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First aid 2011

First aid 2011



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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    First aid 2011 First aid 2011 Presentation Transcript

    • American Heart Association and American Red Cross Guidelines 2010 K S Chew School of Medical Sciences Universiti Sains Malaysia First Aid Principles and Practice
    • First aid….. it is better to know it and not need it than to need it and not know it.
    • “ Whatever can go wrong, will.” - Murphy Law
    • Definition of First Aid
    • 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.
    • 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
    • Example: Bleeding Control
    • Direct Pressure with gauze or clean cloth. Ask the victim to support his/her own injured limb. Bleeding Control
    • Bleeding Control Start from distal to proximal. Make two turns at the start. Check for circulation, sensation and movement before applying
    • Bleeding Control Apply bandage with roller facing up. Ensure the subsequent turn cover 2/3 rd of previous turn.
    • Bleeding Control Cut the end of the bandage into two to use as ties
    • Bleeding Control Check again for circulation, sensation and movement after applying. Ensure not too tight!
    • Bleeding Control Applying 2 nd layer of bandage if still bleeding
    • Bleeding Control Check again for circulation, sensation and movement after applying.
    • 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.
    • 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
    • Elevation and use of pressure points are not recommended to control bleeding 2010 American Heart Association and American Red Cross Guidelines for First Aid
    • 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!
    • Principles of First Aid
    • Principle #1: First, do no harm Know what to do and know what NOT to do
    • 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
    • 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”
    • Any victim trapped inside the vehicle may have injured his cervical spine. Be careful when removing such victim
    • 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
    • Use bags or pillows, etc, to immobilize the cervical spine
    • Impaled or embedded object – DO NOT REMOVE!
    • Make a donut-shaped ring pad to hold the impaled object in place
      • 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?
    • 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
    • Principle #2: First Aid is about Putting First Things First
    • 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
    • Don’t treat him. Forget it!
    • They are also not your priority. Keep them aside and leave them to chat with each other!
      • 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
    • Hollywood Heart Attack
    • 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
    • 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.
    • Principle #3: Safety Is Of Utmost Importance In First Aid
    • All materials, including wooden ones, can conduct electricity if the voltage is high enough!!
    • 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
    • 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)
    • 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
    • “ One important strategy that people use to avoid action is to refuse (consciously or unconsciously) to acknowledge the emergency situation”
    • Jellyfish Sting
      • First aid for jellyfish stings consists of two important actions:
      • preventing further nematocyst discharge and
      • pain relief
    • 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.
    • 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.
    • 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