FIRST AID PROCEDURES Introduction
Quite often, attempts to assist a patient by individuals that lack the knowledge of appropriate first aid procedures may instead hurt the victim. Teachers in schools, by nature of their work, interact with many students and come across life threatening situations. This module is designed to provide guidance for emergency situations. The purpose of first aid is to make a patient secure and comfortable and to prevent deterioration in his /her condition until any necessary professional medical assistance is available.
It is helpful if all teachers particularly those that teach science have a simple but adequate knowledge of first aid. It critical that a teacher should be able to recognise a situation which needs professional medical attention and be able to take appropriate action in those situations where delays could be fatal.
TOP PRIORITY When an injured person is not breathing, artificial respiration must be started at once. All teachers and pupils should be able to undertake some form of respiratory resuscitation e.g. Kiss of life technique. (Such skills are of great value in the community generally as well as school environment).
Other Conditions Requiring Immediate Attention:
- Severe bleeding
- Minor cuts
- Eye injuries
- Shock
- Burning /scalding Severe burns by chemicalS
- Attacks e.g. Epilepsy, Hypersensitivity, colour blindness, haemophilia etc
- Heart attack
- Stroke
- Fainting
- Poisoning
- Snake bites
- Swimming safety tips
1. SEVERE BLEEDING is recognised by a spurting flow of bright red blood.First aid- This can be restricted by applying direct pressure at an appropriate point on an artery between wound and the heart.
- Teachers should be aware of those pressure points where the flow of blood may be stopped by compressing an artery on to the underlying bone.
- An injured person should not be given any thing to drink unless it is essential
Action
- A thick pad of cloth held between the hand and wound would help to control the bleeding by absorbing the blood and allowing it to clot.
- Do not disturb blood clots after they have formed within the cloth. If blood soaks through the entire pad without clotting, do not remove the pad, but add additional thick layers of cloth and continue the direct hand pressure even more firmly.
- On most parts of the body, a pressure bandage can be placed to hold pads of cloth over a severely bleeding open wound and free the hands of the first-aider for other emergency action.
2. MINOR CUTS should be washed thoroughly with water and a suitable sterile dressing applied. Antiseptics should not be applied and the injured person should be taken to or advised to consult a Doctor for an anti-tetanus injection.
3. EYE INJURIES should always be regarded as potentially serious.
First aid
- If corrosive materials have been splashed into the eye, the eye should be held open and washed with plentiful amounts of water. IT Is easier to do this if a laboratory tap is fitted with a short length of rubber tubing so that a stream of water may be directed at the eye.
- In cases of foreign body on the surface of the eyeball or inner surface of the eyelid pull down the lower lid to determine whether or not the object lies on the inner surface.
- If the object lies on the inner surface, lift it gently with the corner of a clean handkerchief or paper tissue. Never use dry cotton around the eye.
- If the object has not been located, it may be lodged beneath the upper lid.
- While the victim looks down, grasp the lashes of the upper lid gently.
- Pull the upper lid forward and down over the lower lid. Tears may dislodge the foreign object.
- If the foreign object has not been dislodged, depress the victim's upper lid with a matchstick or similar object placed horizontally on the top of the cartilage and avert (change) the lid, by pulling upward on the lashes against the matchstick. Lift off the foreign object with the corner of a clean handkerchief and replace the lid by pulling downward gently on the lashes.
- Flush the eye with water.
- If the object is still not removed and is suspected to be embedded, apply a dry, protective dressing and consult a physician/doctor.
- A person with corrosive materials in his eye will be in acute pain and considerable physical force may be necessary before it is possible to treat the eye with water. All injuries should be referred to a doctor.
- The wearing of safety spectacles by pupils is an obvious precaution against eye injury and should always be considered whenever any operation with chemicals is performed; goggles must be worn whether in chemistry, biology, physics, home economics and craft lessons. Goggles can resist the impact of corrosive materials by preventing their direct contact with the eye.
Penetrating injuries of the eyePenetrating injuries of the eye are extremely serious and can result in blindness.
First aid
- Do not try to remove an object stuck into the eye - it is important to get the patient to hospital!
- Cover both eyes with a sterile or clean dressing, secured with tape or a bandage that encircles the victim's head but loose enough to avoid pressure on the eyes. Coverage of both eyes is necessary to eliminate movement of the affected area.
- Keep the victim quiet, preferably on his back.
- Transport the victim by stretcher.
- Call an eye specialist, or take the victim to the nearest appropriate hospital emergency room. The sooner he receives medical care, the greater the chances of saving his sight.
4. SHOCK may be recognised by faintness, giddiness, blurred vision, collapse, pallor clammy (paleness sweaty) or cold skin or breaking into a sweat and anxiety. Shock can be a serious and even fatal; condition and it requires prompt attention.
First aid
- The patient should be laid down and if possible the feet raised slightly higher than the head.
- Reassurance is essential and the patient's anxiety should as far as possible be allayed (calm).
- Cover him to keep him from losing body heat.
- In cases of severe shock medical advice is essential.
- Patients in a state of shock should not be moved unnecessarily nor should they be kept unduly warm.
5. BURNING OR SCALDING: The objective of first aid for burns is to relieve pain and prevent contamination.
First aid- Chemical burns should be washed with copious (plentiful) amounts of water and no attempt should be made to carry out neutralisation reactions on the skin.
- Some substances like phosphorus and bromine cause severe burns and medical advice must be sought as a matter of urgency.
- Cooling the injured areas as rapidly as possible using running water or ice packs (ice from refrigerator) should treat small burns.
- A suitable sterile dressing should be applied but lotions, spray, ointments and oily dressings should be avoided.
- If the arms or legs are affected, keep them elevated.
- Do not remove adhered particles of charred (burnt/residue) clothing.
- Have victims with face burns sit up or prop them up and keep them under continuous observation for breathing difficulty. If respiration problems develop, the victim must be maintained in an open space for enough airation.
- Arrange transportation to the hospital as quickly as possible.
If a person's clothing is on fire
First aid
- It is imperative that the victim is put into a horizontal position immediately. This will limit the spread of the injury.
- The burning clothing should be extinguished by water or by means of a fire blanket.
- If more than 10 percent of the body surface is burnt the injury should be regarded as very severe and arrangements must be made to get the injured person to hospital as an emergency.
6. POISONING BY INGESTION: The most common causes are inadequate operation of a mouth pipette or drinking the contents of a bottle by error/mistake. Where known poisons are used e.g. ethanedioates (oxalates), acids, preventive measures are essential but it is wise safeguard to have access to a suitable antidote.
First aid
- Dilute the poison by having the victim drink a glass of water or milk if he is conscious and not having convulsions (symptoms). Discontinue giving the victim water if it makes him disgusted.
- Save the label or container of the suspected poison for identification. If the victim vomits, save a sample of the vomited materials for analysis.
- Seek medical assistance by calling the poison control centre or a physician.
- If the victim becomes unconscious, keep him in an open space. Give artificial respiration or call an emergency squad as soon as possible.
- Do not induce vomiting in an unconscious person. If the victim is vomiting, position him and turn his head so that the material drains out of the mouth.
7. EPILEPSY Epileptic attack can be a frightening experience especially to anyone who has not seen it before. Its characterised by repeated convulsions and seizures.
First aid
- The first requirement is to prevent the victim from causing himself/herself injury.
- Convulsive movements should not be restrained but a victim should be prevented from knocking into hard objects like desks or stools.
- When the convulsions subside, cradle the patient's head in the arms and loosen any tight clothing around the neck.
- Do not insert a ruler or other hard object into the victim's mouth during the attack, although if an opportunity arises, the corner of a clean, folded handkerchief may be inserted between the teeth to prevent the tongue and lips from being bitten, such biting is relatively rare and recovery from an epileptic fit is normally rapid.
- Keep the victim lying down in an open space.
- If breathing stops give artificial respiration.
- If convulsions take over few minutes a doctor should be called.
- After an epileptic fit, the victim should take some rest at an appropriate point and his parents should be informed.
- However, such cases should be treated individually as each person will often have his own pattern of fits.
- It should be noted that pupils suffering from some forms of epilepsy may be following a prescribed course of drugs and that these drugs may be brought legitimately to school so that they can be taken at a proper time.
- Students that are suffering from epilepsy condition should be treated with care and kindness.
It should be also emphasised that attacks or accidents within a school usually provides somewhat fewer problems than the attacks or accidents which occurs on a field trip or expedition, therefore adequate preparations for out of school activities must recognise this fact and must include an appropriate procedure to be followed in the case of injury to a teacher.
8. HEART ATTACK It usually involves a clot in one of the blood vessels that supply the heart.
First aid- Place the victim in a comfortable position, usually sitting up, particularly if there is shortness of breath, although his comfort is a good guide, use as many pillows as needed.
- Provide ventilation and guard against drafts and cold.
- If the victim is not breathing, begin artificial respiration.
- Have someone call for an ambulance equipped with oxygen and have the victim's own doctor notified.
- Do not give liquids to an unconscious victim.
- Since transportation tosses added strain upon the victim, do not attempt to transport him until you get medical advice, if available within a reasonable time.
- If the victim has been under medical care, help him with his prescribed medicine.
9. STROKE (apoplexy) usually involves a spontaneous rupture of a blood vessel in the brain or formation of a clot that interferes with circulation. Major signs include loss of bladder and bowel control, pupils of the eyes unequal in size, lack of ability to talk, unconsciousness, paralysis and difficulty in breathing and in swallowing.
First aid- Provide moderate covering
- Maintain an open airwaY
- Give artificial respiration if indicated
- Position the victim on his side so that secretions will drain from the side of the mouth.
- Call a doctor for medical advice as quickly as possible
- Do not give fluids unless the victim is fully conscious and able to swallow and unless medical care will be delayed for along time.
10. FAINTING is a partial or complete loss of consciousness due to a reduced supply of blood to the brain for a short time. A person collapses suddenly without warning.
It Is associated with sweating, coldness of the skin, Dizziness, Nausea, extreme paleness and numbness and tingling of the hands and feet.
First aid- Leave the victim lying down.
- Loosen any tight clothing and keep crowds away.
- If the victim vomits, roll him onto his side or turn his head to the side and, if necessary, wipe out his mouth with your fingers, preferably wrapped in cloth.
- Maintain an open airway
- Do not pour water over the victimSs face because of the danger of aspiration (the inhalation of gastric contents into the lower airways); instead bathe his face gently with cool water.
- Do not give any liquid unless the victim has revived.
- Examine the victim to determine whether or not he has suffered injury from falling.
- Unless recovery is prompt, seek medical assistance.
11. SNAKE BITES are always extremely painful, rapid swelling and identified by one or more puncture wounds created by the fangs. First aid is important in order to reduce the circulation of blood through the bitten area, to delay absorption of venom and to prevent aggravation of the local wound and to sustain respiration.First aid
- Keep the victim from moving around.
- Keep the victim as calm as possible and preferably in a lying position.
- Immobilize the bitten extremity and keep it at or below heart level.
- Take the victim to the hospital.
- If mild to moderate symptoms develop, apply a constricting band 2 to 4 inches above the bitten area, but not around the head, neck or trunk. The band should be ¾ to 1½ inches wide, not thin like a rubber band. The band should be snug but loose enough for a finger to be slipped underneath. Observe the swelling. Periodically check the pulse in the extremity beyond the bitten area to insure that the blood flow has not stopped.
- If severe symptoms develop, make a cut and apply suction (usually made of rubber or plastic, that sticks to smooth, nonporous surfaces) immediately. Apply a constricting band, if that has not already been done, and make a cut in the skin through the fang mark (s). Use a sharp, sterilized knife. Cuts should be ½ inch long, extending over the suspected venom deposit point. (Because a snake strikes downward, the deposit point is usually lower than the fang mark). Cuts should be made along the axis of the limb. Do not make cross-cut incisions. Do not make cuts on the head, neck, or trunk. Apply suction with a suction cup (usually made of rubber or plastic that sticks to smooth, nonporous surfaces) for 30minutes. If a suction cup is not available, use the mouth. There is little risk to the rescuer who uses his mouth, but it is recommended that the venom not be swallowed and that the mouth be rinsed out immediately.
If the hospital is closed, i.e cannot be reached in 4 or 5 hours, take the following measures:
- Keep trying to obtain professional care, either by transporting the victim to a place where medical care is available or by using an emergency communications system to obtain medical advice.
- If no symptoms develop, keep trying to reach the hospital and give the general first aid described in the first 3 steps above.
- If any symptoms at all develop, apply a constricting band, make cuts, and apply suction (usually made of rubber or plastic, that sticks to smooth, nonporous surfaces) immediately, as described the last steps above
Several other factors must be considered in cases of snakebite:
- Shock. Keep the victim lying down and comfortable and maintain his body temperature.
- Breathing and heart beat. If breathing stops, gives mouth-to-mouth resuscitation. If breathing stops and there is no pulse, perform cardiopulmonary resuscitation (CPR) IF you have been trained to do so.
- Identifying the snake. If you can kill the snake without risk or delay, bring it to the hospital for identification, but exercise extreme caution in handling the snake.
- Cleaning the bitten area. You may wash the bitten area with soap and water and blot it dry with sterile gauze. You may apply dressings and bandages, but only for a short period of time.
- Medicine to relieve pain. Do not give the victim alcohol, sedatives, aspirin, or any medicine containing aspirin. Some painkillers, however, may be given. Consult a doctor or other medical personal for specific medications that may be used.
- Snake bite kits. Keep a first aid kit accessible for all outings in primitive areas or areas known or suspected to be snake infested.
- It is recommended that cold compresses, ice, dry ice, chemical ice packs, spray refrigerants, or other methods of cold therapy be used in the first aid treatment of snakebite.
4. SWIMMING SAFETY TIPS
Every one should learn how to swim at an early age.
- Never swim alone, make sure there is someone nearby who can help in case of an emergency.
- Adjust slowly to cool or cold water, do not force in.
- Swim at a safe swimming place, preferably one supervised by lifeguards.
- Beware of unfamiliar swimming areas, since they may have double-crossing currents, deep holes, debris, and other hazards.
- Do not swim when overheated or overtired or immediately after eating a heavy meal or even a meal of normal size.
- Before diving, make sure that the water is deep enough and has no hidden objects beneath the surface. Do not dive into a swimming pool without checking first to make sure that the water is deep enough for diving and that there are no swimmers beneath you.
- Know your own ability and do not overestimate it, judging distance accurately over water is difficult.
- When swimming underwater, come up to the surface as soon as your chest is tight and you feel that you need air.
- If you are planning on a distance swim in open water, have someone accompany you with a boat.
- Be courteous; consider the safety of others.
- Do not hold anyone or hold his head under water.
- Do not push anyone into the water.
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