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Chapter 1

THE PROBLEM

Introduction

Accidents and injuries can happen anywhere at any time. These are common

situations that come out in reality that has a great effect on one’s health condition that

may eventually worsen and result to any complications especially when not given an

immediate proper care or first aid or when left untreated. Activities of daily living,

person’s productivity, and the whole aspects of a person can be affected if these happen.

Therefore, there is a need to have adequate knowledge in giving and rendering first-aid to

those in need to avoid complications.

First aid is the immediate care given to a person who has been injured or suddenly

taken ill. It includes self-help and home care if medical assistance is not available or is

delayed. It also includes well-selected words of encouragement, evidences of willingness

to help, and promotion of confidence by demonstration of competence (American

National Red Cross, 1983).

“First aid is the provision of initial care for an illness or injury. It is usually

performed by a non-expert person to a sick or injured person until definitive medical

treatment can be accessed.” (http://en.wikipedia.org/wiki/First_aid).

Proper early measures may be instrumental in saving life and ensuring a better

and more rapid recovery. The avoidance of unnecessary movement and over-excitation of

the victim often prevents further injury. The essentials of first aid treatment also include

the correct bandaging of a wound; the application of splints for fractures and dislocations;
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the effective methods of cardiopulmonary resuscitation (CPR) and artificial respiration;

and treatment of shock, frostbite, fainting, bites and stings, burns, and heat exhaustion.

The person giving first-aid, (the first-aider), deals with the whole situation, the

injured person, and the injury or illness. He knows what not to do as well as what to do;

he avoids errors that are frequently made by untrained persons through well-meant but

misguided efforts. He knows, too, that his first aid knowledge and skill can mean the

difference between life and death, between temporary and permanent disability, and

between rapid recovery and long hospitalization.

Statistics show that accidents are leading cause of death among persons from one

year old to thirty-eight years old, thereafter, accidents are one of the leading causes. The

annual cost of medical attention, the loss of earning ability due to temporary or

permanent impairment, the direct property damage, and the insurance costs amount to

many billions of dollars each year, not to mention the toll in pain, suffering, disability,

and personal tragedy.

Added to the grim accident statistics is the fact that the pattern of medical care has

changed. Individuals today require, and should demand, the best possible care.

Equipment for diagnosis and treatment, which is needed to provide such care, is usually

at a hospital. Moreover, the growing population and expanding health needs have not

been balanced by a proportional increase in numbers of doctors, nurses, and allied health

workers. It is not enough to say, “call the doctor”; a doctor may not be available to come

to the scene of the emergency.(Advanced First Aid and Emergency Care, First Edition,

1989)
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This study aims to determine the level of knowledge and practices of the mothers

in terms of first aid. In our study, it is not only the mothers and their families that are

benefited but the society itself. It covers not only the privilege ones but also the less

fortunate people who have no means of buying expensive health maintaining gadgets but

through reach out programs that lend free assistance giving them great hopes for a more

positive view of life, as our studies main significance.

Results of this study can therefore be used as a baseline data for health authorities

in planning and formulating programs. It would also causes awareness and active

participation of the home and the community in the promotion of these programs. It is

also intended to evaluate and lessen the occurrence of first aid non-discomforts to be able

to manage it properly, promote wellness and healthy lifestyle.

Statement of the Problem

This study aimed to determine the extent of knowledge and practice towards first-

aid among residents in selected barangays of Nueva Era, Ilocos Norte.

Specifically, this study seeks to answer the following questions:

1. What is the profile of the of the respondents in terms of:

A. Socio-Demographic

a. age;

b. civil status;

c. educational attainment; and

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d. occupation;

B. Common illnesses or conditions needing first-aid suffered for past

two years

a. wounds;

b. fainting;

c. vomiting;

d. insect bites; and

e. animal bites;

C. Source of information about first aid

a. print media,

b. broadcast media,

c. internet, and

d. health workers?

2. What is the extent of knowledge and practice towards first-aid among the

respondents?

3. Is there a significant difference in the extent of knowledge and practice

towards first-aid between and among the barangays?

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4. Is there a significant relationship between the extent of knowledge and

practice on first-aid and their socio-demographic factors?

Scope and Delimitation

This study was limited to the determination of the extent of knowledge and

practice towards first aid among residents in selected barangays of Nueva Era, Ilocos

Norte.

Common emergencies that were covered in this study were wounds, fainting,

vomiting, insect bites and animal bites.

The respondents of the study were randomly selected mothers ages 18 to 50 from

the barangays of Acnam, Barikir, Cabittauran, Bugayong, Caray, Garnaden, Sto Nino,

and Poblacion. Each Barangay was composed of 25 respondents.

Mothers were the respondents of the study for the reason that they are the primary

persons that give first aid at home.

The selected barangays (Acnam, Barikir, Cabittauran, Bugayong, Caray,

Garnaden, Sto Nino, Poblacion) were the respondents in these barangays are far from the

town proper and hospitals.

The independent variables were the socio-demographic factor such as age, civil

status, educational attainment, occupation, common illnesses/conditions suffered for the

last two years and sources of information about first aid, and the dependent variables

were the extent of knowledge, and extent of practice towards first-aid among residents in

selected barangays of Nueva Era, Ilocos Norte.

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Data gathering instrument used in this study is questionnaire checklist coupled

with informal interview. The questionnaire used was formulated by the researchers and

was validated by the researchers’ statistician, adviser and three experts in the field of

giving first aid; one representative from Philippine National Red Cross, one with

Doctorate Degree, and one Registered Nurse. Some of the questions were adapted from

related studies about emergency cases and books about first aid.

The statistical tools used in this study were frequency and percentage in

describing the socio-demographic factors of the respondents, mean to describe the extent

of knowledge and practices of the respondents and simple correlation analysis to

ascertain of a relationship exist between the socio-demographic profile and the level of

awareness and practices of the respondents. Analysis of variance was also used to

determine the difference of the extent of knowledge and practice towards first-aid

between and among the barangays.

The data gathering procedure was on December 2010.

Theoretical Framework

This section presents readings and concepts that guided the researchers in

conceptualizing this study.

First Aid, emergency care for a victim of sudden illness or injury until more

skillful medical treatment is available. First aid may save a life or improve certain vital

signs including pulse, temperature, a patent (unobstructed) airway, and breathing. In

minor emergencies, first aid may prevent a victim’s condition from worsening and
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provide relief from pain. First aid must be administered as quickly as possible. In the case

of the critically injured, a few minutes can make the difference between complete

recovery and loss of life.

First-aid measures depend upon a victim’s needs and the provider’s level of knowledge

and skill. Knowing what not to do in an emergency is as important as knowing what to

do. Improperly moving a person with a neck injury, for example, can lead to permanent

spinal injury and paralysis. (Advanced First Aid and Emergency Care, First Edition,

1989)

Despite the variety of injuries possible, several principles of first aid apply to all

emergencies. The first step is to call for professional medical help. Determine that the

scene of the accident is safe before attempting to provide first aid. The victim, if

conscious, should be reassured that medical aid has been requested, and asked for

permission to provide any first aid. Next, assess the scene, asking bystanders or the

injured person’s family or friends about details of the injury or illness, any care that may

have already been given, and preexisting conditions such as diabetes or heart trouble. The

victim should be checked for a medical bracelet or card that describes special medical

conditions. Unless the accident scene becomes unsafe or the victim may suffer further

injury, do not move the victim.

First aid requires rapid assessment of victims to determine whether life-

threatening conditions exist. One method for evaluating a victim’s condition is known by

the acronym ABCs, which stands for:

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A — Airway—is it open and unobstructed?

B — Breathing—is the person breathing? Look, listen, and feel for breathing.

C — Circulation—is there a pulse? Is the person bleeding externally? Check skin

color and temperature for additional indications of circulation problems.

Once obvious injuries have been evaluated, the injured person’s head should be

kept in a neutral position in line with the body. If no evidence exists to suggest potential

skull or spinal injury, place the injured person in a comfortable position. Positioned on

one side, a victim can vomit without choking or obstructing the airway.

Before treating specific injuries, protect the victim from shock—a depression of

the body’s vital functions that, left untreated, can result in death. Shock occurs when

blood pressure (pressure exerted against blood vessel walls) drops and the organs do not

receive enough blood, depriving them of oxygen and nutrients. The symptoms of shock

are anxiety or restlessness; pale, cool, clammy skin; a weak but rapid pulse; shallow

breathing; bluish lips; and nausea. These symptoms may not be apparent immediately, as

shock can develop several hours after an accident. To prevent shock, the victim should be

covered with blankets or warm clothes to maintain a normal body temperature. The

victim’s feet should be elevated because of the danger of abdominal injuries, nothing

should be administered by mouth.

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The presence of blood over a considerable area of a person’s body does not

always indicate severe bleeding. The blood may ooze from multiple small wounds or be

smeared, giving the appearance of more blood than is actually present. The rate at which

blood is lost from a wound depends on the size and kind of blood vessel ruptured. Bright

red, spurting blood indicates injury to an artery while welling or steadily flowing, dark

red blood indicates injury to a vein.

Welling or spurting blood is an unmistakable sign of severe bleeding. If a major

artery ruptures, a person may bleed to death within a minute. Injuries to veins and minor

arteries bleed more slowly but may also be fatal if left unattended. Shock usually results

from loss of fluids, such as blood, and must be prevented as soon as the loss of blood has

been stopped.

To stop the bleeding, apply pressure directly over the wound and, when possible,

elevate the bleeding body part. The first-aid provider should use bandages to hold a

sterile dressing or clean cloth firmly over the wound. Dressings that become saturated

with blood should not be removed but should be reinforced with additional layers. If an

arm or leg wound bleeds rapidly and cannot be controlled by dressings and bandages, the

first-aid provider can apply pressure to the artery at a point adjacent to the bleed called

the pressure point. Arteries pass close to the skin at these points and can be compressed

against underlying bone to stop arterial bleeding. The pressure point for the femoral

artery, which supplies blood to the leg, is located on the front center of the leg’s hinge,

the crease of the groin area where the artery crosses the pelvic bone. The pressure point
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for the brachial artery, which supplies blood to the arm, is located halfway between the

elbow and armpit on the inner side of the arm.

Fainting, a sudden, temporary loss of consciousness, occurs when the brain does

not receive enough blood. Just before fainting, a person’s skin may appear pale and

clammy or sweaty. To restore blood flow to the brain, a first-aid provider should elevate

the unconscious person’s feet or position the individual’s head below the level of the

heart. The victim’s airway and breathing should be closely monitored. A fainting victim

must also be kept warm to prevent shock. If the victim does not fully recover after five

minutes, medical help should be requested.

Seizures, sudden brief episodes of intense neurological activity, may result from a

variety of causes, including epilepsy, a neurological disorder, and head injuries. First aid

for seizures consists of protecting the victim from accidental injury during the seizure.

The first-aid provider should not put any objects in a seizing person’s mouth or try to

hold the tongue. If the victim has medical identification indicating epilepsy, an

ambulance need not be called unless the person experiences multiple seizures or one

seizure lasts more than five minutes. Otherwise, once the seizure stops, question the

person about the need for a hospital evaluation. If no medical identification exists the

first-aid provider should request medical assistance.

A deep state of unconsciousness due to illness or injury is known as a coma.

Comatose individuals cannot be awakened. Heart failure, stroke, epilepsy, diabetes, or

traumatic brain injury can cause comas and a medical alert tag on the victim may identify

a possible cause of the coma. If the person is breathing, first aid is limited to providing
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comfort until medical assistance arrives. If the victim is not breathing, the first-aid

provider should administer mouth-to-mouth or mask-to-mouth resuscitation.

Animals such as snakes, dogs, cats, small rodents like squirrels, certain insects,

and spiders may bite humans with dangerous consequences. Many snakebites are caused

by nonvenomous (nonpoisonous) snakes and do not require treatment beyond cleaning

the wound. Bites inflicted by venomous snakes require immediate first-aid measures. The

victim should be taken as soon as possible to the nearest emergency medical facility. In

the interim, the first-aid provider should not cut the area around the bite, attempt to suck

out the venom, or apply ice to the wound. The focus of first aid should be to prevent the

venom from spreading rapidly through the individual’s bloodstream. The victim should

be kept quiet to avoid stimulating circulation of the venom. In addition, the bite area

should be kept at a lower level than the rest of the body. The wound should be washed

thoroughly with soap and water, blotted dry, and loosely covered with a sterile dressing.

Bites from other animals should be thoroughly washed, treated with an antibiotic

ointment, and bandaged. The victim should seek medical attention if the bite is severe, if

rabies (an infectious viral disease) is suspected, or if the bite becomes infected. Bites

from other humans are particularly prone to serious bacterial infection and should be

treated by a medical professional. Victims of any animal or human bite whose

immunizations are not current may need a shot for tetanus, an often fatal infectious

disease affecting the muscles of the neck and jaw.

Biting insects include fleas, mosquitoes, bedbugs, lice, chiggers, and gnats. Bites

from these insects should be washed to prevent infection, and cold compresses or topical
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medications applied to alleviate itching and pain. Bites from some species of ticks can

cause serious illnesses including Lyme disease and Rocky Mountain spotted fever. When

a tick bites a person, it may attach itself to the body by burrowing into the skin. As a

result, a tick should be removed by carefully pulling it straight out with tweezers so as

not to leave its head behind. The tick should not be squeezed when it is removed. Bites

from most spiders can be treated like those of other biting insects. Bites from black

widow spiders and other poisonous spiders require medical help. They are treated

similarly to poisonous snakebites.

Stoppler (2007) defines first aid as the assistance given to an injured or sick

person in need of urgent medical assistance. First aid applies to a broad range of medical

situations and consists both of specific knowledge and skills (e.g. what to do for each

type of injury or illness) and the ability to assess a situation and make appropriate

decisions (such as when to call for emergency medical assistance). Preparedness is a key

element of first aid. While every home, auto, and boat should be equipped with a basic

emergency kit that includes first aid supplies and first aid manual, special circumstance

may necessitate more advanced or specific degrees of preparation for an emergency. For

example, residents of certain geographic areas where natural disasters (such as

hurricanes, earthquakes, tornados, floods, landslides, or tsunamis) may occur should

prepare for emergencies by assembling disaster preparedness kits such as earthquake kits,

flood kits and evacuation kits. Travellers should also prepare to administer first aid in the

region they plan to visit. In many developed countries, this may amount to packing a

standard first aid kit and manual with your belongings. Medicines to prevent motion

sickness and advanced awareness about the management of traveller’s diarrhea are also
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helpful to travellers. In developing world or in remote regions, a travel medicine kit

should include medicines and supplies that may not be available for purchases as well as

any specific products (such as insect repellent to prevent mosquito and tick bites) needed

for your destination. It’s also important for travellers in foreign countries to learn how to

access emergency services by telephone.

According to Price (2007), first aid is a complicated subject and it is situation-

specific. It is the help and medical assistance that someone gives, not only to an injured

person, but to a person who is sick. Pre3paredness is a key element of first aid, like

having basic medical emergency kits in your home, car or boat. It is also advised to be

prepared for illnesses while travelling locally or to a foreign country. Cuts, puncture,

wounds, sprains, strains, nosebleeds are one type of injury that may require first aid; heart

attacks, strokes, seizures, and heat stroke are examples of ore critical first aid

emergencies.

The National First Aid Science Advisory Board (2005), defined first as

assessments and interventions that can be performed by a bystander (or the victim) with

minimal or no medical equipment. A first aid provider is defined as someone with formal

training in first aid, emergency care, or medicine who provides first aid. First aid

assessments and interventions should be medically sound and based on scientific

evidence or, in the absence of such eveidence, on expert consensus. Administration of

first aid must not delay activation of emergency medical services (EMS) system or other

medical assistance when required. The board recognizes that certain conditions that can

be treated with first aid may not require EMS involvement or assistance by other medical

professionals. The National First Aid Science Advisory Board strongly believes that
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education in first aid should be universal: everyone can learn first aid and everyone

should.

The national first aid science advisory board recognized that the scope of first aid

is not purely scientific and is related to both training and regulatory issues. The definition

of scope is therefore variable, and it should be defined according to circumstances, need,

and regulatory requirements.

Fainting is the temporary unconsciousness caused by a decrease in the blood

supply to the brain. Fainting in brought on by such conditions as shock, emotional upsets,

loss of blood, pain, hunger, or exhaustion. It is commonly preceded by a feeling of

giddiness and weakness, and by pallor and blurring of vision. At this stage, fainting can

usually be prevented by sitting down and placing the head between the knees. A person

who has fainted should be laid on his or her back, and all tight clothing should be

loosened. If the face is pale and the pulse is weak, the head should be lowered or the legs

raised. Either procedure will help increase the blood supply to the brain. If the person’s

face is flushed and the pulse is strong, the person’s head and shoulders should be raised

and the face bathed with cold water. Smelling salts, which are stimulants, are usually of

little or no value. In some cases, they may be harmful. For example, if there is a head

injury, smelling salts may stimulate the flow of blood (New Standards Encyclopedia,

Volume 7).

According to Ronguillo, et.al (1995) retrieved by Palacpac, Sheila M. et.al (2006),

educational background in their studies in the current issue reflected that poor health is

associated with ignorance and superstition. Ignorance is the importance of preventive

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medicine and superstitions make it difficult for more educated and superstitious families

to isolate the sick person, to use chemicals to kill bacteria and to immunized themselves

during childhood and superstitious lead high morbidity and mortality which otherwise

preventable.

Conceptual Framework

This study revolved around the paradigm presented below. It shows the

relationship between the dependent variables such as the extent of knowledge and

practice towards first-aid and the independent variables such as the socio-demographic

factors of the respondents, common illnesses/conditions needing first-aid suffered for the

last two years and sources of information of the respondents.

Independent Variable Dependent Variable

A. Socio-demographic Factors

• Age Extent of Knowledge

• Civil status

• Educational Attainment

• Occupation
B. Common illness / Conditions
needing first aid suffered for
the past two years

• Wound

• Fainting

• Vomiting
Extent of Practice
• Insect bites

• Animal bites
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Figure 1. The Research Paradigm

The paradigm shows the relationship between the dependent variables and

independent variables.

Operational Definition of Terms

For purposes of classification and better understanding, the following terms are

hereby defined:

Extent of Knowledge. This refers to the level of ability to perceive, to feel, or to

be conscious of events, objects of patterns, which does not necessarily imply

understanding

Socio-demographic Factors. These refers to the characteristics of the respondents

in terms of age, civil status, educational attainment, and occupation. .

Age. This refers to the number of years the respondents have been living

until the time this research was conducted.

Civil Status .It refers to being single, married, separated, or widowed.

Educational Attainment. This refers to the highest degree obtained in

schooling. It is categorized as no formal schooling, elementary level, elementary

graduate, high school level, high school graduate, college level, college graduate and post

graduate.
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Occupation. This refers to the work or the means of support for everyday

living. It is categorized as unskilled, semi-skilled, skilled and professionals.

Wound. This refers to an injury or break in the skin.

Fainting. This refers to the temporary loss of consciousness due to insufficient

blood reaching the brain.

Convulsions. This refers to the temporary loss of consciousness with severe

muscle contractions due to many causes; generalized spasm.

Vomiting. This term refers to the dislodging of food from the stomach to the

mouth.

Insect bites. These are bites from mosquitoes, fleas and mites that are more likely

to cause itching.

Animal bites. These are wounds received from the mouth of dogs, snakes, cats,

monkeys, and any other animals, including humans.

Source of Information. These terms refers to the media, or means in which a

person requires knowledge.

Print media. This term refers to print material that can be used as a source

of information, (e.g. books, magazines, newspapers, etc.)

Broadcast media. This is the distribution of audio and or video signals as

source of information.

Internet. This refers to an online acces that links to files or documents.

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Health Workers. this term refers to the people who work as providers of

care. Physicians, nurses, midwives and traditional healers are examples.

Assumptions

Based on the problems raised on this study, the researchers assumed that:

1. Knowledge and practices on first aid can be measured.

2. The responses of the respondents in the questionnaire-checklist are honest and

correct measures of their extent of knowledge and practices towards first aid.

3. The statistical tools used to measure the extent of knowledge and practices on first

aid of the respondents are valid and reliable.

Hypothesis

The study was guided by the following:

1. There is no significant relationship between the extent of knowledge and

extent of practice towards first-aid among residents of the selected barangays in

Nueva Era, Ilocos Norte.

2. There is no significant relationship between the extent of knowledge and

practice towards first-aid in their socio-demographic factors among residents of

selected barangays in Nueva Era, Ilocos Norte.

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Methodology

This section presents the research design of the study, the population and sample,

data gathering instrument, data gathering procedure, and the statistical treatment of data.

Research Design. The researchers utilized the descriptive research design using

correlational technique to find out the extent of knowledge and practice towards first-aid

among the residents in Nueva Era, Ilocos Norte. The descriptive method was employed to

describe the respondents’ socio-demographic factors, common illnesses/conditions

needing first aid suffered for the past two years, and sources of information about first-

aid on how it is related to the extent of knowledge and practice on first aid. The co-

relational method was used to determine the relationship between the dependent and

independent variables. A comparative method was also used to determine the difference

between the extent of knowledge and first-aid practice between and among the

respondents.

Population and Sample. The respondents of the study were mothers ages 18-50

in Nueva Era, Ilocos Norte . The distribution of respondents is presented in Table 1.

Table 1

Distribution of Respondents

BARANGAYS N n %

Acnam 554 25 12.5

Barikir 472 25 12.5

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Cabittauran 781 25 12.5

Bugayong 560 25 12.5

Caray 657 25 12.5

Garnaden 521 25 12.5

Sto. Nino 654 25 12.5

Poblacion 1794 25 12.5

TOTAL 5993 200 100

Data Gathering Instrument. The questionnaire-checklist was used to gather

information about the extent of knowledge and practice towards first-aid among the

residents in selected barangays of Nueva Era, Ilocos Norte. This questionnaire-checklist

was utilized to gather information from the mother respondents. The questionnaire-

checklist was developed by the researchers and was content-validated by the researchers’

adviser, statistician, and experts in the field of first-aid. These experts were composed of

a representative from the Philippine National Red Cross—Ilocos Sur Chapter, a holder of

a doctorate degree, and a nurse. They came out of a validation score of 4.33 which means

that they “strongly agree” on the items presented on the questionnaire-checklist. The

questionnaire-checklist was translated in Iloko by the researchers.

Part I – Profile of Respondents. This part showed the data pertinent to the socio-

demoghraphic factors in terms of age, civil status, educational attainment and

occupation; common illnesses/conditions needing first aid suffered for the past two years

in terms of wounds, fainting, vomiting, insect bites, and animal bites; and sources of

information about first aid such as print media, broadcast media, internet, and health

workers.
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Part II – Extent of Knowledge. This measured the extent of knowledge towards

first aid among the residents in selected barangays of Nueva Era, Ilocos Norte.

Part III – Extent of Practice. This measured the extent of practice towards first-aid

among the residents in selected barangays of Nueva Era, Ilocos Norte.

A five (5) points rating scale was used for both questionnaire-checklist on the

extent of knowledge and practice towards first-aid among the residents in selected

barangays of Nueva Era, Ilocos Norte.

Numerical Values Extent of Knowledge Extent of Practices

5 Strongly Agree Always

4 Agree Often

3 Undecided Sometimes

2 Disagree Rarely

1 Strongly disagree Never

The following norms for interpretation were used to describe the extent of

knowledge and practice towards first-aid among the residents in selected barangays of

Nueva Era, Ilocos Norte.

Numerical Value Descriptive Rating

4.21 – 5.0 Very High

3.41 – 4.20 High

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2.61 – 3.40 Average

1.81 – 2.60 Low

1.00 – 1.80 Very Low

Data Gathering Procedure. Permission was secured from the Dean of the

College of Nursing (CN) to conduct the study. Permission was also requested from the

Municipal Mayor and Barangay Chairman of each barangay. The researchers personally

distributed the questionnaire from the respondents. This was coupled with informal

interview to validate their responses that was asked from the questionnaire.

Statistical Treatment of Data. The following statistical tools were used in the

study:

Frequency and Percentage. This was utilized to show the distribution of

respondents’ profile in terms of socio-demographic factors, common illnesses/conditions

needing first aid suffered for the past two years, and sources of information about first-

aid.

Mean. This was utilized to describe the extent of knowledge and practice

towards first-aid among the residents in selected barangays of Nueva Era, Iloco Norte.

Simple Linear Correlation Analysis. This was utilized to determine the

relationship between the dependent and independent variables.

Analysis of Variance. This was utilized to determine the difference

between the extent of knowledge and practice towards first-aid between and among the

respondents.
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