FIRST AID INEMERGENCY V.V.L.N.S.N.Gupta. AIM To prevent the severity of Any injury Any injury...
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Transcript of FIRST AID INEMERGENCY V.V.L.N.S.N.Gupta. AIM To prevent the severity of Any injury Any injury...
FIRST AID FIRST AID IN IN
EMERGENCYEMERGENCY
V.V.L.N.S.N.GuptaV.V.L.N.S.N.Gupta
AIM AIM
To prevent the To prevent the severity of severity of
Any injuryAny injury PoisoningPoisoning
By simple & prompt By simple & prompt application of application of
Proper First Aid measuresProper First Aid measures
According to the According to the circumsatancescircumsatances
BASICS OF FIRST AIDBASICS OF FIRST AID
A. Recognize source of disaster Look for
1) Smoke, flames2) Electrical wires3) Risk of explosion4) Roadside dangers5) Potential violence
BASICS OF FIRST AIDBASICS OF FIRST AID
B. Do not endanger yourself i. Use PPEs as availableii. Improviseiii.Wash hand before handling woundsiv.Avoid contact with blood and all body
fluids
BASICS OF FIRST AIDBASICS OF FIRST AID C. Keep calm – remember First aid training
Assess victim for i. Responsiveness ii. ABC of resuscitationiii. Take historyiv. Physical examinationv. Monitor for changesvi. If unresponsive victim, tongue may fall backvii.Extend neck by elevating chin
BASICS OF FIRST AIDBASICS OF FIRST AID
D. Call for Medical help
GENERAL MEASURES GENERAL MEASURES
Under Self protection:Under Self protection:Remove the victim from the Remove the victim from the site of accidentsite of accident
Bring him in bright Bring him in bright light & fresh airlight & fresh air
Loosen his clothesLoosen his clothes
Remove the irritant & Remove the irritant & toxic gases toxic gases
Remove Blood dirty Remove Blood dirty material from his eyes, material from his eyes, mouth, nasal cavity etc.,mouth, nasal cavity etc.,
by thoroughly washing with by thoroughly washing with large quantity of Normal large quantity of Normal salinesaline
Take care of any bleeding Take care of any bleeding point.point.
Quickly assess the Quickly assess the condition of victimcondition of victim
Help of the physician Help of the physician should be sought for,should be sought for, in case of serious injuryin case of serious injury
UNCONSCIOUS VICTIMUNCONSCIOUS VICTIM
CleanClean
NoseNoseOral & Pharyngeal CavityOral & Pharyngeal Cavity
Remove all the Remove all the discharge(Blood & Vomitous)discharge(Blood & Vomitous)
Place the victim in ¾ th Place the victim in ¾ th prone positionprone position
With head slightly downward & tiled With head slightly downward & tiled to one side so that any vomiting, to one side so that any vomiting, discharge and blood coming in the discharge and blood coming in the mouth or Pharynx should tickly down mouth or Pharynx should tickly down from the mouth or nosefrom the mouth or nose
VICTIM UNDER SHOCKVICTIM UNDER SHOCKWhat is shock?What is shock?
Difficulty in breathingDifficulty in breathing
When breathing is shallow When breathing is shallow and fast or may be slowand fast or may be slow
Blood Pressure will be low Blood Pressure will be low or may not be recordableor may not be recordable
Pulse will be rapid and Pulse will be rapid and feeblefeeble
Artificial respiration is Artificial respiration is required in difficulty of required in difficulty of
breathing and shallow breathing and shallow respirationrespiration
Best method is mouth to Best method is mouth to mouth to respiration that is mouth to respiration that is
kiss to life and by By kiss to life and by By Ambu’s bagAmbu’s bag
Clean any discharge, blood Clean any discharge, blood or vomitous in the mouth & or vomitous in the mouth & nosenose
Technique for mouth to mouth Technique for mouth to mouth respirationrespiration
With one hand lift the lower With one hand lift the lower jaw forward & with the jaw forward & with the
fingers of the other hand fingers of the other hand pinch the nostril togetherpinch the nostril together
Take deep breath. Place your Take deep breath. Place your mouth over the victim’s mouth over the victim’s mouth & blow out strongly mouth & blow out strongly the air present in your the air present in your mouthmouth
See the victim’s chest wall See the victim’s chest wall with the corners of the with the corners of the eyes, it should rise as his eyes, it should rise as his lungs are inflatedlungs are inflated
When there is stoppage of HeartWhen there is stoppage of Heart
Pulse is not recordablePulse is not recordable
Heart beats are not presentHeart beats are not present
If the blood supply is not If the blood supply is not restored within three restored within three minutes, brain will be minutes, brain will be damaged extensively and damaged extensively and victim may die.victim may die.
Following steps should be Following steps should be taken immediatelytaken immediately
Shout for the help and if Shout for the help and if available for Oxygenavailable for Oxygen
Lay the victim flat on hard Lay the victim flat on hard smooth surfacesmooth surface
Thump the middle of the Thump the middle of the chest firmly once and note chest firmly once and note the time.the time.
If the heart do not starts If the heart do not starts beating effectively then beating effectively then resuscitate the victim byresuscitate the victim by
External Cardiac massageExternal Cardiac massage
Mouth to Mouth artificial Mouth to Mouth artificial respiration as follows:respiration as follows:
1.1.Place the patient flat on Place the patient flat on hard smooth surfacehard smooth surface
2.2.Raise his legs Raise his legs
3.3.Knee down on the right Knee down on the right side of the victimside of the victim
4.4.Clear the victim’s air way Clear the victim’s air way by fingers, clean cloth, by fingers, clean cloth, cotton or gaugecotton or gauge
5.5.Extend the neck and hold Extend the neck and hold chin up.chin up.
6.6.Inflate the lungs of the Inflate the lungs of the victim once by mouth to victim once by mouth to mouth respirationmouth respiration
Do the external cardiac Do the external cardiac massage as follows:massage as follows:
Place the palm of your Place the palm of your right hand on lower 1/3right hand on lower 1/3rdrd of the sternum of the of the sternum of the victim (middle chest). victim (middle chest).
Rest other hand on top of Rest other hand on top of other hand.other hand.
Keep the arm straightKeep the arm straight
Press the lower sternum Press the lower sternum vertically backwards vertically backwards once/second with a jerky once/second with a jerky movement. Lift the hand movement. Lift the hand off the chest momentarily off the chest momentarily between two compressions.between two compressions.
The sternumn should move The sternumn should move 1.5 – 2 inch backward with 1.5 – 2 inch backward with each compression.each compression.
7.7.Inflate the lungs after Inflate the lungs after every eight sternal every eight sternal compressioncompression
This whole process of This whole process of external cardiac massage external cardiac massage and artificial respiration and artificial respiration is called as resuscitation.is called as resuscitation.
Artificial respiration can Artificial respiration can be given by Ambu’s bag be given by Ambu’s bag also.also.
8.8.Continue the resuscitation Continue the resuscitation till ambulance and other till ambulance and other medical facilities are medical facilities are available.available.
Transfer the patient to Transfer the patient to nearest medical center or nearest medical center or hospital at the earliest.hospital at the earliest.
DROWNING: ACTION: Get victim on to dry land with least danger to
yourself. Pull him out while staying on land When bringing victim out of water, his head should be
lower than chest to avoid vomiting leading to inhalation Treat for drowning and effects of cold Prevent and treat low Oxygen - Open airway, check
respiration and pulse, resuscitate, if required. Send him to hospital
CHOKING
Swallowed foreign body: Eg., food, boiled sweets, may cause :-
a) Mechanical obstruction b) Muscle spasm
CHOKING
Diagnosed by:
• * Difficulty in breathing and speaking * Bluing of skin, signs from casualty – grasping neck, pointing to throat
CHOKING
AIM:
Remove obstruction
CHOKING
1. Bend victim forward, give 5 sharp thrusts between shoulder
blades
2. if fails, try abdominal thrusts
3. Alternate 1 and 2
4. If conscious, lay victim face up on floor, kneel astride & give abdominal thrusts
5. If breathing recovers, place victim in recovery position. If not, resuscitate
INHALATION OF FUMES
1. Smoke inhalation as in fires
2. CO inhalation as in angeethi in closed room
- may cause poisoning
INHALATION OF FUMES
AIMS:
Restore adequate breathing
Obtain urgent Medical help
Remove victim from danger and into fresh air
Extinguish Fire or burning on clothes
INHALATION OF FUMES
AIMS:
Do not enter smoke filled room without safety equipment
If unconscious, check breathing and pulse, resuscitate if required.
Give Oxygen
Treat burns/injuries
FOR FUMES & GASES
Aims as for Smoke
BURNS & SCALDS
BURNS Due to dry heat, corrosive substances,
friction, extreme cold, radiation
eg., Sun’s rays and X-rays.
SCALDS
Due to wet heat eg;, Hot liquids, vapours.Establish your own safety before attempting to rescue/treat casualty
To stop burning by means of rapid cooling to prevent further damage to tissues, reduce swelling, minimize shock and reduce pain.
SCALDS
Cover the injury to prevent infection Resuscitate if required.Obtain Medical aid
SEVERE BURNS
Lay victim down with burnt area away from groundDouse the burn with large amounts of waterDo not over cool – Hypothermia may occur
SEVERE BURNS
Do not remove anything sticking to the burn – may bleed get infectedCheck airway, breathing, pulse, resuscitate if requiredGently remove rings, watch, belt, shoes or burning clothing from burning area before it swells.
SEVERE BURNS
Do not remove anything sticking to the burn – may bleed get infectedCheck airway, breathing, pulse, resuscitate if requiredGently remove rings, watch, belt, shoes or burning clothing from burning area before it swells.
SEVERE BURNS
Cover burns with sterile coveringDo not burst blistersDo not apply lotion, ointment etc.,
BURNS TO THROAT AND MOUTH
Obtain Medical help immediately
No first aid
BURNS TO THROAT AND MOUTH
Stop burning, Relieve painMinimize risk of infection
ELECTRICAL BURNS
Due to lightning, low or high voltage current
may cause cardiac arrestIf unconscious, resuscitate
ELECTRICAL BURNS
Treat burns and shock Hospitalize Approach victim only when current has been switch offOpen airway, check breathing & pulse, resuscitate
ELECTRICAL BURNS
Wash with cold waterCover with sterile sheetHospitalize
CHEMICAL BURNS
Identify and note name of chemicalRemove contact with chemicalWash with water Remove contact with clothingHospitalize
CHEMICAL BURNS TO EYES
Hold eye under gently running cold water for 10 minutes If eye is shut due to spasm, gently retract eye lids and wash Cover eye with sterile eye pad Hospitalize
SUN BURNS
Remove from Sun into cool placeCool skin by sponging or soaking in cold bathFrequent sips of cold water
SNAKE BITE
Only 2% of world snakes are poisonousDeath due to fright
SNAKE BITE
AIMS ReassurePrevent spread of venom to body Hospitalize
SNAKE BITE
1. Lay victim down2. Reassure3. Ask him to stay still & calm 4. Wash wound thoroughly with soap & water5. Secure & support injured patient.6. Hospitalize7. Do not apply tourniquet, cut with knife or
attempt to remove venom
SEVERE EXTERNAL BLEEDING
1. If patient has any sores or open wounds keep them covered with water proof adhesive dressing.Use disposable gloves/wash your hand with soap and water before & after treatment.
2. Control bleeding 3. Prevent shock 4. Minimize rise of infection5. Hospitalize
SEVERE EXTERNAL BLEEDING
1. Remove or cut clothing to expose wound 2. Pressure packing 3. Raise & support an injured limb above level of heart.
Handle gently if suspecting fracture.4. Lay victim down to minimize shock5. Bandage over packing6. Support injured part as for broken bone7. Hospitalize
SCALP WOUNDS
1. Very vascular – profuse bleeding2. 3. Disposable gloves – replace skin flap4. Firm direct pressure over sterile dressing or clean pad5. Secure dressing6. If conscious – lay him down with head & shoulders slightly
raised. If unconscious,- lay him in recovery position7. Hospitalize
PALM WOUNDS
Cotton pad over wound & fold finger, pack& bandage from above
INTERNAL BLEEDING
- H/O injury /signs of shock without much blood loss. Bruise at site of injury/Bleed from body orifices.
INTERNAL BLEEDING
1. Treatment:2. Foot end elevation3. Hospitalize4. If unconscious, recovery position5. Note: Amount of bleed, type of bleed, source of
blood loss
BLEEDING FROM EAR
Mostly due to rupture of eardrum, due to foreign body, blow to side of head, explosionSometimes midbrain injury – CSF otorrhoea. - sharp pain – earache & deafness
BLEEDING FROM EAR
TREATMENT
1. Do not plug ear2. Half-sitting position with face towards side of injury to
allow drainage3. Light sterile packing4. Hospitalize
NOSE BLEED
Due to blow to nose, sneezing, nose pick, High B.P, Forceful blowing of nose
NOSE BLEED
TREATMENT
1. Victim made to sit with head forward2. Ask victim to breathe through mouth & to pinch nose below the
bridge.3. Ask him not to exert, cough, speak, swallow, spit or sniff – may
disturb clot.4. Release pressure after 20 minutes. If still bleeding, reapply pressure.5. Once bleeding stops, clean nose & mouth with warm water while
victim leans forward
ORAL BLEED
1. Due to cut tongue, lips, oral mucosa.2. Victim made to sit, leaning forward & inclined towards the
injured side, to allow drainage3. Pressure with sterile gauze pad4. Avoid hot liquids for 12 hrs.
EYE WOUND
Diagnosis
Pain with spasm in affected eyeVisible wound with bleedingRed eye
EYE WOUND
TREATMENT: 1. Lay victim on back, holding head straight 2. Ask victim not to move eyes3. Cover injured eye with sterile pad4. Hospitalize5. Do not attempt to remove embedded foreign body
MINOR EXTERNAL BLEEDING
Minimize infection 1. Wash your hand with soap & water2. Clean dirty wound by rinsing in water3. Sterile swab used to dry4. Sterile gauge used to cover
BONE, JOINT & MUSCLE INJURIES
1. Steady & support injured part with hand2. Find more permanent support for injured part
Soft tissue injury benefits from padding and firm bandaging
Fracture needs splinting. Uninjured part of victim acts as support
3. If a broken bone lies within a large bulk of tissue eg., thigh, treat for shock
4. Hospitalize
INJURIES
a) Fracture b) Dislocationc) Soft tissue injuries
i. Sprain – Partial tearing of muscle at musculo-tendinous junction
ii. Rupture iii. Deep bruising
INJURIES
DIAGNOSIS:H/O TraumaH/O snapping sound at time of injurySharp pain of muscle tearDifficulty in moving a limb normally or at allPain at or near site of injuryDistortion, swelling or bruisingSign of shock
INJURIES
MANAGEMENT:- Prevent movement, Hospitalize Do not move casualty until injured part is secured & supported, unless he is in dangerDo not give anything to eat or drinkTell victim to be still until injured part has been immobilized
INJURIES
Secure injured part to sound part of body Upper limb against trunk with sling and bandagingLower limb against sound limb
Hospitalize
OPEN FRACTURES WITH WOUND
Get help to support limb while you work on woundCover wound with sterile dressingPressure to stop bleedingCover wound with cotton padIf bone is projecting, build up pads of cotton & bandage it upImmobilizeDial for ambulance
SOFT TISSUE INJURIES
Reduce swelling & painMedical attendance
SOFT TISSUE INJURIES
1. Rest, steady & support injured part in most comfortable position
2. If recent injury, ice pack3. Gentle pressure with cotton pad – secure with
bandage4. Raise & support limb5. Hospitalize
FRACTURE COLLAR BONE /SHOULDER DISLOCATION FRACTURE UPPER ARM
Immobilize upper limb on injured sideHospitalize
FRACTURE COLLAR BONE /SHOULDER DISLOCATION FRACTURE UPPER ARM
1. Sit victim down – place arm on injured side across chest
2. Elevation sling3. Secure with bandage over sling4. Hospitalize
Support injured limb
Hospitalize
INJURY AROUND ELBOW
Immobilize A.Lay him down
a)Soft padding between limb and bodyb)Bandage injured limb to trunk at wrist
and Hip and above and below elbow
INJURIES TO FOREARM AND WRIST
Sit victim down, Support fore arm across chest Treat woundSurround and cradle fore arm in paddingSupport in arm slingHospitalizeArrange removal to Hospital
INJURIES TO HAND AND FINGER
Support and elevate handPaddingBandagingSling
Arrange removal to Hospital
FRACTURE RIB CAGE
Support Chest wallCover & seal chest wound Lay victim down on injured side with elevation sling
Hospitalize
KNEE JOINT
Protect knees Victim lying down, support knee in more comfortable positionWrap with soft padding around jointHospitalizeDo not forcefully straighten knee
Do not give anything to drinkDo not let him walk
INJURY TO LEG
Immobilize Padding between legsStrapping both knees together
Hospitalize
SPINAL INJURY
When only spinal column is damageda)Pain in neck or back at level of injuryb)Twist or step in normal curvature of
spinec)Tenderness in spine
SPINAL INJURY
When spinal cord is also injured a) Weak or absent limb movementb) Loss of sensationc) Abnormal sensationd) Difficult breathing
SPINAL INJURY
AIM -Prevent further injury
Do not move victim unless he is in danger or is unconsciousReassureKeep head in neutral positionHospitalize
INJURIES TO THIGH & HIP
Immobilize from chest to toes, using splint from armpit to toe
POISONING
PRINCIPLES OF TREATMENT
1) Removal of unabsorbed toxic substance from the body
2) Use of antidotes3) Eliminatory of toxic substance absorbed into
systems4) Treatment of General symptoms
POISONING
REMEOVAL OF UNABSORBED TOXIC SUBSTANCE :
• Remove patient into fresh air• Artificial respiration, if required• O2 inhalation @ 6-8 l/min.• Mask• Nasal catheter
POISONING
IF CONTRACT OF TOXIC SUBSTANCE WITH SKIN/EYES & IF CLOTHING IS CONTAMINATED:
Remove clothing Wash skin Acid Burns washed with water & Alkali for 20
minutes
POISONING
IF TOXIC SUBSTANCE HAS BEEN SWALLOWED:
Stomach lavage within 2-5 hrs. of ingestion