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(PROGRAM OF INSTRUCTION) Prepared BY: ALLAN G. BERMUDEZ EMT, RRT NATIONAL SAFETY INSTRUCTOR
First Aid & Basic Life Support Training
AM Introduction To First Aid a) What is firs aid b) Roles & responsibilities of the first aider c) Objectives of first aid d) Characteristic of a good first aider e) Hindrances in giving first aid Guidelines In Giving Emergency Care a) Getting started (how to approach in the injured person) b) Emergency action principle Basic life support (cardio pulmonary resuscitation) Shock Poisoning a) Absorbed poison b) Injected poison • Insect bite spider/scorpion bites marine life stings • Snake bites PM Environmental Emergencies a) Mild hypothermia b) severe hypothermia Heat illnesses a) Heat Cramps c) Heat Exhaustion b) Heat Stroke or Sun Stroke Seizure. Epilepsy, convulsion Bone, joints & muscle injuries Immobilization technique Soft tissue injuries • Kinds of wounds • Dangers • First aid management Bandaging technique Patient Casualty Handling (Carries)
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TACTICAL RESCUE TRAINING SERVICES
First Aid & Basic Life Support Training Manual Prepared BY: ALLAN G. BERMUDEZ EMT, RRT
NATIONAL SAFETY INSTRUCTOR
FIRST AID is an immediate care given to a person who has been injured or suddenly taken ill.
It includes self-help and home care if medical assistance is not available or delayed.
Role and Responsibilities of First Aider
1. Bridge that fills the gap between the victim and the physician. • It is not intended to compete with, or take the place of the services of the physician. • It ends when the services of a physician begin. 2. Ensure personal safety and that of patient / bystander. 3. Gain access to the victim. 4. Determine any threats to patient’s life. 5. Summon more advanced medical care as needed. 6. Provide needed care for the patient. 7. Assist Emergency Medical Technician (EMT) and medical personnel. 8. Record all assessments and care given to the patient.
Objectives of First Aid
1. To alleviate suffering. 2. To prevent added/further injury or danger. 3. To prolong life.
Characteristics of a Good First Aider
1. 2. 3. 4. 5. 6.
Gentle - should not cause pain. Resourceful - should make the best use of things at hand. Observant - should notice all signs. Tactful - should not alarm the victim. Empathetic - should be comforting. Respectable - should maintain a professional & caring attitude.
Hindrances in Giving First Aid
1. Unfavorable Surroundings • Night time. • Crowded city streets; churches; shopping malls. • Busy highways. • Cold and rainy weather. • Lack of necessary materials or helpers.
2. The Presence of Crowds • Crowds curiously watch, sometimes heckle, sometimes offer incorrect advice. • They may demand haste in transportation or attempt other improper procedures. • A good examination is difficult while a crowd looks on. 3. Pressure from Victim or Relatives
GUIDELINES IN GIVING EMERGENCY CARE GETTING STARTED
You will never see the emergencies you prevent. However, emergencies can and do happen, regardless of attempts to prevent them. Preparing for an emergency would benefit the provider in giving appropriate care to a victim. The following are guides to assure the provider to response to an emergency properly.
Plan of Action. To respond most efficiently to certain emergencies, you need a plan of action. A plan of this
type is prepared in advance and rehearsed with personnel. Emergency plans should be established based on anticipated needs and available resources.
Gathering of needed materials. The
equipment and personnel before any emergency occurs.
Remember the initial response as follows:
1. A - Ask for help.
In a crisis, time is of essence. The more quickly you recognize an emergency, and the faster you call for medical assistance, the sooner the victim will get help. Immediate care can greatly affect the outcome of an emergency.
2. I - Intervene.
It 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 situations, however, you may become actively involved in the victim’s initial care by giving first aid.
3. D - Do not further harm.
Once you have begun first aid, you want to be certain you don’t do anything that might cause the victim’s condition to worsen. Certain actions should always be avoided and by keeping them in mind, you will be able to avoid adding to or worsening the victim’s illness or injuries.
Instruction to helpers.
Keep in mind that in providing care you might need the assistance of other personnel or probably a bystander. Proper information and instruction to a helper/s would provide organized first aid care.
EMERGENCY ACTION PRINCIPLES (EAP)
The following principles can ensure your safety and that of the victim and bystander/s. They will also increase the victim’s chance of survival if he or she has a serious illness or injury.
Survey the Scene. Once you recognized that an emergency has occurred and decided to act, you must make
sure the scene of the emergency is safe for you, the victim(s), and any bystander/s. It is a quick assessment of the surroundings that will provide you with as much information as possible. Take time to survey the scene and answer these questions: • Is the scene safe? • What happened? • How many people are injured? • Are there bystanders who can help? • Then identify yourself as a trained first aider. Get consent to give care.
Activate Medical Assistance (AMA) or Transfer Facility. In some emergencies, you will have
enough time to call for specific medical advice before administering first aid. But in some situations, you will need to attend to the victim first. Decision in activating medical assistance or transfer facility would make a higher rate of survivability for the victim due to continuing chain of survival in providing early defibrillation and advanced cardiac life support
Information to be remembered in activating medical assistance:
• What happened? • Location? • Number of persons injured? • Extent of injury and first aid given? • The telephone number from where you are calling? Person who activated medical assistance must identify him/herself and drop the phone last
Do a Primary Survey of the Victim. In every emergency situation, you must first find out if there are
conditions that are an immediate threat to the victim’s life. You will discover these conditions by looking for signs, evidence of injury or illness that you can observe. Check for vital body functions, signs of life threatening conditions following the ABC principles. The primary survey takes only seconds to perform. The following are the steps of performing primary survey:
1. Check for Consciousness.
Begin primary survey by determining if the victim is conscious. A victim who can speak and move is conscious, breathing, and with signs of circulation. If the victim is found unconscious try to confirm by checking his/her responsiveness by gently tapping him or her and asking, “Are you okay?”. Do not jostle or move the victim. If the victim is unable to respond, he or she may be unconscious. Unconsciousness can indicate a life-threatening condition. Regardless of the condition of the victim don’t forget to ask for consent
2. Check for A – Airway. (head tilt, chin lift maneuver) Just look for anything that can obstruct the throat 3. Check B – Breathing. (10×) (LLF) (give 2 initial ventilation)
When the victim is unconscious/unresponsive, muscle tone is decreased and the tongue and epiglottis may obstruct the pharynx. Open the airway immediately and proceed to checking of breathing
4. Check C – Circulation. (10×) Reminders: if the victim has a sign of circulation, meaning pulse & breathing is present (± B- ± P) do
secondary survey of the victim
Do a Secondary Survey of the victim. Once you are certain that the victim has no life-threatening conditions, you can begin the fourth EAP. The secondary survey is a systematic method of gathering additional information about injuries or conditions that may need care. These conditions are not immediately life threatening but could become so if not cared for. The following are not in order; it will depend on the condition of the victim or situation of the accident. Interview the victim.
By asking the victim and bystanders simple questions, you learn more about what happened and the victim’s condition. Ask the following questions: • Ask the victim’s name. • Ask what happened. • Ask the SAMPLE history.
Elements of the SAMPLE history are: 1. Signs and Symptoms of the episode. 2. Allergies, particularly to medications. 3. Medications, including prescription, over-the-counter, and recreational (illicit) drugs. 4. Past medical history, particularly involving similar episodes in the past. 5. Last oral intake, including food and/or drinks. This is particular important if the patient may need surgery. 6. Events leading up to the episode.
And also do a head to toe examination
What If the victims pulse & breathing is absent (―P-B―). so you have to perform CPR) Adult (30 compressions; 2 breaths do it for 5 cycles) then recheck pulse.
1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,1,2,3,4,5,6,7,8,9 and 1-2 breaths 1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,1,2,3,4,5,6,7,8,9 and 2-2 breaths 1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,1,2,3,4,5,6,7,8,9 and 3-2 Breaths 1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,1,2,3,4,5,6,7,8,9 and 4-2 breaths 1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,1,2,3,4,5,6,7,8,9 and 5-2 breaths
Do not give any thing by mouth including water. If medical care is delayed and patient complaining of intense thirst, you may wet his/her lips by using cotton.
Recheck for the breathing and signs of pulse for 10 seconds (LLF). If the victim is revived put it in the recovery position (side lying) because it might be vomit. then continue monitor the victim and transport the nearest hospital immediately.
is a depressed condition of many body functions due to the failure of enough blood to circulate throughout the body following serious injury.
1. Pump failure. Poor pump function occurs when disease or injury damages the heart. The heart does not generate enough energy to move the blood through the system. Causes: Heart attack, trauma to heart. 2. Hypovolemia. Blood or fluid loss from blood vessels decreases blood volume, usually a result of bleeding, and results in adequate perfusion. Causes: Trauma to vessels or tissues, fluid loss from GI tract (vomiting/diarrhea can also lower the fluid component of blood). 3. Relative hypovolemia, The blood vessels can dilate enough that the blood within them, even though it is of normal volume, is inadequate to fill the system and provide efficient perfusion.
1. Lead to death. 2. Predisposes body to infection. 3. Lead to loss of body part.
Factors which contribute to shock
1. 2. 3. 4. Pain Rough handling. Improper transfer. Continuous bleeding. 5. Exposure to extreme cold or excessive heat. 6. Fatigue
Signs and Symptoms of Shock
1. Early stage: • Face – pale or cyanotic in color. • Skin – cold and clammy. • Breathing – irregular. • • • • Pulse – rapid and weak. Nausea and vomiting. Weakness Thirsty
2. Late stage: • If the condition deteriorates, victim may become apathetic or relatively unresponsive. • Eyes will be sunken with vacant expression. • Pupils are dilated. • Blood vessels may be congested producing mottled appearances. • Blood pressure has very low level. • Unconsciousness may occur, body temperature falls.
First Aid and Preventive Management of Shock 1. Proper body Position
• Keep victim lying down flat. • Elevate the lower part of the body a foot or so if injury is severe, from eight to twelve inches high. • Place the victim who is having difficulty in breathing on his back, with his head and shoulder raised. Head injury – apply pressure on the injury and keep the victim lying flat. Do not elevate head or lower extremities. When the color of the face return to normal, elevate head and shoulder and continue giving care to the injury. In chest injury, raise the head and shoulder slightly. • When there are symptoms of nausea and vomiting or unconsciousness keep the victim lying on one side preferably opposite from his injury except for sucking wound and stroke. The position is known as recovery, coma or lateral position.
2. Proper body heat
• • •
Maintain body temperature and victim must not be neither perspiring nor chilling. If the weather is warm, the victim need not be covered. If the victim is cold, in spite of the weather, a blanket may be placed underneath him and cover the
Application of blanket
Proper handling of patient would prevent further injury to the patient. Refer proper techniques on transfer method on Patient Handling
Transport of patient
POISON is any substance: solid, liquid or gas that tends to impair health or causes death when
introduced into the body or onto the skin surface. A poisoning emergency can be life threatening.
1. Common in suicide attempts. 2. Occasional accidental poisoning .
Ways in Which Poisoning May Occur:
1. Absorption 2. Injection by skin contact by animal bites, stings etc.
Absorbed Poisons a poison that enters the body through the skin.
• Signs and Symptoms: - History of exposures. - Liquid or powder on the skin. - Burns. - Itching, irritation. - Redness, rash, blisters
Millions of people suffer from contact with poisonous plants whose poison are absorbed into the body.
Remove the clothing that came in contact with the poison. Then with a dry cloth blot the poison from the skin. If the poison is a dry powder, brush it off. Flood the area with copious amounts of water. A shower or garden hose are ideal for this purpose. Continue until medical personnel arrived. Continually monitor the patient’s vital signs. Be alert for sudden changes. Seizures and shock are not uncommon.
Injected Poisons a poison that enters the body through a bite, stings, or syringe.
1. Insect Bites • Signs and Symptoms: - Stinger may be present. - Pain - Swelling - Possible allergic reaction.
Whenever chemical poisons come in contact with the skin, flush the affected area continuously with large amounts of water.
Most stinging insects inject venom. The stinger of the honeybee is barbed and cannot be withdrawn once the bee has stung someone.
First Aid for Insect Bites - Removes stinger - scrape it away or use tweezers. - Wash wound. - Cover the wound. - Apply a cold pack. Watch for signals of allergic reaction.
2. Spider Bite / Scorpion Sting
Signs and Symptoms: - Bite mark. - Swelling - Pain - Nausea and vomiting. - Difficulty breathing or swallowing.
First Aid: - Wash wound. - Apply a cold pack. - Get medical care to receive antivenin. - Call local emergency number, if necessary. 3. Marine Life Stings • Signs and Symptoms: - Possible marks. - Pain - Swelling - Possible allergic reaction. First Aid: - If jellyfish - soak area in vinegar. - If sting rays - soak in non-scalding hot water until pain goes away. Clean and bandage wound. - Call local emergency number if necessary.
The painful sting of some marine animals can cause serious problems. A. stingray, B. sea anemone, C. man-of-war, D. jelly-fish.
4, Snake Bites • Signs and Symptoms - Bite mark. - Pain
There are four kinds of poisonous snakes: A. rattlesnake, B. copperhead, C. water moccasin, D. coral snake
Comparative Characteristics of a Snake
VENOMOUS NON-VENOMOUS Movement Semi-cortina Cortina, side curvature locomotion winding Head Semi-triangular Oblongated Body Rectangular Circular Skin Rough Smooth Pupil Vertical Round Ways/Manner of attack Non-constrictor Constrictor Bite marks With fang marks Horseshoe shape • First Aid: - Wash wound. - Keep bitten part still, and lower than the heart. - Call local emergency number.
The human body is equipped to withstand extremes of temperature. Usually, its mechanisms for regulating body temperature work very well. However, when the body is overwhelmed by extremes of heat and cold, illness occurs.
Normal body temperature must be maintained within a very narrow range for the body’s chemistry to work efficiently. If the body, or any part of it, is exposed to cold environments, these mechanisms may be overwhelmed. Cold exposure may cause injury to individual parts of the body, such as the feet, hands, ears, or nose, or to the body as a whole. When the entire body temperature falls, the condition is called hypothermia.
Frostbitten parts are often identified as hard and firm to touch.
Hypothermia. Exposure to extreme cold for a short time or moderate cold for a long time can cause
hypothermia. 1. Mild Hypothermia. The patient will present with cold skin and shivering and will still be alert and oriented. • Signs and Symptoms Increased breathing rate. Increased pulse rate and blood pressure. Slow, thick speech. Staggering walk. Apathy, drowsiness, incoherence. Sluggish pupils. Uncontrollable shivering. First Aid Check responsiveness, if patient is alert and able, allow him/her to drink warm fluids. Never give a confused or lethargic patient anything to drink. Cover the patient with a warm blanket. Apply hot compress. Check vital signs. Refer to a physician.
2. Severe Hypothermia. Patients may become unresponsive. This is a true medical emergency that can lead to death. • Signs and Symptoms Extremely slow breathing rate. Extremely slow pulse rate. Unresponsiveness Fixed and dilated pupils. Rigid extremities. Absence of shivering. First Aid Check responsiveness. Check ABC, perform CPR if needed. Care for shock. Refer to a physician.
Keep the victim warm by applying blanket.
Our body functions properly within only a limited internal temperature range. A victim of heat illness may start by experiencing muscle cramps (heat cramps). These are brought on by the loss of salt from heavy perspiring. If the victim does not cool off at this point, he or she may develop heat exhaustion because of dehydration. Being in a hot environment is only one factor that can lead to heat illness. There is also internal factor: certain medications or alcohol intake before or after vigorous exercise may increase the risk of heat illness. Children and older people are more susceptible, and they tend to go from feeling fine to sudden collapse. Even succumb to heat illness if he or she ignores the warning signs.
Three general types of heat emergencies
1. Heat Cramps. A muscular pain and spasm due largely to loss of salt from the body in sweating or too inadequate intake of salt. The cramps are more severe if the victim has drunk a large quantity of tap water or softdrinks without replacing the salt deficiency, in which case severe mental confusion and even convulsions may develop. Heat cramps may be associated with heat exhaustion.
Signs and Symptoms Muscle cramps, often in the abdomen or legs. Heavy perspiration. Lightheadedness; weakness. First Aid Have the victim rest with his/her feet elevated 8 to 12 inches. Cool the victim. Do not use an alcohol rub. Give the victim electrolyte beverages to sip (for example, Gatorade or Pedialyte) or make salted drink by adding 1 teaspoon of salt to 1 quart of water. Try to give a half-cup every 15 minutes. (If electrolyte beverage or salts are not immediately available, give the victim cool water.) To relive muscle cramps massage the affected muscles gently but firmly until they relax.
Massage and flex the injured area.
2. Heat Exhaustion. A response to heat characterized by fatigue, weakness, and collapse due to inadequate intake of water to compensate for loss of fluids through sweating. • Signs and Symptoms Cool, pale or red, moist skin (Even if the victim’s internal temperature is rising, his or her skin may still be cool). Dilated pupils. Headache Extreme thirst. Nausea; vomiting. Irrational behavior. Weakness; dizziness. Unconsciousness First Aid Have the victim rest with his or her feet elevated 8-12 inches. Cool the victim. Do not use an alcohol rub. Give the victim electrolyte beverages to sip (for example. Gatorade or Pedialyte) or make a salted drink by adding 1 teaspoon of salt to 1 quart of water. Try to give a half-cup every 15 minutes. (If electrolyte beverages or salt are not immediately available, give the victim cool water.) Monitor the victim for signs of shock, including bluish lips and fingernails and decreasing alertness. If the victim starts having seizures, protect him/her from injury and give first aid for convulsions. If the victim loses consciousness, give first aid for unconsciousness.
Elevate the lower extremities for good circulation and give electrolytes.
3.Heat Stroke or Sunstroke. A response to heat characterized by extremely high body temperature and disturbance of sweating mechanism. • Signs and Symptoms Raised body temperature (above 102 degrees Fahrenheit). Dry, hot, red skin. Dark urine. Small pupils. Rapid, shallow breathing. Extreme confusion. Weakness Seizures Unconsciousness
First Aid Cool the victim. Do not use an alcohol rub. Give First Aid for shock. Lay the victim flat and elevate his/her legs 8 – 12 inches. Do not suspect any head, neck, back or leg injury; if he or she is having breathing problems; or if the position makes the victim uncomfortable. If the victim starts having seizures, give first aid for seizures. Keep the victim cool as you await medical help.
Wrap casualty in wet sheet and continually sprinkle sheet with water.
Bones , Joints & Muscle Injuries
Bone, Joint, and Muscle Injuries
Ligaments – connects bones to bones by stabilizing band of elastic fibrous connective tissues. Tendons- connect muscle to bones. Synovial fluid- lubricating fluid Synovium – were the lubricating fluid came from Articular cartilage -provides smooth surface for movement
1. 2. 3. 4. 5.
Vehicular accidents. Motorbike accidents. Mishandling of tools & equipment. Falls Sports 1. Muscle cramp (or spasm) is the sudden, painful tightening of a muscle. Painful spasms often lasting only a few minutes make the affected muscle become hard and tender. It may occur in any muscle in the body but they are most common in leg muscles. If the abdominal muscles are affected, the condition is also known as a “stitch
• First Aid
Have the victim stretch out the affected muscle to counteract the cramp. Massage the cramped muscle firmly but gently. Apply heat. (Use a heating pad or a hot water bottle wrapped in cloth.) Moist heat is more effective than dry heat. Do not apply direct heat to the skin. Get medical help if cramps persist.
2. Muscle Strain
Is sudden, painful tearing of muscle fiber during exertion.
When a muscle or tendon is over-stretched or forcefully shortened, it can result in a stretch or tear injury called a strain. There is bleeding through a damaged area of a muscle fiber, causing pain, swelling and muscle spasm. A bruise usually appears a few days after the injury. • Some causes of strains include: o Sudden pulling or twisting of a muscle. o Poor body mechanics during lifting. o Not warming up muscles before physical activity. Repetitive, long-term overuse of a muscle and/or tendon.
• First Aid Management
Signs and Symptoms o Sudden sharp pain in the strained muscle o Swelling of the muscles causing severe cramps o Bruising and muscle stiffness o Casualty may not be able to use the affected body part, loss of efficient movement. o Apply cold compress at once. o Elevate the limb to reduce swelling and bleeding within the muscle. Rest the pulled muscle for 24 hours. o Place the patient / casualty in a position of comfort and assess the injury. If there is loss of function, immobilize the injured part. o Get medical help if necessary.
Is cause by torn fibers in a ligaments.
Tearing or stretching of the ligament that hold together the bone ends in a joint, caused by a sudden pull. The fibrous capsule that encloses the joint may also be damaged. • Signs and symptoms o Pain that may be severe and increase with movement of the joint. o Loss of function Swelling, bruising and discoloration First Aid Management o Remove any clothing or jewelry from around the joint. o Apply cold compress over the affected area. o Apply compression bandage, use a pillow or blanket splint to the injury. Loosen the bandage if the swelling increases. o Keep the injured part elevated above the level of the heart and keep the victim from walking if possible (24 hrs). o Analgesic of pain killers may be taken to relieve the pain. o After the first 24 hours, apply heat to the area or soak it in warm water periodically for several minutes at a time. o If the wrist, elbow or shoulder is sprained, place in an arm sling and apply supporting bandages.
Is a technique using splints and bandages to secure the broken or fractured bone and dis-located bone.
Soft Tissue Injury
Is a break in the continuity of a tissue of the body either internal or external.
Types of Wounds: Close wound
It involves underlying tissue without break / damage in the skin or mucous membrane.
Causes: • Blunt object result in contusion or bruises. • Application of external forces such as motor vehicle accidents and falls.
Sign and Symptoms:
• • • • • • • • • • Pain and tenderness. Swelling Discoloration (black or blue which is called ecchymosis.) Hematoma may occur (pool of blood collected within the damaged tissue.) Uncontrolled restlessness. Thirst Symptoms of shock. Vomiting or cough-up blood. Passage of blood in the urine or feces. Sign of blood along mouth, nose and ear canal.
First Aid Management I - ICE – ice or cold packs will slow down the flow of blood due to the constricting of blood vessels. C - COMPRESSION – manual compression over the area of injury will compress the blood vessels and decrease bleeding. E - ELEVATION - decreases the amount of swelling. S - SPLINTING – immobilizing the soft tissue injury with a splint.
it is a break in the skin or mucus membrane; or the protective skin layer is damage.
Classification of Open Wound
NAME PUNCTURE CAUSES
Penetrating pointed instruments such as nails, ice picks, daggers, etc
Deep and narrow; serious or slight bleeding.
Scrapping or rubbing against roughs surfaces. Blunt instruments such as shrapnel’s, rocks, broken glasses, etc. Explosion, animal bites, mishandling of tools, etc. Sharp bladed instruments such as blades, razors, etc.
Shallow; wide; oozing of blood; dirty.
Torn with irregular edges; serious or slight bleeding.
Tissue forcefully separated from the body.
Clean cut; deep; severe bleeding wound is clean.
Dangers: - Hemorrhage – lost of 1 glass (approximately 250 cc) is normal; 2 to 4 glasses – victim becomes anemic and predisposes to infection; and 4 to 6 glasses will be fatal. - Infection – delays the healing of the wound; gangrene may develop; amputation may be necessary to prolong life; may lead to unnecessary death. - Shock – predisposes body to infection; may lead to loss of body part; may itself lead to death.
First Aid Management
C C C
Wound with severe bleeding - Control Bleeding Direct pressure Elevation Pressure point Pressure bandage - Cover the wound with dressing and secure with a bandage. - Care for Shock. - Consult or refer to physician.
Wound at top of the head
sprain ankle (shoe on & shoe off technique
Wound at the forehead
Ear, Cheek, Jaw
Arm or Leg
Patient Casualty Handling
Assist to walk Packstrap Carry Hand as a Litter
Carry by extrimities