Frist Aid PPT For Pharm PDF

Introduction to first Aid and
Accident prevention
By : Mr. Ismael Ahmed (BSc, MSc/AHN)
1 BY: Ismael Ahmed , firs aid and accident preventioon 2/20/2023

Chapter 1 : Introduction of first aid

Learning Objectives
 At the end of this chapter the student will be able to;
 Define first aid
 Explain values for first aid
 Determine the purposes and principles of first aid
 Describe scope of first aid
 Discus general directions to provide first aid.
 Describe principles of accident prevention

BY: Ismael Ahmed , firs aid and accident
3 preventioon 2/20/2023
Introduction
 Human populations are growing and expanding rapidly.
 As a result…
 Growing conflicts, violence and accidents among people. More
chances to acquire sudden injuries and illness.
 Currently the incidence of death from injury increases more
than threefold and
 causing about 3.8 million deaths & 312 million injury/year
world wide
 Injury is the top leading killer and the single greatest cause of
death before the age of 45 years.

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Introduction….
Why ... As a result…
The earth has encountered •More natural disaster events and disturbances
changes in climate and in envn‟tal conditions happening.
environmental degradations
•During such events more people facing
injuries/sudden illness.
•Globally every year about 200 million people

affected by natural as well as man-made
technological accidents.
There is advancement in A systems made by human itself becoming out

technologies and increased use of his control and causing injuries.
of technological products

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Cont’d…
Accident and medical emergencies can happen anytime.
 You need to use first-aid skills on the job, at home, and elsewhere in
your community.
 For better handling of emergencies when you are the first or

only person on the scene.
 It can make the difference between life and death
 It may occasion minimize the need to hospital care

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What is first aid?
 First Aid is
 the initial assistance or treatment given to a casualty for any
injury or sudden illness before the arrival of emergency
medical services.
 First Aid;
 is an immediate & temporary care
 is a rapid assessments & interventions
 is initial care in the acute illness/injury
 can be performed by a bystander or by victim with minimal
or no medical equipment.

Cont’d…
 it is what should you do before EMS arrives including home
care.
 it is an intervention to bring a difference between life and
death
 A first aider– is someone with a formal training in first aid,

emergency care, or medicine who provides first aid.

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Values of First Aid Training
 The need for F.A training is greater than ever; due to rising
magnitudes of sudden illness/injuries rising as a results of
a. rapid growth world population and
b. increased use of technological products;
 There is a growing demand for first aid training;

 for personal use and to be certified as first-aiders, as a part of
industrial & commercial establishments.
 Hence, training should be universal: everyone can learn F.A and

everyone should.
Principles of First Aid
The three P’s of principles of first aid are;
1. Preserve life;
2. Prevent complications;
3. Promote healing and recovery;

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Why we give First Aid?
 The purpose of giving First aid includes;
 To sustain (preserve) life - E.g. rescue breathing.
 To prevent worsening of the problem (complications). E.g.
Immobilizing the fracture.
 To preserve vitality and resistance to further injury or infection
 To provide pain relief - E.g. Use of ice packs or applying of sling
 To provide reassurances
First aid rules
 Be calm and confident (safety first)  Keep victim warm &

comfortable.
 Seek medical attention immediately
 Do not touch open
 Examine the victim gently and treat wounds or burns
the most urgent injuries 1st with fingers
 Do not move injured victim.  Keep NPO, for

unconscious victims
 Keep the victim lying down
Responsibilities as a first aider
 Assess the situation quickly and safely.
 Protect casualties and others at the scene from possible danger
 Comfort, reassure, stay calm and take charge
 Give each casualty early and appropriate treatment, treating the most
serious condition first.
 First ask the victims if you can help them
 The victim can refuse (Medical ID tags, DNR).
 If the victim is confused or cannot answer, assume that he or she
would want you to help.

Cont’d…
 You should
 respond to emergencies that you have been trained to handle
 arrange for the casualty‟s removal to hospital or into the care of a

doctor.
 remain with a casualty until appropriate care is available.
 report your observations to those taking care of the casualty, and

to give further assistance if required.
 You are not expected to give a care beyond a level of your

professional qualifications

Primary Survey
 The Primary Survey is a quick way for you to find out if
someone has any injuries or conditions which are life-
threatening.
 Its purpose is to identify and immediately correct life-

threatening problems.
 If you follow each step methodically, you can identify each

life-threatening condition and deal with it in order of
priority.
 Start with safety, and continue “ABCDs.

Primary survey….
 BLS refers to maintaining of airway patency, and supporting
breathing & circulation without the use of equipment other than a

protective device.
 BLS interventions including CPR (Chest compressions and
artificial ventilation) performed by anyone who knows how to do

it, anywhere, immediately, without any other equipment

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Cont’d…
 DR.- ABCD to remember the order of priority steps of
components of the 1o survey
 usually given by the “ABCDs”:
 D- Danger-
 R- Response
 A- Airway
 B- Breathing
 C- Circulation (Bleeding)
 D- Disability
 Generally ABCDs are parts of primary survey

DANGER:
 If someone needs help, before you go up to them check – is it safe?
 No:  Yes:
 If you can see or hear any  If you can‟t see or hear any
danger nearby, for you or danger then it is safe to go
them, like broken glass or up to them.
oncoming traffic, then
make the situation safe
before you get any closer

RESPONSE:
 Do they respond when you ask them: „Are you alright?‟ or if you say:
„Open your eyes!‟
No: Yes:
 If they don‟t respond, pinch  If they respond by making eye
their ear lobe or gently shake contact with you or some
their shoulders, or with a child gesture then you know that
- tap their shoulder
they‟re responsive and you can
 If they still don‟t respond, then
move on to the next stage –
you can presume they‟re
unresponsive and move on to Airway.
the next stage – Airway.
 Unresponsive victim should
always take priority so you
should treat them first and as
quickly as possible.
Airway:
 Is their airway open and clear?
No: Yes:
 Responsive: If they‟re
 If their airway is open and
responsive, yet blocked airway
treat (e.g. choking) clear, move on to the next
stage – Breathing.
 Unresponsive: tilt their head
and lift their chin to open their
airway.
 Only move on to the next stage –

Breathing – once their airway is
open and clear.

Breathing:
 Are they breathing normally? You need to look, listen and feel to
check they‟re breathing.
 No:  Yes:
 Responsive: If they‟re conscious, treat  If they are breathing
them for whatever is stopping them normally, move on to
breathing, for example, an obstructed the next stage –
airway. circulation.
 Unresponsive: If they‟re unresponsive
and not breathing, call EMS or get
someone else to call if possible, and start
giving chest compressions and rescue
breaths (CPR)

Circulation:
 Are there any signs of severe bleeding?
 Yes:
 No:
 If they‟re bleeding severely,
 If they aren‟t bleeding, and
control the bleeding with
your gloved fingers, dressing you‟re sure you have dealt
or clothing, call EMS and with any life-threatening
treat them to reduce the risk conditions, then you can
of them going into shock. move on to the Secondary
Survey, to check for any other
injuries or illnesses.

First Aid equipment
 Emergency kits should supplied to scene site for use both on-
site and off-site emergencies.
 Standard kit provide a basic standard set of equipment and

drugs with the main emphasis on the basics of resuscitations (to
support ABC‟s of life)

Basic contents of first aid kits
 Basic Airway/Ventilation Adjuncts:-  Immobilization Devices:- Spinal
oral/nasal airway, bag-valve mask immobilization & Cervical collars.
Extremity immobilization devices
 Equipment for vascular access and to
control bleeding:- Cleansing agent,  Life saving drugs:- salbutamol,
IV catheter, IV fluid and IV tubing. Adrenaline, hydrocortisone,
Tourniquet, adhesive tape, gauze, Glucose, Tramadol & others PRN
bandage, scalpel
 Other equipment such as stationery
 PPE:- Gloves, masks, antiseptics and and Communication Devices
etc.

Chapter 2: Cardio-pulmonary
emergencies and basic life support

Objectives
 At the end of this chapter students should be able to;
 Identify cardio-respiratory emergencies/Arrests;
 Define artificial ventilation and cardiopulmonary resuscitation.
 Demonstrate how to assess (ABCs of) the collapsed victim
 Demonstrate how to perform chest compression and rescue breathing

(CPR)
 Demonstrate how to place an unconscious breathing victim in the recovery
position.
 Provide first aid for other common respiratory accident.

Adult Basic Life Support (BLS)

Introduction
Respiratory arrest
 Respiratory failure/arrest - is one in which normal breathing
stops or in which breathing is reduced so that oxygen intake is
insufficient to support life.
 Common causes are ;
 Closure of airway (Unconscious pt., foreign body, trauma,
inflammatory diseases of throat),
 Drowning, Electrical trauma and Musculature weakness (Nervous

system diseases, and Drug overdoses

Resps arrest Causes
• Unconscious patient - caused by the drooping of the tongue
Causes of Stoppage of breathing
A. Anatomical
Obstruction back (Mostly)
• Closure of airway • Foreign body
• Trauma (direct injury by a blow)
• Inflammatory conditions/diseases of throat
(Asthma, Croup, Diphtheria, Laryngeal spasm, Swelling after
burns of the face, Swallowing of corrosive poisons)
B. Mechanical • Solid foreign objects lodging in the respiratory passage

Obstruction (e.g. choking)
• Accumulation of fluids in the airway (back of throat) -
mucous, blood or saliva
• Aspiration - Inhalation of any solid or liquid substance

Causes of breathing arrest …
C. Air Depleted of  Asphyxia –a condition when there is a lack of O2 in
O2 or Containing the blood & the tissue. Occurs due to decreased O2
Toxic Gases in the air or increased CO or other toxic gases in
the air (mining area, sewer etc.)
 Explosion hazard - Combustible gases
D. Other Causes -  Circulatory collapse (shock)

 Heart disease
 Strangulation
 Lung disease e.g. pneumonia
 Poisoning by alcohol, barbiturate, codeine etc.
 Electrical shock/trauma
 Compression of the chest e.g. accident
Musculature weakness
 Nervous system diseases
34  accident
BY: Ismael Ahmed , firs aid and Drug preventioon
overdoses 2/20/2023
Respiratory arrest ….
 Initially, during few minutes, pulse (heart beating) is preserved.
 Cardiac arrest can be prevented by quick and effective first aid
(open the airway, artificial ventilation).
 Artificial respiration is a procedure for making air to flow into

and out of a person‟s lungs when his natural breathing is
inadequate or ceases.
 Cardiopulmonary resuscitation (CPR)- is an emergency

procedure consisting of external cardiac massage and artificial
respiration.
 CPR and artificial respiration should be done for victim‟s of

Respiratory and Cardiac arrest
 An objectives of artificial respiration is
a) To maintain an open air way
b) To restore breathing by maintaining an alternating increase and
decrease in the expansion of the chest.
 If an oxygen supply is cut off , in average a person may die with in

4- 6 minutes
 Recovery is usually rapid except in case of CO poisoning, drugs over

dose, or electrical shock.
 Artificial respiration should have to continue until; the victim begins

to breath by himself, transferred to definitive care or confirmed dead

Artificial respiration …
 Basic techniques of artificial respiration includes
1. Mouth- to- mouth rescue breathing (“kiss of life”)
2. Mouth- to- nose rescue breathing
3. Mouth-to- barrier devices (Mask) rescue breathing
4. Mouth-to- stoma/tracheostomy

Cardiac arrests
 If the heart stops pumping, it is known as a cardiac arrest.
Cause of cardiac arrest
Rhythm disturbances
 Ventricular fibrillation
 Unstable V-tach
 Pulseless electrical activity
 Asystole
A. Myocardial infarction
B. Hypothermia,
C. Electrical trauma,
D. Blood (fluid) loss
Cardiac arrest….
 Clinical and biological death
 After cardiac arrest the brain cells are the first to begin to die.
 Cells have a residual oxygen supply and can survive for a short time
(reversible damage or clinical death duration 4-6 minutes).
 Effective CPR may reverse clinical death and possibly restore the
patient to an undamaged state
 After 4-6 minutes brain damage become irreversible (biological
death)

Management of cardio-pulmonary arrests
 Cardio-pulmonary resuscitation (CPR)
 Is primarily performed to squeeze blood manually out of the
heart for victim‟s with cardiac arrest and provide oxygenated
blood to the brain and heart.
 BLS is a sequences of procedures performed to restore the

circulation of oxygenated blood after a sudden pulmonary
and/or cardiac arrest
 Chest compressions and pulmonary ventilation performed by

anyone who knows how to do it, anywhere, immediately,
without any other equipment.

BASIC LIFE SUPPORT (BLS)
A irway
B reathing
C irculation

Steps of basic life support (BLS/ CPR)
 Po –Survey sequence for BLS (CPR ) for health professional

1. Approach safely
2. Check for response
3. Shout for help
4. Open airway
5. Check breathing
6. Call for EMS 939 and ask for AED
7. 30 chest compressions
8. 2 rescue breaths

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SEQUENCES BASIC LIFE SUPPORT STEPS
Approach safely
Check response
Shout for help
Open airway
Check breathing
Call 997
30 chest compressions
2 rescue breaths
1. APPROACH SAFELY!
 Assure safety of;
Approach safely
 Scene
Check response
 Rescuer
Shout for help
 Victim Open airway
Check breathing
 Bystanders
Call 939
2 rescue breaths
2. CHECK RESPONSE
Approach safely
Check response
Shout for help
Open airway
Check breathing
Call 939
2 rescue breaths
2. CHECK RESPONSE
 Shake shoulders gently
 Ask “Are you all right?”
 If not Pinching the earlobe,
rub eyelid & observing for
grimacing or rubbing on the
sternum
 If he responds
 Leave as you find him.
 Find out what is wrong.
 Reassess regularly.
Cont’d…
 2A. If he responds
 Leave as you find him.
 Find out what is wrong.
 Reassess regularly.
 2B. If he does not respond: Shout for nearby help or

 Activate EMS. Get AED and emergency equipment.

3. SHOUT FOR HELP
Approach safely
Check response
Shout for help
Open airway
Check breathing
Call 939
2 rescue breaths
OPEN AIRWAY
Approach safely
Check response
Shout for help
Open airway
Check breathing
Call 939
BY: Ismael Ahmed , firs aid and accident preventioon

2 rescue breaths
49 2/20/2023
4. AIRWAY OPENING BY NECK EXTENSION
 Technique to open airway are;
1. Head tilt & chin lift,
2. Jaw thrust
Campbell
4. OPEN AIRWAY
 Head tilt and chin lift
 lay rescuers
 for non-healthcare rescuers
 and in non trauma victims
 unless solid material can be seen

 in the airway.
 No need for finger sweep


Relive if - Foreign-body Airway Obstruction (FBAO)
Back Blows
Abdominal thrusts

5. CHECK BREATHING
Approach safely
Check response
Shout for help
Open airway
Check breathing
Call 939

2 rescue breaths
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… CHECK BREATHING
 Check for no breathing,

 use LLF methods (simultaneously
check pulse)
 LLF - Look, listen and feel for
NORMAL breathing
 LOOK: for the chest to rise and fall
 LISTEN: for air escaping during
exhalation,
 FEEL: for the flow of air on your
cheek

6. Call for EMS
Approach safely
Check response
Shout for help
Open airway
Check breathing
Call 939

2 rescue breaths
56 2/20/2023
Cardiopulmonary resuscitation (CPR)
 CPR does not guarantee that the person will survive, but it does give that
person a chance when otherwise there would have been none
 Cardiopulmonary resuscitation (CPR) combines mouth-to-mouth

resuscitation and cardiac compressions to deliver oxygen and artificial
circulation to an unresponsive person until medical help arrives.
 Cardiac or chest compressions are the priority in CPR. If you don‟t want
to do mouth-to-mouth, chest compressions alone may still be life-saving.
 CPR does not guarantee that the person will survive, but it does give that
person a chance when otherwise there would have been none

7. CHEST COMPRESSIONS
Approach safely
Check response
Shout for help
Open airway
Check breathing
Call 939

2 rescue breaths
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CHEST COMPRESSIONS
• Place the heel of one hand
in the centre of the chest
• Place other hand on top
• Interlock fingers
• Compress the chest
– Rate >100 -120 min-1
– Depth 5 -6 cm
– Equal compression: relaxation
• When possible change CPR
operator every 2mins
Adult Child Infant
Chest One 30:2 30:2 30:2

compressions rescuer
ratio
Two 30:2 15:2 15:2
rescuer
Depth of compression 5cm 5cm 4cm
Ventilation rate 1 breath every 5-6 1 breath every 2-3 1 breath every
seconds, 10 to 12 seconds, 20 to 30 2-3 seconds,
breaths/min breaths/min 20 to 30
breaths/min
Chest compression 2 hand 1 or 2 hand 2 fingers

technique
chest compression rate 100-120/min 100-120/min 100-120/min
provide chest compression…
a. Kneel by the side of the victim.
b. Place the heel of one hand in the center of the victim‟s chest
(which is the lower half of the victim’s sternum/breastbone).
c. Place the heel of your other hand on top of the first hand.
d. Interlock the fingers of your hands and ensure that pressure

is not applied over the victim's ribs. Do not apply any
pressure over the upper abdomen or the bottom end of
the sternum.

Cont’d..
e. Position yourself vertically above the victim's chest and,
with your arms straight, press down on the sternum 5-
6cm.
f. After each compression, release all the pressure on the chest
without losing contact between your hands and the
sternum.
g. Repeat at a rate of 100 -120 min
h. Compression & release should take an equal amount of
time.
 Chest compression: ventilation ratio is 30:2, for 5cycles

Quality of chest Compression
 Hand position - straight

 Rate – 100-120/min
 Depth- avoid depth >2.4
inch/6cm
 Chest wall recoil - avoid
leaning on chest b/n
compression
 Minimize interruption in
chest compression -<10sec

8. RESCUE BREATHS
Approach safely
Check response
Shout for help
Open airway
Check breathing
Call 939

2 rescue breaths
65 2/20/2023
Combining with Rescue
:
 After 30 compressions open the airway again (head tilt, chin lift)
 Pinch the soft part of the victim‟s nose closed, using the index
finger and thumb of your hand on his forehead.
 Allow his mouth to open, but maintain chin lift.
 Take a normal breath and place your lips around his mouth,
making sure that you have a good seal.
 Blow steadily into his mouth whilst watching for his chest to rise;
take about 1sec to make his chest rise as in normal breathing; this
is an effective rescue breath.
 Maintaining head tilt and chin lift, take your mouth away from the
victim and watch for his chest to fall as air comes out.

RESCUE BREATHS  Pinch the nose
 Take a normal breath
 Place lips over mouth
 Blow until the chest rises
 Take about 1 second
 Allow chest to fall
 Repeat
NB
Compression to ventilation ratio
is 30:2
Always Initiate compression
67 BY: Ismael Ahmed , firs aid and accident preventioon before ventilation/CAB 2/20/2023
… Rescue breathing
Mouth-to-mask rescue
Mouth-to-mouth rescue
breathing with proper mask
breathing
placement
CONTINUE CPR
 30 2

Compression-only CPR
 If you are not trained to, or
 are unwilling to give rescue breaths, give chest compressions
only.
 If chest compressions only are given,

 these should be continuous at a
 Stop to recheck the victim,

 Recheck only if he starts to show signs of regaining
consciousness,

BLS for infants and children
Approach safely
Check response
Shout for help
Open airway
Check breathing
Call 939
2 rescue breaths
PLACING THE VICTIM IN RECOVERY POSITION

IF VICTIM STARTS TO BREATHE NORMALLY PLACE IN
RECOVERY POSITION

When Can I Stop CPR?
 Victim revives
 Trained help arrives
 Too exhausted to continue
 Unsafe scene
 Physician directed (do not resuscitate orders), or team agree
 Cardiac arrest of longer than 30 minutes
 (controversial)

Why CPR May Fail?
 Delay in starting
 Improper procedures (ex. Forget to pinch nose)
 No Advanced Cardiac Life Support (ACLS) follow-up and

delay in defibrillation
 Only 15% who receive CPR live to go home
 Improper techniques
 Terminal disease or unmanageable disease (massive heart

attack)

Injuries Related and Complications of
CPR
Injuries Related to CPR
 Rib fractures
 Laceration related to the tip of the sternum
 Liver, lung, spleen
Complications of CPR
 Vomiting
 Aspiration
 Place victim on left side
 Wipe vomit from mouth with fingers wrapped in a cloth
 Reposition and resume CPR

CPR in specific population
 Pulse checking - Feel for brachial pulse while maintaining

head tilt with the other hand.
 Never use carotid pulse for infants because you may interrupt
circulation to brain if present.
 The brachial pulse is located on the inside of the upper arm,
between elbow and shoulder.

Infant … Chest compression
 Compression Site- Nipple line technique should be
used
 just 1 finger below the imaginary line between baby's nipples
 Use two thumbs of both hands or
 Hold your index finger up, and use your other 2 fingers
 Rate : >120 per minute
 Depth: 1/3-1/2 the depth for the chest

CPR infant …. Rescue breathing
 Rescue breathing
 Make a tight seal over the mouth and nose of the infant
 Provide two slow rescue breaths
 Time: 1sec per breath and watch chest rises & allows time for
exhalation.
 Volume: enough to see the chest of the infant rise during
ventilation
 Reading assignment
 CPR for pregnant women ??
 CPR for girls/Boys ??

Introduction to first Aid and
Accident prevention
82 firs aid and accident preventioon 2/20/2023

Chapter 3 - Wound & bleeding control

Learning Objectives
 At the end of this chapter the student will be able to
 Define wound and bleeding
 Classify different types of wound
 Identify common causes of wound
 Apply first aid measures to stop bleeding.
 Provide first aid measures for different types of wounds.
 Explain the preventive measures of contamination and

infection of wounds.

Wound & bleeding control
 Wound: - Is a break in to the continuity of the tissue of the
body either internally or externally
AIM of dealing with wounds
To control bleeding
To treat shock
To maintain function
To prevent complication

Wound & bleeding control…
Common cause
 Surgical wounds- Surgical incisions
 Accidental wound
Direct blowing
Bite (animal or human bite)
Mishandling of sharp instruments
Fall
Machinery
Motor vehicle accidents
Classification of Wounds…
 Abrasions Incisions Punctures


Amputation

First aid for open wounds
 Stop bleeding
 Dress the wound
 Treat shock
 Rest and clean
 Refer if necessary

Bleeding control
Bleeding: - escape of blood from vascular
structure either externally or internally.
Fig. 15 Bleeding
Bleeding control cont’d…
 Bleeding may vary from mild to severe or fatal type by depleting
the function of blood
• Transporting O2, nutrients and wastes

• protection against disease
• Maintenance of constant body temperature
 Natural body mechanism to stop bleeding

Clotting
Contraction of cut ends
 Decrease BP

Sign of internal bleedings
 initially, pale, cold, clammy skin. If bleeding continues, skin
may turn blue- grey (cyanosis).
 Rapid, weak pulse
 Thirst
 Rapid , shallow breathing
 Confusion, restlessness, and irritability. Possible collapse and
unconsciousness
 Bleeding from body openings (orifices)
 Pattern bruising: seatbelt sing, battle sign, ecchymosis
(raccoon eyes) etc…
 Pain and informations from Mechanisms of injury
Bleeding….
Severity of Bleeding is depends on:
 How fast blood is flowing from vessel
 Size of vessel injured
 Whether vessel is a vein or artery
 Whether bleeding is internal or external
 Where bleeding originated
 Whether bleeding is a threat to airway and respiration

External bleedings
 Is blood that is escaping from arteries, capillary vessels,
or veins.
1. Arterial bleeding
Characteristics
Rapid, profuse /spurts bleeding
Difficult to control
Bright red in color
2. Venous Bleeding
Characteristics
Flows at steady rate
Dark in color
Simple to control
3. Capillary bleeding
The color of the blood is intermediate between bright and
dark red.
The blood only oozes from the wound.

First aid for bleeding
Act hurry!
 Technique to stop bleeding
 direct pressure
 Elevation
 Pressure point
 Tourniquet

First aid
 For slight bleeding
 Apply slight pressure to bleeding point
 Elevate the bleeding part unless contra indicated
 Wash and apply dressing
 Dry the area with swab
 Refer as necessary

For severe bleeding
Direct pressure
Preferred method to control sever bleeding as it does not
interfere normal circulation
Use your palm
It can be combined with pressure on artery
Once pressure is applied, keep it in place.
Pressure can also be applied by bandage with it‟s knot on the
wound
Do you remove a soaked dressing?

Elevation
 Un less contra indicated wounds of head, neck and

extremity and bleeding from these site can be controlled
by this method
 Unless there is evidence of a fracture,
 Works by force of gravity
 It should be aided by direct pressure


Pressure on supplying artery
 Use of the pressure point technique temporarily compresses

the main artery against the underlying bone and near by
tissues.
 manual pressure by compressing the main artery that

supplies blood to the affected limb against the underling
bone and nearby tissues the technique also stops circulation
within the limb
 Do not substitute its use for direct pressure and elevation

Brachial artery for upper extremity
 Apply pressure over the brachial artery, forcing it against the
arm bone.
 Pressure point is located midway between the armpit and the

elbow
 Grasp the middle of the victim‟s upper arm, your thumb on

the outside of his arm and your other fingers on the inside.
 Press your fingers toward your thumb to create an inward

force from opposite sides of the arm.
Femoral artery for lower extremity
Forcing the artery against the pelvic bone.
Position the victim flat on his back, if possible and place the
heel of your hand directly over the pressure point

Tourniquet
 It is a device used to press up an artery to prevent loss of
blood
Can be rope or bandage
Used only for life threatening hemorrhage

 Place tourniquet just above the wound
 Do not cover tourniquet

Using a Tourniquet

Removal of foreign objects
 Use tweezers, sterilized over a flame or in boiling water, to
pull out any foreign matter from the surface tissue.
 Lift out those objects embedded just beneath the skin
 Some penetrating foreign objects such as sticks or pieces of

metal may protrude loosely from the body.
 Under no circumstance should the victim be pulled loose

from the fixed object.

CONT’D…
 Penetrating Object  DO NOT REMOVE!
 Deeply embedded foreign objects in the tissues, regardless of size should
be left for removal by health personnel.
 If the object is fixed or protrudes more than a few inches from the body, it
should be left in place, be cut off at a distance from the skin, and be
secured from being damaged.
 Immobilize the protruding end with massive dressing around the
protruding part, and then transport the victim to a hospital without delay.

Foreign bodies in minor wounds
 First aids:
 Control bleeding by applying firm pressure on either side of the
object and by raising wounded part

 Cover the wound with gauze to minimize the risk of infection
 Pad around the object until you can bandage over it without
pressing down
 Hold the padding in place while finishing the bandaging
 If you cannot pad high enough, bandage around the object

CONT’D…

Wounds of chest and abdomen
Sucking wounds of chest
 A deep open wounds of the chest through which air can flow
in and out with breathing
 If the wounding object is in place; leave undisturbed to
prevent fatal bleeding

Sucking wounds of chest cont’d…
First aids
 Cover open wounds to prevent air entry
• Use sterile gauze, clean cloth, plastic or metal foil
• The cover should be air tight
• Use tape/ plaster or binder to secure in place
• Be sure it should be not too tight or too loss to disturb breathing
 Refer urgently
Note- you can use palm until you get suitable bandage
Sucking wounds of chest cont’d…

Open wounds of abdomen
 Wounds of the abdomen are particularly dangerous because of
the risk of damage to internal organs.
First Aid
 Do not try to replace protruded organs but cover them with a

sterile dressing, a clean towel, plastic, or metal foil.
 Hold the dressing in place with a firm bandage, but do not apply
bandage so tightly as to cause constriction.
Open wounds of abdomen…
 Do not give fluids or solid food
 If breathing is difficult, keep the victim‟s head and

shoulder elevated with a pillow or a folded coat.
 Call for assistance and for ambulance
 Refer to hospital as rapidly as possible

Open wounds of abdomen…

Internal Bleeding: First Aid
 Activate EMS first.
 Establish & maintain open airway, and monitor ABCDs.
 Assess for fractures; apply a splint if needed.
 Position & treat the victim for shock; keep warm.
 If the victim vomits, place in recovery position.
 Monitor victims every 5 minutes until EMS arrive.

Prevention cont’d…
 Open wounds are subjected to infection & contamination
Measures for wounds with out severe bleeding

 Wash your hands with soap and water
 Wash around and in the wound
 Rinse the wound by flushing with clean water
 Apply dry bandage

 Inform the victim to visit health institution if there is any problem

Safe guard measures for wounds with severe bleeding
 Do not disturb the dressing initially applied on the wound
 Do not attempt to clean the wound since the victims needs

medical care
 Attempt for shock during and before transportation
 Immobile the injured part
 Elevate the affected limb if possible

Dressing of wound
 Protect wound from additional injury and contamination &
assist in the control of bleeding.
 Bandaging a wound holds the dressing in place, assists in

controlling the bleeding.

Identification and management of infection
S/s of infection
 Swelling, redness, hotness, pain, fever, pus formation and
regional lymph node swelling
First Aid
Rest the affected part
Elevate the affected part
Refer

Chapter 4- Dressing and Bandages

Introduction
 Dressing is the immediate protective cover placed over the wound. Sterile
dressings are those free from germs prior to use
 Bandages is A strip of woven materials used to hold dressings and splint in
place
The technique of applying bandage and dressing vary according to;
 The extent and location of the injuries
 The material at hand
 The ability of first aider to adopt to emergency situation

Introduction…
Purpose dressing Purpose Bandages
 To assist control of  To hold dressings in place
bleeding
 To hold splint in place
 To absorb wound secretion
 To immobilize and support the
and bleeding
injured part
 To prevent additional
 To reduce or prevent edema
contamination
 To relieve pain

Introduction…
 Principle of clean dressing
 Hand washing
 Larger than the wound
 Drying of material without contamination
 Use of ironed or in folded cloth if available
 Most are porous, allowing air to circulate
 Do not touch, breath, cough, sneeze and talk over the

wounds and dressing
Application bandage
General principles
1. Bandage should be snug (it is useless if too loose) but not too tight to
interfere with circulation.
2. Leave the persons finger tips exposed when a splint or bandage is applied
to the arm and leave the toes exposed when a splint or bandage is applied
to the leg.
3. Watch for swelling, color changes of fingers and coldness of the tips of
fingers or toes, indicating interference with circulation.
4. Loosen bandage immediately if the victim complains numbness or tingling

sensation.
5. Never apply tight circular bandage about the neck; it may cause
firs aid and accident preventioon
125
strangulation. 2/20/2023
Bandages…
 The most common mistakes are applying bandages too tightly or
too loosely
 Signs that a bandage is too tight
o Nearby skin becomes pale or a bluish color
o Nearby fingernails/toenails develop a bluish tinge
o Skin beyond the bandage is cold, tingling, or numb
o Delay in blood return
126 firs The

o victim
aid and accident cannot move their fingers or toes
preventioon 2/20/2023
Types of bandage
1. Elastic bandage
 Expensive but can be reused
 Most hazardous bandage b/c of the tendency of the first aider to stretch them so much that
circulation or nerve function may be impaired.
 Should not be too tight
2. Gauze bandage
 Never apply wet gauze bandage, it will shrink as it dries & become too tight
 Commonly used as
 Circular bandages
 Spiral bandages
127
Figure
 firs aid andof eightpreventioon
accident (for joint areas) 2/20/2023
Types of bandage…

TRIANGULAR BANDAGES

Chapter 5: Specific injuries
Eye injuries
Nose injuries
Neck injuries
Chest injuries
Abdominal injures

Specific injuries…
Eye Injury
Eyes are extremely delicate organ
Foreign objects are often blown or rubbed in to the eye
Such objects are harm full
 Includes:
o Foreign bodies in the eye
o Blunt Injury of the eye
o Penetrating injuries of the eye

Eye injury cont’d…
Foreign bodies in the eye
 Foreign objects are harmful b/c of the irritating effect & its
scratching the surface or becoming embedded in the eye.
Precaution
Instruct the patient not to rub the eye
Wash hand before examining
Do not try to remove objects using match stick, tooth picks or
other instruments
Refer the victim for removal if objects are embedded or thought to

be embedded
 Removal of foreign body from the surface eye ball/inner surface
of eye lid
 Small objects will be washed out by tears/ blinking
 Seat the person in a lighted area
 Open the injured eye with your thumb & forefinger
 If object is floating try to flushing it out
 If object is removed flush eyes with saline/warm water

Pull down the lower eye lid to determine for the presence of the
foreign object
Lift out with the corner of clean hand kerchief or tissue paper
If objects are not located on the lower eye;
• It may present under the upper eye lid
• While the victim looking down ward grasp the eye lash gently
• Then pull the upper eye lid down ward fore ward over the
lower eye lid – tear may dislodge it

Penetrating injuries of the eye
 Such injuries of the eye are extremely serious and can result in
blindness.
 Urgent referral must be arranged.

Penetrating injuries of the eye
First aid measures
 Do not try to remove the object or to wash the eye.
 Cover both eyes loosely with a sterile or clean dressing.
 Secure with tape or bandage
 Decrease movement which could increase IOP.
 Keep the victim quiet, preferably on his back
 Keep and transport the victim by stretcher

 Position paper cup over injured eye and impaled object. DO NOT touch eye or impaled
object.
 Secure cup in place with bandage or scarf that covers BOTH eyes.
 Use thick cloth or dressing and cut a hole for affected eye
Put paper cup over affected eye.

Harmful Chemicals in the Eye(s)
 Open the injured eye with your thumb and forefinger and
Flush the eye(s) with water immediately!
 Flush the eye(s) with water immediately!
 NB: Flush the eye with a lot of water start at the inside corner and
pour downward to the outside corner.
 This lets the water drain away from the body and keeps it from
getting in the other eye.
 Keep pouring the water for 10 to 30 or more minutes or until

you get medical help.

Flush the eye(s) with water immediately!

Cont’…
If both eyes are injured,
 Place the face in a sink or container filled with water.
 Tell the person to move his/her eyelids up and down.
 Remove the face from the water to take breaths.
 Examine the eye(s).
 DO NOT bandage and touch the eye.
 Get Medical Care Right Away!

Nasal injuries/Nasal bleedings
 Injury to the soft tissue of the nose may with or
without fracture.
 Nose bleeds can result from injury or disease
 Such as hypertension or high blood pressure which can

cause profuse, prolonged and dangerous bleeding.
EPISTAXIS (NOSE BLEED)
 Def/n: - A hemorrhage from the nose.

Causes
* Nose picking
* Blowing nose with force
* Acute febrile illness
* Injuries
* Dryness
* Introducing objects into nose (mostly children)
* Allergies
* High BP
* Sunlight
* Cardiovascular diseases (Atherosclerosis)
* Blood-clotting disorders
Sites of nose bleed…
 Appropriate control of epistaxis calls for identification of the
bleeding site.
 Nose bleeds are classified mainly into:
 anterior nosebleeds and posterior nosebleeds.
Anterior nose bleed

* Most nosebleeds originate from the anterior portion of the nose
* Occurs on lower part of wall that separates nostrils
* The bleeding starts from front of nose

 It flows outward when victim is sitting/standing
Posterior nose bleed
 The bleeding starts deep within the nose
 It flows down the back of the mouth & throat
 Occurs in old people/those with high BP or injuries
 This type of bleeding is severe/requires medical help

First aid for Nose Bleeds
 Priority is to control the bleeding and keep airway open
 Keep the victim quiet.
 Position victim in a sitting position
 Keep head tilted slightly forward
never lie down

nor backwards

First aid measures
 Pinch both nostrils
 Apply direct pressure by pinching nostril against the septum for 10
minute
 Apply cold compress to nasal root and face

 Apply ice to bridge of nose
First aid…
 Cautions –
 If underling cause of bleeding is head injury.
 Check if the blood may appear thin and watery, there is skull
fracture, and it is very serious so call for rapid emergency
medical help
Caution
If it lasts more than

30 minutes, Call
EMS

Neck injury – first aid
 Ensure ABC  Place small pad or towel at
 Spinal immobilization: the space under his neck
 manually stabilizing the  Anchor the restraining
head so that the motion of materials with bricks or
head, neck, and spine is stones.
minimized.
 Immobilization devices
may be needed in special
circumstances when
immediate extrication is
required,

Spinal injury… first aid
 Ensure ABC, and call for ambulance/EMS
 Keep lying down
 Leave in position found in, avoid unnecessary movement.
 If you do need to move, logroll & support head and neck

First Aid
 Logroll technique
 Handle as gently as possible
 Do not twist the neck or back, strict immobilization.
 Arrange rolled up blankets or clothing on both sides of the
trunk,
 the body should be held as a unit with the head, shoulder, trunk,
hip and legs, each supported by one person.

NECK INJURIE

First Aid for chest injuries
 Ensure patient air way
 Remove clothing to assess injury
 Stabilize impaled objects with bulky dressing. Do not move.
 Stabilize flail rib segment with hand followed by application of
large pieces of tape horizontal across the flail segment.
 Assess for other significant injuries and treat appropriately.
 Place patient in a semi-Fowler‟s position or position victim on
the injured side if breathing is easier after cervical spine has been
ruled out.
 Ongoing Monitoring

penetrating chest wounds
 Leave penetrating object in  Occlusive dressing: idea is to
situ create a valve effect, so that
 seal open (sucking) wound on air can escape but not enter
3 sides with sterile occlusive the chest cavity
dressing (or plastic).
 consult with EMS regarding
need for Needle
Thoracocentesis
 If condition of patient
worsens after application of
dressing, remove dressing and
reevaluate patient
 Nil by mouth

Burn injury
 An injury of the body due to transfer of heat energy from heat
source or chemicals agent to the body.
 It vary in depth, size and severity
155 2/20/2023
Burn injury cont’d…
Causes of burn
Carelessness with matches and in cigarette smoking.
Scalds from hot liquids
Defective heating, cooking and electrical equipment.
Use of open fires that produce flame burns, especially
when flammable clothing is worn.
156 2/20/2023
Causes cont’d
UV rays/ sun burn
Immersion in overheated bath waters.
Electrical current
Chemicals, such as strong acids and strong detergents.
157 2/20/2023
Classification of burn
 Burns are classified based on cause:
 Thermal burn
 Electrical burn
 Chemical burn
 Inhalation injury
158 2/20/2023
Severity of burn
Severity of burn injury depends on;
 Extent of burn
 Depth of burn
 Age
 Pre-existing medical problems
 Nutritional status
 Location
159 2/20/2023
The extent of burn
 The estimation of body surface area burned is determined
by:
Palm method – a palm size of a victim is approximately

equal to 1% of TBSAB (total body surface area burned).
Rule of nine- the system that assign percent in multiple of

nine to a major body areas thus:
160 2/20/2023
161 2/20/2023
Depth of burn
 Burn can be classified in to three based on depth or layers
of tissue involved.
 1st degree burn
 First degree burns are those resulting from overexposure

to sun, light contact with hot objects or scalding by hot
water or steam.
 It involves portion of epidermis and irritates dermis.
162 2/20/2023
Signs and Symptoms
 Redness or discoloration
 May be pain
 Redden and blenches with pressure
 Tingling sensation
 Healing time – with in a week
163 2/20/2023
1st degree Cont’d
164 2/20/2023
First Aid
 Remove the burnt clothing
 Usually, medical treatment is not requiring
 Apply cold water applications, or submerge the burned area
in cold water.
 Apply dry dressing if necessary
165 2/20/2023
2nd degree burn
 Resulting from very deep sunburn, contact with hot
liquids and flash burns from gasoline, kerosene and other
products.
 It usually more painful than deeper burns.
 Involves epidermis and dermis.
166 2/20/2023
Sign and Symptoms
 Pain full and greater depth than first degree burn.
 Red and matted appearance
 Swelling for a period of several days
 Blister (exudates fluids)

Healing = 2-3 wks
167 2/20/2023
superficial Ⅱ0
168 2/20/2023
First Aid
 Immerse the burned part in cold water
 Do not break blister or remove tissues

 Apply dry, sterile gauze or clean cloth as protective
bandage.
 Apply wet dressing (soaked in ice)
 Elevate extremity (arms or legs)
 Refer the victim.

169 2/20/2023
Full thickness (3rd degree burn )
Caused by a flame, ignited clothing, and immersion in hot
water, contact with hot objects or electricity.
Temperature and duration of contact are important

factors in determining the extent of tissue destruction.
Involves epidermis, dermis, subcutaneous tissue and

underlying structure.
170 2/20/2023
Sign and Symptoms
 White to red or brown to black in color
 Complete loss of all layers of the skin
 Pain less, shock, Hematuria
 Edema
 Broken skin and exposed fat.
171 2/20/2023
172 2/20/2023
First Aid
 Do not remove adhered particles
 Cover the wound
 Elevate the part
 Do not immerse extensively burned part in water
 Refer immediately
 Healing – over a month
173 2/20/2023
Firsts aids of burn injuries
 The aims of first aid should be
 to stop the burning process, cool the burn, provide pain relief and
cover the burn.
 The principles of pre-hospital first aid are:

1. Ensure rescuer safety.
2. Stop the burning process.
3. Start ABC - CPR if needed
4. Check for other injuries –no miss to other injuries
5. Cool the burn wound - with cold (15°-25°C) tap water for 20mins
or until pain is relieved.
6. Elevate

First aids for Burns
 Other general measures esp. for thermal burn
 remove jewelry
 remove clothing gently if it is NOT stuck to skin.
 Never use ICE for cooling
 cover burned area
 leave blisters intact as it is
 provide emotional support
 maintain body temperature
 call EMS or contact burn unit for further advice
 arrange for casualty to be sent to the hospital

Stop the burning process
 The heat source should be removed.
 Flames should be doused with water or smothered with a blanket

or by rolling the victim on the ground.
 Clothing can retain heat, even in a scald burn, and should be

removed as soon as possible.
 Adherent material, such as nylon clothing, should be left on.
 In the case of electrical burns the victim should be disconnected

from the source of electricity before first aid is attempted.

Cooling the burn
 Active cooling removes heat and prevents progression of the
burn.
 effective if performed within 20 minutes of the injury.
 Immersion or irrigation with running tepid water (15°C)

should be continued for up to 20 minutes.
 Iced water should not be used as intense vasoconstriction can

cause burn progression.

Covering the burn
 Dressings should cover the burn area and keep the patient warm.
 If cling film is not available then any clean cotton sheet

(preferably sterile) can be used.
 Avoid using wet dressings, as heat loss during transfer to hospital

can be considerable.
 Use of topical creams should be avoided at this stage as these may

interfere with subsequent assessment of the burn.

First aids for Chemical burns of the
skin
 Liquid chemical -
 irrigate with copious amounts
of water (15-20L) for 20-30
min
 Remove all clothing
 Powder -
 DUST OFF the skin never
apply H2O, it may activate
the chemical and exacerbate  NB-
the burn
 Follow ABCD always
 Tar burns –
 cool tar with water & leave in
place

Chemical Burns of the Eyes
 May due to chemical
splashes to eyes
 First Aid:
 Flush face, eyelid, & eye for 15 –
20 minutes As Soon As Possible
 Avoid rubbing eye
 Cover eye
 Seek medical attention ASAP

© Business & Legal Reports, Inc. 1110
Bone and joint
injuries
 Fracture
 Dislocation
 Sprain
 Strain
182 6/28/2021
Fractures
 Fracture is a break in the continuity of bone.
 It occur when the bone is subjected to stress greater

than it can absorb.
 Dislocation -is complete or Partial separation of the
joint.
 Types of fracture
 1) Open (compound)–are those associated directly with
open wounds. Bone has broken through skin.
 2) Closed (simple) fracture – are those not associated

with open wounds on the surface of the body. Skin has
not been penetrated on both ends.
CLOSED AND OPEN FRACTURE
BY: Ismael . A 2/20/2023

Causes of Fracture
 Most common causes are Motor vehicle accident (MVA), or
 Fall from a height, Recreational and sport activities
 Other causes includes

 Industrial accident (machine)
 Gunshot injury
 Fighting injury
 Pathologic fractures
 Stress fractures

FRACTURES
 SYMPTOMS:
 Pain & tenderness at or near fractured site
 Swelling over the fracture site
 Deformity e.g. irregularity of bone, unusual angulation or
rotation of limb, shortening of injured leg/arm, depression of
bone etc
 Loss of power & difficulty moving
 Discoloration (ecchymosis, bruising)
 Crepitation (grating sound)
 Signs and symptoms of shock

Fracture first aid
 Objectives of # first aid
 To prevent blood lose
 To keep the broken bone ends and the adjacent joints

from moving. Immobilization
 To transport the victim to hospital
 To give care for shock.
 To relief pain.

Fracture - First Aid
 Prevent motion to injured part or adjacent joints
(immobilize)
 Apply splint
 Elevate involved extremity
 Do not attempt to replace the bones
 Airway and CPR if indicated.

Immobilization
Purpose of immobilization is to:
 Decrease movement at the site of fracture and prevent further soft tissue
injury
 Relieve pain
 Prevent re-displacement of a reduced fracture
 Splinting is one technique of immobilization using splints.
 Splint body part in position as found
 Prevent injured area from moving
 Check for circulation before and after splinting

Splinting
 Splints are metallic, wooden or other devices applied to the
arms, legs or trunk to immobilize the injured part when a
fracture is suspected.
Reasons for Splinting

 Relieve pain by minimizing movement
 Prevent further damage to injury site.

General Principles of Splinting
1. Splint fracture where it lies – DO NOT reposition.
2. Immobilize fracture site before moving casualty.
3. Splint should immobilize joint above and below fracture site.
4. Pad splints before applying.
5. Dress all wounds and/or open fracture (exposed bones) prior

to splinting.
6. Check for neurovascular function before, during and after

application of splint.
Characteristics of splint
Splint should be:

 Rigid
 Long enough to go above and below the injured part

 Wide enough
 Well padded
 Held in place by bandage
BY: Ismael . A 2/20/2023

Open fracture – first aid
 Remove or cut away the victims clothing.
 Control hemorrhage by applying pressure through a large

sterile or clear dressing over the wound.
 Don't wash, or probe or do not insert your fingers in to the

wound.
 If a fragment of bone is protruding, cover the entire wound

with sterile dressing.
 Do not replace any bone fragments.

Scapula
 Dislocations of the shoulder joint, sprains and contusions are
common in this area.
 First aid consists of applying a sling and bandaging the victim‟s upper
arm to his chest wall

Fracture of the upper arm
 First aid for a closed humerus fracture
 Place a pad in the victim‟s arm pit, apply a splint or improvised

splint tied in place above and below the break area.
 Support the forearm with a sling that doesn‟t produce upward

pressure at the fracture site.
 Bind the victim‟s upper arm to his chest wall.

Fracture of the upper arm
196 2/20/2023
Fracture of fore arm and wrist
 The two bones of the fore arm (ulna and radius) may be fractured
individually or together.
 First aid measures

 Mid portion of the fore arm and wrist fractures are treated in the
same way as fractures of the shaft of the humerus.
 Immobilize the broken bone ends at the wrist and the elbow
 Bend the elbow and apply a sling with a slight
 Elevation keeping the thumb pointing upward.

Fracture of fore arm and wrist
198 2/20/2023
Fracture of the upper leg
 Fractures of the shaft of the femur usually result from falls
or traffic injuries.
 The victim is in severe pain and shock and markedly

disabled.
 The foot is characteristically turned outward and the limb

shortened owing to overlapping of the bone ends due to
muscular spasm.

First Aid
 To transport for short distance on a stretcher, place a blanket
between the legs and bind them together.
 To apply the board splint, assemble needed supplies.
 Tie bandage just below the arm pit, at the abdomen, at the
hip, above and below the fracture site, at the lower leg and
ankle and foot with
 figure of eight bandage
Fracture of the upper leg
201 2/20/2023
Fracture of the kneecap (Patella)
 Apply a pillow splint about the knee or padded splints
 From below the victim‟s heel to his buttocks along the

back of the leg, with the leg extended.
 Raise the leg slightly to prevent swelling and urgent

refer.

Fracture of the kneecap (Patella)
203 2/20/2023
Fracture of the lower leg
 Splints on both sides of the leg and foot from the top of
the thigh to foot
 Secure splint with a bandage at five sites at the thigh,

at the knee, below and above the fracture and at the
ankle and foot
 insert blankets or towels between the legs and tie

them to gather.
 keep the victim‟s foot pointing up ward and check for

poor circulation
 Immobilize the broken bone ends, knees and ankle.

Fracture of the lower leg
205 2/20/2023
Fracture of ankle and foot
 First aid measures
 Loosen or remove the victim‟s shoes, and hose (socks) and keep
him lying down with his leg elevated.
 For an open wound apply large bulky dressings.
 Splint with a pillow or blanket firmly applied with out

attempting to correct the deformity

Fracture of ankle and foot
207 2/20/2023
Transferring the victim, the body should be held
as a unit(logroll method)
208 6/28/2021
DISLOCATIONS
 It is complete or partial separation of the joint
 is the displacement of one or more bones at a joint.
 It usually occurs in the shoulders, elbow, thumb, fingers and

the lower jaw.
SYMPTOMS:
 Pain at the site of injury
 Limited movement at joint
 Deformity
 Swelling
 Tenderness

DISLOCATIONS…
First aid:
 Support and immobilize the injured limb
 Use a splint (if possible) to prevent movement of the injured part
 Apply a sling if appropriate.
 Arrange for casualty to hospital
 Elevate the affected part if a limb is involved.
 In doubtful cases, always treat as for a fracture
 Never attempt to reduce a dislocation.

SPRAINS
 A sprain occurs at a joint where there is tearing or over-
stretching of the ligaments and tissues.
 some of the fibers of the supporting ligament are ruptured but the
continuity of the ligament remains intact
 occurs usually as result of forcing a limb beyond the normal range

of movement.
 SYMPTOMS:
 Pain at site of injury
 Swelling and later bruising
 Pain on movement
 Loss of function
STRAINS
 A strain is
 an injury to a muscle in which the Muscle fibers tear as a
result of overstretching or overexertion.
 Commonly strains occur on the back muscles, due to
improper lifting technique.
 While the ankles, fingers, wrists and knees are most often
sprained
 SYMPTOMS:
 Localized pain
 Stiffness
 Inflammation
 Bruising
SPRAINS/STRAINS– first aid
 First aid  P. R. I.C.E.
 P=Protect
 R= rest ,
 I= ice,
 C =compress,
 E =elevate
 Support the joint in most comfortable position
 Limit each application of cold to periods <20 mins

first aid
 When a sprained ankle
occurs outdoors, do not
remove the shoe
 If unsure whether there is a
fracture, always assume it is
one.
 Both strain and sprains are
muscle and ligament
injuries without dislocation
or fracture

Victim transportation
BY :
 Blanket
 Chair
 wincher
 one person
 two person
 three person
 6 person
BY: Ismael . A 2/20/2023
One person
BY: Ismael . A 2/20/2023

Two person
BY: Ismael . A 2/20/2023

Three person
BY: Ismael . A 2/20/2023

Six person
BY: Ismael . A 2/20/2023

BY: Ismael . A 2/20/2023
Summary
221 6/28/2021
Poisoning
222 2/20/2023
Poisoning…
 A poison are any substances (solid, liquid or gas) that tends to
impair health or cause death when introduced in to the body
or on to the skin surface
 Be accidental or non accidental (self poisoning)

 90% of accidental poisoning occur within the home.
 It can be swallowed, inhaled, injected or absorbed through

the skin.
 Ingestion is commonest (77%) route of exposure

Causes of poisoning
 Accessibility of the poisoning agent
 Carelessness – leaving agents within reach of children
 Illiteracy
 Inadequate labeling of drugs and chemicals
 Administration of the wrong drug or the wrong dose;
 Over doses of drugs taken either accidentally or with suicidal

intent
 Combining some drugs and alcohol

Types of poison
1. Man-made poisons- 2. Natural poisons
 found in the home and  Products of plants, and
industry. insects,
 Are chemicals such as  animals venoms, and

bleach, paint stripper, and
 bacteria produced poisons
 pesticides and drugs (OTC
medications)

Routes of Exposure
 Ways in which poisoning may occur includes
1. Through the mouth (by ingestion)-

 Most poisoning happens this way
2. Through the skin (by absorption)
3. Through the lung (by inhalation)
4. By injection –include biting

Diagnosis is made by
 Information by the victim/from an observer.
 Presence of known poison container
 Conditions of the victim (sudden pain/illness)
 Burns around the lips or mouth.
 Breathe odor
 Pupils of the eyes contracted to pinpoint size (opid overdose)

common signs for drug poisoning
1. Stomach pain, nausea and
vomiting 6. Unusually slow or fast
2. Shaking hands pulse
3. Sleepiness leading to 7. Excitable hyperactive
unresponsiveness behavior
4. Hallucinations ‒ claim to 8. Unusually small or large
'hear voices' or 'see things' pupils
5. Confusion and 9. Sweating
deliriousness 10. Needle marks which may
be infected

First aid for swallowed poisons
 The objectives in first aid of ingested poisoning :
 To dilute the poisons quickly as possible.
 To maintain respiration or circulation.
 To preserve vital functions and to seek medical assistance

without delay.

First aid for swallowed poisons
 If the person is conscious, ask them
 what they have swallowed,
 how much and when.
 Look for clues, like plants, berries or empty packaging and
containers.
 Call for medical help and give information as possible.

 Age, amount, type, and how long ago ingested
 Keep checking of
 breathing, pulse and level of response.

First aid for swallowed…
 Dilution or inducing vomiting
 Evidences are insufficient
 Only for conscious victims –
 Dilution with milk or water

 Give him a drink of tepid water with soap in it.
 Continue inducing vomiting until it become clear
 If the victim vomits save a sample of the vomited material into a bag
or container for analysis
 Do not induce vomiting if the poison is one which burns or if it is

petrol or kerosene.
 Instead, give milk with egg or a mixture of whites flour and water.

First aid for swallowed…
Dilute
 Alkali for acid,
 Acid for alkali
 Milk for metal poisoning if he/she is conscious

and not having convulsions
232 2/20/2023
First aids …
 If they become unresponsive,
 Open their airway and check breathing.
 Follow the instructions for CPR (unresponsive).
 Don‟t give fluids and Never try induce vomiting
 if they vomit position him and turn the head, also safe a
sample of the vomit into a bag or container
 It may help them identify the poison
 N.B
 Gastric lavage is an effective alternative if poison has been
swallowed not more than 6 hours ago.
 Gastric lavage could be followed by the use activated
charcoal.
Contact poisoning (skin)
 Chemical Burns ????
 Brush powdered chemicals off the skin
 Remove all contaminated clothing from the victim,
 making sure you do not contaminate yourself
 acid or alkali on the skin –
 Irrigate immediately the affected area with copious amounts of water
 Continue washing all contaminated skin with soap and water for at
least 15mins.
 Keep air way open, consider CPR if needed indicated
 Do not leave the victim alone.
 Eye exposure –
 Irrigate with a copious H2O immediately

Poisoning by Bites
 Injuries produced by animal or human bites may cause
punctures, lacerations or avulsions.
 Have danger of infection, especially rabies.
 The bite of any animal or a pet may result in an open wound.
 Rabies- is a viral infection which can be transmitted from

infected animals such as dogs and cats to human being.
First aid for bites
 Injuries produced by animal or human bites may cause
punctures.
 Irrigate human and animal bites with copious amounts of

water.
 Call and Contact medical help
 Rapid primary assessment and commence BLS/CPR if

required

1. Human Bite
 Human bites that break the skin may become seriously

infected because many bacteria exist in the mouth.
 Cleanse the wound thoroughly with clean water, dry,

cover it and seek medical attention.

2. Animal Bite
 General interventions;
 A bite on the face or neck should receive immediate medical

attention, because of the proximity to brain.
 Keep the animal under observation if possible at least for 10

days.
 Do not kill the animal unless necessary.
 Consider a danger of Rabies and Tetanus

3. Dog bite
Rabies- is zoonotic infection usually caused by bite

of rabid dog
Certain dogs are aggressive by nature and may bite at

the slightest provocation.
Whatever the case give first aid for the victim
239 2/20/2023
Dog bite…
 First aid in the case of dog bite:
 Wash the wound thoroughly with soap and water, flush the bitten
area.
 The cloth used should be discarded and care taken not to touch
the saliva.
 All animal bite wounds are not recommended to be sutured and

dressed.
 Make sure that the victim avoids movement of the affected part
until he/she receives the medical attention.
 The person should be taken to the medical attention immediately.

Dog bite…
 Since there is a chance of being infected with tetanus, the health
professional will administer an injection containing tetanus vaccine.
 The owner of the dog should be informed and the dog taken to a
Veterinarian immediately, to check for symptoms of rabies.
 The dog should not be killed, but should be kept under observation
for 10-15 days to see whether it develops symptoms of rabies.
 If it does not develop symptoms within 10 days, then chances are

that it is not infected by rabies.
4. Snake bites
 Three are different kinds of poisonous snakes in different

parts of the world.
 All reaction from poisonous snake bites is aggravated by

acute fear and anxiety.
 Factors affecting the outcome of poisonous snake bites??

Factors affecting outcome of snake bites
 The amount of venom injected
 The speed of absorption of the venom in to the victim circulation.
 That depends on;
• Location of the bite,
• Protection from clothing, shoes and gloves …
 Access to specific anti venom therapy as soon as possible.

Signs and symptoms of envenomation
 Local signs of envenomation:
 Puncture marks (not always visible), and

 Oedema
 Petechiae (do not blanche)
 Bruising
 Sites may NOT be painful
 May no signs at all
 NB-
 Snakebites are not necessarily painful.

Systemic envenomation signs
 Most of snakes cause an asymptomatic coagulopathy, but the
patient feels OK.
 Systemic envenomation signs mainly includes

A. Signs of bleeding - gums/nose bleed .
B. Neurologic sign - ptosis/confusion, Note any paralysis of limbs
and
 At < 1hr after bite

 Vomiting, Headache, Sweating
 transient hypotension,
 confusion or unconsciousness

Systemic signs …
 1-3 hrs. after bite  Over 3hrs:
 ptosis, double vision, voice  paralysis of limbs
changes  loss of respiratory muscle
 difficulty in swallowing function
 Confusion  hypoxia
 abdominal pain  cyanosis
 dark urine  shock
 haemorrhage  myolysis (muscle weakness,
 Hypertension, pain on movement and
 tachycardia
dark urine)

247 2/20/2023
First Aid Interventions
 Objectives of first aid
 To reduce the circulation of blood through the bite area
 To delay absorption of venom.
 To prevent aggravation of the local wound and to sustain

respiration

First aid for Snake bites
 In all cases of large envenomation the victim will be critical in minutes rather
than hours.
 So conduct rapid assessment , Call and Consult EMS
 Generally the first interventions includes

 Reassuring - Calm and rest the victim
 Delay venom movement

 Apply a firm but not tight cord above the site
 Immobilize the injured part just below the heart
Refer to hospital ASP and Continue monitoring

First aid for Snake bites…
 Applying PIB with adequate pressure around the entire
length of the bitten extremity is an effective and safe way to slow
the spreading of venom by slowing lymph flow.
 Do not apply suction as first aid for snakebites.
 Do not wash the area of the bite
Keep the bitten limb, and the patient, still
 Do not take off clothing
 Bandage can be left in place

First aid for Snake bites…
 Refer to hospital ASP
 All people with snake bite or suspected snake bites

should be admitted and observed
 Continue monitoring level of consciousness and for

respiratory failure (usual cause of death)
 Carry out BLS as required
 Continue observing for signs of envenomation.

252 2/20/2023
Poisonous insect bites
Sting
 Sting is poisoning from insect bite like bee, ants, scorpions etc.
occasionally cause death.
 Death from the sting of such creatures is almost always due to acute
allergic reaction.
Signs and Symptoms of poisoning from insect bite:
Local reaction, sever pain produced by nerve toxin, profuse
sweating, shock, nausea, painful cramps of abdominal muscles,

Difficult in breathing and speaking
First aid for insect bites
Minor bites and stings
Cold application
Discard the venom sack
Severe reactions
Give artificial respiration if indicated
Apply a constricting band above the injection site on the victim‟s arm or leg
(between the site and the heart).
Do not apply tightly.

In case of bee sting, remove and discard the stinging apparatus and venom sac.
Keep the affected part down, below the level of the victim’s heart.
Group assignment
For group two students
FOR G-1
1. Frist aid for shock, fainting ,sudden illness and
unconsciousness
FOR G-2
1. Mass gathering and disaster prevention and
management
255 2/20/2023
Group assignment
For group three students
Group -1
1. First aid for foreign-body airway obstruction (FBO)-
choking
Group -2
1. First aid for drowning, mechanical suffocation
(strangulation) and seizures
256 2/20/2023
257 2/20/2023

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Introduction to first Aid and

By : Mr. Ismael Ahmed (BSc, MSc/AHN)

1 BY: Ismael Ahmed , firs aid and accident preventioon 2/20/2023

2 BY: Ismael Ahmed , firs aid and accident preventioon 2/20/2023

 Define first aid

 Explain values for first aid

 Determine the purposes and principles of first aid

 Describe scope of first aid

 Discus general directions to provide first aid.

 Describe principles of accident prevention

BY: Ismael Ahmed , firs aid and accident

•Globally every year about 200 million people

There is advancement in A systems made by human itself becoming out

BY: Ismael Ahmed , firs aid and accident

 For better handling of emergencies when you are the first or

BY: Ismael Ahmed , firs aid and accident

7 BY: Ismael Ahmed , firs aid and accident preventioon 2/20/2023

 A first aider– is someone with a formal training in first aid,

BY: Ismael Ahmed , firs aid and accident

 There is a growing demand for first aid training;

 Hence, training should be universal: everyone can learn F.A and

3. Promote healing and recovery;

BY: Ismael Ahmed , firs aid and accident

 To sustain (preserve) life - E.g. rescue breathing.

 To prevent worsening of the problem (complications). E.g.

Immobilizing the fracture.

 To preserve vitality and resistance to further injury or infection

 To provide pain relief - E.g. Use of ice packs or applying of sling

 Be calm and confident (safety first)  Keep victim warm &

 Do not move injured victim.  Keep NPO, for

 First ask the victims if you can help them

 The victim can refuse (Medical ID tags, DNR).

 If the victim is confused or cannot answer, assume that he or she

would want you to help.

16 BY: Ismael Ahmed , firs aid and accident preventioon 2/20/2023

 arrange for the casualty‟s removal to hospital or into the care of a

 remain with a casualty until appropriate care is available.

 report your observations to those taking care of the casualty, and

 You are not expected to give a care beyond a level of your

17 BY: Ismael Ahmed , firs aid and accident preventioon 2/20/2023

 Its purpose is to identify and immediately correct life-

 If you follow each step methodically, you can identify each

18 BY: Ismael Ahmed , firs aid and accident preventioon 2/20/2023

 BLS refers to maintaining of airway patency, and supporting

breathing & circulation without the use of equipment other than a

 BLS interventions including CPR (Chest compressions and

artificial ventilation) performed by anyone who knows how to do

BY: Ismael Ahmed , firs aid and accident

 Generally ABCDs are parts of primary survey

20 BY: Ismael Ahmed , firs aid and accident preventioon 2/20/2023

22 BY: Ismael Ahmed , firs aid and accident preventioon 2/20/2023

 Only move on to the next stage –

24 BY: Ismael Ahmed , firs aid and accident preventioon 2/20/2023

25 BY: Ismael Ahmed , firs aid and accident preventioon 2/20/2023

26 BY: Ismael Ahmed , firs aid and accident preventioon 2/20/2023

 Standard kit provide a basic standard set of equipment and

27 BY: Ismael Ahmed , firs aid and accident preventioon 2/20/2023

28 BY: Ismael Ahmed , firs aid and accident preventioon 2/20/2023

29 BY: Ismael Ahmed , firs aid and accident preventioon 2/20/2023

 Identify cardio-respiratory emergencies/Arrests;

 Define artificial ventilation and cardiopulmonary resuscitation.

 Demonstrate how to assess (ABCs of) the collapsed victim

 Demonstrate how to perform chest compression and rescue breathing