COURSE TITLE :

FOUNDATION OF
NURSING

COURSE CODE:NSC 222

FIRST AID

 DEFINATION OF FIRST AID

 PRINCIPLES OF FIRST AID
 QUALITIES OF A FIRST AIDER
 SITUATIONS REQUIRING FIRST AID e.g. BURNS, POISONING,FALLS,BITES,MASS
CASULTIES ,DROWNING ETC.
 TECHNIQUES OF FIRST AID
 MANAGEMENT OF EMERGENCY SITUATION e.g CARDIO PULMONARY, MOUTH TO
MOUTH e.t.c
 PRINCIPLE OF BANDAGING
 APLLICATION OF BANDAGING,SPLINT,DRESSING AND TOURNIQUET
DEFINITION OFN FIRST AID
 First aid is the first and immediate assistance given to any person suffering
from either a minor or serious illness or injury, with care provided to preserve
life, prevent the condition from worsening, or to promote recovery.(
www.wikipidia may 2021).OR
 First aid is the initial assistance given to a victim of injury or illness, before
he or she can be attended to by a professional team(© 2021 IHNA Blog.22 Mar
2018)
 It includes initial intervention in a serious condition prior to professional
medical help being available, such as performing cardiopulmonary
resuscitation (CPR) while waiting for an ambulance, as well as the complete
treatment of minor conditions, such as applying a plaster to a cut.
 First aid, however, does not necessarily require any particular equipment or
prior knowledge, and can involve improvisation with materials available at
the time, often by untrained people.
 First aid is the care initially provided to a person when an injury or illness
occurs.
 The primary goal of first aid is to prevent death or serious injury from worsening. The key
aims of first aid can be summarized with the acronym of 'the three Ps.

THE AIMS ARE : To

 Preserve life: The overriding aim of all medical care which includes first aid, is to
save lives and minimize the threat of death. First aid done correctly should help
reduce the patient's level of pain and calm them down during the evaluation and
treatment process.
 Prevent further harm: Prevention of further harm includes addressing both external
factors, such as moving a patient away from any cause of harm, and applying first
aid techniques to prevent worsening of the condition, such as applying pressure to
stop a bleed becoming dangerous.
 Promote recovery: First aid also involves trying to start the recovery process from
the illness or injury, and in some cases might involve completing a treatment, such
as in the case of applying a plaster to a small wound.
PRINCIPLES OF FIRST AID

 Survey of the scene of accident or incident /safety precautions

 Triage
 Primary assessment and intervention
 Secondary assessment and intervention
Survey of accident scene/safety
precautions
 Immediately a health care provider arrived at the accident scene of accident
or incident, it is very important to take time and look around to ensure that
there is no any potential danger to self or to the victims .
 Your safety and then that of your patient is your first priority in the
management of emergency .
 There is no advantage if a first aider get injured, contacted infection or
even died in a process of providing emergency care to patients or victims .
 Therefore, safety materials such as gloves, apron rain boots ,eye goggles
,face mask etc. should be worn where necessary, before attending to a
patient .
 Universal /Standard precautions most be observed when handling emergency
 Triage

In emergency situations patients are attended to, on the basis of the severity of their conditions not ‘’first
come- first serve.
Triage is a French word meaning ‘’to sort’’
Triage is the process of determine the priority of patient’s treatment based on the severity of their conditions.

Purpose Of Triage
The aim of pre hospital triage is to ensure that patients who need immediate medical care and transportation to
the appropriate hospital are first attended to .
Acuity category of triage
The basic and widely used triage systems is the three (3)categories triage namely Emergent, Urgent and Non urgent.
1 Emergent (Red Code):Is a triage category signifying life threatening injuries or illness requiring
immediate intervention ,Cases under this category are :
a Air obstruction
b Open chest or abdominal injuries
c Cardiac arrest
d Acute heart or renal failure
2 Urgent (yellow code):is triage category signifying serious injury or illness that is not immediately
threating .However if care is not provided for a long period of time, they may suffer irreversible
damage examples are:
a Major or Multiple fracture
b Moderate to sever burns
c Drug overdose or suspect poisoning
d Spinal cord injury
e Intestinal Obstruction

3 Non urgent (Green code):Is a triage category signifying episodic or minor injury or illness in which
treatment may be delay several hour or longer without increased morbidity .Examples are:
a Soft tissue injuries
b Minor fracture or dislocation
c Nail puncture
d Sprain and strain
e Chronic backache etc.
Primary Assessment Of Patient And Intervention

 This is the initial ,rapid assessment of patient to identify and treat those conditions
that present an immediate threat to life.
Components of Primary Assessment of Patient
Primary assessment of patient and intervention is performed in the following
sequence :ABCDE or CAB; Assessment of airway and cervical spine control is the first
priority in the management of emergency .
A-Airway and cervical spine control
 Check the patient for open airway (patency)the airway can be partially or
completely obstructed by excessive secretion of (saliva),blood ,vomitus ,foreign
body dentures, trauma to the airway etc.
 Falling back of the tongue as in unconscious patient can also block the airway
 Before the covid 19 era hand gloved finger sweeping is done for pre-hospital management while suction
machine is used in the hospital to clear the any secretion from the mouth.
-Removal of any identified foreign body
-Open the airway by the head tilt chin lift (Airway maneuver )but Jaw thrust should be used for patient with
suspected cervical spine injury .
-Maintain the patency of the airway by inserting oropharyngeal or nasopharyngeal airway .
-Palace the patient in recovery position to allow free drainage of secretion from the mouth and to prevent tongue
from blocking the airway (Unconscious patient ).
-Cervical spine immobilization using rigid cervical collar for patient with suspected cervical spine injury .if pre-
hospital ,apply head blocks and secure the patient’s forehead to the backboard transporting to the hospital .

B-Breathing
Recognition of respiratory distress or inadequate breathing is based on the ‘’Look, Listen and Feel approach’’
-Check for breathing by looking at the rising and falling of the chest .
-Listen to the air escaping during exhalation .
-Feel for the flow of air against your check and or back of your palm .
-Assess ventilation by observing and counting respiratory rate .
-Check to see if the breathing is regular or irregular, rapid or slow ,deep or shallow
-At rest ,the normal respiratory rate for adult is between 12to 20 cycles per minute and without the use accessory
muscles of respiration .
-Breathing can be compromised by blunt or penetrating chest injury ,fractured rib/flail chest ,sever head injury
,chronic aneamia, advance, effect of some drugs etc.
-If no adequate breathing or no breathing at all ,loosen any tight clothes around the patients neck and chest.
-Commence assisted ventilation via mouth to mouth or mouth to mask (not applicable now due to covid 19)breathing
pre-hospital .
-Bag valve mask (Ambu bag )ventilation can also be done if available .
-Give supplemental oxygen via appropriate delivery system (face mask, nasal prong BVM etc. ).
-Ensure that any identified cause of respiratory impairment is well treated .

C-Circulation and control of hemorrhage

-Assessment of circulation involves assessing the pulse ,Blood pressure ,skin perfusion and cerebral perfusion .
-The normal pulse for an adult at rest is between 60 to 100beats per minute.
-Check for pulse at the redial or carotid artery.
-Note for pulse if it is full, bounding, regular ,irregular ,rapid ,weak and thready,etc.
-Assess capillary refill on the finger nail bed.
-Poor skin perfusion is usually characterized by cool peripheries, skin mottling ,pallor ,cyanosis and a delayed
capillary refill(more than 2seconds ).
-Clinical sign of poor cerebral perfusion include; deterioration in conscious level, confusion, agitation, and lethargy.
-If pulse is absent or pulse is weak ,irregular and less than 40beats per minute.
-Commence chest compression or Cardiopulmonary resuscitation (CPR).
-Arrest any external bleeding by applying a pressure dressing with a conforming bandage .
-Restrict unnecessary movement of patient with suspected internal bleeding .
-Restrict oral intake of fluid if patient is vomiting or unconscious .
 D-Disability
-Assessment of disability (patient’s neurological status)involves assessing level of consciousness using Glasgo
Coma, pupillary assessment and AVPU.
-AVPU is use in the pre-hospital setting ;
A-Alert
V-Respond to vocal stimulus
P-Respond to pain
U-Unresponsive
-Inspect extremities for any obvious deformities
-Determine the range of movement and strength in the extremities.
-Immobilize any obvious deformities using splint.

E-Exposure and control of the environment

-Assess patient’s temperature and establish whether the temperature is normal or there is hypothermia or pyrexia
-The patient need to be expose to allow clinical examination to elude any obvious life threatening conditions.
-Privacy should be maintain during patient expose .
-Normal body temperature is between 36.2to 37.2 degree Celsius .
-A cool, clammy skin may indicate loss of blood as in shock.
-A hot ,dry skin may be caused by fever or exposure to excessive temperature Heat stroke.
- If the patient has subnormal (low),keep patient warm with blanket .
-If temperature is high ,remove extra clothing and expose .
Secondary Assessment Of Patient And
Intervention
 This follows immediately after the primary assessment and intervention ,when the patient’s condition is
relatively stable.it involves history taking and head to toe physical examination .
 Obtain a comprehensive history of what led to the patient’s current illness, past medical and surgical history
,social and family history. Head to toe physical examination is also carried out

History Taking
A mnemonic called AMPLE is used to obtain data from the patient
A-Allergy :Find out if the patient react to any known, specific substance such as drug ,foods pollen etc.
M-Medication :Document the drug patient has taken or is currently taken.
P-Previous illness :Find out if patient has ever be ill before the present illness and what the illness was .
L-Last meal :Find out what kind of food patient ate and the time, before his/her present illness.
E-Event: Find out the circumstances that led to the current illness.
Present illness: Document patients complain ,diagnosis and present state of health.

Past medical and surgical history :Find out patients diabetic,hypertensive,asthmatic, sickle cell disorder
etc. Also find out any previous hospital admission or treatment of sever illness ,including surgery and
blood transfusion.

Social and family history : Find out patient’s age, numbers of siblings/children, occupation, religion and
marital status. Also find out if patient smoke, drinks ,have more than one wife. Family history of
hereditary disease should also be obtain .

Physical Examination
The basic tools of the physical examination are vision ,hearing ,touch and smell. These human sense may be
augmented by special tools such as stethoscope etc.
G-General survey :Look for specific things that will give you immediate clues of how serious the patient’s
condition might be. The following should be noted ;
1 Level of consciousness
2 Obvious wounds or deformities
3 Behavior and degree of distress
4 Skin color
I-Inspection :This involves the use of 4senses namely ;sight ,smell, hear and touch to evaluate the general health
of the patient .Inspect the patient body and orifice for injury, burns, bleeding, discharge etc.
P-Palpation :This involve the use of the sense of touch in examining the affected or desired part of the body to be
examined .
P-Percussion: Is the striking or tapping of the body surface, specifically the chest and abdominal wall to produce
sound and vibration .
A-Auscultation :This involves the use of stethoscope to listen to sounds produce by the function of the organs
e.g heart sound.

NOTE: Physical examination is done systematically from head to toe .Any abnormality noted should be
documented.
Qualities Of A First Aider

1) Good Communicator
Communications is important for emergency management /managers to fully prepare ,and responds to timely manner.
Communication is the key to effective mitigation ,preparedness ,response and recovery.
A good first aider must be able to communicate effectively with other first aiders and medical staff.
Well-conceived and effectively delivered emergency message can save lives ensure public safety and facilitates response
efforts ,during emergency.
2)Quick and Smooth
First aid providers have to be very quick in their actions .As soon as some accident take palace ,they have to be quick in
response and take over the situations immediately without any delay.
3)Intelligent and Decisive
You should be able to decide the course of treatment within seconds .Depending on what is there in front of you ,you
should take an immediate yet a wise call, and keep the injured person stable till help arrives. If there are more than one
causality, you must be quick to judge and must start working on the victim who needs attention the most.
 4)Controlled and Calm
Without showing any panic ,you should be able to perform in front of the people and the victim.
Your actions should exhibit confidence, the only thing that can calm scared people.
The first aid training you have undergone has given you the skills there is no reason to panic.
5)Resourceful
Your first aid kit should at all times, have required material without fail. In case you do not have
it, you should be able to use the people around you resourcefully ,delegating responsibilities to
the people around.
6)Reassuring and sympathetic
It is your duty as a first aider ,to reassure the victim that you are there to take care of him that help
is on its way .You need to be calm, kind and sympathetic to the victims call.
7)Skilled
A first aider has basic medical skills. You are trained to perform skills under pressure You should
have the right skills to judge the problem depending on the symptoms and make quick calls.
8)Efficient
You should be able to start the first aid without the victim feeling too much pain or without
increasing his pain anymore .There is never any time to waste when there is a medical emergency
with the available resources ,you need to attend to as many casualties are there,
till help arrives.
9)Confident
As a first aid provider you must have faith in yourself and action before you start first aid on the
victims .The confidence which you would exhibit while performing would reassure the victim and
onlookers.
10)Team player
Teamwork is an essential and integral part of the successful management of sudden mass causalities
incidents and disasters. A Good first aider must be able to work with other first aiders and medical
staff to reduce deaths ,injuries and impact during disaster and daily emergencies .
General rules of first – aid treatment

1 Ensure safety for yourself and victims

2 Remove patient from danger
3 Check for response by taping victims shoulder if an adult(shout are you all right for adult). and foot for
infant
4 Call for help
5 Treat the most urgent condition first and in order of precedence
6 Unconscious patient should be placed lying on their side
7 Unconscious patient should not be given anything to drink and also patient vomiting .
8 Alcoholic stimulant should not be given as these have a transient effect with a subsequent
depressing effect on the vital centers.
9 Reassure patient
10 Organize unskilled onlookers or survivors to help in anyway possible.
11 Control bystanders and onlookers and prevent them from exciting the patient

12 Handel patients properly. If there is a suspected fracture ,support the affected limb or part
properly.

13 A sensible assessment of the situation is essential ,especially if a decision has to be made regarding
the need for medical aid or the transportation of the patient to the hospital.