FIRST AID

             FIRST AID

INTRODUCTION
Emergency conditions threatening human life & their management is called First Aid.

Emergency care may be required at any time in life and First Aid provided at right time, saves lives and also prevents gross damage of essential organs and tissues. 

The immediate treatment given to the victim of an accident or sudden illness, before medical help arrives is called First Aid.

Due to importance of First Aid,America and Europe has made FirstAid compulsory subject of study for all citizen.

This lesson will provide you basic knowledge to be a skilled health worker, who can provide emergency First Aid in life threatening situations.


FIRST AID

» Saves life

» Lessens pain

» Helps in early recovery

» Prevents conditions from worsening

» Prevents organ damage

» diagnose emergencies from their signs and symptoms

» provide first aid to such diseases and save lives

» learn about different resuccication procedures and practice them in classroom

»also know about the body parameters.

GENERAL OBSERVATIONS

To treat human being during emergency one must know certain facts about human body, like height, weight, pulse and blood pressure.

Any deviation from normal may be due to some diseases or accidents resulting in disturbance of normal human activity.

a) Whenever a patient reports to clinic or hospital, his or her weight should be checked and recorded. 

The weight should be taken by removing shoes and with light indoor clothing.


b) The height is also recorded by height measuring vertical scales with a gliding arm.

c) A patient is declared over-weight when his/her weight crosses the standard of weight as per his/her height. 

A person who is more than 20% of body weight of his/her upper limit of weight, is considered over weight Over weight or obesity leads to different types of diseases like Diabetes, Hypertension and Heart diseases etc.

               PULSE

When the left ventricle of heart contracts, it sends the blood forward and thus set up a pressure wave that can be felt in the arteries.

The pressure wave dilates the arterial wall as it runs forward and this can be felt as a pulse.

As the pulse represents the power of contraction of ventricle, it increases during running or reduced during sleeping. 

The pulse is checked generally at the wrist lower part on the lateral side over the radial artery. It is known as Radial Pulse. 

The other common sites are carotid, subclavian, brachial,post tibial and femoral artery. 

The carotid arterial pulse is usually felt as it is easily accessible and checked whenever a medical emergency case is detected.


          BLOOD PRESSURE

 

a)Auscultatory Method

The arterial blood pressure is routinelymeasured by Auscultatory Methood that is by use of Stethoscope. An inflatable cuff is attached by rubber tubing to a mercury manometer or a dial with hand.


The cuff is wrapped around the arm of the patient and the pressure is raised to a point when our radial pulse is not palpable. 

The dial of Stethoscope is placed above the brachial artery at the elbow joint and pressure in the cuff is lowered gradually tll the sound of the heart is audible at the Stethoscope. 

This point is Systolic blood pressure.The pressure in the cuff is further lowered where the intensity of the sound gradually increases till such time where the sound suddenly reduces and appears to be muffled. This point is taken as Diastolic Pressure.

           SHOCK

Shock is a condition that develops after an injury or internal hemorrhage resulting in lowering of blood pressure, rapid pulse rate, rapid heart rate,pale skin, cold sweating and sensation of collapse, lack of sensation ultmately unconsciousness and sometimes death.


Clinical Features: Low blood pressure (Systolic below 90 mm of Hg), rapid heart rate, rapid pulse rate, pale colour of skin, cold sweating, hurried respiration, altered sensation, signs of intense peripheral vascular constriction, nausea etc

CLASSIFICATION

Shock may be of following types:

a) Hemorrhagic Shock e.g. Peptic ulcer hemorrhage

b) Shock due to an accident or injury

c) Shock due to internal hemorrhage Intestinal hemorrhage

d) Due to dehydration e.g. Diarrhoea, Cholera
e) Due to some disease of internal organ – Pancreatitis

f) Shock due to Acute Myocardial Infraction,left ventricular failure and arrhythmias
g) Vasogenic Shock - Anaphylectic Shock, Neurogenic Shock.

h) Septic Shock - Gram negative, Gram positive bacteria and viral infection

FIRST AID
1).Raise the feet so that maximum blood is available to the heart and circulation

2).Oxygen inhalation through face mask

3).l.V. fluids 5% glucose with NaCl, Ringer's lactate

4) If there is internal hemorrhage, blood transfusion, plasma volume ex-pander

5) Constant monitoring of pulse, blood pressure, heart rate and bloodglucose, blood urea

6) Treatment of the underlying cause

7) Transfer the patient to hospital as soon as possible.

          ELECTRIC SHOCK
When a person comes in contact with electricity whether through naked wire or through leaking electrical appliances, the person gets electric shocks.

If a person receives electric shocks his breathing and heart rate both will be affected. The first effort will be to switch off the main switch if it is nearby or separate him from the source of leakage with the help of a piece of wood and then give artificial respiration, oxygen and IV drip with 5% glucose saline to restore blood pressure. lf possible send the patient to hospital.

              HYPOTHERMIA

This condition develops among old age people or minor children and infants during winter months, when the temperature drop to near zero.

This is more common in hilly areas where small infants,children and old age people cannot cover themselves properly resulting in dropping of temperature of the body and utimately if the process is not reversed,death occurs.

A hypothermic patients present himself with the following  symptoms.

1)Feeling weak and tired

2) Uncontrollable shivering

3) Pulse weak, respiration weak

4) If patient is not treated at this stage, he becomes unconscious and die

              TREATMENT

1) Remove all wet clothings

2) Move the patients to a dry place near a fire or heater

3) Cover him with blankets and quilts

4) Apply hot water bottle under the feet

5) Give warm and soft drinks to drink like tea, coffee, and milk etc. with extra sugar

6) If the condition does not improve, send the patient to hospital.

Chill blens and frostbite - if the weather is very cold nearing 0°C, human body parts which are exposed specially finger of hand and feet gets swollen,red and itchy.

This condition called chill blen and if the condition does not improve the parts become blue due to reduced circulation,this condition is called frostbite.

If the condition does deteriorate further the parts be comes blue in colour and dry gangrene starts.It requires amputation of the part later on.

TREATMENT

1) Initially keeping the part warm by using warm socks or gloves

2) Use of hot bags, adequates warm clothings, blankets and quilts improve the condition.

     ANAPHYLAXIS 
Anaphylaxis is an allergic reaction of the body towards any foreign subStance.

It may be drug, due to food, inhaled allergens, bee stings etc. It is a hypersensitive reaction of the body towards any foreign protein resulting in low blood pressure difficulty in respiration and dyspnoea.

symptoms occur immediately or a few minutes after injection, a drug or nsect bite. Sometimes the anaphylactic reaction occurs within 1/2 hr. to 1 hr. 

after the drug is taken orally, but in case of injection or bee or wasp bite, the reaction occurs immediately. Commonly used agents causing anaphylactic reaction are

1) Drugs like Penicillin, Ampicillin, Amoxycillin, Tetracyclin and Sulfa drugs like Sulfonamides,Co trimoxazole

2) Non Steroidal Anti-inflammatory Injection and tablets e.g. Inj. voveron, Voveron labs

3) Injection of local Anaesthetics like lignocaine or xylocaine, Inj. BI, B6,B12, Inj. Triple Antigen

4) Radiographic agents of lodine contents

5) Venoms of bee, wasp, jelly fish etc.

6) Hormones - Inj. Insulin

7) Various types of pollens and allergens

8) Sea fish and prawns

9) Eggs and milk

ANAPHYLACTIC REACTIONS AND ITS TREATMENT

Such reactions are life threatening and of serious nature and immediate treatment should be started.

-Avil or any anti allergic tablet to be given.

-Rush immediately to doctor or PHC

Foreign body in the airway (Trachea)

It is very common in children and sometimes in infants. Children put various small objects in the mouth like coins, electrical parts, the toys parts small nuts or seeds of plants in the mouth. 

A fit of cough or sneezing and the foreign body goes in to the respiratory tract and giving rise to amedical 

emergency with the sudden onset of respiratory distress, coughing and producing hissing sound along with inspiration.

lf foreign body is suspected and if the child is small, hold the child by the leg in the air and head below and pat at the back. In 90% of the cases, the foreign body will come out.

If the child is bigger and if he cannot be held by the leg then hold the child in prone position with the head down on the hand of the first aider lower than the chest and thump at the back or chest thrust is made when the child is lying on the back on the hand of the first aider, head lower than the body.

The Heimlich's Manuver.

This manuver is applied with bigger children. The steps in this maneuver are as follows:-

1.Stand behind the patient and put your arms below the axillae (armpit),encircle the abdomen below the navel

2.Both the hands should join together and clasp it with the other hand below the xiphoid sternum.

3.Be careful that your hand should not touch the xiphoid otherwise damage of internal organs will occur.

4.Press both fist on the abdomen with a quick upward thrust in the midline upto five to six thrusts will be enough.

If the patient fails to respond to these maneuver, send the patient to the hospital for removal of foreign body through a laryngoscope

RABIES/DOG BITE

All unprovoked bites should be considered as rabies.
Rabies comes from bite of rabid animals like dog, cat, wolf, jackal, monkey,bat etc.

Signs:

1 In the animal

* Acts strangely - restless and irritable

* May go wild

» Foaming at mouth - cannot eat/drink

» Usually dies within 10 days.

2.In people:

» Alert nervous and irritable

* Difficulty in swallowing - thick saliva

* Afraid of drinking water - Hydrophobia

» Convulsion (fits) paralysis and death (Al Patients suffering from rabies will die)

AVOID CONTACT WITH SALIVA,URINE,SWEAT OF THE VICTIM,MILK OF ANIMALS,AS THESE SECRETIONS ARE INFECTIOUS.DO NOT GIVE MOUTH TO MOUTH BREATHING.

 

If a person is bitten by an animal suspected to have rabies then

» Tie / cage the animal for 15 days

» Wash the bitten area with soap and jet of water and hydrogen per oxide or potassium per magnate solution, if available.

» Keep it open.

» Do no stich

» After cleaning the area put few drops of carbolic acid/spirit/tinture iodine/KMNO4

»If the bite is on head/neckf or if the animal dies before 15 days or is killed or cannot be traced -take the victim to the nearest medical center for anti rabies injection, tetanus toxoid, antibiotics, if required other wise within 24 hrs takeri the victim to the doctor for treatment.

EAR ACHE

» Pain in the ear can be because of:-

Infection of ear canal,

Sign and symptoms- Pain when you puill outer ear, itching, redness of ear canal, reduced hearing if the ear is blocked

Treament - mix one teaspoon full of vinegar (sirka) mixed with one tea-spoon of boiled water. Put 3 to 4 drops, 3 to 4 times in a day.

-For pain give paracetamol.

-If person gets fever or pus discharge, seek medical help

-For wax use warm mustard oil/coconut oil.Do not use boro glycerine

Infection of middle ear

II. Common in children after common cold or stuffy nose

Sign & symptoms- fever, pain, (the child is always crying and rubbing the ear), pus discharge from the ear

Treatment - early medical treatment is important else it may cause permanent deafness or meningitis.

Prevention - Do not bottle feed the baby while lying flat on his back as the milk can go upto his nose into the ear and cause ear infection.

Teach the children to wipe and not to blow the nose when they have cold

Foreign bodies in ear

Sign & symptoms - Small objects like grain, beads, or insects can easily go inside the ear causing pain and reduced hearing

Treatment- Pull the outer ear outward and upward to straightened the ear canal, lower the ear and shake the child head.This will help the small objects to fall out.

-In case of insects, showing light sometimes helps the insect to walk out. Drop warm coconut /mustard  oil in the ear. This would kill the insect and it might flow out

-Hardened ear waxed is a common cause of pain and blockage of ear.

Prevention-never use any sharp or pointed object to clear the ear. Seek medical help.

-Refer to patient to PHC/Hospital if not improved.

BLEEDING FROM A WOUND

* Raise the injured part

*With clean cloth apply direct pressure on the wound to stop bleeding

*lf bleeding does not stop-

-Tie a constriction bandage- with a clothbelt, tie the arm/leg close & above the wound, between the wound and the bodY.

- Keep the wound as high as possible.

- Do not make it so tight that the arm/leg become blue

- Don't use wire/string/thin rope

- Losen the tie for a few seconds after few half and hour to check for bleeding. Generally the bleeding stops between 2 to 5 minutes. Keeping it tight for too long can damage the limb.

Do not use cow dung/dirt etc. to stop bleeding.

NOSE ACHE

Foreign bodies: Children sometimes get small object and food particles like chana/dal inserted in the nose.

Sign & Symptoms- Foreign bodies cause whitish mucus discharge from the nose. Later it may become yellowish or foul smelling when it gets infected.

Treatment:

*In older children- ask the child to blow the nose or make him sneeze,

*If the object is deep or if the child is very young - seek medical help and refer to hospitalPHC

 

Nose Bleed:

- Common Causes are nose picking, trauma, high blood pressure etc.

- Treatment

* Stay calm

» Pinch the nose firmly for 10 min in the soft part

* Apply ice/cold water on the nose

* Pack the nostril with a gauze soaked in vaseline and pinch again firmly.

Steps to use ear drops

1.Tilt head sideways or lie on one side with the ear upward

2.Gently pull the lobe to expose the ear canal.

3.Apply the amount of drops prescribed by doctor.

4.Wait five minutes before turning to the other ear

Steps to use eye drops

1.Wash your hands with soap & water

2.Do not touch the dropper opening

3.Look upward

4.Pull the lower eyelid down to make a "gutter'

5.Bring the dropper as close to the 'gutter" as possible without touching it or the eye

6.Apply the prescribed amount of drops in the gutter'

7.Close the eye for two minutes. Do not shut the eye too tight

8.Excess fluid can be removed with a tissue.

9.If more than one kind of eye - drop is used with for at least five minutes before applying the next drops.

10.Eye -drops may cause a burning feeling but this should not last for more than few minutes. If it does last longer consult a doctor.

Points to remember while

giving eye -drops to children:

1.Let the child lie with head straight

2.The child's eyes should be closed

3.Drip the amount of drops prescribed into the corner ot the eye

4.Keep the head straight

5.Remove the excess fluid

Giving nasal drops to children

1.Blow the nose

2.Sit down and tilt head backward strongly or lie down with a pillow under the shoulders, keep head straight.

3.Insert the dropper one centimeter into the nostril.

INTERNAL HAEMARRAGE

(Internal heamorrhage is also called concealed heamarrage as the blood cannot be seen from outside and the bleeding occurs in internai organs like stomach, intestine, liver, spleen, kidney etc.) Sometimes the blood can be seen outside through stool, urine, vomiting and uterine discharges.

When ever an internal hemorrhage is suspected the following signs and symptoms are searched.

1.Pallor or paie coiour as if the blood is drained out.

2.Cold sweaty skin

3.Severe thirsi

4.Giddiness or faintness

5.Restiessness

6 Quick and weak pulse

7 The breathing is allowed and accompanied by yawning

8. Aii hunger or long, d-awn inspiration

9 Unconsciousness

Causes : Injury in the abdomen, Peptic ulcer, Malena, (black stool) Kidney stone etc.

Treatment:- Allow the patıent to lie down, the foot end may be raised so that more blood is available to the vital organs like heart, lungs and liver etc.

Reassure the patient and give some tea or hotmilk only to the patients who are not suffering from G.l. tract haamarrage.

BANDAGES

Bandages may be of two types

1.Roller Bandage

2.Triangular Bandage

A Triangular bandage is made of cloth of one meter square. (show a triangular bandage) cut in to two pieces and hemmed. While tying, the ends are tie wih a reef knot. (show Reef knot) which does not slip. 

A granny knot slips. A triangular bandage may be used as head bandage or can be used as a sling.

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Milan Tomic

Hi. I’m Designer of Blog Magic. I’m CEO/Founder of ThemeXpose. I’m Creative Art Director, Web Designer, UI/UX Designer, Interaction Designer, Industrial Designer, Web Developer, Business Enthusiast, StartUp Enthusiast, Speaker, Writer and Photographer. Inspired to make things looks better.

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