Introduction

to first aid
and
Emergency
Dr. BINIAM
Welcome to Introduction to First
Aid
• First aid is the provision of initial care for an illness or injury, usually
performed until definitive medical treatment can be accessed by a
professional.

• This course on first aid should provide you with the basic knowledge
to help someone in an emergency.
Imagine:
• Whilst feeding your child, they start to gag and appear unable to
breathe. You have tried slapping them on the back, with no success.
They seem close to losing consciousness, their lips are turning a
definite shade of blue.
Differences on ?????

•First aid
•Emergency
 The Definition of First Aid

“Help given to a sick or injured

person until full medical treatment
is available”

“…provision of initial care for an

illness or injury”

FIRSTAIDPOWERPOINT.ORG
 Roles and Responsibilities of a First Aider

A first aider has various roles and responsibilities. They should:

• Manage the incident and ensure the continuing safety of themselves, bystanders and the patient
• Assess victims and find out the nature & cause of their injuries
• Arrange for further medical help or other emergency services to attend
• If trained, prioritise casualties based upon medical need
• Provide appropriate first aid treatment as trained
• If able, make notes/observations of casualties
• Fill out any paperwork as required
• Provide a handover when further medical help arrives

FIRSTAIDPOWERPOINT.ORG
 Incident Management

Always conduct a risk assessment before rushing into any situation. Look for any potential
hazards to yourself, bystanders or the patient (e.g: moving traffic, fire & smoke, electricity).
Never put yourself or other bystanders in danger.

Remember, YOU are the most important person

If the incident is too dangerous to approach, stay back and await the arrival of the
emergency services.

FIRSTAIDPOWERPOINT.ORG
 Incident Management

Think about the photo on the next slide (either individually or in groups)

Take a few minutes to discuss:

1) How would you manage this incident?
2) What dangers are present or could be present?
3) What should your first action be?

FIRSTAIDPOWERPOINT.ORG
 The Aims of first aid
• Preserve life
• Prevent the situation from getting worse
• Promote recovery

These aims are known as the ‘three Ps’ of first aid

1- Preserve life
• This doesn’t just refer to the injured party, but yourself and
anyone helping you.

• Please take a moment to assess the situation, and make sure

there are no threats to you before you step in.
Preserve life …. Remove danger … Infection Control

Various diseases can be transmitted via blood and body fluids (for example HIV and
Hepatitis B & C)

If possible, always wear disposable gloves when dealing with bodily fluids

HOWEVER: This is not always practical! In an emergency situation you can

improvise and use anything to create a barrier. e.g: a plastic carrier bag

Ensure any cuts/open injuries to your hands are covered with waterproof plasters or
dressings.

Wash your hands with soap and running warm water whenever possible
2- Prevent the situation from
getting worse
• If you are in no danger yourself, try to stop the situation from
becoming worse by removing any obvious dangers ….such as
• stopping traffic,
• clearing people away from the casualty,
• opening a window to clear any fumes….. etc.
• Also, act as quickly as you can to stop the casualty’s
condition from worsening.

For example, applying a plaster is preventing the condition (a cut)

from worsening by stopping infection.
3- Promote recovery
• Your role as a first aider is, after ensuring that the situation can not
get worse, helping the casualty to recover from their injury or illness,
or stop their condition from getting worse.

• If the injury is severe, then the best you can do is try to keep them
alive until the emergency services arrive.
 The Recovery Position

1.Kneel by the victim’s waist

2.Place the hand nearest you at right angles
3.Grasp the hand furthest to you, place the back of
their hand against their cheek closest to you
4.Lift the leg furthest away from you at the knee
and place their foot on the floor
5.Using their knee as a lever, pull the person onto
their side
6.Ensure their head is still tilted back and they are
on their side

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 The Recovery Position

FIRSTAIDPOWERPOINT.ORG
The priorities of
treatment
•Primary survey
•Secondary survey
The priorities of treatment

Primary survey (Airway → Breathing):

• A. Make sure the casualty’s airway is clear.
Do this by gently tipping their head back so that the front of the throat
is extended.
• B. Check if they are breathing normally.
You can do this by placing the back of your hand
near their nose and mouth.

You are looking for about two breaths every ten

seconds.

If the casualty is breathing, then their heart is

working, which means blood is being circulated
around their body.
Secondary survey (Breathing → Bleeding → Bones):

• Once you are satisfied that the casualty is

breathing normally, the second thing to do is
make sure to treat any bleeding.

• This is to stem any blood loss and to ensure

there is a steady supply of oxygenated blood
to the casualty’s vital organs.

• If there is no bleeding, or you have dealt with

any cuts, the next priority is broken bones.
An emergency action plan is important to
have in place should you be faced with a
situation requiring first aid.

• 1. REMOVE DANGER: Make the scene safe, do not take risks.

• 2. DANGER: Look for any further danger. If yes, go back a step, if no go

to step 3.

• 3. RESPONSE: Shout and gently shake or tap the casualty. If the casualty
responds, find out what happened. Check their signs and symptoms
(how does the casualty feel or look? ……
If there is no response, shout for help but don’t leave the casualty just
yet, and go to step 4.
• 4. AIRWAY: Open the casualty’s airway by lifting their chin and tilting
their head back.

• 5. BREATHING NORMAL?: Look, listen and feel for two breaths in a

maximum of ten seconds. If casualty is breathing, perform a
secondary survey (check for bleeding, injuries and clues). Put the
casualty into the recovery position, if casualty is not breathing Call
AN AMBULANCE , go to step 7

• 7. RESUSCITATION: Give 30 chest compressions followed by 2 rescue

breaths, continue giving cycles of 30 compressions to 2 breaths.
Resuscita
tion
Resuscitation
• To maintain life, we need our hearts to pump
oxygenated blood to our vital organs.

• To achieve this we need to be breathing and our

hearts need to be pumping.

• Should either of these functions stop, our brain

and other vital organs will start to deteriorate
(brain cells usually die within 3-4 minutes due to
lack of oxygen) which will eventually lead to death.
• ‘Ventricular fibrillation’ is the most common result of cardiac arrest,
caused by heart attack.
• When this happens, the best chance of survival for the patient is to have
their heart ‘restarted’ with a defibrillator.
• These are carried on all ambulances, and can also be found in some
public places (shopping centres, etc.).
• These days’ defibrillators are very sophisticated, and will talk you
through the process, but you should be trained in the use of them before
attempting to use one. However, even if you are trained to use one, you
must call an ambulance first, as this will give the casualty the best
chance of survival.
• Even so, we need to keep the heart and brain oxygenated ; this is
when we start Cardio Pulmonary Resuscitation (CPR).
Cardio Pulmonary Resuscitation
(CPR) – Primary Survey:

D Danger – ensure the area is safe and find out what has happened
R Response – is the casualty conscious?
A Airway – clear the airway
B Breathing – is the casualty breathing normally?
C - CPR
Cardio Pulmonary Resuscitation
(CPR) – Primary Survey:
D Danger – ensure the area is safe and find out what has happened
• Make sure that it is safe for you to approach the casualty. Do not put
yourself in any danger, because if you get injured you won’t be able to
help the casualty.
• Remove any danger from the casualty, or if that is not possible, and
it is safe to do so, try to move the casualty away from the danger
area.
• Try to find out what happened, making sure that you are safe doing
so. DO NOT PUT YOURSELF IN ANY DANGER.
• How many casualties are there? Can you cope with the situation?
R Response – is the casualty conscious?
• Try to get a response from the casualty.
• Gently shake their shoulders,
• shout and clap your hands in front of them,
• pinch their underarm or fingernail to get a pain response.

• If they do not respond, immediately shout for help, or

call . Whatever you do, do not leave the casualty alone.
A Airway – clear the airway
• Clear the airway by placing your fingertips under the casualty’s chin
and lifting, so the front of the neck is extended. Simultaneously
placing your other hand on their forehead to gently tilt the head back.
B Breathing – is the casualty breathing normally?
• When their airway is cleared, check if they are breathing normally.
You are looking for two breaths in ten seconds. Take no longer than
this to assess their breathing, as every second counts.
• Check whether their chest and abdomen are rising and falling.
• Listen for breath (more than a sporadic gasp).
• Use the back of your hand (lick the back of your hand if that will
help) or your cheek to feel for any breath from the casualty.
• This will all determine if the casualty is breathing normally. If they are,
you will need to place them in the recovery position .
C - CPR
• If the casualty is not breathing normally:
• The first thing to do in this situation is call for an ambulance.
• If someone is with you, get them to do this so you don’t have to leave
the casualty.
• If you are alone, and do not have a mobile with you, you may need to
leave the casualty to do this. However, it is vital that an ambulance is
called, as the casualty will stand a much better chance of survival with
help on the way.
• Once the ambulance is called, start CPR:
CPR
• Place the heel of one hand in the centre of the casualty’s chest.
Place the other hand on top and interlink your fingers.
• Take a position next to the casualty’s chest, kneeling at whichever
side feels more comfortable for you.
• Press down firmly on the casualty’s breastbone current guidelines
suggest pushing down to a depth of 6cm) then release the pressure,
but try not to lose contact with the casualty. This is known as a chest
compression.
When applying pressure, avoid doing so on
• Ribs,
• Upper abdomen or
• Breastbone.
• Try to get the casualty onto the floor without hurting yourself or
the casualty.
• If it is not possible, remove any pillows or cushions so the
casualty is lying flat and attempt CPR. This is still better than
doing nothing.
 Combining chest compressions with
rescue breaths:

• After chest compressions, make sure the casualty’s airway is clear by

tilting their head back.
• Pinch the casualty’s nose closed; this will make sure the breath you
give them does not escape.
• Take a breath and place your mouth over the casualty’s, forming a
seal.
• Steadily blow into the casualty’s mouth, making sure their head is
tilted back and the airway is open. Keep your eyes down on the
casualty’s chest to make sure it rises (this should take about a
second). This is known as a rescue breath.
• Remove your mouth from the casualty’s and leave enough room for
you to take a fresh breath of air. Keep the casualty’s airway open and
watch for the chest deflating, as the air is expelled.
• Place your mouth over the casualty’s forming the seal again and give
another rescue breath. You need to do this twice.
• Replace your hands on the casualty’s chest immediately and perform
another 30 chest compressions, followed by 2 more rescue breaths.
• Continue swapping between 30 chest compressions and 2 rescue
breaths.
• Do not give the casualty more than two rescue breaths before
continuing with chest compressions.
• If you have someone with you, take it in turns to administer chest
compressions. Every 1-2 minutes, change over so one person
administers chest compressions while the other gives the rescue
breaths. Ensure there is as little delay in swapping as possible, so the
casualty is constantly receiving CPR.

• Continue CPR until:

• The emergency services arrive to take over.
Resuscitation
for babies and
children:
Resuscitation for babies and
children:
• Understandably, some people are reluctant to perform CPR on a child
or baby for fear of causing further harm to them.
• However, a child in this state is likely to suffer far worse consequences
if CPR is not administered. Please keep that in mind should the
situation ever arise.
• CPR on a child is very similar to CPR on an adult. There are only a few
minor modifications to the process, which are detailed below:
• Give the child 5 rescue breaths before starting CPR, then switch back
to 30 chest compressions to 2 rescue breaths.
• If you are alone, perform CPR for about a minute before going for
help.

• Chest compressions on a child should be about one-third of the depth

of the chest.
• For a baby under 1 year old, only use two fingers to administer CPR.
• For a child over 1 year use either one or two hands to compress the chest,
again one third of the depth of the chest.
 Resuscitation with
chest compressions
only
• An adult cardiac arrest casualty will probably still have oxygen in their
blood stream.
• If there is any reason you cannot give the casualty rescue breaths, you
can still help the casualty by giving them ‘chest compression only’
resuscitation.
• Although not ideal, it will still circulate the residual oxygen in their
blood to their vital organs, so it is better than no CPR.
Vomiting during CPR:
• It is not uncommon for an unconscious casualty who has stopped
breathing to vomit. This is an autonomic reaction from the
unconscious casualty which you may not notice until you come to give
a rescue breath, or their breath comes out with a gurgling noise.
• If this happens, turn their head to the side and allow the vomit to
drain.
• Before continuing resuscitation, clean the casualty’s face, and if you
have a face shield handy use it.
Main causes of
unconsciousness in a
casualty:
• Unconsciousness is an interruption to normal brain activity.
Unconsciousness disrupts the body’s autonomic reflexes such as
coughing.
• The worst position for an unconscious casualty is lying on their back,
as they may ‘swallow’ their tongue (the tongue slides back in the
throat blocking the airway) which will suffocate them, or they may
asphyxiate on their vomit.
• If a casualty is unconscious, you need to take immediate action: clear
the airway, call for an ambulance
main causes of unconsciousness
• To help you remember the main causes of unconsciousness in a
casualty, try to remember FISH SHAPED.
Responses in casualties:
To correctly ascertain the level of consciousness in a casualty, you can
use the AVPU scale:

• Alert ….. Time / place / person

• Voice …..confused / inappropriate words / making sounds / no sounds
• Pain …. Localized / generalized
• Unresponsive ….. unable to respond to pain or vocal stimuli.
Thank you
Group task
• What is first aid kit and list the items ?
• What are the two types of CPR ?
• When do you stop CPR ?
• If burn what do you do ?
• If bleeding what do you do ?
• If no breath what do you do ?
• If bone break what do you do ?