Firstaid Manual

7/28/2019 Firstaid Manual

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W H A T I S F I R S T A I D ?F i rs t A i d i s t h e i m me d ia t e c a re o f t h e i l l o r i n ju r ed b e f or e t r ea t me n t c a n b e g i ve n b y a m e di c alp ro fessio nal.

Aim s of F irs t Aid :

- T o a s se s s t h e si t u at i on .

- T o r ec o gn i z e t he p r ob l em .

- T o p ro v id e i m me d ia t e c a re .

- T o p r es e r ve Li f e.

- T o p re v e nt w o r s en i ng o f i n j u r y.

- T o p ro m ot e r e co v er y.

- T o a r r a n ge t ra n s f e r t o a h o s p i ta l , o r f o r d o c t or s a d v i c e .

What will y ou learn on the c ours e ?

Y o u w i l l l e a r n t h e e s s e n t i al s k i l l s t o d e a l w i t h a c c i d en t s , em e r g en c i e s a n d su d d e n i l l n e s s , w h i c h a r ec o m m o n ly s e e n i n d a y t o d a y l i f e .

N o t e : F i r s t A i d m e a s u re s a r e n o t m e a n t t o r e p la c e t h e m e d i c a l p r o f e s s io n a l c a r e a n d t r e a tm e n t , b u t o nly to p ro vid e temp o ra ry s up po rt until p ro fes s io na lmed ica l help a rrives .

viii

INTRODUCTION

INTRODUCTION1.


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FIRST AID KIT

ScissorsFo r c utting d re ssing s/ band age s

Tweez ersT o p ul l o u t s t i n gs

Charcoal TabletsTo be take n f o r ing e ste dd rug p o iso ning

Th erm om eterFo r me asuring te mp e raturee ithe r und e r the to ng ue /armp it

First Aid KitC O NT E NT S O F F I RS T A I D K I T- S cissors - Ant ise ptic Wip es- C harc oal Tab let s - Gau ze Pad- Tweez ers - Cot to n Woo l- T he rmom ete r - Trian gu lar B an dag e- D ispo sable G love s - Ant ise ptic C ream- A dh e si ve T ap e - E ss en t ia l M e d ic in e- S afet y Pin s - Dressin gs

- C re pe B an da ge s

FIRST AID KIT

3

2.


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Trian g u lar Ban d ag eUse d f o r immo bilisatio no f f rac turesand to co ve r wo und s

DressingsTo c o ve r wo und s

Crep e Ban d ag eFo r band ag ing wo und

Essen tial Med icin e

An tisep tic Cream

Antiseptic WipesTo c le an wo und

Gauze PadTo c ove r wo und s

CottonTo cle an wo und s

Ad h esive Tap eTo tap e e nd s o f d re ssing s/band ag e s

Disposable GlovesFo r P ro te c tion f ro m c o ntaminatio n

S a f e ty P i nsTo pin band ag e s

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GENERAL EMERGENCY GUIDEL INESAs s es s the Situation :

Check scene safety.

T a k e c o nt r o l o f y o u r f e e l i n g s - d o n ' t a c t i m p u l si v e l y.

D e c i de w h e t h e r t o c a l l f o r e m e r ge n c y h e l p o r n o t .

C a l l f o r h e l p ( R E M E MB E R E A C H S E C O N D C O U N T S) .

Controlling YourF eelings :

Remain calm and co mmunicate a calm, sup p o rtive attitud e to the illo r injured Ind ivid ual.

Try to p ro ject a co nfid ent attitud e to the casualty, exp laining whatyo u are d o ing .

N e v e r l e a v e a n i l l o r i n j u r ed i n d i v id u a l u n a t t e n d e d . Ha v e s o m eo n e e l s e c al l f o r h e l p i n t h e f o r mo f Med ical help /Amb ulance d ep end ing o n the serio usness.

D o no t allo w unnecessary cro wd ing o f area b y o nlo okers.

If trained and if necessary, institute CP R o r Rescue Breathing .

D o n o t b e c o m e i n v o l ve d i n u s i n g t r e a t m en t m e t h o ds b e y o n d y o u r s k i l l .

W h e n i n d o u b t, c al l f o r h e l p .

W h e n T o C a l l ?

I n a n e m e r ge n c y , m a k in g t h e r i g h t p h o n e c a l l c a n m e a n t h e d i f f e re n c e b e t w e e n l i f e a n d d e a t h .

Call em erg ency m ed ical services closest to you if th e victim -

H a s n o p u l s e .

I s u n c o n s c i o u s o r s e m i - c o n s c io u s .

I s s h o w i n g s i g n s o f s h o c k .

H a s a s p i n al i n j u r y.

H a s a h e a d i n j u r y.

H asmu ltip le fractures.

Is b leed ing severely.

C a n n o t b e m o v e d e a s i l y.

H a s a n i n j u r y or i l l n e ss t h a t i s l i f e t h r e a t en i n g .

W H AT TO D O F I RS T ?

WHAT TO DO FIRST ?

3.


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H as b reathing p rob lem. B u r n s ( s e r i o u s o r c o v e r i n g l a r g e a r e a ).

P o iso ning .

S eizures ( mo re than o ne co nvulsio n) .

S erio us limb injury or amp utatio n.

F o r e ig n b o d y i n t h r o a t .

Being Prepared :

W h e n y o u c a l l f o r h e l p , b e pr e p a re d to gi v e y o u r n a m e , t h e lo c a t i on , an d t he d et a i l s o f emerg ency.

K n o w t h e r o u t e t o t h e n e a r e st h o s p i ta l e m e r g e n c y r o o m i f p o s s ib l e .

What totell the doc toror am bulanc e staff ?

W h a t h a s h a p p e ne d .

W h a t e v er s y m p t o m s o r s i g n s & n a t u r e o f i n j u r ie s .

W h e r e i s t h e v i c t i m .

T h e p h o n e n u m b e r a n d a d d r e s s o f y o u r l o c a t i o n.

Universal Precautions : For Han d lin g Blood /Bod yFlu id s :

- I t i s i m p o rt a n t t o pr e v e n t i n f e c t io n s f r o m s p r e ad i n g f r o m o n e pe r s o n t o a n o t h e r, t h ro u g hc o n t a c t w i t h i n f e c t i o u s m a t e r i a ls i n r o u t in e a n d e m e r g e n c y s i t u a t i o n s .

- U s e p r o t e c t i v e b a r r i e rs a n d i n f e c t io n c o n t r o l t e c h n i q u e s i n a l l t h e f o l l ow i n g s i t u a t i o n s:

1 . W h e n c a r i n g f o r b l e e d i n g i n j ur i e s o r h a n d l in g o t h e r b o d y f l u i d s.

2 . Bo d y fluid s includ e b lo o d , d rainag e fro m cuts, skin lesio ns, urine, faeces, vo mits, nasald ischarg e and saliva.

3 . A v o i d d i re c t c o n t a c t w i t h b o d y f l u i d s . U s e d i sp o s a bl e g l o v e s f o r c l e a n i n g c u t s a n d s c r a p e so r any injuries/b leed ing wo und s.

4 . I f s k i n c o n t a c t o c c u r s, h a n d s a n d a l l o t h e r a f f e c t ed s k i n s h o u l d b e wa s h e d wi t h s o a p a n dr u n n i n g w a te r a s s o o n a s p o s s ib l e .

For Rescu e Breath in g :

- I f i t i s n e c es s ar y t o p e rf o rm r e sc u e br e at h i ng , a o n e- w ay m a sk o r o t he r i n fe c t io n c o nt r olb arrier ( hand kerchief) sho uld b e used . H o wever, rescue b reathing sho uld no t b e d elayedwhile s u c h a d e v i c e i s b e i n g l o c at e d .

Prior to Treatm ent :

- W a s h h a n d s w i t h s o a p a n d w a t e r o r r i n s e w i t h a n a n t i s e pt i c s o l u t i o n , i f a v a i l a b l e .

- I f a v a i l a b l e , g l o v e s s h o u l d a l w a y s b e w o r n .

- T a k e c a r e n o t t o t o u c h a n y u n c le a n o b j e c t w h e n w e a r i n g g l o v es o r o n c e h a n d s a r e wa s h e d .

- I f p o s s i b l e, u s e a p r o te c t i v e c o v e r o v e r c l o t h i n g .

During Treatment :

- U s e a f a c e s h ie l d o r m a sk w i th a o n e- w ay - v al v e or f i lt e r, i f a v ai l ab l e, w h en d o in g ac t i ve

resuscitatio n, alternatively, use a hand kerchief.

- U s e o n l y c l e a n b a n d a g e s a n d d r e s si n g s .

- A v oi d c o nt a ct w i t h b o d y f lu i ds .

- A v o i d t re a t i n g m o re t h a n o n e c a s u a l t y w i t h o u t w a s h i n g h an d s a n d c h a n g i n g g l ov e s .


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After Treatm ent :- C l ea n u p b o t h c a s u al t y a n d y ou r se l f.

- C l ea n u p t h e i m m e di a t e v ic i n it y.

- D i s p os e o f d r e s si n g s, b a n d a g e s , s h a rp s , g l o v e s a n d s o i l e d c l o t h in g s a f e l y a n d c o r r e c t ly .

- W a s h h a n d s w i t h s o a p a n d w a t e r t h o r o u gh l y , e v e n i f g l o v e s w e r e u s e d .

- W a st e m a te r i al s c a n b e p la c ed i n si d e a p l as t ic b a g, w h ic h i s t h e n p l ac e d in s id e a no t he rp lastic b ag and tied securely.

- C le an t h e s pi ll s.

Hand Washing Procedure :

- W a sh h a n ds v i go ro u sl y w it h s o ap u n de r a s t re a m o f r u n ni n g wa t er f o r a t l e as t 1 0 se c on d s.E n s u r e t h a t h a n d s a r e w a s h e d t h o r o u g hl y b e t w e e n f i n g e rs a n d u n d e r n a i l s .

- R i n s e h a n d s w e l l w i t h r u n n i n g w a t e r a n d t h or o u g h ly d ry w it h p a p e r t o w e l s.

- E v e n i f g l o v e s a r e u s e d , h a n d s s h o u l d b e wa s h e d a f t e r r e m o v a l o f g l o v e s .

- I n c a se o f h a n dl i ng m o r e t h an o n e c a su a lt y, c h a n ge g l o v es a n d w a sh h a n ds i n b e tw e e n t h ec a r e o f e a c h c a s u a l t y.

Gloves :

- G l o v es s h o u l d b e wo r n w h e n d i r e c t c a r e m a y in v o l v e c o n t a ct w i t h a n y ty p e of b o d y f l u i d , asexp lained ab o ve.

- D i s p os a b l e s i n gl e - u s e , w a te r p r oo f g l o v e s ( e . g . , l a t e x o r v i n y l ) s h ou l d b e u s e d .

- D o n o t r e us e g l ov e s.

Disposal of Infectious Waste :

- A l l u s e d o r c o n ta m in a t ed s up p li e s ( e .g . , g l ov e s a n d o t he r b a rr i er s, s a ni t ar y n ap k in s ,

b a n d ag e s ) e x c e p t s y r i n ge s , n e e d l e s, a n d o t h e r s h a r p i m p l em e n t s s h o u l d b e p l a c e d i n t o ap l a s ti c b a g an d s ea l e d . T h i s b a g ca n b e t h ro w n i n t o t he g a r ba g e ou t o f r e a c h o f c h i l d re n o ranimals.

- B o d y w as t e ( e . g ., u r i n e , v o mi t s , f e c es ) s h o u ld b e d i s po s e d o f i n t h e t o i l e t. I f b o d y f lu i d s ( e.g .,u r i n e , v o mi t s ) a r e s pi l l e d, t h e b o d y f l u i ds s h o u l d b e c ov e r e d w it h a n a b s o rb e n t s a n i t ar ymaterial, g ently swep t up , and d iscard ed in p lastic b ag s.

Clean u p : Sp ills of b lood an d b ody flu id s :- S p i l ls o f b l o o d an d b o d y f lu i d s s h o u l d b e c l ea n e d u p i m me d i a t e ly w i t h a d i s i nf e c t a n tcleaner.

- W ea r gl ov es .

- M o p u p s pi l l w i t h a b so r be n t m a t e ri a l.

- W a s h t h e a r e a w e l l , u s i n g 1: 1 0 w at e r / b l ea c h s o l u t i o n o r a p p ro p r i at e d i s i n fe c t a n t .

- D i s p os e o f g l o v e s , s o il e d t o w el s , a n d ot h e r w a s t e i n s e a l e d pl a s t i c b a g s a n d p l a c e i n g a r b a g e ,as alread y ind icated .


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COMMONCONDITIONS

M o s t h e a d a c h e s a r e m i n o r a n d c a n b e t r e a t e d w i t h a p a i n r e l i e v e r.H o we v e r, i t i s i m po r ta n t t o n o t e t h a t s o me t im e s, h e a d ac h e s. . . . c a n b e c a u s e d b y s e r i o u s u n d e r ly i n g p r o bl e m s . I f a h e a d a c he i ss e v er e , g e ts w o rs e d e s pi t e m e d ic a ti o n o r h a s a c c om p an y in gs y m p t om s s u c h a s f e v e r, s t i f f n e c k , v o m i t i n g, c o n f u s i o n , m e d i ca lhelp sho uld b e so ug ht immed iately. Mig raine head aches usuallystart fro m o ne sid e, and may b e asso ciated with nausea/vo miting .

Caus es

Co mmo nly caused b y exhaustio n, eye strain, nervo us tensio n,e m o t i on a l u p s e t o r s t r e s s. M i g r a i n e h e a d ac h e s a r e v e r y c o m m o na n d o f t e n c a u s e d b y ' t r i gg e r s ' su c h a s e x p o su r e t o b r ig h t l i g h t o ra f t e r e a t i n g c e r t a in f o o d s.

F irs t Aid :

a . M a k e t h e a f f e c te d p e r s on s i t d o w n o r l i e d o w n c o m f o r t a b lyi n a q u i e t p l a c e . ( F i g. 4 . 1 . 1 )

b . G i ve 2 t a b le t s o f P ar a ce t a mo l i f t h e p er s on i s a n a d ul t . G iv eS yrup P aracetamo l as p er reco mmend ed d o se to child ren.

c . A p p l y c ol d c o m pr e s s o n t h e f o r e he a d . ( F i g. 4 . 1 . 2 )

d . I f a s s o c ia t e d w i t h a n y of t h e a bo v e - m e n ti o n e d s y m p t om s ,o r u n r e l i e v e d , c o n s u l t a d o c t o r.

HEADACHE

(Fig. 4.1.1)

(Fig. 4.1.2)

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S T O MA C H P A I N

A n y pa i n i n t h e a bd o mi n al a r ea i s c o mm o nl y r ef e r re d t o a s s t om a ch p a in . T h e a b do m en i s a na n a t o mi c a l a r e a t h a t i s b o u n d ed b y t h e lo w e r m a r gi n o f t h e r i b s a b o v e , t h e p el v i c b o n e b el o w, a n dt h e f l an k s o n e a c h s i d e . T h e p a in c a n b e c a u se d b y a v a r i e ty o f c o n d i t io n s . Ma n y o rg a n s a r e f o u n dw i t h i n t h e a b d o m in a l c a v i t y. S om e t i m e s t h e p a i n i s d i r e ct l y re l a t e d t o a s p e c i f i c o r g an s u c h a s t h eb l a d de r o r o v a r y. U s u a ll y , t h e pa i n o r i g in a t e s i n t h e d i g e st i v e s y st e m . F o r e x a m p l e , t h e p a in c a n b ecaused b y ap p end icitis, d iarrheal cramp ing , o rfo o d p o iso ning .

T h e pa i n c o ul d b e co n t in u o us o r i n t er m it t e nt ( c ol i ck y ). A b do m in a l p a in c a n r a ng e f ro m m i ldsto mach ache to severe acute p ain. Itmay b e acco mp anied b y symp to mssuch as b elching , vo mitingo r lo o se mo tio ns.

The co mmo n causes are fo o d p o iso ning , app end icitis, ind ig estio no r m a y b e as s o c i at e d w i th o t h e r s e r i o us u n d e r l yi n g p ro b l e m . I nfemales, ag ynaeco lo g ical o r o b stetric cause may also b e relevant.

Treatment :

M ak e th e pe rs on l ie o r s it d ow n i n a c om fo rt ab le p os it i on .( Fig . 4 .2 .1 )

I f h e h a s v o mi t in g , do n o t g i ve a n y th i n g t o e a t o r d r in k . S ee km e d i c a l h e l p .

G a s t ro e n t e r it i s i s a n i n f l a m m a t i on o f t h e s t o m a ch / i n t e s t in e s .Common causes are :

I n f e c t io n s f r o m V i r u s e s .

F o o d o r w a t e r c o n t a m i n at e d b y b a c t e r ia o r p a r as i t e s.

A l l e rg i c r e a c t i o n s t o c e r t a i n f o o d .

Signs and symptoms include :

N a u s e a o r v o m i t i n g .

D iarrho ea.

Ab d o minalc ramp s.

I n di g es t io n , b ur n i ng s e n sa t i on i n u p pe r p a rt o f a b do m enand b lo ating .

Fever may acco mp any any these symp to ms.

Treatment :

A s k t h e p e r s o n t o r e s t a n d n o t e x e r t ( F i g . 4 . 3. 1 ) .

P r o vi d e p l e n t y o f f l u i d s i n s i p s, t o p r e v e n t d e h y d ra t i o n , s u c ha s O R S ( or a l r e hy d ra t io n s o lu t io n )/ l e m o n w a te r w i t h s a lt .( Fig . 4 .3 .2 ) .

M ay c on si de r g iv in g a n a n ti d ia rr ho ea l o r a n ti v om it in gmed icine.

Avo id g iving heavy o ro ily fo o d .

S e ek m e di c al a t te n t io n i f s y m pt o ms a r e se v e re , o r t h e re i sacco mp anying fever.

GASTROENTERITIS

(Fig. 4.2.1)

(Fig. 4.3.1)

(Fig. 4.3.2)

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D e h y d ra t i o n c a n b e c a u s e d by h e a t - r e la t e d c o n di t i o n s u c h a s h e a t e x h a u s t io n o r h e a t s t r o k e , a s w e l la s a s i de e f f ec t o f d i ar r he a , v om i ti n g a nd f e v er . C hi l dr e n a n d p er s on s o v er t h e a ge o f 6 0 a rep articularly suscep tib le to d ehyd ratio n.

What c aus es dehy dration ?

U n d e r n o r m a l c o n d it i o n s , w e u su a l l y r e pl a c e a l l l o s t b o d y w a te r ( t h r o ug h s w e a t , t e ar s , u r i ne a n ds t o o l) b y d r i n k in g f l u i d s a n d e a t i n g f o o ds t h a t c o n t a i n w a t e r. Wh e n a p e r s on b e c o m es i l l d u e t of e v e r, d ia r r h e a , o r v o m i t in g o r i f a n i n d i v id u a l i s o v e r ex p o s e d t o t h e s u n , t h e b od y lo s e s w a t e rc o n t e n t a n d e s s e nt i a l b o d y s al t s s u c h a s s o d i u m, p o t a s si u m , c a l c iu m b i c a r bo n a t e a n d ph o s p h at ea n d g o e s i n t o a w a t e r a n d e l e c t r o l yt e d e f i c i t .

What are the symptoms of dehydration ?

T h e f o l l ow i n g a r e t h e m o s t c o m m o n s y m p t om s o f d e h y d ra t i o n , a l t h o u gh e a c h i n d i v id u a l m a yexp erience symp to msd ifferently. S ymp to msmay includ e:

1 . T hi rs t

2 . L e s s - f re q u e n t u r i n a t i o n

3 . D ry sk in

4 . F a ti gu e

5 . L i gh t - he a de d ne s s

6 . D iz z in es s

7 . C on fu s io n

8 . D r y mo u th a n d t o n gu e

9 . I n c r e as e d h e ar t r a t e a n d b re a t h i n g

In child ren, ad d itio nalsymp to ms may includ e :

D ry mo uth

S u n k e n a b d o m e n , e y es o r c h e e k s

H i g h f e v e r

Listlessness

Irritab ility

S k i n t h a t d o e s n o t f l a t t e n w h e n p i n c h e d a n d re l e a s ed

DEHYDRATION

T reatm ent fordehy drationI f c a u g h t e a r l y , de h y d r at i o n c a n o f t e n b e t r e a t e d at h o m e u n de r a p h y s ic i a n ' s g u i d a n c e . In c h i l d re n ,d i r e c ti o n s f o r g i v i n g fo o d a n d fl u i d s w i l l d i f f e r a c c o r d i n g t o t he c a u s e o f t h e d e h y dr a t i on , s o i t i si m p o r ta n t t o c o n s u lt a p e d i a t r i c i an .

In cases o f mild d ehyd ratio n, simp le rehyd ratio n is reco mmend ed b y d rinking fluid s. Many d rinks areavailab le, suchas electral ( ORS ) , lemo n juice etc. that effectively resto re b o d y fluid s, electro lytes ands a l t b a l a n c e .

Fo r mo d erate and severe d ehyd ratio n, intraveno usfluid s may b e req uired , so med icalhelp sho uld b es o u g h t e a r l y. C a s e s o f s e r i o u s d e h y d r a t i on s h o u l d b e t r e a t e d a s a m e d i c al e m e r g e n c y.

4.4

* S o l u t io n s h o u l d be m a d e f r e s h d a i l y a n d u s e d w i t hi n 2 4 h o u r s

*O RS / Electral Co mp o sitio n

Ing red ient Q uantity

S o d i um C h l o r id e 3 .5 g m

Triso d ium Citrate D ehyd rate 2 .9 g m

P o t as s i u m C h l o r id e 1 .5 g m

G luco se 2 0 g m

Water 1 lt r.

* If h om e m ad e O R S

Ing red ient

1 ltr.

Tab le S alt

Q uantity

S ug ar

5 g m

W ater

2 0 g m


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B o d y t e m p e ra t u r e h i g h e r t h a n t h e n o r m a l ( > 9 9 . 5 d e g r e e s F ) . U s u a l l y f e v e r i s c a u s e d b y i n f e c t i o n .F e v er m a y b e c a u s ed b y :

A b a c t e r ia l o r a v i r a l i n f e c t io n .

T h e b o d y b e c o m in g o v e r h e a te d a t p l a y o r i n t h e s u n .

0T e m p er a t u r e ab o v e 10 4 F c a n b e d a n g e r o u s a s i t m a y t r i g ge r f i t s i n c h i l d r e n a n d i n f a n t s.

Rec ognition :

S i g n s t h a t m a y i n d i c at e f e v e r m a y i n c l u d e:

- F lu sh e d f ac e

- H ot , d ry sk in

May also have any o ffo llo wing :

Chills and S hivering H ead ache

Bo d yache

R e s p ir a t o r y s y m p to m s s u c h a s s o r e t h r o a t , c o u g h o r r u n n i n g n o s e

Lo o se sto o ls

N a u s e a & v o m i t in g

Treatment :

M a k e t h e c a s u a l t y c o m f o rt a b l e i n a c o o l r o o m .

Ad vise to take rest.

A n a d u l t c a n b e g i v e n P a r a ce t a m o l t a b l e t s.

G i v e l o t s o f f l u i d s t o d r i n k ( P r e f e r a bl y electro lytes o l u t io n i f a v a i la b l e ) .

A c h i l d c a n b e g i v e n t h e r e c o m me n d e d d os e o f P aracetamo lsyrup .

S e e k M e d i c a l o p i n i o n.

FEVER

C o n t a ct t h e p h y s i c i an i m m e d ia t e l y i n c a s e o f :- S ei z ur es

- F e e li n g s le e p y or d u l l

- I r re g ul a r b r ea t h in g

- S ti ff n e ck

- C on f us io n

- R as he s

- E ar p ai n

- P e r si s t e n t s o r e t h r o at

- V om it in g

- D ia rr h oe a

- P a i n fu l a n d b u r n in g u ri n a t i o n(Fig. 4.5.1)

(Fig. 4.5.2)

4.5


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F a in t i ng o c cu r s w h en t h e s u pp l y t o b r ai n i s i n a de q u at e f o r a s h or t t i m e. T h i s c a u se s l o ss o f c o n s c io u s n e ss . T h e l o s s o f c o n s c i o u s ne s s i s u s u a l l y f o r a b r i e f t i m e .

F a i n t i ng m a y b e d u e t o n o r m a l p h y s io l o g ic a l c a u s e s, o r m a y b e c a u s e d b y a n u n d e r l yi n g m e d i c aldisorder.

Common Causes :

- S t an d in g f o r l o ng h o u rs ( F i g . 4 .6 . 1)

- S u dd e n c h a ng e i n p o s it i on

- Injury

- A n u n pl ea sa nt s i g ht

- E mo ti on a l u ps et

H o w t o R e c o gn i z e :

- We ak ne ss

- G id di ne ss

- B lu r re d vi si on

- S we at in g

- C o ld a nd c la m my s ki n

- S lo w & W ea k p ul se

Treatment :

- M a ke t h e c a su a l ty l i e d ow n o n t h e b a c k .

- M a k e su r e t he l e g s a r e e l ev a t e d a b o v e t h e h e ar tlevel. ( Fig . 4 .6 .2 )

- O pe n t he wi nd ow s f or f re sh a ir a nd lo os ent h e t i g h t C l o t h in g .

- L oo k f or a ny i n ju ry t h at m ay h a ve o cc u rr edd uring falland treatacco rd ing ly.

- S e ek m e d i c al a s s i st a nc e .

FAINTING

HEAT EXHAUST IONH e at e x h au s t io n i s a m i ld e r f o rm o f h e at - re l a te d i l ln e s s t h a t c a n d e ve l op a f te r s e v er a l d a ys o f e x p o s ur e t o h i g h t e m p e ra t u r e s a n d i n a d e qu a t e o r u n b a l an c e d r e p l ac e m e n t o f f l u i d s. T h o s e m o s tp ro ne to heatex haustio n are eld erly p eo p le, peo p le with hig h b lo o d p ressure and p eo p le wo rking ore x e r c i si n g i n a h o t e n v i r on m e n t .

Signs of heat exhaus tion inc lude :

P ale skinand face

Excessive sweating

Muscle cramp s

Exhaustio n

W eakness

H ead ache/D izziness N a u s e a o r v o m i t i n g

Fainting

T h e s k i n m a y b e c o o l a n d m o i s t . T h e p u l se r a t e w i l l b e f a s t a n d w e a k , a nd b r e a t h in g w i l l b e f a s t a n ds h a l l ow . I f h e a t e x h a u s ti o n i s u n t r e a te d , i t m a y p r o g re s s t o h e a t s t r o k e .

W h a t t o d o ?

Co o ling measuresthat may b e effective includ e:

Co o l, no n-alco ho lic b everag es

R e s t i n a c o o l p l a c e p r e f e r ab l y a i r c o n d i t i o n e d r o o m

C o o l s h o w e r o r b a t h

Lo o sen the clo thing and if p o ssib le p ro vid e lig htweig htclo thing

S e e k m e d i c a l a t t e n t i o n i f s y m p t om s w o r s e n o r l a s t l o n g e r t h a n 1 h o u r.

HEAT ST ROKE

What is heat s troke ?

H e a t s t r o k e i s t h e m o s t s e v e r e f or m o f h e a t i l l n e s s a n d i s a l i f e - t hr e a t e n in g e m e r ge n c y. I t i s t h e r e s u l to f l o ng , e x tr e me e x po s ur e t o t h e s un , i n w h ic h a p e rs o n d o es n o t s w ea t e n ou g h t o l ow e r b o dyt e m p e ra t u r e . T h e e l d e r ly , i n f a n t s, p e r s on s w h o w o r k o u t d o or s a n d t h o s e o n c e r t a i n t y p e s o f m e d i c at i o n s a r e m o s t s u s c e pt i b l e t o h e at s t r o ke . I t i s a c o n d i ti o n t h a t d e v e l o p s r a p i d l y a n d r eq u i r esimmed iate med ical treatment.

HEAT DISORDERS

(Fig. 4.6.2)

(Fig. 4.6.1)

4.6 4.7


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What c aus es heat s troke ?O u r b o di e s p r od u ce a t r em e n do u s a m ou n t o f i n t er n a l h e at a n d w e n or m a ll y c oo l o u rs e lv e s b ys w e a t in g a n d r a d i a t in g h e a t t h r o u gh t h e s k i n . H o w e v e r, i n c e r t a i n c i r c u m s t a n ce s , s u c h a s e x t r e m eh e at , h i g h h u m id i ty o r v i go ro u s a c t iv i ty i n t h e h o t s u n , t hi s c o ol i ng s y s te m m a y b eg i n t o f a il ,allo wing heatto b uild up to d ang ero uslevels.

What are the symptoms of heat stroke ?

T h e f ol l ow i ng a r e t he m o s t c o mm o n s y mp t om s o f h e at s t ro k e, a l t ho u gh e a ch i n di v id u al m a yexp erience symp to msd ifferently.

S ymp to msm ay includ e:

H ead ache

D izziness

D iso rientatio n, ag itatio n o r co nfusio n

S l u g gi s h n e s s o r f a t i g u e

S eizure

H o t , d ry s k i n t h a t i s f l u s h e d b u t n o t s w e a t y

A hig hb o d y temp erature

L o s s o f c o n s c io u s n e ss

R a p i d h e a r t b e a t

W h a t t o d o ?

I t i s i m p o rt a n t f o r t h e p e r s on t o b e t r e a t e d i m me d i a t el y a s h e a t s t r o ke c a n c a u s e p e r m an e n t d a m a g eo r d e a t h .

The immed iate first aid measuresare:

G e t t h e p e r s o n i n d o o r s o r i n t o a s h a d y a r ea . R e m o v e c l ot h i n g a n d g e n t l y a p pl y c o o l w a t e r u s i n g d a m p s h e e t s o f b y s p r a y in g c o l d w a t e r t o

the skin fo llo wed b y fanning to stimulate sweating .

Ap p ly ice p acksto the g ro in and armp its.

H a v e t h e pe r s o n l i e d o w n i n a c o o l a r e a w i t h t h e i r f e e t s l i g h tl y e l e v at e d .

Co ntinue co o ling untilthe b o d y feelsco ld to to uch.

S eek med ical help immed iately.

HEAT CRAMPSH e a t c r a m p s u s u a l l y a f f e c t p e o p l e w h o s w e a t a l o t d u r i n g s t r e n u o u s a c t i v i t y. T h i s s w e a t in g d e p l e t e st h e bo d y ' s s a l t a n d m o i s t u re . T he l ow s a l t l e v e l i n t h e mu s c l e s c a u s e s p a i n f ul c r a m ps . H e a t c r a m p sm a y a l s o b e a s y m p t o m o f h e a t e x h a u s t i o n .

Recognizing heat cramps

H e a t c r a m p s a r e m u s c l e p a i n s o r s p a s ms - u s u a l ly i n t h e a b d om e n , ar m s , o r l e g s - t h a t m a y o c c u r i na s so c ia t io n w i th s t re n u ou s a c t iv i ty . If y o u h a ve h e a rt p r ob l em s o r a r e on a l o w s o di u m d i et , g etm e d i c a l a t t e n t i on f o r h e a t c r a m ps .

W h a t t o d o ?

I f m e d i c a l a t t e n t i o n i s n o t n e c e s s a r y, t a k e t h e s e s t e p s :

T h e c a s u a l t y s h o u ld s t o p a l l a c t i v i ty , a n d s i t q u i e t ly i n a c o o l p l a c e .

T h e c a s u a l t y s h o u ld b e a d v i se d t o d r i n k c l e a r j u i c e / e l e c t ra l ( O R S ) o r a s p o r t s b e v e r a g e .

A d v i se ca s u a l t y t o n o t r e t u r n t o s t r e n u ou s a c t i v i ty fo r a f e w h o u r s a f t e r t h e c r a m ps s u b s id eb e c a u se f u r t h e r e x e r t i o n m a y l e a d t o h e a t e x h a u s ti o n o r h e a t s t r o k e .

S e e k m e d i c a l a t t e n t i o n f o r h e a t c r a m ps i f t h e y d o n ot s u b s i de i n 1 h o u r .


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B l e e d in g m a y b e f ro m a n A R T E R Y, a b l o o d v e s s e l w h i c h c a r r i e s o x y g e n - r i c h b l o o d f r o m t h e h e a rtt h r o u gh o u t t h e b o dy . Bl e e d i n g m a y b e f r o m a V E I N , wh i c h c a r r i e s b l o o d b a c k t o t h e he a r t t o b eo xyg enated o rb leed ing may b e fro ma CAP ILLARY , whichare tiny b lo o d vessels.

H o w t o r e c og n i z e :

- A rt e ri al b le e di ng i s b ri gh t r ed a nd s pu r ts o ut f ro m a w ou n d, ( se ve re f or m o f b le e di n g) .T h is r e qu i re s i m me d ia t e a t t en t i on a s l a rg e a m ou n t s o f b l oo d l o ss c a n o c cu r q u ic k ly , i f unco ntro lled .

- B l oo d t h a t o o z e s o u t s l o w ly a n d i s d a r k er r e d i n c o l o u r i n d ic a te s v e n o u s b l e ed i ng ( M i l de r f o r mo f b l e e d in g ) . Ve n u s b l e e d in g i s e a s i e r t o c o n tr o l t h a n A r t e r i al b l e e di n g . C ap i l l ar y b l e ed i n g isusually slo w, o o zing innature.

H o w t o c o n t ro l b l e e d i n g :

1 . A p p l y p r e ss u r e di r e c t ly o v e r t h e w ou n d b y p l a c in g s t er i l e ga u z e , dr e s s in g o r a c l e a nhand kerchief o n the b leed ing p o int. ( Fig . 4 .8 .1 )

2 . A p p l y p r e s su r e b y f i n g e rs o r b y h a n d.

3 . O n ce p r es s ur e i s a p pl i ed , k e ep i t i n p l ac e . I f d r es s in g s b e co m e s oa k ed w i th b l oo d , ap p lyn e w d r e s si n g s o v e r t h e o l d d re s s i n gs . T h e l e ss a b l e e d in g w o u n d i s d i s t u rb e d , t h e e as i e r i t w i l lb e to sto p the b leed ing !

4 . A p pl y c o n ti n u ou s p r es s ur e b y pu t t in g m o re g au z e o n t o p o f t h e p r ev i ou s o n e i f i t i sso aked . NEVER TH ROW AW AY S OAKED G AU Z E.

5 . S u p p or t a n d e l e v a t e t h e b l e e d in g p a r t a b o v e h e a r t l e v e l a n dt r e a t t h e s h o c k .

6 . O n c e t h e b l e e d in g s t o ps , d o n o t t r y t o re m o v e t he c l o t ht ha t i s a ga in s t t h e o pe n w ou n d a s i t c ou ld di st u rb t heb lo o d clo tting and restart the b leed ing .

7 . C o v e r a n d b a n da g e t h e wo u n d b e fo r e t ra n s p o rt i n g t o t he

ho sp ital.

BLEEDING

WOUNDSI n j u r i es c a u s i ng w o u n ds a r e v e r y c o m m o nl y e n c o u nt e r e d . In j u r i e s t h a t c a u s e a b r e a k i n t h e s k i n o ru n d e r l yi n g s o ft t i s s u e ar e k n o wn a s a w o u n d . Th e s e m a y b e l a r ge o r s m a l l a n d c a n b e o n a n y p a r t o f the b o d y.

Wounds m ay be of the following ty pes :

O p e n W o u n d : T h e s k i n s u r f a c e h a s b e e n b r o k en .

C l o s e d W o u nd : T h e s k i n s u r f a c e i s u n b r ok e n b u t u n d e r l yi n g t i s s u e s h a v e b e e n d a m a ge d .

T y pes of c los ed wounds :

B r u i s e : D a ma g e t o t i s s u e s b e n e a t h t h e s k i n . W h e n t h e d a m a ge i s m i n o r, t h e w o u n d i s c a l l e d a b r u i s e( co ntusio n) .

Ecchymosis

W h e n t h e t i s s u e h a s e x t e n s i v e d a m a g e , b l o o d a n d f l u i d c o l l e c t u n d e r t h e s k i n c a u s i ng d i s c o l o ra t i o n( ecchymo sis) , swelling ( ed ema) , and p ain.

First aid co nsistso f ap p lying ice o r co ld p acksto red uce swelling and relieve d isco mfo rt.

Hem atom as

Are caused b y severe b lunt injury withe xtensive so fttissue d amag e and co llectio n o f larg e amo untso f b l o od b e l o w t h e s k i n . L a r g e h em a t o m as , m a y b e as s o c ia t e d w i th i n j u r i es s u c h a s b r o k en b o n e s,esp ecially if d efo rmity is p resent.

F i r s t a i d c o n s is t s o f a p p l yi n g i c e o r c o l d p a c ks t o r e d u c e s we l l i n g a n d re l i e v e p a in , d i r e c t p r e s su r e( manual co mp ressio n) to help co ntro l internal b leed ing , splinting , and elevatio n. W hen larg e areaso f b ruising are present, sho ckmay d evelo p .

T y pes of open wounds :

I n o p e n s o f t t i s s u e i n j u r ie s , t h e p r o t ec t i v e l a y er o f t h e s k i n h a s b e e n d a m a ge d :

Abrasions

A b r a si o n s a r e c a u s e d w h e n t h e s k i n i s r u b b e d o r s c r a p e d o f f . A b ra s i o ns e a s i l y c a n b e c o m e i n f e c t e d,b e c a u s e of c o n t a m in a t i o n w i t h d i r t a n d g e r m s. T h e r e i s n o r m a ll y v e r y l i t t le b l e e d i n g or o o z i n g of c l e a r f l u i d .

WOUND AND DRESSINGS

(Fig. 4.8.1)

4. 8 4.9


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Am putationsA m p u t at i o n s ( t r a u m a ti c ) a r e t h e r e m o v a l o f t h e a b o d y p a r t s u c h a s f i n g e rs , t o e s , h a n d s, o r e a r s f r o mthe b o d y. Bleed ing is heavy and no rmally req uires a to urniq uet, to co ntro lt he b lo o d flo w. There aret h r e e t y pe s o f a m p u t a ti o n :

1 . C o m p l et e - B o d y p a r t i s c o m p le t e l y t o r n o f f ( s e v e re d ) .

2 . P ar t i al - M o re t h a n 5 0 % o f t h e b o dy p a r t i s t o r n o f f .

3 . D e - g l ov i n g - S k i n a n d t i s s u e a r e t or n a w a y f r o m b o d y p ar t .

Im m ediate Ac tion :

- E s t a b li s h a n d m a i n t a i n t h e A i r w ay , B re a t h i n g, a n d C i rc u l a t i on ( A B C ) .

- R e q u e s t M e d i c al A s s i st a n c e i m m e d ia t e l y.

- C o n t r ol b l e e d in g w i t h d i r e ct p r e s su r e , e l e v a t io n , i n d i re c t p r e s su r e , o r t o u r n i qu e t o n l y a s a l a s tr e s o rt , d o n o t r e m o v e o r l o o s e n a t o u r n i qu e t o n c e i t h a s b e e n a p p l ie d .

- A p pl y d re s si n g t o th e s t um p .

- T re at f o r sh oc k.

Incisions

I n c i s io n s , c o m mo n l y c a l l e d c u ts , a r e w o u n d s m a d e b y s h a r p c u t t i n g i n s t r u me n t s s u c h a s k n i v e s o rb ro ken g lass. Incisio nst end to b leed freely b ecause the b lo o d vessels may b e cut. The wound ed g esare smo o th.

L ac erations

L a c e r a ti o n s a r e w o un d s t h a t a r e t o rn , r a t h er t h a n c u t . T h e y h av e r a gg e d , i r re g u l a r e d g e s a n d t o r ntissue und erneath.

Punc tures

P u n c t u re s a r e c a u s e d b y o bj e c t s t h a t e n t e r t h e s k i n w h i l e l e a v i n g a s u r f a c e o pe n i n g . W ou n d s m a d eb y n a i l s , n e e d le s a n d b u l l e t s a r e n o r m a l l y p u n c t u re s . S m a l l p u n c t u re w o u n d s u s u a l ly d o n o t b l e e dfreely; ho wever, larg e p uncture wo und smay cause severe internal b leed ing .

W h a t t o d o ?F i r s t a i d t r e a t me n t f o r a l l w o u n d s c o n s i s t s o f c o n t r ol l i n g t h e f lo w o f b l o o d, t r e at i n g fo r s h o c k , a n dp r e v e nt i n g i n f e c t i on . W h e n p r o v id i n g f i r s t a i d t o c a s u a l t y w i t h m u l t i p le i n j u r i e s , t r e a t t h e w o u n d st h a t a p p e ar t o b e l i f e t h re a t e n i n g fi r s t . S in c e m o s t o f t h e b o d y i s c o v e r ed b y c l o t h in g , c a r ef u l l ye x a m i n e t h e e n t ir e b o d y f o r b l e e d i n g . W h e n n e c e s s a r y, t e a r o r c u t c l o t h i ng a w a y f r o m t h e w o u n db e c a u s e e x c e s si v e m o v e m e n t o f t h e i n j u r e d p a r t w i l l c a u s e p a i n a n d a d d i t io n a l d a m a g e .

Bleeding

A f t e r e s t a b l i s h i n g a n a d e q u a t e o p e n a i r w a y, t h e m a i n c o n c e rn w i l l b e t o c o n t r ol b l e e d in g , b y d i r e c tp r e s su r e a n d e l e v a t i on . I n d i r e c t p r e s s u r e a n d t h e u s e o f a t o u r n i qu e t s h o u l d b e u s e d o n l y i f d i r e ctp ressure and elevatio n d o no tco ntro l the b leed ing . A p rotective co vering (d ressing ) thatis p ro p erlyap p lied sho uld ad eq uately co ntro lthe b leed ing . Incases o f severe b leed ing , ad d itio nal d ressing o verthe first o ne may b e req uired .

Shoc k

S h o c k m a y b e s e v er e i n a c a s u a lt y w h o h a s l o s t a l a r g e a m o u n t o f b l o o d o r s u f f e re d a s e r i o u s i n j u r y.I n c a s e o f n o p u l s e p ro c e e d t o k e e p a c h e c k a n d m a i n t a i n A B C .

How to bandage a wound during firs t aid :

- P r op e r d re s si n g a n d ba n da g in g a w o un d w i ll a i d i n t h e h e al i ng p r o ce s s a n d h e lp p r e ve n tinfectio n and scarring .

- P r ot e c t y o ur s el f . S c ru b y o u r h a n ds t h or o ug h ly w i t h s o ap a n d d i s in f ec t e d w at e r a n d p u t o nl a t e x g l o v e s i f a v a i l ab l e , t o p r e v e n t t h e s p r ea d o f i n f e c t i ou s d i s e a s e .

- C l e a n t h e w o u n d w it h w a t e r / a n t i s e pt i c s o l u t i o n a n d c a r e f ul l y r e m ov e a n y e x c es s d e b r i s .

- R e m o v e a n y j e w e l ry , s u c h a s r i n g s o r w a t c h e s t h a t m i g h t i m p a i r c i r c u l a t i o n .

- A p p l y a n t i b io t i c c r e a m t o t h e i n s i de o f t h e m a t e r i al y o u a r e u si n g a s t h e d r es s i n g.

- C o v e r t h e w o u n d w i th t h e d r e ss i n g . T he d r e s si n g s h o ul d e x t e n d b e y o n d t h e w o u n d by a b o u t i n c h s o t h a t i t c o v e r s t h e w o u n d c o m p le t e l y a n d a l l ow s r o o m t o a f f i x t h e d r e s s i n g t o u n i n j ur e dskin.

- C u t f o u r s t r i ps o f t a p e a n d af f ix t h e m t o t h e d re s si n g an d s k in o n a l l f o ur s i de s o f t h e d re s si n g.T h e p u r p o se o f t h e b a n d a ge i s t o h e l p k e e p t h e d r e s si n g i n p l a c e , a n d i t s h o u l d n ' t b e t o o l o o se( ab le to mo ve aro und ) o rto o tig ht ( imp airing circulatio n) .


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P eo p le with asthma have hyp ersensitive airways. Their airways b eco me narro w, causing wheezing ,co ug h and d ifficulty in b reathing d ue to vario ustrig g ers.

Triggers are :

- A n x ie t y a n d e m ot i on a l d i st r es s

- C ol d a ir

- A ll er gi es

- D us t & S mo ke

- V ig or ou s e x er ci se

- C e r t a i n f o o d , f o o d a d d i t iv e s a n d p r e se r v a t i ve s

Rec ognition :

- C a s u a lt y p r ef e r s t o b e i n a s i t t i n g p o s i ti o n ( F i g . 4 . 11 . 1 ) .

- I n a s u dd e n a t t ac k , th e pa t i en t h a s d i ff i c ul t y br e at h i ng a n dthere may b e awhistling so und ( wheeze) whenb reathing o ut.There may b e acco mp anying co ug h.

- T h e p a t ie n t m a y b e a n x i o u s, d i s t re s s e d an d s w e at i n g .

- I n s e ve r e c as e s, t h e re m a y b e b l ue n e ss o f t h e l ip s , h an d s a n df e e t a n d e x h a u s ti o n a n d p o s s ib l e l o s s o f c o n s c i o u sn e s s .

- I n s e ve r e c a se s , t h e pa t i en t i s u n a bl e to sp e ak b e ca u se o f d ifficulty in b reathing .

W h a t t o d o ?

- R e as s ur e t h e ca s ua l ty .

- M a ke t h e p a t i en t s i t u p r i gh t a n d l e a n f o r wa r d.

- E n co u ra g e ca s ua l ty t o t ak e p u ff i f h e / sh e i s o n m e di c at i on .M o s t a s t h m a t i c s w i l l b e f a mi l i a r w i t h t h e u s e o f i n h a l e rs a n dthe d o sag es. ( Fig . 4 .1 1 .2 )

- L o os e n t h e g a r m en t s a n d o p e n t h e w i n do w s f o r f r es h a i r.

- A s k c a s u a l t y t o b r e a th e s l o wl y a n d d e e p ly .

- S e ek p r o f es s io n al h e l p e a r l y.

ASTHM A

T h e s e v e r i ty o f a b u r n d e p e n ds u p o n i t s s i z e , d e p t h a n d l o c a t i o n . B ur n s a r e m o s t s e v e re w h e n l o c a t e do n t h e f a ce , n e c k , h a n d s, f e e t a n d g e ni t a l s. A l s o, w h e n b u r n s a f f e c t l a r g e p a r t s o f t h e b o dy , th e ycause severe fluid lo ssand infectio n, and canb e life threatening .

B u r n s r e s u l t i n p a i n , i n f ec t i o n a n d s h o c k . T h e y a r e a l s o m o re s e r i o u s w h e n t h e v i c t i m s a r e v e r y y o u n go r v e r y o l d .

Burns c an caus e dam age to the body tis s ues by :

- D r y H e at - F l a m es , L i g ht e d C i g ar e t t e s, H o t I r o n

- M o is t H e a t ( s c al d s) - B o i l i ng W a te r o r H o t O i l

- C o ld - L i q ui d N i tr o ge n

- C he m ic al - A ci ds o r A l k al i

- E l ec t r ic a l B u r ns - E l ec t r ic i t y o r L i g h tn i n g

- R ad ia ti on - S un R a y s o r L as e r

T o d i s t i ng u i s h a m i n o r b u r n f r o m a s e r i o us b u r n , t h e 1s t s t e p i s t o de t e r m i n e t h e de g r e e a n d t h ee x t e n t o f d a m a g e .

Burns are classified -

BURNS AND SCALDS

a) 1s t D eg ree Bu rn - Redn ess

- S we ll in g & P ai n ( su ch a s m il d s u n bu rn )

b ) 2n d D egree Burn Blist ers, Re dne ss

Very p a inful

A s s oc i a t e d w i t h l o s s o f f l u i d t h r o u g h t h e

d a m a ge d s k i n a r e t h e m o s t p a i n fu l

b eca us e nerve end ing a re us ua lly inta ct,

d es p ite s evere tis s ue d a ma g e

c) 3rd D eg ree Bu rn - De epes t - S ki n i s c ha rr ed a nd w ax y - F a t, m u sc l e, e v en b o ne m a y b e af f ec t ed

E x t r em e l y p a i n f u l o r r e l a ti v e l y p a i n l e s s .

Accord in g to th e d ep th

(Fig. 4.11.1)

(Fig. 4.11.2)

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Managem ent :Rem em b er4 C's wh ile m an ag ing b u rn s :

1 . C oo l t h e b ur n t p a rt b y k e ep i ng i t u n d er r u n ni n g wa t er f o r a tl e a s t 1 0 m i n u t e s. D o n ' t p u t i c e o n t h e b u r n .

2 . C o ns t r i c to r s sho uld b e remo ved immed iately like ring s,b racelets etc b efo re swelling o ccurs. ( Fig . 4 .1 2 .1 )

3 . C ov er t h e bu rn t p ar t t o p re ve n t i nf e ct io n b y u si ng a n yclean clo th fo r examp le hand kerchief. ( Fig . 4 .1 2 .2 )

4 . C o ns u lt a D o c t or i m m e d ia t e l y.

Gen eral care forb u rn s :

1 . S m o t h er t h e f l am e s o r m o v e th e v i c ti m a w a y f r o m d a n g e r.

2 . L a y t h e c a s u a lt y d o wn o n t h e f l o o r.

3 . C h e c k t h e r e sp o n s e , a i r w a y, b r e a th i n g a nd p u l s e w h i l emanag ing the b urn. Resuscitate the casualty ifnecessary.

4 . C a l l f o r m e d i c a l h e l p i m m e d ia t e l y.

5 . L o o k a n d t r e a t f o r a s s o c i a t e d i n j u r i es o r s h o c k .

6 . C o ve r a l l t h e w o un d s w i t h c l ea n d r e ss i ng .

Precautions :

a . D o n o t t o u c h o r i n t e rf e re w i t h t h e b u r n t a r e a.

b . D o n o t a p p l y t oo t h p a st e , h a i r c r e a m , bu t t e r o r a n y o i n t me n t .

c . D o n o t c o ve r w i t h c o t t on .

d . D o n o t r e m o v e c l o t h es s t i c k in g t o th e b u r n t a r e a .

e . D o n o t b r ea k t h e b l i st e rs .

CHEMI CALBURN S

I n c a s e t h e bu r n s a r e c a u se d b y c h e mi c a l s, i t i s i m p o r ta n t t o r e m ov e c l o t h in g o n w h i c h c h e m i c al sh a v e s p i l l ed a n d f l u s h t h e a f f e c t ed a r e a w i t h c o p i ou s a m o u n t s o f w a t e r f o r 1 5 t o 3 0 m i n u t e s .

ELECTRI CALBURN S

A n e l e c t r i ca l b u r n m a y a p p e a r m i n o r, b u t t h e d a m a ge c a n e x t e n d d e ep i n t o t h e t i s su e s b e n e a t h t h eskin.

Management :

1 . L o ok f i r s t, d o n ' t t o u ch .

2 . T u r n o f f t h e so u r c e o f e l e c t r i c i t y i f p o s s i b l e .

3 . A s s e ss b r e a th i n g , c h e c k p u l s e .

4 . C o v e r t h e af f e c t e d a r e a .

5 . C al l f or h e l p.

(Fig. 4.12.1)

(Fig. 4.12.2)


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D o m e st i c p e t s c a u s e m o s t a n i m a l b i t e s. B i t e s f r o m s h a r p & p o i n t ed t e e t h c a n c a u s e su p e r f i ci a l a n dd eep wo und s. Bites may also b e caused b y p et p up p ies, stray d o g s/cats/mo nkeys. In these cases,t h e r e i s i m m e d ia t e r e q u i re m e n t t o t a k e t r e a t m e n t t o p r o t ec t f r o m r a b i e s . M e d i ca l a d v i c e s h o ul d b etaken immed iately.

W h a t t o d o ?

C a l m a n d r e a s s u r e t h e p e r s o n . W e a r l a t e x g l o v e s o r w a s h h a n d s t h o r o u g h l y b e f o re a t t e n d i n g tot h e w o u n d . W a s h h a n d s a f t e r w a r ds a s w e l l .

Superfic ial Wound :

I f t h e b i t e i s n o t b l e e d in g s e v e re l y , w as h t h e w o u n d t h or o u g hl y w i t h m i l d s o ap a n d runningw a t e r f o r 3 t o 5 m i n u t e s . T h e n, c o v e r t h e b i t e w i t h a n t i b i ot i c o i n t m e n t a n d a c l e a n d ressing .

Deep Wound :

I f t h e b i t e i s a c t i v e l y b l ee d i n g , a p p l y di r e c t p r e s s u r e w it h a c l e a n , dr y c l o t h u n t i l t h e b l e e di n g

sub sid es. Once the b leed ing sto p s, p lace clean d ressing and ap p ly b and ag e. E l e v a t e t h e a r ea o f the b ite.

S eek med ical ad vice immed iately.

ANIM AL BITES

S n a k e s a r e c o m m on l y f o u n d i n t r o p i c a l c l i m a t es . T h e y c a n b e p o i s on o u s o r n o n p o i s on o u s . Pe o p l ew h o w a lk i n j u n g l e s, c a m p , hi k e , p i cn i c , o r l i v e i n s n a k e - in h a b i t ed a r e a s s h o u l d b e a w a re o f t h ep o tential d ang ers p o sed b y veno mo us snakes.

Sy m ptom s of pois onous Snake Bites :

W h i l e e a c h i n d i v id u a l m a y e x p e r i e n c e s y m p to m s d i f f e re n t l y, t h e f o l l ow i n g a r e t h e m o s t c o m m o ns y m p t om s o f p o i s on o u s s n a k e b i t e s :

A n x i o u s l o o k

F a n g m a r k s i n t h e s k i n a n d r e d n e s s/ s w e l l i n g a t t h e s i t e o f t h e b i t e

P a i n l o c a l iz e d t o s i t e o f b i t e

Visio n d iso rd er- b lurred o r d o ub le visio n

Co nvulsio ns

Fainting

D i z z i n es s / w e a k n e ss

Excessive sweating

Lo sso fmuscle co o rd inatio n

N a u s e a a n d vo miting

N u m b n e s s a n dting ling

Rap id p ulse

D ifficulty in b reathing

F irs t Aid forSnake Bites :

- R e a s s ur e t he c a su a l t y t o st a y ca l m .

- D o n' t t r y t o c a pt u re t h e s n a ke .

- D o n' t a t t e mp t t o c u t o r s u c k t h e p a r t t o r em o ve t h e v en o m .

- I m mo b il i z e t h e bi t t en p a r t .

- M a in t a in t h e p a rt b e l o w t h e le v el o f t h e he a rt .

- W a sh t h e w o u nd a n d d r y i t w i t h c l e an c l o t h .

- L i g h t l y c o m p re s s t h e l i m b a b ov e t h e w o u nd . ( F i g. 4 . 1 4 .1 )

- M on it or V i t al s i gn s.

- R u sh t o t h e n e a re s t h o s pi t al .

SNAKE BITESANIMAL BITE SNAKE BITE

(Fig. 4.14.1)

4.13 4.14


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S i g n s a n d s y m pt o m o f a n i n s e c t b i t e r e s ul t f r o m t h e i n j e c t io n o f t o x i n s & a l l e r ge n s i n t o t h e s k i n .

Mild to severe allerg ic reactio ns can rap id ly d evelo p includ ing b reathing d ifficulty, facial swellingand sho ck.

B i t e s f r o m w a s p s , b e e s , h o rn e t s a n d f i r e a n t s a r e u s u a l ly p a i n f u l r a t h e r t h a n d a n g e ro u s w h i c h c a n b erelieved b y firstaid .

Treatment :

F or Mild Reac tions :

1 . S c r a pe o r b r u s h o f f t h e s t i n g e r w i t h a s t r a ig h t -e d g e d o b j e c t s u c h a s c r e d it c a r d o r t h e b a c k o f aknife.

2 . T r y to p u ll o u t t h e s t i n g i f a t w e e z e rs i s a v a i l ab l e .( Fig . 4 .1 5 .1 )

3 . T o r e du c e p a i n a n d s w e ll i n g , a pp l y i c e o r c o l dp ack.

4 . C o n s u l t a d o c t or .

INSECT BITES AND STINGS

What is pois oning ?

A p o is o n i s a n y su b s t a n ce t h a t i s h a r m f u l t o t he b o dy . P o i so n s m a y e nt e r t h e b od y t hr o u g h t h em o u t h , t h e l u n g s, o r t h e s k i n . S u b s ta n c e s t h a t c a n c o m m o nl y c a u s e p o i so n i n g i n c l ud e a v a r i e t y o f m e d i c i ne s ( o v e rd o s e ), h o u s e h o l d s u b s t a n ce s a n d i n d u s t r i al p r o du c t s . T h e p o i s o n m a y c a u s e m o r es e r io u s e f f ec t s i f l a rg e r q u an t i ti e s a r e c o ns u m ed , or i f t i m e e l ap s es . Mo s t p o is o ni n g o c cu r saccid entally, and sp ecially b y d ue to accid entaling estio n b y child ren.

T h e c o m m o n a ge n t s a r e :

I n s e c t ic i d e s s u c h a s B a y g on

C l e a n i ng Ag e n t s l i k e H a r p ic t h a t c o n t a i n a c i d sKero sene ( Fig . 4 .1 6 .1 )

M e d i c in e s k e p t a t h o m e : Pa i n k i ll e r s , S ed a t i v es( like calmp o se ) ( Fig . 4 .1 6 .2 )

Signs and symptoms :

T h e s i g n s a n d s y m p t o m s o f p o i s on i n g d e p e n d o n t h es u b s t an c e in v o l v e d a n d on t h e a mo u n t o f p o i s ontaken. One sho uld loo k o ut fo r:

Ab d o minal p ain

B re at h t h at s me ll s o f t h e s ub st an c e s uc h a sinsecticid e

N a u s e a a n d / o r v o m i t i n g

Breathing d ifficulty

D r o ws i n e s s / F a l l i ng l e v e l o f c o n s c io u s n e s s

B u r n i n g s e n s a ti o n i n c h e s t / s to m a c h

Blurred visio n

S ud d enco llap se

C h a n g e o f s k i n c o l o u r

Burns aro und the mo uth

Behavio ral chang es

Co nvulsio ns

D iarrho ea

A b n o r ma l l y s l o w o r f a s t p u l s e

Ab d o minal p ain

POISONING

(Fig. 4.15.1)(Fig. 4.16.1)

(Fig. 4.16.2)

4. 15 4.16


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Act FastI t i s i m p o r ta n t t o a c t q u i c k ly . A c t io n i s t h e m o s t i m p o r t a nt f a c t o r i n f i r s t a i d i f p o i s o n in g i s s u s p e c t e d .

Before Callin g forHelp :

Treatment :

M o v e t h e c a s u a l ty a w a y f r o m t h e p o i s o n t o a n a r e a w h e r e f r e sh a i r i s a v a i l ab l e .

C h e c k l e v e l o f r e s po n s e , o p e n t h e a i r w a y , c h e c k b r e a t h i n g a n d c h e c k p u l s e .

G ive CP R ifreq uired . U se aface shield .

If co nscio us, reassure the casualty.

Poison ou s Fu m es or Gases :

I m m e d ia t e l y ca r r y o r d r a g t h e p e rs o n t o f r es h a i r. M i n i m iz e y o u r o w n a n d t h e ca s u a l ty ' se x p o su r e t o th e f u m e s. I f t h e v i c ti m i s n o t b r e a t hi n g , s ta r t a r t i f i ci a l r e s pi r a t i on i m m e d ia t e l ya n d c o n t i n u e i t u n t i l t h e v i c t i m i s b r e a t hi n g o r h e l p a r r i v e s . S e n d s o m e o ne f o r h e l p a s q u i c k l y a sp o ssib le.

I f i n d i v id u a l c a n n o t b e m o v e d, t h e r o o m i n w h i c h t h e g a s / va p o r e x p o s u r e o c cu r r e d s h ou l d b eventilated witho p en wind o ws, fans, etc.

Poisons on the Skin :

Wear g loves, if n ot availab le, avoid d irectly tou ch in g th e p oison you rself. W i p e of f a n yd r y p o is o n s a n d f l o o d t h e a f f e ct e d a r e a w i t h l a r g e a mo u n t s o f p l a i n w a t e r f o r 5 t o 1 0 m i n u t e s .T h e n w a s h t h e s k i n w i t h s o a p a n d w a t er f o r a n o t h e r 5 m i n u t e s a n d r i n s e . R e mo v e a n d di s c a rdall affected clo thing .

Poisons in the Eye :

P ou r w a te r f r om a g l as s o n t h e b r id g e o f t h e p a t i e nt ' s e y e a n d a ll o w w a t e r t o f l oo d t h e e y eg e n t l y f o r 1 5 m i n u t e s . U s e p l ai n l u k e w a r m w a t e r . D o n o t a l l o w t h e v i c t i m t o r u b h i s / h e r e y e s .

Swallowed Poisons/Medications :

I n g e st e d p o i s o n in g c a n o c c u r f r o m d r u g o v e r do s e s, m e d i c a t i o n e r r o rs , c a u s t i c a n d c o r r o si v esub stances.

I f a p o t e n ti a l l y ca u s t i c o r c o r r os i v e l iq u i d ch e m i c a l h a s b e e n s w a l lo w e d , ha v e t h e in d i v i du a lr i n s e th e i r m o u t h w i t h w a t e r a n d s pi t i t o u t s e v e r a l t i m e s b e f o re g i v in g t h e m 1 / 2 c u p ( o nl y ) , of w a t e r t o dr i n k . T h i s i s t h e on l y s i t u a t io n i n w h i c h a n i n d i v id u a l c a n h a v e s o m e t h in g t o d r i n kb e f o re c a l l i n g f o r h e l p a t a p o i s o n c e n t e r / m e d i c al p r o f e s s i on a l .

L o o k i n t o t h e v i c t i m 's m o u t h a n d r e m o ve al l t a b l e t s, po w d e r o r a n y m a t e r i al t h a t i s p r e s e nt .

W e a r g l o v e s . E x a m in e t h e m o u t h f o r c u t s , b u r n s, s w e l l i n g , u n u s u al c o l o ri n g o r o d o r. R i n s e a n dw i p e o u t t h e m o u t h w i t h a c l o t h .

I f i n d i v i d u a l i s i n n o a p p a r e nt l i f e t h r e a t e ni n g d i s t r e ss , a l l o w t h e m t o r e s t .

D o n o t g ive any med icatio n, fo o d , o r liq uid untilto ld to d o so b y p oiso n center/d o cto r.

I f s e r i o u s , p e r f o r m A B C .

G ive Rescue Breathing ( use ap ro tective shield o rh and kerchief) o rCP R.

I f n e c e s s a r y, t r e a t f o r S h o c k .

Calls forHelp :

I d e n t i fy y o u r s el f a n d g i v e y ou r r e l a t io n s h i p to t h e p a t i e n t . Gi v e y o u r p h o n e n u m be r i n c a s ey o u r c a l l i s d i s c o n n e c t ed .

F o l l o w t h e a d v i c e o f t h e P o is o n C e n t e r / m e d i c a l p e r s o n n e l.

P ro vid e med ical p erso nnel with:

- A l l c o n t a i n e r s, f o o d , d r i n k i n g g l a ss e s , b o t t le s , e t c . f o u n d n e a r t h e i n d i v i d ua l .

- C o nt a in e r o f k n o w n p o is o n.

- A n y i n f o r m at i o n k n o w n r e g a r d i n g p re s c r i pt i o n m e d i c i n e t h e i n d i v id u a l i s t a k i n g.

- I n f o r ma t i o n o n c o n d i ti o n o f c a s u a lt y .

T r y t o h a v e t h e f o l l o w i n g i n fo r m a t i on w h e n y o u c a l l :

- What h a s b e e n s w a l l ow e d ?

- Time i t w a s t a k e n .

- E x a c t N a m e o f t h e s u b s t an c e o r m e d i c i ne .

- H o w m u c h w a s s w a l l o w ed . ( N u m b er o f p i l l s , m i l l i g r a m s p e r p i l l )

How to produc e v om iting ?

R e m e mb e r :

N e v e r p r o du c e v o m it i n g u nl e s s i n s tr u c t ed t o d o s o ! T h i s i s e s pe c ia l ly i mp o rt a n t i f t h ep a t i e n t h a s s w a l l o w e d p e t r o l e um p r o du c t s s u c h a s g a s o l i n e , c l e a n i n g f l u i d s a n d l i g h t e r f l u i d s.

I p ec a c i s a p l an t e x t ra c t t h a t w h e n s w al l ow e d c au s e s v o mi t i ng . V om i ti n g w il l r e mo v e t hep o i s on f r o m t h e s t o m a ch . T h e r e a r e v e r y f e w i n s t a nc e s w h e r e I p e ca c w o u l d b e r e c om m e n d e d


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b y a d o c t or o r P o is o n C e n t e r ; - N E VE R u s e I pe c a c w i t h o u t t h e a d vi c e o f a d o c t or o r t h e Po i s o n

Co ntro l Center.

N e v e r p r o d u c e v o m it i n g i f t h e p a t i e n t :

- I s d r o ws y o r u n c on s c io u s.- I s h a v i n g c o n v u l si o n s ( f i t s ) .- H a s s w a l l o w ed a s t r o n g c o r r os i v e s u c h a s a c i d . I f t h i s o c c u r s , g iv e l i q u i ds o n l y .

Us e of Ac tiv ated Charc oal:

Ac tiv ated Charc oal

A c t i v at e d c h a r co a l i s n o t r e c o mm e n d e d f or h o m e u s e . I t i s u s e d t o b in d d r u g s a n d c h e m i c a l sb e f o re t h e y a r e a b s o rb e d i n t o a p e r s on , bu t a c t i v a te d ch a r c o al d o e s n o t b i n d a l l d r u g s o rc h e m i c al s a n d h a s s o m e r is k w h e n g i v e n . I m p o r ta n t : O nl y u s e it w h e n t o l d to d o so b y t heP o iso nCenter / d o cto r.

A l c o h ol i s t h e m o st w i d e ly u s e d a n d a bu s e d dr u g t od a y. A l c o ho l i n t o x i ca t i o n , a l s o kn o w n a s

d r u n k e n ne s s , i s s o c o m m o n t h a t i t f a i l s t o r e c e i v e t h e a t t e nt i o n a n d r e s p e c t i t d e s e r ve s . E t h y l a l c o h o l( e t h a n ol ) i s t h e p r i m a r y i n g re d i e n t i n w i n e , b e e r, a n d l i q u o r. E t h a n o l i s c l a s s if i e d a s a d r u g b e c a u se i td e p r es s e s t h e c e n t r al n e r v o u s s y s t e m , a f f e c t i ng p h y s i c a l a n d m e n t a l a c t i v i t i e s. A l c o h o l i s a d d i ct i v e .W h a t s t a r t s o u t a s s o c i a l d r i n k i n g m a y, r e s u l t i n a l c o h ol i s m ?

A l c o h ol a f f e c ts t h e b o d y i n s t a g e s. F i r s t , t h e r e i s a f e e l i ng o f r e l a x at i o n a n d w e l l - b e i n g , f o l l ow e d b y ag r a d ua l d i s r u pt i o n o f c o o r di n a t i on , r e s u l t i n g i n a n i n a b i li t y t o a c c u r a t e l y a n d e f f i ci e n t l y p e r f or mn o r m a l d u t i e s a n d a c t i v i ti e s . C o n t i n u ed dr i n k i n g d e p r es s e s b o d y f u n c t i on s e n o u g h t o ca u s ed i f f i cu l t y b r e a t h in g , l o s s o f c o n s c io u s n e ss , c o m a , a n d d e a t h . W i t h d ra w a l f r o m a l c o h ol c a n r e s u l t i nd elirium tremens ( D Ts) , id entified b y anxiety, co nfusio n, restless sleep , nausea, vo miting , d ep ressio n,hallucinatio ns, and seizures.

S i g n s a n d s y m p t om s o f a l c o h ol i n t o x ic a t i o n i n c l u d e :

1 . S m el l o f a l c o h ol o n b r ea t h .

2 . S t a g ge r i n g , l os s o f b a l a n ce , a n d s l u r re d s p e e ch .

3 . N a u s e a , v o m i t i ng , a n d f lu s h e d f ac e .

T h e s e s i gn s a n d s y m p to m s m a y i n d i c at e a n i l l n e ss o r i n j u r y ( e. g . d i a be t e s , h e a d i n ju r y ) o t h e r t h a na l c o h ol a b u s e . I f y o u s u s p e ct a l c o h ol i n t o x i c a t i o n, d o t h e f o l l ow i n g :

1 . S i t o r l a y t h e c a s u a l t y d o w n , p r ot e c t i n g h i m o r h e r f r o m f u r t h e r i n j u r y.

2 . Estab lish and maintainth e airway, b reathing , and circulatio n ( ABCs) .

3 . O b serve clo sely, casualty may b eco me unco nscio us.

4 . Do n't c r i t i c iz e b u t b e f i r m .

5 . Never leave a n i n t o x i c a t e d p e r so n a l o n e .

6 . R e q u e st m e d i c al a s s i st a n c e a s s o o n a s p o s s i b l e.

I M M E DI A T E C A R E O F A D R U NK P E R S O N :

1 . K e e p t h e pe r s o n c o m f o r ta b l e .2 . I f t h e p e rs o n i s p u t i n b e d - m a k e s u r e t h e p e r s on i s l y i n g on t h e i r s i d e , n o t b a c k .

3 . I f p o ss i bl e , a s se s s w h e th e r t h e p e rs o n i s i n a l i fe t h re a t en i n g h e a lt h c r is i s. I f s o , g e t h e l pad viso ry and /o r p o lice.

4 . I f y o u p u t a p e rs o n t o b e d , m o n i to r t h e i r b re a t hi n g.

5 . K e ep y o ur d i s t an c e .

6 . K e e p a c h e c k w h e t h e r v i c t i m v o m i t s a n d th e l e v e l o f u n c o n s ci o u s n e ss .

DRUNKENESS4.17


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H y p e rg l y c e m ia i s t h e c o n d i t i on w h e n g l u c o s e l e v e l s i n t h e b l o o d a r e h i g h e r t h a n n o r m a l r a n g e .

Rec ognition :

- D ro ws in e ss

- F r eq u en t U r i n at i on

- E x ce s si v e t hi r st

- H ot a n d d ry s ki n

- R ap id p u ls e

Treatment :

1 . M a k e t h e c as u a l t y si t c o m f o r t a b l y i n a c o o l p l a c e .

2 . S e e k m e d i c a l h e l p i m m e d i a t e l y. ( F i g . 4 . 1 8 . 1 )

3 . G i v e s u ga r f r e e o r a l f l u i d s .

HYPERGLYCEMIA (HIGH BLOOD SUGAR)

(Fig. 4.18.1)

D e f i n e d as a l o w e r b l o o d su g a r t h a n t h e n o r m a l r a n g e .

Caus es :

1 . I n s u l in o r a n t i - d i a b e ti c m e d i c i n e o v e r do s e

2 . I n s u f fi c i e n t f o o d i n t a k e

3 . E x c es s iv e E x e rc i se

4 . A m is s ed m ea l

H o w t o R e c og n i z e :

1 . W e a k n es s , t r e m b li n g or s h a k i ng

2 . D i zz i n es s & h u n ge r

3 . N u m b n e ss a r o u n d l i p s a n d f i n g e rs

4 . P al lo r

5 . S weating p ro fusely

6 . R a pi d p u ls e

7 . A l te r ed m e n t a l s t at u s

Treatment :

1 . R e a s s ur e th e c as u a l t y & m a ke h i m/ h e r c o m f or t a b l e .( Fig . 4 .1 9 .1 )

2 . G iv e or al f lu id s w it h g lu co se o r a s we et en ed d ri nk .( Fig . 4 .1 9 .2 )

3 . R ep ea t t h e d ri nk s e v er y 15 m in ut e s u n ti l m e di c al h el parrives.

4 . Lo o sen and remo ve excessive clothing .

HYPOGLYCEM IA (LOW BLOOD SUGAR)

(Fig. 4.19.1)

(Fig. 4.19.2)

4. 18 4.19


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Fractures, sp rains, strainsand d islo catio nsmay b e hard fo r the no nmed ical p erso nto d ifferentiate.

F rac ture m eans broken or c rac ked bones .

F rac tures c an be c aus ed by :

1 . D i r e ct f o r c e - B o n e s a r e b ro k e n a t t h e p o in t w h e r e s e v e re f o r ce i s a p p l i e d .

2 . I n d i re c t f o r c e - B o n e s a r e b r o ke n a w a y f r o m t h e p o i n t w h e r e s e v e r e f o rc e i s a p p l i e d .

Types of fracture :

C l o s ed F r a c t u r e : S k i n i s i n t a c t w i t h b r o k e n b o n e .

O p e n F r a c t u r e : B r o k e n b o n e w i t h o p e n w o u n d .

S k i n i s b r o ke n w i t h e v i d e nt b l e e d in g .

H o w t o r e c og n i ze ?

1 . I m mo b il i ty2 . D e fo r mi t y

1 . L oo k f or p a in

2 . L o ok f o r t e n d e rn e ss

3 . L oo k f or S w e ll in g

4 . L o o k f o r L o s s o f f u n c t i on

5 . Any unnatural mo vement

6 . H i s t or y o f h e a v y bl o w o r f a l l

Com plic ation of frac tures :

- A s s o ci a t e d i n j u r ie s m a y b e p r e s en t

- S h oc k - H y po v ol e mi c o r N e u r o ge n i c

FRACTURES, SPRAINS, STRAINS & DISLOCATIONS

Managem ent :Aims :

- I m m o bi l i z a t io n a n d s u p p or t t o t h e f r ac t u r e d p a r t .

- M i ni m iz i n g t h e p a i nf u l m o v em e n ts .

1 . Reassure the casualty and ask no t to mo ve.

2 . C h e c k c i r c u l a t io n a n d tr e a t f o r s h o c k .

3 . S tead y and sup p o rt the fractured limb .

4 . K e e p t h e j oi n t s a b ov e a n d be l ow t h e f ra c t ur e d pa r t i m mo b il i ze d w it h s p li n t ( o r a n yimp ro vised item) . P ro p ersp linting may red uce p ain.

5 . T o d es i g n a s p l i n t, u s e a r i g i d m a t e r i al s u c h a s w o o d , p la s t i c o r m e t a l .

6 . F a s t e n t h e s p l in t t o t h e l im b w i t h g a u z e , b a n d ag e s , an d s t r ip o f c l o t h , st r i n g or e v e n a

b elt.7 . Tie b and ag esfirmly.

8 . S to p b leed ing with d irect p ressure if p o ssib le.

9 . If p o ssib le elevate the injured p art.

1 0 .Transp o rt the casualty to the nearest ho sp ital.

11 . C h e c k c i r c u l a t i o n , b re a t h i n g, l e v e l o f c o n s c io u s n e ss e v e r y1 0 minutes.

First aid fo rstrains, sp rains, co nf usio ns, d islo catio ns, o runco mp licated fractures.

- R . I . C .E . ( R e s t , I c e , C o m p re s s i on , E l e v a t i on )Treatment.

Rest : ( Fig . 4 .2 0 .1 ) S to p using injured p art

- C o n t i n ue d a c t i v it y c o u l d c au s e f u r t h e r i n j u r y , d el a yhealing , increase p ain, and stimulate b leed ing

U s e c r u t c h e s t o a v o i d b e a r i n g w e i g h t o n i n j u r i e s o f the leg , knee, ankle, o rfo o t

U s e s p l i nt f o r i n j u r i e s o f t h e a r m , e l b o w, w r i s t , o r h a n d

(Fig. 4.20.1)

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I ce :

H astens healing time b y red ucing swelling aro und injury

- S u d d en c o l d c o n t r ac t s b l o o d v e s s e ls

- H e l p s s t o p i n t e rn a l b l e e d i n g f r om i n j u r ed c a p i l l ar i e s a n d b l o o d v e ss e l s

K e e p d a m p or d r y c l o t h b e t w e e n s k i n a n d i c e p a c k

D o n o t a p p l y i ce f o r l o n g e r t h a n 1 5 t o 2 0 m i n u t e s a t a t i m e

- A p p l y a t l e a s t 3 t i m es t h r o u g h o u t t h e d a y f o r 1 5 t o 20 m i n u te s

Compression :

H astens healing time b y red ucing swelling aro und injury

- D e c r e as e s s e e p i n g of f l u i d i n t o in j u r e d a r e a f r o m a d j a c e n t t i s s u e

U se elasticized b and age, co mp ressio nsleeve, o r clo th

- W r ap i n j ur e d pa r t f i r ml y

- - D o n o t i m p a i r b l o o d su p p l y

- - - T o o t i g h t c o m p r e s si o n m a y c a u s e m o r e s w e l li n g

- W ra p o ve r i c e

- L o os e n t h e b a nd a ge i f i t g e ts t o o t i g ht

Elevation :

E l e v a te i n j u r e d p a r t a b o v e l e v e l o f h e a r t

- D e c r e as e s s w e l l i n g a n d p a i n

- U s e o b je c t s a n d p i l l o ws f o r p r o p s , St r a i n s, S p r a in s

W h a t t o d o ?

Rest to the injured p art

P a i n k i l l e r ( A n a l g es i c )

M o st m a jo r s p or t s i n ju r i es c a n b e r e c og n iz e d b y t h e i r s i gn s a n d s y mp t om s , a n d t re a t me n t c a n

b e p ro vid ed as req uired . H ead injuries, co ncussio n, laceratio ns, so ft tissue injuries and fractures,are reco g nizab le and canb e effectively treated b y anyo ne trained inb asic first aid .

C e r t a i n o t h e r s p o r ts i n j u r i es a r e m o r e c o m mo n , a n d m a y r e q u i re m o r e s p e c i f ic f i r s t a i d t r e a t m e n t .These are exp lained b elo w:

Ches t c ram ps (or's titc h')

U s u a l ly c a u s e d by c r a m ps o f t h e m u s c l es b e t w e e n t h e r i b s , o r t h e d i a p h r a gm h i g h i n t h e a b d om e n .B r o u gh t o n b y e x e r t i o n , c h e s t c r a m p s a r e i d e n t i f i e d b y s h a r p, s p a s m o di c p a i n i n t h e c h e s t , d i f f i c u lt yin stand ing up rig ht, and g asp ing resp iratio ns.

A ' S t i t c h ' w i l l d i s a pp e a r w i t h r e s t a n d c o n c e n t r a ti o n o n d e e p b r e a t h in g .

Groin and tes tic le injuries

C a u s e d b y a b l u n t i n j u r y t o t h e p e l v i c a r e a . C a u s es s e v e re p a i n i n t h e a r e a . T h e c a s u a lt y w i l l b e u n a b l eto stand up rig ht, and will 'g uard ' the injured areawith his hand s.

T h e c a s u a l t y s h ou l d b e p l a c e d o n h i s b a c k w i t h k n e e s s l i g h t l y b e n t , a n d h a ve a n i c e p a c k a p p l i e d w i t hc a u t i o n t o t h e i n j u r y s i t e . S e e k m e d i c a l a i d .

Muscle cramps

Caused b y o ver-stretching muscles, o rb y ab no rmal muscle co ntractio n. They may also b e asso ciated

w i t h l o s s o f f l u i d d u e t o e x c e s s i v e s w e a t in g .

W i l l h a v e p a i n , t e n d e r n e s s, l o s s o f p o w e r a n d s t i f f en i n g o r s p a s m s o f t h e m u s c l e s .

M u s c l e s r e s p on d t o r e s t , a p p l i ca t i o n o f a n i c e p a c k , t h e n s u b s e q u e n t g e n t l e s t r e t c h i ng .

D O NOTmassag e the affected muscles.

O t h er s p or t s i n j ur i es s h ou l d b e t re a t ed a s t h e y pr e se n t , a nd m e d ic a l a i d s ou g ht a s a m a tt e r o f c o u r se . If t h e s e i n j u r i es a r e i n t h e fo r m o f s p r ai n s a n d s t r a in s , t h e y m a y r e q u i re su p p o r t i n t h ef o r m o f s t r a pp i n g o r t a p i n g.

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Any blow to the head c an result in a head injury. Head injuries c an caus e dam age to

the :

S calp : l a y e r o u t s i d e t h e s k u l l b o n e .

S kull : b o ny cag e.

B r a i n : a c o n c u s s i on , a c o n t u si o n ( t h e b r ai n t i s s u e is b r u i s ed ) , o r a h e m a t o ma ( b l o od c o l l ec t s i na n a r e a o f t h e b r a i n f r o m a b r o k en b l o o d v e s s e l) .

Signs and Sy m ptoms of head injuries that alert the need for m edic al attentioninc lude :

Lo ss o f co nscio usness, co nfusio n, d ro wsiness

I n a b i li t y t o m o v e a n y pa r t o f t h e b od y o rw e a k n e ss i n a n a r m o r l e g ( F i g . 4 . 2 2 .1 )

B r u i s e , c ut o n t h e s c a l p

S evere head ache

S t i f f n e c k

Vo miting

B l o o d o r f l u i d t h a t c o m e s f r o m t h e m o u t h , n o s e o r e a r

L o s s o f v i s i on , b l u r r e d o r d o u b l e v i s i o n , p u p i ls o f u n e q u a l s i z e

SPINAL INJURIES

Common causes are :

Accid ents-Cars, Mo to rcycles

Falls

D i v i n g m is h a p s - f r o m d i v i n g i n t o t h e w a te r t h a t i s t o o s h a l l o w

A hard b lo w to b ackwhile p laying

G u n s h o t w o u n d t h a t p e n e t r at e s t h e h e a d a n d n e c k

Treatment :

D o the scene survey fo rsafety to self and the casualty.

C a l l f o r t h e a m b u l a n c e.

HEAD INJURIES4.22

Avo id unnecessary mo vements.

Immo b ilize the neck, sp ine and head . ( Fig . 4 .2 2 .2 )

A s s e s s f o r c o n s c i o u sn e s s a n d b r e a t hi n g .

G i v e r e s c u e b r e a t h s i f n o t b r e a t h i n g.

Assess the circulatio n, check p ulse.

C o n t r ol b l e e d i n g i f p r e s e n t .

Reassure the casualty and keep warm and calm.

(Fig. 4.22.1)

(Fig. 4.22.2)


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Y o u c a n t r e a t m a n y m in o r e y e i rr i t a t i on s b y f lu s h i n g t h e e y e, b u t m o r e s e r i o us i n j u r i es s h o u l d b e

sho wn immed iately to the d o cto r.

Routine Irritations :

( S a n d, d i r t , a n d o t h e r f o r e ig n b o d i e s o n t h e e y e s u r f a c e )

W a s h y o u r h a n d s t h o r ou g h l y b e f o re t o u c h i n g t h e e y e l i d s t o e x a m i n e o r f l u s h t h e e y e .

D o no tto uc h, p ress, o rrub the eye itself.

D o no ttry to remo ve any fo reig n b o d y excep tb y flushing .

T i l t t h e v i ct i m ' s h e a d o v e r a b a s i n w i t h t h e a ff e c t e d e y e d ow n a n d ge n t l y p u l l d o w n t h e lo werl i d , e n c ou r a g in g t h e v i c t i m t o o p e n h i s o r h e r e y e s a s w i d e a s p o s s i bl e .

F o r a n i n f a n t o r s m a l l c h i l d , it ' s h e l p f u l t o h a ve a s e c o n d p e rs o n h o l d t h e c hi l d ' s e y e s o p e n w h i l ey o u f l u s h .

G e n t l y po u r a s t e a d y s t r e a m o f t a p w a t e r f r o m a j u g a c r o s s t h e e y e .

F l u s h f o r u p t o 1 5 m i n u t e s, c h e c k i n g t h e e y e e v e r y 5 m i n u t e s t o s e e i f t h e f o r e ig n b o d y h a s b e e nflushed o ut.

C o n s u l t a d o c t or .

Em bedded F oreign Body - An objec t penetrates the globe of the ey e :

C a l l f o r e m e r ge n c y m e d i c a l h e l p .

S t a b i li z e t h e e m b e d d e d o b je c t i n p l a c e & r u s h t o d o c t or / c a l l E M S .

Cuts of the ey e and lid:

S e e k m e d i c a l h e l p i m m e d i at e l y.

D o n o t a t t e m p t t o w a s h o u t t h e e y e o r r e m o v e an y o b j e ct s t u c k i n t h e e y e .

Never ap p ly p ressure to the injured eye o reyelid .

The eye sho uld no tb e rub b ed .

B l u n t i nj u r y ( b l o w ) t o t h e e y e :

Immed iately ap p ly anice co mp ress to the eye to red uce p ain and swelling .

S e e k m e d i c a l h e l p i m m e d i at e l y.

EYE INJURIES

Chem ic al burns :

F l o o d t h e e y e wi t h w a t e r i m m e d ia t e l y, u s i n g y o u r f i n g e rs t o k e e p t h e e y e op e n a s w i d e asp o ssib le.

H o l d t h e h e a d u n d e r a t a p o r s h o w e r, o r p o u r w a t e r g e n t l y i n t o t h e e y e f r o m a c o n t a in e r f o r a tl e a s t f i f t e e n m i n u t e s .

R o l l t h e e y e b a ll a s m u c h a s p o s s ib l e t o w a s h o u t t h e e y e .

D o n o t u s e a n e y e c u p , o r b a n d a ge t h e e y e .

S eek med ical help immed iately.

4.23


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A b d o mi n a l i n j u r i e s a r e c a u s e d b y b l un t o r p e n e t ra t i n g t r a u ma a n d c a n i n v o l ve i n t e r n a l b l e e d i n g o r

t h e e x p o su r e o f t h e i n t e r n a l o r g a n s t o a i r. W h a t e v e r t h e c a u s e o f t h e i n j u r y t he f i r s t a i d p r ov i d e rs h o u l d b e a l e r t f o r s h o c k d u e t o i n t e r n a l b l e e d i n g .

Blunt T rauma / Wound :

I f t h e i n ju r y i s e i th e r b l un t t r au m a , e .g . a s e ve r e b lo w t o t h e a b do m en w i t ho u t a n y a s so c ia t e dw o u n d, o r a p e n e t ra t i n g i n j u r y, t h e f i r s t a i d s t e p s a n d a p p r o a c h w i l l b e t h e s a m e .

Signs and Symptoms :

P ale, co o l, clammy skin

There may b e evid ence o fwo und

Rap id , weakp ulse, sho ck

Rap id , shallo w b reathing

Ab d o minal rig id ity

' G u a r di n g ' o f a b d o m e n w i l l b e r o l l e d u p f o r c o m f o rt a b l e p o s it i o n i f l y i n g d o w n

W h a t t o d o ?

P e r f or m A B C .

C a r e f ul l y p o s i ti o n i n d i v i d u al o n t h e i r b a c k .

I f m o ve m e nt o f t h e l e gs d o es n o t c a us e pa i n, pl a ce a p i ll o w u n d er k n e es t o he l p r e la x t h eab d o minal muscles.

I f m o v e m e n t o f t h e l e g s c a u s e s p a i n , l e a v e i n d i v i d ua l l y i n g f l a t .

W ear g lo ves.

C o n t r ol b l e e d i n g w i t h a d r e s si n g .

D o not g ive fo o d o r d rink.

D o not g ive med icatio n.

S t a b i li s e a n y ob j e c t i n w h e r e it i s , a n d p a d a ro u n d w ou n d . A v oi d r e mo v i n g or t o u c h i n gp enetrating o b jects.

Reassurance.

ABDOM INAL INJURY 4.24

52

W h e n a t o o t h i s k n o c k e d ou t , a p p ro p r i at e e m e r g e nc y m e d i c al a n d d e n t al c a r e i s n e c e s s a r y. I f a c h i l d

i s 7 o r m o r e i t i s l i k e l y t o be a s e c o n d o r p e r m a n e n t t o o t h . A s e c o n d o r p e r m a n e n t t o o t h c a n o f t e n b es a v e d i f p r o m p t a c t i o n i s t a k e n , a n d t h e t o o t h i s h a n d l e d c a re f u l l y. T h e d e l i c a t e t i s s u e c o v er i n g t h ero o t must b e p ro tected to ensure successfulre-imp lantatio n.

I f a c h i l d is 6 o r l e s s i t i s l i k e l y t o b e a b a b y o r p r i m a r y t o ot h . B a b y t e e t h m a y b e c o m e i nj u r e d a f t e r af a ll a n d t ur n g re y i n c o lo u r. T r ea t m en t i s n o t a l wa y s n e c es s ar y, b u t i t i s b e st t o h a ve t h e d en t i ste x a m i n e t h e c h i l d a s s o o n a s p o s s i b l e .

Care and Treatment :

W h en a b a by o r t o d d le r i n j u re s g u m s o r t e e t h :

I f t h e r e i s b l e e di n g , p u t c o l d w a t e r o n a p i e c e o f g a u z e a n d a p p ly p r e s s u re t o t h e s i t e .

O f f e r t h e c a s u al t y a n i c e c u b e t o s u c k , t o re d u c e s we l l i n g ca l l y o u r d e n t i s t. H e o r s h e w i llp r o ba b l y w an t t o s e e t h e ch i l d t o as s e s s t h e n e e d f o r r e a l ig n m e n t , or r e m o v al o f a v e r y l oo s eto o th.

If a perm anent tooth is knoc ked out :

H o l d t h e t o o t h b y t h e c r o w n ( t h e t o p ) , n o t t h e r o o t .

R i n s e t h e t o o t h i m m e d i a t e l y w i th s a l i n e s o lu t i o n o r m i l k , a v o id s c r u b b i ng m a t e r i a l o f f i t . I f t h i si s n o t p o s si b l e , w r a p i n p l a s ti c c l i n g w r a p .

I f t h e c a s u a lt y w i l l c o o p e r a t e , r e p la c e t h e t o o t h g e n t l y i n i t s s o c k e t .

H a v e t h e c a s u al t y b i t e d o w n g e n t l y o n a g a u z e p a d t o k e e p t he t o o t h i n p l a c e .

I f t h e t o ot h c a nn o t b e r e -i n se r t ed , p u t i t i n m i lk w h ic h i s a g o od p re s e rv a ti v e b e c au s e i t sc h e m i c a l m a k e - u p i s c o m p a t i b l e w i t h t e e t h .

I f m i l k i s n o t a v a i l ab l e , t h e t oo t h c a n b e pl a c e d i n t h e c as u a l t y' s m o u t h b e t w e e n t h e t ee t h andc h e e k , i f o l d e n o u g h n o t t o s w a l l ow t h e t o o t h . I f t h i s i s n o t p o s s i b l e, w r a p i n p l a s t i c cling wrap .

G i v e t h e c a su a l t y a g a u z e p ad o r h a n d k e rc h i e f t o g e n t l y b i t e d o wn o n , w h i c h w i l l h e l p co ntro lb leed ing and ease the p ain.

S e e a d e n t i s t r i g h t a w a y , w i t h in 2 0 m i n u t e s i f p o s si b l e .

D o n o t r e p l a c e t h e t o o t h o r p l a c e a n y t h i n g i n t h e m o u t h o f a d r o w sy o r u n c o n s ci o u s c a s u a l t y.

T O OT H I N J U RI E S4.25


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I f t h e t o o t h c a n ' t b e r e - i m pl a n t e d , c on t r o l b l e e d i n g b y p l ac i n g a g a u z e p a d i n t h e t o o t h s o c k e t , a n d

t h e n g e t t h e c a s u a lt y t o b i t e g e n t l y do w n o n t h e p a d . A v oi d r i n s i ng o u t t h e m o u t h b e c a u s e t h i s c a ninterfere withb lo o d clo tting .

I f t h e g u m s a r e bl e e d i ng , p u t c o l d w a te r o n a p i e c e of g a u z e an d p u sh i t b e t w e en t h e l i ps a n d g um s .H ave the casualty ho ld p ressure o nthe b leed ing site.

Stroke /Brain Attac k

What is s troke ?

S t ro k e, a l s o c al l ed a b r ai n a t ta c k , h ap p en s w h en t h e a r te r ie sl e a d i ng t o t h e b r a in a r e b l oc k e d o r r u p t u r e. W h e n t h e b r a in d o e sn o t r e c e i v e t h e n e e d e d o x y g e n s u p p l y , t h e b r a i n c e l l s b e g i n t o d i e .

Reas ons :

C l o t t i ng o f b l o o d o r A r t e r i a l r u p t u r e .

W arning sig nsand symp to ms may includ e :

I n s o m e c a s e s h e a d a n d e y e m a y d e v i a te t o o n e s i d e . s u d de nw e a k n e ss o r n u m b n e ss o f t h e fa c e , a r m , o r l e g o n o n e s i d e o f the b o d y. ( Fig . 4 .2 6 .1 )

S u d d e n d i f f i cu l t i e s w i t h s p e e c h a n d u n d e r st a n d i ng w h a t o t h e r s a r e s a y i n g.

S u d d e n p r o b le m s w i t h v i s i o n- d i m n e ss o r l o s s o f v i s i on , p a r t i c u l ar l y i n o n e e y e

S ud d end izziness.

S u d d e n p r o b le m s w i t h w a l k i n g.

A n o t h e r w a r n i n g s i g n o f s t r o ke i s c a l l e d t r a n si e n t i s c h e m i c a t t a c k ( T I A ) , a l s o c a l l e d a " m i n i - st r o k e ."

A T I A c a n c a u s e m a n y o f t h e s a m e s y mp t o m s a s a s t r o ke , b u t T I A s y m p t o m s g e n e r a l ly o n l y l as t f o r af e w m i n u t e s .

C a l l f o r i m m e d ia t e m e d i c al a s s i st a n c e i f y o u s u s p ec t a p e r s on i s e x p e r i en c i n g a t r a n s ie n t i s c h e m ica t t a c k , a s T I A m a y l e a d t o s t r o k e . A l s o c a l l f o r i m m e d ia t e m e d i c a l a s s i s t an c e i s y o u s u s p e c t a p e r s on i sexp eriencing a stro ke.

Managem ent :

A l e r t e m e r g e n c y m e d i c al s e r v i ce s i m m e d i a t e l y.

C h e c k a n d m o n i t or t h e v i c t i m ' s a i r w a y , b r e at h i n g , a n d c i r c u la t i o n u s i n g y o u r C P R a n d F i r s t A i dskills.

E n s u r e a d e q u at e v e n t i l a t i o n & l o o s en t i g h t c l o t h i n g 's i f a n y .

L a y t h e v i c t im d o w n w i t h t h e i r h e a d a n d s h ou l d e r s s l i g h t l y e l ev a t e d . ( Pl a c e p i l lo w s u n d e r t h ehead and sho uld ers) .This will red uce b lo o d p ressure o nthe b rain.

STROKE4.26

(Fig. 4.26.1)


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I f t h e v i ct i m i s u n re s po n si v e, b ut b re at h in g p l ac e t h e m o n t h ei r l ef t s id e w i th t h ei r c hi n

e x t en d e d. T h is s e r ve s a s t w o pu r po s es . It w i ll a s si s t i n k e ep i ng t h e vi c ti m ' s a i rw a y op e na n d a l l o w v o m i t a n d s e c r e t i o ns t o d r a in f r o m t h e i r m o u t h .

N e v e r g i v e a s u s p e ct e d s tr o k e v i c t i m a n y t h i n g t o e a t o r d r i n k . T h e i r t h r o a t m a y b e p a r al y z e drestricting their ab ility to swallo w.

E n c o u ra g e t h e v i c t i m n o t t o m o v e a n d r e a s s u r e t h e m t h a t h e l p i s o n t h e w a y t o c a r e f o r t h e m .

K e e p t h e v i c t i m w a r m .

What is a fit ?

I t i s a v i o l en t i n v o l un t a r y c on t r a c t io n o f m u s c l e s i n t h e b o d y .

Reason s :

- B r ai n d a m a ge d u e t o v a r io u s d i se a se s .

- H ea d i nj u ry.

- R e d u c e d o x y g e n s u p p l y t o th e b ra i n .

- P oi so ni n g.

- H ig h f ev e r i n c hi ld re n .

Signs and Symptoms :

1 . P o or b a l a n ci n g a n d lo s s o f c o o r di n a t i o n w i t h s t a g g e r i ng .

2 . D i s o ri e n t a t io n a n d i r r i t a b i l i t y.

3 . S t i f f n es s a n d r i g i d i t y. ( F i g . 4 . 2 7 . 1)

4 . R o l l i ng o f t h e e y e t o o n e s i de .

5 . C l e n c h e d t e e t h w i t h f o a m i ng at t h e mo u t h .

6 . I n c o n t in e n c e o f u r i n e a n d l o s s o f b o w e l c o n t r ol .

7 . U n n a t u ra l l i m b mo v e m e n ts .

W h a t t o d o ?

1 . M a k e a c l e a r s u r r o u n d i n g ar o u n d c as u a l t y.

2 . P r o t ec t t h e c a s u a l ty f ro m i n j u r y .

3 . D o n o t r e st r ic t t h e m o ve m e nt t i l l f i t s s t o p.

4 . D o no t p u t a n y t h i n g i n t h e c a s u a l ty m ou t h .

5 . T u r n t h e c as u a l t y t o a s i d e t o fa c i l i t at e an y se c r e t i on s t od r a i n o u t s a f e l y .

6 . M a n a g e i f a n y i n j u r y oc c u r r ed f r o m s e i z u r e s.

7 . D o n o t d i s t u r b i f t h e c a s u a l t y f a l l s a s l e e p .

8 . C h e c k A B C c o n t i n uo u s l y.

9 . S e ek m e d i c al a i d .

FITS

(Fig. 4.27.1)

(Fig. 4.27.2)

4.27


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Fits in Young Children :

F e v e r i s t h e m o s t c o m m o n c a u s e f o r f i t s i n i n f a n t s a n d y o un g c h i l dr e n .

S i g n s a n d S y m pt o m s - S a m e a s a d u l t .

Treatment :

1 . P r o t ec t c h i l d f r o m i n j u r y.

2 . K e e p t h e a i rw a y o p e n a n d c l e a r. T u r n t h e c h i l d t o o n e

Firstaid Manual

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