3. OBJECTIVES
• Define first aid and other terms used in first aid
• State the importance of first aid
• Describe the principles of first aid
• Describe the rules of first aid
• Describe the content of first aid kit
• Describe the procedure of performing first aid
• Describe the various medical emergencies
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4. CASE SCENARIO
• Imagine: Whilst feeding your child, they start to
gag and appear unable to breathe. You have
tried slapping them on the back, with no success.
They seem close to losing consciousness, their
lips are turning a definite shade of blue.
• People rarely give first aid a thought, until the
day they need it.
• The above scenario is the sort of every day
occurrence that can so easily lead to tragedy.
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5. • However, with the correct first aid training
anyone could, in the short term (until the arrival
of the emergency services) save a life.
• I hope the training you undertake with us will
give you the knowledge and confidence to, if the
worst happens, help keep someone alive.
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6. DEFINITION OF FIRST AID
The initial assistance or treatment given to a
casualty for any injury or sudden illness before
the arrival of an ambulance, doctor, or other
qualified personnel.
The emergency care or treatment given to an ill
or injured person before regular medical aid can
be obtained
The provision of immediate care to a victim with
an injury or illness, usually effected by a lay
person and performed within a limited skill
range
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7. The role of the first aider
Assessing the situation
What happened
Number of casualties
History, signs, symptoms
Protecting from dangers
Assess for further danger
Protect yourself first
Getting help
Ask bystanders
Which emergency services?
Recognise your limitations
Prioritising treatment
Most urgent thing first
Most urgent person first
Offer support and comfort
Minimising infection risks
Wash hands before and after giving help
Wear disposable gloves
Wear protective clothing if needed
Cover your own cuts with a plaster
Dispose of contaminated waste carefully
Use sterile, undamaged, in-date dressings
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8. AIMS OF FIRST AID
• Preserve life
• Prevent the casualty’s condition from becoming
worse
• Alleviate suffering
• Promote recovery
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9. PRIORITY OF CASUALTIES
• Save the conscious casualties before the
unconscious ones as they have a higher chance
of recovery.
• Save the young before the old.
• Do not jeopardize your own life while rendering
First Aid. In the event of immediate danger, get
out of site immediately.
• Remember: One of your aims is to preserve life,
and not endanger your own in the process of
rendering First Aid.
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10. PRINCIPLES OF FIRST AID
• The key guiding principles and purpose of first
aid is often given in the mnemonic “4 ps”
i. Preserving life
ii. Preventing deterioration or injury
iii. Promoting recovery
iv. Providing non-chemical pain relieve
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11. 1. Preserve life
The first principle of first aid is to preserve life.
Being the first respondent, the aim is to do the first based on
skills to save life.
If a trained medical person, he/she can do compression, clearing
the airway and rescue or restart breathing
2. Prevent deterioration or injury
The bystander is to make sure that the injured person is in a
comfortable position ( either seated or lying down) than before
and ensure patient is not in prone to further injury or
deterioration of the condition by applying the right first aid
technique.
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12. 3. Promote recovery
The first aider aim is to instill confidence in the
injured and his/her family. Help the injured person
to try and cope with the injury.
4. Provide non-chemical pain relieve
If you are skilled medical personnel, you may give
something to soothe the pain.
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13. Philosophy of First Aid
• In the pre-hospital setting, the key contributors
to survival and recovery from illness or injury are
prompt and effective maintenance of the body's
primary functions
1. Airway
2. Breathing
3. Circulation
4. Bleeding control
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14. • Airway: If someone's not breathing, clear their
airway.
• Breathing: If the airway is clear and they're still
not breathing, provide rescue breathing.
• Circulation: Perform chest compressions to keep
blood circulating, as well as rescue breathing. If
the person is breathing but unresponsive, check
their pulse. If their heart has stopped, provide
chest compressions.
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15. GOLDEN RULES OF FIRST AID
• Based on The Occupational Safety And Health
(First Aid At Work) Rules, 2021, the duties of the
first-Aiders shall be to:
i. Ensure prompt response in all medical
emergencies
ii. Provide appropriate First Aid management and
transfer of casualty when necessary
iii. Notify the Occupier and emergency services
provider of the medical emergency
iv. Provide psychological care and support during the
emergency and may accompany the casualty to
the health care facility or until medical help
arrives
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16. v. Ensure infection control measures are taken to protect self,
the casualties and others
vi. Keep records of all injuries, sudden illnesses and medical
emergencies including First aid treatment given in the form
prescribed in the first schedule
vii. Ensure proper medical waste disposal
viii. Ensure that the pre-requisite of the First –Aid box are
maintained in consultation with the occupier
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17. Content of First Aid Kit
• The red cross recommends that all first aid kits for a family of
four include the following
• DRESSING
2 absorbent compress dressing (5*9 inches)
25 adhesive bandages (assorted sizes)
1 adhesive cloth tape (10 yard* 1 inch)
sterile eye dressing
MEDICATIONS
2 hydrocortisone ointment packets
5 antibiotic ointments packets
5antiseptic wipe packets
2 packets of aspirin
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18. BANDAGES
2 roller bandage ( 3 inches and 4 inches )
5 sterile gauze pads (3*3 inches)
5 sterile gauze pads (4*4 inches)
2 triangular bandages
EQUIPMENTS
Tweezers to pull out stings
Scissors to cut dressing and bandages
Oral thermometer ( non mercury/ non-glass)
2 pair of non latex gloves ( size large)
Safety pin
OTHERS
1 blanket ( space blanket)
1 breathing barrier ( with one way valve
i instant cold compress
first aid instruction booklet
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19. Gloves Face shield
Plasters Wound dressings Eye pad
Finger dressing Burns dressing Triangular bandage Conforming bandage
Wipes
Safety pins Adhesive tape Foil blanket
Eye wash Scissors
First aid kits
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20. Common items found in a first
aid kit SUMMARY
Bandages, roller bandages, and tape
Sterile gauze
Antiseptic wipes and swabs
Absorbent compresses
Antibiotic cream
Burn ointment
Mask for breathing (rescue breathing/CPR)
Chemical cold pack
Eyeshield and eyewash
First aid reference guide that includes local phone
numbers
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23. What things should you consider
before treating anyone?
• What happened?
• Further danger?
• Can you cope?
• Number of casualties?
• Emergency services?
• Who needs help first?
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24. • The following are the major common
emergencies based on a study by Wachira B,
Smith W. Major incidents in Kenya 2013:
1. Poisoning
2. Transport incidences/ accidents
3. Fire incidences
4. Incidences from building collapses
5. Terrorists
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25. COMMON MEDICAL
EMERGENCIES
• To help you remember the main causes of unconsciousness in
a casualty, try to remember FISH SHAPED.
• F Fainting
• I Imbalance of heat
• S Shock
• H Head injury
• S Stroke
• H Heart attack
• A Asphyxia (choking)
• P Poisoning
• E Epilepsy
• D Diabetes
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26. Responses in casualties:
• To correctly ascertain the level of consciousness in a casualty,
you can use the AVPU scale:
• A Alert
• The casualty is fully alert
• The casualty is awake and fully aware of their surroundings
(they will usually know the answer to general questions like
the date, their name, where they are, etc.)
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27. • V Voice
• Confused
The casualty may not be fully aware of their surroundings, but
will ask and answer questions.
• Inappropriate words
This refers to casualties who are conscious, but may not be able
to string a coherent sentence together. Words may be in the
wrong place or missing altogether from responses.
• Making sounds
The casualty is not able to respond verbally, but may make
grunts or moans in response to painful stimuli.
• No sounds
In this case the casualty will make no vocal sounds.
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28. • P Pain
Locating pain
• The casualty will be able to locate painful stimuli, and tell you
where it is being applied (pinch on the underside of the arm,
pressing firmly on a finger nail, etc.).
Pain response (but not able to locate the pain)
• The casualty will respond to painful stimuli, but not be able to
locate where the pain is.
• U Unresponsive
• The casualty is not able to respond to pain or vocal stimuli. They
will remain unresponsive.
• You can perform primary and secondary surveys of the casualty,
which will help you to decide in which order to treat the
casualty, the most urgent first. You can then go on to assess the
casualty further, which may help with diagnosis and treatment.
The more information you can give the ambulance crew the
better
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29. PERFORMING SURVEYS
• There are two types of surveys we need to do before
attending to a casualty.
• Primary survey:
AND
• Secondary survey:
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30. Primary survey (DRAB):
Before opening the airway,
D-REMOVE/CHECK FOR DANGER and check the R- RESPONSE of
the patient by calling them, shaking them gently or tapping their
collarbone
A AIRWAY: Open the casualty’s airway by lifting their chin and
tilting their head back so that the front of the throat is extended.
B. BREATHING : Look, listen and feel for two breaths in a
maximum of ten seconds. You can do this by placing the back of
your hand near their nose and mouth. You are looking for about
two breaths every ten seconds. If the casualty is breathing, then
their heart is working, which means blood is being circulated
around their body. If DRAB is Okey move to secondary survey if
not start place pt in recovery, call for help and start CPR as will be
covered later.
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31. Secondary survey (Breathing → Bleeding → Bones and Burns):
• Once you are satisfied that the casualty is breathing normally,
the second thing to do is make sure to treat any bleeding.
• This is to stem any blood loss and to ensure there is a steady
supply of oxygenated blood to the casualty’s vital organs.
• If there is no bleeding, or you have dealt with any cuts, the
next priority is broken bones
• If a casualty is unconscious, but breathing, you must protect
the airway. Place the casualty in the recovery position
immediately. The secondary survey needs to be done quickly
in the following order of importance:
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32. Cont’
• Bleeding
Check the casualty from head to toe for bleeding.
Make sure to check any covered areas, such as the back.
Stop or control any bleeding you find
Head and neck
Check for any signs of bruising, swelling or bleeding,
particularly from the ears.
Make sure to examine the whole of the head and face.
Feel the back of the neck, as this is a hidden area.
Try to ascertain if the casualty has been in an accident that is
likely to damage the neck
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33. Cont’
• Shoulders and chest
Check both shoulders by placing your hands on them to see if
there are any irregularities.
Run your fingers across the collarbones to check for any
damage.
Run your hands over the ribcage, squeezing and rocking
gently, to make sure there are no breaks, as a broken rib could
easily puncture a lung.
• Abdomen and pelvis
Press the abdomen gently with the palm of your hand to see if
there are any irregularities or pain response.
Gently put pressure on the pelvis to check for any fractures.
Check if the casualty is bleeding or is incontinent
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34. Cont’
• Legs and arms
Run your hands down the legs gently, checking for any fractures or
breaks.
Repeat the action with the arms.
Check the casualty for any clues to their condition (medic alert
jewellery, needle marks, smell of alcohol, etc.).
• Check the pockets
Check there is nothing in the pockets that will injure the casualty
further when you roll them into the recovery position.
Try to have a witness present if you need to remove any items from
the casualty who can vouch for you.
Be wary, there may be sharp objects in the casualty’s pockets such as
needles or a knife.
Be sure to loosen any restrictive clothing, such as ties and belts.
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35. cont’
• Recovery
Gently place the casualty in the recovery position (see
upcoming slides).
If you have any suspicion that the casualty may have an
injured neck, try to get someone to hold the head in line with
the body while you turn the casualty to lessen the risk of further
damage.
Be careful not to cause further injury to the casualty or
exacerbate suspected injuries.
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36. Mechanics of injury
• Before attempting to move a casualty, it is important to
think about the ‘mechanics of injury’.
• This is the process of figuring out what has happened,
and what injuries are likely to have been sustained by the
casualty.
• If you suspect there is a neck injury involved, you must
try to get someone to help you by keeping the casualty’s
head in line with their body at all times, even when the
casualty is lying still. Any movement can cause serious,
irreparable damage
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37. The recovery position (RP)
• When an unconscious casualty is lying on their back, their
breathing can be hampered by them ‘swallowing their tongue’
(the tongue slides back in their throat, cutting off the airway).
Or, the person can vomit while unconscious, and are not able
to reflexively heave or expel the vomit, which can suffocate
them.
• By placing the casualty on their side (the recovery position),
this ensures the airway is clear by stopping the tongue sliding
back in the throat and allowing vomit to drain from the
mouth.
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38. Steps for placing pt into RP
• Step 1
Remove any dangers from the casualty (remove glasses, check
pockets for anything that will cause further injury) and straighten the
legs.
Preferably move the left arm out, with their elbow bent and palm
face up.
• Step 2
Now bring the far side leg into a bent position, with the foot on the
floor, tuck their foot under the near side leg to keep it up.
• Step 3
Bring the far side arm across the chest, with the back of the hand
against the casualty’s cheek, and hold it there.
Now using the bent knee as leverage and holding the back of the
hand against the cheek, pull the knee towards you, rolling the casualty
onto their side. Make sure their knee is touching the ground so that
they don’t roll back.
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39. CONT’
• Step 4
Make sure that the upper leg is bent at both the hip and the
knee, as though the casualty is in a ‘running’ position. Keep their
hand under their cheek and tilt their head back to clear the
airway.
Check the casualty’s back for any hidden injuries, and if you
have anything to hand, cover them for warmth and their dignity.
Call 999 or your emergency contact or nearest hosp and
request an ambulance.
Monitor the casualty’s breathing every 30 seconds while
awaiting the ambulance.
If the casualty stops breathing, return them to their backs and
commence CPR.
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40. Cont’
• Things not to do:
Never put anything into an unconscious casualty’s mouth.
Never move a casualty without performing the checks
mentioned first.
Never place anything under the head of a casualty who is on
their back. This could obstruct the airway.
Never unnecessarily move a casualty as this could cause
further injury
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42. HEAD INJURIES
• Treat any suspected head injury with the utmost caution, as
they have the potential to be very serious. Head injuries often
lead to unconsciousness and all the attendant problems. Also,
head injuries can cause permanent damage to the brain
• The three main areas of concern with head injuries are
concussion, compression and a fractured skull
• .
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43. CONT’
CONCUSSION
• Concussion occurs when the brain is violently shaken. Our brains are
• cushioned within our skulls by ‘cerebro-spinal fluid’ (CSF), so any
blow to the head can cause the brain to bang against the skull which
disrupts its usual functions.
• A casualty may pass out briefly (no more than 2-3 minutes), and
when they come round their level of response should return to
normal.
• Concussion casualties should return to normal if no complications
arise.
• However, a concussed casualty should not be left on their own and
should ideally be monitored for 24 hours. No sporting activity should
be undertaken for at least three weeks after a concussion
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44. COMPRESSION
• Compression injuries are very serious, as the brain is under
extreme pressure which is caused by bleeding or swelling in
the cranial cavity. Compression can arise from a skull fracture
or head injury, but can also be brought on by illness (type of
stroke, brain tumor, meningitis, etc.).
FRACTURED SKULL
• Fractures to the skull are very serious as the broken bone of
the skull can cause direct damage to the brain which can cause
bleeding and therefore compression.
• Treat any casualty who has had a head injury, and whose
response level is low, as having a fractured skull
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45. • POSSIBLE SIGNS AND SYMPTOMS OF HEAD INJURY
• SEE table below
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46. Concussion Compression Fractured skull
Casualty is unconscious for
short
period, after which response
levels are
back to normal, recovery is
usually quick.
Possible history of
recent head trauma
with recovery,
followed by
deterioration.
Casualty may suffer from
concussion
or compression also, so
symptoms of
these may be present
Short term memory loss,
groggy,
confused irritable.
Response level
deteriorates as the
condition develops.
Bleeding, swelling or
bruising of the
head.
Mild headache Severe headache Soft, egg shell feeling of the
scalp.
Rapid, weak pulse. Slow, strong pulse
caused by raised
blood pressure.
Blood or fluid coming from
an ear or
the nose.
Pupils are normal and react
to light.
One or both pupils
may dilate as
pressure on the brain
increases.
Deformity or lack of
symmetry of the
head.
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47. Treatment of head injuries
Keep in mind that a casualty with any head injury may well be
suffering from neck and spine injuries also. Treat the casualty
with the utmost care, and call for an ambulance immediately.
If the casualty is or has been unconscious, you suspect a
fractured skull, or their responses deteriorate CALL AN
AMBULANCE IMMEDIATELY.
Keep their airway clear and monitor their breathing.
If the casualty is unconscious, and you don’t wish to move
them as you suspect a neck injury, you can use the jaw thrust
method of keeping the airway clear
If you are unable to use the jaw thrust method, and you
cannot keep the airway clear, put the casualty in the recovery
position but make sure the head, neck and body are in line as
you turn them to avoid any further damage to a neck or spinal
injury.
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48. If the casualty is conscious, you can help them lie down, making
sure to keep the head and neck in line with the body.
You can help stop any movement of their head by placing your
hands on either side of the head and keeping it still.
If there is bleeding, help to control it by applying pressure
directly to or around the wound. However, if there is blood or
fluid coming from an ear, do not try to stop the flow, as the fluid
must be allowed to drain.
If there are any other injuries on the casualty, attempt to treat
these.
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49. • Some tips for treating head injuries:
Monitor the casualty’s breathing, pulse and response levels. If the
casualty appears to recover, monitor them closely as they may well
deteriorate and their response levels drop.
If a casualty has been concussed, try to make sure they are not
left alone for the next 24 hours. Advise them to seek medical help
as soon as possible.
If a casualty suffers any of the following in the few days after
concussion, they should go to A&E immediately: worsening
headache, nausea or vomiting, drowsiness, weakness in a limb,
problems speaking, dizzy spells, blood or fluid from an ear or the
nose, problems seeing, seizures or confusion.
If the concussion is received playing sports, do not allow the
concussed player to continue until they have seen a doctor. Usually,
concussed players are not allowed to participate for up to three
weeks after being concussed.
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50. STROKE
• DEF;
• There are two types of stroke:
1. A blood clot blocks a blood vessel that supplies part of the
brain. This is the most common.
2. A ruptured blood vessel in the brain. The build-up of blood
‘squashes’ an area of the brain.
With either type of stroke the signs are similar, with the result
that a part of the brain dies. There is no age definition of a
stroke casualty; anyone of any age can have a stroke.
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51. Signs and symptoms of a
stroke:
A stroke must be treated immediately. If you suspect a stroke,
carry out the following FAST test:
• F Facial weakness.- Can the casualty smile? Has their mouth or
eye drooped?
• A Arm weakness-Can the casualty raise both arms?
• S Speech problems- Can the casualty speak clearly? Do they
have problems understanding
• you?
• T Time to call Emergency number- If the casualty fails any of
these tests, call immediately as a stroke is a medical
emergency.
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52. S & S CONT’
• There may be other signs to look for, but the FAST check is the
quickest and may save time. However, please note the
following may occur:
One side of the face or body becomes suddenly numb.
Loss of balance.
Lack of co-ordination.
Suddenly developing a severe headache.
Sudden confusion.
Problems seeing with one or both eyes.
Pupil size becomes unequal
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53. Treatment of stroke
Clear the airway and maintain breathing.
DIAL emergency number FOR AN AMBULANCE IMMEDIATELY.
If the casualty is unconscious, place in the recovery position.
If conscious, lay the casualty down with their head and
shoulders raised.
Be sure to talk to and reassure the casualty. Just because they
may not be able to speak, they still may be able to understand
and react to you.
Monitor their breathing, pulse and response levels. Keep a
record if possible for when the ambulance arrives.
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54. HEART ATTACK OR CHEST
PAIN
• A heart attack occurs when there is loss of blood
supply to the heart. This happens when an artery
supplying blood to the heart muscle is blocked by a
blood clot
• SYMPTOMS:
Pain and discomfort in the chest area
Shortness of breath
Stomach discomfort
Fainting
Sweating
Pain in the neck, jaws or shoulders
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55. • The symptoms of heart attack are different in men and
women.
• Men have cold sweats and pain may be felt descending
through the left arm
• Women are more likely to have shortness of breath, stomach
upset, dizziness and tiredness
• Treatment within the first 90minutes of a heart attack
dramatically increases the chances of survival.
• Before the person reaches a hospital an aspirin tablet can
lower the risk of clot formation
• Seat the patient in comfortable position. If breathing is not
normal or the patent is unresponsive, hands –on CPR may be
applied, to double the chance of survival.
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56. HYPERVENTILATION
Hyperventilation, also known as excessive breathing,
causes a reduction of carbon dioxide concentration (below
normal) of the blood
SYMPTOMS:
Unnaturally fast, deep breathing
Attention-seeking behaviors
Dizziness, faintness, trembling, or marked tingling in
hands, feet and lips
Headache
Chest pain
Slurred speech
Cramps in the hands and feet.
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57. CAUSES:
Stress or anxiety
Consequence of lung diseases, head injuries or stroke
TREATMENT:
When speaking to casualty, be firm but kind
If possible, lead the casualty to a quiet place where he
may be better able to regain control of his breathing
Let him re-breathe his own exhaled air from a paper bag.
(Paper bag is preferred over plastic bag as plastic bag
may cause the casualty to suffocate)
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58. FAINTING
Fainting is a brief loss of consciousness that is
caused by a temporary reduction of blood flow to
the brain.
SYMPTOMS:
A brief loss of consciousness causing the casualty to fall to the
floor
A slow pulse
Pale, cold skin and sweating
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59. CAUSES:
Taking in too little food and fluids (dehydration)
Low blood pressure
Lack of sleep
Over exhaustion
TREATMENT:
Lay casualty down, and slightly elevate legs
Make sure she has plenty of fresh air
As she recovers, reassure her and help her sit up gradually
Look for and treat any injury that has been sustained through
falling
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60. Shock
• Shock occurs when the circulatory system
fails, and insufficient oxygen reaches the
tissues. If the condition is not treated
quickly, vital organs can fail, ultimately
causing death. Shock is made worse by
fear and pain.
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61. SYMPTOMS:
Clammy skin (cool, pale and damp)
Restlessness and nervousness
Thirst
Loss of blood
Confusion
Fast breathing
Nausea or vomiting
Blotched or bluish skin (especially around the mouth
and lips)
Often perspires freely
May pass out.
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62. CAUSES:
Shock can be divided into 4 types:
a) Hypovolemic shock – caused by the loss of blood
volume (such as through bleeding) or profound
dehydration
b) Cardiogenic shock – a result of a weakened heart
that is unable to pump blood as efficiently as it
once did. Commonly occurs after a massive heart
attack
c) Distributive shock – a result of the lack of
distribution of blood to the organs
d) Obstructive shock – results from an obstruction to
blood flow at a site other than the heart
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63. TREATMENT:
• “P.E.L.C.R.N.” (Pronounced Pell-Crin)
Position the casualty on their back
Elevate the Legs
Loosen clothing at neck waist or wherever it is
binding
Climatize (prevent too hot or too cold)
Reassure (keep the casualty calm)
Notify medical personnel (Help, Get a medic!!)
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64. BEE/HORNET STING
SYMPTOMS:
Pain, redness and swelling in injured area
TREATMENT:
Remove stinger as fast as possible with tweezers if
impossible apply pressure around the sting to force
it out
Wash thoroughly with soap and water and apply
antihistamine ointment or lotion to relieve itching
Avoid scratching the area
Reduce pain and swelling with cold compress
WRITE NOTES ON MANAGEMENT OF BITES
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65. CRAMPS
• Cramps are painful sensations caused by
contraction or over shortening, usually of
muscles.
CAUSES:
Cold or overexertion
TREATMENT:
Stretch the muscle and apply heat or cold
(preferably heat)
Cramps from lack of salt and water: Stretch the
muscle, drink water and increase salt intake
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66. CHOKING
• Choking is the mechanical obstruction of the
flow of air from the environment into the lungs.
• when an object blocks the windpipe, causing a
person to be severely short of breathe
CAUSES:
Introduction of foreign object into airway, which
becomes stuck
Respiratory diseases
Compression of airway (e.g. Strangling)
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67. SYMPTOMS:
Unable to speak or cry out
Face turns blue from lack of oxygen
Victim grabbing at his/her throat
Weak coughing, labored breathing produces high-pitched
noise
Unconsciousness
TREATMENT:
Encourage victim to cough
Back slaps: Use of hard blows with heel of the hand on the
upper back of the victim
Abdominal thrusts: Standing behind the victim and using
hands to exert pressure on bottom of the diaphragm (May
result in injuries like bruises or fracture of ribs)
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68. • The Heimlich maneuver is a series of abdominal thrusts that
can help dislodge whatever someone may be choking on. It
should only be done if someone is truly choking.
• Before doing anything, simply ask the person if they are
choking. If someone is coughing or talking, they aren't
choking. If they are unresponsive or exhibit any of the above
signs, proceed with the Heimlich.
•
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69. Treatment of an adult or child
over 1 year:
• Ask the casualty if they are choking firstly to establish this is
the case. If they are not doing so already, ask them to cough
as this will usually dislodge minor obstructions. However, if
this doesn’t work, follow the steps below:
1 – Back slaps
If there is no help around, shout for help. Do not leave the
casualty alone.
Bend the casualty forward at the waist so their head is lower
than the chest. If the casualty is a young child, you can place
them over the knee to help with this.
Find the hollow spot between the shoulder blades and
administer five firm slaps with your open hand. Make sure to
check between blows if the obstruction has dislodged.
If this does not work, go to step 2.
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70. 2 – Abdominal thrusts (Heimlich Manoeuvre)
Stand (or kneel if it is a child) behind the casualty and place both
your arms around their waist.
Make a fist and place it just below the casualty’s ribs with your
thumb facing inwards (as if you’re looking at a watch).
Grab your fist with your other hand. Pull the clenched fist sharply
backward and upward under the rib cage in 5 quick thrusts. Repeat
until the object is coughed up.
If this does not work, repeat step 1 and follow with step 2 until the
obstruction
is dislodged.
If the back slaps and abdominal thrusts do not appear to be working,
shout for help and call emergency number for an ambulance, but do
not stop administering the treatment
NB: For someone who's obese or pregnant, perform thrusts around
the chest instead of the abdomen
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71. Choking adult or child
Cough! 5 Back Blows 5 Abdominal Thrusts
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72. If someone is unconscious:
Place them on their back and kneel over them.
Place the heel of your hand slightly above the
navel.
Place your other hand on top of it.
Give quick upward thrusts to dislodge the
obstruction.
• Note: Methods are different for babies.
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73. Choking in a baby under 1 year
• The baby may attempt to cough on their own. If the choking is
not serious, this will clear the obstruction. The baby may cry
which indicates they are now breathing properly.
• If the obstruction is not cleared by coughing, follow the steps
below:
1 – Back slaps
Shout for help immediately, but do not leave the baby alone.
Lay the baby over your arm facing downwards with their legs
either side of your elbow with their head below their chest.
Administer up to five slaps firmly between the shoulder blades
with the palms of your fingers, not your open hand.
Check between each slap if the obstruction has dislodged.
If this does not work go to step 2.
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74. 2 – Chest thrusts
Turn the baby over, so they are laying chest up on your other
arm, keep their head below their chest.
Using two fingers on the baby’s chest give up to 5 chest
thrusts. This is a similar maneuver to chest compressions in CPR,
but sharper and administered at a slower rate.
Check between each thrust if the obstruction has dislodged.
If this does not work, repeat step 1 and follow with step 2 until
the obstruction is dislodged.
• Never administer abdominal thrusts on a baby.
If the obstruction has still not dislodged repeat steps 1 and 2.
If the casualty becomes unconscious make sure they are laying
on the ground (or on a flat firm surface for a baby) and
commence CPR. Make sure there is an ambulance on the way.
Continue CPR until help arrives or you become fatigued
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75. Choking baby
5 Back Blows 5 Chest Thrusts
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79. Child and baby CPR
The following minor modifications to the adult sequence will, however,
make it even more suitable for use in children:
If you are on your own, perform resuscitation
for about 1 minute before going for help
Give five initial rescue breaths before
starting chest compressions
For a baby
under 1 year,
use two fingers
(4cm)
For a child over 1 year,
use one or two hands
to achieve an adequate depth
(5cm)
Compress the chest by at least one-third of its depth:
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80. CPR with child modifications
1/3 depth of chest
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81. NOSEBLEED
First aid for nosebleed includes:
Lean slightly forward, not back.
Pinch the nose just below the bridge, high
enough that the nostrils aren't pinched closed.
Check after five minutes to see if bleeding has
stopped. If not, continue pinching and check
after another 10 minutes.
You can also apply a cold pack to the bridge of
the nose while pinching
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82. ASTHMA
• See RESP notes
• Add how to help patient use an inhaler- see pdf doc
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84. EYE TRAUMA
• Foreign bodies may enter the eye, causing the
eyelids and the eyeballs comfort.
• TREATMENT
• prevent the person from rubbing the eye and set
them facing the light, standing in front of them
• pull down the lower eyelid and if the foreign
body is seen remove it with the corner of a clean
handkerchief, preferably white, twirled up and
moistened with water
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85. • if the body is embedded, do not attempt to
remove it, but instruct patent to close their eyes.
apply soft pad of cotton wool and secure t with a
bandage.
• if the foreign body is not found and is suspected
to be under the upper eyelid, instruct the patient
to blink under water
• if some liquid irritant goes into the eye, instruct
the patient to blink the eye under water or flush
the eye with a lot of water. apply soft cotton pad
over the eye and keep it in position with a shade
of bandage applied lightly until help arrives
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86. BURNS
The effects of burns are reddening of the skin or
blister formation or destruction of the skin or of
the deeper tissues.
The areas of most burns and scalds including the
clothing are sterile for a short period and effort
should be made to keep them so until medical aid
is possible
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87. TYPES OF BURNS
a) Dry burn - Caused by flame, contact with
hot objects, friction etc.
b) Scalds -Contact with steam and hot fluids
c) Electrical burn -Low-voltage current,
lightning strike
d) old injury - Contact with freezing metals,
dry ice, freezing vapors e.g. liquid oxygen
and liquid nitrogen
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88. e) Chemical burn
Industrial chemicals, including inhaled fumes and
corrosive gases.
Household chemicals, including paint remover,
strong acid and alkali, bleach, weed killers etc.
f) Radiation burn
Sunburn over-exposure to ultra-violet (UV) lamp
and exposure to radioactive source.
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89. DEGREE OF BURN
a) First degree burn: This involves only the outermost layer of
skin and is characterized by redness, swelling and
tenderness.
b) Second degree burn: Any 1% burn affecting layers of the
epidermis, giving rise to rawness, blisters and the presence
of a clear fluid. Can be fatal if it affects over 60% of the
body.
c) Third degree burn: All the layers of the skin are burned and
there maybe be some damage to the nerves, fat tissue and
muscles. Skin may look waxy, pale or charred. Purple fluid is
observed and no pain is felt by casualty. Urgent medical
attention is required.
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90. MINOR BURNS (FIRST
DEGREE BURNS)
TREATMENT:
Rinse the injured part with cold water for at least
10 minutes to stop burning and relieve pain
Gently remove any jewelry, watches, belts or
constricting clothing from injured area before it
begins to swell
Cover area with sterile dressing, or any clean, non-
fluffy material and bandage loosely in place.
NOTE: Cold burns should not be rinsed with cold
water and cold water should never be applied to
anyone with extensive burns
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91. SEVERE BURNS (SECOND
AND THIRD DEGREE BURNS)
TREATMENT:
Lay the casualty down and protect the burnt
area from contact with the ground if possible
Rinse burn with plenty of cold water for at least
10 minutes or use burn-cooling gel
Arrange for casualty to be sent to the hospital
While cooling the burn, watch for signs of
difficulty in breathing and be ready to resuscitate
if necessary
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92. SEVERE BURNS (SECOND
AND THIRD DEGREE BURNS)
Remove any rings, watches, belts, shoes or
burning clothing from injured area before it
begins to swell
Remove burnt clothing, unless it is sticking to
the burn
Cover dressing with sterile dressing or some
other suitable material to prevent infection and
germs (this is not necessary if burn is on face)
Do NOT burst any blisters, touch infected area or
apply any lotions to the injury as this will retain
heat within the burn.
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93. ELECTROCUTION
• Caused by touching a live and naked wire,
cable or rail a shock may be relatively mild
or very severe. Burning is a result, and the
burn may be severe or deep especially
with higher voltage
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94. Break contact of electric source with casualty by
switching off the current and if it cannot put off,
cut off supply by removing the plug, breaking the
cable or wrenching free. Never attempt to cut a
cable with knife or scissors
If unable to reach cable, stand on insulating
material e.g. plastic mat, wooden box and push
casualty’s limbs away from source with a broom or
stick
Remove the casualty from contact with the
current with the greatest care, using dry insulating
materials. With domestic apparatus, gloves are
good, a folded garment or newspaper gives fair
protect
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95. Do not touch the person until the power supply is turned
off
Be careful in areas that are wet
Reassure the person and family
Lay the person down on the back with the head low and
turned to one side unless there is injury to the head,
abdomen or chest when head and shoulder should be
slightly raised and supported
Loosen clothing around the neck, chest and waist
Wrap them in a blanket or rug to keep them warm
Give sips of water, coffee or any other liquid except
alcohol
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96. Burn by corrosive chemical
ACIDIC CHEMICAL
• Thoroughly flood the area with water
• Bathe the part freely with an alkaline solution
made from 2 teaspoons of baking soda or
washing soda in one pint of warm water
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97. GENERAL RULES FOR
TREATMENT OF BURNS
DO not apply lotion of any kind
Immobilize the area by suitable means
Do not remove burned clothing and do not break the blisters
Avoid handling the affected area more than necessary. See
that your hands are clean as possible by washing them
Bandage firmly, except when blisters are present or suspected
in which case, bandage lightly
Treat shock . In case of major burns move the patient to the
hospital ASAP. The patient will probably require an anesthetic,
so don not give any oral meds
Cover the area ( including burned clothing) with a dry sterile
dressing if possible or similar material such as clean lint,
freshly laundered linen.
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98. FRACTURES
A fracture is a break or crack in the continuity of
the bone.
SYMPTOMS:
Pain at or near fractured site
Tenderness on gentle pressure
Swelling over the fracture site
Deformity e.g. irregularity of bone, angulation or
rotation of limb, depression of bone etc.
Loss of power
Signs and symptoms of shock
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99. DISLOCATIONS
A dislocation is the displacement of one or more
bones at a joint. It usually occurs in the shoulders,
elbow, thumb, fingers and the lower jaw.
SYMPTOMS:
Pain at the site of injury
Limited movement at joint
Deformity
Swelling
Tenderness
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100. FRACTURES AND
DISLOCATIONS
TREATMENT:
Treat the fracture on the spot if you have been trained
to do so. If untrained, ensure person is safe call for
help and apply first aid.
Do not move the patient till the injured part has
been immobilized unless life is in immediate danger
from other causes. If, however, circumstances are
such that final immobilization cannot be completed
on the spot, carry temporary fix to enable the
patient to be moved for a short distance to more
suitable and safe surroundings
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101. Hemorrhage and severe wounds must be dealt with
before continuing with the treatment of fractures, with
due regard to requirements of both types of injuries
Steady and support the injured parts at once, so that
movement s immobile. This prevents further injury and
increase in the bleeding which always takes place at the
site of fracture. It also prevents broken bone ends from
piercing or damaging the skin, blood vessels, nerves, or
muscles.
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102. Immobilize the fracture with bandages or splints
Using patient’s body as support, application of bandages
may be adequate. Additional support of splints may be
required when there is possibility of long or difficult transport
before medical aid is possible. Splint are required when both
lower limbs are fractured
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103. summary
Support and immobilize the injured limb
Use a splint (if possible) in order to prevent movement of
the injured part
Arrange for casualty to be removed to hospital
In doubtful cases, always treat as for a fracture
Do not attempt to replace the bones
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104. Fractures of the upper limbs
Close to the shoulders
Near the middle shaft
Close to or involving the elbow joint
Fracture of the forearm
Shortening is unlikely to be observed unless both bones are
broken
Fractures of the hands and fingers
Fracture of the bones of the hand may be accompanied by
severe bleeding into the palm
Fractures of lower end of the radius
This “ colles fracture” is very common due to falls on
outstretched hand. May be mistaken for a sprain wrist or
deformity
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105. Treatment of all fractures of
the upper limbs
• Do not remove the patients jacket if any
• Bend the elbow and lay the injured limb against
the chest with the finger just touching the
opposite shoulder
• Apply adequate padding between the limb and
chest
• Fix the hand in position with collar and cuff sling,
taking care that there is no constriction at the
wrist
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106. • Secure the limb firmly to the chest by 2 broad
bandages
• The first with its upper border level with top of
the shoulder
• The second with its lower border level with the
tip of the elbow
• Tie off both bandage on the opposite side of
the body
• Feel the pulse on the injured side to ensure
there is no interference with the circulation of
the limb
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107. STRAINS
• A strain is an injury to a muscle in which the
Muscle fibers tear as a result of overstretching.
(Sprain – to a ligament
• SYMPTOMS:
Localized pain
Stiffness
Inflammation
Bruising
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108. SPRAINS
• SYMPTOMS:
Pain at site of injury
Swelling and later bruising
Pain on movement
Loss of function
TREATMENT:
Support the joint in most comfortable position
P.R.I.C.E. (Protect, Rest, Ice, Compression, Elevation)
treatment
When a sprained ankle occurs outdoors, do not remove the
shoe
If unsure whether there is a fracture, always assume it is one
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109. MAJOR CUTS
• Major cuts, or wounds can be classified as
• Incised wounds- caused by a sharp instrument like, razor
scissor
• Lacerated wounds- which have torn and irregular edges,
caused by machinery, animal claws, etc.
• Contused wounds- accompanied by bruising of the
tissues caused by direct blow or by crushing
• Puncture wounds- which have comparatively small
opening, but may be very deep, caused by a stab from
any sharp-pointed instrument like a needle, knife or
bayonet
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110. MANAGEMENT OF WOUNDS
Place patient in a suitable position, elevate the
bleeding part, unless it is a fractured limb
Do not disturb any blood clots formed
Removing as little clothing as possible expose
the wound
Remove any foreign bodies which are visible and
can be easily picked out or wiped off with a clean
dressing but do not remove objects that have
gone into the muscles.
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111. Remember, that if there is a foreign boy in the wound which
cannot b removed easily, cover it with a dressing and build up
sufficient pads around the wound without applying pressure
to the foreign body
Apply and maintain both direct and indirect pressure, don’t
remove any pack that you have applied on the bleeding site
even if it is soaked, instead add more packs- this will help the
doctor to estimate amount of bleeding
Apply clean dressing and bandage
If there is no foreign body in the wound, but the cut is deep,
ensure that you use enough padding into the wound’s depth,
and ensure pads project well above the level of the skin to
ensure adequate pressure on the torn ends of the blood
vessels
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112. BANDAGING
Arm sling
Elevated Arm sling
Bandaging the dome of the skull
Palm/Back of hand
Knee
Ankle/Foot
Ring Pad
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113. In the use of bandages
• Never apply a bandage over the site of a fracture. They must
be applied sufficiently firmly to prevent harmful movements,
but not so tight as to prevent the circulation of blood
• In case of a fractured limb, further swelling may occur, causing
the bandage to become too tight. Should this occur, loosen
them at once to allow normal circulation to return.
• Padding must be applied always between the knees and
ankles if these are tied together
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114. procedure for wound dressing,
bandaging and arm-sling
application
REFER TO NMP
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115. TRANSPORTATION OF
CASUALTY
With stretcher:
Keep the stretcher level to the ground
Carry the casualty with his feet facing the direction of move
Bring the stretcher to the casualty and not the casualty to the
stretcher
• Types of stretcher:
a) Wooden stretcher
b) Collapsible stretcher with telescopic handle
c) Improvised stretcher
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117. EMERGENCY METHODS OF
MOVING CASUALTIES
One Man Human Crutch
• Conscious
• Able to walk with some assistance
Pick-a-back
• Conscious
• Light weight
• Able to hold on using arms
Cradle method
• Light weight
• A child
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118. Fore Method
When pick-a-back or fireman’s life method cannot be
used to carry a heavy casualty down the staircase
Fireman’s Lift
Conscious b
Unconscious
Light-weight
Double Human Crutch
Conscious
Able to walk with some assistance
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119. Two-handed Seat
• Unable to walk with assistance
• Able to use his arms to support
Three-handed Seat
• Unable to walk with assistance
• Usually with injury on one leg
• Able to use his arms to support
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120. Four-handed Seat
• Unable to walk with assistance
• Able to use his arms to support
Fore and foot Method
• Unconscious
• Sustained abdominal injury
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