SHOCK
 This life-threatening condition occurs when the circulatory
system (which distributes oxygen to the body tissues and
removes waste products) fails and, as a result, vital
organs such as the heart and brain are deprived of
oxygen. It require immediate emergency treatment. It can
be made worse by fear and pain. Minimize the risk of
shock developing by reassuring the casualty and making
him comfortable.
 It is a condition resulting from a depressed state of many
vital functions. The vital functions are depressed when
there is a loss of a significant amount of blood volume, a
reduced blood flow, or an insufficient supply of oxygen.
 In addition, shock may occur when there is sufficient
blood volume but the heart is unable to pump the blood
around the body. This problem can be due to severe
heart disease, heart attack or acute heart failure. Other
cause of shock include overwhelming infection, low blood
sugar (hypoglycemia), hypothermia, severe allergic
reaction (anaphylactic shock), drug overdose and spiral
cord injury.
Causes of Shock
1. Significant loss of blood
2. Heart failure
3. Dehydration
4. Severe and painful blows to the body
Sign and Symptoms of Shock
1. Sweaty but cool skin (cold and clammy)
2. Paleness of the skin
3. Restlessness and nervousness
4. Thirstiness and dry mouth
5. Fast and shallow breathing
6. Dilated pupils
7. Rapid pulse
8. Nausea or vomiting
Dangers of Shock
1. Lead to Death
2. Predisposes body fluid
3. Lead to loss of body part
Your Aims
● To recognize the shock.
● To treat any cause of obvious shock.
● To improve the blood supply to the brain, heart, and lungs.
● To arrange urgent removal to hospital.
First Aid Measure for Shock
1. Control bleeding
2. Replacement of fluid
3. Control the pain
4. Prevention from heat exposure
5. Loosen the clothing
6. Elevate the casualty’s feet higher than the level of the heart
(Shock Position)
7. NOP ( Nothing by mouth) to an unconscious patient
First Aid Measure for Shock
● Treat any possible cause of shock that you can detect, such
as severe bleeding (serious burn)
● Help the casualty to lie down – on a rug or blanket if there is
one, as this will protect him from cold. Raise and support his
legs above the level of his heart to improve blood supply to the
vital organs. Keeping his head low may also prevent him from
losing consciousness. Stop him from making any unnecessary
movements.
● Loosen tight clothing at the neck, chest and waist to reduce
constriction.
● Keep the casualty warm by covering his body and legs with
coats or blankets.
● Monitor and record vital signs – level of response, breathing
and pulse.
Caution
● Do not allow the casualty to eat and drink because an
anesthetic may be needed. If he complains of thirst, moisten
his lips with a little water.
● Do leave the casualty unattended, unless you have to call
emergency help.
● Do not warm the casualty with a hot-water bottle or any
direct source of heat.
● If the casualty is in the later stages of pregnancy, help her to
lie down leaning towards her left side to prevent the baby
restricting blood flow back to the heart.
● If the casualty loses consciousness, open the airway and
check breathing.
● Place the victim in shock position
● Keep the victim warm and comfortable
● Turn the victim’s head to one side is neck is not suspected.
DROWNING
 A drowning person may be seen either struggling in the
water and making ineffectual movements, floating face
down on the surface of the water, or lying motionless
underwater. Many persons sink very quickly as they lose
buoyancy by swallowing water and by aspirating it into
the lungs, where it replaces the tidal air ( the volume of
the air normally inhaled and exhaled). The victim sinks
beneath the surface and begins to lose consciousness
from asphyxia (inability to breathe). Drowning may result
from excessive deep breathing or hyperventilation
(overventilation) that cause of accidental death, occurring
in swimming, diving, and other water activities, usually in
unsupervised water areas. It can also occur in the home
pools, bathtubs, washtubs and in shallow water. Effective
motion ceases, and the specific gravity of the victim’s
body becomes greater than that of the water it displaces.
Also, result in death from hypothermia due to cold water,
sudden cardiac arrest due to cold water, spasm of the
throat blocking the airway and /or inhalation of water and
consequent airway obstruction. Water pressure on the
victim’s chest wall increases as the victim descends,
forcing air out of the lungs. The victim is unconscious but
still may be revived if an attempt is made immediately.
 A casualty rescued from a drowning incident should
always receive medical attention even if he seems to
have recovered at the time. Any water entering the lungs
causes them to become irritated, and the air passages
may begin to swell several hours later – a condition
known as secondary drowning. The casualty may also
need to be treated for hypothermia.
Your Aims
● To restore adequate breathing
● To keep the casualty warm
● To arrange urgent removal to hospital
First Aid Management
 Immediately after rescue, begin after artificial respiration,
treat for shock, and transport the victim to a place where
he can receive medical care. Water-accident victims who
die usually do so within 10 minutes after the accident,
from lack of air or from heart failure, not directly because
of the presence of the water in the lungs or the stomach.
It is not possible to pour water out of the lungs, and no
attempt should be made to do so.
 Begin mouth-to-mouth respiration as quickly as possible
as shallow water or while holding onto a boat or suitable
buoyant aid. The rescuer must be alert to the possibility
of an instruction in the air passages and must act
immediately if one occurs. Blow into the victim’s mouth or
nose more forcefully than in other types of emergencies
affecting respiration, to force air through water in the air
passages.
1. Open the airway by tilting the head and lifting the chin.
2. Open the mouth and check for any obstructions.
3. If there are no obstructions, Look, Feel, and Listen for
breathing
● Look at the rise and fall of the chest.
● Listen for breaths with your ear close to the nose and mouth
of the victim.
● Feel with your cheek for air coming from the nose or mouth.
4. If the victim is breathing, place him or her in the recovery
position.
5. If the victim is not breathing, perform Cardiopulmonary
Resuscitation (CPR).
6. Treat the casualty for hypothermia; replace wet clothing with
dry clothes, if possible and cover him with dry blankets or
coats. If the casualty is fully conscious, give him chocolate
and/or a warm drink.
Caution
● If the casualty is unconscious, open the airway and check
breathing.
● If the casualty is not breathing give FIVE initial rescue
breaths before you start chest compressions. If you are alone,
give CPR for one minute before you call for emergency help.
● Give chest compressions only if you have not had formal
training in CPR or you are unwilling or unable to give recue
breaths. The ambulance dispatcher will give instructions for
chest compression- only CPR.
HEAT INJURY
 Heat injury is an environmental injury when one is over
exposed to extreme heat or high temperature.
Types of Heat Injury
1. Heat Cramps happen when there is inadequate salt and
electrolytes in the body.
2. Heat Exhaustion is caused by low amount of water in the
body.
3. Heat Stroke is caused by failure of the body’s cooling
mechanism.
Sign and Symptoms
1. Muscles Cramps in the arms, legs and stomach
2. Wet, sweaty skin
3. Extreme thirst
4. Weakness
5. Dizziness
6. Headache
7. Tingling of hands and feet
8. Rapid but weak respiration and pulse
9. Victim may lose consciousness
First Aid Measure for Heat Injury
1. Transfer the victim to a cool or shady area.
2. Loosen tight clothing.
3. Have the victim drink slowly at least one litter of water.
4. Apply cold compress or ice bath if available
5. Evaluate the victim‘s legs in a stroke position.
6. Monitor the victim until the symptoms lessen of disappear.
7. Seek a doctor’s assistance if symptoms persist.
POISON
 refers to any solid, liquid or gas substance that tends to
impair health or cause death when introduced into the
body or into the skin surface.
Methods of administration of Poison
1. Ingestion (by mouth)
2. Injection (skin or blood vessel)
3. Inhalation (breathe in)
First Aid Measure for Poison
1. Check for vital functioning (pulse and breathing) and
administer CPR if necessary.
2. If victim is convulsing, prevent further injury.
3. If poison is unknown, corrosive, of flammable, do not induce
vomiting nor activated charcoal.
4. If poison is known and not corrosive or flammable, induce
vomiting with Syrup of Ipecac followed by 4-5 glasses of water.
One the victim has vomited, give activated charcoal if
available.
5. If the poison container is present but is unknown by first
aider, immediately take the victim to the nearest medical
facility, show the container to the doctor, and allow the doctor
to treat the victim.
SNAKE BITES
 Snake bites is an injury caused by a poisonous snake.
Venom is Poison injected into the victim’s body through a
bite of a snake. A venomous bite is often painless.
Depending on the snake, venom may cause local tissue
destruction, it may spread, blocking nerve impulses,
causing heart and breathing to stop or it can cause blood
clotting (coagulation) and then internal bleeding.
 Note the time of the bite, as well as the snake’s
appearance to help doctors identify the correct
antivenom. Take precautions to prevent others being
bitten. Notify the authorities who will deal with the snake.
The snakes are generally categorized as poisonous and
non- poisonous.
Characteristics of Poisonous Snake
1. Flat and almost triangular or diamond shaped head.
2. With fangs and poi son sacks
3. Slit like pupils
4. With sensory pit
5. Fang mark on the bite site
6. Thick bodies
7. Color markings
Characteristics of Non-Poisonous Snakes
1. Oval-shaped head
2. No sensory pit
3. No fang mark on the bite site
4. Rounded pupils
Sign and Symptoms (Recognition)
1. A pair of puncture marks – a bite may be painless
2. Severe pain, redness and swelling at the bite
3. Nausea and vomiting
4. Disturb vision
5. Increase salivation and sweating
6. Laboured breathing; it may stop altogether
Your Aims
1. To prevent venom spreading
2. To arrange urgent removal from the hospital.
Preventing Measures
1. Handle freshly killed venomous snakes only with a long tool
or stick. Snake can inflict fatal bites by reflex action even after
death.
2. Wear heavy boots and clothing for protection from snake
bites especially in a thick forest or grassy area.
3. Eliminate conditions under with snake thrive: brush piles of
trash, rocks or logs and dense undergrowth . Controlling their
foods as much as possible is also a good prevention.
First Aid Measure
1. Identify the snake and determine if it is poisonous or non-
poisonous.
2. Wash the area thoroughly with clean water.
3. Have the victim lie quietly and instruct him or her not to do
unnecessary movements.
4. Do not elevate the bitten extremity. Keep it at level with the
body.
5. Keep the victim comfortable and reassure him or her.
6. If the part bitten is an arm or leg, place a constricting band
about 1-2 fingerbreadths above and below the bite. If the bite
is on the hand or foot, place a single band above the flow of
blood near the skin but not tight enough to interfere with
circulation.
7. If swelling extends beyond the bond, move or place another
bond the first one.
8. Never give the victim food, alcohol, stimulants, drugs, or
tobacco.
9. Remove rings, watches or other jewelry from the affected
area.
10. Bring the victim to the nearest medical facility as soon as
possible to administer anti- venom if necessary. When
possible, bring the snake that bit the victim.
Important Caution
For snake bite, do not attempt to cut or open the bite or suck
out the venom. The venom may enter any damaged or
lacerated tissues in your mouth and enter your circulation. The
application of “Bato” (Special rock) may be helpful to suck the
venom, although medical doctors disagree with this due to its
possible harmful effects. Some also say that the effect of that
method is only psychological and does not actually cure the
snake bite.
DOG BITE
 Dog bites is an injury cause by a dog. This type of injury
becomes fatal if the dog that bit the victim is infected with
the rabies virus.
First Aid Measures
1. Wipe the dog’s saliva from the wound with a clean cloth. Do
not be in contact with the saliva because it may transmit the
virus to you.
2. Was the injury thoroughly with soap and clean water.
3. Cover the wound with a sterile dressing if available and do
not put any substance on the wound.
4. Transport the victim to the nearest medical facility as soon
as possible.
5. If the dog is caught, let the veterinarian (animal doctor)
assess if it has the rabies virus.
Allergic Reactions (Allergy)
 Allergic reaction occurs when a person’s immune system
reacts to normally harmless substances in the
environment, known as allergens. An allergy can present
itself as mild itching, swelling, wheezing or digestive
condition, or can progress to full blown anaphylaxis, or
anaphylactic shock (opposite), which can occur within
seconds or minutes of exposure to an offending allergen.
 Common triggers include pollen, dust, nuts, shellfish,
eggs, wasp and bee sting, latex and certain medications,
Skin changes can be subtle, absent or variable is up to
20 percent of allergic reactions.
Sign and Symptoms
Features of mild allergy vary depending on the trigger and the
person. There may be:
1. Red, itchy rash or raised areas of skin
2. Red, itchy eyes
3. Wheezing and/or difficulty breathing
4. Swelling of hands, feet and/or face
5. Abnormal pain, vomiting and diarrhea
Your Aims
1. To assess the severity of the allergic reaction.
2. To seek medical advice it necessary.
First Aid for an Allergic Reaction
1. Calmness and reassure the person having the reaction, as
anxiety can make the symptoms worse.
2. Try to identify the allergen and have the person avoid further
contact with it.
3. If the allergic reaction is from the bee sting, scrape the sting
off the skin with something firm (such as a fingernail or plastic
card). Do not use tweezers since squeezing the stinger will
release more venom.
4. Apply cold compress to the rashes and/or hives and apply
anti-itch cream if available.
5. If rashes continue to develop, administer over-the-counter
anti-allergy medications such as diphenhydramine.
6. Observe the person for signs of anaphylactic shock.
ANAPHYLACTIC SHOCK (ANAPHYLAXIS)
 Anaphylactic shock is a sudden and severe allergic
reaction that occurs within minutes of exposure to the
allergen. Immediate medical attention is needed for this
type of reaction because it can cause death in less than
half an hour.
Sign and Symptoms of Anaphylaxis
1. High- pitched breathing sounds (wheezing)
2. Chest tightness
3. Cough or difficulty in breathing
4. Dizziness
5. Nausea or vomiting
6. Abdominal pain
7. Redness and swelling of the face
8. Hives and itchiness on different parts of the body
9. Unconsciousness
First aid of Anaphylaxis
1. Seek medical attention immediately
2. Calm and reassure the person having the reaction
3. Do not wait for the reaction to worsen
4. If the person has allergy medication on hand, help the
person take or inject the medication. Avoid oral medication if
the person is having difficulty in breathing.
NOSE BLEEDING (EPISTAXIS)
 Bleeding from the nose most commonly occurs when tiny
blood vessels inside the nostrils are ruptured, either by a
blow from the nose, or as a result of sneezing, picking or
blowing the nose. Nosebleeds may also occur as a result
of high blood pressure and anti-clothing medication.
 A nosebleed can be serious if the casualty loses a lot of
blood. In addition, if bleeding follows a head injury, the
blood may appear thin and watery. The latter is a very
serious sign because it indicates that the skull is fractured
and fluid is leaking from aroun the brain. There are two
types: anterior (the most common), and posterior (less
common, more likely to require medical attention).
Possible Causes of Nosebleeds
1. Infection
2. Trauma
3. Allergic rhinitis
4. Blood- thinning medications
5. Blood diseases such as hemophilia or anemia
First Aid for Nosebleed
1. Pinch all the soft parts of the nose together between the
thumb and index finger, and press firmly against the bones of
the face.
2. Lean forward slightly with the head tilted forward. Leaning
back or tilting the head back will cause the blood to flow into
the throat and can cause choking.
3. Hold the nose for at least five minutes. Repeat as necessary
until the nose has stopped bleeding.
4. Sit quietly, keeping the head higher than the level of the
heart. Do not lay flat or put your head between your legs.
5. Apply ice ( wrapped in towel) to nose and cheeks.
Your Aims
1. To maintain an open airway
2. To control bleeding
HYPERVENTILATION
 Hyperventilation is also known as over breathing. It is
breathing in excess of what the body needs. The normal
rate of breathing is 16-20 breaths or cycles per minute. If
the respiration rate of a person is above that range and
 the signs and symptoms are present, the person may be
suffering from hyperventilation.
Sign and Symptoms of Hyperventilation
1. Chest pain or discomfort
2. Dizziness
3. Feeling of choking or suffocation
4. Anxiety
5. Fast breathing
6. Muscle spasm in the hand and feet
7. Weakness
8. Palpitations or rapid pulse
First aid for Hyperventilation
1. Remain calm, The first aider needs to calmly instruct the
patient to breathe deep, slowly, and normally. If the first aider
panics, it might cause more anxiety to the patient.
2. Instruct the patient to perform Deep Breathing Exercise
(DBE) by inhaling through the nose and slowly breathing out
through the mouth with pursed lips (like blowing a candle)
3. If the patient fails to follow the instructions, use a brown
paper bag to compensate the high amount of oxygen in the
system. Cover the patient’s nose and mouth with brown bag
and allow him or her to exhale and inhale inside the bag.
4. Position the patient sitting down with knees bent towards the
chest and with the head leaning forward and touching the
knees. This will promote circulation to the different parts of the
body
5. If symptoms persist after several minutes, seek medical
attention.
CHOCKING (AIRWAY OBSTRUCTION)
 Choking is the blocking of the airway that occurs when a
foreign object gets lodged in the respiratory tract (throat
and windpipe). It may be partial or complete.
 To determine whether the obstruction is partial or
complete, ask the patient if he or she is choking. If he or
she is able to talk then the obstruction is only partial.
However, if the patient is unable to talk, then the
obstruction is complete.
First aid for partial obstruction
1. Calm the patient. Anxiety may cause him or her to move
unnecessarily and it may cause the foreign object to move
further into the respiratory tract and cause a complete
obstruction.
2. Instruct the patient to forcefully cough out the foreign object.
Do not attempt to reach into the throat of the patient with your
finger and swipe the foreign object. This may cause the object
to be pushed down into the windpipe.
3. If coughing is ineffective assist the patient by delivering
several back blows between the shoulder blades with the heel
of your hand.
4. Observe for complete airway obstruction
First aid for complete obstruction
1. Perform abdominal thrusts, known as the Heimlich
Maneuver, done in the following manner:
a. Stand behind the person and wrap your arms around his or
her waist. Let the person lean slightly forward.
b. Make first with one hand and grasp the fist with the other
hand.
c. Position the first above the patient’s belly button (navel).
d. Press hard into the abdomen with quick, upward thrust ‘
e. Repeat five times
2. If the Heimlich Maneuver fails after 5 thrust, apply five back
blows between the shoulder blades with the heel of your hand.
3. If the person is unconscious, call for medical help and
perform CPR to dislodge the obstruction
WOUND
 Wound is a break in the continuity of a tissue of the body,
either internal or external. Wounds are classified as open
and closed. In open wounds, the skin is broken and the
underlying tissue is exposed to outside environment . In
closed wounds the skin is intact and the underlying tissue
is not directly exposed to outside world.
 Wounds usually result from external physical forces. The
most common causes of wounds are motor vehicle
accidents, falls and the mishandling of sharp objects,
tools, machinery, and weapons.
 Open Wounds range from those that bleed severely but
are relatively free from danger of infection to those that
bleed little but have greater potential for becoming
infected. Often the victim has more than one type of
wound.
Types and Causes of Open Wounds
 Abrasion wounds result from scraping the skin and
thereby damaging it. Bleeding in an abrasion is usually
limited to oozing of blood from ruptured small veins and
capillaries. However, there is danger of contamination
and infection in abrasion wound because dirt and
bacteria may enter through the broken tissues.
 Incised (Incision) wounds are cuts in the body tissues
which are commonly caused by sharp-edged objects
such as knives, metal edges, broken glass, or surgical
blades.
 Lacerated (Laceration) wounds are jagged, irregular, or
blunts breaks or tears in the soft tissues. Bleeding may
be rapid or extensive. The destruction of tissue is greater
in the lacerations than in cuts.
 Puncture wounds are produced by bullets and sharp-
pointed objects, such as pins, nails, or needles. External
bleeding is usually minor, but the puncturing object may
penetrate deep into the body, damage organs, and cause
severe internal bleeding.
 Avulsion wounds involve the forcible separation or tearing
of tissue from the victim’s body. Avulsion are commonly
caused by animal bites and accidents involving motor
vehicles, heavy machinery, guns, and explosives.
P- puncture, A- abrasion, L- laceration, A- avulsion, I- incision,
add. Decapitation and Amputation
First Aid Management (with severe bleeding)
C - Control Bleeding
C - Cover the wound with dressing and secure with a bandage.
C - Care for shock.
C - Consult or refer to physician.
First Aid to Open Wounds
 Direct pressure. The first aider needs to directly press
his/her fingers/palm on the wound with an adequate
amount of force to constrict the blood vessels and
decrease bleeding.
 Elevation. The first aider may elevate the injured part of
the body above the heart. This would allow gravity to act
on the blood flow and prevent bleeding.
 Pressure on the supplying artery. The first aider may also
direct press the supplying artery that causes the
excessive bleeding. This will help avoid excessive loss of
blood.
 Tourniquet. This is a device that functions to control the
bleeding from a vein or an artery. This can be done with
the use of a rubber tourniquet or a bandage.
1. Place the tourniquet around the limb between the wound
and the heart. It should be placed 2-4 inches above the injury
site.
2. Do not cover the tourniquet; leave it in full view.
3. Record the time of application.
4. Use padding in the application of tourniquet to maintain
intactness of the skin.
5. If the limb is missing, apply dressing to the stump.
6. Fluid replacement may be done by trained medical experts.
This may include giving of intravenous fluids like plasma
volume expanders or transfusing the whole blood.
Note: Use a tourniquet ONLY AS A LAST RESORT, if
bleeding cannot be stopped and the situation is life-
threatening.
 Dressing - any sterile cloth materials used to cover the
wound. Also called compressing, is an immediate
protective cover placed over a wound to assist in the
control of hemorrhage, to absorb blood and wound
secretions, to prevent additional contaminations, and to
ease pain.
Uses of Dressing
1. To control bleeding
2. To cover wound and keep out dirt and bacteria which may
cause infection
3. To absorb excess fluid
4. To maintain temperature around the wound
5. To apply medication
Rules in Applying Dressing
1. Apply dressing directly over the wound.
2. Avoid contamination of the dressing.
3. Use the tail of the dressing as a bandage whenever possible
4. If the dressing is secured by tying, place the knots where
they are easy to see. Never tie knots over the wound.
5. If dressing is applied, it should not be disturbed or replace
unless hemorrhage recurs or dressing exposes the wound.
 Bandaging is the application of bandages of various
kinds, usually triangular or roller bandages. A bandage is
a trip of woven material used to hold a wound dressing or
splint in place. It helps to immobilize, support or protect
an injured part of the body. Occasionally, large pieces of
cloth are used as bandages, slings, and binders. A
bandage must be clean but it doesn’t need to be sterile.
Causes and Symptoms of Closed Wounds
Closed Wounds are usually caused by direct blunt trauma
sustained when falling down or in motor vehicle accidents.
Even with the skin intact, the damage can reach down to the
underlying muscle, internal organs and bones. Crush wounds
can sometimes be caused by heavy falling objects, such as
might happen in a car.
Types and Cause of Closed Wounds
1. Petechiae are pinpoint-sized, red or purple spots on the skin
resulting from small hemorrhages of the capillaries (smallest
blood vessels) in the skin layer.
2. Contusions are a common type of sports injury, where a
direct blunt trauma can damage the small blood vessels and
capillaries , muscles and underlying tissues , as well as the
internal organs and, in some cases, bone. Contusions present
as a painful bruise with the reddish discoloration that spreads
over the injured area of the skin.
3. Hematomas include any injury that damages the small blood
vessels and capillaries resulting in blood collecting and pooling
in a limited space. Hematomas typically present as a painful,
spongey rubbery lump-like lesion. It can be small or large,
deep inside the body or just under the skin; depending on the
severity and site of the trauma.
4. Strain is an overstretching of a muscle instead of an actual
tearing.
5. Sprain is the partial or complete disruption in the continuity
of a muscular or ligamentous support of a joint.
First Aid Management for Closed Wounds
1. Cold Compress. Initially, an ice pack should be placed on
the injured area to reduced swelling and possible internal
bleeding.
2. Immobilization. For sprains, refrain from moving or
massaging the joints to avoid further injury. Put bandage on
the injured joint with a splint to keep it immobilized.
I - Ice Application
S - Splinting
Mnemonics
5 Cardinal Signs
1. Tumor – Swelling
2. Rubor – Redness
3. Calor – Warmth to touch
4. Dolor – Pain
5. Function laesa – Loss of functioning
Objectives: Do no further harm / less body contact
P – protect the injured part
R - rest
I – ice application
C - compression
E – elevation
S – splinting
BURN
 Burns an injury involving the skin, including muscles,
bones, nerves and blood vessels. This results from heat,
chemicals, electricity or solar or other forms of radiation.
 Burns are caused most commonly by carelessness with
matches and cigarettes; scald from hot liquid; defective
heating, cooking, and electrical equipment; use of open
fires that produced flame burns, especially when
flammable clothing is worn; unsafe practices in the home
in the use of flammable liquids for starting fires and for
cleaning and scrubbing wax off floor; immersion in
overheated.
Factors to determine the seriousness of burns:
1. The Depth Superficial (First-degree) burns Partial-thickness
(Second-degree) burns Full-thickness (Third-degree) burns
2. The extent to the affected body surface area.
3. Location of the burns.
4. Victim’s age and medical condition
Types of Burn Injuries
1. Thermal Burns
2. Chemical Burns
3. Electrical Burns
First Aid management for thermal burns
1. 1st and 2nd degree burns
– Relieve pain by immersing in cold water. If cold water is
unavailable, use any cold drinks you have to reduce the
burned skin temperature
– Cover the burn with a dry, non-stick sterile dressing or clean
cloth
2. 3rd degree thermal burns
– Cover the burn with a dry, non-stick sterile dressing or a
clean cloth
– Treat the patient for shock by elevating the legs and keeping
the patient warm by covering with a dry clean sheet or blanket
Care for electrical burns
1. Unplug, disconnect, or turn off power. If that is impossible,
call the power company or ask for help
2. Check the ABC. Provide CPR if necessary
3. If the victim fell, check for spinal injury
4. Treat the victim for shock
5. Seek medical attention immediately. Electrical injuries are
treated in burn centers
Mnemonics
P-power supply (unplug/switch off)
A- assess for ABC (airway, breathing, circulation)
S- spine control
S- shock care S- seek for medical assistance
Multiple injuries to the skeletal system – including the bone,
joints, and ligaments – and to the adjacent soft tissues are
common in all types of major accidents. A break or a crack in a
bone is called a fracture. A dislocation is an injury to the
capsule and ligaments of a joint that results in displacement on
a bone end at a joint. The association of a dislocation with a
fracture is called a fracture dislocation. A sprain is an injury to
a joint ligament or in a muscle tendon In the region of a joint: it
involves the partial tearing or stretching of these structure,
injuries to blood vessel, and contusions of the surrounding soft
tissues without dislocation or fracture. A strain is an injury to
muscle that results from over stretching; it may associated with
a sprain or fracture.
FRACTURE
 Fracture is a break or crack in a bone. Considerable force
is needed to break a bone., unless it is diseased or old.
However, bone that are still growing are supple and may
split, bend or crack like at wig. A bone may break at the
point where a heavy blow is received. Fractures may also
result from a twist or a wrench (indirect force). The most
common cause of fractures are motor vehicle accidents,
falls, and accidents related to recreational sports and
activities. Some fractures result from very slight injuries,
particularly in older people, because of brittle or abnormal
bones. There are two kinds of fracture: open and closed.
 Closed (or simple)are those not related to open wounds
on the surface of the body, although there may be
laceration over or near a fracture site. The skin is not
broken, although the bone ends may damage nearby
tissues and blood vessels. Internal bleeding is a risk.
 Open (or compound) fracture are those associated
directly with open wounds. An open fracture may result
from external violence or may be produced by injury from
within, as broken ends of a bone protrude through the
skin at time of the accident or later through motion or
mishandling of the fractured bone. So, bone is exposed
at the surface where it breaks the skin. The casualty may
suffer bleeding and shock. Infection is a risk.
Signs and Symptoms
1. Deformity
2. Tenderness on the affected area
3. Swelling
4. Pain
5. Presence of protruding bone (open fracture)
6. Inability to the move the injured part.
7. Bleeding (open fracture)
8. Dislocation on the affected area
Your Aim
● To prevent blood loss, movement and infection at the injury
site
● To arrange removal to hospital, with comfortable support
during transport.
First Aid Measures of Fracture
1. Immobilize fracture by applying a splint secured by a
bandage.
2. Apply cold compress to reduce pain and swelling.
3. Control bleeding and apply sterile dressing to an open
wound.
4. Apply the treatment for shock.
5. Give a pain reliever if pain is severe.
6. Avoid unnecessary holding of the injured part.
7. Place the patient on a stretch and secure the injured part
enough to keep it from moving while he is transported.
8. Bring the patient to the nearest medical facility as soon as
possible.
Treating an Open Fracture
1. Cover the wound with sterile dressing or large, clean, non-
fluffy pad. Apply pressure around the injury to control bleeding,
be careful not to press on a protruding bone.
2. Careful place a sterile wound dressing or more clean
padding over and around the dressing.
3. Secure the dressing and padding with a bandage. Bandage
firmly, but not so lightly that it impairs the circulation beyond
the bandage.
4. Immobilize the injured part as for closed fracture and
arrange to transport the casualty to hospital.
5. Treat the casualty for shock if necessary. Do not raise the
injured leg. Monitor and record vital signs – level of response,
breathing and pulse while waiting for help to arrive. Check the
circulation beyond the bandage every ten minutes. If the
circulation is impaired, loosen the bandages.
Treating a Closed Fracture
1. Advice the casualty to keep still. Support the joints above
and below the injured area with your hands, or ask a helper to
do this, until it is immobilized with a sling or bandages.
2. Place padding around the injury for extra support. Take or
send the casualty to hospital; an arm maybe transported by
car: or call Red Cross/ Health Center Office for emergency
help for a leg injury.
3. For firmer support and/or if removal to hospital is likely to be
delayed, secure the injured part to an unaffected part of the
body. For upper limb fractures, immobilize the arm with a sling.
For lower limb fractures, move the uninjured leg to the injured
one and secure with broad –fold bandages. Always tie the
knots on the uninjured sides.
4. Treat for shock if necessary. Do not raise an injured leg.
Elevate an uninjured limb if shock is present. Monitor and
record vital signs while waiting for help. Check the circulation
beyond a sling or bandage every ten minutes. If the circulation
is impaired, loosen the bandages.
Caution
● Do not move the casualty until the injured part is secured
and supported, unless he/she is in immediate danger.
● Do not allow the casualty to eat or drink because anaesthetic
may be needed.
● Do not press directly on a protruding bone end.
DISCOLATION OR BROKEN BONES
 Joint dislocation is the displacement of a bone from its
normal position at a joint. It can be caused by a strong
force wrenching the bone into an abnormal position, or by
violent muscle contraction. This very painful injury most
often affects the shoulder, knee, jaw or joints in the
thumbs or fingers. Dislocation may be associated with
torn ligaments or with damage to the synovial membrane
that lines the joint capsule.
 Joint dislocation can have serious consequences. If
vertebrae are dislocated, the spinal cord can be
damaged. Dislocation of the shoulder or hip may damage
the large nerves that supply the limbs and result in
paralysis. A dislocation of any joint may also fracture the
bone involved. It is difficult to distinguish a dislocation
from a closed fracture. If you are in doubt, treat the injury
as a fracture.
Signs and Symptoms (Recognition)
There may be:
1. “Sickening”, severe pain
2. Inability to move the pain
3. Swelling and bruising around the affected joint
4. Shortening, bending or deformity of the area.
Your Aims
1. To prevent movement in the injury site.
2. To arrange removal to hospital, with comfortable support
during the transport.
First Aid Management
1. If, For example, the casualty has a dislocated shoulder,
advice the casualty to keep still. Help him to support the
injured arm in the position he finds most comfortable.
2. Immobilize the injured arm with a sling or use padding
and/or broad-fold bandages for a leg injury, whichever is most
comfortable.
3. For extra support for an injured arm, secure the limb to the
chest by trying a broad-fold bandage right around the chest
and the sling.
4. Arrange to take or send the casualty to hospital. Treat for
shock if necessary. Monitor and record vital signs while waiting
for help to arrive.
5. Check the circulation beyond the bandages every ten
minutes.
Caution
1. Do not try to replace a dislocated bone into its socket as this
may cause further injury.
2. Do not move the casualty until the injured part is secured
and supported, unless the victim is in immediate danger.
3. For a hand or arm injury remove bracelets, rings and
watches in case of swelling.
4. Do not allow the casualty to eat or drink because an
anesthetic may be needed.
Broken Bones
Broken bone is a break or disruption in bone tissue. A bone
may be completely fractured or partially fractured in any
number of ways (Crosswise, lengthwise, in multiple pieces).
Signs and Symptoms
1. Distortion, swelling and bruising at the injury site
2. Pain and difficulty in moving the injured part
There may be:
1. Bending, twisting or shortening of a limb
2. A wound, possibly with bone ends protruding
First Aid Management
1. Support Injured Part — help the casualty to support the
affected part at the joints above and below the injury in the
most comfortable position.
2. Protect Injury with Padding — place padding. such as
towels or cushions, around the affected part, and support it in
a comfortable position.
3. Support with Slings or Bandages — for extra support or if
help is delayed. secure the injured part to uninjured part of the
body. For upper body injuries, use a sling; for lower limb
injuries. use broad- and narrow-fold bandages. Tie knots on
the uninjured side.
4. Take or Send Casualty to Hospital — a casualty with arm
injury could be taken by car if not in shock; a leg injury should
go by ambulance, so call for emergency help. Treat for shock.
Monitor and record the casualty's level of response, breathing
and pulse, until help arrives.
MUSCLE CRAMP OR SPASM
 This condition is a sudden painful tightening of a muscle.
Cramp commonly occurs during sleep. It can also
develop after strenuous exercise. due to a build-up of
chemical waste products in the muscles, or to excessive
loss of salts and fluids from the body through sweating or
dehydration. Cramp can often be relieved by stretching
and massaging the affected muscles
Your Aim
I. To prevent spasm and pain.
First Aid Management
1. Have the victim stretch out the affected muscle to
counteract the cramp.
2. Massage the cramped muscle firmly but gently.
3. Apply heat. Moist heat is more effective than dry heat.
4. Get medical help if cramps persist.
Cramp in the Foot Help
 the casualty stand with his weight on the front of his foot;
you can rest the foot on your knee to stretch the affected
muscles. Once the spasm has passed, massage the
affected part of the foot with your fingers.
Cramp in the calf Muscles
 Help the casualty straighten his knee. and support his
foot. Flex his foot upward towards his shin to the calf
muscles, then massage the affected area on the back of
the calf.
Cramp in front of the thigh
 Help the casualty to lie down. Raise the leg and bend the
knee to stretch the muscles. Massage the affected
muscles once the spasm has passed.
Cramp in the back of the thigh
 Help the casualty to lie down. Raise the leg and
straighten the knee to stretch the Massage the area one
the spasm has passed.
STRAINS AND SPRAINS
 The Softer structures around the bones and joints —
Ligaments. and tendons can be injured in many ways.
Injuries to these tissues are commonly called strains and
sprains. They occur when the tissues are overstretched
and partially or completely torn (raptured) by violent or
sudden movements. For this reason. Strains and sprains
are frequently associated with sporting activities.
Strains and Sprains should be treated initially by the "RICE"
procedure:
R — Rest the injured part
I — Apply Ice pack or a cold pad
C — Provide Comfortable support
E — Elevate the injured part
This procedure may be sufficient to relieve the symptoms. but
if you are in any doubt as to the severity of the injury. treat it as
a fracture.
Muscle Strain or Pulled Muscle (Muscle and Tendon Injury)
 Is the sudden. painful tearing of fiber during exertion. The
muscles and tendons may be strained. raptured or
bruised. A strain occurs when the muscle is
overstretched: it may be partially torn. often the junction
between the muscle and the tendon that joins it to a
bone. In a rapture. a muscle or tendon is torn completely;
this may occur in the main bulk of the muscle or in the
tendon.
Sprain (Ligament Injury)
 One common form of ligament injury is a sprain. This is
the tearing of a Ligament at or near the joint. It is often
due to a sudden or unexpected wrenching motion that
pulls the bones in the joint too far apart and tear the
surrounding tissues.
Signs and symptoms (Recognition)
There may be:
1. Pain and tenderness
2. Difficulty in moving the injured part, especially if it is a joint
3. Swelling and bruising in the area
Your Aims
1. To reduce swelling and pain.
2. To obtain medical help if necessary.
First Aid Management
1. Help the casualty to sit or lie down. Support the injured part
in a comfortable position, preferably raised.
2. Cool the area by applying a cold compress, such as ice
pack or cold pad to the injury. This help to reduce swelling.
bruising and pain.
3. Apply comfortable support to the injured part. Leave the cold
compress in place or wrap a layer of soft padding, such as
cotton wool around the area. Secure it with the support
bandage that extend to the next joint; for an ankle injury. the
bandage should extend from the of the toes to the knees.
4. Support the injured part in a raised position to help minimize
bruising and swelling in the area. Check the circulation beyond
the bandages every ten minutes. If the circulation in impaired,
loosen the bandages.