Emergency Room-First Aid

Emergency Room
First Aid
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Definitions
 It is the immediate action given to a person
who has been injured or suddenly taken ill
 It is the help that you can provide until
professional help takes over. It includes well
selected words of encouragement. Evidence of
willingness to help and promotion of
confidence by demonstration of competence
Rationale
 People should be trained to care properly for
injuries to themselves and others at home, at
work, or in the community. Since even trivial
injuries are potentially serious, every one
should know the proper steps to prevent
complications. The urgent needs for treating
life threatening situations makes it the
responsibility of everyone to be able to give
proper emergency care until the victim is
transported to a medical facility
Three Basic Objectives Of First Aid
 To alleviate
Suffering
 To prolong Life
 To prevent added
injury or danger
PRECAUTIONS
 Before You Act
 Be realistic
 Know yourself
 Know the facts- Incases where you need to perform
first aid on someone outside your family, you need
to be aware of two legal issues/responsibilities
 Be a good Samaritan
 Obtaining Consent
 Be prepared
 Gather your supplies
 During An Emergency
 Remain Calm
 Use Common Sense
 Be resourceful
 Keep evaluating the Risk
 Do no further harm
1. Control Of Bleeding
 Hemorrhaging or Bleeding- is a flow from
an artery or vein or capillary
 Bleeding from an artery- an artery has been

severed when bright red blood spurts from a wound.
The blood from the arteries comes directly from
the heart and spurts out at each contraction.
Having received a fresh supply of oxygen, the blood
supply is red
 Bleeding from a vein- when dark red blood flows from

a wound in a steady stream, a vein has been cut.
The blood, having given up its oxygen and received
carbon dioxide and waste products in return is dark red
 Bleeding from capillaries- Blood from capillaries ooze.

There is usually no cause for alarm, relatively
little blood is lost
METHODS OF CONTROLLING BLEEDING:
 Direct Pressure- The best all around method

of controlling bleeding is applying pressure
directly to the wound. This is best done by
placing gauze or the cleanest material
available against the bleeding point and
applying firm pressure with the hand until
the bandage is applied
 Elevation- Elevating the bleeding part of the

body above the level of the heart will slow
the flow of blood and speed clotting. Use
elevation with direct pressure when there
are no fractures or fractures that have been
splinted and it will cause no pain and
aggravation toProperty
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injury
 Pressure points- Arterial bleeding can be
controlled by digital pressure applied at
pressure points. Pressure points are places
over a bone where arteries are close to the
skin
 Tourniquets- a tourniquet is a device used to

control severe bleeding. It is used as an
absolute last resort after all other methods
have failed
Procedure For Application of
Tourniquet
While the proper pressure point is being held to
temporarily control the bleeding, place the
tourniquet between the heart and the wound, with
sufficient uninjured flesh between the wound and
tourniquet
In using an improvised tourniquet, wrap the material
tightly around the limb twice and tie in a half knot

on
the upper surface of the limb
Place a short stick to tighten the tourniquet only until

the bleeding stops
Secure the stick in place with the base ends of the

tourniquet, another strip of cloth or a suitable
Tourniquets
Precautions
Do not shield a tourniquet from view
Make a written note of the tourniquet’s location and
the time it was applied and attach a note to the
victim’s clothing. Alternatively, make a “T” on the
victims forehead
Get the victim to a medical Facility as soon as
possible
Once the tourniquet is tightened. It should not be
dislodge, clots and result in sufficient loss of blood
to cause a severe shock or death
Internal Bleeding
 internal bleeding in the
chest or abdominal usually
results from hard blows or
certain fractures. Internal
Bleeding is usually not
visible, but it can be very
serious, even fatal. Internal
bleeding may be
determined by any or all of
the following signs and
symptoms
Signs and Symptoms
 Pain, tenderness ,
swelling, or
discoloration where
injury is suspected
 Abdominal rigidity
and or muscle
spasms
 Bleeding from mouth,
rectum or other
natural body
openings
 Symptoms of shock:
 Dizziness, without other symptoms- dizziness
when going from lying to standing maybe the only
early sign of internal bleeding
 Cold clammy skin
 Eyes dull, vision clouded and pupils enlerged
 Weak and rapid pulse
 Nusea and vomiting
 Shallow and rapid breathing
 Thirst
 Weak and helpless feeling
 Cyanosis(late stage of shock)
Emergency care for internal bleeding is to
secure and maintain an open airway and
treat for shock. Never give the victim
anything by mouth. Transport anyone
suspected of having any internal bleeding
to professional medical help as quickly as
possible. Keep an injured person on
his/her side when blood or vomit is
coming from the mouth. Place the victim
with chest injuries on the injured side if
no spinal injuries are suspected.
Transport the victim gently
Nosebleeds
Nosebleeds are
more often
annoying than life
threatening. They
are more common
during cold
weather, when
heated air dries out
the nasal passages.
First aid for nosebleed is simple:
 Keep the victim quietly seated, leaning forward if possible
 Gently pinched the nostrils closed
 Apply cold compress to the victims nose and face
 If the person is conscious, it maybe helpful to apply pressure
beneath the nostril above lip

 Instruct the victim not to blow his nose for several hours after
the bleeding has stopped, or clots could be dislodged and start

the bleeding again
SHOCK
 Is the failure of the cardiovascular system to provide enough
circulation of blood to every part of the body. The collapse of
the cardiovascular system maybe caused by any of these
conditions:
 A. blood is lost
 Vessel dilate and there
Is insufficient blood to
fill them
 The heart fails to act
properly as a pump
and circulate the blood
Causes of Shock
 Severe or extensive injuries
 Severe pain
 Loss of blood
 Severe burns
 Electrical shock
 Certain illnesses
 Allergic reactions
 Poisoning inhaled, ingested or injected
 Exposure to extremes of heat and cold
 Emotional stress
 Substance abuse
First Aid Treatment for Shock
 Keep the victim lying down if possible.- make sure that head is at
the level with the body, Elevate lower extremities if the injury will
not be aggravated and there are no abdominal or head injuries
 Provide the victim with plenty of fresh air
 Loosen any tight clothing in order to make the breathing and
circulation easier
 Handle the victim as gently as possible and minimize movement
 Keep the victim warm and dry by wrapping in blankets, clothing or
any material available
 Do not give the victim anything by mouth
 The victims emotional well being is just as important as his /her
physical well being. Keep calm and reassure the victim
Anaphylactic Shock
 Is a sensitivity reaction
 It occurs when a person contacts something to
which he/she is extremely allergic. People who
are subjected to anaphylactic shock should
carry emergency medical identification at all
times
Signs and Symptoms of Anaphylactic
Shock
 Itching or burning Skin
 Hives covering large areas
 Swelling of the tongue and face
 Severe difficulty of breathing
 Tightening or pain in the chest
 Weak pulse
 Dizziness
 Convulsion
 Coma
Fainting
 Is a temporary loss of
consciousness due to an
inadequate supply of
oxygen to the brain and is
mild form of shock.
Fainting maybe caused by
sight of blood, exhaustion,
weakness, heat or strong
emotions such as fright ,
joy etc.
Signs and Symptoms
 Victim may feel weak and dizzy, and may see spots
 Face becomes pale and the lips blue in both light
and dark skinned people
 The forehead is covered with cold perspiration
 The pulse is rapid and weak
 The breathing is shallow
First Aid for Fainting
 If the person feels faint, the initial response might
be sitting with the head between the knees
 Have the victim lie down with the head lower than
the feet
 If the victim is unconscious for any length of time,
something may be seriously wrong. Arrange for
transportation to a medical facility
 Treat the victim for physical shock
 Maintain an open airway
 Do not give stimulants
3. Open Wounds
 An open wound is any break in the skin.
Breaks in the skin range from pin punctures
or scratches to extensive cuts, tears, gashes.
An open wound maybe the only surface
evidence of a more serious injury such as
fracture
Classification of Wounds
 Abrasions- caused by rubbing or scraping. These wounds
are seldom deep, but a portion of the skin has been
damaged, leaving a raw surface with minor bleeding. The
bleeding in most abrasions is from the capillaries.
Abrasions are easily infected due to the top layer of skin is
being removed leaving the underlying skin exposed
 Amputations- involves the extremities. When an
amputations occurs, the fingers, toes, hands, feet, or limbs
are completely cut through or torn off which causes jagged
skin and exposed bones. Bleeding may be excessive or the
force that amputates a limb may close off or torn vessels
limiting the amount of bleeding. A clean cut amputation
seals off vessels and minimizes bleeding. A torn
amputations usually bleeds heavily
Abrasions
Avulsions
 Is an injury that tears a whole piece of skin and
tissue loose or leaves it hanging as a flap. This
type of wound usually results when tissue is
forcibly separated or torn from the victims body.
There is a great danger of infection and bleeding.
Body parts that have been wholly or partly torn off
may sometimes be successfully reattached by a
surgeon
Incisions
 Wounds produced by a sharp cutting edge, such
as knife or razor, are referred to as incised
wounds, the edges of the wounds are smooth
without bruising or tearing. If such wound is
deep, large blood vessels and nerves maybe
severed
Lacerations
 Are those wounds made by rough edges, the flesh
has been torn or mashed by blunt instruments,
machinery, or rough edges such as jagged piece of
metal. Because the blood vessel are torn or
mashed, these wounds may not bleed as freely as
incised wounds. The ragged and torn tissues with
the foreign matter that is often or ground into the
wound make it difficult to determine the extend of
the damage. The danger of infection is great in
lacerations.
Punctures
 Are wounds produced by pointed objects such as
needles, splinters, nails, or pieces of wire passing
through the skin and damaging tissues in its path. The
small number of blood vessels cut sometimes
prevents free bleeding. The danger of infection in
puncture wounds is great due to this poor drainage.
There are two types of puncture wounds (a)
penetrating wound causes injured tissues. (b)
perforating puncture wound has entrance and exit
wound. The object causing the injury passes through
the body and out to create and exit wound, which in
many cases is more serious than the entrance wound
General First Aid for open wounds
 Carefully cut or tear the clothing so that the injury maybe seen
 If loose foreign particles are around the wound, wipe them away
with clean material. Always wipe away from wound not toward it
 Do not attempt to remove an object impaled in the wound.
Serious bleeding and other damage may occur if the object is
removed. Stabilized the object with a bulky dressing
 Do not touch the wound with your hands, clothing, or anything
that is not clean
 Place a sterile bandage compress or gauze over the wound and
tie in place
 All dressing should be wide enough to completely cover the
wound and the area around it
 Protect compresses, or gauze dressing with a cover bandage
made from a cravat or triangular bandage. Place outer dressings
in all open wounds except for eyes, nose, chin, finger and toe, or
compound fractures of the hand and foot when splints are applied
 Unless otherwise specified, tie the knots of the bandage
compress and outer dressings over the wound on top[ of the
compress pad to help in checking the bleeding
 Keep the victim quiet and lying still. Any movement will increase
circulation which could restart bleeding
 Reassure the victim to ease emotional reaction
 Treat for shock
Dressings and Bandages
Dressings and Bandages
1. Bandage compress- is a special dressing to cover
open wounds. It consists of a pad made of several
thickness of gauze attach to the middle strip of
gauze. Pad ranges from 1-4 inches. Bandage
compresses usually come folded so that the gauze
pad can be applied directly to the open wound with
virtually no exposure to the air or fingers
Gauze
 Is used in several ways in applying first aid
dressing; plain gauze maybe used in place of a
bandage compress to cover large wounds and
wounds of the trunk. Plain gauze in various sizes is
supplied in pockets
 Gauze roller bandage- is a self adhering form fitting
bandage. It can be made secure with several snug
overlapping wraps when tied in place
 Adhesive compress- is a self adhering bandage that has
gauze to cover the wound and a sticky backing which holds
the victims skin
 Triangular bandage- a standard triangular bandage is made

from a piece cloth approximately 40 inches square by folding
the square diagonally and cutting along the fold. It is easily
applied and can be handled so that part to be applied over a
wound or burn dressings will not be soiled. A triangular
bandage does not tend to slip off once it is correctly applied. It
is usually made from unbleached cotton cloth although any
kind of cloth will do . The triangular bandage is also used to
make improvised tourniquets, to support fractures and
dislocations, to apply splints and to form slings
 Cravat Bandage- a triangular bandage
maybe used open or folded. When it is folded, it
is known as cravat. A cravat bandage is
prepared as follows.
 Make a 1 inch fold along the base of the triangular
bandage.
 Bring the point (apex) to the center of the folded
base, placing the point underneath the fold, to make
a wide cravat bandage
 A medium cravat is made by folding lengthwise
along a line midway between the base and the new
top of bandage
 A narrow cravat is made if folding is repeated
Slings
 Are used to support injuries of the shoulder, upper
extremities or ribs. In a emergency they maybe
improvised from belts , neckties, scarves or similar
articles. Bandages should be used if available
Types of Slings
 Triangular bandage Sling- tie a triangular bandage as follows
 Pace one end of the base of an open triangular bandage over
the shoulder of the injured side
 Allow the bandage to hang down in front of the chest so that the
apex will be behind the elbow and the injured arm
 Bend the arm at the elbow with hand slightly elevated (4-
5inches)
 Bring the forearm cross the chest and over the bandage
 Carry the lower end of the bandage over the shoulder on the
uninjured side of the neck
 Twist the apex of the bandage, and tuck it in at the elbow
 The hand should be supported with the fingertips exposed
whenever possible, to permit the detection of interference with
circulation
2. Cravat Bandage Sling
 Tie a cravat Sling as Follows
 Pace one end over the shoulder of the injured side
 Allow the bandage to hang down in front of the chest
 Bend the arm at the elbow with hand slightly
elevated 4-5 inches
 Bring the forearm across the chest and over the
bandage
 Carry the lower end of the bandage over the injured
arm to the shoulder on the uninjured side and tie at
the uninjured side of the neck
Basket Sling
 Useful sling for transporting or handling a victim
with a suspected neck injury or an unconscious
victim whose arms may create difficulties, can be
made with open triangular bandage as follows
 Place an open triangular bandage across the chest with
the apex down
 Fold the arms over one another on the bandage
 Bring ends together and tie
 Cross the apex over folded arms and tie to the knotted
ends of the base
Principles of Bandaging Principles of
Bandaging
 Bandage wound snugly but not to tightly, for
tight bandage may damage surrounding
tissues or interfere with the blood supply
specially if swelling occurs, a bandage tight
too loosely may slip off the wound
 In bandaging the arms and the legs, leave
the tips of the fingers or toes uncovered
where possible, so any interference with
circulation can be detected
Principles of Bandaging Principles of
Bandaging
 If the victim complains that the bandage is too tight,
loosen it and make it comfortable but snug. Unless
otherwise specified. All knots should be tight over
open wounds to help control bleeding
 If bandages become saturated with blood, apply
additional bandages or dressing. Do not remove
original dressing
Burns and Scalds
 Classified according to extend and damage:
 First Degree Burn (minor)- the burned area is painful

 Second degree burn (moderate)- the burned area is
painful, the under skin is affected, blisters may form. The
affected area may be wet, shinny appearance because of
exposed tissue
 Third degree burns (critical)- insensitive due to the
destruction of nerve endings. Skin is destroyed; muscle
tissue and bone underneath maybe damaged. The area may
be charred, white or grayish in color
Classification according to Cause
 Chemical Burns
 Thermal Burns
 Electrical Burns
 Radiation Burns
First Aid for Burn and Scalds
 Should primarily be exclusion of air from the burnt

area, relief of pain that immediately follows burns,
minimizing the onset of shock, and the prevention of
infection
 Remove all clothing from the injured area, but cut
around any clothing that adheres to the skin and
leave it in place. Keep the patient covered, except
the injured part, since there is tendency to chill
 First aid dressing for burns and scalds should be
free of grease or oil. The use of oils in the treatment
for burn makes it necessary to cleansed the burned
or scalded areas with a solvent before medical
treatment can begin. This delays the medical
treatment and can and is very painful
First Aid for Burn and Scalds
 Be careful when dressing burns and scalds. Burned and
scalded surfaces are subject to infection the same as open
wounds and require the same care to prevent infection. Do not
break blisters intentionally
 Never permit burned surfaces to be in contact with each other

such as areas between the fingers and the toes
 Cover bandages should be loose enough to prevent pressure
on the burned surfaces. As swelling often takes place after
burn dressing have been applied, check them frequently to
see that they are not too tight. Watch for evident of shock and
treat if it is present
First Aid for Chemical Burns
 Remove all clothing containing chemical agent
 Do not use any neutralizing solution, unless recommended by
a physician
 Irrigate with water for at least 15 minutes, use potable water if
possible
 Treat for shock
 Transport to a medical Facility
 First aid for dry, chemical( alkali) burns is exception to the
general first aid for chemical burns because mixing water with
dry alkali creates corrosive substance. The dry alkali should be
brushed from the skin and water should then be used in a very
large amounts
First Aid For Thermal Burns (Minor)
 Use cool, moist application of gauze or bandage

materials to minimize blistering
 Treat for shock
 If the victim has thermal burns on the eyelids, apply
moist, sterile gauze pads to both eyes and secure
in place
First Aid For Thermal Burns
(Moderate and Critical)
 Do not use cold applications on extensive burns,
cold could result in chilling
 Cover the burn with a clean, dry dressing
 Treat for shock
 Transport to a medical Facility
First Aid for Electrical Burns
Conduct a primary survey, as cardiac and
respiratory arrest can occur in cases of electrical
burns
Check for points of entry and exit of current
Cover burned surfaces with a clean dressing
Splint all fractures (violent muscle contractions
caused by the electricity may result in fractures)
Treat for physical shock
Transport to a medical facility
Respiratory failure and cardiac arrest are the
major problems caused by electrical shock and
not the burn
First aid for Radiation Burns
 Radiation presents a hazard to the rescuer as

well as the victim. As a rescuer who must
enter a radioactive area should stay for as
short time as possible. Radiation is
undetectable by the human senses and the
rescuer, while attempting to aid the victim,
may receive a fatal dose of radiation without
realizing it. Notify experts immediately of
possible radioactive materials contamination
Cardio Pulmonary Resuscitation
First aid person prerequisites
 Always remember that you are not a doctor you
are only providing temporary support until
professional medical assistance is available.
 The purposes of first aid are
 to save life,
 prevent further injury
 to minimize or prevent infection.
 Fast reflection and reaction.
 Fast changing in way of thinking.
 Very calm in the bad situation.
CHAIN OF LIFE
PULSE SITES
 ADULT
 CAROTID IN NECK
 RADIAL IN WRIST
 CHILD
 CAROTID IN NECK
 BRACHIAL IN ARM
 INFANT
 -BRACHIAL IN ARM
 FEMORAL IN GROIN
Recovery Position

Emergency Room-First Aid

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Emergency Room-First Aid

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Emergency Room

 Bleeding from an artery- an artery has been

 Bleeding from a vein- when dark red blood flows from

 Bleeding from capillaries- Blood from capillaries ooze.

 Direct Pressure- The best all around method

 Elevation- Elevating the bleeding part of the

 Tourniquets- a tourniquet is a device used to

In using an improvised tourniquet, wrap the material

tightly around the limb twice and tie in a half knot

Place a short stick to tighten the tourniquet only until

Secure the stick in place with the base ends of the

 Gently pinched the nostrils closed

 Apply cold compress to the victims nose and face

 If the person is conscious, it maybe helpful to apply pressure

beneath the nostril above lip

the bleeding has stopped, or clots could be dislodged and start

 Triangular bandage- a standard triangular bandage is made

 Classified according to extend and damage:

 First Degree Burn (minor)- the burned area is painful

 Should primarily be exclusion of air from the burnt

 Never permit burned surfaces to be in contact with each other

 Use cool, moist application of gauze or bandage

 Radiation presents a hazard to the rescuer as

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