Definition:

Shock is a state of inadequate perfusion of vital

organs like Brain,Liver,Kidney etc due to reduction
in the Cardiac Out put.
 SHOCK

• Manifestation of changes in which the

circulation fails because of fall of blood
volume or pressure.

• Condition of collapse.
 TYPES OF SHOCK

A.Nervous shock----pain,bad news,fever.

• True shock.
 CAUSES OF TRUE SHOCK

Severe bleeding
Severe burns.
Heart attack.
Abdominal emergencies.
Crush injuries.
Loss of body fluid due to vomiting,diarrhea.
Bacterial Infection.
SIGNS:
• PALLOR
•SWEATING
• HYPOTENSION
•TACHYCARDIA
•CYANOSIS
•HYPOTHERMIA
 SIGNS & SYMPTOMS

Victim feels faint ,giddy &Weak.

Victim complains of blurred vision.
Victim feels thirst.
 Victim feels cold,clammy skin.
 Victim face looks pale.
 Increased pulse rate.
 Vomiting.
 Unconscious.
FIRST-AID:
 Head low position
 A clear air way must be ensured by pulling the
tongue out or by keeping a metal air way
 Oral Fluids: Do not give oral fluids if patient is
unconscious
 Get medical attention as soon as possible
 FIRST AID
Reassure the victim if conscious.
DO NOT move the victim unnecessarily.
Lay him down with head tilted to one side.
Raise legs.
Loosen tight clothing at neck,chest,waist.
Wrap the victim in light blanket.
DONOT give him anything to eat or drink.
Check breathing &responses at every 10 min.
Transport to hospital with foot end elevated
position.
 UNCONSCIOUSNESS

• Due to interruption of the normal activity of

brain.
 CENTRAL NERVOUS SYSTEM

CNS----Brain +spinal cord.

PNS----ANS +12 pairs of cranial nerves

+31 pairs of spinal nerves.
 CAUSES

1. Brain injuries.
2. Stroke.
3. Fainting
4. Heart attack.
5. Diabetic hypoglycemia
6. Heat stroke/exhaustion
• 7.SHOCK.
• 8.HEMORRHAGE.
• 9.POISON.
• 10.ACUTE FEVER.
• 11.EPILEPSY.
• 12.INFANTILE CONVULSIONS.
• 13.HYSTERIA.
 FIRST AID IN GENERAL

1. Allow free flow of fresh air.

2. Loosen the clothing at neck,chest,waist.
3. Observe A, B, C of B.L.S.
4. DONOT give anything by mouth.
5. Place the victim in recovery position.
 1.HEAD INJURIES

Head injury may cause

A.Concussion.
B.Compression.
C.Fracture of skull.
 CONCUSSION/BRAIN SHAKING

SYMPTOMS & SIGNS

Pale face,dazed,unable to answer correctly.
Skin may be cold.
Pulse may be rapid and weak.
Victim may vomit.
 FIRST AID

Keep the victim in recovery position.

Observe general treatment for

unconsciousness.
 COMPRESSION
Very serious condition
Pressure exerted on brain by blood accumulation
Symptoms and Signs:
1. Breathing is noisy
2. Pulse is full
3. Pupils may be different sizes
4. Weakness and paralysis of one side of body
5. Body temperature may raise
6. Face may become flushed but remain dry
 FIRSTAID

 Carry out general treatment for conscious

victim
 Treat shock
 Transportation to hospital
 2. STROKE

• Blood supply to part of brain is suddenly

impaired by rupture of blood vessel or a clot in
blood vessel.
Symptoms and signs:
1. Sudden headache or giddiness
2. A strong pulse
3. Victim may be confused, anxious
4. Progressive loss of consciousness
5. Unequal sized pupils
6. Loss of bladder and bowel control
 FIRST AID
1. If the victim is conscious lay him down
with head and shoulders slightly raised
and supported
2. Loosen constricting clothes at neck, chest
and waist
3. Assist circulation & breathing.
4. Transport the patient to hospital.
 3.FAINTING

Brief loss of consciousness due to temporary

reduction in the flow of blood to brain.
Example: Exhaustion, lack of food
Symptoms and signs:
1. Pulse will be slow
2. Face may be pale
 FIRST AID
 Lay the victim down with legs raised
 Open the airway
 Loose any tight clothing around the neck, chest
and waist
 Victim must be placed in well ventilated area
 Reassure the victim
 Check circulation, breathing
 DO NOT give the casualty anything by mouth
till he/she is fully conscious
 4. HEART ATTACK
Obstruction to coronary blood flow
SYMPTOMS&SIGNS:
1. Sudden chest pain radiating to arms, jaws
2. Sudden dizziness
3. Profuse sweating
4. Breathlessness, vomiting
5. Rapid pulse
6. Unconsciousness
 FIRST AID
 If conscious, support him in half-sitting position

DO NOT move him unnecessarily

 Loosen any constricting clothing
 Open airway—if necessary
 Place the victim in recovery position.
Check breathing, circulation
 Transportation to hospital .
 5. DIABETES
HYPOGLYCEMIA (LOW BLOOD SUGAR
1. TOO MUCH INSULIN/OHD.

2. TOO LITTLE OR NO FOOD.

3. MORE EXERCISE.
 SYMPTOMS & SIGNS
FEELS FAINT OR DIZZINESS.
VICTIM MAY BE CONFUSED.
SKIN BECOMES PALE,SWEATING.
RAPID PULSE RATE.
LIMBS TREMBLE.
LOOSES CONSCIOUSNESS.
 FIRST AID

 If casualty is conscious—give sugar

lumps, cool drinks or chocolates
 If casualty is unconscious—carryout the
general treatment of unconsciousness
 6. HEAT STROKE
Caused by very high temperature.Working in
heat and high humidity for too long.
Body can no longer control its temperature by
sweating
SYMPTOMS & SIGNS
• Victim complains of head ache, dizziness.
• Victim is restless.
• Temperature raises more than 104 F
• Victim is unconscious.
.
 FIRST AID

 Move the victim to cool environment.

 Remove his/her clothing.
 If conscious place in a half sitting position with
head and shoulders supported.
 If unconscious open airway and check
breathing.Observe A,B,C of B.L.S.
 Wrap the victim in a cold, wet sheet.
 Fan the victim till the temperature falls up to 101F
 Seek medical aid immediately.
 7.EPILEPSY

• Epilepsy is a condition resulting from brief

interruption in electrical activity of brain.
SYMPTOMS&SIGNS
 Sudden loss of consciousness.
 Falls to the ground.
 Victim becomes rigid for few seconds.
 Convulsions or jerky movements occur.
 Convulsions /fits may become vigorous.
 Victim may remain unconscious.
 FIRST AID

• Remove articles of furniture around

• Don’t force anything into patient’s mouth
• Don’t force to stop his seizure
• It will stop on its own
• Recovery position
 FIRST AID

 If causality is falling try to support him/her.

 Lay him/her down.
 Clear the crowd.
 Loosen the clothing around neck.
 Keep pillow/soft under his/her head.
 After stoppage of fits keep the victim in recovery
position.
 DONOT give any thing to drink till he is fully
alert.
8.INFANTILE CONVULSIONS
Common below the age of five.
Raised temp, Throat infections, Ear infections.
Rarely dangerous.
SYMPTOMS&SIGNS
High fever with sweating.
Twitching of muscles of face & limbs.
Upturned eyes.
Breath holding.
Frothing.
 FIRST AID

 Ensure good supply of air.

 Loosen the tight clothing at neck,chest.
 Clear the space around the child.
 Carry out the general treatment for the
unconscious casualty.
 Cool the child,sponge the child with water.
 DONOT allow the child to become too chilled.
 Reassure the parents and advise them to seek
medical aid.
 9.HYSTERIA
• Due to an over-reaction to an emotional upset or
nervous stress increases by presence of any
onlookers.
SYMPTOMS&SIGNS
Temporary loss of behavioral control .
Wild beating of limbs,shouting,crying.
Tearing of cloths,rolling on ground.
Over –breathing
 FIRST AID

Reassure the casualty.

Keep her under observation.
Do not physically slap/assault.
Advise her to visit doctor.
 DRESSING

A DRESSING IS A PROTECTIVE COVERINGTO

A.CONTROL BLEEDING.
B.PREVENT INFECTION.
C.TO ABSORB ANY DISCHARGE.
A DRESSING SHOULD BE
1.LARGE ENOUGH.
2.STERILE.
3.ABSORBANT.
 GENERAL RULES OF HYGIENE

1. Wash hands with soap.

2. Avoid touching wound.
3. Never cough or talk over a wound.
4. Use non adhesive cotton dressing to help control
bleeding and discharge.
5. If a dressing slips off a wound,use another new
dressing.
6. Always place a dressing directly over wound,
never slide it on from the slide.
7. Wash your hands with soap and water after
dressing is completed.
 TYPES OF DRESSINGS
1.ADHESIVE DRESSING /PLASTERS:-
Contain absorbant gauge. They should not
be left more than a few hours.

2.STERILE DRESSING:-Dressing made of

fine gauge and a pad of cotton.
 BANDAGES

Made from cloth,special paper.

Used to A--To control bleeding.
B-- To prevent swelling.
C-- To restrict movement.
D-- To support the limb or joint.
 GENERAL RULES FOR APPLYING
BANDAGES
1. Apply bandages when a casualty is sitting or
lying.Always try to sit or stand in front of the
victim.
2. If victim is lying down pass all bandages under
the natural hollows of ankles,knees,back,neck. .
3. Bandages should be firm enough to hold the
dressing in position,control bleeding or prevent
movement.
4. But not so tight that they interfere with
circulation.
5. If a bandage is used to control bleeding and
maintain direct pressure, tie the knot over the
pad or dressing .
6. If using bandages to immobilize a limb tie the
knots in front on the uninjured side.
7. When using a knot to secure bandage always
use a reef knot.
8. Pay particular attention to filling the natural
hollows before applying slings and bandages.
TYPES OF BANDAGES

1.TRIANGULAR BANDAGES.

2.ROLLER BANDAGES.
 TRIANGULAR BANDAGES

Can be used in number of ways.

Used to form a sling to provide support
or protection for the arms or chest or for
securing dressing over areas such as
head,hand and foot.
 ROLLER BANDAGES
 To Keep dressing in position.
 To apply pressure.
 To control bleeding.
 To support a sprain limb.
TYPES--- CREPE,CONFIRMING&COTTON.
 To bandage a left limb hold the bandage in your
right hand.
 Always work from the inside out and below the
injury upwards.
 SLINGS
Used to provide support and protection for
injured arms, Wrists,hands for proper
immobilizing an upper limb.
TYPES OF SLINGS
A. ARM SLING.
B. ELEVATION SLING.
 ARM SLINGS
• Used where there are injuries to upper limb.
• METHOD:-
• Victim must be in sitting position .
• Place injured forearm across the chest,slightly above the elbow.
• Base of bandage should lie at root of the little finger leaving all
finger nails exposed.
• Place one end of triangular bandage between the chest and
forearm so that its point reaches well beyond the elbow.
• Place the upper end over her shoulder on the healthy side and
around the back of her neck to the front of the injured side.
• Support the forearm and carry the lower end of the bandage ,tie in
the injured side with reef knot.
• Bring the point forward and secure it to the front of the bandage
with a safety pin.
 ELEVATION SLING
• Used to support the hand and forearm in a well
raised position if the hand is bleeding.
METHOD:-
• Ask the victim to sit and support his injured limb
which is resting on opposite shoulder.
• Place an open bandage over his forearm and hand
with its point reaching well beyond the elbow and
upper end,over the opposite shoulder.
• Support victim forearm,ease the base round under
his hand,fore arm and elbow.
• Carry the lower end round across his back and
over to the front of the sound side,
• Use a reef knot tie on sound side.
 SPLINTS
• Splint is a rigid pieces of wood or plastic or
metel applied to a fractured limb to support
&to prevent movement of the broken limb.

• Expertise in application of splints is

required.
 SPLINTS
Used to hold fractured or injured limb steady while a
victim is being moved to hospital.
Basic requirement is that it is long enough to extend
well beyond the joints above and below the injury.
TYPES OF SPLINTS:-
A.INFLATABLE B.FOAM.
C.PLASTIC. D.WOOD.
E. Improvised like sticks,brooms,rolled newspaper
 METHOD OF APPLICATION

• Support the limb with hand on one side and

traction on other.
• Place 4 broad bandages at above&below#,at
knees,at lower legs.Narrow fold at the ankles.
• Two more broad-fold bandages under
chest&pelvis.
• Place splint with adequate padding along the
outside of the fractured limb extending from arm
pit to foot.
• Gently bring the sound limb alongside the injured
limb.
HANDLING&TRANSPORT

PRINCIPLES OF LIFTING
1.Always use the most powerful muscles.
Eg:-thigh,hip,shoulder.

2.Weights should be kept as close to your body

as possible.
CARRIER FOR ONE FIRST AIDER

1. DRAG METHOD.
2. CRADLE METHOD.
3. HUMAN CRUCH.
4. PICK-A-BACK.
5. FIRE MANS LIFT.
 CRADLE METHOD
• Light weight victims or children.

• Pass one arm under the victims thigh and

other around the trunk above the waist.
 DRAG METHOD
• Pulling the victim along the ground without
lifting.
• When the victim is unable to stand and must be
moved quickly.
• METHOD:-
• Victim arms around her chest.
• Crouch behind her head.
• Place hands under her shoulders.
• Grasp her arm pits.
• Cradle her head on your forearm.
• Pull her along the ground.
 HUMAN CRUCH
When the victim can walk with assistance.
NOT recommended for upper arm injuries.
METHOD:-
Stand at victim injured side.
Place his arm around our neck.
Hold his hand with your free hand.
Put your arm around his waist and grasp his
clothing.
 PICK -A-BACK

If casualty is small,light,conscious
and able to hold on.
 FIREMANS LIFT
Child or light weight adult
METHOD:-
• Help the victim to stand.
• Place your arms under his arm pits.
• Raise him on his knees and then on feet.
• Grasp his right wrist with left hand.
• Bend down your head under his right hand.
• Face your right arm around his legs.
• Transfer his right wrist to your right hand.
• Victim weight on right shoulder .
CARRIES FOR TWO FIRST AIDERS

FOUR HANDED SEAT

TWO HANDED SEAT

FORE-&-AFT CARRY

CHAIR METHOD
 FOUR HANDED SEAT

CONSCIOUS CASUALTY.
STAND EACH OTHER & MAKE
SEAT.
INSTRUCT VICTIM TO PLACE
ARMS AROUND YOUR NECK
AND SIT ON HANDS.
RAISE TOGETHER .
 TWO HANDED SEAT
METHOD:-
• Squat facing each other on either side of the
victim.
• Pass and grasp each other forearm near waist .
• Raise the victims legs slightly pass your other arms
under the middle of her thighs and grasp each other
wrists.
• Raise together,step off with your outside feet.
 FORE-&-AFT CARRY
• Used to place the victim on a chair .
• Do not use this method if upper limb injury
METHOD:-
• Both the first aiders should help victim to sit &fold her
arms across the chest.
• One first aider behind the victim &place arms through
&under her armpits and grasp her forearms.
• The other bearer should remain at her side.Place one
arm around her back and the other under her thighs.
 CHAIR METHOD
Conscious, not so serious victims.
METHOD:-
• Test the strong ness of the chair.
• Victim to be seated in a chair.
• Secure the victim with broad bandages.
• One first aider in front of the chair.
• Another behind the chair.
• Person behind the chair support the back.
• Person in front hold front legs.
 STRETCHER

TYPES OF STRETCHERS:-
1. STANDARD STRETCHER.
2. SCOOP STRETCHER.
3. UTILA FOLDING STRETCHER
4. POLE-AND-CANVAS
STRETCHER.
 TYPES OF STRETCHERS

5.NEIL ROBERTSON STRETCHER.

6.PARA GUARD STRETCHER.
7.TROLLY BED.
8.CARRYING SHEET.
9.CARRYING CHAIR.
STANDARD STRETCHER

• Consists of poles, handles, traverses,

runners and a canvas bed.
 SCOOP STRETCHER
• Adjustable stretcher
• Used to carry victim with suspected
spinal fracture or internal injuries.
• Used to lift victim on to an ambulance
trolly bed without altering the position
in which he /she were found.
 TROLLY BED

• Fully adjustable stretcher bed on

wheels made of light metel.
 UTILA FOLDING STRETCHER

• Light weight version of standard stretcher.

• Light metel poles with telescopic handles.

POLE-&-CANVAS STRETCHER

• Most commonly used stretcher

• 80inches long and 20 inches wide canvas.
• Spacer bars may be placed to keep poles
apart.
NEIL ROBERTSON STRETCHER

• Made of stout canvas&bamboos.

• For lifting casualty in upright
position through small openings
like manholes.
PARAGUARD STRETCHER

• Similar to Neil Robertson stretcher.

• Lighter, less cumbersome and durable than
Neil Robertson stretcher.
 LOADING A STRETCHER
• Ideally 5 people are required.
• Four to lift the casualty and one to move the
stretcher.
METHOD:-
• Make 3 folds from the top and 4 from bottom.
• Slide the folded canvas under the casualty through
the hollow of his back.
• Working from the casualty head slide the poles
into the sleeves and place spacer bars over the
ends if they are to be used.
 PLACING A BLANKET UNDER CASUALTY

• Test the strong ness of the blanket.

• Roll lengthwise for half of its width.
• Roll in line with and against injured side.
• All four bearers should kneel at the side of
the casualty,opposite the blanket.
• Turn her gently on to her side towards them.
• Move the rolled portion of the blanket up
against her back.
• Gently turn her back over the roll of blanket.
 BLANKET LIFT
• Two bearers face other on either of the casualty at
trunk & lower limbs.
• Squat and grasp the blanket with palms .
• The bearers at head should each place one hand level
with his head and other at his waist.
• The bearers at the lower limbs should place one
hand at head and another at waist.
• Bearers at the lower limbs should place one hand at
hips and another at ankles.
• Working together, lift the victim high enough to
push a stretcher underneath.
MANUAL LIFT-4 BEARERS
• Three bearers on left side of victim, facing
shoulders,hips and ankles respectively.
• Bearer on the right side should face middle bearer.
• All bearers on their left knees and place their forearms
beneath the victim.
• Bearer on right side must grasp left wrist of 1st bearer
with his left hand and right hand with right wrist of
2nd bearer .
• The third bearer should support lower limbs.
 POWER
MEDICINE
ELECRTIC INJURY
 BLAST
INJURIES