FIRST AID

First aid is the initial treatment or help given to sick particularly injured
individual before professional medical care becomes available with the
materials at hand. Such intervention aims in reducing the situations that
threaten the victim until a professional arrives or the sick individual is
brought to \health facility.
Purpose of first aid treatment-
o To keep the injured or ill person alive ,
o To prevent the injured condition from becoming worse
o To help him/her to recover
o To sustains life
What does first aid knowledge & skill mean?
 The difference between life and death
 The difference between temporary and permanent disability
 The difference between rapid recovery and hospitalization
Steps in giving emergency care:
 Look at the general situation of the causality quickly
 Decide what is wrong and how severe or dangerous the injury is
 Give the appropriate first aid
Principles of first-aid-
There are certain important principles involved in first aid. These are listed
as follows-
The first aid provider must:
 Act calmly and logically.
 Be in control.
 Be gentle and firm, speak to casualty purposefully
 Build up trust with casualty.
 Explain casualty what you are going to do honestly and continuously
reassure the casualty.
 Never leave the casualty alone.
 Never separate a child from form his/her parents or guardian.
 Send the casualty to hospital/doctor ASAP by the quickest means of
transportation.
  Always inform police about serious accidents and at the same time the
relatives of the casualty.
LOOK FOR-
 Signs of internal damage to organ
 Burns
 Dislocation (broken bone)
 Wounds
 Dislocation (bone put out of place)
 Fracture
 Sprain
 Strain
Do Not-
 Touch a wound with your fingers or any instruments.
 Put on unclean dressing or cloth over a wound.
 Allow bleeding to go unchecked.
 Allow crowd to gather around casualty
 Move the casualty unnecessarily.
 Neglect shock.
 Fail to give artificial respiration when necessary.
 Fail to remove fasle teeth, tobacco, or any other object from mouth.
 Permit air to reach burned skin surface.
 Wash wounds.
 Try to reduce dislocation.
 Forget to call for physician.
THE FIRST AID BOX-
A first aid box containing medical supplies for emergency use is usually
kept in the housekeeping department. Types of supplies are –
 First aid box size- 17.5” x 10” x 6.5”
 A first aid book
 Antiseptic cream
 Antiseptic lotion
 Calamine lotion
 Antacid
 Anti diarrhoeal tablets( for diarrhea)
 Paracetamol
 Aspirin
 Methyl Salicylate Ointment( for strained or bruised muscle)
  Soframycin skin ointment
 Oil of cloves( for toothache)
 Clinical thermometer
 Sterilized gauze
 Sterilized dressing (no. 18 and no.24 ) 12 each
 Crepe bandage
 Adhesive plaster
 Unbleached triangular bandage
 Eye pad
 Tweezers
 Dressing scissors
 Safety pins
 Pad and pencils
Bandaging and Dressing-Made from flannel, elastic net or special paper
cotton cloth –
Bandages are used-
 To hold splint in proper place
 To maintain direct pressure over dressing to control bleeding.
 To retain dressings and splints in position
 To prevent or reduce swellings
 To restrict movement etc
Note-
 Bandage should never be used directly over a wound
 Bandaging a wound should be applied firmly enough to keep dressing
and splints in position
The common types of bandage-
 Triangular bandages

 Roller gauze bandage

 Elastic/crape bandage

 T- blinder bandage
Note-
 o Bandage should not be tight, may cause injury to the part or impair
circulation of blood
o Lose bandage is also useless
Dressings
A dressing – is protective covering applied to a wound to:
o Prevent infection
o Absorb discharge
o Control bleeding
o Avoid further injury

An efficient dressing should be sterile (germ free) with high degree of

porosity and allow for oozing of discharge of fluid.
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FIRST AID PROCEDURE- (for different situation)

1. Respiratory Emergencies
Definition:
A respiratory emergency is one in which normal breathing stops or in
which breathing is so reduced that oxygen in take is insufficient to
support life.
Artificial respiration (CPR): is a procedure for using air to flow in to and
out of persons Lungs when natural breathing is inadequate or stops.
Common causes of respiratory failure (problems)-
 Obstruction of the air way by tongue is dropping back
 Inhalation of a small amount of food, smoke, irritation, foreign
objects, carbon monoxide, etc.
 Compression of the neck
 Respiratory disease
 Drowning
 Strangulation
 Combustible gases
Signs and symptoms-
  Unable to breath
 Loss of consciousness
 Difficulty in breathing
 May be no visible breathing

First Aid management of Respiratory problem-

Figure 1- DRSABCD
The ABC of artificial respiration is as follows-
 A- for airways- clear airways
 B- for breathing- restore breathing
 C-for circulation-restore circulation.
Or
 D– Danger (to, in order of priority, you, the bystanders, and the
casualty)
 R– Response (are they conscious / aware?)
 S – Send for help (Call 000 – bystander calls ideally)
 A – Airway (look for obstructions, make sure it is clear & then open)
 B– Breathing (look, listen, feel for normal breathing)
 C– Compressions (commence chest compressions)
 D– Defibrillation (use Automated External Defibrillator, if available,
& follow the prompts)

Step to follow-
 Determine the consciousness of the causality by taping the victim on
the shoulder and asking loudly “Are you okay!”
 If a patient is child, our mouth should cover both his nose and mouth.
Very gentle breathing should be used and the younger the child, the
gentler this should continues at a rate of 25 breaths per minute. Once
the patient can breathe by himself/herself place him/her in what is
called the recovery position.
 If mouth to mouth is failed and no pulse cardiopulmonary
resuscitation is followed. Cardiopulmonary resuscitation (CPR) or
heart lung resuscitation is a combined effort to maintain circulation
and breathing it’s an emergency procedure applied when heart and
lung actions have stopped.
During CPR you will have to perform procedures to:
 A- for airways-
1. Remove the obstructing object or substance from the mouth with
your fingers, using your first finger as a hook to dislodge it.
 2. Extend the neck to open the airway. Place one hand under the nape
of the neck, and the other hand on the forehead, and tilt the head
back. lift the chin up gently without closing the mouth
3. Check if breathing has been restored. If not, start mouth to mouth
resuscitation.

 B- For breathing- Breathe for the patient and force the patients’
blood to circulate. This is done by administrating mouth to mouth
respiration. To start mouth to mouth respiration-
1. Pinch and compress the nose to close the nostril
2. Take a deep breath.
3. Place your mouth around the victim’s mouth, making and airtight
seal and quickly breathe into the victim’s mouth 4 times.
4. Refill your lung by inhaling deeply and repeat it every 5 seconds.
5. Watch the victim’s chest movement for rise and fall of chest.
6. Allow patient to exhale.

 C- for circulation-Restore circulation by external cardiac

compression/massage.
This can be carried out by an individual in the following manner-
1. Place the victim on a hard surface.
2. Kneel at the victim’s side.
3. Locate the xiphoid process (a cartilaginous structure at the lower
end of the breastbone or sternum).
4. Measure 1-2” above xiphoid process. Place the heel of one hand at
the point on the sternum. Place the other hand on top of it.
Interlock fingers to keep them off the victim’s ribs.
5. Keep elbow straight and lean forward, making the full use of body
weight to deliver a downward compression upon the breastbone.
Apply steady and smooth pressure to depress the victim’s sternum
by 1.5”.
6. Relax completely, but do not let your hand leave the victim’s chest
or you may loose the correct hand position.
7. Repeat.
NOTE- A minute of CPR delivers 60 chest compressions (15 at a time
multiplied by 4 times) and 8 lung inflations (2 at a time multiplied by
4 times).
RECOVERY POSITION-
 Figure 2-Recovery Position

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FIRST AID FOR COMMON SITUATIONS-

CHOKING-
When small piece of food or foreign body may be inhaled in to the
windpipe when eating in which sometimes help is needed

First aid management-

N.B. Do not try to hook the foreign body out with your fingers. This
is likely to push it further down.
For babies and small children:
 Hold the baby upside-down by the feet and beet him/her timely
between the shoulder blades.
 Lie the child face down over your knee or arm and beet them sharply
between the shoulder blades.
For adults:
There are two methods depending up on your knowledge and practice-
“Methods A” –
 stand behind the patient and hold around the chest just under the chest
hone
“Method B” –
 Tell the patient to lean over the back of a chair holding on to the seat
and the tenanting him/her sharply 3 to 4 times between his shoulder
blades. Whichever the method you use the foreign body should be
coughed out
 If the breathing has stopped begin mouth to- mouth respiration.
 After you have done the above, refer to the nearest hospital or health
centre
DROWNING-
Death may be caused by water reaching the lungs and either causing lung
tissue damage or spasms of the air way that prevents the inhalation of air.
First aid Management:
 You should begin artificial respiration as soon as possible
 If you cannot get air into his/her lungs, quickly turn the patient on
his/her side, putting his head lower than the leg and push the body
 Then give mouth-to-mouth artificial respiration.
 If the condition of the victim is not improving refer the victim to
the next health facility.
WOUND-
Wound is breaking in continuity to tissue of body, either internal or External.
Classification of Wound-
1. Open: An open Wound is a break in the skin or mucous membrane
2. Closed: A closed wound involves injury to underlying tissue without a
break in the skin or mucous membrane.
Types of Wounds-
 Abrasions
 Incisions
 Lacerated
 Punctures
 Avulsions

First aid management/Prevention of contamination and infection-

 Hand washing before and after wound care (when possible)
 By avoiding contaminates
 By using clean materials as much as possible E.g. cotton gauze,
towels etc...
 Wash in and around the victim’s wound to remove bacteria and other
foreign Matters
 Wash the wound thoroughly by flushing with clean water, preferable
running tap water
 Apply a dry sterile bandage or clean dressing and secure it firmly in
place
 If there is infection refer the victim to the health centre
BLEEDING-
Definition: Defusing or oozing of blood from blood vessels (Haemorrhage-
blood loss)
Methods of controlling bleeding externally-
 Direct pressure- using compresses-
o Pressure bandage can be placed to hold pads of cloth.
o Put a thick pad of cloth held between the hand and wound .

 Elevation The injured part of the body should be raised about the
victim’s heart
 Applying pressure on the supplying artery specially on brachial
artery in severe bleeding,
 Apply tourniquet (a tightly compressed bandage used to stop
bleeding) in severe bleeding.
SHOCK-
Definition: The reaction of the body to the failure of the circulatory system
to provide enough blood to all-the vital origins of the body.
Cause:-
 Trauma
 Heart failures
 Sever bleeding
 Loss of plasma-in burns or crushing injures
 Allergy
 Loss of body fluid- recurrent vomiting from any cause
Symptoms of shock-
 General body weakness – the most significant symptoms
 Nausea with possible vomiting
 Thirst
 Dizziness
 Restlessness, and fear /sign of shock
 Fast breathing and shallow
 pulse – rapid and weak
 Pupils - dilated
 Face – pale
 Lips-blue
 Restlessness, become unresponsive
 Breathing – rapid and shallow
First aid management of shock -
 Have the patient lie down and stay at rest
 Keep the air way open and preventing the forward tilting of the head
 Control External bleeding
 Keep the patient warm by covering with blanket or sheet
 Properly position the patient
 Open air way and alert for vomiting
If there is no spinal injuries use one of the following positions
 Elevate the lower extremities, place patient; flat, face up, and elevate
the legs
8-12”
 Do not tilt the patient's body
  Don not elevate any fractured limb unless they have been properly
splinted
 Monitor the patient vital signs.
 Refer the patient to Hospital.
UNCONSCIOUSNESS-
Definition: victim is said to be unconscious when the patient is asleep,
he/she cannot speak and has no control over his movement. Victim also
cannot respond to place, people and time (PPT)
Cause of unconsciousness
 Head injury (bleeding)
 Fainting
 Heart attacks
 Asphyxia
 Poisoning
 Shock
 Epilepsy
 Diabetes
Aim of giving first aid
1. To find out the cause of the condition and manage it as quickly as possible
2. To refer to Hospital
Level of unconsciousness –
 Alertness: the patient can speak, answers, questions and feels pain
 Lethargy :the patient is awoke but answers questions slowly- he may
be confused about what is happening and where he is
 Drowsiness: the patient is sleep of ht is unable to concentrate on what
we are saying
 Semi-consciousness: the patient is very sleep of and has great
difficulty in speaking and in answering your questions
 Unconsciousness: the patient is sleepy we can not speak and has no
control his movements

Treatment of unconscious Patient-

During treatment of unconscious patient follow principles of A, B, C, D,
i.e. –
  Assessing air way
 check breathing
 check circulation using or by taking Vital sign
 check for any bleeding and attempt to stop bleeding
 If the victim is improving place in Recovery position
 Do not give to an unconscious victim anything by mouth
 Establish level of responsiveness, check pulse, breathing rate and
record any observations
 Give priority to respiratory problems and heart beat.
FRACTURE AND DISLOCATION
Fracture: Is a breakage of bone tissue or discontinuation of bone tissue due
to different causes or accidents.
Types of Fracture - • closed • open • compound/complicated
Signs and symptoms of fracture:
o Pain
o protruding of the parts
o Swelling
o Deformity
o Unable to function
o Numbness or tingling sensation
o severe pain
Dislocation: When bone is no more in an anatomical position or the
displacement of one or more bone at a joint.
N.B: Joints which are most frequently dislocated are - shoulder, elbow,
thumb, finger, Jaw
Signs and symptoms-
• Pain, near the joint,
• victim cannot move,
• deformity- abnormal appearance,
• swelling
First aid management- (for fracture and dislocation)
• support and secure the part in most comfortable position
• obtain medical aid at once
• Do not attempt to replace the bones to normal position
NB. Do not delay to refer patient with fracture or dislocation since proper
investigation and management is done at hospital

STRAIN AND SPRAIN

Strain-
Its due to over stretching of muscles.
Causes:
• Lack of pre- exercise before doing sport activity
• Lifting of heavy loads
• Lifting of heavy weight
• The most common one is back strain.
Signs and symptoms-
• Pain (sudden sharp pain at the site of the injury)
• Stiffness of muscles
• Difficulty in moving the affected parts
Management and First Aid-
 Place the victim in the most comfortable position
 If not improved refer the victim
 In case of back strain use a hard board under the bed or lay the victim
down on a firm surface
Sprain
It’s an injury which occurs at joints when the ligaments and tissue around
particular joints are suddenly twisting or torn.
 Sprain is more severe than strain
 It usually happens or occurs at joint especially at ankle joint.
 It might involve bone ( broken)
 Sprain is also tearing of ligaments
Signs and symptoms-
 Pain specially on movement
 Swelling
 Loss of movement
Treatment:
 Raise the limb
 Put on a cold compress
 Renew the compresses when they get warm and dry
 Support the joint in most comfortable position with bandage
 Bandage firmly with figure of eight bandage –
 Refer for further treatment
BURN-
Fire is an accident that causes great damage to life and properties.
Children are the most vulnerable to burn. Burns that occur around the
mouth and nose and in general in the face are more dangerous and can
cause death.
Causes of burns:
 Fire, boiled water, steam, boiled oil and milk etc;
 Sun-rays;
 Electric and thunder accidents; and
 Different chemicals;
Effects/hazards of the burn accident:-
Immediate effects/hazards:
 Burns and wounds of the body;
 Severe pain;
 Oozing and reduction of body fluid from the wound;
 Difficulty in breathing because of suffocation from smoke, severe
burns around the throat and face; and
 Drowsiness, restlessness and unconsciousness.
Delayed effects/hazards:
 Infections of the wound, septicaemia, and high fever;
 Disability;
 Scar
 Contracture; and
 Tetanus infection
Classification of burns:
Burns are usually classified in three levels based on the depth or degree of
skin damage. These are:-
1. First degree burn;
 2. Second degree burn, and
3. Third degree burn.
1st degree burn:
 Redness or discoloration;
 Mild swelling and pain; and
 Rapid healing.
2nd degree burn:
 Greater depth than first degree burns;
 Redness and mottled appearance;
 Blisters;
 Severe pain;
 Swelling; and
 Prone to infection.
3rd degree burn:
 Deep tissue distraction;
 White appearance;
 No pain and blisters; and
 Complete loss of all layers of skin.
This type of burn results in severe disability and/or death.
First-aid measures:
 If the victim is burned with fire apply cold applications, immerse the
burned area in cold water role the burned person on the ground, or
cover with water socked thick cloth or blanket and put out the fire.
 If the accident is of electric source, quickly disconnect at the electric
meter or check point, or use rope wooden stick, dried cloth etc. to
disconnect;
 Move the victim from the accident place to avoid further injury;
 Loosen and/or remove burned dresses and lay down the victim on
his/her back and let him/her breathe fresh air and ensure that no
foreign objects have entered and blocked the passage of the respiratory
system;
 If the victim is not breathing properly, initiate mouth to mouth
artificial respiration; Thoroughly check the wound to determine the
size, and the degree of burn;
Measures for 1st degree burn:
  Apply cold water application or submerge the burned area in cold
water;
 If the wound is minor and small, clean daily the area with boiled cold
water cover it with clean cloth to prevent contact with flies,
 if the wound located is in a joint, immobilize the joint area until the
wound is cured;
 If the wound is from boiled water, chemical (acid), take out his/her
dress and cover it with clean cloth.
2nd and 3rd degree burn:-
 Cover the wound with clean cloth;
 If the victim is conscious, his/her respiratory parts such as mouth,
nose and throat are free from burn injury and give him/her frequently
plenty of liquid such as ORS or similar solution (prepare the solution
from eight tea spoons of sugar, one spoon salt in one litre of boiled
cold water).
 If the victim is a child below two years old give it one spoon every
two minutes and if the child is over two years give it with a cup or
glass in small amount every two minutes;
 Advise the victim or his family to get tetanus vaccine;
 Refer the victim to the nearest health facility.
Take immediately to a nearby health facility burn victims with the
following signs:
 First degree burn with sizeable area;
 2 and 3rd degree burns;
 If the victim is drowsy, restless and has breathing problem;
 If the victim has burns on his face, eye, extremities, joints and around
genital organs;
 If the source of the burn is electrical, chemical or thunder;
 If the patient has chronic disease such as epilepsy, diabetes etc.; and
 If the burn accident is on elderly persons or children,
Measure to prevent burns:
 Keep away from children items such as matches, burning lamp and
candles;
 Prepare and place stoves and other cooking installations in a safe way.
E.g. locally made standing stove;
 Keep away from fire inflammable materials and don’t come with
materials such as nylon close to fire-place;
  Educate smokers not to smoke inside a house and if they smoke give
them strict advice to put off the burning left over cigarette;
POISON
Definition: Any substance that, if taken in to the body in sufficient
quantity, can cause temporary or permanent damage.
Note: get the poisoned casualty to the hospital or health centre immediately.
The extent of danger depends upon:
 The amount and type of poison
 The age of the person
 Whether the person vomits
 Where the accident takes place
General signs and symptoms-
 Nausea
 Vomiting
 Abdominal pain
 Change in consciousness
 Change in vital signs
 Change in pupils
How to remove the poison from the body-
 Make the victim vomit it
 Give plenty of tap water.
 If it is a child give them syrup or water.
 Repeat the procedure
 Refer the victim if it is not improving

NB.
o Do not make patient vomit if the poison e.g. paraffin or kerosene
o Do not make the patient vomit if unconscious

POISON BY SNAKEBITE
Signs and symptoms-
 Disturbed vision
 Feel nauseated or vomiting
 One or two small puncture wounds with sharp pain and local swelling
  Symptoms and sign of shock
 Sweating and salivation in advanced stages of venom reaction
First aid management-
 Lay the victim down and advise not to move
 Calm the victim
 Immobilized the affected part and keep it below the level of the heart
 Wipe the wound of venom
 Apply firm cord just above the bite
 This must be removed in 15 minutes if you are sure that anti venom
has been injected.
If there is no anti-venom do the following:
 Tie a cord tightly around the limb just above the bite
 Using a razor blade or a clean knife make a cut 1 cm deep
 Suck the liquid which is coming out of the wound
 Continue to suck and dispose for 5-10 minutes
 Loosen the cord around the patients limb
 Disinfect the wound
 Refer to hospital for anti- venom injection
HEAD INJURY
Head injuries such as concussion, brain compression, and skull fracture are
difficult for a first aider to determine, and therefore all head injuries
should be treated in the same way.
Symptoms and signs – Not all may be present
 altered conscious state, often deteriorating over time
 blurred or double vision
 a thumping or pounding headache
 nausea or vomiting
 loss of balance and coordination
 altered sensation in the fingers or down one side of the body
 loss of short-term memory – e.g. recent events
 noisy breathing
 leaking fluid from the nose or one ear
 history of a blow to the head

How you can help

1. Assess the patient
 Assess the patient’s conscious state.
 If not fully conscious, place the patient on the side in a supported
position.
 Check that the airway is clear and for signs of life every few minutes.
 If conscious, help the patient to rest in the position of greatest comfort.
 Sometimes patients with head injury may become agitated. Enlist friends
or family to calm and reassure the patient. Consider calling the police if
the safety of the patient or others becomes threatened.

2. Give care until arrival of the ambulance

 Cover any wound with a sterile dressing.
 If there is any discharge from the ears or nose, cover the area with a
sterile dressing.
DO NOT pack the ears or nose with dressings.
3. Monitor the patient
 DO NOT leave the patient alone and keep a constant watch on breathing
and consciousness level.
 Check for and treat any other injuries that may have been overlooked.

4. Maintain body heat

 Cover the patient lightly with clothing or a blanket and protect from
extremes of temperature.
Always arrange for a doctor to check the patient in the case of a head injury
even if it appears that a full recovery has occurred. In some cases the
recognition of serious head injuries may be delayed for 24 to 48 hours
due to a gradual increase in swelling or bruising around the brain.
STROKE
A stroke is a condition in which part of the brain is affected by an
interruption to the normal blood supply. This can result from a clot in a
blood vessel that stops blood passing through to brain tissue. If this
condition is recognised at an early stage and hospital care is readily
available, drug treatment is able to dissolve the clot, resulting in a full
recovery.
Sometimes a stroke is caused by a burst blood vessel when the internal
bleeding in the skull causes pressure on brain tissue. At first, the patient
may have a severe headache, but it can lead to paralysis down one side of
the body and even the loss of the ability to speak.
Symptoms and signs – Not all may be present
 tingling, weakness or numbness down one side of the body
 loss of muscle tone of the face muscles, with dribbling from one side
 blurred or double vision
 nausea
 loss of bladder or bowel control
 loss of speech or the uttering of meaningless
 sounds
 loss of balance and coordination
 deteriorating conscious state or unconsciousness
 headache
How you can help
1. Assess the patient’s level of consciousness
 If unconscious and breathing normally, or if not fully alert, place the
patient on their side in a supported position.
2. Care for a conscious patient
 Assist a conscious patient into the position of greatest comfort
 Cover the patient to reduce heat loss.
3. Observe the patient
 While waiting for the ambulance to arrive, observe the patient closely for
any change in condition.
 If there is any deterioration in the patient’s conscious state, turn the
patient on their side in a supported position.

FITS OR CONVULSIONS
Fit (convulsions)-
 Convulsion may occur in babies and children during teething or very high
fever. Casualty typically holds their breath, become rigid and often
becomes unconscious.

First Aid Management:

 Keep the air way clear and lie him on one side
 Remove any clothes which is too tight
 Keep from biting his tongue by putting tongue depressor in the mouth;
do not force anything in the mouth.
 Prevent from injury or sharp objective
 Educate the victim and the family to go to health centre or a hospital
for further investigation and management