BRONZE CROSS

Summer 2015

MEDICAL ISSUES
Medical Issues in Bronze Medallion
Heart Attack;

Asthma;

Stroke;

Angina;

Hyperventilation;

Obstructed

Major bleeding.

Drowning.

Airways;
Shock.

Medical Issues in Bronze Cross

Arm or leg wounds (broken bones, sprain, etc.);
Hypothermia;
Heat cramps, heat exhaustion and heatstroke;
Major bleeding (in detail).

FIRST AID REVIEW

What do you remember from Bronze Med First Aid?

In teams of 2 or 3, present one or two Bronze Med First Aid situations in front of the rest of the class.
You must include
1) Signs and symptoms
2) Treatment
3) An example of the treatment

One team must pick each of the following subjects:

1) Heart Attack, Angina
2) Obstructed Airways
3) Asthma, Hyperventilation
4) Shock, stroke & Drowning

You may use all types of ressources:

- The Canadian Lifesaving Manuel and Canadian First Aid Manuel (I have an extra copy if needed);
- Your instructors;
- Your peers;
- Your phones IF YOU HAVE NO OTHER OPTION

HEART ATTACK
Signs & Symptoms

Treatment

Trouble breathing, shortness of breath;

Phone EMS;

Flushed face, sweating;

Pain, pressure or tightness in the chest or

shoulder;

Assist the victim into a comfortable

position. This is often a semi-sitting
position;

Anxiety, fear, confusion, shock;

Weak, rapid pulse;

Loosen tight clothing around the

neck and chest;

If the victim has Aspirin, give them 1

adult tablet (it can reduce the
effects of a heart attack);

Primary & Secondary Assessment +

Treatment for shock.

Pain in the arms, neck, back or jaw;

Nausea, vomiting, weakness, dizziness,

fatigue, indigestion;

Denial of symptoms.

ANGINA
Signs & Symptoms

Treatment

Trouble breathing, shortness of breath;

Phone EMS;

Flushed face, sweating;

Pain, pressure or tightness in the chest or

shoulder;

Assist the victim into a comfortable

position. This is often a semi-sitting
position;

Anxiety, fear, confusion, shock;

Weak, rapid pulse;

Loosen tight clothing around the

neck and chest;

Help a conscious victim take any

prescribed angina medication
(nitroglycerin tablets or sprays);

Primary & Secondary Assessment +

Treatment for shock.

Pain in the arms, neck, back or jaw;

Nausea, vomiting, weakness, dizziness,

fatigue, indigestion;

Denial of symptoms.

ASTHMA
Asthma is a breathing disorder in which airway sensitivity is increased. This sensitivity results in spasms of the
airway muscles and increased production of mucus, which narrows the airway and blocks air exchange.
Common triggers to an asthma attack include allergies, emotional distress and extreme temperatures.
Signs & Symptoms

Difficulty breathing;

Anxiety;

Wheezing.

Treatment

Assist the victim to a comfortable position:

while sitting or standing, try leaning forward
slightly with the arms resting on some object;

Help the victim take his or her medication

(inhaler);

Loosen tight-fitting clothing around the neck

or chest;

If the asthma attack continues or the victim is

distressed, arrange for transportation to
hospital by contacting EMS.

HYPERVENTILATION
Hyperventilation reduces the level of carbon dioxide in the blood, which can depress the brains breathing
centre and result in unconsciousness. Hyperventilation may be a reaction to fear or stress. Treatment aims to
increase the amount of carbon dioxide in the victims blood, which allows normal breathing to return within a
few minutes.

Signs & Symptoms

High rate of respiration, panting,

gasping;

Lightheadedness, weakness, headache;

Tingling of hands, feet, and the area

around the mouth;

Confusion, unconsciousness.

Treatment

Reassure and try to calm victim;

Coach breathing (breathe in breathe out);

Phone EMS if situation does not

improve.

* If hyperventilation has not happened before, watch for chest pain

or other signs of heart attack or more serious medical problems.

DROWNING
Drowning victims can suffocate when the airway is blocked by water and insufficient oxygen reaches the blood
and tissues. In some case aspiration of water, dirt, bacteria, oils or detergents can damage the respiratory system.
This complicates resuscitation and may negatively affect outcomes.
Symptoms may be delayed up to 72 hours after the event.

Signs & Symptoms

Reduced level of consciousness;

Shallow or rapid breathing;

Coughing or wheezing;

Anxiety;

Weakness;

Nausea, vomiting;

Coughing up whitish or pink frothy fluid;

Shock.

Treatment

Advise a conscious victim to see a

doctor. Give a warning about the
seriousness of any later symptoms of
respiratory distress.

Phone EMS if vital signs are abnormal or

victim is distressed.

STROKE
A stroke occurs when the brain does not receive enough blood and oxygen due to internal bleeding or a
blockage in a blood artery. Without blood, brain damage occurs and shows up in the victim as various sudden
impairments. It is essential that stroke victims go to the hospital immediately after noticing the symptoms.
Signs & Symptoms

Weakness, numbness or tingling in the face, arm

or leg;

Treatment

Phone EMS;

Maintain an open airway;

Facial droop;

Sudden trouble speaking or understanding

speech;

Assess breathing, check pulse and other

signs of circulation;

Double vision, sudden dimness or loss of vision,

especially in one eye;

Sudden, severe and unusual headache;

Assist the victim to a comfortable

position (often semi-sitting) or a
recovery position if there are airway
management problems.

Unexplained dizziness, unsteadiness;

Unexplained loss of consciousness.

MILD AIRWAY OBSTRUCTION

A mild obstruction allows some air to pass, yet it can still be very distressing.

Signs & Symptoms

Coughing forcefully;

Can speak;

Wheezing between coughs;

Treatment

Approach, identify yourself. If the choking victim

leaves the room, follow;

Ask: Are you choking? My name is and I am

trained in first aid. Can I help?;

As long as a victim is coughing and clearing the

airway on his or her own, do not interfere
physically;

Monitor the situation. If the victim leaves the

room, follow. The situation may deteriorate.

Flushed skin color.

SEVERE AIRWAY OBSTRUCTION

A severe obstruction does not allow the air to pass by the object.
Signs & Symptoms

Treatment

Weak, ineffective cough;

Shout for help. Send a bystander to phone EMS;

Cannot speak or cry;

Reassure victim.

May be holding the throat;

Difficulty breathing;

No breathing noise;

Grey/blue color of the lips and gums.

Treatment (Adult & Child)

Back blows, abdominal thrusts or chest thrusts are effective for

relieving severe airway obstruction in conscious adults and children.
These techniques should be applied in rapid sequence until the
obstruction is relieved or the victim becomes unconscious;

Treatment (Infant)

Perform 5 back blows;

Perform 5 chest compressions;

Repeat until successful or victim becomes unconscious.

UNCONSCIOUS AIRWAY OBSTRUCTION

Signs & Symptoms

Air does not enter when

attempting to ventilate

Treatment

Phone EMS (send a bystander if one is available);

Open airway: check for breathing.

Start CPR if not breathing or not breathing normally;

Perform 30 compressions;

Give a breath: if air goes in, give another breath. If air does not go
in, reposition head and try again;

Continue with another 30 compressions;

Open mouth: check for foreign object - if you see it, remove it.

Continue sequence of breaths, compressions and checks for

foreign object until victim responds or EMS arrives.

IF VICTIM BECOMES UNCONSCIOUS

Treatment (Adult & Child)

Assist the victim to the floor to prevent injury;

Phone EMS (send a bystander if one is

available);

Treatment (Infant)

Phone EMS (send a bystander, or if you make

the call yourself, take the infant with you);

Perform 30 compressions;

Open mouth: check for foreign object - if you

see it remove it);

Give a breath (a puff): if air goes in, give

another puff. If air does not go in, reposition
head and try again;

Continue compressions and breaths until

victim responds or EMS arrives.

Perform 30 compressions;
Open mouth: check for foreign object - if you
see it, remove it;
Give a breath: if air goes in, give another breath.
If air does not go in, reposition head and try
again;
Continue compressions and breaths until victim
responds or EMS arrives.

IF VICTIM IS PREGNANT OR TOO LARGE

Treatment

Perform chest compressions instead of

abdominal thrusts;

Landmark the same as in CPR compressions;

Pull straight back, not in an upward motion.

SHOCK
Shock is a depression of the bodys circulatory system. When there is not enough blood to
circulate to the bodys vital tissues (in the brain, heart and lungs), cells die - and ultimately, so can
the victim. Assume that shock is present. Most injuries are accompanied by some degree of shock.
Signs & Symptoms

Shallow, rapid breathing;

Weak and rapid pulse;

Treatment

Warmth;

ABCs;

Rest and Reassure;

Pale, cool, clammy skin;

Restlessness, weakness;

Fear, anxiety;

Treatment;

Confusion, disorientation;

Semi-prone / semi-sit.

Nausea, vomiting;

Unconsciousness.

HYPOTHERMIA
Hypothermia happens when someone becomes very cold and their core body temperature drops so low that it stops
functioning properly.

Signs & Symptoms

Treatment

Remove victim to a dry, sheltered place;

Handle gently, do not rub the victims body

surfaces;

Moderate: uncontrollable shivering,

disorientation, confusion, lapses in
memory, decreased consciousness,
blurred vision and hallucinations;

If possible, remove wet clothing and dry

victim;

Severe: shivering reduced or absent,

an overwhelming desire to sleep, loss
of consciousness.

Warm the victims body by giving warm

beverages (no alcohol), wrapping victim in
warm blankets, getting into the huddle
position, applying heat packs to head, neck
and trunk;

Phone EMS if the victim is unconscious,

confused or does not improve quickly.

Mild: shivering, feeling cold, loss of

coordination, fatigue, slurred speech,
stumbling, shock;

HEAT CRAMPS
Heat cramps are a result of excess heat and dehydration. The body loses salt and water faster than it can replace them
through food and drink

Signs & Symptoms

Treatment

Abdominal and leg heat

cramps;

Move to a cool spot out of the

hot environment, remove excess
clothing;

Sweating, pain and spasms in

muscles (particularly in the
legs and stomach);

Give the victim cool water to

drink;

Stretch the cramp;

Fatigue, dizziness, headache,

nausea, shock.

Advise the victim to eat foods that

will help restore normal body salt.

HEAT EXHAUSTION
Heat exhaustion is another possible reaction to sustained heat and sweating. If left untreated, heat exhaustion can progress
into life-threatening heatstroke.

Signs & Symptoms

Hot, sweating;

Normal mental status - oriented to

person, place and time;

Nausea, headache, dizziness,

restlessness, weakness, fear, anxiety,
confusion, disorientation;

Treatment

Move to a cool spot out of the hot

environment, remove excess clothing;

Cool the victim gradually (remove as much

clothing as possible, bathe with cool water, fan);

Cover lightly if victim feels cold;

If the victim is alert and nausea is not a big

problem, give him or her water to drink;

Advice victim to eat well or consume Gatorade

to restore depleted body salt;

Phone EMS if the victims level of consciousness

is decreased.

Weak and rapid pulse;

Shallow and rapid breathing.

HEATSTROKE
Heatstroke occurs when the bodys ability to regulate its temperature fails and the body temperature rises dangerously.

Signs & Symptoms

All Heat Exhaustion
symptoms plus:

Body temperature rises

rapidly;

Vomiting, convulsions,
unconsciousness.

Treatment

Phone EMS. This is a life-threatening emergency;

Move to a cool spot out of the hot

environment;

Cool victim down as quickly as possible: cool

the body core - head, neck, chest, back, groin by:
> removing outer layer of victims clothing;
> wrapping the victim in wet sheets;
> sponging with or immersing in shallow,
cool water;
> fanning his or her body;
> applying ice packs or cold compresses to
head, armpits, groin and along the sides of the
chest.

MAJOR BLEEDING
A bleeding incident is qualified as major when there is more blood than the area of your two hands.

Signs & Symptoms

Treatment

Phone EMS. This is a life-threatening

emergency;

Blood;

Rest - the affected body part, and

reassure victim;

Pain;

Distress;

Anxiety.

Direct pressure - if you are wearing

gloves, apply pressure to the wound
immediately using your finger or hand.
If you do not have gloves, ask the
victim to apply pressure to the wound.
Apply a sterile dressing and badge as
soon as possible.

RESCUE BREATHING COMPLICATIONS

REFERENCE

p. 29, Canadian First Aid

Manuel

COMPLICATION
Victim vomits.
ADAPTATION
1. Roll victim on side (turning
the victim towards you allows
easy access to the mouth).
2. Allow vomit to drain and
finger sweep to clear the
mouth.
3. Resume rescue breathing.

COMPLICATION
Gastric distension (stomach expands
instead of the chest)
ADAPTATION
1. Reposition the head; make sure it is
tilted back so that the airway is
completely open.
2. Deliver each breath (not deep) over 1
second. Each breath should make the
chest rise. Watch the chest rise and
allow exhalation between breaths.
3. Blow just enough air to make the
chest rise.

*Blowing too hard or quickly may

send air into the stomach. This
makes it harder to perform rescue
breathing and increases the
chance of the victim vomiting.*

COMPLICATION
It is not possible to seal the
victims mouth
ADAPTATION
1. Perform mouth-to-nose
rescue breathing.
2. Close the mouth and make
the seal with your mouth
around the victims nose
(dont pinch the nose).

COMPLICATION
The victim breathes through a
stoma (a surgical hole in the
victims neck)
ADAPTATION
1. Perform mouth-to-stoma
rescue breathing.
2. Close the mouth and pinch the
nose.
3. Seal your mouth around the
victims stoma.

https://
www.youtube.com/
watch?
v=5zWB4dLYChM

COMPLICATION
Victim begins to breathe without
assistance
ADAPTATION
1. Continue to monitor ABCs and
vital signs.
2. Place victim in recovery position.
3. Treat for shock.
4. Be prepared to begin rescue
breathing again.
5. Proceed to secondary assessment.

VICTIM AGES IN FIRST AID

Adult 8 years old +
Kid 1 to 8 years old
Baby birth to 1 year old