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CHAPTER HH - I HYGIENE AND SANITATION (PERSONAL AND CAMP HYGIENE) Introduction Maintaining hygiene and sanitation is necessary for many reasons; personal, social, health, psychological or simply as a way of life. Keeping a good stand...

CHAPTER HH - I HYGIENE AND SANITATION (PERSONAL AND CAMP HYGIENE) Introduction Maintaining hygiene and sanitation is necessary for many reasons; personal, social, health, psychological or simply as a way of life. Keeping a good standard of hygiene helps to prevent the development and spread of infections, illnesses and bad odors. Personal and Food Hygiene are necessary to preserve and improve the health of the individual and of the community as a whole. Its study is aimed at making the cadets aware of the many preventable health hazards and to enable them to look after themselves and their community most efficiently. It seeks to develop in them the concepts of healthy living. Personal hygiene involves all aspects of the health of an individual. Responsibility for the maintenance of personal health therefore lies with the individual. Every person must remain in perfect physical, mental and social health, only then can he serve the community and the country well. 2. Personal Hygiene. Personal hygiene involves those practices performed by an individual to care for one’s bodily health and well-being, through cleanliness. Maintenance of personal hygiene is very important in preventing disease. It deals with the practices that help in the maintenance and promotion of a person’s health. Personal hygiene habits such as washing hands and brushing teeth will keep bacteria, viruses and illness at bay. There are mental and physical benefits. Practicing good body hygiene helps you feel good about yourself. Main components of personal hygiene are:- Sleep is the periodical rest of both body and mind and it is extremely essential for a healthy body. The duration of sleep one requires varies with individual age. The average requirement of sleep is about 7 to 8 hours a day. Bathing, keeping the skin clean and in healthy condition is essential for good health. Wash your body regularly. Your body is constantly shedding skin. That skin needs to come off. Otherwise, it will take up and cause illnesses. Brush your teeth twice a day. Brushing minimizes the accumulation of bacteria in mouth which can cause tooth decay and gum diseases. Keeping finger and toe nails trimmed and in good shape will prevent problems such as hang nails and infected nail beds. Feet that are clean and dry are less likely to contact Athlete’s foot. Food Hygiene. Food hygiene is the condition and measures necessary to ensure the safety of food from production to consumption. Food can become contaminated at any point during slaughtering or harvesting, processing, storage, distribution, transportation and preparation. Lack of adequate food hygiene can lead to food borne diseases and death of consumer. The five keys to safer food are listed below:- Keep clean. Separate raw and cooked items. Cook thoroughly. Keep food at safe temperatures. Use safe water and raw materials. 4. Important Components of Food Hygiene. Food is a potential source of infection and is liable to contamination by microorganisms at any point during its journey from the producer to the consumer. Prevention of contamination of food has to be observed from production to handling, distribution and serving. The following are the important components of food hygiene. Milk Hygiene. Milk is an efficient vehicle for many disease organisms Contamination of milk may be through infected animal, human handler or environmental factors. Following aspects should be ensured to obtain clean and safe milk:- The animal and its surroundings should be healthy and clean. The animal should be properly washed before milking. Milk handler should be free from any communicable disease. Milk vessels should be cleaned, sanitized and kept covered. Water supply must be safe.  190 Pasteurization. It is the heating of milk to such temperature and for such periods of time, as are required to destroy any pathogens without destruction of nutritive value. It does not alter taste. Fish Hygiene. Fish for human consumption should be fresh. In fresh fish, the gills are bright red and the eyes are clear and prominent. Consumption of contaminated fish may give rise to fish poisoning. Egg Hygiene. Though the majority of freshly laid eggs are sterile inside, the egg shell may become contaminated by faecal matter from the hen. The egg must be properly washed before cooking. Fruits and Vegetables Hygiene. Fruits and vegetables are an important source for the spread of pathogenic organisms, protozoan and helminthes. Fruits and vegetables consumed raw must be washed well before eating. Hygiene of Eating Places. Eating places should not be located near filthy places, open drains, animal, sheds, manure/soakage pits and other such places. Floors should be easy to clean, and should be preferably tiled. Room for storage of food should be well ventilated, insect and rat proof and should have adequate lighting. Perishable and non-perishable items should be kept separately. Furniture should be strong and easy to clean. Refuse should be collected in covered bins and removed regularly. Water supply should be independent, adequate and safe. Proper place for cleaning of utensils should be provided. Hygiene of Food Handlers. Complete medical examination of food handlers must be done at the time of employment. Regular health check-ups should be done. Food handlers should be regularly educated on health and hygiene aspects. They should be constantly reminded about hand washing, trimming of nails, covering of hair, wearing of overalls and covering mouth while coughing and sneezing during cooking. Camp Hygiene Sanitation means keeping the living area and its surroundings neat and clean. This involves removal of waste products and refuse. Cook House. The quality of food in the Camp should be of high standard and purchased from authorised or reputed dealers. All precautions should be taken to ensure that no case of Food Poisoning occur in the Camps. A sample of food provided to cadets will be preserved for 36 hours after the meal is served. Cooking and serving of food. The following points need attention:- All preliminaries, such as, cutting, peeling and washing of food items will be done in a separate room. Proper preparation tables, cutting and chopping blocks will be used for the purpose The cooked food should be served hot and so timed that food is ready just a few minutes before distribution. Regular inspection of the hygiene, sanitation and cleanliness of the cook house staff and utensils should be carried out. Avoid over peeling, use of excessive oil, condiments, salt and sugar.  191 Soakage Pits. Each cook house will have soakage pit, 6 feet deep and 4 ½ feet wide. These pits will be fly-proofed, filled with lime stone/brick and covered with a top layer of earth. Waste food will be buried in refuse pits which will be located away from the cook houses. Water Points. Water used in the Camp must be from authorised source and must be checked by the local medical authority and certified as potable. Chemical for water treatment should be procured depending on requirement. Emphasis be laid on the following, Cleanliness of the water containers and the surroundings be ensured. Proper drainage facilities/soakage pits to avoid stagnation of water. Wherever possible, provision of RO plant should be ensured for drinking water. Camp Latrines. These are of following types:- Deep Trench Latrines. A pit three feet wide, at least eight feet deep and of a length suitable to the requirement is constructed and wooden seats placed over it with proper partitions and curtains. Soil may necessitate reverting of sides with sand bags, bamboos or wire netting. On vacation of camp, these are filled up with soil to assist in disintegration and prevent breeding of flies. Shallow Trench Latrines. For camps of less than a week’s duration, dig a row of trenches in parallel, each trench being 3 feet long, 1 foot wide and 2 feet deep. Each trench should be 2 feet apart. The ratio is 5 trenches for the first hundred users and three for each subsequent hundred. After defecation, the excreta are covered with loose earth with a shovel or a scoop. These trenches are filled up after 24 hours and new trenches are dug up. Urinals. The most common urinal used for camps is the Funnel Urinals which are constructed over a simple soakage pit. DTLs of proper specifications will be constructed and covered by proper latrine frames. Latrines will be smoked every morning. The wooden frames will also be washed twice a day and treated with lime. Partition screens will be erected for each latrine seat. Night Latrines will be earmarked and lighting provided. Sufficient urinals should be provided within the camp area. These will be treated daily with creosote and lime quick. Separate latrines and urinals will be established for girl and boy cadets and proper security ensured. Conclusion Adequate sanitation, together with good hygiene and safe water, are fundamental to good health and to social and economic development. Many sanitation programs are planned and executed by government bodies, and few are successful due to the failure to convince and educate the people of the importance of sanitation and the need for an active cooperation. Education factors play a very important role because it is only through the basic understanding of the need for sanitation can the people be mobilized for its implementation. It is only when they understand the consequences of the unsanitary conditions they have that they will be willing to change their habits. SUMMARY Personal hygiene involves those practices performed by an individual to care for one’s bodily health and well- being, through cleanliness. Maintenance of personal hygiene is very important in preventing disease. It deals with the practices that help in the maintenance and promotion of a person’s health. Food hygiene is the condition and measures necessary to ensure the safety of food from production to consumption. Food can become contaminated at any point during slaughtering or harvesting, processing, storage, distribution, transportation and preparation. Lack of adequate food hygiene can lead to foodborne diseases and death of consumer. The five keys to safer food are listed below:- Keep clean.  192 Separate raw and cooked items. Cook thoroughly. Keep food at safe temperatures. Use safe water and raw materials. Sanitation means keeping the living area and its surroundings neat and clean. This involves removal of waste products and refuse. DTLs of proper specifications will be constructed and covered by proper latrine frames. Latrines will be smoked every morning. The wooden frames will also be washed twice a day and treated with lime. Partition screens will be erected for each latrine seat.  193 CHAPTER HH - II FIRST AID IN COMMON MEDICAL EMERGENCIES AND TREATMENT OF WOUNDS Introduction First aid is the assistance given to any person suffering a sudden illness or injury, with care provided to preserve life, prevent the condition from worsening, and/or promote recovery. At its most basic, first aid is the initial assistance given to a victim of injury or illness. Comprised of relatively simple techniques that can be performed with rudimentary equipment, first aid is usually carried out by a lay person until professional medical assistance arrives. There will be number of occasions on which we may be faced with a situation where, we may be required to provide First Aid to the injured, because of an accident or due to any calamity. Therefore, it is very important for all cadets to have knowledge of providing basic First Aid in common medical emergencies. Injuries to Internal Organs Internal injuries cannot be seen but can only be suspected, where bleeding instead of coming to the surface occurs into the cavity of chest or abdomen where in important organs like heart, lungs, liver or spleen might get ruptured. The following symptoms are observed in case of internal injuries:- Cold clammy skin. Weak or rapid pulse. Shallow sighing and breathing. Face pinched and pale. Eyes deeply sunken with dark rings around them. Patient usually restless and anxious and may lose consciousness. Recognition. Trouble breathing Shallow breathing Tenderness at site of injury Deformity & bruising of chest Pain upon movement/deep breathing/coughing Dusky or blue lips or nail beds May cough up blood Crackling feeling upon touching victim’s skin Treatment. Call for an ambulance Assist the victim into a position of comfort Conduct a secondary survey Monitor patient’s condition carefully Be vigilant, keep alert for any changes. If a flail segment is suspected, tightly secure a bulky dressing (such as a tightly folded hand towel) to help stabilize the injury. Open Chest Wounds. An open pneumothorax or sucking chest wound - the chest wall has been penetrated (by knife, bullet, falling onto a sharp object...) Recognition. An open chest wound – escaping air Entrance and possible exit wound (exit wounds are more severe) Trouble breathing Sucking sound as air passes through opening in chest wall Blood or blood-stained bubbles may be expelled with each exhalation  194 Coughing up blood Treatment. Assess ABCs and intervene as necessary (ABC- Air way, Breathing, Circulation) Do not remove any embedded objects Call for an ambulance Lateral positioning: victim’s injured side down Treat for shock Conduct a secondary survey Monitor vitals carefully Burns and Scalds. Burns may be caused by heat either, dry by contact with fire or flame, or wet, as caused by moist heat such as hot water, hot fluids and steam, which is called scalding. Chemical burns may be caused by strong acids or alkalis. First aid Treatment. If the burn is chemical, let water from a pipe or hose flow freely on the burn so that the chemical flows off. Protect the burnt area by applying bandage or cover exposed part with clean towel or cloth. Give complete rest and plenty of fluids to the patient. Re-assure the patient. Evacuate patient to the nearest hospital or dispensary. Snake, Scorpion and Dog Bite Snake Bite. In Snake bite, the poison is injected by the snake through a pair of hollow and deeply grooved biting fangs. The majority of bites occur on parts of limbs which are exposed like hands, feet and lower legs. First Aid Treatment. All cases of snake bite should be treated as being bitten by poisonous snakes. The First Aid treatment will be as follows:- Make the victim lie down comfortably. Give convincing reassurance against fear of death. Apply a light constricting tourniquet with hand kerchief, bandage or shoe lace above the knee for a bite on the leg and above elbow for a bite on the arm. So that the poison does not flows to all parts of the body. Wash with soap and water. Use water freely. Evacuate the patient quickly to the nearest dispensary or hospital. If breathing fails, start artificial respiration. Snake Bites: Do’s and Don’ts. Do’s. Stay calm, make the victim lie down comfortably. Give convincing reassurance against fear of death. Call ambulance. Take off anything constricting the area, such as a ring or watch. Position the affected area at above heart level on the basis on the affected site. If breathing fails, start artificial respiration. Don’ts. Don’t apply ice as it can cause local tissue damage. Don’t cut the affected area and don’t attempt to suck venom out. Don’t use a commercially available extraction device.  195 Don’t use electrical therapy. Don’t apply any type of lotion or ointments. Scorpion Bite. Bite by scorpions should be treated like snake bite. First Aid Treatment. If blood has been drawn, the wound should be cleaned well with antiseptic lotion. 15. Rabid Dog Bite. Rabies is a very dangerous disease transmitted by a rabid dog. The disease is preventable by giving anti-rabies vaccine. First Aid Treatment. Immediately wash the bite area with lots of water and soap. Wound should be cleaned with available antiseptic. Patient should be sent to hospital for an anti-rabies injection course. Dog and the patient should be kept under observation for at least 10 days. Asphyxia. The tissue and organs of the body are supplied with oxygen through respiration, essential for the functioning of body. Respiration consists of inspiration, expiration and a pause. During inspiration air is drawn inside causing the lungs to expand. During expiration the lungs contract and air is pushed out. The respiratory system consists of the air passage known as respiratory tract and lungs. The actions of muscles concerned with respiration are controlled and regulated by the respiratory center of the brain. Causes. Anything which interferes with respiration producing irregularities in breathing, produces a condition known as Asphyxia. The main causes of Asphyxia are:- Drowning – due to water entering the air passage. Hanging and Strangulation – due to obstruction to entry of air. Suffocation. Due to obstruction to entry of air through the air passage. Foreign body obstruction in air passage. Inhalation of poisonous gases e.g. carbon monoxide. Over dosage of drugs such as sleeping pills, morphine, pethidine. Electric Shock. Diseases e.g. tetanus, epilepsy, rabies. Signs and Symptoms of Asphyxia. Dizziness and weakness. Shortness of breath rate or breathing increase. Rapid pulse. Partial loss of consciousness. Swelling of the veins of the neck. Face, lips, nails, fingers and toes turn blue. General Rules for Treatment of Asphyxia. Remove the cause if possible or the casualty from the cause. Ensure that there is a free passage for air. Lay the individual on his back. Press the head back-wards supporting the neck on your palm. Lift the tongue clear of the airway. Give mouth to mouth breathing. First Aid for Special Cases - Drowning. Wet clothes should be loosened.  196 Mouth, throat and nostril should be cleaned of mucus and any foreign body. Patient should be made to lie down over his belly, face down, head turned to one side, arms stretched beyond the head, tongue pulled out. Artificial respiration should be given till he starts breathing. Cover the patient with a blanket. First Aid in Case of Strangulation or Hanging. Cut the constriction. Clear the air passage. Start artificial respiration. Give inhalations if possible. Make the patient warm and comfortable. First Aid in Case of Choking. Bend the casualty’s head and shoulders forward, to dislodge the obstructions. In case of small child hold him upside down and thump his back hard between the shoulder blades or encourage vomiting by passing two fingers to the back of the throat. First Aid in Case of Suffocation by Poisonous Gas. Protect yourself and remove the casualty from the gas as early as possible. First Aid in Case of Electric Shocks. Switch off or break the current, if possible. Remove the casualty from contact with the current, if possible. Stand on some insulating material such as rubber soled shoes or boots or piles of newspapers. Give artificial respiration. Treat for shock and burns. Insensibility or Unconsciousness. Insensibility or unconsciousness is caused due to interruption of the action of the brain, through some interference with the functions of the central nervous system. Stages of Unconsciousness. (a) 1st Stage Delirium – When the restlessness of body and mind are present. Patient responds to loud commands, gives maximum response to (b) 2nd Stage Minimum stimulus. Semi- Coma- Patient responds to painful stimuli only (minimum (c) 3rd Stage Response to maximum stimulus). (d) 4th Stage When the patient makes no response to any Stimulus. Causes of Unconsciousness or Coma. Head injury and brain Hemorrhage. Hypoglycemia. Heart failure. Physical agents such as heat strokes, electric shocks. Epilepsy. General Rules of First Aid in Casualties of Unconsciousness. Make the patient lie down with head turned to one side. Pull out his tongue. Loosen the clothing, ensure fresh air. If breathing has stopped or is irregular, start artificial respiration. Keep the air passage clear. Nothing should be given by mouth. Remove false teeth, if any.  197 Artificial Respiration. If there is any irregularity in breathing or a cardiac arrest, artificial respiration is given. If it is given correctly and in time, the patient’s life can be saved. There are three methods for providing artificial respiration, but we will tell you only about the most common one. Mouth to Mouth Respiration. This is the most common and simple method and is given immediately. If given timely, it can save many lives. This can be given by following way:- Casualty should be in supine position. Clean the mouth and throat to maintain clear air passage. Extend the neck to straighten the air passages. Cover the patient’s mouth with clean gauze and blow directly and slowly into it. (10 – 12 times per minutes). First Aid for Different Type of Fractures First Aid In Case of Simple Fracture. The first aid to be rendered is:- Reassure the patient and make him comfortable. Apply splints with any common article like stick or ply board or card board to immobilize the fracture. Relieve him of discomfort and pain and keep the patient warm. 33. In Case of Compound Fracture. The first aid to be rendered is:- Bleeding should be stopped immediately. Remove foreign objects, if any, but do not meddle too much. Cover the wound with a clean pad with light bandage. Apply appropriate splints. Transfer the patient to the nearest hospital immediately. TREATMENT AND CARE OF WOUNDS Classification of Wounds 34. Definition. Wounds can be defined as a break in continuity of the skin or muscles membrane. It is caused by violence. Classification. According to level of contamination, a wound can be classified as under:- Inside Wound. It is wound caused by a sharp instrument like knife, razor and so on. Its edges are clean. Lacerated Wound. It is caused by blunt instrument. The edges are torn or uneven. Open Wound/ Punctured Wound. It is a deep narrow wound caused by a pointed instrument like knife, bayonet. The wound is small on the surface but may be very deep causing injuries to internal organs. Closed Wound/ Contusion. A contusion is an injury or a bruise in which some of the tissues or a part is irregularly torn or ruptured but, the skin may not be broken. It is caused by a blow or blunt instrument.  198 Open Wound. Open wounds can be classified according to the object that caused the wound:- Incisions or Incised Wounds. Caused by a clean, sharp-edged object such as a knife, razor, or glass splinter. Lacerations. Irregular tear-like wounds caused by some blunt trauma. Lacerations and incisions may appear linear (regular) or stellate (irregular). The term laceration is commonly misused in reference to incisions. Abrasions (Grazes). Superficial wounds in which the top most layer of the skin (the epidermis) is scraped off. Abrasions are often caused by a sliding fall onto a rough surface. Avulsions. Injuries in which a body structure is forcibly detached from its normal point of insertion. A type of amputation where the extremity is pulled off rather than cut off. Puncture Wounds. Caused by an object puncturing the skin, such as a splinter, nail or needle. Puncture Wounds Wounds. Caused by a bullet or similar projectile driving into or through the body. There may be two wounds, one at the site of entry and one at the site of exit, generally referred to as a "through- and-through." Closed Wound. Closed wounds have fewer categories, but are just as dangerous as open wounds: (a) Hematomas (or blood tumor). Caused by damage to a blood vessel that in turn causes blood to collect under the skin. Hematomas that originate from internal blood vessel pathology are petechiae, purpura, and ecchymosis. The different classifications are based on size. Hematomas that originate from an external source of trauma are contusions, also commonly called bruises. Crush Injury. Caused by a great or extreme amount of force applied over a long period of time. First Aid For Wounds. The method for giving first aid for different types of wounds are:- Place the patient in a comfortable position. Stop the bleeding, if any. Remove any foreign body, if it is easily visible and can be easily removed. Prevent the entry of germs by applying sterilized dressing like first field or shell dressing. Give rest to the injured part by sling. Immobilize the part, if wound is large or complicated by fracture. Treat the patient for shock. Send the patient to nearest hospital. Dressing of Wounds. A wound is to be cleaned with antiseptic lotion and covered with cotton or gauze piece with medication, before applying the bandage. Aim. The aim of dressing a wound is as under:- To protect the wound from infection. To reduce swelling and early healing. To support the effected part. To enable the individual to carry out his day to day routine. To stop the bleeding.  199 Articles Required for Dressing of Wounds. Anti septic (A/S) lotion. Cotton / Gauze piece Scissors. Bandages of different size and band aid. A/S ointment or powder. Procedure for Dressing of Wounds. The following procedure is to be adopted while dressing of wounds:- Reassure the patient and place him in comfortable position. Stop the bleeding, remove foreign body and clean the wound with A/S lotion and cotton. Apply A/S ointment or powder and cover it with gauze. Select suitable bandage, start bandaging clock wise from outer aspect to inner aspect by covering 1/3 of previous lining. Put the knot away from the wound. Bandaging should not be either too tight or loose. Conclusion Wounds are a common feature among humans who are outdoor oriented. If cared properly during early stage the wounds heal quickly. Resultantly the wounded person suffers less and is available to the society as a healthy and fit person to resume work. NCC cadets by virtue of their routine are prone to injuries and hence must possess this basic knowledge to help fellow cadets or friends in school or at home. SUMMARY First aid is the assistance given to any person suffering a sudden illness or injury, with care provided to preserve life, prevent the condition from worsening, and/or promote recovery. At its most basic, first aid is the initial assistance given to a victim of injury or illness. Comprised of relatively simple techniques that can be performed with rudimentary equipment, first aid is usually carried out by a lay person until professional medical assistance arrives. The following symptoms are observed in case of internal injuries:- Cold clammy skin. Weak or rapid pulse. Shallow sighing and breathing. Face pinched and pale. Eyes deeply sunken with dark rings around them. Patient usually restless and anxious and may lose consciousness. Burns and Scalds. First aid Treatment. If the burn is chemical, let water from a pipe or hose flow freely on the burn so that the chemical flows off. Protect the burnt area by applying bandage or cover exposed part with clean towel or cloth. Give complete rest and plenty of fluids to the patient. Re-assure the patient. Evacuate patient to the nearest hospital or dispensary. Snake Bite. First Aid Treatment. All cases of snake bite should be treated as being bitten by poisonous snakes. The First Aid treatment will be as follows:- Make the victim lie down comfortably. Give convincing reassurance against fear of death.  200 Apply a light constricting tourniquet with hand kerchief, bandage or shoe lace above the knee for a bite on the leg and above elbow for a bite on the arm. So that the poison does not flows to all parts of the body. Wash with soap and water. Use water freely. Evacuate the patient quickly to the nearest dispensary or hospital. If breathing fails, start artificial respiration. 5. Rabid Dog Bite First Aid Treatment. Immediately wash the bite area with lots of water and soap. Wound should be cleaned with available antiseptic. Patient should be sent to hospital for an anti-rabies injection course. Dog and the patient should be kept under observation for at least 10 days. 6. Foreign Body in Eye First Aid Treatment. Ask the patient not to rub the eyes. Wash the eye with water repeatedly for a minute or two. Search for the foreign body by lifting the upper eyelid and parting the lower eyelid down. The patient should face the light. If the foreign body is seen, it can be wiped off with the moistened corner of hand kerchief, cloth or cotton swab. If foreign body is fixed to the eye-ball, patient should be sent to the hospital with a light eye bandage. 7. Foreign Body in Nose First Aid Treatment. Blowing the nose and sneezing may expel the foreign body. Make the casualty breathe through the mouth. Do not try to remove the foreign body. Send the patient to the nearest hospital. The main causes of Asphyxia are:- Drowning – due to water entering the air passage. Hanging and Strangulation – due to obstruction to entry of air. Suffocation. Due to obstruction to entry of air through the air passage. Foreign body obstruction in air passage. Inhalation of poisonous gases e.g. carbon monoxide. Over dosage of drugs such as sleeping pills, morphine, pethedine. Electric Shock. Diseases e.g. tetanus, epilepsy, rabies. Signs and Symptoms of Asphyxia. Dizziness and weakness. Shortness of breath rate or breathing increase. Rapid pulse. Partial loss of consciousness. Swelling of the veins of the neck. Face, lips, nails, fingers and toes turn blue. General Rules for Treatment of Asphyxia. Remove the cause if possible or the casualty from the cause. Ensure that there is a free passage for air.  201 Lay the individual on his back. Press the head back-wards supporting the neck on your palm. Lift the tongue clear of the airway. Give mouth to mouth breathing. First Aid in Case of Electric Shocks. Switch off or break the current, if possible. Remove the casualty from contact with the current, if possible. Stand on some insulating material such as rubber soled shoes or boots or piles of newspapers. Give artificial respiration. Treat for shock and burns. General Rules of First Aid in Casualties of Unconsciousness. Make the patient lie down with head turned to one side. Pull out his tongue. Loosen the clothing, ensure fresh air. If breathing has stopped or is irregular, start artificial respiration. Keep the air passage clear. Nothing should be given by mouth. Remove false teeth, if any. Artificial Respiration. If there is any irregularity in breathing or a cardiac arrest, artificial respiration is given. If it is given correctly and in time, the patient’s life can be saved. There are three methods for providing artificial respiration, but we will tell you only about the most common one. Mouth to Mouth Respiration. This is the most common and simple method and is given immediately. If given timely, it can save many lives. This can be given by following way:- Casualty should be in supine position. Clean the mouth and throat to maintain clear air passage. Extend the neck to straighten the air passages. Cover the patient’s mouth with clean gauze and blow directly and slowly into it. (10 – 12 times per minutes). Wounds Wounds can be defined as a break in continuity of the skin or muscles membrane. It is caused by violence. According to level of contamination, a wound can be classified as under:- Inside Wound. Lacerated Wound. Open Wound/ Punctured Wound. Closed Wound/ Contusion. First Aid for Wounds. The method for giving first aid for different types of wounds are:- Place the patient in a comfortable position. Stop the bleeding, if any. Remove any foreign body, if it is easily visible and can be easily removed. Prevent the entry of germs by applying sterilized dressing like first field or shell dressing. Give rest to the injured part by sling. Immobilize the part, if wound is large or complicated by fracture. Treat the patient for shock. Send the patient to nearest hospital. Procedure for Dressing of Wounds. The following procedure is to be adopted while dressing of wounds:- Reassure the patient and place him in comfortable position. Stop the bleeding, remove foreign body and clean the wound with A/S lotion and cotton. Apply A/S ointment or powder and cover it with gauze. Select suitable bandage, start bandaging clock wise from outer aspect to inner aspect by covering 1/3 of previous lining. Put the knot away from the wound. Bandaging should not be either too tight or loose.  202 CHAPTER HH - III INTRODUCTION TO YOGA Introduction Yoga is a commonly known activity for physical, mental, and spiritual disciplines which originated in ancient India. One of the most detailed and thorough expositions on the subject are the Yog Sutras of Patanjali. Various traditions of yoga are found in Hinduism, Buddhism, Jainism and Sikhism. UNO has declared 21 June as the International Day of yoga. NCC is practising, propagating and celebrating this in a big way every year. Definition and Purpose of Yoga 2. Definition. The concepts and practices of Yoga originated in India about several thousand years ago. Its founders were great Saints and Sages. The great Yogis presented rational interpretation of their experiences of Yoga and brought about a practical and scientifically sound method within everyone’s reach. Yoga today is no longer restricted to hermits, saints and sages; it has entered into our everyday lives and has aroused a worldwide awakening and acceptance in the last few decades. The science of Yoga and its techniques have been reoriented to suit modern sociological needs and lifestyles. Experts of various branches of medicine including modern medical sciences are realizing the role of these techniques in the prevention and mitigation of diseases and promotion of health. Purpose Yoga is a disciplined method utilized for attaining a goal. In the sense the physical postures of yoga are to alleviate health problems, reduce stress and make the spine supple. Yoga is also used as a complete exercise program and physical therapy routine. The characteristics of Yoga are given below:- The Yogic system of health involves the exercise of skeletal as well as the deep-seated smooth muscles of the body. The intra-thoracic and intra-abdominal pressure may be mentioned as special characteristics of the yoga system of health. Little expenditure of energy and money is involved in the Yoga practices. The rich as well as poor, and men and women of all ages can practice Yogic practices. Every school of Yoga emphasized specific practices, but their aim always remained the same; but the highest level of integration through the control of the modification of mind. The nature of Yogic practices is psycho-neurophysical. All yogic practices are complementary. Asanas There are innumerable asanas. Some of the asanas useful for curing ailments and for maintaining good health are as follows:- (a) Padmasana. Sit on the asan. Spread the leg forward, place your left foot on the join of your right thigh, and right foot on the joint of left thigh in such a way that both heels touch each other below your navel in the middle of abdomen. Place your hands on your knees. Keep the head and spinal column erect. Keep your eyes close or open. Stay in the final position for 1- 2 minutes in the initial stage. Later increase the time  203 gradually. This asan is useful for Jaap, Dhyana and Samadhi. This asan also helps in curing diseases like asthama, hysteria and insomnia. Siddhasana. The main function of this asana is to awaken the power of Kundalini. Sit on the carpet. Place the heel of left foot under the testis on the prostrate gland in such a way, that the sole of your foot should be placed at root of genitals. Place the hand on the knees so that palm face upward. This asana helps the mind to be firm, attentive and alert. Gyan Mudra. Sit in Padmasana or siddhasana. Put your Hands on your knees with palm facing upwards. Bend your index finger and place them at the root of your thumbs. Spread the remaining three fingers forward, all joined together. This asana is most suitable for pranayam and dhyana. (d) Suryanamaskara. Suryanamaskara is a combined sequence of 12 positions. By this sequence of 12 positions, the whole body is well exercised. While practicing Suryanamaskara recite the different names of Sun god at each position. Stage 1:- Stand in attention. Fold your hands in the centre of your chest. Now recite the first of the twelve mantras. Stage 2:- Stretch your hands up and take the body backwards from the waist as far as possible. The hands must remain straight and touch your ears. (iii) Stage 3:- Now bend down without bending the knees. Try to put the palms on the ground and touch the nose with knees without bending knees. Stage 4:- Take left leg back. Bend your right knee, the knee will remain between the two arms, with the hands sticking to the ground, Now bend the neck backward as far as possible. Look forward and hold the breath. State 5:- Take right leg back. Put both the toes and the knees together and pull your body up in such a way that it looks like inverted ‘V’. Look backward through your legs keeping the head, the waist and the arms in a straight line. State 6:- Bend down your body in such a way that your forehead, chest and knees should touch the ground except your hips which should be slightly raised from the ground. State 7:- Stretch the arms, Inhale, put the chest forward and move back your neck as much as you can. Look up and hold the breath. State 8:-Maintain same position as in Stage 5. Stage 9:-Maintain same position as in Stage 4.  204 Stage 10:-Maintain same position as in Stage 3. Stage 11:-Maintain same position as in stage 2. Stage 12:- Maintain same position as in Stage 1 and then take your hand down. Make the rest posture. Shavasana. The main aim of this asana is releasing the mind from the body. By this asana we can achieve relaxation in the shortest possible time. This asana provides relief in disease like blood pressure, weakness of nerves and other ailments. Lie on your back and let your body be relaxed completely. Your feet should be 30-45 cm apart, arms in sides with palm upwards, eyes gently closed with attention on breathing. Keep body in a straight position. For proper blood circulation in the body, the legs, hand and neck should have no curves or bend. Take a long and deep breath then concentrate on each and every part of your body, putting it in a relaxed state Timing 5-10 minutes. Vajrasana. Bend the legs and sit on knees. Place the heels at the sides of the anus in such a way that thighs rest on the legs and the buttock rest on the heels. Stretch the arms and place the hands on the knees. Keep the knees close by. Sit erect. This asana can be done immediately after eating food. This helps digestion and eliminates gas troubles. Timing 1-3 minutes. Dhanurasana. Lie down on the chest, legs should be folded at the knees and the feet should be grasped with both the hands near the ankles. The thighs and the chest should be raised, making the body appear like a bow. This asana provides good exercise to the abdominal muscles, lower back and thighs, Timing 10-30 seconds, 4-5 times. Chakrasana. Lie down on the back. Bend the legs at the knees. Heels are close to the hips and sole touching the ground. Bend the arms at the elbows and place them on the ground on either side of the head. Place them in such a way that palms should rest on the ground and the direction of the fingers should be towards your feet. First raise your hips and waist, keeping the legs straight. Raise the back as far as possible. This asana helps in making the spine supple. Timing ½ -1 min, 1-2 times.  205 Sarvangasana. Lie down flat on the back. Raise legs from the hips, push the trunk up until legs are in vertical position. The chin should press against the chest. The hands are giving support to lower ribs. Hold this position up to 2-10 minutes. Come back as slowly as possible. Do not give any jerks to the body. This asana improves circulatory, respiratory and alimentary systems of the body. Timings: ½ -1 minute. Halasana. Lie down flat on the back. Place the arms by sides along the hips, palm facing the ground. The legs are raised up in a single motion and put down behind the head keeping knees unbent. The chin should touch the chest. In this exercise, the legs will remain straight and breathing should be normal. Hold this position for 30-50 seconds. This asana stimulates blood circulation and makes the spine flexible and elastic. Conclusion Yoga is a subject which can be looked at intellectually and some useful and beneficial ideas imbibed. Yoga can be imbibed by adopting certain attitudes which alter the nature of the samskaras. Yoga can be imbibed by living in an ashram environment and trying to be aware of the physical, mental and spiritual dimensions at the same time. Yoga can be learnt in a classroom environment as science, as psychology, as an applied subject, with the aim of providing new understanding and insight into the life process, into areas where karmas are performed, into areas which shape the inner being in terms of awareness, inner development, the experience of harmony or balance, eventually culminating in the experience of samadhi and the fullness of wisdom, prajna. SUMMARY Yoga is a commonly known activity for physical, mental, and spiritual disciplines which originated in ancient India. One of the most detailed and thorough expositions on the subject are the Yog Sutras of Patanjali. The concepts and practices of Yoga originated in India about several thousand years ago. Its founders were great Saints and Sages. The great Yogis presented rational interpretation of their experiences of Yoga and brought about a practical and scientifically sound method within everyone’s reach. The characteristics of Yoga are given below:- The Yogic system of health involves the exercise of skeletal as well as the deep-seated smooth muscles of the body. The intra-thoracic and intra-abdominal pressure may be mentioned as special characteristics of the yoga system of health. Little expenditure of energy and money is involved in the Yoga practices. The rich as well as poor, and men and women of all ages can practice Yogic practices. Every school of Yoga emphasized specific practices, but their aim always remained the same; but the highest level of integration through the control of the modification of mind. The nature of Yogic practices is psycho-neurophysical. All yogic practices are complementary.