Common Emergencies seen in a primary

care level
1. Shock
2. Loss of consciousness
3. Burns
4. Drowning
5. Fractures
6. Minor wounds
7. Poisonings
8. Snake bites
9. Scorpion sting
 First aid for snake bite
Allow bite to bleed freely for 15 – 30 sec.
Cleanse and rapidly disinfect area with Betadine pad.
If bite on hand, finger, foot or toe, wrap leg/ arm rapidly with 3” to 6”
ace or crepe bandage past the knee or elbow joint immobilizing it.
Leave area of fang marks open.
Wrap no tighter than one would for a sprain. Make sure pulses are
present.
Apply hard direct pressure over bite using a 4X4 gauze pad folded in
half twice.Tape in place with adhesive tape.
 Wrap elastic bandage as tight as one would for a sprain. Not too tight.
Check for pulses above and below elastic wrap: if absent it is too tight.
Immobilise bitten extemity, use splinting if available.
If possible, try and keep the bitten extremity at heart level or at gravity
neutral level.Raising it above the heart level can cause venom to travel
into the body. Holding it below heart level can cause swelling.
Try and identify, or if possible kill and bring the offending
snake.Visual identificaion usually suffices.
Bites to face, torso or buttocks are more of a problem. Disinfect.
Prepare area with razor.Elastic bandaging cannot be provided in these
areas. A pressure dressing made of gauze pad may help.

Antivenom is the only and best treatment for snake bite and we must
get as much is necessary as fast as possible.
 WHAT NOT TO DO IF BITTEN BY A VENOMOUS
SNAKE
Contary to advice given elsewhere DO NOT permit removal of the
pressure dressings until you are at a facility ready and able to
administer antivenom.As soon as the dressings rea released the venom
spread will cause the the usual expected problems of the venom.
Do not engage in strenuous physical activity.
Do not apply oral suction to the mouth.
Do not cut into or incise bite marks with a blade.
Do not drink any alcohol or use any medication.
Do not apply hot or cold packs.
Do not apply a narrow constrictive tourniquet such as a belt or cord.
 SHOCK
Causes
Great pain
A large burn
Loosing lots of blood
Dehydration
Allergic reaction
Heart attack
SIGNS
Weak rapid pulse
Cold sweat
Pale,cold,damp skin
Severe thirst, blood pressure drops dangerously low.
Restlessness, mental confusion, weakness or loss of consciousness.
WHAT TO DO TO PREVENT OR TREAT SHOCK
At the first sign of shock have the person lie down with his feet a little higher than
the head.
If the shock is due to head injury then make him lie propped up.
If the patient is cold, cover him.
If he is concious, give him water to drink or other fluids. IF shock is due to injury
then do not give naything oraly as he may need surgical intervention.
If he is in pain give him aspirin or other pain killer but not the one with sedative
action.
Keep calm, reassure the patient.
If shock is due to allergy then give Inj Adrenalin 0.5ml in aduls and 0.25 in
children.
Start iv fluids Dextrose salinne immediately.
If patient is unconscious, do not give anything orally. Start a drip and place him in
the recovery position if the vitals are stable.
 LOSS OF CONSCIOUSNESS
CAUSES
Drunkeness
Trauma
Fainting
Stroke
Shock
Poisoning
Heat stroke
IMMEDIATELY CHECK THE FOLLOWING.
Is he breathing well? Is a pulse present?
Is he loosing lots of blood?
Is he in shock?
Could it be a heat stroke? ( no sweat,high fever, hot red skin)
 CARDIO PULMONARY RESUSCITATION.
Establish Unresponsiveness.
Call for an ambulance.
Open Airway
Head tilt- chin lift or jaw thrust if suspecting spine injury.
The same is done for all the age groups.
Breathing
Look listen and feel for no more than 10 seconds.
If victim is breathing or resumes breathing , place in recovery
position.
If victim is not breathing, give 2 slow breaths.Allow for exhalation
between breaths.
 CIRCULATION
Check carotid in an adult and brachial in a child.
If signs of circulation present but breathing is absent,
provide rescue breathing ( 1 breath every 4-5 seconds for
adult. 1 breath every 3 second for children and infants.)
If signs of circulation absent then begin chest
compression interposed with breaths.
 Summary of ABCD Maneuvers

CIRCULATION ADULT CHILD INFANT

Pulse check Carotid Carotid Brachial or

Femoral
Compression land Lower half of Lower half of 1 fingers
marks sternum sternum Width below
intermammary
line
Compression / 15: 2 5:1 5:1
ventilation ratio
 Check if unresponsive
Call Emergency number

Start the ABCDs

Airway: open airway
Breathing:check breathing

If breathing adquate:place in recovery position. Provide two slow breaths

IF breathing inadequate:start rescue breathing. Check for signs of
(1 breath every 5 sec) Circulation
Monitor signs of circulation every 30-60 sec

Strat rescue breathing Perform CPR

Monitor signs of circulation Start chest compressions (100 min)
Combine compressions and ventilations
Ratio of 15 compressions to 2 breaths