Responding Emergency

Learning Objectives:

That after reading this information sheet , you must be able to:
1. Provide emergency assistance
2. Perform appropriate procedures in providing standard first aid and basic
life support.

First Aid:
First aid is an immediate care given to a person who has been injured or suddenly taken ill.

Objective
 to alleviate suffering
 to prevent added injury
 to prolong life and save limbs

Characteristics of a good first aider

 Observant – notice all signs
 Resourceful – makes best use of all things
 Gentle – shouldn’t cause pain
 Tactful – shouldn’t be alarming
 Sympathetic – should be comforting

Role
 to bridge the gap between the victim and the physician
 is not intended to compete with nor take the place of the services of the physician
 ends when the services of a physician begins

Needs and values of first aid

 to minimize if not totally prevent accident
 to prevent added injury or danger
 to train people the right response at the right time
 accidents happen and sudden illnesses are common and often serious
 people very often harm rather than help
 proper and immediate care is necessary to save life and limbs

Emergency
An emergency is a situation requiring immediate action. Recognizing a situation as an emergency is
the first step in responding to it. The common indicators of an emergency are:

- unusual noises
- unusual sights
- unusual odor
- unusual appearance
- breathing difficulties
- clutching the chest
 - slurred, confused, or hesitant to speak
- confused behavior
- uncharacteristic skin color

Two types of Emergency

Medical emergency – is a sudden illness that requires immediate action or attention, such as heart
attack, diabetic emergency and epileptic seizure.

Trauma emergency – is an injury or damage to the body, such as broken arm, cuts that result from
violent force.

Transmission of diseases and the first aiders

1. Direct contact - occurs when a person touches an infected person’s body fluids.

2. Indirect contact - occurs when a person touches objects that have been contaminated by the blood or
another body fluid of an infected person.

3. Airborne - occurs when a person inhales infected droplets that have become airborne as an infected
person coughs or sneezes

4. Vector - occurs when an animal such as a dog or an insect, such as tick, transmits a pathogen into the
body through a bite.

Standard precautions against disease transmission

1. Personal hygiene
- hand washing
- proper grooming

2. Protective equipment/Body Substance Isolation (precautions taken to isolate or prevent risk of exposure
from any other type of substance)
- mask
- goggles
- surgical gloves
- gown

3. Handle all needles, intravenous equipment and sharp instrument with extreme care

4. Proper immunizations
- DPT ( diptheria-pertusis-tetanus) in childhood
- Tetanus booster every 10 years
- Measles
- Mumps
- Rubella (German measles)
- Polio
- Hepatitis B

Barriers to Action
 presence of bystanders, crowd or family members
 uncertainty about the victims
 nature of the injury or illness
 fear of disease transmission
 fear of doing something wrong
First aid equipment and supplies
1. Basic Equipment
- spine board
- splints
- blankets
- poles

2. Suggested basic first aid kit contents

- sterile gauzes
- roller gauzes
- bandage scissor
- tweezers
- rubbing alcohol
- povidone-iodine
- cotton balls
- tongue depressor
- penlight
- band-aid
- gloves
- forceps
- bandage (triangular)
- elastic roller bandage
- plaster
- white flower
- spirit of ammonia
- efficascent oil
- omega liniment

BODY SYSTEMS
1. Nervous system - is the system that transmits impulses throughout the body

 Parts: brain, spinal cord, nerves

2. Respiratory system - is the system that supplies oxygen and remove carbon dioxide from the blood

 Parts: air passages, chest cage, diaphragm

3. Circulatory system - is the system that transports oxygen, food and water and remove waste products
  Parts: heart, blood, blood vessels

4. Digestive system - is the system that absorbs food and eliminate some waste products

 Parts: mouth, salivary glands, pharynx, esophagus, liver, gall bladder, pancreas, rectum

5. Urinary system - is the system that removes waste products.

 Parts: kidneys, ureters, urinary bladder, urethra

6. Reproductive system - is the system that propagates species.

 Parts: (male): testicles, vas deferens, seminal vessel, prostate gland, urethra, penis
(female): ovary, fallopian tubes, uterus, vagina

7. Musculoskeletal system - is the system that gives form to the body, allow bodily movements, and provide
protection to the vital internal organs, produce red blood cells and serves as a reservoir of calcium,
phosphorous, and other important body chemicals.

 Parts – skull, vertebrae, ribs, pelvis, bones of the upper and lower limbs

BASELINE VITAL SIGNS ASSESSMENT

Baseline vital signs assessment is correctly reading and interpreting the vital signs that clues to what is
happening inside the body. The vital signs that you will measure are the following:
 breathing
 pulse
 skin
 pupils
 blood pressure

Normal ranges of respiration per minute

Age Range
Adult 12 to 20 breaths/min
Child 15 to 30 breaths/min
Infant 25 to 50 breaths/min
Normal range of pulse per minute
Adult 60 to 80 beats/min
Adolescent 60 to 105 beats/min
Child 80 to 150 beats/min
Infant 120 to 150 beats/min
Bodily assessment
a. Look at the victim’s face and lips
b. Record skin appearance, temperature moisture and color.
c. Do head –to-toe examination looking for DCAP-BTLS
 D – deformities
 C – contusions
 A – abrasions
 P - penetrations/punctured
 B – burns
 T – tenderness
 L – lacerations
  S – swelling

Emergency Action Principle

1. Do a primary survey to the victim:
 Check A – airways
 Check B – breathing
 Check C – circulation 10 seconds

2. Do a secondary survey to the victim

 interview the victim – ask the name
 ask what happened
 check the vital signs

1. Shock – is a depressed condition of many body functions due to failure of enough blood to circulate
throughout the body following serious injury

Dangers of shock
- can lead to death
- predisposes body to infection
- lead to loss of body part

Causes
- severe bleeding
- crushing injury
- infection
- heart attack
- perforation anaphylaxis
- bullet wound
- rupture of tubal pregnancies

Factors which contribute to shock

- P – pain
- R – rough handling
- I – improper handling
 - C – continuous bleeding
- E – Exposure to extreme hot and cold
- F – fatigue

2. SOFT TISSUE INJURIES

Wound - is break in the continuity of a tissue of the body either internal or external
Two classifications of wound
a. Closed wound
Causes
- blunt object result in contusion or bruises
- application of external forces

Signs & symptoms

- pain and tenderness
- swelling
- discoloration
- hematoma
- uncontrolled restlessness
- thirst
- shock
- vomiting

Types of closed wound

 Contusions - more commonly known as bruises, caused by a blunt force trauma that damages tissue
under the skin
  Strained muscles - over-stretching of muscles that have not been sufficiently warmed-up (could be
called “cold muscles”)

 Sprained ligament - sudden force causing joint to move beyond its natural range of movement.
First aid management
 R – rest the affected area
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 I – ice application or cold compress
 C – compression over the affected area
 E – elevate the affected area above the heart

b. Open wound
Classification of
Causes Characteristics
open wound:
P – puncture penetrating deep and narrow,
pointed serious or slight
instruments such bleeding
as nails, ice
picks, daggers,
etc.
A – abrasion scrapping or shallow, wide,
rubbing against oozing of blood,
rough surfaces dirty
blunt instruments torn w/ irregular
L – laceration such as edges, serious or
shrapnel’s, rocks, slight bleeding
broken glasses,
 etc
A – avulsion explosion, animal tissue forcefully
bites, separated from
mishandling of the body
tools
I – incision sharp bladed clean cut, deep,
instruments such severe bleeding,
as blades, razors, wound is clean
etc.

Dangers
 hemorrhage
 infection
 shock
FIRST AID
The major principles of open-wound treatment are to:
- control bleeding through direct pressure except eye injury, wound w/ embedded object, possible skull
fractures
- elevation

- prevent further contamination of the wound (wound dressing & bandaging)

10
- immobilize the injured part
- stabilize any impaled object

Wound with bleeding not severe (home care)

- clean the wound with soap and water
- apply mild antiseptics
- cover wound with dressing and bandage

 Dressing – is any sterile cloth material used to cover the wound.

Other uses of dressing:
- to control bleeding
- protects wound from infection
- absorbs liquid from the wound such as blood, plasma, water, and pus

Kinds of dressing
- roller gauze
- square pads (os)
- compress dressing
- adhesive dressing
- occlusive dressing
- butterfly dressing
- eye pads

3. Bone, joint, muscle injuries include the following

a. muscle cramp or spasm - is a sudden, painful tightening of a muscle

First aid
- Have the victim stretch out the affected muscle to counteract the cramp.
- Massage the cramped muscle firmly but gently.
- Apply heat, moist heat is more effective than dry heat.
- Get medical help if cramps persist.

b. muscle strain or pulled muscle - is a sudden and painful tearing of muscle fiber during exertion

Signs & symptoms

- swelling
- bruising
- loss of efficient movement

First aid
- Apply cold compress at once.
- Elevate the limb to reduce swelling and bleeding within the muscle.
- Rest the pulled muscle for 24 hrs.
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- Get medical help.
c. sprain – is caused by torn fibers in a ligament

Signs and Symptoms

- swelling
- bruising

First aid
- Remove any clothing or jewelry from around the joint.
- Apply cold compresses at once.
- Elevate the affected joint with pillow or clothing.

d. fracture - a medical condition in which there is a break in the continuity of the bone. A bone fracture can
be the result of high force impact or stress, or trivial injury as a result of certain medical condition that
weakens the bones.

 Greenstick fracture - an incomplete fracture in which the bone is bent.

 Transverse fracture - a fracture at a right angle to the bone’s axis

 Spiral fracture - a fracture in which the break has a curved or sloped pattern.
 Comminuted fracture - a fracture in which the bone is broken into several pieces
 Compound fracture - meaning the bone ends are no longer touching.
 Compression fracture - is a collapse of a vertebrae, it may be due to trauma or due to a weakening of
the vertebrae
Signs & symptoms
- pain and swelling at the fracture site
- tenderness close to the fracture
- paleness and deformity (sometimes)
- loss of pulse below the fracture, usually in an extremity (this is an emergency)
- numbness, tingling or paralysis below the fracture (rare, this is an emergency)
- bleeding or bruising at the site
- weakness and inability to bear weight
 FIRST AID
 Initial treatment for fractures of the arms, hands, legs, and feet in the field include splinting the extremity
in the position it is found, elevation, and ice application. Immobilization will be very helpful with initial
pain control.

BANDAGING:
A bandage is any cloth material, may or may not be sterile used to hold a dressing in place.

Uses
- to support – fractured bone
- to immobilize – dislocated shoulder/jaw

- to apply pressure – stop bleeding & improve venous blood flow

- to secure a dressing in place
- to retain splints in place

Principles & Procedures for applying bandages

 Wash hands (wear gloves when necessary).
 Assist victim to assume comfortable position on bed or chair and support the body part to be bandaged.
 Always stand in front of the part/victim to be bandaged except when applying a bandage to the head, eye
and ear.
 Be sure the bandage is rolled firm.
 Make sure the body part to be bandaged is clean and dry.
 Assess skin before applying bandage for any breakdown.
 Observe circulation by noting pulse, surface temperature, skin color and sensation of the body part to be
wrapped.
 Always start bandaging from inner to outer aspect and far to near end.
 When bandaging a joint, ensure its flexibility.(except if immobilization of joint is required) .
 Always start and end with two circular turns.
 Cover the area 2 inches above and 2 inches below the affected area (wound).
 Where possible, leave fingertips or toe tips exposed for observation (adequacy of blood circulation).
 End the bandage on the outer side of the body. Do not end a bandage on wound or at the back of the
body.
4. HEAT ILLNESSES:
a. Heat cramps:
Heat cramps are muscle pains, usually in the lower extremities, the abdomen, or both that occur because
of profuse sweating and consequent salt depletion.

Signs & symptoms

- mild to slight abdominal cramping
- tingling in the extremities
- severe incapacitating pain in the abdomen and extremities
- hypotension
- nausea
- rapid pulse
- pale & moist skin
- with normal temperature

Emergency care
- Move the patient to a cool environment.
- Have the patient sip a glass of ORS or Gatorade.
- Let the patient rest.
 - Monitor vital signs.
- Do not massage cramping muscles.
- Restrict patient from strenuous work for 12 hours.
- Untreated heat cramps may progress to heat exhaustion.

b. Heat exhaustion
Heat exhaustion occurs as a result of salt and water loss along with peripheral pooling of blood.

Signs & symptoms

- headache
- fatigue
- dizziness
- nausea
- abdominal cramps
- profuse sweating
- pale and clammy skin
- disoriented
- temperature may be low, normal, or elevated
- weak and rapid pulse
- fast and shallow breathing
- hypotension

Emergency care
- Move the patient to a cool environment.
- Loosen tight clothing and remove excess clothing.
- Place in supine position.
- Cool and fan the patient.
- Do not give fluids, just wet the lips with moist cotton or towel.
- Monitor vital sign.
- Care for shock.
- Transport and refer to physician
c. Heat Stroke
It is caused by a severe disturbance in the body’s heat regulating mechanism and is a profound emergency

Two types of Heat Stroke Syndrome

 Classic heat stroke (passive heat stroke)
- usually occurs during heat waves
- most likely to strike the very old, the very young patients with chronic illness, alcoholic person are
very susceptible
- high environmental temperatures initially elicit the usual heat shedding mechanism and the patient
sweat profusely, but at a certain point the patient becomes too dehydrated to sweat no more
- In classic heat stroke, the patient has two problems to attend to; a dangerously high temperature and
dehydration.

 Exertional heat Stroke

Exertional heat stroke is typically an illness of the young and fit, usually an athlete or a military recruit
exercising under hot and humid conditions.
- when the ambient temperature approaches body
- temperature radiation and convection are no longer present
- ineffective means of shedding excess heat
- the relative humidity rises above 60%
- evaporative cooling becomes ineffective as well
- If a person continues to exercise under such conditions, he will continue generating heat without any
means of excreting it.
 - This heat will build up within the body, causing the core temperature to rocket upward.

Signs & symptoms

- delirium, stupor, or coma
- flushed, hot, may be dry
- elevated temperature
- rapid or weak pulse
- high blood pressure in exertional heat stroke, normal or low in classic heat stroke
- tempers, seizures
- dilated pupils
- decerebrate or decorticate posturing

Emergency care
 Cool the patient as rapidly as possible.
 Apply ice packs to the patient’s flanks while massaging his neck and torso to prevent a
vasoconstrictive response to ice.
 Spray the patient with tepid water while fanning constantly to promote rapid evaporation.
 Monitor vital signs.
 Care for shock.
 Transport and refer to physician.

5. BURNS
Burn is an injury involving the skin, muscles, bones, nerves, and blood vessels. Burns result from heat,
chemicals, electricity or solar or other forms of radiation.

Common causes
- carelessness with match and cigarette smoking
- scald from hot liquid
- defective heating, cooking and electrical equipment
 - immersion in overheated bath water
- use of chemicals such as lye, strong acids, and strong detergents

Environmental factors
- fire
- excessive heat and cold
- water and ice
- electricity
- hazardous materials or chemicals
- radiation

Factors to determine severity of burn

a. Depth:

Superficial burn or 1st degree burn

Signs & symptoms

- skin is red and dry
- painful
- swelling

Partial thickness burn or 2nd degree burn

Signs & symptoms

- skin is red
- painful
- swelling
- presence of blisters

Full thickness burn or 3rd degree burn

Signs & symptoms

- charred skin ( brown or black)
- swelling
- blisters
- extremely painful or relatively painless
Types of Burn Injuries
a. Thermal burns – not all thermal burns are caused by flames. Contact with hot objects, flammable vapor
that ignites and causes a flash or an explosion, and steams or hot liquid are other common causes of burns.

Care for thermal burns

 First & second degree burns
- Relieve pain by immersing the burned area in cold water or by applying wet, cold cloth. If cold
water is unavailable, use any cold liquid you drink to reduce the burned skin’s temperature.
- Cover the burn with a dry, non-sticking sterile dressing or a clean cloth.

 Care for third-degree burns

- Cover the burn with a dry, non-sticking sterile dressing or a clean cloth.
- Treat the victim for shock by elevating the legs and keeping the victim warm with a clean sheet or
blanket.

b. Chemical burns – chemicals will continue to cause tissue destruction until the chemical agent is removed.

Care for chemical burns

- Immediately remove the chemical by flushing water.
- Remove the victim’s contaminated clothing while flushing with water.
- Flush for 20 minutes or longer. Let the victim wash with a mild soap before a final rinse.
- Cover the burned area with a dry dressing or for large areas a clean cloth.
- If the chemical is in the eye, flood it for at least 20 minutes, using low pressure.
- Seek medical attention immediately for all chemical burns.
c. Electrical burns – may produce devastating internal injury with little external evidence. The degree of
tissue injury in an electrical burn is related to the resistance of various body tissues, the intensity of current
that passes through the victim and the duration of exposure.
 Type 1 – contact burn
In an electric injury, the current is most intense at the entrance and exit sites. At those points
you may see a characteristic bull’s eye lesion with a central charred zone of third degree burns, a
middle zone of coagulation necrosis.

 Type 2 – electro thermal burn

It is an injury caused by arching of electric current.

 Type 3 – thermal burn

Thermal burn is another thermal injury, it occurs when electricity ignites a person’s clothing’s
or surroundings.

Care for electrical burns

- Unplug, disconnect or turn off the power.
 - Check the ABC’s (airway, breathing, circulation)if the victim fell, check for spine injury.
- Treat the victim for shock.
- Seek medical attention immediately.

6. Specific body injuries

- blows to the eye
- chemical burns
- eye knocked out
- foreign object
- nosebleeds
- knocked-out tooth

Nosebleed – bleeding from the internal blood vessels of the nose.

Causes
- nose picking
- vigorous nose blowing
- in children – a foreign body lodged in the nose
- repeated sneezing
- upper respiratory infection
- allergic rhinitis
- chemical irritants
- drugs (anticoagulants or anti-inflammatory)
- trauma (broken nose) or irritation
- facial and nasal surgery

Emergency care
- Sit down and lean forward slightly, head turned to the side to prevent blood from running down the
throat and any clots from blocking the air passages.
- Pinch the lower part of the nostrils just below the bony part of the nose for 10 minutes while breathing
through the mouth. Slowly release the nostrils. If bleeding continues, repeat the procedure.
- After the bleeding has stopped, do not touch or blow the nose for about 24 hours. Do not pack the
affected nostril with cotton or gauze unless you are adept at it, as you could further damage the blood
vessels.
- If bleeding continues after doing the above procedure seek medical attention immediately.

7. Poison
Poison is any substance solid, liquid, or gas that tends to impair health or cause death when introduced
into the body or onto the skin surface. A poisoning emergency can be life threatening.

Causes
- common in suicide
- occasional accidental poisoning

Ways in which poisoning occur

- Ingestion – by mouth
- Inhalation – by breathing
- Injection – by animal bites, stings, syringes
- Absorption by skin contact

a. Ingested poison – is one that is introduced into the digestive tract by way of the mouth, including food,
substances, medicines, household or garden items.

Signs & symptoms

- altered mental status
- burns around the mouth
 - history of ingesting poisons
- odd breath odors
- nausea, vomiting
- abdominal pain
- diarrhea

Instances when vomiting should not be induced:

- if unresponsive
- cannot maintain an airway

- has ingested an acid, a corrosive such as lye, or a petroleum product such as gasoline or furniture
polish
- has a medical condition that could be complicated by vomiting , such as heart attack , seizures, and
pregnancy

First aid
- Try to identify the poison.
- Place the victim on his or her left side.
- Monitor ABCs.
- Save any empty container, spoiled food for analysis.
- Save any vomitus and keep it with the victim if he or she is taken to an emergency facility.

b. Inhaled Poison – is a poison breath into the lungs

Signs & symptoms

- history of inhaling poisons
- breathing difficulty
- chest pain
- cough, hoarseness or burning sensation in the throat
- cyanosis (bluish discoloration of skin and mucous membranes)
- dizziness, headache
- seizures, unresponsiveness (advance stages)

First aid
- Remove the victim from the toxic environment and into fresh air immediately.
- Monitor ABCs.
- Seek medical attention.

c. Absorbed Poison – is a poison that enters the body through the skin
Signs & symptoms:
- history of exposures
- liquid or powder on the skin
- burns
- itching, irritation
- redness, rash, blisters

First aid
- Remove the clothing.
- Then with a dry cloth blot the poison from the skin, if the poison is a dry powder, brush it off.
- Flood the area with copious amounts of water.
- Continually monitor the patient’s vital signs.

d. Injected Poison – is a poison that enters the body through a bite, sting or syringe
  Insect bites
Signs and symptoms
- stinger may be present
- pain
- swelling
- possible allergic reaction

First aid
- Remove stinger.
- Wash wound.
- Apply a cold pack.
- Watch for signs of allergic reaction.

 Spider bite/scorpion sting

Signs & symptoms
- bite mark
- swelling
- pain
- nausea and vomiting
- difficulty breathing or swallowing

First aid
- Wash wound.
- Apply a cold pack.
- Get medical care to receive antivenin.

 Marine life stings

Signs & symptoms
- possible marks
- pain
- swelling
- possible allergic reaction

First aid
- Jellyfish – soak area in vinegar
- Sting ray – soak in non-cascading hot water until pain goes away
- Clean and bandage the wound.

Emergency Rescue – is a rapid movement of patient from unsafe place to a place of safety.

Indications for Emergency Rescue:

- danger of fire or explosion
- danger of toxic gases or asphyxia due to lack of oxygen
- serious traffic hazards
- risk of drowning
- danger of electrocution
- danger of collapsing walls

Transfer – is moving a patient from one place to another after giving first
Aid.

Factors to be considered in the selection or choosing the transfer method:

 - nature and severity of the injury
- size of the victim
- physical capabilities of the first aider
- number of personnel and equipment available
- nature of evacuation route
- distance to be covered
- gender of the victims (last consideration)

Pointers to be observed during transfer

 Maintain an open airway.
 Hemorrhage should be controlled.
 Position of the victim must be maintained
 Monitor vital signs.
 Supporting bandages and dressing must remain effectively applied.
 Method of transfer is safe, comfortable, and speedy.
 Move the victim as one unit.
 Taller the first aiders must stay at the head of the victim.
 First aiders/bearers must observe ergonomics.
 This only works with a child or a very light person.
ONE-PERSON LIFT 1. Place your arms under the victim's knees and
around their back.

FIREFIGHTER CARRY This technique is for carrying a victim longer

distances.
It is very difficult to get the person up to this
position from the ground. Getting the victim into
position requires a very strong rescuer or an
assistant.
1. The victim is carried over one shoulder.
2. The rescuer's arm, on the side that the victim is
being carried, is wrapped across the victim's legs
and grasps the victim's opposite arm.

PACK-STRAP CARRY When injuries make the firefighter carry unsafe,

this method is better for longer distances than the
one-person lift.
1. Place both the victim's arms over your
shoulders.
2. Cross the victim's arms, grasping the victim's
opposite wrist.
3. Pull the arms close to your chest.
4. Squat slightly and drive your hips into the victim
while bending slightly at the waist.
5. Balance the load on your hips and support the
victim with your legs
For the conscious victim, this carry allows the victim
to swing their leg using the rescuers as a pair of
crutches. For the unconscious victim, it is a quick
and easy way to move a victim out of immediate
danger.
1. Start with the victim on the ground.
2. Both rescuers stand on either side of the
victim's chest.
3. The rescuer's hand nearest the feet grabs the
victim's wrist on their side of the victim.
4. The rescuer's other hand grasps the clothing of
the shoulder nearest them.
5. Pulling and lifting the victim's arms, the
rescuers bring the victim into a sitting position.
6.The conscious victim will then stand with
rescuer assistance.
7. The rescuers place their hands around the
victim's waist.
8. For the unconscious victim, the rescuers will
grasp the belt or waistband of the victim's
clothing.
9. The rescuers will then squat down.
10. Place the victim's arms over their shoulders so
that they end up facing the same direction as
the victim.
11. Then, using their legs, they stand with the
victim.
12. The rescuers then move out, dragging the
victim's legs behind.