First Aid 急救手册
昨天Packing, 划伤自己两次，一次大拇指那么长，一次指甲盖那么长，bleeding...完全懵掉。
发现自己对First Aid毫无研究。痛定思痛，宝贵的周六下午和晚上研究了Youtube上的免费资源，ranging from First Aid to Adult CPR。如下是所做的NOTES：
一些地方感觉用英文更加精准。
https://www.youtube.com/watch?v=U7MPZINK4AA
https://www.youtube.com/watch?v=QOLrayv2R2s
https://www.youtube.com/watch?v=9ttt4mO3cYk
前言：
1. Always check the scene to ensure the rescue place is safe for wounded person and you yourself! 简单分析是什么造成的事故。如被电击了，确保区域安全再前进。如：spilled chemical,gas,steam,or fire；电子线。
2. 在确保事发地点安全后（建议带手套），遵循美国红十字会Check-Call-Care procedure。可使用First Aid Kit辅助。
Check: Do not move victims easily. Check skin appearance. Bleeding, cuts, bones, bruises.
Call: Always call 911 if people unconscious，address, locations, caller's name, what has happened.
Care: How to check conciousness: 问今天星期几，你叫什么。告诉对方ambulance on the way。
3. 另外一个方法是ABC Check
Airway: Head tilt. Lift the chin. Allow an open airway.
Breathing- check for breathing. Listen and feeling for air for 10s
Circulation. Check signs of circulation.如按压指尖，check血液是否可以回流。
情景：
一. Concious Choking： 对方无法说话或者呼吸，但依旧有意识。
Check the scene for safety, 911 first, 紧急救治：Abdominal thrust
1. 得到对方允许后，站在病人身后：使用两指确定对方腹部位置，将另一只手握拳放置腹部。另一只手环绕保住拳头。
2. Deliver quick and sharp upward thrust. Each attempt should be sharp and distinct.
3. Continue until: ppl start to breath.
二. Unconcious Choking： 对方失去意识。
1)Check the scene for safety
2)Check victim for life threatening condition by tapping and shouting. If no respond: 911
使用First Aid Box.
1. 在不移动对方的基础上，靠近对方，检查嘴巴和鼻子的呼吸。若必须要旋转对方，则一手支持脖子，一手支持胯部，将其翻转。Gently rolling the victim towards you。确保保持头部和脖子一条直线。
2. Tilt the head back and lift the chin to ensure airway open. 原理是将舌头从呼吸处移开。感受呼吸是否在5s内恢复。
二.1
发现victim有呼吸了，或者在呕吐（recovery position后可用食指帮助吐出）。在没有明显头，颈椎伤害时，使用Recovery Position:
1) Lift the arm on the side that the victim will roll to above the head with straight
2) Take the other arm, across neck on the shoulder over the chest. Bend the leg on the other side of the rolling side. Nail between the shoulders and the chips. Gently roll the victim as a union.
3) Support the head so that the angel towards the ground.
二.2
发现Victim没有呼吸了但心脏依旧在跳(sign of circulation)。Put breathing barrier over the mouth（防止传染，First Aid Kit里有）。记住把鼻子堵上! open the airway。Make sure ears closed.
紧急救治：Rescue breath.
1）Place mouth around person’s mouth with a tight seal
2）2.1) Give 2 breathes, each lasting 2s. Check circulation first.
2.2) 1 breath every 5 seconds. Do it for 1min, (12 breaths)
3）Check Circulation for no more than 10s: 脖子脉搏。也就是说每一分钟检查一下脉搏。
三. Heart Attach 心脏病
症状：呼吸困难，脸色发白。
Check the scene to ensure it's safe。一旦失去意识，马上call 911。Check breath and pulse always.
注意，心脏类型突发，每分钟都很珍贵！！！！When breathes stop, brain die in 4-6 minutes!!!
Cardioc chain of survival: 1) Call 2) Early CPR
1. If concious: 1.1) Ask if any pain: pressure in the chest.
1.2) Call 911. if never had this before or victims suffers for longer than 5min
1.3) ASK if on medication.
1.4) Put him on the floor. If he doesn’t want to, don’t push him.
1.5) If he shakes and lies down, stabilize his head fixed. wait for 5 min.
2. If unconcious: Early CPR (caripulmonary resusccation)
2.1) Place heel of the hand two fingers above bottom of sternum. 十指相扣lock the fingers。原理是按胸，帮助circulate oxygon
2.2) When giving 15 compressions, keep arms 90 degrees angle to the body; keep elbows locked.Do 15 compressions in 9 seconds (100 Compression per minute) 1.5-2 inches deep
2.3)Then 2 slow brethes (rescue breath). Continue 15 compressions and 2 breathes for 4 cycles
2.4) Re-check blood circulation.口诀：1-1000，2-1000，3-1000，4-1000，5。确保不会停止太长时间。
记住Tilt he head back + pinch the nost shut。
四. Sudden Illness Stroke:Seizure, Diabetic emergency, Poisoning and Allergic（coughing, shortness of breath, dizzy, vomiting etc.）
1) Check the scene, check the victim
2) Call 911
3) 将西装放在Victim脖子下make a small pillow
将领带衬衫等解开以免窒息。不要在他嘴巴里放东西。remove nearby things to prevent hurt.
带上手套，以免被传染。
3) 还可询问是否病人自己有medicine。
4) 如果是中毒： Have ppl rest in a comfortable position
不要给水或者食物。问是否有没有吃药等。
五. Bleeding
症状：bruise, abrsion(擦伤), cut, deep cut (damage nerves), puncture
治疗方法：Check what happened。First Aid Box, Call 911。核心思想是minimize the effect of the shock until the advanced medical arrives.
1. A cut
Cover the wound with clean clothes/dressing and press firmly (通过压力减小出血)
1.2. Alleviate the wound above the heart
1.3. Use roller bandage. Tie it. Place additional layer of clean clothes and roller bandage if still bleeding.可将手按住伤口加强压力。
1.4. 如果bleeding still not stop. 找到上臂内的止血点(squeeze the artery against the bone)，压住。并且保持手在心脏上方。原理：slow the blood beyond that point。身上有四个止血点：手臂来说是：inside of the upper arm；对于腿是hip ends的地方。
2. Embedded object
Do not remove the object! 因为the object itself may help stop the flow of the blood
2.1 Press clean clothes around the object. Press genltly around the wound
2.2 不要移动object.!!!稍微移动也不要
2.3 Press bandage around the wounds. Use overlapping bandages until secured
做完急救请认真洗手！！
Triangular bandages: short end underneath the arm. one end over one side, and the other one around the another arm. Make the note.
Push fingernail and make sure it comes red—blood circulation
六. Burns Skin is the largest organ in the body
症状：1st degree burn: Skin red and try。 Radiation,Sun burn, ...cooling water
2nd degree: Partial Thinkness Burn。Chemical, thermal 气泡。不要戳破.
3rd : Full thinkness burn。 Electrical Black
Check the scene until it's safe for you
6.1.Thermal Burn 拯救方法：必须Call 911！！！！
6.1.1. Stop the burning--cool the burning area。
6.1.2. Cover the bound with clear clean dressing to prevent infection. Give cares to minimize the effects of shocks.
6.2. Chemiacal Burn 拯救方法：必须Call 911！！！！
6.2.1.Cool by running cool and running water; OR Don’t use too cool water. MSDS data sheet
6.3. Electricity Burn 拯救方法：必须Check Life threatening conditions！！！！
6.3.1. Cover the wounds. Give cares to minimize the effects of shocks until advanced medical care arrives.
七. Injuries to Muscles, Bones, and Joints.使用小工具箱。带手套！
1. Check the scene for safety!! Observe and Ask what happened: any type of medical problem?
2. Call 911 for help if any problem breathing.
若还有意识：Check if sweating or feeling hot, check pause
If ppl exhaustion, no need to call 911. If in 10-15 min still not better, then call 911.
4. If it's heat exhaustion: then it's heat stroke: Sweat+skin cools up.
If red in the face, dry and warm——might be a heat stroke. Could not drink to cool down——get to cool area, cal 911!(MOST importantly)
5. Splint an injury if have to move the victim/ support the injured area
5.1.Check where hurt: If bruise/internal bleeding/broken bone?swelling?Point tender
If leg not hurt, straight that out.
Address from head to toe ensuring no bleeding;
Do not stop bleeding from the head: the brain is bleeding, if stop, swelling
Look around the head for bleeding, broken teeth, noSE?
Check shoulders injury: touch the arms, checking if bones are nice and steady—no bleeding. Get down to hand, take one of finger and thumb. Press on the thumb, if turns white, bleed returns back in 2 second—— good circulation!!!!Ask if could feel me touching the finger
Check head/neck injury
Hold the head/helmet ask if he can hear me.
If bleeding, then remove the helmet
Keep the head steady—hold his head! And I call 911
5.2——>stabilize the bone using books to keep bones steady
If broker the leg: keep immobilize until emergency come…Invent a splint
Put splint material on the side: Bandages under the knees(no need to lift the leg as there is gap underneath the knee) Tie: 1)above the knee. make the knot on the side of the splint material(leave the pressure) 2) Above the knee 3) at the ankle.
若绑在脖子上，在knot下可以垫一块纱布。若针对手臂，则在做了手臂三脚架后，可以绕着脖子再来一圈。
5.3 Keep talking to him (do you feel anything?if hurt? )
Make sure he still has the feeling in his toes
Check calculating socks when taking socks off。摸摸手指末端，确定血液回流。
八. Heat-related Emergencies
8.1. 症状：Moist, Pale or flushed skin, Headache, Nausea, Dizziness, weakness and exhaustion. 最严重的是HEAT STROKE中暑，症状：1)change in the level of consciousness 2) High body temperature 3）Red, hot skin that can be either dry or moist 3) Paulse rapid or weak 4) Breathing oftern rapid and shallow
8.2 解决办法：
1） Move his to a cool envionment, loosen and remove clothing
2) Circulation with fan + cold water. Water evapuate from the skin has the cooling water。擦拭前额，脖子和手臂
3) 如果病人有意识，可以小量喝水
4）如果病人情况不好转，call 911
九. Cold-related Emergencies
9.1 症状：长时间潮湿的衣服在室外会感冒。shivering, slow&irregular pulse, numbnes.不及时治疗，身体机能变低，
9.2 治疗方法：1）换干燥的衣服
2）使用blanket，帽子，zip warm liquid。不要给咖啡因和啤酒的热饮
3）Call 911如果condition does not improve
十.Eye Injuries:
Rinse eyes for 20-30min.
Drift the water through the nose
失去意识（心脏病，窒息,中风等）: 在确定scene safe, 911后CPR。确保tilt the head to keep the airway open. i.e. tongue not locking
AED的使用：
Def: An automated external defibrillator (AED) is a portable device that checks the heart rhythm and can send an electric shock to the heart to try to restore a normal rhythm.AEDs are used to treat sudden cardiac arrest (SCA). SCA is a condition in which the heart suddenly and unexpectedly stops beating。说白了就是民间起搏器。
使用情景：如果没有sign of circulation for no more than 10s/ absence of a pulse, use AED
使用方法：Stand clear, do not touch the patient.！
Let the AET to analyze the victim，他自己会放电的。。。。
如果AED说没有必要点击，check pulse for less than 10s. And use CPR.
