Topic 1: Introduction to First Aid(1)

What is First Aid ?________________________________________________________________________________________________

AIM of Performing First Aid (1)?•_________Life •_________Condition from getting Worse•_________Recovery

What do i need to do to be a First Aider?•Be ____________________________•Examine and _____________________•Constantly Update _________________

AIM of performing First Aid(II)?1. Preserve Life•Pay strict attention to ________•Ensure priority of treatment•A___________•B___________•C___________•Control any major __________

2. Prevent Condition from getting Worse•make diagnosis of casualty using ____________ survey•Treat casualties based on __________•Treat injuries according to __________•Consider ___________ condition that can be hidden

3. Promote Recovery•Relieve any discomfort , _________•Arrange for appropriate medical attention.

Safety Pointers for First Aider

Always wear ________________ when handling casualty

Cover any ___________________ with a water proof plaster.

Wear a _______________ when dealing with large quantities of a casualty’s body fluid.

Wear plastic glasses to protect your eyes against __________

Take care not to prick yourself with any needles found on or near the casualty , or to cut yourself on _________.

If your __________________________ is splashed by the casualty’s blood, wash throughly with soap and water and consult a doctor

Use a mask or face shield for ______________________________________________

Dispose of _____________________________ safely after treating the casualty.

Bandaging

Missing

How to tie reef knot, fold Triangle bandage , broad and narrow

bandages, scalp bandage, arm sling

Topic : type of bandage to use on types on injuries

Arm sling :• Wrist injury• Forearm fracture• Upper arm fracture• Collar bone fracture• Ribcage fracture

Elevation sling :• Shoulder dislocation • If casualty is unable to bend elbow

Scalp bandage :• Skull fracture• Scalp bleeding

Topic 2C: Hand and Finger Fractures Treatment

Sign & Symptoms

How to access an injury?

Pointers

•Note as many feature as possible without moving the uninjured side unnecessary•Try to visualize possible how this injury was caused.•Compare injury site (Shape , Size , Appearance) with non-injured side.•If in doubt about the severity of an injury, treat it as a fracture.

Treatment Objectives:•Immobilization of Joint•Arrange for further Medical Care

•Remove any rings or bracelet before hand begins to swell.•If the injured finger is deform, do not force the finger back.•DO NOT try to attempt to hear the Coarse grating sound by purposefully moving the fracture area.

• Pain Near or at site of Injury•Tenderness near or at site of Injury•Swelling•Loss of Function•Coarse grating sound•Redness•Deformity

Finger Fracture

•For Finger Fracture, Use the sound finger as the splint for the fractured finger. •Use the micro-pore tape to tape the two fingers together to immobilize the fracture.• Do not stick over the fracture area.

Hand Fracture1. Ask Casualty to assist supporting Injured hand. Protect Injured hand with soft padding.Example of Soft Padding : bandage, t-shirt .

2. Place casualty hand at elevated position to reduce swelling.Proceed to support arm in an elevation sling.

3. Place triangle bandage with the tip of the triangle pointing to the elbow

Tip

4. Take lower end of bandage and cover arm. Twist the bandage from elbow onwards.

5. Tie end of the bandage together using the reef knot. (Uninjured side). Tuck loose end neatly .

6. To further secure bandage ,tie a broad bandage over the arm. (Knot to be at uninjured side)

End

Topic : Identitfying fractures and injury Treatment

Theory

When a limb fracture is assumed, pay attention for tenderness (pain or discomfort when an area is being touched), swelling, and bruises with or without bleeding or deformation. Fracture can be assumed when the casualty took a fall or hit and you hear a snap

How to know whether there is a limb fracture:

How to know when there is a skull fracture:

When there is a skull fracture assumed, the casualty might be unconscious, clear or bloody fluids coming out from the ears or nose, changes to pupil (size uneven, not reactive to light), fits, vomiting or headaches.

Palm bandage:• Horizontal cut • Vertical cut

Topic : spinal injury Treatment

Sign & Symptoms

Theory

Pointers

Treatment Objectives:To prevent the injury from worsening.

Causes:• Falling from a height.• Falling awkwardly while doing

gymnastics.• Diving into a shallow pool and

hitting the bottom.• Being thrown from a horse or

from a motorbike.• Being in a collapsed rugby

scrum.• A heavy object falling across the

back.

Recognition When only the bones of the spinal

column are damaged, there may be: 1.Pain in the neck or the back at the level of the injury.2.A step, irregularity, or twist in the normal curve of the spine.3.Tenderness on gently feeling the spine. When only the spinal cord is also

damaged, there may be:1.Loss of control over limbs; movement may be weak or absent.2.Loss of sensation.3.Abnormal sensations, for example burning or tingling.4.Breathing difficulties.

Checking for spinal cord injury1. Examine the casualty carefully in the position found2. Ask helper to maintain support at head.3. Ask casualty to move his limbs to test for loss of power.4. Touch casualty without him knowing to test for loss of sensation.

Treatment for a conscious casualty1. DO NOT move the casualty from the position found, unless she is in danger

or becomes unconscious.2. Reassure the casualty, and tell her not to move.3. Steady and support her head in the neutral position by placing your hands

over her ears. Maintain this support throughout.4. If you suspect neck injury, get a helper to place rolled-up blankets or articles

of clothing on either side of the casualty’s neck and shoulders.5. Call for an ambulance.

o Treatment for a conscious casualtyYou may apply a collar if the neck is injured.

Treatment for a unconscious casualty1. Check ABC and perform CPR if necessary.

2. Maintain open airway.

3.Call for an Ambulance.

4. Keep casualty’s head, trunk, and toes in a straight line at all times.

5. Check for pulse and breathing regularly.

Topic : Ribcage Fracture Treatment

Sign & Symptoms

Theory

Pointers

Treatment Objectives:

Recognition• Sharp pain at the site

of the fracture. • Pain on taking a deep

breath.• Shallow breathing. • Paradoxical breathing.• An open wound over

the fracture, through which you might hear air being “sucked” into the chest

• Features of internal bleeding and shock.

To prevent the injury from worsening

Treatment for a fractured rib 1. Support the limb on the injured side in an elevation sling. 2. Send casualty to hospital.

Treatment for open or multiple fractures1. Immediately cover and seal any wounds to the chest wall.2. Place casualty in the most comfortable position. (Half-sitting, with head, shoulders, and body turned towards the injured side.)3. Support the limb on the injured side in an elevation sling.4. Call for an Ambulance.5. If casualty becomes unconscious, place him in recovery position.

*Remove accessories such as necklace and tie!*Paradoxical breathing refers to all/part of a lung inflate when air is exhaled and deflate when inhaling.

A rib fracture is a crack /break in one of the bones of the rib cage. A break in the thick tissue that connects the ribs to the breastbone may also be called a fractured rib cage, even if the bone itself is not broken.

Topic : Pelvis Fractured Treatment

Sign & Symptoms

Theory

Pointers

Treatment Objectives:

Recognition•Inability to walk or even stand.•Pain and tenderness in the region of the hip, groin, or back, increased when the casualty moves.•Blood at the urinary orifice, especially in a male casualty•Abdominal bruising

To prevent the injury from worsening

1. Help casualty to lie on his back.2. Straighten his leg or, if it is more

comfortable, help him to bend his knees slightly and support them.

3. Immobilize his legs by bandaging them together, placing padding between the bony points.

4. Call 995 for an ambulance. 5. DO NOT bandage the legs together if this

causes intolerable pain.

Causes:•Falls from great heights•Car accidents•Major trauma•Muscle contractions

*Reassure the casualty if he/she is conscious.* Tie figure of eight using triangular bandage to bandage the legs together.

Topic : Hip And Thigh fractureTreatment

1. Lay the casualty down gently.2. Ask helper to steady and support the injured limb.3. Gently straighten the lower4. Call for an ambulance5. Treat for shock but do not raise up the legs6. If ambulance delayed, immobilize the limb by securing or splinting it to the uninjured limb.7. Gently bring the casualty’s sound limb alongside the injured one.8. Maintaining traction ( immobilize) throughout at the ankle.9. Insert padding between the thighs, knees, and ankles 10. Tie the bandages around his ankles and knees.11. Tie the bandages above and below the fracture.12. Release traction only when all bandaging knots are tied.13. Place a leg splint, from the armpit to the foot, against side.14. Pad between the legs and between the splint and body.15. Secure the splint and the body with bandages.

Sign & Symptoms :Pain at the site of the injury.Inability to walk.Signs of shock.Shortening of the thigh.A turning outwards of the knee and foot.

Theory A hip fracture is a break in the upper quarter of the femur (thigh) bone. The extent of the break depends on the forces that are involved. The type of surgery used to treat a hip fracture is primarily based on the bones and soft tissues affected or on the level of the fracture.

PointersTie the knot at the uninjured side!Immobilize the leg!

Treatment Objectives: To prevent the condition from worsening

Topic : Knee Joint injuriesTreatment

1. Help the casualty lie down.2. Place padding under the

injured knee to support it to the most comfortable position.

3. Hold padding in place by bandage.

4. Send casualty to hospital.

Sign & Symptoms :• Pain, spreading

from the injury to become deep-seated in the joint.

• If the bent knee has “locked”, acute pain on attempting to straighten the leg.

• Rapid swelling at the knee joint.

Theory:Causes – A Twist to the knee of a hard knock to the knee with a great force.

Pointers

*DO NOT attempt to straighten the knee forcibly.*DO NOT give anything by mouth.*DO NOT allow the casualty to walk.

Treatment Objectives: To prevent the condition from worsening.

Topic : lower leg fracture Treatment :

1) Steady and support the injured leg2) Gently expose and treat any wound if necessary.3) Straighten the leg using traction. 4) Support the leg with your hands until the ambulance arrives.

Treatment (If ambulance delayed)1) Bring the sound limb to the injured leg.2) Insert padding between the knees and ankles and between the calves.3) Tie the bandages firmly around ankles and knees, then above and below the fracture.

Sign & Symptoms :

1) Localised pain.2) Inability to walk3) Open wound may occur.

Theory:

Causes - A recent blow or wrench of the foot.

Pointers :

Knot on the uninjured side.

Treatment Objectives:

Topic : Sprains and Strains Treatment : R.I.C.E1) Let casualty lie down straight2) Ice the area that is swelled up 3) Compress pressurize the swelled up area4) Elevate the legs which is swelled up

Sign & Symptoms :Pain.Swelling.Bruising.Not being able to move or use the joint

Theory:When do I apply RICE?when a casualty sprains and strains.

What does R.I.C.E stand for?R – RestI – IceC – CompressE - Elevate

Pointers

Treatment Objectives: To reduce swelling and pain

Wound and Bleeding

Topic : wounds and bleeding

Types of wounds :

Incised wounds :Clean cut; sharp objectE.g Scissors, knife

Gunshot Wounds :Gun Shot; round woundE.g Gunshot

Lacerated wound:Unclean cut; blunt objectE.g Rock, Blunt scissors

Abrasion/Grazed wound:FrictionE.g falling down on a Beach

Contused wound:Bruises; blood clotE.g knocking onto hard walls.

Puncture wounds:PiercingsE.g Snake bites, nails

Pointers :Lacerated, Incised and Punctured wounds are all different

Contused WoundsPunctured WoundsGunshot Wounds

Incised WoundsLacerated WoundsAbrasion/Graze Wounds

Topic : wounds and bleeding Treatment of bleedings :

1) Control blood loss by applying pressure over the wound and raising the injured part.2) Take steps to minimize shock, which can result from severe blood loss.3) Cover any open wound with a dressing, to protect it from infection and promote natural healing.4) Pay scrupulous attention to hygiene, so that there is no spread of infection between the casualty and yourself.

Pointers :Use disposable glovesWash hands well in soap and water before and after treatmentCover any sores or open wounds with waterproof adhesive dressing.

Treatment for minor external bleeding:

Direct pressure. Elevation. Small adhesive dressing. Medical aid need only be

sought if the bleeding does not stop, or if the wound is at special risk of infection.

1. Cleaning of Wound If the wound is dirty,

clean it by rinsing lightly under running water, or use an antiseptic wipe.

2. Elevate and Dressing Elevate the wounded

part above the level of the heart.

Apply adhesive dressing.

If there is a special risk of infection, advise to see doctor.

Topic : Wound and Bleeding

Theory:Types of bleeding Arterial Bleeding

Bright Red in Colour Spurts from a wound in time with the heartbeat. Severed main artery may jet blood several feet high. Rapidly reduce the volume of circulating blood.

Venus Bleeding Dark Red in Colour Gush profusely.

Capillary Bleeding Oozing at the site of all wounds. Blood loss is usually slight.

Pointers : Please remember the types of bleeding and their characteristics

Treatment Objectives: to identify the type of bleeding

1) Clotting of blood.2) Cut ends of a blood vessel will contract.3) Blood pressure will drop.

Our body’s mechanism to stop bleeding

Topic : Wound and Bleeding Treatment :

Pointers : If severe bleeding from a limb cannot be controlled by direct pressure, it may be necessary to apply pressure to the pressure points. (Points denoted in Red)

Treatment for Severe External Bleeding1. Direct Pressure2. Elevation and Dressing3. Treat for Shock4. Removal to Hospital.

To expose the wound: Remove or cut clothing to expose the

wound. Watch out for sharp objects, such as

glass, that may injure you.

1. Apply direct pressure Apply direct pressure over the wound

with your fingers or palm, preferably over a sterile dressing or clean pad.

2. Elevation and Dressing Raise and support an injured limb above

the level of the casualty’s heart. Lay the casualty down. Apply sterile dressing. Bandage it in place firmly, but not so

tightly as to impede the circulation.

Removal to hospital:

Dial 995 for an ambulance.

Treat for shock.

Check the dressing for seepage.

Check the circulation beyond the bandage.

1) Press down firmly on either side.2) Build up padding on either side of the object without pressing on it. 3) Secure and support the injured part with bandaging.

Wounds Involving Protruding Objects

Topic :

Sign & Symptoms

Theory :

Treatment Objectives:

Wound and Bleeding

Internal Bleeding-Rupture of blood vessels without wound on skin surface-- Can be caused by knocks or small impacts to an area - Can be bleeding of organs or bleeding within body cavities which can be very serious as we are unable to see how profuse the bleeding is.

Reduce discomfort and If bleeding is suspected to serious, send to hospital

Simple Internal bleeding-Blue black area isolated -No lost of mobility at area of bruising

Serious Internal bleeding-Pallor-Cold, clammy skin-Rapid pulse-Pain -Thirst-Confusion, Restlessness, irritability-Possible leading to collapse and unconsciousness-Pattern bruising-Bleeding from orifices-Information from casualty indicating recent injury or drug related bruising

Treatment Procedure

Simple Internal bleeding1. Raise and support Injured part to a comfortable position2. Apply Cold Compress over area to reduce swelling and bleeding

Serious Internal bleeding3. If bleeding does not stop, or casualty condition worsens, arrange for medical attention immediately

Possible causes when bleeding is detected from orifices siteSite Appearance Causes

Mouth Bright red, frothy, coughed-up bloodVomited blood, red or dark reddish-brown, resembling coffee grounds

Bleeding in LungsBleeding within digestive system

Ear Fresh, bright red blood

Thin, watery blood

Injury to the inner or other ear; perforated ear-drumLeakage of cerebrospinal fluid

Nose Fresh, bright-red blood

Thin, watery blood

Ruptured blood vessel in the nostril.Leakage of cerebrospinal fluid following head injury

Anus Fresh, bright-red blood

Black, tarry, offensive-smelling stool

Injury to anus or lower bowelInjury to upper bowel

Urethra Urine with red-smoky appearance and occasion clots

Bleeding from bladder or kidney

Vagina Either fresh or dark red blood. Menstruation, miscarriage, disease/injury to vagina or womb

Topic :

Sign & Symptoms

Theory :

Pointers:

Treatment Objectives:

Wound and Bleeding

Abdominal Wound

Penetrated Chest Wound

Control Bleeding and prevent deterioration of condition

Open wound at injury site

Abdominal Wound1. Lay Casualty down on firm flat surface2. Raise and support the knees, if wound cuts across the

abdomen3. DO NOT raise the knees if the wound is vertical.4. Cover the wound with a big dressing5. Lightly secure in place with a bandage or adhesive tape. If the

casualty coughs or vomits, press firmly on the dressing.6. If part of the intestine is protruding, do not touch it, but

cover to prevent it from drying out.7. Call 995 for ambulance, treat for shock and stay with the

casualty and check his condition every few minutes.

Penetrated Chest Wound8. Quickly cover the wound with your palm or casualty’s if he is

conscious. 9. Place a sterile dressing over the wound and surrounding area.10. Cover with a plastic bag or foil.11. Secure firmly with adhesive tape on three sides

Treatment Procedure

Abdominal WoundThe actions of coughing or vomiting requires large movement on the abdominal muscles. Pressing firmly on the dressing when casualty coughs or vomits is to ensure that the dressing does not expose the wound.

If intestine has exited the body, do not attempt to push the intestine back in. Use a plastic bag with some water in it to hold the intestine and prevent it from drying out.

Penetrated Chest WoundThe covering of the wound with plastic bag/ foil and only securing 3 side is to allow a 1 way valve for air to escape but not be suck into the chest cavity. Failure to perform this step will result in a collapse lung(s) and death

If Casualty is conscious:1. Provide firm support for a conscious casualty.2. Lean casualty towards the injured side.3. Call 995 for an ambulance.4. Treat for shock.

If Casualty is not conscious:1. Open the airway.2. Check breathing and pulse. Prepare to give

CPR if necessary.3. Place him in recovery position with the

uninjured side uppermost.4. Call 995 for an ambulance.

Topic :

Sign & Symptoms

Theory :

Pointers:

Treatment Objectives:

Wound and Bleeding

Crush injuries Amputation

Treatment Procedure

- Prevent deterioration of injury site - Preserve body part for medical care

Crush injuries - Pin under heavy object Amputation- Partial or complete removal of limb

Crush injuries - There will be a buildup of toxins at the injury site. This is the reason why after 10 minute, its not advised to remove the object as the toxin can be fatal (poison to body)Amputation- Lowering the temperature of the limb will extend the time where the limb can be surgically attached back

Crush injuries Determine duration of injury

If less than 10 Minutes:1. Release the casualty as quickly

as possible2. Control and external bleeding

and cover any wounds3. Treat for fracture and/or shock4. Call for an ambulance

If more than 10 Minutes:1. Do not release the casualty.2. Call for an ambulance.3. Reassure the casualty.

Amputation1. Remove any accessories (e.g. watch , bracelet etc)2. Control Blood lost without usage of a tourniquet3. Apply sterile dressing or non-fluffy clean pad

secured with a bandage.4. Treat for shock.5. Call for an Ambulance.6. Wrap the amputated part in plastic bag.7. Wrap again in gauze or soft fabric.8. Place the package in another plastic bag filled with

crushed ice.9. Send amputated part together with the casualty to

the hospital.

Choking,Recovery Position, CPR, AED

Topic : Choking Treatment

Sign & Symptoms

Theory

Pointers

Treatment Objectives:Free foreign object from airway

Victim is unable to speak, breath, coughCasualty clutch his neck with his hands to show sign of chocking. (Universal Distress Signal)

Conscious casualtyAsk the victim: “Are you chocking?”If the victim nods his head, stand behind the victimPosition one of your leg in between the victim’s leg. Wrap arms around the victim’s waist and make a fist with one hand.Place the thumb side of your fist against the victim’s abdomen, at the midline, 2 fingers above the navel.Grasp the fist with the other hand and advise the victim to lean slightly forward.Applied upward and inward thrusts into the victim’s abdomen.

Determine unresponsiveness by gently shakes or taps victim’s shoulders and shout, “Are you okay?”

Unconscious casualty

If no respond, immediately shout,” Help! Call for ambulance, 955”

Determine BreathlessnessLOOKLISTENFEEL

If no breathing, perform CPR!• Locate sternum using forth finger of

right hand. Place heels of the left hand next to the middle finger of right hand.

• Place left hand directly on the right hand.

• Give 30 compressions at 100 times per minute.

• If the victim’s chest does not rise after the breath, re-position the victim’s head and re-attempt rescue breathing.

• If the victim’s chest still does not rise after the breath, perform the chest compression again.

• Check is there any foreign bodies in the mouth.

• Repeat the above steps if no foreign body visible in the mouth.

• If foreign is visible in the mouth, use Finger Sweep to remove foreign body.

•Take note of pregnant casualty, do not thrust into the abdomen instead thrust below the sternum•Determine Breathlessness should take about 10 sec •If chest does not rise after reposition head, resume 30 compression

Topic : CPR Treatment

Sign & Symptoms:• Chest Pain• Shortness of breath

Theory:

What does CPR stands for?CardioPulmonaryResuscitation

Pointers*Avoid violent shaking.*Fingers should be interlocked.*Straighten your arms.*Do not pause between compressions!*Ratio of compression: rescue blow=30:2

Treatment Objectives: Attempt to restore breathing& circulation.

How to perform CPR? Step 1: Look out for Danger(fire, leaking petrol) *Move casualty to a safe environment if there is danger. Step 2: Response *Gently tap on both shoulders and ask “Hello Hello! Are you okay?” *No response: help call ambulance 995, get an AED. Step 3: Open airway by “head tilt-chin lift” *Remove foreign objects with finger sweep. Step 4: Breathing *Look, Listen and Feel *Look for chest rise and fall, listen for air inhalation and exhalation and feel for flow of air(10 sec) *No breathing: Perform 30 chest compression. Step 5: Give 2 rescue breath.

Missing

Recovery Position

Missing

Usage of AED

Transportation Of Casualty

Topic : TOC

Types of TOC methods:• 1 rescuer Forward drag Backward drag Cradle Pack-a-back Human crutch• 2 rescuer

Theory:Definition:

TransportationOfCasualty

Pointers : * • Do not attempt to move the casualty if he/she is suspected of having spinal injury. *Always check for DRABC and control all bleedings.

Treatment Objectives: To move casualty from unmovable danger.

Treatment:1. Forward drag(neck drag)• Usage: Moving a conscious/unconscious casualty. Moving behind a low wall Under a vehicle*Do not apply if the casualty has a broken arm.

2. Backward drag(Cradle Drop Drag) To quickly move casualty from a life-threatening situation(fire). Move both unconscious & conscious casualty up/down steps.

2,3&4 handed seat Fore and Aft

Human crutch(1 first aider) Human crutch(2 first aider)

Treatment3. Cradle carry Used to move a conscious &

unconscious casualty for a short distance.

4. Pack-a-back(saddleback carry) Used to carry a conscious casualty for a

moderate/long distance.

5. Human crutch Used for carrying a conscious casualty

who can walk/hop on 1 leg. Can be used for a long distance.

Treatment: 6) 2,3&4 Handed seat• Usage: Carry a conscious casualty who cannot

walk/support the upper body for a short distance.

7) Fore and aft• Usage: Transport a conscious/unconscious casualty

for a long distance.

Important!Lifting a casualty:Prepare to lift casualty 2,3,4 upLowering a casualty:Prepare to lower casualty 2,3,4 down.

4-handed seat

2-handed seat

3-handed seat

Topic : Stretcher Drill Treatment

Theory:

What is a stretcher?• It is a medical device

used for transporting of casualties who require medical help.

Pointers*Casualty should always be carried with the feet leading first.

Treatment Objectives: To minimize any further inquiries from occurring.

Stretcher Drill Procedure• Position of the 4 bearers: No. 1-waist(Right side) No. 2-waist(left side) No. 3-Leg(left side) No. 4-Head/shoulder(left side)

Role of no. 1:-Help assist in lifting the casualty’s feet & head for the other bearers to slot their arms in.-Hold no. 4’s left hand and no. 2’s right hand-”Lift” will be given by no. 1 when bearers are ready.-After placing the casualty onto the bearer’s lap, no. 1 will take the stretcher and place it underneath the casualty.-No. 1 will then grasp no. 4’s left hand and no. 2’s right hand.*After the order “lower” is given, raise casualty slightly above the bearer’s knees and slowly lower the casualty to the stretcher.

Prepare to lift casualty 2,3,4 upTo lift casualty : To lift stretcher : Prepare to lift stretcher 2,3,4 upTo lower casualty : Prepare to lower casualty 2,3,4 downTo lower stretcher : Prepare to lower stretcher 2,3,4 down

Missing

How to Open close stretcher, lift casualty onto stretcher, move with

stretcher, stretcher drills

Topic :

Sign & Symptoms

Theory :

Pointers:

Treatment Objectives:

Wound and Bleeding

Topic :

Sign & Symptoms

Theory :

Pointers:

Treatment Objectives:

Wound and Bleeding