Major Dr Inam Danish KhanMedical Officer

Nehru Institute of Mountaineering

FIRST AID

CHOKING FAINTING SHOCK ALLERGY NOSE BLEEDS CRAMPS SEIZURESCUTS/WOUNDS BURNSELECTRIC SHOCK SPRAIN/STRAINDISLOCATIONS FRACTURESSTINGSDOG BITE SNAKE BITE POISONOUS PLANTS DROWNING

PROLOGUE

SYMPTOMS Unable to speak or cry Face turns blue Trying to hold throat Weak coughing Unconsciousness

Choking is the mechanical obstruction of the flow of air from the environment into the lungs. CAUSES Foreign body in Airway

Poorly chewed food, fish bone Dentures Strangulation

CHOKING

FIRST AID Encourage victim to cough Back slaps 4 times Abdominal thrusts Reassure

SYMPTOMS Fall to the floor Slow pulse Pale, cold skin Sweating

Fainting is a brief loss of consciousness that is caused by a temporary reduction of blood flow to the brain.CAUSES Excessive dieting/ Avoiding fluids

Lack of sleep / Over exhaustion

FAINTING

FIRST AID Elevate legs Fresh Air Loosen clothing Don’t give fluids/food Reassure, seek a doctor’s help

FAINTINGertrtrrtrtrffth

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SYMPTOMS Pale, cold, blue skin Restless/ nervous Thirst , sweating Confusion Nausea or vomiting

HYPOVOLEMIC -- Loss of blood / severe dehydrationCARDIOGENIC – Heart unable to pump bloodDISTRIBUTIVE – Inadequate blood distributionOBSTRUCTIVE – Obstruction to blood flow

SHOCK

FIRST AID Elevate legs Fresh Air Loosen clothing Don’t give fluids/food/alcohol Reassure, seek a doctor’s help

Sudden severe life threatening reaction to somethingSIGNS Skin rashes, itching Swollen lips, tongue, ears Difficult breathing, immediate deathMEDICATIONS Antibiotics, muscle relaxants,

seizure med, beta-blockers, vaccinesFOODS Peanuts, milk, shellfish, fish, eggsINSECT STINGS EXERCISECOLD

HEAT

ANAPHYLAXIS/ALLERGY

FIRST AID Tab Avil or Cetrizine Epipen ? Rush to hospital

Painful sensation in muscles esp calf while playing, running, swimming, trekking, climbing etc.

NOSE BLEED/EPISTAXIS

FIRST AID Massage and stretch Apply heat Water and salt (ORS)

CAUSES Cold, Heat Overexertion Lack of salt and water

CRAMPS

Tilt head down, stand over a wash basin Pinch the nose Breath through mouth If bleeding > 20 minutes, seek a doctor’s advice

Not a medical emergencyUsually ends in a few minutes

SEIZURES/FITS

FIRST AID Remove objects that may injure Do not restrain, loosen clothing Do not slap or pour water on

face Do not put anything in mouth After seizure, allow to sleep Reassure, seek a doctor’s help

SYMPTOMS Jerkiness Frothing (mouth) Clenched teeth Fall to ground Passing urine Passing stools

CUTS/WOUNDSLacerations Puncture wound

Contusion/Bruise

Amputation

Incision

CUTS/WOUNDS Don’t touch wounds without washing hands (soap) Don’t breath over/blow over a wound Don’t cover with dirty cloth Clean wounds with soap and water Bleeding – Pressure/ Elevation/ Bandage Pain Killers Paracetamol – Crocin

Ibuprofen – Brufen Diclofenac – Voveran Piroxicam, Nimesulide, Tramadol etc

Skin broken – Inj Tetanus (valid for 5 years) Antibiotics (Septran, Amoxycillin

etc)

BURNS

TYPES OF BURNS DRY BURN Hot objects, friction, flames SCALDS Steam, hot fluids ELECTRICAL BURN Low-V current, lightning strike COLD INJURY Snow, Ice, Very cold wind Freezing metals, dry ice, freezing gases e.g. liquid oxygen, nitrogen CHEMICAL BURN Fumes, corrosive gases, paint

remover, acids, alkalis, bleach, weed killers, quick lime, WP

RADIATION BURN Sunburn, UV lamp, radioactivity,

welding arcs, lasers, microwaves

Outermost layer of skin Mild pain Redness, warmth Swelling and tenderness

FIRST AID Cold water rinsing for 10min Remove gadgets, jewellery Expose body parts Loose bandage Do not apply ointments,

grease, baking soda

10 BURNS

10 BURNS

Upto middle layer of skin Severe pain Redness, warmth Swelling and tenderness Blisters, Clear fluid comes out Death > 60 % burns

FIRST AID No washing with water (20 and 30)

Burnt part not to touch anything Don’t prick blisters Evacuate to medical facility

20 BURNS

All skin layers, nerves, fat, muscles Skin looks waxy, pale or charred No pain Purple fluid

SPECIFIC FIRST AID Eyes- Rinse with water 10 min Cover both eyes Don’t prick blisters Don’t put ice over burns

30 BURNS

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30 BURNS

ELECTRIC SHOCK/BURNSFIRST AID Break contact of electric shock/mains if safe Stand on an insulating material and remove patient Don’t touch unless power supply cut off Be careful in wet areas Remove gadgets, jewellery Loose bandage Artificial respiration or CPR Seek a doctor’s help

SPRAIN / STRAINOverstretching

FIRST AID Rest / Immobilisation Hot fomentation Crepe Bandage Pain Killers Don’t take off shoes

SYMPTOMS Pain Painful movement Swelling Bruising

SPRAINLigamentSTRAINMuscle

DISLOCATIONSDisplacement of bones from a jointShoulders, elbow, thumb, fingers and lower jaw

FIRST AID Never try to reposition Rest / Immobilisation Pain Killers Seek a doctor’s help

SYMPTOMS Pain at site of injury Limited or no movements at the affected joint Deformity Swelling Tenderness

FRACTURESFIRST AID Never try to reposition Rest/Immobilisation Hot fomentation Splint - Comfortably Pain Killers Evacuate to hospital

SYMPTOMS Severe pain Swelling Loss of power Shock

PROTECTREST

ICECOMPRESSION

ELEVATION

PRICE

Bee, Hornet, Wasp, Yellow jacket, Fire ant etcSea Nettle, Jelly Fish, Portuguese Man of War et

INSECT STINGS/BITES

FIRST AID Evacuate patient to a safe place Remove sting Cold compresses First aid for allergy Lie victim down and immobilize limb Transport victim to hospital Leech-Common salt

ANIMAL BITESDog, Cat, BatRat, MouseMonkey, ApeHorse, DonkeyCow, CamelWild AnimalsSnakeBirdSharkHuman

Very dangerous : Can cause RABIES (100% death) Even an animal licking your fingers is dangerous Inj Rabipur/Verorab at 0, 3, 7, 14, 21 days Person having Rabies can transmit to others

BEWARE OF DOGS, CATS, RATS

DOG, CAT, BAT, RAT, WILD ANIMALS

FIRST AID : ANIMAL BITES Wash the area thoroughly with soap and water Bites on face and hands more dangerous Look for cuts, blood - Dangerous Don’t chase or kill the animal Don’t cut the wound Don’t apply ointments, herbs, ice packs Don’t give the patient alcohol, disprin etc Observe the animal for 10 days Immunization must prior to expected exposure Evacuate the patient to hospital

DOG, CAT, BAT, RAT, WILD ANIMALS

WOLF ATTACK ON A 12 YR OLD CHILD

Snakes are cute and beautiful creation of God They live in peace and avoid humans Their poison is meant for killing their prey 3000 species worldwide, 725 poisonous 250 able to kill a human with single bite 275 species in Indian subcontinent 2,50,000 snake bites/yr 50,000 die due to unscientific/delayed treatment Only few Indian species are poisonous Snakes at >11,000 ft are non poisonous

COBRA, KRAIT, VIPER, SEA SNAKE

SNAKE BITE

COBRA

VIPER

KRAIT

SEA SNAKE

POISONOUS Vs NON POISONOUS

POISONOUS Vs NON POISONOUS

Terror effects Fang marks Sweating, flushing Tightness in chest Nausea, vomiting

NEUROTOXIC BITE COBRA AND KRAIT

Eyes start closing Difficult swallowing Pain abdomen Paralysis

FEATURES OF SNAKE BITEHEMOTOXIC : VIPER

Unstoppable bleeding from anywhere (gums)

Low Blood Pressure Shock Acute kidney failure

MYOTOXIC : SEA SNAKE Muscle pain

SNAKE BITEFIRST AID DON’T’S Don’t tie a tourniquet Don’t chase or kill the snake Don’t cut the wound Don’t wash the bitten area Don’t try to suck poison from the bite Don’t let the person move unnecessarily Don’t apply ointments, herbs, ice packs Don’t give the patient alcohol, disprin etc Don’t give Anti Snake Venom outside hospital

SNAKE BITEFIRST AID DO’s Evacuate patient to a safe place Reassure and calm patient Lie victim down and immobilize Provide non-alcoholic liquid to victim if conscious Give artificial respiration/CPR Evacuate victim to hospital immediately Inj Tetanus Inj Antivenom (mixed antivenom for 4 Indian snakes)

LOVE ANIMALS : DON’T LET THEM BITE YOU

Itching, redness, blisters etcPOISONOUS PLANTS

FIRST AID Evacuate patient to a safe place Wash exposed area with soapy water Cold compresses Provide non-alcoholic liquid to victim First aid for allergy Wash yourself after treating Lie victim down and immobilize limb Evacuate to a medical facility

If patient rescued - Near drowningIf patient dead - Drowning

DROWNING

FIRST AID Evacuate patient to a safe place away from water Clean the mouth (Sand, mud, plants etc) Put him on the floor and raise his body Give artificial respiration or CPR After revival, remove wet clothing May require warming of the body Evacuate to a medical facility

FIRST AID BOXMEDICINES Fever- Paracetamol, Disprin Painkillers (For pain, fever, swelling)- Ibuprofen,

Diclofenac, Piroxicam, Nimesulide, Tramadol etc Antibiotics-Amoxycillin,Erythromycin, Ofloxacin etc Anti diarrhoeals-Secnidazole,Tinidazole,Norfloxacin Anti allergics-Cetrizine, Avil(Pheniramine) Antacids-Digene, Ranitidine, Omeprazole Mountain med- Acetazolamide, Dexamethasone Savlon/Dettol, Soframycin/Povidone Iodine cream etc Eye drops, Injections, ORS, Glucose,Cough tablets etc

FIRST AID BOXMEDICAL EQUIPMENT Scissors, Torch, Splints, BP Apparatus etcDRESSING MATERIAL Cotton, Sterile dressing, Gloves, Adhesive Plaster,

Roller Bandage, Bandaids, Gauze, Eye pads etc Crepe bandage, Knee caps, Cervical CollarMISCELLANEOUS (Contents depend on level of first aid training) Water purification tablets, Asthalin inhaler, Foot

Powder, Vaseline, Salt, Sugar, Paper, Pen, Lighter etc Surgical suture, needle, inj Lignocaine, iv fluids,

intracath, infusion set, stethoscope, airway etc HAPO bag, oxygen cylinder, face mask etc

FIRST AID REPORT FORM

Questions

Thank You