First Aid

ELEMENTARY FIRST-AID ADVICE

BRUCE TODD, M.B. ,JOE STUDHOLME and HELEN McKENZIE

updated by Karen Clarke RN,ACGEN – 2010

The following guide was compiled with the assistance of senior officers of the St. John Ambulance Christchurch

 

When approaching the scene of any accident, think first of your own safety.

 

First Aid Equipment in waterproof container:

1. First aid manual

2. Antiseptic wipes – Alcohol free

3. Combine dressing

4. Sterile opsite dressings various sizes

5. Crepe bandages 75mm x2

6. CPR face shield

7. Gauze swabs

8. Disposable gloves – latex or latex free

9. Plasters

10. Scissors

11. Survival blanket or bag

12. Triangular bandage with safety pin

13. Adhesive tape

14. Water proof matches or matches in a waterproof container

Fractures:

Unless essential, do not move the patient but make him as comfortable as possible and provide warmth. With chest injuries where internal bleeding is suspected, turn the patient on to the injured side to prevent blood collapsing the good lung. Splints for limb fractures can be made from boat floorboards, driftwood or any solid object. Slings and padding can be made from towels or clothing. The illustrations show the way to apply splints and slings to fractures of chest wall ribs (fig 2.); upper arm (fig 3); and legs and pelvis (fig 4.). Splints should be padded for comfort and protection of the injured area.

Head Injuries:

A blow to the head can lead to unconsciousness. The patient should be checked immediately to ensure that the airways are clear to allow unobstructed breathing, then checked for major bleeding and fractures and then placed in the recovery position (picture right). If possible, do not leave the victim unattended. Try to raise the head and shoulders (pack with stones, etc.) and provide warmth.

Cuts:

Bleeding from any cut can be controlled by direct pressure over the affected area using any flat object,e.g. a smooth river stone. A clean dressing should be placed over the area first and after bandaging the area should be elevated and rested if possible.

Burns:

Usually the result of petrol first. If a person is aflame, douse with water or smother with a blanket or rug. To reduce pain and disability pour cold water gently over the the affected area for 10 minutes (maximum) and then cover with clean dry material. Do not use oils, creams, butter etc. on burnt areas. Leave blisters alone. Beware of shock setting in. Evacuate early in the case of severe burns. They get worse with time.

Hypothermia:

Excessive cooling of the body causes this condition, e.g. from exposure to excessive cold water, rain, water or from severe exhaustion. The main signs of this condition are:

1. Coolness of the skin.

2. Fatigue.

3. Irritability.

4. Slurred speech.

5. Unsteady walking.

6.. Excessive shivering with increased pulse andrespirations. As they get colder shivering will stop.

7. Finally drowsiness and coma.

Treatment:

Put the patient to rest in a sheltered area and replace any wet clothing with dry. – do not heat them up too quickly. Warm drinks. Provide warm drink and food only to conscious patients. Never give alcohol and don’t rub the patient. Move the patient gently. Huddle up close to them and provide body heat. Evacuate only after the patient’s condition has improved.

Drowning:

Don’t waste time – get help and begin treatment immediately.

Treatment:

1. Quickly remove any obstructions from the victim’s mouth. Place victim on his back and begin artificial ventilation immediately.

2. Check breathing and heartbeat and continue resuscitation if necessary.

3. As soon as the victim begins breathing normally place in the recovery position.

4. Keep the victim warm. If possible remove wet clothes and dry the victim. Then cover with spare clothes and/or towels and, if necessary, treat for hypothermia.

Artificial mouth to mouth ventilation:

1. Remove any obvious obstructions over the face or constrictions around the neck. Open the airway and remove any debris seen in the mouth or throat.

2. Open your mouth wide, take a deep breath, pinch the victim’s nostrils together with your fingers and seal your lips around the mouth.

3.. Blow into the patient’s mouth for one second with sufficient volume to see the chest rise. Note: If the chest fails to rise assume first that the airway is not fully open. Adjust the position of the head and jaw and try again. If there is still no ventilation the airway may be blocked and you will have to provide treatment for choking.

4. Remove your mouth well away from the victim’s and breath out any excess air. Watch the chest fall and then take in fresh air. Repeat inflation. Note: Give the first four inflations as quickly as possible without waiting for complete lung deflation between breaths.

5. Continue inflations at 16 to 18 per minute until the patient is breathing normally.

Adult and Child Cardiac Arrest.

Dial 111 as early as possible. Defibrillation is needed.

1. Place the patient on a hard surface.

2. Kneel alongside the chest, tilt the head back and blow into the patient’s mouth for one second with sufficient volume to see the chest rise if not responsive and not breathing. Repeat this breath.

3. Begin chest compressions immediately after delivering two rescue breaths without checking the pulse. For a child 1-8 years give 5 ventilations.

4. Place the heel of your hand between the breasts on the sternum of the patient. Cover this hand with your other hand and lock your fingers together. Keep your arms straight and vertical above the patient.. Press the sternum down 80mm on an average adult.

3. Chest compression to ventilation rate of 30:2 for patients of all ages except newborn infants who are 3:1. (Adult 2 hands, Child 1 hand, New born 2 fingers)

4. Compressions at a rate of 100 per minute allowing complete chest recoil and minimize interruptions in chest compressions.

5. Complete 5 cycles or two minutes of CPR before checking pulse.

6. Stop compressions as soon as heart beat returns. Continue with breathing if needed.

Shock:

Major signs are:

1. Skin becomes pale, cold and clammy and sweating might develop.

2. Fainting and giddyness.

3. Nausea and vomiting.

4. Anxiety.

5. Pulse and respirations become rapid and

Treatment:

1. Reassure and comfort the victim.

2. Lie the patient down, keep the head low and turned to one side, raise the legs unless you suspect fractures.

3. Keep warm but do not overheat.

4. Loosen any tight clothing.

5. If thirsty, moisten lips with water, but do not give anything to drink.

6. Do not move victims more than necessary.

7. Evacuate to hospital quickly.

 

Note:

Do not move the victim unnecessarily

Do not give anything by mouth

Do not allow the victim to smoke.