Learning to Perform Basic First Aid

First Aid is the care that is provided to an injured or suddenly ill person immediately. It is not meant to be long term care and it is for relieving symptoms and preserving life so that medical interventions can be carried out later if necessary.

Every person needs to learn First Aid so they are able to assist their friends and family, and community members, if they are injured or suddenly fall ill.

There is a risk when providing First Aid that disease can be passed from one person to another. If there are gloves and masks available (such as in a First Aid kit) you should use them. You should also wash your hands thoroughly before providing First Aid to minimise the risk of passing an infection from you to the casualty.

Bleeding

Bleeding is the loss of blood from blood vessels anywhere in the body. If blood is lost from the body the delivery of oxygen to the body is reduced. If bleeding is severe it can interfere with circulation of blood to all parts of the body and may result in death.

• Bleeding from cuts or grazes can be controlled by direct pressure
• If blood or fluid is draining from the ear canal do not plug the ear with dressing or apply pressure. Loosely cover the ear with gauze dressing and tape it at each end
• Position casualty on the side or tilt the head to the side with the affected ear facing down and allow it to drain

A bleeding nose may result from a head injury or a direct blow to the nose. If bleeding is severe the casualty may swallow or inhale the blood and this will cause breathing complications.

• Ask the casualty to sit up, lean slightly forward and pinch nostrils together, while breathing through the mouth
• If there is something in the nose remove it if it is easy to remove otherwise leave it in place until medical help arrives.
• Do not encourage the casualty to sniff or blow through their nose

Bleeding from the mouth can cause difficulty in breathing. Loose teeth as a result of an injury to the mouth may also cause breathing difficulties.

• Ask the casualty to spit out any excess blood to prevent swallowing and vomiting.
• Do not rinse the mouth with water as it will stop the blood from clotting.
• Apply direct pressure with a dressing over the wound
• If a tooth has been knocked out replace the tooth in the socket if possible.
• Control bleeding in the tooth socket by applying a thick pad of dressing.

Amputation -  This is when a limb (arm or leg) has been cut off in an accident

• Place a pressure bandage over the end of the wound to stop bleeding. 
• Place the part of the body that has been cut off into a plastic bag and then into another plastic bag and keep it in water until medical help arrives.

Impaled objects –  An impaled object is one that is stuck into the body of the casualty. It can be in any area of the body.

• Do not remove the impaled object. You will cause more damage and loss of blood by removing the object. 
• Apply a dressing around the object and seek immediate medical intervention where possible.

Shock

Shock occurs when the body is not able to supply oxygen to all the tissues. This can result in a collapse of the circulation of blood in the body and therefore a lack of oxygen to important organs.

Blood is needed for the heart to function. If someone has lost a lot of blood the heart might not be able to function normally and the casualty may go into shock.

Shock can also occur in cases of severe burns, vomiting or diarrhoea because other body fluids are being lost.

People who are in shock will usually have pale, clammy skin and tend to be restless. Other common symptoms are rapid breathing, rapid and weak pulse, nausea and/or vomiting and thirst.

• Monitor airway, breathing and circulation.
• Provide First Aid for bleeding, burns or fractures
• Reassure the casualty and encourage them to rest in a comfortable position
• If injuries permit elevate the casualty’s legs
• Maintain normal body temperature
• Call for medical assistance
• Provide small sips of water only until medical assistance arrives 

Burns

A burn is damage caused to the skin and deep body tissue by excessive heat, friction, chemicals, electricity or radiation. Burns may result in destruction of superficial skin layers, damage to blood vessels, severe pain, blistering, infection and shock.

Burns are classified in reference to the depth of skin that is burned and the percentage of the body that is covered by the burn.

First degree burns

This is superficial burns to an area of skin such as in sunburn or a minor scalding with hot water. The skin will turn red and dry and it will usually heal within a week without leaving any scars.

Second degree burns

These burns are extensive burns to the outer layers of the skin. The area will blister and fluid will come out from the skin. The burns are painful and will usually heal within one month with minimal scarring.

Third degree burns

Burns where severe damage is done to the skin and to underlying tissue, fat, muscle, blood vessels, nerves and sometimes bones. These burns are at risk of getting infection immediately and scarring is unavoidable. Pain levels may vary as nerve cells have been destroyed. The burned area usually appears white and charring is possible.

• Ensure the safety of the rescuer and bystanders if there has been a fire, explosion or chemical leak
• Monitor victim for breathing and pulse
• Cool the burnt area by immersing in cool water or pouring cold water over the area for 20 minutes. If there is a tap with clean water turn the tap on and let the water flow over the burned area. If there is a clean flowing creek or river nearby remove the casualty to the running water and immerse the burned area in running water.
• Cover the affected area using a sterile, non-sticking dressing.
• If the burn is severe always treat for shock
• Remove any loose clothing that is not attached to the skin
• Remove any jewelry, especially rings if that area is burned
• Elevate burnt limbs and treat the casualty for shock

Blisters should never be cut open. The body makes the blister to treat the burn – all the good things your body needs to heal are contained within the blister. If the blister is cut open it makes a pathway for infection to start in the wound. If the blister has been accidentally broken it should be cleaned with boiled water that has been cooled to warm. Cover the wound with a clean gauze dressing to prevent infection from getting into the area.

People may dehydrate if they are burned. Make sure they are given plenty of fluids. The body needs water to be able to perform healing and normal cell function.

Choking

Obstruction of the airway by an impacted object or foreign body is a life threatening situation. If there is some breathing, coughing or speaking a partial blockage is indicated. If the person is unable to breathe, cough or speak a complete blockage is indicated.

Partial obstruction

• encourage casualty to cough
• give reassurance
• if condition worsens, treat as for complete obstruction

Complete obstruction

• place the casualty over your knees with head lower than the chest (gravity assistance)
• if an adult casualty, place in the recovery lateral position
• deliver four back blows between the shoulder blades using the heel of the hand
• If still unsuccessful apply four lateral chest thrusts (see below)
• Continue to apply lateral chest thrusts if necessary

Lateral chest thrust

A lateral chest thrust is performed by:

• placing casualty on their side
• place both hands over the chest wall close to the armpit
• give up to four quick downward thrusts
• after the chest thrusts the casualty’s mouth should be inspected to see whether the obstruction has been dislodged. 

Bees, wasps, fish, marine stingers and centipedes

Bites and stings by these animals and/or insects are painful but rarely fatal. Some people might be allergic to some stings.

For most stings and bites the area of the bite should be bathed in warm to hot water after removing any stings that are still in the skin. Bees and wasps often leave their sting in the skin. These should be carefully removed by scraping with a leaf or the side of a knife. (Being careful not to cut the skin).

After this initial treatment any swelling can be treated with a cold compress or bathing in cool water. Some insect bites will respond well to papaya fruit or cream being placed on the area. Papaya fruit or cream will not cause any harm if applied.

Some people may go into shock as a result of a bite or sting. Treat for shock if this should happen (see previous section on shock)

Musculoskeletal Injuries

Musculoskeletal soft tissue injuries

A sprain is the stretching and tearing of ligaments at a bone or joint.

A strain is the stretching and tearing of muscles or tendons joining the muscles.

• As soon as any bleeding has been controlled, the application of a cold compress is useful in restricting internal bleeding and reducing swelling and pain.
• Place a damp cloth or other cold material over the affected area.
• Depending on the injury, release cold compress after a period of 10 minutes.
• Reapply and if necessary hold cold compress in position.

The acronym RICE is a useful sequence to follow:

• R         Rest
• I          Ice
• C         Compression
• E         Elevation

Fractures and Dislocations

Fracture is the term used to describe a broken or cracked bone.

A fracture may be caused by a direct blow or an indirect force such as twisting.

Fractures may be classified as ‘open’ causing bone to tear the skin, or ‘closed’, where the skin is not broken and these are more common.

The primary symptom is pain and tenderness following the injury. Signs include:

• deformity
• swelling
• loss of mobility
• tender to touch

Treatment

• monitor casualty’s vital signs
• prevent bleeding
• treat shock 

Support and immobilise the injured part.

• Support the injury in a natural, relaxed position.
• Immobilise the limb using a splint or sling
• Do not attempt to straighten any fracture or relocate a dislocation. Seek the help of a medically qualified person to continue treatment.

Activity 

Part 1) Ask participants to divide into pairs. Each pair must choose one person to be the injured person and one to be the first aid person.

Assign a topic to each pair from this list: Bleeding, shock, burns, choking, stings, soft tissue injuries, fractures, heat and cold exposure.

Each pair must now demonstrate how to provide first aid for that particular topic.

Part 2) Change the role of each pair and repeat the activity with the other person being the victim and the first aid provider