118

APPENDIX 1
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APPENDIX 2
 121

APPENDIX 3

LIST OF EXPERTS FOR CONTENT VALITY

1. Prof. Dr. Vijayalakshmi, Msc(N), PhD(N)

Vice principal,
HOD of pediatric nursing department,
KG College of Nursing.
Coimbatore.
2. Prof. Dr.Jeyabharathi, Msc(N), Ph.D(N)
HOD of pediatric nursing department,
PPG College of Nursing.
Coimbatore.
3. Prof. Dr.Lissy, Msc(N), PhD(N)
Pediatric nursing department,
Jem College of Nursing.
Coimbatore.
4. Dr, Senthikumar, MD
Consulting pediatrician,
Masonic hospital for children,
Coimbatore.
5. Dr, Asoke Kumar, MD
Consulting pediatrician,
Ashwin hospital,
Coimbatore.
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APPENDIX 4

PART - A

DEMOGRAPHIC DATA

Instructions

Kindly go through each item of the questionnaire carefully and

indicate your response by placing a () tick mark in the box given.

Sample Number ____________________

1. Age in years

a. 20-30 years

b. 31-40 years

c. > 41 years

2. Sex

a. Male

b. Female

3. Educational Qualification

c. Undergraduate

d. Post graduate

4. Type of college

e. Women

f. Co education
 123

5. Religion

a) Hindu

b) Christian

c) Muslim

6.. Area of the residence

a. Urban

b. Rural

7. Source of information

a. no source

b. mass Media

C.Friends and family

D.health Professional

8. Presence of first aid box in your house

a. yes

b. No
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PART-B

KNOWLEDGE QUESTIONNAIRE

Instructions

Kindly go through each item of the questionnaire carefully and

indicate your response by placing a (√) tick mark in the given box

General

1. What you mean by first aid?

a) Initial and temporary treatment

b) Treatment given after specific time

c) Seeking for medical advice

d) Treatment given after birth

2. What is the main aim of first aid?

a) To promote health

b) To preserve life

c) To alleviate the suffering

d) To terminate medical acceptance

3. Who is a first aider?

a) Only doctors

b) Only nurses

c) Medical professionals only

d) Any person witnessing the accident

4. Which is the quality of a first aider?

a) One who is willing to provide selected first aid

b) One who acts hurrily

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c) One who is able to act quickly and reliable

d) Those who gives first aid for sake of responsibilities rendered

5. if first aid treatment is required you should

a) Gain consent before commencing treatment

b) Start treatment immediately. A first aid certificate gives you automatic

right to treat. anyone

c) Not talk to the causality because it may make you lose concentration.

d) Insist on providing treatment even if the casualty does not want to touch you.

6. What are the key steps in first aid?

a) Airway, breathing

b) Circulation

c) defibrillation

d) All of the above

7. Which is not including in assessing the emergency?

a) Age

b) Hazards

c) Causalities

d) Location

8. After providing first aid while waiting for the ambulance to arrive you should?

a) Make the casualty comfortable, monitor them and response to changeto

their condition until help arrive

b) Make them comfortable and leave them alone to wait for the ambulance

c) Not to anything else

d) Go and get lunch, they may take a while.

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9. Which is not included in first aid kit?

a) First aid guide

b) Aspirin tablet

c) Nebulizer

d) Fingertip fabric bandage

10. First aid for school children is needed in

a) School

b) Home

c) Out door

d) All of the above

Wound and Hemorrhages

11. What is a wound?

a) Skin and underlying tissue are torn

b) Redness of skin

c) Breakage of bone

d) Pain over the skin

12. How will you treat a wound immediately?

a) Washing with running water

b) Applying tea or coffee powder

c) Applying turmeric

d) Seek medical help

13. What is the immediate danger of wound?

a) Pain

b) Bleeding
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c) Infection

d) Fever

14. If there is a foreign body present in the wound and it bleeds, what should
you do?

a) Remove the foreign body

b) Don not remove the foreign body

c) Seal the wound with dressing

d) Seek medical advice

15 .What do you mean by hemorrhage?

a) It isa condition of loss of consciousness

b) It is a superficial injury

c) It is the redness of the skin

d) It is the presence of foreign body

16. What should be done if the child is having a high degree of hemorrhage?

a) Place child in supine position

b) Immobilizing the part

c) Apply pressure to control bleeding

d) Seeking medical advice

17. What is the treatment given to the child with a hemorrhage?

a) Making the child in a comfortable position

b) Removing the foreign body

c) Lifting the affected part

d) Application of sterile dress

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18. How many minutes you will apply pressure for a child with hemorrhage?

a) 5-15 minutes

b) 15-30 minutes

c) 60 minutes

d) Don’t apply pressure

19. What will you do if you find the hemorrhage have been stopped?

a) Removal of foreign bodies

b) Cleaning the wound thoroughly in water

c) Attempt to bleed

d) Application of antiseptic cream with sterile dressing

20. What is the complication of uncontrolled bleeding?

a) Shock and death

b) Nausea and vomiting

c) Pain and swelling

d) Infection

Fracture, Sprains and dislocation

21. What do you mean by sprain?

a) Injury to the joint.

b) Injury to the bone

c) Injury to the ligament and a joint.

d) Injury to the blood vessels around the joint.

22. How will you treat a child with sprain?

a) Moving the joint and assessing pain.

b) Massaging the swollen part.

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c) Elevating the part.

d) Padding inn well and applying bandages.

23. What do you mean by dislocation?

a) A bone has been dislodged from the joint.

b) Disruption of a single bone.

c) Fracture of a bone.

d) Redness over the joint.

24. What should be avoided in a child with dislocation?

a) Attempting to put the bone back in normal position.

b) Treating a fracture if fractured.

c) Bandaging the injured part.

d) Taking child to a doctor.

25. What do you mean by facture?

a) Injury to the ligament around the bone.

b) Break in the continuity of the bone.

c) Redness over the bone.

d) Bruising of the bone.

26. Which of the following is very useful for sprains?

a) Cold application

b) Hot application

c) Apply direct pressure

d) None of the above

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27. What should be done first when a child falls and you doubt that there can be
a fracture on leg?

a) Make child cry.

b) Seek medical help.

c) Provide medications.

d) Apply support on injured leg.

28. How will you diagnose a child with fracture?

a) Continuous cry of the child.

b) Assessing the height of fall.

c) Loss of consciousness of child.

d) Swelling at the site of the fracture.

29. What do you mean by splint?

a) A device which improves mobilization.

b) A device that induces sleep.

c) A device that prevents mobilization.

d) A device that provides heat.

30. What should be avoided in case of fracture?

a) Treating shock, unconsciousness.

b) Mobilizing the child to another place.

c) Immobilizing the fractures limb with splints.

d) Not raising the injured part.

Epistaxis

31. What do you mean by epistaxis?

a) Bleeding from mouth.

b) Bleeding from ear.

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c) Bleeding from nose.

d) Bleeding from wound.

32. What are the causes of epistaxis in children?

a) Sneezing.

b) Vomiting.

c) Rupture of mucous membrane.

d) Exposure to sunlight.

33. What is the position preferred for the child with epistaxis?

a) Supine position with slight turning of head to a side.

b) Sitting position with head tilted slightly forward.

c) Prone position with extremities elevated.

d) Side lying position with head end elevated.

34. What would be advised to the child with epistaxis?

a) To breath through nose.

b) To breath through mouth.

c) To plug the nose.

d) Do not breath.

35. Why do we apply ice pack to root of nose in children with epistaxis?

a) To reduce bleeding.

b) To divert the attention of child.

c) To provide chillness.

d) To initiate bleeding.
 132

36. What should be done for the blood from the nose?

a) Allow to drip into bowl.

b) Plug inside.

c) Don’t allow to drain.

d) Close the nose.

37. What should not be allowed by the child?

a) Blow the nose.

b) Breath through nose.

c) Breath through the mouth.

d) Spitting the oral secretions.

38. What should be done to the clothing of the child?

a) Loosen tight clothing around neck.

b) Loosen clothing in the extremities.

c) Don’t disturb the clothing.

d) Remove the clothing.

39. Which fingers are used to pinch the nose?

a) Both the right and left thumb.

b) Thumb and forefinger.

c) Both middle fingers.

d) All the five fingers.

40. For anterior nasal bleeding what is the first aid management to arrest
bleeding?

a) To plug the nose with cotton

b) To pinch the anterior nostrils together

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c) Hot application

d) Clean the nostrils with water

Epilepsy

41. What do you mean by epilepsy

a) A sudden involuntary contraction of muscle group

b) A physical disorder

c) A deficiency disorder

d) A psychological disorder

42. How will you recognize the onset of convulsions?

a) Laughing

b) Muscle relaxation

c) Closing of eyes

d) Muscle contraction

43. What are the causes of convulsions?

a) Diarrhea

b) Vomiting

c) Injury to brain

d) Juvenile diabetes

44. What are the symptoms after convulsion episode?

a) Loss of consciousness

b) Memory loss

c) Hemorrhage

d) Changes in facial expression

 134

45. What are the precautions to be taken to avoid injury to child with
convulsions?

a) Taking off side rails

b) Restricting the movements

c) Stay away from the child.

d) Remove sharp objects nearby.

46. What are the precipitating factors to be avoided for child with convulsions?

a) Avoid acidic drinks

b) Avoid junk foods

c) Avoid loud noises

d) Avoid playing

47. How the child is prevented from aspiration during convulsion?

a) Side lying position with head turned to one side

b) Supine position

c) Prone position

d) Sitting position

48. How the child is protected from tongue bite during convulsion?

a) Placing the child in side lying position

b) Opening the mouth of child

c) Placing the wooden piece or clothes in between the teeth

d) Holding the tongue

49. What is the importance of giving care after convulsion?

a) To prevent vomiting

b) To prevent hemorrhage
 135

c) To prevent recurrent attacks

d) To prevent tongue bite

50. What are the don’ts to be followed after convulsion?

a) Do not care the precipitating factors

b) Do not keep pillow under head

c) Do not go for follow up

d) Do not check for precautions

 141

 describe sprains and dislocation and its first aid management

 enumerate fracture and its first aid management
 explain about epistaxis and its first aid management
 describe epilepsy and its first aid management

Specific Content Teachers

Objectives Activity
Introduction
Human life is very precious. Life is more than just your body L
and mind. Science cannot even begin to comprehend where E
life begins and ends. Accidents and injuries occur in most C
facilities on almost a daily basis. They involve everything from T
minor cuts and scrapes to broken bones, chemical burns and U
other serious injuries. Human being can prolong a life by using R
preventing and safety measures. In the life saving measures, I
first aid places a major role. First aid is the provision of initial N
care for an illness or injury. It is usually performed by a lay G
person to a sick or injured casualty. However once an injury
does occur knowing what to do, and being able to react
quickly, can limit the severity of the injury, or even prevent a
death. This is what first aid is all about.
Define First Definition
aid First aid is the initial temporary and immediate treatment
given to a person who is injured or suddenly becomes ill,
using facilities available at that time and place, before
regular medical help can be imparted.
- (Kusum Samant, 2000)
First aid is the provision of initial care for an illness or
injury which is usually performed by a lay person to a sick
or injured casualty until definite medical treatment can be
accessed.
- (www.wikipedia.com)
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Specific Content Teachers

Objectives Activity
Tell the Meaning
meaning of First aid is the initial care with certain steps and a few tips
First aid that can be implemented at home or incident spot or on L
way for consulting the physician. E
Enumerate Importance C
the St. John Ambulance Association believes in training T
importance medical and non medical professionals for the first aid. If U
of First aid first aid is given within 2hrs, we can save the precious R
human life. Today’s children are tomorrows citizen. I
Children’s should be handled in proper care because they N
are the prone group for accident and children spent G
significant proportion of a day in the school. Teachers are
one of the care takers and role models for the students.
List down Principles
the The key principle taught in almost all systems is that the
principles of rescuer be they a lay person or a professional, should
First aid assess the situation for DANGER.
Principles for assessing the emergency includes: L
C- casualties E
H- hazards C
A- access T
L- location U
E- emergency services R
T- type of incident I

E- exact location N

T- type of incident G

H- hazards
A- access
N- number of casualties
E- emergency services required
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Specific Content Teachers

Objectives Activity
Point out Aims
the aims of  Preserve life: The overriding aim of all medical care,
First aid including first aid is to save life.
 Prevent further harm: Also sometimes called prevent L
the condition from worsening, this covers both external E
factors, such as moving a patient away from any cause C
of harm, and applying first aid techniques to prevent T
worsening of the condition such as applying pressure to U
stop a bleed becoming dangerous. R
 Promote recovery: First aid also involves trying to start I
the recovery process from the illness or injury, and in N
some cases might involve completing a treatment, such G
as in the case of applying a plaster to a small wound.
 Take the victim to the hospital
Enlist the Key skills
key skills of  Certain steps are considered essential to the provision
First aid of first aid. Particularly the “ABC’s” of first aid, which
focus on critical life-saving intervention, must be
rendered before treatment of less serious injuries. L
A- Airway E
B- Breathing C
C- Circulation T
 Attention must be brought to the airway to ensure it is U
clear. Obstruction (choking) is a life-threatening R
emergency. Following evaluation of the airway, a first I
aid attendant would determine adequacy of breathing N
and provide rescue breathing if necessary. Assessment G
of circulation is now not usually carried out for
children’s who are not breathing.
 144

Specific Content Teachers

Objectives Activity
 Some organizations add a fourth step of,
D- Deadly bleeding or defibrillation, while other
consider this as a part of the circulation step.
Some organizations teach the same order of priority using
the “3 B’s” : Breathing, Bleeding and Bones ( or “4 B’s”
Breathing, Bleeding, Brain and Bones).
Explain the First Aider Qualities
qualities of The first aider is also likely to trained in dealing with
First aider injuries such as cuts, razes, or bone fracture. They may be
able to deal with the situation in its entirety or may be
required to maintain the condition of something like a
broken bone, until the next stage of definitive care (usually
an ambulance) arrives.
Training L
Training is generally provided by attending a course, typically E
leading to certification. Due to regular changes in procedures C
and protocols, based on updated clinical knowledge, and to T
maintain skill, attendance at regular refresher courses or re- U
certification is often necessary, first aid training is often R
available through community organizations such as the Red I
Cross and St.John Ambulance or through commercial N
providers, who will train people for a fee. G
Departmental Arrangements
Head of department: they must appoint a First Aid Co-
ordinator to organize first aid for the departments. The co-
coordinator must be given sufficient time, authority and
support for them to fulfill their responsibilities.
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Specific Content Teachers

Objectives Activity
First Aid Co-ordinators
The person appointed should be willing to take on the role,
able to carry out risk assessments and preferably be a first
aider. They should be a member of the departments safety
committee. Co-ordinators must have an e-mail.
Co-ordinators Responsibility
 Undertaking and reviewing departments assessment of
first aid needs.
 Organizing recruitment of first aider.
 Inducting new first aiders.
 Distributing information notices to first aiders.
 Organizing stocking and replenishment of first aid
supplies.
 Display and updating of first aid notices.
L
First Aiders
E
They must be allowed time to attend incidents and
C
to attend training. All first aiders have to attend an assessed
T
training course to be recognized as a first aider and have to
U
attend and pass a refresher course every 3 years to retain
R
their certificate. There are 2 types of first aider, “fully
I
qulalified first aider” who can provide first aid assistance
N
in situations likely to occur in school or colleges and “life
G
savers” who are able to deal with immediately life-
threatening conditions and look after someone if
unconscious.
Selection of First Aider
Personal Qualities
 Observant: should be a good observer, able to note the
cause and effects of the injury.
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Specific Content Teachers

Objectives Activity
 He should be able to act quickly and fit enough.
 Willing to provide first aid to anyone at any time.
 Tactful: he should not panic or get excited at a critical
time and avoiding thoughtless questions and learning
the symptoms and history of the care.
 Resourceful: one should be resourceful, able to use
whatever things are available.
 Explicit: one should be able to reassure the
apprehensive victim and his relatives and giving clear
instructions to the patient and advice to the assistants.
 Discriminating: that he may decide which of the
several injuries should be given attention.
 Should be able to obtain help from onlooker as
required. Eg: for directing traffic, making phone etc.
Describe the First aid kit
First aid kit A first aid kit is a collection of supplies and equipment for
use in giving first aid, and is made up of different contents
depending on who has assembled the kit and for what
purpose. It may also vary by region due to varying advice L
or legislation between governments or organizations. E
C
Format
T
Standard kits often come in durable plastic boxes, fabric
U
pouches or in wall cabinets. The type of container will vary
R
depending on purpose, and they range in size. It is
I
recommended that all kits are in a clean, water proof
N
container to keep the contents safe and aseptic. Kits should
G
be checked regularly and restocked if any items are
damaged or out of date.
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Specific Content Teachers

Objectives Activity
Appearance
ISO (International Organization for Standardization) sets a
standard for first aid kits of being green with a white cross
in order to make them easily recognizable to anyone
requiring first aid. Some organizations use a red cross on
white background, but use of their symbol by anyone but
the International Committee of the Red Cross (ICRC) or
associated agency may be illegal under the terms of
Geneva convention, which designates the red cross as a
protected symbol. Some first aid kits may also feature the
“Star of Life”, normally associated with emergency
medical services.
List out the Contents of First Aid Box
contents of St. John Ambulance First Aid Kit Information
First aid box School First Aid Kit, 48 pc – Medium Item: FAO-120
48 Piece all purpose kit, small plastic case. L
Be ready for all potential emergencies at home, in E
the car, outdoors or on the water. From cuts and stings to C
minor aches and pains, this kit prepares you for those small T
everyday emergencies. Fits easily into a purse, pocket, U
school bag or glove compartment. R
Kit Includes I
(2) Extra-strength non-aspirin tablets N
(2) Aspirin tablets G
(1) First Aid Guide
(15) 3/4"x3" Adhesive plastic bandages
(3) 3/4"x3" Fabric bandages
(5) 1"x3" Adhesive plastic bandages
(5) 3/8"x1-1/2" Junior adhesive plastic bandages
(1) Knuckle fabric bandage
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Specific Content Teachers

Objectives Activity
(1) Fingertip fabric bandage
(1) Elbow & knee plastic bandage
(1) Butterfly wound closure
(4) Alcohol cleansing pads
(1) Medium safety pin
(3) Antiseptic cleansing wipes (sting free)
(1) First aid/burn cream pack
(1) Antibiotic ointment pack
Kit Dimensions: 6-3/8"x4-1/2"x1-7/8"
*The FAO-120 has been specially designed for use
with the Ready Label Progam. Though it has been
designed with the intention of private labeling, this kit
comes standard with a stock label. L
All Purpose School First Aid Kit, 21 pc - Mini E
Item: FAO-110 C
21 Piece all purpose kit, mini plastic case. T
Be ready for all potential emergencies at school, U
home, in the car, outdoors or on the water. From cuts and R
stings to minor aches and pains, this kit prepares you for I
those small everyday emergencies. Fits easily into a purse, N
pocket, school bag or glove compartment. G
School First aid Kit Includes,
(2) Extra-strength non-aspirin tablets
(1) First aid guide
(5) 3/4"x3" Adhesive plastic bandages
(5) 3/8"x1-1/2" Junior plastic bandages
(1) 1-1/2"x1-1/2" Patch plastic bandage
(1) Medium butterfly wound closure
(3) Antiseptic cleansing wipes (sting free)
(1) Antibiotic ointment pack
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Specific Content Teachers

Objectives Activity
First aid Kit Dimensions: 4-3/4"x3-3/4"x1/2"
All Purpose School First Aid Kit, 33 pc - Mini
Item: FAO-112
33 Piece all purpose School First aid kit, mini
plastic case, 1 ea.
Be ready for all potential emergencies at school,
home, in the car, outdoors or on the water. From cuts and
stings to minor aches and pains, this kit prepares you for
those small everyday emergencies. Fits easily into a purse,
pocket, school bag or glove compartment. L
School First aid Kit Includes: E
(2) Extra-strength non-aspirin tablets C
(2) Ibuprofen tablets T
(1) First aid guide U
(6) 3/4"x3" Curad adhesive plastic bandages R
(10) 3/8"x1-1/2" Curad junior plastic bandages I
(1) 1-1/2"x1-1/2" Curad patch plastic bandage N
(1) Large butterfly wound closure G
(3) Alcohol cleansing pads
(3) Antiseptic cleansing wipes (sting free)
(1) Antibiotic ointment pack
(2) Aspirin tablets
First aid Kit Dimensions: 4-3/4"x3-3/4"x1/2"
Explain Wounds and Hemorrhage
Wounds : Definition
wounds and L
A wound is an injury or an abnormal break in the
hemorrhage E
continuity of the skin or other tisssues. In an external
and its first C
wound, there is danger that germs will enter the wound and
aid T
cause an infection. If the wound is deep, severe bleeding
management U
may occur or there may be serious damage to structures
R
within the body, such as bowel, heart, lungs or brain.
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Specific Content Teachers

Objectives Activity
 is a superficial injury involving only the outer layers of I
the skin. It is painful, but bleeds slightly. N
 Bruise: the causes include blunt face eg: stone, stick or G
fist. The features is a redness due to infiltration of
blood into tissues. Skin over it is intact. It becomes
blue, black, green, yellow and finally disappears with
time.
 Laceration : the causes include blunt force eg: fall of
roof, accidents in industry, fall on a rough surface. The
features are seen as skin and underlying tissues are
torn. It has irregular edges and abrasion.
 Incised wound: the causes include a weapon with a
sharp cutting edge eg: knife, razor. The features
includes like the edges of the wound are clean cut. It
bleeds more than a laceration. L

 Avulsion: the causes include excessive force. The E

features includes like a part of the body is completely C

torn away eg: finger, toe, hand, arm, foot, ear, nose and T

penis. U
R
First Aid Management I
 Place the victim in a supine position. N
 Cover the wound with sterile gauze pad. G
 Apply pressure to control bleeding.
 Immobilize the part.
 Examine the patient for the degree of hemorrhage and
the presence of shock. Treat these conditions if
present. Examine for the presence of fractures and
dislocations and treat them if present.
 Wash your hands thoroughly with soap and water.
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Specific Content Teachers

Objectives Activity
 Remove visible foreign bodies that can be easily
picked up.
 Clean the area around the wound with an antiseptic
solution.
 Clean the wound gently with an antiseptic solution
and put an antiseptic or antibiotic cream over it.
 If the wound edges gape for more than 5mm,
approximate them and maintain them in apposition by
putting a strip of sticking plaster across the wound, but
not entirely covering it.
 Put sterile gauze over the wound.
 Maintain the gauze in place by either application of
sticking plaster, or tying a bandage over it.
L
 With a perforating wound, cover both the wounds
E
with sterile gauze pads, and fix them in place by
C
bandage.
T
 When the wound or injury is extensive, particularly in
U
burns, wrap the patient in a clean, hot, ironed sheet.
R
 Apply ice bag to a contusion on the first ay to
I
decrease the bleeding in the contusion and further
N
increases in its size. Apply hot water bottles locally
G
after 24hours to hasten the absorption of the
hematomas.
The following wounds require the treatment of a doctor;
 Deep wound
 Wide gaping wound that needs to be sutured.
 A foreign body in the wound that cannot be easily
removed.
 Injury to tendons and/or nerves.
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Specific Content Teachers

Objectives Activity
 A wound on hand or foot associated with inability to
move fingers or toes.
 Grossly contaminated wound.
 Wound on chest.
 Wound on abdomen.
First aid measures for penetrating chest injuries are;
 Put the patient in semi-upright position.
 Cover the wound with a firm, air tight dressing.
 Fix the dressing to the chest with a firm bandage.
 Transfer the patient immediately to a hospital.

A penetrating abdominal wound is serious, because

any of the abdominal viscera and major vessels can be
L
injured, with serious, if not fatal consequences. If a foreign
E
body is found projecting from the abdominal wall eg:
C
handle of a knife.
T
 Do not attempt to remove it.
U
 Make the patient as comfortable as possible.
R
 Place a ring pad around the object.
I
 Place dressing over the ring pad and fix both to the
N
abdominal wall with bandage, taking care to see that
G
the object does not enter the abdominal cavity any
more than it already has
 Treat shock.
 Transfer the patient to a hospital immediately.
Hemorrhage
Hemorrhage or bleeding is a flow of blood from an
artery, vein or capillary. It may be external or internal.
Depending on the vessel from which it takes place,
hemorrhage can be classified.
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Specific Content Teachers

Objectives Activity
Types of Hemorrhage
 Arterial - Features include bright red in color, flows
in spurts, can be arrested by compression over the
artery between the heart and the site of injury.
 Venous - Features include, bluish-red in color, flows
continuously without any spurts, cannot be stopped by
compression of the artery between the heart and site of
injury.
 Capillary - Features include bright red in color,
amount much less than that of either the arterial or
the venous hemorrhage, flows in the form of a
continuous ooze without much force.
Depending on the time interval between the injury
and the hemorrhage, there are 3 types of hemorrhage; L

 Primary hemorrhage - It occurs at the time of injury. E

 Reactionary hemorrhage - It occurs with 36 hours C

after injury, usually in 4-6hours. It is due to recovery T

from shock, establishment of collateral circulation, U

slipping of ligatures or dislodgement of blood clot R

sealing the injured vessel eg: with coughing, which I

increases venous pressure. N

 Secondary hemorrhage - It occurs 3-10days after the G

injury. It is usually due to infection at the site of

injury, which causes softening of tissues, ulceration,
sloughing etc. The patient with hemorrhage
complaints of blood loss, feeling cold, thirst and
difficulty in breathing. He is pale, with cold and
clammy extremities, restless, has rapid breathing and
rapid, thread pulse. Blood pressure is low.
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Specific Content Teachers

Objectives Activity
First Aid Management
 Place the patient flat on his back.
 Lift the affected part above the level of the patients
head if there is no fracture.
 If there is a foreign body in the wound, do not remove
it.
 Apply direct pressure over the bleeding area with
sterile gauze pad. Maintain pressure for 5 to 15
minutes. If the hemorrhage is found to have stopped
on removal of pressure, put an antiseptic cream over
the injured area and covet it with tight, sterile
dressing.
Describe Sprains and Dislocation
sprains and Sprains
dislocation A sprain is an injury to the ligament around a joint
and its first due to wrenching of the joint. The patient experiences pain
aid in the joint, especially on moving the joint. The joint is
management swollen. Bruises develops later.

First Aid Management of Sprain

L
 Make the patient comfortable and give a pain killer. E
 Explore the joint, pad in well and bandage firmly. C
 In case of sprain of the ankle joint, do not remove a T
light fitting shoe, but apply the bandage over it. U
 Remove the patient to a hospital or a doctor. R
I
Dislocations
N
Dislocation is disruption of a joint so that the bones
G
forming the joint move away from each other. Dislocation
occurs when fracture of a bone occurs near a joint. A
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Specific Content Teachers

Objectives Activity
dislocation can occur even without an associated fracture.
It can be diagnosed by the following features;
 Sickening pain over the joint
 Swelling of the joint
 Deformity
 Fixity of the joint
Enumerate First Aid Management for Dislocation
fracture and  Give a pain killer.
its first aid  Do not attempt to put the bone back in normal position.
management  If any doubt that a bone has fractured, treat as a
fracture.
 Support and fix by bandaging the injured part in the
most comfortable position.
 Comfort the child and take him to a doctor or hospital.
Fracture L

A fracture is a break in the continuity of a bone E

which may be the result of direct trauma, trauma at a C

distant site or force of contraction of powerful muscles. T

The fracture is called the pathological fracture when it U

occurs in a diseased bone, with the application of force that R

would not cause a fracture in the normal bone. I

Diagnosis of Fracture N

 Pain at or near the site of fracture. G

 Tenderness or palpation at the site of the fracture.

 Swelling at the site of the fracture.
 Deformity.
 Crepitus or palpation at the site of fracture.
 Abnormal mobility at the site of fracture.
 Loss of function.
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Specific Content Teachers

Objectives Activity

Types of Fracture
 Simple or closed fracture - The skin surface over the
fracture is intact.
 Compound or open fracture - The skin surface over
the fracture is broken and fracture communicates with
outside.
 Complicated open or closed fracture - There is injury
too nerves and/or blood vessels in addition to the
fracture.

Based on the anatomical region ,

 Comminuted fracture - When the bone is broken into L

more than two segments at the site of fracture, it is E

called comminuted fracture. C

 Green stick fracture - In children only one side T

periosteum may get broken and the bone then appears U

to be bent, but not broken. R

 Transverse fracture. I
N
 Longitudinal fracture.
G
 Oblique fracture.
 Spiral fracture.
 Impaired fracture.
First Aid Management
 Remove clothing from injured area.
 Treat bleeding, difficulty in breathing, shock, and
unconsciousness first.
 Treat all fractures in the position in which the victim
is found rather than moving to another place.
 Apply an ice pack wrapped in cloth.
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Specific Content Teachers

Objectives Activity
 Immobilize the fractured limb with splints. The
bandaging should be fairly firm so that there is no
movement at the fracture site, but should not cut off
blood supply to the distal part of the limb. Place
padding material in between so that when limbs are
bound together they are comfortable. Never apply
bandage over the area of fracture, apply knots on the
sound site.
 Use a splint when it is available. A splint is right
pieces of wood, plastic or metal. It should be well
padded with cotton or cloth. It is tied to a fractured
limb to support it and to prevent movement at the
fracture site. Wide splints are better than narrow. L
 Raise the injured part after immobilizing it to reduce E
swelling. Rolled up blankets can be used. C

 Shift the child to hospital immediately. T

U
Common Sites
R
 Nasal septum- little’s area 90% of cases I
 Above the middle turbinate- anterior ethmoid vessels N
bleed due to hypertension G
 Woodruff’s plexus- behind the posterior end of the
inferior turbinate

Causes
Local Causes
a) Congenital - Eg:capillary hemangioma in nose
b) Trauma
 Fracture of base of the skull
 Post-operative period
 Picking the nose
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Specific Content Teachers

Objectives Activity
c) Inflammatory
Acute inflammations including acute rhinitis,
sinusitis, acute vestibulitis and chronic
inflammation like chronic rhinitis, sinusitis, TB,
syphilis, leprosy.
d) Neoplasms like angiomas from nasal septum,
nasopharyngeal angioma
e) Miscellaneous like foreign bodies, parasites in
nose, rhinolith
Describe First Aid Management
epilepsy and  Place the victim in sitting position, head tilted slightly
its first aid forward. L
management  Loosen tight clothing around the neck. E
 Allow the blood to drip from nose into a bowl. C

 Pinch the soft part of the nose. T

 Ask child to breath through mouth and spit out any U

blood that enters the mouth. R

 Gently clean around the nose and the mouth. I

N
 Do not plug the nose.
G
 Ask child to avoid swallowing avoid and advice the
child not to blow the nose for at least 4hours after the
bleeding stops, as that may dislodge the blood clot and
start the bleeding again.
 Apply ice pack to fore head and root of nose.
 Seek medical advice.
Epilepsy
It is a condition characterized by repetitive
contraction and relaxation of a group of muscles in the
body due to disturbance in the function of the brain. It is
followed by loss of consciousness.
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Specific Content Teachers

Objectives Activity
Diagnosis of Epilepsy
 There is a cry.
 Then there is stiffness of body. ie, tonic part of
convulsion and child becomes cyanotic)
 It is followed by repetitive movement (clonic part of
convulsion). The cyanosis passes away and there is
frothing at the angle of mouth.
 That is followed by postical phase in which the person
may become unconsciousness. He recovers from it
after a variable interval and may lose all memory of L

this event. E

 First aid management: C

 Keep the child lying down, making no attempt to stop T

his fit. U
R
 Make space around him.
I
 Place a spoon wrapped in a handkerchief or a folded
N
cloth to prevent him from biting his own tongue.
G
 Send him to a hospital immediately after convulsion.

Care at School
 Your initial efforts should be directed first at
protecting the child from additionally injuring himself
or herself.
 Help the child to lie down.
 Remove glasses or other harmful objects in the area.
 Do not try to put anything in the child's mouth. In
doing so, you may injure the child or yourself.
 Immediately check if the child is breathing.
 After the seizure ends, place the child on one side and
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Objectives Activity
stay with the child until he or she is fully awake.
Observe the child for breathing. If he or she is not
breathing within 1 minute after the seizure stops, then
start mouth-to-mouth rescue breathing (CPR). Do not try
to do rescue breathing for the child during a convulsive
seizure, because you may injure the child or yourself.
 If the child has a fever, acetaminophen (such as
Tylenol) may be given rectally.
 Do not try to give food, liquid, or medications by
mouth to a child who has just had a seizure. L
 Children with known epilepsy (a history of seizures) E
should also be prevented from further injury by C
moving away solid objects in the area of the child. If T
the child is in a boat or near the water, restrain the U
child to prevent drowning. If you have discussed use R
of rectal medication (eg, Valium) with your child's I
doctor, give the child the correct dose. N
G
Medical Treatment
 Treatment of children with seizures is different than
treatment for adults. Unless a specific cause is found,
most children with first-time seizures will not be
placed on medications.
 Important reasons for not starting medications
 During the first visit, many doctors cannot be sure if
the event was a seizure or something else.
 Many seizure medications have side effects including
damage to your child's liver or teeth.
 Many children will have only one, or very few,
seizures.
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Objectives Activity
If medications are started
 The doctor will follow the drug levels, which require
frequent blood tests, and will watch closely for side
effects. Often, it takes weeks to months to adjust the L
medications, and sometimes more than one medicine E
is needed. C
 If your child has status epilepticus, he or she will be T
treated very aggressively with antiseizure medications, U
admitted to the intensive care unit, and possibly be R
placed on a breathing machine. I
N
Conclusion G
First aid is the immediate treatment given to the
victim of an accident or sudden illness, before the medical
aid is available. It is very essential for teachers to have
basic knowledge of first aid, which will surely help them to
manage school related emergencies efficiently and
intelligently. Also being one of the most respected
professions in the community, they can easily educate the
public regarding first aid management.
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LIST OF PUBLICATIONS

International Journals

1. Manibharathi Gurusamy 2016, “First aid emergency for school

children”, International Journal of Pediatric Nursing, vol. 2, no. 2, pp. 20-22.

2. Manibharathi, G, Muthulakshmi, P & Kayalvizhi, E 2020, “A study to

assess the knowledge on selected aspects of first aid emergencies and its
management of school students among B.Ed students”, International
Journal of Research and Analytical Reviews, vol. 7, no. 1, pp. 360-361