Well Come

to the
World of
emergency
medical care
 EMERGENCY FIRST AID
 If you are the first on the scene of accident that
results in an injury or serious illness, you may be
the only link between a victim and emergency
medical care. Your role is to take action,
whether by providing first aid, seeking medical
help or calling MC Medical Centre. Your actions
may improve the victims chance of recovery.
 The following slides will provide specific
information from The Manager's Medical Centre
on basic first aid procedures.
 Topics
1.Fainting
2.Injury -Open
3.Soft tissue Injury
4.Bone Injury
5.Bleeding-Internal /External
6.Epilepsy / seizure
7.Electrocution
8.Burn / Cryogenic burn /Chemical burn
9.Forgein body in eye
10.Emergency Response
11.Evecuation of Victim from incident site
 1st aid kit contains
• 1.Crepe Bandage 11.Band aid Plaster
• 2.Bandage Roll 12.Eye Pad
• 3.Eye wash bottle 13.Face Mask [Disposable]
• 4.Gauge Pad 14.Sterile gloves
• 5.Torniquite 15.Scissors
• 6.Savlon Liquid 16.Tab.Paracetamol
• 7.Burn dressings 17.Torniquite
• 8.Splints 18.Normal saline
• 9.Analegesic spray
• 10.Mouth Gag
 Aim & Objects
To provide basic life support
To Minimize Trauma
To Restrict movement of the Injured.
To Stop bleeding.
What to Do
Don’t remove clot from bleeding site
Pour cold water or Ice on burn area
Remove cloths if complains of perspiration or difficulties
in breathing
Maintain ABC
Approach to Medical Facilities
 LIFE SAVING MEASURES

– A Airway and cervical spine immobilisation

– B Breathing
– C Circulation (treatment and diagnosis of
cause)
– D Disability (head injury)
– E Exposure (musculo-skeletal injury )
 ABC

A = Air way
B = Breathing
C = Circulation
These basic vital parameter are
require to be maintain to save a
life of the injured - How ?
CARDIOPULMONARY RESUSCITATION
CPR ABC’s
AIRWAY - Open the
airway with the tilt-chin
method.
Breath - give two
breaths.
Check circulation.

 If there is no pulse or
breathing…..
Cardio Pulmonary Resuscitation
Indication for CPR

Unconsciousness

No breathing

No pulse
 CPR
CPR - Adult: First Aid

Check for consciousness. Shake or tap the victim gently.

See if the victim moves or makes a noise. Shout,
"Are you OK?"

If there is no response, shout for help, immediately call

the local emergency number, then continue CPR. If
someone else nearby can help, have one person call the
local emergency number immediately, while the other
performs CPR.
 CPR

Position the victim on his or her back on a hard,

flat surface, keeping the back in a straight line,
supporting the head and neck.
Loosen the victim's clothing, if necessary, and
expose victim's chest.
 CPR
Place your ear close to the victim's mouth,
and watch for chest movement. Look,
listen, and feel for breathing for up to 10
seconds.

If the victim is breathing, place him or her

in the recovery position .
 CPR

If the victim is not breathing, begin rescue

breaths. Maintain the head position, close the
victim's nostrils by pinching them with your
thumb and index finger, and cover the victim's
mouth tightly with your mouth. Give 2 slow, full
breaths, lasting 2 seconds each, with a pause
in between.
 C P R
 … Perform chest compressions.
 15 compressions and two breaths.
 Count = 1&2&3&4&5…&15
 Call phone no. ????
 RESCUE BREATHING

1 breath every 5 seconds - 12 per

minute.

Compressions : ventilations = 30:2

 If the victim has evidence of
circulation, but is not breathing
effectively on his or her own,
Continue to give 1 rescue breath
every 5 seconds (about 12 breaths
per minute) for as long as needed.
 CPR
Give the victim 2 breaths, followed by 30 chest
compressions. Repeat this sequence 4 times.
Count aloud as you pump in a regular rhythm.
You should pump at a rate of about 80 to 100
times a minute.

Re-check the victim for signs of circulation.

Repeat above steps until signs of circulation

resume or help arrives. If signs of circulation
resume, continue with breathing exercise
 CPR

DO NOT give chest compressions if there is a

pulse -- doing so may cause the heart to stop
beating.
DO NOT move the victim's head or neck to
check for breathing if a Spinal injury is suspected.
 BLEEDING
 Apply direct pressure to
the wound (at this time a
direct pressure bandage
may be used)
 Elevate (do not further
harm)
 Pressure Point additional
pressure may be applied to
a pressure point to help
reduce bleeding.
CARE FOR SHOCK
 Keep the victim laying down
(if possible).
 Elevate legs 10-12 inches…
unless you suspect a spinal
injury or broken bones.
 Cover the victim to maintain
body temperature.
 Provide the victim with
plenty of fresh air.
 If victim begins to vomit -
place them on their left side.
 Call MC Medical Centre
 FIRST AID FOR SPRAINS AND STRAINS
R-I-C-E
R – Rest
I - Ice, apply a cold pack. Do
not apply ice directly to skin.
C - Compress, use an
elastic or conforming wrap -
not too tight.
E - Elevate, above heart
level to control internal
bleeding.
 CARE FOR DISLOCATIONS AND FRACTURES
I-A-C-T
I - Immobilize area. Use pillows, jackets,
blankets, etc. Stop any movement by
supporting injured area.
A - Activate Emergency Medical Services
(EMS).
C - Care for shock. See “Care for Shock”
slide.
T - Treat any additional secondary injuries.
POISONING
Assess the scene for clues and
safety.
Get victim away from poison if
necessary.
Provide care for any life
threatening conditions.
Check Material Safety Data
Sheet (MSDS).
Notify medical staff or on-call
Doctor.
Call the Poison Control Center
and 911 when necessary.
 OTHER FIRST AID PROCEDURES
Burn Care
Neck and Back Injuries
Heat Exhaustion/Heat Stroke
Hypothermia/Frost Bite
Severe Allergic Reactions
Bites and Stings
Faints/Passing Out
Injury - Trauma
 Nature of Injury
* Abrasions and Cut
*Soft tissue Injury {Bruise, Hematoma}
* Dislocation
*Sprain and Strain
* Fracture
* Burns {1st, 2nd, 3rd degree }
* Heat exposure
* Asphyxia {Hypoxia}
* Abdominal & chest Injury
 Spinal / Neck Injury: Symptoms & Signs

Stiff neck
Head held in unusual position
Weakness
Difficulty walking
Shock (with pale, clammy skin; bluish lip and
fingernails; and decreased consciousness)
Paralysis of extremities
Headache, neck pain, abdominal pain, or back pain
Numbness or tingling that radiates down an arm or leg
Loss of bladder or bowel control
Unconsciousness
SAFE POSITION
 Spinal / Neck Injury: First Aid

If necessary, begin rescue breathing and

CPR. If you think the victim might have a
head, neck, or spinal injury; lift the chin
rather than tilt the head back when
attempting to open the airway.
Keep the victim's head, neck and back in
line and roll him or her as a unit.
Immobilize the victim's head and torso in the
position in which they were found.
Do not attempt to reposition the neck.
• If the victim must be moved, get several people
to help. Use a sturdy support (such as a plank)
as a stretcher.

• Roll the victim's entire body as a unit -- keeping

the head, neck, and back in the same position
relative to each other as they were -- onto the
stretcher.
Immobilize the victim's head and torso in
the position found.
Place rolled-up towels, clothing, or blankets
around the victim's head and torso.
Use ropes, belts, tape, or strips of cloth to
hold the victim in place on the stretcher.
Carry the stretcher as horizontally as
possible
• If the victim vomits or is choking on
blood, carefully roll him or her on one
side. Vomiting can signal of internal
injuries.

Keep the victim warm with the help of

Blanket or by other mean to help to
prevent shock.

Give first aid for obvious injuries, but

keep the victim in the position found.
 Spinal / Neck Injury: Do Not

 Bend, twist, or lift the victim's head or

body.
 Attempt to move the victim before medical
help arrives unless it is absolutely
necessary.
 Remove a helmet if a spinal injury is
suspected.
 Electrical Injury: Symptoms & Signs

• Symptoms may include:

 Skin burns
 Numbness, tingling
 Weakness
 Muscle contraction
 Muscular pain
 Bone fractures
 Headache
 Hearing impairment
 Electrical Injury: First Aid
• mean use to remove should be non-conducting, such
as a mat or folded newspapers.
• Do not attempt to rescue a victim near active high-
voltage lines.
• Once the victim is free from the source of electricity,
check the victim's airway, breathing, and pulse. If
either has stopped or seems dangerously slow or
shallow, initiate first aid (CPR)
• If the victim has a burn, remove any clothing that
comes off easily, and rinse the burned area in cool
running water until the pain subsides. Give first aid for
burns.
DO NOT touch the skin of someone who is
being electrocuted.

DO NOT get within 20 feet of someone who

is being electrocuted by high-voltage
electrical current until the power is turned
off.

DO NOT move a victim of electrical injury

unless there is immediate danger.
 • SPRAINS
• SIGNS OF A SPRAIN:

• 1.Affected joint begins to swell immediately

• 2.Joint may also turn black and blue due to

the escaped blood from torn blood vessels

• 3.Victim will experience excruciating,

shooting pains at the time of the injury
because many nerves are injured in a sprain
 TREATMENT:

1. RICE treatment
[R=Rest, I=Immobilization=Compression=Elevation]
2. Thermotherapy (applying moist heat)
promotes healing but should not be applied to
a muscle or ligament injury for at least 24 hours
because heat will increase the swelling.

After the swelling has gone, you should

alternate applying cold compresses and moist
heat to the injury.
 3. To treat the injury with warm, wet packs, place a
water-dampened towel in a microwave oven for
about 30 seconds.

Check to make sure the towel is not too hot before

placing it on the skin. If a microwave oven is not
available, run a towel under very hot tap water, wring
it out, and apply it to the injury.

4. A sprained arm should be placed in a sling.

Most sprains take at least 6-8 weeks to heal.

 • BLEEDING

• EXTERNAL BLEEDING:

• Apply direct pressure. Place a clean, folded cloth

over the injured area and firmly apply pressure. If
blood soaks through, do not remove it. Instead,
cover that cloth with another one and continue to
apply pressure to the wound for 7-10 minutes.

• If the bleeding is from the ear, place a clean bandage

over the ear, lay the victim on his side, and allow the
blood to drain out through the bandage.
long it has been in place.
Elevate the injury. Position the wounded part of
the body above the level of the heart if possible
while you apply direct pressure.

Know the pressure points. If direct pressure and

elevation do not sufficiently slow the blood flow,
find a pressure point. Large arteries found close
to the skin's surface supply blood to the head
and to each arm and leg.
The most common pressure points used during first
aid are located in the upper arms and in the creases
above the upper legs.

Apply pressure to the closest pressure point to the

wound so that the artery is pressed between your
fingers and the bone directly behind the artery.

If using the pressure point on a leg, you may need to

use the heel of your hand instead of your finger.
Resort to a tourniquet. On very rare
occasions everything listed above may
fail. To prevent the victim from dying, you
should apply a tourniquet.

Once a tourniquet is applied, it should

not be loosened or removed until the
victim has reached medical help.
Use a tourniquet ONLY if everything
listed above has failed.

If you use a tourniquet, write down

somewhere on the victim the time it
was applied, so medical personnel
will know how ?
 • INTERNAL BLEEDING:

• Internal bleeding results when blood

vessels rupture, allowing blood to leak into
body cavities.
• It could be a result of a direct blow to the
body, a fracture, a sprain, or a bleeding
ulcer. If a victim receives an injury to the
chest or abdomen, internal bleeding should
be suspected. He will probably feel pain
and tenderness in the affected area.

• Other symptoms to watch for:

 WHAT TO DO FOR THE VICTIM:

1. Check for an open airway and begin rescue

breathing if necessary.

2. Call for medical help as soon as possible

and keep the victim comfortable until help
arrives.

3. The victim may rinse his mouth with water,

but DO NOT give a victim of internal bleeding
anything to drink.
 WHAT TO DO:

1. Clear all objects away from the victim and place something
soft under his head
2. Do not place anything between his teeth or in his mouth
3. Do not give the victim any liquids
4. If the vicitm stops breathing, check to see that the airway
is open and begin rescue breathing
5. Stay calm and keep the victim comfortable until help
arrives.

Most convulsions are followed by a period of

unconsciousness or another convulsion.
 • BURNS

CHARACTERISTICS AND TREATMENT

• 1. Never put butter or greasy ointments on a burn.

They seal heat into the wound and may cause
infection.

• 2. Always seek medical attention if...

* Victim is a child or elderly
* Burn covers more than one body part
* Burn is located on any sensitive area of the body
• (hands, face, feet, etc.)
* Burn is third degree
* Burn is caused by chemicals
 FIRST DEGREE BURNS

First degree burns damage the outer layer of skin.

CHARACTERISTICS:
1. redness
2. mild pain
3. swelling

TREATMENT:
1. Immediately submerge the affected part in cold water.
2. Hold it under cold running water, or place cold, wet
cloths on it until the pain decreases.
3. Cover with a clean, dry gauze dressing for protection.
 SECOND DEGREE BURNS

• Second degree burns go through to the second

layer of skin.
CHARACTERISTICS:

• 1. blisters
2. rough, red skin
3. swelling
4. extreme pain
 TREATMENT

1. Immerse in cold water or have cold, wet

cloths applied to it immediately.
2. Gently blot area dry. Do not rub. Rubbing
may break the blister, opening it to infection.
3. Cover wound with dry, sterile bandage.
4. If burn is located on arm or leg, keep limb
elevated as much as possible.

Second degree burns should heal within a few

weeks.
 CHEMICAL BURNS
•

• 1. Remove clothing on or near the burn area.

Never pull clothing over the head with a chemical
burn. You may need to cut the clothing.

• 2. Wash the area thoroughly with low pressure

water for at least 20 minutes.

• 3. Apply a clean dressing to the area.

• 4. Get medical attention as soon as possible.

 Electrical burns
• An electrical burn may appear minor,
but the damage can extend deep into
the tissues beneath the skin. If the
amount of electrical current that
passed through the body was large,
internal damage such as a heart rhythm
disturbance or cardiac arrest can
occur.
Look first. Don’t touch. The person may
still be in contact with the electrical
source. Touching the person may pass
the current through you.

Turn off the source of electricity if

possible. If not, move the source away
from you and the affected person using a
non conducting object made of
cardboard, plastic or wood.
 Bone Injury

PRINCIPLES OF
TREATMENT OF
FRACTURES
 Fracture Treatment
• ATLS
• Basics
• Reduction
• Hold
• Rehabilitate
COMMINUTED
PROXIMAL-
THIRD
FEMORAL
FRACTURE
WITH
SIGNIFICANT
DISPLACEMENT
EMERGENCY ORTHOPAEDIC
MANAGEMENT
• Life saving measures
• Reducing a pelvic fracture in haemodynamically unstable
patient
• Applying pressure to reduce haemorrhage from open
fracture

– Complication saving
• Early and complete diagnosis of the extent of injuries
• Diagnosing and treating soft-tissue injuries
 DIAGNOSING THE SOFT
TISSUE INJURY
Skin
- Open fractures, degloving injuries and ischaemic necrosis
– Muscles
• Crush and compartment syndromes
– Blood vessels
• Vasospasm and arterial laceration
– Nerves
• Neurapraxias, axonotmesis, neurotmesis
– Ligaments
• Joint instability and dislocation
SEVERE SOFT-TISSUE INJURY
DIFFERENT TYPES OF RIGID FRACTURE
FIXATION
Emergency Response
 Internal Response
& 2-Way Radio
• Do you know how to
respond when
assistance is needed
within your facility?
• What is your role during
a response?
• Is there a difference in
levels of response? i.e:
– “Code Red” vs. “Code Green”
– “May day” vs. “Staff assistance”
 Protocol During Response
• If enough staff have
responded to control the
situation, no other staff should
leave their post unless
another call comes requesting
additional staff.
• When responding listen to
radio communication that may
indicate special instructions
needed and/or “All Clear”
• Safety First! Use caution when
responding to an internal
emergency - many work
related injuries occur during
response.
Tips When Responding
• Its not a race against the clock. Take the
time required to assess the situation &
communicate with other staff responding.
• There is always time to huddle and
communicate a plan.
• In the event that a physical intervention is
already in progress when back-up arrives,
staff will not become part of the
intervention unless instructed by the lead
person.
• Shift Supervisor or designee will ensure
that a de-briefing occurs.
 TRIAGE PLAN Incident
LEGENDS
A - MC
A - MC
HP:HELIPAD

Holding Area
-Medical
Centre

Evecuation

PRIORITY-3
PRIORITY-1 PRIORITY-2 DELAYED
URGENT IMMEDIATE
B1
A 1 A 2 A MC A4 A5

HOSPITALS

BAPS
MAHAVIR Din Bandhu
7TH DAY HP
CARDIAC hospit {59 MIN}
ADVENTIST
{ 55 MIN} { 55 MIN} {12 MIN}
 Other Ambulance BAPS Pramukh
Swami Hospital
Incident

Call Out
Site Medical Surat
Centre Hospital
Site Ambulance
Delhi /Mumbai
Based
Hospital
Mahavir Cardiac
Hospital

Home Country
Company authorized hospital
 Communication
Informing to
HSE officer
Call Ambulance
Siemens – Medical
Centre
Shifting & Transportation
To
Medical centre
To Maintain the competency of the Employee towards Emergency Medical response

Mock Drill
Emergency Mock drill conducted twice a month by
each Sub Contractor
On site with different Scenario.
Schedule and reports to be kept in medical centre .
And
Participatation is mandatory in every emergency
drill
 Thank You

Dr.M.Gemawat

Email:m.gemawat@rediffmail.com