FIRST AID TRAINING

1. FIRST AID TRAINING STANDARD CHARTERED BANK FEB 9, 2010 By Musalaba Mwekundu ltd LTD In corroboration with Uganda Red Cross.

2. TOPIC 1: FIRST AID • Definition: • First aid is the immediate assistance given to a casualty. Or victim of sudden illness or injuries before being taken to a health unit for further management. • AIMS OF GIVING FIRST AID • To save life. • To relieve pain. • To promote quick recovery • To prevent further Injuries and Infection • To control bleeding • To be able transport casualties

3. QUALITIES OF A FIRST AIDER • Must have the right knowledge and skill on first aid • Always continue to learn and discover • Must be a good role model for the Red Cross movement • Must always be willing to assist another first aider • Must be quick as decision making and in action. • Must be empathetic, and not sympathetic. • Must be creative and resourceful (make use of the locally available materials). • Must be able to make use of his common sense in managing situations. • Must be calm. • Must be confident. • Must be observant. • Must be trustworthy. • Should be loud and clear in communication. • Should use short sentences and clear.

4. RULES OF GIVING FIRST AID 1. First aiders life comes number one 2. Do first things first (DR.ABC) remember to give first aid to the most seriously injured victims first. • Danger • Response • Air way • Breathing • Circulation

6. Observe the accident scene as you approach check out for any danger or cause. • Always sit or lie a casualty before attending to him or her • Do not rush to move a casualty from the scene of accident before checking for spinal injuries. • Be calm, steady and in control of the situation. • Keep crowds away and use other first aiders/Health workers or by bystanders present. • Remove casualty from the cause or the cause from the casualty. • Keep casualty dry and cover lightly and minimize movement where necessary. • Reassure the casualty, it means a lot to his/her mind. • Please, accompany the casualty to the Health Unit. • Get background history. Description of accident/illness from by-standers or from the casualty if possible • Cover wounds to prevent infection. • Bear in mind crash injuries where there are no obvious injuries. When a body has been hit hard, there is a period numbness. Take note of this • Never give unconscious casualties any thing to eat or to drink. • Keep the privacy of the casualty it’s your responsibility. • Always work from in front of the casualty

7. NOTE: First Aiders must be able to take charge of a situation, keep calm while working under pressure, and organize others to do likewise. By demonstrating competence and using well selected words of encouragement, First Aider win the confidence of casualty

8. TOPIC 2: CONTENTS OF A FIRST AID BOX • The following are items that must be included in a first aid box: • Bandages • Gauze • Plasters • Scissors • Tweezers • Cotton Wool • Pain Killers • Note Book And Pen • Disinfectant • Iodine /Spirit • Gloves • Surgical Blades • Glucose • Burn Cream • Safety Pins • Ors –Oral Rehydration Salts • Liniment / Deep Heat • Soap Medicated • Splints

9. TOPIC 3: BANDAGE This is a material made of calico (cotton) elastic or net special paper, used to support dressings, splints, injured muscles, fractured bones, injured limbs or any body part in the required position to correct deformity and to control bleeding. • QUALITIES OF A GOOD BANDAGE; • It must not be slippery • It should be elastic. • Must be long enough.

10. RULES OF APPLYING BANDAGING • Apply the bandage while the casualty is sitting or lying down. • Apply a bandage while facing the casualty and be on the injured side. • Support the injured part in a position, which is comfortable for the causality. • A bandage should be neatly and tightly rolled or prepared before commencing bandaging. • A roller bandage should be bandaged from below upwards the limb. • A bandage should be firm but not tight. • A roller bandage should be started with the outer surface on the skin. • A triangular bandage must end with a reef knot • Make frequent checks to ensure the bandage does not become too tight as the tissue swell. • Expose the toes and nails for monitoring circulation. • While bandaging an injury with impelling objects bandage on the sides and not over.

11. BANDAGES • FUNCTIONS OF A BANDAGE • Maintain direct pressure over a dressing to control a bleeding. • Hold dressing and splints in position. • Prevent or reduce swelling • Provide support for limbs/joints • Restrict movement • Assistance in carrying /lifting the causality • TYPES OF BANDAGES: • Roller bandage or crepe • Triangular bandage/universal (It’s called universal because many bandages can be made from it.)

12. TRIANGULAR WIDE BROAD NARROW ROLLER FLAT PAD RING PAD

13. TOPIC 4: BLEEDINGThis is the escape of blood from blood system that is; capillaries, arteries, veins andheart Types of bleeding Internal Bleeding This is the escape of blood from arteries, capillaries and veins into the spaces in the body. (Remains inside the body). EXTERNAL BLEEDING This is the escape of blood from arteries, capillaries and veins out of the body and is seen. CAUSES • Motor accidents • Fighting • Cuts from sharp objects • Falling down while running or walking • Fractures SIGNS AND SYMPTOMS (GENERAL) • Blood is seen • Pain • Wound • Part becomes swollen • General body weakness • Restlessness • Dizziness • Unconsciousness • Blood from natural opens • Blood seen from Urine, Stool, cough ,Vomitus • Thirty

14. BLEEDING • FIRST AID MANAGEMENT (FAM/FAT) • Sit or lie the casualty down • Elevate effected part if possible • Apply direct pressure. • Dress the wound • Reassure the casualty as you do the above • Refer to the nearest medical unit e.g. clinic • NOSE BLEEDING • Sit the casualty upright • Slightly open the legs of casualty (put them apart) • Pinch soft part at the nose (the area between the eyes while the causality breath through the mouth) • Get and place a cold dump (wet) cloth or sponge the fore head • Do the above every 5 minutes for 30 minutes • If bleeding continues, refer

15. TOPIC 5: WOUNDS AND THEIR CARE DEFINITION: A wound is a break or cut in the continuity of a body

16. TYPES Closed wounds This is when the damage occurs under the skin tissue leaving the outer layer unbroken e.g. electrical burn. Open wounds This is when there is a breakage in the continuity of the skin e.g. cut by a razorblade, knife Signs and Symptoms • Pain • Wound • Bleeding • Restlessness • Thirst • Unconsciousness • Swelling. • Causes • Blunt force e.g. a punch while fighting • Sharp forces e.g. knives, razors, pins, niddles • Electrical injuries FAM/FAT N.B Consider the type of wounds and cause. • Safety. • Reassure casualty as you settle him/her in a comfortable position. • Remove the foreign body if possible. • Raise the injured part if possible • Dress and bandage the affected part. • Change the dressing every other day. • Burn all used up dressings so as not to spread infection.

17. TOPIC 6: FRACTURESThis is the break or crack in the continuity of a bone.

18. CLASSIFICATION OF FRACTURES Compound/open fracture This is when a bone breaks and tears through the skin tissue, and it can be seen. Simple/closed fracture This is when a bone breaks/cracks but remains within the body. Green stick fracture This happens in children/infants whose bones have not grown hard. It bends or cracks but doesn’t break. As their bones are not hard enough to break. Complicated fracture This is when a bone breaks and damages other body organs and it may be open or closed fracture. Signs and Symptoms • Pain • Bleeding • Bone may be seen • Body weakness • Restlessness • Difficulty in moving injured part • Deformity of injured part • Swelling. Causes • Direct pressure e.g. car accidents, being punched, being hit with a metallic rod. • Indirect pressure e.g. falling down while running, stepping in a hole/ditch

19. FAM/FAT 1. Safety2. Rest the casualty and place affected part in comfortable position 3. Reassure the casualty4. Immobilize fracture using splints and bandages5. Control bleeding if any6. Refer • Note: Never try to put broken bones back in their positions bandage the way you find them • DISLOCATIONS This is the displacement of bones from their natural positions • Signs and Symptoms • Restlessness • Acute pain • Immediate swelling • At times displacement is visible (Deformity) • Causes • Instant twisting of joint • FAM/FAT • Settle casualty down • Support joint • Apply a cold compress/ice to effected part • Restrict movement • Apply a very firm bandage

20. TOPIC : 7 BURNS AND SCALDSBurns are injuries caused by dry heat e.g. hot metals, iron e.t.c while scalds are injuries caused by vapor or hot liquids. • Signs and Symptoms • Pain • Restlessness • Blisters • Part becomes warm • FAM/FAT • Safety • Pour plenty of cold running water over part • Refer or call for help • NB Never break blisters • Never forcefully remove clothes from burnt skin

21. TOPIC 8: ASPHYXIAIt’s a condition in which there is insufficient or no oxygen supply to the vital organs of the body triangle of life caused by suffocation, chocking and drowning. • SUFFOCATION This is when a person has little or no oxygen supply and fails to breath in a normal way. • CAUSES • Strangulation • Inhaling poisonous gases • Drowning • Being buried under soil. • Unconsciousness • Overcrowding in a poorly ventilated room • Cardiac Failure • Electric shock • Asthma/Diseases • SIGNS AND SYMPTOMS • Difficulty in Breathing • Pale Skin color • Unconsciousness • Tears • Sudden collapse • Restlessness • General body weakness • Anxiety • Rapid and weak pulse • Anxiety • Rapid and weak pulse • Low blood pressure • Cold and clammy skin • High pitch breathing sound

22. FAT/FAM • Safety to you/Casualty • Identify and remove the cause from the casualty or the reverse • If poisonous gas or fire, keep the victim low • Open and clear the air way • Ventilate if necessary (give a kiss of life) • Refer if necessary • Re assure if conscious • PREVENTIVE MEASURES • Keep plastic bags out of reach of children • Ensure proper ventilation • CHOCKING • It’s a partial or complete obstruction, blocking of the air way by an object (Solid) • CAUSES • Serving two masters at ago (laughing or talking while eating) • Improper chewing of food • Coins, beans in children mostly • Improper posture while eating e.g. bending, sleeping and running. • SIGNS AND SYMPTOMS • Difficulty in Breathing, coughing and talking • Neck and Face will show enlarged vessels • Lips and tongue change color • Uncontrolled tears • High pitched breathing sound • Pointing at the throat • Eyes turn red • Restlessness • General Body weakness • Casualty becomes unconscious if not attended to.

23. FAT/FAMIf a casualty is conscious: • Bend the casualty forward and give gentle slaps between shoulder blades. • Do Heimlich maneuvers: • Go behind the casualty • Put your foot between casualty legs which are slightly parted • Place your hand slightly below the rib cage • Make a fist over the first hand with your second hand • Press fist into abdomen with quick upward thrusts • Repeat sequences until casualty is relieved or refer.

24. DROWNINGIt’s when fluids enter the airway even in small quantities e.g. soup, tea, other drinks and water. • CAUSES • Serving two masters at ago i.e. drinking while talking • Falling in large sources of water without knowledge of swimming • Unconscious casualties unattended to when they vomit (vomitus) • Children left unattended to near water bodies i.e. in basin ponds • SIGNS AND SYMPTOMS • Difficulty in breathing • Change in the body temperature (low) • Mucus membrane turns pale • Dilated eyes • FAT/FAM • Observe your safety • If in lakes, rivers, swimming pools, lift the head above the water level • Follow DRABC method • If breathing and circulation are present put casualty in the recovery position, with the head in a slanting position. • Gently massage the casualty’s back to relax the back muscles so that swallowed water comes out • Keep casualty warm as you re-assure • If there are no signs of improvement refer.

25. TOPIC 9: FAINTING This is the temporary inadequate supply of oxygenated blood to the brain. • SIGNS AND SYMPTOMS • Swollen feet • Restless • Dizziness • General body weakness • Sweating • Thirst • Collapsing suddenly • Causes • Standing in the sun for long hours • Over dosage of drugs • Prolonged hunger (fatigue) • Drinking alcohol without eating food • Diseases e.g. Malaria, Tuberculosis, Pneumonia • FAT/FAM • Ensure that you are safe • Remove casualty from danger • Lie casualty on his/her back • Loosen any tight fittings e.g. tie, belt, shoes e.t.c • Elevate the legs above the level of the heart. • Give/ensure enough supply of fresh air • Reassure casualty as you administer first aid procedure • If the casualty recovers, explain what happened and what you intend to do • If casualty doesn’t show signs such as improving refer. • Give a cold sweet drink after recovering

26. TOPIC 10: SHOCKIt is a condition in which a person’s important body organs fails to function or slow down due to less oxygenated blood flow. (Triangle of life Brain, lungs and heart) • CAUSES OF SHOCK • Dehydration • Diseases e.g. convulsion • Allergic reaction • Severe bleeding • Electrocution • Bad/good news excitement) • Cardiac failure • Severe Burns • SIGNS AND SYMPTOMS • Mental confusion • Loss of energy • Dizziness • Rapid breathing • Sweating • Low blood pressure • Restlessness • Thirst • Failure to drink normally • Cold skin • Frequent yawning • He/She may become unconscious • Lips and tongue turn pale

27. FIRST AID MANAGEMENT • Follow DR ABC • Keep the causality lying on his or her back and keep the airway clear. The causality should lie on a mat or blanket to avoid coldness from the ground. • Elevate the legs to the level of the heart • Loosen tight fittings e.g. Belts , shoes, bangles, watch • Cover the causality with a blanket or coat to keep him/her warm • Do not give fluids or food • Refer the causality for medical attention

28. TOPIC 11: UNCONSCIOUSNESS. This is a state of unawareness due to damage or disturbance of the brain functions. • CAUSES. • Brain and head injuries. • Excessive and severe bleeding. • Drowning. • Intoxication-alcohol, carbon monoxide, poisoning etc.. • Fits and convulsions . • SIGNS AND SYMPTOMS. • Loss of consciousness characterized by shallow breathing. • Weak and rapid pulses. • Restlessness. • Loss of memory of events before and after accidents. • Signs and symptoms of shock. • Nausea and vomiting. • LEVELS OF UNCONSCIOUSNESS. • Fully conscious- Here the person is alert and aware of what is happening. • Drowsiness- Casualty can easily be roused by short stimuli to get response. He/she can respond to voice. • Stupor- Here a casualty can be roused with difficulty e.g. by pinching. • Coma- This is the worst state of unconsciousness. A casualty can’t be aroused at all by a first aider. It can be done in the hospital.

29. FIRST AID MANAGEMENT FOR UNCONSCIOUSNESS. • Ensure safety. • Open the airway by lifting the chin and tilting the head. Check breathing and circulation and be prepared to resuscitate if necessary. • If the casualty starts to vomit, put in a recovery position. • If suspect spinal injury, treat the casualty as a spinal injury. • Examine the casualty to identify severe bleeding and fractures. • Control any bleeding as immediately as possible. • Ensure plenty of fresh air by opening doors, windows or in an open environment. • Cover the casualty with a worm blanket. • Put the casualty in recovery position. • Reassure and refer immediately if there’s no improvement. • NB. If the casualty improves explain what happened and what you intend to do after wards

30. TOPIC 12: EPILEPSY.It refers to an abnormal electrical discharge from the brain that appears suddenly, disappears spontaneously and has a tendency to reoccur. • CAUSES. • Trauma • Excessive alcoholism without eating. • Diseases like Meningitis, Cerebral malaria. • Genetic • SIGNS AND SYMPTOMS. • Sudden falls. • Fits/Convulsions/Muscle jerks • Froth/foam on the mouth. • Dilated eyes. • General body weakness. • Deep sleep after jerking. • Faeces and urine. • FAM/FAT. • Ensure that you are safe. • Protect the casualty’s head from hitting sharp edged objects. • Don’t stop the casualty from jerking but when stops, open and clear the airway. • Ensure that the casualty is breathing and if not ventilate. • If breathing resumes address secondary injuries. • Put the casualty in recovery position and refer if necessary. • NB • Epilepsy is not contagious, you cannot catch it by torching the casualty. • Don’t put anything in the casualty’s mouth e.g. spoon, handkerchief etc… • Never run away from the casualty with Epilepsy.

31. TOPIC 13: ANIMAL AND INSECT BITESThese are injuries caused by the teeth/fangs o stings of animals or insectsANIMAL and SNAKE BITES: • SIGNS AND SYMPTOMS • Bleeding • 2 Fang marks • teeth marks • Pain • Swelling of bitten part • Paralysis of an affected part • Thirst • Restlessness • General body weakness • Vomiting • FAM/FAT • Ensure safety for you - (First Aider) - Casualty - Bystanders • Remove casualty from the cause • Restrict movement of the causality • Sit casualty down/lie him/her • Tie slightly above the bitten part (firmly not tight and if possible) • Wash bitten part with plenty of running water • Dress and bandage bitten part • Refer • NOTE: If you can, kill the snake and go with it to health unit for medical personnel for easy medication.

32. DOG BITE Dog bites are very dangerous as they can cause rabies. • SIGNS OF A DOG WITH RABIES • Dog becomes wild • Restlessness • Foam around the mouth • Loss of body weight • Lack of appetite • May die between 4 – 7 days after biting • Symptoms and signs human bitten dog with rabies • Pain • Wound (teeth marks) • Restlessness • Behaves like a dog • Loss of appetite • Thirst • Loss of body weight • Fever • FAM/FAT • Safety You ,Casualty, By-standers • Reassure the casualty • Wash bitten part with plenty of running water • Cover wound lightly • Refer immediately

33. INSECT BITES e.g. BEES Signs and symptoms • Pain • Swelling • Stings • Change in body temperature • Restlessness • General body weakness FAM/FAT • Safety • Remove casualty from cause if possible • Reassure causality • Ask casualty to roll down • Give a blanket to cover him/her self • Remove stings • Use cold cloth over sting part • Refer if necessary

34. TOPIC 14: POISOINING • This is the introduction of toxic substance into a body. Poison is any toxic substance in solid, liquid or gasses form which if introduced into a living body in a sufficient amount will affect the normal functions of the vital normal functions of that living body and its systems. CAUSES OF POISONING • Over dose of drugs • Self medication. • Alcohol being taken in excesses • Breathing in toxic gasses TYPES OF POISONS 1. Corrosive: This is the nature of poison which burns the way destroying the route by causing things such as wounds e.g. acids and strong alkaline. 2. Non corrosive: • This is the nature of poison does not destroy route where it passes thus no wounds may be caused. • The major routes through which the poison can be introduced into the body • Mouth. • Nose • Skin.

35. POISOINING Signs and Symptoms • vomiting • Diarrhea • Asphyxia • Vomiting • unconsciousness • The rips may be stained by the co lour or poison. • The smiling of the poison at the seen First Aid Treatment | First Aid management • Non Corrosive Poison • Assess the situation in relation to type of poison • If it is non corrosive poison induce vomiting • Dilute the poison by use of milk if milk is not available you use water. As you arrange to transport the casualty to the nearest medical unit with the specimen of the poison, container or the vomits. • Corrosive Poison In case of corrosive poison do not induce vomiting dilute the poison with milk or water as you arrange for transport to the nearest medical unit.

36. TOPIC 15: FOREIGN BODIES • Foreign body is anything unknown and unwanted to that existing body that if introduced to it will have an effect to that body. Common routes through which they can be introduced to the body. • Mouth. • Nose. • Skin. • Eyes. CAUSES OF FOREIGN BODIES • Intentional. • Accidental. Signs and Symptoms • Restlessness. • Swelling. • Bleeding . • pain. • Tenderness • Difficult in movement. • Shock. • Humbleness. FIRST AID TREATMENT • Remove the foreign body if it is nearer and you can remove it without causing any • further complicated injuries. • flash the area with water • In case it has caused a wound clean and dress. • Arrange to dispose to the nearest medical unit

37. Practicals TYPES OF BANDAGING • Arm sling • Triangular Sling • Head Bandaging • Chest /Back Bandaging • Knee Bandaging • Jaw Bandaging • Scalp Bandaging • Foot /Palm Sling NB The Bandaging mentioned above are applied using a triangular bandage.

38. Practical Application

39. TRANSPORTATION This is the method a First Aider can improvise to move/transfer causality from place of injury to where he/she is going to be attended to by first aider or medical personnel. NOTE: Things to consider when choosing a method/type/mode of transportation: • Distance to be covered • Level of consciousness of casualty • Type of injury • Weight of casualty compared to that of the First Aider • Number of helpers available. • Topography TYPES OF TRANSPORTATION • Stretcher or improvised e.g. blanket, bed sheets e.t.c • Dragging • Human cradle • Human crutch • Chair lift • Two handed seat • Four handed seat • Three handed seat • Four handed seat • Pick a back

40. Practical Application

41. END Thank you.