First Aid Techniques for Falls

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 EMS, 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 (fill) the towel and report this to a supervisor and/or EMS.
• 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.

 First Aid Techniques for Bruises

A bruise forms when blood vessels below the skin’s surface break and blood leaks into the tissue beneath the skin. Bruises can range from very small to quite large, covering large areas of the body.

Remember the acronym RICE when treating bruises.

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.

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.

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 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.

 First Aid Techniques for 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.
• When the wound has stopped bleeding, dress the area with a clean bandage. Document all injuries and steps taken to provide care.

 First Aid Techniques for 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 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.

First Aid Techniques for Burns

 The treatment of burns depends on the type of burn.

Treating Minor Burns:

• The first step in providing first aid to a patient who has suffered a burn is to remove them from the source of the heat.
• For first and second degree burns that are limited to a small area, apply a clean, cool towel or cloth to the area of the burn for about 15 minutes to help decrease pain.
• Do not use ice as this could result in frostbite.
• Once the pain from the burn has subsided, allow the area to dry for a few minutes, and then apply a clean, dry sterile piece of gauze to the area. Tape the edges down.
• Never apply ointments or grease to the area of the burn. Do not use margarine, butter, or oil on the burn.
• A supervisor should be informed and the patient should be examined with further treatment provided if necessary.
• While the burn is healing over the next few days, keep the area clean and dry. Apply clean dressings to the area as directed by the Care Plan.
• If blisters form, do not break them. Allow blisters to heal naturally. Until the skin is healed, avoid using lotion, soaps, and perfumes directly on the area.

 Treating Third Degree or Large Burns:

• For third degree burns, remove the person from the heat source.
• Ensure that their airway is kept open and they continue to breathe.
• If they stop breathing, or they can no longer feel a pulse, Home Health Aides/Personal Care Aides should perform CPR immediately if they are trained in CPR.
• Stay with the patient at all times.
• Keep the patient calm and call 911 immediately.
• Do not remove clothing that is stuck on the person as you risk tearing skin off with the clothing.
• Keep the area of the burn clean. Cover it with a clean bandage or sheet until help arrives.
• Do not put pressure on the burn and do not rub it.
• To prevent shock if a serious burn has occurred, keep the person warm and lie them flat.
• If they have not suffered from a head, neck, or back injury, elevate their feet and stay with them until help arrives.
• Do not immerse the person in water as this could cause the person to go into shock.

Treating Chemical Burns:

• If a patient is exposed to a chemical, remove the chemical from their skin immediately. Activate EMS by calling 911.
• Flush their skin with cool water for 20 minutes.
• If their clothing has come into contact with the chemical, remove the affected clothing.

Treating Electrical Burns:

In the case of electrical burns, special precautions must be made.

• NEVER touch a person who has been electrocuted with bare hands.
• 911 should be called immediately.
• The appliance should be unplugged if it can be done safely.
• Do not use anything metal or wet to remove the electrical source.
• If possible, switch off the main power supply.
• If the appliance is standing in water, do NOT touch it.
• Never stand in any water, even if it is a small puddle, while touching an electrical appliance.

Remember, Home Health Aides/Personal Care Aides should report ANY burn to their supervisor. The patient needs to be examined and further treatment provided. Always call 911 for any serious burn, for any burn that occurs on a large area of the body, on the head, neck, hands, feet, face, genitals, for burns that occur on more than one part of the body, if smoke has been inhaled, if the person is having trouble breathing after a burn, or if an infant, child, or a very elderly person has suffered from a burn. Home Health Aides/Personal Care Aides should also call for help if the burn was caused by chemicals or electricity. Document all injuries and steps taken to provide care.