DR A.MALIK

1. DR A.MALIK Emergency First Aid and CPR

2. FIRST AID PROCEDURES COVERED • Bleeding/Shock/Minor injuries • Burn Care • Neck and Back Injuries • Heat Exhaustion/Heat Stroke • Hypothermia/Frost Bite • Severe Allergic Reactions • Bites and Stings • Faints/

3. BLEEDING • Apply direct pressureto 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.

4. 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. • Approach for medical help

5. FIRST AID FOR SPRAINS AND STRAINSI-C-E • 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.

6. CARE FOR DISLOCATIONS AND FRACTURESI-A-C-T • I - Immobilize area. Use pillows, jackets, blankets, etc. Stop any movement by supporting injured area. • A - Activate Emergency Medical Services (EMS), call 102. • C - Care for shock. See “Care for Shock” slide. • T - Treat any additional secondary injuries.

7. BURNS • First Degree Burn • Second Degree Burn • Third Degree Burn

8. First Degree Burn • brief exposure to heat • skin is intact, but red and the burned area is painful. • Sunburn Figure:An area of first degree burn surrounding a second degree burn First Aid : immerse or run the burned area under cold water. don’t use ice Apply moist dressings and bandage loosely

9. Second Degree Burn 1.prolonged exposure to heat or very high temperatures 2. skin may be intact or it may appear to be partially peeling. 3. Any burn with blisters is second degree 4. very painful • First Aid : If the skin is intact (not peeling) then run the burned area under cold water • don’t use ice, Do not try to burst the blisters. • Apply dry dressings and bandage loosely

10. Third Degree Burn 1. Deepest 2. look white or charred,extend through all skin layers 3. May have severe pain -- or no pain at all -- if the nerve endings are destroyed Figure 3: A third degree burn.

11. Third Degree Burn:Contd. 4. Third degree burns can go into shock earlier 5. notorious for getting infected 6. Cover the area in a clean, dry dressing Figure 3: A third degree burn.

12. SNAKE BITE- 1.Non Poisonous Snakes2. Poisonous Snakes

13. SNAKE BITE Non Poisonous SnakesDo not have fangs with which to inject venom.

14. SNAKE BITE Poisonous Snakes Poisonous snakes have fangs to inject venom.

15. SNAKE BITE- Tissues Venom Absorbed into the lymphatic system network of tubes that drains fluid (lymph) from the body’s tissues and empties it back into the bloodstream Rarely venom reaches blood stream

16. SNAKE BITE SIGNS AND SYMPTOMS • puncture marks, or parallel scratches on the skin - rarely any pain • anxiety • pale, cool skin with progressive onset of sweating • rapid, weak pulse • rapid, shallow breathing • blurred vision, drooping eyelids • difficulty swallowing and speaking • abdominal pain • nausea and/or vomiting • collapse - progressing to a comatose state

17. SNAKE BITE FIRSTAID & TREATMENT ‘pressure immobilization bandage’ This bandage is applied as firmly as bandaging a sprained ankle, and is designed to slow the movement of venom through the lymphatic system. Bandaging the wound firmly tends to compress the lymph vessels, which helps to slow or prevent the venom from leaving the bite site.

18. SNAKE BITE FIRSTAID & TREATMENT – CONTD. • reassure • complete rest • apply direct pressure over the bitten area • obtain a history • immobilize the limb with a splint • avoid elevating the limb • DO NOT use an arterial tourniquet • DO NOT remove the bandage and splint once it has been applied

19. SNAKE BITE What is venom?Venom is a poison that one animal injects into another. In snakes, venom is modified saliva. A snake injects poison by biting. Venom is at least 90% protein and most of the protein are enzymes. What is anti-venom?Snake bites are effectively treated by anti-venom. Venom is first extracted from the snake. Minute quantities of this venom are then injected into a large animal like a horse, and the quantity increased slowly until the animal develops antibodies to the venom. Its blood is extracted and the antibodies concentrated and freeze dried for storage.

20. Environmental Conditions DEHYDRATION HEAT CRAMPS HEAT EXHAUSTION HEAT STROKE EXPOSURE TO COLD

21. Dehydration Dehydration is a condition caused by the casualty’s loss of fluids from perspiration and prolonged exposure to heat and humidity. When the casualty’s fluid loss exceeds his or her input through drinking, dehydration occurs and the blood volume lessens. A prolonged period of dehydration will lead to shock

22. Dehydration SIGNS AND SYMPTOMS • pale, cool, clammy skin • rapid breathing • profuse and prolonged sweating • thirst • loss of skin elasticity (‘pinch test’ on back of hand) • sunken eyes in children CARE AND TREATMENT • complete rest in the shade remove unnecessary clothing • give cool water to drink, ORS • ensure casualty has assistance when recovered

23. Heat Illness • Predisposing Factors • Physical activity • Extremes of age, poor physical condition, fatigue • Excessive clothing • Dehydration • Cardiovascular disease • Skin disorders • Obesity • Drugs • Phenothiazines, anticholinergics, B and Ca channel blockers, diuretics, amphetamines, LSD, cocaine, MAOIs

24. Heat Stroke ``Condition occurs suddenly &can cause unconsciousness in minutes`` • It is due to failure of ``thermostat`` in the brain • #The body rapidly becomes dangerously • Overheated (>40 degrees) either due to • Prolonged exposure to very hot surroundings or illness involving very • High fever

25. Heat Stroke SYMPTOMS • Hot, Flushed & Dry skin • Headache,Dizziness, • Confusion/restlessness • Altered LOC • And elevated temperature • Body temp >40 deg C (>105 degrees F) • Syncope • History is critical TREATMENT • Cool place • Tub of cold water/cold water bath or wrap in cold wet sheet • Cool until 38deg C(100.4 deg F) • If becomes unconscious start resuscitation & shift to the hospital

26. Frost Bite SYMPTOMS Caused by freezing conditions which cut off circulation, usually in extremities (hands, feet, ears, nose), which may be permanently affected. Frost-bitten areas are cold, pale or marbled-looking, solid to the touch, and painless (until circulation is restored). TREATMENT Giving warm drinks, and covering with blankets. Warm the injured part with body heat only-put a hand under an armpit, for example. Do not rub the skin or apply direct heat to the injured area.

27. Muscle cramps SYMPTOMS Caused by over-stretching muscles, or by abnormal muscle contraction. They may also be associated with loss of fluid due to excessive sweating. Characterized by pain, tenderness, loss of power and stiffening or spasms of the muscles. TREATMENT Rest, application of an ice pack, then subsequent gentle stretching. DO NOT massage the affected muscles.

28. Chest cramps (or ‘stitches’) SYMPTOMS Usually caused by cramps of the intercostals muscles between the ribs Brought on by exertion, chest cramps are identified by sharp, spasmodic pain in the chest, difficulty in standing upright, and gasping respirations. TREATMENT A ‘Stitch’ will disappear with rest and concentration on deep breathing.

29. ‘Tennis elbow’ SYMPTOMS This injury is due to a strain of the tendons and muscles associated with the elbow. Severe cases also involve the ligaments. It is usually a chronic condition, and presents when the elbow is over-used or over-stretched. pain over the bone on the outer side of the joint that becomes more severe on movement. TREATMENT Apply Ice pack and support in a sling

30. Shin splints SYMPTOMS This injury is due to a strain of thelong flexormuscle of the toes, characterized by pain along the shinbone. This is an injury common to track athletes and footballers. FIRST AID rest, application of an ice pack, and elevation of the limb.

31. FRACTURES-TYPES • Closed - where the bone has fractured but has no obvious external wound. • Open - where there is a wound leading to the fracture site or the bone is protruding from the skin. • Complicated - which may involve damage to associated vital organs and major blood vessels as a result of the fracture.

32. SIGNS AND SYMPTOMS OF FRACTURES *pale, cool, clammy skin *rapid, weak pulse *pain at the site *tenderness *loss of power to limb *Associated wound and blood loss *Deformity

33. FRACTURES-FIRST AID The basic aim of management for fractured limbs is to immobilization. Immobilization helps reduce movement and the pain associated with fractures. Immobilize the limb with a natural splint

34. arm sling Fractured Forearm: *check for pulse to the end part of the limb *treat any wounds *pad bony prominences *apply adequate splint *secure above and below fracture, secure wrist *elevate injury with arm sling

35. SLINGS Slings are used to support an injured arm. Generally, the sling is made with a triangular bandage. Any material, e.g.. tie, belt, or piece of thick rope, can be used in an emergency. If no likely material is at hand, an injured arm can be adequately supported by inserting it inside the casualty’s shirt

36. ARM SLING • Support the injured forearm approximately parallel to the ground with the wrist slightly higher than the elbow • Place an opened triangular bandage between the body and the arm, with its apex towards the elbow • Extend the upper point of the bandage over the shoulder on the uninjured side • Bring the lower point up over the arm, across the shoulder on the injured side to join the upper point and tie firmly with a knot • Ensure the elbow is secured by folding the excess bandage over the elbow and securing with a safety pin

37. CARDIOPULMONARY RESUSCITATIONCPR ABC’s • AIRWAY - Open the airway with the tilt-chin method. • Breath - give two breaths. • Check circulation. • If there is no pulse or breathing…..(next slide)

38. CPR Continued • … Perform chest compressions. • 15 compressions and two breaths. • Count = 1&2&3&4&5…&15 • Call 102.

39. RESCUE BREATHING • 1 breath every 5 seconds - 12 per minute. • Compressions : ventilations = 15:2

40. Why should I do CPR? • CPR provides some circulation of oxygen-rich blood to the victim's heart and brain. • This circulation delays both brain death and the death of the heart muscle. • CPR buys some time until the AED can arrive, and it also makes the heart more likely to respond to defibrillation.

41. Unconscious but breathing normally • Turn casualty into the recovery position • Check for continued breathing

42. Sudden cardiac arrest simply means that the heart unexpectedly and abruptly stops beating. This is usually caused by an abnormal heart rhythm called V.F. Sudden Cardiac Arrest

43. Ventricular Fibrillation. (Chaotic rhythm) Pulseless Ventrcular Tachycardia. (Very fast rhythm with no pulse) Asystole (No electrical activity) P.E.A. / E.M.D. (Electrical activity, no pulse Rhythms in Cardiac Arrest

44. Ventricular Fibrillation VF 44

45. Ventricular Fibrillation • Ventricular fibrillation (VF) is an abnormal heart rhythm often seen in sudden cardiac arrest. • This rhythm is caused by an abnormal and very fast electrical activity in the heart. • VF is chaotic and unorganized; the heart just quivers and cannot effectively pump blood.

46. Ventricular Fibrillation • VF will be short lived and will deteriorate to asystole (a flat line) if not treated promptly. • For each minute that VF persists, the likelihood of successful resuscitation decreases by approximately 10 percent.

47. Head Injuries Head injuries can easily mislead the first aid provider by not exhibiting the expected signs and symptoms immediately after the incident.

48. Head Injuries casualty has appeared unaffected after the incident only to collapse with life-threatening symptoms some hours later.This may be due to a small bleed in the brain that eventually increases and applies excessive pressure on the brain tissue.

49. Head Injuries

50. Head Injuries-SIGNS/SYMPTOMS • Head wounds • deformation and/or crepitus of the skull • altered level of consciousness • evidence of CSF leaking from ears or nose • may have unequal pupils • Headache • ‘Black Eyes’ • nausea and/or vomiting • restlessness and irritability, confusion • blurred or double vision • ‘snoring’ respirations if unconscious