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NSTP First Aid Education

National Service Training Program (University of Southern Mindanao)

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NSTP 2

I.LEARNING OUTCOMES

At the end of this module, you are expected to:

a. explain the work of a first aider;

b. determine reasons why one should learn to perform cardio-pulmonary resuscitation;
c. identify the classification/types of burn; and
d. identify the different types of bandaging and wound.
II.TOPICS

➢ Dimension of Development: First Aid Education

III.REFERENCE

Villasoto, S. and Villasoto, N. (2018). NSTP-CWTS 1 Worktext for College Students. Quezon

City: C & E Publishing, Inc.

IV.COURSE CONTENT

FIRST AID

What is First Aid?

First– preceding all others in time or order.
Aid- to provide with what is useful or necessary.
First Aid
➢ the immediate treatment using available facilities or materials and
given to an injured or ill person while waiting for medical assistance
to arrive. It includes either emergency measures for life-threatening
conditions which require further medical attention or care for less
serious injuries which may be adequately treated on the spot. As an
urgent care given to an injured or unexpectedly ill person, first aid
also involves home care and self-care if medical assistance is
delayed or not available.
➢ It is an immediate care given to a person who has been injured or suddenly taken ill. It
includes self-help and home care if medical assistance is not available or delayed.

First Aider
➢ deals with the whole situation involving the patient
and the injury or illness. The Philippine National Red Cross (PNRC)
conducts trainings for people who like to become first aiders. If
interested parties are physically and mentally fit, they can go to
their local PNRC chapter and register for free. The one-week
training focuses on basic first aid and provides the needed medical

kit.

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Characteristics of a Good First Aider

1. Gentle 4. Tactful
➢ First aider should not cause, inflict ➢ Handling the victim with utmost care
pain as much as possible. and in a calm manner.

2. Resourceful 5. Emphatic
➢ Makes the best use of things at ➢ Should be comforting.
hand.

3. Observant 6. Respectable
➢ Should notice all signs. Aware of ➢ Maintains a professional and caring
what is happening and what may attitude.
happen.

The roles and responsibilities of a first aider are as follows:

1. Since the first aider does not perform the functions of a doctor or compete with the latter,
he/she immediately transfers the medical task and care of the victim to a qualified physician
who comes to the rescue.
2. He/She ensures the safety of bystanders.
3. He/She assesses the condition of the victim.
4. He/She identifies the risks or threats to the victim’s life.
5. He/She calls for medical assistance as needed.
6. He/She provides the immediate and necessary care.
7. He/She assists the medical personnel.
8. He/She records the situation, care given, etc.

General Directions for First Aid

➢ A first aider may encounter various problem situations. His/her decisions and actions
depend on the circumstances that cause the accident or sudden illness; the number of
persons involved; the immediate environment; and the availability of medical assistance,
emergency equipment, and help from others. The first aider needs to adapt to the
situation at hand and improvise as necessary.
➢ The first aider should keep two fundamental things in mind. One, he/she must determine
the best way of rescue such as removing the victim from water, fire, or a place filled with
carbon monoxide or smoke. Two, he/she must ensure that the victim has an open airway

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and must administer mouth-to-mouth or mouth-to-nose artificial respiration if necessary,

including controlling severe bleeding.
➢ Unless it is safe to do so, the victim should not be moved at once. He/She should be kept
in the position best suited to his/her condition or injury. The victim should not be allowed
to get up or walk around.
➢ The first aider, in turn, is not expected to explain the victim’s probable condition to
bystanders or even to reporters. He/She is expected, however, to remain in charge until
the victim can be placed in the care of qualified persons, for example, a physician, an
ambulance crew, a squad, or a police officer; the victim can take care of himself/herself;
or the victim can be taken care of by relatives. Above all, the first aider should know the
limits of his/her capabilities. He/She must make minimal effort to avoid further injury to the
victim in his/her attempt to provide the best possible emergency first aid care.
➢ Meanwhile, proper first aid measures should include standard and specific techniques
that have been taught and in view of circumstances that appear to be necessary.

GENERAL GUIDELINES IN ADMINISTERING FIRST AID

1. Planning of Action
➢ Established based on anticipated needs and available resources. •
➢ Example: Getting to know where the First Aid Kits are located as well as other
emergency equipment such as fire extinguishers, fire alarm switches and fire exits.
Also by being aware of the emergency numbers such as Ambulance providers,
Hospital emergency room, Fire department and police stations. Getting Started
2. Gathering of needed materials 3 Preparation of equipment and personnel.
➢ 70% Isoprophyl Alcohol
➢ Povidone Iodine
➢ Cotton Balls
➢ Sterile Gauze Pads
➢ Tongue Depressors
➢ Penlight
➢ Band Aid
➢ Gloves
➢ Set of Scissors and Forceps
➢ Triangular Bandage
➢ Elastic Bandage
➢ Adhesive Plasters
3. Initial Response (Sequence of actions)

A • Ask for HELP

• Intervene. Give appropriate

I interventions

D • Do no further harm

4. SURVEY THE SCENE

➢ Is the scene safe? Safe for you and the injured person?
➢ What happened?
➢ How many people are injured?
➢ Are there someone who can help? 3
➢ Get consent before giving first aid care.

Cardio-pulmonary resuscitation (CPR)

➢ a lifesaving technique useful in many emergencies, including heart attack or near
drowning, in which someone's breathing or heartbeat has
stopped.

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➢ this is a combination of chest compressions and rescue breaths.

STEP BY STEP PROCEDURE ON ADMINISTERING CPR
1. Survey the Scene
➢ Is the scene safe for you and the victim?
➢ Is there someone who can help?
➢ If the scene is secure for you to perform first aid, kindly proceed by introducing
yourself and asking if you can help. - this enables you to gain the trust of the
victim as well as the people around the scene.
Primary Survey

C A B C
CONSCIOUSNESS AIRWAYS. BREATHING CIRCULATION

a. Tap both shoulder and ask the victim for what happened. Take
note of the appropriateness of verbal response.

b. CHECK FOR THE PATENCY OF NOSTRILS AND MOUTH.

USING HEAD TILT CHIN LIFT.

c. CHECK FOR BREATH SOUNDS AS WELL AS THE RISE AND FALL OF THE
CHEST. NOTE FOR DIFFICULTY OF BREATHING
Normal respiratory rate: 18-24 respirations per minute

d. CHECK FOR PULSE. CAROTID OR RADIAL

Normal Pulse Rate: 60-80 beats per minute

Conditions When CPR is Needed

o The victim is UNCONSCIOUS.
o PULSE is WEAK or NO PULSE.
o NO BREATHING / DIFFICULTY IN BREATHING
-Cardiac Arrest caused by Coronary Heart Disease, Dysrhythmias, Respiratory
arrest, Electrocution, Drowning, Choking, and Trauma.

Chest Compressions
• Using the heel of the palm, interlaced with the other hand, perform 30 compressions.
Approximately 2 inches deep on the middle of the chest just in line with the sternum.
• A cycle of chest compression is composed of 30 compressions at a rate of 80 3 100 per
minute.
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• After a cycle, 2 Rescue breaths are administered.

Rescue Breaths
• Giving oxygen via mouth 3 to 3 mouth.
3 HEAD TILT CHIN LIFT, pinch the nose and give a full blow of air directly to the mouth twice.
Note for the rise and fall of the chest
. • If the chest did not move, check for airway patency or re tilt the head.

When to STOP the CPR

S - Spontaneous signs of circulation restored
T- Turned over to medical services or authorized personnel
O- Operator is already exhausted and cannot continue CPR
P-Physician assumes the responsibility
Care of the Victim After Successful CPR
• Transfer in a secured place.
• Place in a side lying position - Recovery position.
• Wait for the emergency response unit and continuously monitor the victim.

Basic Life Support

Life support is a series of emergency life-saving procedures that are carried out to prolong
the life of a victim. It is classified under three types:
1. Basic life support is an emergency procedure that consists of recognizing respiratory or
cardiac arrest or both and the proper application of cardiopulmonary resuscitation (CPR) to
maintain lite until a victim recovers or advanced cardiac life support can be administered.
2. Advanced cardiac life support is the use of special equipment to maintain the breathing and
blood circulation of the victim.
3. Prolonged life support is the post-resuscitation and long-term resuscitation.

Chain of Survival
1. The first link or early access is initiated immediately after the patient collapses. It entails calling
the local emergency number as quickly as possible and giving the hotline as much vital
information as you can about the emergency.
2. The second link or early CPR is initiated while waiting for the arrival of emergency medical
services (EMS) personnel who are trained to provide care. The probability of survival
approximately doubles when it is done before the arrival of the EMS.
3. The third link or early defibrillation is most likely to improve survival. It is the key intervention to
increase the chance of survival of the patient outside without hospital care.
4. The fourth link or early advance care is provided by highly trained EMS personnel and
paramedics who monitor the patient closely on the
way to the hospital.

What is an Emergency?
➢ Emergency is the sudden onset of medical or surgical
severity that, in the absence of immediate medical
attention, could reasonably and expectedly result in
serious danger to health or impairment of bodily
functions.

Emergency Action Principles

The scene must be surveyed entirely. Is the scene safe? What happened? How many
were injured? Are there bystanders who can help? The first aider must get the consent to
give care; check for responsiveness such as alertness, verbal response, pain stimuli, and
unresponsiveness; and protect the spine, if necessary.
To activate medical assistance, the first aider can do care first or call first, especially in
cardio-related problem-adult and care first, and in respiratory problem4child an infant. A
bystander can be requested to call a physician. Take note of the following activating
medical assistance: (1) situation of the person injured; (2) location; (3) number of persons
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injured; (4) extent of injury and first aid given; (5) telephone number from where you are
calling; and (6) the identity of the person who activates the medical assistance.

For primary survey, check the airway for breathing for five seconds and blood
circulation for ten seconds. Secondary survey includes interviewing the victim; knowing her
name; background intervention about the accident; assessing sample medical history of the
victim such as signs and symptoms, allergies, medication taken, past/present medical illness,
last oral intake, and event prior to the incident. To check the vital signs, the first aider must
determine radial or carotid pulse; breathing; and the victim’s face, lips, skin appearance,
temperature, moisture, and color. Head to toe examination must be conducted. This will
enable the first aider to see if there is deformity, contusion, abrasion, puncture,
burn/bleeding, tenderness, laceration, or swelling (DCAP-BTLS).
Emergency rescue is the quick transfer of a patient from an unsafe place to a safe
place. The indications for emergency rescue are:
1. Danger of fire or explosion
2. Risk of toxic gases or asphyxia due to lack of oxygen
3. Serious traffic hazards
4. Risk of drowning
5. Danger of electrocution
6. Danger of collapsing walls

Methods of Rescue
1. For immediate rescue without any assistance, drag or pull the victim.
2. Most of the drags/carries/lifts and other transfer methods can be used as methods of rescue.

Transfer is moving a patient from one place to another after giving first aid. The factors to
consider in choosing the transfer method are as follows:
1. Nature and severity of the injury
2. Physical capabilities of the first aider
3. Size of the victim
4. Number of personnel and equipment available
5. Nature of evacuation route
6. Distance to be covered
7. Gender of the victim

The following guidelines must be followed during transfer:

1. Victim’s airway must be maintained open.
2. Hemorrhage is controlled.
3. Victim is safely maintained in the correct position.
4. The victim’s condition is regularly checked.
5. Supporting bandages and dressing remain effectively applied.
6. The method of transfer is safe, comfortable, and as speedy as circumstances permit.
7. The patient’s body is moved as one unit.
8. The taller first aiders stay at the head side of the victim.
9. First aiders/bearers must observe ergonomics in lifting and moving the patient

Methods of Transfer
1. One-man assists/carries/drags such as assist to walk, carry in arms, carry in a pack-strap
method, carry in a fireman’s way, blanket drag, armpit/shoulder drag cloth drag, feet drag,
and inclined drag (head first in passing a stairway)
2. Two-man assists such as assist to walk, four-hand seat, hands as a litter, carry by extremities,
and fireman’s carry with assistance
3. Three-man assists such as bearers alongside (for narrow alleys) and hammock.

Cloth Material Commonly Used in First Aid

1. Dressing is any germ-free fabric material used to plaster wound.

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2. Bandage is any clean or sterilized fabric material that holds the dressing place.

Bandages and Bandaging Techniques

Bandages and dressings are both used in wound or fracture management. A
bandage is a piece of cloth or other material used to bind or wrap a diseased, injured, or
fractured part of the body. Usually shaped as a strip or pad, bandages are either pad,
bandages are either place directly against the wound or used to bind a fracture of the
body.
The following are bandages and bandaging techniques adapted Survive Outdoors
(Jalic Inc., n. d.).
Bandaging Upper and Lower Extremities
Shoulder Bandage
➢ To apply bandages attached to the field first aid dressing-
1. Take one bandage across the chest and the other across the back and under the arm
opposite the injured shoulder.
2. Tie the ends with a non-slip knot (Figure 1).

Figure 1 Shoulder bandage

To apply a cravat bandage to the shoulder or armpit

1. Make an extended cravat bandage by using two triangular bandages (figure 2A). Then,
place the end of the first triangular bandage along the base of the second one (Figure 2B).
2. Fold the two bandages into a single extended bandage (Figure 2C).
3. Fold the extended bandage into a single cravat bandage (Figure 2D). After folding, secure
the thicker part (overlap) with two or more safety pins (Figure 2E).
4. Place the middle of the cravat bandage under the armpit so that the front end is longer than
the back end and safety pins are on the outside (Figure 2F).
5. Cross the ends on top of the shoulder (Figure 2G).
6. Take one end across the back and under the arm on the opposite side and the other end
across the chest. Tie the ends (Figure 2H).

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Figure 2 Extended cravat bandage applied to shoulder (or armpit)

Be sure to place sufficient wadding in the armpit. DO NOT tie the cravat bandage too
tightly. Avoid compressing the major blood vessels in the armpit.

Elbow Bandage
To apply a cravat bandage to the elbow
1. Bend the arm at the elbow and place the middle of the cravat at the point of the elbow
bringing the ends upward (Figure 3A).
2. Bring the ends across, extending both downward (Figure 3B).
3. Take both ends around the arm and tie them with non-slip knot at the front of the elbow
(Figure 3C).

Figure 3 Elbow bandage

If an elbow fracture is suspected, DO NOT bend the elbow; bandage it in an extended

position.

Hand Bandage
To apply a triangular bandage to the hand-
1. Place the hand in the middle of the triangular bandage with the wrist at the base of the
bandage (Figure 4A). Ensure that the fingers do not come in contact with the absorbent
material to prevent chafing and irritation of the skin.
2. Lace the apex over the fingers and tuck any excess material into the pleats on each side of
the hand (Figure 4B).
3. Cross the ends on top of the hand, take them around the wrist, and tie them Figures 4C, 4D,
and 4E) with a non-slip knot.

Figure 4 Triangular bandage applied to hand

To apply a cravat bandage to the palm of the
hand-
1. Lay the middle of the cravat over the palm of the
hand with the ends hanging down on each side (Figure
5A).
2. Take the end of the cravat at the little finger across the back of the hand, extending it upward
over the base of the thumbs. Then, bring it downward across the palm (Figure 5B).

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3. Take the end under the thumb and across the back of the hand, over the palm, and through
the hollow between the thumb and palm (Figure 5C).
4. Take the ends to the back of the hand and across them; then, bring them over the wrist and
cross them again (Figure 5D).
5. Bring both ends down and tie them with a non-slip knot on top of the wrist (Figures 5E and 5F).

Figure 5 Cravat bandage applied to the palm of hand

Leg (Upper and Lower) Bandage

To apply a cravat bandage to the leg
1. Place the center of the cravat over the dressing (Figure 6A).
2. Take one end around and up the leg in a spiral motion and the other end around and down
the leg in a spiral motion, overlapping in each preceding turn (Figure 6B).
3. Bring both ends together and tie them (Figure 6C) with a non-slip knot.

Figure 6 Cravat bandage applied to the leg

Knee Bandage
In applying a cravat bandage to the knee as illustrated in Figure 7, use the same technique
in bandaging the elbow. The same caution for the elbow also applies to the knee.

Figure 7 Cravat bandage applied to the knee

Foot Bandage
To apply a triangular bandage to the foot
1. Place the foot in the middle of the triangular bandage with the heel well forward of the base
(Figure 8A). Ensure that the toes do not come in contact with the absorbent materials to
prevent chafing and irritation of the skin.
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2. Place the apex over the top of the foot and tuck any excess material into the pleats on each
side of the foot (Figure 8B).
3. Cross the ends on the top of the foot, take them around the ankle, and tie them at the front of
the ankle (Figures 8C, 8D, and 8E).

Figure 8 Triangular bandage applied to the foot

SOFT TISSUE INJURIES

Wounds
➢ a break in the continuity of a tissue of the body either internal or external.
Classifications of wound:
a. Closed Wound
➢ Break in the continuity of a body tissue without the skin being broken
down.
➢ Causes:
3 Blunt object results in contusion or bruises
3 Application of external forces.
➢ Signs and Symptoms
3 Pain and tenderness 3 Discoloration
3 Swelling 3 Hematoma Closed Wound
➢ First Aid Management

R-Rest the affected area. Movement may aggravate the

closed wound condition.

I-Ice Compress. Apply ice compress to the affected areas. It

promotes vasoconstriction and it has an anesthetic effect

C-Compression. Application of firm pressure. To avoid further

hematoma.

E-Elevate the affected area. (For extremities) To promote

venous return of blood and avoid pooling in the area

S-Splinting. For immobilizing the affected area. This helps in

avoiding unnecessary movements.

➢ Perform further assessment and put the injured person under observation.
SEEK FOR MEDICAL ADVISE IF:
3 The pain is unbearable 3 Bleeding is noted in mouth, ears and nose.
3 Involves the spine area. 3 Coughing and vomiting of blood.
3 Hematoma is spreading
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3 The affected area is the head (including face and neck)

b. Open Wound
➢ an injury involving an external or internal break in body tissue,
usually involving the skin.
➢ Classifications:
a. Puncture – wound caused by sharp & pointed object
Penetrating the skin.
b. Abrasion – caused by rubbing/scrapping of the skin
against rough surfaces.
c. Laceration – the skin is torn by sharp objects with
irregular edges.
d. Avulsion – tissues are forcefully separated from the
body.
e. Incision – skin and tissues are cut by a sharp bladed instrument.
➢ Dangers of an Open Wound
a. Hemorrhage – severe bleeding.
b. Infection – introduction of bacteria/parasites.
c. Shock – decreased in circulatory (blood) volume. (a fatal condition)

First Aid Management for Open Wounds: For wounds with severe bleeding

a. Inspect c. Refer to a Physician

-Inspect for foreign object lodged in the
wound area. It can be removed manually
by hand or using a pick-up forceps. Flushing
with normal saline solution or just clean
water is also applicable.
-It is essential in severe bleeding wounds.
Further medical/surgical management may
be needed like suturing or administration of
medications that control bleeding.

b. Control Bleeding d. Continuous Assessment and Observation for

-Done by applying a sterile absorbent gauze Shock
pad over the bleeding site while applying a -Signs and Symptoms:
firm pressure. Dressing can be secured with 1. Pale/Cyanotic
a bandage and splints. 2. Cold and Clammy Skin
3. Irregular Breathing Weak/Rapid Pulse
4. Weakness
5. Thirsty sensation

First Aid Management for Open Wounds: For wounds with mild to moderate bleeding.
1. Clean 3. Dress
-Clean with mild soap and water.

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-Apply sterile gauze pad with dressing. Secure

with adhesive tapes.

2. Disinfect
-Apply topical antiseptics. Povidone Iodine
or Topical Antibacterials (Mupirocin, Fusidic
Acid)

Burns
➢ an injury involving the skin, including muscles, bones, nerves and blood vessels. This results from
exposure to direct heat (fire), chemicals, electricity, solar or other forms of radiation.
➢ Classifications of Burns:
a. Thermal Burns
- caused by direct or indirect contact to
flames and other hot objects, steams
or liquids.

Classified in to 3 according to depth & severity Thermal Burns

- Affects only the first (epidermis) layer of

the skin. Very painful and skin is red.

- Affects the first and second layer

(epidermis + dermis) of the skin. Blisters are
expected to form.

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- Affects the first and second layer of the skin and may extend up to the
proximal subcutaneous tissues. Usually less painful.

First Aid Care for Thermal Burns

• For First- and Second-Degree Burn.
1. RELIEVE PAIN
- Relieve pain by immersing burned area into clean tap water/iced water for maximum
of 5mins for iced water and 10mins for tap water. Prolonged exposure to extremely cold
temperature may cause total numbness due to extreme vasoconstriction.
2. COVER
-Cover the burned area with clean cloth or dressing (if available) and make sure that it
is non sticking. If blisters are forming, do not attempt to pop it out to prevent infection. Always
maintain cleanliness on the burned area. Apply Burn Ointment if available.
First Aid Care for Thermal Burns
• For Third Degree Burns.
1. COVER
- Cover the burned area with a dry and non-sticking dressing. Do not apply anything
unto the skin. Immersing into water is not advisable.

2. PREPARE FOR EMERGENCY TRANSFER

-Continuously monitor for signs of dehydration and shock. Keep the victim warm by
covering with blankets during the transfer. Extend the flexed burned extremities to avoid
contractures.

b. Chemical Burns
➢ Burns caused by direct contact of chemical into skin.
3 Car battery Solutions 3 Bleach
3 Hydrochloric Acid (Muriatic) 3 Ammonia
➢ First Aid Care for Chemical Burns
• Immediately remove the chemical by flushing with
water. Remove the victim’s contaminated clothing. Use
mild soap for the final rinse.
• Pat dry the area using clean cloth and apply dressing
into affected area.
• If the chemical is in the eye, flush for at least 20minutes using low pressure.
• Seek medical attention immediately for chemical burns.

c. Electrical burn
➢ a skin burn that happens when electricity comes in
contact with your body. When electricity comes in
contact with your body, it can travel through your
body. When this happens, the electricity can
damage tissues and organs.
➢ This damage can be mild or severe 3 and it can
even cause death. Organs that are commonly
damaged include the:
●Heart 3 People can get abnormal heart rhythms.
Their heart can also suddenly stop beating, which is
called "cardiac arrest."
●Kidneys 3 The kidneys can stop working normally.
●Bones and muscles 3 If the muscles are severely injured, substances from inside damaged
muscle cells can leak into the blood. This is called "rhabdomyolysis." In some cases, it can
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cause injury to other organs. People can also get an abnormal build-up of pressure in a
group of muscles, called "acute compartment syndrome."
●Nervous system 3 People can pass out, have muscle weakness, or eye or ear damage.

What are the symptoms of an electrical burn?

The symptoms depend on how much electricity came in contact with your body and how
long the contact lasted.
Electricity can cause different types of skin burns, depending on which skin layers are
affected. The terms doctors use to describe different types of burns are:

●Superficial 3 A superficial burn affects only the top layer of the skin. The skin is red, dry, and
painful. When you press on the burn, it turns white.

●Partial-thickness 3 A partial-thickness burn affects the top 2 layers of the skin. The skin is red
and can leak fluid or form blisters.

●Full-thickness 3 A full-thickness burn affects all the layers of the skin. The burn doesn't usually
hurt, because the burned skin can't feel anything. The skin can be white, gray, or black.

How is an electrical burn treated?

Treatment depends on the type of skin burn you have and how serious it is.
Treatments for a mild skin burn can include:

●Cooling the burn 3 You can put a cool cloth on your burn or soak it in cool water. Do
not put ice on a burn.
●Covering the burn with a clean bandage 3 Your doctor might also recommend or
prescribe a cream or ointment to soothe the skin or prevent an infection.
●Treating the pain 3 To ease your pain, you can raise the burned part of your body
above the level of your heart. For example, you can prop your foot or leg up on pillows.
You can also take an over-the-counter pain medicine, such as acetaminophen (sample
brand name: Tylenol) or ibuprofen (sample brand names: Advil, Motrin).
●Getting a tetanus shot, if it has been too many years since your last one

A severe skin burn is usually treated in the hospital. Treatments can include:

●Strong pain medicines

●Special bandages
●Antibiotic and other types of creams or ointments
●Surgery to repair the burned area

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