SIGNS AND SYMPTOMS

Swelling of lips, face, neck, tongue;

Difficulty in breathing;
ALLERGIC
Difficulty in swallowing;
REACTION
Rush;
Pulse may be rapid, weak and/or irregular.

Difficulty in breathing especially breathing out;

Wheezing;
ASTHMA
The casualty may speak with difficulty;
Blueness of the skin (cyanosis) especially the lips and fingernails.
CHOKING
Adult

Airway obstruction may occur when the airway is partially or totally

blocked.

CHOKING
Infant
 Pain, swelling and enderness in one of your legs (usually your calf);
A heavy ache in the affected area;
DEEP VEIN THROMBOSIS
Warm skin in the area of the clot;
Red skin, particularly at the back of your leg below the knee.

Chest pain - a sharp, stabbing pain that may be worse when you breathe in;
Shortness of breath - which can come on suddenly or develop gradually;
PULMONARY
Coughing - this is usually dry, but may include coughing up blood or mucus
EMBOLISM
that contains blood;
Feeling faint, dizzy or passing out.
 Weakness;
Fainting;
Sweating profusely;
Casuaty has a "waxy" look to the skin;
Rapid pulse;
Shallow breathing;
Confusion;
Pale and cold;
The limbs may tremble;
Slurred speech;
DIABETES A deteriorating level of response;
Strange behaviour, casualty may become aggressive, may easly be mistaken
for someone who has taken too much alcohol;
Acetone smell from breath.

Cramp like pains in the lower abdomen or pelvic area;

Excessive, sudden vaginal bleeding;
Signs of shock if bleeding severe;
MISCARRIAGE
Passage of the foetus and contents of the uterus. The casulty may be very
distressed and anxious if she thinks she is miscarrying.

Switching off or staring blankly;

EPILEPSY Twitching or jerking of lips, eyelids, head or limbs;
Minor Fit "Automatic", repetitive movements such as lip smacking;
Chewing or making noises.
 A major fir will take the form or a full body convulsion;
EPILEPSY
The sufferer may have a brief warning period (aura) and may sit or lie down
Major Fit
to prevent injury.

Fever (temperture above 38C);

Flushed skin;
FEBRILE CONVULSION
Sweating;
There may be a rash.
 Concussion:
Brief or partial loss of consciousness following a blow to the head;
Dizziness;
Nausea;
Loss of memory;
Mild generalized headache;
Eyes will react to light.
10 min not recovering, suspect further injury:
Straw coloured fluid oe watery blood from nose or ear;
A wound or bruise on the head;
HEAD INJURY
A soft boggy area of depression on the scalp;
Deterioration in the level of response;
Lack of symmetry of the head or face;
An intense headache;
Noisy slow breathing;
Slow strrong pulse rate;
Unequal pupils;
Flushed face;
There may be weakness pr paralysis down one side of the body;
Possible nausea and vomiting.

Cramping chest pain which can spread to the arms, neck, upper back and
jaw;
Cold clammy skin;
ANGINA Sweating;
Breathlessness;
Weakness;
Pale in colour.
 Very constricting chest pain (vice-like), often radiating down either arm, into
the neck, jaw (more often the left sid ethan the right) and upper back. Often
the worst pain the casualty has ever suffered;
Difficulty in breathing;
HEART ATTACK
Ashen, cold and clammy skin;
Weak, rapid pulse;
Nausea and vomiting;
The casualty will be very frightened and may fear death.

Casualty is unconscious and no sign od normal breathing (may present

CARDIAC ARREST
agonal breathing) and no sign of circulation.

Pale, cold and clammy skin;

Cyanosis (blue tinge) to the lips, earlobes and nail beds due to hypoxia;
Weak, rapid pulse;
Shallow, rapid breathing;
SHOCK Dizziness;
Nausea and vomiting;
The casualty may become agitated or dull and quiet;
Thirst;
Unconsciousness;
The casualty may go into cardiac arrest secondary to shock.
 Weakness or paralysis usually (but not always), on one side of the body;
Slurred speech, or inhability to talk or control mouth;
Noisy breathing, slow bounding pulse;
Skin on the face appears flushed;
STROKE
A sudden severe headache (not always);
A confused mental state, casualty may appear distressed and tearful;
Loss of bladder control;
A sudden or progressive loss of consciousness.
 FIRST AID
TREATMENT

AIRWAY BREATHING

Consider casualty's position, if necessary (whichever eases

Airway swelling may progress to the extent of complete closure of their breathing);
the air passage. Administer Oxygen.

Consider casualty's position - if possible, sit up with their

elbow on the tray table in front;
Encourage them to breathe slowly and deeply. It is helpful
to advise a patient to exhale against her/his lips - to purse
his lips and exhale against that pressure;
Administer oxygen if necessary.
Encourage casualty to cough. "Are you chocking?";
I fcasualty cannot cough or cry/speak, bend fwd and give 5 back slaps
If casualty becomes unresponsive and is not breathing,
between the shoulder blades;
begin CPR to try to relieve the obstruction. Unconscious
Check airway;
casualty's throat muscles may relax and the airway may
Give 5 abdominal thrusts;
open enough to do rescue breathing. Chest compressions
Check airway;
may also help dislodge the item blocking the airway.
Repeat cycle of back s. and abdominal t., rechecking the mouth after
each step, until the item is dislodge.

If an infant heeps coughing, do not hinder his effort to expel the

object;
If unable to cough (or coughing makes no sound), cry or breathe,
place infant face DOWN, along your forearm and thigh. Support the If infant becomes unresponsive and is not breathing, begin
head and give 5 back s. between his shoulder blades; CPR to try to relieve the obstruction. Unconscious
Check airway; casualty's throat muscles may relax and the airway may
Turn baby face UP, along your forearm and thigh. Support the head open enough to do rescue breathing. Chest compressions
and give 5 chest t.; may also help dislodge the item blocking the airway.
Check airway;
Repeat cycle of back s. and chest t. rechecking the mouth after each
step, until the item is dislodge.
Administer oxygen.
Consider casualty's position if necessary;
Administer oxygen if necessary.

Asses casualty's breathing and consider semi reclining

position;
Prop her knees up with cuschions to ease the strain on the
abdomen;
Administer oxygen.
Attempt to maintain airway open and clear, however do not force Check for normal breathing once the convulsions stop and
holding the head or put anything in casualty's mouth. consider casualty's position if necessary.

Remove any near item which may cause injury, pad the area around Consider casualty;s position if necessary;
the casualty's head to protect it. Administer oxygen.
Check for normal breathing and consider casualty's position
(lay flat with head and shoulders raised);
If you suspect neck injury and the casualty is breathing
(regardless if responsive or not) - DO NOT move the
casualty. If responsive, instruct them not to move;
Administer oxygen if necessary.

Assess breathing and consider casulty's position (semi

sitting);
Encourage casualty to breath slowly and deeply.
Assess breathing and consider casulty's position (semi
sitting);
Administer Oxygen.

Check for normal breathing for no more than 10 seconds;

No signs of breathing = begin CPR immediately

Administer oxygen.
Lay casualty down and raise their head and shoulders;
Administer Oxygen.
RST AID
TREATMENT

CIRCULATION DYSFUNCTION EXAMINE

Casualty may be in possession of an EpiPen (adrenaline auto-

Be prepared to resuscitate.
injector).

Casualty should have own medication (inhaler).

Casualty may be unable to speak, cough or breathe
will eventually become unresponsive. If this
happens, open airways and check breathing. Be
prepared to begin breaths and chest compressions.

Infant may be unable to cry, cough or breathe will

eventually become unresponsive. If this happens,
open airways and check breathing. Be prepared to
begin rescue breaths and chest compressions.
 On initial assesstment own medication (insulin) if casualty
requires it;
Consider a deteriorating level of response, confused If not, give a sugary drink (dissolve 3-4 sugars in warm water);
mental state, strange behaviour. If they improve after sugary drink, give another and advise to
see a doctor;
If not, nit by mouth and promote recovery.

Keep any expelled products in a bag (out of woman's sight (f

Discourage casualty from going to the toilet
possible) for medical inspections;
(this may induce further haemorrhaging).
Write down AMPLE history from casualty.

They may be confused or disorientated. Advise to see a doctor.

 Pass on seizure (fit) times to the casualty when they wake up;
It is normal for the sufferer to have a sleep period
If it's casualty's first fit, is the casualty is pregnant or they are
once the seizure (fit) has stopped. Do not shake or
having recurring seizures, then and ambulance in requires on
pinch in seek for response during sleep period;
arrival;
Time seizure and sleep.
If not, advise them to see a doctor.

Ask parents to remove child's/infant;s clothes to cool (do not

over cool). Fan the child/infant with a magazine or safety
instruction card. Too rapid cooling destabilises the
hypothalamus (part of the brain that regulates body
temperature and blood pressure) of the infant and can cause
the situation to worsen. If shivering occurs, sover them with a
light covering.
Time the seizure (fit).
Control bleeding, if present (do not put direct
pressure on the brain);
If there is discharge from the ear, lay casualty If casualty is conscious perform a grip test to
down with the affected side downwards. Place normal brain functions; ask casualty to grasp both
a dressing under the ear - do not plug the ear. your hands and squeeze simultaneously. The force
Observe the amount of fluid lost every 10 min. squeezing should be even.
Keep stained dressings for the hospital
inspection.

On initial assesstmente encourage casualty to take own

medication (GTN).
 Some heart attacks show very unspecific symptoms e.g. a
Put casualty in semi sitting (w) position. The casualty may lose consciousness rapidly. posterior infarction/heart attack patient may only have
untypical stomach pain instead od classic chest pain.

Lay down casualty and elevate legs (Sit upright

Look for and treat what caused shock.
for heart attack or chest injury).
Assess level of consciousness (AVPU), mind the
casualty will be confused.
 SPECIAL CONSIDERATION

Cabin crew may not use EpiPen, only a medically qualified

person can. PA for a medically qualified person should be made
as soon as possible, paramedics on arrival (diversion in
Anaphylaxis).
For a child use less forse when giving back slaps and abdominal
thrusts. Consider administering oxygen once item becomes
dislodge.

For an infant use less force when giving back s. Never give
abdominal t to and infant. Consider administering oxygen on low
flow, once the item becomes dislodge.
First aid treatment for DVT and Pulmonary Embolism is limited.
Patients exihibiting signs or symptoms with predisposing factors
should always be suspected of having a PE until proven
otherwise. Therefore a diversion should be considered and
paramedics on arrival
Cabin crew must not inject insulin, only a medically qualified
person can. Consider making a PA for a medically qualifies
person as soon as possible, consider ambulance on arrival. The
casualty mai be wearing a bracelet or a chain with medical
information on it

Never elevate the legs even if bleeding is quite heavy.

In a minor fit, your initial action should be to pad the area

around the head to protect from injury. Never put anything in
the mouth while having a fit. Do not force holding the head or
body.
Pa for a medically qualified person and paramedics on arrival.
Do not administer mediction or alcohol. Remember that
impaired consciousness may mask othe injuries, so it is
important to EXAMINE the whole casualty thoroughly when
doing the assesstment. PA for a medically qualified person
should be made as soon as possible, paramedics on arrival
(consider diversion).

If the attack last longer than 10 min/GTN does not work/or first
experience of this, treat as heart attack.
PA for a medically qualified person should be made as soon as
possible, paramedics on arrival, diversion. Heart attack is likely
to lead to a cardiac arrest.

CPR and AED must be utilised immediately. PA for a medically

qualified person should be made as soon as possible, diversion,
paramedics on arrival. Ensure the ambulance crew are aware of
the AED being used (see: informing the captain)

The casualty will show some symptoms of shock in most major

medical emergencies, remmber to treat whatever is causing the
shock. In severe cases the casualty may go into cardiac arrest,
therefore a diversion in severe cases is advisable and most likely.
Do not give anything to eat or drink. If the casualty is conscious
you may wet the casualty's lips.