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First Aid is the temporary help given to an injured or a sick person before professional medical treatment can be provided. This timely assistance, comprising of simple medical techniques, is most critical to the victims and is, often, life saving. Any layperson can be trained to administer first aid, which can be carried out using minimal equipments. Basic training in first aid skills should be taught in school, in work places and, in general, be learnt by all, as it is mandatory to our modern and stressful life.

First aid is the help that you give someone quickly after they have hurt themselves or have had an accident . It can stop a person from becoming more ill. In some cases, it can even save a person’s life. Only someone who knows first aid well should try to treat an injured or sick person. Usually, you give first aid until a doctor or an ambulance arrives. Never try to give someone first aid unless you know what to do. The wrong actions can do moreharm than good.

Call for help
When someone has been hurt or has had an accident, the first thing to do is get help. If you don’t know the phone number of the local doctor or hospital dial an emergency number: 144 for an ambulance , 133 for the fire department and 122 for the police. When you call for help you should be able to give correct information. An ambulance needs to know where the injured person islocated and what exactly has happened. In some cases, you will be given instructions on what to do until a doctor or ambulancearrives.

Immediate help
Sometimes you cannot wait until help arrives. You must begin helping a person at once, especially if the victim is bleeding strongly, has been poisoned or if breathing has stopped. Even if you wait for a short time this can be fatal . Here are some important rules forimmediate help Do not move a person who may have a broken bone , internal injuries or an injured spine unless you really have to. If the victim is lying down, keep the person in that position. Do not allow them to walk or stand up. Never give food or liquid to a person who may need an operation. If the victim is unconscious turn the head to one side to keep the person from choking . But do not move the head of a person who may have a spinal injury . Never give water to a person who is unconscious .

Make sure that the victim has an open airway . The nose, mouth and throat should be clear in order for them to breathe . Make the victim comfortable, but touch a person only if you have to. If necessary move the victim away from the sun or put them into the shade . Remain calm and talk to the injured person. Explain what is being done and say that help is on its way.

Sometimes the tongue blocks the airways – Make sure that the victim can breathe.
Shock treatment

If the blood in your body does not circulate properly it may result in shock. Any serious injury or illness may lead to shock. When a person is in shock blood does not carry enough oxygen and food to the brain and other organs. A victim who suffers from shock may look afraid, confused , weak and be extremely thirsty . The skin appears pale and feels cold. Pulse and breathing are fast . To treat shock, place the victim on his or her back and raise the legs a little. Warm the victim by putting blankets around them.

Bleeding
Strong bleeding can cause death in minutes. Bleeding from small wounds usually stops after a short time because the blood clots . Butclotting cannot stop the flow of blood when a wound is big. The best way to stop bleeding is to press on the wound itself. If possible let the person lie down and raise the bleeding part of the body. Then put a sterile handkerchief , cloth or towel on the wound and press it down with your hand. Do with for 10 to 20 minutes until help arrives. Sometimes direct pressure cannot stop strong bleeding . If the leg or arm is hurt you can try to stop bleeding by putting pressure on the artery that carries blood to the injured body part.

Poisoning
There are four ways in which a victim may be poisoned . Poison may be swallowed , inhaled, injected or absorbed through the skin. If a poison victim becomes unconscious or has difficulty breathing call for an ambulance immediately . A person who has swallowed something poisonous may die within minutes if they are not treated . The first step is to find out what kind of poison the person has swallowed. Call a doctor or a poison control centre immediately and follow the instructions that you are given carefully. If a person has inhaled a poison like carbon monoxide or chlorine gas move him or her to fresh air at once. Open all doors and windows . Injected poisons are those that come from insect stings or bites. If you are stung by a bee the stinger remains in the wound .Remove it carefully and put ice on the sting or run cold water over it. If a person is bitten by a tick pull out the remaining part carefully and slowly . Use a glove or something else but not your bare hands. Do not try to burn it off or put oil on it. If a rash or flulike symptoms develop in the following weeks contact a doctor. Sometimes a victim may have an allergy towards bite or stings . In such a case either call a doctor , an ambulance or take the person to the nearest hospital . Poisons can also be absorbed through the skin if you get in contact with poisonous plants or chemical substances . In such a caseremove all the clothes that someone is wearing and flush the skin with water for about 10 minutes.

Artificial respiration
Begin with artificial respiration as soon as possible if a person has stopped breathing. Two or three minutes without breathing cancause brain damage and six minutes can be fatal . The most efficient way is mouth-to mouth resuscitation. Put the victim on their back . Kneel down , press the nose together and place your mouth over the mouth of the victim . Take a deep breath and blow hard enough to make the chest rise . Then remove your mouth and listen for the air to come out . Then repeat the procedure . Do this until the victim starts breathing again or until help has arrived.

Artificial Respiration

Burns

The first aid treatment of burns depends on how severe the burns are. Firstdegree burns show a reddening of the skin. Second degree burns damagedeeper skin layers and third degree burns destroy tissue of deeper layers of skin. To treat a first and second degree burn put ice on it or run cold water over it. Then put on sterile bandages . A person who has third degree burns should not betreated at home . When you treat burns never open blisters and do not put oil or other greasy substances on the burn.

Frostbite
Frostbite occurs when a person has been in extremely cold weather for a long time. It mostly affects the skin of the ears, fingers , nose or toes . Frostbitten skin appears pale or grayish blue and feels numb . It should be treated gently . Warm the affected area with theheat of your hand or cover it with clothes until you can get the victim indoors. Thaw the skin by putting it in lukewarm water. Never use water that is hotter than 40°C. If you get blisters do not open them.

First aid kits
It is a good idea to have a kit with first aid supplies at home or in your car when you travel. It should include bandages , tissue , something to write on, a flashlight , scissors , safety pins , a spray or a lotion that kills germs . Always have a blanket ready to cover a person.

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Basic First Aid Procedures
Quick Tips #207
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Levels of Training
In the workplace, it is often the job of a Certified First Aid Provider to assist in stabilizing an injured or ill person until professional medical help arrives. Certified First Aid Providers are persons who are certified and trained to certain levels in first aid and CPR (Cardiopulmonary Resuscitation). 29 CFR 1910.151(b) states, “In the absence of an infirmary, clinic or hospital in near proximity of the workplace which is used for the treatment of all injured employees, a person or persons shall be adequately trained to render first aid. Adequate first aid supplies shall be readily available.” First Responder is a trade name for a 40-hour certification course in advanced first aid and CPR. This course is taught by hospitals, technical colleges or fire departments, and certification must be updated bi-annually. Basic First Aid and CPR courses are approximately eight hours long and are certified through a number of nationally recognized organizations, such as The American Red Cross, The American Heart Association and The National Safety Council, to name a few. These certifications also should be updated bi-annually. Informed, trained citizens are indispensable in helping people in emergencies. To help citizens be more prepared for emergency situations, the American Red Cross trains people in first aid and CPR. Due to the increased need for first aid services, the development of the EMS (Emergency Medical Services) has been established in most communities. However, it remains equally important for citizens to be trained in first aid and know what to do until the EMS or
other emergency medical professional arrives. First Aid and Infectious Diseases

Infectious diseases are diseases that pass from one person to another. Most commonly, these are referred to as bloodborne or airborne pathogens. In first aid, bloodborne and airborne pathogens are most commonly transmitted through touching, breathing and biting. People can become infected if touched by an infected person, or if the germs in that person’s blood or other bodily fluids pass into the body through breaks in the skin or through the lining of the mouth, nose or eyes. Therefore, the greatest risk is in touching another person’s blood or bodily fluids directly (without protective gloves or some other protective barrier). To learn more about complying with OSHA’s Bloodborne Pathogens Standard (29 CFR 1910.1030), see Quick Tips #105: OSHA’s Bloodborne Pathogens Standard, 29 CFR 1910.1030. Below are some basic guidelines to follow that will help reduce body fluid transmission when rendering first aid care. Avoid direct contact with bodily fluids and blood whenever possible Place barriers, such as gloves or a clean, dry cloth, between the victim’s bodily fluids and yourself Wear protective clothing, such as disposable gloves, to cover any cuts, scrapes or skin conditions you have Wash your hands with soap and water immediately after giving care Do not eat, drink or touch your mouth, nose or eyes when giving first aid Do not touch objects that may be soiled with blood or other bodily fluids Be prepared by having a first aid kit stocked and easily accessible By following these simple guidelines, the risk of getting or transmitting infectious diseases is reduced. Good Samaritan Laws

Most states have enacted Good Samaritan Laws to encourage people to help others in emergency situations. These laws give legal protection to people who provide emergency care to ill or injured persons. They require that the “good samaritan” use common sense and a reasonable level of skill not to exceed the scope of the individual’s training in emergency situations. If you’re interested in learning more about the Good Samaritan Laws in your state, contact a local legal professional or check your local library. Basic First Aid Procedures

Following are some basic first aid procedures for treating shock, bleeding and wounds, burns, choking, electric shock, eye injury, fainting,heat stroke, hypothermia, and unconsciousness. These techniques can be used in the workplace or at home and being prepared will help make the most of a serious situation. Shock

Shock can be life threatening. Symptoms include cold sweat, weakness, irregular breathing, chills, pale or bluish lips and fingernails, rapid weak pulse and nausea. 1. Call 9-1-1 or seek medical help immediately.

2. Do not give the victim anything to eat or drink.
3. Lay the victim on his/her back, but do not move him/her if there’s a back or neck injury. If the victim is unconscious, vomiting or has severe injury to the lower face or jaw, lay him/her on his/her side and be sure the victim is getting adequate air. 4. Keep the victim warm (not hot) by use of blankets or clothes. 5. Raise the victim’s feet and legs with a pillow. (Only do this if it does not cause the victim any pain.)

Bleeding and Wounds
1. Place a clean cloth or gauze and gloved hand over the wound; apply firm, steady pressure for at least 5 minutes. 2. Call 9-1-1 or other emergency personnel if bleeding is severe. 3. Elevate an injured arm or leg above the level of the victim’s heart if practical. 4. When bleeding stops, secure the cloth with a bandage. Do Not lift the cloth from the wound to check if bleeding has stopped. Be sure the bandage is not too tight—it may cut off circulation. 5. Check the victim for shock.

Never use a tourniquet unless you cannot control the bleeding. Tourniquets may result in subsequent medical amputation.

Burns
Chemical or Compressed Gas Burns
1. Use a drench hose, emergency shower or eyewash for at least 15 minutes to rinse away all traces of chemicals while removing any contaminated clothing
from the victim. (See illustration 1.) 2. Cover the burn loosely with a clean, dry cloth or special burn dressing. 3. Check the victim for shock.

4. Call 9-1-1 or seek medical attention as soon as possible.

2. Heat or Electrical Burns
1. If necessary, use water to stop actual burning of skin.
2. If the skin is not broken, immerse the burned area in cool (not ice) water, or gently apply a cool compress until pain is relieved. Bandage with a clean, dry cloth. 3. Do not break a blister if one forms. Do not apply ointments or creams. 4. If skin is broken, or if burns are severe:

Call 9-1-1 or other emergency personnel.
Do not clean the wound or remove embedded clothing.
Cover the burn loosely with a clean, dry cloth.
Expect shock and treat accordingly.
Choking
Note: These instructions are for choking victims over one year of age. There are specific guidelines for treatment of infant choking that are not outlined in this document.

If the victim can speak or cough forcibly and is getting sufficient air, do not interfere with his/her attempts to cough the obstruction from the throat. If the victim cannot speak or is not getting sufficient air, have someone call 9-1-1 while you perform abdominal thrusts. 1. Stand directly behind the victim and wrap your arms around the stomach. (See illustration 2.)

2. Make a fist with one hand and place that fist just above the navel and well below the ribs, with the thumb and forefinger side toward you. (See illustration 3.)

3. Grasp this fist with the other hand and pull it quickly toward you with an inward and slightly upward thrust. Repeat if necessary. (See illustration 4.)

If the victim becomes unconscious:
1. Lay the victim on their back.
2. If the object is visible, use your forefinger to reach deeply into the victim’s mouth (along the inside of the cheek) and try to sweep the obstruction out of the victim’s throat. 3. Even if this is not successful, attempt rescue breathing. 4. If the victim is still not breathing or moving, then begin chest compressions (CPR).

Electric Shock
1. Do Not touch the victim until electrical contact is broken. 2. If possible, unplug or switch off the source of electricity. 3. If victim is not breathing and has no pulse, call 9-1-1 or seek medical attention immediately.

Eye Injury
1. Chemical
1. Hold the eyelids apart and flush the eyeball with lukewarm water for at least 15-30 minutes. Be careful not to let runoff water flow into the other eye. 2. Place a gauze pad or cloth over both eyes and secure it with a bandage. 3. Get to an eye specialist or emergency room immediately.

2. Cut, Scratch or Embedded Object
1. Place a gauze pad or cloth over both eyes and secure it with a bandage. 2. Do not try to remove an embedded object.
3. Get to an eye specialist or emergency room immediately.
Fainting
Note: Fainting victims regain consciousness almost immediately. If this does not happen, the victim could be in serious danger and you should call 9-1-1 as soon as possible. 1. Lay the victim down on their back and make sure they have plenty of fresh air. 2. Reassure the victim and apply a cold compress to the forehead. 3. If the victim vomits, roll the victim on his/her side and keep the windpipe clear. 4. Report the fainting incident to the victim’s doctor.

Heat Stroke
Heat stroke can be life threatening. Symptoms can include a body temperature of 105°F or higher; dry, hot, flushed skin; rapid pulse; unconsciousness; and lack of perspiration. 1. Get the victim out of the heat and into a cooler place.

2. Place the victim in the shock position, lying on the back with feet up. 3. Remove or loosen the victim’s clothing.
4. Cool the victim by fanning and applying cloth-wrapped cold packs or wet towels. 5. Treat for shock.
Hypothermia (Prolonged exposure to the cold)
Hypothermia can be life threatening. Symptoms include lower than normal body temperature, shivering, apathy, disorientation, drowsiness, and eventually, unconsciousness. 1. Immediately move the victim into the best available nearby shelter. 2. Get the victim out of wet clothes and replace with dry clothes, sleeping bag or blankets. 3. Have the victim drink a warm, non-alcoholic beverage if possible. 4. Seek medical help.

Unconsciousness
1. Determine responsiveness by gently tapping the victim’s shoulder and asking, “Are you okay?” 2. If there is no response, shout “Help!” and look for a medical alert tag on the victim’s neck or wrist. 3. If victim is not breathing and has no pulse, begin CPR.

4. Call 9-1-1 or seek medical aid as soon as possible.
How to give First Aid
When at high altitude where professional care is difficult to reach it is important to be trained in basic first aid. Along with a good first aid kit this section should help to prepare you for most emergencies. Mouth to Mouth Resuscitation

Breathing can be stopped by many conditions, notably a heart attack, drowning, electric shocks and suffocation. It may be tricky to diagnose for certain, but the tell-tale signs are a blue-grey tint to the skin, particularly the face, and no ‘rise and fall’ chest movement. If a person’s breathing has stopped, mouth-to-mouth resuscitation is needed. The method
has different types for different situations, as shown below: Adults

Mouth to Mouth

Open the mouth and if necessary remove and blockages from the airway carefully with a finger. Using two fingers under the chin and hand on the forehead tilt the person’s head back. Hold their nostrils closed, breathe in and place your mouth on theirs. Breathe out until their chest rises.

Remove your mouth to allow the chest to fall.
Give 10 breaths then check for a pulse. If there is no pulse then give CPR. Continue method at 10 breaths per minute.
Mouth to Nose
This method can be used when it is difficult to breathe into the mouth. Use steps 1-2 from above.
Hold the persons mouth closed, take a deep breath and place your mouth around the person’s nose. Breathe into their nostrils quite forcefully until the chest rises. Remove your hand and mouth to allow the air to escape.

Continue at 10 breaths per minute.
Children
Mouth to Mouth and Nose for a Baby (under 1 year)
Open the mouth and gently remove any blockages with a finger. Place your mouth around the baby’s nose and mouth.
Gently blow air into the baby’s lungs whilst watching its chest. As soon as the chest rises, stop and let the air escape.
Repeat to give one breath every 3 seconds.
After 20 breaths check the pulse.
If the heartbeat is lower that 60 bpm then start CPR, and if it is above this then continue ventilation until help arrives. Mouth to Mouth for a Child (over 1 year of age)
Use steps one 1-2 from mouth to mouth for adults.
Blow gently into their lungs until you see their chest rise. Stop, and let the air escape.
Repeat to give one breath every 3 seconds.
After 20 breaths check the pulse.
If absent, start CPR, and if present continue mouth to mouth until help arrives. Cardio-Pulmonary Resuscitation
When the heart stops it can often be made to start again using CPR. This involves a series of chest compressions coupled with the ventilation techniques described above. Adults
Give two breaths as described above.
Position the heel of your hand slightly above where the breast bone and the ribs meet. Interlock your fingers with your other hand.
Keep your arms straight and press down firmly, then release but keeping your hands in the same position. Repeat 15 times.
Children
Baby (under 1 year of age)
Ensure the baby is on a firm surface.
Place two fingers slightly below the nipple line in the middle of the chest. Press down and release 5 times, at a rate of twice per second. Continue mouth to mouth for one breath as described above.

Repeat steps 3-4 until help arrives.
If a pulse appears and is above 60 bpm stop the chest compressions but continue ventilation. Child (over 1 year)
Place one hand slightly above where the breast bone and ribs meet. Use the heel of your hand to press down firmly and release.
Repeat 5 times at a rate of 2 per second.
Blow air into the lungs once, as described above.
Repeat steps 3-4 until help arrives.
If a pulse is present stop compressions but continue ventilation. Severe Bleeding

Blood can be lost very quickly from a severed artery, not least because it is highly pressurised. Extensive blood loss can easily lead to shock, unconsciousness or death. This is considered to be anything more than a litre in an adult and a third of a litre for a child. If the injury is in a limb, treat as below: Lay the person down and try to raise the injured part, which will reduce blood flow to the area and so slow down blood loss. Using a clean dressing or, if unavailable, a clean item of clothing, keep firm pressure on the wound. If the wound has glass or small stones in then only apply pressure to the side of the wound until it has been removed. With a clean dressing over the wound, firmly apply a bandage to the whole arm. If a bandage is not immediately available a scarf can be used as a substitute until one can be found.

If the binding becomes soaked in blood then do not remove it. Instead continue pressure for another 10 minutes. Descend and seek medical help if bleeding does not stop.
Head Injury
A head injury may not always be obvious. Sometimes there is no wound so you must look out for other signs, even though a serious head injury may be present without any signs. Signs may include: Blood or any liquid seeping from the ear

Unconsciousness
Dizziness
Nausea
Headache
To treat, follow instructions below:
In the case of a wound, try to put skin flaps back in place. Using a clean dressing press firmly on the wound.
Bind the dressing in place with a bandage.
If the person is conscious lay the down but raise their head and shoulders. If they have fluid leaking from an ear, secure a dressing over it and tilt the person’s head to allow free drainage. If condition worsens then descend and seek medical help.

Chest Injuries
Immediately cover the wound with a palm.
Place a clean dressing over the wound, then cover it with a clean plastic bag or tin foil. Bind this with a bandage or similar to form an airtight seal. Descend immediately. Breathing is far more complex at altitude and with a puncture wound it could be made worse. Internal Bleeding

Internal bleeding is the result of ruptured blood vessels which allow blood to leak into cavities within the body. It can be caused by a fracture or a sprain, or a blow to the body which is strong enough to rupture a blood vessel but not the skin. It can also be caused by a chest or abdomen injury. These are quite likely when climbing, so you should watch out for the signs: Pain in the area

Cold, clammy skin
Fainting
Loss of colour
Nausea
Dizziness
Dilated pupils
Being out of breath
An irregular pulse
Swelling or bruising at the site
To treat:
Begin mouth to mouth resuscitation as above if necessary
Descend immediately
Don’t give the person anything to drink
Dislocation
A dislocation is where one or more bones at a joint, most commonly the shoulder, finger, thumb or jaw become removed from its socket. This is recognisable by: Swelling
Out of place bones
Pain and tenderness
Change in skin colour
To treat, follow these instructions:
Apply a splint to the joint to prevent movement (see below)
Keep the joint elevated
Broken Forearm
If the person can hold the arm across their chest then apply a splint and help position it with a wide sling. The person’s fingers should be positioned above their elbow. If the arm cannot be bent, splint it in the straight position then secure it to the side of the body. Descend and seek
medical help.

Fractures

A fracture is a broken or cracked bone. There are two types of fracture; simple and compound. A simple fracture does not pierce the skin, but if it is left untreated it can develop into a compound fracture. This is where the bone pierces the skin and causes serious bleeding. Other than this obvious sign, others include: Pain and tenderness

Difficulty moving
Difficulty breathing
Swelling
Bruising
Change in skin colour
To treat, see below:
Take care of any bleeding.
Lightly cover an open wound using a clean dressing.
Secure the injured limb to a solid part of the body. Fractured arms should always be supported by the body using a sling, usually made from a triangular bandage. Watch for signs of shock.
Keep the person warm.
Apply a splint (see below).
The Splinff
A splint is a method of keeping movement in a fractured bone to a minimum. They are easy to fit, just follow these guidelines: Examine the suspected fracture to determine whether is simple or compound. Check the circulation above and below the fracture, and movement of fingers/toes if appropriate. Remove any constricting jewellery (watches, bracelets, rings). Control bleeding by applying a dressing if necessary.

Administer pain medication if necessary.
Apply the splint above and below the injury.

If possible, prepare the splint on an uninjurd body part, and then transfer it to the injured area. This minimises potentially damaging movement of the injured part and minimizes the pain associated with splinting. Splints can be created from sticks, cardboard, foam pads, ski poles, tent poles or other similar objects. Fasten using belts, triangular bandages, tape, shirtsleeves, and blankets. Slings can be made from triangular bandages, sheets, and ropes. When applying the splint, be sure not to interfere with circulation.

If the fracture is simple and there are no signs of decreased circulation, it is advisable to apply ice packs/snow to the swollen area, but be sure not to apply ice directly to the skin. After the splint is applied, check the limb every 15 minutes to make ensure that swelling inside the splint has not cut off the circulation. This is particularly important to remember in cold weather, where numbness can be a confusing factor. Elevate the injured part to minimize swelling.

Depending on which bone is affected, descend and seek medical help. e.g. it may be possible to continue with a fractured toe, but not a broken leg. Insist that all victims seek medical evaluation when they return home, to be certain that all bones are properly aligned and that no further intervention is needed. Try to avoid:

Moving the person. Movement can move the broken bones further, which may damage internal organs. Applying pressure to a compound fracture to stop bleeding – it may cause extreme pain and can move bones.

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