First Aid: Basic Life Support With Life Saving Procedures

BASIC LIFE
SUPPORT
WITH LIFE SAVING TECHNIQUES
From the experts who trained over 1,00,000 people covering 850 factories
One day practical workshop on
procedures for treating casualties
during any emergency


Table of Contents
FIVE STEPS OF FIRST AID ................................................................... 5
CPR / CPCR - CARDIO PULMONARY ............................................. 6
1. CPR IN CHILDREN ............................................................................................ 12
2. CPR IN PREGNANCY ....................................................................................... 12
HEART ATTACK ................................................................................. 13
EYE INJURY .......................................................................................... 14
CONVULSIONS.................................................................................... 15
1. CONVULSIONS IN ADULTS ............................................................................ 15
2. CONVULSIONS IN CHILDREN....................................................................... 16
POISONING .......................................................................................... 17
SWALLOWED POISON ...................................................................... 18
1. FOR AN UNCONSCIOUS CASUALTY ........................................................... 18
BURNS - TREATMENT ....................................................................... 19
DIABETES .............................................................................................. 20
ASTHMA................................................................................................ 21
SEVERE BLEEDING ............................................................................ 22
SCALP BANADAGE ............................................................................ 23
TREATMENT FOR FRACTURED COLLAR BONE ....................... 24
TREATMENT FOR FRACTURED UPPER ARM ............................ 24
4
CARRYING POSITIONS ..................................................................... 25
1. HUMAN CRUTCH ................................................................................................ 25
2. DRAG METHOD .................................................................................................... 25
3. CRADLE METHOD................................................................................................ 26
4. THE TWO - HANDED SEAT ................................................................................ 26
EMERGENCY PHONE NOS .............................................................. 27
5
FIVE STEPS OF FIRST AID
1. PPP
P - PRESERVE - Precious Life
P - PREVENT - Things becoming worse
P - PROMOTE - Recovery
2. DTD
D - DIAGNOSIS - to know the problem - Look, Listen, Feel & Smell
T - TREATMENT - before taking to the doctor
D - DISPOSAL - to the hospital
3. FOUR LACKS
During diagnosis check for
A.LACK OF BREATHING (15 - 20 per minute)
B.LACK OF HEART BEAT (60 - 80 per minute)
C.LACK OF BLOOD (4 to 5 litres)
D.LACK OF CONSCIOUSNESS (shake & shout)
4. ABC
Keep brain supplied with oxygen by follwing ABC of Resusciation
A - AIRWAY - Open the airway
B - BREATHING - Maintain Breathing
C - CIRCULATION - Maintain Circulation
5. RECOVERY POSITION / TRANSPORT
6
CPR / CPCR - CARDIO PULMONARY
CEREBRAL RESUSCIATION
CPR or CPCR / Basic Life Support:
Cardio (HEART)
Pulmonary (LUNGS)
Cerebral (BRAIN)
Resusciation (TO BRING BACK)
CPR is an exercise wherein a rescuer takes over the functions of the
heart/lungs artificially, so that the brain is adequately supplied by blood
with Oxygen and Glucose. This enables the person to be brought back to
life.
It implies here that CPR is done only on a person whose heart is not
beating adequately or lungs are not working adequately or both.The concept
of CPR is very simple to learn as it consists only of:
A - Airway
B - Breathing
C - Circulation
This sequence of A, B, C must always be followed.
. “A” is for Airway
What an airway consists of is demonstrated in the fig. In an unconscious
person the airway tends to get blocked commonly because of tongue
falling back or a foreign object. To prevent this the airway must be opened
so that air entry and exit is possible through the airway. This can be done
in two ways:
7
1. HEAD TILT NECK LIFT METHOD
Consists of placing one
hand on the jaw(at the chin)
and another on the forehead
and moving both the
hands in opposite directions
at the same time so
that thechin is pulled up, to
which the tongue is attached
and hence it gets
pulled up. However this
cannot be tried in patients
with neck injury, as it will
2. JAW THRUST METHOD:
Only in the case of neck injury, Jaw Thrust is done.For this, do the following:
a. Use fingers to hook the jawbone just below the ear and pull with Jaw
forward. Make sure there is no movements at the neck.
b. Now that the airway is open the victim may breathe on his own failing
which the rescuer has to breathe for the victim.
How to know if the victim is breathing?
1. By Looking - For chest
movements
2. Listening - For breath
sounds if possible
3. Feeling - For warm air
coming out of nose or
mouth
Look for 10 seconds. If no
breathing is present, proceed
to artificial breaths.
8
. “B” is for Breathing
There are two ways of giving artificial breaths.
1. Mouth to Mouth
2. Mouth to Nose
1. MOUTH TO MOUTH
It is the easier of the two because it allows for comfortable sealing of
rescuer and victims mouth.
Step 1: Keep the airway
open
Step 2: Pinch the nostrils.
Step 3: Take a FULL
breath(in adults only),
and make a tight seal
around victim’s mouth.
Blow for about 2 seconds.
9
Do not forget to watch for chest rise and stop if its too much. Take your
head away from victim’s mouth to prevent taking victim’s breath into
you. Repeat until you have given 2 adequate breaths.
2. MOUTH TO NOSE
Step 1: Keep the airway open.
Step 2: Close the mouth of the victim.
Step 3: Cover the victim’s nose with your mouth.
Step 4. Blow and watch for chest rise.
Step 5: Take your head away.
This is preferred in cases when the victim’s mouth contains
• Blood
• Vomitus
• Poison
What can go wrong?
Air can go into the stomach instead of lungs, which is dangerous because
when stomach gets filled with air it can suddenly release the air
back along with its contents usually food which can get into the lungs.
This can be prevented by SELLICK’S MANOUVRE. Use 2 fingers to press
downwards on the ‘C’ shaped cartilage on the neck.
. “C” is for Circulation
Look for neck pulse and check for 10 Sec. If not felt go ahead with
external cardiac compressions.
OR
If the victim is unconscious and not breathing go ahead with external
cardiac compression.
10
Step 1: Run finger along lower rib margin up to the junction of 2 margins.
Feel the small bony point and place one finger on that. Now, place 2
fingers of other hand next to this finger towards the head.
Place the heel of your other hand a little above the first pointing towards
the head. Slide it down to meet the 2 fingers. Now, place the first hand on
top of the other hand.
Step 2: Get as close to the victim as possible. Move your shoulders directly
above the victim’s chest and press downwards upto 3 - 4 cms. You
can use your body weight to rock forwards and backwards or use muscles
to give the compression.If you use muscular action, you will tire faster.
15 compressions are given at a time
followed by 2 breaths. Remember to
maintain the speed at about 100
compressions / minute for an adult.
Continue CPR until you shift
the patient to a hospital or
until he revives. 15:2 ratio
should be should be carried
atleast 6 - 7 times / minute.
The ratio remains same for
2 person CPR.
11
. Recovery Position
Step 1: Open the airway
and straighten
the limbs of the
victim.Tuck the arm
nearest to you under
the thigh.
Step 2: Bring the
other arm across the
victim’s chest and
place hand, palm facing
outwards, against
the cheek.
Step 3: Pull the far leg
and roll the patient
towards you, so that
the patient is lying on
his/her side.
Step 4: Bend victim’s
upper leg at the knee
so that it makes a
right angle to the
body. Ensure victim’s
airway is open and
the lower arm is free
and lying on its back
with the palm facing
12
CPR IN CHILDREN
In children the size of the child becomes an important aspect, which will
accordingly modify CPR as follows.
INFANTS:
Shake and shout is not recommended. Instead painful stimuli like
pinching and tapping the sole can be done. Airway is short and undue
extension is not recommended. In breathing both mouth and nose
of infant is covered by rescuer. Amount of air blown is less but rate of
blowing is more as infants breathe faster. External Cardiac Compression
is given at level of nipples with 2 fingertips and rate is faster again upto a
depth of 2 cm. CPR is more successful in children and hence MUST be
done always.
CPR IN PREGNANCY
The womb of a pregnant lady compresses the inferior vena-cava, a large
vein which carries blood from the lower part of body back to heart and
runs on the right side at the back of abdomen. This does not allow the
heart to pump adequate oxygen rich blood.
It can be avoided by:
A cushion or pillow can be placed under the right hip.
A Volunteer can push the uterus to the left.
13
HEART ATTACK
a. Help the casualty into a halfsitting
position.
b. Support his sholders, head and
knees.
c. If the casualty has tablets or a
puffer aerosol for angina, let him
administer it himself. Help him if
necessary.
d. Reassure casualty.
2. DIAL AMBULANCE
a. Tell the controller that you suspect
a heart attack.
b. Call the casualty’s doctor also,
if he asks you to do so.
3. MONITOR BREATHING AND
PULSE
a. Encourage the casualty to rest
and keep any bystanders at a distance.
b. Monitor & record the casualty’s
breathing and pulse constantly.
4. GIVE CASUALTY ASPIRIN
a. Give the casualty one tablet of
aspirin, if available.
b. Tell him to chew it slowly.
c. And also ask the victim to take
deep breath and cough.
1.MAKE CASUALTY COMFORTABLE
14
EYE INJURY
a. Lay casualty on her
back, holding her head
on your knees to keep it
as still as possible.
b. Tell the casualty to
keep her “GOOD” eye
still, as movement of the
uninjured eye may damage
the injured eye further.
Give the casualty a sterile
dressing or clean pad,
and ask her to hold it
over the injured eye and
to keep her uninjured
eye closed.
2. GIVE EYE DRESSING TO CASUALTY
a. Call an ambulance if
you cannot transport the
casualty lying down.
b. Use water to pour over
the effected eye, which
should be at a lower to
the other eye, in children
hands can be tied to prevent
them from rubbing
eyes. Also moist swab or
corner of tissue or clean
handkerchief can be
used.
3. TAKE OR SEND CASUALTY TO HOSPITAL
1. SUPPORT CASUALTY’S HEAD
15
CONVULSIONS
a. Try to ease her fall.
b. Talk to her calmly and
reassuringly
a. Clear away any surrounding
objects to prevent
injury to the casualty.
b. Ask bystanders to keep
clear.
c. A guaze piece or a
handkerchief can be used
to prevent victim from
biting the tongue but care
has to be taken not to allow
it to be aspirated.
2. PROTECT CASUALTY
1. SUPPORT CASUALTY
CONVULSIONS IN ADULTS
a. Undo tight clothing
around casualty’s neck.
b. Protect the casualty’s
head, if possible, with
soft material, until the
convulsions cease
3. LOOSEN CASUALTY’S CLOTHING
4. PLACE CASUALTY IN RECOVERY POSITION
a. Place casualty in recovery
position.
b. Stay until the casualty is
fully recovered.
16
CONVULSIONS IN CHILDREN
1. COOL THE CHILD
a. Remove the clothing
b. Ensure a good supply
of cool air
a. Clear away any nearby objects.
b. Surround the child with
soft padding.
Start at her head and
work down.
Once the convulsions
have ceased, put the
child in the recovery position.
Keep her head
tilted well back.
4. PUT CHILD IN RECOVERY POSITION
3. SPONGE WITH TEPID WATER
2. PROTECT THE CHILD
17
POISONING
Swallowed poisons remain in stomach only for a short time where only
small amounts are absorbed while most absorption takes place after poison
passes into small intestine.
WHAT TO LOOK FOR:
a. Abdominal pain and cramping.
b. Nausea and vomiting
c. Diarrhea
d. Burns, odours and stains in mouth
e. Drowsiness and unconsciousness
f. Poison containers nearby
WHAT TO DO:
a. Find out:
1. What was swallwed?
2. How much was swallowed?
3. When was it swallowed?
b. If caustic or corrosive material was swallowed, lips and tongue will be
burnt and black immedialtely. Dilute with water or milk.
c. Vomiting removes 30 – 50% of poison from stomach and must be induced
within 30 min. of swallowing. This can be done using soap water.
Do not induce vomiting during seizures, unconscious or drowsy, petroleum
products, strychnine and rat poison
d. Check ABC for unconscious victim.
e. Keep victim on left side, this position delays stomach emptying into
small intestine.
f. If instructed and available give activated charcoal mixed with water.
18
SWALLOWED POISON
a. Check there is no foreign
matter in the mouth
b. Check the airway and
check breathing
Ensure the airway remains
open
2. PLACE CASUALTY IN RECOVERY POSITION
a. Give as much information
as possible about
the swallowed poison
b. Monitor and record
breathing, pulse, and
level of response every
ten minutes until help
arrives.
3. DIAL AMBULANCE
1. CHECK AIRWAY AND BREATHING
FOR AN UNCONSCIOUS CASUALTY
19
BURNS - TREATMENT
1. COOL THE BURN
a. Make the casualty comfortable
b. Pour cold liquid on injury for ten
minutes.
c. While cooling the burn, watch for
signs of difficulty in breathing.
d. Be ready to resuscitate if needed
a. Carefully remove any clothing or
jewelry from the affected area before
the injury starts to swell.
a. Cover the burn and surrounding area
with a sterile dressing, or a clean piece
of material
b. Reassure the casualty
a. Call an ambulance if you cannot
transport the casualty to hospital
b. Record details of the casualty’s injuries
and any possible hazards.
4. TAKE OR SEND CASUALTY TO HOSPITAL
3. COVER THE BURN
2. REMOVE ANY CONSTRICTIONS
20
It is a disease caused due to lack of insulin in your body.
WHAT TO LOOK FOR:
1. Excessive thirst, hunger, urination
2. Weightloss
WHAT TO DO:
Go to the doctor immediately.
WATCH OUT FOR:
Blood sugar going low when there is
- Excessive sweating
-Shivering
-Dizziness
Immediately give a glass of water with sugar or something sweet to eat.
DIABETES
21
ASTHMA
Asthma may present with ACUTE EPISODES when air passages in lungs get
narrower, making breathing difficult. These problems are caused by over
sensivity of lungs airways, which over react to some factors like exercise,
air pollution, infections, emotions like anger, crying and smoke.
WHAT TO LOOK FOR:
a. Coughing
b. Blue skin
c. Victim unable to speak full sentences
d. Nostrils flaring with breath
e. Wheezing or high pitched whistling sounds while breathing
WHAT TO DO:
a. Victim should rest
b. Take medications / inhaler prescribed by doctor
c. Make victim sit upright and slightly bend forward
d. Victim should double his or her usual fluid intake
e. Seek medical assitance
22
SEVERE BLEEDING
2. RAISE AND SUPPORT INJURED PART
a. Make sure the injured part is raised
above the level of the casualty’s heart.
b. Lay the casualty down.
c. Handle the injured part gently if you
suspect the injury involves a fracture.
a. Remove or cut the casualty’s clothing
to expose wound.
b. If a sterile dressing or pad is immediately
available, cover the wound.
c. Apply direct pressure over the
wound with your fingers or palm of
a. Apply a sterile dressing over any
original pad, and bandage firmly in
place.
b. Bandage another pad on top if blood
seeps through.
c. Check the circulation beyond the
bandage at intervals; loosen it if
Give details of the site of the injury
and the extent of the bleeding when
you telephone.
4. DIAL AMBULANCE
3. BANDAGE WOUND
1. APPLY PRESSURE TO THE WOUND
5. MONITOR CASUALTY AND
TREAT FOR SHOCK
a. Monitor and record breathing,
pulse, and level of response.
23
SCALP BANDAGE
TREATMENT
Wearing disposable gloves, if possible, replace any displaced skin flaps.
Apply firm direct pressure over a sterile dressing or clean pad. Secure the
dressing using a triangular bandage. If bleeding persists, reapply pressure
on the pad. Lay a conscious casualty down with his head and shoulders
slightly raised; if he becomes unconscious, place him in the recovery
position.
Take or send the casualty to hospital in the treatment position
24
TREATMENT FOR FRACTURED COLLAR BONE
a. Sit the casualty down.
b. Place the arm on her injured side across her chest.
c. Support the arm in an elevation sling
d. Secure the arm to her chest with a broad-fold bandage over the sling.
e. Take or send the casualty to hospital, transporting as a sitting case.
TREATMENT FOR FRACTURED UPPER ARM
a. Sit the casualty down.
b. Gently place the injured arm across her chest in the position that is
most comfortable.
c. Ask her to support her arm, if possible.
d. Support the arm in an arm sling, and secure the limb to her chest
e. Place soft padding between the arm and chest, and tie a broad-fold bandage
around the chest over the sling.
f. Take or send the casualty to hospital, transporting in the sitting position.
25
CARRYING POSITIONS
HUMAN CRUTCH
a. Stand on the casualty’s injured or
weaker side.
b. Pass his arm around your neck,
and grasp his hand or wrist with your
hand.
c. Pass your other arm around the
casualty’s waist. Grasp his waistband,
or clothing, to support him.
d. Move off on the inside foot.
e. Take small steps, and walk at the
casualty’s pace.
f. A walking stick or staff may give
him additional support.
DRAG METHOD
a. Place the casualty’s arms across her chest.
b. Crouch behind her,
grasp her armpits, and
pull.
c. Reassure the casualty
throughout.
d. If casualty is wearing
a jacket, unbutton it and
pull it up under the
victim’s head. Grasp the
jacket under the shoulders
and pull.
26
CRADLE METHOD
a. Squat beside the casualty.
b. Pass one of your arms around the
casualty’s trunk, above the waist.
c. Pass your other arm under her thighs.
d. Hug her body towards you, and lift.
THE TWO - HANDED SEAT
a. Squat facing each other on either
side of the casualty.
b. Cross arms behind her back, and
grasp her waistband.
c. Pass your other hands under the
casualty’s knees, and grasp each
other’s wrist.
d. Bring your linked arms up to the
middle of the casualty’s thighs.
e. Move in close to the casualty.
Keeping your backs straight, rise
slowly, and move off together.
27
EMERGENCY PHONE NOS
1. POLICE
DG’s Office:
Commissioner’s Office:
Asst. commissioner of Police:
Bomb Disposal Squad:
2. FIRE
LPG EMERGENCY SERVICES
(Only Gas Leakage):
3. AMBULANCE
ROAD ACCIDENTS ( CTC ):
HEART BRIGADE:
ST.JOHNS HOSPITAL:
MANIPAL HOSPITAL:
MALLYA HOSPITAL:
BANGALORE HOSPITAL:
RAMKRISHNA NURSING HOME :
100
2216242/2866242
2256242
5566242 Ext: 212
2256242
101
2251780/81/82/
2251785/86/87
3349011
102
1062
1050 & 1051
2065000
5532411 / 1050
5268901
2277979 / 90
6562753
6565494
6633148
28
6995000 / 6568121
2277979/91
5268901/ 5266441
2261037 / 2281146
5593796 / 5593797
5530724 / 2065000
5532411, 1050
6345711
8411501
6564516
1919 / 2235005
2237628
6707176
3325311
5268901
2277979 / 90
6562753 / 6565494
NIMHANS
Mallya Hospital
Manipal Hospital
Wockhardt Hospital
& Heart Institute
HOSMAT
St. Johns Medical College
& Hospital
Jayanagar
Sri Sathya Sai Hospital
Sanjay Gandhi Accident
& Research Institute
Hospital
Lions Eye Bank
Minto Eye Hospital
Narayana Netralaya
Manipal Hospital
Mallya Hospital
Bangalore Hospital
4. IMPORTANT HOSPITALS
5. GENERAL HOPITALS(GOVT)
6. EYE BANKS
29
6344131 / 41
2268435 / 2264205
2266807
5293486 / 528790
33431233
6341907
3447666/3340153
6700685/6709970
6645595
3348275
5297991 / 92
3123107
5614111/5612156
Prabha Eye Clinic
Karnataka Red Cross
Lions Blood Bank
Rotary - TTK Blood Bank
Grace Blood Bank
Naveen Blood Bank
Sushruta Blood Bank
Unique Blood Bank
Laxmi Service Trust
Lions
Rotary - Indiranagar
Vanitha Oxygen Service
Bangalore Medical Gases
7. BLOOD BANKS
8. EMERGENCY OXYGEN SERVICES
30
1050
1051
5268901
2268888
2277979 / 991
78 - 35000 / 35018
5268901 / 5266441
5266646
2277979 / 990
5593796
2281540
Mohammed Aneez
98440 - 37424 /
5487424
Rotary Life Saving Brigade
Jayadeva Heart Brigade
Manipal Hospital
Wockhardt Hospital
& Heart Institute
Mallya Hospital
Narayana Hridayalaya
Manipal Hospital
Mallya Hospital
HOSMAT
Khoday’s Pharmacy
Snake Catchers
9. HEART LINE (CARDIAC)
10. 24 HOUR PHARMACIES
11. GENERAL