FIRST AID

First Aid is the immediate care given to the ill or

injured to keep them alive or stop further damage
until qualified medical treatment can be
administered. It includes dealing with the
situation, the person and the injury as well as
encouraging the casualty and showing
willingness to help.

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 WHY DO WE STUDY FIRST AID
First Aid is given to the casualty to,
a) Preserve life in order to,
i) Maintain an open airway
ii) Apply artificial ventilation if casualty
is not breathing.
iii) Control bleeding.

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b) To prevent the casualty’s condition from
worsening by ,
i) Dressing the wound.
ii) Immobilise large wounds and fractures.
iii) Put casualty in recovery position
c) To promote recovery of the casualty by
i) Relieve casualty of anxiety and promote
confidence.
ii) Relieve him or her out of pain and
discomfort.
iii) Handle him gently so as not to cause
more harm
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Qualities of a Good First Aider
• Good Communication Skills.
Communicating with sick and injured
people can be a challenge. ...
• Ability to Work in a Team.
• Ability to Work Under Pressure.
• Leadership.
• Knowledge of Their Own Limits.
• Empathetic.
• Observant.
• Physically Fit.
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On reaching the scene, the first aider
should;
• Assess the situation and casualty.
• Diagnose what is wrong with the
casualty.
• Be calm and take charge.
• Remove casualty to safety
• Ensure safety of the casualty and your
self by;
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Guarding against any further casualties
arising. e.g.
Road accident instruct someone to
control traffic/
Fire and collapsing buildings remove
casualty to safety
Gas and poisonous fumes turn off at
source.
Electrocution, if possible switch off
current and take precaution against
electric shock.
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 Arriving at a diagnosis, the first
aider is guided by,
• History (report given by a conscious
casualty)
• Symptoms(details given by a conscious
casualty of his sensations).
• Signs (obtained by a complete examination
of the casualty by the first Aider using all
his senses to obtain maximum information.

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THE PRIMARY ASSESSMENT OF THE
CASUALTY:
The steps to be followed for an adult, child
and infant casualty are remembered by the
letters
DRS ABCD.
D- Danger
R- Response
S- Send for help/call for help

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A- Airway
B- Breathing
C- Circulation (CPR)
D- Defibrillation
Note: CPR is continued until responsiveness of
normal breathing returns.

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Identify the important organs a first
aider should concentrate on when
performing first aid?

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DANGER: Before approaching any situation,
you must assess the scene for any threat to:
• Yourself and anyone else assisting with
the situation.
• The casualty or casualties
• Bystanders near the scene.

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Response: When checking a person’s response,
you are assessing how well their brain is
functioning.
How to check for responsiveness:
Assess the collapsed victim’s response to verbal
and tactile stimuli (talk and Touch)

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How to check for response

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The four levels of responsiveness are:
A- Alert: The casualty is alert and responsive.
You can have a logical conversation with them.
V- Voice: Even if drowsy, the casualty is able to
reply when you talk to them.
P- Pain: the casualty is responsive to pain(e.g.
Nail- bed pressure).
U- Un responsive: The casualty is
unresponsive to all stimuli.

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If the casualty is breathing normally but is
unresponsive, place them in a stable side
position (recovery position).
S- Send for help: Activating the Emergency
Medical Services (EMS).
Activating EMS means choosing an emergency
medical service response appropriate to the
severity of injury or illness and the situation
encountered.
Use phone numbers:
EMS: 111 15
A-AIRWAY: Is required when the victim;
• Is unconscious
• Has an obstructed airway
• Needs rescue breathing.
How to check an open air way:
Ensuring airway is clear and open.
• Open the mouth and look for foreign
objects.
• Perform a ‘ Head-tilt, chin- lift’.

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17
BREATHING:
Normal breathing is essential to maintaining life.
Victims who are gasping or breathing abnormally
and are unresponsive require resuscitation.
Causes of absent or ineffective breathing.
• Direct depression of/or damage to the breathing
control center of the brain.
• Upper air way obstruction
• Paralysis or impairment of the nerves and or
muscles of breathing.

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• Problems affecting the lungs
• Drowning
• Suffocation.
Signs of ineffective breathing may include:
• Little or un usual movement
• Weak or abnormal breath sounds
(Wheezing)
• Occasional gasps
• Reduced responsiveness

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• Anxiety
• Unusual skin colour (pallor)
• Rapid or slow breathing
• Un usual posture
How to check for breathing
The rescuer should
• LOOK for movement of the upper
abdomen or lower chest.
• LISTEN for the escape of air from nose
and mouth.

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• FEEL for breath on the side of your face/
movement of the chest and upper
abdomen.
This should take you no longer than 10
seconds.

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Checking for breathing

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If the unconscious victim is unresponsive and
not breathing normally after the airway has
been opened and cleared, the rescuer must
immediately commence chest compressions
and then rescue breathing (CPR). Give 30
compressions and then two breaths allowing
about one second for each inspiration.
NOTE: If un willingness or un able to perform
ventilations, rescuers should continue
compression only CPR.

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• C- CIRCULATION
Circulation is detected by the pulse.
Here are some areas to feel the pulse:
- Radial (arm-near the thumb),
- carotid (in the neck)
If not felt then proceed to ,Cardiopulmonary
resuscitation.
Effective CPR- 30 compressions followed by 2
breaths.
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CPR is a repetitive cycle of:
1. Airway opening
2. Chest compression
3. Rescue breathing.

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 External chest compression is the most effective
way of artificially circulating blood. Chest
compressions are accompanied by rescue
breathing which provides oxygen that the blood
delivers around the body to its vital organs. This is
the only way to keep the heart and the brain
oxygenated until a defibrillator arrives.

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28
D- Defibrillation: Because the heart is the
muscle that pumps blood around the body, this
function is achieved through a mechanical
contraction of the heart initiated by a
coordinated electrical stimulation from within
the heart. When the rhythmic electrical
activation of the heart becomes abnormal, the
heart muscle contraction can become less
effective.

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30
PROTECTIVE GEARS USED IN FIRSTAID AND
THEIR USES
1. Gloves: Protect the first aider from direct
contact with blood, bodily fluids and other
contaminants.
2. Face mask:
• Surgical Mask: Protect the first aider from
inhaling airborne pathogens.
• CPR Face shields/ Masks: Used to create a
barrier during mouth to mouth resuscitation
to prevent the transfer of fluids.

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3. Eye protection:
• Goggles or safety Glasses:
Shield the eyes from splashes of blood,
bodily fluids or chemicals.
4. Aprons or gowns:
• Disposable aprons: Provide a barrier to
protect clothing and skin from blood,
bodily fluids and other contaminants

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• Full- body Gowns: Used in more severe cases
where there is a higher risk of exposure to
infectious material.
5. Head protection:
• Head Covers/ Caps: Used in situations where
there is a risk of contaminants coming into
contact with the hair.
6. Foot Protection:
• Shoe covers: Won to prevent contamination of
shoes and protect against contact with
hazardous substances on the ground.
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7. Ear protection:
• Ear Plugs or Muffs: May be used in
environments wit loud noise to protect the
first aider’s hearing.
8. Reflective vests:
• Worn in outdoor or roadside emergencies to
increase visibility and reduce the risk of
accidents.

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35
FIRSTAID KIT
Is an essential item for treating minor injuries
and providing initial care in emergencies.
Essential items.
1. Adhesive bandages: These should be in
various sizes for minor cuts.
2. Sterile gauze pads: For dressing wounds.
3. Adhesive tape: To secure bandages or
dressings

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4. Antiseptic wipes: For cleaning wounds to
prevent infection.
5. Antibiotic ointment: Helps prevent infection
in minor cuts.
6. Hydrocortisone cream: For itching, rashes or
insect bite.
7. Tweezers: For removing splinters or debris
from the wound.
8. Scissors: For cutting tape, gauze or clothings.

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9. Thermometers: To check for fever.
10. Cold packs: For reducing swelling and pain
from injuries.
11. Elastic bandages: For wrapping stains or
sprains
12. Latex gloves: To protect your self and others
when giving first aid.
13.Pain relievers e.g. Panadol

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14. Burn Cream or Gel: For minor burns.
15. Eye wash or saline solution: For rinsing
out eyes
16. First aid manual: Basic instructions on how
to deal with common injuries.
17. CPR face shield: For protection during
resuscitation.
18. To keep an injured person warm.

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19. Splints
20 .Blood pressure monitor.
21. Tourniquet: For controlling severe bleeding.
22 Pen and notebook
NB: Regularly check the kit to ensure all items
are in good condition within their expiration
dates. And replenish supplies as needed.

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41
THE GOLDEN RULES OF FIRST AID
1. Assess the situation safely
• Ensure that the scene is safe for you and the
victim. Do not put your self in danger.
• Identify the cause of the injury or illness if
possible
2. Stay calm:
• Remain calm and compose to think clearly
and act effectively.
• Reassure the victim to help them keep calm

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3. Call for help (emergency Services)
• If the situation is serious, call emergency
services immediately (112, 911).
• Provide clear, concise information about the
situation, your location, and the victim’s
condition.
4. Prioritize Life- Threatening conditions.
Follow the ABC of first aid

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5. Provide comfort and reassurance
• Comfort the victim and keep them as calm
and still as possible
• Provide warmth if necessary, and protect
them from further harm.
6. Do not further harm
• Avoid moving the victim unless necessary (e.g.
to prevent further injury or if the scene
becomes un safe)
• Do not give the victim anything to eat or drink
unless advised by a medical personnel.
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7. Use protective gear : Always wear gloves or
use a barrier when dealing with blood or
bodily fluids to protect your self and the
victim.
8. Know your limits
• Only provide first aid that you are trained
and capable of performing.
• Do not attempt procedures you are unsure
about. Wait for professional help.

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9. Monitor the victim.
• Continuously monitor the victim’s vital signs
(breathing, pulse) until professional help
arrives.
10. Document the incidence.
If possible, document the details of the
incident, the care given and the changes in the
victim’s condition. This can be useful for
medical professionals.

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 WOUND
A wound is an abnormal break in the
continuity of the skin or other tissues of the
body which permits the escape of body
fluids i.e. blood, plasma and allows in
micro-organisms to enter causing infection.

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 CAUSES OF WOUNDS
1. Trauma, is the most common cause of
wounds and it may be accidental as in
road traffic accident or it may be planned
as in surgical operations
2.Physical,chemical and microbial agents
may cause skin loss e.g. insect bites, or any
skin irritant causing skin loss when it gets in
contact with the skin.
3. Ischemia is a cause of skin loss as seen in
venous or diabetic ulceration.

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CLASSIFICATION OR TYPES OF WOUNDS AND
CAUSES.
Wounds can be classified into several types based on
their nature and cause.
• Incised wounds (clean cut wounds): These are
caused by sharp objects e.g. Razorblades, knives
,surgical blades .These objects have a clearance
angle.
• Contused wound (bruised): Caused by a blunt
object e.g. hammer or may be due to a fall on a
hard surface.
• Avulsion: A wound where a portion of the skin
and possibly underlying tissue is torn away
completely. E.g. severe accidents.
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• Punctured or penetrating wounds: caused by
sharp pointed objects e.g. Needles, Spears,
Arrows or Nails. The object penetrates deep in
the tissues
• Lacerated wounds: Caused by irregular object
e.g. Barbed wire, all animal bites cause i.e.
Dogs, leopards .etc.
• Abrasions: A superficial wound caused by the
skin rubbing or scraping against a rough
surface. It usually involves only the outer most
layer of the skin (epidermis) resulting in
redness and some minor bleeding.
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 SPECIAL TYPES OF WOUNDS
• Gunshot wounds which may have a small
entry with a very large exit.
• Human bites
• Dog bites
• Snake bites
All these types of wounds may easily be
contaminated by poisons or by infections.

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 FIRST AID MANAGEMENT OF ALL
WOUNDS
1. Know the cause
2. Remove the cause. It may be foreign body
which is visible and can easily be picked out or
wiped off with dressing or remove the casualty
from danger.
3.Ensure ABC of life.
4.Treat shock
5.Reassure the casualty
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6.Arrest haemorrhage
7.Clean the wound and cover it with a clean
dressing.
8.Transfer the patient to the hospital.

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 HAEMORRHAGE(BLEEDING)
.
This is the escape of blood from the blood vessel due to
disease or injury.
TYPES OF HAEMORRHAGE
The types are grouped according to the following.
1.Blood vessels
• Artery: Bright red blood spurts out with each heartbeat.
• Veins: Dark red blood flows steadily, indicating damage
to the vein.
• Capillaries: Involves slow oozing of blood from the
affected area.

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2.Time of occurrence
• Primary haemorrhage: Bleeding occurs
immediately after an injury.
• Reactionary haemorrhage: It occurs within the
first 24 hours after the initial injury or surgery. It
can happen as the blood pressure normalizes after
the shock or injury.
• Secondary haemorrhage: Occurs within 7-10 days
after the injury or surgery. It is typically caused by
infection, erosion of blood vessels or the break
down of a blood clot.
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3.Situation of haemorrhage
-External haemorrhage;
. Wounds
.epistaxis(nose bleeding)
-Internal haemorrhage
CAUSES OF HAEMORRHAGE
1. TRAUMA- Related causes:
• Injury: Physical injuries, such as cuts, fractures or
blunt force trauma, can damage blood vessels
leading to bleeding.
• Surgery: Surgical procedures may inadvertently
cause bleeding by damaging tissues or blood
vessels. 58
2. MEDICAL CAUSES:
• Liver diseases: Liver dysfunction can
impair the production of clotting factors,
leading to an increased risk of bleeding.
• Haemophilia: this genetic disorder affects
the blood’s ability to clot properly, leading
to excessive bleeding.
3. PATHOLOGICAL CAUSES:
• Aneurysm: An aneurysm is a weakened
area in a blood vessel wall that can rapture,
causing internal bleeding.
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• Peptic ulcers: Ulcers in the stomach or intestines
can erode blood vessels, leading to gastrointestinal
bleeding.
• Cancer: Certain cancers particularly those
affecting the gastrointestinal tract of blood can
cause bleeding.
• Blood vessel abnormalities: Conditions like
arteriovenous malformations (AVMs) can cause
spontaneous bleeding.

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4. OBSTETRIC CAUSES:
• Placenta previa: the placenta covers the
cervix, leading to bleeding during
pregnancy.
• Ectopic pregnancy: A pregnancy outside
the uterus can rapture and cause internal
bleeding.
• Postpartum Hemorrhage: Severe bleeding
after child birth due to retained placenta.

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5. INFECTIONS:
• Infectious diseases: Some infections such as
Ebola can cause hemorrhagic symptoms due
to their impact on blood vessels and clotting
mechanism.
6. Other causes:
• High blood pressure can weaken blood
vessels, leading to raptures and bleeding,
particularly in the brain (hemorrhagic stroke).
• Vitamin K deficiency: Vitamin K is essential
for blood clotting, and its deficiency can lead
to hemorrhage.

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 SIGNS AND SYMPTOMS OF
HAEMORRHAGE
• Subnormal temperature due to low blood
volume circulating around the body.
• Pallor of the lips and mucous membrane.
• Fall in blood pressure (Hypotension) due to
lowered blood volume
• Extreme thirsty
• Air hunger i.e. gasping for air.
• Tinnitus is present
• Casualty will complain of cold
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• Casualty will have blurred vision.
• Pulse is more rapid due to the sensitivity of
the heart due to blood loss.
• Faintness or actual fainting due to lack of
oxygen
• Restlessness
• Shortness of breath.
N.B. All signs of shock will be present.

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FIRST AID MANAGEMENT OF
HAEMORRHAGE
1.Direct pressure. Apply a clean cloth or gauze on the
wound and if its socked with blood do not remove it
instead add more dressing and secure it with a
bandage.
2.Indirect pressure. Use pressure points on the main
arteries which lie directly over the bone e.g. -
brachial artery
-Femoral artery
-Temporal artery

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Press artery against the underlying bone using
your fingers.
3.Elevation.Elevate the bleeding part to speed
clotting and to slow blood flow while continuing
with direct pressure.
4.Apply a tourniquet.
5.Provide absolute rest.
6.Keep the casualty quiet and give continuous
reassurance.
6.Lie the casualty flat and elevate the foot of the
bed to aid blood to reach the vital centres.
7.Refer casualty to the hospital.
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SPECIAL TYPES OF HAEMORRHAGE
• Epistaxis – Bleeding from the nose.
• Hematemesis- Vomiting of blood
• Melena: Passing out black stools that typically
results from bleeding in the upper gastro
intestinal tract.
• Haematuria-:Presence of blood in urine.
• Haemoptysis: Coughing up of blood or blood-
streaked sputum from the respiratory tract.

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 EPISTAXIS: Is a medical term for a nose bleed. It
occurs when blood vessels in the nasal cavity break
and bleed.
Nose bleeds can be classified into two types:
1. Arterial Epistaxis: Bleeding originating
from the front part of the nasal septum, often
from the kissel Bach's plexus (a network of
blood vessels). This is mainly caused by: Dry
air, nasal trauma, nasal infections or irritants
like cigarette smoke.

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2. Posterior Epistaxis: Bleeding comes from
the back of the nasal cavity, often from larger
blood vessels. The common cause is:
Hypertension, nasal tumors etc.
CAUSES OF EPISTAXIS
1. Local Irritants:
• Dry air: can dry out nasal mucosa, making it
more prone to bleeding.

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• Nasal irritants: Smoke, strong odors, or
allergens can irritate the nasal lining.
2. Nasal Trauma:
• Injury: Any trauma to the nose, such as
picking, accidents or nasal surgery.
3. Nasal infections:
• Sinusitis: Inflammation and infection of the
sinuses can lead to bleeding.
• Rhinitis: Inflammation of the nasal mucosa
due to allergies or infections.

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4. Environmental Factors:
• Dry climate: Low humidity can dry out nasal
membranes.
5. Medications:
• Nasal Sprays: Frequent use of decongestant
sprays can cause irritation.
6. Tumors
• Nasal Tumors: Benign or malignant tumors
can cause bleeding.

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7. Underlying medical conditions:
• Hypertension: High blood pressure can
contribute to nose bleeds.
• Blood vessel abnormalities: Conditions
affecting blood structure in the nose.

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FIRST AID MANAGEMENT OF
EPISTAXIS
• Know the cause and remove the cause if any
• Reassure the casualty
• Sit up the casualty with the head slightly
flexed forward.
• Pinch the nose for 5 minutes.
• Instruct the casualty to breath from the
mouth.
• Apply a cold compress on the fore head.
• Continue observing the casualty and if
bleeding fails refer the casualty to the 73
 DRESSING
Dressing refers to a sterile pad or compress applied
to a wound to promote healing and protect the area
from further harm.
Aims of dressing.
1.Protection:
• Barrier against infection
• Prevention of Injury
2. Absorption: Dressing absorb fluid produced by
the wound.
3. Moisture regulations: A moist wound
environment is crucial for optimal healing. 74
4. Support of healing:
• Promoting tissue regeneration (renewal).
• Reducing scarring
5. Hemostasis: Controlling bleeding
6. Pain management

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 BANDAGES
A bandage is a piece of soft absorbent material that
can be used to:
• Hold a dressing in place over a wound
• Support a splint
• Immobilize a wounded part
• Compress a soft tissue injury.

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Bandages are made from,
–Calico: A plain woven textile made
from unbleached and often not fully
processed cotton
–Flannel: A soft,warm fabric made
from wool, cotton or synthetic fibers
–Special paper
–Elastic net
–They can be improvised from the
mentioned materials like,
Scarves, stockings, Ties and belts.
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 TYPES OF BANDAGES
1. Crepe Bandages (Gauze Bandages): Made
from light, woven fabric, usually cotton and
come in rolls. It is used to cover larger
wounds or to hold dressing in place

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2. Adhesive Bandages (Plasters or Band- Aids)
Are small strips of fabric or plastic with an
adhesive backing and a small, absorbent pad in
the center. It is used for minor cuts, abrasions
or blisters

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3. Tubular Bandages: These are in a tubular-
shape and made from stretchy material,
designed to fit snugly over a limb or a joint.
It provides support and holds dressings in
place without the need to tape or fasteners.

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3. Cohesive Bandage:
Is self-adhesive bandages that stick to
themselves but not to skin, hair or clothing.
It is used to secure dressings or support
injured joints without the need for clips or
tapes.

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5.Triangular bandages: Large, triangular
pieces of cloth used as a. slings to support an
injured arm or secure dressings. It is versatile
and can be folded or used in a variety of first
aid situations. E.g.

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Broad bandages. Used on flat bones e.g.
bones of the pelvis ,scapula, Ribs etc.
Narrow bandages: E.g. Bleeding from the
abdomen.
Pad bandages. Used to stop external
bleeding. Pressure is put direct.
Ring pad. Commonly used where there is a
foreign body.

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CAPELINE BANDAGING
Is a type of bandage technique used primarily to
cover and protect the head, shoulder or stump
of an amputated limb. The capeline bandage
gets its name because the finished bandage
resembles a “cap” that snugly covers the body
part.

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Capeline bandage applied on the head

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Capeline bandage applied on the amputated
limb.

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Capeline bandage applied on the shoulder

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 USES OF BANDAGES
• Maintain direct pressure over a dressing
to control bleeding
• Retain dressings and splints in position
• Prevent or reduce swelling
• Provide support for a limb or joint
• Restrict movement

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GENERAL RULES FOR APPLYING A
BANDAGE
• Apply a bandage when the casualty is sitting or
lying down.
• Always try to sit or stand in front of the casualty
on the injured side
• Make sure the injured part is well supported
before you start bandaging.
• Bandages should be firm enough to hold the
dressing in position, control bleeding and to
prevent movements.
• It should not be too tight.
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• Where a limb is involved, ensure that
the finger nails or toe nails are exposed
so that they can be checked for
circulation.

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 FRACTURES
A fracture is a break in the continuity of the bone.

CAUSES OF FRACTURES

1.Forces.
i) Direct force: When the bone breaks at the spot where
the force is applied, e.g. from a kick or a blow.
ii) Indirect force:
a)When the bone breaks at some distance from the spot
where the force is applied e.g. fracture of the collar bone
may result from a fall on the outstretched hand.

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2.Muscular violence When there is a sudden
violent contraction of muscles which may cause
a fracture ,e.g. of the knee cap or the tip of the
elbow.
3.Pathological disorders, e.g. sickle cell disease
due to cell crisis there bones may break or in
osteomyelitis.

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 TYPES OF FRACTURES
There are two main types of fractures
i) Open fracture ii) Closed fracture
Open fracture: Is when there is a wound leading
down to the fracture or when the fracture ends
protrude through the skin thus allowing
microorganisms to gain access to the soft tissue and
broken bones
Closed fracture: Is where the skin surface is not
broken i.e. There is no wound

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 SIGNS AND SYMPTOMS OF FRACTURES
• Discolouration of the skin.
• Pain and tenderness
• Oedema
• Shortening of the limb
• Change of gait cycle
• Loss of function
• Irregularity.

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 Special fractures
• Green stick fractures: mainly occur in growing
children. It cannot easily break, it bends first
before it breaks.
• Impacted fracture: One segment of broken
bone firmly enter in to the other.
• Oblique fracture: Is a break of a slopping angle
to the axis of the bone usually due to indirect
violence.
• Displaced fractures: Here the bone leaves
position to the other side.

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• T-shaped Fracture. Bone is broken in a T-
shape. i.e. Across and there is a crack
longitudinally
• Depressed fractures: The edges of the fracture
are driven below the level of the surrounding.
• Commuted Fractures. Here the bone is broken
into more than two fragments

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 FIRST AID MANAGEMENT OF
FRACTURES.
i)Look for the cause.
ii)Avoid unnecessary movements
iii)Monitor airway, breathing and circulation.
iv)Reassure the casualty
v)Check for the distal pressure points and stop the
bleeding in case of open fracture.
vi)Start immobilisation of the fracture by using splints
and bandages in order to stop the pain.
vii)Keep casualty warm guarding against shock.
viii)Take casualty to hospital.

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PRINCIPALS OF MOBILISATION OF
FRACTURES
• The joints above the fracture and the joints
below the fracture are made immobile.
• If the casualty is unconscious check for airway,
breathing and circulation.

Equipment used when mobilising a fracture

1.splints 3.Ring pad dressing
2.Bandages
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 SPLINTS
These are devices used to stabilize or immobilise fractures.

TYPES OF SPLINTS USED IN FIRST AID

RIGID SPLINTS: such as wood, magazines, newspapers and
other things that can be converted to support the fracture.
- SOFT SPLINT :such as pillows, rolled blankets and other
soft materials
- ANATOMICAL SPLINT: using part of the body to support a
fractured area can also be done.

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 USES OF SPLINTS

• To protect and support the injured part.

• To reduce pain
• To prevent further injuries
• To prevent bone ends from movements.

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 INJURIES TO
MUSCLES,LIGAMENTS AND JOINTS
Strain :Is over-stretching of a muscle.
signs and symptoms
-Sudden sharp pain at the site of injury.
-In the case of a limb, the muscle may swell and
cause severe cramp.
Treatment:
-Place the casualty in the most comfortable
position.
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-Steady and support the most injured part.
-Arrange for medical treatment.
Sprain: It occurs at the joint and it occurs
by the tearing of the ligament and tissues
connected with the joint.
Signs and symptoms
-Pain at the joint.
-Swelling
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-Inability to use the joint.
Treatment
1.Rest and support the joint in the most
comfortable position.
2.Carefully expose the joint.
3.Apply pressure over the joint by.
-surrounding it with a good layer of cotton wool
,keeping it in position by a bandage tied firmly,
or
-apply a cold compress to the joint.
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N.B- If a sprain of the ankle out-of-doors ,do not
remove the boot or shoe but give additional support
by applying a figure-of-eight bandage over the boot
or shoe.

SUMMARY
P- Protect (from further injuries)
R- Rest
I – Immobilize the limb
C – Compression
E – Elevation
S- Support (Casualty can use crutches/ splint)
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 Dislocation
This type of injury is the displacement of one or
more bones at a joint .It usually occurs in the
shoulder ,elbow, thumb, fingers or lower jaw.
signs and symptoms
1.Severe pain at the joint.
2.The casualty cannot move the injured part.
3.The joint is misshaped ie.it appears abnormal
in appearance.
4.Swelling. 105
 Treatment

• Do not attempt to move the bones to their

normal position.
• Support and secure the injured part in the most
comfortable position using pillows.
Immobilise with bandages and splints if
available.
• Take casualty to hospital.
Note :In all doubtful cases treat as a fracture.

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 Displaced cartilage of the
knee.(locked knee)
This occurs when a semi-lunar cartilage in the
knee is displaced or torn ,caused by ,for
example.
-A violent kick failing to connect at football.
-Slipping on a step.
-Twisting the body violently whilst standing on
one leg.

107
 Signs and symptoms
-Severe pain referred to the inner side of the
knee.
-The knee is held in a bent position ,although it
may be further flexed ,it cannot be straightened.
-attempts to straighten the leg cause severe
further pain.
-there is tenderness over the displaced cartilage.
-swelling.
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 Treatment
1.Raise and support the leg.
2.Protect the knee with soft padding extending
well above and below the joint.
3.Keep the padding in position with a firm
bandage in the most comfortable position for the
casualty.
4.Take to hospital.

109
 Cramp
This is sudden involuntary and painful
shortening of a muscle or group of muscles.
Cramp may be caused by ,poor coordination
during the exercise e.g. when swimming or
running.

110
 Signs and symptoms
• Pain
• Tightness or spasms in the affected muscle.
• Casualty is un able to relax the tight muscles.
Treatment
-Gently but firmly, straighten fingers and
massage the area.
In the thigh straighten the knee and raise the leg
with one hand under the heel.
111
Use the other hand to press down the knee.
Massage the area gently.
In the calf, straighten the knee and draw the foot
towards the skin massage the are gently.

112
 ASPHYXIA

• This is a condition in which the body tissues

such as the Lungs, Kidneys etc. are lacking
oxygenated blood. This comes as a result of
insufficient oxygen in the air breathed in.

113
 CAUSES OF ASPHYXIA
Those affecting the airway and lungs.
a)By obstruction: Such as the tongue falling to
the back of the throat in unconscious
casualty lying on his or her back. A foreign body
e.g. teeth, vomitus etc. may broke the air way.
b)Suffocation: By pillows, over lying a baby
without checking on it etc.
c)Fluid, gas or smoke in the air passage.
d)Compression of the wind pipe by hanging.
e)Continuous fits prevent adequate breathing

114
 SIGNS AND SYMPTOMS OF
ASPHYXIA

1.Rapid pulse
2.Gasping for air.
3.Goose skin
4.Cold and clammy skin
5.The person will collapse.
6.Rapid pulse
7.The mucous membrane becomes cyanotic
8.Pupils of the eyes become dilated

115
FIRSTAID MANAGEMENT OF ASPHYXIA

1. Know the cause.

2. Remove the cause if its removable
3. Shout for help by making an alarm(Get other help)
4. Steady and support the casualty
5. Check the mouth, nose and find if there is still
something to block the airway(clear the airway).
6. Start ventilating the lungs by,
i)Mouth to mouth
ii)Mouth to nose or a kiss of life or oral
resuscitation.

116
N.B :Its only exercised on a non breathing
casualty if there is no air ,no heart External
cardiac massage(ECM)or External cardiac
compression(ECC).
If the casualty starts to breath and the heart starts
to beat but he or she is still un conscious, put him
in comma position or recovery position.

117
 UNCONSCIOUSNESS
This is an abnormal state resulting from an interruption of
the brain’s normal activity.
Conscious: Here the person can respond to verbal
communication.
level of consciousness: The following terms are used for
certain stages in a progression from consciousness to
unconsciousness or vice versa.
1. Full consciousness :Alert and answers questions
correctly, and can take himself to the hospital and explain
what has happened.
2.Drowsness:My client is drowsy if there is need to join the
words i.e.. the sentences are not complete.

118
3.Stupour:No communication with verbal, my client
can only respond to painful stimuli e.g. pinprick.
4.Coma i.e. Casualty cannot be roused at all.
These stages will help a first Aider to asses and
quickly record changes in either directions.

119
 CAUSES OF UNCONSCIOSNESS

• Poisoning
• Head injuries, with damage to the brain.
• Bleeding
• Drugs
• Asphyxia
• Shock

120
• Fainting
• Heart attacks
• Epilepsy
• Diabetic emergencies.
• Stroke(apoplexy).Is due to either bleeding
from a ruptured blood vessel in to the brain or
the clotting(thrombosis) in a blood vessel

121
 SIGNS AND SYMPTOMS OF
UNCONSCIOUSNESS
On examination,
The skin is cold and clammy.
Eyes: Pupils are dilated
Smell

122
 FIRSTAID MANAGEMENT OF
UNCONSCIOUS CASUALTY
The aim of first Aid is to ensure an open airway and to
obtain urgent medical attention
1.a)Make sure the air passage is not obstructed.
Remove any foreign body from the mouth.
b)Ensure there is plenty of fresh air to breath. Open
windows and doors and remove casualty from any
harmful place.
2.If breathing fails start artificial respiration
immediately.

123
3.When breathing is satisfactory, put casualty in
recovery position.
4.Make arrangement and refer to the hospital.
5.If removal to the hospital is delayed and the
casualty gains his consciousness back, talk to the
casualty and reassure as much as possible.
N.B .Do not give a drink to unconscious casualty.
Do not leave the casualty unattended.

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 HEAD INJURY

Head injury: Is damage to the head.

Injuries to the head may cause wounds of the
scalp and fractures of the skull bones, with or
without damage to the underlying brain. Many
head injuries would be avoided if precautions
were observed such as the use of seat belts. The
brain like any other tissue may be damaged and
such damage may result in cerebral concussion
and compression.

125
 Concussion
Is where by there is temporary disturbance of
the working of the brain and can be shaken. It
may be caused by a blow on the head or a blow
on the point of the jaw, a fall from the height on
the feet , falling heavily on the lower part of the
spine.

126
 SIGNS AND SYMPTOMS OF
CONCUSSION
a)Partial or complete loss of consciousness
,lasting usually for a short time.
b)Dizziness.
c)Recovery may be accompanied by nausea and
vomiting.
d)Loss of memory for events immediately before
and after the injury is common.
e)Breathing is shallow
127
 Compression
• A condition of actual pressure on some part of
the brain ,by blood or fluid within the skull or
by a depressed fracture within its self. The
condition may directly follow concussion with
no return to consciousness.

128
 Signs and symptoms of compression
 In the early stages irritation of the brain may
cause convulsions.
 Weakness or paralysis on one side of the body
 Unconsciousness or coma
 The casualty’s breathing becomes noisy.
 The pupils of the eyes will be abnormal.
i.e. become un equal in size.
both be dilated
not react to light
Treatment.
Ensure that the casualty recovers fully and safely.
Refer to the hospital.
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 STROKE(apoplexy)
This is due to bleeding from a raptured blood
vessel into the brain or thrombosis in a blood
vessel of the brain.

130
 Signs and symptoms of stroke
• Sudden loss of power or sensation in the limb.
• Weakness or paralysis of one side of the limb.
• Paralysis of the mouth and saliva may dribble.
• Speech may be slurred.
• Loss of bladder and bowel control.
• Pupils may be un equally dilated.
• A strong pulse.
Treatment
1.Carryout the general rules for treatment of
unconsciousness.
2.Take casualty to hospital.
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 EPILEPTIC ATTACK
An epileptic attack results from a health condition
termed as epilepsy which is characterised by
temporary but vigorous seizures together with loss
of consciousness. However not all seizures are due
to epilepsy.
Ahead injury ,brain damaging disease or poisoning
may cause seizures.

132
Clinical presentation:
 The casualty suddenly falls unconscious ,often
letting out a cry.
 The body becomes rigid and the back is usually
bent.
 The muscles become stiff and the body shakes
violently sometimes.
 Breathing may stop and the face and neck may
become puffy.
 When breathing resumes it may be noisy.

133
 The mouth will dribble with saliva and some times blood if
the lips or tongue has been bitten during the fall.
 The casualty may not control urine or bowel movements.
 The muscles relax, breathing returns to normal and
consciousness is regained in less than 10 minutes.
 The casualty may feel dizzy, act strange and may not be
aware of what happened.
 The casualty may then fall into deep sleep.

134
 Note:
Fits are not contagious and one should not
withhold help .Fits can lead to death if the
casualty chokes on their tongue during the
phase when they are unconscious.

135
 Aims of first Aid
• To protect the casualty against injury.
• To give care when consciousness is regained.
• To arrange transport to take casualty to
hospital if necessary.

136
 First Aid management of Epileptic
attack
• Remove any objects that may injure or harm the
casualty.
• Protect the head with soft padding and loosen clothes
around their neck.
• When the seizures are over but the casualty are still
unconscious resuscitate casualty, open airway and lay
the casualty in the recovery position .Monitor the vital
signs to asses if the condition is improving or not. If
condition is improving stay with the casualty until they
fully regain consciousness. If condition deteriorates
refer to the hospital immediately.

137
 Safety for sufferers of epilepsy
Get advise from your doctor.
The following are also generally helpful.
• Before starting any new exercise programme
consult with your doctor
• Always take your medication as prescribed.
• Ensure you keep an adequate supply of
medication.
• Activities such as boxing are dangerous and
should be avoided.

138
• Let family members and friends know your
walking route before you leave and how long
you will be out.
• Do not swim unless you have companions
who are aware of your condition and who are
physically strong enough and know what to do
if you have a seizure.

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 BURNS AND SCALDS
A burn can be by coagulation of the skin(skin
structure changes).
Burns can be by flames ,chemicals, a hot liquid,
electricity or radiation. Any burn that is deep or
covers about twice the size of a palm requires
medical attention.

140
 Aims of first Aid
• To relieve pain and swelling.
• To minimise the risk of infection.
• To maintain an open airway for breathing.
• To treat related injuries.

141
 TYPES OF BURNS.
1.Superficial burns; May be a burn or a scald
where only the outer layer of the skin is
damaged.
2.Deep burns; Is where the whole thickness of
the skin including nerve endings, is destroyed.
An extensive superficial burns is more painful
than a small deep burn.

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 CAUSES OF BURNS
Burns are caused by,
-dry heat: such as fire ,flame, contact with hot
objects.
-electricity
-friction
-corrosive chemicals e.g. acids such as sulphuric,
nitric ,hydrochloric acids.
-non corrosive chemicals, caused by alkaline such as
caustic soda, ammonia solution. etc.

143
 SCALDS
Scalds are caused by
-Moist heat such as boiling water, hot oil etc.
Signs and symptoms of burns and scalds
.Pain
.redness and later swelling and sometimes
blistering.
.shock comes as a result of oozing from the
burnt area where there is loss of fluid(plasma).
144
 FIRST AID TREATMENT OF BURNS
AND SCALDS
1.Lay the casualty in a resting position ,protect the
burnt area from contact with the ground.
2.Cool the burns with clean, cold water for at least
ten minutes.
3.Gently remove jewellery ,watches ,belts or
clothing from the injured area to prevent sticking
when the area swells.
4.Immobilise a badly burned limb.
5.Watch for signs of difficult breathing and be ready
to resuscitate

145
6.Give small cold drinks at frequent intervals to
a badly burned casualty.
7..Cover the area with a clean cloth.
8.Call for an ambulance or transfer the casualty
to the nearest health unit immediately.
9.Reassurance of the casualty is of great
importance at all stages.

146
 POISON
A poison is any substance solid ,liquid or gas
which when taken into the body in sufficient
amount may destroy life.
It may be taken either accidentally or
intentionally.
Methods
• By injection-Under the skin. These arise from
bites of poisonous reptiles, some animals and
certain insects
147
• By the mouth- through swallowing. Swallowed poisons
act quickly, either
-directly on the food passage causing vomiting ,pain
and often diarrhoea.
-On the nervous system after absorption into the
blood. Common causes are excessive taking of alcohol .
• By inhalation through the lungs i.e. breathing in fumes
from fire, stoves and poisonous gases.
• By absorption through the skin i.e. through massage
where by it goes inside through the sweat pores of the
skin.
148
 Signs and symptoms
a) Mouth may be burnt by the poison if taken
by mouth.
b) You can smell it and know that someone has
taken something.
c) Sometimes you may find a container near the
casualty.
d) Drowsiness
e) Dyspnoeic
149
f) Nausea and vomiting
g)Restlessness
h)Confused
i)Dilatation of pupils of the eyes

150
 Treatment
a)First sustain life by,
-diluting the poison.
-Encourage vomiting if the poison is in the
stomach.
b) If conscious, ask him what has happened and
look around to see whether there is anything to
show what he has taken.
c)If lips show signs of burns give water or milk to
dilute the poison.
151
d) If breathing fails commence artificial
respiration.
e)Put him in a recovery position.
f)Transfer the casualty to the hospital.
g) If you find the tin of the poison around ,carry
it with you to hospital.

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 ANIMAL BITES AND INSECT STINGS
SNAKE BITES
Any person bitten by a snake will be
terribly frightened and feel that their life is in
great danger .In the world there are about 2000
species of snakes and out of these 200 are
poisonous .These snakes feed on lizards ,rats
frogs, Birds ,insects and sand.

153
 TYPES OF SNAKES
A snake is a cold blooded creature so it changes
according to the environment.
1. Neuromyotoxic type(Black mambers i.e. Cobra
,blue or green)-Ensweera.
The venom attaches the central nervous system.
They cause punctured wounds “ and close.
There mostly found in the central region.

154
2.Hemamyotoxic type e.g. vipers-Masalambwa
These tend to whistle, defecate where they are so
that the birds may come and feed on them and
then caught. Here the venom attacks the red cells.
3.Cytotoxic type e.g. Boom slangs-Temankima
These snakes live in trees and feed on birds and
lizzards. Mostly found in Kyagwe and Mukono
district
The venom attaches the clotting system of the
body.

155
 Signs and symptoms from poisonous
snake bites
• Fang marks in the skin and swelling at the side of
the bite.
• Severe localised pain.
• Fainting
• Dizziness
• Blurred vision
• Excessive sweating
• Nausea and vomiting
• Rapid pulse.
156
 FIRST AID MANAGEMENT OF SNAKE
BITE
Aims
• To reassure the casualty.
• To prevent the spread of venom through the
body.
• To take casualty to the hospital.

157
 Treatment
1.Lay casualty down, tell him to keep calm and reassure.
2.Flush the wound with soapy water to remove any
foreign body around and apply a dressing.
3.Secure and support the injured part, immobilise the
limb.
4.Obtain medical treatment as soon as possible.
5.Should breathing begin to fail commence artificial
breathing.
6.Keep casualty warm and transport as a stretcher case.

158
 DOG BITES
Dog bites are the most common animal bites.
The bite may cause infections like tetanus but
the most dangerous infection is rabies. Rabies
can be transmitted to the victim through the
bite and it causes death if not treated before
symptoms manifest.

159
 Aims of first Aid
• To minimise bleeding.
• To take the casualty to the hospital.
• To get treatment for rabies if the dog has
rabies.

160
 First Aid steps
1.Make sure you are safe and the animal is not at
large.
2. Remove the casualty from further danger.
3.If the bite is actively bleeding, apply direct
pressure with a clean, dry cloth until bleeding
subsides.
4. Elevate the area of the bite.
5. Cover the wound with a sterile dressing or a
clean pad bandage place.
6. Visit a nearby health unit.

161
 The following tips may help prevent
animal bites.
• Do not disturb animals, not even your family pets,
while they are eating or sleeping. Animal mothers can
be very aggressive when protecting the young.
• Never leave a young child or baby with a pet.
• Do not approach or play with unfamiliar or stray pets.
• Do not run past a dog, because dogs naturally love to
chase and catch things.
• Many animals give a warning sign before they attack. If
you have animals in your home, know their warning
signs and teach them to your children.

162
• Do not try to separate fighting animals. If
available, water sprayed from a horse will often
break up the fight.
• If you see a threatening dog, stay still. Do not run.
• Do not make direct eye contact with the dog or
stare at the dog. Staring at the dog may be
interpreted by the dog as a threat and the sign of
aggression.
• Do not scream. If you say any thing, speak calmly
and firmly.
163
 INSECT STINGS
They cause an allergic reaction and develop rapidly
and may become very serious in a short time.
Signs and symptoms
• Skin rash.
• Swelling of lips, throat or tongue.
• Faintness
• Difficult in breathing.
• Loss of consciousness in some cases.
• Rapid heart beat.
164
 Aims of first Aid
-To remove the casualty to the safe area.
-To remove the sting
-To get medical assistance.
First Aid steps to follow.
• Have the casualty lie down
• Watch for and treat signs of shock.
• If no breathing, resuscitate the casualty
• Get medical assistance.

165