N A TION A L

S E RVIC E
TRA IN IN G
P RO G RA M 1

M O D U L E 7 : H E A LT H P R O G R A M F I R S T A I D
AND BASIC LIFE SUPPORT
 BACKGROUND
First aid refers to the immediate, direct treatment of an injured person.
Anyone with a basic understanding of medical treatment can administer
aid at the first signs of trouble. Simple procedures may include stopping
blood loss by applying pressure, dressing a wound, treating a burn with
ointment, or setting a bone with a splint.
 Some types of first aid, such as performing
cardiopulmonary resuscitation (CPR),
require an individual to receive specialized
BACKGROUND training from an accredited first aid
program.Many minor injuries can be
overcome with simple, immediate medical
attention.
 A small cut, burn, or blister, for instance,
can be attended to by thoroughly cleaning
the injury, applying a topical antibiotic
cream, and covering it with breathable
bandage or wrap. Treating bruises, muscle
BACKGROUND strains, swelling, and animal bites usually
involves icing and compressing the
injuries, as well as taking over-the-counter
anti-inflammatory or pain medication.
 VICTIM ASSESSMENT
In first aid, usually we like to call the person getting hurt a casualty instead of a
victim. The first part of the assessment of the casualty is the Primary Survey.
ABC
• Check the AIRWAYS
• BREATHING
• and Circulation

*before assessing the casualty, you will want to do an Emergency Scene survey,
and call for help.
THE ABC OF FIRST AID

THE PRIORITIES A- AIRWAY B- BREATHING C- CIRCULATION

OF FIRST AID (AND BLEEDING)
ARE…
THE ABC OF FIRST AID

A- Airway
• The airway of an unconscious person may be narrowed or blocked,
making breathing difficult and noisy or impossible. This happens
when the tongue drops back and blocks the throat. Lifting the chin and
tilting the head back lifts the tongue away from the entrance to the air
passage. Place two fingers under the person’s chin and lift the jaw,
while placing your other hand on the forehead and tilting the head
well back. If you think the neck may be injured, tilt the head very
carefully, just enough to open the airway.
THE ABC OF FIRST AID

B- Breathing
• Check for breathing by placing your head near the person’s nose and
mouth. Feel the breath on your cheek or moisture on the back of your
head.
• If a person has just stop breathing use mouth to mouth ventilation, make
sure the airway is open and head tilt back. Pinch the nostrils together, take
a deep breath and blow into the mouth, firmly sealing your lips around the
mouth so air is not lost. You should see the chest rise.
• Remove your lips and let the chest fall. Continue this, giving about ten
breaths every minute until help arrives or breathing begins.
THE ABC OF FIRST AID

C- Circulation
• Check for circulation (to see if the heart is still beating) by feeling for the Adam’s
apple (lump on the windpipe) with two fingers. Slide the fingers to the side of the
windpipe and feel for the pulse. If the heart has stopped beating use chest
compression to try to restart the heart. Place your hand flat just above the point where
the ribs meet the breastbone. Bring the other hand on top of it and lock your fingers
together. With your arms straight, press down firmly on the breastbone, pushing it
down by 4-5 cm. Release the pressure and repeat the compressions at a rate of about
80 per minute. If the person is also not breathing, alternate 15 compressions with two
breaths until help arrives.
• Stop bleeding by applying firm pressure to the wound for about 15 minutes. Never
use a tourniquet.
 • This is the best position for an
unconscious person or someone
having a fit. It allows them to
breathe easily and prevents
them from choking. After
checking the ABC, bend the
THE RECOVERY nearest arm to you, putting the
hand by the head. Then bring
POSITION the far arm across the chest and
hold both hands in one of
yours. With your other hand
pull the furthest legs up at the
knee and roll the person
towards you to lie in this
position.
 THE RECOVERY POSITION
• Try out the positions for all these first aid procedures
now with a friend. Better still, join a first aid class if
any are available. St. John’s Ambulance has many
groups around the world on a day your knowledge of
first aid may save a life!
 In an emergency any number of things may need
FIRST your attention at the same time. If you try to do
THING everything at once you may easily get distracted
FIRST from the essential matters. On arriving at the scene…
FIRST THING FIRST

Assess the situation Take in quickly what Look for dangers to Make the area safe An unconscious person
has happened yourself and to the always takes priority
casualty and needs immediate
help to make sure he or
she can breathe. Only
then should you begin
to assess any injuries
BLEEDING AND WOUNDS

External Bleeding
• External bleeding from a cut or scratch may be so minor
that treatment is unnecessary. In contrast, a more extensive
wound or cut may produce so much bleeding that stitches
are required. Once the bleeding has stopped, however, this
type of hemorrhage does not pose a threat to health. Still,
there are some types of external bleeding that indicate a
serious medical problem that requires prompt attention.
FIRST AID

The three main principles of the treatment of

external bleeding are:
• Look
• Apply
• Elevate
FIRST AID

• Look at the wound to check how large it is. Check that the wound has
nothing in it (such as debris or a foreign body).
• Apply direct pressure to the wound. If the victim is able to press on
the wound, encourage him or her to do so. If not, then apply direct
pressure yourself, initially with your fingers and, if you have it handy,
with a sterile dressing or a piece of clean cloth. Applying direct
pressure to the wound enables the blood to clot and therefore stems
the blood flow from the cut. Once applied, a sterile dressing (or
whatever you have handy) should ideally be held in place with a firm
bandage or improvised bandage such as a scarf or tie.
FIRST AID

• Elevate the part with the wound. If the injury is an

arm or leg, raise the wound above the level of the
heart. It is harder for the blood to pump upward
and this therefore reduces the blood flow and thus
the fluid loss from the body.
• Treat for shock. Keep the victim warm and
continually at rest. Reassure the victim.
INTERNAL BLEEDING

Internal Bleeding
• Is bleeding occurring inside the body. It can be a serious
medical emergency depending on where it occurs (e.g.
brain, stomach, lungs), and can potentially cause death and
cardiac arrest if proper medical treatment is not received
quickly.
INTERNAL BLEEDING

SIGNS AND SYMPTOMS

• The person is known to have had an accident (not necessary in the immediate
past)
• Signs and symptoms of shock
• Bruising
• Boarding – this most commonly occurs where there is bleeding into the stomach
area; the quantity of blood combined with the tissues swelling result in rigidity to
the tissues.
• Swelling
• Bleeding from the body orifices
FIRST AID

• Call or get someone to call emergency services. Don’t wait to see if

the person improves or deteriorates.
• If available put synthetic gloves on as bleeding may become apparent.
• Check airway, breathing and circulation. Begin cardiopulmonary
resuscitation (CPR) if necessary. If you want to understand CPR in
more depth then go to CPR- Q’s & A’s.
• If unconscious and breathing – place the person in the recovery
position and with legs higher than the heart if possible. Injuries
permitting.
FIRST AID

• If conscious – lie the casualty down and raise or bend legs if injuries
permit.
• Keep casualty warm. This may help delay the onset of shock by
minimizing the bodies’ heat loss.
• Reassure and stay calm. This helps provide security for the injured person.
• Continue to check pulse and breathing.
• Treat other injuries as appropriate.
• Do not give anything to eat or drink as they may require surgery to stop
bleeding.
OPEN WOUNDS

A wound is an injury that causes either an internal or external

break in body tissue. An open wound (as in a knife cut) is a break
in the skin or mucous membrane.

Description of Open Wound

The most common accidents resulting in open wounds are falls,
mishandling of sharp objects, accidents with tools or machinery,
and car accidents
OPEN WOUNDS

First Aid Management

• Control Bleeding
• Cover the wound
• Care for the shock
• Consult or refer to physician
Home Care (Wounds with bleeding not severe)
• Clean the wound with soup and water
• Apply mild antiseptics
• Cover wounds with dressing the bandage
CLOSE WOUNDS

Causes:
• Blunt object that may result in contusion or
bruises
• Application of external forces
CLOSE WOUNDS

Signs and Symptoms

• Pain and tenderness
• Swelling
• Discoloration
• Hematoma
• Uncontrolled restlessness
• Thirst
• Symptoms of shock
• Vomiting or cough-up blood
• Passage of blood in the urine or feces
• Sign of blood along mouth, nose and ear canal
CLOSE WOUNDS

First Aid Management

• I – Iced application
• C – Compression
• E – Elevation
• S – Splinting
CLOSE WOUNDS

• Calm the person, lay him/her, and cover with blanket.

• Stop the bleeding, see ‘Bleeding (severe)’ and ‘Shock’
• Wrap amputated part in a clean and dry cloth then put it into a
waterproof plastic bag.
• Close this bag and put it into another bag that contains cool water/ice.
• Do not give alcohol, cigarettes or food to casualty (in case of a surgery
in hospital).
• Do not freeze the amputated part (just keep it cool).
ANIMAL BITES

• Any animal bite requires medical attention. Deep

bites can cause serious wounds, severe bleeding,
and tissue damage, while all animal bites can
cause infection. Puncture wounds from teeth carry
infection deep into the tissue, while scratches are
also an infection risk. The human bite is among
the most infectious.
TREATMENT

• The priority is to ensure the safety of yourself and

bystanders. If the animal is still a risk, do not
approach it but call the local Animal Control
Service through your police department.
NOSE BLEEDING

• Nose bleeds are often the result of common

events, usually trauma, but nose bleeds can be a
warning of other problems. Nose bleeds are
caused by a small blood vessel rupturing. There
are two main types of nose bleed: upper and lower
nose bleeds.
NOSE BLEEDING

First Aid
• If your nose bleeds
• Sit down and lean forward
• Using your thumb & index finger, squeeze soft part of nose
• This part is between end of nose and the bridge of nose
• Continue holding till bleeding stops-
• Do not stop in-between
• If bleeding continues, hold for another 10 minutes
• If the patient is a child, divert attention by TV/Stories
• Avoid picking, blowing or rubbing nose for 2 days
• Place an ice pack on the bridge of nose
BURNS

• Burn is an injury involving the skin, including

muscles, bones, nerves and blood vessels. This
results from heat, chemicals, electricity or solar or
other forma of radiation.
BURNS

First Aid
For Minor Burns
• Cool the burn. Hold the burned area under cool (not cold) running
water for 10 or 15 minutes or until the pain subsides.
• Cover the burn with a sterile gauze bandage. Don’t use fluffy cotton, or
other material that may get lint in the wound.
• Take an over-the-counter pain reliever. These include aspirin, ibuprofen
( Advil, Mortin, others), naproxen (Aleve) or acetaminophen (Tylenol,
others).
BURNS

Caution
• Don’t use ice. Putting ice directly on a burn can cause a
burn victim’s body to become too cold and cause further
damage to wound.
• Don’t apply butter or ointments to the burn. This could
cause infection.
• Don’t break blisters. Broken blisters are more vulnerable
to infection.
POISONING

Swallowed Poison
• Poison is any substance: solid, liquid or gas, that tends to
impair healt or cause death when introduced into the body
or onto the skin surface. A poisoning emergency can be life
threatening.
Causes:
• Common in suicide attempts
• Occasional accident poisoning,
POISONING

First Aid
• Try to identify the poison.
• Place the victim on its left side.
• Save any empty container, spoiled food analysis.
• Save any vomits and keep it with the victim if the
person is taken to an emergency facility.
CARBON MONOXIDE

• Carbon monoxide (sometimes referred to as CO)

is a colorless, odorless gas produced by burning
material containing carbon. Carbon monoxide
poisoning can cause brain damage and death. You
can’t see it, smell it, or taste it; but carbon
monoxide can kill you.
SYMPTOMS

• Headache
• Dizziness
• Nausea
• Flue-like symptoms, fatigue
• Shortness of breath on exertion
• Impaired judgment
• Chest pain
• Confusion
• Depression
SYMPTOMS

• Hallucinations
• Agitation
• Vomiting
• Abdominal pain
• Drowsiness
• Visual changes
• Fainting
• Seizure
• Memory and walking problems
FIRST AID

• Firstly, stay calm and act quickly.

• Immediately, leave the area and get fresh air.
• Turn off the source of carbon monoxide if it can be done safely.
• Call your local emergency medical services.
• If severely affected, administer oxygen with a tight mask once the ambulance arrives.
• Watch for the symptoms and give symptomatic treatment.
• If the victim is unconscious, check for the ABC’s of life and get him to an open area for fresh air.
• Call for medical help immediately.
• Hospitalization is necessary.
• Usually the victim is placed in a compressed, pressurized chamber with oxygen.
• This helps in replacing the carboxyhemoglobin with oxygen.
• This proceeded is called hyperbaric oxygen therapy.
BASIC LIFE SUPPORT

• CPR (or cardiopulmonary resuscitation) is a

combination of rescue breathing (mouth-to-mouth
resuscitation) and chest compression. If someone isn’t
breathing or circulating blood adequately, CPR can restore
circulation of oxygen-rich blood to the brain. Without
oxygen, permanent brain damage or death can occur in
less than 8 minutes.
BASIC LIFE SUPPORT

• CPR may be necessary during many different

emergencies, including accidents, near-drowning,
suffocation, poisoning, smoke inhalation, electrocution
injuries, and suspected sudden infant death syndrome
(SIDS).
• Tips: Use CPR any time a victim’s breathing and heart
beat have stopped. Use rescue breathing whenever there is
pulse but no breathing.
SIGN OF SUCCESSFUL CPR

• Chest rise and fall with each recue breath

• Checking pulse after the 1st minute of CPR and every few
minutes to determine if the pulse has return
• Having a rescue feel for carotid pulse while giving chest
compression
WHEN TO STOP CPR

• When a doctor – or some other appropriate emergency

medical provider – tells you to stop.
• When you become exhausted and cannot continue (this
gets messy, as we’ll see below).
• When the victim begins yelling at you to stop hitting him
in the chest (this really happens). In other words, when the
victim gets better.
WHEN NOT TO STOP CPR

• Situations where attempts to perform CPR would place the rescuer at

risk of serious injury or mortal peril
• Obvious clinical signs of irreversible death (e.g. Rigor mortis,
dependent lividity, decapitation, transaction, or decomposition)
• A valid, signed, and dated advance directive indicating that
resuscitation is not desired, or a valid, signed, and dated DNAR order.
RECOVERY POSITION

• Roll the victim onto side (if no evidence of head

and neck injury)
• Place lower arm behind back
• Place hand on upper arm under the chin
• Flexor bend the top leg
DANGEROUS COMPLICATION
OF CPR
• Vomiting
• Stomach distension
• Inhalation of foreign substances (aspiration)
• Chest compression related injuries
• Dentures, loose or broken teeth or dental appliances
FOREIGN BODY OBSTRUCTION
(CHOCKING)

Choking is the physiological response to sudden airways

obstruction. Foreign Body Airway Obstruction (FBAO)
causes asphyxia and is terrifying condition, occurring very
accurately, withy the patient often unable to explain what is
happening to them. If severe, it can result in rapid loss of
consciousness and death if first aid is not undertaken
quickly and successfully. Immediate recognition and
response are of the utmost importance.
CAUSE OF CHOKING

Choking is most common in children. A marble,

button or food may get in the air passage and cause
blockage. In adults too, food may go down the
wrong way (go into the windpipe instead of food
pipe) and cause choking. The danger of choking
increases if the person has been drinking alcohol
and becomes careless about chewing food well.
CAUSE OF CHOKING

• Trying to swallow large pieces of food

• Drunkenness
• Wearing dentures
• Eating too fast
• Eating while laughing and talking
• Walking, running or playing with objects in the
mouth
TYPES OF UPPER AIRWAY OBSTRUCTION

• Tongue. Relaxed tongue muscle of an unconscious

victim may slip or fall to the airway then cause
obstruction. This is the most common causes of
obstruction.
• Vomit. When at or near death, most people vomit.
TYPES OF UPPER AIRWAY OBSTRUCTION

• Foreign Body. The shape of consistent nuts, candy hotdogs and grapes
have been become the primary reason why children accidentally
inhale this objects.
• Swelling. Victims who suffer allergic reactions (anaphylaxis) and
irritants tend to experience swelling of the throat leading to
obstruction of airway.
• Spasm. If a person accidentally inhaled water, the throat starts to
spasm. This usually happens when someone is drowning.
INFANT CPR

• Step 1: Circulation
• Place the baby gently on a flat surface, like a table
or the floor. CPR should always be done placing
the victim on a flat surface.
INFANT CPR

• Gently place two of your fingers in the middle of the chest of the
baby. To understand the exact point, imagine seeing a horizontal line
going through the chest of the baby, dividing his/her nipples! You
need to pace your fingers (2 fingers of one hard) in the center of the
chest just below this horizontal line!
• With the help of two fingers, gently compress the chest of the baby.
Dig your fingers about 1.5 inches deep into the chest and pump about
100 compression within a minute, that is about 16 compressions per
10 seconds. You can also count aloud to keep a track.
INFANT CPR

• Step 2: Airway
• After the compressions to restore blood circulation in the
infant, the next step would be to clear the airways of the
infant allowing him/her to breath. You can do this after 30
compressions by gently tilting the head of the infant back
by lifting his/her chin with one hand and pushing the
forehead down the other hand.
INFANT CPR

• Make sure that you don’t tilt the head way too
much. It may prove to be harmful for the infant.
• Within 10 seconds of lifting the chin of the infant,
check for movements in the chest and breathing.
Do this by placing your ears and cheeks in front of
the baby’s mouth and nose.
INFANT CPR

• Step 3: Breathing
• If there are still no signs of breathing, then the next step would be to
cover the infant’s nose and mouth with your mouth and provide the
infant with the rescue breathing!
• Slowly breathe into the infant and blow gentle puffs of air by taking a
second for a single breath! While you do this, also check for the rise in
the infant’s chest.
INFANT CPR

• If you see the bay’s chest rising, then give the

second rescue breath. If the chest is not rising,
then you will have to repeat Step #2 and then
again go for the rescue breathing!
• It is advisable to give the infant two rescue breaths
within a period of every 30 compressions.
Continue to do this until help arrives!
ADULT CPR
• 1. Attempt to wake victim. If the victim is
not breathing (or is just gasping for breath),
call 911 immediately and go to step 2. If
someone else is there to help, one of you
calls 911 while the other moves on to step
2.
ADULT CPR
• 2. Begin chest compressions. If the victim is not breathing,
place the heel of your hand in the middle of his chest. Put
your other hand on top of the first with your fingers
interlaced. Compress the chest at least 2 inches (4-5 cm).
Allow the chest to completely recoil before the next
compression. Compress the chest at a rate of at least 100
pushes per minute. Perform 30 compressions at this rate
(should take you about 18 seconds).
ADULT CPR

• 3. Begin rescue breathing. If you have trained in CPR, after 30

compressions, open the victim’s airway using the head-tilt, chin-lift
method. Pinch the victim’s nose and make a seal over the victim’s
mouth with yours. Use a CPR mask if available. Give the victim a
breath big enough to make the chest rise. Let the chest fall, and then
repeat the rescue breath once more. If the chest doesn’t rise on the first
breath, reposition the head and try again. Whether it works on the
second try or not, go to step 4.
If you don’t feel comfortable with this step, just continue to do chest
compressions at a rate of at least 100/minute.
ADULT CPR

• 4. Repeat chest compressions. Do 30 more chest

compressions just like you did the first time.
• 5. Repeat rescue breaths. Give 2 more breaths just
like you did in step 3 (unless you’re skipping the
rescue breaths).
ADULT CPR

• 6. Keep going. Repeat steps 4 and 5 for about two minutes

(about 5 cycles of 30 compressions and 2 rescue breaths).
If you have access to an automated external defibrillator
(AED), continue to do CPR until you can attach it to the
victim and turn it on. If you saw the victim collapse, put the
AED on right away. If not, attach it after approximately one
minute of CPR (chest compressions and rescue breaths).
ADULT CPR

• 7. After 2 minutes of chest compressions and rescue

breaths, stop compressions and recheck victim for
breathing. If the victim is still not breathing, continue CPR
starting with chest compressions.
• 8. Repeat the process, checking for breathing every 2
minutes (5 cycles or so), until help arrives. If the victim
wakes up, you can stop CPR.
COMMON CPR MISTAKES
Rescue breathing (mouth to mouth) mistakes:
• In adequate head tilt
• Failing to pinch the nose shut
• Not giving slow breaths
• Failing to watch chest and listen for chest exhalation
• Failing to maintain tight seal around victim’s mouth and
or nose
COMMON CPR MISTAKES

Chest compression mistakes

• Pivoting at knees instead of hips
• Wrong compression site
• Bending elbows
• Shoulders not above sternum
• Fingers touching chest
• Heel of bottom hand not in line with the sternum
COMMON CPR MISTAKES

Chest compression mistakes

• Placing palm rather than the heel of the hand on sternum
• Lifting hands off chest between compression (bouncing
movement)
• Incorrect6 compression rate
• Jerky or jobbing compression rather than smooth ones
CPR EDUCATIONAL VIDEO
BIBLIOGRAPHY

Dela Cruz, Sonia G. (2005). National Development via National Service

Training Program. Mandaluyong City: Books Atbp. Publishing Corp

Del Rosario, Ed. D. (2012). Resurreccion et. al. National Service

Training Program 1. Bulacan: St. Andrew Publishing House.

Lee, Sergio J. (2007). National Service Training Program: 2nd Edition.

Quezon City: C & E Publishing, Inc.