Learner Guide

HLTAID001 Provide CPR

HLTAID003 Provide First
Aid
Contents
Introduction ..................................................................................................................................................................... 5
First Aid and Emergencies ................................................................................................................................................ 5
What is an Emergency? ........................................................................................................................................................ 5
Principles of First Aid ........................................................................................................................................................ 6
Legal, Workplace and Community Factors ........................................................................................................................ 6
Duty of Care .......................................................................................................................................................................... 7
WHS Legislation and Guidelines ........................................................................................................................................... 7
Consent ................................................................................................................................................................................. 8
Showing Respect................................................................................................................................................................... 8
Negligence and Litigation ..................................................................................................................................................... 8
Privacy and Confidentiality ................................................................................................................................................... 9
Your First Aid Skills and Limits .............................................................................................................................................. 9
Stress Management and Debriefing ................................................................................................................................... 10
Risk Management........................................................................................................................................................... 10
Identify Hazards .................................................................................................................................................................. 10
Minimise Risk ...................................................................................................................................................................... 10
Isolate Hazards ................................................................................................................................................................... 11
Assess the Scene and Casualty ....................................................................................................................................... 11
Initial Assessment ............................................................................................................................................................... 11
Survey the Scene ................................................................................................................................................................ 11
Primary Survey.................................................................................................................................................................... 12
Secondary Survey ............................................................................................................................................................... 13
Triage .................................................................................................................................................................................. 14
Reassure the Casualty......................................................................................................................................................... 14
Make the Casualty Comfortable ......................................................................................................................................... 14
Maintain Hygiene ............................................................................................................................................................... 15
Use Manual Handling Techniques .................................................................................................................................. 16
Provide First Aid Management ....................................................................................................................................... 17
Correctly Operate First Aid Equipment .............................................................................................................................. 17
DRSABCD Action Plan ..................................................................................................................................................... 18
D – Dangers ........................................................................................................................................................................ 19
R – Responsive .................................................................................................................................................................... 19
S – Send for Help ................................................................................................................................................................ 19
A – Open Airway ................................................................................................................................................................. 20
The Recovery Position ........................................................................................................................................................ 20
B – Normal Breathing ......................................................................................................................................................... 21
C – Start CPR ....................................................................................................................................................................... 21
Rescue Breaths ................................................................................................................................................................... 24
Infant and Child CPR ........................................................................................................................................................... 25
Rotating CPR Operators ...................................................................................................................................................... 25
Stopping CPR ...................................................................................................................................................................... 26
D – Attach Defibrillator ....................................................................................................................................................... 26

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Shock.............................................................................................................................................................................. 27
Chest Pain ...................................................................................................................................................................... 28
Heart Attack........................................................................................................................................................................ 28
Sudden Cardiac Arrest ........................................................................................................................................................ 29
The Chain of Survival ...................................................................................................................................................... 29
Angina ................................................................................................................................................................................. 30
Congestive Heart Failure .................................................................................................................................................... 30
Drowning........................................................................................................................................................................ 31
Skeletal Injuries .............................................................................................................................................................. 31
Head, Neck and Spinal Injuries ........................................................................................................................................... 31
Fractures and Breaks ...................................................................................................................................................... 32
Dislocations .................................................................................................................................................................... 33
Immobilisation/Slinging ...................................................................................................................................................... 34
Common Body Splint/Slinging Techniques ......................................................................................................................... 35
Altered Consciousness .................................................................................................................................................... 35
Head Injuries .................................................................................................................................................................. 36
Concussion ..................................................................................................................................................................... 36
Stroke ............................................................................................................................................................................. 37
Seizures .......................................................................................................................................................................... 38
Febrile Convulsions............................................................................................................................................................. 39
Diabetic Emergencies ..................................................................................................................................................... 39
Low Blood Sugar/Hypoglycaemia ....................................................................................................................................... 39
High Blood Sugar/Hyperglycaemia ................................................................................................................................. 40
Fainting ............................................................................................................................................................................... 41
Respiratory Distress/Conditions ..................................................................................................................................... 41
Asthma Attack .................................................................................................................................................................... 41
Severe Allergic Reactions ............................................................................................................................................... 42
Hyperventilation ............................................................................................................................................................ 43
Choking .......................................................................................................................................................................... 44
Bleeding, Wounds and Injuries ....................................................................................................................................... 45
Bleeding .............................................................................................................................................................................. 45
Internal Bleeding ................................................................................................................................................................ 45
External Bleeding/Haemorrhaging ..................................................................................................................................... 46
Wounds and Injuries ........................................................................................................................................................... 47
Nose Wounds ..................................................................................................................................................................... 48
Abdominal Injuries ............................................................................................................................................................. 48
Crush Injuries ...................................................................................................................................................................... 49
Scalp Wounds ..................................................................................................................................................................... 49
Eye Injuries ..................................................................................................................................................................... 50
Ear Injuries ..................................................................................................................................................................... 51
Needle Stick Injuries ....................................................................................................................................................... 51
Sprains and Strains ......................................................................................................................................................... 52
Compression with a Roller Bandage ................................................................................................................................... 52
Figure-of-Eight Technique.................................................................................................................................................. 53

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Burns .............................................................................................................................................................................. 54
Heat Burns .......................................................................................................................................................................... 54
Chemical Burns ................................................................................................................................................................... 54
Electrical Burns/Shock ........................................................................................................................................................ 55
Environmental Impact .................................................................................................................................................... 55
Hypothermia ....................................................................................................................................................................... 55
Hyperthermia ..................................................................................................................................................................... 56
Heat Exhaustion.................................................................................................................................................................. 56
Heat Stroke ......................................................................................................................................................................... 57
Envenomation ................................................................................................................................................................ 57
Insect Bites and Stings ........................................................................................................................................................ 57
Spider Bites ......................................................................................................................................................................... 58
Snake Bite ........................................................................................................................................................................... 59
Marine Bites and Stings .................................................................................................................................................. 60
Bluebottle & Non-Box Jellyfish ........................................................................................................................................... 60
Box Jellyfish ........................................................................................................................................................................ 61
Blue-Ringed Octopus & Cone Shell ..................................................................................................................................... 61
Stonefish, Bull Rout & Stingray ........................................................................................................................................... 62
Poisons ........................................................................................................................................................................... 62
Substance Misuse – Alcohol & Other Drugs .................................................................................................................... 64
Monitor and Respond to Casualty’s Condition ............................................................................................................... 65
Finalise First Aid Treatment ............................................................................................................................................ 65
Providing Assistance ........................................................................................................................................................... 66
Reporting Incident Details .................................................................................................................................................. 66
Reporting to Supervisors .................................................................................................................................................... 67
Maintaining Confidentiality ................................................................................................................................................ 67
Evaluate Your Performance ............................................................................................................................................ 67
Recognising Psychological Impacts ..................................................................................................................................... 68
Dealing with Stress ............................................................................................................................................................. 68
Debriefing and Self-Evaluation ........................................................................................................................................... 68
Basic Anatomy and Physiology ....................................................................................................................................... 69
Appendix A – First Aid/Incident Report Form ................................................................................................................. 71

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Introduction
This training course is based on the unit of competency HLTAID001 Provide cardiopulmonary resuscitation and
HLTAID003 Provide First Aid.

This course describes the skills and knowledge required by a worker to provide a first aid response to a casualty in a range
of situations including community and workplace settings.

First Aid and Emergencies

The basic principles and concepts of first aid are to:

➢ Relieve pain and suffering.

➢ Avoid further illness or injury or worsening of illness or injury.

➢ Protect individuals who are unconscious.

➢ Encourage recovery.

➢ Prevent or reduce disability.

➢ Save lives.

Through First Aid training you will learn the skills you need to respond to a medical emergency, so you can save lives and
reduce pain and injury until qualified medical help takes over.

What is an Emergency?
An emergency is a situation where there is an immediate risk to health, life, property
or environment and urgent action is needed to try to stop the situation from getting
worse.

A situation can only be defined as an emergency if one or more of the following are
present:

➢ Immediate threat to life, health, property or environment.

➢ Loss of life, health detriments, property damage or environmental damage.
➢ A high probability of escalation to cause immediate danger to life, health, property or environment.

It is important that you know and look out for signs of possible emergencies. Sometimes it can be hard to identify an
emergency – using all your senses may help. Signs may include unusual noises, sights, smells and behaviours such as:

➢ Alarms and sirens, moaning, crying or yelling and sounds of breakage, crashing or falling.
➢ Stalled or crashed vehicle, spilled medications and other items, a person collapsed on the floor or who seems to
be confused, in pain or having trouble breathing.
➢ Different or stronger smells than usual (be very careful in these situations as any fumes may be poisonous).

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Principles of First Aid
When you are providing first aid it is important to understand the
established first aid principles.

The 4 principles are:

1. Preserve life.

2. Prevent illness, injury and condition(s) becoming worse.

3. Promote recovery.

4. Protect the unconscious casualty.

The principles of First Aid are built into the Australian Resuscitation Council (ARC) guidelines, which tell you how
to provide first aid.

➢ These guidelines are about:

➢ First aid management of injuries.

➢ The basic life support system “DRS ABCD”.

➢ First aid training requirements.

➢ Following the ARC guidelines will also help you to meet legal obligations relating
to providing first aid.

Legal, Workplace and Community Factors

As someone who is trained in first aid there are a number of legal, workplace and
community factors you need to think about.

The information here is meant as a guide – always make sure that you are familiar
with the particular requirements of your state/territory and organisation.

Being trained in first aid doesn’t mean you can be forced to attempt a first aid rescue
in an emergency situation. You can observe or walk away from the scene, though this
is not encouraged. You should always do what you can to help someone in need. You
should also remember to keep yourself safe and well.

Legal, workplace and community factors you need to consider include:

➢ Duty of care requirements.

➢ Consent.
➢ Respectful behaviour towards a casualty.
➢ Privacy and confidentiality requirements.
➢ Your own skills and limitations.
➢ The need for stress-management techniques and available support following an emergency
situation.
➢ The importance of debriefing.

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The Code of Practice for first aid requires all employers to ensure that their nominated first aiders attend training on a
regular basis to remain current in their skills.

Refresher training in CPR should be undertaken annually. First aid qualifications should be renewed every three years to
keep skills current. Any training that lapses past these periods is considered to be out of date.

Duty of Care
Once you start providing first aid the law says you must continue until:

➢ Vital signs return.

➢ Paramedic assistance arrives from emergency response services.

➢ Exhaustion makes it impossible to continue.

➢ Authorised personnel declare the casualty as officially deceased.

This legal obligation to care is known as ‘duty of care’.

Duty of care means that you must take reasonable steps to ensure your actions don’t knowingly cause harm to another
individual. In a first aid situation you don’t legally have to provide treatment, unless you have a previous duty of care to
the injured person.

Some examples of where a duty of care to provide first aid exists include cases where:

➢ You are a worker who is trained, qualified and designated as a first aid officer
in a company and you have a duty of care to provide first aid to workers in
the company.

➢ You are responsible for the person injured.

➢ You are an official first aid volunteer at a public event.

➢ You have started giving first aid in an emergency.

In a situation where you have started first aid, under duty of care you can’t then stop unless a medical practitioner or a
person with better qualifications takes over. Your duty of care is to do everything reasonable given the situation.

If you are unable to hand the casualty over to a medical practitioner, you should always advise the individual to seek
professional medical assistance/advice.

In the workplace duty of care is also affected by Work Health & Safety (WHS) legislation.

WHS Legislation and Guidelines

WHS legislation are the laws and guidelines designed to help keep your workplace safe.

It is important that you are familiar with the WHS laws that exist in your state or territory.

WHS legislation and regulations outline the responsibilities of a person conducting a business or undertaking (PCBUs) to
provide first aid facilities and workers trained in first aid. The regulations may also detail the requirements of first aid kits
and facilities based on the size of the organisation and the type of work environment.

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WHS guidelines for preventing accidents in the workplace should be found in the company’s polices and standard
operating procedures. It should have procedures on how to deal with a workplace accident.

It may include instructions on how to use Personal Protective Equipment (PPE), which can prevent infection spreading. If
in doubt about following any of the procedures and guidelines contained in the company’s WHS manual talk to the WHS
officer.

WHS guidelines must be followed at all times to ensure the safety of all workers.

Consent
If you decide to go ahead with first aid, you must try to get consent from the casualty, and stop if they ask you to.

If the person doesn’t give consent and you touch them, or they think you will touch them you could be charged with
assault or battery. You may not always be able to get consent from an injured person, as they may be unable to
communicate and/or unconscious.

In these cases, the law assumes that the person would have consented if they had been able to, but only if their life
and/or future health was in danger.

Where the injured person is a minor (child) you should get consent from the child’s
parent or guardian.

If they are not available, it can be assumed that consent for first aid would be given.

If you can’t be sure that the injured individual has consented to receive first aid you
may go ahead with the treatment if there is no outright refusal of assistance.

If the casualty is well enough to speak, ask them if it is all right if you touch them or
move them. Think about how you would like to be treated if you were hurt and
scared and treat the casualty the same way.

Showing Respect
It is important to be aware that individuals may have differing views and beliefs
regarding receiving medical or first aid treatment. These may relate to cultural, religious
or personal beliefs and customs.

Your first aid skills should be applied to the casualty in a way that doesn’t force first aid
procedures and respects the individual’s beliefs. You should follow the guidelines for
consent with every individual.

Also check the casualty for medical identification tags such as a bracelet or necklace.
These will give you information like the name of the casualty, emergency contact, medical illnesses, allergies, and even
what medical treatment they would refuse.

Negligence and Litigation

Most casualties are grateful for receiving first aid, but sometimes a person might take their rescuer to court for
negligence. This should only happen if you are not trained, qualified or authorised to carry out first aid.

The threat of negligence should not stop you from trying to help. The Good Samaritans (or Civil Liability) Act aims to
protect anyone who is trained to perform first aid from being sued on the grounds of negligence if something goes wrong
and the casualty ends up with injuries caused by the actions of the first aider.

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Privacy and Confidentiality
It is important to keep records of emergencies and injuries, including what happened
and how it was addressed. Record keeping, and reporting requirements can vary
between states and territories, industries and organisations.

If you are acting as a first aid officer in your workplace, make sure you follow the
specific recording guidelines and procedures. Records should be made and kept for
every workplace first aid incident, with copies provided to the organisation.

If providing first aid outside of the workplace you should make a record of the event,
or at least keep notes about the first aid you gave.

Records should be clear and concise as they may be used as a legal document in court. Make sure that any first aid records
are accurate, factual and only include your observations and actions, not your opinions.

You should also be aware of privacy and confidentiality legislation. This protects medical data from being circulated to the
general public and ensures it is only handled by authorised workers and on a ‘need to know’ basis.

Each organisation will have policies and procedures for safeguarding sensitive medical information, including first aid
details. Remember, if any patient information is leaked there are serious consequences and legal action could be taken.

Your First Aid Skills and Limits

Paramedics have advanced skills in first aid and when they arrive to treat the
casualty, they can apply advanced life support procedures that they are qualified
to administer.

As a first aider you are not expected to be an expert.

Your role in providing first aid is to respond promptly, be able to prioritise and be
proactive in applying the principles of first aid management.

Be aware of your own personal limitations including:

It is also a good idea to keep trying to improve your first aid skills. Your organisation might provide training, so you can
keep your skills up to date. You could also do your own reading and research. There will always be something that you can
learn and therefore be a more effective first aider.

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Stress Management and Debriefing
Being involved in a first aid incident can be a high-stress situation for many people.

After an emergency you should take part in any debriefing sessions or stress
management support offered by your organisation.

Talking about what happened and what you did, and sharing experiences with
others, will help you to cope with any stress or anxiety you may be going through.

It could also help you and others to improve the way first aid duties are carried out.

Risk Management
Before you start first aid treatment you need to check for any hazards or dangers in the
area. If you find a hazard or danger you need to do something to control it.

This will help to make the emergency situation safer.

Identify Hazards
Following an accident, there may be a range of hazards at the scene.

A HAZARD is the thing or situation that causes injury, harm or damage.

Use all of your senses to check for hazards. Can you see, smell or hear anything that
could be hazardous?

You should also talk to other people at the scene about any hazards they might have
found.

Minimise Risk
Once you know what the hazards and risks are, they
will need to be controlled.

Control measures could include:

• Using protective equipment.

• Eliminating or removing the hazard.

• Isolating the casualty from the hazard.

• Maintaining hygiene.

• Using safe manual handling techniques.

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Isolate Hazards
You can isolate hazards to yourself and others by:

• Asking people not involved in the treatment process to make space

and/or leave the scene of the accident.

• Moving the casualty to a place that doesn’t have any hazards.

You must always act quickly to make the situation as safe as possible. Your own safety is
most important in any situation, so it is important to reduce risks as much as possible.

You need to also make sure the process doesn’t take so long that the casualty is worse off
for lack of treatment.

Refer to the first aid or emergency response plan for information on how to act in order
to resolve the situation as quickly and effectively as possible.

Where possible get the people around you to help out with controlling hazards, provided
they are trained to do so.

Assess the Scene and Casualty

Before you start any first aid treatment you must assess the scene for any hazards or risks to yourself, the casualty and
others. You also need to assess the casualty. This is so you can be sure about how to treat them.

The Emergency Action Process can be followed to help you plan your response to an emergency and in providing first aid.
These steps are:

Initial Assessment
Once you arrive at the scene of an emergency, it’s vital to do a thorough initial assessment of the scene.

Survey the Scene

The first stage in the initial assessment is to survey the scene of the emergency.

This will help you to see the type of accident and any immediate risks/hazards to
the casualty, bystanders and treating workers.

Make sure you are not placing yourself at risk by trying to provide first aid.

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While you are surveying the scene, you might come across some barriers to action. These barriers may be in the form of:

Possible Barriers: Description:

You might feel embarrassed performing first aid in front of others
Presence of Bystanders
or you may assume someone else will be doing it.
The injured person may be a stranger, older, younger, different
Uncertainty about the
gender or race. You should provide assistance anyway even it is
Person
only by calling ‘000’.
The emergency may be unpleasant or confronting (blood, vomit
Nature of the
etc.). Still try to do as much as possible. If needed take a moment
Illness/Injury
to collect yourself but remember – it is still an emergency.
Fear of Disease The risk of disease transmission is actually quite small. If you take
Transmission appropriate precautions, you can greatly reduce the risks.
As long as you do everything reasonably possible and follow your
Fear of Doing Something
duty of care you shouldn’t worry about making an error. Some
Wrong
first aid is better than no first aid.

Primary Survey
The next stage in the initial assessment is to assess the casualty to work out how much and what sort of emergency care is
needed.

This is called a primary survey because it involves looking for any signs that the casualty is
in a life-threatening situation and if you may have to get help from emergency response
personnel.

The 4 points you should check in a primary survey are:

1. State of consciousness.

2. Airways.

3. Signs of life.

4. Severe bleeding.

Common questions that should be in a primary survey include:

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Vital signs are used to measure the condition of the casualty. The vital signs are:

• Conscious state.

• Pulse (or heart rate).

• Breathing.

• Skin colour and appearance.

These vital signs must be constantly checked as they can change very quickly. Keeping up
with any changes can often mean the difference between life and death.

You could also use the “DRS ABCD” method to guide you in a primary survey. Do not proceed with a secondary survey if
the casualty has a life-threatening condition.

Secondary Survey
A secondary survey is done if the initial assessment found no life-threatening conditions. It assesses the casualty more
closely for signs such as cuts, burns, bruising, swelling, puncture wounds and anything out of place (misuse of drugs).

It involves carefully checking the casualty from head to toe.

To do the secondary survey follow these 3 steps:

Throughout the survey keep monitoring the person’s signs of life. Stop the survey if any problems begin to develop and
immediately start first aid.

All information from the survey must be carefully collected, ready to be passed on to emergency response services
personnel and your supervisor.
You must then put these assessments together to work out the appropriate course of action and care required by the
casualty.

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Triage
If it is a major incident and there are a lot of casualties
to treat, you need to prioritise treatment. Start with
the casualties with the worst injuries.

This process is called ‘triage’.

Triage means deciding who to help first. This will give

the most people the best chance of surviving the
incident.

At the incident scene you or someone else must quickly

call for an ambulance or other emergency response
services. The numbers to call are:

Reassure the Casualty

The casualty could be anxious, agitated and in a lot of pain so you need to be calm, respectful
and comforting.

To reassure the casualty you should:

• Make a personal introduction.

• Show empathy.
• Maintain constant communication with the casualty.
• Adopt a caring voice tone and volume.
• Offer reassurance and gentle treatment in a culturally appropriate
manner.

If the casualty is conscious talk to them gently, without raising your voice or
shaking them. If they are badly hurt, be honest but try not to scare them.

To make the casualty feel at ease it’s important to give them information about what has happened, when it happened
and what you are going to do to help them.

For example, if the person has had a car accident, tell them, “Your car rolled over and you’ve been injured for 2 hours
now”.

Once you are sure that an ambulance is arriving, you could say, “Don’t worry, an ambulance will be coming soon to take
you to a hospital.”

Use words to reassure the casualty and it may help to speak slowly and calmly. Be honest with the casualty about how you
are going to help them.

Make the Casualty Comfortable

You need to make the casualty as comfortable as you can until emergency
services arrive. This could mean moving them to a sheltered place out of the
sun, rain, wind or cold. You could use coats, blankets or other things to keep
them warm or shaded. If there is a head injury you could support their head
and neck with a pillow or some other sort of padding.

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Pain management is important in keeping a casualty comfortable during first aid.

You need to find out where the pain is coming from and how bad it is.
This is part of the primary and secondary survey of the casualty.

Remember that some people may not express their pain clearly.
It could be worse than it seems.

Ask the person the questions pictured here.

Some general techniques you could use to manage the pain include:

• Offering reassurance.

• Putting the person in a more comfortable position and/or

supporting or immobilising the injured body part.

• Helping to maintain the casualty’s dignity and privacy – help

clean them up and cover exposed body parts if possible.

• Managing the environment – controlling onlookers, lighting and noise

levels and adjust heating or cooling if possible.

• Distracting and relaxing the person – talking to them and encouraging

them to stay calm and breathe slowly may help. Stop talking if they
seem upset or annoyed with you.

• Helping the person take their prescribed medications (e.g. heart tablets) but you shouldn’t give analgesics (pain
relief drugs).

Remember: Assess the pain regularly while waiting for medical help. A person in pain may go into shock – look out for
signs of this and give the appropriate treatment.

Maintain Hygiene
As a first aider you could come into contact with human blood and bodily fluids like saliva. These can carry viruses or
bacteria, which cause diseases. You therefore need to pay attention to proper hygiene and standard infection control
procedures.

Standard infection control procedures may include:

• Wearing protective gloves to maintain personal hygiene and to act as a physical barrier between you and the
casualty.

• Covering any cuts, abrasions or skin conditions you may have.

• Cleaning away blood and other bodily fluids. If the person is bleeding and you
haven’t got any gloves or other protection you could ask them to help by applying
direct pressure to the wound or placing a dressing or other clean cloth between
your hand and the wound.

• Not touching your face, especially your mouth, ears and eyes. Also avoid eating
and drinking.

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 • Washing your hands thoroughly. Use soap and water or an antibacterial hand gel,
both before and after providing first aid, even if gloves were used.

• Disposing of contaminated waste in biohazard containers. If these are not available

put waste in a leak-proof/sealable bag or container and dispose of it carefully.

• Correctly disposing of contaminated sharp objects (such as needles). If possible, use

tongs to pick them up and put them into the ‘sharps’ container.

• Using a protective mask and following infection control best practice (ARC guidelines 9.6.2) before you perform
resuscitation.

• It is your responsibility to maintain the highest standards of personal hygiene while you are providing first aid.
This will help to protect you and the casualty.

Use Manual Handling Techniques

You may need to move a casualty away from hazards in the area or to make it easier to
get to them for treatment. First check with the casualty to make sure they are
comfortable about being moved and explain what you are going to do.

To make sure you don’t hurt yourself or the patient you should use techniques for safe
manual handling. You should always bend your knees and not your back when lifting.
This will help to avoid straining your back.

Understand your own limitations and strength. If you can, get somebody to help you to
move the casualty. Don’t hurt yourself in the process – you could cause further harm if
you drop the person.

Be careful not to twist or bend the casualty’s neck and back as this could make their injuries worse.

If it looks like any movement is hurting them, stop.

There are different ways to move the casualty and you need to plan how you are going to do it.

In planning the move, you should think about:

• The size of the casualty.

• The condition of the casualty.

• The conditions at the scene.

• Your physical strength and ability.

• Getting other people to help you.

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Provide First Aid Management
To be a good first aider you need to study, learn and be trained in first aid management. You need to be able to recognise
and manage life-threatening illnesses and injuries like loss of consciousness, heart conditions, allergies, bleeding, bites and
many more.

This information will be available in your organisation’s emergency and first aid policies and procedures. You can also find
useful and up to date information about first aid procedures and training for responding to emergencies from the
Australian Resuscitation Council (ARC) guidelines.

The council’s website link is http://www.resus.org.au.

As a first aider you need these skills to:

• Save lives.

• Stop further injury and prevent the condition worsening.

• Promote recovery and healing.

You also need to communicate clearly and firmly. Make sure other people understand
what you mean and get them to repeat any instruction back to you.

Correctly Operate First Aid Equipment

There is a large range of first aid equipment you can use to treat a casualty.

First aid equipment may include:

Always follow workplace procedures

and the manufacturer’s instructions
for using first aid equipment.

If you aren’t sure about something,

check the instructions or talk to your
supervisor.

You might also be able to get some

training.

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DRSABCD Action Plan
A very important part of emergency first aid treatment is the ARC’s ‘Basic Life Support’ chart. It shows the “DRS ABCD”
process for performing resuscitation or CPR.

You should follow these ARC guidelines for each stage of the “DRS ABCD” process.

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D – Dangers
Check the surrounding area and make sure it’s safe for you, the injured person and
others in the area. Do this by looking, listening and smelling.

If the casualty is in immediate danger you should move them, but only if it is safe to do
so. Try to lift or move the person in a way that won’t hurt them more and remember to
protect yourself from back strain or other injuries.

R – Responsive
Check the patient’s responses by talking and touching them
(Squeezing their shoulders).
This is referred to as the “Talk and Touch Method”. You may say:

If the patient responds they are conscious, breathing and have a

pulse. Make them comfortable and check them for any injuries
using the secondary survey technique.

Call for help if required and keep monitoring them for at least 10-
15 minutes before letting them move.

If you don’t get a response call 000 immediately.

A person who doesn’t respond is unconscious. This is potentially life threatening as they could choke, their breathing
might stop, or they could bleed to death.

S – Send for Help

Dial for an ambulance or medical assistance as soon as possible.

When speaking on the phone, try your best to

stay calm, speak clearly to the telephone
operator and try to answer all the questions as
best you can.

You might need to borrow a bystander’s mobile

phone to call 000 or 112. If possible, ask them to
make the call while you stay with the casualty
and treat them. If you are alone, you should
shout for help. If no one comes, start CPR
straight away.

In an emergency at work you could ask your colleagues, supervisors or anybody close by to help. Someone might be able
to take over the treatment if you get tired doing CPR.

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When calling emergency services (by dialling 000) let the operator know the following details:

• Where and when the emergency happened – the exact address/location, including
city/town, nearby crossroads/main roads, landmarks, building name, floor, room
number as applicable. The more details the caller can provide the easier it will be
for emergency response services personnel to find you.

• What happened – car accident, fall, drowning etc., how many people are involved
and the condition of the casualty/s (bleeding, unconscious, chest pain etc.).

• What is being done – details of the first aid that is being/has been provided so far.

• Who you are and the number you are calling from – in case the call is dropped.

• Who the casualty is, if known.

• DO NOT hang up the phone until you have been given instructions on how to proceed.

A – Open Airway
The next step is to check that the casualty’s airway is clear so that their breathing is not
obstructed (blocked).

To check their airway, use the head tilt/chin lift technique as this helps lift the tongue from
the back of the throat.

One hand is placed on the casualty’s forehead to tilt the head back while the fingers of the
other hand are placed on the bony part of the chin to lift it up and outward.

The mouth should then be gently opened by pulling down on the jaw to check for any
obstruction. If there is any foreign material present, you should move the casualty into the
recovery position and allow the material to drain from the mouth. This should also be the action taken if the casualty
vomits/regurgitates.

An open airway is the most important thing, even if you think the casualty has a spinal injury.

The Recovery Position

This is the best position for a casualty who is unconscious and breathing. It keeps their airway open and allows any vomit
to drain onto the floor, so they don't choke on it. It is important that the casualty is put into the recovery position, as it will
prevent asphyxiation due to body position.

1. Kneel beside the person – they should still be on their back.

2. Place the person’s arm furthest from you across their chest, with
the back of their hand against their cheek or on the opposite
shoulder.

3. Position the arm that is closest to you at a right angle to their body along the ground.

4. Lift the leg that is furthest from you so that it is bent at the knee with the foot still on the floor.

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 5. Holding behind the bent knee, gently roll the person
toward you by pulling the bent knee over to the ground,
until they are positioned on their side.

6. Keep the upper leg at a right angle, with the knee

touching the ground to prevent the person from rolling
onto their front.

7. Ensure the mouth is open using the head tilt/chin lift method
and turn the head slightly downward so that fluid can drain out.

8. If necessary remove any visible blockages with your fingers,

although be careful not to probe deeply as you may push material
further down the throat, blocking it or causing damage.

You may need to continue to support the person’s jaw to keep an open
airway. You can do this using a ‘pistol grip’, which involves putting your thumb and forefinger just above the jawbone and
opening the mouth slightly.

B – Normal Breathing
While keeping the airways open, look, listen and feel for normal breathing signs. This is
often easier to do when the injured person is on their back but can also be done while
they are in the recovery position

For a full 3-5 seconds you should position yourself so that you can hear and feel if air is
escaping from the nose and mouth. Also watch the chest and abdomen to see if they rise
and fall with air movement.

If the casualty is breathing normally, position them in the recovery position and again
check their airway and head position.

Check their airway after one minute and then every two minutes.

If you or someone else has not called for emergency services do so now, while continuing
to check the airway and vital signs until they arrive.

If the casualty is NOT breathing normally and there are no signs of life, then you will need
to begin CPR.

C – Start CPR
Cardiopulmonary Resuscitation (CPR) is the name given to the technique of combining
rescue breaths with external cardiac compressions.

When CPR is applied to the casualty, body systems such as the brain and the heart are
affected as oxygen is being pumped into the blood through the circulatory system.

CPR can save lives or increase the chance of survival for the casualty until qualified
medical help takes over.

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You can check if CPR is needed by looking for signs of collapse or a life-threatening
situation such as stopped breathing, no pulse and unconsciousness. If there is no
response or vital signs are missing, then you should start CPR immediately.

The initial assessment is very important. If the casualty has been assessed to be in a
life and death situation appropriate life saving strategies are urgently needed.

For example, if the initial assessment revealed a sudden cardiac arrest, the chain of
survival should be used. If the casualty was found unconscious and not breathing
properly, then CPR could be performed.

If CPR is not done quickly the casualty won’t have enough oxygen. This could cause
brain damage and death.

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CPR consists of 30 chest compressions and 2 rescue breaths. Follow these directions when administering CPR:

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Rescue Breaths
After every 30 compressions you need to deliver 2 rescue breaths. To do this:

When performing rescue breaths on infants, children or individuals with firmly

closed jaws, a mouth-to-nose technique can be used.

Remember to give smaller breaths to infants and children as they have smaller lung
capacities. Whenever possible use a resuscitation mask.

If signs of life return – consciousness, normal breathing, moving – place the person in
the recovery position.

It is more important that CPR is not interrupted too often to check for signs of life as
regular checking has been shown to reduce survival rates.

If you are unwilling to give mouth-to-mouth, you should at least continue to

administer chest compressions – any resuscitation is better than none.

DO NOT STOP until emergency help arrives.

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Infant and Child CPR
When giving CPR to infants (under 1 year old) and children the same process as for adult CPR should be followed.

You can use the same techniques on children, however administering CPR on infant requires some adaptions:

• Opening the airway using the head tilt – chin lift manoeuvre. Be careful
when using this on infants. Their airway can be easily obstructed due to the
smaller diameter and their soft windpipe. If the head is tilted back too far the
airway can become compressed and narrowed. The ARC suggests the head
position should be kept neutral, using the chin lift first, with only a slight
backwards head tilt if needed. DO NOT use maximum head tilt.

• Compressions. For infant compressions the ARC guidelines suggest only using
2 fingers, while still aiming to have the depth of compressions reach about
1/3 of the chest depth.

• Rescue breaths. Smaller breaths should be used. You may need to cover the
infant’s mouth AND nose with your mouth when administering the breaths to
ensure a tight seal.

The same compression to breaths ratio should be followed for all casualties (30 compressions to 2 rescue breaths).

When carrying out compressions on children you can choose whether to use one or two hands (as with adults).
Compressions on smaller children may require less force to reach the appropriate depth.

Rotating CPR Operators

Administering CPR can be very tiring, especially chest compressions, and as a result the quality of the compressions can
get worse and be less effective over time as the first aider becomes tired.

If there is another first aider available then, to help maintain the quality and effectiveness of CPR compressions, it is
suggested that the person doing the compressions is rotated every 2 minutes. If rotations are made more frequently the
effectiveness of the CPR can be reduced due to the interruptions.

You should try to make the changeover as quickly as possible. This can be achieved in a number of ways:

• Have the people rotating compressions on opposite sides of the casualty –

One can be ready and waiting to swap as soon and the one doing the
compressions stops.

• Make the swap during other interruptions – for example, when the AED is
being administered.

• Have someone counting out loud or counting down to when the changeover
should occur – everyone will know when it is to happen and be in position at
the right time.

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Stopping CPR
You should only stop CPR if:

• Emergency response personnel arrive and take over.

• You are physically unable to continue.
• It is unsafe to do so.
• The person starts moving and breathing normally, indicating recovery. In this case move them into the recovery
position.
• Always keep monitoring the person and be prepared to start CPR again if needed.

D – Attach Defibrillator
CPR should not be stopped until ambulance personnel or an AED (Automated External
Defibrillator) arrives.

An AED is an electronic device that is portable, easy to operate, and used when the
casualty is having a Sudden Cardiac Arrest (SCA). When the machine detects an abnormal
heart rhythm, an electrical shock is sent to the heart, which can restore normal heart
rhythm. People who need CPR have abnormal heart rhythms.

Attach an AED if available and follow the instructions. You will find the instructions either
in the booklet that comes with the AED or on the screen of the unit.

AEDs are easy to use so you don’t need formal training. Most have visual and/or verbal instructions that you should follow
as different machines may vary slightly.

Once the pads of the AED have been attached to the casualty – this must be directly to the
skin, which may need to be dried off – the device will detect the person’s heart rhythm
and then deliver an electric shock if required.

Once the shock has been delivered, immediately continue CPR for a further 2 minutes,
leaving the AED attached and following any prompts until ambulance personnel arrive.

Do not use an AED when:

• You are under the influence of drugs or alcohol.

• You are in a flammable gas environment.

General instructions for using an AED involve:

While there is not currently an Australian Standard for AED signage, the Australian
Resuscitation Council has developed this sign to be used in Australia to identify and direct
people to the location of an AED.

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Shock
Shock can be life-threatening and occurs when the body is unable to cope with
serious injuries, illnesses or stressful situations e.g. bleeding, burns, severe
allergic reactions, witnessing an accident.

When a person goes into shock the body sends oxygen/blood to the vital organs
first. This slows the blood flow to the limbs and digestive system, causing pale,
cold, sweaty skin and nausea.

After a time, the tissues of the arms and legs will begin to die. At this stage the
brain will return blood flow to these parts, causing vital organs to lose blood flow.
If this continues the person will become drowsy, and the heart and lungs will
begin to shut down, resulting in death.

Recognising shock:

• Cold, pale, sweaty skin.

• Rapid, weak pulse.
• Rapid breathing.
• Casualty may feel anxious, restless and very thirsty.
• Casualty may develop nausea/vomiting.
• Altered conscious state.

Treatment includes:

If the Patient is Conscious: If the Patient is Unconscious:

1. Prevent further injury. 1. Commence DRS ABCD Basic Life Support.
2. Assess the patient and provide first aid for major 2. Call an ambulance on 000 or 112.
injury/illness.
3. Manage any other injuries e.g. fractures, bleeding.
4. Make the person comfortable and cover with a
blanket to maintain body temperature.
5. DO NOT give the patient any food or drink. If needed
moisten their lips to make them more comfortable.
6. Call for an ambulance – Dial 000 or 112 for help.
7. Continue to monitor ABC (Airway, Breathing, and
Circulation) and consciousness/responses.
8. If the person becomes unconscious move them to the
recovery position and monitor ABC.

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Chest Pain
Chest pain may be a sign of a cardiac emergency. Recognising chest pain:

• Sudden onset of tight/heavy or dull pain or ache across the chest.

• Pain can spread to the neck, jaw, shoulders or arms (usually the left arm).

• May develop nausea, vomiting, shortness of breath, dizziness or light-headedness.

Common conditions associated with chest pain are:

• Heart attack.

• Sudden cardiac arrest.

• Angina.

• Congestive heart failure.

Heart Attack
A heart attack occurs when heart tissue dies and is often linked to cardiovascular disease.

This is where fatty deposits have built up in the inner walls of the coronary arteries, causing a blood clot/s to form and
slowing blood flow to the heart. A person who is experiencing a heart attack will still be conscious and have a pulse.
However, if the heart attack is not treated it may lead to sudden cardiac arrest.

Recognising a heart attack:

• A persistent tight/heavy or dull pain or ache starts in the chest, often felt in the
centre behind the sternum.
• Pain can spread to the neck, jaw, shoulders or arms (usually the left arm).
• The person may develop nausea/vomiting.
• Breathing – difficult, shallow breathing, shortness of breath.
• They may look pale with cold sweaty skin and be anxious/distressed.
• Pulse – rapid, irregular, or weak.
• They may develop dizziness, fatigue or become unconscious.

Treatment includes:

If the Patient is Conscious: If the Patient is Unconscious:

1. Help the patient rest and give reassurance. 1. Commence DRS ABCD Emergency Action Plan.
2. Assist with any prescribed medication. 2. Call an ambulance on 000 or 112.
3. Monitor vital signs.
4. Call for an ambulance – Dial 000 or 112.
5. Be prepared to perform CPR if the patient becomes
unconscious and loses vital signs.

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Sudden Cardiac Arrest
When a heart attack is not promptly controlled and treated, it can get worse and
turn into a sudden cardiac arrest with a loss of vital signs.

In cases of sudden cardiac arrest, the heart stops beating or does not beat regularly
enough to circulate blood properly. Unconsciousness occurs, and breathing will
stop. If nothing is done the person will die. It is vital that DRS ABCD and the chain of
survival are started as soon as possible.

You can recognise signs of cardiac arrest when the casualty:

• Is unconscious.
• Has no signs of life.
• Will not respond to touch.
• Will not respond to questions.
• Is not breathing normally.
• Has no pulse rate.

Treatment if the patient is unconscious:

1. Commence DRS ABCD Basic Life Support.

2. Clear the airways and commence CPR, attach an AED if available and
follow the instructions or on-screen directions of the unit.
3. Call 000 or 112 for an ambulance.

The Chain of Survival

The chain of survival is the rapid administration of CPR in sudden cardiac arrest situations to maximize its life saving
potential. Understanding the links in the chain of survival can improve the chances of survival from a cardiac arrest.

The 4 links in the chain of survival are:

Cardiac arrest is potentially reversible if immediate help is given, unfortunately, most people who suffer a cardiac arrest
do not receive CPR.

If each link in the chain of survival is followed and carried out as soon as possible survival rates can be 20-30% higher – a
delay in any link will greatly reduce a casualty’s, chances of survival.

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Angina
Angina can look like a heart attack, but the chest pain can come and go and last less
than 10 minutes. It will often occur during physical exercise.

A person with angina will still be conscious and have a pulse but it must be treated,
or it may lead to sudden cardiac arrest.

People who have been diagnosed with angina should have prescribed medication
with them to relieve the condition.

Recognising angina (similar symptoms to a heart attack):

• A tight/heavy or dull pain or ache starts across the chest and comes and
goes at different times.
• Pain can spread to the neck, jaw, shoulders or arms (usually the left arm).
• The person may develop nausea, vomiting, shortness of breath and they
usually look pale, distressed.

Treatment includes:

If the Patient is Conscious: If the Patient is Unconscious:

1. Ensure the person stops physical activity/exertion. 1. Commence DRS ABCD Basic Life Support.
2. Rest the patient in a comfortable position and give 2. Call an ambulance on 000 or 112.
reassurance.
3. Help the patient to ‘self-administer’ their prescribed
angina medication.
4. Be prepared as the patient may become unconscious.
5. If medication does not work and there has been no
relief after 10 minutes, call for an ambulance – Dial
000 or 112.

Congestive Heart Failure

Congestive heart failure describes when the heart is weak, doesn’t function well
and can’t pump normally. It is usually due to old age or chronic heart disease.

A person with congestive heart failure may be well for most of the time but they
can suddenly get worse, particularly when they get sick or don’t take prescribed
medications.

A person who is experiencing congestive heart failure will still be conscious and
have a pulse. If it is not treated, the person could have a sudden cardiac arrest.

Recognising congestive heart failure:

• Breathing difficulties – coughing, wheezing, sometimes with gurgling sounds.

• Swollen feet, ankles, legs, and abdomen.
• During exercise – general tiredness and breathlessness. May also occur during times of strong emotion.
• General feeling of ill health.

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Treatment includes:

If the Patient is Conscious: If the Patient is Unconscious:

1. Ensure the person stops physical activity/exertion. 1. Commence DRS ABCD Basic Life Support.
2. Rest the patient in a comfortable position and give 2. Call an ambulance on 000 or 112.
reassurance.
3. Help the patient to ‘self-administer’ their prescribed
medication.
If their condition gets worse:
4. Call for an ambulance – Dial 000 or 112.
5. Monitor vital signs often – Record the breathing and
pulse rates for handover to emergency personnel.
6. Be prepared to perform CPR if the patient becomes
unconscious and loses vital signs.

Drowning
A drowning person can have a cardiac arrest and die. You could put your life
in danger by trying to rescue the casualty from the water. If possible, use an
item that floats to help get the person out of the water.

Check first that it is safe to do so and then:

• Have someone call 000 or 112 for an ambulance.

• Get the person out of the water using a flotation device if available.
• When the casualty is out of the water immediately turn them on to
one side, open the airway and let any water/vomit drain out.
• Follow the Emergency Action Plan DRS ABCD. If no signs of life are present immediately start CPR.
• Continue with CPR until emergency services personnel arrive.

Skeletal Injuries
There are various injuries that may affect the skeletal system. Often if there have been injuries to the skeletal system then
injuries to the muscles, ligaments and tendons will also be present, and vice-versa.

Head, Neck and Spinal Injuries

In providing first aid management you should always be aware of the potential for
damage to the spinal cord, which is the nerve centre for controlling movement.

Head, neck and spinal injuries can often damage both bones and soft tissue, which can
include the brain and spinal cord.

As these injuries can become deadly quickly and they can only be assessed and
diagnosed fully through x-ray, you should always treat the injury as very serious.

Possible head, neck and spinal damage can occur in nearly any situation but particularly
where there has been serious impact, such as in a car accident or a fall from some height.

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Some common warning signs of head, neck or spinal injuries may include:

• Changes in the person’s state of consciousness.

• Seizures.
• Severe pain/pressure in the head, neck or back.
• Large volume of bleeding in the head, neck or back.
• Tingling, pins and needles or numbness in the extremities (hands and feet).
• Partial or complete loss of movement in any body part.
• Discharges or presence of blood or other fluids in the ears or nose.
• Bruising on the head, particularly around the eyes or behind ears.
• Nausea or vomiting.
• Impaired/difficulty breathing.
• Vision problems.
• Persistent headache.
• Loss of balance.
• Unusual bumps/depressions on the head and/or spine.
Head, neck and spinal injuries can result in paraplegia or quadriplegia, depending on the location of the injury. They can
also be potentially life-threatening as breathing can stop.

Some general treatment guidelines are:

If the Patient is Conscious: If the Patient is Unconscious:

1. Reassure the patient and get them to stay still. 1. Commence DRS ABCD Basic Life Support.
2. Call an ambulance on 000 or 112. 2. If unconscious and airways need to be cleared
3. Continually monitor vital signs. carefully turn the person on their side without
twisting, bending or moving the person’s neck and
4. Minimise any movement of the head/neck/spine.
back too much. If another person is able to help, one
5. Manage any other injuries. of you should move the body while the other supports
6. Maintain body temperature. the head, neck and spine.

Fractures and Breaks

Fractures are breaks in bone tissue and can be classed as either open or closed fractures.

Open fractures involve an open wound – both sides of the fracture do not need
to be visible. The limb may be severely bent, or an object may have penetrated
the skin, breaking the bone.

Closed fractures have no broken skin and are more common than open fractures.

Fractures can become life-threatening if there is severe internal or external bleeding and
because of the risk of shock. If organs or major nerves or other structures/systems are
also injured, the fracture, whether open or closed, is classed as ‘complicated’.

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 Common signs and symptoms include:

• Pain/tenderness – at or near the injury site.

• Deformity or abnormal position/twist of limb.
• Swelling.
• Loss of function.
• Discolouration, bruising of skin.
• Shock.

Fractures/breaks are usually checked for as part of the secondary survey, unless
the casualty is in life-threatening danger from loss of blood from an open
fracture.

General first aid treatment may include:

If the Patient is Conscious: If the Patient is Unconscious:

1. Control any bleeding and cover any wounds. 1. Commence DRS ABCD Basic Life Support.
2. Check for signs of fractures. 2. Call an ambulance on 000 or 112.
3. Ask the casualty not to move the injured body part.
4. Immobilise and/or support the fracture.
5. Handle gently – move the limb/body part as little as
possible to prevent making the fracture worse (e.g. a
closed fracture may become an open fracture) and to
lessen the person’s pain.
6. Seek medical aid.

Dislocations
Dislocations occur when a bone is separated or displaced from its normal joint position. If left untreated dislocations may
lead to a permanent loss of function in the affected area.

Do not try to put the joint back in place; this should be done by a qualified medical professional, as more damage may be
caused to the joint and nerves if done incorrectly.

First aid treatment may include:

If the Patient is Conscious: If the Patient is Unconscious:

1. Complete primary and secondary surveys. 1. Commence DRS ABCD Basic Life Support.
2. Support and immobilise the injury. 2. Call an ambulance on 000 or 112.
3. Treat for shock.
4. Apply a cold compress/ice pack to the affected area to
help alleviate pain and swelling.
5. Place the person in a comfortable position.
6. Seek professional medical help.

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Immobilisation/Slinging
A key part of first aid treatment for skeletal injuries is splinting. A splint is anything used to support and/or immobilise a
fracture or dislocation. Immobilisation techniques may include:

• Supporting the injury where it is found by packing available material

around it, e.g. blankets, clothing. This allows the person to relax their
muscles and helps to relieve/reduce pain.

• Applying a splint. Splints may be soft, rigid or body splints, and may be
improvised or a commercial product.

o Soft splints include towels, cushions or folded blankets along with

bandages/slings.
o Rigid splints include metal strips, boards, folded magazines and
papers along with bandages/slings.
o Body splints involve securing an injured body part to another
body part, e.g. an injured arm being secured to the chest or
securing an injured leg to the uninjured one. Also requires
slings/bandages or other material to secure the injured body part.

Points to remember when supporting/slinging injuries:

1. Apply the splint in the position in which you found the limb.
2. When splinting, immobilise the limb above and below the joints closest to the injury site.
3. Check the circulation both before and after applying the splint.
4. After splinting check the person’s airway, breathing and circulation.
5. Help the person to rest in the position most comfortable for them and offer reassurance.
6. Maintain their body temperature.
7. Continue to monitor vital signs and check for signs of shock.

Only splint if necessary and if it can be done without causing more pain/discomfort for the individual.

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Common Body Splint/Slinging Techniques
Some of the most common body splinting techniques are those for the arm, which are outlined in the table below.

Arm Sling Elevation Sling Collar and Cuff Sling

Used for injuries to the Used when there is bleeding from Uses a clove hitch so that the
arm or hand. the hand. circulation is not cut off.
Also used for some chest Also used when chest or Used when pressure should not be
injuries. shoulder injuries are applied to the elbow.
Holds the present. Supports the upper
forearm Supports the forearm arm.
across the and hand in a higher Provides passive
chest. position than the traction for fractures
arm sling. halfway along the
DO NOT use for elbow humerus shaft.
injuries.

Altered Consciousness
If a person is unconscious or has an altered state of consciousness, then it is a sign that something is wrong in the body.
The ARC Guideline (3) identifies the causes of unconsciousness as:

• Blood circulation problems.

• Blood oxygenation problems.
• Metabolic problems (e.g. diabetes, overdoses).
• Central nervous system problems (e.g. head injury, stroke, tumour, epilepsy).

A common cause of unconsciousness is fainting and may occur when the victim’s heart
rate is too slow to maintain enough blood flow for the brain.

The primary survey stage of the Emergency Action Principles is very important, as
unconsciousness can be an indication of a life-threatening illness/injury.

Therefore, states of altered or no consciousness need immediate attention.

Conscious states are classified into 3 levels:

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If a person is unconscious, not breathing or not breathing normally you should follow the DRS ABCD Basic Life Support
chart, recording any changes in condition for ambulance personnel when they arrive.

Assessment by ambulance/medical personnel is required even if the person regains consciousness.

Common causes of unconsciousness/altered consciousness include:

• Head injuries, including:

o Concussion.
o Cerebral compression.
o Stroke.
o Fainting.
• Seizures, including:
o Epileptic seizures.
o Infantile/Febrile convulsions.
o Diabetic emergencies.
o Low blood sugar/Hypoglycaemia.
o High blood sugar/Hyperglycaemia.

Each of these conditions has specific first aid treatment procedures that should be followed.

Head Injuries
It may not always be obvious that a person has a head injury, you might not see bleeding or bruising.

Head injuries can result in injury to the brain and may be caused by direct impact to the head or as a result of other
actions/incidents such as whiplash or falling heavily on the feet.

If you think a person has a head injury you need to watch them closely and regularly for signs of changes in their conscious
state and take appropriate action. Spinal injuries may also be associated with the head injury, so care should be taken if
moving the person.

All head injuries should be considered serious.

Concussion
Concussion is an altered state or temporary loss of consciousness following a head injury and has a quick recovery.

Common signs and symptoms include:

• Headache.
• Nausea/vomiting.
• Confusion/temporary short-term
memory loss.
• Unconsciousness – for brief or extended
periods.
• “Seeing stars”, blurred or double vision.
• Dizziness, stumbling, lack of
coordination.
• Numbness/tingling/weakness/pins and needles in arms and legs.

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For someone you think has concussion get medical help and watch them closely. Immediate first aid management
involves:

1. Assess level of consciousness – talk and touch method. Then:

If the Patient is Conscious: If the Patient is Unconscious:
2. Observe closely and note changes in condition – 2. Commence DRS ABCD Basic Life Support.
improvement/deterioration. 3. Call an ambulance on 000 or 112.
3. Conduct secondary survey.
4. Carry out any required first aid.
5. Person should see a doctor at earliest possible time.

Stroke
A stroke happens when blood flow to the brain is disrupted and brain tissue is
damaged due to bleeding or a blood clot.

The most common method for checking for a stroke is using the FAST method.

F – Facial weakness – Can the person smile? Does the mouth or eye droop?

A – Arm weakness – Can the person raise both arms?

S – Speech – Is the speech slurred? Can the person understand what you say?

T – Time to act fast – Call an ambulance (000 or 112).

Other common signs and symptoms include:

• Sudden weakness/numbness/paralysis of one side of the face, arm or leg.

• Sudden difficulty swallowing.
• Blurred/decreased vision.
• Severe sudden headache.
• May develop nausea, vomiting and drowsiness.
• May develop dizziness, fatigue or become unconscious.

You don’t have much time so call an ambulance straight away.

If the Patient is Conscious: If the Patient is Drowsy or Unconscious:
1. If you haven’t already done so call an ambulance on 1. Commence DRS ABCD Basic Life Support.
000 or 112. 2. Call an ambulance on 000 or 112.
2. Conduct secondary survey. 3. Move them into the recovery position on the side with
3. Carry out any required first aid. the facial droop facing down/closest to the ground.
4. Help the person rest comfortably – the head and 4. Care for any life-threatening illnesses/injuries.
shoulders should be higher than the rest of the body. 5. Continue to monitor vital signs until the ambulance
5. Reassure the person to help relieve anxiety. arrives.
6. DO NOT give the casualty anything to eat OR drink.
7. If the person is drooling or has difficulty swallowing
move them into the recovery position on the side
with the facial droop facing down/closest to the
ground.

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Seizures
Seizures occur when the electrical activity of the brain is interrupted or becomes
irregular. This may be caused by a number of conditions and injuries including:

• Stroke.
• Poisoning.
• Head injury.
• Meningitis.
• Brain tumour.
• Fever/infection.
• Epilepsy.
• Infantile/Febrile Convulsions (in children only).

Seizures can vary in their appearance. Some people having a seizure may appear to
“tune out” for a short time and be unresponsive. Other people have sudden, muscular contractions, called convulsions.
Seizures can look scary, but you need to stay calm and keep the person safe.

First aid management may include:

During the Seizure:
1. DO NOT try to stop the seizure.
2. DO NOT try to restrain/hold the person – this could result in other injuries.
3. Make the area around the person safe – remove objects, furniture etc. away from the person.
4. Protect the person’s head – use a low pillow or folded clothing etc. under their head.
5. DO NOT place anything in the person’s mouth/between their teeth – they will not swallow their tongue. (They
could bite their tongue or cheek, but this shouldn’t cause too much bleeding).
Immediately After the Seizure:
1. Place the person in the recovery position to manage the airway and allow any fluids to drain out of the mouth. This
may include blood and vomit.
2. Keep them on their side until fully conscious – they may be drowsy or disoriented after the seizure.
3. Conduct secondary survey.
4. Carry out any required first aid.
5. Reassure the person.
6. Ask bystanders not to crowd around.
7. If the person became incontinent during/after the seizure cover their clothing if possible.
8. Remain with the person until they are fully conscious and aware of their surroundings.

Call an ambulance (000 or 112) if:

• It is the first time the person has had a seizure/there is no history of seizures.
• The seizure lasts more than a few minutes.
• Another seizure/s occurs soon after the first one.
• The person is pregnant.
• The person has diabetes.
• The person has difficulty breathing after the convulsions stop.
• The person is injured.
• The seizure occurs in water.
• The person involved is an infant/child.
• The person does not regain consciousness after the seizure.

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Febrile Convulsions
Seizures/convulsions in children that are brought on by high fever (from any cause) are called febrile convulsions. These
usually only occur in children between the ages of approximately 6 months to 6 years. Common signs and symptoms of
febrile convulsions are:

• High fever.
• Hot, flushed, sweating skin.
• General unwell appearance.
• Eyes rolling up or squinting.
• Body stiffness with arched spine.
• Jerking of the limbs/twitching of the face.
• Saliva frothing at the mouth/difficulty breathing – child may go pale/blue in
colour.

First aid management may include:

During the Seizure:

Remain calm and follow the guidelines as for regular seizures as well as:
1. Undress the child to minimal clothing to help bring down temperature. DO NOT put them in a bath.
2. Monitor body temperature to ensure they do not become chilled.
3. Convulsions should stop as soon as the body temperature is lowered.
4. If possible, note the time the convulsions begin and end.
5. If convulsions last more than 5 minutes call an ambulance (000 or 112).
After the Seizure:
1. Follow the guidelines as for regular seizures.
2. Call a doctor about treatment of the underlying illness.

Diabetic Emergencies
If you aren’t sure if the person has low or high sugar, give them a sweet drink.

The patient should always self-administer insulin as an incorrect dose can be fatal.

Low Blood Sugar/Hypoglycaemia

Too much insulin, not enough sugar, not enough food or too much exercise or alcohol
causes hypoglycaemia. Hypoglycaemia often starts more quickly than hyperglycaemia
and is often the cause of unconsciousness for diabetics.

Common signs and symptoms of low blood sugar include:

• Cold/pale/sweaty skin.
• Weak, dizzy or confused.
• Shaking/trembling.
• Inappropriate/aggressive behaviour – may appear drunk.
• May be unconscious.

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Treatment includes:

If the Patient is Conscious: If the Patient is Unconscious:

1. Conduct primary survey. 1. Commence DRS ABCD Basic Life Support.
2. Carry out secondary survey including looking for a 2. Call an ambulance on 000 or 112.
Medic Alert tag indicating diabetes. 3. DO NOT give anything by mouth.
3. If able to swallow give the person a sweet, non-diet 4. Monitor ABC.
drink or lolly. Diet/sugar substitute drinks do not
5. Maintain normal body temperature and monitor for
work, as they do not contain sugar.
signs of shock.
4. Observe the person for signs of recovery – this will
occur quickly if low blood sugar levels are the cause.
5. If the person does not recover quickly call 000 or 112
for assistance.
6. If quick recovery occurs and once fully conscious the
person should have a small meal, such as a sandwich.
7. Advise the person to see their doctor.

High Blood Sugar/Hyperglycaemia

Hyperglycaemia occurs when there is too much sugar/glucose in the blood and not enough
insulin. For people with diabetes, hyperglycaemia can happen when they miss insulin doses,
they overeat, don’t exercise and/or are under stress.

Common signs and symptoms of high blood sugar include:

• Drowsiness.
• Excessive thirst.
• Increase in urine output.
• Smell of acetone (nail polish remover) on breath.
• May become unconscious.

Treatment for hyperglycaemia is the same as for hypoglycaemia because if the person already has an excess of sugar
(hyperglycaemia) then more in the short term will not harm them. This means that you will not have to try and work out
the best treatment option until an ambulance arrives.
If the Patient is Conscious: If the Patient is Unconscious:
Follow the same treatment as for hypoglycaemia. That is: 1. Commence DRS ABCD Basic Life Support.
1. Conduct primary survey. 2. Call an ambulance on 000 or 112.
2. Carry out secondary survey including looking for a 3. DO NOT give anything by mouth.
Medic Alert tag indicating diabetes. 4. Monitor ABC.
3. If able to swallow give the person a sweet, non-diet 5. Maintain normal body temperature and monitor for
drink or lolly. Diet/sugar substitute drinks do not signs of shock.
work, as they do not contain sugar.
4. Observe the person for signs of recovery.
5. If the person does not recover quickly/within a few
minutes call 000 or 112 for assistance.
6. If the person becomes unconscious, follow the
emergency phone operator’s instructions.

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Fainting
Fainting occurs when the blood flow to the brain is temporarily reduced and can result in semi-loss or complete loss of
consciousness.
Common signs and symptoms include:

• Light-headedness or dizziness.
• Signs of shock.
• Nausea.
• Numbness/tingling in the fingers or toes.

Fainting will usually resolve itself. If you can reach the person assist them to the ground or other flat surface, then:

If the Patient is Conscious: If the Patient is Unconscious:

1. Leave the person lying flat. 1. Place the person in the recovery position.
2. Check ABC. 2. Follow DRS ABCD Basic Life Support process.
3. If possible, elevate the legs/feet.
4. Loosen tight clothing e.g. belt, tie.
5. Do not give anything to eat or drink.
6. Carry out secondary survey.
7. Carry out required first aid for injuries.
8. If the person is pregnant, place them on their side.
9. Encourage the person to consult their doctor to check
for cause/underlying conditions.

Respiratory Distress/Conditions
Respiratory distress is laboured breathing or shortness of breath. Other medical conditions that may trigger it are asthma,
respiratory infections, drowning, choking, electric shock, heart disorders, poisons, and allergic reactions.

Asthma Attack
Asthma is caused by the air passages to the lungs becoming narrowed by muscle spasm, swelling of the mucous
membrane lining the lungs and increased mucus production in the lungs. This results in the airways narrowing, causing
breathing difficulty and trapping air in the lungs as the person finds it difficult to breathe out.

Common causes of asthma attacks (bronchospasms) include:

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An asthma attack may be called mild, medium or severe, with common signs and symptoms including:

• Coughing – usually dry and irritating.

• Wheezing when they breathe (not all asthmatics wheeze).
• Shortness of breath – particularly when talking.
• Increased pulse rate.
• Cyanosis – bluish colouring of the tongue, skin and lining of
mouth.
• Drawing in of the spaces between the ribs and above the
collarbones – a result of struggling/effort taken to draw breath.
• Collapse/unconsciousness.

Individuals with diagnosed asthma should have an asthma management plan developed with their doctor. This usually
includes steps to take to prevent asthma attacks, as well as what to do in an emergency.

Asthmatics may use bronchodilators, which can be classified as ‘preventer’ and ‘reliever’ medications, typically in the form
of ‘puffers’ or ‘inhalers’. As their names suggest preventers are taken to help prevent attacks, while relievers reduce the
symptoms of an attack, usually within minutes.

First aid treatment involves:

If the Patient is Conscious: If the Patient has Collapsed/is Unconscious:
Follow the person’s asthma management plan if known. 1. If the patient is unable to use the reliever immediately
Otherwise: call 000 or 112.
1. Sit the patient in an upright and comfortable position. 2. If oxygen is available, have a trained person give
2. Reassure the patient and help them to administer oxygen through a mask at 6-8 litres per minute.
their asthma medication with the 4x4 method – give 4 3. If breathing stops, follow DRS ABCD Basic Life Support
puffs of the reliever (through a spacer device if process.
available) over a period of 4 minutes.
3. The person should rest and if possible, receive oxygen For severe asthma attacks much, greater force will be
given by a trained person. required to inflate the lungs when administering CPR.
4. If there is little/no improvement, call 000 or 112 and
continue to administer reliever in the 4x4 method.

Severe Allergic Reactions

Severe allergic reactions, referred to as anaphylaxis, can be extremely life-threatening. Reactions usually occur within 20
minutes of exposure to an allergen/trigger and can have an effect on multiple body systems. Common causes (or triggers)
include:

• Venom – from bee stings.

• Foods:
o Eggs.
o Milk products.
o Peanuts.
• Medications – such as penicillin and morphine.

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Common signs and symptoms may include:

• Swelling/redness of skin.
• Hives, rashes, itching.
• Difficulty breathing, wheezing, coughing – airway may become obstructed as
tongue and throat swell.
• Dizziness.
• Nausea, vomiting.
• Unconsciousness.
Many people with known allergies may carry prescribed medications, including tablets,
puffers or injections (such as an adrenalin auto-injector e.g. EpiPen) to administer in the case of a severe allergic reaction.

Treatment for a suspected allergic reaction involves:

If the Patient is Conscious: If the Patient is Unconscious:
1. Help the patient to lie down – if breathing becomes more difficult help them sit 1. Administer adrenalin auto-
up. injector (such as an EpiPen)
2. Remove the trigger/allergen to prevent further injury. if available. If no response
3. Call 000 or 112. is shown in 5 minutes a
4. Follow the person’s emergency action plan if they have one and administer further dose of adrenalin
casualty’s adrenalin auto-injector – do not give a tablet if the person is having can be administered.
difficulty breathing as this may block the airways.
2. Follow DRS ABCD Basic Life
5. If poisonous substance is:
Support process.
a) On the skin – wash off with water.
b) Inhaled – remove the person from the area if safe to do so. 3. Call 000 or 112 and follow
6. Loosen any tight clothing and remove jewellery. emergency personnel
7. Offer reassurance. instructions.
8. Regularly check the patient’s airways and breathing – if breathing stops follow
DRS ABCD Basic Life Support process.

Hyperventilation
Hyperventilation occurs when a person develops an imbalance of carbon dioxide and oxygen in the body as a result of an
altered breathing pattern. The person then starts to breathe faster.

Common causes include: Common signs and symptoms include:

• Some poisons.
• Anxiety or fear-related stress. • Rapid, shallow breathing.
• Head injury. • Feeling of suffocation.
• Severe bleeding. • Fear/anxiety, feeling of panic.
• Heart failure. • Dizziness due to lowered oxygen levels.
• Collapsed lung. • Numbness/tingling of fingers/toes.
• Diabetic emergency. • Feeling of detachment from body, no longer in
control
Treatment for hyperventilation involves:
If the Patient is Conscious: If the Patient is Unconscious:
1. Reassure the patient – explain that symptoms will end when 1. Follow DRS ABCD Basic Life Support
breathing returns to normal. process.
2. Count the breaths out loud and encourage them to slow down.
2. Call 000 or 112 and follow emergency
3. If no change occurs or hyperventilation follows an injury, call an
personnel instructions.
ambulance on 000 or 112.
4. Prompt medical attention should be sought, due to the possibility of
an underlying condition/s.

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Choking
Choking is the result of either a totally or partially obstructed airway – caused by swollen
tissues or a foreign body or food/material entering the windpipe instead of the gullet.

Common signs and symptoms include:

• Inability to cough, breathe, speak or cry out.

• Clutching/gripping of throat.
• Cyanosis – blue skin, tongue, mouth lining.
• Anxiety/restlessness.
• Noisy breathing/wheezing.
• Red/congested face with bulging neck veins.
• Collapse/unconsciousness.

Can the Patient Breathe, Speak or Cough?

If Yes: If NO and Conscious: If NO and Unconscious:
1. Give the patient 1. Call 000 or 112 for an ambulance. 1. Lay the person on their
reassurance and 2. Have the person stand if able and lean on the back side and try to clear the
encourage coughing until of a chair. airway – check the
cleared. 3. Give 5 sharp, upward back slaps between the mouth for visible foreign
DO NOTHING ELSE. shoulder blades, using the heel of the hand. material.
2. If the patient 4. After each blow check if the object has been 2. Use head tilt and jaw
continues/starts expelled. support to open the
wheezing or breathing 5. If not successful give up to 5 chest thrusts (similar airway – look, listen and
noisily, call 000 or 112. but slower and sharper than CPR compressions). feel for breath signs.
6. Check to see if the object has been expelled. 3. If the person is still not
IF THE PERSON BECOMES UNCONSCIOUS: breathing, start DRS
7. Lay the person on their side and try to clear the ABCD Basic Life Support
airway – check the mouth for visible foreign process.
material.
8. Use head tilt and jaw support to open the airway –
look, listen and feel for breath signs.
9. If the person is still not breathing, start DRS ABCD
Basic Life Support process – try to blow air past
the obstruction.

For an Infant/Child:
1. Position the child face down over your lap to take advantage of gravity.
2. Position the head lower than chest, at a 45-degree angle.
3. Give 5 back blows between the shoulder blades.
4. While giving back blows support the child’s head by placing your hand around the jaw.
5. If unsuccessful give up to 5 chest thrusts.
6. If the child becomes unconscious and stops breathing, start CPR.

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Bleeding, Wounds and Injuries
During the primary and secondary survey, you will need to find and treat:

• Bleeding.
• Wounds.
• Injuries.

Bleeding
Bleeding can be classed as internal or external and is checked for as part of the
primary survey.

Internal Bleeding
Internal bleeding is harder to identify as it is under the surface of the skin. Common signs of internal bleeding include:

• History of an injury that causes internal bleeding.

• Medical conditions such as haemophilia or aneurysm.
• Pain/tenderness in soft tissue – may also include hardness, swelling and distension.
• Discolouration/bruising of skin in injured area.
• Anxiety, restlessness.
• Weak, rapid pulse.
• Rapid breathing.
• Cool/moist/bluish skin.
• Nausea/vomiting.
• Excessive thirst.
• Altered/deteriorating state of consciousness.
• Bleeding from orifices.
Internal bleeding usually needs immediate surgery so the most important thing to do is call an ambulance. However
general first aid management may include:

1. Assist the person to lie down and rest in the most comfortable position.
2. Monitor ABC (airway, breathing, circulation).
3. Monitor for shock and maintain normal body temperature.
4. DO NOT give:
• Medication.
• Alcohol.
• Food.

• Drink.

5. Offer reassurance.

6. Provide first aid for other injuries/illnesses.

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External Bleeding/Haemorrhaging
External bleeding or external haemorrhaging is easier to identify but may be life-
threatening if there is blood spurting from the wound or if the blood doesn’t clot.

Most bleeding will be minor and will stop within about 10 minutes when the
blood clots.

First aid management for bleeding involves:

1. Try to protect yourself by using gloves or an improvised barrier between your hands and the blood/wound.
2. First check if there is any foreign object stuck in the wound then:
If NO Foreign Object: If Foreign Object Present: If Unconscious:
3. Using a sterile dressing pad, ask the 3. Leave the object in the wound – it 3. Follow DRS ABCD Basic Life
person to press directly on the may be controlling the bleeding. Support process.
wound. 4. Using sterile dressings, build up 4. Call 000 or 112 and follow
• If you don’t have a sterile dressings around the wound, emergency personnel
dressing, use an improvised finishing above the object’s height if instructions.
dressing e.g. handkerchief, possible.
towel. 5. Secure the dressings in place with a
• If these are not available, the roller bandage, wrapping diagonally
person should use their hand. above and below the object and
• As a last resort use your own lightly over the object.
hand. 6. If the object is large and sticking out
4. If a broken bone is not suspected above the dressings, bandage firmly
raise the injured area above the all around the object but DO NOT
level of heart. bandage over the object.
5. Have the person rest comfortably. 7. Protect from further damage.
6. Apply a pressure bandage to hold 8. Continue to monitor the person’s
the dressing in place – a triangle ABC.
bandage or roller bandage is best 9. Call an ambulance on 000 or 112.
for this. 10. Monitor for shock or condition
7. Immobilise the injured part using an getting worse.
appropriate body splint/slinging
method.
IF BLEEDING CONTINUES:
8. Apply a second dressing pad over
the first and a firmer bandage over
top of all.
IF SIGNIFICANT BLEEDING CONTINUES:
9. Remove all bandaging and check for
a missed bleeding site.
10. Reapply a better dressing and
bandages. Continue to monitor the
person’s ABC.
11. Call an ambulance if necessary.
12. Monitor for shock or condition
getting worse.
DO NOT disturb dressings once bleeding
stops/is controlled.

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Wounds and Injuries
Wounds may or may not bleed and can involve injuries to underlying organs and
muscles. There may also be damage, whether minor or extensive, to the skin and other
tissues.

Wounds are categorised as either closed or open.

• Closed Wounds – damage occurs under the skin, e.g. a bruise.

• Open Wounds – damage breaks the outer layer of the skin, e.g. scrape, cut.
Usually involves bleeding.

All wounds are considered major if:

• They are more than superficial (small).

• The bleeding is more than minimal and does not stop quickly.

• They are longer than 2.5 cm.

General first aid treatment for major wounds involves:

If the Patient is Conscious: If the Patient is Unconscious:

1. Put a dressing on the wound and control bleeding (as for 1. Follow DRS ABCD Basic Life Support process.
external bleeding). 2. Call 000 or 112 and follow emergency
2. Call an ambulance (000 or 112) or get the person to medical personnel instructions.
attention.
3. DO NOT remove the bandage once bleeding has been
controlled.
4. DO NOT try to clean the wound – medical staff will do this.
5. Continue to monitor the person closely.
6. Be prepared to treat for shock.
7. If the person becomes unconscious, follow DRS ABCD Basic
Life Support process.

All wounds that break the skin’s surface require first aid care as they put the body at risk of infection. Different wound
care procedures are outlined below for:

• Nose wounds.

• Abdominal wounds.

• Crush injuries.

• Eye injuries.

• Ear injuries.

• Needle stick injuries.

• Bruises, sprains and strains.

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Nose Wounds
Often caused by a blow from a blunt object and leads to a nosebleed. May also be caused by
changes in blood pressure, altitude and sneezing, picking or blowing nose.

Nosebleeds may cause breathing problems or vomiting if blood is inhaled or swallowed.

General first aid treatment involves:

If the Patient is Conscious:
1. Ask the person to sit upright with their head leaning slightly forward.
2. Ask them to pinch their nostrils together, breathing through the mouth.
3. Encourage the person to maintain this position for 10 minutes. If the nosebleed has occurred in hot weather or
after exercise the position may need to be maintained for 20 minutes.
4. Ask the person to spit out any blood.
5. While the nostrils are held closed, clean around the nose and mouth area with a dressing dampened with water.
DO NOT pack the nostrils with dressings.
6. After the bleeding has stopped tell the person not to blow, rub or pick the nose as this may restart the bleeding.

Abdominal Injuries
Abdominal wounds/injuries may be open or closed and are potentially life-threatening as there could be damage to
internal organs.

Recognise abdominal injuries:

• Severe pain where the injury occurred or pain/tenderness/tight feeling in

abdomen.
• Bruising.
• Weakness.
• Nausea/vomiting – vomit may contain blood.
• Shock.
• Have difficulty breathing.
• Dark coloured faeces and dark brown urine.
• Protrusion of intestines.

General first aid treatment of an open abdominal wound involves:

If the Patient is Conscious: If the Patient is Unconscious:
DO NOT apply direct pressure on the wound. 1. Follow DRS ABCD Basic Life Support process.
DO NOT touch/try to push organs back into the abdominal 2. Call 000 or 112 and follow emergency personnel
cavity. instructions.
Call an ambulance on 000 or 112.
1. Help the patient into a half-sitting position, with the
knees bent up to prevent the wound gaping.
2. Moisten a bulky sterile dressing – warm tap water
may be used.
3. Apply loosely over the wound to stop the internal
organs from drying out or sticking to the dressing.
NOTE: Clear plastic wrap may be used if a sterile
dressing is not available.
4. Secure the dressing using a broad bandage.
5. Continue to monitor the person closely.
6. Be prepared to treat for shock.
7. If the person becomes unconscious, follow DRS ABCD
Basic Life Support process.

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Crush Injuries
When a large object falls on a person a crush injury may occur. This often causes
broken bones and soft tissue injuries, including life-threatening internal injuries.

Common signs and symptoms include:

• Symptoms similar to shock.

• Numbness, tingling, swelling and/or rigidity in the crushed limb/area.
• Signs and symptoms of fractures.

General first aid treatment involves:

If the Patient is Conscious: If the Patient is Unconscious:

1. Assess dangers; seek assistance to have the heavy 1. Follow DRS ABCD Basic Life Support process.
load removed from the patient. Only do so if it is 2. Call 000 or 112.
reasonably safe and physically possible.
2. Call 000 or 112.
3. Offer reassurance and keep the person comfortable.
4. Treat for shock.
5. Regularly check the patient’s ABC/vital signs – if
breathing stops follow DRS ABCD Basic Life Support
process.

Scalp Wounds
Scalp wounds should be treated carefully as there is the risk of associated skull fractures.
A person with a scalp wound may also suffer from concussion or another head injury.

General first aid treatment involves:

If the Patient is Conscious: If the Patient is Unconscious:
1. Call 000 or 112. 1. Follow DRS ABCD Basic Life Support
2. Apply pressure to the wound – be gentle at first in case of skull process.
fracture. 2. Call 000 or 112.
3. If depression, spongy area or bone fragments are felt a skull
fracture should be suspected.
FOR SUSPECTED SKULL FRACTURE:
4. Do not put direct pressure on the wound.
5. Control the bleeding by applying gentle pressure around the
wound area.
IF SKULL FRACTURE NOT SUSPECTED:
6. Apply direct pressure to the wound.
7. Apply a dressing and keep it in place with your hand.
8. Use a roller or triangular bandage to secure dressing.
9. Assist the person into a comfortable position, lying down with
head and shoulders raised.
10. Continue to monitor closely.
11. Be prepared to treat for shock.
12. If the person becomes unconscious, follow DRS ABCD Basic Life
Support process.

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Eye Injuries
Eye injuries may be serious, even if minor, as the eye is very sensitive and easily damaged.
Eye injuries may involve either or both the bones and soft tissues surrounding the eye, as
well as the eyeball itself.

Common signs and symptoms include:

• Impaired/total loss of vision in injured eye.

• Pain in the eye.
• A high volume of tears in the eye.
• Eyelid spasms.
• Blood or fluid loss from the eye.

General first aid treatment for an eye injury/wound involves:

If the Patient is Conscious: If the Patient is Unconscious:

DO NOT apply direct pressure on the eyeball. 1. Follow DRS ABCD Basic Life Support
DO NOT try to remove any embedded object. process.
1. Call an ambulance on 000 or 112. 2. Call 000 or 112 and follow emergency
personnel instructions.
2. Help the patient into the position most comfortable for them.
3. Support the head and advise them to avoid movement.
IF NO OBJECT IN EYE:
4. Cover the eye with a sterile pad.
5. Use a bandage to hold the pad in place, without putting pressure on
the eyeball.
6. Ask the person to keep the unaffected eye closed to stop
blood/dirt/fluid from entering it.
7. Advise the person to try not to move the unaffected eye – this will
prevent movement in the affected eye also.
IF OBJECT IS EMBEDDED IN THE EYE:
8. Do not attempt to remove the object.
9. Place a sterile dressing around the object.
10. Stabilise the object in place as best as possible – a paper cup could be
used, placing it over the object before applying the bandage.
11. Bandage it in place.
12. Ask the person to keep the unaffected eye closed to stop
blood/dirt/fluid from entering it.
13. Advise the person to try not to move the unaffected eye – this will
prevent movement in the affected eye also.

For foreign bodies in the eye (such as dirt, sand, slivers of wood etc.):

1. Tell the person to try to remove the foreign body by blinking several times – this will produce more tears, which
may flush it out.
2. If this does not work, try flushing the eye with water – keep the affected eye lower so the unaffected eye does
not become contaminated.
3. If this does not remove the object, cover the eye with a pad, taped in place, then seek professional medical
attention.

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Ear Injuries
Bleeding and fluids in or draining from the ear may be from an injury to the ear itself or
as a result of a serious head or spinal injury.

Signs and symptoms of serious ear injuries may include:

• Pain.
• Impaired hearing or deafness in affected ear.
• Bleeding from the ear.
• If related to an injury within the skull: watery fluid mixed with blood coming
from the ear, headache and/or altered conscious state.

General first aid treatment for a serious ear injury involves:

If the Patient is Conscious: If the Patient is Unconscious:

1. Help the person into a comfortable sitting position, tilting the head towards the 1. Follow DRS ABCD Basic Life
side of the injured ear. Support process.
2. Loosely cover the affected ear with a sterile pad and bandage it lightly. DO NOT 2. Call an ambulance on 000
plug the ear or try to stop the flow of blood or fluids from the ear. or 112.
3. Continue to closely monitor ABC and vital signs (consciousness, breathing, and
colour).
4. Be prepared, as the patient may need treatment for shock.
5. If the person becomes unconscious, follow DRS ABCD Basic Life Support process.

For foreign bodies in the ear (such as dirt, sand, insect etc.):

1. If object can be easily seen and grasped: remove it but DO NOT use a toothpick, cotton bud etc.
2. Pull down on the earlobe and tilt the head to the affected side.
3. If either/both methods are unsuccessful seek medical attention.

Needle Stick Injuries

A needle stick injury occurs when a used needle punctures a person’s skin. This puts the person at risk of infection of
blood-borne diseases such as HIV, Hepatitis B and Hepatitis C.

General first aid treatment for a needle stick injury involves:

If the Patient is Conscious: If the Patient is Unconscious:
1. Reassure the patient and get them to rest and stay calm. 1. Follow DRS ABCD Basic Life
2. Let the wound bleed freely for a few seconds. Support process.
3. Flush/wash the injury site with soap and running water – if not available an 2. Call an ambulance on 000 or
alcohol-based hand rub/wash may be used. 112.
4. If necessary, a sterile, waterproof dressing may be applied.
5. Urge the person to go straight to their doctor or an emergency department.
6. If possible, the needle should be retained in a sturdy container (with a lid) for
later testing.

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Sprains and Strains
A sprain occurs when ligaments and other tissue at a joint are partially or completely torn.

A strain occurs when muscle or tendon fibres are stretched and torn.

Common signs and symptoms of sprains and strains include:

• Sprains – generally occur at a joint:

• Pain.
• Swelling.
• Deformity.

Strains – generally occur between joints:

• Pain.
• Swelling.
• Deformity.

First aid treatment for sprains and strains uses the RICER acronym:

RICER stands for:

Rest Avoid movement/activities that cause pain for at least 48-72 hours. Assist the person into
the most comfortable position – if head/neck/spinal injuries are suspected leave the
person lying flat.
Ice Control bleeding if applicable then apply a wrapped ice pack/cold compress for 20 minutes.
Reapply every 2 hours for the first 48-72 hours. This helps to reduce swelling and relieve
pain/discomfort.
Compression Apply a firm, supporting bandage, giving even pressure over the area. Light padding may be
used if pain is severe.
Elevation If possible, raise the injured area above the level of the heart. This slows the blood flow to
the area and reduces swelling. DO NOT elevate if a fracture is suspected.
Referral Refer the person for further advice and treatment, e.g. their doctor or emergency
department.

Compression with a Roller Bandage

Roller bandages can be found in most first aid kits and are available in a range of
sizes and materials. They may be used to manage bleeding, ensure dressings are
kept in place and to support injuries.

Strains and sprains should be treated using elastic roller bandages as they provide
even pressure over the injured area.

This helps to reduce swelling, over the injured area. Whilst the bandage should
apply even pressure on the injured area you should ensure that it is not put on
too tightly as this can cause circulation problems.

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A roller bandage should be applied using the following steps:

1. Ensure that the injured area is supported and in the appropriate position to be
bandaged.

2. Begin bandaging below the injury by completing 2 whole, straight turns (the second
overlapping the first) around the limb in order to keep the end in place.

3. Ensure that you are unrolling only what you need of the bandage as you go and work
up the injured area in a spiralling motion. Each spiral should wind from the inside to
the outside of the injured area and cover two-thirds of the previous spiral.

4. Finish the bandaging completing two whole, straight turns (as in step 2) and secure
the bandage using a bandage clip, tape or a safety pin.

5. Ensure that the bandage is applying the appropriate amount of pressure – not tight
enough to cause circulation problems, not too loose as even pressure is required. The
bandage may need to be altered accordingly.

Figure-of-Eight Technique
The figure-of-eight bandaging technique is used to maintain even pressure on the arm
or leg and is often used when bandaging the hand and foot.

Hand and Foot Compression using a Roller Bandage

When using a roller bandage to manage an injury on the hand or foot you should use the
following steps:

1. Ensure that the hand/foot is supported with the palm/heel down.

2. Begin bandaging by completing 2 whole, straight turns (with the second overlapping
the first) around the wrist/ankle – this should keep the end of the bandage in place.

3. Wrap the bandage in a diagonal spiral over the top of the hand/foot from the
wrist/ankle to the outside of the hand/foot (towards the little finger/toe). Continue
the spiral underneath the hand/foot until the bandage reaches diagonally back to
the wrist/ankle. The bandage has now completed a figure-of-eight around the
injured hand or foot.

4. Repeat the figure-of-eight technique, ensuring that the ends of the fingers/toes are
left exposed, until the bandage is providing a firm and supporting compression over
the area.
5. Finish the bandage by completing 2 whole straight turns around the wrist/ankle (as
in step 2) and secure the bandage using a bandage clip, tape or a safety pin.

6. Check with the casualty that the bandage is not too tight or loose. The bandage may
need to be modified if required.

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Burns
Burns damage the soft tissue of the body and may be
caused by:

Heat Burns
Heat burns from different sources, e.g. flame, friction,
scalding or solar radiation, are generally treated in the
same manner. This involves:

1. Cool the burned area under cold water for 20 minutes.

2. Gently remove any clothing and jewellery from the burned area. DO NOT try to
remove any clothing that is sticking to it.

3. If the area cannot be immersed (kept under water) – such as the face – you can use
towel, sheets or clothes that have been soaked in water. Change/rewet these
regularly as they will absorb heat from the burn.

4. Cover the burn with a sterile, non-stick dressing and loosely bandage in place. If this
is not available or the burn covers a large area use a dry, clean sheet or other
material that is not fluffy.

5. Minimise shock.

6. For bad burns seek medical advice – Call 000 or 112.

DO NOT use ointments, lotions, creams or powders on a burn – these will seal in heat
and may contaminate the burn area.

Chemical Burns
Chemical burns usually occur when the skin comes into contact with a strong acid or
alkaline substance. The longer the substance remains on the skin, the more severe the
burn will be.

General first aid treatment for chemical burns involves:

If the Patient is
If the Patient is Conscious:
Unconscious:
1. If available, consult the Materials Safety Data Sheet or container for the chemical and 1. Follow DRS ABCD
follow instructions. Basic Life
2. Remove the chemical from the body as quickly as possible. Support process.
3. Flush the area with large amounts of cool, running water – continue for at least 20 2. Call an
minutes. ambulance on
4. Call an ambulance on 000 or 112. 000 or 112.
5. DO NOT use high pressure water – this may further damage the skin.
6. Help the person to remove contaminated clothing.
7. Minimise/be prepared to treat shock.
If the eye is affected:
• Flush the eye for 20 minutes – be sure the water flushes underneath the eyelids.
• Keep flushing until ambulance personnel arrive.

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Electrical Burns/Shock
Common signs and symptoms of electrical burns include:

• Unconsciousness.
• Semi consciousness – dazed, confused behaviour.
• Obvious/visible burns on the skin – often on the hand and foot and where the
current entered and exited the body.
• Breathing difficulty.
• Absent/weak/irregular pulse.
• Signs/symptoms of shock.

Always check that the area is safe before entering the scene (survey the scene). First aid treatment for electrical burns
involves:
If the Patient is Conscious: If the Patient is Unconscious:
1. Call an ambulance. 1. Call an ambulance.
2. Monitor for signs of shock and treat accordingly. 2. Place the person in the recovery position.
3. Give care for burns as for heat burns. 3. Clear the airways and check for breathing, following
4. Continue to monitor ABC/vital signs. DRS ABCD Basic Life Support process.
4. Monitor for signs of shock and treat accordingly.
5. Give care for burns as for heat burns.
6. Continue to monitor ABC/vital signs.

Environmental Impact
Normal human body temperature is around 37 degrees Celsius. Usually the body can regulate itself to deal with changes
in external temperatures but sometimes it can’t deal with extreme cold or hot weather and the person becomes ill.

Hypothermia
Hypothermia occurs when the warming mechanism of the body fails and the entire body cools down, dropping below
35°C.

Common signs and symptoms of hypothermia include:

• Mild hypothermia:

o Shivering.
o Slurred speech.
o Skin looks pale and is cool to touch.
o Difficulty concentrating; slowed thinking.
o Poor coordination.
• Moderate to severe hypothermia:

o Increased shivering.
o Increased muscle rigidity.
o Loss of consciousness progresses.
o Slower pulse. Respiration slow.
o May develop cardiac arrhythmia.
o Pupils appear fixed and dilated.
o May appear dead.

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First aid treatment for Hypothermia involves:

If the Patient is Conscious: If the Patient is Unconscious:

1. Call 000 or 112. Same as for conscious patient (except step 5).
2. Remove the person from the cold environment.
3. Remove wet clothing and dry the person off.
4. Wrap in blankets/sleeping bag/thermal blanket to provide
warmth and insulation from wind and ground.
5. If alert provide warm, non-alcoholic, sweet drink.
6. If no longer shivering or the ambulance is delayed proceed with
active rewarming using wrapped hot water bottles, heating pads
(if the person is dry) or other heated sources. Apply heated
sources to the groin, armpits, trunk and sides of the neck. Body-
to-body contact may also be used.
DO NOT place person in warm water or expose to fire/heater – may
cause dangerous heart rhythms.
DO NOT rub or massage the person.

Hyperthermia
Hyperthermia includes heat stroke and heat exhaustion and occurs when the
body can’t lose heat to the environment.

Dehydration may result from heat-induced illness, causing fatigue, dizziness,

nausea, vomiting, headaches, seizures and unconsciousness. Dehydration
should be treated by giving the person small drinks of cool water.

Heat Exhaustion
Heat exhaustion occurs when the body cannot regulate its temperature and
usually occurs after work in a hot environment or after long periods of strenuous exercise. It affects the circulatory system
and can result in cases of mild shock. It is more common than heat stroke.

Common signs and symptoms include:

• Headache, dizziness, weakness.
• Fainting
• Exhaustion.
• Cool, moist, pale skin, sweating.
• Thirst.
• Weak, rapid pulse.
• Higher body temperature – still below 40 degrees Celsius.

First aid treatment for Heat Exhaustion involves:

If the Patient is Conscious: If the Patient is Unconscious:

1. Encourage the person to find a cool place or shelter to 1. Follow DRS ABCD Basic Life Support process.
rest. 2. Call 000 or 112 for an ambulance.
2. Loosen/remove extra clothing.
3. Moisten the skin – use a damp cloth, atomiser or fan.
4. If fully conscious give small drinks of cool water.
5. If unconscious, follow DRS ABCD Basic Life Support
process.
6. Seek medical assistance.

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Heat Stroke
More severe than heat exhaustion, heat stroke indicates that heat has overwhelmed the body system, and some systems
are beginning to stop functioning. Immediate medical attention is required.

Common signs and symptoms include:

• Body temperature more than 40 degrees.

• Noisy or erratic breathing – most likely shallow and rapid.

• Flushed/red, hot, dry skin – although some people will sweat profusely.

• Partial or complete loss of consciousness.

• Pulse rate is fast and bounding.

First aid treatment for Heat Stroke involves:

If the Patient is
If the Patient is Conscious:
Unconscious:
1. Stop the person from continuing any activity. 1. Clear their airways
2. Place the person in a cool place to rest. and follow the
emergency action
3. Call for medical assistance.
plan DRS ABCD.
4. Loosen/remove tight, extra or sweaty clothing.
2. Call 000 or 112 for
5. Moisten the skin with damp cloths/atomiser etc. an ambulance.
6. Apply wrapped ice packs on the groin, neck and armpits.
7. If fully conscious give small drinks of cool water.
8. Be prepared as the patient may become unconscious.
9. If required resuscitate using DRS ABCD Basic Life Support process.
10. Keep cooling until an ambulance arrives and/or body temperature falls to 38°C degrees
Celsius.

Envenomation
Envenomation is where venom (poison) gets into the body from bites or stings by spiders, snakes, and marine creatures
like jellyfish and insects like bees. The poison can be painful, disabling and potentially life-threatening.

Insect Bites and Stings

Common signs and symptoms of stings from bees, wasps, etc. are:

• Pain at the sting site.

• Swelling and redness at site.

• Allergic reaction – may include itching, rash, swollen eyelids, respiratory

distress, altered state of consciousness.

General first aid treatment involves:

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 If the Patient is Conscious: If the Patient is Unconscious:
1. Remove the insect from the skin surface. For bee stings, remove the 1. Clear their airways and follow DRS
venom barb (stinger) by scraping sideways with your fingernail. ABCD Basic Life Support process.
DO NOT remove a tick. 2. Call 000 or 112 for an ambulance.
2. Apply a cold compress to the bite site.
3. If a known allergy exists, apply the person’s anaphylaxis action plan (may
involve administering an EpiPen) and call for an ambulance.
4. Monitor ABC and if needed give CPR.

Spider Bites
First aid treatment for a spider bite will depend on the species of spider involved.

Red-Back Spider
Red-back spiders are about 1cm long with a red or orange stripe on the back. Their
venom can be life-threatening for small children and animals. Anti-venom is available
for red-back spider bites.

Common signs and symptoms:

• Pain at the bite site – spreads, becoming red, swollen, sweating, hot – pain
may also occur on opposite limb/away from bite site.

• Nausea/vomiting/stomach pain.

• Heavy sweating, swollen glands in the armpits and groin.

General first aid treatment involves:

If the Patient is Conscious: If the Patient is Unconscious:
1. Apply an ice/cold compress to the area for no longer than 20 minutes. 1. Clear their airways and follow DRS
2. Continually monitor the person and monitor ABC. ABCD Basic Life Support process.
3. Immediately call for an ambulance – Dial 000 or 112. 2. Call 000 or 112 for an ambulance.
4. If you are in an isolated/remote area, transport the person to a medical
facility.
5. DO NOT apply pressure immobilisation technique.

Funnel Web Spider

There are many species of funnel web, but they are generally greater than 2cm long and can cover an adult’s hand with
their legs. Funnel web spiders are aggressive, rising up to attack prey. A bite from any large, dark-coloured spider should
be considered dangerous, regardless of whether it is known to be a funnel web or not.

Signs and symptoms include:

• Pain with little other reaction in the bite area.
• Heavy sweating.
• Tingling of the mouth.
• Heavy production of saliva.
• Stomach pain.
• Muscle twitching.
• Respiratory distress – may lead to respiratory arrest.
• Altered state of consciousness – progresses to unconsciousness.

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 If the Patient is Conscious: If the Patient is Unconscious:
1. Apply a firm, broad compression bandage over the area of the bite. 1. Clear their airways and
2. Apply another bandage starting from the lower end of the limb (fingers or toes) follow DRS ABCD Basic Life
upwards, covering the entire limb or as much as possible. Support process.
3. Apply a splint to the affected limb. 2. Call 000 or 112 for an
ambulance.
Steps 1-3 are called the pressure immobilisation technique
DO NOT apply pressure immobilisation if the bite is on the person’s head or
torso.
4. Continually monitor the person and their ABC.
5. Be prepared to give CPR.
6. Reassure the patient and get them to rest and stay calm.
7. Immediately call for an ambulance – Dial 000 or 112.
8. If you are in an isolated/remote area, transport the person to a medical facility.

Snake Bite
People have different reactions to different snake bites but there are common
signs and symptoms.

These include:

• Fang marks in the skin – either paired or single.

• Nausea/vomiting.

• Headache and altered conscious state.

• Double/blurred vision.

• Speaking/swallowing problems.

• Weakness/paralysis in extremities.

• Respiratory distress – may lead to respiratory arrest – or sudden cardiac arrest.

• Clotting defects.

First aid treatment involves:

If the Patient is Conscious: If the Patient is Unconscious:
1. Conduct primary survey. 1. Clear their airways and follow DRS ABCD Basic Life
2. Use pressure immobilisation technique if the bite is Support process.
on a limb.
2. Call 000 or 112 for an ambulance.
3. Continually monitor the person and their ABC.
4. Be prepared to give CPR if required.
5. Reassure the patient and get them to rest and stay
calm.
6. Immediately call for an ambulance – Dial 000 or 112.
7. If you are in an isolated/remote area, transport the
person to a medical facility.

Don’t clean the bite site as venom left on the skin or clothes can be used to identify the type of snake and which anti
venom should be used.

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Marine Bites and Stings
There are a number of marine life forms that can sting humans, causing pain and potential death.

Bluebottle & Non-Box Jellyfish

Signs and symptoms of bluebottle and non-box jellyfish stings include:

• Skin – welts appear, often white surrounded by red ring.

• Pain at the site of the sting.
• Pain in the lymph nodes – in the groin and armpits.
• Headache.
• Nausea/vomiting.
• Muscle and back pain.
• Respiratory distress/breathing difficulty.

First aid treatment involves:

If the Patient is Conscious: If the Patient is Unconscious:

1. Rescue the patient from the sea and move to a dry 1. Follow DRS ABCD Basic Life Support process.
area. 2. Call for an ambulance – Dial 000 or 112.
2. Reassure the person and keep them calm and resting.
3. DO NOT rub the stung area.
4. Pick off any tentacles on the skin with your fingers
(not dangerous for rescuer).
5. Wash the area with sea water NOT fresh water.

If the Patient is Conscious: If the Patient is Unconscious:

FOR BLUEBOTTLE STING: 1. Follow DRS ABCD Basic Life Support process.
1. Apply a hot compress over the area of the bite or immerse in 2. Call for an ambulance – Dial 000 or 112.
hot water – be careful not to scald area.
2. If pain is not relieved or hot water is not available use an ice
pack/cold compress.
3. Monitor the person and their ABC.
4. Be prepared to give CPR.
5. Call an ambulance if required 000 or 112.
FOR OTHER JELLYFISH STINGS:
1. Apply a cold/ice pack for pain relief.
2. If pain is not relieved, or generalised pain develops, or the sting
is over a large area: Call an ambulance and seek assistance
from a life guard/lifesaver.

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Box Jellyfish
Signs and symptoms of box jellyfish stings include:

Skin:
o Ladder pattern marks from tentacles.

o Immediate burning pain.

o Pieces of tentacles cling to the skin.

• Pain in the lymph nodes – in the groin and armpits.

• Altered behaviour.

• Respiratory/sudden cardiac arrest.

First aid treatment involves:

If the Patient is Conscious: If the Patient is Unconscious:
1. Move the person to a dry area. 1. Clear their airways and follow DRS ABCD Basic
2. Call for an ambulance on 000 or 112. Life Support process.
3. Seek assistance from a life guard/lifesaver if available.
2. Call for an ambulance on 000 or 112 and
4. Assess the person and start CPR if necessary (DRS ABCD Basic
don’t move the patient.
Life Support).
5. Pour vinegar onto the affected area – DO NOT use fresh
water.
6. If vinegar is unavailable – pick off the tentacle remnants (not
dangerous for the rescuer) and rinse with salt water.
7. Continually monitor the person and their ABC.
8. Be prepared to give CPR.
Anti-venom is available for box jellyfish stings.

Blue-Ringed Octopus & Cone Shell

Signs and symptoms of a bite from a blue-ringed octopus or cone shell include:
• Bite site – relatively painless, may be a spot of blood.
• Numbness of tongue and lips.
• Progressive muscle weakness.
• Respiratory arrest may occur within 30 minutes.
• Paralysis – the person may still be able to hear.

First aid treatment involves:

If the Patient is Conscious: If the Patient is Unconscious:
1. Reassure the patient and encourage them to rest and 1. Follow DRS ABCD Basic Life Support process.
stay calm. 2. Call for an ambulance – Dial 000 or 112.
2. Use pressure immobilisation technique for bite area.
3. Call for an ambulance 000 or 112.
4. If you are in an isolated/remote area, transport the
person to a medical facility.
5. Continually monitor the person and their ABC.
6. Be prepared to give CPR. Respiration may cease
although the heart will still beat with CPR.

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Stonefish, Bull Rout & Stingray

Signs and symptoms of stonefish, bull rout and stingray stings include:

• Severe pain.
• At site – swelling, open wound, discolouration.
• Possible external bleeding.
• Panic/irrational behaviour.

First aid treatment involves:

If the Patient is Conscious: If the Patient is Unconscious:

1. Place the stung area (only on a hand or foot) in hot 1. Follow DRS ABCD Basic Life Support process.
water, as hot as the person can tolerate, being careful 2. Call for an ambulance – Dial 000 or 112.
not to scald the patient.
2. If pain is not relieved a cold/ice pack may be applied.
3. Call for an ambulance on 000 or 112.
4. If you are in an isolated/remote area, transport the
person to a medical facility.
Anti-venom is available for stonefish stings.

Poisons
A poison is a substance that can cause injury, sickness and possibly lead to death.

Poisons can be found in the house, food, plants in the garden, in workplace chemicals or
in the environment.

When workplace chemicals leak into the environment by accident or faulty containment
processes, this is known as chemical contamination.

Poisons can enter the body by contact with the skin, ingested, injected or inhaled and they can be solid, liquid or gas
(including fumes and vapours). Many poisons may only be harmful if exposed to larger quantities.

As with any medical emergency it is important to try and identify the source of the poison and illness so that it may be
treated appropriately.

Inhaled Poisons include:

• Gases, including: carbon monoxide from an engine, carbon dioxide occurring
naturally from decomposition, nitrous oxide used in medicine, chlorine used in
pools and cleaning.
• Fumes from sources such as: glues, paints, petrol, drugs, including cocaine, as well
as other odourless fumes.

Ingested Poisons include:

• Medications – both prescribed and over-the-counter.
• Contaminated foods including mushrooms and shellfish.
• Alcohol.
• Cleaning products.
• Pesticides.
• Plants.

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Injected Poisons include:

• Those obtained through the bite or sting of insects, spiders, snakes, marine animals, etc.
• Those from drugs or medications injected through a needle or other sharp object.

Absorbed Poisons
Enter the body through the skin, mucous membranes or other body surfaces and
may include:

• Plants including: stinging nettle and English ivy.

• Chemicals.
• Fertilisers and pesticides.

Common signs/symptoms of poisoning include:

• Chest and/or abdominal pain.

• Nausea.
• Vomiting.
• Diarrhoea.
• Difficulty breathing/irregular breathing.
• Seizures.
• Presence of drugs.
• Sweating.
• Altered conscious state.
• Burns around the lips and tongue (if breathed in or swallowed).

General Treatment Principles

If the person is conscious and the scene is safe immediately call the Poisons Information Centre on 13 11 26. The operator
will tell you what to do and whether an ambulance should be called. If the person is unconscious call 000 or 112.

General steps for dealing with a poison’s situation are:

If the Patient is Conscious: If the Patient is Unconscious:

1. Survey the scene. 1. Check their airways and DRS ABCD Basic Life Support
i. If necessary, move the person from the scene process.
using one of the manual handling techniques. 2. Call for an ambulance – Dial 000 or 112.
ii. If you think there are still gases/fumes in the air
use extreme caution. Do not enter the scene if it
will endanger your own life – call 000 or 112
immediately and wait for emergency service
personnel to arrive.
2. Conduct a Primary Survey and follow DRS ABCD if
required.
3. If the casualty is conscious conduct a secondary
survey and gather extra information.
4. Collect any relevant items – containers, etc.
5. Call the Poisons Information Centre on 13 11 26 or the
emergency number and follow operator prompts.

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Substance Misuse – Alcohol & Other Drugs
Any drug can be misused when it is taken outside approved medical uses. With
over-the-counter or other commonly used drugs, there are strict instructions on the
package of the drug that specifies the daily dosage.

Examples are aspirin, ibuprofen, paracetamol, acetaminophen (Tylenol) and

products that contain codeine.

With all prescription drugs there is a sticker label with the name of the patient, the
daily amount to be taken and when to take the medication (e.g. morning/afternoon
or before/after meals).

Substance misuse occurs when a person takes an overdose of a drug and it becomes toxic to the cells and organs in the
body. There are accidental and intentional overdoses. As a result, a drug overdose can be life-threatening and require first
aid management.

Illicit drugs or street drugs are those obtained without a prescription and are illegal to possess.

Since drug users can inject drugs into their veins, first aid management includes
treating the patient for “needle stick injuries” as there may be multiple injection sites.

Alcohol overdose can be harmful and in extreme cases cause death.

Prescription drugs, over-the-counter remedies and illicit drugs can lower the person’s
tolerance of alcohol when taken together.

Too much alcohol consumption can cause drunkenness, impair judgment and make
the person more prone to accidents in the workplace when operating machinery or
driving.

Binge drinking can slow respiration and lead to unconsciousness. Too much alcohol
can cause death.

Signs and symptoms of alcohol and another drug poisoning:

• Skin – pale, clammy, cold.

• Nausea/vomiting/abdominal pain.

• Collapse/loss of consciousness.

• Drowsiness, confusion, hallucinations.

• Seizures.

• Mood changes.

• Difficulty or altered breathing.

First aid management of substance misuse is similar to treating casualties who have been affected by poisonous
substances because the body sees a drug overdose as being a poison. First aid treatments can include:

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 If the Patient is Conscious: If the Patient is Drowsy or Unconscious:
1. Survey the scene. 1. Check the person’s airways and follow DRS ABCD Basic
2. Carry out a primary survey and address any life- Life Support process.
threatening conditions. 2. Call for an ambulance – Dial 000 or 112.
3. Call the Poisons Information Centre/local emergency
number and follow directions.
4. Conduct a secondary survey – question the
person/bystanders and try and find out what, when
and how much of the substance was taken.
5. Help the patient into a comfortable position and calm
and reassure them.
6. Help maintain normal body temperature.
7. If the person becomes violent or threatening you
should remove yourself from the area.
Tell ambulance personnel if you think the person has used
a “designer drug” as this can require different treatment
and can affect how they respond to the incident.

Monitor and Respond to Casualty’s Condition

While you are treating the casualty, you need to monitor their condition. You
should also keep a record of any changes that you see as well as what first aid
you have provided.

This could include medication taken, how long a person is unconscious, use of
CPR, first aid procedures, breathing and circulation problems.

Keep monitoring the casualty’s vital signs including:

• Body temperature.
• Pulse (or heart rate).
• Blood pressure.
• Respiratory rate.

It is important to monitor and record these vital signs as they can change rapidly with
the casualty going in and out of consciousness. The casualty’s condition can get
better or worse according to the treatment you are providing.

If there are no life signs, you need to perform CPR. If you have access to an AED, you
may need to use it.

If you are in a remote area or unusual situation, you might be able to move the casualty to hospital yourself, as long as
they are not in a life-threatening situation. Usually, though, a casualty should not be moved as this could make their
condition worse or cause more pain.

Finalise First Aid Treatment

It is time to finalise your first aid treatment when you see and hear the ambulance arrive. You need to prepare for the
handover of the casualty to the emergency response services personnel who will take over treatment.

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Providing Assistance
When they arrive at the incident scene, the emergency services staff may need your help in providing further treatment to
the casualty. You should do everything you can to assist.

This may involve:

• Continuing CPR.
• Washing your hands, cleaning and disinfecting the resuscitation mask and other PPE with antiseptic hand rub.
• Cleaning and packing away items that belong to the first aid kit.
• Providing an incident report or notes – verbally and/or in writing – at the time of treating the casualty (if possible)
or right after you have finished while the information is fresh in your mind.

In reporting incident details after first aid treatment has finished you may need to
complete documentation such as:

• Written reports.
• Casualty details.
• Approved forms.
• Verbal report.
• Personal notes.

Reporting Incident Details

The paramedics, ambulance officers or other emergency services personnel will want
some details about the incident and the casualty’s condition.

You need to be accurate and stick to the facts about what has happened. If you are feeling
anxious or stressed, try to stay calm and take a few deep breaths before you speak.

When providing incident details to emergency response services, answer any questions
and give the information in a calm, clear and concise manner.

Incident and casualty details should include:

• Name of casualty.
• Age.
• Address.
• Time of incident.
• History of incident/injury.
• Description of any injuries and/or illness.
• Changes in level of consciousness.
• Changes in vital signs such as temperature.
• Changes in pulse and respiratory rate.
• Changes in the colour of the skin.
• Treatments administered.
• Changes in mental status.
• Response to each treatment.

Remember there are privacy laws that protect personal information in medical reports. This information must be kept
confidential.

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Reporting to Supervisors
You will also need to provide the same or similar details to your workplace supervisor
where appropriate. This will generally be a written method in the form of an incident
report or other approved document.

Each company has its own incident forms, but they should all record similar information
about the incident and casualty and follow the privacy laws in your state. When you fill
in and sign the form, it becomes a legal document.

See Appendix A for an example of a first aid/incident report form.

Reporting the incident to your supervisor may make your workplace safer by reducing
the chance of other workers being injured by the same, or similar hazard.

Each organisation will have policies and procedures for making incident and first aid
reports. These will be based on:

• Legislation relevant to providing emergency care.

• Legislation relevant to the organisation.

• Operational standard operating procedures.

• Operational performance standards.

Maintaining Confidentiality
You will find out private medical information about the casualty and this must not
be told to anybody except the emergency response service personnel who came to
the incident scene.

Information in incident reports, notes taken, and conversations held between

medical staff (paramedics, nurses and doctors) must be kept confidential.

Even after the incident, you should be careful when talking about it.

It doesn’t matter how long ago the incident occurred. Laws say you must maintain confidentiality about the medical or
personal details of any casualty you treat.

If it is a workplace incident, there are polices and standard operating procedures in place, protecting incident reports.

There is a risk of legal action being taken against you if the casualty holds you responsible for leaking any personal
information. Each state in Australia has its own privacy legislation and regulations that must be followed.

Evaluate Your Performance

Once you have handed over care of the casualty to professional medical personnel and
completed the required reports and forms you should look back and evaluate how well
you performed during the emergency.

This includes recognising and dealing with any psychological impacts the incident might
have had on yourself and the other rescuers.

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Recognising Psychological Impacts
Not everyone who is involved in critical incidents will be badly affected but some people can suffer from mental health
issues such as Post-Traumatic Stress Disorder (PTSD).

The signs of trauma or stress may include:

• Emotional outbursts.

• Irritability.

• Disturbed sleep.

• Flashbacks.

• Feeling numb.

• Anxiety.

Dealing with Stress

To help you deal with stress you could try talking to a friend, co-worker or trained counsellor for support. This is called
debriefing. You might visit your GP (family doctor) who can refer you to a qualified psychologist if necessary.

Community mental health services also provide counselling. Lifeline is a 24-hour confidential telephone crisis counselling
service available Australia wide. Free call on 13 11 14.

Information about accessing support for stress-related disorders can be found on the Beyond Blue website
(www.beyondblue.org.au) or telephone information line 1300 22 4636.

Apart from counselling, things like meditation and relaxation classes can help with stress. Check your general community
health centres or local council for information. You could do pleasant activities or hobbies that have helped in the past
like walking or listening to relaxing music. Eating well and getting enough sleep can also make things easier.

Debriefing and Self-Evaluation

After the emergency incident it is important to take part in debriefing.

Debriefing is important because by talking to your supervisor, work colleagues or a

counsellor you will be able to bring up any issues or concerns you might have had with
the emergency response process, including first aid procedures.

Debriefing is also a chance to learn more about your own abilities and reactions in a
crisis.

This is known as evaluating your performance. It helps you to look at how well you
responded during the emergency and to work out how to provide better first aid next
time.

Your organisation can also learn from your experience and develop methods to improve emergency response techniques.

Your supervisor might decide to send you to relevant training courses for professional development and to update the
skills needed to become a better first aider. Debriefing may also give you closure on the incident.

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Basic Anatomy and Physiology
When checking a casualty for injuries you need to be aware of the basic anatomy and physiology of the human body. You
will then be better able to assess the type of injury; how bad it is and how best to respond.

In life-threatening conditions, the heart can stop beating, organs can bleed internally, and the person may not be
breathing normally because the lungs are being affected by the injury.

Body System Description

This includes the skin, hair and nails.

The skin is the first line of defence in the body and is the organ
Integumentary you will mainly be working with.
System
Changes in the skin colour, temperature or texture should be
noted. Wherever possible, cuts in the skin should be covered to
avoid infection.

The respiratory system is concerned with breathing.

Respiratory It contains the lungs, mouth, nose and the windpipe.
System
If a person can’t breathe, they may suffer brain damage in less
than 4 minutes.

The circulatory system is how blood moves around the body. It

involves the heart, veins and arteries.
Abrasions and cuts to the skin will bleed and the rate of bleeding
will show you whether a vein or artery has been injured. Blood
Circulatory coming from a vein will ooze or flow but blood coming from an
System artery will spurt.
Arterial bleeding needs to be controlled urgently because a
person can bleed to death very quickly.
Pressure should be applied to any areas of bleeding.

The skeletal system is the framework of bones, tendons,

ligaments and muscles that holds the human body together.
You can usually see a broken bone as it will look deformed or out
of shape.
Skeletal System If you believe there is any chance of an injury being a broken or
fractured bone, it is better to treat it as a break and immobilise
the area until medical assistance arrives.
Strains and sprains to the muscles can be painful but are not life-
threatening.

The nervous system sends messages through every muscle, cell,

bone and fibre of the body.
Nervous System Damage to the nervous system that you need to worry about is
potential injuries to the spinal column.
This can kill or cause permanent paralysis.

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 Body System Description

The digestive system processes nutrients from the food provided

to the body. The main digestive system issues for a first aid
officer are:
Allergies.
Vomiting.
Diarrhoea.
Ingestion of poisons and foreign substances.
If a casualty has swallowed a foreign substance you will need to
Digestive System
call for medical advice immediately. This is because different
substances have different first aid responses. Don’t give the ill
person anything to drink unless a medical professional says you
can.
For allergies, a trained medical officer will have to give the
person antihistamine. Food-related upsets, such as vomiting and
diarrhoea, should also be treated by a doctor. Until they arrive,
give the casualty some fluids to sip. Remember to take note of
what fluids have been given, when they were given and how
much.

The urinary system enables the body to dispose of waste

materials.
Urinary System As a first aid officer, you will mainly be dealing with dehydration
of the casualty.
The darker the urine, the more dehydrated the person will be.

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Appendix A – First Aid/Incident Report Form
First Aid/Incident Report Form
Casualty Details
Name Home Address Allergies/Medication

Date of Birth Sex Phone (Home)

Phone (Work) Phone (Mobile)
First Aider Details
Name Home Address

Date of Birth Sex Phone (Home)

Phone (Work) Phone (Mobile)
Witness Details
Name Home Address

Date of Birth Sex Phone (Home)

Phone (Work) Phone (Mobile)
Incident Details

Date Time ____: ____ am / pm Location of Incident

Description of Incident Location of Injuries

Description of Injuries/First Aid Assessment

Observations
Time
Consciousness
Pulse
Respiration
Description of Treatment Referral
 Hospital (ambulance)
 Hospital (private transport)
 Own Doctor
 Other ________________________
First Aider Signature Date/Time

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