first aid 2011

American Heart Association and American Red Cross Guidelines 2010

K S ChewK S ChewSchool of Medical SciencesSchool of Medical SciencesUniversiti Sains MalaysiaUniversiti Sains Malaysia

First Aid Principles and PracticeFirst Aid Principles and Practice

First aid….. it is better to know it and not First aid….. it is better to know it and not need it than to need it and not know it.need it than to need it and not know it.

““Whatever can go wrong, will.” Whatever can go wrong, will.”

- Murphy Law- Murphy Law

Definition of First AidDefinition of First Aid

What is First Aid?What is First Aid?

Definition:• First aid is the assessment and immediate care

that can be performed by a bystander or the victim himself/herself. First aid does not take the place of proper medical treatment and must not delay activation of emergency medical services or other medical assistance when required.

First AidFirst Aid

• Immediate care that can be given to an injured or suddenly ill person– With minimal or no proper medical

equipment– Temporary assistance until arrival of

competent medical care– Does not take the place of proper medical

treatment

Example: Bleeding ControlExample: Bleeding Control

Direct Pressure with gauze or clean Direct Pressure with gauze or clean cloth. Ask the victim to support cloth. Ask the victim to support

his/her own injured limb. his/her own injured limb.

Bleeding ControlBleeding Control


Start from distal to proximal. Make two Start from distal to proximal. Make two turns at the start. Check for circulation, turns at the start. Check for circulation,

sensation and movement before applyingsensation and movement before applying


Apply bandage with roller facing Apply bandage with roller facing up. Ensure the subsequent turn up. Ensure the subsequent turn

cover 2/3cover 2/3rdrd of previous turn. of previous turn.


Cut the end of the bandage into Cut the end of the bandage into two to use as tiestwo to use as ties


Check again for circulation, Check again for circulation, sensation and movement after sensation and movement after applying. Ensure not too tight!applying. Ensure not too tight!

Applying 2Applying 2ndnd layer of layer of bandage if still bleedingbandage if still bleeding



Check again for circulation, sensation Check again for circulation, sensation and movement after applying.and movement after applying.


• Best controlled by applying pressure until bleeding stops

• Amount of pressure applied and the time the pressure is held are the most important factors affecting successful control of bleeding.


• Elevation and use of pressure points are no longer recommended to control bleeding.

Why?1.effectiveness of elevation has not been

studied2.these unproven procedures may compromise

the proven intervention of direct pressure

Elevation and use of pressure points are Elevation and use of pressure points are not recommended to control bleedingnot recommended to control bleeding2010 American Heart Association and American Red Cross Guidelines for First Aid

Who provides first aid?Who provides first aid?

• Police, Bomba/firefighters, JPA staffs• St. John’s Ambulance members, Red

Crescent members, Scouts, Girl Guides• Bystanders, public members• Relatives, family members, friends• Workmates, teachers• Medical students, anyone ……YOU!

Principles of First AidPrinciples of First Aid

Principle #1: First, do no harmPrinciple #1: First, do no harm

Know what to do and know what NOT to doKnow what to do and know what NOT to do

First Do No HarmFirst Do No Harm

• Do no harm does not mean do nothing.• The wisdom is not just to know what to

do, but what NOT to do• Sometimes the best thing you can do for a

casualty is to call for help.• Provide comfort and assurance to the

casualty may be the only thing you can do

First Do No HarmFirst Do No Harm

• Use treatments you know of that are most likely to benefit a casualty

• Do not use a treatment that you are not sure about “just for the sake of trying”

Any victim trapped inside the vehicle may Any victim trapped inside the vehicle may have injured his cervical spine. have injured his cervical spine.

Be careful when removing such victimBe careful when removing such victim

Positioning of VictimPositioning of Victim

• As a general rule a victim should not be moved

• The indications to move the victim include1.If the area is unsafe for the rescuer or victim2.If the victim is face down and is unresponsive3.If the victim has difficulty breathing because

of copious secretions or vomiting4.If the victim shows evidence of shock

Use bags or pillows, etc, to immobilize the cervical spine

Impaled or embedded object –Impaled or embedded object –DO NOT REMOVE!DO NOT REMOVE!

Make a donut-shaped ring pad to hold Make a donut-shaped ring pad to hold the impaled object in place the impaled object in place

• Send any evidence of the snake to the hospital only if safe to do so.

• Avoid elevating the limb• DO NOT use an arterial tourniquet• DO NOT try to capture the snake• DO NOT cut the bitten area• DO NOT suck the bitten area

What to do and NOT to do in What to do and NOT to do in Snake Bite?Snake Bite?

What to do?What to do?

• Ensure safety• Reassure and rest the casualty• Avoid all unnecessary movement to

prevent venom from spreading in the body.

• Direct pressure and immobilize the limb• Get to hospital urgently

Principle #2: First Aid is about Putting Principle #2: First Aid is about Putting First Things FirstFirst Things First

First Things FirstFirst Things First

• Get your priority right• If there are too many injuries in a

casualty, treat the most urgent injuries first

• If there are too many casualties– First, call for help– Treat the ones with the highest chance of survival

Don’t treat him. Forget Don’t treat him. Forget it!it!

They are also not your priority. Keep them They are also not your priority. Keep them aside and leave them to chat with each other!aside and leave them to chat with each other!

• The first step to get our priority right is to know and recognize what is an emergency and what is not an emergency!

• Sometimes it is very difficult, e.g. heart attack can be silent

• Hollywood emergencies don’t always exist in real life

First Things FirstFirst Things First

Hollywood Heart AttackHollywood Heart Attack

Chest DiscomfortChest Discomfort

• Assume all chest discomfort is cardiac origin until proven otherwise.

• The most important intervention is to CALL FOR THE EMS or AMBULANCE.o Call EMS rather than drive

themselves to hospital

Chest DiscomfortChest Discomfort

• While waiting for the EMS arrival, encourage victim to take a tablet of crushed aspirin

provided the patient has no allergy to aspirin or contraindication such as bleeding tendencies, recent bleeding, or a stroke.

Principle #3: Safety Is Of Utmost Principle #3: Safety Is Of Utmost Importance In First Aid Importance In First Aid

All materials, including wooden ones, can conduct electricity if the voltage is high

enough!!

What Information To RelayWhat Information To Relay

• Identify yourself• E: E: Exact Location• T:T: Type of event• H:H: Hazard• A:A: Access• N:N: Number of casualties involved• E:E: Existing emergency services• Put down phone only if asked to

Prank CallsPrank Calls

• 98-99% of all emergency calls are prank calls

• Out of 65,000 calls/day, only 1,300 are real emergency calls–45% of prank callers – children

–(Ref: Kementerian Tenaga, Air dan Komunikasi Malaysia)

Why Some Bystander Refuse To Help?Why Some Bystander Refuse To Help?

• Ignorance– Hiding own fear and incompetency

• Confused about what is an emergency– Too much Hollywood movies

• Characteristics of the emergency situation– The blood, smell, vomitus

• Fear it may be fake– Fear own safety; disguised as emergency

“One important strategy that people use to avoid action is to refuse (consciously or unconsciously) to

acknowledge the emergency situation”

Jellyfish StingJellyfish Sting

• First aid for jellyfish stings consists of two important actions:

1.preventing further nematocyst

discharge and 2.pain relief


• To inactivate venom load and prevent further envenomation, jellyfish stings should be liberally washed with vinegar (4% to 6% acetic acid solution) as soon as possible for at least 30 seconds.

• If vinegar is not available, a baking soda slurry may be used instead.


• For the treatment of pain, after the nematocysts are removed or deactivated, jellyfish stings should be treated with hot-water immersion when possible.

ConclusionConclusion

• First aid does not take the place of proper medical care

• It is a temporary measure using minimal or no medical equipments

• Three basic principles: 1. DO NO HARM2. FIRST THINGS FIRST3. SAFETY IS OF UTMOST IMPORTANCE

first aid 2011

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