Unit 2

First Aid and Health First Aid for the Systems

of Human Body

Prof. Sanjay Saxena

SMS Varanasi
Unit 2: First Aid for the Systems of Human Body

Unit 2
First Aid for the Systems of Human Body
G. First Aid Related to Nervous System and Unconsciousness

The human nervous system is broadly categorized into the central and peripheral
nervous systems. The central nervous system consists of the brain and spinal cord
and the peripheral nervous system consists of ganglion and nerves.
The Brain
The brain is an extremely delicate structure made up of a mass of nerve cells known
as neurons. It is here, that sensations are analyzed, and orders are given to the
muscles. The brain is encased in the skull and suspended in a clear fluid, called the
cerebrospinal fluid (CSF), which acts as a partial shock absorber.
The brain has three main structures:
• The cerebrum, which is concerned with thought, sensation, and conscious
movement.
• The cerebellum, which coordinates movement, balance, and posture.
• The brain stem, which controls basic functions such as breathing.
The Spinal Cord
The spinal cord is a mass of nerve fibers extending from the brain through an opening
in the base of the skull. The cord runs through the spinal column. The main function

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of the spinal cord is to convey signals between the brain and the peripheral nervous
system.
The Somatic Nervous System
The somatic system is the part of the peripheral nervous system that is responsible
for carrying motor and sensory information both to and from the central nervous
system. This system is made up of nerves that connect to the skin, sensory organs,
and all skeletal muscles. The system is responsible for nearly all voluntary muscle
movements as well as for processing sensory information that arrives via external
stimuli including hearing, touch, and sight.
The Autonomic Nervous System
The autonomic nervous system is the part of the peripheral nervous system that
regulates key involuntary functions of the body. This system is not controlled by the
will and acts continuously whether a person is awake or asleep. It controls different
body functions including the activity of the heart muscle; the smooth muscles,
including the muscles of the intestinal tract; and the glands. The autonomic nervous
system has two divisions: the sympathetic nervous system, which accelerates the
heart rate, constricts blood vessels, and raises blood pressure, and the
parasympathetic nervous system, which slows the heart rate, increases intestinal and
gland activity, and relaxes sphincter muscles.
Unconsciousness
Unconsciousness is a state in which the casualty becomes insensible to commands
because of an interruption to the normal functioning of the brain. In an unconscious
state, the person will be unresponsive to your activities (touching, sounds, or other
stimulation). Loss of consciousness causes the muscles to relax. During the period of
unconsciousness, the tongue might fall backward and block the breathing passage.
Check the following:
Whether the person opens his eyes and responds to simple questions:
• What is your name?
• Where do you live?
• How old are you?
• Whether the person responds to simple commands such as Squeeze my hand, or
move your arm/leg/foot/hand.

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• If there is no response, pinch the person and see if he opens his eyes or moves.
What to do?
• Call for help
• Check if the casualty is breathing
• Try to feel their pulse
• If a casualty is unconscious and not breathing start CPR
• Cover them with a warm blanket if the temperature is too cold
• Place an ice pack on them if the temperature is too hot
• Do not place anything in their mouth
• Do not administer medication
• Do not move their neck or back—this can cause permanent paralysis if the spine
is injured
Head Injury
A head injury is any sort of injury to the brain, skull, or scalp. This can range from a
mild bump or bruise to a traumatic brain injury.
Types of Head Injuries
Concussion: This is a jarring injury to your brain. Most of the time, people remain
conscious. They may feel dazed and lose balance for a brief time.
Brain Contusion: This is a bruise of your brain. Minor bleeding in your brain causes
swelling.
Skull Fracture: This is a crack in the skull. Sometimes, the broken skull bones can
cut into the brain.
Hematoma: This is bleeding in your brain that collects and clots, forming a bump. A
hematoma may not appear for a day or as long as several weeks.
Causes of Head Injury:
• Falls (most common cause)
• Exercising and sports-related accidents
• Physical assaults
• Traffic accidents

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What to do in the cases of head injuries?

The treatment for head injuries depends on the injury severity. Most often, mild
injuries do not require treatment. However, you should know the signs and symptoms
that require medical attention.
• If the head injury is severe, call the ambulance immediately.
• If the injured person is bleeding, try to stop the bleeding by using gauze, or a clean
cloth.
• If the wound is open, do not touch or apply pressure on it. Cover or wrap the
wound with a clean piece of gauze (bandage) instead.
• If the person is vomiting while sitting, help them to lean forward. If the person is
vomiting while lying down, roll their body to the side to prevent choking.
• If the person is awake, instruct them not to move their head and neck. This can
help prevent further damage to their spine and brain.
• If the person is unconscious and breathing, try to stabilize their body. This includes
keeping their neck and head in line with their spine.
• If the person is unconscious and not breathing, begin the process of CPR
Stroke
‘Stroke’ is a rapid loss of brain function due to a disturbance in the blood supply to the
brain. It can be the result of bleeding or when a blood clot leads to a blockage in a
blood vessel to the brain, blocking the blood flow. As a result, the affected brain part
can’t function normally and this might result in difficulty in moving, speaking,
understanding, etc. Symptoms occur suddenly and depend on the area of the brain
affected. Strokes occur commonly in later life and in patients that suffer from high
blood pressure or other circulatory disorder.
Signs of Stroke
To check for warning signs of a stroke, use the FAST acronym, which stands for:
Face: Is the face numb or does it droop on one side?
Arms: Is one arm numb or weaker than the other? Does one arm stay lower than the
other when trying to raise both arms?
Speech: Is speech slurred or garbled?
Time: If you answered yes to any of the above, it’s time to call emergency services
immediately.

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What to do in the case of stroke?

• Call emergency services.
• Make sure they’re in a safe, comfortable position. Preferably, this should be lying
on one side with their head slightly raised and supported in case they vomit.
• Check to see if a casualty is conscious and breathing.
• Talk in a calm, reassuring manner.
• Cover them with a blanket to keep them warm.
• Don’t give them anything to eat or drink.
• If the person is showing any weakness in a limb, avoid moving them.
• If an injured person is unconscious and not breathing, perform CPR.
Fits-Convulsions-Seizures
A person has a fit (a seizure or convulsions) if he suddenly shakes uncontrollably. It
is different from normal shivering and trembling. It may manifest in all limbs or just
be limited to a single limb. The person having the fit may urinate and defecate without
control. A fit can be caused by high fever, diseases (e.g., malaria, epilepsy…),
poisoning (e.g. alcohol, drugs…), or trauma (e.g. brain injury).
Epilepsy
Epilepsy is a central nervous system disorder (neurological disorder) in which nerve
cell activity in the brain becomes disrupted, causing seizures or periods of unusual
behavior, sensations, and sometimes loss of consciousness. Epilepsy is usually a
disease of the young. In the beginning, the frequency of convulsions is usually less,
but they become more and more frequent later.
How to Identify Fits, Convulsions, and Seizures?
You may observe the following signs and symptoms:
• Sudden uncontrollable shaking
• Falling on the floor
• Loss of consciousness
• Foaming at the mouth, or
The person might have earlier mentioned that he smelled, felt, tasted, heard or saw
things differently.
If the fit is due to high temperature (fever):
• The skin might then feel hot and look reddish.

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What do I do?
• Remove objects that could hurt the person.
• Do not hold the person down (do not restrain the person).
• If possible, put something soft (cushion, clothing) under the head if the person is
lying
• on the floor.
• Make sure the person can breathe freely by loosening tight clothing around the
• neck (collar, tie).
• Do not put anything into the person’s mouth.
• Do not put your fingers in the person’s mouth.
H. First Aid Related to Gastrointestinal Tract
The gastrointestinal system includes the mouth, pharynx (throat), esophagus,
stomach, small intestine, large intestine, rectum, and anus. It also includes the salivary
glands, liver, gallbladder, and pancreas, which make digestive juices and enzymes that
help the body digest food and liquids.
GI Tract
As food moves through your GI tract, your digestive organs break the food into smaller
parts using:
• motion, such as chewing, squeezing, and
• mixing digestive juices, such as stomach acid, bile, and enzymes
Mouth: The digestive process starts in the mouth when we chew. The salivary glands
make saliva, a digestive juice, which moistens food, so it moves more easily through
the esophagus into the stomach. Saliva also has an enzyme that begins to break down
starches in the food.
Esophagus: After we swallow, peristalsis pushes the food down the esophagus into
the stomach.
Stomach: Glands in the stomach lining make stomach acid and enzymes that break
down food. Muscles of the stomach mix the food with these digestive juices.
Pancreas: Pancreas makes a digestive juice that has enzymes that break down
carbohydrates, fats, and proteins. The pancreas delivers the digestive juice to the
small intestine through small tubes called ducts.

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Liver. The liver makes a digestive juice called bile that helps digest fats and some
vitamins. Bile ducts carry bile from the liver to the gallbladder for storage, or to the
small intestine for use.
Gallbladder: The gallbladder stores bile between meals. When we eat, the
gallbladder squeezes bile through the bile ducts into the small intestine.
Small intestine. The small intestine makes digestive juice, which mixes with bile and
pancreatic juice to complete the breakdown of proteins, carbohydrates, and fats.
Bacteria in your small intestine make some of the enzymes to digest carbohydrates.
The small intestine moves water from the bloodstream into the GI tract to help break
down food. Your small intestine also absorbs water with other nutrients.
Large intestine: The large intestine is a highly specialized organ that is responsible
for processing waste so that emptying the bowels is easy and convenient.
Rectum: The rectum is an 18 to 20 cm (app. 8-inch) chamber that connects the colon
to the anus. It is the rectum's job to receive stool from the colon, to let the person
know that there is stool to be evacuated and to hold the stool until evacuation
happens.
Anus: The anus is the last part of the digestive tract, from where the stool is
evacuated.
Diarrhea
Diarrhea is the passage of three or more loose or liquid stools per day, or more
frequently than is normal for the individual. It is usually a symptom of gastrointestinal
infection, which can be caused by a variety of bacterial, viral, and parasitic organisms.
Diarrhea causes dehydration as too much water and nutrition leave the body. If the
sick person does not receive help, he can die. Babies and children are most at risk of
dehydration.
It may cause due to:
• Drinking contaminated water
• Eating rotten food, and
• Using dirty hands to eating food
First Aid for Diarrhea
• Rehydrate a sick person by making him drink plenty of fluids including ORS (Oral
Rehydration Solution).

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• Avoid giving caffeinated, alcoholic, carbonated, and hot drinks. It will make the
condition worse.
• Give probiotics to eat. Probiotics are microorganisms that can benefit the digestive
system. They can support the workings of the gut and help fight off infection. Curd
is a rich source of probiotics.
Food Poisoning
Food poisoning occurs when we consume foods or drinks that are contaminated with
viruses, bacteria, parasites, or toxins, which are poisonous substances.
Symptoms
Diarrhea, vomiting, fever, headaches, stomach cramps, and dehydration, could be the
major symptoms of food poisoning.
First Aid with Food Poisoning
• Rehydrate a sick person by making him drink plenty of fluids including ORS (Oral
Rehydration Solution).
• Give a glass of warm water with added few drops of lemon juice, and a pinch of
sugar and salt.
• Give a tablespoon of honey with a few drops of ginger juice to reduce inflammation
and pain.
• If the situation deteriorates, take a sick person to the nearest hospital.
I. First Aid Related to Skin, Burn
Skin is the largest organ in our body, made up of several different components
including water, protein, lipids, and different minerals and chemicals. Throughout life
the skin changes and regenerates itself approximately every 27 days.
The skin consists of three layers: epidermis, dermis, and hypodermis.
The Outer Layer: Epidermis
It’s the thinnest layer, but it’s responsible for protecting you from the harsh
environment, with five layers of its own.
The Middle Layer: Dermis
The dermis is a complex combination of blood vessels, hair follicles, and sebaceous
(oil) glands. Here, you’ll find collagen and elastin, two proteins offering the skin’s
support and elasticity. Fibroblasts are the cells that synthesize collagen and elastin.

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This layer also contains pain and touch receptors. It is this layer that is responsible for
wrinkles.
The Fatty Layer: Hypodermis
This layer is also known as the subcutis. It hosts sweat glands, and fat and collagen
cells, and is responsible for conserving your body’s heat and protecting your vital inner
organs.
Skin Functions
The main functions of the skin are protection, sensation, temperature regulation,
immunity, allowing movement and growth, excretion and synthesis of vitamins.
Burn Wounds
Burns are injuries to the skin and underlying tissue that result from the sun, heat
sources, fire, hot items, boiling liquids, chemicals, irradiation, etc. However, cold can
also create burn wounds. Burns are classified by the degree of skin and underlying
tissues that are damaged. You will observe different signs and symptoms according
to the severity of the burn wound.
Types of Burns by Origin
Burns can be differentiated by their origin:
Dry Burns
Dry burns are burns from flames, contact with hot objects (e.g., hot cigarettes, hot
domestic appliances), or friction (e.g., rope burns).
Scalds
Scalds are burns that take place due to steam or hot liquids (e.g., tea, coffee, hot fat).
Electrical Burns
Electrical burns are burns caused by electrical current. These burns can result from
low voltage current (e.g., home appliances) or high voltage current (e.g.,
transformers), or lightning strikes.
Chemical Burns
Exposure to chemical substances like industrial chemicals, corrosive gases, or inhaled
chemical fumes can cause chemical burns. Also, exposure to domestic chemicals and
agents such as paint stripper, caustic soda, weed killers, bleach, oven cleaners, or
strong acids or alkali can cause burns.

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Radiation Burns
Exposure to radioactive sources, e.g., X-rays or radiotherapy-rays, can result in
radiation burns.
Frost Bites (Cold Burns)
Cold burns like frostbites, originate from exposure to cold wind, cold temperature, or
contact with cold freezing materials (e.g., cold metal), or can happen from contact
with freezing vapors (e.g., liquid oxygen or liquid nitrogen).
What to do in the case of frostbite?
• If possible, move the victim to a warmer place.
• It is best that the person avoids walking on frostbitten toes and feet as this can
cause further damage, although in emergency situations this may not always be
possible.
• Replace wet clothing with soft, dry clothing to stop further heat loss.
• Gently remove gloves, rings, and other constrictions, such as boots.
• The affected areas need to be re-warmed.
• Do not rub the affected area as this can damage the skin and other tissues and do
more harm than benefit.
• Do not allow the person to smoke as this can affect blood circulation.
• After the frostbitten area has been thawed, it should be wrapped very gently in
clean bandages, with the fingers and toes separated. It is very important to keep
the skin clean to avoid infection.
Sun Burns
Intensive exposure to sunlight and over-exposure to ultraviolet light (UV) from a
sunlamp or the sun results in sunburns. Long exposure to heat or hot weather can
also lead to heat exhaustion and heatstroke.
First Degree Burns
These burns usually extend only into the epidermis and superficial. Superficial first-
degree burns show the following signs and symptoms:
• Red or darker than usual skin
• Slightly swollen skin
• Painful, but mostly bearable.

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Second Degree Burns

These burns usually involve the epidermis and the dermis. Intermediate second-
degree burns show the following signs and symptoms:
• Blistering
• Swelling
• Very painful
Third Degree Burns
Deep third-degree burns show the following signs and symptoms
• Black, parchment-like, or white-looking burn wound
• Mostly dry
• No pain inside the third-degree area, but very painful in the surrounding second
and first-degree burned parts of the skin.
First Aid with Skin Burns
For All Burns
• Stop burning immediately by putting out a fire or stop the person's contact with
hot liquid, steam, or other material. Help the person "stop, drop, and roll" to
smother flames. Remove smoldering material from the person. Remove hot or
burned clothing. If clothing sticks to the skin, cut or tear around it.
• Remove constrictive clothing immediately by taking off jewelry, belts, and tight
clothing. Burns can swell quickly.
Then take the following steps:
For First-Degree Burns (Affecting Top Layer of Skin)
• Cool burn by holding the burned skin under cool (not cold) running water or
immerse in cool water until the pain subsides.
• Use compresses if running water isn't available.
• Protect burns by covering them with a sterile, non-adhesive bandage or clean cloth.
• Do not apply butter, oil, lotions, or creams (especially if they contain fragrance).
• Apply a petroleum-based ointment two to three times per day.
• Treat pain by giving over-the-counter pain relievers such as acetaminophen
(Panadol, Tylenol), ibuprofen (Advil, Motrin, Nuprin), or naproxen (Aleve,
Naprosyn).

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For Second-Degree Burns (Affecting Top 2 Layers of Skin)

• Cool burn by immersing it in cool water for 10 or 15 minutes.
• Use compresses if running water isn't available.
• Don't apply ice. It can lower body temperature and cause further pain and damage.
• Don't break blisters or apply butter or ointments, which can cause infection.
• Protect burn by covering loosely with a sterile, non-stick bandage and secure in
place with gauze or tape.
Unless the person has a head, neck, or leg injury, or it would cause discomfort:
• Lay the person flat
• Elevate feet about 12 inches
• Elevate burn area above heart level, if possible
• Call for the ambulance to take the casualty to the nearest hospital
For Third-Degree Burns
• Call for the ambulance to take the casualty to the nearest hospital
• Protect the burn area by covering loosely with a sterile, non-stick bandage or, for
large areas, a sheet or other material that won't leave lint in the wound.
• Separate burned toes and fingers with dry, sterile dressings.
• Do not soak the burn in water or apply ointments or butter, which can cause
infection.
Unless the person has a head, neck, or leg injury or it would cause discomfort:
• Lay the person flat
• Elevate feet about 12 inches
• Elevate burn area above heart level, if possible.
• For an airway burn, do not place a pillow under the person's head when the person
is lying down. This can close the airway.
• Have a person with a facial burn sit up.
• Check pulse and breathing to monitor for shock until emergency help arrives.
Heat Exhaustion
Heat exhaustion is a milder form of heat-related illness that can develop after
prolonged exposure to high temperatures and inadequate or imbalanced replacement
of fluids. Those most prone to heat exhaustion are elderly people, people with high
blood pressure, and people working or exercising in a hot environment.

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What to do in case of heat exhaustion?

• Help the casualty move to a cool place.
• Help the casualty to lie down with the legs slightly raised.
• Cool the casualty by sponging him or having him take a cool shower.
• Ask the casualty to drink plenty of water
Heat Stroke
Heatstroke is a form of hyperthermia, an abnormally elevated body temperature with
accompanying physical and neurological symptoms. Heatstroke is a true medical
emergency that can be fatal if not properly and promptly treated. Normally the body
dissipates the heat with the help of sweat glands. In some cases, the body may not
be able to dissipate the heat by sweating and the body temperature rises, sometimes
up to 41.1 C (106 F) or higher. Or a dehydrated person may not be able to sweat fast
enough to dissipate heat, which causes the body temperature to rise. The heat
regulation mechanism fails during heatstroke.
What to do in the case of heatstroke?
• Help the casualty move to a cool place.
• Check the casualty’s breathing and consciousness.
• Help the casualty to lie down with the legs slightly raised.
• Cool the casualty by sponging him or showering him with cool water.
• Make the casualty to rest.
• It the casualty is conscious, ask the casualty to drink water
Prevention of burn
Burn injuries can be caused by cooking accidents, house fires, electrical faults, candles,
incense, or children accessing fire or heat sources.
Following are some preventions:
• Do not leave children alone near heat sources, hot water, or open fires.
• Hot drinks and liquids should be kept out of reach of young children.
• Ensure that gas cylinders do not leak.
• Switch off the gas supply after the work is over.
• Avoid wearing clothing that could easily catch fire whilst cooking.
• Do not overload the electricity sockets.
• Use correct wiring.

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• Do not leave burning candles unattended.

• Ensure they are in sturdy metal, glass, or ceramic holder. Place them where they
cannot be knocked down
• Do not burn candles near flammable materials (like curtains)
• Never sleep with a kerosene lamp near the bed
• Never smoke in bed.
• Never store flammable products in the proximity of a heat source.
• Store chemical, flammable, or corrosive products safely out of the reach of
children.
• Do not stay too long in direct sunlight
• Drink water and liquids frequently, especially in hot weather
• Protect head, face, hands, and feet when in cold weather or cold wind
• Do not block (fire) exits
Fever
A fever is a temporary increase in body temperature. Fever can be a sign of serious
illness. The normal body temperature is around 37 °C (98.6 °F). Fever is generally
agreed to be present if the temperature is above 37.7 °C (100 °F).
• Ask the person to rest
• Keep the person in a cool environment
• Give the person lots of water to drink to prevent dehydration
• Breastfeded babies should be breastfed more frequently than usual
• Bottle-fed babies should be bottle-fed normally and should be given extra
rehydration drinks as a supplement
• Contact the local healthcare worker as soon as possible so the cause of the fever
can be investigated
• Use water at room temperature to sponge the sick person unless he does not like
it and starts shivering. Do not use cold water.
• If the person with fever is suffering, he may benefit from paracetamol. Give the
person the appropriate dose of anti-fever medication. These medications might
bring temporary relief, but do not treat the cause of the illness.

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Hypothermia
Hypothermia occurs when a person's body temperature drops below 35 °C (95 °F)
(the normal body temperature is around 37 °C (98.6 °F)). Hypothermia can quickly
become life-threatening and should be treated as a medical emergency. It's usually
caused by being in a cold environment and can be triggered by a combination of
factors, such as being outdoors in cold conditions for a long time, living in a poorly
heated house, or falling into cold water.
What to do in the case of hypothermia?
• Gently move the person out of the cold
• Gently remove wet clothing. Replace wet things with warm, dry coats or blankets
• If further warming is needed, do so gradually. For example, apply warm, dry
compresses to the center of the body — neck, chest, and groin
• Offer the person warm, sweet, non-alcoholic drinks slowly in sips
• Do not apply direct heat. Do not rewarm the person too quickly, such as with a
heating lamp or hot bath.
• Don't attempt to warm the arms and legs
• Don't give the person alcohol or cigarettes
J. First Aid Related to Poisoning
Poisoning is injury or death due to swallowing, inhaling, touching, or injecting various
drugs, chemicals, venoms, or gases.
Poisoning by Swallowing
Poisoning from swallowing is often caused by household products, an overdose of
medication, or toxic plants. The effects of poisoning depend on what poison has been
swallowed.
• Acids, alkalis, disinfectants, etc. swallowed burn the lips, tongue, throat,
esophagus, and stomach and cause great pain.
• Other swallowed poisons cause vomiting, pain abdomen, and later on diarrhea
(e.g., poisonous fungi, berries, metallic poisons).
• Some swallowed poisons affect the nervous system. To this group belong alcoholic
drinks (methylated spirit, wine, whisky, etc.) when taken in large quantities, and
sleeping pills, tranquilizers, and painkillers when taken in overdoses.

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Poisoning by Gases
Fumes or gases from charcoal stoves, household gas, motor exhausts, and smoke
from explosions, etc., cause choking (asphyxia) which may result in unconsciousness
in addition to difficulty in breathing.
Poisoning by Injection
Poisons get into the body through injection, bites from poisonous snakes and rabid
dogs, or stings by scorpions and poisonous insects.
Poisoning by Skin Absorption
Hazardous chemicals that are spilled on the skin can cause irritation or burns. Certain
substances can be also absorbed through the skin and cause damage inside the body.
First Aid for Poisoning
• If possible, try to find out what poison has been swallowed, injected, inhaled or
has come into contact with his skin.
• If it is safe, keep the container of the poison to show to the doctor.
• Avoid contact with the poison.
• Do not give the person anything to drink or eat.
• Do not give milk or water to a poisoned person.
• Do not induce vomiting.
• Transport the person urgently to the nearest healthcare facility or hospital.
K. First Aid Related to Bites and Sting
Any bite of an animal (or human) that breaks the skin needs special attention because
it carries a high risk of infection. Many animals including dogs, cats, monkeys, foxes,
bats, cows, horses, or jackals may carry the germ of rabies. Rabies is a viral infection
that targets the brain and nervous system. A person can catch rabies when bitten or
scratched by an infected animal. If not treated urgently, the disease is lethal. All
victims of dog (cat, monkey, jackals, etc.) bites or scratches need to be referred
immediately for further treatment and follow-up.
First Aid for Animal Bites
• Put on gloves if available. If not, you can also use a clean plastic bag.
• Try not to come in contact with the injured person's blood or wound.

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• Flush the wound immediately with lots of clean water and then wash the wound
with soap and water or a detergent for 10-15 minutes, if available to remove the
rabies virus from the wound.
• Wash with povidone-iodine (Alopim, Betadine, Clopo, Wokadine, a.o.) if available.
• Washing is also necessary when a person is licked, scratched, or has an abrasion.
• If the person is severely bleeding, stop the bleeding by applying pressure to the
wound.
• Do not cut the wound larger.
• Do not put herbs or unclean materials like chilies, oil, or petrol in or on the wound
• Cover the wound with a dry clean cloth or bandage
• Refer the person to a healthcare facility immediately for further treatment.
Snake Bites
There are more than 2500 different kinds of snakes. The effects of snake bites vary
according to the type of snake. Note that not all snakes are poisonous, and not all
poisonous ones are lethal, but one should always be careful handling snakes. All snake
bites should be treated as if they are poisonous bites.
First Aid for Snake Bite
• Help the injured person to lie down and tell him not to move. Offer comfort and
keep the person calm, but do not forcibly restrain him.
• Try not to come in contact with the person's blood
• Do not suck or cut the venom out of the skin
• Do not rub herbs on the bite
• Do not apply a tourniquet
• Try not to move the injured limb and eventually apply a splint to immobilize the
affected part
• Cover the wound with a clean cotton cloth or bandage
• Arrange urgent transport to the nearest healthcare facility or hospital.
Insects Stings and Bites
Most insect bites and stings cause small reactions that are confined to the area of the
bite or sting (local reaction). They can usually be treated at home.
What to do?
• Ask the person to keep calm.

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• Removing the sting of bees (wasps and hornets don’t usually leave their sting
behind) as quickly as possible can help to keep the bite smaller.
• Wash the sting or bite site and wipe away any venom.
• Do not suck or cut the venom out of the skin.
• Do not rub herbs on the bite.
• Use ice, if you have it, to cool the bite or sting.
• Wrap the ice in a cloth or a towel so that it does not touch the skin directly.
• If you do not have ice, use cold water.
• Do not cool for more than 20 minutes at a time.
Ticks
• Remove ticks using fine tweezers (not with fingers) and grab the tick as close to
the skin as possible. Pull it firmly up until the tick’s mouthparts have been removed.
• Do not use petroleum jelly, alcohol, a lit match or cigarette, or any other method
to try to remove a tick.
Leech
• Slide a fingernail, the edge of a bank card, or whatever thin sturdy material you
have at hand, under the suckermouth (the smaller head of the leech) of the leech
and flick it off right away. Do not squeeze the leech.
• Do not put salt on the leech or burn it, as this will make the leech vomit back into
the wound before it falls off.
• Leech bites tend to bleed for a long time, apply a small bandage and change it
regularly.
L. First Aid Related to Sense Organs
The human body exchanges information with its environment via five senses:
• Sight (the eyes)
• Hearing (the ears)
• Smelling (the nose)
• Tasting (the tongue and nose)
• Touching (the skin)

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Eye
The eyeballs are covered with folds of skin (the eyelids) from which the eyelashes
project. The outermost parts of the eyes are covered by a smooth membrane
(conjunctiva) and are kept moist by tears produced by the tear glands.
Foreign Body in the Eye
Wings of insects, dust, coal, metal particles from lathes, and loose eyelashes are
Common objects which get lodged under the eyelids. They cause pain and later
redness if they are not removed at once.
Sometimes iron particles and wood splinters get lodged in the cornea causing severe
trouble. All penetrating foreign bodies are a danger to the eye itself.
First Aid for Eye
• Ask the casualty not to rub into the eye
• Ask the casualty to sit. Pull the lower lid down to inspect
• Rinse the eye immediately with plenty of water for 10-15 minutes, preferably from
the nose outwards. Use clean water or water that has been boiled and cooled.
Be careful:
• Water at room temperature is more comfortable than cold water
• Very warm water might burn the eye
• Make sure no liquid or rinsing water runs into the other eye
• If washing of eyes did not work, you may try to remove the foreign object with a
narrow moist swab or a twisted corner of a clean handkerchief
• If something is sticking to or embedded in the eye, the eyeball or pupil, do not try
to remove it
• Cover the eye and transport the casualty to the nearest healthcare facility for
further care
• Do not put medication into the eye
Ear
The ear consists of three parts:
• The outer ear is that part that can be seen projecting from the side of the skull,
together with the canal which leads to the eardrum.
• The middle ear, situated inside the skull, receives, and transmits sound waves
concerned in hearing to the inner ear.

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• The inner ear is embedded inside the skull and is concerned with the sense of
balance in addition to the sense of hearing.
Sometimes foreign objects become lodged in the ear. The object might even damage
the drum.
What to do?
• Never try to get lodged objects out of the ear and always refer the person to a
healthcare facility for further treatment.
• In the case of an insect, you may fill the ear with tepid clean water so the insect
can float out.
• If it does not come out refer the person to a healthcare facility for further
treatment.
Tongue
The tongue is the muscular organ that lies on the floor of the mouth; it assists in
tasting, mastication, and swallowing food. In an unconscious casualty, the tongue
tends to obstruct by falling back in the throat, which prevents breathing.
Nose
The nose is an organ of smell and functions as part of the body's respiratory system.
Air enters the body through the nose. As it passes over the specialized cells of the
olfactory system, the brain recognizes and identifies smells. Hairs in the nose clean
the air of foreign particles. As air moves through the nasal passages, it is warmed and
humidified before it goes into the lungs.
Children sometimes push objects into their noses. These objects may get stuck and
may damage the nose tissue.
What to do?
• Do not put something into the nose
• Do not fiddle with the foreign body
• Make casualty breathe through the mouth
• Transport the casualty to a healthcare facility for further treatment
Skin
The pain and touch receptors in the skin allow us to feel touch, pressure, heat, cold,
and pain. Glass, thorns, pieces of iron, wood or stone, needles, etc. may get stuck

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under the skin. Unless it is very easy to deal with (e.g., a wood splinter), do not fiddle
with objects stuck under the skin.
Treat the wound as described in section ‘Bleeding’, dress the wound, and refer the
casualty to a healthcare facility for further treatment.
Swallowed Foreign Objects
Small objects such as coins and buttons may be swallowed by children. Most objects
will follow the digestive track without issues. But they can also lead to choking. In
case the person is choking, treat as described in the section on ‘Choking’.
In case a small harmless object has been swallowed, the object will follow the normal
track and be expelled via the feces. In case of even small doubt, contact a healthcare
facility.
In case of dangerous objects (batteries, cigarette stubs, cosmetics, medication,
poisonous plants, poisonous berries, or fruits …), sharp objects, or when the person
complains of pain, or stomachache, always refer to the casualty to the nearest
healthcare facility.
M. Specific Emergency Situations and Disaster Management
M.1. Emergencies at School
Children are highly vulnerable to injuries and accidents. Sometimes the child may incur
a severe accident resulting in fracture, bleeding, suffocation, fainting, burns, drowning
or electric shock (etc.). Also, a school staff member may suffer a heart attack or a
respiratory disorder with which first aiders have to cope.
The procedure of attending an emergency always remains the same and includes the
following:
• Assess the situation.
• Safety first.
• Alert and seek help.
• Provide first-aid.
• Transport or refer to a healthcare facility, if needed.
• Hygiene.
The school management should ensure that:
• a well-equipped first aid room or station with the necessary materials is available.
• a trained first aider(s) is(are) available in the school or is on call.

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• In each class at least one child (preferably more) is trained in first aid.
Having trained first aiders available is a great asset to the school at the time of
emergency.
M.2. Emergencies at Work
A common injury in workshops and factories is a worker being stuck in or pinned down
under the machinery. This can result in twisted limbs, lacerations, severe bleeding,
and fractures, and may lead to shock.
In some cases, it is not possible to extricate or release the victim easily.
In all cases, the machinery should be stopped immediately, the power of the machine
cut off and a person who is familiar with handling the machine or a senior foreman
should be called to the scene.
The procedure of attending an emergency always remains the same and includes the
following:
• Assess the situation.
• Safety first.
• Alert and seek help.
• Provide first-aid.
• Transport or refer to a healthcare facility, if needed.
• Hygiene.
The workshop or factory management should ensure that:
• a well-equipped first aid room or station with the necessary materials is available
• a trained first aider(s) is (are) available in the workshop or factory, or is on call
• preferably some workers (or all) are trained in first aid; and
• all the workers should be sensitized about possible hazards and help available.
Having trained first aiders available at the workplace is a great asset to the workshop
or factory at the time of emergency.
M.3. Road and Traffic Accidents
On many occasions, the victims of roadside accidents remain lying on the spot without
medical aid or any help of the public until the arrival of police, which in many cases
may take time.
Rendering aid to the injured is the moral and civil duty of each one of us. To avoid the
harassment of a person helping the casualty on moral grounds, the Indian government

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has passed the law. Under that, the escorts should, under no circumstances be
detained in the hospital for interrogation. On the other hand, he should be treated
with courtesy.
The procedure of attending an emergency always remains the same and includes the
following:
• Assess the situation.
• Safety first.
• Alert and seek help.
• Provide first aid.
• Transport or refer to a healthcare facility, if needed.
• Hygiene.
M.4. Emergencies in Rural Areas
Medical facilities are often inadequately available, especially in the remote villages. It
is also difficult to transport the injured or sick persons due to difficult roads or the
non-availability of proper transport services.
In rural areas following specific types of injuries are frequent:
• Fall from a tree or fall off a branch onto a victim (people have the habit to sit or
• sleep under the shade of trees in the summer).
• Fall from walls or roofs. The roofs of houses in villages have usually no parapet
walls and children may fall from the roof.
• Collapsing of mud walls or roofs of houses onto people.
• Caving in of mud while digging and getting buried under the mud.
• Drowning in the village pond, well, or in canal water.
• Railway track accident (when walking on or crossing a railway line or when sitting
or hanging on a wagon).
• Bites of snakes, scorpions, leeches, dogs (rabies!), monkeys, tigers, jackal or
camels.
• Food poisoning.
• Poisoning by DDT or other insecticides, pesticides, and fertilizers.
• Cut from sharp agricultural equipment. (“thresher injuries”)
• Electrocution from electric wires, especially over-head high tension wires.
• Acute diarrhoeal diseases lead to dehydration (e.g., cholera).

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• Carbon Monoxide (CO) poisoning by sleeping in a room where sigri is kept burning
especially at night, when room is kept closed and there is no ventilation.
• Tetanus infection from wound etc.
Many of these problems can be handled by a trained first aider in the initial stage.
Having trained first aiders available is a great asset to the community at the time of
emergency.
M.5. Disasters and Multiple Casualty Accidents
India is such a vast country that some part is affected by flood, drought, cold,
heatwave, fire, earthquake, and vehicle or train accidents … at any given time. These
incidents can cause huge losses from collapsed buildings, and damaged, crops to a
large number of human casualties. Sometimes disasters strike suddenly. For smooth
working at a disaster or mass casualty accident site the first aiders need to:
• Have the appropriate knowledge and training in first aid and disaster management.
• Have the capability to think practically and be able to improvise, if required.
• Obtain the full particulars nature of the accident or disaster and the affected site.
• Coordinate with the appropriate governmental authorities.
• Coordinate with other local agencies, other institutions, or organizations.
• List the resources (transport capacity, available medical personnel, available first
responders and first aiders, stand by medical equipment, available medication
supplies, available equipment, disaster relief materials, etc.) he has at his disposal
and has an estimate of how fast he can mobilize these resources.
• Allot the priorities for treatment and transport of the casualties.
• Treat and transport the casualties to the assigned medical facilities.
Having trained first aiders available is a great asset at the time of disasters.
M.6. Emergency Triage
In medicine, emergency triage is the process of sorting patients in order of priority for
treatment and evacuation. Triage may take many different forms and operates at a
number of different levels. However, it aims to give the right patient the right care at
the right time in the right place.
The casualties are classified in different categories:

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Category → RED YELLOW GREEN BLACK

(U1 or I) (U2 or II) (U3 or III)
Urgency Extremely urgent. Fast treatment is Non-urgent Deceased.
needed. treatment.
Constantly follow
up of breathing
and circulation
required.
Injuries Life-threatening Severe. Not Localized injuries. Fatal injuries.
injuries. immediately life- Non-life-
threatening. threatening.
Condition Cardiac arrest. Relatively stable Walking No respiration.
Hypoxia. Shock. condition. wounded. No pulse. CPR
Life-threatening Bleeding is under unsuccessful.
bleeding. control.
Breathing.
Survival rate Low if no urgent Good when High. None.
medical timely medical
treatment. Better treatment is
if medical provided.
treatment is
available.
Transport Immediate Urgent transport Non-urgent Postmortem
transport when (after RED) when transport (after transport to
stabilized with stabilized under RED, YELLOW) morgue
medical team paramedic by ambulance or
escort in a observation in an any available
medically equipped transport (taxi,
equipped ambulance. car).
ambulance

There is a fifth category: the non-wounded (sometimes tagged ‘BLUE’). They are
victims of the incident but seem not to be injured.
N. Emergency Childbirth
Childbirth usually takes several hours. Although in exceptional cases a baby arrives
suddenly before it is possible to move the mother to hospital. It is rare for this to
happen with a mother’s first baby because the birth canal needs to undergo a great
deal of stretching and adaptation to allow the baby’s head to move down from the
womb.
Symptoms and signs – Not all may be present
• lower abdominal cramp-like pains at regular intervals
• an urge to push down when the baby is ready to be born
• a feeling of excitement mixed with anxiety

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How can you help?

• Assist the mother to lie down on a bed, or the floor, if delivery seems to be
imminent.
• Place a piece of plastic covered by old sheets or towels under the mother to protect
the bed or floor.
• Reassure the mother that help is coming and that you will stay with her.
• Call for midwife if she is available at a nearby place.
Childbirth complications
There are several problems that can occur during childbirth and very little that a first
aider can do except stay with the mother and keep her calm until an ambulance
arrives.
How can you help?
• Call for ambulance and shift mother to nearest hospital
• Keep the mother at rest and lying down.
• Reassure her but tell her to try to stop pushing with each contraction.
• Ask the mother to pant hard with each contraction to slow the baby’s progress
down the birth canal.
• Place some padding under her right hip and buttock to move the baby off her deep
veins and assist with the return of blood to her heart.

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References
1. Indian First Aid Manual
2. Red Cross First Aid/CPR/AED Instructor Manual
3. Alan Carr, (2012). Clinical Psychology: An Introduction, Routledge. 1st edition
4. https://www.medicalnewstoday.com/articles/
5. https://www.healthline.com/health/abc-first-aid
6. https://www.stjohn.org.nz/first-aid/first-aid-library/childbirth-and-miscarriage-in-
an-emergency
7. https://www.niddk.nih.gov/health-information/digestive-diseases
8. https://www.moh.gov.sa/en/HealthAwareness/EducationalContent/Firstaid/Pages
/008.aspx

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