First Aid

Injuries and pain are part of human life. In case of injury, some kind of immediate medical attention or treatment is needed to reduce the discomfort, pain and deterioration of the condition. The medical attention that is given at the first instance before seeking professional medical help is called First Aid.

First-aid is the immediate and temporary treatment given to the victim of an accident or sudden illness, while awaiting the arrival of Medical Aid.

health emergency is a situation in which the health of a person is in danger because of sudden illness or accident, and immediate help is required to save a life. In case of any health emergency, the ill or injured person should be given immediate attention and first aid before the medical help arrives.

Health as a Physical, Mental and Social Well Being

According to the World Health Organisation (WHO), health is a state of complete physical, mental and social well being and not merely the absence of the disease.

Physical health: A person enjoys good physical health when he or she is eating healthy food, exercising regularly, sits or stands in the right posture, sleeps in the right posture, sleeps well, takes care of oral hygiene, visits doctor regularly for check ups and remains positive about his or her state of health.  

Mental health: Mental health is influenced by the people and the environment around you. A person enjoys good mental health if he or she has a positive thinking towards life, work and other people. He or She should be able to control emotions, sensitive to the needs of others, confident in the abilities and whatever he or she does and keeps himself or herself from undue and extreme desires and wants.

Social health: A person is said to have a good social health if he or she gets along with people, work in team, always maintain a pleasant look, helps others in their needs and good deeds, fulfils social obligations and responsibility and does not look for returns while fulfilling social responsibilities.

The Human Body

The human body is an amazing living machine in which hundreds of parts work together to flawlessly perform countless tasks. It consists of a head, neck, torso, two arms and two legs. By the time the child reaches adulthood, the body consists of close to 100 trillion cells, the basic unit of life. These cells are organised biologically to eventually form the whole body.

The organ systems of the body include the musculoskeletal system (related to muscles), cardiovascular system (related to heart), digestive system (related to stomach), endocrine system, integumentary system, urinary system (related to kidney), lymphatic system, immune system, respiratory system (related to lungs), and reproductive system.

Breathing: Breathing is vital to life and a person breathes about 20,000 times a day. Respiratory system includes the nose, throat, voice box, windpipe, and lungs. Air can be taken in through the nose and the mouth. These two openings of the airway (the nasal cavity and the mouth) meet at the pharynx or throat, at the back of the nose and mouth.

The diaphragm that separates the chest from the abdomen plays a lead role in breathing. It moves downward when we breathe in, enlarging the chest cavity and pulling air in through the nose or mouth. When we breathe out, the diaphragm moves upward, forcing the chest cavity to get smaller and pushing the gases in the lungs up and out of the nose and mouth.

When you breathe in, which is called as inhalation, the diaphragm moves downward toward the abdomen, and the rib muscles pull the ribs upward and outward. In this way, the volume of the chest cavity is increased. Air pressure in the chest cavity and lungs is reduced, and because gas flows from high pressure to low, air from the environment flows through the nose or mouth into the lungs. When you breathe out i.e. exhalation, the diaphragm moves upward and the chest wall muscles relax, causing the chest cavity to contract. Air pressure in the lungs rises, so air flows from the lungs and up and out of respiratory system through the nose or mouth. 

Blood circulation: Blood is the viscous fluid composed of plasma and cells. The composition of the blood includes plasma, red blood cells, white blood cells and platelets. The centre of the circulatory system is the heart, which is the main pumping organ.

The heart is made of muscles. The heart is in the middle of the chest. It is located between the two lungs. The heart is tipped somewhat so that there is a little more of it on the left side. The pointed tip at the bottom of the heart touches the front wall of the chest. Every time the heart beats it goes “thump” against the chest wall.

When the heart contracts it pushes the blood out into two major loops or cycles. In the systemic loop, the blood circulates into the body’s systems, bringing oxygen to all its organs, structures and tissues and collecting carbon dioxide waste. In the pulmonary loop, the blood circulates to and from the lungs, to release the carbon dioxide and pick up oxygen. The systemic cycle is controlled by the left side of the heart, the pulmonary cycle by the right side of the heart.

Types of Hazards

Biological: Biological hazards are caused by living organisms like bacteria, viruses, insects, plants, birds, animals, humans, etc. 

Chemical: Chemical hazards, which include acids, poisons, cleaning agents, etc. depends on the physical, chemical and toxic properties of the chemical. The severity of the hazard depends on the toxic properties of the chemical.

Radiation: Radiation hazards are related to exposure to radiations from radioactive substances. 

Ergonomic: Ergonomic hazards are caused due to repetitive movements, improper set up of workstation, faulty designed chairs, tools and equipment, wrong postures, etc. Wrong postures often bring about physical fatigue or bodily harm, including back pain, and discomfort in shoulders and lower limbs.

Physical: Physical hazards are caused due to slippery surfaces, falling objects, manual handling (lifting, pushing, carrying), sharp tools and equipment, radiation, magnetic fields, extreme pressure (high pressure or vacuum), excessive loud and prolonged noise. It may result in stress, depression, loss of self-esteem, feelings of guilt, phobias, sleep and eating disorders, sexual harassment, verbal threat, abusing, etc.

Principles of First Aid

The basic principles of first aid are as follows:

  • Preserve life: This includes the life of the casualty and rescuer.
  • Protect the casualty from further harm: Ensure the scene is safe and the casualty is not affected by the presence of people.
  • Provide pain relief: This could include the use of ice packs or simply applying a sling.
  • Prevent the injury or illness from becoming worse: Ensure the treatment you provide as part of the First Aid does not make the condition of the casualty worse.

Symbol of First Aid

The ISO specified symbol for the first aid is white cross on a green background.

 

First Aid Kit

It is the place where equipment and materials are made available and systematically arranged for providing first aid services. It should have the following:

  • A name plate with the symbol of First Aid.
  • Proper lighting and ventilation.
  • Directory of emergency telephone numbers.

The contents of the First Aid Kit are mainly meant for providing first aid in case of bleeding, bone fractures and burns. A basic first aid kit should include: 

  1. Band-aids of all sizes
  2. 4" by 4" gauze pads - for cleaning wounds
  3. 4" by 4" dressing bandages - for wounds, cuts, and abrasions
  4. 2" dressing rolls or crepe bandage - for wrapping and bandaging injuries.
  5. Medical tape
  6. Cotton balls
  7. Safety pins
  8. Alcohol pads or isopropyl alcohol for cleaning wounds
  9. Antimicrobial hand wipes - placed in a sealed plastic bag to keep them moist
  10. Hydrogen Peroxide for cleansing skin wounds
  11. Sterile water bottle
  12. Eye flushing solution bottle with an eye cup
  13. Ace bandage for wrapping sprains and contused soft tissue
  14. Arm sling
  15. Chemical ice pack
  16. Chemical hot pack
  17. Thermometer - oral and rectal (for kids)
  18. Tweezers
  19. Scissors
  20. Torch
  21. Nail clippers
  22. Jackknife
  23. Clean string - for a variety of uses
  24. Sterile gloves

Important medications and other relief materials that should be kept in a first aid kit and updated (check for expiry of the medicine and replace immediately with fresh batch) include the following: 

  1. Antibiotic ointment - for cuts and scrapes of the skin
  2. Medicated sunburn spray or cream
  3. Calamine lotion
  4. Insect sting relief pads
  5. Tylenol (Acetaminophen): It is used as pain and fever reducer
  6. Advil (Ibuprophen): It is anti-inflammatory, used for pain, swelling, and fever
  7. Benadryl (Diphenhydramine): It is antihistamine for allergic reactions, itching, and runny nose
  8. Cough suppressant
  9. Throat lozenges
  10. Oral Rehydration Salts (ORS)

Tourniquet bandage (compression bandage): If the bleeding does not stop with direct pressure within 15 to 20 minutes the tourniquet bandage is applied

Slings: Sling is a bandage used to support an injured forearm. It is a wide triangular piece of cloth which is used to support the hand from around the neck

Splints: Splints are orthopaedic mechanical devices used to immobilise and protect a part of the body in the case of a fracture (such as a broken leg or hand).

Drugs for Common Ailments

There are a variety of common ailments from which people suffer from. These ailments are not very serious and can be cured by referring to some home remedies or over the counter medicines.

  • Allergies: Cetrizine
  • Headache: Saridon, Aspirin (Aspirin is also used in case of Chest Pain)
  • Heartburn / Acidity: Digene
  • Nasal Congestion: Vicks Vaporub for rubbing on nose and chest
  • Cough and Cold: D’cold Total
  • Fever / Flu: Paracetamol (also used as a General Pain Killer)
  • Constipation: Isabgol (with hot milk)
  • Sprains and Strains: Flexon or Combiflam (used as a anti-inflammatory painkillers)
  • Dehydration: Oral Rehydration Salt (ORS)

Fever

Fever is higher-than-normal human body temperature (normal body temperature is 37°C or 98.6°F. Your body temperature is a good indicator of your health. Fever is a symptom and not disease. Fever can be categorised as: 

  • Low fever: 98.8°F to 100.8°F
  • Mild to moderate: 101°F to 103°F
  • High fever: 104°F and above

If the temperature is high, then it is a sign that your body is fighting illness.

Causes: Fever may be caused due to hot weather, bacterial or viral infection, spending too much time under the sun or allergy to medication or food or water.

Symptom: Symptoms may include hot flushed face, nausea, vomiting, head and body ache, constipation, diarrhea.

In case of fever, the body temperature is measured using a thermometer. Wash the tip of the digital thermometer with clean water and wipe it with a clean cloth. Wipe it with a paper tissue after it has been cleaned. This will remove certain germs on the surface. Switch on the digital thermometer to make sure that it is working properly. The LCD screen should read "0".

Place the thermometer in the mouth of the person by laying the tip on a middle point at the back of the tongue before asking him or her to close the lips around it to hold the length of it. Press the button to make the appliance read the temperature. This can take few seconds to a few minutes. Remove the thermometer from the mouth and read the temperature.

After you have finished using the thermometer, switch off the thermometer and clean the lip with water and wipe with tissue paper or dry cloth.

First Aid: Monitor temperature using a digital thermometer. Remove the excess clothing. Keep the person in a cool place and if required give a sponge bath in luke warm water. Give plenty of fluids and prescribed dose of paracetamol.

Heat Stroke

Heat stroke is the most severe of all heat-related illness. It could be life threatening. It is caused when the cooling mechanism of the body fails due to excessive heat and humidity. Impairment in sweat gland function may be another cause of heat stoke.

Symptoms: Body temperature greater than 104°F. Fever may cause headache, dizziness, fatigue, fluctuating blood pressure and irritability.

First Aid: Shift the person to a shady place. Cool the person by sponging with wet towel. Apply ice packs in armpits and groin. Give luke warm water with electrolyte.

Back Pain

Back pain is a short-term acute pain in the back of the body. It indicates that the body is under stress. It is caused due to problems in bones, ligaments and muscles of spine and nerves.

Triggering Factors: Back pain may be aggravated due to poor posture, inappropriate footwear, incorrect walking habits, prolonged sitting, sleeping on soft mattresses, kidney, bladder prostate disorders, constipation, stress, etc.

First Aid: Massage with hot or cold packs and use pain killers or relaxants for pain relief.

Asthma

Asthma is a chronic inflammatory lung disease that causes airways to tighten and narrow. It creates narrowing of air passages of the lung and therefore produces difficulty in breathing.

Symptoms: Symptoms may include wheezing, cough and cold, tightness in the chest, sticky mucus, disturbed sleep, and breathlessness.

Causes: It is believed that heredity factors are the main cause of asthma. Environmental factors like dust, mite, pollen and occupational exposure to irritants aggravate asthma. Colds, viruses, cigarette smoking, scent, pollution, change in weather, etc. are the triggering factors.

First Aid: In case of asthmatic attack, use asthma inhalers. Asthma inhalers are hand-held portable devices that deliver medication to your lungs.

Food Borne Illness 

Food borne illnesses occur by eating unhygienic food and water. Bacteria are the most common cause of food contamination. 

Symptoms: Common symptoms include diarrhea, which may be bloody, nausea, abdominal cramps, vomiting, fever, dehydration, shallow breath, rapid pulse, pale skin, and chest pain.

First Aid: Oral Rehydration Salt (ORS) should be given with luke warm water. In severe cases, the patient should be hospitalised immediately.

Recipe for Making a 1 litre ORS solution using Sugar, Salt and Water

  1. Clean Water - 1 litre - 5 cups (each cup about 200 ml)
  2. Sugar - Six level teaspoons
  3. Salt - Half level teaspoon
  4. Stir the mixture till the sugar dissolves

Cuts

Cut is an injury which forms an opening in the skin.

Types of Cuts: The two types of cuts are minor and deep cuts.

1. Minor Cuts / Scrapings: Minor cuts are caused by sharp tools and equipment like scissors, razors, saws, knives, pruners, chisels, and snips.

First Aid: Clean the cut with clean water and then with savlon. Apply antibiotic ointment or first aid bandage.

2. Deep Cuts: Deep cuts may expose the underlying tissues and cause heavy bleeding.

First Aid: In deep cuts, stitching of tissues may be required, therefore, immediate medical aid needs to be given. Tetanus toxoid injection should be given to prevent tetanus.

Bleeding

Bleeding refers to the loss of blood. Bleeding can happen inside the body (internal bleeding) or outside the body (external bleeding). Internal bleeding may also occur due to an injury to blood vessel.

External bleeding could be blood flowing through a natural opening (such as the mouth, vagina or rectum). A cut on the skin can lead to severe external bleeding. It involves loss of large amount of blood. 

Causes: Severe bleeding may occur in case of accidents, blow to the head, or due to certain illness like hemophilia, scurvy, cancer, thrombocytopenia, leukemia, hemorrhage, peptic ulcer, etc.

Symptoms: Symptoms include discharge of blood from a wound. 

First Aid: Wash your hands and wear surgical gloves before administering first aid to victim. Make the victim lie down. Keep the affected area elevated. Remove any obvious debris or particle. Apply direct pressure using clean cloth or bandage. Hold the bandage in place using an adhesive tape. In case of bleeding does not stop, call the doctor.

Burns

Burns are injuries to the skin and tissues caused due to heat (e.g., fire, hot water, etc.), chemicals (e.g., acids), electricity or radiation. Burns can cause swelling, blistering, scarring and, in serious cases, shock and even death. They can lead to serious infections as they damage the skin's protective covering. Severe burns affect muscles, fat and even bones.

Burns can be classified into three categories - first, second and third degree burns, depending on the severity of burn.

1. First degree burns: In first degree burns, injuries are superficial or mild.

Symptoms: Swelling and redness of the injured area takes place. Pain develops. No blisters are seen. Burned area becomes white on touch.

First Aid:

  • Remove patient from heat source
  • Remove the burnt clothing
  • Do not apply lotions, ointment or fat (e.g. ghee) to burns
  • Run cool water over burnt area
  • Wear surgical gloves and gently clean the injured area and dry
  • Apply antibiotic, such as Silver Sulphadiazine or Burnol
  • Use a sterile bandage to cover burns

2. Second-degree burns: Burns extend to middle skin layer. 90% body surface injury results in death, while 60% injury in elderly is fatal. 

Symptoms: Swelling, redness and pain are observed. Blisters develop, that ooze a clear fluid. Dehydration may occur.

First Aid:

  • Make the patient lie down
  • Apply antibiotic cream over affected area
  • Splints may be used to rest the affected joints
  • Take the patient immediately to the hospital

3. Third-degree burns: Damage occurs to all the three skin layers. It destroys adjacent hair follicles, sweat glands, and nerve endings.

Symptoms: Lack of pain due to destroyed nerves. The injured area does not turn white on touch. No blisters observed. Swelling occurs. Skin develops leathery texture. Discoloration of skin is observed. Scars develop. Crusty surfaces may occur. 

First Aid: Move the patient to the hospital, without any delay.

Insect Bites and Stings

Insect bites are mostly not severe. Sometimes they cause a severe allergic reaction known as anaphylaxis. Sting of bees, wasps, hornets, and bites of fire ants are painful. Bites of insects, like mosquitoes cause itching and may result in diseases like malaria. The bite of a black widow spider can be fatal, if left untreated.

Symptoms: General symptoms of insect bites and stings include localised pain, swelling, redness, itching, numbness, burning, tingling sensation, beathlessness, and weakness.

First Aid:

  • Remove the stinger using a straight-edged object like sterilised needle
  • Wash the area thoroughly with soap and water. Place ice wrapped in a cloth on the affected area. Repeat after every 10 minutes
  • Apply a gentle cream to prevent itching
  • Consult a doctor in case of severe bite

Dog Bites

Dogs can cause slight injuries such as lesions, light traumas (scratches and bruises) and serious injuries such as bites. They may also cause diseases as a result of infections and allergies caused by bacteria, fungi, acarids or viruses.

Symptoms: Symptoms may include skin break, bruise or puncture, cuts, bleeding, swelling and redness of the area, and oozing of fluid. In case of rabies, the affected person is scared of water (hydrophobia).

First Aid

  • Wash hands before attending to wound
  • Wash wound with soap and running water
  • Apply antibiotic ointmen
  • Dress using sterile bandage
  • Tetanus booster or antibiotics or anti-rabies injection are required to be given at the hospital

Snake Bites

Snake bite is an injury caused by a bite from a snake often resulting in puncture wounds. The outcome of snake bites depends on numerous factors, including the species of snake, the area of the body bitten, the amount of venom injected, and the health conditions of the victim. Feelings of terror and panic are common after snakebite and can produce a characteristic set of symptoms mediated by the nervous system such as increased heartbeat, nausea and giddiness. Even bite from a harmless snake can cause allergic reaction. 

Causes: Snakes which may bite a person includes Viper, Cobra, Rattle snake, Water Moccasin and Coral Snake.

Symptoms: Symptoms may include fang marks, swelling or severe pain at the site, bloody discharge from wound, burning, blurred vision, numbness or tingling sensation, vomiting, loss of muscle co-ordinations, rapid pulse, fainting, etc. 

Treatment: 

  • Immediately call for medical help. Get the victim to the hospital as soon as possible
  • Check the snakebite for puncture wounds. If one or two fang markings are visible, the bite is from a poisonous pit viper
  • Remember what the snake looks like. The doctor will need to know this to provide proper treatment

Keep the victim calm. Keep the bitten arms or leg below the level of his heart to slow the blood flowing from the wound to the heart. The more the victim moves, the faster the venom spreads through the body

Wash wound with soap or water, keep the bitten area slightly elevated, and apply cool compress or wet cloth to the affected part.  Be sure to wipe away from the bite. This keeps any venom on the unbroken skin around the bite from being wiped into the wound.

Watch for general symptom (i.e. sharp pain, bruising, swelling around the bite, weakness, shortness of breath, blurred vision, drowsiness, or vomiting. If any of the these symptoms occur within 30 minutes from the time of the bite, and you are over two hours away from medical help, tie a constricting band (3/4 to 3/2 inches wide) two inches above the bite or above the swelling.

The band needs to be loose enough to slip a finger underneath it. The band slows blood flow away from the bite, keeping the venom from reaching the heart. The band must be applied within 30 minutes after the time of the bite to be effective. If the swelling spreads, move the band so that it is two inches above the swelling. Monitor for pulse, respiration and blood pressure till the medical aid is given to the victim.