Course – Basic First Aid Techniques

Teacher – Dr. Venkata Bhavesh Alluvada MBBS,DNB ,FCD,FICM

What is First Aid

First aid is the first assistance or treatment given to a casualty or a sick person for any injury or
Sudden illness before the arrival of an ambulance, the arrival of a qualified paramedical or
medical person or before arriving at a facility that can provide professional medical care.
AIMS

1) To preserve life,
2) To prevent the worsening of one’s medical condition,
3) To promote recovery, and
4) To help to ensure safe transportation to the nearest healthcare facility.

THE FIRST AIDER

A first aider is the term describing any person who helps the medically needy individual or has
received training render first aid.

WHAT THE LAW SAYS ABOUT FIRST AID

1. A bystander or Good Samaritan, including an eyewitness of a road accident may take an

injured to the nearest hospital and should be allowed to leave immediately.
The eyewitness has to provide his address. No questions are to be asked.

2. The bystander or Good Samaritan shall not be liable for any civil and criminal liability.
3. A bystander or Good Samaritan who makes a phone call to inform the police or emergency
services for the person lying injured on the road cannot be compelled to give his name or
personal details on the phone or in person. The disclosure of contact details of the Good
Samaritan is to be voluntary.

4. The lack of response by a (medical) doctor in an emergency pertaining to road accidents

(where he is expected to provide care) shall constitute ‘Professional Misconduct’.

CONSENT OF THE PERSON IN NEED

A conscious person has the right to either refuse or accept care. If the person is conscious, you
must ask for his consent before commencing any first aid. If he refuses your help, stay nearby
and call the police and emergency services, who can then deal with the situation.

If the person is under 18, it is best to obtain consent from his parent or guardian if they are
present. If they refuse your help, stay nearby and call the police and the emergency services, who
can then deal with the situation.

If the person is unconscious or unable to formally consent, his consent is inferred and you can
then give the necessary first aid.

PRIVACY

In any first aid situation, the first aider must take steps to assist the person to maintain personal
privacy. This means things like, keeping crowds away, putting up a screen if necessary, and
covering any exposed body parts with blankets, or sheets, if available.

The first aider also needs to take steps to maintain confidentiality. This means not talking about
the incident to other people, or answering questions from the media, unless you have
Permission from the person involved in the accident

STEPS IN DEALING WITH AN EMERGENCY

Emergency situations vary greatly but there are four main steps that always apply:

1. Make the area safe.

2. Evaluate the injured person’s condition.
3. Seek help.
4. Give first aid.

STEP 1: MAKE THE AREA SAFE

Your own safety should always come first.

As a first aider, you should:

-Try to find out what has just happened.
-Check for any danger is there a threat from traffic, fire, electricity cables, etc
-Never approach the scene of an accident if you are putting yourself in danger
-Do your best to protect both the injured person(s) and other people on the scene
-Be aware that the property of the injured person is at risk. Theft can occur. So mind your safety.
- seek police or emergency help if an accident scene is unsafe and you cannot offer help without
putting yourself in danger.

An important part of safety also includes washing your hands and wearing gloves or a protection
when coming in contact with the injured or sick person’s blood or body fluids.

As a general rule, the injured person should not be moved from the scene of an accident.
Any movement may make the injury worse if there has been a head, neck, back, and leg or
arm injury.

Only move injured people if:

-The injured person is in more danger if he is left there
-The situation cannot be made safe
-Medical help will not arrive soon, and
-You can do so without putting yourself in danger.

STEP 2: EVALUATE THE CONDITION OF THE SICK OR INJURED PERSON

If it is safe, you can evaluate the sick or injured person’s condition. Always check that he is
conscious and breathing normally. Situations in which consciousness or breathing are impaired
are often life threatening. Immediately start Basic Life Support which is explained later.

Bleeding can also happen inside the body and can be life-threatening although the loss of blood
is not seen.

STEP 3: SEEK HELP

Once you have evaluated the sick or injured person’s condition you can decide if help is needed
urgently.
If help is needed, ask a bystander to call for help. Ask him to come back and confirm that help is
underway.

If you call for help, be prepared to have the following information available:
The location & Nature of Emergency
You might be asked to give your name. Always stay calm and answer their questions calmly.
The call takers are professionals and will give you further guidance.

If an ambulance can be obtained in a short time, it is best to call for one and use it to transport
the injured or sick person to the healthcare facility. An ambulance is the best way to transport ill
or injured persons, but they are not always and everywhere quickly available.
You can always ask the police for help. If no help is available, you will have to arrange transport
yourself (in a van, a truck, a car, an auto-rickshaw, a motorbike, a scooter, a bike-rickshaw, a
bike...). Always move the sick or injured person with great care

STEP 4: PROVIDE FIRST AID

Give first aid in accordance to situation

When providing first aid, try to protect an ill or injured person from cold and heat.

In fact, as a general principle, the rule is not to give a casualty anything to drink or eat.
Important exceptions include hypothermia (low body temperature), hypoglycemic shock (low
blood sugar in a diabetes patient) diarrhoea and fever leading to dehydration and in case of heat
exhaustion or heatstroke. The details can be reviewed in the specific chapters on these
conditions.

To support him through the ordeal, follow these simple tips:

-tell the sick or injured person your name, explain how you are going to help him and reassure
him. This will help to relax him;
- listen to the person and show concern and kindness;
-make him as comfortable as possible;
- If he is worried, tell him that it is normal to be afraid;
- If it is safe to do so, encourage family and loved ones to stay with him; and
- explain to the sick or injured person what has happened and what is going to happen.

WHEN CAN I STOP PROVIDING FIRST AID?

-You see a sign of life, such as breathing;

-Someone trained in first aid or a medical professional takes over;
-You are too exhausted to continue
-The scene becomes unsafe for you to continue.
STRESS WHEN GIVING FIRST AID

It is only normal to feel stress if you are suddenly faced with the need to give first aid in a real
emergency.
Try to bring your emotions under control before you proceed. You may take some time to stand
back from the situation and regain your calm. Do not set about the task too hastily and do not
under any circumstances place your own safety at risk.
It is not always easy to process a traumatic event emotionally. It is not unusual for first aiders to
experience difficulty when working through their emotions afterwards. Talk to your friends,
family, fellow first aiders or someone else. If you are still worried, talk to a professional and seek
counselling.

Main Parts and Blood supply of Body

Severe External Injury may have its affect on internal organs also , just have a outer view of
which organ is present where .it helps us in deciding the mode and how to transport a patient
BASIC LIFE SUPPORT (CARDIO PULMONARY RESUSCITATION ,CPR )

RESUSCITATION (BASIC CPR)

Reviving someone who is unconscious and /or not breathing or not breathing normally is called
Resuscitation.

If the victim is not breathing or is not breathing normally, any source of suffocation should be
removed and resuscitation is to be started.

Chest compressions with or without rescue breathings are performed by an individual during
cardio pulmonary resuscitation (CPR) in an attempt to restore spontaneous circulation.

For untrained or minimally trained first aid providers treating an adult victim, compression-only
CPR is recommended. These chest compressions ensure a small but crucial supply of blood to
The heart and brain.

For formally trained first aid providers (and professionals) treating an adult victim, compression
with breaths is recommended. If the trained first aid provider is unable or unwilling, or in any
other circumstance, compression- only CPR may be substituted for compression with breaths.
For babies and children under one year, compressions with breaths are always recommended.

WHAT DO I SEE AND ENQUIRE?

In case of a cardiac arrest (heart stops functioning) you might notice the following signs:
- Sudden collapse,
- Loss of consciousness,
- No breathing,
- No pulse (however this is not always easy for laypeople to confirm).

HOW TO OBSERVE RESPONSIVENESS AND UNCONSCIOUSNESS?

Unconsciousness occurs when a person is suddenly unable to respond to stimuli like sound or
pain, and appears to be asleep. A person may be unconscious for a few seconds (as is the case
with fainting) or for longer periods of time.

People who become unconscious do not respond to loud sounds or shaking. They may even stop
breathing or their pulse may become faint. This calls for immediate emergency attention.
The sooner the person receives emergency first aid in the form of CPR better , it can be life
saving in some cases

The AVPU scale (an acronym from "alert, voice, pain, unresponsiveness") is a system by which
a first aider can measure and record a patient's responsiveness, indicating the level of
consciousness. It is based on the casualty’s eye opening, verbal and movement (motor)
responses.
See whether person is opening eyes, ask to tell the name and move his limbs if not obeying your
commands then pinch him to see if , feels the pain and withdraws the pinched area .if not
responding any of the above then declare the patient unconscious and start CPR .

Before starting CPR Check the persons and breathing - breathing can be checked easily by the
outward movement of chest and abdomen due to indraw of air by the individual , if Breathing
then keep the individual in recovery position (left lateral position ).But keep observing the
person’s breathing until medical help arrives as the individual may suddenly stop breathing and
no pulse can be felt which mandates CPR . In the first minutes after cardiac arrest it often
appears as if the person is trying to breathe. It can appear as if the person is barely breathing or is
taking infrequent noisy gasps. It is important not to confuse this with normal breathing and you
should start resuscitation immediately.

RESUSCITATION OF A PERSON WHO IS NOT BREATHING OR NOT BREATHING

NORMALLY

1. SAFETY FIRST AND CALL FOR HELP

 2. SECURE AN OPEN AIRWAY – turn the affected individual on his back , kneel
beside the casualty, Lift the chin forwards with the index and middle fingers of one hand
while pressing the forehead backwards with the palm of the other hand. This maneuver
will lift the tongue forward and clear the airways.

Above picture showing Head Tilt and Chin lift Maneuver

The above maneuver should not be performed if you suspect spinal cord injury. Spinal
cord injuries are common in flipped vehicle/body accidents.

3.Head Tilt and Chin Lift procedure will open the air way and person may start breathing ,if
this happens you succeded in saving a person .Keep him in recovery position and keep observing
until medical help arrives .

4 . Individual still not breathing after head tilt and Chin lift maneuver start CPR immediately in
the form chest compressions as below
-Turn the casualty on his back on a hard surface, if not already.
-Kneel next to the casualty, beside his upper arm.
-Place the heel of one hand in the center of the person’s chest(sternum area)
-Place the heel of the other hand on top of your first hand
-Lock your fingers of both hands together.
-Make sure your shoulders are directly above the person’s chest.
-With outstretched arms, push five to maximum six centimetres downwards.
 -Release the pressure and avoid leaning on the chest between compressions to
allow full chest recoil.The compression and release should be of equal duration.
-Releasing the pressure will let the blood back to heart
-Do not allow your hands to shift or come away from the breast bone.
-100 chest compressions should be given per minute .
-If two first aiders present then 2 rescue breaths for every 30 Chest compressions
-If the person’s age is below puberty, only use one hand.
-If the victim is a baby, then give chest compressions by fingers

CHEST COMPRESSIONS

RESCUE BREATHS HEAD TILT CHIN LIFT IN BABIES

Placing Casualty in Recovery Position

SUMMARY

THE INDIVIDUAL/ CASUALTY IS….. PROCEDURE TO BE PERFORMED

CONSCIOUS AND BREATHING GIVE APPROPRIATE FIRST AID

NORMALLY
UNCONSCIOUS AND BREATHING PUT THE CASUALTY IN RECOVERY
NORMALLY POSITION
UNCONSCIOUS AND NOT BREATHING START CPR /RESUSCITATION
OR NOT BREATHING NORMALLY

SAFETY OF THE FIRST AIDER IS THE PRIME IMPORTANCE BEFORE HELPING THE
CASUALTY, ITS BETTER NOT TO GO FOR FIRST AID IF SAFETY OF THE PLACE
CANNOT BE ASSESSED OR PUTS FIRST AIDER AT RISK OF INJURY .

MOVE THE CASUALTY/INDIVIDUAL TO SAFE AND AREATED PLACE

KEEP THE CAUTION SIGN BOARDS IF AVAILABLE AT SPOT ,ALWAYS ASK FOR
OTHER BY STANDERS TO HELP.

ASK SOMEONE TO DAIL EMERGENCY HEALTH CARE/POLICE/FIRE NUMBER AND

RECONFIRM WHETHER SOMEONE HAS CALLED THE NUMBER .

DON’T ALLOW EXCESS CROWD TO ACCUMULATE.

CHECK FOR HIS BREATHING /CONSCIOUSNESS - FOLLOW FLOW CHART .

CPR/RESUSCITATION IS THE GO TO STEP FOR ALL NON BREATHING

UNCONSCIOUS INDIVIDUALS OF WHATEVER CAUSE SUCH AS HEART
ATTACK,DRWONING,SNAKE BITE,SMOKE,CHOKING,ROAD TRAFFIC
ACCIDENT,ELECTRIC SHOCK etc .

A FIRST AIDER MUST BE ABLE TO DO A TIP TO TOE EXAMINATION AT A GLANCE

TO SEE FOR OTHER INJURIES .

WEAR PROTECTIVE COVER WHILE DOING FIRST AID ,SUCH AS GLOVES,MASK IF

NOT AVAILABLE USE YOUR HANDKERCHIEF.

IF ANY BLEEDING POINTS ARE FOUND ON INDIVIDUALS BODY APPLY PRESSURE

TO STOP BLEEDING .

IN CASE OF ON GOING MASS CASUALTY ATTEND TO THE PERSONS WHO CAN BE

MOVED SAFETY FIRST AND THEN UNCONSCIOUS PERSONS.

BE READY TO STEP ASIDE WHEN EXPERIENCED PERSON ARRIVES AT THE SCENE.

WASH YOUR HANDS THOROUGHLY AFTER THE FIRST AID IS COMPLETE.
FIRST AID OVERVIEW FLOW CHART
CHOKING ADULT /BABY

When a person is having severe difficulty in breathing because of an obstructed airway due to
foreign body, FOOD, swelling or lack of air the individual is said to be in choking.

Coughing is the natural way of clearing the airway when the person experiences mild choking. It
is also a sign that he still gets air through the windpipe.

Severe choking happens when the foreign object or a local swelling blocks the airway. This is a
life-threatening emergency.

Infants and children often choke after swallowing non-edible objects such as coins, marbles,
seeds, buttons or small toys.

Most adult cases of choking occur while eating. Since choking often occurs while eating, there
are usually people present near the casualty. This means there is a good chance that someone will
be able to give help quickly.

WHAT DO I SEE AND ENQUIRE?

When a person is choking, you may observe the following:

-The person has difficulty in breathing,

-he tries to cough something out but it does not help,
-He cannot speak or make any sound,
-He puts his hands on his throat,
-The lips and tongue turn blue,
-The veins in the face and neck stick out, or
-The person becomes dizzy and might lose consciousness.

Follow the BELOW guidelines if the choking person’s age is more than one year.

APPROACH AND HELP THE CHOKING PERSON

Ask the person ‘Are you choking?’ (Only if the person can understand and answer the question).

WHAT DO I DO IF THE PERSON CAN ANSWER THE QUESTION, CAN COUGH OR

BREATHES?
Ask the person to keep coughing. Do not do anything else, but stay with the person until he
breathes normally again.
WHAT DO I DO IF THE PERSON CANNOT SPEAK, COUGH OR BREATHE?

1. Stand to the side and a little behind the choking person or child (aged older than one year).
2. Support the person’s chest with one hand and bend him forward.
3. Give five firm blows between the person’s shoulder blades. To do so, use the heel of your free
hand. Verify if the object has come out and the person can breathe again.

WHAT DO I DO IF THE OBJECT DID NOT COME OUT AND THE PERSON IS STILL
CHOKING?

HEIMILICHS MANEUVER

1. Stand behind the choking person and put both hands around him, so your hands meet in front
of the person.
2. Make a fist and place it between the navel and lower tip of the breastbone of the person. Hold
onto this fist with your other hand.

3. Bend the choking person forward and pull your fist firmly towards you and upwards.
4. Give five abdominal thrusts. This method of abdominal thrusts can only be used on people
older than one year.
5. If the passage of air is free, stop giving further abdominal thrusts. But always stop after five
abdominal thrusts.
6. If the object does not come out and the person is still choking, give another five blows on the
back followed by five abdominal thrusts.
7. Repeat this until the object is released or until the choking person loses consciousness

CHOCKING IS GENERALLY WITH FOREIGN BODY AND IT SHOULD BE

DIFFERENTIATED FROM SHORTNESS OF BREATH WHICH IS DUE TO
UNDERLYING DISEASES OF HEART AND LUNGS .HEIMLICHS MANEUVER
SHOULD BE DONE ONLY IN CHOKING INDIVIDUALS.

WHAT DO I DO IF THE PERSON LOSES CONSCIOUSNESS?

1. Carefully place the unconscious person on the floor.

2. The person urgently needs help. Shout or call for help if you are alone but do not leave the
person unattended. Ask a bystander to seek help or to arrange urgent transport to the nearest
healthcare facility. Tell him to come back to you to confirm if help has been secured.
3. Kneel down by the side of the person.
4. If the person is not on his back, turn him on his back.
5. Start CPR.
Do not interrupt the resuscitation until:
-The victim starts to wake up, moves, opens his eyes and breathes normally;
-Help (trained in CPR) arrives and takes over;
-You are too exhausted to continue; or
-The scene becomes unsafe for you to continue.

WHAT DO I DO IF THE CHOKING PERSON IS A BABY UNDER THE AGE OF ONE

YEAR?

1. The baby urgently needs help. Shout or call for help if you are alone but do not leave the child
unattended. Ask a bystander to seek help or to arrange urgent transport to the nearest healthcare
facility. Tell him to come back to you to confirm if help has been secured.
2. Kneel down so that you can use your thighs to prevent the baby from falling.
3. Lay the baby down along your forearm. If you are right-handed, use your left forearm; if you
are left- handed, use your right forearm.
4. Support the baby’s head and neck with one hand without covering the mouth so the baby lies
face down, with the baby’s head below his trunk, over your forearm, supported by your thigh.
5. With your free hand, give five firm blows with the base of your palm to the area between the
baby’s shoulder blades.
6. Quickly turn the baby, while supporting the head, onto his back to face you, resting on your
arm.
7. Check if the object has come out and the baby can breathe freely.

WHAT DO I DO IF THE OBJECT DOES NOT COME OUT?

1. Place two fingers (the two after your thumb) in the middle of the baby’s chest and deliver five
thrusts (pushing inwards and upwards).This method of chest thrust is only to be used on babies
under the age of one year.
2. Stop after five thrusts.
3. If the object does not come out and the baby is still choking, give another five blows on the
back followed by five thrusts.
4. Repeat this until the object is released or the choking baby loses consciousness.

WHAT DO I DO IF THE BABY LOSES CONSCIOUSNESS?

1. Lay the baby down on the floor or on a hard and safe surface.
2. Start CPR on the baby.
Do not interrupt the resuscitation until:
-The baby starts to wake up, moves, opens his eyes and breathes normally; or
-Help (trained in CPR) arrives and takes over.

HYGIENE
Always wash your hands after taking care of a person. Use soap and water to wash your hands.
If no soap is available, you can use ash to wash your hands. Alcohol-based sanitizers can also be
used, if available.

WHEN TO REFER A CHOKING PERSON A HEALTHCARE FACILITY?

Always urgently transport the person to the nearest healthcare facility if he lost consciousness.
Always urgently transport a choking baby or child for a check-up and follow-up to the nearest
healthcare facility, even if the obstruction came out and the baby or child is breathing normally
again.
Always advise the person to visit healthcare facility as soon as possible if abdominal trusts
has been applied.
WHAT DO I DO IN CASE OF A VICTIM SUFFERING SUFFOCATION BY SMOKE?
B.7.1.1 SAFETY FIRST
1. Shout or call for help if you are alone but do not leave the person. Ask a bystander to seek
help. Tell him to come back to you to confirm if help has been secured.
2. Make sure there is no danger to you. Do not take any risk that could endanger you.
The fire brigade has specialized teams and equipment to handle these situations safely.
3. Protect yourself by a towel or a cloth (preferably wet) over your mouth and nose.
4. Crawl on the floor and stay as low as possible.

MOVE THE VICTIM OUT OF THE SMOKE

5. Move the victim as quickly as possible away from the area.

6. Loosen the victim’s clothes at neck and waist.
7. If the breathing stopped, call for help and start CPR.
8. Always arrange transport for the victim to a healthcare facility for further follow up.

FIRST AID FOR BLEEDING (IN GENERAL)

WHAT DO I SEE AND ENQUIRE?

A person who has an injury which is bleeding severely is in a life-threatening situation and needs
immediate help. Therefore, stopping the bleeding is a core first aid activity. In addition, bleeding
in the face or neck may impede the air flow to the lungs.

There might be an open wound that is bleeding.

-The bleeding might be profuse.
-There might be an object stuck in the wound. Even if you cannot see an object, there might be
something stuck in the wound if:
-The injured feels pain in a specific area;
-The injured person reveals a painful lump;
-The injured person feels there is something stuck in the wound;
-There is a discoloured area where the pain is.

Suspect bleeding inside the body if the injured person:

-Is losing blood from body cavities (nose, ear(s), mouth, sex organs, anus);
-Is breathing rapidly;
-Has a cold and clammy skin that is pale or turns blue;
-Has a rapid heartbeat (pulse);
-Is behaving in an irritated or unusual way;
-Has pain or complains about tenderness; sometimes there is also swelling in the abdomen or
chest at the place of the suspected internal bleeding;
-Becomes sleepy or falls unconscious.

WHAT DO I DO?

SAFETY FIRST AND CALL FOR HELP

1. Make sure there is no danger to you and the person.
2. The person urgently needs help. Shout or call for help if you are alone but do not leave the
person unattended. Ask a bystander to seek help or to arrange urgent transport to the nearest
healthcare facility. Tell him to come back to you to confirm if help has been secured.

HYGIENE

3. Wash your hands before and after taking care of the patient. Use soap and water to wash your
hands. If no soap is available, you can use ash to wash your hands. Alcohol-based sanitizers can
also be used, if available.
4. Put on gloves if available. You can also use a clean plastic bag. Try not to come in contact
with the person’s blood.

STOP THE BLEEDING

5. Ask the injured to sit or lie down or put him in comfortable position.
6. Comfort the person and explain what is happening to him. Tell the person to relax and rest. He
should not try to exert .
7.Try to stop or slow down the bleeding; press with both hands on the wound with a clean cloth
or bandage. Alternatively, if possible, ask the injured to press on the bleeding wound himself to
stop the bleeding.
8. If you have a piece of clean (cotton) cloth, then cover the wound with it.If you have no
bandages, improvise with other materials.
9. You can also wrap a bandage around the wound to slow down the bleeding, but continue to
apply pressure until the bleeding stops.
Make sure the bandage is firm enough so it stops the bleeding but doesn’t cut off all the blood
flow.
If the part of the body below the bandage changes colour or is swelling or the injured person says
he is losing any feeling there, loosen the bandage a little but do not remove it. If the blood flow
to a limb is stopped an injured person can lose his limb.
10. Do not apply a tourniquet or fix a bandage above the wound, except in special situations (as
specified below)!

Only apply a tourniquet:

-If the bleeding of an external limb cannot be stopped by putting direct pressure on the wound, or
-If there are many casualties you have to give help to.
-The first aider has been well trained on how to apply a tourniquet.
If a tourniquet is applied on a bleeding limb:
a. apply it above the wound,
b. note down the time when the tourniquet is applied,
c. maximally have a tourniquet applied for 2 hours,
d. transfer the casualty as quickly as possible to a healthcare facility for further treatment.

11. If the bandage becomes soaked in blood, do not remove it, but add another bandage on top of
it and continue to apply pressure.
12. Take off jewels or anything else in the area of the wound that may cut off blood flow because
of swelling. Keep the jewels and belongings with the owner or in a safe place.
13. Keep the injured person warm by taking off wet clothing, covering him with a blanket or
other covering, taking care not to overheat him.
14. Keep checking for the bleeding and also check that the person is conscious and breathing
properly. If not breathing go for the CPR FLOW CHART .
15. Stay with the person until medical help is available.
16. Do not give the injured person anything to eat or drink.
17. Arrange transport to the nearest healthcare facility.

WHAT DO I DO IF AN OBJECT IS STUCK IN THE WOUND?

1. Do not remove the object

2. Check if the object caused an additional exit wound if it passed through; try to stop the
protruding object from moving (do not remove the object) with bulky material and bandages.
3. Build up padding around the object until you can bandage over it without pressing down.
4. Bandage the material above and below the object with a piece of clean (cotton) cloth or
improvise with other materials.
Make sure the bandage is firm enough so it stops the bleeding but doesn’t cut off all the blood
flow.
If the part of the body below the bandage changes colour or is swelling or the injured person says
he is losing any feeling there, loosen the bandage a little but do not remove it. If the blood flow
to a limb is stopped an injured person can lose his limb.

5. Do not apply a tourniquet or fix a bandage above the wound, except in special situations
Only apply a tourniquet:
-If the bleeding of an external limb cannot be stopped by putting direct pressure on the wound, or
-If there are many casualties you have to give help to, and
-The first aider has been well trained on how to apply a tourniquet.
If a tourniquet is applied on a bleeding limb:
a. apply it above the wound,
b. note down the time when the tourniquet is applied,
c. maximally have a tourniquet applied for 2 hours,
d. transfer the casualty as quickly as possible to a healthcare facility for further treatment.

6. If the bandage becomes soaked in blood, do not remove it, but add another bandage on top of
it and continue to apply pressure.
7. Take off jewels or anything else in the area of the wound that may cut off blood flow because
of swelling. Keep the jewels and belongings with the owner or in a safe place.
WHAT DO I DO WHEN I SUSPECT AN INTERNAL BLEEDING?
1. Ask the injured person to sit or lie down or make him comfortable.
2. Check the airway, breathing and circulation.
3. If there is also external bleeding: try to stop or slow down the external bleeding; press with
both hands on the wound with a clean cloth or bandage.
4. Keep the injured person warm by taking off wet clothing, covering him with a blanket or other
covering, taking care not to overheat him.
5. Keep checking that the person is conscious and breathing properly.
6. If the person stops breathing, start CPR.
7. Do not apply hot water bottles or ice bags to the chest or the abdomen.
8. The person needs to be transported urgently to the nearest healthcare facility.

IN SMALL MINOR INJURIES & ABRASIONS WOUND CAN BE CLEANED WITH RUNNING WATER AND FIRST
AID CAN BE DONE
AMPUTATION
Re-attachment of amputated limbs, fingers or toes might be possible if the injured and the
amputated part(s) arrive at the hospital as soon as possible.
In case of an amputation:
1. Control the bleeding by providing direct pressure to the wound. Put a clean cotton bandage on
the wound.
2. Place the amputated part in a clean plastic bag.
3. If possible, place the packed amputated part in a container of ice. Do not put ice directly on the
amputated part – the amputated part should always be packed in a clean plastic bag.

Do not put liquids or antiseptic products on the amputated part

4. Mark the package clearly with the casualty’s name and the time the amputation occurred.
5. Arrange urgent transport of the casualty and the amputated part to the nearest hospital.
6. Wash your hands after taking care of the patient. Use soap and water to wash your hands. If no
soap is available, you can use ash to wash your hands. Alcohol-based sanitizers can also be used,
if available.
Always urgently transport the casualty suffering an amputation injury to the nearest healthcare
facility, If the amputated part has been recovered, do not forget to send it together with the
casualty.

IF THERE IS CRUSH INJURY WITHOUT AMPUTATION THEN DO FIRST AID FOR BLEEDING AND SHIFT THE
PATIENT IMMEDIATELY TO HEALTH CARE FACILITY
IF THE INDIVIDUAL IS ABLE TO SUPPORT HIS FRACTURED LIMB THEN HE SHOULD BE ALLOWED TO DO
SO, AS THE FIRST AIDER SUPPORTING THE LIMB OF INDIVIDUAL WILL LEAD TO UNCESSARY MOVEMENT
OF FRACTURED LIMB AND FURTHER DISPLACEMENT AND INCREASED PAIN.IF THERE IS DOUBT ABOUT
FRACTURE INTERNALLY AND INDIVIDUAL EXPRESSES SEVERE PAIN THEN ALSO THE PART WITH PAIN AND
SWELLING CAN BE SPLINTED/IMMOVABLE SUPPORT.
ANIMAL BITES -
FIRST AID KIT
Steps in Psychological First Aid –
Psychological First Aid should be provided at the scene simultaneously with
physical first aid. Psychological first aid helps in prevention of Post Traumatic
Stress Disorder.
Summary

First Aid is temporary ,Immediate care for a person who is injured or who becomes
suddenly ill.

It does not replace the care of the Registered Physician /Hospital Care , Nurse ,
Paramedic.

Steps of Any First Aid

1.Safety First
2.Privacy & Consent
3.Evaluation of Injury/Person
4.Seek Help /Call Emergency Number
5.Give First Aid /Recovery Position/CPR
6.Take to Hospital Setting / Emergrency Personnel