Republic of the Philippines

Mountain Province State Polytechnic College

Bontoc, Mountain Province

First Aid and Water Safety

Module 1 of 3

First Aid and Water Safety: learning material

Rommel O. Fecha
Contact Information: 09101935794; jonbonromjovi@gmail.com

Criminology Department

First Semester, SY 2020-2021

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Module 1
INTRODUCTION

Welcome to the First Aid and Water Safety: Learning material! This module is
a self-guided learning for BS Criminology students who are enrolled in DT 13 (First
Aid and Water Safety) course. The course aims to equip the students with the
proper knowledge and skills on First Aid and Water Safety. It deals with the proper
actions to do in terms of emergency and situations that needs its application.
Having knowledge and skills in First Aid may have an important role in relation to
the student’s future job as law enforcers and protectors of lives and properties. The
course also emphasizes on the importance of water safety, corresponding
precautionary measures and as a lifeguard.
Another purpose of this module is to provide a capacity and competence to
the students in promoting health, manage injuries, and to minimize the loss of lives,
as well as prepare for and deal with disasters.
There are 3 parts of this offline learning material and each module part
contains a pre-test, the lesson content, activities for knowledge check and a post-
evaluation. This learning material encourages students to determine their prior
knowledge on the course, study the course context and to have self-evaluations on
the topics learned.
This module is not supposed to pressure students but to allow them to freely
reflect on each lesson or to have a peer discussion among their classmates the
topics through online discussions and collaborations. Avenues for student
consultations regarding this module is also provided as face-to-face learning will aid
students to fully comprehend the topics set in this module. However, there are
things that students need to consider and be reminded about.
Gentle Reminders:
1. For online class
- We will be using zoom, messenger, and Gmail, so by now, it is required that you
have your email accounts. It is important that you have access to internet. All
platforms that I have mentioned can be accessed through your smart phones.
- For online discussions, if deem necessary, we will be using zoom and I will just be
sending you the link through messenger where you can easily access and join the
online discussions.
- For submission of requirements online, kindly use your Gmail account to send files
or documents. We will be having a group chat for each class where reminders can
be posted.
2. Keep time lines
It is best that you keep time lines for schedule of submission of outputs. There are
activities where students will be grouped and it is also best that you keep your
communication lines open (cellphone, messenger, email, etc.) for questions,
clarifications, and online meetings especially when we will not be meeting face-to-
face.
3. Submission of requirements.
All written outputs will be encoded and video recordings should be submitted on or
before the due date of submission. You can submit it during the specified date.

LEARNING OUTCOMES

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 At the end of the module, the students will be able to:
1. Enumerate completely the rules in giving emergency care

2. identify correctly the components of the patient assessment.

3. understand and demonstrate properly how to perform rapid exam during assessment
of a victim.

4. define correctly what is first aid and be knowledgeable about giving first aid to
specific injuries.

5. Define properly and understand what is MCI

PRE-TEST. TRUE OR FALSE

Below are some items that you need to answer to determine your prior
knowledge on the basics of giving emergency care. Try to answer each item by
writing T if the statement is correct and F if the statement is false or incorrect. Write
your answers on the spaces before the numbers. Please use CAPITAL/BOLD letters.
T_____1. Do obtain consent when possible in giving emergency care.
F_____2. During emergencies, always do care for the less serious injuries first.
T_____3. Always assess properly and do not assume that the victim’s obvious
injuries are the only one.
F_____4. As the first aider you should trust the judgment of a confused person.
T_____5. Always make sure to wear personal protective equipment in rendering first
aid.
F_____6. First aid is not intended to preserve lives, alleviate suffering, prevent
further illness or injury, and promote recovery.
T _____7. Penetrating trauma is a result in injury by objects that pierce the surface
of the body and injure the underlying soft tissues, internal organs, and body
cavities.
F_____8. As the first responder the last thing you should do is to survey the scene.
F_____9. Mass casualty incident Is an emergency situation that involves one patient.
T_____10. Goals of first aid is to reduce morbidity and mortality by alleviating
suffering, preventing further illness or injury, and promoting recovery.

LESSON 1. RULES IN GIVING EMERGENCY CARE, PATIENT ASSESSMENT, and

INTRODUCTION to FIRST AID

Objectives: In this lesson, you will be learning about the rules in giving emergency
care, patient assessment, and introduction to first aid. It is also the aim of this
lesson for the students to be able to:
1. Enumerate the rules in giving emergency care
2. Identify the components of the patient assessment.
3. Understand and demonstrate how to perform rapid exam during
assessment of a victim.
4. Define what is first aid and be knowledgeable about the roles and
responsibilities of a first aid provider.

BE MOTIVATED TO PARTICIPATE!
As an instructor, I believe that all of us have experience or witness an
emergency situation. Try to think of an emergency situation and recall your actions
when you responded.
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 It is now your turn to answer. On the space below, briefly discuss how
you responded to an emergency situation. Elaborate how you did it and
assess if what you have done is appropriate.

______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
_____________________________________________________________________________.

WHAT TO EXPECT IN THIS LESSON’S JOURNEY?

The primary focus of first aid training is to provide you with the skills and
knowledge necessary, to minimize the effects of accidents or illnesses. First aiders
provide a primary response to emergencies within the community and may
sometimes be first and only person on the scene, resulting in the need to remain
calm and be able to make the right decisions in a situation dominated by emotional
stress and anxiety.
This activity/lesson is actually done to prepare you future law enforcers or
first aid providers during times of emergency. As first aid providers, it’s necessary
to know first the basic concept in emergency situations.

THIS IS HOW IT GOES!

RULES IN GIVING EMERGENCY CARE, PATIENT ASSESMENT, INTRODUCTION

TO FIRST AID
Before anything else, we have here some first aid myths, this learning
module’s intention is to give you solid first-aid principles and an introduction to
emergency response. The most important first step in first aid is to do no further
harm. The correct principles for action are covered in the module, but the following
list briefly outlines some of the more common first-aid myths.
FIRST-AID MYTHS
 Never slap a choking person on the back—let the person cough and
the object may dislodge itself. If the person stops coughing or
breathing, then perform the Heimlich maneuver.
 Never cut and suck the skin of or apply a tourniquet to a person with a
snakebite. Sucking may introduce more bacteria and spread the
venom, and a tourniquet will cut off blood supply to the area.
 Peeing on a jellyfish sting won’t help the pain.
 Don’t breathe into a paper bag for hyperventilation.
 Don’t drink alcohol to warm up when cold, it will only lead to
hypothermia in cold weather.

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  Don’t drink alcohol for a toothache or any other pain.
 Don’t put butter, Crisco, or any other type of grease on a burn; grease
can trap heat and lead to infection and scarring.
 Don’t put a raw steak on a black eye or any other injury; the bacteria
on the meat may contaminate the wound or the eye.
 Don’t use hydrogen peroxide to clean wounds, it may kill the body’s
defensive cells that are rushing to the wound to take care of invading
bacteria.
 People don’t swallow their tongues during seizures, so don’t try to hold
the tongue or put anything in the mouth. Don’t restrain the person
either.
 Don’t squeeze the stinger on a bee sting or try to pull it out with
tweezers—this will squeeze venom into the wound; use a credit card to
scrape it away.
 Don’t throw your head back during a nosebleed—it will cause blood to
run down your throat and you may vomit. Instead, lean forward slightly
and pinch your nose for ten full minutes.
 If you have something embedded in your skin, you should not pull it
out if there is a chance the object is sealing a wound and preventing
bleeding.
 Get medical help if you are not sure.
 Don’t continue to run with shin splints; running while injured will
increase your injury.
 Don’t put vinegar on a sunburn; instead, apply cool compresses.
 You can’t stop motion sickness by staring at a point on the horizon.
 Don’t use rubbing alcohol to cool down a fever—it will absorb into the
skin and may cause further illness.

I. RULES IN GIVING EMERGENCY CARE

A. DO’s
1) Do obtain consent when possible
2) Do think of the worst
3) Do remember to identify yourself
4) Do provide comfort and emotional support
5) Do respect the victim (modesty and privacy)
6) Do be as calm and direct as possible
7) Do care for the most serious injuries first
8) Do assist the victim on medication
9) Do keep on lookers away from the injured person
10) Do handle the victim to a minimum
11) Do loosen tight clothing

B. DONT’S
1) Do not let the victim see his/her injuries
2) Do not leave the victim alone except to get help
3) Do not assume that the victim’s obvious injuries are the only one
4) Do not make any unrealistic promises
5) Do not trust the judgment of a confused person

C. PATIENT ASSESMENT

Scene Size-up
To examine something or someone, and decide how to act.
 Evaluation of the conditions in which you will be operating.

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 D. PRIMARY SURVEY
1. Survey the scene- “safety first”
2. Body Substance Isolation (BSI)/Personal Protective Equipment (PPE)
3. Mechanism of Injury (MOI)-trauma; Nature of Incident (NOI)-medical
4. Determine Number of Patients
5. Consider Additional Resources
6. C-spine immobilization

E. PRIMARY / INITIAL ASSESMENT

1. General Impression
2. Level of Consciousness (A,V,P,U)
The four levels of responsiveness are:

A - Alert: The casualty is alert and responsive. You can have a logical
conversation with them.
V - Voice: Even if drowsy, the casualty is able to reply when you talk to them.
P - Pain: The casualty is responsive to pain (e.g. nail-bed pressure).
U - Unresponsive: The casualty is unresponsive to all stimuli.

If the casualty is breathing normally but is unresponsive, place them (if

possible) in a stable side position (recovery position).

Note: When possible, always approach the casualty from the direction of the
head (for safety).
C- circulation
A- airway
B- breathing
3. Perform secondary assessment (D, C, A, P, B, T, L, S)

4. Determine priority of patient care and transport

II. Introduction to First Aid

Basics in first aid

First aid is complex and situation specific, so the more informed and
better trained you are the more prepared you are to deal with any
unexpected illness or injury. When someone suffers an injury or sudden
illness, first aid is your initial course of action. But first aid is more than
having a properly stocked first-aid kid; it is being able to prevent, prepare
for, recognize, and easily take care of small accidents, and knowing what
to do in the case of an emergency. You can treat most common illnesses
and injuries when you know what to do, but first you must decide if first aid
will be adequate or if you need professional help. And when the condition
warrants measure beyond first aid, knowing how to act until help arrives
can save someone’s life.

Don’t Panic!

Being prepared is the best way to avoid panic. Being ready for
anything will help you to stay calm, sum up the situation quickly, and
proceed with more efficient, capable action. Being prepared will ensure you
are composed and self-assured, which will help calm the injured party.

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 What is First Aid?
 First aid is the immediate assistance provided to a sick or injured person until
professional help arrives.
 It is concerned not only with physical injury or illness but also with other
initial care, including psychosocial support for people suffering from
emotional distress caused by experiencing or witnessing a traumatic event.
 First aid interventions seek to “preserve life, alleviate suffering, prevent
further illness or injury and promote recovery”
 First aid is the assistance given to any person suffering a sudden illness
or injury with care provided to preserve life, prevent the condition from
worsening, and/or promote recovery. It includes initial intervention in a
serious condition prior to professional medical help being available, such as
performing CPR while awaiting an ambulance as well as the complete
treatment of minor conditions, such as applying a plaster to a cut. First aid
is generally performed by the layperson with many people trained in
providing basic levels of first aid, and others willing to do so from acquired
knowledge. Mental first aid is an extension of the concept of first aid to
cover mental health.

Who is a first aid provider?

A first aid provider is someone trained to do the following:
a) Recognize, assess, and prioritize the need for first aid
b) Provide appropriate first aid care
c) Seek medical assistance when necessary

A. SETUP

 It is a mnemonic device that can help you remember the important points
of making sure it is safe to provide care.
 S- Stop - Pause to identify hazards
 E- environment- Consider your surroundings
 T- traffic - Be careful along roadways
 U- unknown hazard - Consider things that are not apparent
 P- personal safety - Use protective barriers

PURPOSE AND LIMITATIONS

The objectives of first aid are to save life, prevent further injury and limit
infection. However, first aid isn’t a substitute for proper medical treatment. Keep in
mind the objectives of first aid. Every trained first-aider must know when and how
to apply first-aid measures and must be prepared to give assistance to persons
injured in battle, collision and other mishaps.
In administering first aid, you have three primary tasks:
1. Maintain breathing
2. Stop bleeding/maintain circulation
3. Prevent or treat for shock
The first step of course, is to determine the victim’s injuries. When you treat a
victim, first consideration usually must be given to the most serious injury. In
general, the order of treatment is to restore breathing, to stop bleeding, and treat
for shock. Work quickly but don’t rush around frantically. Don’t waste time looking
for ready-made materials. Do the best you can with whatever is at hand. Send for
medical help as soon as possible.

ROLES AND RESPONSIBILITIES OF THE FIRST AIDER:

1. Bridge that fills the gap between the victim and the physician.
 It is not intended to compete with, nor take the place of the services of
the physician
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  It ends when the services of a physician begin
2. Ensure safety to him/herself and that of bystanders
3. Gain access to the victim.
4. Determine any threats to patient’s life
5. Summon more advanced medical care as needed.
6. Provide needed care for the patient.
7. Assist more advanced personnel.
8. Record all finding and care given to the patient.
OBJECTIVES OF FIRST AID
1. To A = alleviate suffering
2. To P = prevent added/further injury or danger
3. To P = prolong life

CHARACTERISTICS OF A GOOD FIRST AIDER

1. Gentle – should not cause pain
2. Resourceful – should make the best use of things at hand
3. Observant – should notice all signs
4. Tactfulness – should not alarm the victim
5. Empathetic – should be comforting
6. Respectful – should maintain a professional & caring attitude

HINDRANCES IN GIVING FIRST AID

1. Unfavorable Surroundings
2. The Presence of Crowds
3. Pressure from Victim or Relatives

TRANSMISSION OF DISEASES AND THE FIRST AIDERS

Even if you know what to do in an emergency, you may be concerned about

giving first aid to a stranger. Many people become particularly concerned if blood is
involved, knowing that HIV and hepatitis B are spread through the blood. However,
if first aid precautions are taken, there is a small chance you will become sick from
the aid you give to another.

How Diseases are transmitted:

1. Direct Contact = occurs when a person touches an infected person’s body

fluids.
2. Indirect Contact = occurs when a person touches objects that have been
contaminated by the blood or another body fluid of an infected person.
3. Airborne = occurs when a person inhales infected droplets that have become
airborne as an infected person coughs or sneezes.
4. Vector = occurs when an animal such as a dog or an insect, such as tick,
transmits a pathogen into the body through a bite.

Diseases that causes concern:

Disease Signs and Symptoms Infective Material
Herpes Lesions, general ill feeling, sore Broken skin, mucous
throat membranes
Meningitis Respiratory illness, sore throat, Food and water, mucus
nausea, vomiting
Tuberculosis Weight loss, night sweats, Saliva, airborne droplets
occasional fever, general ill feeling
Hepatitis Flu like, jaundice Blood, saliva, semen,
feces, food, water, etc.
Fever, night sweats, weight loss, Blood, semen, vaginal
HIV chronic diarrhea, severe fatigue, fluid
shortness of breath, swollen lymph
nodes, lesions
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Body substance isolation is a practice of isolating all body substances (blood,
urine, feces, tears, etc.) of individuals undergoing medical treatment, particularly
emergency medical treatment of those who might be infected with illnesses such as
HIV, or hepatitis so as to reduce as much as possible the chances of transmitting
these illnesses. BSI is similar in nature to universal precautions, but goes further in
isolating substances not currently known to carry HIV.
Body Substance Isolation (BSI) = are precautions taken to isolate or prevent
risk of exposure form any other type of bodily substance.
Basic Precaution Practices:
1. Personal hygiene- Wash your hands before and after any medical intervention
2. Protective Equipment- Wear gloves whenever you are in contact with
another’s blood, body secretions, or tissues even if the person you are
helping is a family member. Wear a facemask or body gown whenever there
is a possibility of blood splashing onto the rescuer.
3. Equipment cleaning and disinfecting
4. Dispose of contaminated sharp objects in the appropriate puncture-proof
container.
5. Dispose of all contaminated equipment in an appropriate biohazard
container.

Note:
To carry-out this precaution against infectious disease, you should use a
protective barrier when you are providing care to anyone, even if you know the
person well. In this day and age, it’s just common sense to avoid contact with an
unknown potential source of infection. If you don’t have gloves, improvise and use
something like plastic wrap and wash your hands thoroughly before and after
providing any care.

FIRST AID EQUIPMENT AND SUPPLIES

1. Basic Equipment
= spine board = sets of splint
= short board/ = poles
= Kendrick’s Extrication device = blankets
2. Suggested First Aid Kit Contents (Basic)
= rubbing alcohol = gloves
= Povidone Iodine = scissors
= cotton = forceps
= gauze pads = bandages (triangular)
= tongue depressor = elastic roller bandages
= penlight = occlusive dressings
= band aid/napkins = plaster

3. Clothe materials commonly used in First Aid

 Dressing = a medical covering for a wound, usually made of cloth.
 Bandage = is any clean cloth material sterile or not used to hold the
dressing in place.

End of lesson 1 of module 1

Self-Check. Let us see how far you understood the lesson. Please elaborate your
answer.

1. Why is it important that as a first aid provider you need to follow the rules in
giving emergency care, particularly in conducting patient assessment?
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It’s your turn...

Evaluation:

For your evaluation, it shall be composed of pencil-and- paper test (objective type: multiple
choice, and identification), please review the topics on your lesson and kindly keep your
communications open for further announcements. See you!

LESSON 2. TRAUMA/ MASS CASUALTY INCIDENT

Objectives: It is assumed that after this lesson, the students will be able to:

1. Enumerate the different types of injuries

2. provide first aid to specific injuries.
3. Define and understand what is MCI
BE MOTIVATED TO PARTICIPATE!
If not all most of us have experience/s injuries (e.g. cut, bruises, burns, etc.),
how did you manage such injury?
It is now your turn to answer. On the space below, briefly narrate your experience/s on how you manage
your injuries.

_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_______________________________________________________________________________.

THIS IS HOW IT GOES!

A. TRAUMA
 It is defined as tissue injury due to direct effects of externally applied
energy. Energy may be mechanical, thermal, electrical, electromagnetic
or nuclear.
 Mechanism of Injury (MOI)- force/energy transmission applied to the
body that cause injury.
 Trauma Assessment: DCAPBTLS

D- Deformities
C- Contusion
A- Abrasions
P- Puncture
B- Burns
T- Tenderness
L- Lacerations
S- Swelling

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A. BLUNT TRAUMA VS PENETRATING TRAUMA
1. BLUNT TRAUMA – Result of force causing body injury without anything
penetrating the soft tissues or internal organs or cavities.

2. PENETRATING TRAUMA – Result in injury by objects that pierce or

penetrate the surface of the body and injure the underlying soft
tissues, internal organs, and body cavities.

B. SOFT TISSUE INJURIES

 Injuries to soft tissues range from simple bruises and abrasions to
serious laceration and amputations.
 Soft tissue injury may result in exposure of deep structures such as
blood vessels, nerves, and bones.
 Soft tissues are often injured because they are exposed to the
environment.
3 Types of Soft Tissue Injuries
1. Closed injuries- Soft tissue damage occurs beneath the skin or
mucous membrane but the surface of the skin or mucous
membrane remains intact.
First aid management

2. Open injuries -there is a break in the surface of the skin or the

mucous membrane, exposing deeper tissues to potential
contamination.

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 3. Burns - Soft tissue damage occurs as a result of thermal heat,
frictional heat, toxic chemicals, electricity, or nuclear radiation.
One of the most common and most painful injuries is a burn injury. Burns are
caused by extreme heat (both wet and dry), chemicals, electricity, radiation, and
even extreme cold. They can affect the skin, eyes, lungs, and other internal organs.

Common Causes:
1. Carelessness with match and cigarette smoking.
2. Scald from hot liquid.
3. Defective heating, cooking and electrical equipment.
4. Immersion in overheated bath water.
5. Use of such chemical as lye, strong acids, and strong detergents.
Factors to Determine the Seriousness of Thermal Burns:
1. The depth = the deeper the burn, the more severe it is. Three depth
classifications are used:
 1st degree = They are the least painful and most common of all burns.
(usually referred to as superficial burns) involve only the outermost
layer of skin, called the epidermis. If treated quickly and blisters do not
form, first-degree burns usually heal very well. Sunburns are a
common form of first-degree burns.
 2nd degree = (usually referred to as partial thickness burns) are more
serious because a deeper layer of skin is affected and because they
are easily infected. Second-degree burns are the most painful because
more tissue is damaged, but the nerve endings are still preserved.
These burns heal well and don’t require medical attention unless they
are larger than two to three inches in diameter or they occur on the
hands, face, buttocks, penis, or vaginal area.
 3rd degree = (usually referred to as full-thickness burns) are the most
serious burns, involving all of the layers of the skin. In third-degree
burns, the skin may appear white, black, and or leathery-looking and
there may be very little pain, although the areas surrounding the burn
might be extremely painful. All third-degree burns require medical
treatment. Call for emergency rescue and transport or take the person
to the nearest emergency room.
Note: Never apply adhesive dressings or any lotions, ointments,
or creams to a first or second degree burn that you are treating at
home unless the skin is broken. For any broken blisters, wash

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 carefully with antibacterial soap and tepid water, apply antibiotic
ointment, and re-bandage.

2. The extent to the affected body surface area = this means estimating how
much body surface area the burn covers.
3. Location of the burn/s = burns on the face, hands, feet and genitals are more
severe than on any other body parts.
4. Victim’s age and medical condition = determine if other injuries or pre-
existing medical problems exist or if the victim is elderly (over 55) or very
young (under 5).

Types of Burn Injuries:

1. THERMAL BURNS = usually caused by flames, contact w/ hot objects,
flammable vapor that ignites & causes a flash or an explosion, and steams or hot
liquid. Heat-induced or thermal burn can occur when the skin comes in contact
with any heat source, such as a cooking pan, an iron, a fire, a hot surface or a
hot, scalding liquid.

Care for thermal burns:

 Care for 1st degree and 2nd degree burns:
- Relieve pain by immersing the burned area in cold water or by
applying a wet, cold cloth. If cold water is unavailable, use any cold
liquid you drink to reduce the burned skin’s temperature.
- Cover the burn with a dry, non-sticking, sterile dressing or clean cloth.
 Care for 3rd degree burns:
- Cover the burn with a dry, non-sticking, sterile dressing or a clean
cloth.
- Treat the victim for shock by elevating the legs and keeping the victim
warm with a clean sheet or blanket.
2. CHEMICAL BURNS = this is usually caused by chemicals be it powder or
liquid. Chemicals will continue to cause tissue destruction until the chemical
agent is removed. Chemical burn occurs when living tissue is exposed to a
reactive chemical substance such as a strong acid or base. Chemical burns
follow standard burn classification and may cause extensive tissue damage.
The main types of irritant and/or corrosive products: acids, bases, oxidizers,
solvents, reducing agents and alkylants.
 Care for Chemical burns:
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 - Immediately remove the chemical by flushing with water
- Remove the victim’s contaminated clothing while flushing with water
- Flush for 20minutes or loner. Let the victim wash with a mild soap
before a final rinse
- Cover the burned area with a dry dressing or, for large areas, a clean
pillowcase.
- If the chemical is in the eye, flood it for at least 20minutes, using low
pressure
- Seek medical attention immediately for al chemical burns

3. ELECTRICAL BURN = the injury severity from exposure to electrical current

depends on the type of current (direct or altering), the voltage, the area of
the body exposed, and the duration contact.
An electrical burn may appear minor or not show on the skin at all, but
the damage can extend deep into the tissues beneath your skin. If a strong
electrical current passes through your body, internal damage, such as a heart
rhythm disturbance or cardiac arrest, can occur. Sometimes the jolt
associated with the electrical burn can cause you to be thrown or to fall,
resulting in fractures or other associated injuries.

 Care for Electrical Burns:

- Unplug, disconnect, or turn off the power. If that is impossible, call the
power company or ask for help.
- Check the ABC’s. Provide Rescue Breathing or Cardiopulmonary
Resuscitation (CPR) if necessary.
- If the victim fell, check for spine injury
- Treat the victim for shock
- Seek medical attention immediately. Electrical injuries are treated in
burn center.

C. Bleeding
- It is potentially dangerous, it can cause weakness and if untreated
can result to death.

Types of bleeding:
1. External bleeding- bleeding outside the body
a. – bright red, spurting blood
b. – dark red, flows steadily
c. – dark red, slowly oozing blood
2. Internal bleeding- any bleeding that occurs in cavity or
space inside the body.

Care of patient with External Bleeding:

D -Direct Pressure
E -Elevation
P -Pressure point
T -Tourniquets

@ Always remember to wear clean gloves.

B. MASS CASUALTY INCIDENT (MCI)

- Is an emergency situation that involves three, or more victims
- By available resources, this could mean that we don’t have enough
ambulances, enough personnel or enough hospital beds.
- It could be:
 Natural
 accidental
 Intentional event

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 Types of MCI’s
a) Highway Accidents
b) Air Crashes
c) Major Fires
d) Train Derailments
e) Building Collapses
f) Explosions
g) Terrorist Attacks
h) Hazardous
i) Earthquakes
j) Tornadoes
k) Hurricanes
l) Floods

A. TRIAGE- is the process of prioritizing or sorting of sick or injured

people for treatment according to the seriousness of the condition or
injury.

1. TRIAGE CATEGORIES:
 Red (1) = immediate - critical patient
 Yellow (2) = delayed - serious
• patient that could wait until all reds have been transported
 Green (3) = ambulatory “walking wounded”
• minor injuries
 Black = deceased

TRIAGE PRIORITIES:
a. HIGHEST PRIORITES (Coded RED)
 Requires immediate transport
 Life threatening situation
 compromise C-A-B
 "SCOOP & RUN", "LOAD & GO"
 Airway/ breathing difficulties
 uncontrolled or severe bleeding
 dec./altered mental status
 severe medical problems
 S/Sx of SHOCK(hypoperfusion)
 severe burns w/ airway COMPROMISE
b. SECOND PRIORITIES (Coded YELLOW)
 patient that could wait until all reds have been
transported
 Monitor every 15 minutes.
 Burns without airway compromise
 Multiple or major bone or joints injuries
 Back injuries with or without spinal cord damage

c. LOWEST PRIORITIES (coded GREEN)

 walking injured
 Minor bone or joint injuries
 Minor soft tissue injuries
d. BLACK tag
 Obvious death
 obviously non-survival injury
 Prolonged respiratory arrest
 Cardiopulmonary arrest
The “START” System of Triage “Simple Triage and Rapid
Treatment (START)”

15
  It is a triage method used by first responders to quickly classify
victims during a mass casualty incident (MCI) based on the
severity of their injury.
 Easy to use
 Focus is on signs/symptoms
 Fast

4 things to think about…

 Ability to follow directions and walk
 Respiratory effort
 Pulses/perfusion
 Mental status

End of lesson of module 1

It’s your turn!

Evaluation:

For your evaluation, it shall be composed of pencil-and- paper test (objective type: multiple
choice, and identification), please review the topics on your lesson and kindly keep your communications
open for further announcements. See you!

Module 2. Bandaging and Splinting/rescue lifts and carries

WHAT TO EXPECT IN THIS LESSON’S JOURNEY?

It is very difficult for a man to go out somewhere and return safely because
we cannot give any guarantee or security to our life. This is the world of accidental
world. So many accidents occur in many places like in schools, during travelling,
when doing our daily activities and place is left out. People motive is just to get
away from the place when accident occurs. They do not come forward to help or to
have some first aid care because they are not aware of giving first aid for injuries.

16
 Every time a health worker would not be available: where the accidents can
take place at any point of time. It is needed or desired that as future law enforcers,
they should have knowledge so that they can be responsible to look after the minor
ailments or accidents.
Injuries and incidents within the home are common among all families on any
given day. People get injured during everyday activities, and illnesses occur in the
course of life, any of which may be mild to serious. Some are treatable at home and
some require medical attention. This module will provide you information on
functions of bandaging & splinting, the general principle of bandaging, and general
principles of splinting and rescue lifts and carries.

LEARNING OUTCOMES
At the end of the module, the students will be able to:
1. Know the types of bandages, and the principles of bandaging and splinting.
2. Demonstrate the proper way of bandaging using open phase; broad cravat,
narrow broad cravat, and narrow cravat phase.
3. discuss the general guidelines for moving victims

Lesson 1 of module 2. Bandaging and Splinting

PRE-TEST. Below are some items that you need to answer to determine your prior
knowledge on Bandaging and splinting. Try to answer each item by writing T if the
statement is correct and F if the statement is false or incorrect. Write your answers
on the spaces before the numbers.
Please use CAPITAL/BOLD letters.
T_____1. One of the functions of bandage is use to hold dressing in place over a
wound.
F_____2. Loosely tied bandage create pressure over a bleeding wound.
F_____3. Using dirty bandage helps prevent contamination and infection of wounds.
F_____4. Splints help increase inflammation from trauma.
T_____5. A bandage should never be applied directly over a wound
F_____6. Bandage and splints should restrict circulation.
T _____7. All long bones should be splinted “where they lie” before moving the
victim.
F_____8. In applying splints, joints below the fracture only should be immobilized.
T_____9. Splints should be padded to prevent injury to the limb or discomfort to the
patient.
F_____10. Never used improvised splints.

OBJECTIVES:
At the end of this module, the participants shall be able to:
1. Enumerate the different types of bandages.
2. Appreciate the principles of bandaging and splinting.
3. learn the proper application of bandage.
4. perform properly at least 4 kinds of bandaging.
5. Demonstrate the proper use of splints.

BE MOTIVATED TO PARTICIPATE!

17
 Cuts and abrasions of all kinds can happen every day, from scraped knees on
a patio to deep cuts on fingers and hands in the kitchen and workshop. Cuts are
skin wounds that involve separation of the skin and are usually caused by a sharp
object like a knife or a piece of glass. I do believe you have experience this kinds of
injuries.

It is now your turn to answer. On the space below, briefly discuss

how you took care for simple cuts and abrasions:
Elaborate how you did it and assess if what you have done is
appropriate.

______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
_____________________________________________________________________________.
Please find time to compare on the steps you did.

Take the following steps to care for simple cuts and abrasions:

1. Wash your hands with soap and water and then wash the wound under running
water. For wounds that are bleeding, apply direct pressure with a sterile cloth or
bandage and elevate the wound.
2. Apply antibiotic cream, but avoid using iodine or hydrogen-peroxide solutions, as
they can cause further damage to injured tissues and may cause allergic reactions
in people reactive to iodine and shellfish.
3. Dress the wound with a sterile gauze, preferably nonstick, bandage to protect the
wound from infection and water loss until a scab forms.
4. Keep the area around the wound clean and change any dirty dressings promptly.
Change most dressings daily and replace dressings when any fluids soak through, to
decrease any chance that the wound will dry and stick to the dressing. Cleaning
open wounds can sometimes cause bleeding, which can be easily stopped with
direct pressure using a sterile gauze pad.

Alert!
Never dress a wound with obvious contamination. If you aren’t able to get it clean,
then cover it lightly with a sterile bandage and seek medical attention.

THIS IS HOW IT GOES!

Bandaging and Splinting

A. Bandaging

18
What is a Dressing or Compress and Bandage?
Dressing - Any sterile cloth materials used to cover the wound
USES:
a. Control bleeding
b. Protects the wound from
infection

Bandage- Any clean cloth materials, sterile or not, used to hold dressing in place.

FUNCTIONS OF BANDAGING
A. control bleeding
B. tie splints in place
C. Immobilize body part
D. Reduce Patient Pain/Discomfort.
E. Use to hold dressing in place over a wound.

- It is a piece of clothing material that can be utilized in an emergency.

- it practically is the most readily available since you can convert any clothing
material into a triangular bandage in the event of an emergency.

Application of Bandage
A. Must be proper, neat and correct
B. Apply snugly not too loose or not too tight
C. Always check for tightness caused by later swelling
D. Tie end with square knot

TYPES OF BANDAGES

a) Roller Bandages (Elastic Bandages)

b) Triangular Bandages/ Cravat
TYPES:
A. open phase
1. Head Top Side/ Top of Head
2. Burned Face/Back of Face
3. Chest/Back of Chest
4. Burned Hand/Foot
B. semi-broad cravat
1. Shoulder/Hip Bandage
2. Elbow Bend/Elbow Straight
3. Knee Bend/Straight
C. narrow cravat
1. Forehead Bandage
2. Ear, Cheek and Jaw Bandage
19
 3.Eye Bandage
4.Arm/Leg Bandage
5.Palm Pressure Bandage/Close Palm Bandage
6.Open Palm Bandage
7.Sprained Ankle – Shoe-On
- Shoe-Off
c) Tailed Bandages

A. Roller Bandages (Elastic Bandages)

B. Triangular Bandages/ Cravat

C.Tailed Bandages

B. Splinting
A method of immobilizing an injured part to minimize movement and prevent
further injury.

Splinting Rules
1. Splint an injury in the position in which you find it.
2. For fractures, splint the joints above and below the site of the injury.
3. For sprains or joint injuries, splint the bones above and below the site of the
injury. Do not try to replace a dislocated bone into its socket as this may
cause further injury.

4. If you are not sure if the injury is a fracture or a sprain, splint both the bones
and joints above and below the point of injury.

20
 5. For open fracture, cover the wound with a sterile dressing and apply pressure
around the injury to control bleeding but be careful not to press on a
protruding bone.
6. Splinting material should be soft or padded for comfort.
7. Check for circulation (feeling, warmth and color) before and after splinting to
make sure that the splint is not too tight.

FUNCTIONS OF SPLINTING
A. Reduce inflammation from trauma
B. Prevent further injury
C. Provision of external support
D. Protection of healing structures

GENERAL PRINCIPLE OF BANDAGING & SPLINTING

1. All long bones should be splinted “where they lie” before moving the victim.
2. In applying splints, joints above and below the fracture should be
immobilized.
3. Splints should be applied without interfering circulations.
4. Splints should be padded to prevent injury to the limb or discomfort to the
patient.
5. Splints may be improvised.

End of lesson 1of module 2

Evaluation:
For your evaluation, it shall be composed of pencil-and- paper test (objective
type: multiple choice, and identification), please review the topics on your lesson and
kindly keep your communications open for further announcements.
Return demonstrations will also be conducted in our face to face meetings. See
you!

Lesson 2 of module 2. RESCUE LIFTS AND CARRIES

Objectives: It is assumed that after this lesson, the students will be able to:
a. perform proper posture and movements of body to prevent injury during
lift and carries.

b. Appreciate and apply the different types of carries.

c. Identify the parts of Kendrick Extrication Device (KED) and know its
importance.

21
BE MOTIVATED TO PARTICIPATE!
Most back injuries result from improper lifting. Protect your back by
practicing proper lifting and carrying techniques.

It is now your turn to answer. On the space below, list down how you
protect your back most especially when you lift heavy objects or person:

______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
____________________________________________________________________________.
.

THIS IS HOW IT GOES! Let’s do this….

LIFTING AND MOVING VICTIMS SAFELY

LIFTING IS A ROUTINE PART OF A RESPONDER.

IMPROPER LIFTING CAN LEAD TO INJURY.
BODY MECHANICS- refers to the proper posture and movements of body to
prevent injury.

PRINCIPLES
 DO NOT REACH OVER 20”
 USE LEGS, NOT BACK
 KEEP WEIGHT CLOSE TO BODY
 MOVE AS SINGLE UNIT
 CARRY VICTIMS UPSTAIRS, HEAD FIRST AND DOWNSTAIRS, FEET FIRST

LIFTING AND MOVING TECHNIQUES

POWER GRIP”
 Allows maximum control while raising or lowering stretcher.
 Fingers completely wrapped around to lift.
 Gets the maximum force from your hands.
 Each hand goes under the handle with the palm facing up and the thumb
extended upward.
POWER LIFT”
 Maximizes use of stronger leg muscle.
 Back straight and locked.
 Tighten abdominal muscle.
 Feet and shoulder width apart.
 Keep lift vertical.
ONE RESCUER
ANKLE PULL

22
  Fastest method for moving a victim a short distance over a smooth surface.
This is not a preferred method of patient movement.
SHOULDER PULL
 The shoulder pull is preferred to the ankle pull. It supports the head of the
victim. The negative is that it requires the rescuer to bend over at the waist
while pulling.
BLANKET PULL
 This is the preferred method for dragging a victim.
ONE-PERSON LIFT / LOVERS CARRY / FRONT CRADLE
 This only works with a child or a very light person.
FIREFIGHTER CARRY
 This technique is for carrying a victim longer distances. It is very difficult to
get the person up to this position from the ground. Getting the victim into
position requires a very strong rescuer or an assistant.

TWO RESCUERS
HUMAN CRUTCH/ TWO-PERSON DRAG
 For the conscious victim, this carry allows the victim to swing their leg using
the rescuers as a pair of crutches.
 For the unconscious victim, it is a quick and easy way to move a victim out of
immediate danger.
FOUR-HANDED SEAT
 This technique is for carrying conscious and alert victim’s moderate
distances. The victim must be able to stand unsupported and hold
themselves upright during transport.
TWO-HANDED SEAT
 This technique is for carrying a victim longer distances. This technique can
support an unconscious victim.
CHAIR CARRY
 This is a good method for carrying victims up and down stairs or through
narrow or uneven areas.

THREE OR MORE RESCUERS

HAMMOCK CARRY
 Three or more rescuers get on both sides of the victim. The strongest
member is on the side with the fewest rescuers.
THREE-PERSON CARRY OR STRETCHER LIFT
 This technique is for lifting patients onto a bed or stretcher, or for
transporting them short distances.
If the patient is being placed on a low stretcher or litter basket:
 On the command of the person at the head, the patient is placed down on the
litter/stretcher.
If the victim is to be placed on a high gurney/bed or to be carried:
 At this point, the rescuers will rotate the victim so that the victim is facing the
rescuers, resting against the rescuers' chests.

23
24
25
26
EXTRICATION
Is the removal from entrapment or from a dangerous situation or position
(also called entanglement?)
What is K.E.D?
 Is an emergency patient-handling device designed to aid in immobilization
and short transfer movement of patient suspected of spinal/cervical injuries?
 A semi-rigid brace that secures the head, neck and torso in an anatomically
neutral position.
PARTS OF THE K.E.D
a) Buckles with corresponding straps
b) Leg straps
c) Malleable padding for the head
d) Integrated lifting handles
e) Wrap around head flaps
f) Head straps
g) Wrap around torso flaps
h) Stiff board that is reinforced with wooden slats

27
HOW TO USE THE K.E.D
a) Assess and apply C-Collar / X-Collar
b) Reassess PMS patient
c) Place the KED behind their back
d) Connect Middle and Bottom buckles
e) Connect Leg straps
f) Immobilize head
g) Connect the Top strap
h) Re-tighten all straps
i) Assess PMS and patient status ( LOC)
j) Prepare for extrication
k) Extricate patient onto a backboard

“My Baby Looks Hot Tonight”

 M- Middle (Yellow)
 B- Bottom (Red)
 L- Legs (White)
 H- Head (Black)
 T- Top (Green)
End of lesson 2 of module 2.

Evaluation:

For your evaluation, it shall be composed of pencil-and- paper test (objective type: multiple
choice, and identification), please review theModule 3. lesson and kindly keep your
topics on your
communications open for further announcements.
Emergency action principle & introduction to basic life support
andReturn
Rescue Breathing
demonstrations willdue toconducted
also be Respiratory Arrest & meetings.
in our face-to-face foreignPerformance
body
airway
checklist obstruction
will be (FBAO)
used in assessing your individual performance. See you!

WHAT TO EXPECT IN THIS LESSON’S JOURNEY?

it’s well known that in order to save lives, CPR needs to begin immediately
after a person collapses or “witnessed arrest” occurs (when someone sees
the event occur). But only approximately one-third or less of people
respond in witnessed arrest situations, and even when CPR is begun
immediately it is often done incorrectly. That’s why it’s important to
become certified in CPR and Automated External Defibrillators (AED) and to
take the recommended renewal certification classes. By learning CPR, you
can help preserve life, limit disability, restore health, and even reverse
clinical death in emergency situations.
In this module, participants will be able to acquire knowledge, skills and
attitude necessary in an emergency particularly on basic life support.

28
LEARNING OUTCOMES
At the end of the module, the students will be able to:

1. At the end of the training, participants will be able to acquire

knowledge, skills and attitude necessary in an emergency to help sustain
life and minimize the consequences of respiratory and cardiac emergencies
until more advanced medical help arrives.

PRE-TEST. Below are some items that you need to answer to determine
your prior knowledge on Emergency action principle, introduction to basic
life support, Rescue Breathing due to Respiratory Arrest & foreign body
airway obstruction (FBAO). Try to answer each item by writing T if the
statement is correct and F if the statement is false or incorrect. Write your
answers on the spaces before the numbers.

Please use CAPITAL/BOLD letters.

T_____1. As in all first-aid situations, assess the area for safety before
approaching the unconscious person
F_____2. If there is no need to perform CPR or if you already have
performed CPR and the person begins breathing, then you can now leave
the person to recover.
T_____3. In a suspected spinal or neck injury, your first priority is keeping
the airway open, so if the person is breathing, leave them in the position
you found them.
T_____4. When you suspect someone is choking, ask her, “Are you
choking?” If the person is able to answer you, don’t do anything because
it’s likely that she will free the food or object on her own.
T_____5. The Heimlich maneuver is a technique whereby you administer
abdominal thrusts to yourself or to a person who is choking.
T_____6. An AED is a small, portable electronic device that is used to
deliver an electric shock in an attempt to disrupt or stop abnormal electrical
activity in the heart.
F _____7. The compression-to-ventilation ratio for adult CPR involving a single
rescuer is 20:2.
T_____8. You are treating an adult choking victim. They initially can cough, but
now are gasping their throat and turning blue. The next step is to perform
abdominal thrust.
F_____9. An infant who had been choking becomes unresponsive. The rescuer
should perform abdominal thrust
T_____10. You should ask a person if He/ She is okay before performing CPR.

OBJECTIVES:
At the end of this module, the participants shall be able to:
1. Describe the Five Emergency Action Principles
2. Perform the basic Initial Assessment of the Victim with Sudden Cardiac
Arrest
3. Identify the Chain of Survival for Adult and Pediatric Patients.
4. Explain the importance of the Respiratory, Circulatory, and Nervous
Systems in relation to Basic Life Support.

29
 BE MOTIVATED TO PARTICIPATE!

Question!

Are the symptoms of a heart attack the same for both men and women?

What do you think?

Answer: Women have the same symptoms as men but, are more prone to
also have back or jaw pain, shortness of breath, nausea, and vomiting. You
need to seek immediate medical help for any symptoms, not just the
“classic” symptoms of a heart attack.

THIS IS HOW IT GOES!

Lesson 1 of module 2.
Emergency action principle & introduction to basic life support
LEGAL BASES

Policy: administrative order (a.o.) 155 s. 2004

“the basic life support (bls) training is mandatory to all health workers”

Health emergency management staff (hems) goal:

“at least one member of each household shall be trained in bls”

A.EMERGENCY ACTION PRINCIPLES

 SURVEY THE SCENE
Once you recognized that an emergency has occurred and decide to act, you
must make sure the scene of the emergency is safe for you, the victim/s, and
any bystander/s.
Elements of Survey the Scene
a) Scene safety.
b) Mechanism of injury (MOI) or nature of illness (NOI).
c) Take standard precautions.
d) Determine the number of patients
e) Consider additional/specialized resources.
1.ACTIVATE MEDICAL ASSISTANCE

30
Use of Mobile Phone in Activation of Emergency Medical Service (EMS)
Information to be remembered in Activating Medical Assistance:
 WHAT happened?  The TELEPHONE no.
 LOCATION? from where you are calling?
 NUMBER of Persons  PERSON who
Injured? activated Medical Assistance
 EXTENT of Injury and must identify him/herself
First Aid given? and drop the phone last.
3. DO A PRIMARY ASSESSMENT OF THE VICTIM
 In every emergency situation, you must first find out if there are
conditions that are an immediate threat to the victim’s life.

4. DO A SECONDARY ASSESSMENT OF THE VICTIM

It is a systematic method of gathering additional information about injuries or
conditions that may need care.
a. Interview the victim / look for:
 S - Signs and symptoms  L - Last meal taken
 A – Allergies  E - Events prior to injury or
 M – Medications incident
 P - past medical history
b. Check vital signs- every 15 minutes if stable condition, and every 5
minutes if unstable
c. Head to toe examination
Rescuers should look for other signs of injuries in a quick manner from the head
to toe and apply necessary first aid measures to the injury seen.
D- Deformity B- Burns
C- Contusion T- Tenderness
A- Abrasions L- Lacerations
P- Punctured S- Swelling

5. REFERRAL OF THE VICTIM FOR FURTHER EVALUATION AND

MANAGEMENT

THREE KINDS OF LIFE SUPPORT

1. BASIC LIFE SUPPORT (BLS)
A set of emergency procedures that consist of recognizing respiratory or cardiac
arrest and the proper application of Cardio-Pulmonary Resuscitation (CPR) with
or w/o Automated External Defibrillation (AED) or Foreign Body Airway
Obstruction Management (FBAOM) and Rescue Breathing (RB) or to maintain
life until a victim recovers or advanced life support is available.
2. ADVANCED CARDIAC LIFE SUPPORT (ACLS)

31
A set of clinical interventions for the urgent treatment of cardiac arrest and
other life threatening emergencies, as well as the knowledge and skills to
deploy those interventions.
3. PROLONGED LIFE SUPPORT (PLS)
For post resuscitative and long term resuscitation with the use of adjunctive
equipment such as ventilator, cardiac monitor, pulse oximeter etc.
Basic Life Support
 Level of medical care which is use for victim of life threatening illnesses or
injuries until advance care arrive.
 Includes immediate recognition of sudden cardiac arrest and activation
of the EMS, early performance of High Quality CPR, and rapid
defibrillation when appropriate.

 CHAIN OF SURVIVAL

 This is a strategy which aims to improve the outcome for victims of

cardiopulmonary arrest.
 It involves a series of events which are interconnected to each other like a
link s of a chain.

BODY SYSTEMS
CIRCULATORY SYSTEM
• Consists of the heart, blood vessels, and blood
• Delivers oxygen and nutrients to the body’s tissues and removes waste
products

RESPIRATORY SYSTEM

32
  Delivers oxygen to the body
 Removes carbon dioxide from the body

Ventilation - Passage of air into and out of the lungs

Inspiration - Inhalation or breathing in
Expiration - Exhalation or breathing out
Respiration - Actual exchange of oxygen and carbon dioxide in the alveoli
as well as the tissues of the body.
• Air that enters the • Air exhaled from the
lungs contains: lungs contains:
– 21% Oxygen (O2) – 16% O2
– trace of Carbon dioxide – 4% CO2
(CO2)
NERVOUS SYSTEM
 Composed of the brain, spinal cord and nerves
 Two major functions – communication and control
 Let’s a person be aware of and react to the environment
 Coordinates the body’s responses to stimuli and keeps body
systems working together

B. Cardio-pulmonary Resuscitation

Cardiovascular Risk  Lack of exercise

Factors  Stress
 Non-modifiable  Obesity
(Heredity, Gender, Age)  DM
 Modifiable  Other causes of CPA
 Cigarette smoking (sudden death);
 Hypertension  Drowning, Electrocution
 ↑ Cholesterol levels  Trauma, Poisoning

33
  Epilepsy, Allergy  lightning strikes
 Suffocation, smoke
inhalation
Cardio-pulmonary Resuscitation (CPR)
 Emergency procedure that combines chest compression often with
artificial ventilation in an effort to manually preserve intact brain function until
further measures are taken to restore spontaneous blood circulation and breathing
in a person who is in cardiac arrest.
 Its main purpose is to restore partial flow of oxygenated blood to the
brain and heart.
How does CPR work?
 The brain may sustain damage after blood flow has been stopped for
about 4 min. and irreversible damage after about 10 min.
 The heart also rapidly loses the ability to maintain a normal rhythm.
 CPR is effective only if performed within 7 minutes of the stoppage of
blood flow.

 Effective CPR enables enough oxygen to reach the brain to delay brain
stem death, and allows the heart to remain responsive to defibrillation attempts.
Time Frame of Cardiac Arrest
 0-1 mins.( cardiac irritability )
 0-4 mins. ( Brain damage not likely )
 4-6 mins. ( Brain damage possible )
 6-10 mins. ( Brain damage very likely )
 Above 10 mins. ( Irreversible brain damage )
WHEN TO START CPR
If you see a victim who is:
1. Unconscious/Unresponsive
2. Not breathing or has no normal breathing (only gasping)
3. No definite pulse

When not to start CPR?

1. Body in advance stage of decomposition (putrefaction).
2. Decapitation
3. Rigor Mortis (stiffening of the body)
4. Algor Mortis (Cooling down)
5. Livor Mortis (discoloration of the body caused by pooling of blood)
6. Attempts to perform CPR would place the rescuer at risk of physical injury.

When to STOP CPR?

S- Start breathing and has pulse / Victim recovers.
T- Care is Transferred to another provider of equal or higher level of training.
O- Out of strength or too tired to continue CPR.
P- Physicians assumes responsibility & direct you to discontinue CPR / Valid
DNAR (Do not Attempt to Resuscitate) order is presented.
S- SCENE becomes unsafe (such as traffic, impending or ongoing violence,
gun fires, etc)
S- SIGNED waiver to stop CPR
High quality CPR
• P- Push hard, Push fast
• *Depth: 2- 2.4 inches 5-6 cm,
• *Rate: at 100 - 120 / minute
• * Cycle: 1 cycle = 30 compression and 2 breaths
• A- Allow full chest to recoil
• M- Minimize interruption
• A- Avoid hyperventilation

The CAB's of CPR

Circulation:
 Does the victim has pulse? (HCP).

34
  Is the victim responsive? (lay rescuer)
 Is the victim bleeding severely?
Airway:
 Does the victim has an open airway (air passage that allows the victim
to breath).
 Is the victim moving, coughing & breathing normally?
Breathing: - Is the victim breathing.
Checking for Responsiveness
Tap or gently shake the victim.
• Rescuer shouts “are you ok"?
• Look for medical alert tag, bracelet, or other indicators.
• Activate EMS system if available in the community.
• Proceeds with CPR.
If the victim responds
1. Leave him/her as it is. 3. Try to find out what is wrong.
2. Activate the EMS 4. Reassess regularly.

CHECKING FOR PULSE (Health Care Provider)

 Check for Pulse (Adult and  (28 days to 1 y/o)
Child)  Feel brachial pulse on the
 Maintain head tilt with one upper arm between elbow &
hand on forehead. shoulder
 Locate Adam's apple with  Check sign of circulation (10s).
middle & index finger of hand.
 Slide fingers down into groove  Circulation for Lay Rescuers
of neck on side closest to you.  Quickly scan if the victim is
 Feel carotid pulse for 10 moving, breathing
seconds. normally/coughing.
 Check for Pulse (Infant)
NOTE:
DO NOT use your thumb to check a casualty’s pulse because you may
confuse the beat of your pulse with that of the casualty.

C- CIRCULATION
Chest compressions in an adult
 Kneel facing victim's chest at the level of victim’s shoulder.
 In the Centre of chest in between nipple area, & lower half of the sternum.
 Place heel of hand directly on top of heel of other hand.
 Keep fingers off victim's chest.
 5.Compress breastbone (at least 2 inches (5cm) but not greater 2.4 inches
(6cm). at rate of 100-120/min. Count 1-30, Push hard & push fast.
 Compress down & release pressure smoothly. Keeping hand in contact with
chest at all times.

35
 Chest compression (CHILD)
 Same as adult (use one hand/ two-hand

Chest compression (INFANT)

 Locating proper finger position for chest compression. Note that the other
hand is use to maintain head position (facilitate ventilation).
 2-3 fingers compress the sternum, just below the inter-mammary
line with chest depth about 11/2 inches (4cm): (lone rescuer)
 2 thumb-encircling hands technique (two rescuers)
 Rate of 100-120/mins.

Compression only (Hands only) (Cardio-cerebral) resuscitation (Lay &

HCP)
• Chest compressions without artificial respiration.
• Easier: the method of choice for the untrained rescuer
• In adults with out-of-hospital cardiac arrest, compression-only CPR by the
lay public has a higher success rate than standard CPR.
• The exceptions: cases of drowning, drug overdose (with respiratory arrest)
and arrest in children.
• Rate: the same as standard CPR (at least 100- 120/min.)
CPR during pregnancy
• During pregnancy when a woman is lying on her back, the uterus may
compress the inferior vena cava and thus decrease venous return. It is
therefore recommended that the uterus be pushed to the woman's left.

A- AIRWAY
• Airway (Adult & Child)
• Open airway using head-tilt-chin lift method/ jaw thrust (Trauma).

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• Airway (Infant)
• Head in neutral position (<1y/o).
B- BREATHING
• Victim may either be; (Breathing/ (-) breathing)
*if the victim is breathing*
 Maintain Open airway & position the victim.
*if (-) breathing;
Adult & Child)
• Maintain open airway, pinch nose
• Open mouth wide, take deep breath, and make tight seal around mouth.
• give 2 breaths
• Observe chest rise & fall, listen & feel for escaping air.

(Infant)
• Mouth to nose & mouth
• create a seal
• Give 2 breathes/puff
• Observe chest rise& fall, listen & feel for escaping air
CARDIOPULMONARY RESUSCITATION (CPR)
 Continue CPR until
• AED arrives and starts to analyze
• EMS providers take over the care of the victim
 Reassess victim every after 2 minutes
 Rescuers may switch roles (for Two-Man Rescuers)
 If patient becomes conscious, place patient in RECOVERY POSITION.

Steps of positioning the victim in the Recovery position

Adult chest compression-to-ventilation ratio (1&2 rescuer CPR)

• breathing and pulse: perform cycle of (30:2) for 2 mins., then check pulse.
• If still no pulse, Continue CPR.
• Recheck pulse every 2 minutes.
Paediatric chest compression-to-ventilation ratio
• Infant & Child (1rescuer- same as adult)
• Infant & Child (2 rescuers)
• (-) pulse,15:2
• Neutral position
• Neonate (same as infant)
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 BLS Dos and Don’ts of Adult High-Quality CPR
Rescuers Should
 Perform chest compressions at a rate of 100-120/min
 Compress to a depth of at least 2 inches (5 cm)
 Allow full recoil after each compression
 Minimize pauses in compressions
 Ventilate adequately (2 breaths after 30 compressions, each breath delivered
over 1 second, each causing chest rise)

Rescuers Should Not

 Compress at a rate slower than 100/min or faster than 120/min
 Compress to a depth of less than 2 inches (5 cm) or greater than 2.4 inches
(6 cm)
 Lean on the chest between compressions
 Interrupt compressions for greater than 10 seconds
 Provide excessive ventilation (i.e., too many breaths or breaths with
excessive force)

End of lesson 1 of module 3.

It’s your turn

Evaluation:

For your evaluation, it shall be composed of pencil-and- paper test (objective type: multiple
choice, and identification), please review the topics on your lesson and kindly keep your
communications open for further announcements.
38
Return demonstrations will also be conducted in our face to face meetings. Performance checklist
will be used in assessing your individual performance. See you!
 Lesson 2 of module 3.
Rescue Breathing due to Respiratory Arrest & FOREIGN BODY
AIRWAY OBSTRUCTION
(FBAO)

Objectives: It is assumed that after this lesson, the students will be able to:
1. Describe what Respiratory Arrest is and its causes
2. Compare the Rescue Breathing techniques for infant, child, & adult
3. Demonstrate correct Rescue Breathing techniques for infant, child, &
adult
4. Identify the causes, types, and classification of Obstruction.
5. Be knowledgeable on how to remove foreign body obstruction.

BE MOTIVATED TO PARTICIPATE!

Choking occurs when an object gets stuck in the throat and partly or
completely blocks the airway. Have you encountered any choking incident?

If you happen to have encountered a choking incidents what signs (Signs of choking) have you
observed?

Signs of choking include:

A. Pointing to throat,
B.hands crossed on throat (universal sign of choking)
C.Gasping or coughing
D. Signs of panic
E.Difficulty speaking
F.Red face that steadily turns blue
G. Loss of consciousness

THIS IS HOW IT GOES!

RESPIRATORY ARREST defined- Is the condition in which breathing stops

or is inadequate.

Causes of Respiratory Arrest

A. Obstruction C. Other causes:
1 Anatomical 1. Electrocution
2.Mechanical 2. Circulatory Collapse
B. Diseases 3. Strangulation
1. Bronchitis 4. Chest Compression by other
2. Pneumonia physical force
3. COPD 5. Drowning
4. Diphtheria 6. Poisoning
7. Suffocation

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RESCUE BREATHING
• It is a technique of delivering air into a person’s lungs to supply him/her with
the oxygen needed to survive.
• Given to victims who are not breathing or inadequate but still have pulse.
• Crucial tool to revive the individual or keep him or her until the help comes.

WAYS TO VENTILATE THE LUNGS

 Mouth-to-Mouth
 Mouth-to-Nose
 Mouth-to-Mouth and Nose
 Mouth-to-Stoma
 Mouth-to-Face Shield
 Mouth-to-Mask
 Bag Valve Mask Device

FOREIGN BODY AIRWAY OBSTRUCTION (FBAO)

 Partial or complete blockage of the breathing tubes to the lungs due to
foreign body (Food, Bead, Toys,etc).
 Most common cause in unconscious victim is tongue.
 Could be mild or severe.
 Clutching the neck is the universal distress sign.

Early warning signs of respiratory failure

40
  Unable to speak, breathe or cough.
 Clutches neck (universal distress sign)
 Bluish color of skin & lips.
CAUSES OF AIRWAY OBSTRUCTION
1) Improper chewing of large pieces of food.
2) Excessive alcohol intake.
3) Presence of loose upper and lower dentures.
4) For children who are running while eating.
5) For smaller children of hand-to-mouth stage left unattended.
TWO TYPES OF OBSTRUCTION
1. ANATOMICAL OBSTRUCTION
 tongue drops back and obstructs the throat.
 Other causes are acute asthma, croup, diphtheria, swelling, and cough.
2. MECHANICAL OBSTRUCTION
 Foreign objects
CLASSIFICATION OF AIRWAY OBSTRUCTION
1. Mild Obstruction
 Good air exchange
 Responsive and can cough forcefully
 May wheeze between coughs.
2. Severe Obstruction
 Poor or no air exchange
 Weak or ineffective cough or no cough at all
 High-pitched noise while inhaling or no noise at all
 Increased respiratory difficulty
 Cyanotic (turning blue)
 Unable to speak
 Clutching the neck with the thumb and fingers making the universal sign
of choking
 Movement of air is absent.
FBAO MANAGEMENT
ABDOMINAL THRUST
 An emergency procedure for removing a foreign object lodged in the airway
that is preventing a person from breathing.
 Commonly used for conscious ADULT and CHILD victim.

Complications from Abdominal Thrust

1. Incorrect application may damage the chest, ribs and internal organs.
2. May also vomit after being treated with the Abdominal thrust.
Note: The victim should be examined by a Physician to rule out any life-threatening
complications.

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5 BACK SLAPS AND 5 CHEST THRUST
• For conscious INFANT with foreign body airway obstruction.

FBAO MANAGEMENT UNDER SPECIAL CIRCUMSTANCES

CHEST THRUST
• To be used for: Obviously pregnant and Very obese patient.
• Instead of using abdominal thrusts, Chest thrusts are used for this group of
people.
• The fists are placed against the middle of the breastbone and pressing the
patient’s chest with backward thrust.
• If the victim is unconscious (adult, child or infant) the chest thrusts are
similar to those used in CPR.

FBAO Management Algorithm

Adult / Child / Infant

Determine scene safety.

Introduce yourself to the victim, guardian and/or bystander.
Determine level of breathing difficulty by checking:

A. Infant-
A1. Ask the parent/guardian what happened.
A2. Look for signs and symptoms of airway obstruction:
ineffective coughs, weak or absence of cry.
B. Child/Adult-
A1. Ask the victim if he/she is choking.
If the victim is able to respond with good air exchange:
A1.1 Stay beside the victim and encourage him/her to cough

42
4. Properly position the patient.
a. Infant- support the infant on rescuer’s knee or lap
b. Child/Adult - Assume straddle position behind the victim.
5. Locate proper site:
a. Infant- give 5 back slaps (between the shoulder blades) and 5 chest thrust
using 2 fingers technique.

b. Child/Adult- for abdominal thrust, properly position your balled fist against
the patient’s abdomen at the midpoint between the xiphoid process and
navel. Perform abdominal thrust with a quick inward and upward motion.
6. If patient becomes unconscious, carefully lay him/her down.
7. Activate Emergency Medical Service (EMS) and perform 30 Chest Compression.
8. Check oral cavity for presence of obstruction. If foreign object is visible, perform
finger sweep; if not visible, properly administer FIRST Rescue Breath.
9. If air bounces back, re-position patient’s head and properly administer SECOND
Rescue Breath.
10. If air goes in, assess for pulse and consciousness.
11. If patient becomes conscious, properly place patient in recovery position.

End of lesson 2 of module 3

Evaluation:
For your evaluation, it shall be composed of pencil-and- paper test (objective
type: multiple choice, and identification), please review the topics on your lesson and
kindly keep your communications open for further announcements.
Return demonstrations will also be conducted in our face to face meetings.
Performance checklist will be used in assessing your individual performance. See
you!

Name: _________________________________________ Date: ____________________

Agency: __________________________________________________________________

43
 Skill Performance Sheet
INFANT-FBAO
Performance Guidelines √ if REMARKS
done
correc
tly
1. Determine scene safety.
2. Introduce yourself to the victim, guardian
and/or bystander.
3. Determine level of breathing difficulty
by checking:
a) Ask the parent/guardian what happened.
b) Look for signs and symptoms of airway
obstruction: (ineffective coughs, weak or
absence of cry).
4. Properly position the patient: (support
the infant on rescuer’s knee or lap).
5. Locate proper site: (Infant- give 5 back
slaps between the shoulder blades and 5
chest thrust using 2 fingers technique.).
6. If patient becomes unconscious, carefully lay
him/her down.
7. Activate Emergency Medical Service (EMS)
and perform 30 Chest Compression.
8. Check oral cavity for presence of obstruction.
If foreign object is visible, perform finger sweep;
if not visible, properly administer FIRST Rescue
Breath.
9. If air bounces back, re-position patient’s head
and properly administer SECOND Rescue Breath.
10. If air goes in, assess for pulse and
consciousness.
11. If patient becomes conscious, properly place
patient in recovery position.

Test Results: Infant FBAO P NR (needs

Skills (pass) refresher)
Instruc Date
tor

Name: _________________________________________ Date: ____________________

Agency/
School:__________________________________________________________________

44
 Skill Performance Sheet ADULT-FBAO
Performance Guidelines √ if REMARKS
done
correct
ly
4. Determine scene safety.
5. Introduce yourself to the victim, guardian and/or
bystander.
6. Determine level of breathing difficulty by
checking:
c) Ask the victim if he/she is choking.
d) (If the victim is able to respond with good air
exchange): Stay beside the victim and
encourage him/her to cough
4. Properly position the patient: (Assume
straddle position behind the victim).
6. Locate proper site: (for abdominal thrust,
properly position your balled fist against the
patient’s abdomen at the midpoint between the
xiphoid process and navel. Perform abdominal
thrust with a quick inward and upward motion).
6. If patient becomes unconscious, carefully lay
him/her down.
7. Activate Emergency Medical Service (EMS) and
perform 30 Chest Compression.
8. Check oral cavity for presence of obstruction. If
foreign object is visible, perform finger sweep; if not
visible, properly administer FIRST Rescue Breath.
9. If air bounces back, re-position patient’s head and
properly administer SECOND Rescue Breath.
10. If air goes in, assess for pulse and consciousness.
11. If patient becomes conscious, properly place
patient in recovery position.

Test Results: Adult FBAO P(pass NR (needs

Skills ) refresher)
Instruc Date
tor

REFERENCES

Anita, Kerwin N. (2004). First Aid Handbook.WS Pacific Publication, Inc., Manila,
Philippines.

45
Blackman, James A. (2007) First Aid. Microsoft® Student 2007 [DVD]. Redmond,
WA: Microsoft Corporation, 2006.
Boy Scouts of America (1995) Lifts and Carries, Retrieve on August 31, 2018 from:
file:///C:/Users/Admin/Documents/Documents/documents
/FIRST%20AID/CERTLiftsandCarries.pdf
Microsoft ® Encarta ® 2007. © 1993-2006 Microsoft Corporation.
Browner, Bruce D. (2002). Emergency Care and Transportation of the Sick and
Injured. Jones and Barlett Publishers American National, Sudbury Massachusetts.
Department of Health (2013). Basic Life Support Reference Manual
International Federation of Red Cross and Red Crescent Societies, Geneva, (2016)
“International first aid and resuscitation guidelines 2016” retrieved from:
file:///C:/Users/Admin/Documents/BLS/first%20aid%20research
/First-Aid-2016-Guidelines_EN.pdf_
Kelly, Andrew, Lawlor, Anthony (2017). First Aid Manual, The Step-by-step Guide for
Everyone, Penguin Random House Company., China
Mogol, Adonis A. (2011) First Aid: responding to emergency transport of the sick
and injured.
Nadine Saubers, R.N. (2008) The Everything® First Aid Book. Published by Adams
Media, an F+W Publications Company 57 Littlefield Street, Avon, MA 02322 U.S.A.

PDRRMO Provincial Disaster Risk Reduction Management Notes

Red Cross (2012). First Aid References Manual

Congratulations! you have completed learning our module. Be safe.

Prepared: Rommel O. Fecha

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