BASIC TRAINING - ELEMENTARY FIRST AID

INTRODUCTION

This course is designed to train all seafarers to take immediate actions upon encountering accidents,
or other medical emergencies.

It shall cover mandatory training requirements for the trainee under Section A-VI/1 Paragraph 2.1.3
and columns 1 and 2 of Table A-VI/1-3 of the STCW Code, 2010.

1. ASSESSMENT OF NEEDS OF CASUALTIES AND THREATS TO OWN SAFETY

GENERAL PRINCIPLES OF FIRST AID

FIRST AID – it is an immediate care given to a person who has been injured or suddenly taken ill. It
includes self-help and home care when medical assistance is delayed or not yet available.

All crew members should be prepared to administer first aid. They should have sufficient knowledge
of first aid to be able to apply thru true emergency measure and decides when treatment can be
safely delayed until a medical professional arrives. Those not properly trained should recognize their
limitations. Procedures and techniques beyond rescuer’s ability should not be attempted for more
harm may result from their actions.

OBJECTIVES OF FIRST AID

 To alleviate suffering
 To prevent added / further injury or danger
 To prolong life

ROLES AND RESPONSIBILITIES OF A FIRST AIDER

 Acts as the bridge that fills the gap between the victim and the physician
 Does not compete with nor take the place of the physician
 It ends when the services of the physician begins
 Ensures safety of own self and that of bystander and victim
 Requests advanced medical care as needed and assists advanced personnel

GUIDELINES IN GIVING EMERGENCY CARE

 Getting started phase:

o Planning of action
o Gathering of needed materials
o Remembering the initial response:
 A – Ask for help
 I – Intervene
 D – Do no further harm
o Give instruction to helper(s)

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EMERGENCY ACTION PRINCIPLE – the guiding rules to be utilized by the first aider on the scene of
emergency which acts as the framework on which to base future actions.

SURVEY THE SCENE - Always look for your own safety and do not become the next casualty. Scene
safety is an assessment focused on ensuring the wellbeing of the first aider. You are no help to the
victim if you enter the scene without protecting yourself first for you cannot help your victim if you
yourself is a victim. Also, the secondary concern in the scene safety, the safety of the victim and the
bystanders.

ACTIVATE MEDICAL ASSISTANCE - In some emergencies, you will have enough time to call for specific
medical advice before administering first aid. But in some situations, you will need to attend to the
victim first.

Both trained and untrained bystanders should be instructed to Activate Medical Assistance as soon
as they have determined that an adult victim requires emergency care, “CALL FIRST”.

Information to be remembered in Activating Medical Assistance:

 Identify yourself
 Exact location
 Number of persons injured
 What happened

PRIMARY SURVEY – A procedure performed to identify the life threatening condition of the victim. It
includes airway obstruction, respiratory arrest, cardiac arrest, and severe bleeding. Any problems
identified should be given appropriate treatment before assessing for other possible injuries.

SECONDARY SURVEY – A procedure performed to identify other injuries of the victim. The rapid
physical assessment should be done on both responsive and unresponsive victims. A conscious victim
can be a good source for information regarding his condition.

S.A.M.P.L.E. HISTORY – A type of interview where its main purpose is to gather information about the
possible history of the present condition of the victim.

 Signs and Symptoms – Warning signs that the victim manifests during the onset of
incident. A sign is something that you can see or perceive such as bleeding. A symptom is
something that the patient is experiencing or feeling that is not obvious to another
person such as chest pain.

 Allergies – Identifying existence of patient’s allergy to medication, food, and other

substance and recognizing the reaction the patient exhibited. If there are no allergies,
just note it as N.K.A. or No Known Allergies.

 Medications – If the victim has prescribed medications, note the name of the drug and
what it is for, the dosage, and frequency of intake.

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 Pertinent Past History – This covers the medical history of the victim taking into
consideration any surgical procedures, trauma, illness, or any feelings of abnormalities
before the incident occurred.

 Last Oral Intake – What did the victim last eat, drink, and drugs, how much was
consumed, and when was it taken.

 Events Leading To Injury Or Illness - What was your patient doing immediately prior to
the emergency? How did they find themselves in that situation? Three sample questions
would be "What happened?", "How did it happen?", "What were you doing when this
happened?"

VITAL SIGNS - These are the key signs that are used to evaluate the patient’s general condition. The
first set of vital signs that you obtain is called the baseline vital signs.
90−130
 Blood Pressure – 60−80 𝑚𝑚𝐻𝑔
 Respiratory Rate – 12 – 20 cycles per minute
 Pulse Rate – 60 – 100 beats per minute
 Temperature – 36.5 – 37.5 ˚C

HEAD-TO-TOE EXAMINATION – A rapid medical assessment to quickly identify existing or potentially

life threatening conditions. Evaluating each region, visualize and palpate to identify signs of injury
using the mnemonics D.C.A.P.B.T.L.S.
 D – Deformity
 C – Contusion
 A – Abrasion
 P – Puncture
 B – Burns / Bleeding
 T – Tenderness
 L – Laceration
 S – Swelling

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2. BODY STRUCTURES AND ITS FUNCTIONS

The study of the human body involves anatomy and physiology. The human body can show
anatomical non-pathological anomalies which need to be able to be recognized.

Physiology focuses on the systems and their organs of the human body and their functions. Many
systems and mechanisms interact in order to maintain homeostasis.

SKELETAL SYSTEM – The framework of the body,

consisting of bones and other connective tissues,
which protects and supports the body tissues and
internal organs. The human skeleton contains 206
bones, six of which are the tine bones on the
middle ear (three in each ear) that function in
hearing. The largest bone in the body is the thigh
bone, or femur.

MUSCULAR SYSTEM – Muscles are bundles of cells and fibres that can only contract (shorten) and
relax (lengthen). There are 630 active muscles in the body and they work in groups.

THREE TYPES OF MUSCLES

 Skeletal, or voluntary
- attached to bones by fibrous tissue called a tendon.
- also called striated (or striped) muscle, because under a microscope the minute
filaments within each muscle cell are aligned, giving the cells a striped appearance.

 Smooth, or involuntary
- is located in the walls of internal organs, such as the stomach and intestines, blood
vessels, urinary bladder, uterus and airways.
-is controlled by the autonomic (or involuntary) nervous system and is only to a
limited extent influenced by the will.

 Cardiac muscle – is found only in the heart.

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RESPIRATORY SYSTEM – The specialized organs,

collectively, concerned with external
respiration or the process of breathing. It
includes the nasal passages, larynx, trachea,
bronchi, bronchioles, lungs, and diaphragm.
The integrated system of organs involved in
the intake and exchange of oxygen and carbon
dioxide between the body and the
environment.

CIRCULATORY SYSTEM – The system in the body by

which blood and lymph are circulated. The parts of the
circulatory system include the heart, along with all the
arteries, veins, and capillaries. Nutrients, oxygen, and
other vital substances are carried throughout the body
by the blood, which is pumped by rhythmic contractions
of the heart. Blood is pumped from the heart to the
arteries, which branch into smaller and smaller vessels
as they move away from the heart. The blood passes
oxygen and nutrients to the cells and picks up waste in
the capillaries, then returns to the heart through the
veins.

THE BLOOD
 Red blood cells – Carries oxygen from the
lungs to the body’s tissues and take carbon
dioxide back to the lungs to be exhaled

 White blood cells – Cells of the immune

system that are involved in defending the
body against both infectious diseases and
foreign materials.

 Plasma – A fluid composed of about 92% water, 7% vital proteins such as albumin, and
1% mineral salts, sugars, fats, hormones, and vitamins

 Platelets – Small, colorless cell fragments in the blood whose main function is to interact
with clotting proteins to stop or prevent bleeding.

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THE BLOOD VESSELS

 Arteries - Carry the blood from the heart to all the parts of the body tissues

 Veins – Carries the un-oxygenated blood back to the heart. This blood vessel have much
thinner walls than arteries and are generally larger in diameter

 Capillaries – Small blood vessels at the end of the arteries. The have fine end division of
the arterial system which allows contact between cells of the body tissue and the plasma
and red blood cells.

INTEGUMENTARY SYSTEM – The organ system that protects the body from various kinds of damage,
such as loss of water or abrasion from outside. The system comprises the skin and its appendages
(including hair, scales, feathers, and nails). The integumentary system has a variety of functions; it
may cushion and protect the deeper tissues, regulate body temperature, and is the attachment site
for sensory receptors to detect pain, sensation, pressure, and temperature.

3. MEASURES TO BE TAKEN IN CASES OF EMERGENCY

3.1. POSITION CASUALTY

SIDE LYING POSITION – position choice for unconscious victim; also known as recovery position.

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TRENDELENBURG POSITION – keep the victim on lying position with legs elevated 12 – 18 inches high;
also known as leg elevation.

LONG SITTING OR FOWLER’S POSITION – position of choice for victim with difficulty of breathing.

PROPER BODY HEAT – maintain body heat blanket (must not be perspiring) and keep the patient
warm but not hot. Too much heat raises the surface, temperature of the body and diverts the blood
supply away from the vital organs to the skin.

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3.2. RESUSCITATION TECHNIQUES

AIRWAY OBSTRUCTION – A life threatening condition or emergency that requires prompt diagnosis
and treatment where there is blockage of the upper airway which can be in the trachea, voice box, or
throat area.

CAUSES OF AIRWAY OBSTRUCTION

 Allergic reactions
 Improper chewing of food
 Infection of epiglottis
 Throat cancer
 Trauma
 Loose upper and lower dentures

TYPES OF AIRWAY OBSTRUCTION

 Anatomical obstruction -can be caused by allergic reactions, infections, anatomical
abnormalities, and trauma
 Mechanical obstruction – can be caused by presence of foreign matter

CLASSIFICATIONS OF OBSTRUCTION
 Mild airway obstruction – partial obstruction and that the victim can still cough and
answer the question, “Are you choking?”
 Severe airway obstruction – also referred to as complete obstruction; there is poor air
exchange and increased breathing difficulty, a silent cough, cyanosis, or inability to speak
or breath and if patient become unconscious due to an obstruction

CHOKING - occurs when a foreign object becomes lodged in the throat or windpipe, blocking the flow
of air. In adults, a piece of food often is the culprit. Young children often swallow small objects.
Because choking cuts off oxygen to the brain, administer first aid as quickly as possible.

MANIFESTATIONS OF CHOKING
 Inability to talk
 Difficulty breathing or noisy breathing
 Inability to cough forcefully
 Skin, lips, and nails turn blue or dusky
 Loss of consciousness

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RELIEF OF CHOKING
 Heimlich maneuver – The Heimlich maneuver is an emergency technique for preventing
suffocation when a person's airway (windpipe) becomes blocked by a piece of food or
other object.
 Back blow – designed to use percussion to create pressure behind the blockage, assisting
the patient in dislodging the article.
 Chest thrust - A modified version of the Heimlich maneuver technique which is
sometimes taught for use with pregnant and/or obese patients.

MANEUVERS TO OPEN AIRWAY

 Head tilt – chin lift – an emergency rescue maneuver which maximizes the diameter of
the airway for rescue breathing

 Jaw thrust maneuver - Airway management is the medical process of ensuring there is an
open pathway between a patient’s lung sand the outside world, as well as reducing the
risk of aspiration. Airway management is a primary consideration in cardiopulmonary
resuscitation, anesthesia, emergency medicine, intensive care medicine and first aid.

FOREIGN BODY AIRWAY OBSTRUCTION MANAGEMENT

CONSCIOUS ADULT
1. Check the scene and the victim
2. If the victim cannot cough, speak or breathe (inform the bridge immediately)
3. Perform Heimlich maneuver
4. Continue Heimlich maneuver until the object is forced out or the victim becomes
unconscious

UNCONSCIOUS ADULT
1. Place him on the floor on a supine position (lying down face up)

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2. Look for any blocking object by opening the airway. If there is an obstruction which can
be removed, do a finger sweep.
3. Once the object is removed, do head tilt – chin lift and look, listen, and feel for adequate
breathing.
4. Perform CPR if there is no pulse and absent breathing after assessment for circulation
and respiration.

RESPIRATORY ARREST – a condition in which the breathing stops or is inadequate and circulation
continues for quite some time.

WAYS TO VENTILATE THE LUNGS

 Mouth to mouth
 Mouth to nose
 Mouth to mouth and nose
 Mouth to stoma
 Mouth to face shield
 Mouth to mask
 Bag mask device

MOUTH-TO-MOUTH BREATHING – A quick and effective way to provide oxygen to the victim. The
rescuer’s exhaled air contains approximately 16% oxygen and 5% carbon dioxide. This is enough to
meet the victim’s needs.
 Actions:
o Maintain a head tilt-chin lift to keep the airway open
o Pinch the victim’s nose tightly with thumb and forefinger
o Make a mouth-to-mouth seal
o Provide 2 mouth-to-mouth breaths. Make sure the chest rises with each breath
o If the chest does not rise, repeat the head tilt-chin lift to reopen the airway

FIRST AID MANAGEMENT: RESCUE BREATHING – a technique of breathing air onto a person’s lungs to
supply him or her with the oxygen needed to survive.
 Give each breath in 1 second
 Each breath should result in visible chest rise
 Check the pulse every 2 minutes
 Rescue breathing sequence:
o Blow
o 1 1002 1003 1001 blow
o 1 1002 1003 1002 blow
o 1 1002 1003 1003 blow
o 1 1002 1003 1004 blow
o 1 1002 1003 1005 blow
o 1 1002 1003 1006 blow
o 1 1002 1003 1007 blow
o 1 1002 1003 1008 blow
o 1 1002 1003 1009 blow
o 1 1002 1003 1010 blow
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CARDIAC ARREST – cessation of functional circulation of the blood due to failure of the heart to
contract effectively.

BASIC LIFE SUPPORT – an emergency procedure that consists of recognizing cardiac arrest and the
proper application of cardiopulmonary resuscitation to maintain life until a victim recovers or
advanced life support is available.

TYPES OF DEATH
Clinical death - when breathing and circulation stops.
 0 – 4 minutes – brain damage is likely
 4 – 6 minutes – brain damage is probable
Biological death – when the brain has been deprived of oxygenated blood.
 6 – 10 minutes – irreversible brain damage is probable
 10 minutes or more – irreversible brain damage is certain

THE CHAIN OF SURVIVAL – a metaphor for the elements of the emergency cardiovascular care
systems concept. The 5 links in the chain of survival are:
 Immediate recognition of cardiac arrest and activation of the emergency response
system
 Early cardiopulmonary resuscitation with an emphasis on chest compressions
 Rapid defibrillation
 Effective advanced life support
 Integrated post-cardiac arrest care

C – A – B SEQUENCE – the CAB sequence allows rescuers to start chest compressions sooner, and the
delay in giving breaths should be minimal.
 C – Compressions – push hard and fast on the center of the victim’s chest
 A – Airway – tilt the victim’s head back and lift the chin to open the airway
 B – Breathing – give mouth-to-mouth rescue breaths

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CRITERIA FOR NOT STARTING CPR

 The victim has a valid DNAR/DNR order
 The patient has signs of irreversible death
o Rigor mortis
o Decapitation
o Dependent lividity

WHEN TO S.T.O.P. CPR

 S – spontaneous signs of circulation
 T – turnover to professional provider
 O – Operator is exhausted
 P – Physician assumes responsibility
 S – Scene becomes unsafe

FIRST AID MANAGEMENT: CARDIOPULMONARY RESUSCITATION - It is the combination of external

chest compressions and rescue breathing.
 CPR sequence:
o 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
1 2 3 4 5 6 7 8 9 and 1 blow blow
o 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
1 2 3 4 5 6 7 8 9 and 2 blow blow
o 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
1 2 3 4 5 6 7 8 9 and 3 blow blow
o 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
1 2 3 4 5 6 7 8 9 and 4 blow blow
o 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
1 2 3 4 5 6 7 8 9 and 5 blow blow

HIGH QUALITY CPR improves a victims chances of survival. The critical characteristics of high quality
CPR include:
 Start compressions within 10 seconds of recognition of cardiac arrest
 Push hard, push fast: Compress at a rate of at least 100/min with a depth of at least 2
inches (5cm) for adults, approximately 2 inches (5cm) for children, and approximately 1 ½
inches (4cm) for infants
 Allow complete chest recoil after each compression
 Minimize interruptions in compressions (try to limit interruptions to <10 seconds)
 Give effective breaths that will make the chest rise
 Avoid excessive ventilation

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3.3. CONTROL OF BLEEDING

TYPES OF BLEEDING

 Arterial bleeding – The blood is typically bright red to yellowish in color, due to high
degree of oxygenation. Blood typically exits the wound in spurts, rather than a steady
flow. The amount of blood loss can be copious, and can occur very rapidly.

 Venous bleeding – This blood is flowing from a damaged vein. As a result, it will be
blackish in color due to the lack of oxygen transported and will flow in a steady manner.
Caution is still indicated; while the blood loss may not be arterial, it can still be quite
substantial, and can occur with surprising speed without intervention.

 Capillary bleeding – Usually occurs in superficial wounds such as abrasions. The color of
the blood may vary somewhat and will generally ooze in small amounts, as opposed to
flowing or spurting.

DANGERS OF BLEEDING
 Hemorrhage
 Infection
 Shock

FIRST AID MANAGEMENT FOR MINOR BLEEDING

 Wash with soap and water
 Apply with mild antiseptic
 Cover the wound with sterile dressing and/or bandages

FIRST AID MANAGEMENT FOR SEVERE BLEEDING

 Control bleeding
o Apply direct pressure on the wound
o Elevate the injured part
o Apply direct pressure on the artery / pressure point
o Tourniquet
 Cover the wound with sterile dressing
 Care for shock
 Consult or refer to physician

WOUND – A type of injury in which skin is torn, cut, or punctured (open wound), or where a blunt
force trauma causes a contusion (closed wound).

TYPES OF WOUND
 Open wound (external wound)
 Closed wound (internal wound)

OPEN WOUND – injury where there is presence of break in the continuity of the skin.

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CAUSES
 Falls
 Sharp objects or tools
 Car accidents

TYPES OF OPEN WOUND

 Puncture – Sharp object penetrates the tissue, and travels internally, but does not move
laterally in any direction from the point of entry. Such wounds can be misleading, as they
may appear quite small on surface examination, but extend quite deeply into the body;
even damaging nerves, blood vessels, or internal organs. They may cause substantial
internal bleeding or secondary injuries, such as a collapsed lung, which may not be
readily evident during primary assessment. Occasionally, the object causing the injury will
remain in the wound as an impaled object. A stab wound from a knife or other sharp
object, or a bullet wound would be examples of this type of injury. This is usually referred
to as penetrating trauma.

 Abrasion – a scraping or scratching. Generally quite superficial, and affecting only the
surface layers of the epidermis. No internal organs, nerves, or blood vessels other than
capillaries, are affected. This may be the result of a fall, or of sliding (friction) against
rough surfaces. The road rash often suffered by falling motorcyclists is an example of this
type of wound.

 Laceration – jagged edges to the wound margins, more closely resembling a tear than a
slice. The wounded tissue is random rather than a straight direction and may have
multiple branches. Most often caused by an object with a broken or serrated edge, such
as a piece of broken glass or metal, but may also be caused by a blow from a blunt object
to tissue with bone immediately behind it.

 Avulsion – A full thickness laceration-type wound, often semi-circular in shape. This

creates a flap which, when lifted, exposes the deeper tissues to view, or extrudes them
from the wound itself. Avulsions often occur in mechanical accidents involving fingers,
and on a more serious note, may affect the orbit of the eye or the abdominal cavity,
exposing the internal viscera. Avulsions are difficult to repair, and no avulsion should ever
be considered a minor injury.

 Incision – straight edges to the wound margins, as if sliced with a knife. These can vary in
size, and may be caused by a variety of objects, including a scalpel, a knife, any piece of
straight, sharp metal, or a piece of glass. Tissue is rarely missing from the wound site, and
the margins of the wound may be easily matched from one side of the wound to the
other for the purposes of closure.

CLOSED WOUND – injury involving underlying tissues without breaking the skin or mucus membrane.

CAUSES
 Blunt objects resulting to bruises
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 Application of external forces

 Contusion – Simple bruising. In this type of injury, the capillaries in the epidermis and
dermis are damaged, without breaking in the skin. Blood oozes out of these vessels into
the spaces between cells or interstitial space, causing swelling and discoloration. Blood
loss is generally limited, and not of serious consequence. It may however act as a
signpost, pointing to more serious injuries.

SIGNS AND SYMPTOMS

 Pain and tenderness
 Swelling
 Discoloration
 Hematoma
 Symptoms of shock
 Passage of blood in the urine or feces
 Sign of blood along mouth, nose, and ear canal

FIRST AID MANAGEMENT FOR CLOSED WOUND

 I – Immobilization
 C – Cold compress
 E – Elevation

3.4. SHOCK MANAGEMENT

SHOCK –A depressed condition of the many body functions due to the failure of enough blood to
circulate throughout the body following a serious injury.

BASIC CAUSES OF SHOCK

PUMP FAILURE - The heart’s pumping power is weaker than normal. With heart failure, blood moves
through the heart and body at a slower rate, and pressure in the heart increases.

HYPOVOLEMIA (FLUID VOLUME LOSS) - Hypovolemic shock is an emergency condition in which severe
blood and fluid loss make the heart unable to pump enough blood to the body. This type of shock
can cause many organs to stop working.
 Blood loss can be due to:
o Bleeding from cuts
o Bleeding from other injuries
o Internal bleeding, such as in the gastrointestinal tract
o The amount of circulating blood in your body may drop when you lose too many
other body fluids, which can happen with:
o Burns
o Diarrhea
o Excessive perspiration
o Vomiting

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DILATION OF BLOOD VESSELS – excessive dilation of blood vessels (vasodilation) increases the
capacity of blood vessels, so that blood meets with less resistance as it flows through them. Blood
pressure in the dilated vessels is lower, so the cells fed by those vessels get less blood. Blood vessels
may be excessively dilated because of a serious allergic reaction (anaphylactic shock), a severe
bacterial infection (septic shock), and overdose of drugs or poisons that dilate blood vessels.

FACTORS THAT CONTRIBUTE TO SHOCK

 Pain
 Rough handling
 Improper transfer
 Continuous bleeding
 Exposure to extreme cold or excessive heat
 Fatigue

DANGERS OF SHOCK
 Leads to death
 Makes body susceptible to infection
 Leads to loss of body parts

SIGNS AND SYMPTOMS OF SHOCK

 EARLY STAGE (COMPENSATORY STAGE)

o Pale or cyanotic face
o Cold and clammy skin
o Irregular breathing
o Rapid and weak pulse
o Nausea and vomiting
o Weakness and thirst

 LATE STAGE
o Apathetic or relatively unresponsive
o Sunken eyes with vacant expression
o Dilated pupils
o Mottled skin
o Low blood pressure
o Hypothermia
o Unconsciousness

FIRST AID AND PREVENTIVE MANAGEMENT

 Objectives:
o Improve blood circulation
o Ensure adequate supply of oxygen
o Maintain normal body temperature

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 Methods:
o Proper positioning
o Proper body heat
o Proper medical advice and transfer

3.5. BURNS AND SCALDS, ACCIDENTS CAUSED BY ELECTRIC CURRENT

BURN INJURIES

An injury involving the skin including muscles, bones, nerves and blood vessels.
This result from heat, chemical or radiation and may vary from depth, size and severity and caused
damage to cell in the affected area.

CLASSIFICATION OF BURNS :

FIRST DEGREE BURN

 Cool burn – hold burned skin under cool (not cold) running water or immerse in cool
water until pain subsides
 Protect burn – cover with sterile, non-adhesive bandage or clean cloth and do not apply
butter or ointments for they may cause infections
 Treat pain – give over-the-counter pain reliever such as ibuprofen, acetaminophen, or
naproxen
 Seek medical help if:
o You see signs of infection (increased pain, redness, swelling, fever, or oozing)
o The person needs a booster shot, depending on date of last injection. Tetanus
booster shots should be given every 10 years.
o Redness and pain last more than a few hours
o Pain worsens
 Follow up – the doctor will examine the burn and may prescribe antibiotics and pain
medication

SECOND DEGREE BURN

 Cool burn
o Immerse in cool water for 10 – 15 minutes
o Use compresses if running water isn’t available
o Don’t apply ice (it can lower body temperature and cause further damage)
o Don’t break the blisters or apply butter or ointments for it may cause infection
 Protect burn – cover loosely with sterile, non-stick bandage and secure in place with
gauze or tape
 Prevent shock – unless the person has a head, neck, or leg injury, or it would cause
discomfort:
o Lay the person flat
o Elevate lower extremities about 12 inches
o Elevate burn area above heart level if possible
o Cover the person with coat or blanket
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 See a doctor – the doctor can test burn severity, prescribe antibiotics and pain
medications, and administer a tetanus shot if needed

THIRD DEGREE BURN

 Call the emergency number
 Protect burn area
o Cover loosely with sterile, nonstick bandage or, for large areas, a sheet or other
material that would not leave lint in wound
o Separate burned toes and fingers with dry, sterile dressings
o Do not soak burn in water or apply ointments or butter for it may cause infection
 Prevent shock – unless the person has a head, neck, or leg injury, or it would cause
discomfort:
o Lay the person flat
o Elevate lower extremities about 12 inches
o Elevate burn area above heart level if possible
o Cover the person with coat or blanket
o For an airway burn, do not place pillow under the person’s head when the person is
lying down. This can close the airway
o Have a person with facial burn sit up
o Check pulse and breathing to monitor shock until emergency help arrives
 See a doctor – doctors will give oxygen and fluid, if needed, and treat the burn

FACTORS TO DETERMINE THE SEVERITY OF BURNS

 Depth – The deeper the burn, the more severe it is
 Extent – estimation of how much body surface area is affected by the burn
 Location – burns on the face, hands, feet, and genitals are more severe than on other
body parts
 Age and medical condition – determine if other injuries or pre-existing medical problems
exist or if the victim is elderly or young

RULE OF NINE

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TYPES OF BURN INJURIES

Thermal Burn – Occur when hot metals, scalding liquids, steam, or flames come in contact with your
skin. These are frequently the result of fires, automobile accidents, playing with matches, improperly
stored gasoline, space heaters, and electrical malfunctions. Other causes include unsafe handling of
firecrackers and kitchen accidents (such as a child climbing on top of a stove or grabbing a hot iron).

Chemical Burn – Occurs when living tissue is exposed to a corrosive substance such as a strong acid
or base. Chemical burns follow standard burn classification and may cause extensive tissue damage.
The main types of irritant and/or corrosive products are: acids, bases, oxidizers, solvents, reducing
agents and alkylants. Additionally, chemical burns can be caused by some types of chemical weapons
e.g. vesicants such as mustard gas and lewisite, or urticants such as phosgene oxime.

Electrical Burn - May appear minor or not show on the skin at all, but the damage can extend deep
into the tissues beneath your skin. If a strong electrical current passes through your body, internal
damage, such as a heart rhythm disturbance or cardiac arrest, can occur. Sometimes the jolt
associated with the electrical burn can cause you to be thrown or to fall, resulting in fractures or
other associated injuries.

FIRST AID MANAGEMENT FOR BURNS :

FIRST AID MANAGEMENT FOR THERMAL BURNS

 Stop the burning process - remove hot or burned clothing or stop contact with the hot
steam, liquid, or a hot object and cool the injured area with water (not ice) within 30
seconds. This may limit the extent and severity of the burn. Run your burned hand or
finger immediately under cool tap water for several minutes. Gentle cleansing may be
performed as necessary.
 Control the pain – apply a cool wet compress for pain relief but do not use ice for it may
worsen the injury to the skin. One may use acetaminophen or ibuprofen for pain but
never use butter or mayonnaise as it may increase chance of infection.
 Begin healing process – use an antibiotic ointment to aid in healing and limit the chance
of infection. Remember to never remove blisters especially those on the palms of the
hands or the soles of the feet.

FIRST AID MANAGEMENT FOR CHEMICAL BURNS

 Remove the cause of the burn – brush any remaining dry chemical and then rinsing the
chemical off the skin surface with cool, low pressure water for 20 minutes or more.
 Remove clothing or jewelry – remove all articles worn especially those in contact with the
agent
 Wrap the burned area loosely – use a dry, sterile dressing or a clean cloth
 Rewash the burned area – if the person experiences increased burning after the initial
washing, rewash for 10 – 20 more minutes in free flowing water
 Take an over-the-counter pain reliever – if needed for pain, aspirin, ibuprofen, naproxen,
or acetaminophen may be taken.
 Get a tetanus shot – all burns are susceptible for tetanus.

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FIRST AID MANAGEMENT FOR ELECTRICAL BURNS

 Look first, do not touch – The person may still be in contact with the electrical source.
Touching the person may pass the current through you.
 Turn off the source of electricity if possible. If not, move the source away from both you
and the injured person using a dry, non-conducting object made of cardboard, plastic or
wood.
 Check for signs of circulation (breathing, coughing, or movement). If absent, begin CPR
immediately
 Prevent shock. Lay the person down with the head slightly lower than the trunk, if
possible, and the legs elevated
 Cover the affected areas. If the person is breathing, cover any burned areas with a sterile
gauze bandage, if available, or a clean cloth. Don't use a blanket or towel, because loose
fibers can stick to the burns.

3.6. RESCUE AND TRANSPORT A CASUALTY

EMERGENCY TRANSFER – moving a victim from one place to another after giving first aid by use of
emergency rescue.

POINTERS TO OBSERVE DURING TRANSFER

 Victim’s airway must be maintained open
 Hemorrhage is controlled
 Victim is safely maintained in correct position
 Supporting bandages and dressing remain effectively applied
 The method of transfer is safe, comfortable, and as speedy as circumstances permit

METHODS OF TRANSFER

 One-man assist and carry

Assist to walk Cradle Carry

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Fireman’s Carry Pack strap Carry

 Two-man assist and carry

Two-man assist to walk Four-hand sit

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Carry by Extremities Hammock Carry

 Three-man carry

Bearer’s along side

BANDAGE - a clean cloth material used to hold the dressing in place. It also serves as the support for
immobilization. It uses a sterile clean cloth material to cover the wound which is called a dressing.

GUIDELINES IN BANDAGING
 Use a dressing large enough to extend at least 1 inch beyond the edges of the wound
 Use a non-stick dressing if body tissues or organs are exposed
 If the dressing is over a joint, splint and make a bulky dressing so the joint remains
immobilized

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 Bandaging techniques depends upon:

o Size and location of the wound
o First aid skill
o Materials on hand

3.7. BANDAGES AND OTHER MATERIALS IN THE EMERGENCY KIT

TYPES OF BANDAGES
 Gauze bandage - The most common type of bandage is the gauze bandage, a simple
woven strip of material, or a woven strip of material with a Telfa absorbent barrier to
prevent adhering to wounds. A gauze bandage can come in any number of widths and
lengths, and can be used for almost any bandage application, including holding a dressing
in place.

 Elastic bandage - a "stretchable bandage used to create localized pressure" Elastic

bandages are commonly used to treat muscle sprains and strains by reducing the flow of
blood to a particular by the application of even stable pressure which can restrict
swelling at the place of injury. Elastic bandages are also used to treat bone fractures.

 Triangular bandage - Also known as a cravat bandage, a triangular bandage is a piece of

cloth put into a right-angled triangle, and often provided with safety pins to secure it in
place. It can be used fully unrolled as a sling, folded as a normal bandage, or for
specialized applications, as on the head. One advantage of this type of bandage is that it
can be makeshift and made from a fabric scrap or a piece of clothing. The Boy Scouts
popularized use of this bandage in many of their first aid lessons, as a part of the uniform
is a "neckerchief" that can easily be folded to form a cravat.

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TECHNIQUES IN BANDAGING

CRAVAT PHASE FOR TRIANGULAR BANDAGE

Cravat of head/ear

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Cravat of jaw

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Triangular arm sling

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Triangle of forehead or scalp

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Shoulder – armpit cravat / Triangle of chest or back

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Triangle of shoulder

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Cravat of elbow or knee

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Cravat of arm or leg

USE OF ROLLER BANDAGE

 Spiral (open, closed, and spiral reverse)
 Figure of eight
 Recurrent with spiral turns

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