First Aid Principles.pptx

first Aid Basics

1. Principles of First Aid Dr Ayush Srivastava

2. Definition: First aid is the immediate care given to an injured or suddenly ill person outside a medical setup. Aims of First Aid: To preserve life, To prevent the worsening of one’s medical condition To promote recovery To ensure safe transportation to the nearest healthcare facility. Principles of First Aid

3. Case Scenarion You were out for a walk when you see an accident of a two-wheeler with a Car. The two-wheel driver is badly injured and is lying in the middle of the road. How do you approach the case?

4. How to approach an emergency: Assess the surrounding areas. Move to a safe surrounding (if not already; for example, road accidents are unsafe to be dealt with on roads). Call for help (both professional medical help and people nearby who might help in first aid such as giving compression during CPR). Perform suitable first aid depending on the injury suffered by the casualty. Evaluate the casualty for any fatal signs or danger, or possibility of performing the first aid again.

5. Case continued… You have secured the area, and called for help, an Ambulance is on its way to the site. What do you do next?

6. To preserve Life: Catastrophic bleeding  (massive external bleeding) Airway  (clearing airways) Breathing  (ensuring respiration) Circulation  (internal bleeding) Disability  (neurological condition) Exposure  (overall examination, environment) Principles of First Aid

7. To preserve Life: Catastrophic bleeding  (massive external bleeding) Airway  (clearing airways) Breathing  (ensuring respiration) Circulation  (internal bleeding) Disability  (neurological condition) Exposure  (overall examination, environment) Principles of First Aid

8. Why the ABCDE approach? Approach every patient in a systematic way Recognize life-threatening conditions early DO most critical interventions first - fix problems before moving on The ABCDE approach is very quick in a stable patient

9. ABCDE Approach: Elements Breathing: Ensure adequate Oxygenation and Ventilation. Airway : Check for obstruction Maintain Patency If trauma is suspected-immobilize cervical spine. Circulation: Determine if there is adequate perfusion Restore Perfusion, Control bleeding if present

10. ABCDE Approach: Elements Disability: AVPU/GCS, pupils and glucose Assess and protect brain and spinal functions Exposure and keep warm Is to identify Avoid hypothermia

11. You were travelling back to your hometown in a train. You are talking to an elderly gentleman sitting right in front of you. You suddenly notice a change in his voice, followed by change in his facial expression. A few seconds later the patient collapses on his seat.

12. You were travelling back to your hometown in a train. You are talking to an elderly gentleman sitting right in front of you. You suddenly notice a change in his voice, followed by change in his facial expression. A few seconds later the patient collapses on his seat.

13. Airway Assessment Can the patient talk normally No Yes Yes No The Airway is patent, continue with breathing Are there any added sounds Snoring, gurgling or stridor may indicate an obstructed airway Look for secretions/vomitus, blood, foreign bodies, swelling or edema Absence of sound- complete airway obstruction or apnea Check for paradoxical see-saw movement. Feel for air movement across nares and mouth

14. Airway Assessment

15. Airway Management If the patient is unconscious and not breathing normally: If no concern for trauma : open airway using HEAD-TILT/CHIN-LIFT manoeuvre If trauma suspected: maintain c-spine immobilization and use JAW-THRUST manoeuvre If secretions are present: SUCTION airway or wipe clean Consider RECOVERY POSITION if the rest of the ABCDE is normal and no trauma Allow patient to stay in position of comfort Adult jaw thrust

16. Airway Assessment

17. Breathing: Assessment Look, listen and feel to see if the patient is breathing Assess if the breathing is very fast, very slow or very shallow Check oxygen saturation Look for increased work of breathing Accessory muscle work Chest indrawing Nasal flaring Abnormal chest wall movement

18. Breathing: Assessment Listen for abnormal breath sounds Listen to see if breath sounds are equal Check for the absence of breath sounds on one side If dull sound with percussion to the same side THINK large pleural effusion or haemothroax If also hypotension, distended neck veins or tracheal shift THINK tension pneumothorax

19. Breathing

20. Breathing

21. Circulation: Assessment Look , listen and feel for signs of poor perfusion Cool, moist extremities Delayed capillary refill Diaphoresis Low blood pressure Tachypnoea Tachycardia Absent pulses

22. Hemorrhage Control: Circulation: Assessment

23. Hemorrhage Control: Components of Bleeding Control Direct Pressure Wound Packing Pressure Dressing Tourniquet Application Circulation: Assessment

24. Hemorrhage Control Personal Safety: As with the provision of any medical care, appropriate measures should be taken to reduce provider exposure to blood. Minimum PPE includes gloves and eye protection. Additional protective items may be necessary as the situation dictates.

25. Hemorrhage Control Direct Pressure: Effective most of the time for external bleeding - Direct pressure can stop even major arterial bleeding To be effective, apply pressure with the victim on a firm surface to provide support Don’t release pressure to check the wound

26. Hemorrhage Control Wound Packing: Expose Wound and Identify Bleeding Open Clothing around the wound. Remove excess pooled blood from the wound while preserving any clots already formed in the wound. Locate the source of the most active bleeding.

27. Pack Wound Completely Pack gauze tightly into wound and directly onto the source of bleeding. More than one gauze may be required . Use one gloved hand to feed gauze and the other to maintain pressure and hold gauze in place Hemorrhage Control

28. Pack the wound Completely Hemorrhage Control

29. Apply Direct Pressure Apply and hold continuous direct pressure. The time to hold pressure will be longer when not using hemostatic gauze. Reassess bleeding while holding continuous direct pressure. Hemorrhage Control

30. Pressure Dressing: Limb and torso wounds with significant bleeding Head wounds with significant bleeding As an adjunct to wound packing Hemorrhage Control

31. Pressure Dressing: Do not loosen a pressure dressing to check bleeding. If bleeding continues after applying a pressure dressing: If on an extremity, apply a tourniquet Apply additional pressure Apply an additional pressure dressing Hemorrhage Control

32. Torniquets: Hemorrhage Control

33. Reassess the wound and see if the bleeding has stopped. Re examine the patient, and then do a thorough evaluation of the patient to see for any other life-threatening injury. Note the time and write it on the patient's head with a prefix T. Hemorrhage Control

34. Disability: Assessment Assess level of consciousness AVPU or GCS in trauma Check for low blood glucose ( hypoglycaemia ) Check pupils (size, reactivity to light and if equal) Check movement and sensation in all four limbs Look for abnormal repetitive movements or shaking Seizures/convulsions

35. Disability: Management If altered mental status, no trauma, ABCDEs otherwise normal place in RECOVERY POSITION If altered mental status, low glucose (<70mg/dL) or if unable to check glucose Give GLUCOSE If actively seizing Give BENZODIAZEPINE If pregnant and seizing Give MAGNESIUM SULPHATE

36. Thank You