RLSSA Emergency First Aid
1
RLSSA Emergency First Aid
CPR
2
RLSSA Emergency First Aid
Action Plan
D anger
R esponse
S end for help
A irway
B reathing
C PR
D efibrillation
3
RLSSA Emergency First Aid
DRSABCD
D anger
Check for dangers to:
 Yourself
 Bystanders
 Casualty
Walk 360o around the casualty
Use all 6 senses
 Smell
 Sight
 Taste
 Touch
 Listen
 Common Sense
4
RLSSA Emergency First Aid
DRSABCD
R esponse
Is the casualty responsive?
C an you hear me?
O pen your eyes
W hat’s your name?
S queeze my hands and let go
If the casualty is not responsive, and fluid is suspected in the
airway, roll the casualty into recovery position
5
RLSSA Emergency First Aid
DRSABCD
Send for Help
Dial 000
Be prepared to give the following information







Location of the emergency (including nearby landmarks, closest
intersections etc..)
The telephone number from where the call is being made
What happened
How many persons require assistance
Condition of the casualty
What assistance is being given
Any other information requested
** Never hang up before the emergency services operator hangs up **
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RLSSA Emergency First Aid
DRSABCD
A irway
Open the airway
 Tilt the casualty’s head back to remove
tongue from the airway
Clear the airway
 Check to see the airway is free from
Obstructions
In an unconscious victim, care of the airway takes precedence
over ANY injury
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RLSSA Emergency First Aid
DRSABCD
Breathing – Normal Breathing?*
Check for signs of life
 consciousness, responsiveness, movement
and normal breathing
Look, Listen, Feel
 Look - for rise and fall of the chest
 Listen - for breathing noises
 Feel - for rise and fall of chest
and for breath on cheek
Watch for rise and
fall of the chest
* For drowning related emergencies give 2 rescue breaths prior to
commencing CPR
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RLSSA Emergency First Aid
DRSABCD
Push FIRM
Push FAST
CPR - 30 : 2
If no signs of life are present give 30 chest compressions,
followed by 2 breaths
 Centre of the chest
♥ Compressions applied too high are ineffective
♥ Compressions applied too low may cause regurgitation &/or
damage to the vital organs
 The centre of the chest (sternum) should be depressed by a
third of the chest depth
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RLSSA Emergency First Aid
DRSABCD
2 Breaths
 Pistol grip
 Take a breath for yourself
 Breath into patient
 Watch for rise and fall of
chest
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RLSSA Emergency First Aid
DRSABCD
Automated External Defibrillator
Attach AED (if available) as
soon as possible and follow the
prompts
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RLSSA Emergency First Aid
DRSABCD
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RLSSA Emergency First Aid
DRSABCD - Defibrillators
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RLSSA Emergency First Aid
DRSABCD
C – CPR
D – Dangers
Give 30 chest compressions
Followed by 2 breaths
Check for dangers
Continue until qualified help arrives
or normal breathing returns
For drowning related emergencies give 2 rescue
breaths prior to commencing CPR
R – Response
Check for response
No response
D – Defibrillation
Attach AED
S - Send for help
(automated external defibrillator)
and follow prompts
Call 000
A – Airway
Open Airway
Clear the airway
no
Place in recovery position
Monitor vital signs
Provide oxygen
B – Breathing
Look, Listen & Feel for breathing
Responsive? Breathing normally?
yes
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RLSSA Emergency First Aid
RESCUE BREATHING
Mouth to mouth
 Used when no pocket mask is available
Mouth to mask
 Should always be used by First Aiders
 Minimises transfer of communicable diseases
 Provides mouth to mouth & nose resuscitation
Mouth to nose
 Can be administered in deep water
 Mouth to mouth and nose
 Used to resuscitate infants
Mouth to mouth and nose
 Breath is applied to both the mouth and nose
 Done to infants
Mouth to neck stoma
 Breath is applied to tube in neck
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RLSSA Emergency First Aid
Techniques
ADULTS
Head Tilt:
Full
Breath Size:
CHILDREN
INFANTS
Full
Neutral
Rise and fall of the chest
Compression
Depth:
1/3 depth of the chest
Compression
Point:
Visual – Centre of the chest
Compression
Method:
2 Hands
1 or 2 Hands
2 Fingers
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RLSSA Emergency First Aid
DRSABCD
CPR is the technique of rescue breathing combined with chest
compressions
The purpose of CPR is to temporarily maintain a circulation
sufficient to preserve brain function until specialised treatment is
available
CPR should be continued until:
Signs of life return
Qualified help arrives and takes over
It is impossible to continue
Danger returns
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RLSSA Emergency First Aid
DRSABCD
ADULTS
Aged 8 years old
plus
CHILDREN
30 compressions
2 breaths
Aged 1 year old to 8
years old
5 cycles in 2 minutes
Almost 2 compressions per second
INFANTS
Aged up-to 12
months
“Thirty & Two That’s All You Do”
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RLSSA Emergency First Aid
DRSABCD
Multiple rescuers
 It is recommended that frequent rotation of rescuers
is undertaken to reduce fatigue
 Approximately every 2 minutes
“Thirty & Two That’s All You Do”
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RLSSA Emergency First Aid
DRSABC - infant
D anger
The assessment for danger remains the same
R esponse
 Make loud noises such as clapping
 Blow air in the infants face
 Run fingers along the arches of the feet
 Place finger inside of hands
S end for Help
 Call 000
A irway
 Both mouth and nose should be cleared
 Nose can be cleared using the ‘milking’ technique

Open airway is achieved with head in neutral position
B reathing – Normal Breathing
 Look, listen and feel
 Check for signs of life
C PR
 30 compressions followed by 2 breaths Mouth-to-mouth-and-nose
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rescue breathing
 2 fingers on lower half of the sternum
RLSSA Emergency First Aid
DRSABCD
VOMIT
A voluntary response
Abdominal muscular contraction occurs
Removal is often forceful and projectile
Often appears “chunky”
A good sign – something is working
REGURGITATION
An involuntary response
The stomach distends
The contents ooze out
Often appears “frothy”
A bad sign – often caused by:
Over inflation
Insufficient head tilt
Not allowing enough time between
breaths
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RLSSA Emergency First Aid
DRSABCD
If the casualty vomits or regurgitates during resuscitation they should
immediately be rolled onto their side and airway cleared. If no signs of life
are present, rescuer should continue with rescue breathing and
compressions.
If regurgitation is suspected you may be required to adjust:
 Head tilt
 Breath size
 Breath frequency
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RLSSA Emergency First Aid
DRSABCD - Choking
Choking can be present in a conscious or unconscious casualty
 Varied severity
 Some typical causes:
 Relaxation of the airway muscles
 Due to unconsciousness
 Inhaled foreign body
 Trauma to the airway
 Anaphylactic reaction
 May be gradual or sudden onset
Some of the signs in a conscious casualty:
 Anxiety, agitation, gasping sounds, coughing, loss of voice, clutching at
neck with thumb and fingers
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RLSSA Emergency First Aid
DRSABCD
MILD OBSTRUCTION
Breathing is labored
Breathing may be noisy
Some escape of air can be felt from the mouth
SEVERE OBSTRUCTION
There may be efforts at breathing
There is no sound of breathing
There is no escape of air from nose &/or mouth
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RLSSA Emergency First Aid
DRSABCD
The simplest way to determine the severity of a foreign body
airway obstruction is to assess for ineffective or effective cough
Effective cough (Mild Airway Obstruction)
Give reassurance
Encourage to keep coughing
If obstruction is not relieved, rescuer should CALL 000
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RLSSA Emergency First Aid
DRSABCD
Ineffective cough (Severe Airway Obstruction)
Conscious victim:
CALL 000
Perform up to 5 sharp back blows
 Heel of hand between shoulder blades
 Check for removal of obstruction between each back blow
If back blows aren’t successful, perform up to 5 chest thrusts
 Use CPR compression point
 Similar to CPR compressions but sharper and delivered at a
slower rate
 Check for removal of obstruction between each chest thrust
Continue to alternate between back blows and chest thrusts if
obstruction is not relieved
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RLSSA Emergency First Aid
DRSABCD
Ineffective cough (Severe Airway Obstruction)
Unconscious victim:
CALL 000
If solid material is visible in the airway sweep it out using your
fingers
Commence CPR
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RLSSA Emergency First Aid
DRSABCD
Assess Severity
Effective Cough
Mild Airway Obstruction
Ineffective Cough
Severe Airway Obstruction
Conscious
Unconscious
Encourage Coughing
Continue to check
victim until recovery
or deterioration
Call ambulance
Call ambulance
Call ambulance
Commence CPR
Give up to 5
Back Blows
If not effective
Give up to 5
Chest Thrusts
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RLSSA Emergency First Aid
DRSABCD
Left Lateral Tilt
 When a heavily pregnant women is lying on her back, the
foetus can compress a major blood vessel of the mother
(inferior vena cava).
 This can be minimized by providing sufficient padding
under her right buttock, to provide an obvious pelvic tilt to
the left whilst leaving the shoulders flat on the floor.
“Mothers are always right, padding the right buttock”
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RLSSA Emergency First Aid
DRSABCD
TALKING IN AN UNTRAINED BYSTANDER
If you believe that there is a responsible bystander that
you could use for 2-operator CPR and the casualty would
benefit more from receiving 2-operator CPR, you have the
choice of talking in an untrained bystander in the situation
that you do not have a second trained person to assist.
There are many ways to approach talking in an untrained
bystander. Some examples:
Ask whether the bystander is prepared to help
Establish whether they have any first aid experience
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RLSSA Emergency First Aid
DRSABCD
 Ask them to kneel on the opposite side and place
hands on the ground and do what you are doing
 Ask them to place their hands on top of yours to
gauge the depth of compressions
 Ask them to count the compressions for you
 Ask them to place their hands on the patient and
compress with you
 When you believe they are ready, let them take over
the compressions
♥ Do not rush the change over
♥ The experienced rescuer must always remain at
the head
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RLSSA Emergency First Aid
First Aid
32
RLSSA Emergency First Aid
Aims
 DEFINITION : Emergency care provided
for injury or sudden illness before
medical care is available
THE 5 P’s
Preserve life
Prevent further injury
Protect the unconscious
Promote recovery
Procure medical aid (access medical aid)
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RLSSA Emergency First Aid
Aims
RESPONSIBILITIES OF FIRST AID PROVIDER
Ensure personal health and safety
 Maintain a caring attitude
 Maintain composure
 Maintain up to date knowledge and skills
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RLSSA Emergency First Aid
Priorities of Care – Approach to an incident
Approach to an incident:



Primary survey
Assessment of vital signs
Secondary survey
This approach will



Reduce risk to yourself or others becoming victims
Provided a more thorough examination
Prioritise the victims injuries so as to enable management in
order of severity
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RLSSA Emergency First Aid
OH & S
ROLE OF THE OCCUPATIONAL FIRST AID PROVIDER
Duties may include:
 Provision of first aid
 Maintenance of first aid kits and facilities
 Identification of potential hazards
 Maintenance of records & other tasks
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RLSSA Emergency First Aid
OH&S
DUTIES OF EMPLOYERS
Employers are expected to make every reasonable effort
to provide a safe & healthy workplace. This involves the
provision of safe equipment, safe plant, safe procedures,
appropriate training and welfare facilities
DUTIES OF EMPLOYEES
Employees are expected to make every reasonable effort
to secure the health and safety of both themselves and
others at work
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RLSSA Emergency First Aid
First Aid Kits
Pocket mask
Gloves (disposable)
Telephone numbers of
emergency services
First Aid manual
Cotton bandages (various
sizes)
Triangular bandages
Adhesive tape
Sterile wound dressings
(various sizes)
Sterile saline (for wound
irrigation)
Sterile eye pads
Scissors
Notebook
Alcohol swabs
Accident report forms
Pens
Additional Items (home or specialized kits)
Sun Screen
Tweezers
Vinegar
Asthma reliever &
spacer
Space blankets
Band-Aids
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RLSSA Emergency First Aid
Cross Infection
Can be minimized by:





Attempting to avoid contact with blood and other bodily fluids
Use of protective devices such as disposable gloves &
resuscitation masks
Being vigilant for sharp objects such as syringes or broken
glass
Always washing hands thoroughly following, & if possible prior
to the provision of first aid
Being immunized against communicable diseases such as
hepatitis B
Seek medical advise in the case of exposure
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RLSSA Emergency First Aid
Legalities
There is no legal obligation to act as a “Good Samaritan”. You may
have a moral obligation to help someone in need, otherwise you may
owe a duty of care.
Duty of Care
Common examples:
Teachers  Students
Employer  Employees
Gym Instructor  Gym Patrons
Motorist  Other Motorists & Pedestrians
A duty of care is established if:

It is a legal obligation &/OR

Once first aid begins
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RLSSA Emergency First Aid
Legalities
Negligence







For a First Aid provider to be found negligent (civil liability), the
following need to be considered:
Did the provider owe a duty of care to the casualty
Did the provider act outside their level of training (standard of
care)
Did the provision of First Aid result in damage or loss to any
persons or property
Consent




Consent must be gained before initiating any first aid
Verbally ask for permission/consent
If a minor, ask parent or guardian
If unconscious, consent is assumed
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RLSSA Emergency First Aid
Reporting
All items included in reports must be factual,
and not express personal opinion
Example:
The casualty appeared
intoxicated
INCORRECT 
Vs.
The casualties breath
smelt ‘fruity’
CORRECT 
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RLSSA Emergency First Aid
Impact of Trauma & Counselling
 As everyone deals with trauma in their own way it is
very important to complete your individual report
immediately.
 Then follow this up with a debrief.
 Your employer will offer you counselling or there are
alternatives such as local hospital, police, grief
counselling services (refer yellow pages) or LSV this
should be done as soon as possible.
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RLSSA Emergency First Aid
Vital Signs Survey
Vital Signs Survey

Checking the casualties vital signs at regular intervals (e.g., 1
minute)
Breathing rate and depth


(Average adult 10-20 breaths per minute)
(Average infant 30-50 breaths per minute)
Heart rate



(Average adult resting 60-90 beats per minute)
(Average child resting 70-110 beats per minute)
(Infants resting up to 150 beats per minute)
Responsiveness


Hearing, movement in the eyes
Able to answer questions, movement from limbs
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RLSSA Emergency First Aid
Secondary Survey
45
RLSSA Emergency First Aid
Secondary Survey
We are looking for:
B leeding
B urns
F ractures
O ther things - Signs & Symptoms
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RLSSA Emergency First Aid
Secondary Survey - DOLOR
Assessment of responsive casualty (DOLOR)
Description

Ask the casualty to describe the problem
Onset & Duration

Ask the casualty when the problem arose & how it has
progressed
Location

Ask the casualty where on the body the problem is
Other Signs and Symptoms




Signs: Things you can see
Symptoms: Things the casualty can feel
Do you notice any other signs?
Is the casualty aware of any other symptoms?
Relief

Has anything provided relief? E.g., rest, position or medication
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RLSSA Emergency First Aid
Secondary Survey
ASSESSING Conscious / Unconscious Casualty using Head To Toe Examination
HEAD

Look and feel for bleeding and bumps

Check for fluid discharge from ears and nose

Check the eyes for any signs of injuries
NECK

Look at and feel the back of the neck gently
for tenderness & irregularities. If there are
any concerns of potential spinal injuries, do
not move the victim, unless they become
unresponsive or are in immediate life
threatening danger
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RLSSA Emergency First Aid
Secondary Survey
BACK/CHEST/ABDOMEN

Ask a responsive victim to inhale deeply
and see if it causes discomfort

Look at & feel the chest, back and abdomen
for irregularities & tenderness
LIMBS

Look for an injury &/or deformity

Check from the extremities moving toward
the trunk, feeling for irregularities

Check for altered strength and sensation
Check gloves after each section for bodily fluids
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RLSSA Emergency First Aid
Prioritising Casualties
MULTIPLE CASUALTIES

Treat unconscious casualties first because they are
unable to protect their airway or protect themselves
from external dangers

Triage – priorities casualties in order of urgency of
management
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RLSSA Emergency First Aid
Medical Emergencies
51
RLSSA Emergency First Aid
Fainting and Shock
CONDITION
Fainting is caused by an inadequate blood supply to the brain.
It’s reduced in severity compared to shock.
Shock is caused by lack of oxygen supply to the vital organs.
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RLSSA Emergency First Aid
Fainting and Shock
Causes of Fainting

Prolonged periods of standing

Emotional distress

Low fluids or food
Causes of Shock

Heart failure

Inadequate blood volume/blood loss

External or internal bleeding

Leaky or dilated vessels

Inadequate O² in blood
With Shock the body responds by:

Vasoconstriction

Increased heart rate

Increased breathing rate
53
RLSSA Emergency First Aid
Fainting and Shock
Signs & Symptoms – Fainting & Shock:









Tingling (poor circulation)
Light-headedness, dizziness
Nausea
Pale, cold clammy skin
Brief period of unresponsiveness (1 to 2 minutes)
Rapid, weak pulse & Rapid, shallow breathing
Altered responsiveness
Thirst
Weakness

Collapse
54
RLSSA Emergency First Aid
Fainting and Shock
Management of Fainting and Shock








Primary survey
Lay victim down with legs elevated
Treat cause, if possible (i.e. bleeding)
Reassurance
Monitor & record vital signs
Provide oxygen, if able
Maintain thermal comfort
Seek medical assistance
55
RLSSA Emergency First Aid
Easy to remember treatment
The easiest way to remember the treatment of Fainting or Shock is:
If the face is pale raise the tail,
If the face is red raise the head,
If the face is blue they’re almost through.
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RLSSA Emergency First Aid
Blood Vessels
57
RLSSA Emergency First Aid
Blood Vessels
Blood Vessels – Types
ARTERIES : carry oxygenated blood through the
body from the heart to all other organs
VEINS : carry the carbon dioxide rich blood from the
organs to the heart
CAPILARIES : are the smallest blood vessels where
the exchange of the O² to the CO² happens
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RLSSA Emergency First Aid
Blood Vessels
Bleeding
ARTERIES :


Rapid & profuse (usually spurts)
Bright red
VEINS :


Flows from wound at steady rate
Dark red
CAPILARIES :

Gently oozes from wound
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RLSSA Emergency First Aid
Blood Composition
Plasma (50-60%)
♥ Contains salts, sugar, etc
Red blood cells (40-50%)
♥ Contain haemoglobin to carry oxygen
White blood cells
♥ Fight infection
Platelets
♥ Clotting agents
60
RLSSA Emergency First Aid
Wounds
61
RLSSA Emergency First Aid
Types Of Wounds
Abrasions
 Scrapes on the surface of the skin
with damage to small capillaries
Lacerations & Incisions
 Cuts, usually caused by sharp
objects such as a knife or piece of
glass


Lacerations have ragged edges
Incisions have smooth edges
Avulsions
 Where a flap of skin &/or flesh has
been totally or partially removed
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RLSSA Emergency First Aid
Types Of Wounds
Puncture Wound
 Occurs when a sharp, pointy
object has penetrated the flesh
Embedded Object
 Wound with an embedded
object still in place
Amputation
 Occurs when a body part has
been severed
63
RLSSA Emergency First Aid
Minor Wounds
Definition:



Superficial
Small surface area
(<2.5cm)
Bleeding ceases quickly
64
RLSSA Emergency First Aid
Minor Wounds
Seek medical attention if:





There is any doubt about the severity of the wound
The wound cannot be easily cleaned
Infection is a concern (there is a greater risk of
infection with large abrasions)
Stitches may be required
Tetanus immunization may be necessary
65
RLSSA Emergency First Aid
MINOR WOUND
Management




Wash in clean, running water
Clean thoroughly, take special care with large abrasions to
ensure any debris is removed
Dry using sterile gauze
Cover with a clean dressing
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RLSSA Emergency First Aid
Minor Wounds
Avulsions:


Flap of skin should not be removed unless it’s very small
Large flaps of skin or appendages should be returned to
normal position before applying the sterile dressing /
bandage
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RLSSA Emergency First Aid
Minor Wounds
Nose Bleeds
Nose bleeds may occur as a result of a direct trauma
or may occur spontaneously.
Management




Ask the casualty to firmly squeeze the fleshy part of the nose,
below the bone
Position the casualty sitting upright, with their head slightly
forward
Ask the casualty to breathe through their mouth and avoid
swallowing any blood (can cause vomiting)
Seek medical aid if the bleeding time exceeds 10 minutes
It is best not to apply pressure to a suspected broken nose
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RLSSA Emergency First Aid
Major Wounds
Amputations
•
•
Management of the stump
Refer to general wound management
•

Management of the Severed Part
Wrap the body part in a clean, sterile,
non-adhesive dressing if possible
Place the body part in a sealed plastic
bag or container
Place the sealed body part in a container
of icy water
Do not allow part to come into direct
contact with ice or water
Mark bag/container with name & time
Seek urgent medical assistance
Send severed body part to hospital with
patient






69
RLSSA Emergency First Aid
Major Wounds
P.E.R.
MANAGEMENT



Pressure
Elevation
Rest
Conduct a primary survey & act accordingly
Apply direct pressure to the wound site
Apply a sterile dressing, followed by a pad & bandage where possible
Elevate injured site if possible
Call the ambulance (if required)
Keep casualty still and reassure them
Monitor vital signs and treat for shock if required
Provide supplemental oxygen (if available)
Seek medical attention (if required)
If bleeding continues through the pad:
Apply another pad and bandage (over the original pad and bandage)
Remove
pad and bandage and replace if bleeding still continues
Apply pressure near the artery
70
RLSSA Emergency First Aid
Major Wounds
Puncture Wounds

With a deep puncture wound, even though external bleeding
may be minimal, there is a risk that internal organs may have
been damaged. There is also a high risk of infection so
medical aid should be sought.
71
RLSSA Emergency First Aid
Major Wounds
Embedded Objects
 Sometimes objects are embedded at
the wound site. Where possible, these
objects should be left in place.
Attempting to remove the object can
cause further damage can exacerbate
the bleeding.
Management

Apply pressure to the wound site

Elevate the affected area

Apply a ring/donut bandage around the object

Dress around the wound without applying
pressure to the embedded object
72
RLSSA Emergency First Aid
Major Wounds
Amputations
Management of the stump
Refer to general wound management
Management of the Severed Part

Wrap the body part in a clean, sterile,
non-adhesive dressing if possible

Place the body part in a sealed plastic
bag or container

Place the sealed body part in a container
of icy water

Do not allow part to come into direct
contact with ice or water

Seek urgent medical assistance
73
RLSSA Emergency First Aid
Major wounds
Crush Injury
A crush injury involves changes in blood, decreased
volume of fluid in the blood vessel (hypovolemic shock),
and kidney failure. Generally the victim is protected from
these effects until the crush object is released.
Management
ARC guidelines recommend if safe and physically
possible, all crushing forces should be removed as
soon as possible after the crush injury.
If a crushing force is applied to the head, neck, chest or
abdomen and is not removed promptly death may
ensue from breathing failure, heart failure or blood loss.
DO NOT use a tourniquet for the first aid
management of a crush injury.
74
RLSSA Emergency First Aid
Internal Bleeding
WHEN TO SUSPECT IT
Internal bleeding may be suspected, depending on:





Type of trauma the victim has undergone
Victim’s past medical history (e.g., stomach ulcers)
Victim has signs and symptoms of shock
Pain and swelling in the affected area
Coughing up blood, ‘dark brown’ blood in vomit or
excretion of blood from urinary or digestive system
75
RLSSA Emergency First Aid
Internal Bleeding
Management









Seek urgent medical aid
Conduct a primary survey and act accordingly
Lay casualty down, if possible, and raise legs slightly
Keep still and reassure
Thermoregulation
Provide supplementary oxygen (if available)
Monitor vital signs
Conduct a secondary survey (if appropriate)
Give nothing by mouth
76
RLSSA Emergency First Aid
Burns
77
RLSSA Emergency First Aid
Sources Of Burns








Flames
Hot objects
Hot air
Hot water and steam
Chemicals
Radiation
Electricity
Cold
78
RLSSA Emergency First Aid
When To Call 000
WHEN:
Ambulance is recommended for:
•
•
•
•
•
•
A flame burn the size of the casualty’s palm
Any flame or scald burn involving the hands, face,
perineum or genitals
Any chemical burns
Any electrical burns
Any burns with suspected respiratory tract
involvement
Any infant or child with any type of burn
79
RLSSA Emergency First Aid
Types Of Burns
SUPERFICIAL BURN

Only the top layer of skin is involved (e.g.
sunburn)
PARTIAL THICKNESS BURN

The top layer and part of the next layer have
been burnt
FULL THICKNESS BURN


Both outer layers have been damaged, and
possibly the subcutaneous tissue being
affected
This can result in damage to fat, muscles,
blood vessels and nerve endings
80
RLSSA Emergency First Aid
Types Of Burns
Summary Of Burns
Superficial
Partial
Full
Redness
Severe pain
Painless
Pain
Redness
Cracked and dry appearance
Weeping from the burn
White or charred appearance
Blistering
81
RLSSA Emergency First Aid
General Burns
Management
 Asses for dangers including flames, chemicals and
noxious gas emitions.
 First aid providers should not expose themselves or
others to any of these dangers
 Remove victim to safe environment
 Conduct a primary survey and act accordingly
 Arrange medical aid (as appropriate)
 Immediately cool the affected area with water for up to 20
minutes
 Only the affected area should be cooled due to the risk of
overcooling the victim (greater concern with infants or
children)
 Do not use ice (as there is a possibility of sending a
82
person into shock)
RLSSA Emergency First Aid
General Burns




Remove all rings, watches and other
jewellery from the affected area
Elevate burn limbs (where feasible)
Cover burn area with a clean, sterile, lint-free
dressing
Provide oxygen (if available)
Do Not
 Peel off adherent clothing
 Burst blisters
 Apply ointments or lotions
 Use ice
83
RLSSA Emergency First Aid
Thermal Burns
MANAGEMENT of Burns caused by Flame or Scalding
 Remove any covering of material, especially if no water
for flushing is available
 Ensure no hot water is trapped within the victim’s skin
folds (especially children)
 Continue to cool the site, despite the application of
dressing
84
RLSSA Emergency First Aid
Inhalation
Inhalation of hot gases or flame can cause burns along
the respiratory tract that can result in swelling and possible
airway obstruction. In addition, inhalation of smoke and
toxic gases can result in breathing distress and a variety of
serious problems.
MANAGEMENT



Seek urgent medical aid
Conduct a primary survey and act accordingly
Provide supplemental oxygen (if available)
85
RLSSA Emergency First Aid
Chemical Burns
Sources of Chemical Burns:





Household cleaning agents
Pool or spa chemicals
Gardening and farm sprays
Car batteries
Industrial chemicals
Both acid and base chemicals can damage body tissues,
causing them to release heat. Base burns are more serious
than acid burns as they can penetrate further into the body.
86
RLSSA Emergency First Aid
Chemical Burns
Management





Avoid/neutralize any dangers
Brush any powdered chemical off victim
Flush with fresh, cool water for 20-30 minutes
Ensure that chemicals are not accessible by children
Always keep Material Safety Data Sheets with
chemicals
87
RLSSA Emergency First Aid
Electric & Lightning Burns
Electrical burns can be caused by faulty or misuse of electrical
appliances. In some accidents, downed power lines are a potential
source of severe electrical burns.







Consider DANGER when dealing with electrical burns
Turn off power
If power lines are down, avoid coming close than at least 8-10
meters to the lines
Do not attempt to move power lines, even with non-conductive
material, as at high voltage, electrocution is still possible
Lightning strikes cause a large number of deaths each year. If
caught outside in an electrical storm, stay clear of:
Tall trees or poles
Bodies of water
88
RLSSA Emergency First Aid
Electric & Lightning Burns


Metallic machinery and objects
Most can occur on hilltops or in open spaces
Electrical burns are characterized by entry and exit wounds, which
may appear minimal. Electricity may have passed through and
damaged internal organs resulting in:




No breathing
Irregular or no heart beat
Damage to internal muscles and tissues
Fractures
89
RLSSA Emergency First Aid
Electric & Lightning Burns
Management
It is important to:
 Avoid/Neutralise electrical and other dangers
 Conduct a primary survey and act accordingly
 Arrange medical aid, as required
 Treat burn as appropriate
90
RLSSA Emergency First Aid
Asthma
91
RLSSA Emergency First Aid
Asthma
Asthma is an allergic reaction resulting in the
narrowing of the smaller airways.
This narrowing is brought about by three
mechanisms:



Acute narrowing and spasm of small air
passages
Swelling of the airway lining
Secretion of mucus in the airway
“Preventer” medications, taken daily, act to
prevent the swelling and mucus secretion.
“Reliever” medications are taken to open the
small airways in the event of an asthma attack.
92
RLSSA Emergency First Aid
Asthma
Triggers of asthma:






Changes in weather
Allergies
Upper respiratory tract infection
Exercise
Nervous tension
Emotional distress
93
RLSSA Emergency First Aid
Asthma
RECOGNITION
Mild Cases
More Severe:
Very Severe:
Cough
Pale
Exhaustion
Rapid breathing
Distressed, anxious
Altered responsiveness
Wheeze
Fighting for breath
Cyanosis (blueness)
Rapid pulse
Aspiratory / Expiratory
wheeze
Difficulty / unable to speak
Chest tightness
Severe chest tightness
No wheeze at all
94
RLSSA Emergency First Aid
Asthma
Management
If responsive:

Reassure & encourage slow
breathing with arms elevated
1.
2.
3.
4.



Assist victim into a position of comfort (they
often prefer to have upper body upright)
4 puffs of a bronchodilator (reliever) should be
taken every 4 minutes
If there is no immediate improvement after initial
administration of medication or in severe attack,
call an ambulance promptly
Repeat step 1 - 3
In a severe attack 6-8 puffs may be
given to an adult every 5 minutes
Even if medication appears to be
effective, medical advice should be
sought
Spacers used with the aerosol puffer
can be very effective because a large
dose can be given rapidly
If unresponsive:


Seek urgent medical assistance
Conduct a Primary Survey and
act accordingly
If a person has difficulty breathing and is not known to have asthma, call emergency
services and commence with the three steps above as no harm will come to the person
resulting from the administration of the reliever.
95
RLSSA Emergency First Aid
Anaphylaxis
96
RLSSA Emergency First Aid
Anaphylaxis
Condition & Causes
Anaphylaxis is a severe allergic response to a foreign substance,
resulting in vasodilation and loss of blood pressure. A true
anaphylactic reaction presents an immediate life threat to the
victim & urgent medical aid needs to be obtained.
A severe allergic reaction usually occurs within 20 minutes of
exposure to the trigger. These substances could be some type of
food (commonly peanuts and fish), an insect bite (commonly
bee-stings) or medication (commonly the latex adhesive on band
aids).
97
RLSSA Emergency First Aid
Anaphylaxis
Signs & Symptoms
Management:














Swelling of the throat, tongue &
face
Difficulty swallowing & breathing
Wheezing, breathing distress
Red rash to face, neck & body
Skin becomes red or pale, cold &
clammy
Rapid weak pulse
Abdominal cramps, nausea,
vomiting, diarrhoea
Altered responsiveness
Collapse



Urgent medical aid!
Primary survey
Position of comfort
Assist with medication
Epi-pen (adrenaline injected into
thigh)
Loosen clothing, remove
jewellery
Provide oxygen (if available)
Be prepared for resuscitation
98
RLSSA Emergency First Aid
Anaphylaxis
A typical Action Plan for the treatment of Anaphylaxis
99
RLSSA Emergency First Aid
Anaphylaxis
The tool used for the treatment of Anaphylaxis
100
RLSSA Emergency First Aid
Cardiac Conditions
101
RLSSA Emergency First Aid
Cardiac Emergencies
A heart attack occurs when a coronary artery has become
critically blocked and remains blocked.
A clot develops in the lining of the coronary artery, preventing
blood flow beyond the clot.
Early recognition and activating the Chain Of Survival early will
maximise the chances of resuscitation. This will assist in keeping all
the vital organs alive and along with early defibrillation will restore
the heart rhythm to its natural beat.
102
RLSSA Emergency First Aid
Heart Attack
Recognition





Chest pain or tightness
 May be gradual or sudden onset
 Often described as heavy, dull or
crushing
 May radiate to neck, jaw, shoulders
and arms
Nausea or vomiting
Shortness of breath
Pale, cold & sweaty
May appear distressed
103
RLSSA Emergency First Aid
Heart Attack
Management - If responsive
Management - If unresponsive









Send for urgent medical assistance
Assist the person into a position of
comfort
Rest and reassurance
Loosen any tight clothing
If the casualty has their own
medication, assist them to take it
Provided supplementary oxygen if
available
Do not leave the person unattended
Be prepared for sudden
unresponsiveness

Conduct a Primary Survey
and act accordingly
Provide supplemental oxygen
if able
If the first aider is alone and the casualty appears to be suffering a cardiac
arrest it may be necessary to leave them in order to arrange for medical
assistance. Just make sure you leave them in the recovery position then
return, reassess and commence CPR if required.
104
RLSSA Emergency First Aid
Soft Tissue injuries
105
RLSSA Emergency First Aid
Fractures
DEFINITION
A fracture is a break in a bone. Sometimes a fracture may be a single,
clean break or there may be a number of breaks.
Children often suffer a “greenstick” fracture, which is the splintering of a bone.
Fractures are usually defined as either:
CLOSED
Where the overlying skin is unbroken OR
OPEN
In which case there is an open wound at the fracture site the fracture can
also cause damage to underlying organs – this is known as a
COMPLICATED fracture. Serious internal bleeding can result from fractures
of major bones such as the femur or pelvis.
106
RLSSA Emergency First Aid
Fractures
CAUSES
RECOGNITION
Direct force


A bone is broken at the site of
impact
Indirect force

A bone breaks some distance
from the point of impact as a
result of pressure
E.g. arm breaks from bracing
a fall by putting hands out
Abnormal muscular contraction






Pain at or near the site of
fracture
Difficulty/inability to move
the injured part
Swelling
Deformity
Grating of bone
Tenderness
Possible shock
A fracture can occur due to a “sudden”
muscular contraction.

This is often associated with
electrocution
107
RLSSA Emergency First Aid
Management Of Fractures
RESPONSIVE CASUALTY


Conduct a primary survey & act accordingly
The main aim is to prevent any movement at
the site of the fracture

If unsure, keep the casualty still &
comfortable and call the ambulance

Immobilise the joint above or below the
fracture site, if possible

Splint in a position of comfort for the victim

Do not attempt to realign a badly deformed
limb.

Where possible, an immobilized fractured limb
should be elevated

Treat for shock

Support a fractured jaw with the hand

If necessary, pull the lower jaw forward to
keep the airway open
First Aid Providers may need to Improvise

Tie shoelaces together to avoid feet
moving when a fractured foot is suspected

Use a long sleeve t-shirt to support arm by
pulling arm through top and over shoulder

Using a branch as a splint
UNRESPONSIVE CASUALTY




Arrange urgent medical
assistance
Immediately place the victim in
the lateral position
Conduct a primary survey & vital
signs survey, and act
accordingly
Provide supplemental oxygen is
possible
108
RLSSA Emergency First Aid
Contusions & Bruises




Arise after trauma to a site
Trauma usually occurs as a result of a blow to the
area
Underlying blood vessels are damaged & dark,
purple discolouration arises at the site
Changes colour as it starts to heal (yellowish
green) as the water material is naturally removed
109
RLSSA Emergency First Aid
Sprains & Strains
Sprains:
Occur at the joint
 Usually occurs as a result of stretching and possibly
tearing of the ligaments or other tissues at the joint
 Swelling at the site quickly follows the injury to the
joint
 This acts as a protective mechanism to stop further
movement at the site
110
RLSSA Emergency First Aid
Sprains & Strains
Strains:



Usually associated with muscles & tendons which attach
the muscle to the bone.
Can be caused by overuse or putting excessive load on
a muscle or muscle group.
It can also occur if muscles are not warmed up properly
prior to strenuous use.
Varied severity


Mild discomfort with minor muscle
damage
Complete tearing of the muscle
resulting in loss of use
111
RLSSA Emergency First Aid
Bruises, Sprains & Strains
MANAGEMENT
RICE D/R
R est
 Ensure no further stress is placed on the injury
I ce





Apply an ice pack or cold compress to the injured site
Ice pack or cold compress should be wrapped in a damp
cloth, rather than being applied directly to the skin
The pack/compress should be applied for 10-20 mins
ON/OFF
Ice should not be applied to the head, genitals or nipples
Ice can be applied for approx 48 hours after injury
112
RLSSA Emergency First Aid
Bruises, Sprains & Strains
C ompression

A compression bandage should be applied to the injured
area
 The bandage should not be so tight as to restrict
circulation
E levation

The injured area should be elevated to minimise swelling
and facilitate the healing process
D iagnosis or R eferral

Medical advice should be sought if you are at all unsure of
the extent of the injury
113
RLSSA Emergency First Aid
Bandaging
114
RLSSA Emergency First Aid
Bandaging
How to make a collar and cuff sling
115
RLSSA Emergency First Aid
Bandaging
How to make a donut bandage
116
RLSSA Emergency First Aid
Bandaging
The Elevation sling
Place bandage with apex pointing to elbow
over the arm, tuck in under the arm, then
twist both ends then tie off the two ends on
the uninjured side
117
RLSSA Emergency First Aid
Bandaging
Lower Arm sling
Place bandage with apex to elbow over
patients chest, bring opposite end over
patients arm, tie off on uninjured side then
twist remaining bandage at elbow and tuck
in.
118
RLSSA Emergency First Aid
Bandaging
Head bandage (pirate hat)
Place bandage over head, tying off at the
back tucking in loose bit over the tie off crisscross over loose bit then bring ends over to
front the criss-cross over to back and tie off
ends at the back
119
RLSSA Emergency First Aid
Bandaging
Hand bandage (glove)
Fold over the end of the bandage and place over knee, place fist on
top of the bandage, bring loose end over the fist, criss-cross the two
sides over the fist bringing the loose bit over the tie off the criss-cross
again and tie off
120
RLSSA Emergency First Aid
Bandaging
Fractures / breaks
Place the patients injured part on a splint, ask patient to assist you in
order to minimise the pain they are experiencing, using a long
bandage (triangular) tie off above and below the break leaving injured
area exposed
121
RLSSA Emergency First Aid
Bandaging
Immobilisation
Place injured limb still in a comfortable position,
place a splint between the limbs bring uninjured
to injured. Using the natural hollows place
bandage in and under the limbs tying off the
limbs on the uninjured side. You can use the
patients shoe-lases if bandages are in short
supply.
122
RLSSA Emergency First Aid
Bandaging
Pressure Immobilisation Technique (P.I.T.)
Note: it is a good idea to mark the bite site on the bandage with a
cross to assist medical personnel to locate where the bite is.
Commencing at
the bite site work
your way down to
the fingers, leaving
fingernails exposed
and then work
back up the arm
covering two-thirds
of the bandage at
each turn of the
bandage.
Continue
bandaging all the
way up to the
nearest lymph
node.
123
RLSSA Emergency First Aid
Bandaging
P.E.R. (pressure, elevation, rest)
Place pad on injured area, commence from
bottom moving up over lapping ends of
roller bandage. Once completed tie off and
elevate
124
RLSSA Emergency First Aid
Head Injuries
125
RLSSA Emergency First Aid
Head Injuries
Head injuries, skull, facial and spinal fractures can all be caused by
direct trauma to those regions.
These injuries can also occur without direct trauma (e.g. a person
who has been involved in a car accident, especially where the car has
rolled over, is a prime suspect for sustaining a spinal or head injury)
126
RLSSA Emergency First Aid
Head Injuries
Other possible causes include:
 Gunshot wound  Contact Sports
 Trauma To The Head
Casualties with suspected head or spinal injuries should be kept
as still as possible. There are only 2 exceptions to this:
 If the casualty’s airway is compromised
 If the casualty is in a dangerous environment
If the casualty needs to be moved then extreme caution should be
taken to minimise any twisting or turning movements to the casualty’s
head, neck or back
127
RLSSA Emergency First Aid
Concussion
Concussion is usually caused by trauma to the head
causing the brain to be “shaken” inside the skull. This can result
in a temporary impairment of brain function which usually lasts
for a relatively short period.
The casualty may experience:
 Brief period of unresponsiveness
 Nausea, vomiting
 Blurred vision
 Dizziness
 Headache
 Confusion, loss of
short term memory
128
RLSSA Emergency First Aid
Concussion
In mild cases, these symptoms should resolve relatively quickly
but medical advice should still be sought. The first aid provider
should closely observe for signs of deterioration which could
indicate the likelihood of a more serious head injury such as
fractured skull or cerebral compression.
In this situation, medical advice must be sought immediately.
Tolerance to future similar injuries decreases and repeated
head blows can result in permanent damage.
129
RLSSA Emergency First Aid
Scalp Wounds
Scalp wounds tend to bleed heavily because the scalp
itself has a very rich blood supply. The wound should be
treated in the same manner as normal wound care, except
the first aid provider needs to be aware that there could be
associated head injuries.
A cold compress should be used on the injury as opposed to ice.
130
RLSSA Emergency First Aid
Fractured Skull, Cerebral Compression
CEREBRAL COMPRESSION
Head trauma can result in a skull fracture and/or bleeding within
the skull. As the skull is rigid it does not expand to accommodate
additional fluid built-up. The soft brain can become compressed,
affecting brain function and possibly causing brain damage.
A fracture to the base of the skull may, along with internal
bleeding and brain compression, also cause leakage of cerebral
fluid from the ears or nose.
131
RLSSA Emergency First Aid
Fractured Skull
Recognition














Possible period of unresponsiveness
Headache
Nausea & vomiting
Reduced responsiveness
Visual problems
Numbness, tingling
Paralysis
Convulsions
Discharge from fluid from ears, nose or mouth
Bruising around the eyes and behind the ears
Bleeding into the whites of the eyes
Unequal or slow responding pupils
Altered breathing pattern
132
Breathing stops
RLSSA Emergency First Aid
Head Injuries – Management Of
(Consider the possibility of spinal injury)
If responsive:
•
Keep casualty still and reassure
them
•
Continually monitor the vital
signs
•
Seek medical advice
If skull fracture or cerebral
compression is suspected:
•
Seek urgent medical assistance
•
In the event of discharge from
the ear, do not plug the ear but
cover lightly with a sterile pad,
allowing the ear to drain
(injured side down)
•
Provide supplemental oxygen if
available
If unresponsive:
Conduct a primary survey (use jaw
thrust)
Seek urgent medical assistance
Provide supplemental oxygen if
available
133
RLSSA Emergency First Aid
Eye Injury
134
RLSSA Emergency First Aid
Eye Injury
DEFINITION & RECOGNITION
Eye injuries can result from causes such as direct trauma, flash burns
and chemical contamination. Other conditions such as infection,
allergies and certain other medical conditions can affect the function
of the eye.
The danger with all eye injuries is the possibility of permanent
impairment, so if at all concerned about the injury, medical device
should be sought immediately.
Recognition

Pain or irritation in the eye

Tears

Impairment or loss of vision

Light sensitivity (photophobia)

Swelling or closure of the eye

Bleeding within the eye

Loss of blood or fluid from the eye
135

Visible foreign body within the eye
RLSSA Emergency First Aid
General (management
will vary depending in
injury)
Small foreign body
Embedded object
Chemical injury
Keep the casualty still and
comfortable
Encourage casualty to
blink several times
Do not remove the object
Rinse the affected eye for
at least 15 minutes with
copious fresh, clean
flowing water, ensuring
that fluid does not enter
the uninjured eye
Place a sterile pad over
the both eyes
Flush the affected eye with
clean water or saline
Try to place a protective
cover around and over the
injured eye (e.g.
polystyrene cup) but avoid
putting any pressure on
eye or object
Seek urgent medical aid
Avoid putting any pressure
on the affected eye
Seek medical aid if
problem persists
Seek urgent medical aid
Seek medical advice
Never place any object in
eye, including fingers
136
RLSSA Emergency First Aid
Teeth
137
RLSSA Emergency First Aid
Teeth
Teeth can get dislodged or ‘knocked out’ from a blow to
the mouth, often associated with contact sports.
Management






Put tooth back in ASAP
Do not wash tooth
Ask casualty to bite down
Keep tongue away from hole where tooth was
Avoid drinking so as not to disturb clotting
Can preserve tooth in saliva or milk
138
RLSSA Emergency First Aid
Spinal Injury
139
RLSSA Emergency First Aid
Spinal Injury
DEFINITION
The spine consists of the spinal column and
the spinal cord.
The column is made up of a series of bones
called vertebrae, separated by cartilage known
as discs. These discs act as shock absorbers
during movement.
The spinal cord is made up of bundles of
nerves and passes through holes in the
vertebrae. It acts as a pathway for impulses
between the brain and the rest of the body,
and is also involved in reflex actions. Nerve
tracts run from the spinal cord, through the
gaps in the vertebrae to various parts of the
140
body.
RLSSA Emergency First Aid
Spinal Injuries

Injuries to the spine may involve the body
spinal column or the cord, or both.

Injuries to the spinal cord may arise through
fractures in the vertebrae causing damage to
the cord, which can be compressed or severed
(partially or totally). Injury can worsen as a
result of swelling and bleeding at the site.

There is also the potential to worsen some
spinal injuries by inappropriate handling of the
casualty.

Spinal injuries are most often associated with
motor vehicle and diving accidents, but can
also be caused by a number of other
mechanisms.

When assessing the casualty, the best
indicator of a possible spinal injury is the
history of the accident
141
RLSSA Emergency First Aid
Spinal Injuries
BREAKDOWN
What happens to the spine when injured
C1-C7
Quadriplegic (neck down)
 Head & neck
 Diaphragm
 Hands
T1-T12
Paraplegic (with additional damage
to nerves)
 Chest Muscles
 Abdominal Muscles
L1-L5
Paraplegic (waist down)
 Leg Muscles
S1-S5
Sacral
CX1 – CX4 Coccyx
 Bowel
 Bladder
 Motor Control
142
RLSSA Emergency First Aid
Spinal Injuries
LIKELIHOOD
Incidents with high likelihood of spinal injury




Victim falling, or having an object fall upon them,
from a distance greater than the casualty’s height
Any penetrating injury, or injury involving major
blunt force to the head, neck or trunk
Any accident involving a pedestrian, cyclist,
motorcyclist or casualty thrown from a vehicle
Diving and surfing accidents
143
RLSSA Emergency First Aid
Spinal Injuries
RECOGNITION







History of the incident
Pain or discomfort in the neck or back region
Altered sensation, movement or strength in the
limbs or trunk
Irregular bumps on the neck or back
Diaphragmatic breathing
Erection in injured males (Priaprism). Also
occurs in females
Does not necessarily mean no movement
possible
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RLSSA Emergency First Aid
Spinal Injury
MANAGEMENT
If responsive:
If unresponsive:


Conduct Primary, Vital Signs and
Secondary Surveys and act
accordingly

Use double trapezius grip and log
roll to move casualty

Arrange urgent medical assistance

Keep the casualty still and reassure
them

Thermoregulation

Minimise any movement of the head
and spinal column

Manage any other injuries

Provide supplemental oxygen if
available
Avoid YES/NO questions

Ask WHEN, WHERE, HOW,
WITH WHO questions

Avoid DOES, CAN, IF & IS
questions





Arrange urgent medical
assistance
Conduct a Primary Survey
and act accordingly
Use jaw thrust method for
Rescue Breathing if
required
Support the victims head
and neck, avoiding any
twisting or forward
movement of the neck (jaw
thrust)
Thermoregulation
Continually monitor vital
signs
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