Firstaid Textbook V 9

First Aid
Textbook 9th Edition

This textbook provides the reader with the underpinning knowledge
of first aid and casualty management procedures. This textbook is an
excellent first aid reference book for every household, workplace,
vehicle and first aid kit.
TAFE NSW offers a range of First Aid courses that meet the requirements
of the national Health Training Package first aid units of competency.
For more information about TAFE NSW First Aid courses, contact
the course Information office at a local TAFE Campus or go to the
TAFE NSW website.
Learn how to save a life

Enrol in a TAFE NSW First Aid course now
www.tafensw.edu.au TAFE NSW
First Aid Textbook 9th Edition
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go to www.vetres.net.au or visit your local
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Disclaimer
This textbook has been designed to assist learners who are studying First Aid through TAFE NSW. This
Any attempt at resuscitation textbook is an information resource only and should be studied in conjunction with, or in preparation for
attendance at practical teaching and learning sessions. This book does not replace valuable learning that
is better than no attempt at all. takes place within a classroom setting where you will be given the opportunity to practice the skills of Basic
Life Support and First Aid management of injuries and illnesses.
The information contained within this textbook relates to the current accepted First Aid practices in Australia
at the time of publication. TAFE NSW follows the guidelines and recommendations of the Australian
Resuscitation Council, Safe Work Australia, WorkCover NSW and the Health Training Package when
designing course materials to support first aid training and assessment.
Whilst every effort has been made to ensure that the information is accurate at the time of publication,
TAFE NSW, the writers, the reviewers and the contributors are not responsible for any loss, liability,
damage or injury that may be suffered or incurred by any persons in connection with the information
contained in this textbook.
Image © European Resuscitation Council – www.erc.edu – 2011/044

Basic Life Support
DRS ABCD action plan
D Check for Danger
Make sure it is safe for you, the casualty and bystanders.
R Check for a Response

Use a talk and touch technique to check for a response.
Talk: “Can you hear me?”, “Open your eyes”. Touch: squeeze shoulders firmly
S Call 000 Send for help

Shout for help or send someone to call Triple Zero (000).
If required, send for help at the earliest possible stage.
A Open the Airway

Use the head tilt and chin lift technique to open the airway.
If blocked, turn the casualty onto their side and clear their airway.
B Check for Breathing

Look, listen and feel for normal breathing.
If not breathing or not breathing normally, commence CPR.
C Commence CPR 30:2
Give 30 compressions followed by 2 rescue breaths.

If unable or unwilling to give rescue breaths, give compression only CPR.
D Attach a Defibrillator (AED*)

Attach an AED* as soon as available and follow the prompts.
*AED: Automated External Defibrillator
Continue CPR until the casualty responds or normal breathing returns.

Endorsement
The First Aid Textbook, 9th Edition, is endorsed by the TAFE NSW First Aid Community of
Practice.
Copyright
© 2021 TAFE NSW. All rights reserved.
Copyright of this material is reserved to TAFE NSW. Reproduction or transmittal in whole or
in part, other than subject to the provisions of the Copyright Act, is prohibited without the
written authority of VETRes on behalf TAFE NSW. Enquiries about this publication and use of
copyright material can be made to:
TAFE NSW, VETRes
PO Box 1059
Orange NSW 2800
Phone: +61 (2) 6391 5603
Email: vetres@tafensw.edu.au
TAFE NSW acknowledges the copyright of the Health Training Package material included in the
content of this textbook.
Acknowledgements
TAFE NSW VETRes would like to acknowledge the support and assistance of the following
people in the production of this edition of the First Aid Textbook:
Contributors: Neil MacFarlane, Georgina McInerney
Reviewers: Elizabeth Shuttle
Content endorsed by: The TAFE NSW First Aid Community of Practice
Illustrations: Julie Hulsman of Creative Hitch
Desktop publishing: printWest, TAFE NSW
Photographs: See photograph credits page 114
Printing: Ligare Pty Ltd
TAFE NSW VETRes would also like to acknowledge the support offered by teachers and
students across NSW who were involved in the validation of this product and the staff who
were involved in the development of previous editions of this textbook: Anthony Rogers,
Belinda Wall, Anthony Tier, Leanne McGrath, Jennifer Woschitzka, Pauline Pali, Angie De
Falco, Amanda Culver, Margaret Beck, Karin Canty, Neil Harper and Di Dawbin.
Title: First Aid Textbook

Edition: Ninth Edition
Publisher: TAFE NSW, VETRes
ISBN: 978-1-74236-537-4
10 9 8 7 6 5 4 3 2 1
Printed in Australia
Welcome to First Aid
This textbook will assist you to gain the theory of first aid
and to help you prepare for the face to face training and
assessment that you will attend at a local TAFE campus.
TAFE NSW offers a range of First Aid courses that meet
the requirements of the national Health Training Package
first aid units of competency.
About this resource Instructions for TAFE

This textbook can be used in students who are studying
different ways to support learning. flexibly
For example:
Some TAFE NSW campuses offer
To enhance learning for first aid courses via flexible delivery.
participants studying face to face A flexible delivery course enables
To enable participants to revise learners to undertake self-directed
and prepare for assessment study in their own time.
As a flexible learning tool so
participants can study the theory
in their own time Note: The self directed study
To complement a TAFE NSW First component of the course
Aid Online resource may include: reading this
To be used in class by the teacher textbook, undertaking the self
or the participants assessment activities, and/or
accessing a TAFE NSW First
To support a recertification
Aid online resource.
pathway for people who wish to
update their first aid qualification If you are enrolled in a
To be used as a first aid reference flexible or online course it is
guide in a first aid kit, at home, or important that you undertake
in the workplace. the necessary readings and
activities before attending
the face to face training and
If you are unsure how you assessment. You may be
should be using this resource, required to show evidence
contact your TAFE teacher or that you have completed any
First Aid Coordinator. compulsory activities.
1
Abbreviations and common terms
Listed below are some of the abbreviations and common terms used within this
textbook. For more definitions refer to the glossary [see page 111].
AED Automated External Defibrillation.
BLS Basic Life Support.
Bystanders People at the accident site.
Casualty The injured or ill person.
CPR Cardiopulmonary Resuscitation.
Danger, response, send for help, airway, breathing, CPR and

DRS ABCD
defibrillation.
Emergency Services Police, Fire or Ambulance services.
The immediate treatment or care given to a person suffering

First aid from an injury or illness until more advanced/medical care is
provided, or the person recovers.
First aider /
Someone who is trained to administer first aid.
First aid provider
The act of providing emotional support, as well as providing

Reassurance
information that is comforting and builds trust.
Characteristics of an injury or illness that you can see, feel or

Signs
hear.
Characteristics of an injury or illness that are felt by the

Symptoms
casualty.
2
Table of Contents
Introduction to First Aid 5
 Introduction to first aid  Legal issues and duty of care
 Taking care of yourself and others  Standard precautions
 Moving the casualty  Casualty management overview
 Sending for help  First aid kits
Self assessment activity 21
Basic Life Support 23

 Chain of survival  Basic Life Support – DRS ABCD action plan
 CPR  Using an AED  Airway obstruction and choking
 Drowning  Recovery position
Manage Injury 43
 Bites and stings  Bleeding and wounds  Burns
 Crush injury  Chest injury  Fractures and soft tissue injuries
 Head, neck and spinal injuries  Heat and cold injuries
 Poisoning  Shock
Manage Illness 74
 Allergic reaction  Anaphylaxis  Asthma  Chest pain  Diabetes
 Seizures  Fainting  Hyperventilation  Mental health crisis
 Stroke  Substance misuse
Supplement
First Aid in the Education and Care Setting 90
 How the industry is governed  Specific first aid regulations
 First aid in the early childhood setting  Anaphylaxis and asthma
 Further reading
Further Information 110

 Activity answers  Further reading  Glossary  Index
3
First Aid Guidelines and Codes of Practice
The Australian Resuscitation Council (ARC) represents all major groups

involved in the teaching and practice of resuscitation, and in partnership
with the New Zealand Resuscitation Council (NZRC) - produces Guidelines
on managing emergencies, Basic Life Support, CPR, trauma, medical and
environmental first aid emergencies, and much more.
You can download the latest guidelines at http://www.resus.org.au
Safe Work Australia leads the development of national policy to improve

work health and safety across Australia and has developed the Code of
Practice on first aid in the workplace. This code of practice is a practical
guide to achieving the standards of health, safety and welfare required
under the WHS Act and the WHS regulations.
You can download the Code of Practice at:
http://www.safeworkaustralia.gov.au
It is recommended that all workplace first aiders are familiar with the
relevant Code of Practice and regularly review any updates to first aid
guidelines.
4
Key topics
Introduction
Introduction
Legal issues
Taking care of yourself and others
Standard precautions
Moving the casualty
Casualty management
Sending for help
First aid kits
Introduction to First Aid

‘First aid’ is the immediate treatment or care given to a person
suffering from an injury or illness until more advanced/medical
care is provided, or the person recovers. First aid can be provided
by anyone in any situation and includes self care.
Throughout this textbook the term ‘first aider’ or ‘first aid
provider’ refers to someone who is trained to administer first aid,
and who should:
recognise, assess and prioritise the need for first aid
provide care by using appropriate knowledge, skills and
behaviours
recognise limitations and seek additional care when needed.
In this topic you will learn the fundamentals of first aid. This
includes; aims of first aid, roles and responsibilities, legal issues,
taking care of yourself and others, standard precautions, moving
the casualty, an overview of casualty management, sending for
help and maintaining first aid kits.
5
Introduction
Introduction to First Aid

Serious and life Aims of first aid
threatening injuries The aims of first aid are to:
and illnesses can
occur at anytime, Preserve life
anywhere to Prevent further injury
anyone. First aid
Protect the unconscious
training provides
you with the Promote recovery
knowledge and skills Provide reassurance
to give Basic Life
Support and other
Roles and responsibilities
emergency care.
Providing immediate As a first aider your role will depend on the
and appropriate first accident scene, the available resources or
aid can save lives. any workplace policies and procedures. In
general, a first aider may be required to:
Assess the scene
Call for and assist emergency services
Provide first aid for injuries and illnesses
Direct bystanders
Provide shelter and warmth
Provide food and fluids (if appropriate)
Provide reassurance and emotional
support
Report to a supervisor
Complete injury or illness record
Maintain first aid supplies and equipment
Own skills and limitations

Where first aid management or medical
treatment is beyond a first aid provider’s level of
competence, the first aider should get assistance
from trained professionals such as a paramedic
or doctor – and follow their advice.
6
Introduction
Legal Issues and Duty of Care
Work Health and Safety (WHS)
All Australians have the right to a safe and healthy workplace. Under the
various Work Health and Safety (WHS) laws, employers must take action
to ensure that the workplace is as safe as possible. Certain workplaces
are also required to provide access to first aid facilities and trained first aid
providers. Many workplaces, therefore, appoint a small number of staff as
First Aid Officers /Providers who undertake first aid training and take on the
responsibility of offering immediate management of injuries or illnesses in
their workplace, and maintain resources such as first aid kits and adrenaline
auto-injectors.
Duty of care
In Australia, there is no legal obligation to offer someone first aid unless
a duty of care has been established. If you act in paid or voluntary
employment as a First Aid Provider, or hold a position which is responsible
for the safety of others, you have a duty to provide first aid services to
those in your care. This may include your work colleagues, clients, or
visitors to your place of work.
Once you start first aid you have a duty to provide care to the best of your
ability until: your own safety becomes endangered, the casualty no longer
requires your assistance, or you have been relieved by a more qualified
person.
Across Australia there are various laws that protect people who offer
assistance in the time of an emergency. These laws usually relate to
protecting volunteers and other people who provide first aid in the
community setting. These laws aim to ensure that a person who acts in
good will to help someone in urgent need is protected from civil liability
for something they did (or did not do) when offering their assistance.
[For more information refer to the relevant State or Territory laws].
Consent
Consent is the term used to describe the act of giving permission. Before
providing first aid to a casualty you must obtain their consent. If the
casualty is unconscious or due to their injury or illness is unable to give
consent, their consent is assumed and you should provide first aid. If the
casualty is under 18 years of age consent should be sought (wherever
possible) from their parent or guardian.
7
Introduction
Offering reassurance Reporting and recording

Reassurance is the process All employers are required to keep a
of providing information that register of injuries in the workplace.
is comforting, builds trust and First Aid Providers must complete
increases confidence in your ability relevant workplace records with
to provide first aid. You can offer accurate and factual information
reassurance by providing the whenever they provide first aid
casualty with information about treatment. All first aid treatment
the care you are providing and by records are subject to requirements
letting the casualty know when under Health Records legislation
professional help is on its way. and should be kept confidential and
Through offering reassurance you stored in a secured place. [For an
can greatly assist in reducing fear example completed Injury/Illness
and anxiety. In some circumstances record see page 19]
bystanders may also require
reassurance that the situation is Maintaining skills and
under control.
knowledge
Confidentiality WorkCover NSW and Safe Work
Australia recommend that all
When offering first aid it is important workplace first aid providers
that you keep any information attend regular training to refresh
confidential. Information about their first aid knowledge and
the nature of the accident or the skills. Annual refresher training
condition of the casualty should in CPR and renewal of first aid
only be conveyed to emergency qualifications every three years.
services and/or the workplace First aid providers may also need
supervisor. to undertake additional training to
respond to specific situations at
Cultural awareness their workplace.
It is important for the first aider
to respond to the casualty in a
culturally aware, sensitive and
Note: Gaining consent,
respectful manner. If you are
maintaining confidentiality
uncertain about the cultural
and offering reassurance in a
needs or expectations of the
casualty, ask for their advice. culturally aware and respectful
When offering first aid you may manner should be part of
need to consider differences in every casualty management
language, the use of plain English, situation.
gender roles, role boundaries and
health care preferences.
8
Introduction
Assisting with medication
Some people with health conditions need to take
medications as part of their first aid. Any delays
in accessing and using their medication can
make their situation worse or in some cases, life
threatening.
The laws controlling who can administer medication
vary with each State and Territory. In a medical
emergency, the best advice is to provide assistance
with self-medication as per the casualty’s
instructions. Any assistance with medication should
be done in line with State or Territory legislation,
workplace policies, available medical or pharmaceutical instructions, and
any advice from emergency services/medical personnel.
Taking care of yourself and others

In any first aid situation it is essential that you take precautions to
ensure your own safety and the safety of others. In some first aid
situations there may be the potential risk of injury or illness to the
first aider or bystanders. Risks of injury or illness may result from:
Exposure to blood and other body substances
Acts of aggression
An unsafe scene, for example: oncoming traffic in a road accident
Bystanders placing themselves and others at risk of injury
Moving objects causing back, neck or shoulder injuries
Presence of smoke, fire or toxic gases
Emotional trauma after an event.
Tips for taking care of yourself and others

Always assess for danger and make sure the area is safe
Use standard precautions [see page 10]
Do not unnecessarily move the casualty
Observe and manage bystanders
Where required, seek counselling or debriefing after the incident
9
Introduction
Standard Precautions
Standard precautions are a set of guidelines that aim to protect
people from accidental exposure to blood or other body
substances. Standard precautions include wearing gloves when
in contact with blood (including dried blood) or other body
substances, and washing your hands before and after treating
a casualty.
General principles
When appropriate and wherever possible:
Wear gloves
Use other personal protective equipment such as face shields,
masks or goggles
Encourage the casualty to treat themselves, for example, apply
pressure to their own bleeding wound
Dispose of waste materials and sharps in the correct container
Avoid injuries to yourself, for example, cuts from broken glass
Wash your hands with soap and water or waterless hand wash.
Exposure to blood and other body substances

Care of the person exposed to blood or other body
substances:
Wash affected skin surfaces with soap and water (do not use
soap or waterless solution to wash eyes or mouth)
If eyes are contaminated, rinse thoroughly with water or
saline, making sure the eyes are kept open during the rinsing
If blood or other body substances get in the mouth, spit them
out and rinse the mouth with water several times
If clothing is contaminated, remove clothing and shower
Follow any other workplace policies, seek medical advice,
and attend any follow up treatment or monitoring.
Sharps injury
Wash the wound with soap and water, cover wound with a
clean dressing and seek immediate medical advice from a
doctor or hospital emergency department.
If at work, you will need to notify your supervisor and
complete an injury/illness record.
10
Introduction
Moving the Casualty
Moving the casualty should be avoided in most circumstances. This is
especially true if the casualty has sustained any potential injuries to the
head, neck, back or spine. Moving the casualty unnecessarily may increase
pain, injury, blood loss and shock. However, a person lying in a hazardous
area may need to be moved to ensure safety - and the unconscious and
breathing person should be moved into the recovery (side-lying) position.
Incorrect lifting or moving techniques can result in severe back, neck and
shoulder injury to the first aider. If moving the casualty is essential - consider
the following:
avoid bending or twisting the person’s neck and back
try to have three or more people to assist in the support of the head and
neck, the chest, the pelvis and limbs while moving the person
if available, use a spinal board
if alone, either ankle drag or arm-shoulder drag the casualty.
Road accidents
General considerations for road accidents include:
approach with caution
DO NOT touch a vehicle, or attempt to rescue a person from within
10 metres of a fallen power line
make the accident scene as safe as possible
Use hazard lights, road triangles or torches to warn oncoming traffic of the
accident
Turn off the ignition and apply the park brake of a crashed vehicle
Motorbike accident
Motorbike helmets prevent injury and can provide support to the head,
neck and spine. However, helmets must be removed if it is necessary to
manage the airway, assist breathing or control bleeding. Wherever possible,
removal of a motorbike helmet is best performed by a paramedic or other
trained person.
Do not remove motorbike helmets unless for life saving measures.
11
Introduction
Casualty Management Overview

The following flow chart provides an overview of the various
stages and processes involved in the management of a first aid
situation.
Assess the scene and make sure it is safe to approach.
Initial
Gather immediate impressions and information.
approach
Gain consent before providing any assistance.

Use DRS ABCD to conduct an initial assessment.
Determine if any life threatening situations exist.
Prioritise
Where more than one person requires first aid - the care
DRS ABCD
of an unconscious person has priority.
Give Basic Life Support or other life saving measures.

Send for help If required, call Triple Zero (000) at the earliest stage.
 000 If needed, shout for help or send someone else for help.

Look for and manage injury or illness.
Provide reassurance.
Secondary
Assess for and manage shock.
assessment
Continue to monitor the casualty’s airway, breathing
and general condition.

Hand over information to the emergency services team.
Communicate
Advise workplace supervisor of incident details.
details
Complete any necessary workplace records.

Clean up the scene.*
Finalise the Restock first aid kits and supplies.
incident Evaluate your own performance.
Seek counselling / debriefing as required.
*Note: In some circumstances it may not be appropriate to clean an

accident scene. If in doubt, check with the emergency services personnel.
12
Introduction
1. Initial approach
Approach
For all situations
Stay calm
Assess for any immediate danger
Stay calm
Make sure that the scene is safe
Assess the scene
Introduce yourself
Make sure it is safe
State that you would like to offer help
DRS ABCD
Gain permission to provide assistance
Determine priorities
Assess the scene
Send for help
Assessment of the scene

When assessing the scene, try to gather information that will assist you to
prioritise your actions and help you determine what first aid is needed. This
could include:
Understanding what has happened
The cause of the accident or illness
The number of casualties involved
The type and severity of injury or illness
The availability of any resources to assist in first aid, for example, a first
aid kit, an AED, shelter, alarm systems or a phone
The availability of other people who can help
The approximate time it will take professional help to arrive.
2. Prioritise – the DRS ABCD action plan

Determine the priorities using a primary survey
In any first aid situation you will need to decide quickly on your priorities.
The DRS ABCD action plan will help you to assess if a casualty is in a life
threatening situation and in need of immediate Basic Life Support or other
life saving measures.
[For detailed information on the DRS ABCD action plan and Basic Life Support see pages
25–36].
Note: Where more than one person requires first aid - the care of an
unconscious breathing casualty has priority.
13
Introduction
3. Sending for help  calling Triple Zero (000)

If required, shout for help or send someone to call Triple Zero (000) at the
earliest possible stage. Triple Zero (000) is Australia’s primary emergency
services number. It should only be used in life threatening and emergency
situations to access emergency services (Ambulance, Police and Fire
Department) from fixed, mobile or pay phones. Once connected you will
be asked which service you require.“Police, Fire or Ambulance?”
Triple Zero example questions

What is the exact address?
What is your phone number?
What is the problem?
Tell me what happened.
How old is the person?
Is the person breathing normally?
Is the person conscious?
When calling Triple Zero (000) make sure that you:

Stay calm, do not shout, speak slowly and clearly
Answer the operator’s questions
Give details of where you are, including street number and name
Give distances from known landmarks when in rural areas
Stay focused, stay relevant, stay on the line
Follow any instructions.
Do not hang up the phone until directed to do so.
Children and Triple Zero (000)

Every year many children call Triple Zero (000). Teaching children how to
call Triple Zero (000) can often save a life.
For more information visit the Triple Zero website at www.triplezero.gov.au
14
The Triple Zero logo is used with permission from Fire and Rescue New South Wales, 2017.
Introduction
Mobile phones
Triple Zero (000) is the preferred number to call when using a mobile phone
in Australia. The majority of mobile phones allow you to call Triple Zero
(000) without having to unlock the keypad. If there is no network coverage
you will not be able to connect to the Emergency Call Service. If you are in
areas where there is no network coverage, consider carrying an alternative
personal safety device, such as a Personal Locator Beacon. Wherever
possible, call Triple Zero (000) from a fixed landline.
Alternative ways to send for help Calling 112

112 is the international
Telling others to call for help standard emergency
Yelling number. 112 can only be
Two way radio dialled on a digital mobile
SMS phone with coverage. In
Email some parts of the world
(including Australia), a call
Flags or flares
to 112 will be directed to
Personal distress alarms the country’s emergency
number.
Voice over Internet Protocol

Voice over Internet Protocol (VoIP) is the name for technology that enables
telephones to use broadband internet to make calls. Some VoIP phones are
unable to make Triple Zero (000) calls. Check with the VoIP provider about
access to the Emergency Call Service.
People who do not speak English

If a person is unable to speak English, they can call Triple Zero (000), say
either ‘Police’, ‘Fire’ or ‘Ambulance’. Once connected, stay on the line and
a translator will be arranged.
People who have a hearing or speech impairment

Callers with hearing or speech impairments can call the one zero six (106)
text-based emergency call service using a textphone (TTY) or a computer
with modem access.
15
Introduction
4. Secondary survey assessment

A secondary survey assessment involves a head-to-toe examination of the
casualty. Each body region should be examined for signs and symptoms
of injury or illness. The examination should be thorough and conducted in
a respectful manner.
Examples of signs or symptoms for each body region
Head and face Changes in skin colour

Sweating
Changes to speech, vision or hearing
Facial droop
Fluid from ear, mouth or nose
Neck Artificial airway (stoma)

Medical alert necklace
Chest Noisy breathing

Unequal rise of chest with breathing
Abdomen and Hard stomach muscles

pelvis Pregnancy
Loss of bladder or bowel control
Arms and legs Medical alert bracelet

Movement and strength in arms and legs
Colour and warmth of the fingers and toes
Back and spine Tingling sensations

Reduced movement
In addition, look for the following general signs and symptoms

Bleeding or bruising Fractures or deformity Burns
Swelling Pain, tingling, numbness Reduced movement
Rashes Bite or sting marks Reduced strength
Caution If a neck, back or spinal injury is suspected do not

move or roll the casualty unnecessarily. If the casualty is
unconscious they must be placed in the recovery position
with no twisting or bending of the neck and spine.
16
Introduction
Manage injury and illness
All first aid management should be provided in accordance with established
first aid procedures or guidelines. Specific first aid procedures are described
further in this textbook. If part of your role in a workplace includes first aid
responsibilities, it is essential that you are familiar with your workplace first
aid procedures and the resources available.
5. Communicate details
The information that you have obtained about the casualty’s condition
and the nature of the incident should be given to the emergency services
personnel. When the ambulance arrives:
Continue first aid until the paramedic is ready to take over
If requested to do so, stay and assist the paramedic
Provide as much information as possible, see examples below.
Provide the following information:

Nature of the accident Casualty’s response to first aid
Time you arrived at the scene Types of first aid provided
Type/amount of medication taken Duration of any CPR
Workplace records and reports

All employers are required by law to keep a register of injuries that occur
in the workplace. If you are responsible for providing first aid at work you
may be required to document the details of any injury, illness or incident.
This may include; what happened, the first aid provided, and any follow up
care. While there are various forms used to help capture this information -
many workplaces now offer online and/or over-the-phone incident reporting
services. In general, reports should be lodged within 24 hours of the incident.
Tips for writing first aid records and reports

Write in ink only and do not use correction fluid
Make sure notes are legible, accurate, factual and objective
Write your name, sign and date the record
Keep records confidential and stored in an appropriate location
Notifiable incidents
If there is a serious injury or illness, a death or a dangerous incident, by law,
the workplace must immediately notify your relevant state or territory WHS
regulator. For NSW notify SafeWork NSW on 13 10 50.
17
Introduction
6. Finalise the incident

To finalise any first aid management you may be required to:
Clean up the immediate area, but only if it is appropriate to do so
Take action to prevent any further incidents happening
Complete workplace records or reports (see next page for an example)
Reorder and restock any first aid kits and supplies
Look for opportunities to talk with others about the situation
Refer others to counselling or debriefing after the incident.
Evaluating your own performance

It is useful to look for opportunities to evaluate your own performance
regarding how you managed the first aid situation. To assist you to evaluate
your own performance you could:
Obtain feedback from a supervisor or appropriate first aid provider
Discuss your performance with the emergency services personnel
Participate in ongoing educational opportunities
Participate in formal debriefing and performance management exercises.
Your response to the situation

After witnessing an accident or being involved in providing first aid,
some people might suffer an immediate or delayed emotional response
to the situation. People may respond differently but symptoms such
as: flashbacks, nightmares, depression and a wide range of physical
complaints can occur. If you have offered first aid, or witnessed an
accident, it might be helpful to obtain some form of support services or
counselling, especially if you suffer from any changes in your physical or
emotional health.
You can find out about professional counselling and debriefing services
through your workplace supervisor, emergency services, local doctor or
community health centre.
18
Introduction
EXAMPLE: First aid injury / illness record Date: 07/09/2017
Surname: Given names: DOB:  M
Du nn Ja ne 01/01/1995  F
Casualty details
 Student  Staff  Visitor Contact details:
 Other ____________________ 0401 040 104
Time of illness or injury: Location: (mark on diagram)
8:45a m
What was the casualty doing at time of

illness or injury?
Details of illness Ja ne had sta rted to pa rticipate in the
or injury wa rm-up exercises for the g ym class.
Describe illness or injury:

Ja ne beca me breathless, stating that she
has asth ma.
Describe the first aid that was provided:

Ja ne advised to stop exercising a nd assisted to gain a ccess to her reliever
First aid medication. No spa cer device availa ble but Ja ne ma naged her own
provided medication administration. Ja ne was monitored a nd recovered within 10
minutes. Advised if asth ma symptoms retu rn to stop all exercise, ta ke
medication a nd seek first aid assista nce.
Follow up/
 N/A  AMBULANCE/HOSPITAL  DOCTOR  OTHER
referral
First aider Name: Signature: Time:
details Aaliya h Said AS 09:30
 Incident notifiable  Injury  Near miss (non-injury)  Hazard
WHS Preventative or follow up action recommended / taken:

Committee Recommend storing reliever medication and two
single person use spacer devices in the first aid kit
located in the gym facility.
Please sign this document when any preventative or follow up action
Workplace has been completed, and submit to Human Resources.
Manager
Date: 13/09/2017 Print name: MV BOLI Signature: MBoli
19
Introduction
First Aid Kits

It might be your responsibility to maintain a first aid kit in your workplace.
Providing and maintaining an appropriate first aid kit is an important safety
requirement for all workplaces.
SafeWork NSW provides clear guidelines on the types of first aid equipment
and facilities needed in workplaces. It is essential however, that the
contents of the first aid kit be based on a risk assessment, to ensure that it
meets the specific needs of that work environment. Workplace first aid kits
may also need to be available for field trips, in vehicles or when working
off-site.
First aid kits come in a large range of sizes and the contents may differ but
the basic items are all that you need for personal home and car use.
Basic first aid kit items Note: in some workplaces

there may be a
requirement to stock
Adhesive tapes (non allergenic)
reliever medication
Adhesive strips for asthma and an
Cleaning agent (antiseptic) adrenaline auto-injector
Crepe bandages for anaphylaxis. Other
Current first aid textbook medication (including mild
Disposable splinter remover analgesics) should not be
Emergency rescue blanket included in first aid kits
Face shield or face mask because of their potential
Gloves to cause harm in some
Plastic bags (resealable) people.
Scissors
Sterile eye pad
Sterile saline
Triangular bandages
Tweezers/forceps
Wound dressing materials
Take a look in your first aid kit and medication cupboard.

Make sure the contents are in good working order and that
you have what you would need in an emergency. Remove or
replace any expired stock.
20
Introduction
Self Assessment - Optional Activity
Complete the following multiple choice questions by circling the correct answer.
1. Which of the following is an aim of first aid?

a. Prevent life b. Preserve life c. Promote injury d. Prevent recovery
2. What does the abbreviation BLS stand for?
a. Basic Life Support b. Begin Life Saving c. Blood Loss & Shock d. Bandage Left Side
3. What is the term used to describe the characteristics of an injury that you can see, feel or hear?
a. Symptoms b. Complaints c. Disorders d. Signs
4. What would you use to wash your hands after contact with blood or other body substances?
a. Bleach b. Vinegar c. Soap and water d. Alcohol hand rub
5. Why should any unnecessary movement of the casualty be avoided?
a. It wastes time b. To prevent injury c. To prevent pain d. To avoid a law suit
6. Who is the best person to remove a motorbike helmet?
a. A bystander b. The casualty c. The first aider d. A paramedic
7. What does the first ‘D’ in the DRS ABCD action plan stand for?
a. Defibrillation b. Dial Triple Zero (000) c. Check for Danger d. Do CPR
8. What does the ‘S’ in the DRS ABCD action plan stand for?
a. Start CPR b. Stop compressions c. Start compressions d. Send for help
9. What phone number should you call for Australia’s Emergency Services?
a. Triple Zero (000) b. Triple Nine (999) c. Triple One (111) d. Nine-One-One (911)
10. What is the most important information to give to the Emergency Services phone operator?
a. How the accident b. The name of c. The exact address/ d. The time of the
occurred any witnesses location accident
11. What process should you use when conducting a secondary assessment of the casualty?
a. Front-to-back b. Back-to-front c. Heels-to-head d. Head-to-toe
12. What is the purpose of a secondary assessment of the casualty?
a. To look for b. To reassure the c. To provide a d. To determine
signs of injury casualty diagnosis the priorities
13. How could you protect yourself when managing a casualty with a bleeding wound?
a. Wash their hands b. Wear gloves c. Refuse to help d. Call Triple Zero (000)
14. You find a casualty who is injured and there is no further danger. What would you do next?
a. Clear the airway b. Start compressions c. Check for a response d. Call for an AED
15. What could some people need after witnessing an accident scene?
a. An alcoholic drink b. Counselling c. Hospitalisation d. A medical checkup
You can check your answers in the back of this textbook. Your score /15
21
Introduction
22
Key topics
Basic Life Support

Chain of survival
Basic Life Support
DRS ABCD
CPR
Using an AED
Airway obstruction and choking
Drowning
Recovery position
Basic Life Support

Early recognition and early management of emergency
situations should be the priority of any first aider. Basic
Life Support (BLS) is the care given to casualties with
life threatening injuries or illnesses and can be given
in the community setting without the need for medical
equipment. Basic Life Support includes the administration
of cardiopulmonary resuscitation (CPR) to temporarily
maintain blood circulation and breathing to preserve brain
function and life.
In this chapter you will have the opportunity to learn the
knowledge and skills related to managing emergencies
and life threatening situations. This will include; the chain
of survival, Basic Life Support, the DRS ABCD action
plan, CPR, use of an Automated External Defibrillator
(AED), managing choking, drowning and the recovery
position.
23
Chain of Survival
The concept of the ‘Chain of survival’ and the 4 links in this chain
summarise the vital steps needed for successful resuscitation in
the event of a cardiac arrest.
Basic Life Support
In most communities it can take several minutes for an ambulance to arrive

after the initial Triple Zero (000) call. During this time the survival of the
casualty is dependent on bystanders who commence Basic Life Support
(BLS) and, where available, use an AED for defibrillation. Early recognition
of a life threatening situation, early CPR, early defibrillation, and early
advanced care with access to effective post resuscitation care are the
critical links to increasing the chances of survival.
Early recognition
Recognition and Early CPR
early treatment Immediate Early defibrillation
of a person at bystander
risk of cardiac Early defibrillation Early advanced
CPR can (within minutes
arrest can help care
increase the after collapse)
prevent cardiac chances of Early advanced
arrest. Call can increase
survival. care and post
Triple Zero (000) chances of
resuscitation care
immediately. survival.
in hospital are
critical to survival.
People who experience a cardiac arrest need immediate CPR. Every minute
of delay in CPR and defibrillation decreases survival rates.
Remember: any attempt at resuscitation is better than no attempt at all.
24
Basic Life Support
DRS ABCD action plan
D Check for Danger
Make sure it is safe for you, the casualty and bystanders.
R Check for a Response

Use a talk and touch technique to check for a response.
Talk: “Can you hear me?”, “Open your eyes”. Touch: squeeze shoulders firmly
S Call 000 Send for help

Shout for help or send someone to call Triple Zero (000).
If required, send for help at the earliest possible stage.
A Open the Airway

Use the head tilt and chin lift technique to open the airway.
If blocked, turn the casualty onto their side and clear their airway.
B Check for Breathing

Look, listen and feel for normal breathing.
If not breathing or not breathing normally, commence CPR.
C Commence CPR 30:2
Give 30 compressions followed by 2 rescue breaths.

If unable or unwilling to give rescue breaths, give compression only CPR.
D Attach a Defibrillator (AED*)

Attach an AED* as soon as available and follow the prompts.
*AED: Automated External Defibrillator
Continue CPR until the casualty responds or normal breathing returns. 25

D Danger
Always check for danger. Make sure the area is
safe for you, the casualty and any bystanders.
Basic Life Support
R Response
A collapsed casualty who does not respond
to talk or touch stimuli is unconscious. An
unconscious casualty is not aware of their
surroundings, cannot protect themself from
danger and cannot maintain a clear airway. For
these reasons, assisting an unconscious casualty
is a priority in any first aid situation.
Check for a response

Assess the casualty for a response using a ‘talk and touch’ technique. This
technique is suitable for adults, children and infants. Check for a response
by giving a series of verbal commands. For example;
“Can you hear me?” “Open your eyes” “What is your name?” “Squeeze my hand”
Then use touch. To do this; hold the casualty’s shoulders and squeeze
them firmly. Make sure this does not cause or worsen any injury.
If the casualty responds

Leave the casualty in the current position (if safe to do so).
Try to find out what is wrong and if needed, send for help.
If the casualty does not respond
A casualty who does not respond or who shows only a minor response
(groaning without eye opening) should be managed as if unconscious –
immediately send for help and continue with Basic Life Support.
If the casualty is unconscious and breathing normally, carefully and gently
place in the recovery position, assess for and manage any deterioration.
[For information on the recovery position see page 40].
26
S Send for help
If required, shout for help or send someone
to call Triple Zero (000) as early as possible.
Triple Zero (000) is Australia’s emergency
Basic Life Support

services number which should be used in
an emergency to access an Ambulance,
the Police or Fire Department.
A Airway
When a casualty is unconscious all muscles
relax and the tongue can fall against the back
of the throat – blocking air from entering the
lungs. An unconscious casualty is unable to
swallow or cough effectively and is at risk of an
airway obstruction.
In an unconscious casualty, care of the airway takes priority over other
injuries (including any possible head, neck and spinal injuries).
If the airway is blocked, carefully and gently turn the casualty onto their side.
The mouth should be open and tilted downwards to allow any fluid to drain.
Solid material can be removed using a sweeping motion with the fingers.
In resuscitation, regurgitation and vomiting are managed in the same way:
positioning the person on their side, and manual clearance of the airway
prior to continuing rescue breaths.
Note: After a drowning roll the casualty on their side to clear the
airway of water.
Caution Airway obstruction can occur due to a casualty’s body

position, eg. the unconscious casualty’s head has fallen forward.
27
Opening the airway
Airway management is required to provide an open airway when the
casualty is unconscious, has an obstructed airway or needs rescue breaths.
The following illustrations demonstrate various methods for opening an
airway.
Basic Life Support
Adults and children – head tilt and chin lift technique

Use either of the following methods:
Place one hand on the forehead.

With the other hand, use a ‘pistol grip’ to
support the jaw and lift the chin.
The head (NOT the neck) is tilted
backwards.
or
Place one hand on the forehead.

With the other hand, place 2 finger tips
under the lower jaw and lift the chin.
The head (NOT the neck) is tilted
backwards.
Note: It is important to avoid excessive force, especially where neck

injury is suspected.
Infants – age less than 1 year old

An excessive backward head tilt can block an infant’s airway.
Support the head in a neutral position

(do not over-extend the head and neck).
Gently lift the chin using your finger(s).
Keeping the airway open, look, listen and feel for breathing.
28
B Breathing
Normal breathing is essential to maintaining
life. A casualty who is unresponsive, not
breathing (or not breathing normally) requires
Basic Life Support

immediate resuscitation.
Assessing breathing
Look, listen and feel for breathing and decide if breathing is normal, not
normal or absent.
Look, listen and feel technique

Keeping the airway open, look, listen and feel for breathing:
Look for rise and fall of the chest or upper abdomen
Listen for any sounds of breathing
Feel for movement of air at the mouth or nose
Decide if breathing is normal, not normal or absent.
If breathing is normal
Carefully turn casualty into the recovery position, make sure help is on the
way, continually assess for and manage any deterioration.
If breathing is not normal or absent

If the casualty is unresponsive, and breathing is not normal or absent,
commence cardiopulmonary resuscitation (CPR). Give 30 compressions
followed by 2 rescue breaths. If unable or unwilling to perform rescue
breaths continue with compression only CPR.
Note: For a short period after a cardiac arrest, a casualty may

be taking infrequent, slow or noisy (gasping) breaths. This is not
normal breathing and may indicate the need for immediate CPR.
29
C Commence CPR
Cardiopulmonary resuscitation (CPR) is the
technique of combining chest compressions
with rescue breathing.
Basic Life Support
The aim of CPR is to maintain blood flow so that

oxygen can be circulated to the brain and vital
organs. The commencement of rescuer CPR
dramatically increases chances of survival.
When a casualty is unresponsive and not

breathing (or not breathing normally) chest
compressions must commence immediately.
Compression : rescue breaths ratio

30:2
The current recommendations are:
Commence CPR with 30 compressions, followed by 2 rescue breaths
The 30:2 ratio is suitable for all age groups
The 30:2 ratio is suitable for single rescuer and two rescuer techniques
Compressions must be paused briefly to allow rescue breaths to be given
Each rescue breath should be given in about one second.
30 compressions + 2 rescue breaths = 1 cycle
30
Giving chest compressions
Adults
2 hands over the centre of the chest
Basic Life Support

Depress chest about one third chest depth
100-120 compressions per minute
30 compressions : 2 rescue breaths
Child
1 or 2 hands over the centre of the chest

Infant
2 fingers over the centre of the chest

Xiphoid process Sternum (lower half)
For chest compressions to be effective:

Place the casualty on their back on a firm surface
Hands (or fingers) should be placed over the centre of the chest
Avoid compressing too low on the sternum (as this may cause injury)
Avoid compressing too high on the chest (as this is ineffective)
Interruptions to chest compressions should be minimised
Compressions should be rhythmic (equal time for compression and
relaxation)
The chest should be allowed to rise after each compression
The rescuer should avoid rocking, using thumps or quick jabs
The rescuer should be relieved every two minutes to prevent fatigue.
31
Giving rescue breaths
When giving rescue breaths it is important to maintain an open airway. Form
a good seal around the mouth and/or nose and inflate the lungs enough
to see the chest rise and fall with each rescue breath. Outlined below are
several different methods for the delivery of rescue breaths.
Basic Life Support
Mouth to mouth
Keeping the airway open (maintain head tilt and chin
lift):
Pinch or seal the nose
Take a breath
Place your open mouth over the casualty’s mouth
Breathe into the casualty’s mouth to inflate their lungs
Turn your head towards casualty’s chest to observe
rise and fall of the casualty’s chest with each rescue breath
Each rescue breath should be given in about one second
Child and infant rescue breaths

The smaller the casualty, the smaller the size of the
rescue breath that will be required to inflate their lungs.
When giving rescue breaths to infants, place your
mouth over the infant’s entire mouth and nose area
and give small breaths.
Mouth to mask
Keeping the airway open (maintain head tilt and chin lift):
Place the mask over the casualty’s mouth and nose
Hold the mask with both hands to form a good seal
Breathe into the mouthpiece to inflate the lungs
Observe rise and fall of the casualty’s chest.
Using a pocket mask
Valve
A pocket mask has been folded then packed flat and
requires the following assembly before use: Filter
ensure the white filter is snapped into the underside Dome
of the mask (if one is supplied)
Firmly push out the dome of the mask
Push the one way valve into the top of the mask
Use as per mouth to mask technique (described above)
32
Mouth to nose
Keeping the airway open (maintain head tilt and chin lift):
Close the casualty’s mouth by pressing the chin upwards
Take a breath and place your mouth over the casualty’s nose
Breathe into the casualty’s nose to inflate the lungs
Mouth to neck stoma
Basic Life Support

This method is used when the casualty has an artificial airway in their neck.
This artificial opening in their neck is known as a stoma and the rescuer
needs to deliver rescue breaths directly into the stoma while holding the
casualty’s mouth closed.
CPR – additional considerations

Compression only CPR
If the rescuer is unable or unwilling to give rescue breaths they should
continue with compression-only CPR. Compressions should be given
uninterrupted and at a rate of 100-120 per minute.
Multiple rescuer CPR

Where more than one rescuer is available, the second rescuer makes
sure that Triple Zero (000) has been called, locates and makes ready any
available equipment, including an AED. With two rescuers it is possible
to rotate their roles every 2 minutes to prevent fatigue and deterioration
in chest compression quality. A seamless changeover between rescuers
should be used to reduce any interruptions to CPR.
Vomiting or regurgitation during CPR

If the casualty vomits or regurgitates during CPR, roll the casualty on
their side, clear the airway and reassess breathing. If not breathing or not
breathing normally, roll casualty onto their back and recommence CPR.
Noticeably pregnant women

Commence standard CPR. If resources allow - place a towel or pillow under
the right hip to tilt her hips 15-30 degrees to the left. Leave the woman’s
shoulders flat to enable quality chest compressions.
Duration of CPR
Any interruptions to CPR should be minimised. CPR should continue until:
The casualty responds or begins breathing normally
It is no longer possible to continue
Health care or emergency services personnel are ready to take over
You are directed to stop CPR efforts by a healthcare professional.
33
D Defibrillation
Defibrillation is an important part of resuscitation,
and when used with CPR, it can dramatically
increase the chance of survival.
Basic Life Support
An Automated External Defibrillator (AED) is a

battery powered and computerised device that
can deliver an electric shock to the heart via
disposable chest pads.
*
AEDs are safe and effective when used by

first aiders, making it possible to defibrillate
before the ambulance arrives.
When a casualty collapses from Sudden
Cardiac Arrest (SCA) there is often
uncoordinated electrical activity remaining
in the heart which makes the heart beat
ineffective. The administration of an
electrical shock via an AED aims to stop the
uncoordinated activity so that the heart will
recommence beating with a normal rhythm.
An AED must only be used for a casualty who is unresponsive and not
breathing normally.
Attach and use an AED as soon as it is available.
Continue CPR (with minimal interruptions to chest compressions) while
attaching and using an AED.
Pay attention to, and follow the AED voice prompts.
Once attached to the casualty the AED unit will analyse the heart rhythm,
determine if it is a ‘shockable’ or ‘non-shockable’ rhythm and guide the
rescuer through all steps via visual/voice prompts. Some AED units will
also guide the first aider through CPR.
Note: Keep the AED attached to the casualty until advised by

medical or emergency services personnel to remove it.
34
* Image © European Resuscitation Council – www.erc.edu – 2011/044
AED and its use in children
Infants/children (birth to 8 years)
Ideally use an AED with paediatric pads and settings. If unavailable, use the
standard adult AED unit and pads. Ensure that the adult pads do not touch
each other on the child’s chest.
Basic Life Support

If the pads are too large, place
one pad on the upper back
(between the shoulder blades)
and the other pad on the front
of the chest, if possible slightly
to the left.
For more information about child

and infant Basic Life Support
see pages 99-100.
Children older than 8 years

Standard adult AED units and pads are suitable.
AED and its use with implantable devices and medication

patches
If the casualty has an implantable medical device (such as a pacemaker)
- place the AED pads approximately 8 cm from the device. Remove
medication patches and wipe the area before applying pads.
Additional information about AEDs and their use

All AED pads come with a diagram which illustrates where they should be
placed on the chest.
Pad to skin contact is important for successful defibrillation.
Removing moisture or excessive chest hair may be necessary to ensure
good pad to skin contact - but minimising delays in shock delivery is
essential.
AED units can and should be used on pregnant women.
In large breasted people, the left pad can be placed to the side of the left
breast to avoid breast tissue.
Although AEDs are extremely safe, rescuers should take care not to touch
a person during shock delivery.
35
Using an AED
The following instructions for using an AED are general guidelines only. For
more specific details refer to the manufacturer’s instructions.
1. DRS ABCD.
2. Be sure that the casualty is unresponsive

Basic Life Support
and not breathing or not breathing normally.
3. Call Triple Zero (000), use a bystander if possible.
4. Call for an AED.
5. Immediately commence CPR.
6. As soon as the AED arrives:

Switch on the AED
Carefully follow the visual/voice prompts
Dry the chest and/or remove excessive chest hair
Attach the pads to the casualty’s bare chest.
(if more than one rescuer is present, CPR should
be continued while the AED pads are being
placed). Avoid interruptions to CPR when attaching the AED.
7. Make sure that nobody is touching the casualty while
the AED analyses the heart rhythm.
8. If a shock is required:
Make sure that nobody is touching the casualty
Press the ‘shock’ button as directed
Immediately recommence CPR 30:2 ratio
Continue as directed by the visual/voice prompts.
9. If no shock is required:
Immediately recommence CPR 30:2 ratio
Continue as directed by visual/voice prompts.
10. Continue to follow the prompts and continue CPR until:

Professional help arrives and is ready to take over
The casualty starts to respond and breathe normally
It is no longer possible to continue.
Note: This process should be undertaken as

quickly as possible.
36
Airway Obstruction and Choking
An airway obstruction is a blockage in the upper airway and is most often
caused by an inhaled foreign object (choking), trauma or swelling in the
airway, or from poor body positioning. An airway obstruction can develop
Basic Life Support

rapidly or slowly over time and the blockage to the airway may be partial or
complete. Signs and symptoms will vary but may include:
Partial obstruction
breathing is laboured and noisy
coughing, gasping, wheezing, choking sounds
there is some air moving in and out of the airways.
Complete obstruction
there may be attempts at breathing
there is no air moving in or out of the airways.
Decreased ability to speak, red or blue discoloration to the face, anxiety,
agitation or panic are also often present in an airway obstruction and the
person may grasp and hold their own neck (which is a universal sign of
choking).
Airway obstruction due to body position (positional asphyxia)

Positional asphyxia is where the airway has become obstructed due to
the person’s own body position. In some positions (particularly when
being restrained or lying face down) a person may experience difficulty in
breathing. Risk factors can include obesity, existing breathing problems,
reduced level of consciousness and recent use of alcohol and other drugs.
Signs and symptoms First aid

Person states they cannot DRS ABCD
breathe Assist the person to a
Laboured or noisy breathing comfortable position that will
Red or blue discolouration to help maintain an open airway
the face If unconscious, place in the
Agitation or panic recovery position
A vocal or active person who Call Triple Zero (000)
has suddenly gone quiet or Monitor the casualty
unmoving
37
Choking
Any object that has been caught in the upper part of the airway can cause
choking. Choking is a life threatening emergency and immediate first aid
should be given.
The first aid management of choking depends on severity and whether the
casualty has an effective cough or not.
Basic Life Support
First aid for choking
Assess severity
Ineffective cough Effective cough

Severe airway Mild airway
obstruction obstruction
Unconscious Conscious Encourage

coughing
Continue to
check casualty
Call Triple Zero (000) until recovery or
Call Triple Zero (000)
Give up to 5 back blows deterioration
Start CPR
If not effective
Give up to 5 chest thrusts
Where required, a combination of back blows and chest thrusts should be

given in rapid sequence until the airway is cleared.
Giving back blows – to give back blows use the heel of your hand to apply
force between the shoulder blades. An adult or child should be in a sitting
or standing position and leaning forward.
Giving back blows to infants - Infants should be
placed head downwards and supported across the
rescuer’s lap.
Giving chest thrusts – to give chest thrusts, locate
the centre of the chest (the same compression point
as for CPR) and administer chest thrusts. These are
similar to chest compressions but sharper and given
at a slower rate. Between each chest thrust, stop and
check to see if the blockage has cleared.
38
Drowning
Drowning occurs when a casualty tries to breathe or gasps for air while
immersed in water (or other liquid). Drowning causes an interruption of
oxygen supply to the brain. Permanent brain injury or death can result
Basic Life Support

within minutes. Immediate rescue and resuscitation are the major factors in
survival.

Struggling in the water Remove the casualty from the
Face down in the water water, if safe to do so
(or other liquid) DRS ABCD
Gasping or choking Call Triple Zero (000)
Swallowing of air and water If airway is blocked or the
Vomiting person vomits, roll the
Pale or blue colour to the skin casualty on their side
Loss of consciousness Clear their airway
Floating Reasses breathing
Follow the BLS flow chart
Monitor casualty closely
Note:
Compression only CPR is not recommended for a person who
has drowned. Wherever possible, chest compressions with
rescue breaths should be given.
All drowning casualties should go to hospital in an ambulance.
This also applies to a drowning casualty who has recovered, as
complications can develop.
Caution With a drowning, always suspect that a

head, neck or spinal injury may have occurred.
39
Recovery Position
The recovery position is used to help clear a blocked airway and to position
the unconscious casualty who is breathing normally. Follow the steps below
to safely place a casualty into the recovery position.
Basic Life Support
Placing a casualty in the recovery position

1. Kneel beside the casualty.
2. Place the casualty’s arm that is furthest

away from you, out at 90 degrees.
3. Place the casualty’s other arm across

their chest with their hand high on the
opposite shoulder.
4. Raise the casualty’s knee closest to

you.
5. Using one hand to support the

casualty’s head and neck and your
other hand against their raised knee,
turn the casualty away from you and
onto their side.
Remember, always support the head and neck during this move.
6. Ensure the airway is open and

tilt the casualty’s head slightly
downwards to allow for drainage
of any foreign material.
7. Monitor the casualty’s vital signs.
Note: Variations in the recovery position technique exist.

Whichever technique is used, ensure you maintain spinal alignment
of the head and neck with the torso, both during the turn and
afterwards.
40
1. What link is ‘Early Recognition’ in the chain of survival?

a. The first link b. The second link c. The third link d. The fourth link
Basic Life Support

2. What does the ‘R’ stand for in the DRS ABCD action plan?
a. Roll into recovery b. Remove restrictive c. Check for a d. Raise both legs
position clothing Response
3. What is the term used to describe a casualty who does not respond to talk or touch?
a. Conscious b. Delirious c. Confused d. Unconscious
4. When using touch to get a response from a casualty, what would you do?
a. Squeeze their b. Shake their hand c. Pinch their cheek d. Gently poke their
shoulders chest
5. In what position would you place an unconscious breathing casualty?
a. Resting position b. Sitting position c. Recovery position d. Leaning forward
6. What technique would you use to open the airway?
a. Chin lift/jaw hold b. Head tilt/chin lift c. Head lift/jaw hold d. Jaw lift/head thrust
7. If a casualty is not responding and not breathing normally what would you do?
a. Give rescue breaths b. Check for danger c. Recheck breathing d. Commence CPR
8. How would you commence CPR?
a. 30 rescue breaths b. 2 rescue breaths c. 30 compressions d. 2 compressions
9. How many compressions per minute would you aim to deliver?
a. 30 b. 100 c. 120-150 d. 100-120
10. How deep should you aim to compress the chest in adult CPR?
a. 1/3rd chest depth b. 3-5cm c. 1/2 chest depth d. As deep as possible
11. If you are unable or unwilling to give rescue breaths, what should you do?
a. Wait for the b. Get another c. Stop CPR d. Give compression
ambulance first aider only CPR
12. At what point during CPR would you attach an AED?
a. After 30 b. As soon as c. After 2 minutes d. When the
compressions the AED is available of CPR ambulance arrives
13. What would you check before administering a shock with an AED unit?
a. The packaging b. The battery is on c. Nobody is touching d. The pads are held
is intact charge the casualty in place
14. How would you manage a casualty who is choking and has an ineffective cough?
a. Apply an AED b. Give back blows c. Give rescue breaths d. Commence CPR
15. Even if full recovery occurs, what is the recommendation for all drowning casualties?
a. To rest for 24 hours b. To start antibiotics c. To go to hospital d. To see their doctor
41
Basic Life Support
42
Manage Injury
Every day minor accidents happen
in households, workplaces and
communities. While most of the time
people can tend to their own first aid
needs, sometimes the injury is more
serious and requires Key topics
first aid from others or transport to
Bites and stings
Manage Injury
hospital via an ambulance. Bleeding and wounds
In this chapter you will learn about some Burns | Crush injury
of the more serious and common injuries Chest injury

Fractures and soft tissue injuries
such as: bites and stings, bleeding and
Head, neck and spinal injuries
wounds, burns, chest injuries – as well
Heat and cold injuries
as: fractures, poisoning and shock.
Poisoning | Shock
43
Bites and Stings
Australia is home to some of the world’s most poisonous animals.
Thousands of bites and stings occur every year in Australia. While most
bites and stings cause only minor irritation, some are life threatening. Fast
and appropriate first aid of bites and stings can stop or slow the spread of
venom, which can save lives. The most common method for preventing the
spread of venom is application of the Pressure Immobilisation Technique
(PIT).
Pressure Immobilisation Technique (PIT)

The Pressure Immobilisation Technique (PIT) aims to slow the movement of
the venom from the bite site into the blood circulation. Applying the PIT will
help delay the poisoning until appropriate medical assistance is received.
Manage Injury
The Pressure Immobilisation Technique is effective if: 1. firm pressure is

applied to the bite site, 2. the entire limb is bandaged, and 3. the limb is
immobilised.
1. Apply a firm bandage over the bite site

Broad elasticised bandages are preferred
over crepe bandages. Use about the same
pressure you would apply to a sprain.
2. Bandage the entire limb

Start at the end of the limb (fingers or toes)
and bandage upward over the first bandage
to cover as much of the limb as possible.
3. Immobilise the limb & rest the casualty

Use a splint, sling or other device to
prevent the limb from moving. Keep the
casualty and limb at complete rest. Bring
transport to the casualty if possible.
If the bite is not on a limb, firm direct pressure on the bite site may be useful.
Do not remove the bandage once applied. Do not apply a tourniquet.
Do not wash, cut or bleed the bite site. Do not suck out the venom.
44
Use of the Pressure Immobilisation Technique (PIT)
Recommended for: NOT recommended for:
 All Australian venomous snakes  Jellyfish stings
 Funnel-web Spider  Redback and other spider bites
 Blue-ringed Octopus  Fish stings (including Stonefish)
 Cone Shell S
corpions, centipedes or
beetles
Note: Resuscitation if needed, takes priority over PIT.
Manage Injury
Note: If alone, and unable to get urgent help to you - apply local
pressure to the bite site, and seek urgent help.
Snake bites
Australia has many venomous snakes that are
capable of lethal bites to humans. These include
the taipan, tiger snake, death adder, brown
snakes, black snakes, copperhead snake, rough
scaled snake and many sea snakes. Fortunately,
antivenom is available for all venomous Australian Eastern Brown Snake
snake bites. © Pavel German

Symptoms can vary and their onset may
DRS ABCD
range from minutes to several hours
Rest the casualty
Bite marks may or may not be visible
Provide reassurance
Pale, cool skin and often sweating
Short of breath or difficulty in breathing
Apply the PIT
Abdominal pain, nausea or vomiting
[see page 44]
Drooped eyelids, blurred or double vision
Headache
Limb weakness or paralysis
Collapse, decreased level of consciousness  Antivenom available
45
Spider bites
There are two species of spider that have the potential to cause significant
poisoning; these are the Funnel-web Spider and the Redback Spider.
Funnel-web Spider bites

Funnel-web Spiders are found on the
east coast of Australia. These spiders are
large, black or red-brown in colour and are
aggressive. Funnel-web Spider bites are Blue Mountains Funnel-web Spider
life threatening and should be treated as an Mike Gray © Australian Museum
emergency.

Manage Injury
Pain at the bite site DRS ABCD

Abdominal pain Rest the casualty
Excessive saliva and sweating Provide reassurance
Difficulty in breathing Call Triple Zero (000)
Confusion Apply the PIT [see page 44}
Collapse and unconsciousness
 Antivenom available
Redback Spider bites
The Redback Spider is not aggressive and has a small,
round abdomen with a red, orange or pale stripe on
its back. Many Redback Spider bites result in minimal
symptoms. Redback Spider
Mike Gray © Australian
Museum

Pain that gets worse over time Apply an ice pack
Pain can spread to other areas Monitor the casualty
Red, hot and swollen bite site Provide reassurance
Sweating at the bite site Seek medical advice
Nausea, vomiting or stomach pain
 Antivenom available
Do not use the Pressure Immobilisation Technique as this will increase the pain.
Note: Redback Spider bites can be life threatening for young

children. If a young child is bitten call Triple Zero (000).
46
Other spider bites
Many other species of spider have been associated with venomous bites,
or their bite causing a wound that will not heal. Much of the information
around other spider bites is still unclear. The current recommendations for
all other Australian spider bites are to manage the symptoms (apply an ice
pack for pain), monitor the casualty closely, and seek medical advice.
Insect bites and stings

The bite or sting from many insects causes little more than local pain and
swelling. However, in allergic individuals, an insect bite or sting can quickly
become life threatening.
Bee, wasp and ant stings

Bees, wasps and some ants have a sting at the end of their abdomen
Manage Injury
which they can use to inject venom into the skin. Unlike bees that can only
sting once, wasps and ants can sting many times. The stings can be very
painful, and the burning or itching at the sting site can last for hours.

Sting or barb stuck in the Immediately remove the sting
wound Apply a cold pack to the site
Pain at the site Observe for an allergic
Itching, redness and swelling reaction
at the site
Multiple stings to the face can cause difficulty in breathing. Any casualty
with stings to the face, lips or tongue should immediately go to hospital.
Honey Bee Wasp Bull ant

Andrew Donnelly © Australian Museum
Note: Abdominal pain and vomiting are signs of anaphylaxis for insect
allergy. If any history or signs of an allergic reaction are present:
Manage anaphylaxis Call Triple Zero (000)
47
Tick bites
The Australian Paralysis Tick is found on the east coast
of Australia. A single bite from this tick can cause
paralysis and severe allergic reactions. Signs
and symptoms of envenomation develop over
several days but allergic symptoms can
occur within hours.
Signs and symptoms First aid (non-allergic)

The tick bite may be painless If no history of tick allergy:
Local redness and irritation Do not disturb, squeeze or
General weakness or fatigue scratch the tick
Manage Injury
Blurred or double vision Seek current medical advice

Difficulty in swallowing If you suffer any symptoms -
Difficulty in breathing seek urgent medical assistance.
Summary of ASCIA recommendations for people allergic to tick

bites
Follow the Anaphylaxis Action Plan, including the use of an adrenaline

autoinjector if symptoms of anaphylaxis occur
Call Triple Zero (000) / seek urgent medical attention
Do NOT disturb or forcibly remove the tick
Kill the tick where it is
Note: The killing and removal of a tick (in an allergic individual)
should occur in a safe place, such as a medical facility or
emergency department.
The Australasian Society of Clinical Immunology and Allergy (ASCIA)
is the peak professional body of clinical immunology and allergy
specialists in Australia and New Zealand. For further information visit:
www.allergy.org.au
Note: Abdominal pain and vomiting are signs of anaphylaxis for

insect allergy. If any history or signs of an allergic reaction are
present:
Manage anaphylaxis Call Triple Zero (000)
48
Marine animal bites and stings
In waters around Australia there are many types of fish, jellyfish and other
marine animals that can inflict painful and sometimes life threatening bites
and stings.
If a casualty has been bitten or stung whilst near water (the ocean, rock
pools, rivers or creeks) – be especially alert for signs of distress, pain or
paralysis.
When a person has been bitten or stung in the water, there is a risk that
the casualty may panic or be unable to swim to safety. If it is safe to do
so, assist or encourage the casualty to get out of the water and seek
assistance from a lifeguard. If required, call Triple Zero (000) at the earliest
possible stage.
Some of the more venomous and dangerous marine bites and stings
include: fish and jellyfish stings, the Blue-ringed Octopus and the Cone
Manage Injury
Shell.
Fish stings
Many different species of fish have poisonous spines that can inject venom
deeply into the casualty’s skin. These include the Stonefish, Bullrout
and Stingrays. Fish-spine stings can be extremely painful and on rare
occasions, have been the cause of death. All fish should be handled with
care and if envenomation occurs, seek urgent medical advice.

Puncture or open wound Call Triple Zero (000)
Intense pain at the site Place the sting site in hot
Bleeding or swelling water to relieve pain (test the
Grey/blue colour at the site temperature first)
Irrational behaviour or panic Transport to, or seek urgent
medical attention.
Do not remove an embedded barb or spine.

Do not use the Pressure Immobilisation Technique.
Do not use water hot enough to cause a burn.
49
Jellyfish stings
Many jellyfish, hydroids and corals have stinging
capsules located on the tentacles or body of the
creature. When in contact with the stinging capsules
venom is released. The more contact with the stinging
capsules, and tentacles, the more venom that will be
released.
Fortunately, most jellyfish stings are not serious injuries
and cause little more than localised pain and skin
irritation. In Australia, the more serious (and occasionally
life threatening) jellyfish stings occur in the tropical
regions.
Box Jellyfish
The Australian Box Jellyfish and the smaller four- Guido Gautsch
tentacled jellyfish which causes Irukandji Syndrome, can Creative Commons
Manage Injury
deliver a deadly envenomation. These jellyfish have been

responsible for a number of deaths in the tropical regions.
Signs and symptoms

Immediate pain ranging from mild to severe
Pain can develop in the groin or armpits
Stinging or burning sensations
Muscular aches or cramps
Presence of tentacles on the skin
Redness and swelling at the sting site
Changes in skin colour around the sting site
Patterns or marks around the sting site (known as skin markings and
can vary in appearance)
In severe and more life threatening stings:

Extreme pain or cramps
Headache, nausea or vomiting
Excessive sweating
Irrational behaviour or restlessness
Difficulty in breathing
Collapse, unconsciousness and cardiac arrest
50
No single recommendation for first aid treatment of jellyfish stings can be
made – because of differences between jellyfish species around Australia.
For first aid purposes, jellyfish stings are classified as either: tropical or
non-tropical, according to the location where the jellyfish sting occurred.
Jellyfish that are able to cause life threatening stings are usually located in
the tropical regions from Bundaberg (Queensland) northwards, across the
northern coastline and down to Geraldton (Western Australia).
First aid – Tropical jellyfish stings

DRS ABCD and remove the casualty from the water
Call Triple Zero (000) and seek help from a lifeguard
Pour/spray large amounts of vinegar over the
sting site for 30 seconds and pick off remaining
tentacles
Manage Injury
If vinegar is not available, pick off tentacles by
hand and wash sting sight with sea water
Apply a cold pack or ice in a dry plastic bag* for pain relief
Monitor closely and prepare to provide Basic Life Support
Casualties who initially appear stable but experience severe symptoms
in the following 30 minutes may be suffering Irukandji Syndrome and
need urgent medical attention.
First aid – Non-tropical jellyfish stings

(and known Bluebottle stings)
DRS ABCD and remove the casualty from the water

Seek help from a lifeguard
Pick off tentacles by hand and wash sting site with
sea water
Place casualty’s sting site in hot water for 20
minutes
If hot water does not relieve the pain (or is not Bluebottle Jellyfish
available), apply a cold pack or ice in a dry plastic bag* © US National
Do not use vinegar Oceanic and
Atmospheric
Administration
* The ice bag needs to be dry so that no fresh water comes into contact with the sting site.
Do not use fresh water to wash the sting site.
Do not apply the Pressure Immobilisation Technique.
Do not allow any rubbing of the sting site.
51
Blue-ringed Octopus and Cone Shell
Found in coastal waters and tidal pools around
Australia, the Blue-ringed Octopus can inject
potentially lethal venom via a painless bite. Most
bites occur when people handle or step on the
octopus. Blue-ringed Octopus
David B Fleetham
The Cone Shell is found on beaches or in tidal pools
© Photolibrary 2011
in tropical regions. The Cone Shell has a poisonous
harpoon it can shoot into the skin to inject its
venom.
Both venoms can cause muscle weakness or
paralysis and in serious envenomation the casualty
may stop breathing. Even though the casualty is
paralysed, they are often able to hear and require a Cone Shell
Manage Injury
lot of reassurance. Didier Descouen

Creative Commons

Often painless scratch or bite DRS ABCD
Bite site may be bleeding Call Triple Zero (000)
Numb lips and tongue Seek help from a lifeguard
Weakness or paralysis Apply the Pressure
Difficulty in swallowing Immobilisation Technique
Inadequate or no breathing Provide lots of reassurance
Australian bites and stings – summary of first aid
PIT* All snake bites, Funnel-web Spider bites,

Blue-ringed Octopus, Cone Shell
Ice pack Bee, wasp and ant stings,

Redback Spider bites, Other spider bites
Vinegar Tropical Jellyfish stings
Hot water Fish stings, Non-tropical Jellyfish stings,

Bluebottle Jellyfish stings
* PIT – Pressure Immobilsation Technique

52
Bleeding and Wounds
Bleeding is the term used to describe the loss of blood. Blood loss is
usually classified as either external bleeding or internal bleeding. Severe
bleeding is potentially life threatening and immediate first aid can save lives.
External bleeding
External bleeding is blood loss that occurs outside the body and is usually
the result of an injury to the skin and blood vessels. The bleeding is visible
and the amount of blood loss can be estimated.
The overall aim of first aid for external bleeding wounds is to stop further
bleeding until help arrives, this can usually be achieved through the
application of direct or indirect pressure.
Manage Injury
First aid – general principles
Direct pressure method

DRS ABCD and if required, call Triple Zero (000)
Use standard precautions (wear gloves).
Use gloved hands and/or a pad to apply
firm pressure directly over the bleeding site.
Maintain pressure until bleeding stops.
If bleeding continues, place a second
pad directly over the top and apply a roller
bandage firmly to hold it in place.
Where possible:
If severe bleeding or bleeding from the lower limb - lie the casualty down.
Immobilise the area to restrict any movement.
Encourage the casualty to remain at rest.
Reassure the casualty.
Assess for and manage shock.
Note: Stopping major blood loss is a priority. If severe bleeding is

not controlled - apply a tourniquet above the bleeding site on the
limb (if available and trained in its use) and seek urgent medical
assistance. If the bleeding site is not suitable for a tourniquet
or bleeding does not stop after applying a tourniquet, apply a
haemostatic dressing (if available and trained in its use).
53
Nose bleed
Sit the casualty down with their head
leaning forward.
Get the casualty to pinch the soft part
of the nose (below the bone).
Maintain pressure for 10 to 20 minutes.
Apply a cold pack to the neck, nose or
forehead.
If bleeding continues after 20 minutes, seek
medical advice.
Note: Bleeding from the nose and/or ear may be related to a head
injury. For information on head, neck and spinal injuries see page 65
Manage Injury
Internal bleeding and abdominal injuries

Internal bleeding is blood loss that occurs inside the body and can be
difficult to recognise. Often there is a history of trauma that caused injury
to internal organs or deep body structures. Internal bleeding can be life
threatening and requires medical care in a hospital. Sometimes, the internal
organs can become exposed with a serious abdominal injury.
Special care must be taken to cover these organs with a non-stick dressing
(if unavailable, use a clean dressing kept wet or plastic wrap).

Pain DRS ABCD
Shock Call Triple Zero (000)
Bleeding from any opening in the body, Rest the casualty in a
for example: position of comfort
– coughing or vomiting blood Assess for and
– blood-stained urine manage shock
– bleeding from the vagina or anus Provide reassurance
– blood-stained or black faeces
Do not apply pressure over internal organs.

Do not give anything to eat or drink.
54
Wounds
A wound is any physical injury to the body that involves a break in the skin
or where damage to the underlying body structures has occurred as a result
of trauma. Some wounds can result in severe blood loss. Uncontrolled
bleeding may lead to shock and become a life threatening situation.
Types of wounds
Wounds can be described or classified in different ways. The table below
offers a simple description for some of the most common types of wounds.
Wound type Description Examples

Open wounds/ A wound that has occurred on the A cut or tear to the skin
external injuries surface of the body
Manage Injury
Closed wounds/ Injuries that occur beneath the skin or Crush injury or swelling
internal injuries deep within the body of a joint
A shallow wound often caused Gravel rash or a grazed
Abrasion by friction knee after a fall
A cut made by a sharp edge that A knife cut or a surgical
Incision often leads to heavy bleeding incision
A wound where the skin has been Glass cut or a tear from
Laceration torn in an irregular way barbed wire
Puncture or stab A wound where a sharp or pointed A stab from a knife or

wound object has penetrated the body standing on a nail
Embedded A wound that has resulted in a A large piece of glass

object foreign object remaining in the body stuck in the skin
Bruising or Damage under the skin surface Being hit hard by a

contusions usually caused by blunt trauma tennis ball
Deep Abrasion Laceration Puncture wound Embedded object

Sadeq Rahimi ClockFace James Heilman, MD James Heilman, MD
Wikimedia Commons Creative Commons Creative Commons Creative Commons
55
Basic Wound Care
Basic wound care varies according to the type and severity of the wound
and the available resources, but some of the following general principles
may apply:
Control bleeding and if required, call Triple Zero (000)
Wash hands and wear gloves
Clean the wound (depending on type of wound)
Cover wound with a non-stick dressing
Rest and support the wounded area
Seek medical advice
Specific wound care

Amputation
Manage Injury
Amputation is the word used to describe when a part of the body has
become detached or removed from the body. A finger that has accidentally
been cut off from the hand is an example of an amputation.
First aid
DRS ABCD and call Triple Zero (000).
Use standard precautions (wear gloves):
- manage the bleeding wound (pressure and elevation)
- locate the amputated part(s)
- place body part(s) in a plastic bag and seal the bag
- place the sealed bag in ice water.
Make sure body part(s) go with the casualty to hospital.
Manage shock and reassure the casualty.
Do not allow the amputated body

part to come into direct contact
with the ice water.
56
Ear injuries
The most common types of ear injuries include a ruptured ear drum, blood
or fluid leaking from the ear or a foreign object in the ear canal.
First aid
If blood or fluid is leaking from the ear:
DRS ABCD and call Triple Zero (000)
Manage as per head injury (see page 66)
Rest the casualty in the recovery position (bleeding side down)
Place a sterile pad under the ear and allow fluid to drain freely into the pad.
For most other types of ear injuries it is important to:
Rest and reassure the casualty
Manage Injury
Seek medical advice or if necessary, call Triple Zero.
Do not block any drainage from the ear Do not put liquid into the ear
Do not try to remove a foreign object from the ear
Eye injuries
First aid
For minor eye injuries (such as sand, smoke or dust in the eye)
Flush eye with clean running water and wash out any small objects
Cover the affected eye to keep it rested
Seek medical advice.
If the foreign body is not removed with running water – manage as a
major eye injury.
For major eye injuries (such as an embedded object or trauma to the eye)
Rest the casualty lying down and call Triple Zero (000)
Cover the injured eye (cover both eyes if tolerated by the casualty)
For a large penetrating object - place thick pads above and below the
eye and cover the object with a paper cup
Reassure the casualty and remind them to keep the eyes rested.
Do not place any direct pressure over the eyes. Do not touch the eye.
Do not try to remove an embedded object from the eye.
For information on Welder’s flash see page 60.

57
Embedded object
If there is an obvious embedded object, indirect pressure should be used.
First aid
Indirect pressure method (often used for embedded objects)

Use standard precautions (wear gloves)
Do not remove the embedded object
Place padding around, or above and below the object
Apply pressure over the pads, not the object
Do not apply pressure over an embedded object.

Manage Injury
Caution If the object is embedded in the eye, prevent

further movement of the casualty and seek urgent medical
aid, call Triple Zero (000)
58
Burns
A burn can be described as an injury caused by heat, cold, chemicals,
gases, electricity, friction or radiation (including sunburn). Burns can result
in serious or life threatening injuries. Immediate first aid can slow or stop the
burning process and can save lives.
Many burns occur on the surface of the skin. When large areas of the skin
are damaged, loss of body fluid as well as shock can develop and there is
also a great risk of infection.
Classification of burns
Burns vary in severity and are classified according to the depth of the skin
damage. The three depth classifications are: superficial, partial thickness
and full thickness burns.
Manage Injury
Partial thickness
Superficial burns Full thickness burns
burns
Involve only the top Involve damage to Involve all layers of the skin
layer of the skin the top and middle including the underlying nerve
and the symptoms layers of the skin. and body tissues. The skin
are redness, heat, In addition to the may appear black, charred or
pain and swelling redness, heat, white and pain may be absent
to the local area. pain and swelling in the most affected areas due
– blisters often to nerve damage.
develop.
First aid – general principles (heat, thermal and contact burns)

Cool the burn with cool running water for at least 20 minutes
Carefully remove jewellery or other constrictive items
Cover the burn with a loose clean non-stick dressing
(for example, plastic cling film or a sterile wound dressing)
Rest and elevate the affected part
Assess for and manage shock
Provide reassurance
Seek medical advice
Infants and children with any type of burn should receive medical attention
Do not remove clothing that is stuck. Do not use ice or iced water to cool.
Do not burst or break blisters. Do not apply lotions or creams.
59
Outlined below are a few of the more common types of heat, thermal and
contact burns, and the recommended first aid. These first aid requirements
should be considered in addition to the general first aid principles outlined
on the previous page.
Person alight (on fire)

If a person is on fire they may panic and run, causing the flames to spread.
Stop the casualty from running
Drop the casualty on the ground
Roll the casualty to put out flames
Cover with a blanket or use large amounts of water to put out flames
Treat injuries, manage shock and seek urgent medical attention
Inhalation burns
Manage Injury
Breathing in hot smoke, chemicals or gases can burn the throat and lungs
causing swelling of the airways which leads to difficulty in breathing. Always
suspect inhalation burns where a person has been trapped in an enclosed
space with toxic gas or fumes and/or if there are burns to the face, mouth
or nose.
Remove casualty to fresh air and where possible, give oxygen (if required,
and trained to do so)
Radiation burns
The most common type of radiation burn is sunburn. Others include nuclear
radiation or burns caused by industrial microwave equipment.
Cool with water for at least 20 minutes
If required, seek medical advice
Welder’s flash or Flash burn
Welder’s flash is a radiation burn to the eyes caused by the flash of light
from welding equipment. The damage to the eyes can be serious and
permanent. Symptoms and pain may not develop until several hours after
the incident.
Cover both eyes with eye pads and apply a cold pack
Seek medical advice
60
Chemical burns
Many household and industrial chemicals can cause burn injuries.
Avoid contact with the chemical (wear gloves if needed)
Call the Poisons Information Centre 13 11 26
Refer to Safety Data Sheets (SDS) or manufacturer for advice
Brush powdered chemical off the skin and remove contaminated clothing
If safe to do so, wash the area with cool running water for at least one hour
(or until stinging stops), and avoid the spread of chemical to unaffected areas.
Apply a non-stick dressing
Do not cover with gel dressings or cling wrap.
Electrical burns
Electrical burns, including lightning strike, often cause severe damage to
Manage Injury
the body and can be life threatening. This can lead to heart or breathing
problems, trauma and loss of consciousness.
Turn off the power supply, but only if safe to do so
Cool burn areas if safe to do so.
Where possible, give oxygen (if required, and trained to do so).
Crush Injury
Crush injuries occur when a part of the body, like a hand, leg, foot, chest or
abdomen is squashed between two hard surfaces. These injuries can occur
during natural disasters such as earthquakes and landslides, or as a result
of motor vehicle or heavy equipment accidents.
First aid
DRS ABCD
If safe to do so, remove the crushing force as soon as possible
Manage any bleeding and shock
Assess for and treat other injuries
Reassure and monitor the casualty
Ensure that the casualty is taken to a hospital
Note: If safe to do so, the crushing force should be released, no

matter how long the casualty has been trapped or crushed for.
61
Chest Injuries
Any trauma to the chest can result in fractured ribs or a penetrating chest
injury. These injuries often occur in car and sporting accidents or as a
result of acts of violence. Chest injuries can include damage to the heart
and lungs, which are potentially life threatening. Triple Zero (000) should be
called immediately.
Fractured ribs
Fractured ribs are often associated with extreme pain that gets worse
when the casualty breathes in/out, coughs, laughs, or makes any sudden
movement.
Manage Injury
Penetrating chest injury

A penetrating chest injury is typically caused by an object that has pierced
through the chest wall and into the region around the heart or lungs. The
most common causes are knife attacks or gunshot wounds. With this type
of injury there may be a visible hole in the chest, bleeding from the chest, or
a sucking sound that is heard when the casualty breathes.
Managing all chest injuries:

If unconscious, carefully turn the casualty onto their injured side
If conscious, position the casualty for comfort
(usually half sitting and leaning toward the injured side)
Assess for and manage other injuries (including shock)
Do not leave the casualty alone
Provide reassurance
Managing a penetrating chest wound:
Place an airtight dressing over the wound
Secure dressing on three sides
Leave the bottom edge open for drainage
A gloved hand can also be used to cover and seal the wound until
help arrives.
62
Fractures and Soft Tissue
Injuries
The bones, muscles, ligaments and tendons in our body work together to
provide strength, support, protection and movement. Any damage to these
structures can cause extreme pain and also restrict movement.
Types of fractures
A fracture is a broken or cracked bone. There are three main types of
fractures; open, closed and complicated.
Open fractures Closed fractures Complicated fractures
Manage Injury
An open fracture is A closed fracture is A complicated fracture
where the broken bone where the skin has can be either open or
has come through the not been broken, but closed and involves
skin. Bleeding is often there may be internal damage to the underlying
present and the risk of organ damage or tissues, organs or blood
infection is high. internal bleeding. vessels. For example,
a fractured rib that has
pierced the lung.
Signs and symptoms First aid – general principles

Pain at the site DRS ABCD
Pain with movement If required, call Triple Zero (000)
Restricted movement Immobilise the injured area
Abnormal appearance of If an ambulance has been called,
the injured area do not apply splints and slings,
Swelling but support the injured area in the
Bleeding position of most comfort
Signs of shock Manage any bleeding or shock
Assess for and treat other injuries
Reassure the casualty
Do not elevate a fractured limb. Do not place pressure over the facture site.
63
Slings and bandages
Slings and bandages are devices used to support and/or immobilise an
area of the body, typically a fractured limb. Slings and bandages are usually
made of cloth (such as a triangular bandage or a roller bandage) and
support a limb in a specific position. Splints and bandages are usually
only applied when delays in getting medical assistance are expected, for
example, when in a remote location.
Soft tissue injuries - Sprains, strains and dislocations
A soft tissue injury is the damage that is caused to muscles, ligaments and
tendons. Sprains, strains and dislocations are all examples of soft tissue
injuries. These injuries often occur as a result of sporting accidents, trauma,
falls or overuse. Most soft tissue injuries result in pain and swelling to the
local area and full recovery can normally be expected within a few weeks.
Manage Injury
Sprains Strains Dislocations

A sprain occurs A strain occurs when a A dislocation occurs when
when ligaments muscle or tendon has the normal alignment and
around a joint been overstretched. position of bones around
have been Strains often occur a joint are disturbed.
stretched or torn. as a result of lifting Dislocations are often a
something too heavy result of severe trauma
or from sudden where a fracture as well as
and uncoordinated damage to other tissues
movement. may have occurred.

Sprains and strains: Sprains and strains:
Pain and tenderness DRS ABCD
Swelling to the area Rest, Ice, Compression, Elevation
Seek medical advice.
Dislocation: Dislocation:
Pain and tenderness
DRS ABCD
Inability to move area
If in doubt, treat as a fracture
Joint looks deformed
Support in position found
Swelling to the area
Seek medical advice
Do not try to move bones back
into their original position
64
R.I.C.E. technique
The four-step R.I.C.E. technique can be used to manage sprains and
strains. The R.I.C.E. technique is also the appropriate first aid for bruises.
R Rest the casualty and restrict movement to the injured part.
I Ice* or a cold pack is applied to the injured part

(ice should be wrapped in a wet cloth).
C Compression is placed around the injured part

(by applying a roller bandage).
E Elevation of the injured part helps to decrease swelling.
Manage Injury
All casualties with a sprain or strain should seek prompt medical
assessment of their injury.
* When applying ice:

Do not apply ice directly to the skin, this can cause pain or tissue
damage.
Ice should be applied for 10 to 20 minutes at a time.
Ice should only be re-applied to an area after it has become warm
again.
Head, Neck and Spinal Injuries

Any severe injury to the head, neck, back or spine can be life threatening
or result in permanent damage to the brain, spinal cord or nerves. A head,
neck or spinal injury may lead to various signs and symptoms and should
be suspected where the casualty has had:
A hard hit to any part of the head, neck, back or spine (including from a fall)
A motor vehicle or severe sporting accident
Any accident that resulted in unconsciousness or changes in level of
consciousness.
Any casualty with a suspected head, neck or spinal injury and any casualty
who shows changes in their level of consciousness requires urgent medical
attention. Call Triple Zero (000) as soon as possible.
65
Head injuries
Injuries to the head can result in loss of consciousness, damage to the
brain, eyes, ears, teeth, airways and mouth or other structures. Head
injuries may be associated with:
Damage to the face, airway, neck, spine or other injuries
Changes in level of consciousness (unconscious, drowsy or confused)
Seizures, agitation or aggressive behaviour
Uncoordinated movement or loss of strength in limbs
Bleeding or fluid discharge from the ears, nose or mouth
Nausea or vomiting.
First aid
Manage Injury
DRS ABCD and call Triple Zero If conscious, keep the casualty
(000) lying down at rest
Check for and control any Protect the neck from
bleeding movement
Do not leave the casualty alone Reassure and closely monitor
casualty
Note: Anyone with a head injury should receive urgent medical

attention. If any change in level of consciousness (even brief) - call
Triple Zero (000) immediately.
Skull fractures
Skull fractures can result in bleeding under the scalp or bleeding within
the brain. In addition, there can be blood or straw coloured fluid leaking
from the ear and/or the nose. Manage as a head injury (see above). Place
the casualty in the recovery position with the bleeding side closest to the
ground (this will allow the blood to drain). Next, place a pad (or clean cloth)
under the bleeding ear/nose to collect the draining fluid.
Do not plug the ear canal.
Neck, back and spinal injuries

Severe injuries to the neck, back or spine can cause permanent damage to
the nerves or spinal cord and may be associated with:
Pain at the injury site
The feeling of ‘pins and needles’, tingling or numbness in parts of the body
Weakness or inability to move parts of the body.
66
First aid
Closely monitor airway and breathing
Do not leave the casualty alone
If conscious:
Tell the casualty to lie still (do not move)
Support the casualty’s head and neck to prevent any movement
Provide reassurance
If unconscious:
Airway management and CPR take priority
If required, it is acceptable to gently move the casualty’s head into a
Manage Injury
neutral position to maintain an open airway
If required, turn casualty into the recovery position to clear the airway
It is preferable to place the casualty in the recovery position
For airway management - jaw thrust and chin lift should be tried
before head tilt
Caution While extreme caution must be taken when

moving any casualty with a suspected head, neck, back
or spinal injury, the principles of the DRS ABCD action plan
take priority.
Moving a casualty with neck, back and spinal injuries

Ideally, only paramedics or other trained rescuers should move a casualty
with a suspected spinal injury. If movement is necessary:
Any handling should be gentle with no twisting or sudden jarring
Extreme caution should be taken to minimise movement of the spine,
head, neck or chest in any direction
The painful region should be supported throughout the move
When turning onto their side, make sure that spinal alignment is
maintained throughout the move
Only suitably trained personnel should use any type of spinal
immobilisation device.
Note: The application of cervical collars by first aid providers is no

longer recommended.
67
Heat and Cold Injuries
Exposure to excessive heat or cold can have serious health effects on the
human body. Normally, the human body is kept controlled at a temperature
around 37oC. The two extreme changes in body temperature are known as:
Hyperthermia (hot or high body temperature).
Hypothermia (cold or low body temperature).
Hyperthermia – heat induced illness

Hyperthermia is overheating of the body and usually occurs when the
casualty absorbs or produces more heat than they can remove. If the body
temperature gets too high then serious illness can occur.
Manage Injury
Signs and Symptoms First Aid

Inability to continue the activity. Rest the casualty in the shade
High body temperature. or cool environment.
Dizziness and faintness. Loosen and remove excessive
Nausea, vomiting or diarrhoea. clothing.
Pale skin and other signs of Do not delay calling Triple Zero
shock. (000) if not improving quickly.
Hot dry skin.* Cool the casualty by best
Poor muscle control or means available.
weakness. Give cool/cold water to drink
Decreasing levels of if fully conscious and able to
consciousness, confusion or swallow.
seizures.
*L
ack of sweating may indicate
serious illness as the body is
dehydrated and has insufficient
fluid to sweat.
68
Cooling the Casualty
While waiting for medical assistance to arrive, use the following to cool the
casualty.
Over 5 years
If bath is available:
Immerse whole body (from neck down) in cold water.
If bath is not available:
Wet with cold water from a hose or other water source.
Apply wrapped ice packs to neck, groin and armpits.
Repeatedly moisten skin.
Continuously fan.
5 years and under
Manage Injury
If bath is available:
Place (from neck down) in lukewarm water.
Sponge frequently.
If bath not available:
Repeatedly moisten skin.
Fan continuously.
Continuously monitor casualty for response and normal breathing. Start
CPR if required.
Caution: Be careful not to over-cool the casualty as this may lead

to hypothermia.
Dehydration
Dehydration means your body does not have as much water and fluids as
it needs to be hydrated. This can be caused by excessive sweating (eg.
exercise), vomiting or other factors. First aid includes giving water to drink
and seek medical advice.
69
Hypothermia – low body temperature
The two main cold injuries are hypothermia and frostbite. Hypothermia
is when the casualty’s body temperature slowly drops to below 35°C.
Frostbite is the freezing of a small body area, often the fingers, toes, ears
or nose. Both of these conditions usually occur as a result of exposure to
cold, wind, rain, snow or submersion in water.
Signs and Symptoms First Aid
Mild hypothermia: DRS ABCD

Pale, cool skin and shivering Call Triple Zero (000)
Slurred speech If required, give CPR
Poor coordination and confusion Remove from the cold
Moderate to severe hypothermia: Prevent further heat loss
Manage Injury
Shivering stops Dry the casualty if wet

Muscle stiffness Replace wet clothing
Decrease in consciousness and wrap with blankets
In the most severe cases, the If conscious and alert –
casualty may appear dead give warm oral fluids
Frostbite: Give gentle and gradual
Hypothermia rewarming
Pain in the affected part Use body-to-body heat
Numbness to slowly rewarm any
Impaired movement frostbite injury
Skin feels hard and stiff
Skin looks waxy and pale
Do not rub or massage the frozen areas.

Do not apply direct or radiant heat. Do not burst or break blisters.
Do not place casualty in a warm bath. Do not give alcohol to drink.
Caution With frostbite, never thaw an affected part if there

is any chance that refreezing will occur, as refreezing results in
greater tissue damage.
70
Poisoning
There are many poisons in our environment. Common
poisons include: medicines, cleaning products, insect
sprays, bites or stings, industrial chemicals and
various plants. Poisons can be ingested (swallowed),
injected, inhaled or absorbed. Poisoning can result
in death or serious illness and immediate first aid can
save lives.
Each poisoning may present with different signs and
symptoms. The priority should be to recognise that
a poisoning may have occurred, this could include a
recent history, or evidence of contact with poisonous
substances.
Manage Injury
Signs and symptoms
General signs and symptoms may include:
Sudden illness or the casualty looks and feels unwell
Stomach pains, nausea, vomiting or diarrhoea
Burn injuries to the mouth, tongue, nose or skin
Chest pains, difficulty in breathing
Headaches, changes to vision or speech
Tiredness, seizures and unconsciousness

Protect yourself from being poisoned
If unconscious, place the casualty in the recovery position
Try to find out how much and what type of poison was taken
If possible and safe to do so, take the poison container to the telephone
Call the Poisons Information Centre on 13 11 26 and follow their advice
Do not try to make the casualty vomit (unless advised to do so).

Do not wait for symptoms to occur.
 Poisons Information Centre 13 11 26
71
Poisoning – specific first aid
Some types of poisoning require specific first aid, for example: a poison
that is inhaled, a poison that enters the eye or a poison that is on the skin.
For these types of poisons follow the general principles (described on the
previous page) and consider the following:
If poison is on the Carefully remove contaminated clothing

skin Wash the skin with cold running water
If poison enters Wash the eye with cool water for 15 to 30
the eye minutes
Seek medical advice
If poison is Get casualty to fresh air
inhaled Open windows or doors
Monitor breathing
Manage Injury
Prepare to give CPR
Shock
Shock is a serious and life threatening condition that occurs when the body
does not get enough blood flow. There are many causes of this reduced
blood flow including: heart problems, bleeding, dehydration, severe burns,
anaphylaxis or major infections. This condition is not the same ‘shock’
that you feel when frightened or surprised, it is a medical emergency that
requires immediate first aid.
Signs and symptoms First aid – general principles

Feeling faint or dizzy DRS ABCD and call Triple Zero
Cool, sweaty, pale skin (000)
Thirst, nausea or vomiting Lie the casualty down
Shortness of breath If unconscious, place in the
Confusion or weakness recovery position
Decreased level of Control any bleeding
consciousness Keep warm (cover with a blanket)
Give oxygen (if required, and
trained to do so)
Reassure and monitor the casualty
Note: Elevating the person’s legs is no longer recommended
72
1. What is the first aid for a wasp sting? After removal of barbs/sting:
a. Immobilize site b. Apply ice pack c. Bandage site d. Elevate site
2. On what sting would you apply vinegar?
a. Tropical jellyfish b. Wasp c. Ant d. Spider
3. What is the first aid for a Funnel-web Spider bite?
a. Apply an ice pack b. Give antivenom c. Elevate the limb d. Apply the PIT*
4. What is the first aid for Redback Spider bites?
a. Apply the PIT b. Give antivenom c. Wash with vinegar d. Apply an ice pack
5. Which of the following is part of first aid for a non-tropical jellyfish sting site?
a. Wash with vinegar b. Elevate the site c. Wash with hot water d. Apply the PIT*
Manage Injury
6. What is the first aid for a burn?
a. Apply burn cream b. Cool the burn c. Rest the casualty d. Start antibiotics
7. What type of dressing would you apply to a penetrating chest injury wound?
a. A firm pressure b. The PIT* c. An airtight dressing d. An airtight dressing
dressing secured on 3 sides secured on 4 sides
8. A casualty has a chest injury and is unconscious; on what side would you roll the casualty?
a. Their left side b. Their right side c. The uninjured side d. The injured side
9. What is the name of the fracture where the bone is sticking through the skin?
a. Closed b. Open c. Complicated d. Greenstick
10. What injury would you treat using the R.I.C.E. technique?
a. A bee sting b. A fracture c. A thermal burn d. A sprain
11. Bleeding or fluid leaking from the ear and/or nose may be a sign of what type of injury?
a. A head injury b. A crush injury c. A soft tissue injury d. A spinal injury
12. What is the first aid for frost bite?
a. Massage b. Heat c. Gradual rewarming d. Rapid rewarming
13. What are some of the signs of shock?
a. Cool, sweaty b. Red, hot and c. Headache and d. Pupils of
and pale skin flushed skin rapid pulse unequal size
14. What is the first aid for external bleeding wounds?
a. Apply pressure b. Direct pressure c. Apply the d. Apply the PIT*
and heat & immobilisation R.I.C.E. technique
15. In what position would you manage a casualty with a severe bleeding nose?
a. Lying down b. Leaning backward c. Leaning forward d. On their side
* PIT – Pressure Immobilsation Technique
73
Manage Illness
Many people have health conditions
and long term illnesses which they can
usually manage themselves. Sometimes
these medical conditions can deteriorate
quickly and can become life threatening.
Recognising that someone needs urgent
assistance and providing immediate first aid
can save a life.
In this chapter you will look at some of
the health conditions and illnesses that
can create a medical emergency requiring
first aid. These illnesses include; allergic Key topics
reaction, anaphylaxis, asthma, chest pain,
diabetes, seizures, fainting, hyperventilation, Allergic reactions | Anaphylaxis
Manage Illness
mental health crisis, stroke, and substance Asthma
misuse. Chest pain

Diabetes | Seizures
Fainting | Hyperventilation
Mental health crisis
Stroke
Substance misuse
74
Allergic Reactions
Allergies are very common and increasing in Australia. An allergic reaction
occurs when a person’s immune system reacts to substances (allergens)
in the environment that are usually harmless for most people. Common
causes of allergic reactions in Australia include:
dust mites, pollens and mould
foods (eggs, cow’s milk, peanuts, tree nuts, wheat, soy, sesame & seafood)
pets (cats, dogs and other furry or hairy animals)
insect bites and stings
some medicines.
Symptoms of allergic reactions range from very mild to severe and can be
life threatening. Note: The life threatening form of an allergic reaction is
known as anaphylaxis and is explained on the next page.
Most allergic reactions are mild to moderate and do not result in major
health concerns, but they can cause great discomfort and distress. The
symptoms and areas of the body affected vary widely and depend on
where the allergen enters or makes contact with the body.
Signs and symptoms

Skin dry, red, itchy skin; rashes or hives
Manage Illness
Nose, eyes runny nose; watery red eyes; itchy nose/
and throat eyes; sneezing; sore throat
Lungs and chest asthma; breathlessness; coughing
Stomach and bowel stomach pain; nausea or vomiting; diarrhoea
Most people learn to live with their condition and carefully avoid known
allergens, however occasional and accidental exposure does occur.

Prevent further contact with the allergen
For a bee sting—immediately remove the sting
For a tick bite - do not disturb the tick (see page 48 for details)
Seek urgent medical attention
Provide reassurance
Watch for worsening symptoms, including signs of anaphylaxis
If symptoms worsen prepare to follow the anaphylaxis action plan.
75
Anaphylaxis – Severe Allergic
Reactions
Anaphylaxis is the most severe form of allergic reaction and can be life-
threatening. Anaphylaxis must be treated as a medical emergency requiring
immediate first aid and urgent medical attention.
Most cases of anaphylaxis occur within 20 minutes after a person with
a severe allergy is exposed to the allergen, usually a food, medication or
insect sting. While many substances can cause anaphylaxis, the most
common triggers of severe allergies are:
Foods Medications Venom

Milk, eggs, peanuts,
Bee, wasp or ant stings,
tree nuts, sesame, fish, Penicillin, pain killers
tick bites
shellfish, wheat and soy
Symptoms of anaphylaxis can vary between people and their onset can
range from minutes to hours after exposure to the allergen. The best
management for anaphylaxis is prevention by avoiding all contact with
known triggers.
Manage Illness
If anaphylaxis does occur, adrenaline is the first line emergency treatment.

Adrenaline autoinjectors contain a single, fixed dose of adrenaline, and are
designed for use by anyone.
Currently in Australia there are two doses of adrenaline autoinjectors
available:
EpiPen® (usually prescribed for adults and children over 20kg)
EpiPen®Jr (usually prescribed for children 10-20kg)
Anyone (trained or not) can and should administer an adrenaline
autoinjector in life threatening anaphylaxis.
A second dose of adrenaline should be administered by autoinjector if there
is no improvement 5 minutes after the initial dose.
For information on signs and symptoms and first aid management and how
to administer adrenaline autoinjectors refer to the following anaphylaxis
action plan.
Note: Adrenaline is life saving and must be given promptly. Any

delay in giving adrenaline can result in deterioration and death.
76
ACTION PLAN FOR
www.allergy.org.au Anaphylaxis
Name: For use with adrenaline (epinephrine) injectors
Date of birth:
SIGNS OF MILD TO MODERATE ALLERGIC REACTION
• Swelling of lips, face, eyes • Tingling mouth
• Hives or welts • Abdominal pain, vomiting - these are
signs of anaphylaxis for insect allergy
Photo
ACTION FOR MILD TO MODERATE ALLERGIC REACTION
• For insect allergy - flick out sting if visible
• For tick allergy seek medical help or freeze tick and let it drop off
• Stay with person, call for help and locate adrenaline injector
• Give antihistamine (if prescribed)
Confirmed allergens:
• Phone family/emergency contact
Mild to moderate allergic reactions (such as hives

Family/emergency contact name(s): or swelling) may not always occur before anaphylaxis
1.
Mobile Ph: WATCH FOR ANY ONE OF THE FOLLOWING SIGNS OF
2. ANAPHYLAXIS (SEVERE ALLERGIC REACTION)
Mobile Ph:
Plan prepared by doctor or nurse practitioner (np): • Difficult or noisy breathing • Difficulty talking or hoarse voice
• Swelling of tongue • Persistent dizziness or collapse
The treating doctor or np hereby authorises • Swelling or tightness in throat • Pale and floppy (young children)
medications specified on this plan to be
• Wheeze or persistent cough
given according to the plan, as consented by
the patient or parent/guardian.
ACTION FOR ANAPHYLAXIS
Whilst this plan does not expire, review is
Manage Illness
recommended by DD/MM/YY 1 LAY PERSON FLAT - do NOT allow them to stand or walk
Signed: • If unconscious or pregnant, place in recovery position
Date: - on left side if pregnant, as shown below
• If breathing is difficult allow them to sit with legs outstretched
• Hold young children flat, not upright
Refer to the device label for

instructions on how to give
an adrenaline (epinephrine) 2 GIVE ADRENALINE INJECTOR
injector. 3 Phone ambulance - 000 (AU) or 111 (NZ)
4 Phone family/emergency contact
Instructions are also on 5 Further adrenaline may be given if no response after 5 minutes
the ASCIA website 6 Transfer person to hospital for at least 4 hours of observation
www.allergy.org.au/anaphylaxis IF IN DOUBT GIVE ADRENALINE INJECTOR
Commence CPR at any time if person is unresponsive and not breathing normally
Adrenaline injectors are prescribed
as follows: ALWAYS GIVE ADRENALINE INJECTOR FIRST, and then asthma
• 150 mcg for children 7.5-20kg reliever puffer if someone with known asthma and allergy to food, insects or
medication has SUDDEN BREATHING DIFFICULTY (including wheeze, persistent
• 300 mcg for children over 20kg and
adults cough or hoarse voice) even if there are no skin symptoms
Asthma reliever medication prescribed: Y N
• 300 mcg or 500 mcg for children and
adults over 50kg Note: If adrenaline is accidentally injected (e.g. into a thumb) phone your local poisons information
centre. Continue to follow this action plan for the person with the allergic reaction.
© ASCIA 2021 This plan was developed as a medical document that can only be completed and signed by the patient's doctor or nurse practitioner and cannot be altered without their permission.
This information has been reproduced from the ASCIA website www.allergy.org.au with permission from the Australasian
Society of Clinical Immunology and Allergy (ASCIA), the peak professional body of clinical immunology and allergy specialists
in Australia and New Zealand. Please check the ASCIA website for the latest version of this information as ASCIA resources
are regularly reviewed and updated.
77
Asthma
People with asthma have sensitive airways. When exposed to certain
triggers, muscles around the airways tighten causing their airways to
narrow. Furthermore, the inside lining of the airways becomes swollen and
extra mucus may be produced. This makes it difficult for them to breathe.
Common triggers include: colds and flu, cigarette smoke, exercise, pollens,
dust mites and many more. For most people with asthma, triggers are only
a problem when their asthma is not well controlled.
Asthma medications
There are many different types of asthma medication which help relieve or
control asthma. These include:
Relievers (blue/grey in colour)

Relievers are fast acting medications that give
quick relief of asthma symptoms by relaxing
muscles around the outside of the airways.
Examples include Ventolin & Bricanyl.
This medication is used in an asthma attack/
asthma emergency.
Manage Illness
Preventers (autumn/desert colours)

Preventers are slower acting medications
which reduce swelling in the airways, make the
airways less sensitive, and help control asthma
and prevent asthma attacks.
Examples include Pulmicort and Flixotide.
NOT for use in an asthma attack/asthma
emergency.
Combinations (purple or red & white in
colour)
Medications that are both a reliever and a
preventer.
Examples include Symbicort or Seretide.
Can be used in an asthma attack/asthma
emergency.
78
Images provided with thanks from Asthma Australia 2015 (asthmaaustralia.org.au)
Asthma medication is best given one puff at a time and via a spacer device.
Small child Reliever Child/adult Reliever

spacer device medication spacer device medication
Photographs by: Aidan Carlan
Note: Spacers are designed for single person use only.
Asthma ‘attack’ or asthma emergency

An asthma attack can develop slowly over a few days or rapidly within
minutes. During an asthma attack the casualty’s condition and ability to
breathe can quickly worsen.
Manage Illness
Severe difficulties with breathing DRS ABCD
Chest tightness Follow the person’s
Distress, anxiety or fear Asthma Action Plan (if
Unable to speak many words they have one) OR
between breaths Follow the Asthma First
Little or no improvement after Aid Plan (see next page)
medication If there is no
Young children may cough, wheeze, improvement call
vomit or become unsettled during Triple Zero (000) and
an asthma attack. Due to their keep giving reliever
breathlessness, they may also have medication.
difficulty in speaking or eating.
Severe asthma attack: call Triple Zero (000)

straight away and follow the Asthma First Aid Plan.
79
Asthma First Aid
1 Sit the person upright
— Be calm and reassuring
— Do not leave them alone
2 Give 4 separate puffs of blue/grey reliever puffer

— Shake puffer
— Put 1 puff into spacer
— Take 4 breaths from spacer
Repeat until 4 puffs have been taken
Remember: Shake, 1 puff, 4 breaths
OR give 2 separate doses of a Bricanyl inhaler (age 6 & over) or a Symbicort inhaler (over 12)
3 Wait 4 minutes
— If there is no improvement, give 4 more separate puffs of
blue/grey reliever as above
OR give 1 more dose of Bricanyl or Symbicort inhaler
4 If there is still no improvement call emergency

assistance - Dial Triple Zero (OOO)
— Say ‘ambulance’ and that someone is having an asthma attack
Manage Illness
— Keep giving 4 separate puffs every 4 minutes until emergency

assistance arrives
OR give 1 dose of a Bricanyl or Symbicort every 4 minutes - up to 3 more doses of Symbicort
Call emergency assistance immediately - Dial Triple Zero (000)

— If the person is not breathing
— If the person’s asthma suddenly becomes worse or is not improving
— If the person is having an asthma attack and a reliever is not available
— If you are not sure if it’s asthma
— If the person is known to have Anaphylaxis - follow their Anaphylaxis Action
Plan, then give Asthma First Aid
Blue/grey reliever medication is unlikely to harm, even if the person does not have asthma
AAFAA42016 First Aid Poster A4 | 27 November 2016
Contact your local Asthma Foundation

Translating and
1800 ASTHMA Helpline (1800 278 462) asthmaaustralia.org.au Interpreting Service
© Asthma Australia 2016 Supported by the Australian Government 131 450
80
Images provided with thanks from Asthma Australia 2017 (asthmaaustralia.org.au)
Chest Pain
There are many reasons why someone may
experience chest pain; angina and heart attack are
two of the more common causes.
Chest pain may start suddenly or can slowly
increase over time. The pain may be limited to one
area or spread to other regions, such as the neck,
jaw, back and arms.
Some people may experience a heart attack without pain but shortness of
breath or other symptoms are often present.
Fast recognition of chest pain and immediate access to emergency medical
treatment can help improve survival and reduce heart muscle damage. Do
not delay in calling Triple Zero (000) - every minute counts.

Chest pain that may radiate DRS ABCD call Triple Zero
to the neck, jaw, shoulders, (000)
back, arms or hands
Manage Illness
Rest the casualty in a
Pain in other regions comfortable position
Cool, pale skin or sweating Assist the person to take their
Fast/shallow breathing or prescribed medication (e.g.
shortness of breath tablet or oral spray)
Dizziness Give aspirin 300mg (unless
Nausea and/or vomiting known to be allergic to aspirin)
Collapse Closely monitor the casualty
Loosen any tight clothing
Provide reassurance
Prepare for Basic Life Support
Note: People may describe their experience of chest pain differently. They
may use some of the following words:
Crushing Stabbing Throbbing Sharp
Jabbing Squeezing Burning Dull
81
Diabetes
Diabetes is a condition that affects the ability to regulate the amount of
glucose (sugar) in the blood. Although there are different types of diabetes
the first aid management remains the same. The common emergency
affecting a person with diabetes is hypoglycaemia, also known as a ‘hypo’.
Hypoglycaemia ‘hypo’ (low blood glucose)

People with diabetes can experience a sudden drop in their blood
glucose levels. This can result in changes in their behaviour and lead to
unconsciousness, therefore they can no longer provide their own first aid.
Signs and symptoms

Weakness, shaking, trembling May progress to:
Headache Changes in behaviour
Light headedness, dizziness Confusion, loss of coordination
Lack of concentration Slurred speech
Irritability Loss of consciousness
Sweating Fitting (seizures)
Hunger
Manage Illness
First aid
DRS ABCD
If conscious:
- Give sugar/glucose in a liquid form such as a soft drink, honey or
glucose syrup and repeat if necessary
- Closely monitor the casualty and if no improvement call Triple Zero (000)
If unconscious or unable to swallow:
- Immediately call Triple Zero (000) and do not give any food or drink
- Place casualty in the recovery position and monitor closely
If a person with diabetes is unconscious

call Triple Zero (000) immediately and tell the
operator that it is a diabetic emergency.
For more information visit www.diabetesaustralia.com.au
82
Seizures
A seizure occurs when there is a disturbance in the electrical signals in part
or all of the brain. Seizures usually affect the person’s awareness of their
surroundings and also their actions for a short period of time. Some, but
not all seizures involve convulsions (the stiffening and jerking movements of
the body).
Generalised seizures
Generalised seizures happen when the whole brain is affected; the person
will most likely fall, lose consciousness, convulse, and shake all over. Some
generalised seizures can result in trauma, and life threatening problems with
airway or breathing can occur.

Generalised seizure: During seizures:
Muscle spasms DRS ABCD
Where available, follow the
Jerking movements casualty’s seizure management plan
Changes in breathing Remove any immediate dangers
Collapse If safe to do so, protect the person’s
Manage Illness
head
Unresponsive
Note the time the seizure starts
Unconscious Once seizure has stopped:
Breathing may stop Place in the recovery position
temporarily Maintain an airway
Loss of bladder or bowel Note how long the seizure lasted
control Monitor and reassure
Maintain privacy and dignity
Do not restrain the casualty (unless essential to avoid injury).

Do not place anything in their mouth.
Do not move the casualty unless in danger.
Note: If a seizure occurs while the person is seated in a wheelchair,

car or stroller, support their head and leave them safely strapped in
the seat until the seizure is finished.
If the seizure occurs in water - support the casualty so that their

face is out of water - remove from the water when safe to do so -
call Triple Zero (000). 83
Other types of seizures
There are many different types of seizures and people can experience more
than one type. Two other types of seizures are outlined below.
Partial seizures happen when one part of the brain is affected. The
person may experience a range of abnormal sensations and movements.
Usually the person is awake but may lose awareness of their surroundings;
they can be confused, frightened, drowsy, and irritable for several hours
afterwards.
Absence seizures are a non-convulsive event where the person loses
awareness for a brief period (typically lasting up to 10 seconds); they can
occur frequently, and often involve vacant staring, eye rolling, eye blinking
or eyelid flicker.
Febrile convulsions
Febrile convulsions are fits or seizures that occurs in young children
(normally under the age of 6). Most often this is related to fever or a rapid
change in body temperature. Most seizures last no more than a few
minutes. The child is often drowsy, irritable and disorientated after the
seizure.

Manage Illness
High temperature (fever) DRS ABCD call Triple Zero (000)

Jerking or twitching Keep child out of danger
movements Remove restrictive clothing
When the seizure stops, place
Loss of consciousness child in the recovery position
Difficulty with breathing If the seizure lasts more than
5 minutes call Triple Zero (000)
Child may be stiff or floppy
Seek medical advice
Do not restrain the child. Do not place anything in the child’s mouth.
Do not leave the child unsupervised.
Do not place the child in water (in an attempt to cool them).
84
Fainting
Fainting is a brief loss of consciousness usually caused by a decrease in
blood flow to the brain and a fast recovery is normal. Fainting may occur as
a result of standing in one place for too long, sudden changes in position,
extreme heat, pain, dehydration, fear or emotional distress.

Dizzy, light-headed DRS ABCD
Pale skin colour If unconscious place in recovery
position
Nausea If conscious, lie the casualty
Collapse down and raise legs if possible.
If the casualty does not regain
Unconscious for a brief consciousness quickly,
period call Triple Zero (000)
Do not sit the casualty with their head placed between their knees.
Hyperventilation
Manage Illness
Hyperventilation is the term used to describe rapid or over-breathing. There
are many reasons why someone may be hyperventilating, including some
serious health conditions. For example, asthma, heart failure, a collapsed
lung, poisoning and severe diabetes.

Fast, shallow breaths Reassure the casualty
Chest pain or discomfort Encourage the casualty to
Dizzy, faint or blurred vision slow down their breathing
Tingling or numbness in the (counting each breath aloud
fingers, toes and lips can help)
Hand and finger spasms If there is no improvement,
Anxiety or panic call Triple Zero (000)
Feel as if they are going to die
Do not use any type of bag for re-breathing.

85
Mental Health Crisis
Every year about one in five Australian adults experience an
episode of mental illness. The most common and disabling
mental illnesses are depression, anxiety and substance use
disorders. Psychotic illnesses are not common but can be
very disabling.
Mental health first aid is the help provided to a person
developing a mental health problem or in a mental health crisis. The first
aid is given until appropriate professional help is received or until the crisis
resolves. A mental health crisis can take many forms, examples include; a
person who feels suicidal, a person having an anxiety attack, a person in an
acute stress reaction, a person out of touch with reality or a person who is
in a distressing psychotic state.
Mental Health First Aid ALGEE Action Plan
The 5 steps in providing Mental Health First Aid are:

A pproach the person, assess and assist with any crisis
L isten and communicate non-judgementally
Manage Illness
G ive support and information

E ncourage appropriate professional help
E ncourage other supports
If required, call the local Mental Health Crisis Team or Emergency

Department. If the situation is dangerous or life threatening
call Triple Zero (000).
For more information about

Mental Health First Aid visit:
www.mhfa.com.au
This is a 24-hour mental health telephone

access service. If in a life-threatening situation
please call 000 to receive immediate help’
86
Stroke
A stroke occurs when the blood flow to the brain has been blocked or
because an artery breaks and bursts. When the brain does not get enough
blood and oxygen, the brain cells start to die. The longer a stroke remains
untreated, the greater the chance of brain damage. Fast recognition and
access to emergency medical treatment can help improve survival and
lessen long term damage.

The F.A.S.T. test is an easy way DRS ABCD
to recognise and remember the Call Triple Zero (000)
most common signs of a stroke. Do not give anything to eat or drink
Other Signs and symptoms Lay the person down on the side
include: Loosen any tight clothing
Weakness or paralysis Monitor and reassure the
Dizziness casualty
Headache, loss of vision Prepare to give Basic Life
Difficulty swallowing Support
Manage Illness
Stroke is always a medical emergency. If you think
someone is having a stroke Call Triple Zero (000) immediately.
© National Stroke Foundation, reproduced with permission 2017.
87
Substance Misuse
Substance misuse usually relates to the harmful overuse of any medication,
alcohol or other drugs for non-medical purposes. The misuse of alcohol
and other drugs is a common occurrence and can lead to a life threatening
situation. This is even more likely if more than one drug has been used in the
same period of time e.g. alcohol and benzodiazepines or cannabis and heroin.
Signs and symptoms of substance misuse can vary depending on the person, the
type and amount taken and the situation it was taken in. Signs and symptoms of
overdose will vary widely but some general guidelines are noted below.
Depressant drugs such as alcohol, benzodiazepines, inhalants,
gamma hydroxybutyrate (GHB) and opiates (e.g. heroin) can cause the
person’s heart rate and breathing to slow down, and may progress to
unconsciousness and death.
Stimulant drugs such as cocaine, ice (crystal meth), speed and ecstasy
can cause extreme anxiety, aggression, heart palpitations, headaches,
dizziness, blurred vision. Overdose can cause breathing problems,
extreme agitation, collapse, seizure, heart failure and death.
Hallucinogenic drugs such as LSD and psilocybin (magic mushrooms) can
cause hallucinations, paranoia, disorientation, nausea and dizziness, increased
body temperature alternating with cold and chills, anxiety and panic.
Manage Illness

Changes in behaviour DRS ABCD
(withdrawal, aggression, panic, Any reduced consciousness,
agitation or hallucinations) place casualty into the
Altered consciousness recovery position and call
Disorientation Triple Zero (000)
Lack of coordination Closely monitor the casualty
Slurred speech Try to find out what was taken
Changes in pupil size Avoid giving advice
Seizures Provide reassurance
Slow, noisy breathing Encourage the casualty to get
Slow heart rate help
If the situation is life threatening or you are concerned about

someone’s safety call Triple Zero (000).
Alcohol Drug Information Service (ADIS) NSW 02 9361 8000 or 1800 422 599 (rural).
24 hour support, information, counselling and referral service.
See URL: http://yourroom.com.au/helplines/
88
1. What is anaphylaxis?
a. Type of rash b. Type of infection c. Severe seizure d. Severe allergic
reaction
2. What signs might you see in a young child having an asthma attack?
a. Hot dry skin b. Wheeze and cough c. Low temperature d. Finger spasms
3. What is the most important aspect of first aid for an asthma attack?
a. Assist with b. Give 5 back blows c. Gain the parent’s d. Place in the
medication consent recovery position
4. What should you do if a casualty does not improve after following the asthma first aid plan?
a. Start CPR b. Sit the casualty up c. Call Triple Zero (000) d. Treat for shock
5. What is the most important aspect of first aid for someone who has chest pain?
a. Start CPR b. Call Triple Zero (000) c. Treat for shock d. Attach an AED
6. What is the term used to describe low blood glucose levels?
a. Hyperthermia b. Hyperactive c. Hypoglycaemia d. Hypothermia
7. What signs might you see in a diabetic casualty who says they are having a ‘hypo’?
a. Weak and dizzy b. Muscle spasms c. Rapid breathing d. Chest tightness
8. What would you give a conscious casualty with low blood glucose levels?
a. Medication b. A sweet drink c. A spacer device d. Alcohol
Manage Illness
9. In what position would you manage an unconscious diabetic who is breathing?
a. Sitting up, leaning b. In the recovery c. Lying down on their d. Lying down, legs
forward position back elevated
10. Which of the following is a priority of first aid for a casualty during a generalised seizure?
a. Call Triple Zero (000) b. Sit the casualty up c. Restrain the casualty d. Protect from injury
11. In what position would you place someone who is feeling faint?
a. Lying down, legs b. In the recovery c. Sitting up, leaning d. Sitting upright
raised position forward
12. If a febrile convulsion lasted more than 5 minutes, what would you do?
a. Give a warm drink b. Give medication c. Call Triple Zero (000) d. Apply ice packs
13. What sign might you see in a casualty who is having a stroke?
a. Slurred speech b. Hot skin c. Reddened face d. Rapid eye movement
14. What would you do for a casualty who is having a stroke?
a. Clear the airway b. Call Triple Zero (000) c. Feel for a pulse d. Get an AED
15. What is the term used to describe rapid or over-breathing?
a. Hyperventilation b. Seizure c. Convulsions d. Paralysis
89
Supplement -
First Aid in the Education and
Care Setting
This section provides additional information for students or
workers who have responsibilities for infants and children, and
who are required to undertake specific training to provide first aid
in an education and care setting (such as centre-based and family
day care early childhood services).
Note: This supplement provides only key points on the provision of first aid
in the education and care setting within NSW. This information should be
read in conjunction with the entire TAFE NSW First Aid Textbook and other
relevant resources, workplace policies and procedures.
Key topics
Supplemental
How the industry is governed

Specific first aid regulations
First aid in the early childhood setting
Anaphylaxis and asthma
Further reading
90
How the industry is governed:
A snapshot
Australian Children’s Education and Care Quality Authority
(ACECQA)
ACECQA is an independent national authority which aims to educate and
inform the wider community on the importance of improving outcomes in
children’s education and care.
ACECQA guides the implementation of the National Quality Framework
(NQF) for Early Childhood Education and Care nationally and ensures
service delivery is in line with best practice across the country.
The NQF aims to provide consistent, high quality standards and legislation
for early childhood education and care. This includes long day care, family
day care, preschools, kindergartens, and outside school hours facilities in
Australia.
Education and Care Services National Regulations

National Regulations support the NQF legislation and provide detail on a
range of operational requirements for an education and care service.
Supplemental
91
Specific first aid regulations
See summaries of specific first aid NSW regulations below. For more
detailed and current information - refer to the online version of the
Education and Care Services National Regulations - available at
www.legislation.nsw.gov.au.
Regulation 87 Incident, injury, trauma and illness record

The incident, injury, trauma and illness record of a child being cared for
in an education and care service or by a family day care educator must
include:
casualty details
the name and age of the child
the circumstances leading to the incident, injury or trauma or the
relevant circumstances surrounding the child becoming ill and any
apparent symptoms
the time and date the incident occurred, or the apparent onset of the
illness.
actions taken
details of the action taken
any medication administered or first aid provided
any medical personnel contacted
details of any person who witnessed the incident, injury or trauma
the name of any person whom the education and care service notified
or attempted to notify
the time and date of the notifications or attempted notifications
the name and signature of the person making an entry in the record,
and the time and date that the entry was made.
Supplemental
This information must be recorded as soon as practicable, but no later than

24 hours after the occurrence.
Regulation 89 First aid kits

The approved provider of an education and care service, must ensure
that first aid kits are kept as outlined below:
an appropriate ratio of first aid kits to number of children & educators
the first aid kits must be suitably equipped
the first aid kits must be easily recognisable and readily accessible to
adults, taking into account the design of the education and care service
premises
92
In addition to Regulation 89 - it is considered best practice to regularly
check first aid kits to ensure that they are fully stocked and products are
within expiry. A mobile first aid kit should also be available for excursions or
field trips.
Regulation 136 First aid qualifications
The approved provider of a centre-based service must ensure that the

following persons are in attendance and immediately available in an
emergency:
at least one educator who holds a current approved first aid
qualification
at least one educator who has undertaken current approved
anaphylaxis management training
at least one educator who has undertaken current approved emergency
asthma management training.
The same person may hold one or more of the qualifications.
If children are being educated and cared for at service premises on the
site of a school, it is sufficient if the educators are in attendance at the
school site and immediately available in an emergency.
The approved provider of a family day care service must ensure that each
family day care educator and family day care educator assistant:
holds a current approved first aid qualification
has undertaken current approved anaphylaxis management training
has undertaken current approved emergency asthma management
training
Additional information regarding educator ratios and effective

supervision Supplemental
Education and care services must plan and allocate clear roles and
responsibilities of educators and staff. Services may plan to utilise support
staff, administrative staff and management staff that may be on the
premises to support in an emergency situation.
A child requiring first aid must not be left alone at
any time and will require constant support from
an educator. Other staff may take on the role of
contacting emergency services, accessing the first
aid kit or supporting staff who are supervising the
incident. See example educator ratios (on the next
page), and refer to your workplace policies and
procedures for more precise information.
93
Centre-based services [example educator to child ratios]
1:4 Birth to 24 months
1:5 Over 24 months and less than 36 months
1:10 Over 36 months up to an including preschool age
Family day care services [example educator to child ratios]
1:7 Birth to 13 years

With no more than four children preschool age or under,
including educator’s own children younger than 13 years
of age at the residence.
Meeting educator to child ratios does not automatically mean effective

supervision. For example, additional educators may be needed when going
on an excursion or when children are engaged in a water activity.
A number of factors must be considered when determining if supervision is
adequate, including:
the number, age and ability of children
the number and location of educators
each child’s current activity
areas where children are playing, in particular the visibility and accessibility
of these areas
risks in the environment and of experiences provided to children
the experience, knowledge and skill of each educator.
Supervision of children must be maintained during an emergency.
Supplemental
Educators may consider grouping children together to effectively supervise

and allow others to carry out their roles in assisting in the emergency.
Educators need to ensure children are in a safe environment, supporting
their physical and emotional needs and may need to supervise children in
area away from the emergency incident.
Educators need to give consideration to choice of play experiences,
choosing activities requiring low supervision, such as; story time, drawing,
and puzzles.
94
Regulation 168
Education and care service must have policies and procedures
The approved provider of an education and care service must ensure

that the service has in place policies and procedures that comply to
relevant standards. The policies and procedures most relevant to first
aid include:
health and safety, including matters relating to nutrition, food and
beverage, dietary requirements, sun protection, water safety, and the
administration of first aid.
incident, injury, trauma and illness procedures
dealing with infectious diseases
dealing with medical conditions in children
emergency and evacuation procedures
Regulation 97
Emergency and evacuation
procedures
The service must ensure that a risk
assessment is conducted to identify
potential emergencies that are relevant to
the service.
The emergency and evacuation
procedures must set out:
instructions for what must be done in
the event of an emergency
an emergency and evacuation floor plan
The emergency and evacuations procedures are to be rehearsed every
Supplemental
three months (and documented).
Key point: Adequate supervision of children must be maintained

during an emergency
95
Notification of serious incident
An approved provider must notify the regulatory authority of any serious

incident within 24 hours of the incident or the time that the person
becomes aware of the incident.
Regulation 12 defines a serious incident as:
the death of a child, while being educated or following an incident in a
early childhood setting
any incident involving serious injury or trauma to, or illness of, a child
for which urgent medical attention is required e.g. whooping cough,
broken limb, anaphylaxis reaction
any incident where the attendance of emergency services at the
education and care service premises was sought, or ought reasonably
to have been sought
any circumstance where a child being educated and cared for by an
education and care service
- appears to be missing or cannot be accounted for, or
- appears to have been taken or removed from the education
and care service premises in a manner that contravenes these
regulations or
- is mistakenly locked in or locked out of the education and care
service premises or any part of the premises.
For further information about notifying the regulatory authority; refer to:
Regulation 175
Prescribed information to be notified to Regulatory Authority
Regulation 176
Time to notify certain information to Regulatory Authority
Supplemental
Key point: The regulatory authority must be notified within 24 hours

of a serious incident or the time that the person becomes aware of the
incident. In NSW the regulatory authority is the NSW Early Childhood
Education and Care Directorate - Department of Education and
Communities.
96
First Aid in the Early Childhood Setting
Adults, children and infants have significant anatomical, physiological,
cognitive and psychological differences. These differences often have a
direct impact on the types, presentation, assessment and management of
injury or illness. Age, stage of development, prior experience and culture
also influence how children report and respond to injury or illness.
Young children and infants often lack the appropriate
judgement skills to recognise or avoid danger and may
not have the skills, knowledge or insight to identify,
communicate or self-manage their illness. Furthermore, the
way in which children socialise and explore, together with
their level of maturity will influence the types of injury or
illness they experience. For example, small children regularly
suffer falls, sporting and playground accidents, whereas
infants are more at risk of choking and airway obstruction.
Anatomical differences when compared with adults

The smaller size means that multiple organs can be injured in a single
impact.
Larger surface area to body mass ratio means greater heat loss.
Less total blood volume means that small amounts of blood loss may be
life threatening in small children.
The softer smaller airway and larger tongue places the infant’s airway
more at risk of obstruction and collapse if swollen or not positioned
correctly.
Nose breathing of infants means that a blocked nose can cause
respiratory distress. Supplemental
Bones are softer and more flexible but the skull is thinner and offers less
protection to the brain.
The chest wall is more compliant meaning that trauma to the chest may
not break ribs – but may cause serious damage to internal organs.
The abdominal wall is relatively thin and provides less protection to the
abdominal organs.
The higher metabolic rate means that children have greater oxygen
consumption and associated higher heart and breathing rates.
97
Vital signs by age group
The table below highlights that in general, the younger the child the higher
the heart rate and breathing pattern. While not essential to memorise it is
useful to understand what is considered a ‘normal’ heart and respiratory
rate across the age groups.
Vital sign Adult Child Infant
Heart beats
60 - 100 80 -150 100 - 160
per minute
Breaths per
15 - 20 20 - 35 30 - 50
minute
Note that individual rates vary greatly, particularly in younger children.
Key point: It is important to remember that the basic principles of

DRS ABCD remain the same regardless of the casualty’s age.
Basic Life Support and the differences between age

groups
Differences in basic life support for adults, children and infants simply reflect
the anatomical differences in these age groups. For example; their relatively
smaller lung capacity and chest depth, and the infant’s higher risk of airway
obstruction.
Supplemental
98
Basic Life Support and the differences between age groups
Adults and children Infants <12 months

AIRWAY
head tilt and chin lift neutral position

BREATHS
mouth to mouth / pinch nose mouth over infant’s mouth and nose
normal breath smaller breaths or cheek puffs
COMPRESSIONS
Supplemental
Xiphoid process Sternum (lower half)
1 or 2 hands over centre of Use 2 fingers over centre of

chest chest
Depth of compression: Depth of compression:
One third of chest depth One third of chest depth
99
Adult
Standard adult pad placement

DEFIBRILLATION – AED use and pad placement
Infant/Child
Wherever available an AED with
paediatric pads (smaller in size)
and paediatric AED settings
should be used.
Attach the pads as per the

manufacturer’s instructions.
If paediatric pads are not

available use standard adult
pads ensuring that the pads
do not touch each other on the
child’s chest.
If the pads are too large place
one pad on the upper back
(between the shoulder blades)
and the other pad on the
front of the chest and
slightly to the left.
Supplemental
RATIOS
Ratios remain the same for all age groups

30 compressions followed by 2 breaths
RATE
100 to 120 compressions per minute
100
Communication and emotional support
Communicating clearly with children and supporting their emotional needs
during and after emergency is an essential part of first aid care. Depending
on a child’s age, stage of development and individual responses, the
following actions may be appropriate:
providing reassurance and comfort
giving age-appropriate factual information
discussing with the children the event and their responses
discussing feelings and emotional responses
allowing others time to listen and process
being considerate to change in children’s mood, behaviour and
communication.
Non-accidental injuries
Suspicion of a non-accidental injury may be aroused by:
inconsistencies in the information provided by parents/guardians and child
where the nature of the injuries does not seem to fit with the type of
incident reported.
Note: While workplace guidelines, advice from supervisors and

mandatory reporting requirements should provide guidance in such
cases, any need for immediate first aid or medical care of the child
should take priority.
Further reading
Asthma Australia www.asthmaaustralia.org.au

Australasian Society of Clinical Immunology and Allergy
Supplemental
www.allergy.org.au
Australian Children’s Education and Care Quality Authority
www.acecqa.gov.au
Education and Care Services National Regulations
www.legislation.nsw.gov.au
101
Anaphylaxis and Asthma
The following information provides additional considerations for staff
that care for children with anaphylaxis and/or asthma. This information
is a summary only and must be read in conjunction with the first aid
management of allergies, anaphylaxis and asthma, local workplace
guidelines, health care instructions, and any individualised Action Plans for
the specific child.
Parents/guardians, service providers and staff all have responsibilities in the
care of children with anaphylaxis and/or asthma. These key responsibilities
are highlighted below.
Parent/guardian responsibilities include:
provide appropriate information about the medical needs of the child
notify the service of any change to the child’s medical condition or care
provide an individualised Action Plan completed by a doctor
provide medication that is indicated on the child’s Action Plan
label the child’s name on any medication or administration devices
ensure medication is in date and replaced as required
complete any necessary authorisations or documentation for the service.
Service provider and/or staff responsibilities include:
staff have good knowledge of the relevant workplace guidelines
understand the responsibilities of the service, staff and parents/guardians
ensure staff have undertaken appropriate and accredited training
know which children are at risk of anaphylaxis and/or have asthma
be familiar with the child’s health care and individualised Action Plans
display Action Plans and first aid information in appropriate areas
good understanding of the child’s normal response to illness
know how to recognise anaphylaxis and asthma
Supplemental
ensure availability and know where to locate first aid resources including:
- first aid kits and asthma emergency kit
- personal and general use blue-grey reliever medication
- personal and single use spacer devices (and masks)
- personal and general use adrenaline autoinjectors
- generic and individualised Action Plans
102
ensure first aid resources and individualised action plans are available on
all field trips
ensure staff with appropriate training are present on all field trips
have a planned emergency response (especially when on field trips)
regularly conduct appropriate risk assessment of environment and activity
develop risk minimisation plan in consultation with parents
ensure parents are notified of any known allerges that pose a risk
ensure practices and procedures for the safe handling, preparation,
consumption and service of food are developed and implemented
ensure safety by minimising exposure to known allergens or triggers.
Anaphylaxis and minimising exposure to known allergens

In most cases, anaphylactic reactions can be prevented with good risk
minimisation strategies. This includes age appropriate education of the child
(and their peers) on how to avoid known allergens, and informing all staff
and parents of known allergies.
Example risk minimisation strategies
Each service should undertake a thorough and formalised process for
identifying and minimising risk of exposure to known allergens. The following
table provides only a few common examples of risk management strategies.
Food allergies - example risk minimisation strategies
implement age appropriate avoidance strategies for meal times, art

and craft, special occasions (parties and celebrations) and field trips
food to be eaten in a specified and well supervised area
all children aware of the importance of not sharing food or utensils
food preparation staff are well trained on appropriate food handling,
preparation and storage, and to keep surfaces clean to prevent Supplemental
contamination
parents/guardians to provide specifically prepared food
good consultation with parents/guardians when planning menus
identify foods that contain or are likely to contain known allergen and
replace with other suitable foods
consider non-food rewards.
103
Insect sting allergies - example risk minimisation strategies
decrease number of plants that attract stinging insects and ticks

look for and remove insect nests
identify areas with the least risk and encourage play in these areas
ensure children wear appropriate clothing and shoes when outdoors
keep lids on garbage bins
do not leave food, drinks or drink bottles exposed in the outdoor area
educate children not to drink from open drink containers.
Latex allergies - example risk minimisation strategies
avoid contact with party balloons and latex gloves

Supplemental
104
Anayphylaxis: frequently asked questions
What does Adrenaline is a natural hormone which rapidly

adrenaline do? reverses the effects of a severe allergic reaction
by reducing throat swelling, opening the
airways, and maintaining blood pressure.
How long does it Signs of improvement should be seen rapidly,

take? usually within a few minutes.
How many doses If there is no improvement, or the symptoms are

do I administer? getting worse, then another injection may be
administered 5 minutes after giving the previous
dose.
If I am not Anyone (trained or not) should administer the

confident or adrenaline autoinjector in an emergency.
unsure, should Auto injectors are designed to be used by anyone.
I still give the The needle is thin and short (14 mm) so damage to
injection? nerves and blood vessels is minimal.
When it is suspected that a person is having an
anaphylactic reaction, withholding the injection
when unsure can be much more harmful than
giving it when it may not have been necessary.
Can I administer No. An adrenaline autoinjector should not be

an autoinjector administered to a child less than 12 months of
to an infant (<12 age.
months)?
Supplemental
Call Triple Zero (000) and if required, administer
basic life support.
What if the child If the child is known to be at risk of anaphylaxis

also appears and you are unsure if they are experiencing
to be having anaphylaxis or severe asthma:
symptoms of give the autoinjector first
asthma? then give asthma reliever medication
call Triple Zero (000)
follow the Anaphylaxis Action Plan
continue asthma first aid
105
Good asthma management
The aim of good asthma management is to ensure that the child with
asthma can enjoy a range of activities and take only as much medication
as is needed to stay well and avoid asthma attacks. Education and care
staff have a responsibility to support, encourage and monitor good asthma
management.
Preventing asthma attacks

The best way to reduce the risk of a severe asthma attack is to treat the
underlying airway inflammation with medication. Ensuring that the child
follows their Asthma Action Plan (including use of preventer medication),
and early detection and management of any asthma symptoms is essential
to reducing the risk of a severe asthma attack.
All services should establish a process for minimising exposure to known
asthma triggers (although for most children with asthma, triggers are only
a problem when their asthma is not well controlled). Some examples of
strategies that aim to help reduce the risk of exposure to known triggers
include:
alerting staff and parents to any renovations (use of paint or adhesive)
avoiding use of aerosols, incense or other products with strong odours
avoiding contact with cigarette smoke
ensuring children play inside when dust, mould or pollen is in abundance.
Exercise and asthma
Children with well controlled asthma should be able to participate in normal
activities and almost any sport or exercise. NOTE: It is important for staff
to ensure that any child with an Asthma Action Plan indicating that asthma
medication is required BEFORE exercise or play receives their medication.
Supplemental
106
First aid
If a child develops asthma symptoms while exercising or

playing:
stop the child from all activity
start asthma first aid (follow their Asthma Action Plan)
return to exercise ONLY if breathing easily and free of asthma
symptoms.
If symptoms do not go away or return when resuming activity:

stop all activity
repeat asthma first aid
DO NOT allow any more exercise for that day
document the situation and inform the parents
Key point: Service providers and staff have a duty of care to take
reasonable steps to keep children safe. This includes minimising known
risks, providing appropriate first aid, and when necessary, administering
emergency medication such as adrenaline autoinjectors or asthma
reliever medication.
All injuries or illnesses and their management need to be reported and
documented and conveyed to the parent/guardian.
Administration of medication
Supplemental
The National Regulations require authorisation from a parent (or other
person authorised) to consent to administration of medical attention,
however, in the case of an anaphylaxis or asthma emergency,
medication may be administered to a child without authorisation. In
this circumstance, the child’s parent and emergency services must be
contacted as soon as possible.
107
Asthma: frequently asked questions
What can trigger Common triggers include colds, flu,

asthma? cigarette smoke, exercise, pollens, dust
mites, stress and changes in weather
conditions.
How quickly can It can develop slowly over a few days, or

an asthma attack rapidly (within minutes).
develop?
Which puffer will Blue-grey puffers are known as relievers.

help during an The most common blue-grey puffer is
asthma attack? Ventolin or Salbutamol.
Should I use a Yes, a spacer device helps improve the

spacer device? percentage of medication taken.
Should our centre Yes. An asthma emergency first aid kit

have an asthma should be available for when a child has
emergency kit difficulty breathing, a child has a first
available? attack of asthma, or for when a child’s
own asthma reliever puffer is unavailable,
expired or empty. All staff should be aware
of how to administer asthma first aid.
What’s in an asthma Each kit should contain (at a minimum):

emergency kit? a blue-grey reliever puffer
single-use spacer devices
Supplemental
a mask to use with a spacer device for

under 5’s
asthma first aid information
What if a child Provide asthma first aid and contact

appears to be having parents.
an asthma attack If the child’s condition suddenly deteriorates
but doesn’t have an call an ambulance immediately. In an
asthma management emergency the blue reliever puffer can be
plan? accessed from the asthma emergency kit,
or borrowed from another child.
108
Supplemental
109
Further Information
In this section you will find further information to assist you in your
study of first aid. This includes; activity answers, further reading,
a glossary, an index, credits and acknowledgements.
Key topics
Activity answers
Further reading
Glossary
Index
Acknowledgements
110
Activity Answers
Introduction to first aid
1. b 2. a 3. d 4. c 5. b 6. d 7. c 8. d
9. a 10. c 11. d 12. a 13. b 14. c 15. b
Basic Life Support

1. a 2. c 3. d 4. a 5. c 6. b 7. d 8. c
9. d 10. a 11. d 12. b 13. c 14. b 15. c
Manage injury
1. b 2. a 3. d 4. d 5. c 6. b 7. c 8. d
9. b 10. d 11. a 12. c 13. a 14. b 15. c
Manage illness
1. d 2. b 3. a 4. c 5. b 6. c 7. a 8. b
9. b 10. d 11. a 12. c 13. a 14. b 15. a
Further Reading
Ambulance Service of NSW Heart Foundation
www.ambulance.nsw.gov.au www.heartfoundation.org.au
Asthma Australia Mental Health First Aid
www.asthmaaustralia.org.au www.mhfa.com.au
Australian Museum National Stroke Foundation
www.australianmuseum.net.au www.strokefoundation.org.au
Australian Resuscitation NSW Health
Council www.health.nsw.gov.au
www.resus.org.au SANE Australia
Diabetes Australia www.sane.org
www.diabetesaustralia.com.au Triple Zero (000)
Epilepsy Australia www.triplezero.gov.au
www.epilepsyaustralia.net SafeWork NSW
Healthdirect Australia www.safework.nsw.gov.au
www.healthdirect.gov.au
111
Glossary
AED Automated External Defibrillation
Antivenom Medication to treat or reverse poisons from animal bites or stings
Asphyxia Lack of oxygen in the blood as a result of interruptions in breathing
An easy to use medical device that delivers a single fixed dose of a
Autoinjector
medication, for example adrenaline
BLS Basic Life Support
Bystanders People at the accident site
Cardiac Relating to the heart
Casualty The injured or ill person
Circulation The distribution of blood around the human body
The application of physical force on the chest wall to compress the
Compressions
heart in CPR
Conscious A state of being mentally alert and awake
CPR Cardiopulmonary Resuscitation
The act of applying an electrical shock across the heart in an attempt
Defibrillation
to help the heart regain a normal rhythm
The letters of the DRS ABCD action plan stand for – Danger,
DRS ABCD
Response, Send for help, Airway, Breathing, CPR and Defibrillation
Dressing A pad or bandage that is applied to cover a wound
To raise or heighten (usually referring to raising part of the body
Elevation
above the level of the heart)
Envenomation Bite or sting from a poisonous animal
First aider/ First
Someone who is trained to administer first aid.
aid provider
Frothing Foamy air filled discharge, usually coming from the mouth
Hyperthermia High body temperature
Hypoglycaemia Too little glucose (sugar) in the blood
Hypothermia Low body temperature
A compact/foldable mask which offers protection for the rescuer
Pocket mask
when delivering rescue breaths
PPE Personal Protective Equipment
The act of providing emotional support, as well as providing
Reassurance
information that is comforting and builds trust
The involuntary movement of food or fluid from the stomach back to
Regurgitation
the mouth and/or nose
Respiratory Relating to the lungs and/or breathing
A life threatening condition that results from a loss of blood flow to
Shock
vital organs
Physical characteristics of the injury or the illness that you can see,
Signs
feel or hear. For example: bleeding, hot skin or wheezing
Characteristics of the injury or illness that are felt by the casualty. For
Symptoms
example: pain, headache or numbness
Unconscious Lacking awareness or alertness; not conscious
WHS Work Health and Safety
112
Index
A Cold injuries 69
Abdominal Injuries (see internal Cone shell 52
bleeding) 54 CPR 30-33
Activity answers 111 Crush injury 61
AED 34–36 Cultural awareness 8
Airway 27–28
Airway obstructiion 37 D
Allergic reactions 75-77 Danger 26
Amputation 56 Defibrillation 34–36, 100
Anaphylaxis 76–77 Diabetes 82
action plan 77 Drowning 39
in child care 102–105 DRS ABCD action plan 25
Asphyxia 37
Asthma 78–80
E
Ear injuries 57
in child care 102, 106–108
Embedded object 58
Automated External Difibrillator
Emergency phone numbers
34–36, 100
inside cover, 14
B Eye injuries 57–58
Basic Life Support (BLS) 23–40
Basic wound care 56
F
Fainting 85
Bee sting 47
First aid kits 20
Bites and stings 44–52
Fish stings 49
Bleeding and wounds 53
Food allergy 75, 103
Blue-ringed octopus 52
Fractures 63–64
Box jellyfish 50–51
Frostbite 70
Breathing 29, 32-33
Funnel-web spider 46
Burns 59–61
C H
Head neck & spinal injuries 65–67
Calling Triple Zero (000) 14-15
Heat & cold injuries 68–70
Cardiopulmonary resuscitation 30-33
Heat exhaustion 68
Chain of survival 24
Heatstroke 68
Chest injuries 62
Hyperthermia 68
Chest pain 81
Hyperventilation 85
Choking 37–38
Hypothermia 70
113
Index
I S
Injury/ illness record Secondary assessment 16
17, 19, 92, 95-96 Seizures 83–84
Insect allergy 47-48, 75, 104 Self assessment 21, 41, 73, 89
Insect bites & stings 47–48 Sending for help 14-15, 27
Internal bleeding 54 Shock 72
Snake bites 45
J Soft tissue injuries 64
Jellyfish stings 50–51
Spider bites 46–47
L Spinal injuries 65–67
Latex allergy 75, 104 Sprains, strains & dislocations 64
Legal issues 7 Standard precautions 10
Stroke 87
M Substance misuse 88
Marine animal bites & stings 49–52
Medication 9 T
Mental health crisis 86 Tick bite 48
Moving the casualty 11 Triple Zero (000) 14, 27
with neck/spinal injuries 67
U
N Unconscious 40
Nose bleed 54
W
P Wasp sting 47
PIT 44–45 Wounds 53–58
Poisoning 71–72
Pressure Immobilisation Technique
44–45
R
Recovery position 40
Redback spider 46
Regulations 92-96
Rescue breaths 29, 32–33
Response 26
R.I.C.E. 65
114
Photograph Credits
Photographs sourced from the Australian Museum
Blue Mountains Funnel-web, Hadronyche cerberea

Mike Gray © Australian Museum [see page 46]
Bull ant, Myrmecia sp., from the Royal National Park
Andrew Donnelly © Australian Museum [see page 47]
Cicada-killer wasp, genus Exeirus
Honey Bee, Apis mellifera
Redback Spider, Latrodectus hasselti, female
Mike Gray © Australian Museum [see page 46]
Photographs sourced from Wikimedia Commons and licenced under Creative Commons
attribution – Share Alike licence. A copy of this licence is available at http://creativecommons.
org/licenses/by-sa/2.5/au/deed.en
Box Jellyfish by Guido Gautsch [see page 50]

http://commons.wikimedia.org/wiki/File:Avispa_marina.jpg
Cone Shell by Didier Descouen [see page 52]
http://commons.wikimedia.org/wiki/File:Cone_g%C3%A9ographique.jpg
Embedded Object – ‘Knee Puncture’ by James Heilman, MD [see page 55]
http://en.wikipedia.org/wiki/File:Knee_puncture.JPG
Laceration by ClockFace [see page 55]
http://en.wikipedia.org/wiki/File:Laceration,_leg.jpg
Puncture Wound by James Heilman, MD [see page 55]
http://en.wikipedia.org/wiki/File:Knee_puncture.JPG
Photographs sourced from Wikimedia Commons
Deep Abrasion by Sadeq Rahimi 2007 [see page 55]

Sourced from Wikimedia Commons, http://en.wikipedia.org/wiki/File:Abrasion.jpg
Photographs used under licence
Eastern Brown Snake, Pseudonaja textilis

Australiannature.com © Pavel German [see page 45]
Blue-ringed octopus, Hapalochlaena maculosa
David B Fleetham © Photolibrary [see page 52]
Photographs sourced from National Oceanic and Atmospheric Administration (used in

accordance with information policy of that organisation)
Bluebottle jellyfish © US National Oceanic and Atmospheric Administration [see page 51]
http://oceanexplorer.noaa.gov/explorations/02sab/logs/aug15/media/man_o_war_600.jpg
115
Emergency Phone Numbers
13 11 26
Local hospital
Local doctor
Dentist
Community pharmacy
After hours pharmacy
Disclaimer
This textbook has been designed to assist learners who are studying First Aid through TAFE NSW. This
Any attempt at resuscitation textbook is an information resource only and should be studied in conjunction with, or in preparation for
attendance at practical teaching and learning sessions. This book does not replace valuable learning that
is better than no attempt at all. takes place within a classroom setting where you will be given the opportunity to practice the skills of Basic
Life Support and First Aid management of injuries and illnesses.
The information contained within this textbook relates to the current accepted First Aid practices in Australia
at the time of publication. TAFE NSW follows the guidelines and recommendations of the Australian
Resuscitation Council, Safe Work Australia, WorkCover NSW and the Health Training Package when
designing course materials to support first aid training and assessment.
Whilst every effort has been made to ensure that the information is accurate at the time of publication,
TAFE NSW, the writers, the reviewers and the contributors are not responsible for any loss, liability,
damage or injury that may be suffered or incurred by any persons in connection with the information
contained in this textbook.

First Aid
Textbook 9th Edition
This textbook provides the reader with the underpinning knowledge
of first aid and casualty management procedures. This textbook is an
excellent first aid reference book for every household, workplace,
vehicle and first aid kit.
TAFE NSW offers a range of First Aid courses that meet the requirements
of the national Health Training Package first aid units of competency.
For more information about TAFE NSW First Aid courses, contact
the course Information office at a local TAFE Campus or go to the
TAFE NSW website.
Learn how to save a life

Enrol in a TAFE NSW First Aid course now
www.tafensw.edu.au TAFE NSW
First Aid Textbook 9th Edition
To order further copies of this textbook,

go to www.vetres.net.au or visit your local
TAFE NSW college bookshop
VETRES Product code: 6018 9 781742 365374

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First Aid

Textbook 9th Edition

Learn how to save a life

To order further copies of this textbook,

After hours pharmacy

Image © European Resuscitation Council – www.erc.edu – 2011/044

R Check for a Response

S Call 000 Send for help

A Open the Airway

B Check for Breathing

C Commence CPR 30:2

Give 30 compressions followed by 2 rescue breaths.

D Attach a Defibrillator (AED*)

Continue CPR until the casualty responds or normal breathing returns.

Title: First Aid Textbook

About this resource Instructions for TAFE

AED Automated External Defibrillation.

BLS Basic Life Support.

Bystanders People at the accident site.

Casualty The injured or ill person.

CPR Cardiopulmonary Resuscitation.

Danger, response, send for help, airway, breathing, CPR and

Emergency Services Police, Fire or Ambulance services.

The immediate treatment or care given to a person suffering

The act of providing emotional support, as well as providing

Characteristics of an injury or illness that you can see, feel or

Characteristics of an injury or illness that are felt by the

Basic Life Support 23

Further Information 110

The Australian Resuscitation Council (ARC) represents all major groups

Safe Work Australia leads the development of national policy to improve

Introduction to First Aid

Introduction to First Aid

Own skills and limitations

Offering reassurance Reporting and recording

Taking care of yourself and others

Tips for taking care of yourself and others

Exposure to blood and other body substances

Do not remove motorbike helmets unless for life saving measures.

Casualty Management Overview

*Note: In some circumstances it may not be appropriate to clean an

Assessment of the scene

2. Prioritise – the DRS ABCD action plan

3. Sending for help  calling Triple Zero (000)

Triple Zero example questions

When calling Triple Zero (000) make sure that you:

Do not hang up the phone until directed to do so.

Children and Triple Zero (000)

For more information visit the Triple Zero website at www.triplezero.gov.au

Alternative ways to send for help Calling 112

Voice over Internet Protocol

People who do not speak English

People who have a hearing or speech impairment

4. Secondary survey assessment

Examples of signs or symptoms for each body region

Head and face  Changes in skin colour

Neck  Artificial airway (stoma)

Chest  Noisy breathing

Abdomen and  Hard stomach muscles

Arms and legs  Medical alert bracelet

Back and spine  Tingling sensations

In addition, look for the following general signs and symptoms

Caution If a neck, back or spinal injury is suspected do not

Head and face Changes in skin colour

Neck Artificial airway (stoma)

Chest Noisy breathing

Abdomen and Hard stomach muscles

Arms and legs Medical alert bracelet

Back and spine Tingling sensations

Place one hand on the forehead.

Place one hand on the forehead.

Support the head in a neutral position

2 hands over the centre of the chest

1 or 2 hands over the centre of the chest

2 fingers over the centre of the chest