FIRST AID/BASIC LIFE SUPPORT

FIRST AID- is an immediate care given to a person who has been injured or suddenly taken ill. It
includes self-help and home care if medical assistance is not available or delayed.

GOALS OF A FIRST AID

ALLEVIATE SUFFERING - One of the main objectives is to be able to help reduce or totally alleviate
suffering

PREVENT FURTHER INJURY OR DANGER - Also sometimes called prevent the condition from
worsening, or danger of further injury

PROLONG LIFE - First aid measures aim to preserve and sustain life. Also, to save victims from
imminent danger.

ROLES OF FIRST AID?

• It is the bridge that fills the gap between the victim and the physician.
• It is not intended to compete with, or take the place of the services of the physician.
• It ends when the service of the physician begins.

CHARACTERISTICS OF A GOOD FIRST AIDER

1. GENTLE - First aider should not cause, add pain to the patient.
2. RESOURCEFUL - Makes the best use of things at hand.
3. OBSERVANT - Should notice all signs. Aware what is happening and what may happen.
4. TACTFUL - Handling the victim with utmost care and in calm manner.
5. EMPHATIC - Should be comforting.
6. RESPECTABLE - Maintains a professional and caring attitude.

GENERAL GUIDELINES ADMINISTERING FIRST AID

• PLANNING OF ACTION
Established based on anticipated needs and available resources.
- Ex: Getting to know where the first aid kits are located as well as other emergency equipment such as
fire extinguishers, fire alarm switches and fire exits, Also by being aware of the emergency numbers
such as ambulance providers, hospital emergency room, fire department and police stations.

• GATHERING OF NEEDED MATERIALS

Preparation of equipment and personnel.

• INITIAL RESPONSE (SEQUENCE OF ACTION)

▪ AID
A – Ask for Help
I – Intervene. Give appropriate interventions
D – Do not give further harm
EMERGENCY ACTION PRINCIPLES
✓ Survey the scene
✓ Do a primary survey of the victim
✓ Activate medical assistance/transfer facility
✓ Do a secondary survey of the victim.

SURVEY THE SCENE

- Is the scene safe? Safe for the patient and for the rescuer?
- What happened?
- How many people are injured?
- Are there someone who can help?
- Get consent before giving first aid care.

Do a primary survey of the victim

Check for vital body functions:
AIRWAY, BREATHING and CIRCULATION by following the ABC Steps
1. AIRWAYS
- Is the victim conscious?
- If the victim is conscious, assess breathing as describes in B.
- If the victim is unconscious, start immediately airway management (Open the Air way
refer to CPR)
2. BREATHING
Is the victim’s breathing?
✓ If the victim is breathing
A. Is it shallow or deep?
B. Does he appear to be choking?
C. Is he cyanotic, suggesting poor oxygenation?
If the victim appears to have difficulty breathing, immediately support his breathing
(maintain adequate open airway).
If the victim is not breathing – provide initial ventilation
3. CIRCULATION
- If it is, then how it is? (Assess pulse)- provide other care necessary. If not
perform CPR.
- Is he severely bleeding?
- Activate medical assistance or transfer facility.

• PERFORM L – L – F
LOOK - For the rise and fall of chest.
LISTEN - To the sound of air coming from the mouth or nose of the victim.
FEEL - The Carotid pulse using your index and middle finger

*Do it for 10 seconds (1001, 1002, 1003……... 1010)

Information to be remembered in activating medical assistance:

1. What happened
2. What happened
 3. Number of persons injured
4. Extent of injury and first aid given
5. The telephone number from where you are calling - Person who activated medical
assistance must drop the phone last.

DO THE SECONDARY SURVEY OF THE VICTIM

✓ Interview the victim:
✓ Check the vital signs:

CARDIO-PULMONARY RESUSCITATION
STEP BY STEP PROCEDURE ON ADMINISTERING CPR

• SURVEY THE SCENE

➢ Is the scene safe? Safe for the patient and for the rescuer?
➢ What happened?
➢ How many people are injured?
➢ Are there someone who can help?
➢ Get consent before giving first aid care.

HEAD TILT

CHIN LIFT
 LOOK

LISTEN

FEEL

NORMAL RESPIRATORY RATE:

18 – 24 Respiratory Rate per minute

NORMAL PULSE RATE:

60-80 BEATS PER MINUTE

CONDITIONS WHEN CPR IS NEEDED

• The victim is UNCONSCIOUS.
• PULSE is WEAK or NO PULSE.
• NO BREATHING/ Difficulty in breathing.
 • A cycle of chest compression is composed of 30 compressions at rate of 80-100 per minute.

• After a cycle, 2 Rescue breaths are administered.

CPR CYCLES:
5 Cycles composed of:
CYCLE 1:
- 30 compressions
- 2 rescue breaths
CYCLE 2:
- 30 compressions
- 2 rescue breaths
And so on and so forth until the 5th cycle.
• Re assess the victim after 5 cycles using the primary survey (CABC).
Consciousness, Airway, Breathing, Circulation

CARE OF THE VICTIM AFTER SUCCESSFUL CPR

• Transfer in a secured place.
• Place in a side lying position- Recovery position.
 • Wait for the emergency response unit and continuously monitor the victim.

RECOVERY POSITION

ALL VICTIMS OF CARDIAC ARREST SHOULD RECEIVE CPR UNLESS:

- Patient has a valid DNAR
- Patient has signs of irrevocable death
- No physiological benefit can be expected because functions have detoxicated
- Gestation of < 23 weeks or birth weight of <400g
- Attempts to perform CPR would place the rescuer at risk of physical injury

FOREIGN BODY AIRWAY OBSTRUCTION (FBAO)

- An event most likely witnessed
- Universal Choking Sign: Hands around the neck
- Signs of completely Obstructed Airway
- Making high pitched wheezing noises
- Inability to speak or move away air

HEIMLICH MANUEVER
PROCEDURE:
1. Ask the patient “Are you choking?”
2. If they are unable to speak, stand behind him, place a closed fist (thumb first) above the
belly button and place the other hand over the fist
3. Deliver thrust inward and then upward
4. Do this until object is expelled or patient starts to become unresponsive
5. If they lose consciousness, assist the, gently to the floor and protect their head

SEQUENCE FOR BASIC LIFE SUPPORT

“THE SCENE IS SAFE. I HAVE 1 VICTIM LYING ON THE FLOOR. I’M _____________ TRAINED FIRST
AIDER, CAN I HELP?”
PLEASE ACTIVATE MEDICAL ASSISTANCE
TAP THE SHOULDER 3 TIME AND SAY
“HEY 3X. ARE YOU OKAY?” 2X
“THE VICTIM IS UNRESPONSIVE”
PERFORM HEAD TILT CHIN LIFT MANUEVER AND TOUNGE JAW LIFT.
“MOUTH AND NOSE ARE CLEAR, NO OBSTRUCTION SEEN”
THE VICTIM IS BREATHLESS I GIVE 2 INITIAL VENTILLATION
GIVE 2 INITIAL VENTILLATION TO THE VICTIM.
CHECK THE PULSE WITHIN 10 SECONDS.
“THE VICTIM IS BREATHLESS AND PULSE LESS, FOLLOW UP MEDICAL ASSISTANCE AS I DO CPR”
PERFORM 2 MINUTES CPR
CHECK PULSE WITHIN 10 SECONDS AFTER PERFORMING 2 MINUTES OF CPR
30 ECC, 2 BREATHS

RECHECK BREATHING& PULSE FOR 10 SECONDS USING L-L-F

(1001, 1002, 1003 …… 1010)
“VICTIM IS REVIVED!”
PUT THE VICTIM IN RECOVERY POSITION.
“NO DCAP-BTLS. NO BLOOD.”

D – DEFROMITY P – PERFORATIONS L - LACERATIONS

C – CONTUSIONS B – BURNS S - SWELLING

A – ABRASIONS T – TENDERNESS

SOFT TISSUE INJURIES

WHAT IS WOUND?
- It is the break of the continuity of a tissue of the body either internal or external.

CLASSIFICATIONS OF WOUNDS

CLOSED WOUND
- It is the break of the continuity of a body tissue without the skin is being broken down.

CAUSES:
Blunt object result in contusion or bruises.
Application of external force.

SIGNS AND SYMPTOMS:

 • Pain and tenderness
• Swelling
• Discoloration
• Hematoma

FIRST AID MANAGEMENT: (RICES)

• Rest the affected area. Movement mat aggravate the closed wound condition.
• Ice compress. Apply ice compress to the affected areas. It promotes vasoconstriction
and it has an anesthetic effect.
• Compression. Application to firm pressure. To avoid further hematoma.
• Elevate the affected area. (for extremities) To promote venous return of blood and
avoid pooling in the area.
• Splinting. For immobilizing the affected area. This helps in avoiding unnecessary
movements.

OPEN WOUND
- It is an injury involving an external or internal break in body tissue, usually involving the
skin.

CLASSIFICATION:
1. PUNCTURE – wound caused by sharp & painted object penetrating the skin
2. ABRASION – caused by rubbing/scraping of the skin against rough surfaces
3. LACERATIONS – the skin is torn by sharp objects with irregular edges
4. AVULSIONS – tissues are forcefully separated from the body
5. INCISION – skin and tissues are cut by a sharp bladed instrument

DANGERS OF AN OPEN WOUND

• Hemorrhage – severe bleeding
• Infection – introduction of bacteria/parasite
• Shock – decreased in circulatory volume

FIRST AID MANAGEMENT FOR OPEN WOUNDS

- For wounds with severe bleeding
1. Inspect – inspect for foreign object lodged in the wound area. It can be removed
manually by hand or using a pick-up forceps. Flushing with normal saline solution or just
clean water is also applicable
2. Control Bleeding – done by applying a sterile absorbent gauze pad over the bleeding site
while applying a firm pressure. Dressing can be secured with a bandage and splints.
3. Refer to a Physician – It is essential in severe bleeding wounds. Further medical/surgical
management may be needed like suturing or administration of medication that control
bleeding.
4. Continuous assessment and observation for shock:
Sign and symptoms:
o Pale/cyanotic
o Cold and clammy skin
 o Irregular breathing
o Weak/rapid Pulse
o Weakness
o Thirsty Sensation

For wounds with mild to moderate bleeding:

1. CLEAN – Clean with mild soap and water
2. DISINFECT – Apply topical antiseptics. Povidone Iodine or Topical Antibacterials
3. DRESS – apply sterile gauze with dressing. Secure with adhesive tapes

BURNS
- Is an injury involving the skin, including muscles, bones, nerves and blood vessels. This
results from exposure to direct heat (fire) , chemicals, electricity, solar or other forms of
radiation.

CLASSIFICATIONS:
- Thermal Burns
- Chemical Burns
- Electrical Burns

THERMAL BURNS
- Caused by direct or indirect contact to flames and other hot objects steams or liquids

Classified into 3 according to depth and severity

1. First Degree Burn – affects only the first (epidermis) layer of the skin. Very painful and
skin is red.
2. Second Degree Burn – affects the first and second layer (epidermis + dermis) of the skin.
Blisters are expected to form.
3. Third Degree Burn – affects the first and second layer of the skin and may extend up to
the proximal subcutaneous tissues. Usually less painful.

FIRST AID CARE FOR THERMAL BURNS

1. For first- and second-degree burn

o RELIEVE PAIN
Relieve pain by immersing burned area into a deep clean tap water/ iced water for
maximum of 5 minutes for iced water and 10 minutes for tap water. Prolonged
exposure to extremely cold temperature may cause total numbness due to extreme
vasoconstriction

o COVER
Cover the burned area with clean cloth or dressing (if available) and make sure that it is
non-sticking. If blisters are forming, do not attempt to pop it out to prevention infection.
Always maintain cleanliness on the burned area. Apply burn ointment if available.
 2. For Third Degree Burns
o COVER
Cover the burned area with a dry and non-sticking dressing. Do not apply anything unto
the skin. Immersing into water is not advisable.

o PREPARE FOR EMERGENCY TRANSFER

Continuously monitor for signs of dehydration and shock. Keep the victim warm by
covering blankets during transfer. Extend the flexed burned extremities to avoid
contractures.

CHEMICAL BURNS

Burns caused by direct contact of chemical into skin.

• Car battery solutions
• Hydrochloric Acid (Muriatic)
• Bleach
• Ammonia

FIRST AID CARE FOR CHEMICAL BURNS

1. Immediately remove the chemical by flushing with water. Remove victim’s
contaminated clothing. Use mild soap for the final rinse.
2. Pat dry area using clean cloth and apply dressing into affected area.
3. If the chemical is in the eye, flush for at least 20 minutes using low pressure.
4. Seek medical attention immediately for chemical burns.

FRACTURE
- A broken or cracked bone
- a break in the continuity of the bone.

CLASSIFICATION OF FRACTURE
1. Open Fracture
2. Closed Fracture

CAUSES:
• Motor vehicle accidents.
• Falls
• Accident related to recreation sports and activities
• Some results from the very slight injuries because of brittle or abnormal bones.

SIGNS AND SYMPTOMS:

• Deformity
• Tenderness of the affected area.
• Swelling
• Pain
• Presence of protruding bone
• Inability to move the injured part
 • Bleeding
• Discoloration of the affected area

First Aid Measures:

• Immobilize fracture by splitting.
• Control bleeding and apply sterile dressing to an open wound.
• Treat for shock.
• Give pain reliever if pain is severe.
• Avoid unnecessary holding of the injured part.
• Place the patient on a litter and secured the injured part enough to keep it from moving
while he is transported.
• Evacuate the patient as soon as possible.

SNAKE BITES

Venom – a poison secreted by some animals injected into the body/victims through bites.

Types of Snakes:
1. Poisonous
2. Non-poisonous

PHYSICAL CHARACTERISTICS
Poisonous Non-poisonous:
- Flat and almost triangular head shape.
- With poison sack. - Oval-shaped head.
- Slit like pupils. - No sensory pit.
- With sensory pit. - No fang mark on the bite
- Fang mark on the bite site. site.
- Thick bodies. - Rounded pupils.
- Color markings.
PREVENTIVE MEASURES:
• Handle freshly killed venomous snake only with a long tool or stick. Snake can inflict
fatal bites by reflex action even after death.
• Wear heavy boots and clothing for some protection from snake bites. Keep this in mind
when exposed to hazardous condition.
• Eliminate conditions under which snake thrive: brush, piles of trash, rocks or logs and
dense undergrowth. Controlling their foods as much as possible is also good
prevention.

FIRST AID MEASURES:

• Have the casualty lie quietly, not to move other than necessary.
• Do not elevate the bitten extremity, keep them level with the body.
• Keep the casualty comfortable and reassure him.
• If the snake bite is on an arm or leg, place a constricting band about 1-2 finger above
and below the bite. If the bite is on the hand or foot, place a single band above the flow
of blood near the skin but not tight enough to interfere with circulation.
• swelling extend beyond the band, move or place another bond above the first one.
• Never give the casualty food, alcohol, stimulants, drugs, or tobacco.
• Remove rings, watches or other jewelry from the affected area.
• Evacuate to the nearest medical facility as soon as possible.

CAUTION:
> DO NOT ATTEMPT TO CUT OR OPEN THE BITE NOR SUCK OUT THE VENOM. IF THE
VENOM SHOULD CREEP THROUGH ANY DAMAGED OR LACERATED TISSUES IN YOUR
MOUTH, YOU COULD IMMEDIATELY LOSE CONSCIOUSNESS OR EVEN DIE. (Ref: FM 21-
11)