by NSTP-ROTC University of Makati

1. “GENERAL FIRST AID”

2. “ In times of emergency, anyone who has even elementary first aid training, may be able to save a life…” ~RED CROSS

3. DEFINITION OF FIRST AID First Aid is an immediate care given to a person who has been injured or suddenly taken. It includes self-help and home care if assistance is not available or delayed.

4. INTRODUCTION: First is the immediate treatment administered to a casualty or a victim of injury or illness before the services of a doctor or corpsman can be obtain. Although the medical department has the finest equipment and its personnel have been trained in the most modern methods of saving life and easing pain , there maybe a time when your life or that of a friend will depend on your knowledge of first aid.

5. You can save a life if you know what to do and what not to do, and if you can act quickly and calmly. If you are injured, you can save your own injuries or by directing others toward proper care. Remember, where medical help is not readily available, apply self-aid and then seek professional help or care. The basic rules for first aid given in this handout are to help yourself and your comrades when it is necessary.

6. You must remember that when administering first aid, the following should be his primary objectives to save life, to prevent causing further injury and to prevent unnecessary sufferings on the part of the casually.

7. ROLES OF FIRST AID 1.) It is the bridge that fills can between the victim and the physician. 2.) It is not intended to complete with, nor take the place of the place of the services of the physician. 3.) It ends when the services of a physicians begins.

8. OBJECTIVES OF THE FIRST AID 1.) To alleviate suffering 2.) To prevent added/further injury or danger 3.) To prolong life

9. NEED & VALUE OF FIRST AID 1.) To minimize if not totally prevent accident. 2.) To prevent added injury or danger 3.) To train people to the right thing and right time 4.) Accident happens and sudden illnesses are common and often serious 5.) People very often harm rather than help 6.) Proper and immediate care is necessary to save life or limb

10. GUIDELINES FOR GIVING EMERGENCY CARE 1.) Getting started 1.1 Planning of action 1.2 Gathering of needed materials 1.3 Initial response as follows A- Ask for help I- Intervene D- Do not further harm

11. ASK FOR HELP- in a crisis, time of essence. The more quickly you organize an emergency, and the faster you call for medical assistance, the sooner the victim will get help. Immediate care can greatly the outcome of an emergency. INTERVENE- To intervene means to do something for the victim that will help achieve a positive outcome to an emergency. Sometimes getting medical help will be all you can do, and this alone may save a life. In other situation, however you may become actively involved in the victim’s initial care by giving first aid. Let the golden rules of emergency care guide your effort.

12. DO NOT FURTHER HARM- Once you have begun first aid, you want to be certain you don’t do anything that might causes the victim’s condition to worsen. Certain actions should always be avoided by keeping them in mind, you will be able to avoid adding to or worsening the victim’s illness or injuries.

13. 2.) Emergency Action Principles 2.1 Survey the scene 2.2 Do a primary survey of the victim 2.3 Activate medical assistance/transfer facility 2.4 Do a secondary survey of the victim

14. Survey the scene- - is the scene is safe? - what happened? - how many people are injured? - identify yourself as a trained first aider

15. Do a primary survey of the victim- Check for vital body functions: BREATHING and CIRCULATION by following the ABC steps- A. – AIRWAY > Is the victim is conscious? > If the victim is conscious, asses breathing as described in B. > If the victim is unconscious, start immediately airway management

16. B. Breathing - Is the victim breathing? if the victim is breathing – is it shallow or deep? Does he/she appear to be choking? Is he cyanotic, suggesting poor oxygenation? If the victim appears to have any difficulty breathing, immediately support his breathing (maintain adequate open airway) if the victim is not breathing – provide initial ventilation

19. Information to be remembered in activating medical assistance - what happened -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 drop the phone last

20. Do a secondary survey of the victim - interview the victim - introduce your self - get permission to give care - ask the victim’s name - ask what happened ask “do you have any pain or discomfort?” “do you have any allergies?” “are you taking any medication?”

21. Check the vital signs: - determine radial or carotid pulse (pulse rate per minute) adult – 60-90/min child – 80-100/min - determine breathing(respiration rate) - determine skin appearance - look at the victim’s face and lips - record skin appearance - temperature - moisture - color

22. - Do the head-to-toe examination start with the head. Look and feel for cut bruises and compare pupils of both eyes, dilated pupils involve bleeding and state of shock. Constricted pupils may mean heat stroke or Drug overdose. Unequal pupils may suspect head injury or stroke. -check for fluid or blood in ears, nose and mouth. - check and compare both collar bones and shoulder. - check the chest and rib cage.

23. - check for the victims abdomen for tenderness by pressing lightly with flat part of our fingers. - check the hip bone by pressing slowly downward and inward for fracture - check one leg at a time - check one arm at a time - check the spinal column by placing the victim into side lying down position and press gently from the cervical region down to the lumbar for possible injury - record all the assessment including the time - keep the injured person lying down, his head level with his feet - keep the injured person warm and guard against chilling

25. Do think the worst, it’s best to administer first aid for the gravest possibility.

26. Do call or send for help.

27. Do remember and identify yourself to the victim

28. Do provide comfort and emotional support.

29. Do respect the victim’s modesty and physical privacy

30. Do be as calm and as direct as possible

31. Do care for the most serious injuries first.

33. Do handle the victim to a minimum

35. Trying to arouse an unconscious victim.

36. Administering fluid/alcoholic drink.

37. Do not let the victim see his/her injury.

38. Do not leave the victim alone except to get help.

39. Do not assume that the victim’s obvious injuries are the only ones..

40. Do not deny a victim’s physical or emotional coping limitation.

41. Do not make any unrealistic promises.

42. Do not trust the judgment of the confused victim.

44. DON’T loosen a tourniquet once it has been applied DON’T move a casualty who has a fracture until it has been properly splinted, unless it is absolutely necessary. DON’T give fluids by mouth to a casualty who is unconscious, nauseated, or vomiting, or who has an abdominal or neck wound DON’T permit the head of a casualty with a head injury to be lower than his body. DON’T try to push protruding intestine or brain tissue back into a wound DON’T put any medication on a burn. DON’T administer first aid measures which are unnecessary or beyond your ability.

45. Characteristics of a good first aider Observant -should notices all signs. Resourceful -should make the best use of thing at hand Gentle -should not cause pain Tactful -should not alarm the victim Sympathetic -should be comforting

46. “HURRY CASES” in first aid Stoppage of breathing -Critical time is four minutes to restore the victim to normal before brain damage take place: Management of the Casualty: 1. Clean the Airway 2. Inflate the lungs with five quick breaths(proceed to CPR) Severe bleeding - Bleeding and Hemorrhage mean the same thing, namely that blood is escaping from arteries, capillary vessels, or veins.

47. Types of hemorrhage Arterial Bleeding – blood from an open artery. The color of the blood is bright red. The blood spurts which are synchronized with the pulse. Venous Bleeding – blood from an open vein. The color of the blood is dark red. The blood escapes in a slow steady flow. Capillary Hemorrhage – blood from damage capillaries. The color of the blood is intermediate between bright and dark red . The blood only oozes from the wound. This is the common type of hemorrhage.

48. Controlling external bleeding: Direct pressure Digital pressure (pressure points) -Facial -Temporal -Carotid -Subclavian -Auxiliary -Brachial -Femoral Compress and Bandages Ligation – tying Torsion – Twisting Elevate the injured part to lessen the flow of blood. Indirect pressure - tourniquet

49. C. Poisoning Swallowed – antidote is to dilute with water or milk to lessen the concentration of the poison. Milk coats the lining of the intestines Inhaled – proper ventilation at once(open air). Contacted poison – wawsh at once with soap and water. Bath soap is recommended. Injected as in snake bite

50. D. Fracture -is a break in the continuity of the bone Kinds of fracture: open(compound) fracture – bone has broken through skin Closed(simple) fracture – skin has not been penetrated on both ends. Signs and symptoms Deformity – present when injured limb lies in unnatural position or it is angulated where there is no joint Pain at the point of fracture Crepitation (grating sound) -felt and heard when bones rub together -never move the injured extremity to determine crepitation

51. 4.Discoloration (echymosis, bruising) Loss of motion Exposed bones Swelling (endema) Possible loss of pulse below fracture

52. E. Splinting - a device to immobilize an injured part of the body. Reasons for splinting: 1.relieve pain by minimized movement 2.prevent further damage to injury site General Principles of Splinting Splint fracture where it lies – DO NOT reposition. If fracture is severely angulated, straighten it with a gentle pull so that limb can be incorporated into a splint. Immobilized fracture site before moving casualty. Splint should be immobilized joint above and below the fracture site

53. Pad splints before applying. Dress all wounds and/or open fracture(exposed bones) prior to splinting. Check for neurovascular function before, during and after application of splint.

54. F. Burns - Is an injury that results from heat, chemical agent or radiation. It may vary in: depth, size and severity Scalds – is a burn caused by a liquid. Classification of burns: 1.Dept First degree – the outer skin is reddened and welted or slightly swollen Second degree – the under skin is affected and blisters are formed Third degree – the skin is destroyed and tissues underneath are damaged.

55. 2.Causative Agent Thermal agent (heat) Electricity Radiation burns Chemical agent (acids, alkali)

56. Treatment for first degree burn 1.Immerse burnt area in cold water until the patient ceases to feel pain When it is impossible to immerse the burned area, moist cold towels should be applied and renewed frequently Follow this application for dry dressing If desired a simple burn ointment may be applied

57. Treatment for second degree burn Follow steps prescribed in the first degree except do not apply any burn ointment. Gently blot area dry with sterile gauge or clean cloth. Apply sterile gauze or clean as protective dressing. Never break a blister.

58. Treatment for third degree burn Do not remove adhered particles of charred clothing Cover burned area with sterile dressing or freshly laundered sheet. Do no allow victim to walk If medical help is not available for one hour or more and the victim is conscious, and no vomiting, give a weak solution of salt and soda.

59. G. Fainting - loss of consciousness caused by a temporary reduction of the blood supply to the brain: Causes: 1. Emotional 3. Hunger 2. Fatigue Signs and symptoms 1. Weakness 4. Dizziness 2. Pallor 5. Cold Sweat 3. Unconsciousness

60. Treatment Seat victim with knees far apart and hold head far down between knees for about five minutes If victim consciousness return keep victim quiet for about 15 minutes

61. H. Unconsciousness - a person who does not respond to any spoken words or obeys a shouted command. Check for the ABC Check for hemorrhage Check for fracture Check for the size and reaction of the pupils to light Dilated pupils – (possible cause) shock, cardiac arrest, brain damage, substance abuse(amphetamines, marijuana), disorder of central nervous system Constricted pupils – Head injury, stroke, substance abuse (narcotics)

62. 6. Eyelid Response 7. Response to speech 8. Response to pain

63. Hindrances in giving emergency care Unfavorable surrounding 1.1 night time 1.2 crowded city streets, churches, shopping mall 1.3 busy highways 1.4 cold or rainy weather 1.5 lack of necessary materials or helpers 2. The presence of crowds 2.1crowds curiously watch, sometimes heckle, sometimes offer incorrect advice. 2.2 they may demand haste in transportation or attempt other improper procedures. 2.3 a good examination is difficult while a crowd look on.

64. 3. Pressures from victims or relatives 3.1 the victim usually welcome help, but if he is drunk, he is open hard to examine and handle, and is often misleading in his response 3.2the hysteria of the relatives of the victim, the evidence of pain, blood and possible early death, exert great pressure on the first aider. 3.3 the first aider may fail to examine carefully and may be persuaded to do what he would know in calm moments to be wrong.

65. The first aider can meet all these difficulties – forewarned is forearmed- he should remember the few cases demand haste, or good examination is important and can be done slowly and he has no other job or appointment as important and so gratifying as saving a life or limb.

66. END OF LECTURE