Introduction to First Aid [level 1]

INTRODUCTION

1. First Aid:
First aid is the treatment of any injury or sudden illness given before professional medical care can be provided. First aid is mostly treating minor injuries, such as small wounds, sprains, minor burns, and fractures.
Coping with injuries requires a knowledge of applying bandages, splints, slings, and dressings.

Goal:
The goals of first-aid treatment in an emergency are;
- to preserve life, - to prevent the condition from worsening
- to aid recovery - to protect the victim from any further harm
- to provide reassurance - to make the victim as comfortable as possible.

2. Basic Life Support
Basic Life Support (BLS) includes recognition of signs of sudden cardiac arrest (SCA), heart attack, stroke and foreign-body airway obstruction (FBAO). It also includes cardiopulmonary resuscitation (CPR) and defibrillation with an automated external defibrillator (AED).

3. First Aider:
First Aider is a trained person that arrives at the scene to help and treat the injured victim.
First Aider Criteria:
- Responsible person - Calm and wise
- Adhere to safety principle - Knowledgeable
- Well trained

4 . Legal & Ethical Consideration
4.1 Need For Consent
Ask permission to render first aid to a conscious or an unconscious victim. A first aider should not hesitate to treat an unconscious victim due to implied consent.
Consent of a parent or guardian is required to treat a child, however emergency first aid necessary to maintain life may be provided without such consent.

A VICTIM HAS THE RIGHT TO REFUSE FIRST AID CARE
YOU CANNOT FORCE CARE ON A PERSON WHO DOES NOT WANT IT ... REGARDLESS OF THEIR CONDITION!

4.2 Good Samaritan Laws
Good Samaritan laws are intended to protect good people who offer first aid to others. Two basic requirements which must be met in order for the first aider to be protected by Good Samaritan Laws provisions are:

1. The First Aider did not deliberately cause harm to the victim.
2. The First Aider provide reasonable level & type of care expected from a person with the same amount of training & in similar circumstances.

5. First Aider Responsibility:
The person giving the first aid should assess the situation, give immediate and appropriate care, and arrange for the victim to be seen by a physician or to be taken to a hospital as soon as possible

6. Purpose Of Training
In this course you will learn the essential skills in dealing with accidents, emergencies and sudden illness.
GOLDEN RULE OF FIRST AID
Do no harm
If you are not certain what to do and the situation isn't getting worse, don’t interfere.
BASIC LIFE SUPPORT TREATMENT PROCEDURE

Aider is responsible to give early treatment in emergency cases. It is advisable to use the Chain of Survival to illustrate the important of Golden Hours for victims’ especially cardiopulmonary and respiratory disease.

Chain of Survival
1. Early recognition of emergency and activation of the emergency medical services (EMS) or local emergency system.
2. Early bystander CPR: immediate CPR can double or triple the victim’s chance to survive.
3. Early delivery of a shock with a defibrillator: CPR plus defibrillation within 3-5 minutes of collapse can produce survival rates as high as 49% - 75%.
4. Early advanced life support followed by post resuscitation care delivered by healthcare providers.
DRABC PRINCIPLE

1. DRABC Principles
DRABC is the method used by First Aider to ensure that the correct procedures were used in emergence treatment.

D = Danger
Ensure the safety of all those at the scene i.e. yourself, bystanders, and casualties.
Conduct a primary survey of the scene for Hazards which may include bio-hazards, flammable materials, electricity, unstable structures, slippery surfaces, sharp metal edges, oncoming traffic, and risk of explosion, fallen power lines and fast flowing water.
Try to asses the injury mechanism (trauma, medical or environment) and possible cause of injury from the scene primary survey.

Don’t risk your own safety in a dangerous situation as it may increase the number of casualties. Thus, waiting for the emergency services to arrive is the only option.
First Aider must introduce himself and ask permission from victim/s before giving any aid or treatment.

As a general rule, avoid moving casualties unless there is hazards that cannot be remove, such as fire or poisonous fumes. If it is essential to move a casualty before an ambulance arrives, extreme care should be taken and good manual handling practice must be used.

R = Response
By checking the victim/s awareness level using the AVPU method:

- Aware : Fully conscious
- Voice : Respond to your voice or command. (Drowsy or confused)
o Check the casualty for a response by asking loudly ‘are you all right?’
- Pain : Respond to pain. (Drowsy or confused)
o By slightly rubbing your knuckle between victim collar bones.
- Unconscious : No respond ( fully unconscious)

If the casualty responds

- If the casualty responds by answering and appears conscious, leave them in the position in which you find them (provided they are not in further danger).
- Check the casualty’s condition and get send someone for help. if you are on your own, leave the casualty and go for help
- Observe and reassess the casualty’s signs of life regularly

If the casualty does not respond

- One rescuer:
Activate Emergency Medical Services (EMS). Call the local emergency centre or emergency number.(JPA, GHKL,PBSM etc)
Get automated external defibrillator (AED) if available
Return to the victim to provide (CPR)
- Two rescuers or more
One rescuer should begin the steps of CPR
Second rescuer activates the EMS system and gets AED if available
ü When calling for help, the rescuer should be prepared to answer questions about:
o Location
o What happened
o Number and condition of victims
o Type of aid provided
ü The caller should hang up only when instructed to do so by the dispatcher
ü Then return to the victim for CPR

A = Airway
Check whether the airway is ‘open & clear’. Use the ‘Head Tilt Chin Lift” maneuver for both injured and non-injured victims to keep the airway open for victim to breathe.
The jaw thrust is no longer recommended for lay rescuers because it is difficult for lay rescuers to learn and perform, not an effective way to open the airway, and may cause spinal movement.


Head Tilt Chin Lift
place palm of hand on the forehead and gently tilt the head back
support and lift the chin to open the airway
lift the jaw forward to open the mouth

Avoid excessive head tilt if injury to the neck is suspected. If head tilt is necessary, tilt the head just enough to open the airway.

Airway Clear = check breathing

B = Breathing
While maintaining an open airway, check the victim breathing using the Look, Listen and Feel method simultaneously:

Look : listen and feel for breathing for 10 seconds and check whether the chest
rises
Listen : for the sound of breathing from the casualty’s mouth or nose
Feel : for the rise of the chest or for victim warm breath against your cheek

If Breathing Present
- roll into recovery position
- check the casualty’s condition and get help if needed
- observe and reassess the casualty’s signs of life regularly

If Breathing Absent
- Give two rescue breaths, once every one second
- With enough volume to produce visible chest rise
- The most common cause of invisible chest rise is an improperly open away
- So, perform head tilt chin lift and give second rescue breath



C = Circulation
Most rescuer fail to recognize the absence of a pulse.
Checking for sign of life (breathing, coughing or body movement) is superior for detection of circulation.

If Circulation Present but no breathing
continue to Emergency Airway Resuscitation (EAR)( if you’re trained in EAR) until the casualty starts breathing on their own
if the casualty starts to breathe normally on their own but remains unconscious, turn them into the recovery position.
observe and reassess the casualty’s signs of life regularly


If Circulation Absent
start chest compressions (Caution : only for First Aider well trained in CPR)

o Adult and older children = 30 compressions: 2 breaths
o Younger children and infants = 30 compressions: 2 breaths
Return your hands quickly to the correct position on the chest and then give the next compressions and breaths (5 cycles within 2 minutes)
Compression depth
o Adult and older children = 1.5 – 2 inches
o Younger child and infant = 0.5 -1.5 inches
Stop to re-check for signs of life every 2 minutes. Also stop to check whether the casualty makes a movement or takes a spontaneous breath


2. PROCEED WITH MUSCULARSKELETAL ASSESSMENT:

Do a whole body assessment to ensure whether there any injury and type.

Give treatment in accordance with type of injury such as apply bandage and dressing for bleeding and wound.


3. GIVE THE APPROPRIATE TREATMENT/ASSISTANCE until the authority or medical help arrive.