Opening prayer

BY: WEVINNE GUARTE,RN

FIRST AID
What is first aid?
Initial care for an illness or injury
There are three main aims of first aid,
preserve life, prevent further injury
and to promote recovery.
PRINCIPLES OF EMERGENCY
CARE
GETTING STARTED
1. Planning
Emergency plan should be established based on
anticipated needs and available resource.

2 . Provision of logistics
The emergency response begins with the
preparation of equipment and personnel before any
emergency occurs.

3 . Initial Response

* Ask for HELP
* Intervene
* Do not further harm

4 . Instruction to By-Stander
Proper information and instruction to by stander/s
would provide organized first aid care.
FIVE EMERGENCY ACTION
PRINCIPLES
1 . Survey The Scene
Once you recognized that an emergency has
occurred and decide to act, you must make sure the
scene of the emergency is safe for you the victim/s
and any bystander/s.



ELEMENTS OF THE SURVEY
OF THE SCENE
SCENE IS SAFE

MECHANISM OF INJURY OR NATURE OF ILLNESS

DETERMINE THE NUMBER OF PATIENT AND
ADDITIONAL RESOURCES.
2 . ACTIVATE MEDICAL ASSISTANCE (AMA) OR
TRANSFER OF FACILITY.
In some emergency, you will have enough time
to call for specific medical advice before
administering first aid. But in some situation, you
will need to attend to the victim first.
CALL FIRST AND CARE FIRST

Both trained and untrained bystander should be
instructed to Activate Medical Assistance as soon as
they have determined that an adult victim requires
emergency care Call First. While for infants and
children Care First approach is recommended.
Information to be remembered in Activating
Assistance:

WHAT happened?
LOCATION?
NUMBER of Persons injured?
EXTENT of injury and first aid given?
The TELEPHONE number from where you are calling.
PERSON who activated Medical Assistance must
identify him/herself and drop the phone last.

* Everybody should know the Emergency number and
Hotline number of your areas.(HEMS, RESCUE no.
PNRC, EMS no. Hospital no.)
UPON DOING ASSESSMENT
You have to
A. Interview the victim

S - signs and symptoms
A - allergies
M - medications
P - past medical history
L - last meal taken
E - events prior to injury or incident


B. Check vital signs every 5 minutes to unstable
condition and every 15 minutes for stable
condition.














C. Head to Toe examination
( D C A P B T L S )


D - deformity








C - contusion





A abrasion






P punctures


B - burn







T- tenderness



L - laceration







S - swelling
REFERRAL OF THE VICTIM FOR FURTHER
EVALUATION AND MANAGEMENT
It refers to the transfer of a victim to a hospital
or health care facility if necessary for a definitive
treatment.
GOLDEN RULE IN GIVING
EMERGENCY CARE
The DOs

1. Do obtain consent when possible.
2. Do think of the worst.
3. Do remember to identify your self.
4. Do provide comfort and emotional support.
5. Do respect the victim ( modesty and privacy ).
6. Do as calm and direct as possible.
7. Do care of the most serious injuries first.
8. Do assist the victim on medication.
9. Do keep on lookers away from the injured
person.
10. Do handle the victim to a minimum.
11. Do loosen tight clothing.
The DONTS

1. Do not let the victim see his/her injuries.
2. Do not leave the victim alone except to get help.
3. Do not assume that the victims obvious
injuries are the only one.
4. Do not make unrealistic promises.
5. Do not trust the judgment of a confused person.
PRECAUTION TO PREVENT
DISEASE TRANSMISSION
BODY SUBSTANCE ISOLATION ( BSI )

Are precautions taken to isolate or prevent risk
of exposure from any type of bodily substance
using Personal Protective Equipment ( PPE )

BASIC PRECAUTION AND PRACTICE
1.Hand washing 2. Protective 3. Equipment
Equipment cleansing and
disinfecting



FEVER
CAUSES
Hot weather
Childhood immunization
Bacterial/viral infection
Spending much time in sun
Allergy to medication / food


SYMPTOMS
Hot flushed face
Lack of interest in food
Nausea
Vomiting
Head and body ache
Diarrhea
High fever

maybe associated with
Delirium
Convulsion

TREATMENT
Monitor temperature using a thermometer
Remove the excess clothing
Keep the person in a cool place
Give a sponge bath in luke warm water
Give plenty of fluids
Give prescribed doses of paracetamol
Do not wrap the person in blankets / warm
clothing

Consult a Doctor in case of:
Irregular breathing
Stiff neck
Confusion
Rashes
Persistent sore throat
Vomiting
Diarrhea
Painful urination
Convulsions


HYPOTHERMIA
1. In children and adults,
symptoms include:

Confusion, memory loss, or slurred speech
Drop in body temperature below 35C
Exhaustion or drowsiness
Loss of consciousness
Numb hands or feet
Shallow breathing
Shivering
In infants, symptoms include:
Bright red, cold skin
Very low energy level
2. Restore Warmth Slowly

Get the person indoors.
Remove wet clothing and dry the person off, if
needed.
Warm the person's trunk first, not hands and feet.
Warming extremities first can cause shock.
Warm the person by wrapping him or her in blankets
or putting dry clothing on the person.
Do not immerse the person in warm water. Rapid
warming can cause heart arrhythmia.
If using hot water bottles or chemical hot packs,
wrap them in cloth; don't apply them directly to the
skin
3. Begin CPR, if Necessary,
While Warming Person

If the person is not breathing normally:
For a child, start CPR for children.
For an adult, start adult CPR.
Continue CPR until the person begins
breathing or emergency help arrives.

4. Give Warm Fluids
Give the person a warm drink, if conscious.
Avoid caffeine or alcohol.


5. Keep Body Temperature Up

Once the body temperature begins to rise, keep
the person dry and wrapped in a warm blanket.
Wrap the person's head and neck as well.

6. Follow Up
At the hospital, health care providers will
continue warming efforts, including intravenous
fluids and warm, moist oxygen.

NOSE BLEED (EPISTAXIS)
Overview
A nose bleed occurs when a small vein, along
the lining of nose bursts
Most nosebleeds look scary, but are harmless
Can be treated at home Common in
children/elderly




CAUSES
Dryness
Nose picking
Blowing nose with force
Use of medications, like aspirin
Introducing objects into nose (mostly children)
Injuries
Allergies
Infections
High BP
Atherosclerosis
Blood-clotting disorders
Use of cocaine


SYMPTOMS
Bleeding from nose
Sometimes bleeding from ears/mouth too



TYPES
a. Anterior Nosebleed
Affects lower part of wall that separates
nostrils
The wall or septum contains blood vessels
These can be broken by blow to nose/fingernail
The bleeding starts from front of nose
It flows outward when patient is
sitting/standing
Occurs during dry season/harsh winter

b. Posterior Nosebleed
The bleeding starts deep within the nose
It flows down the back of the mouth & throat
This happens even when the person is
sitting/standing
Occurs in old people/those with high BP/injuries
This type of bleeding is severe/ requires medical
help



TREATMENT
If your nose bleeds,
Sit down and lean forward
Using your thumb & index finger, squeeze soft part of
nose
This part is between end of nose and the bridge of nose
Continue holding till bleeding stops-
Do not stop in-between
If bleeding continues, hold for another 10 minutes
If the patient is a child, divert attention by TV/Stories
Avoid picking, blowing or rubbing nose for 2 days
Place an ice pack on the bridge of nose



Consult a Doctor If,
The bleeding continues for more than 15
minutes
The bleeding is caused by an injury
You get nosebleeds often


Prevention
Keep fingernails short
Quit smoking
Open your mouth while sneezing
Use a humidifier at night in case of dry
weather



WOUNDS

Signs of INFECTION
Swelling
Reddening
Warm to touch
Pus discharge

TYPES OF WOUNDS

CUTS
What is Cut?
An injury due to opening in the skin



Minor Cuts / Scrapings
No treatment is required
Care required to prevent infection


SCRAPES
CUTS
Treatment for Minor CUTS
Clean wound with water
Avoid soap
Remove dirt/debris in the wound
Apply antibiotic ointment
Dress/ bandage the wound
Change dressing daily
Minor cuts stop bleeding in10 min
Apply gentle pressure if bleeding persists


Deep cuts
May bleed heavily
May expose underlying tissues




Treatment For Deep Cuts
May require stitching
Requires Tetanus Toxoid (TT) if:
a. Cut is dirty or has debris
b. TT taken 5 years ago
Consult a doctor in case of:
a. Delayed wound- healing
b. Pus Discharge
c. Fever


Points to note
Do not try to clean a major wound
Do not remove deeply- lodged debris
Do not breathe on an open wound
Do not push back exposed body parts

PUNCTURE
WOUNDS
Risk Factors

Health professionals
Drug Abusers
Causes Puncture wound can be
caused by -
Nails
Needles
Teeth
Objects like ice picks, bullets
Animals, especially pets



Symptoms
Pain
Bleeding
Bruising
Swelling
Treatment
Stop the bleeding applying gentle pressure
Clean the wound
Try to remove embedded debris carefully
Soak wound in warm water for 20 minutes
This should be done 2-3 times a day
Pat the area dry
Apply an antibiotic cream
Apply a bandage
If the bandage needs to be changed, unwrap
carefully


If the bandage sticks to the body, use warm water
to loosen it
Pat dry and apply fresh bandage
Change the dressing regularly
Try to keep the wound above the level of your
heart, for 24 hrs This quickens healing
Rest for 3-5 days
Look out for infection
Take a Tetanus Toxoid injection, if you have not
taken it in 5 years


Consult a Doctor In case of-
Human/animal bite
High temperature
Bleeding
Worsening Pain
Numbness
Swelling
Redness
Pus
Bad odor



Prevention
Health professionals should wear gloves
whenever required
Be careful while handling needles/other
sharp objects
Exercise caution while handling pets



FRACTURE
What is fracture?
A broken or cracked bone
Occurs when pressure is applied to bone
Occurs with / without displacement of bone
fragments



Types
Open fracture: Skin breaks causing open wound
Closed fracture: Skin not broken
Complicated fractures: Damage of adjacent
organs
Stress fracture: Hairline crack due to repeated
stress
Greenstick fracture: In children's flexible bones



Symptoms
Severe pain
Difficulty in movement
Swelling/ bruising / bleeding
Deformity / abnormal twist of limb
Tenderness on applying pressure



For open fractures
Control bleeding before treatment
Rinse and dress the wound

For open / closed fractures
Check the breathing
Calm the person
Examine for other injuries
Immobilize the broken wound
Apply ice to reduce pain / swelling
Consult a doctor


DO NOT
Massage the affected area
Straighten the broken bone
Move without support to broken bone
Move joints above / below the fracture
Give oral liquids / food

SPRAINS
Overview
Sprain is the stretch/tear of ligament
connecting bones .
Occurs in both the upper & lower part of the
body
Most common sites - ankle/wrists/knee


Causes
Trauma/accidents
Lifting heavy objects
Sporting injuries
Symptoms
Pain
Swelling
Lumps other than swelling
Bruising/redness at site of injury
Numbness
Inability to move the joint


Treatment
Apply a cold compress to injured area for 20 min
This may be done 4-8 times a day
Use a plastic bag with crushed ice, wrapped in a
towel
Use compression bandages to reduce swelling
Keep the injured leg elevated on a pillow
Take anti inflammatory pills if necessary
Take rest for the recommended period
When pain/swelling is diminished, do recommended
exercises


Consult a doctor
If the following occurs-Severe
pain/numbness
Inability to move the joint
Inability to assess the severity of injury



Steps To Avoid
Do not return to normal activities if not
completely cured
This could lead to the problem turning
chronic



STRAIN
DEFINITION

It is the stretching or tearing of
muscle fibers. A muscle strain can be
caused by sports, exercise, a sudden
movement, or trying to lift something
that is too heavy. Symptoms of a
muscle strain include pain, tightness,
swelling, tenderness, and the inability
to move the muscle very well.


Symptoms
Pain and difficulty moving the injured muscle
Discolored and bruised skin
Swelling
TREATMENT
Apply ice immediately to reduce swelling. Wrap
the ice in cloth -- avoid using ice directly on the
skin. Apply ice for 10 to 15 minutes every 1 hour
for the first day. Then, every 3 to 4 hours.
Use ice for the first 3 days. After that, either heat
or ice may be helpful.
Rest the pulled muscle for at least a day. If
possible, keep the pulled muscle elevated above
the level of the heart.
Avoid using a strained muscle while it is still
painful. When the pain subsides, start activity
slowly and in moderation.
WHEN TO CALL A MEDICAL
PRACTIONER
You are unable to move the muscle.
The injury is bleeding.
Call your doctor if the pain does not go away
after several weeks.
ANAPHYLAXIS
(ALLERGIC REACTION)
What is Anaphylaxis?
Severe, life- threatening allergic reaction
Occurs as a reaction to an allergen
Anaphylaxis releases various chemicals in
body
Reactions occur in secs / mins of exposure


Causes
Food like nuts, milk, eggs, fish
Insect sting
Latex
Vaccines
Medications like antibiotics, anesthetics
Some tropical insects, plants, animals
Unknown causes


Symptoms
Tingling / warm sensation
Itchiness / Rash
Swelling of areas around mouth / throat
Restricted air-ways
Reduced oxygen level in brain
Signs of asthma
Vomiting
Cramps
Diarrhea
Fluidfilled lungs
Low blood pressure
Palpitations / feeling faint
Loss of consciousness


Who is at risk?
Those with history of food allergy
Those with family history of allergies
Those who have experienced prior attack


Treatment
If nauseated, lie down on the side
If feeling faint, lie down, legs raised
In case of breathing difficulty, sit up
First time patients should be hospital treated
Epinephrine injections effective treatment
Continuous monitoring mandatory
Severity/ response / prior episodes determine
treatment

Prevention
Avoid allergens as far as possible
Those at risk should carry adrenalin auto-injector
Inform school authorities, if children at risk
Children should wear food allergy badges
Emergency protocols necessary in schools/ work
place
Educating the public is vital


INSECT BITES/
STINGS
Overview
Insect bites are, mostly, not severe Sometimes they
cause a severe allergic reaction, anaphylaxis

Anaphylaxis is life-threatening if not treated on time
Sting of bees, wasps, hornets / bite of fire ants,
painful Bites of insects, like mosquitoes, cause itching

The bite of a black widow spider can be fatal, if left
untreated



Causes
Examples of biting insects
Mosquitoes
Fleas
Mites
Spiders
Examples of stinging insect Bees
Wasps
Hornets


Symptoms
Localized Pain
Swelling
Redness
Itching
Numbness
Burning
Tingling sensation
Breathlessness
Weakness


Treatment
Remove the stinger using a straight- edged
object
Wash the area thoroughly with soap and water
Place ice wrapped in a cloth on the affected area
Repeat after every 10 minutes
Apply a gentle cream to prevent itching
Take anti histamines if necessary
Observe for signs of infection like pain, redness
or swelling

In case of emergency-
Try to keep the person calm
Check the person's breathing
Remove constricting items, like rings, from
finger/nose/ears
Do Cardio Pulmonary Resuscitation (CPR), if
necessary
If the person is carrying an emergency kit, use it
If required, treat the person for signs of shock
Seek medical help as soon as possible

Consult a Doctor
In case of the following, seek medical
help
Wheezing
Swelling on the face
Difficulty in breathing
Tight feeling in the throat
Body turning blue


Steps to Avoid
Do not remove the stinger using a tweezer
Do not apply a tourniquet
Aspirin, pain medications, should not be given unless
advised by a doctor


Prevention
Avoid placing hand near the mouth of a seizure-
affected person
Take caution to prevent your child from developing
biting habit


ANIMAL BITES
Overview
Domestic pets cause more bites
Dogs more likely to bite, cats more infectious
Risk of rabies with non-immunized pets /
stray / wild animals
Raccoons, skunks, foxes, bats too carry rabies

Symptoms
Skin break
Bruise / puncture
Cuts
Bleeding
Swelling and redness of the area
Oozing of fluid


Treatment
Calm the affected person
Wash hands before attending to wound
Wash wound with soap & running water
Apply antibiotic ointment
Dress using sterile bandage
After first aid, medical treatment must be sought
quickly
Suturing may be required
Tetanus booster / antibiotics required
Treatment depends on type / location of wound
Prevention
Avoid keeping wild animals as pets
Choose a pet that is friendly to children
Train the pet to obey commands
Vaccinate your pet
When children are around, pets supervision is
required
Avoid leaving infants alone with pets

SNAKE BITE

Causes
Some common venomous snakes include -
Viper
Cobra
Rattle snake
Coral snake
Copper head

VIPER SNAKE

COBRA SNAKE

RATTLE SNAKE

CORAL SNAKE

COPPERHEAD SNAKE

Symptoms
Fang marks
Swelling/severe pain at the site
Bloody discharge from wound
Burning
Diarrhea
Excessive sweating
Blurred vision
Numbness/tingling sensation
Increased thirst
Vomiting
Fever
Loss of muscle co-ordinations
Convulsions
Rapid pulse
Weakness/Dizziness/Fainting

Treatment
A . Seek Medical help as soon as possible.
Meanwhile -Wash wound with soap/water
Immobilize the affected area
Keep area slightly elevated
Apply cool compress/wet cloth to affected part
Apply a firm bandage 2-4 inches above bite to

i. Prevent venom from spreading
ii.Take care of any bleeding
b. Monitor for pulse, respiration and blood
pressure

Prevention
Do not attempt to kill a snake.
If you spot a snake, leave it alone
While hiking or in the woods, stay out of tall grass
Do not put your hand into pits/crevices during
treks
Exercise caution while climbing rocks

POISONING
Overview
Poisons are substances that cause injury,
illness or death
Poisons can be injected, inhaled or
swallowed

Poisoning should be suspected if a person is
sick for unknown reason

Causes
Medications
Drug overdose
Occupational exposure
Cleaning detergents/paints
Carbon mono oxide gas from furnace, heaters
Insecticides
Certain cosmetics
Certain household plants, animals
Food poisoning (Botulism)


Symptoms
Blue lips
Skin Rashes
Difficulty in breathing
Diarrhea
Vomiting/Nausea
Fever
Head ache
drowsiness
Double vision
Abdominal/chest pain
Palpitations/Irritability


Loss of appetite/bladder control
Numbness
Muscle twitching
Seizures
Weakness
Loss of consciousness
Treatment
Seek immediate medical help
Mean while,Try and identify the poison if possible
Check for signs like burns around mouth,
breathing difficulty or vomiting
Induce vomiting if poison swallowed (case to case
basis)
In case of convulsions, protect the person from
self injury
If the vomit falls on the skin, wash it thoroughly
Position the victim on the left till medical help
arrives


For inhalation poisoning
Seek immediate emergency help
Get help before you attempt to rescue others
Hold a wet cloth to cover your nose and mouth
Open all the doors and windows
Take deep breaths before you begin the rescue
Avoid lighting a match
Check the patient's breathing
Do a CPR, if necessary
If the patient vomits, take steps to prevent
choking

Steps to Avoid
Avoid giving an unconscious victim anything
orally
Do not induce vomiting unless told by a medical
personnel
Do not give any medication to the victim unless
directed by a doctor
Do not neutralize the poison with
limejuice/honey


Prevention
Store medicines, cleaning detergents, mosquito
repellants and paints carefully
Keep all potentially poisonous substances out of
children's reach
Label the poisons in your house
Avoid keeping poisonous plants in or around house
Take care while eating products such as berries,
roots or mushrooms
Teach children the need to exercise caution


END
THANK YOU!