St.

John Ambulance Training Branch First Aid Course

Unit 1 29th September 2006
Safety and comfort
Course objective and methodology
The task of a First Aider
Incident management
Casualty management
First assessment of casualty: ABC
Airway
Breathing
Circulation (not any more)
Normal rates of breathing and circulation while casualty is at
rest:
Breathing
o Adult
16 to 18 times pm
(Puberty and over)
o Child
20 times pm
(1 year to puberty)
o Baby
30 times pm
(0 to 1 year)

Circulation
60 to 80 beats pm
100 beats pm
120 beats pm

Managing an incident:
1) Assess the situation
2) Make the area safe
3) Give the casualty emergency aid
4) Get help (Use No. 112)
5) Deal with the aftermath E.g. Check the First Aid kit has anything been used ? Pick up the used ones and
replace with new ones

Unit 2 2nd October 2006

Primary survey
Recovery position
Secondary survey head to toe
Primary survey
Questions to ask yourself
NO

Danger

Are you or the casualty in danger ?

NO

Response

Is the casualty conscious ?

If not, shout for help for someone

to
come to your assistance
?

YES B

Airway

Is the airway open ?

Breathing

Is the casualty breathing normally ?

In and out ?

Send someone for an ambulance by calling on 112 informing

them that the casualty is unconscious but breathing. Ask
the person to return.
PRACTICAL use of dummy
Mistoqsija qed tismaghni ?
Jekk qed tismaghni, iftah ghajnejk (Kmand).
Taptap fuq spallejh
Oqros il-widna
Imbotta r-ras lura mill-mohh
Ghati daqqa tghajn fil-halq biex tara jekk hemmx xi haga
Qieghed zewgt iswaba taht il-geddum u ghafas il-fuq
Erga mbotta r-ras lura mill-mohh
Issemma ghan-nifs
Jekk qed jiehu n-nifs, staqsi lil xi hadd biex isejjah ghallghajnuna billi jcempel 112, isaqsi ghal ambulanza u

jghidilhom li hemm persuna barra minn sensiha izda li qed

tiehu n-nifs
Three key steps for Response:
I. Eyes
II. Speech
III. Movement
Also,
Is he ALERT ?
Does he respond only to VOICE, to PAIN ?
Is he UNRESPONSIVE ?
Recovery position to turn sideways - when a casualty is
unconscious and with a breathing problem. Place one arm
up above the casualtys head with the other across his chest
and below his face. Raise leg from under the knee and then
pulling at the knee towards you the casualty will roll over in
your direction.
If the casualty is breathing normally, then you may proceed
to the SECONDARY SURVEY and then to the recovery
position.
If breathing is noisy, place in recovery position first, then
carry out the secondary survey. The purpose of this
secondary survey is to delve deeper to find out whether
there are other injuries. You should start with the head, the
skull, etc. Are there any broken bones ? Then proceed to
the eyes, nose, mouth, etc. When you reach the neck, look
out for any warning medallions, indicating, for example, that
the casualty is a diabetic or epileptic. Is there any swelling,
etc. ? You may then proceed further to check the ribcage,
shoulders, arms, etc. Are there any syringe markings ?
SECONDARY SURVEY
Describe the clues needed to find out what is wrong.
DO

For conscious and unconscious casualties

DO NOT Jump to conclusions with only 1 or 2 clues

DO
Be methodical exert some pressure
DO NOT Be diverted, move along by priorities Airway first
DO
Record report for the ambulance crew,
employers.
Remember you may have to conduct Secondary Survey in
Recovery Position.
Recognition Features
SYMPTOMS

HISTORY &
EXTERNAL CLUES

SIGNS

What happened ?

Evidence of what
happened

What can be
seen ?

Fall off a ladder

Ladder on the ground

Bruises, cuts ..

Observation CHART
A V P U, that is,
Is he ALERT ?
Does he respond only to VOICE, to PAIN ?
Is he UNRESPONSIVE ?
Take record every 10 minutes

Unit 3 6th October 2006

Cardio pulmonary resuscitation

Modification child / baby
HANDOUT
Unit 4 9th October 2006
Shock (circulation)
Eternal bleeding
Dressings and bandages
Recognise and treat
Disorders of circulation
Lack of oxygen reaching the brain (where oxygen
travels in the blood)
Severe bleeding
Lowering of blood pressure
Features that may help recognition of SHOCK
RESPONSE
AIRWAY
BREATHING
CIRCULATION

may become unconscious

nothing special to help recognition
rapid and shallow
rapid but weak and beat may stop

History and external clues

Causes of shock
Loss of blood (external and internal)
Severe sweating, diarrhea, vomiting
Heart failure
Burns
Other recognition features
Pale grey and blue skin
Thirst
Sweating and cold, clammy skin

Nausea and vomiting

Yawning, gasping for air
Weakness, dizziness
Restless, anxious and aggressive
HOW TO TREAT SHOCK
Danger Airway, Breathing and Circulation
Possibly place blanket under and over the casualty
Lift legs up on to a low stool, if there are no injuries in FEMUR
Treat any other obvious cause of shock
Ask for Ambulance 112
Then monitor and record the pulse rate every 10 minutes (60
to 80 beats pm), the breathing rate (16 to 18 breaths pm)
and levels of response A V P U - Is he ALERT ? Does he
respond only to VOICE, to PAIN ? Is he UNRESPONSIVE ?
DO NOT transport casualty
DO NOT place localized heat (a hot water bottle !!!) next to
the casualty
DO NOT give a cigarette to the casualty
DO NOT leave the casualty unattended
DO NOT give the casualty anything to eat or drink
ASSESS AND TREAT
External Bleeding
In severe bleeding, self-assisting in a natural way is
advisable for the wound to heal on its own

Shed blood clots

Reduce blood pressure it will fall
Cut the ends of the vessels close they will contract
WOUNDS
The priorities DANGER Avoid contamination from infected
blood, Response Airway, Breathing and Circulation (ABC)
and then
In severe bleeding the priority is to control bleeding then to
prevent infection. In slight bleeding, the priority is to
prevent infection. In both cases, one should wash the wound
with running water.
BRUISES
To control through cold compressions using ice in a bag and
in a damp cloth for 10 minutes.
NEVER place in direct contact with the skin this may cause
COLD BURN
To stop bleeding, use gloves and exert direct pressure,
establish elevation above the level of the heart and place
casualty lying down. Treat for shock. If possible raise the
casualtys legs
TO COVER
Distinguish between DRESSING and BANDAGE recognise
the use of each for FIRST AID purposes
DRESSING
Not medicated but OK if sterilized
Cover wounds / burns

a) To protect from further injury

b) To protect against germs
c) To help control bleeding
AVOID Cotton wool but you may use this if placed over
dressing
BANDAGES support
a.
b.
c.
d.

It
It
It
It

holds the dressing in place

controls the bleeding
acts as a support and immobilizes the area affected
prevents or reduces swelling

There are two types of bandages the roller type (once and
from the wrist (narrow) to the elbow (wide) and the
triangular type (90 degrees point with elbow and let the
bandage drop the other point placed with the affected
hand).
You are to check immediately after bandaging and every 10
minutes after that the following:
Loss of movement
Blueness of nails
Coldness
Pallor
Tingling or numbness
Whenever any of these symptoms arise, loosen the bandage
and redo
EXAMPLE
A case of severe bleeding and you do not have gloves
The casualty is to place direct pressure on the affected area /
wound. Place the casualty on the ground and raise his feet

Unit 5 13th October 2006

Disorders of the airway and breathing
Heat exhaustion, heatstroke
RECOGNISE AND MANAGE
Disorders of the Airway and Breathing
Conditions causing low blood oxygen level HYPOXIA
CONDITION
1.
2.
3.
4.
5.
6.

Insufficient oxygen in the area breathed inspired air

Airway obstruction
Conditions affecting the chest wall
Impaired lung function
Damage to the brain or nerves that control breathing
Impaired oxygen uptake by the tissues

CHOKING
Mild obstruction
Casualty finds it difficult but is able to speak, cry, cough or
breathe
Casualty should be able to clear the obstruction without help
Severe obstruction
Casualty is unable to speak, cry, cough or breathe

Casualty will eventually become unconscious if left without

assistance
CHOKING ADULT OR CHILD
RECOGNITION
Ask the casualty Are you choking ?
If the obstruction is severe
Give up to 5 back blows
Give up to 5 abdominal thrusts (using fist (with thumb
inwards) and upwards
If obstruction does not clear after 3 cycles of the above
two actions, call for an ambulance (112)
Continue until help arrives
Medical advice should be sought if abdominal thrusts
are used as severe internal injuries can occur
CHOKING BABY (0 TO 1 YEAR)
RECOGNITION
If the baby can breathe, cough or cry, NO treatment is
necessary
If the obstruction is severe
Give up to 5 back blows
Check mouth and remove obvious (visible) obstructions
Give up to 5 chest thrusts (NOT abdominal), allow head
to tilt down backwards by gravity, locate the centre
between the two nipples, place two fingers and push
down and up gently
Check mouth and remove obvious obstructions
If constriction does not clear after 3 cycles of back
blows and chest thrusts, call for an ambulance (112)

 Continue with the cycle until help arrives

Even if obstruction is removed, the baby should taken
to hospital

In the case of Suffocation

Throttling
Drowning

Hanging
Strangling
Smoke and fumes

ACTION
RESCUE if you can, safely
AIRWAY remove any obstructions and / or constriction to
the airway
BREATHING Rescue breaths
CIRCULATION Chest compression
Carry out CPR and get help
ASTHMA an allergy with different degrees of seriousness
Airway linings are irritated, inflamed causing restriction
Inhalers COLOURS -

BROWN preventer
BLUE to be used during an attack

REMEMBER DO NOT use the brown during an attack

SYMPTOMS
Dry cough, difficult to exhale and tires quickly when running
Improvise if no inhalers are available
Place the individual in a seated position, inclined forward and
asked to take deep breaths from the diaphragm

Also remove from the environment since it would have

triggered the asthma attack in the first place

Features which can help recognition of HYPERVENTILATION

(too much oxygen) may include
RESPONSE responsive eyes, spontaneous movement
but may not speak
AIRWAY being clear, there is nothing special to help
recognition
BREATHING unnatural, fast and deep
CIRCULATION nothing special to help recognition, but
may be attention-seeking behaviour, dizziness,
faintness, trembling, etc.
In cases of HYPERVENTILATION
o speak to the casualty firmly but kindly
o in private in a quiet place
o re-breathe into a paper bag 10 times exhaling CO2
(which includes 16 % oxygen), re-breathing CO2
(including 16 % oxygen), thus reducing oxygen in the
system
o Advise the patient to visit his doctor
HEAT EXHAUSTION
Caused by loss of salt and water from the body through
excessive sweating. This usually happens gradually.
RECOGNITION
As the condition develops there may be
Headache, dizziness and confusion
Loss of appetite and nausea

 Sweating with pale, clammy skin

Cramps in arms, legs, abdominal wall
Rapid weakening pulse and breathing

TREATMENT
Help casualty to a cool place
Lay the person down and elevate legs
Give casualty plenty of water, followed if possible with a
weak salt solution 1 teaspoon of salt with 1 litre of
water
Even if the casualty recovers quickly, ensure that he is
seen by a doctor
HEAT STROKE
Caused by a failure of the thermostat in the brain, which
regulates the body temperature
The body becomes dangerously overheated usually due to a
high fever or prolonged exposure to heat
In some cases heat stroke follows heat exhaustion, when
sweating ceases and the body then cannot be cooled by the
evaporation of sweat
Heat stroke can develop with little warning, causing
unconsciousness within minutes of the casualty feeling
unwell
RECOGNITION
There may be
Headache, dizziness and discomfort
Restlessness and confusion

Hot flushed and dry skin (not sweating)

Rapid deterioration in level of response
Full pounding pulse
Body temperature above 40 degrees Centigrade (104
degrees Fahrenheit) normal 36 37 degrees
Centigrade (98.6 degrees Fahrenheit)

TREATMENT
Help casualty to a cool place remove as much of outer
clothes as possible
Wrap casualty in a cold wet sheet and keep sheet wet
until temperature falls below 38 degrees Centigrade
(100.4 degrees Fahrenheit) under the tongue or 37.5
degrees Centigrade (99.5 degrees Fahrenheit) under
the arm. If the sheet is not available, fan the casualty
and sponge with cold water
Once the casualtys temperature appears to have
returned to normal (36 or 37 degrees Centigrade),
replace the wet sheet with a dry one
Monitor the level of response, pulse and breathing until
help arrives
If the temperature rises again, repeat the cooling
process

Unit 6 16th October 2006

Fainting, heart attack, anaphylactic shock
Internal bleeding
Amputations
Features which can help RECOGNITION of FAINT may include

R
A
B
C

Briefly unresponsive
Nothing special to help recognition
Fast, shallow
Slow

Other recognition features Pale skin, sweaty, feels faint

History and external clues standing still, pain, warm
atmosphere, lack of food, exhaustion
FAINTING
Temporary
Not enough blood in the brain
AIM is to improve the blood flow to the brain. How ? Lying
down and raising legs
ACTION

Danger A B C
Head to toe survey for other injuries
Allow to sit up gradually
If feeling of faintness returns, make the casualty lie down
again
If consciousness is not regained quickly (within 10 minutes)
it is probably not a faint

ACTION
Initial assessment and act accordingly
Features which can help RECOGNITION of ANAPHYLACTIC
SHOCK may include
R
A
B
C

Alert and anxious, deteriorating response, may

become unconscious
May become swollen and obstructed airway
Wheezing, gasping, may stop breathing
Rapid, circulation may stop

Other recognition features tightness in the chest, red skin

patches and swelling of face and neck and around the eyes
History and external clues An injection of a particular drug,
the sting of a particular insect or plant, the eating of a
particular food
ANAPHYLACTIC SHOCK
TREATMENT
AIM Urgent hospital treatment
ACTION

Danger ABC

Get help ambulance 112

Position if conscious half-sitting, sitting with back against a
wall, in so doing one would be facilitating breathing
Position if unconscious recovery position to protect airway
If casualty is a pregnant woman, NEVER turn onto her RIGHT
Monitor the situation and be prepared to resuscitate
ANGINA
Cholesterol, tistrapazza or stress
RECOGNITION
There may be
Gripping chest pain, often spreading to the left arm and
jaw a radiating pain
Pain or tingling in the hand
Shortness of breath
Sudden and extreme weakness
HEART ATTACK
RECOGNITION
There may be
Persistent crushing vice-like pain, often radiating from
the heart. Unlike Angina, it will not ease by rest and in
fact may occur during rest
Breathlessness and discomfort is high in the abdomen
Sense of impending doom
Pale skin, blueness of the lips
Rapid pulse becoming weaker

 Collapse, often without warning

AIM
To ease the strain on the heart to get the casualty through
the attack

Danger make safe

Conscious

Unconscious

Reassure and place in

Half-sitting position
Angina
Help to take
Medication
(GTN)
Place under
tongue. Saliva
melts it to go
straight to the
blood stream

or

ABC and act according to

your findings call
ambulance NOW

Heart Attack
Give an Aspirin
(300mg) tablet
to chew slowly
Ambulance now

If pain persists
Get ambulance
Monitor closely and be prepared for collapse and cardiac
arrest
EXAMINATION OF THE EYE AND DEALING WITH OBJECTS IN
THE EYE

Ask casualty to look right, left, up and down a number of

times
EXAMINATION
Pour water (3 cups) and place a towel on the casualtys
shoulder (irrigation).
ASSESS AND TREAT
INTERNAL BLEEDING
RECOGNITION
There may be symptoms of SHOCK
I. Information from casualty or witness indicating accident
or injury
II. Pattern, bruising red blood from organs, blue fresh
blood from veins
III. Bleeding from the orifices body holes
Blood in the urine kidney
Anus black large intestine
Anus red haemorrhoids, piles
Ears brain
Mouth red lungs
Mouth bright and frothy, brown vomit stomach
Nose dirty white water - brain
Danger and ABC
Place sheet below and above casualty and raise feet
Treat any other obvious case
Ambulance (112)

Monitor and record samples of blood

BLEEDING FROM THE MOUTH
TREATMENT
Sit casualty down with head inclined towards the
injured side
Exert direct pressure with gauze dressing for 10
minutes
If the dressing becomes soaked, replace it

BLEEDING FROM THE EAR

TREATMENT
Help casualty into half-sitting position, with head
inclined to the injured side
Cover ear with sterile dressing, the aim is to prevent
infection and not to stop bleeding
Take to hospital
BLEEDING FROM THE NOSE
TREATMENT
o Sit casualty down with the head forward
o Have the casualty pinch the soft part of the nose for 10
minutes, repeating this three times
o Advise casualty to breathe through the mouth
o After bleeding has stopped, advice casualty not to blow
his nose and to rest for a few hours, out of the sun
o If after 10 minutes, the bleeding has not stopped, try
this drill again. After 30 minutes, the casualty should
go to the hospital
EMBEDDED OBJECT

Do NOT remove object

Apply pressure on either side of the object
Elevate the wound above the heart
Lie the casualty down, legs up
Build up pads on either side

INDIRECT PRESSURE
If it fails to stop bleeding directly from the wound, find an
artery to stop it. For example, if the bleeding is at the wrist,
then exert pressure on the arms muscle near the shoulder
Maximum pressure time
Brachial arm
Femoral groin
CHEST WOUND PENETRATING
TREATMENT
Direct pressure
Sterile dressing
Cover dressing with plastic and seal with tape on three
sides
Support casualty in a comfortable position, incline
towards the injured side
If the casualty becomes unconscious, place in a
recovery position on the injured side
Send to hospital
AMPUTATION
TREATMENT
1. Control the blood loss
2. Apply sterile, non-fluffing, dressing
3. Secure with bandage

4. Send to hospital
CARE OF AMPUTATED PART

Wrap in plastic
Wrap again in soft fabric
Place in bag with ice
Mark package with name of casualty and time of injury
Send to hospital with casualty

Unit 7 20th October 2006

Minor and major epileptic fits
Stroke
Hypoglycaemia
Poisoning
Burns and scalds
Electric shock
Arm sling
MINOR EPILEPSY
RECOGNITION
1.
2.
3.
4.

Sudden switching off

Staring blankly
Slight twitching of lips, eyelids or head
Strange automatic movements like lip smacking,
chewing, making odd noises fiddling with clothes

TREATMENT
Help casualty to sit down
Remove danger
Talk reassuringly to casualty

 If casualty is not aware of condition, advise to see

doctor
MAJOR EPILEPSY
RECOGNITION

Casualty falls unconscious, often letting out a cry

Rigid arching of the back
Breathing may cease
Convulsive movements
Jaw clenched
Breathing noisy
Saliva at the mouth
Blood if lips or tongue has been bitten
Loss of bladder or bowel movements

After the attack is over

o The muscles relax
o The breathing becomes normal
o The casualty recovers consciousness, usually within a
few minutes
o The casualty may want to sleep
EPILEPSY
AIM
To protect from harm
ACTION
Minor Fit

Major Fit

Sit casualty down

Keep casualty calm
Remove any danger

Ease the fall

Loosen neck clothing
Remove any danger

Recovery position when

the fit is over
DO NOT Lift, move, restrain, put anything in the mouth
In the case of a first fit or repeated fits, if injury has been
sustained or is unconscious, take to hospital
STROKE
Area deprived of blood
HEAD
Obstructed artery
Cerebral thrombosis
Clot
Cerebral haemorrhage
Extent of bleeding and ruptured artery
Caused when the blood supply to part of the brain is
suddenly and seriously impaired by a blood clot or ruptured
blood vessel
RECOGNITION
There may be
o Problems with speech and swallowing
o If asked to show teeth, only one side of the mouth will
move or movement will be uneven
o Loss of power or movement in limbs
o Sudden severe headache
o Confused emotional mental state that could be
mistaken for drunkenness
o Sudden or gradual loss of consciousness
TREATMENT
IF CONSCIOUS

1. Reassure casualty
2. Lay casualty down with head and shoulders slightly
raised and supported
3. Incline head to the effected side
4. Loosen any tight clothing that might impair breathing
IF UNCONSCIOUS
o
o
o
o

Danger
Response
Airway
Breathing

and act accordingly

DIABETES
When the pancreas secretes insulin (a hormone) to control
the sugar level in the body
RECOGNISE AND TREAT
So inject insulin and food
HYPOGLYCAEMIA
Blood sugar level falls below normal
RECOGNITION
Weakness, fainting or hunger
Palpitations and muscle tremors
Warning bracelet or card
Strange behaviour, casualty may appear confused or
violent
Sweating
Cold and clammy skin

 Strong, pounding pulse

Deteriorating level of response
Shallow breathing
AIM
Raise the blood sugar urgently
Initial Assessment
NO

Danger

Response Airway

Breathing Circulation

Place at rest
Give the casualty sugar-sweet drinks
Advise doctor
Or if
INITIAL ASSESSMENT
NO

Danger

Response Airway

Breathing Circulation

Place in recovery position

Send for ambulance urgently

RECOGNISE AND TREAT

POISONS
Swallowed (do NOT force to throw up) or inhaled (take out
into
open air) or absorbed or injected or instilled (in eyes) wash
away with water
AIM

Make safe
ABC
Medical aid
Identify the poison

ACTION
-

Keep casualty still

Eliminate the poison if you can
Monitor response and A B C
Get the ambulance urgently

DO NOT make the casualty vomit

If unconscious, place in recovery position

BURNS AND SCALDS

CAUSES OF BURNS

Dry heat
Electrical current
Cold objects
Chemicals
Radiation

CAUSES OF SCALDS
Hot liquids
Steam
ASSESSING BURNS
What caused it ?
Which part of the body has been affected ?
How deep is the burn ?

 How big is the burn ?

DEPTH OF A BURN (Degrees)
1. Superficial thickness BURN
2. Partial thickness BLISTER
3. Full thickness DAMAGED TISSUE
TREATMENT OF BURNS
Danger
Cool cold water at least for 10 minutes, 20 minutes for
chemical burns
Remove constrictions
Place in position of SHOCK on the ground with raised
feet
Dressing or plastic bag
Send to hospital, monitoring A B C continuously
DO NOT
1. Touch the burnt area
2. Remove sticking clothing, unless it is contaminated with
chemicals
3. Burst blisters
4. Apply lotions or creams
5. Use fluffy materials
6. Underestimate the seriousness
BURNS TO THE MOUTH AND THROAT
Danger
Maintain the airway
If resulting from corrosive substances, give the casualty
sips of water IF CONSCIOUS
Get ambulance urgently you need special help
urgently before the throat swells to block the airway
Monitor through A B C continuously

CHEMICAL BURNS
1. Flood with water for a minimum of 20 minutes
2. Remove the contaminated clothing
3. Get an ambulance
CHEMICAL BURNS TO THE EYES
Flood with water
Cover only with an eye pad when you are sure that the
chemical has gone
Get an ambulance
RECOGNISING FLASH BURNS TO THE EYES (Example
Welding)
1.
2.
3.
4.

Intense pain
Redness and watering
Gritty feeling
Sensitive to light

AIM
-

To prevent further damage

Seek medical aid

ELECTRIC BURNS
LOW VOLTAGE
-

Danger disconnect
A B C the heart may stop
Cold water
Dressing
Get ambulance

HIGH VOLTAGE

Danger DO NOT approach

Emergency service
18 metre safety cordon
Treat only when safe

Unit 8 23rd October 2006

Injuries to the muscles, joints and bones
Jaw thrust for spinal injuries
RECOGNISE AND TREAT
INJURIES TO THE MUSCLES AND THE SKELETON
STRAINED OR RUPTURED MUSCLE
LEG AND FOOT
tendon

torn muscle fibres or torn achilles

RECOGNITION FEATURES
-

Difficulty in moving
Pains
Tenderness

Swelling and bruising

Snapping feet of a torn tendon

HISTORY AND EXTERNAL CLUES

Violent wrenching movement
See typical joint
See typical sprain with torn ligament
PROCEDURE FOR STRAINS OR SPRAINS R I C E
REST

steady and support

ICE
asap

cold compress immediately using ice

COMPRESS
pressure

compress the site with soft even

ELEVATE
Seek medical aid

raise and support above heart level

See typical dislocation

To recognise that a fracture has occurred and where it is,
HISTORY is very important HOW WAS IT CAUSED ?
DIRECT FORCE
HEAD
B
CHIN INDIRECT FORCE
Fractures the base of the skull
O
HAND INDIRECT FORCE
Fractures the collar bone
D

FEET INDIRECT FORCE

Fractures the base of the skull
or spine
Y
CLOSED FRACTURE

OPEN FRACTURE

Simple fracture

NOT amputated now but use

of pins
- Steady and support
- Cover with a tented dressing
- Build up padding and secure
in place
- Immobilise as for a closed
fracture using a sling
COMPLICATED FRACTURE
Under the rib cage
Stable and unstable fracture
PELVIS AND LEG
Pelvis stable injury
Leg unstable injury

Page 147
The spine 7 NECK, 12 BACK, 5 WASTE, 5 BUM and 4 TAIL
Vertebra, spinal cord and disc
Features which may help RECOGNITION OF FRACTURED
SPINE may include
Spinal bones only

Spinal cord damaged

RESPONSE

Alert or unconscious

AIRWAY

Nothing to help recognition (NTHR)

BREATHING

NTHR

May be difficult or stops

CIRCULATION

NTHR

May stop

OTHER RECOGNITION FEATURES

Pain, tenderness

Pain, tenderness may be

absent

Step, indentation
or twist in the spine
Loss of limbs control
Loss of sensation

HISTORY AND EXTERNAL CLUES

Evidence of direct or indirect force
Skull fracture
Initial assessment
NO

Danger

Response Airway

Breathing Circulation

G15k

Bleeding ear facing the ground to drain

Place in recovery position

Treat any wound

Get ambulance urgently
Monitor response and carry out A B C every 10
minutes in detail

Or if initial assessment
NO

Danger

Response Airway

Breathing Circulation

With the casualty lying down, face up and with a raised head

Unit 9 27th October 2006

Assessment

Important info:
12 year-olds plus 16 to 18 breaths per minute, 20 children
and 30 babies
60 to 80 heartbeats per minute. To simplify matters, monitor
/ count for 10 seconds and then multiply by 6.
Air contains 21 % oxygen and 79 % nitrogen (pollution)
Out of the 21 % oxygen inhaled, only 5 % is required by the
body and the other 16 % is exhaled, allowing us to give
oxygen to others through CPR
If casualty is breathing, then bring to recovery position, if
not, start CPR

With compression, the casualty exhales, with breathing,

casualty inhales
Therefore they cannot be done together either
compression or breathing
For every 13 kgs of weight we have 1 litre of blood with a
maximum of 6 litres (i.e. 78 kgs !!!) 2 litres loss is critical
REVISE CPR
1.
2.
3.
4.
5.
6.
7.

Check if there is danger in the area

Call out for help if can be heard
Tap on casualtys shoulders
Pinch the casualtys ear
Push head backwards to check airwave
Listen to breathing unconscious ? Breathing ?
Give a message to somebody nearby Go to ask for
help, call 112 for an ambulance, tell them that there is
an unconscious person, who is not breathing. I will start
CPR and come back with a reply.
8. Carry out 30 compressions
9. Carry out 2 rescue breaths / ventilation
10.
Repeat the cycle 8 and 9 above three times
achieving 100 compressions per minute
We have two pipes leading into the body from the mouth,
one is for AIR, the other for FOOD. When eating, the AIR
pipe closes off and if it does not, FOOD passes through it and
can cause CHOKING
DEFIBRILLATOR resets the heart after stopping it
Pancreas frixa left
Liver fwied right
Kidney kliewi right back
Remember two uses for rectangular bandage as a SLING
and as a SUPPORT

TENDON muscle to bone

LIGAMENT bone to bone
STRAIN muscle or tendon stretched too much
SPRAIN ligament