Angeles University Foundation Angeles City College of Nursing
Fir st - A id (Lesson Plan for School Teaching)
Submitted by: Castro, Clariza M. De Guzman, Rafael Espiritu, Neil Gabalunos, Marjorie Galang, Miguel Lingat, Paul Magcalas, Charlie Magne Reyes, Grace Sauva, Joyce Anne Group 7; BSN III ² 2
Submitted to: Jaypee M. Landingin RN MN Clinical Inst ruct ructor; or; CHNCHN- Sa Sapalibu alibutad, A.C A.C.
I.
Introduction
II.
Content
FIRST AID First aid is the provision of immediate care to a victim with an injury or illness, usually affected by a lay person, and performed within a limited skill range. First aid is normally performed until the injury or illness is satisfactorily dealt with (such as in the case of small cuts, minor bruises, and blisters) or until the next level of care, such as an ambulance or doctor, arrives. Guiding
principles The key guiding principles and purpose of first aid, is often given in the mnemonic "3 Ps". These three points govern all the actions undertaken by a first aider. Prevent further harm Preserve life Promote recovery The main aims of first aid are to: 1. Preserve life - This includes the life of the casualty, bystander and rescuer. 2. Protect the casualty from further harm - Ensure the scene is safe. 3. Provide pain relief - This could include the use of ice packs or simply applying a sling 4. Prevent the injury or illness from becoming worse - Ensure that the treatment you provide does not make the condition worse. 5. Provide reassurance-it is important to understand that first aid has its lim itations and does not take the place of professional medical treatment A. FIRST AID FOR BURNS Burn is an injury involving the skin, including muscles, bones, nerves and blood vessels. This results from heat, chemicals, electricity or solar or other forms o f radiation. COMMON CAUSES 1.
2. 3. 4. 5.
Carelessness with match and cigarette smoking. Scald from hot liquid. Defective heating, cooking and electrical equipment. Immersion in overheated bath water. Use of such chemicals as lye, strong acids and strong detergents.
TYPE OF BURN INJURIES 1.
Thermal Burns. Not all thermal burns are caused by flames. Contact with hot objects, flammable vapor that ignites and causes a flash or an explosion, and steams or hot liquid are other common causes of burns.
Care y
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for thermal Burns Care
of First-degree and Second-degree Burns- relieve pain by applying a wet, cold cloth. If cold water is unavailable, use any cold liquid you drink to reduce the burned skin's temperature. Care for Third-degree Burns- Cover the burn with a dry, non-sticking sterile dressing or clean cloth. Treat the victim for shock by elevating the legs and keeping the victim warm with a clean sheet or blanket.
2. Chemical Burns. Chemicals will continue to cause tissue destruction until the chemical agent is removed. Care 1.
2. 3. 4. 5. 6.
for
Chemical
Burns
Immediately remove the chemical by flushing with water. Remove the victim's contaminated clothing while flushing with water. Flush for 20 minutes or longer. Let the victim wash with a mild soap before a final rinse. Cover the burned area with a dry dressing or, for l arge areas, a clean pillow case. If the chemical is in the eye, flood it for at least 20 minutes using low pressure. Seek medical attention immediately for all chemical burns.
3. Electrical Burns. The injury severity from exposure to electrical current depends on the type of current (direct or alternating), the voltage, the area of the body exposed, and the duration of contact. Care 1.
2. 3. 4. 5.
for Electrical Burns Unplug, disconnect, or turn off the power. If that is possible, call the power company or ask for help. Check the ABCs (Airway, Breathing, and Circulation). Provide R escue Breathing (RB) or Cardiopulmonary Resuscitation (CPR) if necessary. If the victim fell, check for spine injury. Treat the victim for shock. Seek medical attention immediately. Electrical injuries are treated in burn center.
B. FIRST AID FOR SNAKE BITE
First aid and treatment for snake bites in the Philippines y
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If you or someone with you is unfortunate enough to get bitten by a snake, in the words of Douglas Adams, DON'T PANIC! Firstly it is important to remember that snakes don't always envenomate when they bite and that there are m ore non venomous snakes than poisonous ones.
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Keep
the victim calm and still, if possible immobilize the victim and do not allow him/her to walk. Do not let the victim eat, drink or smoke. If the bite is on an extremity (hand, foot, arm, leg) keep it level with the body, DO NOT raise the limb, keep it below the level of the heart. Some people may recommend using constricting bands or pressure bandages but these should ONLY be used for envenoming bites by some elapid snakes and NEVER used for bites by vipers. If you are unsure of the type of snake that has bitten the victim do not use a pressure bandage, just get the victim to hospital as soon as possible. The venom injected by bites from some elapid snakes (cobras, king cobras, kraits and sea snakes) can sometimes cause serious respiratory difficulties and so slowing the absorption of the venom into the blood can reduce the risk.
The following method of applying a compression bandage is currently recommended by the World Health Organization: Ideally, an elasticated, st r etchy, c r epe bandage, approximately 10 cm wide and at least 4.5 mete r s long should be u sed. If that is not available, any long st r ip s of mate r ial can be u sed. T he bandage is bound f ir mly a round the enti r e bitten limb, sta r ting distally a round the f inge r s or toes and moving proximally, to include a r igid splint. T he bandage is bound as tightly as for a spr ained ankle, but not so tightly that the pe r iphe r al pulse (r adial, po ste r ior tibial, dor salis pedis) is occluded or that a f inge r cannot easily be slipped between its laye r s.
Ideally, compr ession bandages should not be r eleased until the patient is unde r medical ca r e in ho spital, r esu scitation f acilities a r e available and antivenom t r eatment has been sta r ted ( see Caution below ). Release of a tight tour niquet or compr ession bandage may r esult in the d r amatic development of seve r e systemic envenoming. Caution:
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If possible clean the bite area with soap and water but do not use ointments or lotions of any kind. Remove all rings, watches and other jewelry from the affected limb as some snake bites cause swelling. If venom is spit into the eyes, immediately and copiously irrigate them with any bland fluid, such as water, saline solution, or milk. It is important to get the victim to a hospital immediately because even if the snake is non venomous it may still have tetanus (lock jaw) and so you may need a tetanus injection or if it is poisonous you will need the anti-venom. Don't try to kill the snake that bit you or someone with you, if you attack the snake it will attack you. It is better if you can to take a photograph of the snake to help doctors identify it and provide the correct treatment/anti-venom. DO NOT try to cut out the poison from the wound or suck out the venom, if you have any damaged or lacerated tissue in your mouth the venom could cause you to pass out or even die.
Not all hospitals have anti-venom but they can provide treatment which could save the v ictims life while getting the correct anti-venom from a sp ecialist centre
The two important rules of first aid for s nake bite 1. Never let first aid delay proper medical treatment or transportation to a hospital or medical centre. 2. Never let any first aid treatment do more harm than good. Local people may have great confidence in traditional treatments but they often do m ore harm than good. How to avoid getting bitten by a snake in the Philippines It is always useful to know what types of venomous or poisonous snakes you may encounter and where they like to live. Most snakes are nocturnal and start to become active at dusk which means they sleep or rest during the day. Snake bite is an occupational hazard of agricultural workers and fishermen mainly. Most snake bites occur when a snake is accidentally trodden on in a rice paddy or field by someone barefoot or only wearing sandals or slippers, or by fishermen who catch sea snakes in their nets. The snake may also be disturbed during harvesting when a worker may put their hand within striking distance of a snake without seeing it. Below is a list of the 10 precautions which can be taken to avoid or at least reduce the risk of snake bite: 1. Be vigilant for snakes at night, stick to paths or roads and use a light (torch, flashlight or lamp) when walking at night. 2. Watch out for snakes after rains or during flooding. They may be forced to move to
different areas because of excessive water. Conversely be watchful during extreme dry periods or drought as they may venture into populated areas in search of water. Try to avoid having rubble, rubbish or domestic animals near to your house as these attract snakes. Snakes feed on mice, rats, frogs, lizards and other snakes so mice attracted by food waste or domestic animal feed will attract snakes. 3.
4. If you go walking in long grass, undergrowth, forest, jungle or cultivated areas wear shoes or boots (not sandals or slippers) and long trousers (not shorts) 5. It seems obvious but never handle or attack a snake and never try to trap or corner a snake in an enclosed area. 6. Don't handle a dead snake unless you absolutely have to. Firstly it may not be dead, it could just be sleeping. Secondly dead snakes can still bite and inject venom due to a reflex action! 7. When walking in areas possibly inhabited by snakes create a disturbance, vibration from heavy footsteps will encourage most snakes to move away before you even see them. 8. Regularly check your house for snakes. Most modern house don't provide many good hiding places for snakes but some older houses or those made from natural materials can provide good hiding places (large unsealed spaces beneath floorboards). 9. There are a number of sea snakes found in Philippine waters so if you like fishing avoid touching sea snakes caught in nets and on lines. C.
FIRST AID FOR DOG BITE
Dog bites are very prone to infection, but proper first aid for a dog bite can help to reduce the chances of infection. Types of Dog Bite Wounds Puncture wounds- result when the dog's teeth penetrate the skin. They are very prone to infection because the dog's teeth essentially inject bacteria into the bite wound. They are also a perfect place for bacteria to multiply - warm, dark, and with little air flow. Laceration-which occurs when the dog's teeth penetrate and tear the skin. It is this type of dog bite wound that most often requires stitches. How to Clean a Dog Bite Wound 1.
Allow the puncture wound to bleed for a few minutes (providing that the blood flow is not excessive.) This is a very effective way to flush bacteria from the dog
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7. 8. 9.
bite wound. For lacerations, apply pressure to stop the bleeding at the site of the dog bite. Wash the wound with anti-bacterial soap for five full minutes. This is a vital step to combat wound infection. Flush the wound for an additional five full minutes, allowing water to run into the dog bite wound. Pat the area dry with a gauze pad. If gauze is not available, use a paper towel. Avoid towels, as towels tend to harbor large amounts of bacteria. Pour a generous amount of Betadine into the dog bite wounds and saturate the skin around the wounds as well. This no-sting antiseptic solution will disinfect the wound sites. If Betadine is not available, hydrogen peroxide will suffice. Wipe up drips with sterile gauze, but leave a one-inch diameter around each wound. Allow the wound and the skin within a one-inch diameter of each dog bite wound to air dry. Do not blow on the skin to dry the Betadine (or hydrogen peroxide) ² this contaminates the wound. Using a sterile gauze pad, apply a generous amount of antibiotic ointment into each wound. Cover the dog bite wounds with a sterile bandage. Rolled gauze works best for limbs, while it's easier to tape down sterile gauze squares on the trunk or thigh. Apply ice compresses to the dog bite wounds. This will help to limit the swelling which is responsible for a large amount of the pain that's associated with a dog bite.
D. FIRST AID FOR WOUNDS Wound is a break in the continuity of a tissue of the body either internal or external. CLASSIFICATION
OF WOUNDS
1. Closed wound Causes: y y
Blunt object that may result in contusion or bruises Application of external forces
Signs and Symptoms: y y y y y y y y y
Pain and tenderness Swelling Discoloration Hematoma Uncontrolled restlessness Thirst Symptoms of shock Vomiting or cough-up blood Passage of blood in the urine or feces
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Sign of blood along mouth, nose and ear canal
First Aid Management: y y y y
I- Iced application C- Compression E- Elevation S- Splinting
2. Open Wound- a break in the skin or mucous membrane; or the protective layer is damage. Classification
Classification
of Open Wound Causes
Punctur e
Penetrating pointed instruments uch as nail, ice picks, daggers, etc.
Deep and narrow, serious or slight bleeding.
Ab r asion
Scrapping or rubbing against rough surfaces.
Shallow, wide, oozing of blood, dirty.
Lace r ation
Torn with irregular Blunt instruments such as edges, serious or slight rocks, broken glasses, etc. bleeding.
Avulsion
Tissue forcefully Explosion, animal bites, separated from the mishandling of tools, etc. body.
Incision
Sharp bladed instruments Clean cut, deep, such as blades, razors, severe bleeding, wound etc. is clean.
Dangers: y y y
Hemorrhage Infection Shock
First Aid Management: y y y y
C-
Control bleeding C- Cover the wound C- Care for shock C- Consult or refer to physician
Home Care (Wounds with bleeding not severe) y
Characteristics
Clean the wound with soap and water.
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Apply mild antiseptics. Cover wounds with dressing and bandage.
Reminders: 1.
2.
3. 4. 5. 6.
All wounds must be thoroughly inspected and covered with a dry dressing to control bleeding and prevent further contamination. Once bleeding is controlled by compression, the limb should be splinted to further control bleeding, stabilize the injured part, minimize the victim's pain and facilitate the patient's transport to the hospital. As with closed soft tissue injuries, the injured part should be elevated to just above the level of the victim's heart to minimize severity. Amputated body parts should be saved, wrapped in dry gauze, placed in a plastic bag, kept cool, and transported with the patient. Don't induce further bleeding to clean the wound. Don't use absorbent cotton as a dressing.
E. FIRST AID FOR NOSE BLEEDING Bleeding by nose is common, especially during summers. Causes can range from local cause to systemic diseases. What to do: 1.
2. 3. 4. 5. 6.
Make the patient sit down with head forward Pinch the nose just below the bridge for about 10 minutes and ask the patient to breathe through his mouth and avoiding speaking, swallowing or coughing. Cold compression can be given by using ice packs over the nose area. If bleeding does not stop, repeat nose pinching for another 10 minutes. If bleeding still does not stop, seek immediate medical help. If bleeding stops ask patient to avoid blowing nose.
Do not: 1.
Make the patient exert physically. 2. Insert any object / medication in the nose. 3. Blow nose. 4. Make the patient speak, swallow or cough. F. FIRST AID FOR SPRAIN/STRAIN Sprains A sprain typically occurs when people fall and land on an outstretched arm, slide into base, land on the side of their foot, or twist a knee with the foot pl anted firmly on the ground. This results tearing of the ligament(s) supporting that joint.
Common y
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Types of Sprains
Ankle Sprains The ankle is one of the most common injuries in professional and recreational sports and activities. Most ankle sprains happen when the foot abruptly turns inward (inversion) or outward (eversion) as an athletes runs, turns, falls, or lands after a jump. One or more of the lateral ligaments are injured. Wrist Sprains Wrists are often sprained after a fall in which the athlete lands on an outstretched hand.
Signs and Symptoms of Sprains y y y y
Pain Swelling Bruising Loss of functional ability (the ability to move and use the joint)
Strain is an injury to either a muscle or a tendon, the tissue that connects muscles to bones. Depending on the severity of the injury, a strain may be a simple overstretch of the muscle or tendon, or it can result in a partial or complete tear. Common y y y
Types of Strains
Back Strain Hamstring Strains Tendonitis ( inflammation of a tendon)
Signs and Symptoms of Strains y y y y
Pain Muscle spasm Muscle weakness Localized swelling, cramping, or inflammation
When To See a Doctor for a Sprain or Strain y y y
y y y y y
You have severe pain and cannot put any weight on the injured joint. The area over the injured joint or next to it is very tender when you touch it. The injured area looks crooked or has lumps and bumps that you do not see on the uninjured joint. You cannot move the injured joint. You cannot walk more than four steps without significant pain. Your limb buckles or gives way when you try to use the joint. You have numbness in any part of the injured area. You see redness or red streaks spreading out from the injury.
You injure an area that has been injured several times before. You have pain, swelling, or redness over a bony part of your foot.
y y
Treating Muscle Sprains and Strains The treatment of muscle sprains and strains has two main goals. The first goal is to reduce swelling and pain; the second is to speed recovery and rehabilitation. To reduce swelling it is recommended to follow use R.I.C.E. therapy (Rest, Ice, Compression and Elevation) for the first 24 to 48 hours after the injury. An over the counter (or prescription) anti-inflammatory medication may also help decrease pain and inflammation. R.I.C.E. Therapy Rest Reduce regular exercise or other activities as much as you can. Your doctor may advise you to put no weight on an injured area for 48 hours. If you cannot put weight on an ankle or knee, crutches may help. If you use a cane or one crutch for an ankle injury, use it on the uninjured side to help you lean away and relieve weight on the injured ankle. Ice Apply an ice pack to the injured area for 20 minutes at a time, four to eight times a day. A cold pack, ice bag, or plastic bag filled with crushed ice and wrapped in a towel can be used. To avoid cold injury and frostbite, do not apply the ice for more than 20 minutes. Compression
Compression of an injured ankle, knee, or wrist may help reduce swelling. Examples of compression bandages are elastic wraps, special boots, air casts, and splints. Ask your doctor for advice on which one to use. Elevation If possible, keep the injured ankle, knee, elbow, or wrist elevated on a pillow, above the level of the heart, to help decrease swelling.
III.
Lesson Plan
A. Learners: The learners of this School Teaching are the 3 rd year High School students of Mabalacat Technical High School
B. Topic: ´First-Aidµ
C.
Objectives: 1. Student ² centered The group will be able to:
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Use teaching strategies to their students
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Demonstrate the treatment of certain First-Aid treatment
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Demonstrate the use of materials that will be seen in the community
Client
² centered
The students will be able to: y
Be aware in the concepts of First-Aid
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Learn about the definitions and treatments of First-Aid topics
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Demonstrate the different treatments
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Use materials that can only be found in the community
D. Methods of Teaching:
The class session will be made or conducted through a lecture type of traditional teaching method. The students will have the opportunity to interact with one another by sharing or clarifying some given information.
After all the information have been discussed and clarified, a specific time will be allotted for a questioning type of teaching strategy or in the form of quiz bee. The class will be divided in groups to participate in the said quiz bee. Students will be ask some questions regarding the topic and it can serve as an evaluation tool to asses if all the students understand the discussion and if the strategy used was effective.
E. Materials:
In order for the group to catch the attention of the listeners and for them to understand the topic easily, the following are the m aterials that they will utilize: y
Written visual aids
y
Materials for Demonstrations
y
Chalk and Blackboard
y
Materials for Group Dynamics and Evaluation
Content
To Be Taught
I.
Introduction:
II.
Concepts:
III.
Summary:
IV.
Summary
V.
Evaluation
VI.
Bibliography
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Teacher ² Learner Activities
Evaluation of Performance
http://www.rcyofuplb.org/index.php/Basic-First-Aid/First-Aid-forBurns.html http://horizonsnu.com/treating_snake_bites_in_the_philippines.html http://first aid.suite101.com/article.cfm/how_to_clean_and_treat_a_dog_bite_w ound_at_home http://horizonsnu.com/treating_snake_bites_in_the_philippines.html
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VII.
http://www.rcyofuplb.org/index.php/Basic-First-Aid/First-Aid-forWounds.html http://www.firstaid.ie/tip_nose_bleed.htm http://sportsmedicine.about.com/cs/injuries/a/sprains_2.htm
Appendices
