First-Aid - Treatment
Do No Harm! Know the Local Emergency Number! 1st Aid Kit Always Accessible
Condition
Symptoms (verbal)
Symptoms (observed)
Action
Shock:
 A condition of
inadequate
circulation to the
body tissues, as
a result of injury.
 Development
can be gradual
or rapid.
 Shock results in
deprivation of
oxygen to the
vital organs.
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Anxiety and dizziness or
light-headedness.
Thirst.
Nausea.
Pain.
Skin pale and later bluish
grey colour.
Skin cold and clammy,
often with profuse
sweating.
Extremities (lips, tongue,
earlobes & finger nails)
bluish/purple in colour.
Weak & rapid pulse.
Restlessness, confusion
or decreased level of
consciousness.
Vomiting
Shallow, irregular
breathing.
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Fainting
 Brief loss of
consciousness
caused by a
temporary
shortage of
oxygen to the
brain.
It may be caused by:
 Tiredness,
hunger or a lack
of fresh air.
 Fear and
anxiety.
 Long periods of
standing.
 Severe pain,
injury or illness.

Person may complain of
feeling nauseous, dizzy
or lightheaded.
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Paleness
Sweating.
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Reassure the person.
Loosen tight clothing
around the neck, chest
and waist.
Place the person in a
position that best
maintains open airways.
Cover person to preserve
body heat.
If there is an injury then
ensure movement does
not worsen the injury.
Give nothing orally –
moisten the lips only if
person complains of
thirst.
Continue with personal
care until handing over to
medical help.
If a person feels faint:
 Lie the person down with
legs raised about 30cm.
 If you cannot lie the
person down, have the
person sit with head and
shoulders lowered.
If a person has fainted:
 Loosen tight clothing.
 Look, listen and feel to
determine if person is
breathing. Check
frequently. If person
stops breathing give
artificial respiration
immediately.
 Any change in person’s
condition should be
observed and noted and
described to the medical
personnel when the
person is handed over.
First-Aid - Treatment
Condition
Action
Breathing emergencies
 Occur when breathing
stops or is ineffective,
thereby depriving the
body of oxygen.
 After 4 minutes without
oxygen, brain damage
may result.
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The air you breathe out is enough to sustain the life of a non-breathing person.
The best way to do this is by blowing forcibly into the persons’ mouth – mouth to
mouth AR.
 Place the person face up; protect the head and neck during any movement.
Open the airway by tilting the head and pulling the lower jaw forwards and
upwards
 Check for breathing by placing ear above person’s nose and mouth or look for
chest movement. Check for 10 seconds.
 If no breathing then proceed with AR.
Administer Artificial Respiration (AR):
 Use protective shield, pinch the nostrils and breathe into the person’s mouth
twice. Use enough air to make the chest rise.
 Release the nostrils for air to escape.
 Look for chest to rise and fall and listen for air sounds or feel if air is being
exhaled against your cheek. Give another breath.
 Check for pulse at the side of the neck closest to you.
 If no pulse then start CPR (see Cardiac Arrest), otherwise continue AR.
 After 1 minute of AR check pulse for 10 seconds.
 If there is a pulse and still no breathing then continue AR until person starts
breathing or medical help takes over.
 An alternative method is by blowing into the person’s nose, the mouth to nose
method of AR: As for mouth to mouth AR but close the person’s mouth with your
thumb and fingers.
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First-Aid - Treatment
Condition
Action
Burns:
 May be caused by heat –
dry heat, moist heat or
heat created by friction.
 Fires may also cause
injury through smoke
inhalation.
 May also be caused by
corrosive chemicals,
electric current or
radiation – sun or
radioactive materials.
 Depending on the depth
of the burn, the following
tissues can be damaged:
 Superficial layer of
the skin
 Deeper layer of the
skin
 Subcutaneous tissue.
 Muscle tissue.
Warnings:
 DO NOT overcool the person causing dangerous lowering of the body
temperature.
 DO NOT remove anything sticking to the burn as this may cause more damage
& contamination.
 DO NOT break blisters.
 DO NOT touch the burn with your fingers.
 DO NOT break, talk or cough over the burn.
 DO NOT apply lotions, oils, butter or fat to the burnt area.
 DO NOT cover the burn with cotton wool, fluffy materials, adhesive dressings or
tape.
Heat burns:
 Immerse the burned part in cool water or gently pour cool water over the burned
area, until the pain is relieved.
 Remove jewellery and loosen tight clothing before swelling occurs.
 Cover the area loosely with clean, preferably sterile material and secure, but
make sure that the tape does not touch the burnt area.
 Elevate the limb if applicable and obtain medical help.
Chemical burns:
 Immediately flush the area with cool water for 10 – 15 minutes to stop the
chemical continuing to burn the skin – caution: some chemicals, like liquid
sulphur will react adversely to this treatment.
 Remove contaminated clothing and brush off any dry powder from the skin, but
do not use your bare hands.
 Cover the area loosely with clean, preferably sterile material and secure, but
make sure that the tape does not touch the burnt area.
 Elevate the limb if applicable and obtain medical help.
Electrical burns:
 Shut off the current or remove the person from the vicinity of the current if it is
safe to do so.
 Check breathing and pulse – give AR or CPR is necessary.
 Cover the entry and exit wounds with clean dry dressings and support fractures
or dislocations.
 Always obtain medical help.
Sunburn - Minor:
 Sponge burned area with cool water to relieve the pain.
 Apply sunburn lotion or cream – caution: some may cause allergic reactions –
sunburn is the only burn to which a lotion or cream may be applied.
 Protect burn areas from the sun and do not pop blisters.
Sunburn - Major:
 Treat as for heat burns.
 If person vomits or develops a fever, obtain medical help immediately.
Complications resulting from burns:
 Smoke inhalation.
 Shock.
 Infection.
 Swelling.
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First-Aid - Treatment
Condition
Action
Cardiac Arrest
 When the heart stops
pumping it is in cardiac
arrest
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If there is no pulse, perform Cardio-Pulmonary Resuscitation (CPR) until there is
a pulse or until medical help arrives.
 CPR is two basic life support skills: Artificial Respiration and Artificial Circulation.
 Place the person face up protecting the head and neck during any movement.
 Open the airway by tilting the head and pulling the lower jaw forwards and
upwards.
 Check breathing for 10 seconds. Administer mouth to mouth AR. Check for
pulse.
 If no pulse commence CPR.
Administer CPR:
 Make sure person is on a firm flat surface.
 Locate bottom of the rib cage with the fingers of dominant (bowling) hand.
 Slide fingers to the notch where the ribs meet.
 Place the heel of the other hand midline on the breast bone above these
fingers.
 Place your bowling-hand on top and raise the fingers off the chest; interlock
the fingers.
 With your hands in place, position your shoulders directly over your hands
and keep your elbows locked.
 Press the heels of the hands straight down on the breast bone.
 Ensure that the heel of the bottom hand touches the chest at all times.
Sufficient pressure should be used to compress the heart.
 Depress and release the chest rhythmically. The pressure and release phases
take the same time.
 Give 15 compressions then 2 ventilations (breaths). Count compressions out
loud to keep track of how many you have given, and to keep a steady rhythm, 1
and 2 and 3 and 4 and 5 and 6 etc. at a rate of 80 to 100 per minute.
 Re-assess pulse and breathing. If none, continue CPR until either person’s
pulse returns or medical help arrives and takes over the CPR.
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First-Aid - Treatment
Condition
Action
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Warning:
Any player complaining of severe chest pain or significant indigestion should be
taken seriously particularly if:
 The person is aged or there is a past history of heart disease, high blood
pressure or diabetes mellitus. However do not be fooled by age as even young
people can have a heart attack.
 The pain is centrally situated in the chest or upper abdomen and/or is referred to
the left shoulder or arm or the jaw.
 Pain continues or gets worse.
 The pain is associated with the symptoms of:
 Shortness of breath.
 Dizziness or light headedness.
 Person is clinically shocked if:
 Cold and clammy or sweating profusely.
 Pulse is weak, rapid or irregular.
 Remember what is described as typical angina pectoris (heart pain) is not
always present in a person suffering a heart-attack. Discretion is needed
because any person who is suddenly very short of breath or is clinically shocked
may be having a silent infarct (heart-attack) without experiencing pain.
Treatment:
 Lie the person down in comfortable and quiet circumstances away from the other
curious players.
 Ensure open airways.
 Administer oxygen if available.
 Do not give the person alcohol in any form or feed the patient with solids.
 Unless person is allergic to salicylates give one dispirin or an equivalent amount
of a salicylate to chew and swallow with a small amount of water - this acts as an
anti-coagulant to help dissolve the clot within a time period of 30 seconds.
Seek medical assistance urgently:
 Always have the telephone number for a Life Support ambulance service or
nearby medical practitioner prominently displayed in the club house.
 The Advanced Life Support Ambulance Services have the expertise and the
equipment to deal with this emergency at the scene of the occurrence and they
should be called immediately if the geographical area has this service available.
 The hospital emergency units are appropriately equipped with staff and
resuscitation equipment necessary to best deal with such an emergency.
 If the person’s condition and circumstances do not lend to ready transportation
and none of the above services are readily available call for the services of a
medical practitioner. If the condition of the person is stable and permits for ready
transportation, it is usually advantageous to transport the person to the doctor’s
consulting rooms so that an ECG can be done and the patient more adequately
assessed clinically.
Chest Pain
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First-Aid - Treatment
Condition
Action
Choking
 Occurs when the airway
is partly or completely
blocked.
 Airflow is reduced or cut
off.
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If the person is conscious and can cough, speak or breathe, tell them to cough
up the object.
If the person cannot cough, use abdominal thrust to remove the blockage:
Lie the person on their back and ensure airways are open by lifting lower jaw
upwards and forwards with the head turned to the side.
Swipe index finger through mouth and throat to remove any obvious foreign
body.
Place the heel of one hand over the upper abdominal area below the rib cage.
Place the other hand on top of this hand. Give a firm and sudden thrust upwards.
Keep giving abdominal thrusts until the object is removed – 6 - 10 times.
If airway clears, monitor the breathing and stay with person until fully recovered.
Diabetic Emergency:
 Too much or too little
insulin.
 Eating too much or too
little food, or vomiting.
 Exercising more or less
than usual.
What to look for:
 Check for medical alert device – bracelet or necklace.
 Insulin shock (needs sugar) causes a strong, rapid pulse; shallow breathing;
pale, grey, sweating skin; odourless breath; fast developing faintness or
unconsciousness; and possibly a headache, trembling and hunger.
 Diabetic coma (needs insulin) causes a weak, rapid pulse; deep, sighing
breathing; reddish, dry, warm skin; breath that smells like musty apple or nail
polish; gradual onset of unconsciousness; unsteady walk and nausea.
Treatment:
 If possible give the person something to drink such as concentrated sugar water.
This may help and it will not significantly worsen the situation. Generally a high
blood sugar may cause a keto-acidotic coma (typical smell to breath) well before
death.
 A very low blood sugar, particularly with an insulin dependent diabetic, may
cause death and should be regarded as a medical emergency. If the person is
conscious, find out where their insulin is and assist them to administer it.
Heat Exposure and Illness:
 Prolonged exposure to
extreme heat or heavy
exertion in a hot
environment may result in
a heat illness.
Heat cramps:
 Give the person as much water or rehydrate solution in dilution to drink as they
want.
 If the cramps persist obtain medical help.
Heat exhaustion:
 Place person at rest in a cool place with the feet and legs elevated, as for shock
treatment.
 Remove excessive clothing and loosen tight clothing around the neck and waist.
 Give the person water or rehydrate solution in dilution to drink, as much as they
will take.
 If the person vomits, do not give anything else by mouth and get medical help.
Heat stroke (sunstroke):
 Move the person to a cool shaded place.
 Cool the person down. Sponge the person with cool water, particularly the arm
pits, neck and groin areas.
 When body feels cool to touch cover with a dry sheet.
 Put the person in the shock position.
 Monitor the person closely. If the person’s temperature rises repeat the cooling
process.
 Give care till medical help arrives.
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First-Aid - Treatment
Condition
Action
Hydration:
 Up to 2 litres of water is
lost during a game played
in very hot weather.
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The lost fluid must be replaced – otherwise dehydration will be the result. This is
first indicated by a loss of concentration. Heat stroke or heat exhaustion could
follow.
Prevention: drink a full glass of water before and after the game and ½ glasses
every second end.
For excessive dehydration, see Heat Exhaustion and Heat Stroke above.
Lightning Injury:
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Check breathing.
If not breathing, administer AR.
Check for pulse.
If no pulse, start CPR and AR.
Treat any burns as indicated above.
Support any sprains, strains and fractures if possible.
Seek medical help to ensure a full evaluation of any injuries.
Nose Bleed:
 May occur
spontaneously, possibly
due to high bloodpressure or adverse
environmental conditions.
 May be caused by
blowing the nose or injury
to the nose or skull.
If caused by head injury:
 Steady and support the head and neck.
 Wipe away the trickling blood – do not try to stop the bleeding and do not stuff
tissue paper or cotton wool up the nose.
 Call for medical help immediately.
If not caused by head injury:
 Place person in sitting position with head slightly forward.
 Tell the person to pinch the soft parts of the nose firmly with the thumb and
forefinger for about 10 minutes or until the bleeding stops. A pack of crushed ice
in a plastic bag is useful.
 Loosen tight clothing around the person’s neck and chest.
 Keep the person quiet to avoid increased bleeding.
 Get medical help if bleeding does not stop.
 If bleeding stops tell the person not to blow their nose for a few hours.
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First-Aid - Treatment
Condition
Action
Particles in the Eye:
 May be caused by sand,
grit or loose eyelashes.
Warning: Never attempt to remove a particle from the eye if:
 The particle is on the cornea.
 The particle is sticking to or embedded in the eyeball:
 If the particle is small, cover gently with soft pad and secure lightly in place.
If the person needs to be transported, s/he should do so lying down, but
preferably get medical help on the scene.
 If the particle is a large object, place dressings around the object and ensure
that there is no pressure exerted on the object; immobilise the head to
prevent movement and transport to casualty on a stretcher.
 Use a cup or ring-pad bandage to stabilise the embedded object.
 The eye is inflamed and painful.
 Never apply pressure to the eyeball.
Locate and remove a loose particle under the upper-lid:
 Warn the person not to rub the eye.
 Wash your hands and put gloves on.
 Stand beside the person and steady the head.
 Spread the eye lid apart with your thumb and index finger.
 Shine a light across the eye, not directly into it, and look for a shadow of the
particle.
 If particle is loose and not on the cornea try removing it with a moist corner of a
clean facial tissue or cloth.
Locate and remove a loose particle under the lower lid
 Wash your hands and put gloves on.
 Seat the person facing light.
 Gently draw the lower eyelid downward and away from the eyeball while the
person rolls the eyes upwards.
 If particle is visible wipe it away with the moist corner of a clean facial tissue or
cloth.
 If pain persists after removal obtain medical help.
 If particle does not become visible during examination, do not continue your
attempts.
 Cover the injured eye with eye pad or gauze and tape loosely.
 Obtain medical help immediately.
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First-Aid - Treatment
Condition
Action
Poisons:
 Enter the body in various
ways:
 Taken by mouth.
 Inhaled.
 Absorbed.
 Injected – e.g. bee
stings
Taken by mouth:
 Wipe persons face to remove any poisonous or corrosive material.
 Rinse or wipe out mouth.
 Do not make person vomit if poison is corrosive.
 Get medical help as soon as possible.
Inhaled:
 Remove the person from the source of the gas or vapour.
 Check for clear airway and monitor breathing.
 Obtain medical help as quickly as possible
Absorbed:
 Flush the affected area, including clothes with large amounts of water.
 If poisonous substance is a powder, brush off excessive powder with a dry cloth
before flushing.
 Wash the skin with soap and water if possible.
 Pay attention to hidden areas, finger nails and in the hair.
 Obtain medical help as soon as possible.
Injected (bee stings):
 Scrape the sting and poison sac carefully from the skin with the blunt edge of a
knife.
 Do not squeeze the sting while removing it.
 Apply rubbing alcohol or a weak ammonia solution or a paste of bicarbonate of
soda and water.
 If sting is in the mouth, give the person a mouth wash of one teaspoonful of
bicarbonate of soda to a glass of water or ice to suck.
 If there is swelling in the mouth and breathing difficulty then get medical help
immediately.
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Seizures and
Convulsions:
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Turn the person to the side to allow drainage of fluids and keep the tongue from
falling back and blocking the airway.
Make the area safe – clear away any hard or sharp objects that could cause
injury and chase onlookers away.
Do not try to put anything in the mouth but wipe away fluids from the mouth and
nose.
Do not restrict the person’s movements.
Carefully loosen tight clothing especially around the neck and place something
under the head to support it.
Check for obvious injuries and give necessary first aid.
Monitor breathing.
Keep the person warm.
Do not give the person any liquids during or immediately after the seizure.
Allow person to rest (may require one hour) during post-epileptic automatism or
recovery period.
Call medical help if person is unconscious for more than five minutes or has a
second major seizure.
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First-Aid - Treatment
Condition
Action
Wounds:
 Breaks in the continuity of
the soft tissue of the
body.
 An open wound may
result in bleeding and
may permit the entrance
of bacteria to cause
infection.

Before giving first aid wash your hands with soap and water and use clean
gloves.
 Do not cough or breathe directly over the wound.
 Do not touch the wound.
Treatment of minor wounds:
 If there is loose material on the surface then gently wash the wound under
running water.
 Protect the wound with a temporary clean, preferably sterile, dressing.
 Wash surrounding skin with clean swabs then dry surrounding skin with clean
swabs, wiping away from the wound.
 Remove temporary dressing and cover the wound promptly with a sterile or
clean dressing and tape it in place.
 Remove and dispose of gloves when wound care is completed. Wash your
hands and any other skin area that has been in contact with the person’s blood.
Treatment of severe external bleeding:
 Apply direct pressure to the wound.
 Apply continuous pressure with your hand over a pad of dressings or use the
person’s bare hand. You may have to bring the edges of the wound
together before applying pressure if the wound is large and gaping.
 Continue pressure by firmly securing dressings with a bandage.
 If dressings become blood-soaked do not remove them but apply additional
dressings and secure with fresh bandages.
 Elevation:
 If injuries permit, raise injured limb above the heart as this will help to reduce
the blood flow to the wound – ±30cm.
 Elevate an injured limb as much as the injury and the person’s comfort will
permit.
 Partially amputated part:
 Keep as near as possible to its normal position.
 Apply direct pressure on the wound with a clean dry dressing to stop
bleeding.
 Secure dressings in place with a bandage.
 Obtain medical help as soon as possible.
 Care of amputated tissue
 In many cases amputated parts can be surgically re-attached. Proper care
of the amputated tissue, therefore is very important:
 Wrap it in a clean moist dressing.
 Place it in a clean watertight plastic bag with crushed ice and seal it.
 Place it in another bag and label the bag with the person’s name, the time
and date.
 Send it to the medical facility with the patient.
 For severe injuries, also treat for shock until medical help arrives.
References:
BowlsSA. (2010) Basic first-aid for bowlers; Unit standard TO-F002, Bowls South
Africa, National Standing Committe for Technical Officials.
SJA (1999) First aid: Emergency level, safety oriented workbook, St John
Ambulance, Johannesburg.
The information given by the above was added to by Dr George Middleton.
Note: The Technical Officials document appears to be based on St John Ambulance
information.
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