BASIC FIRST AID COURSE 1

2 BASIC FIRST AID COURSE

 BASIC FIRST AID COURSE 3

BASIC FIRST
AID COURSE
House Keeping
• Fire Exits
• Toilets
• Schedule for today
• Mobile phones
• Smoking areas
4 BASIC FIRST AID COURSE
 BASIC FIRST AID COURSE 1

Content
Roles and responsibilities of a first aider 2
Assessing an incident 6
Managing an unresponsive casualty 11
The respiratory system 15
Wounds and bleeding 17
Shock 21
Seizures 22
Minor injuries 24
Fracture and dislocation 28
Chest injuries 33
Major illness 35
Heat and cold injuries 40
Other injuries 43
 2 BASIC FIRST AID COURSE

Roles and responsibilities

of the first aider
Learning objectives

The learner will be able to:

• Describe the legislative requirements of a first aider
• Describe your role within your employment as a first aider
• List items you would find in a first aid kit
• Explain how the first aider takes control of the scene of an accident
• Demonstrate how to correctly fill out an accident report form
Roles of the first aider:

• Preserve Life – Administer immediate effective first aid to a casualty in

order to save life.
• Prevent the Condition from Worsening – Recognising and treating the cause
will assist with preventing the condition from worsening.
• Promote Recovery – Administer ongoing treatment and offer constant
support until the arrival of qualified medical assistance.

Responsibilities

The responsibilities of the first aider will be dependent on specific workplace

requirements, these could include:
• Ensuring the first aid equipment is fit for purpose
• Arriving at the scene
• Ensuring the scene is safe
• Contacting the emergency services
• Prioritising the treatment of casualties
• Clearing up after an incident
• Incident reporting and recording
Arriving at the scene

When arriving at a scene the first aider must:

• Always try to remain calm
• Take charge of the situation
• Conduct a scene survey
• Ensure the safety of yourself, bystanders and others
• Gather information from bystanders and the casualty
• Fully brief the emergency services
 BASIC FIRST AID COURSE 3

Contacting the emergency services

First aiders with ether contact the emergency services themselves or instruct a
bystander to do so.

Contacting the emergency services at the earliest opportunity is paramount.

When contacting the emergency services on ether 999 or 112, it is important that
the information gives is clear, concise and sufficient.

prioritising the treatment of the casualties

After conducting a primary survey and contacting the emergency services,

casualties should be placed in an order of priority and treated accordingly. This
order is as follows:

Minimising infection

It is important that as the first aider you do not transmit infections to your
casualty or indeed contract infections from your casualty.
To assist in minimising the risk of infection and cross-contamination there are
various precautions that can be taken:
• Having good personal hygiene
• Ensuring that barrier devices are used
• Covering any open cuts or sores
• Minimising contact with blood or bodily fluids
• Changing gloves between casualties
• Washing hands thoroughly after removing gloves

Barrier devices

Barrier devices are essential equipment and help to eradicate the spread of
infection and cross contamination.

Barrier devices place a barrier between the first aider and the casualty

Barrier devices include:

• Nitrile powder free cloves
• Face shields
• Pocket masks
 4 BASIC FIRST AID COURSE

Clearing up after an incident

Once an incident has been handed over to qualified medical assistance, then the
clearing up process must commence.

This process consists of the following:

• Ensure that all used items such as; bandages, gloves etc. are
placed in a yellow clinical waste bag or something similar.
• Ensure that the area where any blood or other bodily fluids
have been spilt is thoroughly cleaned.
• Restock the first aid kit and replace an other equipment that
may have been used during the incident.
• Record and report the incident.

Incident recording and reporting

After any first aid incident it is important the incident is recorded and reported in
full.

Ultimately the employer is responsible for the reporting of accidents however you
should be clear on your role as the first aider in this process.

The accident book should be completed in full and populated with clear and
concise information. There may also be the necessity to inform RIDDOR.

In cases where a public access AED has been used, there may be a requirement to
report the event to your local authority or ambulance service.

Accident form

The accident form should be filled out with as much detail as possible relating to
the incident, including:
• Who was involved
• Specific details of the incident and injury
• Witnesses present

Task
• In pairs choose a casualty and a first aider
• The casualty chooses what injury they have
suffered with and how it happened
• The first aider then fills out the accident report
form asking the casualty for details relating to the injury
 BASIC FIRST AID COURSE 5

Reporting of injuries, diseases and dangerous occurrence regulations

DOSH is the law that requires employers, and other people in control of work
premises, to report and keep records of:

• Work-related accidents which cause

death.
• Work-related accidents which cause
certain serious injuries (reportable
injuries).
• Diagnosed cases of certain industrial
diseases.
• Certain ‘dangerous occurrences’
(incidents with the potential to
cause harm).
 6 BASIC FIRST AID COURSE

Assessing an incident
Learning objectives

• Describe how to survey a scene of an accident

• Demonstrate how to conduct a primary survey of a casualty
• Distinguish between normal and agonal breathing
• Demonstrate gathering information from the casualty and conduct a
secondary survey

Scene survey

Upon arrival at an incident a scene survey must be conducted to ensure the

safety of the casualty, any bystanders and the first aider.
The scene survey should be conducted in the
following way:
• Control the situation
• Look for potential hazards
• Assess the situation
• Protect and prioritise
Primary survey

Having conducted a scene survey and established that the immediate area is safe
from dangers you may now approach the casualty.

An initial assessment should be conducted on the casualty which is called a

primary survey.

The primary survey is a systematic process of approaching, identifying and

dealing with immediate and/or life threatening conditions.

The primary survey can be remembered by the acronym DRABCD

 BASIC FIRST AID COURSE 7

Agonal breathing

In the first few minutes after a cardiac arrest,

a casualty maybe barely breathing or taking
infrequent slow noisy gasps.

Do not mistake this for normal breathing, if in

any doubt act as if no breathing is present and
prepare to start CPR.

Casualty communication

Clear and effective communication should be used at all

times when dealing with a casualty.

A casualty maybe in a distressed or confused state, the first aider should remain
calm and consider the following when dealing with the casualty:
• Gather as much information as possible about the situation, let the casualty
explain if possible
• Only speak about facts, not what your opinion is
• Speak clearly and slowly without shouting and maintain eye contact
• Allow the casualty time to think and respond
• Ask the casualty to assist wherever possible (to distract them)
gathering patient information

Whilst communicating with the casualty it is important to gather as much

information about them and the situation as possible, this will help you the first
aider as well as the emergency services when they arrive.
The best way to gather information is to look at the casualties:
• History – uncover as much information about the casualty as possible,
information such as; time, location, nature of the accident, witnesses and
injuries sustained. It is also important to find out if the casualty is taking
any prescribed medication and a history of similar injuries or conditions.
• Signs – what you as the first aider can see, smell or hear.
• Symptoms – what the casualty actually feels such as any pain or feeling
nauseous or weak.
 8 BASIC FIRST AID COURSE

W What happened
H How did it happen
A Are they wearing a medical alert bracelet or chain?
T The time of the accident/incident
S Sign of injury

K Known medication/previous injuries/allergies

E Eating time of last meal
Y You now need to conduct a secondary survey

Secondary Survey

If the casualty is breathing normally after you check for breathing in your primary
survey you should contact the emergency services and then perform a secondary
survey.

This examination will help you as the first aider gather more information from the
casualty.

Talk to the casualty throughout the survey to reassure them and to tell you if
they have any pain or discomfort.

Head and face

• Inspect the casualties head looking for obvious signs of injury.
• Remove spectacles and gently feel around the head and face for any bleeding,
swelling or depressions.
• Look in the ears and nose for signs of bleeding or the presence of
cerebrospinal fluid (CSF).
• Gently open the eye lids together and check the pupils for any reaction to
light.
• Smell the breath for any distinct odours e.g. alcohol.
• Feel the forehead with the back of your hand to check temperature – does it
feel normal?

Neck
• Loosen any restrictive clothing.
• Gently feel around the back of the neck and spinal area to check for bleeding,
swelling or deformity.
• Check for medical alert necklaces.
• Take the pulse in the neck quickly – Is it fast, slow, irregular? What does this
information tell you?
 BASIC FIRST AID COURSE 9

Chest and shoulders

• Gently feel around the shoulders to check for signs of deformity and bleeding.
• Check the chest for signs of deformity and bleeding.

Abdomen
• Gently check the abdomen for signs of bleeding, swelling or unnatural
softness.
• If you suspect the casualty has any of the above check the stomach for any
bruising if possible.

Spine
• Check as much of the spine as possible without moving the casualty.
• Feel for any tenderness or deformity as well as signs of bleeding.

Pelvis
• Check the hips and pelvis for deformity, unnatural positioning or bleeding.

Legs and feet

• Check the legs and feet for bleeding, unnatural positioning, swelling and
deformity.
• Check the pockets for any form of identification, mobile devices which could
be used to contact the emergency services, medication or any other object
which may cause discomfort when moving them.

Arms and hands

• Check down the arms feeling for any deformity, bleeding or swelling.
• Check wrists for any medical alert bracelets or tattoos.
• Check wrists and in between fingers for puncture marks from injections.
Learning outcomes
• Describe how to survey a scene of an accident
• Demonstrate how to conduct a primary survey of a casualty
• Distinguish between normal and agonal breathing
• Demonstrate gathering information from the casualty and conduct a
secondary survey
10 BASIC FIRST AID COURSE

Chain of Survival

In order for a person to survive:

Pay attention to:

HISTORY; what happened; from the casualty or bystanders
SYMPTOMS; what only the casualty can tell you
SIGNS; what you can see for yourself
 BASIC FIRST AID COURSE 11

MAnAgIng An UnRESpOnSIVE CASUAlTY

Chain of survival

The chance of survival of a casualty who has suffered a cardiac arrest will
diminish by around 6-10% with each passing minute unless action is taken.

The chain of survival is a series of actions, that when put into motion quickly will
increase the casualties odds of survival. If the chain has links broken the odds of
survival will be reduced.

The respiratory system

The respiratory system supplies oxygen to all parts of the body and removes
carbon dioxide from the blood supply. When we inhale we breathe a mixture of:
• Nitrogen (79%)
• Oxygen (20%)
• Other gasses (1%)
When we exhale we breathe out a mixture of:
• Carbon dioxide (4%) � Nitrogen (79%)
• Oxygen (16%) � Other gasses (1%)

Cardio pulmonary resuscitation (CpR)

CPR is a method of combining chest compressions with effective rescue breaths in

order to artificially circulate blood and to put air into the lungs.

• Cardio Heart
• Pulmonary Lungs
• Resuscitation Revive
12 BASIC FIRST AID COURSE

Chest compressions

• Chest compressions should be administered to a casualty who is not

breathing normally.

• For an adult, the depth of the chest compressions is 5-6cm (similar to the
height of a credit card).

• The rate of compressions should be 100-120 beats per minute.

30 compressions should be performed before moving onto rescue breathing.

Rescue breathing

• After completing 30 chest compressions the first aider should then perform 2
rescue breaths

• Each breath should take 1 second to complete.

• Administering 2 rescue breaths should take no longer than 5 seconds to

complete.

Compression only CpR

If unable to give
rescue breaths then
compression only CPR
may be administered.

Compression only
CPR requires the
first aider to perform
compressions on
the casualty at a
depth of 5-6cm and
at a rate of 100-120
compressions per
minute continuously
until medical
assistance arrives.
 BASIC FIRST AID COURSE 13

Automated external
defibrillator (AED)

The AED is used in conjunction

with effective CPR and will
prompt you to do actions.

The AED is completely safe to

use by anyone as it does not
require any training to be able
to use and will not progress to
the next prompt until it has
detected that the step has
been completed.
14 BASIC FIRST AID COURSE

Leave the AED turned on until further medical assistance arrives as it provides a
history of the casualty to the medical professionals.

Do not remove the electrode pads from the casualty or turn off the AED even if
the casualty regains consciousness.

The AED will analyse the casualties heart rhythm every 2 minutes and advise a
shock if necessary.

Using and AED on children

Children between 1-8 years old

An AED is very unlikely to advise a inappropriate shock for a child. Ideally the AED
will state that it is suitable to be used on paediatric casualties. If no such AED
is available a standard AED maybe used. If you are still unsure seek professional
medical advice (999/112).

Children under 1 years old

The AED is not recommended for use for children under 1 years old. Seek
professional medical advice if you are unsure (999/112).
 BASIC FIRST AID COURSE 15

THE RESpIRATORY SYSTEM

Obstructed airway

An obstructed airway is the complete or partial blockage of the airway which leads
to the lungs. An airway can be blocked in various ways:
• Foreign objects
• Foods
• Allergic reactions
• Asthma
• Blood and vomit
• Infections
Choking casualties

A casualty will ether have a mild or severe airway

obstruction. The severity of the blockage will determine
how to treat the casualty.

A casualty who is choking will be:

• Gasping for air
• In distress
• Difficulty breathing or speaking
• Grasping the throat
• Red in the face
A casualty with a partial blockage can be helped by:
• Lean the casualty forward
• Encouraging the casualty to cough
This will normally clear the partial blockage.

If this procedure does not work then more aggressive action is necessary, follow
the following procedure:

Abdominal Thrust
• Stand the casualty and put both arms around the casualties abdomen just
below the rib cage.
• With one hand clench your fist and place it between the naval and rib cage.
• Grasp this hand with your other hand and pull sharply inwards and upwards.
• Repeat this up to 5 times and assess the casualties condition, if the
casualties condition has not improved call 999/112 and repeat the cycles of
back slaps and abdominal thrusts until qualified medical assistance arrives.
16 BASIC FIRST AID COURSE

Choking adult and child flow chart

Hypoxia
Hypoxia is when the tissue of the body is starved of oxygen.

Recognition
• Confused and distressed
• Cyanosis (blue colouration of skin)
• Hyperventilation
• Sweating
• Nausea
• General weakness

Treatment
• Maintain airway
• Call for an ambulance 999/112
• Calm and reassure casualty
• Monitor constantly and be prepared to perform CPR
 BASIC FIRST AID COURSE 17

Wounds and bleeding

The circulatory system

The circulatory system consists of the heart which pumps blood to the entire
body through blood vessels. A failure of this system will be life threating to the
casualty.

Life threatening conditions include: Normal beats per minute

• Heart attack Adult: 60-100
• Angina Child: 90-110
• Blood clots (Inc. stroke) Infant: 110-130

Types of wounds

Laceration (tear)
A wound that can be caused by tearing the skin resulting in a jagged edge wound.
This could be caused by broken bottles or cans. The severity of blood loss will be
dependent on the size of the laceration.

Abrasion (graze)
A superficial wound caused by a scrape. This is caused by falling or sliding on
surfaces. Blood loss from this type of wound is minimal and will tend to bleed
from capillaries and therefore ooze out of the wound.

Incision (cut)
Normally caused by a sharp object such as a knife, scissors or piece of glass. The
wound will be a clean slice and depending on the severity may result in severe
blood loss.

Puncture (piercing)
Caused by an object puncturing or piercing the skin such as a needle, shard of
glass or nail. A puncture wound does not cause excessive bleeding as the wound
closes around the foreign object. There is a high risk of infection and if severe
could cause internal damage.

Embedded (penetrating)
Caused by a knife or bullet entering the body. The object passes through the skin
and causes internal damage. There could be severe internal or external blood loss
with this type of wound as well as a high risk of infection

Wounds and bleeding

Normally classes as a minor injury and will heal without treatment. A contusion
is formed when damaged is formed when blood vessels are damaged underneath
the skin caused by a blow from a blunt object. If the cause is more severe such as
a fall there could be extensive internal damage
18 BASIC FIRST AID COURSE

Example - laceration

Example - Incision

Example - embedded object

 BASIC FIRST AID COURSE 19

Types of bleeding

Arterial bleeding
This is a bleed from an artery and will be bright red in colour, the blood will be
under higher pressure and will pump in time with the casualties heart beat.

Venous bleeding
This bleed is from a vein and will be dark red in colour, the blood will be under
lower pressure and will gush from the wound.

Capillary bleeding
This bleed is from damaged capillaries and will slowly ooze from the wound.

Blood loss

Signs  &  Symptoms   10%  Blood  loss   20%  Blood  loss   30%  Blood  loss   40%  Blood  loss  

Lowered  level  of  

Response  level   Normal   Nausea   response  &  signs  of   Unresponsive  
shock  
Cyanosis  (blue/grey  
appearance  of   Extremely  pale,  
Skin  colour/feel   Normal   Pale/cool  
nose,  ears,  lips),   cold  &  clammy  
cold  &  clammy  

Breathing   Normal   Slightly  raised   Rapid   Gasping  for  breath  

Pulse  rate   Normal   Slightly  raised   Rapid  weak  pulse   Undetectable  

Major bleeding

Treatment
• Ensure you wear personal protective equipment e.g. nitrile gloves.
• Sit or lay the casualty down on the floor is possible.
• Examine the wound but do not attempt to remove any foreign objects.
• Apply direct pressure onto the wound and try to stop the bleeding.
• Dress the wound with a sterile dressing.
• If the wound bleeds through the dressing remove it completely and stop the
bleeding before applying another dressing.
• Call for an ambulance if necessary 999/112 and treat the casualty for shock.
20 BASIC FIRST AID COURSE

Embedded foreign objects

Treatment
• Apply dressings to ether side of the
embedded object if possible to secure it
in place and prevent further damage.
• Apply a larger dressing over the top of
the side dressings and embedded object
if possible.
• Secure the dressing in place e.g. elevation
sling.
• Call for an ambulance 999/112 and treat
the casualty for shock.

Amputation

Amputation can cause severe damage to bone, tendons, muscles as well as loss of
blood.

Treatment
• Put on personal protective equipment e.g. nitrile gloves
• Treat bleeding be applying pressure to the wound (direct and indirect) and
treat for shock.
• Call for an ambulance 999/112.
• Dress the casualties wound and place the amputated part in cling film or
plastic bag. Write the casualties name and details of the body part and place
on ice.
 BASIC
BASICFIRST
FIRSTAID
AIDCOURSE
COURSE 21

SHOCK
physiological shock (circulatory shock)

Circulatory shock is a condition that occurs when the body’s vital organs such as
the heart and brain are deprived of oxygen .due to a problem with the circulatory
system e.g. blood loss, heart attach & poisoning.

Recognition
• Associated injury
• Pale, cyanosis, cold and clammy skin
• Rapid weak pulse
• Rapid shallow breathing
• Nausea and thirst
Treatment
• Treat the cause of shock if applicable
• Lay the casualty on their back and raise their legs above the level of the
heart
• Loosen any tight clothing and keep warm
• Monitor the casualties airway and breathing
• Call for an ambulance 999/112
• Do not allow to eat/drink
Anaphylaxis

Anaphylaxis is an extreme allergic reaction which has the potential to be life

threatening. It results in rapid chemical changes in the body and can be caused
by a trigger such as; insect stings, foods and medicines.

Recognition
• Swelling of the mouth, tongue, face and neck
• Difficulty breathing
• Red, blotchy and itchy skin
• Nausea
• Anxiety

Treatment
• Call for an ambulance 999/112
• Encourage the casualty to use their medication if
applicable
• Sit the casualty down and reassure
• Remove or investigate the trigger
• Monitor and prepare to perform CPR
22 BASIC FIRST AID COURSE

SEIZURES
Epileptic seizure

An epileptic seizures caused by a sudden burst of excessive, electrical activity

in the brain causing a temporary disruption to signals passing between brain
cells. There are many different forms of epilepsy however to aid recognition and
treatment these have been generalised into two categories:

• Partial seizures
• Generalised seizures

partial seizure

A partial seizure is a brief loss of

responsiveness for a few seconds or minutes.

Recognition
• Staring blankly
• Mood swings
• Feeling of Déjà vu
• Tingling sensations
• Twitching (face and body)
Treatment
• Ensure the casualty is safe from harm
• See is the casualty can be laid or sat down
• Stay with the casualty and time the episode
• If it is the first time recommend the casualty to go to hospital or call an
ambulance 999/112

generalised seizure

The most common and widely recognised generalised seizure is called a tonic-
clonic (grand mal) seizure which affects the body in progressive ways. Prior to
suffering a seizure, a casualty may be confused, have headaches or undergo
strange tastes or smells; this is called an ‘aura’.

Recognition – Tonic phase

• Convulsions
• Muscles become rigid
• Arching back
• Cyanosis (blue or purple colouration)
 BASIC FIRST AID COURSE 23

Recognition – Clonic phase

• The limbs make violent jerking movements
• Rolling eyes and crying out
• Clenched teeth
• Possible loss or bladder and bowel control
• Lack of consciousness
Treatment
• Ensure the casualties safety by removing dangerous objects which could
cause injury
• Remove spectacles and loosen clothing around neck if possible
• Do not restrain the casualty
• Record the time and duration of the seizure
• If the seizure continues (depending on site policy) or there are multiple
seizures, call for an ambulance 999/112
• When the seizure stops clear any excessive saliva and check airway, breathing
and place into the recovery position
• Reassure the casualty and be conscious of their embarrassment
24 BASIC FIRST AID COURSE

MInOR InjURIES
Contusion (bruises)
A bruise will often be caused by a blunt blow or a violent movement of a joint
such as during a fall.

Recognition
• Swelling
• Blue, purple or black colouration
• Probable cause associated with injury (e.g. stairs)
Treatment
• Rest the area where the bruise has developed
• Apply Ice
• Compress the area
• Elevate if possible
RICE
Sprains and strains
A sprain or strain attributed to activity or playing sport. It is caused by a sharp
movement or overstretch to a muscle or joint.

Recognition
• Pain, bruising and swelling
• Loss of movement
• Cramps to muscle
Treatment
• Rest the area where the bruise
has developed
• Apply Ice
• Compress the area
• Elevate if possible
RICE
 BASIC FIRST AID COURSE 25

Minor cuts and grazes

A minor cut or graze will not bleed excessively therefore the main concern is to
protect the wound from infection.

Recognition
• Will not bleed excessively
• Ooze blood
• Sometimes very painful

Treatment
• Wear appropriate personal protective equipment. (e.g. nitrile gloves)
• Examine the wound for any foreign objects
• Clean the effected area with a sterile cleansing wipe
• Apply a sterile dressing to the wound

Burns and scalds

Causes
• Dry heat
• Electricity
• Chemicals
• Extreme cold
• Radiation
Burns are classified into 3 levels of severity:
• Superficial burn (1st degree burn)
• Partial-thickness burn (2nd degree burn)
• Full-thickness burn (3rd degree burn)
Superficial burn (1st degree burn)
A superficial burn is where the topmost layer of skin has been burnt. A
superficial burn is extremely painful as the nerve endings are sensitive

Recognition
• Pain at the site of the injury
• Redness, swelling and tenderness
• Possible blistering
Treatment
• Remove the source of heat
• Wear appropriate personal protective equipment (e.g. gloves)
• Cool the area of the burn with water for a minimum of 10 mins
• Remove restrictive clothing and jewellery if possible
• Cover the burn with a layer of cling film if possible and seek medical advice
(999/112) if the burn covers more than 5% of the bodies surface
26 BASIC FIRST AID COURSE

partial-thickness burn (2nd degree burn)

A partial-thickness burn is where the epidermis and dermis have been burnt to
varying degrees. There is a high risk of infection and possibility of the casualty
going into shock.

Recognition
• Skill will appear raw and swollen
• Wound will be painful
• Blisters that emit a clear fluid maybe present
Treatment
• Remove the source of heat
• Wear appropriate personal protective equipment (e.g. gloves)
• Cool the area of the burn with water for a minimum of 10 mins
• Remove restrictive clothing and jewellery if possible
• Cover the burn with a layer of cling film if possible and seek medical
assistance (999/112) if the burn covers more than 1% of the bodies surface

Full-thickness burn (3st degree burn)

A full-thickness burn is where all layers of the dermis and even the subcutaneous
layer have been damaged. This has an very high risk if infection and shock.

Recognition
• Injury will appear brown or black and often
charred
• Dry and leathery texture
• Limited movement around the effected
area
• Less pain than superficial burn as nerves
have been burnt away

Treatment
• Remove the source of heat
• Wear appropriate personal protective equipment (e.g. gloves)
• Cool the area of the burn with water for a minimum of 10 mins
• Remove restrictive clothing and jewellery if possible
• Cover the burn with a layer of cling film if possible and seek medical
assistance immediately (999/112)
 BASIC FIRST AID COURSE 27

Foreign objects

Foreign objects can cause damage when they enter the body through wounds or
orifices such as the nose or eye. You should seek medical attention unless the
injury is extremely minor (e.g. surface dirt in a graze).

Ear and nose treatment

• Do not attempt to remove the object
• Cover with a sterile dressing
• Seek medical attention (999/112) for advice
Eye treatment
• Do not allow the casualty to rub their eye
• Lay the casualty down with their head back and ask the casualty to open
their eye lids using their hands and examine the eye
• Flush the eye from the centre outwards using saline solution of fresh running
water
• No not allow any of the liquid to run into the other eye
• Cover the eye using a sterile dressing if appropriate
If the object in embedded, cover both the eyes using a sterile dressing to
prevent the casualty from blinking and immediately call for medical assistance
(999/112).

Splinters

Splinters are foreign objects which are embedded into the skin, these foreign
objects such as; glass, wood, plastic or metal.

Treatment
• Wear appropriate P.P.E. (nitrile gloves)
• Examine the object to see if it is possible to remove
• If possible draw the splinter out in the same direction as the entry route
• If the splinter is removed, clean the surrounding area using antiseptic wipe
and cover using a sterile dressing

If the object can not be removed, cover using a sterile dressing and advice
casualty to seek medical assistance.
28 BASIC FIRST AID COURSE

FRACTURE AnD DISlOCATIOn

The human skeleton
• The human skeleton is made up of 206 bones
• The skeleton is designed to support and protects the bodies
tissue and organs
• Joints connect individual bones and allow movement through
muscles which are attached by tendons

Fracture
Fractures are classed into the following:
• Closed – bone has fractured but has not
penetrated the skin.
• Open – bone has fractured and penetrated the
skin, this has a high risk of infection and bleeding.
• Complicated – bone has shattered or broken up
internally causing further damage to tendons,
blood vessels or organs if moved.
• green stick – cracking or splintering of the bone.

Fracture
A fracture is a chip, crack or break in a bone.

Recognition
• Pain, swelling, tenderness and bruising around the site of the injury
• Associated bleeding possible in open fractures
• Loss of mobility
• Nausea, pale, cold clammy skin

Treatment
• Wear appropriate P.P.E. (e.g. nitrile gloves)
• Treat any bleeding
• Immobilise the bone in the position that it is found and most comfortable
• Call for an ambulance (999/112)

Example - fractures
 BASIC FIRST AID COURSE 29

Spinal injury
Spinal injuries are very serious as the they may cause paralysis or even death.

7
Cervical

12
Thoracic

5 Lumbar

5 Fused
Sacral

Spinal injury
Spinal injuries are very serious as the they may cause paralysis or even death.

Recognition
• Unusual position of the head or body
• Pain at the site of the injury
• Lack of mobility
• Weakness and tingling sensations
• Loss of bowl or bladder control
• Signs of shock

Treatment
• Call for medical assistance (999/112)
• Keep the casualty in the position that you found them and immobilise the
head and neck
• Reassure the casualty and ask them to remain still
• Keep the casualty warm
• Keep monitoring the casualties airway and breathing
• Be prepared to perform basic life support

Head injury
Head injuries have the potential to be life
threatening and therefore casualties should
always be examined by qualified medical
personnel.
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Head injuries are classes into the following:

• Concussion
• Compression
• Fractured skull
• Stroke
Concussion
Concussion is the shaking of the brain caused by a blow to the head which causes
a temporary disturbance of normal brain activity.

Recognition
• Possible loss of consciousness
• Dizziness and nausea
• Headache
• Brief loss of memory
• Blurred vision
Treatment
• Treat any bleeding
• Call for medical assistance (999/112)
• Lay the casualty down on a flat surface and raise the head and shoulders
• Monitor the casualty and be prepared to carry out basic life support
Compression
Compression is a build up of pressure on the brain caused by accumulation of
blood or swelling.

Recognition
• Intense headache
• Drowsiness
• Unequal pupil sizes
• Slow, strong pulse
• Weakness or paralysis down one side of the body
• Noisy breathing

Treatment
• Treat any bleeding
• Call for medical assistance (999/112)
• Lay the casualty down on a flat surface and raise the head and shoulders
• Monitor the casualty and be prepared to carry out basic life support
 BASIC FIRST AID COURSE 31

Fractured skull
Can ether be open or closed; caused by a blow to the head.

Recognition
• Associated wound
• Tenderness and pain
• Depression or deformity of the skull
• Bruising and swelling at the site of the injury
• Presence of cerebral spinal fluid from ears and nose

Treatment
• Treat any bleeding
• Call for medical assistance (999/112)
• Lay the casualty down on a flat surface and raise the head and shoulders
• Monitor the casualty and be prepared to carry out basic life support

Stroke
A stroke is ether short term or permanent damage to the brain and body. If you
suspect a stroke you must act FAST.

Recognition
• FACE – has the face dropped on one side
• ARM – can the person raise both arms?
• SPEECH – can the person speak clearly and understand what you say?
• TIME to call 999/112 – early treatment can help prevent further damage

Treatment
• Call for an ambulance immediately (999/112)
• Lay casualty down with head and shoulders raised
• If unconscious place in recovery position
• Loosen any restrictive clothing
• Monitor airway and breathing and be prepared to perform basic life support
32 BASIC FIRST AID COURSE

Dislocation
A dislocation occurs when a joint becomes displaced or misaligned. A dislocations
are often caused by a sudden impact to the joint.

Recognition
• Pain, redness and swelling
• Loss of movement
• Deformity

Treatment
• Immobilise and support in the position found
• Allow the casualty to get in a comfortable position
• Call for medical assistance (999/112)
• Treat for shock if necessary

Example - dislocation
 BASIC FIRST AID COURSE 33

Chest injuries
Types of chest injury

Chest injuries are serious injuries and can be life threatening.

Types of chest injuries include:

• Rib fracture
• Flail chest
• Penetrating chest wound

Rib fracture

Fractures of ribs can cause severe pain and panic. Middle ribs are more commonly
broken or fractured.

Recognition
• Pain when breathing or moving
• Grating sound when moving or breathing

Treatment
• Allow the casualty to adopt the most comfortable position
• Seek medical attention immediately

Flail chest

Flail chests is a life threatening condition, are caused by blunt trauma or

underlying medical conditions. It occurs when a segment of the ribcage breaks
under extreme stress which then becomes detached from the rest of the chest
wall.

Recognition
• Pain and bruising
• Grazes and sign of seat belt trauma
• Palpitations

Treatment
• Protect the underlying lung
• Minimise movement
• Call for an ambulance immediately (999/112)
34 BASIC FIRST AID COURSE

Penetrating chest wound

Caused by gun shot, knife wound or other sharp objects which could penetrate
the chest. Id there is a hole in the chest wall, air enters the cavity with each
breath and becomes trapped. This trapped air builds up pressure as the amount
increases and may collapse the lung causing severe breathing problems.

Recognition
• Visible open wound
• Sucking sound as the air enters the chest
• Difficulty breathing
• Blood bubbling from the wound
• Casualty maybe coughing up blood
Treatment
• Call an ambulance immediately (999/112)
• Wear appropriate P.P.E (e.g. nitrile gloves)
• Do not remove embedded objects
• Lay the casualty in a comfortable position and leave the chest wound open
and exposed. Control localised bleeding with direct pressure
• Treat for shock and be prepared to perform basic life support
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MAjOR IllnESS
The heart
From the body

To the lungs To the lungs

From the body

Heart attack
A heart attack occurs when the coronary arteries which supply the heart with
oxygen has become blocked. This causes a section of the heart to start to die.
The heart will therefor not work effectively to supply blood to the rest of the
body.
36 BASIC FIRST AID COURSE

Heart attack

Recognition
• Tightness and/or pain in the chest (mild or severe)
• Casualty clutching the chest
• Possible spreading of pain to the arms, neck and back
• Dizziness or light headed feeling
• Possible shortness of breath
• Nausea, sick and have cold sweats
Treatment
• Call for an ambulance immediately (999/112)
• Sit the casualty down with knees raised in a W-position
• Loosen any restrictive clothing, keep the casualty warm and comfortable
• Monitor the casualties airway and breathing and be prepared to perform
basic life support

Angina

Recognition
• Tightness and/or pain in the chest
(mild or severe)
• Casualty clutching the chest
• Possible spreading of pain to the arms,
neck and back
• Possible shortness of breath
• Nausea, sick and have cold sweats
• Only lasts up to 15 minutes unlike a
heart attack

Treatment
• Call for an ambulance immediately
(999/112)
• Sit the casualty down with knees raised in a
W-position
• Loosen any restrictive clothing, keep the
casualty warm and comfortable
• Ask casualty for their history and ascertain
if they have been diagnosed with angina
• Encourage them to take their medication
(usually GTN spray, Glyceryl trinatrate)
• Monitor the casualties airway and breathing and be prepared to perform
basic life support
 BASIC FIRST AID COURSE 37

Angina Heart Attack

Sudden, usually during exertion, stress or Sudden, can occur at rest.
Onset extreme weather.
Vice-like squashing pain. Vice-like squashing pain.
Pain ‘Dull’, ‘tightness’ or ‘pressure’. ‘Dull’, ‘tightness’ or ‘pressure’.
Can be mistaken for indigestion. Can be mistaken for indigestion.

Central chest. Can radiate into Central chest. Can radiate into arms, neck, jaw,
Location of Pain
arms, neck, jaw, back, shoulders. back, shoulders.

Duration 3 – 8 Minutes, rarely longer. Usually longer than 30 minutes.

Skin Pale, may be sweaty. Pale, grey colour. May sweat profusely.

Variable. Often becomes Variable. Often becomes

Pulse irregular, missing beats. irregular, missing beats.

Other signs and Shortness of breath, Shortness of breath, dizziness, nausea, vomiting,
weakness, anxiety. sense of ‘impending doom’.
symptoms

Factors giving Resting, reducing stress, GTN medication may give

relief taking ‘GTN’ medication. partial or no relief.

Diabetes
Diabetes is caused by a failures of the bodies ability to produce insulin which
regulates the blood sugar levels.

Insulin   Sugar  

Hypoglycaemia
This is caused when the blood sugar level is too low.

Recognition
• Blurred vision
• Hunger
• Tired, confused and feeling faint
• Increased heart rate
• Headache
• Tingling sensations
• Noticeable change in personality
38 BASIC FIRST AID COURSE

Treatment
• Sit the casualty down, calm and reassure
• Ask the casualty to take glucose tablets, sugar or sugary drinks
• If there is no improvement in the casualties condition call for an ambulance
(999/112)
• Monitor the casualties condition, if the casualty becomes unconscious be
prepared to carry out basic life support

Hyperglycaemia
This is caused when the blood sugar level is too high.

Recognition
• Sweet fruity smelling breath
• Increased need to urinate
• Increased thirst
• Dry mouth
• Loss of appetite
• Tiredness and confused
Treatment
• Sit the casualty down, calm and reassure
• Encourage the casualty to use their medication
• If they have not been previously been diagnosed with diabetes then call form
medical assistance (999/112)
• Monitor the casualties condition, if the casualty becomes unconscious be
prepared to carry out basic life support

Poison
A poison is a foreign substance that enters the body by means of ingestion
inhalation, absorption or injection which will interfere the normal bodies function.

Recognition
• Pains in the stomach
• Impaired vision
• Increased/decreased heart rate
• Smell of fumes or chemicals
• Burns and rashes
• Nausea and vomiting
• Difficulty in breathing

Treatment
• Call for ambulance (999/112)
• Ensure the scene is safe
• Remove the cause or remove the casualty from the scene
• Identify the poison if possible and provide the source to the ambulance crew
when they arrive
• Be prepared to carry out basic life support
 BASIC FIRST AID COURSE 39

Asthma
Asthma is a condition that affects the airway by inflaming it making it difficult to
breathe. There are many triggers of asthma which include; dust, pollen and pet
hair.

Recognition
• Breathlessness
• Wheezing
• Tightness around the chest
• Bouts of coughing
• Cyanosis (blue lips, ears and nose)
• May be unconscious
Treatment
• Sit the casualty down on a chair or floor away from the cause of the attack
and let them get in a comfortable position
• Encourage the casualty to take their medication (inhaler)
• Calm and reassure the casualty
• If the attack is prolonged call for medical assistance (999/112)
• Be prepared to carry out basic life support
Hyperventilation (HVS)
Hyperventilation syndrome (HVS) is a name given to a collection of physical and
emotional symptoms, largely brought about by hyperventilation. This happens
when we over-breathe.

Recognition
• Breathlessness / fast breathing
• Tightness around the chest
• Tingling (e.g. in fingers, arms, mouth)
• Muscle stiffness
• Trembling in hands
• Dizziness, blurred vision, faintness
• headaches
Treatment
• Sit the casualty down on a chair or floor and let them get in a comfortable
position
• Calm and reassure the casualty
• Encourage the casualty to slow their breathing
• If the attack is prolonged call for medical assistance (999/112)
40 BASIC FIRST AID COURSE

Heat and cold injuries

Hypothermia
When the body is exposed to prolonged cold caused by weather, water etc. the
bodies core temperature will drop. If the bodies core temperature drops below
35°C then the onset of hypothermia will occur.

Recognition
• Pale, cold skin
• Shivering at onset then the muscles will stiffen as the condition gets worse
• Lethargy
• Breathing, speech and pulse slowing
• Disorientation and confusion
• Diminishing level of response leading to unconsciousness and death
Treatment
• Remove the casualty from the source of the cold
• Cover the casualty with blankets or ensure the room is warm (approx. 25°C)
• If the casualty is outdoors insulate the casualty from the ground
• Give warm drinks
• Monitor their condition
• Call for medical assistance (999/112) if there is no improvement or is elderly
or young

Frostbite
Frostbite is a serious medical condition which normally affects the extremities
(fingers and toes) by causing damage to the skin due to freezing, this will
eventually cause the skin to die.

Recognition
• Prolonged exposure to extremely cold conditions
• Pins and needles in the first stages of frostbite
• Hardening and stiffening of the skin becoming painful
• Skin will become purple/black and extremely painful in the later stages of
frostbite

Treatment
• Remove the casualty from the source of the cold
• Use body heat to warm extremities (e.g. hands under arm pits)
• Cover the body and extremities with blankets
• Call for an ambulance immediately (999/112)
 BASIC FIRST AID COURSE 41

Heat exhaustion
Heat exhaustion is caused by the bodies core temperature rising above 37°C. In
attempt to cool down, excessive sweating occurs causing the body to loose vital
fluids and salts.

Recognition
• Hot flushed skin
• Excessive sweating
• Fatigue
• Headache, nausea and vomiting
• Rapid pulse
• Confusion
• Urinating less (urine dark in colour)
Treatment
• Move the casualty to a cool place
• Give the casualty water to rehydrate
• Remove any excessive clothing
• Monitor the casualty’s response levels
• Call for medical assistance (999/112)
Heatstroke
Heatstroke is when the hypothalamus (the bodies temperature regulator)
ceases working and the body can not cool down through normal actions such as
sweating. The core temperature rises above 40°C which is very dangerous.

Recognition
• High temperature and dry skin
• Nausea, dizziness and vomiting
• Intense headache
• Lower response levels
• Rapid pulse and breathing
• Muscle cramps
• Possibly unconscious
Treatment
• Move the casualty to a cool place
• Call for medical assistance immediately (999/112)
• Give the casualty water to rehydrate
• Try to cool the skin by applying a damp towel or spraying with water
• Be prepared to carry out basic life support
42 BASIC FIRST AID COURSE

Unconsciousness  /  fiFng
Confused  /  restless
Heat  Stroke   Headache,  dizzy,  uncomfortable
Strong  bounding  pulse
Flushed  dry  skin,  hot  to  touch

Cramps  in  stomach  /  arms  /  legs

Heat  Exhaus9on   Pale  sweaty  skin
Nausea  /  loss  of  appe,te

Normal  Body  Temperature  

Shivering  

Fa,gue,  slurred  speech  

Confusion,  forge7ulness  

Mild  Hypothermia   Shivering  stops,  muscle  rigidity  

Very  slow,  very  weak  pulse  
No,ceable  drowsiness  

Severe  reduc,on  in  response  levels  

Unconsciousness  
Dilated  pupils  
Pulse  undetectable  

Severe  Hypothermia   Appearance  of  death  

Death  
 BASIC FIRST AID COURSE 43

Other injuries
Blunt abdominal trauma
Common in motor vehicle accidents due to seat belts and can also be caused by
punches etc. There is a concern that internal organs maybe damaged from the
injury.

Recognition
• Abdominal pain
• Bruising and swelling
• Abrasions
• Nausea and vomiting
• Possible blood in the urine
• Signs of shock
Treatment
• Call for an ambulance immediately (999/112)
• Wear appropriate P.P.E. (e.g. nitrile gloves)
• Gather as much information as possible
• Monitor the airway and breathing
• Try and lay the casualty down with their knees raised, if it is not possible let
the casualty sit in a comfortable position
• Treat for shock and be prepared to carry out basic life support
Penetrating abdominal trauma
A penetrating abdominal trauma occurs when a foreign object pierces the skin
and enters the abdomen. This can cause severe damage to internal organs and
blood vessels.

Recognition
• Visible associated wound
• Abdominal pain
• Nausea and vomiting
• Distressed state
• Possible blood in urine
• Signs of shock
Treatment
• Call for an ambulance immediately (999/112)
• Wear appropriate P.P.E. (e.g. nitrile gloves)
• Gather as much information as possible
• Monitor the airway and breathing
• Try and lay the casualty down with their knees raised, if it is not possible let
the casualty sit in a comfortable position
• Treat for shock and be prepared to carry out basic life support
44 BASIC FIRST AID COURSE

Crush injuries

A crush injury can cause muscle swelling and internal damage to organs and may
stop blood circulating freely around the body. There is two main types of crush
injuries:

Compartment syndrome

This is the compression of nerves, blood vessels and muscles inside a

compartment within the body. This can cause tissues to die from lack of blood
reaching them due to the compression of the blood vessels.

Crush syndrome (Bywater’s syndrome)

This occurs when pressure on the muscles is released. It causes toxins to be

released into the bloodstream. These toxins are highly dangerous to the kidneys
and can cause renal failure and death.

Crush injuries

Recognition
• Loss of sensation in the affected area
• Pale skin
• General weakness in the area of the crush
• Severe pain
Treatment
• Ensure that the area is safe to approach
• Establish how long the casualty has been crushed for.
• If longer than 15 minutes leave them in the position found
• If less than 15 minutes attempt to release the crush
• Treat associated wounds and bleeding
• Treat for shock
• Call and ambulance (999/112) and request additional emergency services if
required
• Be prepared to carry out basic life support
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46 BASIC FIRST AID COURSE