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 2010

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First aid 2011

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