P.E 3 (Individual, Dual, First Aid and Water Safety)

P.
E 3
Individual/Dual
Sport/ First Aid and
Water Safety
Prepared by: James R. Dela Cruz, R-Crim.

Instructor
CHAPTER 1
PAGE \* MERGEFORMAT 15
BASIC CONCEPTS of FIRST AID in RELATION to HUMAN RIGHTS and VICTIMS
WELFARE
Answer first the following questions:
1. If you hear the word First Aid, what is the first idea comes to your mind?
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2. If one of your family members experiences a Respiratory arrest, what will you do if
there’s no medical assistance available?
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3. If you see someone drowning, would you help her or not? And why?
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4. If someone needs first aid, what is the first thing you should need to do?
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5. If someone refuse to accept first aid and its just a minor injuries, would you still apply
first aid or not? And why?
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INTRO DUCTION:
When a person is injured or becomes ill, it rarely happens in a hospital with doctors
and nurses standing by. In fact, some time usually passes between the onset of the injury or
illness and the patient’s arrival at the hospital, time in which the patient’s condition may
deteriorate, time in which the patient may even die. As a First Aider, you can make a
difference.
FIRST AID - is an immediate care given to a person who has been injured or suddenly taken
ill. It includes self-help and home care if medical assistance is not available or delayed.
- Assessments and interventions that can be performed
by a bystander (or by the victim) with minimal or no medical equipment
Roles of First Aid:
1. Bridge that fills the gap between the victim and the physician.
 It is not intended to compete with, or take the place of the services of the physician.
 It ends when the services of a physician begin.
2. Ensure personal safety and that of patient / bystander.
3. Gain access to the victim.
4. Determine any threats to patient’s life.
5. Summon more advanced medical care as needed.
6. Provide needed care for the patient.
7. Assist Emergency Medical Technician (EMT) and medical personnel.
8. Record all assessments and care given to the patient.
Objectives of first Aid:

 To alleviate suffering.
 To prevent added or further injury or danger.
 To prolong life.
Hindrances in Giving First Aid

1. Unfavorable Surroundings
 Nighttime.
 Crowded city streets; churches; shopping malls.
 Busy highways.
 Cold and rainy weather.
 Lack of necessary materials or helpers.
2. The Presence of Crowds
 Crowds curiously watch, sometimes heckle, and sometimes offer incorrect advice.
 They may demand haste in transportation or attempt other improper procedures.
 A good examination is difficult while a crowd looks on.
3. Pressure from Victim or Relatives
 The victim usually welcomes help, but if he is drunk, he is often hard to examine and
handle, and is often misleading in his responses.
 The hysteria of relatives or the victim, the evidence of pain, blood and possible early
death, exert great pressure on the first aider.
 The first aider may fail to examine carefully and may be persuaded to do what he
would know in calm moments to be wrong.
Basic Equipment: See Figure 1 – 3
Spine board Sets of splints
Short board Poles
Blankets
Suggested First Aid Kit Contents (Basic):
Rubbing alcohol Gloves

Povidone Iodine Scissors
Cotton Forceps
Gauge pads Bandage (Triangular)
Tongue depressor Elastic roller bandage
Penlight Occlusive dressing
Band aid
Plaster
Figure 1 – 3
Supplies and
equipment first
aider may have
available.
Clothe materials commonly used in First Aid:
Dressing or Compress - any sterile cloth materials used to cover the wound.
See Figure 1 – 4
Other uses of a dressing or compress:
 Control bleeding.
 Protect the wound from infection.
 Absorbs liquid from the wound such as blood plasma, water and pus.
Kinds of dressing:
 Roller gauze.
 Square or eye pads.
Compress or adhesive:
 Occlusive dressing.
 Butterfly dressing.
Application:
 Completely cover the wound.

 Avoid contamination when handling and applying.
Bandages - any clean cloth materials sterile or it is use to hold the dressing in place. See
Figure 1 – 5
Other uses of bandages:

 Control bleeding.
 Tie splints in place.
 Immobilize body part.
 For arm support – use as a sling.
Kinds:
Triangular Four-tail
Cravat Muslin binder.
Roller Elastic bandage.
Application:
 Must be proper, neat and correct.
 Apply snugly not too loose not too tight.
 Always check for tightness may cause later swelling.
 Tie ends with a square knot.
Triangular Bandage - Usually made from a 45"-50” inch square piece of cloth, cut from one
corner to the opposite to form a triangle.
40”x40”x56” minimum standard.
Guidelines in Giving Emergency Care:
I. Getting Started – Planning of action gathering of needed materials initial response

as follows:
 Ask for HELP- In a crisis, time is of essence. The more quickly you recognize an
emergency, and the faster you call for medical assistance, the sooner the victim will
get help. Immediate care can greatly affect the outcome of an emergency.
 Intervene - It means to do something for the victim that will help achieve a positive
outcome to an emergency. Sometimes getting medical help will be all you can do,
and this alone may save a life. In other situations, however, you may become actively
involved in the victim’s initial care by giving first aid.
 Do not further HARM - Once you have begun first aid, you want to be certain you
don’t do anything that might cause the victim’s condition to worsen. Certain actions
should always be avoided and by keeping them in mind, you will be able to avoid
adding to or worsening the victim’s illness or injuries.
Emergency Action Principles
Survey the scene - Once you recognized that an emergency has occurred and decided to
act, you must make sure the scene of the emergency is safe for you, the victim(s), and any
bystander/s. It is a quick assessment of the surroundings that will provide you with as much
information as possible.
Take time to survey the scene and answer these questions:
Is the scene safe?
 What happened?
 How many people are injured?
 Are there bystanders who can help?
 Then identify yourself as a trained first aider.
 Get consent to give care.
The following are elements of survey the scene for the first aider to perform before
providing care to a victim:
1.1 Scene Safety.

Look for possible threats for personal safety, patient, and bystander.
Personal Safety - Focused first on ensuring the well-being of the first aider See
Figure 3 -2. You cannot help your patient if you become a victim yourself. In any
emergency risks of exposure to communicable diseases are present. In order to prevent any
contamination proper body substance isolation decisions early in the emergency will
prevent needless exposure later on (refer to module 1: Introduction to BLS-CPR, precautions
to prevent disease transmission). In situations of crime scene, acts of violence, and unsafe
scene, you should consider asking appropriate personnel to secure the scene before
providing care. Like for crime scene and acts of violence you might need the assistance of a
police or local official; for unsafe areas like fire, car collisions, hazards of chemicals, and
other alike, a well trained personnel will be necessary. But remember that it takes time for
additional personnel to arrive so try to make the scene safe as your capability permits.
Patient / victim – Our next concern will be the patient/victim. If there are potential
dangers that cannot be stabilized you might need to perform special measures to offer
additional protection to the patient. Like removing the patient from a hazardous environment,
such as a burning car, a home with a gas leak, or a car filled with carbon monoxide, are
lifesaving actions before proper care can begin. But not all need to be removed, like to
prevent patient exposure from/to broken glasses and metal shrapnel’s, from an automobile
accident, instead of removing you can place a blanket on the patient.
Bystanders – Safety of the onlookers or bystanders is also our concern.

Bystanders can become a problem when they try to help or direct your care. Protect yourself
and bystanders alike by moving them to a safe area or assigning them a specific task.
Figure 3 – 2 Securing
the scene to prevent
other complications.
Mechanism of Injury or Nature of Illness.
 Careful evaluation of the scene, including the possible mechanism of injury and/or
the nature of illness, along with the other information that you gather will help
determine the condition of the victim and what will be the next possible action of the
first aider.
Mechanism of Injury - Is what caused the injury (e.g., a rapid deceleration causing the
knees to strike the dash of a car; a fall causing a twisting force to the ankle) See Figure 3 –
3.
Certain injuries are considered “common” to particular accident situations. Injuries to

bones and joints are usually associated with falls and vehicle collisions; burns are common
to fires and explosions; penetrating soft tissue injuries can be associated with gunshot
wounds, and so on.
Even if you cannot determine the exact injury the patient has sustained, knowing the
mechanism of injury allows you to predict various injury patterns.
Figure 3 – 3 Mechanism of injury and affected areas

of the body.
Nature of Illness – There are similarities between the mechanism of injury and the nature of
illness. Both require you to search for clues regarding how the incident occurred. Nature of
illness is often best described by the patient’s chief complaint: the reason for providing care.
In order to quickly determine the nature of the illness, talk with the patient, family, or
bystanders about the problem. But at the same time, use your senses to check the scene for
clues as to the possible problem.
1.2 Determine the number of patients and additional resources.
 As part of survey the scene, it is essential that you accurately determine the total
number of patients. This determination is critical for your estimate of the need for
additional resources.
What to do in Survey the Scene
Before You Approach the Victim.

When you survey the scene, look for anything that may threaten your
safety and that of the victim and bystanders.
As You Approach the Victim.

Try to find out what happened. Look around the scene for clues to what
caused the emergency and the extent of the damage. Doing this will cause you to
think about the possible type and extent of the victim’s injuries.
Once You Reach the Victim.

Quickly survey the scene again to see if it is still safe. At this point, you
may see other dangers, clues to what happened, victims or bystanders that you
did not notice before.
Do a Primary Survey of the Victim:

In every emergency situation, you must first find out if there are conditions that are an
immediate threat to the victim’s life. You will discover these conditions by looking for signs,
evidence of injury or illness that you can observe. Check for vital body functions, signs of life
threatening conditions following the ABC principles. The primary survey takes only seconds
to perform. The following are the steps of performing primary survey:
 A – (Airway) is the victim conscious or unconscious?

 B – (Breathing) is the victim breathing?
Is it shallow or deep?
Does he appear to be choking?
Is he cyanotic?
 C – (Circulation) is the victim’s heart beating?
Assess pulse.
Is he severely bleeding?
Activate Medical Assistance ( AMA ) or Transfer facility:

In some emergencies, you will have enough time to call for specific medical advice
before administering first aid. But in some situations, you will need to attend to the victim
first. Decision in activating medical assistance or transfer facility would make a higher rate of
survivability for the victim due to continuing chain of survival in providing early defibrillation
and advanced cardiac life support.
Activate Medical Assistance or transfer Facility if:

- The first aider is alone, CALL FIRST, that is, activate medical assistance or arrange
transfer facility before providing care for:
- An unconscious adult victim or child 8 years old or older, and
- An unconscious infant or child known to be at a high risk for heart problems.
The first aider is alone, provide 1 minute of care, and then CARE FIRST for:
- An unconscious victim less than 8 years old;
- Any victim of submersion or near drowning;
- Any victim of arrest associated with trauma;
- Any victim of drug overdoes.
The situation in Call First should be assumed to be cardiac emergencies, such as
sudden cardiac arrest, and the time factor is critical. Research shows that the shorter the
time from collapse to first shock of AED, the greater chance of survival for an adult or child 8
years old or older. For an infant or child with a known risk for heart problems, early access to
the EMS system and the advanced medical care that results increases that victim’s chance
of survival.
In the Care First situations, the conditions are most often related to breathing
emergencies rather than sudden cardiac arrest. In these situations, providing support for
airway, breathing and circulation through rescue breaths and/or chest compressions, as
appropriate, is the most important initial step a trained responder should take.
When the first aider is with a companion, you could instruct your companion to activate
medical assistance or transfer facility while you provide the care to your victim. See Figure 3
–4
Figure 3 – 4
Ask your
companion to
get help.
Information to be relayed:
 What happened
 Number of persons injured.
 Extent of injury and first aid given.
 The telephone number from where you are calling.
 Person who activated medical assistance must drop the phone last.
Do a Secondary Survey of the Victim

Once you are certain that the victim has no life-threatening conditions, you can begin the
third EAP. The secondary survey is a systematic method of gathering additional information
about injuries or conditions that may need care. These conditions are not immediately life
threatening but could become so if not cared for. The following are not in order; it will depend
on the condition of the victim or situation of the accident.
Interview the Victim.

By asking the victim and bystanders simple questions, you learn more about what
happened and the victim’s condition.
Ask the following questions:

 Introduce yourself.
 Get permission to give care.
 Ask the victim name.
 Ask what happened.
Elements of the SAMPLE history are:

1. S -Signs and Symptoms of the episode.
2. A -Allergies, particularly to medications.
3. M - Medications, including prescription, over-the-counter, and recreational (illicit)
drugs.
4. P -Past medical history, particularly involving similar episodes in the past.
5. L - Last oral intake, including food and/or drinks. This is particular important if the
patient may need surgery.
6. E - Events leading up to the episode.
Check Vital Signs.

Vital signs can tell you how the body is responding to injury or illness. Note anything
unusual. Recheck vital signs about every 5 minutes for trauma, at least 15 minutes for
medical cases.
PULSE - Each time the heart beats; the arteries expand and contract with the blood that
rushes into them. The pulse is the pressure wave generated by the heartbeat. It directly
reflects the rate, relative strength, and rhythm of the contractions of the heart.
When you take a pulse, note the following:

 Is the pulse rate slow or fast? See Table 3-2
 What is the strength of the pulse? A normal pulse is full and strong. A thready pulse
is weak and rapid. A bounding pulse is unusually strong.
 What is the rhythm of the pulse? A normal pulse has regular spaces between each
beat. An irregular one is spaced irregularly. You can describe the pulse of a patient,
for instance, as “72, strong, and regular.” The rate, strength, and regularity of a pulse
tell what the heart is doing at any given time.
The pulse can be felt at any point where an artery crosses over a bone or lies near the
skin. First Aider often takes a pulse at the wrist. This where the radial artery crosses over the
end of the forearm bone, the radius.
Steps to take the radial pulse

 Have the patient lie down or sit.
 Gently touch the pulse point with the tips of two or three fingers. (Avoid using your
thumb. It has a prominent pulse of its own, which can be counted by mistake).
 Count the number of beats you feel for 30 seconds and multiply by 2. This will give
you the number of beats per minute. If a pulse is irregular, slow, or difficult to obtain,
count the beats for 60 seconds for a more accurate reading.
 Write down the pulse and any other vital sign immediately. Never rely on your
memory.
Other points where a pulse may be taken include the brachial artery in the upper arm,
the carotid artery in the neck, the femoral artery in the groin, the dorsalis pedis on the top of
the foot, the posterior tibial artery on the middle surface of the ankle, and the apical pulse
under the patient’s left breast (requires a stethoscope). See Figure 3 - 9
Checking pulses in several areas will help to determine how well the patient’s entire
circulatory system is working. The absence of a pulse in a single extremity may indicate a
blocked artery. If left untreated, numbness, weakness, and tingling follow pain. The skin also
gradually turns mottled, blue, and cold.
Normal Ranges for Respiration

AGE RANGE
ADULT 12 – 20/min.
CHILD 18 – 25/min.
INFANT 25 - 35/min. PAGE \* MERGEFORMAT 15

RESPIRATION - A respiration consists of one inhalation and one exhalation. The normal
number of respiration per minute varies with gender and age.
Steps to take the respiration
1. Place your hand on the victim’s chest or abdomen.

2. Count the number of times the chest (or abdomen) rises during a 30-second period. Then
multiply that number by 2. But to get an accurate reading, count a 60-second period.
If the patient is aware that you are assessing respiration, he may not breathe naturally.
This can give a false reading. To get around this, take a pulse with the patient’s arm draped
over his chest or abdomen. Count the pulse for 30 seconds. Then without moving the
patient’s arm, count respirations for the next 30 seconds. See Figure 3 – 10 Reading are
easily obtained by observing and feeling the chest rise and fall with your hand, which is
already on the patient’s torso.
Figure 3 – 10 Means of assessing

respiration.
SKIN APPEARANCE
Assessment of the skin temperature, color, and condition can tell you more about the
patient’s circulatory system.
1. Skin Temperature. Normal body temperature is 98.6 °F (37 °C). The most common
way First Aider take temperature is by touching a patient’s skin with the back of the
hand. This is called relative skin temperature. It does not measure exact
temperature, but you can tell if it is very high or low.
2. Skin Color. Skin color can tell you a lot about a patient’s heart, lungs, and other
problems well.
For example:
 Paleness may be caused by shock or heart attack. It also may be caused by
fright, faintness, or emotional distress, as well as impaired blood flow.
 Redness (flushing) may be caused by high blood pressure, alcohol abuse,
sunburn, heat stroke, fever, or an infectious disease.
 Blueness (cyanosis) is always a serious problem. It appears first in the fingertips
and around the mouth. Generally, reduced levels of oxygen as in shock, heart
attack, or poisoning cause it.
 Yellowish color may be caused by a liver disease.
 Black-and-blue mottling is the result of blood seeping under the skin. It is usually
caused by a blow or severe infection.
If your patient has dark skin, be sure to check for color changes on the lips, nail beds,
palms, earlobes, whites of the eyes, inner surface of the lower eyelid, gums, and tongue.
You may also wish to check the patient’s nail beds. This is called assessing capillary
refill. See Figure 3 – 11 It is one way of checking for shock. Capillary refill is
recommended only for children under 6 years of age. Research has proven that it is not
always accurate in adults.
Squeezing one of the patient’s fingernails or toenails performs this procedure. When
squeezed, the tissue under the nail turns white. When you let go, the color returns to the
tissue. To assess capillary refill, you have to measure the time it takes for the color to
return under the nail. Two seconds or less is normal. If refill time is greater than two
seconds, suspect shock or decreased blood flow to that extremity. Capillary refill may be
checked on infants by squeezing the palm of the hand or sole of the foot and watching for
color to return.
Figure 3 – 11 Capillary refill is done by squeezing the fingernails and then being release. Observe the
return of color from white to pink.
Skin Condition
Normally, a person’s skin is dry to the touch. When a patient’s skin condition is wet
or moist, it may indicate shock, a heat-related emergency, or a diabetic emergency. Skin that
is abnormally dry may be a sign of spine injury or severe dehydration
Do the HEAD to TOE examination.

 HEAD – look and feel for cuts & bruises
 EYES – check compare pupils
 NOSE, EAR & MOUTH –check for fluid or blood
 NECK – feel for injury
 COLLAR BONE – check & compare shoulders
 CHEST/RIBS – check & compare chest
 ABDOMEN - check for tenderness, press abdomen using fat parts of the fingers
 HIP BONE – press slowly, inward & upward
 LEG – one at a time
 ARM – one at a time
 SPINAL COLUMN – press gently from cervical region down to the lumbar
Record all Assessment & Time.
Golden Rules of Emergency Care:

What to do:
1. Obtain consent, whenever possible.
2. Think the worst.
3. Call or send for HELP.
4. Identify yourself to the victim.
5. Provide comport & emotional support.
6. Respect victim’s modesty and physical privacy.
7. Care for the most serious injuries first.
8. Assist the victim with his or her prescribed medication.
9. Keep onlookers away from the injured person.
10. Handle victim to a minimum.
11. Loosen all tight clothing’s
What not to do:

1. Do not harm.
- Trying to arouse an unconscious victim.
- Administering fluids/alcoholic drink.
2. Do not let the victim see his own injury.
3. Do not leave the victim except to get HELP.
4. Do not assume that the victim obvious injuries are the only ones.
5. Do not deny victims physical or emotional coping limitations.
6. Do not make unrealistic promises.
7. Do not trust the judgment of a confused victim.
8. Do not require the victim to make decision.
Characteristics of a Good First Aider:

1. Observant – should notice all signs
2. Resourceful – should make the best use of things at hand.
3. Gentle – should not cause pain.
4. Tactful – should not alarm the victim.
5. Sympathetic – should be comporting.
Terminology
First Aid
Is an immediate care given to a person who have been injured or suddenly taken ill.
It includes self help and home care when medical assistance is delayed or not available.
Human Rights
Human rights may be defined as “the supreme, inherent and inalienable rights to life,
to dignity, and to self development. It is the essence of these rights that makes man human,
Human rights are fundamental freedoms which are necessary and indispensable in order to
enable every member of the human race to live a life of dignity.
Duty of Care
A duty of care is a legal obligation set on an individual requiring that they conform to
a standard of reasonable care while performing any acts that could foresee ably harms
others. It is the first element that must be established to proceed with an action in
negligence.
Reasonable care – or the actions of a reasonable person - is a legal basis of Common Law
representing an objective standard against which any individual's conduct can be measured.
It is used to determine if a breach of the standard of care has occurred, provided a duty of
care can be proven.
What is important to remember is that one’s actions would be judged against those of a
reasonable person of the same standing in a similar situation; the actions of a First Aider
would therefore only be judged against those of someone of similar training and experience,
not against the actions or decisions of a paramedic or doctor.
Negligence
Negligence exists when a person breaches their duty of care owed to another
through an act or omission which results in an injury or a loss. This is not the same as
carelessness because someone might be exercising as much care as they are capable of,
yet still fall below the level of competence expected of them.
Common Law
-Also known as case law or precedent is law developed through previous cases by
judges and through decisions of courts and similar tribunals rather than through legislative
statutes.
Statutory Law
Statute law
-Is written law set down by a legislature, as opposed to Common Law
Please answer the following questions:
1. In your own words, what is the meaning of First Aid? (10pts)

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2. After doing a secondary survey of the victim, what is the last thing you need to
do?
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3. In checking for vital body functions, what does ABC stands for?



4. In activating medical assistance (AMA) or Transfer facility, what are the
information you need to relay?
1.
2.
3.
4.
5.
5. Enumerate the 5 Characteristics of a Good first aider.
1.
2.
3.
4.
5.
6. In Emergency action principles, what is the first thing you need to do?
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Write (F) if the statement is TRUE, and (T) if the statement are FALSE.
1. ____ Loosen all tight clothing’s.

2. ____ Identify yourself to the victim.
3. ____ Apply immediately first aid even without a consent of the victim.
4. ____ First Aid a legal obligation set on an individual requiring that they conform to a
standard of reasonable care while performing any acts that could foresee ably harms
others.
5. ____ Treat all the injuries of the victim even you are not trained.
CHAPTER 2
Principles and Practice of First Aid
Principles of First Aid
Preserve Life
First aim of first aid is to preserve life, which involves the key emergency practices to
ensure that the casualty isn’t in any mortal danger. Remember though, this includes
preserving your own life as you shouldn’t put yourself in danger in order to apply first aid. It’s
at this stage where you should do a quick risk assessment to check for dangers to the
injured person, yourself or bystanders which could cause the situation to escalate. If in
doubt, do not attempt to apply first aid and immediately call for a medical professional.
Prevent Deterioration
Once you’ve followed all the steps associated with the first principle, your next priority
is to prevent deterioration of the injured person’s condition. Keeping a casualty still to avoid
aggravating their injury, or from complicating any unseen issues, is crucial. This helps
prevent to further injuries, and clearing the area of any immediate dangers will help you to do
so.
Promote Recovery
Finally, there are steps you should follow which will help lessen the amount of time
taken for a casualty to recover from an accident and aid in minimizing lasting damage and
scarring. The prime example of this is applying cold water to a burn as soon as possible to
lower the chance of long-term scarring and helps speed up the healing process.
First Aid Practices
Taking immediate action
This is the key to the ‘Preserving Life’ principle – a quick response to an accident
can save lives and minimize the risk that things get worse. If someone needs help, either
from an injury or sickness, you shouldn’t hesitate to help if possible.
Calming down the situation
First aiders should be able to remain calm under pressure and help reduce the
overall stress levels of the injured person as well as other people who may be concerned.
Reassurance can provide more support that you might expect in an emergency situation and
help people make the right decisions.
Calling for medical assistance
Make sure to get a hold of the emergency services by calling 999 as soon as
possible, either by calling directly yourself or asking a bystander to do so if you’re
preoccupied handing the injury. This will ensure that a medical professional arrives quickly to
handle the situation in a more comprehensive manner and provide more specialist
treatment.
Apply the relevant treatment
Before a medical professional does arrive, you will need to apply first aid treatments in
order to stabilize the condition of the injured person. This comes under the ‘preserve life’
banner, and follows this flow of procedures:
 Check for consciousness

 Open the airway
 Check for breathing Follow airway, breathing, of resuscitation, administer
CPR if needed
 Check for circulation
 Check for bleeding, controlling any major bleeding
There are number treatments which correspond to the different problems that might arise as
you work through this list, e.g. CPR, applying a tourniquet, running a burn under cold water,
etc.
Emergency rescue and Transfer
Emergency Rescue – A procedure of moving a victim from unsafe place to a safe place
Indications for Emergency Rescue:

1. Danger of fire or explosion
2. Danger of toxic gases
3. Serious traffic hazard
4. Risk of drowning
5. Danger of electrocution
6. Danger of collapsing wall
Objectives of the First Aider:

1. To ensure open airway and to administer Artificial Respiration if needed.
2. To control severe bleeding.
3. To check for injuries.
4. To immobilized the injured.
5. To arrange for transportation.
6. To avoid subjecting the victim to unnecessary disturbances.
Selection in the methods of transfer depends on the following:

1. Nature and severity of injury.
2. Size of the victim.
3. Physical capabilities of the first aider.
4. Number of personnel and equipment available.
5. Nature of evacuation route.
6. Distance to be covered.
7. Sex of the victim ( last consideration )
Pointers to be observe during transfer:

1. Victim’s airway must be maintained open.
2. Hemorrhage is controlled.
3. Victim is safely maintained in correct position.
4. Regular check of victim’s condition is made.
5. Supporting bandages and dressing remain effectively applied.
6. The method of transfer is safe, comfortable and as speedy as circumstances
permit.
7. The victim’s body is moved as one unit.
8. The taller first aiders stay at the head side of the victim.
9. First aider/ bearers must observed ergonomics in lifting and during transfer of
victim.
Methods of transfer:
One – man assists/ carries/ drags
 1.1 assist to walk
 1.2 carry in arms ( cradle )
 1.3 pack strap carry
 1.4 piggy back carry
 1.5 fireman’s carry
 1.6 fireman’s drag
 1.7 blanket drag
 1.8 shoulder drag
 1.9 clothes drag
 1.10 foot drag
 1.11 incline drag
Two man assists/carries
 Assist to walk
 2.2 four hand seat
 2.3 hands as a litter
 2.4 chair as a litter
 2.5 carry by extremities
 2.6 fireman’s carry with assistance
Three mans carries
 3.1 Bearers alongside ( for narrow alleys )
 3.2 Hammock carry
Four/Six/Eight man carry

Blanket carry
Improvised stretchers – two poles with: blanket; empty sacks; shirts or coats;
triangular bandages.
SHOCK – A depressed condition of the many body functions due to the failure of enough
blood to circulate throughout the body following serious injury.
Basic causes of Shock:
1. Pump failure – the heart fails to act properly as a pump.

2. Relative hypovolemia - the blood vessels dilate so that blood within them is
insufficient to fill the system and provide efficient perfusion.
3. Hypovolemia – blood & plasma can lose so that the fluid contained within the
vascular system is insufficient to perfuse to all areas well each minute.
Causes of Shock:
1. Severe bleeding
2. Crushing injuries
3. Infection
4. Heart attack
5. Perforation of stomach ulcer
6. Shell bomb or bullet wound
7. Rupture of tubal pregnancy
8. Anaphylaxis
9. Starvation
Factors which contribute to Shock:

1. P – pain
2. R – rough handling
3. I – improper transfer
4. C – continues bleeding
5. E – exposure to extreme cold or excessive heat
6. F - fatigue
Dangers of Shock:
1. Leads to death
2. Predisposes body to infection
3. Leads to loss of body parts
Respiratory Emergency and Artificial Respiration
Respiratory Arrest – When breathing stops and circulation continues for quite some time.
Causes:
1. Obstruction
1.1 Anatomical obstruction – tongue drops back, acute asthma, croup, diphtheria
and swelling.
1.2 Mechanical obstruction – foreign objects, fluids.
2. Diseases
3. Other Causes
- Electrocution
- Circulation collapse
- External strangulation
- Chest compression
- Drowning
- Poisoning
- Suffocation
Artificial Respiration (Rescue Breathing) – A procedure of causing air flow into and out of
the lungs of a person when his natural breathing ceased or is inadequate.
Methods of Artificial Respiration:

1. Mouth – to – mouth resuscitation
2. Mouth – to – nose resuscitation
3. Mouth – to – mouth & nose resuscitation (for infant or small child)
4. Mouth – to – stoma resuscitation (for laryngectomee)
Objectives of Artificial Respiration

1. To open airway.
1.1 maximum head tilt – chin lift maneuver
1.2 jaw thrust maneuver (for head, neck & spinal cord injuries)
2. To ventilate the lungs.
Important Aspect of artificial Respiration

1. Get started immediately
2. Apply artificial respiration 10 to12 times per minute or 1 breath of 1.5 to 2 seconds, every
5 seconds (adult).
3. Maintain normal body temperature as supplementary help.
4. Continue giving artificial respiration even during transportation, if still needed.
Steps in Giving Rescue Breathing
1. Tap Shoulder
2. Call for help
3. Position the victim, Turn if necessary
4. Open airway, Head tilt, chin lift maneuver
5. Check breathlessness (look, listen & feel for 3-5 seconds) If breathless
6. Give 2 initial ventilation
7. Check pulse for 5-10 seconds. If breathless but w/ pulse
8. Activate Medical Assistance or arrange transfer facility. (Call for a Physician or any
suitable vehicle and report back while 1 perform AR.)
9. Perform 1, 1002, 1003, 1001, breath, 1, 1002, 1003, breath…1, 1002, 1003, 1010,
(or up to 12 breath)
10. Recheck pulse and breathing for 5 sec, after 1 minute & continue AR until necessary.
(Succeeding rechecking should be after more than 1 minute of AR) Place the victim
in recovery position.
Soft tissues and Specific Body Injuries
The Skin is our first line of defense against external forces. And although it is
relatively tough, skin is still quite susceptible to injury. Injuries to soft tissues range from
simple bruises and abrasions to serious lacerations and amputations. Soft-tissue injury may
result in loss of soft tissue, exposing deep structures such as blood vessels, nerves, and
bones. In all instances, you must control bleeding, prevent further contamination, and
protect the wound from further damage. Therefore, you must know how to apply dressings
and bandage to various parts of the body. Soft tissues are often injured because they are
exposed to the environment. There are two types of soft-tissue injuries: Wounds and
Burns
Classification:
1. Closed soft tissue injury.
2. Open soft tissue injury.
Common Causes:
1. External physical forces.
2. Mishandling of sharp objects, tools, machinery, weapon and equipment.
3. Explosion.
Closed Soft Tissue Injury (Closed Wound)
 Involves the underlying tissue without break/damage in the skin or mucous

membrane.
Causes:
1. Blunt objects result in contusion or bruises.
2. Application of external forces such motor vehicle accident and falls.
Factors or other injuries which may be involved:

1. Depends on varying depth
2. Depends on extent of force
3. Varying amount of edema and blood leak into the damage area
4. Possible fracture
Signs and Symptoms:

1. Pain and tenderness
2. Swelling
3. Discoloration (black or blue – ecchymosis)
4. Hematoma (pool of blood collected within the damage tissue)
5. Uncontrolled restlessness
6. Thirst
7. Symptoms of shock
8. Vomiting or cough up blood
9. Passage of blood in the urine or feces
10. Sign of blood along mouth, nose and ear canal.
First Aid
1. I – ice application – ice or cold packs
2. C – compression – manual compression over the area
3. E – elevation – elevating the injured part
4. S – splinting – immobilizing the soft tissue injury
Open Wound – A break in the skin or mucus membrane: or the protective skin layer is
damage.
Dangers:
1. Hemorrhage
 1 glass – normal
 2 – 4 glasses – anemic predisposes to infection
 4 – 6 glasses - fatal
2. Infection
 Delays healing of wound
 Gangrene may develop
 Amputation – to prolong life
 May lead to unnecessary death
3. Shock
 Predisposes body to infection
 May lead to loss of body part
 May itself lead o death
Kinds of Open wounds:
Puncture – Penetrating pointed instruments such as nails, ice picks, daggers, etc.
Characteristics – Deep and narrow; serious or slight bleeding
Dangers – Internal hemorrhage, infection & shock
Abrasion – Scrapping or rubbing against rough surfaces

Characteristics – Shallow: wide: oozing of blood: dirty
Dangers – Infection
Incision – Sharp bladed instruments like knives, bolos, razors, etc.

Characteristics – Clean cut, deep, severe bleeding, wound is clean.
Dangers – Hemorrhage, infection, shock.
Laceration – Blunt instruments such as sharpness, rocks, broken glasses, etc.

Characteristics – Torn with irregular edges, serious or slight bleeding.
Avulsion – Explosion, animal bites, mishandling of tools, etc.

Characteristics – Tissue forcefully separated from the body.
Kinds of Bleeding
1. Capillaries – Slow even flow

2. Veins – Steady flow dark red color
3. Arteries – spurting blood pulsating flow bright red color
First Aid (Emergency care)
1. C – Control bleeding.
 Direct pressure (main help: use of pressure bandage)
 Elevation
 Pressure point bleeding control – pressure on supplying artery
-brachial artery for bleeding of the arm
-femoral artery for bleeding of the leg
2. C – Cover the wound with dressing and bandage.
3. C – Care for shock.
4. C – consult or refer to physician.
Wound with bleeding not severe (home care)

1. Clean the wound with soup and water or mild antiseptic.
2. Apply a topical ointment.
3. Cover wound with dressing and bandage.
Dressing and Bandaging Guidelines:
1. Skin is not sterile. If a dressing slips over the victims skin while you are trying to
position, discard it and use a new or fresh one. Place the dressing over the wound,
don’t slide it into place.
2. Use a dressing that is large enough to extend at least one inch beyond the edges of
the wound.
3. If the body tissue or organs are exposed, cover the wound with a dressing that will
not stick, such as plastic wrap or moistened gauze. Then secure the dressing with a
bandage or adhesive tapes.
4. If the bandage is over a joint, splint and make a bulky dressing so that the joint
remains immobilized. If there is no movement of a wound over the joint, there should
be improved healing and reduced scarring.
5. A bandage should fit snugly but should not cut off circulation or cause the victim
discomfort. If the area beyond the wound changes color begins to tingle or feel cold,
or if the wound starts to swell, the bandage is too tight and should be loosened.
6. Bandaging techniques depend upon:
6.1 Size and location of the wound
6.2 Your first aid skills
6.3 Materials at hand
Use of Triangular Bandage
To hold dressing in place:

1.1 Open phase
1.1.1 Head (topside)
1.1.2 Face; back of head
1.1.3 Chest; back - Apex at the shoulder of injured part• Pull back folded base and secure
with square knot at the center indention of the back. • Knot/tie longer end with apex
1.1.4 Hand; foot - Place the hand in the middle of the triangular bandage with the wrist at
the base of the• Place the apex over the fingers and tuck any excess material into the pleats
on each side of the hand• Cross the ends on top of the hand, take them around the wrist,
and tie them with a square knot.
1.2 Cravat Phase
1.2.1 Forehead; eye
1.2.2 Ear; cheek; jaw
1.2.3 Shoulder; hip
1.2.4 Arm; leg
1.2.5 Elbow; knee (straight, bent)
1.2.6 Palm pressure bandage

1.2.7 Palm bandage of open hand
1.2.8 Sprained ankle bandage (shoe-on)
1.2.9 Sprained ankle bandage (shoe-off)
2. To immobilize or support body part
2.1 arm sling - Place folded base vertically over• One arm, with pointed directly
under the elbow of injured arm• Lower ends of base at the side of the neck using a square
knot• Make several twist with apex and tie a knot• Hide the knot-
2.2 Under arm sling - Same procedure as arm sling except that the lower end of the
base is tucked under the injured arm.• Secure end of base and apex with a square knot the
center indention at the back.
2.3 cravat sling
2.4 cuff sling
POISONING
Poison – Is any substance; solid, liquid or gas, that tends to impair health or cause death
when introduced into the body or onto the skin surface.
Causes:
 Common in suicidal attempts
 Occasional accidental poisoning
Ways in which poisoning may occur:

1. Ingestion – by mouth
2. Inhalation – by breathing
3. Injection – by animal bites
4. Absorption – by skin contact
Common Household Poisons:

1. Sleeping pills – Denatured alcohol
2. Pain relievers – Lye and acids including boric acid
3. Antiseptics – poisonous plants
4. Insect and rodent poisons – Contaminated water
5. Kerosene – Fume
Some Preventive Measures of Poisoning:

1. Keep all drugs and harmful chemicals locked-up away from children’s reach.
2. Never take medicine in the dark.
3. When taking medicine, read the label three times; before, during and after taking the
medicine.
4. Dispose promptly of incomplete prescription drugs and expired medicine.
5. Do not consume canned goods which have rusty tins and bulging top and bottom.
6. Transfer immediately liquid contents from tin cans after opening.
7. Do not consume food which has foul odor, unusual color, molds, etc.
8. Refrigerate foods which contain cream, milk, mayonnaise and other mixtures which
easily change flavor when left unrefrigerated.
9. Educate older children regarding the dangers of poisoning and drugs.
Common Signs and Symptoms:

1. Headache, irritability
2. Chills
3. Increased salivation, pain on swallowing
4. Dizziness, weakness, drowsiness
5. Pale skin
6. Fever
7. Depression
8. Loss of appetite
9. Nausea, abdominal pain, diarrhea
10. Vomiting
11. Double vision, blurred vision disturbance, pupils unusually large or small
12. Unusual breath odor
13. Numbness and dryness of the nose or mouth
14. Skin rash, chemical burns on skin
15. Chemical burns around the nose and mouth, facial burns, singed nasal hairs
16. Bluish lips
17. Chest pain, cough, shortness of breath, difficulty breathing
18. Heart palpitations
19. Muscle twitching
20. Loss of bladder or bowel control
21. Seizures
22. Stupor
23. Unconsciousness
General Reminders:
1. Identify the Poison.
2. Call local Poison Control Center or nearest physician for advise.
3. Do not wait for signs and symptoms to develop if you suspect poisoning
emergency.
4. Do not use any universal antidote.
5. Do not neutralize the poison with vinegar, lemon juice or any substance or
unless you are told to do so by the poison control center or physician.
6. Do not induce vomiting unless you are told to do so by the poison control
center or physician.
7. Do not give an unconscious victim anything by mouth.
8. Do not rely solely on product label information which maybe incorrect.
First Aid:
1. Check victim’s ABCs.
2. If the victim is having seizure, protect him from injury and give first aid for convulsion.
3. If the victim throws up protect the airway.
4. Calm and reassure the victim and keep him comfortable.
BONE, JOINT, AND MUSCLE INJURIES
Musculoskeletal System - Consists of bones, joints and muscle, gives the body a
framework and allows movement.
Muscle – Expand and contract and enables us to move, attached to the bones.
Bones – Help support to the body, protect some internal organs.
Ligaments – Connects bones to each other at flexible joints.
Synovium – Produces syneovial fluid to lubricate joints.
Common Causes of Injuries:

1. Vehicular accidents
2. Motorbike
3. Mishandling of tools and equipment
4. Falls
5. Sports
Injuries involving Bone, Joint, & Muscle.
 Stiff muscle – caused by overexertion, ache, sore, no loss of function.

 Tendonitis – inflammation of a muscle tendon due to repeated use.
 Muscle cramp (spasm) – sudden painful tightening of a muscle.
 Muscle strain or pulled muscle – sudden, painful tearing of muscle fiber during
exertion.
- Pain, swelling, bruising, & loss of efficient movement.
 Sprain – occurs when joint loosens caused by torn fibers in a ligament.
- Painful, swelling, bruising.
 Joint effusion – occurs when the synovium fills up with blood.
 Joint dislocation – bones come out of alignment.
- Pain, misshapen appearance, swelling and loss of function.
 Broken bones (split or snap)
Closed fracture – skin is not broken.
Open fracture – one or both ends pierce the skin.
First aid for Muscle cramps.

 Have the victim stretched out the affected muscle to counteract the cramp.
 Massage the cramped muscle firmly but gently..
 Apply heat. (Use a heating pad or hot water bottle wrapped in cloth)
 Get medical help if cramps persist.
First Aid for Muscle Strain (pulled muscle)

 Apply cold compression at once. Reapply every 3 to 4 hours for the first 24
hours.
 Elevate the limb to reduce swelling and bleeding within the muscle.
 Get medical help if the victim is in great pain or if a body part is not working
properly.
Some reminders:
 If the muscle feels better after 24 hours, apply heat as often as possible for
the next 3 to 4 days.
 Do not apply direct heat to skin.
 If the problem has not improved in 24 hours get medical help.
 A strained muscle should not be used as long as it is painful.
First Aid for Sprain:

 Remove all clothing or jewelry around the joint.
 Apply cold compress at once. Ready them as often as possible (at least for
20 minutes every 3 – 4 hours for 1st 24 hours.)
 Elevate the affected joint with pillow or clothing. Do not move the injured part
for at least 24 hours.
 The victim’s physician may recommend an over the counter anti –
inflammatory medication (aspirin, ibuprofen) appropriate for the victim’s
general health.
Dislocation and Broken Bone:

1. General Information.
 If a joint is overstressed, the bones that meet at that joint may get
disconnected, or dislocated. When this happens there is usually a torn joint
capsule and torn ligaments and often, nerve injury.
 If more pressure is put on a bone more than it can stand, it will fracture (split
or break). Open fractures 9 in which bone pierces the skin) easily become
infected.
 If an infant or toddler does not start to use an injured arm or leg within hours
of an accident, or if he or she continues to cry when the injured area is
touched, assume the child has broken bones, get medical help.
 It is hard to tell a dislocated bone from a broken bone. Both are an
emergency. The general first aid steps are the same for both.
Burns and Environmental Emergencies
Burns – Is an injury involving the skin, including muscles, bones, nerves, and blood vessels.
This results from heat, chemical or radiation.
Seriousness of Thermal Burns

Factors that determine the Seriousness of Burns
a. The depth.
b. The amount of surface area.
c. Involvement of Critical Areas.
d. The patient’s age
e. Patient’s general health.
Critical Burns:
1. All burns complicated by fracture
2. Any degree of respiratory injury.
3. Third degree burn with more than 10% of the body surface area.
4. Second degree burns with 25% of the body.
5. Moderate Burn in an elderly or critically ill patient.
6. For children, any third degree burn and second degree burn of the body.
Moderate Burns:
1. Third degree burns with 2 to 10% of the body.
2. Second degree burns that involve 15 to 25% of the body..
3. First degree burns with 50% or more of the body.
4. For children, a second degree burns of 10 to 20% the body.
Minor Burn:
1. Third degree burns with less than 2% of the body.
2. Second degree burn of less than 15% of the body.
3. For children, a second degree burn less than 10%
.
Thermal Burns:
Sign and Symptoms
1. Red Skin (1st degree burns)
2. Swelling (1st degree burns)
3. Blisters (2nd degree burns)
4. Peeling Skin (3rd degree burns)
5. Pain
6. Shock
7. For an Airway burns:
- Charred mouth
- Singed nose hairs or eyebrows
- Burns on the head, face and neck
- Difficulty in breathing; coughing
First Aid for Thermal Burns:

1. Stop the burning process and prevent injury.
2. Cover the burned area with dry, sterile and non adhesive dressing.
3. Support the patient’s vital functions.
4. Transport the patient promptly to the hospital that has necessary capabilities
to care a burn.
5. If fingers or toes have been burned, separate them with dry, sterile, non-
adhesive dressing.
6. For airway burns-
a) Maintain open airway.
b) For conscious victim, place him in a position easiest for him to breath.
c) For unconscious victim, place him in a recovery position.
Chemical Burns:
Causes
 Strong acids
 Strong alkali
 Strong chemical fumes
First Aid for Chemical Burns:

1. Basically the same with Thermal burns.
2. Do not neutralize but flood the area with water immediately.
3. Do not direct a forceful stream of water from a hose to the affected area.
4. Continue flooding the burn area for 10 minutes after burning pain stop.
Electrical Burns:
Causes
 Faulty electrical equipment
 Careless use of appliances
First Aid for Electrical Burns:
1. Institute Rescue Breathing or CPR if needed.
2. Place a dry sterile dressing on the affected area.
3. Apply splint if there is suspected fracture.
CHAPTER 3
Basic Water Safety and Rescue
Objectives:
 Know the PCG mandates and its capabilities.
 Will update our knowledge about water safety.
 List some examples of the dangers and hazard.
 List the personal protective equipment of a rescue swimmer.
 Identify the (4) category of persons in difficulty.
 Describe the steps of a water based rescue and survival techniques including
basic tips when travelling in groups.
Rescue Techniques:
There are two (2) types of techniques:
1. NON SWIMMING RESCUE
2. SWIMMING RESCUE
Always maintain a good distance between the Rescuer and the person in difficulty.
Non Swimming Rescue:

 TALK – the safest form of rescue.
 REACH – both effective and safe to the rescuer.
 THROW – used by weak or non swimmer.
 WADE – used when there is permissible safety depth.
 ROW – using small craft.
Swimming Rescue:
1. Front approach
 maintain proper distance
 Talk to the victim
 Use of timing when approaching.
2. Underwater Approach
 5 ft, apart to start swimming under water is safest approach.
3. Back approach
 Advantageous to the rescuer
 Easy maneuverability
Types of Water Entries
Swimming and Lifesaving:
 Freestyle – known as “front Crawl” fastest stroke for approaching
 Backstroke – breathing is not interrupted has slow resistance, fast stroke
 Breaststroke – survival and rescue stroke adapted for under water swim
 Butterfly – competitive stroke strength and endurance
 Sidestroke – both personal and survival breathing is not interrupted
 Survival back – referred to as rescue backstroke
DEFENSES - techniques to PREVENT the victim from grabbing the rescuer.
1. Block:
 Prevent the hands of the victim from holding or grabbing the rescuer.
 Push the victim away and make another approach.
2. Block and Carry:

 When victim grasp your hand, immediately carry either of your hand straight
to the victim chest.
 Let him hold your hand while you swim to the surface.
3. Block and Turn:
 When the victim tries to grab you block his hands and turn him around
immediately use one of the carries.
Release and Escape

1. Wrist Lock:
 Holds his right wrist with your right hand
 Place your right foot on the victims left shoulder
 Apply pressure from your right foot twisting him away from you
 Use one of the carries and bring the victim to the surface
Front Strangle Hold – If the victim is holding over the left of the rescuer.
 Place your right hand over the victims left chin and hold his left elbow by your
left hand.
 Twist his elbow while freeing yourself from his grip.
 Surface the victim immediately using one of the carries.
Back Strangle Hold/ Rear Hold Releases

 Grasps the victim’s right hand sliding them to the victim’s right elbows while
holding the victims right wrist with the rescuer left hand.
 Twist the victim’s right wrist down and the same time push up his right elbow.
 Bring the victim’s right hand to his/ her back.
Breaking two (2) Victim’s Apart
 If the victim’s are embracing each other, decide which victim to be save first.
 The victim embracing above the others upper shoulder will be the first one to
get into the surface.
 Hold the victim’s armpit by your hands from behind and lace your right foot on
the second victim’s right or left shoulder.
 Surface the victim.
Surface Diving
 Head face surface.
 Feet face surface dive.
 Extended feet first surface.
Controlled feet first surface dive
Types of Tows
1. Non-Contact tow
2. Contact tow
A Contact Rescue is only recommended for an Unconscious person.
Types of Contact Tow:

 Cross chest tow
 Head tow
 Clothing tow
 Double armpit tow
 Double shoulder tow
 Vice grip tow
 Support tow
 Wrist tow
 Armpit tow
Things to consider and observe when using the swimming rescue

 Types of approach
-Defense techniques
 Blocking techniques
 Search method
 Swimming Stroke
Steps of a water-base rescue

 Use the safest, fastest, direct route towards the distress person.
 Use of floatation aides.
 Grab a rescue equipment and know its use.
Remember: Always maintain a good distance between the rescuer and the person in
difficulty.
SPINE INJURY MANAGEMENT

 Any person found floating in the water should be treated as a suspected spinal
injury.
Carefully managed with the used of spine board, until laid to the safe platform for
treatment by medics/ medical personnel with knowledge of first aid.
Rescue Principles:
1. Awareness – recognizing an emergency.
2. Assessment – making informed judgment.
3. Action – affecting the rescue.
4. After care – emergency survives.
Survival Techniques
“Group huddle technique is one way to attract attention and also provides body heat
from hypothermia”
“Use of floatation aides is the best option to preserve ones energy while awaiting rescue
on the water”
Basic Skills to Learn.

 Basic Life Support
 First Aid Training
 Rope Rescue Techniques
 Rubber Boat Handling
 Rowing/Jet Skiing
 Swimming
 Map Reading
 Scuba Diving
“Rubber boat handling and capsizing, swimming and towing exercise can be helpful”
“Make sure you are well updated of the new developments in applying first aid method”
“Know the technicalities of rope rescue, It’s your lifeline”
Some Water Safety Tips:

 Learn to swim
 Swim near a lifeguard
 Never swim alone
 Look out for children closely, do not pass the responsibility to lifeguards.
 Don’t rely on flotation devices, PFD are not substitute for swimming ability.
 If caught in a rip current, swim sideways until free, don’t swim against the current’s
pull.
 Never swim when under the influence of alcohol, illicit drugs, medications that may
cause impairment.
 Protect your head, neck and spine, don’t dive, jump into unfamiliar waters.
 Call or wave your hands for help if in trouble.
 Observe beach/pool regulations and lifeguard directions.
 Swim parallel and near to shore.
 Scuba dive only if trained and certified and within the limits of your expert and
training.
WATER RELATED TOURS
1. Always CONSIDER THE WEATHER (e.g. Storm warning, Beaufort scale etc…)
2. Follow the instructions from the Boat captain/Authorities.
3. Make appropriate coordination with the authorities (PCG Stations/Detachments) for
your safety.
4. Closely supervise young children.
Remember: The first consideration in any rescue is SELF PRESERVATION.
CHAPTER 4
JURISPRUDENCE RELATED TO FIRST AID AND WATER SAFETY
Does your workplace have a dedicated first aider?
Whenever an accident occurs where someone is injured, it’s crucial that they receive
immediate assistance or treatment. This is in order to prevent further complications and
keeps the victim stable before a qualified medical professional arrives, if necessary.
A quick response is needed whether it is a minor casualty or a more major one, as the first
moments after someone is injured can dictate how the rest of the situation unfolds.
If you’re in the workplace, you will need to have designated first aiders on site who can
respond promptly to any accidents and take charge of a situation.
We’ve put together a more detailed outline of the benefits of first aid as well as how first aid
can be practically applied in an emergency.
First Aid Legislation
Under the Health and Safety at Work etc Act 1974 (HSWA), employers are
responsible for making sure that their workplace has a health and safety policy. This should
include arrangements for first aid.
Employers should also be aware of the Health and Safety (First Aid) Regulations
1981. This places a responsibility on all employers (no matter the size of their business) to
provide adequate resources to those who are injured at work. This includes ensuring there is
equipment, facilities and first aiders who have had appropriate training.
Duty of Care and the First Aider:
For a first Aider nominated in the workplace the situation may be different from those who
are simply bystanders as it could be argued that they have assumed a heightened duty of
care.
Under the Health and Safety at Work Act 1974 and the subsequent Health and
Safety (First Aid) Regulations 1981, an employer is under statutory duty to provide first –
aiders in the workplace for the benefit of their employees. These first aiders must undergo
training to an approved standard in a specified list of competencies. As such, an individual
who takes on this role as part of their job description could be argued to owe a duty of care
to their fellow employees to render first aid.
Rule 1: Only treat if you are willing and able to do so.
Can I choose to do nothing? While there is no law that forces anyone to treat a
casualty this does not mean that one can simply leave a casualty who you know is in
danger. To do so may make you liable through your omission to act. If you are not happy to
provide First Aid treatment in the ‘ classic’ sense there are several things you can and
should do including (but not limited );
 Inform someone else, such as 999 if it is an emergency.
 Make the area around the casualty safe for yourself, others and the casualty.
 Monitor the casualty and/ or find out what happened.
 Comfort the casualty.
These are examples of simple but important actions that can be done without ‘getting your
hands dirty ‘
What if I injure the casualty?
A person who administers First Aid will only be liable for damages if negligent intervention
directly causes injury which would not otherwise have occurred, or if it exacerbates an injury.
If First Aid is administered inappropriately or negligently and a consequential injury can be
proved to have arisen from that procedure, first Aider may be held liable for substantial
damages if the standard of care he employed fell below that which could be expected of him
in given circumstances. This applies whether they are a healthcare professional, a non-
professional volunteer first aider, or simply an unskilled member of the general public.
For example, if a person inappropriately administered chest compressions where a

casualty was not in cardiac arrest, which caused damage to the chest wall or underlying
organs, they would be causing damage which would not otherwise have been suffered and,
given that the casualty was not in need of emergency resuscitation, would by his intervention
be leaving them in a worse position.
If, however, CPR is performed on a casualty in cardiac arrest, it is difficult to see how
a person intervention could leave someone worse off since a victim would, without
immediate resuscitation, certainly die. Furthermore, if an AED is being used, it will only
permit the administration of a defibrillator shock when it detects a shock able rhythm and,
since patients in this state are clinically dead, it is unlikely that any intervention with this
device could make the situation worse.
Attending an accredited First Aid training course not only provides you with life
savings skills but skills, knowledge and understanding of current best practice. A First Aid
certificate is not a ‘Licence to treat ‘but it demonstrates that the candidate, at the time of the
course, was able to perform tasks to a nationally recognised standard. By treating a casualty
to these standards you are protecting yourself against a claim of negligence.
Rule 2: Only treat in the manner you have been trained.
Consent: Under UK Law any form of physical touch without consent could be
interpreted as common assault. (Although is more accurately described as ‘battery ‘in
England and Wales or wrongful interference with the person in Scotland).
Practically this is unlikely to lead to a conviction if- for example – a First Aider were to hold
the hand of a casualty to reassure them, without first gaining consent. A conviction could be
made if the First Aider were to use any form of force against the casualty to administer
treatment.
British Medical association - Consent.
Under the Mental Capacity Act (2005) a person is presumed to have the mental
capacity to make their own decisions unless proved otherwise. On the basis that the
casualty has the capacity to choose to refuse treatment this must be respected. It is
important that the casualty is not coerced or pressured into accepting treatment; rather they
are helped to make an informed decision.
How do I know if they have the mental capacity to make a decision?
The criteria set out by Section 3(1) the Act for a casualty to consent/ refuse treatment
is that they can:
 Understand the information relevant to the decision
 Retain the information long enough to make a decision
 Weigh the information and make a decision
 Communicate the decision
But what if the casualty does not want to be treated?
This situation is not as strange as it may seem; there are several reasons why a
casualty, even with serious injuries may not want you to treat them.
 It may be that they don't want you to treat them, but they might want someone else.
 Is there personal history between you and the casualty?
 Is there a gender issue?
 Is the casualty suffering with a personal or embarrassing issue?
 Is there a lack of trust? Could this be how you presented yourself?
 Is the injury or condition self-inflicted and the casualty is refusing treatment from
anyone?
What if they are unconscious?
If a casualty is unconscious and therefore unable to consent – or indeed they had

refused consent and then became unconscious – you are permitted to undertake treatment
that is only required for the purpose of saving life. You are not permitted to undertake non-
life threatening treatment, such as treating minor injuries.
Section 5 of the Act applies in connection with the care or treatment of another
person.
If a casualty is found unconscious - and therefore their mental capacity cannot be

assessed nor can the casualty express refusal of treatment - it is suggested that a First Aider
who administers life saving actions should not incur any liability in relation to their actions
(that he would not have incurred if the casualty had capacity to consent and had consented
to treatment) providing that:
before performing a procedure the First Aider takes reasonable steps to establish whether
the casualty lacks capacity in relation to the matter in question and
When performing the act reasonably believes that the casualty lacks capacity in relation to
the matter and
That it will be in the casualty’s best interests for the act to be performed.
Is this "implied consent"?
No. It is often stated that there is implied consent when the casualty is
unconscious - the unconscious casualty has not implied anything! Implied consent is non-
verbal agreement; for example if you ask "Do you mind if I examine your wound?" and
the casualty holds their injured hand out towards you without saying anything, their action of
allowing you to get closer to their injury assumes that they consent.
The best interest of the casualty is usually doing as little as you need to, rather than
as much as you can. This is true whether the casualty accepts or refuses your treatment.
Rule 3 – Act in the best interest of the casualty.
Advanced Decisions
What is a 'Living Will'?
A Living Will or, more accurately, an Advanced Decision allows a person over 18
years to refuse specified medical treatment for a time in the future when they might not have
the mental capacity to consent or refuse to that treatment.
Advanced Notices
Are commonly used where a patient with a known or predicted medical condition
sets out their wishes – while they have the capacity to do so – regarding future treatment.
Typically this may be that a patient with a degenerative health problem may request that
should they suffer a cardiac arrest, they are not resuscitated.
For a patient to refuse life sustaining treatment, the Advance Notice must be:
 Be in writing (it can be written by someone else or recorded in healthcare

notes);
 Be signed and witnessed; and
State clearly that the decision applies even if life is at risk.
In terms of a First Aider responding to a life threatening situation it is unreasonable to

assume they would be aware of this written document. It may be that a person known to
the casualty attempts to prevent the treatment of First Aid if the casualty has made an
Advanced Notice. Again, it is difficult and unreasonable for the First Aider to make a
judgment about the validity of this claim.
Should any bystander attempt to prevent life-saving treatment of the casualty, the
emergency services should be called as paramedics and other healthcare professionals can
– in certain circumstances – provide life saving treatment without or against consent.
Children
In the ordinary course of events, of the parents' of a child (a person under 16 years)
would either refuse or consent to treatment of a child. If a child required life-saving First Aid
and the parents refused consent, it would be difficult to assume implied consent. Doctors
and other healthcare professionals are, again, afforded the ability to make decisions
regarding life-saving treatment against the wishes of the casualty on the basis of necessity.
Whether this is afforded to a First Aider is legally unclear.
Can someone refuse treatment on behalf of someone else?

No one can refuse Life-Saving treatment on behalf of a capable adult or child over 16.
ABOUT THE INSTRUCTOR
JAMES R. DELA CRUZ, RCrim
Mr. James R. Dela Cruz is teaching as an Instructor at the Criminology Department of

Aklan State University New Washington Campus.
He graduated his Bachelor of Science in Criminology at Aklan State University College

of Fisheries and Marine Sciences, New Washington, Aklan in the year 2018.

P.E 3 (Individual, Dual, First Aid and Water Safety)

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P.E 3 (Individual, Dual, First Aid and Water Safety)

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Prepared by: James R. Dela Cruz, R-Crim.

Answer first the following questions:

- Assessments and interventions that can be performed

by a bystander (or by the victim) with minimal or no medical equipment

Roles of First Aid:

Objectives of first Aid:

Hindrances in Giving First Aid

Basic Equipment: See Figure 1 – 3

Suggested First Aid Kit Contents (Basic):

Rubbing alcohol Gloves

Clothe materials commonly used in First Aid:

 Completely cover the wound.

Other uses of bandages:

Guidelines in Giving Emergency Care:

I. Getting Started – Planning of action gathering of needed materials initial response

Emergency Action Principles

1.1 Scene Safety.

Bystanders – Safety of the onlookers or bystanders is also our concern.

Certain injuries are considered “common” to particular accident situations. Injuries to

Figure 3 – 3 Mechanism of injury and affected areas

1.2 Determine the number of patients and additional resources.

Before You Approach the Victim.

As You Approach the Victim.

Once You Reach the Victim.

Do a Primary Survey of the Victim:

 A – (Airway) is the victim conscious or unconscious?

Activate Medical Assistance ( AMA ) or Transfer facility:

Activate Medical Assistance or transfer Facility if:

Do a Secondary Survey of the Victim

Interview the Victim.

Ask the following questions:

Elements of the SAMPLE history are:

Check Vital Signs.

When you take a pulse, note the following:

Steps to take the radial pulse

Normal Ranges for Respiration

INFANT 25 - 35/min. PAGE \* MERGEFORMAT 15

Steps to take the respiration

1. Place your hand on the victim’s chest or abdomen.

Figure 3 – 10 Means of assessing

Do the HEAD to TOE examination.

Golden Rules of Emergency Care:

What not to do:

Characteristics of a Good First Aider:

Please answer the following questions:

1. In your own words, what is the meaning of First Aid? (10pts)

1. ____ Loosen all tight clothing’s.

Principles and Practice of First Aid

Principles of First Aid

First Aid Practices

Taking immediate action

Calming down the situation

Calling for medical assistance

Apply the relevant treatment

 Check for consciousness

Emergency rescue and Transfer

Indications for Emergency Rescue:

Objectives of the First Aider:

Selection in the methods of transfer depends on the following:

Pointers to be observe during transfer:

Four/Six/Eight man carry