GENERAL FIRST AID

DEFINITION OF FIRST AID

First Aid is an immediate care given to a person who has been injured or suddenly
taken ill. It includes self help and home care if medical assistance is not available or
delayed.
ROLES OF FIRST AID
l. It is the bridge that fills the gap between the victim and the physician.
2. It is not intended to compete with, nor take the place of the services of the physician.
3. It ends when the services of a physician begins.

OBJECTIVES OF FIRST AID

l. To alleviate suffering
2. To prevent added/further injury or danger
3. To prolong life

NEED AND VALUE OF FIRST AID

l. To minimize if not totally prevent accident.
2. To prevent added injury or danger.
3. To train people to do the right thing at the right time.
4. Accident happens and sudden illnesses are common and often serious.
5. People very often harm rather than help.
6. Proper and immediate care is necessary to save life or limb.

GUIDELINES FOR GIVING EMERGENCY CARE

l. Getting started l. Planning of action l. Gathering of needed materials l. Initial
response as follows:
A Ask for help
I Intervene
D Do not further harm
Ask for help. In a crisis, time is of essence. The more quickly you recognize an
emergency, and the faster you call for medical assistance, the sooner the victim will get
help. Immediate care can greatly affect the outcome of an emergency.
Intervene. To intervene means to do something for the victim that will help achieve a
positive outcome to an emergency. Sometimes getting medical help will be all you can
do, and this alone may save a life. In other situation, however, you may become actively
involved in the victim’s initial care by giving first aid. Let the golden rules of emergency
care guide your effort.
Do no further harm. Once you have begun first aid, you want to be certain you don’t do
anything that might cause the victim’s condition to worsen. Certain actions should
always be avoided by keeping them in mind, you will be able to avoid adding to or
worsening the victim’s illness or injuries.
l. Instruct helpers
2. “Emergency Action Principles” 2. Survey the scene 2. Do a primary survey of the
victim 2. Activate medical assistance/transfer facility 2. Do a secondary survey of the
victim
Survey the scene o is the scene safe? o what happened? o how many people are
injured? o are there bystanders who can help? o Identify yourself as a trained first aider.
Do a primary survey of the victim Check for vital body functions: BREATHING and
CIRCULATION by following the ABC steps
A Airway - Is the victim conscious?
o If the victim is conscious, assess breathing as described in B. o If the victim is
unconscious, start immediately airway management (open the airway refer to Module
4).
B Breathing - Is the victim breathing?
o If the victim is breathing, is it shallow or deep? does he appear to be choking? is he
cyanotic, suggesting poor oxygenation? o If the victim appears to have any difficulty
breathing, immediately support his breathing (maintain adequate open airway). o If the
victim is not breathing, provide initial ventilation (refer to Module 4).
C Circulation - Is the victim’s heart beating? o If it is, then how is it? (assess pulse)
provide other care as necessary. o If not, perform CPR refer to Module 5. - Is he
severely bleeding? o If he is, control bleeding refer to Module 9.
Activate medical assistance (AMA) or Transfer Facility (In some emergencies, you’ll
have enough time to call for specific medical advice before administering first aid. But in
some situations, you’ll need to attend to the victim first.) Depending on the situation: o a
bystander should make the telephone call for help (if available). o a bystander will be
requested to call for a physician. o somebody will be asked to arrange for transfer
facility.
Information to be remembered in activating medical assistance: o what happened o
number of persons injured o extent of injury and first aid given o the telephone number
from where you are calling o person who activated medical assistance must drop the
phone last.
Do a secondary survey of the victim Interview the victim: o introduce yourself o get
permission to give care o ask the victim’s name o ask what happened o ask “do you
have any pain or discomfort?” o “do you have any allergies?” o “are you taking any
medication?”
3. What not to do: Do not let the victim see his own injury. Do not leave the victim
alone except to get help. Do not assume that the victim’s obvious injuries are the
only ones. Do not deny a victim’s physical or emotional coping limitation.
Do not further harm the victim like the following: o trying to arouse an unconscious
victim. o administering fluid/alcoholic drink.
Do not make any unrealistic promises. Do not trust the judgement of a confused
victim. Do not require the victim to make decisions.
CHARACTERISTICS OF A GOOD FIRST AIDER:
1. Observant - should notice all signs.
2. Resourceful - should make the best use of things at hand
3. Gentle - should not cause pain
4. Tactful - should not alarm the victim
5. Sympathetic - should be comforting

CLOTH MATERIALS COMMONLY USED IN FIRST AID

l. Dressing or Compress l. Definition: any sterile cloth materials used to cover the wound
l. Other uses of a dressing or compress: .2. control bleeding .2. protects the wound from
infection .2. absorbs liquid from the wound such as blood plasma, water and pus. l.
Kinds of dressing: .3. roller gauze .3. square or eye pads .3. compress or adhesive (two
types:) - occlusive dressing - butterfly dressing l. Application .4. completely cover the
wound .4. avoid contamination when handling and applying
2. Bandages
2. Definition: any clean cloth materials sterile or not use to hold the dressing
in place.
3. Other uses of bandage: .2. control bleeding .2. tie splints in place .2.
immobilize body part .2. for arm support - use as a sling
4. Kinds: .3. triangular .3. muslin binder .3. cravat .3. elastic bandage .3.
roller .3. four-tail
5. Application: .4. must proper, neat and correct .4. apply snugly not too
loose not too tight .4. always check for tightness caused by later
swelling .4. tie ends with a square knot
6. Triangular Bandage .5. usually made from a 40-inch square piece of cloth,
cut from one corner to the opposite to form a triangle.
.5. can be folded to form cravats (broad cravat, semi-broad cravat or narrow broad). 2.
Square knot - use square knot in the ends of bandage.
.6. Rule in tying square knot: right end over left end then left end over right end (vice
versa)
.6. Advantages of square knot: - easy to tie and untie - it has a comfortable flat surface -
once secured, does not slip nor tightened or loosen.
HINDRANCES IN GIVING EMERGENCY CARE
1. Unfavorable surrounding
1. night time l. crowded city streets; churches; shopping mall l. busy
highways l. cold or rainy weather l. lack of necessary materials or helpers
2. The presence of crowds
3. crowds curiously watch, sometimes heckle, sometimes offer incorrect advice.
4. they may demand haste in transportation or attempt other improper procedures.
5. a good examination is difficult while a crowd look on.
6. Pressures from victims or relatives
3. The victim usually welcomes help, but if he is drunk, he is often hard to
examine and handle, and is often misleading in his response.
4. The hysteria of relatives or the victim, the evidence of pain, blood and
possible early death, exert great pressure on the first aider.
5. the first aider may fail to examine carefully and may be persuaded to do
what he would know in calm moments to be wrong.
The first aider can meet all these difficulties. Forewarned is forearmed. He should
remember that few cases demand haste, or good examination is important and can be
done slowly, and he has no other job or appointment as important and so gratifying as
saving a life or limb.
8. Skin to control body temperature and appreciate sensation.
9. Sense organs (the skin, ears, eyes, nose and tongue) to appreciate touch, pain,
and temperature, hearing balance, sight, smell and taste.
Thus, oxygen is obtained from the air which we breathe to the lungs. It then enters the
bloodstream and distributed to each cell of the body. Carbon dioxide is formed within
the cell and is carried by the blood to the lungs to be expelled during exhalation to the
air. The food we eat and the water we take is absorbed from the digestive system into
the blood. It is utilized by the cells, and waste products formed enter the blood and:
 go to the kidneys to be eliminated in the urine ,
 are passed into the lower bowel to be removed in the feces ,
 are converted to carbon dioxide and lost from the lungs.
THE NERVOUS SYSTEM
Controlling all activities of the body is the nervous system. It consist of the brain and
the spinal cord , with nerves distributed to all organs and tissues of the body. The brain
receives, coordinates and reacts to messages received from internal and external
sources but also stores information so that it can react from memory. It is also
responsible for the control of movements of voluntary muscles.
Motor Nerves : pass from the brain to the muscles of the body to control
movements. Injury to a motor nerve causes paralysis of the muscle supplied.
Sensory Nerve : Sense organs are situated in the eye, ear, skin, joints, tongue and
nose. Sensory nerves receive information from sense organ of sight, hearing, balance,
touch, pain, temperature, taste and smell. Sensory nerves lead from these organs to the
brain. Injury to sensory nerves leads to loss of function of the sense organ.
Damage may be caused to the nervous system by: l. Injury 2. Loss of blood supply 3.
Toxins
Abnormal function of the brain or spinal cord leads to: l. Unconsciousness 2. Paralysis
3. Malfunction
RESPIRATORY SYSTEM
l. Parts
l. Air Passages: l. Chest Cage: l. Diaphragm .l. nose and mouth .2. lungs .l. pharynx .2.
heart .l. larynx .2. ribs and their .l. trachea supports .l. bronchial tubes
2. Air Inspired and Expired:
Air we take in contains 21 percent oxygen and a trace of carbon dioxide approxi- mately
0 percent. For every breath, our body uses only 5 percent of oxygen we inspire to
sustain life and produces 4 percent carbon dioxide waste product. During expiration we
give off 4 percent carbon dioxide and l6 percent oxygen.
3. Process of Breathing:
When we breath, about 500 ml (l pint) of air is taken in ( inspiration ), the diaphragm
moves downward and the ribs upward and outward. This increases the volume of the
chest. A partial vacuum is created in the chest cavity, the lungs expand and the air is
sucked in through the mouth and the nose into the lungs. Normal breathing out
( expiration ) is produced by a relaxation of the chest wall and intercostal muscles and
moving up of the diaphragm. This forces air out of the lungs.
The amount of air supplied to the blood is controlled by a center in the brain at the base
of the skull and in the upper part of the spinal cord ( respiratory center ). This center
controls respiration by analyzing the carbon dioxide content of the blood it receives. Too
much carbon dioxide causes the center to respond by increasing the depth and rate of
the breathing and vice-versa.
The normal breathing rate for an adult at rest is from l2-l8 times per minute, and a
higher rate for children and infants at about l8-25 times per minute and if more oxygen
is required as in exercise, fever or in conditions which restrict the normal function of the
lungs such as pneumonia.
CIRCULATORY SYSTEM
The circulatory system of the body consist of the circulation of the blood through all the
extremities of the body, and it involves the heart, blood vessels, blood and lymph.
l. Parts
1. heart l. blood vessels l. blood
2. Functions 1 HEART The heart is a hollow muscular organ about the size of a fist,
lying between the lungs, behind the breastbone. It slants obliquely downward to
the left side of the chest.
Function as an electromuscular pump having a left and a right chamber, each subdi-
vided into a large and small chamber, provided with valves which aid in the correct
circula- tion of the blood. Heart (Pulse Rate): Adult - 60 - 90 beats/min. Child - 90 - l00
beats/min. Infant- l00 - l20 beats/min.
1 BLOOD
The blood is a red, sticky fluid circulating through the blood vessels, has a peculiar, faint
odor, salty in taste and it varies in color from bright scarlet to a bluish red.
Blood is composed of:
l. Red blood cells ( RBC ) (Erythrocytes) - transport oxygen to the tissues of the body
and carry carbon dioxide from the tissues to the lungs.
crossing the mid-groin and running toward each thigh and leg, where they become
known as the femoral.
DIGESTIVE SYSTEM
l. Parts l mouth l liver l stomach l salivary glands l gall bladder 1 intestine 1 pharynx l
pancreas 1 anus l esophagus l rectum
2. Functions
The food we eat is being chewed within the mouth. Three pairs of salivary glands are
located under the tongue, on each side of the lower jaw and on each cheek which
produce nearly l liters of saliva daily. The digestive enzyme in the saliva initiates the
digestion of starches. It also serve as a binder and as a lubricant. The food and water
we swallow pass the throat along the voice box.
A leaf-shaped valve covering the opening of the trachea is initiated so that liquids and
solids are move into the esophagus and away from the trachea. The contraction of the
muscle in the esophagus propel the food through it to the stomach. Liquids will pass
with very little assistance.
The stomach is located at the upper left quadrant of the abdominal cavity largely
protected by the lower ribs. Muscular contraction in the wall of the stomach and gastric
juice convert ingested food to a thoroughly mixed semisolid mass. The main function of
the stomach is to receive and store in the large quantity and provide for its movement
into the small bowel in regular small amounts. Poisoning or any reaction to trauma may
paralyze gastric muscular action thus causing prolong retention of food in the stomach.
Pepsin, a digestive enzyme, is produced in the stomach to initiate digestion of proteins.
The pancreas , a flat, solid organ, lies behind and below the liver and stomach. It
contains two kinds of glands. One set of glands secretes nearly 2 liters of pancreatic
juice daily. This juice contains many enzymes that help in the digestion of fat, starch
and pro- tein. It flows directly to the intestine through the pancreatic ducts. The other
kind of gland called the Islet of Langerhans secretes its products into the blood stream
across the capillaries. These islet produce a hormone that regulates the amount of
sugar in the blood. It is known as insulin.
The liver is located at the upper right quadrant beneath the diaphragm. It is the largest
solid organ in the abdomen and consequently one of the most often injured. It has
several functions. Poisonous substances produce by digestion are brought to the liver
by the blood and are rendered harmless. It also forms factors necessary for blood
clotting and for the production of normal plasma. It also produces between 0 to l liter of
bile to assist in the normal digestion of fat.
The liver is also the principal organ for the storage of sugar for immediate use of the
body. It also produces many of the factors that aid in the proper regulation of immune
responses.
The liver is connected to the intestine by the ducts. The gall bladder is an outpouching
of a bile duct that serve as a reservoir for produce in the liver. The presence of food in
the intestine triggers the contraction of the gall bladder to empty its content. It usually
contains 2-3 ounces of bile. When stone is formed at the gall bladder and pass into the
bile duct and causes obstruction, it will produce jaundice.
Intestine. Two kinds of intestine are the small and large. The small intestine is so
named because of its diameter in comparison with the large intestine. The small
intestine receives food from the stomach wherein secretions from the pancreas and liver
are mixed
with food for further digestion. It also produce more enzymes and mucus to aid in the
digestion.
Appendix is small tube that opens into the first part of the arge intestine in the right
lower quadrant of the abdomen. It is 3 to 4 inches long. It easily becomes obstructed
and as a result inflamed and infected. Appendicitis, which is the term for this
inflammation, is one of the major causes of severe abdominal distress. The appendix
has no major known function.
The spleen , a major solid organ, is smaller than the liver. It is found in the left upper
quadrant of the abdomen, just beneath the diaphragm. It is not required for life nor it is
associated with the functions of the digestive tract. It’s major function ies in the normal
production and destruction of blood cells. Its function, when removed, can be assumed
by the liver and bone marrow.

THE URINARY SYSTEM

1 l kidney l urinary bladder l ureters l urethra
2. The urinary system consist of two kidneys which act as filters to remove waste
products from the blood. These products are drained via the ureter into the bladder.
The bladder holds urine until it can be conveniently expelled from the body via the
urethra.
THE REPRODUCTIVE SYSTEM
l. Parts l male l female .l testicles .2 ovary .l vasa deferentia .2 fallopian tubes .l Seminal
vessels .2 uterus .l prostate gland .2 vagina .l urethra .l penis
2. Functions
In the male, fluids from the prostate gland and from the seminal vesicles mix during
intercourse. During intercourse, special mechanism in the nervous system prevent the
passage of urine into the urethra. Only seminal fluids, prostatic fluid and sperm pass
from the penis into the vagina during ejaculation.
In the female, the ovaries release a mature egg approximately every 28 days. The egg
travel through the fallopian tubes to the uterus to the vagina. The vagina receives the
sperm during intercourse, when semen and sperm are deposited in it. The sperm may
pass into the uterus and fertilize an egg, causing pregnancy. Should the pregnancy
come to completion at the end of nine months, the baby will pass through the vagina
and be born.
THE SKELETAL SYSTEM
The skeletal system is the framework of the body. It consist of 206 bones joined to each
other loosely or firmly by means of ligaments and muscles. The junction between bones
are called joints.
The main bony structure are:
1. the skull
2. the vertebrae
cating fluids which keeps the joint surfaces moist. The outer layer is made up of strong
fibrous tissues, thickened in certain areas to form ligaments.
The Ligaments
The ligaments are placed in such a way to bind the bones firmly together, without
restricting the normal range of movement of the particular joint.
The Muscles
Muscles are formed of tissues that allows body movement. There are more than 600
muscles in the human body, generally divided in three types.
l. Skeletal muscles are also called striated muscle. It is responsible to all body
movement resulting from contraction and relaxation.
2. Smooth muscles carry out much of the autonomic work of the body. It is also
known as involuntary muscles. It is found in the walls of most of the tubular
structures of the body. With its contraction and relaxation, it propels or controls
the flow of the contents of these structures along their course. Smooth muscle
respond only to primitive stimuli such stretching heat or the need to relieve
waste.
3. Cardiac muscle. The heart is a large muscle comprise of a pair pumps of equal
force - one of the lower and one of higher pressure. The heart must function
continuously from birth to death. It is a specially adapted involuntary muscles
with a very rich blood supply and its own intrinsic regulatory system.
Microscopically, it looks different from both skeletal and smooth muscles. Cardiac
muscle can tolerate an interruption of its blood supply for only a few seconds. It
requires a continues supply of oxygen and glucose for normal func- tion.
Because of its special structure and function, cardiac muscle is placed in a
separate category.
.
MODULE 3. EMERGENCY RESCUE AND TRANSFER
1. EMERGENCY RESCUE - is a procedure for moving a victim from unsafe place
to a place of safety.
2. Indications for Emergency Rescue.
2. Danger of fire or explosion.
3. Danger of toxic gases or asphyxia due to lack of oxygen.
4. Serious traffic hazards.
5. Risk of drowning.
6. Danger of electrocution.
7. Danger of collapsing walls.
3. Methods of Rescue
3. For immediate rescue without any assistance, drag or pull the victim in the
direction of the long axis of his body preferably from the shoulder. If
possible, minimize lifting or carrying the injured person before checking for
injuries --unless you are sure that there is no major fracture or involvement
of his neck or spine.
4. Most of the one-man drags/carries and other transfer methods can be
used as methods of rescue.
4. Objectives of the First Aider -pp2- When it is necessary to remove a person from
a life threatening situation, the objectives for the first aider are:
4. To ensure an open airway and to administer artificial respiration when it is
needed.
5. To control severe bleeding.
6. To check for injuries.
7. To immobilize injured parts before extrication of the victim.
8. To arrange for transportation.
9. To avoid subjecting the victim to any unnecessary disturbance.
TRANSFER
1. The first aider may need to initiate transfer of the victim to shelter, home or
medical aid. Skill in the use of simple techniques of transfer must be practiced
and selection and use of the correct method is necessary. Selection will depend
upon the following:
1. Nature and severity of the injury.
2. Size of the victim.
3. Physical capabilities of the first aider.
4. Number of personnel and equipment available.
5. Nature of evacuation route.
6. Distance to be covered.
7. Sex of the victim (last consideration).
2. Pointers to be Observed During Transfer
2. Victim’s airway must be maintained open.
3. Hemorrhage is controlled.
 4.Victim is safely maintained in the correct position.
5.Regular check of the victim’s condition is made.
6.Supporting bandages and dressing remain effectively applied.
7.The method of transfer is safe, comfortable and as speedy as
circumstances permit.
8. The victim’s body is moved as one unit.
9. The taller first aiders stay at the head side of the victim.
10. First aiders/bearers must observed ergonomics (proper body position
[back maintained straight] in lifting weights) in lifting and during transfer of
victim.
TRIAGE AND DISASTER MANAGEMENT
1. Disaster - a sudden and serious disruption of life caused by nature or humans
that create or threaten to create injuries to a number of persons or properties.
2. Three phases of response to a disaster
2. Alarm phase which is concerned with the immediate activation of
adequate and appropriate resources.
3. Work phase (or implementation phase) - it is sub-divided into four
overlapping steps: .2. locate - find or determine where the victim/s is/are—
.2. access - means of going to the victim/s .2. stabilize - life-threatening
cases are already given necessary care or victim is already out of
danger. .2. transport - transfer the victim to medical facility.
4. Let down phase - after the work is completed, all personnel must recover
from the stress of the disaster with Critical Incident Stress Debriefing
(CISD).
3. Triage - a process use in sorting patients/victims into categories of priority for
care and transport based on the severity of injuries and medical emergencies.
3. Highest priority o patients requiring immediate care and transport. o
airway and breathing difficulties o exsanguinating hemorrhage o open
chest or abdominal wounds o severe head injuries or head injuries with
decreasing level of consciousness o major or complicated burns o tension
pneumothorax o pericardial tamponade o impending shock- o
complicating severe medical problems, such as diabetes with
complications, cardiac disease, pregnancy
4. Intermediate priority - patients whose care/treatment and transportation
can be delayed temporarily. o burns without complications o back injuries
with or without spinal injuries o major, open or multiple fractures o eye
injuries o stable abdominal injuries
5. Delayed or low priority - (the walking wounded) patients whose care and
transportation can be delayed until last. o fracture and sprain o laceration
o soft tissue injuries o other lesser injuries
6. Lowest priority - patients/victims who are dead or near death. o
devastating injuries o little chance of survival (If resources are limited,
these patients must be ignored to enable these resources to be used on
“salvageable” patients.)
The cardinal rule of triage is to do the greatest good for the greatest number.
MODULE 4. SHOCK
Many lives have been lost due to shock, the body’s physiological reaction to major
physical or emotional insult. A tragic fact is that many of these deaths were
needless because proper preventive measures can eliminate or lessen the danger of
shock.
1. The Nature of Shock Shock is a word used in medicine to describe many varied
and often unrelated abnormal condition that affect both mind and body. The
meaning of the term may be clarified by mentioning a few classifications of shock
which the first aiders may not have considered.
2. Definition - Shock is a depressed condition of many body functions due to the
failure of enough blood to circulate throughout the body following serious injury.
3. Kinds of Shock
3. Cardiogenic shock
4. Anaphylactic shock
5. Hypovolemic shock or Hemorrhagic
6. Psychogenic shock or Emotional
7. Neurogenic shock
8. Metabolic shock
9. Respiratory shock
10. Septic shock
4. Basic Causes of Shock
4. Pump failure - the heart can be damaged by intensive muscular disease or
injury, so that it fails to act properly as a pump. It does not generate
sufficient energy to move blood through the system.
5. Relative hypovolemia - the blood vessels constituting the container can
dilate so that the blood within them even though it is of normal volume, is
insufficient to fill the system and provide efficient perfusion.
6. Hypovolemia - blood or plasma can be lost so that the volume of the fluid
contained within the vascular system is insufficient to perfuse all areas
well each minute.
5. Causes
5. Severe bleeding
6. Crushing injury
7. Infection
8. Heart attack
9. Perforation of stomach ulcer
10. Shell bomb and bullet wound
11. Rupture of tubal pregnancies
12. Anaphylaxis
13. Starvation and disease may also cause shock
6. Factors which contribute to shock
6. Pain
 7. Rough handling
8. Improper transfer
9. Continuous bleeding
10. Exposure to extreme cold or excessive heat
11. Fatigue
7. Dangers of shock
7. Lead to death
8. Predisposes body to infection
9. Lead to loss of body part
8. Signs and symptoms of shock
8. Early stage: .1. face - pale or cyanotic in color .1. skin - cold and
clammy .1. breathing - irregular .1. pulse - rapid and weak .1. nausea and
vomiting .1. weakness .1. thirsty
9. Late stage: .2. if the condition deteriorates, victim may become apathetic
or relatively unresponsive. .2. eyes will be sunken with vacant
expression. .2. pupils are dilated. .2. blood vessels may be congested
producing mottled appearances. .2. blood pressure has very low level. .2.
unconsciousness may occur, body temperature falls.
9. Objectives of First Aid
9. To improve circulation of the blood.
10. To ensure an adequate supply of oxygen.
11. To maintain normal body temperature.
10. First Aid and preventive management for shock
10. Proper Position .1. keep the victim lying down flat. .1. elevate the lower
part of the body a foot or so, if injury is severe from eight to twelve inches
high. Observe. .1. place the victim who is having difficulty in breathing, on
his back, with his head and shoulder raised. .1. head Injury - apply
pressure on the injury and keep the victim lying flat. Do not elevate head
or lower extremities. When color of the face return to normal, elevate head
and shoulder and continue giving care to the injury. In chest injury, raise
the head and shoulder slightly. .1. symptoms of nausea and vomiting or
unconsciousness keep the victim lying on one side preferably opposite
from his injury except for sucking wound and stroke. The position is known
as recovery, coma or lateral position.
11. Proper body heat .2. maintain body temperature and victim must not be
perspiring nor chilling. .2. if the weather is warm, the victim need not to be
covered. .2. if victim is cold, inspite of the weather, a blanket may be
placed underneath him and cover the body.
NOTE: Do not give anything by mouth including water. If medical care is delayed and
patient is complaining of intense thirst, you may wet his/her lips.
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