RCY 11

• Primary Survey

  Initial assessment conducted in emergency situations to identify and address life-threatening conditions
• 1. D-R-A-B-C

  Steps in the Primary Survey
• Unable to make the area safe

  Do not approach casualty, call for emergency medical assistance instead
• Casualty unresponsive

  1. Put your hand on their forehead and gently tilt their head back, lifting the chin

  2. Do a visual check of their airway for any obstructions

  3. Carefully remove any visible obstructions

  4. Move on to the next stage of the primary survey immediately
• Casualty responsive

  1. Check if anything is blocking their airway that could cause them to choke

  2. Encourage them to remove an obvious blockage themselves with the use of their hands or by coughing
• Casualty responsive and unable to dislodge blockage

  Give choking adults and children a combination of back slaps and abdominal thrusts
• Choking infants

  Combination of back blows and chest thrusts
• Checking if casualty is breathing normally

  1. LOOK for chest movements

  2. LISTEN for breathing sounds

  3. FEEL air

  4. Check for breathing for 10 seconds to confirm that the breathing is rhythmic and normal
• Nosebleed

  1. Tell the casualty to sit down and tilt his head forward

  2. Ask him to breathe through his mouth and to pinch the soft part of his nose for up to ten minutes, holding constant pressure

  3. Advise the casualty not to speak, swallow, cough, spit, or sniff

  4. After ten minutes, tell the casualty to release the pressure

  5. If the bleeding has not stopped, tell him to reapply the pressure for two further periods of ten minutes

  6. Once the bleeding has stopped, clean around his nose with lukewarm water

  7. Advise him to rest quietly for a few hours

  8. If the bleeding stops and then restarts, help the casualty reapply pressure

  9. If the nosebleed is severe, or if it lasts longer than 30 minutes, arrange to take or send the casualty to the hospital
• Nosebleed (special case)


  A child may be worried about a nosebleed. Tell him/her to lean forward, and then pinch her nose for her, reassure her, and give her a bowl to spit or dribble into.
• Dehydration


  1. Reassure the casualty and help him sit down

  2. Give him plenty of fluids to drink. Water is usually sufficient but oral rehydration solutions can help with a salt replacement

  3. If the casualty is suffering from a cramp, stretch and massage the affected muscles

  4. Advise the casualty to rest

  5. Monitor and record the casualty's condition. If he remains unwell, seek medical advice right away
• Bleeding


  • Characterized by the type of blood vessel that is damaged
  • If an artery is damaged, bleeding will be profuse. Blood will spurt out with each heartbeat
  • If a main artery is severed, the volume of circulating blood will fall rapidly
  • Blood from veins is darker red and under less pressure than arterial blood
  • Bleeding from capillaries occurs with any wound. At first, bleeding may be brisk, but blood loss is usually slight
  • When a blood vessel is damaged, the vessel constricts, and a series of chemical reactions occur to form a blood clot
• Treating severe bleeding


  1. Check first whether there is an object embedded in the wound; take care not to press directly on the object

  2. Do not let the casualty have anything to eat or drink

  3. Remove or cut clothing as necessary to expose the wound

  4. Apply direct pressure over the wound with your fingers using a sterile dressing or clean, gauze pad

  5. Maintain direct pressure on the wound to control bleeding. Raise and support the injured limb above the level of the casualty's heart

  6. Help the casualty lie down and raise and support his legs so that they are above the level of his heart

  7. Secure the dressing with a bandage that is firm enough to maintain pressure, but not so tight that it impairs circulation

  8. If bleeding shows through the dressing, apply a second one on top of the first

  9. Support the injured part in a raised position with a sling and/or bandage. Check the circulation beyond the bandage every ten minutes

  10. Monitor and record vital signs—level of response, breathing, and pulse —while waiting for help to arrive
• Skin


  • Plays key roles in protecting the body from injury and infection and in maintaining the body at a constant temperature
  • Consists of two layers of tissue—an outer layer (epidermis) and an inner layer (dermis)—that lie on a layer of fatty tissue (subcutaneous fat)
• Low body temperature


  Blood vessels narrow (constrict) to reduce blood flow to the skin. The erector pili muscles contract, making the hairs stand upright and trap warm air close to the skin.
• High body temperature


  Blood vessels widen (dilate), making the skin appear flushed, and heat is lost. Sweat glands become active and produce sweat droplets.
• Skin


  • Plays key roles in protecting the body from injury and infection and in maintaining the body at a constant temperature
• Skin


  Consists of two layers of tissue—an outer layer (epidermis) and an inner layer (dermis)—that lie on a layer of fatty tissue (subcutaneous fat)
• How skin responds to LOW body temperature

  1. Blood vessels narrow (constrict) to reduce blood flow to the skin

  2. Erector pili muscles contract, making the hairs stand upright and trap warm air close to the skin
• How skin responds to HIGH body temperature

  1. Blood vessels widen (dilate), making the skin appear flushed, and heat is lost

  2. Sweat glands become active and produce sweat droplets, which evaporate and cool the skin
• What to do for a burn

  1. Start cooling the burn as soon as possible after the injury occurred

  2. Flood the burn with plenty of cool tap water, but do not delay removal of the casualty to the hospital

  3. Help the casualty sit or lie down

  4. If possible, try to prevent the burned area from coming into contact with the ground
• What to do for a burn

  Call for emergency help; if possible, get someone to do this while you cool the burn
• What to do for a burn

  1. Continue cooling the affected area for at least ten minutes, or until the pain is relieved

  2. Watch for signs of breathing difficulty

  3. Do not overcool the casualty because you may lower the body temperature to a dangerous level. This is a particular hazard for babies and elderly people
• What to do for a burn


  1. Do not touch or otherwise interfere with the burn

  2. Gently remove rings, watches, belts, shoes, and burned or smoldering clothing before the tissues begin to swell

  3. Do not remove clothing that is stuck to the burn
• What to do for a burn

  1. When the burn is cooled, cover the injured area with plastic wrap to protect it from infection

  2. Discard the first two turns from the roll and then wrap it lengthwise over the burn

  3. A clean plastic bag can be used to cover a hand or foot; secure it with a bandage or adhesive tape applied over the plastic, not the damaged skin

  4. If there is no plastic wrap available, use a sterile nonstick dressing, or improvise with gauze

  5. Apply any dressing very loosely
• What to do for a burn

  1. Reassure the casualty and treat him for shock if necessary

  2. Record details of the casualty's injuries

  3. Monitor and record his vital signs—level of response, breathing, and pulse—while waiting for emergency help to arrive
• After a burn, blisters may form. These thin "bubbles" are caused by tissue fluid leaking into the burned area just beneath the skin's surface. You should never break a blister caused by a burn because you may introduce infection into the wound.
• If the casualty loses consciousness

  Open the airway and check the breathing
• SUPERFICIAL BURN


  This type of burn involves only the outermost layer of the skin. Superficial burns are characterized by redness, swelling, and tenderness.
• PARTIAL-THICKNESS BURN


  This affects the epidermis, and the skin becomes red and raw. Blisters form over the skin due to fluid released from the damaged tissues beneath.
• FULL-THICKNESS BURN


  With this type of burn, all the layers of the skin are affected; there may be some damage to nerves, fat tissue, muscles, and blood vessels.
• Fractures


  A partial or complete break in a bone. These injuries can occur due to various factors, such as trauma, falls, or repetitive stress.
• What to do for a fracture

  1. Advise the casualty to keep still

  2. Support the joints above and below the injury with your hands until it is immobilized with a sling or bandages, in the position in which it is found

  3. Place padding around the injury for extra support

  4. Take or send the casualty to the hospital; a casualty with an arm injury may be transported by car; call 911 for emergency help for a leg injury
• What to do for a fracture

  1. For firmer support and/or if removal to the hospital is likely to be delayed, secure the injured part to an unaffected part of the body

  2. For upper limb fractures, immobilize the arm with a sling

  3. For lower limb fractures, move the uninjured leg to the injured one and secure it with broad-fold bandages (broad-fold bandages are used to immobilize and support a limb or to secure a splint or bulky dressing)

  4. Always tie knots on the uninjured side
• What to do for a fracture

  1. Treat for shock if necessary

  2. Do not raise an injured leg

  3. Elevate an uninjured limb if shock is present

  4. Monitor and record vital signs while waiting for help

  5. Check the circulation beyond a sling or bandage every ten minutes

  6. If the circulation is impaired, loosen the bandages
• Shock


  A critical condition where the circulatory system fails, leading to oxygen deprivation in vital organs like the heart and brain
• Shock


  • Fear and pain can exacerbate shock
  • Shock typically occurs due to severe blood loss. If blood loss exceeds 2 pints (1.2 liters), shock can develop
• Shock


  Shock can also occur when there is an adequate blood volume, but the heart is unable to effectively pump blood throughout the body
• Signs of shock


  • Rapid, shallow breathing
  • A weak, "thready" pulse
  • Gray-blue skin (cyanosis), especially inside the lips. A fingernail or earlobe, if pressed, will not regain its color immediately
  • Weakness and dizziness
  • Nausea, and possibly vomiting
  • Thirst
• As the brain's oxygen supply weakens


  • Restlessness and aggressive behavior
  • Yawning and gasping for air
  • Unconsciousness
  • Finally, the heart will stop