5TH EDITION FIRST AID MANUAL 5TH EDITION FIRST AID MANUAL Medical Editor-in-Chief Gina M. Piazza, DO, FACEP 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 9 8 7 6 5 4 3 2 1 001–192570–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 [email protected]. 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 life- threatening 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 do for the common, mild, serious, and life- threatening 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 ASSESSING CONTENTS 3 A CASUALTY 38 INTRODUCTION 10 Assessing the sick or injured __________________________ 40 1 BECOMING A Mechanisms of injury _____________________________________ 42 FIRST AIDER 12 Primary survey ________________________________________________ 44 ____________________________________________ What is a first aider? ________________________________________ 14 Secondary survey 46 _______________________________ How to prepare yourself ___________________________________ 15 Head-to-toe examination 49 ______________________________________ Protection from infection ________________________________ 16 Monitoring vital signs 52 Dealing with a casualty ____________________________________ 19 Requesting help ________________________________________________ 22 THE UNCONSCIOUS ______________________________________ 4 The use of medication 24 CASUALTY 54 Remember your own needs _____________________________ 24 Breathing and circulation ________________________________ 56 Life-saving priorities ________________________________________ 57 Unconscious adult ___________________________________________ 62 Unconscious child ____________________________________________ 72 Unconscious infant _________________________________________ 80 How to use an AED __________________________________________ 84 MANAGING AN 2 INCIDENT 26 Action at an emergency ___________________________________ 28 Traffic accidents _______________________________________________ 30 Fires __________________________________________________________________ 32 Electrical incidents ___________________________________________ 34 Water incidents ________________________________________________ 36 RESPIRATORY Major incident/Mass casualties ______________________ 37 5 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 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 Drowning _______________________________________________________ 100 Wound at a joint crease _________________________________ 127 Hyperventilation ____________________________________________ 101 Abdominal wound ___________________________________________128 Asthma ___________________________________________________________ 102 Vaginal bleeding ______________________________________________128 Croup ______________________________________________________________ 103 Bleeding varicose vein ____________________________________129 Penetrating chest wound ______________________________ 104 7 BONE, JOINT, WOUNDS AND MUSCLE INJURIES 130 6 AND CIRCULATION 106 The skeleton ___________________________________________________ 132 The heart and blood vessels __________________________ 108 Bones, muscles, and joints ______________________________134 Bleeding and types of wound ________________________ 110 Fractures ________________________________________________________ 136 Shock _______________________________________________________________ 112 Dislocated joint ______________________________________________ 139 Severe external bleeding ________________________________ 114 Strains and Sprains ________________________________________ 140 Internal bleeding _____________________________________________ 116 The nervous system ________________________________________142 Impalement _____________________________________________________ 117 Head injury ______________________________________________________144 Amputation _____________________________________________________ 117 Facial injury _____________________________________________________146 Crush injury _____________________________________________________ 118 Lower jaw injury ______________________________________________ 147 Cuts and scrapes ______________________________________________ 119 Cheekbone and nose injury ____________________________ 147 Bruising ___________________________________________________________ 119 Collarbone injury _____________________________________________148 Blisters ___________________________________________________________ 120 Shoulder injury ________________________________________________149 Infected wound ______________________________________________