First Aid Nursing

The immediate help given during an injury before hospitalization

1. FIRST AID NURSING Sharon Treesa Antony Junior Lecturer

2. First aid First aid is the temporary and immediate treatment given to a person who is injured/suddenly becomes ill, using facilities or materials available at that time before regular medical help is imparted.

3. objectives To preserve life To prevent further injury and deterioration of the condition To make the victim as comfortable as possible to conserve strength To put the injured person under professional medical care at the earliest

4. Qualities of a first aider ;Observant Able to act quickly Should not get panic or excited Ability to lead and control the crowd and take help from the onlookers Self confidence Able to reassure the victim and his/her relative by demonstrating competence, expressing sympathy and providing good counselling Resourceful

5. principles Be in control, both of yourself and the problem Act calmly and logically Be gentle but firm Build up while talking to the casualty throughout the examination and treatment Explain what you are going to do Answer honestly Never leave casualty alone Reassure the casualty Do not separate a child from its parents or guardian Casualty should be sent to a hospital or doctor by quickest means of transport. Always inform police about serious accidents Inform the relatives

6. FIRST AID KIT

7. Triangular bandages

8. Roller type bandages

9. Dressing/gauze pads

10. Bandage sheets

11. Eye protector

12. Stick for tourniquet

13. blanket

14. pillow

15. Upper extremity splint set

16. Lower extremity splint set

17. Cont.. An up to date first aid manual A list of emergency phone numbers Adhesive tapes Antiseptic wipes Soap Tooth preservation kit Sharp scissors Flash light with extra batteries Mouth piece for giving CPR

18. Concept of emergency An emergency is an acute injury or illness that poses an immediate risk to a person’s life or long term health. Eg : severe bleeding, choking, fractures, shortness of breath, severe burns, poisoning

19. poisoning Poisons are harmful substances and when sufficient doses are taken may kill the person

20. Poisons may be consumed: Accidently For suicidal purpose Intentionally for killing a person

21. Routes of taking poison By mouth Inhaling By injection Absorption through skin

22. General signs and symptoms Others/ the casualty informs about poisoning Seeing a container having poison Delirious convulsions Signs and symptoms of asphyxia Unconsciousness Vomiting/diarrhoea Burns of lips/mouth after contact with corrosive poisons

23. treatment Inform police Remove from offending agent like gaseous atmosphere Collect information from any witness available Preserve any suspicious container for information to doctor If the person has vomited, preserve the vomitus

24. To induce vomiting Plenty of Luke warm water Egg white Milk Touching the fauces 1 glass of water with two teaspoons of salt One teaspoon of mustard powder in luke warm water

25. (cont..) In case of burns to lips/mouth , cool them by giving water/milk. DO NOT INDUCE VOMITING

26. To dilute poison Give Plenty of water Milk If alkali: lemon juice or vinegar in water

27. Sleeping pills Induce vomiting Dilute poison Keep him awakened by giving tea/coffee/ piercing pin If respiration is slow: artificial respiration

28. Gas poisoning CO CO2 Inflammable gases Steam of ammonia Remove from the site If respiration stops, give artificial respiration Keep patient warm under blanket or bed sheet Immediate hospitalisation

29. Food poisoning Water Diluted fruit juice Weak tea If early recognised, can induce vomiting

30. Alcohol poisoning Make him sit and vomit Then give strong tea/coffee If unconscious/ head injury: hospitalise

31. cont If unconscious, but breathing normally, place in recovery position If breathing and heart beat stops, begin resuscitation Shift to hospital immediately

32. Take care Do not contaminate yourself with any poison that may be around the casualty’s mouth DO NOT INDUCE VOMITING IF the casualty has swallowed: Any strong acid/alkali Ammonia Turpentine Bleachers Toilet cleaners Petrol Kerosene Paint thinner Polish

33. antidotes Acetyl salicylic acid:1 tsp soda bicarb in 1 glass of water Conc. Acid: excess water& chalk/ soda bicarbonate in 1 glass of water Conc. alkali: 1 tsp vinegar, orange/lemon CO: O2 Cresol/ lysol / dettol /lead: epsum salt in 1 glass water

34. Snake bite

35. Identification of poisonous and non- poisonous snakes

36. Signs and symptoms Pain and numbness at site Drowsiness Swelling Area becomes bluish purple in 12 hours Dimness of vision Dribbling of saliva, paralysis Convulsions,coma

37. First aid Help the patient to lie down. Keep the head above the level of wounded part Reassure and help to be calm and still Gently wash the wound and pat dry with clean swabs Lightly compress the limb above wound with a roller bandage Use triangular bandages to immobilise the affected area Take the killed snake if available to hospital for identification

38. Do not Apply a tourniquet, slash the wound with a knife or suck out the venom If the casualty becomes unconscious, open the airway and check breathing, be prepared for cardio pulmonary resuscitation

39. Scorpion bite Signs and symptoms Severe burning Intolerable increasing pain Giddiness Vomiting Can become unconscious Itching Swelling Increased numbness near the site of bite

40. First aid Help the casualty to sit or lie down , reassure her Raise the affected part if possible Apply ice packs/cold compress on the region to slow down the absorption of poison Monitor vital signs-pulse, breathing, level of response Watch for signs of allergy like wheezing Hospitalise If stings to mouth or throat, give ice cubes to suck or cold water to drink

41. Other insect stings and bites Like bees Reassure the casualty. If the sting is visible, brush/scrape it off sideways with your finger nail or the blunt edge of a knife . Do not use tweezers because more poison may be injected into the casualty. Raise the affected part if possible and apply an ice pack or cold compress . See doctor if pain and swelling persists Stings to mouth and throat: drink cold water or suck ice cubes

42. Dog bite Put on disposable gloves if available Wash the bite wound thoroughly with soap and water in order to minimise the risk of infection Pat dry with clean gauze swabs and cover with an adhesive dressing or a small sterile dressing Immediately hospitalise if wound is large or deep or suspecting rabies

43. Cont.... If the wound is deep, control bleeding by applying direct pressure and raising the injured part or apply a tight dressing and bandage Seek medical advice if tetanus immunisation not taken/ it is more than 10 years since the casualty’s last injection

44. Foreign body in the eye Can be a speck of dust, a loose eyelash etc Usually such objects can be easily be rinsed off Do not touch anything that Sticks to the eye Penetrates the eyeball Rests on the iris Cover the eye and send to hospital

45. Advise the casualty to sit down facing the light; tell them not to rub their eye Stand behind the casualty. Gently separate the eyelids with your finger and thumb. Examine every part of her eye

46. If you can see a foreign object on the eye, wash it out by pouring clean water from a glass If this is unsuccessful, lift the object off with a moist swab or the damp corner of a tissue or clean hand kerchief. If you can’t still remove it, seek medical help

47. Foreign body under the upper eyelid Ask the casualty to grasp her lashes and pull the upper lid over the lower lid. Blinking under water is also useful

48. Foreign object in the ear Young children push objects into their ears Adults may leave cotton in ear Arrange to take or send the casualty to hospital as soon as possible. Do not try to remove a lodged foreign object yourself. Reassure the casualty during the journey or until medical help arrives

49. Insect inside the ear Reassure the casualty and ask her to sit down. Support the head with the affected ear upper Gently flood the ear with tepid water so that the insect floats out If this flooding does not remove the insect, take or send the casualty to hospital

50. Foreign body in the nose Young children may push small objects up their nose There may be: Difficult or noisy breathing through the nose Swelling of the nose Smelly or blood stained discharge

51. Cont..... Do not try to remove the objects ; you may cause injury or push it further into the airway Try to keep the casualty quiet and calm Tell him to breathe through his mouth at a normal rate. Advise him not to poke inside his nose to try to remove the object himself Send to hospital

52. Inhaled foreign object There may be Some noise of choking, which quickly passes Persistent dry coughing Difficulty breathing

53. Small smooth objects can slip past the throat and enter into the air passages leading to lungs Dry peanuts which can swell up when in contact with body fluids can be a real danger Peanuts can be inhaled into the lungs , resulting in serious damage Management same as choking

54. Choking adult A foreign object that is stuck at the back of the throat may block the throat or cause muscular spasm Ask the casualty ΄ ΄ Are you choking? ˝ Mild obstruction Casualty able to speak, cough and breathe Complete obstruction Casualty unable to speak, cough or breathe and eventual loss of consciousness

55. Cont.. If the casualty is breathing, encourage him to continue coughing . Remove any obvious obstruction from the mouth If the casualty cannot speak or stops coughing or speaking, carry out back blows. Stand to the side and slightly behind him Support his chest with one hand and help him to lean well forwards . Give upto 5 sharp blows between the scapulas with the heel of your hand. Stop if the obstruction clears. Check his mouth.

56. Cont.. If back blows fail to clear the obstruction, try abdominal thrusts. ( Heimlich manoeuvre ) Stand behind the casualty put both arms around the upper part of his abdomen Make sure that he is still bending well forwards. Clench your fist and place it (thumb inwards) between the navel and the bottom of the sternum. Grasp your fist with your other hand. Pull sharply inwards and upwards up to five times

57. Cont.. Check his mouth if the obstruction is still not cleared, repeat back blows and abdominal thrusts up to 3 times, checking the mouth after each step. If the obstruction still has not cleared, continue until help arrives or the casualty becomes unconscious

58. If at any stage casualty becomes unconscious Open the airway and check breathing If not breathing, Give 30 chest compressions to try to relieve the obstructions, then two rescue breaths

59. Choking child Give upto five back blows, check mouth Give upto 5 abodominal thrusts. Check mouth Repeat the sequence upto 3 times .then call ambulance Repeat sequence until help arrives or child becomes unconscious

60. Choking infant Give upto five back blows, check mouth Give upto 5 chest thrusts. Check mouth Repeat the sequence upto 3 times .then call ambulance Repeat sequence until help arrives or child becomes unconscious

61. Swallowed Foreign body Reassure the casualty and try to find out exactly what has swallowed If the swallowed object is small and smooth , take or send the casualty to hospital Always seek medical advice if you know the casualty has swallowed a battery If he has swallowed something large or sharp, or has difficulty breathing or swallowing , get an ambulance to reach hospital soon Do not allow the victim to eat or drink or smoke because a general anaesthetic may need to be given

62. asphyxia Asphyxia is a deficiency of oxygen in blood and an increase of carbon dioxide in the blood and tissues. It occurs due to an interruption in the normal exchange of oxygen and carbon dioxide between the lungs and outside air Lungs do not get sufficient supply of oxygen for breathing

63. Causes Drowning Electric shock Foreign body in air passages (choking) Inhalation of smoke and poisnous gases Suffocation under earth Hanging, strangulation by tight rope

64. Signs and symptoms First stage Increased rate of breathing Breath gets shorter Veins of the neck becomes swollen Face , lips, nails, fingers and toes turns blue Pulse gets feebler and faster

65. Cont...... Second stage Partial or complete loss of consciousness Froth may appear at the mouth and nostrils

66. management Remove the cause if possible Ensure the airway is not obstructed Eg : loosen the tight collar Place the individual on his back. Support the nape of the neck on your palm and press neck back wards. Then press the angle of the jaw forward from behind. Provide 5 mouth to mouth breathing Give artificial respiration until natural breathing is established to ensure proper ventilation of lungs If heart beat stops, give external cardiac massage After breathing is restored, arrange for medical help

67. drowning Death by drowning occurs when air cannot get into the lungs While a drowning person is rescued, do not attempt to force water from stomach because the casualty may vomit and then inhale it If you are rescuing a casualty from water to safety, keep his head lower than the rest of body to reduce the risk of him inhaling water Lay the casualty down on her back on a cloth. If breathing, place in recovery position Be prepared to give chest compressions and rescue breaths if necessary

68. Cont.. Treat hypothermia Remove wet clothing Cover with dry blankets If fully conscious, give a hot drink

69. Shock Life threatening condition Occurs when the circulatory system fails and as a result, vital organs such as heart and brain are deprived of oxygen

70. Causes Severe blood loss(>1.2 litres) Diarrhea Vomiting Blockage in intestine Severe burns Inability of heart to pump Overwhelming infections ....

71. Recognition Initially A rapid pulse Pale, cold, clammy skin, sweating As shock develops, Cyanosis of lips, fingernails Weakness and dizziness Nausea, possibly vomiting Thirst Rapid, shallow breathing Weak, thready pulse Change in level of consciousness

72. First aid Treat any possible causes that you can detect Eg : bleeding Lay the casualty down on a blanket to insulate him from cold ground. Constantly reassure her Raise and support her legs to improve the blood supply to the vital organs. Take care if you suspect a fracture Loosen tight clothing at the neck, chest, waist Keep him warm by covering her body and legs with coats or blankets

73. Cont.. Keeping head low may prevent casualty from losing consciousness Do not let the casualty eat, drink, smoke or move unnecessarily . If thirsty, moisten lips with a little water Monitor and record vital signs Be prepared to give resuscitation

74. Burns and scalds Skin has mainly 3 layers Epidermis Dermis Layer of fat tissue Blood vessels, nerves and hair roots are contained within the dermis

75. Types of burns Dry burns: flames, hot objects Scald :steam, hot liquids Electrical burns Cold injury: frost bite, contact with freezing metals, freezing vapours Chemical burns: strong acids/ alkalies Radiation burns: sunburn, over exposure UV rays, radioactive source

76. Depth of burns Superficial burns : involves only the outer most layer, epidermis Eg : sunburn Partial thickness burns : destroy the epidermis and are very painful. The skin becomes red and blistered Full- thickness burns : pain sensation is usually lost. Skin looks waxy, pale or charred.

77. Burns that need hospital treatment All cases of burns to children All full-thickness burns All burns involving the face, hands, feet or genital area All burns that extend right around an arm or leg All partial thickness burns larger than 1% of the body surface ( an with the size of the palm of casualty’s hand) All superficial burns larger than 5% of the casualty’s body surface Burns with a mixed pattern of varying depths Unsure about severity of burns

78. Severe burns and scalds Help the casualty to lie down if possible. Try to prevent burnt area from coming in contact with ground. Douse the burn with plenty of cold liquid or at least 10 minutes, but do not delay the casualty’s removal to hospital Continue cooling the affected area until the pain is relieved Put on disposable gloves if available. Gently remove any rings, watches, belts or shoes. Carefully remove burnt clothing , unless it is sticking to the burn

79. Cont.... Cover the injured area with a sterile dressing to protect it from infection. If a sterile dressing is not available, use a folded triangular bandage or part of a sheet. A clean plastic bag can be used to cover a hand or foot,; secure it with a bandage or adhesive tape applied over the plastic not the skin

80. Cont... Gather and record details of the casualty’s injuries. Regularly monitor and record her vital signs While waiting for help to arrive, reassure the casualty and treat her for stroke. If the casualty has a facial burn, do not cover the injury. Keep cooling the area with water to relieve pain until help arrives

81. Caution Do not over cool the casualty. ( babies and elder people) Do not remove anything sticking to the burn Do not touch or otherwise interfere with the burnt area Do not burst any blisters Do not apply lotions, ointment or adhesive tape to the burnt area

82. Minor burns and scalds Caused by touching a hot iron or spilling boiling water on the skin Flood the injured part with cold water for at least 10 minutes to stop the burning and relieve pain. Put on disposable gloves if available. Gently remove any jewellery, watches, belts or constricting clothing from the injured area before it begins to swell cover the area with a sterile dressing or a clean, pad and bandage loosely in place Do not break blisters/ apply adhesive tape to skin Do not apply ointments to damaged tissues

83. Electrical burn Flood the site of injury, at the entry and exit points of the current, plenty of cold water to cool the burns Put on disposable gloves if available. Place a sterile dressing , a clean, folded triangular bandage or some other clean material over the burns to protect them against airborne infection Reassure the casualty and treat him for shock

84. Chemical burn Caused by acids/ alkalies and other corrosive chemicals

85. Recognition Evidence of chemicals in the vicinity Intense stinging pain Later, discoloration, blistering , peeling and swelling of the affected area

86. caution Do not attempt to neutralise acid or alkali unless trained to do so Do not delay starting treatment by searching for an antidote

87. First aid Make sure that the area around the casualty is safe Ventilate the area to disperse fumes, seal the chemical container. Flood the burn with water for at least 20 minutes to disperse the chemical and stop burning. If treating a casualty on the ground, ensure that the water does not collect underneath her Gently remove any contaminated clothing while flooding the injury Arrange to take the casualty to the hospital

88. Chemical burn to eye Can damage the surface of the eye, resulting in scarring and even blindness Priority should be to wash out the eye so that the chemical is diluted dispersed. Put on protective gloves and be careful for not to splash the contaminated water on you or casualty while irrigating

89. First aid Put on gloves Hold the casualty’s affected eye under gently running cold water for at least 10 minutes Irrigate the eyelid thoroughly both inside and out If the eye is shut in a spasm of pain, gently but firmly pull the eyelids open. Be careful that contaminated water does not splash the uninjured eye

90. Place or bandage a pad loosely over the affected eye Identify chemical if possible and send him to hospital

91. Wounds and bleeding

92. Types of bleeding Arterial : bright red blood, will spurt out in force Venous: dark red blood, relatively slow bleeding, but injuries to major veins can result in gush of blood

93. Types of wounds Incised wound: caused by clean cut from a sharp edged object s/a a razor. Laceration: crushing or ripping forces result in tears or lacerations. Bleeding is less profuse. More tissue damage. Often contaminated with germs Abrasion: superficial wound in which the topmost layers of skin are scraped off leaving a raw, tender area. By a sliding fall Contusion(bruise):a blunt blow or punch can rupture capillaries under the skin causing blood to leak into tissues.

94. Puncture wound: caused by sharp, pointed objects like nail/ needle. It has a small entry site but deep track of internal damage. Stab wound: caused by long or bladed instrument, usually a knife penetrating the body. Gun shot wound: a bullet or other missile may drive into or through the body, causing serious internal injury

95. Severe bleeding Shock may develop and the victim may lose consciousness Check first whether there is an object embedded in the wound; take care not to press on the object

96. First aid Put on disposable gloves if available. Remove or cut clothing as necessary to expose the wound Apply direct pressure over the wound with fingers or palm, preferably over a sterile dressing/ clean pad/ ask the casualty to apply direct pressure by himself Raise and support the injured limb above the level of heart. Handle the limb very carefully if suspecting fracture Help the casualty to lie down and if you suspect shock, raise his legs above the level of heart

97. Secure the dressing with a bandage that is tight enough to maintain pressure, but not so tight to impair the circulation If further bleeding occurs, apply a second dressing on the top of first. If blood seeps, through this dressing, remove both dressings and apply a fresh one, ensuring that pressure is applied accurately to the point of bleeding Monitor and record v/s , call ambulance

98. Cuts and grazes Bleeding can be controlled by pressure and elevation An adhesive dressing is enough

99. Medical aid is needed If the bleeding does not stop If there is foreign object embedded in the cut If the wound is at particular risk of infection If an old wound shows signs of becoming infected

100. First aid Wash your hands thoroughly, and put on disposable gloves if available If the wound is dirty, clean it by rinsing lightly under running water, or use an alcohol free wipe. Pat the wound dry using a gauze swab and cover with sterile gauze Elevate the injured part above the level of heart supporting it with one hand Avoid touching the wound directly Clean the surrounding area with soap and water; use clean swabs for each stroke. Remove the wound covering and apply an adhesive dressing .

101. Eye wound Help the casualty to lie and hold her head to keep it as still as possible Instruct him to keep both eyes still Do not touch or attempt to remove an embedded foreign object in the eye Place or bandage a clean pad over the affected eye and send to hospital

102. Bleeding from the ear Usually due to perforated ear drum Caused by a foreign object, blow to the side of the head, or an explosion Sharp pain, then ear ache Deafness Possible dizziness Watery blood is a serious sign(???)

103. Help the casualty into a half sitting position, with his head tilted to the injured side (??) Place/ bandage a clean pad on the ear and send to hospital

104. Nose bleed Caused by Blow to nose Sneezing blowing/ picking the nose High blood pressure

105. First aid Ask the casualty to sit down Ask him to tilt his head forward for the blood to drain out Ask to breathe through mouth and to pinch the soft part of the nose

106. Advise him not to speak, swallow, cough/ spit Give a clean cloth to mop up any dribbling After 10 minutes, tell the casualty to release the pressure. If the bleeding has not stopped, tell him to reapply the pressure for 2 further periods of 10 minutes

107. Advise the casualty to rest quietly for a few hours once the bleeding has stopped. Tell him to avoid exertion and not to blow the nose

108. caution Do not let head to tip back; blood may run down the throat and induce vomiting If bleeding stop and then restarts, tell the casualty reapply pressure If the nose bleed is severe or if it lasts more than 30 minutes, take or send the casualty to hospital in the treatment position

109. Bleeding from the mouth Cuts to the tongue, lips, or lining of mouth

110. First aid Ask the casualty to sit down with his head forwards and tilted slightly to the injured side Put on gloves if available. Place a gauze pad over the wound Ask the casualty to squeeze the pad between the finger and thumb and press on the wound for 10 minutes If bleeding persists, replace the pad. Tell the casualty to let the blood dribble out; if swallowed, it may induce vomiting Avoid hot drinks for 12 hours

111. Abdominal wound Crush injury Gunshot Stab wound

112. 1 st aid Put on disposable gloves help to lie down Raise and support the knees to reduce strain on wound Loosen any tight belt/ shirt Put a dressing over the wound and apply adhesive tape, Treat for shock

113. Warning If a casualty with an open wound, coughs/ vomits, press firmly on the dressing do not touch any protruding intestine, cover with a plastic bag Get ready for resuscitation if needed

114. Bleeding varicose vein Veins contain one-way valves If these valves fail, blood will collect behind them and makes the veins swell Varicose veins are taut and may burst even by gentle stroke Shock will develop if bleeding is not controlled

115. First aid Put on disposable gloves Make the casualty lie down on his back Raise and support the injured leg as high as possible Expose the site of bleeding Apply firm direct pressure on the area, using sterile dressing, until the bleeding is controlled Put a large soft pad, and bandage it tightly Keep the injured leg raised and supported until the ambulance arrives Monitor & record v/s

116. Injuries to bones, joints and muscles

117. fractures Break or crack in a bone can be Stable : broken ends do not move Unstable : broken ends can move and cause injury to blood vessels and nerves Or Open : broken ends pierce the overlying skin Closed : overlying skin is intact

118. recognition Deformity, swelling and bruising at the fracture site Pain, difficulty to move Shortening, bending Coarse grating of bone ends ( crepitus ) can be heard A wound possibly both bone ends protruding

119. Closed fracture Advise him to keep still Support the injured part with your hands above and below the injury, until it is immobilised For firmer support, bandage the injured part to an unaffected part of the body Make sure the bandage is tied on the uninjured side Upper limb fracture : bandage to the trunk Lower limb fracture : bandage to unaffected leg

120. Cont... Transport to hospital Treat for shock, do not raise the injured limb if it causes more pain Check for circulation beyond a bandage every 10 minutes If the circulation is impaired, loosen the bandages Do not allow the casualty to eat/ drink

121. Applying traction Applied When a limb is bent or angled Pull steadily in the line of bone until the limb is straight Hold it until the limb is immobilised Do not persist if traction causes intolerable pain

122. Open fractures Put on gloves Loosely cover the wound with a large pad. Apply pressure to control bleeding, but do not press on protruding bone Carefully place clean pad around the dressing Secure the pad with a bandage firmly Immobilise the part Treat for shock Monitor and record v/s

123. Dislocated joint An injury in which the bones are partially or completely pulled out of position Usually affects the shoulders, jaw, joints in thumbs and fingers

124. recognition Severe pain Difficulty in moving the area Swelling and bruising around the area shortening, bending or twisting of the area

125. First aid Advise the casualty to keep still Support the injured part in a position of maximum comfort Immobilise the part with padding, bandages and slings For firm support, bandage the injured part to an unaffected part of the body

126. Transport to hospital Treat for shock Monitor and record v/s Check the circulation beyond the bandage every 10 minutes

127. Strains and sprains STRAIN occurs when a muscle is stretched and may be partially torn. Occurs at the junction of the muscle and the tendon that joints the muscle to a bone Usually accompanied by bleeding into surrounding tissues SPRAIN Tearing of a ligament at or near a joint

128. Initial treatment R - Rest the injured part I - Apply ice or a cold compress C - Compress the injury E - Elevate the injured part

129. Cont.. Advise the casualty to sit or lie down Support the injured part in a comfortable position If the injury has just happened, cool the area by an ice pack Apply gentle, even pressure by surrounding the area with a thick layer of soft padding s/a a cotton/ wool/ plastic and secure it with a bandage Check the circulation beyond the bandaging every 10 minutes

130. First aid For fractured ribs, support the arm on the injured side in an arm sling and take or send him to hospital If there is a penetrating chest wound, lean the casualty towards the affected side and cover and seal the wound along 3 edges ( ??? ) Help the casualty to settle into the most comfortable position inclined towards the injured side( ??? ) Use an elevation sling to support the arm on the injured side

131. Hanging If pressure is exerted on the outside of the neck, the airway is squeezed and the flow of air into the lungs is cut off.

132. Recognition A constricting rope around the neck Marks around the neck Rapid difficult breathing, impaired consciousness, cyanosis Congestion of the face, with prominent veins

133. First aid Quickly remove any constriction from around the casualty’s neck Support the casualty’s body while doing so if he is still hanging Lay the casualty on the ground. Open the airway and check breathing If not breathing, be ready for resuscitation If breathing, place in recovery position

134. Caution Cut the rope away from the casualty Do not destroy any material that has been constricting the neck ( Police may need it as evidence) Do not move the casualty unnecessarily in case of spinal injury Call for an ambulance even if he appears to recover fully

135. Fall Builders , electricians, miners , painters are at high risk Causes can be oily or wet working surface, poor lighting, wrinkled carpets, poor lighting, missing a step while walking, falling eyesight, carelessness, climbing high levels in trees, suicidal attempts etc.

136. First aid Check and monitor for consciousness. Check for pulse, airway, breathing Use jaw thrust maneuver to open the airway Commence CPR if necessary Cover the victim with a blanket to reduce the chance of shock Look for signs of fractures and dislocations and do first aid as needed Shift to hospital immediately

137. THANK YOU