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Basic First Aid Training

SRSA training team Darfur Sudan December 2004 - March 2005

Introduction


Aim of training course Timings for course ; Introduction Period 1 Break Period 2 Break Conclusion

Key subjects to be covered




1. KNOWLEDGE OF BASIC LIFE SUPPORT 2. ASSESSMENT OF LIFE THREATENING SITUATIONS 3. PRIORITISE TREATMENT OF CASUALTIES 4. BASIC AND ESSENTIAL TREATMENT OF INJURIES 5. SAFE EVACUATION OF CASUALTIES

Aims and objectives


The aim and objective of this course is that the participants will be able to carry out the following actions without supervision
    

Give basic life support Assess life threatening situations Prioritise casualties Give basic and essential treatment of injuries Safely evacuate casualties

1. KNOWLEDGE OF BASIC LIFE SUPPORT




First aid is the treatment of the sick and injured before professional medical help can be given. The aims of first aid are to prevent death or further injury, to counteract shock and to relieve pain. Unconsciousness, severe bleeding or burns require immediate treatment. Serious trauma is most likely from road traffic accidents, gunshots, stab wounds, fire, or blasts from bombs and land mines.

2. ASSESSMENT OF LIFE
THREATENING SITUATIONS


Evaluate the three Ss: Safety Situation

Scene

Safety evaluate all possible threats and ensure that none still exist. Scene evaluate the scene to determine what happened. Situation assess if you have to deal with several casualties

Practical assessment of situation

3. PRIORITISE TREATMENT OF CASUALTIES




DANGER

CHECK FOR CONSCIOUSNESS

PRIORITY

4. BASIC AND ESSENTIAL TREATMENT OF INJURIES

A Airway: Clear it if blocked  B Breathing:



breathing

Mouth to mouth resuscitation if victim not

 

Circulation: Stop bleeding by applying direct pressure, prevent shock, CPR

Burns  Fractures

A -

Airway

Check for breathing: put your face close to the casualtys mouth, and look, listen and feel for breathing:
  

Look for chest movements. Listen for sounds of breathing. Feel for breath on your cheek.

How to open the airway: Non trauma patients: Chin lift Trauma patients: Jaw thrust maneuver

Chin lift and Jaw thrust

The recovery position


Unconscious casualties should be placed in the recovery position to prevent the tongue blocking the throat and allows liquid to drain from the mouth.
This is best learned through practical exercises.

B - breathing
Artificial breathing:  Raise the chin slightly, pinch the nose and give 2 quick breaths (1-5 seconds/breath) in to the casualtys mouth.


Evaluate effect by look, listen and feel.

C-

circulation

Bleeding is classified according to the type of blood vessel that is damaged: artery or vein.

Arterial bleeding: Spurting of bright red blood (richly oxygenated) under pressure Venous bleeding: Slow, steady bleeding at low pressure, dark red blood (poorly oxygenated)

Severe external bleeding


The rapid loss can lead to shock or death in a very short period of time so it must be controlled speedily! Bleeding at the face and neck may obstruct the airway. Remember that shock may well develop and the casualty may loose consciousness. Your aims are:  to control the bleeding  to prevent shock

Control of bleeding

Treatment of bleeding
  

 

 

Remove or cut clothing Apply direct pressure over the wound If the wounding body (i.e. knife or bullet ) is still incarcerated in the wound, do not extract it Raise and support an injured limb Apply a clean pad or sterile dressing, bandage it in place firmly Secure and support the injured part Look for help and check periodically the circulation

Casualty treatment
It may help to lay the casualty down. This will reduce blood flow to the site of injury, and minimize shock.

Chest injuries and abdominal injuries


Chest injuries:
 

Clear airway if obstructed Seal open sucking wounds with hand or other airtight material

DO NOT try to remove any objects that might be sticking out of the wound

Abdominal injuries:
 

Cover wound with dressings Lay patient on back, with knees up and head and shoulders raised

DO NOT remove debris from the wound DO NOT push in protruding intestines DO NOT give food, drink or painkillers

Checking of pulse
The preferred method to detect the pulse of a casualty, is on the neck.
1. Feel for the Adams apple with two fingers; slide your fingers back towards you into the gap between the Adams apple and the strap muscle, and feel for the carotid pulse. 2. Feel for ten seconds before deciding that the pulse is absent. 3. If it is, proceed with C.P.R

CPR
CARDIO PULMONARY RESCUSITATION CPR


If pulse is present and breathing not active, administer ventilations for one minute (ten ventilations), before checking again the carotid pulse. If pulse is absent, proceed CPR (15/2 compressions/ventilations) - no stop. If pulse is present check for breathing, ensure free airway.

CPR technique (1 or 2 First-Aiders)


1. Identify the correct position for the hands follow from the level of the lowest rib, measure upwards a distance of 2 fingers along the chest bone. Place the ball of the hand on this postion and add the other hand on top. Give 15 chest compressions. Return to the head and give 2 ventilations, then 15 further compressions

2.

If there are two first-aiders; the one giving chest compressions should set the rythm by counting out loud the pace.

Correct CPR position

Shock
Clinical shock occurs when there is reduced blood circulating through the body. The main cause of shock is substantial loss of blood, which results in an inadequate supply of oxygen to the body tissues. A person suffering from shock needs immediate attention! Recognition: there may be pallor, cold and clammy skin, rapid and weak pulse, pain, thirst, confusion, restlessness and irritability possibly leading to collapse and unconsciousness.
    

Place the casualty in a semi-prone position with the legs elevated Ensure free airway Keep the casualty warm Act calmly and reassuringly Do not give anything to drink

Burns
The main causes of burns are:
 

Fire, dry heat, corrosive substances and friction Wet heat, hot liquids and vapors

1. Extinguish the burn with large amount of liquid, 10 minutes or more. 2. Check airway, breathing, pulse. Be prepared to resuscitate. 3. Gently remove any rings, watches, belts, shoes, or smoldering clothing 4. Cover the injury with a sterile burns sheet or other suitable material. Use a clean plastic bag for a burned hand or foot. Do not drain any blister!

Fractures
Fracture recognition:
    

Difficulty in moving a limb Pain at or near the site of injury Local distortion, swelling and bruising Shortening, bending, or twisting of the limb Signs of shock

Closed fracture treatment:


  

Do not move the casualty until the injured part is secured and supported Support the injured part Immobilize joints above and below a fracture site with a splint

Open fracture treatment:


 

 

Cover the wound and apply pressure to control the bleeding If bone is protruding, build up pads of soft, non fluffy material around the bone Do not press down directly on a protruding bone end Immobilize as for a closed fracture, elevate the injured part Check the circulation beyond the bandaging every 10 minutes

Upper limb fractures


Support the arm against the trunk with a sling and, if necessary, bandaging. In case of fractured collar bone, dislocated shoulder, severe shoulder sprain, fractured upper arm, injuries around the elbow, and to the forearm and wrist proceed as follows:


 

Sit the casualty down; gently steady and support the injured site across the chest Ask him/her to support the arm Support the arm in a sling and secure the limb to the casualtys chest Transport the casualty in a sitting position

Stabilization of upper limb fractures

Lower limb fractures


Injuries to the hip, thigh or lower leg:


Lay the casualty gently down: ask another helper to steady and support the injured limbs Immobilize the limb by splinting it to the uninjured limb Gently bring the casualtys sound limb alongside the injured one

Stabilization of lower limb fractures

5. SAFE EVACUATION OF THE CASUALTY FROM DANGER AREA


Remember! Never move a casualty with suspected spinal injury unless assisted by medical personnel. Exceptions:  Life-threatening situation  At a mass-casualty incident  If the original position of the casualty prevents you from establishing and ensuring a free airway Proceed with extreme caution if you suspect a neck or spinal injury!

Human crutch

Dragging method

Concluding remarks

Any questions ?