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MODULE-16

FIRST AID
CONTENTS
 First Aid
 History
 Scope of First Aid
 Aims of First aid
 Qualities of Frist aider
 Health related fitness
 Priorities in First aid
 Head Injuries – First Aid
 Shock – First aid
 Chemical Burns – First aid
 Bleeding – Control , Noise Bleed
 Burns – First Aid
 Scalds
 Dog Bite
 Snake Bite
 Insect Bite
 Fractures – First aid
What is a first aid
Immediate treatment ,help given to a
sick or injured person until full medical
treatment is available.
FIRST AID
IT IS THE IMMEDIATE
TREATMENT GIVEN TO THE
VICTIM OF AN ACCIDENT OR
SUDDEN ILLNESS BEFORE
MEDICAL HELP IS OBTAINED
FIRST AID TO THE INJURED
HISTORY
F.A IS AS OLD AS MANKIND
F.A. IS BASED ON SCIENTIFIC STUDY OF
MEDICINE AND SURGERY.
IT IS SKILLED ASSISTANCE
AN IDIVIDUAL WITH ELEMENTARY
EDUCATION CAN ALSO DO IT.
DHANVANTARY, SUSHRUTHA, HAKIMS OF
MOGHAL EMPIRE DID IT.
RED + CROSS
HENRY DUNANT IN 1863 STARTED RED
CROSS SOCIETY IN GENEVA
St’ JOHN AMBULANCE ASSOCIATION
FORMED IN ENGLAND IN 1877.
MAHATMA GANDHI LED A BAND OF
DEDICATED AMBULANCE CORPS
VOLUNTEERS IN 1906 IN INDIA.
SCOPE OF FIRST AID

EXAMINATION & DIAGNOSIS

TREATMENT

DISPOSAL
AIMS OF FIRST AID
PRESERVATION OF LIFE

PROMOTION OF RECOVERY

PREVENTION OF COMPLICATIONS

ARRANGE FOR TRANSPORTATION


QUALITIES OF FIRST AIDER
INTEREST IN HUMAN RESCUE
COOL, CALM, CONFIDENT, CAREFUL
INSPIRATION TO Tt A FRIEND OR FOE.
OBSERVE,THINK CLEAR, ACT QUICK
HE IS’NT A DOCTOR. HE SHOULD NOT
OVERACT.
HE SHOULD APPLY SCIENCE &
COMMON SENSE METHODICALLY.
Health related fitness
Aerobic fitness - ability of the heart
and lungs to deliver blood to muscles,
Muscular strength and
endurance - enough to do normal
activities easily and protect the low
back,
Flexibility - ability to move your
many joints through their proper
range of motion.
PRIORITIES IN FIRST AID
EXAMINATION & DIAGNOSIS
CARDIO-PUL RESUSCITATION
CONTROL OF BLEEDING
TREATMENT OF SHOCK
IMMOBILISATION OF # S, DRESSING
INJURY TO SPECIAL ORGANS
CARE OF UNCONSCIOUS
TRANSPORTATION OR DISPOSAL
HEAD & NECK INJURY
HEAD INJURY
SEVERE HEAD ACHE, STIFF NECK
BLEEDING NOSE, EARS, DENTING
UNEQUAL PUPIL SIZE
PERSISTENT VOMITTING
SLURRED SPEECH, DECREASED
ALERTNESS, LAPSES IN CONSCIOUSNESS
UNUSUAL EYE MOVEMENTS.
d
severe head trauma occurs
Keep the person still. Until medical help
arrives, keep the injured person lying
down and quiet, with the head and
shoulders slightly elevated. ...
Stop any bleeding. Apply firm pressure
to the wound with sterile gauze or a
clean cloth. ...
Watch for changes in breathing and
alertness.
CERVICAL PILLOW
FIRST AID FOR NECK INJURY
FIRST AID FOR NECK INJURY
Call 101 or emergency medical help.
Keep the person still. Place heavy
towels on both sides of the neck or
hold the head and neck to prevent
movement. Modify CPR technique
Cardiac
Cardiac Cycle
Symptoms of chest pain
Breathlessness
Profuse sweating
Apprehension/ frustration / restlessness
Vomiting with or without loose motion
Pain chest radiating to back / neck / left arm
Unconsciousness
Froth coming out of mouth
paralysis seen in the lower limbs.
First Aid. If you think someone
is having a heart attack:
Ask if the person takes any chest pain
medicine, such as nitroglycerin, for a
known heart condition, and help them
take it. If the pain does not go away
promptly with rest or within 3 minutes of
taking nitroglycerin, call for emergency
medical help
What is shock
Shock is a life-threatening condition
that occurs when the body is not
getting enough blood flow. Lack of
blood flow means the cells and organs
do not get enough oxygen and
nutrients to function properly. Many
organs can be damaged as a result.
Shock?
What do you do when someone
is in shock?
Lay the Person Down, if Possible. Elevate the person's feet
about 12 inches unless head, neck, or back is injured or you
suspect broken hip or leg bones. ...
Begin CPR, if Necessary. If the person is not breathing or
breathing seems dangerously weak: ...
Treat Obvious Injuries.
Keep Person Warm and Comfortable. ...
Follow Up.
SHOCK
H.AGIC SHOCK
HEART ATTACK
G.E SHOCK
GAS POISONING
SNAKE BITE
FRACTURE SHOCK
ELECTRICAL SHOCK
BURNS SHOCK
CHEMICAL EXPOSURE
CHEMICAL BURN
CHEMICAL BURN
PERMISSIBLE LEVELS
CHLORINE---------------- 1 PPM
SULPHUR DIOXIDE--- 5 PPM
BENZENE --------------- 10 PPM
AMMONIA ------------- 25 PPM
CARBON MONOXIDE– 50 PPM
TCE., TURPENTINE---- 100 PPM
ETHYL CHLORIDE ---- 1000 PPM
ACETYLENE ----------- 2500 PPM
CARBON DIOXIDE ---- 5000 PPM
CN, Hg, COCL2 ---- < 0.01 PPM
EXAMPLE OF CHLORINE
ODOUR PERCEPTION –3.5 PPM
M.A.C----------------------- 1 PPM
S.T.E. L -------------------- 10 PPM
SOB, Chest pain, n,v, Cough ---30 PPM
UNCONCIOUSNESS ---100 PPM
FATAL Complications Pul. Edema, and Death
> 300 PPM
Basic treatment for chemical
Exposure
Most standard sources recommend that
water rinsing/flushing following skin or
eye contact with a chemical should
continue for 15 or 20 minutes.
However, all chemicals do not cause the
same degree of effects (some are non-
irritants while others can cause severe
corrosive injury).
MANAGEMENT OF STROKE
AS PER “DRACB” ACTION PLAN OF St.
JOHN AMBULANCE ASSOCIATION :
D----CHECK FOR DANGER / DRUGS
R---- CHECK RESPONSE
A---- CHECK AIRWAY
C--- CHECK CIRCULATION /GIVE C.P.R.
B-----CHECK FOR BREATHING
Check for response
FIRST RESPONSE
OBSERVE CAREFULLY
THINK CLEARLY
ACT QUICKLY
TO LOOK FOR DANGER :
TO YOU
TO OTHERS
TO THE AFFECTED PERSON
A - FOR AIRWAY
CHECK IF THE AIRWAY IS CLEAR
KNEEL BESIDE THE PERSON
CLEAR THE AIRWAY IF ANY OBJECTS LIKE
PARTIAL DENTURES ARE LYING.
BEND THE TOP LEG AT KNEE TOUCHING THE
GROUND. KEEP THE OTHER LEG STRAIGHT.
PLACE THE ARMS NEAR THE CHEST,ONE AT
RIGHT ANGLES TO CHEST.
TO CLEAR AIR WAY
SCHAFER’S METHOD
Normal Lungs
Chest Radiograph in Disease
 Severe dyspnea
 Worker sought
retirement from work
 X-ray shows
extensive PMF
 Worker expired
within six months
after the x-ray
PNEUMO-THORAX
PNEUMO-THORAX
DEFINATION
the presence of air or gas in the cavity
between the lungs and the chest wall,
causing collapse of the lung.
CLEAR THE AIR WAY
RESCUE BREATHING
Rescue Breathing
B- FOR BREATHING
WATCH IF THE VICTIM IS BREATHING
IF NOT KEEP HIM IN SUPINE POSITION
TILT THE HEAD BACKWARDS
PINCH HIS NOSE & GIVE 2 MOUTH TO
MOUTH BREATHS AND OBSERVE.
IF NO EFFECT GET READY TO DO C.P.R.
Mouth to Mouth Breathing
Mouth to mouth Breathing
C FOR--- C.P.R
CARDIO-PULMONARY RESUSCITATION
DO NOT START CPR IF THE PERSON IS
BREATHING.
WITH TWO HANDS INTER LOCKED KEEPING
OVER THE LOWER END OF BREAST BONE GIVE
15 CHEST COMPRESSIONS ALTERNATING BY 2
MOUTH TO MOUTH BREATHS UNTIL
RECOVERY/ MEDICAL HELP ARRIVES.
CONTROL OF BLEEDING
CHECK PRESSURE POINTS
ELEVATION OF BLEEDING LIMB
APPLY TOURNIQUET
APPLY PRESSURE BANDAGE
INFORM FOR BLOOD GROUPING
PLENTY OF FLUIDS/ O.R.S
CHECK FOR EPISTAXIS, BLOOD VOMIT,
INTERNAL BLEED
CONTROL OF BLEEDING
DIRECT PRESSURE
NOSE BLEED
Don’t panic
Pack nostrils with
lubricant cotton swab
Instill decongestant
nasal drops
Make the causality lie
down
Reassure him.
Degrees of Burn
First degree burn: when superficial layers of
the outer skin is burnt it will be red , swollen,
painful.
Second degree burns involve the outer layer
completely and some superficial layers of the
dermis ie., 2nd layer. Intense pain, blisters,
deeply reddened. If the area is larger than 3
inches or if it is on an imp. body part treat it as
major burn.
Burn injuries
Degree of burns contd..

Important areas even if the burn is less


than 3” ( 7.5 Cm) are
Face
Hands
Feet
Major joints
groins
3 rd Degree Burns
Most serious burns involve all layers of skin
with permanent tissue damage.
Fat , muscle and even bone may be affected.
Areas may be charred black or appear dry and
white.
Difficulty in inhaling or exhaling, or
breathlessness due to CO poisoning.
Toxic effects may develop if smoke inhalation
accompanies the burn.
DRY BURN INJURY
RULE OF NINE
Burns to vital organs
SCALDS
DO NOT USE ADHESIVE DRESSINGS
DO NOT BREAK BLISTERS / INTERFERE
DO NOT APPLY LOTIONS, CREAMS
GENTLY REMOVE RINGS/ WATCHES
COOL THE INJURY WITH WATER
APPLY STERILE DRESSING, COVER WITH
CLEAN PLASTIC BAG.
F.A in Minor Burns
Do not use fluffy cotton or other material
that may get lint into the wound.
Wrap the gauze loosely to avoid pressure
on the wound.
Bandaging reduces pain.
Protects the blistered skin.
Keeps off air and dust that leads to
infection.
Take a pain killer across the pharmacy
counter
F.A . In Minor Burns… tips
Usually heal without treatment.
They may heal with pigment changes.
Use sun screen on the area for at least
one year to avoid pigmentation.
Do not use ice– avoid cold injury.
Don’t use ointments nor apply butter.
Do not break blisters. Broken blisters are
more vulnerable to infection.
F.A in Major Burns
Don’t remove burnt clothing.
Don’t immerse large severe burns in cold
water. It could lower the body
temperature & blood pressure
(Hypothermia & shock)
Ensure that the victim is not exposed to
smoke and heat
Check for A,B,C,D and start C.P.R if
required.
Cover the area with cool sterile, moist
bandage, or clean moist cloth / towel.
Safe pain killers
Acetaminophen
Naproxen
Advil or ibuprofen
Tylenol
Children and teen agers recovering
from viral infections should never take
Asprin.
Get a Tetanus toxoid injection.
F.A in Chemical Burns
Remove the cause of the burn
Remove the clothes and jewelry
Rewash the burnt area for 20 mts or more if
the victim feels more pain after initial washing.
Wrap the burned area loosely.
Seek emergency medical assistance
Need for Emergency Medial
assistance
In case of pallor, fainting, shock
Penetration of chemical beyond the outer layer
of the skin.
Area of burn more than 3 inches
Burn involving eyes, face, hands , major joints,
groin, buttocks, feet.
When the pain cannot be controlled by over the
counter pain relievers.
MAD DOG BITE
DOG BITE
DOG BITE
SNAKE BITE
Sharp pain
Bruise
Swelling
Weakness
Fear / apprehension
Breathlessness
Blurred vision
Drowsiness
vomiting
INSECT & ANIMAL BITES
REASSURE AND INSTIL CONFIDENCE
ARREST SPREAD OF POISON
SQUEEZE OUT POISON
DO’ NT APPLY TIGHT BANDAGE
CHECK PULSE, RESP, LEVEL OF
CONSCIOUSNESS
CALL FOR DOCTOR/ AMBULACE
SNAKE BITE INJURY
SNAKE BITE
CELLULITIS OF LEG
Insect bites
Redness, pain
swelling
Itching, chest pain
Breathlessness
Palpitation
Dizziness
Apply ice pack and
anti allergy drugs.
ARRESTING THE SPREAD OF
POISON
INFECTED SNAKE BITE
FATAL ACCIDENTS
Dog bite / animal bites
Clean the wound with soap & running water
thoroughly
Do not apply tight bandage or close the wound.
Get injection T.T and consult doctor for anti
Rabies treatment.
Do not kill the animal but observe for 15 days.
Bite by H.I.V Patient
Wash the wound thoroughly with soap and
running water
Immediately test for P.C.R within 24 hours.
Consult AIDS control center for prophylactic
treatment.
FIRST AID
Wash with soap water
Don’t elevate the area
Don’t cut & suck.
Remove constricting clothes &
jewelry.
Administer antivenin
Wrap extremity with elastic
pressure bandage
Immunize with T.T
FIRST AID IN SNAKE BITE
REASSURE
GIVE PAIN KILLER
ANTIBIOTICS
PREPARE FOR ARTIFICIAL RESPIRATION
DON’T ALLOW THE VICTIM TO RUN/
EXERTION
Tetanic Spasm
Rusted Nails
Nail Prick
Tetanus patient
PORTABLE KIT
F.A KIT FOR SPECIAL WORKS
CONTENTS OF F.A. BOX

First aid book with latest contact details of


nearest hospitals, ambulance, fire service,
police etc.
List of first aiders, contact Nos. of head of the
organization, safety committee, disaster
management centre and any other relevant
information needed in case of an emergency.
Contents of F.A. KIT
Sterile bandages of assorted sizes.
Sterile absorbent pads of various sizes
Two pairs of latex gloves, safety pins
Tweezers , scissors, pen torch
Adhesive tape, triangular & roller bandages,
band aids, cotton roll.
Antiseptic solution, cleansing soap
Pain killers, Antacids, towels.
CREPE BANDAGE TO ARREST
BLEEDING
TENSOR BANDAGES
EYE PAD
CONTENTS OF F.A BOX
ADDRESSES OF IMPOTANT TEL. NO’S
6 EACH- T & ASSORTED BANDAGES
SPLINTS , TOURNIQUET, TORCH
SCISSORS, BLADE, STERILE PADS.
ANSEPTICS, PAIN KILLERS, SMELLING SALT,
ADHESIVE PLASTER, SAFETY PINS, ALL TO BE
CHECKED OFTEN
ASPRIN,AVIL, SORBITRATE, ANTACIDS.
ELBOW # OR DISLOCATION
GAUZE PADS
TRIANGULAR BANDAGE
FULL ‘T’ BANDAGE

BROAD ‘T’ BANDAGE

NARROW ‘T’ BANDAGE.


ARM SLING
ARM SLING
T-BANDAGE FOR THE HEAD
SPIRAL & REVERSE SPIRAL
BANDAGE

FOR CONTROL OF BLEEDING

FOR IMMOBILISATION

CONTROL OF INFECTION

CONTROL OF INFLAMMATION.
WRIST BANDAGE
FINGER BANDAGES
IMMOBILIZATION OF DRESSING
MANAGE MENT OF # S
PAIN, TENDERNESS, DEFORMITY, LOSS OF
FUNCTION, PULSE, CREPITUS
IMMOBILISE IN RESTING POSITION
USE SPLINTS WHERE NECESSARY
USE T- BANDAGE
FULL –T, BROAD—T
NARROW – T BANDAGE
DRESS ALL TYPES OF INJURIES
Fracture neck of humerus
COLLAR BONE #
Shoulder dressing
Fracture
Swelling of the
thumb, redness
Pain and tenderness
Inability to use / loss
of function
Crepitus
Pressure on nerves
and vessels
SPINAL INJURY
SWIFT IMMOBILIZATION IS THE PRIORITY.
CHECK FOR SIGNS OF LIFE
SUPPORT CASUALITY’S NECK AND SPINE AT ALL
TIMES.
IF CASUALITY IS UNCONSCIOUS PUT HIM IN
RECOVERY POSITION
IF CASUALITY IS ALERT DONOT MOVE BUT SUPPORT
HIS HEAD ON A SPINE BOARD
SPINAL BOARD
SPINAL BOARD & HEAD REST
SPINAL BOARD APPLICATION
TRANSPORTATION IN SPINE
INJURY USING SPINE BOARD
UNCONSCIOUS PATIENT
A.B.C.D ANALYSIS
NOTHING BY MOUTH
KEEP IN RECOVERY POSITION
TAKE NOTE OF ATTENDENTS
CIRCUMSTANTIAL EVIDENCE
QUICKLY INFORM DOCTOR
ARRANGE FOR AMBULANCE
TO CLEAR AIR WAY
ELECTRICAL INJURY & POWER
MEDICINE
In India transmission lines carry 250 volts
Domestic lines carry 220 volts electricity.
Whereas in other countries it is 110 volts.
Electrical shock is a true shock.
1/3 rd of surface burns to the body by electrical
burns will be fatal.
ELECTRICAL HAZARD
Car battery or even 6 volts battery can be
hazardous if skin is ulcerated.
Dry skin has 1 lakh ohms of resistance
It falls to 1000 when the skin is wet.
Our body runs by electrical impulses
EEG, ECG, ERG, EMG ARE EXAMPLES to that
effect.
CASE STUDIES
ESIC INCIDENT
PLUMBER DRAWING G.I. PIPES FROM TOP
FLOOR IN AN APARTMENT.
SLAB CONTRCCTOR TRYING TO PUSH THE
LINES TO MAKE WAY.
LEAKAGE OF CURRENT FROM STREET
POLES IN RAIN
MANAGING ELECTRICAL
SHOCK
SHOCK ON ‘T’ WAVE WHEN THE HEART IS
RELAXING IS DANGEROUS. VENTRICULAR
FIBRILLATION ., AND CARDIAC ARREST ARE
SEQUELAE OF ELECTRICAL SHOCK
PROLONGED ARTIFICIAL RESPIRATION IS A
LIFE SAVING MEASURE.
ELECTRO-CARDIOGRAM
JOULE BURNS
SKIN HAS THE HIGHEST RESISTENCE IN THE
BODY . SO BURNS INVOLVE DEEPER LAYERS
IN THE SKIN WHEN A CONTACT IS MADE
WITH A LIVE CONDUCTOR.
DEEP BURNS ARE SLOW TO HEAL WITH LOT OF
SCARRING.
H > I 2(SQUARE) RT
ELECTRICAL FLASH BURNS
Electric Shock- effects
SINGENING OF HAIR
ANGINA ELECTRICA
ELECTRICAL CATARACT
AGING OF SKIN WITH WRINKLES
ELECTRICAL PSYCHOSIS
LOSS OF LIMBS, INJURIES.
BODY RESISTENCE TO
ELECTRICITY
INTERNALLY IT HAS 500 OHMS ‘R’
TINGLING HEAT, PAIN FELT AT 10 Ma
Tetanic spasm of chest muscles & cessation
of respiration at 20 to 40 mA.
Respiratory arrest without V.F occurs when
current passes through Resp. center.