First aid 2011

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The new set of slides for my lecture Principles and Practice of First Aid For First Years Medical/Dental Students during the First Aid Block 2010/2011. This set of slide is based on AHA Guidelines …

The new set of slides for my lecture Principles and Practice of First Aid For First Years Medical/Dental Students during the First Aid Block 2010/2011. This set of slide is based on AHA Guidelines 2010

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  • 1. American Heart Association and American Red Cross Guidelines 2010 K S Chew School of Medical Sciences Universiti Sains Malaysia First Aid Principles and Practice
  • 2. First aid….. it is better to know it and not need it than to need it and not know it.
  • 3. “ Whatever can go wrong, will.” - Murphy Law
  • 4.  
  • 5. Definition of First Aid
  • 6. What is First Aid?
    • Definition:
    • First aid is the assessment and immediate care that can be performed by a bystander or the victim himself/herself. First aid does not take the place of proper medical treatment and must not delay activation of emergency medical services or other medical assistance when required.
  • 7. First Aid
    • Immediate care that can be given to an injured or suddenly ill person
      • With minimal or no proper medical equipment
      • Temporary assistance until arrival of competent medical care
      • Does not take the place of proper medical treatment
  • 8. Example: Bleeding Control
  • 9. Direct Pressure with gauze or clean cloth. Ask the victim to support his/her own injured limb. Bleeding Control
  • 10. Bleeding Control Start from distal to proximal. Make two turns at the start. Check for circulation, sensation and movement before applying
  • 11. Bleeding Control Apply bandage with roller facing up. Ensure the subsequent turn cover 2/3 rd of previous turn.
  • 12. Bleeding Control Cut the end of the bandage into two to use as ties
  • 13. Bleeding Control Check again for circulation, sensation and movement after applying. Ensure not too tight!
  • 14. Bleeding Control Applying 2 nd layer of bandage if still bleeding
  • 15. Bleeding Control Check again for circulation, sensation and movement after applying.
  • 16. Bleeding Control
    • Best controlled by applying pressure until bleeding stops
    • Amount of pressure applied and the time the pressure is held are the most important factors affecting successful control of bleeding.
  • 17. Bleeding Control
    • Elevation and use of pressure points are no longer recommended to control bleeding.
    • Why?
    • effectiveness of elevation has not been studied
    • these unproven procedures may compromise the proven intervention of direct pressure
  • 18. Elevation and use of pressure points are not recommended to control bleeding 2010 American Heart Association and American Red Cross Guidelines for First Aid
  • 19. Who provides first aid?
    • Police, Bomba/firefighters, JPA staffs
    • St. John’s Ambulance members, Red Crescent members, Scouts, Girl Guides
    • Bystanders, public members
    • Relatives, family members, friends
    • Workmates, teachers
    • Medical students, anyone ……YOU!
  • 20. Principles of First Aid
  • 21. Principle #1: First, do no harm Know what to do and know what NOT to do
  • 22. First Do No Harm
    • Do no harm does not mean do nothing.
    • The wisdom is not just to know what to do, but what NOT to do
    • Sometimes the best thing you can do for a casualty is to call for help.
    • Provide comfort and assurance to the casualty may be the only thing you can do
  • 23. First Do No Harm
    • Use treatments you know of that are most likely to benefit a casualty
    • Do not use a treatment that you are not sure about “just for the sake of trying”
  • 24. Any victim trapped inside the vehicle may have injured his cervical spine. Be careful when removing such victim
  • 25. Positioning of Victim
    • As a general rule a victim should not be moved
    • The indications to move the victim include
    • If the area is unsafe for the rescuer or victim
    • If the victim is face down and is unresponsive
    • If the victim has difficulty breathing because of copious secretions or vomiting
    • If the victim shows evidence of shock
  • 26.  
  • 27.  
  • 28. Use bags or pillows, etc, to immobilize the cervical spine
  • 29. Impaled or embedded object – DO NOT REMOVE!
  • 30. Make a donut-shaped ring pad to hold the impaled object in place
  • 31.  
  • 32.
    • Send any evidence of the snake to the hospital only if safe to do so.
    • Avoid elevating the limb
    • DO NOT use an arterial tourniquet
    • DO NOT try to capture the snake
    • DO NOT cut the bitten area
    • DO NOT suck the bitten area
    What to do and NOT to do in Snake Bite?
  • 33. What to do?
    • Ensure safety
    • Reassure and rest the casualty
    • Avoid all unnecessary movement to prevent venom from spreading in the body.
    • Direct pressure and immobilize the limb
    • Get to hospital urgently
  • 34. Principle #2: First Aid is about Putting First Things First
  • 35. First Things First
    • Get your priority right
    • If there are too many injuries in a casualty, treat the most urgent injuries first
    • If there are too many casualties
      • First, call for help
      • Treat the ones with the highest chance of survival
  • 36.  
  • 37. Don’t treat him. Forget it!
  • 38. They are also not your priority. Keep them aside and leave them to chat with each other!
  • 39.
    • The first step to get our priority right is to know and recognize what is an emergency and what is not an emergency!
    • Sometimes it is very difficult, e.g. heart attack can be silent
    • Hollywood emergencies don’t always exist in real life
    First Things First
  • 40.  
  • 41. Hollywood Heart Attack
  • 42. Chest Discomfort
    • Assume all chest discomfort is cardiac origin until proven otherwise.
    • The most important intervention is to CALL FOR THE EMS or AMBULANCE.
      • Call EMS rather than drive themselves to hospital
  • 43. Chest Discomfort
    • While waiting for the EMS arrival, encourage victim to take a tablet of crushed aspirin
    provided the patient has no allergy to aspirin or contraindication such as bleeding tendencies, recent bleeding, or a stroke.
  • 44. Principle #3: Safety Is Of Utmost Importance In First Aid
  • 45. All materials, including wooden ones, can conduct electricity if the voltage is high enough!!
  • 46.  
  • 47. What Information To Relay
    • Identify yourself
    • E: Exact Location
    • T: Type of event
    • H: Hazard
    • A: Access
    • N: Number of casualties involved
    • E: Existing emergency services
    • Put down phone only if asked to
  • 48. Prank Calls
    • 98-99% of all emergency calls are prank calls
    • Out of 65,000 calls/day, only 1,300 are real emergency calls
      • 45% of prank callers – children
      • (Ref: Kementerian Tenaga, Air dan Komunikasi Malaysia)
  • 49. Why Some Bystander Refuse To Help?
    • Ignorance
      • Hiding own fear and incompetency
    • Confused about what is an emergency
      • Too much Hollywood movies
    • Characteristics of the emergency situation
      • The blood, smell, vomitus
    • Fear it may be fake
      • Fear own safety; disguised as emergency
  • 50.  
  • 51. “ One important strategy that people use to avoid action is to refuse (consciously or unconsciously) to acknowledge the emergency situation”
  • 52. Jellyfish Sting
    • First aid for jellyfish stings consists of two important actions:
    • preventing further nematocyst discharge and
    • pain relief
  • 53. Jellyfish Sting
    • To inactivate venom load and prevent further envenomation, jellyfish stings should be liberally washed with vinegar (4% to 6% acetic acid solution) as soon as possible for at least 30 seconds.
    • If vinegar is not available, a baking soda slurry may be used instead.
  • 54. Jellyfish Sting
    • For the treatment of pain, after the nematocysts are removed or deactivated, jellyfish stings should be treated with hot-water immersion when possible.
  • 55. Conclusion
    • First aid does not take the place of proper medical care
    • It is a temporary measure using minimal or no medical equipments
    • Three basic principles:
      • DO NO HARM
      • FIRST THINGS FIRST
      • SAFETY IS OF UTMOST IMPORTANCE