Chapter 5 :- First Aid

 First Aid:- The initial assistance or treatment given to a casualty for any injury or sudden illness before the arrival of an ambulance, doctor, or other qualified person is called 'first-aid'. The notion of 'first' aid itself signifies that the casualty is likely to be in need of 'secondary aid'.

Principles of First-Aid:

• Act calmly and logically;
• Be in control—-both of himself/herself and the problem;
• Be gentle but firm, and speak to the casualty kindly but purposefully.
• Build up trust by talking to the casualty throughout the examination and treatment.
• Explain the casualty what he/she is going to do.
• Never leave the casualty alone but continue to talk to him/her until the ambulance or doctor arrives.
• Continuously reassure the casualty.
• Never separate a child from its parent or guardian.
• Send the casualty to a hospital or doctor by the quickest means of transport.
• Always inform the police about the serious accidents,
• Inform the relatives of the casualty.

Do Not

• Touch a wound with your fingers or any instrument
• Put an unclean dressing or cloth over a wound.
• Allow bleeding to go unchecked.
• Allow a crowd to gather around the casualty.
• Move a patient unnecessarily.
• Take off clothing unnecessarily.
• Allow a patient with a fracture or suspected fracture to be moved until splints have been applied.
• Fail to give artificial respiration when needed.
• Fail to remove false teeth, tobacco, or any other eatables from the mouth of an unconscious person.
• Leave a tourniquet on for over 20 minutes before loosening it.
• Forget to send for a physician.

The First-aid Box:

• A first-aid book
• Antiseptic cream-useful for cuts and bruises.
• Savlon or Dettol antiseptic solution- 2 bottles
• Calamine lotion – a medicated liquid containing zinc carbonate, this has a soothing effect on painful sunburn. It can also relieve itching caused by minor insect bites and stings.
• Antacid tablets—give relief from mild indigestion and heartburn, a burning sensation caused by stomach acid irritating the gullet.
• Anti-diarrhea tablets—these are used to relieve diarrhea by slowing down bowel movements.
• Paracetamol—used for relieving pain and lowering a high temperature.
• Aspirin—used for relieving pain and lowering a high temperature. Its use should be restricted, however, as it may irritate the stomach lining.
• Pain Relief spray—gives instant relief in back pain, joint pain, muscular pain, sprains & sports injuries.
• Chloromycetin eye ointment—2 tubes-This can be used in case of bacterial infections of the eye.
• Soframycin skin ointment-2 tubes. This is used in bacterial infections of the skin and in burns too.
• Travel sickness tablets—these can be taken before a journey or as directed on the label.
• Oil of cloves—for an aching tooth, this is used to provide temporary relief.
• Clinical Thermometer—can be used either orally or under the arm. It should be cleaned with antiseptic after each use, even for the same patient.
• Sterilized dressing (No.18)—12 packets; for use on fingers
• Sterilized dressing (No. 24) —12 packets; for use on hands and feet.
• Large sterilized dressing —-12 packets; for use on other parts.
• Sterilized cotton wool —-6 packets; can be used to pad a dressing or to clean an injury with soap and hot water.
• Crepe bandage—6 packets; may be needed to bandage a sprained or strained joint such as wrist or knee.
• Adhesive plaster (Large)—can be used on minor wounds or to secure a dressing.
• Adhesive dressing strip—for small cuts and wounds.
• Roller bandages—various sizes, 18 packets, can be used to secure dressings, to apply pressure to control bleeding, and to give support to sprains or strains.
• Eye-pad—for placing on the eye in case of an eye injury.
• Tweezers—to remove splinters from the skin.
• Dressing Scissors—to use when cutting away dressing or bandages.
• Safety pins—1 packet of 10; to be used for fixing bandages or slings in place.
• Pad and pencil for writing—1 each.

CPR (Cardio-Pulmonary Resuscitation):-

• This procedure is carried out on a person whose respiration has ceased. 
• A constant supply of oxygen is vital for the brain and if breathing stops, blood oxygen levels will be affected as all tissues get oxygen through blood circulation.
• The heart maintains this circulation , acting as a pump. 
• If the heart too stops functioning, death will result unless urgent action is taken. 
• The flow of oxygenated blood to the brain is in such case rapidly restored by means of artificial ventilation and chest compression. This dual technique is called CPR.

ABC of artificial respiration:-

• A for Airway:  Clear airway.
• B for Breathing:  Restore breathing .
• C for Circulation:  Restore circulation. 

Holger Nielsen method of artificial respiration:-

• In this method of administering artificial respiration, the patient is turned face downwards with the head turned to one side, kneeling at the patient's head and placing both your hands over the shoulder blades. 
• Pressure should be exerted here by slowly rocking forward. 
• For an adult, the pressure weight nay be about 13.6 kg. 
• As the pressure is released by rocking backwards, the patient's arms are raised by the elbows to expand the chest. 
• The process is repeated until the doctor or an ambulance arrives. 
• Each phase of expansion and compression should last about 2.5 seconds, the complete cycle being repeated 12 times per minute. 

First-aid for Common Situations:- 

• Eye Injury- If rapid blinking fails to dislodge a speck of dust fallen into the eye,lift the lid of the affected eye by the lashes and try to remove the object with the corner of a clean handkerchief. If any acid or other corrosive agents have come into contact with the eye, they should be washed out immediately. Bathe the eye with cold water- if possible, keeping it under running water for 10-15 minutes to ensure that all the acid is washed out. Take the casualty to the hospital immediately. 
• Burns :- For minor burns on the limbs, immediately hold the injury under cold running water for 5 minutes. A small burns needs no further treatment. It should simply be left exposed to air. Do not apply any oil or ointment to the burn and do not prick or remove blisters. 
• Snake bite - confirmation of a snake bite can be obtained if there are teeth marks on the affected area. Make the person lie down comfortably and allow him/her physical and mental rest; try to reassure them. If the snake is indeed poisonous and has bitten the victim on the hands or legs, tie a rope, handkerchief, or tourniquet near the bitten area so as to avoid the venous blood flow carrying the venom towards the heart. A tourniquet should not be tied so tight that blood flow into the organ is inhibited. 
• Choking- The usual response of the victim while choking is violent coughing, because food or some foreign body is caught in the windpipe. If the coughing does not clear the blockage, get the victim to bend over and give him/her a hard slap between the shoulder blades. If this does not dislodge the object, put the victim face down on a table or chair, with the head and chest hanging downwards, and administer another hard slap in the same place. 
• Fracture- The signs of a bone fracture are pain and tenderness even at a gentle touch, swelling and bruising, or loss of control or deformity of the affected limb. A broken bone needs treatment by a doctor. Do not attempt to move the victim unless absolutely necessary and do not try to straighten the bone. Do not loose any of the victim's clothing ,except around the neck. 

Key Terms:-

• CPR- Cardio-Pulmonary Resuscitation. By this method of administering artificial respiration, flow of oxygenated blood is rapidly restored to the brain by means of artificial ventilation and chest compression. 
• First-Aid : This is the initial assistance or treatment given to a casualty for any injury or sudden illness before the arrival of an ambulance, doctor, or other qualified person.