FIRST AID IN EMERGENCIES

Dr. Rajiv Bankar

M.D.(Medicine)
 OBJECTIVES

 Why First Aid ?

 Accidents,Sudden cardiac deaths & some

diseases manifesting acutely & endangering
life require to be attended immediately so
that Mortality (Death) & Morbidity (Disability
due to event) decrease substantially.
 Aims of First Aid
Part 1
To avoid further damage to a victim by
stabilizing & carrying him to Health Centre.
Part 2
To actually try to save a victims life by
undertaking maneuvers to support
functioning of Heart & Respiratory System.
= CardioPulmonary Resuscitation (CPR)
 Why YOU ?

 You are available next

 Consider your Colleague / Kin needing
First Aid
 Consider yourself needing help & you will
definitely welcome person willing to offer
First Aid
Importance for Power Engineers

 As persons involved in Power Generation

you are required to work in places which
consist of Machines, Heights, Electrical
Equipments.
 Hence an accident can occur involving
any of these like getting involved in a part
of machine or a fall from height.
Situations to be Considered
 Injuries
 Skin Wounds –
Abrasions, Incised, Lacerated
 To Soft Tissues - Muscles, Tendons, Fasciae
 To Blood Vessels leading to bleeding
 To Nerves leading to Paralysis
 To Bones = Fractures - General
considerations & Special Situations
 Unconscious victim
 Cardiorespiratory Arrest
 BACKGROUND
 Approximately 700,000 cardiac arrests per year
in Europe
 Survival to hospital discharge presently
approximately 5-10%

 Bystander CPR vital intervention before arrival of

emergency services

 Early resuscitation and prompt defibrillation

(within 1-2 minutes) can result in >60% survival
 Shock
 Shock = Fall of BP, Popularly
called ‘low BP’
IF YOU SEE AND FEEL:

 Pale skin  Weak pulse,

 Cold skin  Unresponsiveness,
 Weakness  Dilated pupils later on
 Shock
 Keep victim lying down and covered
enough to prevent loss of body heat.
The body position should be adjusted
according to the victim's injuries.
 Victims in shock may improve if the
feet are raised 8 to 12 inches.
 Immediately Call for Ambulance
 Wounds

Concerns

 Infection
 Bleeding
 Delayed Healing
 Wounds

WHAT YOU SHOULD DO

 Apply pressure to stop bleeding.

 Cleanse wound with soap and water
 Apply antiseptic ointment / lotion if
available
 Cover with sterile or clean bandage.
 BURNS MINOR BURNS:

 Hold the area of burn under cold

running water for 15mins.
 Gently remove any jewellery,
watches or constricting clothing
from injured area before it begins to
swell.
 Cover the area with sterile dressing
or any clean, non fluffy material and
bandage loosely in place.
 BURNS MAJOR BURNS:

 If casualty’s body catches fire, ask him/her to

Stop, Drop and Roll . If possible wrap with a Fire
Blanket Before rolling them.
 Gently pour water continuously on the affected
area of the casualty.
 Carefully remove burned clothing unless it is
sticking to the burn.
Apply non-adherent dressing on affected area.
For certified First Aider: be ready to resuscitate.
For conscious casualty, give oxygen if
available.
CHEMICAL SPLASHES ON EYE
 Open eyelid and flush with
water for several minutes, make
sure water flow is away from
the other eye.
 Cover the affected eye with
sterile eye pad and bandage.
 Seek immediate medical
treatment.
CHEMICAL SPLASHES ON SKIN

 Remove contaminated clothing

and flush with water for at least
20mins.
 Obtain medical aid immediately.

For Hydrofluoric Acid splashes,

Flush with water
Apply calcium gluconate cream.
INHALATION OF GASES OR VAPOURS
 Evacuate affected Lab
 Remove casualty to a safe area (open area for
fresh air)
 Supply oxygen gas (if available)
 For certified First Aider:
 Apply Cardiac Pulmonary Resuscitation (CPR)
if pulse is absent.
 Call for medical aid without delay

REMEMBER:
ALWAYS CHECK AREA SAFE AND CLEAR FROM
HAZARD BEFORE PROCEED!
ELECTROCUTION
 Cut off main power supply
 ALWAYS CHECK AREA SAFE AND CLEAR
FROM HAZARD BEFORE PROCEED!
 NEVER TOUCH THE CASUALTY WITH BARE
HANDS
 Remove casualty to a safe area
 Call for medical aid without delay
 For certified First Aider: Apply CPR if pulse is
absent.
ELECTROCUTION
 Which type of Electric current is more
dangerous to Human being
 Factors deciding when Electric Current
would be more dangerous.
 Resistance
 Path of Electric Current if involves vital
organs
 Cautions at the time of Lightening
Fracture Spine - Cervical
 In a trauma situation, the neck should be
immobilized until x-rays are taken and
reviewed by a doctor.
 Always assume that an unconscious
individual has a neck injury and respond
accordingly.
 Temporary or permanent paralysis may
occur.
Fracture Spine - Cervical
 Conscious patients with an acute neck injury will
have
 severe neck pain,
 pain spreading from the neck to the shoulders or
arms
 The physician will perform a complete neurological
examination to assess nerve function and may
request additional radiographic studies, such as MRI
or computed tomography (CT), to determine the
extent of the injuries.
Diagram Spine
Cross Section Vertebra
LS Vertebra & Fracture
MRI SCAN SPINE
MRI SCAN SPINE
X RAY SPINE
 Fractures

HOW TO IDENTIFY THAT A PERSON

HAS FRACTURE

 History of Trauma
 Pain at the site of Injury
 Inability to move the limbs
 Deformity of limbs
 Swelling
 Fractures
Prevent movement of injured
parts
Apply Splint before moving
the patient.
For sprains, elevate affected
part and apply cold
compresses.
Elastic bandages may be
used for immobilization.
X RAY ARM # HUMEROUS
X RAY LEG
X RAY Wrist shows NO #
MRI same pt shows #
STEPS FOR APPROACHING A VICTIM

Approach safely
Check response
Shout for help
Open airway
Check breathing
Call Ambulance
30 chest compressions
2 rescue breaths
 Why CPR
Progression to biologic death is a function of the
mechanism of cardiac arrest and the length of the
delay before interventions.
VF or asystole without CPR within the first 4–6 min
has a poor outcome even if defibrillation is successful,
because of superimposed brain damage; there are few
survivors among patients who had no life support
activities for the first 8 min after onset.
Outcome statistics are improved by lay bystander
intervention (basic life support—see below) prior to
definitive interventions (advanced life support), and
even more by early defibrillation.
CHAIN OF SURVIVAL
 APPROACH SAFELY!

Approach safely

Scene Check response

Shout for help
Rescuer Open airway
Check breathing
Victim
Call Ambulance
Bystanders 30 chest compressions
2 rescue breaths
CHECK RESPONSE

Approach safely
Check response
Shout for help
Open airway
Check breathing
Call Ambulance
30 chest compressions
2 rescue breaths
CHECK RESPONSE

Shake shoulders gently

Ask “Are you all right?”
If he responds
 Leave as you find him.
 Find out what is wrong.
 Reassess regularly.
SHOUT FOR HELP
Approach safely
Check response
Shout for help
Open airway
Check breathing
Call 112
30 chest compressions
2 rescue breaths
 OPEN AIRWAY
Approach safely
Check response
Shout for help
Open airway
Check breathing
Call Ambulance
30 chest compressions

HEAD TILT CHIN LIFT 2 rescue breaths

JAW THRUST when Cervical Injury is likely
Knowing Airway
CHECK BREATHING
Approach safely
Check response
Shout for help
Open airway
Check breathing
Call Ambulance
30 chest compressions
2 rescue breaths
CHECK BREATHING
 Look, listen and feel
for NORMAL
breathing

 Do not confuse
agonal breathing
with NORMAL
breathing
 AGONAL BREATHING
 Occurs shortly after the heart stops
in up to 40% of cardiac arrests

 Described as barely, heavy, noisy or

gasping breathing

 Recognise as a sign of cardiac arrest

CALL AMBULANCE
Approach safely
Check response
Shout for help
Open airway
Check breathing
Call Ambulance
30 chest compressions
2 rescue breaths
30 CHEST COMPRESSIONS
Approach safely
Check response
Shout for help
Open airway
Check breathing
Call Ambulance
30 chest compressions
2 rescue breaths
30 CHEST COMPRESSIONS
• Place the heel of one hand in the
centre of the chest
• Place other hand on top
• Interlock fingers
• Compress the chest
– Rate 100/min
– Depth 4-5 cm
– Equal compression : relaxation
• When possible change CPR
operator every 2 min
30 CHEST COMPRESSIONS
RESCUE BREATHS
Approach safely
Check response
Shout for help
Open airway
Check breathing
Call Ambulance
30 chest compressions
2 rescue breaths
RESCUE BREATHS

 Pinch the nose

 Take a normal breath
 Place lips over mouth
 Blow until the chest
rises
 Take about 1 second
 Allow chest to fall
 Repeat
CONTINUE CPR

30 2
RESCUE BREATHS


 Approach safely
Check response
Shout for help
Open airway
Check breathing
Call Ambulance
30 chest compressions
2 rescue breaths
DEFIBRILLATION
DEFIBRILLATION
Approach safely
Check response
Shout for help
Open airway
Check breathing
Call Ambulance
Attach AED
Follow voice prompts
SWITCH ON AED

 Some AEDs will

automatically switch
themselves on when
the lid is opened
ATTACH PADS TO
CASUALTY’S BARE CHEST
ANALYSING RHYTHM
DO NOT TOUCH VICTIM
SHOCK INDICATED

 Stand clear
 Deliver shock
 SHOCK DELIVERED
FOLLOW AED INSTRUCTIONS

30 2
NO SHOCK ADVISED
FOLLOW AED INSTRUCTIONS

30 2
 IF VICTIM STARTS TO BREATHE
NORMALLY

PLACE IN RECOVERY POSITION

 Recovery position for
unconscious adult Person:
 Kneel alongside victim. Place the arm nearest
to you at a right angle to their body. Bring the
furthest arm across their chest. Grab the knee
furthest from you and pull towards you,
rolling them onto their side.
 Tilt the head back so the person can breathe.
Call an ambulance and stay with them.
 Remember; roll the person on their side, tilt
their head back, call ambulance and keep an
eye on them until the ambulance arrives.
Recovery position
Recovery position
 CPR IN CHILDREN

 Adult CPR
techniques can
be used on
children.
 Compressions
1/3 of the depth
of the chest.
 AED IN CHILDREN
Age > 8 years: use adult AED

Age 1-8 years

use paediatric pads / settings if
available (otherwise use adult
mode)

Age < 1 year

use only if manufacturer
instructions indicate it is safe
CPR Video
ANY QUESTIONS?
 Approach safely Approach safely
Check response Check response
Shout for help Shout for help
Open airway Open airway
Check breathing Check breathing
Call Ambulance Call Ambulance
30 chest compressions Attach AED
2 rescue breaths Follow voice prompts
 Drowning
Try to get the person out of water without
you going in water yourself using a wood
stick or robe or any other thing.
Check for his breathing. If he is breathing,
put him in the recovery position.
Ifhe is not breathing, start artificial
respiration and CPR immediately.
Keep the victim warm by using blankets or
give warm fluids if he is conscious.
 SEIZURES
 Make him lie on his back
 Put anything under his head
 Loosen his tight clothes as neck tie
 Don't put any hard thing in his mouth.
 Then turn him on his side then make him to
sit .
 If the fits become continued or come
repetitively after each other call the
emergency service.
 Snake Bite

 Call for emergency assistance immediately if

someone has been bitten by a snake.
Responding quickly in this type of
emergency is crucial.
 Don't try to capture the snake.
 Don't cut the wound or suck the venom with
your mouth.
 Snake Bite
 Wash the bite with soap and water.
 Immobilize the bitten area and keep it lower than
the heart.
 Cover the area with a clean, cool compress or a
moist dressing to minimize swelling and
discomfort.
Monitor vital signs.
If a victim is unable to reach medical care within
30 minutes, the American Red Cross
recommends:
 Snake Bite
 Apply a bandage, wrapped two to four inches above
the bite, to help slow the venom. This should not cut
off the flow of blood from a vein or artery - the band
should be loose enough to slip a finger under it.
 A suction device can be placed over the bite to help
draw venom out of the wound without making cuts.
These devices are often included in commercial
snake bite kits.
 Patient should receive anti snake venom
immediately.
 Preventing snake
bites
Leave snakes alone. Many people are bitten
because they try to kill a snake or get too close
to it.
Stay out of tall grass unless you wear thick
leather boots and remain on hiking paths as
much as possible.
Keep hands and feet out of areas you cannot
see.
Be cautious and alert when climbing rocks.
 Nose bleeding
 Sit or stand upright to slow the flow of blood in the
veins of the nose.
 Don't tip your head back.
 Pinch your nose with your thumb and forefinger for
10 minutes without relieving pressure. Use a watch
or a clock to make sure you keep up the pressure a
full 10 minutes. .
 Breathe through your mouth during this time.
If the bleeding continues despite these efforts, see
your doctor.
 Bleeding
 Make sure there's nothing embedded in the wound.
 Put pressure on the wound,
 Sit the person down and raise it above the level of
the heart. Apply a bandage - a clean towel or
pillowcase will do.
 If bleeding still continues, apply pressure to blood
vessels leading to area—in arm, press just below
armpit; in leg, press against groin where thigh and
trunk join.
 Tourniquette.
 Then call for an Ambulance if necessary.
 Fainting

 Unconsciousness, paleness, rapid pulse,

coldness of the skin, sweating.

 Leave victim lying down, loosen clothing,

roll victim to the side and wipe out mouth
in the event of vomiting.
Raise the legs .
 Heatstroke

 High temperature (as high as 108–

112°F/42–44°C), hot dry skin, rapid pulse,
possibly unconsciousness.

 Immediately undress victim and sponge

with or immerse in cool water or wrap in
water-soaked sheets. Use fan or air
conditioner.
 Heat Cramps
 Painful, muscle spasms during heavy exercise in
hot environments with inadequate fluid intake.
 Usually involves the calves, arms, abdomen and
back, may involve any muscle group involved in
the exercise.
 Rest briefly; Cool down.
Drink water or an electrolyte-containing drink.
Practice gentle, range of motion, stretching and
gentle massage of the affected muscle group.
Don't take salt tablets.
 Dislocations
 Dislocations may occur in major joints or in
smaller joints; will temporarily deform and
immobilize joint and cause sudden and severe
pain.
 A dislocation requires prompt medical attention.
 Until help arrives, splint the affected joint into its
fixed position. Don't try to move a dislocated
joint or force it back into place. This can damage
the joint and its surrounding muscles, ligaments,
nerves or blood vessels.
Put ice on the injured joint. It reduces swelling.
Spinal Injury
 If you suspect a back or neck (spinal) injury, DO NOT MOVE THE
AFFECTED PERSON. Permanent paralysis and other serious
complications can result.
 Assume a person has a spinal injury if:
There is evidence of a head injury, with an ongoing change in the
person's level of consciousness.
The person complains of severe pain in the neck or back.
An injury has exerted substantial force on the back or head.
The person complains of weakness, numbness or paralysis, or
lacks control of the limbs, bladder or bowel.
The neck or back is twisted or positioned oddly.
 If you suspect someone has a spinal injury:
1.Call for emergency medical assistance.
2.Keep the person still.
3.Stabilize the neck with a heavy towel or other soft, bulky material
until emergency care arrives.
4.Provide as much first aid as possible without moving the person's
head or neck.