CPR First Aid

CPR First Aid
Work Book 2019

HLTAID003 and HLTAID004
HLTAID006 Pt1
– Modules 1-10
CPR First Aid (RTO: 21903) – Level 1, 550 Flinders Street, MELBOURNE VIC 3000
ABN: 75 134 879 315 Ph: 1300 305 606 Fax: 03 8677 6501
www.cprfirstaid.com.au info@cprfirstaid.com.au
CPR First Aid Work Book © 2019
Index Reference
Module 1 Introduction to First Aid
Module 2 Principles/Priorities
Module 3 Chain of Survival
Module 4 Illnesses
Module 5 Medical
Module 6 Burns
Module 7 Head Injuries & Illnesses
Module 8 Skeletal Muscular Injuries
Module 9 Environmental Illnesses
Module 10 Bites and Stings
WARNING!
Readers are warned that certain pages contain graphic images of real or simulated injuries
to real people. All images have been added for the purpose of education only.
This workbook is not suitable for minors
Instructions: Mark your answers by placing an x in the appropriate square, submit your
answers as per booking instructions, if your answer is not correct it will be sent back to you
for your second and final attempt. (Questionnaire and Assessment answer sheet can be
requested separately if required – refer to last page)
Please note: The submission of the Assessment Answer sheet (Online or hard copy) is
evidence of completion of the workbook, however you will also be assessed in the
classroom on this workbook. If you are unable to answer the same questions in the
classroom then you will be deemed not competent and not pass the course.
This is to deter copying and cheating.
© Property of CPR First Aid copyright protected www.cprfirstaid.com.au

Module 1 – Introduction to First Aid
In this lesson, you’ll be learning about:
1) First Aid Basics
2) Legal Aspects
3) Record Keeping
4) Human Anatomy
5) Infection Control
Estimated Completion Time: 15 minutes
Topic 1.1 – First Aid Basics
What is First Aid?

First aid is the initial care given to an injured or ill casualty until the arrival of a paramedic,
nurse or medical doctor.
The four aims of first aid are to:
1. Protect life
2. Prevent further deterioration
3. Promote recovery
4. Preserve life
Any attempt is better than no attempt!
Topic 1.1 – First Aid Basics – Calling for Medical Assistance

Triple Zero (000)
Stay focused, stay relevant, stay on the line:
• Is someone seriously injured or in need of urgent medical help?
• Is your life or property being threatened?
• Have you just witnessed a serious accident or crime?
• If you answered YES, call Triple Zero (000). Triple Zero calls are free.
When you call Triple Zero (000), the operator will ask:
• Do you want Police, Fire, or Ambulance?
• Stay calm, don’t shout, speak slowly and clearly
• Tell us exactly where to come. Give an address or location
If you are deaf or have a speech or hearing impairment call 106:

• This is a Text Emergency Call, not SMS
• You can call from teletypewriters
• State which service you need and where to come
Topic 1.1 – First Aid Basics – Calling for Medical Assistance
Mobile phone services: Triple Zero (000) & One One Two (112):
• Triple Zero (000) is Australia's primary telephone number to call for assistance in life
threatening or time critical emergency situations.
• 112 is a secondary emergency number that can be dialled from mobile phones in
Australia.
• There is a misconception that 112 calls will be carried by satellite if there is no
mobile coverage. Satellite phones use a different technology and your mobile phone
cannot access a satellite network
• Important – if there is no mobile coverage on any network, you will not be able to
reach the Emergency Call Service via a mobile phone, regardless of which number
you dialled.
• 112 is an international standard emergency number which can only be dialled on a
digital mobile phone.
Topic 1.2 – Legal Aspects – Duty of Care

In Australia, first aiders are only obliged to render assistance in an emergency (or carry a
duty of care) if:
• They were involved in the incident;
• They are on the ocean (e.g. sailing); or
• They choose to accept responsibility on land
Other situations that would be considered ‘accepting responsibility’ or ‘carrying a duty of

care’ could be:
• Parenting or babysitting a child
• Employment that involves workplace health and safety or first aid provision (e.g.
first aid officer role, police officer, teacher, personal trainer etc.)
• If you are an employer or managing/supervising other workers
• Stopping at an emergency – remember that by starting to help you are
establishing a duty of care
Topic 1.2 – Legal Aspects – Duty of Care

People with first aid qualifications are not always automatically expected to assist in
emergencies. A duty of care needs to exist for the legal obligation to take place. Neglecting
an existing duty of care may result in implications associated with negligence. To identify
your legal implications or for further clarification, you are encouraged to seek legal advice.
The standard of care required of a person who has a duty of care to respond, is higher. Like
other persons in our community who hold themselves out to have a skill, they must perform
their tasks to a standard expected of a reasonably competent person with their training and
experience. However, this does not mean that the standard of care given must be of the
highest level.
All first aiders should remain caring for the casualty at the scene if safe until medical aid
(such as a medical doctor, nurse, paramedic or ambulance officer, or the fire brigade) takes
over.
Topic 1.2 – Legal Aspects – The Protection of Good Samaritans
A Good Samaritan is an individual that provides assistance, advice or care to another person
in relation to an emergency or accident in circumstances in which he or she expects no
money or any other financial reward for providing the assistance,
advice or care.
First aiders providing care should always stay within the limits of
their training. Unless the first aider is put in danger by staying,
they are legally expected to continue to provide their support until
medical aid takes over. Neglecting a duty of care, or ignoring the
limits of first aid training, may result in further implications
associated with the law.
Should a casualty recover and the nature of their condition does not require medical
attention, the first aider may end their duty of care to the casualty.
Topic 1.2 – Legal Aspects – Casualty Consent

Before providing first aid to a “competent” casualty, a first aider
must obtain their consent. If first aid is provided without consent,
it has the potential of being counted as “medical trespass”
(assault). Conscious casualties have the right to refuse first aid
treatment and their wishes need to be respected.
If a casualty is a minor (under 18yrs) you should gain the consent
from a parent/guardian. Parents and guardians have the right to refuse first aid
treatment for their minor. In the absence of a parent/guardian first aiders should
regard children as having impaired-decision making capacity.
In the event of refusal, first aiders with a duty of care should contact 000
(ambulance) for advice and should stay at the scene (if safe to do so) until
otherwise advised.
Topic 1.2 – Legal Aspects –Treatment Without Consent
Although first aid treatment normally requires consent, an injured or ill person should
not be deprived of first aid merely because they lack decision-making capacity. The key
legal factors which determine whether treatment can be given without consent are:
• Whether the casualty has or has not decision-making capacity;
• Whether an advance care directive exists;
• The degree of urgency of the situation, and;
• Whether a substitute decision-maker is present, willing and able to consent
If the casualty is incapable of consenting, (e.g. the casualty is unconscious) and no
substitute decision maker is present, a first aider may provide urgent first aid to
preserve life and health without consent (unless an advance care directive prohibits
such treatment).
This means the legal requirement to obtain consent before providing assistance or
treatment is waived under Common Law and Statute law in several circumstances, e.g.
if the casualty is unconscious or becomes unconscious before consent was discussed.
Refer to ARC Guideline 10.5 “Legal & ethical issues related to resuscitation”
Topic 1.2 – Legal Aspects – First Aid and Workplace Health and Safety
In all Australian states, there is legislation that requires all employers
to provide a safe working environment for all employees. They are also
obliged to ensure there is the provision of first aid and first aid
equipment in the event of an emergency.
A designated workplace first aider has a legal duty of care, if they are
safe to do so, to give first aid to any person suffering an illness or injury
in the workplace. This requires the designated first aider to
attend regular first aid training sessions in order to keep their
skills current. Refresher training in CPR should be undertaken
annually according to ARC guidelines and the Code of Practice
for First Aid.
For further information, contact your state government
occupational health & safety regulator.
Topic 1.2 – Legal Aspects – Privacy and Confidentiality
Where possible, a first aider must take steps to assist the casualty to maintain dignity
and personal privacy. Methods of doing this can be by:
• Having crowd control
• Putting up a privacy screen
• If appropriate to do so, move the casualty to
a quiet area
• Cover up any exposed body parts, e.g.
emergency rescue blanket, sheets, blankets
The Privacy Act and Principles impacts upon all first
aid rendered, therefore a first aider needs to take steps to maintain confidentiality.
This means you should not disclose the casualty’s personal details, incident details,
medical conditions and aid rendered to family members, close friends or answering
questions from the media unless you have permission from the casualty.
Topic 1.3 – Record Keeping
It is important that all first aid incidents,

inside or outside of work, be recorded in
writing.
Each workplace should have appropriate

documentation for the reporting of illness or
injury.
These documents need to be completed in full and should not be altered.

Therefore, correction fluid or pencil should not be used on these documents.
Outside of the workplace, if an incident occurs, first aiders should take accurate,
brief and clear notes and keep them on hand in case an investigation takes
place.
Notes should include:

1. The time of the incident
2. The date of the incident
3. The location of the incident
4. What the first aider found upon arrival
5. What actions the first aider carried out
6. Any changes in the casualty’s condition
7. Any witness details
8. Handover to medical professional’s details
9. Did the casualty recover and relieve the first aider of their duty of care?
All documentation should be signed and dated by the first aider and stored securely to
maintain confidentiality. Keep your notes clear and easy to understand and ensure you
write down exactly how things are presented to you.
(Childcare) - Law Section 174, Regulations 12, 85-87, 168, 177-178, 183
• Centres must have incident, injury, trauma and illness policies and
procedures in the event that a child:
(a) is injured; or (b) becomes ill; or (c) suffers a trauma.
• A Centre must ensure that a parent of a child is notified as soon as
practicable, but not later than 24 hours after an occurrence, if the child is
involved in any incident, injury, trauma or illness
• The details of the occurrence must be correctly and accurately recorded
within 24 hours
• The occurrence records are stored safely and securely until the child is aged
25 years
• That the Regulatory Authority is notified of a serious incident which
includes:
(a) death of a child; or (b) where medical assistance was required; or (c)
attendance of emergency services at the education and care service
premises was sought, or ought reasonably to have been sought.
Topic 1.4 - Human Anatomy
The human body is made up of different anatomical and physiological

systems, each performing a vital role. Whilst is it not crucial for a first aider
to know detailed information about these systems it will benefit the first
aider to have a basic knowledge of how the systems work.
Several are particularly useful for a first aider to have a basic knowledge of.
Topic 1.4 - Human Anatomy – Skeletal System
The skeletal system is made up of 206 bones that provides structure to our bodies, and
protects our internal organs from damage. Muscles, ligaments and tendons are closely
linked with this system and all play vital roles in allowing movement and function of limbs
and body parts.
The bones of the skeleton have 4 main functions:

1. To give shape to the body
2. To produce blood cells
3. Support muscles to allow movement
4. Protect vital organs
Topic 1.4 - Human Anatomy – Cardiovascular System

This system is made up of the heart, blood and blood vessels.
Blood flowing from the heart delivers oxygen and nutrients to
every part of the body. The blood stream removes waste products
via transportation to the kidneys and other organs.
Heart – a muscular organ in the chest that pumps blood

around our body. The heart is divided into four chambers:
upper left and right atria; and lower left and right
ventricles. The average adult resting heart rate is
between 60 – 100 beats per minute.
The heart is muscle that pumps blood to all parts of the

body. Blood provides the body with the oxygen and
nourishment it needs to function. Waste products carried
by the blood are removed from the body by organs such
as kidneys. The right side of the heart obtains de-
oxygenated blood via main veins (Superior and Inferior Vena Cava) and pumps this blood to
the lungs where oxygen is absorbed and carbon dioxide is released.
The oxygenated blood returns to the heart via the pulmonary
vein into the left atrium.
The blood is then pumped into the left ventricle which pumps
blood into the body’s main artery – the aorta. The aorta is the
body’s largest artery and carries blood to smaller arteries which
distribute blood to all parts of the body. On the return trip, the
now de-oxygenated blood carries back to the heart via veins
into the right atrium, and the cycle continues.

Blood – blood is composed of a clear liquid called plasma. Red blood cells make blood look
red, and allow oxygen to be delivered around the body. White blood cells are part of your
body’s defence against disease. Platelets are cells that help your body repair itself after
injury through coagulation (clotting).
Blood Vessels – Arteries transport oxygenated blood away from the heart. Veins transport
de-oxygenated blood back to the heart. Arteries narrow into arterioles. Capillaries are the
smallest vessels which connect the arterioles to the venules. It is at this level that majority
of transfusion with cells takes place.
Heart Rate / Pulse – heart rate, or pulse, is the number Age Range Heart Rate
of times the heart beats per minute. Normal heart rate 1 - 12 months 100 - 160
varies from person to person. The average normal resting 1 - 5 years 80 - 130
heart rates which vary with age are: 6 - 14 years 60 - 110
A basic knowledge of this system will help in 15 - adult 60 - 100
understanding the mechanics of CPR and DRS ABCD.
Topic 1.4 - Human Anatomy – Nervous System

The nervous system is made up of your brain, spinal cord and a huge network of
nerves that thread throughout our entire body.
The nerves receive and conduct information
to the brain for processing, which enables the
coordination of all of our actions and
reactions. From applying correct pressure
when gripping a cup, to retracting your hand
from a sharp or hot object.
A basic knowledge of this system is useful
when dealing with burns and pain
management.
Image by OpenStax College
Topic 1.4 - Human Anatomy – Respiratory System
As all cells in our body need oxygen to survive, our respiratory system is vital to our survival.
This system comprises of 2 parts:
Airway - mouth, nose, trachea, larynx, bronchi and
bronchioles.
Lungs – are literally large bags of air which contain small air
sacks that are called alveoli. As we breathe, oxygen from the
alveoli is filtered into the blood stream and carbon dioxide out
of the blood stream. This process is essential to our survival –
4-6 minutes without oxygen can cause permanent brain
damage.
A basic understanding of this system is useful when learning
about airway management and CPR.
Topic 1.4 - Human Anatomy – Respiratory System
Breathing is the process that moves air in and out of the lungs, or oxygen through other
respiratory organs. This process is also known as ventilation
Normal Respiratory Rate Ranges Age Range Respiratory

Overall, children have quicker respiratory rates than Rate
adults, and women breathe more often than men. The 1 - 12 months 30 - 60
normal ranges for different age groups are listed: 1 - 5 years 20 - 40
6 - 14 years 15 - 30
15 - adult 12 - 20
Topic 1.4 - Human Anatomy – Upper Airway
A child's airway differs from that of an adult in

that the child's tongue is proportionately larger in
the oropharynx compared to that of an adult.
Also, a child's airway is smaller and softer and

more prone to foreign body obstruction. The
trachea is usually about the diameter of a pencil.
Infants have very short and softer tracheas than

adults. This means that overextension of the head
(Tilting the head) during CPR may result in airway
collapse (not too dissimilar to kinking a narrow
garden hose).
Topic 1.4 - Human Anatomy – Unconsciousness
The causes of unconsciousness can be categorised into four general groups:

• Low oxygen levels to the brain
• Heart and circulation problems (e.g. fainting, abnormal heart rhythms, severe blood
loss)
• Metabolic problems (e.g. low blood sugar, drug overdose, intoxication)
• Brain problems (e.g. stroke, head injury, tumour, epilepsy)
Signs and Symptoms
Before the casualty has loss of consciousness, they may experience:
• Yawning
• Dizziness and light headedness, confusion
• Sweating
• Normal skin colour changes
• Changed or blurred vision, slurred speech
• Nausea
Topic 1.4 - Human Anatomy – Musculoskeletal System
The musculoskeletal system is a term used

to describe the bones, as well as the
adjoining ligaments, tendons and muscles.
The following section will provide an
overview of the names and locations of
different bones; however, you are not
expected to demonstrate a complete
knowledge of all the bones listed.
It is recommended that you become

familiar with the following section, as it will
assist you in understanding medical
terminology, and give you a greater
knowledge base as a first aider in which to
understand and communicate effectively.
Topic 1.5 - Infection Control
When giving first aid to a sick or injured person you should try to minimise the risks to
yourself, bystanders and to the casualties.
All around the world, any one person could be infected with a communicable disease. This
any one person could very well be your casualty. Diseases that are life threatening can
include HIV/AIDS and hepatitis strains.
Topic 1.5 - Infection Control - Chain of Infection
Whether or not infection happens will depend on a number of things. This is best explained
by looking at the chain of infection.
The Six links to the Chain of Infection
In order for infection to occur, the links to the Chain of Infection must occur.
1. Infectious Agent: Any disease causing micro-organism (pathogen) i.e. bacteria, virus.
2. Reservoir: Where the pathogen is located (i.e. blood, saliva)
3. Portal of Exit: The route of escape of the pathogen from the reservoir (i.e. saliva via
coughing, blood via cut in skin)
4. Mode of Transmission: How the pathogen gets from the reservoir to its new host
(i.e. propelled through air, direct contact)
5. Portal of Entry: The route in which the pathogen enters the new host (breaks in skin
(cuts, wounds), inhalation, ingestion, sexual contact).
6. Susceptible Host: The organism that accepts the pathogen (you or the casualty)
Topic 1.5 - Infection Control – How to break the Chain of Infection

Correct Hand Washing - appropriate hand washing by the First Aider remains the most
important factor in preventing the spread of micro-organisms. Good hand washing
techniques are displayed in the attached picture.
Barriers - use barrier equipment whenever possible (gloves, masks, face shields, eye
protection and tongs). Barriers dramatically lessen the spread of infection, both to the
casualty and to you!

Needle Stick Injuries - needle stick injuries are an opportunity for a pathogen to penetrate
directly into the blood stream of another person if not handled carefully. HIV (AIDS) and
Hepatitis B are just few of the possible blood borne viruses that can be transferred from one
person to another.
• If injured by a used needle stick, one should always seek medical assistance so that
testing and preventative measures can be done to decrease the risk of infection.
Follow all safety procedures:
• Latex or nitrile gloves will not protect you against needle stick injuries
• Never bend or snap used needles
• Never re-cap a needle
• Always place used needles into a clearly labelled and puncture-proof sharps
approved container
If you do become contaminated by a sharp you should follow these
steps:
• Penetration of skin - wash the blood / body fluid away with
water.
• Contamination of the eye – rinse with water or saline with the
eye open.
• Blood in mouth – spit out blood, and repeatedly wash with
water.
• Seek professional medical assistance from your local doctor or
hospital.
Learner FAQ
For your own reference, please read the following information carefully to ensure that the
practical first aid day is a positive experience and you get the full qualification or statement
of attainment.
Access LINK
Module 2 – Principles/Priorities of First Aid Practices
1) Safe Manual Handling
2) Basic First Aid Kit
3) DRS ABCD
4) Recovery Position
5) Heart Attack
6) Angina
7) Cardiac Arrest
Topic 2.1 - Safe Manual Handling
Manual handling includes pulling, pushing, lifting, moving, carrying, restraining or holding
any person or object.
Assessing the situation and the load:
• Can you move the person yourself, or is help required?

• How far will you have to move the person?
• Is the pathway clear or cluttered?
• Are there any manual handling aids available? (sheets / lifting
equipment etc.)
• Test the weight by lifting the corners, or tilting the object
• Ask for help if it is too heavy
Topic 2.1 - Safe Manual Handling
Use of good lifting techniques:
• Use good body mechanics - maintain a straight back,

bend your legs and use equipment when available
• Maintain a large base of support (stabilising using your
feet)
• Don't move a casualty on your own
• Lift only as a last resort (the best lift is NO lift - unless
life threatening)
• Keep the object close to your body
Topic 2.2 - Basic First Aid Kit
All workers must be able to access a first aid kit. This will require at least one first aid kit at
their workplace. The contents of first aid kits should be based on a risk assessment.
The first aid kit should provide basic equipment for administering first aid for injuries
including:
• Cuts, scratches, punctures, grazes and splinters
• Muscular sprains and strains
• Minor burns
• Amputations and/ or major bleeding wounds
• Broken bones
• Eye injuries
• Shock
Topic 2.2 - Basic First Aid Kit
First aid kits should be well maintained. Check that all items are in
good condition, within expiry date and if any items are missing.
Replenish required items.
For further information on first aid kit requirements go to:

http://www.safeworkaustralia.gov.au/sites/swa/about/publications/pages/first-aid-in-the-
workplace
Topic 2.3 - Caring for the Casualty – DRS ABCD

The Australian Resuscitation Council (ARC) recommends using the following 7 step acronym
when caring for the casualty – D R S A B C D
1. DANGERS Check for danger (hazards/risks/safety)

2. RESPONSIVENESS Check for response (if unresponsive)
3. SEND Send for help (Call 000)
4. AIRWAY Open the airway
5. BREATHING Check breathing (if not breathing / abnormal breathing)
6. CPR Start CPR (give 30 chest compressions followed by two breaths)
7. DEFIBRILLATION Attach an Automated External Defibrillator (AED) as soon as available
and follow the prompts
Bondi Rescue – Cardiac Arrest Video
Please watch this video as you will be assessed on CPR in your course. NB. The casualty
does survive in this video: https://www.youtube.com/watch?v=CcqfI9jRbSE
CAUTION! This video may be disturbing to some viewers as it contains footage of real CPR.
D - Dangers
This step is the same when caring for both a breathing or non -
breathing casualty. YOU are the most important person NOT the
casualty. Ensure the safety for yourself (the first aider),
bystanders and the casualty.
• Checking for danger before approaching any situation is

critical. Rushing into a situation without adequately
assessing the situation can put yourself and others at needless risk
• The amount of dangers greatly depends on the situation; hence it is important to
assess each scene for possible dangers
• Sometimes, danger can be avoided, or the casualty can be moved away from it
R – Responsiveness
This step is the same when both caring for a breathing or non-breathing casualty.
• Check consciousness level, speak in a calm positive manner, identify yourself and ask
if you can help.
• Always approach a casualty with caution, feet first. If
there is no response and it is safe to do so, implement
C.O.W.S.
• C can you hear me?
• O open your eyes?
• W what is your name?
• S squeeze my hand?
Then grasp and squeeze the shoulders firmly to prompt a response. A casualty who fails to
respond or shows only a minor response, such as groaning without eye opening, should be
managed as if unconscious.
S - Send for Help

Once you have determined the casualty requires medical
assistance, you should next immediately send for help.
• Yell out for assistance! If there are any bystanders,

instruct them to call 000. If you are alone and have
access to a phone, call 000 and clearly explain the
situation.
• CALL FOR HELP, EMERGENCY NUMBER 000 (landline/mobile) or 112 (mobile)
S - Send for Help

Free app available: Emergency +
The following is an excerpt from Australian

Communications and Media Authority (acma.gov.au):
Are there advantages in using the Emergency+
smartphone app to call Triple Zero (000)?
The most significant advantage of using the Emergency+
smartphone app to call Triple Zero is that if you do not
know your exact location, it uses the existing GPS
functionality of your smartphone to enable you to
provide emergency call-takers with your location
information as determined by your smartphone.
A- Airway
This step is the same when caring for both a breathing or non-breathing casualty. Airway
management is required to provide an open airway when the casualty:
• Is unconscious
• Has an obstructed airway
• Needs rescue breathing
For responsive adults and children, it is reasonable to open the airway using the head tilt
chin lift manoeuver. Infants are left in the head position neutral position.
B – Breathing
This step is the same when caring for both a breathing or

non-breathing casualty.
• LOOK - LISTEN - FEEL FOR BREATHING.
• Get close to the casualty, placing your ear just above
their mouth.
• Can you feel breathing on your cheek? Can you hear
breathing?
• By looking towards the casualty’s chest you will be
able to check for rise and fall of the chest.
• If the casualty is breathing, they should be turned into the Recovery Position.
• If there is NO SIGN OF BREATHING or the casualty is NOT BREATHING EFFECTIVELY,
you will need to proceed immediately onto CPR.

Gasping is Not Breathing Normally
More than 50% of casualties in cardiac arrest gasp. Gasping has been
described as gurgling, agonal or laboured breathing. This has often been
misinterpreted by onlookers and even first aiders as signs that the
casualty is breathing. The abnormal breathing or gasping may last for a
few minutes.
Note that if the casualty has not responded to COWS and a firm shoulder squeeze, that the
gasping should be considered as NOT BREATHING EFFECTIVELY, therefore, you will need to
proceed immediately onto CPR.
C – CPR
Step 1: Compressions
All first aiders should perform chest compressions on all
casualties who are unresponsive and not breathing
normally.
Compressions are the first part of CPR used in conjunction

with rescue breathing to circulate the oxygenated blood
around their body.
Compressions are performed as follows:

• Kneel beside the casualty (at the level of the casualty’s shoulders)
• Locate the lower half of the sternum on the casualty
• Place the heel of the dominant hand in the centre of the casualty’s chest with the
other hand on top (or 2 fingers for infants)
• Keeping your arms straight, and your wrists and elbows locked, press down vertically
to about a third of the casualty’s chest depth, then release pressure
• Give 30 compressions (about 100 to 120 per minute – around 2 a second)
• Give 2 rescue breaths
• Repeat compression / breaths at 30:2 ratio until help arrives
Rescue Baby Child Adult

Breathing O-1 years 1-8years Over 8 yrs
Head Tilt NIL Full Full
Breath into Mouth & Nose Mouth or Nose Mouth or Nose
Breath Size Puff Shallow Full

CPR
Compressions
Compression Depth 1/3 Chest 1/3 Chest 1/3 Chest
4 cm 5 cm >5 cm
Compress with 2 Fingers One or Two Hands Two Hands
Cycle 30 Comp – 30 Comp – 30 Comp –

1-2 Person 2 Breaths 2 Breaths 2 Breaths
Quality Chest compressions:
• To optimize the effectiveness of chest

compressions, the casualty should be
placed on their back on a firm surface
• Interruptions to chest compressions must
be minimised
o A casualty should not be routinely
rolled onto the side to assess airway
and breathing unless regurgitation
occurs
• Allow for complete recoil of the chest after
each compression
• Avoid compression beyond the lower limit of the sternum
Image Courtesy of European Resuscitation Council

Fractured ribs –this is a common consequence of CPR; however, this is acceptable given
that the alternative to CPR is likely death of the casualty.
First aider change-over – when possible, it is recommended that first aiders change every 2
minutes (5 cycles) to prevent fatigue and also to help ensure that the depth and speed of
compressions is maintained. If this is performed, it is important to minimise interruptions to
compressions.
Step 2: Rescue Breath methods
After 30 compressions, perform 2 rescue breaths using one of the following methods.
Mouth to Mask
This involves using a CPR mask for providing rescue breaths.
• The first aider exhales through a 1-way valve through

the mask into the casualty’s mouth.
• Head tilt is still required to open up the casualty’s
airways. Full head tilt for adults and children while no
head tilt for infants.

Mouth to Mouth
This is the recommended form of rescue breathing
when a mask is not available.
The following steps should be taken to correctly provide
mouth to mouth:
• Head tilt/Chin lift Method: Place one hand onto
the forehead or top of head. The other hand is
used in conjunction by holding up the chin using
the thumb and forefinger to open the mouth.
Place the thumb over the chin below the lip and
supporting the tip of the jaw with the middle finger and the index finger lying along
the jaw line. Then gently tilt the casualty’s head back, not the neck, to open the
airway.
• Block the casualty’s nose using fingers on one hand
Mouth to Mouth (Continued)
• Take a breath and open your mouth as widely as possible
• Make a firm seal of your mouth onto the casualty’s mouth
• Exhale into the casualty’s mouth with the required breath size to inflate the
casualty’s lungs. Visually view the rise of the chest
• Give second breath. Should take around one second per breath
Note: Care should be taken not to over-inflate the chest.
In an infant, maximum head tilt should not be used. Instead
the head should be kept neutral. Because of the narrow
nasal passages, the upper airway is easily obstructed, so
there must be no pressure placed on the soft tissues of the
neck. The lower jaw should be supported at the point of the
chin while keeping the mouth open. Due to the head size of an infant compared to its body,
when laid on its back, the head naturally tips forward towards the chest. A slight backward
tilt may be needed to place the head into a neutral position.
Mouth and Nose
This can be used if preferred by the first aider.
• For infants, the first aider should cover the infant’s
mouth and nose with their own mouth instead of
attempting to pinch the infant’s nose.
• If providing mouth to nose on adults, the same
method as mouth to mouth is used, except that
instead of blocking the nose, the first aider should
ensure the casualty’s mouth is closed when exhaling
into the casualty’s nose (this involves sealing the
mouth by pushing the casualty’s lips together with your thumb).
Blocked Airway:
If the casualty’s chest does not rise during rescue breathing, check that:
• The head is tilted back correctly
• There is no foreign material in the airway
• The seal of your mouth on the casualty's mouth is firm
• The nose has been blocked
• Enough air is being blown in
D – Defibrillation (will be covered in the next topic: Chain of Survival)

Regurgitation:
It should be noted that about one in four casualties will regurgitate whilst having CPR
performed on them, especially when drowning is the cause of unconsciousness.
This is because when unconscious, the casualty’s muscles are totally relaxed, including the
valve that stops regurgitation above the stomach.
If the casualty does regurgitate during CPR:

• Turn them into the recovery position with the mouth opened and the head turned
slightly downwards to allow any obvious foreign matter (e.g. food, vomit, blood and
secretions) to drain.
• If required, clear the airways using the 2 finger scoop method.
• If they are still not breathing once the obstruction is cleared from the airway, place
them on their back again and re-commence CPR.
Those who are trained and willing to give breaths do so for all persons who are unresponsive
and not breathing normally.
Duration and Cessation of CPR

A first aider should continue to perform CPR on a casualty
until:
• The casualty responds or begins to breathe normally
• It is impossible to continue any further due to
exhaustion
• Medical professional/s arrive and take over in
performing CPR
• Directions have been given by Medical professional/s to stop CPR
• The scene/location where CPR is being performed becomes unsafe
Topic 2.4 - Recovery Position
Once you have followed DRS ABCD and established the casualty is breathing, you need
to place them into the recovery position. This is
extremely important as it is the best position for an
unconscious, breathing casualty.
An unconscious casualty lying on their back can very

easily suffocate on their own tongue or stomach
contents.

Recovery Position for a Child (1-8 years) or Adult (8+ years)
• Follow DRS ABCD, ensure the casualty is
breathing effectively.
• Place both of the casualty’s arms pointing away
from you (the closest arm will be across the
casualty’s chest).
• Raise the casualty's knee closest to you and
bend it.
• Place one hand under the raised knee, and the
other arm behind the casualty’s shoulders, and
remember to support the neck as best as possible.
• Make sure you are holding the casualty's hip so that you can control the roll and not
let the casualty fall onto their front.
• Gently turn the casualty onto their side facing away from you and bend up the raised
knee further to the front of the casualty to ensure they don’t roll onto their front.
Recovery Position for a Child (1-8 years) or Adult (8+ years) (Continued)
• Make sure the casualty's mouth is the lowest point so that the stomach contents are
able to drain from their mouth.
• Lift chin forward in open airway position and adjust hand under the cheek as
necessary.
• Continue monitoring DRS ABCD until an ambulance arrives – never leave an
unconscious casualty unattended.
• If injuries allow, turn the casualty to the other side after 30 minutes.
REMEMBER - WHEN MOVING THE PERSON ONTO THEIR SIDE MAKE SURE THEIR NECK AND
BACK DO NOT MOVE. MAKE SURE YOU ARE ROLLING THE BODY NOT TWISTING THE SPINE.

Recovery Position for an infant (Under 1-year-old)
For a baby less than a year old, a modified Recovery Position
must be adopted:
• Cradle the infant in your arms, with their head tilted
downwards on their side to prevent them from
suffocating on their tongue or inhaling stomach contents.
• Monitor and record vital signs - level of response and
breathing until medical help arrives.
• 1-handed recovery position can be used by placing your fingers supporting the
baby’s neck and jaw.
• The baby should be facing towards the ground so that any vomit or regurgitation will
not obstruct their airways.
• This position also leaves your other hand free to make phone calls (i.e. 000 / 112),
open doors, do back blows for choking etc.
• If you need to walk around with the infant, be very careful not to trip as you can
easily cause injury by dropping or falling onto the child.
Topic 2.5 – Heart Attack
Heart Attack
Heart Attack is a cardiovascular event caused by
sudden death to heart muscle cells. The most common
cause of this is due to a blockage of the coronary
arteries (arteries that supply the heart with blood)
either by thrombus, or less commonly spasms.
The cells become starved of oxygen due to this sudden

loss of perfusion which causes the heart to stop
functioning normally or to stop altogether.
Heart Attack
Risk Factors include:
• Fatty deposits on the artery walls (atherosclerosis)
• Smoking
• High blood pressure / Hypertension
• Poor diet
• Obesity
• Lack of Exercise
• Age
• Diabetes
• A positive family history of first degree relatives with
cardiovascular events at a fairly young age (<60yrs)

Signs and Symptoms of a Heart Attack:
• Casualty may complain of central chest pain that may radiate to the shoulders, neck
or jaw. They may also clutch at their chest
• Unfortunately, heart attacks do NOT always involve chest PAINS but rather
DISCOMFORT such as tightness, heaviness, squeezing and dull rather than
sharp/stabbing sensations or simply angina "equivalents" symptoms such as
shortness of breath/lethargy in diabetics
• Pale, cool skin
• The casualty may start sweating for no apparent reason
• Breathing may become strained and rapid. Casualty may have obvious difficulty
breathing
• Loss of consciousness
• Nausea or vomiting
• Feeling dizzy or light-headed.
• Women can have all sorts of "atypical" symptoms, so if in doubt call an ambulance!
Treatment:
• Call 000 / 112 immediately, and ask for an ambulance

• Encourage the casualty to stop what they are doing
• Sit the casualty down, and make them comfortable
• Provide reassurance and stay calm
• Remove clothing that potentially inhibits breathing
• Give dissolvable aspirin 300mg (usually one tablet)
o Withhold if the casualty is known to be anaphylactic to aspirin
• Ensure good access to fresh air (ideally oxygen)
• Monitor DRS ABCD, and be prepared to start CPR if the casualty becomes
unconscious and stops breathing
Topic 2.6 - Angina
Angina is a symptom of a condition called myocardial ischemia. Basically put, this means
that the heart muscles are receiving inadequate blood flow and hence inadequate oxygen
for the amount of work the heart is doing at a particular
time.
This is due to disease of the coronary arteries called

atherosclerosis (fatty deposits causing hardening and
narrowing of the artery lumen). At rest, a casualty will have
no symptoms. This is because although the arteries are
narrowed, the heart does not require a lot of blood at rest
anyway. Angina occurs during physical or emotional
excitement when the heart starts beating faster requiring
more oxygen.
Topic 2.6 - Angina

Signs and Symptoms:
• The same as heart attack symptoms, although generally
not as severe
• Symptoms will subside when the heart slows down or
the casualty takes any medications prescribed for their
angina
• The casualty may tell you that they know they have
angina
Treatment:
• Stop exercise / physical exertion. Advise the casualty to relax
• Keep casualty calm
• Assist casualty to take any medication they have been prescribed by their doctor
(normally Anginine, nitro-glycerine tablets or spray)
• Monitor DRS ABCD
• If pain persists for more than 10-15 minutes, call 000 / 112 (as this could be a sign of
a heart-attack)
Topic 2.7 – Cardiac Arrest
Cardiac arrest is the cessation of effective blood circulation due to the sudden loss of
normal heart function.
Note that a heart attack and a cardiac arrest are not the same. Heart attacks are caused by a
blockage that stops blood flow to the heart and at times may cause a cardiac arrest.
Cardiac arrest is caused when the heart's electrical system malfunctions and stops working
properly, often resulting in death. This may be
caused by abnormal, or irregular, heart
rhythms (called arrhythmias).
A common arrhythmia in cardiac arrest is
ventricular fibrillation – refer to image
Cardiac arrest is a medical emergency and
requires immediate response.
Topic 2.7 – Cardiac Arrest

Signs and Symptoms:
• May occur without prior warning
• A slow or racing heart beat
• Fainting, dizziness, blackouts
• Fatigue
• Chest pain
• Shortness of breath, weakness
• Nausea and vomiting
Treatment will be addressed in the next training module: Chain of Survival
Topic: Special Note for Classroom CPR Training & Assessment

It is important to note that the HLTAID competency standards necessitates a level of
physical ability to meet the evidence requirements for assessment. Due to the potential risk
to health and safety, it is important to note that learners must be able to perform at least 2
minutes of uninterrupted CPR on an adult manikin placed on the floor. These standards
relate to the level of performance required to provide resuscitation and respond to an
emergency situation where there may be risk to life.
For further detailed information: LINK
If you have any concerns about this physical assessment aspect please contact our office on
1300 305 606 to discuss
Module 3 – Chain of Survival
1) The Chain of Survival

2) Post Incident Debriefing
3) Positional Asphyxia
4) Fainting
5) Determining Appropriate Treatment
6) Drowning
7) Respiratory Distress
Topic 3.1 - The Chain of Survival
• Cardiac arrest can happen anytime, anywhere. More than 75% of cardiac arrests
happen outside a hospital, and of that – only 5% survive if left untreated
• Survival from cardiac arrest depends on a series of critical interventions.
• If one of these critical actions is neglected or delayed, survival is unlikely.
• The American Heart Association has used the term Chain of Survival to describe
this sequence.
First Link - Early Access
Early access is recognizing that a person is unconscious or

not breathing, and that they need more than basic first aid
and then calling for an ambulance or medical assistance as
soon as possible.
When calling 000 for assistance you need to be clear on your information. Give specific
details as to your location, the nature of the emergency, and follow all their instructions.
Second Link - Early CPR

The 2 most vital anatomical systems in our body are the
Cardiovascular System and the Respiratory System. If these
systems fail for only a short time the body cannot function
normally and this will eventually cause death.
Statistics show that our brain cells begin to die in

as little as 3-4 minutes without oxygen. Brain cells
do not regenerate therefore if CPR is delayed the
more chance the casualty may suffer permanent
brain damage, and the less chance of survival.
Early CPR within the first 2-3 minutes can greatly

improve the chances of survival.

Third Link - Early Defibrillation (D – Defibrillation)
Automated External Defibrillator (AED) is a portable
computerised device that provides an electrical charge to
return the heart to a normal rhythm.
The portable
device has a built in computer and sensor that
will check for the heart rhythm once placed on
the casualty’s chest and it will determine if
defibrillation is required. Voice prompts are
given to the user to follow and to streamline the
defibrillation process.

Third Link - Early Defibrillation (Continued)
• Access to Early Defibrillation is the single most important step in this cycle
• Every minute early defibrillation is delayed reduces the person’s chances of survival
by 10%. This is why it is so important to call 000 / 112 if a cardiac arrest is suspected.
A defibrillator is necessary to reverse this process and ‘reboot’ the heart back into its
normal cycle
• An AED can be used effectively with minimal training, as all the current models are
designed not to function unless an abnormal “shockable” heart rhythm is detected
by the unit
• AED use is not restricted to trained personnel – any first aider can use an AED
• AED units can accurately identify the casualty’s cardiac rhythm as ‘shockable’ or
‘non-shockable’
• An AED is only to be applied to a non-breathing casualty!
AED for Adults

Once it is determined that the casualty is unconscious and not breathing after having a
suspected cardiac arrest, and after calling 000, the following steps should be taken to
correctly use an AED as soon as one is available:
1. CPR should not be delayed while waiting for the AED to arrive – Start CPR
immediately
2. Defibrillation is to be used in conjunction with CPR on casualties who are
unconscious and not breathing. The casualty is to be supine (lying on their back)
3. Turn on the AED and follow the voice or display commands
4. Move any clothing out of the way of the casualty’s chest
5. If the casualty is wet or sweaty, remove any moisture with something dry before
placing the AED pads on the casualty
6. Tear open the AED pad packets and remove AED pads
7. If the casualty has a lot of body hair and the pads don't stick to the chest you will
need to shave the hair on the chest
AED for Adults (Continued)

Attach one pad to the casualty’s upper right chest, and the
other to the casualty’s lower left chest – these positions
will be labelled on the pads (see diagram)
8. Avoid placing pads over any implantable devices –
pads should be placed at least 8cm from any such
devices
9. Do not place pads over medication patches –
remove the patches before continuing as these can
block the current and cause burns to the casualty
10. If not already attached, plug the cables from the
pads into the unit (most units already have this
ready for use)
AED for Adults (Continued)

11. Move any bystanders out of the way – ensure no one is touching the casualty
12. AED will analyse casualty. If the AED determines that a shock is needed, move
everyone away from the casualty
13. Make sure you are not touching the casualty and press the ‘Shock’ button, and then
let the AED re-analyse
14. Follow the instructions of the AED – at this point you may be instructed to
commence CPR, DO NOT remove the pads, or the AED unit may otherwise instruct
you that another shock is necessary
15. Continue CPR and AED until the ambulance arrives
AED for Adults (Continued) - AED Video Presentation
Please watch this video: https://www.youtube.com/watch?v=7qM9oLrX-ZE
CPR First Aid is a distributor of the Heartsine AEDs.

Please contact the office for a quotation
AED for children
• Standard adult AED pads are suitable for persons 8
years and older.
• For children under 8 years of age, paediatric pads
should be used when available.
• When using paediatric pads on a child, they should
be positioned the same way as an adult
• If these are not available, standard adult AED pads
can be used. Ensure the pads do not touch each
other on the child’s chest. If the pads are too large,
there is a danger of pad-to-pad arcing. In this case, the pads placement is not the
same as for adult AED. One pad needs to be placed in the centre of the chest, and
the other on their back in the centre. This will be labelled on the pads (see image)
NOTE: Always refer to manufacturer’s directions/guidelines as they may vary between brands

Forth Link - Early Advanced Care
Early advanced care means the sooner a paramedic can attend to the
casualty; the greater chance a casualty can be stabilised. As such, it
is important that you call 000 as soon as possible. The sooner you
contact emergency services, the sooner a paramedic will be on the
scene, which dramatically increases the casualties’ chance of survival.
Remember to convey all details of the incident when handing
over to the paramedics.
Topic 3.2 - Post Incident Debriefing
Once you have provided CPR or first aid to a casualty and handed over responsibility
to the paramedics, it is recommended that you undergo a debriefing.
• Talk through your actions with your manager, other first aiders, psychologists,
doctors, family or friends.
• Take time to calm down and reflect on your actions, don't go straight back to
work if incident occurred in a workplace setting.
Note that anyone around the incident such as the casualty, the first aiders and
onlookers which may include children can be affected by stress from the trauma that
had occurred. Psychological stress can badly affect people of all ages either during or
after the incident. For example, talk with children about their emotions and
responses to the incident. Provide support as required.

Post Incident Reactions
The following reactions are normal, and help people come to terms with a critical incident.
Physical reactions
Disturbed sleep, nausea, nightmares, restlessness, headaches, excessive alertness, undue
crying and being easily startled.
Cognitive reactions
Poor concentration, visual images of the event, intrusive thoughts, disorientation or
confusion, poor attention and memory.
Emotional reactions
Fear, numbness and detachment, avoidance, depression, guilt, over-sensitivity, anxiety and
panic, withdrawal and tearfulness.

Seek Professional Help
Traumatic stress can cause very strong reactions in some people.
You should seek professional help if you:
• Are unable to handle the intense feelings or physical sensations
• Don’t have normal feelings but continue to feel numb and empty
• Feel that your emotions are not returning to normal after three or
four weeks
• Continue to have physical symptoms
• Continue to have disturbed sleep or nightmares
• Find that relationships with family and friends are suffering
• Are becoming accident prone and using more alcohol or drugs.
Support can be accessed via counselling, educational material that explains the situation
including stress-management techniques, professional help, wellness programmes
Topic 3.3 - Positional Asphyxia
Positional Asphyxia is a condition that occurs when a person’s position causes their
breathing to be restricted. It can be potentially fatal if they are in such a position for any
length of time. Positional asphyxia occurs commonly in small infants who find themselves in
a position where their airways are restricted and are unable to reposition themselves.
This can also occur in adults either by an accident where
they become stuck in a difficult position, i.e. car accident
or more commonly during restraint by police officers,
security guard or even health care staff if not carefully
performed.
People who are at higher risk include those with:
• Heart problems, such as angina
• High blood pressure or diabetes
• Intoxicated or drug affected people
• The elderly
Topic 3.3 - Positional Asphyxia

Warning Signs:
If the person complains of or demonstrates any of the following:
• Difficulty breathing
• Feeling sick / nauseous
• Obvious distension of the veins in their neck
• A change in behaviour – either becomes more or less resistant
• Becomes limp or unresponsive
What to do if they lose consciousness:

Follow DRS ABCD
• If the person is breathing, lay them in the recovery position and monitor closely
• If the person is not breathing, then you should start CPR immediately and call 000
Topic 3.4 Fainting

Fainting is a temporary loss of consciousness, otherwise called syncope. It is generally
caused by a temporary reduction in the blood supply to the brain. Before fainting, the
casualty may feel light-headed, nauseous or dizzy and may appear pale and clammy.
Fainting can be caused by a variety of factors such as:

• A sudden drop in blood pressure
• A sudden change in position, i.e. from lying to standing
• Dehydration
• Stress or fear
• Poison or Alcohol
• Heat
• Pain
Topic 3.4 Fainting
Management of Fainting
Before Fainting:
• If a casualty is light-headed, and appears near to fainting, the best thing to do is to lie
them down on their back and raise their legs, increasing the blood supply to the
brain
• If the casualty refuses to lie down, keep close to the casualty in case they collapse.
Remember also to protect your back – if the casualty is falling, do not attempt to
keep them upright, but rather guide them gently down onto the ground
• Once on the ground they can be placed in the recovery position
Topic 3.4 Fainting
Management of Fainting
If Unconscious:
• If they lose consciousness, follow DRS ABCD.
Fainting usually only lasts from a few seconds to a
minute or two, and the casualty may even have a
slight seizure
• Proper placement into the recovery position will
assist recovery. Once conscious, encourage the
casualty to lie down until they feel better, then
very gradually moving back into an upright position to reduce the risk of fainting
again
Topic 3.5 - Determining Appropriate Treatment of a Casualty

Respectful Behaviour Towards a Casualty
A first aider at all times should display a respectful attitude towards casualty,
whether they a conscious or not. While giving aid to a casualty be mindful of the
following:
• Help comfort the casualty to feel safe, secure and supported
• Be gentle and help maintain their dignity
• Use appropriate and respectful communication
• Help the casualty to remain calm and reassure them that help is on the way
• Stay with the casualty until help arrives
Determining appropriate treatment of a casualty is heavily reliant upon a good assessment

of the situation and the casualty themselves. When arriving at a scene where there is one or
multiple casualties, a visual survey is the first key in determining what response is necessary.
What to look for:

• Does the casualty appear conscious or unconscious?
• If conscious, does the casualty appear in pain, or are they
demonstrating signs of an altered mental status?
• Is there blood present, or any signs of violence?
• Is medication in the casualty’s hand or laying nearby?
• Is the casualty wearing a medical bracelet or necklace?
• Based on the location and circumstances, is there a high risk
of alcohol and / or illicit drugs being involved?

If the casualty is unconscious, always follow DRS ABCD – this is a highly recommended
method of assessing a casualty because it covers all of the most important aspects of
assessing a casualty’s wellbeing in a logical and easy to remember order.
If the casualty is conscious, follow a logical progression of questioning and assessment to
determine what has occurred.
Ask the conscious casualty:
• TIME: Does the casualty know what the time is? What
the date is? The year?
• PERSON: Does the casualty remember their own name?
• PLACE: Does the casualty know where they are?
• EVENT: Does the casualty know how they got here?
What they are doing here?

If the casualty can answer all of these and is cooperative, then generally they can indicate
what has occurred and how they are injured.
Generally speaking, by undertaking a good visual assessment and verbal questioning you
can almost always form a good idea of what is occurring. From there, it is simply a matter of
putting your first aid skills to use to determine the best course of action.
• If they are bleeding, apply direct pressure, then immobilise and
restrict movement of the injured part if possible
• If they are suffering from an impaired level of consciousness call
an ambulance and monitor them closely until paramedics arrive
Topic 3.6 - Drowning
Drowning is the process of experiencing respiratory impairment from immersion in liquid.

Treatment of a casualty who has been rescued from drowning and is unconscious involves
following DRS ABCD.
The very first step is to place the casualty on their

side during the checking / assessment stages of DRS
ABCD, including checking for breathing (if possible).
This allows for any liquid to drain from the lungs
with the assistance of gravity. If the casualty is
unconscious and not breathing lay the casualty on
their back and commence CPR.
Image: "Used with permission from Microsoft."
Topic 3.6 - Drowning
Specific problems related to treatment of a drowning casualty:
Vomiting / regurgitation
• This is a possibility whenever CPR is performed, however due to inhalation of water
during drowning it is much more likely to occur in this situation
• Laying the casualty on their side during initial assessment will assist in reducing this
risk during CPR
• If the casualty does vomit / regurgitate during CPR, immediately roll them onto their
side, clear the airways, reassess DRS ABCD and continue CPR if necessary
Topic 3.7 - Respiratory Distress
Breathing difficulties can range from:

• Being short of breath
• Being unable to take a deep breath and gasping for air
• Feeling like you are not getting enough air
Some causes of acute ineffective breathing:

• Upper airway obstruction
• Problems affecting the lungs
• Drowning or near drowning
• Asthma
• Suffocation
• Damage to breathing control centre of the brain
• Multiple other conditions will result in respiratory distress as symptoms progress
In any situation where a casualty is unconscious and not breathing effectively, follow
DRS ABCD and perform CPR.
Topic 3.7 - Respiratory Distress
Treatment for conditions causing respiratory distress:

There are specific treatments for different conditions causing of respiratory distress.
Some respiratory distress conditions include:

• Asthma (will also often be accompanied by wheezing)
• Airway obstruction (casualty may be distressed and clutching at throat)
• Heart Attack (accompanied by symptoms such as chest pain)
• Anaphylaxis (after exposure to allergen, may be accompanied by hives and extreme
anxiety)
Please refer to the appropriate sections in this text for first aid directions for these causes of
respiratory distress.
Module 4 – Illnesses
1) Anaphylaxis
2) Asthma
3) Diabetes
Topic 4.1 - Anaphylaxis

What is an Allergy?
An allergy is when a person’s immune system reacts to triggers (allergens) that
the person is hypersensitive to and is usually harmless to most other people.
Symptoms of an allergy can range from mild to potentially life threatening
(severe). It occurs when the body mistakes something as harmful and creates a
defence system (antibodies) to fight it.
The ways allergens can enter the body:

• Ingested (most common, in the mouth)
• Inhaled (breathed in)
• Injected (bees, wasps, ants or medication)
• Absorbed (through touching the skin)
• Allergy symptoms develop when the antibodies
are battling the "invading" allergen
What is anaphylaxis?
Anaphylaxis is a severe and sometimes sudden allergic
reaction. It can occur when a susceptible person is exposed to
an allergen (such as a food or an insect sting). Reactions usually
begin within minutes of exposure and can progress rapidly
over a period of up to two hours or more.
Anaphylaxis is potentially life threatening and always
requires an emergency response.
Common Causes of Anaphylaxis:
• Food allergies, such as peanuts, tree nuts, fish, cow's milk & other dairy foods, eggs,
wheat, seafood, fish, soy
• Insect stings, such as bees, wasps or even ants
• Some materials, such as latex
• Medications, both over the counter and prescribed, can cause life threatening
allergic reactions, e.g. aspirin, antibiotics such as penicillin.
• Some herbal remedies can also induce reactions

Signs and Symptoms (Allergy):
• Initial signs (these can be used as warning signs to get help)
• May begin with itchy hands, mouth or feet
• Eyes may become red, watery and puffy
• Tingly around the mouth
• Swollen lips and face
• Rash or hives can develop, especially on the chest,
armpits and groin (hives are white itchy bumps
which look and feel like insect bites)
• Stomach pain, vomiting, diarrhoea

Soon after hives develop, more serious symptoms (Anaphylaxis) may occur, including:
• Shock
• Altered mental status
• Difficulty breathing, or shortness of breath and gasping
• Casualty may become very anxious and have a great sense of fear
• Respiratory or cardiac arrest and unconsciousness
• Difficulty and/or noisy breathing
• Swelling of the tongue
• Swelling or tightness in the throat
• Difficulty talking or hoarse voice
• Wheeze or persistent cough
• Loss of consciousness and/or collapse
• Pale and floppy (young children)
Management of an Allergic Reaction (Mild to Moderate):
• Follow DRS ABCD as required
• For insect allergy, flick out sting if visible. In the case
of tick bite, if there is no history of tick allergy,
immediately remove the tick
• If the casualty has a history of tick allergy, the tick
must be killed where it is, rather than removed.
• Apply cold compress to bite/sting site
• Stay with casualty and reassure
• Call for help. Get someone to contact 000 / 112
• If prescribed, give other medications as noted on
Personal Action Plan for Allergic Reactions
• Continue to monitor the casualty for signs of
anaphylaxis

Management of Anaphylaxis (Severe Allergic Reaction):
• Follow DRS ABCD
• Lay the casualty flat. If having difficulty breathing, sit them upright and try to calm
them
• If known and possible, remove the source of the allergy
• Use the autoinjector (EpiPen) to inject adrenaline. (Note that EpiPens have been
designed for use by anyone in an emergency as instructions are shown on the label)
• Call 000 / 112 for an ambulance
• Continually monitor the casualty’s airways, breathing and respiration, as a sudden
change may occur which may need CPR at any time. Ensure that the EpiPen has been
administered before commencing CPR.
• Contact parent/guardian or other emergency contact
• If available, further adrenaline doses may be given if there is no response after 5
minutes
• If uncertain whether it is asthma or anaphylaxis, give adrenaline autoinjector FIRST,
then asthma reliever
EpiPen:
• An EpiPen is a small, hand-held, automatic
injection device.
• It contains adrenaline and is injected into
the fleshy part of the casualty’s thigh
when experiencing an anaphylactic
reaction.
• EpiPens are prescribed to people with known allergies and they may be able to inject
themselves, or may need assistance from the first aider
• Note: Single use only

EpiPen:
See video on how to use an EpiPen: LINK
Child Green Auto Injector (<20kg).

Adult Yellow Auto Injector (>20kg)
Anaphylaxis Management Plan

Ensure that all patients prescribed an adrenaline auto-
injector have an anaphylaxis management plan that
includes:
• Referral to an appropriate specialist
• Identification of the relevant allergen(s)
• Education on avoiding allergen(s)
• An anaphylaxis action plan (see image)
• Appropriate follow-up and review
• Train patients to recognise the symptoms of
anaphylaxis and how to use their adrenaline
auto-injector correctly

Parents should advise preschools or schools of their child’s adrenaline autoinjector
prescription, and provide a completed anaphylaxis action plan illustrating the use of the
device prescribed.
Some high-risk patients can be prescribed two adrenaline autoinjectors, but they must be of
the same brand.
Advise patients to check the expiry date of their adrenaline auto injector regularly.
See the Australasian Society of Clinical Immunology and Allergy (ASCIA) website for health
professional and consumer anaphylaxis resources.
Note: Symptoms of severe allergic reactions or anaphylaxis can occur when there is no
history of known allergies. This situation should be treated as an emergency. An adrenaline
Autoinjector should be administered, if available, an ambulance called and first aid provided
until expert help arrives
Topic 4.2 - Asthma
It is estimated that at least 2 million Australians have
asthma. Up to 16% of children are estimated to have asthma
in Australia. The majority of people with asthma do not
have an action plan and many do not carry their reliever
medication with them. People with asthma have very
sensitive airways. An asthma attack is caused by spasm or
narrowing of the bronchioles (air passages) in the lungs.
During an episode, air passages become narrowed by muscle
spasm, swelling of mucous membranes and increased
mucous production. Although the exact cause of asthma is
still unknown, exposure to certain toxins, such as smoking
during pregnancy is linked with the condition.
Topic 4.2 - Asthma

Main Factors that can Cause the Airways to Narrow
Muscle Spasm:
• The layer of muscle surrounding each bronchiole
constricts or tightens, causing the air passage to
become narrower
Inflammation:
• The lining of each passage, being very sensitive,
becomes inflamed and swollen
Image by BruceBlaus
Excess Mucus:
• More than usual amounts of mucus are
produced in each bronchiole that contributes to the narrowing of the airways
These above may cause coughing (varied), wheezy breathing (not always), tiredness,
difficulty speaking, chest tightness, and shortness of breath or rapid breathing. The casualty
may become very distressed because of difficulty in breathing.
Topic 4.2 - Asthma

How to Assess Asthma Attacks
Mild Asthma attack:
• Cough
• Soft wheeze
• Minor difficulty breathing
• No difficulty speaking in a sentence
Moderate Asthma Attack:

• Persistent cough
• Loud wheeze
• Tightness in the chest
• Obvious difficulty breathing
• Able to speak in short sentences only
Topic 4.2 - Asthma

Severe Asthma Attack:
• Very distressed and anxious
• Gasping for breath
• Unable to speak more than a few words in one breath
• Pale and sweaty
• May have blue lips
• Little or no improvement from reliever medication
• Feeling anxious and distressed
Asthma Medication (Bronchodilators)
Relievers:
• Used to relieve symptoms: relaxes tight muscles around
the airways
• Common names: Airomir, Asmol, Bricanyl, Epaq, Ventolin, Atrovent
• Inhaler colour: Blue – Grey
Topic 4.2 - Asthma

Treatment: Using a Puffer (4-6 x 4-6 x 4-6):
1. Sit the person upright, reassure them and attempt to keep them calm
2. Do not leave the person alone
3. Without delay shake a blue reliever puffer and give 4 to 6 separate puffs through a
spacer (if available). Use 1 puff at a time and ask the person to take 4 to 6 breaths
from the spacer after each puff
4. Wait 4 to 6 minutes.
5. If there is no improvement repeat step 2
6. If there is still no improvement after another 4 to 6 minutes, or you are concerned at
any time, call an ambulance immediately (Dial 000), and repeat steps 2 and 3 until
ambulance arrives or the casualty is breathing normally
Topic 4.2 - Asthma

Note: When ringing 000, respiratory physicians and some ambulance services recommend
to state "severe asthma attack" (if appropriate) straight up so there is no unnecessary delay
in dispatching an ambulance - personal and all other details can be collected later.
Using an Inhaler Using an Inhaler with spacer
Topic 4.3 - Diabetes

Diabetes Mellitus is a metabolic disorder in which there is a higher than normal amount of
sugar found within the blood (hyperglycaemia). In a non-diabetic person, the pancreas
creates insulin which breaks down sugars to be transferred to the body's cells. This doesn't
happen to a person with diabetes.
There are three main types of diabetes– Type 1, Type 2 and gestational, all of which have
similar symptoms but vary in the underlying cause.
• Type 1 is generally due to destruction of pancreatic

beta cells which produce insulin
• Type 2 involves resistance to insulin of body tissue
• Gestational diabetes is not well understood, but its
underlying cause is thought to be due to some
abnormal interaction between foetal requirements
and maternal metabolic controls

Hypoglycaemic Attack (Low blood sugar)
There are many symptoms that can be associated with low blood sugar. The following is a
shortlist of the more common ones:
• Mental confusion, inability to concentrate
• Headache
• Sweating
• Pale skin
• Mood swings, such as temper outburst
• Rapid pulse
• Dizziness or light headedness
• Trembling, shaking or weakness
• Hunger, a craving for sweets
• Slurred speech
• Unresponsive or seizure
• May progress to unconsciousness
Management (If a hypoglycaemic attack is suspected):
• Stop any exercise, rest and reassure
• Offer the casualty sugar. Ideally, this should be something that can
be absorbed quickly such as:
o Fruit juice – approx. 200ml
o Soft drink, sugar sweetened beverage (not diet, etc) – approx.
200ml
o Confectionary (jelly beans 5-20, Skittles 20-25)
o Honey or sugar – 3 teaspoons
o Glucose gels - 15g
• Monitor for improvement – resolution of symptoms would be expected within 15
minutes

Management (If a hypoglycaemic attack is suspected):
If symptoms still persist after 10 to 15 minutes, and the casualty is capable of swallowing
and following basic commands, administer another round of substance with sugar as noted
in the previous slide
Once the casualty is feeling better, suggest a small meal with carbohydrates (e.g. sandwich
& milk), as this will help stabilise their blood sugar over a longer period of time
If condition deteriorates, or does not improve:
• By the casualty becoming unconscious, follow DRS ABCD
• Seek medical aid urgently
DO NOT attempt to feed an unconscious casualty sweet food by mouth, as this will only
cause a significant risk to their airways and likely cause them to choke.
Hyperglycaemia (High blood sugar)

High blood sugar occurs generally in people with undiagnosed diabetes. The effect is a build-
up of toxins in the blood called Ketoacidosis. Prolonged high blood glucose also alters the
shape of the lens in the eye, and hence blurred vision can also be a symptom.
When Ketoacidosis is present, the

smell of acetone may be found to
be present in the casualty’s breath
(this is a very sweet smell) as well as
rapid, deep breathing, nausea,
vomiting, abdominal pain and a
state of altered consciousness. It
can lead to unconsciousness if not
managed.

Symptoms:
The most common symptoms of hyperglycaemia are:
• Excessive thirst
• Excessive and frequent urination
• Recent weight loss
• Rapid pulse
• Nausea and vomiting, abdominal pain
• Rapid breathing
• Fruity sweet smell of acetone on the breath (similar to paint thinner or nail polish
Remover)
• Dry skin and mouth, with sunken eyes (signs of dehydration)
• Confusion, a deteriorating level of consciousness, or unresponsiveness
Management
If the casualty presents symptoms suggesting hyperglycaemia and does not have a diabetes
management plan, them immediately refer them to be assessed by professional medical
personnel. If the casualty with diabetes has a diabetes management plan, then that plan
should be followed.
• High blood sugar is a medical emergency and a prompt diagnosis and treatment is
the only way to relieve the casualty’s symptoms
• If the casualty is unresponsive and not breathing normally, commence resuscitation
following DRSABCD and call 000 / 112 for an ambulance
• If the casualty is unconscious but breathing, lie the casualty on their side into the
recovery position while ensuring that the airway is clear

Recommendations (as per excerpt from ANZCOR Guideline 9.2.9 – First aid
Management of a Diabetic Emergency)
As a first Aider:
• When available, and trained to do so, use a blood glucometer to check the victim’s
blood glucose level to confirm hypoglycaemia or hyperglycaemia.
• When available, glucose tablets are preferred over other sugars for the first aid
management of suspected hypoglycaemia in conscious victims
• If unsure of the blood glucose, manage the casualty as having suspected
hypoglycaemia.
Module 5 – Medical
1) Choking – Adult/Child
2) Bleeding - Internal/External
3) Wound Management
4) Projectile Objects
5) Abdominal Injuries
6) Crush Injuries
7) Shock
Topic 5.1 - Choking Adult or Child

In first aid, choking is defined as a mechanical obstruction of the airways by a foreign object
such as food. Choking can lead to unconsciousness or even Cardio Respiratory Arrest if the
obstruction is severe enough. The quick recognition and proper management of a casualty
who is choking is of key importance.
Statistically Children 4 years and under are most at risk of
choking by food and toy parts as they make up the highest
number of deaths.
If the casualty is able to cough and talk, then this is not
considered serious choking, as this is a Mild Airway
Obstruction. The casualty with an effective cough should be reassured and encouraged to
keep coughing to expel the foreign material. Continue to monitor. If the obstruction is not
relieved, the first aider should call an ambulance.
Severe Airway Obstruction choking occurs when the object is firmly lodged in the casualty’s
throat and they are unable to cough effectively, or make any sound.
The danger signs of Severe Airway Obstruction (Choking) are:

• Inability to cry or make any sound
• Unable to cough, or weak, ineffective coughing
• Soft or high-pitched sounds while inhaling
• Difficulty breathing - ribs and chest retract
• Bluish skin colour or lips
• Loss of consciousness if blockage is not cleared
• The casualty may be clutching or pointing at their throat
Do Not use abdominal thrusts (Heimlich manoeuvre) in the management of choking as
there have been reported cases of life threatening complications associated with the use of
abdominal thrusts.
First aid for Severe Airway Obstruction (choking):
• First ask “are you choking?” If the casualty can speak – do not interfere. Encourage
them to cough and reassure them. Continue to monitor.
• If they cannot speak and it appears they have a Severe Airway Obstruction, bend
the casualty forward and support the upper front of their chest while using your
other hand to give back blows between the shoulder blades. Check to see if each
back blow has relieved the airway obstruction. If the blockage hasn't cleared after 5
blows, try chest thrusts
• Place one hand in the middle of the casualty’s back and the other arm across their
chest. Using your hand on the chest, perform 5 chest thrusts like CPR compressions
but slower and sharper. Check to see if the blockage has cleared between each chest
thrust
• If the casualty is still choking, call 000 / 112 and alternate 5 back blows and 5 chest
thrusts until emergency help arrives. If at any point the casualty becomes
unconscious, follow DRS ABCD

Choking Infants
Full blockage choking occurs when food or other small objects lodged in a child’s throat or
airway (trachea), which prevents oxygen from getting to the lungs and brain. Food is among
the objects most likely to cause choking in a child. Children who begin to choke with a
Severe Airway Obstruction typically cannot breathe, cry or make noise. As choking persists,
a child’s face may become initially red, then turn blue as the body runs out of oxygen.
DO NOT perform the following steps if the infant has a Mild Airway Obstruction and is
coughing forcefully and effectively or is crying strongly – either of which can dislodge the
object on its own.

Choking Infants
For a Severe Airway Obstruction (Choking):
• Lay the infant face down, along your forearm
• Hold the infant’s chest in your hand and support
the jaw with your fingers
• Point the infant’s head downward, lower than
the body
• Give up to 5 sharp, forceful blows between the
infant’s shoulder blades
• Use the heel of your free hand
• Check to see if each back blow has relieved the
airway obstruction
• The aim is to relieve the obstruction with each
blow rather than to give all five blows
Choking Infants
If object isn’t free after 5 blows:
• Turn the infant face up. Use your thigh or lap for
support. Support the head
• Place 2 fingers on the middle of the infant's
breastbone
• Give up to 5 sharp thrusts down, compressing
the chest 1/3 the depth of the chest
• Check to see if each chest thrust has relieved the
airway obstruction
• The aim is to relieve the obstruction with each
chest thrust rather than to give all five thrusts
• Continue this series of 5 back blows and 5 chest thrusts until the object is dislodged
or the infant loses consciousness, in which case you commence CPR
Choking Infants
If the infant loses consciousness, becomes unresponsive, stops breathing, or
turns blue:
• Send for help. Call ‘000’
• Give infant CPR.
• Try to remove an object blocking the airway
ONLY if you can see it
• DO NOT interfere if the infant is coughing
forcefully, crying strongly, or is breathing
adequately. However, be ready to act if the
symptoms worsen
• DO NOT perform these steps if the infant stops
breathing for other reasons, such as asthma,
infection, swelling or a blow to the head
Topic 5.2 – Bleeding – Internal/External
Bleeding is a very common condition requiring first aid. Bleeding, also termed haemorrhage,
occurs when there is a rupture of blood vessels causing a loss of blood. Bleeding can vary
from minor to life threatening, depending on which vessels have been damaged.
In the most serious bleeds, arteries (which carry fast flowing blood
from the heart) are damaged. An arterial bleed will typically be
very fast, bright red and can result in a great loss of blood if not
controlled. If damage occurs to the major arteries such as the aorta
or femoral arteries, immediate attention is required to prevent
death from blood loss. This is referred to as arterial bleeding.
Image by Crystal (Crystl)
Types of Bleeding
• External bleeding means there is damage to the vessels and skin, and the blood is
leaking outside the body. This is generally easy to see, however this can be hidden
beneath clothing and should be checked for during your DRS ABCD check. First Aid
measures for external bleeding should include controlling blood loss, using sterile,
hygienic measures to reduce the risk of infection where possible and watching for
signs of shock.
• Internal bleeding is the same process as external bleeding, the only difference being
the blood is leaking INSIDE the body, hence this can be very difficult to detect unless
specifically looking for it. When checking for bleeding during your DRS ABCD check,
you should always include palpation touch of the casualty’s abdomen and thighs so
that any internal bleeding can hopefully be detected early.
First Aid for Bleeding (minor)

For minor bleeding (cuts, scrapes, etc.) apply
pressure with a dressing for about 30 seconds.
Clean the wound if necessary, and cover with a
sterile or clean dressing.
First Aid for Bleeding (external) (R.I.D.)

First aid of serious bleeds should follow 3 basic steps as listed below:
Rest - Any movement of the injured body part can potentially increase the bleeding and
make it harder to control. The body part should be kept still until bleeding is controlled.
Immobilise – Immobilise the bleeding part and

restrict movement
Direct Pressure - This step is by far the most

important and involves using an absorbent material,
ideally a dressing such as sterile gauze. If you do not
have this, then a clean towel, a piece of clothing or
even just their hand can be used if there is nothing
else available. Once the pressure is applied on the wound, a pressure bandage can be used
to maintain the pressure by wrapping it firmly around the wound and dressing.
Bleeding (embedded objects)
• This is an object that has punctured the skin and is physically stuck in the casualty.
Examples include shrapnel, glass, or even being stabbed by a knife.
• NEVER attempt to remove an embedded
object
• A donut bandage should be applied around
the object, to reduce the bleeding and to
keep the object as still as possible
• Carefully place the bandage over the object
without moving the object
• Use a roller bandage to firmly wrap around
the donut bandage to keep it in place. This
will also apply firm pressure around the
object to reduce any bleeding
• Seek medical aid
Bleeding (internal)
Signs of Internal Bleeding:
• bruised, swollen, tender or rigid abdomen
• blood in vomit
• wounds that have penetrated the chest or abdomen
First Aid for Internal Bleeding:

• If the internal bleed is minor, such as some bruising, cold packs can be applied to the
area to reduce the swelling and relieve pain
• If you suspect more severe internal bleeding, carefully monitor the casualty and call
000 / 112 immediately

Bleeding (head/skull)
• If a casualty has sustained a significant head injury, then
internal bleeding into the brain should be considered
• If the casualty complains of a severe headache, or seems
confused, disorientated or loses consciousness after a
head injury you should call 000 / 112 immediately
• If the casualty is bleeding from the head after a trauma, a
first aider should not apply firm direct pressure on the
wound if there is a risk of a skull fracture
• If the skull feels ‘spongy’ or you are not sure, indirect
pressure can be applied by wrapping a bandage around
the head with minimal risk of causing brain injury by
pushing a fractured skull into the brain
Bleeding (head/skull)
Treatment:
• If concussion, bleeding inside the skull, or a skull fracture is suspected, the casualty
should be placed in a quiet and dark room, with the head and shoulders raised
slightly on a pillow or blanket - (lying down the casualty will help reduce the risk of
fainting)
• Try not to move the casualty unnecessarily, and avoid moving the casualty’s neck.
Call 000 / 112
• If a skull fracture is not suspected use firm direct pressure on the wound with a
sterile dressing or clean cloth
• If the area feels spongy, do not apply direct pressure, as the casualty may have a
skull fracture
• Seek medical aid, watch for changes, and apply DRS ABCD as required

Bleeding (ear)
• Bleeding from the ear is a sign of internal bleeding within the skull
• Medical aid should be sought for all situations where this occurs
Treatment:
• If the casualty is conscious ask them to get comfortable (sitting up preferred) and
lean towards the injured side, with the effected ear facing toward the floor
• Place an absorbent cloth underneath to collect the blood
• If the casualty is unconscious, then follow DRS ABCD, and if they are breathing, place
the casualty into the recovery position with the effected ear facing down
• Call 000 / 112 and do not leave the casualty unattended

Bleeding (nose)
Bleeding from the nose is fairly common and normally not
serious, unless bleeding continues for more than 20
minutes
Treatment:
• Ask the casualty to sit down, with their head tilted
forwards
• The casualty should pinch the soft part of their
nose while keeping their head tilted forward to
allow the blood to clot
• The casualty should breathe through their mouth
and avoid speaking, swallowing, coughing, spitting
or sniffing because this may disturb blood clots that may have formed in the nose
• Cold compressions applied to the back of the neck can also assist in reducing the
bleeding
• If the bleeding does not stop within 20 minutes, seek immediate medical help
Amputation (complete)
Amputation is the removal of any part of the body, either by

surgery, disease or traumatic event.
Amputation accidents around the home or workplace normally

involve a finger or a toe. More serious amputations include
legs or arms and can occur in workplaces using industrial
equipment.
First Aid - Stop the bleeding: (R.I.D.)

• In the event of amputation of a body part first aid involves controlling the bleeding
and looking after the casualty, finding the amputated part and transporting the
casualty to hospital or calling 000 / 112.
• Lay the casualty down (REST)
• Apply DIRECT PRESSURE using a sterile gauze, or if unavailable, a clean cloth
• Continue direct pressure for at least 15 minutes
• IMMOBILISE the bleeding part and restrict movement
• If the bandaging soaks through with blood, apply another on top and continue direct
pressure

Amputated Parts:
• Care should be taken for the amputated part, as it may still be possible to surgically
reattach it. The most important thing would be to keep it cool and clean
• Cover and wrap the cleaned amputated part in sterile dressing then place it in a
plastic resealable bag
• Place the sealed bag on ice or in a container of cold water
• Never place the amputated part directly on ice as that could damage the tissue
• Transport the amputated part with the casualty to the nearest hospital
Amputation (Partial)
• Partial amputation is where a limb has been severely damaged, but is still
partially attached to the body
• Wrap or cover the injured area with a sterile dressing or clean cloth
• Apply direct pressure to reduce the bleeding if necessary
• Remember not to cut off blood flow to the area by compressing the area too tightly
• Gently splint the injured area to prevent movement or further damage
• Transport the casualty to medical assistance or call 000 / 112
Topic 5.2 – Bleeding – If Severe or Life-Threatening:

(Following excerpt from ANZCOR Guideline 9.1.1)
Bleeding should be managed as severe, life-threatening bleeding in the following situations:
• Amputated or partially amputated limb
above wrist or ankle
• Shark attack, propeller cuts or similar major
trauma to any part of the body
• Bleeding not controlled by local pressure
• Bleeding with signs of shock, i.e. pale and
sweaty plus pulse rate >100 and/or
decreased level of consciousness

(Following excerpt from ANZCOR Guideline 9.1.1)
Controlling the bleeding takes priority over airway and breathing interventions
• If available, use standard precautions, e.g. gloves, protective glasses
• If bleeding from a limb, & not controlled by pressure, apply an arterial tourniquet *
above bleeding point
• If wound site is not suitable for tourniquet, or from a limb when a tourniquet is not
available or has failed to stop the bleeding, apply a haemostatic dressing *
• For the majority of non-life-threatening cases, follow DRSABCD, where control of
bleeding follows establishing airway and commencing CPR if required
* If trained in its use and one is available
Arterial Tourniquet (Following excerpt from ANZCOR Guideline 9.1.1)
• Arterial tourniquets should only be used for life-threatening bleeding from a limb,
where the bleeding cannot be controlled by direct pressure
• Commercially manufactured windlass tourniquets such as those based on military
designs are more effective than improvised tourniquets. An example of a military
tourniquet is shown
• Effective use of commercial tourniquets is optimal when
first aid providers are trained in proper application
techniques
• All arterial tourniquets should be applied in accordance
with the manufacturer’s instructions (or 5 cm above the
bleeding point if no instructions) and tightened until the
bleeding stops
CAUTION: A tourniquet should not be applied over a joint or
wound, and must not be covered up by any bandage or clothing.

• If a tourniquet does not stop the bleeding its position and application must be
checked. Ideally the tourniquet is not applied over clothing nor wetsuits and is
applied tightly, even if this causes local discomfort
• If bleeding continues, a second tourniquet (if available) should be applied to the
limb, preferably above the first
• If a correctly applied tourniquet(s) has failed to control the bleeding consider using a
haemostatic dressing in conjunction with the tourniquet
• The time of tourniquet application must be noted and communicated to
emergency/paramedic personnel
• Once applied, the casualty requires urgent transfer to hospital and the tourniquet
should not be removed until the casualty receives specialist care
NOTE: An elastic venous tourniquet (generally used to assist with drawing blood samples) is
not suitable for use as an arterial tourniquet

Improvised tourniquets are unlikely to stop all circulation to the injured limb without risk
of tissue damage. Improvised tourniquets which do not stop all circulation can increase
bleeding.
Nonetheless, in the context of life-threatening bleeding, an improvised tourniquet is
likely to be better than no tourniquet. Tourniquets, ideally of a similar broad width to
commercial types, can be improvised using materials from a first aid kit (e.g. triangular
bandage, elastic bandage) from clothing, a surfboard leg rope or other available similar
items.
Improvised tourniquets should be tightened by twisting a rod or stick under the
improvised tourniquet band, similar to the windlass in commercial tourniquets.
Haemostatic dressings (Following excerpt from ANZCOR Guideline 9.1.1)
• Haemostatic dressings are impregnated with agents that help stop bleeding.
• When available and the first aid provider is trained in their use, haemostatic
dressings are of most value in the following situations:
o Severe, life-threatening bleeding not controlled by wound pressure, from a
site not suitable for tourniquet use
o Severe, life-threatening bleeding from a limb, not controlled by wound
pressure, when the use of a tourniquet(s) alone has not stopped the bleeding,
or a tourniquet is not available
• Haemostatic dressings must be applied as close as possible to the bleeding point,
held against the wound using local pressure (manually initially) then held in place
with the application of a bandage (if available). Haemostatic dressings should be left
on the bleeding point until definitive care is available
Summary Statement (Following excerpt from ANZCOR Guideline 9.1.1)
The need to control the bleeding is paramount.
The risks associated with the first aid use of tourniquets and haemostatic dressings are less
than the risk of uncontrolled severe, life-threatening bleeding.
These adjuncts provide temporary bleeding control
and rapid transfer to hospital remains critically
important.
Image: Kaolin impregnated gauze (an example of a
haemostatic dressing)
Topic 5.3 - Wound Management
There are many different recommendations for wound management depending on the
type, location and severity of the wound.
Basic Care of a Wound
Consists of the following fundamental steps:
1) Washing your hands
2) Cleaning the wound and around the wound
3) Protecting the wound
4) Changing the dressing
5) Monitor for infection
1 – Wash Your Hands
Thoroughly wash your hands with soap
and running water. Rinse hands and dry
completely. Wear disposable protective
gloves. Always follow this process before
administering first aid. This helps avoid
cross-infection.
2 - Cleaning the Wound and Around the Wound
Use clear running water under moderate pressure to rinse
the wound. Washing the wound removes much of the dirt,
debris, and bacteria as possible which helps to reduce the
risk for infection.
Also, clean around the wound with soap and a washcloth. If
after washing, some dirt or debris remain, use sterile
tweezers to remove the particles.
Gently pat the wound site and surrounding area dry by using
non fluffy material such as a pad of tissues or a clean towel.

3- Protecting the Wound
• A dressing refers to the material that is placed directly
over the wound
• It is preferably sterile to reduce the chance of infection,
and a material that will not readily stick to the wound
and cause difficulty removing
• The main aim is to provide a fairly sterile environment
for wound healing to occur, and to assist in reducing the
risk of infection
• A pad is an absorbent material placed over the dressing. It assists in controlling
bleeding and absorbing any pus or fluids that may seep from the wound
• A bandage is placed over the pad, and can be used for compression to reduce
bleeding, and to keep the pad in place

4 – Changing the Dressing
Change the dressing regularly at least once a day or whenever the
dressing becomes soiled or wet. Especially for sensitive skin use
hypoallergenic dressings.
Once the wound has healed enough to make infection unlikely, the
wound can be left uncovered as exposure to air will aid in the healing
rate of the wound.
5 - Monitor for Infection
If the casualty experiences any of the following signs in their wound a medical opinion
should be advised as infection is likely:
• Redness
• Swelling
• Pus or discharge from the wound
• Pain that is not improving
• Fever, or not feeling well generally
Additional Risks
Certain wounds are at a high risk of infection, and require further medical assessment and
supervision.
These include:
• Animal and human bites
• If the wound was caused by a particularly dirty or rusty object
• If the casualty has pre-existing conditions that put them at a high risk, such as
diabetes or if they are in any way immuno-suppressed (their immune system is
compromised), such as with chemotherapy treatment
• Burn wounds are also at a high risk of infection, especially partial and full thickness
burns
Topic 5.4 - Projectile Objects (Embedded)
There are many types of projectile objects that can cause injury – from glass or shrapnel,
knives, metal objects such as rods to bullet wounds. If a projectile object becomes
embedded in the skin, you should follow the first aid principles of embedded objects. This
involves forming a donut bandage to secure the object (reducing any movement that can
potentially cause more injury and damage) and assist in reducing the bleeding by providing
indirect pressure to the area.
NEVER attempt to remove an embedded object. If the object is large and deep, the casualty
will likely require surgery to remove it. The main thing is to reduce bleeding, keep the object
secure and keep the casualty calm until the ambulance arrives.
Topic 5.5 - Abdominal Injuries
There are many types and causes of abdominal injury. Basic first aid principles should be
followed depending on the type and cause of the injury, for example:
Penetrating Wounds
• Follow guidelines for treatment of an embedded object. Use doughnut bandage to
avoid movement of the object and to control bleeding
Note: If any internal organs are protruding from the body, DO NOT push them back in. Apply
a damp dressing to prevent them from drying out and call 000 / 112 immediately
Topic 5.5 - Abdominal Injuries
Locations of some major abdominal organs
Topic 5.6 – Crush Injuries
This is an injury that occurs because of pressure from a heavy object onto a body part. A
crush injury may also arise from squeezing of a body part between two objects. Depending
on their severity, crush injuries can be complicated by bleeding, bruising, broken bones,
open wounds, poor circulation, or breakdown of muscle as above.
• If physically possible and safe to do so, remove any crushing forces as soon as
possible
• Call 000 immediately and keep the casualty calm. Do not leave the casualty
unattended
• Control any bleeding using light to moderate pressure (avoid placing firm pressure
on the abdomen unless required to stop serious bleeding)
• The casualty should be monitored and if they become unconscious follow DRS ABCD
CAUTION: A tourniquet should not be used for first aid treatment of a crushed limb
Topic 5.7 - Shock
Shock is a life threatening condition that occurs when the body is not getting enough blood
flow. Shock can damage multiple organs, and requires immediate medical treatment as it
can worsen rapidly.
There are many specific types of shock including:

• Hypovolemic shock
• Cardiogenic shock
• Anaphylactic shock
• Neurogenic shock
• Obstructive shock
Topic 5.7 - Shock
Shock may be caused by any of the following:

• Loss of blood through internal or external bleeding
• Loss of plasma or fluids, i.e. burns, vomiting, dehydration
• Allergic reactions (Anaphylaxis)
• Infections
• Heart trouble, heart attack, or stroke
• Poisoning by chemicals, gases, alcohol, or drugs
• Snake and animal bites
• Respiratory problems, chest trauma
• Lack of oxygen
• Obstructions caused by choking
• Injuries of all types, both severe and minor
Topic 5.7 - Shock
Signs & Symptoms

The signs and symptoms will vary slightly with the specific types of shock. The most
important thing is for a first aider to recognise the signs and symptoms of a casualty going
into shock so that they can assist the casualty and call 000 / 112 when appropriate.
Symptoms may include:
At first:
• Rapid pulse
• Pale grey blue skin
• Capillary test will be slower
• Sweating and cold clammy skin
Topic 5.7 - Shock
Symptoms may include:
As shock develops:
• Weakness and giddiness
• Nausea, and possibility vomiting
• Thirst
• Rapid shallow breathing
• A weak thready pulse
As the brains O2 levels drop:

• Restless, anxious and even aggressiveness
• Yawn and gasp for air
• Unconsciousness
• Finally, the heart will stop
Topic 5.7 - Shock
First Aid
• If unconscious and breathing, place into the recovery position
• If conscious – lay the casualty down flat onto their back
• Promptly control any bleeding. Manage and treat all other injuries
• Call 000 for professional assistance
• Make the casualty comfortable, i.e. loosen clothing
• Keep the casualty warm. Cover with a blanket if cold
• Reassure and keep the casualty calm
• You may moisten the casualty’s lips – but be sure that they do not eat or drink
• If casualty becomes unresponsive and not breathing normally, follow DRS ABCD
Module 6 - Burns
1) The Skin
2) Burns
Topic 6.1 -The Skin
The skin is a waterproof cover designed to protect the body's cells from damage, drying out,
infection and from temperature changes.
The Epidermis Layer

• This is outermost layer of the skin and is especially thick on the palms of the hands
and the soles of the feet
• There are no blood vessels in the epidermis but its deepest layer is supplied with
lymph fluid
Topic 6.1 -The Skin
Dermis or Corium Layer

The dermis is a tough, elastic layer containing
white fibrous tissue interlaced with yellow elastic
fibres
Many structures are embedded in the dermis

including:
• Blood vessels
• Lymphatic capillaries and vessels
• Sensory nerve endings
• Sweat glands and their ducts
• Sebaceous glands
• Hair follicles, hair bulbs and hair roots
Topic 6.1 -The Skin
Hypodermis or Subcutaneous Skin Layer

• This is the deepest skin layer. It connects or binds the dermis above it to the
underlying organs
• This layer is mainly composed of loose fibrous connective tissue and fat (adipose)
cells interlaced with blood vessels
• Females have a hypodermis that is generally about 8% thicker than in males
• The functions of the hypodermis include storing of lipids, insulation, cushioning of
the body and temperature regulation
Topic 6.2 - Burns

Burns are body tissue injuries caused by contact with dry and/or wet heat. When a burn
occurs, the heat destroys the epidermis (top layer of skin). If the burn progresses, the
dermis (second layer) is injured or destroyed. Burns break the skin and can cause infection,
fluid loss and loss of temperature control. Deep burns can damage muscle, tissue and bone.
Burns are classified by the source, such as heat, cold, chemical, electricity, or radiation. They
are also classified by depth. Due to the increased risk of infection with burns you should
attempt not to touch it with your hands or apply lotions or creams.
The three classifications of superficial burns, partial thickness

burns and full thickness burns will help you determine
emergency care.
Image by Kronoman
Topic 6.2 - Burns
Superficial Burn
• The least serious burns are those in which only the
outer layer of skin (epidermis) is burned. The skin is
usually red, with swelling and pain sometimes
present
• The inner layer of skin hasn't been affected
• Treat a superficial burn as a minor burn unless it
involves substantial portions of the hands, feet,
face, groin, buttocks, or a major joint
Image by QuinnHK
Topic 6.2 - Burns
Partial Thickness Burn

• When the first layer of skin has been burned
through and the second layer of skin (dermis) is
also affected, the injury is termed a partial
thickness burn
• Blisters develop and the skin takes on an intensely
reddened, splotchy appearance
• Partial thickness burns produce severe pain and
swelling
• If the partial thickness burn is no larger than 2 to 3
inches in diameter, treat it as a minor burn
Image by Snickerdo
Topic 6.2 - Burns
Full Thickness Burns

• The most serious burns are painless and
involve all layers of the skin
• Fat, muscle and even bone may be affected
• Areas may be charred black or appear dry
and white
• Difficulty inhaling and exhaling, carbon
monoxide poisoning or other toxic effects
may occur if smoke inhalation accompanies
the burn
Image by Craig0927
Topic 6.2 - Burns
Treatment for a Burn (Heat, Thermal or Contact):

• Always monitor a burn victim for signs and
symptoms of shock, seek emergency assistance
• Immediately cool burns with cool running water
for 20 minutes
• If possible, without causing further tissue
damage, remove all rings, watches, jewellery or
other constricting items from the affected area
• Remove wet, clothing soaked with hot liquids if
non-adherent
• Cover the burnt area with a sterile, non-stick
dressing
• Prevent the casualty from the risk of hypothermia by covering unburnt areas
Topic 6.2 - Burns
Note:
The objective of first aid treatment of burns should be to stop the burning process, cool the
burn and cover the burn. This will provide pain relief and minimize tissue loss.
• Do not use ice or iced water to cool burns – these may cause further injury
• Do not break blisters
• Do not apply ointments, creams or powders other than hydrogel
• Do not peel off clothing or burning materials that is stuck to the casualty
• Where possible elevate burnt limbs to minimise swelling
Module 7 – Head Injuries and Illnesses
1) Head Injuries
2) Spinal Injuries
3) Altered Conscious States – The Brain
4) Drugs and Alcohol
5) Poisoning and Chemical Exposure
6) Eye Injuries
7) Stroke
Topic 7.1 - Head Injuries
Head injuries are a common cause of hospitalisation, especially in children. In adults these
can occur from motor vehicle accidents, a fall or assault, an occupational accident, sport
injury etc.
• If the casualty becomes unconscious, DRS ABCD

should be followed, and bleeding from the skull
should be controlled
• If bleeding occurs from the ear the casualty should
be placed in the recovery position with the affected
side down, to allow blood to drain out of the skull
• All casualties who have suffered a head injury
(including a minor head injury) should be referred
onto further medical aid to fully assess and monitor
the casualty
What to look out for

• Any loss of consciousness
• Signs of injury or face such as bleeding or bruises
• Any change – such as becoming groggy or drowsy
• Blurred vision
• Headache
• Dizziness or vertigo
• Confusion or memory loss
• Seizures
• Bleeding from the ears, nose or mouth
Management
• The casualty should be closely monitored. Call an ambulance immediately if the
casualty becomes unconscious or consciousness is altered at any time
• Follow DRS ABCD, and ensure that the airway is clear while protecting the neck
• Any bleeding from the head should be controlled, being careful not to place pressure
onto the skull if a fracture is suspected
• If the skull feels ‘spongy’ DO NOT place any direct pressure, but rather use pads and
indirect pressure to control bleeding
Topic 7.2 - Spinal Injuries
The SPINAL COLUMN consists of a series of interconnected bones, called vertebrae, which
enclose the SPINAL CORD, an integral part of the central nervous system
The spinal column is divided into:

• the cervical spine (neck), 7 vertebrae
• the thoracic spine (chest), 12 vertebrae
• the lumbar spine (back), 5 vertebrae
• fused vertebrae of the sacrum
• a small vertebra called the coccyx
Spinal injuries should be suspected after any serious trauma, such as

vehicle accidents, a fall from height greater than 1.5m, assault, a workplace
accident (such as falling from a ladder) or sport injury (such as falling from a
horse, or heavy rugby tackle).
Signs and Symptoms:

• Such as pins and needles or numbness in the upper or lower limbs may indicate the
spinal cord is already damaged
• Weakness or inability to move limbs
• Pain around the neck or spine
• Headache, dizziness, altered conscious state
• Nausea
• Breathing difficulties
• Shock
• Loss of bladder or bowel control
• If you notice any of the above, an ambulance should be contacted immediately
The priorities of management of a suspected spinal injury are:
1. Calling for an ambulance
2. Management of airway, breathing and circulation
• If unconscious, follow DRS ABCD. Management of the casualty’s airways takes
precedence over any suspected spinal injury
• Remember, DRS ABCD and CPR should not be avoided when a spinal injury is
suspected
3. Spinal care
• If conscious but complaining of pain, weakness or altered sensation in the neck
and/or limbs, instruct the casualty to remain as still as possible
• Avoid moving the casualty unless necessary (if they are in immediate danger or
become unconscious)
• If movement is necessary, take additional steps to immobilise the neck and spine to
avoid movement in any direction such as manually holding the head or neck
Topic 7.3 - Altered Conscious States / The Brain
There are a large number of conditions that can lead to acute disruption of a casualty’s
cognitive function. These can include a direct blow to the head, drug or alcohol abuse, and
low blood sugar caused by diabetes.
The Human Brain

The human brain is a uniquely complex and powerful organ. At any one time, the brain is
registering sensations such as eyesight, hearing and smell, computing and filtering data and
sending appropriate responses.
In basic terms, the brain can be divided into 4 main parts:

• Cerebrum
• Diencephalon
• Cerebellum
• Brain Stem
The Cerebrum is the largest part of the human brain and is associated with higher function
such as conscious thought, intellect and action. It is divided typically into 4 sections called
lobes.
• Frontal Lobe: Reasoning, problem solving, emotions
and movement
• Parietal Lobe: Movement, recognition,
• Occipital Lobe: Visual Processing
• Temporal Lobes: Auditory, memory and speech
The Cerebellum or literally ‘little brain’ is predominantly

responsible for coordination of movement, balance and posture.
The Brain Stem is responsible for the vital life functions such as heartbeat, breathing, blood
pressure etc.
Levels of Alertness
Another way to assess the extent of injury to the brain is to ask questions about the
following:
• TIME (Does the casualty know what the time is? What the date is? What year is it?
• PERSON (Does the casualty remember their own name?)
• PLACE (Does the casualty know where they are?)
• EVENT (Does the casualty know how they got here? What they are doing here?)
All casualties who seem to have suffered a head injury (even a minor head injury) should be
assessed by a health care professional before continuing with sport or other activity.
Topic 7.4 – Drugs, Alcohol Poisoning and Illicit Drug Use
Alcohol presents a very common cause for altered mental status and can be very serious
and even life-threatening if not properly managed.
In short, someone under the influence has a

decreased ability to:
• Recognise danger and react appropriately
• Control their emotions or violent tendencies and feel
physical pain
• Rationally consider a situation and choose a logical
course of action
• Evaluate decisions and consequences of the decisions they make
Alcohol
Alcohol is typically a depressant and impairs judgment, vision, speech, co-ordination,
reflexes, balance and cognitive function.
Management of Acute Alcohol / Drug Poisoning

• If you notice a change in a person’s conscious state, you should not leave them
unattended
• If a casualty’s conscious level is dropping, it can continue to drop very quickly as
more alcohol is absorbed in the brain
• If the casualty is violent you can monitor them from a distance
• Be prepared to call an ambulance if the casualty’s condition changes
• Remember: Do not force yourself on the casualty as they may become violent. Use
assistance of friends if possible
If an Intoxicated Casualty Becomes Unconscious

• Follow DRS ABCD
• Position casualty in recovery position to protect airways
• Remember: Vomiting is a very likely outcome, and if unattended, this can
compromise their airways by causing aspiration or blockage
• Call 000. Emergency medical care is required to prevent further absorption of
alcohol and to monitor the casualty until they regain consciousness
Drugs
Some common types of drugs:
Marijuana
This is one of the most frequently used illicit drugs in society, and
has similar effects as stimulants, depressants and hallucinogens.
Cocaine
This is a very strong stimulant to the central nervous system, and is very
addictive. It can be taken via injection, smoking or snorting.

Ecstasy
This is taken as a capsule or tablet. This affects the serotonin system
which plays a large role in regulating mood, sleep, aggression and
sensitivity to pain, and as such can affect all of these
LSD
This is a synthetic hallucinogen that is found in tablet, capsule or
liquid form (added to paper, sugar cubes etc.)
General signs and symptoms of substance misuse include:
• Sweating
• Increase in pulse
• Irritability
• Increased respiration
• Nausea and vomiting
• Raised temperature
• Odd behaviour
Topic 7.5 – Poisoning and Chemical Exposure
A Poison is any substance that causes injury, illness or death. In terms

of risk, it is estimated that up to 80% of all poisonings occur at home,
particularly in the kitchen or bathroom. Hence the old saying
‘precaution is better than cure’ is very relevant.
Common Poisons
• Paracetamol, this is the most common pharmaceutical
overdose leading to hospital admission and a common cause of
poisoning in children
• Household products including glues, hair spray, aerosol paints,
nail polish, petrol
• Household chemicals including dishwasher detergent
• Some varieties of fungi (such as certain mushrooms and
toadstools)
• Cyanide

Signs and Symptoms
These can be very variable, as they depend on the nature of the poison and the amount
consumed.
• Difficulty breathing, wheezing or shortness of breath

• Burning in the throat and mouth
• Nausea
• Vomiting
• Altered mental state (including hyperactivity, drowsiness, confusion, headache)
• Unconsciousness, or even cardiac arrest
Management
• The first step is to identify the suspected poison and ensure that it is not a danger to
yourself or others
• If safe to do so, attempt to separate the casualty from the substance
• If the poison is swallowed and the casualty is conscious give them a sip of water to
wash out their mouth. DO NOT ask them to swallow or attempt to make them vomit
• Once separated from the poison, contact the Poisons Information Centre on 131126.
This is a 24-hour national hotline, and operators can instruct you on what to do.
They will need to know what type of poison is involved, and approximately how
much has been ingested/inhaled
• Some poisons have specific antidotes – if possible, attempt to identify the poison
(i.e. check for any nearby containers or bottles) as this will significantly assist
diagnosis and treatment
You will need to:

• Identify the poison
• DO NOT give anything by mouth to the
casualty unless instructed
• DO NOT attempt to make the casualty
vomit unless instructed
• Call the Poisons Information Centre (PIC)
and follow their instructions
• You may be advised by PIC to call 000
• While waiting, closely monitor the casualty – do not leave them unattended
Chemical Exposure - Capsicum spray (OLEORESIN SPRAY)

Capsicum spray is an extract of hot peppers consisting of capsaicin and
derivatives. It is a lachrymatory agent, meaning that it is designed to
irritate the eyes to cause tears and pain. It acts within seconds of being
sprayed in a person’s face causing stinging, tearing and blepharospasm
(uncontrolled muscle spasm), causing the eyes to shut.
It also has an effect on the respiratory system, causing broncho-

constriction and coughing as well as mucous secretion, shortness of breath
and laryngeal paralysis (causing inability to speak). The effects can last for
up to 30 to 40 minutes.
Chemical Exposure - Capsicum spray (OLEORESIN SPRAY)

Treatment:
• Assess airway, breathing and circulation
• Continuously rinse with copious amounts of
water or saline until the symptoms subside
• Irrigate eyes with copious amounts of water
• Encourage blinking, this will help flush out the
spray from the eyes
• Treat bronchospasm with an asthma inhaler
• If at any stage the casualty becomes unconscious, follow DRS ABCD
Topic 7.6 – Eye Injuries
Blunt Trauma to the Eye
The eye is susceptible to direct knocks e.g., sporting balls, fistfight, finger poke, traffic
accident, workplace tools, etc.
First Aid Treatment
• Follow DRS ABCD – Call 000
• Rest casualty in semi-sitting position and reassure
• Ask casualty to keep injured eye closed
• Place a cool damp cloth onto injured eye
• Cover the injured eye with a sterile eye pad and gently secure into place using a
bandage or hypoallergenic tape
• Monitor casualty until arrival of medical personnel
Topic 7.6 – Eye Injuries

Foreign Body in the Eye
Flicking sand, sawdust, flying slivers of wood, metal particles, glass
shards, stone, grit and other material are notorious for causing eye
injuries when projected into the eye.
First Aid Treatment
• Follow DRS ABCD
• Use a clean wet cloth to remove any particles from the area surrounding the eye
• If the small foreign object is visible, use damp cotton swab to remove
• If not removed, flush the eye with a steady constant stream using saline or clean
water. Tilt the casualty’s head, while gently pulling the eyelid as you flush the eye
• If the lodged object can’t be removed, cover the injured eye with a sterile eye pad
and gently secure into place using a bandage or hypoallergenic tape
• Seek medical attention
Image - A small piece of iron has lodged the margin of the cornea by E van Herk - E van Herk, CC BY-SA 3.0,
Topic 7.7 - Stroke
A stroke, otherwise called a cerebrovascular accident
(CVA), is an acute disruption to the blood supply within
the brain.
A stroke is a medical emergency and is the second most
common cause of death after heart disease. Without
prompt medical intervention, there can be substantial
neurological damage or even death.
Ischaemic Stroke
• This is by far the most common cause of stroke
• In ischaemic stroke, a blood vessel becomes
either partially or totally blocked by either a
blood clot or debris
Haemorrhagic Stroke
• This occurs when a blood vessel ruptures and bleeds into the brain
Topic 7.7 - Stroke
Signs of Stroke can easily be remembered by:

F.A.S.T.
• Facial Weakness: Has their mouth or eye drooped?
Can they smile?
• Arm weakness: Can the person raise both arms?
• Speech difficulty: Is their speech clear and easily
understood?
• Time to act fast: Immediately call 000 for an
ambulance
Topic 7.7 - Stroke
The most well-known symptom of a stroke is one-sided weakness or

numbness, and is generally on the opposite side of the body as the
stroke (depending on which part of the brain is affected).
Other Signs and Symptoms

• Difficulty in swallowing
• Dizziness, an unexplained fall or loss of balance
• Loss of vision, sudden blurred or decreased vision in one or both eyes
• Abrupt onset of a headache, unusually severe
• Sleepiness, drowsiness
• Confusion
• Level of consciousness is reduced
Topic 7.7 - Stroke
There are 3 basic tasks you can get the casualty to perform if you believe they are having a
stroke:
• Ask the casualty to smile
• Ask the casualty to raise both their arms, and to keep them raised
• Ask the casualty to repeat a simple sentence after you, (e.g. “The train was late
today”)
Difficulty performing any of these tasks may indicate an early stroke.
At times the signs are not very clear. The casualty may be able to talk but is incoherent and
not making much sense.
Prompt transportation to a hospital is vital by calling 000/112. With early diagnosis and
intervention, the severity of the stroke can be drastically reduced, and the casualty’s
outcome can be improved.
Topic 7.7 - Stroke
Management
• Call 000 immediately if a stroke is suspected or in doubt. Time is critical
• Keep the casualty comfortable until the ambulance arrives
• Do not give anything to drink or to eat
• Raise and support their head and shoulders and monitor the casualty's airway
• Do not leave the casualty unattended, as their condition may become worse very
quickly
• Administer oxygen if available and trained to do so
• Provide reassurance if casualty is conscious
• If the casualty becomes unconscious but is breathing normally, place into the
recovery position
• If the casualty becomes unconscious and is not breathing normally, commence CPR
Module 8 – Skeletal and Soft Tissue Injuries
1) Fractures
2) Dislocations
3) Sprains and Strains
4) Bruises
Topic 8.1 - Fractures
A fracture is the medical term used to describe any break in the

cortical surface of a bone. It should be clarified that a break and
a fracture are the same thing. Fractures can occur through a
variety of mechanisms, such as a direct blow to a bone (motor
vehicle accident or being punched in the face).
Types of Fractures
There are 3 main classifications of fractures that first aiders need
to be concerned with and be aware of.
• Closed fracture
• Open Fracture
• Complicated fracture
A closed fracture - refers to a break with no penetration through the skin. This is the
simplest type of fracture.
An open fracture - is penetration of the bone through the skin (e.g. a bone sticking out of a
casualty’s arm). These fractures have a greatly increased chance of infection to both the
wound and the bone.
A complicated fracture - refers to any fracture that has caused additional complications to
organs. A fractured rib can be a simple closed fracture, but if it punctures the lung or an
abdominal organ such as the spleen this becomes complicated as there are secondary
injuries which can be extremely severe.
Signs and Symptoms

There are however some signs and symptoms to look out for. Not all of these listed are
specific to fractures, but a combination of the following may indicate a fracture.
• A loud snap or crack heard by yourself or the casualty

• An obvious deformity will most likely indicate a fracture
• A shortening of the injured limb
• Loss of movement, or extreme pain on touching the injured area or when attempting
to move the part
• Unable to put weight on an injured leg
Signs and Symptoms (Continued)
• The amount of swelling is not always an indication of the severity of the injury.
However, it should be assumed that when there is significant swelling, there is an
underlying injury
• It can be very difficult to judge the extent of an injury based purely on the level of pain
indicated by the casualty. In some cases, a person can walk away with a fractured
ankle, whereas in other cases a casualty may be in hysterical pain with no significant
damage to the part
• In any event, if a fracture is suspected, then prompt, correct first aid can prevent
further injury and assist healing, as well as help reduce pain by immobilisation
Fracture Treatment
First aid of a suspected fracture involves 3 basic principles:

1) Immobilisation, support and elevation of the injured part
2) Assessing and treating the casualty’s condition e.g. for
shock, bleeding or other injuries.
3) Obtaining a prompt medical opinion for diagnosis and
further treatment
Remember: As a first aider, we don’t fix problems. That is the job

of the professionals. (Refer to image)
Tips for First Aid

• NEVER attempt to reposition a deformity
• If the limb appears to be numb, or pale or blue, this could signify damage to the blood
supply. This is a medical emergency and you should call 000 immediately
• Although an obvious statement, you should handle the injured part carefully. Careless
handling of a fractured limb can cause extreme pain and could also send the casualty
into shock
Topic 8.2 – Dislocations
A dislocation involves the bones of a joint being displaced from their

normal position. As the bones move out of position the attached
ligaments are also overstretched and hence a strain can also
commonly accompany a dislocation.
A casualty with a dislocation will present with the symptoms of a

strain but will also have a deformity of a joint and loss of movement.
• A first aider should NEVER attempt to re-position the joint –

some GP’s won’t even attempt this
• A trained, experienced emergency specialist will utilise x-rays
to characterise a dislocation, and then use specific techniques
to minimise the dislocation
• These steps minimise the chance of causing further injury
while reducing the dislocation
Topic 8.2 – Dislocations
Management
• Sit the casualty down, and make them as comfortable as possible
• Support the injured limb in a comfortable position
• Ice packs can be applied to the area to help reduce swelling
• Seek medical assistance immediately. The longer the joint is out of place, the more
significant the injury will be to the blood vessels and nerves
Topic 8.3 - Sprains and Strains
Sprains involve the over extension of a joint,

usually with partial rupture of the ligaments.
There may also be blood vessel, nerve and tendon
damage.
Strains involve over-stretching of the major

muscles of the limb. Muscles are attached to
bones by tendons, which tear if a muscle is forced
to stretch excessively. This injury is usually less
severe than a sprain, but can still have
complications if not managed correctly.
As you can see below, the symptoms are also quite similar.
Signs and Symptoms
Sprain Strain
Pain Pain
Swelling Swelling
Bruising Cramping
Instability Muscle Spasms

Treatment: R.I.C.E.R.
• Rest - Resting the injured part will encourage healing and
prevent further injury.
• Ice - Apply for 20 minutes maximum at a time then remove
for 2 hours. Never apply ice directly to the skin, (place on top
of compression bandage) but rather wrap it in a towel or t-
shirt.
• Compression - A crepe bandage should be applied
moderately tight to help reduce the swelling. Be careful not
to apply too tight, as this can cut off the blood supply excessively.
• Elevation - This again helps to reduce swelling by firstly making it more difficult for
blood to travel to the part, and secondly helping fluids to drain away from the injured
area.
• Referral - Refer the casualty to professional medical advice.
In addition to the RICER treatment, there are also factors that can hinder healing or even
cause further injury. The following should be avoided for the first 48 - 72 hours after injury:
H.A.R.M.
• Heat -This has the opposite effect to cold as it causes blood vessels to dilate, which
increases swelling.
• Alcohol - This also causes dilation of blood vessels, and hence increases the swelling of
the injured area.
• Running or Exercise -Just like bones, ligaments and tendons need time to heal and
recover their strength.
• Massage – Although this can be beneficial for longstanding ailments, it should not be
performed to the injured part in the first 48 hours following the injury.
Topic 8.4 - Bruises
A bruise is a skin discolouration that results from the breakage of

tiny blood vessels leaking close under the skin after an injury.
Blood from damaged blood vessels beneath the skin collect near
the surface of the skin to appear as a black and blue mark.
Medically, a bruise is referred to as a contusion.
Treatment
• Rest - Resting the injured part will encourage healing and
prevent further injury.
• Ice - Apply for 20 minutes maximum at a time then remove
for 2 hours. Never apply ice directly to the skin, but rather wrap it in a towel or t-shirt.
Module 9 – Environmental Illnesses
1) Body Temperature
2) Heat illnesses
3) Cold Illnesses
4) Seizures – Epilepsy
5) Seizures – Febrile Convulsions
Topic 9.1 – Body Temperature
Normal body temperature is between 36 -

37.5 degrees celsius. In normal
circumstances, this remains fairly constant
regardless of the temperature of our
environment through a process called
thermoregulation.
The following is a list of temperature variation effects.

Effects of Body Temperature Variation
Too Hot:
• 37⁰ Normal body temperature
• 38⁰ Sweating, uncomfortable feeling
• 39⁰ Severe sweating, skin becomes flushed and red - exhaustion and possible
convulsions, especially if the casualty is prone to seizures
• 40⁰ Fainting, weakness, vomiting, headache, dizziness, profuse sweating
• 41⁰ Fainting, vomiting, severe headache, altered mental state such as hallucinations,
delirium and drowsiness, sweating stops, breathlessness can occur. At this stage, this
is a medical emergency
• 42⁰ Casualty may become pale. Severe delirium, vomiting and seizures may be
experienced. Heart rate will become very fast, and casualty may collapse
• 43⁰ Serious brain damage may occur, or even death. Shock and continuous
convulsions may also occur. The casualty may go into cardiac arrest
• 44⁰ (and above) Death is almost certain at this point
Effects of Body Temperature Variation
Too Cold:
• 37⁰ Normal Body temperature
• 36⁰ Mild to moderate shivering, however this can be within normal limits
• 35⁰ Intense shivering and numbness. Skin will become bluish/grey
• 34⁰ Severe shivering, loss of movement of fingers. Altered mental status may occur,
including confusion
• 33⁰ Shivering will progressively decrease and confusion will get worse. The level of
consciousness will be altered and casualty may become groggy. Heart rate will
become slower and breathing will become shallow
• 32⁰ Severe alteration in mental status will occur, including hallucinations and delirium.
Sleepiness will increase, possibly even to unconsciousness. Shivering will stop
• 31⁰ Most likely unconscious. Heart rate will be very slow, and breathing very shallow
• 28⁰ Casualty may appear dead. Cardiac arrest may take place
• 26⁰ (or below) generally death due to respiratory arrest will take place
Topic 9.2 – Heat Illnesses
Heat Exposure
Overexposure to the sun is a very common cause of injury due to
excessive heat. When the temperature is too high for the body’s
cooling mechanism to sufficiently cope the body becomes stressed
and injury occurs. Heat cramps, heat exhaustion and heat stroke are
three specific stages that the body undergoes during this time.
Heat Cramps
• Heat cramps can be extremely painful, and can occur
anywhere in the body such as the arms, legs, back and
abdomen
• Dehydration or excessive exercise can exacerbate the problem
• Generally, a casualty will show signs of heat exhaustion and cramps
Heat Exhaustion
Heat exhaustion occurs as the casualty’s body temperature increases, which can lead to heat
stroke. Heat exhaustion can occur very quickly, especially if the casualty has been over-
exerting oneself such as working or exercising in the heat.
Signs to look out for include:
• Fatigue
• Profuse sweating
• Rapid, weak heartbeat
• Feeling faint
• Headache
• Nausea, vomiting
• Heat cramps
Management involves predominantly treating the heat exhaustion, by:
• Move the casualty to a cool, shaded area and recommend
they lie down
• Loosen and remove excessive clothing such as jackets or
heavy tops
• Moisten the skin with an atomizer spray or with a damp cloth
• Cool by fanning
• Encourage clear fluid intake such as water if fully conscious
• Call 000 for an ambulance if casualty does not quickly
improve

Heat Stroke (As per guidance provided by Professor Ian Rogers to the Coroner of Western Australia)
Heat stroke is a medical emergency as it may lead to unconsciousness and death. All the body
organs may be affected. It occurs generally when the body temperature has reached 40
degrees or above. Heat stroke is an uncommon but life-threatening complication of grossly
elevated body temperature with exercise in heat stressed settings.
Risk is highest with: high temperatures and/or high humidity and/or vigorous activity
Signs & Symptoms include:

• Headache
• Skin may become dry and hot, but in some casualties profuse sweating is common
• Altered mental state – grogginess, confusion, incoherent speech, dizziness, etc.
• Abnormal walking, coma or seizures
• Collapse or acutely unwell
• As temperature increases, their mental state will be increasingly affected, and
unconsciousness can occur
• Does not recover promptly on lying flat with the legs elevated

Heat Stroke
If an ill person in a heat-stressed setting hasn’t rapidly responded to lying flat in the
shade, there is no downside to assuming heat stroke is the problem and starting first
aid. Heat stroke is a medical emergency and the following steps to take in this order are:
• STRIP the athlete of as much clothing as possible
• SOAK with any available water
• FAN vigorously by whatever means possible—improvise e.g. use a clipboard, bin lid.
When available, cool or ice water immersion is the most effective cooling means possible:
• IMMERSE the athlete up to the neck in a cool or ice bath OR
• COVER all of the body with ice water-soaked towels that are changed frequently as an
alternative if a bath isn’t available but ice is
• CALL 000 to summon emergency services, but do so once you are certain first aid
cooling is being implemented.
Remember it is early recognition and first aid in heat stroke that is critical to save a life.
Some useful differences between Heat Exhaustion and Heat Stroke are as follows:
Heat Exhaustion Heat Stroke
Skin is moist and clammy Skin is hot and dry
Pupils dilated Pupils constricted
Special note for Heat Stroke: An athlete’s skin may feel dry and hot, or sweaty—so the feel of
the skin is not a useful sign. Similarly, on-field temperature measurement is unreliable, so
don’t use this to rule in or rule out heat stroke.
Remember to keep safe in the sun!

• Drink plenty of water
• Sports drinks are also useful as they contain
3-8% carbohydrate electrolyte fluids, which
are lost as the body sweats especially in
exertion related dehydration
• Wear protective clothing – a hat, t-shirt,
sunglasses
• Wear sunscreen, and remember to reapply
• Take breaks – don’t go overboard if the
temperature is too hot
• Be sensible in the sun
Topic 9.3 – Cold Illnesses
Cold Exposure
It does not have to be freezing for cold exposure
to develop.
Wind and moisture during humid weather or

during rainy season can also rapidly decrease the
body’s temperature.
Mild Hypothermia
Signs and Symptoms:
• Uncontrollable shivering
• Numbness of fingers and hands
• Loss of function of extremities
• Skin may become bluish/grey and cool
• Impaired coordination
Management of mild hypothermia includes:

• Move the casualty to a warmer location
• Give them a warm drink
• Remove any wet clothing and encourage physical activity to increase body
temperature
• Heat packs or hot water bottles can also be used to assist this process
Moderate to Severe Hypothermia

Signs and Symptoms:
• Decrease in shivering, and then loss of
shivering altogether
• Increase of muscle stiffness
• Altered mental status – disorientation,
grogginess, confusion etc.
• Decreased pulse and respiration rate
• May lead to unconsciousness
• Low blood pressure
Management of moderate to severe hypothermia Includes:

• Requires urgent medical aid, contact 000 for an ambulance
• Remove casualty from the cold environment
• Follow principles of DRS ABCD where appropriate
• Do your best to warm the casualty
• Remove all wet clothing. Dry casualty if wet
• Place casualty in a dry sleeping bag or blanket
• Give warm oral liquids but not alcohol and only if the casualty is fully conscious
Management of moderate to severe hypothermia Includes (Continued):

• If the casualty is not shivering and in a remote location, the first aider should
commence active rewarming measures:
o Carefully apply external heat. Use either body heat or another heat source (e.g.
heat packs) to increase their body temperature
o To avoid burns, ensure that the external heat source is warm/tepid but not hot
o If frostbite has occurred, DO NOT attempt to rub warmth into the affected area
as this can cause severe injury to the already damaged tissues
o Do not place the casualty in a warm bath
• If unconscious, follow DRS ABCD
Topic 9.4 - Seizures (Epilepsy)
A seizure is a sudden interruption to the brain’s normal

function when an abnormal level of electrical activity of the
neurons takes place.
Epilepsy is the term given to describe a condition where

someone is predisposed to recurrent, unprovoked seizures.
However, anyone can have a seizure given the circumstances,
not just people with epilepsy.
Causes of Seizures other than Epilepsy:

• Head Injury
• Drug or alcohol intoxication
• Fever (febrile convulsions)
• Tumour
• Certain prescribed drugs, such as some anti-
depressants
• Infection
• Photo-sensitive epilepsy can be triggered by certain TV shows or video games
• Seizures during or shortly after pregnancy can be a symptom of eclampsia
Management – DO:
 Most Important is to stay calm
 Stay with the casualty
 Look at the time to see how long the seizure lasts for
 Move any bystanders and any objects out of the way which could injure the casualty,
especially the head
 Once the seizure has stopped, follow DRS ABCD
 If unconscious and breathing, or if fluid/vomit/food in the mouth, roll the casualty into
the recovery position
 Maintain casualty’s privacy and dignity
 They will likely be very tired, so let them rest and stay with them for reassurance
 If the casualty has injured themselves during the seizure, attend their injuries once it
has finished
Management – DO NOT:
 Do not put anything into their mouth
 Do not restrain the casualty
 Do not move the casualty unless they are in
danger
 Do not give them anything to eat or drink until
they have fully recovered

You need to seek medical assistance (Call 000) if:
• The casualty injures themselves badly during
seizure
• The casualty is having difficulty breathing
after the seizure (this should be distinguished
from normal laboured breathing because the
casualty is puffed out)
• If a second seizure follows the first
• If the seizure lasts longer than 5 minutes (if
the normal time is not known), or if the seizure lasts longer than usual (the casualty
may have a bracelet or card in their wallet which outlines the usual time they last)
• If the casualty is not known to have epilepsy
Topic 9.5 - Seizures (Febrile Convulsions)
A high fever in a child may trigger a

convulsion/seizure known as a febrile convulsion.
This may occur in children aged from six months to
five years. The convulsion can last a few seconds or
up to 15 minutes and is often followed by a brief
period of drowsiness.
Signs and Symptoms:

• Muscles may stiffen, jerk or twitch
• Face may go pale or blue
• Difficulty in breathing
• Moaning, crying
• Vomiting
• Foaming at the mouth
Management – DO:
 Most Important is to stay calm and remain with the child
 Look at the time to see how long the seizure lasts for
 Lay the child onto a soft surface or the floor with a blanket underneath
 Remove any object which could injure the child
 Move the child only if they are in a dangerous location
 Loosen tight clothing and if possible, remove or open clothes from the waist up
Management – DO NOT:
 Do not put anything into their mouth
 Do not restrain the child
 Do not put the child into a bath
 Do not give them anything to eat or drink
Once convulsion has stopped:

• Roll the child into the recovery position whilst drowsy
• Place cool washcloths to the neck and forehead
• Using tepid water (not cold), sponge the rest of the child’s body
• Contact professional medical help (Call 000) if:
o Convulsion lasted more than 5 minutes
o Child does not wake up
o Child had more than one convulsion in a short period of time
o Child has been injured or appears quite ill
• Contact local family doctor if:
o Convulsion lasted less than 5 minutes
o Child had a previous illness before the convulsion
Module 10 – Bites and Stings
1) The Lymphatic System
2) Bites and Stings
Topic 10. 1 - The Lymphatic System
The Lymphatic System is a network of vessels, nodes, ducts and

organs that produce and transport lymph fluid. The lymphatic
system plays a large part in the following:
• Removing fluid from tissues
• Production of immune cells, such as lymphocytes
• Absorbs fat from the intestines
The lymphatic system does not have a pump like the circulatory
system, but rather it utilizes muscle movement in order to
transport fluids. The lymphatic system is predominantly responsible
also for the transportation of venom from snake bites. This is why it
is critical to keep the casualty as still as possible and immobilise the
bitten limb. Muscle contractions cause increased lymph movement
and hence help spread the venom.
Topic 10. 2 - Bites and Stings
Bites and stings from certain creatures can be potentially dangerous, and Australia has
no shortage of such creatures. There are many different varieties of snakes, spiders
and jellyfish which carry venom that can cause pain and swelling, and in extreme cases,
death (most commonly through neurotoxic muscle paralysis causing breathing failure).
Other insect bites can be potentially fatal when a person is allergic to

the insect, such as with bee stings.
Snake Bites
Symptoms
Symptoms that would indicate the need to call an ambulance immediately include:
• Immediate intense pain in bitten area
• Headache
• Altered mental status – including confusion, irritation,
or even unconsciousness
• Abdominal pain
• Hypertension
• Respiratory weakness / difficulty breathing
• Muscle paralysis. This generally takes around 3 hours to develop, and may
affect the lungs and send the casualty in respiratory arrest
Management
You should take care to firstly rest the casualty, and reassure
them as best as possible while you investigate for a possible snake
bite. If found, follow the pressure immobilisation technique
immediately and seek emergency medical assistance.
Pressure Immobilisation Technique (PIT):

• Ideally use a broad pressure bandage (elasticised
bandages are preferred over crepe bandages)
• If bandages are unavailable, anything can be used such as
clothing, tea towels etc.
• Start by applying local pressure over the wound with some
padding

Pressure Immobilisation Technique (PIT) (Continued):
• Bandage should be firm and tight (i.e. tight enough to
prevent easily sliding a finger between the
bandage and the skin) but not uncomfortable or
painful
• Next, bandage the entire limb (using additional
bandage or same bandage if long enough)
• Start distally (furthest from body) and work proximally (closer to body) to
reduce swelling
• Once limb is bandaged, use a splint to restrict any movement of the limb (i.e.
a stick or pole, or if upper limb, use a sling)
• Keep the casualty as still as possible and ideally bring assistance to them
rather than attempt to move them
DO NOT:
 Do not cut, suck or treat the bitten area
 Do not wash the bitten area
 Do not apply an arterial tourniquet
The Pressure Immobilisation Technique is

recommended for the following bites and stings:
• All venomous snakes
• Funnel web spiders
• Blue-ringed octopus and cone shell
Remember: As a first aider, we don’t fix or diagnose, we only preserve life until more
advanced care can be provided.
Spider Bites
Of the numerous species of spiders found in Australia,
only two are capable of causing death; the funnel web
and the red back spider.
It can be difficult to identify a funnel-web, so any bite

from a big, black spider should be considered potentially
dangerous.
Red Back Spider

• Apply cold compress to the affected area to help reduce
swelling and pain for periods of 20 minutes
• Rest the casualty and monitor
• These are generally not fatal however the casualty
should be directed to obtain a medical opinion
• If pain is persistent, or the casualty experiences
headache, nausea, vomiting, an altered level of
consciousness, then they should be taken to hospital, or call 000 for an
ambulance
Stings
Most stings should be treated with ice. If the casualty is allergic to the sting, there is
a risk of anaphylaxis, which is a medical emergency. If an anaphylactic reaction
occurs, follow the Anaphylaxis Guideline and DRS ABCD. Contact 000 immediately.
Bee Sting
• Never pull or squeeze the sting out as more venom
will be injected. Try to scrape it sideways away from
the entry point.
• Apply cold compress to the affected area to help
reduce swelling and pain for periods of 20 minutes (do not apply ice to the
eye area).
• If the person has an allergy to bee stings, they can fall into a life-threatening
state of anaphylactic shock. The only treatment is an injection of adrenaline.
Seek medical attention immediately
Stings
Most stings should be treated with ice. If the casualty is allergic to the sting, there is
a risk of anaphylaxis, which is a medical emergency. If an anaphylactic reaction
occurs, follow the Anaphylaxis Guideline and DRS ABCD. Contact 000 immediately.
Wasp
• Clean the affected area with soap and warm water
• Apply cold compress to the affected area to help
reduce swelling and pain for periods of 20 minutes
• Be alert for signs of anaphylaxis
• Prolonged swelling at the site of the sting may
respond to antihistamines - refer the casualty on for further advice
Blue Ringed Octopus

Basic Treatment:
• Treatment for a Blue Ringed Octopus bite is the
same as a snake bite
• Apply the Pressure Immobilisation Technique
(PIT) and call 000 for an ambulance
• If the person stops breathing, follow DRS ABCD
and commence CPR immediately
Box Jellyfish
Signs and symptoms of someone who has been stung by
a Box Jellyfish include a variety of skin markings, severe
pain around the lymph nodes (armpits, groin etc.),
nausea, vomiting, sudden cardiac arrest or respiratory
distress
Basic Treatment:
• Observe DRS ABCD. Call 000 for an ambulance
• If stung, flood the affected area with vinegar to neutralise the tentacles,
then pick off the tentacles
• Rest the casualty, reassure and keep under observation
Blue Bottle Jellyfish

Most stings from a Blue Bottle are painful and allergic reactions
are possible. Blue Bottle stings leave a whip-like, red, wavy line
on the skin from the tentacle and a rash may occur.
Basic Treatment:
• Clear away the tentacles using sea water, then pick off
any remaining tentacles
• Immerse in hot water for 20 minutes to relieve pain
• The water should be as hot as the casualty can handle it
• Remember, your tolerance to heat may be different to the casualty's. Seek
medical advice if pain continues
• Call 000 if pain persists, stung area is quite large or is in a sensitive area such as
the eye
Cone Shell
The Cone Shell is found in shallow water, sand flats and
reefs around Australia. They are a brightly coloured shell
shaped like an ice-cream cone. The sting can ultimately
lead to respiratory distress and death
Basic Treatment:
• Treatment for a Cone Shell sting is the same as a
snake bite
• Apply the Pressure Immobilisation Technique (PIT) and call 000 for an ambulance
• If the person stops breathing, follow DRS ABCD and commence CPR immediately
Ticks
Ticks can inject a toxin that may cause local skin irritation or a
mild allergic reaction, however most tick bites cause few or no
symptoms. In susceptible people, a tick bite may cause an allergic
reaction or even anaphylaxis, which can be life threatening.
Basic Treatment:
• In the case of tick bite, if there is no history of tick allergy, immediately remove the
tick
• If the victim has a history of tick allergy, the tick must be killed where it is, rather than
removed
• If an anaphylactic reaction occurs, follow the Anaphylaxis Guideline
• Follow DRS ABCD. Contact 000 immediately for an ambulance
• Apply cold compress to the affected area to help reduce swelling and pain for
periods of 20 minutes
• If the casualty has no history of tick allergy, take casualty to a doctor to remove the
tick

Ticks
To kill the tick where it is:
• For small ticks (larvae & nymphs), use permethrin cream
(available at pharmacies)
• For adult ticks, freeze them with an ether-containing spray
(available at pharmacies).
• Wait for the tick to drop off or remove it taking the
utmost care to not compress the tick (as this will squirt allergen, toxin and possibly
infection into you)
Note: Do not use tweezers

Note:
If you require the assessment questionnaire and the Assessment Answer sheet to record your
answers, please contact us by phone, or send us an email.
Phone: 1300 642 427
Email: admin@cprfirstaid.com.au
Our telephone assistance is available on the following days:
Monday - Friday: 8:00am - 6:00pm
Saturday: 8:30am - 10:30am
Sunday: 8:30am - 10:30am
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Work Book 2019

Module 1 Introduction to First Aid

Module 3 Chain of Survival

Module 7 Head Injuries & Illnesses

Module 8 Skeletal Muscular Injuries

Module 9 Environmental Illnesses

Module 10 Bites and Stings

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Estimated Completion Time: 15 minutes

Topic 1.1 – First Aid Basics

What is First Aid?

The four aims of first aid are to:

Any attempt is better than no attempt!

Topic 1.1 – First Aid Basics – Calling for Medical Assistance

If you are deaf or have a speech or hearing impairment call 106:

Topic 1.2 – Legal Aspects – Duty of Care

Other situations that would be considered ‘accepting responsibility’ or ‘carrying a duty of

Topic 1.2 – Legal Aspects – Duty of Care

Topic 1.2 – Legal Aspects – Casualty Consent

Topic 1.2 – Legal Aspects – Privacy and Confidentiality

Topic 1.3 – Record Keeping

It is important that all first aid incidents,

Each workplace should have appropriate

These documents need to be completed in full and should not be altered.

Notes should include:

The human body is made up of different anatomical and physiological

The bones of the skeleton have 4 main functions:

Topic 1.4 - Human Anatomy – Cardiovascular System

Topic 1.4 - Human Anatomy – Cardiovascular System

Heart – a muscular organ in the chest that pumps blood

The heart is muscle that pumps blood to all parts of the

Topic 1.4 - Human Anatomy – Cardiovascular System

Topic 1.4 - Human Anatomy – Nervous System

Normal Respiratory Rate Ranges Age Range Respiratory

Topic 1.4 - Human Anatomy – Upper Airway

A child's airway differs from that of an adult in

Also, a child's airway is smaller and softer and

Infants have very short and softer tracheas than

The causes of unconsciousness can be categorised into four general groups:

The musculoskeletal system is a term used

It is recommended that you become

Topic 1.5 - Infection Control – How to break the Chain of Infection

Topic 1.5 - Infection Control – How to break the Chain of Infection

Estimated Completion Time: 15 minutes

Topic 2.1 - Safe Manual Handling

Assessing the situation and the load:

• Can you move the person yourself, or is help required?

Topic 2.1 - Safe Manual Handling

Use of good lifting techniques:

• Use good body mechanics - maintain a straight back,

Topic 2.2 - Basic First Aid Kit

For further information on first aid kit requirements go to:

Topic 2.3 - Caring for the Casualty – DRS ABCD

1. DANGERS Check for danger (hazards/risks/safety)

• Checking for danger before approaching any situation is

S - Send for Help