Basic First Aid

Chain of Survival

First Aid
-​ immediate care given to an injured or suddenly ill person
-​ DOES NOT take the place of proper medical treatment
-​ legal consideration
-​ implied consent involves an unresponsive victim in a life threatening condition
-​ it is assumed or “implied” that an unresponsive victim would consent to lifesaving
help
-​ only perform first aid assistance for which you have been trained

Scene Survey
-​ when confronted with an accident or illness on duty, it is important to assess the situation
to determine what kind of emergency situation you are dealing with, for your safety, the
victim’s safety and that of others
-​ do a quick survey of the scene that includes looking for 3 elements:
-​ hazards that could be dangerous to you, the victim or bystanders
-​ the cause (mechanism) of the injury or illness
-​ the number of victims

Goal of Initial Assessment

-​ visually determine whether there are life-threatening or other serious problems that
require quick care
-​ breathing
-​ bleeding
-​ shock
-​ burn
-​ choking
-​ heart attack
 -​ fractures
-​ determine if the victim is conscious by tap and shout. check for C-A-B as indicated
-​ C = circulation? check for signs of circulation
-​ A = airway open? head tilt/chin lift
-​ B = breathing? look, listen and feel

Assessment Sequence Components

-​ if the victim is responsive
-​ ask them what injuries or difficulties they are experiencing
-​ check and provide first aid for these complaints as well as others that may be
involved
-​ if the victim is not responsive (unconscious or incoherent)
-​ observe for obvious signs of injury or illness
-​ check from head to toe
-​ provide first aid/CPR for injuries or illness observed

Control Methods for External Bleeding

-​ direct pressure stops most bleeding
-​ wear medical exam gloves (if possible)
-​ place a sterile gauze pad
-​ elevation injured part to help reduce blood flow
-​ combine with direct pressure over the wound (this will allow you to attend to other
injuries or victims)
-​ if bleeding continues, apply pressure at a pressure point to slow blood flow
-​ pressure point locations: brachial (top of elbow), femoral (inside upper thigh)
Bleeding Control

Control Methods
-​ signs of internal bleeding:
-​ bruises or contusions of the skin
-​ painful, tender, rigid, bruised abdomen
-​ vomiting or coughing up blood
-​ stools that are black or contain bright red blood
-​ what to do:
-​ for severe internal bleeding, follow these steps:
-​ monitor ABC’s (Airway Breathing Circulation)
-​ keep the victim lying on his/her left side *this will help prevent expulsion of
vomit from stomach or allow the vomit to drain and also prevent the victim
from inhaling vomit*
-​ treat for shock by raising the victim’s legs 8 to 12 inches
 -​ seek medical attention

Elevate the limb which is bleeding

Shock
-​ refers to circulatory system failure that happens when insufficient amounts of
oxygenated blood is provided for every body part
-​ this can be a result of:
-​ loss of blood due to uncontrolled bleeding or other circulatory system problem
-​ loss of fluid due to dehydration or excessive sweating
-​ trauma (injury)
-​ occurrence of an extreme emotional event
-​ what to look for:
-​ altered mental status (anxiety and restlessness)
-​ pale, cold and clammy skin, lips and nail beds
-​ nausea and vomiting
-​ rapid breathing and pulse
-​ unresponsiveness when shock is severe
-​ what to do:
-​ after first treating life threatening injuries such as breathing or bleeding, the
following procedures shall be performed:
-​ lay the victim on his or her back
-​ raise the victim’s legs 8 to 12 inches to allow the blood to drain from the
legs back to the heart
-​ prevent body heat loss by putting blankets and coats under and over the
victim

Burns
-​ described as:
-​ first degree burns (superficial)
-​ only the skin’s outer layer (epidermis) is damaged
-​ symptoms include redness, mild swelling, tenderness and pain
-​ usually heals without scarring
-​ what to do:
-​ immerse in cold water 10 to 45 minutes or use cold, wet cloths
-​ cold stops burn progression
-​ may use other liquids
-​ aloe, moisturizer lotion
-​ second degree burns (partial thickness)
-​ epidermis and upper regions of dermis are damaged
-​ symptoms include blisters, swelling, weeping of fluids and severe pain
-​ what to do:
-​ immerse in cold water/wet pack
-​ aspirin or ibuprofen
 -​ do not break blisters
-​ may seek medical attention
-​ third degree burns (full thickness)
-​ severe burns that penetrate all the skin layers into the underlying fat and
muscle
-​ symptoms include the burned area appears gray white, cherry red or
black; there is no initial edema or pain (since nerve endings are
destroyed)
-​ what to do:
-​ usually not necessary to apply cold to areas of third degree
-​ do not apply ointments
-​ apply sterile, non stick dressings (do not use plastic)
-​ check for ABC’s
-​ treat for shock
-​ get medical help
-​ burn injuries can be classified as follow:
-​ thermal (heat) burns
-​ caused by: flames, hot objects, flammable vapor that ignites,
steam or hot liquid
-​ what to do:
-​ stop the burning – remove victim from burn source
-​ if open flame, smother with blanket, coat or similar item or
have the victim roll on ground
-​ determine the depth (degree) of the burn
-​ chemical burns
-​ the result of a caustic or corrosive substance touching the skin
-​ caused by: acids (batteries), alkalis (drain cleaners often more
extensive, organic compounds (oil products)
-​ what to do:
-​ remove the chemical by flushing the area with water
-​ brush dry powder chemicals from the skin before
flushing
-​ take precautions to protect yourself from exposure
to the chemical
-​ remove the victim’s contaminated clothing and jewelry
while flushing with water
-​ flush for 20 minutes all chemical burns (skin, eyes)
-​ cover the burned area with a dry, sterile dressing
-​ seek medical attention
-​ electrical burns
-​ a mild electrical shock can cause serious internal injuries
-​ 3 types of electrical injuries
-​ thermal burn (flame)
 -​ objects in direct contact with the skin are ignited by
an electrical current
-​ mostly caused by the flames produced by the
electrical current or arc
-​ arc burn (flash)
-​ occurs when electricity jumps or arcs from one spot
to another
-​ mostly cause extensive superficial injuries
-​ true electrical injury (contact)
-​ occurs when an electric current truly passes
through the body
-​ what to do:
-​ make sure the scene is safe
-​ unplug, disconnect or turn off the power
-​ if that is impossible, call the power company or
EMS for help
-​ do not contact high voltage wires
-​ consider all wires live
-​ do not handle downed lines
-​ do not come in contact with person if the electrical
source is live
-​ check ABCs
-​ if the victim fell, check for spinal injury
-​ treat the victim for shock by elevating the legs 8 to
12 inches if no spinal injury is suspected
-​ seek medical attention immediately

Open Wounds
-​ a break in the skin’s surface that results in external bleeding and may allow bacteria to
enter the body that can cause infection

Abrasion
-​ the top layer of skin is removed with little or no blood loss
-​ scrape

Laceration
-​ a cut skin with jagged, irregular edges and caused by a forceful tearing

Incisions
-​ smooth edges and resemble a surgical or paper cut

Punctures
-​ deep, narrow wounds such as a stab wound from a nail or a knife in the skin and
underlying organs
Avulsions
-​ flap of skin is torn loose and is either hanging from the body or completely removed

Amputation
-​ cutting or tearing off a body part such as a finger, toe, hand, foot, arm or leg

What to do:
-​ wear gloves and expose wound
-​ control bleeding
-​ clean wounds
-​ to prevent infection
-​ wash shallow wound gently with soap and water
-​ wash from the center out/irrigate with water
-​ severe wound: clean only after bleeding has stopped

Wounds Care
-​ remove small objects that do not flush out by irrigation with sterile tweezers
-​ if bleeding restarts, apply direct pressure
-​ use roller bandages (or tape dressing to the body)
-​ keep dressings dry and clean
-​ change the dressing daily or more often if it gets wet or dirty

Signs of Wound Infection

-​ swelling and redness around the wound
-​ a sensation of warmth
-​ throbbing pain
-​ fever/chills
-​ swollen lymph nodes
-​ red streaks [tetanus (lock jaw) should receive injection in first 72 hours]

Dressings and Bandages

The Purpose of a Dressing is to:

-​ control bleeding
-​ prevent infection and contamination
-​ absorb and fluid drainage
-​ protect the wound from further injury

What to do:
-​ always wear gloves (if possible)
-​ use a dressing large enough to extend beyond the wound’s edges
-​ cover the dressing with bandages

Bandage can be used to:

-​ hold a dressing in place over an open wound
-​ apply direct pressure over a dressing to control bleeding
-​ prevent or reduce swelling
-​ provide support and stability for an extremity or joint
-​ bandage should be clean but need not be sterile