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SUEZ CANAL CONTAINER TERMINAL

DEFINITIONS FIRST AID

First

aid is the initial help we can give a casualty for treatment of any sudden injury or illness, until more professional help arrives. This application can be at home or in the workplace. FIRST AIDER A common person who may have learnt a standard method at application of first aid best suited to his skills. He is trained to prevent further injury, reach patient, identify the problem and provide emergency care. GENERAL PRINCIPLES OF FIRST AID Restoration of respiration Control bleeding Treat shock Care for the unconscious Manage fractures Manage burn Treat for multiple injuries Transportation of the victim

QUALIFICATIONS OF FIRST AIDER Should be a good observer Should be able to act quickly Should not get panic or excited Should have the ability to lead and control the crowd and take help from the observers Should have self-confidence and ability to judge injuries Should be able to reassure the victim

THE AIMS OF FIRST AID

Preserve Life
Not only the casualty's life, but your own as well. Far too often only one person's life is in danger when the emergency services are called, but by the time they arrive there are more. If you put your life in danger, you can end up fighting for your OWN life instead of the casualty's.

Prevent the situation from Worsening

The skilled first aider must take action to prevent the whole situation from becoming worse (e.g. removing dangers such as traffic or fumes), as well as acting to prevent the Casualtys condition from deteriorating.

Promote Recovery
The actions of a first aider should, after preventing things from getting worse, help the casualty to recover from their illness or injury.

FIRST AID IN EMERGENCY CASES

HSE DEPARTMENT

SUEZ CANAL CONTAINER TERMINAL

FIRST AID RULES Do not get excited. First, check for danger and then check for responsiveness. Determine whether the victim is conscious. If the victim is conscious, ask him what happened and what is wrong now. If the victim is unconscious, proceed to check the airway, breathing and circulation. Commence resuscitation as appropriate. Do not move injured victim unless it is necessary. If necessary to move a casualty, seek assistance if possible and handle gently. Keep the victim lying down with his head level with his feet while being examined. Keep the victim warm and comfortable. Remove enough clothing to get a clear. To get a clear idea to get a clear idea to the extent of the injury. Examined the victim gently. Threat the most urgent injuries first and then treat the most urgent injuries first and then treat the other injuries to the best of your ability. Avoid allowing the victim to see his own injury. Assure him that his condition is understood and that he will receive good care. Do not try to give any solid or liquid substance by mouth to an unconscious victim nor to a victim who has sustained an injury. Do not touch open wounds or burns with fingers or other objects except when sterile compresses or bandages are not available and it is absolutely necessary to stop bleeding. Do not try to arouse an unconscious person. Seek medical attention immediately. PRIORITIES OF TREATMENT The first priority with any patient is to make sure the Airway is open and then to check they are Breathing normally (A and B). If the patient is breathing normally, this means that their heart must also be beating, so blood is being circulated around the body. As the A and B check is carried out first, we call it the 'primary survey'. Once you are happy that the casualty is breathing normally and oxygen is being circulated around the body, the next priority is to deal with any major Bleeding, because you need to maintain enough blood to circulate the oxygen around. After these steps, the next priority is to deal with any broken Bones (BBB). The check for bleeding and then broken bones is called the 'secondary survey'. PRIMARY SURVEY (A) Airway (B) Breathing

The BBB rule can be used for multiple casualties, to decide who needs treatment first. A rough 'rule of thumb' is that the casualty who is the quietest needs treatment first, where as the one making the most noise (trying to get your attention) is the least serious!

SECONDARY SURVEY

(B)

Bleeding

(B)

Bones

FIRST AID IN EMERGENCY CASES

HSE DEPARTMENT

SUEZ CANAL CONTAINER TERMINAL

HIGHEST PRIORITY
Respiratory arrest, airway obstruction Cardiac arrest Severe bleeding Open chest wound Open abdominal wounds Severe shock Burns involving respiratory tract Unconsciousness

SECOND PRIORITY
Severe burns Injuries to spine Moderate bleeding

LOWEST PRIORITY
Minor bleeding Obvious mortal wounds where 1st response is not helpful Obvious death

Conscious patient with head injuries Multiple fractures

Table (1.0) Indicating Priorities of treatment

FIRST AID IN EMERGENCY CASES

HSE DEPARTMENT

SUEZ CANAL CONTAINER TERMINAL

Emergency Action Plan It is important to have an action plan for emergencies. This flow chart guides you through the actions to be taken when dealing with a patient.
APROACHING AN INCIDENT

SAFE

DANGER Look for any further danger

UNSAFE

RESPONSE? Shout and gently shake or tap the casualty YES

REMOVE DANGER Make the scene safe dont take risk Or SAFE TO MOVE CASUALTY

YES

NO NO HELP Shout for help but dont leave the casualty KEEP PEOPLE BACK UNTIL HELP ARRIVES

HISTORY Find out what has happened SIGNS AND SYMPTOMS How does the patient feel or look? Try to work out whats wrong TREATMENT Remember if you are not sure, always seek a professional

AIRWAY Open the airway by tilting the head back and lifting the chin

RESUSCITATION Give 30 chest compressions, then 2 rescue breaths. Continue giving cycles of 30 compressions to 2 rescue breaths. Only stop to recheck the patient if they start breathing normally otherwise do not interrupt resuscitation. If there is more than one rescuer, change over every 2 minutes to prevent fatigue.

NORMAL BREATHING? Look, listen and feel for no more than 1 0 seconds. If you're not sure if breathing is normal; treat it as though it is not.

RECOVERY POSITION Recovery position. Call for help if not already done. Monitor Airway and Breathing. Keep the casualty warm.

YES

NO (CALL FOR HELP)

FIRST AID IN EMERGENCY CASES

HSE DEPARTMENT

SUEZ CANAL CONTAINER TERMINAL

TRANSPORTATION Unless there is danger from fire, explosion or toxic substances, do not move a casualty until suspected fractures have been immobilised and bad bleeding has been stopped. Then check out the best route for transport and lift the casualty gently and carry him smoothly. Every jolt means unnecessary pain. The method of transport will depend on the situation of the casualty and the nature of the injury. Whatever method is used, try to gain the confidence of the person you are carrying by explaining what you are about to do and then carrying out the manoeuvre in an efficient manner. Ordinary man-handling may be possible, in which case two helpers carry a casualty without forming their hands into a seat, by each using an arm to support the casualtys back and shoulders and each using his spare hand to support the casualty under his thighs.
FIG 1.0 If conscious, the casualty may help to support himself with his hands on the shoulders of the helpers (Figure 1.0). The four-handed seat can be used when a heavy person has to be carried. The disadvantage of this type of seat is that the casualty must be able to co-operate and to hold on with both arms around the shoulders of the two men carrying him. It cannot be safely used to negotiate ladders (Figure 1.0).

The hands should be placed as in Figure 1.1. One advantage of the threehanded seat (Figure 1.2) is that one arm and hand of a helper is left free and can be used either to support an injured limb or as a backsupport for the casualty. According to the nature of the injury, it is decided which of the two helpers has the free arm (Figures 1.3 and 1.4). The firemans lift which should not be used unless the helper is as well built as the casualty is especially useful when you have to move a man by yourself and need the use of your right hand for holding on to a ladder. Roll the patient so that he is lying face downwards; lift him up so that, when you stoop down, you can put your head under his left arm (Figure 1.5). Then put your left arm between his legs and grasp his left hand, letting his body fall over your left shoulder (Figure 1.6).
FIG 1.2

FIG 1.1

Steady yourself and then stand upright, at the same time shifting his weight so that he lies well balanced across the back of your shoulders (Figure 1.7). Hold the casualtys arm above the wrist. In this position it is easy to carry the patient up a ladder as one hand is free to grasp the rail (Figure 1.8).

FIRST AID IN EMERGENCY CASES

HSE DEPARTMENT

SUEZ CANAL CONTAINER TERMINAL

FIG 1.4 FIG 1.3 FIG 1.5

FIG 1.6

FIG 1.8 FIG 1.7

FIRST AID IN EMERGENCY CASES

HSE DEPARTMENT

SUEZ CANAL CONTAINER TERMINAL

As a last resort, the drag-carry method may have to be used in narrow spaces, particularly where there is wreckage following an explosion and where it may be possible for only one man to reach a trapped casualty and to rescue him. After initial rescue, two men may be able to undertake further movement through a narrow space. The method is demonstrated in Figures 1.9 and 2. Ensure that the casualtys wrists, which are tied together, do not interfere with any breathing apparatus the rescuer may be wearing, and safeguard the casualtys head with a bump hat if possible.

FIG 1.9

FIG 2.0

NEIL ROBERTSON STRETCHER This particular type of stretcher is shown in Figure 2.1. It is a simple device for moving a casualty safely from a difficult place where the ordinary stretcher with stiff poles would be useless. Other patterns of rescue stretcher are available but all aim to achieve the same purpose. The casualty is enveloped in a protecting but somewhat flexible case, so that he takes up as little room as possible. The stretcher can be bent slightly in turning sharp corners in narrow passages, as when being hoisted up the ladder ways from engine-rooms, or through the hatches of cargo tanks. The stretcher is made of stout canvas, stiffened by wooden slats (Figure 2.1). The portion A takes the head and neck, which are steadied by a canvas strap passing over the forehead. Thus, the head of an unconscious patient can be steadied.

FIG 2.1

FIRST AID IN EMERGENCY CASES

HSE DEPARTMENT

SUEZ CANAL CONTAINER TERMINAL

The portion B is wrapped round the chest, notches being cut on which the armpits rest. This part has three canvas straps which are used for fastening the stretcher round the chest. The portion D folds round the hips and legs down to the ankles. It is secured by two canvas straps. A central backbone of stout rope passes along the under surface. This has two beckets passing out from it on either side which can be used as handles, for carrying the patient or for securing tackles when he is slung horizontally. At the head end, the rope ends in a grommet which takes extra purchase from two brass eyelets let into the canvas. At the foot end of the rope is a galvanized iron ring which is secured to the stretcher by a span going to brass eyelets in the canvas. When more rigidity in the stretcher is required, as in moving those with injuries to the back, a couple of broom handles, slipped through the ropes underneath, will fulfill this purpose admirably. Some stretchers have a rope about 9 ft long fixed to the galvanized ring at the foot end. This is a steadying rope for use in craft below, or on quay, when the patient is lowered over the side of the ship. When the patient is carried about the ship, this rope can be passed under the various straps to keep it from trailing on the deck or otherwise getting in the way. The patient should be lifted on to and secured in the stretcher as shown in Figures 2.2 to 2.5. Cases of fracture of the spine or other back and pelvic injuries should be transferred to the stretcher as directed under spinal injury.

FIG 2.2 Getting ready to lift the casualty sufficiently for the Neil Robertson stretcher to be slid under him. With only three attendants, the wrists of an unconscious patient have to be tied together but not tightly. FIG 2.3 Lower the patient slowly if he is unconscious, support his head.

FIG 2.5 FIG 2.4 Ensure patients armpits are in the correct place before you finish lowering him Strapped up the arms can be strapped inside or outside the chest section of the stretcher, depending upon the injuries.

FIRST AID IN EMERGENCY CASES

HSE DEPARTMENT

SUEZ CANAL CONTAINER TERMINAL

The patient should be carried by four men, if possible (Figure 2.6). At difficult corners, the stretcher should be lowered at the foot end, and the casualty passed by two of the men to the others. The carry can then be resumed by the four bearers. When passing the casualty through a narrow hatch, or lifting him up over a height, or lowering him to a boat alongside, put the lifting hook or a rope through the grommet at the head end and a further steadying rope through the galvanized ring at the foot end (Figures 2.7 and 2.8). Moving an unconscious casualty If possible, carry an unconscious casualty in the unconscious position and always with a head-down tilt. The tilt is also necessary when carrying a casualty suffering from shock or loss of blood.

FIG 2.6 Carrying the patient but keep the head section level with the chest section if the neck may be hurt. FIG 2.8 Moving a casualty vertically .

FIG 2.7 Hoisting a casualty through a hatch

FIRST AID IN EMERGENCY CASES

HSE DEPARTMENT

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SUEZ CANAL CONTAINER TERMINAL

DRESSINGS, BANDAGES, SLINGS AND SPLINTS STANDARD DRESSING A standard dressing consists of a thick pad of gauze which is attached to a bandage, leaving about 30cm of tail. The dressing is packed in a paper cover and is sterile. Therefore, when the package is opened, it is important that the gauze pad should not be allowed to touch anything (including your fingers) before it is applied to the wound. Standard dressings are available in three sizes: Small Gauze pad measures 7.5 cm by 10 cm. Medium Gauze pad measures 10 cm by 15 cm. Large Gauze pad measures 15 cm by 20 cm. Always select a dressing with a pad which is larger than the wound which you have to cover up. In use the pad is placed upon the wound, the tail is taken round the limb and held, the bandage is held taut as it is taken round the affected part so as to `lock the tail in position. The bandaging can then be continued to hold the dressing firmly in place by making turns above and below the pad so that they overlap it (Figure 2.8).

FIRST AID IN EMERGENCY CASES

HSE DEPARTMENT