First Aid Basics

1. First Aid Basics Dr. Uma B.M.

2. Definition: • Care given to an injured person to stabilize and keep him / her safe until he / she can receive professional medical attention.

3. General guidelines • Remain calm • Communicate a calm and supportive attitude to the ill and injured. • Never leave the injured unattended • Have someone else call the doctor and the child’s parent. • Do not move the injured. Do not allow him to walk • Bring help to the patient. • Other students who may congregate should be cleared

4. Emergencies dealt with • Wound (deep/extensive) • Bleeding (severe) • Head, neck, or back injury • Broken bone • Amputation • Allergic reactions • Breathing difficulty • Insect Bite • Dental Problems • Foreign bodies • Choking • Seizure • Unconsciousness • Burns (chemical, electrical, third degree) • Electrical shock • Poisoning • Drowning • Snake bite

5. First Aid • First aid is as easy as ABC – airway, breathing and Circulation In any situation, apply the DRSABCD Action Plan. • DRSABCD stands for • Danger • Response • Send for help • Airway • Breathing • Circulation • Defibrillation

6. Bruise • Bruise forms when a blow breaks blood vessels near your skin's surface, allowing a small amount of blood to leak into the tissues under the skin What you need to do: • If your skin isn't broken, you don't need a bandage, • Elevate the injured area. • Apply ice or a cold pack several times a day for a day or two after the injury. • Rest the bruised area, if possible. • Consider acetaminophen

7. CUTS/SUPERFICIAL ABRASION Treatment • Cleanse thoroughly with soap and water. Do not use hydrogen peroxide, alcohol, or other disinfectant. • Apply dry dressing (preferably sterile). • Determine individual's tetanus immunization status from school record.

8. Bleeding External or Internal External: • Stop the bleeding • Clean wound thoroughly • Apply an antibiotic • Cover the wound • Change the dressing. • Do not remove old dressing • Get stitches for deep wounds Internal Bleeding : Potentially life threatening

9. Head neck and back injury • Most common cause is fall during play • Most common symptom- Bleeding What should be done? Stop bleeding. If required get it sutured. Observe for signs of internal head injury • Vomiting • Drowsiness • Disorientation, confusion, memory loss, Loc • Bleeding from ears and/or nose, Marked swelling • Seizures • Severe headache

10. Head injury • Do not insert anything into the childs mouth • Control bleeding by applying direct pressure over the wound • Do not wash the wound if you suspect skull fractures • Small cuts on face may bleed excessively. Apply direct pressure with clean dressings • If dressings get soaked apply new one on the old. • Don’t remove old ones • If above signs absent, treat for headache

11. Treatment of Head injury • Keep the child lying and quiet • If unconsious and neck injury suspected, Support head & turn entire body to one side (log roll) • Do not turn head if neck injury is suspected • Loosen cloth around neck • Check for airway obstruction

12. Broken bones • Complaints of pain, tingling, and numbness • Feelings of cold • Swelling • Discoloration Treatment: • Splint the extremity

13. Broken bones

14. OPEN FRACTURE • Complete break or crack, or in bone in which the skin is broken. Child presents with • Possible deformity • Pain and tenderness • Bone piece sticking out of the wound • Inability to use the affected part normally • Bleeding • Injured area is cold and numb Things to be done: Unless there is danger to life, do not move from place of accident until affected limb has been properly supported or immobilized. • Immobilize • Support with pillows, blankets, broomstick,or uninjured limb, Apply ice/cold pack for 15 minutes

15. Dislocation • Inability to move the affected part normally • A bump, ridge, or hollow that does not normally exist in a nonfunctioning joint • Pain • Bruising • Swelling Treatment • Determine cause • Keep him calm and warm • Do not attempt to put the part back in place • Support extremity with pillows, blankets, broomstick, uninjured limb, etc., to reduce pain

16. Amputation If amputation is complete : Dos • Locate severed body part. • Wrap part in clean sterile dressing. • Place in plastic airtight bag and lay bag in pan of water kept cool with ice packs. • Control bleeding Donts • Don’t wash severed part • Do not put part directly on ice. • Never complete the amputation.

17. ALLERGIC REACTION Overreaction of the body’s immune system to specific substances that it misidentifies as harmful How do the kids present? Rashes Itching Swelling Red and hot skin Watering of eyes, nose, Sneezing

18. Anaphylaxis- Severe Allergy • Severe, sudden generalized reaction that is potentially life threatening. • Wheezing • Breathing difficulty • Choking • Swelling of body parts like lips, eyes. • Skin is flushed and dry or pale, cool, and clammy

19. Things to do for allergic reactions In mild cases • Keep the child away from allergen • Apply cold compress • Give antihistaminic medicines In severe cases • If wheezing ,make him sit in comfortable position • Loosen tight clothing and cover the person with a blanket. • Don't give the person anything to drink. • Get emergency treatment even if symptoms start to improve

20. Asthma call ambulance: • Difficulty breathing • Inability to speak more than 3-5 word sentences. • Fast or Slow breathing • Disoriented & Bluish lips or nail Things to do: • Make him sit comfortably • Loosen tight clothing • Do NOT place a pillow under the person's head. This can close the airway. • Do NOT give the person food or drink.

21. Bee and Wasp stings Local Reaction • Intense pain • A whitish bump with a red dot in its center • Swelling at the site of the sting • Chills • Fever • Muscle cramps, joint pain Severe Reaction • Apprehension • Rash (particularly on face) • Swelling of face and tongue • Difficulty breathing, wheezing, gurgling. • Skin feels moist and or appears flushed, pale or bluish

22. Bee and wasp stings TREATMENT • Remove stinger as quickly as possible. • Apply cold compress to reduce pain and swelling. • If the sting is on the arm or leg, keep extremity below the level of the heart. • Give antihistaminics

23. ANIMAL BITE What should be done? • Cleanse wound thoroughly with soap and water for 5 minutes. • Cover wound with clean bandage (preferably sterile). • Determine individual's tetanus immunization status. . In Human bite determine Hepatitis B vaccination status If allergic symptoms, Give antihistaminics

24. DENTAL PROBLEMS Baby teeth/ tooth loss • Rinse mouth with warm water. • If bleeding, have individual bite on gauze for several minutes. • Send tooth home with individual in sealed container (e.g., envelope or plastic bag). Knocked out tooth • Try to locate the tooth • Hold the tooth by its crown not the root • Rinse the tooth gently with water. Do not scrub • Place the tooth in cold milk or water • Control bleeding by applying gentle pressure • Apply cold pack for 15 min on face over injured area

25. Dental Problems Broken/ displaced tooth Broken braces Gently clean dirt from the injured area with warm water. Apply ice/cold pack -15 min on the face.(Do not apply ice directly to skin.) If sharp tooth cover with gauze prevents cutting lips or cheek. Save broken tooth fragments. If tooth has been pushed up into the gum, do not attempt to pull it into position or move it. Cover ends of broken braces and wires with wax or a piece of gauze. If wire becomes stuck in the cheek or gum tissues, do not attempt to remove it. If appliance is loose or broken, save any broken pieces. Call parent and recommend follow-up dental care

26. Ear injuries Earache • If discharge is present, wipe from outer ear only. • Allow free drainage. • Call parent and recommend contact with health provider.

27. Ear Problems cont……. Foreign object in ear: • Do not attempt to remove object at school. • Try using gravity to get the object out by tilting the head to the affected side • Call parent and recommend contact with health provider. Bug in ear/INSECT IN EAR • Place a few drops of oil in the ear to quiet the insect. • Only if visible try to remove with tweezers • Recommend follow-up medical care • AVOID using oil to remove any object other than an insect, since oil can cause other kinds of objects to swell.

28. Eye Problems Foreign body: • Pain • Tearing • Redness • Scratchy feeling in eye • Vision changes • Ask the child not to rub the eye • Flush with lukewarm water. Turn head to the side and pour water from nose outward. • If particle seems imbedded, do not attempt to remove it. • If object remains, cover both eyes loosely with gauze or cloth to restrict eye movement.

29. Eye Problems CHEMICAL BURNS BRUISES/BLOWS Determine type of chemical. If dry chemical, carefully brush off as much as possible, avoiding additional skin contact. Immediately flush eye with large quantities of cool water. Turn head to the side and pour water from nose outward. Do not allow chemical to wash into unaffected eye. If minor trauma apply ice/cold pack for 15 minutes to eye. (Do not apply ice directly to skin.) Patch both eyes to minimize eye movement, and refer for immediate medical care

30. Eye Problems (cont…….) Conjuctivitis: • Change in vision • Painful eye • Feels like foreign body in eye for over 1 hour • Experiences flashing light or floaters in field • Red, watery, swollen eyes • Thick yellow discharge • Do not put a patch over a possible eye infection. • Exclude individual from school until condition has cleared up

31. Nose Problems Nose Bleeds • Bleeding, Swelling, Choking, Bruising Things to do: • Make the child lean forward, make him breathe through mouth • Loosen anything around neck • Pinch the side of nose against septum for 5 to 10 min for clot to form

32. Nose Problems cont… Foreign body in nose • Pain • Swelling • Foul smell What to do: • Do not try to remove the object. • Call the doctor

33. Foreign body in throat Choking • Ask him ‘ are you choking • If patient is unable to do all these he is choked • Universal sign is Clutching of neck • Unable to speak • Weak ineffective cough • High pitched sound or no sound while inhaling • Breathing difficulty • Blue lips Things to do: Do not panic • If the child can breathe, Speak or cough do not interfere • Stay with the child, encourage to cough out the obstruction

34. Choking cont….. Heimlich maneuver Stand behind the child Wrap arms around his waist Make fist Place the thumb side above the navel, well below the breast bone Grasp your fist with other hand Provide quick upward thrusts into the patients abdomen Repeat the thrusts until the patient coughs up the object

35. Finger Injuries ( cont……) Crush Injuries Amputated finger For minor injury, such as shutting door on finger, apply ice/cold pack for 15 minutes. (Do not apply ice directly to skin) Gently clean the amputated part with water (preferably saline) Cover it in moist gauze wrap Or clean paper towel Put it in a watertight bag Place the bag on ice Do not put the amputated part directly in ice. You could further damage Replantation- not possible after 12 hrs For hand or arm its with in 6 hrs

36. Lead pencil puncture wound • Lead contains graphite, it has no other harmful effect other than staining the skin • Complete recovery is difficult What to do: • If lead is superficially lodged remove by tweezers. • Do not push tweezers beneath the skin • Wash with soap and water • Determine the childs tetanus immunization

37. Seizure

38. Seizure • Place a cushion or blanket under the child’s head • Don’t place anything in the mouth • Turn him to a side • Do not hold or restrain the child • Clear the area around the child from sharp objects • Loosen tight clothes • Do not give food , drink, or medicines during seizure • Remain with him during seizure and monitor the patient

39. Seizure cont…. After the episode • Allow individual to sleep in a dark room as needed. (May last from 30 minutes to several hours.) • Record the length of the seizure and activity during and after the seizure • Check for injuries. See appropriate procedures for treatment. • If individual remains unconscious after seizure is over, maintain open airway and continue to • Keep individual comfortable

40. Fainting • Blurred vision • Light-headedness • Nausea • Sweating • Loss of consciousness • Position individual on back on a flat surface. • If other injuries are present, see appropriate procedures. • If no injuries, elevate legs 8-12 inches. • Loosen clothing around neck and waist. • Apply cool, damp cloth to head. • Continue to observe carefully. • Recovery should occur in 2 minutes.

41. Sprains/Strains • Swelling • Tenderness • Pain upon motion • Discoloration RICE Strategy • Rest and Keep individual warm and comfortable. • Ice/cold pack for 15 minutes to the area. (Do not apply ice directly to skin.) • Compression bandage- extend well beyond injury. Immobilize extremity. Support with pillows, blankets, broomstick, uninjured limb, etc. • Elevate -If movement does not cause pain, elevate affected part

42. BURNS CHEMICAL • If the chemical is in a dry or powder form, carefully brush it off the skin before flushing with water. • Flush skin or eye immediately with large amounts of cool water. • Continue flushing 30 minutes. • If possible, remove outer clothing while burn is being flushed. • If available, follow directions on chemical container. Electrical • Do not try to pull away the child until power source is switched off • Wear gloves • Cover the burnt area with a sterile dry non sticky dressing • Look for second burnt area where electricity has left the body • Treat for shock

43. Thermal burns Dos • Cool the burn. Hold - running water for 10-15 min until pain subsides. • Cover with a sterile gauze bandage • If blister is broken, wash with soap and water and apply dry bandage Don’ts • Don't use ice. • Don't apply egg whites, butter or ointments to the burn.. • Don't break blisters • Don't usefluffy cotton as bandage

44. POISONINGS • INGESTED/SWALLOWED • NOTE: Ingested poisoning can occur from drug overdoses, medication errors, household and industrial • Do not give any medication, food, or liquid until told to do so by the doctor • Do NOT induce vomiting unless you are told to do so • Do NOT try to neutralize the poison with lemon juice or vinegar, or any other substance • If the poison has spilled on the person's clothes, remove the clothing and flush the skin with water

45. Common ailments Fever Headache Oral temp 100 ‘ or more Headache, watery eyes Cough, skin rash ,Sorethroat Vomiting diarrhoea What to do: Take temperature Make him lie down Don’t cover him Apply cool compress on forehead Isolate the child for benefit of others Emergency care -when severe; persistent; severe with sudden onset; If no head trauma – Ask to lie down for 20-30 minutes in darkened area. Check temperature. Place a cool cloth on the forehead to promote relaxation. If headache persists, call parent for follow-up medical care.

46. Drowning • Clear airway • Mouth to mouth breathing • Cardiac massage if heart sounds absent • All cases should be hospitalized

47. Snake bite • Fangmarks  swelling/severe pain at the site  Bloody discharge from wound , Burning sensation Things to be done: • Wash wound with soap/water  • Immobilize the affected area  • Keep area slightly elevated  • Apply cool compress/wet cloth to affected part  • Apply a firm bandage 2-4 inches above bite toi. Prevent venom spreadingii. Take care of any bleeding • Monitor for pulse, respiration and      blood pressure

48. Mouth/Jaw Injuries • Maintain open airway. • If conscious, no neck injuries are suspected, prop him up—leaning forward—to allow blood to drain. • If lip penetrated, place a rolled dressing between the lip and gum and another dressing on the outer surface of the lip. • Apply ice/cold pack for 15 minutes to reduce swelling and decrease pain • If tongue is bleeding, apply a dressing with gentle pressure. • Rinse mouth with cold water for 15minutes

49. CPR Cardio Pulmonary Resusitation: What is it? Maneuver to revive breathing, & heart beat • Give two breaths. • To get the breath in, tilt their head back gently by lifting their chin. • Pinch their nostrils closed, place your open mouth firmly over their open mouth and blow firmly into their mouth

50. CPR • Give Compressions: • 30 compressions and two breaths • Let chest rise completely between pushes. Check for breathing • 5 repeats in 2 minutes until you get medical help or until the person responds. How to give Compressions • Place heel of one hand on the center of the chest at the nipple line. • You can also push with one hand on top of the other. • Press down about 2 inches. Make sure not to press on ribs.