First Aid

Definition of first aid:

It is first assistance or treatment given to a casualty for any injury or
sudden illness before the arrival of an ambulance.
The aim of first aid :
1: To preserve life.
a) Pay strict attention to safety.
b) Follow the ABC.
c) Control bleeding.
2: To prevent the condition worsening.
a) Make diagnosis.
b) Give priority to seriously injured casualties.
3: To promote recovery.
a) Relieve any discomfort, pain, anxiety.
b) Call for medical help.
Responsibilities of the first aider.
1. To assess a situation and safety.
2. Make the area safe (for yourself and others).
3. Identify the condition or disease from which the casualty is suffering
(Diagnosis).
4. Give each casualty early and appropriate treatment.
5. Call for medical help.
6. To remain with casualty until medical care available.
7. To report your observation to medical staff.
8. Protect the casualty's belonging.
Safety:
to prevent crossing infection wear gloves , use face mask .

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Road accident:
 Instruct a bystander to control the traffic.
 Watch out for fire risks (petrol spillage).
 Switch off the ignition of the vehicle.
Gas or poisonous fumes:
 Cut off the source.
 Ensure adequate ventilation.
Electric contact: Break the contact

Fire and collapsing building: Move the casualty to safe area.

Priorities in First Aid:
1. First Stopped breathing.
2. Second Sever bleeding.
3. Third Unconsciousness.
Get help (bystander).
a) Make the area safe.
b) To phoning medical aid.
c) Control traffic.
d) Control bleeding or support limb.
e) Maintain the casualty's privacy.
f) Transport the casualty.
g) Assisting in given first aid.
h) Fetch first aid equipment.
Making a diagnosis:
Three factors of diagnosis: (history – symptoms – signs).
1. History: is the story of how an incident happened.

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 Ask the conscious casualty (what happened, eat drink, medicine).
 Ask bystanders.
 Observe the scene.
External clues:
 Medicines... Epilepsy (Tigerton)... Angina (aspirin, glycerin nitrate).
 Puffer (inhaler) for asthma.
 Auto –injector (epi-pen/adrenaline) for anaphylactic shock.
 Warning bracelet: it's a warning sign which gives information about
the casualty's medical history. He has allergic to certain substance.

2. Symptoms: what the casualty can tell you (sensation).

Pain cold Hot
Thirst Nausea Weakness
Dizziness Faintness Loss of abnormal movement

3. Signs: are details of a casualty's condition that you can see, feel, hear
and smell.
Breathing Bleeding Swelling
Pulse Temperature Deformity
Vomit smell breath, gas, alcohol
Making report:
The casualty should always be accompanied by written report include
the following.
a. Name and address.
b. History.
c. Description of any injuries.
d. Unusual behavior.
e. Level of response.
f. Vital signs (pulse, breath, and temperature).
g. Any treatment and when.

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 Respiratory system
Respiratory system consists of mouth , Nose , Nasal passage , Nasal
cavity , throat , trachea(wind pipe), bronchi(small passage),alveoli(air
sac)when gas exchange take place.
Also Epiglottis, Diaphragm, ribcage.

How we breathe: when we breathe in. (inhalation).

The chest muscles pull the ribs upwards causing the chest to expand
in width and height. The diaphragm contracts and flattens increasing the
chest's capacity. This action causes air to be sucked into lungs.
When breathe out. (Exhalation)
The diaphragm and rib muscle relax and resume their position at rest.
Thus forcing air out of the lungs.

Note; air is a mixture of gases about 20% of it is oxygen. So that the air
we breathe out contains 16% oxygen in addition to small amount of CO2
.amount of exhaled oxygen is thus adequate to resuscitate another person.

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Normal breathes: 12 – 20 per minute for adult.
20 – 30 per minute for child and infant.
Checking breathes for:
a. Ratio: (number of breathe/minute).
b. Depth: deep or shallow.
c. Ease: easy, difficult, and painful.
d. Noise: quiet, noisy.
e. Note: one inhalation + one exhalation = full phase (count one breath).

Circulating system
Blood is pumped around the body by the heart.

Types of blood vessels:

1. Arteries: carry oxygenated blood away from the heart.
2. Veins: carry deoxygenated blood back to heart.
3. Capillaries: are very small blood vessels exchange of fluids and gases
to and from tissue cells.
There are 6 liters of blood in the normal adult's body.
Pulse (heart beat):
Adult 60 – 80 beats/minute b/m.
Child 80 – 100 b/m.

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Feeling for a pulse:
 For emergency (first aid): at the neck (carotid artery).
 For a baby: at the brachial artery (on inside of upper arm).
 for normal person: At the wrist (radial artery).

Checking pulse for:

1. The rate (beats/minute).
2. The strength (strong/ weak).
3. The rhythm (regular/irregular).
Note: Don't use thumb finger to check a pulse.

Primary survey (examination)

All animals need a constant supply of oxygen. If the oxygen doesn't
get through brain cells will start to die within 3 to 4 minutes.
For primary survey follow DRs ABC.
1. Check danger.
2. Check response.
3. Shout for help.
4. Open airway.
5. Check breathing.
6. Check circulation.
D: danger R: response A: airway B: breathing C: circulation
Check danger: make the area safe. Do not take risks.

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Check response: gently shake or tap the shoulders and ask loudly (are
you alright).

Open airway: by using head tilt and chin lift.

*place your hand on the forehead and gently tilt the head back.
*with your fingertips under the point of the casualty chin, lift the chin to
open airway.

Check breathing: keeping the airway open and check breathing by.
 Listen at the mouth for breathing sound.
 Look for chest movement.
 Feel for air on your cheek.
Check circulation: identify and treat any life threatening circulation
problem such as severe bleeding or heart attack.
Note: no more than 10 seconds to do primary survey.

Secondary Examination:
After you haven first aid for life threatening condition. You examine
the casualty from head to toe.
S.E uses for conscious and unconscious casualty has breath and pulse.

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 Use both hands to compare one side of the body with the other side.
 Start by considering history, signs, symptoms, vital signs.
 Look and feel sign of bleeding, swelling, deformity.
 Check for loss of muscle power and lack of feeling.
Head and neck Chest and back

Abdomen and hips Legs and arms

And remember you have to give first aid for any injury you find.
Recovery Position
R.P uses for an unconscious casualty has breathing.
Why we apply the recovery position?
 To protect the airway from blocking by the tongue.
 The vomit will run out of the mouth.
Note: change the position of the casualty to the other side every 30
minute if possible. (For circulation reason).
Open the air way and ensure adequate breathing, Place the arm
nearest you at right-angles to his body, elbow bent, with palm of hand
uppermost.

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 Bring the furthest arm to you across the chest. Hold the back of his
hand against his cheek. Using your other hand pull up the casualty’s far
leg just above the knee.

Keeping the casualty’s hand pressed against his cheek, pull on the far
leg and roll him towards you, until he is lying on his side. Ensure the
airway is open.

Bend the casualty’s upper leg at the knee so that it is a right angle to
his body.

Action at an emergency:
Chain of survival (buying time):
1. Early help and recognition.
2. Early C.P.R.
3. Early defibrillation.
4. Early advanced care.

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In emergency condition follow steps below:
Primary survey.
If the casualty is breathing.
 Secondary examination.
 Place him in the recovery position.
 Call ambulance.
If the casualty isn't breathing.
Call for medical help, prepare AED. (No more 1minute).
Then start with 30 chest compressions 2 breaths (use AED if ready).
Continue until:
1. Medical help arrive.
2. The casualty shows signs of recovery (cough, opening eyes, start
breathing normally.

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Notes:
 30 chest compression at rate of 100 to 120 per minute.
 Depth of compression 5-6cm for ADULT. 1-3cm for CHILD.
 For drowning casualty and babies, give 5 breaths at beginning then 30
compression 2breaths for (1minute) then call for medical help.
AED = automated external defibrillation.

Gastric distention during artificial respiration.

It occurs when ventilation are given too fast and with too much force.
So the air enters to the stomach. This will increase the risk of vomiting.
To minimize the risk of gastric distention you should follow:
1. Give slow breath.
2. Use just enough air to expand the chest.

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 Action in emergency (What we do?)
Follow the chart

Primary survey

Breathing Secondary examine.

YES
NO

Recovery position

Call medical help, AED no

more 1 minute Call medical help

30 chest compression

2 breaths

Rate 100-120 comp./m

Depth: 5-6 cm

Continue until,

Medical staff arrives.

The casualty recovery.

You become exhausted.

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 Breathing Emergency
Asphyxia
Asphyxia: lack of oxygen in the body's tissues.
Causes of asphyxia:
Drowning= Suffocation=

Electrocution Choking =

Drug over dose= Poisonous gases =

Obstructed air way compression on chest

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Sing and symptoms of asphyxia:
1. Rapid distressed breathing.
2. Gasping of air.
3. Gray-blue face, lips, fingernails, known as cyanosis.
4. Unconsciousness.
First aid of asphyxia.
1. Remove the cause.
2. O2 or fresh air.
3. Follow action at emergency.
4. Call for medical help.
Note: cyanosis; it's a sign of asphyxia, means that the body isn't getting
enough oxygen.
In breathing emergency case: Do not forget OPEN AIRWAY, OPEN
AIRWAY, and OPEN AIRWAY.
Choking
It's occurs when the airway becomes partially or completely blocked.
Causes of choking:
1. Food or small objects lodged in the throat.
2. The tongue falling to back of throat.
Signs of choking:
 Partially:
 Forceful coughing.
 Difficulty in breathing and speaking.
 Congested face (redness).
 Completely:
 Clutching the throat.
 Inability to speak, breath (cyanosis), coughs.
 Unconsciousness.

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First aid of choking:
1. Finger sweep.
2. Five back slap (blow).
3. Five abdominal thrust.
4. Call for medical help.
If the casualty unconscious follow A, A, E (action at emergency).

Adult casualty

Abdominal thrust

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 For children

Wound and Bleeding

A wound is an abnormal break in the blood vessels.

The average blood quantity in the normal body is 5.5 to 6 liter (1liter
per 13kg proximately) of blood. If the casualty loss more than 30% of
blood .he will be in danger.
Types of wounds:
1. Contusion (bruises) caused by fall or blow .skin is not broken.
2. Abrasions (scrapes) slight bleeding embedded.
3. Lacerations (tear wound) jogged wounds.
4. Puncture wound deep. Caused by sharp pointed object. Wound have
small opening but may. Risk of infection.

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5. Incisions (clean cut).
6. Gunshot (penetrating wound) small entry large exit.
Wound may cause internal bleeding and severe bleeding.

In general we can classify bleeding into two main types which are
internal bleeding (happens in the internal organs) and external bleeding
which can be:
1. Artery bleeding:
 Light red color.
 Spurt.
2. vein bleeding:
 Dark red color.
 Continuous.
Signs and symptoms of sever external and internal bleeding:
1. Rapid weak pulse.
2. Cold, clammy skin.
3. Shallow breathing.
4. Paleness.
5. Dry mouth, thirst.
6. Gasping of air, yawning.
7. Pain and tenderness (internal bleeding).
First aid of external bleeding:
1. Apply direct pressure to wound above of level of heart.
2. Raise and support injured part.
3. Bandage wound.

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First aid of internal bleeding:
1. Call for medical help.
2. Treat as for shock.
Note: Never remove an embedded object.

Nose Bleeding
It causes by. Blow to the nose. Sneezing, picking, high blood
pressure.
Note: if the blood appears thin and watery it means is very serious sign
.it's indicated for skull fracture.
First aid of nose bleeding:
1. Lean the casualty down and tilt his head forwards.
2. Pinch the soft part of the nose for 10minute.
3. Put cold packs over the upper part of nose.

Note:
 If there is still bleeding reapplying the pressure for further periods of
ten minutes.
 If the nose bleed lasts longer than 30minte send the casualty to
hospital.
Amputation
An amputation is complete or partial separation of limb.
First Aid:
1. First control bleeding.

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2. Use direct and indirect pressure.
3. Treat the casualty for shock.
4. Partially severed limb should be bandaged in place.
Indirect pressure point:

Notes:
 Amputated part must be kept dry and cool.
 Never to clean or wash it.
 Wrap the severed part in plastic bag then place it in container full of
crushed ice. Do not allow the amputated part to come into direct
contact with ice.

Bandage:

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The main types are rolled bandage and triangle bandage that use for:
1. Secure dressing.
2. Limit swelling.
3. Restrict movement.
4. Hold splints in place.
Dressing: sterile, non-sterile, adhesive dressing.
It uses for:
1. Control bleeding.
2. Protect the wound.
3. Prevent infection.
Hand and foot bandage:

Scalp bandage method:

Shock
It's an adequate circulation to the body tissues.
Causes of shock: fluid loss, blood loss, burns, illness, heart failure,
severe allergic, C.N.C (central nerve system).
Signs and symptoms:
Initially:
1. Pale cold clammy skin, Sweating.
2. Rapid weak pulse.
As shock develops:
1. Cyanosis.

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2. Nausea, possibly vomiting.
3. Dizziness.
4. Shivering.
5. Thirst.
6. Fast shallow breathing.
7. Gasping of air.
8. Unconscious, death.
First aid of shock:
1. Treat the cause. No smoking
2. Lay the casualty down. No by mouth
3. Elevate limbs (legs). Monitor breathing and pulse
4. Loosen thigh clothing.
5. Keep warm.
6. Call Medical help.

Fainting

It's a temporary unconsciousness caused by shortage of oxygen or

glucose to the brain. (Recovery takes place with minutes).
Causes of fainting:
1. Cold, heat.
2. Fatigue or hunger.
3. Emotional stress.
4. Long period of standing.
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Signs and symptoms:
1. Feel unsteady.
2. Slow pulse.
3. Pale, cold skin and sweating.
First aid:
 ABC + fresh air.
 Treat as shock.

Heat exhaustion
The body temperature goes above 38 t0 40, loss salt and water from
the body.
Causes:
 Exertion in warm weather.
 Excessive sweating.
 Vomiting, diarrhea.
Signs and symptoms:
1. Dizziness.
2. Pale sweating skin.
3. Fast weak pulse, rapid breathing.
4. Cramps (arms, legs, and abdomen).
First Aid:
1. Take the casualty to cool place.
2. Lay down whit raised legs.
3. Give plenty to drink, with 1 teaspoon salt per 1liter of water.
4. Check vital signs.
5. Call medical help.

Heat stroke
The body’s natural cooling system does not cope with heat. Body
temperature goes above 40 within 10 – 15 minute.
Causes:
 Heat exhaustion. (When sweating cease).
 High fever, illness.
 Prolonged exposure to heat.

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Signs and symptoms:
1. Headache, dizzy.
2. Hot, flushed dry skin (no sweating).
3. Strong bounding pulse.
First Aid:
1. Call medical help.
2. Move the casualty to a cool place.
3. Wrap the casualty in cold, wet sheet.
4. If no sheet available fan the casualty or sponge him with cold water.
5. Check vital signs.
If the temperature falls to 37.5 replace the wet sheet with a dry one.

Snake bite
Determine the nature of bite.
a. Non-poisonous
- Four to six rows of teeth - No fang marks on victim.
b. Poisonous
Two rows of teeth - Two fangs which create puncture wounds.

c. Scorpion sting will have only one hole in the center of reddened area.
Signs and symptoms:
1. A pair of puncture marks.
2. Sever pain, redness, swelling at site of bite.
3. Nausea, vomiting.
4. Increase salivation, sweating.
5. Slow breath.
6. Breathing may stop.
First Aid:
1. Lay the casualty down.
2. Reassure him.
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3. Apply roller bandage over the wound.
4. Immobilize the injured limb.
5. Keep bitten part below heart level.
6. Check vital signs.
Notes:
 Bear in mind that venom is active even if the snake is dead.
 Don’t apply tourniquet .incise the wound or suck out the venom.
 Note the snake appearance to the doctors give correct anti venom.
Fracture
The skeleton
The body is built on a framework of bones called the skeleton. This
skeleton supports the muscles, blood vessels and nerves of the body and
gives protection to certain organs, e.g., the skull protects the brain, while
the ribcage and breastbone protect the heart, lungs and other vital organs.
Movement of the body is made possible by bones and their attached
muscles.
The skeleton is consist of:
1) Skull. 2) Vertebra. 3) Thorax (rib cage). 4) Spine. 5) Pelvis.
6) Upper limb.
 Humerus {upper arm bone}.
 Elbow joint.
 Radius and ulna.
 Wrist joint.
 Metacarpals {hand bone}.
 Phalanges.
7) Thigh bone {femur}. 8) Patella {knee cap}.
9) Fibula and tibia. 10) Foot bones.

Definitions:-
 Bone: the hard tissues that form the skeleton.
 Muscles: The tissue that shortens has result of nerve stimulation and
result of movement.
 Tendons: tough ropes of tissues which attach the muscles to the bone.
 Joint: the place where two or more bones are meet, joint interacting
with tendons and muscles to make movement possible.
 Ligaments: bonds of strong supporting tissue which connect bone to
bone about joint or support organ.

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Definition of fracture:
Fracture is broken or cracked bone.
The types of fractures:
1. Closed fracture: (the skin surface is not broken).

2. Open fracture: the skin surface in the fractured area is broken).

3. Green stick fracture: it is popular injury with children.

Symptoms and sings of fracture:

1. Pain made worse by movement.
2. Tenderness.
3. Swelling and discoloration.
4. Deformity.
5. Inability to move the injured limb.
6. Vomiting may occur.
7. Shock.
First Aid of fracture in general:
 Control bleeding (open fracture).
 Immobilize the injured part. (Splints, slings, bandages).
 Check vital signs.
 Transport to hospital.
 Give nothing by mouth.

Splints and slings

Splints: it used to prevent movement of fractured bone.
Characteristics of good splint:
1. Rigid.

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2. Long enough to prevent movement in the joint above and below the
fracture.
3. Wide enough to be comfort.
4. There must be padding between the injured part and splint.

Slings
Slings: slings are used to support the arm.
Arm sling
Provide support for an injured upper limbs and sample chest fracture.

Elevation sling:
Is use to keep the forearm and hand raised in higher position.
a) Helps to control bleeding.
b) Keep hand in raised.
c) Immobilizing an upper arm when there is collar bone fracture.

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 Fracture of the tight bone (femur)
It is longest bone in the body.
Signs and symptoms:
General S.S of fracture.
First Aid:
1. Lay casualty down gently.
2. Give first aid to the wound (open fracture).
3. Apply gently traction holding his knee.
4. Immobilize closed fracture.
5. Seek medical aid. (Give nothing by mouth).

For a long and rough journey to medical aid, use the following
techniques:-
 While traction is maintained slide.
 Seven bandages into place under the body and legs.
 Place padding between the legs and draw the good leg to injured one.
 Position splint along the injured side of the body, ensure that it extend
from the armpit to below the foot.
 Knot the bandages in the splint in the following order.

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 Pelvic fracture
Signs and symptoms:
1. Pain, inability to walk or stand.
2. Desire to pass urine, May blood stained.
3. Sign of shock.
First aid of P.F:
1. Lay casualty down.
2. Straight legs.
3. Put padding under knee (cushion).
4. Immobilize the legs. (See pic.).
5. Treat shock.

Shoulder Dislocation
Dislocation: occurs when the tissues around the joint are stretched or torn
and the bones of joint remain out of its position.

Signs and symptoms of sprain:-

1. Severe pain increase by movement.

2. Deformity.
3. Swelling may bruise at the site of injury.

First Aid:

1. Sit the casualty down.

2. Place triangle bandage between the arm and e chest.
3. Insert soft padding between the bandage and the arm.
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4. Secure the limb to chest. By tying arm sling and broad-fold bandage
around the chest over sling.

Back injury (spinal cord injury)

Signs and symptoms:
1. Pain in neck or back. A step or twist in curve of spine.
2. Loss or abnormal sensation.
3. Difficulty in breathing.
4. Loss of bowl or bladder control.
5. Unconsciousness.
First aid of back injury:
a) Seek medical help.
b) Don’t move the casualty unless he is in danger.
c) If the casualty in water don’t move him to the land.
d) Keep the person worm.
e) Don’t give anything by mouth.

Neck injury
First aid of neck injury:
1. Don’t move the casualty.
2. Support his head and neck by your hand.
3. Support the neck (by apply collar).
Note: Avoid movement of the casualty’s neck when fitting the collar.
Continue support of his head and neck with your hands, even after the
collar is fitted, Ensure there is no obstruction to breathing.

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 Chest injury
The chest cavity is formed by the breast bone {sternum}, 12pairs of
ribs and spine. Those bones form a cage which protect the lungs, heart
and the major blood vessels e.g. aorta.
There are three types of chest injury:
a. Penetrating wound.
b. Fractures of the ribs or breast bone.
c. Blast injury.
Chest injury considered as serious injury because of possibility of:-
 Breathing problem.
 Damage to the heart and lungs.
 Internal bleeding.

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Signs and symptoms:
1. Pain during coughing and breathing.
2. Coughed up frothy, red blood.
3. Sound of air being sucked into the chest during exhalation.
4. Blood bubbling out of the wound.
5. Veins in the neck becoming prominent.
First aid for chest injury:
 Place the casualty in a semi-sitting position.
 Loosen tight clothing around neck, chest and waist.
 Cover the wound with foil, plastic bag. Secure firmly with adhesive
tape on three edges.
 Prevent shock from worsening.
 Obtain medical aid.

Sprain
Sign and symptoms:
1. Pain and tenderness.
2. Swelling around the joint.
3. Inability to move the injured limb.
First Aid of sprain:
(RICE)
1) Rest the injured part.
2) Apply ice or cool compress.
3) Compress the injury joint.
4) Elevate the injured part.
5) Seek medical aid.

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 Compression (skull)
It’s caused by blood accumulating within the skull or pressure from
depressed fracture.

Signs and symptoms:

1. Breathing may become noisy.
2. Pulse become strong but slow.
3. Pupils in deferent size.
4. Paralysis of one side of the body.
5. Temperature rise and face flushed.
First aid of compression:
1) Immobilize the neck.
2) Obtain medical aid.
3) Open air way.
4) Clean the wound and apply dressing on it.

Concussion
The brain is free move little within the skull, described as brain shaking.

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Signs and symptoms:
1. Unconscious for short period.
2. Memory loss.
3. Dizziness or nausea.
4. Generalized headache.
First Aid:
1. Treat as neck injury.
2. ABC.
3. Check breathing, pulse.
4. Seek medical aid.

BURNS
Burn: Injuries caused by extremes of temperature (hot, cold), chemical,
radiation.
Types of burns:
1. Dry burn: caused by contact with hot object.
2. Wet, scald burn: caused by hot liquid or steam.
3. Cold burn: caused by contact with metal in freezing or pressurized
gases.
4. Chemical burn: caused by acid or alkalis.
5. Electric burn: caused by contact with Ac electrical current.
6. Radiation burn: caused by expose to sun ray or x ray etc.
Degree of burns:
 Superficial burn: this involves outer layer of skin and characterized
by redness, swelling, tenderness.

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 Intermediate burn: caused formation of blisters with an area
surrounding redness.

 Deep burn: this burn involves all layer of skin may appear pale,
waxy, charred.

First aid of burn:

1. Protect the burnt area from contact with the ground.
2. Flood the injured part with cold water for at least 10 minute.
3. Gently remove any ring, watches, constricting clothing.
4. Cover the injured area with sterile dressing or plastic bag or kitchen
film makes good temporary covering.
5. Prevent shock and fallow ABC if necessary.
6. Seek medical aid.

Do not do 5:
 Do not break the blister.
 Do not apply adhesive dressing.
 Do not apply lotions, ointment.
 Do not touch the injury part.
 Do not remove any thing sticking to the burn.

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The rule of nine:
This diagram divides the
body surface into areas
of nine per cent. Any
injury of an equivalent
area will require hospital
treatment; any burn
larger than 2—3cm
(1 in) diameter requires
medical attention.

Eye injury
How to prevent eye injury:
1. Wear safety glasses (spectacle, goggles, and face shield).
2. Wear dark glass in sun light.
3. Avoid looking into bright light such as welding flash or an eclipse of
the sun.
First aid of eye injury:
 Inflammation
1. Cover the injured eye.
2. Advice the casualty to do not touch or rub his eye.
 Chemical injury
1. Flush the eye with water keeping the eye open at least 10 minute.
2. You should keep the uninjured eye up to avoid contamination.

Handling and transport casualties

If the casualty’s life is endangered by fire, falling debris or
poisonous gases, move the casualty as quickly as possible without
endangering yourself. Otherwise it is important, particularly if the
casualty is unconscious, to carry out a quick - examination before
attempting to move the casualty.

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Warning:
Never move a seriously injured casualty on your own if help is
available. Always make sure that everyone involved including the
casualty, if conscious, knows exactly what is going to happen and what
they must do before you begin and always give a preparatory command
before each stage.
Method of handling and transport:
There are various methods of carrying casualties using support from
one or more helpers. The method used depends on: the nature, severity of
the injury, the number of helpers, and the facilities available the
casualty’s build and the distance to shelter.
Human crutch:
This is used to support a conscious casualty who is able to walk with
assistance. Lt should not be used if an upper limb is injured.

Pick-A- back:
If the casualty is small, light, conscious and able to hold on to you,
carry him in the ‘pick-a-back’’ fashion.

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Fireman’s lift :
This method is used to move a couscous or unconscious child or a
lightweight adult when you need to keep a hand free.

Four-hand seat:
This method is used to carry a conscious casualty who can assist the
bearers by using one or both arms to hold on.

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Fore-&-aft :
This method can be used to place the casualty on a chair or a carrying
chair.

Chair method :
When a conscious casualty with no serious injuries is to be moved
up or down stairs or along passageways, the casualty can be seated on an
ordinary chair and carried by two people. However, the passages must be
cleared of any obstructions or dangers such as loose matting before you
start.

Drag method:
This method involves pulling the casualty along the ground without
lifting. It should only be used where a casualty is unable to stand and
must be moved quickly from a source of danger.

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Stretchers:
These are used to carry a seriously ill or injured casualty to an
ambulance or similar shelter to minimize the risk of further injury. The
stretchers can be used to transport casualties with any injury and should
be rigid enough to carry casualties with a suspected spine fracture without
additional boards. All equipment must be tested before it is used.

Scoop (orthopedic stretcher): it is used to lift a casualty on to a

stretcher, trolley in the position in which he is found (most of legs
fracture and spinal injury).

Vacuum mattres stretcher . Spinal board.

Automated external defibrillation (AED):

An automated external defibrillation is a safe, reliable, computerized
device that can analyses heart rhythms enable a non-medically qualified
rescuer to safely deliver the life saving shock.
(For every one minute delay in delivering the shock. the chance of
survival reduces by up to 10%).

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AED: its use to reverse abnormal heart rhythm and restart a heart.

Resuscitation with an AED:

Primary survey

No breathing (send for AED, medical help}

CPR 30: 2 until AED is attached

AED assesses rhythm

Shock advised no shock advised

1shock

Resume CPR 30:2 for 2minute resume CPR 30:2 for 2min
Only stop resuscitation if the casualty starts to wake up,
i.e. moves, open eyes and breathes normally.

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When the AED arrive:
 If you have a helper, ask them to continue CPR whilst you get and
attach the AED.
 Whilst the AED analyses the rhythm – stop CPR and ensure that no
one touches the casualty.
 If a shock advised: ensure that no body touches the casualty (check
from top to toe and shout (stand clear).
 Push the shock button as directed.
 Continue as directed by the voice prompts.
 If a shock is not advised resume CPR 30:2.
 AED will allow 2minutes of CPR before analyzing the heart.

AED safety consideration:

 Jewelry: Take care not to place the pads over jewelry.
 Medication patches: remove any visible medication patches.
 Implanted devices: as pacemaker or defibrillator (you can feel or see
them under the skin) tries to avoid placing the pad directly over it.
 Flammable atmosphere: there is a danger of the AED creating a
spark when the shock delivered. (Petrol fumes).
 Do not use an AED on casualty who is fitting or vibrating machinery.
 Wet chest: it must be dried before applying the pads.
Recommended accessories:
a) Spare AED pads.
b) Spare battery.
c) Pediatric (children) pads.
d) Scissors.
e) Towel and razor.
f) Gloves + facemask.

Epilepsy
It is the result of abnormal electric activity in the brain.

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Cause of epilepsy:
Lack of oxygen, disease, head injury, flashing lights, high fever 60%
unknown.
First Aid:
1. Protect casualty from injury.
2. Protect head (cushion) and loosen tight clothing.
3. When the jerking stop, open air way and check breathing.
4. Put him in recovery position.
5. Check vital signs.

Who needs attend hospital?

 It is first fit (seizures).
 If unconscious lasts more than 10 minutes.
 If the fit lasts more than 5minute.
 If has repeated fits.
 Babies.

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 Workplace first aid kit
Recommended size of
small medium large Travel
kit
Less than
Low risk (office , 25-100 More than Per
25
shops, libraries employees 100 vehicle
employees
Higher risk, food More than
Less than 5 5- 25 Per
processing, 25
employees employees vehicle
manufacturing, employees
contents small medium large travel
First aid guidance
1 1 1 1
leaflet
Disposable gloves 6 9 12 1
Resuscitation face
1 1 2 1
shield
Water resistant plaster 40 60 100 10
Sterile dressing
4 6 8 1
12cmx12cm
Sterile dressing
1 2 2 1
18cmx18cm
Eye pad sterile
2 3 4 1
dressing
Finger sterile dressing 2 3 4 0
Burns
1 2 2 1
dressing10cmx10cm
Triangular bandage 2 3 4 1
Rolled bandage
1 2 2 1
5cm,7.5cm,10cm,
Alcohol free moist
20 30 40 4
cleansing wipes
Safety pins 6 12 24 2
Adhesive tape 2.5cm 1 1 1 1
Foil blanket 1 2 3 1
Sterile eye wash250ml 0 0 0 1
Scissors(for cutting
1 1 1 1
clothing + leather)

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 Low- high blood sugar
Diabetes or hypoglycemia – hyperglycemia
Low blood sugar:
Too much insulin not enough sugar.
Signs and symptoms:
 Fast onset 2 minutes - 1 hour Deteriorate quickly.
 Weakness, dizziness.
 Confused, memory loss.
 Uncooperative, maybe violent behavior.
 Pale, cold and sweating.
 Confused for drunkenness.
 Unconsciousness.
First aid:
 ABC.
 If alert give sugar.
 Nil (nothing) by mouth if unconscious.
 Seek medical help.
High blood sugar:
Too much sugar not enough insulin.
Signs and symptoms:
• Slow onset 12 - 48 hours.
• Drowsy lethargic behavior.
• Dry warm skin.
• Excessive thirst.
• Excessive urination.
• Hunger.
• Fruity smelling breath
First aid:
• ABC.
• Seek medical aid.

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Note: If in doubt (low or high) give sugar.

Inhalation of fumes
The inhalation of smoke, gases (CO, CO2) can be lethal.
A casualty who has inhaled fumes is likely to have (hypoxia) low
levels of oxygen in body tissues.

Gas source effects

Headache ,Nausea ,vomiting

Exhaust fumes of motor
cyanosis ,fast difficult
CO vehicle, smoke from most
breathing,
fires
Unconsciousness.
Fast, noisy, difficult
breathing, coughing,
Fires: smoke is big killer, wheezing, burning in the
Smoke may contain toxic fumes nose or mouth. Soot around
from burning materials. the mouth and nose,
unconsciousness

Concentrated in deep Headache, faint,

CO2 enclosed space ,coal breathlessness.
burning, unconsciousness

Glues ,cleaning fluid, Headache, vomiting, may

solvent
propane choke airway obstruction.

First Aid of inhalation if fumes:

a. Call for medical help.
b. Open the doors wide and windows to let the gas escape.
c. Remove the casualty from danger and move him into fresh air.
d. Open an airway and give rescue breathing.
e. Give O2 if available.
f. AAE (Action at Emergency).

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 How can we remove gloves?

The HOLEGER NIELSEN method:

It is a manual ventilation technique but is not as efficient as mouth to
mouth .it can be used if the casualty is trapped in a face-downward
position.

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References:
1. First aid manual 5th ,7th , 8th edition authorized by :
 St. John ambulance.
 St. Andrew ambulance.
 British Red Cross.
2. Practical first aid. Authorized by British Red Cross.
3. First aid made easy, first aid made easy CPR and AED (Nigel
Barraclough).
4. First aid. Prepared by Mustafa ail (PTQI) 2008 – 2009.

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