I.

First Aid
The immediate care given to a person who has been injured or suddenly taken ill. It includes self help and home care if medical assistance is not available or encouragement, evidence of willingness to help, and promotion of confidence by demonstration of competence.

II.

Roles of First Aid

A. It is the bridge that fills the gap between the victim and the physician. B. It ends when the service of the physician begins. C. It is not intended to compete with or take the place of the physician.

III.

Needs and Value of First Aid

A. B. C. D. E. F. To minimize if not totally prevent accident. To prevent added injury or danger. To train people to do the right thing. Accident happens and sudden illnesses are common and often serious. People very often harm rather help. Proper and immediate care is necessary to save life and limb.

IV.

Principles of First Aid

Preserve Life Check, clear, maintains AIRWAY. Check, clear, maintain BREATHING Check, restore and maintain CIRCULATION Control bleeding (Hemorrhage) Treat shock Prevent Deterioration of Injury Or Illness Cover wounds. Immobilize fractures Check for other injuries Promote Recovery, And Protect The Unconscious Relieve pain. Reassurance Gentle handling Protection from the elements Position casualty in LATERAL position

Medical Immediate Action (I.A)

D - Danger. R - Response. A - Airway B - Breathing. C Circulation

DRABC

Check for danger to you, others and the casualty. Response. Determine conscious state of casualty, do this before entering incident site. If responds ABCs are clear, may inform you of other dangers.

V.

Types of First Aid

Aquatic/Marine first aid is usually practiced by professionals such as lifeguards, professional mariners or in diver rescue, and covers the specific problems which may be faced after water-based rescue and/or delayed MedEvac. Battlefield first aid takes into account the specific needs of treating wounded combatants and non-combatants during armed conflict. Hyperbaric first aid may be practiced by SCUBA diving professionals, who need to treat conditions such as the bends. Oxygen first aid is the providing of oxygen to casualties who suffer from conditions resulting in hypoxia. Wilderness first aid is the provision of first aid under conditions where the arrival of emergency responders or the evacuation of an injured person may be delayed due to constraints of terrain, weather, and available persons or equipment. It may be necessary to care for an injured person for several hours or days. Hydrofluoric Acid first aid is taught to first aiders in the chemical industry where hydrofluoric acid may be used. Instructs the first aider how to initially treat (with calcium gluconate) any skin that has been splashed with the acid. Mental health first aid is taught independently of physical first aid. How to support someone experiencing a mental health problem or in a crisis situation. Also how to identify the first signs of someone developing mental ill health and guide people towards appropriate help.

Wounds
A wound is a type of injury in which skin is torn, cut, or punctured (an open wound), or where blunt force trauma causes a contusion (a closed wound). In pathology, it specifically refers to a sharp injury which damages the dermis of the skin.

Open
Open wounds can be classified according to the object that caused the wound. The types of open wound are: Incisions or incised wounds, caused by a clean, sharp-edged object such as a knife, razor, or glass splinter. Lacerations, irregular tear-like wounds caused by some blunt trauma. Lacerations and incisions may appear linear (regular) or stellate (irregular). The term laceration is commonly misused in reference to incisions. Abrasions (grazes), superficial wounds in which the topmost layer of the skin (the epidermis) is scraped off. Abrasions are often caused by a sliding fall onto a rough surface. Puncture wounds, caused by an object puncturing the skin, such as a nail or needle. Penetration wounds, caused by an object such as a knife entering and coming out from the skin. Gunshot wounds, caused by a bullet or similar projectile driving into or through the body. There may be two wounds, one at the site of entry and one at the site of exit, generally referred to as a "throughand-through."

Closed
Closed wounds have fewer categories, but are just as dangerous as open wounds. The types of closed wounds are: Contusions, more commonly known as bruises, caused by a blunt force trauma that damage tissue under the skin. Hematomas, also called a blood tumor, caused by damage to a blood vessel that in turn causes blood to collect under the skin. Crush injury, caused by a great or extreme amount of force applied over a long period of time.

Wound healing
Repair or reconstitution of a defect in an organ or tissue, commonly the skin A global response to injury to re-establish homeostasis and to stabilize the entire organisms physiology The process of wound healing depends on the type of tissue which has been damaged and the nature of tissue disruption

The phases are:

Inflammatory phase

Occurring from days 4 to 21 Prioritizes the ff: Re-epithelialization Begins immediately following tissue injury Prioritizes attainment of the ff:

Hemostasis removal of dead tissues prevention of colonization of microbial pathogens The healing response starts at the moment of injury the clotting cascade is initiated The inflammatory phase is characterised by heat, swelling, redness, pain and loss of function at the wound site Early (haemostasis) Late (phagocytosis) This phase is short lived in the absence of infection or contamination

Proliferative phase
Increase in fibroblast cells Production of fibrin matrix that is gradually replaced by granulation tissue Formation of new blood vessels Epithelialization o The epidermis immediately adjacent to the wound edge begins to thicken within 24hrs after injury o In approximated incised wounds re-epithelialisation is usually complete within 48hrs. Characterised by the formation of granulation tissue in the wound Granulation tissue consists of a combination of cellular elements including: Fibroblasts, Macrophages Endothelial cells forming new capillaries (angiogenesis)

Remodeling phase
Longest part of wound healing Lasts from 21 days to 1 year Wound contraction and collagen remodeling 70 to 80 % strength only Wound maturation o New collagen forms, changing the shape of the wound and increasing the tensile strength o During the remodelling process there is a gradual reduction in cellularity and vascularity of the reparative tissue Wound contraction o Only undesirable where it leads to unacceptable tissue distortion and an unsatisfactory cosmetic result o Wound contraction usually begins from day 5 and is complete at approx. day 12 - 15

Wound Symptoms & Causes A chronic, non-healing wound is one that does not heal in six to eight weeks with traditional wound care. More than 5 million Americans suffer from non-healing wounds, which can cause serious infections, illness and loss of a limb. To ensure your health and safety, you should learn to recognize the causes and symptoms of non-healing wounds.
Certain health conditions can cause chronic non-healing wounds, such as: Anemia Bowel disorders

Chronic Osteomyelitis Circulation or clotting disorders, often caused by arteriosclerosis Diabetes Heart Disease High Cholesterol Hypertension Kidney Failure Lymphedema Malnourishment Obesity Sickle Cell Anemia Venous Insufficiency

Inflammatory diseases such as: Lupus Scleroderma Vasculitis

Other causes of non-healing wounds include a past or current history of smoking, steroid use, radiation therapy, cancer or infection, lying in one position for too long or a family history of non-healing wounds. Symptoms Everyone experiences wounds at some point in your life, but most heal on their own with proper care. When does a wound become a chronic, non-healing wound? Look for these signs: Persistent, increased pain in the area of the wound Discoloration of the wound near the edges of the wound often a dark or bluish color Increased drainage from the wound Redness or swelling around or spreading away from the wound A foul odor coming from the wound

Bone Fracture
A bone fracture (sometimes abbreviated FRX or Fx, Fx, or #) is a medical condition in which there is a break in the continuity of the bone. A bone fracture can be the result of high force impact or stress, or trivial injury as a result of certain medical conditions that weaken the bones, such as osteoporosis, bone cancer, or osteogenesis imperfecta, where the fracture is then properly termed a parthological fracture.

Sign and Symptoms

Although bone tissue itself contains no nociceptors, bone fracture is painful for several reasons: Breaking in the continuity of the periosteum, with or without similar discontinuity in endosteum, as both contain multiple nociceptors.

Edema of nearby soft tissues caused by bleeding of torn periosteal blood vessels evokes pressure pain. Muscle spasms trying to hold bone fragments in place

Damage to adjacent structures such as nerves or vessels, spinal cord and nerve roots (for spine fractures), or cranial contents (for skull fractures) can cause other specific signs and symptoms.

Diagnosis
A bone fracture can be diagnosed clinically based on the history given and the physical examination performed. Imaging by X-ray is often performed to view the bone suspected of being fractured. In situations where x-ray alone is insufficient, a computed tomograph (CT scan) or MRI may be performed. Classification By cause 1. Traumatic fracture - This is a fracture due to sustained trauma. e.g.- Fractures caused by a fall, road traffic accident, fight etc. 2. Pathological fracture - A fracture through a bone which has been made weak by some underlying disease is called pathological fracture. e.g.- a fracture through a bone weakened by metastasis. Osteoporosis is the most common cause of pathological fracture. Orthopedic In orthopedic medicine, fractures are classified in various ways. Historically they are named after the doctor who first described the fracture conditions. However, there are more systematic classifications in place currently. All fractures can be broadly described as: Closed (simple) fractures: are those in which the skin is intact Open (compound) fractures: involve wounds that communicate with the fracture, or where fracture hematoma is exposed, and may thus expose bone to contamination. Open injuries carry a higher risk of infection.

Other considerations in fracture care are displacement (fracture gap) and angulations. If angulations or displacement is large, reduction (manipulation) of the bone may be required and, in adults, frequently requires surgical care. These injuries may take longer to heal than injuries without displacement or angulations. Compression fractures: usually occurs in the vertebrae, for example when the front portion of a vertebra in the spine collapses due to osteoporosis (a medical condition which causes bones to become brittle and susceptible to fracture, with or without trauma).

Other types of fracture are: Complete fracture: A fracture in which bone fragments separate completely.

Incomplete fracture: A fracture in which the bone fragments are still partially joined. In such cases, there is a crack in the osseous tissue that does not completely traverse the width of the bone.[4] Linear fracture: A fracture that is parallel to the bone's long axis.
Transverse fracture: A fracture that is at a right angle to the bone's long axis. Oblique fracture: A fracture that is diagonal to a bone's long axis. Spiral fracture: A fracture where at least one part of the bone has been twisted.

Comminuted fracture: A fracture in which the bone has broken into a number of pieces. Impacted fracture: A fracture caused when bone fragments are driven into each other. Avulsion fracture: A fracture where a fragment of bone is separated from the main mass.

Principle of Fractures
Fractures are usually divided into closed and open two classes. Closed fracture refer to skin soft tissue relatively complete, fracture ends not communicated with the outside world; open fracture of phalanx of fold is a wound, fracture end is communicated with the outside. All parts of the body can be a fracture occurs, but the most common is fracture of the extremities. Once suspected of having fractures, should minimize the affected area of the activity, transfer as far as possible with rigid bed. Below are the 5 principles of fracture after first aid. Rescue a life Severe trauma first aid first principle is to save lives. If found the wounded heart, breathing has stopped or is on the verge of stop, shall immediately proceed to external cardiac massage and artificial respiration; coma patients should keep the respiratory tract unobstructed, timely removal of the oropharyngeal foreign body; patients with consciousness disorder can acupuncture the Renzhong and Baihui point; open fracture wounds can be a massive haemorrhage, generally available dressing hemostasis by compression bandage. Severe bleeding if the use of tourniquet, must record began using tourniquet time, every 30 minutes to relax 1 times (every time 30 to 60 seconds), to prevent limb ischemia necrosis. In case of the above have life-threatening fracture patients, should be fast to hospital treatment. Wound treatment Open wound treatment should be appropriate and timely hemostasis, also should immediately with a sterile gauze or a clean cloth tied to prevent wound, wound continued to be contaminated. The wound surface of the foreign body should be removed, the exposed end of fracture not push into the wound, to avoid contamination of deep tissue. Qualified are best to use potassium permanganate disinfection liquid washing of the wound and dressing, fixed. Simple fixed Field first aid timely and correctly fixed limb can reduce the pain and the surrounding tissues continue to injury, but also to facilitate the handling and transfer. But when fixing at the first aid, it is a temporary. Therefore, should simple and effective, does not require accurate reduction of fracture; open fracture with bone exposed persons should not be reset, but should be fixed in situ. The first-aid site can obtain raw material locally, such as wood, lath, branches, sticks or cardboard and so can be used as a fixed equipment, its length to fix fracture at the upper and the lower two joints. If you can't get fixed hard objects, can also be used directly to the injured limb cloth strapped to his body, fractures of the extremities can be fixed on the chest wall, hanging in front of the forearm; fractures of the lower extremities with healthy limbs can be fixed together. Necessary for pain relief After severe trauma, intense pain stimulation can cause shock, therefore should give necessary analgesics. Such as oral pain pills, can also be a painkilling injection, such as morphine 10 mg or pethidine 50 mg. But the brain, chest injury can not be injected with morphine, so as not to suppress the respiratory center.

Safe transportation

After the rescue, should be rapid, safe transport of wounded to hospital. Transit should pay attention to action of light stability, prevent vibration and damage of the injured limb, in order to reduce the pain; noted for its warm and appropriate activities.

Burn
A burn is a type of injury to flesh or skin caused by heat, electricity, chemicals, light, radiation or friction. Most burns affect only the skin (epidermal tissue). Rarely, deeper tissues, such as muscle, bone, and blood vessels can also be injured. Burns may be treated with first aid, in an out-of-hospital setting, or may require more specialized treatment such as those available at specialized burn centers.

Types of Burns
First Degree Burns
The first degree burns are the minor burns which only damage the upper most layer of the skin, the epidermis. They produce pinkish to red color marks on the skin and their symptoms include a mild swelling, tenderness of skin and of course pain. They are caused by the brief contact of skin with steam, any hot liquid or flame.

Second Degree Burns

The second degree burns are more severe than the first degree burns and involve the damage of not only the epidermis of the skin but also the second layer of the skin known as the dermis. They produce blisters and red marks on the skin. They cause scars and swelling of the skin and are very painful. They are caused when the skin is exposed to hot liquids and flames. They require a proper treatment.

Third Degree Burns

The third degree burns are the most dangerous type of burns. Not only do they destroy the epidermis and the dermis but they completely destroy and damage the entire skin also reaching into the internal parts of the body. They leave the skin blackened or white. They destroy and deform the bones.

Rule of Nine

Introduction Of First Aid

Submitted by: (21) Lacdao, Myrna Y. DPH 221-DLC Submitted to: Marilyn Colcol Dulig-Cabanes R.N.Ph.D