ABC First Aid Guide PDF

ABC First Aid
Guide
Clear & Simple First Aid Advice
International
Emergency Numbers
2010 Guidelines
Dr Audrey Sisman
ABC FIRST AID GUIDE Introduction Contents
3nd Edition 2011 Congratulations on taking positive steps towards Essential First Aid
Published by: ABC Publications learning first aid which is an essential life skill we Unconscious...................................2
PO Box 106, Mapleton, Qld 4560 DRSABCD......................................3
should all learn in order to help others and possibly CPR................................................4
save a life. Choking..........................................6
Author: Dr Audrey Sisman, MBChB Drowning........................................7
The ABC First Aid Guide is written by a medical Trauma
ISBN: 978-0-646-50354-7
practitioner with experience in emergency medicine, Soft Tissue Injury & Fracture..........8
hospital medicine, general practice and natural Upper Limb Injury...........................9
Copyright © 2008-2011 by ABC Publications Lower Limb / Pelvic Injury............10
All rights reserved. Reproduction of this book, in part or entirely, without written permission is therapies. Bleeding.......................................12
prohibited. Shock...........................................14
The book contains clear, simple first aid advice Crush Injury..................................14
which will assist you in handling most emergency Burns............................................15
This book has been written based on current guidelines and requirements as defined by: situtations. Electric Shock...............................16
Multiple Casualties/ Prioritizing....16
• Australian Resuscitation Council Keep this book with your first aid kit at home, in your Chest............................................17
• New Zealand Resuscitation Council Abdomen......................................18
car or when travelling overseas.
• European Resuscitation Council Eye...............................................19
• Epilepsy Association of Tasmania Head Injury...................................20
• Roads and Traffic Authority Spinal Injury..................................21
• National Heart Foundation of Australia How to use this book: Medical Emergencies
• Australasian Society of Clinical Immunology & Allergy (ASCIA) Heart Conditions...........................22
• Asthma Foundation of Queensland The ABC First Aid Guide is divided into four main Asthma.........................................23
• WorkCover QLD colour coded sections: Croup/ Epiglottitis.........................24
Faint.............................................24
• Essential First Aid • Trauma Seizure/ Epilepsy..........................25
• Medical Emergencies • General First Aid Febrile Convulsion........................25
For more information about this book, and for the latest updates visit: Diabetes.......................................26
Stroke...........................................27
Each subsection shows you step-by-step how to
www.abcpublications.com.au Hyperventilation............................27
recognise and deal with an emergency situation. Heat Exposure..............................28
Emergencies are recognised by SIGNS & Cold Exposure..............................29
SYMPTOMS which are contained in a red box. Bites and Stings...........................30
Poisons.........................................32
Displayed in a green box is the FIRST AID Allergy/ Anaphylaxis.....................33
management of an emergency situation. General First Aid
Principles of First Aid....................34
☎ means dial your country’s emergency number. Legal Issues.................................34
Communication/ Reports..............35
.......empowering people
Record Keeping/ Self-Help...........35
A fold out World Map of international emergency
Safe Manual Handling/ Hygiene...36
numbers at the back of the book identifies emergency First Aid Kits/Needlestick Injury....36
numbers across the world. Casualty Assessment...................37
The information in this book contains, at the time of printing, the most current resuscitation Natural Medicine in First Aid.........38
guidelines. This book is designed to be an information resource and is not a substitute for Also at the back, there is a First Aid Report Form
First Aid Report Form
attending a first aid course conducted by an approved provider. The author of this book which can be torn out and used in a first aid incident,
accepts no responsibility for any injury or damage that may occur as a result of using this and an Emergency Numbers page for writing World Map ☎
book in first aid management. local, national and international emergency numbers. Emergency Numbers ☎
2 | Essential First Aid Essential First Aid | 3
Unconsciousness is a state of unresponsiveness, where the casualty is

unaware of their surroundings and no purposeful response can be obtained. Basic Life Support & AED
NO RESPONSE NO Breathing or Follow Basic Life Support Chart
D
© ABC Publications
Abnormal Breathing
Dangers?
Breathing Normally Recovery Position, Call ☎, monitor
Causes of an unresponsive (unconscious), breathing state:
R
Response Obtain history,
• A - Alcohol • T - Trauma (head/ spinal (Pg 20, 21) Response? Monitor,
Combinations of different
causes may be present in • E - Epilepsy (Pg 25 ) • I - Infections (meningitis) Send for help
an unconscious casualty eg • I - Insulin (Diabetes Pg 26 ) • P - Pretending
head injury and diabetes. • O - Overdose (Poisons Pg 32) • S - Stroke (Pg 27 )
• U - Uraemia (renal failure) NO RESPONSE
NB.The sense of hearing is usually the last sense to go, so be careful what you say near an unconscious casualty.
All unconscious casualties must be handled gently and every effort made to avoid any twisting
or forward movement of the head and spine.
(An unconscious, breathing woman in advanced pregnancy should be placed on her left side). S Send for help. Call ☎
The recovery position:
A
• Maintains a clear airway - allows the tongue to fall forward.
• Facilitates drainage and lessens the risk of inhaling Open Airway
foreign material.
• Permits good observation and access to the airway.
B
• Avoids pressure on the chest which facilitates
breathing. Airway management
NO Breathing or Breathing Recovery position
• Provides a stable position and minimises injury to casuality. takes priority over abnormal breathing Normally & monitor
spinal injury
Send or go for AED

Call ☎
C Compressions
Start CPR
1
Shock
• Switch on
30 x Compressions • Attach pads
• Follow voice
CPR No Shock
prompts
30:2 Shock Advised
Step 1 Step 2 Step 3 Advised
• Raise the casualty’s furthest • Stabilise the casualty by • Carefully tilt the head 2 x Rescue Breaths
arm above the head. flexing the bent knee to 90° slightly backwards
• Place the casualty’s nearest when resting on the ground. and downwards. This AED
arm across the body.
• Bend-up the casualty’s nearest
leg.
• Tuck the casualty’s hand
under their armpit.
• Ensure the casualty’s
facilitates drainage of
saliva and/or stomach
contents and reduces
D Defibrillation
use AED
Analyses
Rhythm
• With one hand on the shoulder head is resting on their the risk of inhalation
and the other on the knee, roll
casualty away from you.
outstretched arm. which may cause
pneumonia.
In an EMERGENCY CALL ☎ or
CPR HAZARDS! CPR

• Biohazards – blood, bodily fluids
Dangers • Survey Scene
• Chemicals – spills, fumes, fuel Compressions 30 Chest Compressions : 2 Rescue Breaths = CPR
• Remove or Minimise Hazards • Electricity – power-lines • Depth = 1/3 of chest wall (~ 5 cms)
Protect yourself • On coming traffic 30 Compressions • Rate = 100 per min (almost 2 compressions per sec)
- use antiseptics • Fire, explosion
• Place heel of one hand in centre of casualty’s chest
and barrier • Unstable structures
• Slippery surfaces
(which is the lower half of the sternum)
protection: • Place other hand on top, arms straight and press down
• Broken glass
gloves, mask, • Sharp metal edges on sternum at least 5 cm in adults
goggles. • Needle stick • Allow complete recoil of chest after each compression
• Aggressive behaviour • Keep compressions rhythmical at a rate of 100 per min
• Use 1 or 2 hands in children (Infants 2 fingers)
Response •Talk and touch SPEAK LOUDLY – Don’t shout
“Hello, can you hear me”? Are you all right? 2 Rescue Breaths • 2 breaths over 2 secs
“Open your eyes” • Inflate until chest starts to
rise.
“Squeeze my hands”
• Over-inflation forces air
SQUEEZE SHOULDERS firmly – Don’t shake into the stomach causing
NB. When approaching a collapsed casualty with regurgitation.
caution, ascertain a response from a standing position • Infants – perform mouth to
by tapping casualty’s foot with your foot before kneeling mouth/nose RB and inflate
down. with puff of air from cheeks.
• Take a breath. • Turn head after each RB. • Use resuscitation mask or
Send for help. Call ☎ • Close casualty’s nostrils
(pinch with fingers).
• Listen and feel for air exhaled
from mouth.
barrier protection if possible
• If unwilling or unable
• Check - for foreign material which could be obstructing the airway. • Mouth to mouth (good seal). • Avoid inhaling re-expired air. to give RB, do chest
Airway • Open - use chin lift and backward head tilt to open airway. • Blow to inflate lungs. compressions only.
• Use pistol grip to achieve chin To clear foreign material Same ratio
Chin lift CPR • Cardio Pulmonary Resuscitation • Rate = 5 cycles every 2 mins
for infant,
lift. Watch that your knuckle doesn’t
Head
compress neck and obstruct airway
30:2 • Combines 30 Compressions with 2 Rescue Breaths (30:2) = 1 cycle child, adult
tilt
and breathing. • Change rescuers every 2 mins to reduce fatigue. Stop CPR when:
• If foreign material is present, roll • Do compression only CPR, if unwilling or unable • Casualty responds or begins breathing normally
casualty into recovery position and to give rescue breaths (RB). • Exhaustion – can’t continue.
clear using postural drainage and • Continue CPR until responsiveness or normal • Health professional arrives and takes over.
breathing returns. • Health professional directs that CPR be ceased
finger sweep method. Spinal injury and infants(<1yr): Keep head in a
An AED (Automated External Defibrillator) delivers electric shock to
neutral position (i.e. minimise backward head tilt) Defibrillation reverse abnormal heart rhythms. Not all heart rhythms are reversible
• The airway takes precedence over any other injury including a possible spinal injury.
• Check airway and breathing in recovery position if incident involves drowning (Pg 7) or vomiting. • When there are 2 rescuers, continue CPR while one
rescuer organises and attaches AED pads:
• Look - for rise and fall of lower chest/ upper abdomen • Expose chest – cut clothing.
Breathing • Listen - for breath sounds • Remove any medication patch, remove jewelry, wipe
• Feel - for movement of chest and escape of air from mouth chest dry, remove chest hair with razor.
Take 10 seconds Abnormal or NO Breathing? • Switch on AED & attach pads – peel backing off first.
to check for • If casualty is unresponsive and not breathing • Follow voice/ visual prompts of the AED.
breathing normally after the airway has been cleared and • Nobody should touch casualty during analysis or shock
opened, the rescuer must immediately commence delivery
chest compressions then rescue breathing (CPR). • DO NOT have casualty in contact with metal
• If unwilling or unable to perform rescue breathing, NB.No harm to rescuers has occurred while using an AED in the wet
continue with compression only CPR.
NB. In the first few minutes of a casualty’s cardiac arrest, Chain of survival: is the key to improving the survival rate from cardiac arrest. Time is the
sounds of gurgling, sighing or coughing may be present, but
this is ineffective breathing and CPR should be commenced.
essence. The 4 steps required are: 1) Call ☎ Early 2) Begin CPR immediately
3) Early Defibrillation 4) Advanced cardiac life support by paramedics
Choking Inhalation of a foreign body can cause partial or complete airway obstruction. Drowning
Drowning or near drowning is the process of experiencing respiratory impairment from
Partial Airway Obstruction (Effective cough): immersion in liquid. Interruption of the oxygen supply to the brain is the most important
SIGNS & FIRST AID consequence of drowning so early rescue and resuscitation are the major factors in survival.
SYMPTOMS • Encourage casualty to keep SIGNS & SYMPTOMS • DO NOT attempt to save a
• Coughing coughing •Coughing •Chest pain •Frothy sputum drowning casualty beyond your
• Wheezing • Reassurance •Clenched teeth •Shortness of breath swimming ability.
• Difficulty breathing • DO NOT deliver back-blows •Blue lips and tongue •Unconscious • Remove casualty from water as
• Noisy breathing if cough is effective •Irregular or no breathing soon as possible.
• Cyanosis
(blue skin colour)
☎
• Call
clear
If blockage doesn’t
• Only begin Rescue Breathing in
A Drowning Victim water if trained to do so (requires a
floatation aid) and immediate exit is
Complete Airway Obstruction (Ineffective cough): impossible.
FIRST AID • Cardiac compressions in water
SIGNS & are both difficult and hazardous and
SYMPTOMS • Deliver 5 back-blows.
• Check and clear mouth after each blow. should not be attempted.
• Unable to breathe,
speak or cough • Deliver 5 chest thrusts.
FIRST AID
• Agitated/ • Check and clear mouth after each blow.
On land or boat:
distressed • Repeat back blows and chest thrusts if
• Grips the throat obstruction not relieved. • Call ☎
• Cyanosis (blue) ☎
• Call .
• If unconscious, commence CPR (Pg 4,5).
• Roll casualty into recovery position
for assessment of airway and
• Rapid loss of
consciousness DO NOT apply abdominal pressure – may breathing.
cause internal injury. The risk of regurgitation and inhalation is high
• Commence CPR if required (Pg 4,5)
following immersion. This is due to distension of
• Roll into recovery position if vomiting
Chest thrusts are delivered standing the stomach from swallowing large volumes of
Back blows are delivered or regurgitation occurs.
standing or lying using the or lying using one or two hands- a water. The airway and breathing is assessed in
• DO NOT attempt to empty distended
heel of the hand between the wall or firm surface is required. The the recovery position to
stomach by external compression.
shoulder blades. elbow(s) are slightly bent and chest minimise risk of inhalation.
thrusts are sharper • Treat for Hypothermia (Pg 29) - often
If after 5 back associated with immersion.
blows the and slower than chest
compressions (CPR). • Give oxygen if available.
airway is still
Check airway after • All immersion casualties must be
obstructed, use chest
thrusts. each chest thrust. assessed in hospital as complications
often follow.
Back Blows Back blows
Chest Thrusts Rescuing a Drowning Victim
are delivered
with the
infant lying
face down
across the
lap. Check
airway after
each back • If conscious: throw a buoyant aid (life jacket, surf board) or drag from water using an
blow. umbrella, rope, towel, stick.
When giving Rescue Breaths in an attempt to blow past the obstruction, there will be • If unconscious: Turn casualty face up and remove from water.
resistance. If the obstruction is blown further down the airways, the obstruction can be • Consider possibility of spinal injury – remove from water gently, maintaining spinal alignment
removed later by bronchoscope. as much as possible.
8 |Trauma Trauma | 9
Soft Tissue Injury & Fracture Arm Sling: Use a triangular

Upper
Limb Injury
bandage or improvise.
Sprain: Over-extension of a joint with stretching and tearing of ligaments. Soft
Strain: Over-stretching of muscles and tendons with tearing of muscle tissue or Tissue
tendon fibres. Injury
Improvise:
Dislocation: Displacement of bone ends in a joint. By using a belt or
Fracture(#): Broken bone, classified as: buttons on shirt
Closed: Fractured bone doesn’t penetrate skin.
Open: Fracture is exposed through open wound or penetrates skin.
Complicated: Vital organ, major nerve or blood vessel is damaged by a broken bone.
The Signs & Symptoms and First Aid for a fracture and soft tissue injury are very similar.
SIGNS & SYMPTOMS FIRST AID
• Pain • Control external bleeding or cover wound (Pg 12) Elevation Sling
• Tenderness • Remove rings from fingers – swelling likely The radius
• Snap or pop at time of injury • Support or Immobilise +/_ R.I.C.E always
• Restricted movement • Medical Assistance: X-rays are the only sure attaches to
• Discolouration way of diagnosing the type of injury. the thumb.
• Swelling
• Deformity*
• Call

☎ if: Deformity as blood vessels
and nerves can be damaged.
* Indicative of fracture or dislocation
Open Fracture: Risk of blood loss
and infection.
Fracture Management: Breathing difficulty
Finger Splints: Immobilisation reduces
Rigid Splint: Rolled up newspaper,
The main aim of fracture treatment is pain. After splinting, apply an elevation
• Monitor Vital Signs (Pg 37,40) sling to minimise swelling. tied either end with triangular
to support or immobilise an injured Arm Sling bandages.
part which: • minimises pain • prevents further damage • minimises bleeding and
• prevents a closed fracture becoming an open fracture. Fractured
Support: •Leave injured part as found and pack around to give support. humerus:
Notice
Immobilise: •Use Splint, Sling or bandage to prevent movement. deformity
•Stabilise joint above and below fracture site.
•Apply triangular or broad bandages above and below fracture site.
•Check circulation every 15mins (Pg 11).
•DO NOT elevate a suspected fracture until it has been immobilised.
Soft Tissue Management:
R.I.C.E: Method used to treat soft tissue injuries (sprains/ strains) and fractures. Collar
Rest: Rest casualty and injured part; this prevents further damage and reduces bleeding. & Cuff Sling
Ice: Reduces pain, fluid and swelling by constricting blood vessels. Apply wrapped ice pack Pain in: Could be: Management:
for 10 - 20mins – do not place ice directly on skin. Ice pack or frozen peas can be placed
over a bandage. Continue to cool injury three times/day for 2-3 days after the injury. •Fractured clavicle •Dislocated shoulder •Allow casualty to adopt
Shoulder •Fractured upper humerus •Sprain/ strain
Compression: Apply a firm supporting bandage to injured part. This restricts movement of position of comfort.
injured part and reduces bleeding and swelling. •Apply sling which best
Elevation: Raise injured area above the level of the heart if possible. This slows the flow of Upper Arm •Fractured mid-humerus •Sprain/ strain suits casualty.
blood and reduces swelling.
•Keep hand higher than
Fore Arm/ •Fractured radius/ ulna •Sprain/ strain elbow to reduce swelling
• Degree of pain is not a good indicator of injury type since pain tolerance varies in individuals. Wrist •Fractured carpal bone
• Never manipulate a dislocation - there may be an associated fracture.
•If unsure whether injury
• When in doubt, always treat an injury as a fracture. •Fractured/ dislocated metacarpal is a fracture or soft tissue
• Check circulation (Pg11) after immobilisation ie after bandaging, splinting, sling. Hand
•Fractured/ dislocated phalange injury, treat as for fracture
• May need to slowly adjust position of limb if no circulation is present. •Sprain/ strain (Pg 8)
Lower Limb Injury FIRST AID Lower Limb Injury

Pelvic Injury:
• Call☎
• Reassure casualty
Immobilising Lower limb:
• A body splint is an effective way
Fracture site.
• Control any external bleeding. to immobilise lower limb fractures.

• Lie casualty flat with knees slightly bent and • The key to immobilising leg
supported. fractures is a figure of 8 bandage Use triangular
• Place padding between legs and on either side around the feet. bandages,
of hips (eg blanket, towel, pillow). • Place padding in natural hollows broad bandages,
• ‘Figure-of-eight’ bandage around ankles and between legs. Fracture site. belts, clothing or
feet. • Stabilise joints above and below sheets to tie legs
• Apply broad bandage above knees. fracture site. together. Tie-off on
SIGNS & • Position all bandages before tying uninjured leg, above
• Don’t attempt to move casualty.
SYMPTOMS off. and below fracture
• Discourage attempts to urinate.
• Pain in hip or • Maintain body temperature. • Apply broad bandages above and site.
groin region • Monitor vital signs (Pg 37,40) below injured area.
Splints can be classified as:
• Pain worse on • Tie bandages off on uninjured
• Body Splint: Uses uninjured, adjoining body part to
movement side of body.
immobilise an injury. Lower limbs, fingers and toes are
• Inability to walk • If using a rigid splint (eg stick)
commonly strapped together as body splints.
• Shock (Pg 14) ensure splint doesn’t extend • Soft Splint: Folded blankets, towels, pillows
further than length of legs. • Rigid Splint: Boards, sticks, metal strips, folded
Consider internal
• Ensure splint stabilises joints magazines and newspapers
bleeding from
above and below injury.
bladder, uterus,
bowel damage. • Pad over splint to make more Checking Circulation:
comfortable. • Check skin colour below injury - if pale or discoloured,
• Check circulation there may be impaired circulation.
Left leg appears A 1.5 litre blood loss • Assess skin temperature by gently placing hand below
SIGNS AND SYMPTOMS that level of injury. Compare to other side. If colder, there
shorter and is rotated can result from a
a bandage is too tight: may be impaired circulation.
outwards. closed fracture of the
• Pain • Numbness • Cold • Squeeze fingernail until nail turns white. Colour should
Notice swelling over femur. In this case a 3
to touch • Tingling • Pale or return within a few seconds.
hip due to internal litre blood loss could
discoloured • Pulse weak/absent • Compare pulse below injury with other side - If weaker or
bleeding. This is the result in shock (Pg 14)
below injury absent, circulation may be impaired.
typical position of the and death.
leg with a fractured This type of injury is
hip (fractured neck of common in road traffic Pain in: Could be: Management:
femur) and is common accidents. • Allow casualty to
Hip/groin •Fractured Pelvis •Fractured neck of femur
in the elderly after a •Dislocated head of femur •Sprain/strain adopt position of
Hip Injury minor fall. Thigh Injury comfort.
•Fractured femur •Strain: front of thigh • If unsure whether
R.I.C.E for a R.I.C.E Thigh (quadriceps) •Strain: back (hamstrings) injury is a fracture or
sprained ankle: Support knee soft tissue injury, treat
as for fracture (Pg 8).
Rest: Casualty in position •Fractured patella •Dislocated patella
Knee •Cartilage tear •Sprain • Elevate a suspected
doesn’t move ankle of comfort. fracture after it has
Ice: Cool injured area Do not try to been immobilised.
Compression: Use a straighten Lower Leg/ •Fractured tibia •Fractured fibula • Minimise movement to
crepe bandage knee if Ankle •Dislocation •Sprain/ strain avoid further injury.
Elevation: Place foot painful. •Fractured tarsal/metatarsal/phalange • Check circulation after
Ankle Injury higher than hip Knee Injury Foot •Dislocation •Sprain/ strain immobilisation (above).
Bleeding Embedded Object: eg knife, glass, stick or metal. Bleeding

Bleeding (haemorrhage) can be external and obvious or internal (within the body) and often FIRST AID
not seen. • DO NOT remove the object - it could be plugging the wound.
Bleeding is classified according to the type of blood vessel damaged: • Build up padding around the object.
Artery - bright red, spurting; Vein - dark red, flowing; Capillary - bright red, oozing
• Apply sustained pressure over the pad (indirect pressure).
Types of wounds associated with bleeding are: Abrasions, incisions, laceration, puncture,
• Bandage firmly over the pad.
embedded object, tear, amputation.
• DO NOT apply pressure over the object.
Major External Bleeding: • DO NOT shorten object unless its size is unmanageable.
• Elevate, immobilise, restrict movment of the limb.
Direct, sustained pressure is the
• Advise casualty to remain at rest.
fastest, easiest, most effective
The aim is to
way to stop bleeding. • Call☎
reduce blood TOURNIQUET: Used to control Internal Bleeding: Signs, symptoms and management as for Shock (Pg 14)
loss from the life-threating bleeding.
casualty. • Suspect internal bleeding if a large blunt Concealed:
• Use as a LAST RESORT. force is involved - road traffic accident, fall Spleen, liver, pancreas, brain (no
• Use a wide bandage (>5cm from a height; or a history of stomach ulcers, bleeding visible).
wide). early pregnancy (ectopic pregnancy) or Revealed:
Direct Pressure and Elevation penetrating injury. Lungs – Cough up frothy pink sputum.
• Apply high above wound.
• Internal bleeding may be concealed or revealed. Stomach – Vomit brown coffee grounds
• Ensure tourniquet is clearly • If a casualty is coughing up frothy blood, allow
FIRST AID or red blood.
visible. casualty to adopt position of comfort – normally
• Check for Dangers to self, casualty & bystanders. Kidneys/ Bladder – Blood stained urine.
• Tighten until bleeding stops. half-sitting. Bowels – Rectal bleeding: bright red or
• Use disposable gloves if available.
• Note the time of application; • First aiders can’t control internal bleeding but black and “tarry”.
• Direct Pressure Method:
• Quickly check for embedded objects (Pg13)
write time of application on early recognition and calling☎ can save lives. Uterus - Vaginal bleeding.
casualty.
• Apply firm direct pressure untill bleeding stops. • Continue to maintain direct Nose bleed
• Maintain pressure over the wound using hands or pressure over wound.
FIRST AID
pad (sterile dressing, tea towel or handkerchief). • DO NOT apply tourniquet over a • Pinch soft part of nose just below the bone.
• Bandage firmly to hold pressure pad in place. joint or wound. • Have casualty seated and leaning forward.
• If bleeding continues - apply another pad and a • DO NOT remove tourniquet • Ask casualty to breathe through their mouth.
tighter bandage. until casualty receives specialist • Maintain pressure and posture for at least 10mins (longer may
• Elevate, immobilise and rest injury. care. be required after exercise, hot weather or if casualty has high
blood pressure or takes aspirin or warfarin tablets - maintain
• Call☎ pressure for at least 20 minutes).
• Reassure casualty. • If bleeding continues >20mins - seek medical assistance.
• Assist casualty into comfortable position. • Apply cold compress to forehead and neck.
• Monitor vital signs (Pg 37, 40) • Advise casualty not to blow or pick their nose for a few hours.
• Give oxygen if available.
• DO NOT give casualty food, alcohol, medication. Amputation Manage amputated limb as for major external bleeding (Pg 12).
• If major bleeding continues - remove all pads Amputation of a limb often requires a tourniquet (Pg12) to control life-threatening bleeding.
to locate a bleeding point, then apply a more direct • DO NOT wash or soak amputated part in water or any other liquid.
pressure over bleeding point. • Wrap the part in gauze or a clean handkerchief and place in watertight plastic bag.
• If above methods fail - use a tourniquet. • Place sealed bag or container in cold water which has ice added to it
(The part should not be in direct contact with ice).
• Treat for shock (pg 14) if required.
Tourniquet with time of application noted • Send to hospital with the casualty.
Shock Shock is a term used to describe an ineffective blood circulation. Burns Burns may result from: heat (flame, scald, direct contact), cold, friction,
chemical (acid, alkali), electrical or radiation (sunburn, welders arc).
CAUSES • DO NOT apply ice directly to burns.
FIRST AID
Loss of blood volume: Bleeding or fluid loss • DO NOT break blisters.
• DRABCD
Loss of blood pressure: Heart/ pump failure
• Cool affected area with water for as long • DO NOT apply lotions, ointments, creams or
or abnormal blood vessel dilatation.
as necessary - usually 20mins. powders (except hydrogel).
• Internal or external bleeding
bleeding • Remove rings, watches, jewelry from • DO NOT peel off adherent clothing or other
• Major or multiple fractures
• Severe burns or scalds affected area. substances.
• Severe diarrhea and vomiting fluid loss • Cut off contaminated clothing – do not • DO NOT use “fluffy” dressings to cover burn
• Heat stroke remove clothing contaminated with (towels, tissues, cotton wool).
The total blood volume in the body is
• Heart attack - pump failure about 6 litres. Blood loss of >1 litre chemicals over the head or face. Seek medical help for:
• Severe infection • Elevate burnt limb if possible. • Chemical burns • Electrical burns
abnormal (20%) may result in shock. Rapid
• Allergic reactions • Cover burnt area with a loose, non-stick • Inhalation burns • Full thickness burn
dilatation of blood loss leads to more severe
• Brain/ spinal cord injury dressing (sterile non-adherent dressing, • Infant, child or elderly.
blood vessels shock.
plastic cling wrap, wet handkerchief, • Burns to hands, face, feet, major joints, or
SIGNS & SYMPTOMS sheet, pillow case). genital area.
FIRST AID
• Pale, cool, clammy skin • DO NOT allow shivering to occur. • Burn size > casualty’s palm.
• DRSABCD - Ensure your own safety
• Burns encircling limbs or chest.
• Thirst
• Feeling cold
• Call☎
• If conscious – lie casualty flat with legs
• Hydrogel products are an alternative if
water is not available. • Burns associated with trauma.
• Rapid, shallow breathing. elevated.
• Nausea/ vomiting • Control external bleeding (Pg12); stabilise Extensive burns may result in shock from fluid loss (Pg14).
• Confusion fractures; treat injuries (use disposable gloves if
• Reduced level of consciousness. available).
• Rapid, weak pulse • Reassure
• Ridged, painful abdomen (from • Give nothing by mouth (may cause vomiting
internal abdominal bleeding). and delay surgery).
NOTE: In early stages of blood loss, • Keep casualty warm but don’t overheat.
children may have a normal pulse • Monitor vital signs (Pg 37, 40).
rate, but pallor is the warning sign. • If casualty becomes unconscious, vomits or Superficial Burn Partial Thickness Burn Full Thickness Burn
has breathing difficulty, place in recovery position, (1st degree) (2nd degree) (3rd degree)
legs elevated if possible. Reddening (like sunburn) Red and Blistering White or blackened
Painful Very Painful Not painful
Crush Injury A heavy, crushing force to part of the body usually causing Flame: • STOP, DROP, COVER, ROLL the casualty to put out flames • Smother flames with a
extensive tissue damage from internal bleeding, fractures, ruptured organs, or an impaired
blood supply.
blanket, coat or rug and force casualty to lie on the ground • Move to safety • Call ☎
Inhalation: (See also Pg 32, Poisions) • Inhalation of flames or heated air can cause severe
FIRST AID damage to the airways resulting in swelling and possible airway obstruction • DO NOT enter a
• DRSABCD - ensure your own safety. buring or toxic atmosphere without appropriate protection • Remove to a safe, ventilated area
Crush Injury Syndrome:
☎
• Call
• If safe - remove crushing force as soon as possible.
• Is a complication of crush injury
ASAP • Look for evidence of inhalation injury around nose or face • Coughing or hoarseness
may indicate exposure • Give oxygen if available • Call ☎
usually involving a thigh or pelvis
• Control external bleeding (Pg12). Chemical: • Acids and alkalis cause chemical burns • Brush powered chemicals from the
(ie not a hand or foot).
• DO NOT use a tourniquet (Pg12) to manage a crush skin before cooling with water • Do not neutralise either acid or alkali burns because this will
injury.
• Toxins released from damaged
tissue may cause complications but
increase heat generation and cause more tissue damage • Call ☎
• Manage other injuries. Bitumen: • Bitumen holds heat therefore cool with water for 30mins • DO NOT remove from
the risk of sudden death following
• Comfort and reassure. skin unless it’s obstructing the airway • If the limb is completely encircled, split the bitumen
removal of a crushing force is
• Monitor vital signs (Pg 37, 40)
NB - the casualty’s condition may deteriorate quickly
extremely small. lengthwise as it cools • Call☎
Electrical: • Burns are usually more severe than they appear and often associated with other
due to extensive damage.
☎
injuries (Pg 16) • Call
Electric Shock Chest Major chest injuries include fractured rib, flail chest (multiple rib fractures,
Electric shock may cause: • Respiratory Arrest • Cardiac Arrest • Burns producing a floating segment of ribs), and sucking chest wound. A fractured
FIRST AID rib or penetrating injury may puncture the lung.
• ENSURE SAFETY OF YOURSELF AND FIRST AID
BYSTANDERS. Fractured Rib/
• Position casualty in position
• Call☎
• Disconnect Electricity supply where possible (switch
Flail Chest: of comfort; half-sitting, leaning
toward injured side, if other
off at fuse box or main circuit breaker and/ or unplug injuries permit.
appliance). SIGNS & SYMPTOMS
• Holding chest • Encourage casualty to breathe
• If not possible, use non-conducting material (wooden
• Pain at site with short breaths.
stick, dry clothing) to move casualty from electrical
supply. • Pain when breathing • Place padding over injured area.
• Commence CPR if required (Pg 4,5). • Rapid, shallow breathing • Bandage the upper arm on
• Apply first aid to burns (Pg 15). • Bruising injured side to the body.
• Tenderness • If bandages increase discomfort,
• Blue lips (flail chest or loosen or remove them.
DO NOT touch casualty’s skin before electrical source is disconnected.
punctured lung) • Apply a ’Collar & Cuff’ sling to
BEWARE: Water on floor and metal materials can conduct electricity from casualty to you.
• Flail Chest –section arm on injured side.
of chest wall moves in
• When POWERLINES are in contact with a vehicle
or a person, there should be no attempt at removal or
opposite direction during
• Call ☎ for an ambulance
• Monitor for internal bleeding/
breathing.
resuscitation of the casualty until the situation is declared shock (Pg 13, 14)
• Onset of shock (Pg 14)
safe by electrical authorities. • If Unconscious: Recovery
• Remain at least 6m from energized material (car body, pool position, injured side down.
of water, cable).
• You can do nothing for a casualty within the danger zone!
Protect yourself and others.
Sucking Chest Wound:
Multiple Casualties/ Prioritizing You may be faced with the • Pain
• Breathing difficulty
• Position casualty in position of comfort; half-sitting,
leaning toward injured side.
dilemma of two or more casualties needing your care. In making a decision who to treat first,
• Sucking sound over wound • If the object is still in place, stabilise with padding
remember the goal is for the greatest good for the greatest number of people. In all
when casualty breathes. around the wound.
cases remember the principles of safety to yourself, bystanders and casualty. • Bloodstained bubbles • If the wound is open, cover with plastic or non-stick
PRIORITIES: 1= top priority, 5 = lowest priority around wound when casualty pad taped on 3 sides: This allows air to escape
breathes. from pleural cavity and prevents lung collapse
1 ALWAYS manage an UNCONSCIOUS casualty first. Opening the airway and rolling
the casualty into the recovery position may be all that’s required initially.
• Coughing up bloodstained
frothy sputum.
(pneumothorax).
• Call☎ for an ambulance .
2 •Severe 3 • Spinal injury

bleeding (> 1 litre) • Moderate bleeding (< 1 litre) • Onset of shock (Pg 14). • Monitor for internal bleeding/ shock (Pg 13, 14).
•Crush injury
•Shock • Multiple fractures
• Open chest wound • Burns (10-30% of body)
• Open abdominal wound
• Open fractures
• Burns to 30% of body
4 • “Walking Wounded”
• Head injury, showing

deterioration 5 • Obvious death – decapitation,
massive head or torso injuries
Remember: A casualty is always in a changing, non static condition. This is especially

important in head and abdominal injuries in which deterioration can occur.
Abdomen Eye Types of eye injuries:•Burns •Foreign bodies •Penetrating injury •Direct blow
An injury to the abdomen can be an open or closed wound. Even with a closed wound the
rupture of an organ can cause serious internal bleeding (Pg 13, 14), which results in shock Burns: FIRST AID
(Pg 14). With an open injury, abdominal organs sometimes protrude through the wound. Chemical - acids, caustic soda, lime • IRRIGATE with cool running water or sterile
UV - Welder’s flash, snow blindness eye (saline) solution for
FIRST AID (the eyes are red and feel gritty hours later) 20 -30mins.
☎
• Call
• Place casualty on their back with pillow
Heat - flames or radiant heat • Flush from the inside to the outside of eye.
Contact Lenses: • DO NOT remove if the • Irrigate under the eyelids.
under head and shoulders and support surface of eye is badly damaged • Casualty • Lightly pad affected eye(s).
under bent knees. should remove own lenses • Lenses may • Seek urgent medical assistance.
• If unconscious, place in recovery initially protect the eye but if a chemical or • If chemical burn, DO NOT waste time
position, legs elevated if possible. foreign body tracks under the lens, severe looking for neutralizing agent.
• Cover exposed bowel with moist non-stick injury may occur. (alkaline burn is worse than acid burn).
dressing, plastic cling wrap or aluminium
foil.
Plastic cling wrap has been placed over an Foreign body: Grit, dust, metal particles, insects, eyelashes
• Secure with surgical tape or bandage (not open abdominal wound and secured with
tightly). FIRST AID
surgical tape. • Gently irrigate eye to wash out object – use sterile eye
• Rest and reassure.
• Monitor vital signs (Pg 37, 40). (saline) solution or gentle water pressure from hose/ tap.
• Elevate legs if shock develops (Pg 14). • If this fails, and the particle is on white of eye or eyelid,
gently lift particle off using a moistened cotton bud or the
• DO NOT push bowel back into abdominal corner of a clean handkerchief.
cavity. (DO NOT attempt this if particle is on coloured part of eye –
• DO NOT apply direct pressure to the irrigate only)
wound. • If still unsuccessful, cover the eye with a clean pad ensuring
• DO NOT touch bowel with your fingers no pressure is placed over injured eye.
(may cause spasm). • Seek medical aid.
• DO NOT give food or drink (this may delay • DO NOT allow casualty to rub eye.
surgery for wound repair). Penetrating Injury:
FIRST AID
• Lay the casualty flat
• Reassure
• Call☎
• Place padding around the object.
• Place a paper cup over the object to stabilize it.
• Tape or bandage to hold in place.
• Advise casualty to avoid moving unaffected eye, because
this will cause movement of injured eye.
• Cover the unaffected eye, but remove if casualty becomes
anxious.
• DO NOT remove embedded object.
• DO NOT apply pressure over the object.
Direct Blow: Any direct blow to the eye such as a fist or squash ball can cause fracture
of the eye socket or retinal detachment.
FIRST AID • Rest and Reassure • Place padding over eye • Secure with tape or
bandage • Ask casualty to limit eye movement • Seek urgent medical aid
Head Injury Spinal Injury

Blood or fluid from the ear may indicate a The key to managing a spinal cord injury: Protect airway & Minimise spinal movement
ruptured eardrum or skull fracture:
Conscious:
Cervical
• Position casualty injured side down to
allow free drainage of fluid from the ear. SIGNS & SYMPTOMS FIRST AID
• DO NOT plug or bandage ear. • Pain in neck or back. • Prevent further injury by AVOIDING movement
• AIRWAY management takes priority • Pins and needles in any part of of patient - leave this to the experts.
over any other injuries. body. • Advise casualty to remain still.
Spinal Column
• Numbness or weakness. • Call☎
Thoracic
• ALL cases of unconsciousness, even
if casualty was unconscious only • Unable to move legs or arms. • Support the head and neck.
briefly, must be assessed by a doctor. • Uncontrolled penile erection. • Reassure casualty.
• If casualty didn’t lose consciousness, • Onset of shock (Pg 14). • Maintain body temperature with a blanket.
but later develops any of the following
signs and symptoms (below), urgent QUICK CHECK Conscious Casualty:
medical advice must be sought. • Can you wriggle your fingers and toes for Support the head and
• Monitor all casualties closely for the Lumbar me? neck in a conscious
first 8 hrs after a head injury. casualty with neck pain.
• Can you make a fist?
• All head injuries should be suspected Do not remove helmet
as a spinal injury until proven • Can you shrug your shoulders? and ask casualty to
otherwise. • Can you pull your toes up towards you remain still.
and point them away?
FIRST AID • Do you have pins and needles anywhere?
SIGNS & SYMPTOMS • Can you feel me touch your hands/ feet?
Check DRSABCD (Pg 3)
• Headache or giddiness
Conscious: NB. If the casualty has neck or back pain-
• Nausea or vomiting
• Support casualty’s head as best as possible. treat as a spinal injury. The pain may be
• Drowsy or irritable
• Reassurance, especially if confused. due to an unstable vertebral fracture which
• Slurred speech
• If blood or fluid coming from ear or nostril, loosely may result in spinal cord damage if handled
• Blurred vision
cover with a dressing (do not plug). incorrectly.
• Confused or disorientated.
• Control bleeding and cover wounds (Pg 12).
• Loss of memory Suspect spinal injury with:
• DO NOT give anything to eat or drink.
• Swelling and bruising around eyes. motor vehicle accidents, motor bike and Unconscious casualty:
• DO NOT give aspirin for headache (may cause
• Bleeding into corner of eyes. cyclists, diving, falls from a height, minor Turn casualty onto their side,
bleeding within skull).
• Bruising behind ears. falls in the elderly and sports injuries such maintaining head, neck, and spinal
• Prepare for possible vomit – locate bowl, towel.
• Straw coloured fluid or bleeding as rugby and horse riding. alignment. Maintain an open airway.
• Seek urgent medical aid.
from nose or ear.
• Loss of power in limbs.
Unconscious: Unconscious:
• Recovery position with head & neck support.
• Loss of co-ordination. Any person found unconscious is potentially spinal injured until proven otherwise - turn
• Seizure
• Call ☎
• Monitor Vital Signs every 5-10mins (Pg 37, 40).
casualty onto their side and maintain an open airway. REMEMBER, airway management
• Unequal pupils takes priority over spinal injury.
• Control bleeding and cover wounds.
• Loses consciousness, even briefly. FIRST AID
• Support/stabilize head and neck. Helmet Removal: Helmets could
• Keep warm with a blanket. be preventing further spinal or head • Recovery position with head & neck support
Concussion: “Brain Shake” is a • Prepare for possible vomit. injuries. If a full-face (motorcycle) helmet ☎
• Call
• Monitor Vital Signs every 5-10mins (Pg 37, 40)
temporary loss or altered state of is impeding proper airway management
in an unconscious casualty and/ or you • Control bleeding and cover wounds
consciousness followed by complete Cerebral Compression: Brain swelling or bleeding
recovery. Subsequent decline need to perform CPR, the helmet needs • Support/ stabilize head and neck
within the skull shows deteriorating signs and
(see signs and symptoms above) to be removed carefully. Otherwise leave • Keep warm with a blanket
symptoms (above). This is a serious brain injury and
suggests a more serious brain injury. helmet removal to the experts. • Prepare for possible vomit
could be life threatening.
22 | Medical Emergencies Medical Emergencies | 23
Heart Conditions Angina is a “cramping” of the heart muscle; relieved Asthma Asthma is spasm and narrowing of the airways with inflammation and
by rest, with no permanent muscle damage. increased mucus production which causes breathing difficulties. Asthma attacks are
Heart attack is caused by a blocked coronary artery, triggered in sensitive airways by changes in the weather, exercise, emotional stress, pollen,
resulting in muscle damage which may lead to dust-mite, food preservatives, smoke, fumes or cold and flu infection.
complications such as cardiac arrest. SIGNS & SYMPTOMS FIRST AID
Cardiac arrest is a condition in which the heart stops Mild: • Sit casualty comfortably upright.
beating and pumping effectively. The damage caused • Dry cough • Calm and reassure.
by a heart attack may cause abnormal rhythms • Wheeze – during exhalation • • Follow casualty’s Asthma Action Plan
(Venticular Fibrillation) which result in cardiac arrest. • Breathless but speaks in sentences or give
Some abnormal rhythms can be reversed by an AED. • Reliever Medication
Cardiac arrest is fatal without basic life support (Pg 3). Moderate:
• Wheeze - during exhalation and inhalation (4 puffs every 4 mins)
“Heart attack” and “Angina” are heart conditions • Rapid breathing • If no improvement, repeat
which present with similar signs and symptoms. • Breathless - speaks in phrases • Call☎ if no improvement
• Give oxygen if available (8L / min)
SIGNS & SYMPTOMS – vary greatly, and not all symptoms and signs are present! • Anxious
• Pale and sweaty • Keep giving 4 puffs every 4 mins until
• Central chest pain – may be described as •Crushing •Tightness •Heaviness
• Rapid pulse ambulance arrives or casualty improves
• Breathlessness or difficulty “catching the breath”
significantly.
• Indigestion type pain in the upper abdomen (referred pain from the heart) Severe: • Collapse:
• Pain radiating to the •Jaw •Neck •Shoulder •Left arm • Can’t speak (too breathless) • Commence DRSABCD (Pg 3)
• Heaviness or weakness in left arm • Wheeze inaudible (no air movement)
• Dizzy • Cyanosis (blue lips) Rescue breaths require much greater
• Nauseous NB. Casualties having a heart attack may present with • Exhaustion force due to narrowed airways. Slowly
• Pale and sweaty breathlessness alone while others may have heaviness • Distressed inflate with a steady pressure until chest
• Irregular pulse in the arm or believe they have indigestion. • Altered state of consciousness begins to rise. Allow time for chest to fall
• Collapse -Respiratory arrest during expiration. You may only achieved
FIRST AID a rate of 6 breaths/ min.
• STOP and REST – in position of comfort (usually sitting). Give Reliever Medication
• Reassure and talk to casualty – Are you on prescribed heart medication? via spacer. Use puffer
Do you have angina? Can you take aspirin? on it’s own if spacer not
• If casualty has no heart medication and has never been diagnosed with heart problems available.
– treat as for HEART ATTACK • Call ‘ ☎ ’ • Give aspirin • Monitor
• Assist casualty to take prescribed heart medication (anginine tabs or GTN spray).
• If after 5 mins symptoms are not relieved, give another dose of heart medication.
ANGINA should be relieved by rest and medication (tablets or spray). Spacer

• If after 3 doses of medication over 10mins, the pain has not diminished,
then the condition should be considered a HEART ATTACK
Reliever Medication: • Shake inhaler (Puffer). • Shake inhaler and place
Warning signs: DON’T WAIT • Blue - grey coloured • Place mouthpiece in mouthpiece into spacer.
Pain lasts > 10 mins
Pain gets suddenly worse
ACT NOW
Call ☎ Give Aspirin 300mg
(one chewable tablet)
inhalers (puffers) eg
Ventolin, Respolin,
casualty’s mouth.
• Administer 1 puff as casualty
• Place spacer mouthpiece into
casualty’s mouth.
Atrovent, Salbutamol. inhales slowly and steadily. • Administer 1 puff and ask
Aspirin should be given if directed. •Borrow an inhaler if casualty to breath in and out for
Monitor vital signs • Casualty holds breath for
DO NOT give aspirin if: necessary. 4 breaths.
Give Oxygen if trained 4 secs then takes 4 normal • Continue until 4 puffs have been
• Casualty takes Warfarin • No harm is likely to breaths. given.
(blood thinning medication) result from giving a
Vital Signs • Continue until 4 puffs have • Wait 4mins and repeat.
• Allergic to aspirin Prepare for CPR Reliever to someone who
(Pg 37, 40) been given. • (Spacers can be improvised
• History of Asthma or Stomach ulcers does not have asthma. • Wait 4mins and repeat. using a paper or styrofoam cup)
Croup/ Epiglottitis Seizure/ Epilepsy A seizure is caused by abnormal electrical activity in

Croup and Epiglottitis are infections of the upper airways (larynx, pharynx and trachea) the brain. Seizures vary from the briefest lapses of attention to prolonged convulsions
and occurs in young children. Both conditions start with similar signs and symptoms but (tonic-clonic or grand mal seizure). A seizure can occur in a person with • Epilepsy • Head
epiglottitis progresses to a life-threatening state. Croup: Viral infection Injury • Stroke • Meningitis • Fever (febrile convulsion) • Hypoglycaemia (diabetics)
affecting upper airways • Poisoning • Alcohol and • Drug Withdrawal.
CROUP: • DO NOT examine child’s in infants and children FIRST AID
• Cold-like symptoms throat – this may cause < 4yrs. Slow onset, SIGNS & SYMPTOMS • Protect from harm – remove dangerous objects
• Barking cough complete blockage. usually follows a cold or Tonic-Clonic Seizure (Grand Mal) or protect head with cushion/ pillow.
Mild
• Noisy breathing • Calm and Reassure. sore throat and lasts 3 – • Aura (warning sign: eg abnormal • Note the time.
• Slight temperature • Steamy shower room. 4 days. taste, smell, sound or sight). • AVOID restraining unless this is essential to
• Worse at night • Paracetamol • Cry out or make moaning sound. avoid injury.
Epiglottitis: Bacterial • Collapse and momentary rigidity • DO NOT put anything into casualty’s mouth.
• Breathing difficulties • Seek medical aid. infection of the epiglottis
• Cyanosis (blue lips) (tonic phase – lasts few secs). • Roll into Recovery position as soon as possible.
(flap above the vocal
• Eyes roll upwards or stare. • Monitor Vital Signs (Pg 37, 40).
cords) causing upper
EPIGLOTTITIS: • Jerking movements of body (clonic • Reassure casualty and allow to sleep under
airway obstruction. It
Severe
• Drools –can’t swallow phase – lasts few mins). supervision at end of seizure.
occurs in the 4 - 7yr age
• Quiet, doesn’t cough group and has a rapid
• Blue discolouration of face/ lips • Call ☎ if:
• Leans forward • Call ☎
• Comfort, reassure onset over 1-2hrs.
• Excessive salivation
• Tongue biting may result in blood
• Seizure lasts longer than 5mins.
• Another seizure quickly follows.
• Won’t talk This is an emergency
• High temperature • Sit upright on your lap. stained saliva. • Casualty is pregnant or has diabetes.
• Lots of TLC until and requires urgent • Loss of bladder or bowel control. • Seizure occurred in water.
• Skin flushed ambulance transport
ambulance arrives. • Breathing ceases – resumes once • This is casualty’s first ever seizure.
to the hospital. seizure finishes. • Casualty is injured or you’re in doubt.
Steam helps • Drowsiness and lethargy follows. A person known to have epilepsy may not require
alleviate symptoms ambulance care and may get upset when one is called.
of ‘Croup’ but won’t
cure the problem.
Doctors find it
difficult to clinically
differentiate
between ‘Croup’
and ‘Epiglottitis’
- further tests are
usually required.
Febrile Convulsion (Normal body temperature = 37°C)
Faint Febrile convulsions are associated with a high body temperature (>38°C). It is the rate of rise
in temperature, not how high it gets, which causes the convulsion. They occur in 3% of all
Fainting is a sudden, children between the age of 6mths and 6yrs.
brief loss of consciousness
caused by lack of blood flow SIGNS & SYMPTOMS FIRST AID SIGNS & SYMPTOMS FIRST AID
to the brain with full recovery. • Dizzy or light headed. • Lie casualty flat (Similar to epilepsy + fever) • Manage as for ‘Seizure/
It often occurs in hot • Nausea • Raise legs • Fever Epilepsy’.
• Sweating • Pregnant woman turn onto • Skin hot, flushed PLUS:
conditions with long periods
• Return of consciousness left side. • Eyes roll up • Remove excess clothing
of standing; sudden postural
within a few seconds of • Recovery position if • Body stiffens • Apply cold compress to
changes (eg from sitting to • Back and neck arches
standing); pregnancy (lower lying flat. unconscious > few secs. forehead
• DO NOT give food or drink. • Protect from harm • Place in • Jerking of face, limbs • DO NOT allow shivering
blood pressure); pain or • Pale and sweaty
• Check for other injuries. recovery position after seizure • Frothing at mouth to occur
emotional stress (eg sight of • Mild confusion or
stops • Remove excess • Blue face and lips • DO NOT put in cold bath
blood). embarrassment.
clothing • Lethargy follows
26| Medical Emergencies Medical Emergencies | 27
Diabetes Stroke
• Diabetes is an imbalance between glucose and insulin levels in the body. The blood supply to part of the brain is disrupted, resulting in damage to brain tissue.
• The imbalance may result in Hypoglycaemia (Low blood sugar) or Hyperglycaemia This is caused by either a blood clot blocking an artery (cerebral thrombosis) or a ruptured
(High blood sugar). Both conditions, if left untreated, result in altered states of artery inside the brain (cerebral haemorrhage).
consciousness which are medical emergencies. The signs and symptoms of a “stroke” vary, depending on which part of the brain is damaged.
SIGNS & SYMPTOMS - Both conditions share similar signs and symptoms: SIGNS & SYMPTOMS FIRST AID
• Appear to be drunk (Dizzy, drowsy, confused, altered level of consciousness) • Confusion or dazed state • If casualty fails one of the FAST tests, act
• Rapid breathing • Rapid pulse • Unconscious • Headache
• Unequal-sized pupils
fast and Call☎
• Adopt position of comfort
HYPOglycaemia (LOW) HYPERglycaemia (HIGH)
• Blurred vision • Reassure
DIFFERENCES
• Pale, cold sweaty skin • Warm, dry skin

• Drooping of one side of face • Recovery position if unconscious
• Fast progression • Slow progression
• Slurred speech • Maintain body temperature
• Hunger • Acetone smell on breath (nail polish remover)
• Difficulty swallowing - drool • Give oxygen if available
• Trembling • Thirst
• Weakness or paralysis affecting one • Monitor Vital Signs (Pg 37, 40)
• Weakness • Passes urine frequently
side of body.
• Seizure • Nausea and vomiting
• Loss of balance New drugs and medical procedures can limit or
• Abdominal Pain
• Incontinence of bladder/ bowel. reduce damage caused by a stroke.
• The most common type of diabetic emergency is Hypoglycaemia. • Seizure Therefore, prompt action is essential for optimum
• Hyperglycaemia is not common, as its slow onset allows diabetics to take corrective • Unconsciousness recovery.
measures. TIA (Transient Ischaemic Attack) is a mini-stroke
FAST is a simple way of with signs and symptoms lasting < 60mins.
FIRST AID Hypoglycaemia can occur if a remembering the signs of a
Both conditions (Hypo and Hyperglycaemia) are person with diabetes: The risk of a stroke subsequent to a TIA is high,
stroke:
managed the same way by first aiders. • Takes too much insulin therefore early recognition and treatment is vital.
• Facial weakness – Can the
Conscious: • Fails to eat adequately casualty smile? Has their mouth or
• Give sweet drink/ food: 5-7 jelly beans, 2-4 • Over-exercises ie burns off sugar eye drooped?
teaspoons of sugar or honey, glass of fruit juice faster than normal • Arm weakness – Can casualty
(not diet or low sugar type). • Becomes ill – viral infection raise both arms?
• Repeat if casualty responds eg. diarrhoea and vomiting • Speech – Can casualty speak
• On recovery assist with high carbohydrate food: • Experiences great emotional clearly and understand what you
sandwich, few biscuits, pasta or rice meal. stress say?
• Call ☎
if no improvement within a few minutes of The reason sugar is given to
giving sugar (could be hyperglycaemia or another diabetics with an altered state of
• Time to act fast - Call ☎ Cerebral haemorrhage Cerebral thrombosis
medical condition).
Unconscious:
consciousness is that most will be
hypoglycaemic. The symptoms Hyperventilation
• Place in recovery position of hypoglycaemia progress more Hyperventilation syndrome is the term used to describe the signs and symptoms resulting
• Call ☎
• DO NOT administer insulin – could be fatal
rapidly and must be addressed
quickly.
from stress-related or deliberate over-breathing. The increased depth and rate of breathing
upsets the balance of oxygen and carbon dioxide which results
SIGNS & SYMPTOMS
• GIVE NOTHING by mouth If the casualty is hyperglycaemic, • Rapid breathing in diverse symptoms and signs.
the small amount of sugar given • Light-headedness NB. Other conditions
by a first aider will not significantly • Tingling in fingers and FIRST AID which may present with
raise blood sugar levels and will do toes. • Calm and Reassure. rapid breathing:
no harm. • Blurred vision • Encourage slow regular breathing • Asthma attack
• Spasms in hands and - count breaths aloud. • Heart failure
fingers. • Seek medical aid – exclude other • Heart attack
Don’t give diet or diabetic food/ drink medical condition. • Collapsed lung
which contains artificial sweetener – • Severe Anxiety • Embolus (clot) in lung
• Chest discomfort • DO NOT use a bag for
Fruit Juice Sugar Jelly Beans this doesn’t correct low blood sugar. rebreathing. • Diabetes
• Rapid pulse • Some poisons
Heat Exposure Normal body temp = 37°C Cold Exposure

Exposure to cold conditions can lead to hypothermia (generalised cooling of the body) or
Heat Exhaustion: occurs when the body cannot lose heat fast enough. Profuse frostbite (localised cold injury).
sweating occurs in an effort to lower body temperature but this leads to fluid loss and
decreased blood volume (mild shock). If not treated quickly, it can lead to heat-stroke. Hypothermia: is a condition where the body temperature drops below 35°C
• Hypothermia can be mistaken for drunkenness, stroke or drug abuse.
Heat Stroke: occurs when the body’s normal cooling system fails and the body • Suspect hypothermia when conditions are cold, wet and windy, especially in the young
temperature rises to the point where internal organs (eg brain, heart, kidneys) are damaged: and elderly or individuals under the influence of alcohol or drugs.
Blood vessels near the skin’s surface dilate in an attempt to release heat, but the body is • As the core body temperature drops, so does the metabolic rate which means the cells
so seriously dehydrated that sweating stops (red, hot, dry skin). Consequently, the body require less oxygen. Hypothermia protects the brain from the effects of hypoxia so
temperature rises rapidly because the body can no longer cool itself. resuscitation should be continued until the casualty can be rewarmed in hospital.
This is a life-threatening condition. MILD Hypothermia MODERATE Hypothermia SEVERE Hypothermia
Heat Exhaustion 35°– 34°C 33°– 30°C <30°C
Organs cook at 42°C FIRST AID • Maximum shivering • Shivering ceases • Unconscious
(Mild – Moderate Hyperthermia)
• Move casualty to cool, • Pale, cool skin, blue lips • Muscle rigidity increases • Cardiac arrhythmias
• Body Temp 37°C – 40°C Heat Stroke shaded, ventilated area. • Poor coordination • Consciousness clouded • Pupils fixed and dilated
SIGNS & SYMPTOMS
• Sweating
(Severe hyperthermia)
• Body Temp > 40°C
• Lie flat with legs elevated.
• Loosen and remove excess
• Slurred speech
• Apathy and slow thinking
• Irritable or confused
• Slow pulse }
• Slow breathing hard to
detect
• Appears dead
• Cardiac arrest
• Pale, cold, clammy skin SIGNS & SYMPTOMS clothing.
• Headache • Cool by: •fanning •spraying • Memory loss
• NO Sweating FIRST AID
• Muscle cramps
• Thirst
• Red, hot, dry skin
• Nausea and vomiting
with water •applying wrapped
ice packs to neck, groin and • DO NOT re-warm too quickly- can
• Call☎
• Seek shelter – protect from wind chill.
• Fainting • Visual disturbances armpits •draping wet sheet cause heart arrhythmias. • Handle gently to avoid heart arrhythmias.
• Nausea • Irritability/ confusion over body and fanning. • DO NOT use radiant heat (eg fire • Keep horizontal to avoid changes in blood
• Rapid pulse • Staggering/ unsteady • Give cool water to drink if or electric heater) - re-heats too supply to brain.
(Onset of mild shock due to fluid fully conscious. quickly.
• Seizures • Replace wet clothing with dry.
loss, Pg 8) • Seek medical help or • DO NOT rub or massage
• Unconscious • Wrap in blankets/ sleeping bag or space
Progresses to (Sometimes profuse sweating occurs) ☎
• Call if in doubt extremities- dilates blood vessels in
skin so body heat is lost.
blanket and cover head.
• Give warm, sweet drinks if conscious.
• DO NOT give alcohol – dilates IF NOT SHIVERING:
Heat radiates from the blood vessels in skin and impairs
body, especially the head • Apply heat packs to groins, armpits, trunk
Breeze or fan shivering. and side of neck.
into the surrounding air
During breathing, cold air • DO NOT put casualty in hot bath • Body-to-body contact can be used.
is inhaled and warm air is as monitoring and resuscitation if
exhaled IF UNCONSCIOUS:
needed may be difficult. • DRSABCD (Pg 3) - Check breathing/ pulse
for 30- 45secs as hypothermia slows down
Heat is lost through
evaporation (sweat) on
Frostbite: is the freezing of body everything.
Heat Exhaustion and Heat Stroke are tissues and occurs in parts exposed to the • If no signs of life – commence CPR while
the skin usually caused by over-exertion in hot,
cold. re-warming casualty.
humid conditions with poor fluid intake.
Heat is lost through
convection ie warm SIGNS & SYMPTOMS • White, waxy skin • Skin feels hard • Pain or numbness
air around the body is
replaced with cold air FIRST AID
- worse on windy days • Seek shelter • Treat hypothermia before frostbite • Gently remove clothing from
Heat is
conducted affected area • Rewarm affected area with body heat - place in armpit (rewarming can
from the be very painful) • DO NOT rub or massage affected area – tiny ice crystals in tissue
warm body to may cause more damage • DO NOT use radiant heat • DO NOT break blisters
a cold object • NEVER thaw a part if there is any chance of it being re-frozen. Thawing and refreezing
Frost bite results in far more tissue damage than leaving tissue frozen for a few hours.
Body heat can be lost quickly in high, exposed areas
Bites/ Stings (Found in Tropical waters) Bites/ Stings

Box Jellyfish Irukandji Jellyfish
LAND TYPE FIRST AID
ANIMALS SIGNS & SYMPTOMS SIGNS & SYMPTOMS
FATAL Snakes Pressure Immobilisation Technique
• Severe immediate skin pain • Mild sting followed 5-40mins later by:
(PIT) • Frosted pattern of skin marks • Severe generalised pain
Funnel web Spiders
• Collapse • Nausea, vomiting, sweating
Red back spiders/ others COLD COMPRESS/ ICE PACK • Cardiac Arrest • Collapse /Respiratory arrest
(PIT if allergic to bite/ sting)
Bees (Anti-venom available) (No anti-venom)
Wasps
Scorpion FIRST AID
Ants
Red Back Spider •DRSABCD •Remove casualty from water •Call ☎ •Reassure •AVOID rubbing sting area
•Flood sting with VINEGAR for 30 secs •If no vinegar–pick off remnants of tentacles and
SEA TYPE FIRST AID rinse with seawater (NOT freshwater) •If no signs of life, commence CPR
CREATURES
FATAL Sea Snakes Fish stings: •Sharp barb •Painful wound •Bleeding •Place wound in hot water
Blue-Ringed Octopus Pressure Immobilisation Technique (PIT) Red Back Spider: •Intense local pain at bite site •Not life-threatening •Apply cold pack
Tropics
Cone Shell
Bee/Wasp stings: •Scrape sting off sideways •Apply cold pack •PIT if allergic to sting
Box Jelly Fish VINEGAR - Use salt water (not fresh water) if
Ant/ Scorpion: •Painful sting •Not life-threatening •Apply cold pack for pain relief
Irukandji Jelly Fish vinegar not available
Bluebottles
Pressure Immobilisation Technique (PIT): This method is used to treat a variety of
Fish Stings : Stingray HOT WATER - Use cold compress if no pain relief bites and stings: •Snake •Funnel web spider •Blue-ringed octopus •Cone shell
: Stonefish with hot water •Bee, wasp and ant bites in allergic individuals.
: Bullrouts
Snakes Funnel web Spider Blue-Ringed Octopus Cone Shell
SIGNS & SYMPTOMS: similar for all 4 species with death from Respiratory Arrest
within minutes to hours.
•Painless bite •Droopy eyelids •Blurred vision •Difficulty speaking and swallowing
•Breathing difficulties •Abdominal pain •Nausea and vomiting •Headache
•Tingling/numbness around mouth •Profuse sweating •Copious salivation •Collapse
1. Apply a pressure 2. Apply a second 3. Splint the bandaged
FIRST AID bandage over the bite area bandage from fingers or limb, including joints either
• DRSABCD as firmly as a bandage to a toes extending upwards side of bite site.
• Rest and reassurance. sprain. covering as much of limb as •Rest casualty and limb.
• Call ☎
• Pressure Immobilisation Technique
Blue-
Ringed
•DO NOT wash bite site
•Mark “X” over bite site
possible.
•Bandage over the top of
•Check circulation (Pg 11)
•DO NOT elevate limb.
• Resuscitation if needed, takes Snake Octopus (If only one bandage jeans/ shirts as undressing •DO NOT remove bandage
priority over PIT. available: start from causes unnecessary and splint once it has been
• DO NOT wash bite site (land Funnel web fingers/ toes and wind as movement applied.
animals). Spider far up limb as possible •Mark “X” over bite site • DO NOT suck venom
• DO NOT suck venom from a bite. covering the bite). from bite site.
• DO NOT kill animal – identification
of species is made from venom on PIT (Pressure Immobilisation Technique) slows the lymph flow and
skin. Cone Shell inactivates certain venoms by trapping them in the tissues.
Poisons Allergy/ Anaphylaxis Anaphylaxis is a life-threatening allergic reaction
A poison is any substance which causes harm to body tissues. which can be triggered by nuts (especially peanuts), insect stings (bee, wasp, ant),
A toxin is a poison made by a living organism (eg animal, plant, micro-organism). shellfish, latex products and certain drugs (eg Penicillin).
A venom is a toxin which is injected by a fang or sting (eg snake, spider, fish). The airways rapidly swell and constrict, interfering with breathing, and the blood vessels
13 11 26 - Australian Poisons Information Centre widen, leading to shock (Pg 14). Casualties need an immediate injection of adrenaline.
Free Call, Available 24hrs, Australia wide. People who know they are at risk may wear a medical alert bracelet and carry their own
Poisons can be ingested (swallowed), absorbed, inhaled or injected. The effect of a poison injectable adrenaline. FIRST AID
will vary depending on what the substance actually is and how much has been absorbed. SIGNS & SYMPTOMS • Assist casualty to position of comfort.
Ingested: Mild to moderate Allergic • Call ☎
• Apply Pressure Immobilization Technique
Swallowed substances can be broadly categorised into ‘corrosive’ or ‘non-corrosive’. reaction:
• Swelling of lips, face, eyes if allergic to bite/ sting (Pg 31).
Corrosive: Burning substances eg dish washer detergents, caustics, toilet/ bathroom
• Hives or rash (red, itchy) • Follow casualty’s Action Plan for Anaphylaxis.
cleaners and pertoleums.
• Metallic taste in mouth • Assist casualty with EpiPen/ Anapen.
Non-Corrosive: Non-burning substances eg medications (tablets/ liquids) and plants.
• Dizziness and Weakness • Record time EpiPen/ Anapen was given.
SIGNS & SYMPTOMS of a corrosive FIRST AID • Rapid pulse • Administer oxygen if available.
substance: •pain in the mouth/ • Identify type and quantity of poison • Nausea • Collapse or unconsciousness - DRSABCD (Pg 3).
abdomen •Burns to lips/ mouth •Nausea/ (from container/ bottle). • Abdominal cramps NB - Rescue Breaths require more force due to narrowed airways
vomiting •Tight chest •Difficulty breathing • Establish the time of poisoning.
•Sweating •Unconscious • DO NOT induce vomiting. Severe Allergic Reaction Use EpiPen or Anapen when symptoms become severe.
• DO NOT give anything by mouth. (Anaphylaxis): EpiPen and Anapen are pre-loaded auto-injecting pens
• Swelling of throat, tongue containing a measured dose of adrenaline (Epinephrine).
• Difficulty swallowing It takes only 1- 2mins for a mild allergic reaction to
• If rescue breathing is required, wipe away FOR ALL POISONING: • Noisy breathing (stridor) escalate to anaphylaxis.
any contamination from around the mouth. • DRSABCD
• Use a resuscitation mask if available. • Wheezing
• What? When? How Much? • Difficulty talking/ hoarseness
• DO NOT use Syrup of Ipecec to induce • Call Poisons Information Centre for advice
vomiting unless advised by Poisons • Pale and floppy (young child)
Information Centre.
or Call ☎
• Monitor Vital Signs (Pg 37, 40) • Collapse or unconsciousness
• Send any containers and/ or suicide notes Hives Swelling
with casualty to hospital.
Absorbed: • Send any vomit with casualty to hospital. How to Use an Anapen: How to Use an EpiPen:
Chemical splash from eg pesticide, weed killer. 1. 2.
FIRST AID
• DO NOT become contaminated yourself – wear gloves, goggles, protective clothing.
• Ask casualty to remove all contaminated clothing.
• Flood affected area with running water • Seek medical advice if required 1. 2.
Form fist around Place black end against
Inhaled: Pull off Black needle
shield.
Pull off grey safety cap
from red button. EpiPen and pull off outer mid-thigh. (with or
Toxic fumes from gas, burning solids or liquids. Inhaled poisons include: carbon monoxide grey safety cap. without clothing)
(car exhausts); methane (mines, sewers); chlorine (pool chemicals, cleaning products); 3. 4.
fumes from paints, glues, and industrial chemicals. FIRST AID
• Move casualty to fresh air
SIGNS & SYMPTOMS
• Loosen tight clothing
• Breathing problems • Headache
• Give oxygen if available
• Nausea • Dizziness • Confusion
Injected: • Call ☎ Place needle end firmly Press red button so it 3. 4.
As a result of a bite or sting (Pg 30, 31) or may be injected with a needle. against outer mid-thigh clicks and hold for 10secs. Push down hard until a click Remove EpiPen and
The most common type of drug overdose via injection are narcotics which cause respiratory (with or without clothing)
Remove Anapen and is heard or felt and hold in massage injection site
depression (slow breathing), respiratory arrest (no breathing) or unconsciousness. The most massage injection site for place for 10secs. for 10secs.
common injection sites are: hands, feet, crease of elbow, between toes and fingers. 10secs DO NOT remove grey cap until ready to use.
NB. Narcotic users may be carriers of Hepatitis B, C, and/ or HIV (AIDS). BEWARE of needle protruding from end after use. BEWARE of needle protruding from black end after use.
34 | General First Aid General First Aid | 35
Principles What is First Aid? It’s the immediate care of an injured or Communication
of First Aid suddenly sick casualty until more advanced care arrives. The role of the first aider depends on gaining and honouring the trust of casualties.
Maintaining trust requires attentiveness to body language, quality of listening and finding
The aims of first aid are to:
culturally appropriate ways of communicating that are courteous and clear. It may sometimes
• Preserve life – This includes the life of rescuer, bystander and casualty.
be necessary to communicate through verbal and non-verbal communication and you may
• Protect from further harm – Ensure the scene is safe and avoid harmful intervention.
need to identify issues that may cause conflict or misunderstanding. The first aider also
• Prevent condition worsening – Provide appropriate treatment.
needs to maintain respect for privacy and dignity and pay careful attention to client consent
• Promote recovery – Act quickly, provide comfort and reassurance, get help, call
Helping at an emergency may involve:
. ☎ and confidentiality.
•Phoning for help •Comforting casualty or family •Keeping order at an emergency scene Reports
•Administering first aid While waiting for help and if time permits, make a brief written report to accompany the
There are many ways you can help, but first you must decide to act. casualty to hospital. This will reduce time spent at the scene for ambulance crew and further
Reasons why people do not help: assist medical and nursing staff with initial patient management. A report can be written on a
•Fear of doing something wrong •Fear of disease transmission •Uncertainty about the spare piece of paper and should include the following:
casualty •Nature of injury or illness (blood, vomit, burnt skin can be unpleasant) •Presence • Date, time, location of incident
of bystanders (embarrassed to come forward or take responsibility) The back inside page
• Casualty details - Name, DOB, Address. contains a ‘First Aid Report
You may need to compose yourself before acting. Do not panic – a calm and controlled first • Contact Person for casualty - Family member, friend. Form,’ which can be torn
aider gives everyone confidence. If you follow basic first aid procedures, you should deliver • What happened - Brief description of injury or illness. off and used at a first aid
incident.
appropriate care, even if you don’t know what the underlying problem is. Remember, at an • First aid action taken – What you did to help the casualty.
emergency scene, your help is needed. • Other health problems – Diabetes, epilepsy, asthma, heart problems, operations.
Helping at an emergency may involve: • Medications/ allergies – Current tablets, medicines.
•Phoning for help •Comforting casualty or family •Keeping order at an emergency scene • When casualty last ate or drank – Tea, coffee, water, food.
•Administering first aid • Observations of Vital Signs - Conscious state, pulse, breathing, skin state, pupils.
There are many ways you can help, but first you must decide to act. • First Aider’s name/ phone number incase medical staff need any further information.
Reasons why people do not help:
•Fear of doing something wrong •Fear of disease transmission •Uncertainty about the
Record Keeping
In the workplace, it is important to be aware of the correct documentation
casualty •Nature of injury or illness (blood, vomit, burnt skin can be unpleasant) •Presence
and record keeping used in first aid situations.
of bystanders (embarrassed to come forward or take responsibility) Each organisation has its own set of procedures and documentation so
You may need to compose yourself before acting. Do not panic – a calm and controlled first
familiarize yourself with the correct process.
aider gives everyone confidence. If you follow basic first aid procedures, you should deliver
All documentation must be legible and accurate and must contain a description of the illness
appropriate care, even if you don’t know what the underlying problem is. Remember, at an
emergency scene, your help is needed. or injury and any treatment given. Thorough and accurate medical records are essential in
any court case or workers compensation issue.
Legal Issues In addition:
No ‘Good Samaritan’ or volunteer in Australia has ever been successfully sued for the •Write in pen (not pencil) •Never use correction fluid – cross out and initial any changes
consequences of rendering assistance to a person in need. A ‘Good Samaritan’ is a person •Sign and date the form •Keep contents strictly confidential
acting in ‘good faith’ without the expectation of financial or other reward.
Duty of care: In a workplace environment there is an automatic duty of care to staff and Self-help/ Evaluation
Each person reacts differently to traumatic events and in some instances strong emotions
customers - a failure to act in a way that is consistent with an obligation to provide reasonable may affect wellbeing and work performance. Symptoms may appear immediately or
assistance, to the best of our ability, may result in negligence and possible litigation. In the sometimes months later after an event and may develop into chronic illness.
community, you are under no legal obligation to provide first aid. There is no right or wrong way to feel after an event but what a person experiences is valid
Consent: Before providing first aid, you must first gain consent from the casualty. If the for that person. It is useful to identify and work through these reactions/feelings as early as
casualty refuses help, you must respect their decision. If the casualty is unresponsive or of possible. Speaking to an understanding friend, counselor or medical professional may be
unsound mind and therefore unable to give consent, it is assumed they would give consent beneficial in assisting you to cope with the situation.
if they were conscious and/ or orientated. If the casualty is a child, the parent/ guardian In addition, seeking feedback from medical personnel about your first aid performance may
should be asked permission, but if no parent/guardian is present and the injury/illness is life- assist with self-improvement and prepare you better for any future events.
threatening, immediate first aid should be given. Some Reactions/ Symptoms •Crying for no apparent reason •Difficulty making decisions
Confidentiality: Personal information about the health of a casualty is confidential. This •Difficulty sleeping •Disbelief •Irritability •Disorientation •Apathy •Sadness •Depression
information includes details of medical conditions, treatment provided and the results of tests. •Excessive drinking or drug use •Extreme hunger or lack of appetite •Fear/anxiety about the
Disclosure of personal information, without the person’s written consent is unethical and in future •Feeling powerless •Flashbacks •Headaches •Stomach problems •Heart palpitations
some cases may be illegal. •Muscle aches •Stiff neck
36 | General First Aid General First Aid | 37
Safe Manual Handling Casualty Assessment When dealing with a person who is ill or injured,
When lifting or moving a casualty it’s important the first aider protects him/herself from you need a clear Plan of Action:
injury by using correct lifting techniques - bending the knees and using leg muscles Radial pulse 1.Start with a Primary Survey (DRSABCD), (Pg 3)
will help protect against back injury. However, knowing your own limitations and asking which enables identification and management of
for assistance if required is also important in preventing injury. In addition, learning the life-threatening conditions.
correct procedures for moving a casualty (eg rolling casualty into recovery position) further 2.If there are no life-threatening conditions which
minimises injury to the casualty and first aider. require immediate first aid (severe bleeding, no
Needle Stick Injury FIRST AID response) then proceed to Secondary Survey.
The risk of catching a serious infection (Hepatitis B, C • Squeeze blood out of injury site. Secondary Survey: is a systematic check of the casualty involving
and HIV) from needle stick injury is very low. • Wipe with alcohol swab. • Questions • Examination • Clue Finding to help identify any problems that may have
Reduce the risk of needle stick injury: • Wash hands. been missed.
•Never bend or snap used needles • Place syringe in plastic drink • If the casualty is unconscious, the secondary survey is conducted in the recovery
•Never re-cap a needle bottle or sharps container. position. You may need to look for external clues and ask bystanders some questions.
•Place used needles into a sharps approved container • Take syringe with you to • If the casualty is conscious start with questions followed by examination. Remember to
•Hepatitis B vaccination for workers who regularly hospital for analysis. introduce yourself, ask for consent to help and ask their name.
come in contact with blood/ body fluids Questions Examination
NB. Disposable gloves will not protect against needle stick injury. • What happened? Vital Signs: are indicators of body function and provide
Hygiene Minimise the risk of cross infection to yourself, bystanders and casualty
by taking appropriate precautions:
• Do you feel pain or numbness
anywhere?
a guide to the casualty’s condition and response to
treatment.
Prior to treatment: During treatment: After treatment: • Can you move your arms and • Conscious State: There are 3 broad levels –
• Wash hands with soap • Use a face shield/ • Clean up the casualty, yourself and legs? •Conscious •Altered consciousness •Unconscious
and water, or rinse with mask, if available immediate vicinity. • Do you have any medical Altered consciousness = uncooperative, aggressive,
antiseptic. when performing • Safely dispose of used dressings, conditions? confused, drowsy.
• Cover cuts on your hands resuscitation. bandages and disposable gloves • Do you take any medications? • Pulse: The carotid pulse in the neck is the best pulse
with a waterproof dressing • DO NOT cough, • Wash hands thoroughly with soap • Do you have any allergies? to check. Feel for rate, rhythm, force, irregularities.
before putting on gloves. sneeze or breath and water, even if gloves were used. • When did you last eat? Normal pulse rates: Adults: 60-80 /min
• Wear disposable gloves. over a wound. • Restock first aid kit. • (Bystanders may be helpful) Children: 80-100/min
• Do not touch any unclean • Avoid contact with Recommended Contents of
object when wearing body fluids. External Clues • Breathing: Look, listen and/or feel for breathing rate,
a Personal First Aid Kit depth and other noises eg wheezing, noisy breathing.
gloves . • DO NOT treat Medical Alert: casualties
Adhesive Strips (Band Aids) 10 Normal breathing rates: Adults 16-20 breaths/min
• Use a plastic apron and more than one with medical conditions such
eye protection. casualty without Adhesive Tape 1 Children: 25-40 breaths/min
Alcohol Swab 3 as diabetes, epilepsy or severe
• Cover any adjacent areas washing hands allergy usually have a bracelet, (Check pulse/ breathing for 15 secs then x by 4 to
likely to produce infection. and changing Combine Dressing - Large 1 get rate/min. Use a watch)
Crepe Bandage 5cm 1 pendant or card to alert people of
gloves. • Skin State: Look at face and lips.
Crepe Bandage 7.5cm 1 their condition.
First Aid Kits Eye Pad - Sterile 1 Medications: People on Red, hot skin – fever, heat exhaustion, allergy
Cool, pale, sweaty – shock, faint, pain, anxiety
• Keep a first aid kit at home, in your car and at First Aid Booklet/Guide 1 regular medication usually carry
it with them. Blue lips (cyanosis) – airway obstruction, asthma, flail
work in a clean, dry location. Gauze Swab 3 chest, collapsed lung, heart failure, hypothermia
• Make sure it is kept in easy reach and that all family Gloves Disposable 2 Carotid pulse • Pupils: Unequal, reactive to light
members and staff know where the kit is located. Hand Towels 3
• A regular check of contents is essential to ensure Head to Toe:
Non-Adhesive Dressing 2 • Seek consent from the conscious casualty before you
contents are present, not out of date and are in Plastic Bag for Amputations 1
good condition. begin.
Resuscitation Mask 1 • Look and feel for bruises, cuts, deformities and painful
• First aid kits will vary depending on the number of Safety Pins 5 areas.
employees, and even the industry you work in. If Scissors - Blunt/Sharp 1 • Start from the head and work down.
living in a remote area the contents will vary from Splinter Probe 1 • Explain to casualty what you are about to do at each
kits kept at homes in the city. Sterile Eye (saline) Solution- 15ml 2 stage eg “I’m just going to move your arm”.
• Under State and Territory legislation first aid Triangular Bandage 2 • Ask casualty for feedback at each stage eg “Does it
kits are required in all workplaces. Wound Dressing No. 14 1 hurt when I move your arm?”
38 | General First Aid
First Aid Report Form
Natural Medicine in First Aid (Complete this form as best you can and give to ambulance officer/ medical personnel)
Some natural remedies may be of benefit in first aid management.
REMEDY USE DESCRIPTION

Date: / / Time: Location:
Aloe Vera Burns Aloe vera gel (a Hydrogel) is very soothing when applied Casualty Details: Pension No:
topically to superficial burns (eg, sunburn).
Arnica Bruising Arnica ointment or tincture applied topically to a bruised area Name: DOB: / / M/F
assists healing. DO NOT apply to broken skin. Homoeopathic
arnica taken orally is also effective. Address:
Calendula Antiseptic Calendula tincture or ointment can be applied topically to minor Postcode:
cuts and grazes.
Cantharis Burns Homoeopathic cantharis dissolved under the tongue assists Contact Person for Casualty (friend/ relative):
healing of all burn types.
Name: Phone:
Comfrey Fractures/ Soft Grind fresh comfrey leaf in a mortar/ pestle to form a rough
(Symphytum) Tissue Injury paste. Apply paste to a dressing and secure in place over injury.
Homoeopathic comfrey (Symphytum) under tongue also assists
What Happened (a brief description):
healing.
Epsom Salts Soft Tissue On day 3 or 4 after injury, soak injury for 20mins in bucket
injury of Epsom salts and warm water to draw inflammation and
swelling.
Hydrogen Antiseptic/ 6% H2O2 kills infection in wounds when applied topically.
Peroxide Throat Gargle Effective for sore throat when gargled –froths in mouth. NOT
poisonous if swallowed. First Aid Action Taken:
Hypericum Nerve Injury Remedy for nerve injuries, especially crushed finger and
toenails. Homoeopathic hypericum taken orally helps relieve
pain and assist healing.
Mulla Mulla Burns/ Fever Mulla mulla, an Australian Bush Flower Essence, taken orally
helps to lower fevers and heal burns.
Rescue Emotional Bach flower, ’Rescue Remedy’ and Australian Bush Flower,
Remedy stress ‘Emergency Essence’ taken orally are effective remedies for
emotional stress.
Other health problems: Current Medications:
Rhus Tox Soft tissue Homoeopathic Rhus Tox and Ruta Grav taken orally are
Ruta Grav injury effective for ligament and tendon injuries. Combine with Diabetes
homoeopathic Arnica and Symphytum for fracture and soft
tissue injuries. Epilepsy
Peppermint Fever/ Heat Peppermint essential oil rubbed onto soles of feet helps lower Asthma
Exhaustion body temperature. Heart problems
Sea Salt Wound Clean wounds with sterile gauze swabs soaked in warm water
Cancer Allergies:
Cleaner and sea salt. DO NOT use cotton wool for cleaning – cotton Operations
fibres stick to wound.
Tea tree Antiseptic A few drops of tea tree essential oil mixed with Previous injuries
Papaw ointment makes an effective antiseptic for minor cuts
and grazes. Last ate or drank:
Topical: Apply to skin
cut here
Oral: Homoeopathic and flower remedies are dissolved under the tongue Turn over
Emergency Numbers
Casualty Examination: mark location of injuries on diagram and
Country
briefly describe injury eg cut, bruise, pain, swelling, burn.
Australia
☎ 000
112
13 11 26
Embassy
Travel
Agent
Observations
of Vital Signs:
Time Dial ‘112’ or ‘911’ from a mobile phone with GSM coverage anywhere in the world and
Conscious State your call will be automatically translated to that country’s emergency number.
Fully Conscious
Drowsy Local Emergency Numbers
Unconscious
Phone Notes
Pulse rate:
description: DOCTOR
Breathing rate: DENTIST
description: HOSPITAL
Skin State Colour:
PHARMACY
Temp:
Dry/Clammy: POLICE
Pupils TAXI
R L ELECTRICAL
GAS
First Aider’s Details: WATER
(Incase the hospital needs to contact you for more information regarding the incident).
VEHICLE
Name:__________________________________________________ BREAKDOWN
Phone: Mobile:
cut here
World Map of International Emergency Numbers
© ABC Publications
☎
112
Most of Europe, Azores, Bali,
Canary Islands, Columbia,
Cyrus, Kuwait, Malta, Vanuatu
Bahamas, Belize, Bermuda,

911 Botswana, Canada, many
Caribbean Islands, Fiji,
Hawaii, some South America
countries, Tonga, United
States (USA)
Beijing, Burma, Channel

999 Islands, Falkland Islands,
Ghana, Gibralta, Hong Kong,
Kenya, Malaysia (Singapore
995), Mauritius, Niue, Qatar,
Samoa, Seychelles, Sierra
Leone, Solomon Islands,
Sudan, Tansania, Uganda,
United Arab Emirates (UAE),
United Kingdom (UK),
Zimbabwe
France, Mali, Martinique, Mayotte, Morocco, Cambodia, Indonesia, Japan,

15 St Pierre & Miquelon, Tahiti (French Polynesia)
119 South Korea, Taiwan
110 Bhutan, Jamaica, Sri Lanka, Syria, Turkey 115 Iran, Pakistan, Suriname, Vietnam
Armenia, Belarus, Kyrgyzstan,

117 Madagasca, Mozambique, Philippines 103 Mongolia
Andorra, Angola, Bolivia, Haiti, Nicaragua, Azerbaijan, Kasakhstan, Russia
118 03 (Asian) Tajikstan, Uzbekistan
San Marino
Australia, Christmas Island,
112
199 000
911
Bangladesh (Dhaka), Nigeria
Norfolk Islands
No National Emergency Number

ABC First Aid Guide is
ABC
First
divided up into four main
colour coded sections:
Aid
1. Essential First Aid
2. Trauma
3. Medical Emergencies
Guide
4. General First Aid
Each subsection shows you step-by-
step how to recognise and deal with
an emergency.
In conjunction with an approved first aid
course, this book will assist you learn
the skills to handle most emergency
situations.
This book incorporates the 2010

Guidelines and is written for Australian
conditions.
For training purposes, this book
satisfies the Australian Health Training
Package competency units:
HLTFA301B: Apply First Aid
HLTCPR201A: Perform CPR
HLTFA201A: Provide Basic Emergency
Life Support
Keep this book with your first aid kit in the

workplace, at home, in your car or when
travelling overseas.
This book contains international
emergency numbers and is a useful
resource no matter where you are in the
world.

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ABC First Aid

Unconsciousness is a state of unresponsiveness, where the casualty is

Send or go for AED

CPR HAZARDS! CPR

Soft Tissue Injury & Fracture Arm Sling: Use a triangular

Lower Limb Injury FIRST AID Lower Limb Injury

• Control any external bleeding. to immobilise lower limb fractures.

Bleeding Embedded Object: eg knife, glass, stick or metal. Bleeding

2 •Severe 3 • Spinal injury

• Head injury, showing

Remember: A casualty is always in a changing, non static condition. This is especially

Head Injury Spinal Injury

ANGINA should be relieved by rest and medication (tablets or spray). Spacer

Croup/ Epiglottitis Seizure/ Epilepsy A seizure is caused by abnormal electrical activity in

• Pale, cold sweaty skin • Warm, dry skin

Heat Exposure Normal body temp = 37°C Cold Exposure

Bites/ Stings (Found in Tropical waters) Bites/ Stings

Snakes Funnel web Spider Blue-Ringed Octopus Cone Shell

REMEDY USE DESCRIPTION

Bahamas, Belize, Bermuda,

Beijing, Burma, Channel

France, Mali, Martinique, Mayotte, Morocco, Cambodia, Indonesia, Japan,

Armenia, Belarus, Kyrgyzstan,

No National Emergency Number

This book incorporates the 2010

Keep this book with your first aid kit in the

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