first aid training practical session (for junior trainers) (1).docx_0

First Aid training Practical sessionsFIRST AID : IMMEDIATE treatment given for the occurrence of any injury/ case of illness, before medical aid arrives.PURPOSE :To preserve life

To prevent further injury

To promote recovery

REMEMBER: apply the principle of first aid and aims of first aid in every situation!!Principle of First Aid : DR. ABCD- Danger

R- Response

A- Airway

B- Breathing

C- Circulation

Wound and Bleeding

Recall the types of wounds

Management

Irrigate/Clean the wound (if abrasion then clean the dirt etc) using sterile water, normal saline or pipe water.

If NOT BLEEDING already, apply antiseptic and dressing. If small wound, use plaster; if bigger wound, use gauge or pad (sterile/non-sterile) and use surgical tape or leucoplast to secure it. If not possible, then use bandages.

If BRUISES/HEMATOMA, then use cold compress. Find a pack of ice and gently press against the bruising part, put a layer of cloth in between the ice and skin to prevent hypothermic injury.

If bleeding (large and deep wound), follow the steps:

A) apply direct pressure by using gauge or pad (sterile, if not possible, use normal gauge), choose the size of the gauge and pad according to the size of the wound. Press for 10-15 minutes.B) Elevate the injured part, above the level of heart while compressing the wound.C) If the gauge/pad is soaking wet with blood, remove the top layers only, not the bottom 2/3 layers that stick to the skin.D) If the bleeding doesnt stop, press on the pulse point.E) If the bleeding continues, send to hospital.Minor Wounds: the bleeding is oozing, slow, or the wound appears like a scrape, nick or s scratchMake sure the person is sitting or lying down

CLEAN to remove dirt and foreign debris by using running tap water or with an alcohol-free wipe. Dont use antiseptics as it may damage the skin

Apply a sterile bandage or dressing to the wound

Use finger or hand pressure directly on the wound.

For minor injuries in people who do not haveclotting problemsor are on anticoagulants (blood thinners), bleeding is likely to stop in under 10 minutes. If not please go visit a hospital.

Serious WoundGet the person to lie down

Lessen the likelihood of shock if you can elevate the legs or position of the head lower than the trunk.

Check the breathing and circulation

If possible, ELEVATE a wounded limb

Help to control the bleeding if a wounded limb can be elevated above the heart

But!! if you suspect a broken bone, dont attempt to move the limb

Remove dirt, any visible foreign body and debris, but dont clean thw wound thoroughly.

If the foreign object is large, do not remove it. It is most likely stopping a lot of the bleeding itself. Just put pressure and bandage around the object. Taking care not to push it in further.

Apply firm pressure directly to the wound until the bleeding stops

Use a pad of clean gauze, dressing or clothing.

Place your hand over the pad and apply firm pressure with fingers or hand to the wound

Continue applying pressure steadily

If injury is on a limb, can use tape/cloth wrapped around the wound to maintain pressure.

For groin or other parts of the body where you cannot wrap the wound, use a heavy pad and keep using your hands to press on the wound.

Look for seepage from the wound

Add more gauze or additional bandages if the original soaks through.

Do not over-wrap it, but, as increased bulk risks reducing pressure on the wound.

If suspect the bandage is not working, remove the bandage and pad and reassess the application

If the bleeding appears controlled, maintain pressure until you ensure the bleeding has stopped/medical help has arrived

Use pressure points if necessary

If cannot stop bleeding by pressure alone, combine using direct pressure to the wound with pressure to one of these pressure points

Use fingers to press the blood vessel against the bone.

Eg: branchial artery: For wounds on lower arm

Femoral artery: For thigh wounds. Runs along the groin near the bikini line

Popliteal artery: For wounds on the lower leg.

Continue applying pressure until the bleeding stops or help arrives

Monitor the victims airway and breathing at all times

P/S: DO NOT use a tourniquet unless necessary.

P/S: if signs of shock are seen, ie. Tachycardia, pallor, pale lips, cold hand and feet, then elevate the legs. (this is to increase the blood supply to the brain)

P/S: Always wear a pair of gloves when in contact with patients blood. Clean your hands after managing the patient.

Fracture

Recall the types of fractures (open & closed) and their differences in appearance.

Fracture : Break/ crack in a bone

Closed fracture : Overlying skin intact

Open fracture : Disruption of soft tissue; hematoma which communicates with external environment; High chance of infection

IMPORTANT: History of fall, ask which part land 1st. Patient should complain of very painful sensation (screaming like hell) in the fractured part.

NOTE: In case of Axial bones fracture, DO NOT touch the patient, just calm him/her and call for ambulances. If Appendicular bone fracture, manage appropriately.

You cant confirm its a fracture unless an imaging eg. X-rays has been done.

Management of closed fracture:

Dont move the casualty unless in danger

Identify the fractured part, observe carefully. You should be able to see bruises/hematoma and swelling.

Perform immobilization (with bandages and an arm sling). Recall the principle of immobilization

Treat for shock if needed.

Send to hospital.

Management of open fracture:

Dont move the casualty unless in danger

Identify the fractured part, observe carefully. Sometimes you are able to see the bones sticking out of the skin.

Placed a sterile padding on the open wound (to cover it). Try to stop the bleeding by pressing the pulse point, etc.

Perform immobilization (with bandages). Recall the principle of immobization.

Treat for shock if needed.

Send to hospital.

Bandages

Recall Figure of 8 and Spiral Bandage.

Function/when to use bandages (the important ones):

To secure the dressing and splint.

To maintain a direct pressure over the wound (after the initial management)

To reduce swelling (in case of joint sprain).

Check for SMC after bandaging. (Sensation whether he/she can feel u at the distal part of bandage. Movement whether he/she can move the distal part of the bandage. Capillary refill check for it)

Types of BandageArm sling : provides support for an injured upper arm, wrist or forearm, on a casualty whose elbow can be bent, or to immobilise the arm for a rib fracture.

Elevation sling : supports the forearm and hand in a raised position to

Control bleeding from wounds in the forearm/ hand

Minimise swelling

Support the arm in the case of injured hand

Scalp bandage : Help to support the bandage to help to control the bleeding

Hand bandage : Hold a dressing in place on a hand/foot, will not provide enough pressure to control bleeding

Sprain, Strain and Cramps

Recall the differences of sprain, strain and cramps

Sprain : Stretched/ torn ligament

Strain : Stretched/ torn muscle/ tendon. Twisting/ pulling these tissues cause it.

Cramps : neural sensations caused by muscle contraction or overshortening

Treat every case of joint sprain as a fracture case.

Management of sprain RICE

Rest

Ice pad

Cold compression

Elevation of the injured part

Management of strain:

Cold compression

Rest, restrict activities involving the muscle

Management of cramps:

Based on experiences.

P/S : If ice is not available, use cold spray or cold cream instead of ice. Use anti-muscleache cream in case of strain.

Nose injury

Management:

Tilt the head down, let it bleeds.

Advise the patient to breathe through mouth, do not scratch, blow and breathe through the nose.

Press against the hard part of the bridge of the nose. Press for 10-15 mins and release the pressure, check for bleeding.

If bleeding continues, press again for another 10-15 mins, then release the pressure.

You can put a packet of ice at the bridge of the nose.

If the bleeding continues, send to hospital.

P/S : Do not tilt the head backwards, to prevent the backflow of blood that might cause irritation which result in sneezing and to prevent choke.