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FIRST AID. Prepared by: DR. GHAZI K. HAMADEH Chief Physician / Director (A), Medical Center King Fahad University of Petroleum & Minerals. WHAT IS FIRST AID?.

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    1. FIRST AID Prepared by: DR. GHAZI K. HAMADEH Chief Physician / Director (A), Medical Center King Fahad University of Petroleum & Minerals

    2. WHAT IS FIRST AID? It is the immediate assistance or care given to a person who has been injured or suddenly became ill, from the moment of the accident until availability of specialized medical care. Note: First Aid is not restricted to physical but also involves psychological support as well. Who needs First Aid? Cardiac and Respiratory Arrest Electric Shock Wounds Bleeding Burns Fractures and Traumatic Injuries Poisoning Drowning Snake bites

    3. 1) Examination of the Pulse Radial Pulse Brachial Pulse Carotid Pulse Feeling Heart Beats on the Chest Wall. Note: It is not necessary to feel the pulse, you can Start chest compressions. If breathing didn’t restart after giving 2 breaths, then starts compressions 2) Examination of Breathing Normal Breathing Dyspnea Respiratory Arrest

    4. First Aid Priorities Save the victim and self Keep breathing and heart beats Control Bleeding Treat Poisoning Prevent Shock Examine the victim carefully Ask for specialized Medical Care Continue first aid measures until arrival of medical care providers

    5. Respiratory Arrest Breathing may Stop meanwhile the heart is still beating for few minutes Breathing may stop because of electrical shock, drowning, suffocation, poisoning, chest, abdomen and head trauma. Steps: Open the airway Tilt the head back and raise the chin Examine breathing for 5 seconds a) feel the air b) hear the sound of breaths. c) See the chest movements If no breathing close the nose and give 2 breaths Examine the pulse every minute and give a breath every 5 seconds. If pulse stopped do CPR

    6. CHOKING Choking is usually caused by a piece of food and or a small object in the mouth. Choking cause coughing, dyspnea, but the most important sign to see is the victim holding his neck FIRST AID If the victim talks or coughs encourage him to continue coughing. If the victim can’t talk or cough do 6-10 Abdominal thrusts. If the victim is unconscious put him on the floor give 2 breaths. Do 6-10 adominal thrusts, clean the mouth by 2 fingers and give 2 breaths. Repeat the abdominal thrusts, if needed. If the victim is less than one year Hold the infant face down on your forearm which is resting on your thigh. Thump the back 5 times by the heel of the hand. If not improved put him on your forearm and face upward, head is lower than trunk, and apply 5 chest thrusts by 2 fingers (on the middle of the chest bone). If no response repeat back and chest thrusts as before If no response call for medical help. Note: Adults and children above one year are given abdominal thrusts only.

    7. C.P.R. C.P.R. is a life saving technique It is indicated whenever heart and breathing stop. It is a combination of mouth to mouth breathing and chest compressions. If breathing stops → brain damage occurs within few minutes but death occurs within 8-10 minutes. STEPS BEFORE STARTING C.P.R. - Make sure that victim is unconscious (by shaking shoulders and asking loudly are you ok.?) - Call 999 before starting C.P.R. but if the victim is a child between 1-8 years start C.P.R. for 2 minutes before calling 999

    8. C.P.R. STEPS ARE CALLED ABC 1. AIRWAY STEP - Put the victim on his back on a firm surface - Kneel close to the victim neck or shoulders - Tilt the chin upward to open the airway - Check breathing for 10 seconds. • BREATHING STEP - Close the nostrile and give 2 breaths (mouth to mouth) and observe the chest rises.

    9. CIRCULATORY STEP - Place the heel of one hand on the center of the chest between the nipples. - Apply the other hand over it. - Push the chest down (1.5 – 2 inches) in an average of 2 compressions per second (100 times) - Give 2 breaths after each 30 compressions. If the victim didn’t breath after 5 cycles (2 minutes) we can use Automatic External Defibrillator (if available) otherwise, we continue C.P.R., however this device is not recommended for infants less than one year. NOTES ON C.P.R. FOR CHILDREN - For children 1-8 years we start C.P.R. before calling 999 for 5 cycles (minutes) - We use one hand only for chest compressions. Rate of chest compressions to breathing is the same as adults 30/2. NOTES ON C.P.R. FOR INFANTS LESS THAN 1 YEAR. - Start C.P.R. 5 cycles (2 minutes) before calling 999. - No need for deep breath. - Use 2 fingers of one hand for chest compressions - Compressions should compress the chest from 1/3 – ½ its depth.

    10. WOUNDS • First Aid - Bleeding stops on its own, but pressure with a clean cloth or bandage can be applied for 20-30 minutes. - Use water if the wound needs cleaning but don’t use antiseptics (iodine or others) • FIRST AID FOR CUTS - Apply direct pressure by a piece of cloth and raise the limb above the level of the trunk. - Add more pieces of cloth and apply pressure on the major artery that supply the limb, if needed. - Minimize Movement by fixing the wounded limb on the body. - Transfer the victim to Medical Facility.

    11. EPISTAXIS (Nose Bleeding) - Tilt head down to prevent bleeding to the throat. - Close the victim’s nostrils with the tips of 2 fingers. - Ask victim to breath through mouth - We may apply a gauze packing to the bleeding nose. - If bleeding didn’t stop after 20 minutes we ask Medical Care Provider.

    12. SHOCK • It is a state characterized by low blood pressure, rapid pulse, and decrease blood supply to brain and other vital organs. CAUSES • Fluid loss (as in severe vomiting, severe diarrhea, major burns, sun strokes….) and severe bleeding. FIRST AID • Call 999 • Restore breathing • Try to stop bleeding • Assurance • Transfer the victim to the hospital with lower limbs elevated and the victim is lying on his back (if there is no neck injury) • In case of suspected neck injury don’t move the victims during transfer • Keep the victim warm. • Continue observation and give mouth breathing if needed and put him on his side if he vomits. • If you are not sure of correct position keep victim on his back.

    13. SNCOPE (Fainting) • It is transcient loss of consciousness due to lack of blood supply to the brain. • Most common is vasovagal (blood vessels dilate, and less blood supply to brain) as in hot crowded places, stress, standing too long, fatigue, low blood sugar, dehydration. • Some cases occur after coughing or micturation or changing position but other cases are due to cardiac or brain diseases. • Raise lower limbs above the level of the trunk. • Call for medical help • Observe breathing and pulse • Leave the victim lying for 20 minutes after he retains consciousness

    14. POISONINGFIRST AID MEASURES Conscious Victim • Give water or milk • Recognize the poisonous substance if possible • Call Doctor or Poison Center • Induce Vomiting • Observe for breathing Unconscious Victim • Observe for cardiac and respiratory arrest. • Keep him on his side and transfer him. • Do not induce vomiting. NOTE; NEVER INDUCE VOMITING IN CASE OF:kerosene, petroleum and its derivatives, strong alkalies and acids.

    15. BURNS DEGREES OF BURNS • 1st degree – Skin only • 2nd degree – Vesicles • 3rd degree – Deep tissues FIRST AID MEASURES • 1st degree – Cold water + Sterile gauze • 2nd & 3rd degree – Don’t use water - Apply sterile gauze - Prevent shock - Call for assistance - Don’t remove clothes - Don’t apply oil or salt EYE BURNS • Heat Burns – Same as above • Chemical Burns – Eye wash for 15 minutes

    16. FRACTURESTYPES1. Closed – No Wounds2. Open – With Wounds FIRST AID - Never try to put bone in place. - Stop bleeding - Cover open wound - Prevent shock. - Immobilize the fractured bone by splinting (apply cotton, gauze and bandage) IMPORTANT POINTS TO REMEMBER WHILE TRANSFERRING THE VICTIM - In case of a fractured cervical vertebral bones keep victim on his back. - In case of fractured of thoracic and lumber keep victim on his abdomen. - If unconscious keep him on his back. - Avoid excessive or unnecessary movements. - In case of fracture pelvis fix pelvis, thighs, legs and feet. - Fracture of fore arms make two splints and hang the forearm to the neck.

    17. ANIMAL BITES AnimalsDogs/CatsMouse Rats First aid1. Clean wound with water and soap2. Cover with guaze3. Try to catch the animal or kill it.

    18. SNAKE BITE • GENERAL INFORMATION: - Most snakes are not poisonous. - The first several hours after the bite are most critical. - Most snakes avoid human unless frightened. - Poisonous bites cause local signs (oedema, hemorrhage, ecchymosis necrosis and systemic signs mainly involving nervous and cardiac system). - First aid measures should be applied as quickly as possible. - Identification of poisonous bites could be possible if the two fang marks are there or some local or systemic signs occur. - Introducing antivenum is not deprived from serious side effects, therefore, it is given only in severe cases.

    19. FIRST AID MEASURES FOR SNAKE BITE: • Reassure and calm the victim. • Put the victim in lying position and restrain from unncessary movements. • Clean wound with water and soap, then dry it with sterilized gauze. • Observe pulse and breathing, if breathing stop, give mouth to mouth breathing. If pulse stops apply CPR. • Keep the affected limb below heart level. • Immobilize the limb and splint. • You may apply a bandage above level of the bite adequately tight to permit passage of a finger underneath. • Make sure, you can feel the peripheral pulse below level of bandage. • If you are more than 20 minutes away from medical facility, apply a bandage as before, then make small longitudinal incision • 1 cm long and 2 mm deep and suck the venum with suction cup or with your mouth. (Avoid suction by mouth if you have mouth sores or wound). • Transfer patient to the nearest hospital as fast as possible and on the way continue to reassure observe and maintain airway and breathing.

    20. SUN STROKE AND HEAT EXHAUSTION • Signs of Heat Exhaustion - Headache - Dizziness - Nausea - Muscle Cramps - Skin is cold, and sweating • First Aid - Transfer the person to cold or shaded area - Give him liquid composed of:(1 cup of water + ½ teaspoon of salt) Repeat the salt solution 4 times once every 15 minutes. - If the person didn’t improve transfer him to Medical Care. • Signs of Sun Stroke - High Fever (May read 41 degree Centrigade) - Skin is dry and no sweating - Convulsions may occur. • First Aid: - Cool the victim by placing him under tap water - Continue cooling until temperature reach 39 then stop for 10 minutes. - If temperature relapse continue cooling - Don’t give any drinks - Seek Medical help

    21. DROWNING • Remove the victim from water • Clean the mouth from sands and other foreign bodies • Put him on the floor and raise his body • Start C.P.R. • Call for Medical Help

    22. ELECTRIC SHOCK • Avoid direct contact with the victim • Before touching the victim • wear plastic gloves • stand on dry wooden chair • push the victim with a wooden ladder or chair or wooden stick • Disconnect power if possible • Do C.P.R. if needed • Treat burns • Call for Medical Help