first aid to the injured

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FIRST AID TO THE INJURED:

1 FIRST AID TO THE INJURED

FIRST AID TO THE INJURED:

2 FIRST AID TO THE INJURED First Aid is an immediate and temporary treatment given to casualty for any injury or sudden illness before the arrival of an ambulance or a Doctor.

THE AIMS OF FIRST AID:

3 THE AIMS OF FIRST AID First –Aid treatment is given to a casualty. To preserve life. To prevent the worsening of the casualty condition. To promote recovery.

RULES OF FIRST AID:

4 RULES OF FIRST AID Rules of First – Aid to check. An open airway, clearing the airways. Breathing, see the breathing rate i.e. 18 to 20 / minute. Circulation: To see the arteries pulse rate i.e. 72 / minute.

SCOPE OF FIRST AID :

5 SCOPE OF FIRST AID DIAGNOSIS : of a case is based on its history, sign, symptoms. HISTORY : is the accident occurred. SIGN : are the First – Aider faces and finds out for himself. SYMPTOMS : are what the casualty tells like pain, shivering and faintness TREATMENT : To be given until the doctor takes charge. DISPOSAL : To send the casualty to his house or hospital.

QUALITY OF FIRST – AIDER:

6 QUALITY OF FIRST – AIDER He should be calm, cool & confident. He should not get excited. He should ask some one to call a doctor or inform hospital immediately giving some details of cases. He should give First – Aid Methodically.

CONTENTS OF FIRST – AID BOX:

7 CONTENTS OF FIRST – AID BOX Sterilized Finger dressing Sterilized Foot & Hand dressing Sterilized dressing extra large Triangular bandage 100cms on border side. Roller bandage 5cms X 5mts. Crepe bandage Roller bandage 1 inch, 2 inch. 2.5 inch, 3.5 inch, 6 inch. Scissor 12.5 cms sharp

9. Splints set of six (3Arm/3Leg) 1st set each. 10. Tourniquet. 11. Sterilized Cotton 25 gms 12. Sevlon / Dettol Soap bottle of Tincture of Iodine 13. Safety pins 14. Torch 2 cells. 15. Record card in plastic cover. :

8 9. Splints set of six (3Arm/3Leg) 1 st set each. 10. Tourniquet. 11. Sterilized Cotton 25 gms 12. Sevlon / Dettol Soap bottle of Tincture of Iodine 13. Safety pins 14. Torch 2 cells. 15. Record card in plastic cover.

DRESSINGS AND BANDAGES:

9 DRESSINGS AND BANDAGES A dressing is a protective covering applied to a wound.

TYPES OF DRESSING :

10 TYPES OF DRESSING Adhesive dressing Non adhesive dressing Gauze dressing Improvised dressing

USES OF DRESSING:

11 USES OF DRESSING To prevent infection To absorb discharge To control bleeding to avoid further injury

APPLICATION OF DRESSINGS:

12 APPLICATION OF DRESSINGS Can get care must be taken in Harding & applying dressing wash your hands thoroughly Avoid touching any part of the wound with the fingers or any part of the dressing which will be in contact with the wound .

BANDAGES.:

13 BANDAGES . These are made from calico, cloth, it is a one meter of cloth & cut triangular, it becomes two bandages.

TYPES OF BANDAGES:

14 TYPES OF BANDAGES Triangular bandage Roller bandage crepe

USES OF BANDAGES:

15 USES OF BANDAGES Maintain direct pressure overdressing to control bleeding Retain dressing & slings in position Prevent or reduce swelling Provide support for limb or joint Restrict movement Assist in lifting & carrying casualties

TYPES OF KNOTS:

16 TYPES OF KNOTS 1. Reef knot 2. Granny knot 3. Clove hitch

SLINGS : USES OF SLINGS:

17 SLINGS : USES OF SLINGS To support injured arms To prevent pull by upper limp of injuries to chest, shoulder & neck

ROLLER BANDAGES :

18 ROLLER BANDAGES Face the patient When bandaging left limb, hold the head of the bandage in the right hand & vice versa Apply the outer side of the bandage over the pad & wind it around the injury twice. So that it is firm

Bandage from the below upwards over the limb. Also make it a rule to apply bandage from the inner side to the outer side. See that the bandage is neither too loose nor too tight. Roll bandage so that each layer covers two-thirds of the earlier layer :

19 Bandage from the below upwards over the limb. Also make it a rule to apply bandage from the inner side to the outer side. See that the bandage is neither too loose nor too tight. Roll bandage so that each layer covers two-thirds of the earlier layer

WIDTH OF ROLLER BANDAGES:

20 WIDTH OF ROLLER BANDAGES 1 inch for fingers & toes 2 ½ inches for head and arm 3 ½ inches for leg 6 inches for body

THERE ARE FOUR METHODS OF APPLYING ROLLER BANDAGES:

21 THERE ARE FOUR METHODS OF APPLYING ROLLER BANDAGES Simple spiral The reverse spiral Figure of eight The spica

THERE ARE FOUR METHODS OF SLINGS:

22 THERE ARE FOUR METHODS OF SLINGS The arm sling Collar & cuff sling Triangular slings Improvised slings

DIFFERENT TYPES OF TRIANGULAR BANDAGES:

23 DIFFERENT TYPES OF TRIANGULAR BANDAGES For the scalp For the forehead The shoulder Fronter back of the chest The elbow The hand The hip or groin The knee The foot The stump

STRUCTURE AND FUNCTIONS OF THE HUMAN BODY:

24 STRUCTURE AND FUNCTIONS OF THE HUMAN BODY STRUCTURE The skeleton forms the supporting framework of the body & consists of separate bones joined together by means of cartilage ligaments and muscles.

The parts of the skeleton are:-:

25 The parts of the skeleton are:- The skull The backbone or spine The ribs & breast bone The upper limbs bones The pelvis The lower limbs bones

1) THE SKULL:

26 1) THE SKULL Is the skeleton of the head and is made up of the following bones:-

Slide 27:

27 One on the top called the dome. One in the front corresponding to the face called frontal. Two-one on the either side called parietals. One behind corresponding to the back of the head called occipital. Two forming the roof of the mouth or the upper jaw.

Slide 28:

28 The skull contains the brain and has bony provision for formation of eyes, ears & nose. It is rounded in shape and has an opening at the bottom, through which the spinal cord enters the vertebral column. The lower jaw is a separate single bone which is attached to the skull. One has to be familiar with the position of the angle of the jaw because this has to be pressed

Slide 29:

29 forward in case of an unconscious victim to prevent the fall back of the tongue which impedes the airway. When a blow on the head causes bleeding grom torn vessels inside the closed box of brain, the blood is unable to escape and gets collected and presses the brain

Slide 30:

30 tissue. This leads to headache irritability unconsciousness and may cause death. This dangerous development makes it important to place all persons to head injury under care of medical supervision.

2) THE BACKBONE OR SPINE ( VERTEBRAL COLUMN ):

31 2) THE BACKBONE OR SPINE ( VERTEBRAL COLUMN ) It consists of thirty-three small rounded pieces of bones, each called vertebra, placed one above the other.

Slide 32:

32 7 in the Neck Region ( Cervical ) 12 in the Back Region ( Thoracis or Dorsal ) 5 in the Waist Region ( Lumber ) 5 in the Hip Region ( Special ) 4 in the Tail Region ( Coccygial )

Slide 33:

33 In between each vertebra there is a thick place of cartilage “disc” which allows movement as well as acts as a shock absorber. There is a central canal through which the spinal cord passes and carries nerves impulses to and from the brain. If there is any injury, one vertebra may be displaced over another, thus the spinal cord is pressed

Slide 34:

34 or cut causing paralysis, due to interruption in the pathway of nerves. This damage may occur immediately at the time of injury or may be caused by careless handling after the accident. It is therefore extremely important to handle with care all persons who have suffered severe injury to their back or neck.

3) THE RIBS & BREAST BONE ( STERNUM ):

35 3) THE RIBS & BREAST BONE ( STERNUM ) There are twelve pairs of ribs which are attached to the corresponding vertebrae at the back. The first seven pairs of these ribs are attached to the breastbone in front, eight, ninth & tenth ribs are attached to the rib above and last two pairs of ribs,

Slide 36:

36 i.e. eleventh and twelfth, have no attachment in front and are known as floating ribs. The ribs and breastbone are liable to be fractured in accidents due to either direct or indirect causes. An injury of the rib should be taken seriously and requires urgent hospitalization.

4) THE UPPER LIMB & SHOULDER:

37 4) THE UPPER LIMB & SHOULDER The bones are the collar bone (clavicle ) one on each side between upper part of the breastbone on the front & shoulder joint, the shoulder blade (scapula ), The clavicle is a very brittle bone, and is the common site of fracture. Its function is to keep away the upper limb from the chest.

5) SHOULDER BLADE ( SCAPULA ):

38 5) SHOULDER BLADE ( SCAPULA ) One on each side in the upper & other part on the back of the chest.

THE BONES OF THE UPPER LIMBS ARE:

39 THE BONES OF THE UPPER LIMBS ARE Upper arm bone ( Humerus ) Forearm bones :-There are two bones 1) Radius ( outer side of foreman) 2) Ulna (inner side of forearm) (The joint between upper arm & forearm is called elbow joint ). There are three small bones in each finger called phalanges & two bones for each thumb.

6) THE PELVIS & LOWER LIMBS ::

40 6 ) THE PELVIS & LOWER LIMBS : The two hip bones joined together form the pelvis . The pelvis forms a basin shaped cavity which contains intestines, urinary bladder and reproductive organs. There are two sockets on either side of the pelvis where the thigh bones join, forming the hip joint.

Slide 41:

41 Femur or the thigh bone is the longest & strongest, bone in the body. Its upper end forms a part of the hip joint while its lower end forms a part of the knee joint. The upper end of the femur is easily liable to fracture in old age due to even minor falls. Knee cap ( Patella ) is a small bone over the front of the knee joint lying loosely in the muscles ligaments and under the skin.

Slide 42:

42 The bone of the leg are the shin bone ( tibia ) and the brooch bone ( fibula ). The tibia extends from the knee to the ankle, in both of which joints it plays an important part. Its sharp edge can be felt immediately beneath the skin of the front of the leg. The fibula lies on the outer side of the tibia. It does not enter into a formation of the knee joint but its lower end forms the outer part of the ankle-joint.

THE BONES OF THE FOOT ::

43 THE BONES OF THE FOOT : These comprise 7 irregular bones-tarsus at the instep. The largest the heel bone and the uppermost forms the lower part of the ankle joint. Five long bones ( metatarsus ) in front of the instep support the toes. The toe bones ( phalanges ) are 14 in numbers two in the big toe and three in each of the other four toes.

JOINTS ::

44 JOINTS : Joints are at the junction of two or more bones. There may be no movements as in skull, or there may be free movements as in knee, elbow shoulder and hip joints. In movable joints, the ends of the bones are covered by cartilage and is overall again encased in capsule with some lubricant material inside the joint. e.g. ball & socket, elbow hinge joint. Gliding joint, e.g. in the wrist, the feet, in between ribs.

MUSCLES ::

45 MUSCLES : Muscles to the layman mean flash and are primarily meant to produce movements of the limbs & organs. There are broadly two types of muscles viz. voluntary muscles which can cause movements under the dictates of will & involuntary muscles like those found in the heart which continue to work even without the dictates of the will.

NERVES & STIMULI ::

46 NERVES & STIMULI : The muscles go into action called contraction by stimuli of nerves arising from brain or spinal cord carrying motor impulses. The damage to the nerves result in paralyses of the muscles.

LIGAMENTS ::

47 LIGAMENTS : Thickened portions of a joint capsule are called ligaments. They check movements beyond normal permissible limits. If there is simple injury to the ligaments of the joints, it is called sprain.

STRAINS & RUPTURES ::

48 STRAINS & RUPTURES : A strain is caused by overstretching of a muscle. It generally happens as a result of a twist or a sudden effort such as lifting a heavy weight. A few muscles or tendon fibers will be torn. A rupture ( or tear ) is a more serious injury a entire muscle bundle or tendor is torn across. The sudden publing of the calf muscle is common example of a rupture.

SIGN & SYMPTOMS ::

49 SIGN & SYMPTOMS : There is a sudden sharp pain at the muscle. The muscle may smell & feel stiff. In a rupture there is a severe pain & casualty cannot move the injured part.

AIMS OF THE FIRST AID :

50 AIMS OF THE FIRST AID To reduce pain To give rest & support of the part. To get medical Aid.

T R E A T M E N T:

51 T R E A T M E N T Place the casualty in the position most comfortable to him. Support the injured part ( use a sling in case of a upper limb & a crutch or a stick for a lower limb ). Apply a cold compress. If he has to travel a long distance immobilizes the limb as in fracture.

SPRAINS ::

52 SPRAINS : A sprain is the tearing of the ligaments of a joint or the tissues round the joint.

SIGN & SYMPTOMS:

53 SIGN & SYMPTOMS There is a severe pain at or near the joint. The casualty cannot move the joint. The joint looks deformed & limb assume as an unnatural position. Later there is swelling.

AIM OF THE FIRST AID:

54 AIM OF THE FIRST AID To immobilize the joint To reduce pain.

T R E A T M E N T:

55 T R E A T M E N T In the case of the shoulder support the limb in the most comfortable position. Place a pad of folded . Newspaper or cloth between the arm and the body. Bandage the arm to the body. Place the casualty on a bed in the position most comfortable to him. Support the limb on pillows or cushions.

IN THE CASE OF THE LOWER JAW ::

56 IN THE CASE OF THE LOWER JAW : Support the lower jaw by a bandage tied over the top of the head.

IN THE CASE OF THE ELBOW JOINT ::

57 IN THE CASE OF THE ELBOW JOINT : Apply a large arm sling and take the casualty to a hospital.

FRACTURE:

58 FRACTURE A fracture is the partial or complete breakage of a bone

CAUSES OF FRACTURES:

59 CAUSES OF FRACTURES

1.DIRECT FORCE ::

60 1. DIRECT FORCE : The none breaks at the spot of application of force. e.g. bullet passing into bones, severe fall on a projecting stone or a wheel passing over the body etc.

2. INDIRECT FORCE : :

61 2. INDIRECT FORCE : The bone breaks away from the spot of application of force e.g. collar bone fracture. When the fall is on, out stretched hand etc.

3. FORCE OF MUSCULAR ACTION : :

62 3 . FORCE OF MUSCULAR ACTION : When there is a violent contraction of a group of muscles. This happens very rarely. e.g. fracture of ribs on violent cough.

TYPES OF FRACTURES ::

63 TYPES OF FRACTURES :

1. SIMPLE ( CLOSED ) FRACTURE ::

64 1. SIMPLE ( CLOSED ) FRACTURE : The broken ends of the bone do not cut open the skin and show on the outside.

2. COMPOUND ( OPEN ) FRACTURE ::

65 2. COMPOUND ( OPEN ) FRACTURE : When the fractured bone is in contact with outside air as a result of an injury ( so that dirt ) dust & germs get into the protruding bone and the wound.

3. COMPLICATED FRACTURE ::

66 3. COMPLICATED FRACTURE : In addition to the fracture, an important internal organ like the brain or major blood vessels, spinal cord, lungs, liver, spleen etc. may also be injured. Further more a complicated fracture may be simple or compound.

SIGN AND SYMPTOMS ::

67 SIGN AND SYMPTOMS : Pain at the spot of fractures and / or around it. Tenderness i.e. pain on gentle pressure over the injured spot. ( Do not press hard ) Swelling of the area and discoloration. Loss of normal movements of the part.

Slide 68:

68 5. Deformity of limb : The limb may lose its normal shape. Sometimes the muscles will pull up the lower free ends, causing apparent shortening of the limb. 6. Irregularity of the bone : If as in the leg bone, the break is under the skin, the irregular outline of the bone can be felt easily.

Slide 69:

69 7. Crepitus ( grating ) : When one end of the broken bone moves against the other, and crackling sound is heard, which is known as crepitus. Unnatural movement at the spot of fracture can be felt.

THE AIMS OF THE FIRST AID:

70 THE AIMS OF THE FIRST AID To prevent further damage. To reduce pain. To make the patient feel comfortable. To get medical aid as soon as possible. Handle very gently, avoid all unnecessary movements of the injured part Treat for shock.

TREATMENT USING BANDAGE:

71 TREATMENT USING BANDAGE Steady and support the injured part immediately. By using bandages. By using splints where available and where a First Aider is confident of their use. Do not apply bandage over the area of fracture.

Slide 72:

72 As the patient will be lying down the bandages should be passed through the natural hollows like the neck the lower part of trunk knees and just above the ankles. So that patient’s body is not jarred. Always tie knots on the sound side.

USING SPLINTS ::

73 USING SPLINTS : A splint is a rigid piece of wood or plastic or metal applied to a fractured limb to support it and the prevent movements of the broken bone. Reasonably wide splints are better than narrow ones. They should be long enough so that the joints above and below the fractured bone can be made immobile.

Slide 74:

74 The splints should be well padded with cotton or cloth so as to fit softly and snugly on the injured limb. Splints are best applied over the clothing. Use of splints becomes obligatory only when, e.g. both legs or both thigh bones are broken.

FRACTURE OF THE SKULL : :

75 FRACTURE OF THE SKULL : Fracture of the skull may injure the brain nervous system or the arteries and may cause concussion & compression.

There are two varieties of skull fractures ::

76 There are two varieties of skull fractures : Fracture of the dome or side. Fracture of the base.

a) FRACTURE OF THE UPPER PART OR SIDES:

77 a) FRACTURE OF THE UPPER PART OR SIDES This is caused by direct blow or fall upon the head. There will be swelling with a longish or circular, irregularity of the bone.

b) FRACTURE OF THE BASE OF THE SKULL:

78 b) FRACTURE OF THE BASE OF THE SKULL This is caused by indirect injury, for example fall on the feet, fall on the lower part of the spine. Severe blow on the lower jaw and rarely by a severe blow on the side of the head.

Slide 79:

79 Blood or brain-fluid may flow from the ear or nose. Which may be swallowed and cater vomited. If the injury affects the bony socket of the eye, the eyes become blood spot.

MANAGEMENT ::

80 MANAGEMENT :

1. If breathing is soft & normal : :

81 1. If breathing is soft & normal : Lay the casualty on his back with head & shoulders slightly raised by cushions b. Turn the head to one side ( if there is bleeding from the ear, the head should be turned so that the bleeding side is down).

2. If breathing is noisy with bubbling of air through secretions in the chest ::

82 2. If breathing is noisy with bubbling of air through secretions in the chest : Lay the casualty in the there-quarter-prone position. Support him in this position by pads in front of the chest and draw up the casualty’s upper knee. Keep the air passages clear. In cases with bleeding from the ear arrange the position of casualty so as to keep this side the face down.

Slide 83:

83 Treat for shock Keep careful watch on the casualty. Do not give anything to drink. Do not rouse him. Maintain the same position in transport avoid disturbing the casualty.

FRACTURES OF THE LOWER JAW:

84 FRACTURES OF THE LOWER JAW This is mostly the result of direct force. Usually one side is affected but rarely both sides may be fractured. In most cases this fracture is, a compound. There is usually a wound inside the mouth.

SIGNS & SYMPTOMS ::

85 SIGNS & SYMPTOMS : The casualty has difficulty in speaking / opening mouth. His spittle becomes blood stained. There is pain, which is increased by speaking & swallowing. The face & lower jaw becomes swollen.

Slide 86:

86 The teeth look irregular, some teeth may have fallen out. There may be crepitus, it can be felt both by the patient & First Aider, when they try to steady the jaw. If there is an injury of the tongue, it may fall back & block the air passage & there will be profuse bleeding.

MANAGEMENT:

87 MANAGEMENT Ask the casualty not to speak. Make sure the tongue does not slip back ensure an open air way. Place a narrow bandage under the chin carry one end up & over the top of the head, cross with the other and over the ear. Carry the shorter end across the front of forehead and the longer and in the opposite direction around the back of the head. Tie just above the opposite ear.

Slide 88:

88 If the casualty shows signs of vomiting remove the bandage and tie it up again after vomiting stops. Remove him to hospital.

SUFFOCATION AND ARTIFICIAL RESPIRATION SUFFOCATION ( ASPHYXIA ):

89 SUFFOCATION AND ARTIFICIAL RESPIRATION SUFFOCATION ( ASPHYXIA ) Asphyxia is a condition in which the lungs do not get sufficient supply of air for breathing. If this continues for some minutes, breathing & heart action stop & death occurs.

A CAUSES ::

90 A CAUSES : 1. SPASM : Food going down the wrong way i.e. into the air passage. Water getting into the air passage like drowning. Irritant gases ( Motor – exhaust fumes, smoke ).

B. OBSTRUCTION ::

91 B. OBSTRUCTION : Foreign body like artificial teeth. Tongue falling back in an unconscious patient.

C. COMPRESSION ::

92 C. COMPRESSION : Tying a rope or scarf tightly around the neck, causing strangulation. Hanging or throttling.

D. CONDITIONS AFFECTING THE RESPIRATORY MECHANISM ::

93 D. CONDITIONS AFFECTING THE RESPIRATORY MECHANISM : Epilepsy, Tetanus, Rabies etc. Nervous diseases causes paralysis.

E. CONDITION AFFECTING RESPIRATORY CENTRE, LIKE SLEEPING TABLET :

94 E. CONDITION AFFECTING RESPIRATORY CENTRE, LIKE SLEEPING TABLET Lack of oxygen at high attitudes with low atmospheric pressure.

SIGN & SYMPTOMS:

95 SIGN & SYMPTOMS Rate of breathing increases. Breath gets shorter. Jugular vein of the neck become swollen. Face, Lips, nails, fingers & toes turn blue. Pulse gets faster & feebler. Consciousness is lost totally or partially. Froth may appear at the mouth & nostrils. Fits may occur.

ARTIFICIAL RESPIRATION ::

96 ARTIFICIAL RESPIRATION : Respiration means breathing in and breathing out of air. This functions is necessary to supply oxygen to all the organs in the body. Stoppage of oxygen supply to the organs result in death.

THE ORGANS CONNECTED WITH RESPIRATION ARE ::

97 THE ORGANS CONNECTED WITH RESPIRATION ARE : The Air passage The lungs The air passage consists of the Nose , the Throat ( Pharynx ) the Windpipe ( Trachea ) Two air tubes ( Bronchi )

THE MECHANISM OF RESPIRATION ::

98 THE MECHANISM OF RESPIRATION : During inspiration ( breathing in ) the diaphragm ( The muscle separating the chest capacity from above downwards ). The ribs move upwards and forwards. The lungs expand & air enters them.

Slide 99:

99 During expiration ( breathing out ) the diaphragm comes back to its original state & ribs fall back. Thus forcing the air out of the lungs. The nerves which are connected to the area in the brain called Respiratory centre.

MOUTH TO MOUTH:

100 MOUTH TO MOUTH Place the casualty on his back. Hold his head tilted back. Take a deep breath with mouth open widely. Keep nostrils of casualty pinched. Cover the mouth of casualty with your mouth handkerchief.

Slide 101:

101 Watching the chest, blow into his lungs until the chest blows up. Withdraw your mouth note the chest falls back. If the chest does not rise ( as in 5 above ) look for an obstruction. Use mouth to nose respiration. If the heart is not working you will notice the following : The face is blue or pale. Heart beats & pulse at roof of neck carotid pulse not felt.

EXTERNAL HEART COMPRESSION : CPR CARDIO PULMONARY RESPIRATION:

102 EXTERNAL HEART COMPRESSION : CPR CARDIO PULMONARY RESPIRATION This should go on along with artificial respiration. Feel & mark the lower part of sternum. Place the heel of your hand on the marked part. With your right arm press the sternum, backward towards the spine ( it can be pressed 1 to 1.5 inches in adults. Adults should be given about 60 pressure a minute)

IF THE TREATMENT IS EFFECTIVE ::

103 IF THE TREATMENT IS EFFECTIVE : Color will become normal Pupil will contract as improvement begins. Carotid pulse begins with each pressure.

ASPHYXIA ( SUFFOCATION ) AND ARTIFICIAL RESPIRATION ::

104 ASPHYXIA ( SUFFOCATION ) AND ARTIFICIAL RESPIRATION : Respiration means breathing in and breathing out of air. This function is necessary to supply oxygen to all the organs in the body. Stoppage of oxygen supply to the organs result in death.

THE ORGANS CONNECTED WITH THE RESPIRATION ARE ::

105 THE ORGANS CONNECTED WITH THE RESPIRATION ARE : The air passage Lungs.

Slide 106:

106 The air passage consists of the nose, the throat ( pharynx ) the wind pipe ( trachea ) & two air tubes ( bronchi ). The lungs are two in number & situated on the right & left sides of the chest cavity. Each lung is made up of a number of small sacs called alveoli. The lungs are covered by a membrane called pleura which lines the inner wall of the chest cavity.

THE MECHANISM OF RESPIRATION ::

107 THE MECHANISM OF RESPIRATION :

Slide 108:

108 During inspiration ( breathing ) the diaphragm ( the muscle separating the chest from the abdominal cavity ) flattens and increases the chest capacity from above downwards. The ribs move upwards and forwards increasing the capacity of the chest cavity from front to back by the action of the muscles situated between the ribs. The lungs thus expand and air enters them.

Slide 109:

109 During expiration ( breathing out ) the reverse process takes place. The diaphragm comes back to its original state & the ribs fall back. Thus forcing the air out of the lungs. Asphyxia is a condition in which the lungs do not get sufficient supply of air for breathing. If this continues for some minutes, breathing & heart action stop & death occurs.

CAUSES OF ASPHYSIA : :

110 CAUSES OF ASPHYSIA : Food going down the wrong way i.e. into the air passage. Water getting into air passage, as in drowning. Irritant gases ( coal gas, exhaust fumes smoke, gas in deep unused wells etc. ) getting into the air passage. Mass of food or foreign body, like artificial teeth in the air passage.

Slide 111:

111 Tongue falling back in an unconscious patient. Swelling of tissues of the throat as a result of scalding ( boiling water ) or injury, burns. Tying a rope or scarf tightly around the neck causing strangulation. Hanging or throttling ( applying pressure with fingers on the wind pipe ). Something like overlaying an infant an in conscious per lying face downwards on pillow or plastic bags or sheets covering face completely for some time.

SIGN & SYMPTOMS ::

112 SIGN & SYMPTOMS : Rate of breathing increases. Breath gets shorter Veins of the neck become swollen Face, lips, nails, fingers & toes turns blue. Pulse gets faster & feebler. Consciousness is lost totally or partially, Froth may appear at the mouth & nostrils. Fits may occur.

MANAGEMENT ::

113 MANAGEMENT : Remove the cause if possible or remove the casualty from the cause. Ensure an open airway to allow the air to reach the lungs. Place the individual on his back. Support the nape of the neck on your palm & press the head backwards. Then press the angle of the jaw forward from behind. This will extend the head on the neck & lift the tongue clear off the airway. If airway is opened by this method the individual gasps and starts to breathe or give artificial respiration & check heart beating & carotid pulse can be felt at the base of the neck.

DIFFERENT KINDS OF ASPHYXIA ::

114 DIFFERENT KINDS OF ASPHYXIA : Drowning Hanging Choking Swelling within the throat Suffocation by smoke Poisonous gases.

Slide 115:

115 All above, different kinds of asphyxia give Sylvester's or mouth to mouth or mouth to nose method.

MOUTH TO MOUTH METHOD & TO MOUTH TO NOSE :

116 MOUTH TO MOUTH METHOD & TO MOUTH TO NOSE Place the casualty on his neck. Hold his head tilted back. Take a deep breath with mouth open widely. Keep nostrils of casualty pinched. Cover the mouth of the casualty with your mouth smugly.

Slide 117:

117 Watching the chest, blow into his lungs until the chest bellows up. Withdraw your mouth. Note the chest falls back. Repeat the above 15 to 20 times a minute. If casualty is young the operations are as above, but your open mouth should cover blow into his lungs & nose of the casualty and blow gently. Repeat the above 15 to 20 times a minute till casualty comes in conscious.

SHOCK:

118 SHOCK Shock is a symptom complex condition of collapse (depression of vital functions) which should be treated on top priority second only to attending to obstructed breathing, stoppage of heart, or severe bleeding. It may lead to death. If not treated in time.

TYPES AND CAUSES:

119 TYPES AND CAUSES Shock can be divided into two Types: Nervous shock and True shock.

NERVOUS SHOCK:

120 NERVOUS SHOCK It is due to strong emotional upset, e.g. fear, pair, or bad news: and not necessarily due to a serious injury. Does not need treatment, as such, except for reassuring and sympathetic handling.

TRUE SHOCK:

121 TRUE SHOCK It is seen in the following accidents:

1.SEVERE BLEEDING:

122 1. SEVERE BLEEDING Shock is produced due to loss of blood. It may develop at once or be delayed. Bleeding may be seen outside when coming out of a cut artery or the tear of a varicose vein: or it may be inside: for example, bleeding into the chest or abdominal cavity. The faster the loss of blood the faster the onset of shock. But beware of slow loss of blood, which will appear to be simple at first but later may become very serious.

2.SEVERE BURNS:

123 2.SEVERE BURNS When extensive, i.e. when more than 15% of the skin surface is affected.

3. HEART ATTACKS:

124 3. HEART ATTACKS When the blood supply to the heart is obstructed

4.ABDOMINAL EMERGENCIES:

125 4.ABDOMINAL EMERGENCIES Like burst appendix, perforated stomach, intestinal obstruction etc.

5. CRUSH INJURIES:

126 5 . CRUSH INJURIES As in collapsed building, explosion etc.

6. LOSS OF BODY FLUID :

127 6. LOSS OF BODY FLUID Due to excess of vomiting, diarrhea, dysentery etc.

7.BACTERIAL INFECTIONS:

128 7. BACTERIAL INFECTIONS Discharge of poisons ( Toxins ) into the blood caused by bacteria or by excessive soft tissue damage.

SIGNS AND SYMPTOMS OF SHOCK:

129 SIGNS AND SYMPTOMS OF SHOCK Casualty feels faint or giddy Complaints of blurring of vision Feels cold with clammy skin Face and lips look pale Pulse may become slow at first but later always beats faster but gets feeble. Nausea / vomiting Becomes unconscious in later stages of shock

MANAGEMENT:

130 MANAGEMENT Reassure the casualty ( when conscious ). Put him comfortably on his back. However, in cases of injury of the head, chest or of the abdomen, lower the head slightly and turn it to a side. In cases of vomiting place in the three-quarter prone position ( Recovery position ) Loosen tight clothing, do not remove clothing. Wrap in light bed sheet or thin rug

Slide 131:

131 Never use hot water bottles or very warm rugs. Do not rub any part of the body with anything . In cases of injuries to chest or abdomen, nothing should be given by mouth as he may later need an operation or blood transfusion. Observe all the above quickly as even a minutes delayed may mean death. If there is no chest or abdominal injury and the patient is conscious, give sips of water, hot tea, coffee or coconut milk ( Never give any alcoholic drinks ). Most important: Remove to hospital on top priority.

ELECTRICAL INJURIES / SHOCK:

132 ELECTRICAL INJURIES / SHOCK CAUSES OF ELECTRICAL INJURIES

Slide 133:

133 If any part of the body comes in contact with a ‘live’ wire which is exposed and not covered by insulator, or with a cable or rail in which current is leaking, a person gets an electric shock. In houses the blowing out of switches or fuses or faulty electrical connections can cause much injury. The injury may be quite mild or so severe as to cause immediate death.

Slide 134:

134 Electrical shock is produced only when an electric current passes through the human body which is in contact with earth. It passes even more quickly if the part is wet. In wet conditions even lower voltage may be dangerous. A very strong current passing to earth through lower limbs may be less dangerous than a weaker current passing through the chest, especially so when it enters through the hands and arms.

THE EFFECT OF ELECTRIC SHOCK:

135 THE EFFECT OF ELECTRIC SHOCK breathing has stopped. In this There may be fatal paralysis of heart There may be sudden stoppage of breathing due to paralysis of muscles used in breathing. Heart may continue to beat, while condition the face appears blue. There may be burns, either superficial or deep. They depend on the strength of the electric current causing the injuries.

MANAGEMENT:

136 MANAGEMENT Intelligent and prompt action is required if the first aider is not cautious he may also receive severe electric shock or even die along with the casualty. 1. If the casualty is still in contact with the source, switch off the current. If the switch is not to be found, remove the plug or cut off the current by breaking the wire. Before cutting off the current, ensure that you stand on a dry piece of wooden board. Do not use scissors or knife.

PRECAUTIONS:

137 PRECAUTIONS When the current is of low voltage the first aider should stand on an insulated material which is dry. Insulating materials are rubber / soled shoes, wooden planks or piles of newspaper. Rubber gloves, if available should be worn. If not, dry coat, cap or other clothing may be used. Folded newspapers also give protection.

Slide 138:

138 When the current is of a very high voltage, as in the cases of over-head ( high tension ) lines, there is a greater danger. The casualty may not be in actual contact with the wire as the current can pass through the gap ( causing an arc ). The first Aider in such circumstances should keep as far away as possible from the electric wires. The casualty is to be dragged out by means of a non / conducting material. A walking stick, dry bamboo, wooden plank or a dry rope is to be used.

Slide 139:

139 If the casualty is not breathing normally, or heart has stopped beating, give artificial respiration and external cardiac message for long time ( C.P.R. ) Treat for shock Treat for burns, if any Transfer to a hospital, or seek the help of a medical practitioner, who is nearest. Even when the casualty has recovered fairly well after first aid is given he must be examined by a medical doctor if necessary.

NOTE :

140 NOTE Reassure the casualty and stay with him at all times. Do not give him anything to eat or drink it will delay subsequent administration of an anesthetic . Do not apply hot water bottles- this will increase the blood flow to the skin and take it away from the vital organs. Do not allow the casualty to smoke.

ELECTRIC SHOCK:

141 ELECTRIC SHOCK Electricity is dangerous. It should be respected and feared. The result of electrocution is death. The cause of death due to one of the following or all combined.

Slide 142:

142 1. Asphyxia or suffocation due to contraction of muscles of breathing mechanism. 2. Ventricular Fibrillation due to passage weak current through the heart. 3. High blood pressure due to heat of the current causing cerebral hemorrhage. 4. Third degree burns.

Slide 143:

143 The above facts depend upon the electrical pressure, flow of the current though the body and duration of time. Victims who electrocuted tell that the low voltage is dangerous. The laboratory tests have shown that the resistance of the skin of the hand when dry is 4,000 ohms per cm2. When the hand is wet or perspired the resistance comes down to 1,000 ohms / cm2. Internal body resistance is estimated 200 ohms / cm2.

Slide 144:

144 Once the current enters the body, the muscles of breathing mechanism contract and asphyxiates, in case of low voltage, the victim could not relieve himself from the contact, and passage of weak current through the heart, ventricular fibrillation ( i.e. heart pumps contract and dilate. Instead, they flutter corresponding to the frequency of the cycle which do not come to normalcy ) occurs. Heart stops.

Slide 145:

145 In case of high voltage the contraction of the muscles is so violent the victim is thrown out of contact. If the contract is continued in high voltage, due to heat the blood pressure is so raised that the blood vessels in the brain burst causing cerebral hemorrhage. Further, where the victim came with contact with circuit, there will be deep burns in the contacted area, but the area of the exit of the current is widely burnt.

TREATMENT:

146 TREATMENT Give artificial respiration by mouth to mouth or mouth to nose. If the heart has stopped, start C.P.R. ( External ) Cardiac Pulmonary Resuscitation. Compression of the breast bone. Continue this operation till the natural breathing and heart beats. If both not started continue the operation until the Doctor declares the victim dead.

THANK YOU:

147 THANK YOU