First Aid

Facilitator: Andrew Wanjohi

Objectives
At the end of the course, having passed the mandatory
assessment, The candidate will be competent in the skill
needed to:
1. Manage an Incident in which people are ill or have been
injured
2. Administer proper First Aid in a manner that is Prompt,
Safe and Effective
3. Take good care of the casualty (i.e.) until medical help is
available
Problems
Incident Problems Casualty problems

✓Crowd ✓Bleeding
✓Hazardous material ✓Unconsciousness
✓Fire ✓Fainting
✓Burns
✓Visibility ✓Fractures
✓Falling objects ✓Asthma attack
✓Smoke and fumes ✓Seizures
✓Power lines
 What is First Aid?
The initial help given to a casualty
using available materials and
generally accepted principles
before handing over to a more
responsible person.
Aims /Why?
✓Preserve /save life

✓Prevent the condition from getting worse

✓ Promote recovery
Incident management
Incident Management
✓Assess the situation
✓Make the Area Safe

✓Emergency aid

✓Get Help

✓Aftermath
Summoning For Help
 4WCT
PHONE CALL CONTENTS
1. WHO
2. WHY
3. WHERE
4. WHAT
5. CONFIRMATION
HOSP
6. TIME
CASUALTY
MANAGEMENT

LIFE THREATENING PRIORITIES

AIRWAY
BREATHING
CIRCULATION
 What your tongue could do..

Obstructed Airway Open Airway

The Primary Survey
✓Danger

✓Response

✓Airway:

✓Breathing

✓Circulation
Secondary survey
(assessment for other injuries/medical conditions)

This includes the following:

1.Head-to-toe survey
2.History
3.External clues
4.Recognition features:
Signs & symptoms
SECONDARY SURVEY
• CONSCIOUS • UNCONSCIOUS
Signs & Symptoms History &external clues
Allergies Head to toe survey
Medication
Past history
Last oral intake
Events
The Unconscious Casualty
Aim : Is To Maintain An Open Airway
Management: Turn To Recovery Position
CASUALTY MANAGEMENT-
BREATHING
✓Danger
✓Response
✓HELP-SHOUT
✓Airway
✓Breathing-PRESENT
✓Circulation
✓Secondary SURVEY
✓RECOVERY POSITION
✓HELP(GO/CALL/SEND)
Cardio-Pulmonary
Resuscitation(CPR)
 CARDIO PULMONARY
RESCUSCITATION (cpr)
✓If casualty is not breathing or if you have any
doubt whether breathing is normal begin CPR
✓CPR entails giving air and pumping blood with
your hands in order to sustain a casualty. I.E.
• Chest compressions
• Artificial ventilations

(Continued)
 CPR..
…
3
0
2
 Danger

Response

Airway (open)
SUMMARY

Breathing (absent)send 4 help now

CPR:

Chest compressions -30

Artificial ventilations– 2
Keep repeating till……
• Help comes
• Casualty recovers
• Too exhausted to carry on
• The scene is no longer safe
• On physicians orders

If you are alone, perform around 2 minutes

of resuscitation first before going for help
yourself.
CASUALTY MANAGEMENT-
BREATHING
✓Danger
✓Response
✓HELP-SHOUT
✓Airway
✓Breathing-ABSENT (DIAL 4 HELP)
✓30 CHEST COMPRESSIONS
✓2MOUTH VENTILATIONS
✓HELP(GO)
CHILD (1 – Puberty)
INFANT (Below 1 year)
Disorders of
the Airway &
Breathing
 Choking
Partial or complete obstruction of
the airway by a foreign body
Choking: Treatment of an
Adult or Child
✓Encourage them to continue
coughing.
✓Give up to 5 back blows
✓Give up to 5 abdominal thrusts
✓Alternate blows with thrusts
BACK BLOWS
Abdominal thrusts
Choking: Treatment of an Infant

✓Give up to 5 back blows

✓Give up to 5 chest thrusts

Choking expectant
Give chest thrusts
till obstruction
clears or becomes
unconscious
Disorders of Circulation
 Fainting
Brief loss of consciousness due
to inadequate oxygen/blood
supply to the brain
 Causes of fainting
• Sudden news
• Hunger
• Exhaustion
• Sudden sharp pain/ extreme pain
• Standing for a long time
• Early stages in pregnancy
Recognition features
✓Sudden collapse
✓History
✓Shallow breathing
✓Slow pulse
✓Sweating
 Fainting: Treatment
Aim: to improve blood supply to the brain
Action
✓DR.ABC-loose tight clothing
✓Lay casualty flat on back and elevate his legs
Shock
Insufficient blood (oxygen)supply to vital
body organs
Causes:
1. Reduction in blood(fluid) volume
✓Severe bleeding: internal/external
✓ Severe burns
✓Severe dehydration due to vomiting,
sweating, diarrhoea
(Continued)
Shock: Recognition
✓Pale ,cold and sweaty skin
✓Dizziness and nausea
✓Fast, shallow breathing
✓Rapid, weak pulse
✓Cyanosis: blueness of extremities
✓Thirst
✓Progressively deteriorating level of
response
Shock management
✓DR.ABC-send for help
✓Lay the casualty down, raise and support
their legs.
✓Cover to keep them warm and reassure
✓If uncons…turn to recovery position
✓Monitor breathing and pulse frequently.

(Continued)
Shock :
Treatment Position
Dressings
and
Bandages
Dressing
Cover for wounds(sterile) to:
• Control bleeding
• Prevent against infection
• To protect from further injury

Types: gauze, standard sterile, adhesive,

improvised..

(Continued)
Dressing…
✓If blood seeps through the dressing,
apply another on top.
✓If it seeps through the 2nd, remove
both and tie a new one.
Bandage
Support for dressings or limbs (not
necessarily sterile) to:
• Immobilize limbs
• hold dressings in place
• reduce swelling
• control bleeding
Types: gauze roller, crepe, plaster, triangular……
BLEEDING
 Types of bleeding
✓Internal bleeding

✓External bleeding
Internal Bleeding
✓May present with signs of shock without
apparent visible blood loss (concealed) e.G.
From liver, spleen…
✓A bruise
✓May cause bleeding through the natural body
orifices depending on actual source of the
bleeding e.g.Via nose, urethra…
Priority is to recognize / minimize shock and get
urgent medical aid.
Internal bleeding ….mngt
External Bleeding
A. Minor Bleeding
Priority Is To Minimize The Risk Of
Infection
B. Severe Bleeding
Priority To Control Bleeding, Minimize
Shock And Get Help.

The fate of the wounded lies in the hands of the one who applies the first
dressing – Nicholas Senn MD
Minor bleeding
✓Put On Disposable Gloves.
✓Clean The Cut Under Running Water And
Dry It
✓Cover The Cut Completely With A Sterile
Dressing.
✓Advice To Seek Anti-tetanus Treatment
Severe Bleeding

Expose
eXamine
Pressure
Elevate
Cover
Treat for shock
Embedded Objects
✓Do Not Remove The Object
✓

✓Build Up Padding Around The Object

Then Bandage Without Pressing On It.
✓Take The Casualty
To Hospital.
Dangers:

Penetrating chest wound

Penetrating chest wound
Aim: Prevent Air From Entering The Chest
Cavity And Control Bleeding
✓DRABC – Put The Casualty Half Sitting
Position Leaning Towards Injured Side
✓Cover The Wound With A Sterile
Dressing

(Continued)
Cover wound
immediately with
casualties hand if
dressing is not
readily available.

If casualty unconscious and breathing, place in

Recovery Position lying on the injured side.
Abdominal Wound
✓Cover The Wound With Sterile Dressing
✓If The Wound Is Along The Abdomen, Lie
The Casualty Flat On His Back
✓ If The Wound Is Across The Abdomen,
Lie The Casualty On His Back And Raise
And Support The Knees

(Continued)
In case intestines are protruding, secure
them with a kitchen film or moist
dressing.
Head wound
 Head
Injuries &
Brain
Illnesses
 Head Injuries

✓Concussion
✓Compression
✓Skull Fracture

Due to mechanisms of injury, a head injury

could be accompanied by a neck (spinal) injury
so great care should be taken.
 Concussion
Brief Loss Of Consciousness Due To
Temporary Shaking Of The Brain.
Causes: Traffic Incidents, Sports Injuries, Falls
And Blows Received In Fights.

However, all casualties who are believed to have

suffered a concussion must be seen by a doctor.
Concussion: Recognition
• Brief loss of consciousness following A
blow to the head/fall.

There may also be :

✓Dizziness/nausea on recovery.
✓Loss of memory of events at the time
of, or immediately preceding, the injury.
✓Mild, generalized headache
✓Blurred vision
Management of concussion
✓DRABC
✓Monitor and record response and vital
signs even if the casualty appears to
recover fully.
Advise the casualty to seek urgent medical attention
should they later develop: Headache, Nausea,Vomiting, or
Excessive sleepiness
 Compression
✓Build-up of pressure on the brain

Causes:
1. Accumulation of blood within the
skull or swelling of injured brain tissues.
2. Tumor
 Recognition
✓Deteriorating level of response - casualty
may become fully unconscious.
There may also be :
✓History of a recent head injury.
✓Intense headache.
✓Slow, noisy breathing.
✓Slow, strong pulse.

(Continued)
Contd….

✓Unequal pupil size.

✓Weakness and/or paralysis
down one side of the face of
body.
Management of compression
✓ DR.ABC-send for an ambulance
✓ Keep them supported in a comfortable
resting position and reassure them.
✓Monitor and record vital signs until medical
help arrives.
If unconscious or excessively sleepy:
Place in recovery position or perform CPR if
not breathing
Skull Fracture: Recognition
✓Wound or bruise on the head.
✓Soft area or depression on the
scalp/deformity
✓Thin and watery blood from the
nose or ears.
✓Deterioration in the level of
response.
Management of skull fracture
✓DRABC-send for help
✓Help them to lie down with head &
shoulders slightly raised and
supported
✓If there is discharge from an ear,
cover the ear with a sterile dressing
or clean pad. Do not plug the ear
✓Control any bleeding from the scalp
by applying pressure around the
wound.
(Continued)
Do not raise or incline the head when
neck/spine injuries are suspected support in a
neutral position

If the casualty is unconscious:

• Open the airway using the jaw thrust
• Be prepared to do CPR if need be
Burns
Assessment of burns
(factors)
1. Cause

2. Location

3. Extent

4. Depth
Management of Burns
✓Cool with cold water for at least 20
minutes.
✓Remove constrictions e.G. Jewellery,
watches
✓Cover the burn with sterile dressing
✓ Treat for shock
✓Take to hospital if necessary
✓DO NOT use lotions, ointments and
creams
✓DO NOT break blisters
✓DO NOT Use fluffy material to cover
the burn
✓DO NOT remove any clothing stuck
on the burn
Chemical burns

Causes: Corrosive substances-Acids,powders,

some cleaning agents etc.
Management:
✓Irrigate with cold running water for at least
20mins
✓when pain subsides, cover with dressing
✓Get help
✓Dust off any powder as best as you
can
Electrical Injuries
Low voltage burns
✓Switch of main switch or push the gadget away with
a dry piece of wood.
✓DRABC, this casualty’s heart may stop, be ready
to resuscitate
✓Look for entry and exit
points.
✓Treat as for any other burn.
Electrical Injuries
High voltage burns:
✓Maintain a safety cordon of 18meter
Radius around
casualty.
✓Call for help
Electrical
Electrical
Burns
Burns

Look for both

entrance and exit
wounds
ELECTRICAL BURNS
Burns to the Airway: Recognition
Features
Burns to the Airway Mngmt
✓DRABC-send for help urgently
✓Swelling can obstruct the airway –
suffocation
✓Give frequent sips of water or ice to suck
to reduce pain and swelling
✓Monitor vital signs and be ready to
resuscitate if need be.
Bites & Stings
 Insect Stings
✓Reassure and calm the casualty down.
✓If visible, carefully remove the sting.
✓Apply an ice pack or for at least 10mins.
✓If swelling and pain persist advise the
casualty to see their doctor.

(Continued)
Animal Bites
✓Wash the wound with soap and water
✓Cover with a sterile dressing
✓If bleeding severely apply EXPECT
procedure instead
✓Take to hospital
Snake Bites
Snake Bites
Most snakes are not poisonous but snake
bites usually cause a lot of anxiety and
distress to the casualty.
Aims
• Ensure safety – no more bites
• Identify the snake
• Control distribution of venom in the
body
• Get medical aid ASAP.
 Snake Bite: Treatment
Rest, calm and reassure the casualty to slow down the
heart rate
Lay him with the heart higher than the bite, wash the
bite with soap and water
Use a roller bandage to tie a spiral bandage above the
bite
Get help
(Continued)
Snake Bite management…
✓DO NOT use a tourniquet or a
constricting bandage
✓DO NOT cut the wound
✓DO NOT attempt to suck out the
venom
Musculoskeletal Injuries
 Sprains & Strains
Sprain: tearing or overstretching of ligaments

Strain: overstretching and tearing of a tendon

Management
Rest
Ice
Comfort /Compress
Elevate
Soft tissue injuries:
Muscle Cramps/pulls
Involuntary and painful muscular
contractions.

Due to poor oxygenation & accumulation

of waste (lactic acid)– vigorous activity or
cold
Management
✓A soft massage and stretching the
cramped muscle,
✓Applying heat improves superficial
blood circulation and makes muscles
more flexible
Fractures
• Break or a crack in a bone
Types of Fractures
1. Open: bone protrudes through
the skin
2. Closed: broken bones hidden
inside flesh
Open and closed fracture
Types of fractures
Fractures:
Recognition features
✓History of a recent blow or fall
✓Sound of snapping from the injured site
✓Difficulty in moving the limb
✓Severe pain and tenderness
✓Deformity, bone appears to be in an
unusual position

(Continued)
Recognition features
contd…
✓Swelling or bruising
✓Visible bone if its an open
fracture
✓Signs of shock if the injury is
severe
Management of
fractures/dislocations
✓Immobilise by using slings for the upper
limb and splints for the lower limbs then
apply an icepack or cold compress
✓For open fractures: cover the wound,
place and bandage padding on either
sides of the protruding bone, steady and
support the injured limb
Lifting and carrying
Factors to consider:
✓Distance
✓Weight
✓Nature of injuries/condition
✓Number of helpers
✓Terrain/location
 Methods
One helper:
✓Drag
✓Pick a back (piggy back)
✓Cradle
✓Fire man’s lift
✓Human crutch
2 helpers
✓2 handed seat
✓4 handed seat
More helpers
✓Blanket lift
✓Stretcher
✓Spine board
Guidelines
✓Keep back in locked in position
✓Flex at hips, not the waist
✓Bend at the knees
✓Lift without twisting
✓Have feet positioned properly
✓Communicate with partner/s
✓Keep weight close to the body
Questions?