first Aid Basics

1. Principles of First Aid
Dr Ayush Srivastava

2. • Definition:
• First aid is the immediate care given to an injured or suddenly ill person outside a
medical setup.
• Aims of First Aid:
• To preserve life,
• To prevent the worsening of one’s medical condition
• To promote recovery
• To ensure safe transportation to the nearest healthcare facility.
Principles of First Aid

3. Case Scenarion
• You were out for a walk
when you see an accident of
a two-wheeler with a Car.
The two-wheel driver is
badly injured and is lying in
the middle of the road.
How do you approach the case?

4. How to approach an emergency:
• Assess the surrounding areas.
• Move to a safe surrounding (if not already; for example, road accidents are unsafe to be
dealt with on roads).
• Call for help (both professional medical help and people nearby who might help in first aid
such as giving compression during CPR).
• Perform suitable first aid depending on the injury suffered by the casualty.
• Evaluate the casualty for any fatal signs or danger, or possibility of performing the first aid
again.

5. Case continued…
• You have secured the area, and
called for help, an Ambulance is
on its way to the site. What do
you do next?

6. • To preserve Life:
• Catastrophic bleeding (massive external bleeding)
• Airway (clearing airways)
• Breathing (ensuring respiration)
• Circulation (internal bleeding)
• Disability (neurological condition)
• Exposure (overall examination, environment)
Principles of First Aid

7. • To preserve Life:
• Catastrophic bleeding (massive external bleeding)
• Airway (clearing airways)
• Breathing (ensuring respiration)
• Circulation (internal bleeding)
• Disability (neurological condition)
• Exposure (overall examination, environment)
Principles of First Aid

8. Why the ABCDE approach?
• Approach every patient in a systematic way
• Recognize life-threatening conditions early
• DO most critical interventions first - fix problems before moving on
• The ABCDE approach is very quick in a stable patient

9. ABCDE Approach: Elements
• Breathing:
• Ensure adequate Oxygenation and Ventilation.
• Airway:
• Check for obstruction
• Maintain Patency
• If trauma is suspected-immobilize cervical spine.
• Circulation:
• Determine if there is adequate perfusion
• Restore Perfusion, Control bleeding if present

10. ABCDE Approach: Elements
• Disability: AVPU/GCS, pupils and glucose
• Assess and protect brain and spinal functions
• Exposure and keep warm
• Is to identify
• Avoid hypothermia

11. • You were travelling back to your hometown in a train. You are talking
to an elderly gentleman sitting right in front of you. You suddenly
notice a change in his voice, followed by change in his facial
expression. A few seconds later the patient collapses on his seat.

12. • You were travelling back to your hometown in a train. You are talking
to an elderly gentleman sitting right in front of you. You suddenly
notice a change in his voice, followed by change in his facial
expression. A few seconds later the patient collapses on his seat.

13. Airway Assessment
Can the patient
talk normally
No
Yes
Yes No
The Airway is patent,
continue with
breathing
Are there any added
sounds
• Snoring, gurgling or stridor may indicate an
obstructed airway
• Look for secretions/vomitus, blood, foreign
bodies, swelling or edema
• Absence of sound- complete airway
obstruction or apnea
• Check for paradoxical see-saw movement.
• Feel for air movement across nares and mouth

14. Airway Assessment

15. Airway Management
• If the patient is unconscious and not breathing normally:
• If no concern for trauma: open airway using HEAD-
TILT/CHIN-LIFT manoeuvre
• If trauma suspected: maintain c-spine immobilization and
use JAW-THRUST manoeuvre
• If secretions are present:
• SUCTION airway or wipe clean
• Consider RECOVERY POSITION if the rest of the ABCDE is
normal and no trauma
• Allow patient to stay in position of comfort
Adult jaw thrust

16. Airway Assessment

17. Breathing: Assessment
• Look, listen and feel to see if the patient is breathing
• Assess if the breathing is very fast, very slow or very shallow
• Check oxygen saturation
• Look for increased work of breathing
• Accessory muscle work
• Chest indrawing
• Nasal flaring
• Abnormal chest wall movement

18. Breathing: Assessment
• Listen for abnormal breath sounds
• Listen to see if breath sounds are equal
• Check for the absence of breath sounds on one side
• If dull sound with percussion to the same side
• THINK large pleural effusion or haemothroax
• If also hypotension, distended neck veins or tracheal shift
• THINK tension pneumothorax

19. Breathing

20. Breathing

21. Circulation: Assessment
• Look, listen and feel for signs of poor perfusion
• Cool, moist extremities
• Delayed capillary refill
• Diaphoresis
• Low blood pressure
• Tachypnoea
• Tachycardia
• Absent pulses

22. • Hemorrhage Control:
Circulation: Assessment

23. • Hemorrhage Control:
• Components of Bleeding Control
• DirectPressure
• WoundPacking
• Pressure Dressing
• Tourniquet Application
Circulation: Assessment

24. Hemorrhage Control
Personal Safety:
• As with the provision of any medical care, appropriate measures should be taken
to reduce provider exposure to blood.
• Minimum PPE includes gloves and eye protection. Additional protective items
may be necessary as the situation dictates.

25. Hemorrhage Control
Direct Pressure:
• Effective most of the time for external bleeding
• - Direct pressure can stop even major arterial bleeding
• To be effective, apply pressure with the victim on a firm surface to provide
support
• Don’t release pressure to check the wound

26. Hemorrhage Control
Wound Packing:
• Expose Wound and Identify Bleeding
• Open Clothing around the wound.
• Remove excess pooled blood from
the wound while preserving any
clots already formed in the wound.
• Locate the source of the most
active bleeding.

27. • Pack Wound Completely
• Pack gauze tightly into wound and
directly onto the source of bleeding.
• More than one gauze may be
required.
• Use one gloved hand to feed gauze
and the other to maintain pressure
and hold gauze in place
Hemorrhage Control

28. Pack the wound
Completely
Hemorrhage Control

29. Apply Direct Pressure
• Apply and hold continuous
direct pressure.
• The time to hold pressure will be
longer when not using
hemostatic gauze.
• Reassess bleeding while holding
continuous direct pressure.
Hemorrhage Control

30. Pressure Dressing:
• Limb and torso wounds with significant bleeding
• Head wounds with significant bleeding
• As an adjunct to wound packing
Hemorrhage Control

31. Pressure Dressing:
• Do not loosen a pressure dressing to check bleeding.
• If bleeding continues after applying a pressure dressing:
If on an extremity, apply a tourniquet
Apply additional pressure
Apply an additional pressure dressing
Hemorrhage Control

32. Torniquets:
Hemorrhage Control

33. • Reassess the wound and see if the bleeding has stopped.
• Re examine the patient, and then do a thorough evaluation of the
patient to see for any other life-threatening injury.
• Note the time and write it on the patient's head with a prefix T.
Hemorrhage Control

34. Disability: Assessment
• Assess level of consciousness
• AVPU or GCS in trauma
• Check for low blood glucose (hypoglycaemia)
• Check pupils (size, reactivity to light and if equal)
• Check movement and sensation in all four limbs
• Look for abnormal repetitive movements or shaking
• Seizures/convulsions

35. Disability: Management
• If altered mental status, no trauma, ABCDEs otherwise normal
• place in RECOVERY POSITION
• If altered mental status, low glucose (<70mg/dL) or if unable to check
glucose
• Give GLUCOSE
• If actively seizing
• Give BENZODIAZEPINE
• If pregnant and seizing
• Give MAGNESIUM SULPHATE

36. Thank You