SFA TRAINING

This training program on Standard First Aid (SFA) is unique among the DOH-HEMS courses in
that it focuses on building the emergency response capabilities of non-health professionals. It
aims to provide laypersons the knowledge, skills, and attitudes that will enable them to provide
efficacious first aid interventions during emergencies and disasters. Having people in the
community who are capable of administering first aid is thus a crucial building block of an
effective community response to emergencies.
- The Department of Health Emergency Management Service
The CKC NSTP Officers (AY 2022-2023) were fortunate to have this kind of training and is now
imparting this knowledge to their co-students in this program.

MODULE 1
Session 1
INTRODUCTION TO FIRST AID
A. What is First Aid?
⁃ Helping behaviors and initial care provided for an illness or injury.
⁃ response to emergency health situation

B. Disaster Risk Reduction and Management Cycle

1. Prevention
2. Preparedness
3. Response
4. Rehabilitation & Recovery Mitigation

C. Goals of First Aid

• Prevent further injury
• Preserve life
• Alleviate Suffering
• Promote Recovery

D. Responsibilities of the First Aid Provider

• Bridge the gap between the victim and the physician.
• Ensure his own safety, that of the victim's and of the bystanders.
• Gain access to the victim.
• Determine threats to the victim's life.
• Call for more medical assistance as needed.
• Provide emergency care to the victim
• Assist Health Care Providers and other personnel when they arrive.
• Handover to medical services or properly trained and authorized personnel.
 E. Limitations of First Aid
⁃ Limited skill range
⁃ Limited medical knowledge
⁃ Minimal or no medical resources
⁃ Legal concerns

Legal Basis
Republic Act No. 3815
"Article 12 Section 4 of the Philippine Revised Penal Code Book 1: Any person who, while
performing a lawful act with due care, causes an injury by mere accident without fault or
intention of causing it is exempt from criminal liability"

Characteristics of a First Aider:

G Gentle - does not cause pain to the victim.
R Resourceful - make the best use of things at hand and available
O Observant - notice all signs.
T Tactful - does not alarm the victim.
E Empathetic - should be comforting.
R Respectful - maintain a professional and caring attitude.

Session 2
STEPS IN FIRST AID: EMERGENCY ACTION PRINCIPLES
A. EMERGENCY ACTION PRINCPLES
1 Scene Safety
1.1 Scene Safety
- Don't engage if it is unsafe.
- Secure the scene.
1.2 Know what happened
- Mechanism of injury.
- Nature of illness.
1.3 Protect yourself/well-being.
-Use personal protective equipment (PPE) to prevent possible transmission of diseases.
2. Activate Medical Assistance
• Call for help:
National Emergency Hotline 911.
Local Emergency Hotline of your municipality. _____________

CALL FIRST CARE FIRST

•Adults and Adolescents
•Witnessed collapse of children and infants
•If you are ALONE with no mobile phone,
leave the victim to activate the emergency
response system and get AED/emergency
equipment before beginning CPR
•Otherwise, send someone and begin CPR
immediately; use the AED as soon as It is
available
•Adults and Adolescents with likely asphyxia
arrest (e.g., drowning)
•Unwitnessed collapse of children and
infants.
1)Give 2 minutes (5 cycles) of CPR
2) Leave the victim to activate emergency
response system and get the AED
3) Return to the child or infant and resume
CPR; use the AED as soon as it is available.

3. Initial / Primary Assessment

R.A.B.C.
R – Responsiveness
(AVPU)
Awake/Alert
Verbal, responsive to verbal stimuli
Pain, responsive to pain stimuli
Unresponsive
A – Airway
Able to speak / cry
Note quality of speaking / crying
Ensure that airway is open
B – Breathing
Check the signs of breathing (within 10 seconds)
See the rise and fall of the chest.
C – Circulation
Skin: Color- Reddish? Whitish/pale? Bluish?
Temperature- Cold? Clammy? Hot? Sweaty? Very Dry?
Pulse: For responsive patient- Check for Peripheral Pulses.
4. Secondary Assessment
Thorough assessment of the victim’s condition
4.1 Interview the Victim
Interview the patient/relative/by-standers:
Chief Complaint- SAMPLE
Pain Assessment- OPQRST
Other important information
4.2 Head to Toe Examination
Identify specific signs of illness or injuries.
⁃ Head and neck
⁃ Shoulders/Chest/Back
⁃ Arms and hands
⁃ Abdomen
⁃ Hips
⁃ Legs

S-Signs & Symptoms O-Onset D-Deformity

A-Allergies P-Provocation C-Contusion
M-Medications Q-Quality A- Abrasion
P-Past Medical History R-Radiation P-Puncture
L-Last Meal Taken S-Severity T-Time B-Burns
E-Event Prior to event T-Tenderness
L-Lacerations

MODULE 4: TRAUMA INJURIES

Session 1
WOUNDS

Wounds - Injuries to soft tissue that damages the skin and the structures underlying it.
1.1 Types of Wounds:
A. Closed Wound
B. Open Wound
A. Closed Wound:
⁃ No break on the surface of the skin
⁃ Application of external forces.
A. 1 Signs & Symptoms:
• Bruise or contusion
• Redness
• Swelling
• Hematoma (pasa)
• Severe bruising = possible internal bleeding
A.2 First Aid for Closed Wounds:
- Cold compress done within 15 (range to 20 mins) every 20 minutes until referred
- Cold compress done within 15 (range of 10-20 mins) minutes every 2 hours on the first 24
hours, for home remedies
- Hot compress for 15 minutes 3x a day after 24 hours.
- Keep affected part elevated when possible

B. Open Wounds
B.1. Abrasion (gasgas)
⁃ Affects the top layer of the skin
⁃ Priority: prevent infection.
First Aid Intervention:
⁃ Wash with soap & water
⁃ Apply mild antiseptic
⁃ Keep surface exposed

B.2. Lacerations (punit)

⁃ Tear on surface of the skin
⁃ More severe bleeding
⁃ Goal: control bleeding
First Aid Intervention:
⁃ Wash with large amounts of clean water
⁃ Control bleeding by direct pressure using clean dressing
⁃ For persistent bleeding: apply 2nd dressing over first; use elastic bandage
⁃ Bring victim to health care facility.
B.3. Incision (hiwa)
⁃ Cut or wound of body tissue caused by sharp edged object or material.
First Ald Intervention
⁃ Wash with large amounts of clean water
⁃ Control bleeding by direct pressure using clean dressing
⁃ Persistent bleeding: apply 2nd dressing over first; elastic bandage
⁃ Bring victim to health care facility
⁃ First aid intervention for incision will be the same as for laceration.

B.4. Puncture (Tusok)

⁃ Entry of sharp, pointed object
⁃ Can cause massive internal bleeding
⁃ Very painful
First Aid Interventions:
⁃ Wash with large amounts of clean water
⁃ Apply mild antiseptic
⁃ Cover the wound
⁃ Bring victim to health care facility

B.5 Amputation (Putol)

⁃ Total separation of body part or limb
⁃ Massive bleeding
⁃ Very painful
First Aid Interventions:
⁃ Control bleeding using pressure dressings
⁃ Cover detached part with moist dressing, place in clean plastic bag, place in bag with ice
⁃ Apply tourniquet to minimize or control massive bleeding
⁃ Bring victim and detached part to health care facility.

B.6 Avulsion (Tuklap)

⁃ Skin and tissues under it torn off from surface
⁃ Severe bleeding
⁃ Very painful
First Aid Interventions:
⁃ Wash with large amounts of clean water
⁃ Pressure dressing
⁃ Bring victim to health care facility.

B.7 Impaled Wound (Tusok)

⁃ Foreign object that penetrates the skin and remains embedded in tissue
First Aid Interventions:
⁃ Do NOT remove unless causing airway obstruction
⁃ Control bleeding using pressure dressing around impaled object
⁃ Stabilize impaled object using bulky soft dressing or bandages (doughnut ring)
⁃ Protect impaled object from being moved
⁃ Bring to health care facility immediately

B.8 Evisceration
⁃ Severe open wounds in abdominal wall may expose organs à organs protrude out of wound
First Ald Interventions:
⁃ Do NOT touch or push back exposed organs
⁃ Cover wound with moist ., clean dressing
⁃ Do NOT use dressing material that sticks to exposed organs or that breaks up when wet
⁃ Bring to health care facility immediately

B.9 Human Bite Wound

⁃ Caused by the piercing of skin by human teeth
⁃ Bacteria are usually present and serious infection often follows
⁃ Also known as: fight bites
First Aid Interventions:
⁃ Thoroughly wash with an antiseptic or soap and water; rinse well
⁃ Cover wound with moist, clean dressing
⁃ Bring to health care facility, for advanced intervention

Other Wounds: Crashing Injurles, Sucking Chest Wound, Blast Injuries First Aid Interventions:
⁃ Call 911; Local Response /RescueTeams ⁃ Control bleeding ⁃ Bring victim to health care facility
C. LIFE THREATENING BLEEDING
C.1 Control Bleeding
⁃ Body will not tolerate >20% blood loss
Adult = I Liter
Children = 100 - 2000 ml
⁃ Control bleeding using direct pressure.
C.2 How to apply direct pressure on the wounds?
⁃ Take any clean cloth (e.g., shirt) and cover the wound.
⁃ If the wound is large and deep, try to "stuff" the cloth down into the wound.
⁃ Apply continuous pressure with both hands directly on top of the bleeding wound.
⁃ Push down as hard as you can.
⁃ Hold pressure to stop bleeding. Continue pressure until relieved by medical responders.

D. BANDAGING
- Maintains pressure for controlling bleeding and keeps dressing in place.
Guidelines in using dressing and bandages:
⁃ Use a dressing that is large enough to extend at least 1 inch beyond the edges of the wound
⁃ Bandages should ft snugly but should not cut off circulation or discomfort
⁃ If the area beyond the wound changes color, feels cold or starts to swell the bandage is too
tight and should be loosened.

Bandages
D.1 Elastic bandage - are stretchable bandages designed and used to create continuous
localized pressure.
D. 2 Triangular bandage - are bandages to support an injured forearm; consisting of a wide
triangular piece of cloth hanging from around the neck.
SQUARE KNOT
- One of the most basic knots; where it can be used to tie a bandage around a wound to stop
the bleeding quickly and this knot can be easily removed.

D.3 BANDAGING TECHNIQUES:

OPEN PHASE

 Top of the Head

The purpose of this bandage is to apply pressure to control hemorrhage from wounds of
scalp, or to hold dressings on wounds of ear or lower scalp.
PROCEDURE:
- The first thing to do is to fold the base of the bandage at least one and a half (1 1/2)
inch once or twice.
- Place the folded base on the tip of the eyebrow making sure that the folded base is
placed outside.
- After placing the folded based of the bandage on the tip of the eyebrow, ensure that
the apex is directly on the opposite side. Basically, the apex would be at the back of the
head.
- Grab the points of the bandage towards the back insuring that the ears are slightly
covered. This will create an inclination of the bandage on the side to prevent it from
slipping later.
- Once the points are on the back, simply make an overhand. Ensuring that the overhand
will cover the apex. Remember the basic rule in bandaging, “not too tight not too loose.”
- After making an overhand, proceed to square knot. Then hide the ends in the folded
base.
- Lastly, hide or insert the apex in the overhand. Fold and hide it neatly.
 Back of the Head
Focuses to protect the back part of the head. It should be snugly fit. The knot is on the
front.
PROCEDURE:
- Do the first 5 procedures of top of the head bandaging because the first 5 steps are the
same.
- After making the overhand, bring the points at the front and bring it just on top of the
folded base. Make a square knot.
- From there, just insert the apex at the back on the overhand and spread the insertion
accordingly to create a tightening effect at the back.
- After this, go back to the front and insert the square not at the front along with the rest
of the points spreading accordingly to the sides on the folded base (figure 6). This will
tighten the whole bandage and likewise create a housekeeping effect on the whole
application.

 Chest / Back (R/L)

This bandage is used to hold dressings on burns or wounds of chest or back
PROCEDURE:
- Drop apex of triangle over shoulder on injured side. Bring bandage down over chest (or
back) to cover dressing so that middle of the bandage is directly below injury. Turn up a
cuff at base.
- Carrie ends around and tie in a square knot, leaving one and longer than the other.
- Bring the apex down and tie it to the long ends of the first knot.

 Burned hand / foot (R/L)

This is used to hold dressings of considerable size on the hand.
PROCEDURE:
- Place middle of base of triangle well up on palmar surface of wrist.
- Carry apex around ends of fingers. Cover back (dorsum) of hand to wrist, and tuck
excess fullness of bandage into small pleats on each side of the hand.
- Then do a square knot.

 Arm sling (R/L)

To protect the injured arm. The arm should NOT be drooping when doing this technique.
PROCEDURE:
- Bend arm at elbow so that little finger is about a hand breadth above level of elbow.
 - Place one end of the triangle over shoulder on injured side and let bandage hang down
over chest with base toward hand and apex toward elbow.
- Slip bandage between body and arm.
- Carry lower end up over shoulder on uninjured side.
- Tie the two ends with a square knot, at the neck. Knot should be on either side of neck,
not in the middle where it could cause discomfort when the patient is lying on back.
- Draw apex of bandage toward elbow until snug, then knot it snugly.

 Shoulder / Hip (R/L) (Need 2 T-bandages)

This is used to hold dressings on the buttock or hip. It requires two bandages; one is
open phase and the other a narrow cravat.
PROCEDURE FOR HIP:
- Fasten cravat around waist, this will serve as a belt.
- Place base triangle below buttock, and slide apex under narrow cravat at waist. Fold
base upward to form a cuff and carry ends of base around thigh.
- Tie and a base with square knot. Fasten apex to waist narrow cravat by talking under.

This is used to hold dressings on the wounds of the shoulder. Two bandages are
required, one an open phase and the other narrow cravat.
PROCEDURE FOR SHOULDER:
- Play center of narrow cravat at base of neck on injured side and fasten just forward of
opposite armpit.
- Slide apex of open phase triangle under narrow cravat at base of neck and place over
dressing on injury shoulder and upper arm. Turn up cuff at base.
- Bring ends around arm and tie. Secure apex to narrow cravat at neck by tucking in.

SEMI BROAD

 Shoulder-armpit (R/L)
This is used to hold dressings in the armpit or on the shoulder.
- Place cravat over dressing in armpit so the front and is longer than the back. Carry the
ends upward.
- Bring the ends across each other over top of shoulder.
- Cross ends over back and chest respectively to opposite armpit. Tie ends just in front of
uninjured armpit.

 Elbow / Knee (R/L)

This is used to hold dressings around the elbow/knee.
 PROCEDURE FOR ELBOW/KNEE:
- Place center of cravat over kneecap/elbow and let ends hang down each side of
knee/elbow.
- For knee: Cross ends underneath and continue several overlapping descending turns
down calf and several overlapping ascending turns up thigh.
- For elbow: Cross ends over and continue several overlapping descending and ascending
turns around the arm.
- Bring ends together and tie a square knot.

 Forehead
Protect the injured forehead. The knot must be placed on top of the forehead.
PROCEDURE:
- Put the middle of the base on the forehead, a little above the eyebrows. Make sure the hem is
on the outside.
- Allow the point to fall over the head and down at the back of the head, over the ears, cross
them over the point, bring them around the forehead, and tie in a square knot.

 Genital (Narrow + Semi Broad)

To protect the injured genital part.

NARROW CRAVAT

 Ear, Cheek, Jaw

This is used to hold dressings on the chin, cheeks, ears, and scalp and as temporary
support to immobilize a fractured or dislocated jaw.
PROCEDURE:
- After making a triangular bandage into a narrow cravat of proper with, place it under
the chin and carry ends upward with one end longer than the other.
- Bring longer and over top of head. Cross both ends on side of head.
- Pass ends around head and opposite directions and tie with square knot on the other
side of head on primary turn of cravat.

 Neck (Front, Back, Side)

To protect the injured neck.
PROCEDURE:
- Place the middle of the cravat on to the injured part of the neck.
- Then put the bandage across to the uninjured side. When done, place the bandage on
top of the shoulder and cross over, then place it underneath the armpit and cross over.
- Now bring the excess ends from under to over the shoulder, and do a square knot.
 Forearm, Leg
To protect the injured forearm/leg.
PROCEDURE:
- Place center of cravat over the dressing
- Begin ascending turns with upper end and descending turns with lower end, with each
turn covering two-third of preceding turn until dressing is covered.
- Terminate by tying both ends in square knot.

 Cuff Sling
Just like the arm sling, this is used to protect the injured arm.
PROCEDURE:
- Create a clove hitch with two large loops of the bandage. One loop is made by bringing
one end of the bandage pointed upwards with the other end pointed downwards.
- Fold the two loops’ inwards to the middle, making sure that both ends are trapped
between the loops.
- Ask the patient to hold their injured arm across the body with their fingers pointing to
the opposite shoulder tip. Carefully slide the two loops over the hand and lower arm
with the ends hanging downwards.
- Bring the bandage ends up on either side of the limb and around the patient’s neck.
Make sure to adjust the bandage so you can use a reef knot for tying it just above one
side of the collarbone, preventing any pressure on the neck.
- The knot can be placed on either side of the neck, depending on where the injury is
located, and which position offers the best comfort to the patient.

 Doughnut
This is used when there is an impaled object in the injured part.
PROCEDURE:
-. To make a doughnut bandage, roll a triangle bandage/sling into a tight, snakelike coil,
then making a loop the size required to support the impaled object. (Loop it around a
finger, fingers or hand as a mold.)
- Then take the loose, coiled ends of the bandage and lace them though your loop,
around the outer side, and back through the loop.
- Tuck the tips of the bandage back into the doughnut shaped structure to secure them.

 Shoe on (R/L)
Used when the injured foot has a shoe on and is complicated to remove.

 Shoe off (R/L)

Used when the injured foot is not wearing a shoe. The difference between the two is
how you wrap the foot.