"KNOWLEDGE FOR HEALING, HEALING

FOR ALL"

POCKET GUIDE
TO
BASIC FIRST-AID
SKILLS

DIMITAR N. DASKALOV
 Table of Contents

Assessing the scene and patient

Safety precautions

CPR and rescue breathing

Choking and airway obstruction

Bleeding and wound care

Burns and scalds

Head, neck, and spinal injuries

Fractures and dislocations

Poisoning and drug overdose

Heat stroke and hypothermia

Circulatory system

Heart

Brain

Muscles

Bones of the body

 Chapter 1: Assessing the Scene and Patient

As a medical professional, it is crucial to have a thorough understanding

of assessing the scene and patient in an emergency situation. Proper
assessment can help in providing timely and effective treatment and can
be the difference between life and death. This chapter will provide an
overview of the key elements of assessing the scene and patient.

Assessing the Scene:

The first step in assessing the scene is to ensure your own safety. Before
entering the scene, ensure that there are no ongoing hazards such as
electrical wires, chemical spills, or fire. Once you have established that
the scene is safe, assess the surroundings and the patient's position. Look
for any potential causes of injury such as sharp objects, unstable
structures, or heavy machinery. If there are multiple patients, prioritize
those who require immediate attention.

Assessing the Patient:

When assessing the patient, there are several key elements to consider.
Begin by checking for responsiveness by gently shaking the patient and
calling out their name. If there is no response, check for breathing by
placing your ear close to the patient's mouth and nose to listen for
breathing sounds and feel for any movement of air.

If the patient is breathing, assess the airway to ensure it is clear of any

obstruction. Check for signs of bleeding or injuries to the head, chest, and
abdomen. Assess the patient's vital signs, including heart rate, blood
pressure, and respiratory rate. Look for any signs of shock, such as
clammy skin, altered mental status, or low blood pressure.

Assessing the patient's level of

consciousness is also important. The
Glasgow Coma Scale (GCS) is a useful tool
for assessing a patient's level of
consciousness. The scale ranges from 3 to
15, with 15 being the highest level of
consciousness. The GCS assesses three
areas: eye-opening, verbal response, and
motor response.
Generally, having a score of 8 or fewer
means you're in a coma. The lower the
score, the deeper the coma is. There are
several other assessments that can be
performed in addition to assessing the
patient's level of consciousness.
 Chapter 2: Safety Precautions

As a healthcare provider, your primary concern is always the safety of

your patient. Safety precautions are essential to avoid any potential risks
to the patient's health and wellbeing. In this chapter, we will cover some
general safety precautions that every healthcare provider should follow.

Hand Hygiene: Proper hand hygiene is the single most important measure
to prevent the spread of infection. Healthcare providers should wash
their hands with soap and water or use alcohol-based hand rubs before
and after patient contact.

Personal Protective Equipment (PPE): PPE such as gloves, gowns, masks,

and eye protection are essential to prevent the transmission of infections
between patients and healthcare providers. Use the appropriate PPE for
the type of patient care you are providing.

Environmental Controls: Environmental controls such as proper

ventilation, cleaning, and disinfection are important to prevent the
spread of infections. Make sure the patient's room is adequately
ventilated, and surfaces are cleaned and disinfected after every patient
contact.

Patient Safety: Patient safety should always be a top priority. Ensure that
the patient's bed is at the correct height, bed rails are up, and the patient
is not left unattended if they are at risk of falling. Also, check the
patient's identification before administering any medications or
performing any procedures.

Emergency Procedures: Every healthcare provider should be familiar with

emergency procedures such as fire safety, code blue, and evacuation
protocols. Ensure that you know the location of fire exits, extinguishers,
and emergency equipment.

Infection Control: Infection control measures such as isolation

precautions, respiratory hygiene, and cough etiquette are essential to
prevent the spread of infections. Follow the recommended infection
control measures to protect yourself and your patients.
 Chapter 3: Cardiopulmonary Resuscitation (CPR)
and Rescue Breathing
Cardiopulmonary resuscitation (CPR) is a medical procedure that involves
performing chest compressions and rescue breathing on a person whose
heart has stopped beating or who has stopped breathing. CPR can help
keep the person's blood flowing and supply oxygen to the brain and other
organs until medical help arrives. In this chapter, we will discuss the basic
steps for performing CPR and rescue breathing.

Assessing the Need for CPR

Before beginning CPR, you need to determine whether the person needs
it. Check the person's responsiveness by tapping or gently shaking them
and calling their name. If they do not respond, check their breathing by
placing your ear close to their mouth and nose while looking at their
chest to see if it is rising and falling. If the person is not breathing, you
need to start CPR immediately.

Performing CPR
CPR involves two basic techniques: chest compressions and rescue
breathing. To perform chest compressions, kneel beside the person and
place the heel of one hand on the center of the chest, between the
nipples. Place your other hand on top of the first hand, interlacing your
fingers. Keeping your arms straight, press down on the person's chest
with your upper body weight, compressing the chest about 2 inches.
Repeat the compressions at a rate of 100-120 per minute.
After 30 compressions, tilt the person's head back and lift their chin to
open their airway. Pinch the person's nose closed and give two full
breaths into their mouth, making sure to watch for chest rise. Each breath
should last one second and be given with enough force to cause the chest
to rise. If the chest doesn't rise, reposition the head and try again.
Continue with the cycle of 30 compressions and two breaths until the
person begins breathing on their own or medical help arrives. It is
important to maintain the proper rate and depth of compressions and
breaths to ensure the best chance of survival.
Performing Rescue Breathing
Rescue breathing is a technique used to provide oxygen to a person who
is not breathing on their own. To perform rescue breathing, tilt the
person's head back and lift their chin to open their airway. Pinch the
person's nose closed and give two full breaths into their mouth. Each
breath should last one second and be given with enough force to cause
the chest to rise. Watch for the chest to fall before giving the next breath.
If the person's chest does not rise with the breath, reposition the head
and try again. If the chest still does not rise, the person may have an
obstructed airway and you should perform the Heimlich maneuver or
another technique to remove the obstruction.
 Chapter 4: Choking and Airway Obstruction

Choking and airway obstruction can occur when an object becomes

lodged in the throat or windpipe, preventing air from flowing in and out of
the lungs. This can lead to a lack of oxygen and potentially life-
threatening consequences if not promptly treated. Therefore, it is crucial
for healthcare professionals to recognize and manage choking and airway
obstruction effectively.

Signs and Symptoms:

Difficulty breathing or noisy breathing
Gagging or coughing
Clutching at the throat or neck
Blue skin or lips
Loss of consciousness (in severe cases)

Treatment:
If you suspect that someone is choking or has an airway obstruction,
prompt action is necessary. Follow these steps:

Assess the person’s airway and breathing: Ask the person if they are
choking and if they are unable to speak, cough or breathe. If the
person is responsive, but has signs of airway obstruction, encourage
them to cough forcefully to try to dislodge the object. If the person is
unresponsive, assess for breathing and pulse.

Call for emergency medical services: If the person is unresponsive,

activate the emergency response system (e.g. call 911 in the US).

Perform abdominal thrusts (Heimlich maneuver) if the person is

conscious: The Heimlich maneuver can help dislodge the object and
restore normal breathing.

The Heimlich maneuver is performed by

wrapping your arms around a person, making a
fist with one hand and clasping it with the other.
You place your fists between the person's
ribcage and belly button and thrust your hands
into their abdomen until the object is freed.
 Give back blows or chest thrusts if the person is unconscious: Back
blows or chest thrusts can help dislodge the object in an unconscious
person.

Continue to monitor the person’s breathing and pulse: If the person

loses consciousness, start CPR. If the person regains consciousness
and is breathing normally, monitor them for signs of complications.

Prevention is key when it comes to choking and airway obstruction. It is

important to be mindful of what you eat and how you eat it, and to avoid
talking or laughing while eating. Small children should be supervised
while eating and should not be given foods that are a choking hazard,
such as hard candies or popcorn kernels.
 Chapter 5: Bleeding and wound care

As healthcare professionals, it is essential to understand how to treat

bleeding and manage wounds. Traumatic injuries, whether minor or
severe, can lead to significant blood loss and tissue damage. This chapter
will focus on the assessment and management of bleeding and wounds,
including types of wounds, stages of wound healing, and appropriate
wound care techniques.

Assessment
The first step in treating bleeding and wounds is to assess the injury's
severity and location. The extent of blood loss and wound characteristics
will determine the appropriate course of action. Healthcare professionals
should use personal protective equipment (PPE) when handling open
wounds to prevent the spread of infection.

Types of Wounds
There are six types of wounds: abrasions, lacerations, incisions, puncture
wounds, avulsions, and crush injuries. Abrasions are caused by the
scraping or rubbing of the skin against a rough surface, resulting in the
removal of the top layer of skin. Lacerations are caused by a sharp object
and result in a tear in the skin. Incisions are similar to lacerations, but
they are made intentionally by a sharp object like a scalpel during a
surgical procedure. Puncture wounds are caused by sharp, pointed objects
like nails or needles that penetrate the skin. Avulsions occur when a
chunk of tissue is torn away from the body, while crush injuries happen
when a body part is trapped between two objects or crushed by a heavy
object. Understanding the type of wound is important for determining the
proper treatment.
Stages of Wound Healing
Wound healing is a complex process that takes place in four stages:
hemostasis, inflammation, proliferation, and maturation. Hemostasis is
the first stage, where the body tries to stop the bleeding by forming clots.
Inflammation follows, and it involves the body's immune response to
prevent infection. During the proliferation stage, new tissue forms to
cover the wound, and blood vessels grow to provide oxygen and nutrients
to the area. Finally, the maturation stage involves the remodeling of the
wound tissue, where collagen fibers align to provide strength to the
wound. The time frame for these stages varies depending on the severity
and size of the wound, as well as individual factors such as age and
overall health. Proper wound care can help facilitate each stage of the
healing process and prevent complications.

Wound Care Techniques

Effective wound care can prevent infection, promote healing, and reduce
scarring. The primary goal of wound care is to keep the wound clean and
moist. It is crucial to avoid using harsh soaps or other irritating
substances, which can damage the tissue and delay healing. The following
wound care techniques are recommended:
Cleaning a wound:
Cleaning a wound is an important step in the wound care process as it
helps to remove any dirt, debris, or bacteria from the wound site, which
can lead to infection. The first step in cleaning a wound is to wash your
hands thoroughly with soap and water or an alcohol-based hand sanitizer.
Once your hands are clean, you can begin cleaning the wound site. The
wound should be irrigated with sterile saline or water to remove any
debris. If there is significant bleeding, it is important to apply direct
pressure to the wound to control the bleeding before cleaning. Avoid
using hydrogen peroxide, iodine, or other strong antiseptics as they can
damage the tissue and delay the healing process.

Dressing a wound
After cleaning the wound, the next step in wound care is to dress it.
Dressings are used to protect the wound from further contamination,
absorb excess moisture, and promote healing. The type of dressing used
depends on the type and severity of the wound. For example, a non-stick
pad can be used for wounds with light drainage, while a hydrocolloid
dressing may be used for wounds with heavier drainage. It is important to
choose the appropriate size and type of dressing to ensure adequate
coverage of the wound and to prevent it from becoming dislodged. The
dressing should be changed regularly, typically every 1 to 3 days, or more
often if it becomes soiled or wet. Proper wound dressing can help prevent
infection and promote healing, leading to a better outcome for the
patient.

Topical medication:
 Chapter 6: Burns and Scalds

Burns and scalds are among the most common injuries that individuals
can sustain. A burn is caused by dry heat, such as fire or an iron, while a
scald is caused by hot liquids or steam. Burns and scalds can range from
minor injuries to severe, life-threatening conditions. It is important to
know how to treat these injuries to avoid further complications.

Classification of Burns:
First-degree burns: These are superficial burns that affect only the
outer layer of the skin (epidermis). Symptoms include redness,
swelling, and pain, but the skin remains intact. Sunburns and mild
scalds are common examples of first-degree burns.

Second-degree burns: These burns extend beyond the epidermis and

affect the underlying layer of skin (dermis). Symptoms include
blistering, swelling, and pain. Second-degree burns are more severe
than first-degree burns and can take several weeks to heal.

Third-degree burns: These are full-thickness burns that extend through

the dermis and can also damage the underlying tissues, muscles, and
bones. Symptoms include charred or white skin, loss of sensation, and
pain. Third-degree burns are the most severe and can be life-
threatening. They require immediate medical attention and often
require skin grafting for proper healing.

Scalds are burns caused by hot liquids or steam. They are one of the most
common types of burns. Scalds can happen at home, at work, or in any
environment where hot liquids or steam are present.
First Aids to Burns
Cooling a burn or scald is an essential step in the first aid treatment
for burns. Running cool (not cold) water over the affected area for at
least 10 minutes can help to reduce pain and prevent further damage
to the skin. The cool water helps to lower the skin temperature,
stopping the burning process. Avoid using ice, as it can cause further
damage to the skin and tissue. If cool water is not available, any cool
liquid, such as milk or juice, can also be used to cool the burn. It is
crucial to begin cooling the burn as soon as possible, ideally within
minutes of the injury, to help minimize the damage and promote
faster healing.

Covering a burn is an important step in the first aid treatment of

burns. After cooling the affected area under cool (not cold) water for at
least 10 minutes, it is essential to cover the burn with a sterile, non-
fluffy dressing. The dressing should be large enough to completely
cover the burned area but not so tight that it restricts circulation. It is
important to avoid using cotton wool as it can stick to the wound and
cause further damage. Covering the burn will protect the wound from
infection and help to keep it moist, which can promote healing and
reduce scarring.

A list of medications that can be used for burns:

Acetaminophen: It is an over-the-counter pain relief medication that
can be taken to manage pain associated with burns.
Ibuprofen: Another over-the-counter pain medication that can help to
relieve pain, and reduce swelling, and inflammation.
Lidocaine: It is a topical anesthetic that can be used to provide pain
relief for minor burns.
Silver Sulfadiazine: It is a topical antimicrobial medication that can be
used to prevent infection in burns.
Hydrocortisone cream: It is a topical steroid that can help to reduce
inflammation and itching associated with minor burns.
Antihistamines: They can be used to manage itching and allergic
reactions caused by burns.
 Chapter 7: Head, neck, and spinal injuries

Head injuries:
Head injuries can range from a minor bump to a severe traumatic brain
injury. Signs of a head injury include a headache, dizziness, nausea,
vomiting, confusion, memory loss, seizures, or loss of consciousness. If
you suspect someone has a head injury, call for emergency medical help
right away. Until help arrives, keep the person still and comfortable. Do
not move them unless it is absolutely necessary, as movement can
worsen the injury.

Neck injuries:
Neck injuries can be caused by whiplash, falls, or physical assaults. The
most common sign of a neck injury is neck pain. Other symptoms include
stiffness, numbness, tingling, or weakness in the neck or arms. If you
suspect someone has a neck injury, immobilize the neck by keeping the
person still and not moving the head or neck. Call for emergency medical
help right away.

Spinal injuries:
Spinal injuries are caused by trauma to the spinal cord, which can result
in paralysis or loss of function below the injury site. Signs of a spinal
injury include pain, numbness, tingling, or weakness in the arms, legs, or
trunk. If you suspect someone has a spinal injury, do not move them
unless it is necessary to prevent further injury. Call for emergency
medical help right away.

Head, neck, and spinal injuries are serious and potentially life-
threatening. Any injury to the head, neck, or spine should be treated with
extreme caution to avoid further damage. The first step in managing
these injuries is to ensure that the patient is immobilized. This can be
done by placing a cervical collar around the neck and using a backboard or
other device to keep the patient's head and neck in a stable position. Any
movement of the head, neck, or spine should be avoided until the patient
can be evaluated by a medical professional. In cases of severe head
trauma, the patient may require immediate surgery to relieve pressure
on the brain. Other treatments may include medication to control pain
and swelling, physical therapy to regain strength and mobility, and
rehabilitation to help the patient recover from any long-term effects of
the injury. It is important to follow all medical recommendations and to
closely monitor the patient's condition to ensure the best possible
outcome.
 Chapter 8: Fractures and Dislocations

Fractures and dislocations are common injuries that can result from
trauma, falls, or accidents. These injuries can be painful and debilitating,
and proper management is critical to ensure optimal healing and
recovery.

A fracture is a break in the bone, while a dislocation is when the bones in

a joint are forced out of their normal position. Fractures and dislocations
can occur in any bone or joint in the body, and the severity of the injury
can range from mild to severe.

The signs and symptoms of a fracture or dislocation include pain,

swelling, deformity, and limited mobility. In some cases, the bone or joint
may appear visibly deformed or misaligned. It is essential to seek medical
attention immediately if you suspect you have a fracture or dislocation.
Types of fractures:
Simple fractures: A simple fracture is a clean break in the bone that
does not puncture or damage surrounding tissue.
Compound fractures: Also known as open fractures, these occur when
the bone breaks and punctures the skin, leaving the bone exposed to
the environment.
Comminuted fractures: This type of fracture occurs when the bone is
shattered into several pieces.
Greenstick fractures: Common in children, greenstick fractures occur
when the bone bends and cracks, but does not break all the way
through.
Hairline fractures: These are small cracks in the bone that may not be
visible on X-rays and can be caused by repetitive stress or overuse.
Compression fractures: This type of fracture occurs when the bone is
crushed, often due to osteoporosis or other diseases that weaken the
bones.
Treating fractures involves immobilizing the affected area to prevent
further damage and promote healing. This can be done by using a splint or
cast to keep the bones in place. Pain relief medication can be used to
manage pain and swelling. In severe cases, surgery may be required to
realign the bones and fixate them with screws, plates, or rods.

Treating dislocations involves reducing the joint back into its normal
position. This should only be done by a trained medical professional, as
improper reduction can cause further damage. After reduction, the
affected area is immobilized with a splint or cast, and pain relief
medication can be used to manage pain and swelling. In severe cases,
surgery may be required to repair any damage to the surrounding tissues
or structures.
 Chapter 9: Poisoning and Overdose

If someone has been poisoned, the first step is to remove them from the
source of poisoning as quickly as possible to prevent further exposure.
This may involve moving the person to a different room or getting them
outside into fresh air. In some cases, it may be necessary to evacuate the
area if there is a risk of further exposure or if the poisoning has occurred
in a confined space.

Identifying poisons:
Identifying the type of poison is crucial for providing the correct
treatment. Poisons can be ingested, inhaled, or absorbed through the
skin, and they can cause a range of symptoms depending on the type and
amount of poison involved. Some common signs and symptoms of
poisoning include vomiting, nausea, abdominal pain, confusion, difficulty
breathing, seizures, and loss of consciousness. In some cases, there may
be no immediate symptoms, but the person may start to experience
symptoms later on. It is important to identify the type of poison and seek
medical attention as soon as possible to prevent further harm.

Antidotes to common poisons:

Identifying an overdose can be challenging as the symptoms vary
depending on the drug taken, the amount consumed, and the individual's
physical and mental health. However, some common signs of an overdose
include difficulty breathing, abnormal heart rate, chest pain, seizures,
confusion, loss of consciousness, and uncontrollable shaking.

If you suspect someone is experiencing an overdose, the first step is to

call for emergency medical services immediately. While waiting for help
to arrive, try to keep the person awake and breathing. If they are
unconscious and not breathing, perform CPR if you are trained to do so.

Treatment for an overdose depends on the type of drug involved. Some

drugs, such as opioids, have antidotes that can reverse the effects of the
overdose and save the person's life. For example, naloxone is an opioid
antagonist that can quickly reverse the effects of an opioid overdose and
restore breathing.

Other drugs may require different treatments. For example, in the case of
a benzodiazepine overdose, medical professionals may administer a
medication called flumazenil, which acts as a benzodiazepine antagonist
and can reverse the overdose's effects.

It's crucial to remember that attempting to treat an overdose without

medical supervision can be dangerous and potentially life-threatening.
Always call for emergency medical services and follow their instructions
until help arrives.

Poisons are classified into (i): Homicidal poisons, (ii) Suicidal poisons, (iii)
Accidental poisons, (iv) Abortifacient poisons, (v) Stupefying agent/poisons,
(vi) Agents used to cause bodily injury (vii) Cattle Poison (viii) Used for
malingering.
 Chapter 10: Heat stroke and hypothermia

Heat stroke and hypothermia are two conditions that can be life-
threatening if not treated promptly. Heat stroke occurs when the body's
temperature regulation mechanisms fail, causing the body temperature
to rise to dangerous levels. Hypothermia, on the other hand, occurs when
the body's temperature drops to a dangerously low level. Both conditions
require immediate first aid treatment to prevent serious complications.

Heat stroke is a medical emergency that requires prompt treatment.

Symptoms of heat stroke include a body temperature of 104°F or higher,
confusion, seizures, and loss of consciousness. Other symptoms include
headache, dizziness, nausea, and rapid heartbeat. If you suspect someone
is suffering from heat stroke, call for emergency medical help
immediately.

The first step in treating heat stroke is to move the person to a cool place
and remove any unnecessary clothing. Apply cool water to the person's
skin and use a fan to help cool the body. If the person is conscious and
able to swallow, give them small sips of cool water. Do not give them
anything to drink if they are unconscious or vomiting.

Hypothermia occurs when the body's temperature drops below normal

levels, typically below 95°F. Symptoms of hypothermia include shivering,
confusion, slurred speech, and loss of coordination. In severe cases,
hypothermia can lead to a loss of consciousness and even death.

If you suspect someone is suffering from hypothermia, move them to a

warm place and remove any wet clothing. Cover them with blankets or
warm clothing and give them warm fluids to drink. Do not give them
alcohol or caffeine, as these can cause further dehydration and worsen
hypothermia. Call for emergency medical help as soon as possible.

Preventing heat stroke and hypothermia is key to

avoiding these conditions. Stay hydrated in hot
weather and avoid prolonged exposure to the sun.
Dress in layers and stay dry in cold weather, and
avoid prolonged exposure to extreme cold.
Knowing the signs and symptoms of heat stroke
and hypothermia, and taking prompt action, can
help save lives in these potentially dangerous
situations.