FIRST AID

FIRST AID: is the provision of initial care for an illness or injury. It is usually
performed by non-expert, but trained personnel to a sick or injured person until
definitive medical treatment can be accessed.

MEDICAL AID: Professional treatment given by or under the direction of a doctor.

Objectives of First Aid:

- preserve life
- prevent further injury
- promote recovery

ROLES AND RESPONSIBILITIES OF THE FIRST AIDER:

1. ACT AS A BRIDGE that fills the gap between the victim and the physician.
2. ENSURE THE PERSONAL SAFETY and that of the patient and bystanders.
3. GAIN ACCESS to the victim.
4. DETERMINE ANY THREATS to the patient’s life.
5. SUMMON more advanced medical care as needed.
6. PROVIDE NEEDED CARE for the patient.
7. ASSIST Emergency Medical Technician (EMT) and medical personnel.
8. RECORD all assessments and care given to the patient.

CHARACTERISTICS OF A GOOD FIRST AIDER:

GENTLE - should not cause pain.

RESOURCEFUL - should make the best use of things at hand.
OBSERVANT - should notice all signs.
TACTFUL - should not alarm the victim.
SYMPATHETIC - should be comforting.
CHEERFUL - inspires and develop confidence.

Direction in giving First Aid:

Breathing – get the patient breathing (if they stopped)

Bleeding – stop the bleeding using dressing and bandage
Fracture – immobilize or strap any fracture
Shock – treat the patient for shock, keep warm make the patient comfortable.

TRANSMISSION OF DISEASES
1. Direct Contact
2. Indirect Contact
3. Airborne Transmission
4. Vector

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FIVE EMERGENCY ACTION PRINCIPLES

Sequence of actions you should follow at the scene of an emergency to ensure safe
and appropriate first aid.

1. SURVEY THE SCENE

2. ACTIVATE MEDICAL ASSISTANCE
3. INITIAL ASSESSMENT OF THE VICTIM
4. SECONDARY ASSESSMENT OF THE VICTIM
5. REFERRAL FOR FURTHER EVALUATION AND MANAGEMENT

1. SURVEY THE SCENE

Once you recognized that an emergency has occurred and decide to act, you must
make sure the scene of the emergency is safe for you, the victim/s, and any
bystander/s.

ELEMENTS OF THE SURVEY THE SCENE

1. Scene safety.
2. Hazards that could be dangerous to you, the victim, or bystanders.
3. Mechanism of injury or nature of illness.
4. Determine the number of patients and additional resources.

2. ACTIVATE MEDICAL ASSISTANCE (AMA) OR TRANSFER FACILITY

In some emergency, you will have enough time to call for specific medical advice
before administering first aid. But in some situations, you will need to attend to the
victim first.

CALL FIRST AND CARE FIRST

Both trained and untrained bystanders should be instructed to Activate Medical
Assistance as soon as they have determined that an ADULT victim requires
emergency care “Call First”.
While for INFANTS and children a “Care First” approach is recommended.

Information to be remembered in activating Medical Assistance:

WHAT happened?
LOCATION?
NUMBER of Persons Injured?
EXTENT of Injury and First Aid given?
The TELEPHONE number from where you are calling?
Important:
PERSON who activated Medical Assistance must identify him/herself and drop the
phone last….

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3. DO A PRIMARY SURVEY OF THE VICTIM

In every emergency situation, you must first find out if there are conditions that are
an immediate threat to the victim’s life.

The primary survey is the first step in assessing the casualty for life-threatening
conditions and giving life-saving first aid.

In the primary survey you check for the priorities of first aid. These are:

A. CIRCULATION - to ensure effective circulation

B. AIRWAY - to ensure a clear airway
B. BREATHING - to ensure effective breathing
C. DEADLY BLEEDS- to ensure that there are not any life-threatening
bleeds
D. EMERGENCY MEDICAL TAGS( BRACLETS, ANKLETS OR TATTOOS)- it
may provide information about mechanism of injury

Even if there is more than one casualty, you should perform a primary survey on
each casualty in turn. Give life-saving first aid only.

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Page 4 of 32
STEPS OF THE PRIMARY SURVEY:

The sequential steps of the primary survey should be performed in the position
found, unless it is impossible to do so.

RESPONSIVE CASUALTY

- Check the airway Ask, "What Happened?" How well the casualty can answer will
tell you if the airway is clear.

- Check for breathing Ask, "Is your breathing O.K.?"

If breathing is effective,:
a) control obvious severe bleeding,
b) check for shock by checking the skin condition and temperature, check for a
radial pulse
c) check for a rapid body survey for hidden, severe, external bleeding and signs of
internal bleeding, e.g. obvious deformities.

If breathing if ineffective,:
a) check circulation (color/temp. of skin)
b) assess quality of breathing, (rate, depth) ( for an adult 10-20 per min.)
c) assist breathing

UNRESPONSIVE CASUALTY

- Check Circulation – Check Patients pulse

- Open the airway - With a head-tilt, chin-lift.
- Check for breathing - Keep the airway open.
Look for the rise and fall of the chest for 6-8 seconds.
If breathing is present – put in Recovery position
If breathing is absent, give 2 breaths and begin CPR.

4. SECONDARY ASSESSMENT OF THE VICTIM

It is a systematic method of gathering additional information about injuries or

conditions that may need care.
Once you have given first aid for life threatening conditions, you may need to do a
secondary survey.

A secondary survey should be done when:

- medical help is delayed
- the casualty tells you about more than one area of pain
- you must transport the casualty to a hospital

The secondary survey consists of four steps that you should do in the following
order:
1. obtain the history of the casualty
2. assess and record vital signs
3. perform a head-to-toe examination
4. give first aid for non-life threatening conditions

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Medical Alert Information:
A medical alert device (ie. bracelet, necklace, anklet or pocket card) contains
valuable information about the medical history of a casualty.
Some medical alert devices give a phone number where more information about the
casualty can be obtained.

Vital Signs:
The vital signs are important indicators of a casualty’s condition. The four vital signs
are:
Level of consciousness Breathing Pulse Skin Condition

How to Assess Breathing:

In your primary survey, you determined that the casualty is breathing. Now you
should check if the breathing is effective or ineffective.
If the casualty is conscious: - look at the chest/abdomen and ask, “Is your
breathing OK?”
- listen to how well the
casualty answers and note the quality of breathing.
If the casualty has difficulty responding or is unconscious:
- place a hand on the
chest
- check the rate, rhythm
and depth of breathing
BREATHING RATES: - Adult – 10 to 20 breaths per minute
- Child – 20 to 30
breaths per minute
- Infant – 30 to 50 breaths per minute

a. Interview the victim (HISTORY OF THE CASUALTY)

S - Signs and symptoms
A - Allergies
M - Medications
P - Past medical history
L - Last meal taken
E - Events prior to injury or incident

b. Check vital signs- every 15 minutes if stable condition, and

every 5 minutes if unstable
c. Head to toe examination
CHECK FOR:
D - Deformity
C - Contusion
A - Abrasion
P - Punctures
B - Burn
T - Tenderness
L - Laceration
S - Swelling

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5. REFERRAL OF THE VICTIM FOR FURTHER EVALUATION AND
MANAGEMENT

It refers to the transfer of a victim to hospital or health care facility if necessary for a
definitive treatment.

SOFT TISSUE INJURIES

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WOUNDS

Is a break in the continuity of a tissue of the body either internal or external.

Two Classifications of Wound

1. Closed Wound
- the soft tissue damage occurs beneath the surface of the skin,
leaving the outer layer intact, such as contusion, and crushing
injuries.

First Aid Management

C- Cold Application
S - Splinting

2. Open Wound
- It is a break in the skin or mucus membrane; or the protective skin
layer is damage.

Types of OPEN WOUND

P- Puncture
A- Abrasion
L- Laceration
A- Avulsion
G- Gunshot

FIRST AID MANAGEMENT WOUND WITH SEVERE BLEEDING

4 C’s
1. Control Bleeding
2. Cover the wound
3. Care for Shock
4. Consult or refer to M.D.

Dangers :
- Haemorrhage
- Infection
- Shock
Kinds of Bleeding:
- Arterial
- Venous
- Capillary

BURNS
Is an injury involving the skin, including muscles, bones, nerves and blood vessels.
This results from heat, chemicals, electricity or solar or other forms of radiation.

Factors to determine the seriousness of burns:

1. The Depth
2. Burns that need hospital treatment
3. Patient’s age and medical condition
TYPES OF BURN INJURIES:
1. Thermal Burn
2. Chemical Burn

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 3. Electrical Burn

Burn injuries can be classified as follow:

1. THERMAL (heat) BURNS caused by:
•Flames
•Hot objects
•Flammable vapor that ignites
•Steam or hot liquid
What to Do:
•Stop the burning
– Remove victim from burn source
– If open flame, smother with blanket, coat or similar item, or have
the victim roll on ground.
Determine the depth (degree) of the burn

2. CHEMICAL BURNS
The result of a caustic or corrosive substance touching the skin
caused by:
• ACIDS (batteries)
• ALKALIS (drain cleaners- often more extensive)
• ORGANIC COMPOUNDS (oil products)
What to Do:
 Remove the chemical by flushing the area with water
 Brush dry powder chemicals from the skin before flushing
 Take precautions to protect yourself from exposure to the
chemical
 Remove the victim’s contaminated clothing and jewelry while
flushing with water
 Flush for 20 minutes all chemical burns (skin, eyes)
 Cover the burned area dry, sterile dressing
 Seek medical attention

3. ELECTRICAL BURNS
A mild electrical shock can
cause serious internal injuries.
There are three types of electrical injuries:
• Thermal burn (flame) – Objects in direct contact with
the skin are ignited by an electrical current.
– Mostly caused by the flames produced by the
electrical current and not by the passage of the
electrical current or arc.
• Arc burn (Flash) – Occurs when electricity jumps, or
arcs, from one spot to another.
– Mostly cause extensive superficial injuries.
• True Electrical Injury (contact) – Occurs when an
electric current truly passes through the body.

What to Do:
1. Make sure the scene is safe
• Unplug, disconnect, or turn off the power.
• If that is impossible, call the power company or EMS for

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 help.
a) Do not contact high voltage wires
b) Consider all wires live
c) Do not handle downed lines
d) Do not come in contact with person if the
electrical source is live
2. Check CAB’s. (Circulation Airway Breathing)
3. If the victim fell, check for a spinal injury.
4. Treat the victim for shock
by elevating the legs 8” – 12” if no spinal injury is suspected.
5. Seek medical attention immediately.

BANDAGING TECHNIQUE

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OPEN PHASE
1. Head (Topside)

2. Ear; Cheek; Jaw

Shoulder ; Hip

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3. Arm; Leg

4. Elbow / Knee (straight;

bent)

5. Palm Pressure Bandage

6. Palm Bandage (Open Hand)

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Page 13 of 32
EMERGENCY RESCUE
is a rapid movement of patient from unsafe place to a place of safety.

INDICATIONS FOR EMERGENCY RESCUE

1. Danger of Fire or explosion
2. Danger of Toxic gases
3. Serious Traffic hazard
4. Risk of Drowning
5. Danger of Electrocution
6. Danger of Collapsing Walls

TRANSFER
is moving a patient from one place to another after giving first aid.

Selection will depend upon the following:

1. Nature and severity of the injury.
2. Size of the victim.
3. Physical capabilities of the first aider.
4. Number of personnel and equipment available.
5. Nature of evacuation route.
6. Distance to be covered.
7. Sex of the victim. (Last consideration)

Pointers to be observed during transfer.

1. Victim’s airway must be maintained open.
2. Hemorrhage is controlled.
3. Victim is safely maintained in the correct position.
4. Regular check of the victim’s condition is made.
5. Supporting bandages and dressing remain effectively applied.

ONE MAN ASSIST/CARRIES/DRAGS TWO MAN CARRIES

Fireman’s carry Hand as a litter
Assist to walk Two Man assist
Cradle/Lovers Carry Four hand seat
Pack-strap carry Carry by extremities
Piggy back carry
Fireman’s drag
Armpit/shoulder drag
Inclined drag

THREE – MAN CARRIES FOUR/SIX/EIGHT MAN CARRY

Hammock carry Blanket carry
Bearers alongside Spine Board/ Stretcher

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SHOCK
is a life threatening condition in which the circulatory system fails to
circulate oxygen-rich blood to all parts of the body. It is the inevitable
result of any serious injury or illness.

Dangers of Shock
1. Lead to death.
2. Predisposes body to infection.
3. Lead to loss of body part.

Factors which contribute to Shock

P– Pain
R – Rough handling
I– Improper transfer
C – Continuous bleeding
E– Exposure to extreme cold & excessive heat.
F– Fatigue

SHOCK, UNCONSCIOUSNESS, AND FAINTING

Shock
- Can be life threatening and needs to be recognized and cared for immediately.
- a condition of inadequate circulation to the body tissues.
- it results when the brain and other vital organs are deprived of oxygen.
- can develop gradually or rapidly.
- TREAT ALL VICTIMS FOR SHOCK!

Common Causes of Severe Shock

CAUSE: HOW IT AFFECTS THE CIRCULATION:
- Breathing problems - Not enough oxygen in the blood to supply the
vital organ.
- Severe bleeding, external - Not enough blood in circulation to supply all
or internal, including vital organs.
major fractures.
- Severe burns - Loss of fluids, reducing amounts of blood to fill
the blood vessels.
- Spinal cord injuries - Nervous system can’t control the size of blood
vessels and blood pools away from vital organs.
- Heart attack - Heart isn’t strong enough to pump blood
properly.
- Medical emergencies - these conditions may affect breathing, heart and
i.e. diabetes, allergies, nerve function.

Signs & Symptoms of Shock

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The signs and symptoms may not be obvious immediately, but any of the following
may appear as shock progresses.

Signs and Symptoms of Shock

1. EARLY STAGE:
• Face – pale or cyanotic in color.
• Skin – cold and clammy.
• Breathing – irregular.
• Pulse – rapid and weak.
• Nausea and vomiting
• Weakness
• Thirsty

2. LATE STAGE:
• If the condition deteriorates, victim may become apathetic or relatively
unresponsive.
• Eyes will be sunken with vacant expression.
• Pupils are dilated.
• Blood vessels may be congested producing mottled appearances.
• Blood pressure has very low level.
• Unconscious may occur, body temperature falls.

YOU MAY SEE (signs): - restlessness

- decreased consciousness
- pale skin at first, later bluish grey
- bluish/purple colour to lips, tongue, earlobes and
fingernails
- cold, clammy skin
- profuse sweating
- vomiting
- shallow, irregular breathing; could be rapid and
gasping for air
- a weak, rapid pulse (in later stages the radial pulse
may be absent)

Note: If your casualty has dark skin, the inside of the lips, the mouth, the tongue
and
the nail beds will be blue; the skin around the nose and mouth greyish.

THE CASUALTY MAY TELL YOU OF : (symptoms)

- feelings of anxiety and doom
- being confused and dizzy
- extreme thirst
- nausea and faintness
- pain

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First Aid Management of Shock
1. Proper Body Position.
2. Proper Body Heat
3. Proper Transfer

Treatment

To prevent shock from becoming worse:

- give prompt and effective first aid for any injury or illness
- reassure the casualty often
- loosen tight clothing at neck, chest and waist
- place the casualty into the best position for the condition
- cover the casualty to preserve body heat
- place a blanket under the casualty, if available. Ensure movement does not
aggravate injuries.
- give nothing by mouth (moisten lips if casualty complains of thirst)
- monitor the casualty’s condition and note any changes
- continue ongoing casualty care until the casualty is handed over to medical help

Note: Positioning of a casualty in shock will depend on the casualty’s condition.

Always consider the casualty’s comfort when choosing a position.
Position Found : to prevent further injury, maintain and support a casualty with
suspected head/spinal injuries.
Semisitting : to ease breathing. (ie heart attack, asthma)
Recovery: to maintain an open airway with an unresponsive casualty.

Shock Position : to increase blood flow to the vital organs elevate the feet and legs
30 cm (12 inches).

Unconsciousness:
When you assess a casualty and find her/him unresponsive, you should
immediately:
Send of go for medical help!
If the casualty remains unresponsive, they are considered to be unconscious.
This is a medical emergency.

Fainting:
Fainting is a brief loss of consciousness caused by a temporary shortage of oxygen
to the brain.

FAINTING MAY BE CAUSED BY:

- fatigue, hunger or lack of fresh air
- fear and anxiety
- long periods of standing or sitting
- severe pain, injury or illness

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THE FOLLOWING MAY WARN YOU THAT A PERSON IS ABOUT TO FAINT:
- you may observe paleness and sweating
- the casualty may complain of feeling sick and dizzy

Treatment:
THE CASUALTY THAT FEELS FAINT:
- lay the person down with legs raised about 30 cm (Shock Position)
- ensure a supply of fresh air
- loosen tight clothing around the neck, chest and waist
- if you can’t lay the person down, have them sit with their head and shoulders
lowered.
THE CASUALTY THAT FAINTED:
- a person who has fainted is temporarily unconscious. The first aid is the same as
for the person who is unconscious.
- when the casualty regains consciousness,
*make them comfortable
*keep them lying down for 10 to 15 minutes

ANAPHYLACTIC SHOCK
Another type of shock is called anaphylactic shock. Anaphylactic shock is a severe
allergic reaction to insect bites, medicines, or certain foods. Symptoms include
hives, overall weakness, and swelling of the throat.
 Ask if the person has medication. If so, give it to him or her right away. People
with severe allergies also usually wear a medic alert tag, so look for that, too,
in order to help give EMS workers the best possible information.
 Anaphylactic shock can be deadly, so call for help fast, and
 Be prepared to start CPR.

POISONING
Is any substance: solid, liquid or gas, that tends to impair health or cause death
when introduced into the body or into the skin surface. A poisoning emergency can
be life threatening.

Ways in Which Poisoning May Occur

1. Ingestion – by mouth
2. Inhalation – by breathing
3. Injection – by animal bites, stings, syringes
4. Absorption – by skin contact

1. INGESTED POISON – Is one that is introduced into the digestive tract by way of
the mouth.
Signs and Symptoms: First Aid for Ingested Poisoning:
• Altered mental status. 1. Call poison Control Center
• History of ingesting poisons. 2. Try to identify the poison
3. Place the victim on his or her left side.
• Burns around the mouth.
4. Monitor CABs.
• Odd breath odors.
5. Do not induce vomiting; if patient’s save any
• Nausea, vomiting.
vomitus and keep it with the victim if he or
• Abdominal pain.
she is taken to an emergency facility.
• Diarrhea
6. If a responsive patient’s mouth or lips are
2. INHALED POISON – Is a poison breathed into the lungs.
burned a corrosive chemical, rinse the mouth
Signs and Symptoms
with cold water.

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 • History of inhaling poisons.
• Breathing difficulty.
• Chest pain.
• Ringing in the ears
• Cough, hoarseness, burning sensation in the throat.
• Cyanosis (bluish discoloration of skin and mucous membranes).
• Dizziness, headache.
• Seizures, unresponsiveness (advance stages)

First Aid for Inhaled Poisoning:

1. Call Poison Control Center
2. Remove the victim form the toxic
environment
and into fresh air immediately.
3. Monitor CABs.
4. Seek medical attention.
3. ABSORBED POISON – Is a poison that enters the body through the skin.
Signs and Symptoms
• History of exposures. First Aid for Absorption Poisoning:
• Liquid or powder on the skin. 1. Call Poison Control Center
• Burns 2. Remove the clothing. Then with a dry
• Itching, irritation. cloth blot the poison from the skin. If the
• Redness, rash, blisters. poison is a dry powder, brush it off.
3. flush the affected area with large amount
of water for 20 minutes
4. Continually monitor the patient’s vital
signs.
4. INJECTED POISON – Is a poison that enters the body through a bite, sting, or
syringe.
Signs and Symptoms (Insect Bites) First Aid for Insect Bites
• Stinger may be present. 1. Remove stinger. If the sting is in the
• Pain mouth or throat give patient an ice cube
• Swelling or cold water to sip.
• Possible allergic reaction. 2. Wash wound.
3. Cover the wound.
4. Apply a cold pack.
5. Watch for signals of allergic reaction.
6.
SNAKE BITES
Signs and Symptoms
• Possible marks
• Pain
First Aid for Snake bites
1. Call Poison Control Center
2. Wash wound.
3. Monitor CAB
4. Keep bitten part still, and lower than the heart.
5. Immobilize or splint the bitten extremity.

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COMMON EMERGENCIES

Environmental Emergencies
HYPOTHERMIA – When a person’s body is not able to produce enough
Energy to keep the internal body temperature at a satisfactory level (below 95⁰F or
35⁰C) like prolongs exposure to cold.

1. Early stage – The patient will present with cold skin and shivering and will
still be alert and oriented.
First Aid:
• Check responsiveness
• Cover the patient with a warm blanket.
• Apply hot compress.
• Check vital signs.
• Refer to a physician.

2. Late stage – Patients may become unresponsive. This is a true medical

emergency that can lead to death.
First Aid:
• Check responsiveness.
• Check CAB, perform CPR if needed.
• Quickly replace the wet clothing with warm or dry garment
• Cover the patient with warm blanket
• Move the patient to warm place
• Give warm liquid or chocolate to help re-warm the patient if conscious.
• Apply warm compress for early stage
• Check vital signs
• Care for shock.
• Do not massage the extremities
• Refer to a physician.

TYPES OF HEAT EMERGENCIES

1. Heat Cramps
2. Heat exhaustion
3. Heat Stroke or Sunstroke

1. HEAT CRAMPS – Occurs as a result of loss of fluid and salt from heavy
sweating. They occur rapidly and involve painful spasm or skeletal muscle.
First Aid:
• Have the patient rest with his or her feet elevated.
• Cool the patient.
• Give the patient electrolyte beverages to sip or make a salted drink.
• Massage the affected muscles gently but firmly until they relax
• Cold application on the affected muscles
• Monitor the patient for signs of shock.
• If the patient starts having seizures, protect him/her from injury and give first
aid for convulsions.

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 2. HEAT EXHAUSTION – A response to heat characterized by fatigue,
weakness, and collapse due to inadequate intake of water to compensate for
loss of fluids through sweating.
First Aid:
• Have the patient rest with his or her feet elevated.
• Cool the patient.
• Give the patient electrolyte beverages to sip or make a salted drink.
• Monitor the patient for signs of shock.
• If the patient starts having seizures, protect him/her from injury and give first
aid for convulsions.
• If the patient loses consciousness, give first aid for unconsciousness.

3. HEAT STROKE or SUNSTROKE – A response to heat characterized by

extremely high body temperature and disturbance of sweating mechanism
due to exposure in a hot environment for a long period of time.
First Aid:
• Remove patient from hot environment.
• Cool the patient.
• Give First Aid for Shock.
• Monitor the patient’s CAB
• If the patient starts having seizures, give first aid for seizures.
• Keep the patient cool as you await medical help.

MEDICAL EMERGENCIES
1. STROKE
2. DIABETES
3. SEIZURES
4. FEBRILE SEIZURES

STROKE - Is a condition that occurs when the blood flow to the brain is interrupted
long enough to cause damage.
• People over age 50 are the common victims, but younger people can have
them too.
Causes:
1. Thrombus or embolism.
2. Ruptured artery in the brain.
3. Compression of an artery in the brain.
First Aid:
• Check the patient’s CAB.
• Have the patient rest in a comfortable position.
• Seek immediately medical help.
• Do not give the patient anything by mouth.
• If the patient loses consciousness, place him or her in the recovery position
and administer first aid for unconsciousness.
• Continue to monitor CAB’s.
• Stay with the patient until you have medical help.

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DIABETES - A condition wherein a person is unable to produce the right amount of
insulin in the body. A chemical that controls how much sugar there is in the blood.

Types of Emergency Diabetes

1. Hypoglycemia (Insulin Shock) – Occurs when too much insulin is in the body.
Signs and Symptoms:
1. Cold, pale, sweating and clammy skin
2. Rapid onset of symptoms
3. Fast breathing.
4. Fast pulse.
2. Hyperglycemia (Diabetic Coma) – Happens when there is too much sugar and
too little insulin in the blood, and body cells do not get enough nourishment.
Signs and Symptoms:
• Warm and dry skin
• Rapid weak pulse
• Drowsiness and confusion
• Deep and fast breathing
• Extreme thirst
First Aid:
• Give any fully conscious person in a diabetic emergency sugar, candy, fruit,
juice, or a soft drink containing sugar.
• Assist the patient’s medication like oral glucose.
• If the person is unconscious, check CAB and call for a physician.
• Immediate transport to the hospital.

SEIZURES - Is a sudden involuntary muscle contraction, usually due to uncontrolled

electrical activity in the brain, caused by many different conditions, including
epilepsy, high fever in young children, certain injuries, electric shock and other
causes.

First Aid:
If you know the person has epilepsy, it is usually not necessary to call physician
unless;
• The seizure lasts longer than a few minutes.
• Another seizure begins soon after the first.
• He or she does not regain consciousness after the jerking movement has
stopped.
However, you should call physician when someone having a seizure also;
• Is in the water and has swallowed large amounts of water.
• Carries identification as a diabetic.
• Is pregnant.

FEBRILE SEIZURES – A high temperature does not necessarily mean the victim is
seriously ill. Some children however, have febrile seizure when a high fever is rising
or falling.

First Aid:
• After the episode of febrile seizures, take the child’s temperature.
• It is important to bring the child’s temperature to normal.
• Remove all clothes or bedclothes
• Give the child a sponge bath on a counter with cold water; and turn on a fan.

Page 22 of 32
 Stop if the child shivers (do not place child in a bathtub because he or she
could have another seizures in the water).
CHOKING:
A person chokes when the airway is partly or completely blocked and airflow is
reduced or cut off. A choking person may die if first aid is not given immediately.
Choking is a life threatening breathing emergency.

A partially blocked airway results in either:

- mild airway obstruction
- severe airway obstruction

Common Causes of Choking Are:

- food or some other object stuck in the throat
- trying to swallow large pieces of food
- eating and drinking while doing something else
- drinking too much alcohol before or during a meal
- gulping drinks with food in your mouth

- blood or vomit collects in the throat

- the tongue of an unconscious person falling to the back of the throat

Signs of Choking:

Mild Airway Obstruction

- person can speak
- coughing and gagging are forceful
- you may hear wheezing when trying to breathe
- the facial colour is reddish
- stand behind person, the way you would before doing compressions and
encourage coughing

Severe Airway Obstruction

- person cannot speak
- coughing and gagging are forceful
- you may hear high pitched noises when trying to breathe
- the facial colour is bluish
- start first aid for choking

NOTE: the universal sign of choking is Clutching the Throat

FIRST AID FOR CHOKING:

Treatment:
A choking person clutches their throat, is read in the face:
CONSCIOUS (Mild Choking )
1. stand by and encourage coughing

CONSCIOUS (Severe Choking)

1. Ask – “Are you Choking? Can I help?”
2. Landmark using the hips
3. Give abdominal thrusts well below the xyphoid process

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UNCONSCIOUS
5. ease the casualty to the floor
6. call 911
7. open the mouth and look to see if there is anything there
8. tilt the head backward and try to ventilate
9. reposition the head. Check the seals at the mouth and nose and try to
ventilate again.
10. give 30 chest compressions
11. repeat steps 7 - 10
12. if you are successful in clearing the airway, continue with the primary
survey
13. give ongoing casualty care until they are handed over to medical help.

Note: Breathing problems, and other signs of choking may be caused by swelling in
the airway due to an allergic reaction to food or a bee sting, an infection or
injury. Do not waste time trying to relieve this obstruction. Get medical help
immediately.

Risk Factors Associated with Heart Disease

Controllable Uncontrollable

Lack of Exercise Age

Smoking Gender
Stress Hereditary
Obesity Diabetes
High Blood Pressure
Cholesterol
Diet

Angina, Heart Attack, Cardiac Arrest and Stroke

Angina is a temporary shortage of oxygen to the heart muscle. The signs

and symptoms are the same as for a heart attack, but there is no damage
to the heart.

Heart Attack is a shortage of oxygen to the heart muscle. Although the

heart is still beating, due to lack of oxygen heart tissue starts to die.

Cardiac Arrest is when the heart stops beating, the casualty will be
unconscious, not breathing and have no pulse.

TIA – Transient ischemic attack – temporary shortage of oxygen to the

brain.

Stroke is a lack of oxygen to the brain.

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Signs and Symptoms of a Heart Attack

Nausea Dizziness
Sweating Shortness of Breath
Feeling of Indigestion Paleness
Chest pain that may spread to the neck, jaw, shoulders and/or arms
Denial

Signs and Symptoms of a Stroke

Headache Blurred Vision

Dizziness Numbness on one side of the body
Paralysis of facial muscles Decreased consciousness
Slurred speech Drooling
Unsteadiness or sudden fall Loss of coordination
Unequal size of pupils Loss of bladder or bowel control

WHAT SHOULD WE DO?

1. Recognize the early warning signals.

2. Take Charge!
3. Have the victim stop their activity.
4. Loosen tight clothing.
5. Offer reassurance.
6. If the victim suffers from heart disease. Help them take their medication.
NOTE: Take 1-nitroglycerin every 5 minutes - 3 times only. So in total, the
victim with have taken 3 Nitroglycerines.
7. If no history of heart disease, have casualty chew one Aspirin.
8. Be prepared for CPR.

ASTHMATIC ATTACK:
Signs & Symptoms (Severe Asthmatic Attack)
- shortness of breath/ trouble breathing
- coughing or wheezing
- fast and shallow breathing
- anxiety
- casualty sitting upright trying to breathe
- fast pulse rate
- bluish colour in the face
- shock
- restlessness, then fatigue

TREATMENT: NOTE: No drinking during an attack!

- call for medical help immediately
- have casualty stop activity
- place the casualty in the most comfortable position
- reassure
- assist the casualty to take prescribed medication

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BONES AND MUSCLES INJURIES MANAGEMENT
Common Causes:
1. Vehicular accidents.
2. Motorbike accidents.
3. Mishandling of tools and equipment.
4. Falls
5. Sports
Signs and Symptoms
 Pain
 Bruising
 Swelling
 Misshapen appearance and obvious deformity.
 Exposed bone.
 Pale, Bluish skin; loss of pulse in an injured limb.
 Numbness furthers down the arm or leg.

1. MUSCLE CRAMP (Spasm) – is the sudden, painful tightening of a muscle.

First Aid Management:
 Have the victim stretch out the affected muscle to counter the cramp.
 Massage the cramped muscle firmly but gently.
 Apply heat; moist heat is more effective than dry heat.
 Get medical help if cramps persist.
2. MUSCLE STRAIN/PULLED MUSCLE - is the sudden painful tearing of the
muscle fibers during exertion.
Signs and Symptoms:
 Pain
 Swelling
 Bruising
 Loss of efficient movement.
First Aid Management:
 Apply cold Compress at once.
 Elevate the injured limb.
 Rest the pulled muscles for 24 hours.
 Get Medical help.

3. SPRAIN - A sprain is a tearing of ligaments at a joint when the bones are

forced beyond their normal range of motion.
Signs and Symptoms:
 Pain
 Swelling
 Bruising
First Aid Management:
 Remove all clothing or jewelry around the joint.
 Apply cold compress at once.
 Elevate the affected joint.
 The victim’s Physician may recommend an OTC anti inflammatory
medication.
4. DISLOCATION - is the displacement of a bone from its normal position at a
joint.

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5. BROKEN BONES – is a break or disruption in bone tissue.
Signs and Symptoms:
 Pain
 Misshapen appearance
 Swelling
 Loss of function
First Aid Management:
 Check the victim’s CAB.
 Keep the victim still.
 Prevent infection by covering the wound before immobilizing.
 Splint or sling the injury in the position, which you found it.
 Take steps to prevent shock.
 Get medical help.

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 BASIC LIFE SUPPORT
(Based on AHA 2010 Guidelines)

INTRODUCTION TO BASIC LIFE SUPPORT

THREE KINDS OF LIFE SUPPORT

1. BASIC LIFE SUPPORT (BLS) – A set of emergency procedures that consist
of recognizing respiratory or cardiac arrest and the proper application of
Cardio-Pulmonary Resuscitation (CPR) with or w/o Automated External
Defibrillation (AED) or Foreign Body Airway Obstruction Management
(FBAOM) and Rescue Breathing (RB) or to maintain life until a victim
recovers or advanced life support is available.
2. ADVANCED CARDIAC LIFE SUPPORT (ACLS) – A set of clinical
interventions for the urgent treatment of cardiac arrest and other life
threatening emergencies, as well as the knowledge and skills to deploy those
interventions.
3. PROLONGED LIFE SUPPORT (PLS) – For post resuscitative and long term
resuscitation with the use of adjunctive equipment such as ventilator, cardiac
monitor, pulse oximeter etc.

ADULT CHAIN OF SURVIVAL

1. The First Link: IMMEDIATE RECOGNITION & ACTIVATION OF EMS

It is the event initiated after the patient’s collapse until the arrival of
Emergency Medical Services personnel prepared to provide care.
2. The Second Link: EARLY CPR
It is most effective when started immediately after the victim’s collapse. The
probability of survival approximately doubles when it is initiated before the
arrival of EMS.
3. The Third Link: RAPID DEFIBRILLATION
It is the cornerstone therapy for patients who have just suddenly collapsed
probably due to ventricular fibrillation and pulse-less ventricular tachycardia.
4. The Fourth Link: EFFECTIVE ACLS
Provided by highly trained personnel like paramedics.
5. The Fifth Link: INTEGRATED POST-CARDIAC ARREST CARE
Post cardiac arrest care after return of spontaneous circulation (ROSC) can
improve the likelihood of patient survival with good quality of life.

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HUMAN BODY
ANATOMY AND PHYSIOLOGY

*Clinical death
0 - 1 min. - cardiac irritability
1 - 4 min. - brain damaged not likely
4 - 6 min. - brain damage possible
*Biological death
6 - 10 min. - brain damaged very likely
over 10 min. - irreversible brain damaged

CARDIOVASCULAR DISEASE
Risk Factors for Cardiovascular Disease
1. Risk factors that cannot be changed (Non-modifiable)
• Heredity • Age • Gender
2. Risk factors that can be changed (modifiable)
• Cigarette Smoking • Hypertension • Stress
• Obesity • Diabetes Mellitus • Lack of Exercise
• Elevated cholesterol and triglyceride level

CARDIOPULMONARY RESUSCITATION
• is series of assessments and interventions using techniques and maneuvers
made to bring victims of cardiac and respiratory arrest back to life.

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WHEN NOT TO START CPR
All victims of cardiac arrest should receive CPR unless:
1. Patient has a valid DNAR (Do Not Attempt Resuscitation) order.
2. Patient has signs of irreversible death (Rigor Mortis, Decapitation,
Dependent Lividity).
3. No physiological benefit can be expected because the vital functions
have deteriorated as in septic or cardiogenic shock.
4. Confirmed gestation of < 23 weeks or birth weight < 400 grams,
anencephaly.
5. Attempts to perform CPR would place the rescuer at risk of physical
injury.

When to Stop CPR?

S - SPONTANEOUS signs of circulation are restored
T -TURNED over to medical services or properly trained and authorized personnel
O - OPERATOR is already exhausted and cannot continue CPR
P - PHYSICIAN assumes responsibility (declares death, takes over, etc.)
S – SCENE becomes unsafe (such as traffic, impending or ongoing violence—gun
fires, etc)
S – SIGNED waiver to stop CPR

1 and 2 Rescuer Adult CPR

1. Establish scene safety.
2. Introduce self to establish authority.
3. Determine unresponsiveness (movement & breathing)
4. IF unresponsive and not breathing or gasping, call for HELP! Activate EMS
and get the AED.
5. Pulse check within 10 seconds.
6. Perform 30 Compressions on the chest
7. Open Airway- Head/Tilt chin lift and perform
2 Rescue Breaths
8. Do this for 5 cycles or approx. 2 minutes.
Rescuer may switch roles.
9. Do this until AED/Defibrillator arrives, ALS provider takes over, or victim starts
to move.
10. If patient becomes conscious, place patient in recovery position

ADULT CHILD INFANT

Compression Lower half of sternum, between the Just below the

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Landmark nipples nipple line (lower
half of sternum)
Location for Pulse Carotid Pulse Carotid Pulse or Brachial Pulse or
Check Femoral Pulse Femoral Pulse
Compression At least 2 inches At least 1/3 of the AP Diameter of the
Depth (5 cm) chest
About 2 in (5 cm) About 1 1/2 in (4
cm)
Compression Heel of one hand Heel of one hand Lone Rescuer: 2
method (Push hard with hand of the with hand of the finger technique
and fast, Allow other on top other on top or one 2 HCP rescuers: 2-
Complete recoil) hand technique thumbs hand
encircling
technique
Compression rate At least100 Compressions per minute
Counting for 1-29, 1 up to 5 cycles
Standardization (30 compressions within 18 seconds)
Purpose 1-14, 1 up to 10 cycles for 2-rescuer
Pedia CPR
(15 compressions within 9 seconds)
Compression- 1 or 2 - Rescuer 1-rescuer (30:2)
Ventilation Ratio (30:2) 2-rescuer (15:2)

RESPIRATORY ARREST AND RESCUE BREATHING

RESPIRATORY ARREST – Is the condition in which breathing stops or is

inadequate.

Causes of Respiratory Arrest

1. Obstruction
1.1 Anatomical
1.2 Mechanical
2. Diseases
2.1 Bronchitis
2.2 Pneumonia
2.3 COPD
3. Other causes
3.1 Electrocution
3.2 Circulatory Collapse
3.3 Strangulation
3.4 Chest Compression (by other physical force)
3.5 Drowning
3.6 Poisoning
3.7 Suffocation

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RESCUE BREATHING
● Is a technique of breathing air into a person’s lungs to supply him or her with the
oxygen needed to survive.
●Given to victims who are not breathing or inadequate but still have pulse.
● Crucial tool to revive the individual or keep him or her until the help comes.

WAYS TO VENTILATE THE LUNGS

1. Mouth-to-Mouth
2. Mouth-to-Nose
3. Mouth-to-Mouth and Nose
4. Mouth-to-Stoma
5. Mouth-to-Face Shield
6. Mouth-to-Mask
7. Bag Valve Mask Device

● Rescuer to avoid pressing soft tissue under the chin this might obstruct the airway
● Rescuer not to use the thumb to lift the chin
● Rescuer not to close the victim’s mouth completely (unless mouth to nose is the
technique)
● Each rescue breath should give enough air to make the chest rise and be given at
1 second;
● Rescuer should avoid delivering more breaths (more than the number
recommended) or breaths that are too large or too forceful.
● Rescuers should take a normal breath (not a deep breath) mouth to mouth or
mouth-to-barrier device rescue breaths.

ADULT CHILD INFANT

Opening of airway Head Tilt-Chin Lift
(Head-Tilt_ Chin- (HCP: If suspected spine injury perform Jaw thrust maneuver)
Lift Maneuver)
Method Mouth-to-mouth or mouth-to-nose Mouth-to-mouth
and nose
Amount of Breath Normal breath enough to make the chest rise
Rate 1 breath every 5 – 1 breath every 3 - 5 seconds then
6 seconds then reassess every 2 minutes
reassess every 2
minutes
Counting for Breathe Breathe 1001,1002, 1003, breathe
Standardization 1001,1002, 1003,
Purposes 1004, 1005,
breathe 25 cycles

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