First aid

DEFINITION OF FIRST AID
First Aid is the initial assistance or treatment
given to a casualty for any injury or sudden
illness before the arrival of an ambulance,
doctor, or other qualified personnel.

AIMS OF FIRST AID
Preserve life
Prevent the casualty’s condition from becoming worse
Promote recovery

RESPONSIBILITIES AS A FIRST AIDER
Assess the situation quickly and safely and summon appropriate help
Protect casualties and others at the scene from possible danger
To identify, as far as possible, the nature of illness or injury affecting casualty.
To give each casualty early and appropriate treatment, treating the most serious condition first.

RESPONSIBILITIES OF A FIRST AIDER
To arrange for the casualty’s removal to hospital or into the care of a doctor.
To remain with a casualty until appropriate care is available.
To report your observations to those taking care of the casualty, and to give further assistance if required.

PRIORITY OF CASUALTIES
Save the conscious casualties before the unconscious ones as they have a higher chance of recovery.
Save the young before the old.
Do not jeopardize your own life while rendering First Aid. In the event of immediate danger, get out of site immediately.
Remember: One of your aims is to preserve life, and not endanger your own in the process of rendering First Aid.

Casualties should always be treated in the order of priority, usually given by the “3 Bs”:
Breathing
Bleeding
Bones

RECOVERY POSITION
For people who are unconscious, or semiconscious, but are still breathing.
If there are spinal or neck injuries, do not attempt to place the casualty in the recovery position.
NOTE: Leaving the victim in this position for long periods may cause them to experience nerve compression.

STEP 1: Kneel next to the person. Place the arm closest to you straight out from the body. Position the far arm with the back of the hand against the near cheek.
STEP 2: Grab and bend the person’s far knee.
http://www.health.harvard.edu/fhg/firstaid/recovery.shtml

STEP 3: Protecting the head with one hand, gently roll the person toward you by pulling the far knee over and to the ground.
STEP 4: Tilt the head up slightly so that the airway is open. Make sure that the hand is under the cheek. Place a blanket or coat over the person (unless he/she has a heat illness or fever) and stay close until help arrives.
http://www.health.harvard.edu/fhg/firstaid/recovery.shtml

HYPERVENTILATION
SYMPTOMS:
Unnaturally fast, deep breathing
Attention-seeking behaviors
Dizziness, faintness, trembling, or marked tingling in hands, feet and lips
Headache
Chest pain
Slurred speech
Cramps in the hands and feet
Hyperventilation, also known as excessive breathing, causes a reduction of carbon dioxide concentration (below normal) of the blood.

HYPERVENTILATION
CAUSES:
Stress or anxiety
Consequence of lung diseases, head injuries or stroke
TREATMENT:
When speaking to casualty, be firm but kind
If possible, lead the casualty to a quiet place where he may be better able to regain control of his breathing
Let him re-breathe his own exhaled air from a paper bag.
(Paper bag is preferred over plastic bag as plastic bag may cause the casualty to suffocate)

FAINTING
SYMPTOMS:
A brief loss of consciousness causing the casualty to fall to the floor
A slow pulse
Pale, cold skin and sweating
Fainting is a brief loss of consciousness that is
caused by a temporary reduction of blood
flow to the brain.

FAINTING
CAUSES:
Taking in too little food and fluids (dehydration)
Low blood pressure
Lack of sleep
Over exhaustion
TREATMENT:
Lay casualty down, and slightly elevate legs
Make sure she has plenty of fresh air
As she recovers, reassure her and help her sit up gradually
Look for and treat any injury that has been sustained through falling

Shock
Shock occurs when the circulatory system fails, and insufficient oxygen reaches the tissues. If the condition is not treated quickly, vital organs can fail, ultimately causing death. Shock is made worse by fear and pain.
SYMPTOMS:
Clammy skin (cool, pale and damp)
Restlessness and nervousness
Thirst
Loss of blood
Confusion
Fast breathing
Nausea or vomiting
Blotched or bluish skin (especially around the mouth and lips)
Often perspires freely
May pass out.

Shock
CAUSES:
Shock can be divided into 4 types:
Hypovolemic shock
caused by the loss of blood volume (such as through bleeding) or profound dehydration
Cardiogenic shock
a result of a weakened heart that is unable to pump blood as efficiently as it once did. Commonly occurs after a massive heart attack
Distributive shock
a result of the lack of distribution of blood to the organs
Obstructive shock
results from an obstruction to blood flow at a site other than the heart

Shock
TREATMENT:
“P.E.L.C.R.N.” (Pronounced Pell-Crin)
Position the casualty on their back
Elevate the Legs
Loosen clothing at neck waist or wherever it is binding
Climatize (prevent too hot or too cold)
Reassure (keep the casualty calm)
Notify medical personnel (Help, Get a medic!!)

BEE/HORNET STING
SYMPTOMS:
Redness and swelling in injured area
TREATMENT:
Remove stinger as fast as possible
Reduce pain and swelling with cold compress

CRAMPS
Cramps are painful sensations caused by contraction or over shortening, usually of muscles.
CAUSES:
Cold or overexertion
TREATMENT:
Stretch the muscle and apply heat or cold (preferably heat)
Cramps from lack of salt and water: Stretch the muscle, drink water and increase salt intake

Choking is the mechanical obstruction of the flow of air from the environment into the lungs.
CAUSES:
Introduction of foreign object into airway, which becomes stuck
Respiratory diseases
Compression of airway (e.g. Strangling)
CHOKING

CHOKING
SYMPTOMS:
Unable to speak or cry out
Face turns blue from lack of oxygen
Victim grabbing at his/her throat
Weak coughing, laboured breathing produces high-pitched noise
Unconsciousness
TREATMENT:
Encourage victim to cough
Back slaps: Use of hard blows with heel of the hand on the upper back of the victim
Abdominal thrusts: Standing behind the victim and using hands to exert pressure on bottom of the diaphragm (May result in injuries like bruises or fracture of ribs)

TYPES OF BURNS
Dry burn
Caused by flame, contact with hot objects, friction etc.
Scalds
Contact with steam and hot fluids
Electrical burn
Low-voltage current, lightning strike
Cold injury
Contact with freezing metals, dry ice, freezing vapours e.g. liquid oxygen and liquid nitrogen

TYPES OF BURNS
Chemical burn
Industrial chemicals, including inhaled fumes and corrosive gases.
Household chemicals, including paint remover, strong acid and alkali, bleach, weed killers etc.
Radiation burn
Sunburn over-exposure to ultra-violet (UV) lamp and exposure to radioactive source.

DEGREE OF BURN
First degree burn:
This involves only the outermost layer of skin and is characterized by redness, swelling and tenderness.
Second degree burn:
Any 1% burn affecting layers of the epidermis, giving rise to rawness, blisters and the presence of a clear fluid. Can be fatal if it affects over 60% of the body.
Third degree burn:
All the layers of the skin are burned and there maybe be some damage to the nerves, fat tissue and muscles. Skin may look waxy, pale or charred. Purple fluid is observed and no pain is felt by casualty. Urgent medical attention is required.

MINOR BURNS
(FIRST DEGREE BURNS)
TREATMENT:
Rinse the injured part with cold water for at least 10 minutes to stop burning and relieve pain
Gently remove any jewelry, watches, belts or constricting clothing from injured area before it begins to swell
Cover area with sterile dressing, or any clean, non-fluffy material and bandage loosely in place.
NOTE: Cold burns should not be rinsed with cold water and cold water should never be applied to anyone with extensive burns.

SEVERE BURNS
(SECOND AND THIRD DEGREE BURNS)
TREATMENT:
Lay the casualty down and protect the burnt area from contact with the ground if possible
Rinse burn with plenty of cold water for at least 10 minutes or use burn-cooling gel
Arrange for casualty to be sent to the hospital
While cooling the burn, watch for signs of difficulty in breathing and be ready to resuscitate if necessary

SEVERE BURNS (SECOND AND THIRD DEGREE BURNS)
Remove any rings, watches, belts, shoes or burning clothing from injured area before it begins to swell
Remove burnt clothing, unless it is sticking to the burn
Cover dressing with sterile dressing or some other suitable material to prevent infection and germs (this is not necessary if burn is on face)
Do NOT burst any blisters, touch infected area or apply any lotions to the injury as this will retain heat within the burn.

ELECTRIC SHOCKS
(LOW-VOLTAGE CURRENTS)
Break contact of electric source with casualty by switching off mains or meter point (Only if it is safe for you to do so)
If unable to reach cable, stand on insulating material e.g. plastic mat, wooden box and push casualty’s limbs away from source with a broom or stick
Do not touch the person until the power supply is turned off
Be careful in areas that are wet
Dial 995 to summon an ambulance

FRACTURES
SYMPTOMS:
Pain at or near fractured site
Tenderness on gentle pressure
Swelling over the fracture site
Deformity e.g. irregularity of bone, angulation or rotation of limb, depression of bone etc.
Loss of power
Signs and symptoms of shock
A fracture is a break or crack in the
continuity of the bone.

DISLOCATIONS
SYMPTOMS:
Pain at the site of injury
Limited movement at joint
Deformity
Swelling
Tenderness
A dislocation is the displacement of one or more
bones at a joint. It usually occurs in the shoulders,
elbow, thumb, fingers and the lower jaw.

FRACTURES AND DISLOCATIONS
TREATMENT:
Support and immobilize the injured limb
Use a splint (if possible) in order to prevent movement of the injured part
Arrange for casualty to be removed to hospital
In doubtful cases, always treat as for a fracture
Do not attempt to replace the bones

STRAINS
SYMPTOMS:
Localised pain
Stiffness
Inflammation
Bruising
A strain is an injury to a muscle in which the
Muscle fibres tear as a result of overstretching.
(Sprain – to a ligament)

SPRAINS
SYMPTOMS:
Pain at site of of injury
Swelling and later bruising
Pain on movement
Loss of function
A sprain occurs at a joint where there is
tearing or over-stretching of the ligaments
and tissues.

SPRAINS
TREATMENT:
Support the joint in most comfortable position
P.R.I.C.E. (Protect, Rest, Ice, Compression, Elevation) treatment
When a sprained ankle occurs outdoors, do not remove the shoe
If unsure whether there is a fracture, always assume it is one

FOREIGN BODIES IN MINOR WOUNDS
TREATMENT:
Control bleeding by applying firm pressure on either side of the object and by raising wounded part
Cover the wound with gauze to minimise the risk of infection
Pad around the object until you can bandage over it without pressing down
Hold the padding in place while finishing the bandaging
If you cannot pad high enough, bandage around the object

BANDAGING
Arm sling
Elevated Arm sling
Bandaging the dome of the skull
Palm/Back of hand
Knee
Ankle/Foot
Ring Pad

TRANSPORTATION OF CASUALTY
With stretcher:
Keep the stretcher level to the ground
Carry the casualty with his feet facing the direction of move
Bring the stretcher to the casualty and not the casualty to the stretcher
Types of stretcher:
Wooden stretcher
Collapsible stretcher with telescopic handle
Improvised stretcher

IMPROVISED STRETCHERS
Rolled blanket
Blanket with 2 poles
Chair method
Shirts/Gunnysacks with 2 poles
An improvised stretcher made from a blanket and two poles

EMERGENCY METHODS OF MOVING CASUALTIES
One Man Human Crutch
Conscious
Able to walk with some assistance
Pick-a-back
Conscious
Light weight
Able to hold on using arms
Cradle method
Light weight
A child

EMERGENCY METHODS OF MOVING CASUALTIES
Fore Method
When pick-a-back or fireman’s life method cannot be used to carry a heavy casualty down the staircase
Fireman’s Lift
Conscious
Unconscious
Light-weight
Double Human Crutch
Conscious
Able to walk with some assistance

EMERGENCY METHODS OF MOVING CASUALTIES
Two-handed Seat
Unable to walk with assistance
Able to use his arms to support
Three-handed Seat
Unable to walk with assistance
Usually with injury on one leg
Able to use his arms to support

EMERGENCY METHODS OF MOVING CASUALTIES
Four-handed Seat
Unable to walk with assistance
Able to use his arms to support

EMERGENCY METHODS OF MOVING CASUALTIES
Fore and Aft Method
Unconscious
Sustained abdominal injury

Questions?