CHAPTER ONE

INTRODUCTION
1. Definition first aid………………………………………
2. Recognize the reasons why first aid is given…………
3. Values of first aid …………………………………………
4. General directions for giving first aid…………………………

CHAPTER TWORESPIRATORY EMERGENCIES AND

ARTIFICIAL RESPIRATION
1. Respiratory emergencies and artificial respiration………………
2. The breathing process…………………………………..
3. Causes of respiratory failure……………………………..
4. Prevent respiratory accident, give artificial respiration and manage
respiratory accident………
Drowning……………………………………………
CHAPTER THREEWOUNDS AND BLEEDING
1. Define wound and bleeding ………………………………
2. Different types of wound……………………
3. Common causes of wound …………………………………
4. Give first aid measures for different types of wounds……………
5. Apply first aid measures to stop severe bleeding………………
6. The preventive measures of contamination and …………………
7. Infection of wounds………………………….

CHAPTER FOURSHOCK
1. Define shock different causes of shock…………………….
2. Signs and symptoms of shock………………………….
3. Describe first aid measures of shock……………………………

1 ABAARSO TECH UNIVERSITY | (Bashe Adem farah B.S.c in M.W )

CHAPTER FIVEBURN

1. Definition burn injury. ……………………………………………

2. Differentiate different causes of burn in different areas. ……………
3. Different classifications and degrees of burn…………………
4. First aid measures for different degrees of burn…………………

CHAPTER SIXPOISONING
1. Describe poisoning……………………………………………
2. Different causes of poisoning……………………………………
3. different poisonous substances around home environment
4. Signs and symptoms of poisoning ……………………………………
5. Give first aid for different types of poisoning……………………

UNIT EIGHT
Bites…………………………………………………
Snake Bite……………………………………………
Dog bite ……………………………………………
CHAPTER NINEBONE AND JOINT INJURIES
1. Definenation fracture, dislocation, sprain and strain…………………
2. First aid principles for bone and joint injuries…………………………
3. Specific fractures, their sign and symptoms and first aid measures…
4. First aid management for dislocation……………………………
5. Apply first aid management for sprain…………………………
6. The precautionary measures which help to prevent strain……………
7. Preventive measures of accidents that result muscloskeletal injuries……

UNITTEN: Eye, Ear and Nose Injury

1. Injury to the eye ...............................................................
2. Problems with ear.............................................................
3. Bleeding from the nose ......................................................

(Bashe Adem farah B.S.c in M.W ) |SHIFA UNIVERSITY BURAO 2

 CHAPTER ONE
INTRODUCTION
Learning Objectives
After studying the material in this chapter, the student will be able to:
Define first aid
Recognize the reasons why first aid is given
Appreciate values of first aid
Identify general directions for giving first aid

Definition
First aid is the immediate care given to a person who has been injured or
suddenly taken ill. It includes home care if medical assistance is not
available or delayed.
Reasons for First Aid giving
To sustain (preserve) life.
E.g. mouth to mouth respiration when breathing has stopped.
To prevent worsening of the problem (complication).
E.g. Immobilizing the fractured bone.
To promote healing and recovery.

Values of First Aid Training

The need for first aid training is greater than ever because of population
growth throughout the world and due to the increased use of technological
products; such as mechanical and electrical appliances in everyday use at
home, working place and play areas which make more people at risk of
injury.

3 ABAARSO TECH UNIVERSITY | (Bashe Adem farah B.S.c in M.W )

General directions to give first aid Responsibility of a first -aider in the
management of casualty:
Assessment of the situation
Identify the problem
Giving immediate and adequate treatment, bearing in mind that a
casualty may have more than one injury and that some casualties will
require more urgent attention than others (to give priority).
Arrangement for the transport of casualty according to the seriousness of
his/her condition without delay accompanied with brief written report.
Prevent cross infection

Assessment
Be calm, take charge and be confident
Talk, listen and reassure the conscious casualty
Check safety of casualty and of yourself and check for
breathing, bleeding and level of consciousness.
Get others to help.
Problem identification (Diagnosis)
The history of the incident must be taken in to consideration and an
examination made to determine the signs and symptoms and level of
consciousness.
History:-The story of how the accident happened or the illness
began can be obtained from:-
• The causality ( e.g. I slipped and fall down)
• A witness or a bystander(s) whether he/she saw the happeningsPoints to be
considered during history taking:
Any history of illness: Eg. Epilepsy, Diabetes mellitus,
For history of ingested material E.g. Drug, Alcohol, type of food or fluid .
Symptoms:- Sensations and feelings that are described by the E.g.
• I feel pain
• I feel cold
Signs:- variations from normal by the first- aider.
E.g. Pallor of the inner surface of the eyelids or nail beds; blueness
(cyanosis) of face, lips, fingers and toes. There may be evidence of
poisoning e.g. medications, alcoholic smell, bottles and other containers
beside the victims.

(Bashe Adem farah B.S.c in M.W ) |SHIFA UNIVERSITY BURAO 4

Level of consciousness:-
Recognition of any change of level of consciousness is important.
Full consciousness- the casualty is able to speak and answer questions
normally
Drowsiness- the casualty is easily aroused but lapses in to unconscious state
Stupor –the casualty can be roused with difficulty, aware of painful stimuli.
Coma - cannot be roused by any stimuli.
In general make full use of your senses to obtain maximum information
(Look, smell, listen and touch).
Action: -If the cause of the condition is still active, remove the cause.
E.g. -a lodging of wood on the causalities leg, contaminated clothing or
remove the causality from the cause, such as traffic, fire, water, poisonous
fumes. Etc.

The scope of first aid treatment:

Assessing the situation
Diagnosing the problems
Giving immediate treatment.
First Aid Management and Accident Prevention

A. By observation:
Cheek for any external bleeding and determine whether the bleeding is
severe or not
Check for breathing pattern and determine whether there is respiratory
problem or not.
Note:Bleeding and respiratory problems are the top urgent emergency
conditions that need fast decision and action.

B. Brief Examination of patient

First check:
Breathing (Listen and look at rise and fall of the chest)
Color of skin (darks skin due to shortage of oxygen)
Circulation of blood (by taking pulse and blood pressure)
Pupils of the eye (large, small, altered with light) .

5 ABAARSO TECH UNIVERSITY | (Bashe Adem farah B.S.c in M.W )

C. Check parts of the body:
Look carefully and quickly of each part of the body in the
following order or steps: Arms, hands, fingers
Head Chest
Back legs, feet, toes
Neck Abdomen

D. Look for:
Signs of internal damage to organ
Burns
Dislocation (broken bone)
Wounds
Dislocation (bone put out of place)
Fracture
Sprain
Strain

What is the role of a first aid person?

The first aider is to provide immediate, lifesaving, medical case before the
arrival of further medical help. This could include performing procedures
such as: Placing an unconscious casualty into the recovery position.

(Bashe Adem farah B.S.c in M.W ) |SHIFA UNIVERSITY BURAO 6

 CHAPTER TWO
Respiratory emergency

Learning Objectives
After studying the material in this chapter, the student will be able to:-
1. Define respiratory emergencies and artificial respiration.
2. Explain the breathing process.
3. Identify causes of respiratory failure
4. Prevent respiratory accident, give artificial respiration and manage
respiratory accident.

Definition
Respiratory emergency is one in which normal breathing stops or in which
breathing is reduced so that oxygen intake is insufficient to support life.
Artificial respiration is a procedure for making air to flow into and out of a
person’s lungs when his natural breathing is inadequate or ceases .
The breathing process
Natural breathing is accomplished by increasing and decreasing the capacity
of the chest and the lung. During the inhalation phase of breathing
(inspiration), the muscles of the chest lift the ribs, expanding the chest.
At the same time the diaphragm contracts and descends toward the
abdomen. In this way, the chest cavities increased in size and air flows in.

Causes of Respiratory Failure

A. Anatomical Obstruction
The most common cause of respiratory emergency is interference with
breathing caused by the drooping of the tongue back and obstructing the
throat.
Other causes of obstruction that constrict the air passages are:
Asthma
Swelling after burns of the face
Swallowing of poisons

7 ABAARSO TECH UNIVERSITY | (Bashe Adem farah B.S.c in M.W )

 B. Mechanical Obstruction
 Solid foreign objects lodging in the respiratory passage e.g. choking of
food.
 Aspiration (Inhalation of any solid or liquid substance)
C Air Depleted of Oxygen or Containing Toxic Gases
Asphyxia – Is a condition in which there is a lack of oxygen in the
blood and the tissue do not receive an adequate supply of oxygen.
 It may occur due to decreased oxygen in the air or increased carbon
monoxide (CO) or other toxic gases.
D Additional Causes of Respiratory Failure are:-
Drowning Lung disease e.g. pneumonia
Circulatory collapse (shock) Electrical shock
Heart disease

Artificial Respiration and Management of Respiratory Accidents

A. Objectives:-
1. To maintain an open air way through the mouth and nose.
2. To restore breathing by maintaining an alternating increase and decrease
in the expansion of the chest.
General Information
The average person may die within 4- 6 minutes if his/her oxygen supply
is cut off.
Recovery is usually rapid except in case of carbon monoxide poisoning,
over dosage of drugs or electrical shock. In such cases, it is often necessary
to continue artificial respiration for a long time.

Mouth- to- mouth (mouth- to- nose”

Steps in mouth- to- mouth or mouth- to- nose respiration
Determine consciousness by tapping the victim on shoulder and asking
loudly ''Are you OK''?
Tilt the victim’s head back so that his/her chin is pointing upward. In this
case the two procedures can be applied, i.e. Head tilt- neck lift and head tilt.
Place your cheek and ear close to the victim’s mouth and nose.
Look at the victim’s chest to see if it rises and falls; listen and
Feel for air to be exhaled for about 5 seconds. If there is no breathing, pinch
the victim’s nostrils shut with the thumb and index finger of your hand i.e.
pressing on the victim’s forehead.

(Bashe Adem farah B.S.c in M.W ) |SHIFA UNIVERSITY BURAO 8

Steps for mouth to mouth respiration.
Open your mouth wide.
Take a deep breath.
Figure 1 Steps of mouth to mouth respiration (steps of opening air way)
Seal (close) your mouth tightly around the victim’s mouth and with your
mouth forming a wide open circle and blow into the victim’s mouth.
Initially give four quick full breaths without allowing the lungs to fully
deflate (empty) between each breath.
Maintain the head tilt and again look, listen, and feel forexhalation of air and
check the pulse for at least 5 seconds but not more than 10 seconds.
If no pulse and breath do cardiopulmonary resuscitation (CPR).
If there is pulse and no breath, provide at least one breathe every 5 seconds
or 12 per minute for adults and this provides sufficient air.
If the airway is clear only moderate resistance to blowing will be felt Watch
the victim’s chest to see when it rises.
Stop blowing when the victim’s chest is expanded and check for exhalation
Watch the chest to see that it falls.
Repeat the blowing cycle.
For the mouth -to -nose method maintain the backward head -tilt
Position with the hand on the victim’s forehead and use your other hand to
close the victim’s mouth. (fig.3).
Note: Mouth- to- mouth and -nose resuscitation are administered
For infants and children as described above except that the backward head
tilt should not be as extensive as that of adult.
Both the mouth and nose of the infant or child should be sealed off by your
mouth. Blow in to the infant’s mouth and nose once every 3 seconds
(About 20 times per minutes). But in the case of children blow once every
4 seconds (about 15 times per minute). The amount of air is determined by
the size of the victim.

D Obstructed airway - unconscious victim

If you are not getting air exchange, reposition the head and again attempt to
ventilate.
If you still do not get an air exchange immediately turns the victim
On his side towards you, resting his chest against your knees
And administer four sharp blows between the shoulder blades (fig.4).
Place the victim on his back (supine) and spread legs wide apart, straddle
his hips or one thigh. This position gives comfort for the first -aider.
Open the victim’s airway and sweep with the fingers.

9 ABAARSO TECH UNIVERSITY | (Bashe Adem farah B.S.c in M.W )

If the procedures are ineffective, you must repeat the sequence.
1 Attempt to ventilate.
2 Perform four rapid back blows
3 Perform four thrusts (push on the chest)

E. Obstructed Air Way - Conscious Victim: The urgency of this

Immediate recognition and proper action are essential if the victim has good
air exchange with only partial obstruction and is still able to speak or cough
effectively.
 Do not interfere with his attempts to expel foreign body.
 If the victim cannot speak or cough, shows a distress signal, appears
cyanotic or reveals an exaggerated effort to breathe, you must intervene
appropriately.

(Bashe Adem farah B.S.c in M.W ) |SHIFA UNIVERSITY BURAO 10

F. Ingested and Inhaled Objects (Choking)
A small piece of food or a bone (foreign body), may be inhaled in to
the wind pipe when eating. Most people on such occasions are able to
cough it up at once. Sometimes, however, this may not be possible
and help is needed.

For babies and small children (under one year)

Hold the baby upside down by the feet and smack him firmly between his
shoulder blades three to four sharp slaps (fig.5). If the obstruction is still
present
For Children (1-7 years)
Lie the child face down over your knee or arm and smack them sharply
between their shoulder blades three to four sharp slaps.

STEP ONE
If the obstruction is still present or the child is getting weaker
GIVE UP TO FIVE BACK SLAPS Check the mouth and remove any .
STEP TWO
 If the obstruction is still present
 GIVE UP TO FIVE CHEST THRUSTS
 Check the mouth and remove any obvious obstruction
STEP THREE
 If the obstruction is still present
 GIVE UP TO FIVE ABDOMINAL THRUSTS
 Check the mouth and remove any obvious.

11 ABAARSO TECH UNIVERSITY | (Bashe Adem farah B.S.c in M.W )

 STEP FOUR
If the obstruction is still present
GIVE UP TO FIVE ABDOMINAL THRUSTS
Check the mouth and remove any obvious
STEP FIVE
If the obstruction doesn’t clear after three cycles of back slabs, chest
Thrusts and abdominal thrusts DIALL FOR ANAMBULANCE
For Adults Method - A
Stand behind the patient and grasp them around the chest just under the chest
bone (sternum). Give a sharp bear hug (fig.6).

STEP ONE
Method - B
Tell the patient to lean over the back of the chair holding on to the seat
and then bang him sharply three or four times between his shoulder
blades. Whichever method you use, the foreign body should be coughed
out.

Drowning
Death caused by water reaching the lungs and either causing lung tissue
damage or spasms of the air way that prevents the inhalation of air. Drawing
can happen in many different places, Lake, swamp and spring, rivers etc.

(Bashe Adem farah B.S.c in M.W ) |SHIFA UNIVERSITY BURAO 12

 First aid Management:
You should begin artificial respiration as soon as possible Do not wait to get
water out of the patient’s chest first If you cannot get air into his/her lungs,
quickly turn the patient on his/her side, putting his head lower than the leg
and push the body . Then give mouth-to-mouth artificial respiration.
If the condition of the victim is not improving refer the victim to the next
health facility.

S.A Questions
1. Define first aid
2. Describe reasons why first aid is given
3. What are the values of first aid?
4. What are the general directions to be followed while giving first aid?

13 ABAARSO TECH UNIVERSITY | (Bashe Adem farah B.S.c in M.W )

 UNIT THREE
Wound and Bleeding
Definition of wound
A wound is a break in the continuity of the tissue of the body either internal
or external.
Common Causes of Wounds:
Wounds usually result from external physical forces. The most common
accidents resulting in open wounds are accidental falls and handling of sharp
objects, tools, machinery and weapons.

Classification of Wound
1. Open: An open Wound is a break in the skin or
mucous membrane
2. Closed: A closed wound involves injury to underlying
tissue without a breaking the skin or mucous
membrane.
Types of Open Wounds
 Abrasions  Punctures
 Incisions  Avulsions
 Lacerations
Abrased Wounds
• The outer layers of the protective skin are damaged. It usually results when
the skin is scraped against a hard surface.
• Bleeding is limited.
• Danger of contamination and infection is high.

(Bashe Adem farah B.S.c in M.W ) |SHIFA UNIVERSITY BURAO 14

Incised Wound
It frequently occurs when body tissue is cut on knives, rough edges of
metal, broken glass or other sharp objects.
Bleeding may be rapid and heavy.
Deep cuts may damage muscles, tendons and nerves.

Lacerations
• It is jagged, irregular or blunt breaking or tearing of the soft tissues and is
usually caused when great force is exerted against the body Bleeding may
be rapid and extensive.
• Destruction of tissue is greater in a lacerated wound than in acute.
Deep contamination of the wound increases the chance for later infection.

15 ABAARSO TECH UNIVERSITY | (Bashe Adem farah B.S.c in M.W )

 Puncture
It is produced by objects such as bullet and pointed objects like pins, nails
and splinters.
• External bleeding is usually quite limited. Internal damage may have
resulted to the organs causing internal bleeding.
• The hazard of infection is increased because of the limited flushing action
of external bleeding Tetanus may develop.

Common Causes
Cause or resulting in open wounds from:
 Motor accidents
 Fall
 Mishandling of sharp objects, tools and machineries
The main aims when dealing with wound
 To control the wound stop bleeding
 To treat and prevent shock
 To protect the wound from contamination and infection
 To prevent complication
 Obtain medical attention
Prevention of contamination and infection
 Hand washing before and after wound care (when
possible)
 By avoiding contaminates
 By using lean materials as much as possible
E.g. cotton gauze, towels etc...
 Wash in and around the victim’s wound to remove
bacteria and other foreign Matters
 Apply a dry sterile bandage or clean dressing and secure
it firmly in place

(Bashe Adem farah B.S.c in M.W ) |SHIFA UNIVERSITY BURAO 16

 Bleeding
Definition: Defusing or oozing of blood from blood vessels
(Hemorrhage)
Types of bleeding

Arterial bleeding- bright red in color, flow from the wound

inside Blood loss
Venous bleeding – dark red in color, flow is steady
Capillary bleeding –oozing from bed of capillaries, red in
color, usually less bright than arterial blood with slow flow.

First Aid for Severe Bleeding

Need for Immediate Action:-The reason why intervention of first aider
needed is to stop any large rapid loss of blood and to treat for shock and
prevent death.

Methods of controlling bleeding externally

Direct pressure- using compresses Pressure bandage can be placed to hold
pads of cloth.
Put a thick pad of cloth held between the hand and wound.
Elevation
The injured part of the body should be raised about the
victim’s heart applying pressure on the supplying artery
especially on brachial artery in severe bleeding,

Direct pressure and

elevation

Apply tourniquetin sever bleeding Pressure point:

Direct Pressure Tourniquet

17 ABAARSO TECH UNIVERSITY | (Bashe Adem farah B.S.c in M.W )

How to recognize internal bleeding
Initially, pale, cold, clammy skin. If bleeding continues, skin may
Turn blue- grey (cyanosis).
Rapid, weak pulse
Thirst
Rapid, shallow breathing
Confusion, restlessness, and irritability.
Possible collapse and unconsciousness
Bleeding from body openings (orifices)

(Bashe Adem farah B.S.c in M.W ) |SHIFA UNIVERSITY BURAO 18

 UNIT FOUR
Shock
Definition Shock is a condition resulting from a depressed state of many vital
body functions due to decreased tissue perfusion. It is a condition that could
threaten life.
Traumatic shock, electrical shock, insulin shock, hypovolemic shock and other
special forms of shock are among the various types of shock.
The reaction of the body to the failure of the circulatory system to
provide enough blood to all-the vital origins of the body.

Causes
Hemorrhage
Severe vomiting and diarrhea.
Burn.
Infection.
Heart attack or stroke.
Poisoning by chemicals gases, alcohol or drugs.
Other causes like stress, pain, temperature instability, and delay
of treatment. And many other underlining causes.
The main types of shock include:
Distributive shock
– a result of the lack of distribution of blood to the organs
Obstructive shock
– results from an obstruction to blood flow at a site other than the heart
– Cardiogenic shock (due to heart problems)
Hypovolemic shock (caused by too little blood volume)
Anaphylactic shock (caused by allergic reaction)
Septic shock (due to infections)
Neurogenic shock (caused by damage to the nervous system)

19 ABAARSO TECH UNIVERSITY | (Bashe Adem farah B.S.c in M.W )

Symptoms of shock
Pale or bluish skin and mucus membrane, cold extremities to touch.
Moist and clammy skin.
Weakness.
Perceptible in the carotid artery Rapid and shallow breathing
especially in case of abdominal And chest injury.
Low blood pressure.
Restlessness, anxiety severe thirst, vomiting or retching.
The victim’s eyes are sunken with a vacant expression, and his
pupils may be totally dilated.
Unconsciousness and hypothermia, finally death

First aid management of shock

 Have the patient lie down and stay at rest
 Keep the air way open and preventing the forward tilting
of the head
 Control External bleeding
 Keep the patient warm by covering with blanket or sheet
 Properly position the patient
 Open air way and alert for vomiting

Treatment Objectives
 To identify and treat the cause.
 To improve circulation.
 To ensure an adequate supply of oxygen
 To maintain normal body temperature.
 To transfer the patient to health facility immediately.

First Aid Measures

Body Position
It must be based on type of injuries. The most satisfactory position
for the injured person will be lying down to improve the circulation
of the body.
If injury is on the neck or spine, don’t move the victim until he is
Prepared for transportation.
A person with a head injury may be kept flat or propped up but his
head must not be lower than the rest of his body.
Raise foot of the stretcher or bed from 20-30 inches for other types of
injuries.

(Bashe Adem farah B.S.c in M.W ) |SHIFA UNIVERSITY BURAO 20

B. Regulating Body Temperature
Keep the victim warm enough to avoid or overcome chilling. If the victim is
exposed to cold or dampness, blankets or additional clothing should be
placed over and under him to prevent chilling.

C. Administering Fluids
Don't give fluid by mouth if:
• Victim is unconscious
• Victim is vomiting or about to vomit and having a convulsion.
• When a victim likely to have surgery or anesthetic or have brainor
abdominal injury.

N.B.
When the victim is conscious give plenty of fluids prepared from half
teaspoon of salt, two to three table spoon of sugar or honey and some orange
or lemon juice in a litter of water.
Encourage the victim to drink as often as possible especially until he/ she
urinates frequently.

S.A Questions
1. Define shock.
2. List different causes of shock.
3. What are the main signs and symptoms of shock?
4. What are the first aid measures for shock?

21 ABAARSO TECH UNIVERSITY | (Bashe Adem farah B.S.c in M.W )

 UNIT FIVE
Burn of the Body
Fire is an accident that causes great damage to life and
properties. Children are the most vulnerable to burn. Burns
that occur around the mouth and nose and in general in the
face are more dangerous and can cause death.

Causes of burns:
 Fire, boiled water, steam, boiled oil and milk etc;
 Sun-rays;
 Electric and thunder accidents; and
 Different chemicals;

Effects/hazards of the burn accident:-

Immediate effects/hazards:-
 Burns and wounds of the body;
 Severe pain;
 Reduction of body fluid from the wound;
 Difficulty in breathing because of suffocation from
smoke, severe burns around the throat and face; and
 Drowsiness, restlessness and unconsciousness.

Delayed effects/hazards:
 Infections of the wound, septicemia, and high fever;
 Disability;
 Scar;
 Contracture; and
 Tetanus infection
Classification of burns:
Burns are usually classified in three levels based on the depth
or degree of skin damage. These are:-
 First degree burn;
 Second degree burn, and
 Third degree burn.

(Bashe Adem farah B.S.c in M.W ) |SHIFA UNIVERSITY BURAO 22

1st degree burn:
 Redness or discoloration;
 Mild swelling and pain; and
 Rapid healing.

2nd degree burn:

 Greater depth than first degree burns;
 Redness and mottled appearance;
 Blisters;
 Severe pain;
 Swelling; and
 Prone to infection.

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3rd degree burn:
 Deep tissue distraction;
 White appearance;
 No pain and blisters; and
 Complete loss of all layers of skin.
This type of burn results in severe disability and/or death.

First-aid measures:
If the victim is burned with fire apply cold applications,
immerse the burned area in cold water role the burned person
on the ground, or cover with water socked thick cloth or
blanket and put out the fire. If the accident is of electric
source, quickly
Disconnect at the electric meter or check point, or use rope
wooden stick, dried cloth etc. to disconnect;
Move the victim from the accident place to avoid further injury
If the victim is not breathing properly, initiate mouth to
mouth artificial respiration;
Thoroughly check the wound to determine the size, and the
degree of burn;

(Bashe Adem farah B.S.c in M.W ) |SHIFA UNIVERSITY BURAO 24

Measures for 1st degree burn:
 Apply cold water application or submerge the burned
area in cold water;
 If the wound is minor and small, clean daily the area
with boiled cold water cover it with clean cloth to
prevent contact with flies, if the wound located is in a
joint, immobilize the joint area until the wound is cured;
 If the wound is from boiled water, chemical (acid), take out his/her dress
and cover it with clean cloth
2nd and 3rd degree burn:-
 Cover the wound with clean cloth;
 If the victim is conscious, his/her respiratory parts such as
mouth, nose and throat are free from burn injury and give
him/her frequently plenty of liquid such as ORS or
similar solution (prepare the solution from eight tea
spoons of sugar, one spoon salt in one liter of boiled cold
water). If the victim is a child below two years old give it
one spoon every two minutes and if the child is over two
years give it with a cup or glass in small amount every
two minutes;
 Advise the victim or his family to get tetanus toxoid
vaccine;
 Refer the victim to the nearest health facility

Follow up and education on preventive measures:

 Educating on the consequence of severe burns and the
importance of referring the victim to a nearby health
facility;
 Education to prevent using harmful foreign substances on
the burned area, frequent touching of the wound, moving
joints etc; and
 Identify the causes of the burn accident and give
appropriate education to the family and the community.

25 ABAARSO TECH UNIVERSITY | (Bashe Adem farah B.S.c in M.W )

Measure to prevent burns:
 Keep away from children items such as matches,
burning lamp and candles;
 Prepare and place stoves and other cooking
installations in a safe way. E.g. locally made standing
stove;
 Keep away from fire inflammable materials and don’t'
come with materials such as nylon close to fire-place;
 Educate smokers not to smoke inside a house and if
they smoke give them strict advice to put off the
burning left over cigarette;

(Bashe Adem farah B.S.c in M.W ) |SHIFA UNIVERSITY BURAO 26

 CHAPTER SIX
Poison
Definition: A poison is a substance which, if taken in to the body in
sufficient quantity, may cause temporary or permanent damage. Poisons can
be swallowed, absorbed through the skin, inhaled, splashed in to the eyes, or
injected. Once in the body, they may inter the bloodstream and be carried
swiftly to all organs and tissues. Signs and symptoms of poisoning vary with
the poison- they may develop quickly or over a number of days. Vomiting is
common if it has been ingested and breathing difficulties if inhaled.
The extent of danger depends upon:
The amount and type of poison
The age of the person
Whether the person vomits
Where the accident takes place

There are different types of poisons:

- Acids - Sleeping pills
- Insecticides (sedatives)
- Alkali - Mercury
- Drugs given for - lead
allergy - Paraffin, petrol
(antihistamines) (Gasoline)
-Aspirin over dose in
children

General signs and symptoms

 Nausea  Change in consciousness
 Vomiting  Change in vital signs
 Abdominal pain  Change in pupils

Frequent causes of poisoning

• Aspirin overdose especially in children.
• Improper storage and disposal of poisonous substances.
• Improper handling of spray equipment including the mixing of pesticides,
insecticides and weed killers.
• Inhalation or swallowing of poisonous substance.
• Over doses of drugs taken either accidentally or with suicidal intent
combining some drugs and alcohol
27 ABAARSO TECH UNIVERSITY | (Bashe Adem farah B.S.c in M.W )
Examples of poisons around the home
Poisonous substances within the home environment are extremely
Prevalent and it would be difficult to name all of them. A few typical
Household poisons are listed below:
Cosmetics and hair preparations
Paint and turpentine
Strong detergents
Bleaches
Cleaning solutions
Acids
Ammonia
Poisonous plants
DDT

Ways in which poisoning may occur

• Through the mouth (by ingestion)
• Through the skin (by absorption)
• Through the lung (by inhalation)
• By injection
Signs and Symptoms of Poisoning
Symptoms of poisoning vary greatly. Aids in determining whether or
not a victim has swallowed poison include:
• Presence of a container known to contain poison.
• Conditions of the victim (sudden onset of pain or illness).
• Burns around the lips or mouth.
• Pupils of the eyes contracted to pinpoint size from an over dose
of morphine or similar drugs.

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Objectives in treatment of poisoning by mouth
The objectives in treatment of poisoning by mouth are:
• To dilute the poisons quickly as possible.
• To seek medical advice from a physician or a poison control center.
• To maintain respiration or circulation.
• To preserve vital functions and to seek medical assistance without delay.

First aid measures for poisons swallowed through mouthfor a conscious victim
In most cases, the first-aider can try to remove the poison from hisbody by
inducing vomiting.
• Give him a drink of tepid water with soap in it.
• Repeat the procedure of inducing vomiting until the vomiting isclear.
• Safe the label or container of the suspected poison for identification. If the
victim vomits safe a sample of the vomited material for analysis.

For unconscious victim

• Maintain an open airway and administer artificial respiration.
• Don’t give fluids and don’t induce vomiting.
• If the victim is vomiting, position him and turn the head so that the vomits
drains out of the mouth. Safe the label or container of the suspected poison
for identification. If the victim vomits safe a sample of the vomited material
for analysis.
First aid for victim having convulsion
• Do not attempt to restrain the victim but position him in a way that he
should not injure him self
• Loosen tight clothes at the victims neck and west Watch for an obstruction
of air way and attempt to correct behead positioning, if necessary give
artificial respiration.
• Do not give any fluid
• Do not induce vomiting
Poisons enter the body either accidentally or intentionally through
 Ingestion (through the mouth)
 Inhalation (by breathing in)
 Absorption (through the skin) through contact with
poisonous sprays, pesticide, and insecticides
 Injection into the skin as the result of bites from some
animal, insects, poisonous fish or by syringes

29 ABAARSO TECH UNIVERSITY | (Bashe Adem farah B.S.c in M.W )

Steps to treatment of poison:
 Remove the poison from the body
 Give the patient the antidote
 Treat symptoms
 Give comfort and confidence
How to remove the poison from the body
 Make the victim vomit it
 Give plenty of tape water.
 If it is a child give them syrup or water.
 Repeat the procedure
 Refer the victim if it is not improving
NB. Do not make patient vomit if the poison e.g. paraffin or kerosene
- Do not make the patient vomit if unconscious
- For poisoning by acid, give alkali, anti acids

(Bashe Adem farah B.S.c in M.W ) |SHIFA UNIVERSITY BURAO 30

 UNIT EIGHT
Bites
A. Snake Bite
Signs and symptoms
 Disturbed vision
 Feel nauseated or vomiting
 One or two small puncture wounds with sharp pain and
local swelling
 Symptoms and sign of shock
 Sweating and salivation in advanced stages of venom
reaction
First aid management
 Lay the victim down and advise not to move Calm the victim
 Immobilized the affected part and keep it below the level
of the heart
 Wipe the wound of venom
 Apply firm cord just above the bite
 This must be removed in 15 minutes if you are sure that
anti venoum has been injected and you cannot get the
victim to hospital in time. If there is no anti venoum do
the following
 Tie a cord tightly around the limb just above the bite
 Using a razor blade or a clean knife make a cut 1 cm deep
 Suck the liquid which is coming out of the wound
 Continue to suck and dispose for 5-10 minutes
 Loosen the cord around the patients limb
 Disinfect the wound
 Refer to hospital for anti- venom injection.

31 ABAARSO TECH UNIVERSITY | (Bashe Adem farah B.S.c in M.W )

 Snake bite
B. Dog bite
Rabies is a sickness due to an infection from an animal
usually rabid dog, cat, fox, and, wolf. The infection grows in
the animal’s nerves, may develop the disease, if the saliva
enters a wound or scratch on a human being.

Signs and symptoms of a rabid dog.

Has difficulty in swallowing
Does not want food, but swallows, pieces of wood stone
Barks in unusual way and never stop barking
Saliva runs out of its mouth
First aid management
1. Clean the wound with soap and water
2. Cover the wound with dressing ointment/powders
3. Find out if anyone knows the dog that bit the patient
4. If the dog known, ask its owner to watch the dog
- See, during that time, it begins to show any of the above signs and
symptoms
- get the dog Killed
- Send the person to hospital or Health center immediately for antirabies
vaccination

(Bashe Adem farah B.S.c in M.W ) |SHIFA UNIVERSITY BURAO 32

 UNIT NINE
Fracture
Fracture:
Description: Is a breakage of bone tissue or discontinuation
of bone tissue due to different causes or accidents.
Possible cause:
 Accident / trauma
 Pathological due to bone infection
 Tumor of the bone
Types of Fracture
Closed fractures- closed (simple) fractures are those not associated with
open wounds on the surface of the body
Open fractures– open (compound) fractures are those associated directly
with open wounds

Signs and symptoms of fracture:

- Pain - protruding of the parts
- Swelling - mispositions
-Deformity - Unable to function
-Numbness or tingling sensation - Patient may shout due to
-Discoloration severe pain

33 ABAARSO TECH UNIVERSITY | (Bashe Adem farah B.S.c in M.W )

Complications
Immediate complications
 Hemorrhage/ bleeding
 Severe pain
 Hypotension ( shock) due to bleeding
Late complications
 Disability  Malunion
 Disfiguring  Delay in union
 Deformity
Objectives of first aid
To prevent blood lose
To keep the broken bone ends and the adjacent joints from moving.
To transport the victim to hospital
To give care for shock.
To relief pain
First aid principles
• Rescue if necessary and protect against further injury.
• Maintain an open air way and apply artificial respiration if indicated.
• Call for an ambulance or medical assistance if indicated.
• Prevent movements of the injured parts and the adjacent joint.
• Elevate involved extremities if possible without disturbing the suspected
fracture.
• Remove or cut away the victims clothing.
• Control hemorrhage by applying pressure through a large sterile
or clear dressing over the wound.
• Don't wash, or probe or do not insert your fingers in to the wound.
• If a fragment of bone is protruding, cover the entire wound with sterile
dressing

(Bashe Adem farah B.S.c in M.W ) |SHIFA UNIVERSITY BURAO 34

General First aid management of Fracture
 Assess carefully but by fast
 Check respiratory condition
 Check bleeding / hemorrhage
 Consider the amount of loss
 Determine and arrange referral
 Asphyxia, bleeding, and severe wounds must be dealt
with before treating any fracture
 Support the injured part with supporting device,
immobilize the fracture, bandaging and use splints
 Refer the patient to hospital urgently
NB: Proper immobilization is important to prevent further trauma, pain and
complications.

Fracture of the hummers (The bone of the upper arm)

First aid for a closed hummers fracture
• Place a pad in the victim’s arm pit, apply a splint or improvised splint tied
in place above and below the break area.
• Support the forearm with a sling that doesn’t produce upward pressure at
the fracture site.
• Bind the victim’s upper arm to his chest wall.

35 ABAARSO TECH UNIVERSITY | (Bashe Adem farah B.S.c in M.W )

First aid measure for an open fracture
• Remove the victim’s cloth
• Control bleeding by applying direct pressure and elevating the part
• Cover the wound with a large sterile or clean dressing and apply
a splint that does not press against the area of the break. • Do not attempt to
cleanse the wound and push a protruding bone back • Arrange for
transportation as soon as possible
N.B. Remember that the three places to immobilize a fracture of the upper
arm are:
Broken bone ends
Shoulder
Elbow

Elbow fracture
Elbow fractures may involve the lower part of the hummers or the upper
bones of the forearm.
First aid measures
• Place the victim’s forearm in a sling and bind it to his body (if the elbow
can be bent).
• If the elbow cannot be bent, immobilize the fracture at the upper arm, at
the elbow and at the wrist against the chest and the abdomen and at the hip.
• Lie the victim down and elevate the arm.
• If a splint is not available, wrap a pillow about the arm centering it at the
elbow and tie or pin the two sides together.
Fracture of fore arm and wrist
The two bones of the fore arm (ulna and radius) may be fractured
Individually or together.
First aid measures
Fractures in the mid portion of the fore arm and wrist are treated in
the same way as fractures of the shaft of the humerus.
Immobilization of an injured part with bandage.
Dislocation
Definition:- When bone is no more in an anatomical position
or the displacement of one or more bone at a joint.
Cause:-
 -Strong force acts directly or indirectly on a joint
 Sudden muscular contraction
N.B:- Joints which are most frequently dislocated are shoulder, elbow,
thumb, finger, Jaw

(Bashe Adem farah B.S.c in M.W ) |SHIFA UNIVERSITY BURAO 36

Signs and symptoms
Pain, near the joint, victim cannot move it, deformity-
abnormal appearance, swelling and brusy are usually
present
First aid and manage:-
support and secure the part in most comfortable
position
obtain medical aid at once
Do not attempt to replace the bones to normal position

Note: - The causes, the signs and symptom

First aid management, quite similar to fracture.
NB. Do not delay to refer patient with fracture or dislocation
since proper investigation and management is done at
hospital

Elbow dislocation

Strain and Sprain

Strain
Definition: over stretching of muscles due to over pulling of muscles.
Causes:
Lack of pre- exercise before doing sport activity
Lifting of heavy loads
Lifting of heavy weight
The most common one is back strain.

37 ABAARSO TECH UNIVERSITY | (Bashe Adem farah B.S.c in M.W )

 Signs and symptoms
Pain (sudden sharp pain at the site of the injury)
Stiffness of muscles
Difficulty in moving the affected parts
Management and First Aid
Place the victim in the most comfortable position
Cold compress during fracture phase Warm compress
(physiotherapy)
Ant pain support and elevate the inured part or limb
and If not improved refer the victim
In case of back strain use a hard board under the bed
or lay the victim down on a firm surface
Sprain
Definition: An injury which occurs at joints when the
ligaments and tissue around particular joints are suddenly
twisting or torn.
Sprain is more severe than strain
It usually happens or occurs at joint especially at ankle joint.
It might involve bone (broken)
Sprain is also tearing of ligaments8
Signs and symptoms
Pain specially on movement
Swelling
Loss of movement
Treatment:
Raise the limb
Put on a cold compress
Renew the compresses when they get warm and dry
Support the joint in most comfortable position with
bandage
Bandage firmly with figure of eight bandage - Refer
for further treatment

Bandaging of sprain ankle

(Bashe Adem farah B.S.c in M.W ) |SHIFA UNIVERSITY BURAO 38

 UNIT TEN
Eye, Ear and Nose Injury to the eye
- Injury to the eye
- Since the eyes are delicate, they can be affected easily therefore; immediate help should
be given.

Signs and symptoms

Pain inside the eye
Wound or cut around the eye ball
Different between the size of eye ball
Sight decreases
Inflammation and infection
Management of the eye injury
Avery light covering be applied to an injured eyes
Do not apply pressure
Reassure the patient
If no improvement in few days, Refer the victim to the
nearest health facility
Foreign bodies in the eyes:
A foreign can be; dust, ash, particles of sands, or small fly etc.
Often you can remove foreign from the eyes by flooding it with
taped boiled water.
If no improvement in few days, Refer the victim to the
nearest health facility
Foreign bodies in the eyes:
A foreign can be; dust, ash, particles of sands, or small fly
etc. Often you can remove foreign from the eyes by flooding
it with taped boiled water.
If it does not work:
Instruct the patient not to rub his eyes, while the patient is looking
up; gently draw the lower lid down and out. If the foreign body is
seen on the lower lids remove it with moistened cotton wool or
the corner of a clean hand kerchief,

39 ABAARSO TECH UNIVERSITY | (Bashe Adem farah B.S.c in M.W )

If it does not
Stand behind the patient
Carefully place a smooth match stick at the base lid
and pull and turn it inside out over the math stick
Remove the often body with wisp of cotton wood
Note: - Do not try to remove a foreign body from the eye ball
If an acid or alkali gets in to the eye, this can be very dangerous
hence, flood the eye with running water for several minutes

Hold the affected side of the eye

First aid treatment of Chemical burn

Problems with ear:
Bleeding from the ear:
Bleeding from the ear may be due to broken (fractured) skull
 Cover the ear with a clean material (sterile if available)
dressing.
 Do not plug the ear with wool
 Do not put in drops
 Refer the victim to the nearest health facility
Foreign body in the ear:
Turn the patient’s head to the affected part of the ear
so that the foreign body may drop out.
If it is an insect which is inside the ear, direct torch-
light to the ear- the insect may follow the light and
come out of the ear. If this does not succeed
Pour in taped boiled water, the insect may float out
If neither these treatment is successful refer the client
to the next health facility.

(Bashe Adem farah B.S.c in M.W ) |SHIFA UNIVERSITY BURAO 40

Bleeding from the Nose:
If the foreign body is either beans, peas, avoid putting
water or any fluid
Get the patient to pinch the lower part of his nose
firmly for 10 minutes, while breathing through his
mouth
Loose tight clothing around his neck
Tell the patient not to blow his nose for several hours
If bleeding persists, refer the client to the next health facility

How to stop a nose bleed

41 ABAARSO TECH UNIVERSITY | (Bashe Adem farah B.S.c in M.W )

Foreign body in the nose:
In an adult, a foreign body may enter the nose by accident, but mostly
common in children who insert a pea or a bean in to their noses.
NB. - Do not attempt to remove it, refer to the next health facility

Foreign body in the nose

Glossary

1. Fracture: The breakage of bone tissue or interruption of continuation of

bone tissue
2. Dislocation: it is the separation of bone at Joint abnormally
3. Sprain: over pulling or over stretching of ligament (tearing of ligaments)
4. Strain: over stretching of muscles of different parts of the body
5. Unconsciousness: when a person is unable to aware or respond to
External stimuli or objectives such as place, people and time (Disoriented)
6. First aid: The treatment gives when an accident o sudden illness occurs
7. Respiratory Arrest: When the breathing stops it the airways becomes
blocked due to different accidents
8. Drowning: The condition that happens to air way such as sea, liver lake,
bath, spring, while swimming and soon
9. Cardiac arrest: Stopping of heart function to different causes.
10. Wound: is the continuity of the tissue if the body ether internal or
External.
11. Bandage: is a material used to keep splint and dressing place and also
to apply pressure
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12. Causality: a person he seeks first aid treatment until he reaches Hospital
(Vic timed person).
13. Burns: When the skin of the body is a burned or destroyed by burning
causing factors.
14. Poison: when substances that are very toxic to the body hitter they reach
to digestive system by swallowing
15. Antidotes: substances which neutralizes
16. Pain: sensation of Discomfort just like sharp knife
17. Abortion: is expulsion of the fetus stimulation
18. Complete abortion: When the placenta are expelled
19. Incomplete abortion: when the fetus comes out but pieces of placenta
after birth remain in the womb
20. Fit: Jerking movements which can be controlled(convulsion)
21. Fever: Height body temperature
22. Hypothermia: Temperature below normal
23. Split: Any firm material that helps to support the fractured bone or part

References

1. Skeet, Muriel. First aid for community health worker to developing

countries, 1984
2. American, Red Cross standard first aid and personal safety second edition
new work 1978
3. Caroline L.Nacy. Emergency care in the streets U.S.A1979
4. Warner L. Germanie emergency cares assessment and intervention 3
edition, Moset comp. London 1983
5. J.David Bergeron and GloriaBizjak. Brady, First Responder, Fourth
edition1996by prentice Hall,IncSimon&Schuseter/AViacon Company USA.
6. Dorling Kindersley, St.John Ambulance& St. Andrew’s Ambulance
Association, First Aid Manual,1985.
7. St. John Ambulance Association and Brigade. Essentials of first Aid, 1974
8. Warner D. Where there is no Doctor: Village care hand book for African
1993.
9. Health Education department: First-Aid training manual. Addis Ababa
1983.

43 ABAARSO TECH UNIVERSITY | (Bashe Adem farah B.S.c in M.W )