessness
• Fainting
• Thirst
• Nausea
• Weakness
• Anxiousness
• Fright
• Dizziness

• Signs include:
• Pulse- weak and rapid
• Breathing- Shallow, Rapid, and irregular
• Skin- Cold, clammy (sweating)
• Pupils- Dilated
• State of consciousness- Alert (may be decieving) to unconscious.

Initial Treatment- Limit patient's activity, ideally having the person lie down and remain alert for the signs and symtoms of shock. If unconscious, appropriate treament is to activate EMS and institute resuscitation procedures.

Perform CPR in necessary.

Warm with blankets. If hot, if requested.

Do not allow patients to eat or drink.

Never give alcohol.

Handle gently.

Description: Anaphylactic shock is a rapid, extreme allergic reaction.

• Causes:
• Eating fish or shellfish
• Ingesting particular types of berries
• Oral drugs such as penicillin
• Insect stings
• ect....

• Symptoms:
• Skin- itching, hives, flushing
• Swelling of lips, tongue, feet, throat, hands
• Respitory tract: wheezing, shortness of breath, coughing
• Gastrointestinal: nausea and vomiting, abdominal cramps, diarrhea
• Headache
• Altered mental status
• loss of consciousness

• Treament:
• epinephrine kit
• treat for shock
• record everything

• Artificial Respiration:
• Mouth to Mouth
• Mouth to Nose
• Mouth to Stoma (opening in the lower neck through which individuals breathe when they have had their voice box removed.)

Once started, CPR must be continued until one of the following conditions exists:

• The giver is properly relieved.
• The giver is too tired to continue.
• It becomes too dangerous to continue.
• The victim shows signs of life (i.e. breathing, pulse, movement).

• 1: Make sure the area around the victim is safe to be in.
• 2: Ensure there are universal precautions: gloves, pocket mask, etc.
• 3: Check the level of responsiveness of the victim by tapping and shouting, "Are you ok?"
• 4: If no response, notify EMS.
• 5: Position the victim on their back.
• 6: Open airway with a head-tilt, chin-lift, or jaw thrust maneuver.
• 7: Look, Listen and Feel for 5-10 seconds.
• *Look to see if the chest rises and falls.
• *Listen for air exhalation through the nose or mouth
• *Feel for breath coming from the nose or mouth. If there are no signs of
• breathing, check the victim's airway to ensure there is nothing blocking it
• and try opening the airway again.
• 8: If there is still no sign of breathing, administer two rescue breaths with a duration of two seconds each.
• 9: Look, Listen and Feel for sign of breathing again as well as check for signs of circulation (movement, pink warm skin).
• 10: If there is no sign of breathing or circulation, start CPR procedure prescribed by the American Heart Association or American Red Cross for basic life support.
• 11: If victim recovers, treat for shock and monitor conditions.
• 12: If victim's heart stops or respitory failure reoccurs after initial resuscitation, start again at step 3.

• 1. If the victim is still able to breath or cough, monitor the situation until either victim frees the article from their throat, or they can no longer breath on their own.
• 2. If they are no longer able to breath, notify EMS.
• 3. Attempt to free the article from their throat by the following methods:
• *Back blows for infants.
• *Chest thrusts for obese or pregnat persons.
• *Abdominal thrusts (Heimlich maneuver).
• *Continue back blows, chest thrusts until the object is removed, or until the patient goes unresponsive.
• 4. If the object is still not cleared, lay the victim of their back and open the airway using the head-tilt, chin-lift method and check for breathing using the Look, Listen, and Feel techniques.
• 5. If no signs of breathing, attempt one rescue breath. If unsuccessful, repostion the head and try one more rescue breath.
• 6. If second ventilation is unsuccessful, begin CPR looking in the mouth before each attempted rescue breath.
• 7. A finger sweep of the mouth can be performed (Adults Only), but be careful not to force the object deeper into the throat.
• 8. If object is removed, check airway, breathing, and circulation. If no signs of breathing, but signs of circulation, administer rescue breaths. If no sign of breathing or circulation, begin CPR.

Cardiopulmonary arrest

• Symptoms:
• *Severe, crushing type of pain under the breastbone, arms, neck, and jaw.
• *Profuse sweating
• *Shortness of breath
• *Extreme anxiety
• *Nausea and Vomiting
• *Bluish discoloration of lips, fingernails, and skin.

• Treatment
• *Keep the victim quiet and at rest.
• *Administer oxygen.
• *Place the victim in the position of most comfort. Sometimes the victim may want to sit up, especially if the person is short of breath.
• *Seek immediate medical assistance, activate local EMS
• *Determine if the victim is on any type of medication for a heart condition such as nitroglycerin. If so, determine if the victim has taken the medication as prescribed.
• *Reassure the patient that assistance is on the way or that transport to a hospital is imminent.
• *Transport as quickly, but as safely, as possible.

A stroke is any bleeding or clotting affecting the blood vessels of the brain.

• Symptoms:
• *Unconsciousness.
• *Shock.
• *Confusion.
• *Dizziness.
• *Numbness/weakness to one side of the body.
• *Seizures.
• *Impaired vision.

• However, if brain damage is slight, the only symptoms may be:
• *Headache.
• *Facial Droop.
• *Difficulty speaking, or limited usage of or difficulty in using a limb.

• Treatment:
• *Activate EMS.
• *Obtain Medical assistance immediately.
• *Treat as for shock.
• *If the victim has difficulty breathing, help the person maintain an open airway and provide rescue breathing if needed.

The Coast Guard has no statutory responsibility for providing treatment for decompression sickness other than assisting in locating a treatment facility and trasporting.

When transporting treat for shock but do not elevate the legs.

Air Emboli- air bubbles in the divers blood, mostly found in divers that hold there breath during ascent. Victims may have convulsions and can quickly lose consciosness.

The Bends- decompression sickness, result of coming up to quickly from a deep, prolonged dive. Rapid ascent defeats the body's ability to filter escaping gases through the lungs resulting in nitrogen gas bubbles in the blood stream.

Onset- up to 48 hours to appear.

Divers Increase risk if they fly within 12 hours after dive.

• Signs and Symptoms:
• Deep pain to the muscles and joints
• Choking
• Coughing
• Labored Breathing
• Chest Pains
• Blotches on the skin (mottling)

• Treatment:
• *Immediately notify EMS and start transport to nearest recompression facility.
• *Place the diver on his/her left side with head down, and provide oxygen if available.
• *Treat for shock.
• *Get dive profile
• *Secure dive gear for transport with patient.

• Each District Rescue Coordination Center(RCC) and Group Operations Center (OPCEN)
• has information on all rempression chambers located within its area of operations. In addition, Diver's Alert Network (DAN) can be contacted by telephone for further assistance at (919)684-8111

• Info to be passed:
• *Depth of the victim's diving activities.
• *Number of dives that day.
• *Victim's overall medical condition including current level of consciousness.
• *First occurence of victim's symptoms.
• *Problems which may have occured during the dive, such as panic ascent, loss of air at depth, or equipment failure.

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Binder- A binder of muslin is used for injuries to the chest or abdomen.

Guaze Bandages- Guaze is useful as a bandage for almost any part of the body.

Band-Aids- Band-Aids or substitutes are useful for small wounds that are clean.

Triangular Bandages- useful as an emergency cover for an entire scalp, hand, foot, or other large area. Also good as a sling for fratured or injured arms or hand.

• Bandage Application- two general principles for bandage application
• 1. Bandage should be snug, but not so tight as to interfere with circulation.
• 2. Useless if tied to lose.

• Types:
• Arterial: blood coming from an artery, is bright red and gushes forth in spurts that are synchronized with the victims pulse.
• Venous: blood coming from a vein, is dark red, and comes in a steady flow.
• Capillary: blood that is coming from damaged capillaries, bright red and oozes from the wound.

Bloodborne Pathogens: Hepatitis B and HIV (where latex or vinyl gloves)

Universal Medical Precaution: In the instances where crewmembers may be exposed to human tissues such as blood, seepage from burns, saliva, urine or feces they should wear gloves and goggles. Additional PPE would be masks and protective gowns or aprons.

Under all circumstances Crewmembers should thoroughly wash there hands or any other contaminated area with soap and water.

• Control of Bleeding: Bandage application, Direct Pressure, Elevate, Pressure points, and Tourniquet
• Direct Pressure: Best Method, elevate while applying pressure, always with PPE and if possible a pad or cloth.
• Pressure Points: USE PAGE 5-18

Types of Fractures: Compound and Simple

• Compound- bone has broken and an open wound is present. The bone may protrude from the wound, leaving little doubt that there is a fracture.
• Simple- No open wound present.

• Symptoms:
• *Pain, Swelling, and discoloration at the injury site.
• *Misalignment (deformity) and/or disability of the injured part.
• *Victim's indication (may have heard a "crack" or "snap")

• Handling:
• *Do not attempt to straighten.
• *Protect and immobilize all injured areas.
• *Check pulse before and after splint application

• Causes:
• Thermal
• Chemical
• Sunburn
• Electric shock
• Radiation

• Classification:
• *First-Degree: Mildest of burns, involves only the outer layer of skin and produce redness, increased warmth, tenderness, and mild pain.
• *Second-Degree: Entends through the outer layers of skin, involves the inner layers of the skin, but not enough to prevent rapid regeneration. Produces blisters, severe pain, redness, and warmth.
• *Third-Degree: Penetrates through the full thickness of the skin, destroying both outer and inner layer of the skin. Severe pain, characteristics of second degree burns, may be absent because nerve endings have been destroyed. Color may range from white and lifeless to black (charred). Healing may take many months, and usually results in scarring of the skin tissue.

• First Aid-
• In order to determine percentages of a victim's body surface area adult patients.
• *Chest = 18%
• *Back = 18%
• *Each Arm = 9%
• *Each Leg = 18%
• *Head = 9%
• *Genitals = 1%

• Procedures:
• *Eliminate the source of the burn.
• *Treat to prevent shock.
• *Try to event infection.
• *Do not apply ointments.

• First Degree:
• Immerse in cool water.
• Flush chemical burns for 20 minutes.
• Cover with clean or sterile dressing.

• Second Degree:
• Same treatment as first.
• Don't break blisters.
• Cover with dry, sterile, non-adhesive dressing.

• Third Degree:
• Cover burn to reduce exposure to air.
• Cool the burn.
• Do not remove clothing unless smoldering.
• Treat for shock.
• Obtain medical care.
• Monitor airway.
• Assess vitals every 5 minutes.
• Nothing to eat or drink.
• No ice.
• No ointment.

• Exposure to Heat:
• *Heat cramps-painful contractions of various skeletal muscles. Depletion of salts due to excessive sweating. Drink cool fluids, sports drinks, keep away from heat for atleast 12 hours.
• *Heat exhaustion- Symtoms are similar to those of shock. Collapse and continues to perspire. To much fluid loss by perspiration.
• *Heat stroke- Serious medical emergency, failure of body's sweating mechanism. Calls for immediate measures to reduce body temp in order to prevent brain damage and/or death. Symptoms- headache, dizziness, irritability, disturbed vision.

Emergencies caused by cold: Pg 5-35- 5-40