UNDER THE AUTHORITY OF

MARINA, NOTIP
WELCOMES YOU

Basic training On ELEMENTARY FIRST

AID

STCW Regulation VI/1-3 of Chapter VI

(STCW 2010 Resolution 1)

1 Nautical Options Training Institute of

the Philippines., Inc
Nautical Options Training Institute of the
Philippines., Inc.

DAY 1
INTRODUCTION

2
 Course Introduction
Explain the following:
—requirements in Regulation VI/1 and Section
A-VI/1;
—competences and KUPs in Table A-VI/1-3;
—objectives of the course and;
—course requirements
 STCW convention requirement
(Regulation)

In accordance with Course package Part A which

is the framework
The reason why you are attending
This course covers the mandatory competences
and the required knowledge, understanding and
proficiencies prescribed in Table A-VI/1-3 of the
STCW Code as amended.

This requires a total of 16 instructional hours to

cover the subject areas enumerated in Part B -
Course Outline.
INTENDED LEARNING OUTCOME

At the end of this session, the trainees should be

to take immediate action upon encountering
an accident or other medical emergency
 1. Assessment of needs of
casualties and threats to own
safety
1. Explain the importance of own safety as first
consideration during emergency
2. Explain the sequence of immediate measures to
be taken in cases of emergency
3. Raise an alarm based on the given medical
emergency
4. Examine the need of casualties in a given
medical emergency
 1. Assessment of needs of
casualties and threats to own
safety
1. 1 The importance of own safety as first
consideration during emergency

• One of the first things you will learn during your

first aid training is that you must look after
yourself
• ensure your own safety as a priority. It's not
being selfish, it's being practical.
• Keeping yourself safe means you are in a
position to help others rather than needing help
yourself.
 1. Assessment of needs of
casualties and threats to own
safety
Checking an Injured or Ill Person

1 CHECK the scene for safety, form an initial

impression, obtain consent, and use personal protective
equipment (PPE)

2 If the person appears unresponsive, CHECK for

responsiveness, breathing, life-threatening bleeding or
other life-threatening conditions using shout-tap-shout.
 Learning Checklist

► Assess the conditions of an accident.

► Identify immediately life threatening conditions.
► know when and how to call for medical
assistance.
► Do a detailed physical examination of a trauma
or medical patient.
► Obtained a concise but targeted medical
history of a patient.
► Know the difficulties to be expected when
giving first aid.
 Patient Assessment

Overview
1. Definition
a. Mechanism of kinematics of injury – How the
patient was injured.
b. Trauma – acquired injuries from accidents (
may include falls,motor vehicle
accidents,mauling,gunshot or stabbed wounds and
etc.)
c. Non trauma – afflictions or injuries of a patient
related to medical conditions ( infections,heart
and lung disease and etc.) without evidence of
trauma
2. Objectives
a. Physical examination of a patient whether trauma
or non trauma is aimed at determining other injuries that
may affect life or limb that are not immediately life
threatening.
b. Directed examination of a patient, with particular regard
to the mechanism injury will allow the first aider to direct
their examination by looking for probable injuries.
c. Vital signs are important but should not take precedence
over the presence of an open airway,breathing and
circulation, or bleeding.
Trauma assessment
1. Spine control
a. the most important aspect of
trauma assessment is the
documentation of injury and the
prevention of added injury during
the examination.
b. All trauma patient should be
suspected as having a spinal injury
unless proven otherwise by
radiographic means and/or
physician’s evaluation
c. Manual in line cervical spine
stabilization with or without
the use of a rigid cervical
collar is required in all trauma
patients.
2.Head to toe examination
a. Once the cervical collar has
been secured to the patient,
examination of the head,
neck, chest, abdomen, pelvis
and the extremities can
proceed.
b. trauma assessment is
focused on the identification
of the following injuries:
(Deformities,contusions,abras
ions,puncture,burns,tenderne
ss,lacerations,swelling)
c. The absence of the above
injuries in a patient may
indicate a non traumatic
cause. Further evaluation by
a physician may be needed.
d. Patients with suspected
cervical spine injuries should
be moved as a unit and
secured to a spine board or a
similar device to prevent
movement of the spine.
Non–trauma (Medical Assesment)
1. Sample history
a. In situations that there is no
evidence of trauma, the most
important tool to determine the possible
cause of the patients injury lies
on the ability of the first aider to ask
for the medical history of the patient
whether from the patients
themselves, relatives, or bystanders.
b. Of particular importance is
the history of previous illnesses (DM,
heart,
disease, etc.)
and,medications being taken will serve
as guides to the possible affliction of
the patient.
2. Head to toe examination
a. In the absence of
obvious injuries
(DCAP-BTLS), the focus of
the examination would
return to the ABC’s of life,
the vital signs, and other
clues from the Sample
history.
b. Always care for shock,
and refer immediately to a
physician for further
management.
 1. Assessment of needs of
casualties and threats to own
safety

1.2 Explain the sequence of immediate

measures to be taken in cases of
emergency
 FIRST AID

It is immediate and
continuing care given to a
person who has been injured
or suddenly taken ill.

It includes self helf if medical

assistance is not available; or
evidence of willingness to
help; and promotion of
confidence by the
demonstration of
competence.
 Objectives of First Aid

► To alleviate human suffering

► To prolong life
► To prevent added injury or danger
 Objectives of First Aid

Roles of First Aid

► It is the bridge that fills the

gap between the victim and
the physician
► It ends when the service of
physician begins.
► It is not intended to compete
with or to take the place of a
physician.
 Needs and Values of First Aid

► To minimize, if not totally prevent,

accidents
► To prevent added injury or danger
► To train people to do the right thing at
the right time.
► Accidents happen and sudden illnesses
are common and often serious.
► People very often harm rather than help
► Immediate and continuing care is
needed to save life or limb
Characteristics of a Good First
Aider
► Gentle
► Good Judgment
► Resourceful
► Tactful
► Observant
► Cheerful
► Common sense
 1. Assessment of needs of
casualties and threats to own safety

1. 3 Raise an alarm based on the given

medical emergency

Activate Medical Assistance

1.Who do I call?
2.Do I have the necessary
information?
3.What happened?
4.Number of injured?
5.What did I do to help the
patients?,
6.When do I call?
 1. Assessment of needs of
casualties and threats to own safety

1. 4 Examine the need of casualties in a

given medical emergency
 Emergency Care Principle

► Survey the scene

► Primary survey
► Activate medical
assistance
► Secondary survey
 Emergency Care
Scene survey
1. Is the scene safe?
a. What happened? { know the mechanism of injury}
b. Can I safely enter the scene?
2. Am I safe?
a.Do I have the necessary protection?{ clothes,
helmet, shoes, breathing equipment ,etc.}
b.Did I practice universal precaution?{ body
substance isolation precaution, mask, gloves, goggles,
gow n,etc
3. Can I help?
a. How many are injured?
b. Are there others that can help?
 ► Primary Survey
Check and perform 1. Is the patient conscious? (
Tap or shake the shoulders
Airway,Breathing and lightly and shout,” hey are
Circulation you ok?”
2. Is the airway open?
( Do the Head Tilt Chin Lift
Maneuver or Jaw Thrust
Maneuver
Head Tilt Chin Lift
Maneuver
-method of opening
the airway

Jaw Thrust Maneuver

- use when suspect
cervical spine injury
3. Isthe patient breathing?
( Look, Listen and Feel)
Look for chest to rise and
fall,Listen for breathing,
Feel for air coming out of the
victim’s nose and mouth.

a. If the patient is not breathing give

2 slow, long and full breaths just
enough to make the chest visibly
rise using either mouth to mouth
ventilation or mouth to nose
ventilation
4. Does the patient have signs of
circulation? ( Carotid pulse,
movement, coughing, etc:
a. Check the carotid pulse, first
locate the laryngeal
prominence(adam’s apple) and
slide your fingers toward you
until you reach a groove
between the windpipe and the
large neck muscles
5. Is the patient bleeding? Do a
rapid blood sweep.
b.The use of available barrier
devices to decrease the incidence
of disease transmission to and
from the rescuer.
(i.e: face shield and pocket mask)
► Secondary survey
1.Does the patient have other
injuries?( look for deformities,
contusions,
abrasions,punctures,burns,tendern
ess,lacerations,swelling,etc:
2. Did I take a good history? for
conscious patients only
a. signs and symptoms
b. allergies
c. medications
d. past medical history
e. last meal
f . Events leading to the
accident or injury.
3. Is the patient in pain?
a. Onset of the pain
b. Provocative and palliative factors
c. Quality of the pain
d. Radiation of the pain
e. Severity of the pain
f . Timing of the pain
4. What are the patients vital sign?
a. Pulse rate = Normal: 60 - 100
b. Respiratory rate = Normal: 12 -20
c. Blood pressure = Normal: 120/80
d. Capillary refill time = Normal: 2-3sec
e. Body temperature = Normal: 36.5-37.5 deg Celsius
5. Did I do a proper head to toe assessment?
Golden Rules of Emergency Care
What to do:
a. Do remember to identify yourself to patient.
b. Do obtain consent to give care or examine a
patient whenever possible.
c. Do call or send for help
d. Do think of the worst, its best to administer first
aid to the gravest possibility.
e. Do be as calm and as direct as possible.
 f. Do loosen tight clothing.
g. Do respect the patient’s modesty and
physical privacy.
h. Do handle a patient to a minimum.
i. Do provide comfort and emotional support.
j. Do keep onlookers away from the injured
person.
k. Do assist the patient with their
prescription medication.
What not to do:
a. Do not further harm the victim.
b. Do not let the patient see their own injury
c. Do not leave the patient alone except to get help.
d. Do not assume that the patient’s obvious injuries are the
only injuries
e. Do not make unrealistic promises.
 2.0 Body Structure and
Functions

2.1 Explain the body structure and function of the

following:
— Skeletal system
— Joints, muscles and tendons
— Major organs (brain, heart, lungs)
— Circulatory system
 2.0 Body Structure and
Functions
2.1 Explain the body structure and function of the
following:
— Skeletal system

Body's central framework.

It consists of
•bones and connective tissue,
•including cartilage, tendons,
•and ligaments.
• It's also called the musculoskeletal system.
 Musculoskeletal system

The musculoskeletal system

(also known as the locomotor
system) is an organ system that
gives the ability to physically move
using the muscles and skeletal
system
 Musculoskeletal system

The human musculoskeletal

system consists of the human
skeleton, made by bones
attached to other bones with
joints, and skeletal muscle
attached to the skeleton by
tendons.
Skeletal system
 Functions of Musculoskeletal
system

Leverage:

A lever is a simple machine that magnifies speed of

movement or force. The levers are mainly the long
bones of the body and the axes are the joints where the
bones meet.
 Functions of Musculoskeletal
system

Joints, muscles and tendons

 Functions of Musculoskeletal
system
Joints, muscles and tendons
Joints:

Bones come together to form

joints. Some joints have a large
range of motion, such as
•the ball-and-socket shoulder
joint.
•Other joints, like the knee, allow
bones to move back and forth
but not rotate.
 Functions of Musculoskeletal
system
Joints, muscles and tendons

•Muscles: Each muscle is made

of thousands of stretchy fibers.
•muscles allow you to move, sit
upright and stay still. Some
muscles help you run, dance
and lift.
•You use others to write your
name, fasten a button, talk and
swallow.
 Functions of Musculoskeletal
system
Joints, muscles and tendons

Tendons:

•. Tendons connect muscles to

bones.
•Made of fibrous tissue and
collagen,
•tendons are tough but not very
stretchy
 2.0 Body Structure and Functions

2.1 Explain the body structure and

function of the following:
— Major organs (brain, heart, lungs)
 2.0 Body Structure and
Functions

The human body contains five organs

that are considered vital for survival.
They are the brain, heart, kidneys,
liver, and lungs
 2.0 Body Structure and Functions

• Brain. The brain is the body's control center.

• Heart. The heart is the most important organ of the
circulatory system, which helps deliver blood to the
body. ...
• Lungs. The lungs work with the heart to oxygenate
blood. ...
• Liver. The liver is the most important organ of the
metabolic system. ...
• Kidneys.
 Nervous system

Nerve Cells

The nervous system is the body's

information gatherer, storage center
and control system. Its overall
functions are to collect information
about the body's external/internal
states and transfer this information
to the brain (afferent system), to
analyze this information, and to send
impulses out (efferent system) to
initiate appropriate motor responses
to meet the body's needs
 The brain is a complex organ that
•controls thought
• memory
• emotion
• touch,
•motor skills
•vision,
•Breathing
•Temperature
• hunger and
•every process that regulates our body.
► Brain Structures
► the cerebrum
► the cerebellum
► the diencephalon
(thalamus,
hypothalamus,
sometimes classed as
cerebral structures); and
► the brain stem (medulla
oblongata, pons,
midbrain), which is an
extension of the spinal
cord.
Nervous system
 Body Structure and Functions

Cardiovascular system

is an organ system that moves

nutrients, gases, and wastes to and
from cells, helps fight diseases and
helps stabilize body temperature
and pH to maintain homeostasis.
 Cardiovascular system

Components:
a. Heart
b. Blood
c. Blood vessels
The Heart
Cardiovascular system
 Respiratory system

Respiratory system is made

up of the organs in your
body that help you to
breathe.
Respiration = Breathing.
The goal of breathing is
to deliver oxygen to the
body and to take away
carbon dioxide. It also
maintains the acid base
balance.
► The major function of respiratory
system is gas exchange
► BREATH IN -- your body gets
oxygen from the air. Rib muscles
contract to pull ribs up and out.
The DIAPHRAGM muscle
contracts to pull down the lungs.
Tissue expands to suck in air.
► BREATH OUT -- you get rid of
other gases that your body does
not need. Rib muscles relax. The
Diaphragm muscle relaxes. Tissue
returns to resting position and
forces air out.
 2.0 Body Structure and Functions

2.1 Explain the body structure and function of

the following:
— Circulatory system
 2.0 Body Structure and Functions
— Circulatory system

The circulatory system is made up of blood

vessels that carry blood away from and towards
the heart. Arteries carry blood away from the heart
and veins carry blood back to the heart. The
circulatory system carries oxygen, nutrients, and
hormones to cells, and removes waste products,
like carbon dioxide.
 The Blood

► Consisting of liquid plasma and

cell
Composition:
a. Red blood cells
( erythrocytes) – carries
hemoglobin that transport
oxygen into tissue
b. White blood cell
( leukocytes) – responsible in
combating infection
c. Platelets
( thrombocytes) - responsible for
clotting mechanism
 The Blood Vessels

► Arteries – carries blood away

from the heart
( oxygenated blood).
► Veins- Carries blood towards the
heart
( unoxygenated blood).
► Capilliaries – connect arteries
and veins. They are tiny tubes
that exchange food, oxygen and
wastes between blood and body
cells.
 Digestive system

► The digestive system is made up of the digestive

tract—a series of hollow organs joined in a long,
twisting tube from the mouth to the anus—and other
organs that help the body break down and absorb food
(see figure).
► Organs that make up the digestive tract are the mouth,
esophagus, stomach, small intestine, large
intestine—also called the colon—rectum, and anus.
Inside these hollow organs is a lining called the
mucosa. In the mouth, stomach, and small intestine,
the mucosa contains tiny glands that produce juices to
help digest food. The digestive tract also contains a
layer of smooth muscle that helps break down food and
move it along the tract.
 Functions of digestive
system:

►Digestion
►Absorption
►Secretion
►Motility
►Metabolism
Video/Picture of Body
structure

Video clip Film – Anatomy

and Physiology
3D anatomy tutorial from AnatomyZone, published 10/5/2012
on
YouTube (https://youtu.be/OIU7Mdx4DTg)
3.0 Measures to be taken in
case of emergency

3.1 Position Casualty

3.1.1 Explain the procedures in
positioning a casualty in an
emergency:
— Recovery position
— Resuscitation position
 3.0 Measures to be taken in
case of emergency

Recovery position

In first aid, the recovery

position (also called
semi-prone) is one of a
series of variations on a
lateral recumbent or
three-quarters prone position
of the body, often used for
unconscious but breathing
casualties.
 . Recovery position:

1.Place nearest arm at right angle.

2.Put the back of other hand next to the cheek
closest to you and hold it there.
3.Bend the far knee, grasp the far leg and roll
them onto their side.
4.Open airway
 The Recovery Position

1.The patient should be in near a true lateral

position as possible with the head depended
to allow free drainage of fluid.
2. The position should be stable.
3. Any pressure on the chest that impairs
breathing should be avoided.
4. It should be possible to turn the victim onto
his or her side and return to the back easily
and safely, heaving particular regard for the
possibility of cervical spine injury.
5. Good observation of and access to the
airway should be possible.
6. The position itself should not give rise to any
injury to the victim.
Procedure, Part 1 Procedure, Part 2

Procedure, Part 3
3.1.2 Position a casualty in
accordance with the
established procedure
 Unconscious Casualty

an abnormal state resulting from an interruption

of the brain’s normal activity brought about by
some interference with the function of the nervous
system and circulation. It may be progressive, and
urgent treatment is necessary.
 Level of consciousness

a. Alert – well aware of what is going on and reacts

appropriately to factors in the environment.
b. Restless – extremely sensitive to factors in the
environment and exaggerates them.
c. Stuporous – lies quietly in bed,seems to be sleeping
and request nothing, is awakened by a voice or by pressure
or pain being applied.
d. Comatose – lies quietly in bed,appears to be sleeping
and cannot be awakened.
 Priority

Airway
Breathing
Circulation
If the casualty has an
accompanying neck and back
injury – do not move him
unless necessary. Keep him
flat his back or maintain
position where you have found
in.
If the casualty is unconscious and
without any spinal injury. Place him in
the recovery position.
3. Keep the casualty arm, by covering
him with a blanket. Loosen any tight
clothing, which restrict any breathing
movement.
4. If casualty complains of thirst,
moisten his lips with water.
5. Monitor and record the pulse and
breathing rate.
6. Transfer casualty if possible. His life
depends on immediate blood
transfusions and other medical
treatment.
Film – Medical Emergency
at Sea
Link: https://youtu.be/vHU2xU9hdZs
 Resuscitation position

• Put the person on his or her back on a firm

surface.

• Kneel next to the person's neck and shoulders.

• Place the lower palm (heel) of your hand over the

center of the person's chest, between the nipples.

• Place your other hand on top of the first hand.

Kinds of Airway Obstruction

A. Anatomic – occurs when the airway is blocked

by the tongue (most common cause),
dropping to the back of throat.
B. Mechanical – cause by solid foreign objects.
.
Types of Airway Obstruction

a. Partial airway obstruction with good air

exchange – the victim can still cough,talk, and
breath but with some difficulty.
b. Partial airway obstruction with poor air exchange
- the victim presents with a high pitched noise while
breathing and has a weak and ineffective cough.
c. Complete airway obstruction – the victim may clutch
their throats with one or both hands ( universal distress
signal for choking)
 Airway Obstruction

Partial or complete blockage of

the breathing tubes to the
lungs. Obstruction of the
airway can be due to different
causes including foreign
bodies, allergic reactions,
infections, anatomical
abnormalities and trauma
Causes of obstruction:
a. improper chewing of large pieces of food.
b. excessive intake of alcohol
c. the presence of upper and lower dentures

Signs and symptoms of airway obstruction:

a. Victim gasping for air

b. Victim cannot speak and cough
c. Victim is holding of throat
d. Victim collapses – falls unconscious
e. Victims becomes cyanotic ( bluish discoloration).
 First aid management
For conscious victim
Heimlich maneuver
( abdominal thrust)
- 6 to 10 quick upward thrusts
compression above the navel
but will below the xiphoid
process to avoid abdominal
injuries.
- this produces an artificial
cough that might remove the
obstruction.
• Standing chest thrust Chest thrust
- for obese and
obviously pregnant
patients, the abdominal
thrust cannot
performed.

• Supine chest thrust - the hands are placed

on the breastbone and
backward thrusts are
performed
Conscious victim and victim who
becomes unconscious.
a. identify airway obstruction – ask
the victim if he/she is choking
b. apply the heimlich maneuver
( subdiaphragmatic abdominal
thrust) until the foreign body is
expelled or the victim becomes
unconscious.
c. open the mouth of the unconscious
victim and perform finger sweep.
d. if unable to ventilate,additional 6
to 10 subdiaphragmatic abdominal
thrust.
e. Repeat the sequence of heimlich if
necessary.
Unconscious victim
c. open the mouth of
the unconscious victim and
perform finger sweep.

d. if unable to ventilate,additional
6 to 10 subdiaphragmatic
abdominal thrust.
e. Repeat the sequence of
heimlich if necessary.
3.2 Resuscitation techniques
 Resuscitation
Basic Life Support
- This includes the Artificial Respiration and
Cardio – Pulmonary Resuscitation

- An emergency life saving procedure that

consists of recognizing and correcting failure of
the respiratory of cardiovascular systems.

- It compromises the ABC step, which

concerns the airway .breathing ,circulation.
 Resuscitation
Basic Life Support
- It compromises the ABC step, which concerns
the airway .breathing ,circulation.
 Resuscitation

Basic Life Support

- It requires no instruments or supplies and the

correct application of the steps for dealing with the
above three problems.

- Must be undertaken with maximum sense of

urgency. - Once you have started BLS,do not
interrupt it for more than 5 secs for any
reason,except when it is necessary to move the
patient, even in that case,interruptions should not
exceed 15 secs each
 Resuscitation
2 Cases of BLS (Basic Life Support)

▪ Respiratory arrest

▪ Cardiac arrest
 Resuscitation
2 Cases of BLS (Basic Life Support)

▪ Respiratory arrest
The victim is negative breathing, positive
pulse, Artificial respiration is necessary.

Objectives

- To open the airway

- To maintain the airway open all times.
- to restore breathing
 Resuscitation
2 Cases of BLS (Basic Life Support)

Ways to perform Artificial Respiration

-Mouth to mouth

- Mouth to nose

- Mouth to mouth to nose

- Mouth to stoma

--Mouth to mask breathing

 Artificial Resuscitation

❖ Survey the scene “ the scene is safe”

❖ Check for responsiveness( by tapping the

shoulder of the victim). “Hey, are you ok?
The victim is unresponsive!”

❖ Shout Help! Activate Medical Assistance

maneuver)

❖ Check the mouth. “Mouth is clear

 Artificial Resuscitation

❖ Do the LLF procedures. Look for the chest

movement, Listen to the air sounds, Feel for the
air movement. This is done for 5 seconds. “Victim
is breathless.”

❖ Give 2 initial blows.

❖ Check the carotid pulse for 10 seconds – initial

checking. “Victim is (-) breathing, (+) pulse”.
 Artificial Resuscitation

❖ Activate Transfer facility (EMS/RMA) while I am

doing the AR”. Do the AR: 1 blow / 5 seconds =
12 cycles

❖ Do the AR: 1 blow / 5 seconds = 12 cycles.

❖ Check the carotid pulse for 5 seconds –

rechecking. “The victim has (+) breathing and (+)
pulse”.

❖ Position victim in Recovery Position.

 Artificial Resuscitation
Cardiac arrest
❖-for life to be sustained, a constant supply of oxygen
to the brain must be maintained. The oxygen is
delivered to its tissue by the circulating blood. The
pump that maintains this supply is the heart. If the
heart stops (cardiac arrest), death will result unless
urgent action is taken.

❖ a condition wherein the heart and lung function

cease to provide circulation to the body

❖can be due to medical conditions like heart

attack,stroke etc. .
 Artificial Resuscitation
Signs and symptoms

❖ Chest discomfort – uncomfortable pressure,

sqeezing, a feeling of fullness or tightness, aching,
crushing, constricting, oppressive or heavy.The pain
described as being in the center of the chest behind
the breastbone. The pain may spread to one or both
shulder’s and arms, or to the neck jaw or back.

❖Shortness of breath

❖- Nausea - Sweating
 Cardio Pulmonary Resuscitation
❖ an artificial means of restoring the body’s circulation
by means of external chest compression and rescue
breathing.

❖ may give as much as 25% of the normal circulation of

the brain when properly done.

❖Objectives

- to provide circulation when the patient’s natural

circulation has stopped or is inadequate to provide the
brain or and other vital organs with circulating blood.

- To provide artificial respiration when breathing has

stopped
 Cardio Pulmonary Resuscitation
❖Check the mouth. “Mouth is clear”.

❖DO the LLF procedures. Look for the chest movement,

Listen to the air sounds, Feel for the air movement.
This is done for 5 seconds. “Victim is breathless”.

❖Give 2 initial blows.

❖Check the carotid pulse for 10 seconds – initial

checking. “Victim is (-) breathing, (-) pulse”. Activate
Transfer facility (EMS/RMA) while I am doing the
 Cardio Pulmonary Resuscitation
❖Do the CPR:

❖IMO = 15:2 = 4 cycles/ 1 minute

❖AHA = 30:2 = 4 cycles.

❖PHA = 30:2 = 4 cycles

❖Check the carotid pulse for 5 seconds – rechecking.

“The victim has (+) breathing and (+) pulse

❖Position victim in Recovery Position

Procedures of CPR
Procedures of CPR
Procedures of CPR
Procedures of CPR
 Procedures of CPR
Don’t’s in doing chest compression

- jerker - bouncer - bender

- Rocker - massager - double crosser

When not to start resuscitation

- when the patient has spontaneous breathing and

circulation.
-when the patient has suffered severe mutilation

-when the patient show signs of death or

decomposition
 Procedures of CPR

When to stop resuscitation

-when spontaneous breathing and circulation has returned

- when medical assistance arrived or other trained in doing
CPR
- when rescuer is exhausted - when doctor pronounced
victim is dead
 3.3 Control of bleeding

The first and the most commonly used way of

controlling external bleeding is to:

❖apply pressure over the bleeding spot and

❖applying firm pressure for five to ten minutes,
continuously. ...

In addition to the pressure pack, you may use certain

agents that control bleeding effectively. ...
Tie a tight bandage over the bleeding part. ...
 3.3 Control of bleeding
Wounds and Bleeding Wounds

-Is an abnormal break in the continuity of skin or

skin or underlying tissue of the body, which permits
the escape of the blood, externally or internally.

Types of wounds

a.Open wounds

b. Closed wounds
Types of open wounds

A. Abrasion – Caused by
scraping or rubbing
against rough surfaces. It
often embedded
particles that may cause
infection.
Types of open wounds

B. Puncture – Caused by
sharp pointed instruments
like nails, ice picks,
bullets etc.

C. Avulsions – Caused by
motor vehicle accidents,
explosions, animal bites,
power tools, etc. Thes skin
I seither partially or
completely torn apart.
Types of open wounds

D. Lacerations – caused by
rough edged like broken
glass, tin cans, barbed wire,
or blunt instruments, usually
has torn, irregular edges
often has profuse bleeding.

E. Incision – Caused by sharp

objects like knife, razors,
bolos etc. Usually has clean
edges but often has profuse
bleeding.
Types of bleeding
Internal bleeding
- resulting from an injury in
which blood escapes into
tissue spaces or the body
cavity.

External bleeding
- may result due to an
injury outside the body.
 Classification of Bleeding in
open wounds
Capillary bleeding
- dark red turning bright red in
color
- little blood can be lost
- clotting is spontaneous

Venous bleeding
- Dark purplish red turning bright
red in color
- blood oozes from the wound
- bloodloss could be significant
 Classification of Bleeding in
open wounds

► Arterial bleeding
- bright red in color
- blood spurts from the blood
vessel
- blood loss is profuse
Signs and symptoms for excessive
blood loss

- anemia - dizziness
- body weakness or fatigue - thirst
- moist, clammy skin - pale in color
- increased pulse rate - restlessness
- shortness of breath - apprehension
- dilated pupils
Management for open
wounds
1. Control bleeding
- direct pressure
- elevate the affected
extremity
- pressure bandage or
torniquet
2. Cover the wound
- clean small wound with
sterile saline solution
- cover the wound with
sterile dressings
- cover and secure the
dressings with clean
bandages.
3. Care for shock
4.Refer to physician.
Closed wounds
The simplest closed wound is
a bruise also known as
contusion
Bruises result when the body is
subjected to force.
- any injury resulting from
trauma without breaking through
the skin
- may involved muscles,
subcutaneous tissue, most
importantly the internal organs.
- can be life threatening if it
involves the brain, chest,
abdomen, and pelvic cavity.
 Signs and symptoms of closed
wounds
- pain and tenderness on the
surrounding area
- swelling
- discoloration
- deformity
►Management of Closed Wounds
- ice application
- compression (manual)
- elevate the injured part
- splinting (if necessary)
 3.4 Shock management

3.4.1 The factors causing shock and

identify its signs
3.4.2 The measures to be taken in case
of shock
 The factors causing shock and
identify its signs
Shock
- A depressed condition of
many of the body’s vital
functions due to the failure of
enough blood to circulate
through the body.
- Usually follows serious injury
or illness.
- May be caused by
Hemorrhage, Burns, Crushing
Injuries, Infections, Fractures,
Heart Attack, Stroke, Bullet
Wounds, Poisoning, Spinal
Injuries, etc.
 Causes of Shock

- Primary Pump Failure

> injury to the heart due to trauma or an underlying
heart disease.
- Fluid Loss
> blood loss due to traumatic injuries or fluid
and electrolyte losses which may be caused
by diarrhea, vomiting, or excessive perspiration.

- Disseminated Shock
> due to blood vessel dilatation due to toxins or
allergens, spinal cord injuries, psychogenic
stimulus, etc.
Factors Contributing to Shock
1. Pain
2. Rough Handling
3. Improper Transportation
4. Continuous Bleeding
5. Exposure to the Elements
6. Fatigue
Stages of shock
- Early stage( non progressive or compensated stage)
- Late stage( progressive or decompensated stage)
- Irreversible stage ( near death)
Treatment
- In treating a person in shock,
objectives should include
improvement of the circulation of the
body; supplying an adequate supply of
oxygen and maintaining normal body
temperature
Positioning
1. Lay the casualty down and treat
the cause of shock
2. Position the casualty
- If conscious and without any neck
injury or back injury – place the victim
flat on his back and elevate the lower
extremities about 8-12 inches
Signs and symptoms of shock

a. In the early stages

- restlessness and irritability
- rapid and weak pulse
- rapid breathing
- Paleness, bluish skin
- excessive thirst
- Nausea and vomiting
- Drowsiness
Signs and symptoms of shock

b. Late stage
- apathetic
- unresponsive
- dilated pupils
- Blood pressure progressively decreased
3.5 Burns and Scalds, Accidents
caused by Electric Current

3.5.1 Identify the signs of burns and scald and of

accidents caused by electric current

3.5.2 Explain the appropriate measures to be taken

in the event of burns and scalds and of accidents
caused by electric current
 Burns
► It is injury to the skin due to
exposure to heat , chemicals to
heat, chemicals, electricity and
radiation.
► It causes shock by damaging
surface tissue and dilating
underlying blood vessels
leading to an extensive loss of
body fluids and heat.
► It is considered severe when it
involves individuals in the
extreme age groups ( the very
young and the very old) when it
involves the face, genital area,
or any circumferential part of
the body.
 Types of Burns

1. Thermal Burns –
caused by fire,flame,hot
objects, hot water and
steam.
a. Dry or direct heat
b. Moist heat or scalds

2. Electrical burns –
caused by electricity
 Types of Burns

3. Chemical burns – caused by

chemical or corrosive
substance may irritate or
damage the skin

4. Radiation burns – this can

be exposed by over exposure
to the rays of the sun or any
matter that had radiation.
 Depth of the burn
a. Superficial burns – first degree burn, the affected
area is painful but only the outermost layer is
involved, no blister occur
b. Superficial partial thickness burns and deep partial
thickness burns – second degree burn, often result
from contact with hot liquids or solid, flame or direct
chemical contact, blister formation and extremely painful.
c. Full thickness burns – third degree burn, most serious
type of burn, destroy all layers of the skin and any or all of
the underlying structures. They can be either extremely
painful or relatively painless if the destroy all nerve endings.
First degree burn
Second degree burn
Third degree burn
Extent of burns
- The area of burns gives an
approximately indication of the
degree of shock that will develop,
and, with depth, can be used as a
guide to the level of treatment
required. Extent is expressed in
terms of percentage of the body’s
total surface area. The “Rule of
Nine” which divides the surface
area of the body into areas of
approximately nine percent, used
to calculate extent.
 Emergency care for burns
► Remove the patient from source of the burn
► Eliminate or reduce the source of the burn (cool
thermal burns, remove the patient from the sun
or electrical apparatus, wife off the chemicals).
► Assess the condition of the patient
► Cover the burn with a sterile non adhering
dressing
► Care for shock
► Refer to physician for further management
 Management for specific
types of burns
Radiation Burns
- for superficial and superficial partial thickness burns
without blisters, flush with lots of cool running water.
- apply moist dressing and bandage loosely.
- do not attempt to open blisters.
- care for shock.
- consult or refer to a physician for further management.
Chemical Burns
- immediately wipe off the chemicals from the affected area
with a clean cloth.
- flush with copious amounts of cold running water for at least
15 minutes or until the sensation of burning stops.
- Remove clothing and jewelry where the chemicals have
spilled.
Electrical burns
- Do not touch downed power lines.
- Keep the bystanders well away from any source
of live current.
- If the emergency is inside, turn off the electricity at
the fuse box or circuit breaker.
- Call for medical assistance
- Do a primaryand secondary survey, check for more
than one burn site or other associated injuries.
- Cover all burns with moist loose dressing then
bandage.
6.0 Rescue and transport a casualty

6.1 Procedure in rescuing and transporting

a casualty and the appropriate
 Rescue and Transport of Casualty

Spinal Cord Injury

- Spinal injury is a common condition following trauma
especially after vehicular accidents and as such should be
considered in all patients with trauma until proven
otherwise by physical examination by a physician and or
radiographic means.
- a. Muscle weakness
b. Loss of sensation of a particular area of the
body.
c. Loss of bladder or bowel function
d. Shock (Hypotension, Tachycardia, Tachypnea, etc.)
 Management of Spinal Injury
Cervical Spine Injury Control
- Immediate manual in line stabilization of
the cervical spine is of primary importance
in any victim of trauma along with the
recognition and management of airway,
breathing and circulation problems.
- the use of a rigid cervical collar has
decreased the incidence of the complications
of spinal injury (e.g. paraplegia or
quadriplegia)
 Transfer

► Is the transfer of a patient from a place of relative

safety to more secure area or a medical facility.
► During transfer care, should be done to prevent
added injury to the patient.
► Factors to be considered:
a. nature and severity of the injury.
b. Size and weight of the victims
c. physical capabilities of the rescuer
d. Number of available rescuer and equipment.
e. Distance to be traveled.
 Basic Principles

a. Maintain an open airway

b. Control bleeding
c. The victim is safely maintained in the correct position
d. Secure the victim
e. Regular checks of the victim’s condition are made.
 Methods of Rescue and Transfer
Single Rescuer
- Assist to walk
- Carry in arms
- Pack strap carry
- Fireman’s drag
- Fireman’s carry
- Body drag
- Shoulder or inclined drag
- Foot drag
- Packstrap
- Fireman’s crawl
 Single Rescuer

Assist to walk Arm’s Carry

• Packstrap • Body
carry drag
Shoulder drag • Fireman’s carry

• Fireman’s drag
 Two Rescuer
The two man carries describe
below are considered “
Types: emergency techniques”, like
► Four hand seat the one –man carry, they are
designed primarily to move
► Hands as a litter sick or injured patients from
► Carry by extremities hostile environments.
Rescuer should remember,
► Fore and Aft Carry however, that neither of these
methods is suitable for
moving patients with spinal
injuries .
Hand as a litter • Four hand seat

• Fore and Aft • Carry by

Carry extremeties
 Three – Man or more Carries

Bearers along side – this carry

is desirable for picking up a
person and carrying abreast in
a straight line or for passing
through a narrow passageway
 7.1Bandages and other materials
in the emergency kit

First Aid - Types of Bandages

Bandages are an essential part of every first aid
kit. They’re amongst the most useful items for
any first-aider, with a number of potential
applications which are useful when dealing with
the majority of everyday accidents and injuries.
 Bandaging, Infectious Diseases
and Enclosed Spaces
Dressing
- Any sterile material used to directly cover the
wound
- Can be made out of cloth, gauze, or any available material.
- It is used to control bleeding, absorbs fluids from the wound
and to prevent germs from entering the area.
Types
- Commercially prepared ( e.g rolled gauze, pads, or sheets,
synthetic wounds pads or dressings,etc)
- Improvised – any sterile absorbent material.
 Types of Bandage

Roller Bandages

Roller bandages are the most common

type of bandage. They’re normally made
from a single continuous strip of lightweight
and breathable cotton gauze, used
primarily for holding dressings against
wounds.

Triangular
Bandage
Triangular bandages are amongst the
more versatile types of bandaging you
can usually find in a first aid kit. They
are designed for constructing slings
that Support soft tissue injuries and
immobilize broken bones.
 Types of Bandage

Tubular Bandage

Tubular bandages are perhaps the least

versatile of the three conventional
bandages. They provide compression,
can be used to immobilize/support knee
and elbow joints and, in some cases, hold
a dressing against a limb.

Tubular bandages look like a long ring of

bandage within a first aid kit,
► Bandaging
- Any clean cloth or
material used to hold
the dressing in place.
- Can be used to control
bleeding, to secure a
splint, to immobilize and
support body part
Bandaging
Triangular bandage
A. Open Phase
- Top of the head bandage
- Front or back of the phase
bandage
- Front or back of the chest
bandage
- Arm or underarm sling
- Hand or foot bandage
B. Broad Cravat
- Abdominal binder
- Knee bandage
C. Semi- broad Cravat
- Shoulder or hip bandage
- Arm or leg bandage
- Elbow bandage
D. Narrow Cravat
- forehead bandage
- eye bandage
- neck bandager
- Ear, cheek, and jaw bandage
- Palm bandage
- Palm pressure bandage
- Sprained ankle bandage shoe
on/off.