Understanding and Implementing First Aid

First aid is the immediate assistance given to any person suffering from either a minor or serious illness or injury, with care provided to preserve life, prevent the condition from worsening, and promote recovery. It includes a range of simple, potentially life-saving techniques that an individual can perform with minimal equipment. Effective first aid requires a clear understanding of the principles of preserving life, preventing further harm, and promoting recovery. This often involves recognizing the severity of the situation, knowing the appropriate responses, and having the ability to stay calm under pressure. Whether dealing with common incidents such as cuts and burns, or more serious emergencies like cardiac arrests and strokes, first aid knowledge is crucial. Prompt and appropriate first aid can significantly improve outcomes and, in many cases, mean the difference between life and death.

1. FIRST AID TRAINING BY Dr. vidhi gupta ( pt ) Bpt , mpt (neuro)

2. What is First Aid ?  Definition:  First aid is the immediate assistance given to a casualty. Or victim of sudden illness or injuries before being taken to a health unit for further management.  AIMS OF GIVING FIRST AID  To save life.  To relieve pain.  To promote quick recovery  To prevent further Injuries and Infection  To control bleeding  To be able transport casualties

3. Objectives of first aid/guiding principle: • The key guiding principles and purpose of first aid, is often given in the mnemonic "3 Ps". • P reserve life P revent further injury • P romote recovery

4. Golden rule’s of first aid. • Do first things first quickly , quietly and without fuss or panic. • Give artificial respiration if breathing has stopped-every second counts. • Stop any bleeding . • Guard against or treat for shock by moving the casualty as little as possible and handling him gently. • Do not attempt too much-do the minimum that is essential to save life and prevent the condition from worsening. • Reassure the casualty and those around and so help to lessen anxiety . • Do not allow people to crowd a round as fresh air is essential. • Do not remove clothes unnecessarily. • Arrange for the removal of the casualty to the care of a Doctor or hospitals soon as possible

5.  Call for Help  Calmly Take Charge  Check the scene & the casualty  Carefully apply FIRST AID Steps for First Aid (4 C’s) DR CAB  D anger  R esponse  C irculation  A irway  B reathing

6. Do & Don’ts DO’S Before handling Casualty, Use  Mask  Gloves Head Cover DON’TS First Aider can never ,  Prescribe Medicine  Declare Death

7. Heart attack A heart attack, also called a myocardial infarction, refers to damage to the heart caused when the blood supply to part of the heart muscle is blocked. Heart attack symptoms The symptoms of a heart attack may be quite mild and many people take too long to realise they need help. A feeling of pressure or tightness, crushing pain or unusual discomfort in the centre of the chest, or a feeling like indigestion. Pain or tightness may spread to the shoulders, neck or arms, or it may affect the jaws or throat, making the person feel like they’re choking. Some people don’t get chest discomfort, but only get symptoms in their arms or throat. Others don’t get pains in their arms, but their arms feel heavy or useless. nausea (feeling sick); sweating; breathlessness feeling light-headed or dizzy.

8. Cardiac arrest A cardiac arrest is when your heart suddenly stops functioning, resulting in loss of effective circulation of blood around the body. How do you know when someone has had a cardiac arrest? The person is unresponsive. Their heart has stopped beating. Their skin turns pale or blue. What should you do? A cardiac arrest is a medical emergency. A person who has had a cardiac arrest won’t survive unless the blood starts pumping and the body gets a supply of oxygen very quickly. Call an ambulance: dial 000 and tell the emergency services that someone has had a cardiac arrest. Start CPR (cardiopulmonary resuscitation). CPR involves mouth-to-mouth breathing and external heart massage through the chest (chest compressions). Act fast: get someone to call for skilled help

9. Cardiopulmonary resuscitation (CPR) is a lifesaving technique useful in many emergencies, including cardiac arrest or near drowning, in which someone's breathing or heartbeat has stopped. Cardio Pulmonary Resuscitation is a technique of basic life support for oxygenating the brain and heart until appropriate, definitive medical treatment can restore normal heart and ventilatory action CPR

10. Danger  To yourself  To others  To casualty Response • Gently “Shake and Shout” at the casualty • Is the casualty is conscious? • Is the casualty drowsy or confused? • Is the casualty unconscious, but reacting? • Is the casualty unconscious with no reaction? • If unconscious, place the casualty in the stable side position .

11. Pulse Check  Early CPR Chest compressions Rescue Breaths  Early Defibrillation With an AED

12. The lay rescuer should not check for a pulse and should assume that cardiac arrest is present Healthcare providers also may take too long to check for a pulse  The healthcare provider should take no more than 10 seconds to check for a pulse and, if the rescuer does not definitely feel a pulse within that time period, the rescuer should start chest compressions PULSE CHECK

13. Early CPR Chest compression Rescue Breaths Effective chest compressions are essential for providing blood flow during CPR. To provide effective chest compressions, push hard and push fast  Compress the adult chest at a rate of at least 100 compressions per minute with a compression depth of at least 2 inches/5 cm  Allow complete chest recoil after each compression. The rescuer should place the heel of one hand on the center (middle) of the victim’s chest (which is the lower half of the sternum) and the heel of the other hand on top of the first so that the hands are overlapped and parallel MANAGING CIRCULATION

14. Rescuer fatigue may lead to inadequate compression rates or depth. When 2 or more rescuers are available it is reasonable to switch chest compressors approximately every 2 minutes to prevent decreases in the quality of compressions  Every effort should be made to accomplish this switch in 5 seconds

15. Managing the Airway  A significant change in these guidelines is to recommend the initiation of chest compressions before ventilations (CAB rather than ABC).  A healthcare provider should use the head tilt– chin lift maneuver to open the airway of a victim with no evidence of head or neck trauma .  If healthcare providers suspect a cervical spine injury, they should open the airway using a jaw thrust without head extension Head tilt, chin lift + jaw thrust

16. Rescue Breathing ● Deliver each rescue breath over 1 second ● Give a sufficient tidal volume to produce visible chest rise ● Use a compression to ventilation ratio of 30 chest compressions to 2 ventilations • Pinch the nose • Take a normal breath • Place lips over mouth • Blow until the chest rises • Take about 1 second • Allow chest to fall • Repeat

17. Approach safely Check response Shout for help Call 108 30 chest compressions 2 rescue breaths 30 chest compressions 2 rescue breaths REPEAT

18. AED- Automated external defibrillator

19. 1 Turn on the AED and follow the visual and/or audio prompts. 2 Open the person's shirt and wipe his or her bare chest dry. 3 Attach the AED pads, and plug in the connector (if necessary). 4 Make sure no one is, including you, is touching the person. Tell everyone to "stand clear.“ 5 Push the " analyze " button (if necessary) and allow the AED to analyze the person's heart rhythm. 6 If the AED recommends that you deliver a shock to the person, make sure that no one, including you, is touching the person – and tell everyone to "stand clear." Once clear, press the "shock" button. 7 Begin CPR after delivering the shock. Or, if no shock is advised, begin CPR. Perform 2 minutes (about 5 cycles) of CPR and continue to follow the AED's prompts. If you notice obvious signs of life, discontinue CPR and monitor breathing for any changes in condition.

20. Stroke The sudden death of brain cells due to lack of oxygen, caused by blockage of blood flow or rupture of an artery to the brain. Sudden loss of speech, weakness, or paralysis of one side of the body can be symptoms. The medical term for stroke is cerebrovascular accident , or CVA. Signs/symptoms : • Numbness, tingling, paralysis on one side of the body, extremities, hands, and feet. • Slurred speech, not making sense. • Trouble understanding you. • Uneven pupils. • Nausea or vomiting. • Decreased level of consciousness

21. Arrange transport quickly. The earlier the person is treated, the better is the outcome. Try to find out when the problem started, note it down and report it. If the person can sit up, make him to sit upright. This helps the person to breathe. If the person cannot sit up, place him in the recovery position. Comfort the person and explain what is happening. Tell the person to relax and rest. He should not try to do anything. Do not give food or drink to the person having a stroke. There is an increased risk of choking or vomiting. Keep checking that the person is awake and breathing properly. Arrange urgent transport to a healthcare facility

22. What are bloodborne pathogens ? Pathogenic microorganisms present in human blood that can lead to diseases Examples of primary concern Hepatitis B (HBV) Hepatitis C (HCV) Human Immunodeficiency Virus (HIV) Bloodborne Pathogens

23. Risk of exposure Administering first aid Cleaning rest room Using an item covered with dried blood A co worker sneezes on you POTENTIALLY INFECTIOUS BODILY FLUID Blood Saliva Semen or vaginal discharge Skin, tissue, cell cultures Other bodily fluid

24. Spread of bloodborne pathogens occurs through: Direct contact Indirect contact Respiratory transmission Vector-borne transmission

25. Controlling Exposures Treating all blood and bodily fluids as if they are contaminated Proper cleanup and decontamination Safer medical devices Sharps disposal containers Hand hygiene

26. WEARING PPE KIT PPE examples: Gloves Masks Aprons/Smocks/Gowns Face shields Mouthpieces Safety glasses CPR pocket masks Employee’s responsibilities: Properly wear PPE Attend training Care for, clean, and maintain Notify when repairs/replacement needed

27. Housekeeping: Written schedule for cleaning and decontamination Picking up broken glass Not picked up by hands Mechanical means only

28. Clean-up and decontamination: Wear protective gloves Use appropriate disinfectant Clean and disinfect contaminated equipment and work surfaces Thoroughly wash up immediately after exposure Properly dispose of contaminated PPE, towels, rags, etc.

29. Regulated waste disposal: Dispose of regulated waste in closable, leak-proof red or biohazard labeled bags or containers Dispose of contaminated sharps in closable, puncture-resistant, leak-proof, red or

30. When Exposure Occurs Immediate actions Wash exposed area with soap and water Flush splashes to nose, mouth, or skin with water Irrigate eyes with water and saline

31. Foreign body in throat (Chocking) Choking (Asphyxia due to obstruction in wind pipe): This is most common with children. A marble, a seeds, coin, weed or a button may get stuck in the air passage. In adults too, food may go down the wrong way and cause choking. Signs/Symptoms: difficulty in breathing, talking, and swallowing. – Ask “are you choking?” – Step behind them and do abdominal thrusts (chest thrusts if they are big or pregnant). – Continue until the food comes out or until they become unconscious. – If the food comes out make them comfortable and activate ambulance if they need it. – If they become unconscious; • Lay them down. • Call for an ambulance. • Check their mouth for the food.

32. – The thrusts need to be quick and forceful. And if unsuccessful, the force needs to be increased. – If they are visibly pregnant, or you can’t get your arms around their abdomen then you must do chest thrusts on the breast bone. – If they are considerable shorter than you, such as a child, kneel down behind them and do the exact same thing. – After wards, this person should go see a doctor to make sure there was no internal damage done during the procedure.

33. Seizures Definition : Seizures are neurological disorders where the signals in the brain become mixed up .

34. Management for Generalized Convulsive Seizures: • Keep calm; let the seizure take its course. Do not try to stop the seizure or revive the person • Protect person from further injury by moving hard or sharp objects away, but do not interfere with the person’s movements. Place something soft and small, such as a sweater, under their head, and loosen tight clothing around the neck. • Do not force anything in the person’s mouth. This could cause teeth and jaw damage, or choking. The person will not swallow their tongue during a seizure. • Roll the person on their side as soon as possible, to allow saliva or other fluids to drain away, helping to clear the airway. Do not be frightened if a person having a seizure stops breathing momentarily. • If a seizure goes on longer than 5 minutes, repeats without full recovery, or the person becomes injured, then call for medical assistance.

35. Hemorrhage /Bleeding : External bleeding : This is where the blood vessels and the skin are cut and blood is escaping the body. Causes : • Damage to the skin caused by trauma. • Can be a laceration (clean cut), abrasion, or avulsion (with skin still hanging). Management : • If it’s a minor bleed allow some bleeding to take place as this will help clean the wound. • Then wash with warm water and soap, apply a dressing to keep it clean, change the dressing every few hours, and monitor for signs of infection

36. Management • If the bleeding is severe then apply the RED principle: • Rest • Elevate • Direct Pressure Notes : • If there is an impaled object do not remove it as this can cause more bleeding. Instead, apply a dressing around the object then tie it in place to control bleeding. • Take extra care not to move the object.

37. Wash your hands before giving care. 2. Try to stop or slow down the bleeding: press on the wound with a clean cloth or bandage. If possible, ask the injured person to press on the cut or graze himself to stop the bleeding. 3. Rinse out the wound with clean water. wash out the wound under running water. In the event the wound is bleeding profusely, do not waste time cleaning it. Your priority is to stop the bleeding by applying pressure on the wound. 4. If you have a piece of clean (cotton) cloth, then cover the wound with it.. Bandage the dressing to the wound. Do not apply the bandage too firmly. If the part of the body below the bandage changes colour , is swelling or is feeling numb, loosen the bandage a little bit. 5. If a dressing needs to be changed, do not tear the old one off as this can damage the healing wound. Instead, put enough wate r on the old dressing so that it comes off easily. 6 . If the wound is infected, then always refer him to a healthcare facility for further care 92

38. Fracture Signs : The seven things to look for are: • Swelling • Difficulty moving • Movement in an unnatural direction • A limb that looks shorter, twisted or bent • A grating noise or feeling • Loss of strength • Shock

39. Management: • If it is an open fracture, cover the wound with a sterile dressing and secure it with a bandage . Apply pressure around the wound to control any bleeding. • Support the injured body part to stop it from moving. • C all medical help. While waiting for help to arrive, don’t move them unless they’re in immediate danger. • Protect the injured area by using bandages to secure it to an uninjured part of the body to stop it from moving. • Keep checking the casualty for signs of shock . often caused by losing blood. • If they lose responsiveness at any point, open their airway, check their breathing and prepare to resuscitate

40. Injuries to the soft tissues: • Causes : – Any kind of force that is greater than what the tissue can withhold will cause such an injury. Some common activities include falling, twisting, getting hit, etc. Signs/Symptoms: • A ‘snapping’ noise. • Pain. • Deformity. • Inability to move. • Swelling. • Bruising

41. Spinal Injuries: Definition : • An injury to the muscles, bones, or nerves associated with the spine. The higher up on the spine it is the more serious the injury will be. Signs/symptoms: – Mechanism of injury (how it occurred). – Pain, numbness, or paralysis. – Bleeding, swelling, or bruising around the head, ears, or nose. – Unconsciousness.

42. If the spinal cord injury is suspected, try to ensure that: The injured person continues to lie still until transported to a hospital. The injured person is not made to sit or stand. Keep the injured person warm by taking off wet clothing, covering him with a blanket or other covering, taking care not to overheat him. If not done yet, arrange transport to a healthcare facility. Do not leave the person alone and keep on checking his breathing. Do not give the casualty anything to drink or eat.

43. A MPUTATION Re-attachment of amputated limbs, fingers or toes might be possible if the injured and the amputated part(s) arrive at the hospital as soon as possible. In case of an amputation: 1. Control the bleeding by providing direct pressure to the wound. Put a clean cotton bandage on the wound. 2. Place the amputated part in a clean plastic bag. 3. If possible, place the packed amputated part in a container of ice. Do not put ice directly on the amputated part – the amputated part should always be packed in a clean plastic bag. Do not put liquids or antiseptic products on the amputated part. 4. Mark the package clearly with the casualty’s name and the time the amputation occurred. 5. Arrange urgent transport of the casualty and the amputated part to the nearest hospital. 9 9 6. Wash your hands after taking care of the patient. Use soap and water to wash your hands. If no soap is available, you can use ash to wash your hands. Alcohol-based sanitizers can also be used