EFA Course PDF Handout

CHITKARA UNIVERSITY SCHOOL OF
MARITIME STUDIES
Basic Safety Training
Elementary First Aid

Course Handout
Chandigarh-Patiala National Highway, Punjab 140401.

Ph: +91 8288088578
Web: www.chitkara.edu.in
BST_EFA Course Handout
BST_EFA COURSE OUTLINE

Duration: 2.5 days Total hours: 15 hours
Approximate time (hours)

SNo.
Knowledge, understanding and proficiency Demonstra
Lectures tions / Total
Practical
1. General Principles 1.0 1.0
2. Body Structure and Functions 2.0 2.0
3. Positioning of Casualty 1.0 0.5 1.5
4. The Unconscious Casualty 1.0 1.0
5. Resuscitation 1.0 1.0 2.0
6. Bleeding 1.0 0.5 1.5
7. Management of Shock 1.0 1.0
8. Burns and Scalds, & Accidents caused by Electricity 0.5 0.5 1.0
9. Rescue and Transport of Casualty 1.0 0.5 1.5
10. Miscellaneous Topics 1.0 0.5 1.5
11. Review and Assessment 1.0 1.0
TOTAL 11.5 3.5
GRAND TOTAL 15.0

COURSE SCOPE AND OBJECTIVE
This course covers the training recommended in regulation VI/I read along with section A-VI/ 1-3 of code
A of the STCW convention 2010.
Course Objectives
On successful completion of the course a trainee should be able to
• Assess the needs of casualties and threats to own safety
• Appreciate the body structure and functions
• Understand immediate measures to be taken in cases of emergency, including the ability to
• Position casualty
• Apply proper first aid techniques
• Control bleeding
• Apply appropriate measures of basics shock management
• Apply appropriate measures in event of bums and scalds, including accidents caused by Electric
current
• Rescue and transport a casualty vii. Improvise bandages and use materials in emergency kit
CHAPTER 1
GENERAL PRINCIPLES OF FIRSTAID
First aid is the initial assistance/treatment given to a casually for any injury or sudden illness before the
arrival of an ambulance, doctor or other qualified person.
Aims of First Aid:

1. To save life
2. To limit the effects of the condition
3. To promote recovery
The First Aiders:

1. Highly trained
2. Examined and regularly re-examined
3. Up to Date in knowledge and skill
The Principles and practice of First Aid are based on the principles of practical medicine and surgery.
Knowledge of which, in case of accident or sudden illness, enables trained persons to give such skilled
assistance as will preserve life, promote recovery and prevent the injury or illness becoming worse until
medical aid has been obtained.
Responsibilities of a First Aider
• To assess a situation quickly and safely and render appropriate help.

• To identify, as far as possible the injury or nature of illness affecting a casualty.
• To give early, appropriate and adequate treatment in a sensible order of priority.
• To arrange for the removal of casualty to hospital to the care of a doctor.
• To remain with a casualty until handing him or her over to the care of an appropriate person.
• To make and pass on a report and give further help if required.
CHAPTER 2
BODY STRUCTURE AND FUNCTIONS
Treatment of illness on board ship requires some understanding of the Anatomy structure and physiology
functions of the Human Body. Some of the systems discussed below for better understanding
Circulatory System (Heart and Blood vessels)
The body contains about five litres of blood, which circulates to all tissues of the body. It is kept
moving round the body by the Heart, a muscular pump about the size of a clenched fist situated in the
chest behind the breast bone (sternum) lying between the lungs where it passes through minute tubes gives
up carbon-di-oxide and takes up the supply of Oxygen. The oxygenated blood now passes to the left side
of the heart, which pumps it to all parts of the body through the arteries. This blood carries Oxygen, Food,
Water and salts to the tissues, it is bright red in colour. It also conveys heat to all parts of the body and
contains various substances to counteract infections in the tissues. The arteries are like thick walled tubes
and decrease in diameter away from the heart. In the tissues, the smallest blood vessels are very minute
and called capillaries: substances like Carbon-di-oxide that is accumulated gives the blood a dark colour.
The veins, the thin walled tubes that carry the blood back to the right side of the heart.
Some of the blood passed to the stomach and the guts and having taken food products, carries them
away to be stored in the liver. Blood is also taken by arteries to the kidneys and there gets rid of waste
products, which are passed in the urine.
As the blood passed along the arteries, they pulsate at the same rate as the heart is pumping. The
average normal pulse rate is about 72 times per minute. But it increases with exercise, nervousness, fear,
fever and various illnesses. The pulse is usually counted by feeling the artery at the front of the wrist just
above the wrist joint.
Respiratory System
Every time a breath is taken, the air containing Oxygen, passes through the nose or mouth and pass
the larynx or voice box into the Trachea-windpipe. The Windpipe divides into two main tubes called
Bronchi, each of which then divides up into many smaller bronchial tubes that pass into the lung tissue.
The air breathed in passes through these small tubes into minute air cells called alveoli, each of
which is surrounded by capillaries.
The blood in the capillaries gives up carbon-di-oxide and takes up Oxygen. In breathing out the air
passes back along the same respiratory passages and is breathed out through the nose or mouth.
The liver secretes the important digestive juice called the bile and on its surface has a smaller
reservoir called the gallbladder where the bile is concentrated and kept available. The liver also deals with
the storage of digested food material.
The spleen is a solid oval shaped organ in the upper part of the left side of the abdominal cavity at
the back of the stomach, just above the kidney. Its functions are largely connected with the blood and it
may enlarge in certain diseases.
Urinary System
The kidneys are at the back of the upper part of the abdominal cavity, one on either side of the spine.
They remove water and certain waste products from the band produce urine.
Urine leaves each kidney by small tubes called the urethras. The two urethras entering the back of the
urinary bladder, which is a muscular bag situated in the front part of the pelvic cavity.
Urine collects in the bladder and is expelled from it through a tube leaving its under surface. This tube
is called the urethra. In male, it is contained in the penis.
Urinary system
Nervous System.
The nervous system consists of the brain, the spinal cord, and the nerves. The brain, in the cavity
of the skull, is a mass of nervous tissue. The coordination centre of the body, it acts like computer,
receiving messages through the incoming (sensory) nerves and the special nerves connected with sight,
smell, hearing etc., deciding on the action necessary, and then sending out orders to the various parts of the
body by the outgoing (motor) nerves.
Running between the brain and the various parts of the body and a number of local nerve centres. At
intervals down the spinal column, nerve trunks issue from the spinal cord containing both motor and sensory
fibres; these nerves makes contact with the muscles, which they cause to contact skin and other organs.
Autonomous nervous system

This is a fine network of nerves, which help control the functions of various organs in the body has
local nerve centers, such as the solar plexus, which is situated in the upper part of the abdomen behind the
stomach. Although connected certain parts of the brain, it is not controlled by the will but functions
automatically day and night. It regulates the rate at which the heart pumps, in accordance with the
demands of the various bodily systems at any particular time. It also helps to control the muscles of the
stomach and intestine and the rate and depth of breathing.
The lungs are like elastic sponges and the many air cells in their expelled with breathing in and are
compressed with breathing out. Most people think that it is the ribs moving in and out that produce the 30
of breathing. Rib movement does in fact play quite a big part, but the diaphragm moving up and down
does the main work. The diaphragm is a large dome shaped muscle which separates the chest from the
abdominal cavity. When the diaphragm muscles contracts, its dome becomes flattened and draws down the
lungs, causing air to enter them and when relaxes, the lungs become smaller and the air in them is
expelled. The muscles of the abdomen also help in breathing when they tighten, they press the abdominal
contents against the diaphragm and help in expelling air from the lungs and when they relax, and they help
in inhaling air diaphragm down the lungs in breathing.
Digestive System and Abdomen:

Food in the mouth is broken up by chewing and tongue movements and mixed with saliva, which
lubricates it and starts the digestive process. When it is in a suitable state, it passes to back of the throat,
where muscular action forces it down the esophagus or food pipe (a muscular pipe behind the windpipe).
The food pipe runs down the back of the chest between the two lungs and then passes through the
diaphragm into the stomach.
The stomach lies mainly in the lest upper part of the abdominal cavity, partly behind the lower left rib
cartilage and just under the heart when food enter the stomach, various digestive juices act upon it and the
muscles of the stomach contracts and relaxes, mixing the food thoroughly. The capacity of the adult stomach is
one litre.
Still only partly digested, the food passes into the small intestine, where more digestive juices and especially
those from the liver and pancreas, mix with it. Nourishment and fluids are absorbed from this Coiled-up tube,
which is about six meters long and the residue of the food passes into the large intestines or colon, at a point in
the lower part of the right side of the abdomen, close to where the appendix is situated. In large intestines, most
the water is absorbed from the food residue. As its far end, the large intestines join the rectum and where the
unwanted food residue faces collected are passed out of the body by anus.
Digestive System
Skin
The skin covers and protects the body. It consists of two layers. The outer layer is hard and protects
the inner layer, where the very sensitive nerve endings lie. The skin contains numerous sweat glands that
lubricate the skin and the hair. Sweat consists of water, salt and other substances. Sweating cools the body
and helps to regulate its temperature.
Skeletal System
The skull forms a case that contains and protects the brain. It consists of many bones firmly joined
to one another except for the lower jaw, which moves at joints just in front of the ears. The skull rests on
the upper end of the backbone which is made up of a series of small bones called the vertebral column
within which is housed the spinal cord nerves emerge from the cord at the level of each vertebra.
At the lower end of the backbone is the pelvis, formed by the hip-bones one an either side, which
together form a basin to support the contents of the abdomen. On the outer side of either hip is a cup shaped
socket into which the rounded head of the thighbone fits, forming a ball and socket joint.
The femur ends at the knee, where it forms hinge like joint with the strong shin-bone is attached the
slender fibula. In front of the knee lies the kneecap, the shape of which can be easily felt. At the ankle, the foot
is joined to the lower ends of both the tibia and fibula by another hinged joint. The foot is made up of many
small bones (tarsal, metatarsal & phalanges) of different shapes. There are two bones in the great toe and three
in each of the other toes.
Twelve ribs are attached to the backbone on either side. Each rib, with the exception of the two lower
most on either side, curves round the chest from the backbone to the sternum in front. The lower most ribs have
no attachment to the sternum in the front. The ribs from the chest protect the lungs, move slightly upwards and
outwards to expand our chest. The sternum lies just under the skin of the front of the chest, and to its upper end
is attached the collarbone. The outer end of the collarbone joints with the scapula (shoulder bone). Each scapula
has a shallow socket into which fits the rounded upper end of the humours (arm-bone). At the elbow, the arm-
bone forms another hinge like joint with the forearm-bones (the Radius and Ulna) and these joints with the hand
at the wrist. This wrist like the foot is made up of many small bones (carpal, metacarpals & phalanges). There
are two bones in the thumb and three in each finger.
Muscular System
Voluntary muscles are found in the head, neck, limbs, back and walls of the abdomen. They are.
Attached to bones by fibrous tissues, which is frequently in the form of a cord and is called a tendon. Muscle
contracts in response to an impulse sent to it through a nerve, it becomes shorter and thicker draws the bones to
which it is attached nearer to one another. The brain controls such movements. Involuntary muscles are found
in the stomach and intestines, heart blood vessels and other internal organs of the body. As the name indicates,
they are not under the influence of the will but function on their own, day and night.
CHAPTER 3
POSITIONING OF CASUALITY
Casualty Positioning
Once you've treated the injury or illness you are not quite out of the woods until further help arrives. In that
time, correct positioning of the casualty can aid recovery in the same way that poor positioning can very
easily aggravate the injury or exacerbate the condition. Here are a few positions to consider.
Safe Airway Position
Without airway management equipment or techniques unconscious casualties will die on their back. We can
open their airway with a simple head tilt but this does not prevent fluids (blood or saliva) draining down or
coming up (vomit or blood) and entering the airway.
Any unconscious casualty (even with a suspected spinal injury) should be positioned onto their side because,
quite simply, if you don't have an airway, you don't have a casualty.
Regardless of whether you call it the Safe Airway Position, Recovery Position, Drainage Position, Left lateral
Recumbent or Three-Quarter Prone, we're going to flip them over.
How to do it:-
• Remove the victim’s glasses, if present.
• Kneel beside the victim and make sure that both his legs are straight.
• Place the arm nearest to you out to you side – DO NOT place the shoulder and elbow at right angles.
This is unnecessarily painful for people with limited range of movement and places pressure on the
lower arm.
• Bring the far arm across the chest, and hold the back of the hand against the victim’s cheek nearest to
you.
• With your other hand, grasp the far leg just above the knee and pull it up, keeping the foot on the
ground.
• Keeping their hand pressed against their cheek, pull on the far leg to roll the victim towards you on to
their side.
• Adjust the upper leg so that both the hip and knee are bent at right angles.
• Tilt the head back to make sure that the airway remains open.
• If necessary, adjust the hand under the cheek to keep the head tilted and facing downwards to allow
liquid material to drain from the mouth.
• Check breathing regularly.
• If the victim has to be kept in the recovery position for more than 30 min turn him to the opposite
side to relieve the pressure on the lower arm.
Left of Right?
The Safe Airway Position is often called Left lateral Recumbent, especially in the US. There is sometimes
milage in positioning the casualty on their left; the most cited reason - and most plausible - is significant for
women in the later stages of pregnancy when positioning the casualty on their right will apply pressure from
the foetus onto the superior vena cava (one of the two large vessels which return deoxygenated blood to the
heart) impeding circulation. Other reasons include:
• Stomach curves to the left, so vomit would have an extra curve to overcome
• Stomach curves to left, so contents won't be pushing against sphincter.
• In the ambulance, attendant can watch him better facing toward him.
• Improved ventilation given the right lung being slightly larger than the left and left main stem
bronchus being at an angle.
There is no real evidence for any of these justifications so it would seem that many of the reasons given are -
as is often the way in First Aid - largely historical cliche's perpetuated because it is really easy to teach people
what you have been taught rather than actually looking into what you are teaching.
In fact, positioning on the left can have adverse effects for some conditions, such as
• Congestive Heart Failure (1) or

• Increase absorption of ingested poisons (2).
Let’s be pragmatic.
Depending on the position your casualty is already found in and obstacles around them you may not have the
luxury of this choice. Practice positioning your casualties on either left or right and position them
appropriately to
1. Maximize drainage without
2. Aggravating injuries or illnesses.
3. Roll casualties with chest injuries onto the injured side to protect the unaffected lung.
If the causality is alert or we are able to manage their airway with suction and airway adjuncts, it is
sometimes beneficial for the casualty to remain on their back. Recumbent is a posh word for simply lying
down with their head supported by a pillow and is the most common and appropriate position for
someone who simply needs rest. A slight modification for this would be to remove the pillow which
would be appropriate for someone with a suspected spinal injury. This position is now called Supine.
Neither of these positions are recommended for head injury (where the priority is to reduce intracranial
pressure) or for casualties with breathing problems or chest pain. In reality most conscious casualties with
these conditions won't let you lay them flat While we're on the subject of letting the casualty assume the
most comfortable position, most people with abdominal pain will draw their knees in. If that's what they
want, let them do it. Supporting under the knees is also meant to relieve pain from pelvic injuries - this is
subjective so offer it, don't force it.
Sometimes a tilt can help; most ambulance trolleys will have this option but in the outdoors we have hills and
slopes we can utilize. With the legs elevated the Trendelenburg position can improve venous drainage from
lower limbs and improve blood supply to the head but with pressure on the diaphragm from below,
respiration can be reduced. Inclining the whole body downhill can reduce intracranial pressure and without
pressure on the diaphragm, easy respiration.
Sat Up
We often have a tendency to force our casualty to lie down. It's traditional. Like a default position for poorly
people. Sometimes, allowing or encouraging your casualty to sit up will make their day.
An upright or semi-recumbent position is not just comfortable for some casualties it can greatly assist their
recovery. Upright positions will reduce intracranial pressure, essential for head injuries, and assist breathing.
The W Position is one of the most common positions the conscious casualty will adopt and a safe bet for
anyone with a reduced level of consciousness; if they're on the floor they can't fall off it. It's good for head
injuries, chest pain, breathing problems and abdominal pain
The Shock Position
For years we have been told that the casualty who is in shock needs to lie down with their legs elevated
because this will drain blood from the legs into the core to:
• Improve cardiac output
• Improve systemic vascular resistance
• Improved mean arterial pressure
• Improved systolic blood pressure
There is no evidence of any standard that this is of real benefit. If you think about it, you know there is no
available blood in the legs because the casualty is cold and pale - they are already shunting any available
blood to the core by vasoconstriction.
And if they are going into shock we can expect their level of consciousness to drop. How do unconscious
casualties die? Oh, that's right, on their backs.
Anaphylaxis
Several awarding bodies still teach this for the treatment of hypovolemic shock as well as the treatment of
anaphylactic shock. This position may be helpful for the anaphylactic casualty with low blood pressure but
given 80% of cases present with skin rashes and 70% with difficulty breathing compared to the 10-45% who
present with low blood pressure (5) elevating the legs could be the absolute worst thing you can do for them.
For the conscious casualty, they will adopt a comfortable position, probably the W Position or Semi
Recumbent (6, 7). Anyone unconscious is placed into the Safe Airway Position if airway management
equipment and techniques are not available.
Conclusions
Don't just leave them as you found them for fear of causing injury and neither flip them into a textbook
position just because you were told to once.
Prioritise the airway - even with a spinal injury - a casualty without a clear and open airway will not last long.
If the casualty is conscious allow them to adopt the most comfortable position for them; they will know what
relives pain or eases breathing much better than you and they will not appreciate being forced into an
uncomfortable position just because it 'looks right'.
Be pragmatic: Do the best you can based on the position they are found in and obstacles around them with as
little movement as possible to avoid aggravating injuries. More often than not the Real World is not Text
Book.
CHAPTER 4 – THE UNCONSCIOUS CASULITY

A. Someone who is unconscious
If you see someone who has collapsed, you need to confirm whether they are unconscious and breathing or
unconscious and not breathing.
The safest thing to do is get professional help as quickly as possible. If other people are around, get someone
help. If you are alone, shout for help and as soon as someone arrives get them to inform bridge as soon as
possible.
B. Unconscious and breathing
DRAB survey
While you are waiting for help to arrive, follow the primary DRAB survey steps -
Danger
Response
Airway
Breathing
Danger
Check that neither you nor the unconscious person is in any danger. If necessary make the area safe and then
assess them.
Response - unconscious adult or child
If you are still alone, shout for help again and then see if the person responds:
• Shout at them - for example: 'Can you hear me?' or 'Open your eyes'.
• Gently shake their shoulders.
Response - unconscious infant
If it is an unconscious infant (under 12 months), to check for a response:
• Tap or flick the sole of an infant's foot to try to elicit a response.
• Do not shake an infant.
Airway
If they respond, they are breathing but check for severe bleeding and other injuries. You may need to help
them to breathe by opening their airway:
• Place one hand on the forehead and, using two fingers, lift the chin
Breathing
If they don't respond, you need to check if they are breathing:
• Position your cheek close to their mouth.
• Look, listen and feel for no more than 10 seconds:
• Look to see if the chest is rising and falling.
• Listen for breathing.
• Feel the breath against your cheek.
Recovery position
If they are breathing put those in the recovery position until help arrives:
• Turn them on to their side.
• Lift chin forward in open airway position and adjust hand under the cheek as necessary.
• Check they cannot roll forwards or backwards.
• Monitor breathing continuously.
• If injuries allow, turn them to the other side after 30 minutes.
Unconscious and not breathing
Having completed the DRAB survey steps above and established the person is not breathing; give
cardiopulmonary resuscitation (CPR). This is a technique whereby oxygen is pumped around the body, using a
combination of chest compressions and rescue breaths.
Unconscious and not breathing adult
• Chest compressions:
§ Place the heel of your hand (the base of your thumb) in the centre of the chest.
§ Place your other hand on top and interlock fingers.
§ Keeping your arms straight and your fingers off the chest press down by five to six centimeters
and release the pressure, keeping your hands in place.
§ Repeat the compressions 30 times, at a rate of 100-120 per minute (about the speed of the song
'Staying Alive' or 'Nelly the Elephant').
• Next give 2 rescue breaths:
§ Ensure the airway is open.
§ Pinch their nose firmly closed.
§ Take a deep breath and seal your lips around their mouth.
§ Blow into the mouth until the chest rises.
§ Remove your mouth and allow the chest to fall.
§ Repeat once more.
If you are unable, unwilling or untrained to give rescue breaths, give chest compressions only and continue at
a rate of 100-120 per minute.
Unconscious and not breathing child
If it is an unconscious child (1 year to puberty) who is not breathing, start with rescue breaths:
• Ensure the airway is open.
• Seal your lips around the child's mouth.
• Blow gently into their lungs, looking along the chest as you breathe.
• As the chest rises, stop blowing and allow it to fall.
• Repeat this 5 times.
Then give compressions:
• Place one or two hands in the centre of the chest (depending on the size of the child). You can do this
without removing the child's clothes.
• Use the heel of that hand with arms straight and press down to a third of the depth of the chest.
• Press 30 times, at a rate of 100-120 compressions per minute (about the speed of the song 'Staying
Alive' or 'Nelly the Elephant').
After 30 compressions, give 2 more rescue breaths, Repeat the sequence of 30 chest compressions and 2
rescue breaths until help arrives.
Unconscious and not breathing infant
If the infant is not breathing, start with 5 rescue breaths as for a child, followed by compressions:
• Place the baby on a firm surface.
• Locate a position in the centre of the chest - it is possible to identify the correct hand position without
removing the infant's clothes.
• Using two fingers, press down sharply to a third of the depth of the chest.
• Press 30 times, at a rate of 100-120 compressions per minute.
After 30 compressions, give 2 more rescue breaths and if help still hasn't arrived, repeat the sequence of 30
chest compressions and 2 rescue breaths until help arrives.
CHAPTER 5 - RESUSCITATION
“DO NOT DELAY”

Place the victim on his back on a hard surface
Step - C - Circulation
If the pulse is absent, begin heart compression if possible, use two rescuers. Don't delay; one rescuer can
do the job.
• Locate pressure point (Cover half of sternum)
• Depress sternum 4-5cm, 60-80 times/minute
• If one rescuer-15 compression and quick inflations
• If two rescuer-5 compression and one inflation.
Step - A - Airway
If patient is unconscious, open the airway thereafter make sure it stays open
• Lift up neck
• Push forehead back
• Clean out mouth with fingers
Step - B - Breathing
• Before beginning artificial respiration, check the pulse in the neck arteries. It should be felt again
after the first minute and checked every five minutes thereafter.
• Give four quick breaths and continue at the rate of 12 inflations / minute. Chest should rise and fall.
• If fit does not. Check to make sure the victim's head is tilted as far as Possible.
• If necessary, use fingers to clean the airway,
Cardiopulmonary resuscitation, commonly known as CPR, is an emergency procedure that combines chest
compression often with artificial ventilation in an effort to manually preserve intact brain function until
further measures are taken to restore spontaneous blood circulation and breathing in a person who is in
cardiac arrest. It is indicated in those who are unresponsive with no breathing or abnormal breathing, for
example, agonal respirations.
CPR involves chest compressions for adults between 5 cm (2.0 in) and 6 cm (2.4 in) deep and at a rate of at
least 100 to 120 per minute. The rescuer may also provide artificial ventilation by either exhaling air into the
subject's mouth or nose (mouth to mouth resuscitation) or using a device that pushes air into the subject's
lungs (mechanical ventilation). Current recommendations place emphasis on high quality chest compressions
over artificial ventilation; a simplified CPR method involving chest compressions only is recommended for
untrained rescuers. In children only doing compressions may result in worse outcomes.
CPR alone is unlikely to restart the heart; Its main purpose is to restore partial flow of oxygenated blood to
the brain and heart. The objective is to delay tissue and to extend the brief window of opportunity for a
successful resuscitation without permanent brain damage. Administration of an electric shock to the subject's
heart, termed defibrillation, is usually needed in order to restore a viable or "perfusing" heart rhythm.
Defibrillation is effective only for certain heart rhythms, namely ventricular fibrillation or pulse less ventricular
tachycardia, rather than asystole or pulse less electrical activity. CPR may succeed in inducing a heart rhythm
that may be shock able. In general, CPR is continued until the person has a return of spontaneous circulation
(ROSC) or is declared dead.
If an adult is unresponsive and not breathing, you’ll need to do CPR (which is short for cardiopulmonary
resuscitation). CPR involves giving someone a combination of chest compressions and rescue breaths to keep
their heart and circulation going to try to save their life. If they start breathing normally again, stop CPR and
put them in the recovery position.
MOUTH TO MOUTH TYPE OF ARTIFICIAL RESPIRATION

A person may stop breathing in the following conditions:
1. Heart has stopped beating Heart attack
2. Choking, drowning & hanging.
3. Unconscious person in whom the tongue falls back and obstructs the airway
4. Carbon-di-oxide and carbon monoxide poisoning in big fires.
5. Epilepsy
6. Acute poisoning, Snakebite
7. Crash injury to the chest
8. Head injury
9. Strokes
Diagnosis
1. The victim is usually unconscious or will soon become unconscious
2. His heart may continue to beat even after the breathing has stopped
3. The upward and downward movements of the abdomen and chest along with the respiration are absent.
4. Listen and feel breath sounds over the mouth, nose, windpipe and chest wall. There will be no
breath sounds audible.
5. There may be bluish discoloration of the skin and mucous membrane of the victim. This is
easily noticeable on the tongue, lips and in the nail beds.
Procedure
1. a) Remove the cause and remove the casualty from the scene of the accident clear out all
secretions, foreign bodies dentures, food particles and vomits from the airway.
b) Give first 5 breaths rapidly to replenish the patient's blood with oxygen, e.g. drowning.
Hanging. Fire accidents, Building collapse etc.
2. Relieve the choking, if any.
3. Place the casualty on his back and till the head back as far as possible.
4. Press the angle of jaw forwards and upwards.
5. Loosen all clothing at neck, chest and waist.
6. Maintain body warm.
7. Take a deep breath with your mouth open wide.
8. Pinch the nostrils of the casualty.
9. Cover the mouth of casualty with your mouth snugly and blow.
10. Watch the chest bellowing up. Withdraw your mouth and note the chest falls back.
11. a) Repeat the procedure 15-20 times a minute as in a normal individual
b) If you interrupt the procedure give 5 breaths rapidly and continue again
12. If the casualty is a baby or a child the first aiders mouth must cover both the mouth and the nose of
the casualty and blow must be gentle yet sufficient to make the chest bellow up.
13. If the chest does not bellow up, the victim is choking, relieve the choking.
14. If the mouth to mouth technique cannot be applied for any reason, use mouth to nose technique.
But now the casualty's mouth should be kept closed by the first aider
15. Confirm the presence of carotid pulsations (arteries of the neck) throughout the procedure.
16. If the heart has stopped beating, you must provide artificial circulation by external heart compression.
17. Warning: It is blunder to resort to artificial respiration on a victim just because he is unconscious
or fainted or having fits; yet breathing all right. However, it is a graver mistake if artificial
respiration is not provided when respiration stops.
18. Forget all other types of artificial respiration. They are too complicated to comprehend, remember
and to practice. The mouth to mouth type of artificial respiration is the best and very effective and
easy to understand. External heart compensation can be given easily when needed along with this
type of artificial respiration.
CHAPTER 6 - BLEEDING
Venous Bleeding
Venous blood having given up its oxygen as dark red in colour. Venous walls are capable of
great Distension. Blood may pool within them.
Capillary bleeding
This type of bleeding characterized as oozing occurs at the site of all wounds.
External and internal bleeding

If the bleeding is from the surface of the body and seen, it is called external bleeding. If it is not
seen and is within the chest, skull or abdomen etc., it is called internal bleeding. Detected by blood May
oozing put through the nose or ear, coughed up from the lungs or vomited through stomach.
Signs and symptoms of bleeding

1. The casualty feels faint and may even collapse
2. Skin becomes pale, cold and clammy
3. Pulse is rapid but very weak
4. Breathing becomes shallow; casualty gasps for breath and sighs deeply
5. There is profuse sweating and the casualty feels thirsty.
Management
In case of severe external bleeding
1. Bring the edges of the wound together and press firmly.
2. Place the casualty in comfortable position and raise the injured part (if no bone fracture is suspected)
3. Press at the pressure point firmly for 10-15 minutes
4. Apply a clean sterile pad larger than the wound, and press it firmly with the palm until bleeding.
5. Change pads if bleeding continues. Finally bandage firmly but not too tightly
6. Treat for shock, get the casualty to hospital as soon as possible.
In case of internal bleeding

The aim is to prevent the condition from getting worse.
1. Lay the casualty down with head low. Raise his legs by use of pillows etc.
2. Reassure him and keep him calm and relaxed. Do not allow him to move.
3. Keep up his body heat with warm clothing blankets etc.
4. Do not give anything to eat or drink as he may have to be given an anaesthetic later.
5. Take him to a hospital as soon as possible. Transport gently.
CHAPTER 7
MANAGEMENT OF SHOCK
Shock is a state of circulatory failure due to there being insufficient blood which cannot fill in all
the blood vessels in our body thus leading to collapse.
Causes
1. Hemorrhage
2. Diarrhea
3. Vomiting
4. Burns
5. Injection reactions
6. Burst internal organs- appendix-intestines
7. Heart attack
8. Bacterial infections causing toxemia
9. Crush injuries
Signs and symptoms

1. The victim feels faint or giddy or he may be in stupor or unconscious
2. The victim complains of blurring of vision.
3. The skin is cold and moist.

4. The victim will be sweating
5. The victim may vomit.
6. The pulse is thready (a thready pulse is one where the rate is very much increased but the volume
is low or weak)
7. The respiration is shallow (the depth of respiration is decreased and the rate is increased).
8. The victim is thirsty and may ask for water.
9. The face and lips look pale or the victim may even be cyanosed (bluish discoloration of skin,
Tongue, lips, earlobes)
10. Urine output is lowered.
Management of shock
1. Reassure the victim
2. Put him in lying position on his back and turn him to a side.
3. Maintain airway breathing and circulation
4. If the victim is unconscious put him in a three quarter prone (or recovery) position.
5. Elevate the lower limbs or tilt the body so that the head is at a lower level.
6. Loosen tight clothing at neck, chest, abdomen and waist.
7. Wrap the victim ill bed sheets or thin rug to maintain body's warmth.
8. Do not give anything by mouth if the victim is unconscious or seriously injured or if he needs to
undergo anesthetic or surgical procedure or if he is nauseated or vomiting. Otherwise you can give
warm sip of coffee, tea or water.
9. Shift him immediately to the hospital in a stretcher.
CHAPTER 8
BURNS AND SCALDS, ACCIDENTS CAUSED BY ELECTRICITY
Causes of burns and scalds

Bums are injuries that result from dry heat like fire, flame a piece of hot metal or the sun, contact
with wire carrying high tension electric current or by lighting or friction. Scalds are caused by moist heat
due to boiling water, steam, oil, hot air etc.
Chemical bums are caused by strong acids (example Sulphuric Acid, Nitric Acid) or by strong
Alkalis (Caustic Soda, Caustic Potash, quicklime or strong Ammonia).
A Nuclear bum is caused by the instantaneous flash of intense heat given off by a nuclear explosion
it is capable of causing superficial burns on the exposed skin of persons several miles away.
Degree of burn
The Degree of bums indicates the degree of damage to the tissues. There are three degrees of bun
• First Degree: When the skin is reddened
• Second Degree: When there are blisters on the skin and
• Third Degree: When there is destruction of deeper tissues and of Charring.
The danger from bums depends on the area of the bums rather than the degree. Superficial burns over a
large area of the body are more dangerous than the complete charring of a part of a limb. It must be noted
that in the same person, different parts of the body may show different degrees of burns.
Rule of nine for areas of burn

Any burn of over 30% - irrespective of degree - should be hospitalized as priority. The first two
degrees are seen in scalds also. When the chemicals fall all on skin or cloth Wore by the person any of the
three degrees of bums may be produced,
When swallowed, the chemicals, if strong will damage the tissues with which they come into
contact while swallowing viz., tips tongue, throat, food passages, stomach. There may be damage to the
skin around the mouth.
Results of burns
• Immediate: 1. intense pain 2. Shock
• Later: 1. there may be infection in the burnt area 2. After handling, it will leave scare
causing disfigurement and/or restriction of movements.
Management of minor Burns and Scalds

1. Clean the area gently with clean water.
2. Submerge the burnt area in cold water.
3. Cover with dry dressing.
4. Do not apply cotton wool direct to the burnt.
5. Do not apply any greasy substance.
6. Luke warm drinks.
FIRE BURNS
Dangers due to fire helping a person whose clothes have caught fire.
The First Aider should know how to deal with a person whose clothes have caught fire:-
1. Put out the flames by whatever means available. Most of the causes of bums occur in homes and
drinking water is ready available to quench the flames water also cools the burnt area causing less
damage to occur.
2. Do not allow the person to run about. This only fans the fire and makes the flame spread.
3. Hold a rug, blanket, coat or table cover in front of you while approaching a man whose clothing
have caught fire.
4. Lay him down quickly on the ground and wrap tightly with any thick piece of cloth, rug or
coat. Smoother the flame by gently rolling the casualty or by gentle pats over the covering.
5. If the clothes in front of the body have caught fire, lay him on his back and vice versatile
suitable Material is brought to smoother the flame.
Rescuing persons from fire

In rescuing persons from a room which has caught tire, speed and clear thinking are required: Member,
clean air is at ground level. So crawl along the floor to pull out a person who is lying conscious or is
disabled.
1. Have a wet handkerchief around your face when you rescue
2. If there is carbon mono-oxide in the room, these precautions do not protect the rescue from carbon
mono oxide poisoning. When there is fire in a closed room, there is always some amount of carbon
monoxide. Therefore quick action is important.
3. When there is fire in a room in which the doors and windows are closed, do not open the windows
and the doors to let in air. The rush of air will increase the fire and it will burn more intensely.
OTHER TYPE BURNS

Eye - Acid Burns
1. First aid for acid bums of the eye should be given as quickly as possible by thoroughly washing the
face. Eye lids and the eye for at least five minutes.
2. If the casualty is lying down, turns his head to the side held the eyelids open and pour water from
the inner comer of the eye outward makes sure that the chemical does not wash into the other eye.
Cover the eye with a dry clean protective dressing (do not use cotton) and bandage
3. Caution the victim against rubbing his eye.
4. Get medal help immediately (preferably an eye specialist)
Alkali Burns
Alkali bums of the eye can be caused by drain cleaner or other cleaning solution. An eye that first appears
to have only a slight injury may develop deep inflammation and tissue destruction and the sight may be
lost.
1. Flood the eye thoroughly with water for fifteen minutes.
2. If casualty is lying down, turn his head to the side. Hold the lips opened and pour water from the
inner comer outward. Remove any loose particles of dry chemicals floating on the eye by lifting
them off gently with sterile gauze or a clean hand Kerchief
3. Do not irrigate with soda solution
4. Immobilize the eye by covering with a dry pad or protective clothing. Seek immediate medical Aid.
Burns in the mouth and throat

They occur from drinking very hot liquids, inhaling hot air (fire in the room) or drinking corrosive
chemicals. They cause severe and dangerous choking by producing very quickly swelling of the mouth,
difficulty in breathing, may have symptoms of shock and may be unconscious immediately evaluate to the
nearest hospital.
Electrical Burns
These are caused by high current and voltage at the point of contact and going through the body and at the
point of exit. High voltage industrial (power) current can jump 16-18 meters (17-20 yards) and kill the
rescuer. Therefore do not approach the casualty till the switch has been turned off. The current not only
cause local damage but affects the respiratory and cardiac centres. They produce therefore, superficial or
deep burns including charring. But also cause stoppage of breathing and heartbeat.
Treatment
1. Separate the casualty from the cause of injury
2. Cover the burn treat the shock
3. Breathing or heartbeat has stopped, resuscitate.
4. Put in recovery position
5. Evaluate speedily to the hospital.
Sun Rays: Direct exposure can have ill effect on
1. Skin
2. Eyes
3. The injury to the skin known as "Sun Bum" is due to ultraviolet rays.
The turn is produced by over exposure to sun rays when the body is covered with sweat, sea water or while
wind is blowing strongly. However, high up in the mountains burns can be produced even on a dull
overcast day with strong winds. The skin becomes red, itchy and painful it may go into blister formation
with marked swelling and become very painful.
Treatment: Remove the casualty to a shaded cool place and bathe the skin with cold water, cover the
burn area and evacuate to the hospital-giving frequent sips of cold water.
Eyes: Reflected light from the skin produces thermal and photochemical burns in the front and back ofthe
eye depending upon the duration of exposure. Reflected light from snow( snow-blindness) welder's flash
and looking at the solar eclipse also produces the same. The eye becomes red, painful, water profusely,
cannot be opened and sight is affected.
Treatment
• Bathe eyes with cold water
• Lightly dress the eyes with sterile non fluffy
• Send to the eye specialist

Prevention
Wear dark glasses, protect eyes by protective helmets and goggles while doing welding.
Management of serious burns and scalds

Immediate attention that is required in serious burns are:
1. Keep the casualty quiet and reassure him.
2. Wrap him up in cloth.
3. Do not know adhering particles of charred clothing.
4. Cover burnt area with sterile or dean dressing and bandage. In case of burns covering a large part
of the body. It is sufficient to cover the area with a clean sheet or towel.
5. Keep him warm but do not overheat him.
6. If the hands are involved, keep them above the level of the victim's heart.
7. Keep burnt feet or legs elevated.
8. If victim's face is burnt, sit up or prop him up and deep him under continuous observation for
breathing difficulty. If respiratory problems develop an open airway must be maintained.
9. Do not immerse the extensive burnt area or apply ice water over it because cold may intensified
shock reaction. However a cold pack may be applied to the face or to the hands or feet.
10. Shift the casualty to the nearest hospital if he is fit to be moved.
11. If you cannot take him to a hospital, wait for the doctor to arrive.
12. Do not open blisters.
13. Treat for shock.
14. Remove quickly from the body anything of a constructing nature like rings, bangles, belt and boots if
this is not done early, it would be difficult to remove them later as the limb begins to swell.
15. If medical help or trained ambulance personnel cannot reach the scene for an hour or more and the
victim is conscious and not vomiting. Give him a weak solution of salt and soda at home and in route
one level teaspoon full of salt and half level teaspoon full of baking soda to each quarter water,
neither hot nor cold. Allow the casualty to sip slowly. Give about 4 ounces to adult over a period of
15 minutes. Two ounces to a child between 1 and 12 years of age and abort one ounce an infant
under one year of age discontinue fluid if vomiting occurs. Do not apply ointment or form of grease
or other home remedy.
Management of minor Burns and Scalds
1. Clean the area gently with clean water.
2. Submerge the burnt area in cold water.
3. Apply a solution of salt and water (one teaspoonful to a pint of water) in out of the way places.
4. Cover with dry dressing

5. Do not apply cotton wool direct to the burns.
6. Do not apply any grease substance
7. Give warm drinks (example: sweetened tea or coffee)
Prevention of Burns
Most of the conditions under which burns occur can be prevented.
1. Women and children get burnt more often than men; women get burnt while cooking in the
kitchen. They should take the following precautions.
a. Ovens or stoves should be kept at a higher level about two feet above the ground.
b. While working near fire, see that your clothes are not hanging free or flapping about.
c. Never go near the fire while wearing material made out of nylon or similar fibres as these
clothes catch fire easily and quickly. It is a good practice to use a cotton overall while cooking
d. Never put kettles or other vessels with hot liquids near the edge of a stove, sink or table
the handle pointing towards you.
2. Never leave children alone in a room where there is a fire or a naked lamp burning.
3. Keep matches out of reach of children
4. Never sleep with a kerosene lamp near the bed.
5. Do not hang clothes near an open fire.
CHAPTER 9
RESCUE AND TRANSPORTATION OF CASUALTY
Unless there is danger from fire, explosion or toxic substances, do not move a casualty until
suspected fracture have been immobilized and bad bleeding has been stopped.
Then check on the best route for transport and lift the casualty gently and carry him smoothly.
Every jolt means unnecessary pain. The method of transport will depend on the situation of the casualty
and the nature of the injury, Whatever method is used, try to gain the confidence of the person you are
carrying by explaining what roll are about to do and then carrying out the manoeuvre in an efficient
manner. Two helpers carry a casualty without forming their hands into a seat, by using an arm to support
the casualty's back and shoulders and each using his spare hand to support the casualty under his thighs.
If conscious, the casualty may help to support himself with his hands on the shoulders of the helpers.
The four handed seat can be used when a conscious and cooperative heavy person has to be carried. The
disadvantage of this type of seat is that the casualty must be able to co-operate and to hold on with both arms
around the shoulders of the two men carrying him. It cannot be safely used to negotiate ladders.
One advantage of the three handed seat L that one arm and hand of a helper is left free and can be
used either to support an injured limb or a back support for the casualty. According to the nature of the
injury, it is decided which of the two helpers has the free arm.
The fireman's lift which must never be used unless the helper is as well built as the casualty
especially useful when you have to move a man by yourself and need the use of our right hand for holding
on to a ladder.
• Roll the patient so that he is lying face downwards.
• Lift him up so that, when your stoop down, you can put your head under his left arm.
• Then put your left arm between his legs and grasp his left hand, letting his body fall over your left
shoulder.
• Steady yourself and then stand upright, at the same time shifting his weight so that he lies well
balanced across the back of your shoulders. Held the casualty's arm above the wrist in this position
it is easy to carry the patients to a ladder as one hand is free to grasp the fall.
As a last resort, the drag-carry method may have to be used in narrow spaces particularly where
there is wreckage following an explosion and where it may be possible for only one man to reach a trapped
casualty and to rescue him.
After initial rescue, two men may be able to undertake further movement through a narrow space
FIREMEN’S LIFT
NEIL ROBERTSONSTRETCHER
The stretcher is made of stout canvas stiffened by wooden salts. The portion ‘A' takes the head
and neck which are steadied by a canvas strap passing over the forehead. Thus, the head of an unconscious
patient can be steadied.
The portion 'B' is wrapped round the chest, notches being cut on which the armpits rest. This part
has canvas straps which are used for fastening the stretcher round the chest. The portion 'D' folds round the
hips and legs down to the ankles. It is secured by two canvas straps.
A central backbone of stout rope passes along the under surface. This has two beckets passing out
I from it on either side which can be used as handles, for carrying the patient or for securing tackles when
he is slung horizontally. At the head end, the rope ends in a grommet which takes extra purchase from two
brass eyelets let into the canvas. At the foot end of the rope is a galvanized iron ring which is secured to the
stretcher by; span going to brass eyelets in the canvas. When more rigidity in the stretcher is required, as in
moving those with injuries to the back, a couple of broom handles slipped through the ropes underneath, will
full fill this purpose admirably. Some stretchers have a rope about 9 ft long fixed to the galvanized ring at
the foot end. This is a steadying rope for use in craft below, or on quay when the patient is lowered over
the side of the ship. When the patient is carried about the ship this rope can be passed under the various
straps to keep it from trailing on the deck or otherwise getting in the way. The patient should be lifted on to
and secured in the stretcher.
The patient should be carried by four men if possible. At difficult comers, the stretcher should be
lowered at the foot end and the causality passed by two of the men to the others. The carry can then be rest
timed by the four bearers.
When passing the casualty through a narrow batch, or lifting him up over a height, or lowering
him to a boat alongside, put the lifting hook or a rope through the grommet at the head end and a farther
steadying rope through the galvanized at the foot end.
CHAPTER 10
MISCELLANEOUS TOPICS
A. HEART ATTACK
Coronary artery is a branch of aorta arising from base of aorta and goes back and supplies them itself.
When this blood supply to the heart through the coronary artery is diminished or complete occluded. It
causes heart attack.
Contributing Factors:
• Sex: More in male
• Age: More in elderly people
• Smoking
• Sedentary habits
• Overweight
• High blood pressure
• Diabetes (or sugar complaint)
• Genetic predisposition
• High fate cholesterol) level in blood
• Alcohol consumption
• Long term use of oral contraceptive pills in women
Symptoms
• History of previous attacks
• Chest pain
• Nausea, Vomiting
• Breathlessness
• Fainting
• Tiredness
• Sweating
Signs
• Paleness of face.
• Extensive sweating
• Cyanosis (Bluish discoloration of skin and mucous membrane due to increased amount of
Un-oxygenated blood circulating through them)
• Breathlessness
Complication to be avoided: Death due to heart stopping
First Aid
• Absolute rest in a position most comfortable to the casualty. Preferably lying with back propped up
on pillows.
• Reassurance
• Avoid panic and confusion let loose
• Guard airway breathing circulation
• Loosen the clothing around neck and throat
• If doctor is available, act under the supervision of the doctor, who can supervise the entire operations.
• If doctor is not available, shift the casualty immediately to the hospital on a stretcher in an ambulance.
B. EXTERNAL HEART COMPRESSION

Causes for heart to stop
Causes are similar to those listed under the respiratory arrest, lightning, electric shock injection reaction,
heart attack etc.
Diagnosis
1. The victim is always unconscious
2. Respiration is always absent in a person in whom heart has stopped beating
3. Carotid pulsations at the root of the neck are absent
4. Heartbeats are not heard when you keep your ear to the left of the breast bone of the victim
5. The pupils are dilated
6. Face is blue or pale
7. The body is cold to touch
First aid
1. Give 3 firm thumb over the lower half of the breast bone and check whether the heart has
started beating. If not,
2. Lie the patient on a hard surface on his back
3. Elevate the legs vertically and keep them propped up in this way
4. Kneel alongside the patient put the heel of one hand on the lower half of the breast bone and heel
of the second hand on the top of the first. Do not use the lowest part of the breast bone. By leaving
the last inch clear the risks of damaging the liver, the stomach and other organs is minimized. Keep
your fingers and palm off the chest,
5. Press the breast bone down by rocking your body forwards and keeping your arms straight.
6. Relax the pressure by rocking your body back a little. The breast bone can be pressed back 1 to 1
12 inches in an adult.
7. Repeat the procedure 60 times a minute,
C. STROKES
Stroke or apoplexy or paralysis is the disturbed functioning of the brain due to diminished blood supply to
the brain.
Contributing Factors
• Sex-More common in men
• Age - More common in elderly people.
• High blood pressure.
Signs and symptoms
1. Disturbed level of unconsciousness
2. Paralysis of part or parts of the body
3. In-continence of urine
4. Fits
5. Difficulty in speech or loss of speech 6. Shock
First Aid
1. Guard airway, breathing, circulation
2. Give the care of the unconscious if the casualty is unconscious
3. Treat Shock
4. Shift to the hospital on a stretcher.
D. FRACTURES
A Fracture is the partial or complete break in the continuity of a bone. Causes Direct Force: The bone
breaks at the spot of application of force.
Example
• Bullet passing into bones
• Severe fall on a projecting stone
• Wheel passing over the body etc.
Indirect force: The bone breaks away from the spot of application of force.
Example: Fall on outstretched hand
Force of muscle action: Occurs when there is a violent contraction of group of muscles. This happen
very rarely.
Example: Fracture of rib due to violent cough, patella (knee cap) due to violent thigh muscle contraction
Signs & Symptoms

1. Pain at the spot of fracture or around it.
2. Tenderness i.e., pain on general pressure over the injured part
3. Swelling of the area and discoloration
4. Loss of normal movements.
5. Deformity of the limb. The limb may lose its normal shape. Some time, the muscle will pull up the
lower free ends, causing apparent shortening of the limb.
6. Irregularity of bum. If as in the leg bone, the break is under the skin, the irregular outline of the bone
can be felt easily.
Management of Fracture:
• Support: Use Splint
• Immobilize: Use Bandage
• Reduce Pain: Use medicine
E. CHOKING
Choking is the obstruction to breathing due to a foreign body in the air passages.
Example: Food particle, Chewing gum, Chocolate, false tooth, toys etc. Choking is more common in children.
Signs and Symptoms

• The victim is in distress, coughing violently.
• The face and the neck are congested.
• He keeps his hands on his throat (Heimlich sign) even if he is unconscious. He will make
violent efforts to breath.
• The victim may fall forwards and become unconscious.
First Aid (HEIMLICH'S MANOEUVRE)

In the upright position
Stand behind the victim. Keep your right clenched fist midway between the victim's navel and the
lower end of the breast bone. Hold your clenched right fist with the other hand. Give a powerful and abrupt
thrust with your right fist in an upward and backward direction. Repeat the procedure till the offending foreign
body is out. The same manoeuvre can be carried on a victim who has collapsed in a sitting position. The first
aider in this instance positions himself behind the chair in which the victim has collapsed.
If the victim has fallen on the floor
Heimlich’s manoeuvre is most successful when carried out with victim standing up. However, if
the victim is unconscious and fallen down and is too heavy to hold, we have to modify the manoeuvre.
Kneel at the patient's side and keep the heel of the right hand on the epigastria. Keep the heel of
the left hand over the heel of the right hand. Deliver a series of abrupt powerful thrusts upwards and
backward still the offending foreign body is out-.
In the absence of the first aider, the victim can render self-aid on himself. The victim must clench
a fist and place it thumb side against the abdomen slightly above the navel. With the other hand, jerk it
inwards several times.
Alternatively, the victim can render self-aid by using the back of a chair or table edge. The victim
must lean ever the edge supported by his hands on either side. He must thrust inwards and upwards just
above the navel till the offending foreign body is out.
F. POISONING
Poisoning is usually due to substances taken by inhalation or by mouth Ingestion or by Injection.

Example - Snakebite.
Types of Poisons
• Solids: Sleeping tablets, Opium, Ganja, Datura, Ergot, Lead cyanide, Mercury, Metal
Salts, acids, alkalis.
• Liquids: Alcohol, Spirits, Insecticides, Kerosene, Acids, alkalis
• Gases: Carbon monoxide, Ammonia, Sulphur dioxide, Methane, Chlorine.
Principles of Treating Poisoning

l. If the patient is conscious, determine the type of poison.
2. (a). If the patient is conscious and breaths, put the patient in the recovery position.
(b). If the patient is not breathing, begin resuscitative measures.
Treatment
The patient should be in bed and kept warm. In early stages, the stomach should be emptied by
warm water or warm normal saline solution wash. A small dose of (15ml) caster oil should then be given.
If diarrhea is severe, this should be treated. Antibiotic will be used as a precautionary method as in the
case of Bacterial toxins.
G. DIARRHOEA, VOMITING AND DEHYDRATION
Children and infants may suffer from vomiting and diarrhea. At this time the child may even be febrile.
(Having fever) all refuse to accept feeds. All these factors tend to cause dehydration. This disease is known as
acute gastro enteritis. This disease frequently affects the adults also and we often read in the newspaper as to
how many people died of this disease. Acute gastro enteritis is caused by bacterial, viral, or parasitic infections
of the intestines. Dehydration is due to loss of water and (electrolytes) salts from the body.
Signs and symptoms

1. The child looks dull, irritable, cries continuously is not playful and is apathetic.
2. Urine output is reduced. Both the frequency and the amount of urine passed each time are reduced.
3. The tongue is dry (or parched)
4. The skin loses its elasticity
5. The fontanels is depressed (This sign can be elicited only in infants whose fontanels have not yet united)
6. The child loses its body weight.
7. The child's eyeballs are sunken.
Diarrhea is the commonest cause of death in children in developing countries like India.
The aim of first aid is to correct dehydration. In presence of nausea or vomiting give frequent small
sips of fluids in a teaspoon. Control fever. Foods that are liquid and tolerated better are water, curd
buttermilk, boiled rice kanji, tender coconut water and mashed ripe banana. It is better to avoid all other
foods unless advised by your doctor. Take the child to your doctor at the earliest and administer medicine;
as advised by him.
H. WOUND
Management
1. Place the causality in suitable position wearing in mind that escapes with less force when the
patient sits and still less when the patient lies down.
2. Elevate the bleeding part except in cases of fractured limb.
3. Do not disturb any blood clot already formed.
4. Remove foreign body which is visible and can be easily picked out or whipped of with peaces of
clean dressing this should not open up the wound again which will cause more bleeding.
5. Apply a dressing, pad and bandage.
Management
1. Stop Bleeding.
2. Handle the injured part as gently as possible.
3. Wash hands thoroughly or clean them with an antiseptic lotion of available.
4. Remove foreign objects if it can be removed easily.
5. Place clean dressing over the wound and bandages firmly.
6. Get a Radio Medical Advice.

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CHITKARA UNIVERSITY SCHOOL OF

Basic Safety Training

Elementary First Aid

Chandigarh-Patiala National Highway, Punjab 140401.

BST_EFA COURSE OUTLINE

Approximate time (hours)

2. Body Structure and Functions 2.0 2.0

3. Positioning of Casualty 1.0 0.5 1.5

4. The Unconscious Casualty 1.0 1.0

5. Resuscitation 1.0 1.0 2.0

6. Bleeding 1.0 0.5 1.5

7. Management of Shock 1.0 1.0

9. Rescue and Transport of Casualty 1.0 0.5 1.5

10. Miscellaneous Topics 1.0 0.5 1.5

11. Review and Assessment 1.0 1.0

TOTAL 11.5 3.5

GRAND TOTAL 15.0

COURSE SCOPE AND OBJECTIVE

Aims of First Aid:

The First Aiders:

Responsibilities of a First Aider

• To assess a situation quickly and safely and render appropriate help.

Circulatory System (Heart and Blood vessels)

Autonomous nervous system

Digestive System and Abdomen:

• Congestive Heart Failure (1) or

CHAPTER 4 – THE UNCONSCIOUS CASULITY

“DO NOT DELAY”

Place the victim on his back on a hard surface

MOUTH TO MOUTH TYPE OF ARTIFICIAL RESPIRATION

External and internal bleeding

Signs and symptoms of bleeding

In case of internal bleeding

Signs and symptoms

3. The skin is cold and moist.

Causes of burns and scalds

Rule of nine for areas of burn

Management of minor Burns and Scalds

Rescuing persons from fire

OTHER TYPE BURNS

Burns in the mouth and throat

• Send to the eye specialist

Management of serious burns and scalds

4. Cover with dry dressing

B. EXTERNAL HEART COMPRESSION

Signs & Symptoms

Signs and Symptoms

First Aid (HEIMLICH'S MANOEUVRE)

Poisoning is usually due to substances taken by inhalation or by mouth Ingestion or by Injection.

Principles of Treating Poisoning

G. DIARRHOEA, VOMITING AND DEHYDRATION

Signs and symptoms

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