 Standard

science and English

Compiled by Sadiq yahaya Mustapha (Dr)

07037648121

Email sadiqyahaya3388@[Link]
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

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 Key terms:- is working, which means blood is being
 Anaphylaxis, Cardiopulmonary resuscitation
circulated around their body
(CPR)3,
Convulsion3,Haematoma3,Haemorrhage  Secondary survey (Breathing →
3,Haemothorax3,Hyperthermia3,Hypoglycaemia Bleeding → Bones):
3,Hypothermia3,Hypotension3,Hypoxia3,Oedem o Once you are satisfied that the
a3,Oxygen saturation (O2
sat)3,Perfusion3,Pericardial tamponade,Pleural
casualty is breathing normally,
effusion3,Pneumothorax3,Seizure3,Shock3, the second thing to do is make
 Introduction sure to treat any bleeding. This
 Health emergencies happen every day, is to stem any blood loss and to
everywhere. They affect adults and children and there is a steady supply of
include injuries and infections, heart attacks and oxygenated blood to the
strokes, acute complications of pregnancy and of
chronic disease. While specialised care may
casualty’s vital . If there is no
never be available at all times in all places, a bleeding, or you have dealt with
systematic approach to emergency conditions any cuts, the next priority is
saves lives. The Disease Control Priorities Project
broken bones. emergency
estimates that nearly half of deaths and a third of
disabilities in low- and middle-income countries action plan is important to have
result from conditions that could be addressed in place should you be faced
by emergency care. with a situation requiring first
 The Aims of first aid aid.
 (1) preserve life. o 1. REMOVE DANGER: Make the
 (2) prevent the situation from getting scene safe, do not take risks.
worse. o 2. DANGER: Look for any further
 (3) promote recovery. danger. If yes, go back a step, if
 The priorities of treatment no go to step 3.
 primary survey (Airway o 3. RESPONSE: Shout and gently
Breathing) shake or tap the casualty. If the
 A. Make sure the casualty’s airway casualty responds, find out what
is clear. Do this by gently tipping their happened. Check their signs and
head back that the front of the throat symptoms (how does the
is extended. casualty feel or look? Try to
 B. Check if they are breathing work out what’s wrong), and
normally. You can do this by placing determine a treatment
the back your hand near their nose (remember - if you are unsure,
and mouth. You are looking for about always seek medical advice). If
two breaths every ten seconds. If the there is no response, shout for
casualty is breathing, then their heart help but don’t leave the

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 casualty just yet, and go to step these functions stop, our brain
4. and other vital organs will start
4. AIRWAY: Open the casualty’s airway to (brain cells usually die within
by lifting their chin and tilting their 3-4 minutes due to lack of
head back. oxygen) which will eventually
5. BREATHING NORMAL?: Look, listen lead to death.‘Ventricular
and feel for two breaths in a maximum fibrillation’ is the most common
of ten seconds. If you can clearly result of cardiac arrest, caused
determine the casualty is breathing, by heart attack. When this
perform a secondary survey (check for happens, the best chance of
bleeding, injuries and clues). Put the survival for the patient is tohave
casualty into the recovery position, their heart ‘restarted’ with a
dial 112 if not already done, monitor defibrillator. These are carried
airway and breathing and keep the on all ambulances, and can also
casualty warm. If you cannot be found in some public places
determine if the casualty is breathing, (shopping centres, etc.). These
go to step 6. days’ defibrillators are very
6. DIAL 112 FOR AN AMBULANCE sophisticated, and will talk you
NOW IF YOU HAVEN’T DONE SO through the process, but you
ALREADY. should be trained in the use of
7. RESUSCITATION: Give 30 chest them before attempting to use
compressions followed by 2 rescue one. However, even if you are
breaths, continue giving cycles of 30 trained to use one, you must
to 2 breaths. If there is more than one call an ambulance first, as this
first aider on hand, change over every will give the casualty the best
2 minutes to prevent fatigue. Continue chance of survival. so, we need
until the ambulance arrives. to keep the heart and brain
oxygenated as best we can
o while help is on the way; this is
when we start Cardio
Resuscitation Pulmonary Resuscitation (CPR).
o To maintain life, we need our Primary Survey:
hearts to pump oxygenated
D Danger – ensure the area is safe and
blood to our vital organs. To
find out what has happened
achieve this we need to be
1. sure that it is safe for you to
breathing and our hearts need
approach the casualty. Do not
to be pumping. Should either of
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 put yourself in any danger, [Link] their airway is cleared, check
because if you get injured you if they are breathing normally. You are
won’t be able to help the looking for two breaths in ten
casualty. seconds. Take no longer than this to
2. Remove any danger from the assess their breathing, as every second
casualty, or if that is not counts.
possible, and it is safe to do so, [Link] whether their chest and
try to move the casualty away abdomen are rising and falling.
from the danger area. 3. Listen for breath (more than a
[Link] to find out what sporadic gasp).
happened, making sure that you [Link] the back of your hand (lick the
are safe doing so. DO NOT PUT back of your hand if that will help) or
YOURSELF IN ANY DANGER. your cheek to feel for any breath from
o 5. How many casualties are the casualty
there? Can you cope with the o This will all determine if the
situation? casualty is breathing normally. If
o R Response – is the casualty they are, you will need to place
conscious? them in the recovery position,
[Link] to get a response from the which will be covered later in
casualty. Gently shake their shoulders, the notes. the casualty is not
shout and clap your hands in front of breathing normally: The first
them, pinch their underarm or thing to do in this situation is
fingernail to get a pain response. call 112 for an ambulance. If
2. If they do not respond, immediately someone is with you, get them
shout for help, or call 112 if you have a to do this so you don’t have to
mobile phone on you. Whatever you leave the casualty. If you are
do, do not leave the casualty alone. alone, and do not have a mobile
A Airway – clear the airway with you, you may need to leave
[Link] the airway by placing your the casualty to do this.
fingertips under the casualty’s chin However, it is vital that an
and lifting, so the front of the neck is ambulance is called, as the
extended. Simultaneously placing your casualty will stand a much
other hand on their forehead to gently better chance of survival with
tilt the head back. help on the way. Once the
B Breathing – is the casualty breathing ambulance is called, start CPR
normally?

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 o Cardiopulmonary to get the casualty onto the
floor without hurting yourself or
resuscitation the casualty. If it is not possible,
o [Link] the heel of one hand in remove any pillows or cushions
the centre of the casualty’s so the casualty is lying flat and
chest. Place the other hand on attempt CPR. This is still better
top and interlink your fingers. than doing nothing
2. Take a position next to the
casualty’s chest, kneeling at whichever o Combining chest compressions
side feels more comfortable for you. with rescue breaths:
o [Link] down firmly on the [Link] chest compressions, make sure
casualty’s breastbone current the casualty’s airway is clear by tilting
guidelines suggest pushing their head back.
down to a depth of 6cm) then 8. Pinch the casualty’s nose closed;
release the pressure, but try not this will make sure the breath you give
to lose contact with the them does not escape.
casualty. This is known as a 9. Take a breath and place your mouth
chest compression. When over the casualty’s, forming a seal.
applying pressure, avoid doing 10. Steadily blow into the casualty’s
so on the ribs, upper abdomen mouth, making sure their head is tilted
or the end of the casualty’s back and the airway is open. Keep
breastbone. your eyes down on the casualty’s
[Link] compression should take the chest to make sure it rises (this should
same amount of time. take about a second). This is known as
5. Carry out 30 chest compressions at a rescue breath.
a speed of 100-120 compressions per . [Link] your mouth from the
o 6. After 30 chest compressions, casualty’s and leave enough room for
you must administer two rescue you to take a fresh breath of air. Keep
breaths (see images below). In the casualty’s airway open and watch
an ideal situation, the casualty for the chest deflating, as the air is
will be on a flat hard surface to expelled.
be able to administer CPR. [Link] your mouth over the
However, this isn’t always the casualty’s forming the seal again and
case, and you may find that you give another rescue breath. You need
need to perform CPR on a to do this twice.
casualty who is, for example, in o 14. Replace your hands on the
bed. If this situation arises, try casualty’s chest immediately
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 and perform another 30 chest o
compressions, followed by 2
Resuscitation for babies
more rescue breaths.
o swapping between 30 chest and children:
compressions and 2 rescue Understandably, some people are
breaths reluctant to perform CPR on a child or
baby for fear of causing further harm
o Should your rescue breaths not to them. However, a child in this state
be effective, follow the steps is likely to suffer far worse
below: consequences if CPR is not
[Link] a further 30 chest administered. Please keep that in
compressions. mind should the situation ever arise.
[Link] any visible obstructions in CPR on a child is very similar to CPR on
the casualty’s mouth. an adult. There are only a few minor
17. Make certain their airway is clear modifications to the process, which
by tilting their head back and lifting are detailed below:
the chin. If the airway is not clear, the o [Link] the child 5 rescue
breath you give will not fill their lungs. breaths before starting CPR,
Do not give the casualty more than then switch back to 30 chest
two rescue breaths before continuing compressions to 2 rescue
with chest compressions. breaths.
o you have someone with you, 2. If you are alone, perform CPR for
take it in turns to administer about a minute before going for help.
chest compressions. compressions on a child should be
Every 1-2 minutes, change over so one about one-third of the depth of the
person administers chest chest. For a baby under 1 year old,
compressions while the other gives only use two fingers to administer
the rescue breaths. Ensure there is as CPR. For a child over 1 year use either
little delay in swapping as possible, so one or two hands to compress the
the casualty is constantly receiving chest, again one third of the depth of
CPR. the chest.
Continue CPR until: Main causes of unconsciousness in a
The emergency services arrive to take casualty:
over. You become too fatigued to o Unconsciousness is an
continue. interruption to normal brain
activity. Unconsciousness the
body’s autonomic reflexes such
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 as coughing. The worst position o 1. A blood clot blocks a blood
for an unconscious casualty is vessel that supplies part of the
lying on their back, as they may brain. This is the most common.
‘swallow’ their tongue (the o 2. A ruptured blood vessel in the
tongue slides back in the throat brain. The build-up of blood
blocking the airway) which will ‘squashes’ an area of the brain.
suffocate them, or they may With either type of stroke the signs
asphyxiate on their vomit. are similar, with the result that a part
o To help you remember the main of the brain dies. There is no age
causes of unconsciousness in a definition of a stroke casualty; anyone
casualty, try to remember FISH of any age can have a stroke.
SHAPED. These points are dealt o Signs and symptoms of a stroke:
with more fully elsewhere in o A stroke must be treated
these notes. immediately. If you suspect a
o F Fainting stroke, carry out the following
S Stroke FAST test:
o I Imbalance of heat o F Facial weakness
o H Heart attack o Can the casualty smile? Has
o S Shock their mouth or eye drooped?
A Asphyxia (choking)
o H Head injury o A Arm weakness
o P Poisoning o Can the casualty raise both
o E Epilepsy arms?
o D Diabetes o S Speech problems
o Can the casualty speak clearly?
oStroke Do they have problems
o Strokes must always be treated understanding you?
as a medical emergency, and an o T Time to call 112
ambulance called immediately. o If the casualty fails any of these
Any delay in the treatment of a tests, call 112 immediately as a
stroke can have a dramatic stroke is a medical emergency.
effect on the casualty’s o There may be other signs to
recovery. If you suspect a look for, but the FAST check is
stroke, CALL AN AMBULANCE the quickest and may save time.
IMMEDIATELY. However, please note the
There are two types of stroke: following may occur:

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o 1. One side of the face or body can lead to tragedy if not dealt
becomes suddenly numb. with properly.
o 2. Loss of balance. o Signs and symptoms
o 3. Lack of co-ordination. o 1. Casualty is unable to talk,
o 4. Suddenly developing a severe breath or cough.
headache. o 2. They may be gasping and
o 5. Sudden confusion. clutching their throat.
o 6. Problems seeing with one or o 3. They may appear distressed.
both eyes. o 4. They may become pale and
o 7. Pupil size becomes unequal show signs of cyanosis in later
o Treatment of stroke: stages.
o 1. Clear the airway and maintain o Treatment of an adult or child
breathing. over 1 year:
o [Link] 112 FOR AN AMBULANCE o Ask the casualty if they are
IMMEDIATELY. choking firstly to establish this is
o 3. If the casualty is unconscious, the case. If they are not doing
place in the recovery position. so already, ask them to cough as
o 4. If conscious, lay the casualty this will usually dislodge minor
down with their head and obstructions. However, if this
shoulders raised. doesn’t work, follow the steps
o 5. Be sure to talk to and below:
reassure the casualty. Just o 1 – Back slaps
because they may not be able o a. If there is no help around,
speak, they still may be able to shout for help. Do not leave the
understand and react to you. casualty alone.
o 6. Monitor their breathing, o b. Bend the casualty forward at
pulse and response levels. Keep the waist so their head is lower
a record if possible for when the than the chest. If the casualty is
ambulance arrives. a young child, you can place
them over the knee to help with
o Choking this.
o c. Find the hollow spot between
o Choking is a very common the shoulder blades and
occurrence, and is probably one administer five firm slaps with
of the most usefull skills you can your open hand. Make sure to
have as a first aider. Choking

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 check between blows if the obstruction is not cleared by
obstruction has dislodged. coughing, follow the steps
o d. If this does not work, go to below:
step 2. o 1 – Back slaps
o 2 – Abdominal thrusts (Heimlich o a. Shout for help immediately,
Manoeuvre) but do not leave the baby alone.
o a. Stand (or kneel if it is a child) o b. Lay the baby over your arm
behind the casualty and place facing downwards with their
both your arms around their legs either side of your elbow
waist. with their head below their
o b. Make a fist and place it just chest.
below the casualty’s ribs with o c. Administer up to five slaps
your thumb facing inwards (as if firmly between the shoulder
you’re looking at a watch). blades with the palms of your
o c. Grasp your fist with your free fingers, not your open hand.
hand and pull in sharply. Do this o d. Check between each slap if
up to five times, making sure the obstruction has dislodged.
you check between each thrust o e. If this does not work go to
if the obstruction has dislodged. step 2.
o d. If this does not work, repeat o 2 – Chest thrusts
step 1 and follow with step 2 o a. Turn the baby over, so they
until the obstruction is are laying chest up on your
dislodged. other arm, keep their head
o e. If the back slaps and below their chest.
abdominal thrusts do not o b. Using two fingers on the
appear to be working, shout for baby’s chest give up to 5 chest
someone to call 112 for an thrusts. This is a similar
ambulance, but do not stop manoeuvre to chest
administering the treatment if compressions in CPR, but
the casualty is conscious. sharper and administered at a
o Choking in a baby under 1 year slower rate.
o The baby may attempt to cough o c. Check between each thrust if
on their own. If the choking is the obstruction has dislodged.
not serious, this will clear the o d. If this does not work, repeat
obstruction. The baby may cry step 1 and follow with step 2
which indicates they are now
breathing properly. the
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 until the obstruction is o These can be swelling or
dislodged. narrowing of the airway caused
o e. Never administer abdominal by:
thrusts on a [Link] the o 1. Swallowing or swelling of the
obstruction has still not tongue.
dislodged repeat steps 1 and2. o 2. Vomit.
o If the casualty becomes o 3. Choking.
unconscious make sure they o 4. Burns.
are laying on the ground (or on o 5. Strangulation.
a flat firm surface for a baby) o 6. Hanging.
and commence CPR. Make sure o 7. Anaphylactic shock.
there is an ambulance on the o Breathing causes
way. Continue CPR until help o The lungs are unable to function
arrives or you become fatigued. properly, caused by:
oHypoxia o 1. Crushing of the chest.
o 2. A collapsed lung.
o Hypoxia means low oxygen in o 3. Injury to the chest.
the blood stream. This condition o 4. Poisoning.
has the potential to be fatal, so
o 5. Asthma attack.
it is vital for a first aider to
o 6. Disease or illness.
recognise the signs and know
o Circulation causes
how to treat the casualty
o Oxygenated blood is unable to
o There are five categories for the
circulate around the body,
causes of hypoxia. These are:
falling blood pressure, or
o External causes
oxygen is not absorbed by the
o There is not enough oxygen in
blood, caused by:
the air surrounding the casualty,
o 1. Heart attack.
such as:
o 2. Cardiac arrest.
o 1. Suffocation by smoke or gas.
o 3. Angina.
o 2. Drowning.
o 4. Severe bleeding.
o 3. Suffocation by earth, sand or
o 5. Poisoning.
a pillow/cushion, etc.
o 6. Anaemia.
o 4. High altitude (lower oxygen
o Control centre causes
levels)
o The respiratory control centre in
o Airway causes
the brain, or the nerves

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 connecting it to the lungs, fails, o 2. Try to remove or treat the
caused by: cause of hypoxia (stop bleeds,
o 1. Stroke. open windows to clear smoke or
o 2. Head injury gas, etc.).
Drug overdose. o 3. Do not allow the casualty to
o 1. Poisoning. eat, drink or smoke.
o 2. Spinal injury. o How the body responds to
o 3. Electric shock. hypoxia
o Signs and symptoms of hypoxia o Adrenalin is released if the body
o 1. Skin appears pale and feels detects that there are low levels
clammy to the touch. For dark of oxygen in the blood. The
skinned casualties, check the effect this has on a body is:
skin inside the lips and eyelids. o 1. Increases the heart rate.
o 2. A bluish tinge to the o 2. Increases the strength of the
casualty’s skin and lips heartbeat, and therefore blood
(cyanosis). pressure.
o 3. Increased pulse. o 3. Diverts blood away from the
o 4. Weakening pulse. skin, stomach and intestines.
o 5. Nausea or vomiting. o 4. Diverts the blood towards the
o 6. An increase to the casualty’s brain, heart and lungs.
breathing rate (caused by lack o 5. Dilates the air passages
of oxygen). (bronchioles) in the lungs.
o 7. A decrease to the casualty’s o Adrenaline being released into
breathing rate (check for control the body has a dramatic effect
centre causes). on the signs and that it is vital
o 8. Distressed breathing, or you as the first aider recognise.
gasping. o The respiratory system
o 9. Confused or dizzy. o Air is taken in through the nose
o 10. Decreasing levels of and mouth where it is warmed,
consciousness. filtered and moistened. It then
o 11. Look for clues from the travels through the throat and
cause of the hypoxia (bleeding, past the epiglottis (the flap of
injury, chest pain, etc.). skin at the back of the throat
o Treatment of hypoxia that closes over the airway
o 1. Clear the airway and maintain when we swallow), where it
breathing. enters the larynx (the voice box

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 or ‘Adam’s apple’). It then allows the chest walls to move
continues between the vocal without [Link] ribs curl around
cords in the larynx and on into from the spine, connecting to the
the trachea (windpipe). The sternum (breast bone),and protects
trachea is protected by cartilage the thoracic cavity.
rings that surround it and stop it
from kinking.
o The trachea then splits into two
‘bronchi’, each supplying oxygen 
to a lung. The bronchi are 
divided into ‘bronchioles’, or
smaller air passages. Right at
the end of the bronchioles are
‘alveoli’, microscopic air sacks.
The walls of the alveoli are one
cell thick, which allows oxygen
to pass through them and into
the blood, which is carried in
capillaries around the alveoli.
The waste gas from our body is
carbon dioxide, which passes
from the blood through the
alveoli and is breathed out.
o The ‘thoracic cavity’ is in the
chest, and is where the trachea,
bronchi and lungs are all
situated. To enable us to draw
air into the thoracic cavity, the
diaphragm flattens and the
chest walls expand, which
increases the size of the
thoracic cavity creating a void
which draws in air.
Each lung is encased in a two layered
membrane known as the ‘pleura’.
Between these two layers is a thin
layer of fluid called ‘serous fluid’. This
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