Unresponsive No breathing or no normal breathing (i.e.

, only gasping) Activate Emergency Response System/call for help

Adult Basic Life Support

Check pulse DEFINITE pulse within 10 seconds? Begin cycles of 30 COMPRESSIONS and 2 BREATHS AED/defibrillator ARRIVES Check rhythm Shockable rhythm?
No pulse

High Quality CPR Rate at least 100/min Compression depth at least 2 inches Allow complete chest recoil after each compression Minimise interruptions in chest compression Avoid excessive ventilation Give 1 breath every 5-6 seconds Recheck pulse every 2 minutes
Definite pulse

Bleeding Control direct firm pressure, manually or with elastic bandage until bleeding stops

Wounds & abrasions thoroughly irrigated with large volume of potable water with or without soap until there is no foreign matter Burns Cool the part with cold tap water and continue till pain is relieved Do not apply ice directly to burn Blisters leave them intact and cover with sterile dressing Electric Injuries Turn off the power at its source Assess victim, who may need CPR, and treatment for burns

FIRST AID READY RECKONER Call for help Positioning the victim Do not move victim (esp. if you suspect spinal injury) unless Area unsafe for rescuer/victim If face down and unresponsive, turn face up If victim has difficulty in breathing (due to secretions/vomitus) place him in Recovery position, as shown below If evidence of shock, place victim in supine position, raise feet ~6to12

Shockable

Not Shockable

Poison Emergencies Chemical Burns o Brush powdered chemicals off skin with gloved hand or cloth o Remove all contaminated clothing from victim o In case of exposure to alkali/acid, immediately irrigate affected skin/eye with copious amounts of water Ingested Poison. Insufficient evidence that milk or water help. o Activated charcoal may be helpful

Give 1 shock Resume CPR immediately for 2 minutes

Resume CPR immediately for 2 minutes Check rhythm every 2 minutes; continue till recovery

Spine Stabilisation in Spinal Injury. Maintain spinal motion restriction by manually stabilising head so that motion of head, neck and spine is minimised. Suspect spinal injury if Age 65 years Driver/passenger/pedestrian in motor vehicle/bicycle crash Fall from height > standing height Pain in neck/back Sensory deficit/muscle weakness of torso/upper extremities Not fully alert/intoxicated Other painful injuries esp. of head & neck Children 2 years with head/neck trauma

Musculoskeletal Trauma Sprains & strains Cold application decreases bleeding, swelling, pain & disability o With plastic bag/damp cloth filled with mixture of ice & water o Limit each application to period 20 minutes, to prevent cold injury o If uncomfortable reduce to 10 minute periods

 Fractures assume that any injury to extremity includes a bone fracture Cover open wounds with a dressing Do not move or try to straighten an injured extremity Splinting to reduce pain & prevent further injury. Splint should be padded to cushion injury

Human & Animal Bites Irrigate wound with copious amounts of water Snakebite o Reassure patient o Immobilise part bitten (with a splint if required), like used in case of a fractured limb; NO TIGHT BANDAGES/NO TOURNIQUETs o Keep limb below level of chest o Evacuate immediately o If snake killed, send along with patient for identification o Do nots * Do not apply tourniquet * Do not use tight bandages * Do not wash wound * Do not delay evacuation * Do not cut bitten part/apply suction Bee Sting causes immediate pain and area becomes red & puffy; stings barbed end usually left behind in flesh with venom sac attached o Scrape sideways with knife blade (dont pinch out, which injects more venom) o After sting removed Wipe area clean (apply Soda-bicarbonate locally) Apply cold compresses and give pain killer
Ref. 2010 American Heart Association and American Red Cross Guidelines for First Aid

o If blood pressure cuff available, pressure immobilisation with pressure 40-70 mmHg in upper extremity & 55-70 mmHg for lower extremity (slows lymphatic flow)
Ref. Indian National Snakebite Protocols 2007

Environmental Emergencies Cold Emergencies Hypothermia caused by extreme cold o Begin rewarming by Moving victim to warm environment Removing wet clothing Wrapping exposed body surfaces with blanket/clothing/ newspapers o Active rewarming, if away from definitive health care Placing victim near a heat source Placing containers of warm (not hot) water in contact with skin Frostbite. Usually affects exposed part of body (extremity/nose) o Remove wet clothing and dry & cover victim o Simple, rapid rewarming by immersing in warm water (37C-40C) for 20-30 minutes o Evacuate o Do not try to rewarm, if very close to medical facility

Dental Injuries Clean bleeding wound with saline or tap water Stop bleeding by applying local pressure with gauze/cotton Handle tooth by crown not the root Place the tooth in milk/clean water if milk unavailable and send with victim

Scorpion Sting usually not life threatening; causes severe local pain with immediate burning pain followed by throbbing and numbness o Apply cold pack or compress o Evacuate

Heat Emergencies Heat Cramps. Painful involuntary muscle spasms that most often affect calves, arms, abdominal muscles and back o Rest and cooling off o Drinking electrolyte-carbohydrate mixture (juice, cold drink etc.) o Stretching, icing, massaging may be helpful Heat Exhaustion. By combination of exercise induced heat and fluid & electrolyte loss as sweat. Signs include nausea, dizziness, muscle cramps, feeling faint, headache, fatigue, heavy seating. Vigorously treated due to potential to progress to Heat Stroke. o Lie down in cool place o Remove clothes o Cool body with cool water spray o Encourage victim to drink cool fluids Heat Stroke. All symptoms of Heat Exhaustion plus signs of Central Nervous System involvement (dizziness, fainting, confusion, fits) o Begin immediate cooling by immersing in cold water o Do not force victim to drink liquids. Drowning Remove victim rapidly & safely from water Start CPR and if alone, continue with ~5cycles (~2 minutes) of chest compression & ventilation, before calling for help

Ref. 2010 American Heart Association and American Red Cross Guidelines for First Aid