FIRST AID NURSING

FIRST AID: First aid refers to the actions taken in response to help someone who is injured or suddenly taken ill. OR First aid is the immediate and temporary care given to the victim of an accident or sudden illness. FIRST AIDER: First aider is the person who takes this action while taking care to keep everyone safe and cause no further harm. Purposes of first aid: 1. To prevent disability 2. Preserve life 3. Assist recovery 4. Prevent aggravation of condition 5. Help in transporting to hospital 6. To avoid further injury Points to remember while giving first aid: Quick assessment Protect yourself Prevent cross infection Provide comfort and reassurance Early treatment Arrange for help Qualities of a fist aider: Be calm-stay in control Build and maintain trust Be aware of risk

 Give early treatment Remember your own needs Give comfort and reassurance Observe carefully and quickly Control crowd Possess good judgment Provide first aid according to priority Acts tactfully

Golden rules of first aid: 1. Be calm and quick, be methodical 2. In cases of cessation of breathing give artificial respiration 3. Stop bleeding as soon as possible 4. Guard the casualty from shock, in case of difficulty transport to nearby hospital 5. Do only what is necessary 6. Reassure the casualty 7. Prevent crowding around the casualty 8. Do not remove clothes unnecessarily 9. Arrange for removal of casualty How to deal a casualty? Build trust Make eye contact Use calm, confident voice Do not speak too quickly Keep instructions simple Use simple hand gestures

 Be sensitive to casualtys feelings Do not interrupt the casualty Take care of the casualtys belongings

I.BANDAGES
PURPOSES OF BANDAGES: o o o o o To retain dressings and splints To afford support to an injured part To control bleeding To reduce or prevent swelling To assist in carrying casualties whole

broad Triangular bandage

narrow BANDAGES Roller bandage

Application of triangular bandage: Triangular bandaging can be used for the scalp,for the shoulder, forehead,side of the head, for the elbow, for the hand, for the hip, the knee, the foot ,for a stump. Triangular bandage as sling can be used for:arm sling,collar and cuff sling,triangular sling, improvised slings. PURPOSES OF SLINGS: To afford support To rest an upper limb To prevent extra weight

Application of roller bandages: General rules: Face the casualty Hold the bandage in right hand Apply the outer side of the free end to the part. Bandage firmly from below upwards Apply each layer of bandages so that it covers two-thirds of preceding one See that the bandage is neither too tight nor too slack Secure the bandage when completed Methods of application: a) Simple spiral b) The reverse spiral c) The figure of 8 d) The spica

II.TRANSPORTING METHODS OF CASUALTY

Factors influencing selection of methods: Nature of injury Severity of injury Number of helpers Distance to shelter Transportation methods I. II. III. IV. Support by helpers Hand seats Stretcher Wheeled transport Human crutch Pick-a-back One bearer Firemans lift and carry Cradle

METHODS OF CARRYING

Four handed seat Two handed seat Two or more bearers Fore and aft method

Stretchers

III.WOUNDS AND BLEEDING

Wound- Break in the continuity of the tissues of the body. Bleeding- Blood loss due to the loss of continuity of blood vessels. CLASSIFICATION OF WOUNDS: 1) Puncture wound 2) Stab wound 3) Lacerated wound 4) Abrasion wound 5) Incised wound 6) Contusion wound 7) Gunshot wound TYPES OF BLEEDIG: Arterial bleeding-From artery, profuse, blood spurts out. Venous bleeding-Darker red, less pressure. Capillary bleeding-Slight blood loss. Internal bleedingSigns: bleeding from body orifices, pain, rapid shallow breathing, confusion, pale, cold, clammy skin, may develop shock. First aid: Treatment of shock. Visible external bleedingSigns: visible blood loss according to the type of injury.

First aid: apply direct pressure, protect from shock, support injured part and give raised position, give temporary dressing. SHOCK Condition in which the circulatory system fails and as a result the vital organs are deprived of oxygen. Signs: InitiallyRapid pulse, pale cold clammy skin, sweating. Laterrapid breathing, weak thready pulse , Grey-blue skin, weakness, nausea, thirst, restlessness, unconciousness and Finally the heart stops.

Treatment: Treat the cause of shock, raise the leg above heart level, stop unnecessary movements, loosen tight clothing, keep casualty warm, monitor vitals.

IV.FRACTURES
Simple or closed Compound or open FRACTURES Communited Impacted Greenstick Depressed SIGNS: Pain, tenderness, swelling, loss of power, deformity of limb, irregularity of bone, crepitus, unnatural movement TREATMENT-CLOSED FRACTURE: Advice to keep still provide extra support with padding treat for shock if necessary. TREATMENT-OPEN FRACTURE: Cover the wound secure sterile dressing with a bandage for shock if necessary. immobilize injured part treat casualty secure the part to an unaffected part

SPINAL INJURY Spine may be broken either by direct or indirect force. it is usually caused by falling from height, falling awkwardly, diving into a pool, sudden deceleration, heavy object falling, injury to head etc. SIGNS: Pain in neck, irregularity in normal curvature of spine, tenderness, loss of control of limbs, loss of sensation, loss of bladder and bowel control.

FIRST AID: Do not move the casualtyplace the body in a straight lineopen the casualtys airway by using jaw thrustcheck breathingbegin CPRmonitor vital signsapply broad bandage if needed. FRACTURE OF RIBS Rib fracture can be caused by direct or crush injury. FIRST AID: Help him/her to sitsupport the arm on the injured sidearrange to send to the hospital.

V.BURNS AND SCALDS

CAUSES: Dry heat, Friction, Corrosive chemicals ,Contact with hot objects etc. TYPES: Dry burn--fumes, friction Scald--steam, hot liquids Electrical burn--high voltage current Cold injury--Frost bite Chemical burn--chemicals Radiation burn--sunburn Based on depth of burns

Superficial burn Partial thickness burn Full thickness burn

FIRST AID: Help to sit or lie...start cooling the injurydo not touch the burnt woundgently remove the constraintscover the areareassure the casualty.

BURNS TO AIRWAY: FIRST AIDimprove the air supplyoffer casualty ice chips or small sips of cold watermonitot the vital signs. SUNBURN Over exposure to the sun or a sunlamp can result in sunburn. SIGNS: headache, dizziness, restlessness and confusion, hot flushed dry skin, bounding pulse ,body temperature above 104F. FIRST AID: Move the casualty to a cool placewrap him in a cool wet sheetmonitor and record the vital signs.

VI.POISONING
Poison is substance that if absorbed into the body in sufficient quantity can cause temporary or permanent damage. ROUTES OF POISONING: Swalloweddrugs, alcohol, plant poisons, viral food poisons. Absorbed through the skincleaning products, industrial poisoning. Inhaledfumes from fires, industrial poisons. Splashed in the eyecleaning products Injected through the skinvenom from stings, drugs.

SWALLOWED POISONING:

SIGNS: Vomiting, diarrhoea, cramping pain, burning sensation, impaired consciousness, seizures. FIRST AID: Collect history about the poison, dont induce vomiting, wear protective gloves, goggles and mask, in case of burnt lips give him cool sips. DRUGS CAUSING POISONING: Pain killers: Paracetamol, Aspirin. Sedatives: Benzodiazepines Stimulants: Amphetamines Anaesthetic agents: Ketamine Narcotics: Morphine

SIGNS OF ALCOHOL POISONING: Strong smell of alcohol, empty bottles, impaired consciousness, flushed and moist face, full bounding pulse, deep noisy breathing. SNAKE BITE SIGNS: A pair of fang marks, severe pain, redness, swelling, nausea, vomiting, disturbed vision, increased salivation, sweating. FIRST AID: Help to lie down, apply pressure bandage after cleaning the wound, try to identify the snake, monitor the casualty, allow him to remain still, take the casualty to the hospital.

FOREIGN BODY IN THE EYE: SIGNS: Blurred vision, pain or discomfort, redness, eye lids screwed up. FIRST AID: Prevent the rubbing of the eye, gently separate and examine the eye, pour clean water for removing the object, also the object can be removed by using moist swab or using a clean handkerchief. FOREIGN OBJECT IN THE EAR: SIGNS: Temporary deafness, damage in the ear drum. FIRST AID: reassure the casualty, in case of insect flood the ear with tepid water, send the casualty to hospital.

FOREIGN BODY IN THE NOSE: SIGNS: noisy breathing, swelling of nose, blood stained discharge from the nose. FIRST AID: Reassure the casualty, instruct to breathe through the mouth, and dont try to remove the object himself, send the casualty to the hospital. ANIMAL BITES SIGNS: Pointed teeth marks, puncture wounds, crush injury. FIRST AID: Try to identify the animal, wash the bite wound with soap and water, raise and support the wound, take the casualty to the hospital. INSECT STINGS: SIGNS: Pain, Redness and swelling. FIRST AID: Raise the affected part, apply ice packs to reduce swelling, monitor anaphylaxis, monitor vital signs.

HYPERGLYCEMIA
SIGNS: Dry and warm skin, rapid pulse, fruity sweet breath, drowsiness, unconsciousness. FIRST AID: Monitor vital signs, take the casualty to the hospital.

HYPOGLYCEMIA
SIGNS: Weakness, faintness, confusion, irrational behaviour, sweating with cold clammy skin, rapid pulse, deteriorating level of response, history of diabetes. FIRST AID: Make the casualty to sit, give him a sugary food, help him to check the sugar level, allow him to take rest, send the casualty to the hospital.

VII.BASIC LIFE SUPPORT [BLS]

DEFINITION: Basic life support refers to maintaining airway patency, supporting breathing and circulation without the use of supportive equipments.

COMPONENTS: Basic life support focus on three aspects: Airway: cleared by removal of any obstruction. Breathing: restored by artificial breathing Mouth to mouth Mouth to nose Mouth to mask PROCEDURE: ASSESSMENT: Check for the response of the patient-grasp the shoulders and ask Are you ok. Check airway of the client. Check for any foreign body or secretions that obstruct the airway. If present remove them by Heimlich maneuver. Check breathing of the victim- LOOK, LISTEN and FEEL the respiration. Check the pulse mainly the carotid pulse. PREPARATION OF THE PATIENT: Position yourself at the victims side. Make sure that the victim is lying on his back on a firm, flat surface. Remove any foreign materials in the mouth. Use jaw thrust or head tilt and chin lift method to clear the airway.

GIVING ARTIFICIAL RESPIRATION: Pinch the nose closed with your thumb and index finger. Take a regular (not a deep) breath and seal your lips around the victims mouth creating a tight seal. Give 1 breath; watch the chest for rise as you give breath. If the chest does not rise, repeat the head tilt and chin lift.

 Give a second breath and watch for the chest rise. Reassess the victim and prepare the victim for chest compression.

GIVING CHEST COMPRESSIONS: o o o o o o o o o o o Position yourself at the victims side. Make sure the victim is lying on his back on a firm and flat surface. Remove the clothing so that the chest can be visualized. Place the heel of one hand on the centre of the victims chest between the nipples. Place the heel of your other hand on the top of the first hand. Straighten your arms and position your shoulders directly over your hands. Compress the Sternum to about one and a half to two inches. For each compression make sure that you push straight down on victims breast bone. At the end of each compression make sure that you allow the chest to recoil. Deliver the compressions in a smooth fashion at a rate of 100 compressions per minute. Give it as a ratio of 30 compressions to 2 breaths.

AFTER CARE OF THE PATIENT: Assess the pulse and respiration. If the victim is recovered, place the victim in side lying position. Position is called Recovery position. If the victim does not recover, call for help and immediately shift to hospital.