Introduction to First Aid

First Aid is an important skill and should be taught to everyone who has the ability to learn. If more people knew First Aid, more lives would be saved. Myths and old fables are still being used because of ignorance Proper training would result in a vast difference between life and death or being handicapped.

What is First Aid

First Aid is the immediate and temporary care/treatment given to someone who is injured or has suddenly taken ill, using facilities and materials available at the time of the accident

Who is a First Aider?

A First Aider is someone who has been trained and examined in the skills of first Aid. When you are trained, you feel apprehensive when dealing with the real thing. By facing up to these feeling, the First Aider is better able to cope with the unexpected.

Responsibilities of a First Aider

Observe if there is any danger to you, the people around and the casualty Is the situation medical or a trauma case? What is the nature of the illness of injury? How many casualties are involved? What are the resources that you need or is available to you?

The 3 Ps of First Aid

PRESERVE PREVEENT

LIFE

CONDITION FROM BECOMING WORST PROMOTE RECOVERY

The ABC of First Aid

AIRWAY BREATING

CIRCULATION

4 Steps to know before treating casualty

What

is it? What causes it? Signs and symptoms How to treat

How does a First Aider work?

A first Aider work in calm, skilful and methodical way and must always be prepared

The Fight or Flight Response

In an emergency your body responds by releasing certain hormones called adrenalin. Your heart beats faster and your breathing is deeper and more rapid. You must stay calm! Taking slow, deep breaths will help you to calm down, leaving you better able to remember your First Aid procedures. A First Aider must always protect himself/herself first and try to prevent cross infection by washing his/her hands with soap and water, and wearing protective gloves

Giving Care with Confidence

Every casualty needs to feel secure and safe in the hands of the First Aider. You can create an air of confidence and assurance by:

Being in control both of your own reactions and of the problem. Working in a calm, skilful, methodical way. Being gentle but firm; speaking to the casualty kindly but in a clear and purposeful way Build up Trust (Talk to the casualty, explain what you are going to do, try to answer questions honestly)

Taking Charge at the Scene

What you should do at the scene of an accident? Use the three Cs (3Cs) of First Aid.

1. Fist Assess the Situation

Check the Scene for safety, is the scene safe for you? Before you approach the scene you must do body, substance, isolation (BSI). Protect yourself from all body fluids by wearing protective gloves and try to prevent cross infection. Wash your hands with soap and water.

Taking Charge at the Scene

What you should do at the scene of an accident? Use the three Cs (3Cs) of First Aid.

2. Delegate Responsibilities

Call for help,

call the ambulance, tell

them where you are, how many persons are injured and the nature of the incident.

You may need to call the police, fire brigade or other mode of transportation to take the casualties to the hospital

Taking Charge at the Scene

What you should do at the scene of an accident? Use the three Cs (3Cs) of First Aid.

3. Delegate Responsibilities

Care. It is important to give proper

care to the casualty. You need to do a more detailed assessment of the casualty to see what need to be done and to prioritize the care you will give. The care you give will make a difference between life or death.

Mass Casualties
Where there are mass casualties, your aim is to try to save as many persons as possible using triage to treat the most critical persons/s. Using the BBC approach, that is breathing, bleeding and consciousness your would it give priority treatment to casualties 1. B Breathing: Give mouth-to-mouth breathing 2. B Bleeding: Treat or arrest the bleeding 3. C Conscious: Put in the recovery position

Rapid Physical Assessment

When assessing a casualty you must determine if it is a medical or trauma case Medical Cases Involve Natural Illnesses such as: a. Asthma b. Fainting c. Seizure d. Stroke e. Heart Attach

Rapid Physical Assessment contd

When assessing a casualty you must determine if it is a medical or trauma case Trauma Cases Involve External Force, forced upon the body a. Laceration b. Abrasion c. Burns and scalds d. Fractures e. Amputation f. Stab/puncture g. Fall h. Motor Vehicle Accident

Fainting & Unconsciousness

Fainting is a temporary loss of consciousness caused by temporary loss of oxygenated blood to the brain. Other causes by reaction to pain, exhaustion, lack of food, emotional stress physical inactivity, long standing or sitting, heat stress (dehydration), thirst and low blood sugar.

Fainting & Unconsciousness

a.
b. c. d. e.

f.

Signs & Symptoms Extreme paleness Perfuse sweating Dizziness Nausea Cold and Clammy Skin Numbness and tingling of hands and feet

Fainting & Unconsciousness

Treatment
1.

When treating the unconscious fainting, the aim is to put back blood to the brain:
Check the ABC to find out if the casualty is breathing. Loosen tight clothing. Elevate the persons leg 8 to 12 inches to allow the blood to flow to the brain. Give plenty of fresh air.

The casualty should regain consciousness

Fainting & Unconsciousness

Unconsciousness

Unconsciousness means that the brain is not working properly. An unconscious person is completely unresponsive or unaware of what is happening in his/her surrounding.

Causes of Impaired Consciousness

The causes of impaired consciousness are: lack of nutrients (oxygen and glucose sugar reaching the brain) head injury Brain tumor Poisoning Epilepsy Diabetes Shock Fainting Stroke Heart attach Electric shock

Levels of Consciousness
For responsiveness, user the AVPU System: Alert is the casualty responsive/aware Verbally Are they responding verbally? Pain Are they responding to pain? Unconscious/Unresponsivene ss Are they unconscious?

1.

2.
3. 4.

Unconsciousness
Treatment

Check the ABC and treat accordingly Assess the level of response using the AVPU Arrange urgent removal of the casualty to the hospital

Seizures/Convulsions (Fits)
A Seizure also called a convulsion or fits consists of involuntary contractions of many of the muscles of the body. The condition is due to a disturbance in the electrical activity of the brain. Seizures usually result in loss or impairment of consciousness. The most common cause is epilepsy

Seizures/Convulsions (Fits)
A Seizure is not a disease but a sign of an underlying condition. Some causes of seizures are: a. b. c. d. e. f. g. h. Drugs, Alcohol or poison Brain tumours Infection, high fever Diabetic problems Trauma, Stroke Heat stroke Epilepsy Unknown

Seizures/Convulsions (Fits)
Tonic-Clonic or Granmal Seizure usually last only a few minutes and consist of dramatic body movement.

Absence of Petit Mal Seizures usually only last 10 - 30 seconds and there are no dramatic body movements.

Seizures/Convulsions (Fits)
Signs & Symptoms
a.
b.

Sudden loss of consciousness with casualty falling to the ground, often making a loud cry.
An epileptic attach can be caused by bright light or colours, sensation of strong odour or perfumes, exhaustion, hunger, fright, fever, taste. The body will stiffen, breathing may stop, convulsive movements begin, the jaw may be clenched and breathing my be noisy. Saliva at the mouth may b e blood-stained if the tongue and lips have been bitten. There may be a loss of bladder and bowel control. Muscle and breathing become normal the casualty recovers consciousness within a few minutes, but is very tired and confused. May complain of headaches.

c.

d. e.

Seizures/Convulsions (Fits)
Treatment 1. 2. Check the scene for safety for yourself and the casualty. Protect the casualty from injury, place something soft under the persons head, and loosen restrictive clothing. Remove potentially dangerous items such as hot drinks and sharp objects, please note the time the seizure started Do not try to hold the casualty still during convulsions, after the convulsion place the casualty in the recovery position and stay with the person until recovery, which is usually within 5 10 minutes Do not put anything into or over the persons mouth. Protect the casualty from embarrassment by asking

3.

4.

5. 6.

Types of Seizures
1. 2. Generalised this involves both sides of the brain Tonic-Clonic (grand mal) seizures The patient becomes rigid, falls to the ground and the body goes into violent jerky movements Tonic Sudden stiffening of the muscles, the person becomes rigid and fall (no jerking) injuries may occur from the fall Absences Interruption of consciousness, patient stares blankly with fluttering eyelids and nodding of the head, usually lasting few seconds (petit mal). Partial seizures (simple) Usually consciousness and awareness is maintained. The persons may have a strange feeling, taste, smell or sensation (aura). There jerking of the body without changes in consciousness.

3.

4.

5.

Seizures/Convulsions (Fits)
Management Ensure an open airway. Protect the patient from injury during the seizure by moving objects out of the way. Loosening any tight clothing, removing spectacles, and supporting the head from injury with a blanket or pillow. Do force anything into the mouth. Place the patient in the recovery position once movements have stopped. Patients should be allowed to recover in their own time. Treat any injuries that the patient may have received.

Treatment for Unconscious Fainting SKILL STEPS

Check the scene Check for responsiveness Call for help Position the casualty Is the scene safe? If the scene is safe BSI and proceed. Tap gently and shout Are you OK? Shout for help to attract other people. Roll casualty on their back in a single unit as you roll, support the head.

Open the airway

Check for breathing

Use the head tilt/chin lift method.

Look, listen and feel for 3 0 5 seconds, keeps airway open.

Loosen tight clothing and elevate feet

It the casualty is breathing, loosen tight clothing, elevate feet 8 12 inches, give lots of fresh air, the casualty should revive within 5 minutes.
When the casualty revives put the casualty to sit & ask questions i.e. Are you on medication? Are you hungry: Observe the surroundings.

Put the casualty to sit

Give something sweet

If the casualty is hungry give something sweet i.e. glucose, sugar, chocolate, sweetie etc.

Recovery Position
Who should you place in the recovery position?
Casualties who are unconscious and breathing and whose hearts are beating

This position ensures the following: An open airway Comfort Stability Draining Insert Get pictures of each position

Recovery Position

ARTIFICIAL RESUSCITATION (AR)

RESPIRATORY ARREST
What is Respirator Arrest? Respiratory arrest is when breathing stops. So, whey does breathing stop? Breathing stops when there is a blockage in the air passage caused by:

1. Choking on objects: food, false teeth, seeds, toys etc. 2. Drowning, suffocation, strangulation, asthma, burns, stings, poisons, smoke, fumes, rolling back of the tongue, vomitting, drug or alcohol overdose

What should you do if breathing stops?

1. Remove the cause or remove the casualty. 2. Check for breathing if the casualty is not breathing then 3. Start rescue breathing at once 4. If the air passage is blocked, check the position of the hand then check mouth and throat for objects/s. 5. When breathing starts, place casualty in the recovery position. 6. Monitor the casualty as breathing may

When do you apply pressure?

AR is done when casualty is not breathing and has a pulse (heartbeat). If there is no breathing and no heartbeat then Cardio Pulmonary Resuscitation or CPR should be applied.

Difference between Rescue Breathing and Rescue Breath Rescue Breathing 1 breath every 5 seconds. If there is no pulse you administer Rescue Breathing (breath 1 and 2 and 3 and 4 breath).
Rescue Breaths First 2 breaths that are given after you open the airway and check for breathing. If there is no breathing you must check the mouth to see if it is clear and then give 2 rescue breaths at a rate of 1 1 seconds.
The purpose for Rescue breaths is to find out if there is a clear air passage and to send oxygen to the lungs.

Rescue Breath We breath in 21% of Oxygen

Our bodies use only 5%

That leaves 16% which is usually exhaled This is enough to resuscitate someone. Deprivation of oxygen from the brain for 4 6 minutes will cause the brain cells and tissues to die therefore quick response is necessary.

Rescue Breath After Opening the Airway -

A. By using the head-tilt/chin left method, check for breathing

B. By looking, listening and feeling for 3 5 seconds If the victim is not breathing gently pinch the nose shut and give 2 full breaths

Rescue Breath Use the thumb and index finger of the hand that is on the victims forehead, pinch the victims nose shut while keeping the heel of the hand in place to maintain head-tilt. Your other hand should remain under the victims chin, lifting up immediately, give 2 full breaths while maintaining an airtight seal with your mouth over the victims mouth

Rescue Breath After giving 2 rescue breaths, if breaths go in you check for circulation C. By feeling the carotid pulse at the neck.

If there is a pulse but not breathing, administer rescue breathing i.e. 1 breath every 5 seconds.
After the first 5 sets of breaths check if breathing starts.

Rescue Breath 1. The victim begins to breathe.

2. Medical help arrives.

3. Another trained first Aider come to take over, or 4. You are too exhausted to contine.

Rescue Breathing for Adults

1. Kneel next to the casualtys head. 2. Open the airway using the head tilt, chin lift method. 3. Check for breathing: Look listen, and fell for 5 seconds. Check mouth for food or objects/s that could block air passage. 4. Give 2 rescue breaths seal lips over casualtys mouth, pinch the nose and breathe.

5. Check pulse for 10 seconds using the carotid at the neck.

6. Give 1 rescue breath every 5 seconds. After the 1st 4 of breathing, check if breathing starts.

Rescue Breathing for Adults

Rescue Breathing for Child

Give 1 breath every 4 seconds

Rescue Breathing for Infant

1. Be careful and gentle with infants
2. Tilt the head back gently not as far as an adult or an older child.

3. Put you mouth over the babys mouth and nose to form a seal.
4. Give 1 puff every 3 seconds

When to Stop Breathing for the Casualty 1. When the casualty starts breathing again. 2. When qualified aid arrives. 3. A next First Aider comes to assist. 4. When you are tired and exhausted
Note: In all cases you must take the casualty to the hospital whenever Rescue Breathing is applied. When the casualty starts breathing, place

When to Stop Breathing for the Casualty

Mouth-to-Mouth breathing

Skills for Rescue Breathing

SKILL Check for responsiveness Call for help Position the Patient STEPS Tap the patient gently, pinch on ear lobe, Are you OK? Shout for help to attract another person and to call an ambulance Roll the casualty on back in a single unit. As you roll, support head.

Open the airway Check for breathing

Give 2 Rescue Breaths Check for Pulse Rescue Breathing Recheck Pulse

Use the head-tilt/chin-tilt method. Look, Listen and feel for 3-5 seconds. Keep airway open.
At a rate of 1 1 seconds. Maintain open airway. Feel the CAROTID PULSE for 5- 10 seconds. Give 1 breath every 5 seconds. Do 5 sets. Then check for breathing Feel the CAROTID PULSE for 5 10

Pulse Rate
AGE Infants Toddler Pre-Schooler RATE 120 160 beats per minute 90 140 beats per minute 75 100 beats per minute

Adults

60 80 beats per minute

Respiratory Rate
AGE Infants Toddler Pre-Schooler School Age RATE 30 60 breaths per minute 24 40 breaths per minute 22 34 breaths per minute 18 - 30 breaths per minute

Adults

12 - 20 breaths per minute

The Heart
The Heart is a muscular organ which acts like a double pump. It is situated in the chest behind the breastbone and rib cartilages, between the lungs and immediately above the diaphragm. The Heart is divided into a right and left side and there is no direct communication. Each side is further divided into an upper or collecting chamber (auricle or atrium) and a lower or pumping chamber (ventricle). Between each auricle and ventricle there is a non-return valve.

Heartbeat
The heartbeat may be felt just below and to the inner side of the left nipple. The heart contracts in adults at an average rate of 72 times per minute when sitting or at rest but the rate can vary with excitement, exertion, fear or change of position; hence the importance or considering the patients position in cases of

Mechanism of the Circulation

The right side of the heart pumps the blood through the lungs Pulmonary Circulation. The left side is concerned with the SYSTEMIC (or general) circulation of the blood through the body.
With each contraction of the heart, blood is forced through both of these circulatory systems from the ventricles and with each relaxation of the heart blood pours into collecting auricles from which the ventricles are refilled.

Pulmonary Circulation
Venuous blood is collecting from 2 large veins draining the upper and lower parts of the body into the right auricle and from this chamber passes through a valve to the right ventricle, whence it is forced by compression through the pulmonary artery to the lungs. In the lungs it gives off carbon dioxide gas and water vapour and picks up oxygen gas from the inspired air. This process is known as the interchange of gases. After being recharged with oxygen the blood returns to the left auricle through the pulmonary veins.

Systemic Circulation
From the left auricle the blood now rich in oxygen passes through a valve to the left ventricle and from there is forced out through the main artery of the body (Aorta) which through numerous branches, distributes it to all parts of the body

Heartbeat

On an average the heart beats 60 to 80 times per minute. Pumps approximately 5 liters (1.3 gallons) per minute at rest With activity the heart pumps a much as 25 liters (6.5 gallons) per minute

Heartbeat

In heart failure, the heart is unable to increase the amount of blood it pumps as you exercise This may make you feel short of breath when you try to walk a long distance or climb a flight of stairs. Most persons with heart failure also feel tired.

Angina Pectoris
Angina Pectoris is a common symptom of chronic heart disease (C.H.D). It is a transient pain or discomfort due to temporary lack of adequate blood supply to the heart muscle. The pain may be located in the centre of the chest. The pain is usually described as being crushing, pressing, constricting, oppressive or heavy. May spread (more often the left) or both shoulders and/or arms to the neck, jaw, back or upper mid-portion of the abdomen

Angina Pectoris
Angina Pectoris that is either new, worsening in severity (e.g. more frequently, lasting longer, responding less to nitro-glycerine or rest), or coming on at rest is called unstable angina. Patients with this form of angina are at high risk for acute myocardial infarction and should be hospitalized immediately.

Characteristics of Angina Pectoris

Rapid Short Chest

onset usually triggered by exertion or stress. duration 3 5 minutes pain radiating down the arms and into the jaw. (difficulty breathing) (profuse sweating)

Dyspnoea Mild

to moderate nausea

Diaphoresis Anxiety Relieved

by rest and nitro-glycerine tablets within 10

minutes The Most frequent cause of angina is coronary atherosclerosis.

ATHEROSCLEROSIS
Atherosclerosis is the condition in which an artery wall thickens, as the result of a building up of fatty materials such as cholesterol. It is commonly referred to as hardening of the arteries. It is caused by the formation of multiple plaques within the arteries. It can cause strokes, heart attacks, congestive heart failure and most cardiovascular diseases because it interferes with the coronary circulation supplying the heart or cerebral circulation supplying the brain

Clinical Manifestation of Coronary Heart Disease

Persons

with coronary artery disease may show no signs or signals of heart disease (asymptomatic) or have signs that do suggest coronary heart disease (symptomatic).
In

a person with symptomatic CAD, coronary artery narrowing progresses over time.

Heart Attack (Acute Myocardial Infraction)

A

Heart attack occurs when an area of the heart muscle is deprived of blood (oxygen) for a prolonged period (usually more than 20 to 30 minutes)
Usually

results from severe narrowing or complete blockage of a diseased coronary artery and result in death of the heart muscle cells supplied by the artery.

Embolism Embolism occurs when an object or plaque moves from one part of the body through circulation and causes a blockage of blood vessel in another part of the body
Coronary

Embolism Embolism

Pulmonary Cranial

Embolism

Signs of Heart Attack The most common signal of a heart attach is an uncomfortable pressure, fullness, squeezing or pain in the centre of the chest. It usually lasts fro 2 or more minutes and may come and go.

Other signals may include:

Nausea

Sweating
Shortness A feeling

of breath

of weakness

Sudden Cardiac Death (Cardiac Arrest) Sudden death occurs when heartbeat and breathing stop abruptly or unexpectedly.
May May

occur as the initial an only manifestation of C.H.D. occur before any symptom. within 1 to 2 hrs after the beginning of a heart attack.

Occurs

Actions for Survival

Know

the warning signs. Have the person stop whatever he or she is doing. the person sit or lie down comfortably prescribed by a physician, nitroglycerine tablets can be administered to relieve the pain or Angina Pectoris. No more that 3 tables within 10 minutes your doctor or take the victim to the nearest hospital

Have If

Call

Risk Factors

Risk factors are conditions or behaviours that may increase the changes of someone developing a disease. Heart disease develops over a long period of time. You should begin reducing risks at an early age.

Risk Factors that cannot be changed

Some risk factors cannot be modified or eliminated Heredity A history of premature C.H.D. in siblings or parents suggest an increased susceptibility that my be generic. A woman has a lower incidence or coronary arteriosclerosis before menopause. The incidence increase significantly, however, in postmenopausal women, who also have worse clinical case when compared to men. Men are at a greater risk than women The death rate from C.H.D. increases with age. However, nearly 1 in 4 deaths occurs in persons under age 65.

Gender

Age

Risk Factors that can be changed

Exercise Stress Exercising on a regular basis will strengthen the heart and blood vessels. Because of stress, blood vessels may constrict, blood pressure may rise and the liver may be stimulated to produce more cholesterol.

Diet

Reduce cholesterol intake and maintain and ideal body weight to reduce you risk of heart disease.
Every time you smoke, your arteries and heart react. Nicotine constricts blood vessels, increases the heart rate, raises cholesterol levels, lower the ability of blood to carry oxygen and increase blood

Cigarette Smoking

Keeping a Healthy Heart Keep your weight at an ideal level by eating nutritious diet meals and exercising regularly
Eat

Fruits, vegetables, cereals, pasta, low-fat diary products, fish, poultry and lean meats. the saltshaker and limit the amount of highly-salted, processed foods you can eat.

Ignore

Keeping a Healthy Heart Keep your weight at an ideal level by eating nutritious diet meals and exercising regularly
Eat

Fruits, vegetables, cereals, pasta, low-fat diary products, fish, poultry and lean meats. the saltshaker and limit the amount of highly-salted, processed foods you can eat.

Ignore

Fats and your Heart

Certain fatty foods tend to increase the amount of cholesterol in the blood while other types of fats help to decrease cholesterol
Saturated

Fats tend to raise the level of cholesterol in the blood. They are fats that harden at room tempeture.
Polyunsaturated

Fats tend to lower the level of cholesterol in the blood. They are found in liquid oils of vegetable origin. They include oils made from corn, cottonseed, sunflower, sesame seed, soybean and sunflower seed.

Animal Origin Saturated Fats

Fatty

cuts of beef, pork and

lamb Butter, cream and whole milk Cheese made from cream and whole milk

Vegetable Origin Saturated Fats

Hydrogenated Coconut Cocoa

shortenings

Oil

butter and palm oil used in most commercially prepared cookies

Pie

fillings and non-dairy cream substitute.

High-fat foods, which are concentrated sources of calories, include:

Fats of all kinds(shortening, oil, butter, margarine) Cheese Salad dressing Fried foods Sauces and gravies, bacon fat Scrapple Sausage Ribs Potato chips and other snack chips

Cardio Pulmonary Resuscitation (CPR) C.P.R. is administered when someones pulse and breathing stops. When both breathing & pulse have stopped, the victim has suffered sudden death. C.PR. Is never used to restart the heart. There a many causes of sudden death: drowning, smoke, inhalation, suffocation, poisoning, electrocution and choking. The most common cause is heart attach

Definition of Death
Clinical Death: The heartbeat and breathing have stopped. This is best thought of as near or apparent death, and it may be reversed. Biological Death: This is permanent brain death due to lack of oxygen. This death is final. During the 1st few minutes of clinical death, promptly initiate C.P.R. which may turn the victim back to productive life. Without C.P.R. biological death will occur.

Decision Making
Make a decision about what to do next, based on what the instructor says. Continue to give appropriate care. The ABCs of C.P.R. Begin the ABCs of C.P.R. by:

Opening the airway using the head-tilt, chin left method. Once the airway is open, place you ear close to the victims mouth. b. Check for breathing
a.

Look at the chest for movement Listen for sounds of breathing Feel for breath on your cheek

After 3 5 seconds, if none of these signs are present, the victim is not breathing

External Chest Compressions

Artificial circulation is provided by external chest compressions. In effect, when you apply rhythmic pressure on the centre of the casualtys breastbone, you are forcing heart to pump blood.

Performing Chest Compressions

Kneel

at victims side near the chest. Place the heel or your hand in the middle of the breastbone and the middle of the nipple line Place your other hand on top of the hand in position. Be sure to keep you fingers up off the chest wall. Bring you shoulders directly over the victims sternum as you compress downwards, keeping your arm straight. Depress the sternum about 1 inches to 2 inches for an adult victim then relax pressure on the sternum completely

Performing Chest Compressions contd

Do

not remove your hands from the victims sternum but allow the chest to return to its normal position between compressions. Relaxation and compressions should be of equal duration. If there is no breathing do external chest compressions (C.P.R.) The proper ratio is 30 compressions to 2 breaths.

Emergency Actions Steps

Remember the 3 steps: Check, Call, Care upon finding a collapsed person. 1. CHECK the scene and victim 2. CALL for help and send for emergency medical services 3. CARE give appropriate care. If the victim is not lying flat on his or her back, roll the victim over, moving the entire body at once. Your instructor will demonstrate this

Emergency Actions Steps

Skills for CPR

SKILL
Check for responsiveness Call for help Position The Patient Open the airway Check for breathing Give 2 rescue breaths Check for pulse Locate Compression Position

STEPS
Tap gently on patient. Shout Are you OK? Shout for help to attract another person and to call an ambulance Roll the casualty on back in a single unit. As you rools, support the head. Use the heat-tilt/chin-lift method Look, listen, and feel for 3 5 seconds. Keep airway open At a rate of 1 1 seconds. Keep airway open. Feel the CAROTID PULSE for 5 10 seconds. If there is no pulse Place the heel of your hand in the middle of the breastbone an the middle of the nipple line. Place your hand on the top of the hand in position. Position shoulders over hands with elbows locked and arms straight. Compress breastbone 1 - 2 inches. 100 compressions per minute. Pinch nose shut. Maintain an open airway. Give 2 rescue breaths at a rate of 1 - 1 seconds. Do 5 cycles of 30 compressions and 2 breaths.

Give 30 compressions

Give 2 rescue breaths Do Cycles

Skills for CPR contd

SKILL
Recheck pulse Give 2 rescue breaths

STEPS
Feels the CAROTID PULSE for 5 10 seconds. If no pulse, maintain open airway, pinch nose shut and give 2 full breaths.

Continue compression/breathing cycle

Continue cycles of 30 compressions and 2 breaths. Recheck pulse every few minutes.

Stroke
Stroke (cerebovascular accident, CVA) is damage to part of the brain due to obstruction or rupture of a blood vessel. Extensive damages lead to death.

Stroke occur when a blood vessel is blocked by a blood clot preventing that area of the brain from receiving oxygenated blood, or a blood vessel ruptures and blood pours into or over the brain.

Causes of Stroke
1.

Thrombus/Tumor - A Blood Clot

2.

Aneurysm A weakening of an arterial wall which may lead to a rupture due to bulging of the artery. Embolism Movement of a blood clot or foreign body (fat or air) inside a blood vessel. The clot is called bolus. Compression Blood leaks into the surrounding space causing pressure against the artery preventing blood flow.

3.

4.

Signs & Symptoms of Stroke

Headache (may be only the symptom at first) Collapse or fainting (syncope) Weakness or paralysis in one or more limbs (usually the hand.) Difficulty speaking and facial weakness Intense dizziness and visual disturbance Seizures Unequal pupils Loss of strength, typically on one side of the body

Treatment

Emergency care depends on signs shown Perform an incident size up (BSI) Call the emergency medical service immediately Maintain an open airway and be prepared to provide CPR Keep the patient at rest Protect all paralyzed parts Provide emotional support Place the patient in the recovery position to allow for drainage

Risk Factors for Cardiac Illnesses

Hypertension Cigarette smoking Diabetes High cholesterol Lack of exercise Family history of heart disease/stroke History of angina or previous chest pain

Aneurysm
An Aneurysm is a localized, blood-filled dilation (a blood-like bulge) of a blood vessel caused by disease or weakening of the vessel wall. Aneurysm most commonly occur in the arteries in the brain in the aorta, as the size increases there is a risk of rupture which can result in severe hemorrhage, stroke and other complications including sudden death.

Signs & Symptoms of Aneurysm

No

Response Abnormal breathing No signs of circulation

Treatment
the victim stop them from doing what they are doing and put them to sit or lie down Activate the emergency medical service immediately Stay with the patient and monitor his condition. If an Automated External Defibrillator (A.E.D.) is available, keep it close by Place the patient in a comfortable position If the patient has medication you may assist with the prescribed dose If the pain persists after 5 minutes activate the emergency medical service and be prepared to start C.P.R.
Keep

Causes of Aneurysm
A condition of the arteries in which the blood flow is blocked by fatty deposits. Arteriosclerosis Any condition in which the walls of the arteries are thickened and made rigid, making them unable to process an adequate supply of blood.
Atherosclerosis

Airway Obstruction (Choking)

Choking is the result of an object in the air passage. A foreign object that is stuck at the back of the throat my block the throat or cause muscular spasm. A casualty with a completely blocked passage will show the following signs:
Clutching

the throat with the hands. Unable to

speak Unable to breath, unable to cough Will lose consciousness

The Unconscious Chocking Victim

If the victim becomes unconscious: Turn over on back Perform finger sweep and try to remove the object Open the airway and attempt to ventilate Re-tilt head and give 2 full breaths Perform up to 5 abdominal trusts Do finger sweep. Give 2 full breaths Repeat abdominal trust, finger sweep and 2 full breaths

Conscious Chocking
Determine

if patient is choking Stand behind patient and deliver abdominal trusts Repeat until object is expelled or patient loses consciousness

Skills for Treating Unconscious Choking

SKILL
Check of scene safety Check for responsiveness

STEPS
If the scene is safe, BSI and proceed Tap gently on patient. Shout Are you OK?

Call for help

Position The Casualty Open the airway Check for breathing

Shout for help to attract another person and to call an ambulance - 110
Roll the casualty on back in a single unit. Support the head as you roll. Use the heat-tilt/chin-lift method to open airway and check for breathing Look, listen, and feel for breath 3 5 seconds. Use the head tilt/chin left method. If not breathing Look into the mouth for food, loose dentures and other foreign objects. Turn head to you, use index finger to hook sweep to clear the mouth Give 2 quick rescue breaths At a rate of 1 1 seconds. Maintain an open airway. If air does not go in you should re-tilt the head to make sure that the airway is fully open and give 2 breaths again

Check the Mouth

Give 2 rescue breaths Re-tilt Head

SKILL

Skills for Treating Unconscious Choking

STEPS
If air does not go in for the second time you are now sure that the throat is blocked, straddle the casualty Place the heal of one hand on the abdomen above the navel and below he tip of the sternum. Place your hand on top of the hand in position and give 5 abdominal thrust pressing down while pushing up. When the object is dislodged, place the near hand across the chest, roll the casualty on their side for drainage and hook sweep with index finger to clear the mouth. Place casualty on their back Use head tilt/chin lift method Look, listen and feel for breath 3 5 seconds. Use head tilt/chin lift method. If no breathing Give 2 rescue breaths at a rate of 1 1 seconds, air goes into the chest, rise and fall, maintain an open airway If there is no pulse and no breathing give rescue breathing, i.e. 1 breath every 5 seconds. If there is no pulse, no breathing give 30 chest compressions, 2 breaths

Straddle the Casualty Give 5 Abdominal thrusts

Roll the casualty on side

Position casualty Open the airway Check for breathing

Give 2 breaths

Check for pulse

Skills for Treating Unconscious Choking

Asthma
In an asthma attack, the muscles of the air passage in the lungs go into spasm and the lining of the airway become swollen. This causes the narrowing of the air passage, making breathing difficult. Sometimes there is a recognized trigger for an attack such as an allergy, a cold, dust, drugs, carpet, animals, flowers etc..

Signs & Symptoms of Asthma

Difficulty

in breathing Wheezing as the casualty breathes out Difficulty speaking and whispering Distress and anxiety Coughing Casualty my lose consciousness and stop breathing

Treatment
Keep

calm and reassure the casualty, ask the person to sit and lean forward. if lying down prop the person with 3 to 4 pillows to have them in the sitting position.
Ask Ask

the person to breathe slowly and deeply to get more oxygen. casualty for medication. Allow or Assist with the taking of medication. If casualty does not respond to the medication, prepare to take to the hospital
Get

history from casualty or relatives and friends using acronym S.A.M.P.L.E.

Treatment contd S - Signs and Symptoms (How long has the casualty
been wheezing or breathing short?

AMP-

Allergies (any known allergies to drugs, food, pollens, pet, carpet, smoke, dust) Medications (does the casualty have his/her medication (inhaler)? Pertinent past history (did the casualty have a recent cold or respiratory infection?) Last meal (Has he/she had any fluids since this attack started?) Events leading to the attack (What was he doing or exposed to that may have caused the attack?)

LE-

Wounds
A wound is an abnormal break in the skin or tissues of the body that allow bleeding and enables germs to enter. A wound is either open or closed. As a first Aider, your priorities are as follows:A.
B. C.

Assess the casualtys condition (ABC)

Protect yourself (BSI) put on gloves Control bleeding by applying direct pressure and elevation. To prevent shock apply pressure pad. Comfort, reassure and prepare to take casualty to hospital.

D.

Types of Wounds (GLACIAS CAP)

G L Gunshot the entry may be small and neat. Any exit wound may be large and jagged. Laceration jagged or ripping forces resulting in tear or lacerations, rough edges caused by barb wire, band saw. Abrasion (graze) superficial wound, damage to skin surface. Contusion (bruise) closed would, the skin is not broken, the blood flows between the tissue and is caused by a blunt blow. Otherwise called coco or black and blue. Incisions - this is a clean cut caused by a sharp edged object such as a razor, knife, thread. Avulsion the tearing loose or tearing off of large flaps of skin or flesh e.g. earring torn from ears.

A C -

I A -

Types of Wounds contd

S CAStab wound caused by knife or long instrument driven forcefully into the body. Crush occurs on hard/soft tissues of the body, for example an iron dropping on the toes. Amputation the cutting or tearing off the hands, fingers, arms, legs, feet, toes.

P -

Puncture caused by knives, nails, ice picks puncturing the body in a straight line. When there is an entry and exit it is called a perforated would

Evisceration - protrusion of the intestines Penetrating Chest Wound

The heart, lungs, and major blood vessels are protected by 12 pairs of ribs which make up the ribcage. If a sharp object penetrates the chest wall, there will be internal bleeding.

Treatment for Wounds

Rest

Elevate
Direct Pressure

Clean
Use material available to make bandage

Tie bandage

Bleeding
Bleeding is the emission of blood from the circulatory system. The heart pumps blood around the body. The blood is the vehicle in which oxygen travels throughout the body. The blood carries oxygen to the cells and takes away carbon dioxide. Types of Bleeding:
Arterial
Venous Capillaries

Types of Blood Vessels

Arteries
Veins Capillaries

Arteries Arteries carry blood away from the heart and they have a strong outer thick muscular layer and run next to the bones. The blood in the artery is bright red in color. When an artery is cut, the blood spurts to the rhythm of the

Veins
Veins carry blood to the heart. This is made possible by the surrounding muscles and the heart suction. The walls are thinner and are provided with valves to prevent blood going in the wrong direction. The smaller arterioles and venues control the blood flow into and out of the capillary bed. They are next to the surface. The blood in the vein is dark red in colour. When a vein is cut, there is a heavy steady stream.

Capillaries
Capillaries connect the arteries to the veins. This is where exchange takes place between the bloodstream and the body tissues. They allow for the exchange of gasses and transfer of nutrients and waste products.
Remember:

The typical Adult has 6 litres (About 12 pints) of blood. The volume must be maintained for proper circulatory functions.

Pressure Points
Arterial bleeding can be controlled by digital pressure applied at pressure points. Pressure points are placed over a bone where arteries are close to the skin. Pressing the artery against the underlying bone can control the flow of blood to the injury. The most commonly used pressure points to control profuse bleeding in emergencies are:
Brachial Femoral

Artery for bleeding from the arm Artery for bleeding from the leg

Pressure Points

Functions of the Blood

Carry Carry Carry

oxygen and Carbon dioxide nutrients and water

waste products from the tissues to the excretory organs enzymes and hormones heat generated by muscular activity and transported to the skin for cooling. the body from infection by means of the white blood cells. of wounds by platelets when they come into contact with damaged tissue.

Distributes Distributes Protects

Coagulation

Lymphatic System
The lymphatic System is a network of vessels called lymph vessels. These vessels contain fluid similar to plasma, called lymph. Lymph in filtered through bodies known as lymph nodes. The lymphatic system assists in the removal of waste from body tissues, transportation of nutrients

How to control bleeding

There are 2 methods used to control bleeding:
A.

Direct pressure

B.

Elevation

Direct Pressure Most cases of external bleeding can be controlled by applying direct pressure to the site of the wound, by using a sterile dressing. You can also apply pressure at the pressure points. Pressure points are sites where an artery that is close to the skin surface lies directly over a bone, for example on the inside

How to control bleeding contd

Elevation Elevation is to elevate the would or the affected part above the heart, if there are no suspected fractures. Nose Bleeding

The best way to control bleeding is by using direct pressure, or even elevation.
Put the casualty to sit, tilt the head forward, pinch the nose shut and breathe through the mouth for 10 15 minutes. Repeat the procedure if bleeding continues
Remember to protect yourself at all times from body

Shock
Circulatory Shock occurs when there is not enough blood to fill the circulatory system needed to supply the vital organs of the body. Hypovolemic Shock means bleeding profusely, vomiting and diarrhoea, severe dehydration and burns caused by the loss of plasma component of the blood.

Metabolic Shock is fluid shock caused by loss of blood fluid by way of diarrhoea and or vomiting (hypovolemic shock).
Cardiogenic Shock is heart shocks caused by the heart failing to pump enough blood to all parts of the body. This is caused by damage to the heart itself.

Shock contd
Neurogenic Shock is nerve shock, when something goes wrong with the nervous system such as injury in a accident, when there is not enough blood in the body to fill the new space. Anaphylacatic Shock is allergy shock caused by something to which the casualty is extremely allergic. Pshycogenic Shock is fainting caused by fear, grief, exhaustion, hunger, emotional stress, heat, low blood sugar, anaemia. This causes the nervous system to react and dilate the blood vessels. The flow of blood to the brain is interrupted. Septic Shock is bloodstream shock caused by infections. Poisons are released that causes the blood vessels to dilate.

Symptoms
Signs & Symptoms Altered mental status Anxiety, restlessness Causes Internal and external bleeding Crush injuries

Pale, cool clammy skin

Nausea, vomiting Rapid breathing, Tachycardia Unresponsiveness Strong thirst Cyanosis Hypertension Profuse bleeding Diarrhoea Shaking and trembling Nausea Thirst Weakness Restlessness Fear Dizziness

Burns plasma
Illness-peritonitis, cardiac conditions Severe allergic reaction Severe bleeding Poisoning Heart attack Electrical Shock

Casualty Appearance
Cold

and Clammy Skin

Breathing
Pulse

rapid and Shallow

rapid and weak

Pupils

dilated

Treatment for Shock

Check

for breathing and maintain an open

airway
Control

bleeding, splint major fractures and treat any other cause. the legs 8 12 inches, if there are no fractures.
Elevate Loosen Do

tight clothing, monitor, and record vital signs. This must be done every 5 minutes. not give the casualty anything by mouth, prepare for vomiting.
Prepare

to take the casualty to the hospital.

Other conditions which may cause Shock

Diarrhoea

& Vomiting

Dehydration Vomiting

How to prepare Oral Rehydration Fluid

i.
ii. iii. iv.

Boil and cool one (1) litre water.

Add 4 tablespoons of dark sugar. Add 1 teaspoon salt Pour into clean covered bottle.

Burns & Scalds

Burns - injuries resulting from exposure to dry heat, extreme cold, radiation, corrosive substances and friction. Scalds injuries caused by (moist) wet heat from hot liquids, vapours, teas or hot fat.

Burns & Scalds

Burns are usually classified according to depth, size or degree of skin damage as first, second or third degree burns. First Degree Superficial burns: Involve the top layer of the skin known as the epidermis. There is redness, swelling, pain and tenderness. Sun burn is a superficial burn. Second Degree Partial thickness: involves both the epidermis and the dermis(the 2 top layers of the skin). Second degree burns involve intense pain, redden skin that is moist and has blistes

Burns & Scalds

Third Degree Full Thickness Burns: involves all dermal layers, nerves, fat tissue, muscle, bone or organs. This can be dry and leathery and may appear white, dark brown or charred. Since there is often nerve damage present, there may be no sensation or pain present.

Treatment - Burns & Scalds

If a burn involves the mouth, nose, throat or airway, this is considered critical and requires medical attention.
1.

Flush the burned area under cool running water for 15 20 minutes or until cool. Do not break blisters. Remove all jewellery. Monitor ABC shock. and treat or

2. 3. 4.

Classification of Burns
Heat (Thermal): This includes fire, steam and hot object

Chemicals:
Electricity: Lightning:

This includes caustics, such as acids and alkalis.

This includes electric outlets, frayed wires and faulty circuits. This includes electrical burns and injuries during thunder storms. This includes burns to the skin or eyes due to the ultraviolet rays from the sun.

Sunlight:

Classification of Burns

Caring for Burns

Chemical Burns - To care for chemical burns wash the chemical from the body with water, flush the area for 15 30 minutes, remove contaminated clothing, shoes, socks and jewellery during the wash. Apply dry an sterile dressing. Electrical Burns On the scene of an electrical burn, the most serious problem sustained is cardiac arrest. Nervous system damage and injury to internal organs may also occur. Make sure that the source of electricity has been turned off, use dry stick or board and wear rubber sole shoes.

Caring for Burns

Electrical burns contd: Treatment
1.

Prepare for complications involving the airway and heart. Evaluate the burn. Look for entrance and exit wound (enter the hand and exit the foot). Apply dry sterile dressing to the burn sites. Monitor ABS and treat for shock. Prepare for removal to the hospital.

2.

3. 4. 5.

Caring for Burns

Lightning Burns Lightning burns occur when someone is electrocuted during a thunder storm. Treat as electrical shock. Sunlight (Radiation) This is a superficial burn. Treat have bath and pat dry. Friction (Brush Burns) Spinning wheel or fast moving rope cool with plenty of water.

Poisoning, Bites and Stings

A poison is a toxic substance solid, liquid or gas, if it enters the body may cause harm or death. 4 main ways by which poison may enter the body:
1. 2. 3. 4.

Swallowed (ingested) by Mouth Inhalation (Breathing) Absorption (Contract) Injection (under the skin)

Signs & Symptoms

Ingested poison May include any of the following:
1.
2. 3.

4.
5. 6.

7.
8.

9.

Burns or stains around the casualtys mouth. Breath odours, body odours. Abnormal breather and pulse rate Dilated or constricted pupils Sweating Excessive saliva or foaming at the mouth Pains in the mouth or throat, stomach, abdomen Convulsion Altered mental status including

Treatment
Swallowed Poison
1.

Do not give anything by mouth, take the casualty to the hospital at once, take the poison or container with you. Prepare to treat for shock. Carry the casualty in the recover position, should vomiting occur.

2.

3.

Give plenty of fresh air and monitor ABC.

Treatment
Inhaled Poison
1.

Look for possible sources that cause inhaled poison before you try to save life, because your life comes first. Make sure it is safe for you to enter any building or area that I contaminated. Remove the casualty from the source, give plenty of fresh air. Maintain an open airway, monitor the casualtys ABC.

2.

3.

4.

Prepare for shock and take to the

Treatment
Absorbed Poison
1.

Remove the casualty from the source, remove clothing, wash the affected area with soap and water. Monitor ABC and prepare to take to hospital, give elixir to prevent allergic reactions

2.

Treatment
Injected Poison
1. 2.

Prepare for (anaphylactic) allergic shock. Scrape away bees and wasp stingers and venom sacs. Place and ice-pack over the area to lessen the pain and reduce swelling. An aspirin moistened and applied to the area as a dressing will take away the pain. Give a dose of elixir, observe for symptoms of allergic reactions. Monitor ABCs.

3.

4.

5.

Dressing
Dressing: Any material used to cover a wound that will help to control bleeding and reduce contamination and infection. Bandage: Any material that is used to hold a dressing in place. Rules for Using Dressing
1.

Always wear disposable gloves.

2.
3.

Place the dressing over the would.

If blood seeps through the dressing, place another over it.

4.

Dispose of gloves, used dressing and soiled items

Types of Dressing
1.

Non-sterile

2.
3.

Adhesive
Cold compress

Bandaging
There are a number of different, first aid uses for bandages. Bandages used to secure dressings, control bleeding, support and immobilize limbs and reduce swelling in an injured part. 3 main types of bandages
1.

Roller Bandages Secure dressing and support injured limbs. Tubular Bandages Holds dressing on fingers and toes or support injured events. Triangular Bandages This can be used in may ways, to make a dressing a pressure pad and immobilize limbs.

2.

3.

Types of Bandages
Round bandage 2. Arm bandage 3. Hand bandage 4. Amputation bandage 5. Chest/back bandage 6. Head bandage 7. Wrist/ankle bandage 8. Knee bandage 9. Foot bandage 10. Arm sling bandage 11. Elevated arm sling bandage 12. Clavicle bandage 13. Dislocation bandage
1.

Types of Bandages

Bones, Muscles & Joints

Joint Muscles Where 2 or more bones are joined A soft tissue that lengthens and shortens to create movements. There are 2 types of muscles - Voluntary (controls movements) and Involuntary (control internal organs, heart etc.) Sprain The stretching and tearing of ligaments and other soft tissue at a joint. This is caused by sudden or awkward wrenching movements. Ligament - Tough, fibrous tissue that hold bones together at a joint. Strain The stretching and tearing or muscles and tendons caused by sudden or awkward movements. Tendons - Fibrous bands of tissues that attach muscles

Signs & Symptoms of Sprains and Strains

Pain and tenderness B. Difficulty in moving the injured part. C. Swelling and bruising in the area if the muscles are torn. Treatment R Rest the injured part. I Immobilize C Cold compress (15 20 minutes) E Elevate the injured part
A.

Fractures
A Fracture is a cracked, chipped, splintered or broken bone caused by direct or indirect forces, strong twisting forces. Any strong force to the extremities can cause a fracture, a dislocation, a sprain, a strain and damage to soft tissues. Types of Fractures Simple (closed) - A simple fracture is when the bone is clearly broken. Compound A compound fracture is when the bone is Commuted (Open) broken in more than one place and into many pieces. Angulated And angulated fracture is an injury to an extremity that causes the bone to bend.

Fractures
Types of Fractures contd Complicated This is when the fractured bone interferes with an organ. Greenstick Greenstick fractures are commonly associated with infants, toddlers whose bones are soft and bend like a greenstick. Depressed A depressed fracture is referred to as a dent. The bones are driven inwards mainly in the skull. Linear This type of fracture mainly occurs in the head. Linear fracture is a crack.

Sign & Symptoms of Fractures

a.

b.

c.

Pain nerves surrounding the injury have been pressed by swelling tissue or broken bone ends. Swelling the injured area begins to swell because blood from ruptured blood vessels is collecting inside the tissues. Deformity a part of the limb looks different in size or shape (always compare both arms and legs to one another)

Sign & Symptoms of Fractures

SPLINT
Any hard/rigid material used to immobilize a fracture

SPLINT-

Swelling Pain Loss of use Irregularity Numbness Tenderness

Sign & Symptoms of Fractures

DDEP-

Deformity Dislocation Exposed bone Patient heard sound of broken bones

Treatment of Fractures
During your initial assessment, do not focus on obvious injuries, but first assess responsiveness, then airway, breathing and circulation. Control all major bleeding, check and correct life-threatening problems as quickly as possible

Sign & Symptoms of Fractures

After correcting and stabilizing lifethreatening injuries, first priority is given to possible injury to the Spine. a. Skull because it protects the brain and contains a portion of the airway. b. Pelvis because it protects reproductive and urinary organs and major nerves and blood vessels. c. Thigh because it I the longest, sturdiest bone (femur) in the body, major nerve and blood vessels surround it. d. Rib Cage because it protects the heart and lungs, broken bone may damage these organs and the patient may have difficulty

Sign & Symptoms of Fractures

e.

f.

Extremity Injury where no distal pulse is detected during the initial assessment, extremities should be straightened. Injuries to the arm, lower leg and individual ribs are considered and managed last.

Treatment
1.

2.

3. 4. 5.

Assess the casualty before you focus on any particular injury. Treat life threatening problems first. Prioritize and manage other injuries. Apply a dressing if there is an open wound. Check for distal pulse (radial), sensation and motor function. Distal pulse (circulation), sensation (feeling) motor function (ability to move) check before and after splinting. Immobilized the extremity Tie bandages above and below the injury Check ABC

Why Splint
Pain A splint can reduce much of the casualtys because it immobilizes the broken or dislocated bones in place and prevents them from damaging nerves and tissues. Bleeding Fractured bone ends, dislocated bones and moving bone fragment can damage blood vessels and cause internal and external bleeding. Rules for Splinting 1. Assess and reassure casualty and explain what you plan to do. 2. Expose the injury site. 3. Control bleeding by dressing the wounds.

Why Splint
Rules for Splinting contd 4. Check distal pulse, sensation and motor function before and after splinting. 5. Reposition limb and apply splint if allowed to do so, tie above and below the wound. 6. Firmly secure the splint, and reassess distal pulse and sensation. 7. Monitor casualty ABC and prepare to take to the hospital. 8. The reason for straightening closed angulated fractures is to improve circulation. It makes splinting easier. 9. Make no attempt to straighten angulation.

Why Splint
Rules for Splinting contd
10.

Do not attempt to straighten angulations if the injuries involve the shoulder, pelvis, hip, thigh, wrist, hand, foot or a joint immediately above or below the injury site.

Injuries to the Spine

Injuries to the spine can cause one to become paralysed and reduces normal body function and movement. Spinal injuries are caused by forces to the head, neck, back, chest, pelvis or legs. A whiplash is caused by motor vehicle accidents. The spine is a column made up of 33 bones called vertebrates.

The Spine
The spine is a column made up of 33 bones called vertebrates.
Cervical spine Thoracic spine back Lumbar spine back Sacrum Coccyx 7 bones in neck 12 bones in the upper 5 bones in the lower 5 fused bones 4 fused bones

Signs & Symptoms of Spinal Injuries

A. B. C. D. E. F. G. H.

Weakness, numbness or tingling sensation or a loss of feeling in arms or legs. Paralysis to the arms or legs. Painful movements of arms and legs or no pain sensation. Pain or tenderness along the back of the neck or the backbone. Burning sensation along the spine or an extremity. Deformity of the spine, angle of head and neck. Loss of bladder and bowel control, difficulty breathing. Persistent erection priapism

Treatment for Injuries of the Spine

Make certain the airway is open by using the jaw-thrust manoeuvre. 2. Control serious bleeding avoid moving the injured part when applying dressing. 3. Always presume that an unconscious accident patient has spinal injuries. Check distal pulse, check sensation (feeling), motor function (ability to move) 4. Do not attempt to splint fracture if there are indications of spinal injuries.
1.

Treatment for Injuries of the Spine

Never move a casualty with spinal injuries unless you must do so to provide A.R. or CPR and to treat severe bleeding. 6. Keep the casualty still, stabilize or immobilize the casualtys head, neck and as much of the body as possible. 7. Monitor casualty with possible spinal injury. These casualties will go into shock. Sometimes their chest muscles will be paralyzed and they will go into respiratory arrest.
5.

Head to Toe Examination

Injuries and illnesses usually manifest themselves as groups of distinctive features. There a 2 types of features:
1.

Sign: Surface of the body, which you may detect Symptom: what is coming from inside the body.

2.

Head to Toe Examination

Always start at the head and work down to the toes using DCAPT-BTLS or DOTS method D C A P B T L S DEFORMITIES CONTUSION ABRASIONS PUNCTURE/PENETRATIONS BURNS/BLOOD TENDERNESS LACERATIONS SWELLING

Head to Toe Examination

Always start at the head and work down to the toes using DCAPT-BTLS or DOTS method D O T S DEFORMITIES OPEN WOUNDS TENDERNESS SWELLING

Head to Toe Examination

To begin your assessment: 1. Check the head and scalp for cuts, bruises and depressions. 2. Examine the patients eyes using a penlight. Look for foreign objects and check the size of the pupils. Dilation or constriction may indicate a brain or spinal injury. 3. Inspect the ears and nose for blood, bloody fluid or clear fluid. The clear fluid is called cerebro spinal fluid and indicates severe head injury. 4. Inspect the mouth for possible airway obstructions: bleeding, broken teeth, bridges, dentures, crowns, chewing gums, food, vomit or other foreign objects.

Head to Toe Examination Contd

To begin your assessment contd: 5. Check the cervical spine bones for tenderness and deformities. Check the neck for injury or deformities. 6. Feel clavicles for tenderness and deformities, inspect the chest for cuts, bruises, penetrations and impaled objects. Check for possible fractures and equal expansion of the chest and rib cages. 7. Inspect the abdomen for cuts, bruises, penetrations, distension and impaled objects. Fee abdomen for tenderness and pain. 8. Feel the upper back. Check the thoracic spine 12 bones for point tenderness and deformities

Head to Toe Examination Contd

To begin your assessment contd: 9. Feel the lower back lumbar spine 5 bones for point tenderness and deformities. 10. Fee the pelvis for possible injuries and incontinence. 11. Examine the legs and feet individually. Do not lift or move the legs or feet. Compare both legs length, shape, swelling or deformities. 12. Check distal pulse for circulation. Check the posterior tubial pulse. Feel behind the ankle or the dorsalis-pedis pulse, locutid lacteral to the large tnedons of the big toe.

Head to Toe Examination Contd

To begin your assessment: 13. Examine the upper extremities from the shoulders to the fingertips. Feel each hand and note any cuts bruises, impaled objects, bleeding, deformities, swelling, dislocations, protruding bones or fractures. Check the radial pulse. Check for sensation by the touch of a finger and motor function by asking the casualty to grasp your hand. 14. If there are no injuries to the head, neck, spine or extremities, inspect the back surface.

Rapid Physical Assessment

Medical Asthma Fainting Seizure Stroke Heart Attack Cardiac Arrest
Neck: Chest: Abdomen: Extremities:

Trauma Laceration Abrasion Burns Fractures Amputation Motor Vehicle Accident Fall

Neck vein, distension and medical identification devices. Presence and equality of breathing sound Distension, firmness or rigidity Pulse, motor function, sensation and medical alert devices.

Vital Signs
The vital signs include: 1. Pulse 2. Respiration 3. Temperature 4. Blood Pressure 5. Skin Colour

Lifting & Moving Casualties

a.

b.

c.

Position your feet properly They should be on a firm, level surface and positioned shoulder-width apart. Use your legs, not your back, to do the lifting Keep your back straight and bend your knees. Never twist or attempt to make any moves other than the lift Attempts to turn or twist while you are lifting are a major cause of injury.

Lifting & Moving Casualties

Lifting & Moving Casualties contd

d.

e.

When lifting with one hand, do not compensate avoid leaning to either side. Keep your back straight and locked. Keep the weight as close to your body as possible This is part of good body mechanics and allows you to used your legs rather than your back, while lifting. The farther the weight is from your body, the greater your chance of injury.

Lifting & Moving Casualties

Lifting & Moving Casualties contd

f.

When carrying a patient on stairs, use a stair chair instead of a stretcher whenever possible keep your back straight. Flex your knees and lean forward from the hips, not the waist. If you are walking backwards down stairs, ask a helper to steady your back.

Lifting & Moving Casualties contd

When lifting or moving patients you should: Explain to the patient what you are doing.

Not lift, or move too fast or in ways that will make the injury or illness worse. Not grasp the injured area. Move by grasping specialist equipment. clothing or

Keep you back straight.

Lifting & Moving Casualties contd

When lifting or moving patients you should: Bend your knees and hips in order to make good use of your leg muscles and lift with arms straight.

Keep you chin and elbows tucked in and grip shoulder width.
Stand with your feet apart to allow a balanced distribution of your body weight. Stand close to the patient.

Lifting & Moving Casualties contd

When lifting or moving patients you should:

The load should be held as close to the body as possible to allow for central gravity. Break down lifting in stages as to allow for rest and proper control during the movement. Lift with your feet straight and one foot slightly forward