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

This is my 45th powerpoint....being published here...!!

It deals with introduction into First Aid, what is to be done in specific emergency situations, and what measures should never be opted!!
Happy reading!!

1. FIRST AID MEASURES: A DEEP INSIGHT

2. GENERAL INTRODUCTION

3. 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: SELF-HELP: Help, that the casualty can do for himself/herself 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.

4. OBJECTIVES OF FIRST AID???

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

6. ROLES & RESPONSIBILITIES OF FIRST-AIDER???

7. 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: To remain calm & cool as much as possible To be alert in case of injury & note down its causes & manifestations shown in the patient To be tactful enough, so as to gain confidence of the patient, as well as that of persons standing nearby Ability to control the crowd & take help from onlookers Quality of self-confidence & politeness with patient 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.

8. FIRST-AID PRINCIPLES

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

10. 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.

11. FIRST-AID KIT: A BRIEF INSIGHT

12. A first-aid kit consists of: Sterile gauge Bandages(of different sizes) Triangular bandages Adhesive bandages Pair of scissors Pair of forceps Aromatic ammonia spirit Burn ointments Antiseptic solutions(like Dettol, mercurochrome, etc) Emergency drugs(like painkillers, antibiotics, ORS packets, etc).

13. HOW TO MANAGE A FIRST-AID KIT???

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

15. TYPES OF FIRST AID?

16. 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: 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).

17. 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.

18. 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).

19. FIRST-AID MEASURES FOR ACCIDENTS:

20. 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: INDOOR ACCIDENTS: Can happen in: Kitchens(gas stoves, knives, pressure cookers related accidents) Bathrooms(electric geysers, washing machines & acid bottles related accidents) Sitting rooms, dining rooms Miscellaneous accidents(falls, accidental poisoning, etc)

21. 2. OUTDOOR ACCIDENTS: Includes: Road accidents Industrial accidents(machinery/chemical-related accidents) Sports grounds-related accidents 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.

22. FIRST AID MEASURES IN CASE OF ACCIDENTS: 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.

23. FIRST-AID MEASURES FOR ABRASIONS

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

25. FIRST-AID MEASURES FOR CUTS

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

27. FIRST-AID MEASURES FOR CHOCKING

28. Condition, in which AIR PASSAGE IS BLOCKED  leads to difficulty in breathing More commonly seen in young children First-aid measures include: Bend the adult over the knee  give a number of blows on his shoulders  helps in removal of foreign particles 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. Using light blankets  keep body warm.

29. WHAT IF FOREIGN BODY ENTERS INTO THROAT?

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

31. WHAT IF FOREIGN BODY IS INSIDE EAR??

32. First-aid measures include: Put WARM OIL inside ear (if insect enters into ear) If step (1) is unsuccessful  contact doctor NEVER EVER TRY TO REMOVE FOREIGN OBJECT INSIDE EAR using MATCHSTICKS, HAIR PINS!!

33. WHAT IF FOREIGN BODY ENTERS INTO NOSE????

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

35. WHAT IF FOREIGN BODY ENTERS INTO EYE????

36. Measures include: Make patient sit in a chair Ask patient to NOT RUB THE EYES Gently wipe the foreign body out using: Cotton wool 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.

37. WHAT IF FOREIGN BODY IS LODGED INSIDE SKIN???

38. First-aid measures include: If part of the foreign object(that entered into skin) is PROJECTING OUT  it is grasped & pulled out If foreign object is DEEPLY LODGED inside the skin  patient should be taken to the doctor After removal of foreign object  apply solution of Dettol/iodine to affected part.

39. FIRST-AID TREATMENT FOR SHOCKS

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

41. Major clinical manifestations of shock include: Dryness of mouth Blueness of lips Paleness of skin Coldness of skin Blurred vision Anxiety Hypotension Transition from either “being alert” or to “sudden collapse”

42. Emergency tips for shock treatment include: Remove patient to a well-ventilated area Remove crowd tactfully  helps in improving ventilation & easing anxiety for the patient. If there is difficulty in breathing  raise head & chest of patient Loosen clothings (avoid removing them) Keep patient warm with a blanket Avoid giving hot/cold drink to patient(since patient may require emergency operation by doctor) Make immediate arrangements to shift patient to a hospital 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)

43. FIRST-AID TREATMENT FOR SNAKE BITE

44. Out of 2,500 species of snakes  only 200 species are poisonous Most poisonous snakes in India include: Common krait Common cobra Saw-scaled viper 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.

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

46. A SHORT INSIGHT INTO TORNIQUETS!

47. 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.

48. FIRST-AID TREATMENT FOR BURNS & SCALDS:

49. 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: Extinguish fire by splashing water, covering the flames with blanket/ coat Splash cold water/ any other non-inflammable liquid over the affected part If possible  immerse affected part in cold water for 15-20 minutes Do not try to remove the clothings from burnt area(instead, cut them around!) Keep victim calm & in LIE-DOWN POSITION to avoid shock Provide reassurance to patient Give any liquid to the victim to drink if the patient is conscious

50. 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.

51. FIRST-AID TREATMENT FOR ELECTRIC SHOCK

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

53. FIRST-AID TREATMENT OF POISONING

54. 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: ORAL: Contaminated food Drugs Alcohol Insecticides Strong acids/alkalis B. INHALATION: CO CO 2

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

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

57. FIRST-AID treatment strategies for poisoning: If patient is conscious  as him/her the following questions: 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 If patient is conscious & co-operative  induce emesis by any of the following methods: By tickling back of patient’s throat with the help of fingers By administering a glass of warm water (containing 2 tsp of common salt) 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!

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

59. 9. If gaseous poisoning (like smoke, CO, CO 2 )  focus on the following first-aid measures: Evacuate patient from room filled with poisonous gas to an open place, where fresh air is available Avoid crowding near the patient ! Loosen patient’s clothings If necessary, give him artificial respiration If condition is serious shift patient to a hospital immediately 10. Inform the police.

60. FIRST-AID MEASURES FOR HEART DISEASES

61. FOR ANGINA PECTORIS: 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: Give patient complete bed rest If there is pain  keep a tablet of nitroglycerin under his tongue  helps to dilate coronary arteries & improves blood supply Ask patient to not involve in laborious work Avoid obesity In severe cases  bed room should be on the ground floor.

62. FOR ACUTE MI(HEART ATTACK): 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: Provide patient complete bed rest Give sublingual tablet of sorbitrate to patient  helps in dilation of coronary vessels & relieves pain Loosen clothings of patient & reassure him If oxygen is available  administer it If cardioactive drugs (digoxin, lidocaine) are present  provide them immediately.

63. 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)!

64. FIRST-AID FOR HAEMORRHAGE

65. 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: For minor bleeding cases  usually they tend to cease automatically after some time/ apply firm pressure & bandage, followed by antiseptic lotion For external bleeding  remove clothings from affected part Lay person down in a comfortable position & raise the injured part(if no fracture is suspected) Apply direct pressure on exposed bleeding part using bandages/handkerchief etc

66. 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.

67. FIRST-AID MEASURES FOR FRACTURES

68. FIRST-AID TIPS FOR FRACTURES

69. Refers to breakage of bone Classified into following types: 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.

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

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

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

73. FIRST-AID MEASURES FOR CARDIOPULMONARY RESUSCITATION

74. 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!!!

75. 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).

76. 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!!!!

77. 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.

78. 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.

79. 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!!!

80. 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!!!