first aid (entire presentation)

Introduction to First Aid

First Aid is an important skill and should be taught to everyone who has the ability to learn.

If more people knew First Aid, more lives would be saved.

Myths and old fables are still being used because of ignorance

Proper training would result in a vast difference between life and death or being handicapped.

What is First Aid

First Aid is the immediate

and temporary

care/treatment given to

someone who is injured or

has suddenly taken ill,

using facilities and

materials available at the

time of the accident

Who is a First Aider?

A First Aider is someone who has

been trained and examined in the

skills of first Aid. When you are

trained, you feel apprehensive

when dealing with “the real thing”.

By facing up to these feeling, the

First Aider is better able to cope

with the unexpected.

Responsibilities of a First

Aider Observe if there is any danger to you,

the people around and the casualty

Is the situation medical or a trauma

case?

What is the nature of the illness of

injury?

How many casualties are involved?

What are the resources that you need

or is available to you?

The 3 P’s of First Aid

PRESERVE LIFE

PREVEENT

CONDITION FROM

BECOMING WORST

PROMOTE

RECOVERY

The ‘ABC’ of First Aid

AIRWAY

BREATING

CIRCULATION

4 Steps to know before

treating casualty

What is it?

What causes it?

Signs and symptoms

How to treat

How does a First Aider work?

A first Aider work in

calm, skilful and

methodical way and

must always be

prepared

The Fight or Flight Response

In an emergency your body responds by

releasing certain hormones called adrenalin.

Your heart beats faster and your breathing is

deeper and more rapid. You must stay calm!

Taking slow, deep breaths will help you to

calm down, leaving you better able to

remember your First Aid procedures.

A First Aider must always protect

himself/herself first and try to prevent cross

infection by washing his/her hands with

soap and water, and wearing protective

gloves

Giving Care with Confidence

Being in control – both of your own reactions and of the problem.

Working in a calm, skilful, methodical way.

Being gentle but firm; speaking to the casualty kindly but in a clear and purposeful way

Build up Trust (Talk to the casualty, explain what you are going to do, try to answer questions honestly)

Every casualty needs to feel secure and safe in the

hands of the First Aider. You can create an air of

confidence and assurance by:

Taking Charge at the Scene

Check the Scene for safety, is the scene

safe for you?

Before you approach the scene you must

do body, substance, isolation (BSI).

Protect yourself from all body fluids by

wearing protective gloves and try to

prevent cross infection. Wash your hands

with soap and water.

What you should do at the scene of an accident? Use the three Cs

(3Cs) of First Aid.

1. Fist Assess the Situation


Call for help, call the ambulance, tell

them where you are, how many persons are

injured and the nature of the incident.

You may need to call the police, fire

brigade or other mode of transportation

to take the casualties to the hospital


(3Cs) of First Aid.

2. Delegate Responsibilities


Care. It is important to give proper

care to the casualty. You need to do a

more detailed assessment of the

casualty to see what need to be done

and to prioritize the care you will give.

The care you give will make a

difference between life or death.


(3Cs) of First Aid.

3. Delegate Responsibilities

Mass Casualties

1. B – Breathing: Give mouth-to-mouth

breathing

2. B – Bleeding: Treat or arrest the bleeding

3. C – Conscious: Put in the recovery

position

Where there are mass casualties, your aim is

to try to save as many persons as possible

using triage to treat the most critical

persons/s. Using the BBC approach, that is

breathing, bleeding and consciousness –

your would it give priority treatment to

casualties

Rapid Physical Assessment

Medical Cases Involve Natural

Illnesses such as:

a. Asthma

b. Fainting

c. Seizure

d. Stroke

e. Heart Attach

When assessing a casualty you must

determine if it is a medical or trauma

case


cont’d

Trauma Cases Involve External Force,

forced upon the body

a. Laceration

b. Abrasion

c. Burns and scalds

d. Fractures

e. Amputation

f. Stab/puncture

g. Fall

h. Motor Vehicle Accident

When assessing a casualty you must

determine if it is a medical or trauma case

Fainting & Unconsciousness

Fainting is a temporary loss of

consciousness caused by

temporary loss of oxygenated

blood to the brain. Other causes

by reaction to pain, exhaustion,

lack of food, emotional stress

physical inactivity, long standing

or sitting, heat stress

(dehydration), thirst and low blood

sugar.


Signs & Symptoms

a. Extreme paleness

b. Perfuse sweating

c. Dizziness

d. Nausea

e. Cold and Clammy Skin

f. Numbness and tingling of hands

and feet


Treatment

1. When treating the unconscious

fainting, the aim is to put back blood

to the brain:• Check the ABC to find out if the casualty

is breathing.

• Loosen tight clothing.

• Elevate the person’s leg 8 to 12 inches

to allow the blood to flow to the brain.

• Give plenty of fresh air.

The casualty should regain consciousness

within 5 minutes

Unconsciousness

Unconsciousness means that

the brain is not working

properly. An unconscious

person is completely

unresponsive or unaware of

what is happening in his/her

surrounding.

Causes of Impaired

ConsciousnessThe causes of impaired consciousness are:

lack of nutrients – (oxygen and glucose sugar

reaching the brain)

head injury

Brain tumor

Poisoning

Epilepsy

Diabetes

Shock

Fainting

Stroke

Heart attach

Electric shock

Levels of Consciousness

For responsiveness, user the

AVPU System:

1. Alert – is the casualty

responsive/aware

2. Verbally – Are they

responding verbally?

3. Pain – Are they responding to

pain?

4. Unconscious/Unresponsivene

ss – Are they unconscious?

Unconsciousness

Treatment

• Check the ABC and treat

accordingly

• Assess the level of response

using the AVPU

• Arrange urgent removal of the

casualty to the hospital

Seizures/Convulsions (Fits)

A Seizure also called a convulsion or

fits consists of involuntary contractions

of many of the muscles of the body.

The condition is due to a disturbance in

the electrical activity of the brain.

Seizures usually result in loss or

impairment of consciousness. The

most common cause is epilepsy


a. Drugs, Alcohol or poison

b. Brain tumours

c. Infection, high fever

d. Diabetic problems

e. Trauma, Stroke

f. Heat stroke

g. Epilepsy

h. Unknown

A Seizure is not a disease but a sign of an

underlying condition. Some causes of

seizures are:


Tonic-Clonic or Granmal Seizure

usually last only a few minutes and

consist of dramatic body movement.

Absence of Petit Mal Seizures

usually only last 10 - 30 seconds

and there are no dramatic body

movements.


Signs & Symptomsa. Sudden loss of consciousness with casualty falling to the

ground, often making a loud cry.

b. An epileptic attach can be caused by bright light or colours,

sensation of strong odour or perfumes, exhaustion, hunger,

fright, fever, taste.

c. The body will stiffen, breathing may stop, convulsive

movements begin, the jaw may be clenched and breathing

my be noisy. Saliva at the mouth may b e blood-stained if

the tongue and lips have been bitten.

d. There may be a loss of bladder and bowel control.

e. Muscle and breathing become normal the casualty

recovers consciousness within a few minutes, but is very

tired and confused. May complain of headaches.


Treatment

1. Check the scene for safety for yourself and the

casualty.

2. Protect the casualty from injury, place something

soft under the person’s head, and loosen restrictive

clothing.

3. Remove potentially dangerous items such as hot

drinks and sharp objects, please note the time the

seizure started

4. Do not try to hold the casualty still during

convulsions, after the convulsion place the casualty

in the recovery position and stay with the person

until recovery, which is usually within 5 – 10 minutes

5. Do not put anything into or over the person’s

mouth.

6. Protect the casualty from embarrassment by asking

onlookers for some privacy.

Types of Seizures

1. Generalised – this involves both sides of the brain

2. Tonic-Clonic (grand mal) seizures – The patient

becomes rigid, falls to the ground and the body

goes into violent jerky movements

3. Tonic – Sudden stiffening of the muscles, the

person becomes rigid and fall (no jerking) injuries

may occur from the fall

4. Absences – Interruption of consciousness, patient

stares blankly with fluttering eyelids and nodding of

the head, usually lasting few seconds (petit mal).

5. Partial seizures (simple) – Usually consciousness

and awareness is maintained. The persons may

have a strange feeling, taste, smell or sensation

(aura). There jerking of the body without changes

in consciousness.


Management

• Ensure an open airway.

• Protect the patient from injury during the seizure by

moving objects out of the way.

• Loosening any tight clothing, removing spectacles,

and supporting the head from injury with a blanket

or pillow.

• Do force anything into the mouth.

• Place the patient in the recovery position once

movements have stopped.

• Patients should be allowed to recover in their own

time.

• Treat any injuries that the patient may have

received.

• Do not physically restrain the patient.

Treatment for Unconscious

FaintingSKILL STEPS

Check the scene Is the scene safe? If the scene is safe BSI

and proceed.

Check for responsiveness Tap gently and shout “Are you OK?”

Call for help Shout for help to attract other people.

Position the casualty Roll casualty on their back in a single unit as

you roll, support the head.

Open the airway Use the head tilt/chin lift method.

Check for breathing Look, listen and feel for 3 0 5 seconds, keeps

airway open.

Loosen tight clothing and elevate

feet

It the casualty is breathing, loosen tight

clothing, elevate feet 8 – 12 inches, give lots

of fresh air, the casualty should revive within 5

minutes.

Put the casualty to sit When the casualty revives put the casualty to

sit & ask questions i.e. Are you on

medication? Are you hungry: Observe the

surroundings.

Give something sweet If the casualty is hungry give something sweet

i.e. glucose, sugar, chocolate, sweetie etc.

Recovery Position

Who should you place in the recovery position?Casualties who are unconscious and breathing and

whose hearts are beating

This position ensures the following:

• An open airway

• Comfort

• Stability

• Draining

Insert Get pictures of each position

Recovery Position

ARTIFICIAL RESUSCITATION (AR)

RESPIRATORY ARRESTWhat is Respirator Arrest? Respiratory arrest is

when breathing stops.

So, whey does breathing stop? Breathing stops

when there is a blockage in the air passage

caused by:

1. Choking on objects: food, false teeth,

seeds, toys etc.

2. Drowning, suffocation, strangulation,

asthma, burns, stings, poisons, smoke,

fumes, rolling back of the tongue, vomitting,

drug or alcohol overdose

What should you do if breathing stops?

1. Remove the cause or remove the

casualty.

2. Check for breathing – if the casualty is

not breathing then

3. Start rescue breathing at once

4. If the air passage is blocked, check the

position of the hand then check mouth

and throat for objects/s.

5. When breathing starts, place casualty in

the recovery position.

6. Monitor the casualty as breathing may

stop.

When do you apply pressure?

AR is done when casualty is not

breathing and has a pulse

(heartbeat). If there is no

breathing and no heartbeat then

Cardio Pulmonary Resuscitation

or CPR should be applied.

Difference between Rescue Breathing and

Rescue Breath

Rescue Breathing –

• 1 breath every 5 seconds.

• If there is no pulse you administer Rescue

Breathing (breath 1 and 2 and 3 and 4 breath).

Rescue Breaths –

• First 2 breaths that are given after you open the

airway and check for breathing.

• If there is no breathing you must check the mouth

to see if it is clear and then give 2 rescue breaths at

a rate of 1 – 1½ seconds.The purpose for Rescue breaths is to find out if there is a clear air passage and

to send oxygen to the lungs.

Rescue Breath

We breath in 21% of Oxygen –

• Our bodies use only 5%

• That leaves 16% which is usually

exhaled – This is enough to resuscitate

someone.

• Deprivation of oxygen from the brain for

4 – 6 minutes will cause the brain cells

and tissues to die therefore quick

response is necessary.

Rescue Breath

After Opening the Airway -

A. By using the head-tilt/chin left method,

check for breathing

B. By looking, listening and feeling for 3

– 5 seconds

If the victim is not breathing gently pinch

the nose shut and give 2 full breaths

Rescue Breath

Use the thumb and index finger of the

hand that is on the victim’s forehead,

pinch the victim’s nose shut while

keeping the heel of the hand in place to

maintain head-tilt.

Your other hand should remain under

the victim’s chin, lifting up immediately,

give 2 full breaths while maintaining an

airtight seal with your mouth over the

victim’s mouth

Rescue Breath

After giving 2 rescue breaths, if breaths

go in you check for circulation -

C. By feeling the carotid pulse at the

neck.

If there is a pulse but not breathing,

administer rescue breathing i.e. 1

breath every 5 seconds.

After the first 5 sets of breaths check

if breathing starts.

Rescue Breath

1. The victim begins to breathe.

2. Medical help arrives.

3. Another trained first Aider come to

take over, or

4. You are too exhausted to contine.

Rescue Breathing for Adults

1. Kneel next to the casualty’s head.

2. Open the airway using the head tilt, chin lift

method.

3. Check for breathing: Look listen, and fell for 5

seconds. Check mouth for food or objects/s that

could block air passage.

4. Give 2 rescue breaths – seal lips over casualty’s

mouth, pinch the nose and breathe.

5. Check pulse for 10 seconds using the carotid at

the neck.

6. Give 1 rescue breath every 5 seconds. After the

1st 4 of breathing, check if breathing starts.

Rescue Breathing for Adults

Rescue Breathing for Child

Give 1 breath every 4 seconds

Rescue Breathing for Infant

1. Be careful and gentle with infants

2. Tilt the head back gently – not as far as an adult

or an older child.

3. Put you mouth over the baby’s mouth and nose

to form a seal.

4. Give 1 puff every 3 seconds

When to Stop Breathing for the Casualty

1. When the casualty starts breathing

again.

2. When qualified aid arrives.

3. A next First Aider comes to assist.

4. When you are tired and exhausted

Note: In all cases you must take the

casualty to the hospital whenever

Rescue Breathing is applied. When

the casualty starts breathing, place

the casualty in the recovery position.

When to Stop Breathing for the

Casualty

Mouth-to-Mouth

breathing

Skills for Rescue Breathing

SKILL STEPS

Check for

responsiveness

Tap the patient gently, pinch on ear lobe, “Are

you OK?”

Call for help Shout for help to attract another person and

to call an ambulance

Position the Patient Roll the casualty on back in a single unit. As

you roll, support head.

Open the airway Use the head-tilt/chin-tilt method.

Check for breathing Look, Listen and feel for 3-5 seconds. Keep

airway open.

Give 2 Rescue Breaths At a rate of 1 – 1½ seconds. Maintain open

airway.

Check for Pulse Feel the CAROTID PULSE for 5- 10

seconds.

Rescue Breathing Give 1 breath every 5 seconds. Do 5 sets.

Then check for breathing

Recheck Pulse Feel the CAROTID PULSE for 5 – 10

seconds.

Pulse RateAGE RATE

Infants 120 – 160 beats per minute

Toddler 90 – 140 beats per minute

Pre-Schooler 75 – 100 beats per minute

Adults 60 – 80 beats per minute

Respiratory RateAGE RATE

Infants 30 – 60 breaths per minute

Toddler 24 – 40 breaths per minute

Pre-Schooler 22 – 34 breaths per minute

School Age 18 - 30 breaths per minute

Adults 12 - 20 breaths per minute

The Heart

The Heart is a muscular organ which acts

like a double pump. It is situated in the chest

behind the breastbone and rib cartilages,

between the lungs and immediately above

the diaphragm.

The Heart is divided into a right and left

side and there is no direct communication.

Each side is further divided into an upper or

collecting chamber (auricle or atrium) and

a lower or pumping chamber (ventricle).

Between each auricle and ventricle there is a

non-return valve.

Heartbeat

The heartbeat may be felt just below

and to the inner side of the left

nipple.

The heart contracts in adults at an

average rate of 72 times per minute

when sitting or at rest but the rate

can vary with excitement, exertion,

fear or change of position; hence the

importance or considering the

patient’s position in cases of

bleeding or shock.

Mechanism of the Circulation

The right side of the heart pumps the

blood through the lungs – Pulmonary

Circulation.

The left side is concerned with the

SYSTEMIC (or general) circulation of the

blood through the body.

With each contraction of the heart, blood is forced

through both of these circulatory systems from the

ventricles and with each relaxation of the heart

blood pours into collecting auricles from which the

ventricles are refilled.

Pulmonary Circulation

Venuous blood is collecting from 2 large veins

draining the upper and lower parts of the body

into the right auricle and from this chamber

passes through a valve to the right ventricle,

whence it is forced by compression through the

pulmonary artery to the lungs.

In the lungs it gives off carbon dioxide gas and

water vapour and picks up oxygen gas from the

inspired air. This process is known as the

interchange of gases.

After being recharged with oxygen the blood

returns to the left auricle through the pulmonary

veins.

Systemic Circulation

From the left auricle the blood now rich in

oxygen passes through a valve to the left

ventricle and from there is forced out

through the main artery of the body (Aorta)

which through numerous branches,

distributes it to all parts of the body

Heartbeat

On an average the heart beats

60 to 80 times per minute.

Pumps approximately 5 liters

(1.3 gallons) per minute at rest

With activity the heart pumps a

much as 25 liters (6.5 gallons)

per minute

Heartbeat

In heart failure, the heart is unable

to increase the amount of blood it

pumps as you exercise

This may make you feel short of

breath when you try to walk a long

distance or climb a flight of stairs.

Most persons with heart failure

also feel tired.

Angina Pectoris

Angina Pectoris is a common symptom of

chronic heart disease (C.H.D). It is a transient

pain or discomfort due to temporary lack of

adequate blood supply to the heart muscle.

The pain may be located in the centre of the

chest.

The pain is usually described as being

crushing, pressing, constricting, oppressive or

heavy.

May spread (more often the left) or both

shoulders and/or arms to the neck, jaw, back or

upper mid-portion of the abdomen

(epigastrium).

Angina Pectoris

Angina Pectoris that is either new,

worsening in severity (e.g. more

frequently, lasting longer, responding

less to nitro-glycerine or rest), or

coming on at rest is called unstable

angina. Patients with this form of

angina are at high risk for acute

myocardial infarction and should be

hospitalized immediately.

Characteristics of Angina

PectorisRapid onset usually triggered by exertion or stress.

Short duration 3 – 5 minutes

Chest pain radiating down the arms and into the jaw.

Dyspnoea (difficulty breathing)

Mild to moderate nausea

Diaphoresis (profuse sweating)

Anxiety

Relieved by rest and nitro-glycerine tablets within 10

minutes

The Most frequent cause of angina is coronary

atherosclerosis.

ATHEROSCLEROSIS

Atherosclerosis is the condition in which an

artery wall thickens, as the result of a building

up of fatty materials such as cholesterol. It is

commonly referred to as hardening of the

arteries.

It is caused by the formation of multiple

plaques within the arteries.

It can cause strokes, heart attacks, congestive

heart failure and most cardiovascular diseases

because it interferes with the coronary

circulation supplying the heart or cerebral

circulation supplying the brain

Clinical Manifestation of Coronary

Heart Disease

Persons with coronary artery disease

may show no signs or signals of heart

disease (asymptomatic) or have signs

that do suggest coronary heart disease

(symptomatic).

In a person with symptomatic CAD,

coronary artery narrowing progresses

over time.

Heart Attack (Acute Myocardial

Infraction)

A Heart attack occurs when an area of

the heart muscle is deprived of blood

(oxygen) for a prolonged period (usually

more than 20 to 30 minutes)

Usually results from severe narrowing or

complete blockage of a diseased

coronary artery and result in death of the

heart muscle cells supplied by the artery.

Embolism

Embolism occurs when an object or

plaque moves from one part of the body

through circulation and causes a

blockage of blood vessel in another part

of the body

Coronary Embolism

Pulmonary Embolism

Cranial Embolism

Signs of Heart Attack

The most common signal of a heart

attach is an uncomfortable pressure,

fullness, squeezing or pain in the

centre of the chest. It usually lasts fro 2

or more minutes and may come and go.

Other signals may include:

Nausea

Sweating

Shortness of breath

A feeling of weakness

Sudden Cardiac Death (Cardiac Arrest)

Sudden death occurs when heartbeat

and breathing stop abruptly or

unexpectedly.

May occur as the initial an only

manifestation of C.H.D.

May occur before any symptom.

Occurs within 1 to 2 hrs after the

beginning of a heart attack.

Actions for Survival

Know the warning signs. Have the

person stop whatever he or she is

doing.

Have the person sit or lie down

comfortably

If prescribed by a physician, nitro-

glycerine tablets can be administered to

relieve the pain or Angina Pectoris. No

more that 3 tables within 10 minutes

Call your doctor or take the victim to the

nearest hospital

Risk Factors

Risk factors are conditions or

behaviours that may increase

the changes of someone

developing a disease. Heart

disease develops over a long

period of time. You should begin

reducing risks at an early age.

Risk Factors that cannot be

changedSome risk factors cannot be modified or eliminated

Heredity - A history of premature C.H.D. in siblings

or parents suggest an increased

susceptibility that my be generic.

Gender - A woman has a lower incidence or

coronary arteriosclerosis before

menopause. The incidence increase

significantly, however, in postmenopausal

women, who also have worse clinical case

when compared to men. Men are at a

greater risk than women

Age - The death rate from C.H.D. increases with

age. However, nearly 1 in 4 deaths

occurs in persons under age 65.

Risk Factors that can be changed

Exercise - Exercising on a regular basis will

strengthen the heart and blood vessels.

Stress - Because of stress, blood vessels may

constrict, blood pressure may rise and the

liver may be stimulated to produce more

cholesterol.

Diet - Reduce cholesterol intake and maintain

and ideal body weight to reduce you risk of

heart disease.

Cigarette - Every time you smoke, your arteries and

Smoking heart react. Nicotine constricts blood

vessels, increases the heart rate, raises

cholesterol levels, lower the ability of blood

to carry oxygen and increase blood

pressure

Keeping a Healthy Heart

Keep your weight at an ideal level by

eating nutritious diet meals and

exercising regularly

Eat Fruits, vegetables, cereals,

pasta, low-fat diary products, fish,

poultry and lean meats.

Ignore the saltshaker and limit the

amount of highly-salted, processed

foods you can eat.

Fats and your Heart

Certain fatty foods tend to increase the amount

of cholesterol in the blood while other types of

fats help to decrease cholesterol

Saturated Fats tend to raise the level of

cholesterol in the blood. They are fats that

harden at room tempeture.

Polyunsaturated Fats tend to lower the level

of cholesterol in the blood. They are found in

liquid oils of vegetable origin. They include oils

made from corn, cottonseed, sunflower, sesame

seed, soybean and sunflower seed.

Animal Origin Saturated Fats

Fatty cuts of beef, pork and

lamb

Butter, cream and whole milk

Cheese made from cream

and whole milk

Vegetable Origin Saturated Fats

Hydrogenated shortenings

Coconut Oil

Cocoa butter and palm oil used in

most commercially prepared

cookies

Pie fillings and non-dairy cream

substitute.

High-fat foods, which are

concentrated sources of calories,

include:

Fats of all kinds(shortening, oil, butter,

margarine)

Cheese

Salad dressing

Fried foods

Sauces and gravies, bacon fat

Scrapple

Sausage

Ribs

Potato chips and other snack chips

Cardio Pulmonary Resuscitation (CPR)

C.P.R. is administered when someone’s

pulse and breathing stops.

When both breathing & pulse have

stopped, the victim has suffered sudden

death. C.PR. Is never used to restart the

heart.

There a many causes of sudden death:

drowning, smoke, inhalation, suffocation,

poisoning, electrocution and choking.

The most common cause is heart attach

Definition of Death

Clinical Death: The heartbeat and breathing

have stopped. This is best

thought of as near or apparent

death, and it may be reversed.

Biological Death: This is permanent brain

death due to lack of oxygen.

This death is final.

During the 1st few minutes of clinical death,

promptly initiate C.P.R. which may turn the

victim back to productive life. Without C.P.R.

biological death will occur.

Decision Making

Make a decision about what to do next, based on what

the instructor says. Continue to give appropriate care.

The ABCs of C.P.R.

Begin the ABCs of C.P.R. by:

a. Opening the airway using the head-tilt, chin

left method. Once the airway is open, place

you ear close to the victim’s mouth.

b. Check for breathing

Look at the chest for movement

Listen for sounds of breathing

Feel for breath on your cheek

After 3 – 5 seconds, if none of these signs are present, the victim is

not breathing

External Chest Compressions

Artificial circulation is

provided by external chest

compressions. In effect,

when you apply rhythmic

pressure on the centre of

the casualty’s breastbone,

you are forcing heart to

pump blood.

Performing Chest Compressions

Kneel at victim’s side near the chest.

Place the heel or your hand in the middle of the

breastbone and the middle of the nipple line

Place your other hand on top of the hand in

position. Be sure to keep you fingers up off the

chest wall.

Bring you shoulders directly over the victim’s

sternum as you compress downwards, keeping

your arm straight.

Depress the sternum about 1½ inches to 2

inches for an adult victim then relax pressure

on the sternum completely

Performing Chest Compressions

cont’d Do not remove your hands from the victim’s

sternum but allow the chest to return to its

normal position between compressions.

Relaxation and compressions should be of

equal duration.

If there is no breathing do external chest

compressions (C.P.R.) The proper ratio is 30

compressions to 2 breaths.

Emergency Actions Steps

Remember the 3 steps: Check, Call, Care upon

finding a collapsed person.

1. CHECK the scene and victim

2. CALL for help and send for emergency

medical services

3. CARE – give appropriate care. If the victim

is not lying flat on his or her back, roll the

victim over, moving the entire body at once.

Your instructor will demonstrate this

Emergency Actions Steps

Skills for CPRSKILL STEPS

Check for responsiveness Tap gently on patient. Shout “Are you OK?”

Call for help Shout for help to attract another person and to call an

ambulance

Position The Patient Roll the casualty on back in a single unit. As you

rools, support the head.

Open the airway Use the heat-tilt/chin-lift method

Check for breathing Look, listen, and feel for 3 – 5 seconds. Keep airway

open

Give 2 rescue breaths At a rate of 1 – 1½ seconds. Keep airway open.

Check for pulse Feel the CAROTID PULSE for 5 – 10 seconds. If

there is no pulse…

Locate Compression Position Place the heel of your hand in the middle of the

breastbone an the middle of the nipple line. Place

your hand on the top of the hand in position.

Give 30 compressions Position shoulders over hands with elbows locked

and arms straight. Compress breastbone 1½ - 2

inches. 100 compressions per minute.

Give 2 rescue breaths Pinch nose shut. Maintain an open airway. Give 2

rescue breaths at a rate of 1 - 1½ seconds.

Do Cycles Do 5 cycles of 30 compressions and 2 breaths.

Skills for CPR cont’d

SKILL STEPS

Recheck pulse Feels the CAROTID PULSE for 5 – 10 seconds.

Give 2 rescue breaths If no pulse, maintain open airway, pinch nose

shut and give 2 full breaths.

Continue compression/breathing cycle Continue cycles of 30 compressions and 2

breaths. Recheck pulse every few minutes.

Stroke

Stroke (cerebovascular accident, CVA) is

damage to part of the brain due to

obstruction or rupture of a blood vessel.

Extensive damages lead to death.

Stroke occur when a blood vessel is blocked

by a blood clot preventing that area of the

brain from receiving oxygenated blood, or a

blood vessel ruptures and blood pours into or

over the brain.

Causes of Stroke

1. Thrombus/Tumor - A Blood Clot

2. Aneurysm – A weakening of an arterial wall

which may lead to a rupture due to bulging

of the artery.

3. Embolism – Movement of a blood clot or

foreign body (fat or air) inside a blood

vessel. The clot is called bolus.

4. Compression – Blood leaks into the

surrounding space causing pressure against

the artery preventing blood flow.

Signs & Symptoms of Stroke

Headache (may be only the symptom at

first)

Collapse or fainting (syncope)

Weakness or paralysis in one or more limbs

(usually the hand.)

Difficulty speaking and facial weakness

Intense dizziness and visual disturbance

Seizures

Unequal pupils

Loss of strength, typically on one side of the

body

Loss of bowel and bladder control

Treatment

Emergency care depends on signs shown

Perform an incident size up (BSI)

Call the emergency medical service

immediately

Maintain an open airway and be prepared to

provide CPR

Keep the patient at rest

Protect all paralyzed parts

Provide emotional support

Place the patient in the recovery position to

allow for drainage

Risk Factors for Cardiac Illnesses

Hypertension

Cigarette smoking

Diabetes

High cholesterol

Lack of exercise

Family history of heart

disease/stroke

History of angina or previous chest

pain

Aneurysm

An Aneurysm is a localized, blood-filled

dilation (a blood-like bulge) of a blood

vessel caused by disease or weakening

of the vessel wall. Aneurysm most

commonly occur in the arteries in the

brain in the aorta, as the size increases

there is a risk of rupture which can result

in severe hemorrhage, stroke and other

complications including sudden death.

Signs & Symptoms of Aneurysm

No Response

Abnormal breathing

No signs of circulation

Treatment

Keep the victim – stop them from doing what they

are doing and put them to sit or lie down

Activate the emergency medical service

immediately

Stay with the patient and monitor his condition. If

an Automated External Defibrillator (A.E.D.) is

available, keep it close by

Place the patient in a comfortable position

If the patient has medication you may assist with

the prescribed dose

If the pain persists after 5 minutes activate the

emergency medical service and be prepared to

start C.P.R.

Causes of Aneurysm

Atherosclerosis – A condition of the arteries in

which the blood flow is blocked by fatty

deposits.

Arteriosclerosis – Any condition in which the

walls of the arteries are thickened and made

rigid, making them unable to process an

adequate supply of blood.

Airway Obstruction (Choking)

Choking is the result of an object in the air

passage. A foreign object that is stuck at the

back of the throat my block the throat or cause

muscular spasm. A casualty with a completely

blocked passage will show the following signs:

Clutching the throat with the hands. Unable to

speak

Unable to breath, unable to cough

Will lose consciousness

The Unconscious Chocking

Victim

If the victim becomes unconscious:

Turn over on back

Perform finger sweep and try to remove the

object

Open the airway and attempt to ventilate

Re-tilt head and give 2 full breaths

Perform up to 5 abdominal trusts

Do finger sweep. Give 2 full breaths

Repeat abdominal trust, finger sweep and 2

full breaths

Conscious Chocking

Determine if patient is choking

Stand behind patient and deliver abdominal

trusts

Repeat until object is expelled or patient loses

consciousness

Skills for Treating Unconscious

ChokingSKILL STEPS

Check of scene safety If the scene is safe, BSI and proceed

Check for responsiveness Tap gently on patient. Shout “Are you OK?”

Call for help Shout for help to attract another person and to call an

ambulance - 110

Position The Casualty Roll the casualty on back in a single unit. Support the head as

you roll.

Open the airway Use the heat-tilt/chin-lift method to open airway and check for

breathing

Check for breathing Look, listen, and feel for breath 3 – 5 seconds. Use the head

tilt/chin left method.

If not breathing

Check the Mouth Look into the mouth for food, loose dentures and other foreign

objects. Turn head to you, use index finger to hook sweep to

clear the mouth

Give 2 rescue breaths Give 2 quick rescue breaths At a rate of 1 – 1½ seconds.

Maintain an open airway.

Re-tilt Head If air does not go in you should re-tilt the head to make sure

that the airway is fully open and give 2 breaths again


ChokingSKILL STEPS

Straddle the Casualty If air does not go in for the second time you are now sure that

the throat is blocked, straddle the casualty

Give 5 Abdominal thrusts Place the heal of one hand on the abdomen above the navel

and below he tip of the sternum. Place your hand on top of the

hand in position and give 5 abdominal thrust pressing down

while pushing up.

Roll the casualty on side When the object is dislodged, place the near hand across the

chest, roll the casualty on their side for drainage and hook

sweep with index finger to clear the mouth.

Position casualty Place casualty on their back

Open the airway Use head tilt/chin lift method

Check for breathing Look, listen and feel for breath 3 – 5 seconds. Use head tilt/chin

lift method.

If no breathing

Give 2 breaths Give 2 rescue breaths at a rate of 1 – 1½ seconds, air goes into

the chest, rise and fall, maintain an open airway

Check for pulse If there is no pulse and no breathing give rescue breathing, i.e. 1

breath every 5 seconds. If there is no pulse, no breathing give

30 chest compressions, 2 breaths


Choking

Asthma

In an asthma attack, the muscles of

the air passage in the lungs go into

spasm and the lining of the airway

become swollen. This causes the

narrowing of the air passage,

making breathing difficult.

Sometimes there is a recognized

trigger for an attack such as an

allergy, a cold, dust, drugs, carpet,

animals, flowers etc..

Signs & Symptoms of Asthma

Difficulty in breathing

Wheezing as the casualty breathes out

Difficulty speaking and whispering

Distress and anxiety

Coughing

Casualty my lose consciousness and stop

breathing

TreatmentKeep calm and reassure the casualty, ask the

person to sit and lean forward. if lying down

prop the person with 3 to 4 pillows to have

them in the sitting position.

Ask the person to breathe slowly and deeply

to get more oxygen.

Ask casualty for medication. Allow or Assist

with the taking of medication. If casualty does

not respond to the medication, prepare to take

to the hospital

Get history from casualty or relatives and

friends using acronym S.A.M.P.L.E.

Treatment cont’dS - Signs and Symptoms (How long has the casualty

been wheezing or breathing short?

A - Allergies (any known allergies to drugs, food,

pollens, pet, carpet, smoke, dust)

M- Medications (does the casualty have his/her

medication (inhaler)?

P - Pertinent past history (did the casualty have a

recent cold or respiratory infection?)

L - Last meal (Has he/she had any fluids since this

attack started?)

E - Events leading to the attack (What was he doing

or exposed to that may have caused the attack?)

Wounds

A wound is an abnormal break in the skin or

tissues of the body that allow bleeding and

enables germs to enter. A wound is either

open or closed.

As a first Aider, your priorities are as follows:-

A. Assess the casualty’s condition (ABC)

B. Protect yourself (BSI) – put on gloves

C. Control bleeding by applying direct

pressure and elevation. To prevent shock

apply pressure pad.

D. Comfort, reassure and prepare to take

casualty to hospital.

Types of Wounds (GLACIAS CAP)

G - Gunshot – the entry may be small and neat. Any exit

wound may be large and jagged.

L - Laceration – jagged or ripping forces resulting in tear

or lacerations, rough edges caused by barb wire,

band saw.

A - Abrasion (graze) – superficial wound, damage to

skin surface.

C - Contusion (bruise) – closed would, the skin is not

broken, the blood flows between the tissue and is

caused by a blunt blow. Otherwise called “coco” or

black and blue.

I - Incisions - this is a clean cut caused by a sharp

edged object such as a razor, knife, thread.

A - Avulsion – the tearing loose or tearing off of large

flaps of skin or flesh e.g. earring torn from ears.

Types of Wounds cont’dS - Stab wound – caused by knife or long instrument

driven forcefully into the body.

C - Crush – occurs on hard/soft tissues of the body,

for example an iron dropping on the toes.

A - Amputation – the cutting or tearing off the hands,

fingers, arms, legs, feet, toes.

P - Puncture – caused by knives, nails, ice picks

puncturing the body in a straight line. When there

is an entry and exit it is called a perforated would

Evisceration- protrusion of the intestines

Penetrating Chest Wound

The heart, lungs, and major blood vessels are protected by 12 pairs

of ribs which make up the ribcage. If a sharp object penetrates the

chest wall, there will be internal bleeding.

Treatment for Wounds

Rest

Elevate

Direct Pressure

Clean

Use material available to make bandage

Tie bandage

BleedingBleeding is the emission of blood from the

circulatory system. The heart pumps blood

around the body. The blood is the vehicle in

which oxygen travels throughout the body.

The blood carries oxygen to the cells and

takes away carbon dioxide.

Types of Bleeding:

Arterial

Venous

Capillaries

Types of Blood Vessels

Arteries

Veins

Capillaries

Arteries

Arteries carry blood away

from the heart and they have

a strong outer thick muscular

layer and run next to the

bones. The blood in the artery

is bright red in color. When

an artery is cut, the blood

spurts to the rhythm of the

heart beat.

Veins

Veins carry blood to the heart. This is

made possible by the surrounding

muscles and the heart suction. The walls

are thinner and are provided with valves

to prevent blood going in the wrong

direction. The smaller arterioles and

venues control the blood flow into and

out of the capillary bed. They are next to

the surface. The blood in the vein is dark

red in colour. When a vein is cut, there is

a heavy steady stream.

Capillaries

Capillaries connect the arteries to the

veins. This is where exchange takes

place between the bloodstream and

the body tissues. They allow for the

exchange of gasses and transfer of

nutrients and waste products.

Remember:

The typical Adult has 6 litres (About 12 pints)

of blood. The volume must be maintained for

proper circulatory functions.

Pressure Points

Arterial bleeding can be controlled by

digital pressure applied at pressure

points. Pressure points are placed over

a bone where arteries are close to the

skin. Pressing the artery against the

underlying bone can control the flow of

blood to the injury. The most commonly

used pressure points to control profuse

bleeding in emergencies are:

Brachial Artery for bleeding from the arm

Femoral Artery for bleeding from the leg

Temporal Artery for bleeding from the scalp

Pressure Points

Functions of the Blood Carry oxygen and Carbon dioxide

Carry nutrients and water

Carry waste products from the tissues to the

excretory organs

Distributes enzymes and hormones

Distributes heat generated by muscular activity

and transported to the skin for cooling.

Protects the body from infection by means of the

white blood cells.

Coagulation of wounds by platelets when they

come into contact with damaged tissue.

Lymphatic System

The lymphatic System is a

network of vessels called lymph

vessels. These vessels contain

fluid similar to plasma, called

lymph. Lymph in filtered through

bodies known as lymph nodes.

The lymphatic system assists in

the removal of waste from body

tissues, transportation of nutrients

and fighting infection.

How to control bleedingThere are 2 methods used to control bleeding:

A. Direct pressure

B. Elevation

Direct Pressure

Most cases of external bleeding can be

controlled by applying direct pressure to the

site of the wound, by using a sterile dressing.

You can also apply pressure at the pressure

points. Pressure points are sites where an

artery that is close to the skin surface lies

directly over a bone, for example on the inside

of the upper arm, femoral in the thigh.

How to control bleeding cont’dElevation

Elevation is to elevate the would or the affected

part above the heart, if there are no suspected

fractures.

Nose Bleeding

The best way to control bleeding is by using

direct pressure, or even elevation.

Put the casualty to sit, tilt the head forward,

pinch the nose shut and breathe through the

mouth for 10 – 15 minutes. Repeat the

procedure if bleeding continues

Remember to protect yourself at all times from body

fluids

ShockCirculatory Shock – occurs when there is not enough

blood to fill the circulatory system needed to supply the

vital organs of the body.

Hypovolemic Shock – means bleeding profusely,

vomiting and diarrhoea, severe dehydration and burns

caused by the loss of plasma component of the blood.

Metabolic Shock – is fluid shock caused by loss of

blood fluid by way of diarrhoea and or vomiting

(hypovolemic shock).

Cardiogenic Shock – is heart shocks caused by the

heart failing to pump enough blood to all parts of the

body. This is caused by damage to the heart itself.

Shock cont’d

Neurogenic Shock – is nerve shock, when something

goes wrong with the nervous system such as injury in a

accident, when there is not enough blood in the body to

fill the new space.

Anaphylacatic Shock – is allergy shock caused by

something to which the casualty is extremely allergic.

Pshycogenic Shock – is fainting caused by fear, grief,

exhaustion, hunger, emotional stress, heat, low blood

sugar, anaemia. This causes the nervous system to

react and dilate the blood vessels. The flow of blood to

the brain is interrupted.

Septic Shock – is bloodstream shock caused by

infections. Poisons are released that causes the blood

vessels to dilate.

SymptomsSigns & Symptoms Causes

• Altered mental status • Internal and external bleeding

• Anxiety, restlessness • Crush injuries

• Pale, cool clammy skin • Burns – plasma

• Nausea, vomiting • Illness-peritonitis, cardiac conditions

• Rapid breathing,

Tachycardia

• Severe allergic reaction

• Unresponsiveness • Severe bleeding

• Strong thirst • Poisoning

• Cyanosis • Heart attack

• Hypertension • Electrical Shock

• Profuse bleeding

• Diarrhoea

• Shaking and trembling

• Nausea

• Thirst

• Weakness

• Restlessness

• Fear

• Dizziness

Casualty Appearance

Cold and Clammy Skin

Breathing rapid and Shallow

Pulse rapid and weak

Pupils dilated

Treatment for Shock

Check for breathing and maintain an open

airway

Control bleeding, splint major fractures and

treat any other cause.

Elevate the legs 8 – 12 inches, if there are no

fractures.

Loosen tight clothing, monitor, and record vital

signs. This must be done every 5 minutes.

Do not give the casualty anything by mouth,

prepare for vomiting.

Prepare to take the casualty to the hospital.

Other conditions which may

cause Shock

Diarrhoea & Vomiting

Dehydration

Vomiting

How to prepare Oral

Rehydration Fluid

i. Boil and cool one (1) litre water.

ii. Add 4 tablespoons of dark sugar.

iii. Add 1 teaspoon salt

iv. Pour into clean covered bottle.

Burns & Scalds

Burns - injuries resulting from

exposure to dry heat, extreme

cold, radiation, corrosive

substances and friction.

Scalds – injuries caused by

(moist) wet heat from hot liquids,

vapours, teas or hot fat.

Burns & Scalds

Burns are usually classified according

to depth, size or degree of skin damage

as first, second or third degree burns.

First Degree – Superficial burns: Involve

the top layer of the skin known as the

epidermis. There is redness, swelling,

pain and tenderness. Sun burn is a

superficial burn.

Second Degree – Partial thickness:

involves both the epidermis and the

dermis(the 2 top layers of the skin).

Second degree burns involve intense pain,

redden skin that is moist and has blistes

(steam burn)

Burns & Scalds

Third Degree – Full Thickness Burns:

involves all dermal layers, nerves, fat

tissue, muscle, bone or organs. This can

be dry and leathery and may appear white,

dark brown or charred. Since there is

often nerve damage present, there may be

no sensation or pain present.

Treatment - Burns & Scalds

If a burn involves the mouth, nose,

throat or airway, this is considered

critical and requires medical attention.

1. Flush the burned area under

cool running water for 15 – 20

minutes or until cool.

2. Do not break blisters.

3. Remove all jewellery.

4. Monitor ABC and treat or

shock.

Classification of Burns

Heat (Thermal): This includes fire, steam and

hot object

Chemicals: This includes caustics, such as

acids and alkalis.

Electricity: This includes electric outlets,

frayed wires and faulty circuits.

Lightning: This includes electrical burns

and injuries during thunder

storms.

Sunlight: This includes burns to the skin

or eyes due to the ultraviolet

rays from the sun.

Classification of Burns

Caring for Burns

Chemical Burns - To care for chemical burns

wash the chemical from the body with water,

flush the area for 15 – 30 minutes, remove

contaminated clothing, shoes, socks and

jewellery during the wash. Apply dry an sterile

dressing.

Electrical Burns – On the scene of an

electrical burn, the most serious problem

sustained is cardiac arrest. Nervous system

damage and injury to internal organs may also

occur. Make sure that the source of electricity

has been turned off, use dry stick or board and

wear rubber sole shoes.

Caring for Burns

Electrical burns cont’d:

Treatment

1. Prepare for complications involving the

airway and heart.

2. Evaluate the burn. Look for entrance and

exit wound (enter the hand and exit the

foot).

3. Apply dry sterile dressing to the burn sites.

4. Monitor ABS and treat for shock.

5. Prepare for removal to the hospital.

Caring for Burns

Lightning Burns – Lightning burns occur

when someone is electrocuted during a

thunder storm. Treat as electrical shock.

Sunlight (Radiation) – This is a superficial

burn. Treat – have bath and pat dry.

Friction (Brush Burns) – Spinning wheel or

fast moving rope – cool with plenty of water.

Poisoning, Bites and Stings

A poison is a toxic substance – solid,

liquid or gas, if it enters the body may

cause harm or death.

4 main ways by which poison may

enter the body:

1. Swallowed (ingested) by Mouth

2. Inhalation (Breathing)

3. Absorption (Contract)

4. Injection (under the skin)

Signs & Symptoms

Ingested poison

May include any of the following:

1. Burns or stains around the casualty’s mouth.

2. Breath odours, body odours.

3. Abnormal breather and pulse rate

4. Dilated or constricted pupils

5. Sweating

6. Excessive saliva or foaming at the mouth

7. Pains in the mouth or throat, stomach,

abdomen

8. Convulsion

9. Altered mental status including

unconsciousness

Treatment

Swallowed Poison

1. Do not give anything by mouth, take

the casualty to the hospital at once,

take the poison or container with you.

2. Prepare to treat for shock. Carry the

casualty in the recover position,

should vomiting occur.

3. Give plenty of fresh air and monitor

ABC.

Treatment

Inhaled Poison

1. Look for possible sources that cause

inhaled poison before you try to save life,

because your life comes first. Make sure

it is safe for you to enter any building or

area that I contaminated.

2. Remove the casualty from the source,

give plenty of fresh air.

3. Maintain an open airway, monitor the

casualty’s ABC.

4. Prepare for shock and take to the

hospital.

Treatment

Absorbed Poison

1. Remove the casualty from the

source, remove clothing, wash the

affected area with soap and water.

2. Monitor ABC and prepare to take to

hospital, give elixir to prevent allergic

reactions

Treatment

Injected Poison

1. Prepare for (anaphylactic) allergic shock.

2. Scrape away bees and wasp stingers and

venom sacs.

3. Place and ice-pack over the area to lessen

the pain and reduce swelling.

4. An aspirin moistened and applied to the

area as a dressing will take away the pain.

5. Give a dose of elixir, observe for

symptoms of allergic reactions. Monitor

ABCs.

DressingDressing: Any material used to cover a wound

that will help to control bleeding and

reduce contamination and infection.

Bandage: Any material that is used to hold a

dressing in place.

Rules for Using Dressing

1. Always wear disposable gloves.

2. Place the dressing over the would.

3. If blood seeps through the dressing, place another

over it.

4. Dispose of gloves, used dressing and soiled items

properly.

Types of Dressing

1. Non-sterile

2. Adhesive

3. Cold compress

BandagingThere are a number of different, first aid

uses for bandages. Bandages used to

secure dressings, control bleeding, support

and immobilize limbs and reduce swelling in

an injured part.

3 main types of bandages

1. Roller Bandages – Secure dressing and support

injured limbs.

2. Tubular Bandages – Holds dressing on fingers

and toes or support injured events.

3. Triangular Bandages – This can be used in may

ways, to make a dressing a pressure pad and

immobilize limbs.

Types of Bandages1. Round bandage

2. Arm bandage

3. Hand bandage

4. Amputation bandage

5. Chest/back bandage

6. Head bandage

7. Wrist/ankle bandage

8. Knee bandage

9. Foot bandage

10. Arm sling bandage

11. Elevated arm sling bandage

12. Clavicle bandage

13. Dislocation bandage

Types of Bandages

Bones, Muscles & Joints

Joint - Where 2 or more bones are joined

Muscles - A soft tissue that lengthens and shortens to

create movements. There are 2 types of

muscles - Voluntary (controls movements)

and Involuntary (control internal organs, heart

etc.)

Sprain - The stretching and tearing of ligaments and

other soft tissue at a joint. This is caused by

sudden or awkward wrenching movements.

Ligament - Tough, fibrous tissue that hold bones together

at a joint.

Strain - The stretching and tearing or muscles and

tendons caused by sudden or awkward

movements.

Tendons - Fibrous bands of tissues that attach muscles

to bones.

Signs & Symptoms of Sprains

and Strains

A. Pain and tenderness

B. Difficulty in moving the injured

part.

C. Swelling and bruising in the area if

the muscles are torn.

Treatment

R – Rest the injured part.

I – Immobilize

C – Cold compress (15 – 20 minutes)

E – Elevate the injured part

Advise the casualty to go to the doctor

Fractures

A Fracture is a cracked, chipped, splintered or broken

bone caused by direct or indirect forces, strong twisting

forces. Any strong force to the extremities can cause a

fracture, a dislocation, a sprain, a strain and damage to

soft tissues.

Types of Fractures

Simple (closed) - A simple fracture is when the bone is

clearly broken.

Compound - A compound fracture is when the bone

is Commuted (Open) broken in more than one

place and into

many pieces.

Angulated - And angulated fracture is an injury to

an extremity that causes the bone to

bend.

Dislocation - This is when one end of the bone is

Fractures

Types of Fractures cont’d

Complicated - This is when the fractured bone

interferes with an organ.

Greenstick - Greenstick fractures are

commonly associated with infants,

toddlers whose bones are soft and

bend like a greenstick.

Depressed - A depressed fracture is referred to

as a dent. The bones are driven

inwards mainly in the skull.

Linear - This type of fracture mainly occurs

in the head. Linear fracture is a

crack.

Sign & Symptoms of Fractures

a. Pain – nerves surrounding the injury

have been pressed by swelling tissue

or broken bone ends.

b. Swelling – the injured area begins to

swell because blood from ruptured

blood vessels is collecting inside the

tissues.

c. Deformity – a part of the limb looks

different in size or shape (always

compare both arms and legs to one

another)


SPLINT –Any hard/rigid material used to immobilize a

fracture

S - Swelling

P - Pain

L - Loss of use

I - Irregularity

N - Numbness

T - Tenderness

S - Shortening


D - Deformity

D - Dislocation

E - Exposed bone

P - Patient heard sound of

broken bones

Treatment of Fractures

During your initial assessment, do not

focus on obvious injuries, but

first assess responsiveness, then

airway, breathing and circulation.

Control all major bleeding,

check and correct life-threatening

problems as quickly as possible

Sign & Symptoms of FracturesAfter correcting and stabilizing life-

threatening injuries, first priority is given to

possible injury to the Spine.

a. Skull – because it protects the brain and

contains a portion of the airway.

b. Pelvis – because it protects reproductive and

urinary organs and major nerves and blood

vessels.

c. Thigh – because it I the longest, sturdiest

bone (femur) in the body, major nerve and

blood vessels surround it.

d. Rib Cage – because it protects the heart and

lungs, broken bone may damage these

organs and the patient may have difficulty

breathing.


e. Extremity Injury – where no distal pulse is

detected during the initial assessment,

extremities should be straightened.

f. Injuries to the arm, lower leg and

individual ribs – are considered and

managed last.

Treatment

1. Assess the casualty before you focus on

any particular injury. Treat life threatening

problems first. Prioritize and manage other

injuries.

2. Apply a dressing if there is an open wound.

Check for distal pulse (radial), sensation

and motor function. Distal pulse

(circulation), sensation (feeling) motor

function (ability to move) check before and

after splinting.

3. Immobilized the extremity

4. Tie bandages above and below the injury

5. Check ABC

6. Prepare casualty for the hospital

Why Splint

Pain – A splint can reduce much of the

casualty’s because it immobilizes the broken or

dislocated bones in place and prevents them

from damaging nerves and tissues.

Bleeding – Fractured bone ends, dislocated

bones and moving bone fragment can damage

blood vessels and cause internal and external

bleeding.

Rules for Splinting

1. Assess and reassure casualty and explain

what you plan to do.

2. Expose the injury site.

3. Control bleeding by dressing the wounds.

Why Splint

Rules for Splinting cont’d

4. Check distal pulse, sensation and motor

function before and after splinting.

5. Reposition limb and apply splint if allowed to

do so, tie above and below the wound.

6. Firmly secure the splint, and reassess distal

pulse and sensation.

7. Monitor casualty – ABC – and prepare to

take to the hospital.

8. The reason for straightening closed

angulated fractures is to improve circulation.

It makes splinting easier.

9. Make no attempt to straighten angulation.

Why Splint

Rules for Splinting cont’d

10. Do not attempt to straighten angulations if

the injuries involve the shoulder, pelvis, hip,

thigh, wrist, hand, foot or a joint immediately

above or below the injury site.

Injuries to the Spine

Injuries to the spine can cause one

to become paralysed and reduces

normal body function and

movement. Spinal injuries are

caused by forces to the head,

neck, back, chest, pelvis or legs. A

whiplash is caused by motor

vehicle accidents. The spine is a

column made up of 33 bones

called vertebrates.

The Spine

The spine is a column made up of 33

bones called vertebrates.

Cervical spine – 7 bones in neck

Thoracic spine – 12 bones in the upper

back

Lumbar spine – 5 bones in the lower

back

Sacrum – 5 fused bones

Coccyx – 4 fused bones

Signs & Symptoms of Spinal

InjuriesA. Weakness, numbness or tingling sensation or

a loss of feeling in arms or legs.

B. Paralysis to the arms or legs.

C. Painful movements of arms and legs or no pain

sensation.

D. Pain or tenderness along the back of the neck

or the backbone.

E. Burning sensation along the spine or an

extremity.

F. Deformity of the spine, angle of head and neck.

G. Loss of bladder and bowel control, difficulty

breathing.

H. Persistent erection priapism

Treatment for Injuries of the Spine

1. Make certain the airway is open by using

the jaw-thrust manoeuvre.

2. Control serious bleeding – avoid moving

the injured part when applying dressing.

3. Always presume that an unconscious

accident patient has spinal injuries. Check

distal pulse, check sensation (feeling),

motor function (ability to move)

4. Do not attempt to splint fracture if there are

indications of spinal injuries.

Treatment for Injuries of the Spine

5. Never move a casualty with spinal

injuries unless you must do so to

provide A.R. or CPR and to treat severe

bleeding.

6. Keep the casualty still, stabilize or

immobilize the casualty’s head, neck

and as much of the body as possible.

7. Monitor casualty with possible spinal

injury. These casualties will go into

shock. Sometimes their chest muscles

will be paralyzed and they will go into

respiratory arrest.

Head to Toe Examination

Injuries and illnesses usually manifest

themselves as groups of distinctive features.

There a 2 types of features:

1. Sign: Surface of the body, which you may

detect

2. Symptom: what is coming from inside the

body.


Always start at the head and work down to the

toes using DCAPT-BTLS or DOTS method

D - DEFORMITIES

C - CONTUSION

A - ABRASIONS

P - PUNCTURE/PENETRATIONS

B - BURNS/BLOOD

T - TENDERNESS

L - LACERATIONS

S - SWELLING


Always start at the head and work down to

the toes using DCAPT-BTLS or DOTS

method

D - DEFORMITIES

O - OPEN WOUNDS

T - TENDERNESS

S - SWELLING


To begin your assessment:

1. Check the head and scalp for cuts, bruises and

depressions.

2. Examine the patient’s eyes using a penlight.

Look for foreign objects and check the size of

the pupils. Dilation or constriction may

indicate a brain or spinal injury.

3. Inspect the ears and nose for blood, bloody

fluid or clear fluid. The clear fluid is called cere-

bro spinal fluid and indicates severe head

injury.

4. Inspect the mouth for possible airway

obstructions: bleeding, broken teeth, bridges,

dentures, crowns, chewing gums, food, vomit

or other foreign objects.

Head to Toe Examination Cont’d

To begin your assessment cont’d:

5. Check the cervical spine bones for tenderness

and deformities. Check the neck for injury or

deformities.

6. Feel clavicles for tenderness and deformities,

inspect the chest for cuts, bruises,

penetrations and impaled objects. Check for

possible fractures and equal expansion of the

chest and rib cages.

7. Inspect the abdomen for cuts, bruises,

penetrations, distension and impaled objects.

Fee abdomen for tenderness and pain.

8. Feel the upper back. Check the thoracic spine

– 12 bones – for point tenderness and

deformities


To begin your assessment cont’d:

9. Feel the lower back lumbar spine – 5 bones –

for point tenderness and deformities.

10. Fee the pelvis for possible injuries and

incontinence.

11. Examine the legs and feet individually. Do not

lift or move the legs or feet. Compare both

legs – length, shape, swelling or deformities.

12. Check distal pulse for circulation. Check the

posterior tubial pulse. Feel behind the ankle

or the dorsalis-pedis pulse, locutid lacteral to

the large tnedons of the big toe.


To begin your assessment:

13. Examine the upper extremities from the

shoulders to the fingertips. Feel each

hand and note any cuts bruises, impaled

objects, bleeding, deformities, swelling,

dislocations, protruding bones or

fractures. Check the radial pulse. Check

for sensation by the touch of a finger and

motor function by asking the casualty to

grasp your hand.

14. If there are no injuries to the head, neck,

spine or extremities, inspect the back

surface.


Medical Trauma

Asthma Laceration

Fainting Abrasion

Seizure Burns

Stroke Fractures

Heart Attack Amputation

Cardiac Arrest Motor Vehicle Accident

FallNeck: Neck vein, distension and medical identification

devices.

Chest: Presence and equality of breathing sound

Abdomen: Distension, firmness or rigidity

Extremities: Pulse, motor function, sensation and medical

alert devices.

Vital Signs

The vital signs include:

1. Pulse

2. Respiration

3. Temperature

4. Blood Pressure

5. Skin Colour

Lifting & Moving Casualties

a. Position your feet properly – They

should be on a firm, level surface

and positioned shoulder-width

apart.

b. Use your legs, not your back, to do

the lifting – Keep your back straight

and bend your knees.

c. Never twist or attempt to make any

moves other than the lift – Attempts

to turn or twist while you are lifting

are a major cause of injury.


cont’dd. When lifting with one hand, do not

compensate – avoid leaning to

either side. Keep your back straight

and locked.

e. Keep the weight as close to your

body as possible – This is part of

good body mechanics and allows

you to used your legs rather than

your back, while lifting. The farther

the weight is from your body, the

greater your chance of injury.


cont’df. When carrying a patient on stairs,

use a stair chair instead of a

stretcher whenever possible –

keep your back straight. Flex your

knees and lean forward from the

hips, not the waist. If you are

walking backwards down stairs,

ask a helper to steady your back.


cont’dWhen lifting or moving patients you

should:

Explain to the patient what you are

doing.

Not lift, or move too fast or in ways

that will make the injury or illness

worse.

Not grasp the injured area.

Move by grasping clothing or

specialist equipment.

Keep you back straight.

Lifting & Moving Casualties cont’d

When lifting or moving patients you

should:

Bend your knees and hips in order to

make good use of your leg muscles

and lift with arms straight.

Keep you chin and elbows tucked in

and grip shoulder width.

Stand with your feet apart to allow a

balanced distribution of your body

weight.

Stand close to the patient.


cont’dWhen lifting or moving patients you

should:

The load should be held as close to

the body as possible to allow for

central gravity.

Break down lifting in stages as to

allow for rest and proper control

during the movement.

Lift with your feet straight and one

foot slightly forward

first aid (entire presentation)

Healthcare

aidfirst aid

aid introduction

aider work

aid procedures

scene safe

methodical way

situationtaking charge

body fluids