SECTION E

FIRST AID
CONTENTS

1. Introduction………………………………………………………..pg 2
2. Equipment necessary……………………………………………..pg 2
3. Examples of emergencies…………………………………………pg 3
4. Coping with emergencies/protecting the first aider……………….pg 2
5. Asthma……………………………………………………………pg 4
6. Disorder of consciousness………………………………………..pg 4
7. Head injuries……………………………………………………..pg 5
8. Diabetes mellitus…………………………………………………pg 6
9. Epilepsy…………………………………………………………..pg 7
10. Convulsions in children…………………………………………..pg7
11. Fainting…………………………………………………………..pg 8
12. Stroke…………………………………………………………….pg 8
13. Heart attack………………………………………………………pg 9
14. Bleeding …………………………………………………………pg10
15. Shock…………………………………………………………….pg 10
16. Cuts and grazes…………………………………………………..pg 11
17. Bruising………………………………………………………….pg11
18. Burns &scalds…………………………………………………..pg 12
19. Clothing on fire…………………………………………………pg 12
20. Chemical burns…………………………………………………pg 12
21. Electrical burns…………………………………………………pg 14
22. Friction burns……………………………………………………pg 15
23. Sunburns…………………………………………………………pg 15
24. Bone, joint and muscles injuries…………………………………pg 16
25. Fractures…………………………………………………………pg16-19
26. Sprains and strains……………………………………………….pg19
27. Dislocated joints…………………………………………………pg 19
28. Muscle cramps…………………………………………………..pg 19
29. poisoning…………………………………………………………pg 19
30. bites &stings……………………………………………………...pg 21
31. Anaphylactic shock………………………………………………. Pg21
32. effects of temperature……………………………………………..pg22
33. heat strokes……………………………………………………….pg 24
34. foreign bodies in the eye, ear &nose……………………………...pg 25
Follow the ABCs of resuscitation if the casualty is unconscious, check his response and ensure
that he’s breathing.

Get help if necessary. Call the emergency services.ideally gets someone else to call while you
stay the casualty and initiates care.

Treat the most serious conditions first before they become life threatening.

Support any broken bones or injured limbs.

EXAMPLES OF EMERGENCIES

BREATHING AND CIRCULATION

cardiopulmonary resuscitation

 choking
 asthma

DISORDERS OF CONSCIOUSNESS

 head injuries
 diabetes mellitus
 epilepsy
 convulsions in children
 fainting
 stroke
 heart attack

WOUNDS &BLEEDING

 bleeding &its management

 internal bleeding and shock
 cuts, grazes and bruising

BURNS &SCALDS

 Types of burns
 Treatment of burns
 Face and head burns
 Electrification
  Sunburns

BONE, JOINT &MUSCLE INJURIES

 Treating broken bones

 Sprains &strains
 Dislocated joints
 Cramps

POISONING

 Ingested ,inhaled, injected

 Skin contact
 Insect and snake bites
 Anaphylactic shock

CAUSES OF UNCONSCIOUSNESS

May be gradual or sudden.

Can be the result of an injury or an illness. Common causes include:

- Head injury
- Conditions that prevent blood containing oxygen getting in to the brain such a s heart
failures, severe bleeding, blockage in the arteries that supply blood to the brain(stroke) or
fainting
- Conditions that prevent oxygen entering the lungs e.g. chest injuries, electrical injury,
blocked airway, or lack of oxygen in the air
- Poisoning
- Some illness or conditions such as epilepsy,diabetis,hypothermia or heat exhaustion

HOW TO TREAT AN UNCONSCIOUS CASUALTY

 Check the response by talking to the casualty, gently shaking his shoulder s or pinching
the skin on the back of his hand
 Tilt his head and lift the chin to open airways
 Check the casualty breathing.look,listen and feel for up to 10seconds
 If the casualty is breathing treat life threatening conditions such as serious bleeding
 Put the casualty in the recovery position
 Check the pulse and look for other signs of circulation
 If you suspect a spinal injury, take extra care to keep the head and neck aligned while
turning the casualty.
  Call for medical help.
 Regularly check the breathing pulse and response until help arrives.

HEAD INJURIES

Any blow to the head heavy enough to cause a bruise or a scalp wound can fracture the skull and
or result in concussion

Concussion is a short period of impaired consciousness caused by shake up of the brain in the
skull

Concussion can also result from an indirect force.

Concussion is usually followed by complete recovery

If the recovery is not rapid and complete the casualty should see a doctor as soon as possible

There may be delayed effects such as swelling of the brain leading to deepening of
unconsciousness

SIGNS AND SYMPTOMS

- A period of unconsciousness
- Casualty may be dazed and confused as he regains full consciousness
- Casualty may vomit
- Casualty may not remember the incident or anything that happened immediately before
it.

IF THERES A SKULL FRACTURES, THERE MAY BE:

- Blood or blood stained fluid coming from inside the ear or nose
- Discolouration,bruising or redness around the eyelids or the white part of the eyes
- Bleeding from the scalp
- Possibly open fracture. This is particularly dangerous.

HYPERGLACEMIA

- High blood sugar levels can lead to unconsciousness and eventually coma
- Look for deep, heavy ,breathing, dry skin and rapid pulse
- Breath may smell of acetone
- If you suspect hyperglycemia call an ambulance and transfer the casualty to a medical
facility immediately.
EPILEPSY

This is a condition in which a person suffers from fits

It’s caused by disturbance of electrical activity in the brain

There are two main types of fits: Major or Tonic/clonic fits and minor fits.

Minor fits can sometimes pass unnoticed and the person may just appear to be daydreaming

SIGNS AND SYMPTOMS

- Sudden loss of consciousness. Casualty may let out a strange cry

- Casualty may become rigid
- Violent convulsive jerky movements
- At the end of an attack the muscles relax and the casualty returns to normal
- May be incontinent of urine and or/stool
- May have a period of confusion
- May sleep deeply after a fit

MANAGEMENT

-Never try to hold someone down or stop the convulsion

-Never put anything in their mouth

-Never try to give a person anything to eat or drink during a fit

-If possible try to ease the casualty’s fall. Keep calm and try to stop on lookers rushing to the
casualty. There is little you can do to help.

-Let the fit run its course without interference

-Clear a space around the casualty so that he/she does not hurt himself. Protect the casualty from
any danger.

-If possible loosen any tight clothing on the casualty and protect the head.

-When the fits stops open airway, check for breathing and turn the casualty into a recovery
position until recovery is complete.
The fits last more than 5mins, unconsciousness more than 10minutes if consciousness is not
retained between fits or if this is the person first fit call an ambulance and transfer the casualty to
a health facility as soon as possible.

CONVULSIONS IN CHILDREN

Occur mainly in young children between the ages of 1-4years

Generally caused by high temperatures

Usually not dangerous and problems rarely occur afterwards

SIGNS AND SYMPTOMS

- The child may be flushed and sweating

- The back may stiffen and arch
- Eyes may be rolled upwards
- The child may hold breathing
- Consciousness may be lost

MANAGEMENT FOR A CONSCIOUS CASUALTY

 Lay casualty down making sure that head and shoulders are slightly raised
 Tilt the head to one side. Wipe any dribbling if present
 DO NOT allow the casualty to eat or during
 Call an ambulance.

FOR UNCONSCIOUS CASUALTY

 Open airways check for breathing and resuscitate if necessary.

 Place in recovery positioning and ensure that the airway remains open
 Monitor and record breathing pulse and responses at regular intervals
 Call an ambulance.

HEART ATTACK

Usually occurs when blood supply to a part of the heart muscles becomes blocked by a blood
clot in one of the coronary arteries.

Severity of the attack depends on the extent of muscles damage.

IF SUSPECTED-TRANSFER THE CASUALTY TO A HOSPITAL AT ONCE.

SIGNS AND SYMPTOMS

- Severe crushing pain in the centre of the chest that may radiate down the casualties left
arm
- Breathlessness, faintness and nausea
- Pale, cold and clammy skin
- Rapid, weak or irregular pulse
- Casualty may feel a sense of impending doom
- Casualty may collapse suddenly

MANAGEMENT

 Place the casualty in a comfortable position to lessen the strain on the heart
 Usually this is a sitting position with the back and shoulders supported and the knees bent
and supported.
 Monitor breathing and pulse and be ready to resuscitate
 If the pain continues and the casualty conscious give him an aspirin to chew slowly
 Call an ambulance.

BLEEDING

TYPES OF BLEEDING

A) External and internal

b) Artery, capillary&vein

Allow the blood to drain away so a to reduce infection

 Do not attempt to plug the ear

 Get the casualty to lie down with the head and shoulder raised
 Gently place a dressing over the injured ear
 Tilt the head towards the injured side

Yellowish bloodstained fluid coming from the other either the nose or the ear after a blow to the
head may mean the casualty has fractured skull.

Cover the ear or the nose with sterile padding lay down the casualty with head and shoulder
raised and transfer to a medical facility

CUTS AND GRAZES

Small cuts and grazes, the bleeding soon stops on its own. However any break in the skin can get
infected. The aim is to clean and dress the wound as soon as possible to prevent an infection
from developing
  Put on a pair of latex gloves
 Rinse the wound under cold running water
 Carefully clean the area around the wound
 Remove any loose foreign matter from the wound
 Do not try to remove anything that is embedded in the wound
 Gently dry the area around the wound
 For a large cut or graze ,apply an antiseptic cream and a sterile dressing
 Secure it in place with a bandage
 Rest the injured part and elevate if possible.

BRUISING

Caused by an injury and the bleeding is just under the skin or the deeper tissues. The area often
becomes black.

The aim is to minimize swelling by cooling the area

 Apply a cold compress on the injury

 Support the injured part in the most comfortable position for the casualty
 Apply a sling appropriately

A black eye is a bruise normally caused by a blow to the face. It may also cause damage to the
eye or the skull. Always have this type of injury checked by a doctor

BURNS AND SCALDS

A burn or a scald can break the skins protective function and allow infection to occur

CAUSES

- Extreme dry heat

- Extreme cold
- Scalds are caused by extreme moist such as in boiling water or steam
- Chemical burns caused by strong acids or alkaline
- Friction burns
- Radiation burns caused by exposure to sunlight
- Electrical burns caused by direct contact with electricity

MANAGEMENT

 Do not remove anything sticking to the skin

 Cover the blunt area with a sterile dressing(polythene bag)
 Sit or lie the casualty down and reassure constantly
 Monitor the breathing pulse and responses
  Transfer to a medical facility as soon as possible

HEAD BURNS

May be dangerous because they can cause rapid swelling and inflammation of the airway.

Soot around the mouth may an evidence of internal burn. First aid treatment for an extreme case.
The swelling will rapidly block the airway and immediate medical attention is required

SIGNS AND SYMPTOMS

May develop features of shock

Mouth throat and head may be very painful

Will have difficulty breathing

May have damaged skin around the mouth

TREATMENT

- Get the casualty to a medical facility immediately

- Keep the airway open
- Get urgent medical attention
- Loosen any tight clothing
- Keep the burnt area cool
- Ensure an open airway
- Give oxygen if trained to do so

CHEMICAL BURNS-TO THE SKIN

SIGNS AND SYMPTOMS

- Chemical near the casualty

- Stinging pain
- Discolouration,swelling and blistering

TREATMENT

 Wash the chemical away by flooding the area(injured)under cold running water for
atleasts 20minutes to disperse the chemical
 Remove contaminated clothing while you are flooding the area
 After washing cover the area with sterile dressing
  Take or send the casualty to a medical facility

AIM&TREATMENT

- To relieve pain and minimize the risk of infection

- Wash the affected area carefully with the soap and water and rinse with clean water
- Gently dry the affected area thoroughly with clean pad
- Carefully cover the blister with a plaster. Make sure the blister pad is larger than the
blister
- If the blister is very large use a sterile dressing secured with adhesive tape or a bandage

SUNBURN

Overexposure to the sun without adequate protection can result in widespread superficial burns
and in severe cases blistering. The casualty’s skin feels very hot.

AIM&TREATMENT

- To take the casualty out of the sun, cover the skin with light clothing and move the
casualty into the shade
- To relieve discomfort and pain, cool the burnt area by sponging gently with cold water
- Give the casualty frequent sips of water
- If the sunburn is mild, apply calamine or after sun-cream to the skin
- If the skin is blistered send the casualty to a medical facility.

BONE.JOINT AND MUSCLE INJURIES

Bones normally are very strong but can break if struck or twisted or overstressed. This is called a
fracture. Injuries can also occur if the ligaments that support joints are torn or if the muscles are
torn or strained .x-rays are usually required to distinguish between a bone, joint or muscle injury.
If in doubt, treat it as a fracture.

BROKEN BONES

- All breaks must be handled extremely carefully because bones have important blood
vessels, nerves and organs that lie alongside them.
- The aim is to prevent further damage by avoiding any uncessecary movement
- A bone may be broken by direct force in which case the break will be at the point of
impact. Alternatively a broken bone could be caused by indirect force. In this case the
break occurs at some distance from the point of impact
- A break may also be the result of a bad twist
- Casualties with suspected breaks should be treated in the position found
- Steadily and support the injured bone with one hand above and the other below the site of
the injury.
 - HOW TO TREAT INJURIES
- DO NOT move the casualty unless hi is in danger. In that case, support the injury while
others move him.
- Use both hands to support the injury above and below the joints.
- Cover any open wounds with a sterile dressing or a clean cloth
- Call an ambulance and transfer the casualty to a medical facility
- If necessesary treat the shock.

MANAGEMENT

- If possible bend the arm at the elbow so that the arm is across the trunk
- Pad between the fracture site and the body
- If unable to bend the arm pad around the elbow
- Put the arm in a sling
- For extra support secure the casualty’s arm to the body with a broad fold bandage

BROKEN HANDS AND FINGERS.

Usually present with pain, tenderness deformity and swelling

MANAGEMENT

- Raise the hand to control bleeding and swelling

- If possible remove any jewellery
- If bleeding put a dressing on
- Pad around the hand
- Apply a sling and secure with a broad fold bandage

BROKEN RIBS

- Present with swelling and sharp pain at the site of injury

- Pain worse with taking deep breaths, coughing or movement
- Tenderness around the affected ribs
- There maybe a crackling sounds(crepitus)at the site of the injury

MANAGEMENT

- Broken ribs are splinted naturally because they are attached to the rib cage
- Make sure the casualty is in a comfortable position, sitting down
- Support the arm on the injured side in a sling.
BROKEN PELVIS

- Must be handled with great care because there are many internal injuries
- Present with pain, swelling and loss of movement.
- Urine may be blood stained

MANAGEMENT

- Help the casualty onto his back with legs straight or knees slightly bent
- Put a cushion under the knees
- Treat for shock if necessesary and keep casualty warm
- Monitor breathing pulse and responsiveness and transfer to a medical facility

BACK INJURIES

- May be serious because they may affect the spinal cord

- Damage to the spinal cord can result in paralysis of the body below the injured area
- Suspect a spinal injury in any cases of head and neck or multiple traumas
- Mild back injuries can be made worse by incorrect handling.

SIGNS AND SYMPTOMS

 Swelling of damaged area

 Pain and tenderness around the affected area made worse by movement
 Inability to move a joint
 Unable to stand on the affected limb if knee or ankle involved
 Gradual bruising of affected area.

TREATMENT

Follow RICE procedure if you suspect a sprain or a strain

R=REAT sit or lay the casualty down rest the injures part in comfortable positions

I=apply an ice pack or cold pad to reduce blood flow and minimize

C=apply gentle pressure by compressing the injury with padding such as cotton wool or securing
the compress with a crepe bandage

E=raise and support the casualty’s injured limb to minimize any bruising. Use appropriate slings
when practical’s
DISLOCATED JOINT

- A dislocation is the displacement of bones at a joint

- Normally caused by a violent or awkward twisting strain on the joint
- This also tears the ligaments that are supporting it.

SIGNS AND SYMPTOMS

- Pain around the affected joint

- Inability to move the affected joint
- Swelling around the joint
- Severe deformity at the site of the injury

AIM AND TREATMENT

 Keep the injured limb supported.suppoert it with pillows, rolled blankets or a sling if
applicable
 Help the casualty into the position he finds comfortable
 Get the casualty to a medical facility

CRAMP

It’s a sudden pain caused by tightening or contraction of one muscle or a group of muscles

Normally it’s relived by stretching the affected muscles

May be accompanied by severe sweating and exhaustion

POISONING

Poisons are substances that result in temporary or permanent damage to the body if taken in
sufficient amounts

Effects vary according to the type of poison and amounts taken.

INSECT STINGS

Insects such as bees leave a small sting embedded in the skin

Wasps and hornets stings are more alarming than dangerous

AIM AND TREATMENT

- Carefully remove a visible sting with a pair of tweezers

- Avoid squeezing the sac at the top of the sting because it will force more poison into the
casualty
- Apply a cold compress to reduce pain and swelling
- Rest the injured part

SNAKE BITES

Common in many areas. Learn to recognize the poisonous species of snakes in your area

SIGNS AND SYMPTOMS

-One or two small puncture marks

-pain, redness and possible swelling

AIM AND TREATMENT

 Lay the casualty down and reassure

 If possible wash around the wound with soap and water
 Cover the area with a dressing and secure this with a conforming bandage
 Support and immobilize the injured area.
 Keep the heart above the level of the wounded area to contain the poison
 Transfer the casualty to a medical facility as fast as possible

ANAPHYLAPTIC SHOCK
- This is a severe allergic reaction.
- It may occur after an insect bite or by an allergy to certain foods such as pea nuts.
- The reaction is usually very fast.
- The casualty will have difficulty breathing and will require urgent medical help.
- Susceptible individuals may carry a dose of adrenaline at all times .may be in the
form of a pre-loaded syringe called an EPI-PEN.
- Help the casualty to take the drug or administer it yourself if trained to do so.
SIGNS AND SYMPTOMS

- Anxiety with difficulty in breathing. The casualty may wheeze.

- Blotchy, red skin.
- Puffy eyes
- Very fast pulse
- Swelling the feet and neck

AIM AND TREATMENT

- Treat with epi-pen if available

- Rush to a medical facility as fast as possible
- Be ready to resuscitate

FROSTBITE

- Occurs when parts of the body, e.g.fingers or toes, become frozen due to intense cold.
- May be accompanied by hypothermia.

SIGNS AND SYMPTOMS

- Prickling pain followed by gradual loss of feeling in the affected area.

- Affected skin will fee hard and turn pale, then blue and finally black.

AIM AND TREATMENT

To warm the affected area slowly and to prevent further tissue damage

DO NOT thaw a frost bitten foot if further walking is necessary

DO NOT warm the frost bitten part with a hot water bottle.

Remove any tight constrictive articles from the affected part e.g. eye, gloves, boots

Warm the affected area slowly (putting extremities in armpits

Apply a loose dressing or a gauze bandage

Keep affected area covered until color and feeling return to the skin

Take or send the casualty to a medical facility

HEAT EXHAUSTION

Caused by abnormal loss of salt and water from the body through excessive and prolonged
sweating.

SIGNS AND SYMPTOMS

- Cramp like pains and/or headache

- Pale moist skin
- Fast weak pulse

AIM AND TREATMENT

 To cool down lay the casualty in cool place

 Raise the casualty’s leg to improve blood flow
 Give the casualty plenty of water to drink slightly salted if possible

HEAT STROKE

It occurs when the body is unable to cool on itself by sweating due to illness or prolonged
exposure to heat and humidity. It’s potentially dangerous

SIGNS AND SYMPTOMS

- Restlessness
- Casualty may have a head ache and feel dizzy
- Skin will be flushed and feel very hot
- Rapid loss of consciousness
- Fats strong pulse
- Body temperature is raised and may reach 40degrees or higher

AIM AND TREATMENT

 To lower the casualty’s body temperature as quickly as possible

 To seek medical help as soon as possible
 Lay the casualty down in a cool place and remove clothing
 Wrap the casualty in a cold, wet sheet and keep it wet
 Sponge down the casualty with cold or tepid water
 Fan the casualty until his temperature falls to 380 degrees.
 when the casualtys
temperature has dropped to safe level replace the wet sheet with a dry one
 monitor regularly until help arrives
SMALL FOREIGN BODIES

Small foreign bodies such as a piece of gravel, a splinter or a piece of glass that enter the body
through break in the skin or through one of the body’s natural openings

Children may swallow small peas or beads or push them into their ear or up their noses.

SPLINTERS

Tiny pieces of wood, glass or metal that become embedded in the skin are the most common
types of foreign. They are rarely clean and may cause infection.

SIGNS &SYMPTOMS

- pain at the site of entry

- cause of the injury may be nearby
- usually the splinter is visible in the skin

TREATMENT

- Never dig into area. Its easy to push a splinter further in

- remember to keep tetanus inoculations to date
- wear gloves if possible
- rinse the area the splinter with cold water to rinse away loose foreign particles
- Sterilize a pair of tweezers by passing them through the flame from a match or brighter.
Allow to cool
- DO NOT wipe the soot off or touch the end of the tweezers
- Holding the tweezers as near to the skin as possible, grasp the end of the splinter. Pull it
out in a straight line at the same angle to which it entered.
- If it breaks do not carry on trying to remove it.

FOREIGN BODIES IN THE EYE

Most common of these objects are pieces of dust, eyelashes or small insects.

SIGNS AND SYMPTOMS

- Pain and discomfort

- Blurry vision
- Red watery eye
TREATMENT

- Sit the casualty down facing a light and leaning back slightly
- Refrain the casualty from rubbing the eyes
- Stand behind the casualty’s as he/she looks up. Gently separate the eyelids and look for
the object
- If the object is visible inside the eyelids or on the white part of the eye, pour water from a
jug into the inner corner of the eye to flush it out.
- Grasp the upper lid ask the casualty to blink. The object should float off
- DO NOT remove anything from the colored part of the eye or that is struck in the eye
- Cover the eye with a sterile dressing and get the casualty to a medical facility

FOREIGN BODIES IN THE EAR

Common in young children who have a habit of trying to put things into their ears

MANGEMENT

- DO NOT try to dig anything out of the ear even if you can see it
- Reassure the casualty and tilt the head with affected ear downwards. The object may drop
out
- If it’s an insect or a very light object tilt the casualty. Head to one side with the affected
ear uppermost
- Place a towel over the shoulder and shoulder and support the head with your hand
- Place a towel over the shoulder and support the head with your hand
- Gently pour tepid water into the ear until the insect or object floats to the surface

FOREIGN BODIES IN THE NOSE

-a common occurrence with the children

-often cause blockage and infection

SIGNS AND SYMPTOMS

- Difficulty breathing or noisy breathing through the nose

- Swollen of the nose
- Smelly blood stained discharge from the nose
MANAGEMENT

-keep the casualty quiet and calm

-have they breathed through their mouth

-DO NOT try to remove a foreign body with fingers or instruments even if it’s visible

-take or send the casualty to a medical facility