First Aid training Practical sessions

FIRST AID : IMMEDIATE treatment given for

the occurrence of any injury/ case of illness, before
medical aid arrives.
PURPOSE :
To preserve life
To prevent further injury
To promote recovery
REMEMBER: apply the principle of first aid and aims
of first aid in every situation!!
Principle of First Aid : DR. ABC
D- Danger
R- Response
A- Airway
B- Breathing
C- Circulation
1. Wound and Bleeding
Recall the types of wounds
Management
i)
Irrigate/Clean the wound (if abrasion then clean the dirt etc) using
sterile water, normal saline or pipe water.
ii)
If NOT BLEEDING already, apply antiseptic and dressing. If
small wound, use plaster; if bigger wound, use gauge or pad
(sterile/non-sterile) and use surgical tape or leucoplast to secure it.
If not possible, then use bandages.
iii)
If BRUISES/HEMATOMA, then use cold compress. Find a pack
of ice and gently press against the bruising part, put a layer of cloth
in between the ice and skin to prevent hypothermic injury.
iv)
If bleeding (large and deep wound), follow the steps:
A) apply direct pressure by using gauge or pad (sterile, if not possible,
use normal gauge), choose the size of the gauge and pad according to the
size of the wound. Press for 10-15 minutes.
B) Elevate the injured part, above the level of heart while compressing the
wound.
C) If the gauge/pad is soaking wet with blood, remove the top layers only,
not the bottom 2/3 layers that stick to the skin.
D) If the bleeding doesnt stop, press on the pulse point.
E) If the bleeding continues, send to hospital.
Minor Wounds: the bleeding is oozing, slow, or the wound appears like a scrape, nick or
s scratch
Make sure the person is sitting or lying down

 CLEAN to remove dirt and foreign debris by using running tap water or with
an alcohol-free wipe. Dont use antiseptics as it may damage the skin

Apply a sterile bandage or dressing to the wound

Use finger or hand pressure directly on the wound.

For minor injuries in people who do not have clotting problems or are on
anticoagulants (blood thinners), bleeding is likely to stop in under 10
minutes. If not please go visit a hospital.

Serious Wound
i.

Get the person to lie down

Lessen the likelihood of shock if you can elevate the legs or position of the head
lower than the trunk.
Check the breathing and circulation

ii.

If possible, ELEVATE a wounded limb

Help to control the bleeding if a wounded limb can be elevated above the
heart
But!! if you suspect a broken bone, dont attempt to move the limb

iii.

Remove dirt, any visible foreign body and debris, but dont clean thw wound
thoroughly.

If the foreign object is large, do not remove it. It is most likely stopping a lot of
the bleeding itself. Just put pressure and bandage around the object. Taking care
not to push it in further.
iv.

Apply firm pressure directly to the wound until the bleeding stops

Use a pad of clean gauze, dressing or clothing.

Place your hand over the pad and apply firm pressure with fingers or hand to the
wound

v.

Continue applying pressure steadily

 If injury is on a limb, can use tape/cloth wrapped around the wound to maintain
pressure.
For groin or other parts of the body where you cannot wrap the wound, use a
heavy pad and keep using your hands to press on the wound.

vi.

Look for seepage from the wound

Add more gauze or additional bandages if the original soaks through.
Do not over-wrap it, but, as increased bulk risks reducing pressure on the
wound.
If suspect the bandage is not working, remove the bandage and pad and
reassess the application
If the bleeding appears controlled, maintain pressure until you ensure the
bleeding has stopped/medical help has arrived

vii.

Use pressure points if necessary

 If cannot stop bleeding by pressure alone, combine using direct pressure

to the wound with pressure to one of these pressure points
Use fingers to press the blood vessel against the bone.
Eg: branchial artery: For wounds on lower arm

Femoral artery: For thigh wounds. Runs along the groin near the bikini
line

Popliteal artery: For wounds on the lower leg.

viii.

Continue applying pressure until the bleeding stops or help arrives

ix.

Monitor the victims airway and breathing at all times

P/S: DO NOT use a tourniquet unless necessary.

P/S: if signs of shock are seen, ie. Tachycardia, pallor, pale lips, cold hand
and feet, then elevate the legs. (this is to increase the blood supply to the
brain)
P/S: Always wear a pair of gloves when in contact with patients blood.
Clean your hands after managing the patient.

2. Fracture

Recall the types of fractures (open & closed) and their differences in
appearance.
Fracture : Break/ crack in a bone
Closed fracture : Overlying skin intact
Open fracture : Disruption of soft tissue; hematoma which
communicates with external environment; High chance of infection

IMPORTANT: History of fall, ask which part land 1st. Patient should
complain of very painful sensation (screaming like hell) in the fractured
part.

 NOTE: In case of Axial bones fracture, DO NOT touch the patient, just
calm him/her and call for ambulances. If Appendicular bone fracture,
manage appropriately.
You cant confirm its a fracture unless an imaging eg. X-rays has been
done.
Management of closed fracture:
i)
Dont move the casualty unless in danger
ii)
Identify the fractured part, observe carefully. You should be able to
see bruises/hematoma and swelling.
iii)
Perform immobilization (with bandages and an arm sling). Recall
the principle of immobilization
iv)
Treat for shock if needed.
v)
Send to hospital.
Management of open fracture:
i)
Dont move the casualty unless in danger
ii)
Identify the fractured part, observe carefully. Sometimes you are
able to see the bones sticking out of the skin.
iii)
Placed a sterile padding on the open wound (to cover it). Try to
stop the bleeding by pressing the pulse point, etc.
iv)
Perform immobilization (with bandages). Recall the principle of
immobization.
v)
Treat for shock if needed.
vi)
Send to hospital.
3. Bandages
Recall Figure of 8 and Spiral Bandage.
Function/when to use bandages (the important ones):
i)
To secure the dressing and splint.
ii)
To maintain a direct pressure over the wound (after the initial
management)
iii)
To reduce swelling (in case of joint sprain).
Check for SMC after bandaging. (Sensation whether he/she can feel u at
the distal part of bandage. Movement whether he/she can move the distal
part of the bandage. Capillary refill check for it)
Types of Bandage
Arm sling : provides support for an injured upper arm, wrist or forearm,
on a casualty whose elbow can be bent, or to immobilise the arm for a rib
fracture.
Elevation sling : supports the forearm and hand in a raised position to
Control bleeding from wounds in the forearm/ hand
Minimise swelling
Support the arm in the case of injured hand
Scalp bandage : Help to support the bandage to help to control the
bleeding

 Hand bandage : Hold a dressing in place on a hand/foot, will not provide

enough pressure to control bleeding
4. Sprain, Strain and Cramps
Recall the differences of sprain, strain and cramps
Sprain : Stretched/ torn ligament
Strain : Stretched/ torn muscle/ tendon. Twisting/ pulling these tissues
cause it.
Cramps : neural sensations caused by muscle contraction or
overshortening

Treat every case of joint sprain as a fracture case.

Management of sprain RICE
i)
Rest
ii)
Ice pad
iii)
Cold compression
iv)
Elevation of the injured part
Management of strain:
i)
Cold compression
ii)
Rest, restrict activities involving the muscle
Management of cramps:
i)
Based on experiences.
P/S : If ice is not available, use cold spray or cold cream instead of ice.
Use anti-muscleache cream in case of strain.

5. Nose injury
Management:
i)
Tilt the head down, let it bleeds.
ii)
Advise the patient to breathe through mouth, do not scratch, blow
and breathe through the nose.
iii)
Press against the hard part of the bridge of the nose. Press for 1015 mins and release the pressure, check for bleeding.
iv)
If bleeding continues, press again for another 10-15 mins, then
release the pressure.
v)
You can put a packet of ice at the bridge of the nose.
vi)
If the bleeding continues, send to hospital.

P/S : Do not tilt the head backwards, to prevent the backflow of blood that
might cause irritation which result in sneezing and to prevent choke.