ASSESSMENT OF VICTIM AT

THE ACCIDENT SITE

WHAT IS FIRST AID?
 First
aid is the temporary and immediate
treatment given to a person who is injured
or suddenly becomes ill using the facilities
or materials available at the time before
regular medical help is imparted.
PRINCIPLES OF FIRST AID
1.RESTORATION OF RESPIRATION
2.CONTROL OF BLEEDING
3.TREATMENT OF SHOCK
4.CARE FOR THE UNCONCIOUS
5.ASSESSMENT OF ASSOCIATED
INJURIES.
6.TRANSPORTATION.
OBJECTIVES
1.To preserve life.
2.To prevent further injury and deterioration
of the condition.
3.To make the victim as comfortable as
possible.
4. To put the injured person under
professional medical care at the earliest
time possible.
QUALIFICATIONS
1.BE A GOOD OBSERVER
2.BE ABLE TO ACT QUICKLY
3.SHOULD NOT GET PANICKY OR EXCITED.
4.BE ABLE TO LEAD, CONTROL CROWDS,
AND TAKE HELP FROM ONLOOKERS.
5.ABLE TO JUDGE THE INJURIES TO BE
HANDLED FIRST.
6.ABLE TO REASSURE THE APPREHENSIVE
VICTIM, RELATIVES, AND PROVIDE GOOD
COUNSELLING.
FIRST AID PRIORITIES
 Assess a situation
 Protect yourself
 Prevent cross infection
 Comfort & reassure
 Assess the casualty
 Give early treatment
 Arrange for appropriate help
PRIMARY SURVEY/ BASIC LIFE
SUPPORT
 The approach to any incident requires a
Common Sense Planning
 The basic priority step of approaching an
incident is called Primary Survey
 It is the initial rapid assessment of a
casualty to establish & treat immediate life
threatening conditions
It is an easily remembered practice by using the
letters – D R A B C D
PRIMARY SURVEY

Remember …
DR A B CD
D = Danger
 R = Response
 A =Airway
 B = Breathing
 C = Circulation/ chest compression
 D= Defibrillation
D- DANGER
 Most accident scenes are uncontrolled and
potentially dangerous
 Do not become a casualty yourself
CALLING FOR ASSISTANCE
 Ask the bystanders to call for assistance
R
 Is the victim conscious… ?
RESPONSE
 SHOUT !!! and SHAKE

 No response??
 ACTIVATE THE EMERGENCY
RESPONSE SYSTEM & GET
AED/defibrillator
Give painful stimuli
AIRWAY
 Tongue is the most common of airway
obstruction in an unconscious victim
AIRWAY

 Head tilt , chin lift

techniques
JAW THRUST
 USED WHEN THERE IS SUSPECTED INJURY ON
THE CERVICAL SPINE INSTEAD OF HEAD TILT &
CHIN LIFT
B
 Look , Listen, and Feel
 Is he breathing
BREATHING
 Observe for breathing
 Watch and feel the chest rise and fall
 Check breathing for 5 seconds
 Ifbreathing move to next step
 If not breathing start mouth to mouth

ventillation/ breathing
 ADULTS: aim at 10- 12 breathes/min
 CHILDREN: aim at 12-20 breathes/ min
 NOTE: if pulse is below 60 in children

START CPR( sign of poor perfusion)

CHEST COMPRESION/
CIRCULATION
 CHECK FOR PULSE IN 5- 10 SECONDS
• CAROTID PULSE FOR ADULTS (30:2)
• FEMORAL PULSE – 1YR- PUBERTY (30:2)
• BRACHIAL PULSE- 0-1YR 30: 2 (1 RESCUER)
15:2 (2 RESCUERS)

 NO PULSE-BEGIN CHEST COMPRESIONS

30 : 2 UPTO 100/MIN

 IF PULSE IS PRESENT, MOVE TO AIRWAY THEN

BREATHING.
DEFIBRILLATION
 USE OF AUTOMATED EXTERNAL
DEFIBRILLATOR

 AED: ARE COMPUTERIZED DEVICES THAT CAN

IDENTIFY CARDIAC RHYTHMS THAT NEED A
SHOCK ,THEN DELIVERS THE SHOCK. (Ventricular
fibrillations)

 SIMPLE AND SAFE TO USE, ALLOWS A LAY

PERSON & HEALTH CARE WORKERS TO
ATTEMPT DEFIBRILLATION SAFELY
PROCEDURE FOR AED USE
 TURN ON AED
 ATTACH AED PADS ON VICTIM(ADULT/CHILD)

 AED OPERATOR CLEARS THE VICTIM BEFORE

RHYTHM ANALYSES
 ACTIVATE ANALYSE FEATURE OF AED

 CLEAR VICTIM & EVERYONE BY SHOUTING

COMMAND
 PRESS SHOCK BUTTON

 START/ CONTINUE CPR

 NOTE; IF THE PATIENT IS UNCONSCIOUS, THE
RESCUER SHOULD ADDRESS CIRCULATION
FIRST.
 DRCABD
SECONDARY SURVEY
SECONDARY SURVEY
 This is the methodical process of checking for
other injuries or illnesses.

 Involveshistory taking and a head to toe

examination.

 It should take 1 to 2 minutes.

 It is not necessary to be sequential

HISTORY
 Use mnemonic AMPLE as a reminder.

 A- allergy
 M-medications
 P- previous medical history
 L- last meal
 E- event history
HEAD TO TOE EXAMINATION
HEAD

 Observe skin color, lacerations, contusions, and

facial asymmetry.
 Assess the level of consciousness. (AVPU)

 Check pupil’s size.

 Check ears and nose for blood.

 Check mouth for foreign objects and bleeding

NECK AND ARMS
 observe and palpate areas of tenderness.

ARMS;
 Palpate the entire length for pain, wounds,
deformity, and sensations.
 Ask about pain and tingling sensations
CHEST
 Observewhether the chest expands
normally upon inspiration.

 Palpate clavicles and shoulders

 Pressgently on the ribs, checking for

integrity of the chest wall .
ABDOMEN, PELVIS.
 Check for distention or for wounds.
 Palpate the four quadrants for tenderness
and rigidity.

PELVIS
 Palpate the iliac crests and pubis for pain.
 Observe for incontinence
SPINE AND LEGS
SPINE
 Palpate for tenderness, wounds, and deformity
from the shoulders to the buttocks.
NOTE : LOG ROLL VICTIM WITH
SUSPECTED C- SPINE INJURY TO PREVENT
FURTHER INJURY
LEGS
 Palpate the entire length for pain, deformity,
wounds.
Ask about pain, numbness, and movement
TREATMENT
 AIM : To preserve life
 Maintain an open airway by positioning
the casualty correctly.
 Begin resuscitation if the casualty is not
breathing and the heart is not beating and
continue treatment until skilled help
arrives
 Control bleeding.
TO PREVENT THE CONDITION FROM
WORSENING

 Dress the wounds.

 Immobilize any fractures./ SPLINTING
 Place the casualty in a comfortable
position consistent with the requirements
of treatment.
 Keep the casualty warm.
MONITOR VITAL SIGNS
 LEVEL OF RESPONSE (AVPU)

 A- alertness /eye opening

 V-response to VOICE

 P- response to PAIN

 U- unresponsiveness to any stimuli

REMOVING CLOTHING
 COAT, JACKET,SHIRT, VEST:
 Raise the casualty and slip the garment
over the shoulders.
 Bend the arm on the sound side and
remove garment from that side first.
 Slip the injured arm out of its sleeve while
keeping it straight.
 If necessary slit up the seam on injured
side
REMOVING TROUSERS
 pull them down from the waist to reveal
the thigh, knee and calf.
 if necessary, slit up the inside seam .
SHOES, AND SOCKS
 Support the ankle, undo or cut the laces.
 If socks are difficult to remove, insert your
first two fingers between the sock and the
leg and cut between your fingers.
DISPOSAL OF THE CASUALTY
 Arrange transport to hospital by ambulance or
any other vehicle nearby.
 Hand over the casualty to a medical worker at
the scene .
 Take the casualty to a nearby shelter or home to
await the arrival of an ambulance.
 If the injury is minor , allow patient to go home
and ask them to get medical advice.
EMERGENCY MEDICAL SERVICE
SYSTEM/ RESCUE SERVICE
 EFFICIENT TRANSPORT & COMMUNICATION
SERVICES

 TRAINED PERSONNEL

 EQUIPED HOSPITAL

 AVAILABLE RESOURCES
 RECOMMENDED PROCEDURE FOR
VERY INJURED
 Position the victim on his back on a hard
flat surface.
 Check for pulse
 Open the victim’s airway by head tilt-chin
lift or jaw thrust method.
 Take five seconds to look, listen and feel
for breathing.
 Deliver four successive breaths by mouth
to mouth ventilation.
RESUSCITATION TECHNIQUES
 Use the A.B.C’s of basic life support.

AIRWAY:
 Position the casualty on their back.
 Find out if the patient is unconscious.
 Check whether there is any debris in the mouth
or throat .
 Check for breathing:
 See movement of the chest and abdomen.
 Listen for breath sounds.
METHODS OF RELIEVING AIRWAY
OBSTRUCTION
HEAD TILT:
Place your palm on the patient’s
forehead.
Apply firm backward pressure
pushing the forehead as far back as
possible.
Additional assistance is gained by
placing your other palm under the
patient’s neck.
JAW THRUST:
 Is used when a cervical or spinal injury is suspected.

 The mandible is displaced forwards by placing the

fingers of both hands at the angles of the jaws.
 Support the head carefully without tilting it backwards or
turning it side to side.
AIRWAY
 Tongue is the most common of airway
obstruction in an unconscious victim
AIRWAY
 Head tilt chin lift
B
 Look , Listen, and Feel
 Is he breathing?
BREATHING
 Observe for breathing
 Watch and feel the chest rise and fall
 Check breathing for 5 seconds
BREATHING
 If
patient is breathing
Leave the patient on their side with the
jaw supported
BREATHING
 If
patient is not breathing
Turn on to their back
Breathe for the patient

Give two (2) initial breaths

RESTORATION OF BREATHING
 MOUTH TO MOUTH VENTILLATION.
Principles:
 Exhaled air contains 16% of oxygen which is
enough to sustain life.
 You blow air from your lungs into the casualty’s
mouth and or nose to fill the casualty ‘s lungs.
 Avoid this in case of poisoning, serious facial
injuries, recurrent vomiting.
PROCEDURE
 Remove any obvious obstructions over the face
or any constrictions around the neck.
 Open the airway and remove any debri from the
mouth and throat.
 Open your mouth wide, take a deep breath
pinch the nostrils together with your fingers.
 Seal your lips around the mouth and blow into
the casualty’s lung.
 Do this until you see the chest rise to maximum
expansion.
TROUBLESHOOTING
Failure of chest expansion:
Check if the airway is fully open:
adjust the position of the jaw and the
head.
If there is still no chest movement,
the airway may be blocked therefore
first treat for chocking.
PROCEDURE
 Remove your mouth well away from the
casualty and breath out any excess air.
 Watch the chest fall and take in fresh air.
 Repeat the inflation.
 Give the first four inflations as quickly as
possible without waiting for complete deflation
of the lungs between breaths.
 Check the casualty’s pulse to ascertain that the
heart is beating.
 If the heart rate is normal give inflations at 16
breaths /min.
PROCEDURE
 When the casualty is breathing normally, place
them in the recovery position.
 Assessment of effective ventilation:

 Observe the rising and falling of the chest

 Hearing and feeling the escape of air during

pressure
 Feeling resistance in your airway as the victims
chest starts expanding.
CARDIO PULMONARY RESCUCITATION
(CPR)
 This is the use of artificial ventilation with
external heart compression.

 Itshould be commenced in all cases of cardiac

arrest (sudden death).

 Sudden death Is defined as the immediate and

unexpected cessation of respiration and
functional circulation.
HOW C.P.R WORKS
 During C.P.R , the heart is squeezed
between the breast bone ( sternum) and
the spine and the lungs are ventillated.
CPR
 When??

If
No danger
No response

Airway clear and open

No breathing

No pulse
CPR
 Hand location
 Locate the lower end of the breastbone
 Place two fingers below where the ribs meet the
breastbone
 Place the heel of one hand on the breastbone
 Place your other hand securely on top of the first
hand
CPR
 Technique /push hard, push fast
Compression technique uses the heel of
the hand with the fingers locked and
clear of the chest
Keep your shoulder vertically over the
victim’s chest
Depth of compression: 4-5 cm
Rate 100 compressions / minute
CPR
 Procedure
One rescuer
2:3O

2 ventilations : 30 compressions

Rate 100 compressions / minute or 6-7

cycles/ minute
CPR
 Procedure

Two rescuers
First use one person CPR whilst the 2nd

person gets help

Then with 2 persons

2 :30

2 ventilation : 30 compressions

Rate 100 compressions/ minute or 16-18

cycles/minute
CAUSES OF CARDIAC ARREST
 Heart attack
 Electric shock
 Asphyxia
 Suffocation
 Drowning
 Chocking
 Allergic reactions
 Severe injuries
SIGNS OF CARDIAC ARREST
 Unconsciousness
 No pulse in the neck ,wrist, or groin.
 Absence of breathing
 Dilated and fixed pupils
 No heart beat
 Bluish colour of the skin ,lips, and the nail
beds.
BASIC LIFE SUPPORT (BLS)
CPR CRITICAL CONCEPTS
Start chest compressions in the first 10 seconds of cardiac
arrest
Push hard , push fast .

Rate of 100/min depth of 2 inches or 5cm(adults),

5cm (children) and 4cm (infants)

Allow complete chest recoil

Minimize interruptions

give effective breathes to make sure chest rises

Avoid excessive ventillation