11

FIRST AIDFIRST AID

Prepared by:Prepared by:DR. GHAZI K. HAMADEHDR. GHAZI K. HAMADEH

Chief Physician / Director (A), Medical CenterChief Physician / Director (A), Medical CenterKing Fahad University of Petroleum & MineralsKing Fahad University of Petroleum & Minerals

22

WHAT IS FIRST AID?WHAT IS FIRST AID?It is the immediate assistance or care given to a person who has It is the immediate assistance or care given to a person who has been injured or suddenly became ill, from the moment of the been injured or suddenly became ill, from the moment of the accident until availability of specialized medical care.accident until availability of specialized medical care.Note:Note:First Aid is not restricted to physical but also involves First Aid is not restricted to physical but also involves psychological support as well.psychological support as well.

Who needs First Aid?Who needs First Aid?Cardiac and Respiratory ArrestCardiac and Respiratory ArrestElectric ShockElectric ShockWoundsWoundsBleedingBleedingBurnsBurnsFractures and Traumatic InjuriesFractures and Traumatic InjuriesPoisoningPoisoningDrowning Drowning Snake bitesSnake bites

33

1)1) Examination of the PulseExamination of the Pulse

Radial PulseRadial Pulse Brachial PulseBrachial Pulse Carotid PulseCarotid Pulse Feeling Heart Beats on the Chest Wall.Feeling Heart Beats on the Chest Wall.

Note:Note:It is not necessary to feel the pulse, you can Start chest compressions.It is not necessary to feel the pulse, you can Start chest compressions.If breathing didn’t restart after giving 2 breaths, then starts If breathing didn’t restart after giving 2 breaths, then starts

compressionscompressions

2)2) Examination of BreathingExamination of Breathing Normal BreathingNormal Breathing DyspneaDyspnea Respiratory ArrestRespiratory Arrest

44

First Aid PrioritiesFirst Aid Priorities Save the victim and selfSave the victim and self Keep breathing and heart beatsKeep breathing and heart beats Control BleedingControl Bleeding Treat PoisoningTreat Poisoning Prevent ShockPrevent Shock Examine the victim carefullyExamine the victim carefully Ask for specialized Medical CareAsk for specialized Medical Care Continue first aid measures until arrival of Continue first aid measures until arrival of

medical care providersmedical care providers

55

Respiratory ArrestRespiratory Arrest

Breathing may Stop meanwhile the heart is still beating Breathing may Stop meanwhile the heart is still beating for few minutesfor few minutes

Breathing may stop because of electrical shock, Breathing may stop because of electrical shock, drowning, suffocation, poisoning, chest, abdomen and drowning, suffocation, poisoning, chest, abdomen and head trauma.head trauma.

Steps:Steps: Open the airwayOpen the airway Tilt the head back and raise the chinTilt the head back and raise the chin

Examine breathing for 5 secondsExamine breathing for 5 secondsa) feel the aira) feel the airb)b) hear the sound of breaths.hear the sound of breaths.c)c) See the chest movementsSee the chest movements

If no breathing close the nose and give 2 breathsIf no breathing close the nose and give 2 breaths Examine the pulse every minute and give a breath every Examine the pulse every minute and give a breath every

5 seconds.5 seconds. If pulse stopped do CPRIf pulse stopped do CPR

66

CHOKINGCHOKING Choking is usually caused by a piece of food and or a small object in Choking is usually caused by a piece of food and or a small object in

the mouth.the mouth. Choking cause coughing, dyspnea, but the most important sign to Choking cause coughing, dyspnea, but the most important sign to

see is the victim holding his necksee is the victim holding his neck

FIRST AIDFIRST AID If the victim talks or coughs encourage him to continue coughing.If the victim talks or coughs encourage him to continue coughing. If the victim can’t talk or cough do 6-10 Abdominal thrusts.If the victim can’t talk or cough do 6-10 Abdominal thrusts. If the victim is unconscious put him on the floor give 2 breaths.If the victim is unconscious put him on the floor give 2 breaths. Do 6-10 adominal thrusts, clean the mouth by 2 fingers and give 2 Do 6-10 adominal thrusts, clean the mouth by 2 fingers and give 2

breaths.breaths. Repeat the abdominal thrusts, if needed.Repeat the abdominal thrusts, if needed.

If the victim is less than one yearIf the victim is less than one year

Hold the infant face down on your forearm which is resting on your Hold the infant face down on your forearm which is resting on your thigh.thigh.

Thump the back 5 times by the heel of the hand.Thump the back 5 times by the heel of the hand. If not improved put him on your forearm and face upward, head is If not improved put him on your forearm and face upward, head is

lower than trunk, and apply 5 chest thrusts by 2 fingers (on the lower than trunk, and apply 5 chest thrusts by 2 fingers (on the middle of the chest bone).middle of the chest bone).

If no response repeat back and chest thrusts as beforeIf no response repeat back and chest thrusts as before If no response call for medical help.If no response call for medical help.Note:Note:Adults and children above one year are given abdominal thrusts only.Adults and children above one year are given abdominal thrusts only.

77

C.P.R.C.P.R. C.P.R. is a life saving techniqueC.P.R. is a life saving technique

It is indicated whenever heart and breathing stop.It is indicated whenever heart and breathing stop.

It is a combination of mouth to mouth breathing and chest It is a combination of mouth to mouth breathing and chest compressions.compressions.

If breathing stops → brain damage occurs within few minutes but If breathing stops → brain damage occurs within few minutes but death occurs within 8-10 minutes.death occurs within 8-10 minutes.

STEPS BEFORE STARTING C.P.R.STEPS BEFORE STARTING C.P.R.

- Make sure that victim is unconscious (by shaking - Make sure that victim is unconscious (by shaking shoulders and asking loudly are you ok.?) shoulders and asking loudly are you ok.?)

- Call 999 before starting C.P.R. but if the victim is a child - Call 999 before starting C.P.R. but if the victim is a child between 1-8 years start C.P.R. for 2 minutes before calling 999 between 1-8 years start C.P.R. for 2 minutes before calling 999

88

C.P.R. STEPS ARE CALLED ABCC.P.R. STEPS ARE CALLED ABC

1. 1. AIRWAY STEPAIRWAY STEP

- Put the victim on his back on a firm surface- Put the victim on his back on a firm surface- Kneel close to the victim neck or shoulders- Kneel close to the victim neck or shoulders- Tilt the chin upward to open the airway- Tilt the chin upward to open the airway- Check breathing for 10 seconds.- Check breathing for 10 seconds.

2.2. BREATHING STEPBREATHING STEP

- - Close the nostrile and give 2 breaths (mouth to Close the nostrile and give 2 breaths (mouth to mouth) and observe the chest rises.mouth) and observe the chest rises.

99

CIRCULATORY STEPCIRCULATORY STEP- - Place the heel of one hand on the center of the chestPlace the heel of one hand on the center of the chest between the nipples.between the nipples.- - Apply the other hand over it.Apply the other hand over it.- - Push the chest down (1.5 – 2 inches) in an average of 2 Push the chest down (1.5 – 2 inches) in an average of 2

compressions per second (100 times)compressions per second (100 times)- - Give 2 breaths after each 30 compressions.Give 2 breaths after each 30 compressions.

If the victim didn’t breath after 5 cycles (2 minutes) we can use If the victim didn’t breath after 5 cycles (2 minutes) we can use Automatic External Defibrillator (if available) otherwise, we continue Automatic External Defibrillator (if available) otherwise, we continue C.P.R., however this device is not recommended for infants less than C.P.R., however this device is not recommended for infants less than one year.one year.

NOTES ON C.P.R. FOR CHILDRENNOTES ON C.P.R. FOR CHILDREN-- For children 1-8 years we start C.P.R. before calling 999 For children 1-8 years we start C.P.R. before calling 999

for 5 cycles (minutes)for 5 cycles (minutes)-- We use one hand only for chest compressions.We use one hand only for chest compressions.- Rate of chest compressions to breathing is the same as adults 30/2.Rate of chest compressions to breathing is the same as adults 30/2.

NOTES ON C.P.R. FOR INFANTS LESS THAN 1 YEAR.NOTES ON C.P.R. FOR INFANTS LESS THAN 1 YEAR.-- Start C.P.R. 5 cycles (2 minutes) before calling 999.Start C.P.R. 5 cycles (2 minutes) before calling 999.-- No need for deep breath.No need for deep breath.-- Use 2 fingers of one hand for chest compressionsUse 2 fingers of one hand for chest compressions-- Compressions should compress the chest from 1/3 – ½ its depth.Compressions should compress the chest from 1/3 – ½ its depth.

1010

WOUNDSWOUNDS

First Aid First Aid -- Bleeding stops on its own, but pressure with a clean Bleeding stops on its own, but pressure with a clean cloth or bandage can be applied for 20-30 minutes.cloth or bandage can be applied for 20-30 minutes.- - Use water if the wound needs cleaning but don’t Use water if the wound needs cleaning but don’t use antiseptics (iodine or others)use antiseptics (iodine or others)

FIRST AID FOR CUTSFIRST AID FOR CUTS- - Apply direct pressure by a piece of cloth and raise the Apply direct pressure by a piece of cloth and raise the

limb above the level of the trunk.limb above the level of the trunk.-- Add more pieces of cloth and apply pressure on the Add more pieces of cloth and apply pressure on the

major artery that supply the limb, if needed.major artery that supply the limb, if needed.-- Minimize Movement by fixing the wounded limb on Minimize Movement by fixing the wounded limb on the the body.body.-- Transfer the victim to Medical Facility.Transfer the victim to Medical Facility.

1111

EPISTAXIS (Nose Bleeding)EPISTAXIS (Nose Bleeding)

-- Tilt head down to prevent bleeding to the throat.Tilt head down to prevent bleeding to the throat.

-- Close the victim’s nostrils with the tips of 2 fingers.Close the victim’s nostrils with the tips of 2 fingers.

-- Ask victim to breath through mouthAsk victim to breath through mouth

-- We may apply a gauze packing to the bleeding nose.We may apply a gauze packing to the bleeding nose.

-- If bleeding didn’t stop after 20 minutes we ask If bleeding didn’t stop after 20 minutes we ask Medical Medical Care Provider.Care Provider.

1212

SHOCKSHOCK

It is a state characterized by low blood pressure, rapid pulse, and It is a state characterized by low blood pressure, rapid pulse, and decrease blood supply to brain and other vital organs.decrease blood supply to brain and other vital organs.

CAUSESCAUSES Fluid loss (as in severe vomiting, severe diarrhea, major burns, Fluid loss (as in severe vomiting, severe diarrhea, major burns,

sun strokes….) and severe bleeding.sun strokes….) and severe bleeding.

FIRST AIDFIRST AID Call 999Call 999 Restore breathingRestore breathing Try to stop bleedingTry to stop bleeding AssuranceAssurance Transfer the victim to the hospital with lower limbs elevated and Transfer the victim to the hospital with lower limbs elevated and

the victim is lying on his back (if there is no neck injury)the victim is lying on his back (if there is no neck injury) In case of suspected neck injury don’t move the victims during In case of suspected neck injury don’t move the victims during

transfertransfer Keep the victim warm.Keep the victim warm. Continue observation and give mouth breathing if needed and put Continue observation and give mouth breathing if needed and put

him on his side if he vomits.him on his side if he vomits. If you are not sure of correct position keep victim on his back.If you are not sure of correct position keep victim on his back.

1313

SNCOPE (Fainting)SNCOPE (Fainting) It is transcient loss of consciousness due to lack of blood It is transcient loss of consciousness due to lack of blood

supply to the brain.supply to the brain.

Most common is vasovagal (blood vessels dilate, and less Most common is vasovagal (blood vessels dilate, and less blood supply to brain) as in hot crowded places, stress, blood supply to brain) as in hot crowded places, stress, standing too long, fatigue, low blood sugar, dehydration.standing too long, fatigue, low blood sugar, dehydration.

Some cases occur after coughing or micturation or Some cases occur after coughing or micturation or changing position but other cases are due to cardiac or changing position but other cases are due to cardiac or brain diseases.brain diseases.

Raise lower limbs above the level of the trunk.Raise lower limbs above the level of the trunk.

Call for medical helpCall for medical help

Observe breathing and pulseObserve breathing and pulse

Leave the victim lying for 20 minutes after he retains Leave the victim lying for 20 minutes after he retains consciousnessconsciousness

1414

POISONINGPOISONINGFIRST AID MEASURESFIRST AID MEASURES

Conscious VictimConscious Victim

Give water or milkGive water or milk Recognize the poisonous substance if possibleRecognize the poisonous substance if possible Call Doctor or Poison CenterCall Doctor or Poison Center Induce VomitingInduce Vomiting Observe for breathingObserve for breathing

Unconscious VictimUnconscious Victim

Observe for cardiac and respiratory arrest.Observe for cardiac and respiratory arrest. Keep him on his side and transfer him.Keep him on his side and transfer him. Do not induce vomiting.Do not induce vomiting.

NOTE; NEVER INDUCE VOMITING IN CASE OF:NOTE; NEVER INDUCE VOMITING IN CASE OF:kerosene, petroleum and its derivatives, strong alkalies and acids.kerosene, petroleum and its derivatives, strong alkalies and acids.

1515

BURNSBURNSDEGREES OF BURNSDEGREES OF BURNS 1st degree – Skin only1st degree – Skin only 2nd degree – Vesicles2nd degree – Vesicles 3rd degree – Deep tissues3rd degree – Deep tissues

FIRST AID MEASURESFIRST AID MEASURES

1st degree – Cold water + Sterile gauze1st degree – Cold water + Sterile gauze

2nd & 3rd degree – Don’t use water2nd & 3rd degree – Don’t use water- Apply sterile gauze- Apply sterile gauze- Prevent shock- Prevent shock- Call for assistance- Call for assistance- Don’t remove clothes- Don’t remove clothes- Don’t apply oil or salt- Don’t apply oil or salt

EYE BURNSEYE BURNS Heat Burns – Same as aboveHeat Burns – Same as above Chemical Burns – Eye wash for 15 minutesChemical Burns – Eye wash for 15 minutes

1616

FRACTURESFRACTURES

TYPESTYPES1. Closed – No Wounds1. Closed – No Wounds2. Open – With Wounds2. Open – With Wounds

FIRST AIDFIRST AID- - Never try to put bone in place.Never try to put bone in place.

- - Stop bleedingStop bleeding

- - Cover open woundCover open wound

- - Prevent shock.Prevent shock.

- - Immobilize the fractured bone by splinting Immobilize the fractured bone by splinting (apply cotton, gauze and bandage)(apply cotton, gauze and bandage)

IMPORTANT POINTS TO REMEMBER WHILE TRANSFERRING THE VICTIMIMPORTANT POINTS TO REMEMBER WHILE TRANSFERRING THE VICTIM

- - In case of a fractured cervical vertebral bones keep victim on In case of a fractured cervical vertebral bones keep victim on his his back.back.- - In case of fractured of thoracic and lumber keep victim onIn case of fractured of thoracic and lumber keep victim on

his abdomen.his abdomen.- - If unconscious keep him on his back.If unconscious keep him on his back.- - Avoid excessive or unnecessary movements.Avoid excessive or unnecessary movements.-- In case of fracture pelvis fix pelvis, thighs, legs and feet.In case of fracture pelvis fix pelvis, thighs, legs and feet.- - Fracture of fore arms make two splints and hang the forearm toFracture of fore arms make two splints and hang the forearm to the neck.the neck.

1717

ANIMAL BITESANIMAL BITES

AnimalsAnimalsDogs/CatsDogs/CatsMouse Mouse RatsRats

First aidFirst aid1. Clean wound with water and soap1. Clean wound with water and soap2. Cover with guaze2. Cover with guaze3. Try to catch the animal or kill it.3. Try to catch the animal or kill it.

1818

SNAKE BITESNAKE BITE GENERAL INFORMATION:GENERAL INFORMATION:

- - Most snakes are not poisonous.Most snakes are not poisonous.

- - The first several hours after the bite are most critical.The first several hours after the bite are most critical.

- - Most snakes avoid human unless frightened.Most snakes avoid human unless frightened.

- - Poisonous bites cause local signs (oedema, hemorrhage, Poisonous bites cause local signs (oedema, hemorrhage, ecchymosis necrosis and systemic signs mainly involving ecchymosis necrosis and systemic signs mainly involving nervous nervous and cardiac system).and cardiac system).

- - First aid measures should be applied as quickly as possible.First aid measures should be applied as quickly as possible.

-- Identification of poisonous bites could be possible if the two fang Identification of poisonous bites could be possible if the two fang marks are there or some local or systemic signs occur.marks are there or some local or systemic signs occur.

- - Introducing antivenum is not deprived from serious side Introducing antivenum is not deprived from serious side effects, therefore, it is given only in severe cases.effects, therefore, it is given only in severe cases.

1919

FIRST AID MEASURES FOR SNAKE BITE:FIRST AID MEASURES FOR SNAKE BITE: Reassure and calm the victim.Reassure and calm the victim.

Put the victim in lying position and restrain from Put the victim in lying position and restrain from unncessary movements.unncessary movements.

Clean wound with water and soap, then dry it with sterilized gauze.Clean wound with water and soap, then dry it with sterilized gauze.

Observe pulse and breathing, if breathing stop, give mouth to mouth breathing. Observe pulse and breathing, if breathing stop, give mouth to mouth breathing. If pulse stops apply CPR.If pulse stops apply CPR.

Keep the affected limb below heart level.Keep the affected limb below heart level.

Immobilize the limb and splint.Immobilize the limb and splint.

You may apply a bandage above level of the bite adequately tight toYou may apply a bandage above level of the bite adequately tight topermit passage of a finger underneath.permit passage of a finger underneath.

Make sure, you can feel the peripheral pulse below level of bandage.Make sure, you can feel the peripheral pulse below level of bandage.

If you are more than 20 minutes away from medical facility, apply a bandage as before, If you are more than 20 minutes away from medical facility, apply a bandage as before, then make small longitudinal incisionthen make small longitudinal incision

1 cm long and 2 mm deep and suck the venum with suction cup or with your mouth. 1 cm long and 2 mm deep and suck the venum with suction cup or with your mouth. (Avoid suction by mouth if you have mouth sores or wound).(Avoid suction by mouth if you have mouth sores or wound).

Transfer patient to the nearest hospital as fast as possible and on the way continue to Transfer patient to the nearest hospital as fast as possible and on the way continue to reassure observe and maintain airway and breathing.reassure observe and maintain airway and breathing.

2020

SUN STROKE AND HEAT EXHAUSTIONSUN STROKE AND HEAT EXHAUSTION

Signs of Heat ExhaustionSigns of Heat Exhaustion-- HeadacheHeadache-- DizzinessDizziness-- NauseaNausea-- Muscle CrampsMuscle Cramps-- Skin is cold, and sweatingSkin is cold, and sweating

First AidFirst Aid-- Transfer the person to cold or shaded areaTransfer the person to cold or shaded area-- Give him liquid composed of:(1 cup of water + ½ teaspoon of salt) Give him liquid composed of:(1 cup of water + ½ teaspoon of salt)

Repeat the salt solution 4 times once every 15 minutes.Repeat the salt solution 4 times once every 15 minutes.-- If the person didn’t improve transfer him to Medical Care.If the person didn’t improve transfer him to Medical Care.

Signs of Sun Stroke Signs of Sun Stroke -- High Fever (May read 41 degree Centrigade)High Fever (May read 41 degree Centrigade)-- Skin is dry and no sweatingSkin is dry and no sweating-- Convulsions may occur.Convulsions may occur.

First Aid:First Aid:-- Cool the victim by placing him under tap waterCool the victim by placing him under tap water-- Continue cooling until temperature reach 39 then stop for 10 Continue cooling until temperature reach 39 then stop for 10 minutes.minutes.-- If temperature relapse continue coolingIf temperature relapse continue cooling-- Don’t give any drinksDon’t give any drinks-- Seek Medical helpSeek Medical help

2121

DROWNINGDROWNING

Remove the victim from waterRemove the victim from water Clean the mouth from sands and Clean the mouth from sands and

other foreign bodiesother foreign bodies Put him on the floor and raise his Put him on the floor and raise his

bodybody Start C.P.R.Start C.P.R. Call for Medical HelpCall for Medical Help

2222

ELECTRIC SHOCKELECTRIC SHOCK

Avoid direct contact with the victimAvoid direct contact with the victim Before touching the victimBefore touching the victim

– wear plastic gloveswear plastic gloves– stand on dry wooden chairstand on dry wooden chair– push the victim with a wooden ladder or chair or push the victim with a wooden ladder or chair or

wooden stickwooden stick

Disconnect power if possibleDisconnect power if possible Do C.P.R. if neededDo C.P.R. if needed Treat burnsTreat burns Call for Medical HelpCall for Medical Help