Definition of First aid

Help given to a sick or injured person

until full medical treatment is
available.

 The purposes of first aid:

1) To save a life
2) To prevent further injury
3) To preserve vitality and resistance
to infection

Chain of Survival

Early
Access 9911

Early
First
Aid/CPR
You

Early
Defibrilla
tion
Scene

Early
Advanced
Care
Hospital

Principles cont
o Make sure the airway is open and
clear,place the victim in appropriate
position
o Do not let the crowd gather provide
fresh air
o Be calm. assess and note all major
injuries and wounds and give first
aid.
o If breathing stops give immediate
artificial respiration

Principles cont
o If there is bleeding try to stop
bleeding
o Prevent shock and arrange for
transportation to health care facility.
o Keep the victim warm and let him/her
lie down in comfortable position
o Victim should send to hospital by
fastest means of transport,never
send alone

Principles cont
o Always inform police about serious
accidents
o Remove foreign body which can
easily be removed or wiped out
o Loosen tight clothes
o Handle the victim gently
o Support the wound site or fracture.

Purposes of first aid

1) To save a life
2) To prevent further injury
3) To preserve vitality and resistance to
infection
The ABCDE of life support constitutes the
absolute top priority of first aid
A:airway
B: breathing
C: circulation D: deformity and E: environment

Steps of firstaid
1. Assessment of the situation :
. help the victim until a doctor or
qualified person arrives
. Be calm and take responsibility
. Ensure safety
. Make use of volunteers

2.Assessment of the victim:

With he help of eyes, ears, smell
and touch ,one can diagnosis
precisely what is wrong with the
victim.
Look: look for Breathing, change of color and
cyanosis
Swelling, bleeding and deformity
Any container,bottles, and drug
packet

 Listen: listen to The bystander to know what was

happened
Breathing sound
If the victim ask question e.g how are
you?
Do you have any pain or loss of
sensation in any body part?
Smell: note the breathing and
surroundings
Touch: touch gently and carefully
,examine head to toe.

3. Give immediate and appropriate

treatment according to the principle
of first aid
4. Refer the victim to nearest Doctor,
hospital or home as needed

Choking
What is it?
Obstruction in the airway.

General Precaution
If someone is coughing, leave the person alone.
Do not perform the Heimlich Maneuver.

Keep eyes on that person.

Ask the person if he/she needs help.

Signs and Symptoms

Person is not able to breath or talk due to obstruction,
choking sign given, distressed, and panic.
Hands wrapped around the neck is universal sign for
choking.

Sign and symptoms cont

Violent coughing
Asphyxiated
Unable to speak and breath
Blue or pale lips and skin
Complaining of burning sensation in
substernal region
Prominent vein in neck
May develop loss of conscious in
complete throat obstruction.

First aid treatment

Reassure the victim .open airway and
remove any false teeth or foreign
bodies
Encourage the victim to cough
Help the victim to bend forward with
the lower than lungs
Firmly slap the victim between the
shoulder blades up to four times with
hands .this helps to remove
obstruction.

First aid treatment

Stand behind the patient and give
the victim strong upward jerk
,repeat jerk four times.
Check the victims mouth again
Repeat the back slaps and abdominal
thrusts if necessary

On an Unconscious
Person
If person is lying down, straddle the person with
your knees
Place heel of one hand above waistline
Place other hand over the first
Give four inward and upward thrust
Repeat till object is coughed out
If the victim is unconscious start artificial
respiration and transfer to hospital.

Prevention

While eating, concentrate on the task

Do not eat quickly, without chewing
Supervise children while they eat
Give easily chewable, soft food to
children
Do not leave tiny objects within the
reach of children

Shock
Definition: Shock is a medical
emergency in which the organs and
tissues of the body are not receiving
an adequate flow of blood. This
deprives the organs and tissues of
oxygen (carried in the blood) and
allows the buildup of waste products.
Shock can result in serious damage
or even death.

Shock
Shock refers to circulatory system failure
that happens when insufficient amounts
of oxygenated blood is provided for every
body part. This can be as the result of:
Loss of blood due to uncontrolled bleeding or
other circulatory system problem.
Loss of fluid due to dehydration or excessive
sweating.
Trauma (injury)
Occurrence of an extreme emotional event

causes

Severe or extensive trauma

Heart attack or severe chest pain
Excessive loss of body fluids
Severe allergy
Poisons

Types of shock

Hypovolemic
Cardiogenic
Septic shock
Neurogenic shock
Anaphylactic shock

 Hypovolemic shock:this is the most common

types and results from loss of fluids in
intravascular space.
Cardiogenic shock:it is caused by failure of
the heart to pump an adequate blood to
vital organ. It may occur after myocardial
infraction.
Septic: inadequate tissue perfusion
associated with bacteremia due to
underlying infection
Anaphylactic : caused by antigen antibody
response and a life threatening condition by
hypersensitivity reaction.

Shock Cont.
What to Look For(sign and symptms)
Altered mental status
Anxiety and restlessness

Pale, cold, and clammy skin, lips, and nail

beds
Nausea and vomiting, profuse sweating
Rapid breathing and pulse
Unresponsiveness when shock is severe
Breathing difficulty
Loss of consciousness

Shock Cont.
What to Do
After first treating life-threatening
injuries such as breathing or bleeding,
the following procedures shall be
performed:
Lay the victim on his or her back
Raise the victims legs 8 12 to allow the
blood to drain from the legs back to the
heart.
Prevent body heat loss by putting blankets
and coats under and over the victim

 If external bleeding present ,stop

immediately
Give stimulant tea , coffee, if there is no
brain injury
Assess the causes of shock
Looses tight clothes to help circulation
and assist breathing
If breathing and heart beat stops,then
establish airway and begin resusciation
immediately
Do not move the casualty unnecessarily
Transfer to hospital if condition does not
improve

Burn

A burn is a type of injury to the skin

caused by heat, electricity, chemicals,
light, radiation or friction.
A burn is an injury to the skin or other
organic tissue primarily caused by heat or
due to radiation, radioactivity, electricity,
friction or contact with chemicals. Skin
injuries due to ultraviolet radiation,
radioactivity, electricity or chemicals, as
well as respiratory damage resulting from
smoke inhalation, are also considered to
be burns.

Types of burn
Heat burns (thermal burns) are
caused by fire, steam, hot objects, or
hot liquids. Scald burns from hot
liquids are the most common burns
to children and older adults.
Cold temperature burns are
caused by skin exposure to wet, or
cold conditions.
Electrical burns are caused by
contact with electrical sources or by

Types of burn cont

Chemical burns are caused by contact with
household or industrial chemicals in a liquid,
solid, or gas form.eg.bleach,amonia,oven
cleaner,wood preserver etc.
Radiation burns are caused by the sun,
sunlamps, X-rays, or radiation therapy for
cancer treatment.
Friction burns are caused by contact with any
hard surface such as roads ("road rash"),
carpets, or floor surfaces. They are usually both
a scrape (abrasion) and a heat burn.

Types of burn a/c to extent of injury

Superficial partial thickness (1 st
degree)burn:burns affects epidermis
causing erythemia,edema,and
pain,fluidloss slight especially if lessthan
15% of body surface is involved
Deep partial thickness(2nd degree):burn
affects epidermis and dermis causing
erythemia,pain, vesicles with
woozing,fluidloss to moderate especially if
lessthan 15% body surface is involved

Types of burn a/c to extent of injury

Full thickness(3rd degree):burn affects
entire dermis and at times
subsutaneous tissue,resulting in
pearly white ,dry skin and absence of
pain,fluidloss usually
severe,especially if more than 20%of
the body surface is involved.
Full thickness(4th degree):burn
involves skin,fat, muscles and bone .

First degree burn

Second degree

Third degree burn

Fourth degree

Sign and symptoms

Skin becomes red and raw

Blister and damages tissue
Severe pain(depends on degree)
Sometimes skin becomes black
Swelling of affected area
Restless and thirsty
Extreme tenderness
Oozing of fluid
Shock may be in severe burn

Assessing Burns and Planning

Resuscitation: The Rule of Nines

Head/neck - 9%
Each arm - 9%
Anterior thorax - 18%
Posterior thorax - 18%
Each leg - 18%
Perineum - 1%

First aid treatment

Reassure the victim
If the victims clothing is on the fire
lay the victim down and put out the
flame with water and wrap him,with
thick material eg blanket
Lay the victim flat on the ground but
dont roll the victim
Immerse the burnt part in cold water
and keep for 15-20 mins or until pain
is relieved

First aid treatment

Remove the victims wet clothing and
jewellery carefully as the swelling
may develop later on make it difficult
to remove
Cover the burn site with clean
dressing to prevent infection
If condition permits ,provide fluid to
drink
Do not use adhesive tape or dry
dressing it stick to the burn

First aid treatment

Do not break blisters while the skin is
still intact,it will continue to protect
infection
Raising a burnt limb to minimize
swelling
Asssess for any sign of shock
Seek medical help as soon as
possible

Bites
The act of cutting,tearing,holding or
gripping with the teeth or sting is
called bites.
Types of bites
Insect bite
Snake bite
Dog bite

Insect bite
When
the
insect
pierces its sting into
the
tissue
and
releases venoum,it is
known
as
insect
bite.the
venoum
contain
chemical
compound
whhich
produces allergy.

Common insect bites

Bees
Wasps(af?nf])
Scorpions (laR%L)
Harnets
Spider

Sign and symptoms

Severe burning pain

Swelling
Dizziness
Children especially may have sign of
shock,sweating,nausea,vomiting and
difficulty in breathing.
Painful muscle all area ,extreme pain in
stomach muscles which becomes rigid
especially spider bites.
Allergic reaction (anaphylaxis) occurs will
be a life threatening

First aid treatment

Ask the victim if he/she has had a reaction
before.
Remove the sting
Wash the sting site with soap and water to
prevent infection.
Calamine lotion may provide relief from itching
Apply an ice pack over the sting site to slow
absorption of the venom and relieve pain.
Because bee venom is acidic, a paste made of
baking soda and water can help.

If sting in mouth wash mouth salt solution.

Seek medical attention if necessary.

Snake bites
When a poisonous snake bites ,it
releases its venoum.the venoum
contains hemotoxin /monotoxin that
destroy redblood cells.if the patient
doesnot get prompt treatment it may
be fatal and cause death.
All snakes are not poisonous but
victim requires treatment.

 Common snakes are viper

(releases hemotoxin) and
cobra (releases monotoxin)
Sign and symptoms of
viper snake bites
Immediate swelling
Discolouration
Slight bleeding from mouth
and conjunctiva
May vomit blood
May have hematuria
Coma and death occurs
with in 24 hours

Sign and symptoms of cobra snake bites

Slow or moderate
swelling
No discolouration
Spasm of respiratory
muscles
Asphyxiated
Death in delay
treatment

Sign and symptoms of all poisonous

snake bites
Pain
Swelling
Diarrhea
Dizziness due to hypotension
Skin may become cool and pale
Extreme weakness and faintness
Rapid and weak pulse
Blurring vision
Nausea and vomiting , unconscious

First aid treatment

Reassure the victim,lay him/her down and
give him/her complete rest and
support.immobilize the part.
Clean the wound with soap and water
Make vertical cut incision inch deep with
sterile bladein each mark with in 30
minutes
Try to flush out the blood from wound by
squeezing or suction to drain venoum
If available apply cold pack for an hour in
the bite area

First aid treatment cont

Apply torniquet over the area at least
3-4 inch above the bites for 1520min and release for 2-3 mins in
between
Splint the part to rest
Seek medical help as soon as
possible.

Dog bite
Dog bites are
sometimes very
serious.all the
dog bites must
be referred for
medical
treatment
especially in
nepal because
rabies virus

First aid treatment of dog

bite
Reassure the victim and keep him in a
comfortable position.
Wash the wound with soaps water before saliva
gets into the body. Allow the wound to bleed for a
while.
Apply antiseptic solution if available.
Cover the wound with a clean cloth.
Seek for medical aid immidiately.
If possible advise the patients relatives to watch
the dog for 10 days. If the, dog is alright, no need
to wary. Otherwise advise, for anti-rabies vaccine.

Haemorrhage
Haemorrhage is the condition in which blood
flows out from the blood vessels due to
some injury or accident.it may be internal
and external.
Primary haemorrhage: immediate
bleeding from cut inury or incision
Reactionary haemorrhage:bleeding
occurs with in 24 hours
Secondary haemorrhage: bleeding after
24 hours

Sign and symptoms:

Visible andd non visible bleeding
Dizziness and faint ness
Pallor, cold and clammy skin, excessive
sweating
Low BP
Restlessness
Thirsty ,light headache and may even collapse
Weak feeble and rapid pulse
Difficulty in breathing,cyanosis

First aid treatment of external

haemorrhage
Direct pressure stops most bleeding.
Wear medical exam gloves (if possible)
Place a sterile gauze pad or a clean cloth over
wound

Elevation injured part to help reduce blood

flow.
Combine with direct pressure over the wound (this
will allow you to attend to other injuries or victims).

If bleeding continues, apply pressure

at a pressure point to slow blood flow.
Pressure point locations:
Brachial (Top of elbow)
Femoral (Inside upper thigh

For internal bleeding

Monitor ABCs (Airway Breathing Circulation)
Keep the victim lying on his/her left side.
(This will help prevent expulsion of vomit
from stomach, or allow the vomit to drain
and also prevent the victim from inhaling
vomit).
Treat for shock by raising the victims legs 8
12
Check the pulse and general condition of the
patient
Seek immediate medical attention

Epistaxis(nose bleed)
Epistaxis is a haemorrhage from the
nose caused by the rupture of tiny
distended blood vessels in the mucus
membrane of any area of nasal
passage.

First aid of epistaxis

Let the patient sit upright with the head tilt
forward to prevent swallowing and aspiration of
blood.
Loosen the tight clothes around the chest and
neck
Instruct the patient to breath orally
Pinch the nose firmly in the littles area(below
the hard part)
Instruct the patient not to blow
If bleeding is still continue apply nasal packing
Refer the patient to hospital.

Cardiopulmonary resuscitation (CPR): First

aid

Cardiopulmonary resuscitation (CPR)

is a lifesaving technique useful in
many emergencies, including heart
attack or near drowning, in which
someone's breathing or heartbeat
has stopped. The American Heart
Association recommends that
everyone untrained bystanders
and medical personnel alike begin
CPR with chest compressions.

CPR cont
Before you begin
Before starting CPR, check:
Is the person conscious or unconscious?
If the person appears unconscious, shake
his or her shoulder and ask loudly, "Are
you OK?"
If the person doesn't respond and two
people are available, one should call local
emergency number and one should begin
CPR. If you are alone and have immediate
access to a telephone, ask for help before
beginning CPR.

 unless you think the person has

become unresponsive because of
suffocation (such as from drowning).
In this special case, begin CPR for
one minute and then call the local
emergency number.
Purposes of CPR:
The purpose of CPR is to maintain
oxygenated blood flow and
respiration throughout the person's
body .

Remember to spell C-A-B

The American Heart Association uses the short
form of CAB circulation, airway, breathing to
help people remember the order to perform the
steps of CPR.
Chest compression(circulatin): Restore
blood circulation with chest compressions
Put the person on his or her back on a firm
surface.
Kneel(go down on your knee) next to the person's
neck and shoulders.
Place the heel of one hand over the center of the
person's chest, between the nipples. Place your
other hand on top of the first hand. Keep your
elbows straight and position your shoulders
directly above your hands.

Chest compression

 Use your upper body weight (not just

your arms) as you push straight
down on (compress) the chest at
least 2 inches (approximately 5
centimeters). Push hard at a rate of
about 100 compressions a minute

 Airway: Clear the airway

If you're trained in CPR and you've
performed 30 chest compressions, open the
person's airway using the head-tilt, chin-lift
maneuver. Put your palm on the person's
forehead and gently tilt the head back. Then
with the other hand, gently lift the chin
forward to open the airway.
Check for normal breathing, taking no more
than five or 10 seconds. Look for chest
motion, listen for normal breath sounds, and
feel for the person's breath on your cheek
and ear. Gasping is not considered to be
normal breathing.

Open airway

Listen or feel the patients

breath

Airway: Clear the airway cont

If the person isn't breathing normally
and you are trained in CPR, begin
mouth-to-mouth breathing. If you
believe the person is unconscious
from a heart attack and you haven't
been trained in emergency
procedures, skip mouth-to-mouth
rescue breathing and continue chest
compressions

Breathing: Breathe for

the person
Rescue breathing can be mouth-tomouth breathing or mouth-to-nose
breathing if the mouth is seriously
injured or can't be opened.
1. With the airway open (using the
head-tilt, chin-lift maneuver), pinch
the nostrils shut for mouth-to-mouth
breathing and cover the person's
mouth with yours, making a seal.

Mouth to mouth breathing

2.Prepare to give two rescue breaths. Give

the first rescue breath lasting one
second and watch to see if the chest
rises. If it does rise, give the second
breath. If the chest doesn't rise, repeat
the head-tilt, chin-lift maneuver and
then give the second breath. Thirty
chest (30)compressions followed by
two(2) rescue breaths is considered one
cycle.
3. Resume chest compressions to restore
circulation.

4.If the person has not begun moving

after five cycles (about two minutes)
and an automatic external
defibrillator (AED) is available, apply
it . (one shock)
If an AED isn't available, go to step 5
below. 5.Continue CPR until there are
signs of movement or emergency
medical personnel take over.

To perform CPR on a child

The procedure for giving CPR to a child age
1 through 8 is essentially the same as that
for an adult. The differences are as follows:
If you're alone, perform five cycles of
compressions and breaths on the child
this should take about two minutes
before calling help or your local emergency
number or using an AED.
Use only one hand to perform heart
compressions.
Breathe more gently.

To perform CPR on a
child cont

Use the same compression-breath rate as

is used for adults: 30 compressions
followed by two breaths. This is one cycle.
Following the two breaths, immediately
begin the next cycle of compressions and
breaths.
After five cycles (about two minutes) of
CPR, if there is no response and an AED is
available, apply it and follow the prompts
Continue until the child moves or help
arrives

Fractures

Open fracture

Close fracture