SECTION ONE
Introduction to principles of First Aid

1.1 Introduction
• Human populations are rapidly growing. As a results
– disturbances in environmental conditions & habits happening, this
leads to;
• rising occurrence of natural & man-made disasters
– there is an alterations in natural resource consumptions and land
usage taking place.
• leads to rising conflicts & violence among people
– there is an advancement in technologies and increased use of its
products also occurring.
• leads to rising amount of injuries/illness as a systems made by
human itself become out of his control
• Thus more peoples facing a sudden injuries and acute
illness

Introduction…
• The SSA disproportionate worse outcomes
– after injuries and acute illness
– this attributed to timeliness & poor emergency care
• The solution:
– “Afro-centric” emergency care systems / EMS /
• Emergency care is =
– Prehospital Care + Transportation + Hospital Care
– Prehospital Care - determine patients outcomes
independent of in-hospital emergency care

Introduction…
• Prehospital Care =
►a community based FIRST
AID + ambulance care
►Tier-One model of care
• “Afro-centric” EMS

… Introduction
• What is First Aid?
– it is a temporary and immediate care given to an
injured or suddenly ill person before the arrival of
emergency medial care
• First Aid
– is helping behavior & initial care
– include home based care before arrival of EMS
– Doesn't replace definitive care by professionals
– only given for life-and-death situations
– it can be performed by a bystander or by victim

… Introduction
• First aid can brings a difference between life &
death
• A first aider – is someone with a formal
training
– or first people on an emergency scene

1.2. Values of First Aid Training
• the need for first aid training is greater than ever;
– due to rising magnitudes of sudden illness & injuries
rising as a results of
1. rapid growth world population and
2. increased use of technological products
• Further, there is growing demand for first aid
training;
– for a personal use and to be certified as first-aiders;
– as a part of industrial & commercial establishments.
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Why we need first aid skills?
– because sudden illness & injuries can happen
anytime, hence a basic skills of first aids helps to
rescuing,
– perhaps saving lives and minimizing injury at
events of an urgency.
– you need to use those skills on the job, at home,
and elsewhere in community.

… Values of First Aid Training
• Why firs aid skills for a personal use? Because
– sudden illness & injuries can happen anytime,
• hence basic skills of first aids helps for rescuing,
perhaps saving lives and minimizing injury at events of
an urgency.
– you need to use those skills on the job, at home,
and elsewhere in community.
– a better handling of tragic emergencies,
• can make the difference between life and death
• may an event that minimize the need to hospital care

Cont’d…
• The best way to prepare for emergencies is
– to be certified in first aid basic skills such as;
• Airway & respiratory intervention
• Cardiopulmonary resuscitation (CPR)
• Bleeding control and special wound care
• Stabilization of injuries and splinting of fractures
• Hence, first aid training should be universal:
– everyone can learn and
– everyone should give first aid

Help! Emergency!
• Minutes could
make a
difference
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1.3 Principles of First Aid
• Generally the 3 P’s of principles of first aid are;
1. Preserving life;
2. Preventing complications;
3. Promoting healing and recovery;
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Principal Aims of First Aid Care
• To recognize life-threatening situations.
• To activate the EMS system.
• To sustain (preserve) life – e.g CPR
• To prevent worsening of the problem
– E.g. - Immobilizing the fracture.
• To preserve vitality & further resistance.
– Control bleeding...
• To provide pain relief.
– E.g.- Use of ice packs or applying of sling
• To provide reassurances.

1.4) Responsibilities as a First Aider
• as a first aider your are expected to
– respond to emergencies that you have been trained to
handle
– assess the situation quickly and safely and summon
appropriate help
– protect casualties and others at the scene from
possible danger
– identify, as far as possible, the nature of illness or
injury affecting casualty.
– give each casualty early and appropriate treatment,
treating the most serious condition first.

Responsibilities of a First Aider
• Anybody providing first aid, has an obligations to
– arrange for the casualty’s removal to hospital
– remain with a casualty until definitive care or handover
– report your observations to those taking care of the
casualty, and to give further assistance if required.
• Duty to act
– Initially ask the victims, if you can help them (assume that
he/she would want to help)
– Do not act beyond your level of qualifications
– there are circumstances under which you can decide
whether to help or not

1.5. First Aid Rules
• Be calm and confident (safety first)
• Seek medical attention immediately
• Examine the victim gently and treat the most urgent
injuries1st & then other injuries to the best of your ability.
• Do not move injured victim.
– Keep the victim lying down
– Keep victim warm & comfortable.
• Do not touch open wounds or burns with fingers
• Avoid allowing a victim to see his own injury
• Keep NPO, for unconscious victims
• Do not try to arouse an unconscious person.
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2. General directions to provide first
aid
• Basic plan of action are:
– Assess situation - observe scene upon approach.
– Assure Safety - Keep yourself & others at scene safe.
– Assess the victim - Gain access to the victim, and
determine immediate threats to life.
– Activate the EMS system/ CALL for help.
– Provide basic life support to those whose lives are
threatened (to those most seriously injured first).
– Move the victims only if necessary
– Arrange for the transfer or transport of the casualty

I. Assessing the casualty…
• Assessing the casualty (identifying the problem)
– A detailed evaluations is not essential
– Checking for medical alert tags
– Prioritize care
• treat the greatest threat to life first
• To assessing - Carryout a rapid primary Survey
– “ABCDE” approach of primary Survey is key to identify
life threatening injuries.
• Once a life threatening injury is discovered
actions should not be delayed
– If a victim’s condition is instantly life threatening, perform first aid
immediately.

A) Primary Survey
• Most crucial assessment tool in acute illness
and injuries care
– About 1-2 minutes is MAX !
– Designed to identify and immediately correct life
threatening problems ACCURATELY
– Establish priorities
– Provide simultaneous interventions.

Primary survey …
• Po survey often referred as Basic Life Support /
BLS
– BLS is maintaining of airway patency, and
supporting breathing & circulation without the
use of equipment other than a protective device.
– BLS interventions including CPR (Chest
compressions & artificial ventilation)
• can be performed by anyone who knows how to do it,
anywhere, immediately, without any other equipment
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Primary Survey… Steps of BLS
• Steps of Po Survey in basic life support (BLS/ CPR)
1. Approach safely
2. Check for response
3. Shout for help
4. Open airway
5. Check breathing
6. Call for EMS 939 and ask for AED
7. Provide 30 chest compressions
8. Give 2 rescue breaths
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Primary Survey…
• ABCDEs of care are (Primary survey )
– A Airway (with c-spine protection in trauma)
– BBreathing (with giving ventilation)
– CCirculation (with bleeding control)
– D Disability (checking neurologic status)
– EExposure (Environmental control)
• Always, precede with evaluation of the
– danger (D) and response (R);
– change it to DR- ABCDE method
– follow each step logically, deal with it in order of priority

D - DANGER:
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• If someone needs help, before you go up to them check – is
it safe?
• No:
– If you can see or hear
any danger nearby, for
you or them, like broken
glass or oncoming
traffic,
– then make the situation
safe before you get any
closer
 Yes:
– If you can’t see or hear any
danger then it is safe to go
up to them.
Staying safe is your first priority.
Don’t enter an unsafe situation without proper training and equipment.

R- RESPONSE:
• Do they respond when you ask them:
– ‘Are you alright? or if you say: ‘Open your eyes!’
• No:
• If they don't respond,
• Adult- pinch their ear lobe/
gently shake shoulder.
• Child, baby ?
• If they still don’t respond,
then you can presume
they’re unresponsive & move
on to the next stage 
Airway.
• Yes: -
– If they respond by making
eye contact or some gesture
with you then they’re
responsive & you can move
on to the next stage 
Airway.
NB- Unresponsive victim should always take priority treat them first & as
quickly as possible.

Calling for help
• Call for help /EMS/ –
– Getting assistance from a companion;
• Call a trained person certified in first aid to the scene or
those who have been designated as emergency first
responders, if you can’t handle yourself.
– if you are alone – determine the seriousness of
• the injury and may need to provide immediate firs aid
 then leave victim to call for help /EMS/
• NB:- Administration of first aid must not delay activation
of the emergency medical services
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A - Airway
• Airway should be assessed for patency
– Is the patient able to communicate verbally?
– Inspect for any foreign bodies
– Look for stridor, gurgling, pooled secretions or
blood
• Assume cervical (C-spine) injury in patients
with multiple trauma
– C- spine protection should remain in place
How to assess & open the airway?

… Airway:
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• Is their airway open and clear?
• No:
– Responsive: If they’re
responsive, yet blocked airway
treat (e.g. choking)
– Unresponsive: tilt their head
and lift their chin to open their
airway.
• Yes:
– If the airway is open and
clear, move on to the next
stage – Breathing.
• NB 
– Only move on to the
next stage – once their
airway is open and clear.
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… Airway techniques
© 2012 Pearson Education, Inc.
Head-tilt/Chin-lift Maneuver Jaw-thrust Maneuver

B- Breathing
• You need to look, listen and feel to check
they’re breathing (LLF).
– Look – for chest movement
– Listen – air movement
– Feel – for incoming air
• Airway patency alone does not ensure
adequate ventilation

B- Breathing …
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• Are they breathing normally?
• No  Unresponsive:
– If they’re unresponsive and
not breathing, call EMS or get
someone else to call if
possible, and start giving chest
compressions and rescue
breaths (CPR)
– If this happens you won’t
move on to the next stage as
casualty needs CPR
• No  Responsive:
– If they’re conscious, treat
them for whatever is
stopping them breathing,
for example, an obstructed
airway.
• Yes  breathing
– If they are breathing
normally, move on to the
next stage – circulation.
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Breathing …
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• No - Breathing Interventions
• Unresponsive:
– start giving artificial ventilation
– chest compressions and
rescue breaths /CPR
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chest compressions & rescue breaths
Artificial ventilation

C- Circulation:
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• Are there any signs of severe bleeding?
• Yes:
– If they’re bleeding severely,
control the bleeding with your
gloved fingers, dressing or
clothing, call EMS and treat
them to reduce the risk of
them going into shock.
• No:
– If they aren’t bleeding, and
you’re sure you have dealt
with any life-threatening
conditions, then you can
move on to the disability
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… Circulation Interventions
• Hemorrhagic shock should be assumed in any
hypotensive trauma patient
– Check for skin color and check pulses in four
extremities (for rate and strength)
• Controlling of External Hemorrhage
– Apply direct pressure to sites of bleeding
– Elevation
– Compression of pressure points (arteries, veins)
– AVOID tourniquets…can compromise loss of
circulation and loss of limb

D- Disability
• Disability is all about neurological conditions
– Check level of consciousness –
• Level of consciousness
• Motor and sensory function
– abbreviated neurological status
• AVPU or GCS (Glasgow coma scale)
• Utilized to determine severity of injury
– Never offer any fluid (anything) orally for unconscious
or victims with altered mentation
– Immobilize the victim
• If spinal cord injury or Pelvic Fractures ???

E- Exposure
• Expose the victims
– Complete undressing of patient
– Logroll to inspect back
– Warm blankets/external warming device to
prevent hypothermia
• giving comfort measures… pain control,
reassurance to causality
• inspect for hidden injuries-log roll patient to
inspect posterior aspect.

Always Inspect the Back

II. Move only if necessary
• Move the victim only if absolutely necessary to prevent
further injury from a hazard at the scene.
• RECOVERY POSITION
– For people who are unconscious, or semiconscious, but are
still breathing.
– If there are spinal or neck injuries, do not attempt to place
the casualty in the recovery position.
– NOTE: Leaving the victim in this position for long periods
may cause them to experience nerve compression.
• Conduct frequent reassessment of victims conditions
while considering for transfer or transporting
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III. Transport of victims
• The time from injury to
definitive care is a
determinant of survival,
particularly those with
major internal hemorrhage.
• Careful attention must be
given to the airway with
cervical spine
immobilization, breathing
and circulation. (ABC’s)
►How is it decided?
♫ Travel time
♫ Topography
♫ Availability of air or
ground transport
♫ Capability of personnel
♫ Weather
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What if Non-accidental injuries?
• Key is SUSPICION!!!
• Incongruent stories of mechanisms of injury
• Delay in seeking help
• Multiple stages of injuries
• Patterns of Injuries
– Injury mechanism beyond the scope of the age of
child (6week old rolled over off the bed)
– Bite marks, submersion injury, cigarette burns

Priority (Hurry) cases
• Airway
– Airway blockage
• Breathing
– Stoppage of Breathing
– (respiratory arrest)
• Circulations
– Severe Bleeding
– Heart attack
– Shock, and Fainting
• Disability
– Fracture
– Burns and Scalds
– seizures
– Poisoning – (including
ingested & injected
poisons / snake bite).
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Priority Interventions
• Ensure patent airway
• Maintaining adequate ventilation
• Adequate gas exchange
• Then:
– Control bleeding,
– restore tissue perfusion
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Precautions …
• While caring for ABCs Infectious Disease issues
….
• Safety is first priority.

Case scenario
• A young man involved in a high speed
motorcycle accident. He was not wearing a
helmet. He is response status, is drowsy but
arousable to voice. He has large bleeding from
scalp, obvious deformity to Left ankle
– What are the intervention priorities at this time?
– What are the interventions that need to happen
now?

3) First Aid equipment
• emergency kits should
supplied to scene site for
use both on-site and off-
site emergencies.
• Standard kit provides a
basic standard set of
equipment and drugs with
the main emphasis on the
basics of resuscitations (to
support ABC’s of life)
►While using the F.A kit
♫ Stocks for the pack
♫ Check the contents
regularly and restock after
use
♫ Maintain all components in
the standard format
♫ Replenish for used/missed
contents
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Basic contents of first aid kits
• Basic Airway/Ventilation
Adjuncts:- oral/nasal
airway, bag-valve mask
• Equipment for vascular
access and to control
bleeding:- Cleansing
agent, IV catheter, IV fluid
and IV tubing. Tourniquet,
adhesive tape, gauze,
bandage, scalpel
• PPE:- Gloves, masks,
antiseptics and etc.
►Immobilization Devices:-
Spinal immobilization &
Cervical collars. Extremity
immobilization devices
►Life saving drugs:-
salbutamol, Adrenaline,
hydrocortisone, Glucose,
Tramadol & others PRN
• Other equipment such as
stationery and
Communication Devices
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