ATLANTIC TRAINING INSTITUTION

FIRST AID TRAINING BY: Ms. Lea Ekandjo

EMERGENCY CARE PRACTITIONER (BLS)
FIRST AID INSTRUCTOR
BECOMING A FIRST AIDER
 SPECIFIC OUTCOME NO 1
MEDICO-LEGAL ASPECTS OF FIRST AID
 Rules and guidelines provided must be followed
to ensure that your actions stay within the law.
 THREE BASIC PRINCIPLES OF A FIRST
AIDER
 To preserve life,
 To prevent the patient condition from worsening
 To promote remotes
 SCOPE OF PRACTICE
- one is allowed to manage treatment according to
their trained level, if the scope of practice is
exceeded one can be held liable for their action.
DEFINITIONS

 Consent –permission granted to give care  Involuntary consent - Applies to patients who are
by the patient if they are conscious and mentally ill
they have a mental capacity, The right to refuse treatment
 In case the patient is under age the guardian
 Conscious, alert adults with decision-making
capacity:
can give consent.
 Have the right to refuse treatment
 Expressed consent-Patient gives verbal or  Can withdraw from treatment at any time
written consent or just a nod of the head,
allowing you to proceed with treatment
 Even if the result is death or serious injury
Before you leave a scene where a patient or caregiver
 Implied consent - When the patient is has refused care:
unconscious, the law protects you and gives  Encourage them again to allow care
you the right to proceed with treatment.
You are also protected when treating minors
 Ask them to sign a refusal of care form
who are not accompanied by their parents  Document all refusal
or family  A witness is valuable in these situations
Before you leave a scene where a patient
or caregiver has refused care
 Encourage them again to allow care
 Ask them to sign a refusal of care form
 Document all refusal
 A witness is valuable in these situation
CONTINUES……………….

 Confidentiality - You should always protect the Responsibility towards possessions

patient’s privacy.  Keep a written record of everything you remove
 Negligence - Failure to provide the same level of from the patient. Take it with you to the hospital
care that a person with similar training would and hand the possessions over to the hospital
provide staff or, if the patient is transported by
 Abandonment - When you have started treating a ambulance, the ambulance staff. Insist on
patient and then stop treatment, with the intention written receipt of the items.
of not carrying on. Another example would be Advanced directives
handing your patient over to someone below your
own level of qualification.  Advance directive specifies treatment should the
patient become unconscious or unable to make
Records and reports
decisions.
 It is important to compile a written report of every
patient you treat. Should the incident be taken to
 Do not resuscitate (DNR) order is an advance
court, you would then have documented directive that gives permission not to resuscitate.
information (and not only memory) of the incident  “Do not resuscitate” does not mean “do not treat
and your treatment.
SPECIFIC OUTOCME NO 2
EMS system and Communication
EMS System and the role of the First Communication and Radio Procedures
Aider in Namibia:
The following is important when contacting
 Quite often First Aiders will be first on the emergency medical services for help: 
the scene and the role of the Fist Aider is  State you name clearly
to identify the Emergency, ensure safety
measures in place and to call the  Give the telephone number from where
necessary emergency services and to you are calling in case you are
stabilize to the level of his/her scope of disconnected
proactive and training.  Give the exact location and or
landmarks in the area
 State the type of injuries or conditions,
e.g. unconscious and not breathing
Continues…….
A AlpAha N November

B Bravo O October

C Charlie P Papa
 Radio communications are an important
aspect of the Emergency Care Profession. D Delta Q Quebec

The transmission of accurate and concise E Echo R Romeo

information when receiving a call, or asking
for assistance is vital in ensuring that no F Foxtrot S Sierra

details are misinterpreted and forms an G Golf T Tango

integral part of the profession. .
H Hotel U Uniform
 
I India V Victor
 The phonetic alphabet tabulated below is
commonly used when the need arises to G Juliet W Whiskey

spell a word over the radio. It is very K Kilo X X-ray

effective in ensuring that words and
instructions are properly relayed. There are L Lima Y Yankee

different variations but the alphabet detailed M Mike Z Zulu

below is commonly used in South Africa.
Continues……..

 When using the alphabet, we spell the

word not by using the individual letters
but instead we use the phonetic. When
spelling the word patient, we would not
spell it as follows: P-A-T-I-E-N-T, the
correct way is PAPA - ALPHA - TANGO
- INDIA - ECHOE -NOVEMBER –
TANGO
SPEICIFIC OUTCOME NO 3:
Basic Anatomy and physiology: how the body
works
Anatomy is the study of the structure and
relationship between body parts. Physiology
is the study of the function of the body parts
and the body as a whole.
TERMS THAT RELATE TO THE
POSTION/POSTURE
 Knowing the terms will certainly help in
the field, and also earn respect with other
Paramedical or Medical staff.
Continues……

 Anterior - towards the front, the toes

are anterior to the ankle
 Posterior - towards the back of the
body or the structure
 Superior - towards he upper part of
the body (head)
 Inferior - towards the lower part of the
body (feet)
PATIENT POSITIONING
Continues……

Upper Extremities (Upper Limbs)

 Each upper extremity extends from the
shoulder to the finger tips and consists of
the shoulder, upper arm, forearm and
head.
 Lower Extremities (Lower Limbs)
 The lower extremities, which extend from
the tip to the toes, consist of the thigh, leg
and foot.
SYSTEMS OF THE HUMAN BODY AND
THEIR FUNCTIONS
1. Integumentary System (Skin) 3. Muscular System
 Protects underlying tissues  Moves body and maintains posture
 Provides skin sensation
 Internal transport of fluids (blood circulation)

 Help regulate body temperature

 Generation of heat 
4. Nervous System
 Synthesizes vitamin D
 Regulates and integrates body functions via neurons
   (sensory, relay and motor)
2. Skeletal System  Maintains homeostasis  
 Attachment for muscles 5. Cardiovascular System
 Protects vital/internal organs  Transport nutrients, respiratory gases, waste and heat
 Store Calcium and Phosphorus  Transports immune cells
 Produces blood cells  Regulates pH
  
 Transport hormones
Continues……

6. Respiratory System  Regulates blood pH

 Exchange respiratory gases with the  Regulates blood volume and blood pressure
environment (ventilation – in and out of the
lungs)
 Control levels of electrolytes and
metabolites
 Exchange respiratory gases in the alveoli
(respiration)   Eliminates waste from the body 
7. Digestive System 9. Reproductive System
 Physical and chemical breakdown of food  Produces and secrets hormones
 Absorbs, processes and store food substances  Produces and releases egg and sperm cells
 Eliminates waste from the body   Houses embryo/ fetus (female)
8. Urinary System (Excretory)  Produce milk to nourish offspring (female)
 Maintains constant internal environment
through the excretion of nitrogenous waste
SPECIFIC OUTCOME NO 4:
Patient Assessment: Primary and Secondary Survey

1.Primary survey AIRWAY - (open, maintain and protect

the airway)
 The purpose of the primary survey is to
recognize and treat life threatening injuries BREATHING - (look, listen and feel for
and conditions. The steps/sequence of the breathing)
primary survey is as follows:
CIRCULATION - (check for pulse-carotid,
 On approaching the scene, or any signs of life)
HAZARDS/SAFETY - (gloves, scene, POSITION - (place the patient in the
bystanders, patient) position of comfort)
CALL HELP - (get bystanders to assist you DON'T DELAY - (stop bleeding, serious
& activate Emergency Medical Services) bleeding must be controlled immediately)
HELLO - (level of consciousness of patient -
AVPU)
2.Secondary survey
The secondary survey is a systematic method of physical assessing and gathering information regarding the
patient's injuries and overall condition.

VITAL SIGNS - (pulse, breathing, temp, skin, Level of consciousness (LOC)

pupils)  You need to determine the patient's LOC by
HISTORY - (SAMPLE - From conscious patient assessing the AVPU scale.
or from family if unconscious) The AVPU scale
HEAD-TO-TOE - (thorough examination to  A -Alert (the patient responds to all commands and
identify all other injuries) is completely orientated)

DOCUMENTATION - (Record all findings and  V -Verbal (the patient only responds when spoken
treatment) to)
 P -Pain (the patient responds to pain stimulus, e.g.
TRANSPORT - (prepares for transport and hand
pinching the patient)
over to medical staff)
 U -Unresponsive (the patient does not respond at all
- patient is unconscious)  
 Vital signs must be checked on a regular basis The patient's positioning will be determined by the
to monitor the patient's improvement or nature or type of injury/illness and is crucial in
deterioration - at least every 5 minutes. ensuring that the primary survey remains intact.
Continues…….

 Medical illness: e.g. heart attack, stomach cramps, headaches, etc. The patient is placed in the
"recovery position".
 Trauma injury: e.g. stab wounds, bullet wounds, Motor Vehicle Accident (MVA) etc. Stabilize the
neck as found, at all times ensuring an open airway.
 Don't delay - stop bleeding (Profuse bleeding should be controlled immediately)
 Profuse bleeding is a serious, life threatening emergency and should be managed/treated during the
primary survey, immediately after the scene has been secured.
History taking

 The history that you get from the patient,  S - Signs and symptoms of the
bystanders or family will assist in patient
determining what is wrong with your  A - Allergies - Is the patient allergic to
patient and guide you in your treatment.
anything?
You or the bystanders may have been the
last person that the patient spoke to  M - Medications - is the patient taking
before collapsing. The following is any medication (e.g. diabetes or high BP)
important to remember and will help you  P - Past - past medical history, e.g. has
cover the history in detail: the patient had this problem before?
 L - Last oral intake - last time the
patient had something to eat or drink
 E - Events leading up to the incident
SPECIFIC OUTCOME NO 5
Respiratory Emergencies: Airway Obstruction,
Choking, Asthma
Respiratory Physiology
The primary function of the respiratory system is
to supply oxygen to the body. 
 Each cell in the body requires constant
supply of oxygen
 Brain cells may die after 4-6 minutes without
oxygen – dead cells can never be replaced
 Other cells are not as vitally dependent –
they can tolerate short periods without
oxygen and still survive
 Air that we breathe contains 21% oxygen
and 78% nitrogen – other gases make up the
1%
Continues……

 The respiratory system consists of the Mechanism of Breathing

structures of body that contribute to  Inhalation: The diaphragm and the intercostal
respiration or breathing e.g. muscle contract, the diaphragm moves down into
the abdomen cavity and enlarges the thoracic
 Nose, Mouth, Throat, Trachea cavity. When the intercostal muscle contract,
(windpipe), Lungs with Bronchus, they raise the ribs up and outward which also
Bronchi an Alveoli. enlarges the thoracic cavity. This causes a
negative pressure on the inside of the chest cavity
 The respiratory system is responsible for and the lungs are filled with air. Once the
the supply of oxygen to all body cells and pressure is equal to the outside pressure,
expelling carbon dioxide from the body. inhalation stops. This is an active process.
The diaphragm and intercostal muscle  Exhalation: The diaphragm and intercostal
support normal breathing. muscles then relax and the chest resumes its
normal size / position (smaller dimensions) and
forces "old" air out of the lungs, via the trachea,
mouth and nose
Continues…..

COMPLICATIONS OF ABSENT  DEFINTION OF AN AIRWAY

BREATHING OBSTRUCTION
 Brain damage occurs after 4 to 6 minutes  Any object or structure which impedes
if the patient is not breathing. the flow of air from the environment into
the upper air passage and lungs may
 Cardiac arrest (heart stops beating)
result in respiratory distress and may lead
follows shortly after breathing stops
to unconsciousness and ultimately death.
CAUSES OF BREATHING  CAUSES OF AIRWAY
EMERGENCIES
OBSTRUCTION
 Lack of oxygen in the air we breathe  In small children: beads, buttons,
 Injury or disease to the lungs/heart marbles, sweets, food or other foreign
objects may obstruct the airway
Continues……..

Adults: Food, dentures (false teeth), teeth, Unconscious patient signs and symptoms
blood clots, vomiting and secretions are often  No sign of breathing
the cause.
 Cyanosis-blue discoloration of the skin
Conscious patient signs and symptoms
(lips, tongue and eventually entire face)
 Grabs at throat - international distress  No air entry when you ventilate (chest
signal
does not rise)
 Cannot speak  Patient may go into cardiac arrest due to
 Tries to cough lack of oxygen to the brain, heart and
lungs
 Cyanosis (blue discoloration of the skin)
 Decreasing LOC
 Extremely distressed
TREATMENT FOR CHOKING
Choking is a life-threatening emergency and
must be treated as follows:
 Partial obstruction treatment  Complete obstruction treatment
 Do not interfere with the pt's attempts to  The conscious pt should be in a standing
clear his/her own airway position
 Encourage the pt to try to cough the  Perform abdominal thrusts "Heimlich
obstruction out Maneuver" until the obstruction is
cleared
 Stand by to assist as the partial airway
obstruction could develop into a complete  If the patient is pregnant or extremely
airway obstruction obese (overweight), then chest thrusts can
be used
Asthma

 Asthma is an ACUTE spasm of the lower  Treatment includes getting rid of the
airway in which the airways become cause if possible. Sprays or dilators of
narrowed to varying degrees. A lung the bronchi taken by mouth and steroid
disorder marked by attacks of breathing drugs are also used. Certain drugs must
difficulty, wheezing, coughing and thick not be used by persons with asthma (for
mucus coming from the lungs. The example, some of the drugs for treating
episodes may be started by breathing circulatory disease). Repeated attacks
foreign substances (allergens) or often result in shortness of breath
pollutants, infection, vigorous exercise or (emphysema) and permanent obstructive
emotional stress lung disease.
Continues……

Causes:  Signs and Symptoms:

 1. An allergy to eaten (INGESTED),  1. Wheezing - This normally begins
breathed in (INHALED) or (INJECTED) suddenly and usually worsens through the
subjects. night or early morning. It can also get
worse with exercise, or exposure to cold.
 2. Emotional stress (STRESS ASTHMA)
 2. The patient takes longer to breathe
OUT than in
 3. The patient uses all the chest and
shoulder muscle to assist EXPIRATION.
 4. You will usually find the patient
sitting upright, gripping onto the side of
the bed/chair.
Continues……

The narrowing is caused by a combination  Often attack of asthma is brought on by

of the 3 S's asthma: failure of the patient to take his
medication, or a viral infection of the
 Oedema of the walls of the bronchi and
upper respiratory tract (upper airways).
bronchioles. (Swelling)
 Too much mucous in the air ways.
(Secretions)
 Contraction of the muscles in the walls of
the bronchi and bronchioles. (Spasms)
Management (treatment)

 Reassure the patient in every possible  Place the patient in a position which he
way finds most comfortable. Normally seated
 Do not delay, check the vital signs  Loosen any tight constricting clothing
e.g. tie's and top shirt bottoms.
 This patient needs "wet" humidified
medical oxygen, so call for back-up  Continue to reassure the patient.
immediately.  Transport to hospital in a sitting position
 If the patient is exhausted and ventilation if possible
appears inadequate, assist ventilation
until help arrives.
 SPECIFIC OUTCOME NO 6:
Cardiovascular Emergencies: Circulatory system
review, Heart Attack, Stroke
 The heart is a hollow, muscular organ that lies in the media sternum, well protected by the sternum and ribs.
 
Continues…………….

Chamber and valves of the heart   The atria are very thin-walled muscular
chambers. The ventricles have much
 The heart consists of 4 chambers. A left
thicker muscular walls, the left ventricle
and right atrium and a left and right
being thicker than the right ventricle,
ventricle.
because it pumps at a higher pressure.
 The atria receives blood returning to the The muscle of the heart is known as the
heart. The ventricles pump blood into the myocardium. 
great arteries leaving the heart. The left  Blood flows from the right atrium into the
and right sides of the heart are separated
right ventricle, and from the left atrium to
in the middle by a septum; which is
the left ventricle. To prevent the back
muscular between the ventricles, and
flow of blood, there are two valves
membranes between the atria.
between the atria and ventricles, the Atria
ventricular Valves (AV Valves)
Continues…..

 When the ventricles contract they eject

blood into the vessels and to prevent
back-flow of blood into the ventricles,
there are also valves situated at these
points.
 The great vessels
 The vena cava
 The aorta
Places to palpate pulse
CARDIAC ARREST (Heart Attack)

 Cardiac arrest – is a sudden loss of blood  The pain that arises when the heart is
flow resulting from the failure of the deprived of oxygen, is most often due to
heart to pump effectively. Signs include disease in the arteries (coronary arteries)
loss of consciousness and abnormal or that supply the heart with oxygen and
absent breathing. Some individuals may nutrients.
experience chest pain, shortness of breath  During assessment of a pt with chest
or nausea before heart attack.
pain, the history taking is important in
 Many types of pain occur in the chest order to assist in determining whether the
pain may arise form damaged structures cause of the chest pain is due to a heart
in the chest wall, or within the thoracic attack. The following question should be
cavity itself. asked;
 OPQRST

 Onset – What happened/what were you  Radiation - Is the pain radiating

doing? E.g. dusting the house. anywhere? E.g. to the jaw
 Provokes - What provokes the pain? E.g.  Severity - How severe is the pain? E.g.
patient was exercising. on a scale of 1-10
 Quality - What is the quality of the pain?  Time - How long has the pain lasted?
E.g. crushing E.g. 1 hour
 STROKE

 A stroke may be defined as complete or

partial blockage of one of the arteries of
the brain. The blockage may be due to a
clot or a rupture of one of the arteries in
the brain
 Signs and symptoms

 Decreased level of consciousness  Speech disturbances

 Loss of function of extremities  Facial asymmetry/paralysis
 Pupil difference  Unconsciousness
 Nausea and vomiting  Convulsion
 Death
 Treatment of a stroke

 Monitor the patient's primary survey  Protect any weak or paralyzed limbs
(ABC) and treat any irregularities  Position your pt lateral
 Do a full secondary survey and treat for  Remember that your patient can hear you,
any injuries
so keep communicating with them.
 Calm and reassure the pt
 Tender Loving Care
 SPECIFIC OUTCOME NO 7
Other Medical emergencies: Epilepsy, Fainting and Diabetes

INTRODUCTION TO FITS Common causes of epilepsy (seizure)

(EPILEPSY):   Trauma/ birth
 A generalized seizure (Also known as a  Tumors
grand mal seizure, fit or convulsion)
generally causes an acute decrease in  Inflammation/ infection
state of consciousness, repeated  Genetic
movements of the body, excessive
salivation, vomiting and often a loss of  Hyper/hypothermia
bladder and bowel control. This event  Hypoglycemia
may last from 30 seconds to a few
minutes.  Hypoxia
 Seizures are caused by an abnormal
electrical activity in the brain.
 
Treatment for a pt who is having a seizure:

 Don't restrain the pt  Once the patients finished their seizures,

turn them onto recovery position
 Remove any objects from the pt so that
he can't hurt themselves  Monitor the patient's vital signs
 Put a pillow under their head so that they  Call for assistance as soon as possible
don't bang their head on the floor  Get a full history of the pt (sugar, drugs,
 Don't put anything into the pt's mouth etc.)
 Allow the episode of the seizure to finish
 Seizures in children

 All the factors that plays a part in adults Treatment for a child having a seizure: 
also is effective in children. A rise in  The treatment for a child having a seizure
body temp however causes the child to
is identical to that of an adult but you can
start to fit so much quicker.
add that the child (depending on the
Signs and symptoms of a child fitting: temp.) may also be sponged down to try
and break their fever.
 Breathing is impaired
  
 Not reacting to voice (verbal commands)
 Some children have a fit in the sense that
they have fluttering eyelid and a glare and
is completely unaware of its surroundings
  FAINTING

 Fainting is most commonly caused by a Signs and symptoms of fainting

temporary shortage of blood and oxygen  The following signs and symptoms may
to the brain. The most common causes of
indicate that a person is about to faint:
fainting are:
 Paleness and sweating
 Bad news or a fight
 Constant ringing in ears
 Long periods of standing, especially in
hot weather  Dizziness and unsteady actions
 Fatigue, hunger or lack of fresh air
 Pain, fear or anxiety
First aid for a pt that is about to faint
 Should you realize that a pt is about to
faint, applying the following first aid:
 Seat the pt with his/her head and
shoulders lowered towards his/her legs First aid for a pt who has already fainted
 Place the unconscious pt on his/her back  If the pt has already fainted, then apply the following
and raise the legs by 15 to 30cm first aid:
 Loosen the pt to rest  Place the pt in the recovery position
 Ensure an adequate supply of fresh, cool  Treat any injuries the pt might have sustained when
air he/she fainted, e.g. pt might have bumped their head
against a table when he/she collapsed
 Loosen tight clothing
 Allow the pt to rest on regaining consciousness
Note: Most pt's recover quickly. If fainting persists, get
professional help
 Diabetic emergencies

 This is when the body can't use sugar  Signs and symptoms:
(glucose) effectively, due to the  Rapid in onset
inadequate insulin production or the  Hungry
ineffective use of Insulin.    Confused
a) Hypoglycemia (low blood sugar):  Decrease level of consciousness

The following may cause it:  Weak and in coordinated

 Irritable
 Too much insulin
 May seem drunk
 Too much exercise  Cold clammy skin
 Not enough food intake  Seizures
 Emotional stress  Slurred speech
 Coma
 Death
 Treatment:

 Safety
 History-Last oral intake, any medication that the patient takes
 Hello-Determine the patients LOC and get permission to treat them
 Help-Call for assistance as soon as possible
 Monitor the patient's vitals
 Be alert for vomiting
 Transport as soon as possible
b) Hyperglycemia (High blood sugar):

Signs and symptoms   Anorexia

 Warm dry skin  Nausea and vomiting
 Tachycardia  Fruity odor
 Polyuria  Kussmaul breathing
 Polydipsia  Decrease in level of consciousness
 Polyphagia  Seizures
 Treatment:

 History-Last oral intake, any medication  Monitor the patient's vitals

that the patient takes  Be alert for vomiting
 Hello-Determine the patients LOC and  Transport as soon as possible
get permission to treat them
  
 Help-Call for assistance as soon as
possible
 SPECIFIC OUTCOME NO 8:
Bleeding: wounds, control of bleeding and
bandaging
DEFINITION OF A WOUND
 A wound can be defined as a break in the
continuity of the skin affecting the
epidermis, dermis subcutaneous tissue
and muscle tissue (caused by a stabbing,
gun shot, cut, abrasion or amputation).
 Six types of wounds

 Abrasion: the epidermis (skin) is injured  Avulsion: when a flap of skin has been
by scraping or rubbing torn loose, partially or completely
amputated
 Incision: a cut inflicted by a sharp
instrument like a knife, razor blade etc.  Contusion: skin is intact and a bruise is
visible, damage has occurred beneath the
 Puncture: a stab from a pointed object,
skin
such as a nail or a knife
 Laceration: a torn ragged wound
TREATMENT OF A CONTAMINATED
WOUND
 Clean the wound with sterile or clean
water, as the wound should be kept as
clean as possible
 Don't use cotton wool or other materials
where fibers may get stuck and stay
behind in the wound
 You may use a mild antiseptic solution
to clean the wound, but make sure that
the pt is not allergic to the antiseptic and
that the antiseptic has been diluted
 Cover the wound with a sterile dressing
or clean cloth
 BLEEDING

 There are 3 types of bleeding, namely:

 Arterial - bright red, spurting blood
 Venous - dark red, heavy flow of blood
 Capillary -slow oozing of blood
 EXTERNAL BLEEDING

External bleeding is caused by damage to the skin  4. Immobilization - Immobilize the

or underlying tissues and muscle and can normally limb with a splint and immobilize the
be seen. Severe external bleeding is an immediate splinted limb with support bandages
threat to life and the following important first aid
treatment must be applied immediately:  5. Pressure points - Apply firm
pressure to the pressure point above the
 1. Direct pressure - Apply direct pressure to
the wound site of injury, i.e. the femoral or
brachial arteries. Remember to keep the
 2. Pressure bandage - Bandage dressings pt calm and at rest.
firmly over the wound. Do not remove blood-
soaked dressings; rather apply additional
dressings over the previous dressings.
 3. Elevation - Elevate the injured limb
where possible
 NOSE BLEEDS
A nose bleed can occur at any time and, if not treated properly may be life
threatening.
Continues…..

Treat as follows:  After the second 15 minutes, re-check if

bleeding has stopped. If still bleeding, or if
 Seat the pt with their head tilted slightly
bleeding recurs, get professional help/assistance
forward
 Place the pt in the recovery position if necessary
 Firmly pinch the pt's nostrils below the
bridge of the nose  Make sure that the pt's airways is open and that
the pt is breathing properly
 Place an ice pack wrapped in a cloth on
the bridge of the pt's nose Note: Do not attempt to stop bleeding from the nose
when there is an indication of an associated head
 Check if bleeding has stopped after 15
injury.
minutes. If still bleeding, repeat the
procedure for a further 15 minutes.
 EAR BLEEDS
Bleeding from the ear could indicate a head injury, which can be
extremely serious.
Treats as follows:  Place the pt in the recovery position (on
affected side) if necessary and if other
 Inspect the ear to identify whether
injuries permit this
bleeding is internal or external
 Make sure that the airway is clear and
 Place a sterile dressing loosely over the
that the pt is breathing properly
ear or ears
 Monitor vital signs continually
 Allow blood or fluid to passively drain
out of ear (unless bleeding from external  Transport the pt to the hospital
ear where direct pressure can be
practiced)
 Never place anything in the ear; never
plug the ear
 BANDAGING

There are many different bandaging EMBEDDED OBJECTS

techniques for various injuries. The  First aid treatment for an embedded
objective of bandaging is to provide:
object is as follows:
 pressure to control bleeding  Do not remove the object
 stabilization of a fractured bone or limb  Stabilize the object in the position in
to prevent further injury
which it is found (ring bandage or
 support and to reduce pain of a fracture padding)
and/or sprain  Control the bleeding
 protection of a wound to prevent further  Obtain professional help/assistance or
contamination
transport to hospital
 SPECIFIC OUTCOME NO 9:
Shock: kinds and recognition of signs and symptoms

SHOCK There are three main causes of shock

1. Pump/hear failure (cardiogenic)
 Shock is an extremely serious condition
and can lead to the death of a patient even  When a pt has suffered a heart attack, the heart may
be severely damaged and unable to pump
though his/her injuries may seem to be
adequately. As a result, tissue perfusion is no
non-fatal. In this respect, it is very longer maintained.
important for the first aider to be able to
2. Content failure (hypovolemic)
recognize shock
 When a pt has suffered from a traumatic injury, e.g.
a gunshot wound, and is bleeding severely, blood
loss causes insufficient perfusion to the body.
3. Blood vessel failure (neurogenic)
 When the blood vessels lose their ability to
constrict and as a result the blood volume left in the
system is not enough to perfuse the system
adequately.
Continues……

 Injuries and illnesses that can cause a Signs and symptoms of shock
pt to go into shock  Restlessness and anxiety
 Severe bleeding  Rapid, weak pulse (initially)
 Breathing problems  Pale, cold and clammy skin
 Burns  Rapid, shallow breathing
 Fractures  Nausea and vomiting
 Heart attack  Dilated (big) pupils that react slow to
 Head and spinal injuries light
 Severe allergic reactions  Pt is extremely thirsty
The immediate first aid for shock

 Obtain/call for professional  Give nothing by mouth

assistance/help  Keep the pt warm
 Treat the cause of shock (bleeding,  Place the conscious pt on his/her back
fractures, etc.)
and elevate/raise their legs by 15 to 30cm
 Calm and reassure the pt if other injuries allow/permit this
 Handle the pt in a gentle manner  Place the unconscious pt in the recovery
position
 Loosen any tight clothing
 SPECIFIC OUTCOME NO 10:
Chest Injuries: Sucking Chest Wound
CHEST WOUNDS Signs and symptoms of a penetrating chest
wound:
What can be classified as a penetrating
chest wound?  Blood
 Also referred to as an open wound. The  Pain
term is used when the chest wall is  Discoloration of the skin (cyanosis or a
penetrated for example a bullet, a knife or
contusion at the site of the injury)
spike. The problem with an open chest
wound is the possible damage that might  Guarding of the affected/injured side
have occurred to the lung, heart, or the  Air bubbles may be seen and heard (rales)
great vessels that passes through the chest at the site of the injury
cavity.
 Object might still be penetrating
 Dyspnea (difficulty breathing)
Signs and symptoms of a chest injury:

 Tachypnea  Discoloration of the skin (cyanosis)

 Decreased air entry on the affected side  Tracheal deviation
 Chest pain at the site of the injury  Decrease to an absence of breath sound
(may even be bilateral)
 Guarding of affected side
 Death
 Decrease in level of consciousness
Treatment of a chest wound:
sucking chest wound
Continues………..

 Inspect the chest area if your suspect a  Stop any bleeding (using a 3-way
chest wound dressing)
 Respiratory arrest may follow and  Ensure that the EMS are on the way, as
artificial respiration may need to be this is a life-threatening emergency
started  Turn pt on the affected side
 Beware of a possible spinal injury and
treat as necessary
SPECIFIC OUTCOME NO 11:
Abdominal Injuries: system review by quadrant
  THE ABDOMEN 
 The abdomen is divided into four quadrants,
a method describing the portions of the
abdomen by forming two imaginary lines
that intersect the umbilicus.
 The quadrants thus formed are the Right
Upper Quadrant (UQ), Left Upper Quadrant
(LUQ) Right Lower Quadrant (RLQ) and
the Left Lower Quadrant (LLQ).
 Pain or injury in a given quadrant arises or
involve the organs that lie in that quadrant,
and allows us to identify injured or diseased
organs that require emergency care
Continues……

What is a bowel evisceration (open abdominal injury)?

 This occurs when bowel protrudes out from the normal enclosed
environments of the abdomen and is in danger of injury from a number of
sources. Firstly, due to the decrease in blood flow to that specific organ.
Secondly to the fact that that part dries out it might rupture. Thirdly that
damage might occur due to external sources
Treatment of a bowel evisceration:

 Hello - Determine the pt's LOC and get  Treat any evisceration by not putting back
permission to treat them the bowel (it may tear, impair circulation,
etc.) Do not cut off anything protruding
 Help - Call for assistance as soon as
out of the hole. Keep the bowel as close
possible
to the exit hole as possible i.e. stop any
 Monitor pt vitals and note any traction on the vascular supply
abnormalities  Cover the bowel with wet, moist dressing
 Don't delay - Stop any profuse bleeding and flex the pt's thigh to relax the
 Treat the pt for shock and stabilize any abdominal muscles and prevent decreased
fractures circulation
 Transport to hospital as soon as possible
Treatment for an open abdominal injury
An open injury needs to be covered with a sterile dressing and then the pt
needs to be taken to a hospital as soon as possible.
SPECIFIC OUTCOME NO 12:
Head and spinal injuries
 Continues…..

 HEAD AND SPINAL INJURY Signs and symptoms of head injuries

 Head and spinal injuries are extremely  Swelling may occur (don't palpate the
serious and may result in severe permanent swelling in a skull fracture)
disability or death if overlooked during
your assessment or improperly treated.
 Lacerations and/or contusions
 Second only to primary assessment and
 Deformity or scull depression (due to a
care for ABC'S, proper assessment and care fracture) may be present
for the head and spinal injuries will be your  Battle signs and/or raccoon eyes may be
most important responsibility, present
 Head and spinal injuries go hand in hand.  Possible CSF (cerebrospinal fluid)
With every serious head injury, the
leakage from ears and nose
possibility that the spinal cord was also
injured is likely and the pt needs to be
treated accordingly.
RECOGNISING A SPINAL INJURY

Mechanism of injury plays a vital part and Paralysis

spinal injuries should be expected in all  The pt may present with loss of the following motor
traumatic injuries
and/or sensory bodily functions:
 Obtain a proper history from both
1. Loss of muscle (motor) function
bystanders and pt.
2. Loss of feeling (sensory) function or a numbness
Pain
(pins and needles feeling) in extremities
 The pt will feel pain at the site of the  Most spinal injuries associated with paralysis occur
spinal fracture/injury
in the neck and may cause numbness or paralysis of
 Pain is not always present: it depends on all four extremities (quadriplegia), as well as
your pt's condition difficulty in or absence of breathing
 Another common injury is paralysis from the waist
down, where breathing is not impaired (paraplegia)
Continues …………….

Bowel and bladder control TREATMENT FOR A PT WITH HEAD/SPINAL

INJURY
 Loss of bowel and bladder control, duet
to loss for muscle and nerve control  HHH -ABC
 Airway and alignment of spine (jaw thrust, log roll)
 Breathing may be absent if a spinal fracture occurred
in the neck area and the nerves are severed, resulting
in paralysis of respiratory muscles. In this case you
may need to give your pt breaths (ventilate).
 Support and stabilize the pt's head and don't move the
pt unless to prevent death
 Maintain body temperature by covering pt with a
blanket
 SPECIFIC OUTCOME NO 13:
Fractures: Broken bones
DEFINITION OF A FRACTURE CLASSIFICATION OF FRACTURES
 A fracture is a break in the continuity  Simple fracture - The fracture is closed
(length) of the bone (this could be a and there is no visible wound (no external
simple crack or a severe shattering of the bleeding or bone showing).
bone.  Compound fracture (open) - A wound is
present, caused by bone protruding through
the skin or by the impact of an object (e.g.
bullet) piercing the skin.
 Complicated fracture - Can be simple or
compound, but this fracture clamps or
damages vessels and /or nerves in the
injured area, disrupting distal circulation
and/or motor and sensory function of the
limb.
SIGNS AND SYMPTOMS OF A
FRACTURE
 Pain
 Swelling
 Deformity
GENERAL TEREATMENT FOR A FRACURE
Immobilization
 Discoloration
 Try not to move the pt before the fracture has been immobilized
 Loss of motor and sensory function  Expose the whole limb in order to identify all possible injuries
 Distal pulse may be absent prior to splinting
 Affected limb may be cold, pale r blue
 Check for distal pulses and cover all wounds before splinting the
fracture
 may experience numbness or pins and needles  Immobilize (splint) the fracture in the position found, distal and
in affected limb proximal to the fractured bone
 If distal circulation is absent, slight traction may be applied in an
attempt to restore circulation. Tractions should be maintained
until a splint has been applied.
 After splinting, check all neurovascular functions again
 SPECIFIC OUTCOME NO 14:
Burns
DIFFERENT DEPTHS OF BURNS Full thickness (3rd Degree)
Superficial burns (1st Degree)  Complete destruction of the epidermis
and dermis. The wound itself is not
 Involves the epidermis. Characterized by
painful, but there is pain around the
reddening of the skin and possible
wounds where the epidermis and dermis
blisters. Painful but with cooling down
are affected.
(with water) the pain subsides.
Partial thickness (2nd Degree)
 Involves the epidermis and the upper part
of the dermis. Also, characterized by
redness and bigger blisters, which are
very painful. Scarring is present and
patient may require a skin graft for
complete recovery.
TREATMENT FOR BURN WOUDS
Thermal burns Electrical burns
Caused by heat in the form of wet heat (steam), dry heat (friction burns) or Caused by high electrical voltage and currents, electrical burns cause
naked flames. It is also caused by extreme cold (frostbite) and sunburns.
devastating internal injuries with or without external evidence. There will be
 Determine the depth of the burn possible entry and exit wounds. Patients may go into cardiac arrest.
 Apply cold water irrigation for 10 to 15 minutes minimum until pain  With electrical burns, extreme caution must be taken with regards to
subsides your own safety
 Burn shield is an excellent form of treatment and if available should  Power must be switched off at the mains and not just at the 'plug'. The
be used
wire must be removed by means of a non-conducting source (wood,
 Cover the wound with clean, moist dressing (do not use cotton wool) plastic, paper etc.) after the power has been switched off.
 Cover the patient to maintain body temperature  An electrical current passing through the body could affect the electrical
 Never put butter or any other ointment on the burn conduction system of the heart, resulting in an irregular or absent
heartbeat. CPR must be started as the patient may be successfully
 Never pull clothing off affected area if burnt into skin, rather cut resuscitated.
around the wound
 Remove jewelry from burnt limb as swelling may cause a decrease in
 With electrical burns, it is important to keep in mind the possibility of
tissue perfusion fractures or spinal injuries. The patient must be packaged properly for
the journey to the hospital.
 Never break or drain blisters or apply any form of antiseptic agents or
topical creams
Chemical burns

This is caused by acids, alkalis and corrosive  Remove the victim's contaminated clothing
substances in liquid or dry preparations. Alkalis burns while flushing with water. Clothing can also
longer and deeper, and will continue burning until absorb chemicals, allowing them to burn as
removed from the skin.
long as they are in contact with the skin.
 A chemical burn is the result of a caustic or
corrosive substance touching the skin. Since
 Flush for 20 minutes or longer. Dilution
chemicals continue to 'burn' as long as they are in with large amounts of water will decrease
contact with the skin, they should be removed from the chemical's concentration and wash the
the victim as quickly as possible. chemical away.
 Brush dry powder chemicals from the skin before  Cover the burnt area with a sterile dressing
flushing, unless large amounts of water are
immediately available.  Should the eyes be exposed to chemicals,
 Immediately remove the chemical by flushing with flush with water for at least 20 minutes
water. Use hose or shower if available. using low pressure
 Water may activate a dry chemical and cause more Seek medical attention for all chemical burns
damage to the skin
 SPECIFIC OUTCOME NO 15:
Poisoning and Drug abuse, Animal bites
Routes that poison enters the body  Throbbing headache in temples
 Inhalation  Nausea and vomiting
 Absorbed  Irritability/ dizziness
 injection  Tachycardia/ tachypnea
 Ingestion  Confused
Signs and Symptoms of an inhalation  Coma/seizures
poisoning:  Respiratory failure
 These may range from mild to severe  Death
 Pt seems tired
Skin may be cherry red, which is a sign of
 Tight feeling in chest carbon monoxide poisoning, but it's a late
sign.
Same as for inhaled poisonings:
 Pt seems tired
 Tight feeling in chest
 Throbbing headache in temples
 Nausea and vomiting
 Irritability/ dizziness Signs and Symptoms of an absorbed
poison:
 Tachycardia/ tachypnea
 Urination
 Confused
 Coma/seizures
 Pin point pupils
 Respiratory failure
 Bradycardia
 Death
 Broncho rhea (fluid in lungs)
 Excitation/ irritable
 Salivation
Signs and Symptoms of injected poisoning:
 Deepening coma
 Respiratory depression
 Help - Call for assistance as soon as possible (Contact the
 Constricted pupils
poison center)
 Nausea and Vomiting
 Monitor the patient's vital signs and treat any abnormalities
 Convulsions
 Only remove clothing that has had poison spilt on it,
especially in case of absorbed poisoning
Treatment for pt who has been poisoned:  Wash the pt down with water if necessary, at least 20min
 Safety - Remove the pt from the cause or the cause (poisons on the skin)
from the pt
 DON'T give anything by mouth to induce vomiting except
 History - Get a full history to determine the instructed by the poison center
mechanism of injury (what type of poison)
 Hello - Determine the patients LOC and get
permission to treat them Human or animal bites are quite serious due to the bacterial
that is produced in the mouth. Extreme care must be taken to
clean the patient's wound properly to prevent any severe
infection from setting
Treatment for any animal or human bite

 Safety - Remove the pt from the cause or  Calm and reassure the pt and don't let
the cause from the pt them walk around
 History - Get a full history to determine  Dress the wound with a constructive
the mechanism of injury (what type of bandage for spiders or scorpions if on a
poison) limb Proximal to Distal
 Hello - Determine the patients LOC and  Don't give pt anything to drink - Be alert
get permission to treat them of vomiting
 Help - Call for assistance as soon as  Full secondary survey
possible (Contact the poison center)
 Monitor the patient's vital signs and treat
any abnormalities
Snakebites:
 Snakes are generally peaceful animals
and non-aggressive, and take flight when Treatment for snakebites:
they hear a noise. They only attack when  Safety- Don't try to catch the snake, ensure the scene is
they feel threatened or when someone safe
gets in their way. Some snake bites are
extremely poisonous and cannot be taken
 History - Get a full history to determine the mechanism
lightly of injury
 Hello - Determine the patients LOC and get permission
to treat them
 Help - Call for assistance as soon as possible (Contact
the prison control center)
 Don't delay - Stop any profuse bleeding
 Monitor the patient's vital signs and treat any
abnormalities
 Calm and reassure the pt and don't let them walk around
Poison in eyes:
 Don't rub the eyes
 Wash with copious amounts of water (at
least 20 min or longer)
Depending on the severity of the reaction,
 Call for back-up transport to hospital as the signs and symptoms may vary:
soon as possible  Sneezing
 Itchy nose
Routes that allergens enter the body:  Coughing and wheezing
 Allergens are inhaled, some only needs to  Pulse increase
touch the skin and an allergic reaction
occurs  Blood pressure may fall
 Nausea, vomiting, diarrhea and
abdominal cramps
 Anxiety, dizziness, weakness, headache,
seizures, coma
Treatment for allergic reaction:

 Hello - Determine the patients LOC and  Calm and reassure the patient
get permission to treat them  Give the patient nothing to eat or drink
 Help - Call for help as soon as possible  Treat for shock
 Monitor the patient's ABC (The airway  Transport as soon as possible
could become restricted causing the
patient to go into respiratory distress)
 SPECIFIC OUTCOME NO 16:
Movement of Casualties
When will you move an injured pt from
the scene for an accident?
 Every scenario is different and you have
to decide on your own (busy road/house
on fire). If the scene becomes dangerous
for you and the patient. When the pt’s life
is in danger in any situation, or from the
potion they are in, and the pt is a trauma
pt, they must be moved in such a manner
that their spine is protected but their life
would be saved
Different methods of dragging a patient
 SPECIFIC OUTCOME NO 17:
Emotional problems
WHAT IS A PSYCHIATRIC Situational causes
EMERGENCY?  Normal individuals may develop abnormal reactions to
stressful events. Nearly anyone can "go to pieces" if
 Psychiatric, or behavioral, emergencies are subject to enough stress, but some people are more
those in which the patient's presenting vulnerable than others. When a person's basic need is
problems in some disorder of mood, though threatened, that person faces a crisis. The severity of
the crisis will depend on the individual's ability to deal
or behavior that is dangerous or disturbing with his own feelings. There are two alternatives open
to themselves or to others. to a person in crisis.

CAUSES OF DISTURBED BEHAVIOUR  a) He may cope with it, finding ways to alter his
situation or his perception of it so that it is no longer so
 Not every pt that acts crazy is crazy, stressful
(hypoglycemic pt or stunned or mute  b) He may attempt to decrease his discomfort by
person after an unexpected death of escaping from the stress. Escape may take many forms,
including alcohol, drugs, suicide, and even psychiatric
husband or wife). We all realize that there symptoms. Symptoms thus present a compromise for
are a variety of things that can cause the pt, a means of reducing the anxiety that is internal
disturbances of behavior. crisis created.
ASSESSMENT OF THE DISTURBED
PT
 In assessing the disturbed pt you are the  All of that takes a little practice, for most
diagnostic instrument. You must use your people are not accustomed to using their
thinking process to evaluate someone feelings for anything. Your manner of
else's thinking process, your perceptions speaking will also play a major part in the
to test the validity of someone else's treatment of the pt and it will influence
perception, your feelings to measure the pt in some or other manner.
someone else's feelings.
GENERAL PRINCIPLES

 You must be prepared to spend time with  let the pt tell the story in his own way
the disturbed pt  Maintain a non-judgmental attitude
 Be as calm and direct as possible  Provide honest reassurance
 Identify yourself clearly  Take a definite plan of action
 Assess the pt where ever the emergency  Stay with the pt at all times
occurs
 Take all medications to hospital
 Exclude disruptive persons from the
interview  Don't assume that it is impossible to talk
to him until you have tried
 Sit down to interview the pt
 Set the ground rules
Understanding Depression

 Common signs and symptoms of depression

 Feelings of helplessness and hopelessness. A
break outlook-- nothing will ever get better and
there's nothing you can do to improve your
situation.
 Loss of interest in daily activities. No interest
in former hobbies, pastimes, social activities, or
sex. You've lost your ability to feel joy and
pleasure.
 Appetite or weight changes. Significant
weight loss or weight gain--a change of more
than 5% of body weight in a month.
 Sleep changes. Either insomnia, especially
waking in the early hours of the morning, or
oversleeping (also known as hypersomnia)
 Anger or irritability. Feeling agitated,  Concentration problems. Trouble focusing,
restless or even violent. Your tolerance level making decisions, or remembering things
is low, your temper short, and everything and  Unexplained aches and pains. An increase
everyone gets on your nerves.
in physical complains such as headaches, back
 Loss of energy. Feeling fatigued, sluggish pain, aching muscles and stomach pain.
and physically drained. Your whole body may
Depression and suicide
feel heavy, and seven small tasks are
exhausting or take longer to complete.  Depression is a major factor for suicide. The
deep despair and hopelessness that goes along
 Self-loathing. Strong feelings of
with depression can make suicide feel like the
worthlessness or guilt. You harshly criticize
only way to escape and the pain. Thoughts of
yourself for perceived faults and mistakes.
death or suicide are a serious symptom of
 Reckless behavior. You engage in escapist depression, so take any suicidal talk or
behavior such as substance abuse, compulsive behavior seriously. It's not just warning sign
gambling, reckless driving, or dangerous that a person is thinking about suicide: It's a
sports. cry for help.
 Warning signs of suicide include:

 Talk about killing or harming one's self  Calling or visiting people to say goodbye

 Expressing strong feelings of hopelessness or  Getting affairs in order (giving away prized
being trapped possessions, typing up loose ends)

 An unusual preoccupation with death or dying

 Saying things like "Everyone would be better
off without me" or "I want out"
 Acting recklessly, as if they have a death wish
 A sudden switch from being extremely
(e.g. speeding through red lights)
depressed to acting calm and happy
Postpartum Depression
 Many new mothers suffer from some fleeting
form of the "baby blues" Postpartum
depression, in contrast, is a longer lasting and
more serious depression triggered, in part by Depression causes and risk factors
hormonal changes associated with having a  Some illnesses have a specific medical cause, making
baby. Postpartum depression usually treatment straightforward. If you have diabetes, you
develops soon after delivery, but any take insulin. If you have appendicitis, you have
depression that occurs within six months of surgery. But depression is more complicated.
childbirth may be postpartum depression Depression is not just the result of a chemical
imbalance in the brain, and is not simply cured with
medication. Experts believe that depression is caused
by a combination of biological, psychological and
social factors. In other words, your lifestyle choices,
relationships and coping skills matter just as much-- if
not more so--than genetics. However, certain risk
factors make you more vulnerable to depression.
Causes and risk factors for depression

 Loneliness The cause of your depression helps

determine the treatment
 Lack of social support
 Understanding the underlying cause of
 Recent stressful life experiences your depression may help you overcome
 Family history of depression the problem. For example, if you are
depressed because of a dead-end job, the
 Marital or relationship problems best treatment might be finding a more
 Financial stain satisfying career, not taking an
antidepressant. If you are new to an area
 Early childhood trauma or abuse and feeling lonely and sad, finding new
 Alcohol or drug abuse friends at work or through a hobby will
probably give you more of a mood boost
 Unemployment or underemployment than going to therapy. In such cases, the
 Health problems or chronic pain depression is remedied by changing the
situation.
 SPECIFIC OUTCOME NO 18:
Cardiopulmonary Resuscitation Training
UNDERSTANDING CPR
 The previous sections dealt with the airway and
breathing components of the primary survey. This
section deals with the third aspect - circulation. the
emergency first aid procedure used to restore or  CAUTION 1: Only practice CPR on practice
simulate a patient's heartbeat in case of cardiac
arrest is called cardiopulmonary resuscitation mannequins. Do not, under any circumstances,
n(CPR). practice CPR skills on people who are alive.
 CPR should not be performed without proper  CAUTION 2: Never perform chest compressions
training. CPR involves the compression of the (CPR) on someone whose heart is still beating, unless
heart and rescue breathing, which keeps
oxygenated blood circulating around the body.
in case of clearing any airway obstruction.
When performing CPR the hands are squeezed
between the breastbone and the spine, which ejects
blood out of the heart to the rest of the body. CPR
is used universally by first aiders and medically
trained personnel.
 RULES PERTAINING TO CPR
 In order for CPR to be effective, the following golden
rules must be followed:
1. CPR must be:

Interesting facts about CPR:  Started as soon as possible

   Performed on a firm, flat surface
 Sudden cardiac arrest (heart attack) is the leading cause of  Not be interrupted for longer than 10 seconds
death in adults. Most cardiac arrests occur in persons with
underlying heart disease.
 CPR double as person's chances of survival form sudden 2. Once CPR has been started, it can only be stopped:
cardiac arrest
 75% of all cardiac arrests happen in people's homes
 When the pt recovers
 The typical victim of cardiac arrest is a man in his early 60's  On instruction from a doctor or paramedic (who
and a woman in her late 60's declare the patient dead)
 When someone with the same qualification, or who is
higher qualified than you, takes over CPR
3. If the pt recovers, then:  Opening the airway may be all that is
needed to restore breathing. Opening the
 Place the unconscious pt in the recovery
airway raises/lifts the tongue and clears
position
the airway passage. Remember that the
 Keep the pt warm tongue is the most common cause of
 Do a secondary survey and monitor the airway obstruction in unconscious adult
pt's vital signs continually until patients!
professional help arrives
Head-tilt chin-lift/jaw thrust method of
opening the airway to assess breathing
 Breathing:

 Assess breathing (look, listen and feel for

10 seconds)
 No breathing- administer 2 breaths
 Circulation

 No pulse - immediately start 30 chest

compressions and 2 breaths, for 2 minutes
 (5 cycles) Assess breathing and
pulse after 2 minutes
Assess Effectiveness of CPR
 Monitor improvement in skin color
(blue to pink)
 Continue CPR until the pt recovers or
professional assistance (EMS) arrives The correct hand position during CPR
 Palm of your hand must be placed in the middle
of the chest, between the nipple line
 Position yourself directly above the casualty's
chest
 With your arms straight, press directly down on
the sternum
 Compress chest (4-5 cm depth)
METHOD OF ARTIFICIAL
VENTILATION:
 Administer rescue breathing (ventilations) at
a rate of 1 breath every 5 seconds  Seal pt's mouth completely with your
 Check for breathing after every minute. (12 mouth
breaths)  Seal pt’s nostrils by pinching them
 Continue until patient starts breathing or until together
help arrives  Ensure an airtight seal
 Each breath must be approximately 1 to 2
seconds long
 Reposition the airway if the chest does
not rise (having difficulty ventilating)
 Ensure chest rises when you ventilate
FIRST AID PROTOCOL STEPS

 1. identify hazard/incident  4. identify the required response (first aid/emergency

services)
 2. assess the situation (don't panic.
panicking causes mistakes and may  5. if incident requires first aid: (a) introduce yourself
make the causality nervous, anxious or and what you are about to do, (b) seek consent, (c)
scared) proceed with first aid treatment (d) record incident
 3. determine if the incident warrants a If incident requires emergency services: (a) do observations
hospital visit or simply first aid and give assistance within your capacity/level, (b) if
causality is conscious, keep him/her as calm as possible, (c)
help causality into rest position if possible, (d) gather as
much information as possible to hand over to the
emergency services when they arrive, (e) record incident