Introduction

Learning basic first aid can safe lifes and is especially important for those living in a disaster prone region. In this section, we offer reference material that is only intended as a supplement for First Aid courses. Please do not use this information as your only guide for First Aid unless you are faced with an emergency situation.

Section 1: How to react responsibly

KEEP CALM. Remaining calm while helping the victim will help him/her to keep calm and cooperate with the rescuer. It will also help prevent any further injury.
PLAN QUICKLY WHAT YOU NEED TO DO. Learn basic procedures, or have your first aid manual available, so you can care for the victim.
SEND FOR PROFESSIONAL HELP. Reaching help quickly could save a life. Know your local emergency telephone numbers.
BE AN ENCOURAGEMENT TO THE INJURED PERSON. Let the victim know that help is on the way and try to make them as comfortable as possible. Showing care and concern for the victim can give them hope during their circumstances.

Section 2: Assessing the Situation

When arriving at a scene, assess the situation immediately. Be aware of any situation which may put your life at risk. Avoid all dangerous situations and do not put yourself into a situation where you may also become a victim. If the scene is dangerous, wait for professional help to arrive at which time you may be asked to assist.
When you are faced with multiple casualties and you are the only rescuer follow these rules:

1. DO NOT MOVE A VICTIM UNLESS HE/SHE IS IN IMMEDIATE DANGER (e.g. An unsafe building, burning car, etc.)
2. CALL THE EMERGENCY MEDICAL SERVICES IMMEDIATELY. Ask an onlooker to call Emergency Medical Services. If you are alone, asses the situation, attend to life threatening situations and then call the Emergency Medical Services.
3. Assess all victims:
   a. Check to see if the victim is breathing.
   b. Check to see if the victim has a pulse.
   c. Check to see whether the victim is bleeding.
4. Attend the victims in the following priority:
   a. Those who are not breathing and do not have a pulse. BEGIN CPR IMMEDIATELY
   b. Those who are not breathing and have profound bleeding. CHECK AIRWAY and try to resume breathing. Start artificial respiration if necessary. Be aware that the victim may go into cardiac arrest if you do not stop the bleeding.
   c. Those who are breathing and have profound bleeding. Remember that the victim may go into cardiac arrest if you do not stop the bleeding.
5. Reassess the situation frequently.
6. Once you have attended to a victim and restored cardiac functions, breathing and stopped bleeding MOVE ON to the next victim. Remember to always reassess the situation.

Section 3: First Aid for Burns

1. Call the Emergency Medical Services to the scene. Victims of burns must be seen by medical professionals.
2. YOU RISK INFECTION by putting ointments on burns.
3. Seek immediate medical attention if:
   a. The victim is a child or elderly
   b. If the burn covers multiple areas of the victim's body
   c. If the burn is on a sensitive area
   d. If the burn is caused by chemicals
4. FIRST DEGREE BURNS:
   a. First degree burns are characterised by redness, mild pain and swelling. These types of burns damage only the outer layer of skin.
   b. Immediately submerge the affected body part in water. Running water is preferable. You may also put wet cloths on the burn until the pain decreases.
   c. Cover the burn with a clean, dry gauze for protection
   d. ALWAYS have a burn checked out by medical professionals.
5. SECOND DEGREE BURNS:
   a. Call the Emergency Medical Services Immediately.
   b. Second degree burns go through to the second layer of the skin and are characterised by blisters, red skin, swelling and extreme pain.
   c. Immerse the burn in cold water or apply wet cloths IMMEDIATELY.
   d. Do not rub the area as this may break blisters and cause infections.
   e. If possible elevate the body part which has been burnt
   f. Cover the burn with a dry, preferably STERILE bandage.
   g. Seek professional medical help immediately
6. THIRD DEGREE BURNS:
   a. CALL EMERGENCY MEDICAL SERVICES IMMEDIATELY. THIRD DEGREE BURNS CAN BE LIFE THREATENING.
   b. Third degree burns are characterised by whitish or charred appearance. They are less painful than first or second degree burns as the nerve cells have been destroyed by the extensive tissue damage.
   c. DO NOT remove clothing on or near the site of the burn
   d. DO NOT apply cold water or medication to the burn
   e. Place clean, dry and preferably STERILE cloths over the burn.
   f. If possible elevate the body part which has been burnt.
   g. Frequently check that the victim is not having difficulty breathing and is conscious and has a pulse. THIRD DEGREE BURN VICTIMS ARE AT DANGER OF DEVELOPING BREATHING PROBLEMS AND GOING INTO SHOCK AND CARDIAC ARREST.
   h. TRANSPORT THE VICTIM TO A HOSPITAL IMMEDIATELY. THIRD DEGREE BURNS CAN BE LIFE THREATENING.
7. CHEMICAL BURNS:
   a. CALL EMERGENCY MEDICAL SERVICES IMMEDIATELY. CHEMICAL BURNS MAY BE LIFE THREATENING.
   b. Remove all clothing from the burn area and surrounding tissue BY CUTTING THE CLOTHING.
   c. NEVER PULL CLOTHING OVER OTHER BODY PARTS (HEAD etc.).
   d. Wash the area thoroughly with water for at least 20 minutes or until a medical professional tells you otherwise.
   e. Apply a clean bandage, preferably sterile to the area.
   f. Get professional medical help as soon as possible.

Section 4: First Aid for Cuts

1. Clean the area with soap and water. Carefully wash away any dirt.
2. Apply direct pressure to stop bleeding. If necessary apply a tourniquet above the wound.
3. Put STERILE bandages on the wound. If you need to put on another bandage, DO NOT REMOVE bandages that have already been applied. THIS MAY CAUSE FURTHER BLEEDING.
4. If there is perfuse bleeding, seek professional medical attention immediately.
5. If you observe swelling, redness, fever, pus and the victim complains of pain seek professional help IMMEDIATELY.

Section 5: First Aid for Dislocations

1. Dislocations are characterised by; swelling, deformed look, pain, tenderness and possible discoloration of the affected area.
2. Dislocations commonly occur in the shoulder, elbow, finger, thumb and hip joint.
3. Apply a splint to immobilise the dislocated joint. DO NOT MOVE THE VICTIM UNLESS HE/SHE IS IN ANY IMMEDIATE DANGER (burning car etc.)
4. Call the Emergency Medical Services IMMEDIATELY. Dislocated bones must be set back into position by medical professionals.
   

Section 6: First Aid for Fainting

1. Keep an eye out for the warning signs:
   a. light-headedness
   b. weakness
   c. nausea
   d. pale skin
   e. confusion
2. If a person begins to faint they will lean forward and lower their head towards their knees. This will lower the head below the heart so that more blood flows to the brain.
3. If the person faints and is unconscious:
   a. KEEP THE VICTIM LYING DOWN. Fainting is a physiological response to the need for more blood to the brain. Laying will ease the work the heart has to do and supply more blood to the whole of the body.
   b. Call the Emergency Medical Services. Fainting is a physiological response but the cause must be determined.
   c. LOOSEN TIGHT CLOTHING especially in the neck and waist.
   d. Apply cool cloths to the face and neck.
   e. Put the victim into the RECOVERY POSITION: The persons legs must be extended, hands at his/her side and his/her head tilted to one side, face down. DO NOT LEAVE THE VICTIM LYING ON HIS/HER BACK. If the patient vomits, this position may cause suffocation.
   f. In most cases the victim will regain consciousness shortly after being put in the recovery position.
   g. After the patient regains consciousness, DO NOT LET HIM/HER GET UP until you have assessed his/her consciousness level. Ask questions like "What is your name?", "Where are you?", "What day is it?". Even if the victim is fully conscious, keep him/her lying down until the Emergency Medical Services arrive.

Section 7: First Aid for Fracture

1. There are two types of fractures; simple and compound fractures. Simple fractures can become compound if not cared for properly.
2. If a fracture is suspected check for swelling and discoloration. The victim may complain of tenderness of say that he/she felt or heard a bone snap
3. A compound fracture pierces through the skin. Therefore, serious bleeding may occur with this wound. DO NOT APPLY PRESSURE TO A COMPOUND FRACTURE TO STOP BLEEDING.
4. If you suspect a compound fracture:
   a. Call the Emergency Medical Services IMMEDIATELY
   b. Cover the injured part of the body with a STERILE PAD.
   c. Apply a splint to keep the bone from causing further injury.
   d. Keep the victim warm and comfortable. DO NOT MOVE THE VICTIM UNLESS HE/SHE IS IN IMMEDIATE DANGER.
5. How to apply a splint:
   a. A splint will help protect the injury until professional help arrives.
   b. The splint should be long enough to extend beyond BOTH joints on BOTH side of the fracture.
   c. A splint can be made from cardboard, folded newspapers, boards, straight stick, or a rolled up blanket. If there is a compound fracture of bone in the leg, the opposite leg may be used as a splint by tying the two legs together.
   d. How to apply the splint:
        i. Use strips of cloth, handkerchiefs, ties or belts to hold the splint in place. Take care not to secure the splint too tightly as this will cause poor circulation below the wound.
       ii. FOR ARM FRACTURES: Apply a splint and then use a large triangular bandage to make a sling, which will prevent the arm from moving.
      iii. Once a splint has been applied, carefully elevate the wound to slow bleeding.
      iv. For a compound fracture control bleeding by holding a clean cloth on the wound before applying a splint. AVOID PUTTING PRESSURE ON A COMPOUND WOUND TO STOP BLEEDING. This may cause the bone to splinter, resulting in further tissue damage.

Section 8: First Aid for Frostbite

1. CALL EMERGENCY MEDICAL SERVICES IMMEDIATELY.
2. If possible, take the victim indoors and remove any wet clothing.
3. Immerse the frostbitten parts in WARM water until they regain their pink colour. NEVER IMMERSE FROSTBITTEN PARTS IN HOT WATER. If warm water is not available, wrap the affected parts in a sheet and warm blankets and keep elevated.
4. DO NOT RUB OR MASSAGE THE FROSTBITTEN AREA. This could cause gangrene - leading to death of the tissue.
5. DO NOT WARM THE VICTIM WITH A HEAT LAMP OR HOT WATER BOTTLE OR BY PLACING NEAR A HOT STOVE. This could also cause gangrene.
6. DO NOT BREAK ANY BLISTERS.
7. If the victim is conscious and not vomiting, give warm liquids to drink as this will help the warming process.
8. After frostbitten parts are warm, have the victim exercise to maintain good circulation.
9. If the victims toes or feet are frostbitten, DO NOT LET THEM WALK.
10. A DOCTOR MUST BE SEEN AS SOON AS POSSIBLE TO MAKE SURE THE PARTS HEAL PROPERLY WITHOUT PERMANENT TISSUE DAMAGE.

Section 9: First Aid for Hypothermia

1. CALL THE EMERGENCY MEDICAL SERVICES IMMEDIATELY
2. Hypothermia is the medical term for low body temperature. Symptoms, in order of appearance is:
   a. Uncontrollable shivering
   b. Dizziness
   c. Light-headedness
   d. Muscular stiffness
   e. Difficulty in moving
   f. Slurred speech
   g. Slow pulse
   h. Memory loss
   i. Unconsciousness
   j. Eventual death
3. The body temperature of the victim must be raised slowly. Warming the victim too quickly may cause tissue damage.
4. Take victim indoors or into a shelter
5. Remove any wet clothes and replace with warm, dry clothes
6. The victim may want to wrap up in a blanket and sit near a heater or fireplace.
7. If the victim is FULLY conscious, give warm liquids to help the warming process. DO NOT GIVE FLUIDS CONTAINING CAFFEINE.
8. Get professional medical attention IMMEDIATELY

Section 10: First Aid for Nosebleeds

1. Nosebleeds are caused by nose injuries, strenuous activities, high blood pressure, exposure to high altitudes and blowing your nose too hard.
2. If you get a nosebleed:
   a. Sit down
   b. Lean slightly forward to prevent blood from running into your throat.
   c. Place cold cloths on your nose to help stop the bleeding.
   d. Pinch the nostril (or both) for at least 10 minutes.
   e. If bleeding continues continue to apply pressure for another 10 minutes.
   f. If heavy bleeding persists or if nosebleeds recur frequently, consult a physician.

Section 11: First Aid for Asphyxiation

1. Asphyxiation is the loss on consciousness due to lack or oxygen or too much carbon dioxide in the blood.
2. The victim may stop breathing for a number of reasons - drowning, electric shock, heart failure, poisoning or suffocation. The flow of oxygen throughout the body stops within minutes if a person's respiratory system fails. If the victim's breathing cannot be restarted heart failure, brain damage and eventual death will result.

ARTIFICIAL RESPIRATION:
   · A person suffering from asphyxiation should be given artificial respiration. Before you begin make sure the victim has actually stopped breathing:
i. Kneel beside the victim. Place your ear near his/her nose and mouth and watch his/her chest carefully. You should feel and hear breaths and see the chest rising and falling
   · If the victim is not breathing:
i. Open the victim's airway. Place the victim on his/her back and open his/her mouth. Clear any material in the victim's mouth and make sure his/her tongue is not effecting the airway.
ii. Tilt the victim's head back by placing the heel of one hand on his forehead and the other under the bony part if his chin to lift slightly.
iii. IF AT ANY TIME YOU SUSPECT CHOKING, BEGIN THE HEIMLICH MANOEUVRE IMMEDIATELY
iv. IF YOU SUSPECT ASPHYXIATION CALL THE EMERGENCY MEDICAL SERVICES IMMEDIATELY. IT IS ESSENTIAL THAT ARTIFICIAL RESPIRATION IS BEGUN IMMEDIATELY.
v. If there are no signs of breathing, pinch the victim's nostrils closed. Seal your mouth over the victim's mouth and blow two full breaths. Watch the victim's chest rise and fall. IF THE VICTIM'S STOMACH IS EXPANDING INSTEAD OF HIS CHEST, THE VICTIM'S NECK IS POSITIONED IMPROPERLY. GENTLY PUSH ON THE VICTIM'S ABDOMEN UNTIL THE AIR IS EXPELLED AS AIR IN THE STOMACH MAY CAUSE VOMITING.
vi. Look, listen and feel again for signs of breathing. If the victim is still not breathing on his own, continue blowing into his/her mouth, at a rate of approximately 12 breaths a minute (of one breath every 5 seconds) until professional help arrives.

ARTIFICIAL RESPIRATION FOR INFANTS:
i. Follow the procedure outlined above, but take care of the following points:

1. Blow through the infant/small child's mouth and nose at the same time.
2. give two puffs, using your mouth and check for breathing air into the infant's lungs. DO NOT OVER-INFLATE THEIR LUNGS.
3. Administer one breath every 3-4 seconds, approximately 20 breaths per minute.

Section 12: First Aid for Bleeding

1. EXTERNAL BLEEDING:
   · Apply direct pressure to the wound. Place a clean, folded cloth over the wound and apply firm pressure. If blood soaks through, DO NOT REMOVE THE CLOTH. Instead, cover that cloth with another one and continue to apply pressure for 7-10 minutes.
   · If bleeding is from the ear, place a clean bandage over the ear, lay the victim on his side and allow blood to drain to drain through the bandage. BLEEDING THROUGH THE EAR(S) IS A SIGN OF SERIOUS INJURY AND IMMEDIATE MEDICAL ATTENTION IS ESSENTIAL TO SAVE THE VICTIM'S LIFE.
   · Elevate the injury. Position the wounded part of the body above the level of the heart if possible while you apply direct pressure.
   · If direct pressure and elevation do not sufficiently slow the blood flow, find a pressure point. The most common pressure points are located in the upper arms and in the creases above the upper legs. Apply pressure to the axillary region for arm injuries, and the groin for leg injuries.
   · If all of the above fails USE A TOURNIQUET to prevent the victim from dying. Apply a tourniquet above the wound or at a pressure point. Once a tourniquet is applied, it should not be loosened or removed until medical help has arrived. Use a tourniquet ONLY IF EVERYTHING LISTED ABOVE HAS FAILED. If you use a tourniquet, WRITE DOWN SOMEWHERE ON THE VICTIM THE TIME IT WAS APPLIED SO THAT MEDICAL PERSONNEL WILL KNOW HOW LONG IT HAS BEEN IN PLACE. IF MEDICAL PERSONNEL HAVE NOT ARRIVED WITHIN 10 MINUTES AND THE VICTIM IS STILL CONSCIOUS, loosen the tourniquet to allow tissues below the tourniquet to receive blood. REAPPLY THE TOURNIQUET WITHIN A MINUTE OF LOOSENING.
2. INTERNAL BLEEDING:
   · Internal bleeding results when vessels rupture allowing blood to leak into body cavities. This could be caused due to a direct blow to the body, a fracture, a sprain, or a bleeding ulcer.
   · If the victim receives an injury to the chest or abdomen, internal bleeding should be suspected. The victim will feel plain and tenderness in the affected area.
      · Look out for:
   o Cold skin
   o Pale lips or face
   o Weakness and fainting
   o Dizziness and nausea
   o Rapid, weak or irregular pulse
   o Short breath
   o Swelling or bruising at site of injury
      · WHAT TO DO:
   o Check for an open airway and begin artificial respiration if necessary.
   o Call the Emergency Medical Services immediately
   o IF YOU SUSPECT INTERNAL INJURY DO NOT GIVE THE VICTIM ANYTHING TO DRINK.
   o DO NOT MOVE THE VICTIM. Keep him/her comfortable until professional help arrives.

Section 13: First Aid for Concussion and Contusion

1. A sharp blow to the head may result in the jostling of the brain inside its protective bony covering - a concussion. More serious injuries may result in bruising to the brain, or a contusion. Unconsciousness may indicate brain damage. Look out for:
   a. Clear or reddish fluid draining from the ears, mouth or especially nose. THESE SIGNS POINT TO SERIOUS INJURY AND PROFESSIONAL MEDICAL HELP IS REQUIRED IMMEDIATELY.
   b. Difficulty in speaking or understanding
   c. Headache
   d. Unequal size of pupils
   e. Paralysis of arm, leg or face.
2. WHAT TO DO:
   a. Call the Emergency Medical Services Immediately
   b. Keep the victim lying or in the recovery position.
   c. Control any bleeding and make sure the victim is breathing and has a pulse.
   d. DO NOT GIVE THE VICTIM ANY LIQUIDS TO DRINK.
   e. Note down any unconscious periods to report when professional help arrives.
   

Section 14: First Aid for Convulsions

1. A convulsion (seizure) is violent involuntary contractions or muscle spasms. They can be caused by epilepsy or sudden illness. Convulsions are not likely to cause death unless the victim stops breathing. However, the victim should be controlled by professional medical personnel.
2. WHAT TO LOOK OUT FOR:
   a. Victim's muscles become stiff, followed by jerking movements.
   b. Victim may bite his/her tongue or stop breathing.
   c. The victim's face and lips may turn blue.
   d. The victim may drool excessively or foam at the mouth.
3. WHAT TO DO:
   a. Clear all objects away from the victim and place something soft around his/her head. DO NOT TRY TO RESTRAIN THE VICTIM.
   b. DO NOT PLACE ANYTHING BETWEEN HIS/HER TEETH OR MOUTH.
   c. Do not give the victim any liquids
   d. If the victim stops breathing, open his/her airway and begin artificial respiration.
   e. After a convulsion is over the victim may remain unconscious. When the victim regains consciousness, he/she may be in a state of confusion. Stay calm and keep the victim comfortable until professional help arrives.
   f. Convulsions do not last over 30 seconds but may be followed by further convulsions.

Section 15: First Aid for Electric Shock

• Call the Emergency Medical Services Immediately
• REMOVE THE VICTIM FROM THE SOURCE OF ELECTRICITY BEFORE YOU TOUCH HIM/HER. Turn off the master switch to disconnect the power or use a NON-METAL, DRY OBJECT such as a stick to pull the wire or electrical source away from the victim's body.
• Check the victim is breathing and he/she has a pulse. If the victim has stopped breathing start artificial respiration immediately. If necessary start CPR immediately.
• If the person is unconscious but breathing and has a heartbeat, place him/her in the recovery position. Monitor the victim's breathing and heart beat until professional help arrives.
  

Section 16: First Aid for Heatstroke

• A heatstroke victim's body must be cooled immediately
• If possible place the victim into cool water, wrap him/her in cool wet clothes or sponge his/her skin with cool water, rubbing alcohol, ice or cold packs.
• Once the victim's temperature drops to 38C or 101F, lay him/her in the recovery position in a cool room. Monitor the victim's temperature and repeat the cooling process if necessary.
• Give the victim fluids if he/she is able to drink.
• DO NOT GIVE A HEATSTROKE VICTIM ANY KIND OF MEDICATION.
• Watch out for signs of shock while waiting for professional medical help to arrive.

Section 17: How to Perform CPR on an Adult

1. Make sure the scene is safe for you to help.
2. Make sure you have universal precautions: gloves, pocket mask, etc.
3. Make sure you know how many patients you have.
4. Determine if they are conscious by tapping and shouting "Are you OK?"
5. If there is no response CALL THE EMERGENCY MEDICAL SERVICES IMMEDIATELY.
6. Position the patient on their back.
7. Open the airway with a head-tilt chin-lift or jaw-thrust manoeuvre.
8. LOOK-LISTEN-&-FEEL for breaths. CHECK BREATHING FOR 5-10 SECONDS.
9. If they aren't breathing VENTILATE TWICE.
10. Check for a pulse by palpating(feeling) the carotid artery. CHECK THE PULSE FOR 10 SECONDS.
11. If there is no pulse BEGIN CHEST COMPRESSIONS at a rate of 15 COMPRESSIONS to 2 BREATHS.
12. Recheck the pulse after ONE MINUTE.
13. CONTINUE UNTIL HELP ARRIVES.