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FIRST AID

BY ANIMUT .A

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1.1. Learning Objectives

After studying the material in this chapter, the

student will be able to:

1. Define first aid

2. Recognize the reasons why first aid is given

3. Appreciate values of first aid

4. Identify general directions for giving first aid

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Unit oneintroduction

• First aid is the immediate care given to a person who has

been injured or suddenly taken ill.

• It includes home care if medical assistance is not available

or delayed.

• It also includes well selected words of encouragement,

evidence of willingness to help, and promotion of

confidence by demonstration of competence (American red

cross, 1998).

Objectives(3p’s)

1. preserve life, E.g. mouth to mouth respiration when breathing has

stopped

2. prevent the injuries or illness from becoming worse

E.g. Immobilizing the fractured bone.

3. promote recovery.

e.g., reassure the patient, relief pain, protect from cold

and arrange patient transfer

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WHY YOU LEARN FIRST AID ? The need for first aid training is greater than ever because of

population growth through out the world and due to the

increased use of technological products

Thus, there is an ever growing demand for first aid training

for personal use.

In general first aid is aimed to help for others,

preparation for knowing what to do during disaster as well as

to help self.

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General directions to give first aid

1) Assess the situation- determine what assistance can be

given.

2) Identify themselves- offer to help.

3) Assess or diagnose- the condition.

4) Establish priorities- give appropriate urgent aid.

5) Arrange for medical aid.

6) Prevent cross infection

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Assessment

Be calm him.

Talk, listen, and reassurance the conscious

casualty.

Check safety of casualty and your self ,check

breathing, bleeding and level of consciousness

Get others to help.

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Problem identification (Diagnosis)

History:-The story of how the accident happened or the illness.

we can be obtained from:-

• The causality ( e.g. I slipped and fall down)

• A witness or a bystander(s) whether he/she saw the

happenings Points to be considered during history taking:

• Any history of illness: E.g. Epilepsy, Diabetes mellitus,

• For history of ingested material E.g. Drug, Alcohol, type

of food.

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Cont…

Symptoms:- Sensations and feelings that are described by

the Casualty E.g. I feel pain ,cold, numbness.

Signs:- variations from normal ascertained by the first-

aider.

E.g. Pallor of the inner surface of the eyelids or nail beds.

• There may be evidence of poisoning

• e.g. medications, alcoholic smell, bottles and other

containers beside the victims.

• information (Look, smell, listen and touch).

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Examining the casualty

The nature and extent of injuries can be readily observed and

a detailed examination of the casualty is not required.

Two stages may be required in the examination of a

casualty:

1. Primary examination to determine life-threatening

conditions.

2. Secondary examination to determine injuries/illness

which normally would not be an immediate threat to life.

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PRIORITIES FOR TREATMENT

 

When there is more than one casualty the first aider must

decide the order in which they will be treated and

evacuated to medical aid.

1. First priority:- required immediate treatment and

transportation for condition as: ABC.

Cont..

2. Second priority:- person for whom treatment and

transportation may be deferred such as: burns,

fracture and back injuries.

3. Third Priority:- who may receive treatment and

transportation last.

These include: minor fracture, minor bleeding,

behavioral disorder. 

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Level of consciousness

Recognition of any change of level of

consciousness is important.

Full consciousness- the casualty is able to

speak and answer questions normally.

Drowsiness- the casualty is easily aroused but

lapses in to unconscious state.

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cont,…Stupor –the casualty can be roused with

difficulty, aware of painful stimuli.

E.g. pin prick, but not of other external

elements like being spoken to.

Coma - cannot be roused by any stimuli.

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General principle of first aid

1. Rescue and removal the causality in the

shortest possible time without aggravating

existing health institution.

2. First aid should be confined to essential only.

3. Immediate arrest of hemorrhage.

4. Restoration of circulation.

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Cont….5. Preventing of impending shock and treatment of

shock

6. Immobilization of simple or compound fracture

and dislocation.

7. Alleviation of pain by simple procedure or

medication.

8. Assurance of getting well quickly to the victim

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•READING ASSIGNMENT:GCS(glascow coma scale)

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Unit two

2. RESPIRATORY EMERGENCY

• Definition

• Respiratory emergency:- is one in which normal

breathing stops or in which breathing is reduced so that

oxygen intake is insufficient to support life.

• Artificial respiration:-is a procedure for making air

to flow into and out of a person’s lungs when his natural

breathing is inadequate or ceases.

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Cont..Normal breathing process:- air is moved into

and out of the chest in a process called

ventilation.

-The exchange of gas between alveoli & blood and

blood &cellular is called respiration(internal

and external)

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Cont….Inhalation is an active process. The muscles of the

chest, including the intercostals muscles between the ribs,

expand at the same time the diaphragm contracts in a

downward motion. These movements increase the size of

the chest cavity and create a negative pressure.

• This negative pressure pulls air in through the glottis

opening and inflates the lungs. Conversely

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Cont……..

Exhalation is a passive process. That is, it occurs

when the previously discussed muscles relax. As the

size of the chest decreases, it creates a positive

pressure and pushes air out.

Because it is passive.

exhalation typically takes slightly longer than

inhalation.

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2.1 ASPHYXIA

Asphyxia:- a condition in which there is lack of

oxygen in the circulating blood resulting in damage

to vital tissue and eventually death.

Cause:-1. Insufficient oxygen in the inhaled air.

2. Loss of effective function of the lungs and heart.

3. Airway obstruction (anatomical obstruction).

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2.2 respiratory distress

it is increase work of breathing a sensation of

shortness of breathing by using accessory muscles.

Respiratory failure :- is the reduction of breathing.

It is especial important to recognize, because it is

often the precursor to the complete stoppage of

breathing (respiratory arrest).

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Signs of respiratory distressRate of respiration is irregular, too fast

Depth of breathing- shallow/ abnormally deep

Breathing is noisy, gasping, blood vessels of head and

neck are swollen (congested), lips, ears and finger nails

beds become bluish discoloration-cyanosis, chest not

raise and fall.

The patient skin lips, tongue, ear lobe are blue ,gray

these condition is called cyanosis.

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2.2.1. Causes of Respiratory Failure

A. Anatomical Obstruction

The most common cause of respiratory emergency is interference with

breathing caused by the drooping of the tongue back and

obstructing the throat.

Other causes of obstruction that constrict the air passages are:

• Asthma •Laryngeal spasm

• Croup •Swelling after burns of the face

• Diphtheria • Swallowing of corrosive poison

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B. Mechanical Obstruction

• Solid foreign objects lodging in the respiratory passage

e.g. choking of food.

• Aspiration (Inhalation of any solid or liquid substance)

C. Air Depleted of Oxygen or Containing Toxic Gases

• Asphyxia – Is a condition in which there is a lack of oxygen

in the blood and the tissue do not receive an adequate

supply of oxygen.

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D. Additional Causes of Respiratory Failure

are:-

1. Drowning

2. Circulatory collapse (shock)

3. Heart disease

4. Strangulation

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2.3 Management

Open airway

techniques used to open the airway are

1. head tilt-chin lift,

2. jaw thrust with head tilt,

3. jaw thrust without head tilt.

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2.4. Artificial Respiration and Management of Respiratory Accidents

Objectives:-

1. To maintain an open air way through the mouth and

nose (or through the stoma)

2. To restore breathing by maintaining an alternating

increase and decrease in the expansion of the chest.

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General Information• The average person may die with in 4- 6 minutes if

his/her oxygen supply is cut off.

• Recovery is usually rapid except in case of carbon

monoxide poisoning, over dosage of drugs or electrical

shock.

• In such cases, it is often necessary to continue artificial

respiration for a long time.

Cont..

• When a victim revives he/she should be treated for shock.

• A physician’s care is necessary during the recovery period.

• Artificial respiration should always be continued until

• The victim begins to breath by himself

• He/she is pronounced dead by a doctor or he/she is

dead beyond any doubt

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2.4. ARTIFICIAL RESPIRATION

Artificial respiration:- is the technique of

supplying air to the lungs of a casualty who is

unable to breathe for himself.

When respiratory functions fail for any reason, it

is vital that artificial respiration started

immediate.

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Moth to moth (moth to nose) method or

‘Kiss of life' step 1-determine consciousness by tapping the

victim on shoulder & asking loudly” are you

ok”

2-tilt the victim head back so that his chin is

pointing up ward.

Cont..3-place your cheek & ear close to the victim mouth &

nose. look at the victim chest to see if it rises &

falls ,listen & feel for air to be exhaled for about

5seconds.

4-If there is no breathing ,pinch the victim nostril shut

with the thump &index finger of your hand i.e. pressing

on the victim forehead. Blow air in to the victim mouth.

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Cont…..5- seal your mouth tightly around the victim mouth &

with your mouth forming a wide open circle & blow in

to the victim mouth.

6-Initially give 4 quick full breaths without allowing the

lungs to fully deflate(empty) between each breath.

7-Maintain the head tilt & again look ,listen &feel for

exhalation of air &check the pulse for at least 5-10

seconds. If no pulse & breath do CPR.

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Cont….

8-If there is pulse & no breath ,provide at one breath at

least every 5 seconds or 12 per minute for adult &this

provides sufficient air.

9-If the air way is clear only moderate resistance to

blowing will be felt.

10-Watch the victim chest to see when it rises.

11-Repeat the blowing cycle.

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Steps of mouth to mouth respiration (steps of opening air way)

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Figure 2 Mouth- to- mouth respiration

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Cont.…•Note: Mouth- to- mouth and -nose resuscitation

are administered for infants and children as

described above except

1. that the backward head tilt should not be as

extensive as that of adult.

2. Both the mouth and nose of the infant or child

should be sealed off by your mouth.

Cont..

3. Blow in to the infant’s mouth and nose once

every 3 seconds (about 20 times per minutes).

4. But in the case of children blow once every 4

seconds (about 15 times per minute).

5. The amount of air is determined by the size of

the victim.

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2.5 CHOCKING

It is the inability to breath caused by blockage of the

throat due to infection or bodies, particularly

foods, lodged in the throat for children- marble,

coins, hard candy stuck in their throat.

• In order for oxygen from the air to flow to and

from the lungs, the upper airway must be

unobstructed.

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2.5.1 Signs and symptoms

1. inability to talk

2. difficulty of breathing,

3. inability to cough

4. loss of consciousness.

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Chocking management

N.B. Do not try to hook the foreign body out with

your fingers.

This is likely to push it further down.

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• An infant`s airway is more easily

• blocked than an adult`s because:

1. The head is relatively large

2. The neck is relatively short

3. The tongue is large

4. The trachea (windpipe) is soft and easily compressed

5. The adenoids may be large

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Treatment for choking infants

• The following procedure is for a choking infant:

Check to see if the obstruction can be cleared using the

finger sweep.

Lay the infant in a lying face down position over your

forearm, supporting the baby’s face and body with your

arm.

The infant’s body should be inclined downwards to utilize

the effects of gravity.

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Cont..• Deliver up to five blows between the infant’s

shoulder blades. • If the obstruction is still present, turn the infant

onto their back, again with the body inclined.• Deliver up to five chest thrusts between the

infant’s nipples (breast bone) using two fingers.• Repeat this process until the obstruction is

cleared or the infant becomes unresponsive.• Commence CPR if the infant becomes

unresponsive.

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Cont.….

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2. For adults: there are two methods using alternatively. Opening the Obstructed Airway—Conscious Casualty

“Method A” Tell the patient to lean over the back of a chair holding on to the seat(bend forward) and the tenanting him/her sharply 4 to 5 times between his shoulder blades

“Methods B” stand behind the patient and hold around abdomen(Hemilienchi maneuver or abdominal thrust.)

We can do helmilienchi maneuver on our selves

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Cont.….• The manual thrust with the hands centered

between the waist and the rib cage is called an abdominal thrust (or Heimlich maneuver).

• The chest thrust (the hands are centered in the middle of the breastbone) is used only for an individual in the advanced stages of pregnancy, in the markedly obese casualty, or if there is a significant abdominal wound.

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Heimlinchi maneuver

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Cont…• For unconscious casualty ;quickly

callout for help to medical aid (911) place on back on a firm flat surface

• open air way attempt to ventilate the lung. • if un able to ventilate give 5 back blow and

chest thrust. • if all does not get into the lung go though steps

again and start artificial respiration.

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Cont..

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Cont…..

you use the foreign body should be coughed outfor Px & obesity we use chest trust instead of

abdominal trust.If the breathing has stopped begin mouth to-

mouth respiration.After you have done the above, refer to the

nearest hospital or health Center

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Prevention of air way obstruction

1. Cut food specially meat, into small pieces and chew

2. Avoid talking ,laughing or drinking while chewing food.

3. Caution children not to run with food or other objects in their mouth.

4. Avoid excessive drinking while chewing foods.5. Keep small objects out of reach of infants and

children.

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2.5 Cardio-pulmonary resuscitation(CPR)

• CPR stands for Cardio Pulmonary Resuscitation;

1. Cardio refers to the heart.2. Pulmonary refers to the lungs.3. Resuscitation refers to the attempts made to

try and keep someone alive.• CPR Is an emergency procedure applied when

heart and lung actions have stopped.

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Cont.….• it is squeezing the victim heart between the

sternum works like a pump, forcing blood to reach the brain and the vessel supply blood to the heart.

• During CPR you will have to perform procedures to:

I. Maintain an open airway II. Breathe for the patient III. Chest compression.

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CPR involves two main things 1. Blowing air into the casualty (because they

are not breathing on their own) 2. Compressing their chest to squeeze the heart.

When the heart is squeezed blood will circulate. By circulating blood we also circulate oxygen that is in the blood stream.

• The main purpose of CPR is to keep organs alive by supplying them with oxygen.

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Cont…ProcedureIf one First Aider1. Establish unresponsiveness and alert for

emergency medical service and Position the causality.

2. Establish an open airway.3. Look, Listening, and feel for breathing (3-5

seconds).4. Ventilate twice (1 to 2 seconds) per breath

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Cont….5. If no pulse (5-10 seconds)6. Locate Compression site(between breast bones )7.Palpate the lower tip of the sternum place the palm of the

one hand about 3 finger above the tip of the breast bone with the thumb and fingers raised the second hand should be placed on the top of first hand and interlocked.

• for children one hand enough and only two fingers for infant.

8. Began compressions, the chest should be pushed down about 4-5cm with a quick force(100compression per minutes)

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Cont…9. Along with cardiac massage ,mouth to mouth

should be continued(30 compression with 2rescue breathing).

if two first aiders 15 compression:2 rescue breathing

10. Recheck pulse after 4 cycles, then every few minutes.

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Cont….

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Cont…..

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CPR for infant

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Unit three3-wound and bleeding

learning objectivesAfter the end of this chapter the student will be able to;1. Define wound and bleeding2. Identify different causes of wound.3. Give first aid measures for different wounds and sever

bleeding4. Explain the preventive measures of contamination and

infection.5. Explain the preventive measures of contamination andinfection of wounds.6. Recognize different types of bite.

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Cont….Definition:- Wound is breaking in continuity to

tissue of the body, either internal or External.Common Causes of Wounds: • Wounds usually result from external physical

forces. • The most common accidents resulting in open

wounds are accidental falls and handling of sharp objects, tools, machinery and weapons.

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Cont….

Classification of Wound based on skin involvement

1.Open: An open Wound is a break in the skin or mucous membrane.

2. Closed: A closed wound involves injury to underlying tissue with out a break in the skin or mucous membrane.

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1. Abrasions2. Incisions3. Laceration4. Punctures5. Avulsions

Types of open Wound based on mechanism of injuries

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1-abrased wound

The outer layer of the protective skin are damage. It usually results when the skin is scraped against a hard surface.

Bleeding is limitedDanger of contamination and infection is high.

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Figure below shows Abrased Wounds

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2-Incised wounds

It frequently occurs when body tissue is cut on knives, rough edge of metal, broken glass or other sharp objects

Bleeding may be rapid and heavyDeep cuts may damage muscles ,tendon,

and nerves.

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Figure 9 Incised Wound

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3-lacerationsIt is jagged, irregular or blunt breaking or

tearing of the soft tissue and usually caused when great force is exerted against the body.

Bleeding may be rapid and extensive.Destruction of tissues is great in a lacerated

wound than cuts.Deep contamination of the wound increase the

chance for later infection.

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4-punctureIt is produced by an object piercing skin layers,

creating a small hole in the tissue.It is produced by objects such as bullet and

pointed object like pins, nails etc.External bleeding is usually quit limited.Internal damage may have resulted to the organs

causing internal bleeding.The hazard of infection is increased because

limit flushing action of external bleeding.Tetanus may develop.

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5-avulsionsIt results when tissues is forcibly separated or

torn off from the victims body.An incised wound, a lacerated wound, or both will

usually occurs when a body part is avulsed.There will be heavy and rapid bleeding.An avulsed body part may be reattached to a

victim body by a surgeon.Avulsed wound occurs in accident such as

motor vehicle, wrecks, gun shots, animal bite.

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according to the likelihood or rate ofwound infection.

1. Clean: Non-traumatic, non-infected wound, no break in sterility technique, the respiratory, gastrointestinal or genitourinary tracts not entered.

2. Clean-contaminated: Minor break in technique, oropharynx entered, gastrointestinal or respiratory tracts entered without significant spillage, genitourinary or biliary tracts entered in absence of infected urine or bile.

3. Contaminated: Fresh traumatic wounds, major break in sterility, gross spillage from gastrointestinal tract, and entrance of genitourinary or biliary tracts in the

• presence of infected urine or bile

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Dirty and Infected

4. Dirty and Infected: Acute bacterial inflammation without pus, wound with heavy contamination and evidence of infection, transection of “clean” tissue for the purpose of surgical access for collection of pus, traumatic wound with

• delayed treatment, or from dirty sources

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3.2-Bleeding Bleeding is the escape of blood from vessels into

surrounding tissue whether • External-obvious bleeding or• Internal-concealed or hiddenTypes of bleeding1. Arterial bleeding:- bright red in color, flow from

the wound inside Blood loss, flow is raped 2. Venous bleeding:- dark red in color, flow is

steady3. Capillary bleeding –oozing from bed of

capillaries, red in color, usually less bright than arterial blood with slow flow.

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Internal bleeding• Bleeding inside body cavity may follow an injury

such as a fracture or a penetrating wound, but can also occur spontaneously for example bleeding from gastric ulcer.

• the main risk from internal bleeding is hypovolemic shock.

• Check for any bleeding from body orifices such as the ear, mouth, or anus

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Cont….• How to recognize internal bleeding1. Initially pale cold, clumpy skin. 2. If bleeding continue cyanosis3. Rapid, weak pulse4. Rapid, shallow breathing5. Confusion, restlessness6. Possible collapse and unconsciousness7. Bleeding from body openings

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Cont…..

8. In case of violent injuries “patent bruising" an areas of discolored skin with shape.

9. Pain10.Information from the causality that indicates

recent injury or illness

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3.3 first aid measures for sever bleeding• Need for Immediate Action:-The reason why

intervention of first aider needed is to stop any large rapid loss of blood and to treat for shock and prevent death.

• Techniques to stop severe bleeding simple to complex

• A-direct pressureIt is the preferred method for the control of severe

bleeding since it prevents blood loss from the body with out interference with normal blood circulation.

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Cont..• Apply direct pressure by placing the palm of the

hand over a thick pad directly on the entire area of an open wound;

• protecting the hand from contact to the blood in order to prevent HIV/ AIDS transmission.

• Apply the pressure bandage, maintain a steady pull on the bandage, and then tie the bandage with the knot directly over the pad.

• DO NOT TAKE THE FIRST BANDAGE OFF

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Cont….

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B-elevation

• Unless there is evidence of a fracture, a severely bleeding open wound of the hand, neck, arm or leg should be elevated above the level of the victim’s heart.

• Elevation uses the force of gravity to help reduce blood pressure in the injured area and slows down the loss of blood through the wound.

it should be aided by direct pressure.

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C-Pressure on the Supplying ArteryIf severe bleeding from an open wound of the arm

or leg does not stop after the application of direct pressure plus elevation, the pressure point technique may be required

Use the pressure point technique by temporarily compressing the main artery(which supplies blood to the affected limb) against the underling bone and nearby tissues.

the technique also stops circulation within the limb.• Use it for short duration of time.

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cont.…• Use the brachial artery for the control of

severe bleeding from an open arm wound (it is situated in the inside of the arm between the biceps and triceps about mid way between the armpit and the elbow).

• E.g. use femoral artery for the control of severe bleeding from an open leg wound.

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Cont….

PRESSURE POINTS:

PRESSURE POINT IS A SITE WHERE MAIN ARTERY LIES NEAR THE SURFACE OF THE BODY, DIRECTLY OVER A BONE. PULSATION CAN BE FELT IN THESE AREAS.THERE ARE 22 PRESSURE POINTS(11 ON EACH SIDE).OF THESE 11 ARE USED TO CONTROL PROFUSE BLEEDING.

1. BRACHIAL ARTERY - FOR BLEEDING FROM UPPER LIMB.2. FEMORAL ARTERY - FOR BLEEDING FROM LOWER LIMB.3. CAROTID ARTERY - FOR BLEEDING FROM NECK.4. TEMPORAL ARTERY - FOR BLEEDING FROM SCALP.5. FACIAL ARTERY - FOR BLEEDING FROM FACE.6. SUB CLAVIAN ARTERY - FOR BLEEDING FROM CHEST WALL & ARMPIT

PRESSURE POINTS

APPLICATION OF INDIRECT PRESSURE

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D Tourniquet

• The use of a tourniquet is dangerous and the tourniquet should be used only for a severe life threatening hemorrhage that can not be controlled by other means.

• Precaution: release the tourniquet every 15 minutes, and notify others as tourniquet is applied not to forget in its applied site

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3.4 Prevention of Contamination and Infection

• Open wounds are subject to contamination and infection.

• This danger can be prevented or minimized by appropriate first aid measures, depending up on the severity of bleeding.

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Cont..A. Safeguards. Whenever a dressing is applied to control bleeding, whether

bleeding is severe or not, safeguards must be taken. Do not remove or disturb the cloth pad initially placed

on the wound. Do not try to cleanse the wound, since the victim requires

medical care.• Watch for signs of shock before and during transportation. • Immobilize the injured area.• Adjust the victim in a lying position so that the affected limb

can elevated.

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• B. Measures to be taken with wounds without severe bleeding

To cleanse a wound, wash your hands thoroughly with soap and water.

Wash in and around the wound to remove bacteria and other foreign materials (wash the wound from inside to outer side).

Rinse the wound thoroughly by flushing with clean water. Blot the wound, dry with a sterile gauze pad or clean cloth. Apply a dry bandage or clean dressing and secure it firmly

in place. Inform the victim to see a physician immediately if

evidence of infection appears

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3.5 Removal of foreign objectsIn small open wounds, some foreign materials

often remain in the skin, tissues or underlying surfaces.

Such objects irritate the victim, and unless they are removed they can cause infection.

Use tweezers, sterilized over a flame or in boiling water, to pull out any foreign matter from the surface tissue.

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Cont…• Lift out those objects embedded just beneath the

skin with a tip of a sterilized needle (with alcohol or flame).

• Deeply embedded foreign objects in the tissues, regardless of size should be left for removal by health personnel.

• Immobilize the protruding end with massive dressing around the protruding part, and then transport the victim to a hospital without delay.

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3.6. Dressing the Wound

Dressing a wound helps to protect it

1. from additional injury2. contamination3. to assist in the control of bleeding.

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3.7 Infection

If bacteria get inside tissues of the body through breaks in the skin or mucous membranes, serious infection may develop within hours or days following an injury.

These will result in delay of wound healing.The first-aider should recognize this fact and

combat against development of infection, e.g. Tetanus.

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Signs and Symptoms of Infection

1. Swelling of the affected part2. Redness of the affected part.3. A sensation of heat4. Throbbing pain5. Fever6. Pus formation7. Swelling of lymph nodes depending on the

affected sites

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Emergency Care for Infection In case of delay of medical care the first-aider

should do the following for infection.1. Keep the victim lying down and quiet, and

immobilize the entire infected area.2. Elevate the affected body part if possible.3. Apply heat to the area with hot water bottle or

placing warm, moist towels or clothes over the wound.

4. Do not delay efforts to get medical care for the victim

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3.2 BITES AND STING 3.2.1 INSECT STIN

Usually, a sting from a bee, wasp, ants, scorpion and other insects is painful rather than dangerous.

An initial sharp pain is followed by mild swelling, redness, and soreness.

However, multiple insect stings can produce a serious reaction.

Cont…

• A sting in the mouth or throat is potentially dangerous because swelling can obstruct the airway.

• With any bite or sting, it is important to watch for signs of an allergic reaction, which may lead to anaphylactic shock

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Cont…..Sign and symptomPain at the site of the sting.Redness and swelling around the site of the sting. Aim of managementTo relive swelling and pain.To arrange removal to hospital if necessary.

Management

Reassure the casualty. If the sting is visible, brush or scrape it off sideways with your fingernail or the blunt edge of a knife.

Raise the affected part if possible, and apply an ice pack or cold compress

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WARNING

If the casualty shows signs of anaphylactic shock, such as

impaired breathing or swelling of the face and neck, send him to hospital immediately Note Stings or bites from flea, lice, tick, mosquito and

other similar insects do not produce serious reaction but they can transmit disease to human bings

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Animal bite The bite of animal whether it is wild animal or a

pet may result an open wound .Dog and cat bite are common. Although a dog bite is likely to cause more

extensive tissue damage than cat bite, the cat bite may be more dangerous because a wider variety of bacteria is present in the mouth of the cat.

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Cont..Many wild animals especially bat, fox, Jackals,

raccoons and rats transmits rabies.Rabis Can be transmuted even when a rabid animal

licks an existing open wound on human or a non rabid Animal.

Tetanus is an added danger in animal bite. There is no known cure for rabies in human

beings or in Animals, once its final stage symptoms develop. If the animal proves to be rabid, vaccine therapy must be give to build up body immunity in time to prevent the disease.

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Cont……

A bite of the face, neck or heads should receive immediate medical attention because the rabies virus has to travel shorter to reach the brain.

Restrain any suspected rabid animal (for 10 days) so that it can be kept under observation to determine whether or not it develops the final stage of rabies.

Cont..

Do not kill the animal unless necessary. If the animal has to be killed, have the body to

be examined for rabies. If killing is necessary, take precaution not to

damage the animals head

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Cont…If a suspected rabid animal cannot be caught or

found and thus cannot be identified and observed, arrange immediate medical care for any person it has bitten.

Injection is effective in preventing rabies in 95% of victims.

So anti rabies vaccines should be stared immediately.

Injection of TAT is mandatory

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Aim of management 1. To control bleeding 2. To minimize the risk of infection both to the

casualty and yourself 3. To obtain medical aid if necessary First aid Managementput on disposable glove if available wash the bite would thoroughly with soap and

water .to washout the animal saliva so as to minimize

the risk of infection /it decease the viral load /

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Cont…….• dry with clean gauze swab and cover the would

with small dressing • Never suture the bite wound as this will

spread the virus • Watch for symptom like increase in pain and

swelling, pus or fever, these indicate infection of the wound and require medical help.

• Make sure that the victim should avoid movement of the affected part until he get medical help

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Human bite Human bite that breaks the skin may become

seriously infected because the mouth is heavily contaminated with bacteria.

Management 1. clean the wound thoroughly with soap and

water2. cover with piece of gauze but not sealed

covalently 3. Arrange to send the causality to hospital

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Snake Bites While a snake bite is not usually a serious

injury, it can be frightening. Reassurance is vital, if the causality keeps calm,

the spread of venom (poison) through the body may be delayed.

The venom of poisonous snakes affects the circulatory and the nervous system and is toxic.

All reactions from snake bite is aggravated by acute fear and anxiety.

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Effect of poisonous snake bite Factors that affect the severity of local and general

reaction from poisonous snake bite include 1. The amount of venom injected and the spread of

absorption of venom into the victim’s circulation

2. The size of the victim 3. Protection from clothing 4. Specific anti venom therapy as soon as possible 5. Location of the bite

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Sign and symptom

Depends on the species, but there may be: -A pair of puncture marks Severe pain, redness and swelling at the site of

the bite Nausea and vomiting Disturbed vision double vision and difficulty in

opening the eye Labored breathing; in extreme cases breathing

may stop altogether

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cont….Discoloration of the skin around the bite Severe abdominal pain Limb weakness and weakness of the muscles

of respiration Drowsiness Difficulty in swallowing Paralysis, convulsions and coma. Shock

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Objective of management

1. To reduce the circulation of blood through the bite area

2. To prevent the spread of venom in the body ( to delay absorption of venom )

3. To prevent aggravation of the local wound and to sustain respiration

4. To arrange urgent removal to hospital

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Management The most important step is to get the snake bite

victim to the hospital quickly. Mean while, take the following first aid measures Help the causality to lie down. Reassure her/him and tell her /him to keep calm

Gently wash the wound with soap and water and dry with clean swabs

Keep the victim from moving around so as to decease the blood circulation, thereby slowing the absorption and spread of the snake venom.

Lightly compress the limb above the wound with a roller bandage. Use triangular bandages to immobilize the affected area

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Cont….If the victim can reach a hospital with in 4 or 5

hours and if no symptom develop, no further first aid measures needed to be applied

If mild to moderate symptoms develop, apply a constricting band above the bite, but loose enough. Loosen the bandage if it becomes too tight. check the pulse in the extremity beyond the bite to insure that the blood flow has not stopped

If severe symptoms develop, make an incisions and apply suctions immediately (mouth suction)

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Other factors must be considered in cases of snake bite

Shock:- keep the victim lying down and comfortable and maintain his body temperature

Breathing and heart beat: - If breathing stop give mouth to mouth respiration. If breathing stops and there is no pulse, perform CPR

Medicine to relieve pain: - do not give alcohol, sedatives, and aspirin. Some pain killers however may be given.

Identification of the snake: - If you can kill the snake without risk or delay, bring it to hospital for identification whether the snake was poisonous or not.

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Cont….• The head must not be destroyed since it serves as

the most important marker to distinguish a poisonous with non poisonous shake (non poisonous shakes have round pupil, no fangs and a double row of plates beneath the tail)

• It is not recommended that cold compress, i.e. dry ice, Spray refrigerants and other methods of cold therapy are not used in the first aid treatment of shake bite.

 

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