GOOGLE CLASSROOM MODULE 1

STANDARD FIRST AID

INTRODUCTIONs

When a person is injured or becomes ill, it rarely happens in a hospital with

doctors and nurses standing by. In fact, some time usually passes between the
onset of the injury or illness and the patient’s arrival at the hospital, time in which
the patient’s condition may deteriorate, time in which the patient may even die.
As a First Aider, you can make a difference.

COURSE LEARNING OUTCOMES

At the end of the module, the student’s characteristics are applied to skills
and the way the students learn them:
1. Course skills are complex. Students often have some difficulties when they first
begin.
2. Skills are learned by practice. Refinements in technique take time, and
immediate success in demonstrating the skill is unlikely.
3. Skill requires a defined sequence to movements. Students should follow the
sequence to perform the skill correctly.
4. Learning times for each skill differ, since some skills are easier than others.
5. Students have different learning rates. Take individual differences into account
when learning the course.
6. Skills are quickly forgotten. Regular practice improves retention of skills.

CONTENTS OF THE MODULE

This module contains the following lessons:
Lesson 1. Definition of First Aid
Lesson 2. Good Samaritan Laws
Lesson 3. Must you Give First Aid?
Lesson 4. Get the Victims Consent
Lesson 5. Follow Standard of Care
Lesson 6. Role and Responsibilities of the First Aider
Lesson 7. Objectives of First Aid
Lesson 8. Characteristics of a Good First Aider
Lesson 9. Hindrances in Giving First Aid
Lesson 10. Transmission of Diseases and the First Aiders
Lesson 11. Comparison of Transmittable Diseases
Lesson 12. First Aid Equipment and Supplies

DIRECTIONS ON HOW TO USE THE MODULE

1. Read the explanations thoroughly so that you would understand the lesson
entirely.
2. You will find the specific learning outcomes (SLOs) of each lesson. SLOs are
knowledge and skills you are expected to acquire at the end of the lesson. Read
them heartily.

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 3. You must answer the learning Activities/Exercises (LAEs). The LAEs are designed
to help you acquire the SLOs.
4. Feel free to chat about the module’s contents or activities.
5. The Practice Task/Assessment and the Assignment shall be checked by me.

MODULE ONE
STANDARD FIRST AID
What is First Aid?
FIRST AID- Is an immediate care given to a person who has been injured or
suddenly taken ill. It includes self-help and home care if medical assistance is not
available or delayed.

What are the 8 areas of first aid?

Here is a list with the 8 most common injuries requiring first aid and what you can
do when an accident like this occurs.
● Cut/Scrape, Burns, Insect Bite/Sting, Splinter, Sunburn, Nosebleed, Sprains, Strains
and Tears, Fractures.
Source: blog.safetec.com>8-of the-most-common-first-aid-injuries. Retrieved
9/25/20

GOOD SAMARITAN LAWS:

Most states have laws called Good Samaritan laws designed to encourage
people to help others in an emergency without worrying about being sued. These
laws protect you legally when you give first aid. It is unlikely you would be found
liable or financially responsible for a victim’s injury as long as you follow the
guidelines on this module. Ask your instructor about the specific Good Samaritan
laws in your area.

MUST YOU GIVE FIRST AID?

In most country you have no legal obligation to give first aid as a citizen or a
bystander at the scene of an emergency. As the specific obligations may vary, ask
your instructor about the law in your area. If you do begin giving first aid,
however, you are obliged to continue giving care if you can to remain with the
victim. Your job may require giving first aid, and that does make you legally
obligated. This is called a duty to act. Of if the job, however, depending on your
country laws, you are usually not legally required to give first aid except in special
cases, such as a parent or guardian caring for a child and other special situations.

GET THE VICTIM’S CONSENT

A responsive (awake or alert) victim must give consent before you can give
first aid. Tell the person you have been trained and described what you will do to
help. The victim may give consent by telling you it is okay or by nodding
agreement.
An unresponsive victim, however, is assumed to give consent for your help-this is
called implied consent. Similarly, consent is assumed if a parent or guardian is not
present and a child needs first aid.

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FOLLOW STANDARDS OF CARE
Legally, you may be liable for the result of your actions if you do not follow
accepted standards of care. Standard of care refers to what others with your same
training would do in a similar situation. It is important you do only as you are
trained. Any other actions could result in the injury or illness or injury becoming
worse.

You may be guilty of negligence if:

1. You have a duty to act
2. You breach that duty (by not acting incorrectly)
3. Your actions or inaction causes injury or damages (including such things as
physical injury or pain).

Examples of negligent actions could include moving a victim unnecessarily,

doing something you have not been trained to do, or failing to give first aid as you
have been trained. Once you begin giving first aid, do not stop until another
trained person takes over. Stay with the victim until help arrives or someone with
the victim until help arrives or someone with equal or greater training takes over.
If you leave the victim and the injury or illness becomes worse, this is called
abandonment. Note that abandonment is different from justified instances of
stopping care, such as if you are exhausted and unable to continue or you are in
imminent danger because of hazards at the scene.

Role and Responsibilities of the First Aider

1. Bridge that fills the gap between the victim and the physician.
.It is not intended to compete with, or take the place of the services
of the physician.
.It ends when the services of a physician begin.
2. Ensure personal safety and that of patient/bystander
3. Gain access to the victim
4. Determine any threats to patient’s life.
5. Summon more advanced medical care as needed
6. Provide needed care for the patient
7. Assist Emergency Medical Technician (EMT) and medical personnel
8. Record all assessments and care given to the patient

Objectives of First Aid

1. To alleviate suffering
2. To prevent added/further injury or danger
3. To prolong life

Characteristics of a Good First Aider

1. Gentle-should not cause pain
2. Resourceful-should make the best use of things at hand

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 3. Observant-should notice all signs
4. Tactful-should not alarm the victim
5. Empathetic-should be comforting
6. Respectable-should maintain a professional & caring attitude

Hindrances in Giving First Aid

1. Unfavorable Surroundings
. Night time
. Crowded city streets, churches, shopping malls.
. Busy highways
. Cold and rainy weather
. Lack of necessary materials or helpers
2. The Presence of Crowds
. Crowds curiously watch, sometimes heckle, and sometimes offer
incorrect advice
. They may demand haste in transportation or attempt other
improper procedure.
. A good examination is difficult while a crowd looks on.
. Pressure from victims relatives.
. The victim usually welcomes help but if he is drunk he is often hard
to examine and handle, and is often misleading in his responses.
. The hysteria of relatives or the victim, the evidence of pain, blood
and possible early death, exert great pressure on the first aider.
. The first aider may fail to examine carefully and may be persuaded
to do what he would know in calm moment’s to be wrong.

TRANSMISSION OF DISEASES AND THE FIRST AIDERS

1. How Diseases are transmitted
. Direct contact transmission- occurs when a person touches an infected
person’s body fluids. This type of transmission presents the greatest risk of
infection for the first aid provider.
. Indirect contact transmission- occurs when a person touches objects that
have been contaminated by the blood or another body fluid of an infected person.
These include soiled dressings, equipment and vehicle surfaces with which an
infected person comes in contact.
. Airborne transmission- occurs when a person inhales infected droplets
that have become airborne as an infected person coughs or sneezes.
. Vector transmission- occurs when an animal such a dog or an insect, such
as tick, transmit a pathogen into the body through a bite.
2. Diseases that cause concern.
As a first aider, you should be familiar with diseases that can have severe
consequences if transmitted. These includes herpes, meningitis, tuberculosis,
hepatitis and HIV infection, the virus that causes AIDS, and the most latest COVID
19.

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 TABLE 1-1 COMPARISON OF TRANSMITTABLE DISEASES

DISEASE SIGNS & MODE OF INFECTIVE

SYMPTOMS TRANSMISSION MATERIAL
Herpes- is a viral infection Lesions, general ill feeling, Direct contact Broken skin, mucous
that causes eruptions of sore throat membranes
the skin and mucous
membranes
Meningitis- is an Respiratory illness, sore Airborne, direct and Food and water, mucus
inflammation of the brain throat, nausea, vomiting indirect contact
or spinal cord caused by a
viral or bacterial infection
Tuberculosis- is a Weight loss, night sweats, Airborne Saliva airborne droplets
respiratory disease occasional fever, genera ill
caused by bacteria feeling
Hepatitis-is a viral Flake, jaundice Direct and indirect contact Blood, saliva, semen.
infection of the liver feces, food, water, other
products
HIV- (Human Immune Fever, night sweats, Direct and indirect contact Blood, semen, vaginal
deficiency virus) is the weight loss, chronic fluid
virus that destroys the diarrhea, severe fatigue,
body’s ability to fight shortness of breath,
infection. The resultant swollen lymph nodes
state is referred to as lesions
AIDS (Acquire immune
deficiency syndrome).

3. Body Substance Isolation (BSI)

Precautions are taken to isolate or prevent risk of exposure from any other
type of bodily substance. Regardless of the type of exposure risk, you must follow
basic precautions and safe practices each time you prepare to provide care. Basic
Precautions and Practices are as follows.
. Personal Hygiene- Maintaining good personal hygiene habits, such as frequent
hand washing and proper grooming, are two important ways to prevent disease
transmission regardless of any personal protective equipment you might use.
. Protective Equipment- It includes all equipment and supplies that prevent you
from making direct contact with infected materials. This includes disposable
gloves, gowns, masks, masks and shields, protective eyewear, and resuscitation
devices.
. Equipment Cleaning & Disinfecting-It is important to clean and disinfect
equipment to prevent infections. Handle all contaminated equipment, supplies, or
other materials with the utmost care until they are properly cleaned and
disinfected.

FIRST AID EQUIPMENT AND SUPPLIES

1. Basic equipment:
. Spine board . Sets of splints
. Short boards . Poles
. Kendricks Extrication Device . Blankets

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 Spineboard
Source: https://www.pinterest.ph/ironduck413/spine-boards/ retrived 9/23/20

Kendricks extrication device Source:

https://www.pinterest.ph/ironduck413/extrication device/ retrived 9/23/20

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Source:https://www.shutterstock.com/search/spine+board retrieved 9/23/20

Sets of splints
Source:https://www.shutterstock.com/image-vector/fullyapplied-leg-splint-vintag
e-engraved-illustration-154886633retrieved 0/23/20

2. Suggested First Aid Kit Contents (Basic)

. Rubbing alcohol, Providone iodine. Cotton, gauge pads, tongue depressor,
penlight, band aid, plaster, gloves, scissors, forceps, bandage (triangular) , elastic
roller bandage, occlusive dressing.

3. Cloth materials commonly used in First Aid:

. Dressing or Compress-any sterile cloth materials used to cover the wound.
Other uses of a dressing or compress
. control bleeding
. Protect the wound from infection
. Absorbs liquid from the wound such as blood plasma, water and pus

Kinds of dressing
. Roller gauze
. square or eye pad
. compress or adhesive
. occlusive dressing
. butterfly dressing

Application
. Completely cover the wound
. Avoid contamination when handling and applying

Bandages- any clean cloth materials, sterile or not use to hold the dressing in
place.

Other uses of bandages

. control bleeding
. tie splints in place
. immobilize body parts
. for arm support- use as a sling

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Kinds
. triangular, cravat , roller, four tail, muslin binder, elastic bandage

Application
. must be proper, neat and correct
. apply snugly not to lose not too tight
. always check for tightness may cause later swelling
. tie ends with a square knot

Triangular bandage
. Usually made from a 45-50 inch square piece of cloth, cut from one corner to the
opposite to form a triangle.
. Can be folded to form cravats (broad cravats or narrow cravats)

LEARNING ACTIVITIES/ EXERCISES: (SLAs)

1. True or False. First Aid given promptly can save lives and reduce severity of
injuries.

2. Being prepared for emergency means:

a. knowing what to do
b. being ready to act anytime, anywhere
c. knowing how to get medical care for a victim
d. all of the above

3. True or False The best thing to do in any emergency is move the victim to your
car and get to an emergency room.

4. You have duty to act when:

a. you stop at the scene of an emergency
b. you have taken a first aid course
c. you have a first aid kit
d. your job requires you to give first aid when needed

5. Check off which victims you have consent to give first aid to:
a. ___ an unresponsive victim
b. ___ a child without parent or guardian present
c. ___ all victims, all of the time
d. ___ a victim who nods when you ask if it is okay to give him or her first aid
e. ___ a child whose parent or guardian gives consent for him or her.

6. True or False. Good Samaritan laws protect only professionals like paramedics
and front liner (medical).

7. Check off things you should always do when giving first aid:

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_____a. move the victim
_____b. do what you have been trained to do
_____c. try any first aid technique you have read or heard
_____d. ask for the victims consent
_____e. stay with the victim until another trained person takes over
_____f. transport all victims to the emergency room in your vehicle.

8. Any clean cloth materials sterile or not use to hold the dressing in place.
a. Dressing b. triangular bandage c. bandage d. gauge pads

9. Any sterile cloth materials used to cover the wound.

a. Dressing b. triangular bandage c. bandage d. gauge pads

10. It occurs when an animal such as dog or an insect, transmit a pathogen into
the body through a bite.
a. direct contamination c. airborne transmission
b. indirect contamination d. vector transmission

11. It occurs when a person inhales infected droplets aerosol like COVID 19 that
have spread in the surroundings as an infected persons coughs or sneezes.
a. direct contamination c. airborne transmission
b. indirect contamination d. vector transmission

12. It is the virus that destroys the body’s ability to fight infection.
a. COVID 19 c. Herpes
b. Tuberculosis d. HIV

13. Which one does not belong to the objectives of First Aid?
a. To alleviate suffering c. To be empathetic
b. To prevent added/further injury d. To prolong life

14. First Aid means;

a. Is an immediate care given to a person who has been injured or suddenly taken
ill.
b. It includes self-help and home care if medical assistance is not available or
delayed.
c. Is what paramedics or first aider delivers to attain to whoever needs in an
emergencies.
d. all of these.

15. What is not a hindrances in giving first aid?

a. nighttime b. crowded c. cold/rainy weather d. no victim

END OF YOUR SPECIFIC LEARNING ACTIVITIES IN THE MODULE ONE.

GOOD LUCK. HOPE YOU GET IT.

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 PROF. GALO B. ALVIOLA Ph. D. Crim.
DEFTAC 200 INSTRUCTOR

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 MODULE 2
THE HUMAN BODY
Introduction
As a first aider, you must be able to recognize illness and injury and know
how to care for each. You must be able to tell other medical personnel about a
patient’s problem quickly and accurately in order to do all this; you need a solid
foundation of basic knowledge on human body, its parts and functions.

COURSE LEARNING OUTCOMES

At the end of the module of the Human Body the students will be able to
familiarize the body system. Understanding the human body will be a guide in
providing proper emergency care in giving first aid to the victim.

CONTENTS OF THE MODULE 2

This module contains the following lessons
Lesson 1 Anatomical Terms
Lesson 2 Terms of Direction and Location
Lesson 3 The Different systems of the human body
Lesson 4 The Skin

HUMAN BODY
The Body systems have unique structures and functions.

ANATOMICAL TERMS
It is important to describe a patient’s position, direction and location to
other medical personnel. Using correct terms will help you communicate the
extent of a patient’s injury quickly and accurately.

TERMS OF POSITION INCLUDE THE FOLLOWING:

. Anatomical position. In this position, a patient’s body stands erect with arms
down at the sides, palms facing you “Right” and “Left” refer to the patient’s right
and left.

Source: www.dreamstime.com>illustrations retrieved 9/25/20

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. Supine position. The patient is lying face up on his or her back.

Source: https://www.pinterest.ph/kimkaywv/patient-positions/retrieved 9/25/20

. Prone position. The patient is lying face down on his or her stomach.

Source: https://www.pinterest.ph/kimkaywv/patient-positions/retrieved
9/25/20

. Lateral recumbent position. In this position the patient is lying on the left or
right side. This is also known as the recovery position.

Source: https://www.pinterest.ph/kimkaywv/patient-positions/retrieved
9/25/20

TERMS OF DIRECTION AND LOCATION ARE AS FOLLOWS:

. Superior- means toward, or closer to the head.
. Inferior- means toward or closer to the feet.
. Anterior- is toward the front. Posterior- is toward the back.
. Medial- means toward the midline, or center of the body. Lateral- refers to the
left or right of the midline.
. Proximal- means close or near the point of reference. Distal- is distant or far
away from the point of reference. The point of reference is usually the torso. For
example, a wound of the forearm is proximal to the wrist because it is closer to

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the torso than the wrist. The same wound is distal to the elbow because it is
farther away from the torso than the elbow.
. Superficial- is near the surface. Deep- is remote or far from the elbow.
. Internal- means inside. External- means outside.

Source:
https://courses.lumenlearning.com/ap1x94x1/chapter/anatomical-orientation-a
nd-directions/retrieved 9/25/20

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 DIRECTION AND LOCATION OF THE HUMAN BODY
Source:
https://courses.lumenlearning.com/ap1x94x1/chapter/anatomical-orientation-and-directions/r
etrieved 9/25/20
A body cavity is a hollow place in the body that contains organs such as the
heart, lungs, and liver. The five major cavities:
Cranial cavity- is located in the head. It contains the brain and its protected by the
skull.
Spinal cavity- is the extending from the bottom of the skull to the lower back. It
contains the spinal cord and is protected by the bones of the spine.

Thoracic cavity- is also called chest cavity, located in the trunk between the
diaphragm, a dome shape muscle used in breathing and the neck. It contains the
heart the lungs and other important structures. The rib cage and the upper
portion of the spine protect the thoracic cavity.

Abdominal cavity- is located in the trunk between the diaphragm and the pelvis. It
contains many organs including the liver, pancreas, intestines, stomach, kidneys
and spleen. Because the abdominal cavity is not protected by any bones, the
organs in it are vulnerable to injury.

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Pelvic cavity- is located in the pelvis the lowest part of the trunk. It contains the
bladder the rectum, and the reproductive organs. It is protected by the pelvic
bones and the lower portion of the spine.

BODY SYSTEMS
Knowing how the respiratory circulatory and nervous systems normally
function will help you understand what happens when systems fail. When body
systems fail physical signs and symptoms appear. These are often your first
indication that something is wrong, especially if we talk about providing life
support.

THE RESPIRATORY SYSTEM

The body gets enough nutrition from food to last for several weeks. It can
store water to last for several days. But it can only store oxygen for a few.
The passage of air into and out of the lungs is called respiration. Breathing
in is called inspiration or inhaling. Breathing out is called expiration or exhaling.
The area posterior to the mouth and nose is called the pharynx, which is
divided into the oropharynx and nasopharynx. Air then travels down through the
larynx (voice box) and into the trachea (windpipe). The trachea is the air
passageway to the lungs. It is made of cartilage rings and is visible in the anterior
portion of the neck.
The epiglottis is a leaf shaped structure that prevents foreign objects
entering the trachea during swallowing. The trachea splits into the two bronchi.
These air passage gradually become smaller and smaller until they reach the
alveoli where carbon dioxide and oxygen are exchange with blood.

THE CIRCULATORY SYSTEM

The circulatory system delivers oxygen and nutrients to the body’s tissues
and removes waste products. It consists of the heart, blood vessels, and blood.

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Source: Circulatory system.Definit…biologydictionary.net retrieved 9/25/20

The heart is a hollow muscular organ that is responsible for pumping blood
through the body. The adult heart contracts between 60 and 80 times per minute
when at rest and faster when under stress. Problems with the heart account for
many of the emergencies you will encounter as a First Aider.

The heart is divided into four chambers. The upper chambers are called
atria. The lower chambers are called ventricles. The heart has a left and right side,
each of which has an atrium and a ventricle.

The right side of the heart receives blood from the body and pumps it to
the lungs. The left side of the heart receives oxygenated blood from the lungs and
pumps it to the body.

THE HEART
Source: mammothmemory.net retrieved 9/25/20

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 When the heart pumps blood from the left ventricle blood enters the
arteries. This pumping action causes a wave of pressure that can be felt as a pulse.
There are many points where a pulse can be felt in the body. The most common
are:
The carotid pulse point, felt on either side of the neck

Source: dreamstime .com retrieved 9/25/20

The brachial pulse point, felt on the inside of the arm between the elbow
and the shoulder.

THE BRACHIAL PULSE POINT

Source: wikihow.com retrieved 9/25/20

The radial pulse point, felt on the thumb side of the wrist.

THE RADIAL PULSE POINT

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 Source: montrealgazzete.com retrieved 9/25/20
The femoral pulse point, felt in the area of the groin in the crease between
the abdomen and thigh.

THE FEMORAL PULSE POINT

Source: fayllar.org retrieved 9/25/20

Sources: slideshare.net retrieved 9/25/20

The blood vessels are closed system of tubes through which blood flows.
Arteries and arterioles take blood away from the heart.

The capillaries are distributors. They are the smallest vessels through which
the exchange of fluid, oxygen and carbon dioxide takes place between blood and
tissue cells. The venules and veins are the collectors. They carry blood back to the
heart from the rest of the body.

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 BLOOD VESSELS

Source: shutterstock.com retrieved 9/25/20

BREATHING AND CIRCULATION

1. Air that enters the lungs contains about 21 percent oxygen and only a
trace of carbon dioxide. Air that is exhaled from the lungs contains about 16
percent oxygen and 4 percent carbon dioxide.
2. The right side of the heart pumps blood to the lungs where blood picks
up oxygen and releases carbon dioxide.
3. The oxygenated blood then returns to the left side of the heart where it is
pumped to the tissues of the body.
4. In the body tissues blood releases oxygen and takes up carbon dioxide
after which it flows back to the right side of the heart.
5. All body tissues require oxygen but the brain requires more than any
other tissue.
6. When breathing and circulation stop, this is called clinical death (0-4
minutes brain damage not likely, 4-6 minutes damage probable)
7. When the brain has been deprived of oxygenated blood for a period of 6
minutes or more, irreversible damage probably occurred. This is called biological
death (6-10 minutes brain damage probable, over 10 minutes brain damage is
certain).
8. It is obvious from the above stated facts that both respiration and
circulation are required to maintain life.

THE NERVOUS SYSTEM

The nervous system is composed of the brain, the spinal cord, and nerves,
which has two major functions communication and control.

It lets a person be aware of and react to the environment. It coordinates the

body’s responses to stimuli and keeps body systems working together.

The nervous system has two main parts the central and the peripheral
nervous system.
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 THE NERVOUS SYSTEM
Source: pininterest.com retrieved 9/25/20

THE MUSCULOSKELETAL SYSTEM

The musculoskeletal system is made up of the skeleton and muscles. Each
helps to give the body shape and protects internal organs. The muscles also
provide for movement.

The Skeleton
The human body is shaped by its bony framework. Bone is composed of
living cells and non-living matter.

The non-living matter contains calcium compounds that help make bone hard and
rigid. Without bones, the body would collapse.

The adult skeleton has 206 bones. It must be strong to support and protect,
jointed to permit motion, and flexible to withstand stress.

It is held together mainly by ligaments, tendons and layers of muscle. Ligaments

connect bone to bone.

Tendons connect muscle to bone. Bone ends fit into each other at joints.

The three kinds of joints are immovable like the skull, slightly movable like the
spine, and freely movable like the elbow or knee.

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 THE SKELETON
Source: pinterest.com retrieved 9/25/20

The major areas of the skeleton include the following:

The skull has a number or broad flat bones that form a hollow shell. The top
back and sides of the shell make up the cranium. It houses and protects the brain.
There are several small bones of the face. They give shape to the face. They give
shape to the face and permit the jaw to move. The major features of the face are
the nose, ears, eyes, cheeks, mouth and jowls.

The spinal column houses and protects the spinal cord. The spinal column
is the central supportive bony structure of the body. It consists of 33 bones known
as vertebrae. The spine is divided in top five sectioned, the cervical spine the neck
formed 7 vertebrae the thoracic spine the upper back formed by 12 vertebrae,
the lumbar spine the lower back formed by 5 vertebrae, the sacrum the lower
part of the spine, formed by 5 fused vertebrae and the coccyx the tail bone,
formed by 4 fused vertebrae.
The thorax or rib cage protects the heart and lungs vital organs of the body.
They are enclosed by 12 pairs of ribs that are attached at the back to the spine.
The top 10 are also attached in front to the sternum is or breast bone. The lowest
of the sternum is called the xiphoid process.

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 The pelvis or hip bones consists of the illium, pubis and ischium lilac crests
from the wings of the pelvis. The pubis is the anterior portion of the pelvis. The
ischium is in the posterior portion.
The shoulder girdle consists of the clavicle the collarbone and the scapulae
shoulder blades.
The upper extremities extend from the shoulders to the fingertips. The arm
shoulder to elbow has one bone known as the humerus. The bones in the forearm
are the radius and ulna. The lower extremities extend from the hips to the toes.
The bone in the thigh or upper leg is known as femur. The bones in the lower leg
are the tibia and fibula. The knee cap is called the patella.

THE MUSCLES
The movement of the body depends on the work performed by the
muscles. Muscles have the ability to contract (become shorter and thicker) when
simulated by a nerve impulse. Each muscle is made up of long threadlike cells
called fibers, which closely packed or bundled. Overlapping bundles are bound by
connective tissue.
There are three basic kinds of muscles:
Skeletal muscle or voluntary muscle makes possible all deliberate acts such
as walking and chewing. It helps shape the body and form its walls. In the trunk
this type of muscle is broad, flat, and expanded. In the extremities, it is long and
rounded.
Smooth muscle or involuntary muscle, is made of longer fibers. It is found in
the walls of tube like organs, ducts and blood vessels. It is also forms much of the
intestinal wall. A person has little or no control over this type of muscle.
Cardiac muscle makes up the walls of the heart. It is able to stimulate itself
into contraction, even when disconnected from the brain.

THE MUSCLES

Source: www.vectorstock.com. Retrieved 9/28/20

THE DIGESTIVE SYSTEM

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 The digestive system is composed of the alimentary tract(food passageway)
and accessory organs. Its main functions are to ingest food and get rid of waste.
Digestion consists of two processes mechanical and chemical.

The mechanical process includes chewing, swallowing, the rhythmic

movement of matter through the tract, and defecation (the elimination of waste).
The chemical process consists of breaking food into simple components that can
be absorbed and used by the body.

Except for the mouth and esophagus, the organs of this system are in the
abdomen. They include the stomach, pancreas, liver, gallbladder, small intestine,
and large intestine.

Source: www.en-ppt-online.org. retrieved 9/28/20

THE URINARY SYSTEM

The urinary system filters and excretes waste from the body. It
consists of two kidneys and two ureters one urinary bladder and one urethra.

The ureters take urine from the kidneys to the next part of the system
the bladder.

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 The bladder stores urine until it is passed through the urethra and
excreted from the body.

THE URINARY SYSTEM

Source: www.biologydictionary.net retrieved: 9/28/20

The urinary system helps the body maintain the delicate balance of water
and chemicals needed for survival. During the process of urine formation, wastes
are removed and useful products are returned to the blood.

THE REPRODUCTIVE SYSTEM

The reproductive system of the male includes two testes a duct system,
accessory glands and the penis. The reproductive system of the female consists of
two ovaries two fallopian tubes, the uterus, vagina and external genitals.

24
 Source: www.anatomynotes.org. retrieved 9/2820

THE SKIN

The skin separates the human body from the outside world. It protects the
deep tissues from injury, drying out, and invasion by bacteria and other foreign
bodies. The skin helps to regulate body temperature. It aids in getting rid of water
and various salts, as well as helps to prevent dehydration. It acts as the receptor
organ for touch, pain, heat and cold.

The epidermis is the outermost layer of skin. It contains cells that give the
skin its color. The dermis or second layer contains a vast network of blood vessels.
The deepest layers of the skin contain hair follicles, sweat and oil glands and
sensory nerves. Just below the skin is a layer of fatty tissue which varies in
thickness. For example. It is extremely thin in the eyelids, but thick over the
buttocks.

THE
SKIN

25
 Source: www.canchonaturals.com retrieved 9/28/20

Directional Terms

We’ve seen how the sections and views included in a typical anatomical
atlas are obtained, but how can we describe the position and relation between
various structures? By using anatomy directional terms. These adjectives compare
the position of two structures relative to one another in the anatomical position.
They are in pairs of opposites, so if the nose is superior to the mouth, it is
automatically inferred that the mouth is inferior to the nose.

Directional terms and relations

Anterior In front of or front

Posterior In behind of or behind

Ventral Towards the front of the body

Dorsal Towards the back of the body

Distal Away or farthest away from the trunk or the point of origin of the body part

Proximal Closer or towards the trunk or the point of origin of the body part

Median Midline of the body

Medial Towards the median

Lateral Away from median

Superior Towards the top of the head

Inferior Towards the feet

26
Cranial Towards the head

Caudal Towards the tail

External Towards the surface, superficial

Internal Away from the surface, deep

Superficial Nearer to the surface

Deep Farther from the surface

Palmar Anterior hand or palm of hand (palmar)

Dorsal (of hand) Posterior surface of hand (dorsum)

Plantar Inferior surface of foot (sole)

Dorsal (of foot) Superior surface of foot (dorsum)

Specific Learning Activities :Exercises/Assignment: IN MODULE TWO

1. Fill in the blank with the appropriate directional term to complete the following
sentences. More than one answer may be correct.
The heart is _______________________ to the lungs.
The knee is ____________ ___________to the hip.
The wrist is ________________________ to the hand.
The mouth is_______________________to the nose.
The thorax is _______________________ to the abdomen.
The thumb is _______________________ to the ring finger.
The sternum is ______________________ to the heart.
The skull is _________________________ to the scalp.
The ears are ________________________ to the nose.
Dorsal refers to the ____________ of the human body, while ventral refers to the
____________ of the human body.

27
 THE FOREARM
 2. Find the indicated structures in the diagrams provided, based on the directional
terms given. The structure to find will be one of those at the end of an unlabeled line.
A. Label the extensor digitorum muscle in the figure below. It is:
● Distal to the anconeus muscle
● Lateral to the extensor digiti minimi muscle
● Superficial to the Extensor pollicis brevis muscle

3. Using your knowledge of the different body planes shown in Figure 1-2 (shown again
below), fill in the blanks with the appropriate body plane for each of the following
descriptions. Here’s a human body diagram that provides you with an overview:

1. The plane that divides the body into anterior and posterior parts is the
________________ plane.
2. A transverse plane divides the body into ________________ and
________________ regions.
3. A ________________or ________________ plane divides the body into right and
left parts.

THE ANATOMICAL DIRECTIONAL TERMS

SOURCE: www.kenthub.com. Retrieved 9/28/20

28
4. To test your knowledge about the major areas of the skeleton below are some filling
the blanks to answer the specific learning activities about the skeleton coverage?
a. The knee cap is called the _________.
b. It protects the heart and lungs vital organs of the body______.
c. The _____ has a number of broad flat bones that form a hollow shell.
d. Its other term is the rib cage known as _______.
e. It houses and protects the spinal cord__________.
f. The lowest part of the sternum is called__________.
g. It is the hip bone of the human skeleton_______.
h. The collarbone in the shoulder girdle is called_______?
i. Sometimes the neck is called_________.
j. It houses and protects the brain_______.
Answers: xiphoid process, thorax, skull, pelvis, cranium, patella, spinal column, cervical
spine, clavicle.

END OF YOUR SPECIFIC LEARNING ACTIVITIES IN THE MODULE TWO.

GOOD LUCK. HOPE YOU GET IT.

PROF. GALO B. ALVIOLA Ph. D. Crim.

DEFTAC 200 INSTRUCTOR

29
 THE MODULE 3
GUIDELINES IN GIVING EMERGENCY CARE

INTRODUCTION
As a first Aider, you will sometimes encounter a patient with problems that
are immediately threatening. A patient may die within minutes, unless he or she
receives immediate treatment and transport to a hospital. Therefore assessment
of the patient would provide priorities of life-threatening conditions, treatment
and or immediate transport that would save or prolong the life of the patient.

COURSE LEARNING OUTCOMES

At the end of this module the students will be able to know the necessary
things on how execution of task during emergencies is carried out. It provides
students answers to commonly asked questions in giving emergency. It provides
tools and resources to use during and after first aid program implementation. It
provides examples from other practices describing how they have implemented
victims experience programs and their impact.

CONTENTS OF THE MODULE 3

This module contains the following lessons
Lesson 1 Getting Started
Lesson 2 Plan of Action
Lesson 3 Gathering of needed materials
Lesson 4 Initial Response
Lesson 5 EAP (Emergency Action Principle)
Lesson 6 AMA (Activate Medical Assistance or Transfer Facility)
Lesson 7 Do a Primary Survey of the Victim (consciousness, airway, breathing,
circulation)
Lesson 8 Do a Secondary Survey of the victim (interview, vital signs, pulses)
Lesson 9 Blood Pressure
Lesson 10 Head to Toe examination
Lesson 11 Golden Rules in Giving Emergency Care

GETTING STARTED
You will never see the emergencies you prevent. However, emergencies can
and do happen, regardless of attempts to prevent them.

Preparing for an emergency would benefit the provider in giving appropriate care
to a victim. The following are guides to assure the provider to response to an
emergency properly.

PLAN OF ACTION
To respond most efficiently to certain emergencies, you need a plan of
action.

30
A plan of this type is prepared in advance and rehearsed with personnel.
Emergency plans should be established based on anticipated needs and available
resources.

THE GUIDELINES
Source: www.slideshare.net retrieved 9/29/30

GATHERING OF NEEDED MATERIALS

The emergency response begins with the preparation of equipment and
personnel before any emergency occurs.

REMEMBER THE INITIAL RESPONSE AS FOLLOWS:

1. A- Ask for help
In crisis, time is essence. The more quickly you recognize an emergency, and
the faster you call for medical assistance, the sooner the victim will get help.
Immediate care can greatly affect the outcome of an emergency.

2. I- Intervene
It means to do something for the victim that will help achieve a positive
outcome to an emergency. Sometimes getting medical help will help to achieve a
positive outcome to an emergency. Sometimes getting medical help will be all you
can do this alone may save a life. In other situations, however you may become
actively involved in the victim’s initial care by giving first aid.

3. D- Do no further harm.
Once you have begun first aid, you want to be certain you don.t do anything
that might cause the victim’s condition to worsen. Certain actions should always
be avoided and by keeping them in mind, you will be able to avoid adding to or
worsening the victim’s illness or injuries.

Instruction to helpers/s. Keep in mind that in proving care you might need the
assistance of other personnel or probably a bystander. Proper information and
instruction to a helper’s would provide organized first and care.

EMERGENCY ACTION PRINCIPLES (EAP)

The following principles can ensure your safety and that of the victim and
bystanders. They will also increase the victims chance of survival if he or she has a
serious illness or injury.
31
SURVEY THE SCENE
Once you recognize that an emergency has occurred and decided to act,
you must make sure the scene of the emergency is safe for you, the victims and
bystanders. It is a quick assessment of the surroundings that will provide you with
as much information as possible.

Take time to survey the scene and answer these questions:

. Is the scene safe?
. What happened?
. How many people are injured?
. Are there bystanders who can help?
. Then identify yourself as a trained first aider.
Get consent to give care

The following are elements of survey the scene for the first aider to perform
before providing care to a victim.

1. Scene Safety.
Look for possible threats for personal safety, patient and bystander.
. Personal Safety- Focused first on ensuring the well being of the first aider. You
cannot help your patient if you become a victim yourself. In any emergency risks
of exposure to communicable diseases are present. In order to prevent any
contamination proper body substance isolation decisions early in the emergency
will prevent needless exposure later on refer to module 1. Introduction to prevent
disease transmission.

In situation of crime scene acts of violence and unsafe scene you should
consider asking appropriate personnel to secure the scene and acts of violence
you might need the assistance of a police or local official, for unsafe areas like fire,
car collisions, hazards of chemicals, and other alike, a well trained personnel will
be necessary. But remember that it takes time for additional personnel to arrive
so try to make the scene safe as your capability permits.

. Patient/Victim- Our next concern will be the patient/victim if there are potential
dangers that cannot be stabilized you might need to perform special measures to
offer additional protection to the patient.

Like removing the patient from a hazardous environment, such as a burning

car, a home with a gas leak or a car filled with carbon monoxide, are lifesaving
actions before proper care can begin. But not all need to be removed, like to
prevent patient exposure from or to broken glasses and metal sharpnels from an
automobile accident, instead of removing you can place a blanket on the patient.

. Bystanders- Safely of the onlookers or bystanders is also our concern. Bystanders

can become a problem when they try to help or direct your care. Protect yourself

32
and bystanders alike by moving them to a safe area or assigning them a specific
task.

2. MECHANISM OF INJURY OR NATURE OF ILLNESS. - How do you determine the

mechanism of injury? Mechanism of injury, or MOI, refers to the method by which
damage (trauma) to skin, muscles, organs, and bones occurs. Health care providers
use MOI to help determine how likely it is that a serious injury has occurred. But the
term is not used only by health care providers.

Source: Mechanism of Injury and Co-Morbid Factors - Verywell Health

www.verywellhealth.com › mechanism-of-injury-129867 retrived 9/30/20

Source:
www.shutterstock.com/image-photo/sport-doctors-provide-first-aid-injured
-1691015356 9/20/30

The following are the 4 primary mechanisms of injury? There are four primary
mechanisms of TBI: direct impact, sudden or rapid acceleration and deceleration,
penetrating injury, and blast injury.

Source; www.tbicemmlibrary.org>Mild-TBI-concussion>Mechanism retrived: 9/30/20

Careful evaluation of the scene, including the possible mechanism of injury

and/or the nature of illness, along with the other information that you gather will
help determine the condition of the victim and what will be the next possible
action of the first aider.
. Mechanism of injury- Is what caused the injury such as a rapid deceleration
causing the knees to strike the dash of a car, a fall causing a twisting force to the
ankle.

33
Certain injuries are considered “common” in particular accident situations. Injuries
to bones and joints are usually associated with falls and vehicle collisions, burns
are common to fires and explosions, penetrating soft tissue injuries can be
associated with gunshot wounds and so on.

Even if you cannot determine the exact injury the patient has sustained,
knowing the mechanism of injury allows you to predict various injury patterns.
. Nature of illness- There are similarities between the mechanism of injury and the
nature of illness. Both require you to search for clues regarding how the incident
occurred. Nature of illness is often best described by the patients chief complaint
the reason for providing care. In order to quickly determine the nature of the
illness, talk with the patient, family or bystanders about the problem. But at the
same time, use your senses to check the scene for clues as to the possible
problem.

3. Determine the number of patients and additional resources

As part of survey the scene, it is essential that you accurately determine the
total number of patients. This determination is critical for your estimate of the
need for additional resources.

What to do in Survey the Scene

Before you approach the Victim. When you survey the scene, look for
anything that may threaten your safety and that of the victim and bystanders.

As you approach the victim. Try to find out what happened. Look around the
scene for clues to what caused the emergency and the extent of the damage.
Doing this will cause you to think about the possible type and extent of the
victim’s injuries.

Once you reach the Victim. Quickly survey the scene again to see if it is still safe.
At this point you may see other dangers clues to what happened, victims or
bystanders that you did not notice before.

ACTIVATE MEDICAL ASSISTANCE (AMA) or Transfer Facility

In some emergencies you will have enough time to call for specific medical
advice before administering first aid. But in some situations, you will need to
attend to the victim first. Decision in activating medical assistance or transfer
facility would make a higher rate of survivability for the victim due to continuing
chain of survival in providing early defibrillation and advance cardiac life support.

1. Activate Medical Assistance or Transfer Facility

. The first aider is alone, CALL FIRST, that is activate medical assistance or arrange
transfer facility before providing care for;
- an unconscious adult victim or child 8 years old or older and,
- an unconscious infant or child known to be at a high risk for heart
problems.

34
. The first aider is alone provide one minute of care, then CALL FAST for:
- an unconscious victim less than 8 years old.
- any victim of submersion or near drowning
- any victim of arrest associated with trauma
- any victim of drug overdose

The situation in Call First should be assumed to be cardiac emergencies,

such as sudden cardiac arrest and the time factor is critical. Research shows that
the shorter the time from collapse to first shock of AED, the greater chance of
survival for an adult or child 8 years old or older. For an infant or child with a
known risk for heart problems, early access to the EMS system and the advanced
medical care that results increases that victim’s chance of survival.
In the Call Fast situations, the conditions are most often related to
breathing emergencies rather than sudden cardiac arrest. In the these situations
providing support for airway breathing and circulation through rescue breaths and
or chest compressions as appropriate is the most important initial step a trained
responder should take.
When the first aider is with a companion you could instruct your companion
to activate medical assistance or transfer facility while you provide the care to
your victim.

Bystanders checking up and providing first aid to an injured bleeding driver after a
car crash. A man is taking pictures as amateur journalist for social media
networks.

35
Source: www.
https://www.123rf.com/photo_8727961_bystanders-checking-up-and-providing-fi
rst-aid-to-an-injured-bleeding-driver-after-a-car-crash-a-man.html retrieved:
9/30/20

2. Exceptions to the “phone first/phone fast” rule include:

. submersion/near- drowning (phone fast all ages)
. arrest associated with trauma (phone fast all ages)
. drug overdose (phone fast all ages)
. cardiac arrest in children known to be at high risk for arrhythmias (phone first all
ages)

3. Information to be remembered in activating medical assistance.

. what happened?
. Location?
. number of persons injured?
. extent of injury and first aid given?
. the telephone number from where you are calling?
. person who activated medical assistance must identify him/herself and drop the
phone fast.

Do a Primary Survey of the Victim.

In every emergency situation you must first find out if there are conditions
that are an immediate threat to the victim’s life. You will discover these conditions
by looking for signs, evidence of injury or illness that you can observe. Check for
vital body functions, signs of life threatening conditions following the ABC
principles. The primary survey takes only seconds to perform. The following are
the steps of performing primary survey.

1. Check for Consciousness

Begin primary survey by determining if the victim is conscious. A victim who
can speak and move is conscious, breathing and with signs of circulation.

If the victim is found unconscious try to confirm by checking his/her

responsiveness by gently tapping him/her and asking, “Are you okay?”.

Do not jostle or move the victim. If the victim is unable to respond he/she
may be conscious. Unconsciousness can indicate a life-threatening condition.

Regardless of the condition of the victim don’t forget to ask for consent. For your
information, obtaining consent, before giving care to a conscious victim you must
first get consent, before you start.
. state your name
. tell the victim you are trained in first aid
. ask the victim if you can help

36
 . explain what you may think may be wrong
. explain what you plan to do

Source:www.slideshare.com retrieved: 9/30/20

Source:www.sja.org.uk retrieved 9/30/20

Once the victims give consent provide appropriate care. A victim who is
unconscious, confused or seriously ill may not be able to grant consent in such
cases, consent is implied. Implied consent means that the victim would agree to
the care if he/she could.

2. CHECK FOR A- AIRWAY

If the victim is conscious, assess breathing as described in Check B-
Breathing.
When the victim is unconscious/unresponsive, muscle tone is decreased
and the tongue and epiglottis may obstruct the pharynx. Open the airway
immediately and proceed to checking of breathing.

WAYS IN OPENING THE AIRWAY

1. Head Tilt- Chin Lift Maneuver. For the patients who have not sustained trauma,
this simple maneuver is sometimes all that is needed for the patient to resume
breathing.
To perform the head tilt-chin lift maneuver, follow these steps:

37
. With the patient in a supine position, position yourself beside the patient’s
head.
. Place one hand on the patient’s forehead, and apply firm backward
pressure with your palm to tilt the patient’s head back. This extension of the neck
will move the tongue forward away from the back of the throat and clear the
airway if the tongue is blocking it.
. Place the tips of the fingers of your other hand under the lower jaw near
the bony part of the chin. Do not compress the soft tissue under the chin, as this
may block the airway.
Lift the chin upward, bringing the entire lower jaw with it, and helping to tilt the
head back. Do not use your thumb to lift the chin. Lift so that the teeth are nearly
brought together, but avoid closing the mouth completely. Continue to hold the
forehead to maintain the backward tilt of the head.

Source: www.talkshealth.blogspot.com. Retrieved: 9/30/20

2. JAW THRUST MANEUVER

If you suspect a cervical spine injury use the jaw thrust maneuver. If it is a
technique to open the airway by placing the fingers behind the angle of the jaw
and lifting the jaw upward. You can easily seal a mask around the mouth while
doing the jaw thrust maneuver. This is the method of choice for patients with
suspected cervical spine injury.
Perform the jaw thrust maneuver in an adult in the following maneuver:
. Kneel above the patient’s head. Place your fingers behind the angles
of the lower jaw and forcefully move the jaw upward. Use your thumbs to help
position the lower jaw to allow breathing through the mouth as well as the nose.
. The completed maneuver should open the airway with the mouth
slightly open and the jaw jutting forward.

38
 Source: www.slidesplayer.com. Retrieved 9/30/20

3. CHECK B- BREATHING
If the victim is conscious assess breathing by identifying his/her
characteristics of respiration.

If the victim is unconscious identify absent or inadequate breathing by performing

Look, Listen and Feel (look for the rise and fall of the chest, Listen for air coming
out from the nose and mouth, and feel for air touching your cheek.).

If breathing is present proceed to checking for circulation. If identified absent or

inadequate breathing refer to Module 4 Respiratory Arrest & Rescue Breathing.

CHARACTERISTICS OF A RESPIRATION
. Breathing is neither shallow nor deep
NORMAL . Average chest wall motion
. No use of accessory muscles
___________________________________________________________________
SHALLOW . Slight chest or abdominal wall motion
. Increased breathing effort
. Grunting, stridor
. Use of accessory muscles
LABORED . Possible gasping
. Nasal flaring, supraclavicular and intercostal
refractions in infants and children
___________________________________________________________________
NOISY .Increase in sound of breathing, including snoring,
wheezing, gurgling and crowing.
___________________________________________________________________

39
 CHECK B- BREATHING
Source:www.slidesplayer.com retrieved:9/30/20

LOOK TO THE CHEST

LISTEN FROM THE NOSE
FEEL THE PULSE (CAROTID)

Source: www.pinterest.co.uk retrieved: 9/30/204.

4. CHECK C- Circulation

40
 Where previously instructed to check for a pulse responders are now
instructed to look, listen and feel for signs of circulation and severe bleeding.
Signs of circulation include:
. Pulse, Normal breathing and coughing or movement in response to rescue
breaths for a certified Healthcare Provider, while;
. Normal breathing and coughing or movement in response to rescue
breathes; for certified lay responders.

If the victim is unconscious breathing is present and adequate and has signs
of circulation, place the victim in the recovery position and proceed refer to
Module 5 Cardiac Arrest & Cardiopulmonary Resuscitation.
If the victim has signs of severe bleeding, control bleeding.

DO A SECONDARY SURVEY OF THE VICTIM

Once you are certain that the victimhas no life-threatening conditions you
can begin the fourth EAP. The secondary survey is a systematic method of
gathering additional information about injuries or conditions that may need care.
These conditions are not immediately life threatening but could become so if not
cared for. The following are not in order, it will depend on the condition of the
victim or situation of the accident.

1. Interview the victim

By asking the victim and bystanders simple questions, you learn more about
what happened and the victim’s condition. Ask the following questions:
. Ask the victim’s name
. Ask what happened
. Ask the SAMPLE history

Elements of the SAMPLE history are:

1. Signs and symptoms of the episode
2. Allergies, particularly to medications
3. Medications, including prescription over the counter and recreational illicit
drugs
4. Past medical history, particularly involving similar episodes in the past
5. Last oral intake, including food and or drinks. This is particular important if
the patient may need surgery
6. Events leading up to the episode

2. CHECK THE VITAL SIGNS

Vital signs can tell you how the body is responding to injury or illness. Note
anything unusual. Recheck vital signs about every 15 minutes for medical cases.

PULSE. Each time the heart beats the arteries expand and contract with the blood
that rushes into them. The pulse is the pressure wave generated by the heart
beat, it directly reflects the rate relative strength and rhythm of the contractions
of the heart.

41
When you take a pulse, note the following:
. Is the pulse rate slow or fast?
. What is the strength of the pulse? A normal pulse is full and strong. A thread
pulse is weak and rapid. A bounding pulse is unusually strong.
. What is the rhythm of the pulse? A normal pulse has a regular spaces between
each beat. An irregular one is spaced irregularly. You can describe the pulse of a
patient, for instance as “ 72 strong and regular”. The rate strength and regularity
of a pulse tell what the heart is doing at any given time.

The pulse can be felt at any point where an artery crosses over a bone or lies near
the skin. First aider often takes a pulse at the wrist. This where the radial artery
crosses over the end of the forearm bone, the radius.

Steps to take the radial pulse.

1. Have the patient lie down or sit
2. Gently touch the pulse point with the tips of the two or three fingers. (Avoid
using your thumb. It has a prominent pulse of its own, which can be counted by
mistake.
3. Count the number of beats you feel for 30 seconds and multiply by two. This
will give you the number of beats per minute. If a pulse is irregular slow or difficult
to obtain count the beats for 60 seconds for a more accurate reading.
4. Write down the pulse and any other vital sign immediately. Never rely on your
memory.

Checking pulses in several areas will help to determine how well the patient’s
entire circulatory system is working. The absence of a pulse in a single extremity
may indicate a blocked artery. If left untreated numbness weakness and tingling
follow pain. The skin also gradually turns mottled, blue and cold.

REPIRATION
A respiration consists of one inhalation and one exhalation. The normal
number of respirations per minute varies with gender and age.

NORMAL RANGES FOR RESPIRATION

AGE RANGE
ADULT 12-20/min.
CHILD 18-25/min.
INFANT 25-35/min.

STEPS TO TAKE THE RESPIRATION

1. Place your hand on the victim’s chest or abdomen
2. Count the number of times the chest or abdomen rises during a 30 second
period. Then multiply that number by 2. But to get an accurate reading count a 60
second period.
If the patient is aware that you are assessing respiration, he may not breathe
naturally. This can give a false reading. To get around this take a pulse with the

42
patient’s arm draped over his chest or abdomen. Count the pulse for 30 seconds.
Then without moving the patient’s arm, count respirations for the next 39
seconds. Reading are easily obtained by observing and feeling the chest rise and
fall with your hand which is already on the patient’s torso.

SKIN APPEARANCE. Assessment of the skin temperature, color and condition can
tell you more about the patient’s circulatory system.
1. Skin temperature. Normal body temperature is 98.6 `F (37`C). The most
common way First aider take temperature is by touching a patient’s skin with the
back of the hand. This is called relative skin temperature. It does not measure
exact temperature, but you can tell it is very high or low.
2. Skin color. Skin color can tell you a lot about a patient’s heart, lungs and other
problems well. For example;
. Paleness may be caused by shock or heart attack. It also may be caused by
fright, faintness or emotional distress as well as impaired blood flow.
. Redness (flushing) maybe caused by high blood pressure, alcohol abuse,
sunburn, heat stroke, fever or an infectious disease.
. Blueness (cyanosis) is always a serious problem. It appears first in the
fingertips and around the mouth. Generally reduced levels of oxygen as in shock,
heart attack or poisoning cause it.
. Yellowish color maybe caused by a liver disease.
. Black and Blue mottling is the result of blood seeping under the skin. It is
usually caused by a blow or severe infection.

If your patient has dark skin, be sure to check for color changes on the lips, nails
beds, palms, earlobes, whites of the eyes, inner surface of the lower eyelid, gums
and tongue.

You may also wish to check the patient’s nail beds. This is called assessing capillary
refill. It is one way of checking for shock. Capillary refill is recommended only for
children under 6 years of age. Research has proven that it is not always accurate in
adults.

43
 Source: www.youtube.com retrieved 10/05/20
Squeezing one of the patient’s fingernails or toenails performs this procedure.
When squeezed, the tissue under the nail turns white. When you let go the color
returns to the tissue. To assess capillary refill, you have to measure the time it
takes for the color to return under the nail. Two seconds or less is normal. If refill
time is greater than two seconds, suspect shock or decreased blood flow to that
extremity.

Capillary refill maybe checked on infants by squeezing the palm of the hand or
sole of the foot and watching for color to return.
Note: That when rechecked capillary refill be sure to do it at the same place.
Different parts of the body may have different refill times.

Skin Condition. Normally a person’s skin is dry to the touch. When a patient’s skin
condition is wet or moist, it may indicate shock, a heat related emergency or a
diabetic emergency. Kin that is abnormally dry may be a sign of spine injury or
severe dehydration.

PUPILS. Normally pupils constrict (get smaller) when exposed to ight and dilate
(enlarge) when the level is reduced. Both pupils should be the same size unless a
prior injury or condition changes this.

44
 Source:www.angelfire.com retrieved 10/05/20

With these normal responses in mind assess a patient’s pupils. Shine your penlight
into one of the patient’s eyes and watch for the pupil to constrict in response to
the light. If you are outdoors in bright light, cover the patient’s eyes and observe
for dilation of the pupils. Do not expose the patient’s eyes to light for more than a
few seconds, as this can be very uncomfortable to the patient.

Source:www.emsworld.com. retrieved 10/05/20

Abnormal findings for pupils include:
. Pupils that do not react to light.
. Pupils that remain constricted (this may be caused by a drug overdose).
. Pupils that is unequal. This maybe an indication of a serious head injury or
stroke).

BLOOD PRESSURE: Some first aider are taught to assess blood pressure.Others are
not. Blood pressure is the amount of pressure the surging blood exerts against the
arterial walls. It is an important index of the efficiency of the whole circulatory
system. In part, it tells how well the organs and tissues are getting the oxygen they
need. The blood pressure cuff is the instrument used to measure blood pressure.

Source:www.preparednessadvice.com. 10/05/20

The result of a contraction of the heart which forces blood through the arteries is
called systolic pressure. With most diseases or injuries these two pressures rise or
fall together. Blood pressure normally varies with the age gender and medical
history of the patient. The usual guide for systolic pressure in the adult male is 100
plus the individual’s age up to 150 mmHg. Normal diastolic pressure in the male is
65 mmHg to 90 mmHg. Both the systolic and diastolic pressures are about 10
mmHG LOWER IN THE FEMALE THAN IN THE MALE. Blood pressure is reported as
systolic over diastolic (for example, 120/80).
45
Measuring Blood Pressure. There are two methods of obtaining blood pressure
with a blood pressure cuff. One is by auscultation or by listening for the systolic
and diastolic sounds through stethoscope. The second method is by palpitation or
by feeling for the return of the pulse as the cuff is deflated.

Source:www.alamy.com retrived: 10/05/20

DO HEAD TO TOE EXAMINATION.
This examination helps you gather more information about the victim’s
condition. When you do the head to toe examination use your sense sight, sound,
smell and touch to detect anything abnormal. Look for DCAP-BTLS (Deformity,
Contusion, Abrasion, Puncture, Burn, Tenderness, Laceration, and Swelling).

STEPS IN PERFORMING HEAD TO TOE EXAMINATION:

. Inspect the entire body starting with the head.

Source:www.personneltoday.com.retrieved 10/05/20

. Check the neck look and feel any abnormalities the victim has no pain have
the victim turn his head entirely from side to side.

46
 Source:www.worksafebc.com.retrieved 10/05/20

. Check the shoulders by looking for deformity. Ask the victim to shrug his
shoulders.

Source:www.machilaw.com.retrieved 10/05/20
. Check the chest by feeling the ribs for deformity. Ask the victim to take a
deep breath and exhale.

Source:www.dreamstime.com.retrieved 10/05/20

. Apply slight pressure to the abdomen to see if it is soft and rigid.

Source:www.dreamstime.com.retrieved 10/05/20

47
. Check the arms by feeling for any deformity. If there is no apparent sign of
injury ask the victim to bend the arms and move the hands and fingers.

Source:www.dreamstime.com.retrieved 10/05/20

. Check the hips, place your hands on both sides of the pelvis and push down
and in asking the victim if he or she feels any pain.

. Check the legs by feeling for any deformity, if there is no apparent sign of
injury ask the victim to bend the legs and move the feet and toes.

. Gently reach under the victim to check the back.

. Record all assessment and prepare patient for transport.

48