First Aid

• Preserve life
• Prevent the situation from worsening
• Promote recovery

• Airway
• Breathing
• Bleeding (or Burns)
• Bones

• Airway
• Breathing

• Bleeding
• Burns
• Bones

• Danger?
• Response?
• Airway?
• Breathing?

• Is it safe for you to help the casualty. Do not put yourself at risk.
• How casualties are there? Triage.

• Is the casualty conscious?
• Gently shake their shoulders and try to get a verbal response.
• If there is no response, shout for help and stay with the casualty.

Open the airway by placing your palm on the casualty's forehead and fingertips under the point of their chin.

• With the airway open, is breathing normal?(Check for no more than 10 seconds)
• Look at the chest and abdomen for movement.
• Listen for breathing (More than an occasional gasp), looking down the casualty's chest/abdomen for movement.
• If the casualty is breathing normally, carry out a secondary survey and place them in the recovery position.

• 30 chest compressions then 2 rescue breaths.
• Compression rate:100 per minute.
• Compression pressure: 1/3 the depth of the casualty's chest.

• If the casualty resumes normal breathing.
• When help arrives.
• You become exhausted and can't continue.

Any head injury is potentially a very serious condition. Injuries to the head often lead to unconsciousness, which in turn compromises the airway. Permanent damage to the brain may result from a head injury.

It is important to remember that any patient with a head injury may also have a spinal injury to the neck.

• Fainting
• Imbalance of heat(Intoxication)
• Shock
• Head Injury

• Stroke
• Heart Attack
• Asphyxia
• Poisoning
• Epilepsy
• Diabetes

• Concussion
• Compression
• Fractured skull

A skull fracture is serious because the broken bone may directly damage the brain, or cause bleeding, which in turn results in compression. Suspect a skull fracture with any patient who has received a head injury, especially if the patient has lowered levels of response.

Compression is a very serious condition, because the brain is placed under extreme pressure, caused by bleeding or swelling in the cranial cavity. The cause of compression can be from a skull fracture or head injury, but can also occur from illness, such as a ruptured blood vessel (a type of stroke), a brain tumour or infection (such as meningitis).

Concussion is caused by "shaking" of the brain. The brain is cushioned within the skull by cerebro-spinal fluid, so if the head receives a blow the brain can bounce from one side to the other, causing widespread disruption to its normal functioning. The casualty may become unconscious for a short period (usually less than 3 minutes), after which the levels of response should improve. The casualty should recover completely if no complications are present.

• Possibly unconscious for a short period followed by an improvement in levels of response and recovery.
• Short term memory loss (particularly of the incident). Confusion, irritability.
• Mild, general headache.
• Pale, clammy skin.
• Shallow/normal breathing.
• Normal pupils, reacting to light.
• Possible nausea or vomiting on recovery.

• WARNING! A patient suffering from head injury may also have a neck injury, so treat the patient with care.
• Dial 999 for an ambulance if the casualty has been unconscious, their levels of response deteriorate, or you suspect a fractured skull.
• Maintain Airway and Breathing.
• If the casualty is unconscious and breathing, use the jaw thrust method to keep the airway open, because this doesn't move the neck.
• If you can't maintain the airway using the jaw thrust method, place the patient in the recovery position. Keep the head, neck and body in line as you turn the patient.
• If the patient is conscious, help them to lie down. Keep the head, neck and body in line in case there is a neck injury.
• Control any bleeding by applying gentle pressure around the wound. If there is bleeding or discharge from an ear, don't try to plug the ear or stop it bleeding.
• Look for and treat any other injuries.

• Constantly monitor and record breathing, pulse and levels of response, watch out for a subsequent reduction in levels of response.
• Ensure that a concussed casualty who recovers is not alone for the next few hours. Advise them to see a doctor as soon as possible.
• Advise the patient to go to hospital immediately if they suffer from headache, nausea, vomiting or excessive sleepiness in the next few days.
• Do not allow a concussed sports player to 'play on' until they have seen a doctor.

• Clinical name for stroke is 'cerebro-vascular accident' (CVA).
• 60% of strokes are caused by a blood clot (thrombosis) in an artery supplying blood to the brain. Most patients who suffer this type of stroke are elderly people. The other form of stroke is caused by bleeding into the cranial cavity following the rupture of an artery. Patients who suffer this type of stroke can be younger, and often have a history of high blood pressure.

• Weakness or paralysis down one side of the body or face.
• Slurred or confused speech.
• Gradual or sudden loss of consciousness.
• Unequal pupil size.
• Agitation or aggression to the point of crying.
• Headache.
• Slow, strong pulse.
• Slow, deep, noisy breathing.
• Flushed, dry skin.
• Vomiting or incontinence.

• Facial Weakness Can they smile?
• Arm Weakness Can they raise both arms?
• Speech Problems Can they speak clearly and understand you?
• Test these signs! Dial 999 if they fail any test.

• Hypo 'low' xia 'oxygen' in the blood.
• A low level of oxygen in the blood is potentially fatal, so it is important that the First Aider recognises the signs and symptoms of this condition and takes immediate action to treat the casualty.

• Pale, clammy skin.
• Blue tinges to the skin (cyanosis).
• Increase in pulse rate.
• Weakening of the pulse.
• Nausea or vomiting.
• Increased breathing rate (caused by oxygen deficiency).
• Lowered breathing rate (look for control centre causes.
• Distressed breathing or gasping.
• Confusion or dizziness.
• Lowering levels of consciousness.
• Clues from the cause of the hypoxia (i.e. bleeding, injury, chest pain etc).

• Airway.
• Breathing.
• Circulation.
• Control centre.
• External.

• A blockage, swelling or narrowing of the airway caused by:
• The tongue.
• Vomit.
• Choking.
• Burns.
• Strangulation.
• Hanging.
• Anaphylaxis.

• Inability of the lungs to function properly.
• Crushing of the chest.
• Collapsed lung.
• Chest injury.
• Poisoning.
• Asthma.
• Disease or illness.

• Inability of the blood to take up oxygen, a fall in blood pressure or failure to circulate blood around the body.
• Heart attack.
• Cardiac arrest.
• Angina.
• Severe bleeding.
• Poisoning.
• Anaemia.

• Failure of the respiratory control centre in the brain or the nerves connecting it to the lungs.
• Stroke.
• Head injury.
• Intoxication.
• Poisoning.
• Spinal injury.
• Electric shock.

• Lack of oxygen in the environment.
• Suffocation by gas or smoke.
• Drowning.
• Suffocation by sand, earth, pillow etc.
• High altitude.

• If the body detects low levels of oxygen in the blood ADRENALINE is released. The effect of adrenaline on the body is to:
• Increase the heart rate.
• Increase the strength of the heart beat (and blood pressure).
• Divert blood away from the skin, intestines and stomach.
• Dilate the air passages in the lungs (bronchioles).

'Inadequate tissue perfusion, caused by a fall in blood pressure or blood volume'.

There is an inadequate supply of oxygenated blood to the tissues of the body.

• Hypovolaemic.
• Cardiogenic.
• Anaphylactic.

• Hypo low, vol volume, aemic blood.
• Hypovolaemic shock is caused by loss of body fluids, which results in a low volume of blood

• External bleeding.
• Internal bleeding.
• Burns.
• Vomiting and diarrhoea (loss of body fluids).
• Excessive sweating.

• Initial response: A rise in pulse rate and pale, clammy skin (due to release of adrenaline).
• As the conditions worsens: Fast, shallow breathing. Rapid, weak pulse. Cyanosis (grey blue tinges to skin and lips). Nausea or vomiting. Dizziness, weakness. Sweating. Unconsciousness.
• As the brain suffers a lack of oxygen: Deep sighing breathing (air hunger). Confusion, anxiety, even aggression. Unconsciousness. 

• Treat the cause of loss of body fluids (e.g. external bleeding).
• Lie the casualty down and elevate their legs, returning blood to the vital organs (take care if you suspect a fracture).
• Dial 999 for an ambulance.
• Keep the casualty warm. Use coats and blankets - place a blanket under the patient if they are on a cold surface. (Do not use direct heat as it will dilate the blood vessels causing blood pressure to fall even more).
• Loosen tight clothing around the neck, chest and waist.
• Monitor breathing, pulse and levels of response.
• Be prepared to resuscitate.

This is a fall in blood pressure due to the heart not pumping effectively. This is the most common type of shock.

• Heart attack.
• Cardiac failure.
• Heart value disease.
• Tension pneumothorax.
• Cardiac arrest.

Every heart attack is different. Only a few of the signs and symptoms may be present. Up to 25% of heart attacks are "silent" without chest pain.

Anaphylaxis is an extremely dangerous allergic reaction caused by the body's immune system releasing massive amounts of histamine.

• Dilates blood vessels (reducing blood pressure).
• Constricts the bronchioles in the lungs (causing breathing difficulties).
• Makes blood capillary walls 'leaky' (causing severe swelling and shock).
• Reduces the strength of the heart's contractions.
• Causes itchy skin.
• Causes a skin rash.

• Sudden swelling of the face, tongue, lips, neck and eyes.
• Hoarse voice, 'lump in the throat', developing into loud pitched noisy breathing (which may stop altogether).
• Difficult, wheezy breathing, tight chest (the patient may have the equivalent of an asthma attack as well as a swollen airway).
• Rapid weak pulse.
• Nausea, vomiting, stomach cramps, diarrhoea.
• Itchy skin.
• Red, blotchy skin eruptions.
• Anxiety - a feeling of 'impending doom'.