first aid-module one
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CONTENT PAGE
Lesson 2:
A B C of First Aid
Lesson 1:
Principles & Practice of First Aid
Lesson 3:
First Aid Equipments
Lesson 4:
Wounds & bleeding
Lesson 6:
Shock
Lesson 5:
Fractures
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Principles &
Practice of
First Aid
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By the end of this lesson, you will be able to: Identify the principles of first aid;
Identify the practice of first aid.
bjectives
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Principles of First Aid
1.1 What is First Aid1.2 Aim of First Aid1.3 Responsibility of First Aider1.4 Protecting yourself as a First
Aider
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1.1 What is First Aid
It is immediate assistance or treatment given to someone injured or suddenly taken ill before the arrival of an ambulance, doctor, or other appropriate qualified person
The person offering help must be: Calm Confident Willing to offer assistance whenever
necessary
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1.2 Aim of First Aid
reserve life
revent condition from worsening
romote recovery
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1.3 of First Aider
Give casualty early and appropriate treatment, treating the most serious conditions first.
Responsibility
Assess a situation and summon help;
Protect casualties and others from danger;
Identify the injury or nature of the illness;
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Prevent cross-infection.
1.3 of First AiderResponsibility
Arrange for the casualty into the care of a doctor
Remain with casualty until further care is available;
Report your observations to those taking over care of the casualty;
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1.4 Protecting yourself as a First Aider
Personal Safety, e.g assess the situation
Protection from infection, e.g wash hands
Prevent cross infection, e.g. dispose waste
carefully
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Practice of First Aid
1. Assess the situation2. Make the area safe3. Give emergency aid4. Get help from others
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1. Assess the situation
Possible Risk?Yes
No
Clearing of obstacles possible?
Approach Casualty
No
Call for help – Ambulance/ Fire engine
YesClear ObstacleReassess situation,Safe?
Yes
No
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2. Make the area safe
Protect the casualty from dangerProtect the casualty from danger..
SURVEYSURVEY the incident site to the incident site to ENSURE ENSURE thatthat
AREA IS SAFEAREA IS SAFE..Aware of your Aware of your limitations.limitations.
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3. Give emergency aid
Assess each casualty to determine Assess each casualty to determine treatment priorities, and treat those with treatment priorities, and treat those with life-threatening conditions first.life-threatening conditions first.
Perform Perform initial assessment, or primary , or primary survey.survey.
Summon necessary helpSummon necessary help
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What is initial assessment?
Gloves are to be worn
Response > Consciousness
Airway > Open/ clotted
Breathing> Chest rising/
breath blowing on face
Circulation> Pulse and signs of
survival
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Making A Diagnosis, on the basis of:
History & clues Full story of the incident How the injury was sustained How the illness began and
continued? Sign & symptoms Detailed examination
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Making A Diagnosis, on the basis of History & Clues, some questions to ask:
Last eat and drink Any illness or on any current
medication The amount of force The environment Age & state of health. Establish who is the casualty
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Signs & Symptoms
What is it???
SignsSigns are details of a casualty’s are details of a casualty’s condition that you can see, feel, condition that you can see, feel, hear or smell.hear or smell.
SymptomSymptomss
are sensations that the are sensations that the casualty experiences, and casualty experiences, and may be able to describe, if may be able to describe, if she is conscious.she is conscious.
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What senses???
Using your senses to look for the signs & symptoms.
Look : Observe the casualty
Listen : Listening to the casualty’s breathing
Feel : Feel for any swelling
Smell : Smell for any strange smells
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You may xxx some of these signs…
Seeing Feeling Hearing Smelling Asking
Anxiety &
Painful
expression
Burns
Deformity IrregularityDampness
Sucking sounds Grating bone
Acetone Burning Urine
Loss of sensation Abnormal sensationNausea StiffnessPain Hot/Cold
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4. Get help from others
Make the area safeTelephone for assistance;Fetch the first aid equipment or first aid
box;Control traffic and onlookers;Control bleeding or support a limb;Maintain the casualty’s privacy;Transport the casualty to a safe place.
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A B COf
First Aid
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By the end of this lesson, you will be able to: Understand what is ABC in First Aid; Perform an ABC examination on a casualty;
Identify the need for a recovery position;
Place a casualty in a recovery position.
bjectives
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1.What is ABC in First Aid
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Airway may become blocked by the tongue when unconscious or lying flat.
Closed airway
Open airway
Open airway by lifting the casualty’s chin with two fingers and pressing on the forehead to tilt back the head.
Do not leave an unconscious casualty lying face upwards.
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Look Listen FeelMovement in the chest or abdomen
sounds of breathing
casualty’s breath on your cheek
Check for 10 seconds !!!
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The pulse indicates the condition of the circulation,
Place to feel for a pulse: carotid pulse in the neck.
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Meant for unconscious casualty who’s is still breathing
Do not use on conscious or likely to regain conscious casualty.
2. What is recovery position
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First Aid Equipment
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By the end of this lesson, you will be able to: Recognize the different first aid material; Know the application of each first aid materials;
Identify the various type of bandages;Know the Principles of bandaging;
bjectives
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1. Types of material in First Aid Kit
Materials are classified as follows: Dressings Bandages Other
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2. How to use thema) Plaster: Dry surrounding area of wound. Peel back protective strips without touching the pad. Place pad on the wound. Pull away protective strips. Press the end and edge down.
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2. How to use themb) Sterile dressing pad: Hold pad by the edge. Place it directly on the wound. Add a layer of cotton wool padding on top. Secure it with adhesive tape or with a roller bandage.
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2. How to use themc) Roller bandage: Place tail of bandage below the injury. Make 2 straight turns to anchor the bandage. Make a series of spiral turns up the limb covering the injury. Finish off with 1 straight turn and secure the end of the bandage.
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A broad-fold bandage to immobilise and support a limb;
d) Triangular bandage
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•A narrow fold bandage to immobilise feet and ankles
d) Triangular bandage
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Pass the left end over and under the right. Bring both ends up. Pass the right end over and under the left. Pull the ends firmly to tighten.
e) Reef knot
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Untying reef knot Pull one end of the bandage firmly It will become straighten Hold the knot and pull the straightened
end through it.
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3) Types of bandaging : Scalp bandage
It is only use hold the dressing on the scalp in place.
They do not control bleeding.
Check for foreign body before bandaging.
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It holds the forearm in a horizontal position.
It provides support to upper arm; wrist; forearm or rib fracture.
3) Types of bandaging: Arm sling
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3) Types of bandaging: St. John Arm sling
Support the forearm & hand in a raised position. It helps to control bleeding; minimize swelling and support chest in rib fracture.
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3) Types of bandage: Ring pad
Used when there is an embedded object. Vital to control bleeding; Vital to protect wound from infection; Vital to immobilize the affected area.
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4. Principles of bandaging
Reassure the casualty and give clear explanation.
Make the casualty comfortable.
Keep the injured part supported
Always work at the front of the
casualty, and the injured side.
Rules
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Pass the bandage under the body’s natural hollows at the
ankles, knees, waist, and neck when lying down.
Apply bandages firmly, but do not interfere with circulation.
Leave the fingers or toes exposed to check the circulation.
Use reef knots to tie bandages.
Regularly check the circulation.
4. Principles of bandagingRules
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Checking circulation after bandaging
A swollen and congested limb
Blue skin with prominent veins
A feeling that the skin is painfully distended
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WOUNDS &
BLEEDING
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bjectives
By the end of this lesson, you will be able to:
Define what is wound;Identify the types of wounds;Identify the types of bleeding;
Recognize the signs and symptoms;Provide the treatment for wounds &
bleeding.
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1. DEFINITON OF WOUNDWound is defined as:
Any abnormal break in the skin or body surfaces.
Two types: - Open wound blood and other body fluid lost
from body, permit the entry of germs.- Close wound
Skin is intact, bleeding occur internally.
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2. TYPES OF WOUND
There are 7 types of wound.
1.Incised wound2.Laceration3.Abrasion / graze4.Contusion / bruise5.Puncture wound6.Gunshot wound7.Stabbed wound
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WOUNDS – Incised wound
Clean cut from a sharp edge. Blood vessels at edges of
wound are cut straight across and may cause profuse bleeding.
Injury on a limb may sever underlying structures such as tendons.
Causes: Sharp knife or broken glasses
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Results from rough tear by crushing or ripping forces.
Usually bleed less profusely than clean cut.
More tissue damaged and bruising.
High risk of infection.
Causes: Machineries
WOUNDS – Laceration
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Superficial wound in which top layers of skin are scraped off leaving a raw and tender area.
Abrasion often contain embedded foreign particles that may cause infection.
Causes: Sliding fall or friction burn
WOUNDS – Abrasion (graze)
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Rupture capillaries beneath the skin.
Blood leaks into tissue causing bruising.
Skin may be broken but usually unbroken.
May indicate hidden damages such as fracture or internal injury.
Causes: Blunt blow or punch
WOUNDS – Contusion (bruise)
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A small site of entry but a deep track of internal damage.
High risk of infection.
WOUNDS – Puncture
Causes: Standing on a nail or stabbed or jabbed with a needle.
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Will cause serious internal injury and sucking in of contaminants.
Wound at point of entry may be small and neat but the exit may be large and ragged.
Causes: A bullet or other missile driven through the body.
WOUNDS – Gunshot wound
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May cause danger of injury to vital organs or life-threatening internal bleeding
WOUNDS – Gunshot wound
Caused : Gun
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WOUNDS – Stabbed wound
Cause: sharp object
•May cause several internal damage within the chest and upper abdomen.•Can cause pneumothorax
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How to remember?
I Like Going to Changi
AirPort.
Incised GunshotLaceration
Contusion Abrasion Puncture
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TYPES OF BLEEDING
There are three types of bleeding:
1. Arterial 2. Venous 3. Capillary
Name after the blood vessel they are from: Artery, vein, capillary
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Bleeding – Arterial bleeding
Blood richly oxygenated. Bright red. Under pressure from pumping
heart. Rapidly empty the circulation of
blood.
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Bleeding – Venous bleeding
Less oxygenated (oxygen already given off). Dark red. Under less pressure than arterial blood. Blood from major vein may gush profusely.
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Bleeding – Capillary bleeding
Most common for almost all sites of injuries.
Superficial – Blood loss only slight. Rupture of capillary under the skin –
bruises.
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SIGNS AND SYMPTOMS Site Appearance Cause
s
Mouth Bright red, cough out blood xxxxxxxx
Vomited blood, red/ dark reddish brown, resembling coffee grounds
xxxxxxxx
Ear Fresh, bright-red blood; Thin watery blood xxxxxxxx
Nose Fresh, bright-red blood; Thin, watery blood xxxxxxxx
Anus Fresh, bright-red blood xxxxxxxx
Black, tarry, offensive smelling stool xxxxxxxx
Urethra
Urine with red or smoky appearance and occasionally clots xxxxxxxx
Vagina Either fresh or dark red xxxxxxxx
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Direct pressure & Indirect Pressure
Direct Pressure = applied over the wound directly using a dressing.
Indirect Pressure = applied at the pressure points above bleeding artery
NEVER apply tourniquet.
TREATMENT for bleeding
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Direct Pressure Treatment Remove or cut casualty’s clothing to expose wound Apply direct pressure over wound Cover wound with sterile dressing Apply a pad
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Raise and support injured part:
Lie casualty down if possible Raise injured part above level of heart Handle gently if you suspect a fracture.
Direct Pressure Treatment
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Bandage wound: bandage firmly in place apply another dressing or pad if bleeding continues.
Direct Pressure Treatment
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Check the circulation below wound. Press till it turns white. It should turns pink
when the pressure is released.
Direct Pressure Treatment
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What is Pneumothorax?
When a sharp object penetrates the chest wall, air can enter between the membranes and exert pressure on the lung, thus the lung may collapse.
Layers of membrane
RibcageDiaphragm
LungBlood in the membrane
Air between membrane Collapsed
lungHealthy lung
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Fracture
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bjectives
By the end of this lecture, you will be able to:
Define what is fractureKnow the different causes of fracturesIdentify the different types of fracturesIdentify the signs and symptoms of open
and closed fractureProvide treatment for casualty with open
and closed the fracture
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1. What is a Fracture?
Fracture is
a break or a crack in a bone.
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2. What causes a fracture
Direct force Bone breaks at
the point where a heavy blow is received
Eg. A punch to the upper arm may fracture it.
Indirect force Force travels from
the source of impact to break the bone(s) elsewhere.
Eg. A fall landing on the upper arm may lead to a fracture in the collar (clavicle) bone
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Other causes of Fracture
Old or diseased bonesEg:
OsteoporosisCongenital abnormalitiesTumours
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Types of Fracture
Open fractureClosed fractureSimple fractureComminuted fractureGreenstick fracture
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The skin near the fracture site is broken.
The bone may or may not protrude out.
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The skin surrounding the skin is not broken. The skin around the fracture site usually is swollen or bruised.
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A clean break or crack in the bone
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The bone is broken into fragments.
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An incomplete break of the bone. One side is broken while the other is bent.
This fracture is more common in children.
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Signs and symptomsBreak may be felt or heard;Intense pain is experienced around the site of
the break;Deformity of the affected limb;Painful, difficult or impossible normal movement;Tenderness when gentle pressure is applied;Swelling over the fracture;Bruising;Visible external bleeding in open fracture;Possible shock;Crepitus
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Aims for treating fracture
Prevent blood loss, movement and infection to the injured site.
Arrange removal to hospital with comfortable support.
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The DO NOT…
… move the person;… move a person with an injured hip, pelvis, or upper
leg unless it is absolutely necessary;… move a person who has a possible spine injury;… attempt to straighten a bone unless blood circulation
appears hampered;… try to reposition a suspected spine injury;… test a bone's ability to move;… test for crepitus;… give the casualty any food or drink.
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Treatment xxx
Closed fractureControl bleeding if there is any;Cover the wound with a sterile dressing;Secure with cotton wool or a soft, non-fluffy, non- adhesive material and bandage the dressing. Do not tie the bandage too tightly in case you impair the circulation;Keep the injured limb still by supporting it fully and securely with your hand until the casualty can
be transported to hospital.
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Treatment xxx
Open fracture Place a sterile gauze dressing or piece of clean, non-fluffy, non-adhesive cloth over the wound; Place a ring bandage around the open wound. It must be higher than the protruding bone; Secure the ring bandage; Keep the injured limb immobile until the casualty can be transported to hospital.
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TreatmentGeneral principlesUpper limb fracture: support arm against the
trunk of the body. Use a sling if necessary. Lower limb fracture: bandage sound leg to
the uninjured one. Dial 995 for an ambulance.Prepare to treat for shock, if necessary Check the blood circulation every 10 minutes.
Loosen the bandages if necessary.
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A condition with loss of the normal density of bone and fragile bone. This weakens the bone leading to an increase in the risk of breaking bones (bone fracture).
Bones affected by osteoporosis can fracture with only a minor fall or injury that normally would not cause a bone fracture.
The spine, hips, and wrists are common areas
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Shock
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By the end of this lesson, you will be able to: Understand what is shock Identify the causes of shock
Identify the signs and symptoms of shockProvide the treatment for shock casualty
bjectives
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What is shock?
A serious, life-threatening condition, as the amount of fluid in the blood vessels is insufficient
Vital organs (brain, heart & kidneys) not able to functioning properly
Thus shut down blood supply to the less vital parts of the body, such as the skin and intestines
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What Causes Shock
Heart attackBlood lossFluid lossSevere blood infection
(septicaemia)Burns
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SIGNS & SYMPTOMS
Pale face, cold skinRapid and weak pulseFainting, dizzy or nauseaExtremities become blueishBreathlessnessSevere thirstPossible loss of consciousness
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Treatment
ABCTreat any cause of shock you identify
Dial 995 Lay casualty down.
Provide reassurance. Stay alertRaise and support casualty’s legs.
Loosen clothing. Keep warm
Check and record breathing, pulse and level of response.
Place in the recovery position.Start AR or CPR as appropriate.
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Do not …….
.. let casualty smoke, eat, drink or move. Moisten lips only.
.. leave the casualty unattended.
.. warm casualty with any direct source of heat.
.. move the casualty unless it is absolutely essential
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