FIRST AID

1. FIRST AID

2. INTRODUCTION • It is the provision of treatment to preserve life and minimise the consequences of illness or injury until medical help is available. • Aid means help. • Preserve Life ,Prevent Worsening, Promote Recovery • First Aid can be defined as "measures to be taken immediately after an accident not with an idea to cure but in order to prevent further harm being done”. • It uses the available human and material resources at the site of accident to provide initial care to the victim of injury or sudden illness until more advanced care is provided

3. Very Important Three Things Are A,B,C A – AIRWAY. B– BREATHING. It is the process of drawing air into and expelling air from the lungs. C - CIRCULATION. . Sh. B R M HOSPITAL, LPU

4. . Adult Basic Life Support Unresponsive. Shout for help. Open airway. Not Breathing Normally. 30 chest compressions. 2 rescue breaths. 30 compressions. Sh. B R M HOSPITAL, LPU

5. Make sure the victim, any bystanders, and you are safe. • Check the victim for a response. Gently shake his shoulders and ask loudly, ‘Are you all right?’ A. If he responds: • Leave him in the position in which you find him provided there is no further danger. • Try to find out what is wrong with him and get help if needed. • Reassess him regularly. Sh. B R M HOSPITAL, LPU

6. B. If he does not respond: 1. Shout for help. 2. Turn the victim onto his back and then open the airway using head tilt and chin lift: 3. Place your hand on his forehead and gently tilt his head back. With your fingertips under the point of the victim's chin, lift the chin to open the airway. Normal position lifted chin to open the airway Sh. B R M HOSPITAL, LPU

7. 4. Keeping the airway open, look, listen, and feelfor normal breathing. • Lookfor chest movement. • Listenat the victim's mouth for breath sounds. • Feelfor air on your cheek. • In the first few minutes after cardiac arrest, a victim may be barely breathing, or taking infrequent, noisy, gasps. This is often termed agonal breathing and must not be confused with normal breathing. • Look, listen, and feel for not more than 10 s to determine if the victim is breathing normally. If you have any doubt whether breathing is normal, act as if it is not normal. Sh. B R M HOSPITAL, LPU

8. 5. If he is breathing normally: • Turn him into the recovery position. • Summon help from the ambulance service by mobile phone. If this is not possible, send a bystander. Leave the victim only if no other way of obtaining help is possible. • Continue to assess that breathing remains normal. If there is any doubt about the presence of normal breathing, start CPR . Sh. B R M HOSPITAL, LPU

9. Cardiopulmonary Resuscitation (CPR) • If he is not breathing normally: • Call for an ambulance . • Leave the victim only when no other option exists for getting help. • Start chest compression as follows: • Kneel by the side of the victim. • Place the heel of one hand in the centre of the victim’s chest(which is the lower half of the victim’s sternum (breastbone)). • Place the heel of your other hand on top of the first hand. • Interlock the fingers of your hands and ensure that pressure is not applied over the victim's ribs. Do not apply any pressure over the upper abdomen or the bottom end of the sternum. • Position yourself vertically above the victim's chest and, with your arms straight, press down on the sternum 5 - 6 cm. • After each compression, release all the pressure on the chest without losing contact between your hands and the sternum. Repeat at a rate of 100 - 120 min-1. • Compression and release should take an equal amount of time. Sh. B R M HOSPITAL, LPU

10. 1st step 2nd step For Baby 3rd step Sh. B R M HOSPITAL, LPU

11. Combine chest compression with rescue breaths: After 30 compressions open the airway again using head tilt and chin lift. Pinch the soft part of the victim’s nose closed, using the index finger and thumb of your hand on his forehead. Allow his mouth to open, but maintain chin lift. Take a normal breath and place your lips around his mouth, making sure that you have a good seal. Blow steadily into his mouth whilst watching for his chest to rise; take about one second to make his chest rise as in normal breathing; this is an effective rescue breath. Maintaining head tilt and chin lift, take your mouth away from the victim and watch for his chest to fall as air comes out. Sh. B R M HOSPITAL, LPU

12. 7. Take another normal breath and blow into the victim’s mouth once more to give a total of two effective rescue breaths. The two breaths should not take more than 5 s. Then return your hands without delay to the correct position on the sternum and give a further 30 chest compressions. 8. Continue with chest compressions and rescue breaths in a ratio of 30:2. 9. Stop to recheck the victim only if he starts to show signs of regaining consciousness, such as coughing, opening his eyes, speaking, or moving purposefully and starts to breathe normally; otherwise do not interrupt resuscitation.

13. SHOCK Elevation of lower limb up to 60degree. Sh. B R M HOSPITAL, LPU

14. Epileptic Seizures Sh. B R M HOSPITAL, LPU

15. EPILEPSY • First-aid measures: • Stay calm. • Prevent injury. • During the seizure, you can exercise your common sense by insuring there is nothing within reach that could harm the person if she/he struck it. • Pay attention to the length of the seizure. • Make the person as comfortable as possible. • Keep onlookers away. • Do not hold the person down. • If the person having a seizure thrashes around there is no need for you to restrain them. Remember to consider your safety as well. Sh. B R M HOSPITAL, LPU

16. Do not put anything in the person's mouth. • Contrary to popular belief, a person having a seizure is incapable of swallowing their tongue so you can breathe easy in the knowledge that you do not have to stick your fingers into the mouth of someone in this condition. • Do not give the person water, pills, or food until fully alert. • If the seizure continues for longer than five minutes. Be sensitive and supportive, and ask others to do the same. • After the seizure, the person should be placed on her left side. Keep in mind there is a small risk of post-seizure vomiting, before the person is fully alert. Therefore, the person’s head should be turned so that any vomit will drain out of the mouth without being inhaled. Stay with the person until she/he recovers (5 to 20 minutes).

17. Recovery position: • Remove the victim’s glasses, if present. • Kneel beside the victim and make sure that both his legs are straight. • Place the arm nearest to you out at right angles to his body, elbow bent with the hand palm-up. • Bring the far arm across the chest, and hold the back of the hand against the victim’s cheek nearest to you. • With your other hand, grasp the far leg just above the knee and pull it up, keeping the foot on the ground. • Keeping his hand pressed against his cheek, pull on the far leg to roll the victim towards you on to his side. Sh. B R M HOSPITAL, LPU

18. Adjust the upper leg so that both the hip and knee are bent at right angles. • Tilt the head back to make sure that the airway remains open. • If necessary, adjust the hand under the cheek to keep the head tilted and facing downwards to allow liquid material to drain from the mouth. • Check breathing regularly. • If the victim has to be kept in the recovery position for more than 30 min turn him to the opposite side to relieve the pressure on the lower arm.

19. CHOCKING • Attack occurs while eating • Victim may clutch his neck. Sh. B R M HOSPITAL, LPU

20. Signs of severe airway obstruction:-:s of severe airway obstru • Response to question ‘Are you choking?’ • Victim unable to speak • Victim may respond by nodding Other signs • Victim unable to breathe • Breathing sounds wheezy • Attempts at coughing are silent • Victim may be unconscious Sh. B R M HOSPITAL, LPU

21. Signs of mild airway obstruction: • Response to question ‘Are you choking?’ • Victim speaks and answers yes • Other signs • Victim is able to speak, cough, and breathe.

22. Sequence for the treatment of adult choking • 1. If the victim shows signs of mild airway obstruction: • Encourage him to continue coughing, but do nothing else. • 2. If the victim shows signs of severe airway obstruction and is conscious: • Give up to five back blows. • Stand to the side and slightly behind the victim. • Support the chest with one hand and lean the victim well forwards so that when the obstructing object is dislodged it comes out of the mouth rather than goes further down the airway. • Give up to five sharp blows between the shoulder blades with the heel of your other hand. Sh. B R M HOSPITAL, LPU

23. Heimlich maneuver Back blows Sh. B R M HOSPITAL, LPU

24. Back Blows: • Check to see if each back blow has relieved the airway obstruction. The aim is to relieve the obstruction with each blow rather than necessarily to give all five. • If five back blows fail to relieve the airway obstruction give up to five abdominal thrusts. • Stand behind the victim and put both arms round the upper part of his abdomen. • Lean the victim forwards. • Clench your fist and place it between the umbilicus (navel) and the bottom end of the sternum (breastbone). • Grasp this hand with your other hand and pull sharply inwards and upwards. • Repeat up to five times. • If the obstruction is still not relieved, continue alternating five back blows with five abdominal thrusts.

25. 3. If the victim becomes unconscious: • Support the victim carefully to the ground. • Call an ambulance immediately. • Start doing CPR .

26. Types Of Wound 1. Contusion (doesn't break the skin) 2. Abrasion (where the skin is torn) 3. Laceration (deeply cut edges) 4. Incision (made during surgery) 5. Puncture (a pointed instrument) 6. Gun Shot 7. Amputation (Removal of extremity part ) 8. Degloved (skin and subcutaneous tissue of the hand are torn) Sh. B R M HOSPITAL, LPU

27. Different types of wounds Sh. B R M HOSPITAL, LPU

28. HEAD , NECK, SPINAL INJURY • Immobilize the head, neck and body on both sides • Movements may dislocate vertebra and cause further injury • If there is no sign of breathing, perform CPR . • Do not tilt head backward during CPR Sh. B R M HOSPITAL, LPU

29. BURNS Sh. B R M HOSPITAL, LPU

30. 1 2 3 First Aid For Burns ( By Heat Or Chemical) COOL! REMOVE DRESS Sh. B R M HOSPITAL, LPU

31. FIRST AID FOR ELECTRIC SHOCK • Do not attempt to move the victim from current source • First step is to switch off the current source. • Otherwise, move the source using a wooden stick • Attend to the victim • Check for breathing • No breathing, do CPR • Call emergency medical aid • Treat for minor burns • If breathing, do a physical examination • Re-establish vital functions ( BP, PULSE) • Excessive burns may require hospitalization/ surgery • Supportive care must be provided Sh. B R M HOSPITAL, LPU

32. FIRST AID FOR SPRAIN AND STRAIN SPRAINmeans sudden and excessive exertion on a joint, ligament, or muscle. STRAIN means to pull, draw, or stretch tight. • Rest • ICE Application • Compression • Elevation Sh. B R M HOSPITAL, LPU

33. Unconsciousness / fitting. Confused / restless. Headache, dizzy, uncomfortable. Strong bounding pulse. Flushed dry skin, hot to touch. Cramps in stomach / arms / legs. Pale sweaty skin. Nausea / loss of appetite. Normal Body Temperature Shivering Fatigue, Slurred speech Confusion, forgetfulness Shivering stops, muscle rigidity Very slow, very weak pulse Noticeable drowsiness Severe reduction in response levels Unconsciousness Dilated pupils Pulse undetectable Appearance of death Heat Stroke Heat Exhaustion Normal Mild Hypothermia Severe Hypothermia 0F 0C 109.4 43 107.6 42 105.8 41 104 40 102.2 39 100.4 38 98.6 37 96.8 36 95 35 93.2 34 91.4 33 89.6 32 87.8 31 86 30 84.2 29 82.4 28 80.6 27 78.8 26 77 25 75.2 24 BODY TEMPERATURE

34. Heat exhaustion, Heat stroke/Sun stroke • Get the person out of the sun and into • a shady or air-conditioned location. • Lay the person down and elevate the • legs and feet slightly. • Loosen or remove person's clothing. • Have the person drink cool water or • other non alcoholic beverage without caffeine. • Cool the person by spraying or sponging him or her with cool water and fanning. • Monitor the person carefully. Heat exhaustion can quickly become heatstroke. • Note: In Heat stroke body temp goes up to 105 degree F. it may be fatal because of brain damage. Sh. B R M HOSPITAL, LPU

35. DOG BITE • If the wound barely breaks the skin, treat it as a minor wound. • Scrub the bite thoroughly with soap and running water. • Apply antibiotic cream and a loose sterile bandage. • If the bite creates a deep puncture of the skin or the skin is badly torn and bleeding, apply pressure to stop the bleeding and see your doctor. Sh. B R M HOSPITAL, LPU

36. SNAKE BITE Sh. B R M HOSPITAL, LPU

37. Keep the victim calm, restrict movement. • Stop lymphatic spread of venom - bandage firmly, splint and immobilise. The limb, which has been affected by the bite, should be immobilized with splint. Victim to keep the hand as close to the level of the heart as possible - this reduces the flow of venom to major areas. A compression bandage (as firm as you would put on a sprained ankle) should cover the entire limb with the splint. The wrapping should start from the digits and extend till armpit in case of hands and groin in case of bite to the leg. • Assure the victim and do not let him panic. When under panic, it will enhance heart rate and would circulate the venom faster in the body.

38. Remove any rings or constricting items; the affected area may swell. • A snakebite victim is under tremendous psychological stress. It is necessary to keep the patient warm. However, no alcohol/hot beverages should be given. • The patient should not be allowed to exert himself in any manner. Do not allow the victim to eat or to drink water in order to keep metabolism at low rate. • No water No food is the golden rule. • Do Not Cover The Bite Area And Puncture Marks. The wound should be gently cleaned with antiseptic. Sh. B R M HOSPITAL, LPU

39. Try to aspirate the venom out of the puncture marks with standard suction devices. It has been identified that a suction more than 270 mmHg can initiate the flow from the puncture marks. Suction instruments often are included in commercial snakebite kits. But, the suction should be applied within 5 minutes of the bite. • The only remedy for venomous snakebite is the anti- venom serum, which is available at most government hospitals and public health centres. Some private nursing homes have also started stocking it and treat snakebite cases.

40. BEES AND WASP STINGS 1. Remove the Stinger Scrap the area with a fingernail or use tweezers to remove it. Don't pinch the stinger -- that can inject more venom. Sh. B R M HOSPITAL, LPU

41. 2. Control Swelling Ice the area. If you were stung on your arm or leg, elevate it. Remove any tight-fitting jewellery from the area of the sting. As it swells, rings or bracelets might become hard to get off. Sh. B R M HOSPITAL, LPU

42. 3. Treat Symptoms For pain, take an over-the-counter painkiller like acetaminophen or ibuprofen. Do not give aspirin to anyone under age 18. For itchiness, take an antihistamine. You can also apply a mixture of baking soda and water or calamine lotion. 4. Follow-Up It might take 2-5 days for the area to heal. Keep it clean to prevent infection.

43. POISON • Poisoning by swallowing: • Check and monitor the person's airway, breathing, and pulse. If necessary, begin rescue breathing and CPR. • Try to make sure that the person has indeed been poisoned. It may be hard to tell. • Some signs include chemical-smelling breath, burns around the mouth, difficulty breathing, vomiting, or unusual odors on the person. If possible, identify the poison. • Do NOT make a person throw up unless told to do so by poison control or a health care professional. Sh. B R M HOSPITAL, LPU

44. If the person vomits, clear the person's airway. Wrap a cloth around your fingers before cleaning out the mouth and throat. If the person has been sick from a plant part, save the vomit. It may help experts identify what medicine can be used to help reverse the poisoning. • If the person starts having convulsions, give convulsion first aid. • Keep the person comfortable. The person should be rolled onto the left side, and remain there while getting or waiting for medical help. • If the poison has spilled on the person's clothes, remove the clothing and flush the skin with water.

45. Inhalation Of Poison: • Call for emergency help. Never attempt to rescue a person without notifying others first. • If it is safe to do so, rescue the person from the danger of the gas, fumes, or smoke. • Open windows and doors to remove the fumes. • Take several deep breaths of fresh air, and then hold your breath as you go in. Hold a wet cloth over your nose and mouth. • Do not light a match or use a lighter because some gases can catch fire. Sh. B R M HOSPITAL, LPU

46. After rescuing the person from danger, check and monitor the person's airway, breathing, and pulse. If necessary, begin rescue breathing and CPR. • If necessary, perform first aid for eye injuries (eye emergencies) or convulsions ( convulsion first aid). • If the person vomits, clear the person's airway. Wrap a cloth around your fingers before cleaning out the mouth and throat. • Even if the person seems perfectly fine, get medical help.

47. Diabetes Sh. B R M HOSPITAL, LPU

48. Chin up as you lift Keep your back upright Bend with your knees not your back Keep the load as close to your body as possible Feet apart to give you balance Moving and Handling Sh. B R M HOSPITAL, LPU

49. PROMISE: I will maintain my health and guide others. I will help every victim during accident & sudden emergency to save every life. I will abide traffic & others rules for safety, peace & prosperity. I will avoid drugs and intoxication and also guide others. I will keep me and my surroundings clean and hygienic. Sh. B R M HOSPITAL, LPU