Theme - 4

First aid in Emergency

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July 2010 5.03-0008-2010

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Contents It's an old saying that............................”An Ounce of Prevention, is Worth a Pound of Cure”,
especially in an emergency situation when seconds count. Here are a few selected first
aid tips that may be useful in a disaster situation!!
1. Why it is needed -2
2. What is First aid -3
Warning about the module
3. Principles of First aid -5
4. Emergency situations -7 This module is made to educate the readers who are involved in chemical emergency
management. This module does not recommend any one to take first aid steps what
4.1. Respiration -7 have been discussed herewith unless he/she is trained first aid trainer or volunteer
4.2. Asphyxia -8 after having qualified training from either Red cross or St. Johns ambulances or any
other govt approved agency.
4.3. Poisoning - 15
4.4. Burns - 18
5. First aid kit - 22
6. Elements of training in First aid - 25
1. Why it is needed
6.1. Teaching Methods - 25
First aid is emergency care provided for injury or sudden illness before emergency
6.2. Assessing the scene and the Victim(s) - 25 medical treatment is available. The first-aid provider in the workplace is someone who
6.3. Responding to Life-Threatening Emergencies - 26 is trained in the delivery of initial medical emergency procedures, using a limited
amount of equipment to perform a primary assessment and intervention while awaiting
6.4. Responding to Non-Life-Threatening Emergencies - 27 arrival of emergency medical service (EMS) personnel. A workplace first-aid program is
7. Conclusion - 28 part of a comprehensive safety and health management system that includes the
following four essential elements:
8. Glossary - 30 Management Leadership and Employee Involvement
9. References - 31 Worksite Analysis
Hazard Prevention and Control
Safety and Health Training
The purpose of this module is to present a summary of the basic elements for a
first-aid program at the workplace. Those elements include:
Identifying and assessing the workplace risks that have potential to cause worker
injury or illness.
Designing and implementing a workplace first-aid programme that:
-Aims to minimise the outcome of accidents or exposures
-Complies with essential provisions of regulations
-Includes sufficient quantities of appropriate and readily accessible first-aid
supplies and first-aid equipment, such as bandages and automated external
physical and medical support.
-Assigns and trains first-aid providers who, receive first-aid training suitable to
the specific workplace and receive periodic refresher courses on first-aid skills
and knowledge.

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 -Instructs all workers about the first-aid programme, including what workers see some accident, there are a few basic principles you should follow to protect yourself
should do if a co-worker is injured or ill. Putting the policies and programme in and the victim. The following steps are required immediately:
writing is recommended to implement this and other programme elements. 1. Survey the Scene. Before you help the victim, determine if the scene is safe. If
-Provides for scheduled evaluation and changing of the first-aid programme to anything dangerous is present, don't put your own life at risk to try and help the victim;
keep the programme current and applicable to emerging risks in the workplace, you will be of no aid if you become a victim too. Summon help and wait for trained
including regular assessment of the adequacy of the first-aid training course. people to resolve the situation. If the scene is safe, try and determine what happened
and how many victims there may be. Never move the victim unless an immediate, life
2. What is First-aid threatening danger exists, such as a fire or the threat of a building collapse.
2. Primary Victim Survey. After ensuring the scene is safe, you can turn your
attention to the victim. Begin by performing a primary survey to determine if the
First aid is the immediate care given to a person who is injured or ill. Sudden illness or victim:
injury can often cause irreversible damage or death to the victim unless proper care is
initiated as soon as possible. First aid includes identifying a life-threatening condition, A) is conscious
taking action to prevent further injury or death, reducing pain, and counteracting the B) has an open, unobstructed airway
effects of shock. Because life-threatening situations do occur, everyone should know C) is breathing
how to provide emergency care until a victim can be treated or transported to a D) has a heartbeat
medical facility. First aid is not intended to replace care by a physician or surgeon. Its E) is not bleeding severely
intent is to protect the victim until medical assistance can be obtained.
To check for consciousness, gently tap the person and ask if they are okay. If there is no
The primary purpose of first aid is to: response, this in an indication that a possible life-threatening situation may exist. If
Care for life-threatening situations the person is responsive and can talk or
Protect the victim from further injury and complications cry, this indicates they are conscious,
Arrange transportation for the victim to a medical facility breathing, have an unobstructed airway,
Make the victim as comfortable as possible to conserve strength and a pulse. If the victim is unconscious,
Provide reassurance to the victim kneel down next to the head and check
An accident can occur at any time or any place where hazardous chemicals are being for the ABC's:
used and the working conditions are not safe. If you are the first person to arrive and Airway,
Breathing, and
Circulation.
To check the Airway (clear and maintain
an open airway), Breathing (restore
breathing), and Circulation (restore
circulation), place your ear next to
the victim's mouth and
listen/feel for breath sounds while
looking for a rise and fall of the chest.
While doing this, check for a pulse by
placing your fingers on the neck, just
below the angle of the jaw, and feel
for the pulse from the carotid artery.
These three steps will determine if
cardiopulmonary resuscitation (CPR)is needed.

3 4
3. Principles of First aid breathing, they may need their head repositioned. If they are still not breathing
they need rescue breathing, do not give unless you are trained, instead, find an
adult.
The Gurumantra (thumbrule) of First aid is RAPABCH. To make it convenient we are C is for circulation
opting the point wise followings: If there is not a pulse, then this person needs CPR. The best place to check for a
R is for Responsiveness which means that we have to check the following: pulse is the carotid artery along the side of the neck along the windpipe.
If you are not trained in CPR, then find someone who is.
Is the victim conscious?
H is for hemorrhaging
Touch their shoulder, ask if they are alright.
If the victim is bleeding, then provide the necessary care. If not, then begin a
Ask if they need help.
secondary assessment.
If they say no, then proceed no further.
If yes, or no response, then proceed to A
A summary of the first aid can be briefed in Fig-1:
A is for Activate Emergency Management Services (EMS), in India recently the 108 has
started in jointly with health and police department. Please see what emergency
management services number is available in your area.
What are the four things you need to remember when making an EMS call? And YES
therefore the following points are suggested: IS THE CASUALTY TREAT ANY INJURIES
CONSCIOUS? GET HELP IF NECESSARY
Your name and contact number
The emergency NO
The location of the emergency condition of the victim YES
Check the victim for responsiveness. If he do not respond or if he tells you that he IS THE CASUALTY
IS THE CASUALTY BREATHING NOISILY?
need help, ask what need, to be contacted, when and where? Some very basic
question and stay till EMS arrives to take care of victim BREATHING?
YES
P is for Position OPEN AND CLEAR AIRWAY
NO NO
Only re-position the victim if the victim is in further danger in their present location.
And / or there does not seem to be spinal injury and additional care requires moving TREAT ANY LIFE
them. THREATENING INJURIES.
IS THERE PULSE?
PLACE CASUALTY IN
Explain when an injured person should and should not be moved? If there are suspected RECOVERY POSITION
spinal injuries, do not move the victim (except when the victim is in a life threatening NO AND CALL FOR HELP.
situation). YES

DIAL FOR HELP. GIVE BREATHS OF

Four Steps of Victim Assessment is important and it should be conducted by the use of
the “ABCH” GIVE ARTIFICIAL ARTIFICIAL RESPIRATION
A is for airway and check to see if the airway is blocked by: RESPIRATION AND DIAL FOR HELP
Use your finger to sweep the mouth to remove any seen object. If this fails, then EXTERNAL CARDIAC CONTINUE ARTIFICIAL
perform the Heimlich maneuver or abdominal thrusts. MASSAGE TILL HELP RESPIRATION TILL HELP
B is for breathing ARRIVES. ARRIVES
Look, listen and feel by watching the chest and placing your cheek a few inches
above the mouth of the victim to sense any movement of air. If the victim is not Fig-1

5 6
4. Emergency situations -Lungs being elastic and spongy, it comes back to the original state.
-Volume of lungs decreases and pressure in lungs increases. So air is pushed out.

Now in the following paragraphs some of the emergency situations are being Exchange of gases:
discussed from first aid angle: This occurs in capillaries surrounding the alveoli. Oxygen is absorbed by red blood
corpuscles (RBC) and water vapour and carbon-dioxide is let out from the blood plasma
4.1 Respiration into the alveoli, which is expelled during expiration.

Respiration means breathing in and breathing out of air. It helps in supply of oxygen Respiratory centre:
(of the air) to all parts of the body. Lungs are supplied with nerves, which are connected to the respiratory centre in brain.
This controls respiration. It determines the rate and depth of respiration.
Breathing contains three phases: -
Breathing in (inspiration). Respiratory rate:
Breathing out (expiration). Average adult- 16 to 18 times (per minute).
Pause. Children - 20 to 30 times (per minute).

Respiratory system: This varies during stress, exercise, injury, illness, etc.
Air passage.
Lungs. Heart rate will accordingly increase to carry the extra oxygen around the body.

Air passage:
Air passage consists of nose, mouth, throat (pharynx), the windpipe (trachea), and the CLINICAL DEATH - O MINUTES.
air tubes (bronchi). The bronchi divide in to minute branches (bronchioles), which end in
BREATHING AND CIRCULATION STOPS.
the lung substance (alveoli).
LETHAL BRAIN DAMAGE - 4 TO 6 MINUTES.
Lungs:
Two in number. BIOLOGICAL DEATH - 10 MINUTES.
Situated on right & left sides of chest cavity.
Made up of small sacs (alveoli). BRAIN CELLS DIE.
Covered by a membrane called pleura, which lines the inner wall of the chest cavity.

Mechanism of respiration:
Inspiration: 4.2 Asphyxia
-Diaphragm contracts and flattens.
(this increases chest cavity, above downwards) Asphyxia is a condition where lungs do not get sufficient supply of air for breathing.
-Ribs move upward and forward due to contraction of intercostals muscles.
(this increases the chest cavity from and to back). Causes:
-Due to this lungs expansion, volume of the lungs increases and pressure inside the Affecting air passages.
lungs decreases. At a point when the pressure in lungs is less than the atmospheric
pressure, air enters from atmosphere in to the lungs. Spasm:
Expiration: Food, water, irritant gases (coal gas, exhaust fumes, smoke, etc.), sewage gas, gas in
-Diaphragm relaxes and comes back to its original state. unused wells, etc., entering air passage, bronchial asthma.
=Intercostal muscle relaxes and ribs also come back to the original state.

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 Obstruction: Continue till normal breathing sets.
Due to foreign body, falling back of tongue in case of unconscious patient, swelling of Prevent damage to brain and other vital organs.
tissues of throat (scalding, burns, corrosives, etc.). Artificial respiration.
External cardiac compression.
Compression: Keep body warm by light blanket.
Strangulation, smothering, throttling. Provide shelter.

Affecting respiratory mechanism: Different kinds of asphyxia:

Epilepsy, tetanus, rabies.
Paralysis of chest wall, diaphragm (polio, poisoning, etc). Drowning:
Water (any other liquid) enters in to air passage and clogs the lungs.
Affecting respiratory centre:
Morphine, sleeping tablets, electric shock, stroke, etc. Management:
Drain the fluid from lungs.
Compression of chest: Give artificial respiration.
Fall on earth, wall, etc.
Crushing against wall (stampede, etc). Treatment:
Act quickly.
Lack of oxygen at higher altitude and lower atmospheric pressure. Remove foreign bodies from throat and nose.
Acclimatisation (gradualascent is necessary). Start artificial respiration (even while in water).
Put the casualty face down and head to one side and arms stretched beyond his
Signs and symptoms: head.
First phase: Infants or child can be held upside down for a short period.
Breathing rate increases. Raise middle part of the body with your hands round the belly. This will help in
Short breathing. draining out water.
Swollen neck veins. Give artificial respiration till breathing becomes normal.
Face, lips, nails, tongue, and toes turning blue (cyanosis). Remove wet clothing.
Fast and feeble pulse. Keep body warm.
If conscious, give hot drinks.
Second phase: Don't allow to sit.
Shift to hospital as stretcher case.
Semi- consciousness or unconsciousness.
Froth in mouth and nostrils and Fits.
Strangulation, hanging, throttling:
Management: Pressure from outside the air way and obstructs air way.
Remove the cause or remove the casualty from the cause.
Ensure open airway. This enables air to reach the lungs. Hanging:
Open airway Suspension of body by a noose.
Support the nape of neck on your palm and press the head backwards. It can also cause fracture in spine causing damage to spinal cord.
Press the angle of the jaw forward from behind.
(this extends the head on the neck and lifts the tongue to clear off the airway). Strangulation and throttling:
If airway is clear, the casualty gasps and starts to breathe. Airway is blocked due to tight contraction or intentional squeezing of person's throat.
Give 3 or 4 inhalations by 'mouth-to-mouth method.

9 10
Management: Grasp your fist with the other hand.
Cut and remove the band contracting the throat, supporting the weight of the body Pull both hands towards you with quick inward and upward thrust so that upper
in case of hanging (cut below the knot). abdomen is compressed.
'ABC' of resuscitation. Repeat 4 times if needed.
Put in recovery position after recovery. In case of unconscious patient:
Shift to hospital. -Lay the patient back with head in open airway position.
-Kneel astride the patient's thigh.
Choking: -Place heel of one hand in the centre of patient's upper abdomen and cover with
It is due to obstruction of windpipe. other hand, with fingers clear of abdomen.
Common in children. -Press with both arms straight into the abdomen with quick inward and upward
Signs and symptoms: thrust.
-General signs of asphyxia. -Repeat if needed, for 4 times.
-Unable to speak or breathe.
-Gripping of throat. In children:
-Congestion of face and neck, etc. With prominent veins. Make the child sit on your lap.
Give abdominal thrust with one hand, with less pressure.
Management: Infant:
Remove the obstruction. -Place on firm surface.
Shift to hospital. -Press the upper abdomen with two fingers, with less pressure.

Treatment: Swelling within throat:

Remove any visible obstruction by hooking out with your fingers. Due to drinking of very hot liquids, corrosive poisons and inflammation.
Encourage patient to cough.
If not cleared, bend the casualty head lower than lungs. Slap between shoulder Management:
blades with the help of hands, four times. Give ice to suck or cold water sip.
Check the mouth and remove the foreign body if dislodged. Give butter, olive oil and liquid paraffin, orally.
If not, perform abdominal thrust four times. Apply cloth wrung out of hot water, to the front of neck.
Remove the foreign body, if dislodged. Give artificial respiration if needed.
If not, repeat slapping, checking mouth & abdomen thrusts, till obstruction is
removed. Suffocation by smoke:
Give artificial respiration if breathing stops. Protect yourself by a towel or wet cloth over mouth and nose.
Keep low and remove the casualty quickly.
In children:
Hold upside down and smack on the back 2 or 3 times. Suffocation by poisonous gases:
If not successful lay the child prone with head hanging over the knee & give sharp Carbon monoxide [CO] (lighter then air)
smacks, between the shoulder blades. -Ensure fresh air.
Induce vomiting by introducing two fingers into the throat. -Opening doors and windows if there is no fire.
-Before entering to rescue the patient, take deep breath and hold.
Abdominal thrust: -Crawl along the floor.
Applying series of thrust to upper abdomen, to force air out of choking lungs. -Remove to fresh air.
Stand or kneel behind the casualty. -Loosen clothing.
Put one arm around the patient's abdomen and clench your fist and place it with -Give artificial respiration.
your thumb inwards in the centre of upper abdomen Carbon-dioxide [CO2](heavier then air)

11 12
 In coal-mines, deep unused wells, sewages, other gases emitted from leaking Continue artificial respiration till normal breathing resumes.
refrigerators, LPG, etc. Note:
Artificial respiration can be given even if breathing is there, but not normal.
Management:
Same as above except enter in upright position. If heart also not working:
Signs:
Bronchial asthma: Face will be pale or blue.
Due to sudden contraction of air way, due to allergy, infection, anxiety. Dilated pupils.
Heart beat and pulse will be absent.
Management:
Reassure the patient to sit up and lean forward with a table or pillows to lean. Management:
Open windows for fresh air. Lay casualty on back on a hard surface (bench, table, etc).
Shift to hospital. Give a hit, with edge of your hand on the lower and left angle of the sternum. This
usually stimulates the heart.
Artificial respiration: If heart does not work, persist striking for 10-15 times, at the rate of 1 strike/second.
Best method - mouth to mouth or If hear beat starts, then stop striking.
-Mouth to nose breathing. Continue artificial respiration side by side.
Other methods are: If heart does not function, start ECC.
-Sylvester's method.
-Holger nelson method. External Cardiac Compression (ECC):
-Schafer's method.
Note: - thumping the heart or ECC should not be done until the heart has stopped
Mouth to mouth method: beating.
Place the casualty on his back.
Hold the head tilted back. Feel and mark the lower part of sternum.
Take deep breath with your mouth wide open. Place heel of hand, two fingerbreadth above the joint of rib margin and breastbone.
Keep the casualty's nose pinched. Place heel of other hand over it.
Cover the mouth of casualty with your mouth smugly. (cover mouth with clean cloth With arms straight, press sternum backward (about 4 to 5 cms. In adults) and release.
if possible). Compression must be regular, smooth, not jerky or jabbing.
Blow on to the lungs and watch chest raise.
Withdraw your mouth and watch chest falling back. Rate: -
Repeat at the rate of 15 to 20 times per minute. Adults - above 60 per minute.
Note: Children (2 to 10 years) - above 80 to 90 but with one hand.
In case of small children, the open mouth should cover the mouth and nose and blow
gently. Rate 18-22 per minute. Children (0 to 2 years) - 100 per minute only with finger.

If two trained people are there:

If chest does not rise on blowing:
Person giving artificial respiration should be on right side, near the head and one
Suspect obstruction.
giving ECC on the left, at the level of the middle of the chest.
Ensure open air way.
Give two inflation and check.
Remove any obstruction by thumping on back, etc.
If there is no heartbeat, give 5 compressions at rate of 80 compressions per minute.
If mouth-to-mouth is not possible, use mouth to nose method, but mouth should be
Give single inflation on the upstroke of every fifth compression.
kept closed.
Continue till recovery.

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Signs of effective treatment: -Unusual odours of breath, on clothing or at the scene. (garlic smell rat poison)
Colour will become normal. -Abnormal breathing.
Pupils will contract. -Abnormal pulse.
Carotid pulse is felt. -Sweating.
-Dilated or contracted pupils.
If only one trained person is available: -Excess salivation or foaming from the mouth.
Artificial respiration and ECC is done alternatively by shifting position. -Painful swallowing.
15 compressions at the rate of 80 per minute, followed by two breaths of mouth-to- -Distension, pain & tenderness of abdomen.
mouth method. -Nausea & vomiting.
Check pulse after first minute and then every three minutes, till pulse is felt. -Diarrhoea.
Stop ECC, as soon as pulse is felt. -Convulsions.
Continue, mouth-to-mouth respiration till breathing becomes normal. -Altered state of consciousness.
Put in recovery position after the recovery.
Treatment:
4.3 Poisoning -Open airway.
-Dilute poison with water or milk.
Poison: -Induce vomiting with syrup ipecac, soap & water, etc. (except if patient is
A poison is a substance that, if taken into the body in sufficient quantity, can cause unconscious, ingested corrosives, gasoline products, etc.)
temporary or permanent damage. -Ensure patient does not aspirate vomitus.
-Give one tablespoon of powdered charcoal or white of egg.
Types of poisons: -Antidote, if known & available, can be given.
1. Ingested poison: eating or drinking poisonous substances. (Rat poison, poisonous -Transport to hospital in lateral recumbent position.
plants, etc.)
2. Absorbed poison: Absorbed through skin. (Insecticides) Inhaled poison:
3. Inhaled poison: Chemical vapours. (Sprays, cleaning fluids, etc.) Fumes from fire,
stoves, exhausts, sewer gases, etc. Signs and symptoms:
4. Injected poison: Insect bites. (Spiders, wasps, etc.), Snake bite, etc. -Unconsciousness or altered behaviour.
5. Drugs. -Shortness of breath.
-Cough.
Effects: -Abnormal pulse.
Depends on the nature, concentration and how it enters the body. -Burning eyes, mouth, nose, throat, chest, etc.
-Severe headache.
Acts as -Nausea & vomiting.
Corrosive or irritant. -Reddening of lips. (in carbon monoxide poisoning)
Suffocating agent displacing oxygen.
Treatment:
Signs, symptoms and management: -Remove the patient from the spot.
-Open airway.
Ingested poison: -CPR if needed.
-Remove contaminated clothing, carefully.
-Provide intensive First aid, if possible.
Signs and symptoms
-Shift to hospital.
-Burns and stains around the mouth.

15 16
Injected poison: Absorbed poison:

Signs and symptoms: Signs and symptoms:

-Noticeable stings or bites. -Skin reactions.
-Localised pain or itching or burning sensation. -Itching.
-Swelling or blistering at the site. -Irritation of eyes.
-Weakness or collapse. -Headache.
-Abnormal pulse and breathing. -Increased relative skin temperature.
-Headache. -Anaphylactic shock.
-Dizziness.
-Nausea & vomiting. Treatment:
-Muscle cramps, chest tightening & joint pains. -Remove the patient from the spot.
-Excessive salivation, sweating, etc. -Brush off any dry material.
-Anaphylactic shock. -Wash the area with soap and water.
-Remove all contaminated clothing, shoes, jewellery, etc.
Treatment: -Shift to hospital.
-Treat for shock.
-Scrap away bee or wasp stingers & venom sacs. Points to be remembered while handling poisonous cases:
-Place ice bag over the sting area.
Look for evidence.
In snake bite: Get details from the patient or others.
Retain any left over poison, bottle or any container, etc. This will help in
Signs and symptoms: identification.
-Noticeable bite on skin. Retain the vomitus, stained clothing, dead snake, insects etc. This will help to
-Pain & swelling over the bite area. identify the poison.
-Rapid pulse & laboured breathing. While rescuing a person, take all safety precautions, before attempting.
-Progressive general weakness.
-Vision problems.(dim or blurred) 4.4 Burns
-Nausea or vomiting.
-Convulsions. Burns are caused by extremes of temperature (hot or cold), chemicals or radiation.
-Drowsiness or unconsciousness.
-Bleeding (in viper bites) Types of Burns:

Treatment: 1.Dry burns:

-Keep patient calm.
-Clean the area with soap & water.
-Treat for shock.
-Remove constrictive items on the bitten extremities.
-Immobilise bitten extremities.
-Keep bite area at the level or at a lower level from the heart.
-Apply constrictive band above and below the wound.
-Avoid cutting over the wound and shift to hospital.
Caused by dry heat, like fire, flame, hot metal, high tension electric current, lightening,
friction, etc.
2.Scalds:
Caused by moist heat like boiling water, steam, oil, hot tar, etc.
3.Cold Burns:
Caused by metals in freezing condition, liquid oxygen, liquid nitrogen, etc.

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4.Chemical Burns:
Caused by strong acids like Sulphuric Acid, Nitric Acid, etc., strong Alkalis like Caustic
Soda, Potash, Quick Lime, etc.

5.Electrical Burns:
Caused by high tension electric current.

6.Radiation Burns:
Caused by exposure to Sun, X-Rays, and radiation after Nuclear explosion, etc.

Classification of Burns: Second Degree Burn

First degree (Superficial Burns)
-Skin reddening seen.
Second degree (Intermediate Burns)
-Blister formation is seen.
Third degree (Deep Burns)
-Destruction of deeper tissues and scaring seen.

Severity of Burns:
This is judged by the area of burns than the degree of burns. Superficial burns affecting
larger area is more dangerous than third degree burns affecting a smaller area. Area of
burns is judged by “rule of nines”. Third Degree Burn

Burns are considered to be critical, when: Complications due to burns:

-Area of second degree burns is > 30 %. Damage to tissues. Scars & disfigurement seen later.
-There is third degree burns of face, groin, hand, feet or major joints. Loss of plasma, resulting in decrease in blood volume.
-Third Degree Burns > 10 %. Shock.
-It is associated with other complications affecting respiration, etc. Respiratory problems.
Sepsis.
The photos as shown below and in next page show the types of burns. First, second and Death.
third degree burns need to be reviewed
in the chemical (industrial) emergency before any type of medical treatment victims Dangers due to fire
should be decontaminated first.
How to help a person whose clothes have caught fire?
Put out flames using water or whatever means available.
Water is best since it quenches the flames & also cools the burnt area so that the
damage is minimised.
Don't allow the person to run about.
Hold a wet rug in front of you, while approaching.
Lay him down & wrap tightly with a cloth so as to smother the flames.
If the clothes in front have caught fire, lay him on his back & vice versa, till suitable
First Degree Burn material is brought to smother the flame.

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How to rescue a person from fire? Burns in the mouth and throat:
Clean air will be at ground level. So crawl along the floor to pull out the person. (Usually Chemical Burns or Scalds)
Tie a wet kerchief round your face, to prevent inhalation of smoke. Swelling of mouth, tongue, throat, etc. Can cause airway obstruction. So treat
Act quickly. accordingly.
Don't open the windows.
Sun burns:
Management: Remove to shady cool place & bathe with cool water.
In minor cases: Cover with sterile dressing.
Pour cold water. If water is not available, use any cold harmless liquid like milk, etc. Treat for general effects of over heating.
Remove any material of constrictive in nature, like rings, watches, belts, shoes, etc. Shift to hospital.
Apply clean dressing.
Don't break blisters or remove any loose skins. Prevention of burns:
Don't apply any ointments. Stoves should be kept at a higher level.
Don't apply adhesive dressings. Avoid free hanging clothes.
Avoid using clothes made of nylon or similar fibres, which can catch fire quickly.
In Severe Cases: Better use cotton.
Lay casualty down. Never open Fire unattended in hazardous area.
Pour water. Restrict entry of local ignition sources in hazardous area.
Protect the burnt area from contact with the ground. Never keep combustible material near to open or direct flame or sources of heat.
Gently remove any rings, watches, etc. Keep Inflammable materials safe.
Carefully remove any clothing soaked in boiling liquid.
Cover the injured area with sterile dressing and secure. 5. First aid kit
Don't remove anything that is sticking to the burnt area.
Don't break blisters.
Don't apply ointments, Tips for making First aid kit
Immobilise badly burnt limbs.
Give oral rehydration fluids, if person is conscious. Container To keep all first aid items in one common container.
If unconscious, open airway & check breathing. Complete “ABC” of resuscitation and Gauze Pads -To cover wounds and prevent infection.
then put in recovery position. Roll Bandage -To stabilize strains and sprains and cover wounds.
Shift to hospital. Triangular Bandage -To cover wounds and prevent infection .
Bandages -To stop minor bleeding and prevent infection.
Chemical burns: Adhesive Tape -To secure bandages to wounds.
Wash the chemical with large quantities of water. Antibacterial Ointment -To prevent infection on small cuts.
Ensure that the washings does not flow over normal areas. Calamine Lotion -To prevent itching.
Cut out contaminated clothing. Soap -To clean minor wounds and cuts and to prevent infection.
Treat as for burns. Latex Gloves -To protect the rescuer from infection and blood pathogens.
Bandage Scissors -To cut gauze and bandages.
Burns of eye: Tweezers -To pull splinters.
Wash immediately with cold water. Moleskin -To protect blisters and prevent infection.
Ensure washing do not flow over other eye. Antiseptic lotion - To prevent infections.
Caution the patient against rubbing the eye. Analgesic - Pain killer
Treat as for burns. Anti-inflamatory - pyretic/ painkiller

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 Establish where extra items are kept to restock the kit.
Make up an inventory list. One copy with the kit, one copy with the troop.
Show everyone the kit, what is in it, and how to find/use the contents.

What should be in first aid kit

We recommend the following items must be in kit essentially:

Coban - Also called selfadhering bandage.
Carry the 1/2 inch size and one larger
size like 2 or 3 inch. Once applied it keeps
most dirt out, is flexible, and will stay on
if wet. Very useful for use in the outdoors.
Wound wash - How about a small bottle of
contact lens saline solution? It is near
sterile and can be used to wash a cut or
rinse the eye.
It should be placed in a visible location near the center of the activities. Everyone Gloves - Carry medium and large size,
should be aware of its location. which should fit just about everyone.
Replace them periodically if they age
and break down.
Antibiotic - Carry the triple antibiotic type.
Band Aids - Have both small and large sizes.
Check them periodically, as they will age
and become unusable.
Gauze Pads - You can purchase the
"semi-sterile" type that come in bulk
packages. Transfer them to plastic bags
to put in the kit. 4x4 inch and 2x2 inch are useful sizes.
Ace Bandages - Also called elastic bandages. You may
need the 3 inch size for wrists and the 6 inch size for
larger joints.
Triangular Bandages - They can be used as slings,
dressing, and ties for splints
Scissors - Obtain an inexpensive pair of small medical
Steps to make a first aid kit
scissors. It cuts bandages, ties, tape, clothing, whatever.
Very useful to have.
The following points need to be addressed before making a first aid kit: Mouth Barrier Device - We recommend a pocket mask
type…the one that comes in a hard plastic case.
Identify how kit will be used and where it will be kept (determines size and type of Small splints - A few wooden tongue depressors or
container). popsicle sticks work as finger splints, scrapes, or as a
Analyse what type of injuries are expected (determines what to carry). tongue depressor.
Select and obtain the bag, box, or container for the kit. Side cutters (pliers) - If you are active with fishing
Obtain the contents, repackage them if necessary, and pack the kit. activities this is needed to cut fish hooks.

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 Thermometer - Good to know just how high the fever is.
Aspirin - You can carry this in the kits for cardiac issues.
Ibuprofen - Used for ailments such as joint and muscle
pain, etc.
Chap stick - Dehydration can lead to cracked lips.
Throat Lozenges - Helpful for a sore throat.
Antacid - Helps with some of that camp cooking or for
stomach illness or disorder.
Sanitiser - In the field a quick way to wash up before and
after treatment.
Soap - J and J shampoo mixed with water works well to clean
cuts. Small soap bars are available in the travel section.
6. Elements of Training in first aid
6.1 Teaching methods
Training programmes should incorporate the following principles:
Having appropriate first-aid supplies and equipment available;
Exposing trainees to acute injury and illness settings as well as to the appropriate
response through the use of visual aids;
Including a course information resource for reference both during and after training;
Allowing enough time for emphasis on commonly occurring situations;
Emphasising skills training and confidence-building over classroom lectures;
Emphasising quick response to first-aid situations.
6.2 Assessing the scene and the victim(s)
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The training programme should include instruction on the following:
Assessing the scene for safety, number of injured, and nature of the event;
Assessing the toxic potential of the environment and the need for respiratory
protection;
Establishing the presence of a confined space and the need for respiratory
protection and specialised training to perform a rescue;
Prioritising care when there are several injured;
Assessing each victim for responsiveness, airway patency (blockage), breathing,
circulation, and medical alert tags;
Taking a victim's history at the scene, including determining the mechanism of
injury;
Performing a logical head-to-toe check for injuries;
Stressing the need to continuously monitor the victim;
Emphasising early activation of EMS;
Indications for and methods of safely moving and rescuing victims;
Repositioning ill/injured victims to prevent further injury.
6.3 Responding to Life-Threatening Emergencies
The training program should be designed or adapted for the specific worksite and may
include first-aid instruction on the following:
Establishing responsiveness;
Establishing and maintaining an open and clear airway;
Performing rescue breathing;
Treating airway obstruction in a conscious victim;
Performing CPR;
Using an AED;
Recognising the signs and symptoms of shock and providing first aid for shock due
to illness or injury;
Assessing and treating a victim who has an unexplained change in level of
consciousness or sudden illness;
Controlling bleeding with direct pressure;
Poisoning;
Recognising asphyxiation and the danger of entering a confined space without
appropriate respiratory protection. Additional training is required if first-aid
personnel will assist in the rescue from the confined space.
Responding to Medical Emergencies
-Chest pain;
-Stroke;
-Breathing problems;
-Anaphylactic reaction;
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 -Hypoglycemia in diabetics taking insulin; 7. Conclusion
-Seizures;
-Pregnancy complications;
Many deaths and impact of injuries can be prevented with First Aid if causalities are
-Abdominal injury;
treated immediately. First aid is the initial care given to an injured person. Mostly, this
-Reduced level of consciousness;
timely care prior to the arrival of the medical help means the difference between life
-Impaled object.
and death.
It must start immediately when the injury or illness occurs and continue until medical
6.4 Responding to Non-Life-Threatening Emergencies
help arrives or the casualty recovers.
The training programme should be designed for the specific worksite and include first- The basic aims of first aid are:
aid instruction for the management of the following:
To save life
Wounds
To protect the casualty from getting more harm
-Assessment and first aid for wounds including abrasions, cuts, lacerations,
To reduce pain and
punctures, avulsions, amputations and crush injuries;
Priorities of Casualty Treatment
-Principles of wound care, including infection precautions;
-Principles of body substance isolation, universal precautions and use of personal
Priorities of Casualty Treatment
protective equipment.
Asphyxia
Burns
Cardiac Arrest
-Assessing the severity of a burn;
Severe Haemorrhage (Bleeding)
-Recognising whether a burn is thermal, electrical, or chemical and the appropriate
Other Injuries/Illnesses
first aid;
Shock
-Reviewing corrosive chemicals at a specific worksite, along with appropriate first
aid.
Temperature Extremes Immediate Requirement
-Exposure to cold, including frostbite and hypothermia;
-Exposure to heat, including heat cramps, heat exhaustion and heat stroke. Critical four minutes
Musculoskeletal Injuries One of the most common causes of an accidental death is due to loss of oxygen supply.
-Fractures; This is mostly caused by a blocked airway. Normally it takes less than four minutes for a
-Sprains, strains, contusions and cramps; blocked airway to cause death.
-Head, neck, back and spinal injuries;
-Appropriate handling of amputated body parts. The 'golden hour'
Eye injuries In emergency medicine, the golden hour is the first 60 minutes after the occurrence of
-First aid for eye injuries; a major multisystem trauma. It is widely believed that the victim's chances of survival
-First aid for chemical burns. are greatest if he or she receives definitive care within the first hour. First aid is the
Mouth and Teeth Injuries first step to save a victim.
-Oral injuries; lip and tongue injuries; broken and missing teeth;
-The importance of preventing aspiration of blood and/or teeth. The first aid steps can be summarised again as in next Fig-2.
Bites and Stings
-Human and animal bites;
-Bites and stings from insects; instruction in first-aid treatment of anaphylactic
shock.

Training should be imparted by qualified trainers only.

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 DANGER 8. Glossary

RESPONSE Consequence: Outcome or impact of an event.

Event: Occurrence of a particular set of circumstances.

Air Yes Manage bleeding, shock
they Breathing First aid: Is an attempted to a ill person to provide health care immediately after
and other injuries
sudden health problems.

Frequency: A measure of the number of occurrences per unit of time.

AIRWAY
Roll to side, supporting Hazard: A source of potential harm or a situation with a potential to cause loss.
head and neck.
Clear airway
Health Loss: Any negative consequence or adverse effect on human health.

BREATHING Health Risk: The chance of something happening that will have an impact upon the
Looks, listen and Feel huma health.

Health treatment: Process of selection and implementation of measures to modify

Yes Place in lateral risk.
DANGER position, monitor ABCs,
treat other injuries Likelihood: A general description of probability or frequency.

Roll onto back,

supporting head and
neek, 5 full breaths
in 10 seconds

CIRCULATION

Do
Yes No
they have a
pulse?
Commence Ear
Commence CPR
(not breathing, pulse
(not breathing, no pulse)
present)

Fig-2

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9. References Notes

1. Best Practices Guide: Fundamentals of a Workplace First-Aid Programmes, U.S.

Department of Labor Occupational Safety and Health Administration OSHA 3317-
06N 2006.

2. Best Practices Guide: Fundamentals of a Workplace First-Aid Programmes, Indian

Red Cross Society.

3. www.hrdp-idrm.in

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