Adventist Youth Honors Answer Book/Health and Science/First Aid, Standard

Instructor for Skills Required

If residing in the United States or another country in which Red Cross instruction is given, satisfactorily pass the Red Cross Examination in Standard First Aid and receive your certificate.

In British countries pass the examination in St. John Ambulance and receive certificate for the same.

Or complete the following requirements:

5. Know the proper method of applying a tourniquet and when to apply one.
A tourniquet is a tightly tied band applied around a body part (an arm or a leg) sometimes used in an attempt to stop severe traumatic bleeding. Severe bleeding means the loss of more than 1,000 ml (1 litre) of blood. This flow of blood can soak a paper or cloth handkerchief in a few seconds. In such a situation, the bleeding will cause the death of the casualty in seconds to minutes.

A tourniquet is a last resort method of bleeding control. Other methods that should be applied first and in conjunction, if possible, include:


 * direct pressure
 * elevation of the limb or wound above the heart
 * the use of a pressure point to slow the artery above the injury(s)
 * blood-clotting agents or bandages

Even in cases of amputation, most bleeding can be controlled through these alternative methods. The rare exception is when a limb is shattered by massive trauma or when a major blood vessel is torn along its length. Even in these cases, the use of a pressure point above the wound is strongly preferred.

As the tourniquet stops blood flow to the limb, it can cause the death of the limb, forcing the later surgical amputation of the limb just below the level the tourniquet is applied. This is likely to occur when the tourniquet stays in place several hours. In any event, once a tourniquet has been applied, advanced medical care from a doctor or hospital will be required to salvage the limb if not save the life of the patient.

The decision to employ a tourniquet should be made by an emergency medical technician or preferably a doctor if at all possible. But when severe external bleeding cannot be controlled by other means, a tourniquet may be the only way for a first-aider to save the casualty.

Most civilian first aid instruction in the United States no longer teaches the use of the tourniquet for the following reasons:
 * the effectiveness of direct pressure, elevation and pressure points (controlling severe bleeding in up to 90% of cases as estimated by US medical sources)
 * the increased difficulty of reattaching an amputated limb when a tourniquet has been applied to the victim
 * unnecessary use by poorly trained bystanders
 * the unavoidable risks to both limb and life even when properly employed
 * the rare nature of injuries that require tourniquets, which typically occur in unusual settings such as working with agricultural or industrial machinery and the battlefield

The use of a tourniquet by a layperson in countries where it is considered outside the scope of practice of first aid may result in civil lawsuits and/or criminal charges, especially if the application was later found to have been unnecessary.

a. Open and closed spiral
Start by laying a strip of roller bandage along the length of the limb, from the larger portion to the smaller (for example, from the elbow to the wrist, or from the knee to the ankle). Then make two or three turns around the smaller part of the limb, and then wind upward in a spiral fashion, covering the first part of the bandage that was laid down. For an open spiral, leave gaps between successive windings. This is useful for holding dressings in place over a large area, as needed in the case of a burn. For a closed spiral, overlap each winding. Secure at the top by tying the two ends of the bandage together with a square knot.

b. Figure-eight
The figure-eight bandage can also be used on the hand, wrist, elbow, and knee.

c. Fingertip
Begin by laying the bandage along the length of the injured finger, leaving the end extending a couple of inches to the center of the palm. Then take the bandage over the fingertip, and going back down again on the other side to the base of the finger. Twist the bandage, and begin spiraling towards the fingertip. When the top joint of the finger is reached, spiral downwards again towards the base of the finger. Tie the two ends together with a square knot to secure the bandage.

c. Gunshot wounds
A gunshot wound is a medical emergency and will require treatment at a medical facility. First, control any bleeding by using the pressure points and by elevating the injured area. Do not try to remove the bullet, it may help a doctor to determine the extent of the injury, and its removal may increase the bleeding. Cut or tear away any clothing covering the wound. Do not pour any liquids into the wound. Wipe any debris away from the wound, but be careful not to wipe it towards the wound - always wipe away from the wound. Cover the wound with a bandage and fasten it securely so that it will not hang on anything during transport or slip off. Reassure the victim and get him to a hospital as soon as possible.

d. Injuries to the eye
Wounds that involve the eyelids or the soft tissue around the eye must be handled carefully to avoid further damage. If the injury does not involve the eyeball, apply a sterile compress and hold it in place with a firm bandage. If the eyeball appears to be injured, use a loose  bandage. (Remember that you must NEVER attempt to remove any object that is embedded in the eyeball or that has penetrated it; just apply a dry, sterile compress to cover both eyes, and hold the compress in place with a loose bandage). Any person who has suffered a facial wound that involves the eye, the eyelids, or the tissues around the eye must receive medical attention as soon as possible. Be sure to keep the victim lying down. Use a stretcher for transport.

Many eye wounds contain foreign objects. Dirt, coal, cinders, eyelashes, bits of metal, and a variety of other objects may become lodged in the eye. Since even a small piece of dirt is intensely irritating to the eye, the removal of such objects is important. However, the eye is easily damaged. Impairment of vision (or even total loss of vision) can result from fumbling, inexpert attempts to remove foreign objects from the eye. The following precautions must be observed:
 * DO NOT allow the victim to rub the eye.
 * DO NOT press against the eye or manipulate it in any way that might cause the object to become embedded in the tissues of the eye. Be very gentle; roughness is almost sure to cause injury to the eye.
 * DO NOT use such things as knives, toothpicks, matchsticks, or wires to remove the object.
 * DO NOT UNDER ANY CIRCUMSTANCES ATTEMPT TO  REMOVE  AN  OBJECT THAT IS EMBEDDED IN THE EYEBALL OR THAT HAS PENETRATED THE EYE! If you see a splinter or other object sticking out from the eyeball, leave it alone!   Only specially trained medical personnel can hope to save the victim’s sight if an object has actually penetrated the eyeball.

Small objects that are lodged on the surface of the eye or on the membrane lining the eyelids can usually be removed by the following procedures:
 * 1) Try  to  wash  the  eye  gently  with  lukewarm, sterile water.    A sterile medicine dropper or a sterile  syringe  can  be  used  for  this  purpose. Have the victim lie down, with the head turned slightly  to  one  side. Hold the eyelids apart.  Direct the flow of water to  the  inside  corner  of  the  eye,  and  let  it  run down to the outside corner.  Do not let the water fall directly onto the eyeball.
 * 2) Gently pull the lower lid down, and instruct the victim to look up. If you can see the object, try to remove it with the corner of a clean handkerchief or with a small moist cotton swab. You can make the swab by twisting cotton around a wooden applicator, not too tightly, and moistening it with sterile water. CAUTION: Never use dry cotton anywhere near the eye.  It will stick to the eyeball or to the inside of the lids, and you will have the problem of removing it as well as the original object.
 * 3) If you cannot see the object when the lower lid is pulled  down, turn the upper lid back  over a smooth wooden applicator.  Tell the victim to look down. Place the applicator  lengthwise across the center of the upper lid.  Grasp  the lashes of the upper lid gently but firmly.   Press gently   with   the   applicator. Pull   up   on   the eyelashes,   turning   the   lid   back   over   the applicator.     If  you  can  see  the  object,  try  to remove it with a moist cotton swab or with the corner of a clean handkerchief.
 * 4) If the foreign object cannot be removed by any of the above methods,  DO NOT MAKE ANY FURTHER ATTEMPTS TO REMOVE IT. Instead, place a small, thick gauze dressing over both  eyes  and  hold  it  in  place  with  a   loose bandage.   This limits movement of the injured eye.
 * 5) Get medical help for the victim at the earliest opportunity.

e. Animal and insect bites
Animal Bites

Insect Bites

f. Fainting and epilepsy
Fainting

Epilepsy

g. Effects of heat and cold
Heat Exhaustion

Heat Stroke

Hypothermia

Frostbite

12. Know the proper procedure to assist a radiation-exposure victim.
In the case of a nuclear accident or terrorist plot, a person might be exposed to radiation. First aid is to
 * Remove all the victims clothing and discard it.
 * Vigorously wash the victim with soap and water for an extended period of time in a shower.
 * Get the victim to a medical care facility.
 * Report the incident to authorities.

15. Know how to obtain help in an emergency
With the advent of the cell phone, the most effective way of obtaining help in an emergency is by calling 911. Most cell phones are equipped with a GPS module which allows their location to be pin-pointed by a satellite. The cell phone automatically relays this information to the 911 operator.

However, sometimes a cell phone is either not available, or it is not within range of a cell phone antenna tower. If you find yourself facing an emergency in the wilderness, you may have to attempt to signal aircraft. Three ways of doing that are presented here: