Emergency Room-First Aid

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Emergency Room

First Aid


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Definitions

It is the immediate action given to a personwho has been injured or suddenly taken illIt is the help that you can provide untilprofessional help takes over. It includes well

selected words of encouragement. Evidence of willingness to help and promotion of

confidence by demonstration of competence


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Ra tion ale

P eople should be trained to care properly for injuries to themselves and others at home, atwork, or in the community. Since even trivial

injuries are potentially serious, every oneshould know the proper steps to preventcomplications. The urgent needs for treatinglife threatening situations makes it the

responsibility of everyone to be able to giveproper emergency care until the victim istransported to a medical facility


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Thr ee B asic Objectives Of Fi rst Aid

k To alleviateSuffering

k To prolong Lifek

To prevent addedinjury or danger


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D uring An EmergencyRemain CalmUse Common SenseB e resourcefulKeep evaluating the RiskD o no further harm


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1. Control Of Bleeding H emorrhaging or Bleeding- is a flow from

an artery or vein or capillary Bleeding from an artery- an artery has been

severed when bright red blood spurts from a wound.The blood from the arteries comes directly fromthe heart and spurts out at each contraction.Having received a fresh supply of oxygen, the bloodsupply is red

Bleeding from a vein- when dark red blood flows froma wound in a steady stream, a vein has been cut.

The blood, having given up its oxygen and receivedcarbon dioxide and waste products in return is dark red

Bleeding from capillaries- B lood from capillaries ooze.There is usually no cause for alarm, relativelylittle blood is lost


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Pressure points- Arterial bleeding can becontrolled by digital pressure applied atpressure points. P ressure points are placesover a bone where arteries are close to theskin

T ourniquets- a tourniquet is a device used tocontrol severe bleeding. It is used as anabsolute last resort after all other methodshave failed


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P rocedu re Fo r App lica tion of

Tou rniquetW hile the proper pressure point is being held totemporarily control the bleeding, place thetourniquet between the heart and the wound, withsufficient uninjured flesh between the wound and

tourniquetIn using an improvised tourniquet, wrap the material

tightly around the limb twice and tie in a half knot onthe upper surface of the limb

Place a short stick to tighten the tourniquet only untilthe bleeding stops

Secure the stick in place with the base ends of thetourniquet, another strip of cloth or a suitable

material


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Tou rniquets


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PrecautionsD o not shield a tourniquet from viewMake a written note of the tourniquets location andthe time it was applied and attach a note to the

victims clothing. Alternatively, make a T on thevictims foreheadGet the victim to a medical Facility as soon aspossible

Once the tourniquet is tightened. It should not bedislodge, clots and result in sufficient loss of bloodto cause a severe shock or death


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I nternal Bleeding

r internal bleeding in thechest or abdominal usuallyresults from hard blows or certain fractures. InternalBleeding is usually notvisible, but it can be veryserious, even fatal. Internalbleeding may bedetermined by any or all of the following signs andsymptoms


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Signs and Symptoms

P ain, tenderness ,swelling, or discoloration whereinjury is suspected

Abdominal rigidityand or musclespasmsB leeding from mouth,rectum or other natural bodyopenings


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S ymptoms of shock:D izziness, without other symptoms- dizzinesswhen going from lying to standing maybe the onlyearly sign of internal bleedingCold clammy skinEyes dull, vision clouded and pupils enlergedWeak and rapid pulseNusea and vomitingShallow and rapid breathing

ThirstWeak and helpless feelingCyanosis(late stage of shock)


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NosebleedsN osebleeds are

more often

annoying than lifethreatening. Theyare more commonduring coldweather, whenheated air dries outthe nasal passages.


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First aid for nosebleed is simple:

Keep the victim quietly seated, leaning forward if possibleGently pinched the nostrils closed Apply cold compress to the victims nose and faceIf the person is conscious, it maybe helpful to apply pressurebeneath the nostril above lipInstruct the victim not to blow his nose for several hours after the bleeding has stopped, or clots could be dislodged and startthe bleeding again


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SHO CK Is the failure of the cardiovascular system to provide enoughcirculation of blood to every part of the body. The collapse of the cardiovascular system maybe caused by any of theseconditions:

A. blood is lostVessel dilate and there

Is insufficient blood tofill them

The heart fails to actproperly as a pumpand circulate the blood


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Ca uses of S hock

Severe or extensive injuriesSevere painLoss of blood

Severe burnsElectrical shockCertain illnesses

Allergic reactionsP oisoning inhaled, ingested or injectedExposure to extremes of heat and coldEmotional stressSubstance abuse


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Fi rst Aid Tr ea tment fo r Shock

Keep the victim lying down if possible.- make sure that head isat the level with the body, Elevate lower extremities if the injurywill not be aggravated and there are no abdominal or headinjuries

P rovide the victim with plenty of fresh air Loosen any tight clothing in order to make the breathing andcirculation easier Handle the victim as gently as possible and minimizemovement

Keep the victim warm and dry by wrapping in blankets, clothingor any material availableD o not give the victim anything by mouthThe victims emotional well being is just as important as his /her physical well being. Keep calm and reassure the victim


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An a p hy lactic S hock

Is a sensitivity reactionIt occurs when a person contacts something towhich he/she is extremely allergic. P eople whoare subjected to anaphylactic shock shouldcarry emergency medical identification at alltimes


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Signs and S ymptoms of An a p hy lactic

Sh

ock Itching or burning SkinHives covering large areasSwelling of the tongue and faceSevere difficulty of breathingTightening or pain in the chestWeak pulseD

izzinessConvulsionComa


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Signs and S ymptoms

x Victim may feel weak and dizzy, and may see spotsx Face becomes pale and the lips blue in both light

and dark skinned peoplex The forehead is covered with cold perspirationx The pulse is rapid and weakx The breathing is shallow


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First Aid for Fainting

If the person feels faint, the initial response mightbe sitting with the head between the kneesHave the victim lie down with the head lower than

the feetIf the victim is unconscious for any length of time,something may be seriously wrong. Arrange for transportation to a medical facility

Treat the victim for physical shockMaintain an open airwayD o not give stimulants


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Cla ssific a tion of Wounds

A brasions- caused by rubbing or scraping. These woundsare seldom deep, but a portion of the skin has beendamaged, leaving a raw surface with minor bleeding. Thebleeding in most abrasions is from the capillaries.

Abrasions are easily infected due to the top layer of skin is

being removed leaving the underlying skin exposedA mputations- involves the extremities. When anamputati ons occurs, the fingers, toes, hands, feet, or limbsare completely cut through or torn off which causes jaggedskin and exposed bones. B leeding may be excessive or theforce that amputates a limb may close off or torn vesselslimiting the amount of bleeding. A clean cut amputationseals off vessels and minimizes bleeding. A tornamputations usually bleeds heavily


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A brasions


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Avu lsionsIs an injury that tears a whole piece of skin andtissue loose or leaves it hanging as a flap. Thistype of wound usually results when tissue is

forcibly separated or torn from the victims body.There is a great danger of infection and bleeding.B ody parts that have been wholly or partly torn off may sometimes be successfully reattached by asurgeon


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IncisionsWounds produced by a sharp cutting edge, suchas knife or razor, are referred to as incisedwounds, the edges of the wounds are smooth

without bruising or tearing.If such wound isdeep, large blood vessels and nerves maybe

severed


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L ace ra tions

Are those wounds made by rough edges, the fleshhas been torn or mashed by blunt instruments,machinery, or rough edges such as jagged piece of

metal.B

ecause the blood vessel are torn or mashed, these wounds may not bleed as freely asincised wounds. The ragged and torn tissues withthe foreign matter that is often or ground into thewound make it difficult to determine the extend of the damage. The danger of infection is great inlacerations.


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P unctu res Are wounds produced by pointed objects such asneedles, splinters, nails, or pieces of wire passingthrough the skin and damaging tissues in its path.The small number of blood vessels cut sometimesprevents free bleeding. The danger of infection inpuncture wounds is great due to this poor drainage.There are two types of puncture wounds (a)penetrating wound causes injured tissues. (b)

perforating puncture wound has entrance and exitwound. The object causing the injury passesthrough the body and out to create and exit wound,which in many cases is more serious than theentrance wound


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G ene ral Fi rst Aid fo r open wounds

Carefully cut or tear the clothing so that the injury maybe seenIf loose foreign particles are around the wound, wipe them awaywith clean material. Always wipe away from wound not toward itD o not attempt to remove an object impaled in the wound.

Serious bleeding and other damage may occur if the object isremoved. Stabilized the object with a bulky dressingD o not touch the wound with your hands, clothing, or anythingthat is not cleanP lace a sterile bandage compress or gauze over the wound and

tie in place


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All dressing should be wide enough to completely cover thewound and the area around itP rotect compresses, or gauze dressing with a cover bandage

made from a cravat or triangular bandage.P

lace outer dressings in all open wounds except for eyes, nose, chin,finger and toe, or compound fractures of the hand and footwhen splints are appliedUnless otherwise specified, tie the knots of the bandage

compress and outer dressings over the wound on top[ of thecompress pad to help in checking the bleedingKeep the victim quiet and lying still. Any movement willincrease circulation which could restart bleedingReassure the victim to ease emotional reactionTreat for shock


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Dressings and Bandages


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D ressings and B and ages1 . Bandage compress- is a special dressing to cover

open wounds. It consists of a pad made of severalthickness of gauze attach to the middle strip of gauze. P ad ranges from 1-4 inches. B andagecompresses usually come folded so that the gauzepad can be applied directly to the open wound withvirtually no exposure to the air or fingers


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A dhesive compress- is a self adhering bandage that hasgauze to cover the wound and a sticky backing which holdsthe victims skin

T riangular bandage- a standard triangular bandage is madefrom a piece cloth approximately 40 inches square by foldingthe square diagonally and cutting along the fold. It is easilyapplied and can be handled so that part to be applied over awound or burn dressings will not be soiled. A triangular bandage does not tend to slip off once it is correctly applied. Itis usually made from unbleached cotton cloth although anykind of cloth will do . The triangular bandage is also used tomake improvised tourniquets, to support fractures anddislocations, to apply splints and to form slings


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C ravat Bandage- a triangular bandage

maybe used open or folded. When it isfolded, it is known as cravat. A cravatbandage is prepared as follows.

Make a 1 inch fold along the base of the triangular

bandage.B ring the point (apex) to the center of the foldedbase, placing the point underneath the fold, tomake a wide cravat bandage

A medium cravat is made by folding lengthwisealong a line midway between the base and thenew top of bandage

A narrow cravat is made if folding is repeated


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Slings Are used to support injuries of the shoulder, upper extremities or ribs. In a emergency they maybeimprovised from belts , neckties, scarves or similar

articles.B

andages should be used if available


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Ty pes of S lings

Triangular bandage Sling- tie a triangular bandage as followsP ace one end of the base of an open triangular bandage over the shoulder of the injured side

Allow the bandage to hang down in front of the chest so that theapex will be behind the elbow and the injured armB end the arm at the elbow with hand slightly elevated (4-5inches)B ring the forearm cross the chest and over the bandageCarry the lower end of the bandage over the shoulder on theuninjured side of the neckTwist the apex of the bandage, and tuck it in at the elbowThe hand should be supported with the fingertips exposedwhenever possible, to permit the detection of interference withcirculation


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2 . Cra v a t B and age S ling

Tie a cravat Sling as FollowsP ace one end over the shoulder of the injuredside

Allow the bandage to hang down in front of thechestB end the arm at the elbow with hand slightlyelevated 4-5 inchesB ring the forearm across the chest and over thebandageCarry the lower end of the bandage over theinjured arm to the shoulder on the uninjured sideand tie at the uninjured side of the neck


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Basket S ling

Useful sling for transporting or handling a victimwith a suspected neck injury or an unconsciousvictim whose arms may create difficulties, can be

made with open triangular bandage as followsP lace an open triangular bandage across the chest withthe apex downFold the arms over one another on the bandageB ring ends together and tieCross the apex over folded arms and tie to the knottedends of the base


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P rincip les of B and aging P rincip les of Band aging

B andage wound snugly but not to tightly, for tight bandage may damage surroundingtissues or interfere with the blood supplyspecially if swelling occurs, a bandage tighttoo loosely may slip off the woundIn bandaging the arms and the legs, leave

the tips of the fingers or toes uncoveredwhere possible, so any interference withcirculation can be detected


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P rincip les of B and aging P rincip les of Band aging

If the victim complains that the bandage is too tight,loosen it and make it comfortable but snug. Unlessotherwise specified. All knots should be tight over

open wounds to help control bleedingIf bandages become saturated with blood, applyadditional bandages or dressing. D o not removeoriginal dressing


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Burns and Scalds

Classified according to extend and damage:

F irst Degree Burn (minor)- the burned area is painfulS econd degree burn (moderate )- the burned area ispainful, the under skin is affected, blisters may form. Theaffected area may be wet, shinny appearance because of exposed tissue

T hird degree burns (critical )- insensitive due to thedestruction of nerve endings. Skin is destroyed; muscletissue and bone underneath maybe damaged. The area maybe charred, white or grayish in color


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Cla ssific a tion acco rding to Ca use

Chemical B urnsThermal B urnsElectrical B urnsRadiation B urns


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First Aid for Burn and Scalds

Should primarily be exclusion of air from the burntarea, relief of pain that immediately follows burns,minimizing the onset of shock, and the preventionof infectionRemove all clothing from the injured area, but cutaround any clothing that adheres to the skin andleave it in place. Keep the patient covered, exceptthe injured part, since there is tendency to chill

First aid dressing for burns and scalds should befree of grease or oil. The use of oils in thetreatment for burn makes it necessary tocleansed the burned or scalded areas with asolvent before medical treatment can begin. Thisdelays the medical treatment and can and is verypainful


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First Aid for Burn and Scalds

B e careful when dressing burns and scalds. B urned andscalded surfaces are subject to infection the same as openwounds and require the same care to prevent infection. D o notbreak blisters intentionally

Never permit burned surfaces to be in contact with each other such as areas between the fingers and the toesCover bandages should be loose enough to prevent pressureon the burned surfaces. As swelling often takes place after burn dressing have been applied, check them frequently tosee that they are not too tight. Watch for evident of shock andtreat if it is present


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First Aid for Chemical Burns

Remove all clothing containing chemical agentD o not use any neutralizing solution, unless recommended bya physicianIrrigate with water for at least 15 minutes, use potable water if possibleTreat for shockTransport to a medical FacilityFirst aid for dry, chemical( alkali) burns is exception to thegeneral first aid for chemical burns because mixing water withdry alkali creates corrosive substance. The dry alkali should be

brushed from the skin and water should then be used in a verylarge amounts


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First Aid For Thermal Burns (Minor)

Use cool, moist application of gauze or bandagematerials to minimize blisteringTreat for shock

If the victim has thermal burns on the eyelids, applymoist, sterile gauze pads to both eyes and securein place


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Fi rst Aid Fo r Th erm al Bu rns(Mode ra te and Critic al)

D o not use cold applications on extensive burns,cold could result in chillingCover the burn with a clean, dry dressing

Treat for shockTransport to a medical Facility


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First A id for E lectrical BurnsS C onduct a primary survey, as cardiac and

respiratory arrest can occur in cases of electricalburns

S C heck for points of entry and exit of currentS C over burned surfaces with a clean dressing

S Splint all fractures (violent muscle contractionscaused by the electricity may result in fractures)S Treat for physical shockS Transport to a medical facilityS Respiratory failure and cardiac arrest are the

major problems caused by electrical shock andnot the burn


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Fi rst a id fo r Ra di a tion Bu rns

Radiation presents a hazard to the rescuer aswell as the victim. As a rescuer who mustenter a radioactive area should stay for asshort time as possible. Radiation isundetectable by the human senses and therescuer, while attempting to aid the victim,may receive a fatal dose of radiation withoutrealizing it. Notify experts immediately of possible radioactive materials contamination


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Cardio Pulmonary Resuscitation


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First aid person prerequisites

Always remember that you are not a doctor youare only providing temporary support untilprofessional medical assistance is available.

The purposes of first aid areto save life,prevent further injuryto minimize or prevent infection.

Fast reflection and reaction.Fast changing in way of thinking.Very calm in the bad situation.


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CHAIN OF LIFE


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PULSE SITES

AD ULTCAROT ID IN NECKRADI AL IN WR IST

CH ILDCAROT ID IN NECKB RACH I AL IN ARM

INFANT

-B RACH I AL IN ARMFEMORAL IN GRO IN


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Recovery Position


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Emergency Room-First Aid

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