PRACTICAL-4, Preparation of First aid Kit and Dealing with Different Emergency Situations

 

Meaning:

First Aid is the immediate medical assistance given to an injured person, within the available resources before getting to a qualified medical help.

First Aid is the provision of initial care for an illness or injury. It generally consists of a series of simple and in some cases, potentially life-saving techniques that an individual can be trained to perform with minimal equipment.

 “Help given to a sick or injured person until full  medical treatment  is available”

 

How to Prepare a First Aid Kit

Stock

A well-stocked first aid kit allows you to respond quickly and effectively to emergencies. It should include supplies to treat a variety of injuries, including cuts, scrapes, sprains, and minor burns.

What should be in a basic first aid kit?

The first step in caring for a cut, scrape, or other wound is making sure it is clean. To help you with this, your first aid kit should include:

• ·         Disposable medical gloves.
• ·         Antiseptic cleanser or antiseptic wipes
• ·         Hand sanitizer
• ·         Antibiotic ointment to apply once the cut has been thoroughly cleaned
• ·         Bulb suction device for flushing wounds
• ·         Plasters in a variety of different sizes and shapes
• ·         Small, medium and large sterile gauze dressings
• ·         At least 2 sterile eye dressings
• ·         Triangular bandages
• ·         Crêpe rolled bandages
• ·         Safety pins
• ·         Disposable sterile gloves
• ·         Tweezers
• ·         Scissors
• ·         Alcohol-free cleansing wipes
• ·         Sticky tape
• ·         Thermometer (preferably digital)
• ·         Skin rash cream, such as hydrocortisone or calendula
• ·         Cream or spray to relieve insect bites and stings
• ·         Antiseptic cream
• ·         Painkillers such as paracetamol (or infant paracetamol for children), aspirin (not to be given to children under 16), or ibuprofen
• ·         Cough medicine
• ·         Antihistamine cream or tablets
• ·         Distilled water for cleaning wounds
• ·         Eye wash and eye bath
• ·         It may also be useful to keep a basic first aid manual or instruction booklet with your first aid kit.
• ·         Medicines should be checked regularly to make sure they're within their use-by dates.

All first aid kits should have a variety of supplies to cover cuts and scrapes, including:

• ·         Bandage strips in a range of sizes
• ·         Butterfly bandages, used for pressing cuts together to help promote healing
• ·         Non-stick gauze pads and rolled gauze
• ·         Adhesive tape
• ·         Wrap bandages that can be used to hold gauze in place or support sprains

There are several topical treatments you can include, such as:

• ·         Petroleum jelly to protect minor cuts or dry, cracked skin
• ·         Aloe vera gel for minor burns
• ·         Calamine lotion or hydrocortisone cream for the itch from bug bites or poison ivy

 

In addition to those basics, many first aid kits include:

• ·         First aid manual
• ·         Eye shield or pad
• ·         Finger splint
• ·         Safety pins
• ·         Scissors
• ·         Tweezers
• ·         Cotton balls and cotton-tipped swabs
• ·         Instant cold packs or plastic bags for making an ice pack
• ·         Eyewash solution
• ·         Medical face masks
• ·         A flashlight
• ·         Sunscreen
• ·         Insect repellent
• ·         Anti-diarrhea medication
• ·         Pain relievers, such as acetaminophen (Tylenol, others), ibuprofen (Advil, Motrin IB, others), and aspirin. (Warning: Never give aspirin to children.)
• ·         Cough and cold medications
• ·         Thermometer
• ·         Syringe, medicine cup, or spoon

It is also helpful for first aid kits to include emergency information. This can include:

·         Emergency numbers for your family doctor, local EMS, poison control, roadside assistance, and emergency contact names with contact information

·         Medical history for each family member that includes past and current medical conditions, current prescription medications, precautions, and known allergies.

Customizing first aid kits

The elderly

·         As people get older, their skin thins and can break or tear easily. First aid kits for the elderly should reflect this, as bandages that stick to skin can cause tears.

·         First aid scissors - Unlike household scissors, these are strong enough to cut through clothing but have a blunt side so they won’t cut the skin.

·         Self-adhering bandages- These don’t have absorbent qualities so when they are used to cover a wound, they should be paired with non-stick gauze. They are similar to elastic wrap bandages but don’t need clips to keep them closed. They can be wrapped around an arm or leg to hold non-stick gauze in place. They can also be used for compression.

·         Transparent film dressings- Resembling plastic wrap, they allow you to see how healing is progressing.

·         Paper tape-It can be easier to use than adhesive tape and may not tear the skin as easily as other medical tapes.

·         Roller gauze- This allows you to wrap a wound rather than using tape to hold the gauze in place. You can use the roller gauze and then cover with self-adhering bandages to eliminate any portion of the bandage sticking to the skin. Keep in mind that gauze bandages may still stick to wounds that are oozing or bleeding.

THE AIMS OF FIRST AID

Broadly, there are three main aims when administering first aid (3 Ps):

•     Preserve life

•     Prevent worsening of the condition (if possible)/Prevent further injury

•     Promote speedy recovery

For example, applying a plaster is preventing the condition (a cut) from worsening by stopping infection!

These aims are known as the ‘three Ps’

Give clear, precise information about

●    The location of the incident

●    The number of casualties/people involved

●    The nature of their injuries

●    In some cases, their age

●    Any hazards at the incident (e.g: spilt fuel, fire, electricity)

•     Remove the victim from the accident spot

•     Check vital parameters

•     Seek help from others if trained in first aid

•     Ensure that police and ambulance have been informed.

•     Ensure personal safety.

•     Assess the Situation

•     Safety of yourself & the casualty.

•     Assess the casualty

•     Treat the Casualty

•     Arrange removal of casualty to the hospital or safe area.

•     Write a Report / communicate the status.

•     Observer

•     Listen

•     Feel

•     Talk

•     Touch

•     Build Trust

ROLES OF A FIRST AIDER

•     Manage the incident and ensure the continuing safety of themselves, bystanders and the casualty

•     Assess casualties and find out the nature & cause of their injuries

•     Arrange for further medical help or other emergency services to attend (e.g: the fire service)

•     If trained, prioritize casualties based upon medical need

•     Provide appropriate first aid treatment as trained

•     If able, make notes/observations of casualties

•     Fill out any paperwork as required

•     Provide a handover when further medical help arrives

INITIAL ASSESSMENT OF THE SCENE

The goal of the initial assessment: Visually determine whether there are life-threatening or other serious problems that require quick care.

•     Breathing

•     Burn

•     Heart Attack

•     Bleeding

•     Choking

•     Fractures

•     Shock

VICTIM ASSESSMENT SEQUENCE

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)

•     Observe for obvious signs of injury or illness:

•     Check from head to toe

•     Provide first aid/CPR for injuries or illness observed.

 

FIRST AID FOR MINOR WOUNDS

•     Wear gloves if available

•     Clean the wound thoroughly with antiseptic wipes or solution

•     Do not remove any embedded objects (e.g: glass or any sharp particle)

•     Seek medical advice

•     Cover the wound using a clean dressing (plaster, non-adherent pad, etc.)

•     Seek medical advice if there are any signs of infection – redness, swelling or the area is warm to the touch

REMEMBER: PEEP

PEEP is a way of remembering what to do if someone is bleeding.

P: Position the casualty in a position of rest E: Elevate above the level of the heart

E: Expose & examine the wound P: Pressure. Apply direct pressure.

DRESSINGS AND BANDAGES

•     The purpose of a dressing is to:

–    Control bleeding

–    Prevent infection and contamination

–    Absorb blood 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.

FIRST AID IN BLEEDING

•     Control Methods for External Bleeding:

–    Direct pressure stops most bleeding.

•     Wear gloves (if possible)

•     Place a gauze pad or a clean cloth over wound

–    Elevating injured part to help reduce blood flow.

•     Combine with direct pressure over the wound (this will allow you to attend to other injuries of 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)

FIRST AID FOR SHOCK

Shock is a medical emergency which can be caused by severe blood loss. The casualty does not receive enough oxygen due to the loss of blood

Signs & symptoms include:

●    Pale clammy skin

●    Drowsiness

●    Thirst

●    Confusion

●    Nausea & vomiting

•     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” – 12”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-Cover them with a blanket

•     Call for emergency help if you haven’t already done so.

FIRST AID IN SPINAL INJURIES

CHECKING FOR SPINAL INJURIES

–    What to Look For

•     General signs & symptoms

–Painful movement of the arms or legs

–Numbness, tingling, weakness, or burning sensation in the arms or legs

–Loss of bowel or bladder control

–Paralysis of the arms or legs

–Deformity (odd-looking angle of the victim’s head & neck

•     What to Do:

–    Stabilize the victim against any movement.

–    Check ABCs. (Airway Breathing Circulation)

•     Unresponsive Victim:

–    Look for cuts, bruise, and deformities.

–    Test response by pinching the victim’s hand, and bare foot.

•     If no reaction, assume the victim may have spinal damage.

•     Responsive Victim

–    Upper Extremity Checks:

•     Victim wiggles fingers.

•     Victim feels rescuer squeeze fingers.

•     Victim squeeze rescuer’s hand.

–    Lower Extremity Checks:

•     Victim wiggles toes.

•     Victim feels rescuer squeezes toes.

•     Victim pushes foot against rescuer’s hand.

FIRST AID FOR BURNS

•     Burns have been described as:

–    First-degree burns (Superficial)

•     What to Do:

–    Immerse in cold water 10 to 45 minutes or use cold, wet cloths.

 Cold stops burn progression

May use other liquids

–    Moisturizer lotion

•     Second-degree burns (Partial Thickness)

–    What to Do:

•     Immerse in cold water /           wet pack

•     Do not break blisters

•     May seek medical attention

•     Third-degree burns (Full Thickness)

–    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 ABC’s

•     Treat for shock

•     Get medical help

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 burns (skin, eyes)

–    Cover the burned area with a dry, sterile dressing

–    Seek medical attention

•     Electrical Burns

–    There are three 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 and not by the passage of 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. (Airway Breathing Circulation)

–    If the victim fell, check for a spinal injury.

–    Treat the victim for shock by elevating the legs 8” – 12” if no spinal injury is suspected.

–    Seek medical attention immediately.

WHAT NOT DO TO

>    Do not try to remove clothing sticking to a burn, instead of cool through the clothing

   Do not apply toothpaste/butter/creams to a burn.

   Running water is the most effective cooling method.

>    Do not burst any blisters

>    Do not stop cooling before 10 minutes is up!

FIRST AID IN CHOKING

–    Obstruction in the airway.

•     General Precaution

–    If someone is coughing, leave the person alone.

–    Keep eyes on that person.

–    Ask the person if he/she needs help.

•     Signs and Symptoms

–    Person is not able to breath or talk due to obstruction, choking sign given, distressed, and panic.

–    Hands wrapped around the neck is universal sign for choking.

•     What to Do:

–    Perform Heimlich Maneuver if properly trained

•     Conscious Victim:

–    Approach from behind and wrap arms around the victim’s waist.

–    Place one fist just above the victim’s navel  thumb side against the abdomen.

–    Second hand over the fist.

–    Press into the victim’s abdomen with one upward thrust

–    Repeat thrust if necessary.

–    Try to pop the obstruction out with swift thrusts in and up.

–    Continue until the obstruction is relieved or victim collapses.

–    Have someone call for help.

Note: Always stay calm.

FIRST AID IN FRACTURES

       •    There are two categories of fractures:

–    Closed (Simple) fracture

•     The skin is intact and no wound exists anywhere near the fracture site.

–    Open (Compound) fracture

•     The skin over the fracture has been damaged or broken.

•     The wound may result from bone protruding through the skin.

•     The bone may not always be visible in the wound.

•     What to Look for:

–    General signs and Symptoms:

•     Tenderness to touch.

•     Swelling.

•     Deformities may occur when bones are broken, causing an abnormal shape.

•     Open wounds break the skin.

•     A grating sensation caused by broken bones rubbing together

–    can be felt and sometimes even heard.

–    Do not move the injured limb in an attempt to detect it.

•     Loss of use.

MANAGING A FRACTURE OR DISLOCATION

•     Control any bleeding and cover any wounds.

•     Ask patient to remain as still as possible.

•     Immobilize fracture:

–    use broad bandages (where possible) to prevent movement at joints above and below the fracture

–    support the limb, carefully passing bandages under the natural hollows of the body

–    place a padded splint along the injured limb

–    place padding between the splint and the natural contours of the body and secure firmly

–    for leg fracture, immobilize foot and ankle

–    check that bandages are not too tight (or too loose) every 15 minutes.

•     Watch for signs of circulation loss to hands and feet

•     Ensure an ambulance has been called

NOTES ON FIRST AID IN FRACTURE

•     Do not attempt to force a fracture or dislocation back into place – this could cause further injuries.

•     It can be difficult for a first aider to tell whether the injury is a fracture, dislocation, sprain, or strain. If in doubt, always treat the injury as a fracture.

•     If the collarbone is fractured, support arm on the injured side in a St John sling.

•     If you suspect the joint is dislocated, rest, elevate and apply ice to the joint.

•     DO NOT MOVE THE AREA UNWANTEDLY

 

FIRST AID IN BITES AND STINGS

      Insect stings and bites

–    What to Look For:

•     Check the sting site to see if a stinger and venom sac are embedded in the skin.

–    Bees are the only stinging insects that leave their stingers and venom sacs behind.

–    Scrape the stinger and venom sac away with a hard object such as a long fingernail, credit card, scissor edge, or knife blade.

•     Reactions generally localized pain, itching, and swelling.

•     Allergic reaction (anaphylaxis) occurs will be life-threatening.

•     Insect stings and bites Cont.

–    What to Do:

•     Ask the victim if he/she has had a reaction before.

•     Wash the sting site with soap and water to prevent infection.

•     Apply an ice pack over the sting site to slow absorption of the venom and relieve pain.

– Because bee venom is acidic, a paste made of baking soda and water can help.

•     Seek medical attention if necessary.

FIRST AID IN HEART ATTACK

•     Heart Attack – Usually that happens when one of the coronary arteries is blocked by an obstruction or a spasm.

–    Signs and symptoms of a heart attack include:

•     Pressure in chest, fullness, squeezing, or pain that lasts more than a few minutes or that goes away and comes back.

•     Pain spreading to the shoulders, or arms.

•     Chest discomfort with lightheadedness, fainting, sweating, nausea, shortness of breath.

HEART ATTACK

•     What Do:

–    Call Ambulance or get to the nearest hospital emergency department

–    Monitor victim’s condition.

–    Help the victim to the least painful position, usually sitting with legs up and bent at the knees.

•     Loosen clothing around the neck and midriff.

–    Determine if the victim is known to have coronary heart disease

–    If the victim is unresponsive, check ABCs and start CPR, if needed.

VIDEOS

1. https://youtu.be/lH3Th8KpA0w
2. https://youtu.be/bB6Rhcuec7M
3. https://youtu.be/Zhhld2yYyLQ
4. https://youtu.be/Zhhld2yYyLQ

PPT

Practical 4 Preparation of ... by Deepak Chhikara