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Contents
1. Definition
2. The Primary Survey
3. The Recovery Position
4. Rescue Breaths
5. Cardiopulmonary Resuscitation CPR
6. Automated External Defibrillator AED
7. Tension Pneumothorax
8. Major Bleeding
9. Cuts and grazes (abrasion)
10.Puncture Wounds
11.Nosebleeds (epistaxis)
12.Shock
13.Fractures
14.Sprain and Strain
15.Concussion
16.Burns
17.Chemical burns
18.Heart attack
19.Anaphylaxis
20.Stroke
21.Seizures
22.Fainting
23.Hyperglycemia and Hypoglycemia
24.Asthma
25.Choking
26.Poisoning
27.Dog bites
28.Scorpion and Spiders Stings
29.Snake Bite
30.Ticks Bite
31.Heat Stroke
32.Hypothermia and Frostbite
Definition
 First aid: Medical care steps to do for any person suffering a sudden
illness or injury until ambulance arrives or seeking for professional medical
care to:
1. Preserve Life
2. Prevent Deterioration
3. Promote Recovery
Basic Life Support BLS
 Basic life support is a part of the first aid.
 Includes: ABC management (Airway, Breathing, Circulation), CPR
(Cardiopulmonary resuscitation) and AED (Automated external
defibrillation).
 88% of cardiac arrest incidents occur at home.
 Effective bystander CPR that is administered immediately can double or
triple the victim's chances of survival.
 Only 32% of victims receive assistance from a bystander.
The Primary Survey: SSS ABC (DRS ABC)
1. Safety (Danger):
 The main principle of incident management is that you are the most
important person and your safety comes first.
 Check for any dangers to yourself or bystanders.
 Manage any dangers found (Be careful for trauma victims in suspicion
of spinal injury)
 Infection control: Hand Hygiene and Personal Protective Equipment
(PPE)
Cervical Collar (Neck Brace/C-Spine
Collar)
 Cervical collar: is a medical device used to support a person's neck
applied by emergency personnel to those who have had traumatic
head or neck injuries. Also can be used to treat chronic medical
conditions.
 2 rescues are needed, one to support the head and the other one to
apply the collar.
 Measure proper collar size.
C-Collar
Maneuver
1 2
3 4
Log-Roll
 Log-Roll or Logrolling: is a maneuver used to move a patient without flexing
the spinal column.
 Patient's legs are stretched, the head is held, to immobilize the neck. Some
sources recommend patient's arms crossed over the chest, while others
suggest that to minimize the amount of lateral spinal displacement the
arms must be stretched along the sides, with palms resting on the
thighs. After that the patient is carefully rolled in the desired direction
without twisting or bending the body.
Log-Roll
Maneuver
1 2
3 4
5
Cont…
2. Stimulate (Response):
 Adults: Attempt to wake the person up
by shouting loudly in both ears and gently
shaking the shoulders.
 Babies/infants: flick the bottom of the foot
3. Shout:
 Call for help and ambulance.
 If you are alone, continue with the survey while
putting the cellphone on speaker.
 Know the number
 Ask the operator for an ambulance
 Give the operator details: your name, why you need
an ambulance, your location, nearest landmark.
Cont…
4. Airway:
 It can become blocked by the tongue
and regurgitation of stomach contents.
 Adult and Children (Head tilt chin lift):
Tilting the head backwards and lifting
the chin
 For babies: Neutral position with using
your finger tips to lift the chin.
 For trauma situations (Jaw thrust): Push
the posterior aspects of the lower
jaw upwards by index and middle
fingers and push down on the chin to
open the mouth by thumbs.
Cont…
5. Breathing:
 Keep your hands on the person’s head &
chin. Place your cheek above their mouth
and look at their chest.
 Look, listen and feel for regular breathing for
up to 10 seconds
6. Circulation:
 Check pulse for 5-10 seconds while assessing
breathing.
 Feel the pulse by two fingers:
 Carotid artery pulse (preferred)
 Radial artery pulse
The Recovery Position
 Unconscious: A person who does not wake up and is not aware of
themselves/surroundings.
 If a victim is unconscious but breathing normally then you should place
them into the recovery position in order to protect their airway.
 Re-check every 2 minutes.
 Adult
 The recovery position involves rolling the casualty onto their left side with
their head tilted back. By doing this, the tongue is kept clear of the
airway and any vomit is able to drain and not obstruct the casualty’s
airway.
 Babies / infants
 Hold the baby on their side with the head tilted downwards. Ensure you
have fully supported the head.
Recovery
Position
Maneuver
1 2 3
4 5 6
7 Baby
Rescue breaths
 If a victim is not breathing but has a pulse.
 Maintain airway.
 Pinch the nose by two fingers.
 1 breath every 3-5 seconds.
 Blow for 1 second till the chest clearly rise.
 Don’t over-ventilate to cause chest
expansion.
 Re-check every 2 minutes.
Introduction to CPR
 CPR, the kiss of life, resuscitation, heart massage
 If the casualty has no pulse, you should
immediately call an ambulance/activate EMS and
commence cardiopulmonary resuscitation (CPR)
 The purpose of CPR is to keep oxygenated blood
flowing through the body to keep the vital organs
alive. CPR itself will not restart someone’s heart, it just
keeps them alive until a defibrillator arrives. A
defibrillator is a device which delivers an electrical
shock to the heart to restart it.
 Without a supply of oxygen, the cells in the body start
to die. Brain cells are incredibly sensitive, after about 4
– 5 minutes of no oxygen brain cells will begin dying
leading to brain damage and death.
The Chain of Survival
Performing Adult and Children CPR (High-quality)
1. Kneel by the side of the victim while he is on a hard ground.
2. Place the heel of one hand in the center of the victim’s chest
3. Place the heel of your other hand on top of the first hand
4. Interlock the fingers of your hands and ensure that pressure is not applied to the victim’s ribs. Do
not apply any pressure over the upper abdomen or the bottom end of the sternum
5. Position yourself vertically above the victim’s chest and, with your arms straight, press down on
the sternum approximately 5 – 6 cm
6. After each compression, release all the pressure on the chest without losing contact between
your hands and the sternum
7. Repeat at a rate of 100 – 120 chest compressions per minute
8. Each compression and release should take an equal amount of time
9. Decrease interruption.
10. If trained, you can attempt 2 rescue breaths after every 30 chest compressions by pinching the
nose and blowing for 1 second till the chest clearly rise.
11. Switch rescuers about every 2 minutes.
Performing infant CPR
1. First deliver 5 rescue breaths
 Ensure the baby’s head is in the neutral position.
Cover their mouth and nose with your mouth and
deliver five rescue breaths. Each breath should
only need a ‘puff’ of air from your cheeks.
2. Then give chest compressions and breaths.
 30 chest compressions to 2 breaths (1 rescuer)
 15 chest compressions to 2 breaths (2 rescuer)
3. Use two fingers to compress the baby’s chest on
the breastbone (sternum) at a rate of 100 – 120
chest compressions per minute.
4. Press down on the sternum approximately 4 cm.
5. Switch rescuers about every 2 minutes.
Hands-only CPR
 Previous slide the CPR called Mouth-to-Mouth CPR.
 Hands-only CPR used for whom you see suddenly collapse. Because this
person most likely was breathing normally before the incident happened,
and there may already be sufficient oxygen in the victim's blood for the first
few minutes after cardiac arrest limiting interruption to pump blood to the
heart and brain.
 Hands-only CPR is an easy-to-remember and effective option for people
who have been trained in CPR before but may not remember the steps of
conventional CPR.
When to Stop CPR
 Only stop CPR if:
1. The casualty shows signs of life: coughing, breathing etc.
2. You are asked to stop by a healthcare professional (ambulance, crew etc.)
3. You become too exhausted to continue
4. The situation suddenly becomes too dangerous
 Ideally, you should only carry out CPR for only 2 minutes before swapping
with someone else. This is to ensure that the chest compressions remain
effective
C-A-B Versus A-B-C
 In 2010 the AHA (American Heart Association) Guidelines recommended a
change from A-B-C (Airway-Breathing-Compressions) to the C-A-B
sequence (Compressions-Airway-Breathing) to decrease the time to
initiation of chest compressions and reduce “no blood flow” time.
Automated External Defibrillator AED
 Defibrillator: is a device which delivers
an electrical shock to the heart to stop the
disorganized electrical activity, this gives the
heart a chance to start in a normal
rhythm again.
 Automated External Defibrillator: a defibrillator
which can be used by anyone with no medical
training as everything is fully automated.
 An AED will analyze the heart rhythm in the
patient, if appropriate, it will then deliver a
controlled electrical shock to the patient.
Accessory Equipment
 An AED may contain other items
including:
1. Small towel: this is used to dry the
chest of the patient before
applying pads
2. Razor: excessive chest hair may
prevent the pads sticking so a
razor is provided
3. Scissors: pads should be applied
to bare skin so scissors may be
provided to cut through clothing
Safety Considerations
 Water: Water and electricity don’t
mix! A towel should be provided
along with an AED, this is to dry the
patient’s chest.
 Direct contact: No one should touch
the patient during delivery of the
electrical shock by an AED. The AED
will instruct everyone
to stand clear.
 Explosive environment: If Oxygen is
being used, it should be at least 1
meter away from the AED
 Chest hair: A razor is supplied so you
can shave excessive chest hair.
AED Procedure
1. If alone, connect the AED before starting CPR (if in a group, one person can
start CPR once another sets up the AED).
2. Once the AED is connected it will analyze the heart rhythm. The AED will either
decide to deliver a shock or instruct you to continue CPR for 2 minutes.
 Shock: ensure everyone is clear of the patient before delivering the shock. A
loud verbal command of “stand clear” is suggested.
 Continue CPR: immediately begin CPR on the patient for 2 minutes.
3. The AED will continue in this cycle of analyzing and then deciding to shock
or continue CPR.
Tension Pneumothorax
 Tension pneumothorax: is a life-threatening condition that can occur with
chest trauma and is more likely to happen with trauma involving an
opening in the chest wall.
 It may present with either a closed or open chest injury.
 Signs and Symptoms:
1. Severe shortness of breath
2. Unequal chest (one side looks bigger than the other)
3. Veins on the neck bulging (jugular vein distension)
4. Blue lips or fingers (cyanosis)
Performing Chest (Needle) Decompression
1. Ensure patient is oxygenated if possible.
2. Select proper site in the affected side preferably at the second intercostal
space and along the mid-clavicular line.
3. Clean site with alcohol or povidone solution.
4. Prepare needle decompression preferably 14 or 16 gauge.
5. Insert the needle into the second intercostal space at a 90-degree angle to the
chest, just over the third rib.
Note: There are blood vessels running along the bottom of the ribs. Ensure the
needle is closer to the top margin of the lower rib in the intercostal space. This
will prevent these vessels from being damaged.
6. Listen for a rush of exiting air from the needle.
7. Remove the needle and leave the catheter in place, properly disposing of the
needle.
8. Secure the catheter in place with tape.
9. Ensure the tension has been relieved and the patient's condition improves. If
there is no improvement, the procedure will need to be repeated with another
needle placed adjacent to the first needle.
10. Monitor, then reassess the patient.
Cont…
Fifth intercostal
space (3.4 cm)
Anterior
axillary line
(4.3 cm)
Bleeding
Dealing With Major Bleeding PEEP
1. Position – position the victim in a safe / comfortable position
2. Elevate limbs above level of the heart
3. Expose & examine the injury. Check for any embedded or foreign objects such
as pieces of glass.
4. Pressure – apply direct pressure over the injury to control blood loss If there are
no foreign objects
 Do not apply a tourniquet unless specifically trained to do so.
 Do not attempt to wash out a major wound – your aim is to control the bleeding
as quickly as possible.
 Seek medical advice urgently if complicated or you couldn’t stop the bleeding.
 An average adult has around 5 liters of blood in their body.
Cuts and grazes (abrasion)
1. Stop any bleeding. You can elevate the wound or apply
direct pressure using a sterile gauze swab/pad.
2. Clean the wound using running water or antiseptic wipes.
Dry with a sterile gauze swab/dressing.
3. Ensure the area around the wound is clean (no dirt, grit
etc.)
4. Cover with a sterile dressing/plaster. Remember some
people might be allergic to regular plasters!
 Infected wounds are often very red, swollen, painful and
may have pus. As the infection develops you may
develop a fever. If you see any of these signs you should
seek medical advice urgently.
 One of the infection risks in any open wound is Tetanus.
Tetanus is caused by Clostridium tetani, a bacteria which
lives in soil which can lead to muscle spasms, fever and
sweating. There is a vaccine course available.
Puncture Wounds
 The object may remain embedded in the wound or may
have passed clean through the body part involved.
1. Do not remove the object unless it is very small.
2. Stop the bleeding by applying pressure around the
wound – take care not to dislodge the object.
3. If possible, elevate the limb to prevent further blood loss.
4. Seek urgent medical attention.
 It is important to keep the object as still as possible to
prevent further injury to the deeper structures below the
skin.
 Whilst it is tempting sometimes to attempt to remove the
object, this can actually worsen the situation by causing
further bleeding and tissue damage.
Nosebleeds (epistaxis)
 There are countless causes for nosebleeds, some
common ones include:
1. Trauma
2. High blood pressure (hypertension)
3. Blood thinning medication (e.g: Warfarin)
4. Foreign bodies (fingers!)
5. Inflammation
 Management of epistaxis:
1) Ask the person to tilt their head forwards and
pinch the soft part of their nose for 10 minutes.
Encourage them not to pick at their nose or sniff.
Ask them to breathe through their mouth.
Cont…
2) After 10 minutes release the pressure and see if the bleeding has stopped. If it
hasn’t, reapply the pressure. You can also try placing something cool on the
nose (ice pack etc.) to constrict the blood vessels
3) Once the bleeding has stopped, clean up any blood from around the
face/mouth. Tell the person not to sneeze/pick at their nose/sniff for several
hours as this could cause the bleeding to start again.
 It can be very difficult to get a child to sit still and hold their nose, so try your
best. In some cases you might have to hold their nose for them.
 If the bleeding does not stop (after around 20 – 30 minutes), you should seek
medical advice. In addition, if the cause of the nosebleed is unclear or they are
recurring you should also seek advice.
 A nosebleed after a head injury can be the sign of a more serious injury
 A common misconception is that you should tilt head backwards. This isn’t
recommended as blood will travel back down into your mouth and into your
stomach. This can make bleeding continue, choking or stomach irritation.
Shock
 Shock: A lack of oxygen and essential nutrients reaching the tissues.
 Medical shock is a life threatening medical emergency.
 There are various different causes of shock, major blood loss will
cause hypovolemic shock.
 Signs & symptoms of shock include:
1. Pale, cold and clammy skin
2. Confusion
3. Drowsiness (reducing level of consciousness)
4. Fast, weak pulse
5. Fast, shallow breathing
First aid for shock
1. Control any external blood loss (think
PEEP)
2. Lie the casualty down and raise their legs
if possible
3. Cover the casualty with a coat or blanket
to keep them warm
4. Call for emergency medical help
 Do not give the casualty anything to eat
or drink!
 Recovery position and CPR if needed.
Fractures
1. Open fracture: This is where the bone
has pierced the skin and caused an
open wound which may bleeding. There
is a high risk of infection with these
injuries
2. Closed fracture: A fracture which has
not caused an open wound
3. Complicated fracture: A fracture which
damages nerves and blood vessels, this
can cause permanent nerve damage or
loss of blood supply to a limb.
4. Greenstick fracture: Common in children
as their bone’s are more “bendy”,
therefore their bones are less likely to
fully break.
Signs and symptoms of fractures
First aid for fractures
1) Keep the area as still as possible, ask the person
not to move it
2) Expose the site of injury to check for any
bleeding or open wounds. If there is a bone
through the skin then do not move it, instead
cover with a sterile dressing if available. If the
wound is bleeding then apply gentle pressure
around the wound.
3) Pad around the injured area with blankets /
clothing. If the person has hurt their arm then
ask them to hold it in the most comfortable
position possible
4) Quickly arrange transport to the nearest
hospital.
5) Call an emergency ambulance if:
a. You cannot move the person (for example,
because they have hurt their leg)
b. They have fractured a limb and it is turning
blue / cold, this indicates a loss of blood supply
to the limb which needs correcting urgently
c. The casualty is in severe pain
d. You suspect they may have other serious
injuries
Sprain and Strain
Concussion
 Concussion: head injury where the brain can be shaken inside the skull.
 It leads to short loss of consciousness or confusion (seconds to few minutes).
 Most of them recover but sometimes it might become serious.
First aid for Concussion
1. Ask them to rest and apply a cold compress to the injury (ice pack, bag of
frozen vegetables wrapped in a towel)
2. Call for ambulance in:
a) Confusion
b) Drowsiness
c) Vomiting
d) Fall was greater than 2 times of their height.
e) Dizziness
f) Loss of consciousness
g) Headache
h) Blurred vision
i) No memory of what happened
Burns
 Superficial (1st degree) – this is when only the top layer of skin has been
damaged. These are the most minor burns. Often the only sign is a
reddening of the skin. Minor sunburn falls into this category of burns.
 Partial thickness (2nd degree) – these burns cause blisters in the skin due to
the damaged tissue releasing fluid.
 Full thickness (3rd degree) – this is the most serious type of burn. In a full
thickness burn, every layer of the skin has been affected and the
underlying bone, muscle or fat may have also been damaged.
Assessment of Burn Size
Body Surface Area BSA
First aid for a minor burn
1. Immediately run the burn under cold running water for a minimum of 10 minutes. If running
cold water is not available you can use other non-toxic liquids such as drinks.
2. Expose the affected area and if possible remove anything that could be constricted
(watches, jewelry etc.).
3. After cooling the burn, cover with a non-fluffy dressing/covering.
4. Seek medical advice for anything except the most minor of burns. Call an ambulance if
serious or if the burn is near the face/neck.
 What not to do:
a) Do not try to remove clothing sticking to a burn, instead cool through the clothing
b) Do not apply toothpaste / butter / creams to a burn. Running water is the most effective
cooling method.
• Exception: “Aftersun” lotion is useful for sunburn
c) Do not burst any blisters
d) Do not stop cooling before 10 minutes is up!
e) Be careful not to constrict the burn!
Chemical burns
1. Check for any dangers to yourself. The chemicals that caused the casualty’s
injuries could also pose a danger to you.
 Try to establish what caused the burn and how safe the chemicals are.
 If you are in an enclosed area, move the casualty outside or open windows to
prevent the build up of fumes. Wear disposable gloves.
2. Cool the burn with copious running water for at least 15 – 20 minutes. Ensure
that you do not come into contact with the water used to cool the burn as it
may contain the harmful chemical.
3. If any clothing has come into contact with the chemical, it should be removed
providing it isn’t sticking to the burn.
4. Cover the burn with a sterile, non-fluffy first aid dressing.
5. Seek medical advice If the burn is serious. Call an ambulance if the casualty
shows signs of shock or the casualty becomes drowsy/looses consciousness.
Criteria for Admitting Patients to Burn Unit
1. 2nd and 3rd degree burns >10% body surface area (BSA)
2. 2nd and 3rd degree burns with serious threat or cosmetic impairment.
3. 3rd degree burns >5% BSA in any age group.
4. Electrical burns, including lightening injury.
5. Chemical burns with serious threat or cosmetic impairment.
6. Inhalation injury with burn injury.
Heart attack
 The heart receives its blood supply from the coronary arteries which branch
off from the aorta (the main artery in your body).
 If a coronary artery becomes blocked (e.g: due to a clot), then the heart
muscle beyond the point of the blockage will not receive an adequate
blood supply. This will result in death of the heart muscle.
 The medical term for a heart attack is ‘myocardial infarction’ (myocardium
means heart muscle, infarction is tissue death due to lack of oxygen)
How do I recognize a heart attack?
1. Sudden central chest pain, which
may spread to the
arms/jaw/back/abdomen. Does not
ease or go away.
2. Shortness of breath
3. Casualty becomes pale and sweaty
4. Fear and anxiety
5. Irregular or weak pulse
6. Some heart attacks can be ‘silent’
with very little pain which is often
mistaken for indigestion, are more
common amongst women and
diabetic patients.
First aid treatment
1. Call an ambulance/emergency medical help,
say that you suspect someone is having a heart
attack.
2. Make the person comfortable, if possible ask
them to sit on the floor. The best position is known
as the “W” position, this involves the person sitting
up with something under their knees to raise them.
This reduces the strain on the heart.
3. If you are able to, ask the casualty to chew on
a 300mg aspirin. If they have any other
medication for their heart (a spray etc.) which a
doctor has told them to use, then let the casualty
use it.
 Try to be reassuring and calm, the casualty will be
incredibly frightened and anxious which could
aggravate their condition.
 Be prepared that the casualty may suffer a
cardiac arrest (the heart stops beating) and you
may have to perform Cardiopulmonary
Resuscitation.
Anaphylaxis
 Life threatening whole body severe allergic reaction.
 When the body detects this allergen, it reacts by releasing a large amount of
inflammatory substances such as histamine. These substances cause blood
vessels throughout the body to widen, leading to a drop in blood pressure, and
airways in the lungs to constrict and secrete mucus causing severe difficulty in
breathing.
 This often happens very quickly, possibly even seconds after coming into
contact with the allergen
First aid for anaphylaxis
1. Call an ambulance immediately.
2. Stop the causative allergen or substance.
3. If the casualty is carrying any medication, such as an auto-injector containing adrenaline
(EpiPen), assist them to use it. injected into muscle and not into a vein.
4. If the casualty starts showing signs of shock, then lie them down with their legs raised to
increase blood flow to the brain and vital organs. Otherwise, keep the casualty in the most
comfortable position to help with their breathing.
5. Reassure the casualty as they may be very anxious and frightened. Be prepared that they
may collapse and stop breathing. If they do then you should
commence Cardiopulmonary resuscitation (CPR) immediately.
 Adrenaline has three main effects:
a) Constriction, or tightening, of the blood vessels.
b) Increases the heart’s contraction and heart rate.
c) Relaxes the muscles around the airways in the lungs.
Stroke
 A stroke (or ‘CVA’ –
cerebrovascular accident) is a
problem with the blood supply to
the brain.
 Broadly, there are two types of
stroke:
1. Ischemic stroke: A clot blocks an
artery in the brain causing death
of brain tissue.
2. Hemorrhagic stroke: An artery in
the brain ruptures causing
bleeding.
Recognizing a stroke
Seizures
 One of the most well known causes is a medical condition called
Epilepsy where the electrical activity in the brain is disturbed. However
there can be a variety of other causes including:
1. Head injuries
2. Drugs / Alcohol
3. Poisoning
4. Low blood sugar (Hypoglycemia)
5. In infants, high temperatures.
6. Seizures are often characterized by a loss of consciousness followed
by uncontrolled muscle contractions.
First aid for a seizure
1. Remove any objects from around the casualty (chairs, tables etc.) to prevent
them injuring themselves. Make the area as safe as practically possible
2. Protect the casualty’s head by padding around it and underneath the neck.
Don’t place bulky padding underneath the casualty’s head as this could tilt
their head forwards and close their airway.
3. Try and establish a cause for the seizure. Are they a known to suffer from
Epilepsy? Do they have Diabetes? Have they had an injury recently?
4. Call an ambulance unless the casualty is known to have seizures regularly and
doesn’t normally go to hospital.
5. Note how long the seizure lasts for, and whether there are any gaps.
6. When the seizure stops, open the casualty’s airway by tilting their head
backwards and check for normal breathing for up to 10 seconds. If they are
breathing then roll them onto their side to protect their airway. If they are not
breathing then commence cardiopulmonary resuscitation.
 Remember to protect and maintain the casualty’s dignity throughout. Move on
any crowds of people and try to offer some privacy. Although the person
having the seizure is unconscious, they may still be able to hear or have an
awareness of people around them. When the casualty wakes up they may be
very confused. Speak slowly and clearly and explain what has happened.
Fainting
 A faint is a brief and sudden loss of consciousness, normally due to a
reduction in the blood flow to the brain.
 If you suddenly stand up, the heart has to work harder to pump this blood
upwards against gravity.
 Generally once a person has fainted and fallen to the floor, they regain
consciousness very quickly. This is because when lying down, the heart finds
it easier to pump blood to the brain as it isn’t working against gravity.
 They may go very pale/white, and look unsteady on their feet. Also they
may complain of feeling ‘light headed’
First aid for a faint
1. Raise their legs to improve the blood supply to the brain.
2. If they’ve fallen, check for any injuries such as fractures or head injuries.
3. Once they recover, help them sit up gradually. Don’t let the casualty stand
up straight away as they may just faint again!
4. If they casualty does not wake up, you should open their airway by tilting
their head backwards and check to see if they’re breathing. If they are, roll
them onto their side and call an ambulance.
Hyperglycemia and Hypoglycemia
 Diabetes: is a problem with the body’s control of blood sugar levels (high).
 The body produces a variety of hormones to control blood sugar. The most
important is insulin which is released by the pancreas. Insulin acts to reduce
blood sugar levels.
 There are two main types of diabetes:
1. Type 1: In this case, the body fails to produce enough insulin. Typically onset
occurs in childhood however this is not always the case. Type 1 diabetes is
often called Insulin Dependent Diabetes Mellitus (IDDM).
2. Type 2: In type 2 diabetes, the pancreas produces enough insulin however
cells in the body become resistant to insulin so its effects are reduced. Type
2 diabetes is more common in later life, and may be affected by various
lifestyle factors such as diet and exercise.
Management
 Hyperglycemia may develop over several days and weeks. If you suspect
someone has high blood sugar, you should urge them to seek medical
attention. If they become very drowsy or unconscious then phone for an
emergency ambulance and place them into the recovery position to
protect their airway.
 If you suspect someone is suffering from low blood sugar, you should
attempt to raise the blood sugar by offering something sweet such as a
sugar cube / sugary drink / sugary snack. The casualty may be carrying
snacks for such a situation. If the casualty has a reduced level of
consciousness, or does not respond to the treatment above, you
should call an emergency ambulance.
Asthma
 Asthma is an inflammatory condition of the smallest airways –
the bronchioles. These tiny tubes can become inflamed and secrete
excessive amounts of mucous causing severe difficulty in breathing.
First aid for an asthma attack
1. Sit the casualty down in the position they find most comfortable for their
breathing.
2. Find their medication, which is normally an inhaler (possibly with a spacer
device) containing a drug such as Salbutamol.
3. Assist the casualty to use their medication. They should know how many doses
to take and how to use the inhaler. As a guide, a maximum of up to 10 puffs
over 30 – 60 seconds each is recommended.
4. Provide reassurance and help calm the person’s breathing if they are
hyperventilating.
5. Call for emergency medical help if the Salbutamol inhaler has no effect, or the
patient shows any signs of deterioration.
 If the casualty becomes unconscious, then open their airway by tilting their
head back and check for normal breathing. If they are breathing then roll
them onto their side to protect their airway. If they are not breathing then
commence cardiopulmonary resuscitation (CPR).
Choking
 Adult / Children (Heimlich maneuver)
1. Give five back blows
Hit the person using the palm of your hand in the
center of their back. Your aim is to create
vibrations to dislodge the object from the airway
2. Give five abdominal thrusts
Stand / kneel behind the person. Place a fist just
above their belly button. With your other hand,
grasp the fist and pull sharply inwards and
upwards
3. Repeat the cycle of five back blows and five
abdominal thrusts until help arrives
Cont…
 Babies
1. Give five back blows
Lay the baby face down across your thigh or
forearm (ensure the head is supported). Give
up to five firm blows using the palm of your
hand in between the baby’s shoulder blades.
2. Give five chest thrusts
Turn the baby over so that they are on their
back. Using two fingers, deliver five firm chest
thrusts inwards and upwards towards the head.
3. Repeat the cycles of back blows and chest
thrusts until further help arrives
First Aid for Poisoning
1. Establish what they have taken, when and how much.
2. Call for ambulance in:
a) Unresponsive
b) Change in behavior
c) Difficulty breathing
d) Abdominal pain and vomiting
e) If you think they are suicidal
3. You may need to put them in recovery position or do CPR.
 Don’t give them anything to drink, that may cause more poisoning or block
airways.
Dog bites
1. Using clean water (with soap/an antiseptic product if
possible) wash the wound thoroughly. Make sure to
clean the area around the wound as well.
2. Cover the wound with a sterile wound dressing. If
the bleeding is severe, apply direct pressure and call
for an ambulance.
3. If there is a risk of infection (i.e you are in a rabies risk
area) or the wound appear serious, then seek medical
advice immediately. The casualty may require an
injection to protect them from the rabies virus.
 If you are concerned that the dog may still be in the
vicinity and poses a danger to yourself then call the
police immediately. Do not try to capture or calm the
dog down, as this may result in further injury to yourself
or others.
 The advice above can also apply to any animal /
human bites, not just dogs.
First Aid for Scorpion and Spiders Stings
 The venom contains a complex mix of toxins that affect the nervous system
(neurotoxins).
1. Try to identify the scorpion or spider.
2. Call for ambulance.
3. Remove the victim from danger and put them in rest with reassurance.
4. Immobilize the affected part below the level of the heart.
5. Remove constricting items on the victim (rings, watches).
6. Wash the wound thoroughly.
7. Apply an ice pack or anesthetic agent to the injured are to reduce pain and
swelling
8. Use local antibiotic if has no known allergy to prevent infection.
9. Victim may develop anaphylaxis.
 Don’t cut or suck the site.
 Don’t use tourniquet or constriction bands.
First Aid for Snake Bite
 Depends on the type of snake it is either have:
a) Neurotoxic effect (neuromuscular junction)
b) Hemotoxic effect (quick coagulation or blood clotting).
1. Try to identify the scorpion or spider.
2. Call for ambulance.
3. Remove the victim from danger and put them in rest with reassurance.
4. Immobilize the affected part below the level of the heart.
5. Remove constricting items on the victim (rings, watches).
6. Wash the wound thoroughly.
7. Victim may develop anaphylaxis.
8. Don’t use ice pack or alcohol or any agent.
 Don’t cut or suck the site.
 Don’t use tourniquet or constriction bands.
First Aid for Ticks Bite
 Ticks are vectors of some serious and important
arthropod-borne diseases such as: Lyme,
tularemia, Rocky Mountain spotted fever, and some types
of encephalitis as well as Crimean
Congo hemorrhagic fever(CCHF).
 Ticks bite signs and symptoms may include:
 Rash, neck stiffness, headache, nausea, weakness,
muscle or joint pain and fever.
1. Wear disposable gloves if available.
2. Grasp tick with fine-tipped tweezer close to skin and pull
slowly.
3. Wash the bitten area with soap and water.
4. Apply antiseptic or antibiotic (if not allergic) if available.
5. Call for ambulance.
First Aid for
Heat Stroke
 Heat exhaustion: involves the loss of
body fluids through heavy sweating
during strenuous exercise or
physical labor in high heat and
humidity.
 Heat cramps: muscular pain and
spasms that usually occur in the
legs or abdomen due to heat
exhaustion.
 Heat stoke: life-threatening
condition in which a person’s
temperature control system stops
working and the body is unable to
cool itself.
Hypothermia and Frostbite
First Aid for Hypothermia and Frostbite
1. Call ambulance.
2. If they are outside, bring them inside.
3. Minimize movement.
4. Warm them slowly (blanket, warm drinks)
 Don’t use radiant heat (fire, electric heaters)
 Don’t rub affected area
 Don’t provide person alcohol
 Avoid putting person in bath
References
 https://www.redcross.org
 https://eccguidelines.heart.org
 https://www.firstaidforfree.com/
 http://www.sja.org.uk
 https://cprguidelines.eu
 https://www.surefirecpr.com
 https://bhcpr.org
 https://www.ambulance.qld.gov.au
 https://en.wikipedia.org
 https://www.ems1.com
 https://www.verywellhealth.com

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First Aid and Basic Life Support By Essam Sidqi

  • 1.
  • 2. Contents 1. Definition 2. The Primary Survey 3. The Recovery Position 4. Rescue Breaths 5. Cardiopulmonary Resuscitation CPR 6. Automated External Defibrillator AED 7. Tension Pneumothorax 8. Major Bleeding 9. Cuts and grazes (abrasion) 10.Puncture Wounds 11.Nosebleeds (epistaxis) 12.Shock 13.Fractures 14.Sprain and Strain 15.Concussion 16.Burns 17.Chemical burns 18.Heart attack 19.Anaphylaxis 20.Stroke 21.Seizures 22.Fainting 23.Hyperglycemia and Hypoglycemia 24.Asthma 25.Choking 26.Poisoning 27.Dog bites 28.Scorpion and Spiders Stings 29.Snake Bite 30.Ticks Bite 31.Heat Stroke 32.Hypothermia and Frostbite
  • 3. Definition  First aid: Medical care steps to do for any person suffering a sudden illness or injury until ambulance arrives or seeking for professional medical care to: 1. Preserve Life 2. Prevent Deterioration 3. Promote Recovery
  • 4. Basic Life Support BLS  Basic life support is a part of the first aid.  Includes: ABC management (Airway, Breathing, Circulation), CPR (Cardiopulmonary resuscitation) and AED (Automated external defibrillation).  88% of cardiac arrest incidents occur at home.  Effective bystander CPR that is administered immediately can double or triple the victim's chances of survival.  Only 32% of victims receive assistance from a bystander.
  • 5. The Primary Survey: SSS ABC (DRS ABC) 1. Safety (Danger):  The main principle of incident management is that you are the most important person and your safety comes first.  Check for any dangers to yourself or bystanders.  Manage any dangers found (Be careful for trauma victims in suspicion of spinal injury)  Infection control: Hand Hygiene and Personal Protective Equipment (PPE)
  • 6. Cervical Collar (Neck Brace/C-Spine Collar)  Cervical collar: is a medical device used to support a person's neck applied by emergency personnel to those who have had traumatic head or neck injuries. Also can be used to treat chronic medical conditions.  2 rescues are needed, one to support the head and the other one to apply the collar.  Measure proper collar size.
  • 8. Log-Roll  Log-Roll or Logrolling: is a maneuver used to move a patient without flexing the spinal column.  Patient's legs are stretched, the head is held, to immobilize the neck. Some sources recommend patient's arms crossed over the chest, while others suggest that to minimize the amount of lateral spinal displacement the arms must be stretched along the sides, with palms resting on the thighs. After that the patient is carefully rolled in the desired direction without twisting or bending the body.
  • 10. Cont… 2. Stimulate (Response):  Adults: Attempt to wake the person up by shouting loudly in both ears and gently shaking the shoulders.  Babies/infants: flick the bottom of the foot 3. Shout:  Call for help and ambulance.  If you are alone, continue with the survey while putting the cellphone on speaker.  Know the number  Ask the operator for an ambulance  Give the operator details: your name, why you need an ambulance, your location, nearest landmark.
  • 11. Cont… 4. Airway:  It can become blocked by the tongue and regurgitation of stomach contents.  Adult and Children (Head tilt chin lift): Tilting the head backwards and lifting the chin  For babies: Neutral position with using your finger tips to lift the chin.  For trauma situations (Jaw thrust): Push the posterior aspects of the lower jaw upwards by index and middle fingers and push down on the chin to open the mouth by thumbs.
  • 12. Cont… 5. Breathing:  Keep your hands on the person’s head & chin. Place your cheek above their mouth and look at their chest.  Look, listen and feel for regular breathing for up to 10 seconds 6. Circulation:  Check pulse for 5-10 seconds while assessing breathing.  Feel the pulse by two fingers:  Carotid artery pulse (preferred)  Radial artery pulse
  • 13. The Recovery Position  Unconscious: A person who does not wake up and is not aware of themselves/surroundings.  If a victim is unconscious but breathing normally then you should place them into the recovery position in order to protect their airway.  Re-check every 2 minutes.  Adult  The recovery position involves rolling the casualty onto their left side with their head tilted back. By doing this, the tongue is kept clear of the airway and any vomit is able to drain and not obstruct the casualty’s airway.  Babies / infants  Hold the baby on their side with the head tilted downwards. Ensure you have fully supported the head.
  • 15. Rescue breaths  If a victim is not breathing but has a pulse.  Maintain airway.  Pinch the nose by two fingers.  1 breath every 3-5 seconds.  Blow for 1 second till the chest clearly rise.  Don’t over-ventilate to cause chest expansion.  Re-check every 2 minutes.
  • 16. Introduction to CPR  CPR, the kiss of life, resuscitation, heart massage  If the casualty has no pulse, you should immediately call an ambulance/activate EMS and commence cardiopulmonary resuscitation (CPR)  The purpose of CPR is to keep oxygenated blood flowing through the body to keep the vital organs alive. CPR itself will not restart someone’s heart, it just keeps them alive until a defibrillator arrives. A defibrillator is a device which delivers an electrical shock to the heart to restart it.  Without a supply of oxygen, the cells in the body start to die. Brain cells are incredibly sensitive, after about 4 – 5 minutes of no oxygen brain cells will begin dying leading to brain damage and death.
  • 17. The Chain of Survival
  • 18. Performing Adult and Children CPR (High-quality) 1. Kneel by the side of the victim while he is on a hard ground. 2. Place the heel of one hand in the center of the victim’s chest 3. Place the heel of your other hand on top of the first hand 4. Interlock the fingers of your hands and ensure that pressure is not applied to the victim’s ribs. Do not apply any pressure over the upper abdomen or the bottom end of the sternum 5. Position yourself vertically above the victim’s chest and, with your arms straight, press down on the sternum approximately 5 – 6 cm 6. After each compression, release all the pressure on the chest without losing contact between your hands and the sternum 7. Repeat at a rate of 100 – 120 chest compressions per minute 8. Each compression and release should take an equal amount of time 9. Decrease interruption. 10. If trained, you can attempt 2 rescue breaths after every 30 chest compressions by pinching the nose and blowing for 1 second till the chest clearly rise. 11. Switch rescuers about every 2 minutes.
  • 19. Performing infant CPR 1. First deliver 5 rescue breaths  Ensure the baby’s head is in the neutral position. Cover their mouth and nose with your mouth and deliver five rescue breaths. Each breath should only need a ‘puff’ of air from your cheeks. 2. Then give chest compressions and breaths.  30 chest compressions to 2 breaths (1 rescuer)  15 chest compressions to 2 breaths (2 rescuer) 3. Use two fingers to compress the baby’s chest on the breastbone (sternum) at a rate of 100 – 120 chest compressions per minute. 4. Press down on the sternum approximately 4 cm. 5. Switch rescuers about every 2 minutes.
  • 20. Hands-only CPR  Previous slide the CPR called Mouth-to-Mouth CPR.  Hands-only CPR used for whom you see suddenly collapse. Because this person most likely was breathing normally before the incident happened, and there may already be sufficient oxygen in the victim's blood for the first few minutes after cardiac arrest limiting interruption to pump blood to the heart and brain.  Hands-only CPR is an easy-to-remember and effective option for people who have been trained in CPR before but may not remember the steps of conventional CPR.
  • 21. When to Stop CPR  Only stop CPR if: 1. The casualty shows signs of life: coughing, breathing etc. 2. You are asked to stop by a healthcare professional (ambulance, crew etc.) 3. You become too exhausted to continue 4. The situation suddenly becomes too dangerous  Ideally, you should only carry out CPR for only 2 minutes before swapping with someone else. This is to ensure that the chest compressions remain effective
  • 22. C-A-B Versus A-B-C  In 2010 the AHA (American Heart Association) Guidelines recommended a change from A-B-C (Airway-Breathing-Compressions) to the C-A-B sequence (Compressions-Airway-Breathing) to decrease the time to initiation of chest compressions and reduce “no blood flow” time.
  • 23. Automated External Defibrillator AED  Defibrillator: is a device which delivers an electrical shock to the heart to stop the disorganized electrical activity, this gives the heart a chance to start in a normal rhythm again.  Automated External Defibrillator: a defibrillator which can be used by anyone with no medical training as everything is fully automated.  An AED will analyze the heart rhythm in the patient, if appropriate, it will then deliver a controlled electrical shock to the patient.
  • 24. Accessory Equipment  An AED may contain other items including: 1. Small towel: this is used to dry the chest of the patient before applying pads 2. Razor: excessive chest hair may prevent the pads sticking so a razor is provided 3. Scissors: pads should be applied to bare skin so scissors may be provided to cut through clothing
  • 25. Safety Considerations  Water: Water and electricity don’t mix! A towel should be provided along with an AED, this is to dry the patient’s chest.  Direct contact: No one should touch the patient during delivery of the electrical shock by an AED. The AED will instruct everyone to stand clear.  Explosive environment: If Oxygen is being used, it should be at least 1 meter away from the AED  Chest hair: A razor is supplied so you can shave excessive chest hair.
  • 26. AED Procedure 1. If alone, connect the AED before starting CPR (if in a group, one person can start CPR once another sets up the AED). 2. Once the AED is connected it will analyze the heart rhythm. The AED will either decide to deliver a shock or instruct you to continue CPR for 2 minutes.  Shock: ensure everyone is clear of the patient before delivering the shock. A loud verbal command of “stand clear” is suggested.  Continue CPR: immediately begin CPR on the patient for 2 minutes. 3. The AED will continue in this cycle of analyzing and then deciding to shock or continue CPR.
  • 27.
  • 28. Tension Pneumothorax  Tension pneumothorax: is a life-threatening condition that can occur with chest trauma and is more likely to happen with trauma involving an opening in the chest wall.  It may present with either a closed or open chest injury.  Signs and Symptoms: 1. Severe shortness of breath 2. Unequal chest (one side looks bigger than the other) 3. Veins on the neck bulging (jugular vein distension) 4. Blue lips or fingers (cyanosis)
  • 29. Performing Chest (Needle) Decompression 1. Ensure patient is oxygenated if possible. 2. Select proper site in the affected side preferably at the second intercostal space and along the mid-clavicular line. 3. Clean site with alcohol or povidone solution. 4. Prepare needle decompression preferably 14 or 16 gauge. 5. Insert the needle into the second intercostal space at a 90-degree angle to the chest, just over the third rib. Note: There are blood vessels running along the bottom of the ribs. Ensure the needle is closer to the top margin of the lower rib in the intercostal space. This will prevent these vessels from being damaged. 6. Listen for a rush of exiting air from the needle. 7. Remove the needle and leave the catheter in place, properly disposing of the needle. 8. Secure the catheter in place with tape. 9. Ensure the tension has been relieved and the patient's condition improves. If there is no improvement, the procedure will need to be repeated with another needle placed adjacent to the first needle. 10. Monitor, then reassess the patient.
  • 30. Cont… Fifth intercostal space (3.4 cm) Anterior axillary line (4.3 cm)
  • 32. Dealing With Major Bleeding PEEP 1. Position – position the victim in a safe / comfortable position 2. Elevate limbs above level of the heart 3. Expose & examine the injury. Check for any embedded or foreign objects such as pieces of glass. 4. Pressure – apply direct pressure over the injury to control blood loss If there are no foreign objects  Do not apply a tourniquet unless specifically trained to do so.  Do not attempt to wash out a major wound – your aim is to control the bleeding as quickly as possible.  Seek medical advice urgently if complicated or you couldn’t stop the bleeding.  An average adult has around 5 liters of blood in their body.
  • 33. Cuts and grazes (abrasion) 1. Stop any bleeding. You can elevate the wound or apply direct pressure using a sterile gauze swab/pad. 2. Clean the wound using running water or antiseptic wipes. Dry with a sterile gauze swab/dressing. 3. Ensure the area around the wound is clean (no dirt, grit etc.) 4. Cover with a sterile dressing/plaster. Remember some people might be allergic to regular plasters!  Infected wounds are often very red, swollen, painful and may have pus. As the infection develops you may develop a fever. If you see any of these signs you should seek medical advice urgently.  One of the infection risks in any open wound is Tetanus. Tetanus is caused by Clostridium tetani, a bacteria which lives in soil which can lead to muscle spasms, fever and sweating. There is a vaccine course available.
  • 34. Puncture Wounds  The object may remain embedded in the wound or may have passed clean through the body part involved. 1. Do not remove the object unless it is very small. 2. Stop the bleeding by applying pressure around the wound – take care not to dislodge the object. 3. If possible, elevate the limb to prevent further blood loss. 4. Seek urgent medical attention.  It is important to keep the object as still as possible to prevent further injury to the deeper structures below the skin.  Whilst it is tempting sometimes to attempt to remove the object, this can actually worsen the situation by causing further bleeding and tissue damage.
  • 35. Nosebleeds (epistaxis)  There are countless causes for nosebleeds, some common ones include: 1. Trauma 2. High blood pressure (hypertension) 3. Blood thinning medication (e.g: Warfarin) 4. Foreign bodies (fingers!) 5. Inflammation  Management of epistaxis: 1) Ask the person to tilt their head forwards and pinch the soft part of their nose for 10 minutes. Encourage them not to pick at their nose or sniff. Ask them to breathe through their mouth.
  • 36. Cont… 2) After 10 minutes release the pressure and see if the bleeding has stopped. If it hasn’t, reapply the pressure. You can also try placing something cool on the nose (ice pack etc.) to constrict the blood vessels 3) Once the bleeding has stopped, clean up any blood from around the face/mouth. Tell the person not to sneeze/pick at their nose/sniff for several hours as this could cause the bleeding to start again.  It can be very difficult to get a child to sit still and hold their nose, so try your best. In some cases you might have to hold their nose for them.  If the bleeding does not stop (after around 20 – 30 minutes), you should seek medical advice. In addition, if the cause of the nosebleed is unclear or they are recurring you should also seek advice.  A nosebleed after a head injury can be the sign of a more serious injury  A common misconception is that you should tilt head backwards. This isn’t recommended as blood will travel back down into your mouth and into your stomach. This can make bleeding continue, choking or stomach irritation.
  • 37. Shock  Shock: A lack of oxygen and essential nutrients reaching the tissues.  Medical shock is a life threatening medical emergency.  There are various different causes of shock, major blood loss will cause hypovolemic shock.  Signs & symptoms of shock include: 1. Pale, cold and clammy skin 2. Confusion 3. Drowsiness (reducing level of consciousness) 4. Fast, weak pulse 5. Fast, shallow breathing
  • 38. First aid for shock 1. Control any external blood loss (think PEEP) 2. Lie the casualty down and raise their legs if possible 3. Cover the casualty with a coat or blanket to keep them warm 4. Call for emergency medical help  Do not give the casualty anything to eat or drink!  Recovery position and CPR if needed.
  • 39. Fractures 1. Open fracture: This is where the bone has pierced the skin and caused an open wound which may bleeding. There is a high risk of infection with these injuries 2. Closed fracture: A fracture which has not caused an open wound 3. Complicated fracture: A fracture which damages nerves and blood vessels, this can cause permanent nerve damage or loss of blood supply to a limb. 4. Greenstick fracture: Common in children as their bone’s are more “bendy”, therefore their bones are less likely to fully break.
  • 40. Signs and symptoms of fractures
  • 41. First aid for fractures 1) Keep the area as still as possible, ask the person not to move it 2) Expose the site of injury to check for any bleeding or open wounds. If there is a bone through the skin then do not move it, instead cover with a sterile dressing if available. If the wound is bleeding then apply gentle pressure around the wound. 3) Pad around the injured area with blankets / clothing. If the person has hurt their arm then ask them to hold it in the most comfortable position possible 4) Quickly arrange transport to the nearest hospital. 5) Call an emergency ambulance if: a. You cannot move the person (for example, because they have hurt their leg) b. They have fractured a limb and it is turning blue / cold, this indicates a loss of blood supply to the limb which needs correcting urgently c. The casualty is in severe pain d. You suspect they may have other serious injuries
  • 43. Concussion  Concussion: head injury where the brain can be shaken inside the skull.  It leads to short loss of consciousness or confusion (seconds to few minutes).  Most of them recover but sometimes it might become serious.
  • 44. First aid for Concussion 1. Ask them to rest and apply a cold compress to the injury (ice pack, bag of frozen vegetables wrapped in a towel) 2. Call for ambulance in: a) Confusion b) Drowsiness c) Vomiting d) Fall was greater than 2 times of their height. e) Dizziness f) Loss of consciousness g) Headache h) Blurred vision i) No memory of what happened
  • 45. Burns  Superficial (1st degree) – this is when only the top layer of skin has been damaged. These are the most minor burns. Often the only sign is a reddening of the skin. Minor sunburn falls into this category of burns.  Partial thickness (2nd degree) – these burns cause blisters in the skin due to the damaged tissue releasing fluid.  Full thickness (3rd degree) – this is the most serious type of burn. In a full thickness burn, every layer of the skin has been affected and the underlying bone, muscle or fat may have also been damaged.
  • 46. Assessment of Burn Size Body Surface Area BSA
  • 47. First aid for a minor burn 1. Immediately run the burn under cold running water for a minimum of 10 minutes. If running cold water is not available you can use other non-toxic liquids such as drinks. 2. Expose the affected area and if possible remove anything that could be constricted (watches, jewelry etc.). 3. After cooling the burn, cover with a non-fluffy dressing/covering. 4. Seek medical advice for anything except the most minor of burns. Call an ambulance if serious or if the burn is near the face/neck.  What not to do: a) Do not try to remove clothing sticking to a burn, instead cool through the clothing b) Do not apply toothpaste / butter / creams to a burn. Running water is the most effective cooling method. • Exception: “Aftersun” lotion is useful for sunburn c) Do not burst any blisters d) Do not stop cooling before 10 minutes is up! e) Be careful not to constrict the burn!
  • 48. Chemical burns 1. Check for any dangers to yourself. The chemicals that caused the casualty’s injuries could also pose a danger to you.  Try to establish what caused the burn and how safe the chemicals are.  If you are in an enclosed area, move the casualty outside or open windows to prevent the build up of fumes. Wear disposable gloves. 2. Cool the burn with copious running water for at least 15 – 20 minutes. Ensure that you do not come into contact with the water used to cool the burn as it may contain the harmful chemical. 3. If any clothing has come into contact with the chemical, it should be removed providing it isn’t sticking to the burn. 4. Cover the burn with a sterile, non-fluffy first aid dressing. 5. Seek medical advice If the burn is serious. Call an ambulance if the casualty shows signs of shock or the casualty becomes drowsy/looses consciousness.
  • 49. Criteria for Admitting Patients to Burn Unit 1. 2nd and 3rd degree burns >10% body surface area (BSA) 2. 2nd and 3rd degree burns with serious threat or cosmetic impairment. 3. 3rd degree burns >5% BSA in any age group. 4. Electrical burns, including lightening injury. 5. Chemical burns with serious threat or cosmetic impairment. 6. Inhalation injury with burn injury.
  • 50. Heart attack  The heart receives its blood supply from the coronary arteries which branch off from the aorta (the main artery in your body).  If a coronary artery becomes blocked (e.g: due to a clot), then the heart muscle beyond the point of the blockage will not receive an adequate blood supply. This will result in death of the heart muscle.  The medical term for a heart attack is ‘myocardial infarction’ (myocardium means heart muscle, infarction is tissue death due to lack of oxygen)
  • 51. How do I recognize a heart attack? 1. Sudden central chest pain, which may spread to the arms/jaw/back/abdomen. Does not ease or go away. 2. Shortness of breath 3. Casualty becomes pale and sweaty 4. Fear and anxiety 5. Irregular or weak pulse 6. Some heart attacks can be ‘silent’ with very little pain which is often mistaken for indigestion, are more common amongst women and diabetic patients.
  • 52. First aid treatment 1. Call an ambulance/emergency medical help, say that you suspect someone is having a heart attack. 2. Make the person comfortable, if possible ask them to sit on the floor. The best position is known as the “W” position, this involves the person sitting up with something under their knees to raise them. This reduces the strain on the heart. 3. If you are able to, ask the casualty to chew on a 300mg aspirin. If they have any other medication for their heart (a spray etc.) which a doctor has told them to use, then let the casualty use it.  Try to be reassuring and calm, the casualty will be incredibly frightened and anxious which could aggravate their condition.  Be prepared that the casualty may suffer a cardiac arrest (the heart stops beating) and you may have to perform Cardiopulmonary Resuscitation.
  • 53. Anaphylaxis  Life threatening whole body severe allergic reaction.  When the body detects this allergen, it reacts by releasing a large amount of inflammatory substances such as histamine. These substances cause blood vessels throughout the body to widen, leading to a drop in blood pressure, and airways in the lungs to constrict and secrete mucus causing severe difficulty in breathing.  This often happens very quickly, possibly even seconds after coming into contact with the allergen
  • 54.
  • 55. First aid for anaphylaxis 1. Call an ambulance immediately. 2. Stop the causative allergen or substance. 3. If the casualty is carrying any medication, such as an auto-injector containing adrenaline (EpiPen), assist them to use it. injected into muscle and not into a vein. 4. If the casualty starts showing signs of shock, then lie them down with their legs raised to increase blood flow to the brain and vital organs. Otherwise, keep the casualty in the most comfortable position to help with their breathing. 5. Reassure the casualty as they may be very anxious and frightened. Be prepared that they may collapse and stop breathing. If they do then you should commence Cardiopulmonary resuscitation (CPR) immediately.  Adrenaline has three main effects: a) Constriction, or tightening, of the blood vessels. b) Increases the heart’s contraction and heart rate. c) Relaxes the muscles around the airways in the lungs.
  • 56. Stroke  A stroke (or ‘CVA’ – cerebrovascular accident) is a problem with the blood supply to the brain.  Broadly, there are two types of stroke: 1. Ischemic stroke: A clot blocks an artery in the brain causing death of brain tissue. 2. Hemorrhagic stroke: An artery in the brain ruptures causing bleeding.
  • 58. Seizures  One of the most well known causes is a medical condition called Epilepsy where the electrical activity in the brain is disturbed. However there can be a variety of other causes including: 1. Head injuries 2. Drugs / Alcohol 3. Poisoning 4. Low blood sugar (Hypoglycemia) 5. In infants, high temperatures. 6. Seizures are often characterized by a loss of consciousness followed by uncontrolled muscle contractions.
  • 59.
  • 60. First aid for a seizure 1. Remove any objects from around the casualty (chairs, tables etc.) to prevent them injuring themselves. Make the area as safe as practically possible 2. Protect the casualty’s head by padding around it and underneath the neck. Don’t place bulky padding underneath the casualty’s head as this could tilt their head forwards and close their airway. 3. Try and establish a cause for the seizure. Are they a known to suffer from Epilepsy? Do they have Diabetes? Have they had an injury recently? 4. Call an ambulance unless the casualty is known to have seizures regularly and doesn’t normally go to hospital. 5. Note how long the seizure lasts for, and whether there are any gaps. 6. When the seizure stops, open the casualty’s airway by tilting their head backwards and check for normal breathing for up to 10 seconds. If they are breathing then roll them onto their side to protect their airway. If they are not breathing then commence cardiopulmonary resuscitation.  Remember to protect and maintain the casualty’s dignity throughout. Move on any crowds of people and try to offer some privacy. Although the person having the seizure is unconscious, they may still be able to hear or have an awareness of people around them. When the casualty wakes up they may be very confused. Speak slowly and clearly and explain what has happened.
  • 61. Fainting  A faint is a brief and sudden loss of consciousness, normally due to a reduction in the blood flow to the brain.  If you suddenly stand up, the heart has to work harder to pump this blood upwards against gravity.  Generally once a person has fainted and fallen to the floor, they regain consciousness very quickly. This is because when lying down, the heart finds it easier to pump blood to the brain as it isn’t working against gravity.  They may go very pale/white, and look unsteady on their feet. Also they may complain of feeling ‘light headed’
  • 62. First aid for a faint 1. Raise their legs to improve the blood supply to the brain. 2. If they’ve fallen, check for any injuries such as fractures or head injuries. 3. Once they recover, help them sit up gradually. Don’t let the casualty stand up straight away as they may just faint again! 4. If they casualty does not wake up, you should open their airway by tilting their head backwards and check to see if they’re breathing. If they are, roll them onto their side and call an ambulance.
  • 63. Hyperglycemia and Hypoglycemia  Diabetes: is a problem with the body’s control of blood sugar levels (high).  The body produces a variety of hormones to control blood sugar. The most important is insulin which is released by the pancreas. Insulin acts to reduce blood sugar levels.  There are two main types of diabetes: 1. Type 1: In this case, the body fails to produce enough insulin. Typically onset occurs in childhood however this is not always the case. Type 1 diabetes is often called Insulin Dependent Diabetes Mellitus (IDDM). 2. Type 2: In type 2 diabetes, the pancreas produces enough insulin however cells in the body become resistant to insulin so its effects are reduced. Type 2 diabetes is more common in later life, and may be affected by various lifestyle factors such as diet and exercise.
  • 64.
  • 65. Management  Hyperglycemia may develop over several days and weeks. If you suspect someone has high blood sugar, you should urge them to seek medical attention. If they become very drowsy or unconscious then phone for an emergency ambulance and place them into the recovery position to protect their airway.  If you suspect someone is suffering from low blood sugar, you should attempt to raise the blood sugar by offering something sweet such as a sugar cube / sugary drink / sugary snack. The casualty may be carrying snacks for such a situation. If the casualty has a reduced level of consciousness, or does not respond to the treatment above, you should call an emergency ambulance.
  • 66. Asthma  Asthma is an inflammatory condition of the smallest airways – the bronchioles. These tiny tubes can become inflamed and secrete excessive amounts of mucous causing severe difficulty in breathing.
  • 67.
  • 68. First aid for an asthma attack 1. Sit the casualty down in the position they find most comfortable for their breathing. 2. Find their medication, which is normally an inhaler (possibly with a spacer device) containing a drug such as Salbutamol. 3. Assist the casualty to use their medication. They should know how many doses to take and how to use the inhaler. As a guide, a maximum of up to 10 puffs over 30 – 60 seconds each is recommended. 4. Provide reassurance and help calm the person’s breathing if they are hyperventilating. 5. Call for emergency medical help if the Salbutamol inhaler has no effect, or the patient shows any signs of deterioration.  If the casualty becomes unconscious, then open their airway by tilting their head back and check for normal breathing. If they are breathing then roll them onto their side to protect their airway. If they are not breathing then commence cardiopulmonary resuscitation (CPR).
  • 69. Choking  Adult / Children (Heimlich maneuver) 1. Give five back blows Hit the person using the palm of your hand in the center of their back. Your aim is to create vibrations to dislodge the object from the airway 2. Give five abdominal thrusts Stand / kneel behind the person. Place a fist just above their belly button. With your other hand, grasp the fist and pull sharply inwards and upwards 3. Repeat the cycle of five back blows and five abdominal thrusts until help arrives
  • 70. Cont…  Babies 1. Give five back blows Lay the baby face down across your thigh or forearm (ensure the head is supported). Give up to five firm blows using the palm of your hand in between the baby’s shoulder blades. 2. Give five chest thrusts Turn the baby over so that they are on their back. Using two fingers, deliver five firm chest thrusts inwards and upwards towards the head. 3. Repeat the cycles of back blows and chest thrusts until further help arrives
  • 71. First Aid for Poisoning 1. Establish what they have taken, when and how much. 2. Call for ambulance in: a) Unresponsive b) Change in behavior c) Difficulty breathing d) Abdominal pain and vomiting e) If you think they are suicidal 3. You may need to put them in recovery position or do CPR.  Don’t give them anything to drink, that may cause more poisoning or block airways.
  • 72. Dog bites 1. Using clean water (with soap/an antiseptic product if possible) wash the wound thoroughly. Make sure to clean the area around the wound as well. 2. Cover the wound with a sterile wound dressing. If the bleeding is severe, apply direct pressure and call for an ambulance. 3. If there is a risk of infection (i.e you are in a rabies risk area) or the wound appear serious, then seek medical advice immediately. The casualty may require an injection to protect them from the rabies virus.  If you are concerned that the dog may still be in the vicinity and poses a danger to yourself then call the police immediately. Do not try to capture or calm the dog down, as this may result in further injury to yourself or others.  The advice above can also apply to any animal / human bites, not just dogs.
  • 73. First Aid for Scorpion and Spiders Stings  The venom contains a complex mix of toxins that affect the nervous system (neurotoxins). 1. Try to identify the scorpion or spider. 2. Call for ambulance. 3. Remove the victim from danger and put them in rest with reassurance. 4. Immobilize the affected part below the level of the heart. 5. Remove constricting items on the victim (rings, watches). 6. Wash the wound thoroughly. 7. Apply an ice pack or anesthetic agent to the injured are to reduce pain and swelling 8. Use local antibiotic if has no known allergy to prevent infection. 9. Victim may develop anaphylaxis.  Don’t cut or suck the site.  Don’t use tourniquet or constriction bands.
  • 74. First Aid for Snake Bite  Depends on the type of snake it is either have: a) Neurotoxic effect (neuromuscular junction) b) Hemotoxic effect (quick coagulation or blood clotting). 1. Try to identify the scorpion or spider. 2. Call for ambulance. 3. Remove the victim from danger and put them in rest with reassurance. 4. Immobilize the affected part below the level of the heart. 5. Remove constricting items on the victim (rings, watches). 6. Wash the wound thoroughly. 7. Victim may develop anaphylaxis. 8. Don’t use ice pack or alcohol or any agent.  Don’t cut or suck the site.  Don’t use tourniquet or constriction bands.
  • 75. First Aid for Ticks Bite  Ticks are vectors of some serious and important arthropod-borne diseases such as: Lyme, tularemia, Rocky Mountain spotted fever, and some types of encephalitis as well as Crimean Congo hemorrhagic fever(CCHF).  Ticks bite signs and symptoms may include:  Rash, neck stiffness, headache, nausea, weakness, muscle or joint pain and fever. 1. Wear disposable gloves if available. 2. Grasp tick with fine-tipped tweezer close to skin and pull slowly. 3. Wash the bitten area with soap and water. 4. Apply antiseptic or antibiotic (if not allergic) if available. 5. Call for ambulance.
  • 76. First Aid for Heat Stroke  Heat exhaustion: involves the loss of body fluids through heavy sweating during strenuous exercise or physical labor in high heat and humidity.  Heat cramps: muscular pain and spasms that usually occur in the legs or abdomen due to heat exhaustion.  Heat stoke: life-threatening condition in which a person’s temperature control system stops working and the body is unable to cool itself.
  • 78. First Aid for Hypothermia and Frostbite 1. Call ambulance. 2. If they are outside, bring them inside. 3. Minimize movement. 4. Warm them slowly (blanket, warm drinks)  Don’t use radiant heat (fire, electric heaters)  Don’t rub affected area  Don’t provide person alcohol  Avoid putting person in bath
  • 79.
  • 80. References  https://www.redcross.org  https://eccguidelines.heart.org  https://www.firstaidforfree.com/  http://www.sja.org.uk  https://cprguidelines.eu  https://www.surefirecpr.com  https://bhcpr.org  https://www.ambulance.qld.gov.au  https://en.wikipedia.org  https://www.ems1.com  https://www.verywellhealth.com