Emergency For Community Health

4)
5)
6)
FEDERAL GOVERNMENT APPROVED

SCHOOL OF HEALTH TECHNOLOGY
LECTURE NOTE ON ACCIDENT
AND
EMERGENCY FOR COMMUNITY
HEALTH WORKER STUDENTS
Stand or kneel behind the person place the other hand over the first. Use the outer hand to increase the
choking. place one arm around her force as you press inward and
waist with the fist positioned upward, quickly forcing air out of
between the navel and ribcage. the victim's lunqs. If this fails to
The thumb should be inward eject the obstruction, repeat the
maneuver as; many as 4 times.
COMPILED BY NWOKOLO A.A
1
Table Content
FEDERAL GOVERNMENT APPROVED SCHOOL OF HEALTH TECHNOLOGY LECTURE NOTE ON
ACCIDENT ……………………...................................................................................................................................................1
AND …………………………....................................................................................................................................................1
EMERGENCY FOR COMMUNITY HEALTH WORKER STUDENTS .........................................................................................1
INTRODUCTION ........................................................................................................................................................................4
TYPES OF ACCIDENT ...............................................................................................................................................................4
EMERGENCY .............................................................................................................................................................................5
FIRST AID: ..................................................................................................................................................................................5
ROAD TRAFFIC INJURIES (RTI) .............................................................................................................................................10
DOMESTIC ACCIDENTS: .........................................................................................................................................................11
OCCUPATIONAL ACCIDENTS .................................................................................................................................................12
RAILWAY ACCIDETS: ...............................................................................................................................................................13
DISCUSSSING THE COMMON EMERGENCY CONDITION IN THE COMMUNITY: ...............................................................14
CONVULSION ..........................................................................................................................................................................14
CHOKING: …………............................................................................................................…………………. 17
DROWNING: ........................................................................................................................................................................ 21
ASPHYXIATION …………………………………………………………………………………………………… 24
CARDIOPULMONARY RESUSCITATION.................................................................................................................................25
EPISTAXIS ...............................................................................................................................................................................26
ACUTE ABDOMENAL PROBLEM ............................................................................................................................................27
POISONS AND DRUG OVERDOSE ........................................................................................................................................29
DEHYDRATION ........................................................................................................................................................................32
WHO IS AT RISK OF DEHYDRATION;- ....................................................................................................................................33
PROLONGED LABOUR ...........................................................................................................................................................35
BLEEDING ................................................................................................................................................................................39
UNCONTROLLED BLEEDING .................................................................................................................................................40
BLOOD LOSS ...........................................................................................................................................................................42
PRESSURE POINT ..................................................................................................................................................................44
FAINTING, SEIZURES, UNCONSCIOUSNESS AND COMA ...................................................................................................50
2
ELECTRIC SHOCK ………………………………………………………………………………………………… 62
WOUNDS ........................................................................................................................................................................................65
HEAT ILLNESS ..............................................................................................................................................................................67
COLD ILLNESS .............................................................................................................................................................................68
HEAD, EYE, NOSE INJURIES .....................................................................................................................................................69
SPRAINS AND FRACTURES ......................................................................................................................................................69
FRACTURES: ................................................................................................................................................................................71
3
INTRODUCTION
ACCIDENT
Accident is defined as unintended and unforeseen event, usually resulting in personal injury or
property damage. In popular usage, however, the term accident designates an unexpected event,
especially if it causes injury or damage without reference to the negligence or fault of an
individual. The basic causes of such accidents are, in general, unsafe conditions of machinery,
equipment, or surroundings, and the unsafe actions of persons that are caused by ignorance or
neglect of safer principles. Or accident can be defined as all unplanned or unintentional acts or
events resulting into injury, death or damage to person or property.
TYPES OF ACCIDENT
1) Road traffic accident (RTA). (13) Animal bite eg. Snake
2) Home or domestic accident. (14) Burns.
3) Work place occupational or (15) Dislocation and fractures.

industrial accident.
4) School accident eg. During games (16) Suffocation.
5) Natural disaster eg. Flood, (17) Drowning

Earthquakes, lightening.
(18) Bomb/explosive, wounds.
6) Railway accident
7) Air traffic accident. (19) Chocking
8) Electrocution (electric shock). (20) Falls
9) Chemical poisoning. (21) Frostbite.
10) Gun shot. (22) Sport injuries
11) Sharp object cuts.
12) Insect stinging.
situation needing prompt and immediate attention without which it results loss
of life of person or properties.
COMMON EMERGENCY CONDITIONS IN THE COMMUNITY

9) Prolonged labour.
INCLUDES
10) Fracture.
11) Severe cuts/injuries.
1) Convulsion.
12) Asthma attack
2) Poisoning.
13) Choking
3) Animal bites e g snake bite.
14) Drowning
4) Insect sting e g bees sting,
15) Dislocation
16) Fainting
17) Automobile accident
scorpion sting.
5) Shock.
6) Bums.
7) Acute abdominal pain!
problem.
8) Severe dehydration
FIRST AID:
First Aid is emergency care for a victim of sudden illness or injury until more skillful medical
treatment is available.
Emergency medical help: emergency medical treatment for somebody who is ill or
injured, given before more thorough medical attention can be obtained.
First Aid is literally the very FIRST assistance been given to someone who suddenly becomes ill
or sustained an injury before an expert care may be given. First Aid is usually performed by
non-experts but trained personal to the ill/injured person until definitive medical treatment can
be accessed. Minor cases may not require further medical care other than the first intervention.
It generally consists of a series of life-saving techniques that an individual can be trained in to
perform with minimal equipment.
REASONS FOR FIRST AID
First aid may save a life or improve certain vital signs including pulse, temperature, a patent
(unobstructed) airway, and breathing. In minor emergencies, first aid may prevent a victim's
condition from worsening and provide relief from pain. First aid must be administered as
quickly as possible. In the case of the critically injured, a few minutes can make the
difference
between complete recovery and loss of life.
The key aims of first aid are:
 PRESERVE LIFE:- The overriding aim of all medical care including first aid is to
save lives,.
 PREVENT FURTHER DAMAGE:- Prevent severe loss of function and harm, which
times called prevention of the condition from worsening
 PROMOTE RECOVERY:- First Aid also involves all attempts to start
the recovery processes of the person from his illness/injury
 PREVENTION OF ILLNESS/INJURY:- This involves initial measures
and action taken in order to avoid injuries and illnesses in the human
environment.
 To make people more secured and increase safety.
 TO PREP ARE FOR MEDICAL TREATMENT:-Good first aid practice,
is designed to form the basis for subsequent specialized treatment by the
Doctor or other trained health worker.
First-aid measures depend upon a victim's needs and the provider's level of
knowledge and skill. Knowing what not to do in an emergency is as important
as knowing what to do. Improperly moving a person with a neck injury, for
example, can lead to permanent spinal injury and paralysis.
RULES OF FIRST AID

Despite the variety of injuries possible, several principles of first aid apply to all
emergencies.
I. The first step is to call for professional medical help.
II. Determine that the scene of the accident is safe before attempting to provide first aid.
III. The victim, if conscious, should be reassured that medical aid has been
requested, and asked for permission to provide any first aid.
IV. already been given, and preexisting conditions such as diabetes or heart
trouble.
V. The victim should be checked for a medical bracelet or card that
describes special medical conditions.
VI. Unless the accident scene becomes unsafe or the victim may suffer
further injury, do not move the victim.
VII. First aid requires rapid assessment of victims to determine whether life-
threatening conditions exist. One method for evaluating a victim's
condition and how safe the scene of the accident/illness is, is known by
the acronym DRSABCs, which stands for:
\
D-DANGER-Assess the place where the ill/injury took place, so that

you keep yourself out of danger,
-keep passer-by out of danger,
-make safe any hazard if you can do so without endangering the life of
the casualty/yours/others, only move the casualty away from danger in
extreme circumstances.
R-RESPONSE- Try to establish the responsiveness level of the casualty
/victim,
if the casualty appears to be unconscious or semi unconscious, speak
loudly to him or her ego Can you hear me? If this falls to get a response,
tap him/her firmly on the shoulders.
S-SHOUT ---if the above steps falls to rise any response: shout out
loudly for help to any passer-by /person near-by with the situation.
A - Airway-is it open and unobstructed?
B - breathing-is the person breathing? Look, listen, and feel for
breathing.
C - Circulation-is there a pulse? Is the person bleeding externally?
Check skin change in color and temperature for additional indications of
circulation problems.
VIII. Once obvious injuries have been evaluated, the injured person's head
should be kept in a neutral position in line with the body. If no evidence
exists to suggest potential skull or spinal injury, place the injured person
in a comfortable position. Position on one side, so that a victim can vorni:
without the vomitus going into the airway resulting to choking C'~
obstructing the airway without the vomitus going into the airway resulting to choking
or
obstructing the airway.
THE CONTENT OF A STANDARD FIRST AID BOX
A first aid kit/box is collection of supplies and equipment in a kit or box ready
for use in giving first aid. First aid kits/boxes may be made up of different
contents depends on who has assembled the kit/box and for what purpose. It
may also vary by country due to varying advice or legislation of the government
or organizations.
Sample of First Aid Kit commonly contain items that can help in the control of
bleeding such as bandages, in breathing barriers items to help in performing
cardiopulmonary resuscitation (CPR) may be in the kit and other as in the
sample below.
."
Dressings
Adhesive bandage strips,

Butterfly bandages
Elastic bandage, 3 inches wide

Hypoallergenic adhesive tape
Roller bandages
Crepe bandage 5cm,7.5cm,l0cm
Sterile cotton balls
Sterile eye patches
Sterile gauze pads, 4 by 4 inches
Sterile nonstick pads
Triangular bandage
First aid plaster
Instruments
Safety pins
Blunt-tipped scissors
Dressing
7) forceps
Razor blade
Equipment
Cotton swabs
Eye cup or small plastic cup

Instant-acting chemical cold packs
Paper cups
Space blanket
Clinical Thermometer
Tongue depressor
Hand gloves
Torch light
Face shields (masks)
Medication
Activated charcoal
Antiseptic wipes or antiseptic solution
Antiseptic/anesthetic ointment or spray/cream
Calamine/antihistamine lotion
Sterile eye wash (saline/distilled H20)
Syrup of ipecac
Tenure of iodine
AII inside a First aid Box (39.3x30.5x12cm)
Source: American Red Cross
EXPLAIN THE CONTENT OF FIRST AID BOX:

Bandage is an external cover designed to protect an injury from contamination during the
healing process. Bandages are made of different material and meant for sung but not tight as
to impede the circulation of blood. It can help hold cut skin edge together. Cotton is meant
for packing and cleansing of the wound. Syrup of ipecac is a drug given to cause vomiting
when a poison has been swallowed. In most cases of poisoning, the best treatment is to get
the substance out of the victim's stomach as quickly as possible. Syrup of ipecac is excellent
for this. Antiseptic liquid is for cleaning the body/wound. Using the blunt scissor to pick the
cotton and clean the part as the case may be.
ROAD TRAFFIC INJURIES (RTI)

RTI has been defined as any injury due to crashes originating, terminating involving a
vehicle partially or fully on a public highway. In other words road traffic injuries come as
the result road traffic accidents.
CAUSES OF ROAD TRAFFIC ACCIDENTS:
1) . Excessive speed 3) Poor street light

2). Defective roads
4). Defective layout of cross roads and speed breakers.
5). Defective vehicles. 7) Fatigue.
6). Disregard of road signs 8) Alcoholism.
9) Unusual behaviours of men and animals on the road
MEASURES TO PREVENT ROAD TRIFFIC ACCIDENTS/INJURIES

ARE:
i. Stop excessive speed on the road by installation of speed limit device

in the vehicle.
ii. Effective repair and continuous maintain of defective road by
owners.
iii. Proper and correct lighting of the road especially at night.
IV. Proper and clear layout of cross roads and junctions for clear view of
the oncoming vehicle(s).
v. Defective vehicle must be off the road only to return after the defects
must have been repaired.
VI. All the road signs must be learnt the vehicle drivers and be strictly
observed whenever on ride on the road.
VII. The act of excessive intake of alcohol by drivers/vehicle operator,
before embarking on or during, riding on the road should be avoided
viii. Whenever the vehicle operator is tried / fatigued they should not drive but rest /
have IX. breakRearing
to avoidofsleeping on the
animals on the high
stirring wheel.
ways should be stopped. if'
ix. Rearing of animals on the high ways should be stopped.

x. Men and Women (pedestrians) should avoid unusual behavior while
moving on the road.
Xl. Individuals, families, communities, schools and other groups should

from time to time be health educated on how to use the high ways in
order to avoid road traffic injuries.
DOMESTIC ACCIDENTS:
It means an accident which takes place in the homes or in the immediate
surroundings, and more generally all domestic accidents are not connected with
traffic, vehicles or sports.
THE MOST FREQUENT DOMESTIC ACCIDENTS ARE:
1) Poisoning by items like (drug, insecticides, rat poisons, antiseptics,

mushrooms and plants).
2) Bums by things like (flame, hot liquids, electricity, chemicals, and
fireworks.
3) Drowning which is the process of experiencing respiratory impairment from
submission/ immersion in liquid.
4) Falls: A fall is an event which results in a person coming to rest

inadvertently on the ground or floor or other lower level.
5) Injuries from sharp or pointed instrument.
6) Bites and other injuries from other animals.
CAUSES OF DOMESTIC ACCIDENTS
1) Keeping the poisons within the reach of the children.

2) Not labeling them properly.
3) Improper construction of the platform to the wells.
4) Lighting the stove on the floor.
5) Improper keeping of sharp and pointed instruments.
6) Playing with or harassing domestic animals.
7) Defective floor. 8) Bad
lighting.
9) Not obeying the safety rules at homes.
..
Jl. All poisons, drugs and such like items must be properly labeled. ,.
111.
The parapet and platform of wells must be properly constructed with a gc<
fitting lid.
iV.
The cooking equipment (gas cookers, electric stoves, kerosene stove, trip:
etc.) must always be kept in their proper place either at high pedestal or :::-.
v. well protected place.
VI.
Safe kccping=rr'sharp and pointed instrument away from human harm.
V11.
All member of the family should avoid playing with provoked dome s-;
animals noke harassing stt.~.
Floors of the homes must constructed appropriately and be maintained e
no defective of the floor, 0"," spilling of water/oil or other liquids on -'
Vlll.
IX. tloor.
X. All belongs In the house must be properly arranged kept 111
XI. places when not in use.
XII. Proper and regu lar sanitation of the home and its environs.
All rooms, passages and surrounding must be well lighted.
Always observing the home/domestic safety rules of each family/home.

OCCUPATIONAL ACCIDENTS
Every family must have their own first aid box/kit in their home.
Occupational accidents occur mainly in places of work (industries and factories.
CAUSES OF OCCUPATIONAL ACCIDENTS:
a) Falls.
c) Trapping and machinere
b) Moving objects and striking. accidents.
d) Faulty machines.
c) U ntra ined factory workers operating machine
f) Poor ventilation of the g) III equipped factory.
factory house.
l\IEASURES OF PREVENTING OCCUPIONAI.J ACCIDENTS ARE:-
d. floor of the factory ,must be well constructed and spilling of c.,

a) The
b)
water always avoided or dried immediately to avoid slippery and falls.
c) Moving and striking parts must be welled caged.
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MEASURES TO PREVENT DOMESTIC ACCIDENTS ARE:
8)l. Keeping all poisons and drugs out of the reach of children and aged.
Faulty machines should be removed and replace
10)
9)
,
1
.
d) The factor) workers should be well trained before posting ~o man the
machine/operate any machine .
. \
e) Factory buildings must be well ventilated with windows and skylights.

f) There should be regular inspection of the factory by trained factory
inspector( s).
g) The factory workers' should be health educated on factory safety
measures at regular interval (seminars and workshops).
h) Strict observancel\~l factory safety rules e.g. using of protective wears
etc.
RAILWAY ACCIDETS:
Railway accidents mainly occur in the Train or along its runway (lines).
CAUSES OF RAIL\VAY ACCIDENTS
I. Faulty railway lines. iv. Not obeying the safety rule 111
II. Negligence by the personals. 'railway
Ill. Becoming a victim of terrorists.
lVIEASURES OF PREVENTING RAILWAY ACCIDENT ARE:-
Proper and effective communication and information system along all the
runway of the train.
Faulty railway lines must be repaired and maintained before train is allowed
to run on the route.
Proper checking in and checking out of passengers of the train to avoid
terrorist attacks.
Every cutch of the train must be well equipped with automatic alarm! fault
dictating device.
Every cutch of the train must be well equipped with standard first aid
kit/box
Both the personals and passengers must obey all the safety rules governing
train operations.
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THE PERSON MAY HAVE WARNING SYMPTOMS BEF(I::.~ .
Fear or anxiety
DISCUSSSING THE COMMON EMERGENCY CONDITION IN THE

COMMUNITY:
CONVULSION
Ci'.;l\Ttlsion is a medical condition where the body muscles contract and relax
rapidly and repeatedly, resulting in an uncontrolled shaking of the body. The term
'(,Y1 vulsion ' is often used interchangeably with seizure. Most seizures arc
relatively harmless they usuaUy last from 30 seconds to 2 minutes. However, if a
seizure is prolonged or if multiply seizure the person doesn't waken in between.
this is (1 medical emergency.

If a person has rcoccurring seizures and no causes can be identified that person is
id to l .,
sau to nave epiiepsy.
~CAUSES OF CONVULSION
6. Head injury
1. Alcohol use/drug abuse
7. Heart disease
2. Brian tumor
R. Poisoning
3. Electric shock
I 9. Stbke
4. Epilepsy 1\
10. VeJ101110LlS bites and stings

5. fever particularly in young
children 11. Very high blood pressure
ii. Nausea
SYMPTOIVIS
Brief blackout followed by period of confusion, drooling or frothing (It the
mouth
v. sudden falling
ii. Lye ITIOVCIl1Cnts
iii. Loss of bladder or bowl control vi .Unusual behavior like sudden

anger, sudden laughter etc.
iv. lceth clinching
14
(OfV:PILED BY NWOKOLO A.A
iii. Vertigo
iv. Visual symptoms (such as flashing, blights, lights, spots or waves lines
before the eyes)
MANAGEMENT OF CONVULSION
When a seizure occurs the main goal is to protect the person, from injury. Try to
prevent a fall. Lay the person on the ground in a safe area.
I. Loosen tight clothing especially around the neck.
II. Turn the person on his or her side, if vomiting occurs this helps make sure that
the vomit is not inhaled into the lungs.
III. Stay with the person until he or she recovers, or until you have professional
medical help.
IV. Meanwhile monitor the person's vital signs. .
In an infant or child, if seizures occur with a high fever, cool the child gradually
with tepid water. \
You can give the child acetaminophen (Tylenol/paracetamol) once he or she i~

awake.
DO NOT
1. Do not restrain the person.
ii. Do not place anything between the person's teeth during the seizure even
fingers.
iii. Do not move the person unless he or she is in danger or near something
hazardous like fire, water pound/river etc.
iv. Do not try to make the person stop convulsing) he or she has no control over
seizure and is not aware of what is happening at the time.
15
iii. Do not move the person unless he or she is in danger or near

something
hazardous like fire, water pound/river etc.
iv. Do not try to make the person stop convulsing, he or she has no
control over
seizure and is not aware of what is happening at the time.
v. Do not give the person anything by mouth until the convulsion have
stopped
and the person fully awake arid alert.
PREVENTION
1. Keep fever under control especially in children by tepid sponging.
ii. Epileptic people should always take their prescribed medication at the
ri9J:
time and wear on medical alert tag/ bracelet.
iii. Avoid excess alcohol intake /intoxicant substance.
ASTHMAATIACK:
A person having asthma attack is literally panting for breath. Asthma is L

condition that causes inflammation and obstruction of the airways. The
muscles
surrounding the air tubes (bronchial tubes) of the lungs go into spasm, the
mUC0:..i-
lining swells, and secretions build up.
Breathing becomes quite difficult .Asthma usually occurs in attacks or

episodes.
During an attack, the person may make a wheezing or whistling sound
whi.e
.. br.eat.hing, cough great deal and ");it up mucus. Many things trigger
disease which attacks both sexes about equally and may occur at an" age from
infancy to old age,
TREAT~l E~T/ lVIANAGElVIENT OF ASTHl\1A:

Antihistamine and decongestants may relieve some allergy symptoms. But this
drug must be used with caution.
PREVETION
1. Discover and avoid the thing that causes the asthma attack.
2. Avoid smoke of all kind.
3. A void any type of dust and dusty environment.
4. The patient of asthma should try to stay an appropriate climate/weather his
/her body is adopted to.
CHOKING:
Choking has being defined as the blocking of the windpipe by something lodging
in the throat. This could happen when food or vomit goes down the wrong way, or
if a small object held in the mouth suddenly slips back into trachea.
\VHAT TO DO
I f the patient is conscious:
(1) Give several slaps or hard thumps between the shoulder blade to try to
dislodge/loosen the substance/object in the throat.
(2) If this fails try to hook out the object with your finger (by putting it to the
back of the mouth and the matter is pulled forward) It may cause vomiting with
the removal of the foreign body.
(3) Or, if the victim is standing or sitting, stand behind him and wrap your arm
around his waist. Keep your elbows out, away from the victim's ribs. Make a
17

11)
12)
13)
fist with one hand, and place the thumb side on the midline of the abdomen ,.
slightly above the navel and well below the xiphoid process. Grasp your fist
with your other thumb hand, thumb towards the victim. Press your fist into the
victim's abdomen with a quick, inward and upward thrust. If there is need
repeat this action/movement, 'make each thrust separate and distinct. Continue
until the object is released or the victim becomes unconscious. (Victim could
perform this abdominal thrust on self using the back rest of a chair)
\-f) For small children /chi1d it can be held firmly upside down during treatment.
(5) If the object cannot be loosen send to the health facility/hospital.
(6) If when the object is loosed and freed but the victim is not breathing, give
artificial respiration at once.
I n the case of choking, a procedure known as the Heimlich maneuver can be

used to clear the windpipe of food or other objects. In this procedure quick
upward thrusts are applied to the victim's abdomen to eject the object blocking
the windpipe. The first-aid provider stands behind the victim with both arms
around the victim's waist. One fist is placed slightly above the navel and below
the rib cage with the thumb against the victim's body. The other hand is used to
hold the fist and apply pressure. The abdomen is then pressed quickly inward
and upward, forcing air from the lungs to eject the object from the windpipe. If
the victim is too large to hold. while standing, or becomes unconscious, the
maneuver can be accomplished by laying the person down face up and using the
heel of one hand in the same manner as above. The person performing the
maneuver must be careful not to apply pressure on the rib cage to avoid
breaking ribs, especially in children and the elderly. For obese or pregnant
choking victims, the providers hands should be placed over the lower half of the
sternum (breastbone) and pressure applied as described in picture below.
IF THE VICTJ~1 BECOl\lES

UNCONSCIOUS
(1) Place the victim on his back, face up.
(2) Kneel astride his thighs or to his side. (3) Place the heal of one hand on the
midline of the victim's abdomen, between the xiphoid process and umbilicus
(navel), put your second hand directly over the first. (4) Lock your elbow and
exert pressure from the shoulders, press downward and forward with a quick
thrust. Yourbody weight will make the thrust more energetic. But take care to
avoid the xiphoid process because putting pressure on the xiphoid process may
lacerate vital organs.
18
COMPILED BY NWOKOLO
A.A
---.--~
-
"
(5) If this action does not dislodge the foreign body, open the victim-s mouth by
gripping the tongue and lower jaw between the thumb and fingers of one hand and
shift, and shift the jaw bone forward. This will draw the tongue away from the
back of the throat and mav partiallv relieve the obstruction.
..
(6) Insert the index finger of your other hand along the cheek and deep into the
throat to the base of the tongue with a slow, careful hooking motion (use this
maneuver only on an unconscious victim. A conscious victim will gag.
(7) Be careful not force the object deeper into the airway. You may have to push
the object against the opposite side of the throat to dislodge it .Hook it up into the
mouth where you can remove it .Remove dentures if they are present and are
causing difficulties.
(8) This maneuver is called a FINGER SWEEP. The finger sweep removes
material from the oropharynx so that it does not re-enter the airway during
subsequent attempts at rescue breathing .Never use it in a baby. Since the foreign
body may be pushed further back in the throat and cause further obstruction.
(9) If the foreign body is still not expelled, open the airway and perform mouth to
mouth resuscitation. If you cannot succeed in providing respiration, repeat the
cycle of abdominal thrust, the finger sweep and resuscitation.
5t.;.nd or kn"el behind the per so n Pi.:cce the other ha.t\,l over the first,
pl,j.ce one a.rrn Q.roi.~nd her

v·.~,3,ist the fist positioned
beti()een the n,j,l.lel ,j.nd ribca,IJt,
The thumb shuuld be Inl,>.)",ra
use the outer h"nci to incr e ese the

force as j'OIJ press in,,'ard and
upv·l.:t,rdJ qqichy forcing ,:dr out of
the 1.lictirnls lunas. tf this fails to
eject the obstruction, r epe at the
maneuver e.s rn.:,n~1Q.S < time s.
MEASlTRES OF PREVENTING CHOCKING ARE: -
19
14)
A. Avoid eating things in hurry
,.
B. Avoid biting at a time more food into the mouth than the mouth can
contain.
C. Do not eat much hard items without drinking corresponding fluid.
DROWNING:
It is usually as the result of obstruction to breathing by submergence or immersioc
of the mouth and nose under liquid/water. In majority of the cases Df~rowning,
water is inhaled into the lungs. This lessen the chance of survival by putting areas
of the lungs out of function/action .This result in difficult resuscitation and acts as.
an irritant setting up an inflammatory reaction.
A person who has been drowned in water for any length of time must have
struggled a great deal and will be suffering from exposure and exhaustion. The
victim must have also swallowed a great deal of water/liquid and mouth may be
full of mud, sand or weeds.
TREATMENT
(1 ) Get the victim out of the water as quickly as possible.
(2) For a second or two that the head is lower than the rest parts of the body, if
it is a child, the child need resuscitation for this hold the child upside down. If
an adult, lift the person by the waist with the head held downwards. By this
means some of the water/liquid may drain from the respiratory tract.
(3) Quickly loosen tight clothing around the neck, chest, and waist.
20
COMPILED BY NWOKOLO
15) 21
:i.-\pply l~;-;c<t c.nd.ac rn(lSS~_1L2e if several lungs inflation there \\<lS no rC~11ol1SL'.
.n 111e c~:su S~ brc.ulnnz
\ _ \.,.. (-
1)I"'nnl,3S nO"111,;II\, You
,I L C l .•..•... \..
,-I j. J. L _ _L~ l
should adiust \'1..'\111'
1 ) u. ~ L l '--_
J. '- --I- n ... l.J '- ' __ ' _ •••...•
..• 1-.1' I c,
lJ i (fl" :11"11 't

: ~ I) I] i-: breathi Jl (J
... ,"t;:- 1 •• ) .....,c II 2-
'C •• ,,- •• ,'-
;'\c\er leave the casualty until skill ful assistance (DOCTOR OR

,mur .\i\CL) arrives.
::: ..:-rUle tre;ltiil:?- specific injuries, protectthe victim from shock --d depression of
- : hU:,iy \it;l! functions that, if left untreated, can result in death.
.ick «l:Ui", \\11cl1 blood pressure (pressure exerted against blood vl..:-s~;el w,111s)
.:"ps ,lild i11C organs do not receive enough blood, depriving them or o\ygeJ1
'::8.iunicnts.
,_:l: svmntorns of shock arc anxiety or restlessness; Dale, cool, clammv skin: a
_ I _ - 1. ~ _
.uk hut rapid pulse: shallow breathing; bluish lips; and nausea These
illploms ma ,: not be apparent immediately, as shock can develop several
-"S (1 r ~:!1 .icc.dent.
;1, ",_~'1'\;""'1';
l.,-_;~L (~~
l bodv remner.nure The "1'''tl'J"1'S fe"'; should h" cl ;'\ "1"l,'I'
,_,,_.., -_''_ l' I.~l .•.••••.. i. j .\~ \ '-' ~ • _______••••• L ,-_ Lt.. ~'-- " ••.•.. ,j~_ (i,,-,_.
tS3~ '"utl;,
,c(~"..:-,; (if dnm nil1g. artificial respiration should be attempted even if the
.tirn z:ni1)Cdr,; dc.id. Peonlc submerged in cold water for more than 30 minutes
j • ~
1() ;lPPCCilcd blue 11:1\(' responded to first-aid efforts and recovered with no
16)
IV. One who does not know how to swim must not go into any big body
water rather these groups should be trained on how to swim.
Y. Those who are good in the act swimming must not go swimming 111
moving water.
VI. Swimmers must survey any unfamiliar body of water properly
engaging in swimming in them.
vii. The must be proper he~lth education on the dangers of entering water/liq,
bodies, to members of the community.
viu. Elimination and abolition of hazard like unnecessary body of water witri
the premises/community e.g. trench, pond, trough, bathtub etc. with wate-.
IX. Provision of life saving jacket, and flotation devices at swimming poi-
pools and for sea vessels passengers by the community and sea vess
owners.
x. The sea vessel operators must be well trained and equipped berc
engaging on seal on these waters.
XI. The sea routes must be well studied to avoid the sea vessels from running .
troubled water/high water currents and/or against sea winds.
XII. Community in/near sea/rivers should have emergency intervene
personals and equipment.
XIII. The country/community should develop strategies of ensuring effect:
inspection, certification, regulation, monitoring, and evaluation of sea.
sea vessels and route lit the water.
XIV. Formulation, promotion, implementation and facilitation of policies
prevent people from being drowned like during rainy season cornmun:
living near river banks should move up land or higher land.
xv. Collection and keeping of data on drowned victims. Carrying out resez:
on the causes, predisposing and preventive factors to drowning in .
communities.
RISK FACTORS TO DROWNING ARE:-

a. Age: because of the inexperience of these tender persons, they have .,
high drowning index.
b. Sex: this case, research and records have it that males are more invo.v
drowning than females.
22
COMPILED BY NWOKOLO;
c. Occupation: in communities with vast body of water have many

services
and occupations within and around these waters like, fishing, boat
rolling
etc. thereby exposing themselves to drowning.
d. Topography of the area: this refers to the out stretch of the earth surface
where some are valley while others are on hill. Those living in the
valley are
\
more likely flooded during flooding cases than those living on the tops
of
the hill resulting to mass drowning
e. Nearness to body of water like dams, pool, wells, irrigation channels to
human dowelling are high risk factors to the community but most
especially
to the children and the old aged people.
f Ignorance/neglect to rules governing sea vessels and sea routes. Like
overloading this sea vessel with goods and passengers, riding on high
current sea waves and others. Can many a time lead to drowning of many
people at one time.
g. Drug/alcohol abuse this is risk factor among the abusers and alcoholics
especially during their boot.
h. State of health: epilepsy; epileptic patients who are caught inside such
water
are most a time found drowned.
1. Socio-economic status: poor members of the community who are many

a
time in the river searching for something to use as food for themselves/
their
fami ly or to sale for money are at risk of drowning.
ASPHYXIATION
Asphyxiation occurs when air cannot reach the lungs, cutting off the supply
of
oxygen to circulating blood. This can cause irreparable damage to the brain.
Among the causes of asphyxiation are drowning, gas poisoning, over dose of
narcotics, electrocution, choking, and strangulation. Victims may collapse,

be
unable to speak or breathe, and have bluish skin. Most people will suffer
brain
death within four to six minutes after breathing ceases unless first aid is
administered.
For victims of other types of asphyxiation, the most practical method of

artificial respiration is the mouth-to-mouth technique in which the first-aid
provider forcefully exhales air into the victim's lungs after first clearing the
airway of any obstruction. The provider tilts the victim's head backward by
placing one hand under the victim's chin and lifting while the other hand
23
COMPILED BY
NWOKOLO A.A
17)
presses down on the victim's forehead. At this point, the mouth and-airwav ':..:!I.
be checked for foreign objects, which can be removed with the fingers. To be;"
mouth-to-mouth resuscitation, gently pinch the victim's nostrils rogether -
prevent air from escaping out the nose. Take normal breaths, seal the victi:r
mouth with a pocket mask or mouth, and exhale into the mouth. \\:-_
performed properly the victim's chest should rise visibly. The provider :~_
listens for the victim to exhale; ifusing a pocket mask, it need not be removes
This process is repeated at a rate of about 12 times per minute (one breath c\~_
five seconds) for adults and about 20 times per minute for children, using .e
pressure and volume for children. Once beginning artificial respiration, the 1;3:
aid provider should continue until the victim begins to breathe or medical l.e _
arrives.
Heimlich Maneuver
The force required to dislodge a foreign object from a choking victim's 1:..::--.:
may cause injury to internal organs. This technique should be employed OE:~.
back slapping does not help. In this first step, a conscious person bends so -~
her head is below her lungs. The person administering first aid delivers a s~-
slap between the shoulder blades, as many as four times if necessary.
CARDIOPULMONARY RESUSCITATION
Cardiopulmonary resuscitation (CPR) is used to restore the heartbeat in a v.;

whose heart has stopped-s-a condition known as cardiac arrest. Symptoir-
this life-threatening condition may include crushing pain or pressure behin.;
breastbone; pain in the anTIS, neck, or shoulder; anxiety and a feelir.;
impending doom; difficulty breathing; heavy perspiration; weakness; na~~
and loss of consciousness. The American Red Cross recommends that cpr:.
performed only by individuals who have received special training p-
recognition of cardiac arrest and proper performance of CPR skills.
CPR combines the techniques of artificial respiration with the applicaticr

external heart massage to keep blood flowing through the victim's body. ~
24
COMPILED BY NWOKC:
First-aid provider positions the victim face up on a firm surface and clears the
airway of any obstructions. To maintain an open airway, the head is tilted back
and the chin lifted forward. The provider then gives the victim two breaths by
mouth or mask. If no pu Ise is detected at the carotid artery (located in groove
beside windpipe in the neck), the first-aid provider kneels next to victim,
placing the heel of one hand on top of the other over the lower half of the
sternum. The provider depresses the chest about 5 em (2 in), forcing blood from
the heart through the victim's arteries. When the pressure is released, blood
flows into the heart. The first-aid provider applies the pressure in short;
rhythmic Thrusts about 15 times every ten seconds. This cycle of two breaths
followed by 15 chest compressions is repeated until the victim revives or
pr()fessional medical help arrives.
19)
18)
EPISTAxrs:- Is nose bleeding or bleeding from one or both nostrils. It is
sudden trickling (gushing) of blood from the nose(nostrils) especially if it isn't
caused by injury. Most nose bleeding steams from dryness of the mucous
membranes that lay the inside of the nose as the result of irritation caused by
viral illness or from picking/blowing or roughly wiping of the nose and other
pathological conditions/malformation in the respiratory system
CAUSES OF EPISTAXIS
1. Foreign bodv in the nose

2. Fractured skull
3. Strenuous activities
4. Varicos vain
20)
S. Haemophilia 8. High blood pressure ,

6. Trauma 9. S inusi
7. Growth tis/infection
10 .Inj uries
~ Iv1ANAGEMENT OF EPISTAXIS:
I. Reassure the victim
II. Place the victim in a sitting position with his /her head bent sligi::~:. :
forward
~
..
Ill. The victim should pinch his/her nostrils firmly for at least
minutes.
I\'. Loosen any tight clothing around the neck chest and warst. *
~.
v. Ask the victim to open and breath through the mouth. .

,
.
VI. Apply cool compress to the forehead over the ridge of the nose 2.::-jj;
the back of the neck.
VIt. If nose bleeding continues put several drops of aqueous solutior, -
adrenaline onto a cotton wool ball and place it firmly into ,'-
nostrils for about 10-1 Sminutes.
VIll. Repeat this process several time jf necessary.
IX. Advise the victim to stop blowing his/her nose to avoid
reoccurrences of the nose bleeding.
x. But if bleeding continues after several trial or attempts and i: -
ACUTEABDOMENALPROBLEM
not stop, refer the victim to the health facility.
Acute abdominal is a condition characterized by the acute onset of abdon: -
pain, or persistent pain which may be localized or generalized and InC.'.
associated with-shock and vomiting.
CAUSES OF ACUTE ABDOl\'lENAL PAIN
1. Ruptured blood vessel 4. Acute cholectystitis.

2. Ruptured gastric ulcer. 5. Salphingitis.
6. Typhoid perforation.
3. Ruptured ectopic
pregnancy. 7. Acute pancreatitis
4 Ruptured appendix. 26
(OMPILED BY NWOKC_:
21)
22)
23)
9. Strangulated hemia. 1 O:Perforated peptic ulcer.
11.Carcinoma of the abdominal system.

12. Trauma due to ruptured liver, spleen and mesentery.
now TO DIAGNOSE ACUTE ABDOlVIENAL PAIN
L Blood test. III. Liver function test
H. Urine analysis IV. Ultra sound.

V. CT scan-a type of X-Rays that uses computer to make picture of the
structures inside abdomen.
VI. KUB (kidney, urter and bladder X-Rays).
~ SIGNS AND SYMPTOMS OF ABDOlVIENAL PAIN

1) Nausea and vomiting. 3) Shallow, fast breathing.
2) Diarrhoea and constipation. 4) Back pain.

S) Persistent severe pain, swelling and tenderness in the upper, middle or
lower abdomen.
6) Guarding =involuntary. contraction of the abdominal muscles.
7) Bulging or Rigidity--when the abdominal muscles are tense.
8) Pyrexia-high body temperature.
9) Lump or Mass in the abdomen.
10) Any bleeding from the rectum, 111 the unne or non-menstrual
vaginal bleeding
TREATl\TENT OF ACUTE ABDOMINAL PAIN WITH REGlJlDE TO

SO!\IE SYlVIPYOMS.
1. Have a vessel/pan ready/nearby in case of vomiting.
I I. General, non-acute stomach/abdominal aches (pain): keep the sufferer

comfortable and give them fluid little at a time and often rather than a
glassful that may be vomited back. A hot -water bottle or heating pad
placed on the painful area may ease the pain. If the pain does not settle
with simple painkillers and rest refer or call a Doctor.
27
III. For heart bum from gastrophrangeal reflux disease (GERD) t;;ea: .
antacid or acid neutralizer e.g. Andrews's liversalt, Mist Magne.
Trisilicate, Gestid, Sodium bicarbonate and others.
IV. For constipation, take a mild stool softener or laxative e.g. Biser
(ducolax tablet).
V. F or pain, take acetaminophen (paracetamol) or other druc-
acetylsalicylic acid(ASA) free drugs, avoid nonstroidal
inflammatory drugs (NSAIDS) such as aspirin(ASA),Ibuprofcr ..
because they can cause stomach irritation or bleeding (ulcer).
POISONS AND DRUG OVERDOSE
A poisonous substance introduced into the body through the mouth 0;-
causes symptoms such as nausea, cramps, and vomiting. Poisons include
medications, herbicides, insecticides, rodenticides, household disinfectan..
nux IOUS gases.
I n a case of poisoning, the first-aid provider should remove the victim ::

toxic environment, contact the poison control center listed in most es :
28
COMPILED BY Nwm:::
24)
books. 1 f the number is unavailable, the provider should call a physician or
hospital emergency department. If possible, the provider should try to identify
the poison, either by questioning the victim or searching for suspicious
containers. Containers of many poisonous substances list the antidote, or
remedy, on the label. Burns or stains on the skin or a characteristic odor on the
breath may also help the first-aid provider recognize the poison
Unless instructed to do so by the poison control center, the first-aid provider

should never give a poisoning victim anything to eat or drink. Vomiting should
not be induced unless the poison control center recommends it. If the victim
vomits, the first-aid provider should turn the individual on the side and clear the
airway. Before clearing the victim's mouth of any obstructions, however, the
provider should first put on clean first-aid gloves or wrap a cloth around his or
her fingers. If the person who ingested the poison is unconscious, the airway,
breathing, and circulation should be checked and CPR started if necessary
A drug overdose occurs when an individual takes too large a dose of a drug or
takes a dose that is stronger than the person can tolerate. A drug overdose can
be di fficult to diagnose because the signs and symptoms vary widely and often
mimic other illnesses or injuries. Symptoms of a drug overdose include
unusually dilated or contracted pupils, vomiting, difficulty in breathing,
hallucinations, and in severe cases unconsciousness and slow, deep breathing. If
an overdose is not treated, the individual may die. Victims of overdose should
be taken immediately to a hospital emergency room
TYPES OF POISONS COMMON IN THE COMMUNIT
1. Spermicidal a substance that kills sperm.
2. Poisoned by an insect or animal bite e.g. snake
1. Prescription or over the counter medicines

2. Taken in doses that are too high.
3. Consummation of illegal/Illicit drug
29
9. Metals such as lead and mercury
6 Carbon monoxide from gas
,
appliances.
7. Furniture polish.
10 Injecting a harmful substances
8 Pesticide e.g. heroin

cury
.; "
SIGNS AND SYMPTOMS OF POISONING
1. Burns or redness around the 4.
Empty medication bottles or
mouth and lips, from drinking scattered pills.
celiain poisons. 5. Vomiting, difficulty
2. Breathe that smells like
breathing, sleeping confusion
chemicals such as gasoline. etc.
3. Burns, stains and odors on the 6.
Stomach pain
person 7. High body temperature of the
victim
lVIANAGElVIENT OF POISONED VICTIlVIS
I. If the person has been exposed to poisonous fumes such as carbm

monoxide get him or her into fresh air immediately ,
,
2 .. if the person swallo'-"ed the poison remove anything remaining in tll
mouth.
3. . If the suspected poison is a household cleaner or other chemical, read tIi
label and follow instructions for accidental poisoning.
4. Follow treatment directions that arc given by the poison control centre .:
5. If the poison spilled on the person's clothing skin or eyes, remove t~
clothing, Hush the skin or eyes with cool or lukewarm water.
6. Make
DO NOT sure the person is breathing, if not start CPR and rescue breathing'
;
Do not give one Paccar syrup or do anything to induce vomiting.

30
COMPILED BY NWOKOLO:}
t
;
r
ances
/
TREATMENT
person who is poisoned is normally admitted to hospital for

-i-'~
observation. A substance known as active charcoal may be given to

poison being absorbed into the blood.
- There are also several medications known as antidotes that call act against the
harmful; effects of a specific poison e.g. antidotes to paracetamol poisoning is
called N- acetylcysteine which protects the liver against the harmful effects of
paracetamol.
PHEVENTIVE J\lEASURE OF POISON ~"I\'D DRUG OVERDOSE:-
There arc several steps you can take to reduce the risk of poisoning.
These include carefully reading the poisons information leaflet that comes with
I
substance.
Making sure any poisoning substances are locked away out of the sight and
reach of your children.
Keeping all drugs out of the r~ach of children and aged.
Medication for children and aged person must be given under observation by
another matured /knowledgeable person in medicine
DEHYDRATION
Dehydration is the excessive loss of body water with an accompanying

disruption of metabolic processes in tile human body. The dehydration of the
skin and mucous membranes can be called medical dryness. It also means a
condition which occurs when loss of body fluids, mostly water exceeds the
amount that is taken into the body.
THERE ARE T\VO TYPES OF DEHYDRATION
31

1. Isotopic hydration
2. Hyper- natural dehydration

I S-olOl--tl c. '
ISOTORc DEHYDRATION; Water and salt are lost in the same
proportion as the water and salt present in the fluid surrounding your cells. This
is the type of dehydration that's most often caused by diarrhea.
HYPER-NATURAL DEHYDRATION; Usually affects infants or children,

hypernatremia means high level of salt in the blood hypernatremic dehydration
is where a child loses relati\(ely more water than salt for C.g, when t~1~ have
watery diarrhea or excessive vomiting water makes up over two-~~~f the
healthy human being. It lubricates the joints and eyes, aids digestion, flushes aul
waste and toxins and keeps skin being not dried.
SOME OF THE EARLY WARNING SIGNS THAT lNDICATE~

THAT SOME ONE IS DEHYDRATED INCLUDE
1. Feeling thirsty .I 5. Few or no tears when the)

2. Having dark, yellow color, cry.
strong-smelling urine 6. Fewer wet nappies
3. Passing urine less often than 7. Drowsiness and others sigrj
i
less.
4. A baby may be dehydrated if
they have
WHO IS AT RISK OF DEHYDRATION;-
Anyone can become dehydrated, but certain groups are particularly at &
these include:
Babies and infants because t~ey have a low body weight and are sensitivt
even to small amounts of fluid loss. , ,
II. -older people because they may be less aware that they're becOlnt
dehydrated and need to keep drinking fluids.
'
t
Ill. -pcople with a long-term health condition such as diabetes or alcoholisr . '
IV. -athlctics because they lose a large amount of body fluid through spottin ;
SIGNS AND SYMPTOMS OF bEHYDRA TrON
I. -fecling tired or confuse. II. not passing urine for eight hours.
III. -dry mouth and eyes that don't produce tears.
IV. -elry skin that sags slowly back into position after been pinched up.
V. -rapid heartbeat. VII. -headache
Vf. -low blood pressure.
CAUSES OF DEHYDRA TrON
Dchvdrarion is caused by not drinking enough fluid or by losing more fluid

than you Like in through different mean gaining fluid into the body.
<wcat. tears, vomiting, urine or diarrhea.

I
Dehvdration is also linked to a number of factors which include

Illnes-. sweating
Alcohol because of its diqretic effects, it makes you urinate more
I
when taken. '

Diabetes- as one has high level of glucose, kidney will try to get rid of
the glucose (by creating more urine) by urinating more frequently, you can
be dchvdratcd.
TREATMENT OF DEHYDRA TrON
TIle best \\ ~:>' to treat dehydration is to rehydrate the body by drinking plenty of
fluids Su..:;' .;.;; \\',ltc..'L diluted fruit juice, semi skimmed milk etc.
A sweet drink can help replace lost sugar

A salty suac]; can also help replace lost sugar
lnfnur-, tkl: arc dehydrated should be given diluted fruit juice or special
dehydration <olunon instead of water because water will make problem worst
by further diluting the minerals i<ln their body.
33

25)
If you are-dehydrated, you will have lost sugar and salts as well-as water.
Drinking a rehydration solution will enable you to re-establish the right balance
of the body fluids. The solution should obtain mixture of potassium and sodium
salt as well as glucose.
PIZEVENTION OF DEHYDRP TION
./ Drink fluid abouj, 6-8 glasses of water or more a day. Because

severe dehydration on attended to, can lead to death.
./ Start ORS as soon as the child/adult or aged became ill wiyh

diarrhea or/and vomiting .
./ Older children ami adults can pevent dehydration by drinking plenty
of fluids during illness.
./ Drinking enough water and non- alcoholic fluids during wellness
prevents dehydration among the aged.
PROLONGED LABOUR
Labour is a series of intense, repeated muscle contractions help push the bab)
out of the uterus (womb) and into the birth canal.
You wi 11 probably feel the contraction in the lower back and belly area. This
called labour pain. The contraction help to dilate (widen) the opening to
34
COMPILED BY NWOKOLO
"(l;zma (caJ led the cervix) this allows the baby to move of your body and be
born. First-time moms (mothers) are usually in labour for about 12-18 hours. If
,l have had a baby before labour usually goes more quickly, usually about
half that amount of time. prolonged labour is labour stalls or occurs much
slowly, prolonged labour may also be referred to as "failure to progress".
Prolonged labour can be determined by labour stage and whether the cervix has
opened or thinned appropriately during labour if your baby is not bom after
apprr)priatcly 20 hours of regular contractions you are likely to be in prolonged
labour. Sometimes it can be pronounced, prolonged labour after 18 to 24 hours
I f you arc carrying twins or more, prolonged labour is labour that lasts more
than 16 hours. Doctor may refer to slow labour as prolonged latent labour.
PROLONGED LABOUR MAY OCCUR
.~ I. The baby is very big and cannot move through the birth canal.
Tl. The baby is in an abnormal position.( Normally, the baby is head down
facing your back)
III. The birth canal is too small for the baby to move through.
IV. The contractions arc very weak.
V. Multiple babies (twins or more) in one birth.
TRE/\. TMENT OF PROLONGED LABOUR
l. If your labour is going slowly, you may be advised to just rest for a litrlc
IDSKSOFPROLONGEDLABOUR
1. Prolonged labour mcreases the chances that you will need a Cesarain-
section.
II. Labour that take too long can be dangerous to the baby it may cause
(a) low oxygen levels for the baby.
(b) Abnormal, heart rhythm in the baby.
whi lc. SO!11dimes, medicine is given to ease' your labor pains and help you
re lax
JI. If 111e baby is already in the birth canal the doctor or midwife may use
special tools called forceps or a vacuum devise to help pull the baby out
through the vagina
11 I. If your baby can fit through the birth canal, you 111ay receive pitocin
(oxytocin). This medicine speeds up contractions and makes them stronger.
COMPILED BY N\;VOKCLC
A.A
26)
Doctors have used the drug to help avoid the need of caesarian-section in
I-
pregnant women
If the baby is too big or the medicine does not speeds up delivery, you will
need a C-section.
27)
BURNS
A bum is an injury to the skin caused by exposure to fire, hot liquids or .

metals, radiation, chemicals, electricity, or the sun's ultraviolet rays. Bums
classified according to the depth of tissue damage and extent of the bum.
A first-degree, or superficial, burn, which involves only the surface of the s'
is characterized by ~ddening. A second-degree bum extends beneath
surface and causes .. istering and severe pain while a third-degree, or '
thickness, burn cause i charring and destruction of the cell-producing lay
skin. The severity of a burn depends also on the area involved, expressed
percentage of the total body surface area. Severe bums cause shock and 10
body fluids. A person suffering third-degree bums over more than 10 perce
body surface area should be hospitalized as soon as possible.
3
6
COMPILED BY
NWOKC
28)
29)
30)
31)
First aid for burns involves removing the source of the burn as soon as possible
burn should be cooled immediately with cold water. A clean, cold wet
towel or dressing can be placed on less serious burns to ease pain and protect
the burn from contamination. Continuously bathe chemical burns with running
,:tcr for at least 20 minutes to dilute the substance. Any powder should be
IJy brushed off with gloved or protected hands before washing. Wet
inf::~ or ointments should never be used for burns. Instead, the first-aid
ider should gently apply dry, sterile dressings held in place by bandages
and seek immediate medical attention
'1(" 1
2' '-degree rums
When the first layer of the skin has been burned through and the second layer of
skin (dennis) also is burned the injury is called a second-degree burn.
1. Blister develop II. Skin takes on an intensely
reddened appearance
i. There is severe pain and swelling. If the second degree burn is not longer
than 3 inches in diameter, treat it as a minor burn.
For minor burns: including first degree burns and second and second degree
burns limited 10 an area no larger than 3 inches in diameter.
.., Take the following actions:
<II Cool the burn: hold the burned area under cool (not cold) running water
for 1 OorIS minute or until the pain subsides. Immerse the burn in cool
water or cool it with cold compressor, cooling the burn reduces swelling
by conducting heat away from the skin. Do not put ice on the burn. Cover
the burn with a sterile gauze bandage.
~ L>
 Don't use fluty cotton, or other material that may get lint in the wound.
Wrap the pause loosely to avoid putting pressure on burned skin.
Bandaging, keeps air ~ffthe burn, reduces pain and protects blisters.
 Takes an over the counter Pain reliever these includes aspirin, ibuprofen,
use caution when giving aspirin to children or teenagers.
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32)
Through aspirin is approved for use in children older than-age 12years old.
Those Children above 12years old and teenagers recovering from chicken pox
or flu-like symptoms should never take aspirin.
33)
34)
Minor bums usually heal without further treatment. They may heal with'
pigment changes, meaning that the healed area may have different colour from'
the surrounding skin.
CAUTION
-Dont use ice: putting ice directly on a bum can cause a person's body to
become too cold and cause further damage to the wound.
-Dont apply egg whites, butter or ointments top the bum, this could cause
Infection.
-Dori't break blisters; broken blisters are more vulnerable to infection
3rd DEGREE BURN
The most serious bums involve all layers of the skin and cause permanent tissue,
damage, to fat muscle and even born may be affected.
Areas may be black or appear dry and white. Difficulty inhaling and exhaling
.carbon monoxide ( carbon oxide) poisoning or other toxic effects may occur if
smoke inhalation accompanies the bum.
-don 't remove burned clothing-however do make sure the victim is no longer
contact with smoldering materials or exposed to smoke or heat.
-don't immerse large server bums in cold water doing so could cause a drop in ~
temperature.
-checks of signs of circulation (breathing, coughing) if there is no breathing or
other sign of circulation begin CPR immediately.
-elevate the bumed body part or parts, raised above heart level, when possible-
cover the area of the bum: use a cool moist, sterile damage, clean moist cloth
moist cloth towels.
-get a tetanus shot: bums are susceptible to tetanus. Doctors recommend you
tetanus shot every 10 years.
38
COMPILED BY NWOKOLO
A lay casualty down.

36)
35)
· ..
,.
CAUSES OF BURN
Bind B theApply
cloth strip
directfirmly aground
pressure thesight
to the injured
of limb above the bleeding point
bleeding
. a pulse callflames
no longer 2 hot metals
be felt, beyond the constrictive, bandage
of a fire and
C Raise
bleeding and rest thefirmly.
is controlled.tie injured part when possible
3 electric or gas fires or coming in contact with lives electric fires
Note D theLoosen
time of tight
applications.
clothingAfter 30 minutes release the bandage
F Seek and check
medical aid urgently
for bleeding,4jflighting 5 frictions
there is no bleeding, remove it. If bleeding recommences, apply
directEpressure
Give nothing
if this isbyunsuccessfully,
mouth reapply the constrictive bandage back
recheck every 6 strong acids e.g HYDROCHLORIC ACID [HC1], SULPHURIC
30 minutes.
ACID [H2S04]
EnsureTO
HOW that APPLY
the bandage
DIRECTis clearly visible and inform the medical aid of the
PRESSURE
location and time of its application.
I. Apply direct pressureMANAGEMENT
to the wound withOFyour finger or hand.
BURNS
II. As soon as possible, .place a clean dressing over the wound. Apply a
J . Rescue the patient.
bulky
..
INTERNAL BLEEDING 2. Estimate the affected area and depth.
pad extending beyond the edges of the wound and firmly bandaged.
if bleeding continues, live the
Symptoms anddressing
signs in4.place and relocate the pad.
3. Weight the patient. Give analgesics
III. Do not disturb pads or bandages once bleeding is controlled
5.Evidence
Placeofpatient
internal
in bleeding
bed. from some
6. organs
Dress may be seenand
the wound by apply
the first aider violate
gentian
paint 7. Give tetanus toxoid
-cougliing up red frothy blood
UNCONTROLLED BLEEDING
-vorniting blood the colour of coffee grounds or bright red. The blood may be
BLEEDING
mixed with food.
IfBleeding
severe bleeding cannot
is a loss of blood be controlled
from the bloodby directsevere
vessels pressure, it may be
or continued
necessary
-passing
bleeding toofapply
may fecestopressure
lead with to
andthe
a black,
collapse pressure
tarry points'
appearance
death, thus, the first these are found
aider must aim toon the >HU>UI!'
control
artery
severe above
bleeding. theThe
wound. When
quantity bleeding
of blood in thehas beenbody
human controlled remove pressure
varies according to to
the -passing of reapply
feces which arepressure
red in colour.
sizepoint and direct to the wound. Occasionally in major limb
.,111 adult can lose 500ml of blood without any harrn, but the loss of 300ml
injuries
might
suchdeath
as partial
,'::,]USCurine
amputations and shark attack, severe bleeding cannot be
in an infant.
-passing which has a red smoky appearance,
controlled by direct pressure. Only then, it may be necessary to resort to the
application of a constrictiveEXTERNAL Bandage above BLEEDING
the elbow or knee.
-concealed bleeding within theiabdomen may be suspected when there IS:
USINGbleeding
Symptoms and signs-obvious A CONSTRICTIVE BANDAGE
a. pa Jl1 rigidity of abdomen muscles

selects a strip of firmOF
M/\NAGETZMENT cloth, at least 7.5 centimeters (3 inches) wide and about 7
BLEEDING:-
Apply direct
centimeters (30 inches)
pressure
b. tenderness long.
to the site This
of themay beloss
blood improvised
with yourfromclothing
hand or the or a narro
causality's
folded band unless
triangular the wound contains foreign matter such as glass. In this
bandage.
case, -;quecze
INTERNAL the edges of
IHJIEDING the wound
\\IILL together.
BE ACCO~lPANIED BY ANY O]~" THE
40
FOLl,O,\VING SYl\lPTOMS Al~D SIGNS: 39 COMPILED BY NWOKOLO A
COIVIPilED BY NWOKOLO A.A
41
COMPILED BY NWOKOLO /1, .• 4
, .
Faintness or dizziness - Weak rapid pulse, cold, clammy
skin
Restlessness, nausea, thirst
sweating
MANAGEMENT
Lay the casualty downOF INTERNAL BLEEDING
seek medical and urgently
- raise the legs or bend the knees give nothing by mouth
loosen tight clothing. reassure the casualty
Bleeding is known as hemorrhaging: is the loss of blood or blood escaping from

the circulatory system. Bleeding can occur internally, where blood leaks from
blood vessels, inside the body or externally, either through a natural opening
such as the mouth, nose, ear,' urethra, vagina, or anus or through a break in the
skin. DESANGUINATION is a massive blood loss. And the complete loss of
blood is referred to as EXSANGUINATIUON. The blood donation typically
takes 8-10% of the donor's blood volume.
WORLD HEALTH ORGANISATION STANDARD, SCALE GARDING
BLOOD LOSS
Hemorrhage is graded into four (4) classes:
1 class 1 hemorrhage-involves up to 15% of blood volume
2 class 11 hemorrhage: involves 15-30% of total blood volume.(rapid

heartbeat
Skin look pale and the cool to the touch
3 class III hemorrhage: 'involves loss of 30-40%of blood volume(patient'

blood
Pressure drops, heart rate increases)
4 Class IV hemorrhage; involve loss of blood.>40% of blood volume (c

follow
42
COMPILED BY NWOKOLO
MEASURE OF SEVEREITY OF BLEEDING.
Group 0 - no bleeding
Group 1 - petechial bleeding
Group 2 - mild blood loss (clinical significant)
Group 3 - gross h160d loss requires transfusion

Group 4 - debilitating blood loss associate with fatality.
ORIGANS THROUGH WHICH BLOOD CAN BLEED ARE

Mouth
- Hematemesis -vomiting fresh blood

- Hemoptysis - coughing of blood from the lung.
Anus
- Hematochezia - rectal blood
URINARY TRACT
- Hematuria -blood in the urine from urinary bleeding
.upper bleeding
-Intracranial hemorrhage - bleeding in the skull
LUNGS
- Pulmonary hemorrhage
43
. "
37)
38)
Gynecologic
- Vaginal bleeding
PRESSURE POINT
39)
Pressure point is where an important artery (takes blood away from the heart
can be compressed against an underlying bone to prevent the flow of blood
beyond that point.
~HE COMMON PRESURE POINTS
~ 1. Brachial pressure point: the bronchial artery is located along

the innerside of the muscles of each upper arm.
2. Femoral artery pressure point : The bronchial artery passes

into each lower limb at a point corresponding to the centre of
the fold of the groin
3. Radial pressure point; the radial artery is located at the
anterior surface of the corist on thumb side.
4. Subclavin pressure point: The sub clavin artery is located one
on each side just under the collar bones.
5. Temporal pressure point: The temporal comer of the eye.
2. The facial pressure point: The facial artery is located 2C111 in

front of the angle of the jaw Carotial pressure point: the carotid
artery is located on each side of the neck slightly away from
the trachea .
.\
Major pressure point
Large arteries may be compressed against underlying bone to stem severe blood
loss from a limb {Top} :The point at which the brachial artery passes closet to
the skin is halfway between the elbow and shoulder. Clamping the fingers
44

around this points stops the blood supply to a wound on the hand or lower
arm.(Bottom):The major pressure point for leg injuries is where the femoral
artery crosses the joint between the pelvis and leg. The heel of the hand applied
at this point will best reduce blood flow. It should be noted that because these
procedures deprive the entire extremity of blood, they should be used only in
case of absolute emergency.
The presence of blood over a considerable area of a person's body does not
always indicate severe bleeding. The blood may ooze from multiple small
wounds or be smeared, giving the appearance of more blood than is actually
present. The rate at which a blood is lost from a wounds depends on the size and
kind of blood vessels ruptured. Bright red, spurting blood indicates injury on
artery while welling or steadily flowing, dark red blood indicates injury to a
vem.
Welling or spurting blood bias an unmistakable sign of severe bleeding. If a

major artery ruptures,a person may bleed to death within a minute injury to
veins and minor arteries bleed more slowly but may also be fatal if it is left
unattended. Shock usually results from loss of fluids, such as blood, and must
be prevented as soon as possible ..
To stop the breeding, apply pressure directly over the wound and, when
possible, elevate the breeding body part. The first-aid provider should us
bandages to hold a sterile dressing or clean Cloth firmly over the wound.
Dressings that become saturated with blood should not be removed but should
be reinforced with additional layers. If an ann or leg wound bleed rapidly and
cannot be controlled by dressings and bandage, the first- aid provider can apply
pressure to the artery at a point Adjacent to the bleed called the pressure point.
.Arteries pass close to the skin at these point and can be compressed against
underlying bone to stop arterial bleeding. The pressure point for the femoral
artery, which supplies blood to the leg,is located on the front center of the leg's
hinge, the crease of the groin area where the artery crosses the pelvic bone. The
pressure point for the brachial artery, which supplies blood to the arm, is located
halfway between the elbow and armpit on the inner side of the ann.
Bleeding from a medium -sized blood vessel can be halted by applying direct
pressure. Flattening the injured blood vessel slows the flow of blood to make
45

SEVERE BLEEDING
To stop the breeding, apply pressure directly over the wound and, when
possible, elevate the breeding body part. The first-aid provider should us
bandages to hold a sterile dressing or clean cloth firmly over the wound.
Dressings that become saturated with blood should not be removed but should
be reinforced with additional layers. If an ann or leg wound bleed rapidly and
cannot be controlled by dressings and bandage, the first- aid provider can apply
pressure to the artery at a point Adjacent to the bleed called the pressure point.
.Arteries pass close to the skin at these point and can be compressed against
underlying bone to stop arterial bleeding. The pressure point for the femoral
artery, which supplies blood to the leg,is located on the front center of the leg's
hinge, the crease of the groin area where the artery crosses the pelvic bone. The
pressure point for the brachial artery, which supplies blood to the ann, is located
Bleeding from a medium -sized blood vessel can be halted by applying direct
pressure. Flattening the injured blood vessel slows the flow of blood to make
clothing possible. A clean dressing and padding should cover the elevated
wound, and pressure should be applied over it with the finger for 5 to 15
minutes, until the bleeding stops. if there is a foreign body in the wound
pressure should be applied tb one side. If bleeding continues, news bandages
should be added to. But not substituted for, the saturated one; removing the first
bandage may disrupt clots in the process of formation, once the bleeding has
stopped, securing the bandage and padding. as shown here, maintains pressure
on the wound to minimize chances of renewed bleeding.
46
@MicrosoftC ation, All . htsReserved.
Major Pressure Points

Large arteries may be compressed against the underlying bone to stem severe
blood loss from a limb. (Top): The point at which the brachial artery passes
closest to the skin is halfway between the elbow and shoulder. Clamping the
fingers around this point stops the blood supply to a wound on the hand or
lower ann. (Bottom): The major pressure point for leg injuries is where the
femoral artery crosses the joint between the pelvis and leg. The heel of the hand
. I
applied at this point will best reduce blood flow. It should be noted that because
these procedures deprive the entire extremity of blood, they should be used only
in cases of absolute emergency.
The presence of blood over a considerable area of a person's body does not
always indicate severe bleeding. The blood may ooze from multiple small
wounds or be smeared, giving the appearance of more blood than is actually
present. The rate at which blood is lost from a wound depends on the size and
kind of blood vessel ruptured. Bright red, spurting blood indicates injury to an
artery while welling or steadily flowing, dark red blood indicates injury to a
vem.
47

Welling or spurting blood is an unmistakable sign of severe bleeding. If a
major
artery ruptures, a person may bleed to death within a minute. Injuries to
veins
and minor arteries bleed more slowly but may also be fatal if left
unattended.
Shock usually results from loss of fluids, such as blood, and must be
prevented
as soon as the loss of blood has been stopped.
To stop the bleeding, apply pressure directly over the wound and, when
possible, elevate the bleeding body part. The first-aid provider should use
bandages to hold a sterile dressing or clean cloth firmly over the wound.
Dressings that become saturated with blood should not be removed but
should
be reinforced with additional layers. If an arm or leg wound bleeds rapidly
and
cannot be controlled by dressings and bandages, the first-aid provider can
apply
pressure to the artery at a point adjacent to the bleed called the pressure
point.
Arteries pass close to the skin at these points and can be compressed
against
underlying bone to stop arterial bleeding. The pressure point for the
femoral
artery, which supplies blood to the leg, is located on the front center of the
leg's
hinge, the crease of the groin area where the artery crosses the pelvic bone.
The
pressure point for the brachial artery, which supplies blood to the arm, is
located
Pressure Dressing
Bleeding from a medium-sized blood vessel can best be halted by applying
direct pressure. Flattening the injured blood vessel slows the flow of blood
to
make clotting possible. A clean dressing and padding should cover the
elevated
wound, and pressure should, be applied over it with the fingers for 5 to 15
minutes, until the bleeding 'stops. If there IS a foreign body in the wound,
48
COMPILED BY
NWOKOLO A.A
pressure should be applied to one side. If bleeding continues, new bandages
should be added to, but not substituted for, the saturated one; removing the
first
bandage may disrupt clots in the process of forming. Once the bleeding has
stopped, securing the bandage and padding, as shown here, maintains
pressure
on
40)
41)
the wound to minimize chances of renewed bleeding.
FAINTING, SEIZURES, UNCONSCIOUSNESS AND COMA
Fainting, a sudden, temporary unconsciousness occurs when the brain does not
receive enough blood. Just before fainting, a person's skin may appear pale and
clammy or sweaty. To restore blood flow to the brain, a first-aid provider
should elevate the unconscious person's feet or position the individual's head
below the level of the heart. The victim's airway and breathing should be
closely monitored. A fainting victim must also be kept warm to prevent shock.
If the victim does not fully recover after five minutes, medical help should be
requested.
Seizures, sudden brief episodes of intense neurological activity, may result from
a variety of causes, including epilepsy, a neurological disorder, and head
injuries. First aid for seizures consists of protecting the victim from accidental
injury during the seizure. The first-aid provider should not put any objects in a
seizing person's mouth or try to hold the tongue. If the victim has medical
identification indicating epilepsy, an ambulance need not be called unless the
person experiences multiple seizures or one seizure lasts more than five
minutes. Otherwise, once the seizure stops, question the person about the need
for a hospital evaluation. Ifno medical identification exists the first-aid provider
should request medical assistance.
Unconsciousness is a state of unawareness or insensibility in which the patient
receives no sensory impulses. The person is unaware of things happening
around him i.e. his mental activities are suspended. Coma is complete
unconsciousness. The patient appears to be asleep and is at the same time
incapable of sensing or responding adequately to .either stimuli or inner need i.e.
all reflexes are absent.
CAUSE OF UNCONSCIOUSNESS:
A. PRIMARY CAUSES-
These includes all causes in which the patient becomes unconscious as the
immediate result of an injury or a disease affecting the central nervous system
(CNS).
(1 )HEAD INJURIES-fracture vault of the skull, fractured base of the skull,

conclusion of the brain, compression of the brain etc.
,
50
(2) MEDICAL CONDITION: like apoplexy, epilepsy, infantile convulsions,

brain tumor, electric shock, tetanus etc.
(3)POISONING -narcotics, prussic acid, alcohol or gas drugs, and strychnine.
B. SECONDARY CAUSES: -
These are causes in which the patient becomes unconscious as a result of injury
or disease which first affects other systems of the body before involving the
nervous system. These include asphyxia, anoxia (lack of oxygen), fainting
(syncope), heart attack, diabetic coma, kidney diseases, eclampsia, heat illness,
cold exposure (frostbite) a deep state of unconsciousness due to illness or injury
is known as a coma. Comatose individuals cannot be awakened. Heart failure,

stroke, epilepsy, diabetes, or traumatic brain injury can cause comas and a
medical alert tag on the victim may identify a possible cause of the coma. If the
person is breathing, first aid is limited to providing comfort until medical
assistance arrives. If the victim is not breathing, the first-aid provider should
administer mouth-to-mouth or mask-to-mouth resuscitation.
AN UNCONSCIOUS PERSON IS USUALLY SHOWING THE FOLLOW

FEATURE
1) They are not

awake.
2) they are not
attentive.
3 ) they not aware of .
In addition, they may not be breathing and they may not have pulse. in this case,
the person is at risk of dying because there is no oxygen, vital to the survival of
the living cells, being carried around the body. This can be compared with
ordinary/natural sleeping. Natural sleeping can be said to be a lower or reduced
form of the normal wakeful state (which full consciousness). When you lift a
sleeping person's ann, it feels loose but still has some firmness to the touch,
because full muscles are still Contracting.
In an unconscious person the limb is very soft and loose, like a ragdoll' s
because there is no contraction. This is very important to understand because it
is the chief reason why, in an unconscious person the tongue tends to fall back
wards and blocks off then air passage. This obviously does not happen in
naturally sleeping person. any unconscious may need first-aid to unblock the air
51
COMPILED BY NWOKOLO
A.A
way. Reflexes are missing in unconscious-person, so any fluid or material in the
throat cannot be cleared and may be breathed into the lungs, causing
asphyxiation (suffocation). This serious affect is most often the result of
bringing up the stomach contents (vomiting). When this vomit (materials)
passes down the air way into the lungs, the delicate linings of the lungs are
intensely irritated. Liquid ooze out and fill the lungs, there by stopping the
•
oxygen the air reaching the bloodstream.
The level of consciousness of a casualty can change over a period of time, and
knowledge of these changes can be very important to the first aider when
deciding on possible treatment. If possible you should note and record the
levels. These levels can be assessed by examining the response of the casualty
to conversation, questioning and commands and response to painful stimuli.
A sample scheme for monitoring level of consciousiness by response is as

follows:
--
RESPONSE LEVEL POSSIBLE DESCRIPTION
Response only to normal conversation Full conscious
Response only to clear question Drowsy
Gives wrong or muddled reply Confussed
Carries out only simple instruction Semi-conscious
(e.g. moving arm) •
. Body react s only to painful stimuli Unconecious
(thumb pressure over a bone/ pm
plick)
No reaction to any of the above Deeply unconscious(coma)
If the person is semi conscious (half conscious) ofwrose,always put him/her in

a recovery position and check AIR WAY, BREATHING, AND
CIRCULATION (PULSE) . The first aider should monitor the vital signs after
every few minutes
RECOVERY POISTION:
The recovery position is a steady position which keeps the air way open, then
allow fluid(particularly vomit) to drain out of the mouth so that it does not
enter the lungs. It also prevents the tongue from falling back and blocking the
back of the throat.
POSITIONING CASUALITY IN THE RECOVERY POSITION WILL BE
DONE PRACTICALLY WITH THE STUDENTS, TAKE NOTE.
GENERAL CARE OF THE UNCONSCIOUS PATIENT:
(1) If there is no particular injury and the patient's face is pale with cold
clammy skin, place him/her in the prone position with head turned to the side.
(2) If the face is flushed the patient should be placed on his back with shoulders
raised slightly.
(3)Clear any salvia from the mouth and ensure that the tongue is well forward .
ELECTRIC SHOCK
Contact with electrical current is potentially fatal. Electricity passing through

the body can cause injury to the skin and internal organs. If electricity passes
through the heart, the heart muscle may be damaged and the heart's rhythm
interrupted, leading to cardiac arrest. The signs and symptoms of electric shock
include tingling, bums on the skin where the current entered or exited, muscle
..
pain, headache, loss of consciousness, irregular breathing or lack of breathing,
and cardiac arrest. The severity of the injury depends on the strength of the
electric current and the path the current takes through the body. The person
providing first aid to a victim of electric shock should not touch the individual's
body until the source of the shock is turned off. Because of the potential for
34internal injuries, victims of electrical injury should not be moved unless they
are in immediate danger. The first-aid provider should monitor the victim for
symptoms of shock. If the victim has stopped breathing and has no pulse, CPR
should be performed after the airway, breathing, and circulation have been
checked. When the victim's vital signs are stable, the site of the bum should be
treated using the same methods used for other bums.
54

ANIMAL BITES AND STINGS
Animals such as snakes, dogs, cats, and rodents like squirrels, certain insects,
and spiders may bite htfmans with dangerous consequences. Many snakebites
are caused by 1:1Zfi-.venomous ,(nonpoisonous) snakes and do not require
treatment beyond cleaning the wound. Bites inflicted by venomous snakes
require immediate first-aid measures. The victim should be taken as soon as
possible to the nearest emergency medical facility. In the interim, the first-aid
provider should not cut the area around the bite, attempt to suck out the venom,
or apply ice to the wound. The focus of first aid should be to prevent the venom
from spreading rapidly through the individual's bloodstream. The victim should
be kept quiet to avoid stimulating circulation of the venom. In addition, the bite
area should be kept at a lower level than the rest of the body. The wound should
be washed thoroughly with soap and water, blotted dry, and loosely covered
with a sterile dressing.
Bites from other animals should be thoroughly washed, treated with an

antibiotic ointment, and bandaged. The victim should seek medical attention if
the bite is severe, if rabies (an infectious viral disease) is suspected, or if the bite
becomes infected. Bites from other humans are particularly prone to serious
bacterial infection and should be treated by a medical professional. Victims of
any animal or human bite whose immunizations are not current may need a shot
for tetanus, an often fatal infectious disease affecting the muscles of the neck
and jaw.
Biting insects include fleas, mosquitoes, bedbugs, lice, chiggers, and gnats.
Bites from these insects should be washed to prevent infection, and cold
compresses or topical medications applied to alleviate itching and pain. Bites
from some species of ticks can cause serious illnesses including lyme disease
and Rocky Mountain spotted fever. When a tick bites a person, it may attach
itself to the body by burrowing into the skin. As a result, a tick should be
removed by carefully pulling it straight out with tweezers so as not to leave its
head behind. The tick should not be squeezed when it is removed. Bites from
most spiders can be treated like those of other biting insects. Bites from black
widow spiders and other poisonous spiders require medical help. They are
treated similarly to poisonous snakebites. .
. i
55
DOG BITES:
Dog bite is a wound caused by dog bite and is usually of the puncture type and
may be deceptively deep. The danger of dog bite is infection especially with
rabies.
TREATMENT
First aid treatment of dog bite is the same as for snake bite. It is important to get
the victim to the health facility as quickly as possible so that the specific antidote
(anti-rabies) can be administ~red after confirmatory test.
PREVENTION OF RABIES:
A. HEAL THY DOG:
(1) Cleanse the wound with iodine.
(2)Tie and muzzle the dog for teen days to observe (during this time if it is
necessary to feed it and give it water as usually done ).If it is incubating rabies, it
will become mad or die in that period. Should rabies develop in the animal within
this period, send the bitten patient (victim) immediately for anti rabies vaccination.
A RABIES DOG
(1) Cleans the wound, swab well with iodine.

(2) Do not stitch.
(3) Send patient (victim) immediately for anti rabies vaccine.
STINGS
Stings in themselves are not serious but some people react violently to them. This
reaction is due to the person being sensitive to the sting, as poison is being
injected into the victim which acts as a foreign body
CAUSES:
(1) Bees
(2) wasps
(3)mosquitoes bite
SIGNS AND SYMPTOMS

(1) Pain And swelling
(2)sepsis
(3)Some people are unduly susceptible to bees and when stung ,they suffer from
unpleasant general symptoms such as shortness of breath, palpitations ,sweating or
even collapse.
56
Insect sting, spider bites, bee and wasp sting usually cause a localized reaction
with swelling, redness and itching.
Some people do have severe skin reaction to insect /spider bite/stings and a few
have allergic (anaphylactic) reaction that affects the whole body.
Symptom may include hives all over the body, shortness of breath and tightness in
the chest, dizziness, wheezing, or swelling of the tongue and face.
A point to remember is that the bees leaves their stings within the wound and this
must be extracted
TREATMENT:
Remove the bee stinger by gentle scraping or flicking or teasing it out (if the
stinger is not visible, assume there isn't one)rather pulling or tweezing which may
inject additional venom into the body. Apply a cold pack of ice cube to the bite
or sting then activated charcoal mixed with little water help in relieving pain and
decrease the reaction. An oral antihistamine (chlorpheniramine e.g. piriton) may
help relieve pain, swelling and itching. In severe insect sting /bite adrenalin
(epinephrine) injection will be administered to avoid bee sting wear white
or light-colored and solid fabrics.
PREVENTIVE MEASURES OF SCORPION STING .
• •
(1) Bees are attracted to bright flower of prints so people avoid being near it when
bees are visiting these flowers.
(2) Avoid wearing perfumes and colognes when outside.

(3) Apply an insect repellent containing DDT every few hours when in insect
/spider infested areas.
(4) Wear gloves and tuck pants into socks when work in woodpiles, sheds, and
basements where spiders are found.
SCORPION STING:
Some scorpions are far more poisonous than others. The adult (matured) scorpion
stings can be dangerous, especially if the sting is on the head or trunk part of the
body.
TREATMENTS:
For adult persons, take some aspirin tablets and if possible apply ice on the stung
part.
For the numbness and pain which sometimes last for weeks/months, hot
compresses may be helpful. Emetine 30mg injected around the sting site may
completely take the pain away, but sometimes causes necrosis. Or local
anesthetics with adrenalin e g lignocaine or xylocaine, injected around the sting
helps for 1-2 hours and may be repeated. If a child is stung and the child is very
young or has been stung on the main part of the body, Or if you know the scorpion
was a deadly type, treat as bite and seek help fast.
SNAKEBITE
Snake bite is an injury caused by a bite from a snake.
The outcome of snake bite depends on numerous factors, including

- the species of snake, - the area of the body bitten
- the amount of venom injected into the victim -the health condition of the person.
SIGNS AND SYMPTOMS OF SNAKE BITE
l. The most common signs and symptoms of all snake bites are overwhelming
fear, panic and emotional instability which may cause symptoms such as
nausea and vomiting, diarrhea, cold, bleeding from the bitten site with
pain and later swallowing of the part of the body affected

2 .. Most snakes bite whether by a venomous snake or not will have some type
of local effect. There is minor pain and redness in over 90% of the cases,
although this varies depending on the site of bite. Examples, the bites of
vipers and cobras may be extremely painful, with the local tissue, sometime
becoming tender and severely swollen within 5 minutes.
3. There will be two small punctured marks formthe fangs of the snake at the
site of bite.
4. This area may also bleed and can eventually lead to tissue necrosis.
5. Progressive respiratory and circulatory depression.
6. Mental confusion 7. .Dysphagia. 8. Dyspnoea
MANAGEMENT OF SNAKE BITE
1) Protect the person from further bites
2) Keep the victim calm and avoid acute stress as reaction increases the flow
of blood and endangers the victim's life.
58

3) Tiel legate the bitten part some distance above to reduce fast flow of blood
through the blood vessels.
4) Call for help to arrange for transport to the nearest hospital emergency room
where anti-venom for the snake common in the area will be available and
given.
5) Make sure to keep the bitten limb in a functional position and below the
person's heart level so as to minimize blood returning to the heart and other
organs of the body
6) Do not give the person anything to eat or drink.

7) Do not administer stimulants or pain relieving drug unless specified by the
Physician.
8) Remove any item or clothing which may constrict the bitten limb if it is
swollen e.g. ring, bracelets wrest, foot wears etc.
9) Keep the person as still as possible.
10) Do not incise the bitten site ..
PREVENTION OF SNAKE BITES
1) Snakes are most likely to bite when they are threatened, provoked or have
no means of escape so people should not provoke these snakes .
•
2) Snakes are likely to approach residential area when attracted by prey, such
as rodents practicing regular pest control can reduce the threat and bite of
snakes.
3) The use of a flash light when engaged in camping activities, tracking during
the night through the bush paths can be helpful.
4) It is as well important to avoid snakes that appear to be dead as some will
actually roll over on their back and stick out their tongue to fool potential
threats.
5) A snake detached head can immediately act by reflex and potentially bite,
the induced bite can be just as severe as that of a life snake.
6) Dead snake are also incapable of regulating the venom they injects, so a bite
from a dead snake can often contain large amount of venom.
7) Use of boot when working Iwalking in snake endemics area.
8) Wearing of hand gloves while working in the farm.
9) Stones lying on the earth surface must always be removed with care.
10) Bushes around homes should be cut down while rat-holes in and
around be filled.
59
COMPILED BY
NWOKOLO A.A
GANGRENE
Gangrene is the death of body tissue, generally in considerable mass
either due to
loss of blood supply or effects of certain infections
TYPES OF GANGRENE
1. Dry gangrene.
2. Gas gangrene
3. Cold
4.
Diabetic gangrene
gangrene
5. Angioneurotic gangrene
6. Decubital gangrene
7. Tocurtin gang~
CAUSES OF GANGRENE
Gangrene is caused by ischemia or infection. It is usually as the result of
critically insufficient blood supply and is often associated with dryness,
diabetes and long time tobacco smoking .
1) The' treatment of gangrene is carried out by revascularization i.e.
restoration of blood supply to the affected body part/organ(s) which
then can reverse some of the necrotized tissue and effect healing.
2) Another management of gangrene is debridement and surgical
amputation of the affected dead, damaged or infected part so as to
allow the healing of the underlying tissue.
3) Scrapping of surface when it is externally affected so as to allow the
under lying flesh/organ to improve and be restored to healthy tissue.
60
AT RISK CASES
At risk cases are those conditions that place the life of an
5) Prolonged labour.
6) Severe bums
7) Electric shock
8) Severe malnutrition
individual
at danger e.g.
1) Intestinal
obstruction
2) Acute appendicitis
3) Acute asthma
4) Road traffic
accident.
9) Chronic infection e.g. tuberculosis, paralysis etc.
VITAL SIGNS
Vital signs are measures of various physiological function of the human body
by
health professionals in order to assess the most basic essential health. These
vital
signs are essential in understanding the state of human health and health case
presentation. .i
FOUR BASIC VITAL SIGNS ARE

Body temperature normal range 36.5co---37.2°C or 90.50f __990f
Body temperature during Pyrexia ranges from 37.5°C and above or 99.50f and
above.
Pulse rate (number of heart beats per minute)

100-120 in infants
60--- 100 inchildren
and50-80 in adults
BLOOD PRESSURE 120/80 MM Hg

. i
61
RESPIRATORY RATE;- 12---22breathe per minute in adults
24---30 breathe per minute in children
30 -40 breathe per minute in infants
SHOCK
Shock is the depression of the vital centre in the medulla oblongata of the brain
due to its being deprived of sufficient blood supply
TYPES OF SHOCK
1) 0 ligaemia shock
2) Traymatic shock
3) Neurogenic shock
4) Respiratory shock
5) Psychologenic shock
6) Ccariogenic shock
EXPLAINING EACH TYPE OF SHOCK
7)
8)
9)
10)
11 )
12)
Septic shock
Eelectic shock
Insulin shock
Metabolic shock
Anaphylactic shock
Hemorrhagic shock
1) OLIGAEMIA SHOCK:-It is associated with pronounced fall in blood

volume, resulting from increased permeability of the blood vessels
2) TRAUMATIC SHOCK:A condition of depressed body functions as
reaction to injury with loss of body fluids and lor lack of oxygen.
3) NEUROGENIC SHOCK:- It is as a result from nervous system damage,
•
which leads to lowered blood pressure and low supply of oxygen to the
body system. It is life threatening and requires immediate medical attention.
4) RESPIRATORY SHOCK:-This type of shock comes as the result of
damage to the respiratory system part(s)which leads to low supp[y of
oxygen to the tissues and as well low removal of carbon (IV) oxide under
this condition the cells will not function optimally resulting to shock.
5) PSYCHOLOGENIC SHOCK:-It is caused by overwhelming emotional

factors resulting in fainting because of lack of blood flow into the brain.
62

6) CARIOGENIC SHOCK:-In the condition there is damage to
the heart
muscle, and the heart, will be unable to pump the amount of
blood the
, ,
needed to function optimally thereby resulting to shock.
7) TOXIC SHOCK:-It occurs when bacteria responsible for
Straphylococcus
Aureus andStreptococcus pyogenes which normally lives
harmless on the
skin invade the blood stream, an release poisonous toxins into
the blood.
These toxin causes a sudden high fever and a massive drop in
blood
pressure (shock) the toxin also damage the tissues of the skin
and other
organs
8) SEPTIC SHOCK:-poisonous substances accumulate in the
blood stream and
causes decrease in blood pressure, impairing blood flow into
the organs,
tissue and cells.
9) EELECTIC SHOCK:- This comes when one is in direct
contact with
electricity current which passes through the person thereby
interrupting the
free flow of blood throughout the body. .
10) INSULIN SHOCK:-insulin shock is as the result of
low sugar in
the blood as found in diabetes mellitus.
11) METABOLIC SHOCK:- During metabolic shock the
body's
homeostasis is impaired as the acid-alkali(base) balance is
disrupted and the
body fluids become unbalanced leading to shock.
12) ANAPHYLACTIC SHOCK:- This happen when
people reacts to
drug/substance which he/she is hypersensitive or allergic to,
resulting to
shock.
13) HEMORRHAGIC SHOCK:-Severe bleeding or loss
of body fluid
from trauma, , diarrhea, excessive vomiting, low blood
pressure etc which
leads to reduced blood flow into the cells, tissues and organs.
CAUSES OF SHOCK
1) Heart problems such as heart attack/failure
2) Low blood volume which can occur when plenty blood

is lost during
heavy bleeding, qr body fluid (dehydration).
3) Change in blood vessels as with infection or severe
allergic reactions.
4) Certain drugs that can significantly reduce heart
function or blood
pressure.
63
COMPILED
BY
NWOKOLO
A.A
5) Shock can be caused by other condition that can reduce blood
pressure e.g. atrophy of the blood vessels and other tissues in the
body.
6) Dehydration. 7)Tissue damages
SIGNS AND SYMPTOMS OF SHOCK
I. Anxiety/restlessness III. Dizziness.
II. Chest pain. IV. Pale skin.

V. Low or no urine at all for up to the past 24hours.
VI. Profuse sweating /moist VIII. Shallow breathing
skin., IX. Confusion
•
VII. Rapid but weak pulse. X. Unconsciousness
MANAGEMENT OF SHOCK
I. Call for immediate medical help.
II. Check the victim's airway, breathe, and circulation.

III. If the casualty is conscious find out if he/she has any injury to the head ,leg,
neck, spine bleeding from the mouth lear/nose etc if none place the victim
in the shock position i.e lay the victim on his/her back and elevate the legs
up to a hight of about 12inches/30centimeters.If raising the leg will cause
potential pain or harm to him/her leave him/her lying flat on the floor.
IV. Give the right treatment according to the injury or illness of the victim.
V. Keep the casualty warm and comfortable loosen any tight clothing. If the
victim vomit or stool take appropriate action to avoid any complication of
the casualty's emergen,cy condition .
.,
VI. Turn the head to one side so that he/she will not be choked by the vomit. Do
this as long as the victim has no suspected spinal injury.
VII. If spinal injury is suspected log roll the victim and instead keep his/her
head, neck and backbone all in a straight line.
DONaT
Do not give the victim anything by mouth including food and liquid drinks
Do not move the victim if there is suspected /known spinal injury
64

Instead of waiting for condition toget worsen before calling expert medical
i
care.
PREVENTATION OF SHOCK
(1 )Heart diseases (2) Falls
(3)Injuries
(4 )Dehydration
WOUNDS
WOUND: Is break in continuity of the skin or mucous membrane paving way for
microorganisms to invade the affected part of the body.
GROUPS OF WOUND: Wounds can be grouped into two.
1. Open wounds
2. Closed wounds
CLASSIFICATION OF WOUNDS
TYPES OF OPEN WOUND:
y INCISIONS OR INCISED WOUNDS; These type are caused by clean

sharp- edged objects such as knife razor, glass splinter.
y LACERATIONS; Irregular tear -like wounds caused by some blunt

trauma e.g. vehicle accidents sporting accidents.
y ABRASIONS; Superficial wounds in which the top most layer of the skin
,the epidermis is scraped off at times caused by sliding fall onto a rough
surface.
y PUNCTURED WOUNDS: This many a time caused by sharp pointed
objects which punctured into the skin/flesh, things like nails, needles etc.
y GUNSHOT WOUNDS: This type is caused by bullet or similar projectile
driving into or through the body. There may be two openings of the wound
one at the site of exit and another at the site of entry which is generally
referred to as through and through
TYPES OF CLOSED WOUNDS
y CONTUSIONS/BRISES: It is most commonly caused by blunt objects
moving in high/force. onto the body resulting into trauma that damages the
tissues underl beneath the skin.
65
y HEMATOMAS: This sometimes called blood tumor caused by damages to

the blood vessel which in turn results to blood collection under the
skin/within the muscle/flesh.
y CRUSH INJURY: Crush injury is caused by great /extreme amount of
force applied to the tissue of the body over a long period of time.
WOUND HEALING
Wound healing is a gradual process which involves so many physiological and

metabolic activities in the body of human being. Some healing of wound can take
place with little or no medical care, while others will get healed without much
drug but only with early proper and hygienic care. While the rest must be managed
with the combination of drug-and hygiene before they will be healed completely.
MANAGEMENT OF WOUND
Cleaning of wound can be carried out using different types of solution which
include tap water, sterile saline, eusol-A, eusol-B lukewarm water etc. The
cleaning of wound is as well known as WOUND TOILETING. Wound toileting is
the act of proper washing, cleaning and removing any foreign body in/on the body
of the wound. To be followed with covering the wound with the proper and
appropriate dressing materials.
COMPLICATIONS OF WOUNDS
Shock Haemorrhage
Infection e.g. tetanus and other micro organisms .

Fractures
Injuries to deeper tissues and organ
F ACTORS AFFECTING WOUND HEALING:- When we say factors affecting

healing we mean both the positive and negative, internal and external influences
that can brought quick/fast healing or delayed/retard healing of the wound.
THE FACTORS AFFECTING WOUND HEALING ARE;
1) Malnutrition
2) Blood supply
3) Vitamins
4) Level of immunity.
5) Healthy attitude.
6) Regular medical care.
42)
HEAT iLLNESS
Exposure to excessive heat may cause heat exhaustion or heatstroke. Heat ustion results from
excessive loss of body fluids and body salts. Symptoms include pale and clammy skin, heavy
perspiration, a weak pulse, and shallow breathing. Headache and vomiting may also occur. In
heat exhaustion the internal body temperature remains close to normal. Heatstroke, a alfunction
of the heat-control centers in the body, occurs less frequently than heat exhaustion and is much
more serious. It commonly affects .hc elderly. The symptoms of heatstroke are hot and flushed
skin, absence of perspiration, a rapid but weak pulse, rapid breathing, and a high body
temperature. The affected person may feel dizzy and lose consciousness. Victims of heat
exhaustion should rest in a cool area with their feet elevated. FUI1her cooling can be achieved
with cool water compresses and a fan. The victim should never be given .medications used to
treat fever, such as aspirin. The person suffering from heat exhaustion may feel nauseous at first,
but after resting for a period, he or she may be able to sip minimally salty water or an
electrolyte solution to replenish salt lost from perspiration. In serious cases, medical care is
required. First-aid measures for heatstroke are similar to those for heat exhaustion, but the victim
should be more aggressively and rapidly cooled, should not be given anything by mouth, and the
feet should not be raised if breathing difficulties are observed. The heatstroke victim must be
taken immediately to an emergency care center.
67
43)
COLD ILLNESS
,
Exposure to cold can lead to hypothermia, a condition in which the body's
internal temperature drops below normal. The first-aid provider should seek
medical help first, if possible, and warm a hypothermic individual by whatever
means available, including body warmth. If the victim is alert, warm, sweet
fluids may be given. If the victim is breathing at a rate less than six breaths per
minute, mouth-to-mouth or mask-to-mouth resuscitation can be started. CPR
should not be performed because a hypothermic person may have a heartbeat
even when the pulse is undetectable and any CPR may cause cardiac arrest.
\
Frostbite is a condition in which the skin freezes, initially causing pain and
redness in the affected area, 'which 'may develop into numbness and whiteness.
The first-aid provider should warm frozen areas (usually extremities) of the
victim's body slowly by using skin to skin contact, immersing frozen part in
warm, not hot, water, or using warm compresses. Avoid massaging the affected
area, which may cause tissue damage. The first-aid provider should not thaw
frozen areas that may refreeze before the victim reaches a medical facility.
68
COMPILED BY NWOKOLO
A.A
HEAD, EYE, NOSE INJURIES
Injuries to the head may involve the scalp, skull, or brain. If the victim has a
head wound, the first-aid provider should not apply pressure to it, as this may
damage the brain. The victim's airway should be kept clear from obstructions,
such as vomitus, which is common in cases of head injury. If the victim has a
seizure, a sudden spasm of the body, the head must be protected with cushions
to prevent further injury. All individuals with head injuries should be evaluated
by a physician.
Medical attention should be sought for all eye injuries as well. In the case of
foreign material in the eye, especially caustic substances, or those that can bum,
corrode, or dissolve tissues, the eye should be flushed immediately with a cool,
sterile saline solution, if available, or plain tap water for 15 to 30 minutes. The
first-aid provider should not attempt to remove embedded objects from the eye.
The most common injuries to the nose involve nosebleeds, objects lodged in the
nasal passages, and broken n~sal bones. The victim of a simple nosebleed
should sit down, lean forward, and gently pinch together the soft part of the
nose for 15 minutes. A cold compress can also be placed on the bridge of the
nose. If material lodged in the nose cannot be forced out by gently blowing the
nose, the victim should request medical help. In the case of a broken nose, the
first-aid provider should apply a cold compress to the bridge of the nose and
seek medical attention.
SPRAINS AND FRACTURES

69
COMPILED BY NWOKOLO
A.A
FRACTURES:
Fracture is a break in continuity of the bone, which may occur as a result of direct
or indirect force on the bone.
CAUSES OF FRACTURE:
(l ) Direct violence- in type of fracture the bone breaks where it is hit by
something, e.g. a car wheel running over the leg.
(2) Indirect violence-the bone break some distance away from where it is hit by
something e.g. a fracture of the humerus or clavicle caused by the patient falling on
his outstretched hand. Again a man may fracture his spine after jumping from a
height and landing on his feet with legs held rigid. The violence in this case is
transmitted through his lower limbs to his vertebral column resulting in a fracture of
one or more of the vertebrae. .
(3) Muscular action -fracture occur as a result of forcible contraction of the
muscle. Ribs are sometime broken by coughing. Another example is the knee cap
can be broken by the forcible contraction of the quadriceps extensor group of
muscles when they try to avoid backward fall which many a time occur suddenly.
CLASSIFICATION OF FRACTURE
(l) simple fracture or closed fracture: The bone is broken but there is no communication
directly or indirectly between the broken bone and the extensors
In other words the skin is not broken.
(2) Compound fracture or Open fracture: In this type the bone is broken as well as the
skin/muscle immediately surrounding the broken bone. The danger of this type of
fracture is infection because the skin which breaks allows micro organisms to
enter the body thereby infecting wound and/or bone.
TYPES OF FRACTURES:
a. GREEN STICK:Is at times called incomplete fracture, which occurs

among the children's bone. Here the child's bone breaks on one side while
the other side bends resulting to fracture.
b. COMMIUNTED FRACTURE: Here bone breaks into several pieces of up

to three pieces of bones of the same bone.
c. PATHOLOGIC FRACTURE: Is the broken of the bone caused by disease
which led to the weakening of the bone i.e. osteoporosis
d. DEPRESSED FRACTURE: This occurs in flat bones like the bone of the
(head) skull which during breakage depresses in, as it cracks.
71
COMPLICATED FRACTURE: It is the type of fracture where bone

btttaks involving other tissues like the joint, artery,
flesh, ligaments and
()~ers.
r IMPACTED FRACTURE: Is the type of fracture
where the end of one of
the broken bones is pushed into the other and tightly
wedged together
thereby shortening the length of the bone. This can
happen in a fracture of
the femur.
SIGNS AND SYMPTOMS

FRACTURE:
A. Deformity
B. Shortening of the length of the bone.(the injured limb

may be shorter than
it's fellow of the opposite side due to "over riding"
which occurs due to the
pull of strong muscles which may pull the lower part of
the bone over the
upper part)
C. Unnatural movement of the broken part.

D. History of injury to the affected part of the body.
E. There is pain at the site of the fracture.
F. The area is tender and swollen.
G. BRUISING OCCURS.
H. There might be shock.
I. Loss of function and power in the affected part.
FIRSTAID TREATMENT FOR
FRACTURES:
a) Position: Patient should be kept lying down unless the

particular fracture
makes this position unsuitable.
b) Prevent infection by immediately covering any wound

with a clean
dressing as soon as possible.
c) Stop hemorrhage by all means.
d) Treat shock
e) Immobilize the injured.part.
f) Arrange for transportation to the hospital.
AIMS OF FIRST AID TREATMENT FOR FRACTURES:
To prevent further movement of the fractured part which if not

properly managed
might result in simple fracture becoming
compound/complicated fracture ..
72
To arrange for transportation that will carry the patient to the

hospital/health
facility as quickly as possible for x-ray and treatment.
If fracture is compound/complicated type to stop bleeding and

undertaker suitable
treatment in order to prevent infection of the fragment.
GENERAL PRINCIPLE OF FIRST AID TREA TNEMT IN
FRACTURES
A patient with fracture should never be moved unless there is

enough people to lift
and carry him/her satisfactorily.
DISLOCATION:
Dislocation is the displacement of bone from its anatomical

position which is
caused by twist or severe wrench which may also tear the
ligaments and tendon
of affected joints.
Almost any bone can be pulled or knocked from its joint if
enough force is
73
applied. Dislocation usually affects joints that move, such as

the ankles, knees,
hips, wrists, elbow and, most commonly, the shoulders and
fingers.
Non mobile joints, such as in the pelvis, can also be

"separated" when a
ligament that holds the joint together is stretched or
tom.
Dislocation of a vertebra can be life-threatening if it

damages nerves or the
spinal cord. Dislocation of a vertebra sometime occurs in
spinal cord trauma
which can cause paralysis.
SIGNS AND SYMPTOMS OF

DISLOCATION
(I) Severe pain and tenderness.
(2) Inability to move the joint normally,
(3) Sometimes numbness down the limb occurs due to the
stretching of the
nerves.
(4) Swelling and deformity.
(5) Redness on
the affected
area.
(6) Weakness
on the affected
'area.
TREATMENT:
DO NOT TRY TO PUT THE BONE BACK INTO

POSITION, BUT MOVE
THE LIMB AS LITTLE AS THE PAIN CAN ALLOW.
(I ) Support the injured part in the most comfortable
position using plenty of
padding.
(2)If the dislocation has taken place at any joint of the upper
limb apply a sling
to support the part.
(3Ifany of the joint of the lower limbs are involved, a splint
may be applied.
(4)It is important to transport the patient to the health
facility/hospital as quickly
as possible to have the bones replaced into their natural jointed
position. It is
easier to replace the bones if the injury has just occurred.
(5) Analgesic medication may be given to relieve pain,
antibiotics to treat any
possible infection.

Emergency For Community Health

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4)

FEDERAL GOVERNMENT APPROVED

FEDERAL GOVERNMENT APPROVED SCHOOL OF HEALTH TECHNOLOGY LECTURE NOTE ON

EMERGENCY FOR COMMUNITY HEALTH WORKER STUDENTS .........................................................................................1

TYPES OF ACCIDENT ...............................................................................................................................................................4

FIRST AID: ..................................................................................................................................................................................5

ROAD TRAFFIC INJURIES (RTI) .............................................................................................................................................10

DOMESTIC ACCIDENTS: .........................................................................................................................................................11

OCCUPATIONAL ACCIDENTS .................................................................................................................................................12

RAILWAY ACCIDETS: ...............................................................................................................................................................13

DISCUSSSING THE COMMON EMERGENCY CONDITION IN THE COMMUNITY: ...............................................................14

ACUTE ABDOMENAL PROBLEM ............................................................................................................................................27

POISONS AND DRUG OVERDOSE ........................................................................................................................................29

WHO IS AT RISK OF DEHYDRATION;- ....................................................................................................................................33

PROLONGED LABOUR ...........................................................................................................................................................35

BLOOD LOSS ...........................................................................................................................................................................42

PRESSURE POINT ..................................................................................................................................................................44

FAINTING, SEIZURES, UNCONSCIOUSNESS AND COMA ...................................................................................................50

COLD ILLNESS .............................................................................................................................................................................68

HEAD, EYE, NOSE INJURIES .....................................................................................................................................................69

SPRAINS AND FRACTURES ......................................................................................................................................................69

1) Road traffic accident (RTA). (13) Animal bite eg. Snake

2) Home or domestic accident. (14) Burns.

3) Work place occupational or (15) Dislocation and fractures.

4) School accident eg. During games (16) Suffocation.

5) Natural disaster eg. Flood, (17) Drowning

7) Air traffic accident. (19) Chocking

8) Electrocution (electric shock). (20) Falls

9) Chemical poisoning. (21) Frostbite.

10) Gun shot. (22) Sport injuries

11) Sharp object cuts.

12) Insect stinging.

COMMON EMERGENCY CONDITIONS IN THE COMMUNITY

REASONS FOR FIRST AID

RULES OF FIRST AID

I. The first step is to call for professional medical help.

D-DANGER-Assess the place where the ill/injury took place, so that

THE CONTENT OF A STANDARD FIRST AID BOX

Adhesive bandage strips,

Elastic bandage, 3 inches wide

Eye cup or small plastic cup

Sterile eye wash (saline/distilled H20)

Source: American Red Cross

EXPLAIN THE CONTENT OF FIRST AID BOX:

ROAD TRAFFIC INJURIES (RTI)

CAUSES OF ROAD TRAFFIC ACCIDENTS:

1) . Excessive speed 3) Poor street light

MEASURES TO PREVENT ROAD TRIFFIC ACCIDENTS/INJURIES

i. Stop excessive speed on the road by installation of speed limit device

ix. Rearing of animals on the high ways should be stopped.

Xl. Individuals, families, communities, schools and other groups should

THE MOST FREQUENT DOMESTIC ACCIDENTS ARE:

1) Poisoning by items like (drug, insecticides, rat poisons, antiseptics,

4) Falls: A fall is an event which results in a person coming to rest

CAUSES OF DOMESTIC ACCIDENTS

1) Keeping the poisons within the reach of the children.

Always observing the home/domestic safety rules of each family/home.

d. floor of the factory ,must be well constructed and spilling of c.,

e) Factory buildings must be well ventilated with windows and skylights.

CAUSES OF RAIL\VAY ACCIDENTS

lVIEASURES OF PREVENTING RAILWAY ACCIDENT ARE:-

DISCUSSSING THE COMMON EMERGENCY CONDITION IN THE