New First Aid Protocols
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CPR
- Adult: 2 rescuer - 15 compressions to 2 breaths
- Adult: 2 rescuer switching - compressor says "switch", give 2 breath, rescuers exchange positions, re-check ABC.... continue
Choking
- Adult and child - unconscious: chest compressions (not abdominal thrusts)
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Topic: Use of Polysporin by Brigade Members
Memo on the Use of Polysporin® by Brigade Members as released by our National Headquarters - effective 28 July 1999
In response to a request from the field, appropriate consultation shave been conducted about the use of Polysporin® by Brigade members who provide patient care services.Polysporin® is an over-the-counter (OTC) product used to help keep open wounds free of infection. The use of Polysporin® by Brigade members providing patient care services on behalf of St. John Ambulance is acceptable
under the following conditions:
- it is used only by Brigade members with a minimum of BTS Level 1 certification;
- it is used only with the patient's permission;
- the patient should be asked if they are allergic to Bacitracin or Polymixin B (the two
indgredients of Polysporin®)
- it must not be used on wany wounds that require suturing;
- it must not be used if it is necessary to remove foreign objects or dead tissue from the
wound.
The use of Polysporin® by Briage members is optional, not mandatory.
Brigade members are also cautioned that OTC products may be used only after formal
approval by National Headquarters on a product-by-product basis.
Dr. Marco Terwiel
National Commissioner
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Topic: First aid for a heart attack
Source: Ontario Council, No. 1-97
Rationale: current research has shown that early administration of 160-325mg of
ASA can reduce the effects of a heart attack by as much as 20%.
- when you detect the casualty has chest pain, call 911
- while waiting, assist him/her to most comfortable position
- ask if he/she carries medication (Nitroglycerine)
- if so, place one under tongue, repeat every 5-10min if needed (max. 3 tablets)
- if asprin is available, ask casualty if he is allergic to it
- if not allergic and if chest pain is not relieved still, ask casualty to chew 2 children's tablet (80mg each) or 1 adult dose (325mg)
Do NOT substitute with Tylenol (acetaminophen)
- Monitor A, B, C and provide first aid if needed
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Topic: Fraction traction
Source: Ontario Council, No. 2-97
Rationale: Applying & maintaining traction to fractured bones are difficult skills.
If head & spinal injuries are suspected, traction of the leg bones may allow movement of
head / spine, increasing the danger
- identify leg fractures
- injuries are to be steadied, supported
- if medical help is delayed, splint leg in the position found
- Do not apply traction
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Topic: Knock-out tooth
Source: Ontario Council, No. 4-97
Rationale: Previous protocol of replacing the tooth in the socket may allow swallowing.
Placing it in water has been found to lessen the chances of successful implantation
- consider if the hit to knock out the tooth caused head/spinal injury (treat as so)
- places tooth in small container of milk
- if no milk, either use:
- saline (5mL of salt to 1L of water) or
- plastic wrap containing some of the casualty's saliva
- see dentist immediately
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Topic: Care of a newborn baby
Source: Ontario Council, No. 5-97
Rationale: Previous materials appear to give the impression that the infant is
not to be wrapped in a blanket until the ABC's have been assured
- Note & record the time of birth
- Receive the newborn into a blanket or towel , preferably warmed
- Keep baby on her/his side with head lower than body to clear fluids from the airway
- Wipe the baby's face (nose & mouth) to clear mucus
- If baby does not breathe, stimulate the baby by
- rubbing the back gently or by slapping the soles of the feet
- plastic wrap containing some of the casualty's saliva
- Start AR / CPR if needed
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Topic: Flail chest treatment
Source: Ontario Council, No. 1-96
Rationale: Flail chest casualties have been through a major trauma
Moving him/her may cause broken ribs to puncture lung tissue
- if mechanism of injury leads you to suspect major trauma
- call 911 and treat as suspected head/spinal injuries
- examine chest, hand support over the injury may help breathing
- Do not semi-sit casualty
- Do not apply padding over the area
- Do not wrap bandages around the chest
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Topic: Closed rib cage fracture treatment
Source: Ontario Council, No. 2-96
Rationale: Bandage should not be used around the chest
of casualties with chest injuries-they may compromise breathing
- when casualty complains of difficulty breathing and pain in chest
- call 911
- expose and examine injury
- hand support over the injury may help breathing
- check circulation
- support arm (injured side) with St. John tubular sling
- Do not secure with broad bandages
- semi-sit casualty ( incline toward injured side )
- ongoing casualty care
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Topic: How to relieve pressure of blood from under a pinched nail
Source: Ontario Council, No. 3-96
Rationale: Pain can be relieved easily
- Place the injured part under cool, running water (to reduce pain and swelling)
- Straighten a paper clip and heat one end to red hot on a stove element or on an open flame (ie. lighter)
- Do Not use a needle, it is more likely to damage deeper tissues
- Place the heated end of the paper clip on top of the nail, allow heat to create a hole for the release of the blood
- Once the pressure has been released, wash the area with soap and water and put on an adhesive dressing
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Topic: Brigade may assist patients with the administration of Inhalers, EpiPen or Ana-Kit
Source: Provinicial Commissioner's Directive No. 2-98
- Epinephrine (Ana-Kit / EpiPen) should be included in Mobile First Aid Units labeled "For Administration by a Physician or his/her Designate"
- first aiders may assist with the administration
- please refer to the St. John Ambulance "First on the Scene" Manual - 1st Edition, 1995
- Pages: 4-38 to 4-41
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Topic: Asprin usage in Heart Attacks - clarification
Source: Ontario Council
- when you detect the casualty has chest pain (radiating, crushing), call 911
- while waiting, assist him/her to most comfortable position
- ask if he/she carries medication (Nitroglycerine)
- if so, check 5 rights, then place ONE pill under tongue
- if after 5 minutes, still no relief of pain, suggest casualty to chew 2 children asprins or 1 adult aspirin
- also, allow casulaty to take 2nd nitroglycerine (under the tongue)
- if after 5 minutes, still no relief, allow 3rd nitroglycerine
- if after 5 minutes, still no relief, the casualty is most likely in heart attack stage
- first aiders should prepare in case CPR is needed
