First Aid-module One

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CONTENT PAGE Lesson 1: Principles

Lesson 2: &

Lesson 4: Wounds

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Practice of First Aid First A B C of First Aid Aid Equipments

Lesson 5: &

Lesson 3:

bleeding Fractures

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Lesson 6: Shock

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Principles & Practice of First Aid 10-Sept-05

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bjectives By the end of this lesson, you will be able to: Identify the principles of first aid; Identify the practice of first aid.

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Principles of First Aid 1.1 What is First Aid 1.2 Aim of First Aid 1.3 Responsibility of First Aider 1.4 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 St John Ambulance Brigade Zone 6 10-Sept-05

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1.2 Aim of First Aid reserve life

revent condition from worsening romote recovery

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1.3Responsibilitof First Aider y

Assess a situation and summon help; Protect casualties and others from danger; Identify the injury or nature of the illness; Give casualty early and appropriate treatment, treating the most serious conditions first. 10-Sept-05

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1.3Responsibilitof First Aider y

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; Prevent cross-infection. 10-Sept-05

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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 situation

2. Make the area safe 3. Give emergency aid 4. Get help from others

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1. Assess the situation Possible Risk? Yes

Clearing of obstacles possible?

No

Approach Casualty Yes

Yes

Clear Obstacle Reassess situation Safe?

No

No

Call for help – Ambulance/ Fire engine 10-Sept-05

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2. Make the area safe Protect the casualty from danger. SURVEY the incident site to ENSURE that AREA IS SAFE. Aware of your limitations. 10-Sept-05

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3. Give emergency aid Assess each casualty to determine treatment priorities, and treat those with life-threatening conditions first. Perform initial assessment, or primary survey. Summon necessary help

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What is initial assessment?

Response > Consciousness

Airway > Open/ clotted Gloves are to be worn

Breathing > Chest rising/ breath blowing on face

Circulation > Pulse and signs of survival 10-Sept-05

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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 10-Sept-05

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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 10-Sept-05

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Signs & Symptoms

What is it??? Signs

Symptom s

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are details of a casualty’s condition that you can see, feel, hear or smell. are sensations that the casualty experiences, and may be able to describe, if she is conscious. St John Ambulance Brigade

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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 Asking  Anxiety &



Painful

expression 

Feeling Deformity  Irregularity Dampness  

Hearing Sucking sounds Grating bone 

Smelling Acetone  Burning  Urine  

Burns

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Loss of sensation Abnormal sensation Nausea  Stiffness Pain  Hot/Cold 

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4. Get help from others Make the area safe Telephone 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. 10-Sept-05

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ABC Of First Aid 10-Sept-05

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bjectives 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 10-Sept-05 St John Ambulance Brigade Zone 6 24

1.What is ABC in First Aid

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Airway may become blocked by the tongue when unconscious or lying flat. Open airway by lifting the casualty’s chin with two fingers and pressing on the forehead to tilt back the head.

Closed airway

Open airway

Do not leave an unconscious casualty lying face upwards. 10-Sept-05

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Check for 10 seconds !!! Look

Listen

Feel

Movement in the chest or abdomen

sounds of breathing

casualty’s breath on your cheek

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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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2. What is recovery position Meant for unconscious casualty who’s is still breathing Do not use on conscious or likely to regain conscious casualty.

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First Aid Equipment

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bjectives 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 10-Sept-05 St John Ambulance Brigade Zone 6 34 bandages;

1. Types of material in First Aid Kit Materials are classified as follows:  Dressings  Bandages  Other

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2. How to use them a) 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. 10-Sept-05

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2. How to use them b) 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 them c) 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 10-Sept-05 St John Ambulance Brigade Zone 6

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d) Triangular bandage A broad-fold bandage to immobilise and support a limb; 

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d) Triangular bandage •A narrow fold bandage to immobilise feet and ankles

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e) Reef knot 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.

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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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3) Types of bandaging: Arm sling 



It holds the forearm in a horizontal position. It provides support to upper arm; wrist; forearm or rib fracture.

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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 Rules 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.

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4. Principles of bandaging Rules

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. 10-Sept-05 St John Ambulance Brigade Use reef knots to tie bandages.

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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 10-Sept-05 St John Ambulance Brigade Zone 6

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1. DEFINITON OF WOUND Wound 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. 10-Sept-05 St John Ambulance Brigade Zone 6

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2. TYPES OF WOUND There are 7 types of wound. 1.Incised wound 2.Laceration 3.Abrasion / graze 4.Contusion / bruise 5.Puncture wound 6.Gunshot wound 7.Stabbed wound 10-Sept-05

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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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WOUNDS – Laceration 







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 10-Sept-05

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WOUNDS – Abrasion (graze) 



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 10-Sept-05

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WOUNDS – Contusion (bruise) 







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 Blunt blow or punch Causes: injury. 10-Sept-05

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WOUNDS – Puncture 

A small site of entry but a deep track of internal damage.



High risk of infection.

Causes: Standing on a nail or stabbed or jabbed with a needle. 10-Sept-05

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WOUNDS – Gunshot wound 



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 10-Sept-05

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WOUNDS – Gunshot wound 

May cause danger of injury to vital organs or lifethreatening internal bleeding

Caused : Gun 10-Sept-05

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WOUNDS – Stabbed wound •May cause several internal damage within the chest and upper abdomen. •Can cause pneumothorax

Cause: sharp object 10-Sept-05

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How to remember? Incised

Laceration

Gunshot

I Like Going to

Changi AirPort.

Contusion 10-Sept-05

Abrasion

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TYPES OF BLEEDING There are three types of bleeding: 3. 4. 5.

Arterial Venous Capillary

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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

Bright red, cough out blood

xxxxxxxx

Vomited blood, red/ dark reddish brown, resembling coffee grounds

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Ear

Fresh, bright-red blood; Thin watery blood

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Nose

Fresh, bright-red blood; Thin, watery blood

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Anus

Fresh, bright-red blood

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Black, tarry, offensive smelling stool

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Mouth

Urethr Urine with red or smoky appearance and occasionally clots a Vagina Either fresh or dark red

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TREATMENT for bleeding 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 10-Sept-05 St John Ambulance Brigade Zone 6

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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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Direct Pressure Treatment Raise and support injured part:  Lie casualty down if possible  Raise injured part above level of heart  Handle gently if you suspect a fracture.

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Direct Pressure Treatment Bandage wound:  bandage firmly in place  apply another dressing or pad if bleeding continues.

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Direct Pressure Treatment  

Check the circulation below wound. Press till it turns white. It should turns pink when the pressure is released.

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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. Air between Lungmembrane Blood in the membrane

Collapsed lung Healthy lung

Layers of membrane Ribcage Diaphragm 10-Sept-05

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Fracture

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bjectives By the end of this lecture, you will be able to: Define what is fracture Know the different causes of fractures Identify the different types of fractures Identify the signs and symptoms of open and closed fracture Provide treatment for casualty with open and closed the fracture 10-Sept-05

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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.

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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) St John Ambulance Brigade Zone 6 bone

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Other causes of Fracture Old or diseased bones Eg: Osteoporosis Congenital abnormalities Tumours

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Types of Fracture Open fracture Closed fracture Simple fracture Comminuted fracture Greenstick 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 symptoms Break 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 10-Sept-05

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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 fracture Control bleeding if there is any; Cover the wound with a sterile dressing; Secure with cotton wool or a soft, non-fluffy, nonadhesive 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 10-Sept-05 St John Ambulance Brigade Zone 6 97

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 10-Sept-05

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Treatment General principles Upper 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 10-Sept-05 St John Ambulance Brigade Zone 6 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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bjectives 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 shock Provide the treatment for shock casualty 10-Sept-05

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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 10-Sept-05 St John Ambulance Brigade Zone 6 105

What Causes Shock Heart attack Blood loss Fluid loss Severe blood infection (septicaemia) Burns 10-Sept-05

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SIGNS & SYMPTOMS Pale face, cold skin Rapid and weak pulse Fainting, dizzy or nausea Extremities become blueish Breathlessness Severe thirst Possible loss of consciousness 10-Sept-05

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Treatment ABC Treat any cause of shock you identify Dial 995 Lay casualty down. Provide reassurance. Stay alert Raise 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. 10-Sept-05

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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 10-Sept-05

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