First Aid Honor - intermediate

Science & Health

Requirements

1. Have the First Aid Honor - basic

   Answer: You must complete the First Aid - basic Honor before starting the intermediate one. This ensures mastery of fundamental concepts such as the ABC of life, hemorrhage control, recovery position and calling for specialized rescue. — Prerequisites in Adventist honors exist to ensure progressive knowledge. Without the basics, intermediate concepts (advanced CPR, PPE, complex maneuvers) lack foundation and can be applied in a wrong and dangerous way.

2. What is PPE (Personal Protective Equipment)? What is its importance for first aid care?

   Answer: PPE is equipment that protects the first responder from risks such as blood, body fluids and diseases. The main ones are disposable gloves, a face mask, protective goggles, a CPR mask with a valve and an apron. — Regulation NR-6 of the Ministry of Labor regulates PPE in Brazil. In first aid, gloves reduce by more than 95% the risk of transmission of bloodborne pathogens such as HIV and hepatitis B during care.

3. What does the ABC of life (or of the first responder) mean? When should it be used? Demonstrate how to apply the ABC of life maneuvers.

   Answer: 1) WHAT IT MEANS: the ABC of life (or of the first responder) is the basic sequence of assessment and maintenance of vital functions — A (Airway): clear the mouth and open the airway with the head-tilt and chin-lift maneuver; B (Breathing): check whether the victim is breathing (look, listen and feel for the air); C (Circulation): check signs of circulation, such as pulse and skin color/temperature, and control hemorrhages. 2) WHEN IT SHOULD BE USED: whenever the victim is unconscious or unresponsive, or in any serious emergency (drowning, shock, trauma, cardiac arrest), to quickly assess, in the order A→B→C, whether the vital functions are preserved before any other action; if breathing and circulation are absent, CPR is started. 3) DEMONSTRATE HOW TO APPLY: position the victim on a firm surface; A — tilt the head and lift the chin to open the airway, removing visible objects from the mouth; B — bring your face close and observe the chest for up to 10 seconds to confirm breathing; C — check the pulse (carotid/radial) and stop bleeding with direct pressure; if there is no breathing or pulse, call SAMU 192 and begin chest compressions (CPR). — The ABC protocol has been the global basis of basic life support since the 1960s, when doctors Peter Safar and James Elam systematized it. In cardiac arrest, every minute without CPR reduces the victim's chance of survival by 10%.

4. What is the difference between an acute myocardial infarction and a stroke (cerebrovascular accident)? What is the appropriate procedure for each situation?

   Answer: DIFFERENCE: an acute myocardial infarction (AMI) is the obstruction of a heart artery, which interrupts the supply of blood to the heart muscle — pain or tightness in the chest that may radiate to the left arm, jaw, neck or back, shortness of breath, cold sweat, nausea. A stroke (cerebrovascular accident) is the interruption of blood flow to the brain (due to a blockage or rupture of a vessel) — signs of facial drooping/deviation, weakness or numbness on one side of the body, slurred/confused speech, loss of vision or balance. PROCEDURE FOR A HEART ATTACK: call SAMU 192 immediately; keep the victim seated or at rest, calm, loosen the clothing; do not let them exert themselves; if they already use prescribed medication you can help them take it; if they stop breathing and have no pulse, start CPR and use an AED if available. PROCEDURE FOR A STROKE: use the SAMU/FAST test (Face-smile, Arms, Speech, Time), note the time the symptoms began (it is decisive for treatment), call SAMU 192 immediately, keep the victim lying down with the head slightly elevated and turned to the side if they vomit, do not offer food or drink and do not give medications on your own. — The quick test for a stroke is SAMU (Sorriso/Smile, Abraço/Hug, Mensagem/Message, Urgência/Urgency) or the international FAST (Face, Arm, Speech, Time). Every minute without treatment loses 1.9 million neurons, according to the Brazilian Society of Cardiology.

5. Know the main pulse points, and demonstrate the ability to measure the pulse at at least two of them.

   Answer: The main pulse points are: radial (wrist), carotid (neck), brachial (inner part of the arm), femoral (groin), popliteal (behind the knee) and dorsalis pedis (top of the foot). — The thumb has its own pulse and can confuse the count. The normal resting adult pulse is 60 to 100 beats per minute, according to the Brazilian Society of Cardiology. Children have higher values (up to 140 bpm).

6. Know the method of applying a tourniquet and when to use it and when not to use it.

   Answer: A tourniquet is a wide band applied above a severe hemorrhage in an arm or leg, tightened until the bleeding stops. Use it only as a last resort, when direct pressure has failed or in an amputation. — The Committee on Trauma of the American College of Surgeons recommends the tourniquet as a vital tool in exsanguinating bleeds. The band must be at least 4 cm wide to avoid nerve injury, and the maximum safe time is 2 hours.

7. Know how to properly apply the following bandages:
   • Spiral
   • Crossed or figure-eight
   • Frontal, for the head
   • Demonstrate skill by applying the bandages above to the following regions of the body: head, forearm, hand, foot, knee.

   Answer: 1) Spiral bandage: applied by wrapping the band around the limb, from bottom to top, so that each turn covers about one third of the width of the previous turn. It is used on parts of the body of more uniform thickness, such as the forearm, leg and fingers. 2) Crossed or figure-eight bandage: the band is passed forming the figure of an eight (crossing one turn over the other), which allows good wrapping of joints that bend, such as the knee, elbow, ankle, hand and foot, keeping the bandage firm even with movement. 3) Frontal bandage for the head: begin by securing the band on the forehead (front part), passing over the top of the head and crossing at the back, on the nape, returning to the front in successive turns until the head is well covered; it serves to secure dressings on the scalp or forehead. 4) Demonstrate, in practice, the correct application of these bandages on the following body regions: head (frontal bandage), forearm (spiral bandage), hand (figure-eight bandage), foot (figure-eight bandage) and knee (figure-eight or crossed bandage), applying them firmly but without tightening to the point of cutting off circulation. — The basic rule is to keep the distal pulse/circulation palpable after bandaging — if the extremity becomes purplish or cold, it is too tight. Bandages should completely cover the sterile gauze and never touch the wound directly, according to the Pre-Hospital Care Manual.

8. What type of materials can be used as splints in emergency situations? Know how to apply splints to the following parts of the body:
   • Arm
   • Forearm
   • Ankle
   • Knee

   Answer: Improvised splints can be made with boards, stiff cardboard, rolled-up newspaper, thick magazines, straight branches or umbrellas. Apply by covering the joints above and below the fracture, fasten with a bandage or cloth without tightening, and check the distal pulse afterward. — The splint needs to immobilize two joints to prevent movement of the fracture, a basic principle of PHC (Pre-Hospital Care). Distal circulation must be checked before and after — pulse, color and temperature — according to the PHTLS manual.

9. Know the appropriate treatment for the following:
   • Head injuries
   • Internal bleeding
   • Gunshot wounds
   • Eye injuries
   • Fainting and seizures
   • Effects of extreme heat or cold

   Answer: 1) Head injuries: always suspect a cervical injury; do not move the victim, immobilize the head and neck in the position they are in, control bleeding with a dressing without applying direct pressure if there is a skull depression, observe the level of consciousness, the pupils and any fluid coming out of the nose/ears, and call for specialized rescue (SAMU 192). 2) Internal hemorrhages: lay the victim down, keep them warm and at absolute rest, do not offer anything to eat or drink, watch for signs of shock (paleness, cold sweat, rapid pulse, drop in pressure) and call SAMU urgently, since only hospital care can resolve it. 3) Gunshot wounds: never remove the projectile or impaled objects, control the bleeding with compression around the wound, cover with a clean dressing, keep the victim lying down and warm, monitor breathing and consciousness and call SAMU immediately. 4) Eye injuries: do not rub or try to remove impaled objects; in the case of an impaled object, stabilize it and cover both eyes (the movement of one drags the other), protect without pressing and take the victim to a medical service; in case of a chemical splash, rinse with abundant running water for several minutes. 5) Fainting and seizure: in fainting, lay the person down and elevate the legs for the blood to return to the brain, loosen clothing and ensure fresh air; in a seizure, protect the head with something soft, move away dangerous objects, do NOT hold the person down or put anything in their mouth, and after the episode place them in the recovery position and call for help if it lasts more than 5 minutes or recurs. 6) Effects of extreme heat or cold: in heatstroke/heat exhaustion, take the victim to a cool, shaded place, cool the body with damp cloths and offer water if they are conscious; in hypothermia, take them to shelter, change wet clothes for dry ones, warm them gradually with blankets and warm drinks (never alcohol) and seek medical care in severe cases. — Covering both eyes in eye injuries prevents reflexive eye movement. In a seizure, never put objects in the mouth — this is an old myth, and it can cause dental fractures and asphyxiation, according to the Brazilian Society of Neurology.

10. Know what to do in an electrical accident.

    Answer: You must immediately turn off the main switch or the circuit breaker before touching the victim. If you cannot turn it off, use a dry insulating object (a wooden broomstick) to move them away. — Touching an electrified victim directly turns the rescuer into the next victim — the current passes from one body to the other. Dry wood and rubber are natural insulators. Regulation NR-10 of the Ministry of Labor regulates electrical safety.

11. Know how to escape from a fire.

    Answer: You should get out fast and stay low, because smoke is more lethal than fire and rises. Cover your mouth and nose with a damp cloth, feel the door before opening (if hot, do not open), use stairs (never an elevator) and stay near the floor until you reach the exit. — Smoke contains carbon monoxide and toxic gases that kill more than heat — about 80% of fire victims die from inhalation, according to the Fire Department. This is why the cleaner, more breathable air is 30 cm from the floor.

12. Know how to get help in an emergency.

    Answer: You should call the appropriate emergency number: SAMU 192 (health), Fire Department 193, Military Police 190 or Civil Defense 199. State your name, the exact location with reference points, the number of victims, the type of accident and stay on the phone until the operator hangs up. — These numbers are free and work from any phone, including a cell phone without a SIM card or locked, throughout Brazil. The SAMU operator is trained to guide you through basic procedures while the team is on its way.

13. Know the appropriate procedure to treat a radiation victim and what the first responder's safety measures are.

    Answer: Move the victim away from the radiation source, remove their clothes into a sealed plastic bag and bathe them with water and neutral soap for 15 minutes. Use gloves, an N95 mask and disposable clothing. — Decontamination removes up to 90% of surface radiation, according to CNEN (the National Nuclear Energy Commission). The Goiânia accident (1987) with Cesium-137 showed that basic decontamination care saves lives and protects the rescue team.

14. Know the following ways of carrying a victim in a rescue:
    • Drag by the shoulders
    • Using a blanket
    • Two-person carry
    • Carry by the extremities
    • Improvised stretcher
    • Three people carry in a net
    • Using a stretcher

    Answer: 1) Pulling by the shoulders: used to quickly drag an unconscious victim out of a dangerous place (fire, smoke); the rescuer holds the victim under the armpits, supporting the head on their own arms, and drags them backward keeping the spine as aligned as possible. 2) Using a blanket: the victim is laid on a blanket and dragged by the blanket for short distances, indicated when there is no suspicion of spinal trauma; it distributes the effort and protects the victim from the floor. 3) Two-person carry: done with the 'two-handed seat', in which the two rescuers interlock their arms forming a seat for the conscious victim, who leans on their shoulders; it is used to transport over medium distances. 4) Carrying by the extremities: one rescuer holds the victim under the armpits and the other by the legs (behind the knees), lifting together; used over short distances when no stretcher is available. 5) Improvised stretcher: a stretcher is assembled with materials at hand, such as two poles/broomsticks passed through the sleeves of jackets or rolled in a firm blanket, ensuring strength before placing the victim; useful when it is necessary to immobilize and transport over longer distances. 6) Three-person carry in a net: the victim is placed lying on a net and three rescuers support them (one at the head, one in the middle, one at the feet), keeping the body level; good for uneven terrain where the net accommodates the weight. 7) Using a stretcher: the safest form of transport, especially when spinal trauma is suspected; the victim is placed on the stretcher as a block (coordinated movement), the body is secured with straps and the rescuers lift them and walk at a firm, synchronized pace, with the victim always feet-first. — The choice depends on the type of injury and the number of rescuers. When spinal trauma is suspected, any improper movement can cause permanent spinal cord injury — this is why a rigid stretcher and cervical stabilization are the international PHTLS standard.