first aid theory

• Definition and Aims of First Aid:

  • First Aid is the immediate management of a person who is injured or has suddenly taken ill
  • Aims of First Aid:
  • To preserve life by providing chest compressions/CPR if casualty is not breathing normally and controlling any serious bleeding
  • To prevent the condition from worsening by covering wounds, immobilising open wounds and fractures, and placing the casualty in a comfortable position
  • To promote recovery
• • To provide comfort and relief by relieving pain and discomfort, reassuring and comforting, and protecting the casualty from extreme heat or cold
• Roles and Limitations of a First Aider:

  • Roles of a First Aider:
  • Provide First Aid to the casualty until medical help arrives
  • Be familiar with the layout of frequented places and understand associated hazards
  • Take note of the casualty's condition, type and time of treatment, and basic details
  • Periodically check the First Aid kit and contents
  • Limitations of a First Aider:
  • Should not prescribe any medication to the casualty
  • Seek consent before administering First Aid treatment, with deemed consent applying to unconscious casualties
• Universal Precautions:

  • Infections by blood-borne pathogens may be transmitted during life-saving activities
  • Use Personal Protective Equipment (PPE) whenever possible while providing First Aid
  • Examples of PPE usage:
  • Keep open wounds covered with dressings
  • Use disposable latex/nitrile gloves in situations involving blood or other body fluids
  • Use a mouth-to-barrier device with a one-way valve for protection during ventilations
  • Wash hands with soap and water thoroughly after exposure to blood or other body fluids
• First Aid Kit Content and Maintenance:

  • Appointed First Aiders must be familiar with the First Aid kit's location, content, and usage
  • First Aid kit should only contain materials required for First Aid treatment
  • Check the First Aid kit frequently to ensure it is fully equipped and all items are usable
  • Replace used or expired items promptly
  • Medication should not be stored in the First Aid Kit
• First Aid kit contents:

  • Individually wrapped sterile adhesive dressings: 20-40
  • Crepe bandage (5 cm): 1-4
  • Crepe bandage (10 cm): 1-6
  • Absorbent gauze (sealed packets): 5-15
  • Hypoallergenic tape: 1-26
  • Triangular bandages: 4-6
  • Scissors: 1
  • Safety pins: 4-6
  • Disposable gloves (pairs): 2-4
  • Eye shield: 2-6
  • Eye pad: 2-67
  • Resuscitation mask with one-way valve or Disposable face-shield: 1-2
  • Sterile water or saline in 100 ml disposable containers: 1-3
  • Penlight: 1
• Factors to consider during Primary Survey:

  • Environmental conditions: assess dangers like moving vehicles, fumes, unsafe structures, trapped casualty
  • Hazards: look out for fire, smoke, faulty electrical wires, spilled water, toxic gases, risk of falling objects
  • Mechanisms of injury: identify extent of injuries based on fall from height, ejection from a vehicle, sudden deceleration
• Primary Survey steps:

  • Danger: Ensure personal safety
  • Response: Check casualty's responsiveness
  • Shout for Help: Get help and call 995 for Singapore Civil Defence Force (SCDF)
  • AED: Have a nearby AED brought to the casualty
  • Breathing: Look for normal breathing
  • Chest Compressions: Start Chest Compressions if breathing is absent or unsure
• Purpose of Primary Survey:

  • Ensure casualty receives immediate priority and treatment for life-threatening conditions
  • Manage external injuries, apply direct pressure on severe bleeding, start chest compressions if casualty is unresponsive and not breathing
• Rapid Body Survey:

  • Do a head-to-toe examination of the body to look for injuries, bleeding, and wounds
  • Check for external bleeding/deformities at head and neck, chest and abdomen, back and lower extremities, upper extremities
  • Provide appropriate emergency care accordingly: Arrest bleeding, cover wounds, immobilize fractures
• Secondary Survey:

  • Should be performed when casualty's life is not in immediate danger
  • Covers history, vital signs, head-to-toe examination
  • History includes chief complaint, details of chief complaint, medical history, allergies
  • Vital signs assessment includes level of consciousness, pulse rate, breathing rate, skin color
• Record and Report:

  • Provide basic information regarding the incident and treatment to SCDF officers
  • Provide a written report if required by the workplace, covering scene of incident, mechanism of injury, history, vital signs, unusual behavior, treatment given, response, progress
• Definition of Unconsciousness:

  • Impairment of awareness ranging from drowsiness to total lack of response
  • Involves different brain structures like frontal lobe, parietal lobe, temporal lobe, occipital lobe, pons, cerebellum, medulla oblongata
• Spinal Cord:

  • Relays messages from the brain to different parts of the body
  • Performs actions
  • Passes messages from sensory receptors to the brain
  • Coordinates reflexes managed by the spinal cord alone
• Causes of Unconsciousness:

  • Cardiac Arrest
  • Head injury
  • Electrocution
  • Poisoning
  • Drowning
  • Fainting
  • Fits
  • Stroke
  • Low blood sugar
  • Alcohol/drug related causes
• Fainting:

  • Temporary loss of consciousness in response to severe pain, unpleasant sights, prolonged standing, or hunger
• Important Notes:

  • Ensure the scene is safe to enter
  • Call 995 for SCDF
  • Do not give the casualty anything by mouth
  • Do not move the casualty unnecessarily
  • Treat any obvious injuries
  • Perform the Primary Survey
  • If casualty is unresponsive and not breathing, start chest compressions and apply an AED
  • If the casualty is breathing normally, place in the recovery position to keep the airway clear
  • Do not leave the casualty unattended at any time
  • Monitor the casualty and record vital signs at regular intervals
• Head Injury:

  • Causes: direct or indirect force resulting in concussion, compression, or skull fracture
• Spinal Injury:

  • Causes: fall from height, diving into shallow waters, being thrown off a motor vehicle, hit across the back by a heavy object or force, injury to the head or face
• Heat Disorders:

  • Group of illnesses caused by prolonged exposure to hot temperatures, insufficient fluid intake, or failure of temperature regulating mechanisms
  • Disorders include heat cramps, heat exhaustion, and heat stroke
• Fits:

  • Uncontrolled shaking of limbs and disturbance of consciousness
  • Two or more unprovoked fits or seizures indicate epilepsy
• Low Blood Sugar:

  • Loss of consciousness due to lack of blood sugar
  • May affect diabetics or individuals with insufficient food intake
• Stroke:

  • Blood supply to the brain is suddenly impaired by a blood clot or ruptured blood vessel
  • Recognition: altered level of consciousness, slurred speech, loss of movement and sensation on one side of the body, severe headache
  • Identify signs with the acronym "FAST" (Facial weakness, Arm weakness, Speech difficulty, Time to act fast)
• The Recovery Position:

  • Used for an unresponsive casualty who is breathing normally
  • Prevents airway obstruction by tongue, mucus, or vomit
  • Steps to position the casualty:
  • Tuck the hand nearer to you under the hip
  • Bring the other arm across the chest and place the back of the hand against the cheek
• • The former far leg should preferably be bent at the knee to a 90-degree angle
  • Stay with the casualty and monitor their breathing continuously
• Steps to place a casualty in the Recovery Position:

  • Bring the arm further from you across the casualty's chest and place the back of their hand against their cheek
  • Put your palm against the casualty's palm on the cheek and maintain this position
  • Using your other hand, bend the casualty's far knee to a 90-degree angle, hold the far hip, and roll them towards you
  • Ensure the casualty's cheek is resting on the back of their palm
  • Check that the other hand is positioned alongside the body with the palm facing upwards
• Breathing Rates for Normal Persons at Rest:

  • Adult: 12-16 breaths per minute
  • Babies and young children: 20-30 breaths per minute
• Recognition of Respiratory Emergencies:

  • Difficulty in breathing and gasping for breath
  • Use of accessory muscles to breathe
  • Anxious, restless, and panicky appearance
  • Inability to speak a few words between breaths
  • Bluish skin color (cyanosis)
  • Confusion, disorientation, leading to unconsciousness
  • Breathing or heart may stop
• Common Causes of Respiratory Problems:

  • Choking
  • Fumes inhalation
  • Drowning
  • Hanging, strangulation, and throttling
  • Hyperventilation
  • Bronchial asthma/Chronic obstructive pulmonary disease
  • Heart failure
• Actions to Take for Foreign Body Airway Obstruction:

  • Techniques include the Heimlich Maneuver (abdominal thrusts) and chest thrusts for pregnant and obese casualties
  • Heimlich Maneuver elevates the diaphragm and increases airway pressure to expel the foreign body
  • Chest thrusts are used for obese or pregnant casualties
  • If the casualty is unconscious, perform chest compressions and check the mouth for foreign bodies
• Asthma:

  • Asthma is a condition characterized by difficulty in breathing
• Asthma is a condition where there is difficulty in breathing due to the muscles of the air passages going into spasm
• Recognized triggers for an asthmatic attack include allergies, cold weather, particular drugs, dust, or pollen
• Environmental triggers for asthma include cold air, pollen, cigarette smoke, and perfumes
• Asthmatics carry inhalers that dilate the air passages to ease breathing difficulties
• Actions to take during an asthma attack:

  • Place the casualty in a comfortable position, often sitting down
  • Ask them to breathe slowly and deeply
  • Ensure a good supply of fresh air
  • Assist in using the Metered Dose Inhaler (MDI) or spacer if needed
  • Follow the Asthma Action Plan if available
  • Call 995 for SCDF if the attack is severe or prolonged
• Hyperventilation is over-breathing commonly seen in cases of acute anxiety, hysteria, panic attacks, or emotional shock
• Causes of hyperventilation include anxiety, hysteria, panic attacks, and fright
• Recognition of hyperventilation:

  • Unnaturally fast, deep breathing
  • Dizziness, faintness, trembling, or tingling in the hands
  • Cramps in the hands and feet
• Actions to take during hyperventilation:

  • Reassure the casualty
  • Lead them to a quiet place to regain control of breathing
  • Advise them to see a doctor