First Aid Measures: A deep insight, by RxVichuZ! :)

 Refers to the process of “Carrying out ESSENTIAL EMERGENCY TREATMENT
of an injury/illness, in order to benefit the casualty(patient).”
 After appropriate discharge of first aid to the casualty  patient is sent to
hospital / to a doctor for further treatment .
 First aid is divided into 2 parts:
A. SELF-HELP: Help, that the casualty can do for himself/herself
B. FIRST-HELP: Help, that other people discharge for the casualty.
• Roles of first-aider(person who provides first-aid to the casualty):
First aider should:
- Remain calm & maintain control of the situation as much as possible, unless
further help arrives
- Be quick in making worthwhile decisions
- Be tactful & wise in taking help from onlookers, calling ambulance, etc.

Include:
1. To prevent danger to life
2. To prevent further injury & progression into complications
3. To provide relief from pain
4. To ensure that medical care is available AT THE
EARLIEST!

ROLES & RESPONSIBILITIES
OF FIRST-AIDER???

 First-aider (as we discussed before)  refers to the person, who provides
emergency treatment during accident/ sudden illness, quickly & correctly, before
medical help is available.
 Roles & responsibilities of first-aid provider include:
1. To remain calm & cool as much as possible
2. To be alert in case of injury & note down its causes & manifestations shown in
the patient
3. To be tactful enough, so as to gain confidence of the patient, as well as that of
persons standing nearby
4. Ability to control the crowd & take help from onlookers
5. Quality of self-confidence & politeness with patient
6. To send for someone to inform the doctor or nearby hospital for arranging
ambulance, while maintaining his composure & taking control of immediate
situation of the patient.

 Include:
1. Promptness of action  enhances life-saving chances of the affected
2. Carrying of first-aid materials (as far as possible)
3. Avoid unnecessary questions  prevents wastage of time(especially in critical
situations like this!)
4. Finding out the real cause of injury
5. To dissociate the accident victim from cause of accident(eg: fire, electric
current, etc)  locate the casualty to a safer place
6. To find out if the patient is :
a. Conscious or not
b. Dead/ alive
7. Decide which first-aid measure SHOULD BE GIVEN FIRST(eg : cardiac
function restoration, restoration of breathing, stoppage of bleeding, etc).

8. Arrange for medical help(as soon as possible)
9. To keep patient comfortable as far as possible
10. In case of conscious patients  to give reassurance of speedy recovery.

FIRST-AID KIT: A BRIEF
INSIGHT

 A first-aid kit consists of:
1. Sterile gauge
2. Bandages(of different sizes)
3. Triangular bandages
4. Adhesive bandages
5. Pair of scissors
6. Pair of forceps
7. Aromatic ammonia spirit
8. Burn ointments
9. Antiseptic solutions(like Dettol, mercurochrome, etc)
10. Emergency drugs(like painkillers, antibiotics, ORS packets, etc).

HOW TO MANAGE A FIRST-
AID KIT???

1. Always keep a small, portable first-aid kit
2. Always make it available at homes public places, colleges,
schools, etc.
3. Contents of first-aid kit  should be properly arranged &
well-preserved inside kit (to prevent
contamination/spoilage)
4. Periodically examine the contents of first-aid kit
5. Proper periodical examination of first-aid kit  helps in
removal of damaged/ expired contents & replacement with
fresh ones

 Since accidents can occur at any time & at any place  it is the responsibility of
the first-aider to ensure that immediate first-aid measures are meted out to the
sufferers
 On reaching the accident spot  first-aider may obtain a brief history of
accident(either from the patient himself if he is conscious/ from the onlookers if
the opposite)
 Patient should be examined for:
A. PULSE RATE:
- If pulse is felt  it indicates that the patient is alive
- If pulse is not felt (even after external cardiac massage)  it means the patient is
dead!
- If pulse is very weak & rapid  it indicates severe bleeding(external/internal).

B. BREATHING:
- Check the breathing if it is absent, slow/fast
- If patient requires breathing  give him ARTIFICIAL RESPIRATION!
C. PALLOR:
- Indicates bleeding severity
- Note pallor/degree of whiteness of tongue, conjunctiva & nails.
D. COLOUR OF TONGUE & LIPS:
- If colour of tongue & lips has turned blue  it indicates that there is LACK OF
OXYGEN.
E. BLEEDING:
- Body parts like ears, mouth, nose & other parts must be checked for bleeding &
their severity.

F. FRACTURE:
- Movements of joints should be checked (to see if there is fracture/not)
G. BURNS:
- Note the cause & degree of burns
H. POISONS:
- Patient should be examined to ensure whether he has taken any poison/ not (can
be determined by noting sings & symptoms of poisonous materials).

FIRST-AID MEASURES FOR
ACCIDENTS:

- Anything, that happens UNEXPECTEDLY, & by CHANCE, which affects the
health of a person can be called as an ACCIDENT
- Can happen at any time & place
- Intensity can vary from minor bruises or so to even the death of the victim!!
- Accidents are classified into:
1. INDOOR ACCIDENTS:
- Can happen in:
a. Kitchens(gas stoves, knives, pressure cookers related accidents)
b. Bathrooms(electric geysers, washing machines & acid bottles related accidents)
c. Sitting rooms, dining rooms
d. Miscellaneous accidents(falls, accidental poisoning, etc)

2. OUTDOOR ACCIDENTS:
- Includes:
a. Road accidents
b. Industrial accidents(machinery/chemical-related accidents)
c. Sports grounds-related accidents
d. Accidents in sea, river, wells, lakes, etc.
3. ACCIDENTAL POISONING:
- Unintentional poisoning(eg: Food poisoning)
- Intentional poisoning(eg: Suicidal activities)
4. SEASONAL ACCIDENTS:
- Summer seasons  risk of heat strokes
- Fire accidents that can occur during Diwali, etc.

FIRST AID MEASURES IN CASE OF ACCIDENTS:
1. Redirect traffic(if necessary)
2. In cases of bleeding  control it immediately by direct pressure on the affected
area
3. Revive heartbeat/ breathing(if it’s improper)
4. If victim is mentally shocked  give him assurance & keep him in a cool & calm
mental level
5. Call for doctor/arrange an ambulance
6. Keep injured person’s mouth & nose free from obstruction by vomits(to avoid
choking risks)
7. In cases of fractures  do not remove fracture parts unless necessary
8. Make sure that the injured person is taken to the hospital as soon as possible.

ABRASIONS

 Refers to injury caused to skin due to FORCEFUL RUBBING / SCRAPING
 High risks of swelling, contamination / infections
 First aid measures include:
1. Clean wound with antiseptic solution
2. Remove all dirt & dust particles from affected area
3. Apply antiseptic solution
4. If necessary  go for non-adherent dressing/sterile gauze
5. Give an injection of tetanus toxoid.

 Also known as “incised open wounds”
 Can be caused by sharp-edged articles like KNIVES, RAZORS, etc.
 First-aid measures include:
1. Apply pressure  prevents bleeding
2. Apply antiseptic solution  follow it up with non-adherent/sterile dressing!

CHOCKING

 Condition, in which AIR PASSAGE IS BLOCKED  leads to difficulty in
breathing
 More commonly seen in young children
1. Bend the adult over the knee  give a number of blows on his shoulders 
helps in removal of foreign particles
2. In cases of children  hold the child upside down (with one hand)  give
number of blows on the child’s shoulder(with other hand), unless the foreign
particle is expelled.
3. Using light blankets  keep body warm.

WHAT IF FOREIGN BODY
ENTERS INTO THROAT?

 Foreign bodies include:
a. Coins
b. Marbles, etc
• Foreign bodies inside throat  irritates throat  leads to pain & discomfort for
patient
• First-aid measures include:
1. Patient reassurance
2. Make patient sit in a comfortable position with mouth downwards  give few
blows on shoulder unless foreign body is expelled
3. On failure of step (2)  give patient cooked potatoes, banana, soft rice/bread to
eat  helps swallowed object to pass down
4. Avoid purgatives
5. Examine stools on next morning for foreign body.

WHAT IF FOREIGN BODY IS
INSIDE EAR??

1. Put WARM OIL inside ear (if insect enters into ear)
2. If step (1) is unsuccessful  contact doctor
3. NEVER EVER TRY TO REMOVE FOREIGN OBJECT INSIDE EAR using
MATCHSTICKS, HAIR PINS!!

ENTERS INTO NOSE????

1. Make patient sneeze(by using snuff/ inserting the end of a piece of thread in the
opposite nostril)
2. If step(1) is unsuccessful  seek doctor’s help
3. Avoid usage of PINS/ HOOKS!!

ENTERS INTO EYE????

 Measures include:
1. Make patient sit in a chair
2. Ask patient to NOT RUB THE EYES
3. Gently wipe the foreign body out using:
a. Cotton wool
b. Folded part of a clean handkerchief
4. Rinse eyes with warm water
5. Put eye drops
6. Never ever attempt to remove foreign body(that is lodged inside eyeball!!)
7. If above steps are unsuccessful  seek doctor attention.

WHAT IF FOREIGN BODY IS
LODGED INSIDE SKIN???

1. If part of the foreign object(that entered into skin) is PROJECTING OUT  it
is grasped & pulled out
2. If foreign object is DEEPLY LODGED inside the skin  patient should be
taken to the doctor
3. After removal of foreign object  apply solution of Dettol/iodine to affected
part.

FIRST-AID TREATMENT FOR
SHOCKS

 Defined as “condition of severe depression of vital functions of the body due to
poor circulation of blood”
 Shock is mainly classified into:
a. Hemorrhagic shock
b. Neurogenic shock
c. Anaphylactic shock
d. Toxic shock
• Main types of shock include:
a. NEUROGENIC SHOCK:
- Nerves are involved
- No blood loss
b. HEMORRHAGIC SHOCK:
- Severe loss of blood, due to burns, dehydration, etc.

 Major clinical manifestations of shock include:
1. Dryness of mouth
2. Blueness of lips
3. Paleness of skin
4. Coldness of skin
5. Blurred vision
6. Anxiety
7. Hypotension
8. Transition from either “being alert” or to “sudden collapse”

 Emergency tips for shock treatment include:
1. Remove patient to a well-ventilated area
2. Remove crowd tactfully  helps in improving ventilation & easing anxiety for
the patient.
3. If there is difficulty in breathing  raise head & chest of patient
4. Loosen clothings (avoid removing them)
5. Keep patient warm with a blanket
6. Avoid giving hot/cold drink to patient(since patient may require emergency
operation by doctor)
7. Make immediate arrangements to shift patient to a hospital
8. Keep patient in lying-down flat position with HEAD LOWERED & turned to a
side  raise the legs slightly upwards by keeping a pillow under the legs (to
improve circulation)

SNAKE BITE

 Out of 2,500 species of snakes  only 200 species are poisonous
 Most poisonous snakes in India include:
a. Common krait
b. Common cobra
c. Saw-scaled viper
d. Russell’s viper
• If snake bite is poisonous  only then go for antivenom treatment
• Clinical manifestations of snake bite include nausea, vomiting, mild swelling,
pain at site of wound, shortness of breath, numbness, blurred vision, shock,
convulsions & paralysis, slow pulse, etc.

 First-aid treatment strategies include:
a. Lay patient down  try to cool down & calm the patient (assurance is required,
to prevent neurogenic shock)
b. Avoid moving the bitten part(to prevent faster absorption of venom into
systemic circulation)
c. Apply a constricting band, cloth / tourniquet above fang mark(helps to prevent
spread of poison to other body parts)
d. Wash wound with soap & water
e. Make a CROSS-WISE SHARP CUT over bitten area  allow to bleed by
squeezing the area
f. Suck out the poison (using suction pump/mouth) CAREFULLY  then spit it
out
g. If breathing ceases  give artificial respiration
h. Transfer patient immediately to a hospital.

A SHORT INSIGHT INTO
TORNIQUETS!

 Refer to devices made of cord, rubber tube, leather/ tight bandage
 Tied around arm/leg to prevent flow of blood/ to prevent spread of poison
systemically
 Since tourniquet is tightly bound around the affected area  there wont be flow
of blood beyond the part over which it is tied  increase risk of permanent tissue
damage/gangrenes(if left for more than 15 minutes)
 No longer recommended as FIRST-AID MEASURE to stop bleeding/prevent
poison spreading, due to the risk of reduced oxygen supply to other tissues.

BURNS & SCALDS:

 Burns refer to injuries caused by DRY HEAT like fire, flames, hot metals,
caustics, acids, etc
 Scalds refer to injuries caused by MOIST HEAT like boiling water, steam, hot oil,
etc.
 Since both burns & scalds cause similar damage to body tissues  hence first-aid
treatment for both of them is relatively similar.
 First-aid treatments include:
1. Extinguish fire by splashing water, covering the flames with blanket/ coat
2. Splash cold water/ any other non-inflammable liquid over the affected part
3. If possible  immerse affected part in cold water for 15-20 minutes
4. Do not try to remove the clothings from burnt area(instead, cut them around!)
5. Keep victim calm & in LIE-DOWN POSITION to avoid shock
6. Provide reassurance to patient
7. Give any liquid to the victim to drink if the patient is conscious

8. Do not disturb blisters in any way
9. Do not use absorbent cotton, oily substances, antiseptics, baking soda, etc on the
burn
10. In case of chemical burns  wash the area with water until all the chemical
has been washed away
11. If eyes are affected with burns  wash them thoroughly
12. For extensive burns  wrap victim in a clean cloth shift patient immediately
to nearby hospital.

ELECTRIC SHOCK

 Measures include:
a. Switch off electric current
b. Remove plug from socket
c. Separate victim from current source with a long wooden stick/ any other
NONCONDUCTOR
d. If current is on  NEVER TRY TO SEPARATE VICTIM WITH NAKED
HANDS/ BARE-FOOTED!
e. If necessary  go for ARTIFICIAL RESPIRATION/ CARDIAC MASSAGE
f. Based on need  shift patient to a hospital as early as possible
g. Keep body of patient warm by covering with a blanket
h. Treat shock(if present)
i. Treat burns.

FIRST-AID TREATMENT OF
POISONING

 A poison refers to a substance, which when introduced into the body/brought into
contact with a person (via any route)  can produce ill health/even death
 Poison may enter into body via any of the following routes:
A. ORAL:
- Contaminated food
- Drugs
- Alcohol
- Insecticides
- Strong acids/alkalis
B. INHALATION:
- CO
- CO2

C. INJECTION:
- Narcotics
- Sedatives
- Toxic agents
D. SKIN:
- Pesticides, etc.
E. BITES:
- Dog, wild animals, snake, bee, wasp, etc.

 Preventing measures for poisoning:
a. Always keep drugs under LOCK & KEY, so as to prevent beyond reach of
children
b. Do not store medicines for long periods
c. Discard expired drugs
d. Take proper precautions while storing & handling common poisonous
substances like insecticides, pesticides , disinfectants & petroleum products
e. Do not take drugs in the dark
f. Always read label of the container while taking the drug
g. Use cooking gas carefully
h. Get your pets immunized against rabies
i. Carefully destroy the empty containers of poisonous substances!!!!

 FIRST-AID treatment strategies for poisoning:
1. If patient is conscious  as him/her the following questions:
2. If there are empty containers, wrappers/ drugs lying near the patient  collect
& examine them  may provide information regarding the poison the patient
has consumed  may help in directing the right treatment
3. If patient is conscious & co-operative  induce emesis by any of the following
methods:
a. By tickling back of patient’s throat with the help of fingers
b. By administering a glass of warm water (containing 2 tsp of common salt)
c. By administering emetics like SYRUP OF IPECAC.
4. Vomit  should be preserved for chemical analysis
5. If patient is unconscious / is suspected have consumed strong acid/alkali  DO
NOT INDUCE VOMITING!

6. For ingestion of strong acids (like sulfuric acid, HCl, etc)  give:
a. Chalk powder
b. Milk of magnesia
c. Calcium hydroxide
d. Baking powder
7. For ingestion of STRONG ALKALIES (Sodium hydroxide, potassium hydroxide,
strong ammonia)  give:
a. Lemon juice
b. Vinegar
c. Butter milk
8. After vomiting & gastric lavage  give the patient MILK, TEA, COFFEE/ EGG
ALBUMIN

9. If gaseous poisoning (like smoke, CO, CO2)  focus on the following first-aid
measures:
a. Evacuate patient from room filled with poisonous gas to an open place, where
fresh air is available
b. Avoid crowding near the patient !
c. Loosen patient’s clothings
d. If necessary, give him artificial respiration
e. If condition is serious shift patient to a hospital immediately
10. Inform the police.

HEART DISEASES

 In angina pectoris  there is pain in the chest
 Induced by exercise & relieved by rest
 May spread to jaws & arms
 Occurs due to low supply of blood to heart by coronary arteries
 FIRST-AID MEASURES INCLUDE:
1. Give patient complete bed rest
2. If there is pain  keep a tablet of nitroglycerin under his tongue  helps to
dilate coronary arteries & improves blood supply
3. Ask patient to not involve in laborious work
4. Avoid obesity
5. In severe cases  bed room should be on the ground floor.

 One of the GREATEST & MOST IMPORTANT MEDICAL EMERGENCIES
 In this condition  there is damage/death of a part of heart muscles/ due to
deposition of cholesterol in coronary vessels  causes interruption of blood
supply to that area of the heart
 Can cause severe pain in the chest that radiates to the medial site of the left arm
 FIRST-AID TREATMENT includes:
1. Provide patient complete bed rest
2. Give sublingual tablet of sorbitrate to patient  helps in dilation of coronary
vessels & relieves pain
3. Loosen clothings of patient & reassure him
4. If oxygen is available  administer it
5. If cardioactive drugs (digoxin, lidocaine) are present  provide them
immediately.

6. Make arrangements to shift patient to hospital emergency room as early as
possible
7. Never allow patient to walk to emergency room (instead carry patient on a
stretcher/wheel chair)!

 Defined as “severe loss of blood from blood vessels”
 May be external/internal
 In external hemorrhage  blood escapes from external parts of body
 In internal hemorrhage  blood passes into tissues surrounding ruptured blood
vessels
 A serious clinical condition, demanding URGENT MEDICAL ATTENTION!!
 FIRST-AID MEASURES include:
1. For minor bleeding cases  usually they tend to cease automatically after some
time/ apply firm pressure & bandage, followed by antiseptic lotion
2. For external bleeding  remove clothings from affected part
3. Lay person down in a comfortable position & raise the injured part(if no
fracture is suspected)
4. Apply direct pressure on exposed bleeding part using bandages/handkerchief
etc

5. Bandage should not be tied too tightly  can risk blockade of blood flow to other
parts of body
6. Avoid controlling bleeding of neck & head by applying direct pressure (IT CAN
BE DANGEROUS!!)
7. Keep the patient warm
8. Check pulse rate & general health of patient
9. If case is unmanageable  shift patient immediately to nearby hospital
emergency room.

FRACTURES

 Refers to breakage of bone
 Classified into following types:
A. SIMPLE FRACTURE:
- Also known as “closed fracture”
- Bone is broken, with no breakage of skin
B. COMPOUND FRACTURE:
- Also known as “open fracture”
- Bone is broken, along with open wound in soft tissues
- Bone may even protrude out through the wound!!
- Can also increase propensity for infections
C. COMPLICATED FRACTURES:
- Here  injury to blood vessel, nerve / any vital organs like brain, lungs, spleen,
etc.

 Clinical manifestations of fractures include:
a. Pain (at/near site of fracture)
b. Tenderness/pain over affected area(on applying pressure)
c. Swelling at fracture site
d. Chances of DEFORMITY
e. Patient is unable to move affected part
f. Unnatural movements (crepitus/grating) may be heard may be felt / heard

 FIRST-AID MEASURES for fractures include:
a. Immediately control bleeding by applying pressure bandage
b. Cover all wounds with STERILE DRESSINGS
c. Immobilize fractured part immediately so as to avoid injury to other body
parts(due to unwanted movements of fractured part)
d. Do NOT MOVE FRACTURED PART UNLESS NECESSARY!
e. During immobilization of broken bones  use adequate padding in the natural
hollows(simply means additional support!)
f. Do NOT give anything orally to the patient, since emergency operation may be
required
g. Keep the patient warm
h. Treat the shock, if necessary
i. Analgesics may be given to the pain(in excruciating pain!)
j. Make arrangements to shift patient to hospital as early as possible!!!

BE
TACTFUL
DURING
FIRST-AID
SERVICES!!
(VIDEO
GUIDANCE)

CARDIOPULMONARY
RESUSCITATION

 Cardiopulmonary resuscitation (CPR) is a lifesaving technique useful in many
emergencies, including a heart attack or near drowning, in which someone's
breathing or heartbeat has stopped.
 The American Heart Association recommends that everyone — untrained
bystanders and medical personnel alike — begin CPR with chest compressions.
 It's far better to do something than to do nothing at all if you're fearful that your
knowledge or abilities aren't 100 percent complete.
 Remember, the difference between your doing something and doing nothing could
be someone's life!!!

 Here's advice from the American Heart Association:
a. Untrained. If you're not trained in CPR, then provide hands-only CPR. That
means uninterrupted chest compressions of 100 to 120 a minute until paramedics
arrive (described in more detail below). You don't need to try rescue breathing.
b. Trained and ready to go. If you're well-trained and confident in your ability,
check to see if there is a pulse and breathing. If there is no breathing or a pulse
within 10 seconds, begin chest compressions. Start CPR with 30 chest
compressions before giving two rescue breaths.
c. Trained but rusty. If you've previously received CPR training but you're not
confident in your abilities, then just do chest compressions at a rate of 100 to 120
a minute. (Details described below.)
 The above advice applies to adults, children and infants needing CPR, but not
newborns (infants up to 4 weeks old).

CPR can keep oxygenated blood flowing to the brain and
other vital organs until more definitive medical treatment
can restore a normal heart rhythm.
When the heart stops, the lack of oxygenated blood can
cause brain damage in only a few minutes.
A person may die within eight to 10 minutes!!!!

 Before starting CPR, check:
a. Is the environment safe for the person?
b. Is the person conscious or unconscious?
c. If the person appears unconscious, tap or shake his or her shoulder and ask
loudly, "Are you OK?"
d. If the person doesn't respond and two people are available, have one person call
911 or the local emergency number and get the AED(Automated External
Defibrillator), if one is available, and have the other person begin CPR.
e. If you are alone and have immediate access to a telephone, call 911 or your local
emergency number before beginning CPR. Get the AED, if one is available.
f. As soon as an AED is available, deliver one shock if instructed by the device,
then begin CPR.

The American Heart Association uses the letters C-A-B —
compressions, airway, breathing — to help people remember
the order to perform the steps of CPR.
A. Compressions: Restore blood circulation:
 Put the person on his or her back on a firm surface.
 Kneel next to the person's neck and shoulders.
 Place the heel of one hand over the center of the person's chest, between the
nipples. Place your other hand on top of the first hand. Keep your elbows
straight and position your shoulders directly above your hands.
 Use your upper body weight (not just your arms) as you push straight down on
(compress) the chest at least 2 inches (approximately 5 centimeters) but not
greater than 2.4 inches (approximately 6 centimeters). Push hard at a rate of 100
to 120 compressions a minute.
 If you haven't been trained in CPR, continue chest compressions until there are
signs of movement or until emergency medical personnel take over. If you have
been trained in CPR, go on to opening the airway and rescue breathing.

B. Open the airway:
- If you're trained in CPR and you've performed 30 chest compressions, open the
person's airway using the head-tilt, chin-lift maneuver.
- Put your palm on the person's forehead and gently tilt the head back.
- With the other hand, gently lift the chin forward to open the airway!!!

C. Breathing: Breathe for the person:
 Rescue breathing can be mouth-to-mouth breathing or mouth-to-nose breathing if the
mouth is seriously injured or can't be opened.
 With the airway open (using the head-tilt, chin-lift maneuver), pinch the nostrils shut
for mouth-to-mouth breathing and cover the person's mouth with yours, making a seal.
 Prepare to give two rescue breaths. Give the first rescue breath — lasting one second —
and watch to see if the chest rises. If it does rise, give the second breath. If the chest
doesn't rise, repeat the head-tilt, chin-lift maneuver and then give the second breath.
Thirty chest compressions followed by two rescue breaths is considered one cycle. Be
careful not to provide too many breaths or to breathe with too much force.
 Resume chest compressions to restore circulation.
 As soon as an automated external defibrillator (AED) is available, apply it and follow
the prompts. Administer one shock, then resume CPR — starting with chest
compressions — for two more minutes before administering a second shock. If you're not
trained to use an AED, a 911 or other emergency medical operator may be able to guide
you in its use. If an AED isn't available, go to step 5 below.
 Continue CPR until there are signs of movement or emergency medical personnel take
over!!!

First Aid Measures: A deep insight, by RxVichuZ! :)

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First Aid Measures: A deep insight, by RxVichuZ! :)