11.3.1: First Aid Techniques

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Page ID: 67690

Erin O'Hara-Leslie, Amdra C. Wade, Kimberly B. McLain, SUNY Broome

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Falls

If a patient falls, it is important to immediately assess them and for Home Health Aides/Personal Care Aides to inform their supervisor.

If they are trained to take vital signs, such as blood pressure, they should do so.
Check to see if the patient has hit their head.
Never move someone who appears to have hit their head or who may have a back injury. This could do more damage.
Check for cuts, bleeding, and any obvious injuries.
If there is an injury, try to determine the extent of the injury. Report any observations made to a supervisor or to emergency medical services, if there is a need for emergency help.
If there is bleeding, put on gloves and apply pressure to the wound with a clean and dry towel.
Note how long it takes for the blood to saturate the towel and report this to a supervisor and/or emergency medical services.
If there is a need for additional towels, place another clean towel on top of current one. Do not let up pressure on the bleed.
Never leave a patient alone who has fallen. Stay with the patient until additional help arrives.
Document all injuries and steps taken to provide care.

Bruises

A bruise forms when blood vessels below the skin’s surface break and blood leaks into the tissue beneath the skin (Mayo Clinic, 2014). Bruises can range from very small to quite large, covering large areas of the body. Bruises change color as they heal. Remember the acronym RICE when treating bruises (WebMD, 2014a).

R (Rest): Encourage the patient to rest the affected area to prevent further injury and to allow it to heal.
I (ice): If the skin is not broken, Home Health Aides/Personal Care Aides should immediately apply a cool cloth or ice pack (wrapped in a towel to protect the patient’s skin) to the area for about 20 minutes. This can be repeated several times a day, as directed by the Care Plan. Remember to never apply ice directly on skin as this could cause injury to the skin. Do not use heat and encourage the patient to avoid hot showers and baths for the first 48 hours after injury as this will encourage swelling (WebMD, 2014a).
C (compression): Wrap the area of injury with an ACE bandage, if directed by the Care Plan or a supervisor. Compression helps to relieve swelling and pain. Remember not to wrap the area too tightly as this could cause further injury. Signs the bandage is too tight are numbness, tingling, coolness in the affected area, increased pain, or swelling below the area that is wrapped (WebMD, 2014a).
E (elevate): Elevate the bruise above the level of the person’s heart if possible. This will help to decrease swelling.

Seek further guidance from a supervisor. Remember to inform him or her of ANY injury a patient has sustained. Document all injuries and steps taken to provide care.

If the bruise covers a large area of the body and appears to be serious, or if a hematoma has developed, or if skin has broken and the patient is bleeding profusely (a lot), activate emergency services. Call 911. Calmly inform EMS of the situation and the observations made. It is also important to inform EMS if the patient is on any anticoagulants (blood thinners). Anticoagulants cause blood to take a longer time to clot. This will result in a longer bleed time and could be potentially life threatening to the patient.

Self Check Activity \(\PageIndex{1}\)

a). for a longer time

b). for a shorter time

2. The acronym RICE, which is used to treat bruises and injuries, stands for which of the following?

a). Reassure, Inquire, Cold compress, Elevate

b). Rest, Ice, Compression, Elevate

c). Rest, Ice, Cool water, Emergency

d). Reassure, Instill heat, Calm, Electricity

Answer

1. A

2. B

FEEDBACK:

1. People taking anticoagulants will bleed for a longer period of time as this type of medication is used to prevent blood clots. It can present a serious issue if an injury occurs as a person can potentially lose a lot of blood.

2. The acronym RICE is used to treat bruises. It stands for Rest, Ice, Compression, and Elevation. The person should rest the injured area, ice should be applied for 20 minutes at a time, and the area can be wrapped with a bandage, and elevated to reduce swelling.

Cuts and Scrapes

For minor cuts and scrapes, basic first aid at home may be adequate. Home Health Aides/Personal Care Aides should still inform their supervisor of the situation and seek guidance from them in caring for the wound.

Always wash hands and apply gloves when performing first aid.
Basic first aid for caring for cuts and scrapes includes first washing the area with cool water. The cool water will wash away any debris that may be in the wound and will help blood vessels to constrict (become narrow), which helps to stop bleeding. Do not use soap.
Once the area is clean and the blood has decreased, place gentle pressure on the wound with a clean and sterile gauze pad. Add additional gauze if the first gauze saturates with blood. Do not remove the gauze pad as this could cause any clots that have begun to form to be removed and bleeding to continue.
When the wound has stopped bleeding, dress the area with a clean bandage.
Document all injuries and steps taken to provide care.

Dizziness/Fainting

Should a patient report that they feel dizzy, immediately lower them to a seated or lying down position.
Remember to always allow a patient time to sit on the edge of a bed or chair and dangle their legs before rising to a standing position. This will help prevent falls from feeling light-headed or dizzy if the patient experiences orthostatic hypotension.
If a patient is standing or walking and reports they feel faint, Home Health Aides/Personal Care Aides should lower them to a chair or to the ground if a chair or bed is not nearby.
If possible, Home Health Aides/Personal Care Aides can wrap their arms around the patient’s waist securely, and using good body mechanics, lower them to the floor.
Avoid having their head hit the ground or nearby objects.
While lowering the patient to the floor, keep a wide stance to provide a strong base of support, and bend using the knees to slowly and carefully lower the patient to the floor.
Document all injuries and instances when patients report dizziness or faintness and the steps taken to provide care.

Self Check Activity \(\PageIndex{2}\)

True or False

1. If a patient feels faint, attempts should be made to lower them to a chair or the ground to prevent a fall. True or False? _______

2. It is important to allow a patient time to sit on the edge of the bed before standing to prevent dizziness and falls. True or False? _______

Answer

1. True

2. True

FEEDBACK:

1. If a patient reports feeling faint the HHA/PCA should have them sit immediately or assist with lowering them to a chair or the floor to prevent a fall.

2. To prevent orthostatic hypotension, always allow a patient to sit and dangle their legs at the edge of a bed prior to standing.