lOMoARcPSD|30422391

GOOGLE CLASSROOM MODULE 1

STANDARD FIRST AID
MODULE ONE
STANDARD FIRST AID

FIRST AID- Is an immediate care given to a person who has been injured or suddenly taken ill.
It includes self-help and home care if medical assistance is not available or delayed.

What are the 8 areas of first aid?

Here is a list with the 8 most common injuries requiring first aid and what you can do when an
accident like this occurs.
• Cut/Scrape, Burns, Insect Bite/Sting, Sunburn, Nosebleed, Sprains and Tears, Fracture.

GOOD SAMARITAN LAWS:

Most states have laws called Good Samaritan laws designed to encourage people to
help others in an emergency without worrying about being sued. These laws protect you
legally when you give first aid. It is unlikely you would be found liable or financially responsible
for a victim’s injury as long as you follow the guidelines on this module

MUST YOU GIVE FIRST AID?

If you do begin giving first aid, however, you are obliged to continue giving care if you
can to remain with the victim. Your job may require giving first aid, and that does make you
legally obligated. This is called a duty to act.

GET THE VICTIM’S CONSENT

The victim may give consent by telling you it is okay or by nodding agreement. An
unresponsive victim, however, is assumed to give consent for your help-this is called implied
consent. Similarly, consent is assumed if a parent or guardian is not present and a child needs
first aid.

FOLLOW STANDARDS OF CARE

Legally, you may be liable for the result of your actions if you do not follow accepted
standards of care. Standard of care refers to what others with your same training would do in a
similar situation. It is important you do only as you are trained. Any other actions could result in
the injury or illness or injury becoming worse.

You may be guilty of negligence if:

1. You have a duty to act
2. You breach that duty (by not acting incorrectly)
3. Your actions or inaction causes injury or damages (including such things as physical injury or
pain).

. If you leave the victim and the injury or illness becomes worse, this is called
abandonment.

Role and Responsibilities of the First Aider

1. Bridge that fills the gap between the victim and the physician.
• It is not intended to compete with, or take the place of the services of the physician.
• It ends when the services of a physician begin.
2. Ensure personal safety and that of patient/bystander
3. Gain access to the victim
 lOMoARcPSD|30422391

4. Determine any threats to 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

Objectives of First Aid

1. To alleviate suffering
2. To prevent added/further injury or danger
3. To prolong life

Characteristics of a Good First Aider

1. Gentle-should not cause pain
2. Resourceful-should make the best use of things at hand
3. Observant-should notice all signs
4. Tactful-should not alarm the victim
5. Empathetic-should be comforting
6. Respectable-should maintain a professional & caring attitude

Hindrances in Giving First Aid

1. Unfavorable Surroundings
. Night time
. Crowded city streets, churches, shopping malls.
. Busy highways
. Cold and rainy weather
. Lack of necessary materials or helpers
2. The Presence of Crowds
. Crowds curiously watch, sometimes heckle, and sometimes offer incorrect advice
. They may demand haste in transportation or attempt other improper procedure.
. A good examination is difficult while a crowd looks on.
. Pressure from victim’s relatives.
. The victim usually welcomes help but if he is drunk he is often hard to examine and handle,
and is often misleading in his responses.
. The hysteria of relatives or the victim, the evidence of pain, blood and possible early death,
exert great pressure on the first aider.
. The first aider may fail to examine carefully and may be persuaded to do what he would know
in calm moment’s to be wrong.

TRANSMISSION OF DISEASES AND THE FIRST AIDERS

1. How Diseases are transmitted
o . Direct contact transmission- occurs when a person touches an infected person’s body fluids.
This type of transmission presents the greatest risk of infection for the first aid provider.
o . Indirect contact transmission- occurs when a person touches objects that have been
contaminated by the blood or another body fluid of an infected person. These include soiled
dressings, equipment and vehicle surfaces with which an infected person comes in contact.
o . Airborne transmission- occurs when a person inhales infected droplets that have become
airborne as an infected person coughs or sneezes.
o . Vector transmission- occurs when an animal such a dog or an insect, such as tick, transmit a
pathogen into the body through a bite.
2. Diseases that cause concern.
As a first aider, you should be familiar with diseases that can have
 lOMoARcPSD|30422391

severe consequences if transmitted. These includes herpes, meningitis, tuberculosis, hepatitis

and HIV infection, the virus that causes AIDS, and the latest COVID 19.

TABLE 1-1 COMPARISON OF TRANSMITTABLE DISEASES

DISEASE SIGNS & MODE OF INFECTIVE

SYMPTOMS TRANSMISSION MATERIAL
Herpes- is a viral infection Lesions, general ill feeling, Direct contact Broken skin, mucous
that causes eruptions of sore throat membranes the skin and mucous membranes
Meningitis- is an Respiratory illness, sore Airborne, direct and Food and water, mucus inflammation of the brain throat, nausea,
vomiting indirect contact or spinal cord caused by a viral or bacterial infection
Tuberculosis- is a Weight loss, night sweats, Airborne Saliva airborne droplets respiratory disease caused occasional fever, genera ill
by bacteria feeling
Hepatitis-is a viral Flake, jaundice Direct and indirect contact Blood, saliva, semen. infection of the liver feces, food, water, other
products
HIV- (Human Immune Fever, night sweats,Direct and indirect contact Blood, semen, vaginal
deficiency virus) is the weight loss, chronic fluid
virus that destroys the diarrhea, severe fatigue, body’s ability to fight
shortness of breath, infection. The resultant swollen lymph
nodes state is referred to as AIDS lesions
(Acquire immune deficiency syndrome).

3. Body Substance Isolation (BSI)

Precautions are taken to isolate or prevent risk of exposure from any other type of bodily
substance. Regardless of the type of exposure risk, you must follow
o Personal Hygiene- Maintaining good personal hygiene habits, such as frequent hand washing
and proper grooming, are two important ways to prevent disease transmission regardless of any
personal protective equipment you might use.
o Protective Equipment- It includes all equipment and supplies that prevent you from making
direct contact with infected materials. This includes disposable gloves, gowns, masks, masks and
shields, protective eyewear, and resuscitation devices.
o Equipment Cleaning & Disinfecting- It is important to clean and disinfect equipment to
prevent infections. Handle all contaminated equipment, supplies, or other materials with the
utmost care until they are properly cleaned and disinfected.

Basic precautions and safe practices each time you prepare to provide care. Basic Precautions
and Practices are as follows.

FIRST AID EQUIPMENT AND SUPPLIES

1. Basic equipment:
o Spine board
o Sets of splints
o Short boards
o Poles
o Kendricks Extrication Device
o Blankets
 lOMoARcPSD|30422391

Sets of Splints

2. Suggested First Aid Kit Contents (Basic)

- Rubbing - tongue - forceps

alcohol depressor - bandage
- Povidone - penlight (triangular)
iodine - band aid - elastic roller
- Cotton - plaster bandage
- gauge pads - gloves - occlusive
- scissors dressing
3. Cloth materials commonly used in First Aid:
o Dressing or Compress-any sterile cloth materials used to cover the wound.

Other uses of a dressing or compress

o control bleeding
o Protect the wound from infection
o Absorbs liquid from the wound such as blood plasma, water and pus

Kinds of dressing
o Roller gauze
o square or eye pad
o compress or adhesive
o occlusive dressing
o butterfly dressing

Application
Completely cover the wound
Avoid contamination when handling and applying

Bandages- any clean cloth materials, sterile or not use to hold the dressing in place.

Other uses of bandages

• control bleeding
• tie splints in place
• immobilize body parts
• for arm support- use as a sling

Kinds
• triangular, cravat , roller, four tail, muslin binder, elastic bandage
 lOMoARcPSD|30422391

Application
• must be proper, neat and correct
• apply snugly not to lose not too tight
• always check for tightness may cause later swelling
• tie ends with a square knot

Triangular bandage
• Usually made from a 45-50 inch square piece of cloth, cut from one corner to the opposite to
form a triangle.
• Can be folded to form cravats (broad cravats or narrow cravats)

MODULE 2
THE HUMAN BODY
HUMAN BODY
The Body systems have unique structures and functions.

ANATOMICAL TERMS
It is important to describe a patient’s position, direction and location to other medical
personnel. Using correct terms will help you communicate the extent of a patient’s injury quickly
and accurately.

TERMS OF POSITION INCLUDE THE FOLLOWING:

Anatomical position. In this position, a patient’s body stands erect with arms down at the sides,
palms facing you “Right” and “Left” refer to the patient’s right and left.

Supine position. The patient is lying face up on his or her back.

Prone position. The patient is lying face down on his or her stomach.

Lateral recumbent position. In this position the patient is lying on the left or right side. This is
also known as the recovery position.

TERMS OF DIRECTION AND LOCATION ARE AS FOLLOWS:

 lOMoARcPSD|30422391

Superior- means toward, or closer to the head.

Inferior- means toward or closer to the feet.
Anterior- is toward the front.
Posterior- is toward the back.
Medial- means toward the midline, or center of the body.
Lateral- refers to the left or right of the midline.
Proximal- means close or near the point of reference.
Distal- is distant or far away from the point of reference. The point of reference is usually the
torso. For example, a wound of the forearm is proximal to the wrist because it is closer to the
torso than the wrist. The same wound is distal to the elbow because it is farther away from the
torso than the elbow.
Superficial- is near the surface.
Deep- is remote or far from the elbow.
Internal- means inside.
External- means outside.

A body cavity is a hollow place in the body that contains organs such as the heart, lungs,
and liver. The five major cavities:
• Cranial cavity- is located in the head. It contains the brain and its protected by the skull.
• Spinal cavity- is the extending from the bottom of the skull to the lower back. It contains the
spinal cord and is protected by the bones of the spine.
• Thoracic cavity- is also called chest cavity, located in the trunk between the diaphragm, a dome
shape muscle used in breathing and the neck. It contains the heart the lungs and other important
structures. The rib cage and the upper portion of the spine protect the thoracic cavity.
• Abdominal cavity- is located in the trunk between the diaphragm and the pelvis. It contains
many organs including the liver, pancreas, intestines, stomach, kidneys and spleen. Because the
abdominal cavity is not protected by any bones, the organs in it are vulnerable to injury.
• Pelvic cavity- is located in the pelvis the lowest part of the trunk. It contains the bladder the
rectum, and the reproductive organs. It is protected by the pelvic bones and the lower portion
of the spine.

BODY SYSTEMS
Knowing how the respiratory circulatory and nervous systems normally function will help
you understand what happens when systems fail. When body systems fail physical signs and
symptoms appear. These are often your first indication that something is wrong, especially if we
talk about providing life support.

THE RESPIRATORY SYSTEM

The body gets enough nutrition from food to last for several weeks. It can store water to
last for several days. But it can only store oxygen for a few.
The passage of air into and out of the lungs is called respiration. Breathing in is called
inspiration or inhaling. Breathing out is called expiration or exhaling.
 lOMoARcPSD|30422391

The area posterior to the mouth and nose is called the pharynx, which is divided into the
oropharynx and nasopharynx. Air then travels down through the larynx (voice box) and into the
trachea (windpipe). The trachea is the air passageway to the lungs. It is made of cartilage rings
and is visible in the anterior portion of the neck.
The epiglottis is a leaf shaped structure that prevents foreign objects entering the trachea
during swallowing. The trachea splits into the two bronchi. These air passage gradually become
smaller and smaller until they reach the alveoli where carbon dioxide and oxygen are exchange
with blood.

THE CIRCULATORY SYSTEM

The circulatory system delivers oxygen and nutrients to the body’s tissues and removes
waste products. It consists of the heart, blood vessels, and blood.
The heart is a hollow muscular organ that is responsible for pumping blood through the
body. The adult heart contracts between 60 and 80 times per minute when at rest and faster
when under stress. Problems with the heart account for many of the emergencies you will
encounter as a First Aider.
The heart is divided into four chambers. The upper chambers are called atria. The lower
chambers are called ventricles. The heart has a left and right side, each of which has an atrium
and a ventricle.
The right side of the heart receives blood from the body and pumps it to the lungs. The
left side of the heart receives oxygenated blood from the lungs and pumps it to the body.

When the heart pumps blood from the left ventricle blood enters the arteries. This
pumping action causes a wave of pressure that can be felt as a pulse.

There are many points where a pulse can be felt in the body. The most common are:

CAROTID PULSE POINT, felt on either side of the neck

BRACHIAL PULSE POINT, felt on the inside of the arm between the elbow and the shoulder.

RADIAL PULSE POINT, felt on the thumb side of the wrist.

FEMORAL PULSE POINT, felt in the area of the groin in the crease between the abdomen and
thigh.
 lOMoARcPSD|30422391

The blood vessels are closed system of tubes through which blood flows. Arteries and
arterioles take blood away from the heart.

The capillaries are distributors. They are the smallest vessels through which the exchange
of fluid, oxygen and carbon dioxide takes place between blood and tissue cells. The venules and
veins are the collectors. They carry blood back to the heart from the rest of the body.

BREATHING AND CIRCULATION

1. Air that enters the lungs contains about 21 percent oxygen and only a trace of
carbon dioxide. Air that is exhaled from the lungs contains about 16 percent oxygen and 4
percent carbon dioxide.
2. The right side of the heart pumps blood to the lungs where blood picks up oxygen
and releases carbon dioxide.
3. The oxygenated blood then returns to the left side of the heart where it is pumped
to the tissues of the body.
4. In the body tissues blood releases oxygen and takes up carbon dioxide after which
it flows back to the right side of the heart.
5. All body tissues require oxygen but the brain requires more than any other tissue.
6. When breathing and circulation stop, this is called clinical death (0-4 minutes brain
damage not likely, 4-6 minutes damage probable)
7. When the brain has been deprived of oxygenated blood for a period of 6 minutes
or more, irreversible damage probably occurred. This is called biological death (6-10 minutes
brain damage probable, over 10 minutes brain damage is certain).
8. It is obvious from the above stated facts that both respiration and circulation are
required to maintain life.

THE NERVOUS SYSTEM

The nervous system is composed of the brain, the spinal cord, and nerves, which has two
major functions communication and control.

It lets a person be aware of and react to the environment. It coordinates the body’s
responses to stimuli and keeps body systems working together.

The nervous system has two main parts the central and the peripheral nervous system.
 lOMoARcPSD|30422391

THE NERVOUS SYSTEM

THE MUSCULOSKELETAL SYSTEM

The musculoskeletal system is made up of the skeleton and muscles. Each helps to give
the body shape and protects internal organs. The muscles also provide for movement.

The Skeleton
The human body is shaped by its bony framework. Bone is composed of living cells and
non-living matter.

The non-living matter contains calcium compounds that help make bone hard and rigid. Without
bones, the body would collapse.

The adult skeleton has 206 bones. It must be strong to support and protect, jointed to permit
motion, and flexible to withstand stress.

It is held together mainly by ligaments, tendons and layers of muscle. Ligaments connect bone
to bone.

Tendons connect muscle to bone. Bone ends fit into each other at joints.

The three kinds of joints are immovable like the skull, slightly movable like the spine, and freely
movable like the elbow or knee.

THE SKELETON
The major areas of the skeleton include the following:
The skull has a number or broad flat bones that form a hollow shell. The top back and
sides of the shell make up the cranium. It houses and protects the brain. There are several small
bones of the face. They give shape to the face. They give shape to the face and permit the jaw
to move. The major features of the face are the nose, ears, eyes, cheeks, mouth and jowls.

The spinal column houses and protects the spinal cord. The spinal column is the central
supportive bony structure of the body. It consists of 33 bones known as vertebrae. The spine is
divided in top five sectioned, the cervical spine the neck formed 7 vertebrae the thoracic spine
the upper back formed by 12 vertebrae, the lumbar spine the lower back formed by 5 vertebrae,
the sacrum the lower part of the spine, formed by 5 fused vertebrae and the coccyx the tail
bone, formed by 4 fused vertebrae.
The thorax or rib cage protects the heart and lungs vital organs of the body. They are
enclosed by 12 pairs of ribs that are attached at the back to the spine. The top 10 are also
attached in front to the sternum is or breast bone. The lowest of the sternum is called the
xiphoid process.
The pelvis or hip bones consists of the illium, pubis and ischium lilac crests from the wings
of the pelvis. The pubis is the anterior portion of the pelvis. The ischium is in the posterior
portion.
The shoulder girdle consists of the clavicle the collarbone and the scapulae shoulder
blades.
The upper extremities extend from the shoulders to the fingertips. The arm shoulder to
elbow has one bone known as the humerus. The bones in the forearm are the radius and ulna.
The lower extremities extend from the hips to the toes. The bone in the thigh or upper leg is
known as femur. The bones in the lower leg are the tibia and fibula. The knee cap is called the
patella.
 lOMoARcPSD|30422391

THE MUSCLES
The movement of the body depends on the work performed by the muscles. Muscles have
the ability to contract (become shorter and thicker) when simulated by a nerve impulse. Each
muscle is made up of long threadlike cells called fibers, which closely packed or bundled.
Overlapping bundles are bound by connective tissue.
There are three basic kinds of muscles:
Skeletal muscle or voluntary muscle makes possible all deliberate acts such as walking
and chewing. It helps shape the body and form its walls. In the trunk this type of muscle is
broad, flat, and expanded. In the extremities, it is long and rounded.
Smooth muscle or involuntary muscle, is made of longer fibers. It is found in the walls of
tube like organs, ducts and blood vessels. It is also forms much of the intestinal wall. A person
has little or no control over this type of muscle.
Cardiac muscle makes up the walls of the heart. It is able to stimulate itself into
contraction, even when disconnected from the brain.

THE MUSCLES

THE DIGESTIVE SYSTEM

The digestive system is composed of the alimentary tract(food passageway) and accessory
organs. Its main functions are to ingest food and get rid of waste. Digestion consists of two
processes mechanical and chemical.
The mechanical process includes chewing, swallowing, the rhythmic movement of matter
through the tract, and defecation (the elimination of waste).
The chemical process consists of breaking food into simple components that can be absorbed
and used by the body.
Except for the mouth and esophagus, the organs of this system are in the abdomen.
They include the stomach, pancreas, liver, gallbladder, small intestine, and large intestine.

THE URINARY SYSTEM

The urinary system filters and excretes waste from the body. It
consists of two kidneys and two ureters one urinary bladder and one urethra.
The ureters take urine from the kidneys to the next part of the system
the bladder.
The bladder stores urine until it is passed through the urethra and
excreted from the body.

The urinary system helps the body maintain the delicate balance of water and chemicals
needed for survival. During the process of urine formation, wastes are removed and useful
products are returned to the blood.

THE REPRODUCTIVE SYSTEM

The reproductive system of the male includes two testes a duct system, accessory glands
and the penis. The reproductive system of the female consists of two ovaries two fallopian tubes,
the uterus, vagina and external genitals.

THE SKIN
The skin separates the human body from the outside world. It protects the deep tissues
from injury, drying out, and invasion by bacteria and other foreign bodies. The skin helps to
regulate body temperature. It aids in getting rid of water and various salts, as well as helps to
prevent dehydration. It acts as the receptor organ for touch, pain, heat and cold.
 lOMoARcPSD|30422391

The epidermis is the outermost layer of skin. It contains cells that give the skin its color.
The dermis or second layer contains a vast network of blood vessels.
The deepest layers of the skin contain hair follicles, sweat and oil glands and sensory nerves. Just
below the skin is a layer of fatty tissue which varies in thickness. For example. It is extremely thin
in the eyelids, but thick over the buttocks.
Directional Terms
We’ve seen how the sections and views included in a typical anatomical atlas are
obtained, but how can we describe the position and relation between various structures? By
using anatomy directional terms. These adjectives compare the position of two structures
relative to one another in the anatomical position. They are in pairs of opposites, so if the nose
is superior to the mouth, it is automatically inferred that the mouth is inferior to the nose.
 lOMoARcPSD|30422391

THE MODULE 3
GUIDELINES IN GIVING EMERGENCY CARE

GETTING STARTED
You will never see the emergencies you prevent. However, emergencies can and do
happen, regardless of attempts to prevent them.
Preparing for an emergency would benefit the provider in giving appropriate care to a victim.
The following are guides to assure the provider to response to an emergency properly.

PLAN OF ACTION
To respond most efficiently to certain emergencies, you need a plan of action.
A plan of this type is prepared in advance and rehearsed with personnel. Emergency plans
should be established based on anticipated needs and available resources. Sources:(The
Philippine National Red Cross Safety Services 2020).

THE GUIDELINES
GATHERING OF NEEDED MATERIALS
The emergency response begins with the preparation of equipment and personnel before
any emergency occurs.

REMEMBER THE INITIAL RESPONSE AS FOLLOWS:

1. A- Ask for help
In crisis, time is essence. The more quickly you recognize an emergency, and the faster
you call for medical assistance, the sooner the victim will get help. Immediate care can greatly
affect the outcome of an emergency.

2. I- Intervene
It means to do something for the victim that will help achieve a positive outcome to an
emergency. Sometimes getting medical help will help to achieve a positive outcome to an
emergency. Sometimes getting medical help will be all you can do this alone may save a life. In
other situations, however you may become actively involved in the victim’s initial care by giving
first aid.

3. D- Do no further harm.
Once you have begun first aid, you want to be certain you don’t do anything that might
cause the victim’s condition to worsen. Certain actions should always be avoided and by keeping
them in mind, you will be able to avoid adding to or worsening the victim’s illness or injuries.

EMERGENCY ACTION PRINCIPLES (EAP).

The following principles can ensure your safety and that of the victim and bystanders.
They will also increase the victims chance of survival if he or she has a serious illness or injury.

SURVEY THE SCENE

Once you recognize that an emergency has occurred and decided to act, you must make
sure the scene of the emergency is safe for you, the victims and bystanders. It is a quick
assessment of the surroundings that will provide you with as much information as possible.
 lOMoARcPSD|30422391

Take time to survey the scene and answer these questions:

. Is the scene safe?
. What happened?
. How many people are injured?
. Are there bystanders who can help?
. Then identify yourself as a trained first aider.
Get consent to give care

The following are elements of survey the scene for the first aider to perform before providing
care to a victim.

1. Scene Safety.
Look for possible threats for personal safety, patient and bystander. . Personal Safety-
Focused first on ensuring the well-being of the first aider. You cannot help your patient if you
become a victim yourself. In any emergency risks of exposure to communicable diseases are
present. In order to prevent any contamination proper body substance isolation decisions early
in the emergency will prevent needless exposure later on refer to module 1. Introduction to
prevent disease transmission.
In situation of crime scene acts of violence and unsafe scene you should consider asking
appropriate personnel to secure the scene and acts of violence you might need the assistance
of a police or local official, for unsafe areas like fire, car collisions, hazards of chemicals, and
other alike, a well trained personnel will be necessary. But remember that it takes time for
additional personnel to arrive so try to make the scene safe as your capability permits.

. Patient/Victim- Our next concern will be the patient/victim if there are potential dangers that
cannot be stabilized you might need to perform special measures to offer additional protection
to the patient.

Like removing the patient from a hazardous environment, such as a burning car, a home
with a gas leak or a car filled with carbon monoxide, are lifesaving actions before proper care
can begin. But not all need to be removed, like to prevent patient exposure from or broken
glasses and metal shrapnel’s from an automobile accident, instead of removing you can place a
blanket on the patient.

. Bystanders- Safely of the onlookers or bystanders is also our concern. Bystanders can become
a problem when they try to help or direct your care. Protect yourself and bystanders alike by
moving them to a safe area or assigning them a specific task.

2. MECHANISM OF INJURY OR NATURE OF ILLNESS. –

How do you determine the mechanism of injury? Mechanism of injury, or MOI, refers to
the method by which damage (trauma) to skin, muscles, organs, and bones occurs. Health
care providers use MOI to help determine how likely it is that a serious injury has occurred.
But the term is not used only by health care providers.

The following are the 4 primary mechanisms of injury?

There are four primary mechanisms of TBI:
- Direct impact
- Sudden or rapid acceleration and deceleration
- Penetrating injury
- Blast injury.
 lOMoARcPSD|30422391

3. Determine the number of patients and additional resources

As part of survey the scene, it is essential that you accurately determine the total number
of patients. This determination is critical for your estimate of the need for additional resources.

What to do in Survey the Scene

Before you approach the Victim. When you survey the scene, look for anything that may
threaten your safety and that of the victim and bystanders.

As you approach the victim. Try to find out what happened. Look around the scene for clues to
what caused the emergency and the extent of the damage. Doing this will cause you to think
about the possible type and extent of the victim’s injuries.
Once you reach the Victim. Quickly survey the scene again to see if it is still safe. At this point
you may see other dangers clues to what happened, victims or bystanders that you did not
notice before.

ACTIVATE MEDICAL ASSISTANCE (AMA) or Transfer Facility

In some emergencies 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. Decision
in activating medical assistance or transfer facility would make a higher rate of survivability for
the victim due to continuing chain of survival in providing early defibrillation and advance
cardiac life support.

1. Activate Medical Assistance or Transfer Facility

. The first aider is alone, CALL FIRST, that is activate medical assistance or arrange transfer facility
before providing care for;
- an unconscious adult victim or child 8 years old or older and,
- an unconscious infant or child known to be at a high risk for heart problems.
. The first aider is alone provide one minute of care, then CALL FAST for: - an
unconscious victim less than 8 years old. - any victim of submersion or near
drowning
- any victim of arrest associated with trauma
- any victim of drug overdose

Bystanders checking up and providing first aid to an injured bleeding driver after a car crash. A
man is taking pictures as amateur journalist for social media networks.

2. Exceptions to the “phone first/phone fast” rule include:

. submersion/near- drowning (phone fast all ages)
. arrest associated with trauma (phone fast all ages)
. drug overdose (phone fast all ages)
. cardiac arrest in children known to be at high risk for arrhythmias (phone first all ages)

3. 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?
. person who activated medical assistance must identify him/herself and drop the phone fast.
 lOMoARcPSD|30422391

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. You will discover these conditions by looking for signs,
evidence of injury or illness that you can observe. Check for vital body functions, signs of life
threatening conditions following the ABC principles. The primary survey takes only seconds to
perform. The following are the steps of performing primary survey.

1. Check for Consciousness

Begin primary survey by determining if the victim is conscious. A victim who can speak
and move is conscious, breathing and with signs of circulation.
If the victim is found unconscious try to confirm by checking his/her responsiveness by
gently tapping him/her and asking, “Are you okay?”.
Do not jostle or move the victim. If the victim is unable to respond he/she may be
conscious. Unconsciousness can indicate a life-threatening condition.
Regardless of the condition of the victim don’t forget to ask for consent. For your
information, obtaining consent, before giving care to a conscious victim you must first get
consent, before you start.
. state your name
. tell the victim you are trained in first aid
. ask the victim if you can help
. explain what you may think may be wrong
. explain what you plan to do
Once the victims give consent provide appropriate care. A victim who is unconscious,
confused or seriously ill may not be able to grant consent in such cases, consent is implied.
Implied consent means that the victim would agree to the care if he/she could.

2. CHECK FOR A- AIRWAY

If the victim is conscious, assess breathing as described in Check B Breathing.
When the victim is unconscious/unresponsive, muscle tone is decreased and the tongue
and epiglottis may obstruct the pharynx. Open the airway immediately and proceed to checking
of breathing.

WAYS IN OPENING THE AIRWAY

1. Head Tilt- Chin Lift Maneuver.
 lOMoARcPSD|30422391

2. JAW THRUST MANEUVER

3. CHECK B- BREATHING
If the victim is conscious assess breathing by identifying his/her characteristics of
respiration.

If the victim is unconscious identify absent or inadequate breathing by performing Look, Listen
and Feel (look for the rise and fall of the chest, Listen for air coming out from the nose and
mouth, and feel for air touching your cheek.).

If breathing is present proceed to checking for circulation. If identified absent or inadequate

breathing refer to Module 4 Respiratory Arrest & Rescue Breathing.

CHARACTERISTICS OF A RESPIRATION
. Breathing is neither shallow nor deep
NORMAL. Average chest wall motion
. No use of accessory muscles
SHALLOW. Slight chest or abdominal wall motion
. Increased breathing effort
. Grunting, stridor
. Use of accessory muscles
LABORED. Possible gasping
. Nasal flaring, supraclavicular and intercostal refractions in infants and children
NOISY.Increase in sound of breathing, including snoring,
wheezing, gurgling and crowing.
 lOMoARcPSD|30422391

CHECK B- BREATHING
LOOK TO THE CHEST
LISTEN FROM THE NOSE
FEEL THE PULSE (CAROTID)

4. CHECK C- Circulation
Where previously instructed to check for a pulse responders are now instructed to look,
listen and feel for signs of circulation and severe bleeding.
Signs of circulation include:
. Pulse, Normal breathing and coughing or movement in response to rescue breaths for a
certified Healthcare Provider, while;
. Normal breathing and coughing or movement in response to rescue breathes; for
certified lay responders.

If the victim is unconscious breathing is present and adequate and has signs of circulation,
place the victim in the recovery position and proceed refer to Module 5 Cardiac Arrest &
Cardiopulmonary Resuscitation.
If the victim has signs of severe bleeding, control bleeding.

DO A SECONDARY SURVEY OF THE VICTIM

Once you are certain that the victimhas no life-threatening conditions you can begin the
fourth EAP. The secondary survey is a systematic method of gathering additional information
about injuries or conditions that may need care. These conditions are not immediately life
threatening but could become so if not cared for. The following are not in order, it will depend
on the condition of the victim or situation of the accident.

1. Interview the victim

By asking the victim and bystanders simple questions, you learn more about what
happened and the victim’s condition. Ask the following questions:
. Ask the victim’s name
. Ask what happened
. Ask the SAMPLE history

Elements of the SAMPLE history are:

1. Signs and symptoms of the episode
2. Allergies, particularly to medications
3. Medications, including prescription over the counter and recreational illicit drugs
4. Past medical history, particularly involving similar episodes in the past
5. Last oral intake, including food and or drinks. This is particular important if the patient
may need surgery
6. Events leading up to the episode

2. CHECK THE VITAL SIGNS

Vital signs can tell you how the body is responding to injury or illness. Note anything
unusual. Recheck vital signs about every 15 minutes for medical cases.

REPIRATION
A respiration consists of one inhalation and one exhalation. The normal number of
respirations per minute varies with gender and age.
 lOMoARcPSD|30422391

NORMAL RANGES FOR RESPIRATION

AGE RANGE
ADULT 12-20/min.
CHILD 18-25/min.
INFANT 25-35/min.

STEPS TO TAKE THE RESPIRATION

1. Place your hand on the victim’s chest or abdomen
2. Count the number of times the chest or abdomen rises during a 30 second period. Then multiply
that number by 2. But to get an accurate reading count a 60 second period.
If the patient is aware that you are assessing respiration, he may not breathe naturally. This can
give a false reading. To get around this take a pulse with the patient’s arm draped over his chest
or abdomen. Count the pulse for 30 seconds. Then without moving the patient’s arm, count
respirations for the next 39 seconds. Reading are easily obtained by observing and feeling the
chest rise and fall with your hand which is already on the patient’s torso.

SKIN APPEARANCE. Assessment of the skin temperature, color and condition can tell you more
about the patient’s circulatory system.
1. Skin temperature. Normal body temperature is 98.6 `F (37`C). The most common way
First aider take temperature is by touching a patient’s skin with the back of the hand. This is
called relative skin temperature. It does not measure exact temperature, but you can tell it is
very high or low.
2. Skin color. Skin color can tell you a lot about a patient’s heart, lungs and other problems
well. For example;
. Paleness may be caused by shock or heart attack. It also may be caused by fright, faintness or
emotional distress as well as impaired blood flow.
. Redness (flushing) maybe caused by high blood pressure, alcohol abuse, sunburn, heat stroke,
fever or an infectious disease.
. Blueness (cyanosis) is always a serious problem. It appears first in the fingertips and around
the mouth. Generally reduced levels of oxygen as in shock, heart attack or poisoning cause it.
. Yellowish color maybe caused by a liver disease.
. Black and Blue mottling is the result of blood seeping under the skin. It is usually caused by a
blow or severe infection.

If your patient has dark skin, be sure to check for color changes on the lips, nails beds, palms,
earlobes, whites of the eyes, inner surface of the lower eyelid, gums and tongue.

You may also wish to check the patient’s nail beds. This is called assessing capillary refill. It is
one way of checking for shock. Capillary refill is recommended only for children under 6 years of
age. Research has proven that it is not always accurate in adults.
 lOMoARcPSD|30422391

Squeezing one of the patient’s fingernails or toenails performs this procedure. When squeezed,
the tissue under the nail turns white. When you let go the color returns to the tissue. To assess
capillary refill, you have to measure the time it takes for the color to return under the nail. Two
seconds or less is normal. If refill time is greater than two seconds, suspect shock or decreased
blood flow to that extremity.

Capillary refill maybe checked on infants by squeezing the palm of the hand or sole of the foot
and watching for color to return.
Note: That when rechecked capillary refill be sure to do it at the same place. Different parts of
the body may have different refill times.

Skin Condition. Normally a person’s skin is dry to the touch. When a patient’s skin condition is
wet or moist, it may indicate shock, a heat related emergency or a diabetic emergency. Kin that
is abnormally dry may be a sign of spine injury or severe dehydration.

PUPILS. Normally pupils constrict (get smaller) when exposed to ight and dilate (enlarge) when
the level is reduced. Both pupils should be the same size unless a prior injury or condition
changes this.

With these normal responses in mind assess a patient’s pupils. Shine your penlight into one of
the patient’s eyes and watch for the pupil to constrict in response to the light. If you are outdoors
in bright light, cover the patient’s eyes and observe for dilation of the pupils. Do not expose the
patient’s eyes to light for more than a few seconds, as this can be very uncomfortable to the
patient.

Abnormal findings for pupils include:

. Pupils that do not react to light.
. Pupils that remain constricted (this may be caused by a drug overdose). . Pupils that is unequal.
This maybe an indication of a serious head injury or stroke).

BLOOD PRESSURE: Some first aider are taught to assess blood pressure. Others are not. Blood
pressure is the amount of pressure the surging blood exerts against the arterial walls. It is an
important index of the efficiency of the whole circulatory system. In part, it tells how well the
organs and tissues are getting the oxygen they need. The blood pressure cuf is the instrument
used to measure blood pressure.
 lOMoARcPSD|30422391

The result of a contraction of the heart which forces blood through the arteries is called systolic
pressure. With most diseases or injuries these two pressures rise or fall together. Blood pressure
normally varies with the age gender and medical history of the patient. The usual guide for
systolic pressure in the adult male is 100 plus the individual’s age up to 150 mmHg. Normal
diastolic pressure in the male is 65 mmHg to 90 mmHg. Both the systolic and diastolic pressures
are about 10 mmHG LOWER IN THE FEMALE THAN IN THE MALE. Blood pressure is reported as
systolic over diastolic (for example, 120/80).

Measuring Blood Pressure. There are two methods of obtaining blood pressure with a blood
pressure cuff. One is by auscultation or by listening for the systolic and diastolic sounds through
stethoscope. The second method is by palpitation or by feeling for the return of the pulse as
the cuff is deflated.

TOE EXAMINATION.
This examination helps you gather more information about the victim’s condition. When
you do the head to toe examination use your sense sight, sound, smell and touch to detect
anything abnormal. Look for DCAP-BTLS (Deformity, Contusion, Abrasion, Puncture, Burn,
Tenderness, Laceration, and Swelling).

STEPS IN PERFORMING HEAD TO TOE EXAMINATION:

. Inspect the entire body starting with the head.

. Check the neck look and feel any abnormalities the victim has no pain have the victim turn his
head entirely from side to side.
 lOMoARcPSD|30422391

. Check the shoulders by looking for deformity. Ask the victim to shrug his shoulders.

. Check the chest by feeling the ribs for deformity. Ask the victim to take a deep breath and
exhale.

. Apply slight pressure to the abdomen to see if it is soft and rigid.

. Check the arms by feeling for any deformity. If there is no apparent sign of injury ask the victim
to bend the arms and move the hands and fingers.

. Check the hips, place your hands on both sides of the pelvis and push down and in asking the
victim if he or she feels any pain.
. Check the legs by feeling for any deformity, if there is no apparent sign of injury ask the victim
to bend the legs and move the feet and toes.
 lOMoARcPSD|30422391

. Gently reach under the victim to check the back.

. Record all assessment and prepare patient for transport.

GOLDEN RULES IN GIVING EMERGENCY CARE:

What to DO:
1. Do obtain consent, when possible.
2. Do think the worst, its best to administer first aid for the greatest possibility.
3. Do remember to identify yourself to the victim
4. Do provide comfort and emotional support
5. Do respect the victim’s modesty and physical privacy
6. Do be as calm and as direct as possible
7. Do care for the most serious injuries first
8. Do assist the victim with his or her prescription medication
9. Do keep onlookers away from the injured person
10. Do handle the victim to a minimum
11. Do loosen tight clothing
 lOMoARcPSD|30422391

What not to DO:

1. Do not let the victim see his/her own injury
2. Do not leave the victim alone except to get help
3. Do not assume that the victim’s obvious injuries are the only ones
4. Do not make any unrealistic promises
5. Do not trust the judgment of a confused victim and require them to make decision.

SURVEY THE SCENE. IS IT SAFE?

HELP. CALL FOR MORE HELP.

BEGIN A PRIMARY SURVEY.

IS THE VICTIM CONCIOUS?
DOES THE VICTIM HAVE AN OPEN AIRWAY?
IS THE VICTIM BREATHING?
DOES THE VICTIM HAVE SIGNS OF CIRCULATION?
IS THE VICTIM BLEEDING SEVERELY?
DO A SECONDARY SURVEY
INTERVIEW THE VICTIM
CHECK THE VITAL SIGNS
PERFORM HEAD TO TOE EXAM

USE THESE EAPs EMERGENCY ACTION PRINCIPLES TO MAKE CARE DECISIONS IN ANY
EMERGENCY.

MODULE FOUR
FIRST AID PATIENT/CASUALTY HANDLING

EMERGENCY RESCUE- is a rapid movement of patient from unsafe place to a place of safety.

Indications for emergency rescue:

• Danger of fire or explosion

• Danger of toxic gases or asphyxia due to lack of oxygen.
• Serious traffic hazards
• Risk of drowning
• Danger of electrocution
• Dangers of collapsing walls

METHODS OF RESCUE
. For immediate rescue without any assistance drag or pull the victim in the direction of
the long axis of his body preferably from the shoulder. If possible, minimize lifting or carrying the
injured person before checking for injuries unless you are sure that there is no major fracture or
involvement of his neck or spine.
. Most of the one man drags/carries and other transfer methods can be used as methods
of rescue.
TRANSFER- is moving a patient from one place to another after giving first aid.
 lOMoARcPSD|30422391

1. The first aider may need to initiate transfer of the patient to shelter, home or medical aid. Skill
in the use of simple technique of transfer must be practiced and selection and use of the correct
method is necessary. Selection will depend upon the following:
o Nature and severity of the injury
o Size of the victim
o Physical capabilities of the first aider
o Number of personnel and equipment available
o Nature of evacuation route
o Distance to be covered
o Sex of the victim (last consideration).

2. Pointers to be observed during transfer.

o Victim’s airway must be maintained open
o Hemorrhage is controlled
o Victim is safely maintained in the correct position
o Regular check of the victim’s condition is made
o Supporting bandages and dressing remain effectively applied
o The method of transfer is safe, comfortable and as speedy as circumstances
permit
o The patient’s body is moved as one unit
o The taller the first aiders stay at the head side of the victim
o First aiders/bearers must observe ergonomics in lifting and moving of patient.

3. Methods of Transfer
. One man assist/carries/drags:
. assist to walk blanket drag
. carry in arms (cradle) armpit shoulder drag
. pack strap cloth drag
. pack strap carry feet drag
. piggy back carry inclined drag (head first-passing a stairway)
. fireman’s carry fireman’s drag
lOMoARcPSD|30422391
lOMoARcPSD|30422391
 lOMoARcPSD|30422391

FOR YOUR INFORMATION- Face towards patient’s head only for the following situations:
1. Loading victim to an ambulance
2. Going towards an elevated area
3. Situation where there is no choice to turn
4. COMMAND USED IN 2 OR MORE RESCUERS
PREPARATORY EXECUTORY
o .Ready to kneel towards the patient’s
o Head/legs…………………………………………………………………. Kneel
o Hands over the patient…………………………………………….. Move
o .Ready to insert…………………………………………………………. Insert
o .Place patient on your knees, ready to lift………………….. Lift
o .Patient’s body press to the chest………………………………. Press
o .Ready to stand………………………………………………………….. Stand
o .Leg/head center………………………………………………………… Move
o .Ready to walk, inner foot first……………………………………. Walk
o .Ready to stop…………………………………………………………….. Stop
o .Face center………………………………………………………………… Move
o .On your knees and rest………………………………………………. Kneel
o .Ready to unload………………………………………………………….Unload

5. Reminders
. All team members must answer “ready” after the leader gives preparatory command. Likewise,
leader shall only give the executory command for all members answer “ready”.
. It is difficult for inexperienced helpers to lift and carry a person gently. They need careful
guidance. If there is time, it wiser to rehearse the lifting procedure first using a practice subject.

INITIAL TRIAGE AND TAGGING

You will recall that the primary survey has three steps that involve checking the victims
airway, breathing and circulation. You will also recall that the secondary survey has three steps
that include interviewing the victim, checking vital signs, and doing a head to toe examination.
 lOMoARcPSD|30422391

TRIAGE- is a process use in sorting patients into categories of priority for care and transport
based on the severity of injuries and medical emergencies.
The START (Simple Triage and Rapid Treatment) system is one method of triage that has proven
to be effective. Patients evaluation is based on 3 primary observation (RPM).
Respiration…...Perfusion…..Mental status. Under this system patients are tagged for easy
recognition.
For your information. The cardinal rule of Triage is to do the greatest good for the greatest
number.

2. Tagging of Patient

Source:www.firstaidmart.com.retrieved:10/09/20
Priority one (red tag)- immediate care, life threatening
Priority two (yellow tag)- delayed care; can delay transport and treatment to one hour.
Priority three (green tag)- hold care; can delay transport up to three hours Priority four (black
tag)- no care required; patient is dead.

METHODS OF TRANSFER
 lOMoARcPSD|30422391

MODULE FIVE
SHOCK
SHOCK- is a depressed condition of many body functions due to the failure of enough blood to
circulate throughout the body following serious injury.

BASIC CAUSES:
1. PUMP FAILURE- Poor pump function occurs when disease or injury damages the heart.
The heart does not generate enough energy to move the blood through the system.
Causes: heart attack, trauma to heart.

2. HYPOVOLEMIA- Blood or fluid loss from blood vessels decreases blood volume, usually a
result of bleeding, and results in adequate perfusion. Causes: Trauma to vessels or tissues, fluid
loss from GI tract (vomiting/diarrhea can also lower the fluid component of blood).
3. BLOOD VESSELS DILATE- The vessels can dilate enough that the blood within them, even
though it is of normal volume, is inadequate to fill the system and provide efficient perfusion.
Causes: Infections, drug overdose (narcotic), and spinal injury.

CAUSES OF SHOCK:
 lOMoARcPSD|30422391

1. SEVERE BLEEDING 6. ANAPHYLAXIS

2. CRUSHING INJURY 7. SHELL BOMB AND BULLET WOUND
3. INFECTION 8. RUPTURE OF TUBAL PREGNANCIES
4. HEART ATTACK 9. STARVATION AND DISEASE
5. PERFORATION MAY ALSO CAUSED SHOCK

A. Poor pump failure occurs when the heart is damaged by disease or injury. The heart does not
generate enough energy to move the blood through the system.
B. Hypovolemia usually result of bleeding, results inadequate perfusion. Relative hypovolemia
blood vessels can dilate enough that the blood within them, even though it is of normal volume,
is inadequate to fill the system and provide efficient perfusion.

FACTORS WHICH CONTRIBUTE TO SHOCK

1. Pain 4. Continuous bleeding
2. Rough bleeding 5. Exposure to extreme cold or excessive heat
3. Improper transfer 6. Fatigue

DANGERS OF SHOCK
1. Lead to death
2. Predisposes body to infection
3. Lead to loss of body part

SIGNS AND SYMPTOMS OF SHOCK

1. Early stages
. Face-pale-or cyanotic in color . nausea and vomiting
. Skin-cold and clammy . weakness
. Breathing . thirsty
. Pulse-rapid and weak

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
. Unconsciousness may occur, body temperature falls.

OBJECTIVES OF FIRST AID

1. To improve circulation of the blood
2. To ensure an adequate supply of oxygen
3. To maintain normal body temperature

FIRST AID AND PREVENTIVE MANAGEMENT OF SHOCK

1. Proper Position
. Keep victim lying down flat.
. Elevate the lower part of the body a foot or so if injury is severe, from eight to twelve inches
high
 lOMoARcPSD|30422391

. Place the victim who is having difficulty in breathing on his back, with his head and shoulder
raised

. Head injury-apply pressure on the injury and keep the victim lying flat. Do not elevate head or
lower extremities. When the color of the face return to normal, elevate head and shoulder and
continue giving care to the injury in chest injury, raise the head and shoulder slightly.

. When there are symptoms of nausea and vomiting or unconsciousness keep the victim lying on
one side preferably opposite from his injury except for sucking wound and stroke. The position
is known as recovery, coma or lateral position.

2. PROPER BODY HEAT

. Maintain body heat temperature and victim must not be neither perspiring nor chilling.
. If the weather is warm, the victim need not be covered.
. If the victim is cold, in spite of the weather a blanket may be placed underneath him and cover
the body.

3. PROPER TRANSFER
. Proper handling of patient would prevent further injury to the patient.
. Refer proper techniques on transfer method on Patient Handling.

TRANSFER METHOD ON PATIENT HANDLING

For your information. Do not give anything by mouth including water. If medical care is delayed
and patient is complaining of intense thirst, you may wet his/her lips.
 lOMoARcPSD|30422391

TYPES OF SHOCK
 lOMoARcPSD|30422391

MODULE SIX
SOFT TISSUE INJURIES
INTRODUCTION
The Skin is our first line of defense against external forces. Although it is relatively tough,
skin is still quite susceptible to injury, injuries to soft tissues range from simple bruises and
abrasions to serious lacerations and amputations. Soft tissue injury may result in loss of soft
tissue, exposing deep structures such as blood vessels, nerves and bones. In all instances, you
must control bleeding, prevent further contamination, and protect the wound from further
damage. Therefore, you must know how to apply dressings’ and bandage to of the body. Soft
tissues are often injured because they are exposed to the environment. There are two types of
soft tissue injuries: Wounds and Burns. Source: (The Philippine National Red Cross Safety
Services, 2020).

WOUND –is a break in the continuity of a tissue of the body either internal or external.

TWO CLASSIFICATION OF WOUNDS:

1. Closed Wound. Involves the underlying tissue without break/damage in the skin or mucous
membrane.
. Causes:
Blunt object result in contusion or bruises
Application of external forces such as motor vehicle accidents and falls.

. Factors or other injuries which may be involved:

Damage beneath the epidermis depends on varying depth
Depending on extent of force, cells are damaged and small blood vessels are usually torn.
Varying amount of edema fluid and blood leak into the damaged area. Possible fracture

Signs and Symptoms:

Pain and tenderness
Swelling
Discoloration (black or blue which is called ecchymosis)
Hematoma may occur (pool of blood collected within the damaged tissue).
Uncontrolled restlessness
Thirst
Symptoms of shock
Vomiting or cough up blood
Passage of blood in the urine or feces
Sign of blood along mouth, nose and ear canal

FIRST AID MANAGEMENT:

Ice application. Ice or cold packs can be effective in helping control both pain, swelling
and cause the blood vessels to constrict, which will slow bleeding.
Compression. Manual compression over the area of injury will compress the blood vessels
and also decrease the bleeding.
Elevation. Elevating the injured part will decrease the amount of swelling.
Splinting. Immobilizing the soft tissue injury with a splint is another way to decrease
bleeding. Remember me. ICES acronym for first aid management for closed wounds.

2. OPEN WOUND. A break in the skin or mucus membrane or the protective skin layer is damage.
 lOMoARcPSD|30422391

CLASSIFICATION OF OPEN WOUNDS

DANGERS:
Hemorrhage- lost of 1 glass (approximately 250 cc) is normal,2 to 4 glasses victim
becomes anemic and predisposes to infection and 4 to 6 glasses will be fatal.
Infection- delays the healing of the wound; gangrene may develop, amputation may be
necessary to prolong life; may lead to unnecessary death.
Shock-predisposes body to infection; may lead to loss of body part; may itself lead to
death.
 lOMoARcPSD|30422391

KINDS OF BLEEDING:
Arterial bleeding-occurs when an artery is severed or opened. Characterized by the
irregular spurting of blood.
Venous bleeding-occurs when a vein is severed or punctured. Characterized by an even
flow of blood.
Capillary bleeding –described as capillary oozing. This type of bleeding is expected in all
minor cuts, scratches and abrasions.

FIRST AID MANAGEMENT:

Wound with severe bleeding Control bleeding by:
Direct pressure (main help) with the use of a compress, pressure is applied directly over the
wound; can be applied to any kind of bleeding and to any body part.
Do not apply direct pressure on:
. Eye injury
. Wound with embedded object
. Head injury with possibility of skull fracture.

Elevation raise the bleeding part above level of victim’s heart if you don’t suspect a broken bone
and if elevating the injury doesn’t cause he victim more pain.

Pressure point bleeding control(pressure on supplying artery)- if direct pressure and elevation
don’t control the bleeding from an uninjured arm or leg, compress the major artery that supplies
the blood to the injured area while, pressure is applied while direct pressure and elevation are
maintained.

• Brachial artery (between the large muscles biceps and triceps on the inside of the upper
arm) for arm injury.
• Femoral artery (in the groin at the top of the leg bends) for leg injury.
• Cover the wound with dressing and secure with bandage.
• Care for shock
• Consult or refer to physician.

Wound with bleeding not severe (home care)

. Clean the wound with soap and water
. Apply mild antiseptics
. Cover wound with dressing and bandage

Reminders:
1. All wounds must be thoroughly inspected and covered with a dry dressing to control bleeding
and prevent further contamination.
2. Once bleeding is controlled by compression, the limb should be splinted to further control
bleeding, stabilize the injured part, minimize the victims pain and facilitate the patient’s
transport to the hospital.
3. As with closed soft tissue injuries, the injured part should be elevated to just above the level of
the victim’s heart to minimize severity.
4. Amputated body parts should be saved, wrapped in a dry gauze, placed in aplastic bag, kept
cool, and transported with the patient.
5. Do not induce further bleeding to clean the wound.
6. Do not use absorbent cotton as a dressing.
 lOMoARcPSD|30422391

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.

Common Causes:
1. Carelessness with match and cigarette smoking
2. Scald from hot liquid
3. Defective heating, cooking and electrical equipment
4. Immersion in overheated bath water.
5. Use of such chemical, as lye, strong acids and strong detergents.

Factors to Determine the Seriousness of Burns:

1. The Depth-The deeper the burns, the more severe it is. Making an assessment of burns depth
will help you decide whether to seek medical care for the victim.

Generally, three depth classifications are used.

. Superficial (First-degree) burns involve only the top layer of skin the epidermis. The skin turns
red but does not blister or actually burn through. The burn site is painful. A sunburn is a good
example of a superficial burn.
. Partial thickness (second degree) burns involve the epidermis and some portion of the dermis.
These burns do not destroy the entire thickness of the skin, nor is the subcutaneous tissue
injured. Typically, the skin is moist, mottled, and white to red. Blisters are common. Partial
thickness burns cause intense pain.
. Full thickness (third degree) burns extend through all skin layers and may involve subcutaneous
layers, muscle, bone or internal organs. The burned area is dry and leathery and may appear
white, dark brown, or even charred. Some full thickness burns feel hard to touch. Clothed blood
vessels or subcutaneous tissue may be visible under the burned skin. If the nerve endings have
been destroyed, a severely burned area may have no feeling. However, the surrounding, less
severely burned areas may be extremely painful.

2. The Extent to the affected body surface area. This means estimating how much body
surface area the burn covers. A rough guide known as the Rule of Nine assigns a percentage
value to each part of an adult body. The rule of nines must be modified to take into account the
different proportions of a small child and infant. For small or scattered burns, Use the Rule of
Palm. The victim’s hand, excluding the fingers and the thumb, represents about 1 percent of his
or her total body surface. For a very large burn, estimate the unburned area in number of hands
and subtract from 100 percent.

3. Location of the Burns. Burns on the face, hands, feet and genitals are more severe than
the other body parts. A circumferential burn (one that goes around a finger, toe, arm, leg, neck,
or chest) is considered more severe than a noncircumferential one because of the possible
constriction and tourniquet effect on circulation and, in some cases, breathing. All these burns
require medical care.

The Rule of Nine

4. Victim’s age and medical condition. Determine if other injuries or preexisting medical
problems exist or if the victim is elderly (over 55) or very young under (5). A medical problem
or belonging to one of those age groups increases a burn’s severity in general, people under
age 5 and over 55 have thinner skin and often burn more severely, with chronic medical
problems also tend to have more severe burns, especially if they are not well nourished, have
heart or kidney problems, or are exposed to the burn source for a prolonged period because
they are unable to escape.
 lOMoARcPSD|30422391

For your information:

These factors will enable the First aider to Determine the Severity of Burn:
1. Critical Burn:
• Full thickness burns involving the hands, feet, face, upper airway or genitalia.
• Full thickness covering more than 10% of the body’s total surface area. .
• Partial thickness burns covering more than 30% of the body’s total surface area.
• Burns associated with respiratory injury (smoke inhalation).
• Burns complicated by fractures.
• Burns on patients younger than age of 5 years or older than age 55 years that would be
classified as moderate on young adult.

2. Moderate Burns
• Full thickness burns involving 2% to 10% of the body’s total surface area (excluding the
hands, feet, face, upper airway or genitalia).
• Partial thickness burns covering 15% to 30% of the body’s total surface area.
• Superficial burns covering more than 50% of the body’s surface area.

3. Minor Burns
• Full thickness burns covering less than 2% of the body’s total surface area. .
• Partial thickness burns covering less than 15% of the body’s total surface area.
• Superficial burns covering less than 50% of the body’s surface area.

TYPES OF BURN INJURIES:

1. THERMAL BURNS. Not all thermal burns are caused by flames. Contact with hot object,
flammable vapor that ignites and causes a flash or an explosion, and steam or hot liquids are
often common causes of burns.

Care for thermal Burns:

Care of first degree and second degree Burns:
Relieve pain by immersing the burned area in cold water or by applying a wet, cold cloth. Apply
cold until the part is pain free both in and out of the water (usually in 10 minutes. Cold also stops
the burn’s progression into deeper tissue if cold water is unavailable, use any cold liquid you
drink to reduce the burned skin’s temperature.

Cover the burn with a dry, non-sticking sterile dressing or a clean cloth. Covering The burn
reduces the amount of pain by keeping air from exposed nerve endings. The main purpose of a
dressing over a burn is to keep the burn clean, prevent evaporate loss, and reduce the pain.

Care for third degree Burns. It usually is not necessary to apply cold to third degree burns since
pain is absent. Any pain felt with a third degree burn comes from accompanying first and second
degree burns, for which cold applications can be helpful.
Cover the burn with a dry, non-sticking, sterile dressing or a clean cloth.
Treat the victim for shock by elevating the legs and keeping the victim warm with a clean sheet
or blanket.
Care for Scald Burn. Cover scald burns with a cool, moist, sterile dressing and transport the
patient to a hospital. Do not apply ointment, grease or butter to the scalded area.

2. CHEMICAL BURNS. A wide range of chemical agents is capable of causing tissue damage and
death on contact with the skin. As with thermal burns, the amount of tissue damage depends
on the duration of contact, the skin thickness in the area of exposure and the strength of the
chemical agent. Chemicals will continue to cause a tissue destruction until the chemical agent
 lOMoARcPSD|30422391

is removed. Three types of chemicals; acids, alkalis, and organic compounds are responsible
for most chemical burns.

Care for chemical burns:

Immediately remove the chemical by flushing with water if available, use a hose or a
shower. Brush dry powder chemicals from the skin before flushing unless large amounts of water
are immediately available. Water may activate a dry chemical and cause more damage to the
skin. Take precautions to protect yourself from exposure to the chemicals.
Remove the victim’s contaminated clothing while flushing with water. Clothing can hold
chemicals allowing them to continue to burn as long as they are in contact with the skin.
Flush for 20 minutes or longer. Let the victim wash with a mild soap before a final rinse.
Dilution with large amounts of water decreases the chemical concentration and washes it away.
Cover the burned area with a dry dressing or for large areas a clean pillowcase.
If the chemical is in eye, flood it for at least 29 minutes using low pressure. Seek medical
attention for all chemical burns.

3. ELECTRICAL BURNS. The injury severity from exposure to electrical current depends on the
type of current (direct or altering) the voltage, the area of the body exposed and the duration
of contact.

Types of Electrical Burns:

Contact burns (when the current is most intense at the entrance and exit sites.
Flash burns (when extremity is close to an electrical flash by a flash of lightning).
Arcing injuries (when a current jumps from one surface to another)

Care for Electrical Burns:

Make sure the area is safe. Unplug, disconnect or turn off the power. If that is impossible
call the Power Company or ask for help.
Check the ABCs (Airway, Breathing, Circulation) Provide A.R. or C.P.R. if necessary.
If the victim fell, check for spine injury.
Treat the victim for shock by elevating the legs 8-12 inches and prevent heat loss by
covering the victim with a coat or blanket. Seek medical attention immediately
Electrical injuries are treated in burn center.

For your information. Rules for downed power lines:

1. If any lines are suspected of being downed, notify the power company and request an
emergency crew. Then notify all rescue personnel of possible danger.
2. Inspect the emergency scene as you arrive. If there is a possibility of a downed line or weakened
pole, do not proceed in your vehicle, and do not leave your vehicle until you have inspected the
surrounding area.
3. If the vehicle is in contact with the line, stay inside and wait for the power company crew.
4. When entering an area, if the soles of your feet tingle, go no further. You are entering an
energized area.
5. A downed power line should be assumed to be live unless the powers company crew says
otherwise.
6. Remember that vehicles, guardrails, metal fences, conducts electricity.
7. If a vehicle is in contact with a live wire, maintain a safe distance, and tell victims to remain in
the vehicle until the power company crews can assist. Never have a patient attempt to jump
clear of a vehicle unless there is immediate danger of explosion or fire.
8. Remember that hurried actions in an emergency situation involving downed power line can
jeopardize the patient and the first aider.
 lOMoARcPSD|30422391

9. Never attempt to move a high voltage power line without instructions or power company
assistance.

SPECIFIC BODY INJURIES

Care for Eye Injuries

1. BLOWS TO THE EYE. Apply an ice pack immediately for about 15 minutes to reduce pain and
swelling. Do not exert pressure on the eye.
. Seek medical attention immediately in cases of pain, reduced vision or discoloration ( a black
eye).
2. CHEMICAL BURNS:
Use your fingers to keep the eye open as wide as possible.
Flush the eye with water immediately. If possible use warm water. If water is not available
use any non-irritating liquid.
Hold the victims head under a faucet or pour water into the eye from any clean container
for at least 20 minutes, continuously and gently. You cannot use too much water on these
injuries.
Irrigate from the nose side of the eye toward the outside, to avoid flushing material into
the other eye.
Tell the victim to roll the eyeball as much as possible to help wash out the eye.
Loosely bandage both eyes with cold, wet dressing.
Seek medical attention.

3. EYE KNOCK OUT

Cover the eye loosely with a sterile dressing that has been moistened with water. Do not
try to push the eyeball back into the socket.
Protect the injured eye with a paper cup, cardboard folded into a cone or a doughnut
shaped cravat bandage.
Cover the undamaged eye with a patch to stop movement of the damaged eye (known as
sympathetic movement).
Seek medical attention immediately.

4. FOREIGN OBJECT
. Try flushing the object out by rinsing the eye gently with warm water. Hold the eyelid open and
tell the victim to move the eye as it is rinsed.
. Examine the lower lid by pulling it down gently. If you can see the object, remove it with a
moistened gauze or clean cloth.
. Many foreign bodies lodge under the upper eyelid, requiring some expertise in everting the lid
and removing the object. Examine the upper lid by grasping the lashes of the upper lid placing
matchstick or cotton tipped swab across the upper lid and roll the lid upward over the stick or
swab. If you can see the object, remove it with a moistened gauze or clean cloth.

Care for Nose Injuries-Nosebleeds

1. Keep the victim in a sitting- up position to reduce blood pressure. Keep the victim’s head tilted
slightly forward so blood can run out the front of the nose, not down the back of the throat,
which can cause choking, nausea or vomiting. Vomit could be inhaled into the lungs.

2. Pinch (or have the victim pinch) all the soft parts of the nose together between thumb and two
fingers with steady pressure for five minutes. Compress the pinched parts against the bones of
the face.
 lOMoARcPSD|30422391

3. If bleeding persists, have the victim gently blow the nose to remove any irregular clots and excess
blood and to minimize sneezing. This allows new clots to form. Then pinch the nostrils again for
five minutes.
4. Apply an ice pack over the nose and cheeks to help control bleeding especially if caused by a
blow to the nose.
5. Place an unconscious victim on his or her side to prevent inhaling of blood and try the
procedures listed above.
6. Seek medical attention if any of the following applies:
• . The nostrils pinching and other methods do not stop bleeding.
• . You suspect a posterior nosebleed.
• . The victim has a high blood pressure or is taking anticoagulants (blood thinners) or large
doses of aspirin.
• Bleeding happens after a blow to the nose, and you suspect a broken nose.

Care for Impaled Objects- Is an object that is embedded in an open wound. It should never be
removed in the field unless it is through the patient’s cheek or it interferes with airway
management or CPR.
1. Do not remove or moved an impaled object. Movement of any kind could produce
additional bleeding and tissue damage.
2. Expose the area. Remove or cut away any clothing surrounding the injury. If clothes cover
the object, leave them in place; removing them could cause the object to move.
3. Control any bleeding with direct pressure. Straddle the object with gauze. Do not press
directly on the object with gauze. Do not press directly on the object or along the wound next
to the cutting edge especially if the object has sharp edges.
4. Stabilize the object. Secure a bulky dressing or clean cloth around the object. Some
experts suggest securing 75 percent of the object with bulky dressing or cloths to reduce motion.
5. Shorten the object only if necessary in most cases, do not shorten the object by cutting or
breaking it.
6. There are times however when cutting off or shortening the object allows for easier
transportation. Be sure to stabilize the object before shortening it. Remember that the victim
will feel any vibrations from the object being cut and that the injury could be worsened.
Care for Amputations- Amputated body parts left uncooled for more than 6 hours have little
chance of survival; 18 hrs. is probably the maximum time allowable for a part that has been
cooled properly. Muscles without blood lose viability within 4 to 6 hours.
1. Control the bleeding with direct pressure and elevate the extremity. Apply dry dressing or bulky
cloths. Be sure to protect yourself against disease. Tourniquet’s are rarely needed and if used
will destroy tissue blood vessels and nerves necessary for re-plantation.
2. Treat the victim for shock.
3. Recover the amputated part and whenever possible take it with the victim. However in multi-
casualty in reduced lightning conditions or when untrained people transport the victim someone
may be requested to locate the severed body part to the hospital after the victim’s departure.
4. To care for the amputated body part
. If possible rinse it with clean water to remove any debris, do not scrub. The amputated portion
does not need to be cleaned.
. Wrap the amputated part with a dry gauze or clean cloth.
 lOMoARcPSD|30422391

. Put the wrapped amputated part in a plastic bag or other waterproof container or a cup or
glass.
. Place the bag or container with the wrapped part on a bed of ice.
5. Seek medical attention immediately.
Care for Abdominal Injuries Protruding Organs- An evisceration occurs when internal organs
protrude from an open wound. This is most commonly occurring with abdominal wounds.
1. Cover protruding organs with a dressing or clean cloth.
2. Pour drinkable water on the dressing to keep the organ from drying out.
3. Seek medical attention.

DRESSING AND BANDAGES

Guidelines in using dressing and bandages
1. Use a dressing that is large enough to extend at least 1 inch beyond the edge of the edges of the
wound.
2. If body tissue or organs exposed, cover the wound with a dressing that will not stick, such as
plastic wrap or moistened gauze. Then secure the dressing with a bandage or adhesive tapes.
3. If the bandage is over a joint, splint and makes a bulky dressing so the joint remains immobilized.
If there is no movement of a wound over the joint, there should be improved healing and
reduced scarring.
4. A bandage should fit snugly but should not cut off circulation or cause the victim discomfort if
the area beyond the wound changes color begins to tingle or feel cold or if the wound starts to
swell, the bandage is too tight and should be loosened.
5. Bandaging techniques depends upon:
. Size and location of the wound .
Your first aid skills. .
Materials at hand.

Bandaging Technique
1. Triangular Bandage
. Open Phase Head (topside)
Face; back of the head
Chest; back of chest
Hand; foot
. Cravat Phase Forehead; eye
Ear, cheek, and jaw
Shoulder, hip
Arm, leg
Elbow, knee (straight; bent)
Palm pressure bandage
Palm bandage of open hand

TECHNIQUES IN BANDAGING:
S- PEED -with time element to finished
C- AREFUL HANDLING - do no further injury to the victim
A- CCURACY - the correct and proper application of bandaging
N- EATNESS - that the bandage is not snuggling clean to look

SQUARE KNOT- IS THE KNOT BEING USED IN BANDAGING. EASY TO TIE AND EASY TO UNT
 lOMoARcPSD|30422391

MODULE 7 - FIRST AID: POISONING

POISON is any substance: solid, liquid or gas that tends to impair health or causes death
when introduced into the body or onto the skin surface. A poisoning emergency can be life
threatening.
Causes:
1. Common in suicide attempts.
2. Occasional accidental poisoning.

Ways in Which Poisoning May Occurs: See Figure

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

Common Household Poisons:

1. Sleeping pills. 6. Lye and acids including boric.
2. Pain relievers. 7. Poisonous plants.
3. Insect and rodent poisons. 8. Contaminated water.
4. Kerosene 9. Fume
5. Denature alcohol.
Ingested Poisons is one that is introduced into the digestive tract by way of the mouth. One
form of ingestion poisoning is food poisoning, a general form that covers a variety of conditions.
Suspect food poisoning if:
1. The victim ate food that “didn’t taste right” or that may have been old. Improperly prepared,
contaminated, left at room temperature for a long time, or processed with an excessive amount
of chemicals.
2. Several people who ate together become ill.

Botulism is a form of food poisoning that can cause paralysis and death
if it is not treated. Botulism toxins are most often found in home-canned vegetables, honey, and
smoked meats or fish. Signs and symptoms develop 12 to 36 hours and include:

Signs and Symptoms

- Headache - Difficulty swallowing
- Dizziness - Difficulty breathing
- Slurred speech

Signs and Symptoms:

- Altered mental status. - Nausea, vomiting.
- History of ingesting poisons. - Abdominal pain.
- Burns around the mouth. - Diarrhea
- Odd breath odors.

Instances when vomiting should not be induced:

● If unresponsive.
● Cannot maintain an airway.
● Has ingested an acid, a corrosive such as lyle, or a petroleum product such as gasoline or
furniture polish.
● Has a medical condition that could be complicated by vomiting, such as heart attack, seizures
and pregnancy.
 lOMoARcPSD|30422391

First Aid:
˗ Try to identify the poison by seeking information from the victim or bystanders and look for clues.
˗ Place the victim on his or her left side to position the end of the stomach where it enters the small
intestine (pylorus) straight up. Gravity will delay (by as much as two hours) advancement of the
poison into the small intestine, where absorption into the victim’s circulatory system is faster.
The side position also helps prevent aspiration (inhalation) into the lungs if vomiting begins.
˗ Save any empty container, spoiled food for analysis.
˗ Save any vomitus and keep it with the victim if he or she is taken to an emergency facility.

Reminders:
● Do not administer anything by mouth unless advised by a poison control center. The results of
some animal studies suggested that dilution or neutralization of caustic agents by water or
milk after ingestion reduces tissue injury, but no human studies have demonstrated a clinical
benefit of this practice. Administration of milk or water may be considered if a large amount of
an industrial strength caustic or a solid caustic has been ingested, but call the poison control
center first.
˗ At this time there is insufficient data to support or exclude administration of ipecac to induce
vomiting poisoning victim. The potential danger of aspiration and the lack of clear-cut evidence
of a benefit support our recommendation: do not administer ipecac unless specifically directed
by a poison control center of other authority (e.g. local emergency department physician). If
ipecac is administered, it should be given only within 30 minutes of ingestion and only to victims
who are alert and responsive. The decontamination effects of ipecac have been extrapolated
from studies performed in dogs, but the findings are probably not applicable to humans. Result
of studies perform in human volunteers are not applicable to poisonings because the volunteers
were given nontoxic drugs.
˗ Administration of activated charcoal immediately after drug ingestion decreases the amount of
drug absorbed, but the amount varies and decreases with time. Activated charcoal is
unpalatable and difficult to administer, and death due to its aspiration has been reported.

Inhaled Poisons
A poison breathed into the lungs. See Figure 7 - 3 ● Signs and
Symptoms:
˗ History of inhaling poisons.
˗ Breathing difficulty.
˗ Chest pain.
˗ Cough, hoarseness, burning sensation in the throat.
˗ Cyanosis (bluish discoloration of skin and mucous membranes).
˗ Dizziness, headache.
˗ Seizures, unresponsiveness (advance stages).

FYI Carbon monoxide (C0) is a poison gas that is especially lethal. The gas
is invisible, tasteless, odorless and nonirritating. The incomplete burning of organic material
such as gasoline, wood, paper, charcoal, coal, and natural gas produces it.

Signs and Symptoms:

- Headache. - Nausea and vomiting.
- Ringing in the ears (tinnitus). - Dizziness and visual changes (blurred or
- Chest pain (angina). double vision).
- Muscle weakness. - Unconsciousness
- Respiratory and cardiac arrest.
 lOMoARcPSD|30422391

● First Aid:
˗ Remove the victim from the toxic environment and into fresh air immediately.
˗ Seek medical attention. All suspected CO victims needs 100% oxygen and should obtain a blood
test to determine the level of CO.
Absorbed Poisons a poison that enters the body through the skin. See Figure
7-4

● Signs and Symptoms:

- History of exposures.
- Liquid or powder on the skin.
- Burns.
- Itching, irritation.
- Redness, rash, blisters.

● First Aid:
- Remove the clothing that came in contact with the poison.
- Then with a dry cloth blot the poison form the skin. If the poison is a dry powder, brush it off.
- Flood the area with copious amounts of water. A shower or garden hose are ideal for this
purpose. Continue until medical personnel arrived. See Figure 7 - 5
- Continually monitor the patient’s vital signs. Be alert for sudden changes. Seizures and shock are
not uncommon.

Injected Poisons a poison that enters the body through a bite, stings, or syringe.
1. Insect Bites
● Signs and Symptoms:
- Stinger may be present.
- Pain
- Swelling
- Possible allergic reaction.

● First Aid:
Removes stinger - scrape it away or use tweezer. See Figure 7 - 7
Wash wound.
Cover the wound.
Apply a cold pack.
Watch for signals of allergic reaction. See Figure 7 - 8

2. Spider Bite/Scorpion Sting See Figure 7 - 9

● Signs and Symptoms:

Bite mark.
Swelling
Pain
Nausea and vomiting
Difficulty breathing or swallowing.
● First Aid:
Wash wound.
Apply a cold pack.
Get medical care to receive antivenin.
Call local emergency number, if necessary.
 lOMoARcPSD|30422391

3. Marine Life Stings See Figure 7 - 10

● Signs and Symptoms:
Possible marks.
Pain
Swelling
Possible allergic reaction.
● First Aid:
If jellyfish - soak area in vinegar.
If sting rays - soak in non-scalding hot water until pain goes away. Clean and bandage wound.
Call local emergency number if necessary.

4. Snake bites See Figure 7-11

● Signs and Symptoms:
Bite mark
Pain

TABLE 7-1
Comparative Characteristics
VENOMOUS NON-VENOMOUS
Movement
Semicortina curvative Cortina, side
locomotion winding
Head
Semi-triangular Oblongated
Body
Rectangular Circular
Skin
Rough Smooth
Pupil
Vertical Round
Ways/Manner of attack
Nonconstrictor Constrictor
Bite marks
With fang marks Horseshoe shape

First Aid:
Wash wound.
Keep bitten part still, and lower than the heart. - Call local emergency number

5. Human and Animal Bites Signs and Symptoms

- Bite mark
- Bleeding

● First Aid:
- If bleeding is mirror - wash wound.
- Control bleeding.
- Apply antibiotic ointment.
- Cover the wound.
- Get medical attention if wound bleeds severely or if you suspect animal has rabies. - Call local
emergency number or contact animal control personnel.
 lOMoARcPSD|30422391

General Care for Poisoning

1. Survey the scene to make sure it is safe to approach and gather clues what happen.
2. Remove the victim from the source of the poison.
3. Do a primary survey to assess the victim’s airway, breathing, and circulation.
4. Care for any life-threatening condition.
5. If the victim is conscious, do a secondary survey to gather additional information. Look for
containers or pills.
6. Contact Hospital with/or without Poison Control Center and/ or summon more advanced
medical personnel
7. Do not give the victim anything by mouth unless advised by medical professionals. If poison is
unknown and the victim vomits, save some of the vomitus, which may be analyzed later to
identify the poison.

FYI Poison Control Centers provide information on toxins, management of

poisoning victims, and antidotes. A poison control center can provide access to experts in
toxicology. There are full-time staffs and consultants who can be reached by phone. Contact
National Poison Control Information Service at 5241078/521-8450 loc. 2311 or 117 for
assistance.

Note: This may change so refer to PLDT Directory and your Local Government Hospital.

DRUG AND ALCOHOL EMERGENCIES

DRUG ABUSE is the self-administration of one or more drugs in a way that is not accord
with approved medical or social practice.

● Signs and Symptoms - Life-threatening

Emergency
⮚ Unresponsiveness.
⮚ Breathing difficulties or inability to maintain an open airway.
⮚ Abnormal or irregular pulse.
⮚ Fever.
⮚ Vomiting with an altered mental status or without gag reflex. ⮚ Seizures

- High Priority for Transport

⮚ Altered mental status
⮚ Extremely low or high blood pressure
⮚ Sweating tremors, and hallucinations (with alcohol withdrawal).
⮚ Digestive problems, including abdominal pain and bleeding.
⮚ Visual disturbance slurred speech, uncoordinated muscle movement.
⮚ Disinterested behavior, loss of memory.
⮚ Combativeness.
⮚ Paranoia.

● First Aid
- Establish and maintain an open airway.
- Monitor the patient’s mental status and vital signs frequently.
 lOMoARcPSD|30422391

- Maintain the patient’s body temperature.

- Take measures to prevent shock.
- Care for any behavioral problem.
- Support the patient.

ALCOHOL is a powerful Central Nervous System (CNS) depressant. It is both a sedatives,

a substance that decreases activity and excitement, and a hypnotic meaning that it induces
sleep. In general, alcohol dulls the sense of awareness, slows reflexes, and reduces reaction time.
It may also cause aggressive and inappropriate behavior and lack of coordination.

Signs of Intoxication

- Odor of alcohol on the breath.

- Swaying and unsteadiness.
- Slurred speech. - Nausea and vomiting - Flushed face.
- Drowsiness.
- Violent, destructive, or erratic behavior.
- Self-injury, usually without realizing it.

● Effects
- Alcohol is a depressant. It affects judgment, vision, reaction time, and coordination.
- When taken with other depressants, the result can be greater than the combined effects of the
two drugs.
- In very large quantities, alcohol can paralyze the respiratory center of the brain and cause death.

FYI Do not immediately decide that a patient with apparent alcohol on the breath is drunk.
The signs may indicate on illness or injury such as epilepsy, diabetes, or head injury.
● First Aid
- Give the same attention as you would to any patient with an illness or injury.
- Monitor the patient’s vital signs constantly. Provide life support when necessary
- Position the patient to avoid aspiration of vomit.
- Protect the patient from hurting him or herself

FYI Overdose is an emergency that involves poisoning by drugs or alcohol.

Withdrawal refers to the effects on the body that occur after a period of abstinence from the
drugs or alcohol to which the body has become accustomed.

FIRST AID: BONES, JOINTS,

& MUSCLE INJURIES
INTRODUCTION Injuries to the bones, joints or
muscles range from minor to severe. Bone for example, is rigid and can be fractured when they
break or split. Muscle and ligaments are made up of many separate fibers, and they can stretch,
tear or snap if overstressed. Medical advice is often needed to diagnose the problem correctly.
When in doubt, get medical help.
 lOMoARcPSD|30422391

People tend to ignore or underestimate minor muscle and joint injuries. You should know that a
delay in the repair of certain kinds of injuries could lead to permanent loss of function. Also, if
minor injuries are not allowed to fully heal, it is easy to re injure them, and that could lead to
serious lifetime limitations. (Source: The Philippine National Red Cross Safety Services, 2020).

Common Causes See Photos/Images below.

1. Vehicular accidents.
2. Motorbike accidents.
3. Mishandling of tools & equipment.
4. Falls

Signs and Symptoms

1. Pain
2. Bruising; discoloration (gravity, sometimes make bruises show up some distance from the
original injury).
3. Swelling.
4. Misshapen appearance and obvious deformity. (A limb may appear bent or shortened)
5. Exposed bone.
6. Pale, bluish skin; loss of pulse ¡n an injured limb. (A serious bone or joint injury keeps blood from
flowing properly to points further down the arm or leg).
7. Numbness furthers down the arm or leg.

Bone, Joint, and Muscle Injuries Include the Following:

1. Muscle cramp (or spasm) is the sudden painful tightening of a muscle See Photos/Images below.

● First Aid
˗ Have the victim stretch out the affected muscle to counteract the cramp.
˗ Massage the cramp muscle firmly but gently.
˗ Apply heat. (Use a heating pad or a hot water bottle wrapped in cloth.) Moist heat is more effective
than dry heat. Do apply direct heat to the skin.
˗ Get medical help if cramps persist.
Photos/Images: Cramp in the calf.
2. Muscle strain or pulled muscle is the sudden, painful tearing of muscle fiber during exertion.
Signs and symptom include pain, swelling, bruising and loss of efficient movement.
● First Aid
˗ Apply cold compresses at once. Reapply them for 20 minutes every 3 to 4 hours for the first 24
hours. (Do not apply ice directly to the skin.)
˗ If the strained muscle is in an arm or leg, elevate the limb to reduce swelling and bleeding with in
the muscle. Rest the pulled muscle for 24 hours.
˗ Get medical help if the victim is in great pain or if a body part is not working properly.

3. Sprain occurs when a joint loosens; this is caused by torn fibers in a ligament. Sprains are painful
and can cause swelling and bruising, but the joint may still function and usually does not appear
misshapen unless all the fibers of a ligament are torn. See Photos/Images below.
.
● Some Reminders
˗ If the victim is severely injured or you suspect a broken bone, get medical help.
 lOMoARcPSD|30422391

˗ If the injured area is misshapen, victim is in great pain, a body part not working properly, or if
there are signs that circulation beyond the injured area has been impaired, seek medical help.
˗ Do not give the victim anything by mouth if you suspect severe injury.
˗ Do not ignore persistent joint pain. A body part that hurts should not be used.

● First Aid
˗ Remove any clothing or jewelry from around the joint.
˗ Apply cold compresses at once. Reapply them as often as possible (at least for 20 minutes every 3
to 4 hours) for the first 24 hours. (Do not apply ice directly to the skin.)
˗ Elevate the affected joint with pillow or clothing. Do not move the injured part for at least 24
hours.
˗ The victim’s physician may recommend an over the counter anti-inflammatory medication (aspirin,
ibuprofen) appropriates for the victim’s general health.

4. Dislocation and Broken Bones - joint dislocation can happen when bones come out of
alignment. Signs and symptoms include pain, misshapen appearance, swelling and loss of
function. Broken bones (split or snap) fractures can be closed (the skin is not broken) or open
(one or both bone ends pierce the skin). Signs and symptoms can include pain, swelling, and
misshapen or even very painful, and it is a myth that you cannot use a broken bone. If you have
any suspicion that a bone is broken, assume that it is. See Photos/Images below.

● General Information
˗ If a joint is overstressed, the bones that meet at that joint may get disconnected or dislocated.
When this happens there is usually a torn joint capsule and torn ligaments and often, nerves
injury.
˗ If more pressure is put on a bone than it can stand, it will fracture (split or break). Open fractures
(in which bone pierces the skin) can easily become infected.
˗ If an infant or toddler does not start to use an injured arm of leg within hours of an accident, or if
he or she continues to cry when the injured area is touched, assume the child has a broken bone,
get medical help.
˗ It is hard to tell a dislocated bone from a broken bone. Both are an emergency. The general first
aid steps are the same for both.
˗ Significant force that cause fractures or dislocations. Direct blows, indirect forces, high energy injuries and
twisting forces. See Photos/Images below.

● Some Reminders
˗ If you suspect that the victim has a dislocation or broken bone and there is severe bleeding, call
emergency medical assistance.
˗ If you cannot completely immobilize the injury at the scene by yourself, call emergency medical
assistance.
˗ Do not move the victim unless the injured area is totally immobilized.
˗ Do not move the victim with an injured hip, pelvis or upper leg unless it is absolutely necessary. If
you must move the victim immediately, use the clothes drag technique.
˗ Do not attempt to straighten a misshapen bone or joint or to change its position.
˗ Do not test a misshapen bone or joint for loss of function.
˗ Do not give the victim anything by mouth.
● First Aid
˗ Check the victim’s ABC. Open the airway; check breathing and circulation. If necessary, begin
rescue breathing, CPR, or bleeding control.

˗ Keep the victim still.

 lOMoARcPSD|30422391

˗ If the skin ¡s pierced by broken bone, or if you suspect there maybe a broken bone beneath and
open wound, take steps to prevent infection,

˗ Do not breath on the wound and do not wash or probe it. Cover it with sterile dressing before
immobilizing the injury. See Photos/Images below.
˗ Splint or sling the injury in the position, which you found it. It is important to immobilize the area
both above and below the injured joint and to check the circulation of the affected area after
immobilization.
˗ Take steps to prevent shock. Lay the victim flat, elevate his/her feet 8 to 12 inches and cover the
victim with a coat or blanket. Do not place the victim in the shock position if you suspect any
head, neck, or leg injury or if the position causes the victim discomfort.
˗ Get medical help.

● How to Splint
A splint is used to keep an injured body part from moving. It protects from further damage until
you have medical help. There are many commercially made splints, but you probably will have
to improvise. Remember to check circulation after immobilizing the body part. Follow these
general guidelines: See Photos/Images below.
˗ Always care for wounds before applying a splint.
˗ Splint an injury in the position in which you found it. You will need strong supports to make a
splint. Possibilities include boards, sticks, cardboard, poles, branches, broom handles, umbrellas,
baseball bats, or rolled newspapers or magazines. If you have nothing rigid on hand, use a pillow
or blanket. Sometimes you can tape an injured part of the body to an uninjured part to prevent
movement.
˗ The splint must extend both above and below the injured area to keep it immobilize.
˗ Secure the splint to uninjured parts of the body. Put ties or tape above and below but not on top
of the injury. For ties, you can use cloth strips, neckties, torn sleeves, belts, etc.
˗ Make sure any knots are not pressing against the injury. Tie them securely, but not so tightly that
circulation is impaired. If the area beyond the splint becomes pale, numb or throbs with pain,
loosen the ties. If an injured area swells after the splint has been applied, the splint could be too
tight. Check often for swelling, and loosen the splint it necessary.
˗ Check Pulse, Motor & Sensory (PMS) before and after splinting.
˗ Immobilization/splinting Procedures

Immobilization/Splinting Procedures
˗ If straight, apply splint along the arm add tie it in several places. Do not bend elbow as you apply
the splint.
˗ If already bent, apply splint diagonally across the underside of the arm or sling maybe used.

FYI Counteraction means a force exerted by upper end of the splint

against the ischial tuberosity (for commercial type) or prepared cravat bandage (for improvised)
of the patient’s pelvis when traction is applied through the ankle hitch. The splint must be seated
well on the ischial tuberosity/prepared cravat for effective counteraction.
 lOMoARcPSD|30422391

FIRST AID: BASIC EXTRICATION & SPINAL

INJURY MANAGEMENT
INTRODUCTION In various accident situations,
it is impossible for a victim to free himself. He may be confined in an automobile, pinned and
held in machinery, or trapped by a cave-in. He may be injured and there may be danger – known
or unknown but possible – to him/her or the rescuer. It is necessary for a first aider to get the
accident victim whenever possible, to provide life support until persons trained in operating
rescue equipment and in taking the proper action in an interruption of utilities (such as electric,
gas, and water) can be brought to the scene. (Source: The Philippine National Red Cross Safety
Services, 2020).

EXTRICATION is a removal of the victim from a difficult situation or position; or removal

of a patient from a wrecked car or other place of entrapment. See Photos/Images below.

1. When to Perform Extrication

● Automobile & motorcycle accidents.
● Train derailment.
● Collapse building.
● Unconscious injured victim.
● Emergency situations:
Cave-in - Farm machine injuries.
Fire - Gunshot wounds.
Water accident. - Fall from height.
2. Classification of Rescue Operation
● Basic Rescue with minimum equipment involved rescue operation (example: motor vehicle
accident and stable building) See Photos/Images below.
Source:www.JICA.203.140.31.66. Emergency Disaster Relief (Building stable collapse).
Photos/Images: Equipment used in basic rescue
Medium Rescue involves specialized equipment normally found in rescue vehicle
(example: use of rigging A-frames and tripods for patient access) and extrication tools for
disentanglement of the patient. See Photos/Images below.

Heavy Rescue includes complicated rigging, patient handling under extremely difficult or adverse
conditions, breaching or wall disimpactation of vehicles and all types of rescue involving
buildings with major structural damage.

FYI The Fire Department or the Military Rescue Groups usually do medium
and heavy rescue.

3. Elements of Rescue
In Work Phase follows:
L - Locate
A - Access
S - Stabilize
T - Transport
 lOMoARcPSD|30422391

Because extrication of some may be quite difficult, consume much time and require specialized
equipment, the priorities of assessment, stabilization and transport may need to be adjusted for
certain victims/patients.

4. Problems in Rescue Situation

Several medical and rescue units.
Lack of identifiable leadership.
Disorganized provision of care.

It is therefore, essential for one person to be in charge of the overall rescue operation. This
person must be medically trained and qualified to judge the priorities of patient care. This person
has to assume responsibility for the overall management of the extrication process as well as
the details of patient care. It is best to reach an agreement on the protocol of assigning this
responsibility in advance through the development of an incident command system or as a part
of the local disaster plan. See Photos/Images below.

5. Principles of Extrication
Although no two-accident situations will be identical, the following basic principles of extrication
apply to all rescue situations:

Locate all victims.

Provide for the safety of rescue personnel and the patient.
Secure the scene.
Gain access of the patient.
Provide emergency medical care (stabilize the patient) ● Disentangle the patient.
Prepare the patient for transfer.
Transfer the patient.

Ingenuity, common sense, and a basic knowledge of mechanics will solve most extrication
problems. All rescue groups should enhance their basic training through additional workshops
and courses, as well with practice session on wrecked vehicles at the local junkyard.
SPINAL INJURY MANAGEMENT
1. Situations when Spinal Injuries occur
Violent impact to the head, neck, torso or pelvis.
Sudden acceleration or deceleration accidents.
Falls from a significant height with the patient/victim landing on the head or feet.
Gunshot wounds to the neck or trunk.
All shallow water diving accidents.
All unrestrained victim of a vehicle crash.
2. Signs and Symptoms of Spinal Injuries
● Pain in the head, neck or back.
● Numbness, tingling or weakness.
● Pain when in motion.
● Deformity.
● Tenderness.
● Laceration or contusion.
● Paralysis.
 lOMoARcPSD|30422391

3. Examination of Spinal Injury

All injured patients caused by any of the above mechanism must be evaluated for the possibility
of a spinal injury. In conscious patient, you take the following steps to determine the presence
of a possible spinal injury:
Ask the victim/patient or witness about the nature of the accident.
Ask the victim carefully about areas of pain, numbness or weakness.
Look for contusion, laceration and abrasion about the face, head, or trunk and look for any
deformity of the spine.
Feel for any irregularity, deformity or point of tenderness along the spinous process posteriorly.
Check arms and legs for decreased sensation.
Check for weakness or paralysis by asking the patient to wiggle his/her fingers and toes,
unassisted: See Figure 9 - 8
PHOTOS/IMAGES: Assess the equality of strength of each extremity by asking the patient to
squeeze your hands. Ask the patient to gently push each foot against your hands.
Emergency Care for Spinal Injury (First Aid)
Proper emergency care for spinal injury may prevent the need for extensive medical care and
permanent disability. You have the opportunity to prevent paralysis and death; failure to
examine a possible spinal injury or ineffective splinting of the unstable spine might cause
significant, long-term problem. See Photos/Images above.
Maintain the victim’s/patient’s breathing and ensure adequate ventilation. Perform C-Spine
control and or Jaw thrust maneuver.
Control serious bleeding using local pressure dressing.
Most importantly, immobilize the victim before you move him/her. Photos/Images: Stabilize the
neck in a neutral, in-line position, and perform a jaw-thrust maneuver.
Helmet Removal
Many patients with neck injury are motorcyclists or football players who may be wearing
protective helmet.
Four circumstances in which part or the entire helmet should be removed.
● When the facemask or visor interferes with adequate ventilation or with your ability to restore
an adequate airway.
● When the helmet is so loose that securing it to the spinal immobilization device will not provide
adequate immobilization of the victim’s head.
● When life-threatening hemorrhage under the helmet can only be controlled by its removal.
● When because of the size of the helmet, using it as a part of the spinal immobilization will cause
extreme flexion of the neck (this situation usually occurs in children).

See Photos/Images above: Proper steps of helmet removal (this procedure requires 2
rescuers/first aiders):

STEP 1
The first rescuer removes the chinstrap while the second rescuer holds the head in line with the
body.
STEP 2
While the first rescuer supports the head, the second rescuer spreads the sides of the helmet.
STEP 3
The second rescuer slides the helmet off the victim.
STEP 4
Once the helmet is removed, the second rescuer applies in-line stabilization.
 lOMoARcPSD|30422391

6. Immobilization of Spinal Injury

● Immediately begin stabilization by holding the head firmly with two hands. Gently lift the head
to the position where the victim’s eyes are looking straight ahead and the head and torso are in-
line (neutral in-line position).

● At no time should the head or neck be twisted or excessively flexed or extended. Manual support
must continue until the patient is completely secured to the spinal immobilization device. See
Photos/Images below.

Figure 9 - 10 Manual stabilization means holding the patient’s head firmly and steadily in a
neutral, in-line position.

● In certain circumstances movement of the head to the neutral in-line position should not be
pursued. You should not force the head into this positon if:

˗ Neck muscle spasm occurs.

˗ Pain increases.
˗ Numbness, tingling or weakness develops.
˗ The airway or ventilation becomes compromised. In this circumstances stop and immobilize the
victim in the deformed position.

● Use cervical collar if available. If none, improvise (rolled blanket or towel):

˗ Should be appropriately sized (correct size). See above photos/IMAGES.

˗ Should rest on the shoulder girdle and provide firm under both mandible.
˗ Must not prevent the victim or you from opening the mouth to clear the airway.
˗ Should never obstruct ventilation in any way.

See Photos/Images below. Place your finger on the patient’s neck under the corner of the
jawbone to determine the height (length) to the shoulder. Size the device to the same
measurement as the patient’s neck. For the device shown here, the measurement is taken under
the black knob that fastens the device together.

● Manual support must continue even after the collar is applied until the patient/victim is
completely secured to a spinal immobilization device (long spine/back board). See Photos/Images
above.

See Photos/Images below. Apply a rigid cervical immobilization device to the patient.

7. Full spinal immobilization

The general rule for management of spinal injury is to support and immobilize the spine, the
head, the torso, and the pelvis. Your goal is to end up with a patient who is properly immobilized
on a long spine board. It is best to over-treat than to risk further injury. See Photos/Images
below.

SKILL See Photos/Images below. Application of Spine Board.

 lOMoARcPSD|30422391

STEP 1
Prepare the needed materials.
STEP 2
The first aiders (three) will position on the victim and another one will do the C Spine control.
STEP 3
Team leader will give the command to kneel and will also instruct the person who do the C-spine
control to take over the command. First aiders on the side will hold the body of the victim and
prepare to roll.
STEP 4
C-spine controller will give the command to roll the victim to one side.
STEP 5
The middle first aider will reach on the spine board and insert this to victim’s body. (Must be on
a 45 angle)
STEP 6
The C-spine controller will give the command to load the victim, then instruct a push and pull
movement toward the head.
STEP 7
The C-spine controller will instruct to secure the victim with a triangular bandage starting from
the chest, hips, tights, legs, foot.
STEP 8
Place a head support from both side or use a blanket roll following the contour of the head and
put a triangular bandage to secure. Recheck Pulse, Motor, Sensory (PMS) then patient is ready
to transport.

FYI Reminders on Spinal immobilization:

· Maintain and support an adequate airway and ventilation at all times.

· Ensure and maintain in-line support of the entire spine throughout the entire splinting process.
· Apply property a correct cervical extrication collar as described earlier.
· Secure the victim’s torso to the spinal extrication device before securing the head.
· Avoid hyperextension or hyperflexion of the neck when you secure the head. In most adults,
the neutral in-line position will create a space between the head and the spinal immobilization
device.
· Adequate padding should be placed between the head and the device. In contrast, small
children will need padding placed between the shoulder and the device to prevent
hyperflexion of the neck when secured to the device.
This situation occurs because the child’s head is relatively large, and securing the child to a flat
surface naturally forces the head to flex on the trunk.
· Secure all straps snugly to minimize motion. However they should not restrict chest expansion
or circulation to the limb.
· Be certain that the patient’s mouth can be opened to clear the airway.
·Secure the victim well to spinal immobilization device (long spine/back board) with the head,
torso and pelvis aligned so that no motion will occur between any of these parts during
 lOMoARcPSD|30422391

movement and transport. The patient should be so well secured that the entire body can be
turned to one side to facilitate airway management or vertical extrication if necessary.

8. Rescue form Automobile

It is usually not necessary to move a victim from an automobile before a professional/trained
resource arrives; automobiles do not often explode after accidents. If you can do so without
moving the victim, turn off the ignition and set the parking brake. If you must remove the victim
from an automobile because he/she is in immediate danger, first immobilize the neck and back
with a short backboard. If you have no board, you will have to weigh the urgency of moving the
victim without a board against waiting for a professional help with proper equipment.

SKILLS :Application of Bandaging and Body Splints Step1-24.

STEP 1 Ensure that the Body Splint contents are shown.

STEP 2 Properly immobilize the patient with the correct size cervical collar. With manual
traction still being applied, gently move the patient forward by grabbing clothing in one hand
and support back with the collar.

STEP 3 Place the Body Splint behind the patient at 45° angle with the buckle on the outside.

SPTEP 4 Free the body splints leg straps by pulling the straps outward and down next to the
patient’s legs. Be sure that the straps are not tangled. Rotate the splint upright and center on
the patient’s spine.

STEP 5 Ease the patient back onto the body splint and position the wings snugly under the
patient’s axilla.

STEP 6 In the application of the body wings, exercise care when applying pressure to the ribs
to prevent further injury to the axilla. Gently pull the wings together across the chest while
maintaining tension on the wings. Extend the bottom support strap from the splint, connect
buckles together and tighten.

STEP 7 Pass a leg strap under one leg using a seesaw motion. Pull the end up between the legs
and couple it to the receiver on the opposite side of the device. Repeat for the other leg. Tighten
both leg straps. For a suspected groin injury. Pass restraint around leg and couple on the same
side.

STEP 8 Position head panels around patient’s head. Apply forehead restraint strap to the body
splint by centering the foam pad on the upper portion of the forehead. Wrap the remainder of
the strap around the wings of the splint with gentle pressure. The chinstrap is applied in the
same manner as long as the airway is not compromised.

STEP 9 Extend the top chest strap across the patient fasten the buckles and tighten.

STEP 10 Position the patient for extrication with one person maintaining traction on the patient,
swivel patient to where rescuers can obtain hold of the lifting handles. Gently lay patient on
transporting device and remove.

STEP 11 Once the patient has been removed, loosen the top chest strap to ease breathing and
loosen leg straps so legs can be straightened.

STEP 12 Patient is ready for transport.

 lOMoARcPSD|30422391

FIRST AID: COMMON EMERGENCIES

INTRODUCTION An individual may experience
different kinds of emergencies. Sometimes there are no warning signs and symptoms to alert
you or the victim that something is about to happen. It could be a cold or heat related like
hypothermia, heat cramps, heat exhaustion and heat stroke. Medical emergency that is not
caused by trauma like stroke, emergency diabetes and seizure. Emergency childbirth, which may
occur to any pregnant mothers while minor illnesses like fever, headache, abdominal pain,
vomiting and diarrhea, could happen to anyone. Identifying this common emergency situation
would prevent further injuries, disability or progression to death. Sources: (The Philippine
National Red Cross Safety Services, 2020).

ENVIRONMENTAL EMERGENCIES
The human body is equipped to withstand extremes of temperature. Usually, its mechanisms for
regulating body temperature work very well. However, when the body is overwhelmed by
extremes of heat and cold, illness occurs.

COLD EMERGENCIES
Normal body temperature must be maintained within a very narrow range for the body’s
chemistry to work efficiently. If the body, or any part of it, is exposed to cold environments, these
mechanisms may be overwhelmed. Cold exposure may cause injury to individual parts of the
body, such as the feet, hands, ears, or nose, or to the body as a whole. When the entire body
temperature falls, the condition is called hypothermia. See Photos/Images below.

Photos/Images above of page 2 Frostbitten parts in feet and hands are often identified as hard
and firm to touch.
Hypothermia Exposure to extreme cold for a short time or moderate cold for a long time can
cause hypothermia.

1. Mild Hypothermia. The patient will present with cold skin and shivering and will still be alert
and oriented.

● Signs and Symptoms

˗ Increased breathing rate.
˗ Increased pulse rate and blood pressure.
˗ Slow, thick speech.
˗ Staggering walk.
˗ Apathy, drowsiness, incoherence.
˗ Sluggish pupils.
˗ Uncontrollable shivering.

● First Aid
˗ Check responsiveness, if patient is alert and able, allow him/her to drink warm fluids. Never give
a confused or lethargic patient anything to drink.
˗ Cover the patient with a warm blanket.
˗ Apply hot compress.
˗ Check vital signs.
˗ Refer to a physician.
 lOMoARcPSD|30422391

2. Severe Hypothermia. Patients may become unresponsive. This is a true medical emergency that
can lead to death.

● Signs and Symptoms

˗ Extremely slow breathing rate.
˗ Extremely slow pulse rate.
˗ Unresponsiveness
˗ Fixed and dilated pupils. ˗ Rigid extremities, ˗
Absence of shivering.

● First Aid
˗ Check responsiveness.
˗ Check ABC, perform CPR if needed.
˗ Care for shock.
˗ Refer to a physician.

HEAT EMERGENCIES
Our body functions properly within only a limited internal temperature range. A victim of heat
illness may start by experiencing muscle cramps (heat cramps). These are brought on by the loss
of salt from heavy perspiring. If the victim does not cool off at this point, he or she may develop
heat exhaustion because of dehydration. Being in a hot environment is only one factor that can
lead to heat illness. There is also internal factor: certain medications or alcohol intake before or
after vigorous exercise may increase the risk of heat illness. Children and older people are more
susceptible, and they tend to go from feeling fine to sudden collapse. Even succumb to heat
illness if he or she ignores the warning signs. Sources: (The Philippine National Red Cross Safety
Services, 2020).

Mechanism of Heat Loss See Photos/Images in pages 3.

1. Convection – Body heat is lost to surrounding air, which becomes warmer, rises, and is replaced
with cooler air.
2. Respiration – This occurs when a person breathes in cold air and breathes out air that was
warmed inside the body.
3. Radiation – Body heat is lost to nearby objects without physically touching them.
4. Conduction – Body heat is lost to nearby objects through direct physical touch.
5. Evaporation – Body heat causes perspiration, which is lost from the body surface when changed
from liquid to vapor.

Mechanism of Injury

Three general types of heat emergencies

1. Heat Cramps. A muscular pain and spasm due largely to loss of salt from the body in sweating
or too inadequate intake of salt. The cramps are more severe if the victim has drunk a large
quantity of tap water or softdrinks without replacing the salt deficiency, in which case severe
mental confusion and even convulsions may develop. Heal cramps may be associated with heat
exhaustion.

●Signs and Symptoms

˗ Muscle cramps, often in the abdomen or legs
˗ Heavy perspiration.
˗ Lightheadedness; weakness.
 lOMoARcPSD|30422391

●First Aids
˗ Have the victim rest with his/her feet elevated 8 to 12 Inches.
˗ Coot the victim. Do not use an alcohol rub.
˗ Give the eIectroIyte beverages to sip (for example, Gatorade or Pedialyte) or make salted drink by
adding 1 teaspoon of salt to 1 quart of water. Try to give a half cup every 15 minutes. (If
electrolyte beverage or salts are not immediately available give the victim cool water.)
˗ To relive muscle cramps massage the affected muscles gently but firmly until they relax.

2. Heat Exhaustion. A respond to heat characterized by fatigue, weakness, and collapse due to
inadequate intake of water to compensate for loss of fluid through sweating.

● Sign and Symptoms

˗ Cool, Pale or red, moist skin (Even if the victim’s internal temperature is rising, his or her skin may
still be cool).
˗ Dilated pupils
˗ Headache
˗ Extreme thirst
˗ Nausea; vomiting.
˗ Irrational behavior.
˗ Weakness; dizziness
˗ Unconsciousness

● First Aid
˗ Have the victim rest with his or her feet elevated 8-12 inches.
˗ Cool the victim. Do not use an alcohol rub. Give the victim electrolyte beverages to SIP
˗ (for example. Gatorade or Pedialyte) or make a salted drink by adding 1 teaspoon of salt to 1 quart
of water. Try to give a half-cup every 15 minutes. (If electrolyte beverages or salt are not
immediately available, give the victim cool water.) See Photos/Images below.
˗
˗ Monitor the victim for signs of shock, including bluish lips and fingernails and decreasing alertness.
˗ If the victim starts having seizures, protect him/her from injury and give first aid for convulsions.
˗ If the victim loses consciousness, give first aid for unconsciousness.

3. Heat Stroke or Sunstroke. A response to heat characterized be extremely high body temperature
and disturbance or sweating mechanism.

● Signs and Symptoms

˗ Raised body temperature (above 102 degrees Fahrenheit).
˗ Dry, hot, red skin.
˗ Dark urine.
˗ Small pupils.
˗ Rapid, shallow breathing.
˗ Extreme confusion.
˗ Weakness.
˗ Seizures.
˗ Unconsciousness.

● First Aid
˗ Cool the victim. Do not use an alcohol rub.
 lOMoARcPSD|30422391

˗ Give First Aid for shock. Lay the victim flat and elevate his/her legs 8 – 12 inches. Do not suspect
any head, neck, back or leg injury; if he or she is having breathing problems; or if the position
makes the victim uncomfortable.
˗ If the victim starts having seizures, give first aid for seizures.
˗ Keep the victim cool as you await medical help. See Photos/Images below.

Prevention of heat emergencies

1. Avoid exposure to direct rays of sun. Keep head covered.
2. Wear proper clothing. Light colored clothing reflects rather than absorbs sunlight. Sweating
cools only as sweat evaporates, so wear loose clothing.
3. Intake of much water, 12-15 glasses a day, together with extra salt
4. Exposure to air currents from fans or open windows aids currents from fans or open windows
aids evaporation and cooling.

Some Reminders
1. Do not underestimate the seriousness of heat illness especially if the victim is a child, is elderly,
or is injured.
2. Do not give the victim liquids that contain alcohol or caffeine. These drugs interfere with the
body’s ability to regulate its internal temperature.
3. Do not give the victim over-the-counter medications that are used to treat fever (for example
aspirin). They will not be effective, and they may be harmful.
4. Do not give the victim salt tablets. Salt is appropriate, but it should be taken as a salt and water
solution.
5. Do not overlook possible complications resulting from the victim’s ongoing medical problems
(for example, high blood pressure or heart disease).
6. For heatstroke – do not give the victim anything by mouth – not even salted drinks.

How to Cool a Victim of Heat Illness

A victim of heat illness needs help right away. Don’t worry about subjecting the victim to
extremes in temperature; the important thing is to cool him or her immediately.
Take the victim’s temperature as you begin your cooling efforts to see how serious his or
her condition is. Take it again after a few minutes to see if it is being brought under control.

To control the victim, you can use a combination of approaches, depending upon the
circumstances:

1. Move the victim into the shade, into a cool room, or to air-conditioned building or car.
2. Spray the victim with hose, or pour a bucket of water over him or her (not in the face). Tell the
person what you are going to do, and do not use these measures if victim is confused.
3. Wrap the victim in wet towels or sheets, then turn on a fan. Evaporation is a very effective way
to cool off.
4. Place cold compresses on the victim’s neck, groin, and armpits.

If medical help is not immediately available and you suspect heatstroke, immerse the victim
in cold water (bath, lake, stream), but only if you can carefully monitor his or her level of
alertness and ABC’s (airway, breathing and circulation).
Once the victim’s temperature is down to 100 degrees Fahrenheit, you can ease up on your
cooling efforts, but keep checking the victim’s temperature every half-hour for the next 3 to 4
hours. There is a possibility it may rise again.
 lOMoARcPSD|30422391

MEDICAL EMERGENCIES
Medical emergencies can develop very rapidly (acute conditions) or develop gradually and
persist for a long time (chronic conditions). They can result from illness or disease. Several
conditions, such as stroke, diabetes and seizure can cause a change in consciousness. In an
emergency, you may not know what caused the change, but the cause is not important. You do
not need to know the exact cause but identifying the illness would provide appropriate care for
the victim.

1. 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 most common victims, but younger people can
have them, too.

● Causes: See Figure 10 - 7

˗ Thrombus or embolism. Formed in an artery the brain or carried to the brain in the bloodstream.
˗ Ruptured artery in the brain. Resulting from a head injury, high blood pressure, a weak spot in
the wall of a blood vessel (aneurysm), or fat deposits lining a vessel (atherosclerosis).
˗ Compression of an artery in the brain. Decreasing the blood flow, This is often the result of a
brain tumor.

Signs and symptoms:

˗ Weakness and numbness of the face, arm or leg, often on one side only.
˗ Dizziness
˗ Confusion
˗ Headache
˗ Ringing in the ears.
˗ Change of mood
˗ Difficulty in breathing and swallowing.
˗ Loss of bowel and bladder control.

● First Aid
˗ Check the victim’s ABC. If necessary, begin rescue breathing, CPR or bleeding control.
˗ Have the victim rest in a comfortable position.
˗ Seek immediately medical help.
˗ Do not give the victim anything by mouth.
˗ If the victim loses consciousness, place him or her in the recovery position and administer first aid
for unconsciousness.
˗ Continue to monitor ABC’s.
˗ Stay with the victim until you have medical help.

2. Diabetes is a condition that affects the way the body uses food. It causes the sugar level in the
blood to be too high. Physiology: Normally, during digestion, the body changes sugars, starches,
and other foods into glucose. The blood then carries the glucose to the cells in the body, where,
with the help of a hormone called insulin, glucose is changed into energy for immediate use by
the cells or is stored for the future needs. See Photos/Images below.

In diabetes, the pancreas cannot make insulin or makes too little insulin. When insulin is
absent, the cells cannot use the glucose in the bloodstream. Instead, glucose collects in the
blood, leading to the high sugar levels that are typical of untreated diabetes.
Diabetes- is defined as a lack of or ineffective action of insulin. Without insulin, cells begin to
“starve” because insulin is needed to allow glucose to enter and nourish the cells.
 lOMoARcPSD|30422391

Types of Diabetes See Photos/Images below.

˗ Insulin Shock. Occurs when too much insulin is in the body. Too much insulin rapidly reduces the
level of sugar in the blood, and brain cells suffer. Insulin reaction can be caused by taking too
much medication, by failing to eat, by heavy exercise, and by emotional factors.
⮚ Sign and Symptoms
* Fast breathing * Vision difficulties.
* Fast pulse. * Sweating
* Dizziness * Headache
* Weakness * Numb hands or feet.
* Change in the * Hunger level of
consciousness. * Anxiety
˗ Diabetic Coma. Happens when there is too much sugar and too little insulin
in the blood, and body cells do not get enough nourishment. Eating too much
sugar, by not taking prescribed medication, by stress, and by infection
can cause diabetic coma.

⮚ Signs and Symptoms

* Drowsiness and confusion. * Dehydration
* Deep and fast * Fever
breathing. * A fruity- smelling.
* Thirst * Change of consciousness.
Diabetis has: The two most common diabetic emergencies, diabetic coma and insulin shock,
develop when the patient has either too much or too little glucose in the blood, respectively.
● First Aid
˗ In a diabetic emergency, it is possible to confuse the signs and symptoms of insulin reaction and
diabetic coma. Since insulin reaction is a true emergency that needs quick response:
˗ Give any fully conscious person in a diabetic emergency sugar-candy, fruit, juice, or a soft drink
containing sugar. This will quickly get sugar into the blood to help someone having an insulin
reaction. If instead of having an insulin reaction he or she is in diabetic coma, the sugar will not
cause further harm. See Figure 10 - 10
˗ If the person is unconscious, check ABCs and call for a physician.
˗ Victim of diabetic coma also needs immediate transport to the hospital.

3. Seizure. Is a sudden involuntary muscle contraction, usually due to uncontrolled electrical

activity in the brain.

Many different problems, some more serious than others can cause brain cells to fire
abnormally.

In some cases, an individual can sense that a seizure is going to occur.

He or she may hallucinate, hear an imagined sound, get a strange taste in the mouth
experience abdominal pain, or feel an urgent need to get safety.
Most seizures last from 30 to 45 seconds. Seizures are also known as convulsions. Seizures
associated with fever are called febrile seizures.

When seizures recur, and there are no underlying causes that can treated directly, a person
is said to have epilepsy, is usually well controlled with medication.
 lOMoARcPSD|30422391

There is nothing you can do to stop seizure once they have started. First aid is aimed at
protecting the victim from injury and getting medical help as needed.
If a toddler experiences multiple seizure for the first time, assume he or she has swallowed
poison.

1. AURA PHASE.
Often described as unusual smell or flash of light that lasts a split second.

2. TONIC PHASE.
15 to 20 seconds of unresponsiveness followed by 5 to 15 seconds of extreme muscle rigidity.

3. CLONIC PHASE.
1 to 15 minutes of seizures.

4. POSTICTAL PHASE.
5 to 30 minutes to several hours of deep sleep with gradual recovery.

Stages of a generalized seizure.

● Signs and Symptoms

˗ Local tingling or twitching in part of the body (local seizures).
˗ Brief blackout or period of confused behavior (petit mal seizures).
˗ Sudden falling, loss of consciousness.
˗ Drooling, frothing of the mouth.
˗ Vigorous muscle spasm; twitching, jerking limbs. Stiffening (grand mal seizure).
˗ Grunting; snorting.
˗ Loss of bladder and bowel control.
˗ Temporary cessation of breathing.
˗ Seizure are often associated with epilepsy; high blood pressure; heart disease; brain tumor, stroke
or other brain illness or injury; shaking young children violently; fever in children; head injury;
electric shock; heat illness; poisoning; venomous bites and stings; choking; and drug or alcohol
overdose or withdrawal.

● 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 pregnant.
˗ Carries identification as a diabetic.
˗ Is in the water and has swallowed large amounts of water.

Moves objects away from seizure patient.

When the seizure stops, position the patient to allow drainage of saliva and vomit.

● Febrile Seizure (Convulsion). 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.
 lOMoARcPSD|30422391

Although they are extremely frightening for the parents or caregivers, these seizures are self-
limited and pass relatively quickly.
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 lukewarm water; and him on a fan. Stop if the child shivers (do not place chiId
in a bathtub because he or she could have another seizures in the water).

The child’s physician may recommend an over the counter drug such as acetaminophen.
Notify the child’s physician that a seizure has occurred. If the cause of the seizures in unknown
asks a physician to determine if it was a cause by infection.

Remove any clothes or covering bedclothes. Ensure a good supply of cool, fresh air (although
you should be careful not to overcool the child). Use pillows or rolled blankets for padding.
Sponge the child with tepid water to help cooling.

● When to get help for a Fever

Fever is not always cause for alarm, but sometimes it is a sign of a serious problem. Seek
immediately medical attention if:

˗ Fever is over 102 degrees Fahrenheit (measure rectally in a baby under 3 months).
˗ Fever is over 103 degrees Fahrenheit ˗ Fever is accompanied
by:
⮚ Difficulty in breathing.
⮚ Unusual skin colors (blue, gray, purple).
⮚ A rash of tiny red or purple dots under the skin.
⮚ Shock
⮚ Stiff neck.
⮚ Bulging fontanel (soft spots of the baby’s skull).
⮚ Sign of dehydration (sunken fontanel, little or no urine, dry mouth, sunken eyeballs, sever thirst,
sleepiness, weakness).
⮚ If the victim appears to be very ill, take steps to reduce the fever while you seek medical
assistance. Don’t hesitate to call a physician if you are unsure whether or not the fever needs to
be evaluated.

EMERGENCY CHILDBIRTH
1. General Information: The following information is provided only for the very rare occasion
when delivery occurs unexpectedly and you cannot get medical help in time.

During childbirth, the contractions of the uterus dilate (open) the cervix and help the
mother as she pushes the baby down the vagina (birth canal) and out of the vaginal opening.
Usually the baby is born head first, facing down. After the baby is delivered, the placenta (after
birth) detaches from the uterus and is also expected.
The early stages of labor can last many hours. During this time, the cervix expands and the
baby begins to move down the birth canal. Once the mother is actively pushing out the baby,
delivery proceeds quickly.

2. Causes of Emergency Childbirth

● Rupture tubal pregnancy with concealed hemorrhage into the abdominal cavity.
 lOMoARcPSD|30422391

● Unusual bleeding from the vagina at any stage.

● Convulsions associated with pregnancy.
● Miscalculations in the anticipated delivery.
● Premature onset of labor after an accident.
● Delay in transportation.
● Other factors which may abbreviate delivery.

3. Sign and Symptoms

● If labor contractions are approximately 2 minutes apart.
● If the woman is straining or pushing down with contractions.
● If the woman is crying out constantly.
● Warning from the woman that the baby is coming.

4. Materials and supplies needed: See Figure 10 - 15 ● At home en route to the hospital:
˗ Assemble clean cloth, plastic bags or other materials to protect bed clothes or car upholstery.
˗ Clean towels, one or two folded sheets.
˗ Set of sterile cord ties or sterilized shoelaces.
˗ New razor blade in protective paper.
˗ Diaper
˗ Alcohol
˗ Sanitary napkins
˗ Receiving blanket for the baby.
˗ Safety pins.

For a long automobile ride:

˗ The mother should wear a nightgown, or slip and a robe (no other underclothing) and place a
sanitary napkin or clean folded towel between her thighs if the bag of waters has broken or if
the blood and mucous are draining from the birth canal.
˗ Take along a flashlight, if the trip will be at night.
˗ Blanket and pillow.
˗ Container of some sort for the after birth.

Sample of materials needed.

5. Delivery Procedures
Position the patient:
˗ Remove underclothing that may interfere with delivery.
˗ The woman should be lying down on her back with knees bent, feet flat and thighs separated
widely on the floor, the seat of a vehicle, the ground or any other flat surface. See Figure 10 - 16
˗ At home, the woman may lie across a bed in the same position as mentioned above with her feet
resting on two straight chairs and her thighs and abdomen covered with clean towels or sheets.
˗ In public places, quickly arrange for as much privacy as possible by having some people stand
around the woman with their backs turned to her to shield the scene from others.
˗ Place clean cloth or any clean materials under the woman’s buttocks.
˗ First aider should wear gloves before handling the delivery procedure.

Position the mother with her legs bent and knees drawn up and apart. Place clean
sheets, blankets, towels, or even clothes under the mother.

● Inspection of the Presenting Part:

 lOMoARcPSD|30422391

˗ Inspect the opening of the woman’s birth canal (vagina) to determine whether the baby’s head is
visible at the time of construction. See Figure 10 - 17
˗ The back of its head is usually the presenting part, a wrinkled scalp and hair may be noted,
although the head may still be enclosed in the bag of waters.
˗ If the woman has had previous pregnancies, and the exposed area of the baby’s head is
approximately the size of a 1 peso or larger, delivery will probably occur within a few minutes
during the next two or three contractions.
˗ If the woman is having her first child and the exposed area of the baby’s head is smaller than 1
peso coin, proceed to the nearest hospital, if it is not more than 20 minutes away.
˗ Encourage the woman not to bear down or strain with contractions but instead to breathe in and
out rapidly with short, panting breath.

⮚ Some Don’ts:
* Don’t try to hold back the baby’s head or tell the woman to cross her legs to delay delivery.
* Don’t place your hands or fingers into the birth canal at anytime, because of the danger of
infection.
* Don’t interfere by not allowing the delivery to proceed until the baby’s head has emerged fully.

When crowning begins, birth is imminent.

FYI When urgent crisis exist, like the rupture of the bag waters, the cord protrudes into the
birth canal. The patient should be taken to the hospital immediately and meanwhile the patient
should stay in a jack-knife or knee-chest position to relieve pressure on the cord and prevent
shutting off the blood supply to the infant.

● Delivery of the head

˗ As the infant’s head emerges, guide and support it with your hands to prevent its becoming
contaminated with blood, mucus or fecal material. See Figure 10 - 18
˗ If the baby’s head passes through the birth canal to the outside with the bag of water still
unbroken, tear it with your fingers to let the fluid escape and prevent aspirations the infant takes
its first breathe.
˗ When the head emerges, check it to see whether the umbilical cord is wrapped around the infant’s
neck. If so, gently but quickly slip it over the baby’s head with your forefinger between its neck
and the cord.
˗ If the cord is wrapped around the infant’s neck more than once, or you cannot slip it over the
baby’s head, it must be cut immediately to prevent strangulation.
˗ Squeeze the cut ends with gauze cloth or your fingers until ties can be applied.
˗ If any part of the baby, other than its head, is seen at the opening of the birth canal, proceed
immediately to the nearest hospital.

Place your hand on top of the baby’s head and apply light pressure. As the infants emerges,
support the head.

● Cutting the Cord

˗ Though there will be no harm if the infant is left attached to the afterbirth by the umbilical cord
until the mother can be taken to the hospital, the cord must be cut if it is strangling the baby as
its head emerges. This is waiting for contractions to resume to expel the placenta. Wait until all
pulsation of the cord has stopped, maybe for about 5 minutes.
 lOMoARcPSD|30422391

˗ Use a new razor blade one-edge if possible or boil scissors or soak them in rubbing alcohol, or after-
shave lotion, or other alcohol-based preparation, for 20 minutes. Boil new white shoelaces or
narrow strips of clean white cloth for 20 minutes; it can be applied wet.
˗ The cord must not be cut closer than 4 inches from the infant’s navel.
˗ The Square knot or two or three simple knots 4 to 6 inches from the baby and a second knot 8
inches from the baby.

FYI The cord end attached to the baby dries out, shrivels up, and falls off within a few days.

If the umbilical cord is wrapped around the baby’s neck and cannot be removed clamp
the cord in two places and, being extremely careful not to injure the baby, cut the cord between
the clamps.
● Expulsion of the Afterbirth
˗ Shortly after the birth of the baby, the mother’s contractions resume in preparation for expelling
the afterbirth (placenta), as it detaches from the wall of the womb (uterus).
˗ Do not pull on the cord and do not push hard the mother’s lower abdomen, severe damage to the
uterus may result.
˗ As afterbirth emerges, place your hand over the mother’s lower abdomen and massage the uterus
to contract and will help control bleeding. Repeat every 5 minutes for at least the next hour or
until the mother is seen by a physician. Save the afterbirth and take it to the hospital with you.

Delivery of the placenta. The placenta must be collected and transported with the
mother and baby.

● Care after delivery

˗ After a home delivery, gently cleanse the vaginal opening with a clean, moist towel, or pour soapy
water over the vaginal opening.
˗ Lay a sanitary napkin or other suitable clean cotton material across the vaginal opening.
˗ Give the mother tea, coffee; or other fluids and keep her warm.
˗ Keep the infant warm
˗ Do not attempt to cleanse the infant of the white, greasy protective coating covering its skin.

˗ Do not wash infant’s eyes, ears and nose.

˗ Check to be sure that the infants breathing is normal and that it is kept warm during transfer to the
hospital.
˗ If the afterbirth is not expelled, there is danger of hemorrhage, Medical care should be sought
without delay.
˗ Do not pull on the afterbirth or on the cord.
˗ If there are tears in the birth canal, with serious bleeding, treat as an open wound by applying
direct pressure to the bleeding area with a pad of sterile or clean cloth.

OTHER COMMON EMERGENCIES

1. Fever is a sustained body temperature above the level of 37°C (98.6°F) is known as fever. Is
usually caused by a bacterial or viral infection, and may be associated with influenza, measles,
chicken pox, meningitis, earache, sore throat, or local infections, such as an abscess.

● When to call a doctor. A moderate fever is not harmful, but a temperature of above 40°C (104°F)
can be dangerous, and may trigger fits in babies and young children. Call a doctor, even if only
for advice, if in doubt about the casualty’s condition.
 lOMoARcPSD|30422391

● Signs and Symptoms ˗ In the early stages:

⮚ Pallor
⮚ A “chilled” feeling — goose pimples, shivering, and chattering teeth.
˗ As the fever advances:
⮚ Hot, flushed skin, and sweating.
⮚ Headache
⮚ Generalized “aches and pains”. ⮚ Higher
temperature.

● First Aid
˗ Make the patient comfortable in cool surroundings, preferably in bed with a light cover. Allow her
to rest.
˗ Give the casualty plenty of cool, bland drinks to replace lost fluids.
˗ An adult may take two paracetamol tablets.
˗ Give a child the recommended dose of paracetamol syrup (not aspirin).
˗ If you are worried about the casualty’s condition, call a doctor.

Sponging with tepid water may comfort child.

2. Headache may accompany any illness, particularly a feverish ailment such as flu, but it may be
the most prominent symptom of a serious condition, such as meningitis or stroke. Mild
“poisoning” caused by a stuffy or fume filled atmosphere, or by excess alcohol or any other drug,
can induce a headache in an otherwise healthy person.
Headaches may develop for no apparent reason, but can often be traced to tiredness,
nervous tension, stress or emotional upset or undue heat or cold. Headaches can range from
constant low-grade discomfort to
“blinding” pain that is completely incapacitating.

● When to call a doctor. Always seek urgent advice if the pain:

˗ Develops very suddenly;
˗ Is severe and incapacitating;
˗ Is recurrent or persistent;
˗ Is accompanied by loss of strength or sensation, or impaired consciousness;
˗ Is accompanied by a stiff neck; ˗ Follow a head injury.

● First Aid
˗ Help the patient to sit or lie down comfortably in a quiet place. If possible, remedy any likely cause
of the headache, such as loud noise, bright light, or lack of fresh air.
˗ An adult may take two paracetamol tablets or her own painkillers. Give a child recommended dose
of paracetamol syrup (not aspirin).
˗ If in doubt or if the pain does not ease within two hours, call a doctor.

Place in comfortable position and apply cold compress may give relief.

3. Abdominal Pain is a pain in the abdomen often has a relatively trivial cause, but can indicate
serious disease, such as perforation or obstruction of the intestine.
Intestinal distension or obstruction causes pain that comes and goes in “waves” (colic). This
often makes the sufferer double up in agony and can be accompanied by vomiting.
 lOMoARcPSD|30422391

A perforated intestine or leakage of its contents into the abdominal cavity causes
inflammation of the cavity lining (peritonitis). This potentially life-threatening condition causes
sudden, intense pain made worse by movement or abdominal pressure.

First Aid
˗ Make the patient comfortable, and prop her up if breathing is difficult. Give her a container to use
if vomiting.
˗ Do not give the patient any medicines or anything to eat or drink.
˗ Give patient a covered hot-water bottle place against the abdomen.
˗ If the pain is severe, or does not ease within 30 minutes, call a doctor. Place

the patients on his comfortable position.

4. Vomiting and Diarrhea are most likely to be cause by food poisoning, contaminated water,
allergy, or unusual or exotic food. Vomiting may, of course, occur without diarrhea, and vice
versa. When both occur together there is an increased risk of dehydration, especially in infants,
young children, and the elderly, which can be serious.

First Aid
˗ Reassure the patient while he or she is being sick. Afterwards give the patient warm damp cloth
with which to wash him- or herself.
˗ Give the patient lots of bland fluids to sip slowly and often. If the appetite returns give him only
bland, starchy or sugary food for first 24 hours.
˗ If you are worried about the patient’s condition, particularly if it is persistent, call a doctor.

Put the patient on her side if she is vomiting.