DR A.MALIK

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DR A.MALIK

• Emergency First Aid
• and CPR

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FIRST AID PROCEDURES COVERED

• Bleeding/Shock/Minor injuries
• Burn Care
• Neck and Back Injuries
• Heat Exhaustion/Heat Stroke
• Hypothermia/Frost Bite
• Severe Allergic Reactions
• Bites and Stings
• Faints/

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BLEEDING

• Apply direct pressure to the wound (at this time
  a direct pressure bandage may be used)
• Elevate (do not further harm)
• Pressure Point additional pressure may be
  applied to a pressure point to help reduce
  bleeding.

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CARE FOR SHOCK

• Keep the victim laying down (if possible).
• Elevate legs 10-12 inches unless you suspect a
  spinal injury or broken bones.
• Cover the victim to maintain body temperature.
• Provide the victim with plenty of fresh air.
• If victim begins to vomit - place them on their
  left side.
• Approach for medical help

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FIRST AID FOR SPRAINS AND STRAINSI-C-E

• I - Ice, apply a cold pack. Do not apply ice
  directly to skin.
• C - Compress, use an elastic or conforming wrap -
  not too tight.
• E - Elevate, above heart level to control
  internal bleeding.

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CARE FOR DISLOCATIONS AND FRACTURESI-A-C-T

• I - Immobilize area. Use pillows, jackets,
  blankets, etc. Stop any movement by supporting
  injured area.
• A - Activate Emergency Medical Services (EMS),
  call 102.
• C - Care for shock. See Care for Shock slide.
• T - Treat any additional secondary injuries.

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BURNS

• First Degree Burn
• Second Degree Burn
• Third Degree Burn

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First Degree Burn

• brief exposure to heat
• skin is intact, but red and the burned area is
  painful.
• Sunburn

Figure An area of first degree burn surrounding
a second degree burn
First Aid immerse or run the burned area under
cold water. dont use ice
Apply moist dressings and bandage
loosely
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Second Degree Burn

• 1.prolonged exposure to heat or very high
  temperatures
• 2. skin may be intact or it may appear to be
  partially peeling.
• 3. Any burn with blisters is second degree
• 4. very painful

• First Aid If the skin is intact (not peeling)
  then run the burned area under cold water
• dont use ice, Do not try to burst the blisters.
• Apply dry dressings and bandage loosely

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Third Degree Burn

• 1. Deepest
• 2. look white or charred,extend through all skin
  layers
• 3. May have severe pain -- or no pain at all --
  if the nerve endings are destroyed

Figure 3 A third degree burn.
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Third Degree BurnContd.

• 4. Third degree burns can go into shock earlier
• 5. notorious for getting infected
• 6. Cover the area in a clean, dry dressing

Figure 3 A third degree burn.
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1.Non Poisonous Snakes2. Poisonous Snakes
SNAKE BITE-
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Non Poisonous SnakesDo not have fangs with
which to inject venom.
SNAKE BITE
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Poisonous snakes have fangs to inject
venom.
SNAKE BITE Poisonous Snakes
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SNAKE BITE-
Tissues
Venom
Absorbed
into the lymphatic system
network of tubes that drains fluid (lymph) from
the bodys tissues and empties it back into the
bloodstream
Rarely venom reaches blood stream
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SNAKE BITE
SIGNS AND SYMPTOMS

• puncture marks, or parallel scratches on the
  skin - rarely any pain
• anxiety
• pale, cool skin with progressive onset of
  sweating
• rapid, weak pulse
• rapid, shallow breathing
• blurred vision, drooping eyelids
• difficulty swallowing and speaking
• abdominal pain
• nausea and/or vomiting
• collapse - progressing to a comatose state

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SNAKE BITE
FIRST AID TREATMENT
pressure immobilization bandage
This bandage is applied as firmly as bandaging a
sprained ankle, and is designed to slow the
movement of venom through the lymphatic system.
Bandaging the wound firmly tends to compress the
lymph vessels, which helps to slow or prevent the
venom from leaving the bite site.
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SNAKE BITE
FIRST AID TREATMENT CONTD.

• reassure
• complete rest
• apply direct pressure over the bitten area
• obtain a history
• immobilize the limb with a splint
• avoid elevating the limb
• DO NOT use an arterial tourniquet
• DO NOT remove the bandage and splint once it has
  been applied

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SNAKE BITE
What is venom?Venom is a poison that one animal
injects into another. In snakes, venom is
modified saliva. A snake injects poison by
biting. Venom is at least 90 protein and most of
the protein are enzymes.
What is anti-venom? Snake bites are effectively
treated by anti-venom. Venom is first extracted
from the snake. Minute quantities of this venom
are then injected into a large animal like a
horse, and the quantity increased slowly until
the animal develops antibodies to the venom. Its
blood is extracted and the antibodies
concentrated and freeze dried for storage.
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Environmental Conditions

• DEHYDRATION
• HEAT CRAMPS
• HEAT EXHAUSTION
• HEAT STROKE
• EXPOSURE TO COLD

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Dehydration

• Dehydration is a condition caused by the
  casualtys loss of fluids from perspiration and
  prolonged exposure to heat and humidity. When the
  casualtys fluid loss exceeds his or her input
  through drinking, dehydration occurs and the
  blood volume lessens. A prolonged period of
  dehydration will lead to shock

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Dehydration

• SIGNS AND SYMPTOMS
• pale, cool, clammy skin
• rapid breathing
• profuse and prolonged sweating
• thirst
• loss of skin elasticity (pinch test on back of
  hand)
• sunken eyes in children
• CARE AND TREATMENT
• complete rest in the shade remove unnecessary
  clothing
• give cool water to drink, ORS
• ensure casualty has assistance when recovered

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Heat Illness

• Predisposing Factors
• Physical activity
• Extremes of age, poor physical condition, fatigue
• Excessive clothing
• Dehydration
• Cardiovascular disease
• Skin disorders
• Obesity
• Drugs
• Phenothiazines, anticholinergics, B and Ca
  channel blockers, diuretics, amphetamines, LSD,
  cocaine, MAOIs

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Heat Stroke
Condition occurs suddenly can cause
unconsciousness in minutes

• It is due to failure of thermostat in the
  brain
• The body rapidly becomes dangerously
• Overheated (gt40 degrees) either due to
• Prolonged exposure to very hot surroundings or
  illness involving very
• High fever

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Heat Stroke

• SYMPTOMS
• Hot, Flushed Dry skin
• Headache,Dizziness,
• Confusion/restlessness
• Altered LOC
• And elevated temperature
• Body temp gt40 deg C (gt105 degrees F)
• Syncope
• History is critical

• TREATMENT
• Cool place
• Tub of cold water/cold water
• bath or wrap in cold wet sheet
• Cool until 38deg C(100.4 deg F)
• If becomes unconscious start
• resuscitation shift to the
• hospital

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Frost Bite

• SYMPTOMS
• Caused by freezing conditions which cut off
  circulation, usually in extremities (hands, feet,
  ears, nose), which may be permanently affected.
  Frost-bitten areas are cold, pale or
  marbled-looking, solid to the touch, and painless
  (until circulation is restored).

• TREATMENT
• Giving warm drinks, and covering with
• blankets. Warm the injured part with body
• heat only-put a hand under an armpit,
• for example. Do not rub the skin or apply
• direct heat to the injured area.

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Muscle cramps

• SYMPTOMS
• Caused by over-stretching muscles, or by
  abnormal muscle contraction. They may also be
  associated with loss of fluid due to excessive
  sweating. Characterized by pain, tenderness,
  loss of power and stiffening or spasms of the
  muscles.

• TREATMENT
• Rest, application of an ice pack, then subsequent
  gentle stretching.
• DO NOT massage the affected muscles.

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Chest cramps (or stitches)

• SYMPTOMS
• Usually caused by cramps of the intercostals
  muscles between the ribs
• Brought on by exertion, chest cramps are
  identified by sharp, spasmodic pain in the chest,
  difficulty in standing upright, and gasping
  respirations.

• TREATMENT
• A Stitch will disappear with rest and
  concentration on deep breathing.

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Tennis elbow

• SYMPTOMS
• This injury is due to a strain of the tendons
  and muscles associated with the elbow. Severe
  cases also involve the ligaments. It is usually a
  chronic condition, and presents when the elbow is
  over-used or over-stretched. pain over the bone
  on the outer side of the joint that becomes more
  severe on movement.

• TREATMENT
• Apply Ice pack and support in a sling

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Shin splints

• SYMPTOMS
• This injury is due to a strain of the long
  flexor muscle of the toes, characterized by pain
  along the shinbone. This is an injury common to
  track athletes and footballers.

• FIRST AID
• rest, application of an ice pack, and elevation
  of the limb.

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FRACTURES-TYPES

• Closed - where the bone has fractured but has no
  obvious external wound.
• Open - where there is a wound leading to the
  fracture site or the bone is protruding from the
  skin.
• Complicated - which may involve damage to
  associated vital organs and major blood vessels
  as a result of the fracture.

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SIGNS AND SYMPTOMS OF FRACTURES

• pale, cool, clammy skin
• rapid, weak pulse
• pain at the site
• tenderness
• loss of power to limb
• Associated wound and blood loss
• Deformity

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FRACTURES-FIRST AID

• The basic aim of management for fractured
  limbs is to immobilization. Immobilization helps
  reduce movement and the pain associated with
  fractures. Immobilize the limb with a natural
  splint

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arm sling

Fractured Forearm

• check for pulse to the end part of the limb
• treat any wounds
• pad bony prominences
• apply adequate splint
• secure above and below fracture, secure wrist
• elevate injury with arm sling

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SLINGS

• Slings are used to support an injured arm.
• Generally, the sling is made with a triangular
  bandage.
• Any material, e.g.. tie, belt, or piece of
  thick rope, can be used in an emergency. If no
  likely material is at hand, an injured arm can be
  adequately supported by inserting it inside the
  casualtys shirt

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ARM SLING

• Support the injured forearm approximately
  parallel to the ground with the wrist slightly
  higher than the elbow
• Place an opened triangular bandage between the
  body and the arm, with its apex towards the elbow
• Extend the upper point of the bandage over the
  shoulder on the uninjured side
• Bring the lower point up over the arm, across the
  shoulder on the injured side to join the upper
  point and tie firmly with a knot
• Ensure the elbow is secured by folding the excess
  bandage over the elbow and securing with a safety
  pin

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First Aid training.
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CARDIOPULMONARY RESUSCITATION CPR ABCs

• AIRWAY - Open the airway with the tilt-chin
  method.
• Breath - give two breaths.
• Check circulation.
• If there is no pulse or breathing..(next slide)

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CPR Continued

• Perform chest compressions.
• 15 compressions and two breaths.
• Count 1234515
• Call 102.

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RESCUE BREATHING

• 1 breath every 5 seconds - 12 per minute.

• Compressions ventilations 152

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Why should I do CPR?

• CPR provides some circulation of oxygen-rich
  blood to the victim's heart and brain.
• This circulation delays both brain death and the
  death of the heart muscle.
• CPR buys some time until the AED can arrive, and
  it also makes the heart more likely to respond to
  defibrillation.

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Unconscious but breathing normally

• Turn casualty into the recovery position
• Check for continued breathing

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Sudden Cardiac Arrest

• Sudden cardiac arrest simply means that the heart
  unexpectedly and abruptly stops beating.
• This is usually caused by an abnormal heart
  rhythm called V.F.

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Rhythms in Cardiac Arrest

• Ventricular Fibrillation.
• (Chaotic rhythm)
• Pulseless Ventrcular Tachycardia.
• (Very fast rhythm with no pulse)
• Asystole
• (No electrical activity)
• P.E.A. / E.M.D.
• (Electrical activity, no pulse

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Ventricular Fibrillation
VF
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Ventricular Fibrillation

• Ventricular fibrillation (VF) is an abnormal
  heart rhythm often seen in sudden cardiac arrest.
• This rhythm is caused by an abnormal and very
  fast electrical activity in the heart.
• VF is chaotic and unorganized the heart just
  quivers and cannot effectively pump blood.

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Ventricular Fibrillation

• VF will be short lived and will deteriorate to
  asystole (a flat line) if not treated promptly.
• For each minute that VF persists, the likelihood
  of successful resuscitation decreases by
  approximately 10 percent.

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Head injuries can easily mislead the first aid
provider by not exhibiting the expected signs and
symptoms immediately after the incident.
Head Injuries
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casualty has appeared unaffected after the
incident only to collapse with life-threatening
symptoms some hours later.This may be due to a
small bleed in the brain that eventually
increases and applies excessive pressure on the
brain tissue.
Head Injuries
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Head Injuries
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Head Injuries-SIGNS/SYMPTOMS

• Head wounds
• deformation and/or crepitus of the skull
• altered level of consciousness
• evidence of CSF leaking from ears or nose
• may have unequal pupils
• Headache
• Black Eyes
• nausea and/or vomiting
• restlessness and irritability, confusion
• blurred or double vision
• snoring respirations if unconscious

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EMERGENCY FIRST AID

• If you are the first on the scene of accident
  that results in an injury or serious illness, you
  may be the only link between a victim and
  emergency medical care. Your role is to take
  action, whether by providing first aid, seeking
  medical help or calling 102. Your actions may
  improve the victims chance of recovery.
• The following slides will provide specific
  information on basic first aid procedures.

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Heat Illness

• Predisposing Factors
• Physical activity
• Extremes of age, poor physical condition, fatigue
• Excessive clothing
• Dehydration
• Cardiovascular disease
• Skin disorders
• Obesity
• Drugs
• Phenothiazines, anticholinergics, B and Ca
  channel blockers, diuretics, amphetamines, LSD,
  cocaine, MAOIs

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THE ENDHEALTH CENTRECFCL GADEPAN
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HEAT STROKE Human Heat Balance Equation

• MR-C-CV-E-S
• Basic equation can be used for any adjustment in
  relation to
• existing Environmental condition to keep body in
  thermo neutral
• in that particular environment

HEAT Evaporative cooling will be more COLD
Process of conserving heat from conductive,
radiative convective heat will be more
so that the body will remain in
thermo-neutral e.g. it will neither
gain or loss heat irrespective of
environment heat or cold change.