1.
FIRST AID Principles and Practice K.S. Chew Lecturer/Emergency Physician School of Medical Sciences Universiti Sains Malaysia

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

5.
“ Whatever can happen to one man can happen to every man.” Lucius Annaeus Seneca (4 B.C.? – A.D.65)

6.
Definition of First Aid

7.
What is First Aid? <ul><li>Definition: </li></ul><ul><li>First aid is the immediate care given to an injured or suddenly ill person. First aid does not take the place of proper medical treatment. </li></ul>

8.
First Aid <ul><li>Immediate care given to an injured or suddenly ill person </li></ul><ul><ul><li>Without any 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>

9.
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>

10.
Principles of First Aid

11.
Principle #1: First, do no harm Know what to do and know what NOT to do

12.
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>

13.
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>

17.
Principle #2: First Aid Is Not An Exact Science And Is Open To Error

18.
First Aid Is Not An Exact Science <ul><li>First aid is practiced by people from all walks of life </li></ul><ul><li>Therefore there are great variations in terms of methods and practice </li></ul><ul><li>A casualty may not respond as you hoped no matter how good and how hard you try </li></ul>

19.
First Aid Is Not An Exact Science <ul><li>Don’t feel bad if the casualty don’t respond as you would like him to. </li></ul><ul><li>If you have done your best, your conscience should be clear. </li></ul><ul><li>You may also have to deal with your own fear in real life situations </li></ul>

21.
Principle #3: First Aid is about Putting First Things First

22.
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>

24.
Don’t treat him. Forget it!

25.
They are also not your priority. Keep them aside and leave them to chat with each other!

27.
<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

29.
Hollywood Heart Attack

30.
Recognize An Emergency <ul><li>Factors that determine whether bystander recognize an emergency: </li></ul><ul><li>Severity: motor-vehicle crash </li></ul><ul><li>Physical distance: the closer, the more noticeable </li></ul><ul><li>Relationship: knowing the victim, the more noticeable, e.g. mother and child </li></ul><ul><li>Time exposed: the longer exposed, the more noticeable </li></ul>

31.
Principle #4: Safety Is Of Utmost Importance In First Aid

35.
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>

37.
One important strategy that people use to avoid action is to refuse (consciously or unconsciously) to acknowledge the emergency situation

38.
Other Excuses <ul><li>It could be harmful </li></ul><ul><ul><li>HIV infection </li></ul></ul><ul><li>Helping doesn’t matter </li></ul><ul><ul><li>Victim is drunk </li></ul></ul><ul><li>Obstacles may prevent helping </li></ul><ul><ul><li>Drowning victim in a mining pool (bystander doesn’t know how to swim) </li></ul></ul>

39.
Decide to help <ul><li>If you decide to help, you must: </li></ul><ul><li>Feel confident to help </li></ul><ul><li>Take time to help </li></ul><ul><li>Put the potential risks of helping in perspective </li></ul><ul><li>Take charge at an emergency scene </li></ul><ul><li>Comfortable in seeing a victim who is bleeding or vomiting </li></ul>

40.
Chain of Survival

41.
RECOGNITION Is this an emergency condition? DECIDE TO HELP CONTACT EMS if needed or if not sure ASSESS SCENE AND VICTIM FIRST AID NO YES MEDICAL CARE ARRIVED CHANCE OF RECOVERY WITHOUT MEDICAL CARE ASSURED

42.
Scene Survey <ul><li>Scene safety </li></ul><ul><li>Mechanism of injury </li></ul><ul><li>Number of patients </li></ul>

43.
RECOGNITION Is this an emergency condition? DECIDE TO HELP CONTACT EMS if needed or if not sure ASSESS SCENE AND VICTIM FIRST AID NO YES MEDICAL CARE ARRIVED CHANCE OF RECOVERY WITHOUT MEDICAL CARE ASSURED

44.
Need EMS? <ul><li>Call EMS if </li></ul><ul><li>The victim’s condition life threatening or could get worse </li></ul><ul><li>The victim need the skills or equipment of EMS </li></ul><ul><li>Distance or traffic could cause a delay in getting to hospital </li></ul><ul><li>If you are not sure </li></ul>

45.
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>

46.
History <ul><li>S ymptoms </li></ul><ul><li>A llergies </li></ul><ul><li>M edicatios </li></ul><ul><li>P ast Medical History </li></ul><ul><li>L ast oral intake </li></ul><ul><li>E vents leading up to the illness or injury </li></ul>

47.
Physical Examination <ul><li>D eformity </li></ul><ul><li>O pen wound </li></ul><ul><li>T enderness </li></ul><ul><li>S welling </li></ul><ul><li>For extremities </li></ul><ul><li>Remember to add P ulses, M ovement, S ensation (PMS) </li></ul>

48.
Seven Essential First Aid Interventions <ul><li>Call for ambulance </li></ul><ul><li>DO NOT move and DO NOT allow movement unnecessarily of a trauma casualty </li></ul><ul><li>Perform chin lift or head tilt chin lift </li></ul><ul><li>Mouth-to-mouth breathing (if willing) especially in children, drowning or poisoning </li></ul>

49.
<ul><li>Chest compression </li></ul><ul><li>Operate an automated external defibrillator </li></ul><ul><li>Stop any bleeding </li></ul>Seven Essential First Aid Interventions