Chapter 7 Dimension of Development First Aid Education PDF

Chapter 7: Dimension of Development: First Aid Education Learning Objectives At the end of this chapter, the learners are expected to: 1. explain the meaning and principles of first aid education; 2. hone and apply first aid skills during emergency situations; and 3. participate actively...

Chapter 7: Dimension of Development: First Aid Education Learning Objectives At the end of this chapter, the learners are expected to: 1. explain the meaning and principles of first aid education; 2. hone and apply first aid skills during emergency situations; and 3. participate actively in the delivery of first aid services. Overview This chapter discusses first aid education and how the basic steps of first aid are carried out by people who are knowledgeable of and trained in it. First Aid First aid is the immediate treatment using available facilities or materials and given to an injured or ill person while waiting for medical assistance to arrive. It includes either emergency measures for life-threatening conditions which require further medical attention or care for less serious injuries which may be adequately treated on the spot. As an urgent care given to an injured or unexpectedly ill person, first aid also involves home care and self-care if medical assistance is delayed or not available. First Aider The first aider deals with the whole situation involving the patient and the injury or illness. The Philippine National Red Cross (PNRC) conducts trainings for people who like to become first aiders. If interested parties are physically and mentally fit, they can go to their local PNRC chapter and register for free. The one-week training focuses on basic first aid and provides the needed medical kit. Characteristics of a Good First Aider A good first aider must be gentle, resourceful, observant, tactful, sympathetic, consoling, and respectful. He/She should maximize the use of materials at hand; know how to improvise and how to assess the situation and the victim properly, and exhibit professionalism. Moreover, he/she must not cause further harm by making the victim panic. The roles and responsibilities of a first aider are as follows: 1. Since the first aider does not perform the functions of a doctor or compete with the latter, he/she immediately transfers the medical task and care of the victim to a qualified physician who comes to the rescue. 2. He/She ensures the safety of bystanders.  3. He/She assesses the condition of the victim. 4. He/She identifies the risks or threats to the victim's life. 5. He/She calls for medical assistance as needed. 6. He/She provides the immediate and necessary care. 7. He/She assists the medical personnel. 8. He/She records the situation, care given, etc. General Directions for First Aid A first aider may encounter various problem situations. His/Her decisions and actions depend on the circumstances that cause the accident or sudden illness; the number of persons involved; the immediate environment; and the availability of medical assistance, emergency equipment, and help from others. The first aider needs to adapt to the situation at hand and improvise as necessary. The first aider should keep two fundamental things in mind. One, he/she must determine the best way of rescue such as removing the victim from water, fire, or a place filled with carbon monoxide or smoke. Two, he/she must ensure that the victim has an open airway and must administer mouth-to-mouth or mouth-to-nose artificial respiration if necessary, including controlling severe bleeding. Unless it is safe to do so, the victim should not be moved at once. He/She should be kept in the position best suited to his/her condition or injury. The victim should not be allowed to get up or walk around. The first aider, in turn, is not expected to explain the victim's probable condition to bystanders or even to reporters. He/She is expected, however, to remain in charge until the victim can be placed in the care of qualified persons, for example, a physician, an ambulance crew, a squad, or a police officer, the victim can take care of himself/ herself; or the victim can be taken care of by relatives. Above all, the first aider should know the limits of his/her capabilities. He/She must make minimal effort to avoid further injury to the victim in his/her attempt to provide the best possible emergency first aid care. Meanwhile, proper first aid measures should include standard and specific techniques that have been taught and in view of circumstances that appear to be necessary. Basic Life Support Life support is a series of emergency life-saving procedures that are carried out to prolong the life of a victim. It is classified under three types: 1. Basic life support is an emergency procedure that consists of recognizing respiratory or cardiac arrest or both and the proper application of cardiopulmonary resuscitation (CPR) to maintain life until a victim recovers or advanced cardiac life support can be administered.  2. Advanced cardiac life support is the use of special equipment to maintain the breathing and blood circulation of the victim. 3. Prolonged life support is the post-resuscitation and long-term resuscitation. Chain of Survival 1. The first link or early access is initiated immediately after the patient collapses. It entails calling the local emergency number as quickly as possible and giving the hotline as much vital information as you can about the emergency. 2. The second link or early CPR is initiated while waiting for the arrival of emergency medical services (EMS) personnel who are trained to provide care. The probability of survival approximately doubles when it is done before the arrival of the EMS. 3. The third link or early defibrillation is most likely to improve survival. It is the key intervention to increase the chance of survival of the patient outside without hospital care. 4. The fourth link or early advance care is provided by highly trained EMS personnel and paramedics who monitor the patient closely on the way to the hospital. Note that the immediate aims of the first aider are to ease the pain, prevent further harm or danger, and extend the life of the victim. Furthermore, the first aider must eradicate the hindrances in giving the initial intervention such as the surroundings, curious and unruly crowd, the victim's relatives, panic, pressure, etc. It must be remembered that the safety percentage for the first aider is 80% and that for the victim is 20%. What is an Emergency? Emergency is the sudden onset of medical or surgical severity that, in the absence of immediate medical attention, could reasonably and expectedly result in serious danger to health or impairment of bodily functions. Emergency Action Principles The scene must be surveyed entirely. Is the scene safe? What happened? How many were injured? Are there bystanders who can help? The first aider must get the consent to give care; check for responsiveness such as alertness, verbal response, pain stimuli, and unresponsiveness; and protect the spine, if necessary. To activate medical assistance, the first aider can do care first or call first, especially in cardio-related problem-adult and care first, and in respiratory problem-child and infant. A bystander can be requested to call a physician. Take note of the following in activating medical assistance: (1) situation of the person injured; (2) location: (3) number of persons injured; (4) extent of injury and first aid given; (5) telephone number from where you are calling; and (6) the identity of the person who activates the medical assistance.  For primary survey, check the airway for breathing for five seconds and blood circulation for ten seconds. Secondary survey includes interviewing the victim; knowing his/her name; background intervention about the accident; assessing sample medical history of the victim such as signs and symptoms, allergies, medication taken, past/ present medical illness, last oral intake, and event prior to the incident. To check the vital signs, the first aider must determine radial or carotid pulse; breathing; and the victim's face, lips, skin appearance, temperature, moisture, and color. Head to toe examination must be conducted. This will enable the first aider to see if there is deformity, contusion, abrasion, puncture, burn/bleeding, tenderness, laceration, or swelling (DCAP-BTLS). Emergency rescue is the quick transfer of a patient from an unsafe place to a safe place. The indications for emergency rescue are: 1. Danger of fire or explosion 2. Risk of toxic gases or asphyxia due to lack of oxygen 3. Serious traffic hazards 4. Risk of drowning 5. Danger of electrocution 6. Danger of collapsing walls Methods of Rescue 1. For immediate rescue without any assistance, drag or pull the victim. 2. Most of the drags/carries/lifts and other transfer methods can be used as methods of rescue. Transfer is moving a patient from one place to another after giving first aid. The factors to consider in choosing the transfer method are as follows: 1. Nature and severity of the injury 2. Size of the victim 3. Physical capabilities of the first aider 4. Number of personnel and equipment available 5. Nature of evacuation route 6. Distance to be covered 7. Gender of the victim The following guidelines must be followed during transfer. 1. Victim's airway must be maintained open. 2. Hemorrhage is controlled. 3. Victim is safely maintained in the correct position. 4. The victim's condition is regularly checked. 5. Supporting bandages and dressing remain effectively applied. 6. The method of transfer is safe, comfortable, and as speedy as circumstances permit. 7. The patient's body is moved as one unit. 8. The taller first aiders stay at the head side of the victim.  9. First aiders/bearers must observe ergonomics in lifting and moving the patient. Methods of Transfer 1. One-man assists/carries/drags such as assist to walk, carry in arms, carry in a pack-strap method, carry in a fireman's way, blanket drag, armpit/shoulder drag, cloth drag, feet drag, and inclined drag (head first in passing a stairway) 2. Two-man assists such as assist to walk, four-hand seat, hands as a litter, carry by extremities, and fireman's carry with assistance 3. Three-man assists such as bearers alongside (for narrow alleys) and hammock carry Cloth Material Commonly Used in First Aid 1. Dressing is any germ-free fabric material used to plaster wound. 2. Bandage is any clean or sterilized fabric material that holds the dressing in place. Bandages and Bandaging Techniques Bandages and dressings are both used in wound or fracture management. A bandage is a piece of cloth or other material used to bind or wrap a diseased, injured, or fractured part of the body. Usually shaped as a strip or pad, bandages are either placed directly against the wound or used to bind a fracture of the body. The following are bandages and bandaging techniques adapted from Survive Outdoors (Jalic Inc., n. d.). Bandaging Upper and Lower Extremities Shoulder Bandage To apply bandages attached to the field first aid dressing 1. Take one bandage across the chest and the other across the back and under the arm opposite the injured shoulder. 2. Tie the ends with a non-slip knot (Figure 2). Figure 2. Shoulder bandage To apply a cravat bandage to the shoulder or armpit 1. Make an extended cravat bandage by using two triangular bandages (Figure 3A). Then, place the end of the first triangular bandage along the base of the second one (Figure 3B). 2. Fold the two bandages into a single extended bandage (Figure 3C). 3. Fold the extended bandage into a single cravat bandage (Figure 3D). After folding, secure the thicker part (overlap) with two or more safety pins (Figure 3E). 4. Place the middle of the cravat bandage under the armpit so that the front end is longer than the back end and safety pins are on the outside (Figure 3F). 5. Cross the ends on top of the shoulder (Figure 3G). 6. Take one end across the back and under the arm on the opposite side and the other end across the chest. Tie the ends (Figure 3H). Figure 3 Extended cravat bandage applied to shoulder (or armpit) Be sure to place sufficient wadding in the armpit. DO NOT tie the cravat bandage too tightly. Avoid compressing the major blood vessels in the armpit. Elbow Bandage To apply a cravat bandage to the elbow 1. Bend the arm at the elbow and place the middle of the cravat at the point of the elbow bringing the ends upward (Figure 4A). 2. Bring the ends across, extending both downward (Figure 4B). 3. Take both ends around the arm and tie them with non-slip knot at the front of the elbow (Figure 4C). Figure 4. Elbow bandage If an elbow fracture is suspected, DO NOT bend the elbow; bandage it in an extended position. Hand Bandage To apply a triangular bandage to the hand 1. Place the hand in the middle of the triangular bandage with the wrist at the base of the bandage (Figure 5A). Ensure that the fingers not come in contact with the absorbent material to prevent chafing and irritation of the skin. 2. Place the apex over the fingers and tuck any excess material into the pleats on each side of the hand (Figure 5B). 3. Cross the ends on top of the hand, take them around the wrist, and tie them (Figures 5C, 5D, and 5E) with a non-slip knot. Figure 5 Triangular bandage applied to hand To apply a cravat bandage to the palm of the hand 1. Lay the middle of the cravat over the palm of the hand with the ends hanging down on each side (Figure 6A). 2. Take the end of the cravat at the little finger across the back of the hand, extending it upward over the base of the thumbs. Then, bring it downward across the palm (Figure 6B). 3. Take the end under the thumb and across the back of the hand, over the palm, and through the hollow between the thumb and palm (Figure 6C). 4. Take the ends to the back of the hand and across them; then, bring them over the wrist and cross them again (Figure 6D). 5. Bring both ends down and tie them with a non-slip knot on top of the wrist (Figures 6E and 6F). Figure 6 Cravat bandage applied to the palm of hand Leg (Upper and Lower) Bandage To apply a cravat bandage to the leg 1. Place the center of the cravat over the dressing (Figure 7A). 2. Take one end around and up the leg in a spiral motion and the other end around and down the leg in a spiral motion, overlapping in each preceding turn (Figure 7B). 3. Bring both ends together and tie them (Figure 7C) with a non-slip knot. Figure 7 Cravat bandage applied to the leg Knee Bandage In applying a cravat bandage to the knee as illustrated in Figure 8, use the same technique in bandaging the elbow. The same caution for the elbow also applies to the knee. Figure 8. Cravat bandage applied to the knee Foot Bandage To apply a triangular bandage to the foot 1. Place the foot in the middle of the triangular bandage with the heel well forward of the base (Figure 9A). Ensure that the toes do not come in contact with the absorbent materials to prevent chafing and irritation of the skin. 2. Place the apex over the top of the foot and tuck any excess material into the pleats on each side of the foot (Figure 9B). 3. Cross the ends on the top of the foot, take them around the ankle, and tie them at the front of the ankle (Figures 9C, 9D, and 9E). Figure 9 Triangular bandage applied to the foot Conclusion It is imperative that first aid or the immediate treatment of an ill or injured person be learned by everyone since accident happens anytime. Serious attention and readiness must be demonstrated by any individual who wishes to learn the rudiments of first aid. A first aider may encounter different problems in the performance of his/her duty. He/ She must remember that his/her decision and active participation depend on the circumstances that cause the injury or the sudden illness, the number of persons involved, the immediate environment, and the availability of medical assistance, emergency equipment, and help from others. The first aider needs to adapt to the situations at hand and improvise as necessary. He/She should also know the limits of his/her capabilities and should apply minimal effort to avoid further damage or injury to the victim. A good first aider must have a strong desire to help the victim. He/She should act tactfully and make quick and wise decisions depending on the condition of the injured person. REFERENCE: Villasoto, H.S & Villasoto, N. S. (2018). Human person gearing towards social development: NSTP- CWTS 1 worktext for college students. 2nd Edition. C & E Publishing, Inc. pp. 79 – 90