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5TH EDITION FIRST AID MANUAL 5TH EDITION FIRST AID MANUAL Medical Editor-in-Chief Gina M Piazza, DO, FACEP www.cambodiamed.blogspot.com | Best Medical Books | Chy Yong Credit(Kodiai) LONDON, NEW YORK, MUNICH, MELBOURNE, DELHI DORLING KINDERSLEY Consultant editor Senior art editor Jemima Dunne Spencer Holbrook Senior editor Jacket designer Janet Mohun Duncan Turner Jacket editor Producer Maud Whatley Vivienne Yong US senior editor Photography Margaret Parrish Gerard Brown, US editor Vanessa Davies, Jill Hamilton Ruth Jenkinson Pre-production producer Jacket design development manager Francesca Wardell Sophia MTT Managing editor Managing art editor Angeles Gavira Guerrero Michelle Baxter Publisher Art director Sarah Larter Philip Ormerod Associate publishing director Publishing director Liz Wheeler Jonathan Metcalf AMERICAN COLLEGE OF EMERGENCY PHYSICIANS Medical Editor-in-Chief Associate Executive Director, Gina M Piazza, DO, FACEP Membership and Education Division Robert Heard, MBA, CAE Director, Educational Products Marta Foster Text revised in line with the latest guidelines from the Resuscitation Council (US) Fifth edition first published in the United States in 2014 by DK Publishing, 4th floor, 345 Hudson Street, New York, NY 10014 14 15 16 17 18 10 001–192570–September/2014 Text copyright © 2014 St John Ambulance; St Andrew’s First Aid; The British Red Cross Society Illustration copyright © 2014 Dorling Kindersley Limited, except as listed in acknowledgments on p.288 All rights reserved Without limiting the rights under copyright reserved above, no part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means (electronic, mechanical, photocopying, recording, or otherwise), without the prior written permission of the copyright owner Published in Great Britain by Dorling Kindersley Limited A catalog record for this book is available from the Library of Congress ISBN: 978-1-4654-1950-7 DK books are available at special discounts when purchased in bulk for sales promotions, premiums, fund-raising, or educational use For details, contact: DK Publishing Special Markets, 345 Hudson Street, New York, New York 10014 or SpecialSales@dk.com Printed and bound in China by Leo Discover more at www.dk.com FOREWORD THE AMERICAN COLLEGE OF EMERGENCY PHYSICIANS (ACEP) The goal of the American College of Emergency Physicians (ACEP) is to support high-quality emergency care throughout our country More than 130 million persons come to hospital emergency departments every year, seeking care for everything from mild illnesses and injuries to lifethreatening conditions Emergency care is provided in a continuum that starts with the bystander who first recognizes a problem and begins treatment, through the care rendered by emergency medical services (EMS) personnel, to the care provided in GINA M PIAZZA, DO, FACEP hospital emergency departments nationwide MEDICAL EDITOR-IN-CHIEF Either directly or indirectly, every citizen is affected by injury or illness at some point It is important for all of us to be able to recognize emergency medical events and to possess the basic knowledge and skills necessary to summon appropriate help and to provide basic care until that help arrives The goal of this manual is to instruct you in these basic skills and to provide you with the knowledge you need to make a positive difference in the life of any ill or injured person to whom you give aid This manual discusses what to for the common, mild, serious, and lifethreatening situations you may face, in a step-by-step-manner, using illustrations and photographs to help you understand the problem at hand Although it is designed to provide you with a good knowledge base, it is strongly encouraged that you also take a formal first aid course from an organization in your community that provides such training These organizations include the American Red Cross, the American Heart Association, EMS agencies, and local hospitals It is also recommended that you refresh your skills on a regular basis On behalf of ACEP and emergency medicine specialists throughout the United States, it is my pleasure to bring this fifth edition of the ACEP First Aid Manual to you I hope that you will enjoy learning how to help those in need of emergency care and that you will gain confidence in your knowledge and skills as you proceed through the book Thanks for joining the emergency care team—you can make a difference! Gina M Piazza, DO, FACEP Medical Editor-in-Chief CONTENTS INTRODUCTION BECOMING A FIRST AIDER 10 12 What is a first aider? 14 How to prepare yourself _ 15 Protection from infection 16 Dealing with a casualty 19 Requesting help 22 The use of medication 24 Remember your own needs _ 24 MANAGING AN INCIDENT ASSESSING A CASUALTY 38 Assessing the sick or injured 40 Mechanisms of injury _ 42 Primary survey 44 Secondary survey 46 Head-to-toe examination _ 49 Monitoring vital signs 52 THE UNCONSCIOUS CASUALTY 54 Breathing and circulation 56 Life-saving priorities 57 Unconscious adult _ 62 Unconscious child 72 Unconscious infant _ 80 How to use an AED 84 26 Action at an emergency _ 28 Traffic accidents _ 30 Fires 32 Electrical incidents _ 34 Water incidents 36 Major incident/Mass casualties 37 RESPIRATORY PROBLEMS 88 The respiratory system _ 90 Hypoxia 92 Airway obstruction 93 Choking adult 94 Choking child _ 95 Choking infant 96 Hanging and strangulation 97 Inhalation of fumes 98 Drowning _ 100 Hyperventilation 101 Asthma _ 102 Croup 103 Penetrating chest wound 104 WOUNDS AND CIRCULATION Foreign object in a wound 121 Scalp and head wounds 122 Eye wound _ 123 Bleeding from the ear _ 123 Nosebleed _ 124 Knocked-out adult tooth _ 125 Bleeding from the mouth _ 125 Finger wound 126 Wound to the palm 127 Wound at a joint crease _ 127 Abdominal wound _ 128 Vaginal bleeding 128 Bleeding varicose vein 129 106 The heart and blood vessels 108 Bleeding and types of wound 110 Shock _ 112 Severe external bleeding 114 Internal bleeding _ 116 Impalement _ 117 Amputation _ 117 Crush injury _ 118 Cuts and scrapes 119 Bruising _ 119 Blisters _ 120 Infected wound 120 BONE, JOINT, AND MUSCLE INJURIES 130 The skeleton _ 132 Bones, muscles, and joints 134 Fractures 136 Dislocated joint 139 Strains and Sprains 140 The nervous system 142 Head injury 144 Facial injury _146 Lower jaw injury 147 Cheekbone and nose injury 147 Collarbone injury _ 148 Shoulder injury 149 Upper arm injury _150 Elbow injury 151 Forearm and wrist injuries 152 Hand and finger injuries _ 153 Rib injury 154 Fractured pelvis _ 155 Back pain 156 Spinal injury 157 Hip and thigh injuries 160 Lower leg injuries _ 162 Knee injury 164 Ankle injury 165 Foreign object in the eye 196 Foot and toe injuries _ 166 Foreign object in the ear _ 197 Cramps _ 167 Foreign object in the nose 197 How poisons affect the body 198 Types of poisons _199 Swallowed poisons _ 200 Drug poisoning 201 Alcohol poisoning _ 202 Animal and human bites _ 203 Insect sting 204 Tick bite _ 205 Other bites and stings 205 Snake bite 206 Stings from sea creatures _ 207 EFFECTS OF 168 Marine puncture wound _ 207 HEAT AND COLD The skin 170 Assessing a burn 172 Severe burns and scalds 174 Minor burns and scalds _ 176 Burns to the airway _ 177 Electrical burn _ 178 Chemical burn 179 Chemical burn to the eye 180 Flash burn to the eye 181 Incapacitant spray exposure 181 Dehydration _ 182 Sunburn 183 MEDICAL Heat exhaustion _ 184 208 CONDITIONS Heatstroke 185 Hypothermia 186 Angina 210 Frostbite _ 189 Heart attack 211 Stroke _ 212 Diabetes mellitus _ 214 FOREIGN OBJECTS, Hyperglycemia _ 214 POISONING, BITES & STINGS 190 Hypoglycemia 215 _ 192 Seizures in adults _ 216 The sensory organs Splinter 194 Seizures in children 218 Embedded fishhook _ 195 Fever _ 219 Swallowed foreign object 195 Meningitis _ 220 10 ... BECOMING A FIRST AIDER BECOMING A FIRST AIDER WHAT IS A FIRST AIDER? First aid refers to the actions taken in response to someone who is injured or has suddenly become ill A first aider is a person... 5TH EDITION FIRST AID MANUAL 5TH EDITION FIRST AID MANUAL Medical Editor-in-Chief Gina M Piazza, DO, FACEP www.cambodiamed.blogspot.com | Best Medical Books... regular basis On behalf of ACEP and emergency medicine specialists throughout the United States, it is my pleasure to bring this fifth edition of the ACEP First Aid Manual to you I hope that you