Professional Documents
Culture Documents
Tantawi, 2017
First Aid
List of Contents
References ........................................................................ 72
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All rights reserved to the authors dr Bothayna N. Sadek and Dr. Hayam S. Tantawi, 2017
Caution
This type of box highlights areas where additional caution is
needed.
Don't do this!
This type of box shows the reader a common mistake or
something that could harm the victim.
Best Practice
These boxes highlight a technique commonly used because it's
the best (or one of the best) ways of doing things or it is
something important to remember.
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VIP
Purposes of first aid
The key guiding principles and purposes of first aid are
MCQ
often given in the mnemonic "3Ps".
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2. If first aid begins, the responder must not leave the scene
until:
Arrival of medical assistance.
Somebody of equal or higher ability can take over.
Continuing to give aid is unsafe. (( If the place is unsafe ))
3. The responder is not legally liable for the death,
disfigurement or disability of the victim.
First aid consent
Importance
The first aid provider should gain a permission to avoid
causing offense or distress. Most people and cultures involve
a certain respect for a person's personal space.
Gaining consent
The simplest way to gain consent is to ask the victim if
they will allow you to treat them. Talk to the victim, and build
up a rapport with them. During this conversation, it is
important to identify the following key points:
1. Who you are? - Start with your name, and explain that
you are a trained first aider.
2. Why you are with them? - They are likely to know they
have an injury or illness.
3. What you are going to do? - Some first aid procedures
can be uncomfortable (such as cleaning a wound with
saline). So, it is important to be honest with the victim
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about what you are doing, and if necessary, why it is
important.
Judgment of consent
The first aider may have to assess the level of judgment
in helping a victim who cannot give permission or initially
refuse for the following cases:
1. Unconscious victim or reduced level of consciousness.
2. Intoxicated.
3. Irrational (i.e. delusional and confused due to the
injuries).
4. Victim suffering from learning difficulties. First aid
protective precautions
I. Awareness of Dangers
Rushing into a situation without first checking for safety
may result in you also becoming injured which mean you will
not be able to help the other person, and you are now also a
casualty.
Types of dangers:
a. Environmental dangers: A danger in the surroundings,
such as broken glass, falling objects, electrical wires,
fast vehicles, fumes or chemicals
b. Human dangers: Danger from people at the scene
(including the victim) (( As infectious diseases )) which
can be intentional or accidental.
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Caution
Remember, if you get hurt you are not going to be able to help
anyone else.
1. Gloves
Gloves protect the hands and maintain safety. They protect
not only from bodily fluids, but from any dermatological
infections that the victim may have. ) (
M The first action should be taken by the first aider in case of
C
bleeding Gloves On
Q
Best Practice Remember GO to the victim
(Gloves On) Types of gloves:
Nitrile it is often purple or blue color. It is completely
impermeable to bodily fluids.
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Latex - These are not used as widely as they once were
due to a prevalence of allergies to latex.
2. CPR Adjunct
The other key piece of protective equipment that should be in
every first aid kit is an adjunct for helping to perform safe
mouth-to-mouth resuscitation.
3. Safety Glasses
Prevents spurting or pooled fluid which could splay from
coming in contact with the eyes.
4. Apron or gown
Disposable aprons are common items in larger kits, and help
protect the rescuers clothing from contamination.
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Primary assessment
1. Protecting yourself
Dont place yourself in a situation which might put you
in danger.
2. What has happened?
a. Gain as much information as possible about the
incident.
b. Assess the Scene (place, causes of injury).
c. Be sure to listen - While working on a victim you may
overhear information from witnesses in the crowd.
3. Responsiveness
a. Check what is wrong with the person. e.g. are they
bleeding, conscious or unconscious, breathing or not
breathing, etc.
b. Assess the initial responsiveness of the victim by greeting
and question.
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c. The best response to this would be a victim looking at you
and replying. This means that the victim is alert.
Key indicators on the victim are their:
1. Eyes - Are they open spontaneously? Are they looking
around? Do they appear to be able to see you?
2. Response to voice - Do they reply? Can they obey
commands?
3. Response to Pain through:
Sternal rub - This involves digging your knuckle in to
the sternum, or breastbone of the victim (between the
nipples).
Nail bed squeeze - Using the flat edge of a pen or
similar object, squeeze in to the bottom of the victim's
fingernail (hard).
Ear lobe squeeze - using thumb and fore finger,
squeeze the victim's ear hard.
Best Practice
MCQ
If the victim is Unresponsive. You must check on key life
critical systems of breathing and circulation (ABC).
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All rights reserved to the authors dr Bothayna N. Sadek and Dr. Hayam S. Tantawi, 2017
..
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Cardio Pulmonary Resuscitation Cardio (heart)
pulmonary (lung) Resuscitation (revitalize) serves
as an artificial heartbeat and an artificial respirator.
C Chest compressions
A Airway C -A-B
B Breathing
High-Quality CPR
1. A compression rate of at least 100/min (this is a change
from approximately 100/min).
2. A compression depth of at least 2 inches (5 cm) in adults
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Unresponsive
No breathing
or only gasping
Activate
emergency
Response Get defibrillator
Check pulse
Check rhythm/
Start CPR
Push hard shock
Push fast If indicated repeat
Every 2 minutes
Assessment
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All rights reserved to the authors dr Bothayna N. Sadek and Dr. Hayam S. Tantawi, 2017
1. Check the victims pulse (take pulse for no more 10
seconds). MCQ
2. If you do not definitely feel pulse within ((10 seconds)),
perform 5 cycles of compressions and breaths (30:2
ratio), starting with compressions (C-A-B Sequence).
Dont compress on the ribs to avoid its fracture and injury of the lung
which then cause bleeding
Dont compress on
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3. When performing chest compressions, position yourself
at the victims side.
4. Make sure the victim is lying face up on a firm, flat
surface.
5. Put the heel of one on the center of the victims chest on
the lower half of the breast bone
6. Put the heel of your other hand on the top of the first
hand.
7. Straighten your arms and position your shoulders
directly over your hands.
Squeezing
the heart
between back
bone and
chest bone
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Fig. (4): cardiac compression
9. Count aloud as you compress 30 times at the rate of
about 3 compressions for every 2 seconds or
approximately 100 compressions per minute.
10.Chest compressions will supply blood flow to the heart
and the brain but if victim remains unresponsive you
will need to check their airway.
II. Assess Airway (A) If no raising of chest during chest recoil .. should
open the airway by two methods
"A" is for AIRWAY.
1. With the victim lying flat on his back, place your hand
on his forehead and your other hand under the tip of the
chin (the head tilt- chin lift maneuver).
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III. Breathing (B)
"B" is for Breathing.
1. If the person is still not breathing on his own after the
airway has been cleared, you will have to assist him
breathing.
2. Pinch the victim nose with your finger tips to prevent air
from escaping once you begin to ventilate and place
your mouth over the victim's, creating a tight seal.
3. Give two full breaths. Between each breath allow the
victim's lungs to relax - place your ear near his mouth
and listen for air to escape and watch the chest fall as
the victim exhales. (( In children put mouth to mouth
and nose ))
4. Deliver air over 1 second to make the victims chest rise.
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I. Child BLS
The child BLS sequence and skills are similar to the
sequence for adult BLS. The key differences between the child
and adult BLS are:
1. Compression-ventilation ratio for lone rescuer is 30
compressions to 2 breaths when giving CPR to victims
for all ages except newborns. In case of two rescuers
CPR give 15 compressions to 2 breaths.
2. Compression depth: for children, compress at least one
third the depth of the chest, approximately 2 inches
(5cm).
3. Compression technique: may use 1- or 2 handed chest
compressions for very small children.
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All rights reserved to the authors dr Bothayna N. Sadek and Dr. Hayam S. Tantawi, 2017
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All rights reserved to the authors dr Bothayna N. Sadek and Dr. Hayam S. Tantawi, 2017
Chocking:
Choking is usually caused by a piece of foreign matter
such as food becoming lodged in a person's airway. Because a
choking victim is fully aware that he cannot breathe normally,
a sense of panic may overcome them. It is important to try and
keep the victim calm to determine whether your assistance is
truly necessary or if the victim's own coughing reflex is
sufficient.
1. Start by asking the person if he is choking (A choking
victim will not be able to speak, he can do gesture or point
to his throat and you notice his face starting to turn blue).
2. Ask them if you can help.
3. Perform the Heimlich maneuver immediately.
Heimlich maneuver
VIP 1. Start by finding the proper stance - behind the victim with
one of your feet planted firmly between the victim's feet.
2. Wrap one of your arms around the victim and place your
hand in a closed fist just slightly above his belly button.
3. Place your other hand directly on top of the first.
4. Squeeze the victim's abdomen in quick upward thrusts as
many times as it is necessary to dislodge the foreign
object (chest thrusts if they are big or pregnant).
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All rights reserved to the authors dr Bothayna N. Sadek and Dr. Hayam S. Tantawi, 2017
5. If the food comes out make them comfortable and
activate ambulance if they need it.
6. If you fail to clear the victim's air passage, dial 1-2-3
immediately and continue to perform the Heimlich
maneuver until help arrives.
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If they are visibly pregnant, or you cant get your arms
around their abdomen then you must do chest thrusts on
the breastbone.
If they are considerable shorter than you, such as a child,
kneel down behind them and do the exact same thing.
Never pick up a child to put them on a table or a chair
simply because you dont want to kneel down.
After wards, this person should go see a doctor to make
sure there was no internal damage done during the
procedure.
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Infant Chocking
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All rights reserved to the authors dr Bothayna N. Sadek and Dr. Hayam S. Tantawi, 2017
7. Provide up to 5 down ward chest thrusts on the midline of
the chest over the lower half of breastbone. Deliver chest
thrusts at a rate of 1 per second, each with the intension of
creating enough force to dislodge the foreign body.
8. Repeat the sequence of up to 5 back slaps and 5 chest
thrusts until the object is removed or the infant becomes
unresponsive.
Don't do this!
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All rights reserved to the authors dr Bothayna N. Sadek and Dr. Hayam S. Tantawi, 2017
2. Call for help and activate the emergency response system.
Place the infant on a firm, flat surface.
3. Begin CPR with 1 extra step: each time you open the
airway, look for the obstructing object in the back of the
throat. If you see an object and can easily remove it,
remove it.
4. After approximately 2 minutes of CPR, activate the
emergency response system.
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Recognition of bleeding
N.B. If there is large amount of bleeding, this means life-
threatening.
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Caution
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All rights reserved to the authors dr Bothayna N. Sadek and Dr. Hayam S. Tantawi, 2017
3. Direct Pressure
Refers to placing direct pressure on the wound in order to
stop the flow of blood. This is best done using a dressing,
such as a sterile gauze pad or any suitable material.
If the blood starts to come through the dressing, add
additional dressings to the top, to a maximum of three.
If you reach three dressings, you should remove all but the
one in contact with the wound itself (as this may cause it
to re-open) and continue to add pads on top.
Repeat this again when you reach three dressings.
: 3
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Internal Bleeding
Internal bleeding is bleeding which occurs inside the
body causing blood loss and shock. Sometimes the blood leaks
from inside the body through natural openings. Other times the
blood stays inside the body.
Causes:
Internal is more dangerous
Falls
than external because cant
Motor car accidents
Gunshot wounds see it
Injures from explosions
Impaled Objects
Surgery Warning signs:
Blood comes out of the nose or mouth (severe head
trauma).
Blood or clear fluid comes out of the ear (severe head
trauma).
Blood is in the stool.
Blood is in the urine.
Fresh bright red blood or blood like 'coffee-grounds', in the
vomit.
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All rights reserved to the authors dr Bothayna N. Sadek and Dr. Hayam S. Tantawi, 2017
Wound:
It is a break in the continuity of the tissues of the body either
internal or external usually caused by an act or accident?
VIP Wound Classification:
I. Closed wound as: II. Open wounds as:
Contusion Abrasion.
Laceration
Puncture
I. Closed Wound
It is damage to underlying tissues without breakdown of
the skin or mucous membranes.
Causes:
They are usually caused by a blunt force striking the body
such as: fall, in proper handling of a closed fracture and hitting
with a hammer.
Signs and Symptoms:
1. Immediate swelling and pain due to blood leakage into
the tissue.
2. Hematoma -------- localized redness. - Tenderness.
3. Shock due to blood loss (if sever).
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First Aid for Closed Wound: (COLD WATER)
1. If swelling and discoloration are evident, indicating
internal bleeding. The use of cold compresses is
recommended.
2. A bandage, such as roller gauze, may be applied to
provide pressure to help control the bleeding.
3. After 24 hours hot compresses applied to enhance
absorption.
4. Administer analgesic if necessary.
5. First aid care for shock should be administered if any of
the symptoms of shock are present (This is if the wound
is sever).
II. Open Wounds ( COLD WATER)
It is a break of the continuity of the skin or mucous
membrane. It is obvious and subject to bleeding, infection and
shock, tissue and nerve damage can occur.
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III. Third Degree (Full Thickness) o Extends through
epidermis, dermis, and into
subcutaneous tissues.
o Dry, leathery appearance
o May be charred, mottled, Or
white
o If red, will not blanch with
pressure
o Painless in the center of the burn
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For 3rd degree burns do not put anything on the burn,
seek medical help immediately and treat for shock. 3rd
degree is extremely life threatening even when a small
body part is affected. If there is clothing on the burn do
not remove it as this may also remove skin. There is a
very high risk of infection from this kind of burn.
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All rights reserved to the authors dr Bothayna N. Sadek and Dr. Hayam S. Tantawi, 2017
First Aid:
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All rights reserved to the authors dr Bothayna N. Sadek and Dr. Hayam S. Tantawi, 2017
Assess and document:
o Alignment o Warmth o Tenderness
o Sensation
o Motion
o Circulatory status distal to injury o
Intactness of skin
Cover open fractures with a sterile dressing.
Remove rings from fingers immediately if upper
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First Aid:
Remove or inactivate the poison before it's absorbed.
Provide supportive care in maintaining vital organ
function
Administer a specific antidote to neutralize specific
poison
To implement treatment that hastens the elimination of
the absorbed poison
1) Ingested poisons:
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Corrosive poisons include alkaline and acids agents that can
cause tissue destruction. After coming in contact with mucous
membranes. Alkaline products include lye, drain cleaners,
toilet bowl cleaners, bleach. Acid products include toilet bowl
cleaners, pool cleaners, metal cleaners, rust removers and
battery acid.
First aid:
Measures are instituted to remove the toxin or decrease
its absorption.
2) Carbon Monoxide Poisoning :
May occur as a result of industrial or house -held incidents or
attempted suicide. Carbon monoxide exerts its toxic effect by
binding to circulating hemoglobin and thereby reducing the
oxygen carrying capacity of the blood. Hemoglobin absorbs
carbon monoxide 200 times more readily than it absorbs
oxygen.
Signs and Symptoms
Progress rapidly to coma. Skin color, which can range
from pink or cherry red to cyanotic and pale, is not a
reliable sign.
All rights reserved to the authors dr Bothayna N. Sadek and Dr. Hayam S. Tantawi, 2017
Good Luck
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