First Aid And Artificial Respiration Techniques

First aid

First aid is the first and immediate assistance given to any person suffering from either a minor or serious illness or injury.

Objectives of first aid

·        To preserve life

·        To prevent the victim’s condition from worsening

·        To promote recovery

General rules of first aid

    Never panic: Take a few slow deep breaths and determine what resources are available and what is needed?

    Evaluate the situation:  Check the level of victim’s consciousness, open the victim’s airway, check for breathing and pulse.

    Is the victim in a safe environment free from danger?

    Determine the priorities of treatment – which condition requires immediate care?

• Life threatening cases ( heart stroke/serious burns and injuries/poisoning)
• Non-life threatening cases ( fractures/  sprains)

Decide what care is needed and do only what you are trained to do.
Call for an ambulance or send for help.

Goals of first aid

The ABC's of first aid are the primary things that need to be checked when you approach the victim

• Airway,
• Breathing, and
• Circulation.

Action plan

Arriving at the scene of an accident remember the letters D R A B C

D- Check for DANGER – see if it’s safe to go to the patient.

R- Check for RESPONSE - Quickly assess if the patient is conscious or unconscious.

A- Check AIRWAY to make sure it’s clear.

B- Check if the casualty is BREATHING. Is chest rising and falling?

C- CIRCULATION – check the pulse

First Aid Techniques for Various Ailments

1. First aid for fainting or Losing Consciousness

Fainting is a temporary loss of the consciousness that happens when there isn't enough blood going to the brain because of a drop in blood pressure.

• If someone’s feeling faint, tell them to lie down. 
• Tilt the head back and keep arms at a right angle to the body. 
• Kneel down next to them and raise their legs, supporting their ankles on your shoulders to help blood flow back to the brain. 
• Make sure that they have plenty of fresh air. 
• Reassure the casualty and help them to sit up slowly. 
• If they don’t regain responsiveness again quickly, open their airway, check their breathing and pulse. 

2. First aid for burns and scalds

Burns and scalds are damage to the skin caused by heat. A burn is usually caused by dry heat, like fire, a hot iron, or the sun. A scald is caused by wet heat, like steam or a hot cup of tea.

There are three primary types of burns- first, second and third-degree burns. Each degree is based on the severity of damage to the skin, with first-degree being the most minor and third-degree being the most severe. Damage includes:

• First-degree burns: red, non blistered skin
• Second-degree burns: blisters and some thickening of the skin
• Third-degree burns: widespread thickness with a white, leathery appearance

There are also fourth-degree burns. This type of burn includes all of the symptoms of a third-degree burn and also extends beyond the skin into tendons and bones.

First aid for burns includes

• Immediately immerse the burnt area in cool water or by applying clothes soaked in cool water. 
• Remove any jewelry or clothing near the burn.
• Cover the area with a dry, sterile dressing and not with cotton or other fluffy material. This will protect from infection.
• If necessary , treat for shock.

4. First aid for Bleeding

Cuts, scrapes, and punctures can result in bleeding. Severe bleeding can be life-threatening. To stop bleeding: 

• Apply direct pressure 
• Elevation – lie victim down and raise the injured part above the heart and handle gently if you suspect a fracture. 
• If bleeding from a limb doesn’t stop applying pressure with hand to pressure point. 
• If any embedded objects are in the wound, apply pressure either side of the wound and place pad around it before bandaging. 
• Wear gloves, if possible to guard against infection.
• If the victim becomes unconscious, follow DRABC.

    5. First aid for Electrocution 

   Electricity can be very dangerous unless used with care. When an accident occurs with electricity, one must remember that it is not safe to touch the victim until the power has been turned off.  Electrical shocks always need emergency medical attention. 

    The signs and symptoms include 

•      Surface and internal burns 
•      Breathing and heartbeat may have stopped

                                                                                         

1.     Separate the person from the current’s source: The best way to treat an electrocuted person is to cut off the power supply and remove the victim from the current source with a nonconductive material.
2.     Do CPR, if necessary: When you can safely touch the person, do CPR if the person is not breathing or does not have a pulse. 
3.     Check for Other Injuries: If the person is bleeding, apply pressure and elevate the wound if it's in an arm or leg. 
4.     There maybe a fracture if the shock caused the person to fall.
5.     Treat for burns if any. 
6.     Call for help or ambulance.

      6. First aid for fractures (Broken bones)

     A fracture is a broken bone. It requires medical attention. If the broken bone is the result of major trauma or injury, call an ambulance or your local emergency number.  

    Don't move the person except if necessary to avoid further injury. Take these actions immediately while waiting for medical help:

•    Stop any bleeding. Apply pressure to the wound with a sterile bandage,a clean cloth or a clean piece of clothing. 
•    Immobilize the injured area. Don't try to push or force the bones back into the wound. 
•    Place sufficient padding to support the fracture site. 
•    Apply ice packs to limit swelling and help relieve pain. Don't apply ice directly to the skin. Wrap the ice in a towel, piece of cloth or some other material. 
•    Treat for shock. If the person feels faint or is breathing in short, rapid breaths, lay the person down with the head slightly lower than the trunk and, if possible, elevate the legs.

     7. First aid for snake bites

    Many snake bites are caused by non-venomous snakes but we should always assume that the bite is from a venomous snake and It’s essential to get emergency treatment as quickly as possible. However, there are some tips that you should also keep in mind:

•     Call for an ambulance immediately. 
•     Note the time of the bite. 
•     Keep the bitten limb below the level of the heart.
•     Allow the affected area to bleed freely for 15-30 seconds.
•     If the bite is on the limb, apply a firm roller bandage two inches away from the wound.
•     Wash the affected area with soap and disinfect the area.
•     Constantly check Airway, Breathing and Circulation.
•     Keep calm and still as movement can cause the venom to travel more quickly through the body.
•     Remove constricting clothing or jewelry because the area surrounding the bite will likely swell.
•     Don’t allow the victim to walk. Carry or transport them by vehicle.

    8. First aid for insect bites: 

    Insect bites and stings are mild, causing little more than redness, itching, stinging or minor swelling. Rarely, insect bites and stings, such as from a bee, a wasp, a hornet, a fire ant or a scorpion, can result in severe reactions. 

    To take care of an insect bite or sting that causes a mild reaction: 

•    Move to a safe area to avoid more bites or stings. 
•    If needed, remove the stinger. Wash the area with soap and water. 
•    Apply a cool compress. Use a cloth dipped in cold water or filled with ice. This helps reduce pain and swelling.
•    If the injury is on an arm or leg, elevate it. \
•    Apply 0.5 or 1 percent hydrocortisone cream, calamine lotion or a baking soda paste to the bite or sting several times daily until your symptoms go away. 
•    Take an antihistamine to reduce itching. 
•    If the injured person experiences severe symptoms like dizziness and difficulty in breathing, Begin CPR and call for help.

      9. First aid for heatstroke :

    Heatstroke occurs when the body temperature continues to rise, often to 40°C (104°F) or higher. Signs of rapidly progressing heatstroke include: 

•    Unconsciousness for longer than a few seconds.
•    Convulsion (seizure).  
•    Signs of moderate to severe difficulty breathing.
•    A rectal temperature over 40°C (104°F) after exposure to a hot environment.
•    Confusion, severe restlessness, aggressive behavior or anxiety.
•    Fast heart rate. 
•    Sweating may be heavy or may have stopped. 
•    Skin that may be red, pale, hot, and dry, even in the armpits.
•    Severe vomiting and diarrhea.

    Heatstroke is a medical emergency. Even with immediate treatment, it can be life-threatening or result in serious, long-term complications. After calling an ambulance, follow these first aid steps.

•   Move the person into a cool place, out of direct sunlight. 
•    Remove the person's unnecessary clothing, and place the person in cool place.
•    Cool the person's entire body by sponging or spraying cold water, and fan the person to help lower the person's body temperature. Watch for signs of rapidly progressing heatstroke, such as seizure, unconsciousness for longer than a few seconds, and moderate to severe difficulty breathing. 
•    Apply ice packs in each armpit and on the back of the person's neck.
•    If breathing has stopped, begin rescue breathing. 
•    Do not give aspirin or acetaminophen to reduce a high body temperature that can occur with heatstroke. These medicines may cause problems because of the body's response to heatstroke. 
•    If the person is awake and conscious, give the person enough fluids for hydration. 

Artificial respiration and Types

    Artificial respiration is a process in which air is forced into and out of the lungs of a person who has stopped breathing. Artificial respiration is started at the site of the accident & continued till the patient is shifted to the hospital. It can be performed in prone and supine positions.

   1) Schafer’s method (Prone pressure Method)

   2) Holger Neilson’s method (Arm lift back pressure method)

   3) Sylvester’s method (Arm lift chest pressure method) 

   4) Mouth to mouth respiration 

   

   Schafer’s method (Prone pressure Method) 

•   1. Lay the victim down. 
•   2. The doctor kneels near the patient’s waist. 
•   3. Put palm on the patient’s loin. By bending forward doctor will apply  pressure. 
•   4. Pushing abdominal viscera brings about expiration. 
•   5. When doctor presses on loin ,expiration  takes place ,when doctor bend backward  Inspiration takes place. 
•   6. Inspiration lasts for 3 sec ,expiration lasts  for 2 sec . 
•   7. Main advantage of Schafer’s method is it’s  prone position.
•   8. So water from abdomen &  lungs can be easily drained. 
•   9. If there are injuries of the abdomen , this method cannot be applied. 
•  10.Repeat these two movements for about 10 to 15 times in a minute until the doctor arrives.

   

      Holger Neilson’s method ( Arm liftback pressure method)

•    This is also in the prone position
•    Doctor kneels near the patient’s head facing  towards him
•    Doctor pulls his arms up. This will bring  about inspiration
•    Then the doctor leaves his hands on side &  put his palms on the patient’s back  &  bending forward he will apply deep pressure on his chest. This will cause expiration
•    Main advantage of this method is adequate  drainage of water from abdomen & thorax.So this is a good method in cases of drowning
•    Both inspiration & Expiration are active, so  good ventilation is obtained.

    

  

         Sylvester’s method ( Arm lift chest pressure method)

•    It is in Supine position
•    Pillow is given below shoulder & neck is  fully extended
•    Doctor kneels  near the patient’s head, facing  towards him
•    He catches the patient’s wrist & by bending forward he pulls the patient’s arms up. This  will cause Inspiration
•    Then bending forward, he puts  deep  pressure on the chest, with patient’s hands this  will cause expiration
•    Inspiration should last for 3 sec &  expiration for 2 sec
•    Main advantage of this method is both inspiration & expiration are active,so good ventilation is obtained.
•    Disadvantages are, as the patient is in the supine position, there is no drainage of water from the lungs. So this method should not be used in cases of drowning 
•    If there is rib fracture or thorax  , this  method cannot be used

       Mouth to mouth respiration

• It is the best method of artificial respiration

• Doctor kneels near the patient’s neck, facing  towards him.

• Pillow is given below shoulder, so as to  extend neck fully

• With left-hand patient’s nostrils are closed. Tissue paper or the handkerchief is put on the patient’s mouth.

• Doctor blows expired air in patient’s mouth. This will cause inspiration

• By taking mouth away, expiration occurs  passively

• Advantages of this method are giving  expired air , which contain CO 2, which  stimulate patient’s respiratory center.Good  ventilation is obtained

• It is the best method of artificial respiration in newborn babies.

         External cardiac massage

•  It is done, in the patient’s cardiac arrest

•  It is given by putting left palm on the sternum & impacts are given by the right palm

•  With this cardiac massage, mouth to mouth  respiration can be continued with 30:2 ( 30 Chest compressions with 2 rescue breaths)

Cardiopulmonary resuscitation (CPR)

    Cardiopulmonary resuscitation (CPR) is a lifesaving technique useful in many emergencies, including a heart attack or near drowning, in which someone's breathing or heartbeat has stopped. CPR can be performed by any trained person. It involves external chest compressions and rescue breathing.

    CPR can be summarized as ABCs:

     Airway: Open the airway

    Open the person's airway using the head-tilt, chin-lift maneuver. Put your palm on the person's forehead and gently tilt the head back. Then with the other hand, gently lift the chin forward to open the airway.

    

    Breathing: Breathe for the person

     Rescue breathing can be mouth-to-mouth breathing or mouth-to-nose breathing if the mouth is seriously injured or can't be opened.

1.With the airway open (using the head-tilt, chin-lift maneuver), pinch the nostrils shut for mouth-to-mouth breathing and cover the person's mouth with yours, making a seal.

2. Prepare to give two rescue breaths. Give the first rescue breath — lasting one second — and watch to see if the chest rises. If it does rise, give the second breath. If the chest doesn't rise, repeat the head-tilt and then give the second breath.

C

                   

ompressions: Restore blood circulation

1. Put the patient on his back on a firm surface, like the ground or floor.

2. Kneel at his side, next to his neck and shoulder. Place the palm of your hand on his chest between his nipples, and place your other hand on top of your hand.

3. Then press his chest straight down by at least two inches. You won’t break the sternum this way. Do this 30 times.

4. Today, instead of A-B-C, which stood for airway and breathing first, followed by chest compressions, AHA has recommended to begin CPR with chest compressions, followed by airway and breathing (C-A-B)