First aid by Dr Hariom Sharma Global Speciality Hospital Gwalior

Dr Hariom Sharma MBBS, MSDr Hariom Sharma MBBS, MSGlobal Speciality Hospital Gwalior Global Speciality Hospital Gwalior

First Aid Principles and PracticeFirst Aid Principles and Practice

Why to know first aid procedures?

• Lives can be saved by the steps anyone can take until medical help can arrive.

Definition of First AidDefinition of First Aid

What is First Aid?What is First Aid?

Definition:Assessment and immediate care .Does not take the place of proper medical

treatment and Must not delay activation of emergency

medical services or other medical assistance when required.

First AidFirst Aid

• Immediate care that can be given to an injured or suddenly ill person– With minimal or no proper medical

equipment– Temporary assistance until arrival of

competent medical care– Does not take the place of proper medical

treatment

AIMS OF GIVING FIRST AID

To save life.To control bleedingTo relieve pain.To promote quick recovery To prevent further Injuries and

InfectionTo be able transport casualties

CONTENTS OF A FIRST AID BOX

• Bandages• Gauze• Plasters• Scissors• Cotton Wool• Pain Killers• Note Book And Pen• Disinfectant • Iodine /Spirit• Gloves

TRIANGULAR WIDE

BROAD NARROW

ROLLER FLAT PAD RING PAD

CONTENTS OF A FIRST AID BOX

• Surgical Blades• Glucose• Burn Cream• Safety Pins• Ors –Oral Rehydration Salts • Liniment / Deep Heat• Soap Medicated• Splints

RULES OF GIVING FIRST AIDFirst aiders life comes number oneDo first things firstD – angerR – esponseA – irwayB – reathingC – irculation

The three C’s

Check, Call, Care!

A-Airways:-Check airway before you give chest compression .

Pull the tongue out if it is falling back and blocking the airway.

Look for A B C

•Breathing

•3

•Step

If the victim doesn't speak or open his eyes tilt his head back and lift the chin.

Look, listen and feel their breathing.

B-breathing:

BLEEDING

• Escape of blood from blood system i.e.Capillaries, Arteries, Veins and Heart.

Types of bleeding

Internal BleedingThis is the escape of blood from arteries, capillaries and veins into the spaces in the body. (Remains inside the body).

EXTERNAL BLEEDING This is the escape of blood from arteries, capillaries and veins out of the body and is seen.

Types of BleedingTypes of Bleeding

•Veins

•Capillary

Spurting

Steady flow

Oozing

Artery

Internal Injuries

Direct Pressure with gauze or clean Direct Pressure with gauze or clean cloth. Ask the victim to support cloth. Ask the victim to support

his/her own injured limb. his/her own injured limb.

Bleeding ControlBleeding Control

Bleeding ControlBleeding Control

Start from distal to proximal. Make two Start from distal to proximal. Make two turns at the start. Check for circulation, turns at the start. Check for circulation,

sensation and movement before applyingsensation and movement before applying

Bleeding ControlBleeding Control

Apply bandage with roller facing Apply bandage with roller facing up. Ensure the subsequent turn up. Ensure the subsequent turn

cover 2/3cover 2/3rdrd of previous turn. of previous turn.

Bleeding ControlBleeding Control

Cut the end of the bandage into Cut the end of the bandage into two to use as tiestwo to use as ties

Bleeding ControlBleeding Control

Check again for circulation, Check again for circulation, sensation and movement after sensation and movement after applying. Ensure not too tight!applying. Ensure not too tight!

Applying 2Applying 2ndnd layer of layer of bandage if still bleedingbandage if still bleeding

Bleeding ControlBleeding Control

Bleeding ControlBleeding Control

Check again for circulation, sensation Check again for circulation, sensation and movement after applying.and movement after applying.

Bleeding ControlBleeding Control

• Best controlled by applying pressure until bleeding stops

• Amount of pressure applied and the time the pressure is held are the most important factors affecting successful control of bleeding.

Bleeding ControlBleeding Control

• Elevation and use of pressure points are no longer recommended to control bleeding.

Why?1.effectiveness of elevation has not been

studied2.these unproven procedures may compromise

the proven intervention of direct pressure

Control of BleedingControl of BleedingDirect Pressure

Elevation

Cold ApplicationsPressure bandage

Elevation and use of pressure points are Elevation and use of pressure points are not recommended to control bleedingnot recommended to control bleeding2010 American Heart Association and American Red Cross Guidelines for First Aid

NOSE BLEEDING

• Make the Victim to sit facing the breeze with the head slightly forward .

• Ask him to breath through the mouth and not to blow his nose .

• Apply cold compresses over the nose and fore head

• Pinch the soft part of nose with the fingers for 10 minutes .

• Apply cold on the back of the neck and forehead

•Nose Bleed

10 MINUTES

•Step 1.

•> Get the person to sit down.

• > Tilt their head forward.

• > Pinch the end of their nose for 10 minutes.

•Step 2.

•> If the nose is still bleeding then do Step 1 twice more. •12

•Step 3.

•> If still bleeding after 30 minutes call 108

WOUNDS

• A break or cut in the continuity of a body

Types Of Wounds

Closed wounds This is when the damage occurs under the skin tissue leaving the outer layer unbroken e.g. electrical burn.

Open wounds This is when there is a breakage in the continuity of the skin e.g. cut by a razorblade, knife

Types of WoundsTypes of Wounds

Basic First Aid for Wounds• Open Wounds

– A break in the skin’s surface that results in external bleeding and may allow bacteria to enter the body that can cause infection

• Abrasion– The top layer of skin is removed with

little or no blood loss– Scrape

• Laceration– A cut skin with jagged, irregular edges and

caused by a forceful tearing away of skin tissue

• Incisions– Smooth edges and resemble a

surgical or paper cut

Facilities Planning & ManagementUW-Eau Claire

Basic First Aid for Wounds Cont.• Open Wounds Cont.

– Punctures• Deep, narrow wounds such as

a stab wound from a nail or a knife in the skin and underlying organs

– Avulsion• Flap of skin is torn loose and is either

hanging from the body or completely removed

– Amputation• Cutting or tearing off of a body part

such as a finger, toe, hand, foot, arm, or leg

Facilities Planning & ManagementUW-Eau Claire

FAMSafety.Reassure casualty as you settle him/her in a

comfortable position.Remove the foreign body if possible.Dress and bandage the affected part.Change the dressing every other day.Burn all used up dressings so as not to

spread infection.

SHOCK

• A condition in which a person’s important body organs fails to function or slow down due to less oxygenated blood flow. (Triangle of life Brain, lungs and heart)

ShockShockShock affects all major functions of the body

loss of blood flow to the tissues and organs

Shock must be treated in all accident cases

Treatment for ShockTreatment for Shock•Lie victim down if possibleLie victim down if possible

•Face is pale-raise the tailFace is pale-raise the tail

•Face is red-raise the headFace is red-raise the head

•Loosen tight clothingLoosen tight clothing

•Keep victim warm and dryKeep victim warm and dry

•Do not give anything by mouthDo not give anything by mouth

•No stimulantsNo stimulants

BURNS AND SCALDS

• Burns are injuries caused by dry heat e.g. hot metals, iron e.t.c while scalds are injuries caused by vapor or hot liquids.

FAM

SafetyPour plenty of cold running water over partRefer or call for help

• NB Never break blisters• Never forcefully remove clothes from

burnt skin

•Burns

• Put the burn under cold water for 10 minutes.

•Step 2.

•> Cover the burn with a clean pad or cling film.

•> If the burn is bad dial 108.

•Step 1. •8

Chemical BurnsChemical Burns

Treatment: Flood the area with slowly running water for at Flood the area with slowly running water for at least ten minutes. (or proper neutralizing agent)least ten minutes. (or proper neutralizing agent)Gently remove contaminated clothing while Gently remove contaminated clothing while flooding injured area, taking care not to contaminate flooding injured area, taking care not to contaminate yourself. yourself. Continue treatment for SEVERE BURNS Continue treatment for SEVERE BURNS Remove to hospital. Remove to hospital.

ASPHYXIA

• A condition in which there is insufficient or no oxygen supply to the vital organs of the body triangle of life caused by suffocation, chocking and drowning.

CAUSES

StrangulationInhaling poisonous gasesDrowningBeing buried under soil.UnconsciousnessOvercrowding in a poorly ventilated roomCardiac FailureElectric shockAsthma/Diseases

FAM

Identify and remove the cause from the casualty or the reverse

If poisonous gas or fire, keep the victim low Open and clear the air way Ventilate if necessary (give a kiss of life) Refer if necessary

FRACTURES

Break or crack in the continuity of a bone.

CLASSIFICATION OF FRACTURES Compound/open fracture

This is when a bone breaks and tears through the skin tissue, and it can be seen.

Simple/closed fractureThis is when a bone breaks/cracks but remains within the body.

Green stick fractureThis happens in children/infants whose bones have not grown hard. It bends or cracks but doesn’t break. As their bones are not hard enough to break.

Complicated fracture This is when a bone breaks and damages other body organs and it may be open or closed fracture.

Fractures & DislocationsFractures & DislocationsMust treat for bleeding first

Do not push bones back into place

Don’t straighten break Treat the way you found it

FAM

1. Safety2. Rest the casualty and place affected part in comfortable position 3. Reassure the casualty4. Immobilize fracture using splints and bandages5. Control bleeding if any6. Refer

SplintsSplints

Must be a straight line break Can be formed to shape of deformity

Be careful of temperature change

UNCONSCIOUSNESS

• A state of unawareness due to damage or disturbance of the brain functions

FIRST AID MANAGEMENT FOR UNCONSCIOUSNESS

Open the airway by lifting the chin and tilting the head. Check breathing and circulation and be prepared to resuscitate if necessary.

If the casualty starts to vomit, put in a recovery position. If suspect spinal injury, treat the casualty as a spinal injury. Examine the casualty to identify severe bleeding and fractures. Control any bleeding as immediately as possible. Ensure plenty of fresh air by opening doors, windows or in an open environment. Cover the casualty with a worm blanket

Who provides first aid?Who provides first aid?

• Workmates • Friends • Relatives, • Family members,• Teachers• Medical students, anyone ……YOU!

Principles of First AidPrinciples of First Aid

Principle #1: First, do no harmPrinciple #1: First, do no harm

Know what to do and know what NOT to doKnow what to do and know what NOT to do

First Do No HarmFirst Do No Harm

• Do no harm does not mean do nothing.• The wisdom is not just to know what to

do, but what NOT to do• Sometimes the best thing you can do for a

casualty is to call for help.• Provide comfort and assurance to the

casualty may be the only thing you can do

First Do No HarmFirst Do No Harm

• Use treatments you know of that are most likely to benefit a casualty

• Do not use a treatment that you are not sure about “just for the sake of trying”

Any victim trapped inside the vehicle may Any victim trapped inside the vehicle may have injured his cervical spine. have injured his cervical spine.

Be careful when removing such victimBe careful when removing such victim

Positioning of VictimPositioning of Victim

• As a general rule a victim should not be moved

• The indications to move the victim include1.If the area is unsafe for the rescuer or victim2.If the victim is face down and is unresponsive3.If the victim has difficulty breathing because

of copious secretions or vomiting4.If the victim shows evidence of shock

Use bags or pillows, etc, to immobilize the cervical spine

• Send any evidence of the snake to the hospital only if safe to do so.

• Avoid elevating the limb• DO NOT use an arterial tourniquet• DO NOT try to capture the snake• DO NOT cut the bitten area• DO NOT suck the bitten area

What to do and NOT to do in What to do and NOT to do in Snake Bite?Snake Bite?

What to do?What to do?

• Ensure safety• Reassure and rest the casualty• Avoid all unnecessary movement to

prevent venom from spreading in the body.

• Direct pressure and immobilize the limb• Get to hospital urgently

Principle #2: First Aid is about Putting Principle #2: First Aid is about Putting First Things FirstFirst Things First

First Things FirstFirst Things First

• Get your priority right• If there are too many injuries in a

casualty, treat the most urgent injuries first

• If there are too many casualties– First, call for help– Treat the ones with the highest chance of survival

Don’t treat him. Forget Don’t treat him. Forget it!it!

They are also not your priority. Keep them They are also not your priority. Keep them aside and leave them to chat with each other!aside and leave them to chat with each other!

• The first step to get our priority right is to know and recognize what is an emergency and what is not an emergency!

• Sometimes it is very difficult, e.g. heart attack can be silent

First Things FirstFirst Things First

Principle #3: Safety Is Of Utmost Principle #3: Safety Is Of Utmost Importance In First Aid Importance In First Aid

All materials, including wooden ones, can conduct electricity if the voltage is high

enough!!

TRANSPORTATION

• Method a First Aider can improvise to move/transfer causality from place of injury to where he/she is going to be attended to by first aider or medical personnel.

TYPES OF TRANSPORTATION Stretcher or improvised e.g. blanket, bed sheets Dragging Human cradleHuman crutchChair liftTwo handed seatFour handed seatThree handed seat Four handed seatPick a back

Practical Application

What Information To RelayWhat Information To Relay

• Identify yourself• E: E: Exact Location• T:T: Type of event• H:H: Hazard• A:A: Access• N:N: Number of casualties involved• E:E: Existing emergency services• Put down phone only if asked to

ConclusionConclusion

• First aid does not take the place of proper medical care

• It is a temporary measure using minimal or no medical equipments

• Three basic principles: 1. DO NO HARM2. FIRST THINGS FIRST3. SAFETY IS OF UTMOST IMPORTANCE