First Aid care & It's Implication 19-8-17.pptx

A good presentation on First Aid

1. WELCOME

2. First Aid Care & its Implications Maj Neamatullah Ahmed,PBGMS,MPH,MCPS

3. Introduction The word “First” means initial and “Aid “ means help. The initial help or immediate care given to an injured or suddenly sick person before arrival of an ambulance or an expert medical personnel is known as First Aid Care .

4. Fire Land Slide First Aid is Provided In

5. Drowning Choking First Aid is Provided In

6. Road Traffic Accident Battlefield First Aid is Provided In

7. Different Bites Trauma / Injury First Aid is Provided In

8. Aim Aim is to highlight the First Aid measures necessary to handle emergency situations

9. Scope Brief appraisal of First aid Cardio-Pulmonary R esuscitation First Aid of common medical emergencies Surgical aspect of First Aid First Aid of some environmental emergencies

10. First Aid First Aid is the assistance or treatment given to a casualty for any injury or sudden illness before the arrival of an ambulance or qualified medical expert. It may involve improvising with facilities and materials available at the time. - WHO First Aid can be initiated by anyone in any situation & includes self-care.

11. Aim of First Aid First Aid treatment is given to a casualty in order: To preserve life To prevent the condition from worsening To promote recovery.

12. Goals of First Aid

13. Principles of First Aid Do not harm (know what to do and what not to do). First Aid is not an exact science and is open to error. First Aid is about putting first things first. Safety is of utmost importance in First Aid.

14. History of First Aid 1740 : The Paris Academy of Sciences recommended mouth to mouth resuscitation for drowning victims. 1903 : Dr. George Crile reported 1 st successful use of external chest compressions in human resuscitation 1954 : James Elam was the first to prove that – expired air was sufficient ( 16% ) to maintain adequate oxygenation. 1956 : Peter Safar & James Elam invented mouth-to-mouth resuscitation.

15. 1957 : The US Military adopted the mouth to mouth resuscitation method to revive unresponsive victims. 1960 : CPR was develop. AHA became the forerunner of CPR training for the general public. 1999 : 1 st task force on First Aid was appointed. 1 st International Conference on Guideline for CPR & ECC. 2010 : 50th Anniversary of CPR. 2015 : The 2015 AHA Guidelines updated for CPR & ECC ( Emergency Cardiovascular Care ). History of First Aid

16. Statistics of First Aid 2016 (USA) Total incidence more than 3,50,000 cases. 90% of outside hospital cases among them were dead. Among them 70 % cases ensued at home. Out of that, 46% heart attack cases And 32% cardiac arrest cases got CPR & ¼ th of them were survived.

17. First Aid Kit Cotton wool Adhesive tape Crepe bandage Sterile Dressing Bandage Thermometer Scissors Glove Soap Pain reliever Antacid ORS Packets

18. First Aid Symbols / Emblems

19. First Aid Symbols / Emblems

20. Action Plan This Action Plan is a vital aid to the first aider in assessing whether the victim has any life-threatening conditions and if any immediate first aid is necessary. They are DRABC   . D - Check for DANGER To you To others To victim R - Check RESPONSE Is victim conscious? Is victim unconscious?

21. A - AIRWAY Is airway clear of objects? Is airway open ?   B - BREATHING Is chest rising and falling? Can you hear victim's breathing? Can you feel the breath on cheek?   C - CIRCULATION Can you feel a pulse? If B & C OK→ Check for other injuries If B & C absent →Start CPR Action Plan

22. Fainting Fainting also called syncope is a sudden, brief loss of consciousness and posture caused by decreased blood flow to the brain. It is a common problem, accounting for 3% of emergency room visits and 6% hospital admission .

23. If you have seen a person is fainting then: Don’ts : Don’t give the patient anything to eat or drink. Don’t allow the person who has just fainted to get up until the victim is fully conscious. If the area is warm, don’t crowd around the victim.  

24. Catch the person before he/she falls. Pinch the person and see if he/she moves or opens his/her eyes. Examine the injuries and causes of unconsciousness. Tilt head back and keep arms at right angle to body. Do’s :

25. Raise the legs 8 – 12 inches. This promotes blood flow to the brain. Loosen any tight clothing Keep the victim warm if it is cold outside. Keep a record of the casualty’s condition. Do’s :

26. 1 To initiate breathing 2 To restore blood circulation 3 Prevent irreversible brain damage from anoxia Purposes of CPR

27. Rate Five key aspects of CPR 1 Depth 2 Release 3 Ventilation 4 Uninterrupted CPR 5

28. R : Responsiveness Tap shoulder and shout “Are you ok?” “Can you hear me?” Give simple orders “Press my hand.” If there is no reply and no response, the victim is unconscious . Survey The Patient: RAP : ABCDE

29. RAP A : Activate EMS If you are two persons there, one should go for - call 112– come back and let another know what they said. If you are alone, you may have to make the call rapidly & come-back to help people- because time is very much valuable in this regard .

30. P : Position on back / left lateral All body parts rolled over at the same time Always be aware of head and spinal cord injuries Support neck and spinal column. RAP

31. Summary of First Aid Patient Survey ABCDE A : Airway Open the airway Head tilt chin lift

32. B : Check For Breathing Look, listen and feel for breathing No longer than 10 seconds

33. Mouth to Mouth Barrier Devices Masks Shields

34. Summary of First Aid Patient Survey C : Circulation Check Pulse at Carotid Artery (5-10 seconds ). If no pulse, start chest compressions.

35. D Assess for Deformity. Hands on; Head to toe Examination for all other injuries and conditions that will require treatment. E Expose If you can’t see it, you can’t treat it. Summary of First Aid Patient Survey

36. External Chest Compressions No pulse = No heart beat External Chest Compressions must be delivered to keep the blood circulating Without a proper blood supply to the brain, DEATH results in 3 minutes!

37. Start CPR Immediately Better chance of survival. Brain damage starts in 4-6 minutes. Brain damage is certain after 10 minutes without CPR.

38. CPR-cardio pulmonary resuscitation After 30 chest compressions give 2 slow breaths Continue until help arrives or victim recovers. If the victim starts moving : check breathing .

39. CPR

40. When one c an s top CPR? If Victim revives If Replaced by another rescuer If trained help arrives If too exhausted to continue If unsafe scene If physician directed (do not resuscitate orders ) If cardiac arrest persists for longer than 30 minutes ( controversial ).

41. CPR Training Precautions Do not practice on a person. Clean faces properly after each use on a manikin.

42. Complications of CPR Rib fractures Fracture sternum Vomiting & Aspiration Internal injuries: punctured lung, liver contusion or laceration, spleen injury, diaphragm injury. Pneumothorax Haemothorax Haemopericardium

43. Self First Aid during heart-attack while remain alone Call 112 Call a close ally / friend / relative to come for help. Take Tab Aspirin 325mg( 2 Tab Jusprin 81mg) chew and swallow with a glass of water. Take Tab Nitroglycerine : 1 tab sublingally or Nitromint Spray : 2 spray sublingually if prescribed by concerned specialist earlier. Lie down flat on a bed comfortably with leg ends raised . Massage round wise around any one ( right or left ) carotid artery to ↓ HR & ↓ BP.

44. A person chokes when the airway is partially or completely blocked. Unless given correct first aid treatment, the casualty may die. Choking

45. How To Recognize Choking ? Can you hear breathing or coughing sounds? High pitched breathing sounds? Is the cough strong or weak ? Can’t speak, breathe or cough Turning blue Universal distress signal (clutches neck ).

46. Universal distress signal (clutches neck )

47. Conscious Choking Give 5 abdominal thrusts (Heimlich maneuver) Place fist just above the umbilicus Give 5 upward and inward thrusts Pregnant or obese? 5 chest thrust Fists on sternum If unsuccessful, support chest with one hand and give back blows with the other Continue until successful or victim becomes unconscious.

48. What to do if y ou a re Choking and y ou a re alone ? Use fist or Use rounded corner Blunt end of a furniture Be creative.

49. Choking Choking = Airway obstruction Requires the Heimlich Maneuver

50. Video of Chocking

51. If Victim Becomes Unconscious After Giving Thrusts Call 112 Try to support victim with your knees while lowering victim to the floor. Assess Begin CPR After chest compressions, check for object before giving breaths .

52. 53 Heat Exhaustion Recognition Wet/sweaty appearance, Fatigue/Pale look Headaches with possible cramps Treatment Remove from offending environment Fan / cool patient Provide cool drink Advise to see doctor dial 112 if they deteriorate

53. Recognition Hot ,dry ( NO SWEATING ), red skin Rapid Lowered level of consciousness Nausea and/or vomiting Body temperature above 40ºC (104ºF) Heat Stroke

54. Treatment Remove from offending environment Dial 112 for an Ambulance Cool patient with cold, wet sheets Nothing by mouth if unconscious. Heat Stroke

55. What you might see: The casualty may be unconscious Burns Signs of shock. Electrocution

56. What you should do : make the area safe if possible. Do not approach the casualty until the electrical contact has been broken treat any burns treat for shock be prepared to resuscitate. Electrocution

57. Lightning

58. Five Ways Lightning can Kill A direct strike A side flash Conducted current Step voltage Secondary effects

59. Lightning-Caused Hazards Fallen Wires Electrical Fires Forest fires

60. Safety Measures Have a plan Postpone activities Sensitive electronics should be unplugged Keep away from electrical equipment, wiring and water pipes.

61. Warning Signs of Lightning If you feel your hair stand on end, skin tingle, or hear crackling noises (signs of an imminent lightning strike) assume a “lightning-safe position.” If you can see it (lightning), flee it; If you can hear it (thunder), clear it

62. Lightening-safe Position If outside: Crouch on the ground Weight on the balls of your feet Heels together Head lowered Eyes closed Ears covered

63. First aid for Lightning Victims Injured persons do not carry an electrical charge; apply first-aid (if trained) & call 112 Administer first aid as quick as possible If unconscious: Check breathing and pulse Person has a pulse, but not breathing: Begin mouth-to-mouth resuscitation If person has no pulse: Begin cardiopulmonary resuscitation- CPR Check for other injuries Most people die from heart attacks/stop breathing. When Thunder Roars, Go Indoors!

64. Drowning

65. 1. Get Help Notify a lifeguard, if one is close. If not, ask someone to call 112. 2. Move the Person Out of the water. Clean the mouth from sands & other foreign bodies 3. Perform scene survey -assess for danger Drowning

66. 4. Check for Airway Breathing & circulation Place your ear next to the person's mouth and nose to feel air on cheek. Look if the person's chest is moving. 4. If the Person is Not Breathing: Check pulse for 10 seconds. Drowning

67. 5. If There is No Pulse, Start CPR For an adult or child , place the heel of one hand on the center of the chest. You can also push with one hand on top of the other, press down about 2 inches For an infant , place two fingers on the breastbone, press down about 1.5 inches.. Drowning

68. 30 chest compressions followed by 2 breaths Pinch the nose of the victim closed. Take a normal breath, cover the victim's mouth with yours to create an airtight seal, and then give 2 one-second breaths as you watch for the chest to rise. Drowning

69. Check to see if the person has started breathing. Continue this cycle(30:2) until victim starts breathing or emergency help arrives. Drowning

70. Poisoning Identify the ingested substance by looking at presence of any Container or Clues like Stains, Odors, etc. Contact 112 Be careful not to induce vomiting if patient is unconscious or have ingested acids, alkalis, kerosene, petroleum and its derivatives If victim is Vomiting then r oll them onto their sides for drainage (Recovery position) to avoid aspiration

71. Recovery position

72. Outbreak of Fire RACE R : Remove people from immediate danger A : Activate EMS 112 C : Compartmentalize destroy an unaffected room beside a burning room to create a dead space E : Extinguish the fire

73. Extinguishing Fire PASS P : Pull the pin A : Aim at the base of fire S : Squeeze the trigger S : Sweep from side to side

74. Earthquake and Landslide Response of the 1 st responders: Locate the trapped persons To shout for help Maintaining scene survey Moving a casualty First Aid management including Management of trauma & CPR

75. Rattlesnake Copperhead Snake & Scorpion bite Horned viper Scorpion

76. Identification of venomous vs non venomous snake bite

77. Reassure / Calm the victim Immobilize the entire limb lower limb: do not walk upper limb: do not move Do not cut or suck wound Do not apply tourniquet Transport to medical facility Anti-snake venom & Anti scorpion venom should only be given by a doctor. Snake & Scorpion bite

78. Pressure Immobilization of the bitten Limb

79. First aid remedies of bees and wasp bites comprises Bi-carbonate like carbonated drink/soda can be used for bee bites Vinegar for Wasp/Hornet bites. Bees & Wasp & Hornet bites

80. Trauma Care ABCDE

81. Wound Dangers of wound : Bleeding Infection Aim of first aid : Stop bleeding Minimize Germs entering the wound

82. Wound management Stop bleeding Handle gently Wash your hands thoroughly Remove any foreign body if possible Don't remove embedded objects Don’t disturb blood clots Place clean dressing and bandage firmly Shift to hospital

83. What To Do Control of bleeding 2. Immobilize the limb 3. Treat the victim for shock Traumatic amputation 4. Recover the amputated part and whenever possible take it with the victim.

84. Musculoskeletal Injuries Splinting Immobilize the affected part Remember- RICE Rest Ice Compression by Crepe Bandage Elevation

85. Fractures & Dislocations Must treat for bleeding first Don’t straighten break bone. Treat the way you found it Do not push bones back into place

86. Dislocation of the Shoulder

87. Fractures of the Forearm

88. Head & spinal Injury 1 . ASSESMENT Minor/ Major injury ABCDE management Stop bleeding Watch for vomiting, level of consciousness

89. 5. If unconscious place them in recovery position whilst protecting their neck. 6. Call for emergency. Head & spinal Injury

90. Care For Bleeding Apply pressure to the wound Raise & support injured part Bandage wound Check circulation below wound If severe bleeding persists, keep nothing by mouth and & call emergency services. Remember PPP=Pressure, Pack, Position

91. Tourniquet Absolute last resort in controlling bleeding, Remember - Life or limb Once a tourniquet is applied, it is not to be removed , only by a doctor

92. Epistaxis Have patient sit down and lean forward Apply or instruct patient to apply direct pressure Keep patient quiet and calm Do not let patient lean back

93. Immediate care of the burn patients Pre hospital Care - Ensure rescuer safety b. Stop the burning process c. Check for other injuries d. Cool the burn wound e. Give oxygen f. Elevate

94. Assessment of the burn wound a. Patients whole hand Digits & palm ) which represents 1% of TBSA b. The rule of Nine – which states that Each upper limb is - 9% Each lower limb - 18% The torso - 18% each side & The head & neck - 9% Assessing size

95. 2. Assessing the depth of the burn The history is important – temp, time and burning material Superficial burn have capillary filling Deep partial thickness burns do not blanch, but have some sensation Full thickness burns feel leathery & have no sensation

96. 1. Local burn wound care a. Blisters b. Initial cleaning of the burn wound 2. Dressing the minor burn wound Management of minor burns

97. Require immediate medical treatment Call for medical help The volume of fluid lost is directly proportional to the area of burn Third degree burn Above 15 % of surface area the loss of fluid produces shock

98. Electrical burn Low voltage injuries cause small localized , deep burns They can cause cardiac arrest High voltage injuries damage by flash ( external burn) conduction ( internal burn) Never approach or touch a victim of electrical injury until you are sure the power is turned off

99. Chemical burn Damage is from corrosion and poisoning Copious lavage with water helps in most cases Then identify the chemical and assess the risk of absorption

100. Moving a casualty urgently - When ? Always ask yourself if it is really necessary to move the injured person? When? Only when the life of the injured person (and sometimes of the rescuer) is in greater danger.

101. Moving a casualty - How ? 1- If you are alone and there is a flat surface : The foot drag

102. 2- If you are alone and there are obstacles on the ground = The wrist drag Moving a casualty - How ?

103. 3- If you are alone and need to get the victim out of a vehicle. Switch off ignition. Look at the car damage. It will indicate how severely the person is injured. Moving a casualty - How ?

104. 4- If there is spine injury = Move as a block ( Log roll). First Aid management of the affected personsFirst Aid management of the affected persons Moving a casualty - How ?

105. ?

106. Conclusion First Aid Kit : May not always be available, so Be Creative Be Innovative and Use available resources Following acronyms are important while rendering First Aid Care: Patient’s survey: DR’S ABCDE While rendering Fist Aid to a Fire victim : RACE While using Fire Extinguisher : PASS Musculoskeletal injury : RICE

107. For any type of Bleedings: If no other means are available - just press the bleeding point by your own hand. If no pulse, no breathing : Start CPR . When ambulance arrives shift the patient ASP as per procedure. Conclusion

108. If we can render First Aid Care to an injured in due time , we can be able to prevent complications & also can save life . I hope & wish , by utilizing the above information's , we can be able to help mankind whenever and wherever is required. Conclusion

109. Thank You

110. Concluding Speech Principal

111. Thank You

112. Cough CPR

113. Symbols Used in First Aid Appliances Symbols generally used in First Aid Appliances are as follows: