EMERGENCY

FIRST AID AT
WORK
 Introduction
 Trainer(s)

 Participants

 Name/Something we don’t know about you

 Certification rules

 House Keeping
TOPICS TO BE COVERED
Introduction to First Aid
Incident and Casualty management; Mass Casualty
Incidents
Breathing emergencies
Medical emergencies
Injuries
Environmental Emergencies
Emergency child birth
Movement of casualties
Stress Management(Open discussion)
END OF COURSE EXAMINATION
 The immediate help given to a casualty
after an accident or sudden illness using
available resources before handing over to
a medically trained person or hospital.

NB:PREVENTION is key in First Aid

 Casualty
 Casualty/Patient:
 Injured or Medically Ill person, in need of first aid
 Casualty rights:
 Right to the highest standards of emergency care
 Right to privacy
 Right to express their opinions and exercise their freedoms, including
freedom to refuse treatment
 Right to non-discrimination
 Right to life, including respect to life
First Aider

 An individual that has undergone a prescribed training and certified

in first aid.
 The certificate needs to be valid
 Renewal is usually annually
 AIMS OF FIRST AID
 PRESERVE LIFE

 PREVENT FURTHER INJURIES

 PROMOTE RECOVERY

 ALLEVIATE SUFFERING
 First aid is not just concerned with physical illness.

 Psychological and emotional care alleviates suffering

First Aid Chain of Survival
 Qualities of a Good First Aider
 Knowledgeable

 Skilled and Competent

 Willing to Assist

 Keeps healthy

 Can make decisions

 Bold/Courageous/Brave

 Swift/Fast/works with speed

 Resilient/able to work under high stress

 LEGAL ISSUES IN FIRST AID

1. Duty of Care (your obligation)

2. Negligence
3. Consent
4. Recording
INCIDENT MANAGEMENT
EMERGENCY ACTION PLAN (E.A.P)

 A detailed step by step process for assessment and treatment of

casualties at a scene of an incident.

 There are unique challenges that will arise

 Nature of the scene (safety, security, location)

 Number of and condition of casualties

 Number and competence of responders

 Availability of additional resources

 Who is in charge
 Steps In Emergency Action Plan
A – Assess the situation

M – Make area safe

E – Emergency Aid provision

G – Getting Additional help

A - Dealing with aftermath

 1. ASSESMENT
IMPORTANT QUESTIONS
 What happened? (Past)

 What is happening? (Continuous)

 What might happen? (Future)

 2. MAKE AREA SAFE
Safety Priority (ABC)

1. AIDER(Yourself)
2. BYSTANDERS
3. CASUALTY
ENGAGE IN LIFE SAVING PRIORITIES
D. DANGER
R. RESPONSE
A. AIRWAY
B. BREATHING
C. CIRCULATION
D. DCAPBTLS/SAMPLE HISTORY

DR ABCD
 Getting Additional Help
 Additional Help can come from

 Other First Aiders/First Responders

 Ambulance and EMS team

 Fire department (as necessary)

 Law enforcement (as necessary)

CALLING FOR HELP. WHAT
DO YOU NEED TO CONVEY?
 GET HELP:
PHONE CALL CONTENTS 4WCT

WHO

WHERE

WHY

WHAT

CONFIRMATION

TIME
G-Plus Emergency Ambulances

4396989

9090119

1199 (Toll Free)-Emergency Ops Centre

 Aftermath
Involves:-

 Clearing the Incident Scene

 Waste disposal

 Handing Over

 Restocking the First Aid kits

 Debrief and psychosocial care

 MCI TRIAGE

Triage

Triage is a system of sorting casualties to

determine the order in which they will receive
medical care and transportation to definitive care
Highest Priority
Patients whose
survival requires care
or transport without
delay
Second Priority
Patients who will
survive even if care is
delayed
 Low Priority
Patients who do not
require or will not benefit
from prompt care

Dead Victims

With Minor Injuries

CASUALTY ASSESSMENT
CASUALTY MANAGEMENT

 This involves care of victims before transfer to hospital or

medical help arrives
 Always remember the Acronym- DR ABC

Danger
Response
Airway
Breathing
Circulation
DANGER
Body Substance Isolation (BSI)

 Assume that all body fluids are potentially infectious

 Be aware of the risks associated with emergency medical care.

REMEMBER…IF IT IS WET,STICKY AND IT IS NOT

YOURS…DON’T TOUCH IT!
RESPONSE
 A-Alert

 V-Voice

 P-Pain

 U-Unresponsive
 If casualty is Unresponsive,
call for Help and
Proceed as CAB
 Carotid CIRCULATION
• Carotid
Brachial • Femoral
Femoral
• Brachial
• Radial
Radial • Dorsalis pedis

Dorsalis pedis

Done to determine if heart is pumping

Carotid pulse
 Neck or carotid  Wrist or radial
pulse pulse
 Arm or brachial  Groin or
pulse femoral pulse
DORSALIS
PEDIS
 AIRWAY
What your tongue could do..
Open Airway
Obstructed Airway
 AIRWAY

Head Tilt Chin Lift

Head Tilt Chin Lift
Jaw Thrust
 BREATHING

PRIORITIES
• Look (rise & Fall of Chest)
• Listen (breath sounds)
• Feel (warmth from mouth)
 Recovery position

 Usedfor Unconscious but

Breathing casualties
 If the casualty shows signs of no breathing and
circulation(unresponsive) what is the next step of
action?

CPR! CPR !! CPR!!!

CPR
Cardio-
Pulmonary
Resuscitation
 Cardiac Arrest
 Cardiac Arrest:

 occurs when the heart suddenly stops functioning as a PUMP

 There is therefore no blood flow to all body organs

 It is accompanied by no breathing
 Causes
Adults Infants and Children
• Problems with the heart • Same as adults BUT
– Heart Disease (Heart failure) mainly from

– Diseases of blood vessels – Diseases with severe

diarrhea and vomiting
• Near drowning
– Severe pneumonia
• Poisons and Intoxication – Chocking

• Electrocution – Poor sleeping positions

– Child physical abuse

• Shock from severe bleeding
 What is CPR?

 CPR helps keep blood and oxygen flowing to the brain and heart (vital
organs); and buys time until you can use an Automated External
Defibrillator (AED) or until professional help arrives.

 NB. The earlier you start CPR (cardiac arrest casualty’s) the greater the
chances of survival/Only effective for a short period of time
 Circulatory System
 Consists of heart,
blood vessels, blood

 Heart pumps blood

to lungs and rest of
body.

 Pulse is generated
when heart
contracts.
CHEST COMPRESSION
RESCUE BREATHS
• Approach Safely

• Check responsiveness. If unresponsive

• Get Help (call, shout)

Shout for help
• Assess PULSE and other signs of life

• If No Pulse, give 30 Chest Compressions

•
Begin CPR
Open Airway (Head Tilt, Chin Lift)

•
30
Give 2 Rescue Breaths chest compressions

• 2 rescue
Continue CPR (30:2) for 2mins, breaths
and reassess

30uninterrupted
NB: If unsafe to give breaths, perform :2 Chest compressions
only
Infant CPR
• Locate top and bottom of sternum.
• Place the heel of your hand in the center of the chest,
in between the nipples.
Complications of CPR
 Broken ribs

 Check and correct your hand position.

 Gastric distention

 Caused by too much air blown too fast and too

forcefully into stomach

 Regurgitation

 Be prepared to deal with it!

CPR Chain of Survival
 THE S.T.O.P OF C.P.R…

S – Casualty STARTS BREATHING

spontaneously
T - Transfer of care
O – You are OUT OF BREATH
P – Physician (Doctor) tells you to
stop
 Approach safely
Check response
Activate EMS
Locate the heart
Give 30 Compressions
Open and clear Airway
Give 2 rescue breaths
Continue 2 min or 5
cycles
Assess D, and E as well
D. DANGER
R. RESPONSE
A. AIRWAY
B. BREATHING
C. CIRCULATION
D. DISABILITY- confirm the level of
consciousness (AVPU)
E. EXPOSE (maintain decency and privacy)
S. Secondary Survey and SAMPLE history
Defibrillation

An automated external defibrillator.

AUTOMATED EXTERNAL
DEFIBRILLATOR (AED)
Analyzes the
heart rhythm
Advise if shocks
are necessary
Deliver the
shocks
 Have partner
resume CPR
 Attach device
 Turn on
defibrillator power
• Attach electrodes and adhesive
pads
If victim starts to breathe and there is a pulse
place the victim in recovery position
 SAMPLE HISTORY

• S (signs and symptoms)

• A (history of any allergies)

• M (Are you taking any medications, as prescription medication or over

the counter)

• P (any relevant past medical history)

• L (Ask about last meal taken)

• E (ask about the events that led to the illness, e. g what were you doing
before this occurred)
Secondary Survey
 Identify any other injuries
 Rapid Trauma Assessment
Perform a rapid Top to toe
assessment on Casualties to
determine underlying
injuries.
THIS IS THE SECONDARY
SURVEY
 DCAPBTLS
Deformities
INSPECT Contusions
PALPATE Abrasions
Punctures/Penetrations
Burns
Tenderness
Lacerations
Swelling
Deformities
Contusions
Abrasions
 Punctures/
Penetrations
Burns
Tenderness
Lacerations
Swelling
Top to Toe
Assessment
Head
Neck
Chest
Abdomen
Pelvis
Legs & Hands
 BACK

Roll patient with spinal precautions and assess

Back of body for injuries or signs of injury.
 SAMPLE HISTORY

S (signs and symptoms)

A (history of any allergies)
M (Are you taking any medication, as
prescription medication or over the counter)
P (any relevant past medical history)
L (Ask about last meal taken)
E (ask about the events that led to the illness,
e. g what were you doing before this occurred)
BREATHING PROBLEMS
 CHOKING
Foreign
bodies in the
airway
 Causes
Tongue falling back
In unconscious persons
Foreign bodies
Fluid, solid, stomach contents or other
Swelling of upper airway
Due to allergy, infection, trauma or
tumor
 Signs of choking

PARTIAL COMPLETE

Wheeze between Clutching of the neck

cough when partial with thumb and
obstruction fingers(universal
High pitched noise choking sign)
when breathing in Inability to breathe or
Difficulty breathing speak
Unconsciousness Movement of airway
may be absent
Death
Ask “ are you choking ?”
If responds and coughs
ENCOURAGE TO COUGH
If not…
Undertake Heimlich
maneuver /Abdominal
thrust for Adult
 Chest thrust

Appropriate for:
• Pregnancy more than 3
months /obese victims
• When in doubt always
use chest thrusts
 Management of FBAO in Children

 In a conscious child:
 Kneel behind the child.
 Give the child five
abdominal thrusts.
 Repeat the technique
until object comes out.
Management of choking in Infants

5 Chest thrusts 5 Back slaps

RECAP
MEDICAL
EMERGENCIES
 Process of giving first aid to
casualties

 Determine your own safety

 Approach casualty and determine responsiveness.

 If unresponsive BUT has signs of life, put in recovery position and

assess for clues to illness (Look, smell, ask bystanders)

 If responsive, introduce yourself and offer your self to assist

 Get SAMPLE history if possible

 Provide First Aid

MEDICAL EMERGENCIES
 HYPOXIA
 ASTHMA
 ANAPHYLACTIC SHOCK(Allergy)
 FAINTING
 DIABETES
 SEIZURES(EPILEPSY)
 DISORDERS OF THE HEART
 STROKE
 HYPOXIA
 Is a condition that arises from insufficient oxygen levels reaching
the body tissues; from the blood.

Causes of hypoxia:

 Airway obstruction; by foreign objects like food & teeth in the

windpipe, inhalation of foreign fumes (choking).

 Blockage by the tongue, fluids like vomit.

 Internal swelling of the respiratory system e.g. after a burn ordeal or

anaphylaxis shock.
 Management

 Open and maintain the airway

 Give ventilations-Artificial breaths

 Refer to hospital
ASTHMA
 Pharynx
Air

Hypopharynx
 Constriction of the air passages Trachea

normally triggered by dust, cold

Bronchi Bronchioles
weather, pollen grains, and fur
from animals or even fabrics. R. lung L. lung
(3 lobes) (2 lobes)
Diaphragm
 The air passages are usually (separates chest from abdomen)

blocked by thick sticky mucus.

Recognition Features
 Wheezing especially when breathing out
 Tightness in chest
 Whispered speech
 Anxiety and distress
 History of previous episode
 Medication e.g. inhalers
 Deteriorating levels of consciousness
 MANAGEMENT
 Reassure and calm the casualty

 Sit them leaning forward

 Ensure adequate supply of air

 Help them to take medication

ANAPHYLACTIC
SHOCK
Anaphylaxis
Massive allergic

reaction due to

1. Stings

2. Ingestion

3. Injection

4. Absorption
Signs and symptoms
 Rapid deterioration in consciousness
 Partial Airway obstruction (wheezing)
 Swellings round face & neck
 Rapid weak pulse
 Puffiness around the eyes
 Wide spread red blotchy skin
eruptions.
 Management
 Manage ABCs

 Reassure the victim

 Identify source of allergy and keep victim

away from the same.

 Give Epinephrine to reduce swelling

Epi-pen/ Adrenalin
injectors
SYNCOPE
(Fainting)
FAINTING

 Brief loss of consciousness normally caused by

the Brain being temporarily starved of
oxygenated blood.
RECOGNITORY FEATURES
 Yawning (air hunger)
 Brief loss of consciousness
 Pale face
 Sweaty skin
FIRST AID FOR FAINTING
 Ensure the ABC are taken care of
 Lay the casualty head and shoulders lower than the legs(PLR)
 Ensure adequate ventilation
 If conscious for more than three minutes turn them to recovery
position and continue monitoring
DIABETES
(DM)
Hypoglycaemia

Low blood sugar.

 Sweating

 Headache

 Rapid pulse

 Blurred vision

 Decreased coordination and concentration

Hyperglycaemia
High blood sugar
General weakness
Extreme thirst
Frequent urination
Fruity breath
Nausea and vomiting
Abdominal pain
Deep rapid breathing
 Diabetes Management

 Conscious-Give sugar drink or oral glucose,

ask about his medications

 Unconscious-Manage the ABCs,place

something sweet under the tongue and seek
urgent medical help
Instant glucose provides a high concentration of sugar.
SEIZURES/CONVULSIONS
 Seizure
A sudden, temporary alteration in
behavior caused by massive
electrical discharge in a group of
nerve cells in the brain.
 Causes
• Epilepsy – most common
• Other causes:
 High fever
 Infections
 Stroke
 Poisoning
 Drugs or alcohol
 Head trauma
Hypertension
 Shock
 Complications
 Hypoxia of pregnancy
Hypoglycemia
Management & Care

During
 Keep the victim safe by moving objects
or the patient away
 Do not interfere with the fits
 Do not put anything inside the mouth
After
 Clear the airway and ensure adequate
breathing
 Place in the recovery position
 Control any bleeding and stabilize any other
injury
 Stay with victim until he/she fully recovers
 Take To Hospital If
 First time fits

 Fits are continuous

 Victim remains unconscious for more than

30 minutes

 Injured after fits

Heart and Circulatory
problems
 The Heart
Pulmonary Aorta
arteries

Superior Pulmonary
Vena Cava veins

Left Atrium
Right Atrium

Right Ventricle Left ventricle

Inferior Vena Cava

Angina pectoris
(chest pain)
Angina
(Narrowing of
Coronary
Arteries)
Heart Attack
(Blockage of
Coronary Artery
 Heart attack
Signs and Symptoms

Squeezing, dull pressure, chest pain

commonly radiating down the left
arm ,back or to the jaw.
Breathing problems, dizziness &
sweating.
Nausea and vomiting
 PREVENTIVE MEASURES
Eliminate cigarette smoking
Control hypertension
Manage cholesterol levels
Control diabetes
Exercises
Eliminate obesity
STROKE
Stroke/Cerebral vascular
disease
 Blood clot deprives a portion of
the brain from an adequate
supply of oxygen.

 High blood pressure increases

the risk of stroke.
STROKE (Brain Attack)
 Occurs when a
part of the
brain is starved
of oxygen.
Signs and Symptoms of
Stroke

 Headache  Inability to speak

 Dizziness  Difficulty seeing

 Confusion  Unequal pupil size

 Drooling  Unconscious

 Numbness/paralysis on one  Convulsions

side of body  Respiratory arrest
 Incontinence
 Stroke Scale
 A tool to determine if a patient is showing signs or symptoms
of stroke:

 Facial droop-Is there weakness on one side?

 Arm drift-Are they able to lift and support both arms?
 Speech-Are they comprehensible?
 Stick Out The Tongue-Does it appear
crooked?
 Time-If any sign observed, call EMS.
 Care for Stroke
 Maintain an open airway.

 Provide psychological support.

 Place an unconscious person in recovery

position.

 Be prepared to provide rescue breathing.

 Stroke patient
management.

CONSCIOUS VICTIM
• Rest victim laying down head and
shoulders supported.
• Loosen clothing around neck chest and
waist.
• Monitor airway. Breathing and
Circulation.
• Call EMS

FOR AN UNCONSCIOUS VICTIM

• Turn victim to the recovery position
weaker side down.
• Monitor ABC
• Stay with victim until EMS Arrives.
 INJURY
EMERGENCIES
Amount of Blood in the
Body?
 Average is 6 Lts. Equivalent to 12 Pints

 If you lose ½ L, you feel dizzy and weak.

 If you lose between 1 & 2 Lts, you get signs

of shock.

 If you lose more than 3 Lts, Heart may stop,

pulse at the wrist becomes un-detectable.
Start CPR Promptly
BLEEDING AND SHOCK
Bleeding occurs due to rupture of blood vessels that is
veins, arteries and capillaries

TWO TYPES OF BLEEDING

 External- can be seen
 Internal -from internal organs
Arterial bleed;
 bright red, bleeding profuse and jetting/spurting
out blood (hard to control)
Venous bleed;
 Dark red, easy to control doe to less pressure,
mostly a flowing blood (controllable)
Capillary bleed;
 bleeding often clots spontaneously
 Types of Bleeds

Recognizing the types of external bleeding.

A. Capillary. B. Venous. C. Arterial.
(2 of 2)
 Nose bleeding-Epistaxis
Place the patient in a
sitting position
leaning forward.
Apply direct pressure
by pinching the
fleshy portion of the
nostrils together
Apply finger tip pressure directly on
the point of bleeding ...\OFA VIDEOS\Bleeding Control_ Venous Bleeding.mp4
 INTERNAL BLEEDING
 Mouth cough up (from lungs)

 Mouth vomited (upper abdomen)

 Ear oozing (skull fracture)

 Anus stool (lower abdomen)

 Urethra ( bladder)

 Vaginal discharge (menstrual/abuse/labour)

 INTERNAL BLEEDING

RECOGNITORY FEATURES
 History of injury
 Cyanosis-blueing of extremities
 Sign and symptoms of shock
 Cold clammy skin
 Blood may come out from the body orifices
 FIRST AID FOR INTERNAL BLEEDING
 Lay casualty head and shoulders lower than the legs
 Loosen tight clothing
 Reassure and explain the necessity of relaxing
 Treat for any other injuries as required
 When conscious put to recovery position and monitor
 Keep the casualty warm but do not give anything to eat or drink
 Observe and note progress with ABC as the priorities
 Be ready to resuscitate

 Arrange URGENT evacuation to hospital

AMPUTATION
 Amputations

 Wrap amputated part in sterile dressing

 Place in plastic bag and keep cool
 Transport with patient
 Do not complete partial amputations
 Immobilize to prevent further injury
 SHOCK
 If bleeding is not taken care of, the victim might
go into SHOCK

 Shock is insufficient supply of oxygen and

nutrients in the body

 Signs include cold clammy skin, thirst ,dizziness,

deteriorating levels of consciousness
 Make sure that you place your casualty at a safe place.
 Get help
 Assist the casualty to lie down with his or her back
 Apply PLR
 Meanwhile treat the cause of shock e.g. use pressure to
control bleeding.
 Cover the victim with a blanket; one on top, another
beneath, to insulate the casualty from the ground effects.
 Treatment for Shock

Offer nothing to eat, drink, or smoke

If bleeding is SEVERE control the bleeding

If bleeding is SLIGHT prevent infection

 INJURIES into the skin or the body surfaces can cause
wounds.

 There are two types of wounds (open & closed)

 Open wounds bleed and are a source of infection. While closed wounds only
bleed under the skin (bruise, black eye & a blister)
 Avulsion

Flaps of skin or tissue are torn

loose or pulled completely off
Penetration/Puncture

 Caused by sharp
pointed object
 Internal bleeding
may be severe
 Exit wounds may
be present
 Impaled Objects

Do not remove an impaled object, unless

it is through the cheek, it would interfere
with CPR, or interferes with transport.
 Pierced Objects
 Expose wound
 Control bleeding
 Utilize a bulky
dressing to help
stabilize object in
place
 Abrasion
 Outermost layer
of skin is
damaged by
shearing
forces.
 Painful injury,
although
superficial
 No or very little
oozing blood
Contusion
 Epidermis
remains
intact
 Swelling and
pain are
present
 Blood

accumulation
causes
discoloration
Laceration
 Break in skin of
varying depth
 May be linear or
stellate
 Caused by forceful
impact with
sharp object.
 Bleeding may be
severe
INCISED WOUNDS
 These are the types of wound that
are caused by a clean cut to the
tissues as a result of sharp edges
such as knifes razors or even
paper. The wounds may bleed
profusely.
GUNSHOT WOUNDS
 Could lead to serious
internal injuries. The entry
point is always very neat
while the exits are always
very rough and rugged and
could come out with
internal body parts.
Gunshot Wound
General First Aid Treatment for
Wound & Bleeding
E Examine the wound/bleeder

X eXpose the wound

P Pressure direct/indirect

E Elevate the affected area (higher that the heart)

C Cover the casualty the wound

T Treatment for shock

CHEST INJURIES
GUNSHOT WOUND(GSW)
UNDERGROUND ROCK FALL
Penetrating chest wounds

 These are sucking wounds that may

result in the collapsing of either of the
lungs caused by accumulation of air
( Pneumothorax) or blood
(haemothorax) in the chest cavity.
PNEUMOTHORAX
Penetrating Chest Injuries
Apply occlusive dressing to
open wounds
Injuries Within the Chest Cavity

Flutter Valve
ABDOMINAL
INJURIES
Abdominal wounds
Evisceration
Management
 Abdominal
Injuries

Evisceration

 Do not touch or try to replace

 Cover with sterile dressing,
moistened with sterile water or saline
 First Aid
Treatment for
abdominal
injures.
EMBEDDED
BODIES
Impaled/Embedded Objects
RING PAD
 Impaled
Objects

Do not remove an impaled object,

unless it is through the cheek, it would
interfere with CPR, or interferes with
transport.
 FIRST AID FOR EMBEDDED BODIES

 Remove small particles by carefully wiping or rinsing with

water
 Never attempt to remove embedded foreign bodies
 Apply direct pressure at the sides of the wound to control
bleeding
 Secure the foreign body with bandages to limit movements
 Keep the injured part elevated and immobilize
 Arrange urgent removal to hospital
 Treat the casualty for shock
MUSCULOSKELETAL
INJURIES
 Definition
 Fracture – break, crack or chipping of the bone

 Dislocation – displacement of two or more bones at a

joint

 Sprain – ligament injuries (joints)

 Strain – injuries to muscles due to overstretching

SOFT TISSUE INJURIES

SPRAIN
&
STRAIN
 Musculoskeletal Review

Tendons – specialized
connective tissue that connects muscle to
bone
Ligaments – specialized
connective tissue that connects bone to
bone
SPRAIN
Sprain is the wrenching, tearing or overstretching of ligaments
at a joint by direct or indirect force on the joint
STRAIN
Strain is the wrenching, tearing or overstretching of muscles or
tendons either by direct or indirect force

DISLOCATION
This is a total displacement of joints as result of direct or
indirect force on the joint
DISLOCATED FINGER
DISLOCATED ANKLE
DISLOCATED OPEN WRIST
SOFT TISSUE INJURIES

First Aid Treatment

Rest
Ice
Compress
Elevate
Improvise
FRACTURES
Some or all of the following signs and symptoms occur in most
bone and joint injury:

 Swelling and discoloration

 Deformity and irregularity
 Protruding bone ends
 Inability to use the limb
 Swelling around the injured area
 Granting sounds as bone ends rub together
 Sign of shock increasing with severity of injury
 Pain made worse by movements
 Tenderness on touching
Foot Injuries
Thigh/Femur
 Fractures

Closed Open
Principles of Splinting
 Remove clothing.

 Assess limb.

 Cover all open

wounds with dressing.

 Do not attempt to
move before splinting.

 Immobilize joint
above and below
injury.
Apply Manual
Stabilization
Measure Splint
 Apply splint
immobilizing
the bone and
joint above and
below the
injury.

Secure entire injured

extremity
Management
 Joint
Injury

Immobilize the
site of injury
Immobilize
bones above
and below site
of injury
Elbow Injuries
RECAP
ENVIRONMENTAL
EMERGENCIES
NEAR-DROWNING
 Near DROWNING

 Near Drowning -
involuntarily submersion
of the body.

 Hypoxia(Oxygen
starvation) leads to
unconsciousness
 What to expect
 Airway obstruction

 Cardiac Arrest

 Signs of a heart attack

 Injuries to the head and neck

 Internal injuries

 Hypothermia

 Substance abuse

 Spinal injuries
 FIRST AID
 Take care of the ABC’s as a priority
 Be ready to resuscitate
 If breathing adequately, place in recovery position
 Treat for hypothermia
 Do not induce vomiting or force water out
 Keep on reassuring the casualty
 Arrange transfer to hospital
CPR FOR DROWNING CASUALTIES

 Rescue breaths may be

difficult due to water in the
lungs
 Give ventilations with a little
bit more force
 If gastric distention interferes with
you ability to ventilate the patient,
place patient on his left side, and
place your hand over the epigastric
area and apply firm pressure to
relieve the distention.
POISONING
 POISON

Any substance which if introduced in your

body in sufficient quantity causes either
temporary or permanent harm
 Route of entry into the body

Poisons can enter the body through:

The skin ( absorbed) - Chemicals on the skin
The lungs (inhaled) - Inhaled gases
The mouth (ingested) – swallowed poisons
The blood stream (injected) - Drug & substance abuse
 Routes of Exposure
INGESTION INJECTION
Cleaners
Meds Bites
Drugs

Toiletries Stings
Plants
ABSORPTION
INHALATION
Plants

Sprays
Solvents
CO Insecticides Chemicals
 General effects of poisoning
Breathing problems
Abdominal pain
Vomiting & Diarrhea
Skin reactions
Seizures
Organ damage (eyes, liver, heart, kidneys, etc.)
 Aims of first aid
Ensure airway and breathing

Manage any seizures

Prevent further contamination by dispersing any

chemicals on the skin or in the eyes

Identify poisonous substance

Call for help

 Swallowed poisons

Try to identify poison, look for empty

containers or other evidence

Never make the casualty vomit; If lips are

burned by chemicals.

Be prepared to perform life-saving

techniques
Chemicals on the skin

Ensure your own safety- do not

become contaminated
Flood the affected area with water
Attempt to remove any contaminated
clothing
Do not attempt to neutralize acid or
alkali burns
 Inhaled gases

Ensure your own safety- do not inhale fumes

Move casualty away from fumes
Provide good ventilation
Be prepared to apply CPR if casualty stops breathing
 Poisons in the eye
Ensure your own safety- do not become contaminated
Hold eye under running water for at least 10 minutes
Ensure that water drains away from the face
Place loose, sterile eye dressing over eye
Don’t remove contact lenses, or touch the eye
 Alcohol Poisoning

 May be accompanied by empty cans or bottles, and an alcohol smell on

the breath

 Keep an open airway

 Be prepared to perform life-saving techniques

 Do not induce vomiting

Food poisoning

Encourage casualty to rest

Give lots of fluids to prevent
dehydration
Poisoning Prevention
Properly label all poisonous substances
Keep poisons in their original container
Store poisons out of reach of children and away
from food
Understand and follow doctors’ prescriptions
Generally avoid behavior that may expose you
to poisoning case.

Prevention is better than cure!

BITES

AND

STINGS
 Bee stings

Causes

massive allergic reaction

(anaphylaxis) from the venom

 Care & Management

Aim:

 Remove the stinger without inducing release of more venom

 Relieve pain and reduce swelling

 Care & Management

 Scrap the stinger off by using a plastic card

 Apply ice at the site to reduce swelling and pain

 Scrape stinger out
 Avoid using tweezers or
forceps as these can squeeze
venom into the wound

If stinger present,
remove it
Snake Bites
 Snake bites

 Can be poisonous or non poisonous

 Poisonous snakes would usually leave two puncture marks at
the site when the fangs pierce through the skin
 Snake bites cause panic which in turn raise the heart rate
Snake Bites
 Care & Management
 Wash area with soap and water

 Ensure an open airway

 Reassure the victim

 Minimize the spread of the venom(Use an elastic

bandage)

 Take the patient to hospital immediately

 Care & Management
Actions:
 Scene safety
 Lay the casualty down and keep the heart higher than the
site
 Reassure and clean the bite site with water
 If it’s at the extremities Immobilize like a fracture
 Take to hospital immediately
DONT’S

 Apply a tourniquets
 Cut or slice at the wound
 Suck the venom
BURNS
 The Skin

Epidermis
Capillary
network
Sebaceous Dermis
glands

Shaft of
Hair
hair Subcutaneo
Hair root
follicle
us
(Bulb,
Sweat fatty
papilla)
gland tissue
Muscle fibers
Deep fascia
 Burns & scalds
Damage to the skin caused by heat

Burns are caused by dry heat where as scalds are

caused by moist heat.
 SEVERITY DETERMINANTS
 CAUSES
 LOCATION
 AGE (<5-55>)
 DEPTH
 EXTENT
 PRE-EXISTING MEDICAL CONDITIONS
 Rule of 9's

Compares burn area

to casualty's palm
Palm equals
approximately
1% of BSA
 Head & neck 9
Posterior trunk 18
Anterior trunk 18
Each upper extremity 9
External genitalia 1
Each lower extremity 18

14 9
18 18
14
Posterior trunk 9
18
ELECTRICAL BURNS
Chemical Burns
Treatment Chemical Burns
Chemical Burns to Eyes
 Superficial Burn (1st
Degree)

•Involves the outermost layer of the

skin (epidermis)
•Pain at the site
 Partial Thickness Burn (2nd
Degree)

Involves both the dermis and epidermis

Intense pain; blisters may form
White-to-red skin that is moist and spotted
 Full Thickness Burn
(3rd Degree)

Burn involves all dermal layers and may include

muscle, bone, or organs
Dry and leathery skin; Charred
Little or no sensation;; pain at periphery
 Assessment
And Care

Ensure safety & do a Body Surface Area Estimation

Help the casualty lie down (as this may help prevent shock).
Cut around areas of clothing that adhere to patient; do not attempt to
remove adhered fabric.
Remove jewelry and any clothing on fire; (advise the casualty to STOP,
DROP & ROLL)
 Stop The
Burning
Process
Use water or saline
to cool burn injuries
(Copious amount)

in the first 10 minutes of injury.

Cover the injured area with a sterile dressing to protect
it from infection.
Be ready to resuscitate (burn to the face)
 PRECAUTIONS WHEN GIVING
FIRST AID FOR BURNS
Constrictions, e.g. watches and rings must be removed before swelling starts

 DO NOT overcool the burn you might lower their body temperature

 DO NOT remove anything sticking to the burn

 DO NOT break blisters

 DO NOT touch the burn with your bare hands

PRECAUTIONS WHEN GIVING
FIRST AID FOR BURNS

 DO NOT breath, talk or cough over the burn

 DO NOT apply lotion, oils Vaseline, butter or fat to the

injury

 DO NOT cover the burn with cotton wool, fluffy

materials, adhesive dressings or tape

 DO NOT underestimate burn seriousness

RECAP
HEAD INJURIES
Recognition of an head injury
CONCUSSION
This is defined as
shaking of the brain
following a violent
blow to the head
leading to temporary
but wide spread
disturbance, brief loss
of consciousness and
loss of memory.
 Concussion:
Recognition features
 History of violent blow to the head.

 Brief loss of memory of events preceding the

blow.

 Nausea and possible vomiting

 Mild headache

 Blurred vision.
COMPRESSION
This is the exertion of
pressure on the brain
either by clotted blood or
swelling of the brain
pressing itself against the
skull. This could be hours
after experiencing a
concussion.
Compression: Recognition
 Rapid deterioration in levels of response
 Airway is partially obstructed
 Noisy breathing
 Slow weak but full pulse
 Weakness on one side of the body
 Unequal pupils
 History of concussion
 Skull Fracture
 A skull fracture may result from
either direct or indirect force. i.e. a
violent blow to the head can cause
fracture directly or landing flat on
the feet from a height can cause a
fracture to the base of the skull.
LINEAR SKULL FRACTURE
COMPRESSED SKULL FRACTURE
BASILLAR SKULL FRACTURE
OPEN SKULL FRACTURE
 Skull Fx: Recognition
 Rapid deterioration in levels of response
 Noisy breathing
 Racoon eyes
 Clear or blood stained discharge from ear and or nose.
 Unequal pupils
 Battle’s sign
 Swelling around the affected part
 Soft area at the point of injury
Raccoon eyes
Battle’s sign
 Management of skull fracture

 Ensure manual head stabilization

 Ensure the ABC’s are present and clear

 Do not move the casualty unnecessarily

 Call for an ambulance

EMERGENCY CHILD
BIRTH
Anatomy of a Pregnant
Woman
 The Female Reproductive System
 Ovaries: Produce eggs
 Uterus: Holds fertilized egg as it develops
 Fallopian tubes: Connect ovaries and uterus
 Birth canal (vagina): External opening
 Foetus: Developing baby
 Umbilical cord: Delivers nutrition and removes waste products from
developing infant
 Placenta: Draws nutrients from uterus which are then transported
through umbilical cord
Equipment for Delivery
 Sterile gloves
 Sterile towels
 4 x 4 gauze pads
 Bulb syringe
 Umbilical cord clamp/strings
 Sanitary pads
 Towel or blanket for baby
 Preparation for Delivery
 Wash your hands thoroughly.

 Place a towel or sheet under the woman.

 Have plenty of towels on hand.

 Place the woman in a comfortable position (often on back with knees

bent and legs drawn up and apart).-Lithotomy Position
STAGES OF LABOUR
 Stage 1: First contraction to Crowning lasting
between 6-24hrs

 Stage 2: Crowning to Delivery of the child

 Stage 3: Delivery of child to Delivery of the

Placenta (afterbirth)
1st Stage
of Labor
Delivery is
imminent
Last an average
of about 16hours
 2nd Stage
of Labor

Birth of the infant

3rd Stage
of Labor

Delivery of the
Placenta
Assisting With Delivery
 Have the woman lie on
her back with her knees
drawn up and apart.

 Tell the mother to

breathe rapidly.

 Do not attempt to pull

the baby during delivery.
 Crowning

The infant’s head appearing at the

opening of the birth canal.
 Place your gloved fingers on
the bony part of the infant’s
skull, and exert gentle
pressure to prevent explosive
delivery.

(Continued)

Use caution to avoid

fontanelles
 As infant’s head is being born,
support the head, suction mouth two
(Continued)

or three times and then the nostrils.

 Wrap infant in a
warm blanket and
place on its side,
head lower than
trunk.

Receive newborn
in clean or sterile
towel. Grasp feet
as they are born.
Caring for the Newborn
 Clear mouth and nose.

 Dry infant with towel.

 Wrap child to keep warm.

 Place infant on side with head slightly lower than

trunk.
Aftercare of the Mother
 Observe mother and baby.

 Recheck firmness of uterus.

 Recheck vagina for excessive bleeding.

 Clean mother with towels.

 Cover vaginal opening.

 Observe for
delivery of
placenta.

 Expect delivery within 10 – 20 minutes

 Guide placenta from vagina when it
(Continued)
appears by grasping and rotating –
NEVER PULL
 Do not delay transport
 1st clamp

2nd clamp Clamp, tie,

and cut
umbilical
cord.

Wait for pulsations to cease (Continued)

 1st Clamp approximately 4 finger’s

width from the infant
STEP 1 STEP 2 STEP 3

STEP 4 STEP 5 STEP 6

COMPLICATIONS
Prolapsed Cord
 Prolapse of Umbilical Cord

 Umbilical cord comes out of the vagina before the baby is

born.

 A serious emergency that requires rapid transport

 Prop the mother’s hips and legs higher than the rest of her
body.

 Keep cord covered and moist.

TRANSPORT
OF
CASUALTIES
 Movement Determinants
• Distance
• Transport Aids
• Weight (Not heavier than you)
• Terrain
• Bulk
General Principles
 Do no further harm to the patient.

 Move patient only when necessary.

 Move patient as little as possible.

 Move patient’s body as a unit.

 Use proper lifting and moving

techniques.

 Have one rescuer give commands.

 The Principles
 Keep your back straight
 Use the body’s strongest muscles
 Keep load close to the body
 If of irregular weight, heaviest side closest to the body
 Safety is always a priority
 Push rather than pull
 Maintain a firm grip
 Use the most correct and safest way to move
 Consider injuries
 If aids are available, use them in the most convenient way
Straight Back
Power Grip
Recommendations
 Delay movement.

 Treat patient before starting the move.

 Try not to step over patient.

 Explain to patient what is going to be done

and how.

 Move patient as few times as possible.

Body Mechanics
 Ensure your own safety.
 Exercise good body mechanics.
 Use leg muscles when lifting.
 Get close to patient and keep your back
straight.
 Lift without twisting.
 Assess the weight of your patient.
Body Mechanics
 Know your limitations. Call for additional help if
needed.

 Communicate with all those lifting.

 Practice lifts and moves.

(3 of 3)
Emergency Movement
 Move patients immediately when:
 Danger of fire, explosion, or structural collapse
exists.
 Hazardous materials are present.
 Accident scene cannot be protected.
 Access to other seriously injured patients is
needed.
 CPR must be performed.
 Emergency Drags
 Clothes drag

 Cardiac patients and clothes drag

 Blanket drag

 Arm-to-arm drag

 Fire fighter drag

 Emergency drag from a vehicle

Clothes Drag for Cardiac
Patients
 Incline Drag
Clothes Drag
 Fireman’s Drag

Shoulder Drag
 One Rescuer Assist

Blanket Drag
Carries for Nonambulatory
Patients
 Two-person extremity carry
 Two-person seat carry
 Cradle-in-arms carry
 Two-person chair carry
 Pack-strap carry
 Direct ground lift
 Draw-sheet method
One-Person Walking Assist
 Stretchers

Wheeled Portable
ambulance stretcher
stretcher
Stair Chair
Suspected Head or Spine
Injury
 Move patient as a unit.
 Transport patient face up.
 Keep patient’s head and neck in a neutral
position.
 Be sure all rescuers know what is being done.
 Be sure only one rescuer is giving commands.
 Log Rolling

 Primary technique to move patient onto a long backboard

 Move patient as a unit.

 Keep the patient’s head in a neutral position at all times.

 Head Immobilization
 Blanket roll

 Commercial devices

 Head stabilization must be maintained throughout entire procedure.

Movements When alone
Movements When you are two
 Direct
Ground
Lift

(no suspected
spine injury)
(no suspected spine injury)

Extremity Lift
Movements When your more than two
Fireman’s Lift