What does first aid knowledge and skill mean? .................

4
Steps during giving emergency care ..................................4

AFRICAN INSTITUTE OF UNIT TWO: Respiratory Emergencies

Common causes of respiratory failure................................9
RESEARCH AND First aid management of respiratory problem...................10

DEVELOPMENT STUDIES Choking ...........................................................................15

UNIT THREE: Drowning
LECTURE NOTES ON
First aid management ......................................................18
UNIT FOUR: Wound
Classification of wound.....................................................19
FIRST AID
Common causes .............................................................19
UNIT FIVE: Bleeding
TABLE OF CONTENTS Types of bleeding ............................................................21
Content Topics Pages Methods of controlling bleeding externally .......................21
UNIT ONE: introduction to first aid UNIT SIX: Shock
Learning objectives ............................................................3 Symptoms of shock ..........................................................24
General objectives..............................................................3 First aid management of shock ........................................25
Specific objectives..............................................................3 UNIT SEVEN: Unconsciousness
Purpose of first aid treatment .............................................4 Cause of unconsciousness ..............................................26

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Level of unconsciousness ................................................27 Measure to prevent burns ................................................44
Treatment of unconscious patient ...................................27 UNIT TWELVE: Poison
Bandaging and Dressing .................................................28 Types of poisons ..............................................................46
The common types of bandages .....................................28 General signs and symptoms...........................................47
UNIT EIGHT: Fracture Steps to treatment of poison ............................................47
Possible cause .................................................................30 UNIT THIRTEEN: Bites
Signs and symptoms of fracture ......................................32 A Snake Bite.....................................................................49
General first aid management of fracture ........................33 B Dog bite.........................................................................51
UNIT NINE: Dislocation UNIT FOURTEEN: Fit
Cause...............................................................................34 Signs and symptoms ........................................................53
Sign and symptoms..........................................................34 UNIT FIFTEEN: Eye, Ear and Nose Injury
UNIT TEN: Strain and Sprain Injury to the eye ...............................................................54
Strain ...............................................................................36 Problems with ear.............................................................56
signs and symptoms ........................................................36 Bleeding from the nose ....................................................56
Sprain ..............................................................................37 UNIT SIXTEEN: Diarrhea
UNIT ELEVEN: Burn of the Body Causes of diarrhea and/or vomiting ................................ 59
Causes of burns ...............................................................39 First-aid measures............................................................60
Classification of burns .....................................................40 Measures to be taken after first-aid assistance................62
First-aid measures............................................................41 Preventive Measures........................................................63

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UNIT SEVENTEEN: Disease Characterized by Fever Learning Objective
Common diseases that precipitate fever ..........................64 General Objectives: The aim of the first-aid treatment or
Emerging adverse consequences of febrile diseases ......64 management of Health Extension Package is to give lifesaving
treatment and to prevent accident as well as emergency illness at
First-aid measures for febrile cases in general ................65 community setting or environment.
Preventive measures .......................................................66 Specific objectives
First-aid measures............................................................68
At the end of each topic the health extension package students will
Management of Abortion...............................................69 be able to:

Glossary .........................................................................73 1. Describe first aid and the role of first aide
2. Describe the purpose of emergency care.
Reference .......................................................................75
3. Outline steps of emergency care.
Review Questions .........................................................76 4. Provide first aid for the causality and suddenly ill
individuals.
5. Identify the emergency situations.
6. Differentiate problems of pregnant woman and every labor
mgt.
7. Use appropriate, knowledge skill and materials while helping
the causality
8. Equipping the HEPW with basic knowledge, and skill.
9. Differentiate between emergency situation and other use.
10. Practice how to transport the causality.
11. Give first aid treatment for diarrheal problems.
12. Provide first aid management for fever related disease.
13. Give first aid management for patient who is suffering with
UNIT ONE: INTRODUCTION TO FIRST AID. Epilepsy.

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First aid is the initial treatment or help given to sick particularly Resourceful; - she/he may use to the best advantage who ever and
injured individual before professional medical care becomes whatever is at hand to prevent further damage.
available with the materials at hand. Such intervention aims in
Tactful: - She/he may, without the ought less questions, learn the
reducing the situations that threaten the victim until a professional symptoms and history of the case, and secure the confidence of the
arrives or the sick individual is brought to \health facility. causality, and the bystanders in the treatment of the causality.

Purpose of first aid treatment Dexterous; - that she/he may handle a causality without causing
unnecessary pain and use appliances efficiently, quickly and neatly
1. To keep the injured or ill person alive
2. To prevent the injured condition from becoming worse Explicit; - that he/she may give clear instructions to the causality and for
3. To help him/her to recover the by standers how best to assist him
4. To sustains life
Persevering; - that she/or may continue his efforts, though not at first
What does first aid knowledge & skill mean? successful, until relieved by a superior medical authority, or death of the
causality is undoubted
1. The difference between life and death
Discriminating: - that she/he may decide which of several causalities and
2. The difference between temporary and permanent disability
injuries should be treated first and where modification of the correct
3. The difference between rapid recovery and hospitalization treatment as the result of commonsense, may be necessary.

Sympathetic: - that she/he may give real comfort and encouragement to the
suffering, always remembering the first principles of humanity.
Steps in giving emergency care:
The scope of first aid treatement:
1. Look at the general situation of the causality quickly
2. Decide what is wrong and how severe or dangerous the a. Assessing the situation
injury is b. Diagnosing the problems
3. Give the appropriate first aid c. Giving immediate treatment
d. Referring of the causality to higher health institutions
Characteristic of a first aider
A. By observation:
Must be a good observant: -

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Cheek for any external bleeding and determine whether the bleeding is  Dislocation (broken bone)
severe or not  Wounds
 Dislocation (bone put out of place)
Check for breathing pattern and determine whether there is respiratory  Fracture
problem or not.  Sprain
 Strain
B. Brief Examination of patient

First check:
UNIT TWO
1. Breathing (Listen and look at rise and fall of the chest)
2. Color of skin (darks skin due to shortage of oxygen) RESPIRATORY EMERGENCIES
3. Circulation of blood (by taking pulse and blood pressure)
4. Pupils of the eye (large, small, altered with light) Definition: A respiratory emergency is one in which normal breathing
stops or in which breathing is so reduced that oxygen in take is insufficient
C. Check parts of the body: to support life.
Look carefully and quickly of each part of the body in the following order N.B. Artificial respiration: is a procedure for using air to flow in to and out
or steps: of persons Lungs when natural breathing is inadequate or stops.
 Head Common causes of respiratory failure (problems)
 Back
 Neck  Obstruction of the air way by tongue is dropping back
 Arms, hands, fingers  Inhalation of a small amount of food, smoke, irritation, foreign
 Chest objects, carbon monoxide, etc.
 legs, feet, toes  Compression of the neck
 Abdomen  Respiratory disease
 Drowning
 Strangulation
 Combustible gases
D. Look for:
Signs and symptoms
 Signs of internal damage to organ
 Burns  Un able to breath

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  Loss of consciousness  Continue the breathing procedure at the rate 12 to 18 breaths per
 General pallor (paleness) minute until the chest is seen to rise and the patient is breathing for
 Difficulty in breathing him self or until is certain his is dead.
 May be no visible breathing  If a patient is child, our mouth should cover both his nose and
mouth. Very gentle breathing should be used and the younger the
First Aid management of Respiratory problem child, the gentler this should continues at a rate of 25 breaths per
minute.
 Shout for help (depend on the condition)
 Determine the consciousness of the causality by taping the victim
on the shoulder and asking loudly
 “Are you oky!”
 Assess and ensure that patient air way is clear
 Place the patient flat on his back with the head turned to one side
 Remove any thing which is preventing the taking in of air
(Remove constraints from the neck)
 Kneel beside the patient’s head place one hand under his neck and
the other hand under his lower Jaw extend his head and neck
gently back ward. This prevents the tongue from falling back in to
the throat.
 Place your cheek and ear close to the victim’s mouth and Nose.
Look at the victim’s chest to see if it rises, falls, and listen and fell
for air to be exhaled for about 5 seconds.
 If there is no breathing pinch the victim’s nostrils shut with thumb
and index finger of your hand that is pressing on the victim’s
forehead. This action prevents leakage of air when the lungs are
inflated through the mouth.
 Take very deep breath and hold it.
 Fit your mouth tightly over the patients open mouth and forcibly
in to the lungs
 While carrying out respiration, check the patient’s pulse every 2 or
3 minutes to ensure the heart has not stopped.

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Once the patient can breathe by himself/her self-place him/her in what is • If mouth to mouth is failed and no pulse cardiopulmonary resuscitation is
called the recovery positi followed. Cardiopulmonary resuscitation (CPR) or heart lung resuscitation
is a combined effort to maintain circulation and breathing.

• Is an emergency procedure applied when heart and lung actions have

stopped?

• During CPR you will have to perform procedures to:

 Maintain an open airway to maintain circulation

 Breathe for the patient and force the patients’ blood to circulate.

Procedure

If one First Aider

1. Establish unresponsiveness and alert for emergency medical

service and Position the causality.
2. Establish an open airway.
3. Look, Listening, and feel for breathing (3-5 seconds).
4. Ventilate twice (1 to 2 seconds) per breath.
5. If no pulse (5-10 seconds)
6. Locate Compression site
7. Position your hands
8. Began compressions
9. Ventilate twice
10. Recheck pulse after 4cycls of ventilation, then every few minutes.

If two first aider rescuer CPR

1. Determine unresponsiveness
2. Open the air way, look, listen, (feel 3-5 seconds)
Fig. 1 .How to give artificial respiration and positioning of casualty 3. Ventilate twice ( 1 -2 seconds per breath ).

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 4. Determine no pulse and locate CPR compression site First aid management
5. Say “No pulse.” Begin compressions
6. Ventilate once (1-2 seconds) Stop mouth-to-mouth ventilation. N.B. Do not try to hook the foreign body out with your fingers.
7. Continue with one ventilation every five compressions. This is likely to push it further down.
8. After 10 cycles, reassess breathing and pulse. No pulse says,
“Continue CPR.” Pulse- says, “Stop CPR.” For babies and small children:

NOTE: Assess for spontaneous breathing and pulse for 5 seconds at the Hold the baby upside-down by the feet and beat him/her timely between
end of the first minute, then every few minutes thereafter. the shoulder blades.

Lie the child face down over your knee or arm and beat them sharply
between the shoulder blades.

For adults: there are two methods depending up on your knowledge and
Choking
practice
When small piece of food or foreign body may be inhaled in to the
“Methods A” stand behind the patient and hold around the chest just
windpipe when eating in which sometimes help is needed
under the chest hone

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 If the breathing has stopped begin mouth to- mouth respiration. After you
have done the above, refer to the nearest hospital or health the Center.

UNIT THREE

Drowning

Definition

Death caused by water reaching the lungs and either causing lung tissue
damage or spasms of the air way that prevents the inhalation of air.

Drawing can happen in many different places, Lake, swamp and spring,
rivers etc

First aid Management:

 You should begin artificial respiration as soon as possible

 Do not wait to get water out of the patient’s chest first
 If you can not 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.

“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 UNIT FOUR
coughed out.

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Wound  To control the wound stop bleeding
 To treat and prevent shock
Definition: Wound is breaking in continuity to tissue of body, either  To protect the wound from contamination and infection
internal or External.  To prevent complication
 Obtain medical attention
Classification of Wound
Prevention of contamination and infection
1. Open: An open Wound is a break in the skin or mucous membrane
 Hand washing before and after wound care (when possible)
2. Closed: A closed wound involves injury to underlying tissue without a
 By avoiding contaminants
break in the skin or mucous membrane.
 By using lean materials as much as possible E.g. cotton gauze,
Types of Wounds towels etc...
 Wash in and around the victim’s wound to remove bacteria and
 Abrasions other foreign Matters
 Incisions  Wash the wound thoroughly by flushing with clean water,
 Lacerated preferable running tab water
 Punctures  Apply a dry sterile bandage or clean dressing and secure it firmly
 Avulsions in place
 Small wounds even can be taken care at home
 If there is infection refer the victim to the health center
Common Causes

Cause or resulting in open wounds from:

 Motor accidents
 Fall
 Mishandling of sharp objects, tools and machineries

The main aims when dealing with wound

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 1. UNIT FIVE

Bleeding

Definition: Defusing or oozing of blood from blood vessels (Hemorrhage)

Types of bleeding

 Arterial bleeding- bright red in color, flow from the wound inside
 Blood loss
 Venous bleeding – dark red in color, flow is steady
 Capillary bleeding –oozing from bed of capillaries, red in color,
usually less bright than arterial blood with slow flow.

Methods of controlling bleeding externally

 Direct pressure- using compresses

Pressure bandage can be placed to hold pads of cloth.

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 in severe bleeding

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 • Restlessness, become unresponsive
• Skin- cool and clammy- eyes- lack luster
• Breathing – rapid and shallow
UNIT SIX
First aid management of shock
Shock
 Have the patient lie down and stay at rest
Definition: The reaction of the body to the failure of the circulatory  Keep the air way open and preventing the forward tilting of the
system to provide enough blood to all-the vital origins of the body. head
 Control external bleeding
Cause:-  Keep the patient warm by covering with blanket or sheet
 Properly position the patient
• Trauma
 Open air way and alert for vomiting
• Heart failures
• Sever bleeding If there is no spinal injuries use one of the following positions
• Loss of plasma – in burns or crushing injures
 Elevate the lower extremities, place patient place patient-flat, face
• Allergy
up, and elevate the legs 8 to 12 inches
• Loss of body fluid- recurrent vomiting from any cause
 Do not tilt the patient's body
Symptoms of shock  Don not elevate any fractured limb unless they have been properly
splinted
• General body weakness – the most significant symptoms  Do not elevate the leg if there are fractures to the pelvic
• Nausea with possible vomiting  Nothing by mouth (NPO)
• Thirst  Monitor the patient vital signs
• Dizziness  Refer the patient to Hospital
• Restlessens, and fear /sign of shock/
UNIT SEVEN
• Fast breathing and shallow -
• Pulse – rapid and weak Unconsciousness
• Pupils - dilated
Definition: victim is said to be unconscious when the patient is asleep,
• Face – pale
he/she cannot speak and has no control over his movement. Victim also
• Lips-blue
cannot respond to place, people and time (PPT).

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Cause of unconsciousness  Assessing air way
 check breathing
 Head injury (bleeding)  check circulation using or by taking Vital sign
 Fainting  Check for any bleeding and attempt to stop bleeding
 Heart attacks  If the victim is improving place in Recovery position
 Asphyxia  Do not give to an unconscious victim anything by mouth
 Poisoning  Establish level of responsiveness, check pulse, breathing rate and
 Shock record any observations
 Epilepsy  Give priority to respiratory problems and heartbeat.
 Diabetes
Bandaging and Dressing
Aim of giving first aid
Made from flannel, elastic net or special paper cotton cloth
1. To find out the cause of the condition and manage it asquickly as
possible - Bandages are used-

2. To refer to Hospital  To hold splint in proper place

 To maintain direct pressure over dressing to control bleeding.
Level of unconsciousness  To retain dressings and splints in position
 To prevent or reduce swellings
 Alertness: the patient can speak, answers, questions and feels pain
 To restrict movement etc
 Lethargy :the patient is awoke but answers questions slowly- he
may be confused about what is happening and where he is -Bandage should never be used directly over a wound
 Drowsiness: the patient is sleep of ht is unable to concentrate on
what we are saying -Bandaging a wound should be applied firmly enough to keep dressing and
 Semi-consciousness: the patient is very sleep of and has great splints in position
difficulty in speaking and in answering your questions
 Unconsciousness: the patient is sleepy we cannot speak and has no The common types of bandages
control his movements  Triangular bandages
Treatment of unconscious Patient  Roller gauze bandage
 Elastic bandage
During treatment of unconscious patient follow principles of A,B,C,D, i.e.  T- blinder bandage

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  Many tailed abdominal bandage Types of Fracture

- Bandage should not be tight, may cause injury to the part or impair  closed
circulation of blood  open
 compound/complicated
- Lose bandage is also useless

Dressings

A dressing – is protective covering applied to a wound to:

 Prevent infection
 Absorb discharge
 Control bleeding
 Avoid further injury
 An efficient dressing should be sterile (germ free) with high
degree of porosity and allow for oozing of discharge of fluid.

UNIT EIGHT

Fracture

Fracture:

Description: Is a brakage of bone tissue or discontinuation of bone tissue

due to different causes or accidents.

Possible cause:
Sings and symptoms of fracture:
1. Accident / trauma
2. pathological due to bone infection  Pain
3. Tumor of the bone  protruding of the parts

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  Swelling  Support the injured part with supporting device, immobilize the
 mispositions fracture, bandaging and use splints
 Deformity  Refer the patient to hospital urgently
 Unable to function
 Numbness or tingling sensation NB: Proper immobilization is important to prevent further trauma, pain
 Patient may shout due to severe pain and complications.
 Discoloration

Complications

Immediate complications UNIT NINE

 Hemorrhage/ bleeding Dislocation
 Severe pain
 Hypotension ( shock) due to bleeding Definition:- When bone is no more in an anatomical position or the
displacement of one or more bone at a joint.
Late complications
Cause:-
 Disability
 Disfiguring  Strong force acts directly or indirectly on a joint
 Deformity  Sudden muscular contraction
 Malunion
 Delay in union N.B:- Joints which are most frequently dislocated are shoulder, elbow,
thumb, finger, Jaw
General First aid management of Fracture
Signs and symptoms
 Assess carefully but by fast
 Check respiratory condition -Pain, near the joint, victim cannot move it, deformityabnormal
 Check bleeding / hemorrhage appearance, swelling and brusy are usually present
 Consider the amount of loss
First aid and manage:-
 Determine and arrange referral
 Asphyxia, bleeding, and severe wounds must be dealt with before  support and secure the part in most comfortable position
treating any fracture  obtain medical aid at once

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  Do not attempt to replace the bones to normal position  Ant pain support and elevate the inured part or limb and give
antipain
Note: - The causes, the signs and symptoms  If not improved refer the victim
 In case of back strain use a hard board under the bed or lay the
NB. Do not delay to refer patient with fracture or dislocation since proper
victim down on a firm surface
investigation and management is done at hospital.
Sprain
UNIT TEN
Definition: An injury which occurs at a joints when the ligaments and
Strain and Sprain
tissue around particular joints are suddenly twisting or torn.
Strain
 Sprain is more severe than strain
Definition: over stretching of muscles due to over pulling of muscles.  It usually happens or occurs at joint especially at ankle joint.
 It might involve bone ( broken)
Causes:  Sprain is also tearing of ligaments
 Lack of pre- exercise before doing sport activity Signs and symptoms
 Lifting of heavy loads
 Lifting of heavy weight  Pain specially on movement
 The most common one is back strain.  Swelling
 Loss of movement
Signs and symptoms
Treatment:
 Pain (sudden sharp pain at the site of the injury)
 Stiffness of muscles  Raise the limb
 Difficulty in moving the affected parts  Put on a cold compress
 Renew the compresses when they get warm and dry
Management and First Aid  Support the joint in most comfortable position with bandage
 Bandage firmly with figure of eight bandage
 Place the victim in the most comfortable position
 Refer for further treatment
 Cold compress during fracture phase Warm compress
(physiotherapy)

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  Difficulty in breathing because of suffocation from smoke, severe
burns around the throat and face; and
 Drowziness, restlessness and unconsciousness.

Delayed effects/hazards:

 Infections of the wound, septicemia, and high fever;

 Disability;
 Scar;
 Contracture; and
 Tetanus infection
UNIT ELEVEN
Classification of burns:
Burn of the Body
Burns are usually classified in three levels based on the depth or degree of
Fire is an accident that causes great damage to life and properties. Children
skin damage. These are:-
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.  First degree burn;
 Second degree burn, and
Causes of burns:
 Third degree burn.
 Fire, boiled water, steam, boiled oil and milk etc;
1st degree burn:
 Sun-rays;
 Electric and thunder accidents; and  Redness or discoloration;
 Different chemicals;  Mild swelling and pain; and
 Rapid healing.
Effects/hazards of the burn accident:-
2nd degree burn:
Immediate effects/hazards:-
 Greater depth than first degree burns;
 Burns and wounds of the body;
 Redness and mottled appearance;
 Severe pain;
 Blisters;
 Oozing and reduction of body fluid from the wound;
 Severe pain;
 Swelling; and

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  Prone to infection.  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
3rd degree burn: the wound located is in a joint, immobilize the joint area until the
wound is cured;
 Deep tissue distraction;
 If the wound is from boiled water, chemical (acid), take out his/her
 White appearance;
dress and cover it with clean cloth.
 No pain and blisters; and
 Complete loss of all layers of skin. 2nd and 3rd degree burn:-
This type of burn results in severe disability and/or death  Cover the wound with clean cloth;
 If the victim is conscious, his/her respiratory parts such as mouth,
First-aid measures:
nose and throat are free from burn injury and give him/her
 If the victim is burned with fire apply cold applications, immerse frequently plenty of liquid such as ORS or similar solution
the burned area in cold water role the burned person on the (prepare the solution from eight tea spoons of sugar, one spoon
ground, or cover with water socked thick cloth or blanket and put salt in one liter of boiled cold water). If the victim is a child below
out the fire. If the accident is of electric source, quickly disconnect two years old give it one spoon every two minutes and if the child
at the electric meter or check point, or use rope wooden stick, is over two years give it with a cup or glass in small amount every
dried cloth etc. to disconnect; two minutes;
 Move the victim from the accident place to avoid further injury;  Advise the victim or his family to get tetanus toxoid vaccine;
 Loosen and/or remove burned dresses and lay down the victim on  Refer the victim to the nearest health facility
his/her back and let him/her breathe fresh air and ensure that no
Take immediately to a nearby health facility burn victims with the
foreign objects have entered and blocked the passage of the
following signs:
respiratory system;
 If the victim is not breathing properly, initiate mouth to mouth  First degree burn with sizeable area;
artificial respiration;  2nd and 3rd degree burns;
 Thoroughly check the wound to determine the size, and the degree  If the victim is drowsy, restless and has breathing problem;
of burn;  If the victim has burns on his face, eye, extremities, joints and
around genital organs;
Measures for 1st degree burn:
 If the source of the burn is electrical, chemical or thunder;
 Apply cold water application or submerge the burned area in cold  If the patient has chronic disease such as epilepsy, diabetes etc.;
water; and

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  If the burn accident is on elderly persons or children, - Nausea
- Vomiting
UNIT TWELVE
- Abdominal pain
Poison - Change in consciousness
- Change in vital signs
Definition: Any substance that, if taken in to the body in sufficient - Change in pupils
quantity, can cause temporary or permanent damage.
Poisons enter the body either accidentally or intentionally through
Note: get the poisoned to the hospital or health center immediately.
- Ingestion (through the mouth)
The extent of danger depends upon:
- Inhalation (by breathing in)
 The amount and type of poison - Absorption (through the skin) through contact with poisonous
 The age of the person sprays, pesticide, and insecticides
 Whether the person vomits - Injection into the skin as the result of bites from some animal,
 Where the accident takes place insects, poisonous fish or by syringe

There are different types of poisons: Steps to treatment of poison:

- Acids - Remove the poison from the body

- Insecticides - Give the patient the antidote
- Alkalis - Treat symptoms
- Drugs given for allergy (antihistamines) - Give comfort and confidence
- Aspirin over dose in children
How to remove the poison from the body
- sleeping pills (sedatives)
- Iron - Make the victim vomit it
- mercury - Give plenty of tape water.
- lead - If it is a child give them syrup or water.
- paraffin, petrol (Gasoline) - Repeat the procedure
- Lysol - Refer the victim if it is not improving

General signs and symptoms NB. Do not make patient vomit if the poison e.g. parafin or kerosene

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 - Do not make the patient vomit if unconscious - Apply firm cord just above the bite
- For poisoning by acid, give alkali, anti-acids - This must be removed in 15 minutes if you are sure that anti
venoum has been injected and you cannot get the victim to
hospital in time. If there is no antivenoum 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
UNIT THIRTEEN - Disinfect the wound
- Refer the patient to the hospital
Bites -
A. Snake Bite

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 B. Dog bite
- Wipe the wound of venom

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Rabies is a sickness due to an infection from an animal usually a rabid UNIT FOURTEEN
dog, cat, fox, wolf, and bats. The infection grows in the animal’s nerves,
may develop the disease, if the saliva enters a wound or scratch on a Fit
human being. Fit (convulsions)
Signs and symptoms of a rabid dog. When some one has jerking movements and which cannot be controlled it
- has difficulty in swallowing is called fit or convulsion.
- rarely bites Signs and symptoms:-
- Is lethargic /lazy/
- hides it self - uncontrolled jerking movements
- does not want food, but swallows, pieces of wood stone etc - Unconconscious to the environment
- barks in unusual way and never stop barking
Management:
- Saliva runs out of its mouth
- Keep the air way clear and lie him on one side
First aid management
- Remove any clothes which is too tight
1. Clean the wound with soap and water - Keep from biting his tongue by putting tongue depressor in the
mouth
2. Cover the wound with dressing ointment/powders - Note vital signs and time of fit
3. Find out if anyone knows the dog that bit the patient - Prevent from injury or sharp objective
- Educate the victim and the family to go to health center or a
4. If the dog known, ask its owner to watch the dog carefully for lodges hospital for further investigation and management
and to let you know it shows any of the above sign and symptoms in that
time UNIT FIFTEEN

- See, during that time, it begins to show any of the above signs and Eye, Ear and Nose Injury
symptoms Injury to the eye
- get the dog Killed
- Send the person to hospital or Health center immediately for Since the eyes are delicate, they can be affected easily there fore;
antirabies vaccination immediate help should be given.

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Signs and symptoms - Carefully place a smooth match stick at the base lid and pull and
turn it in side out over the math stick
- Pain inside the eye - Remove the often body with wisp of cotton wood
- Wound or cut around the eye ball
- Different between the size of eye ball Note: - Do not try to remove a foreign body from the eye ball
- Sight decreases
- If an acid or alkali gets in to the eye, this can be very dangerous hence,
- Inflammation and infection
flood the eye with running water for several minutes
Management of the eye injury

- Avery light covering be applied to an injured eyes

- Do not apply pressure
- Reassure the patient
- If no improvement in few days, Refer the victim to the nearest
health facility

Foreign bodies in the eyes:

- A foreign can be; dust, ash, particles of sands, or small fly etc.
- Often you can remove foreign from the eyes by flooding it with
taped boiled water.

If it does not work:

Instruct the patient not to rub his eyes, while the patient is looking up;
Problems with ear:
gently draw the lower lid down and out. If the foreign body is seen on the
lower lid remove it with moistened cotton wool or the corner of a clean Bleeding from the ear:
hand kerchief,
Bleeding from the ear may be due to broken (fractured) skull
If it does not
- Cover the ear with a clean material (sterile if available) dressing.
- Stand behind the patient - Do not plug the ear with wool

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 - Do not put in drops Diarrhea
- Refer the victim to the nearest health facility
If some one has over three frequent/subsequent loose stool in a day, it is
Foreign body in the ear: called diarrhea. When an individual loses much fluid from the body due to
diarrhea and vomiting, it is likely that he/she becomes unconscious and /or
- Turn the patient’s head to the affected part of the ear so that the dies.
foreign body may drop out.
- If it is an insect which is inside the ear, direct torch- light to the Causes of diarrhea and/or vomiting:
ear- the insect may follow the light and come out of the ear. If this
• Food poisoning; and
does not succeed
• Intestinal parasites.
- Pour in taped boiled water, the insect may float out
- If neither these treatment is successful refer the client to the next Emerging adverse consequences:
health facility.
• Depletion of body fluids;
Bleeding from the Nose: • Unconsciousness;
• Failure of kidneys;
- If the foreign body is either beans, peas, avoid putting water or
any fluid • Malnourishment and dehydration; and
- Get the patient to pinch the lower part of his nose firmly for 10 • Death, if untreated in time.
minutes, while breathing through his mouth Signs of dehydration/excessive loss of body fluids:
- Loose tight clothing around his neck
- Tell the patient not to blow his nose for several hours • Body debilitation or loss of weight;
- If bleeding persists, refer the client to the next health facility • Dryness of the mouth or tongue, sunken eye balls, eye
drops, and sunken fontanel, in children;
Foreign body in the nose: • Dry and wrinkled skin, and when the skin on the stomach
In an adult, a foreign body may enter the nose by accident, but mostly is stretched up with fingers and let down, it remains as
common in children who insert a pea or a bean in to their noses. wrinkled;
• Reduced amount of urine are observed and ; and
NB. - Do not attempt to remove it, refer to the next health facility. • Restless and unconscious.

UNIT SIXTEEN First-aid measures:

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 • First, ensure that there are no adverse signs that are - If the victim is over 10 years old, give the fluid until satisfied;
usually precipitated by diarrhea and vomiting such as:- - If the victim vomits the fluid, wait for about 10 minutes, and give
• Sunken eye balls, wrinkled skin, restlessness; and one spoon of the solution every three minutes;
unconsciousness; and in children, continuous vomiting - Frequently breast feed the victim and add in small amount other
after taking fluids, shivering etc. supplementary foods such as gruel/oat meals every 10 minutes;
• Prepare ORS in one litter of boiled and cold water. If ORS and
is not available prepare home made solution as follows. - Continue the supplementary feeding for about two weeks after the
Mix eight spoon of sugar, with half a spoon salt in one diarrhea ceased.
litre (three normal beer bottles) of boiled cold water. If
available, add half a glass of orange or banana juice into Rationale for referral
the solution;
• Persistent vomiting after taking fluids;
• The ORS or home-made solution is prepared for an adult.
• If the diarrhea is stained/mixed with blood and the victim
• Therefore, he/she must take the fluid in small amount
has high fever;
every five minutes. If the one liter solution is not finished
• If the vomiting is accompanied with sign such as
in 24 hours, prepare and give a new/fresh solution in the
tenderness and sever cramp of the stomach; and
following day. In addition frequently provide the victim
• If the diarrhea continues for 3 days in children and 4 days
soup, ricewater, gruel/oatmeal (an adult can take daily up
in adults without improvement
to three liters of fluid);
• For children give ORS or a solution mix of eight spoon of Measures to be taken after first-aid assistance:
sugar and half spoon of salt in one liter of boiled
coldwater or mix of 2 times rice flour or corn or wheat or • Explain the causes of diarrhea and vomiting'
smashed potato in one liter of water and boiled for 5-7
• Observe on the presence of precipitating factors in the household, such as
minutes. Feed children after it is properly cooled in the
the maintenance of house cleanliness and personal hygiene, water source
following manner.
usage, the handling of food and feeding practices. Based on the findings
- Children 2 months to 2 years old must get 50-100 milliliters (1 or
educate the household or the community with demonstrations.
2 cups), a maximum of 500 milliliters in one day (one spoon every
2 minutes);
- Children 2-10 years old must get 100-200 milliliters or 2-4 cups of
ORS or home-made solution after every diarrhea episode the child
can take up to one liter of the solution);
UNIT SEVENTEEN

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 Diseases Characterized By Fever • Put cloth soaked in lukewarm water on the chest, face and
abdomen to bring down the fever;
When an individual’s body temperature is too hot than normal (above 37.5
• Ask or ensure perhaps the presence of convulsion,
oc) he/she has a fever. Fever itself is not an illness, but a sign of many
chillness, vomiting, diarrhea, meningitis etc;
different illnesses.
• If the area is malarious and the fever has lasted for at least
Common diseases that precipitate fever:- two days, give the victim malaria treatment according to
the guidelines on malaria case treatment (refer to the
• Yellow fever; malaria prevention and control extension package).
• Typhus, relapsing fever etc; • If the victim has not improved three days after he/she got
• Typhoid; the malaria treatment and if he/she has signs and
• Meningitis’ symptoms such as vomiting, diarrhea, meningitis,
• Influenza; and jaundiced eyes, convulsion, inability to breathe, rapid and
• Malaria intermittent breathing, dyspnea, no urination after drinks,
mental confusion, unconscious etc. and if the locality is
Emerging adverse consequences of febrile diseases not malarious and the cause of the fever is unknown, brig
the victim immediately to a nearby health facility for
• Mental confusion, unconsciousness; treatment. If the victim is a child and has not improved
• Reduction of body fluid; with first-aid treatment, take him rapidly to the next health
• Convulsion; and facility;
• High fever precipitates brine damage, paralysis, low blood • Consult the professional staff in the health facility to find
pressure, dysfunction of kidneys, inability to hear, speak, out whether the cause of the fever is or not an infectious
and liver damage. disease;
• Assess if similar illness is observed in the same
First-aid Measures for febrile cases in general
community; follow and register if the number of cases is
• Cover with or put light dress on the victim. If the victim is rising. Then report and solicit support from the nearby
a child, cover it with light cloth and carry it in your arms; health facility; and
• replace fluids lost by profuse sweating give frequently the • Give health education on the causes and preventive
victim, soup, gruel oatmeal, if the victim is a child, give measures of the illness.
frequently breast-milk;

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 • If the cause is identified, treat accordingly or refer when - Clean the fluid or the saliva coming out through the victim’s
necessary because meningitis and cerebral malaria are mouth;
serious condition to refer soon. - Keep him/her laid down on his/her side until jerking is over. When
the jerking is over, bring him/her immediately to a nearby health
Signs and symptoms: facility;
- Unconsciousness; - Understand the cause of the sudden illness, and if the victim was
- Convulsion; already on drugs, advise and educate him/her to take medicine
regularly. Also keep record of the victim and follow him/her and
- Foaming at the mouth;
advise him/her not to come near fire, or to stay always where there
- Only the white part of the eye ball becomes visible; and
are people; and
- When the convulsion subsides, the victim gradually becomes
- Advise the victim to refrain from crossing deep rivers or climb
conscious. The victim is weak and dizzy for sometime.
high trees.
Emerging adverse consequences
Management of Abortion
- Depletion of oxygen in brain, dysfunction and retardation of the
Danger signs in pregnant women
brain;
- The victim incurs head damage, wound, body burns etc. during the If in spite of all care and advice, any of the following happens urgent
attack; and medical help should be obtained at once.
- Perhaps death
Bleeding
First-aid measures:
If a pregnant woman loses any amount of blood however little from the
- Move or push the victim from potentially dangerous site to breathing- opening (Vaginal) she should be treated as an emergency.
prevent him/her from further accident or injury while in
Vaginal bleeding due to abortion
convulsion;
- Remove nearby objects to avoid further accident; Definition Abortion is an expulsion of the fetus from the womb during the
- Loosen tight dress, necktie, belt etc.; first weeks of less than 28 weeks, of pregnancy.
- Lay him/her on his/her side, to prevent the biting of his/her
tongue, insert splint of wood wrapped by stripes of cloth in NB. There are two types of abortions
between his/her teeth;
1. This is loss of the un born fetus during the first 3 months of pregnancy

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2. Therapeutic Abortion

This abortion which is legally induced by drugs in order to save the

woman’s life.

a) Criminal abortion

This is abortion which is illegally induced in order to end the life of on un

wanted fetus.

First Aid and Management:-

• Arrange for urgent referral, until then:-

- Keep the woman quiet and clean

- Observe and record pulse and respiration rate

􀂃 Collect any tissue or collected blood which may be discharged from the
womb

􀂃 Put clean piece of cloth as a pad on the genitalia

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