First Aid English

10/14/2008

Revision No.

10.2.2 A)

Revision Date

: -1-

: 01/04/00

First aid

Arrested Breathing : If breathing movements stop, begin artificial respiration immediately to prevent permanent brain damage or death. Causes of Arrested Breathing

Preliminaries before Applying Artificial Respiration

Poisonous gases

Remove the patient into the fresh air (B.A should always be used)

Asphyxiation

As for poisonous gases

Suffocation

Remove any causes of suffocation

Heart attack

Apply external heart compression (details shall follow)

Shock

Shock should be suspected and treated even if all the symptoms are not obvious (details shall follow)

Electric Shock

Switch off the power before touching the patient if he is still in contact with live equipment.

Drowning

Commence artificial respiration immediately (help the casualty to get out the liquid)

Mouth-to-Mouth Ventilation : If required do not wait for the medic. Start ventilation immediately. Prepare for mouth-to-mouth/nose ventilation as follows: 1.

In case of electric shock, make sure that contact with current is broken. If that is not possible, ensure that you are properly insulated and pull the victim away with a dry rope or stick or by grasping dry clothing.

2.

Remove any obstruction from mouth and nose. False teeth should be removed only if they are loose fitting.

3.

Place the patient on his back.

4.

Loosen any tight clothing around the neck and throat, and incline the patient's head backwards. This will straighten and open the throat and air passage.

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Mouth-to-mouth/nose ventilation is carried out as follows : Kneel alongside the patient's shoulder, taking a deep breath and blowing into his mouth or nose (which may be dictated by injuries). Using the mouth-to-mouth method, the nose should be closed by pricing between the fingers. Close the mouth with your hand when applying nose ventilation. Blow forcibly four times into the patient's mouth and check for expansion of the chest. When you have exhaled, remove your mouth and listen for the sound of exhaled air. If there is no air exchange, re-check the victim's head and jaw position. His tongue may be blocking air passage. Try again. If you still get no air exchange, turn the victim on his side and slap him sharply several times between the shoulder blades in order to dislodge any foreign matter from the throat. If the victim is a child, hang him momentarily head downwards over your arm or lap and slap him sharply between the shoulder blades. Wipe his mouth clear. 6. 7.

Check the carotid pulse to ensure that the heart has not stopped breathing. If the heart has stopped beating, commence resuscitation. If the heart is beating, continue the ventilation in time with your own breathing rate of about 15 - 18 times per minute, until either the patient commences breathing himself, or skilled help takes over.

Artificial respiration is known to have saved life after being applied for more than one hour. DO NOT GIVE UP C)

Severe Bleeding

When possible, without causing a delay in the application of First Aid, summon the assistance of the Medical Specialist. NOTE : Uncontrolled bleeding can be fatal. Treatment is carried out as follows: Health & First Aid

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1.

Carefully remove from wound any foreign bodies, which are visible and can easily be picked out or wiped off with dressing.

2.

If there are any embedded foreign bodies, apply pressure alongside wound, or squeeze sides of wound firmly, but gently, together. 3.

If there are no foreign bodies, apply pressure directly over the wound with as clean a dressing as possible and elevate the wound. Maintain pressure until skilled assistance is available. 4. Lay casualty down in suitable and comfortable position. If possible, lower his head. Unless an underlying fracture is suspected, raise and support injured part. 5. If the dressing becomes saturated, do not remove it but cover with additional clean dressing. In most cases, bleeding can be controlled by this method. 6. If the bleeding is very severe or continues, then in addition to direct pressure over the wound, apply pressure at one of the two pressure points as shown over. A tourniquet should not be used, but a constrictive bandage may be used in dire emergencies. Note: This will stop the flow of blood to a limb and could cause the loss of that limb. 7. Immobilise injured part and treat for shock. D)

Resuscitation

If the pulse is absent, summon help and begin emergency treatment for heart stoppage as described below : 1. Kneel beside the patient and place the heel of one hand about two inches above the bottom of his breastbone. 2. Place the other hand on top of it, interlocking the fingers and apply firm and controlled pressure downwards (the ribs can bend at least two inches towards the spine). However, erratic and violent action may cause damage to the casualty's ribs or internal organs. 3. Fifteen chest compressions should be given at the rate of eighty per minute followed by two deep lung inflation, and then repeat. 4. When two persons are present, one should undertake five chest compressions at the rate of sixty per minutes whilst the other undertakes one lung inflation and this cycle is then repeated. The operator at the head checks for heart beat after the first minute and then after every three minutes. Compressions and inflation should be performed continuously. The operator at the head gives the inflation on the upstroke of the fifth compression so that there is NO pause. Health & First Aid

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5. If the casualty's pulse returns, stop the chest compressions but continue mouth-to-mouth ventilation until the breathing restarts. Do not leave the patient until medical assistance has arrived.

E)

Shock

Shock usually follows the witnessing of, or the suffering of severe injury such as bleeding, extensive burns, pain, heart attack, heat exhaustion, etc. Shock should be suspected and treated even if all the symptoms are not obvious. Remember shock can kill. SYMPTOMS Face

Pale and anxious with vacant expression

Skin Cold and clammy with perspiration on forehead and palms of hands Pulse

Weak and shallow

Breathing

Gasping, yawning or sighing

General

Chills, nausea and vomiting may be present

Treatment for Shock : 1.

If breathing has stopped, apply mouth-to-mouth/nose ventilation.

2.

Correct (where possible) the cause of shock (e.g. control bleeding).

Keep the patient lying down. Raise the patient's feet (if there are no broken bones) keeping the head in a lower position. 4. Release tight clothing at the neck to keep the airways open. Keep the head to one side in case vomiting occurs. 5.

Keep patient warm. Place blankets above and below his body.

6. Do not give drinks to the patient. If patient is thirsty, moisten lips with water. F)

Eye Contamination Health & First Aid

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A foreign body in the eye must be treated immediately by a doctor. The eye must not be rubbed as this may drive the particle deeper into tissues. If a small metallic object is known to have come from a tool or rotating machine, in spite of no obvious evidence of damage and no defect of sight, casualty should be referred to medical aid. Treat chemical burns of the eye immediately by washing out the chemical completely with a continuous, gentle stream of water using an eye bath (for at least 15 minutes). Notify a doctor as soon as possible. Do not use any chemical eyewash; leave this to the doctor. Eyewashes are available in the first aid boxes.

G)

Putting out Clothing Fires Do not run in order to avoid fanning the flames.

1. If possible, wrap yourself in a rug, blanket or woollen coat and shout for help. Wrap it around the neck first and then drop to the floor and roll over slowly. 2. Try not to inhale the flames. Put your hands on opposite shoulders and pull the arms against your face for protection. 3. If water is near, douse yourself and roll in the spilled water on the floor. 4. If clothing of another person takes fire, use similar measures and shout for help. If water is handy, apply immediately. H)

Hypothermia

This is the reduction of body temperature by prolonged exposure to cold. It is not always easy to diagnose, but with anyone who is ill following cold water immersion, hypothermia should be suspected. Remember normal body temperature is 36.9 oC (98.4 oF). Symptoms (Mild Condition) • • • • •

Shivering. Increase in pulse and breathing rates. Numbness of hands and feet. Mental confusion. Loss of muscular co-ordination, slurred speech.

Symptoms (Severe Condition) • Below a body temperature of 35oC, breathing and heart rates become progressively depressed. Health & First Aid

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• Below 33oC, shivering tends to disappear and the pupils become dilated. • Below 30oC, shivering is replaced by muscular rigidity. • By 27oC, evidence of life may be extremely difficult to detect. As with all accidents, prevention is better than cure. The prevention in this case is to wear appropriate clothing. Keep out of the wind if wet. For mild hypothermia, the patient should be moved to a warm place and given warm tea or coffee. Controlled warming of the affected parts should be made by placing the patient in a warm (41oC) bath. No alcohol should be given. Note : All cases of prolonged exposure to cold should be regarded as serious. For severe hypothermia the victim must be transported to the nearest hospital as soon as possible.

Since the journey will take some time, it will be necessary to commence some curative First Aid as follows: 1. The patient will obviously be removed from the cold environment. 2. Handling must be kept to a minimum. Manhandling or exercise may precipitate heart failure. 3. Wet clothing should be cut off. 4. Further heat loss should be prevented by wrapping in blankets and also enclosing in a plastic bag or wrapper (for transportation) until the patient can be placed in a hypothermia bath. Water temperature should be maintained at 41oC for an unclothed patient and 45oC if clothed. Only the trunk should be immersed leaving the arms and legs out of the water. 5. 100% oxygen may be given. 6. Even in extreme cases, external heart compression must never be attempted. 7. Alcohol must not be given. I)

How to Save a Choking Victim

Two rescue techniques have been developed. One is to try to extract the object using fingers or tongs; the other is to attempt to force the object out by squeezing out air trapped in the victim's lungs (the Heimlich Manoeuvre). The first method must only be used if you are sure that you can remove the obstruction: there is a great possibility of pushing the obstruction further into the windpipe and making the situation worse.

1.

Treatment must be immediate, if the victim is to survive. Follow these steps : Send someone for help but do not wait for it to arrive.

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2. Ask the victim if he can talk. If he is conscious but unable to make a sound, you can be reasonably sure he is choking. 3. Using a napkin to get a firm grip, pull the victim's tongue forward as far as possible. This should lift the obstruction to where it can be seen. 4. If you are sure you can remove the obstructions, using the index and middle fingers like tweezers, grasp the obstruction and pull it out. If you are unsure, place the victim on his side and strike him several times between the shoulder blades with the heel of your hand to bring the obstruction further out. 5. If this fails, use the Heimlich Manoeuvre. Stand behind the victim and wrap your arms around his waist, allowing his head and arms to hang forward. 6. Make a fist with one hand and clasp it with the other hand. Place the fist, against the victim's abdomen just above the navel and below the rib cage. 7. Press in forcefully with a quick upward thrust. Repeat several times. This pushes the diaphragm up, compressing the lungs, and may force the object out of the windpipe.

.

After the obstruction is removed, restore breathing by mouth-tomouth/nose ventilation. Keep the patient warm and quiet. Seek medical attention. J)

General Rules for the Treatment of an Unconscious Casualty If casualty's breathing begins to fail or stop, immediately commence artificial ventilation. Control any serious bleeding. Having completed the above, and unless a fracture is suspected, place the victim in the recovery position to prevent inhalation of saliva or vomit. Stay with victim and monitor his condition. RECOVERY POSITION

To turn a casualty when lying on his back into the recovery position : -

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Kneel at the side of the casualty, turn his head towards you. Place casualty's nearest arms close into side, if possible placing hand under hip, palm upwards. Bring far arm over the front of chest. Cross far leg over near leg. Grasp casualty's clothing at far hip and pull him towards you, protecting his head with your other hand. Whilst supporting casualty on side against your thighs, bend upper leg well forward at hip and knee. - Tilt casualty's head to ensure open clear way. Check that casualty's lower arm is clear at back. Place other arm bent at the elbow with the Health & First Aid

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upper arm square to the body. - Cover casualty with blanket and, if possible, place another one under him. DO NOT give casualty a drink.

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