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First aid notes.v2.1
First aid notes.v2.1
Notes
2
ISBN 0 909896 73 9
Copyright © 2022 Australian Red Cross
Useful numbers
Ambulance 000
Poisons 13 11 26
First Aid is help given in the case of an accident or sudden illness before
To promote recovery
• Comfort and reassure the person
• Give protection from the weather
Legal considerations
People are sometimes afraid that they may make mistakes when they
give first aid and cause harm to the person. They might also worry that a
mistake may lead to a legal problem such as being sued.
Be reassured that in the eyes of the law, first aiders are not expected to
be perfect. The general legal principle is that the first aider is expected
to act reasonably with a genuine concern for the best interests of the
person and in accordance with their level of knowledge and training.
If you are following this principle, you need not worry about any legal
ramifications.
2. What happened?
• Look for clues about what caused the emergency, and the extent of
the injuries or condition
Recovery position
12
Sending for help
Call 000, ask for ‘ambulance’. Follow operator’s
instructions and be prepared to give information on:
• The exact location with landmarks and cross streets if possible
• Any issues with access
• The number of persons
• The condition of the person(s)
• The details of the person if known
• The caller’s name and number
• Any first aid given
Cardiopulmonary
Resuscitation (CPR)
Respiration is the process of breathing in which oxygen is taken into
the body and carbon dioxide is removed.
Every cell of the body needs a constant supply of oxygen. If the vital
centres of the brain and heart are kept short of oxygen for more than
a few minutes, serious damage may occur. The casualty will become
unconscious, and the breathing will stop. Next the heart stops beating,
and death occurs.
If a casualty is unconscious and not breathing normally it is vital to start
resuscitation immediately.
in special circumstances
Infants (0 to 1 year):
• Ensure infant has a neutral head tilt position
• Use the tips of two fingers to compress the chest
• Puff gently into the infant’s mouth and nose.
• Maintain head in a neutral position
16
Chest compressions
Children (1 to 8 years):
• Full head tilt (as per adults)
• Blow gently into the child’s mouth
• Use the heel of one hand or two hands to compress the chest
Basic life support flow chart 17
Start CPR
D
Attach AED (as soon as available
and follow its prompts)
AED = Automated External Defibrillator
What to do:
•
Use the ‘talk and touch’ method to ascertain consciousness: ask
them their name, squeeze their shoulder, say “can you hear me?”
Ask them to “squeeze my hand and let go.”
•
If there is no response, Send for help - call 000 and check airway
and breathing using the Basic Life Support Flow Chart. If the person is
unconscious and not breathing normally, immediately commence CPR.
•
Check for any severe bleeding and quickly control it.
•
Perform a secondary survey and check for any other serious injuries.
•
Do not allow any food or drink to be given to an unconscious victim.
•
Stay with an unconscious victim until emergency personnel arrive.
Note any changes in condition such as breathing difficulties, poor
colour, restlessness, etc. and report these to emergency personnel
when help arrives.
Choking 19
5x
5x
Asthma 21
What to do:
Step 1 Stay with the person and sit the person upright; continue
•
to reassure and access asthma reliever medication.
Step 2
• Asthma Action Plan 4 x 4 x 4: Using a puffer or a puffer
and spacer (if a spacer is available) administer one (1) puff
of inhaler followed by four (4) breaths; administer another
puff, then four (4) breaths; another puff, then four (4)
breaths and a final puff, then four (4) breaths
• Step 3 Wait four (4) minutes, to see if the reliever treatment is
effective
Step 4 If there is little or no improvement repeat steps 2 and 3
•
Step 5 If there is still no improvement, Send for help - call 000.
•
Continue to repeat steps 2 and 3 while waiting for the
ambulance
4x
Asthma spacer
22
Severe allergic reactions
(anaphylaxis)
Common triggers for the onset of allergic reactions include:
•
Foods such as nuts, peanuts, eggs, dairy, shellfish, soy and sesame
•
Venoms such as bee stings, wasp and ant stings
•
Medications such as penicillin
•
Others such as latex, herbal medications
If too much blood is lost from the body through a wound or injury, the
Bruises
Applying a cold compress (for approximately 20 minutes) for minor
bleeding under the skin can help to ease the pain and reduce the
bleeding. A “black eye” is a bruise that should always be seen by a
doctor because there may be damage to the eye, skull or cheekbone.
Do not apply pressure over a black eye.
Wound dressings
Dressings are used to cover wounds in order to stop any bleeding,
prevent bacteria from entering the wound and protect the wound from
further damage.
Dressings are often sealed in an airtight wrapper ready for use. When
a sterile dressing is not available, an emergency dressing may be used.
It should be made from any material on hand and be free of fluff: for
example, a clean handkerchief or a towel.
What to do:
•
Send for help – Call 000
•
Help the person to lie down if possible and rest in the most
comfortable position
•
Monitor the person.
•
Maintain body temperature and reassure the person
•
If the bleed is minor a cold compress can be used
•
Closed Bleeding in a Limb
- If there is bruising to a limb and no external bleeding, use
pressure and a cold pack if available.
- If closed bleeding in a limb is causing severe swelling or pain, or
the person is showing signs of shock, send for help - call 000
Do not give any food or fluid
•
• Do not give any medication or alcohol
• Do not attempt to apply pressure
Shock 27
Indications of shock:
•
May feel faint and giddy
•
Looks very pale
•
Has cold and clammy skin
•
Has rapid breathing
•
May feel sick and may vomit
•
May be thirsty from loss of body fluids
•
May become unconscious
What to do:
•
Lay the person flat
•
Control any bleeding promptly
•
Send for help – call 000
•
Reassure and constantly re-check the person for any change
•
Treat the cause of shock
•
Maintain body temperature
•
Do not give any food or fluid
• If unconscious, manage as per the Basic Life Support Flow Chart
•
Send for help Call 000
28
Heart attack
A person experiences a heart attack when there is a sudden partial
or complete blockage of one of the coronary arteries that supply the
heart muscle. As a result of the interruption to the blood supply, there
is an immediate risk of life-threatening changes to the heart rhythm. If
not corrected quickly there is also a risk of serious, permanent heart
muscle damage. To reduce the chance of sudden death from heart
attack, urgent medical care is required — “every minute counts”.
Heart attack is different from, but may lead to, cardiac arrest. Cardiac
arrest is cessation of heart action.
What to do:
•
Stop what they are doing
•
Stay with the person
•
Locate closest Automatic External Defibrillator (AED) and bring to
the person
•
If the person is conscious, assist them into the most comfortable
position. This is generally supported in a half-sitting position. Give
reassurance and loosen tight clothing at the neck and waist
•
Send for help – Call 000
•
Ask about medications for angina or other heart-related illness and
assist them to take their medication as directed
• I f the person is not allergic to aspirin, administer 300mg
dissolvable aspirin tablet
•
If the person is unconscious, check their airway; if necessary, place
them in the recovery position, clear airway of any obstructions and
check for normal breathing. If signs of normal breathing are absent,
commence CPR immediately, attach a defibrillator if available and
follow prompts
Burns and scalds 29
What to do:
•
If the clothing is on fire use the stop, drop, cover and roll technique
and smother the flames using a non-flammable material such as
towels or blankets
•
Cool the burned areas quickly with water for at least 20 minutes.
Use the tap, shower, buckets etc. to cool the burn
In electrical burns, cool entry and exit wounds after ensuring the
•
area is safe
•
If the clothing is soaked with boiling water or hot oil, carefully
remove the outer clothes before cooling the skin. DO NOT attempt
to remove any clothing that has burnt into the flesh
•
Cover the burn with a loose and light non-stick dressing, preferably
clean, dry, lint-free (non-fluffy) material e.g., plastic cling wrap
•
Blisters may appear after a burn or scald and should never be
pricked or broken. Only apply dressing if you have ensured the burn
has been adequately cooled
•
Never apply a cream or ointment to a burn
•
Chemicals which have splashed the skin should be washed off
thoroughly for 20 to 30 minutes before a dressing is applied
•
Chemical burns affecting the eye must be flushed continuously
under running water. The eye is then covered with a clean pad and
the casualty checked by a doctor as soon as possible
•
When a large area of the body is involved, there will be severe
shock. Avoid over-cooling of the injured person
•
Unless the injury is very slight, a doctor should check all burns
and scalds
•
All infants and children should be medically assessed
30
Foreign objects in the eye,
ear or nose
Eye
Great care is needed when a foreign object is present in the eye.
Rough treatment may lead to permanent loss of vision.
What to do:
•
Inspect the object in the person’s eye
•
If the object seems to be embedded, call for an ambulance, lie the
person down and cover the injured eye by placing thick pads above
and below the eye or cover with a paper cup
•
If the object has not embedded into the eye, gently flush the eye with
saline or cool, running water which may dislodge the foreign object
What to do:
•
Send for help/call 000
•
Look for the source of the electricity and turn off at the power point
or switch. It is also wise to remove the plug to make it doubly safe.
Never touch a plug or switch with wet hands!
•
If you are unable to disconnect the electricity at the power point,
try to switch off the mains supply
•
If there is a fallen power line, remain clear and send for help - call
000 and advise them of the danger
•
When the area is safe, check that the casualty is conscious, has
a clear airway and is breathing normally. If not, start resuscitation
at once
•
If the casualty is breathing, check them for any burns; flush entry
and exit wounds with cool water and cover these with a dry
dressing. Always seek medical advice for electrical burns because
they can lead to serious complications
Remember: Occasionally power cables are knocked down in a car
accident. Never attempt to help a person when power lines are down;
always wait until the electricity supply has been turned off by officials.
Keep well clear of fallen cables because “arcing” of electricity can
occur for up to 6 metres.
32
Poisons
A poison is a substance which is harmful to the body. Poisons may be:
Inhaled, Absorbed, Ingested or Injected.
Decontamination
•
If the poison is swallowed: wash out their mouth with water. Do not
try to make them vomit
•
If the poison is inhaled: immediately get the person into fresh air if
safe to do so. Avoid breathing in the fumes
•
If the poison enters the eye: flood the eye with saline or water from
a running tap or a cup/jug. Continue flushing for 20 to 30 minutes,
holding the eyelids open
•
If the poison contacts the skin: have the person remove
contaminated clothing, taking care to avoid contact with the poison
•
If the person is unconscious, place them on one side in the
recovery position and send for help - call 000. If breathing stops,
begin CPR at once if it safe to do so. If poisoning is suspected
wipe area around mouth to remove any possible residue. Send any
evidence of the poison to hospital with the person
•
If the person is conscious and stable, the first aid treatment is to
contact the Poisons Information Centre on 13 11 26
Snake bite
What to do:
•
Keep the person at rest, reassured and under observation
•
Send for help-call 000
•
Follow basic life support (DRSABCD) as required
•
If resuscitation is needed it takes precedence over the PIT
•
If on a limb, apply a broad pressure bandage over the bite as soon
as possible
•
Elasticised bandages (10-15cm wide) are preferred over crepe
bandages. If neither are available, clothing or other material should
be used. The bandage should be firm and tight, you should be
unable to easily slide a finger between the bandage and the skin.
•
In order to further restrict lymphatic flow and to assist in
immobilisation of the limb, apply a further pressure bandage,
commencing at the fingers or toes of the bitten limb and extending
upward covering as much of the limb as possible. The bandage
should be applied over existing clothing if possible. The purpose
of this bandage is to further restrict lymphatic flow and assist
immobilisation. (Alternatively, a single bandage may be used to
achieve both pressure on the bite site and immobilisation of the
limb. In this method, the bandage is initially applied to the fingers or
toes and extended up the limb as far as possible including the bite
site).
•
Splint the limb including joints on either side of the bite, to restrict
limb movement. The splint material can be incorporated under the
layers of the bandage. For the upper limb, use a sling.
34 If only one bandage is available, commence at the extremities and
work upwards including the bite site in the process. Once applied, the
bandage and splint should be kept in place until the person reaches
hospital.
•
The limb should be immobilised with a splint or sling, as
appropriate. Once applied, the bandage and splint should be kept
in place until the person reaches hospital. Note: mark outside of
bandage where bite site is so hospital staff can find the bite site.
•
Do not wash venom off the skin as it will assist in identification of
the snake and the decision about which antivenom is required.
•
The bandage can be applied over existing clothing if the clothing is
not too bulky.
1. K
eep the person at rest, reassured and 2. Dial 000
under observation
000
Bee sting
After a bee sting, the barb may be left in the skin. It should be removed
promptly by brushing or scraping sideways; never pull the sting out as
more venom will be injected.
1. Apply an ice compress to the sting site to limit pain and swelling.
2. If there are signs of an allergic reaction, send for help - call 000
and follow first aid for severe allergic reactions.
Marine stings 37
A blue-ringed octopus may appear small and harmless but is really
very dangerous. If touched or provoked, the creature may bite and
Management of a seizure
• If the casualty is unresponsive and not breathing normally,
follow DRSABCD
• If the casualty is unconscious and actively seizing, the first aider
should:
- manage the casualty following DRSABCD
- remove the casualty from danger or remove any harmful
objects which might cause secondary injury to the casualty
- note the time the seizure starts.
- protect the head.
- avoid restraining the casualty during the seizure unless this is
essential to avoid injury.
- lay the casualty down and turn the casualty on the side when
practical.
- maintain an airway.
- reassure the casualty who may be dazed, confused or drowsy.
- send for help-call 000.
- frequently reassess the casualty.
Continued over page.
40 Do not:
•
Do not force the casualty’s mouth open nor attempt to insert any
object into the mouth.
•
A seizure in water is a life-threatening situation. If the seizure occurs
in water:
- support the casualty in the water with the head tilted so the
face is out of the water.
- remove the casualty from the water as soon it is safe to do so.
- send for help - call 000.
- if the casualty is unresponsive and not breathing normally,
follow DRSABCD.
What to do:
•
If the person is fully conscious, help them into the lying or a half-
position at total rest with the head and shoulders slightly raised.
Reassure the person and send for help - call 000 .
•
If the person is unconscious, turn them on to the stable recovery
position injured/paralysed side down and send for help - call 000.
• DO NOT give anything to eat or drink
What to do:
Send for help – call 000 if there has been a loss of consciousness
•
or altered consciousness at any time, no matter how brief.
•
If there is any external bleeding apply direct pressure to stem
the bleed.
•
If the skull appears to be damaged apply pressure around the injury.
•
If a clear or bloodstained fluid is seen leaking from the ear or nose,
allow it to drain freely on to a clean pad. An unconscious person
with this condition should be turned on to one side, lying with the
affected side downwards. Avoid moving the person’s neck and spine.
•
If the casualty has any loss of consciousness, even if only for a
minute, send for help - call 000.
•
Reassure the casualty who has loss of memory of events around
the time of injury. The casualty may ask, “Where am I?” or “What
happened?” and may need frequent reassurance.
•
Keep the casualty lying down (recovery position if unconscious and
breathing) and make frequent checks of pulse; breathing;
skin colour, size and reaction of pupils; spoken response; mental 43
state, etc. until the ambulance has arrived.
•
If the casualty is alert and fully conscious, continue to observe
them for any deterioration.
Fainting
Fainting may be caused by a fall in blood pressure, dehydration,
standing still and having blood pooling in the legs, standing suddenly
from a sitting position or bad news or nervous excitement. The victim
looks shocked, feels faint and giddy, and may collapse.
What to do:
•
If the person does not respond, place them into the recovery
position (as per the unconscious person).
•
If the person has become responsive, lay them down for a few
moments until fully conscious.
•
Loosen any tight clothing at the neck and waist.
•
Do not give food or drink until the casualty has recovered fully.
44
Diabetes
The pancreas produces insulin which is essential to the metabolism
of sugar and fats. A person with diabetes may either cease producing
insulin or not effectively be able to use insulin. Some diabetics require
regular insulin injections and will need to monitor their diet. Sometimes
a person with diabetes develops an imbalance between the insulin and
blood sugar levels.
What to do:
•
If the person is conscious, give them a sugary drink or fruit juice
(approx. 200 mls) OR jellybeans (15-20) OR honey or sugar (3
teaspoons).
•
If the person has high blood sugar and you give them more sugar
it will not improve the state however will not worsen it either. When
your blood sugar is very high it tends to ‘plateau’ even if you have
more sugar.
•
If the person has low blood sugar (which is more likely) they should 45
soon recover enough to then have a small meal such as a sandwich.
Medical advice should be sought.
When in doubt as to whether the casualty has too high or too low blood
What to do:
•
Help the person to rest in a cool and shaded area.
•
Loosen and remove excessive clothing.
•
Call 000 if the person does not improve
46 Persons over 5 (while waiting for the ambulance)
•
Immerse the whole body in cold water (if bath available)
•
Wet the person with cold or cool water
•
Apply ice packs to the groin, armpits, facial checks, palms and soles
•
Repeatedly moisten the skin with a moist cloth or spray
Persons under 5
•
Cool in a tepid (luke-warm) bath, sponging frequently if
a bath is available
•
Repeatedly moisten in with a moist cloth or spray
If the person is fully conscious and can swallow give cool or cold water
to sip. A 3-8% carbohydrate electrolyte fluid (sports drink). If available,
may be provided to sip.
Cold related illness (Hypothermia) 47
Types of fractures
Closed fracture: A bone is broken but the skin is undamaged.
Open fracture: A wound is present over the broken bone.
Complicated fracture: A broken bone which has damaged a
neighbouring organ, e.g., lung damage from fractured ribs, or brain
damage from a skull fracture.
What to do:
•
call 000
•
try not to move the spine, keep it immobilised if possible
• O NOT move the person except when necessary to remove them
D
from danger or to protect the airway of an unconscious casualty
•
reassure the casualty
•
treat other injuries as appropriate
An awareness of potential spinal injury and careful victim handling, with
attention to spinal alignment, is the key to harm minimisation.
NOTE: Airway management takes precedence over suspected
spinal injury.
Strains
A strain is caused by an overstretched muscle or tendon. Swelling
may not occur, but the person may complain of pain and loss of power
in the injured area. Treat as for a sprain using rest, ice, compression,
elevation and referral (RICER).
Sprains 51
What to do:
• Rest: Place the victim in the most comfortable position.
Ice: Apply a cold compress or an ice pack over the bandage for no
•
longer than 20 minutes every two hours for the first 48 to 72 hours
Avoid using heat for 48 to 72 hours.
Compression: Support the joint with a firm bandage.
•
Elevation: Raise the injured part to reduce the swelling.
•
• Referral: for medical assessment
Dislocations
Following a sudden, unnatural movement, bones within a joint may
become dislocated. Severe pain, deformity and swelling are common,
with loss of power or function of the injured area. In addition, there
may be a fracture in, or around, the joint. Never attempt to correct the
dislocation yourself.
What to do:
•
Place the person in the most comfortable position.
•
Treat dislocation as per fracture management.
•
Give support to the injured part.
•
Seek urgent medical aid.
52
Bandages
In first aid, bandages are generally triangular and of strong cotton
fabric. They are made from a square of material which is at least one
metre long on each side, and then cut in half diagonally.
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