first aid 1.ppt

7/28/2019 FIRST AID 1.ppt

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Disaster Management

There are no Disasters without people Disaster Management - Multi-Institutional

Approach

Definition:

Disaster is any occurance that causes

Damage

Economic Disruption

Loss of Human Life Deterioration of Health & Health Services

On a scale sufficient to warrant an extraordinaryresponse from outside the community or Area of

Tragedy.


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Disasters

Natural

SlowSudden

Man Made

TYPES OF DISASTERS


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Sudden Disasters

Earth Quakes Under Sea Earth Quakes (Tsunami)

Floods

Tropical Storms

Volcano Eruptions

Land Slides


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Slow Disasters

Draught

Famines

Environmental Degradation Deforestation

Pest Infestations


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Man Made Disasters

Industrial / Technological

System Failures / Accidents

Spillages / Gas Leaks Explosions

Fires


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Other Disasters

Wars & Civil Strikes

Armed Aggression

Insurgency Terrorism


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Emergency Relief & ResuscitationServices during Disaster

Disaster is a situation when Number of patientsfar exceed the capacity of Health care providersduring peace time.

In Disasters, there is always severe pressure onMedical personnel (Doctors, Nurses, Para-Medical) and severe constraint on MedicalEquipment, Transport, House Keeping Facilities

Therefore careful planning will go a long way inin avoiding pig-falls in Disaster Management.


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Pre-requisites of Disaster Planning

1. Emergency system must be functioning well ona routine basis.

2. Sufficient scope in the form of

Trained Man Power

Equipment

Materials

Space

3. Laid down Drill Procedures Details offunctions of each Individual Departments

4. Frequent Rehearsals of the Above


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Modern Management of Injured

Treat Lethal Injury First

Primary Survey

Primary Resuscitation

Secondary Survey Definitive Care

Triage

Identify what is Killing theVictim & Treat then & there

Hospital Setup andSpecialist Care

Immediate Urgent Non-urgent

Resuscitation UrgentTreatment Area

Non-UrgentTreatment Area


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Primary Survey

A. Air way & C. Spine ControlB. Breathing & Ventilation

C. Circulation & Control of Hemorrhage

D. Dysfunction of CNS

E. Exposure to Controlled Environment


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Pre-Hospital Retrieval & Management

Air Way Protect & Spine

Oxygenation

Covering with Warm Clothing Scaling open

Control external Bleeding

Monitor Neurological skills


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Monitoring Neurological skills

A. Alertness.V. Response to Voice

P. Response to pain

U. Unresponsiveness

P. Pupil size and reaction.


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Trimordial DistributionDeath Injury

Death

Time0 3 Hrs2 Wks 4 Wks

Immediate -50% Early -30% Late - 20%

Laceration of -

Brain & Brain Stem

Aorta

Spinal Cord

Heart

Air Way Obstruction

Massive Blood Loss

Multiple long bones

Dys-function of CNS

Sepsis

Multi-organ Failure


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MEDICAL AID AT THE TIME OF

RAILWAY ACCIDENTS

(GENERAL POLICY)

RAPID EVACUATION AFTER

RENDERING IMMEDIATE ANDNECESSARY FIRST AID


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MEDICAL AID AT THE TIME OF RAILWAY

ACCIDENTS Contd.

TIME IS THE KEY

THE TIME FACTOR IS OF PARAMOUNT

IMPORTANCE IN REMOVING THE

INJURED PERSONS TO THE NEARESTHOSPITALS BY THE FIRST AVAILABLE

MEANS OF TRANSPORT TO ENABLE

ALL NECESSARY MEDICAL AID BE

RENDERED.


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TYPES OF ACCIDENT RELIEF MEDICAL

EQUIPMENT

(Available in Indian Railways)1. SCALE - I : IN MEDICAL VEHICLES, AS

PART OF ACCIDENT RELIEF TRAINS.

2. SCALEII : AS BOXES, AT SPECIFIEDSTATIONS LOCATED PREFERABLY ONEITHER SIDE OF SCALEI STATIONS.

3. POMKA: (PORTABLE MEDICAL KIT FORACCIDENTS)IN ALL HEALTH UNITS,

POLYCLINICS AND SUB-DIVISIONAL,DIVISIONAL AND ZONAL HOSPITALS


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4. FIRST AID BOXES IN ALL STATIONSDEALING WITH PASSENGER TRAFFIC,WORKSHOPS, MARSHALLING YARDS,LOCOSHEDS AND C&W DEPOTS AND ALSOIN BREAKDOWN VANS OF ACCIDENT

RELIEF TRAINS AND GUARDS.

5. SPECIAL FIRST AID BOXESPROVIDED INALL LONG DISTANCE SUPERFAST,SHATABDI AND RAJDHANI TRAINS

6. FIRST AID BOXES FOR GANGMEN

TYPES OF ARME Contd.


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POLICY REGARDING PROVISION OF DIFFERENT

TYPES OF ACCIDNET RELIEF MEDICAL EQUPMENT

ARME- SCALE-I ACCIDENT RELIEF MEDICAL EQUIPMENT

SCALEI IN MEDICAL VEHICLES FORMS AUNIT OF THE ACCIDENT RELIEF TRAIN AND ISSTATIONED AT DIVISIONAL HEADQUARTERSAND AT OTHER SELECTED IMPORTANT

STATIONS PREFERABLY WHERE THERE AREHOSPITALS OR HEALTH UNITS IN CHARGE OFRAILWAY MEDICAL OFFICERS.

THE FUNCTION OF THE VEHICLE IS TOCARRY MEDICAL EQUIPMENT TO THE SITEOF ACCIDENT SO THAT PROMPT MEDICAL

AID COULD BE RENDERED AND INJUREDPERSONS TRANSPORTED EXPEDITIOUSLY TOTHE NEAREST HOSPITALS.


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SCALE - II ACCIDENT RELIEF MEDICAL EQUIPMENT

SCALEII IS LOCATED AT SELECTED

STATIONS WHERE THERE IS NO ACCIDENTRELIEF TRAIN.

THEY SHOULD BE LOCATED AT EVERY 80 TO100 KMS APART AND PREFERABLY WHERETHERE IS A RAILWAY HOSPITAL OR AHEALTH UNIT.

GENERALLY THERE SHOULD BE AT LEASTONE SCALE II EQUIPMENT STATIONED ONEITHER SIDE OF A SCALE I EQUIPMENT SO

THAT IN CASE OF MAJOR ACCIDENTS, ATLEAST ONE OR THE OTHER CAN REACH ANDBE AVAILABLE AT THE SITE OF ACCIDENT INQUICK RESPONSE.


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THE EQUIPMENT WHICH CONSISTS OF 3 SETS OFPOMKA AND ADDITIONAL ITEMS SHOULD BE IN

CHARGE OF THE STATION MANAGER/DY..S.S ANDSHOULD BE STORED IN PORTABLE BOXES OFSUITABLE SIZE AND STANDARD PATTERN ASAPPROVED BY THE CHIEF MEDICAL DIRECTOR, ON ARAISED CONCRETE PLATFORM SO THAT ITS BOTTOMDOES NOT TOUCH THE FLOOR, IN A SEPARATE ROOM

OR ADJACENT TO THE STATION BUILDING. IF NECESSARY, A ROOM SHOULD BE SPECIALLY

CONSTRUCTED FOR THE PURPOSE. IT SHOULD HAVESEPARATE ENTRY AND EXIT ONE ON EITHER SIDE,AND IT SHOULD BE SO SITUATED AS TO FACILITATEEASY LOADING OF THE BOXES IN TRAIN. FOR QUICKTRANSPORTING, LOADING AND UNLOADING OF THEBOXES CONTAINING SCALE II EQUIPMENT, AWHEELBARROW WITH HANDLE SHOULD ALSO BEPROVIDED

SCALE II Contd.


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POMKA

CONTENTS OF POMKA SHOULD BE STORED IN

A CONVENIENT SUITCASE (SIZE 21 INCHES)FOR EASY TRANSPORT BY ROAD/RAIL.

THERE SHOULD BE ONE SET OF POMKA INHEALTH UNITS & POLYCLINICS AND TWO

SETS IN SUB-DIVISIONAL HOSPITALS.

THE DIVISIONAL/ZONAL HOSPITALS AREREQUIRED TO HAVE THREE SETS OF POMKAWITH SOME ADDITIONAL ITEMS.


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STATIC FIRST AID BOXES IN BREAKDOWNVANS OF ACCIDENT RELIEF TRAINS, ANDAT STATIONS, WORKSHOPS, YARDS, LOCOSHEDS AND CARRIAGE AND WAGONDEPOTS ETC., SHOULD BE HUNG IN APROMINENT PLACE ON A WALL BRACKETIN THE RESPECTIVE OFFICES.

THESE BOXES SHOULD BE MADE OFMETAL, PREFERABLY ALUMINUM, WITHTHE LID FITTING WELL DOWN OVER THESIDES AS TO BE DUST PROOF, AND SHOULDHAVE A HANDLE OR A CANVAS STRAPARRANGEMENT FOR EASE OF CARRYING.

THE EXACT SIZE AND PATTERN OF THEBOXES SHOULD BE STANDARDISED BY THECHIEF MEDICAL DIRECTOR.

FIRST AID BOXES


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THE KEYS OF FIRST AID BOXES FOR USE AT STATICLOCATIONS SUCH AS STATIONS, MARSHALLING YARDS,WORKSHOPS, LOCO SHEDS, CARRIAGE AND WAGON

DEPOTS, ETC., WILL BE KEPT IN CHARGE OF THE LOCALSUPERVISORS ON DUTY.

STATION MASTERS/DY.SS SHOULD MAINTAIN A LIST OFALL RAILWAY AND NON RAILWAY MEDICALINSTITUTIONS, PRIVATE PRACTITIONERS AND FIRST-

AIDERS AVAILABLE IN THE NEIGHBORHOOD.

THESE LISTS SHOULD BE EXHIBITED IN A CONSPICUOUSPLACE IN THE OFFICE OF THE STATION MASTER AT EACHSTATION FOR THE GUIDANCE OF ALL CONCERNED.

THE STATION MASTER SHOULD MAKE CERTAIN THATTHESE LISTS ARE KEPT UP-TO-DATE. THE MEDICALOFFICER IN CHARGE OF THE SECTION SHOULDPERIODICALLY INSPECT THE SAME TO SEE THAT THESEARE PROPERLY MAINTAINED AND KEPT UPDATED.

FIRST AID BOX Contd.


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A RAILWAY EMPLOYEE OR A PASSENGER OR ATRESPASSER SHALL BE CONSIDERED TO BEINJURED ONLY WHEN HE/SHE ISINCAPACITATED FROM THE FOLLOWINGCUSTOMARY VOCATION FOR MORE THANFORTY EIGHT HOURS, SUCH INJURIES ARE

CLASSIFIED AS UNDER SERIOUS (INCLUDE GRIEVOUS INJURIES AS

DEFINED BELOW)

MINOR OR SIMPLE, BUT EXCLUDINGTRIVIAL INJURIES SUCH AS ABRASIONS OR

BRUISES.

CLASSIFICATION OF INJURIES



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EMASCULATION

PERMANENT PRIVATION OF THE SIGHT OF EITHEREYE.

PERMANENT PRIVATION OF THE HEARING OFEITHER EAR.

PRIVATION OF ANY MEMBER OR JOINT.

DESTRUCTION OF PERMANENT IMPAIRMENT OF

POWERS OF ANY MEMBER OR JOINT. PERMANENT DISFIGUREMENT OF HEAD OR FACE.

FRACTURE OR DISLOCATION OF A BONE ORTOOTH.

ANY HURT WHICH ENDANGERS LIFE, OR WHICH

CAUSES THE SUFFERER TO BE, IN SEVERE BODILYPAIN OR UNABLE TO FOLLOW HIS ORDINARYPURSUITS DURING THE SPACE OF TWENTY DAYS


GRIEVOUS INJURIES Contd.


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INJURIES OTHER THAN THOSE DEFINEDABOVE ARE CONSIDERED TO BE MINOR ORSIMPLE INJURIES.

APART FROM THE INJURED CASES AS ABOVE,THERE MAY BE CASES WHERE A PASSENGEROR TRESPASSER RECEIVES ONLY PETTYABRASIONS OR BRUISES. THESE ARE OFTRIVIAL NATURE AND TECHNICALLYSPEAKING SHOULD NOT BE TAKEN AS

INJURED PERSONS

CLASSIFICATION OF INJURIES Contd.

MINOR/SIMPLE INJURIES & TRIVIAL INJURIES


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THE MOST SUITABLE AND RESPONSIBLE

RAILWAY OFFICIAL ON WHOM IS TO DEVOLVETHE RESPONSIBILITY OF SUMMONING THENEAREST AVAILABLE MEDICAL AID ACCORDINGTO THE URGENCY OF THE CASE IS THE STATIONMASTER.

WHEN THE STATION MASTER ON DUTYRECEIVES INFORMATION THAT THERE HAS BEENA SERIOUS ACCIDENT IN HIS JURISDICTION ANDTHE SERVICES OF THE MEDICAL DEPARTMENTARE NECESSARY, HE SHOULD IMMEDIATELY

TAKE ACTION TO SEND THE ACCIDENT RELIEFMEDICAL EQUIPMENT TO THE SITE OF ACCIDENTBY THE FIRST AVAILABLE MEANS OFTRANSPORT.

STATION MASTER KEY PERSON IN RAILWAY

ACCIDENTS


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IF THE EQUIPMENT IS BEING SENT BY THERELIEF TRAIN, AND THE MEDICAL

OFFICER DOES NOT ARRIVE BEFORE THE

TRAIN IS READY TO START, THE

EQUIPMENT SHOULD BE SENT WITH THE

TRAIN IN CHARGE OF A RESPONSIBLE

PERSON, PREFERABLY ONE HOLDING A

FIRST AID CERTIFICATE. THIS MEDICAL

EQUIPMENT WILL BE PLACED AT THE

DISPOSAL OF ANY AVAILABLE MEDICALMAN ON THE SPOT.

STATION MASTER KEY PERSON IN RAILWAY

ACCIDENTS Contd.

RECORDING INFORMATION OF


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NAME

FULL ADDRESS. TICKET/PASS NO. WITH FULL PARTICULARS OF

JOURNEY. TWO MARKS OF IDENTIFICATION. DETAILS OF INJURIES.

EXISTING DEFORMITIES AND OLD SCARS. ONLY ROUGH NOTES ARE TO BE RECORDED AT

THE SITE OF THE ACCIDENT. DETAILED REPORTS TO BE MADE OUT LATER. THE OFFICIAL NOMINATED BY THE DRM WILL

ALSO MAKE ARRANGEMENTS FOR REFRESHMENTSAND FOOD AND TO COLLECT NAMES ANDADDRESS OF THE RELATIVES OF THE INJUREDPASSENGERS TO BE INFORMED

RECORDING INFORMATION OF

PASSENGER INJURY


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CAUTION

NO STATEMENT WITH REGARD TO NUMBER OR

NATURE OF CASUALTIES SHOULD BE GIVENMEMBERS OF PRESS OR PUBLIC TILL ALL

CASUALTIES HAVE BEEN RECONCILED AND AFTER

ENSURING THAT NOT A SINGLE CASE HAS ESCAPED

ATTENTION.

THESE RECONCILED AND FINAL FIGURES SHOULD

ONLY BE GIVEN TO PRESS OR PUBLIC BY THE

SENIOR MOST RAILWAY OFFICIAL ON THE SPOT.

EXAMPLE : DRM, CMS OR OTHER DIVISIONAL

OFFICERS AS THE CASE MAY BE.


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IN MAJOR RAILWAY ACCIDENTS WHERE THE

NUMBER OF CASUALTIES IS EXPECTED TO BELARGE, IT MAY BE WORTHWHILE TOESTABLISH ONE OR MORE TEMPORARY FIELDDRESSING STATIONS AT THE SITE OFACCIDENT.

AS ON THESE OCCASIONS, THE MEDICALSTAFF ARE FULLY ENGAGED IN DEALINGWITH THE CASUALTY CASES, A RESPONSIBLEOFFICIAL SHOULD BE DETAILED BY THEDIVISIONAL RAILWAY MANAGER TO TAKENOTES, REGARDING DETAILS OF THE INJURED

AS MENTIONED AND AS DICTATED BY THEDOCTOR.

TEMPORARY FIELD DRESSING STATIONS


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TEMPORARY FIELD DRESSING


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DUTIES OF ATTENDING DOCTOR

RAILWAY MEDICAL OFFICER PROVIDINGMEDICAL AID AT THE SITE OF ACCIDENTSHALL USE DOCTORS APRONS WITH ARM

RED CROSS BADGES.

ALL OTHER MEDICAL PERSONNELRENDERING MEDICAL AID AT THEACCIDENT SITE SHALL WEAR ARMBADGES.


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ATTENDING DOCTOR TO RECORD ADDITIONAL

INFORMATION FOR OFFICIAL INQUIRY

TIME AND MODE OF RECEIPT OF FIRST

INFORMATION OF ACCIDENT TIME OF OCCURRENCE OF THE ACCIDENT.

TIME OF HIS DEPARTURE FROM HIS STATIONFOR THE SITE OF ACCIDENT.

TRANSPORT USED.

DETAILS OF THE STAFF WHO ACCOMPANIED,AND MEDICAL EQUIPMENT TAKEN OR ORDEREDTO BE DESPATCHED TO THE SITE OF ACCIDENT.

TIME OF HIS ARRIVAL AT THE SITE OF

ACCIDENT. COPIES OF ALL MESSAGES, INCLUDING

TELEPHONIC MESSAGES TO HIS IMMEDIATESUPERIOR OR ANY OTHER PERSON.


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SUBMISSION OF REPORTS

ON RETURN TO HEAD QUARTERS A DETAIL

REPORT SHALL BE MADE OUT BASED ON ROUGHREPORT MADE EARLIER WHICH SHOULDINCLUDE HOW EACH CASE HAS BEEN DISPOSEDOFF.

THE DETAIL REPORT SHALL ALSO INCLUDE THEPARTICULARS OF NON-RAILWAY DOCTORS AND

NAME AND ADDRESS OF SUCH DOCTORS. THE REPORT SHOULD BE SUBMITTED TO THE CMD

ALONG WITH INJURY REPORTS ON ACCIDENTBLOCK FORMS FOR PASSENGERS AND RAILWAYEMPLOYEES SEPARATELY.

THESE NOTES SHOULD BE KEPT CONFIDENTIAL ASTHEY FORM IMPORTANT DOCUMENTS FORCOMPENSATION.


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FIRST AID

The immediate treatment given to thevictim of an accident or sudden illnessbefore the arrival of the doctor is calledFirst Aid.

AIM/OBJECTIVES Save the life.

Promote the recovery.

Prevent the worsening of the condition.

Arrange the transport.


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Contents of the First Aid box.

Set of splints. : One Set

Roller Bandage : 10 Triangular bandages : 4

Tourniquet bandages : 2

Cotton Wool : 4

Safety Pins : 10 Adhesive Dressing : 20

Paracetamol Tab : 20

Antiseptic Cream : 1

Diazepam Tab : 10 Injury Card : 1


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UTILISATION OF FIRST AID BOX ITEMS:

TRIANGULAR BANDAGES:

To retain dressings and splints in position and to

immobilize fractures.

To afford support to an injured pact or in the formof slings.

To control bleeding.

To reduce or prevent swelling. To assist in the lifting and carrying of casualties.

Mainly used as bandages like Head bandage, chestbandage, shoulder bandage, elbow bandage, handbandage, hip bandage, foot bandage etc. It is alsoused as slings like Arm sling, Triangular sling andcuff and collar sling.


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Tourniquet/Rubber Bandage:- It isused to stop bleeding and to stopspreading of poison when snake bites.

Roller Bandages:- It is used to retaindressings and splints in position and to

cover the wounds. SPLINTS:-They are used to immobilize

and support the fractured limbs.

Paracetamol Tab:- These are used to

relieve minor pains.


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Antiseptic Cream:- It is used to minimizeor prevent infection to wounds.

Cotton wool:- It is used to clean/pad thewounds. It is also to be utilised to absorbdischarges when there is a wound.

Adhesive Dressings:- It is used for minorwounds only.

Safety Pins:- It is used when Triangularbandage used for victim.

Injury Card:- To maintain the account ofthe First Aid items.


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ASPHYXIA (SUFFOCATION)

Definition:- When lungs are not getting sufficient

fresh air, important organs of body mainly braindeprive of oxygen, it is a dangerous condition calledAsphyxia.

Causes:- 1. Drowning

2. Breathing polluted air

3. Pressing of wind pipe(Hanging, Throttling and strangulation)

4. Choking

5. Pressure/weight on chest.

6. Electric shock7. Some poisons.

8. Obstruction in air passage.


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Signs and Symptoms of

Asphyxia/Suffocation

Low/No Breathing

Blue/Pale colour of cheeks and lips.

Swelling of veins at neck.

Unconsciousness.


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General Treatment for Asphyxia:

Remove cause from casualty or casualty fromcause.

Ensure more fresh air (By opening doors andwindows and removing the people surrounded);loosen the tight clothing at chest and neckregions.

Start artificial Respiration without wasting evenfew seconds.

Arrange medical aid.Note:-

Normal Breathing (Respiration) Rate 15 18

times per minute. Normal Heart Beat/pulse rate 72 times perminute.


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HEART ATTACKTHE TERM COVERS CORONARY THROMBOSIS CORONARY

OBSTRUCTION, MYOCARDIAL INFARCTION AND OTHER FORMS OF

HEART DISEASE. SYMPTOMS & SIGNS:

Sudden crushing, vice-like pain in the centre of the chest (Sometimesdescribed as severe indigestion) which may spread to the arms, throat,jaw, abdomen or back, and does not subside with rest.

Sudden dizziness or giddiness causing the casualty to sit down or leanagainst a wall.

Skin may be ashen, lips and extremities may become blue (Cyanosist)

Profuse sweating may develop.

Breathlessness can occur.

Fast pulse, which becomes weaker and may become irregular.

Symptoms and signs of shock.

Unconsciousness may develop.

Breathing and heartbeat may stop.

HEART ATTACK


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HEART ATTACK Contd.TREATMENT

If the casualty is conscious, gently support and place him

in a half-sitting position with his head and shoulderssupported and his knees bent.

Do not let him move unnecessarily as this will put extrastrain on his heart.

Loosen any constricting clothing around his neck, chest

and waist. Check breathing rate , Pulse and level of responsiveness at

10-minute intervals.

If he becomes unconscious, open his airway and checkbreathing. Complete the ABC of Resuscitation if requiredand place him in the Recovery Position.

Arrange urgent medical aid or removal to hospital.Transport as a stretcher case, maintaining the treatmentposition.

M th t M th M th d f A tifi i l R i ti


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Mouth to Mouth Method of Artificial Respirations:

Place the casualty on his back on a plain and hard surface.

Sit by the side of the face, place the hand by the side of chin,

and push it farther so that clear ventilation at throat. Cover the casualtys mouth with clean cloth and pinch the

nostrils.

Open your mouth, take fresh air, cover the lips of casualty withyour lips, and blow the air into the mouth of casualty @ 10-12

times per minute. While blowing ensure that nostrils are pinched and chest is

rising. If chest is not raising it indicates some obstruction in airpassage clear the air passage and restart Mouth to Mouthartificial respiration. This process to be continued until the

normal is resumed or Doctor arrives which ever is earlier. Mouth to Nose method of artificial Respiration: - In this

method blow the air into the nose of the victim by closing themouth of the victim with fingers.


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WHEN HEART STOPS FUNCTIONING

If the Heart is not working you will noticethe following.

The face is blue or pale.

Heart beat and pulse at the root of Neck(carotid pulse) are not felt.

Note: -a) Even if the casualty is breathing but the

breathing is not normal, it is wise to start

Artificial respiration.

b) Do not begin Heart compression until youare sure that the heart has stoppedbeating.


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EXTERNAL HEART COMPRESSION or CARDIACMASSAGE.

Place the casualty flat on his back on a hardsurface and remove the cloths over the chest. Feel and mark the lower part of the sternum. Place the heel of your left hand on the marked

point make sure that the palm and fingers are

not in contact with chest. Place the heel of the right hand over the lefthand.

With your right hand heel press the sternumtowards the spine. It can be pressed upto 1 to

1.5 inches.

EXTERNAL HEART COMPRESSION or CARDIAC


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EXTERNAL HEART COMPRESSION or CARDIACMASSAGE. Contd.

Adults should be given about 60 pressures per minute.

For children from 2 to 10 years pressure with one handheel will be enough, but pressure should be

@ 80-90 times per minute. For infants below 2 yearspressures with two fingers is good enough and appliedat a rate of 100 times per minute.

Press firmly but carefully, carelessness may cause injuryto ribs.

If the treatment is effective

colour will become normal.

Pupil will contract.

Carotid pulse begins. When pulse is not restarted, continue compression till

the patient reaches the hospital or Doctor arrives thespot.


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EXTERNAL HEART COMPRESSION or CARDIAC


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EXTERNAL HEART COMPRESSION or CARDIACMASSAGE. Contd.

If heart and breathing both are failed.

IF THERE IS ONE FIRST AIDERgive 2inflations of artificial respiration and thengive 15 heart compressions and repeat theprocess.

IF THERE ARE TWO FIRST AIDERS Istperson will give two inflations of artificialrespiration then IInd person will give fivetimes heart compressions and repeat theprocess till the normal is resume or doctor

arrives which ever is earlier.


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SHOCK

Definition:- Shock is severe depression to vitalfunctions of organs like brain, heart, lungs etc. due

to less blood supply to the brain. Established Shock:- Established shock or true shock

is due to less blood supply to the brain.

Causes:- 1. Wounds.

2. Fractures3. Burns & Scalds

4. Snake bite

5. Sunstroke

6. Heart attack7. Dog bite

8. Electrical shock etc.


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Signs & Symptoms of Shock

1. The skin may appear pale and is cool and

clammy to the touch.2. The heartbeat is weak and rapid, andbreathing is slow and shallow. The bloodpressure is reduced.

3. The eyes lack shine and seem to stare.Sometimes the pupils are dilated.

4. The person may feel Giddiness (symptom),Vomiting sensation, Thirsty.

5. The person may be conscious or unconscious.If conscious, the person may faint or be very

weak or confused. On the other hand, shocksometimes causes a person to become overlyexcited and anxious.

P ti ft i j


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Precautions after an injury:

1. Get the person to lie down on his or her back andelevate the feet higher than the person's head. Keep the

person from moving unnecessarily.

2. Keep the person warm and comfortable. Loosen tightclothing and cover the person with a blanket. Do not givethe person anything to drink.

3. If the person is vomiting or bleeding from the mouth,place the person on his or her side to prevent choking.

4. Treat any injuries appropriately (bleeding, brokenbones, etc.).

5. Summon emergency medical assistance immediately

WOUNDS AND HEMORRHAGE


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WOUNDS AND HEMORRHAGE(BLEEDING)

Definition:- Wound is breakageof skin/tissue.

Types of Wounds:

1. Contused Wounds

2. Lacerated Wounds3. Punctured Wounds

4. Incised Wounds.

WOUNDS


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WOUNDS

Blunt instruments cause contused woundswhere there is no opening.

Lacerated wounds are caused by irregularedges of instruments like glass piecesmetal pieces, machine injuries, animal sitesand occurrences where the edges ofwound is irregular.

Sharp edged instruments like Razor/knifecause incised wounds where the edge ofwound is in straight line.

Punctured wounds are caused by sharpedged instruments like needles, nails and

most of gun-shot wounds where lessopening and more deep.

Ci l ti f Bl d


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Circulation of Blood

The circulatory system consists

Heart, Lungs, Arteries, Capillaries andveins.

A average Heart beat /Pulse rate:-

72 times per minute

While noticing the pulse we have toobserve speed, Strength and Rhythm ofpulse.


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T f Bl di (H h )


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Types of Bleeding (Hemorrhage)

Artery Bleeding Bright red in colour and

flow in jets.

Vein Bleedings Dark red in colour andflow continuously.

Capillary Bleedings Red in colour and

Oozing from all parts of wound.

Danger of wounds:


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Danger of wounds:

It allows precious blood to escape

from body. It permits harmful Bacteria/virus or

other injurious agents to enter intobody.

Direct Pressure Method. Indirect Pressure Method.

General Treatment (First Aid) to Wounds:


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General Treatment (First Aid) to Wounds:

Place the victim in sitting/lying position andelevate the injured part if possible.

Expose the wound and clean the wound andsurrounding area but do not disturb bloodclot if already there.

Remove any foreign body which arefloating.

Arrest bleeding by applying pressure directlyon the wound or apply constrictive bandage.

Apply Antiseptic cream, dressing andbandage.

Immobilize the part where it is possible. Give pain relievers and treat for shock. Arrange Medical Aid.

I t t P P i t


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Important Pressure Points:

Carotid Pressure point on the neck either

side of voice box.

Sub-clarion P.Ps on the inner end ofcollar bone.

Bronchial P.P. on the inner side of upper

arm.

Femoral P.P. on the thigh bone.

Nose bleeding T eatment


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Nose bleeding Treatment :

Place the victim near a window or against

current of air in sitting position with thehead slightly bent forward.

Pinch the junction of the Nose just belowthe hard part. If available put ice piece

over the nose. Advice him to use his mouth to breath and

avoid breathing through nose.

Warn him not to blow the nose.

Do not block the nostrils. Arrange medical aid.

Ear bleeding Treatment:


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Ear bleeding Treatment:

Place the victim on a suitable place on side-

ways, and see that the affected ear is down (ifboth ears bleeding keep face upward and headlittle bit low for free drainage of blood.

Do not block the ear.

Arrange medical aid. InternalBleeding: Whenever internal organs

or blood vessels got damaged and bloodcomes out through mouth, nose ,ears etc. suchbleeding is known as internal bleeding.

INTERNAL BLEEDING


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INTERNAL BLEEDING

SYMPTOMS OF INTERNAL BLEEDING

Giddiness. Skin becomes pale, cold and clammy.

Pulse gets rapid but very weak.

Sweating, Thirsty, feels vomitingsensation.

Become unconscious.

TREATMENT FOR INTERNAL BLEEDING.

Check-up air-way, breathing and heart if anyfailure restore them. Lay him on his back

and raise the legs by using pillow to enablethe blood supply to the brain.

HEAD INJURY


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HEAD INJURY

HEADINJURY:- As a result of head injury

blood and brain fluid may flow out of the nose,ear or mouth.

Symptoms:

Giddiness.

Skin becomes pale, cold and clammy. Pulse gets rapid but very weak.

Sweating, Thirsty, feels vomiting sensation.

Become unconscious.

HEAD INJURY Contd.


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Treatment: Ask the person not to blow his nose. Do not pack

ear or nose. Lay the patient on the affected side.

Ensure tongue should not fall back. Embedded Objects Whether youve stepped on a nail or fallen on broken

glass, never try to pull out an object embedded in awound. Removing embedded objects from a wound

may cause more damage and increase bleeding.Instead, follow these tips:

Place a clean, preferably sterile dressing around theobject.

Build up padding around the object so it doesnt

move. Secure padding a narrow bandage. Get medical help.

BURNS AND SCALDS


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BURNS AND SCALDS Burns can be caused by fire, the sun,

chemicals, heated objects or fluids, and

electricity. They can be minor problems or life-threatening emergencies. Distinguishing aminor burn from a more serious burn involvesdetermining the degree of damage to thetissues of the body. If you are not sure howserious the burn is, seek emergency medicalhelp.

First-degree burns are those in which only theouter layer of skin is burned. The skin is usuallyred and some swelling and pain may occur.Unless the burn involves large portions of the

body, it can be treated at home.

BURNS AND SCALDS Contd


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BURNS AND SCALDS Contd.

Second-degree burns are those in which thefirst layer of skin has been burned through

and the second layer of skin is also burned.In these burns, the skin reddens intenselyand blisters develop. Severe pain andswelling also occur. If a second-degree burnis no larger than 2 or 3 inches in diameter, itcan be treated at home. If the burn covers alarger area, seek medical attention.

Third-degree burns are the most serious andinvolve all layers of skin. Fat, nerves,muscles, and even bones may be affected.

Areas may be charred black or appear a drywhite. These burns should receiveemergency medical attention.

Steps to be followed for minor burns


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Steps to be followed for minor burnsat home:

1. If the skin is not broken, run coolwater over the burn for severalminutes.

2. Cover the burn with a sterilebandage or clean cloth.

Treatment for major burns :


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Treatment for major burns :

1. Remove the person from the source of the burn (fire,electrical current, etc.).

2. If the person is not breathing, begin mouth-to-mouth resuscitation immediately.

3. Remove all smoldering clothing to stop further burning.4. If the person is breathing sufficiently, cover the

burned area with a cool, moist, sterile bandage or clean

cloth. Do not place any creams, ointments or ice on theburned area or break blisters. Look for medical help.Protect from nearby hazards.

Scald is an injury caused by Moist Heat such asHot water, milk oil tar steam etc.

If a persons cloth catches fire, do not allow him to runpour plenty of water or gently place him on ground androll him slowly to put off flames.

DEGREES OF BURNS


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DEGREES OF BURNS Degrees of burns: Ist degree - Redness of skin and blister formation, IInd degree - Internal tissue damage and scar

formation, IIIrd degree - Complete charring of part. General treatment (F.A.Treatment) for Burns and

scalds. Cool and clean the affected area with wet cloth/cotton

or flood with water or dip into water if it is possible.Remove any constraint articles like bangles, rings,watches immediately otherwise they can not beremoved later. Remove the burnt cloths by cuttingwhich are not stick to the skin.

Cover the area preferably with laundered towel andbandage but do not disturb blisters while bandage.

If he is conscious give water with pinch of salt to makegood of lost salt and water, weak tea with more sugaralso may be given if he is not diabetic patient.

FRACTURE, DISLOCATION, SPRAIN AND


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, ,CRAMP

Definitions:-

Fracture is breakage, crack/bend of a bone.

Dislocation is displacement of one or more bones

from joint..

Sprain is wrenching tearing of cartilage near amovable joint.

Strain is over lapping of muscles at a particular

place. Cramp sudden painful involuntary contraction of

voluntary muscles.

FRACTURES


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FRACTURES

Causes :- Direct Force, Indirect force andMuscle action.

Signs and symptoms -1. Pain2. Tenderness (Sever pain by gentle touch)3. Swelling

4. Loss of power5. Deformity (Bending/breaking into pieces)6. Crepitus (bonny gratting sounds)7. Unnatural movements.8. Irregularity (by touching or comparing with

other limb)


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FRACTURES Contd


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FRACTURES Contd.

Types of Fractures:-

Simple Fracture:- The broken ends of thebone do not out open the skin and thusremain inside only.

Compound Fracture:- When the fracturedbone is in contact with outside air as a

result of an injury. Complicated Fracture:- In addition to the

fracture, an important internal organ likethe brain or major blood vessel, the spinalcord, lungs, lever, spleen etc. may also beinjured.

FRACTURES Contd.


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First Aid tips for Fractures:

Steady and support the injured limb. Do not move the person.

Dress wounds and control bleeding. Check for circulation beyond the site of the fracture. If

impaired, get medical help quickly.

If the injured person must be moved from the site, secure thelimb with padded splints and bandages.

Reassure the injured person, and keep him warm. Give pain relievers and treat for shock if necessary.

Arrange medical aid as early as possible.

Sprain and Strain F.A.Treatment:

Place in suitable position and put firm bandage and in case ofstrain wet it with water frequently.

Arrange medical aid.


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POISONS


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Definition: Any substance (liquid, solid or gas) when enterinto body in sufficient quantity which has power to injure thehealth or destroy life is called poison.

A poisoning may or may not be obvious. Sometimes the sourceof a poisoning can be easily identified -- an open bottle ofmedication or a spilled bottle of household cleaner. Look forthese signs if you suspect a poisoning :

1. Burns or redness around the mouth and lips.

2. Breath that smells like chemicals.3. Burns, stains, and odors on the person, his or herclothing, or on the furniture, floor, rugs, or otherobjects in the surrounding area.

4. Vomiting, difficulty breathing or other unexpectedsymptoms.

If you can find no indication of poisoning, do not treat theperson for poisoning, but call for emergency help.

Suspected poisoning?


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take the following steps:

1. Some products have instructions on the label

specifying what to do if a poisoning occurs. If theproduct known to be the poison has theseinstructions, follow them.

2. If the person is alert, give him or her a glass of water ormilk or white portion of the egg to drink. The liquid will

slow the rate at which the poison is absorbed by thebody. But if the person is weak, lethargic, unconsciousdo not give him or her anything by mouth.

3. If you cannot identify the poison or there are noinstructions on the product label, call for medical help

immediately.4. Certain poisons should be vomited; others should not. If

you do not know the identity of the substanceswallowed, do not induce vomiting.

Suspected poisoning?t k th f ll i t


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take the following steps: Contd.

5. If you are told to induce vomiting in the person

who has swallowed poison, use syrup of ipecac todo so. An alternative method to induce vomiting istouching the back of the throat of the person toinitiate gagging. If you have no other alternative,have the person drink a glass of warm watercontaining 1 teaspoon of dried mustard or 3

teaspoons of salt. After the person has vomited,give a glass of water or milk.6. If the poison has spilled on the person's clothing,

skin, or eyes, remove the clothing and flush theskin or eyes with cool or lukewarm water for 20minutes.

7. Get immediate medical attention. If you haveidentified the poison, take the container with you.

Gas poisons enter through breathing


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Gas poisons enter through breathing.

TREATMENT:- Take the casualty to safeplace and start artificial respiration if

necessary (before enter into room make

proper ventilation cover face with wet cloth,

take long breath and hold it and tie a rope to

your vest (life belt) and ask the outsiders topull you out if necessary.

Swallowed Poisons:- Enter through mouth.


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TREATMENT:- Act quickly and collect poison or carterand/or send messenger for doctor, before doctorarrives.

1. Check whether he is conscious or not ifunconscious check breathing and pulse. If there isno breathing start artificial respiration and if thereis no pulse start cardiac massage except corrosivechemicals like Acids or Alkalies (by giving emetic

like salty water etc. or tickle the back of throat (incase of children tightly catch the jaws).2. Dilute poison by making him to drink more water.3. Neutralize poison by giving antidote with water

Eg. Acids Chalk powder etc., Alkalies. Lemon juice,

Aspiri cooking soda if not readily available washingsoda, sleeping pills, Epsim/common salt.

Swallowed Poisons:- Enter through mouth.


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Swallowed Poisons: Enter through mouth.Contd.

4. If it is doubt or proper antidote is not available givesoothing drinks such as milk, white of egg,Rice/Barley/Wheat-flour/Charcoal powder mixed inwater, Tender coconut water etc.

NOTE:- Among soothing drinks char-coal powder is

cheaper and most effective but to get it difficult now-a-days but use presence of mind and make char-coal byburning bread or wooden piece in flame.

Injected Poisons:- Entered skin either through injectionneedles or by snake bites/insect bites and rabey animalbites where the First aid is required.

SNAKE BITE TREATMENT (F.A.)


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SNAKE BITE TREATMENT (F.A.)

Tie Rubber (Constriction) Bandage (if the bite

took place on legs/bands)

Wash the area immediately with flow of

water.

Dont allow him to run or walk.

Treat the wound.

Treat for shock.

Give Artificial Respiration if there are any

signs of Asphyxia.

Arrange medical aid or carry the person to thedoctor.

DOG BITE


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TREATMENT:-(Disease Rabies and spread through virus)

Wash the bitten area with soap water or anyother antiseptic solution.

Encourage bleeding and do not cover thewound.

Collect information about dog and dog bite

such as it is pet/stray dog and provoking/nonprovoking bite. If it is pet dog about thebehavioral change of the dog and advice himchain the dog about 10 days.

Watch the dog whether it is alive or not about

10 days. Arrange medical aid.

SCORPION BITE TREATMENT:


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Wash the bitten area.

Apply sodium Bi-carbonate paste or potassium per

magnate + Sodium bi-carbonate mixture on the bittenarea.


DROWNING:

Remove the person from the water.

Lay him on the ground on his stomach and turn the headto one side.

Apply pressure on the back (waist portion) or raise thebelly so that the water gone into the body preferably intothe lungs should come out.

Once lungs got vacated breathing will start if it has notstarted give artificial respiration to restart the breathing.


UNCONSCIOUSNESS (INSENSIBILITY)


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When sensory organs are not in workingcondition apart from sleep is calledunconsciousness. Unconscious ness is due

to interruption of the brain act ion throughsome interference with the functions ofthe nervous system.

It is 2 stages 1) partial (Stupor) 2)Complete-coma.

CAUSES: Ensure an abundant supply of fresh air. If breathing stopped or appear to failing

start artificial If breathing is not noisy keep face upward

and head and shoulders to be raisedslightly.

UNCONSCIOUSNESS (INSENSIBILITY) Contd.


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( )

If breathing is noisy keep prone position

(side-ways). Undo-all tight clothing about neck and chest.

Apply the special treatment for the cause if any.

Wrap in a blanket.

Do not leave the casualty alone.

Do not attempt to give food/fluids whileunconscious through mouth..

Remove him to Shelter /hospital. Treatment forcauses not dealt previously.

Apoplexy:


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Apoplexy:

The face is flushed, breathing is

noisy, the pulse is slow, thetemperature may raise, the pupilsor the eyes may be unequal orthey may be dilated. Sudden on

set in above middle age. Treatment: Apply general

treatment for unconsciousness.

EPILEPSY (FITS)


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( )

Signs and Symptoms:

Suddenly looses consciousness.

Sometime remains rigid with flush face.

Convulsions start with froth at mouth.

TREATMENT:-

Do not stop convulsions by force.

Try to remove hard articles away from the Victim.

Wipe away the froth from his mouth.

Keep careful watch for a possible failure ofbreathing and heart.

Advice the casualty to see the doctor after theconvulsion is over.

Electrical Shock/Injuries


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We experiences minor electrical shocks from timeto time. In some cases, however, even small

amounts of electricity can be life threateningbecause they can produce unconsciousness,cardiac arrest, and cessation of breathing.

Electrical shocks also can produce serious, deepburns and tissue injury, although often even aserious electrical burn appears as only a minormark on the skin.

If you find a person, whom you think has beenelectrocuted, look first--do not touch. He or she

may still be in contact with the electrical source,and touching him or her may only pass thecurrent through you.

Electrical Shock/Injuries Contd


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Electrical Shock/Injuries Contd. If possible, turn off the source of electricity. If this is

not possible, move the source away from you andthe affected person using a non-conducting objectmade of cardboard, plastic, or wood while doing soensure your safety.

Once the person is free of the source of electricity,check the person's breathing and pulse. If either has

stopped or seems dangerously slow or shallow,initiate resuscitation immediately.

If the person is faint or pale or shows other signs ofshock, lay the person down with the head slightlylower than the trunk of his or her body and the legs

elevated. Treat any major burns and wait foremergency medical assistance to arrive.

Diabetes


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People suffering from diabetes need to controltheir blood sugar levels by balancing the amount

of sugar in their diet with insulintablets/injections. As a result, many carryhypodermic needles, insulin bottles, medication,card or identity bracelet with them, indicating thatthey have diabetes.

If a person with diabetes on treatment has misseda meal or taken too much exercise, theconcentration of sugar in the blood falls, andunconsciousness can follow. The aim of first aid inthis situation is to restore the sugar/insulinbalance as soon as possible.

Diabetes Contd.


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Diabetes Contd.

Treatment:

If the patient is conscious and capable ofswallowing, immediately give sugar lumps, asugary drink, chocolate or other sweet food inorder to raise the level of sugar in the blood. Ifthe casualty is unconscious but breathing

normally, place in the recovery position, andcarry out general treatment for unconsciousness .IF VICTIM IS UNCONSCIOUS DO NOT GIVEANYTHING BY MOUTH.

Eye Injuries


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Impaled Objects:DO NOT ATTEMPT TO REMOVE THE OBJECT.

Stabilize the impaled object by placing bulky dressingson each side of the object and then securing thedressings together, or by placing a paper cup over theobject and then securing to the face.

Foreign Bodies:Foreign bodies such as dirt, sand, wood, or metal chipsmay cause tearing. Tearing may rid the eye of theforeign body. If the object remains in the eye, have thevictim blink several times. If the object still remains inthe eye, gently flush the eye with water or remove withthe help of the corner of the handkerchief moisten withwater. If the foreign body is on the black portion of theeye do not try to remove the same.

Heat Related Emergencies


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Heat exhaustion occurs when your heart and vascularsystem do not respond properly to high temperatures.

The symptoms of heat exhaustion resemble shock andinclude faintness, rapid heartbeat, low blood pressure,an ashen appearance, cold clammy skin, and nausea. Ifyou suspect heat exhaustion, get the person out of thesun and into a cool spot.

Lay the person down and elevate his or her feet slightly.Loosen or remove most or all of the person's clothing.Give the person cold (not iced) water to drink, with ateaspoon of salt added per quart.

Heat Related Emergencies Contd.


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The main indication of heat stroke is a fever of 105

degrees Fahrenheit with hot, dry skin. Other signsinclude rapid heartbeat, rapid and shallow breathing,either elevated or lowered blood pressure, and confusionor unconsciousness.

If you suspect heat stroke, get the person out of the sunand into a cool spot. Cool the person by covering him orher with damp sheets or spraying with water. Direct aironto the person with a fan or a newspaper, and monitorthe person's temperature with a thermometer.

Stop cooling the person when his or her temperaturereturns to normal. If breathing ceases, start mouth-to-mouth resuscitation. Heat stroke is an emergency thatneeds immediate medical attention.

Cold Related Emergencies


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When exposed to very cold temperatures, the skin andunderlying tissues may freeze, resulting in frostbite.The areas most likely to be affected are the hands, feet,nose, and ears.

Frostbite is distinguishable by the hard, pale, and coldquality of the skin that has been exposed to the cold.As the area thaws, the flesh becomes red and painful.

If your fingers, ears, or other areas are frostbitten, getout of the cold. Warm your hands by tucking them intoyour armpits; if your nose, ears, or face are frostbitten,warm the area by covering it with dry, gloved hands.

Do not rub the affected area. If numbness remainsduring warming, seek professional medical care

immediately. If you are unable to get immediateemergency assistance, warm severely frostbitten handsor feet in warm--not hot--water. (The water should be

between 100 and 105 degrees Fahrenheit).

Heimlich Maneover


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The Heimlich Maneuver is the best known method ofremoving an object from the airway of a person who is

choking. You can use it on yourself or someone else.These are the steps:1. Stand behind the choking person and wrap your

arms around his or her waist. Bend the personslightly forward. Make a fist with one hand and

place it slightly above the person's navel.2. Grasp your fist with the other hand and press hardinto the abdomen with a quick, upward thrust.Repeat this procedure until the object is expelledfrom the airway.

3. If you want to perform this maneuver on yourself,position your own fist slightly above your navel.

4. Grasp your fist with your other hand and thrustupward into your abdomen until the object isexpelled.


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first aid 1.ppt

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