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First aid is the immediate care of someone who has become suddenly ill or is injured. The intention is to relieve pain until medical attention arrives. As the first aid attendant, you act as the first line of defense against possible death or further injury. It is important that you remember the objectives of first aid; first, to control conditions that may endanger life; second, to prevent further injury from occurring; third, to relieve pain, prevent contamination and treat for shock; and finally, to make the injured or ill as comfortable as possible.
The first person on the scene of an accident or sudden illness must set the emotional stage for both the patient and other arriving responders. It is important that you react quickly while remaining calm and reassuring. The first person on the scene should immediately specify one person to summon help; if no other people are in the area, the first responder must leave long enough to call for assistance. Unless the injured is at risk from the environment (chemical spill or release, fire, etc.), he or she should not be moved. All laboratory workers are highly encouraged to obtain CPR and first aid training. In no way can the general description presented in this document cover all the topics or options that should be learned in a bona fide first aid course.
1) Medical Emergency Arising from a Chemical Exposure
The information that follows is so urgent that it is repeated from the previous section, "Chemical Release: If a Co-Worker is Exposed to a Hazardous Chemical". All chemical exposures should be viewed as significant and every precaution taken to guard against these exposures.
a. Initial response and decontamination
- A potentially dangerous situation exists. The initial condition of the victim is not a good indicator of the urgency of the problem. Recognize that the symptoms from many inhalation exposures take up to 12 hours to appear, and the result may lead to pulmonary edema and death.
- Alert nearby co-workers of the potential danger from exposure to the released chemical.
- Remove the injured person form the area of exposure. Do this only if you can do it without injury to yourself!! If you have protective equipment suitable for the hazard, don this first before entry into the contaminated area. If you do not have adequate protective equipment, DO NOT ENTER. Instead, wait for properly attired emergency personnel to perform the rescue.
- From a safe location call for emergency medical assistance:
a) Give the location of the emergency- Building 484. Specify the Wing, if known
b) Give the extent and nature of injury, if known.
c) Give any details that may be important in a rescue situation - what chemicals are involved, are there toxic fumes involved, etc.
- Notify the Chemistry Business Office of the emergency so that the University HazMat Emergency Team may be activated.
- If you are able to remove the individual to a safe location, do so. The primary concern initially should be to determine if the person has normal respiratory and circulatory functions. If the person is not breathing or does not have a pulse, do not begin CPR until the person has been decontaminated unless you can protect yourself adequately against exposure in the process.
- Begin decontamination. Place the person under an emergency shower and flush the skin with copious amounts of water. All contaminated clothing must be removed, including shoes. Make certain that the person's hair is also thoroughly flushed if the possibility of contamination exists.
- If the chemical splash affected the persons eyes, reaction time is critical. The person should be led or forced to the eyewash area and the eyes flushed thoroughly for at least 15 minutes. The victim will most likely be in great pain and panic stricken. I may take several people to get the person to the eyewash and perform the needed washing. Make certain that the eyes are held open while the water washes the eyes and face.
- While decontamination is taking place, steps should be taken to identify the chemical. Material Safety Data Sheets should be consulted, as well as any co-workers who may have information as to what was in use and what happened. This information should be collected and ready for the attending emergency medical personnel.
- After decontamination is complete, the individual should be kept warm with blankets until professional medical attention arrives.
- If the material in use has a specific antidote, it should be administered immediately. Certain gases such as hydrogen cyanide and hydrogen sulfide do not respond to oxygen alone; their effect must be counteracted. Persons knowingly working with such materials should always make certain that all co-workers know the location of any antidotal agents.
- It is important that all personnel suffering from an accidental chemical exposure be examined by a medical professional before they return to work or leave for home. Many chemicals have a delayed reaction period of several hours before the onset of symptoms.
b. General guidelines in case of exposure to unknown chemicals
It is important that all Chemistry Building personnel know what to do in case of a medical emergency. The following guidelines should be read and understood BEFORE an emergency occurs, so that the appropriate actions may be taken without delay. Please read over these guidelines on a regular basis to refresh your memory regarding the correct response.
- Follow the Golden Rules:
1. Protect yourself before attending to the injured!
2. Decontaminate the injured person.
3. Treat cessation of breathing first.
4. Check for pulse and begin CPR if no pulse is present.
5. Treat eye injuries next
6. Treat injuries resulting from skin contact.
7. Treat shock.
8. Call for help.
- Make a quick assessment of the most likely route of exposure. Check the eyes, nose, mouth and skin for signs of the chemical itself, or signs of damage such as swelling, redness, bleeding, burns, discharge of fluids, or excessive paleness or pallor. Signs of ingestion of a corrosive might be drooling, difficulty in swallowing, noisy or labored breathing. If a splash has occurred to the face, assume eye contact. The following general guidelines should be followed for poisoning by inhalation, ingestion, skin or eye contact.
1) After protecting yourself, remove victim from area of exposure.
2) If breathing has stopped, administer artificial respiration using a bag valve mask, or if this is not available, use the chest pressure-arm lift technique. DO NOT use mouth to mouth respiration if the nature of the chemical is not known!
3) Once the airway has been opened, maintain it and monitor.
4) Notify emergency medical personnel of nature of exposure and arrange transport of injured.
ii. Poisoning by Ingestion
1) If the injured person is conscious:
a) Vomiting may be induced by giving person 2 teaspoons of syrup of ipecac. If this is not available, induce vomiting by having the person touch back of throat with their finger or other blunt instrument.
1) Remove the person
from the contaminated area, taking care not to contaminate yourself.
2) Remove the person's contaminated clothing, including shoes and jewelry, from the affected areas. This should be done under an emergency or while flushing with water.
3) Flushing should continue
until all traces of the chemical are gone and any slippery feeling to the
skin has disappeared. Continue rinsing for at least 15 minutes.
4) Cover the person with a blanket or clean dry clothing.
5) If there exists inflammation, burns or blisters, apply a loose, dry sterile dressing, or cover area with a clean, dry cloth.
DO NOT break blisters or remove skin. If clothing is stuck to skin after rinsing, do not try to remove it.
DO NOT rub or apply pressure to affected skin.
DO NOT apply any oily substance to skin.
DO NOT use hot water.
DO NOT apply a neutralizing
agent to the skin, the heat evolved could cause even more serious injury.
6) If the person is in a state of shock, have them lie down on their side, elevate the feet, and cover with a blanket.
7) Notify emergency personnel of the nature of the accident and arrange for transport to the nearest medical facility. If the identity of the chemical is known, a Material Safety Data Sheet should accompany the medical personnel to the hospital.
1) Remove injured person
from contaminated area, taking care not contaminate yourself.
2) ACT QUICKLY! Every second counts when chemicals are in contact with the eye. Flush the eyes with clean, tepid water for at least 15 minutes. If an eyewash unit is available, use that. If not, have the injured person down and tilt head back while you slowly pour water into their eyes, starting at the inner corners and letting the water run out of the outer corners. Eyes must be held open so that the chemical can be removed from the eyeball. Ask the person to roll their eyes as you rinse to make certain that all surfaces of the eye are cleansed.
3) The injured person will quite likely be in great pain and will want to keep the eyes closed or rub them. It may take several people to restrain the person to allow rinsing of the eyes to continue.
4) Arrange for immediate transport to a medical facility, even if no pain remains after rinsing. Depending upon the nature of the chemicals, delayed damage may occur. If there is pain, cover the eyes loosely with sterile dressing. It is important to maintain verbal and physical contact with the injured person until help arrives.
2) Medical Emergency Arising from a Non-Chemical Situation
Whether an emergency situation arises from an accident in the lab, or a co-worker is struck by a sudden illness, it is important that all personnel know how to react to the emergency and do so immediately. Often the few moments it may take to search the literature on how to treat an illness or injury can be the difference between life and death fro the victim. You must know how to react before a crisis arises. If doubts surface as to the best course of action in the event of an emergency, remember that your best course of action may be to call for emergency assistance and to simply make the victim as comfortable as possible while awaiting professional help. To call for immediate emergency assistance have someone
After emergency service is on the way, have someone call
and notify the Business Office of the situation.
The first section that follows outlines the steps that should be taken if you, the first aider, comes upon the scene of an accident. The second section outlines steps to be taken if a co-worker becomes suddenly ill.
a. Person is the Victim of an Accident
The potential for accidents in the laboratory is high. It is important that all laboratory personnel know at least the most rudimentary aspects of first aid and how to react in an emergency situation. The most common types of accidents encountered in the lab are those involving cuts and lacerations, most commonly resulting from broken glassware. Burns are another class of injuries that are frequently encountered in the laboratory setting. Far less frequent are serious injuries related to shock or broken bones. All of these topics are examined briefly in the following pages. It is important that all personnel read this material to refresh their memory as to the appropriate response before injury occurs. All personnel are encouraged to participate in a First Aid training course.
i. Severe Bleeding
1) Direct Pressure
a) Apply direct pressure on a bandage over the wound. This prevents loss of blood from the body without disrupting normal circulation. The bare hands may be used if a compress cannot be found, though some sort of protective barrier should be placed between your hands and the victim's blood to prevent contamination and transmittal of blood borne pathogens.
b) A thick pad of cloth held tightly over the would will absorb blood and enhance clotting. Do not disturb the clots once formed. If blood soaks through the cloth add additional layers of cloth and continue applying pressure.
c) A pressure bandage may be applied to most parts of the body to allow the first-aider more freedom. To apply the pressure bandage, place and hold the bandage directly over the pad; maintain a steady pressure on the bandage so that the pad remains in place as you wrap the bandage around the limb. End by tying a knot in the bandage directly above the pad and wound.
a) If a pressure bandage or suitable substitute is not available, make use of gravity by elevating the wound above the level of the victim's heart. The force of gravity will help reduce the blood pressure and decrease the loss of blood.
b) Direct pressure on a pad of cloth directly over the wound must be continuously maintained.
Next, notify the Business Office by dialing
and alert them to the situation.
a) Usually result of light contact with hot surface or scalding by hot water.
b) Symptoms include redness, mild swelling and pain. Healing is usually rapid.
c) Treat by applying cold water to affected area. Apply a dry dressing if necessary.
2) Second Degree Burns
a) Usually the result of a very deep sunburn, contact with hot liquids or flash burns from flammable liquids. These can be more painful than deeper burns because the nerve endings in the skin are not destroyed.
b) Symptoms are a red, mottled appearance to the skin, blistering, considerable swelling over several days, and a wet appearance due to loss of plasma through the skin.
c) Treat by immersing burned area in cold water (not ice water) until pain subsides. Apply cloth that has been soaked in ice water and wrung out. Gently blot dry. Apply dry sterile gauze to protect wound. Do not break blisters or remove damaged tissue. Do not apply ointments, sprays, or home remedies on severe burns. If an arm or leg is affected, elevation of the limb may be beneficial.
3) Third Degree Burns
a) Usually the result of fire, burning clothing, immersion in hot water, contact with hot objects or electricity. Temperature and duration of contact are crucial in determining the extent of tissue destruction.
b) Symptoms are deep tissue destruction, white or charred appearance and complete loss of all layers of skin.
c) Do not remove charred clothing. Cover burns with thick layers of sterile dressing or clean cloth. Elevate limbs above heart level. Victims with face burns should be propped up in a sitting position and continuously monitored for difficulties in breathing. Do not immerse a significant portion of the body in cold water since this could result in shock. Cold packs may be applied to the face or limbs as needed. Do not apply ointments, grease or home remedies.
d) If it has not already been arranged, arrange for transport to medical facility as rapidly as possible.
Also, call the Business Office and alert them to the situation.
iv. Bone Injuries
a) the person heard
or felt the bone snap,
b) there is difficulty moving the part,
c) there is a grating sensation when the broken bones rub together,
d) the injured part moves abnormally,
e) difference in the length or shape between the uninjured and injured body part,
g) discoloration, and/or
h) pain or tenderness to the touch.
and then notify the Business Office by dialing
to alert them of the emergency situation.
Person is Struck by Sudden Illness
Not all first aid situations are centered around an accidental injury. All personnel should be aware of how to handle a situation where a co-worker is struck by a sudden unexpected illness, such as a heart attack or fainting, or crisis brought on by a chronic illness, such as epilepsy or diabetes. The following pages discuss certain illnesses that may require immediate first aid attention.
a) professional help arrives,
b) the victim begins breathing on his own,
c) a physician says to stop,
d) you become completely fatigued.
4. open airway (tilt
head, push jaw),
5. look-listen-feel for breathing (5 seconds),
6. two long breaths,
7. feel for carotid artery pulse for 5-10 seconds (major decision step-begin CPR or not??),
8. if no pulse, locate correct hand position and correct body position,
9. begin cardiac compressions at correct rate and compression/ventilation ratio,
10. stop CPR after first minute and check for possible return of pulse for 5 seconds unless a body response is seen before this time. If no pulse continue CPR until
a) professional help arrives,
b) a physician says stop,
c) you, the rescuer, becomes totally fatigued or
d) the victim responds to CPR and breathing and a pulse returns.
|Compression Depth||Compression Rate|
|Adult 1.5 to 2 inches||80-100 compressions per minute|
|Child 1 to 1.5 inches||80-100 compressions per minute|
|Infant 0.5 to 1 inches||100 compressions per minute|
|1-Man CPR : 15 compressions/2 ventilations|
|2-Man CPR : 5 compressions/1 ventilations|
|Child CPR : 5 compressions/1 ventilations|
|Infant CPR : 5 compressions/1 ventilations|
iii. Heart Attack
Specify the person who should do this ("YOU, go call 9-911!"). Also have the victim's doctor notified if possible. When these calls have been made, the person should notify the Business Office by dialing
and alert them to the situation.
and then notify the Business Office by dialing
and alert them as to
the situation. Remain with the victim until help arrives.