Practical Guide to First Aid

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A
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Practical Guide to First Aid
Morocco First Aid - MFA

Elaborated by:
Pr. M. Mouhaoui & Dr. O. Halli
Edition: August 2023
Sommaire
1. First Aid
2. Choking
3. Bleeding and hemorrhage
4. Unconsciousness
5. Cardiac arrest
6. Fainting
7. Burns
8. Trauma
9. Emergency numbers
First Aid
 First Aid

First aid is the immediate help or treatment given to a

What is
victim who has been injured or who has suddenly fallen ill
First Aid?
while waiting for the arrival of a specialized team.

Save lives.
The objectives
Limit the aggravation of the disasters.
of first aid
Aid in healing.

First aid steps: P.A.R = Protect - Alert - Rescue

Ensure individual Alert the Perform the

and collective safety. emergency services necessary first aid
to intervene actions.

- Calmness, self-control and thoughtful

decision-making in stressful situations.
Qualities - Basic first aid skills and knowledge to
of good provide effective assistance.
rescuers - Empathy and compassion towards the
victim the ability to provide psychological
support.
 Protect
A victim, the rescuer or any other person threatened by danger must be
protected from it. As soon as the rescuer arrives at the scene of the distress
they need to lookout for hazards that can lead to an over-accident.

Order of protection: 1/Rescuer(self-protection) 2/Victim 3/Witnesses

Steps for protection

Eliminate surrounding hazards to protect
the rescuer's action, the victim and the
witnesses.
Ensure that the rescuer acts without risk
to their own safety.
Delineate the danger zone clearly and extensively, ensuring that the
delineation is visible to prevent any intrusion.
Use all available material means to carry out the delimitation.
Seek help of able-bodied people in the area to help delineate the area.

If protection is not possible, the victim must be extricated urgently.

 Protect
If it is impossible to eliminate the danger and the victim is unable to remove
themself from the danger, the victim must be urgently and safely
extricated from the danger zone.

Extrication of the victim

Conditions for a safe extrication
Make sure the victim is visible, easily accessible and that there
are no obstacles preventing the victim from being freed.
Move the victim to a place far enough from the danger and its
The priority of
consequences.
the rescuer is
to protect The release maneuver must remain exceptional as it can be
themself. dangerous for the rescuer.

There is no set technique for emergency extrication

Choose an extrication technique suited to

the rescuer's physical strength.
Grab the victim firmly and pull them down on the
ground, regardless of their position, until they are safe.
Ask for help from another person if necessary.
Try as much as possible to maintain the alignment of
the victim "head-trunk-neck" .

In case the danger cannot be eliminated or the victim cannot be freed

Alert specialized emergency services.
Ensure permanent surveillance of the danger zone and prevent anyone
from entering it until the arrival of specialized help.
 Protect
Protection in case of a road accident

If the rescuer is in a car

Turn on the hazard warning lights at the sight of a road accident and
slow down the vehicle
Park the vehicle, if possible AFTER the scene of the accident, on the
hard shoulder if there is one
Make sure to immediately get all the occupants of your vehicle out
and put them in safety on the roadside, behind the guardrails if any

In any case
Mark out at 150 / 200 m away, before and after the accident , to
avoid any further accidents using pre-signaling triangle, electric lamp,
white linen, vehicle hazard lights, and with the help of any witnesses
Prohibit any approach if a danger persists
Do not smoke and do not let smoke in the presence of an incipient fire
in an engine compartment, use a fire extinguisher
Switch off accident cars, if possible

200m before the accident 200m after the accident

 Alert
Alerting involves informing emergency services of the presence of victims
in distress. This enables professional rescue services to be mobilized to
intervene appropriately. Alerting plays an essential role in ensuring
coordination between first aid provider by rescuers and professional
medical assistance.

Choosing the appropriate rescue service

EMS (Emergency medical services) 141: for urgent health
problems.
Civil defense (Firefighters) 15: for all emergency situations
Police 19 and Gendarmerie 177 : for any security or public
order problems.
Highway services 5050.

Information to be transmitted
Telephone number from which you Precise location of the event.
the rescuer is calling, if necessary they Number of people involved.
must give their name. Assessment of the seriousness of each
Nature of problem, illness or accident. victim's condition.
Possible risks: fire, explosion, collapse, Initial measures and actions taken.
chemicals and any other hazard.
Always wait for instructions before
interrupting the communication +++
Choking
Acute airway obstruction
 Choking
Acute airway obstruction

The movement of air between the outside and the lungs is completely
impeded due to airway obstruction. This is a major emergency that can
lead to death within minutes if left untreated.
Acute obstruction of the airways by foreign object remains the main cause
of accidental suffocation.

How to recognize a choking condition?

The victim is most often eating, or if it is a child, playing with an object put
in the mouth. Suddenly, the victim brings her hands to her throat.
In the event of partial obstruction, the victim:
Can speak or shout,
Coughs vigorously,
Breathing is present, but sometimes with an added noise.
In case of total obstruction, the victim:
Keeps it mouth open and no sound is audible
Can no longer speak or cannot cry, if it is a child
Can no longer cough
Cannot breathe, and begins to fuss

What are the contributing factors?

Big bites,
Poorly chewed food,
Drunkenness,
Poor dentition.
 Choking
Acute airway obstruction

In the event of partial obstruction

The victim can speak or shout, coughs vigorously, his breathing is present.

Never use deobstruction techniques

Place the victim in the position in which
the vicitm feels most comfortable
Encourage coughing
Monitor the victim carefully

In case of total obstruction

the victim keeps it mouth open and no sound is heard, can no longer speak or cry, can no
longer cough, cannot breathe, and begins to agitate.

Leave the victim in the position they are in

Clear the airway by giving up
five firm blows in the back

Between the victim's shoulder blades

With the heel of the hand, open
In a vigorous manner
 Choking
Acute airway obstruction

If the back blows are unsuccessful

Perform 5 abdominal compressions
according to the Heimlich method
In the pit of the stomach
Without pressing the ribs
Backwards and upwards.
Abdominal compressions (Heimlich)
are replaced by chest compressions
In the middle of the sternum
in infants < 1 year according to
Without pressing on the ribs
Mofenson's method.
Towards the back.
It can also be used for pregnant
women and overweight victims.

Results
In case disobstruction In case the obstruction still persists
maneuvers are effective Call the emergency services
Expulsion of foreign object Continue performing desobstruction techniques
Signes :

Apparition of cough In case the victim loses consciousness:

Resumption of breathing - Support the victim on the ground
The rescuer should - Perform cardiopulmonary resuscitation (CPR)
- Check the presence of a foreign object in the mouth, at
talk to the victim
the end of each cycle of chest compressions
and comfort them.
- Carefully remove the foreign object if accessible
Bleeding
and
Hemorrhage
 Bleeding
Blood loss comes from a wound or natural orifice. When this blood loss is
abundant or prolonged, it is called hemorrhage. It is divided into three
groups:
External bleeding,
Exteriorized bleeding,
Internal bleeding.

How to recognize bleeding or hemorrhage?

Two cases can be distinguished:
Bleeding from a scrape or skin abrasion that stops on its own. In this
case, we are talking about bleeding,
Heavy bleeding or hemorrhage that soaks a cloth or paper handkerchief
in seconds and does not stop on its own.

Sometimes the bleeding is hidden by clothing. Stopping this bleeding

takes precedence over all other first aid actions.

The risks of heavy or prolonged blood loss

For the victim: to cause circulatory distress or cardiac arrest, by a
significant reduction in the quantity of blood in the body,
For the rescuer: to be infected by a transmissible disease if the rescuer
has broken skin or in the event of splashing on the mucous membranes
(mouth, eyes).
 Bleeding

Directly compress the bleeding site

The compression can be done by the victim himself or by the
rescuer,
Direct compression can be done manually and/or with a
compression bandage.

In case of inefficient direct compression

tourniquet
In the event of persistent bleeding despite compression, or
contraindicated (underlying fracture, foreign body) or even
impossible compression, a tourniquet must then be applied.
Rules for applying a tourniquet:
Use a wide tourniquet, DO NOT use ropes, or narrow belts,
Place the tourniquet over the wound, directly on the skin,
Tie a simple knot to tie the tourniquet loosely,
DO NOT release or remove the tourniquet, wait for medical assistance to arrive.

Monitor the victim

Put the victim in a lying position and
lift the limb that is the site of the wound.
Do not give food or drink to the victim.
 Bleeding
In case of a nose bleeding
Leave the victim seated, head tilted forward,
DO NOT lie down to prevent the victim from swallowing their blood,
Compress both nostrils for 5 to 10 min
Blow nose vigorously.
The alert of a medical service is not compulsory. It becomes so in case of:
Persistence of bleeding,
Epistaxis following a fall or a blow,
Concomitant intake of antithrombotic drugs.

In case of vomiting or coughing up blood

Alert the medical emergency services immediately,
Place the victim in a seated or semi-seated position,
Keep vomiting or sputum, if possible, in a container to
be shown to the doctor,
Talk to the victim regularly.

Self-protection when in contact with blood

Use gloves or a plastic bag to avoid direct contact with the victim's blood.
In the event of contact with the blood of a victim it is advisable: to not touch the
face, to wash hands and remove any soiled clothing. It is important to disinfect
properly. In case of a soiled wound or any projection on the face, seek medical
advice.
Unconsciousness
Unresponsiveness and
normal breathing
 Unconsciousness

How to recognize a victim in loss of consciousness?

A victim who doesn't reply questions, remains motionless and breathes.
The stimuli that can be used to assess the victim's state of consciousness
can be verbal, physical/tactile or even painful.

A person who does not react to stimuli is an

unconscious victim.

It's a life-threatening emergency!

Complications and aggravation

If no action is initiated, the situation may progress to respiratory and
circulatory failure (cardiac arrest).
If first-aid measures are carried out in time and in a manner suited to the
situation, the victim's condition may not worsen, or may even regress and
improve.

Causes of unconsciousness
A person may become unresponsive because of an injury (e.g. head injury)
or medical condition (e.g. diabetic emergency) that may indicate a greater
health risk.
If possible, the cause of unconsciousness must be identified.
 Unconsciousness

Assess the victim's state of consciousness

Ask a simple question: "How are you? Can you hear me?"
Take the victim's hand and ask: "Shake my hand, open your eyes"
If the victim does not respond or react => The victim is unconscious

IMMEDIATELY open the victim's airway

Quickly loosen or unfasten anything that may interfere
with breathing (belt buckle, trouser button, tie, collar)
Gently tilt the victim's head back and raise the chin
unless a trauma is suspected
Open the victim's mouth with the hand holding the chin,
and remove visible foreign objects inside the victim's mouth

Check for breathing L.L.F = LOOK . LISTEN . FEEL

Bend over victim, rescuer's ear and cheek over victim's mouth and nose, keeping
chin up. Search, in 10 seconds at most:
L With the eyes: the lifting of the belly and/or the chest
L With the ear: normal or abnormal breathing sounds
F With the cheek: the flow of air exhaled via the nose and mouth
The victim breathes if the chest rises or respiratory sounds and the victim's breath are perceived.
 Unconsciousness

Place the victim in Recovery Position

The victim should be placed on their side by the rescuer.
1
The position in which the victim was placed by the
rescuer must respect the following principles:
Turning the victim to the side must limit the
movements of the cervical spine as much as 2
possible
The victim is in the most lateral position possible to
prevent the tongue from falling backwards and
3
allowing the flow of liquids to the outside
The position is stable
Any compression of the chest should be avoided
Breathing monitoring and airway access must be
possible.

Alert or have the medical emergency services alerted

Monitor breathing regularly

Every minute, the rescuer must verify if the victim's belly
and chest rise, listen to any respiratory sounds and feel the
lifting of the chest with the flat of the hand.
Cardiac arrest
Unresponsiveness and
abnormal breathing
 Cardiac arrest
If a person's heart cannot pump enough blood around the body, that
person is in cardiac arrest. The person will quickly lose consciousness and
show signs of abnormal breathing.
Warning sign of cardiac arrest and early warning
++ Main warning sign: Sudden chest pain that doesn't disappear rapidly.++
Recognition of the signs, which may appear a few minutes before the onset of
cardiac arrest, should encourage the rescuer to alert quickly. This immediate
alert is necessary for the continuation of the chain of survival.

Signs of cardiac arrest

The victim does not speak, does not react to a simple command, no
movement of the chest or abdomen is visible and no respiratory sounds or
breath is perceived. No pulse for more than 10 seconds.

Chain of survival
Post cardio-
Alert Basic CPR Defibrillation Specialized pulmonary arrest
CPR
*CPR: Cardio-Pulmonary Resuscitation resuscitation

Causes of cardiac arrest

Stopping breathing with loss of consciousness can be linked to:
The evolution of a sudden obstruction of the airways, for which the
clearing maneuvers were in vain,
Poisoning, trauma, drowning, or electrocution,
A disease, which can affect the heart, such as myocardial infarction.
 Cardiac arrest

Alert
Must be done early, so Comes after the CPR if the victim is:
that help, an automated - Child < 8 years old
external defibrillator and - Polytraumatized
specialized rescue teams - Poisoned
can be called in. - Drowning
Helps guide basic cardiopulmonary resuscitation.

Basic cardiopulmonary resuscitation (CPR)

Basic CPR includes 2 gestures, external cardiac massage (ECM) and rescue breaths.
External cardiac massage (ECM): High priority +++
The victim is on its back, on a hard surface
Heel of
The heel of the hand is placed on the center of the chest the hand

Frequency of compressions between 100 and 120

compressions per minute
Compression time = decompression time
Note: The ECM is performed with one hand on children,
2 fingers on infants and 2 thumbs on newborns.
Rescue breaths:
Mouth to mouth, mouth to nose or mouth to mask
Insufflation duration = 1 second
The insufflated volume must be sufficient to raise the victim's thorax
 Cardiac arrest
Alternating ECM / Rescue breaths

Alternate

30 chest compressions 2 rescue breaths

Start with 30 chest compressions, as these take priority

The alternation is 30 compressions for 2 rescue breaths, regardless of th victim's age
Chest compressions should not be interrupted
In case rescue breaths can't be performed, it will be necessary to undertake the ECM alone
A relay must be carried out every two minutes in order to limit rescuers' fatigue
DA A
EED

Automated External Defibrillator (AED)

Make sure no explosive materials are present (gas leaks, petrol fumes, etc.)
Place the victim on a flat, dry, non-metallic surface
Undress the victim's torso and dry the victim's torso quickly
Turn on the device and follow the instructions carefully
IMPORTANT: CPR (ECM + Rescue breaths)
must be performed BEFORE and AFTER
the installation of the AED D
A
E
Fainting
 Fainting
Fainting is a distressing sensation that reflects a disturbance in the body's
functioning, without the individual experiencing it necessarily being able to
identify its origin. It may be fleeting or long-lasting, sudden or gradual in
onset. Fainting reflects a temporary or lasting failure of part of the body,
without the disorder initially leading to unconsciousness, respiratory
arrest or cardiac arrest.
Some people, such as cardiac patients, diabetics and asthmatics, experience
recurrent, often identical fainting episodes.

Risks
Some fainting situations are said to be serious because they may indicate a
situation that could lead to life-threatening distress at any moment.
These serious fainting situations call for an immediate response by the
emergency services, after administering the treatment prescribed to the
victim for this type of situation.
 Fainting
When faced with a conscious victim who says they doesn't feel well

Look for signs of faintness

The victim reacts and answers questions.
The victim suffers intense chest or abdominal it can be
persistent or recurring.
The victim feels cold, is covered in profuse sweat,
without having exerted themselves or without the
surrounding heat being significant, and is intensely pale.
The victim has difficulty breathing, can no longer speak,
or does so with great difficulty.
The victim has paralysis of arm or leg, even transient,
has difficulty speaking and/or has a deformed mouth
(Stroke - Cerebral Vascular Accident ++).

Place the victim to rest immediately

The victim should be put to rest immediately.
Remember to elevate the victim's lower limbs and give sugar.
The victim should be reassured, spoken to calmly, and even isolated.
In the event of respiratory discomfort, place the victim in a sitting or
half-sitting position.
In all other cases, lay down the victim unless the victim
spontaneously adopts another position.

Seek medical advice and monitor the victim

Burns
 Burns
A burn is a lesion of the skin, the airways or the digestive tract. It can be
caused by heat, chemicals, electricity or radiation.

Depending on the extent, depth and location, the burn can cause:
An immediate danger such as circulatory failure (in the event of an
extensive burn) or respiratory failure (during a burn to the face, neck or
following smoke inhalation),
Severe pain,
Delayed consequences such as infection, functional or aesthetic
sequelae.

What are the types of burns?

The rescuer must distinguish between two types of burns:

Severe burns: extensive, deep, near natural orifices, location on the

face, neck, hands and joints, electrical or radiological burns, child burns.

Simple burns.
 Burns

Remove the cause or remove the victim from the cause

Cool the burned area as soon as possible

The 15 x 3 Rule
A golden rule, simple to remember, is the rule of three 15s:
Rinse the burn with warm water at 15°C
Applied at a distance of approximately 15 centimeters
For a minimum of 15 minutes

15°C 15cm 15min

If the victim's clothing is on fire
Prevent the victim from running
Roll the victim or make them roll on the ground
Smother the flames with clothing, blanket or
fire extinguisher

Assess the severity of the burn

 Burns

Case of a simple burn:

Protect the burn with a sterile dressing
Never pierce the blisters
Continuously monitor the victim.

Case of a severe burn:

Lay the victim down, except if breathing difficulty in this case sitting position
Lay the burn victim down on the unburned area
Protect with a clean sheet without covering the burnt part
Alert and monitor the victim on an ongoing basis

Emergency numbers

141 - EMS (Emergency medical services)

15 - Civil defense (Firefighters)
Trauma
 Trauma
Trauma to the bones (fractures) and/or joints
(sprains, dislocations) cause difficulty in moving,
possibly accompanied by signs such as swelling
and/or deformation of the affected area.

When the shock is located in the head, thorax or abdomen, the

underlying organs can be damaged and it can be revealed secondarily by
other signs as: loss of consciousness, headache, vomiting, agitation ,
abdominal pain.

Important ++
During trauma, the possibility of associated
spinal trauma must always be kept in mind.

The main complications of trauma

Neurological complications: paralysis, impaired consciousness
Respiratory complications: respiratory distress
Circulatory complications: circulatory distress, hemorrhage
 Trauma
Back, head or neck trauma
Never mobilize (move) the victim,
Firmly advise the victim not to move
Call the emergency services
Hold the victim's head with both hands on either side
Monitor the victim continuously and try to talk to them

Limb trauma
Prohibit any mobilization of the affected limb.
The injury must be stabilized to minimize movement and pain
Alert the emergency medical services or seek medical advice
Follow the recommendations given by the EMS
Monitor the victim by talking to them regularly
Protect the victim against cold, heat and bad weather.

Numéro d'urgence

141 - EMS (Emergency Medical Services)

15 - Civil defense (Firefighters
Emergency
numbers
 Emergency
numbers

141 EMS - (Emergency medical services)

Medical assistance for any urgent health
problem.

15 Civil defense (Firefighters)

For any emergency problem.

19 Police
For any security or public order problem in
urban areas.

177 Gendarmerie
For any security or public order problem in
non-urban/rural areas.

5050 Highway services

For any incident on the
motorway network.

Information to be transmitted
 Alert

Information to be transmitted
Telephone number from which you Precise location of the event.
the rescuer is calling, if necessary they Number of people involved.
must give their name. Assessment of the seriousness of each
Nature of problem, illness or accident. victim's condition.
Possible risks: fire, explosion, collapse, Initial measures and actions taken.
chemicals and any other hazard.
Always wait for instructions before
interrupting the communication +++

Instructions and tips

The rescuer must protect themself and stay calm
Be clear and precise in the descriptions of the
emergency situation
Inform the emergency services of any changes or
development in the situation
Have the services alerted by another person if
first aid maneuvers are required/undertaken.
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