First Aid Training

Introduction

Your duty as a Flight Attendant is to offer immediate and temporary care to a customer of an accident or sudden illness until professional care can be obtained. It is given in order to prevent death or further injury, to relieve pain, and to counteract shock. It may mean the difference between life and death, or temporary and permanent disability. It includes well selected words of encouragement, evidence of willingness to help, and promotion of confidence by demonstration of competence.

BASIC RULES FOR ADMINISTERING FIRST AID INFLIGHT

Listed below are six basic rules for administering first aid inflight. They are applied in all first aid situations.

Keep calm and determine the injuries or sudden cause of illness.
Find out exactly what happened. Information may be obtained from the customer, friends, family or witnesses.
Put on latex gloves before administering first aid, particularly when treating an open wound. Gloves are available in the CPR bags, Vital 1 and one box is attached to each First Aid Kit.
Check for an emergency medical alert emblem or other identification, such as a card, bracelet or necklace to provide information on the customer’s condition (have a witness when searching for identification).
If customer’s condition appears serious, do not hesitate to use the P.A. and request medical assistance from a doctor that may be on board. Credentials should always be checked before relinquishing your duties.
Treat injuries in order of their importance.
Act quickly and deal with the urgent conditions first.

Breathing
Bleeding
Broken bones
Burns
Loosen tight clothing around neck and waist.
Reassure customer by telling him what you are doing and what it will do for him.
Do not give liquids to an unconscious customer.
Maintain communication with flightdeck.
Once emergency measures have been taken to ensure the customer’s safety, at least one Flight Attendant continues first aid treatment while another Flight Attendant relays all pertinent information to the captain.

The Captain will determine if an unscheduled landing is necessary, based on your assessment of the situation. Whenever an ambulance has been summoned by the Captain, request that all customers remain seated until the customer has been deplaned. (Any costs incurred will be the customers responsibility).

Treat for shock.
Conserve body temperature, but do not overheat.
Make customer as comfortable as possible, keep him quiet and encourage him to rest.
Stay with the customer.
Remain in charge until customer can be turned over to qualified medical personnel, family, or until the customer can take care of himself.
Do not move the customer unless it is necessary for safety reasons.
No medication of any type including aspirin and dramamine is to be administered to an unaccompanied minor.
ADMINISTERING FIRST AID DURING LANDING

If a life-threatening situation occurs during a routine landing, the Flight Attendant may be called on to administer first aid. In this event the Flight Attendant would not be able to occupy the assigned jumpseat and an able-bodied assistant (ABA) would need to be briefed, time permitting. If deadheading or non-reving crewmember is available, use them as a first choice. A flight attendant training program has all these kind of emergency training incorporates.

When supplemental oxygen is needed during flight and entails use during a routine landing, the P.O.B. should be added with pillows and blankets, placed next to the customer and both P.O.B. and victim secured for landing.

In the event of a planned emergency landing during the above situation, it would be necessary for the Flight Attendant to occupy the jumpseat. Medical emergency customers would have to be secured for landing.

APPARENT DEATH INFLIGHT

As a Flight Attendant, if a customer fails to respond to first aid treatment:

Initiate CPR and continue through landing until relieved by qualified medical personnel.

Never consider a customer deceased unless pronounced so by medical authorities. Maintain communication with flightdeck.

After landing, you may be requested to either dictate or write a statement about the incident for local officials.

Stand by with customers until released by officials, Captain, and/or airline officials.

A Flight Attendant Report of Irregularity must be completed.

RULES FOR ADMINISTERING MEDICATION

A Flight Attendant may offer only those medications provided in the First Aid Kits and Flight Attendant Pouch.

No medication will be administered directly to a customer by a Flight Attendant. If a customer asks for help taking his own medication or medications provided from the First Aid Kit or Flight Attendant Pouch, provide water, napkin, or any other convenience, but tactfully ask him to take the medicine himself.

When offering medication from the Flight Attendant Pouch, always tell the customer the name of the medication so that he can determine if it is acceptable.

Do not assist with administering medication that is not properly labeled.

Do not administer hypodermic injections. Do not fill syringe.

Do not store medication for a customer. If a customer advises that he is carrying medication that must be refrigerated, place ice along with medication in a clean airsick bag and leave with the customer at his seat.

Other than minor instances, maintain communication with the flightdeck and report anytime equipment is used.

Flight Attendant Report of Irregularity for minor instances should be filled out at the Flight Attendant’s discretion.

CONTENTS OF Flight Attendant REPORT OF IRREGULARITY-MEDICAL

Anytime first aid is administered inflight, a Flight Attendant Report of Irregularity must be completed.

Always obtain the following information:

Customers full name, address and phone number.
Names, addresses, phone numbers and statements of several witnesses – at least three (3) if possible.
Medical History – Always obtain as much information as possible.
What Is the problem? (i.e., passed out, shortness of breath, chest pain, abdominal pain, complete arrest)
Time problem was first noted. If prior to flight, indicate hours, days, weeks etc.
Has this ever happened before? If so, when and where? Also note number of seizures or attacks and duration of such. If oxygen is administered, note the length of time on oxygen.
Is the customer under care for an illness at this time? If so, when and where?
Is the customer under a physician’s care at this time? If so, obtain physician’s name, address, and phone number.
Is the customer currently on medication? If so, obtain name of medication.
Explain treatment given.
Customer’s response to treatment, including remarks.
Should medical attention be requested, the preceding information will help the Captain with ground communication.
FIRST AID EQUIPMENT

Flight Attendant POUCH

The Flight Attendant Pouch contains various items for first aid. It is available for daily use as required. First aid items in this pouch should be used instead of the sealed First Aid Kit unless a situation occurs requiring additional items.

Contents of the Flight Attendant Pouch:

Non-Aspirin
Aspirin
Alka-Seltzer
Adhesive Bandages (Band-Aids)
Dramamine
Antacid Tablets
Ammonia Inhalants
Merthiolate swabs/Iodine Wipes
Triple Antibiotic
Be aware that often times product names may vary in the pouch; however, the product types remain consistent.

The Flight Attendant Pouch is located in the AFT most right Over Head Bin.

FIRST AID KIT (FAK)

The sealed First Aid Kit aboard each aircraft is to be used in a situation requiring items not available in the Flight Attendant Pouch. When this occurs, it will be noted on the Flight Attendant Report of Irregularity. Each kit will be sealed with either a leaded wire seal and/or tape seal.

Contents of the First Aid Kit:

Adhesive bandage compresses, 1 inch (16)
Antiseptic swabs (20)
Ammonia inhalants (10)
4″ Compress bandages (8)
Triangular bandages compresses, 40 inch (5)
Arm splint, noninflatable (1)
Leg splint, noninflatable (1)
Roller bandage, 4 inch (4)
Adhesive tape, 1 inch standard roll (2)
Bandage scissors (1)
Maintenance has made available to all stations a First Aid Kit for replenishing a used kit which contains one of everything that is in a First Aid Kit. Should an inflight situation arise where the First Aid Kit must be opened and used, the next station should be able to replenish the kit. The Captain should be notified prior to landing as to the contents needing to be replenished. The flightdeck crew will verify the kit.

Upon arrival at a maintenance base, the First Aid Kit shall be inventoried and sealed or replaced with a serviceable kit prior to the next flight.

LATEX GLOVES To be used as necessary when administering or giving first aid treatment, especially when you might possibly come into contact with any bodily fluids. One box is attached to each First Aid Kit. The box contains 100 sets of gloves.

EMERGENCY MEDICAL KIT (EMK)

All aircraft are equipped with one Emergency Medical Kit. This kit is to be used by or under supervision of a licensed MD or DO physician only, (Medical Doctor or Doctor of Osteopathic Medicine). Credentials must be checked prior to opening the kit.

Unauthorized opening of the kit by an airline employee may subject such employee to disciplinary action, up to and including termination.

The Emergency Medical kit is located on the flightdeck and contains no narcotics. Contents of the Emergency Medical Kit:

Sphygmomanometer (1)
Stethoscope (1)
Airways, oropharyngeal (3 sizes) (3)
Syringes (4)
Needles (6)
50% Dextrose injection 50cc (1)
Epinephrine 1:1000 (2)
Diphenhydramine HC1 injection (2)
Nitroglycerin tablets (10)
Protective latex gloves (1)
Basic Instructions (1)
The Emergency Medical Kit contains one of certain items (i.e., Blood Pressure Cuff), but contains twice the amount of medication that is called for in the F.A.R.’s, and in most cases, should an emergency arise and medication be used, the kit will still meet minimum requirements. All flight attendant training programs teach the usage of this emergency medical kit.

Included in each kit is at least two copies of the Use of Airline Emergency Medical Kit form. The attending physician must fill out this form. Make sure the physician signs and prints his/her signature and title and gives their license number. This form should be attached to the Flight Attendant Report of Irregularly and turned into a Supervisor.

Listed on the inside lid are the quantities of medication and the F.A.R. quantities required, which can be verified by the MD or DO and final verification from the flightdeck.

BIOHAZARD KIT These kits are disposable and at the Flight Attendant’s request will be replaced by Provisioning when used. They are located in the aft closet of the aircraft on the upper shell. Use these to clean up after any incident involving bodily fluids.

Contents of the BioHazard Kit:

BioHazard chlorinated absorbent beads
A pair of gloves
Surface disinfectant
Small scoop shovel
Hand cleaning towelettes
Bags for disposal
EIGHT (8) STEP PROCEDURE

Put on disposable gloves immediately. (Gloves are primarily used to protect personnel from body substances that contain virulent microorganisms.)
Completely cover the spill with the BioHazard Absorbent Beads from the white pouch. In emergency clean-up, this compound instantly deodorized and binds vomit, urine, feces, blood and other body substances. BioHazard Absorbent Beads contains stabilized chlorine.
When a semi-solid forms, use the pick-up shovel to place the congealed fluid back into the white bag.
Seal the white bag tightly by using ties provided.
Apply the ready to use germicidal towelette to the contaminated area and wipe.
Dispose of all materials (used germicidal towelette, white bag) shovel, packet, wiping cloth and gloves) in the red plastic bag and secure with tie.
Discard red bag in trash can.
Wash hands thoroughly with soap and water and wipe hands with antiseptic handwipe towelette which provides rapid bactericidal action and has a persistent antimicrobial effect against a wide range of microorganisms. Allow to air dry.

ILLNESS AND INJURY

ABDOMINAL PAIN

GAS EXPANSION

Cause:

Gas is being trapped in GI track; caused by the expansion of gas within the digestive tract as the body adjusts to pressurization of the aircraft.
Symptoms:

Pain in lower abdomen
First Aid:

Do not try to hold; expel the gas.
GAS PAINS

Symptoms:

Gas pains are a common occurrence and may be recognized by intermittent pain. Indications of serious illness or disease:
Pain is persistent or severe and may be local (confined to a small area) or diffuse (widespread)
Tenderness which may be local or diffuse
Rapid pulse
Nausea and vomiting
First Aid:

Communicate:

Time of onset of pain
Location of pain
Nature of pain
Give nothing by mouth other than crushed ice if symptoms appear severe.

If severe pain persists, if possible the Captain may descend to a lower altitude. Pain could be caused by trapped gas at high attitudes.

GAS BUBBLE FORMATION (EVOLVED GAS)

This phenomenon is best equated with the bubbles in carbonated beverages. Under pressure the gases are in a solution and are not visible; however, when pressure is decreased (such as in removing the cap from a bottle), the gases escape and form bubbles. In the case of the human body, these bubbles form in the blood and certain tissues causing pain. Fatty tissue contains more nitrogen than other tissue thus making an overweight person more susceptible to the effects of evolved gas sickness.

Consider the effects of evolved gas as they relate to the particular areas of the body which are most commonly affected.

The bends –

Common to divers, have many of the same characteristics. The bends are characterized by pain in and about the joints, and may be mild at the onset. Nitrogen gases in the blood gather to form bubbles which generally settle in the area of the joints.

Symptoms:

Oxygen and nitrogen get into the blood stream causing inflammation of the joints
Extreme pain in and around joint
First Aid:

Must have oxygen
Must get to a lower altitude
ALZHEIMER’S DISEASE

Cause:

Alzheimer’s disease is the progressive, not acute, loss of many mental abilities. The losses are irreversible. Alzheimer’s disease can strike people age 40 and older.

Symptoms:

Forgetful
Confused about the time, the year, and their location
Restless
Personality and/or mood changes
Difficulty finding words
Irritable and suspicious
First Aid:

Be calm and patient.
Give the person your full attention.
Make the person aware of who you are.
Ask the person to give you some identification.
Repeat questions the same way each time you ask them.
Distract the person, or change the subject, if the situation is becoming difficult.
Avoid a confrontation.
Remember that the person with Alzheimer’s disease cannot help his or her behavior. It is a neurological disease that is difficult for all involved.

AIRSICKNESS

Symptoms:

Headache
Pale
Warm, perspiration
Weak and dizzy
Apprehensive and restless
Nausea and vomiting
Sense of motion or floating
Prevention:

Seat victim near front of cabin.
Have victim look at ceiling; this breaks the sensation of movement. Open air vents. Place cold, damp towels on forehead, wrists and back of neck. Dramamine may be given with a small amount of water every four (4) hours.
Dosage:

Adult-l tablet
Children (6-12 years) – 1/2 tablet
Children (under 6 years)- NONE

First Aid:

Offer airsick bag, Kleenex and cold towels.
Loosen tight clothing.
If victim wants medical attention, advise the Captain.
Crushed ice, carbonated beverages, or club soda with a squeeze of lime is helpful.
Use BioHazard Kit as necessary

ILLNESS AND INJURY

ABDOMINAL PAIN

GAS EXPANSION

Cause:

Gas is being trapped in GI track; caused by the expansion of gas within the digestive tract as the body adjusts to pressurization of the aircraft.
Symptoms:

Pain in lower abdomen
First Aid:

Do not try to hold; expel the gas.
GAS PAINS

Symptoms:

Gas pains are a common occurrence and may be recognized by intermittent pain. Indications of serious illness or disease:
Pain is persistent or severe and may be local (confined to a small area) or diffuse (widespread)
Tenderness which may be local or diffuse
Rapid pulse
Nausea and vomiting
First Aid:

Communicate:

Time of onset of pain
Location of pain
Nature of pain
Give nothing by mouth other than crushed ice if symptoms appear severe.

If severe pain persists, if possible the Captain may descend to a lower altitude. Pain could be caused by trapped gas at high attitudes.

GAS BUBBLE FORMATION (EVOLVED GAS)

This phenomenon is best equated with the bubbles in carbonated beverages. Under pressure the gases are in a solution and are not visible; however, when pressure is decreased (such as in removing the cap from a bottle), the gases escape and form bubbles. In the case of the human body, these bubbles form in the blood and certain tissues causing pain. Fatty tissue contains more nitrogen than other tissue thus making an overweight person more susceptible to the effects of evolved gas sickness.

Consider the effects of evolved gas as they relate to the particular areas of the body which are most commonly affected.

The bends –

Common to divers, have many of the same characteristics. The bends are characterized by pain in and about the joints, and may be mild at the onset. Nitrogen gases in the blood gather to form bubbles which generally settle in the area of the joints.

Symptoms:

Oxygen and nitrogen get into the blood stream causing inflammation of the joints
Extreme pain in and around joint
First Aid:

Must have oxygen
Must get to a lower altitude
ALZHEIMER’S DISEASE

Cause:

Alzheimer’s disease is the progressive, not acute, loss of many mental abilities. The losses are irreversible. Alzheimer’s disease can strike people age 40 and older.

Symptoms:

Forgetful
Confused about the time, the year, and their location
Restless
Personality and/or mood changes
Difficulty finding words
Irritable and suspicious
First Aid:

Be calm and patient.
Give the person your full attention.
Make the person aware of who you are.
Ask the person to give you some identification.
Repeat questions the same way each time you ask them.
Distract the person, or change the subject, if the situation is becoming difficult.
Avoid a confrontation.
Remember that the person with Alzheimer’s disease cannot help his or her behavior. It is a neurological disease that is difficult for all involved.

AIRSICKNESS

Symptoms:

Headache
Pale
Warm, perspiration
Weak and dizzy
Apprehensive and restless
Nausea and vomiting
Sense of motion or floating
Prevention:

Seat victim near front of cabin.
Have victim look at ceiling; this breaks the sensation of movement. Open air vents. Place cold, damp towels on forehead, wrists and back of neck. Dramamine may be given with a small amount of water every four (4) hours.
Dosage:

Adult-l tablet
Children (6-12 years) – 1/2 tablet
Children (under 6 years)- NONE
First Aid:

Offer airsick bag, Kleenex and cold towels.
Loosen tight clothing.
If victim wants medical attention, advise the Captain.
Crushed ice, carbonated beverages, or club soda with a squeeze of lime is helpful.
Use BioHazard Kit as necessary

ILLNESS AND INJURY

ABDOMINAL PAIN

GAS EXPANSION

Cause:

Gas is being trapped in GI track; caused by the expansion of gas within the digestive tract as the body adjusts to pressurization of the aircraft.
Symptoms:

Pain in lower abdomen
First Aid:

Do not try to hold; expel the gas.
GAS PAINS

Symptoms:

Gas pains are a common occurrence and may be recognized by intermittent pain. Indications of serious illness or disease:
Pain is persistent or severe and may be local (confined to a small area) or diffuse (widespread)
Tenderness which may be local or diffuse
Rapid pulse
Nausea and vomiting
First Aid:

Communicate:

Time of onset of pain
Location of pain
Nature of pain
Give nothing by mouth other than crushed ice if symptoms appear severe.

If severe pain persists, if possible the Captain may descend to a lower altitude. Pain could be caused by trapped gas at high attitudes.

GAS BUBBLE FORMATION (EVOLVED GAS)

This phenomenon is best equated with the bubbles in carbonated beverages. Under pressure the gases are in a solution and are not visible; however, when pressure is decreased (such as in removing the cap from a bottle), the gases escape and form bubbles. In the case of the human body, these bubbles form in the blood and certain tissues causing pain. Fatty tissue contains more nitrogen than other tissue thus making an overweight person more susceptible to the effects of evolved gas sickness.

Consider the effects of evolved gas as they relate to the particular areas of the body which are most commonly affected.

The bends –

Common to divers, have many of the same characteristics. The bends are characterized by pain in and about the joints, and may be mild at the onset. Nitrogen gases in the blood gather to form bubbles which generally settle in the area of the joints.

Symptoms:

Oxygen and nitrogen get into the blood stream causing inflammation of the joints
Extreme pain in and around joint
First Aid:

Must have oxygen
Must get to a lower altitude
ALZHEIMER’S DISEASE

Cause:

Alzheimer’s disease is the progressive, not acute, loss of many mental abilities. The losses are irreversible. Alzheimer’s disease can strike people age 40 and older.

Symptoms:

Forgetful
Confused about the time, the year, and their location
Restless
Personality and/or mood changes
Difficulty finding words
Irritable and suspicious
First Aid:

Be calm and patient.
Give the person your full attention.
Make the person aware of who you are.
Ask the person to give you some identification.
Repeat questions the same way each time you ask them.
Distract the person, or change the subject, if the situation is becoming difficult.
Avoid a confrontation.
Remember that the person with Alzheimer’s disease cannot help his or her behavior. It is a neurological disease that is difficult for all involved.

AIRSICKNESS

Symptoms:

Headache
Pale
Warm, perspiration
Weak and dizzy
Apprehensive and restless
Nausea and vomiting
Sense of motion or floating
Prevention:

Seat victim near front of cabin.
Have victim look at ceiling; this breaks the sensation of movement. Open air vents. Place cold, damp towels on forehead, wrists and back of neck. Dramamine may be given with a small amount of water every four (4) hours.
Dosage:

Adult-l tablet
Children (6-12 years) – 1/2 tablet
Children (under 6 years)- NONE
First Aid:

Offer airsick bag, Kleenex and cold towels.
Loosen tight clothing.
If victim wants medical attention, advise the Captain.
Crushed ice, carbonated beverages, or club soda with a squeeze of lime is helpful.
Use BioHazard Kit as necessary

ALCOHOL INTOXICATION

Symptoms:

The odor of alcohol on breath
Warm feeling
Stupor condition, incoherent, uncoordinated
In early stages, breathing is slow and deep, pulse is strong, and face is moist and flushed
In later stages, breathing is shallow, pulse becomes weak and rapid, and face becomes dry and pale
Extreme cases manifested by hallucinations, delirium tremors (D.T.’ s), partial or compete unconsciousness, and may experience bleeding from the mouth
First Aid:

Maintain open airway.
Administer oxygen if victim is pale.
Allow victim to sleep.
NOTE: Alcoholism often masks the symptoms of injury, illness, diabetic coma or shock, as they all produce symptoms that resemble acute alcohol intoxication. Check victim in the presence of a witness for medic alert emblem/card and follow the directions given.
ASTHMA

Cause:

Asthma is a multi-factional disease which may be triggered by allergy, exercise, cold air, smoke or infection.
Symptoms:

Severe shortness of breath, wheezing, coughing, difficulty in breathing
Victim is usually anxious and is afraid he is suffocating. This tends to prolong the attack.
First Aid:

Victim usually has had attacks before and carrys his own medication with him. Assist victim in taking his medication.
Administer low flow of oxygen.
EXTERNAL BLEEDING

Dangers:

The two main dangers in any wound are bleeding and infection.
Types of Bleeding:

Arterial bleeding will be bright red and will flow in spurts.
Vein bleeding will be dark red and will flow in a steady stream under much lower pressure than arterial bleeding.
Ways to Control Bleeding:

Direct Pressure – taught in an actual scenario in any flight attendant training course
Direct pressure in conjunction with elevation of the limb is the quickest and most efficient means of controlling external bleeding. It prevents loss of blood without interfering with blood circulation.
Put on latex gloves.
Press a sterile pad of gauze directly over the wound.
Apply pressure with your hand to slow and stop bleeding.
After the bleeding has been controlled, apply additional layers of cloth to form a good-sized covering and then bandage snugly.
If blood saturates the entire compress, do not remove it; add more layers of gauze and continue direct hand pressure even more firmly.
Elevation of Limb:

Elevation is used to reduce the blood pressure in the injured area and thus aid in slowing down the loss of blood. Therefore, unless there is evidence of a fracture or possible spinal injuries, a severely bleeding wound on the head, neck, arm or leg should be elevated. To elevate you should:
Put on latex gloves
Raise the affected area above the level of victim’s head
Continue direct pressure.
Digital Pressure:

If direct pressure and elevation do not stop bleeding, digital pressure can be applied to the pressure points.
Main pressure points are:

Arm – Brachial artery located midway on the inside of the upper arm. The pressure point is about half-way between the armpit and the elbow, in the groove between the muscles.

To use this pressure point, continue to use direct pressure and elevation. Reach in from behind the arm and place the flat part of your fingers over the pressure point. Press in hard and pull back toward the bone.

Leg – Femoral artery-located on the crease between the body and the leg, where the femoral artery crosses over the pelvic bone on the front of the body. To use the leg pressure point, lean forward and push hard with the heel of your hand into the femoral area.

Nosebleeds:

May occur spontaneously, or as a result of an injury, lack of humidity, or exposure to high altitude, especially in the young.

First Aid:

Put on latex gloves.
Keep quiet and in a sitting position.
Apply direct pressure by pinching nostrils for several minutes.
Apply direct pressure immediately under nose.
Apply cold, wet compresses over bridge of nose.
Instruct victim to breathe through his mouth.
Don’t blow nose.
If an unaccompanied minor has a nosebleed, the party meeting the child should be notified and a Flight Attendant Report of Irregularity should be completed.
BROKEN BONES OR FRACTURES

Types of Fractures:

Simple – One in which the bone is broken but doesn’t protrude and break through the skin. (Improper handling of a simple fracture may cause a compound fracture). Hence one should understand the intricacies of a flight attendant job.

Compound – One in which the bone is broken and does protrude and break through the skin. This type of fracture is more dangerous due to the chance of infection and bleeding.

Simple Fracture

First Aid:

Put on latex gloves
Use blankets, pillows, sprints, or slings to immobilize the injured area. Elevate if possible.
For added support, carefully wrap pillow around fractured area and immobilize joints above and below.
Secure with gauze.
Compound Fracture

First Aid:

Put on latex gloves
Use blankets, pillows, sprints, or slings to immobilize the injured area, if possible. Cover lightly with gauze or compress bandage.
Carefully elevate if possible to help control bleeding.
Treat for shock.
Never apply a splint or sling too tight on either simple or compound fractures as circulation may be impaired.
Strains and Sprains

A strain is an injury to muscle, either torn or stretched. A sprain is an injury to soft tissue around a joint; swelling and pain will occur.

First Aid:

The correct first-aid treatment for all new injures is always ice and cold therapy for the first 24 to 48 hours.
Apply cold compresses or ice-filled bag for 20 minutes every hour.
Give asprin or non-aspirin.
Elevate if possible.
When in doubt, always treat as a fracture.

BURNS

TYPES OF BURNS:

First Degree

Skin is reddened. Do NOT apply ointment, unless customer insists.

Second Degree

Skin is blistered. Do NOT apply ointment.

Third Degree

Skin is black and charred. Do NOT remove clothing that might be stuck to the burn, and do NOT apply ointment.

FIRST AID:

Put on latex gloves.
Apply cool water to all types of heat burns. Do not apply ice directly to any burn. Cover burn lightly with a sterile compress bandage to keep air out. Treat for shock as necessary.
Electrical Burn

First Aid:

Shut off current.
If not breathing, notify Flight Attendant to bring CPR masks, POB, gloves and begin Rescue Breathing. Continue Rescue Breathing until relieved by qualified medical personnel.
Treat external burns same as heat burns.
Ammonia inhalants are helpful to maintain consciousness.
Chemical Burn

First Aid:

Put on latex gloves.
Remove all of the chemical by washing burned area carefully with volumes of cool water.
After chemical has been removed, treat as a heat burn.
Eye Burn

First Aid:

Put on latex gloves.
Wash with water. Water may be poured into the inner side and allowed to run out over outer part of eye. If burn is due to a chemical, more copious washing is necessary.
Cover eye with a compress bandage.
CHILDBIRTH

Procedure

Put on latex gloves and place mother on blankets in galley area.
Page for MD or DO, a nurse or paramedic would be acceptable in this circumstance. Instruct the mother to lie flat on her back with legs apart.
Encourage mother to grunt and groan.
Give her something to grab on to.
When labor pains are two minutes apart – watch out – here comes the baby.
When water bag breaks, the baby is just about due.
Normal birth, head first – encourage mother to strain with you.
After baby has been delivered, lay it on the mothers stomach.
Be sure to keep mother and baby warm. It is most important to keep baby warm by covering with clean shirt or other clean material. A blanket may be used if necessary, but not recommended because of its wool content and flame retardant chemicals.
Do not move mother or baby.
Keep her quiet and reassure her.
Assess and monitor infant for pulse and breathing.
You may need to clean the baby’s airway by using sterile bandages found in the First Aid Kit.
If ground help is delayed, the umbilical cord may be cut. Clamp the cord 10 Inches, then 7 inches from the baby (only after the cord has stopped pulsating). Cut between the clamps. While cutting, keep the baby at the level of the placenta to prevent complications.
What NOT to do:

DO NOT hurry.
DO NOT pull on the baby; let the baby be born naturally.
DO NOT pull on the cord; let placenta (afterbirth) come naturally.
DO NOT tie the cord.
DO NOT cut the cord if ground help is available within 20 minutes.
DO NOT give medication.
DO NOT HURRY-LET NATURE TAKE HER COURSE.
Remember, the person attending the delivery should wear latex gloves and thoroughly scrub hands with soap and water after removal of gloves.
Miscarriage:

Have mother rest at seat.
Elevate legs.
Administer 02,
Get medical attention as soon as possible.
All aircrew are trained to handle such situation during their flight attendant training program.

DIABETES

Insulin Shock

The diabetic who has taken too much insulin, has eaten too little sugar, or has overexerted himself may go into insulin shock. Insulin shock, unlike diabetic coma, comes on suddenly.

Symptoms:

Ashy, white face
Moist clammy skin
Usually perspires a great deal
May become unconscious, dizzy, or go into convulsions
Breath may have an odor of alcohol
Rapid, pounding pulse
May complain of being very hungry
First Aid:

Needs sugar desperately.
If still conscious, give orange juice with sugar, teaspoon of sugar, or sips of sugar and water solution.
If unconscious, place teaspoon of moistened sugar under the tongue. It will be absorbed into the bloodstream.
Recovery will usually be rapid.

Diabetic Coma

May be caused by taking insufficient insulin or eating too much sugar for the amount of insulin being taken. Can be a gradual event, taking several days to develop.

Symptoms:

Flushed face
Bright red lips
Becomes sleepy
May become unconscious
Breathes in gasps
Breath has fruity odor
Rapid, weak pulse
First Aid:

Needs insulin desperately.
If insulin is available, and victim is still conscious, have him administer the insulin to himself.
If victim is unconscious, get medical attention immediately.
Remember, diabetics are supposed to carry an I.D. card or tag to identify them as such. If you are in doubt as to whether or not the victim is a diabetic, look for this information in the presence of witness(es).

If there is question of diabetic coma or insulin shock, administer sugar! If sugar is given for diabetic coma, there is little risk of seriously worsening the condition.

Convulsions occur quite often with diabetics. If the diabetic person becomes unconscious, lie the person on the floor or seat, on their side with their head turned toward the floor so that any secretions will drain from the mouth, to prevent stoppage of breathing and to keep the airway open.

YOU ARE NEVER TO ADMINISTER A HYPODERMIC INJECTION TO A CUSTOMER, DIABETIC OR OTHERWISE.

EAR DISTRESS

Whenever you have to clear your ears, remember that your customers should be doing the same thing. People unaccustomed to air travel may not be familiar with the necessary precautions.

Infants

Advise mothers to give infant a bottle or use a pacifier on ascent and descent so infant’s ears will clear and not hurt.

Sleeping Customers

Be sure to awaken customers when the plane begins to descend for landing.

First Aid:

Continued jaw thrusting until ears pop
Yawning
Swallowing (provide beverage)
Afrin or other nasal spray.
Ammonia inhaling (especially for customers with head colds or sinus problems).
Valsalva method – Hold nostrils to form a airtight seal. Slowly and gently build up pressure in your nose as though you were blowing up a balloon. Use no more pressure than can fill your cheeks. This procedure is not recommended for anyone with a cold.
Chewing gum
In case of severe pain, suggest:

May give aspirin for pain (Adults only, do not give aspirin to children).
That the victim deplane; he runs the risk of a rupture.
Suggest that he consult a physician.
Indication of a rupture:

Sudden cessation of pain.
Bloody discharge; wipe from outer ear only.
EMOTIONAL PROBLEMS

Symptoms:

Apathy
Blank expression
Crying
Nervous laughter
Moodiness
Irritability
Untidiness
Avoiding crowds
Overconfidence
First Aid:

Stay calm – notify Captain.
Be confident in your ability to handle the situation.
Use authority. Authority creates a feeling of security in people.
If bordering on hysterics, give maximum of four aspirin tablets and try to get victim to lie down and sleep.
Divert victim’s attention away from anything that might be harmful to him or others.
Restrain physically only if victim seems likely to injure himself or others.
What not to do:

DO NOT scold or talk harshly unless necessary.
DO NOT give alcohol.
DO NOT slap or strike.
EPILEPTIC SEIZURE

Causes:

Epilepsy is a disorder that involves the nervous system, spinal column, and brain. It is characterized by severe and involuntary spasms.

Types of Epileptic Seizures:

PETIT MAL- A slight lapse of awareness.

GRAN MAL- A major seizure in which victim loses consciousness and experiences convulsive movements of the body.

Symptoms of Gran Mal Seizure:

Victim may have premonition or give a warning cry.
If sitting, victim will slump; If standing, victim will fall.
The face and lips will be discolored (blue or ashen gray).
The eyes will roll upward.
Victim may make some unintelligible sounds.
Violent involuntary muscle contractions over part or all of body.
Arms, legs, and head may jerk violently.
There may be frothing at the mouth. Victim may bite his tongue.
The face may be contorted.
Victim may lose consciousness.
Occasionally there is involuntary action of bowels and bladder.
NOTE: Usually after about two minutes, the discoloration and convulsive seizure will pass. There may be a gradual return of consciousness, but victim will not remember anything about the seizure. If there is a lengthy Gran Mal seizure (over 2 minutes in duration), and the customer’s coloration continually remains blue when monitored, it may be necessary to administer oxygen, as brain damage may result if the person is not breathing adequately.
First Aid:

Put on latex gloves.
If possible, prevent the fall.
Make no effort to restrain the convulsive movements, but guide movements. Prevent injury to the victim by surrounding with padding (pillows, blankets, etc.) If attack occurs at seat, stand beside or behind seat to insure that victim does not fall on the floor.
When the convulsion is over, loosen tight clothing and turn victims head to the side so that any secretions will drain from the mouth.
Victim may be disoriented when coming out of seizure.
Place the victim in a comfortable position and allow to sleep. Cover with a blanket. Give no stimulants or alcohol.
Try in all ways to guard victim against embarrassment.
Administer 02,
Watch victim carefully for at least 30 minutes, as additional seizures are a possibility.
Remind victim to take his meditation.
Notify Captain.
Request medical attention only if necessary.

HEART ATTACK

Disease of the heart and blood vessels. Many symptoms may be associated with a heart attack, and prompt medical attention may make the difference in damage to the heart muscle. All aircrew are trained to handle such situation during their flight attendant training program.

Symptoms:

Dull aching chest pain
Tightness in the chest
Squeezing type chest pain
Heavy feeling on the chest
Aching in the shoulder, neck, arms or jaw
Nausea and/or vomiting
Shortness of breath
Weakness and profuse sweating
Indigestion
First Aid:

Ask victim if he has medication and assist him in taking it. Heart patient should have nitroglycerin pills, a nitroglycerin patch, or nitroglycerin spray. The pills are to be placed under the tongue. The patch should be placed on a hairless part of the upper body. The spray should also go under the tongue.
Reassure him and don’t mention the words “heart attack”.
Administer oxygen.
Loosen tight clothing.
Get medical attention as soon as possible.
Note time and length of attack and time between attacks if more than one.
If breathing stops, begin Rescue Breathing.
If breathing and pulse stop, begin CPR.
HEAT EXHAUSTION

Not a life threatening situation, but if not treated will lead to a heat stroke.

Symptoms:

Usually perspires a great deal
Moist, clammy skin, usually pale
Pupils dilated
Normal or subnormal temperature
Weak, dizzy or faint
Headache
No appetite, nausea
First Aid

Give sips of liquids containing high salt content, (i.e, tomato juice, diet cola, club soda) every fifteen minutes for 3 or 4 doses.
Recline victim’s seat; direct airflow.
Loosen tight clothing.
Apply cool, wet cloaks.
If victim vomits, do not give him any more liquids.
HEAT STROKE

Heat stroke is a life threatening situation.

Symptoms:

No perspiration
Dry hot skin, usually red
Pupils constricted
Very high body temperature
May become unconscious
Pulse strong and rapid
First Aid:

Cool victim quickly; soak or sponge person with cool water. Need to cool trunk of body as well as arms and legs.
Stop cooling and observe for ten minutes. If temperature starts to rise again, cool the victim again.
Do not give coffee, tea, or alcoholic beverages.
Have victim rest and get medical attention as soon as possible.

HYPERVENTILATION

Cause:

Over-breathing due to nervous, fright or emotional upset. The exception is hiccups.
Symptoms:

Rapid and deep breathing
Dizziness and faintness
Numbness and tingling in the extremities
Muscular spasms of hands and feet
Blurring of vision
Loss of balance and ability to think clearly
Loss of consciousness (extreme cases)
First Aid:

Reassure customer and instruct him to breathe slowly; or
Instruct him to hold his breath for a few seconds; or
Breath in a coached manner; or
If victim insists on receiving oxygen, place the mask over his nose and mouth, but do not turn on oxygen.
HYPOXIC HOPOXIA

Cause:

Insufficient amount of oxygen in the body cells and tissues.
The undesirable side effects to be discussed here, affect different people at different attitudes and under different circumstances depending upon each person’s physical make-up/condition. There is a remote possibility that some individuals may be stricken in a normally pressurized aircraft: however, the most common occurrence of these maladies is following a decompression and as a result of the rapid increases and decreases of pressure on the body surfaces.

Symptoms:

Headache
Dizziness
Fatigue
Listlessness
Judgement and vision impaired
Overconfident, though poorly coordinated
Euphoria – victim is unaware that he is in trouble
Personality change
Loss control of hands
Cyanosis – victim turns blue around mouth, fingernails and ear lobes
Unconsciousness
NOTE: The main danger of hypoxia lies in the fact that the victim becomes euphoric and is completely unaware of his own symptoms.
First Aid:

Must have oxygen. Recovery from hypoxia is usually within 15 seconds after oxygen is administered.
Time of useful consciousness:
22,000 feet = 5 – 10 minutes
25,000 feet = 3 – 5 minutes
28,000 feet = 2-1/2 – 3 minutes
30,000 feet = 1 – 2 minutes
35,000 feet = 30 – 60 seconds
40,000 feet = 15 – 20 seconds
NOTE: These figures relate to non-smoking adults. Smokers, anemic individuals, infants, as well as those with respiratory problems, will experience the effects of hypoxia sooner, and to a greater degree. If the Flight Attendant is working, the time of useful consciousness is shortened because of the increased oxygen consumption.

POISONING

CHEMICAL

Symptoms:

Nausea
Vomiting
Diarrhea
Headache
Cramps
Chills and fever
First Aid:

If antidote is not available:
Get medical attention as soon as possible.
Dilute poison immediately. If antidote is available:
Administer antidote from container.
Dilute poison with large amounts of fluid to cause vomiting. Plain water or milk (coats stomach) If nothing else is available.
DO NOT induce vomiting if lips show stains of burns from lye or other strong material.
Use the universal antidote as a neutralizer.
Universal antidote:

Slice of burnt toast crumbled up.
A tablespoon of milk of magnesia.
A cup of strong tea.
Food Poisoning

Cause:

Eating contaminated food – apparent within 2 hours.
Symptoms:

Diarrhea
Severe stomach cramps
Vomiting
Headache
Chills and fever
First Aid:

Keep as quiet and comfortable as possible.
Get medical attention as soon as possible.
Keep in mind that food poisoning may not have been caused by food served on board. Determine if customer brought food on board. Depending on the time of occurrence, find out where and what the customer ate at the last meal before boarding the aircraft.
Keep samples of all food under refrigeration. Do not let food samples freeze as this will kill any bacteria that might be the cause of food poisoning.
Note all pertinent information about the customer including time food was eaten and onset of illness, etc., in a Flight Attendant Report of Irregularity. An aircrew of any airline is trained to handle such situation in their flight attendant training program.

If working a Charter flight on which food is served; a sample of all food served aboard the aircraft on that flight is to be saved for inspection by the Local Board of Health.

SIMPLE FAINTING

Temporary loss of consciousness when not enough blood reaches the brain.

Causes:

Hunger
Fatigue
Emotional distress
Severe injury
Symptoms:

Blurring of vision
Weakness
Paleness
Sweating
Nausea
First Aid:

Use any of the following methods that may apply:

Lay flat with feet elevated.
Sit down or kneel and bend forward at the waist with head lower than waist. Break open an ammonia inhalant in a kleenex, paper towel, etc., and pass at least 6 inches under nose.
SPINAL INJURIES

Causes:

Blunt injury to neck or back (i.e., air turbulence, falls, etc.)
Penetrating injury (goes through the skin)
Disease
Surgery
Congenital defects
Symptoms:

Pain
Numbness or tingling
Paralyses
Abnormal appearance to or near the areas of the spinal column.
First Aid:

Do not move victim. Assess ABC’s and proceed accordingly.
Manually immobilize victim. Stay with them (i.e., hold head or area affected in position so there is no unnecessary movement.) Pillow and blankets may be of use.
Control external bleeding as necessary.
Any victim whose injury may possibly involve the spine or who sustains an injury which renders them unconscious, should be assumed to have sustained possible head and/or spinal injuries and be treated as such until proven otherwise.
Request medical attention.
Continue assessing/treating person until paramedics meet the aircraft.
TRAUMATIC SHOCK

Traumatic shock is the depressed condition of the body’s functions due to poor blood circulation. Usually follows serious injury. Degree of shock will depend upon the age and condition of the person.

Causes:

Loss of blood
Injury
Fear
Pain
Emotional strain
Fatigue
Loss of sleep
Sight of one’s injury
Symptoms:

Pale
Cold, clammy skin
Rapid, weak pulse
Shallow, rapid breathing
Low body temperature
Uncoordinated and halting speech
Vacant and dilated eyes (pupil is larger than normal)
First Aid:

Lay flat with feet elevated unless spinel/head injury is suspected.
Administer 02.
Conserve body temperature by covering lightly but do not overheat.
Reassure victim and continually monitor.
Get medical attention as soon as possible.
Rememberer-shock can and has caused death. If a victim develops, and remains in shock, death may result even though the injury causing the shock is not fatal. The proper course is to give first aid for shock to any seriously injured victim. It is acceptable to give a small amount of water upon request from a coherent customer.

UNCONSCIOUSNESS

This is a symptom of many different illnesses and injuries.

Causes:

Fainting
Head injury
Acute alcoholism
Apoplexy (stroke)
Shock
Heart attack
Insulin reaction
First Aid:

Assess ABC’s
If breathing fails, begin Rescue Breathing.
If no breathing/no pulse begin CPR.
If breathing appears normal and there are no apparent reasons for this condition, check the customer for a medic alert emblem or card.
If no medic alert emblem or card examine for signs of injury and treat. Check complexion color:
Pale – Lay victim flat with feet elevated; conserve body temperature, and use ammonia inhalant.
Red – Lay victim down with head slightly raised. Apply cold compress to head.
Blue – Lay victim down, conserve body temperature, and administer oxygen.
Never give liquids or food to an unconscious victim.
Continually monitor and maintain communication with flightdeck.
GUIDELINES FOR POST EVACUATION SURVIVAL

Land Survival

Gather emergency equipment.
Administer First Aid
Create a shelter from elements of nature using accessible materials.
Organize camp, assign duties, pool food and water.
Make landmark signals.
Start log book.
Stay near aircraft.
Give assistance to rescue personnel.
Desert Survival:

Ration available water.
Keep head and neck covered. Stay in shade to reduce sweating and loss of water.
Clothing – loose pants, long sleeve shirt – light colors.
Avoid foods with large quantities of protein.
Cold Climate Survival:

Dress as warmly as possible.
Huddle together share body heat.
To treat frost bite, warm frozen part slowly. Do not rub, do not apply ice or snow, do not thaw by exercising.
Cold Water Survival:

Protect high heat loss areas of the body which include:
Head and neck area.
Underarm and sides.
Groin area.
Movement can cause a 35% increased loss in body heat. Only move to remain afloat.
Watch for indications of hypothermia which include:
Intense shivering.
Poor coordination.
Loss of memory.
Maintain body heat.
“Help” position – Heat Escape Lessening Position – tuck arms/legs towards torso
Huddle position – huddle together.

Leave a Reply

Your email address will not be published. Required fields are marked *