BPED 218: EMERGENCY PREPAREDNESS AND SAFETY Consent of the mentally ill
MANAGEMENT (WEEK 1).(GROUP 1)
(As with Consent for a minor) In a case of life and
FIRST AID BASICS death, the First Aider can act without actual consent.
DEFINITION: FIRST AID Actual Consent
This is the emergency care given to an injured or This is the permission for treatment given by the
suddenly ill person, using readily available materials. casualty himself.
This may be given while awaiting the transportation of
the casualty or while medical aid is underway. Patient assessment
The aim of the first aid is to: The procedures of patient assessment may bring you in
contact with the patient's blood or body fluids.
a. PRESERVE life - Ventilate, CPR, stop bleeding,
manage airways, etc. YOUR SAFETY FIRST: WEAR PROTECTIVE LATEX OR
RUBBER GLOVES
b. PROMOTE healing - work as sterile as possible when
Patient assessment is a systematic procedure, but it is
attending to wounds.
not always done in the same step-by-step order.
c. PREVENT injury or illness from becoming worse. Successful pre-hospital emergency care is quite
dependent upon the evaluation of the vital signs and
Get Assistance overall injury. Interpreting vital signs correctly is basic to
distinguishing between life-threatening and non-life
To phone for an Ambulance.
threatening conditions. Changes in vital signs reflect not
Traffic Department - to regulate and direct the only alterations in the patient's condition with time, but
traffic, .to take down details, etc. also the effectiveness of injury or illness management.
Other medically qualified persons- Can assist
Assessment
with the patient treatment, etc.
Bystanders- they can organize the traffic, they 1. Primary assessment - quick check to determine life
can call the Ambulance, the can help hold the threatening conditions, such as no breathing, no
casualty, etc. heartbeat and severe bleeding, unconsciousness.
Fire Department - in case someone is trapped in
a car, if there is a fire risk, etc. In case there 2. Secondary assessment - done when all life
chemical spillages, etc threatening injuries have been treated and the casualty
Police / Security - making the scene safe - there has been stabilized
might a crowd of people, etc.
Important
Legal matters
Be observant as you approach the patient. Early
Let us look at the LEGAL ASPECTS which a First Aider observations can be critical factors in how soon you can
may face when offering Assistance to someone ill or initiate care. Bear in mind that for every obvious injury,
injured: This all is based upon the "GOOD SAMARITAN there may be a number of hidden ones. Knowing what
ACT” Under normal circumstances a First Aider is an accident can do, and being able to recognize the
covered, except if he exceeds his qualifications or acts mechanisms of injury is important.
without consent.
THE PATIENT ASSESSMENT
CONSENT
The Conscious Injured
Means: permission to actually treat someone. There are
1. Check safety.
different forms of consent which we will briefly discuss
in this paragraph. 2. Position yourself close to the patient and make eye
contact.
Consent regarding a minor
3. Introduce yourself, state that you are trained in first
Permission to treat is required from parents or aid and ask for his/her name and primary complaint.
guardian of the child under 18 years of age. This may be
4. Get consent to render assistance.
overruled in an emergency situation where the child's
life depends on immediate action 5. Calmly reassure the patient with a gentle touch on his
shoulder or hand.
Implied consent
6. Begin the patient survey.
(Consent in an emergency) Casualty is who unable to
Primary assessment
give consent due to e.g. a head injury, or who is
When the patient is breathing and has circulation,
unconscious, would have given consent if he was able to
Check the patient’s vital signs every 2- 3 minutes.
understand the situation.
Airway Check for obstructed airway Legs
Breathing Is the patient breathing
Press in the legs feel for fractures asking the casualty if
Circulation Pulse, bleeding, shock
he could feel pain.
The primary survey is always the first step in patient Level of consciousness
assessment. It takes precedence over all other aspects
of history taking and physical examination. In many *Speak to the casualty - determine his LEVEL OF
instances, the primary survey will be completed at a CONSCIOUSNESS
glance. However, when the patient is unconscious or Are his eyes open, or does he opens them to sound?
has a major injury, close examination will be required. Does he answer back?
If, while doing the primary survey, an obstructed airway, Do his words make sense?
cardiac arrest or serve bleeding is found, you will have Can he remember what happened?
to attend to the problem ASAP. Can he give personal details, date and time?
Does he move upon touch or pain?
Secondary assessment (Head to toe examination) Place the unconscious casualty on the survival
position - demonstrated later (on his side) and
This includes the following:
remember to take care with his neck and spine!
Pulse
History
Feel for the carotid (neck) or radial (wrist) pulses and To complete the picture, you need the details of what
determine the strength, rate & rhythm. Record beats happened prior to your arrival. This can be found out
over 30 seconds and times by two, and that will fix’s you while treating the casualty etc.
rate per minute.
Signs
Respiration
Things that you can see yourself, bleeding, etc
Determine rate, character, depth and sound record
breaths for 30 seconds and times by two, that will give Symptoms
you rate per minute. Things that the casualty MUST tell you, e.g. nausea,
Skin headache, pain,
The skin is responsible for maintaining normal body Things to remember
temperature. Normal temperature is 37 C. Skin
condition can be hot, cool, moist, clammy or dry. Skin * Your safety always comes FIRST
colour: Can be white, pale, ashen grey, red, flushed or * Arrange for an ambulance ASAP.
* Never leave the casualty alone!
blue.
* Monitor vital signs between 2-10min intervals
* Stay with your casualty until the ambulance or
Eyes
assistance arrives
Size of pupils, and reaction to light * Hand over the casualty to the emergency personnel.
* Keep records for yourself for each person treated.
Ears, Nose and Mouth
7 Note any fluid leakage
Neck and Spine
Look for obstruction or bleeding Spine: Feel for
deformity and bleeding
Chest
Press on the rib cage and chest wall ask the casualty if
he feels pain
Abdominal and pelvic area
Check for rigidity and bleeding by observing if blood
could be noticed
Medic - alert Device
This is in the form of a bracelet or a necklace. It contains
life saying Info on the patient's allergies and/or illnesses
