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First aid in emergencies
 Dr. Shankar Hippargi
 Consultant
 Dept of Accident & Emergency
 Medicine
 MMHRC- Madurai
First aid
• The emergency care, help and
  treatment of an injured person,
  before arrival of medical care

• It is not a substitute for medical
  care

• First aid should not delay the
  transport
First aid- Aims
• To sustain the life of the victim
• To prevent his condition from
  deteriorating
• To prevent the occurrence of further
  injuries
• To prevent contamination
• To seek medical help
Types of emergencies
• Fatal emergencies:
   • Cases which lead to death if first aid
     is not provided immediately
     Ex: cardiac arrest, major fractures,
     profuse bleeding etc…
• Non fatal emergencies:
   • Cases which are not life threatening
     but will require first aid to prevent
     worsening
     Ex: minor fractures, nasal bleeding
     etc…
First aid box
contents
 •   First aid Manual
 •                      • Roller bandage
     Scissors
 •                      • Spirit, dettol
     Forceps
 •                      • Gloves, masks
     Crepe bandage
 •                      • Antiseptic creams
     Gauze swabs
                          (silverex, betadine)
 •   Cotton bandage
                        • Saline bottles
 •   Adhesive plaster
                        • Safety pins
 •   Cotton
                        • Pain killers
Burns
• Destruction of the skin & deeper
  tissues due to heat
• There will be loss of body fluids
  (plasma)
• Severe dehydration
Types of burns
Causes of burns
       •   Fire
       •   Hot liquids
       •   Chemical substances
       •   Hot objects
       •   Radiation
       •   Electric current
       •   Lightening
First aid treatment
• Reassure the person & keep him in safe
  place
• Cool the burn area with running water
  for 10-20 mins especially in chemical
  burns
• Apply silverex cream only for minor
  burns
• Prevent contamination
• Do not puncture the blisters
• Keep nil by mouth for major burns
First aid treatment

• Gently remove any rings, watches,
  belts or constricting clothing from the
  injured area before it begins to swell
• Don't remove anything that is sticking
  to the burn
• Cover loosely with sterile dressing
• Do not use adhesive dressings
• Transfer to hospital as soon as
  possible
TRAUMA (RTA)
• Injuries in RTA may range from minor
  abrasions to severe head, thoracic and
  abdominal injuries which may cause
  immediate death

• Identifying life threatening injuries and
  rapid transport to the nearest multi
  specialty hospital may improve the
  chances of survival
Mechanism of injury
• Mechanism of injury is very important
  in predicting the severity of injuries
• Any death in a mass casualty should
  alert the possibility of severe injuries to
  other passengers
Cervical spine
Cervical spine
• Cervical spine is most susceptible for
  injuries
• Any injury above the level of collar
  bones will have associated C-spine
  injury
• Injury to spinal cord can cause
  permanent paralysis of both upper and
  lower limbs
• Very important to immobilize the C-
  spine while extricating from scene and
  transport
Cervical spine immobilization
Bleeding
•   Could be external or
    internal or both
•   Internal bleeding
    more profuse and
    dangerous than
    external bleeding
First Aid for External
Bleeding
• Apply direct pressure with the hand to
  the bleeding points with a sterile
  dressing
• Elevate the bleeding part & support in
  that position until bleeding stops.
First Aid for External
Bleeding
• If bleeding continues, do not remove
  soaked pad, apply another dressing
  pad on previous one
• The tourniquet is to be used only as the
  last resort.
           “LIFE OR LIMB ”
• Refer to hospital immediately
Internal bleeding
  • Signs & symptoms of internal
    bleeding
     • Pale color
     • Rapid weak pulse
     • Rapid & shallow breathing
     • Cold, clammy skin
     • Pain in the bleeding part
     • Restless, anxiety & thirst
     • Sweating
     • Unconsciousness
First aid for internal
bleeding
•   Lay the person flat on his back with raised legs
•   Do not give any thing by mouth
•   Reassure the person & transfer to hospital as
    soon as possible
Traumatic Amputation
        •   Wash the organ with saline

        •   Wrap the organ in a sterile
            gauze

        •   Place it in a dry plastic bag

        •   Place the bag in another bag
            containing ice

        •   Send the amputated organ with
            the patient to hospital
Fracture
• Signs: Swelling, deformity, pain on
  movement, not able to use the limb, profuse
  bleeding
Types of fracture
First aid in fracture
• Reassure the patient, give pain killers if
  available
• Control bleeding by direct pressure
• Splint the limb and elevate above the level
  of heart
• Support the upper & lower joint of the
  injured part with a splint
• Do not try to straighten or repair the
  fractured part
Lower limb fractures
• Splint the limb and elevate
Upper limb fractures
Penetrating injuries
First aid in penetrating
injuries
• Reassure the patient
• Never attempt to remove the object-
  may cause severe uncontrollable
  bleeding and may cause sudden death
• Rapid transport
Poisoning
• Poisons are any substance in a form of
  solid, liquid or gas which, when taken
  into the body in sufficient amount will
  have a negative or destructive effect on
  health
Routes of poisoning
•   Oral
•   Inhalational
•   Direct skin contact
•   Intravenous (rare)
Signs & symptoms of
poisoning
  •   Burns or stains around the mouth
  •   Unusual breath odours
  •   Abnormal breathing & pulse rate
  •   Abdominal pain
  •   Sweating
  •   Vomiting
  •   Diarrhea
  •   Seizures
  •   Unconscious
First aid in poisoning
• Check the responsiveness, then seek
  medical help
• Decontaminate (wash) the skin
• Do not induce vomiting
• Transport the patient as soon as
  possible
• Send the container / medication
  strip to hospital
Nasal bleeding
• Bleeding from the nose
• Causes: Trauma, hypertension,
  bleeding disorders, assault
First aid
• Pinch the nose
• Lean forwards
• Apply ice packs over nose
Heat stroke
• Heat stroke is a potentially fatal
  emergency
• Temperature regulation center-
  inoperable
• The temperature continuously rises,
  causing eventual brain damage
• Immediate active intervention is
  necessary to avoid coma and death
• Very high mortality
Signs & Symptoms
• Flushed, hot, dry skin- victim has
  ceased sweating
• Rapid, strong pulse
• Irrational or aggressive behavior, visual
  disturbances
• Vomiting
• Seizures
• Decreased level of consciousness
• Coma
First aid
• Complete rest in shade
• Remove victim's clothing
• Cool victim with any means possible
• Evaporative cooling: Spray water on
  patient’s body and keep him under a fan
• Nil by mouth - dehydration should be
  corrected by intravenous fluids
• Rapid transport
Universal precautions
• Assume every patient as potentially
  infected with HIV, HBV, HCV

• Health care provider must be protected
  against exposure to blood and other body
  fluids from patients

• Chances of getting infected with HIV, HBV,
  and HCV are high in health care providers

• Use appropriate protective equipments like
  gloves, gowns, masks, shoes, goggles
Universal precautions
• Your life is more important to you than
  the victims life, so be careful about
  your health
• Remember that “ I ” comes before “U”
  even in the alphabets
• Do not become a patient yourself
• Do not do the things which you are not
  trained
  Ex: Trying to save a drowning victim
  without knowing swimming
First aid

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First aid

  • 1. First aid in emergencies Dr. Shankar Hippargi Consultant Dept of Accident & Emergency Medicine MMHRC- Madurai
  • 2. First aid • The emergency care, help and treatment of an injured person, before arrival of medical care • It is not a substitute for medical care • First aid should not delay the transport
  • 3. First aid- Aims • To sustain the life of the victim • To prevent his condition from deteriorating • To prevent the occurrence of further injuries • To prevent contamination • To seek medical help
  • 4. Types of emergencies • Fatal emergencies: • Cases which lead to death if first aid is not provided immediately Ex: cardiac arrest, major fractures, profuse bleeding etc… • Non fatal emergencies: • Cases which are not life threatening but will require first aid to prevent worsening Ex: minor fractures, nasal bleeding etc…
  • 5. First aid box contents • First aid Manual • • Roller bandage Scissors • • Spirit, dettol Forceps • • Gloves, masks Crepe bandage • • Antiseptic creams Gauze swabs (silverex, betadine) • Cotton bandage • Saline bottles • Adhesive plaster • Safety pins • Cotton • Pain killers
  • 6. Burns • Destruction of the skin & deeper tissues due to heat • There will be loss of body fluids (plasma) • Severe dehydration
  • 8. Causes of burns • Fire • Hot liquids • Chemical substances • Hot objects • Radiation • Electric current • Lightening
  • 9. First aid treatment • Reassure the person & keep him in safe place • Cool the burn area with running water for 10-20 mins especially in chemical burns • Apply silverex cream only for minor burns • Prevent contamination • Do not puncture the blisters • Keep nil by mouth for major burns
  • 10. First aid treatment • Gently remove any rings, watches, belts or constricting clothing from the injured area before it begins to swell • Don't remove anything that is sticking to the burn • Cover loosely with sterile dressing • Do not use adhesive dressings • Transfer to hospital as soon as possible
  • 11. TRAUMA (RTA) • Injuries in RTA may range from minor abrasions to severe head, thoracic and abdominal injuries which may cause immediate death • Identifying life threatening injuries and rapid transport to the nearest multi specialty hospital may improve the chances of survival
  • 12. Mechanism of injury • Mechanism of injury is very important in predicting the severity of injuries • Any death in a mass casualty should alert the possibility of severe injuries to other passengers
  • 14. Cervical spine • Cervical spine is most susceptible for injuries • Any injury above the level of collar bones will have associated C-spine injury • Injury to spinal cord can cause permanent paralysis of both upper and lower limbs • Very important to immobilize the C- spine while extricating from scene and transport
  • 16. Bleeding • Could be external or internal or both • Internal bleeding more profuse and dangerous than external bleeding
  • 17. First Aid for External Bleeding • Apply direct pressure with the hand to the bleeding points with a sterile dressing • Elevate the bleeding part & support in that position until bleeding stops.
  • 18. First Aid for External Bleeding • If bleeding continues, do not remove soaked pad, apply another dressing pad on previous one • The tourniquet is to be used only as the last resort. “LIFE OR LIMB ” • Refer to hospital immediately
  • 19. Internal bleeding • Signs & symptoms of internal bleeding • Pale color • Rapid weak pulse • Rapid & shallow breathing • Cold, clammy skin • Pain in the bleeding part • Restless, anxiety & thirst • Sweating • Unconsciousness
  • 20. First aid for internal bleeding • Lay the person flat on his back with raised legs • Do not give any thing by mouth • Reassure the person & transfer to hospital as soon as possible
  • 21. Traumatic Amputation • Wash the organ with saline • Wrap the organ in a sterile gauze • Place it in a dry plastic bag • Place the bag in another bag containing ice • Send the amputated organ with the patient to hospital
  • 22. Fracture • Signs: Swelling, deformity, pain on movement, not able to use the limb, profuse bleeding
  • 24. First aid in fracture • Reassure the patient, give pain killers if available • Control bleeding by direct pressure • Splint the limb and elevate above the level of heart • Support the upper & lower joint of the injured part with a splint • Do not try to straighten or repair the fractured part
  • 25. Lower limb fractures • Splint the limb and elevate
  • 28. First aid in penetrating injuries • Reassure the patient • Never attempt to remove the object- may cause severe uncontrollable bleeding and may cause sudden death • Rapid transport
  • 29. Poisoning • Poisons are any substance in a form of solid, liquid or gas which, when taken into the body in sufficient amount will have a negative or destructive effect on health
  • 30. Routes of poisoning • Oral • Inhalational • Direct skin contact • Intravenous (rare)
  • 31. Signs & symptoms of poisoning • Burns or stains around the mouth • Unusual breath odours • Abnormal breathing & pulse rate • Abdominal pain • Sweating • Vomiting • Diarrhea • Seizures • Unconscious
  • 32. First aid in poisoning • Check the responsiveness, then seek medical help • Decontaminate (wash) the skin • Do not induce vomiting • Transport the patient as soon as possible • Send the container / medication strip to hospital
  • 33. Nasal bleeding • Bleeding from the nose • Causes: Trauma, hypertension, bleeding disorders, assault
  • 34. First aid • Pinch the nose • Lean forwards • Apply ice packs over nose
  • 35. Heat stroke • Heat stroke is a potentially fatal emergency • Temperature regulation center- inoperable • The temperature continuously rises, causing eventual brain damage • Immediate active intervention is necessary to avoid coma and death • Very high mortality
  • 36. Signs & Symptoms • Flushed, hot, dry skin- victim has ceased sweating • Rapid, strong pulse • Irrational or aggressive behavior, visual disturbances • Vomiting • Seizures • Decreased level of consciousness • Coma
  • 37. First aid • Complete rest in shade • Remove victim's clothing • Cool victim with any means possible • Evaporative cooling: Spray water on patient’s body and keep him under a fan • Nil by mouth - dehydration should be corrected by intravenous fluids • Rapid transport
  • 38. Universal precautions • Assume every patient as potentially infected with HIV, HBV, HCV • Health care provider must be protected against exposure to blood and other body fluids from patients • Chances of getting infected with HIV, HBV, and HCV are high in health care providers • Use appropriate protective equipments like gloves, gowns, masks, shoes, goggles
  • 39. Universal precautions • Your life is more important to you than the victims life, so be careful about your health • Remember that “ I ” comes before “U” even in the alphabets • Do not become a patient yourself • Do not do the things which you are not trained Ex: Trying to save a drowning victim without knowing swimming