First Aid

First aid is the treatment given to an injured person before taking him/her to see a qualified health worker. In other words, it is the temporary emergency measures serving to assist and maintain the victim of sudden illness or injury until more skillful treatment is available. The emergencies most frequently requiring first aid are caused by accidents involving asphyxiation, cardiac arrest, fainting and coma, poisoning, severe bleeding, burns, heatstroke and heat exhaustion, sprains and fractures, and animal bites.





FIRST AID ADMINISTRATION
The purpose of first aid is to ease the victim's pain and anxiety and to prevent deterioration of his or her condition. In extreme cases first
aid may be required to prevent death before medical assistance can be obtained.




In the course of administering first aid, behave calmly and confidently and reassure the injured. First aid measures vary according to the needs of the victim and the knowledge and skill of the person giving the treatment. Knowing what not to do in an emergency is as important as knowing what not to do; because a first aid measure misapplied may lead to serious complications. In an acute attack of appendicitis. for example, even a milk laxative or the application of heat to relieve pain may endanger the patient.



PRINCIPLES OF FIRST AID ADMINISTRATION
Despite the wide variety of possible injuries, several principles of first aid apply in general to all emergencies. Avoiding panic or undue haste is important. Unless the position of the victim exposes him or her to further harm, the victim should not be moved until the nature of the injury has been determined. A competent person trained in first aid may examine the victim for wounds, burns and fractures. The victim, if conscious, should be reassured that medical aid has been summoned.

The most urgent measures are maintaining an airway; putting the patient in the recovery position; and mouth-to-mouth resuscitation.
These may be needed whether the patient is unconscious or conscious.



ASSESSMENT AND MAINTENANCE OF AIRWAY
The most urgent priority is the assessment and maintenance of an airway. This is far more important than the control of bleeding or the diagnosis of shock and should be carried out immediately. It is vital to ensure that the patient is breathing and has a pulse; it is ’ essential to check whether the heart is beating. The pulse is best felt with the fingertips slide backwards along one side of the Adam’s apple (carotid artery pulse). It is no good giving artificial respiration if the heart is not beating. The victim’s head should be kept at body level unless the person complains of difficulty in breathing. in the absence of a skull or spinal injury, the victim's head and shoulders may be raised slightly to make the person more comfortable. If vomiting occurs, the head may be turned to one side. No liquids should be given to an unconscious person. In such serious conditions as asphyxia, severe bleeding and poisoning an ambulance must be called. Paramedic ambulance crews are capable of all necessary resuscitations; including treatment of cardiac arrest.


RECOVERY POSITION
An unconscious person should be put in the recovery position. This procedure must not be carried out on a victim with a suspected broken neck or spine as it may cause death or total paralysis. The movement into the recovery positon starts with the person lying on his or her back. Ensure that the airway is open. The nearest arm is placed at right angles to the body; with the elbow bent and the palm uppermost. The other arm is brought across and the hand held with its back against near the cheek of the patient By grasping the thigh furthest away, raise the knee with the foot remaining flat on the ground. The thigh can then be pulled on to roll the person onto his or her side, keeping the arm near the cheek and resting the head on the outstretched hand. The head should be tilted back and turned a little to one side with the hand under the cheek adjusted to keep the airway open. The leg should then be adjusted so that the hip and knee are at right angles.


GIVING ARTIFICIAL RESPIRATION
The most effective method of artificial resuscitation is the mouth-to-mouth technique in which air is blown into the victim's lungs, thereby inflating them; for this. a good seal is needed. A finger swept around the inside of the mouth will ensure it is clear. Tilt the victim's head backwards by placing one hand under the victim's chin and lifting; while placing the other hand on the victim's forehead and tilting downwards. The victim’s nostrils are then pinched together with the operator's fingers to prevent leakage of air. Then take deep breaths and, with your mouth sealed over the victim’s mouth, blow in strongly. The victim’s chest must be watched until it can be seen to rise. Then remove your mouth and listen for the victim to "exhale” (the victim does not actually exhale, rather the lungs just collapse by their own elasticity).

When administering artificial respiration to a very young child, the mouth and nose of the child should be covered. This process is repeated at a rate of about 12 times a minute for adults and about 20 minutes for children. with less pressure and volume being used for children.

If the airway is not clear, re-check the position of the victim's head. If ventilation is skill not accomplished, turn the victim to the side and apply sharp blows between the shoulder blades (also of children) to dislodge any obstruction. The mouth-to-mouth blowing effort should then be repeated.

Once begun, artificial respiration must not be interrupted until the person begins to breathe or a doctor pronounces the person dead. When the victim begin: to breathe spontaneously he or she should not be moved; artificial respiration may be needed to aid abnormal breathing. in cases of apparent drowning, artificial respiration should be attempted even if the victim seems to have been dead for several minutes. There have been several recorded cases of individuals who had been submerged in water for more than 30 minutes. had turned blue and were seemingly beyond revival, yet responded to first-aid efforts and recovered with no brain damage. A reflexive response of the body. the so-called mammalian diving reflex. is apparently involved. More signihcant, however, is the effect of very cold water in reducing the body's metabolic requirements so that the brain can survive longer without oxygen.

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