SFAT Lecture 07/09/23

PHILIPPINE RED CROSS * Duty to Act

- those who have the privilege to know have the duty to
STANDARD FIRST AID AND BASIC LIFE SUPPORT act

FIRST AID- immediate help given to an injured person. Moral Obligation

• Id - pleasure principle
2 types of Emergencies • ego reality principle
- Trauma • superego - conscience (con means you, science
- Medical means -) principle

* medical patient ► one who has or describes * Confidentiality

symptoms of an ill- ness; a patient with no injuries. Right & Obligation of Healthcare worker
* trauma patient ► one who has a physical injury Article CLIV of 1997 on Health, Section 138
caused by an external force.
* Standard of Care
when endorsing in pre hospital, we always use the
word “possible or suspected “ BSI- Body Substance Isolation
PPE- Personal Protective Equipment
SCOPE AND LIMINATIONS
- First aid does not imply medical treatment and is by no Secretion- Mouth
means a replacement for it. Discharge- Genitals & Butt

IMPROVISATION This is the public’s expectation that personnel

- created without preparation summoned to an emergency will provide care with a
certain level of knowledge and skill
OBJECTIVES OF FIRST AID
- Preserve life * Negligence
- prevent further harm & complication According to the Article 12 no.4 of Act No.3815 of the
- seek immediate medical help Philippine Revised Penal Code Book One
- provide reassurance "any person who, while performing a lawful act with
* false & true reassurance due care, causes an injury by mere accident without
fault or intention of causing it" is exempt from criminal
Infections develops after 7 days liability.

LEGAL CONCERNS Responsibility starts once you touch the patient.

* Consent
1. express/direct consent (pt reponse yes) • Abandonment
2. implied consent (assurance need to help According to the Article 275 no. 1 & 2 of Act No. 3815
3. Minor Consent (mostly in school, teacher is the of the Philippine Revised Penal Code Book Two:
guardian) *Abandonment of person in danger and abandonment
of one's own victim"
Mandate: 1. Anyone who shall fail to render assistance to any
Article 218, 220, 233 of the Family Code of the person whom he shall in an uninhabited place wounded
Philippines P.D. 603 or in danger of dying, when he can render such
- administration, school teacher in charge assistance without detriment to himself, unless such
omission shall constitute a more serious offense.
2. Anyone who shall fail to help or render assistance symptoms, but often leads to yellow discoloration of
to another whom he has accidentally wounded or the skin, mucus membranes, and conjunctivae, poor
injured. appetite and malaise.

Situation: If the patient refuses to be aid by you due to * HIV/AIDS

personal issues, find someone/other who will help - a condition in humans in which progressive failure of
him/her the immune system allows life-threatening
opportunistic infections and cancers to thrive. Can be
HEALTH HAZARD & RISK contacted through blood
* Herpes
- is a viral disease of several distinct disorders based on HIV Transmission
the site of infection. - Blood Transfusion
- Two most common are oral herpes, the visible - Needle Prick
symptoms of which are colloquially called cold sores or - Unsafe Sex (Bodily Fluid)
fever blisters. and genital herpes whose typical signs are - Breastfeeding
clusters of inflamed papules and vesicles on the outer
surface of the genitals resembling cold sores Ways of Disease Transmission
Infectious diseases are those that can spread from one
* Meningitis person to another through the following ways:
- Is an inflammation of the membranes (meninges) • Direct Contact
surrounding your brain and spinal cord. The swelling, • Indirect Contact
associated with meningitis often triggers the "hallmark" • Airborne Transmission
signs and symptoms of this condition, including • Bites
headache, fever and a stall neck. Test is TUMBLER TEST
Symptoms: Mask: (Invert)
- Headache • I protect myself from you- Colored part
- Altered Mental Status (stimulus & response is • I protect you from myself- White part
not related)
- Phenophobia Universal Precaution
- Photophobia Basic Precaution and Practices
- Stiffness 1. Handwashing
- High Fever 2. Personal Protective Equipment
- Petechiae 3. Equipment Cleaning and Disinfecting

Note: EMERGENCY ACTION PRINCIPLES

- rea = discharge
- itis = inflammation S- Scene Size Up
P- Primary Assessment
* Tuberculosis (TB)
- is a potentially serious infectious disease that mainly
A- Activating Medical Help
affects your lungs. The bacteria that cause tuberculosis S- Secondary Assessment
are spread from one person to another through tiny
droplets released into the air via coughs and sneezes. Its S- Scene Size Up
classic symptom is cough atleast a month (Check area if safe) “Safety for all”
- Sense of sight
* Hepatitis - Sense of smell
- is a medical condition defined by the inflammation of - Sense of Touch
the liver. Hepatitis may occur with limited or no - Sense of Hearing
 C- Contact Number
Ask the following
• What happened?
If trauma, RBS- random blood sweep
• How many are injured?
• Are there any bystander who can help?
• If they can help?
• Identify yourself as a trained first aider and get A- Activating Medical Help
consent to give care - Hotline No.
S- Secondary Assessment
P- Primary Assessment D- Disability & E- Exposure
• C- Consciousness • Head to Toe Assessment
• A- Airway • Vital Sign Taking

• B- Breathing Head to Toe Assessment

• C-Circulation Remember,
D- Deformity
CONSCIOUSNESS O- Open wound
• A-Alert T- tenderness
• V- Responsive to Voice/Verbal S- swelling
• P- Responsive to Pain and Blood
• U- Unresponsive
Check VS
AIRWAY • Respiration
- Head Tilt Adult - 12-20/min
• Infant- Neutral Position Child - 18-25/min
• Child- Neutral Plast/ Tilt Infant- 25-35/min
• Adult- Maximum Head Tilt • Pulse Rate
- Chin Lift • Skin Appearance (Cyanotic, Jaundice, Pale,
Redness)
BREATHING • Pupils (Dilate, Constrict, Uneven)
- Rise & fall • Blood Pressure

CIRCULATION SAMPLE
Check for pulse. is an acronym or mnemonic used by first responders
• Infant- Brachial Pulse during the secondary assessment.
• Child- It depends
• Adult - Carotid Pulse S- Signs & Symptoms
If Pt is conscious, Get PASAC A- Allergies
P- Patient Name M- Medication
A-Address P- Pertinent Past Health History
S- Sex L- Last oral intake & output
A- Age E- Event that lead to injury
Note: Include date & time for endorsement - Dark Red color (deoxygenated)
Capillary Bleeding
- slow, even flow

WAYS TO CONTROL EXTERNAL BLEEDING

o Direct Pressure
o Pressure Bandage

OPQRS
-Each letter stands for an important line of questioning SHOCK
for the patient assessment. - is a condition in which the circulatory system fails to
O- Onset deliver enough oxygen-rich blood to the body’s tissues
& vital organs.
P- Provocation
Q- Quality of Pain SHOCK POSITION
- Lie patient on his back
R- Radiation - Elevate the legs
S- Severity
CRUSH INJURY
Remember: - direct injury resulting from a crush.
Primary Assessment
C- Consciousness CRUSH SYNDROME
A- Airway - is a systemic manifestation of muscle damage
B- Breathing resulting from pressure or crushing.
C-Circulation
- Crush syndrome is a clinical condition caused by
Secondary Assessment compression of muscle with subsequent
D- Disability rhabdomyolysis which can then cause complications of
E- Exposure electrolyte disturbance, fluid sequestration and
myoblubinuria which leads to renal failure.
LOG ROLL TECHNIQUE
WOUNDS
Complications:
• Bleeding & Shock
• Infection
• Tetanus
• Rabies

Types of Wounds
• Abrasion
BLEEDING & SHOCK • Laceration
Types of External Bleeding • Avulsion
Arterial Bleeding • Amputation
- Spurting Blood • Puncture
- Pulsating Flow • Embedded Object
- Bright Red Color (oxygenated)
Venous Bleeding CLOSED WOUND
- Steady, slow flow • Apply an ice pack to the area.
 • Elevating the injured part may help to reduce • An open chest wound is a life.
swelling.
• Do not assume that all closed wounds are minor Open Abdominal Wound
injuries. • Put on disposable gloves or use another barrier.
• With all closed wounds, help the person to rest • Carefully position the person on his or her back
in the most comfortable position possible. with the knees bent, if that position does
• It is also helpful to comfort and reassure the • not cause pain.
person. • Do not apply direct pressure.
• Do not push any protruding organs back into
Minor Open Wounds the open wound.
• Use a barrier between your hand and the • Remove clothing from around the wound.
wound. • Apply moist, sterile dressings loosely over the
• Apply direct pressure. wound. Tap water that is clean and has been
• Wash abrasions and other superficial wounds. warmed can be used to moisten the dressings.
• Apply a Povidone-iodine (PVP-I) antiseptic • Cover dressings loosely with plastic wrap, if
solution or, if available, a triple antibiotic available.
ointment or cream. • Take necessary steps to minimize shock.
• Cover the wound with a sterile dressing.
• Wash your hands immediately after giving care. AVULSION
If the victim has an avulsion in which a body part has
MAJOR OPEN WOUNDS been completely severed;
• Call the local emergency number. • Call the local emergency number.
• Put on PPE. • Put on disposable gloves.
• Control bleeding by applying direct pressure or • Wrap the severed body part in sterile gauze or
employing a pressure bandage. any clean material.
• Monitor airway and breathing. • Place the wrapped part in a plastic bag. Keep
• In cases where the injured party is in shock, the body part cool by placing the bag on ice.
keep him or her from experiencing chills or • Do not place the bag on dry ice or in ice water.
feeling overheated. • Make sure the part is transported to the
• Have the person rest comfortably and provide medical facility with the victim.
reassurance.
• Wash your hands immediately after giving care. EMBEDDED OBJECT
If the victim has an embedded object in the wound:
SPECIAL CONSIDERATION: • Call the local emergency number.
Open Chest Wound • Put on disposable gloves.
• Call the local emergency number. • Do not remove the object yourself.
• Put on disposable gloves. • Use bulky dressings to stabilize the object.
• Help the patient sit down properly. Encourage • Any movement of the object can result in
him to lean towards the injured side and cover further tissue damage.
the wound with the palm of his hand. • Control bleeding by bandaging the dressing in
• Place a sterile dressing or clean non-fluffy pad place around the object.
over the wound and surrounding area. Cover • If the object is lodged in the airway of the
with an occlusive dressing (plastic bag, foil or injured party, transport the patient immediately
kitchen film). to the hospital if there is no medical help
• Secure firmly with adhesive tape on three edges available.
only • Wash your hands immediately after giving care.
• Take steps to minimize shock.
• Monitor the person's breathing. BLAST INJURY
 • A blast victim may not have any external injury. • Never go near the person until you are sure that
• A single, large explosion may injure many he or she is no longer in contact with the power
people at the same time. Some injuries are due source.
to the blast wave itself, others are due to • Turn off the power at its source and be aware of
burning and fragments sent off by the any life-threatening conditions.
explosion. • Call the local emergency number.
• The blast wave may also throw people against • Be aware that electrocution can cause cardiac
walls which may result in blunt injuries. and respiratory emergencies.
• The secondary fragments from broken glass and • Care for shock and thermal burns.
debris caused by the blast wave may also cause • Look for entry and exit wounds and give
penetrating wounds. appropriate care.
• Finally, a blast may cause a building to collapse • Remember that anyone suffering from electric
and people caught inside may suffer crush shock requires advanced medical attention.
injuries.
RADIATION BURNS
BURNS • Care for a radiation burn, i.e. sunburn, as you
THERMAL BURNS would for any thermal burn.
• Check the scene for safety. • Always cool the burn and protect the area from
• Stop the burning by removing the victim from further damage by keeping the person away
the source of the from the burn source.
• burn.
• Check for life-threatening conditions. open fracture already outside the body
• Cool the burn with large amounts of cold closed fracture inside the body
running water.
• Cover the burn loosely with a sterile dressing. POISONING
The bandage should not put pressure on the POISONING BY:
burn surface. • ingestion
• Prevent infection. Do not break blisters. Do not • inhalation
touch a burn with anything except a clean • injection
covering. • absorbed
• Apply a triple antibiotic ointment.
• Take steps to minimize shock. Keep the victim Poisoning by Ingestion
from getting chilled or overheated. • Food Poisoning
• Comfort and reassure the victim. • Caustics
o Solid and liquid drain and toilet bowl cleaners
CHEMICAL BURNS o Muriatic acids
• Remove the chemical from the skin as quickly as o Car battery fluids
possible. o Rust removersbleaches
• Flush the burn with large amounts of cool o Detergents
running water. o Ammonia-containing products
• If an eye is burned by a chemical, flush the • Hydrocarbons
affected eye with water until advanced medical • Drug Overdose
personnel take over.
• If possible, have the person remove Poisoning by Inhalation
contaminated clothes to prevent the spread of • Carbon Monoxide
infection while you continue to flush the area. • Cyanide
• Chlorine
ELECTRICAL BURNS • Tear Gas
 • Remove contaminated clothing and jewelry
Poisoning by Injection which may constrict circulation when
• SNAKEBITES • swelling occurs.
• Reassure the patient who may be very anxious. • Rinse the affected area immediately. Do it
• Avold any interference with the bite wound such thoroughly.
as incising, rubbing vigorous cleaning, • Seek medical advice if a rash or weeping lesion
• massaging or applying herbs or chemicals to it. (oozing sore) develops.
• Immobilize the whole of the patient's body by Soothe the area with medicated lotions.
laying him/her down in a comfortable and safe Stop or reduce itching with antihistamines that
position. will dry up the lesions.
• + Ideally, a broad elastic roller bandage should • Advice the victim to see a physician if the
be used for the person. condition worsens and large areas of the body
• Do not remove the trousers as the movement of or the face are affected..
doing so will only assist the venom into entering • Give care for severe allergic reactions if it does
the blood stream. develop.
• As far as the snake is concerned - do not • Remove contaminated clothing and jewelry
attempt to kill it as this may be dangerous. which may constrict circulation when swelling
occurs.
• BEE STINGS
• Remove any visible stinger. Scrape it away from HEAD & SPINE INJURY
the skin with a clean fingernail or a plastic card. • Head Injury
• Wash the site with soap and water. • Concussion
• Cover the site with a dressing. • Spinal Injury
• Apply a cold pack to the area to reduce pain and
swelling. First Aid for Spinal Cord Injury:
• Call the local emergency number if the person • Call the local emergency number.
has any trouble breathing or shows any other • Minimize movement of the head, neck and back.
signals of anaphylaxis. • Excessive movement can damage the spinal
cord irreversibly. Keep the victim as still as
• MARINE LIFE WITH POISONOUS SPINES possible until advance medical personnel arrive.
• Immerse the wound in 45°C water, or as can be Use a technique called manual stabilization to
tolerated, for 30 to 90 minutes. Many marine minimize movement of the head and neck.
toxins are proteins which are destroyed by heat. • Check for life-threatening conditions.
• Soak the affected area in vinegar. This inhibits • Maintain open airways.
bacterial infection and dissolves the spine • Monitor consciousness and breathing.
skeleton which is made of calcium carbonate-- • Control any external bleeding with direct
the same basic material as human bones. pressure unless the bleeding is located directly
• Leave an inaccessible spine alone and only if it over a suspected fracture. Wear disposable
hasn't penetrated a joint, nerve or blood vessel, gloves or use another barrier. Help victim
• Cleanse the wound with an antiseptic solution. maintain normal body temperature.
• Washing out remaining venom and pieces of
spine will help minimize damage. speed healing MANUAL HEAD STABILIZATION
and prevent infection. Helmet Removal
Removal of the helmet is necessary when there is:
ABSORBED POISON • Uncontrollable and excessive head movements.
To care for a victim who has come into contact with a • Restriction of airway or breathing.
poisonous plant: • Inability to assess and/or reassess the patient's
airway and breathing.
 • Proper spinal immobilization cannot be
performed because of the helmet. First Aid Management
• Patient needs to be resuscitated, such as when If you suspect that someone might be having a heart
having a cardiac arrest. attack, you should:
• Call the local emergency number immediately.
SPINE IMMOBILIZATION • Have the person stop what he or she is doing
SPINE BOARD MANAGEMENT (Supine & Prone) and rest comfortably.
• Loosen any tight or uncomfortable clothing.
BONES, JOINTS AND MUSCLE INJURIES • Closely watch the person until advanced
Types: medical personnel take over. Notice any
o Strain changes in the person's appearance or
o Sprain behaviour. Monitor the person's condition.
o Dislocation • Be prepared to perform CPR and use an AED, if
o Fracture available, once the person loses consciousness
FIRST AID MANAGEMENT and stops breathing.
R- Rest • Ask the person if he or she has a history of heart
disease.
I- Immobilize • Offer aspirin if it is prescribed by his/her
C- Cold physician for his/her condition and only if the
patient can swallow.
E- Elevate
• Be calm and reassuring.
• Talk to bystanders and if to possible the person
MEDICAL EMERGENCIES
to get more information.
• Heart Attack
• Do not try to drive the person to the hospital
• Stroke
yourself.
• Diabetic Emergency
• Seizure
STROKE
• Anaphylaxis
A Stroke is a disruption of blood flow to a part of the
• Fainting brain which may cause permanent damage to the brain
tissue
HEART ATTACK
Heart attack, also called myocardial infarction, occurs Causes:
when the blood and oxygen supply to the heart is Most commonly, a stroke can be caused by the
reduced causing damage to the heart muscle and following:
preventing blood from circulating effectively. It is • A blood clot (thrombus or embolus), that
usually caused by coronary heart disease. forms or lodges in the arteries that supply blood
to the brain.
Signs and Symptoms • Bleeding from a ruptured artery in the brain
The following are the signals of a heart attack: caused by a head injury, high blood pressure or
• Chest pain, discomfort or pressure. an aneurysm.
• The pain associated with a heart attack can range • Fat deposits lining an artery (atherosclerosis
from discomfort to an unbearable crushing • A tumor or swelling from a head injury may
sensation in the chest. compress an artery.
• The person may describe it as pressure,
squeezing, tightness, aching or heaviness in the FAST ASSESSMENT
chest.
• Many heart attacks start slowly as mild pain or
F- Face
discomfort. A- Arms
 S- Speech condition still is to be determined or still
remains unknown (Are they hypoglycaemic or
T- Time hyperglycaemic?).
• If the diabetic person is conscious and is able to
First Aid Management swallow and then states that they need sugar,
Recognize the "signals" and take action: give hisugar or orange juice.
• Call the local emergency number immediately.
Minutes count! SEIZURE
• Have the person stop what he or she is doing When the normal functions of the brain are disrupted
and have them rest comfortably by sitting or by injury, disease, fever, poisoning or infection, the
lying down. electrical activity of the brain becomes irregular. This
• Give the victim supportive care and irregularity can cause a loss of body control known as a
reassurance. seizure.
• Be prepared to perform CPR if the victim
becomes unresponsive FIRST AID MANAGEMENT
• Reassure the victim that you are going to help.
DIABETIC EMERGENCY •Remove nearby objects that might cause injury.
A diabetic emergency is caused by an imbalance • Protect the victim's head by placing a thinly folded
between sugar and insulin the body. towel or piece of clothing beneath it. Do not restrict the
airway in doing so.
Types and Causes: • Do not hold or restrain the patient when a seizure is in
• Too much sugar in the blood(hyperglycemia): progress.
The person may not have taken enough insulin or may • Do not place anything between the victim's teeth or
be reacting adversely to a large meal that is high in put anything in the victim's mouth.
carbohydrates. • Take care to ensure that the victim will not swallow
• Too little sugar in the blood (hypoglycemia): his/her tongue.
The person may have taken too much insulin, eaten too Loosen clothing and fan the victim if the seizure was
little, or has suffered from overexertion. Extremely low caused by a sudden rise in body temperature. Do not
blood sugar levels can quickly become life threatening. cool the victim by splashing cold water or rubbing
alcohol on his/her body.
Although hyperglycemia and hypoglycemia are different • Ensure that the victim's airway is open and check for
conditions, their major signals are similar. These breathing and other injuries once the
include: * seizure is over.
• Changes in level of consciousness, including • Stay and watch over the victim until the victim is fully
dizziness, drowsiness and confusion. conscious.
• Irregular breathing.
• Abnormal pulse (rapid or weak). ANAPHYLAXIS
Anaphylaxis is a severe allergic reaction that is usually
First Aid Management: life-threatening.
• First, check and determine if there are any life-
threatening conditions. Signs and Symptoms
• •A person with diabetes who is experiencing a Anaphylaxis usually occurs suddenly and within seconds
diabetic emergency must be instructed to test or minutes after contact with the substance. The skin or
his or her blood glucose level. area of the body that comes in contact with the
• A victim experiencing a diabetic emergency due substance usually becomes swollen and turns red.
to hypoglycemia must be encouraged to treat
himself/herself with food or drink that contains Other signals include the following
sugar. The same action is advised if the
• Difficulty in breathing, wheezing or shortness of • Pregnant women and the elderly are more likely
breath than others to faint when suddenly changing
Tight feeling in the chest and throat positions. This could occur when moving from a
• Swelling of the face, throat or tongue sitting or lying position or when standing up.
• Weakness, dizziness or confusion
• Rashes or hives First Aid Management
• Low blood pressure • Position the victim on his or her back. Elevate
• Shock the legs about twelve inches to keep blood
circulating to the vital organs.
Causes: • Keep the victim in a lying position, especially
The most common antigens that often cause reactions when unsure of the victim's condition or if
for allergic people are the following: movement is painful to him/her.
• Bee or insect venom • Loosen any restrictive clothing, such as a tie or a
• Pollen buttoned-up collar.
• Animal dander • Check for any other life- threatening and non-
• Latex life-threatening
• Certain antibiotics and drugs • conditions.
• Certain foods like nuts, peanuts, shellfish and • Do not give the victim anything to eat or drink.
dairy products Do not slap the victim or splash water on
First Aid Management his/her face.
If you suspect anaphylaxis, • Splashing water on the victim could cause the
• Call the local emergency number. victim to suck in water through the mouth.
• •Calm and reassure the person.
• Help the person to rest in the most comfortable ENVIRONMENTAL EMERGENCIES
position for breathing. This is usually via a Heat Cramps
sitting position. Heat Exhaustion
• Monitor the person's breathing. Look for any Heat Stroke
changes in their condition. Hypothermia
• •Assist the person with the use of a prescribed
epinephrine auto-injector. Give this to the HEAT CRAMPS
individual if available. Heat cramps are painful involuntary muscle cramps that
• Give care for life- threatening emergencies. can occur during and after exercise or work in a hot
• Document any changes in the person's environment.
condition over time.
First Aid Management
FAINTING Remove the patient from the hot environment.
Fainting is a partial or complete loss of consciousness • Encourage the patient to drink a beverage
resulting from a temporary reduction of blood flow to containing salt. If available, have the patient
the brain. drink an Oral Rehydration Solution (ORS).
• If ORS packets are not available, make an oral
Causes rehydration solution
Fainting can be triggered by: Stretch the affected muscle and massage the
• An emotionally stressful event area once the spasm has passed.
• •Pain
• Specific medical conditions such as heart Heat Exhaustion
disease; Heat exhaustion is a milder form of heat-related illness
• Standing for long periods of time or that can develop after exposure to high temperatures.
overexertion.
This may also be a result of inadequate fluid intake or (ventricular fibrillation) may develop and the heart
the insufficient replacement of fluids. eventually stops.

First Aid Management First Aid Management

• Remove the patient from the hot environment. •Gently move the person to a warm place.
Fan the body, place ice bags, or spray water on • Care for any life-threatening conditions.
the skin. • Call the local emergency number.
• Start oral rehydration with a beverage • Remove any wet clothing and dry the person.
containing salt, or make them drink an Oral • Warm the person by wrapping him/her in blankets or
Rehydration Solution (ORS). by replacing the person's clothes with dry clothing
(passive re-warming).
Heat Stroke • If available, apply heat pads or other heat
Heat stroke is a form of hyperthermia. Prolonged sources to the body. Hot water bottles and
exposure to high temperatures can contribute to failure chemical hot packs may be used, but first wrap
of the body's temperature control system. these in a towel or blanket before applying.
• Do not warm the person too quickly, such as by
Signs and symptoms of heat stroke include: immersing him or her in warm water. Rapid
• Strange behavior, headaches, dizziness, warming may cause dangerous heart rhythms.
hallucinations, confusion, agitation, • If the person is alert, give warm liquids that do not
disorientation, and coma. contain alcohol or caffeine. Monitor ABCs and continue
• High body temperature. to warm the victim until EMS personnel arrive. Be
• Absence of sweating. prepared to perform CPR if necessary.
• Red, hot, dry and flushed skin.
• Rapid pulse and difficulty breathing. TRIAGE
• Nausea, vomiting, fatigue and weakness. Mass Casualty Incident
A mass casualties incident results in an imbalance
First Aid Management between assistance needs and the help available. The
• •Call or have someone call the local emergency number of casualties and the severity of their injuries
number. exceed the human and material resources available in
• Move the person into a cool place, a shaded the casualty-care chain.
area, or an air-conditioned room.
• Cool the patient immediately by immersing Triage is a management process for sorting casualties
him/her in water. Make the water level reach into groups based on their need for priority treatment
the patient's chin. or evacuation to definitive care.

If water immersion is not possible or is delayed, the Concepts and Principles

following actions can be performed: The decisions involved in triage are the most difficult in
• Douse the patient with copious amounts of cold all health care.
water, spray the patient with water, fan the However, choices are made to achieve the greatest
• patient, or cover the patient with ice towels or good not for any particular individual but for the
surround the patient with ice bags. greatest number of people.
• Respond to any life-threatening conditions that • Adherence to general guidelines will ensure
may come about. the best matching of patient conditions with
available resources. Triage decisions must not
HYPOTHERMIA be questioned to avoid confusion.
Hypothermia is the general cooling of the entire body. • Triage is only a "snapshot" of the casualty's
In hypothermia, body temperature drops below 35° C. condition at the time of assessment. Priority
As the body cools, an abnormal heart rhythm categories may change as time goes by.
 • The most experienced first aider arriving at the • Move through the patients in an orderly fashion.
scene becomes the triage officer • Assess each casualty you come to and mark the
category using triage ribbons.
TRIAGE CATEGORIES AND PRIORITIES • Maintain a count of casualties by marking on
There are four common triage categories. They can be two to three inch tape on your thigh, or by
remembered using the mnemonic IDME, which stands : saving small piece of triage ribbon.
• Give only minimal treatment.
Immediate (red-tag) - These are life- threatening • Keep moving!
conditions that are treatable at least for a time. This is
achieved through immediate and simple measures such Lifting & Moving
as airway and gross hemorrhage control. Immediate Lifting and carying are dynamic processes.
case signs include: airway and breathing difficulties, A patient can be moved to safety in many different
uncontrolled or severe bleeding, decreased metal ways, but no one way is bust for every situation, The
status, patients with severe medical problems, shock objective is to move a patient to salaty withour causing
(hypoperfusion), and severe burns. injury to either the patient or the fist aider.

Delayed (yellow-tag) - These are major but not Emergency Move

immediately life-threatening conditions where some Is the movement of a patient to a safe place before
delay is acceptable. initial assessment and care is provided, typically
Delayed case signs include: burns without airway because there is some potential danger.
problems, major or multiple bone or joint injuries and
back injuries with or without spinal cord damage. Non-Emergency Move
Is the movement of a patient when both the scene and
Minimal (green-tag) - These minor injuries require the patient are stable.
minimal surgical care. These are injuries for which an
indefinite wait is possible, if not desirable. Casualties Consideration
are often classified as the walking wounded. These •Dangerous conditions at the scene
casualties should be transported to a space away from •The size and weight of the victim
the main triage and immediate treatment area to avoid • Physical ability of the first aider
crowding and confusion. • Presence of other rescuers
* The victim's condition
Expectant (black-tag) - These are severe conditions that •Available carrying device
medical and/or surgical cares can no longer help. These • Terrain and distance to travel
conditions are often classified as having little hope of
recovery. Lifting Guidelines
* Only attempt to move persons who you are sure you
can comfortably handle.
START METHOD Bend your body at the knees and hips.
The START method, which stands for Simple Triage and Lift with your legs, not with your back.
Rapid Treatment, is one of the easiest triage methods Walk carefully using short steps.
which may be used when performing primary triage. It • When possible, move forward rather than backward.
uses a limited assessment of the patient's condition. • Always look where you are going.
The following factors are checked: the victim's ability to •Support the victim's head, neck and back, if necessary.
walk, respiratory status, hemodynamic status (pulse), If supine, lift and carry the patient's entire body as one
and neurologic status. unit.
Avoid bending or twisting a victim with a possible head,
Additional guidelines Include: neck or back injury.
• Begin where you stand.
• Use the log-roll technique when placing a blanket or a 14. Use hollow parts of the body when using splint.
spine board under the paten
• preparation for a carry.

Splint Board
- Largest Longest Splint
Uses:
- to stabilize pt.
- Carry pt.
- transfer pt.
- for transport

Triangular bandage
Least- 7
Max- 12

‘’Always kneeling position”

COMPOSITION OF A TEAM:
-Team Leader
- Assistant team leader/Treatment officer
-Logistic
-Crowd Control

Splint
3 types of splint
- Hard : Wood but padded
- Soft: Fabrics
- Anatomical: own body part is used as splint BANDAGES
1) Top of the head (Open Bandage)
RULES IN SPLINTING 2) Burn injury (Face)
1. Always use a square knot. • front
2. Always use padding. • Back
3. Use the applicable size of a splint. 3) Chest bandage
4. Combine all splints to maximize all resources. 4) Left / Right Elbow Injury
5. Splint according to its position. 5) Underarm sling bandage
6. Tie below & above the injured part. 6) Bum Injury Hand
7. Always check PMS: before and after applying a 7) Forehead Injury
splint. 8) Ear Injury (L)
a. PULSE
9) Neck Injury (R)
b. MOTOR
10) Bent Elbow Injury
c. SENSORY
II) Forearm Injury
8. Move the injured part 1 time only.
12) Laceration
9. Always inform the PT before applying the splint.
10. Knot must be on the left side of the PT. • Horizontal
11. Knot should not be too tight or too loose. • Vertical
12. Control bleeding before using splint. 13) Shoulder Injury
13. When in doubt, splint it. 14) foot Injury
 • Shoes On
• No Shoes

CARRIES
One man Carry
- Lover’s Carry
- Piggyback Carry (Short Distance)
- Pack strap/Back Strap Carry (Long Distance)
- Firesman/ firefighter Carry

Two Man Carry

- Forehand Seat
-Hand as a Litter
- Carry by extremities

Three Man Carry

- Bearer Alongside Carry
-Hammock Carry