First Aid Quiz

or

Some things to think about

by Greg d. Moore

The questions and answers are culled from various sources. They include course books from the American Red Cross (including Standard and Advanced First Aid, CPR, and Advanced Lifesaving), courses from the American Red Cross and SOLO, personal experience, and discussions with numerous emergency personnel. Comments and corrections are always welcome.

Keep in mind that while the Rensselaer Outing Club requires Standard First Aid, CPR and SOLO certification to be a leader, there is more to first aid than having gotten a passing grade on a test. Experience counts for a great deal, as does common sense.

Questions

1. Describe when and how you would use a tourniquet. Answer

2. You arrive first on the scene of an accident. What is the absolute first thing that you do? Answer

3. Describe the difference between a primary survey and a secondary survey. When is either one done, and what are you looking for in each survey? Answer

4. What does LOC stand for and why can it be useful? Answer

5. What is Hyperglycemia? Hypoglycemia? What is standard first aid for each? Answer

6. True or False? rubbing butter, margarine or other oil on a burn will help. Answer

7. Is carrying a snake-bit kit is a good idea if you are going into an area where you know there are poisonous snakes? Answer

8. Is rubbing snow or ice on frostbite is a good way to warm it up or to treat it? In all cases is it a good idea to treat frostbite immediately? Does severe frostbite means definite loss of the area? Answer

9. True or False? anti-histamines taken before a bee-sting can help lessen a reaction. Answer

10. What is APAIL? Answer

11. True or False? Hypothermia can occur in 50-degree weather. Answer

12. What is the correct ratio of chest compressions to breaths when performing CPR? Answer

13. How effective is CPR? Answer

14. When performing a water rescue, what is the American Red Cross suggested course of action? (On a VERY general level!) Answer

15. True or False? you should NEVER apply traction to a broken limb. Answer

16. What one treatment should always be done regardless of the type of injury? Answer

17. What is the most important part of a first-aid kit? Answer

18. What is the average airspeed of an unladen swallow? Answer

19. At what point should you go get help? Immediately? After hanging around 5 minutes? After having a cup of hot tea? Answer

Comments

As the next to last question points out, your brain is the most useful item in your first-aid kit. By using it properly, you may save your life, or someone else's life someday. Below are some tips to keep in mind.

Prevention: If you can prevent an injury or accident from happening, you've done a lot. Obviously there will always be some "bolt from the blue" accidents that are not preventable, but many are. For example, knowing what to do in a lightning storm can prevent you from being struck by lightning. Knowing when to turn back or not try something can prevent an injury. Sure, you might make the summit without the crampons and ice-axe you left at the base, but what if you fall, how will you stop yourself?

Preparation: Be prepared. Take a moment every once in a while and say, "Hmm, if Lee broke his leg right now, what could I do, and how would I do it?" By running these scenario's through your head at different times, when an accident actually happens you'll have some idea of what you want to do and how to do it.

Practice: Related to the above idea. Before you ever set foot in the backcountry, practice your first-aid. It is one thing to read in a book about how to backboard someone. It is another thing to actually do it. Perhaps you'll discover that you move the neck too much. Better to find this out and practice on a healthy person, than to find this out on a helpless patient who you've just crippled because of your mistake. Also, make your practice realistic. Practice how to immobilize an injured arm when the person is sitting in a chair. Now practice when that person has "fallen" on their shoulder and the injured arm is beneath them. Be the patient sometimes. Find out how a secondary survey feels. You'll learn a lot about what to look for.

Answers to the Quiz

(remember, these are only a starting point)

1. Never.

   Contrary to what you may think, the use of a tourniquet is highly discouraged. Remember, the proper treatment for a wound with flowing blood is:
   1) Direct Pressure
   2) Elevation
   3) Pressure Point,
   4) Pinch.

   The proper use of these will stop just about any wound you will come across. Personally, I have yet to meet an EMT or other medical person who has needed to use a tourniquet. This includes the loss of a limb. In fact, ironically enough, the loss of a limb is among the least likely cases that will ever need a tourniquet. This is because the arteries tend to be drawn into the remaining portion of the limb, and the muscles pinch them off. If all else fails, grab the artery between your fingers (if it is exposed) and PINCH it. Sure it isn't fun or clean, but who said First Aid was?

   But let's say you happen to have that one case where NOTHING else works. Keep the following in mind. When you apply a tourniquet, you are writing off the rest of the limb. The minute the tourniquet is applied, you've made the decision that everything below the tourniquet will be sacrificed. NEVER remove a tourniquet. Since the tissue below it is dying, large amounts of toxins will build up in the blood. By releasing the tourniquet you will release these toxins into the rest of the body and quite possibly kill the patient with toxic shock. Next Question

2. Survey the scene. If the person fell down a rock slide, make sure you don't make the same mistake trying to get to them. Try to discover if a danger is still present and how you are going to avoid it if necessary. Next Question

3. As the name implies, a primary survey is done first. The goal of this survey is to find anything immediately life-threatening. The ABC rule is the suggested rule to follow.
   A - Airway: Check to see if anything is blocking the airway.
   B - Breathing: Check to see if the patient is breathing.
   C - Circulation: Check the circulation. First check for a pulse. If one is present, then check very quickly for SERIOUS bleeding. A bloody knuckle doesn't count. A severed femoral artery that is gushing blood does count.

   After checking the ABC's, begin the proper first aid treatment.After you've resolved the immediate problems, then you can go onto a secondary. With a secondary survey you want to look for less immediate problems; minor bleeding, broken or dislocated bones, etc. These are problems that you may have to treat eventually, but that don't immediately endanger the patient's life. Next Question

4. LOC is an acronym for Level Of Consciousness. This indicates the level of awareness of the patient. Some examples include:
   • Totally unconscious and no response to stimuli
   • Unconscious but some reaction to stimuli
   • Semi-conscious
   • Totally conscious.
   
   The LOC can give an indication of what happened or is happening to the patient. If the patient's LOC slowly slides from totally conscious, to semi conscious, to unconscious with no apparent reason, it may mean a head injury occurred, or something else is going on. One way to determine the LOC is to ask questions. Determine if the person has a sense of self, "who are you?"; sense of place, "where are you?"; sense of time, "what time or day is it?"; etc. Next Question

5. Hyperglycemia is caused by too much sugar in the body, hypoglycemia is caused by too little sugar in the body. The treatment for both is to give the patient sugar, because if they are hypoglycemic, it will help, if they are hyperglycemic, it won't do any harm. Next Question

6. False. In fact, rubbing these on may make the burn worse since they will trap the heat in. For 1st degree burns and some 2nd degree burns, run under cold water. Next Question

7. This question is subject to a lot of debate depending on who you talk to. Some say that it can help. Generally these people are involved in the making or selling of these kits. Every medical professional I've talked to thinks these kits are a bad idea. By cutting you only introduce another wound in the patient (which is subject to infection) and the sucking will remove too little venom to be useful. If snakebites are a concern, learn what type of snake and venom you might encounter. Wear boots with leather uppers. Talk to a doctor or a herpetologist about the possibility of carrying anti-venom. Next Question

8. The idea of rubbing frostbite with ice or snow apparently came from Napoleon's army when he was in Russia. He lost a large part of army to hypothermia and frostbite. Rubbing frostbite with ice or snow does NOT work.

   Also, it is NOT always the best idea to rewarm the area. If the area is partly rewarmed, then refrozen, even more damage can result. It is better to walk on a completely frozen foot, then one that was frozen, thawed, and then refrozen. Once the area is completely frozen, there is little more damage that can be done. (Of course, avoiding frostbite should be a goal in the first place.) Also, the frozen areas, since the tissue has been killed, can release toxins into the blood stream if thawed out. This is normally not a problem, unless large areas (foot, leg, etc) has been frozen than thawed. Thawing a finger or two is not dangerous. With some of the more aggressive therapies at SOME hospitals, it is possible to save frostbitten areas that at one time had to be removed. Keep in mind, though, that severe frostbite is NOT an area most hospitals have much experience with. Next Question

9. True. the reaction to a bee-sting is a histamine reaction. By taking anti-histamines before one gets stung, the reaction can be lessened. Even taken AFTER a bee-sting, it can help reduce minor swelling and aches and pains. Generally, though, it is NOT effective against anaphylatic shock. This is because it can't get into the blood stream fast enough. Also, it can cause droziness and depress vital signs. If you or someone in your party is known to be allergic to bee-stings (or wasp-stings), you may want to consult with your doctor about carrying epinephrin or other adrenalin derivative. Next Question

10. A pail is something you carry water in.
    APAIL is an acronym for:
    A - Avulsion, tearing of skin off the body
    P - Puncture, a deep penetrating wound that generally has a small cross-section
    A - Abrasion, superficial scrapes. Road-rash from a bike fall is an example
    I - Incision, a cut, for example from a knife
    L - Laceration, a deep ragged messy cut, for example from a chain saw.
    These describe typical soft-tissue injuries where the skin is broken. Some injuries may be a combination of the above. Next Question

11. True. Hypothermia is generally thought to be a winter/cold-weather problem. This is true. But it can also occur at warmer temperatures. Hypothermia is defined as the lowering of the bodies core temperature due to the inability of the body to heat itself as fast as it is losing heat. This can occur at almost any temperature due to a variety of factors. In MY personal experience, every single case of hypothermia that I've seen have occurred at over 32 F. Most have occurred on rainy days in the 40's. My theory on this is that when it is below freezing, people tend to dress appropriately. Also, any outside water sources (such as snow or ice) are frozen and don't as easily penetrate clothing, so the person's clothing doesn't get as wet. In the 40's though, people tend to think that they will be warm, even in the rain. The rain however penetrates their clothing quickly and they get cold quickly. So, be aware that hypothermia can occur at almost any temperature. Next Question

12. 15 compressions to 2 breaths in 1 person CPR. Next Question

13. A lot less than you would think. 90%? Too high, 75%? Still too high. 50%? Still way too high! 10%? Much closer to the mark. Yes, contrary to what you believe, in general CPR is NOT effective without IMMEDIATE advanced care. (i.e. a "crash" cart being on the scene in a minute or so.) One of the SOLO instructors I talked to last time they were here says in all his years of being an EMT, he has yet to see a patient survive with the use of CPR. At this point you may be asking yourself, "why bother learning it then?" To answer this it is important to understand why CPR generally is not effective. If a person suffers a heart attack, generally, there are several medical problems that are occurring. The heart attack may simply be a result of all these problems. Performing CPR won't fix these problems. On the other hand, when heart failure is caused by a single transient event, there is a good chance CPR will work. This same SOLO instructor mentioned above, did relate a story of a friend of his who was leading a Boy Scout camping trip. The area where they were camping was struck by lightning. The heart of one of the boys stopped. The friend was able to perform CPR and get it going again fairly quickly. An analogy is that of an old car with 100,000 miles on it. One day you're driving along and it stops for no apparent reason. Push starting it probably won't do a whole lot in the long run. However, if you downshift wrong and stall out a brand new car, chances are that restarting it will work just fine. Next Question

14. Reach, Throw, Go. It is tempting to jump into the water, swim over, grab the person and drag them out of the water. This is the way that they do it in the movies, and it looks REAL impressive! How ever, if you can't swim, there is a strong current, or other factors, you may start drowning and also need rescuing. A better course of action is first to try to reach out to the person from a stable position, or reach to them with something, a branch, paddle, etc. If they are too far away, try throwing them something. (And come on folks, make it USEFUL! Throwing them a six-pack of Bud won't be much appreciated at the time! :-) Throw them a life ring, a life vest, heck if all you've got is an empty cooler that floats, toss that towards them, it'll give them something to hold onto and float with. It is helpful if whatever you throw has a rope attached so you can pull them to shore, but this is not necessary. Also, make sure you do NOT hit them. Finally if all else fails, survey the scene and decide whether it is safe to go after them. If they dump a canoe in the middle of rapids, it is better for example to wait until the rapids end before you jump in the water. Also, without proper training, it can be very difficult and dangerous to rescue a struggling victim; so be careful out there. Next Question

15. True and False. The American Red Cross says never to do it. SOLO tells you when you should. Who's right? Both of them. If you are someplace where an immediate professional treatment is available, don't apply traction. Let the experts do it. On the other hand, if you are in the back-country, properly applied traction can mean the difference between life and death, or at the very least it can lessen the level of pain. Make sure that you earn how to do it safely, and when to do it. Next Question

16. Treat for shock. Treat for shock, and treat for shock! (Got it?) Next Question

17. Your brain. The most well equipped first-aid kit is useless if you don't know when or how to use the items in it. There may come a time when you need something not in your first-aid kit. Then it may be necessary to rely on your brain. Not a single first-aid kit in the club carries a Hare Traction Splint (a 15-lb or more item 3-4 feet long!). Yet you may need to perform traction on a broken femur. Next Question

18. African or European? Next Question

19. After having a cup of hot tea. Actually, I am somewhat serious. One of the first reactions is to immediately send someone running down the trail to get help. After all, every minute counts, right? Wrong! Useful and correct information are much more important. If you wait and take your time, you will learn exactly what is the matter with the patient. You will have an idea of what help may be required. Perhaps they need a full fledged rescue with a back-board and litter. Perhaps they will be able to walk out under their own power. Also, being able to plan a course of action makes a big difference. What if you go sprinting down the trail in the WRONG direction? What if you aren't sure where you are? How are you going to return with help? By waiting long enough, you have time to think these things through. If you force yourself to make a cup of tea, you force yourself to take some time. Finally, consider it from the time point of view. If it took you 4 hours to get there from the trailhead, it will take you 4 hours to get back (you are being careful and not putting yourself in danger by running down the rocky trail and risking twisting an ankle, right?). Once at the trailhead, it could take anywhere from 4-24 hours for help to get back to the accident scene. Taking the extra 20 minutes to make your tea is an insignificant amount of time on this scale. Return to the comments.

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    The purpose of the above exercise is not to qualify you for any test given by the American Red Cross, SOLO, or the RPI Outing Club.. However, it should get you to start thinking about some of the issues involved in proper first aid training.

    So, go out, have fun, and remember, "Be careful out there."

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    All material on this page is Copyright © 1995 Greg d. Moore. Last Updated: December 14th, 1995
    This document is not to be used as a authorative source for First Aid. Please take the time to take a course offered by the American Red Cross, SOLO, or other recognized First Aid Authority.