HES First Aid 9800 05

HES
Practical Skills
9800-05
First Aid
9800-05: First Aid
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Lesson Objectives
At the end of the training, participants should be able to:
Show the basic principles of rendering First Aid
Show the basic procedure to determine the root cause of a condition
Show the process to stabilise a patient until medical help arrives
Show how to safely clear a victims air passage
Show the process for rendering mouth-to-mouth resuscitation
Show the process to deal with Choking
Show the process to render basic CPR
Show the process to deal with a victim suffering from 'fits'
Show the basic principles of controlling bleeding and safety precautions
Show the process to assess for possible internal bleeding
Show the process of handling victims with possible Spinal Cord injuries
Show the process of managing Burns
Show the process of managing Sprain, Strain and Dislocation
Show the process of managing Drowning casualty
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First Aid
9800-05: First Aid
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Introduction
It should not be only Doctors and Nurses who are able to care for
a person who suffers a sudden illness or injury
Even a child may be the only person available to save anothers
life!
If there is a life-threatening emergency, there may be no time to
summon professional medical help.
The First Responder is the one who has the responsibility to
stabilize the casualty and arrange further treatment if necessary.
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What is First Aid?

First Aid is the initial assistance or treatment given to someone
who is injured or suddenly taken ill.
First Aid must be administered as quickly as possible. In the case
of the critically injured, a few minutes can make the difference
between complete recovery and loss of life.
First Aid should be applied within the first 4 Golden minutes of
an accident. The first 4 minutes are crucial! Incidents tackled
within this period have reportedly resulted in a more favorable
outcome. The Human Brain can only last about 6 minutes without
oxygentherefore; you need to apply FIRST AID skills swiftly and
correctly!
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Aims of First Aid

These are called the three (3) Ps
Preserve life
Prevent the injury or condition from becoming worse
Promote recovery
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Parties involved in Managing First aid

First Aider - skilled person who gives first aid
Casualty- the suddenly ill person or the injured person
Bystanders or passersby
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Who is a First Aider?
A person who provides help or assistance to an injured person before the

arrival of a medical team.
A First Aider could also be a person trained by able bodies like St. John
Ambulance, Red Cross and St. Andrews; and certified by the body to
administer first aid.
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Qualities of a First aider

Sympathetic
Communicate explicitly
Perseverance
Patience
Tactful
Resourceful
Ready to help at any time
Quick and calm
Ability to take charge
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Responsibilities of a First aider

To assess a situation quickly and safely, and summon
appropriate help.
To protect casualties and others at the scene from possible
danger.
To identify, as far as possible the injury or nature of illness
affecting the casualty.
To give each casualty early and appropriate treatment, treating
the most serious conditions first.
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Responsibilities of a First aider

To arrange for the casualtys removal to hospital, into the care
of a doctor or to his/her home if necessary.
If medical aid is needed, to remain with the casualty until
further care is available
To report your observations to those taking on care and give
further assistance if required
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Who is an Appointed Person?

The role of the appointed person includes looking after firstaid equipment and facilities and calling the emergency
services when required. They can also provide emergency
cover where a first-aider is absent due to unforeseen
circumstances (annual leave does not count).
Most organisations that have fewer staff may decide to have
an appointed person instead of a First Aider in their
workplace.
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Priorities of First Aid

Assess the situation quickly and calmly.
Protect yourself and casualties from danger (never put yourself
at risk)
Prevent cross infection between yourself and the casualty as
far possible.
Comfort and reassure the casualties.
Deal with any life threatening condition first (e.g. first attend to
an unconscious victim in an emergency)
Obtain medical aid if necessary.
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Primary Survey- DRABC
The primary survey is a quick, systematic assessment of a

person to establish if any condition or injuries sustained are
life threatening. By following a methodical sequence using
established techniques, each life threatening condition can
be identified in priority order and dealt on find and treat
basis.
The sequence should be applied to every casualty you
attend.
If any life threatening conditions are successfully managed,
or if none exists, you should perform a secondary survey.
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Assess for Danger (D)

Is there a threat to yourself or the casualty? (Remember not to
put yourself in danger)
Ensure safety by evaluating all possible threats and ensure
that none exist.
Make the area safe.
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Check for Response (R)

You
need to make a quick assessment to find out whether a
casualty is conscious or unconscious
Observe the casualty as you approach.
Introduce yourself even if he does not appear to be responding
to you
Ask the casualty some questions, such as, What happened?
or give a command, such as, Open your eyes!
If there is no initial response, gently shake the casualtys
shoulders; if the casualty is a child, tap his shoulder; if he is an
infant, tap his foot.
If there is still no response, he is unconscious. If he responds
and makes eye contact or some other gesture, he is
conscious.
Unconscious casualties take priority and require urgent
treatment.
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Check Airway (A)

Is the airway open and clear? If the casualty is alert and talking to
you, it means the airway is open and clear. If however, a casualty
is unconscious, the airway could be obstructed. You need to open
and clear the airway do not move on to the next stage until it is
open and clear.
When a victim is unconscious, loss of muscular control allows the
tongue to fall back and block the airway.
When this happens, the casualtys breathing becomes difficult
and noisy and may stop. Tilting the head backwards and lifting the
chin, moves the tongue away from the entrance to the air
passage, allowing the casualty to breath.
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Head tilt - chin lift

Check casualtys mouth for
any obstruction, and remove
any that exist in a safe
manner
Place the palm of one hand
on the casualtys head, and
the finger tips of the other
hand under his/her chin
Gently tilt the head
backwards to open the
airway
Closed
airway
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Head tilt - chin lift,

to open the
Casualtys airway
Open
airway
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Check for Breathing (B)

Is the casualty breathing normally? Look, listen and feel for
signs of normal breathing, for no more than 10 seconds. If he is
alert and talking to you, then he is breathing.
When checking for breathing look out for the casualtys chest
movements, listen for breaths and concentrate to feel breath on
your cheek.
For babies or a young child, it might be easier to place your
hand on the chest and feel for movement of breathing.
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Check for Breathing (B)

If the casualty is breathing, it is important to note the rate, depth,
and ease with which he is breathing. For example, conditions
such as asthma that cause breathing difficulty require urgent
treatment.
If the casualty is not breathing, call for help and start
cardiopulmonary resuscitation (CPR).
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Look, listen and feel for breath
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Check for disruption in blood Circulation (C)

Conditions that affect blood circulation can be life-threatening,
for example Wounds, Heart Attack, Fainting, Amputation etc.
Injuries that result in severe bleeding can cause blood loss from
the circulatory system so must be treated immediately to
prevent the casualty going into shock (which is a life threatening
condition).
Only when life-threatening conditions have been stabilised, or
there are none present, should you make a detailed secondary
survey of the casualty.
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The ABC Flowchart
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Secondary Survey
The secondary survey follows the primary survey and it is a

step-by-step way of gathering information to form a complete
picture of the condition of the casualty. It is a detailed
examination of a casualty to look for other injuries or conditions
that may not be apparent. To do this we need to find out the
following: History, Symptoms and Signs.
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SurveyHistory
Two Secondary
aspects to consider
under
history are what happened and
any previous medical history.
Event History: First, we try to find out what happened. The
casualty can provide us with information, so can people nearby.
However, with people near-by, we need to verify that they are
telling us facts and not just their opinions. We should also try to
identify the mechanism of injury. This is the circumstances in
which the injury was sustained, and the forces in involved.
Previous Medical History: Though the casualtys medical history
may not have anything to do with the present condition, it could
be a clue to the cause. Clues to the existence of such a condition
may include a medical bracelet or medication in the casualtys
possession.
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Secondary Survey- History

Use the mnemonic AMPLE to ensure that you have covered
every major area when assessing for history.
A - Allergies. If the casualty is conscious ask if he/she has any
allergies, especially allergies to drugs.
M - Medication. Ask if the casualty has taken any medication in
the past 24 hours.
P - Past Health Record. Ask about the casualty past medical
history and whether there is anything that could be related to the
current injury or illness. Note the presence of a medical warning
bracelet as this may indicate an ongoing medical condition like
epilepsy, diabetes or anaphylaxis.
L - Last Meal. Find out when the casualty last ate. This may be
important for medical help.
E - Event. Ask what happened.
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Secondary Survey- Symptoms
These are the sensations that the casualty feels and describes to
you. When you talk to the casualty, ask him to give you as much
detail as possible. Make eye contact with the casualty as you talk
to him. Keep your questions simple, and listen carefully to the
symptoms he describes.
If he complains of pain, ask where it is
Ask him to describe the pain (is it constant or intermittent, sharp
or dull)
Ask him what makes the pain better or worse
Ask him if the pain is affected by movement or breathing
Ask him if the pain did not result from an injury, where and how it
began
Listen carefully to the casualtys answers and do not interrupt him
while he is speaking.
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Secondary Survey- Signs
These are features such as swelling, bleeding, discoloration,

deformity and swells that you can detect by observing and feeling
the casualty.
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Secondary Survey- Head-To-Toe Examination

When you have taken the casualtys history and asked about
any symptoms he has, you should carry out a detailed
examination.
Remember if the casualty is unconscious, they may vomit and
obstruct their airway without you being aware. If this is the
case, it may be advantageous to place the casualty in a
recovery position prior to the head-to-toe examination.
Run your hand over the persons scalp looking for bleeding,
swelling or indentation. Try not to move the head and neck.
Look into ear for any blood or fluid.
Open the eyes and check for foreign, blood or bruising in the
whites of the eyes.
Check the nose for blood or fluid.
Check the rate and dept of breathing and for smell on the
breath
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Check in the mouth for anything that might obstruct the airway.
DO NOT remove dentures unless they are loose. Also check
for wounds.
Note the colour and temperature of the skin
Look at the face for any wound or injury.
Gently check under the neck without causing movement and
carefully feel the bones of the neck and the base of the skull,
looking for any injuries or swelling.
Gently check the shoulder for swelling or injuries.
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Move your hand down and feel the chest for swelling or
injuries. If the casualty is conscious ask them to take a deep
breath and assess the chest equal and even movement
Check each arm in turn for any wound or injuries. If the
casualty is conscious ask him/her to bend and straighten
fingers and all bones.
Check each hand and finger for injuries.
Check the abdomen for swelling, wound or injuries.
Check pelvic for any signs of injury
Examine each leg in turn for wounds and swelling; if the
casualty is conscious ask him/her to move each joint in turn.
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Check each feet and ankle for swelling, injuries and
movement.
When you have completed the survey, treat any problems you
may have found. It will be useful to note down any injury so that
this information can be passed to the medical teams.
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The Recovery position
A person who is unconscious is at risk of dying because of a

blocked airway. Before turning the casualty into the recovery
position, remember to carry out the appropriate steps (DRABC).
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Kneel beside the casualty. Remove his/her spectacles and any
bulky objects, such as mobile phones or large bunches of keys,
from his/her pockets. Do not search his pockets for small items.
Make sure that both of the casualtys legs are straight. Place the
arm that is nearest to you at right angles to the casualtys body,
with the elbow bent and the palm facing upwards.
Bring the arm that is farthest from you across the casualtys
chest, and hold the back of his hand against the cheek nearest to
you. With your hand, grasp the far leg just above the knees and
pull it up, keeping the foot flat on the ground.
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Keeping the casualtys hand pressed against his cheek, pull on
the far leg and roll the casualty towards you and onto his side.
Adjust the upper leg so that the hip and the knee are bent at right
angles.
Tilt the casualtys head back and tilt his chin so that the airway
remains open.
If necessary, adjust the hand under the cheek to keep the airway
open.
Now the casualty is in the recovery position!
If the casualty has to be left in the recovery position for longer than
30 minutes, roll him/her onto the opposite side-unless other
injuries prevent you from doing so.
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Monitoring Vital Signs
Monitoring starts after the casualty has been put in the

recovery position. Having done this, you would need to assess
and monitor the casualtys level of response, breathing and
pulse.
This information can help you identify problems and changes
in a casualtys condition. Monitoring should be repeated
regularly, and your findings recorded and handed over to the
medical personnel taking over.
In addition, if a casualty has a condition that affects his body
temperature, such fever, heat stroke or hypothermia, you will
also need to monitor his temperature.
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Monitoring Vital Signs- Level of Response

You need to monitor a casualtys level of response to assess her
level of consciousness and any changes in her condition.
Any injury or illness that affects the brain may affect
consciousness, and any deterioration is potentially serious.
Assess the level of response using the AVPU scale, and make a
note of any deterioration or improvement.
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Monitoring Vital Signs- Level of Response
A Is the casualty Alert? Are his eyes open and does he respond
to questions?
V Does the casualty respond to Voice? Can he answer
questions and obey commands?
P Does the casualty respond to Pain? Does he open his eyes
or move if pinched?
U Is the casualty Unresponsive to any stimulus (i.e.
unconscious)?
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Monitoring Vital Signs- Breathing

When assessing a casualtys breathing, check the rate of
breathing and listen for any breathing difficulties or unusual
noises.
When checking for breathing, listen for breaths and watch the
casualtys chest movements. For a baby or young child, it might
be easier to place your hand on the chest and feel for movement
of breathing.
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Monitoring Vital Signs- Breathing
An adults normal breathing rate is 12 16 breaths per minute

In babies and young children, it is 20 30 breaths per minute
Record the following information:

Rate count the number of breaths per minute
Depth are the breaths deep or shallow?
Ease are the breaths easy, difficult, or painful?
Noise is the breathing quiet or noisy, and if noisy, what are the types of
noise?
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Monitoring Vital Signs- Pulse

Each heartbeat creates a wave of pressure as blood is pumped
along the arteries. Where arteries lie close to the skin surface
such as on the inside of the wrist and at the neck, this pressure
wave can be felt as a pulse.
The normal pulse rate in an adult is 60-80 beats per minute. The
rate is faster in children and may be slower in very fit adults. An
abnormally fast or slow pulse may be a sign of illness.
The pulse may be felt at the wrist (radial pulse), or if this is not
possible, the neck (carotid pulse).
In babies, the pulse in the upper arm (brachial pulse) is easier to
find.
When checking for a pulse, use your fingers to press tightly
against the skin. Do not use your thumb, as it has a pulse as
well.
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Checking for pulse- radial pulse
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Checking for pulse- carotid pulse
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Checking for pulse- brachial pulse (Babies)
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Checking for pulse

Record the following information:
Rate number of beats per minute
Strength strong or weak
Rhythm regular or irregular
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Monitoring Vital Signs- Body Temperature

Although not a vital sign, you may need assess body temperature
and record the results. You can feel exposed skin but use a
thermometer to obtain an accurate reading.
Normal body temperature is 37OC (98.6OF)
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Breathing and Circulation
With an unconscious casualty your priorities are to maintain

an open airway, to breathe for the casualty (to get oxygen into
the body), and to maintain blood circulation (to get oxygenated
blood to the tissues).
In an adult, during the first minutes after the heart stops (cardiac
arrest), the blood oxygen level remains constant, so chest
compressions are more important than rescue breaths in the
initial phase of resuscitation. After about five minutes, the blood
oxygen level falls and rescue breathing becomes more
important.
In children and infants, a problem with breathing is the most
likely reason for the heart to stop. They are therefore given FIVE
initial rescue breaths before chest compressions are started.
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Resuscitation: Unconscious Adult
D- Danger (check pg.7)

R- Response (check pg.7)
A- Airway (check pg.8)
B- Breathing (check pg.8) -If the casualty is breathing, go to C (check
pg.9).
CAUTION: Agonal Breathing
This type of breathing often takes the form of short irregular gasps of breath. It is
common in the first few minutes after a cardiac arrest. It should not be mistaken for
normal breathing and, if it is present, CPR should be started immediately.
We assume here that the victim is an unconscious adult that is not

breathing, so proceed to give CPR starting with chest
compressions.
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CAUTION: Place your hand on the casualtys breastbone as
indicated here. Make sure that you do not press on the casualtys
ribs, the lower tip of the breastbone or the upper abdomen.
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Actions:
Knell beside the casualty level with his chest. Place the heel of one
hand on the center of the casualtys chest.
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Actions:
Place the heel of your other hand on top of the first hand, and interlock your
fingers, making sure the fingers are kept off the ribs.
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Actions:
Leaning over the casualty, with your arms straight, press

down vertically in the breastbone and depress the chest by
4-5cm (11/2-2in). Release the pressure without removing
your hands from the chest. Allow the chest to come back up
fully (recoil) before giving the next compression.
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Actions:
Compress the chest 30 times at a rate of 100 compressions per

minute. The time taken for compression and release should be
about the same.
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Actions:
Move to the casualtys head and make sure that the airway is still open. Put
one hand on his forehead and two fingers of the other hand, under the tip of
his chin. Move the hand that was on the forehead down to pinch the soft part
of the nose with the finger and thumb. Allow the casualtys mouth to fall open.
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Actions:
Take a breath and place your lips around the casualtys

mouth, making sure you have a good seal. Blow steadily
into the casualtys mouth until the chest rises. This should
take a second.
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Actions:
Maintaining head tilt and chin lift, take your mouth off the casualtys mouth
and look to see the chest fall. If the chest rises visibly as you blow and falls
fully when you lift your mouth away, you have given a rescue breath. If the
chest does not rise, you may need to adjust the head, and give a second
breath
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Actions:
Repeat 30 chest compressions without delay. Continue the cycle of 30

chest compression followed by 2 rescue breaths until either emergency
help arrives and takes over, the casualty starts to breathe normally, or you
become too exhausted to carry on.
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Resuscitation: Unconscious Child

D- Danger (check pg.7)
R- Response (check pg.7)
A- Airway (check pg.8)
B- Breathing (check pg.8) -If casualty is breathing, go to C
(check pg.9).
We assume here that this is an unconscious child that is not
breathing, so you will start by giving rescue breaths.
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CAUTION: Place your hand on the childs breastbone as
indicated here. Make sure that you do not press over the childs
ribs, the lower tip of the breastbone or the upper abdomen.
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Actions:
Ensure the airway is still open by keeping one hand on the childs
forehead and two fingers of the other hand on the point of her chin
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Actions:
Pick out any visible obstructions from the mouth.

Do not sweep the mouth with your finger to look
for obstructions.
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Actions:
Pinch the soft part of the childs nose with the finger and thumb
of the hand that was on the forehead. Make sure that her nostrils
are closed to prevent air from escaping. Allow her mouth to fall.
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Actions:
Take a deep breath in before placing your lips around the childs mouth, making
sure that you form an airtight seal. Blow steadily into the childs mouth for one
second; the chest should rise.
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Actions:
Maintaining a head tilt and chin lift take your mouth off the childs mouth
and look to see the chest fall. If the chest does not rise you may need
to adjust the head. Give FIVE initial rescue breaths.
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Actions:
Kneel level with the childs chest. Place one hand on the centre of
her chest. This is the point at which you will apply pressure.
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Actions:
Lean over the child, with your arms straight, and then press down vertically on the
breastbone with the heel of your hand. Depress the chest by one-third of its depth.
Release the pressure without removing your hand. Allow the chest to come back up
completely (recoil), before you give the next compression.
Compress the chest 30 times, at a rate of 100 compressions per minute. The time
taken for compression and release should be about the same.
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Actions:
Return to the childs head, open the airway and give 2 further rescue breaths.
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9. If you are on your own, continue alternating 30 chest
compressions with 2 rescue breaths for one minute, then
stop to call the emergency number for help. If help is on the
way, continue CPR until either emergency help arrives and
takes over, the child starts to breathe normally or you
become too exhausted to continue.
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Resuscitation: Unconscious Infant (under

one year)
CAUTION: Place your finger on the breastbone as indicated here.
Make sure that you do not press over the ribs, the lower tip of the
infants breastbone or the upper abdomen.
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one year)
Actions:
Place the infant on his back on a flat surface, at about waste height in front of
you, or on the floor. Make sure that the airway is still open by keeping one hand
on the infants forehead and one finger tip of the other hand under the tip of his
chin.
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one year)
Actions:
Pick out any visible obstructions from mouth and nose. Do not sweep the
mouth with your finger looking for obstructions.
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one year)
Actions:
Take a breath. Place your mouth around the infants mouth and nose to
form an airtight seal. If you cannot make a seal around the mouth and
nose, close the infants mouth and make a seal around the nose only.
Take a breath and blow steadily into the infants mouth for one second;
the chest should rise.
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one year)
Actions:
Maintaining head tilt and chin lift, take your mouth off the infants
mouth and see if his chest falls. If the chest rises visibly as you blow
and falls fully when you lift your mouth, you have given a breath. Give
5 rescue breaths.
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one year)
Actions:
Place 2 fingers of your lower hand on the centre of the infants chest. Press down
vertically on the infants breastbone and depress the chest by one-third of its
depth. Release the pressure without losing the contact between your fingers and
the breastbone. Allow the chest to come back up fully before giving the next
compression. The time taken for compression and release should be about the
same. Repeat to give 30 compressions at a rate of 100 times
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one year)
Actions:
Return to the infants head, open the airway and

give 2 further rescue breaths.
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one year)
Actions: 7
If you are on your own, continue alternating 30 chest
compressions with 2 rescue breaths for one minute, then
stop to call the emergency number for help. If help is on the
way, continue CPR until either emergency help arrives and
takes over, the infant starts to breathe normally or you
become too exhausted to continue.
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Special Considerations for CPR

There are circumstances where it may be more difficult to deliver
CPR. This may be as a result of the mouth of the casualty not
being safe enough for contact, for example if a casualty has
chemical around the mouth, or where it is not possible to get a
good seal around the casualtys mouth.
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Mouth-To-Nose Rescue Breathing
If the casualty has been rescued from water or injuries to the
mouth make it impossible to achieve a good seal, you can use
the mouth to nose method for giving rescue breaths. With the
casualtys mouth closed, form a tight seal with your lips around
the nose and blow steadily into the casualtys nose. Then allow
the mouth to fall open to let the air escape.
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Mouth-To-Stoma Rescue Breathing
A casualty who has had his voice-box surgically removed breaths
through an opening in the front of the neck (stoma), rather than
through the mouth and nose. Always check for a stoma before
giving rescue breaths. If you find a stoma, close off the mouth
and nose with one hand and then breathe into the stoma.
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Problems with rescue breathing
If a casualtys chest does not rise when giving rescue breaths:
Recheck the head tilt and chin lift
Recheck the casualtys mouth. Remove any obvious
obstructions, but do not do a finger sweep of the mouth.
Make no more than two attempts to achieve rescue breaths
before repeating chest compressions
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Pregnant Casualties
In the late stages of pregnancy, when a woman lies flat on her
back, the uterus presses on the veins that return blood to the
heart, reducing the flow of blood.
If resuscitation is required, tilt the woman on to her left side in
order to relieve the pressure on the veins and assist the return
of blood to the heart when giving chest compressions.
This can be done by placing rolled-up clothing under her right
hip. Or, if you have helpers they can place their knees under her
back.
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Face Shields and Pocket Masks
First Aiders may use these aids for hygienic purposes.
Face shields are plastic barriers with a filter that is placed over
the casualtys mouth.
A pocket mask is more substantial and has a mouthpiece
through which breath can be given.
If you know how to use one of these aids, you should carry it
with you and use it if you need to resuscitate a casualty.
However, if you do not have a pocket mask or face shield with
you and need to resuscitate a casualty, do not hesitate to give
rescue breaths without them.
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Using a Face Shield
Tilt the casualtys head backwards to open the airway. Place

the shield over the casualtys face so that the filter is over
the mouth, then pinch the nostrils shut. Deliver rescue
breaths through the filter.
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Using a Pocket Mask
Kneel behind the casualtys head. Open the airway and place the mask,
narrow end towards you, over the casualtys mouth and nose. Deliver
rescue breaths through the mouthpiece.
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Automated External Defibrillator (AED)

When the heart stops, a cardiac arrest has occurred. The most
common cause is an abnormal rhythm of the heart, known as
ventricular fibrillation. This abnormal rhythm can occur when the
heart muscle is damaged as a result of a heart attack or when
insufficient oxygen reaches the heart. An AED can be used to
correct the heart rhythm by one or more electric shocks.
The machine analyses the casualtys heart rhythm and shows
with visual prompts- or tells you by voice prompts- what action to
take at each stage.
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The machine analyses the casualtys heart rhythm and shows
with visual prompts- or tells you by voice prompts- what action to
take at each stage.
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Steps involved in using the AED

1. Switch on the AED and take the pads out of the sealed pack.
Remove or cut through clothing and wipe away sweat from the
chest.
2. Remove the backing paper and attach the pads to the
casualtys chest by placing the first pad on the casualtys upper
right side, just below his collarbone.
3. Place the second pad on the casualtys left side, below his
armpit. Make sure the pad has its long axis along the head-totoe axis of the casualtys body
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Steps involved in using the AED
4.The AED will start

analysing the heart
rhythm. Ensure that
no one is touching
the casualty. Follow
the oral and/or visual
prompts given by the
machine.
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Considerations when using an AED

Clothing and jewelry: Remove or cut away any clothing or jewelry
that could interfere with the pads.
External factors: Excessive sweat or water on the chest can
reduce the effectiveness of the shock, so the chest should be dry.
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Considerations when using an AED

Pregnant casualties: there are no contra-indications to using an
AED during pregnancy; however the increased breast size may
present some problems. Therefore, to place the AED pads
correctly, you may need to move one or both breasts. This must
be carried out with respect and dignity.
Pediatric AED pads should be used for children between the ages
of one and eight. For this category, place one pad in the centre of
the childs back. Then place the second upper pad over the
centre of the childs chest. Make sure both pads are vertical.
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Handing over to the Emergency Services

When the emergency services arrive, they would need to know:
The casualtys present status. For example, if he is unconscious
and not breathing.
The number of shocks you have delivered.
When the casualty collapsed and the length of time he has been
unconscious.
Any relevant history.
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Spinal Injury
Injuries to the spine can involve one or more parts of the back
and/or neck: the bones (vertebrae), the discs of tissue that
separate the vertebrae, the surrounding muscles and
ligaments, or the spinal cord and the nerves that branch off
from it.
The most serious risk associated with spinal injury is damage
to the spinal cord. Such damage can cause the loss of power
and/or sensation to below the injured area. The spinal cord or
nerve roots can suffer temporary damage if they are pinched
by displaced or dislocated discs, or by ligaments of broken
bone. If the cord is partly or completely severed, damage may
be permanent
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Spinal Injury
The most important indicator is the mechanism of the injury.

Suspect spinal injury:
if abnormal forces have been exerted on the back or neck
If a casualty complains of any changes in sensation or
difficulties with movement
If the incident involved violent forward or backward bending
If the incident involved twisting of the spine
If any of these conditions occur, you must take particular care
to avoid unnecessary movement of the head, neck and spine
at all times.
Although spinal cord injury may occur without damage to the
vertebrae, spinal fracture generally increases the risk. The
areas that are most vulnerable are the bones in the neck and
those in the lower back.
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Spinal Injury
Any of the following incidents should alert you to a
possible spinal injury:
Falling from a height, such as a ladder
Falling awkwardly
Diving into a shallow pool and hitting the bottom
Falling from a moving vehicle
A heavy object falling across the back
Injury to the head or the face
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Spinal Injury
Treating a conscious casualty with Spinal Injury
Your aims:
To prevent further injury
To arrange further removal to hospital
Caution:
Do not remove the casualty from the position in which you found
him unless he is in immediate danger
If the casualty has to be moved, use the log-roll technique (see
below).
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Actions: (Dont forget to begin by checking for danger and response )
1.Reassure the casualty and advice him not to move. Call for emergency help or ask
a helper to do this.
2. Kneel or lie behind the casualtys head. Rest your elbows on the ground or on
your knees to keep your arms steady. Grab the sides of the casualtys head.
Spread your fingers so that you do not cover his ears-he needs to be able to
hear you. Steady and support his head in this neutral position, in which the
head, neck and spine are aligned.
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Actions:
Ask a helper to place rolled-up blankets, towels or items of clothing on either side of
the casualtys head and neck, while you keep his head in the neutral position.
Continue to support the casualtys head until emergency services take over, no
matter how long this may be.
4. Get your helper to monitor and record vital signs.
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Treating an Unconscious casualty with Spinal Injury

Your aims:
To maintain an open airway
To begin CPR if necessary
To prevent further spinal damage
To arrange urgent removal to hospital
Caution:
If the casualty has to be moved and you have help. Use the
log-roll technique (see below)
If you are alone and you need to leave the casualty to call for
emergency help, and if the casualty is unable to maintain an
open airway, you should place her in the recovery position
Actions: (Dont forget to begin by checking for danger and response)
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1. Kneel or lie behind the casualtys head. Rest your elbows on
the ground or on your knees to keep your arms steady.
Grab the sides of the casualtys head. Support her head so
that her head, trunk and legs are in a straight line.
2. Open the casualtys airway using the jaw-thrust technique.

Place your finger tips at the angles of her jaw. Gently lift
the jaw to open the airway. Take care not to lift the
casualtys neck.
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3. Check the casualtys breathing. If she is breathing, continue
to support her head. Call for emergency help or ask a helper
to do this.
4. If the casualty is not breathing, begin CPR. If you need to
turn the casualty, use the log-roll technique.
5. Monitor and record vital signs- level of response, breathing
and pulse- while you wait for help.
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Spinal Injury
Log-Roll Technique
This technique should be used to turn a

casualty with a spinal injury. While you
support the casualtys head and neck,
ask your helper to straighten her limbs
gently.
Position three people along one side to
pull the casualty towards them, and two
on the other to guide her forward. The
person at the legs should place his hands
under the furthest leg. The middle helper
supports the casualtys leg and hip.
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Spinal Injury
Direct your helpers to roll the casualty.

Keep the casualtys head, trunk and
legs in a straight line at all times; the
upper leg should be supported in a
slightly raised position to keep the spine
straight.
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Choking
A foreign object that is stuck in the throat may block it and

cause muscular spasm. If blockage of the airway is mild, the
casualty should be able to clear it; if it is severe, he will be
unable to speak, cough or breath, and will eventually lose
consciousness.
If he loses consciousness, the throat muscles may relax and
the airway may open enough to do rescue breathing. Be
prepared to begin rescue breaths and chest compressions.
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Choking Adult
Recognition:
Ask the casualty, Are you choking?
Mild obstruction- casualty able to speak, cough and breathe.
Severe obstruction- casualty unable to speak, cough or breathe with
eventual loss of consciousness
Your aims:
To remove the obstruction
To arrange urgent removal to hospital if necessary
Caution:
If at any stage the casualty loses consciousness, open the airway and
check breathing. If the casualty is not breathing, begin CPR.
Any victim who has been given abdominal thrusts must seek medical
advice.
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Choking Adult
Actions:
If the casualty is breathing, encourage her

to continue coughing. Remove any obvious
obstructions to the mouth.
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Choking Adult
Actions:
If the casualty cannot speak or stops coughing or breathing, carry out back blows.
Support her upper body with one hand, and help her to lean well forward. Give up to
five sharp blows between her shoulder blades with the heel of your hand. Stop if the
obstruction clears. Check her mouth.
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Actions:Adult
Choking
If back blows fail to clear the obstruction, try abdominal thrusts. Stand behind the
casualty and put both arms around the upper part of her abdomen. Make sure that
she is still bending well forwards. Clench your fist and place it between the navel and
the bottom of her breastbone. Grasp your fist firmly with your other hand. Pull sharply
inwards and upwards up to five times.
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Actions:4
Choking Adult
Check her mouth. If the obstruction is not cleared, repeat
steps 2 and 3 up to three times, checking the mouth after
each step.
Actions:5
If the obstruction still has not cleared, call for emergency
help. Continue until help arrives or the casualty loses
consciousness.
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Choking Child (one year to puberty)

Young children especially are prone to choking. A child may choke
on food, or may put small objects into her mouth and cause a
blockage of the airway.
If a child is choking, you need to act quickly. If she loses
consciousness, the throat muscles may relax and the airway may
open enough to do rescue breathing. Be prepared to begin
rescue breaths and compressions
Recognition:
Ask the child, Are you choking?
Mild obstruction- child able to speak, cough and breathe.
Severe obstruction- child unable to speak, cough or breathe with
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Your aims:
Caution:
If at any stage the child loses consciousness, open the airway
and check breathing. If the child is not breathing, begin CPR to try
to relieve the obstruction.
Seek medical advice for any child who has been given abdominal
thrust.
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Actions:
If the child is breathing, encourage her to cough;

this may clear the obstruction. Remove any
obvious obstructions to the mouth.
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Actions:
If the child cannot speak, or stops coughing or breathing, carry out back
blows. Bend her well forward and give up to five blows between her
shoulder blades using the heel of your hand. Check her mouth but do
not sweep the mouth with your finger.
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Actions:
If the back blows fail, try abdominal thrusts. Put your arm around the childs
upper abdomen. Make sure that she is bending well forwards. Place your fist
between the navel and the bottom of her breastbone, and grasp it with your
other hand. Pull sharply inwards and upwards up to five times. Stop if the
obstruction clears. Check her mouth again.
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Actions:4
If the obstruction has not cleared, repeat steps 2 and 3 up to
three times. Keep checking the mouth.
Actions:5
If the obstruction still has not cleared, call for emergency help.
Continue until help arrives or the child loses consciousness
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Choking Infant (under one year)

An infant is most likely to choke on food or small objects than an
adult. The infant will rapidly become distressed, and you need to
act quickly to clear any obstruction. If the infant loses
consciousness, the throat muscles may relax and the airway may
open enough to do rescue breathing. Be prepared to give rescue
breaths and chest compressions.
Recognition:
Mild obstruction- infant able to cough, but has difficulty crying or
making any other noise.
Severe obstruction- unable to make any noise or breathe, with
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Your aims:
Caution:
If at any stage the infant loses consciousness, open the airway
and check breathing. If the infant is not breathing, begin CPR to
try to relieve the obstruction.
Seek medical advice for any infant who has been given chest
thrust.
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Actions:
If the infant is distressed, is unable to cry cough or breathe, lay him

face down along your forearm, with his head low, and support his back
and head. Give up to five back blows, with the heel of your hand.
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Actions:
Check the infants mouth; remove any obvious

obstructions with your finger tips. Do not sweep the
mouth with your finger as this may push the object
further down the throat
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Actions:
If back blows fail to clear the obstruction, turn the infant

on to his back and give chest thrusts. Using two
fingers, push inwards and upwards (towards the head)
against the infants breastbone, one fingers breadth
below the nipple line.
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Actions:4
Perform up to five chest thrusts. The aim is to relieve the
obstruction with each chest thrust rather than necessary doing
all five. Check the mouth. If the obstruction still has not
cleared, repeat steps 1 to 4 three times
Actions:5
If the obstruction still has not cleared, take the infant with you
to call for emergency help. Continue until help arrives or the
infant loses consciousness.
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Shock
Shock is what happens when the heart and blood vessels are
unable to pump oxygen-rich blood to the vital organs of the body.
Although every illness that involves shock to some degree can be
life threatening. The best way to protect people from the serious
damage that shock can have on the system is to recognise the
signs before the person gets into serious trouble.
In most cases, only a few of the symptoms will be present, and
many do not appear for some time.
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Shock
Recognition:
Pale, cold, clammy and moist skin.
Vacant and dull eyes.
Anxiety, restlessness, and fainting.
Weak, rapid or absent pulse.
Shallow, rapid, and irregular breathing.
Nausea and vomiting
Excessive thirst.
Person may seem confused or tired
Loss of blood pressure
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Shock
Treatment
Keep casualty warm use blanket
Lay the casualty down, keep the head low (dont use pillows) and
raise the legs gently. This will help to keep blood in the vital areas
such as the brain.
Loosen tight clothing around the neck, chest and waist.
Ensure rest & reassurance
Ensure access to good circulation of air
Seek Medical Advice as soon as possible
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Shock
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Heart Attack
A heart attack is most commonly caused by a sudden obstruction

of blood supply to part of the heart muscle- for example, because
of a clot in the coronary artery (coronary thrombosis). It can also
be called a myocardial infarction. The main risk is that the heart
will eventually stop beating.
The effect of a heart attack depends largely on how much of the
heart muscle is affected.
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Heart Attack
Recognition:
Persistent vice-like central chest pain often spreading to the jaw
and down one or both arms. Unlike angina, the pain does not
ease when the casualty rests.
Breathlessness
Discomfort occurring high in the abdomen, which may feel similar
to severe indigestion
Collapse, often without any warning
Sudden faintness or dizziness
Casualty feels a sense of impending doom
Profuse sweating
Rapid, weak or irregular pulse
Extreme gasping for air
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Heart Attack
Your aims:
To ease the strain on the heart by ensuring that the casualty rests
To call for urgent medical help without delay
Caution:
If the casualty loses consciousness, open the airway and check
breathing
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Heart Attack
Actions:
Make the casualty as comfortable as possible to ease the strain

on his heart. A half-sitting position, with his head and shoulders
supported and his knees bent is often best. Place cushions
behind him and under his knees.
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Actions:2
Heart Attack
Call for emergency help, saying that you suspect a heart attack. If
the casualty asks you to do so, call his own doctor as well.
Actions:3
If the casualty has angina medication, such as tablets or aerosol
spray, let him administer it; help him if necessary. Encourage him
to rest.
Actions:4
Monitor and record vital signs- level of response, breathing and
pulse- while waiting for help to arrive.
Actions:5
Avoid undue stress by staying calm
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Angina
The term angina means literally a constriction of the chest.
Angina occurs when coronary arteries that supply the heart
muscle with blood become narrowed and cannot carry sufficient
blood to meet increased demands during exertion or excitement.
An attack forces the casualty to rest; the pain should ease soon
afterwards.
Recognition:
Vice-like central cheat pain, often spreading to the jaw and one
or both arms.
Pain easing with rest
Shortness of breath
Weakness, which is often sudden and extreme
Feeling of anxiety
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Angina
Your aims:
To ease strain on the heart by ensuring that the casualty rests
To help the casualty with any medication
To obtain medical help if necessary
Caution:
breathing
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Angina
Actions:1
Help the casualty to stop what he is doing and sit down. Make
sure that he is comfortable and reassure him; this should help the
pain ease.
Actions:2
If the casualty has angina medication, such as tablets or aerosol
spray, let him administer it himself. If necessary, help him to take
it.
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Angina
Actions:3
Encourage the casualty to rest, and keep bystanders away. The
pain should ease within a few minutes.
Actions:4
If the pain subsides after rest and /or medication, the casualty will
usually be able to resume what he was doing. If he is concerned
tell him to seek medical advice.
Actions:5
If the pain persists, or returns, suspect a heart attack.
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Fainting
A faint is a brief loss of consciousness caused by a temporary

reduction of blood flow to the brain. It may be a reaction to pain,
exhaustion, and lack of food or emotional stress. Fainting is also
common after long periods of physical inactivity, such as standing
or sitting still, especially in a warm atmosphere. This inactivity
causes blood to pool in the legs, reducing the amount of blood
reaching the brain.
Fainting is not life threatening, although if the person faints on a
regular basis it may be a sign of a more serious medical disorder,
and should be discussed with your doctor.
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Fainting
Recognition:
Brief loss of consciousness
A slow pulse
Pale, cold skin and sweating
Your aims:
To improve blood flow to the brain
To reassure the casualty and make him comfortable
Caution:
If the casualty does not regain consciousness quickly open the
airway and check breathing
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Fainting
Actions:1
Lay the person on their back with their feet elevated above their
heart, or 8-12 inches, if possible.
Actions:2
Loosen any tight clothing and jewelry especially around their head
and neck.
Actions:3
Watch their airways, are they breathing correctly? If they stop
breathing begin to administer CPR. If breathing stops then the
situation becomes more serious and you should try to get medical
help as soon as possible.
Actions:4
Sometimes when people lose consciousness they vomit, you
may want to turn the person onto their side in case this happens.
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Fainting
Actions:5
If you suspect a head, neck, or spinal injury get medical
help as soon as possible and do not move the person
unless absolutely necessary.
Actions:6
Do not try to give the person anything to eat or drink
Actions:7
If the person does not regain consciousness within 2
minutes call for help.
Actions:8
If the person is older (over 40) contact a doctor in order to
make sure it is not a heart related problem.
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Seizures
A seizure also called a convulsion or fit consists of

involuntary contractions of many of the muscles in the body.
The condition is due to a disturbance in the electrical activity of
the brain. Seizures usually result in loss or impairment of
consciousness. The most common cause is epilepsy. Other
causes include head injury, some brain-damaging diseases,
and shortage of oxygen or glucose in the brain and the intake
of certain poisons including alcohol.
Epileptic seizures result from recurrent, major disturbances of
brain activity. Just before a seizure, a casualty may have a brief
warning period (aura) with, for example, a strange feeling,
smell or taste.
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Seizures
No matter what the cause of the seizure, care must always

include maintaining an open, clear airway and a monitoring of the
casualtys vital signs- level of response, breathing and pulse.
Recognition:
Sudden unconsciousness
Rigidity and arching of the back
Convulsive movements
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Seizures
Recognition:
In epilepsy, the following sequence is common:
The casualty suddenly loses consciousness;
He becomes rigid, arching his back;
Breathing may become difficult;
Convulsive movements begin. The jaw may be clenched and
breathing may be noisy. Saliva may appear at the mouth and may
be blood stained if the tongue or lips have been bitten;
Possible loss of bladder or bowel control;
Muscles relax and breathing becomes normal; the casualty
recovers consciousness, usually within a few minutes. He may
feel dazed or act strangely. He may be unaware of his actions;
After a seizure, the casualty may feel tired and fall into a deep
sleep.
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Seizures
Your aims:
To protect the casualty from injury during the seizure
To care for the casualty when consciousnesses is regained and
arrange removal to hospital if necessary
Actions:1
Make space around the casualty; ask bystanders to move away.
Remove potentially dangerous items, such as hot drinks and
sharp objects; note the time that the seizure started.
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Seizures
Actions:
Protect the head of the casualty from objects nearby; place soft padding such
as rolled towels underneath or around his neck if possible. Loosen tight clothing
around his neck if necessary
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Seizures
Actions:
When the convulsive movements have ceased, open the

casualtys airway and check breathing. If he is breathing,
place him in the recovery position
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Seizures
Actions:4
Monitor and record vital signs level of response, breathing and
pulse until he recovers. Note the duration of the seizure.
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Bleeding
Bleeding refers to the loss of blood. Bleeding can happen inside

the body (internally) or outside the body (externally). It may occur:
Inside the body when blood leaks from blood vessels or organs
Outside the body when blood flows through a natural opening
(such as the vagina, mouth, or rectum)
Outside the body when blood moves through a break in the skin
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Bleeding
Internal Bleeding
Bleeding inside body cavities may follow an injury, such as a
fracture or a blow from a blunt object, but it can also occur
spontaneously for example bleeding from a stomach ulcer. The
main risk from internal bleeding is shock. In addition, blood can
build up around organs such as the lungs or brain and exert
damaging pressure on them.
Suspect internal bleeding if a casualty develops signs of shock
without obvious blood loss. Check for any bleeding from body
openings (orifices) such as the ear, mouth and nose. There may
also be bleed from the urethra or anus.
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Bleeding
Recognition:
Initially, pale, cold, clammy skin.

Rapid weak pulse
Thirst
Rapid, shallow breathing
Confusion, restlessness and irritability
Possible collapse and unconsciousness
Bleeding from body orifices
Pain
Information from the casualty that indicates recent injury
or illness
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Bleeding
Severe External Bleeding

When bleeding is severe, and not controlled, shock may develop
and the casualty may lose consciousness. Bleeding around the
mouth or face may affect breathing. When treating severe
bleeding, check first whether there is an object embedded in the
wound; take care not to press directly on the object. Do not let the
casualty have anything to eat or drink, as he may need an
anesthetic later.
Your aims:
To control bleeding
To prevent and minimise the effects of shock
To minimise infection
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Bleeding
Caution:
Do not allow the casualty to eat or drink because an anesthetic
may be needed
breathing
Actions:1
Remove or cut clothing as necessary to expose the wound.
Actions:2
Apply direct pressure over the wound
with your fingers using a sterile
dressing or clean, non-fluffy pad. If you
do not have a dressing, ask the
casualty to apply direct pressure
himself. If there is an object in the
wound, apply pressure on either side of
the object
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Bleeding
Actions:
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Maintain direct pressure on the wound to control

bleeding. Rise and support the injured limb above
the level of the casualtys heart to reduce blood
loss.
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Bleeding
Actions:
Help the casualty to lie down on a rug or a blanket if there is one, as

this will protect him from the cold. As shock is likely to develop, raise
and support his legs so that they are above the level of his heart.
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Bleeding
Actions:
Secure the dressing with a bandage that is firm enough to

maintain pressure, but not so tight that it impairs circulation
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Bleeding
Actions:6
If bleeding shows through the dressing, apply a second one on
top of the first. If blood seeps through this, remove both dressings
and apply a fresh one, ensuring that pressure is applied
accurately at the point of bleeding
Actions:7
Support the injured part in a raised position with a sling and/or
bandage. Check the circulation beyond the bandage every ten
minutes. If the circulation is impaired, loosen the bandage and
reapply.
Actions:8
Call for emergency help. Monitor and record vital signs level of
response, breathing and pulse while waiting for help to arrive.
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Bleeding
SPECIAL CASE: If there is an object in the wound.
Actions:
Control bleeding by pressing firmly on either side of the embedded

object to push the edges of the wound together. Do not press
directly on the object, or try to remove it. Raise the injury above the
level of the heart.
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Bleeding
SPECIAL CASE: If there is an object in the wound
Actions:
To protect the wound, drape a piece of gauze over the object. Build up
padding on either side, then carefully bandage over the object and pads
without pressing on the object. Check the circulation beyond the bandage
every ten minutes. If the circulation is impaired, loosen the bandage and
reapply
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Bleeding
SPECIAL CASE: If there is an object in the wound
Actions:3
Treat for shock. Call for emergency help. Monitor and record vital
signs level of response, breathing and pulse while waiting for
help to arrive.
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Dressings and Bandages

Dressings
Always cover a wound with a dressing because this helps to
prevent infection. With severe bleeding, dressings are used to
help the blood-clotting process by exerting pressure on the
wound. If a dressing is not available, use a sterile pad or a nonfluffy material. Protect small cuts with an adhesive dressing.
A Dressing
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Rules for using Dressings

These rules enable you to apply dressings correctly; they also
protect the casualty and yourself from cross infection.
Always wear disposable gloves, if these are available, before
handling any dressing.
Cover the wound with a dressing that extends beyond the
wounds edges.
Hold the edge of the dressing, keeping your fingers well away
from the area that will be in contact with the wound.
Place the dressing directly on top of the wound; do not slide it on
from the side.
Remove and replace any dressing that slips out of position
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Rules for using Dressings

If you only have one sterile dressing, use this to cover the wound,
and put other clean materials on it.
If blood seeps through the dressing, do not remove it; instead
place another dressing over the top. If blood seeps through the
second dressing, remove both dressings completely and then
apply a fresh dressing, making sure that you put pressure on the
bleeding point.
After treating a wound, dispose of gloves, used dressings and
soiled items in a suitable plastic bag (such as a yellow biohazard
bag). Keep disposable gloves on until you have finished handling
any materials that may be contaminated, then put them in the
bag.
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Bandages: There are three main types of bandages:
Roller bandages: these items are used to give support to injured
joints, secure dressings in place, maintain pressure on wounds
and limit swelling.
Roller Bandage
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Gauze Tubular Bandages: Gauze tubular bandages are used with
an applicator to secure dressings on fingers and toes. Elasticated
tubular bandages are sometimes used to support injured joints such
as the knee or elbow.
Gauze Tubular Bandage
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Triangular Bandages: Made of cloth, these items can be used
folded as bandages or slings. If they are sterile and individually
wrapped, they may also be used as dressings for large wounds
and burns. The triangular bandage can also be used for the
following:
As a whole cloth for fanning unconscious casualty
As a broad or narrow folded bandage for wounds
As a support for injuries and fractures
Scalp and head injury dressing
Triangular Bandage
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Making a Broad-Fold Bandage

A Triangular Bandage can be
folded as a broad-fold
bandage.
This broad-fold bandage can
be used to support and
immobilise a limb, or to secure
a splint or bulky dressing.
To make a broad-fold bandage, open out

a triangular bandage and lay it flat on a
clean surface.
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Making a Broad-Fold Bandage
Fold the bandage in half horizontally, so that the point of the triangle
touches the centre of the base.
Fold the bandage in half again in the same direction, so that the first
folded edge touches the base. The bandage should bow form a broad
strip
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Rules for applying a bandage

Reassure a casualty before applying a bandage and explain
clearly what you are going to do.
Help the casualty to lie down or sit in a comfortable position.
Support the injured part of the body while you are working on it.
Ask the casualty or a helper to do this.
Work from the front of the casualty and from the injured side
where possible.
Pass the bandages through the bodys natural hollows at the
ankles, knees; waist and neck, and then slide them into position
by easing them back and forth under the body.
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Rules for applying a bandage

Apply bandages firmly, but no so tightly that they interfere with
circulation to the area beyond the bandage.
Fingers or toes should be left exposed, if possible, so that you
can check the circulation afterwards.
Use reef knots to tie the bandages. Ensure that the knot does not
cause discomfort, and do not tie the knot over a bony area. Tuck
lose ends under a knot if possible, to provide additional padding.
Check the circulation in the area beyond the bandage every ten
minutes once it is secure. You can do this by briefly pressing on
one of the nails or the skin, until it turns pale, then release the
pressure.
If the colour does not return, or returns slowly, the bandage may
be too tight. If this happens, unroll the bandage until blood supply
returns, and reapply it more loosely.
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Burns
When skin is damaged by burning, it can no longer function

effectively as a natural barrier against infection. It is particularly
important to consider the circumstances in which the burn has
occurred; whether or not the airway is likely to have been
affected; and the extent, location and depth of the burn.
There are many causes of burns. By establishing the cause of the
burn, you may be able to identify any other potential problems
that could result. For example a fire in an enclosed space is likely
to have produced poisonous carbon monoxide gas, or other toxic
fumes may have been released if burning material was involved.
If the casualtys airway has been affected, he may have difficulty
breathing and will need urgent medical attention and admission to
hospital.
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Burns
The extent of the burn will also indicate whether or not shock is
likely to develop. Shock is a life-threatening condition and occurs
whenever there is a serious loss of body fluids. In the case where
a burn covers a large are of the body, fluid loss will be significant
and the risk of shock high.
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Burns
TYPES OF BURNS AND POSSIBLE CAUSES
Type of burn
Causes
Dry burn
Flames
Contact with hot objects (domestic appliances,
cigarettes)
Friction (rope burns)
Scald
Steam
Hot liquids (tea, coffee)
Electrical burn
Low-voltage current (domestic appliances)

High-voltage currents (mains overhead cables)
Lightning strikes
Cold burn
Frostbite
Contact with freezing metals
Contact with freezing vapours (liquid oxygen or
liquid nitrogen)
Chemical burn
Industrial chemicals (inhaled fumes, corrosive

gases)
Domestic chemicals and agents (caustic soda,
bleach)
Radiation burn
Sunburn
Over-exposure to ultraviolet rays (sunlamp)
Exposure to radioactive source (X-ray)
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Burns
CLASSIFICATION OF BURNS
Burns are classified according to the depth of skin damage. There

are three depths:
Superficial
Partial-thickness
Full-thickness
A casualty may suffer one or more depths of burn in a single
incident.
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Burns
Superficial burn
This type of burn involves only the outermost layer of skin.

It usually heals well if first aid is given promptly and if
blisters do not form. Superficial burns are characterised by
redness, swelling and tenderness. Sunburn is a common
type of superficial burn.
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Burns
Partial-thickness burn
This affects the epidermis, and the skin becomes red and raw. Blisters form over the
skin due to fluid released from the damaged tissues beneath. Partial-thickness
burns are very painful. They usually heal well, but can be very serious if they affect
more than 20% of the body in an adult and 10% in a child.
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Burns
Full-thickness burns
With this type of burn all the layers of the skin are affected; there may be some
damage to nerves, fat tissue, muscles and blood vessels. Pain sensation can
be lost, which masks the severity of the injury. The skin may look waxy, pale or
charred and needs urgent medical attention
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Burns
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Burns
BURNS THAT NEED HOSPITAL TREATMENT
If the casualty is a child, seek medical advice or take the child to

hospital, however small the burn appears. For adults, medical
attention should be sought for any serious burn. Such burns
include:
All full-thickness burns
All burns involving the face, hands, feet or genital area
All burns that extend right around an arm or leg
All partial-thickness burns larger than one per cent of the body
surface (an area the size of the casualtys palm and fingers)
All superficial burns larger than five per cent of the casualtys
body surface (equivalent to five palm areas)
Burns comprising a mixed pattern of varying depths.
If you are unsure about the severity of any burn, seek medical
advice.
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Burns
Severe Burns and Scalds
If a casualty has been injured in a fire, you should assume that
smoke or hot air has also affected his breathing. Your priorities
are to cool the burn (which stops the burning process and relieves
the pain) and to monitor his breathing. A casualty with a severe
burn or scald injury will almost certainly be suffering from shock
because of the fluid loss and will need urgent hospital treatment.
Keep an accurate record of what happened and what treatment
you have given. If you have to remove or cut away clothing, keep
it in case of future investigation.
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Burns
Recognition:
Possible areas of superficial, partial-thickness and/or fullthickness burns
Pain
Difficulty in breathing
Features of shock
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Burns
Your aims:
To stop the burning and relieve pain
To treat associated injuries
To minimise the risk of infection
To minimise the risk of shock
To gather information for the emergency services
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Burns
Actions 1:
Help the casualty to sit or lie down. If possible, try to prevent the
burnt area from coming into contact with the ground.
Actions 2:
Start cooling the injury.
Flood the burn with plenty
of cold water, but do not
delay the casualtys delay
to
hospital.
Call
for
emergency
help;
if
possible, get somebody to
do this while you cool the
burn.
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Burns
Actions 3:
Continue to cool the affected area for at least ten minutes or

until the pain is relieved. Watch for signs of breathing difficulty.
Do not over-cool the casualty because you may lower the body
temperature to a dangerous level. This is a particular hazard
for babies and elderly people.
Actions 4:
Do not touch the burn. Gently

remove any rings, watches
etc, before the tissues begin
to swell. A helper can do this
while you are cooling the
burn. Do not remove clothing
that is stuck to the burn.
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Burns
Actions: 5
Cover the injured area with kitchen

film to prevent it from infection.
Discard the first two turns from the roll
and then apply it lengthways over the
burn. A clean plastic bag can be used
to cover a hand or foot; secure it with
a bandage or adhesive tape applied
over the plastic, not the damaged skin.
Actions: 6 Reassure the casualty and treat him for shock if necessary.
Record details of the casualtys injuries. Monitor and record his

vital signs level of response, breathing and pulse while waiting
for help.
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Burns
Minor Burns and Scalds
Small, superficial burns and scalds are often due to domestic
accidents. After a burn, blisters may form. These are caused by
tissue fluid leaking into the burnt area just beneath the skins
surface. You should never break a blister caused by a burn
because you may introduce infection into the wound.
Recognition:
Reddened skin
Pain in the area of the burn
Later there may be blistering of the affected skin.
Your aims:
To stop the burning
To relieve pain and swelling
To minimise the risk of infection
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Burns
Caution:
Do not break blisters or otherwise interfere with the injured area
Do not apply adhesive dressings or adhesive tape to the skin;
removing them may tear damaged skin
Do not apply ointments or fats; they may damage tissues and
increase the risk of infection
The use of specialized dressings and, sprays, and gels to cool
burns is not recommended
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Burns
Actions:1
Flood the injured part with cold water for at least ten minutes or
until the pain is relieved. If water is not available, any cold,
harmless liquid, such as milk or can drinks can be used.
Actions:2
Gently remove any jewelry, watches, belts, or constricting
clothing (e.g. tie), from the injured area before it begins to swell
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Burns
Actions:
Cover the burn with kitchen film or

place a clean plastic bag over a
foot or hand. Apply the kitchen film
lengthways over the burn, not
around the limb because the
tissues swell. If you do not have a
kitchen film, use a sterile dressing
or non-fluffy pad and bandage
loosely in place
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Burns
Actions 4
Seek medical advice if the casualty is a child, or if you are in
doubt about the casualtys condition
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Burns
Burns to the Airway
Any burn to the face and/or within the mouth or throat is very
serious because the air passages rapidly become swollen.
Usually, signs of burning will be evident. Always suspect
damage to the airway if a casualty sustains burns in a confined
space since he is likely to have inhaled hot air or gases.
There is no specific first aid treatment for an extreme case of
burns to the airway; the swelling will rapidly block the airway,
and there is a serious risk of hypoxia (low blood oxygen).
Immediate and specialized medical help is required
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Burns to the Airway

Recognition: there may be
Soot around the nose or mouth
Singeing of the nasal hairs
Redness, swelling, or actual burning of the tongue
Damage to the skin around the mouth
Hoarseness of the voice
Breathing difficulties
Your aims:
Caution:
breathing
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Burns to the Airway Burns

Actions:1
Call for emergency help. When help arrives, tell them you suspect
burns to the casualtys airway
Actions:2
Take any steps possible to improve the
casualtys air supply, such as loosing
clothing around his neck.
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Burns to the Airway Burns

Actions:3
Offer the casualty ice or small sips of cold water to reduce
swelling and pain.
Actions:4
Reassure the casualty. Monitor and record vital signs level of
response, breathing and pulse while waiting for help to arrive.
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Electrical Burn
Burns may occur when electricity passes through the body.
There may be surface damage along the point of contact, or at
the points of entry and exit of the current. In addition, there may
also be internal damage between the entry and exit points.
Burns may be caused by a lightning strike or by a low or high
voltage electric current. Electric shock can cause cardiac arrest. If
the casualty is unconscious, your priority, once the area is safe, is
to open the airway and check his breathing.
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Electrical Burn
Unconsciousness
Full-thickness burns, with swelling, scorching and charring
Burns at points of entry and exit of electricity
Signs of shock
Your aims:
To treat the burns and shock
Caution:
Do not approach a victim of high-voltage electricity until the
current has been switched off
If the casualty is unconscious, open the airway and check his
breathing
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Electrical Burn
Actions 1:
Make sure that contact with the electrical source is broken before
you touch the casualty
Actions:2
Flood the injury with cold water
(at the entry and exit points if
both are present) for at least ten
minutes or until pain is relieved.
If water is not available, any
cold, harmless liquid can be
used.
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Electrical Burn
Actions:3
Gently remove any jewelry, watches, belts, or constricting clothing
(e.g. tie), from the injured area before it begins to swell
Actions:4
Place a clean plastic bag over a
burn on a foot or hand, or cover
the burn with kitchen film. The
burnt tissues will swell.
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Electrical Burn
Actions:5
Call for emergency help. Reassure the casualty and treat him for
shock. Monitor and record vital signs level of response,
breathing and pulse while waiting for help to arrive.
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Chemical Burn
Certain chemicals may irritate burn or penetrate the skin,
causing widespread and sometimes fatal damage. Most strong
corrosive chemicals are found in industry, but chemical burns
can also occur in the home; for instance from dishwasher
products, pesticides, oven cleaners etc.
Chemical burns are often serious, and the casualty may need
urgent hospital treatment. If possible, note the name and brand
of the burning substance. Before treating the casualty, ensure
the safety of yourself and others because some chemicals give
off poisonous fumes, causing breathing problems.
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Chemical Burn
Evidence of chemicals in the vicinity
Intense stinging pain
Later
Discoloration, blistering and peeling
Swelling of the affected area
Your aims:
To make the area safe and inform the relevant authority
To disperse the harmful chemical
To arrange transport to hospital
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Chemical Burn
Caution:
Never attempt to neutralize acid or alkali burns unless trained to
do so
Do not delay starting treatment by searching for an antidote
If the incident occurs in the workplace, notify the safety officer
and/or emergency services.
Actions 1:
Make sure that the area around the casualty is safe. Ventilate the
area to disperse fumes. Wear protective gloves to prevent you
from coming in contact with the chemical. If it is safe to do so,
seal the chemical container. Move the casualty if necessary. If the
chemical is in powder form, it can be brushed off the skin.
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Chemical Burn
Actions:
Flood the burn with water for at least 20 minutes to disperse the
chemical and stop the burning. If treating a casualty lying on the
ground, ensure that the contaminated water does not collect
underneath her. Pour water away from yourself to avoid splashes.
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Chemical Burn
Actions:3
Gently remove any contaminated clothing while flooding the
injury.
Actions:4
Arrange top take or send the casualty to hospital. Monitor and
record vital signs level of response, breathing and pulse while
waiting for help to arrive. Pass on details of the chemical to
medical staff if you can identify it.
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Burns
Burn Prevention
Burns of all kinds can be prevented easily. Keep household
chemicals out of reach of children.
Make sure hazardous chemicals are well marked and caps are
screwed on tight.
Keep hot object safely out of reach and make sure to turn off
heaters and stovetops when finished to prevent burns.
Keep socket caps over all unused electrical sockets to protect
against electrical shock.
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Sprain, Strain and Dislocation

A Sprain is an injury to the soft tissue, or ligaments, around a
joint. It is often due to a sudden or unexpected wrenching
motion that pulls the bones in the joint too far apart, and tears
the surrounding tissues.
A Strain is an injury to muscles and tendons. A strain occurs
when the muscle is overstretched; it may be partially torn, often
at the junction between the muscle and the tendon that joins it
to a bone.
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A Dislocation is when the bone becomes separated from the
joint it meets, or it pops out of its socket. This sometimes
happens when the bone and joint are overstressed. It can also be
caused by contact sports, rheumatoid arthritis, inborn joint
defects, and suddenly jerking that arm or hand of a small child.
Dislocation is most common in the shoulders, but fingers, hips,
ankles, elbows, jaws, and even the spine are also prone to
dislocation.
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Sprain, strain and Dislocation
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Recognition:
Pain and tenderness
Swelling and bruising in the area
Difficulty in moving the injured part, especially if it is a joint
A discoloration
Your aim:
To reduce swelling and pain
To prevent movement of the injury site
To obtain medical help if necessary
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Caution:
For dislocation, do not try to replace a dislocated bone into its
socket as this may cause further injury
For dislocation, do not move the casualty until the injured part is
secured and supported, unless she is in immediate danger
For a hand or arm injury remove bracelets, rings and watches in
case of swelling
Do not allow the casualty to eat or drink because an anaesthetic
may be needed
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Actions:
Strains and sprains should be treated using the RICE procedure.
R Rest the injured part
I apply Ice pack or a cold pad
C provide Comfortable support
E Elevate the injured part
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Actions:
For Dislocation
Advice the casualty to keep still. Help her to support the injured
arm in the position she finds most comfortable
Immobilise the injured arm with a sling, or use broad-fold
bandages for a leg injury
Place padding between the injured limb and the body. For extra
support for an injured arm, place a broad-fold bandage around
the sling and the body
Arrange to take or send the casualty to hospital. Treat for shock if
necessary. Monitor and record vital signs while waiting for help to
arrive.
Check the circulation beyond the bandages every 10 minutes
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Near Drowning
Almost drowning, or near drowning, is a frightening experience and
potentially fatal. There are two kinds of this:
Wet- Where the person has taken water into their lungs, and the lungs
function has been affected
Dry- Less common condition where the airways close due to spasms
induced by water.
When rescuing someone who has nearly drowned, make sure to watch out
for your own safety as well, do not attempt a rescue that is beyond your
abilities. Let other people help out as well, for example, if you are not
physically strong do not attempt to remove someone larger than you from the
water, let someone else do this while you wait onshore ready to begin
resuscitation.
From such an incident the following could result: hypothermia due to
immersion in cold water, sudden cardiac arrest and spasm of the throat
blocking the airway.
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Near Drowning
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Near Drowning
A casualty rescued from a near drowning incident should always
receive medical attention even if he seems to have recovered at
the time. Any water entering the lungs causes them to become
irritated, and the air passages may begin to swell several hours
later a condition known as secondary drowning.
Recognition:
Pale, cool skin
Weak or absent pulse
Labored or absent breathing
Slightly conscious or unconscious
Cyanosis (bluish discoloration of the skin)
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Near Drowning
Your aim:
To restore adequate breathing
To keep the casualty warm
Caution:
If the casualty is unconscious, open the airway and check
breathing.
If the casualty is not breathing give five initial rescue breaths
before you start chest compressions. If you are alone, give CPR
for one minute before you call for emergency help.
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Near Drowning
Your actions:
If you have rescued the casualty from the water, help him to lie
down on a rug or coat with his head lower than the rest of the
body so that water can drain from his mouth. This reduces the
risk of inhaling water.
Treat the casualty for hypothermia; replace wet clothing with dry
clothes if possible and cover him with dry blankets or coats. If the
casualty is fully conscious, give him a warm drink.
Call for emergency help even if he appears to recover fully
because of the risk of secondary drowning. Monitor and record
his vital signs level of response, breathing and pulse until help
arrives.
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Conclusion
The qualified and certified first aider is a life saver. However, he is
able to prevent a bad condition from getting worse or promote
recovery when he performs his functions with promptness- time is
essential in first aid.
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Lesson Objectives
You should now be able to:
Show the basic principles of rendering First Aid
Show the basic procedure to determine the root cause of a condition
Show the process to stabilise a patient until medical help arrives
Show how to safely clear a victims air passage
Show the process for rendering mouth-to-mouth resuscitation
Show the process to deal with Choking
Show the process to render basic CPR
Show the process to deal with a victim suffering from 'fits'
Show the basic principles of controlling bleeding and safety precautions
Show the process to assess for possible internal bleeding
Show the process of handling victims with possible Spinal Cord injuries
Show the process of managing Burns
Show the process of managing Sprain, Strain and Dislocation
Show the process of managing Drowning casualty
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HES First Aid 9800 05

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HES First Aid 9800 05

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HES

9800-05: First Aid

9800-05: First Aid

9800-05: First Aid

9800-05: First Aid

What is First Aid?

9800-05: First Aid

Aims of First Aid

9800-05: First Aid

Parties involved in Managing First aid

9800-05: First Aid

Who is a First Aider?

A person who provides help or assistance to an injured person before the

9800-05: First Aid

Qualities of a First aider

9800-05: First Aid

Responsibilities of a First aider

9800-05: First Aid

Responsibilities of a First aider

9800-05: First Aid

Who is an Appointed Person?

9800-05: First Aid

Priorities of First Aid

9800-05: First Aid

Primary Survey- DRABC

The primary survey is a quick, systematic assessment of a

9800-05: First Aid

Assess for Danger (D)

9800-05: First Aid

Check for Response (R)

Check Airway (A)

9800-05: First Aid

Head tilt - chin lift

9800-05: First Aid

Head tilt - chin lift,

Check for Breathing (B)

9800-05: First Aid

Check for Breathing (B)

9800-05: First Aid

Look, listen and feel for breath

9800-05: First Aid

Check for disruption in blood Circulation (C)

9800-05: First Aid

The ABC Flowchart

9800-05: First Aid

The secondary survey follows the primary survey and it is a

9800-05: First Aid

9800-05: First Aid

Secondary Survey- History

Secondary Survey- Symptoms

9800-05: First Aid

Secondary Survey- Signs

These are features such as swelling, bleeding, discoloration,

9800-05: First Aid

Secondary Survey- Head-To-Toe Examination

Secondary Survey- Head-To-Toe Examination

9800-05: First Aid

Secondary Survey- Head-To-Toe Examination

9800-05: First Aid

Secondary Survey- Head-To-Toe Examination

9800-05: First Aid

The Recovery position

A person who is unconscious is at risk of dying because of a

9800-05: First Aid