MODULE 1

Introduction to First Aid

First Aid
Helping behaviors and initial care provided for an illness or injury

Disaster Risk Reduction and Management Cycle

DEPARTMENT OF HEALTH

STANDARD Goals of First Aid

• Prevent further injury

FIRST AID • Preserve life

• Alleviate Suffering
• Promote recovery

TRAINING Responsibilities of the First Aid Provider

• Bridge the gap between the victim and the health care provider
• Ensure his own safety, that of the victim’s, and of bystanders
• Gain access to the victim
TRAINEE’S MANUAL • Determine threats to the victim’s life
• Call for more medical assistance as needed
• Provide emergency care to the victim
• Assist Health Care Providers when they arrive
• Handover to medical services or properly trained and authorized personnel

Limitations of First Aid

This manual belongs to:
• Limited skill range
• Limited medical knowledge
__________________________ • Minimal or no medical resources
• Legal concerns

Republic Act 3815

Article 12. Section 4 of the Philippine Revised Penal Code Book 1: Any person who, while
performing a lawful act with due care, causes an injury by mere accident without fault or intention
of causing it is exempt from criminal liability.
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Characteristics of an Effective First Aid Provider Primary Assessment
• Gentle Goal: To identify and initiate treatment of immediate or potential life threats.
• Resourceful • Responsiveness
• Observant • Airway
• Tactful • Breathing
• Empathetic • Circulation
• Respectable Responsiveness
• Awake/Alert
Steps in First Aid: Emergency Action Principle • Verbal, responsive to verbal stimuli
• Pain, responsive to pain stimuli
Steps in First Aid: Emergency Action Principle • Unresponsive
• Scene Size-up
• Activate Medical Assistance Airway
• Primary Assessment • Able to speak / cry = open airway
• Secondary Assessment • Note quality of speaking / crying
• Open the airway (Module 2)
Scene Size-up Breathing
SCENE SAFETY • Check for signs of breathing (within 10 seconds!)
Don’t engage if it is unsafe. o See the chest rise and fall
Secure the scene.
Circulation
KNOW WHAT HAPPENED • Skin - color: reddish? whitish? bluish?
Mechanism of injury - temp: cold? clammy? hot? sweaty? very dry?
Nature of illness • Pulse – For responsive victim, check for peripheral pulses
PROTECT YOURSELF/WELL-BEING
Secondary Assessment
Use Personal Protective Equipment (PPE) to prevent possible transmission of diseases.
Thorough assessment of victim’s condition.
• History Taking
NUMBER OF CASUALTY
• Physical Examination
Activate Medical Assistance
History Taking
Call for HELP:
Interview the victim/relative/bystander:
➢ National Emergency Hotline 911
• Chief Complaint
➢ Local Emergency Hotline of your Municipality
➢ SAMPLE
• Pain Assessment
➢ OPQRST
• Other important information

Physical Examination
Identify specific signs of illness or injuries.
• Head and neck
• Shoulders, chest and back
• Arms and hands
• Abdomen
• Hips
• Legs and feet 2
 MODULE 2 • Avoid unnecessary or sudden movements or change in position
• Place the victim in a comfortable position
Medical Emergencies • Reassure the anxious dizzy person
• If symptoms persist, bring the victim to the nearest medical facility
❖ Fever
• Higher-than-normal body (greater than 37.8 degrees Celsius) temperature
When to seek medical care
• Slightly elevated body temperature in children, infants = serious illness
• Dizziness without a clear, certain cause
• Dizziness followed by loss of consciousness
Common Causes of Fever
• Inability to walk straight; falling
• Childhood immunizationsz
• Worsening or new symptom
• Infections
Fainting
Taking the temperature
Not enough blood supply to the brain which causes loss of consciousness
• Orally: under the tongue
• Axillary: under the armpit
What to do for Fainting
• If person is breathing, lay him down, elevate legs
What to do for Fever
• Loosen constrictive clothing
• Monitor temperature
• Don’t get the person up too quickly
• Remove excess clothing; DO NOT wrap in blankets
• Seek for medical assistance
• If possible, keep person in a well-ventilated place
• Make sure airway is clear; watch out for vomiting
• Give tepid sponge bath
• Treat injuries from fall, if any
• Give plenty of fluids
• DO NOT pour water over victim’s face
• Give prescribed doses of paracetamol; DO NOT give aspirin
• DO NOT give any liquids unless victim is awake
• Promote bedrest
Convulsions
When to seek emergency help
• Seizures
• Severe headache
• Uncontrolled, rapid shaking
• Sore throat
• Muscles contract and relax repeatedly
• Unusual skin rash
• Unusual eye Sensitivity to bright light
Characteristics of Convulsions
• Stiff neck; neck pain when head bent forward
• With or without warning signs
• Confusion
• Rigid; shaking vigorously, uncontrollably with upward rolling of eyes; drooling
• Persistent vomiting
• Staring blankly
• Difficulty breathing
• Victim may not remember
• Chest pain
• Restlessness/Irritability
What to do for Convulsion
• Abdominal pain or pain when urinating
• Place the person in a safe environment
• Seizures
• Provide adequate breathing space
• Support the head and neck
❖ Head and Neck Problems
• Note for duration, recurrence and interval
• After the convulsion, roll the person to his side
Dizziness
• Call for medical assistance
Feeling of unsteadiness; spinning sensation
• Stay with person until help arrives
• Vertigo: feeling of motion when there is no actual motion
• Lightheadedness: feeling of about to faint
What NOT to do for Convulsion
• DO NOT place anything in the mouth
What to do for Dizziness
• DO NOT try to make the person stop convulsing 3
• Drink plenty of water; have regular meals; get enough rest
• DO NOT give anything by mouth until he/she is fully awake and alert= What to do for Foreign Object in Nose
• Let the victim inhale through the mouth, pinch the unaffected nostril and ask the victim to
Headache gently exhale through the affected nostril with mouth closed.
• Most common pain complaint • Seek medical help
• May indicate an underlying disorder What not to do for Foreign object in Nose:
DO NOT probe the nose with cotton buds or other tools
What to do for Headache DO NOT make the victim inhale deeply
• Most headaches are treated with painkillers, as prescribed by doctors DO NOT try to remove the object if it is not visible or easily grasped
• Stay in a cool and quiet environment
• Apply cold compress on painful area Foreign object in ear
• Rest • Common among toddlers
• Drink plenty of water • Mostly in ear canal
• Avoid stressors
Usual Foreign objects in Ear
When to seek medical help • Food material
• If headache persists • Beads
• Headache with stiff neck, vomiting • Small toys
• Headache with numbness and weakness of arms or legs and difficulty speaking • Corn, seeds
• Headache after head injury • Insects
• With difficulty of breathing • Hardened earwax may cause similar symptoms

Nosebleed Foreign object in ear: Symptoms

Bleeding from the nose • Ear pain
• Decrease in hearing
Common Causes of Nosebleeding • Irritation to ear canal may cause desire to vomit
• Injury / trauma • Bleeding
• Disease / medical conditions • Buzzing in the ear
• Extremes in environmental temperature
• Changes in altitude Foreign object in Ear: Do’s and Don’ts
• If an alive insect is in the ear, have the person tilt his head, put a few drops of mineral oil.
What to do for Nosebleed • Seek medical help
• Calm the victim; have him sit with head lean forward • DO NOT poke into the ear
• Pinch victim’s nose; have him breathe through mouth • DO NOT try to remove the object
• Apply ice pack on nose bridge, forehead
• Don’t let victim rub, blow or pick nose after bleeding stops Eye injuries
• Persistent bleeding: bring victim to hospital • Include cuts, scratches, objects, burns, chemical exposure, and blunt injuries to the eye or
eyelid
Foreign object in Nose (common in Children) • Can lead to vision loss if left untreated
• May be inhaled or obstruct the air flow
• May be present in child’s nose without any adult being aware What to do with objects in the eye
• May dislodge into the mouth and might be swallowed • Often clear itself of tiny objects through blinking and tearing
• Do not rub the eye
Foreign object in nose: Symptoms • Try to gently flush it out with water
• Difficulty breathing in affected nostril • Do not touch it or apply any pressure to it
• Feeling of something inside nose • Cover both eyes with clean cloth and bring to the nearest hospital
• Irritation, pain • Get medical help immediately
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• Foul-smelling or bloody nasal discharge
What to do for a person with eye injury due to chemicals What to do for cases of Stroke
• Flush the injured eye with tap water immediately. • Check the victim’s ABC
• Turn the person's head so the injured eye is down and to the side. Hold the eyelid open, allow • Have the victim rest in a comfortable position
running water for 15 minutes. • Do not give anything by mouth
• If both eyes are affected, or if the chemicals are on other parts of the body, have the person • Seek immediately medical help
take a shower. • Go to the nearest hospital
• After following the above instructions, seek medical help immediately.
❖ Breathing Emergencies and Heart Attack
What to do for a person with eye cuts, scratches or blows
• If the eyeball has been injured, get medical help immediately Breathing Emergency
• Gently apply cold compresses to reduce swelling and help stop any bleeding. DO NOT apply Occurs when a person is having trouble breathing or cannot breathe.
pressure to control bleeding
• If blood is pooling in the eye, cover both of the person's eyes with a clean cloth or sterile Causes of difficulty of Breathing
dressing, and get medical help • COPD
• Asthma
When to seek medical help • Pneumonia
• Scratch, cut, or something has penetrated the eyeball • Hyperventilation
• Chemical gets into the eye • Pulmonary TB
• The eye is painful and red • Traumatic injury to chest
• Nausea or headache occur with the eye pain
• Change in vision (such as blurred or double vision) Breathing Emergencies Signs and Symptoms
• Uncontrollable bleeding • Trouble breathing or no breathing
• Slow or rapid breathing
Stroke • Unusual deep or shallow breathing
• A condition that occurs when the blood flow to the brain is interrupted. • Gasping for breath
• This is also known as “Brain Attack”. • Wheezing
• Flushed, pale skin
Types of Stroke • Shortness of breath
• Ischemic (Block) • Chest pain
• Hemorrhagic (Bleed) • Apprehensive or fearful tears

Assessment System for Stroke What to do for difficulty of Breathing

F-acial Droop • Call for EMS
A-rm Drift • While waiting for the EMS to arrive:
S-lurred Speech • Provide adequate ventilation
T-ime of onset • Place in comfortable position
• Advise the patient to regulate his/her breathing
*Note: if any of the symptoms present, bring to the nearest capable hospital • If the patient has known medical condition, may give maintenance medication
Signs and Symptoms of Stroke
• Weakness and numbness of the face, arm or leg, often one side of the body only Heart Attack
• Dizziness Serious Medical Condition in which the blood supply to the heart is suddenly blocked.
• Confusion
• Headache Signs and Symptoms of Heart Attack
• Slurring of speech • Chest Pain
• Difficulty in breathing and swallowing • Chest Discomfort
• Pale, clammy skin
• Difficulty of breathing 5
• Profuse sweating Stomachache
• Weakness Any discomfort in the stomach due to gas pain and indigestion.
• Dizziness
• Nausea & vomiting Common Causes of Stomachache
• Weak and rapid pulse • Food poisoning
• Loss of consciousness • Indigestion
• Food Allergies
What to do for cases of Heart Attack • Cramps
CALL for EMS • Constipation
• Lactose Intolerance
While Waiting for the EMS to Arrive: • Stomach Flu
• Gas
If awake: • Bowel Incontinence
• Stop any activity • Gastritis
• Loosen tight clothing
• Assist with medication (maintenance medication/aspirin) What to do for Stomachache
• Seek medical consultation • Have the person lie down and rest
• Observe victim’s condition
If unconscious: • Keep a container nearby for vomiting
• Follow BLS Algorithm • Watch out for signs of dehydration
• Call for emergency medical assistance • If symptoms persist, bring to a nearest health facility

❖ Breathing Emergencies and Heart Attack ❖ Diabetic Emergencies

Diarrhea Diabetes
• Frequent, loose, watery stools Long-term disease that affects how the body turns food into energy.
• It can lead to dehydration and electrolyte problems
Types of Diabetic Emergencies
What to do for Diarrhea 1) Hyperglycemia
• Promote rehydration 2) Hypoglycemia
➢ Give water / oral rehydration solution (ORS)
o 1L of water + half tsp of salt + 6 tsp of sugar Hypoglycemia
➢ Juices Occurs when there is too low sugar in the body.
➢ Fruit water
• BRAT: Banana, Rice, Apple, Tea (dry) Hyperglycemia
Happens when there is too much sugar in the body.
What NOT to do for Diarrhea
• DO NOT drink coffee, milk, or alcoholic drinks Common Signs and Symptoms Diabetic Emergencies
• DO NOT take diarrhea medications unless advised by doctor • Dizziness
• DO NOT give spicy, greasy or fatty foods • Weakness
• Change in the level of consciousness
When to seek medical help • Sweating
• Diarrhea of more than 3 episodes • Tremors
• Bloody, black, or oily-looking stools • Hunger
• Dizziness, weakness, muscle cramps • Change in the Level of Consciousness
• Deep and fast breathing
• A fruity smelling breath 6
• Thirst For Anaphylaxis
• Inject the pre-filled EpiPen.
What to do for Diabetic Emergencies • When the person with anaphylaxis does not respond to the initial dose, and arrival of
• Give any fully conscious person in a diabetic emergency sugar candy, fruit juice, or a soft advanced care is expected to exceed 5 to 10 minutes, repeat dose may be considered.
drink containing sugar.
• If the person is unconscious, check ABC’s, and call the physician. ❖ Animal Bites and Stings
• Monitor and observe victim’s condition.
• Immediately transport to the nearest health care facility. Insect Bites and Stings
• causes pain, swelling, allergic reaction
• can lead to serious illness or death
MODULE 3
Insect Bites / Stings: Signs & Symptoms
Environmental Emergencies • stinger present
• pain
❖ Allergic reaction • swelling
• over-reaction of protective mechanisms to substances that are normally harmless • itchiness
• can be mild or life-threatening • rash
• redness
Triggers of allergic reactions • hives or wheal
• Food • allergic reaction
• Medications
• Chemicals Insect Bites / Stings: What To Do
• Insect bites, stings • DO NOT pinch the stinger
• Plants • Remove stinger by gently scraping the skin
• Wash wound with soap and water
Allergic reaction: signs & symptoms • Cover the wound
• Apply cold compress
• Watch for signs of allergic reaction

Spider Bite and Scorpion Sting

• causes pain, swelling, allergic reaction, infection
• can cause paralysis and death

Spider Bite and Scorpion Sting: Signs and Symptoms

• bite mark or sting present
• pain
• swelling
What to do for allergic reaction • desire to vomit, with or without vomiting
• Assess ABCs • difficulty of breathing or swallowing
• Call for emergency medical assistance
• Remove the potential source of the allergic reaction Spider Bite and Scorpion Sting: What To Do
• Assist the person in taking anti-allergy medications • Wash wound with soap and water
• Have the patient rest calmly • Apply antiseptic, as available
• Provide fresh air • Apply cold compress
• Help patient lie down • Bring victim to the nearest health care facility/ Poison Control Centers immediately
• Loosen tight clothing
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Marine Life Stings Snakebite: What To Do
• common marine animals causing injuries
• very painful wounds may cause severe • Clean the area of the bite with soap and water
• allergic reaction • Apply pressure immobilization bandage with splint on the bitten limb.
• Make the victim lie down quietly and comfortably
Marine Life Stings: Signs & Symptoms • Keep victim calm; do not allow unnecessary movements
• strong, sharp, stinging, radiating pain • Bring victim to the nearest health care facility/ Poison Control Centers immediately.
• skin redness, rash, blisters • For other parts of the body affected, wash wounds, do wound care and minimize movement.
• bleeding (stingray sting)
• Burning sensation Snakebite: What NOT To Do
• itching, skin irritation • DO NOT suck the wound to remove the venom
• desire to vomit, vomiting, numbness, muscle spasm, headache • DO NOT apply cold compress
• severe reactions: paralysis, coma • DO NOT incise the bitten area
• Do NOT use tourniquet
Jellyfish Stings: What To Do Land Animal Bites
• Remove victim’s clothing • causes direct damage to skin and soft tissues
• Rinse affected area with vinegar as soon as possible for 30 seconds. • causes infections
• Pain should be treated with hot water immersion (as tolerated) when possible. ➢ tetanus
• Use seawater in washing the injury to dilute the toxin. ➢ rabies
• Monitor victim’s condition
• Bring victim to hospital Land Animal Bites: What To Do
• Wash bitten area with soap and water
Jellyfish Stings: What Not To Do • DO NOT induce bleeding
• Remove, but DO NOT touch the tentacles • Control bleeding
• DO NOT use fresh water and ice • Cover wound with sterile or clean dressing
• DO NOT rub the affected area • Bring victim to the nearest health care facility / Animal Bite Treatment Center
• DO NOT apply pressure
❖ Poisoning
Stingray / Sea Urchin Stings: What To Do
• Irrigate / immerse affected area with hot water Poison
• Cover the wound any substance that causes illness or death when it enters the body or comes in contact with the
• Bring victim to the nearest health care facility or Poison Control Centers immediately surface of the skin

Snake: Poisonous vs. Non-poisonous How do poisons enter the body?

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Ingested poisons Alcohol intoxication: Signs & Symptoms
Introduced into the digestive tract by way of the mouth • odor of alcohol on victim’s breath, clothing
• sleepiness, confusion
• overdose of alcohol • poor balance, coordination
• overdose of medicines • numbness
• insecticides, pesticides • slurred speech
• kerosene • Nausea/vomiting
• denatured alcohol • convulsions
• acids
• toxins from poisonous plants What To Do If Victim Is Responsive
• contaminated food or water • Look for injuries
• Protect the intoxicated person from injuring himself
Ingested Poisons: Signs & Symptoms • Protect yourself
• abdominal pain, cramping • If the intoxicated person becomes violent, call for police & medical assistance
• nausea and vomiting • Keep at a safe distance until help arrives
• diarrhea
• burns, odors, stains around and in victim’s mouth What To Do If Victim Is Unresponsive
• drowsiness; loss of consciousness • Make sure airway is clear & victim is breathing
• container of poison near victim • Call medical assistance immediately
• Place victim in side-lying position to avoid aspiration of vomitus.
Ingested Poisons: What To Do • If there are signs of injury: assume spine injury
• Check the victim’s level of consciousness • Regulate victim’s body heat
• If conscious, get the following information • DO NOT give anything by mouth
o WHO is the victim? age? • Bring victim to hospital
o WHAT was swallowed? HOW much?
o HOW did it happen? Inhaled Poisons
o WHEN did it happen(date and time)? inhaled into the lungs
• If unresponsive: check airway & breathing; place in side-lying position ➢ smoke, fumes from chemicals
• Keep and bring the poison container, plants, and vomitus for analysis. ➢ carbon monoxide
• Contact Poison Control Centers.
• If unable to contact, bring the victim to the nearest health care facility. Inhaled Poisons: Signs & Symptoms
• nausea and vomiting
Ingested Poisons: What NOT To Do • difficulty of breathing
• DO NOT make victim vomit. • chest pain
• DO NOT administer anything by mouth unless advised to do so by a Poison Control Center • cough
(PCC) or Emergency Medical Personnel. • hoarseness
• burning sensation in throat
Alcohol Intoxication • bluish discoloration of skin, lips, walls of mouth
Alcohol • dizziness
• Is a powerful CNS depressant, both sedative and hypnotic. • headache
• Dulls the sense of awareness, slow reflexes, and reduces reaction time. • seizures
• May cause aggressive and inappropriate behavior. • unresponsiveness

Alcohol intoxication Carbon Monoxide Poisoning: Common Signs & Symptoms

when a person takes in more alcohol than his body can tolerate can lead to decreased physical • Dull headache
and mental abilities • Weakness
• Dizziness
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• Nausea or vomiting Special Considerations
• Shortness of breath • In case of exposure to an acid or alkali on the skin or eye, immediately irrigate the affected
• Confusion area with copious amounts of water.
• Blurred vision
• Loss of consciousness • In case of CHEMICAL SPILL/S:
- EVACUATE THE AREA
Inhaled Poisons: What To Do - CALL appropriate authority e.g., 911, BFP, HazMat Team
• Ensure scene safety
• Immediately remove victim from toxic environment ❖ Heat-Related Problems
• Remove all contaminated clothing from the victim, making sure you do not contaminate Heat-related problems can develop in people who are exposed to hot environments for longer
yourself in the process than the body can tolerate.
• Keep airway open, make sure victim is breathing fresh air
• Monitor ABCs Types of Heat Related Illnesses
• Bring victim to nearest hospital • Heat Cramps
• Heat Exhaustion
Absorbed Poisons • Heat Stroke
enter the body by passing through the skin
➢ household cleaning fluids Heat Cramps: Signs and Symptoms
➢ agricultural chemicals, pesticides • Painful tightening of muscles after prolonged use
➢ industrial products • Heavy sweating leading to electrolyte imbalance and muscle tightening
➢ creams, ointments, and dyes
➢ secretions of poisonous plants Heat Exhaustion: Signs and Symptoms
• pale, moist, cool skin
Absorbed Poisons: Signs & Symptoms • dry tongue, thirst
• skin redness, rash, or blisters • dizziness, faintness
• hot, dry skin, lips • irritability, confusion
• burns • weakness
• itching, skin irritation • nausea (with or without vomiting)
• liquid or powder on skin • headache
• blurring of vision • rapid pulse
• dizziness • normal or slightly high body temperature
• headache
• seizures Heat Stroke: Signs and Symptoms
• unresponsiveness • skin is flushed, hot, dry
• rapid, weak pulse and breathing
Absorbed Poisons: What To Do • can lead to death if untreated
• Remove all contaminated clothing from the victim, making sure you do not contaminate
yourself in the process.
• DO NOT wipe the poison to remove it
o liquid: blot it off victim’s skin
o powder: brush it off victim’s skin
• Wash exposed area with running water; ask victim to bathe using mild alkaline soap. i.e.
Perla™
• Monitor the victim’s condition
• Bring victim to the nearest health care facility

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 Management

Heat Cramps: Management

• Move victim to the coolest possible place
• Have him rest, drink plenty of cold fluids (electrolyte beverages)
• Stretching, applying cold packs, and massaging the painful muscle until it relaxes. MODULE 4
• Loosen tight clothing
• If with persistent cramps, bring victim to nearest health care facility Trauma Injuries

Heat Exhaustion: Management ❖ Wounds

• Move victim to the coolest possible place • Injuries to soft tissue that damages the skin and the structures underlying it
• Loosen victim’s clothing • First aid depends on types of wound:
• Apply cold packs to neck, groin, armpits ➢ Closed
• Have victim lie down, elevate legs ➢ Open
• If awake: give cold fluids to drink
• DO NOT give caffeinated, alcoholic drinks Closed wounds
• For unresolved symptoms, bring victim to nearest health care facility • No break on the surface of the skin
• Application of external forces
Heat Stroke: Management ➢ bruise, contusion
• Move victim to coolest possible place ➢ redness
• Check for ABC ➢ swelling
• Loosen victim’s clothing ➢ hematoma
• Apply cold packs to neck, groin, armpits ➢ severe bruising = possible internal bleeding
• Call of emergency medical assistance immediately
• Place victim in comfortable position First aid for closed wounds
• DO NOT force victim to drink • Cold compress done within 15 (range to 20 mins) every 20 minutes until referred
• Cover victim with cold, wet towels or sheets then bring victim to the nearest health care • Cold compress done within 15 (range of 10-20 mins) minutes every 2 hours on the first 24
facility as fast as possible hours, for home remedies
• Hot compress for 15 minutes 3x a day after 24 hours
• Keep affected part elevated when possible

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 • Cover the wound
Open wounds • Bring victim to health care facility

Abrasion Amputation
Clinical Presentations, Signs and Symptoms: Clinical Presentations, Signs and Symptoms:
• affects the top layer of the skin • total separation of body part or limb
• priority: prevent infection • massive bleeding
• very painful
First Aid Intervention:
Wash with soap & water First Aid Intervention:
Apply mild antiseptic • Control bleeding using pressure dressings
Keep surface exposed • Cover detached part with moist dressing, place in clean plastic bag, place in bag with ice
• Apply tourniquet to minimize or control massive bleeding
Laceration • Bring victim and detached part to health care facility
Clinical Presentations, Signs and Symptoms:
• tear on surface of the skin Avulsion
• more severe bleeding Clinical Presentations, Signs and Symptoms:
• goal: control bleeding • skin and tissues under it torn off from surface
• severe bleeding
First Aid Intervention: • very painful
• Wash with large amounts of clean water
• Control bleeding by direct pressure using clean dressing First Aid Intervention:
• For persistent bleeding: apply 2nd dressing over first; use elastic bandage • Wash with large amounts of clean water
• Bring victim to health care facility • Pressure dressing
• Bring victim to health care facility
Incision
Clinical Presentation, Signs and Symptoms Impaled wounds
• Cut or wound of body tissue caused by sharp Clinical Presentations, Signs and Symptoms:
edged object or material • foreign object that penetrates the skin and
• Synonyms: gash, laceration, rent, rip, slash, slit, tear remains embedded in tissue

First Aid Intervention: First Aid Intervention

• Wash with large amounts of clean water • Do NOT remove unless causing airway
• Control bleeding by direct pressure using clean dressing obstruction
• Persistent bleeding: apply 2nd dressing over first; elastic bandage • Control bleeding using pressure dressing
• Bring victim to health care facility around impaled object
• First aid intervention for incision will be the same as for laceration • Stabilize impaled object using bulky soft dressing
or bandages (doughnut ring)
Puncture • Protect impaled object from being moved
Clinical Presentations, Signs and Symptoms: • Bring to health care facility immediately
• entry of sharp, pointed object
• can cause massive internal bleeding Evisceration
• very painful Clinical Presentations, Signs and Symptoms:
• severe open wounds in abdominal wall may
First Aid Intervention: expose organs
• Wash with large amounts of clean water o organs protrude out of wound
• Apply mild antiseptic 12
First Aid Intervention: Controlling Bleeding
• Do NOT touch or push back exposed organs • body will not tolerate >20% blood loss
• Cover wound with moist, clean dressing o adult = 1 L
• Do NOT use dressing material that sticks to exposed organs or that breaks up when wet o children = 100-200 mL
• Bring to health care facility immediately • Control bleeding using direct pressure

Human bite wounds If you DON’T have a trauma first aid kit:
Clinical Presentations, Signs and Symptoms: Apply Direct Pressure on the wound
• Caused by the piercing of skin by human teeth 1. Take any clean cloth (e.g. shirt) and cover the wound.
• Bacteria are usually present and serious infection 2. If the wound is large and deep, try to “stuff” the cloth down into the wound.
often follows 3. Apply continuous pressure with both hands directly on top of the bleeding wound.
• Also known as: fight bites 4. Push down as hard as you can.
5. Hold pressure to stop bleeding. Continue pressure until relieved by medical responders.
First Aid Intervention:
• Thoroughly wash with an antiseptic or soap and water; rinse well Bandage
• Cover wound with moist, clean dressing • maintains pressure for controlling bleeding
• Bring to health care facility, for advanced intervention • keeps dressing in place
Other wounds
First Aid Intervention: Guidelines in using dressing and bandages
• Call 911 • Use a dressing that is large enough to extend at least 1 inch beyond the edges of the wound
• Control bleeding • Bandages should fit snugly but should not cut off circulation or discomfort.
• Bring victim to health care facility • If the area beyond the wound changes color, feels cold or starts to swell the bandage is too
tight and should be loosened.
What is “Life-Threatening” Bleeding?
Elastic bandages are stretchable bandages designed and used to create continuous localized
pressure.

Triangular bandages are bandages to support an injured forearm; consisting of a wide triangular
piece of cloth hanging from around the neck.
Phases

Open

Broad

Semi-broad

Narrow cravat

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If you DO have a trauma first aid kit: • can be swollen
For life-threatening bleeding from an arm or leg and a tourniquet is available:
Apply the tourniquet Second-degree burns
1. Wrap the tourniquet around the bleeding arm or leg about 2 to 3 inches above the bleeding site • moist
(be sure NOT to place the tourniquet onto a joint – go above the joint if necessary). • redness
2. Pull the free end of the tourniquet to make it as tight as possible and secure the free end. • swollen
3. Twist or wind the windlass until bleeding stops. • has blisters
4. Secure the windlass to keep the tourniquet tight. • very painful
5. Note the time the tourniquet was applied.
Third-degree burns
If you DO have a trauma first aid kit: • dry, leathery
For life-threatening bleeding from an arm or leg and a tourniquet is available: • white, dark brown or charred
Apply the tourniquet • hard to touch
1. Wrap the tourniquet around the bleeding arm or leg about 2 to 3 inches above the bleeding site • numb
(be sure NOT to place the tourniquet onto a joint – go above the joint if necessary).
2. Pull the free end of the tourniquet to make it as tight as possible and secure the free end. Fourth-degree burns
3. Twist or wind the windlass until bleeding stops. • Injury extends to all layers of the skin
• Often there is no pain
Tourniquet Pain • burnt area is stiff
• Tourniquets HURT when applied effectively. • Healing typically does not occur on its own
- Explain this fact to the victim. • Injury to deeper tissues, such as muscle, tendons, or bone
• Pain DOES NOT mean you put on the tourniquet incorrectly.
• Pain DOES NOT mean you should take the tourniquet off. First Aid for First-degree and Second-degree burns
• Once paramedics arrive, they will treat the pain with medication. • Quickly remove victim from burn source
• Remove clothing over burnt area except if stuck to the skin
❖ Burns • Immerse affected area in room-temperature water
• due to large amounts of heat energy absorbed by the skin • Apply burn ointment
• very painful • Encourage victim to drink plenty of liquids
• can cause scarring • Do NOT prick blisters of second-degree burns
• severe burns > death • Do NOT apply ice directly to a burn, it can produce tissue ischemia.
• recognizing type of burn > correct first aid
First Aid for Third-degree and Fourth-degree burns
Causes of Burns • Assess ABCs and manage accordingly
• Thermal Burns- sun exposure; contact with fire, very hot/very cold objects, liquids or gases; • Cover burned area with clean, loose sterile dressing
blasts, fireballs • Check nose and mouth for soot and ash
• Electrical Burns - direct contact with live electrical currents or lightning • Bring victim to health care facility
• Chemical Burns - direct contact with corrosive substances
First Aid for Chemical Burns
Depth of Burns For wet chemicals:
• First-degree burn (superficial) • Remove victim from source. Blot it off the victim’s skin.
• Second-degree burn (partial thickness) • Flush the affected area with water for at least 20 minutes
• Third-degree burn (full thickness) • Do NOT apply anything on the affected area
• Fourth-degree burn (full thickness involving the bones, fat, and/or muscles)
For dry chemicals
First-degree burns • Brush off the chemical
• redness; no blisters • Do NOT use your bare hands
• painful • Flush with water for at least 20 minutes 14
• Remove all contaminated clothing • loss of function (extreme cases)
• Bring victim to health care facility
❖ Spine Injuries
First Aid for Electrical Burns The Spine
• Turn off the power source. Do NOT attempt to turn it off if it is not accessible. Do NOT • pillar of 33 bones along neck and back
attempt to go near the person if the power source is not yet turned off. • protects the spinal cord
• Quickly separate the victim from the source of the electric current.
• Assess the victim’s responsiveness. The Spinal Cord
• Provide first aid to any open wound. • bundle of nerves that runs down the neck and back
• Bring victim to appropriate health care facility i.e . with Burn Unit immediately. • carries signals between the brain and other parts of the body
• spine injury > injury to spinal cord > loss of functions; death
❖ Musculoskeletal Injuries
Musculoskeletal System Most Common Causes of Spinal Cord Injury
bones • Vehicular crash
muscles • Fall
tendons body movement • Acts of violence
joints • Sports injuries (i.e. diving, recreational)
ligaments
Suspect a spine injury if there is…
Musculoskeletal Injuries • dizziness
• Fracture- broken bone • head, neck or back pain
• clear fluid coming out of nose and ears
Musculoskeletal injuries: DON’Ts • difficulty of breathing
• Do NOT try to re-align a limb if you suspect a fracture • numbness, inability to move the limbs
• Do NOT try to put back an exposed bone • loss of urinary or bowel control
• Do NOT massage the affected area • paralysis
• unconsciousness
First aid for musculoskeletal injuries
• R – Rest/ Immobilize What to do for a Spine Injury Victim
• I – Ice/ cold packs • Call for emergency medical assistance immediately
• C -Compression • If the victim is conscious, explain to him that he may have a serious injury and that he should
• E – Elevate NOT move
• Spinal motion restriction- attempt to maintain the spine in anatomical alignment and
Musculoskeletal Injuries minimize gross movement.
• Dislocation – bone ends are no longer in contact • Check the victim for responsiveness
• Sprain – stretched or torn ligament • Wait and assist the incoming EMS
• Strain – stretched or torn muscle or tendon • Bring the victim to the nearest health care facility immediately

Recognizing Musculoskeletal Injuries ❖ Splinting

• tenderness Splint
• deformity • rigid device used to immobilize an injured body part
• swelling • prevents further injury
• pain • reduces pain
• discoloration
• crepitus General principles of splinting
• false motion • Do NOT move the victim before splinting unless there is immediate danger
• guarding • Do NOT try to straighten or re-align any deformity; splint in the position found 15
• Open fractures: stop bleeding, protect wound before splinting • Assume deep squat position
• Maintain manual stabilization while applying the splint to minimize movement of the injured • Straighten knees to stand
limb and to support the injury site • Keep back straight
• Fracture of the middle of a long bone: immobilize the joints above and below the fracture
• Joint injuries: immobilize the bones above and below the injured joint Use the power grip
• Pad all splints to prevent excessive pressure and discomfort • Palms up
• Hands at least 10” apart
Types of Splints • Weight should be on the curved palm
• Soft • Gives the maximum force from the hands
- blanket, pillow, binder (swathe) Reasons for Moving a Victim
• Anatomic • For victim and responder’s safety
- Any part of the body • For transferring victims
• Rigid
- improvised or commercial splint Considerations before moving the injured
• Evaluate type and extent of injuries
• Make sure dressings are reinforced
MODULE 5 • Make sure fractures are immobilized and supported
Transferring the Injured ❖ Transferring the injured
• Manual carries
Definitions o One-man carries
• Transfer – moving victim to a safer place o Two-man carries
• Emergency Rescue Transfer (ERTr) – is a procedure of rapid movement of victim to a safer o Three-man or more carries
place • Drags
• Body mechanics – allows rescuers to carry out activities without excessive use of energy and • Stretchers including improvised stretchers and carrying devices
prevent injuries
• Log Roll – is a maneuver used to move the victim without flexing the spinal column. ➢ Manual Carry
• One-man Carry
General Principles in Transferring the Injured - Assist to walk
• Determine reasons for moving victims - Lover’s/Sweetheart’s / Cradle’s Carry
• Apply proper body mechanics - Pack-strap Carry
o Power lift - Piggy-back Carry
o Power grip - Fireman’s Carry
• Promote minimal handling of victims
• Perform Log Rolling technique except for suspected spine injury One-man Carry
• Choose carry method based on victim’s injuries
• Tell victim/s the manner how they will be moved
• Rescuers must consider the weight of the victim

Body Mechanics Assist to walk

• Back straight, bend knees when lifting
• Avoid twisting and bending forward
• Spread legs at shoulder width (approx. 15”)
• Evenly distribute weight on both lower extremities

Performing the power lift

- Safest way to lift 16
 Sweetheart’s/ Lover’s/
Cradle’s Carry Hand as a litter

Hammock Carry
Pack-strap carry Piggyback carry

Four-hand Seat
Carry

Multiple-person Carry
- Bearers along side
Fireman’s carry - Hammock Carry

- Directions and Commands

• Anticipate and understand every move
• Moves must be coordinated
• Command must be given by Lead Man in two parts:
o Preparatory
Two-man Carry o Executory
- Carry by extremities • Command must be acknowledged by other members
- Hand-as a litter
- Four-hand seat
- Assist to walk

Carry by extremities
• More comfortable for the Bearers along side
victim
• Less likely to worsen
injuries
• Less tiring for bearers

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 Fireman’s Drag
Hammock Carry

Carry and Drag Using Improvised Devices/Materials

• Chair as a litter
• Blanket Carry
❖ Drags • Improvised stretchers
Used to immediately transfer the victim to a safer area by pulling - Pole and Blanket
- Clothes drag - Pole and Sacks
- Body drag - Pole and Clothes
- Foot drag - Blanket Drag
- Fireman’s drag

Clothes drag Chair as a litter

Foot drag

Blanket Carry
Body Drag

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 Carry using Spine Board or Improvised Materials

Improvised stretchers

Blanket + 2 poles

Considerations in moving victims

Sacks + 2 poles

Jackets + 2 poles SPECIAL

Shirts + 2 poles++ CONSIDERATIONS

Drowning
Respiratory impairment due to submersion or immersion in liquid.

Special Considerations
• Make sure that the scene is safe.
• Always check first to see whether a lifeguard or other trained professional is present before
Blanket drag
helping someone who may be having trouble in the water.
• DO NOT swim out to a victim unless you have the proper training, skills and equipment.
• If the appropriate safety equipment is not available and there is a chance that you cannot
safely help a person in trouble, call for help immediately.
• If you must assist someone who is having trouble in the water, you must have the appropriate
equipment both for your own safety and the victim’s.
• Send someone else to call the local emergency number while you start the rescue.

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Submerged Victim Signs and Symptoms of Shock
• Call for trained help immediately if a victim is at or near the bottom of the pool in deep water. Early Stage:
• If the victim is in shallow water that is less than chest deep, carefully wade into the water • Face – pale or cyanotic in color.
with some kind of flotation equipment. • Skin – cold and clammy.
• Reach down and grasp the victim. • Breathing – irregular.
• Pull the victim to the surface. • Pulse – rapid and weak.
• Turn the victim face-up and bring him or her to safety. • Nausea and vomiting
• Remove the victim from the water. • Weakness
• Provide emergency care. • Thirsty
Late Stage:
What To Do for Unresponsive Victim • If the condition deteriorates, victim may become apathetic or relatively unresponsive.
• Unresponsive • Eyes will be sunken with vacant expression.
o Perform chest compression plus rescue breaths • Pupils are dilated.
• Out of water • Blood vessels may be congested producing mottled appearances.
o A-B-C Approach • Blood pressure has very low level.
✓ Open Airway, check breathing, circulation • Unconscious may occur, body temperature falls.
✓ Rescue breaths
✓ Chest compressions First Aid for SHOCK
✓ Cycle: 30 compressions, 2 breaths • Loosen the victims clothing
• Recovery Position • Place the victim in a comfortable position
• If vomiting, facilitate drainage • Provide first aid for specific injuries
• Keep warm. Remove cold wet clothes. • Avoid heat loss
• Bring victim to the nearest health care facility • Keep the victim calm
• Do NOT give any food or drink
Shock • Bring the victim to the hospital
• A state of collapse and failure of the of the heart and blood vessels to deliver enough blood to
the body tissues. ❖ Special Emergencies
• If not treated promptly, DEATH follows.
Non-institutional Delivery (Child Birth)
Causes of Shock First Aid Tip:
A. Pump Failure Newborn Care
B. Hypovolemia • Keep the newborn dry and warm
C. Dilation of blood vessels • Promote skin to skin contact
• Do not attempt to cut the umbilical cord
Conditions that lead to shock • Bring to the nearest health care facility
1. Severe bleeding
2. Spine injury Maternal Care
3. Crushing injuries • Monitor ABC
4. Severe Infection • In cases of laceration, apply pressure dressing
5. Heart attack • Contact local health care provider
6. Multiple severe fractures • Immediately, bring to the nearest health care facility
7. Shell bomb and gunshot wound • In case the placenta is still intact: do not massage
8. Rupture of tubal pregnancies • In case the placenta was already expelled: apply massage at the lower abdominal area and
9. Anaphylaxis apply ice pack if available
10. Severe thermal burns.

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 Mass Casualty
First Aid Tip:
• Call 911 immediately
• Provide first aid, as possible
• Initiate and support crowd control

Hazardous Spills
First Aid Tip:
• Evacuate the area
• Call 911 immediately
• Provide first aid, if possible
• Initiate and support crowd control

Terrorist Acts
First Aid Tip:
• Evacuate the area
• Call 911 immediately
• Provide first aid, if possible
• Initiate and support crowd control

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