Standard First Aid &

Basic Life Support – CPR with AED

Introduction to First Aid and Basic Life Support Health Hazards and Risks
Common Transmittable Diseases
First Aid Helping others is not without risks and hazards, most important of which is the risk of
Is an immediate help provided to a sick or injured person until professional medical contracting an infectious disease. Infectious diseases are those that can spread from
help arrives or becomes available. one person to another and develop when germs invade body and cause illness
Scope and Limitation: (e.g. Herpes, Meningitis, Tuberculosis, Hepatitis, Human Immunodeficiency Virus,
First aid does not imply medical treatment and is by no means a replacement for it. Acquired Immune Deficiency Syndrome)
Diseases spread from one person to another through the following ways:
Basic Life Support 1. Direct contact
An emergency procedure that consists of recognizing respiratory or cardiac arrest or 2. Indirect contact
both and the proper application of CPR to maintain life until a victim recovers or 3. Airborne transmission
advanced life support is available. 4. Vector transmission

Objectives of First Aid Prevention and Protection

First aid aims to accomplish the following goals: Universal Precautions are set of strategies developed to prevent transmission of blood
• Preserve life borne pathogens.
• Prevent further harm and complications Body Substance Isolation (BSI) are precautions taken to isolate or prevent risk of
• Seek immediate medical help exposure from body secretion and any other type of body substance such as urine,
• Provide reassurance vomit, feces, sweat, or sputum.
Personal Protective Equipment (PPE) is specialized clothing, equipment, and supplies
According to Article 12 no. 4 of Act no. 3815 of the Philippine Revised Penal Code Book One that keep you from directly contacting infected materials.
“any person who, while performing a lawful act with due care, causes an injury by mere
accident without fault or intention of causing it” is exempt from criminal liability

Legal Concerns
• Consent
• Duty to Act
• Standard of Care
• Negligence
• Abandonment
• Confidentiality

According to Article 275 nos. 1 & 2 of Act no. 3815 of the Philippine Revised Penal Code
Book Two: “Abandonment of person in danger and abandonment of one’s own victim”
1. Anyone who shall fail to render assistance to any person whom he shall in an
uninhabited place wounded or in danger of dying, when he can render such assistance
without detriment to himself, unless such omission shall constitute a more serious
offense.
2. Anyone who shall fail to help or render assistance to another whom he has
accidentally wounded or injured.
 Emergency Action Principles III. Airway
An open airway allows air to enter the lungs for the person to breather. If the
An emergency scene can be overwhelming. In order for the first aider to help airway is blocked, the person cannot breathe.
effectively, it is important that actions have to be prioritized and planned well.
IV. Breathing
Scene Size-up While maintaining an open airway, quickly check an unconscious person for
I. Scene safety breathing by doing the LLF technique for no more than 10 seconds.
II. Knowing what happened L – Look for the rise and fall of the chest
• Cause of injury L – Listen for the breathing sounds
• Nature of illness F – Feel the breathing from the nose
III. Role of bystanders
IV. Number of casualties V. Circulation
V. Asking permission or consent • Pulse
Check for definitive pulse at carotid area for adult or child, while
brachial for infant.
To obtain consent, do the following:
• Bleeding
• Identify yourself to the victim
Quickly look for sever bleeding by looking over the person’s body
• State your level of training
from head to toe for signals such as blood-soaked clothing or blood
• Ask the victim whether you may help spurting out of a wound.
• Explain what you observe • Shock
• Explain what you plan to do If left untreated, shock can lead to death. Always look for signals of
shock whenever you are giving care.
Primary Assessment • Skin color, temperature, and moisture
Primary assessment can be done with the patient in the position in which you find Assessment of skin temperature, color, and condition can tell you more
him/her, and begins with checking the patient’s responsiveness. about the patient’s circulatory system.
I. Assessing Responsiveness Secondary Assessment
AVPU mnemonic: If you determine that an injured or ill person is not in an immediately life-threatening
A – Alert condition, you can begin to check for other conditions that may need care.
V – Responsive to Voice
• Interviewing the person and bystanders
P – Responsive to Pain
• Checking the person from head to toe
U – Unresponsive/Unconscious
• Checking for vital signs
II. Activate Medical Help
Ask someone to call for local emergency number and get an AED (Automated
External Defibrillator) To gain essential information about the patient’s medical history, ask the patient
questions based on the SAMPLE approach:
Call First or Care First S – signs and symptoms
If you are alone, it is important to know when to call during emergencies. A – allergies (e.g., medicine, food)
Call First situations are likely to be cardiac emergencies, where time is a critical M – medications
factor. P – past medical history
In Care First situations, the conditions are often related to breathing emergency L – last intake and output
E – events leading up to the injury or illness
Information to be remembered in activating medical help: CHANT
C- Case
H – Help needed N – Name (+age/sex of the patient)
A – Address/ location of emergency T – Telephone number
 Cardiac Emergencies Heart Attack
Also called myocardial infarction, occurs when the blood and oxygen supply to the
Chain of Survival heart is reduced causing damage to the heart muscle and preventing blood from
In Hospital Chain of Survival circulating effectively. It is usually caused by a coronary heart disease.
1. Surveillance and prevention
The term “angina pectoris” means literally “a constriction of the chest.” Angina pectoris
2. Recognition and activation of the emergency response system occurs when coronary arteries, which supply the heart muscle with blood, become narrowed
3. Immediate high-quality CPR and cannot carry sufficient blood to meet increased demands during exertion or excitement.
4. Rapid defibrillation
5. Advanced life support and post arrest care Signs and Symptoms
Out of Hospital Chain of Survival What to look for:
1. Recognition and activation of the emergency response system • Chest pain, discomfort or pressure
2. Immediate high-quality CPR • Pain or discomfort becomes constant
3. Rapid defibrillation
• Some individuals may show no signs
4. Basic and advanced emergency medical services
• Discomfort in other areas of the upper body
5. Advance life support and post arrest care
Pediatric Chain of Survival • Trouble breathing
1. Prevention and early recognition • Pale or ashen (gray) skin, especially around the face
2. Early high-quality CPR • Damp sweat or may sweat heavily
3. Prompt access to the emergency response system • Feeling dizzy, nauseated, or vomiting
4. Rapid pediatric advanced life support (PALS) • Fatigued, lightheaded or lose consciousness
5. Integrated post-cardiac arrest care
First Aid Management
• Call the local emergency number immediately
• Have the person stop what he/she is doing
• Loosen any tight or uncomfortable clothing
• Person who is experiencing chest pain may take prescribed aspirins
• Closely watch the person until advanced medical personnel takes over
• Be prepared to perform CPR and use an AED, if available, once the person loses
consciousness
• You can help by assisting patient when taking prescribed medication
• Be calm and reassuring
• Talk to bystanders and if possible, to the person to get more information
• Do not try to drive the person to the hospital Patient could quickly get worse on
the way

Cardiac Arrest
Occurs when the heart stops contracting and no blood circulates through the blood
vessels and vital organs are deprived of oxygen.
Note: There are various types of cardiac arrest. In an emergency however, it is not necessary
to determine which type of cardiac arrest is present. Begin CPR immediately when you
recognize cardiac arrest.

Cardio-Pulmonary Resuscitation (CPR)

A combination of chest compressions and rescue breathes. When the heart is not
beating, chest compressions are needed to circulate blood containing oxygen.
 CPR Comparisons for Adult, Child, and Infants Integrated CPR and AED Use
Age 13> 1-12 <1 When arriving at the scene of a suspected cardiac arrest, rescuers must rapidly integrate
Recognition of Unresponsive CPR with the use of the AED. Most of the time, two or more rescuers are at the scene.
Cardiac Arrest No breathing/no normal breathing In this case, rescuers can imitate these functions simultaneously:
No definite pulse felt within 10 secs • Activate the emergency response and getting the AED
Checking of
• Performing CPR
Breathing & Carotid pulse Brachial pulse
Circulation • Operating the AED
Compression Depth 2 – 2.4 inches 2 inches 1 ½ inches
Airway Minimize interruptions in chest compressions Use AED immediately when victims have the following 3 critical findings: no
Attempt to limit interruptions to <10 seconds response, no breathing, no pulse
Defibrillation Attach and use AED as soon as available. Minimize interruptions in
chest compressions before and after shock; resume CPR beginning Defibrillation is the treatment of irregular, sporadic or absent heart rhythms by an
with chest compressions immediately after each shock. electrical current to the heart.
Note:
When to STOP CPR? • The most effective treatment for VF is electrical defibrillation
• Spontaneous signs of breathing and circulation are restored • The probability of successful defibrillation decreases over time
• Turned over to professional provider • VF deteriorates to asystole if not treated
• Operator is exhausted and cannot continue CPR
Special situations when not to use AED
• Physician assumes responsibility
• The victim is less than 1 year old
• Scene becomes unsafe
• The victim has a hairy chest
When not to START CPR? • The victim is immersed in water or water is covering the victim’s chest
• The patient has a valid “Do Not Attempt Resuscitation” (DNAR) Order • The victim has an implanted defibrillator or pacemaker
• The patient has signs of irreversible death: rigor mortis, decapitation, or • The victim has a transdermal patch or other on the surface of the skin where the
dependent lividity AED electrode pads are placed
• No physiological benefit can be expected because the vital functions have
deteriorated despite maximal therapy for such conditions as progressive septic or
cardiogenic shock.

Chest compressions only (Hands only) CPR is performed if a person is unwilling or

unable to perform ventilation (mouth-to-mouth or rescue breathing). *For use in
dispatcher-assisted CPR instructions where the simplicity of this modified technique
allow untrained bystanders to rapidly intervene.

Automated External Defibrillator (AED)

AEDs are computerized devices that are attached to a pulseless victim with adhesive
pads. They will recommend shock delivery only if the victim’s heart rhythm is one
that a shock can treat. AEDs give rescuers visual and voice prompts to guide rescuer
actions.
In many cases however, CPR alone cannot correct the underlying heart problem: defibrillation
delivered by an AED is needed, the electrical impulse allows the heart to develop spontaneous
effective rhythm on its own.
 Airway and Breathing Emergencies Rescue Breathing
Age 13> 1-12 <1
Airway Maximum head tilt & Neutral plus position Neutral position
Foreign-body Airway Obstructions
Opening chin-lift
Also known as choking, it is a common breathing emergency that occurs when the Method Mouth-to-mouth/ Mouth-to-mouth/ Mouth-to-mouth
person’s airway is partially or completely blocked by a foreign object (such as a piece Mouth-to-nose Mouth-to-nose & nose
of food or a small toy), by swelling in the mouth or throat, or by fluids (such as vomit Breaths Normal breath
or blood). Rate 24 breaths for 2 mins 40 breaths for
2 mins
Classification of Airway Obstruction Counting vent vent
Mild Airway Obstruction is a type of obstruction in which a patient can still talk, 1, 1002, 1003, 1001 1, 1001
cough, make wheezing sounds, and answer the question, “Are you choking?” vent vent
Severe Airway Obstruction is characterized by poor air exchange and increased 1, 1002, 1003, 1002 1, 1002
breathing difficulty, inability to speak, cough, and breathe. vent vent
1, 1002, 1003, 1003 …
vent vent
Types of Obstruction 1, 1002, 1003, 1004 1, 1039
Anatomical Obstruction. When tongue drops back and obstructs the throat. Other vent vent
causes are acute asthma, croup, swelling, and whooping cough. 1, 1002, 1003, 1024 1, 1040
Mechanical Obstruction. When foreign objects lodged in the pharynx or airways; solid vent vent
or liquid accumulated in the back of the throat.
Asthma Attack
Causes An illness in which certain substances or conditions called “triggers” causes
• Swallow large pieces of poorly chewed food inflammation and constriction of the airways, making breathing difficult.
• Drinking alcohol
• Wearing dentures Signs and Symptoms
• Eating while talking excitedly, laughing, or eating too fast • Hoarse whistling sound during exhalation (wheezing)
• Walking, playing, or running with food or objects in the mouth • Trouble breathing or shortness of breath
• In infant and children, choking occurs while eating of by purring non-food items • Rapid, shallow breathing
(e.g. coins & toys) inside the mouth • Sweating
• Tightness in the chest
Back blows & Abdominal/Chest Thrust • Inability to talk without stopping for a breath
These are first aid procedure performed on a person who is choking. This is done be
applying pressure on the upper back and upper abdomen or on the chest at the center First Aid Management
of the breastbone from the back so as to remove the object that is causing the • Remain calm
obstruction. • Help the person to sit comfortably
• Loosen any tight clothing around the neck and abdomen
Respiratory Arrest • Assist the person with his/her prescribed quick-relief medication under the
Respiratory arrest is a type of breathing emergency which occurs when breathing has following conditions:
stopped. - The victim states that he/she is having an asthma attack and has medications or
an inhaler
Respiratory Breathing - The victim identifies the medication and is unable to administer it without
A technique of breathing air into a person to supply him/her with the oxygen needed assistance
to survive. Rescue breathing is given to victims who are not breathing or with
inadequate breathing but still with pulse.
 Hyperventilation Bleeding and Shock
Occurs when a person’s breathing is faster and more shallow than normal. When this
happens, the body does not take enough oxygen to meet its demands. Bleeding
Bleeding is the loss of blood escaping from the circulatory system.
Signs and Symptoms
People who are hyperventilating feel as if they cannot get enough air. Often, they are Bleeding that is severe enough to critically reduce blood volume is life threatening.
afraid and anxious or seem confused. They may say that they feel dizzy or that their This can cause tissues to die from the lack of oxygen. Life threatening bleeding can be
fingers and toes feel numb or tingly. either external or internal. External bleeding occurs when a blood vessel is opened
from the outside, such as a tear in the skin.
First Aid Management
• Help the person rest in a comfortable position Types of Bleeding
• If the person is conscious, check for other conditions • Arterial bleeding
• Try to reassure the person to reduce their anxiety • Venous bleeding
• If bystanders are present ask them what they know about the person’s condition • Capillary bleeding
• Tell the person to relax and breathe slowly Techniques to Control Bleeding
• Seek medical help immediately. • Direct pressure
• Pressure bandage

Shock
Shock is a condition in which the circulatory system fails to deliver enough oxygen-
rich blood to the body’s tissues and vital organs.

Signs and Symptoms

• Restlessness or irritability
• Altered level of consciousness
• Pale, ashen or greyish color, moist skin
• Rapid breathing
• Rapid and weak pulse
• Excessive thirst

Types
• Cardiogenic shock – due to heart problems
• Septic shock – due to infections
• Hypovolemic shock – caused by too little blood volume
• Anaphylactic shock – caused by an allergic reaction
• Neurologic shock – caused by damage to the nervous system

Causes
• Loss of blood volume – blood or fluid loss from blood vessels decreases blood
volume, usually as a result of bleeding and results inadequate perfusion
• Pump failure – poor pump function when disease or injury damages the heart
• Dilation of peripheral blood vessels – even though blood vessels dilate normally,
it is inadequate to fill the system and provide efficient perfusion
First Aid Management Soft Tissue Injuries
• Make the person lie down
• Control any external bleeding A wound is any physical injury involving a break in the layers of the skin. Wounds are
• Legs may be raised 6-12 inches generally classified as either closed or open.
• Help the person maintain normal body temperature
• Do not give the person anything to eat or drink Wound complications: bleeding, infection, tetanus, rabies
• Reassure the person every so often
Closed Wound

A closed wound is a wound where the outer layer of the skin is intact and the damage
lies below the surface.

Signs and Symptoms

• Tender, swollen, bruised or hard areas of the body
• Rapid, weak pulse
• Skin that feels cool or moist or looks pale or blush
• Vomiting of blood or coughing up blood
• Excessive thirst
• An injured extremity that is blue or extremely pale
• Altered mental state

First Aid Management

• Apply an ice pack
• Elevate the injured part
• Do not assume that all close wounds are minor injuries
• Help the person to rest
• Provide comfort and reassure the person

Open Wound

In an open wound, the outer layer of the skin is broken. The break in the skin can be
as minor as a scrape of the surface layers or as severe as a deep penetration.

Types of open wounds: abrasions, lacerations, avulsion, amputation, puncture, incision

(clean cut & ragged)

First Aid Management

General care for open wounds includes controlling bleeding, preventing infection and
using dressing and bandages correctly.

Minor Open Wounds

• Use a barrier between your hand and the wound
• Apply direct pressure
• Wash abrasions and other superficial wounds
• Apply a Povidone-Iodine (PVP-I) antiseptic solution or, if available, a triple
antibiotic ointment or cream Note: Critical Burns
• Cover the wound with a sterile dressing Critical burns are those burns that require immediate medical care. These are based on
factors such as depth, area, and location. The following are considered critical burns:
• Wash your hands immediately after giving care
• Full thickness burns that cover more than 5% of the body’s surface area
• Partial thickness burns that cover more than 10% of the body’s surface area or those
Major Open Wounds that can be found in multiple locations
• Call the local emergency number • Burns to the face, genitals, and injuries that completely encircle the hands or feet
• Put on PPE which may cause possible constriction and prevent circulation
• Control bleeding by applying direct pressure or employing a pressure bandage • Burns caused by chemicals, electricity, or explosives
• Monitor airway and breathing • Burns involving people with chronic medical problems (e.g., heart or kidney ailments)
• In cases where the injured party is in shock, keep him/her from experiencing chills • People who may be undernourished. People who are exposed to burn sources who
or feeling overheated may not be able to leave the area
• Have the person rest comfortably and provide reassurance
Electrical Burns
• Wash your hands immediately after giving care
• Never go near the person until you are sure that he/she is no longer in contact with
the power source
Burns
• Turn off the power at its source and be aware of any life-threatening conditions
Burns are injuries to the skin and other body tissues that is caused by heat, chemicals, • Call the local emergency number
electricity, or radiation. • Be aware that electrocution can cause cardiac and respiratory emergencies
• Care for shock and thermal burns
Classification • Look for entry and exit wounds and give appropriate care
1. Superficial burns (first-degree) • Remember that anyone suffering from electric shock requires advanced medical
2. Partial-thickness burns (second-degree) attention
3. Full-thickness burns (third-degree)
Radiation Burns
First Aid Management • Care for a radiation burn (eg., sunburn) as you would for any thermal burn
• Always cool the burn and protect the area from further damage by keeping the
Thermal Burns person away from the burn source
• Check the scene for safety
• Stop the burning by removing the victim from the source of the burn Bandaging
• Check for life-threatening conditions General Bandaging Guidelines
• Cool the burn with large amounts of cold running water • Use a dressing that is large enough to extend at least one each beyond the edge of
• Cover the burn loosely with a sterile dressing the wound
• Prevent infection. Do not break blisters • If body tissues or organs are exposed, cover the wound with a dressing that will
• Apply a triple antibiotic ointment if the person has no known allergies not stick (e.g., plastic wrap or moistened gauze). Then secure the dressing with a
• Take steps to minimize shock bandage or adhesive tapes.
• Comfort and reassure the victim • If the bandage is over a joint, use a splint and make a bulky dressing so the joint
remains immobilized. If there is no movement of a wound over the joint, there
Chemical Burns should be improved healing and reduced scarring
• Remove the chemical from the skin as quickly as possible • Check for feeling, warmth and color in the area below the injury site. Observe
fingers and toes before and after applying the bandage
• Flush the burn with large amounts of cool running water
• A bandage should be snug, but not so tight as to interfere with circulation, either
• If an eye is burned by a chemical, flush the affected eye with water until advanced
at the time of application or later if swelling occurs
medical personnel take over
• Do not cover fingers or toes. By keeping these parts uncovered, you will be able
• If possible, have the person remove contaminated clothes to prevent the spread of
to see if the bandage is too tight. If fingers or toes feel too cool to the touch or
infection while you continue to flush the area
 seem to look pale or blue, the bandage may be too tight and should be loosened Poisoning
slightly.
• Apply additional dressings and a supplementary bandage if blood soaks through Poison is any substance that can cause injury, illness or death when introduced into the
the first covering. Do not remove the blood-soaked bandage and dressings. body. Poisons includes solids, liquids, gases, and vapors. A poison can enter the body
Disturbing them may disrupt the formation of a clot and restart bleeding through 4 ways: ingestion, inhalation, injection, and absorption.
• Bandaging techniques depends upon: (1) size and location of the wound; (2) first
aid skills; and (3) materials at hand Ingested Poison
Poisoning by ingestion is considered any substance that’s harmful to the body when
*Square Knot ingested, whether intentionally or unintentionally.
A square knot (or reef knot) is used to tie the ends of a triangular bandage. It is easy
and quick to tie and untie. It is formed by tying a left-handed overhand know and then Poisoning by Ingestion
a right-handed overhand knot, or vice versa. 1. Food poisoning
“right over left, left over right, 2. Caustics
makes a knot body tidy and tight.”
3. Hydrocarbons
Skills Set 4. Drug overdose
First Aid for minor wound Untying a square knot
Tying a square knot Folding a triangular bandage into a cravat First Aid Management
Bandaging technique using a triangular bandage • If the person is in a toxic area, remove the person from the scene.
Top of head Shoulder/hip • Check the person’s level of consciousness and breathing.
Face/back of the head Arm/forearm/thigh/leg • Check for any life-threatening conditions.
Chest/back, shoulder blades Elbow/knee straight • Ask questions to get more information if the person is conscious.
Hand/foot Elbow/knee bent • Look for any containers and take them with you to the telephone area.
Forehead/eye Palm bandage of open hand
• Call the National Poison Management & Control Center (NPMCC) or the
Ear/cheek/jaw Palm bandage of close hand
local/regional poison control center and follow the directions of the NPMCC or
Elastic Roller Bandage
Close spiral Recurrent Technique local/regional poison control center.
Open spiral Figure of eight • If unable to contact the NPMCC or local/regional poison control center, bring the
Reverse Spiral patient immediately to the hospital.
Specific Body Injuries • Do not give the person anything to eat/drink. Do not induce vomiting unless
Application of occlusive dressing/sucking Nose bleeding instructed by a medical professional.
chest injury • Save some samples of the person’s vomit if you do not know how to classify the
Stabilization of impaled object Amputation poison.
Eye knockout Knockout toot • A person who has swallowed a caustic substance should not be made to vomit.
Foreign object to the eyes Protruding organ on the abdomen
• Do not dilute acids with water, especially sulfuric acid.
• The Department if Health recommends giving 6 to 8 egg whites to a child and 8
to 12 egg whites to an adult who has ingested a watusi.

Inhaled Poisoning
Poisoning by inhalation occurs when a person breathes in toxic fumes.

Poison by Inhalation
1. Carbon Monoxide – gasoline fumes
2. Cyanide – metal cleaners
3. Chlorine – multi-purpose cleaners
4. Tear Gas
First Aid Management Absorbed Poison
• Remove the victim(s) from the toxic environment. An absorbed poison enters the body after it comes in contact with the skin.
• Open all doors and windows.
• Maintain a patient’s airway if the victim is unconscious. Poisoning by Absorption
• Seek medical attention. 1. Jellyfish stings
2. Stinging nettles or nettle trees
Injected Poison
Injected poison enters the body through the bites or stings of insects, spiders, ticks, First Aid Management for Jellyfish Stings
snakes, and some marine life. It could also enter the body through the insertion if a • Limit further discharge by minimizing patient movement.
hypodermic needle. • Wash out wounds or injury with injury.
• Remove any remnant of allergen such as jellyfish tentacles and other foreign
Poisoning by Injection materials by scraping them off.
1. Snakebites • Keep the patient warm.
2. Bee stings
3. Marine Life with poisonous spines To care for a victim who has come into contact with a poisonous plant:
• Remove contaminated clothing and jewelry which may constrict circulation when
First Aid Management for Snakebites swelling occurs.
• Reassure the patient who may be very anxious. • Rinse the affected area immediately.
• Avoid any interference with the bite wound (e.g., incising, rubbing, vigorous • Seek medical advice if a rash or weeping lesion (oozing sore) develops.
cleaning, massaging or applying herbs/chemicals) • Soothe the area with medicated lotions.
• Immobilize the patient’s body by laying him/her down in a comfortable and safe • Stop or reduce itching with antihistamines that will dry up the lesions.
position. • Advise the victim to see a physician if the condition worsens and large areas of
• A broad elastic roller bandage should be used to cover the bitten limb. the body or the face are affected.
• Do not remove the trousers as the movement of doing so will only assist the venom • Give care for severe allergic reactions if it does develop.
into entering the bloodstream.
• Do not attempt to kill the snake as this may be dangerous.

First Aid Management for Bee Stings

• Remove any visible stringer.
• Wash the site with soap and water.
• Cover the site with a dressing.
• Apply a cold pack to the area to reduce pain and swelling.
• Call the local emergency number if the person has any trouble breathing or shows
any other signals of anaphylaxis.

First Aid Management for Marine Life with poisonous spines

• Immerse the wound in 45°C water or as can be tolerated for 30 to 90 minutes.
• Soak the affected area in vinegar.
• Leave an inaccessible spine alone and only if it hasn’t penetrated a joint, nerve or
blood vessel.
• Cleanse the wound with an antiseptic solution.
• Washing out remaining venom and pieces of spine will help minimize damage,
speed healing and prevent infection.
 Head and Spine Injuries Bones, Joints, and Muscle Injuries

Types
Types • A strain or pulled muscle is caused by overstretching and tearing or tendons. This
• Head Injury usually involves muscles in the neck, back, thigh or back of the lower leg.
A head injury is potentially dangerous. If not properly treated, injuries that seem minor
could become life-threatening. Head injuries include scalp wounds, skull fractures, • A sprain is the tearing of ligaments at a joint. The joints most easily injured are
and brain injuries. the ankle, knee, wrist, and fingers.

• Concussion • A dislocation is the movement of a bone at a joint away from its normal position.
A concussion involves a temporary loss of brain function from a blow received by a This movement is usually caused by a violent force tearing the ligaments that hold
victim to the head. Loss of consciousness may not always occur, but its after-effects the bones in place.
can be easily recognized. *bone to bone

• Spinal Injury • A fracture is a complete break, a chip, or a crack in a bone. In general, fractures
Spine injuries often fracture the vertebrae and sprain the ligaments. are not life-threatening. However, a breakage in the large bones, a severed artery,
and difficulties in breathing are dangerous signals to look out for. A fracture is
*Prevent injuries to the head, neck, and back by practicing these safety either closed or open.
guidelines: *joint to joint
- Wear safety belts (lap and shoulder restraints) and place children in car safety
seats. Signs and Symptoms
- Wear approved helmets, eyewear, faceguards, and mouth guards. • Pain
- Climb steps carefully to prevent slipping or falling. • Significant bruising and swelling
- Obey rules in sports and recreational activities. • Significant deformity
- Avoid inappropriate alcohol use. • Inability to use affected body part normally.
- Inspect work and recreational equipment regularly. • Bone fragments sticking out of a wound.
- Think and talk about safety. • Grating sensations after hearing a bone pop or snap.
• Cold, numb, and tingly sensations on the injured area.
First Aid Management
• When the cause of injury suggests that it may be severe.
• Call the local emergency number.
• Minimize movement of the head, neck, and back.
First Aid Management
• Check for life-threatening conditions. Maintain open airways. • R – rest
• Monitor consciousness and breathing.
• I – immobilize
• Control any external bleeding with direct pressure unless the bleeding is located
• C – cold
directly over a suspected fracture.
• E – elevate
• Help patients maintain normal body temperature.
 Medical Emergencies • Abnormal pulse (rapid/weak)
• Feeling or looking ill
Stroke
A stroke is a disruption of blood flow to a part of the brain which may cause permanent First Aid Management
damage to the brain tissue. This is also called “cerebrovascular accident (CVA).” • First, check and determine if there are any life-threatening conditions.
• A person with diabetes who is experiencing a diabetic emergency must be
Assessment instructed to his/her blood glucose level.
• For stroke assessment, BE FAST • A victim experiencing a diabetic emergency due to hypoglycemia must be
B – balance encouraged to treat him/herself with food or drink that contains sugar.
E – eyes *The same action is advised if the condition is still to be determined or still
F – face remains unknown (are the hypoglycemic or hyperglycemic?)
A – arm • If the diabetic person is conscious and is able to swallow and then states that they
S – speech need sugar.
T – time • If the person is unconscious or is about to lose consciousness, call the local
emergency number. Maintain an open airway and do not give anything by mouth.
Signs and Symptoms
• Sudden numbness or weakness in the face, arm or leg, especially on one side of Seizures
the body. Seizure is when the normal functions of the brain are disrupted by injury, disease,
• Sudden confusion, trouble speaking or understanding. fever, poisoning or infection, and the electrical activity of the brain becomes irregular.
• Sudden trouble seeing with one or both eyes.
• Sudden trouble walking, dizziness, loss of balance or coordination. Types & Causes
• Sudden severe headache with no known cause. • Chronic: This condition occurs suddenly and without warning.
• Febrile: This condition brings about a rapid increase in body temperature.
First Aid Management
Recognize the “signals” and take action. Signs and Symptoms
• Call the local emergency number immediately. Minutes count! • Unusual sensation or feelings such as visual hallucination
• Have the person stop what he/she is doing and have them rest comfortably by • Irregular breathing patterns
sitting or lying down. • Drooling
• Give the victim supportive care and reassurance. • Upward rolling of the eyes
• Be prepared to perform CPR if the victim becomes unresponsive. • Rigid body
• Sudden, uncontrollable, rhythmic muscle contractions, and convulsions
Diabetic Emergencies • Decreased level of responsiveness
Diabetes is the inability of the body to change sugar (glucose) from food into energy. • Loss of bladder or bowel control

Types & Causes First Aid Management

• Hyperglycemia: Too much sugar in the blood. The person may not have taken • Reassure the victim that you are going to help.
enough insulin or may be reacting adversely to a large meal that is high in • Remove nearby objects that might cause injury.
carbohydrates. • Protect the victim’s head by placing a thinly folded towel or piece of clothing
• Hypoglycemia: Too little sugar in the blood. The person may have taken too much beneath it.
insulin, eaten too little, or has suffered from overexertion. • Do not hold or restrain the patient when a seizure is in progress.
• Do not place anything between the victim’s teeth or put anything in the victim’s
Signs and Symptoms mouth.
• Changes in level of consciousness, including dizziness, drowsiness, and • Loosen the clothing and fan the victim if the seizure was caused by a sudden rise
confusion. in body temperature.
• Irregular breathing
• Ensure that the victim’s airway is open and check for breathing and other injuries • An emotionally stressful event.
once the seizure is over. • Pain
• Stay and watch over the victim until the victim is fully conscious. • Specific medical conditions (e.g., heart disease).
• Standing for long periods of time or overexertion
Anaphylaxis • *Pregnant women and the elderly are most likely than other to fain when suddenly
An allergy caused by the over-activity of the immune system against specific antigens. changing positions.

Signs and Symptoms First Aid Management

• Skin becomes swollen and turns red. • Position the victim on his/her back.
• Difficulty in breathing, wheezing of shortness of breath. • Keep the victim in a lying position.
• Tight feeling in the chest and throat. • Loosen any restrictive clothing (e.g., tie, buttoned-up collar).
• Swelling of the face, throat, or tongue • Check for any other life-threatening and non-life-threatening conditions.
• Weakness, dizziness or confusion • Do not give the victim anything to eat or drink.
• Rashes or hives
• Low blood pressure
• Shock

Causes
• Bee or insect venom
• Pollen
• Animal dander
• Latex
• Certain antibiotics and drugs
• Certain foods (e.g., nuts, peanuts, shellfish, dairy products)

First Aid Management

• Call the emergency local number.
• Calm and reassure the person.
• Help the person to rest in the most comfortable position for breathing.
• Monitor the person’s breathing. Look for any changes in his/her condition.
• Assist the person with the use of a prescribed epinephrine auto-injector, if
available.
• Give acre for life-threatening emergencies.
• Document any changes in the person's condition over time.

Fainting
Fainting is a partial or complete loss of consciousness resulting from a temporary
reduction of blood flow to the brain.

Signs and Symptoms

• Light-headedness or dizziness.
• Signs of shock (e.g., pale, cool or moist skin).
• Nausea and numbness or tingling in the fingers and toes.

Causes
 • High body temperature
Environmental Emergencies • Absence of sweating.
• Red, hot, dry, and flushed skin.
Heat-related Emergencies • Rapid pulse and difficulty breathing.
Heat cramps • Nausea, vomiting, fatigue, and weakness.
Heat cramps are painful involuntary muscle cramps that can occur during and after
exercise or work in a hot environment. First Aid Training
• Call or have someone call the local emergency number.
First Aid Management • Move the person into a cool place, a shaded area or an air-conditioned area.
• Remove the patient from the hot environment. • Cool the patient immediately by immersing him/her in water.
• Encourage the patient to drink a beverage containing salt. • If water immersion is not possible or is delayed, the following actions can be
• If Oral Rehydration Solution (ORS) packets are not available, make an oral performed:
rehydration solution. - Douse the patient with copious amounts of cold water, spray the patient with
• Stretch the affected muscle and massage the area once the spasm has passed. water, fan the patient or cover the patient with ice towels or surround the
patient with ice bags.
Heat Exhaustion • Respond to any life-threatening conditions that may come about.
Heat exhaustion is a milder form of heat-related illness that can develop after exposure
to high temperatures. This may also be a result of inadequate fluid intake or insufficient Cold-related Emergency
replacement of fluids. Hypothermia
Hypothermia is the general cooling of the entire body. In hypothermia, the body
Signs and Symptoms temperature drops below 35°C.
• Heavy sweating
• Muscle cramps Signs and Symptoms
• Dizziness • Shivering (may be absent in the later stages of hypothermia).
• Paleness • Numbness
• Nausea or vomiting • Glassy stare or a blank expression
• Cool, moist skin • Apathy or decreasing level of consciousness.
• Tiredness and weakness • Weakness
• Headache • Impaired judgment
• Fainting
• Fast, weak pulse rate First Aid Management
• Gently move the person to a warm place.
First Aid Management • Care for any life-threatening conditions.
• Remove the patient from the hot environment. • Call the local emergency number.
• Fan the body, place ice bags or spray water on the skin. • Remove any wet clothing and dry the person.
• Start oral rehydration with a beverage containing salt or make them drink an Oral • Warm the person by wrapping him/her in blankets or by replacing the person’s
Rehydration Solution. clothes with dry clothing (passive rewarming).
• If available, apply heat pads or other heat sources to the body.
Heat Stroke • Do not warm the person too quickly (e.g., immersing him/her in warm water).
Heat stroke is a form of hyperthermia. Prolonged exposure to high exposure to high Rapid warming may cause dangerous heart rhythms.
temperatures can contribute to failure of the body’s temperature control system. • If the person is alert, give warm liquids that do not contain alcohol or caffeine.

Signs and Symptoms

• Strange behavior, headaches, dizziness, hallucinations, confusion, agitation,
disorientation, and coma.
 Special Situations
Materials and supplies needed:
Emergency Preparedness At home en route to the hospital: For a long automobile ride:
- Assemble clean cloth, plastic bags or - The mother should wear a nightgown or
Emergency Evacuation Drill
other materials to protect bed clothes or slip a robe (no other underclothing) and
A physical or mental exercise aimed at perfecting facility or skill especially by regular car upholstery. place a sanitary napkin or clean folded
practice. - Clean towels, one or two folded sheets. towel between her thighs if the bag of
- Set of sterile cord ties or sterilized waters has broken or if the blood and
Three Types of Drill shoelaces. mucous are draining from birth canal.
1. Scheduled Drill - New razor blades in protective paper. - Take along a flashlight, if the trip will
2. Unannounced Drill - Diaper, alcohol, sanitary napkins be at night.
3. In-Services Drills - Receiving blanket for the baby - Blanket and pillow
- Safety pins - Container of some sorts for the after
*Mass Casualty Incident (MSI) birth.
Triage Colors:
Color Assessment
GREEN Walking wounded Aquatic Emergencies
YELLOW Wounded that cannot walk; can be delayed in less than 1 hour An emergency can happen to anyone in, on or around water. Regardless of how good
RED Critical cases; priority to be sent in the hospital; MARCH a person is at swimming, anyone can get into trouble because of a sudden illness or
BLACK No signs of life injury.

*MARCH for RED Triage Color: Causes

M – massive bleeding • Panic
A – airway • Exhaustion in the water
R – rapid respirations • Losing control and getting swept into water that is too deep.
C – circulation • Losing support (as in a sinking boat).
H – head circulation/ hypothermia • Getting trapped or entangled in the water.
• Using drugs or alcohol before getting into the water.
Emergency Childbirth • Suffering from a medical emergency while in the water.
Emergency childbirth occurs when delivery is unexpectedly, and you cannot get • Using poor judgment while in the water.
medical help in time. • Hypothermia.
• Trauma
Signs and Symptoms • Having a diving accident.
• If labor contractions are approximately 2 minutes apart.
• If the woman is straining or pushing down with contractions. Emergency Actions
• If the woman is crying out constantly.
• Warning from the woman that the baby is coming. Near-Drowning
• Make sure that the scene is safe.
Causes • Always check first to see whether a lifeguard or other trained professional is
• Rupture tubal pregnancy with concealed hemorrhage into abdominal cavity. present before helping someone who may be having trouble in the water.
• Unusual bleeding from the vagina at any stage. • Do not swim out to a victim unless you have the proper training, skills, and
• Convulsions associated with pregnancy. equipment.
• Miscalculations in the anticipated delivery. • If the appropriate safety equipment is not available and there is a chance that you
• Premature onset of labor after an accident. cannot safely help a person in trouble, call for help immediately.
• Delay in transportation. • If you mast assist someone who is having trouble in the water, you must have the
• Other factors which may abbreviate delivery. appropriate equipment both for your own safety and the victim’s.
• Send someone else to call the local emergency local number while you start the Lifting and Moving
rescue.
Submerged Victim Lifting and carrying are dynamic processes. A patient can be moved to safety in many
• If the victim is at or near the bottom of the pool in deep water, call for trained help different ways, but no one way is best for every situation. The objective is to move a
immediately. patient to safety without causing injury to either the patient or the first aider.
• If the victim is in shallow water that is less than chest deep, carefully wade into
the water with some kind of flotation equipment. Emergency Move
• Reach down and grasp the victim. Is the movement of a patient to a safe place before initial assessment and care is
• Pull the victim to the surface. provided, typically because there is some potential danger.
• Turn the victim face-up and bring him/her to safety. Non-emergency Move
• Remove the victim from the water. Is the movement of a patient when both the scene and the patient are stable.
• Provide emergency care.
*Generally, do not move an injured or ill person while giving care except in the
following situations:
• When faced with immediate danger (e.g., fire, lack of oxygen, risk of explosion
or collapsing structure), give care only when it can be done safely.
• When there is need to get another person who may have a more serious problem.
In this case, a person with minor injuries may be moved to reach someone needing
immediate care.
• When it is necessary to give proper care. For example, if someone needs CPR,
he/she might have to be moved from a bed because CPR needs to be performed
on a firm, flat surface. If the surface or space is not adequate for giving the
necessary care, the person should be moved.

Lifting and Moving Guidelines:

• Only attempt to move persons who you are sure you can comfortably handle.
• Bend your body at the knees and hips.
• Lift your legs, not with your back.
• Walk carefully using short steps.
• When possible, move forward rather than backward.
• Always look where you are going.
• Support the victim’s head, neck, and back if necessary.
• If supine, life and carry the patient’s entire body as one unit.
• Avoid bending or twisting a victim with a possible head, neck or back injury.
• Use the log-roll technique when placing a blanket or a spine board under the
patient in preparation for a carry.

Skills Set
Assisting a victim lying supine on the ground to standing up
Assist to walk Extremity carry
Armpit clothes drag Extremity carry (hand as a litter)
Ankle drag Chair carry
Cradle carry (carry in arms) Hammock carry
Pack-strap carry Blanket carry
Firefighter carry Bearer’s alongside