First Aid Kit

FIRST AID GUIDE

2002-2007 Dr. Michael Stachiw, Ph.D.

Revised July 4, 2007


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This first aid guide is provided as a set of general instructions in using the materials included in the average first aid kit. It should be noted that this guide is also for the treatment of minor injuries, and that these general instructions are consistent with current standard first aid practices. Some portions of this guide are focused towards outdoor enthusiasts, which Dr. Stachiw is a participant, and may not reflect normal first-aid situations. Dr. Stachiw is not responsible or liable in any way for the use of this guide, or for when or how the caregiver provides first aid. Trained medical personnel should always treat serious injuries and persistent conditions as soon as possible. This document may be copied freely as long as it is copied in its entirety and credit is given to Dr. Michael Stachiw. Single printed copies of this document can be obtained for free by contacting Dr. Michael Stachiw ([email protected]).


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Table of Contents

Topic Page General Guidelines 4 First Things First 7 Animal Bites 9 Artificial Respiration 10 Bleeding 12 Blisters 14 Burns 15 Cuts and Scrapes 17 Drugs 19 Frostbite 20 Insect Bites & Stings 22 Bed Bug Bites 22 Bee & Wasp Stings 23 Chiggers 24 Fire-Ant Sting 25 Flea Bite 26 Mosquito Bites 26 Scorpion Stings 26


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Spider Bite 27 Ticks 29 Poisonous Plants (to the touch) 32

Poison Ivy 32 Poison Oak 32 Poison Sumac 32

Sore Throat 33 Splinters 33 Sprains 34 Stomach Pains 34 Sunburn 35 Toothache 36 Emergency Telephone Numbers 37 First Aid Kits 38

References 42


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General Guidelines:

First Aid is exactly as the term implies, the first aid given for an injury. It is not intended as a long-term solution to a problem, nor does it replace treatment provided by trained medical personnel.

Before attempting to administer First Aid, you need to perform an initial assessment which should include: Safety (yours and the victims), mechanism of the injury (how did it happen), medical information devices (Medic Alert tags or bracelets), number of casualties (if more than one person involved), bystanders (those that might be able to help you).1

Always avoid contact with blood or other body fluids. Use latex gloves whenever possible.

If administering mouth-to-mouth resuscitation, use a face shield, following instructions on the packet.

In an emergency, you should follow these priorities: o Check that you are not placing yourself in danger by providing

first aid. If you become injured you will not be able to help others!

o Check to see if the person is conscious. If conscious and they are breathing, stay with the victim while sending somebody else to call for help.

1 Standard First Aid Course: NAVEDTRA 13199.


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o Check to see if the person is breathing. If you are alone, call 911 first if possible before starting rescue breathing.

o Check for a pulse. If no pulse found begin CPR if you know the technique.

o Check for bleeding. Immediately stop bleeding by applied direct pressure before you worry about any fancy bandages.

o Check for neck and spinal injuries, injuries on the head. You should never move the victim unless its absolutely necessary.

o If the person is unconscious do not attempt to give them fluids.

Do not become involved in using treatment methods beyond your skill. Recognize the limits of your competence. Only perform First Aid procedures that are within your scope of knowledge and skills.2

Always stay calm and do not ever give up. Continue to provide aid to the victim until help arrives!

2 First Aid Guide for School Emergencies


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First Things First3

All too often we get caught up in some minor detail and miss the big picture, or to put it another way, we miss the forest for the trees. It is important to keep in mind the following priorities when performing first aid. Always perform first aid in the following order:

1. Restore Breathing: A person becomes brain dead in 6 minutes if

breathing is not restored.

2. Stop Severe Bleeding: Without blood, oxygen can not get to the vital organs of a persons body.

3. Treat Shock: A victims mind and body must work together in order to be healthy. Never overlook shock situations, be they mental or physical.

3 USDA Handbook #227


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4. Call advanced medical help immediately: Always realize that you

are providing a stop-gap function to an injured person. Always obtain trained medical assistance as soon as possible. It also is good first aid practice to have even minor wounds checked when expert medical assistance is available.


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Animal Bites Bites from wildlife, cats & dogs.

1. Wash wound for several minutes with soap and water.

2. Apply antiseptic.

3. Apply sterile pad or bandage to protect the wound.

4. CALL DOCTOR AND/OR POLICE IMMEDIATELY. If bite is from an unknown dog or other animal, try to have animal caught for examination by authorities. If the animals must be killed, take precautions not to injure the brain of the animal since this is where rabies examinations are conducted. They can then determine if victim will need a series of anti-rabies injections.


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Artificial Respiration4

Mouth-to-Mouth or

Mouth-to-Nose Rescue Breathing

Place casualty on back immediately Dont water time moving to a better place, loosening clothing, or draining water from lungs.

Quickly clear mouth and throat Remove mucus, food and other obstructions

Tilt head back as far as possible The head should be in a chin-up or sniff position and the neck stretched

Lift lower jaw forward

Grasp jaw by pacing thumb into corner of mouth. Do not hold or depress tongue.

Pinch nose shut (or seal mouth) 4 From Graphic Training Aid 21-45, Headquarters, Department of the Army, October 1961


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Prevent air leakage

Open your mouth wide and blow Take a deep breath and blow forcefully (except for babies) into mouth or nose until you see chest rise

Listen for exhalation Quickly remove your mouth when chest rises. Lift jaw higher if casualty makes snoring or gurgling sounds.

Repeat (last two steps) 12 to 20 times per minute Continue until casualty begins to breath normally

For infants seal both mouth and nose with your mouth Blow with small puffs of air from your cheeks


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Bleeding

Internal

Bleeding is most likely to occur in the stomach, lungs, or bowels. Blood from the lungs is coughed up; from the stomach vomited; from the bowels it appears in the stools. With internal bleeding, signs of restlessness, weakness, pallor, thirst and a faint, rapid pulse are usually present.

In an accident where internal bleeding may have occurred, contact a doctor as soon as possible. While you wait, keep the patient quiet, comfortably warm, and lying flat. Give him nothing to drinknot even water. When moving injured person to advanced medical facilities, only transport (if possible) in a laying position.

External

Place a pressure dressing (several layers of sterile gauze) over the wound. Secure it in place firmly enough to stop the bleeding or hold it in place with firm hand pressure. Whenever possible, elevate the wound.


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If no sterile bandages are available, use a thick pad of the cleanest cloth on hand. Sheets, towels, handkerchiefs or other freshly laundered clothing can be used if nothing better is available. In a serious emergency, when severe bleeding is encountered, do not hesitate to apply direct pressure with your bare hand, unless better methods are available.


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BLISTERS

1. Use shears to cut a donut-shaped piece of moleskin. Be sure the hole in the middle is slightly larger than the blister.

2. Place over the blister. Note: The same technique can also be used when a "hot spot" develops to

prevent the formation of a blister, or to ease pressure on corns and calluses.


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Burns5

Burns can be one of the most traumatic injuries to deal with. The victim can be in severe pain, there can be the smell of burnt flesh and depending on the degree of the burn, and charred clothing can be attached to the victims flesh. The first step in dealing with burns is to determine the level of the burn. It should be realized that First and second degree burns can be caused by prolonged exposure to intense sunlight. Classification of burn:

First Degree skin is reddened

Second Degree skin is blistered

Third Degree skin cooked or charred, the burn may extend into the underlying tissue. In sever cases skin or appendages may be burned off.

Treatment: First degree and second degree burns, only covering up to about

1% (like the size of a hand) body surface: 1. Wash/soak burned portions in cold water 2. Wash burned are in soapy water 3. Place sterile gauze over burned area 4. Bandage burned area snugly

Large burns of any degree

1. If a doctor or hospital is available within 30 minutes or less: Treat victim for shock Get victim to advanced medical treatment, attempt no

treatment

5 In part from USDA Handbook #227


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2. If advanced medical aid is not readily available (like in an outdoor/camping/backpacking setting):

Remove clothing from burned area. Cut around clothing/cloth that sticks to burned area

Apply antiseptic cream to burned area Cover burned area with sterile dressings Bandage snugly (not too tight however) Treat for shock If victim is conscious, allow them to drink all the water they

desire. Commercial sport drinks are even better than water if available

Get victim as soon as possible to advanced medical support Do Not! Touch the burned area with fingers Breath on the burn Break or drain blisters Change any dressings that have been applied. Only advanced medical

support should change or remove any dressings applied as first aid


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CUTS AND SCRAPES 1. Remove as much loose debris from the wound as possible, rinsing with

clean water, if available.

2 Gently clean wound with an antiseptic wipe.

3. If the wound gapes open slightly, it can be pulled closed with a butterfly closure.

4. Apply a thin layer of antibiotic ointment.

5. Cover the wound with an adhesive bandage. For larger wounds, use gauze pads and adhesive tape.


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6. Watch for signs of infection, such as: Swelling, redness or warmth around the wound. . Discharge of pus. . Red streaks around the wound 7. If infection develops, consult a physician.


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DRUGS

Aspirin and non-aspirin can be used for temporary relief of headaches, minor aches and pains, and for fever reduction.

Chlorpheniramine maleate (Chlorphen) temporarily relieves the

symptoms of hay fever and other respiratory allergies.

Read all warnings and follow the dosage directions on individual packets.


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Frostbite6 7

Damage to the skin resulting from exposure to low temperatures (cold) and/or wind. Often affects parts of the body that have the poorest circulation of blood and the greatest exposure to the cold. Hands, feet, face, and ears are the most commonly affected body parts.

Symptoms:

Considerable pain and redness in fingers, toes, cheeks, ears or nose.

Grayish white color due to frozen tissues

Much like burns, the degree of severity is described as first degree, second and third degree.

First Degree: Skin is white or slightly yellow, there is a burning or itching feeling.

Second Degree: Skin is reddened or swollen and there is no feeling.

Third Degree: If the skin is waxy or hard, the skin tissue has died. There may be blistering. Severe cases may result in damage to

6 The Little First Aid Book, Amber Raine, 2002. 7 Information in part from: USDA Handbook #227


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the muscles, tendons and nerves. Blood clots may form and inhibit circulation causing gangrene.

Treatment:

Until victim can be brought indoors, cover exposed parts of the body

In all cases, go indoors, thaw affected area by immersion in water slightly warmer (NOT HOT) than bath water. After immersion, pat the affected area dry. Do not rub or chafe frozen members. Apply warm, not hot cloths. Give warm liquids. Handle patient gently and don't expose him to excessive heat. Do not have patient drink alcoholic beverages or smoke as this constricts the blood vessels.

Get advanced medical assistance as soon as possible


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INSECT BITES & STINGS8 GENERAL INSECT STINGS

1. If a stinger is present, remove it by scraping away or gently pulling it out with forceps.

2. Apply paste of baking soda and cold cream or use a commercially available sting aid for topical relief of mosquito and other insect bites. Calamine lotion will also relieve itching

3. If multiple stings, or unusual reaction (i.e. excessive reddish skin or breathing issues), or a history of severe reactions, take victim immediately to advanced medical support.

Bed Bug Bites

Description: Bedbugs are flat-bodied, oval, reddish brown and about a in size. Although not painful at first, bed bug bites usually become red, swollen and itchy. Reactions to bites range from mild to severe.9

Treatment: Apply paste of baking soda and cold cream or use a commercially available sting aid for topical relief of bed bug bites.

8 Information in part from: USDA Handbook #227 9 Information in part from www.denvergov.org Division of Animal Control & from the University of Nebraska at Lincoln Cooperative Extension Service.


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Bee & Wasp Stings Description: A very sore area that is red and swollen. Usually there is a stinger protruding from the skin. Treatment:

1. Scrape the stinger away with the edge of a credit card, knife blade, or thumbnail. Do not try and squeeze the stinger out, as this will cause more bee/wasp venom into the skin.

2. After removing the stinger, wash the area with soap and water.

3. Apply a cool washcloth or ice pack.

4. Some people have symptoms of severe allergic reactions are:

shortness of breath thickening of the tongue sweating an anaphylactic shock Seek medical help immediately if you have an allergic

reaction.


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Chiggers10

Description:11 It is generally visible only with magnification. Chiggers are different than mites in that they feed only in the larval stage. The chigger larvae get onto the skin and move around until they meet some obstacle, for example the waistband of underwear, the elastic band of socks, etc. They then attach to the skin and begin feeding. The area around where they are feeding usually turns red with an itching sensation.

Treatment:

1. Wash area with soap and water

2. Apply local topical hydrocortisone cream; antihistamine, or local anesthetic cream should be applied to reduce the itching. Calamine lotion can also be used.

3. The wounds must not be scratched

10 Drawing of a chigger from North Carolina Department of Environment and Natural Resources 11 Information for this first aid procedure provided in part form the Oklahoma College of Pharmacy with additional information available via their website located at: www.oklahomapoison.org


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Preventive:

Spray your feet and ankles with a quality insect repellent containing Deet12. Dimenthyl phthalate or flowers of sulphur can also be used in the socks and around the ankles13.

Fire-Ant Sting

Description: After being stung by the fire ant, tiny painful red bumps appear. After an hour or so, they usually change into blisters. Treatment:14,15

1. Apply ice pack at ten minute intervals for a period up to hour

2. When through with ice pack treatment, apply bite soothing lotion such as calamine.

3. Some people have symptoms of severe allergic reactions are:

shortness of breath thickening of the tongue sweating an anaphylactic shock Seek medical help immediately if you have an allergic

reaction. 12 DEET is produced by Morflex, Inc 13 Information in part from: USDA Handbook #227 14 Treatment information in part obtained from Windaroo Valley High, with more information on Fire Ants available at: www.windvallshs.qld.edu.au/curriculum/fireants/index.html 15 Additional treatment information obtained from Queensland Government, with more information on Fire Ants available at: www.dpi.qld.gov.au/fireants/


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Flea Bite

Description: Usually flea bites are suspected when tiny itchy red bumps appear below the knee. Treatment:

1. Reduce itching by applying an ice pack

2. After removing ice pack and drying skin, applying soothing lotion such as calamine

Mosquito Bites

Description: Have a long proboscis (snout) for sucking blood. They are most active in shady, low light, damp or marshy areas. Treatment: Use sting aid for topical relief of mosquito bites.

Scorpion Sting Description: Usually found in the south western portions of the US. Less dangerous than the black widow, with the exception of babies. Treatment:

1. Cold packs

2. Get victim to advanced medical support as soon as possible.


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Spider Bites

Description and Identification of Spiders:

Description Habitat Problem

Brown16 Recluse

Oval-body with eight legs. Light yellow to medium dark brown. Has distinctive mark shaped like a fiddle on its back. Body from 3/8 to 1/2 inch long, 1/4 inch wide, 3/4 inch from toe-to-toe

Prefers dark places where it's seldom disturbed. Outdoors, old trash piles, debris and rough ground. In-doors attics, storerooms closets. Found in Southern Midwestern US

Bites producing an almost painless sting that may not be notices at first. Shy, it bites only when annoyed or surprised. Left along, it won't bite. Victim rarely sees the spider.

Treatment: 1. Keep victim lying down, quite and warm. If the victim must

be moved, use a stretcher

2. Get advanced medical aid immediately

16 Information obtained in part from The Ohio State University Extension Service


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Description Habitat Problem Description

Black Widow

Spider

Color varies from dark brown to glossy black. Densely covered with short microscope hairs. Red or yellow hourglass marking on-the underside of the female's abdomen. Male does not have this and is not poisonous. Overall length with legs extended is 1 1/2 inch. Body is 1/4 inch wide.

Found with eggs and web. Outside: in vacant rodent holes, under stones, logs, in long grass, hollow stumps & bush piles. Inside in dark corners of barns, garages, piles of stone wood. Most bites occur in outhouses. Found in Southern Canada through US, except Alaska.

Bites causing local redness. Two tiny spots may appear. Pain follows almost immediately. Larger muscles become rigid. Body temperature rises slightly. Profuse perspiration and tendency toward nausea follow. It's usually difficult to breathe or talk. May cause constipation, urine retention.

Treatment: 1. Keep victim lying down, quite and warm. If the victim must

be moved, use a stretcher

2. Get advanced medical aid immediately


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Description Habitat Problem

Tarantula

Large dark, "spider" with a furry covering. From 6 to 7 inches in toe-to-toe diameter.

Found in South western US and the tropics. Only the varieties found in the tropics are poisonous.

Bites produce a pinprick sensation with negligible effect. It will not bite unless teased.

Treatment:

1. Wash the wound with soap and water

2. Apply a cold pack

3. Apply antibiotic cream to prevent infection

TICKS

Description: Oval with small head, the body is not divided into definite-

segments. Gray or brown. Measures from 1/4:inch-to 3/4 inch when mature. They can burrow into the skin.

Prevention:

1. Examine body and clothes after any exposure to tick infested areas, and always remove ticks immediately


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2. Have a partner inspect your backside

3. Before entering tick infested area, cover neck, legs, back of neck and arms with an insecticide containing Deet17

Treatment:

1. Grasp the tick with forceps as close to the skin surface as possible and pull slowly and firmly. Do not twist or crush the tick.

2. After tick removal, swab the area with iodine solution,

3. If you cannot remove the tick, or if its mouthparts remain embedded, get medical care.

4. If rash or flu-like symptoms appear (see list below), get medical help immediately. Chills and fever

17 DEET is produced by Morflex, Inc


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sweating Pains in bones, muscles and joints back and head aches Coughing, vomiting and weakness Rash appears in 2 to 4 days


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Poisonous Plants18

Prevention: 1. Wash thoroughly any areas of your body that might have come in

contact with the poisonous plants forming thick suds

2. Wash clothing and shoes in thick hot suds

3. Avoid smoke from these plants if burned

4. Wear protective clothing

18 Information in part from: USDA Handbook #227


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Sore Throat

Gargle with hot salt water. Give aspirin. If condition persists, contact physician.

Splinters 1. If an end of the splinter is exposed, gently pull it out with forceps. If no

end is exposed, determine the splinter's orientation and press with your finger on the embedded end, pushing the splinter toward the entrance of the wound until an end is exposed.

2. After removal, swab the area with iodine solution or antibiotic ointment.

Watch for signs of infection.


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Sprains

One of most common injuries in outdoor activities is sprains. A sprain is defined as tears of ligaments supporting a joint. Symptoms include pain at the joint, swelling and possibly discoloration.

Treatment: Elevate the sprained portion of the body if possible. For sprained wrist, put in a sling, place sprained ankles on a pillow elevated

Apply cold compress (i.e. ice in a bag) or allow cold running water over the sprain for the first 6 or 8 hours. After 24 hours, apply hot compress

Stomach Pains

Suspect appendicitis. Check lower right-hand side of abdomen. If area is hard and in constant pain, apply ice and call a doctor. Keep patient quiet. If no fever and no firmness exists in lower right abdomen, apply


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hot-water bottle or warm cloths and give only bland foods. Avoid milk and fruit juices.

Sunburn

If area is not blistered, apply thin layer of soothing ointment. If skin is blistered, apply sterile dressings saturated with baking soda mixture (2 tablespoons to 1 quart water). Watch for infection and don't expose burned area to sun until healed.


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Toothache

For temporary relief, take aspirin and pack tooth with oil of clove. See your dentist immediately.


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Emergency Telephone Numbers

Ambulance:

______________

Doctor:

______________

Poison Control Center:

______________

Hospital:

______________

Police Department:

______________

Fire Department:

______________

24-Hour Pharmacy

______________

Electric Company:

______________

Gas Company:

______________

Other:

______________


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First Aid Kits19

In any emergency a family member or you yourself may be cut, burned or suffer other injuries. If you have these basic supplies you are better prepared to help your loved ones when they are hurt. Remember, many injuries are not life threatening and do not require immediate medical attention. Knowing how to treat minor injuries can make a difference in an emergency. Consider taking a first aid class, but simply having the following things can help you stop bleeding, prevent infection and assist in decontamination.

Things you should have:

Two pairs of Latex, or other sterile gloves (if you are allergic to

Latex).

Sterile dressings to stop bleeding.

Cleansing agent/soap and antibiotic towelettes to disinfect.

Antibiotic ointment to prevent infection.

Burn ointment to prevent infection.

Adhesive bandages in a variety of sizes.

19 U.S. Department of Homeland Security. Get A Kit, December 11, 2004.


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Eye wash solution to flush the eyes or as general decontaminant.

Thermometer

Prescription medications you take every day such as insulin, heart medicine and asthma inhalers. You should periodically rotate medicines to account for expiration dates.

Prescribed medical supplies such as glucose and blood pressure monitoring equipment and supplies.

Things it may be good to have:

Cell Phone

Scissors

Tweezers

Tube of petroleum jelly or other lubricant

Non-prescription drugs:

Aspirin or non-aspirin pain reliever

Anti-diarrhea medication

Antacid (for upset stomach)

Laxative


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Depending on the activity or situation, different first aid kits are desirable. Listed below are the suggested contents of several first aid kits. Insect Bite Kit useful at picnics, ball games, and short duration hikes. antiseptic wipes antibiotic bandages aspirin

Road Rash Kit useful for long duration vehicles rides surgical scrub brush surgical gloves bandage gauze tape antiseptic wipes iodine wipes

Family Kit general purpose family first aid kit. You should have this kit around the house and another in each car tweezers scissors syringe benzoin 1oz. insect sting swabs a&d ointment aloe vera gel antiseptic towelletes gauze dressing non-adherent dressing 5*9 trauma pad gauze bandage tape adhesive strips adheshive bandages cotton tipped applicators cotton balls


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pill vials safety pins wash towelletes plastic Ziploc bag eye drops surgical scrub brush surgical gloves bandage gauze tape antiseptic wipes iodine wipes copy of this first aid guide


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References

First Aid Guide for Employees, United States Department of Agriculture, Handbook # 227, October 1962.

First Aid Guide for School Emergencies, Virginia Department of Health

STANDARD FIRST AID COURSE: NAVEDTRA 13119, Department of the Navy, Bureau of Medicine and Surgery, 2300 E Street, NW Washington, DC 20372-5300

The Little First Aid Book: Important Facts for Saving a Life, Amber Raine, Ereader Book, Oct. 28, 2002

Training Aid 21-45, Headquarters, Department of the Army, October 1961

CPR-Pro.com Inc. Free First Aid Resources

CPR & First Aid training is mandatory if using this information. Please contact your local training facility.

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ASTHMA ATTACKS

DISCLAIMER:

The information contained in this document has been compiled from sources be-

lieved to be reliable at the time and is presented here as a study aid and for general

information use only. This information is not intended to replace or supercede the

information or procedures outlined in your first aid textbook, other officially issued

study materials or government published acts or legislative documents.

Whilst every effort has been made to ensure that the information is accurate at the

time of publication, the authors are not responsible for any loss, liability, damage or

injury that may be suffered or incurred by any person in connection with the infor-

mation contained on this site, or by anyone who receives first aid treatment from a

reader or user of this information.

Signs and symptoms of a severe asthmatic attack:

Shortness of breath, trouble breathing

Coughing or wheezing

Fast and shallow breathing

Person sitting upright as they are trying to breathe

Bluish colour in the face

Anxiety, tightness in the chest

Fast pulse rate, shock

Restlessness at first, then fatigue, casualty becomes tried from trying so hard to

breathe

First aid for asthma attacks:

ESM (scene survey) and a primary survey. As soon as you identify emergency is

a severe asthma attack, get medical help.

Stop person from what ever it is they are doing and place them in the most

comfortable position for breathing i.e. sitting upright with arms resting on a ta-

ble.

Help the casualty take medication if they have any

Keep giving care until medical help arrives.



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BURNS

DISCLAIMER:











Heat/Thermal burns - too much heat applied to the body i.e. open flames, fire,

stoves or car engines, even friction.

First Aid:

ESM, scene survey, primary survey

cool the burn right away, pour cool water on area, cover it with clean wet cloth.

Cool until pain is lessened and burn is cooled to reduce temperature or casualty

tells you that they feel numbness in the area due to the cold water.

Loosen anything that is tight as long as it is not stuck to the burn

When pain is not as bad cover burn loosely

Continue with care until help arrives

If your clothes catch fire, stop moving, drop to the ground and roll several times

to put flames out.

Exit a smoke filled room if you can by covering your mouth and nose with a

damp cloth. Hot smoke rises, so keep your head low as you crawl under the

smoke to get out.

In the event of a fire, get out by taking the stairs not the elevator. On your way

out, pull the fire alarm if it is not sounding. If you are trapped in a burning

building, seal the room you are in with tape around the door, place a wet towel

around the bottom of the door, close and seal air vents, keep low to the ground,

place a sign in the window with the words help, and cover your mouth and nose

with a wet/damp cloth.

Chemical burns - are serious as they continue to burn as long as they remain on

the skin i.e. acids, alkalies, phenols and phosphorus. In the home i.e. paint stripper,

oven cleaner, drain cleaner and rust remover.



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First Aid:

ESM, scene survey, primary survey

Remove chemical from body, flushing the area with large amount of water

Continue flushing area for 15-20 minutes

Cover burn afterwards loosely

Continue to give care until help arrives

Important Note - You must always know what chemicals you are working with be-

fore an accident occurs. While most chemicals can be flushed with water, some can-

not and may even burn more when added to water such as drain cleaners. Read the

labels and in the workplace your Materials Safety Data Sheets (MSDS) for all chemi-

cals before using them.

Electrical burns - from current, electricity, wire, plug etc.

First Aid:

ESM, scene survey. Make sure there is no other electricity danger. Donxt put

yourself in danger

Do a primary survey, give first aid for life-threatening injures

Secondary survey to locate burns and any fractures, dislocations, etc.

Give first aid for the entry and exit burns by covering them with clean, dry

dressings

Give first aid for any fractures or dislocations

Continue to give care until help arrives.

Radiation burns - can be in form of a sunburn i.e. x-rays, welding, other radioac-

tive material. In addition to the burn caused by the radioactive material, there is

also the concern of radioactive contamination of the casualty and others in the im-

mediate vicinity of the accident. Medical attention must be obtained.

Severity of burn depends on;

The dept of the burn, degree of the burn

Amount of body surface burned

Part of the body that is burned

Age and physical condition of the casualty

1st degree burn - only the top layer of the skin is damaged

Skin color is pink to red

Slight swelling

Skin is dry

Tenderness to severe pain in the injured area



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2nd degree burn - both layer of the skin are damaged

Skin looks raw and is mottled red

Moist skin white to cherry red colored

Blisters that contain clear fluid

Extreme pain

3rd degree burn - the full thickness of the skin, including tissues under the skin

are damaged.

Skin is pearly-white, tan even charred black

Ski is dry and leathery

See blood vessels and bones under the skin

Little or no pain b/c nerves are destroyed

Do not breathe on, cough over or touch burned area

Do not break blisters

Do not remove clothing that is stuck to burns

Do not use lotions, butter, oil etc.

Do not cover a burn with cotton, wool or other fluffy material

Do not sue adhesive dressings

Do not cool casualty too much, you will need to keep them warm once burnt area

is cool



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CPR REVIEW (CHILD)

DISCLAIMER:











CPR - Child casualty (1 - 8 years old)

Arrive at the scene, an unconscious child between 1-8 years old is lying on the

floor.

You must obtain consent from the parent or guardian prior to performing first aid

on a child whether conscious or unconscious.

1Begin ESM, start the scene survey, identify yourself as a first aider to the par-

ent or guardian and offer to help (if those people are around). If there is no par-

ent or guardian to obtain consent from, you MUST CALL EMERGENCY SER-

VICES FIRST and then make the judgment call whether to proceed further.

Assess responsiveness, Are you ok? Assess any response, gently tap the shoul-

ders. If no response go to the next step.

Send a bystander for medical help. If you are alone, go for help yourself but

carry the child with you if possible.

Place the casualty face up, protecting the head and neck during any movement.

Open the airway by tilting the head as you would for an adult casualty.

Check for breathing for up to 10 seconds. (same as adult casualty).

Breathe into the casualty twice. For a child casualty, use just enough air to

make the chest rise.

If the chest doesn't rise when you blow: reopen the airway by tilting the

head, pinch the nose again, make a better seal around the mouth, try blow-

ing again and if the chest still doesn't rise give first aid for choking.



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Check for signs of circulation-movement, coughing in response to the 2

breaths, and a pulse at the neck. Do not feel or compress on both sides of the

neck at the same time for the pulse. This is done by keeping the head tilted.

Slide 2 fingers into the groove of the neck just down from the Adams apple,

press gently to detect the pulse, take no more than 10 seconds.

Pulses can be hard to find, so if you are not sure if there is a pulse start

CPR right away. If there are signs of circulation begin AR.

Make sure the casualty is on a firm flat surface and landmark to position one

hand on the chest for chest compressions.

Kneel so your hands can reach the head and chest

Keep the head tilted with one hand, put the index finger on the breast-

bone.

Locate the bottom edge for the rib cage with the fingers of the hand clos-

est to the feet, slide middle finger to the notch where the ribs meet.

Place the heel of the landmarking hand midline on the breastbone just

above the spot where the index finger was positioned

Give CPR for one minute, which is about twenty cycles of CPR. Give 5 com-

pressions

Depress and release the chest rhythmically

Press the heel of one hand straight down on the breastbone

Keep the heel of the hand touching the chest at all times

The pressure and release phases take the same time

Give compressions out loud to keep track of how many you have given,

and to help keep a steady rhythm.

And one ventilation - this is one cycle of 5:1 (5 compressions to 1

breath). Give 10 more cycles of 5:1. This will be about one minute of CPR.

Reassess the signs of circulation to see if the casualty's heart has started to

beat, and if breathing has also started. Go to the next step if there are still no

signs of circulation.

Continue compressions and ventilations in the ration of 5:1 and begin with

compressions. Check for signs of circulation and breathing every few minutes.

Continue CPR until either the casualty's pulse returns. Another first aider

takes over, medial help takes over or you are exhausted and cannot continue.

If you are exhausted and cannot continue, stop but remain with the casualty until

help arrives.



1

CPR REVIEW (CHILD)

DISCLAIMER:











CPR - Child casualty (1 - 8 years old)

Arrive at the scene, an unconscious child between 1-8 years old is lying on the

floor.


on a child whether conscious or unconscious.

1Begin ESM, start the scene survey, identify yourself as a first aider to the par-

ent or guardian and offer to help (if those people are around). If there is no par-

ent or guardian to obtain consent from, you MUST CALL EMERGENCY SER-

VICES FIRST and then make the judgment call whether to proceed further.

Assess responsiveness, Are you ok? Assess any response, gently tap the shoul-

ders. If no response go to the next step.

Send a bystander for medical help. If you are alone, go for help yourself but

carry the child with you if possible.

Place the casualty face up, protecting the head and neck during any movement.

Open the airway by tilting the head as you would for an adult casualty.

Check for breathing for up to 10 seconds. (same as adult casualty).

Breathe into the casualty twice. For a child casualty, use just enough air to

make the chest rise.

If the chest doesn't rise when you blow: reopen the airway by tilting the

head, pinch the nose again, make a better seal around the mouth, try blow-

ing again and if the chest still doesn't rise give first aid for choking.



2

Check for signs of circulation-movement, coughing in response to the 2

breaths, and a pulse at the neck. Do not feel or compress on both sides of the

neck at the same time for the pulse. This is done by keeping the head tilted.

Slide 2 fingers into the groove of the neck just down from the Adams apple,

press gently to detect the pulse, take no more than 10 seconds.

Pulses can be hard to find, so if you are not sure if there is a pulse start

CPR right away. If there are signs of circulation begin AR.

Make sure the casualty is on a firm flat surface and landmark to position one

hand on the chest for chest compressions.

Kneel so your hands can reach the head and chest

Keep the head tilted with one hand, put the index finger on the breast-

bone.

Locate the bottom edge for the rib cage with the fingers of the hand clos-

est to the feet, slide middle finger to the notch where the ribs meet.

Place the heel of the landmarking hand midline on the breastbone just

above the spot where the index finger was positioned

Give CPR for one minute, which is about twenty cycles of CPR. Give 5 com-

pressions

Depress and release the chest rhythmically

Press the heel of one hand straight down on the breastbone

Keep the heel of the hand touching the chest at all times

The pressure and release phases take the same time

Give compressions out loud to keep track of how many you have given,

and to help keep a steady rhythm.

And one ventilation - this is one cycle of 5:1 (5 compressions to 1

breath). Give 10 more cycles of 5:1. This will be about one minute of CPR.

Reassess the signs of circulation to see if the casualty's heart has started to

beat, and if breathing has also started. Go to the next step if there are still no

signs of circulation.

Continue compressions and ventilations in the ration of 5:1 and begin with

compressions. Check for signs of circulation and breathing every few minutes.

Continue CPR until either the casualty's pulse returns. Another first aider

takes over, medial help takes over or you are exhausted and cannot continue.


help arrives.



1

CHOKING

DISCLAIMER:











Choking is when a persons airway is partly or completely blocked resulting in mini-

mal or no airflow to the lungs. If the foreign body is removed and victim is not

breathing, begin the primary survey for ABC):

AIRWAY - open the airway;

BREATHING - if still no breaths, attempt rescue breathing.

CIRCULATION - if no pulse, perform chest compressions.

SIGNS OF CHOKING

Choking with a good air exchange:

Able to speak

Signs of distress - eyes are showing person is afraid

Harsh coughing

Wheezing and gagging between coughing

Face is red

Person is grabbing at their throat

Choking with poor or no air exchange

Not able to speak

Signs of distress - eyes are showing person is afraid

Weak or not able to cough with sound

No noise when trying to breath or a high pitched sound

Face discoloration - pale, blue lips and ears

Person is grabbing at their throat

Semi consciousness or Unconsciousness



2

PREVENTION

Adults:

Cut food into small pieces.

Chew food slowly and thoroughly, especially if wearing dentures.

Avoid laughing and talking during chewing and swallowing.

Avoid excessive intake of alcohol before and during meals

Infants and Children:

Keep marbles, beads, thumbtacks, and other small objects out of their reach

and prevent them from walking, running, or playing with food or toys in their

mouths.



1

CARDIOPULMONARY RESUSCITATION

DISCLAIMER:











Cardiopulmonary resuscitation (CPR)

CPR is two basic life support skills put together, artificial respiration and artificial

circulation. Artificial respiration provides oxygen to the lungs. Artificial circulation

causes the blood pick up oxygen from the lungs and to flow through the body in or-

der to deliver it to vital organs. The purpose of CPR is to circulate oxygenated blood

to the brain and other organs until either the pulse returns or medical help takes

over.

The CPR sequence follows from the scene survey and is the major component of

the primary survey from Emergency Scene Management.

1. When you find an unresponsive casualty send for help (scene survey)

2. Start the primary survey by opening the airway and checking for breathing. Give

two breaths if there is no breathing (AR rescue sequence)

3. Check for signs of circulation, begin CPR



1

CRUSH INJURY

DISCLAIMER:











Crush injury - when a part of the body is crushed under heavy weight. The weight

and force may cause, bruising, fractures or ruptured organs. Major crush injury can

cause serious shock which in turn can be life threatening.

First aid for crush injuries:

Begin ESM and primary survey & scene survey

Give first aid for shock right away as shock will probably develop even though

there may be no signs.

Keep giving casualty care until medical help arrives.



1

DRESSINGS & BANDAGES

DISCLAIMER:











Dressings and bandages are the basic tools used for first aid. As a first aider it is

important to know some of the products on the market as well as how to improvise

with materials on hand at an emergency scene.

Dressings - are protective coverings to treat wounds, to control bleeding and cover

from possible spread and infection (contamination).

Dressings should be:

As clean as possible, sterilized when possible

Able to cover wounds

Absorbent

Thick and soft - to cater to excessive bleeding and to apply even pressure on a

wound

Lint free and a non-stick material such as gauze, linen and cotton.

Improvising dressing:

Use any available material that is lint-free sterile or clean, preferably white. A

towel, sheet, pillow slip, even a clean sanitary pad can be used as a dressing where

commercial products are not at hand. Plastic wrap or the packaging from sterile

dressings can be used to wrap around a dressing to have an airtight hold. However,

a breathable dressing is preferable in most situations. The only major exception be-

ing a sucking chest wound.

Applying dressings:

Use the cleanest material, wear gloves and wash hands before and after care to

avoid contamination.

Extend the dressing beyond the edges of the wound so it is covered completely.

If blood goes through a dressing, leave it on and cover with more dressings

Secure and seal dressing with tape or bandages



2

Bandages - are any materials that hold the dressing in place, hold pressure on a

wound, as support or to secure a splint. Like dressings, bandages can be bought

or improvised.

Using bandages:

Apply firmly so bleeding is controlled

Check the circulation beyond the bandage often to make sure the bandage is

not too tight

Make sure bandages are not used as padding or dressings.

Examples of improvised bandages: Tie, belt, scarf, cloth (rolled or folded), fabric

cut into a triangle and folded to make a broad or narrow bandage etc.

Head bandage

Stand behind the casualty. Use a triangular bandage as a whole cloth with a

narrow hem folded along the base. Place the centre of the base in the middle

of the forehead, close to the eyebrows.

Bring the point over the top of the head to cover the dressing, and down the

back of the head, cross over the point, and around the head to the front. Tie

the ends together, using a reef knot, low on the forehead.

Steady the head with one hand, and gently pull the point down to put the de-

sired amount of pressure on the dressing. Fold the point up toward the top of

the head and secure it carefully with a safety pin or tuck it under the back

crisscross.

Knee or elbow bandage

Use a triangular bandage as a whole cloth with a narrow hem folded along the

base. Place the centre of the base on the leg below the kneecap with the point

toward the top of the leg (or to bandage an elbow, on the forearm with the

point toward the shoulder).

Bring the ends around the joint, crossing over the point in front of the elbow

or at the back of the knee.

Bring the ends up and tie off over the point. Pull the point up to put the right

amount of pressure on the dressing and then fold it down and secure it with a

safety pin or tuck it under the knot.



3

Foot or hand bandage

Use a triangular bandage as a whole cloth. Place it on a flat surface with the

point away from the casualty

Place the foot or hand on the triangular bandage with the toes or fingers to-

ward the point, leaving enough bandage at the ankle or wrist to fully cover the

part. Bring the point up and over the foot or hand to rest on the lower leg or

wrist.

Bring the ends alongside the foot of hand and crisscross the folded ends up

and around the ankle or wrist. Cross over the point and wrap any extra ban-

dage before trying it off.

Tie off over the point. If the point extends beyond the knot, pull it up to apply

the desired pressure. Fold it downward and tuck under the knot.

Roller bandages - are usually made of gauze like material and are packages as a

roll. They are used to hold dressings in place to secure splints.

Roller bandages can be put on in a simple spiral. Start at the narrow part of

the limb, anchor the bandage as directed\

Place the end of the bandage on a diagonal at the starting point

Wrap the bandage around the injured part so the corner of the bandage end is

left out

Fold this corner of the bandage over and wrap the bandage around again to

cover the corner. Keep wrapping the bandage, overlapping each turn by one

quarter to one third of the bandages width. Make full-width overlaps wit the

final two or three turns and secure with a safety pin, adhesive tape or by cut-

ting and tying the bandage as shown. Check circulation below the bandage.

Slings - Provide support and protection for an arm. Slings can be commercially

bought but be easily improvised with a scarf, belt, necktie or other item that can

go around the casualty's neck - any material will do as long as it is sturdy enough

to support the arm. You can also support the arm by placing the hand inside a

buttoned jacket or by pinning the sleeve of a shirt or jacket to the clothing in the

proper position.



1

GUN SHOT WOUNDS

DISCLAIMER:











Gun shot wounds

Have a small entry into the part of the body, usually with burns around it. There

can be an exit wound and it would be larger than the entry wound. Usually the en-

try and exit wounds are across from each other.

First aid for gun shot wounds

Begin ESM and primary survey

Monitor ABC's.

Apply direct pressure to wound, bandage and get to medical aid as soon as pos-

sible.

Cover with blanket, to reduce risk of shock.

If large enough caliber to the front upper torso / chest area, the wound may be

a sucking chest wound. If so, apply a square piece of plastic with about to 1

inch border around the wound, tape three sides leaving bottom open. If there is

also an associated exit wound you may also have to do the same procedure but

in this case tape all four sides of the plastic on the exit side, if on back.



1

HEAD INJURIES - SIGNS & SYMPTOMS

DISCLAIMER:











Head injury - Serious injury of the head where the brain function is or may be af-

fected.

Head injury - Signs & Symptoms

Deformed skull

Swollen, bruised or bleeding scalp

Straw-coloured fluid or blood coming from the nose or ears

Bruising below the eyes or behind the ears

Nausea vomiting, especially in kids

Confused, dazed

Semi-conscious or unconscious

Stopped breathing

Very slow pulse rate

Pupils are of unequal size

Pain at the injury site

Weakness or paralysis of the arms and/or legs

Pain when swallowing or moving the jaw

Wounds in the mouth

Knocked-out teeth

Shock

Convulsions

Skull fractures - result of direct force or an indirect force that is transmitted

through the bones. Fractures may occur in the cranium, at the base of the skull, or

in the face. Facial fractures include the nose, the bones around the eyes, the upper

jaw and lower jaw. Fractures of the jaw are often complicated by wounds inside the

mouth.



1

HEAD INJURY - FIRST AID

DISCLAIMER:











First aid for Head injury & Skull fracture

1. Begin ESM, do a scene survey. When you recognize it may be a head injury tell

the casualty not to move and get medical help. Steady and support the head.

2. Assess responsiveness and do a primary survey. If there is no breathing open

the airway using the jaw-thrust without head-tilt and give AR if needed.

3. If blood or fluid is coming from the ear canal, secure a sterile dressing lightly

over the ear, making sure fluids can drain.

4. Protect areas of depression, lumps, bumps, or scalp wounds where an underly-

ing skull fracture is suspected. Avoid pressure on the fracture side.

5. Warn the casualty not to blow their nose I there is blood or fluid coming fro it.

Wipe any external blood to prevent it from entering the mouth.

6. Give care until medical help arrives.

Concussion - a temporary disturbance of brain function caused by a blow to the

head or neck.

Signs & symptoms:

Partial or complete loss of consciousness, usually of short duration

Shallow breathing

Nausea and vomiting when regaining consciousness

Casualty says she is seeing stars

Loss of memory of events immediately preceding and following the injury

Compression - excess pressure on some part of the brain causes by a buildup of

fluids inside the skull.

Signs & symptoms

Decreasing level of consciousness

Unconsciousness from the time of injury, may be deeply unconscious

Nausea and vomiting

Unequal size of pupils

One or both pupils don't respond to light



2

First aid for a head or spinal injury

Goal is to prevent further injury on the spinal cord.

1. Begin ESM, scene survey. Tell casualty not to move when you suspect it is this

type of injury.

2. Steady and support he casualty's head and neck and show a bystander how do

to this and show another how to support the feet. Keep both fully supported

until medical help arrives.

3. Assess responsiveness and then do a primary survey. If the casualty is unre-

sponsive, check for breathing before opening the airway. No breathing, then

open the airway using the jaw-thrust without head-tilt and check for breathing

again.

If breathing hold the airway open with the jaw-thrust

If there is still not breathing give AR, check circulation look for signs of

sever bleeding and shock.

4. Do a secondary survey but do not move the casualty or poke and probe any

possible spinal injury.

5. Decide if you need to move casualty. It is best to leave casualty as is until

medical help arrive.

6. Continue to give care until help arrives.



1

CPR REVIEW (INFANT)

DISCLAIMER:











CPR - Infant casualty (1 years old and under)


on an infant whether conscious or unconscious.

Begin ESM, start the scene survey. Identify yourself as a first aider to the parent

or guardian and offer to help. If there is no parent or guardian to obtain consent

from, you MUST CALL EMERGENCY SERVICES FIRST and then make the judge-

ment call whether to proceed further.

Assess responsiveness, gently tap the baby's feet, if there is no response, next

step.

Get medical help, or send a bystander to get help.

Place the baby face up, protecting the head and neck during any movement.

Open the airway by tilting the head.

Keep the head tilted and place your ear near the baby's mouth and nose. Check

for breathing for up to 10 seconds. Look, listen and feel (same as adult and

child CPR)

The back of an infants head is quite large to the rest of their body. This causes the

baby's head to come forward and close off the airway. When giving AR or CPR it

may help to put a thin pad under the shoulders to help keep the airway open but

don't waste time looking for a pad. Also, unlike an adult or child, it is possible to

over-tilt the head back which will also close the airway. So, if you have tilted the

head back and it seems like air is not getting into the infant, slightly move the head

forward and try again.

Breathe into the casualty twice. An infants lungs are easily filled with the

amount of air an average adult can place in their own mouth in order to extend

their cheeks. It just takes puffs not breaths to fill their lungs. Observe the chest,

if it rises, you have put the correct amount of air in.



2

Check for signs of circulation-movement, coughing as a response to the 2

breaths, and a brachial pulse. Start CPR if you cant find the pulse. The brachial

pulse is located inside the upper inner arm, midway between the armpit and

elbow.

Make sure the casualty is on a firm, flat surface and landmark to position the

tips of two fingers on the chest for chest compressions.

Give CPR for one minute, give five compressions and one ventilation, this is

one cycle of 5:1 (5 compressions to 1 breath-puff) If there is no pulse or

breathing, go to the next step.

Continue compressions and ventilations in the ratio of 5:1, starting with com-

pressions. Check for signs of circulation and breathing every few minutes. Con-

tinue CPR until either signs of circulation return, another first aider takes over,

medical help takes over or you are exhausted and cant continue.


help arrives.



1

WOUNDS & BLEEDING FIRST AID

DISCLAIMER:











First aid for severe external bleeding

Begin ESM - scene survey. Assess mechanism of injury. If you suspect a head or

spinal injury, steady and support the head and neck before continuing.

Do a primary survey and give first aid for life threatening injuries.

Apply direct pressure to control severe bleeding as quickly as possible. If the

wound is large and wide open, you may have to bring the edges of the wound

together first.

While keeping pressure on the wound, elevate the injury - this will reduce blood

flow at the wound

Place the casualty at rest, this will further reduce blood flow

Quickly replace the casualty's hand with dressings (preferably sterile) and con-

tinue direct pressure over the dressings.

Once bleeding is under control, continue the primary survey, looking for other

life-threatening injuries. Give life-saving first aid as needed.

Before bandaging the wound, check circulation below the injury.

Bandage the dressing in place.

Check the circulation below the injury and compare it with the other side. If it is

worse than it was before the injury was bandaged, loosen the bandage just

enough to improve circulation

Give ongoing casualty care, including first aid to minimize shock.

First aid for severe, internal bleeding

Begin ESM

If casualty is awake or there are signs of consciousness, place them on their

back or in a position of comfort. If unconscious, place casualty in recovery posi-

tion if injuries permit.

Get medical help

Continue giving care but do not give the casualty anything by mouth. You can

moisten their lips with a wet cloth but do not let them try to swallow or drink

anything. Casualty should always be kept as comfortable as possible and warm.



2

Amputation - when some part of the body has been cut off such as a finger, toe,

foot etc. The bleeding needs to be controlled where the part of the body has been

cut off.

First aid for amputations

Begin ESM

Control the bleeding by applying pressure

Casualty should be at rest and the injury should be elevated and then bandage

dressings in place.

For partly amputated fingers reposition the partial amputated part to its origi-

nal position

Bandage in position

Get medical help

Care for amputation

Wrap the amputated body part in a moist dressing if possible. Make sure the

dressing is clean. Place body part that is in the dressing in a clean plastic bag and

seal it very tightly. A second plastic bag should be used to create an air space

around the first and then should be placed in a third bag or container that is filled

with ice. The date, time and casualty's name should be recorded on the bag. The

amputation should go with the casualty to medical help.

Note: The amputated part should not be cleaned and no solutions should be used

on it.

firstaidfa_asthmafa_burnsfa_child_cpr (1)fa_child_cprfa_chokingfa_cpr_infofa_crush_injuryfa_dressings_bandagesfa_gun_shot_woundsfa_head_injuriesfa_head_injuries_firstaidfa_infant_cprfa_wounds_review

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First Aid Kit