FIRST AID

PAGE1

SECTION ONE

STANDARD

FIRST AID

THEORY AND SKILLS

CHAPTER I

THE WHY AND HOW OF FIRST AID

Definition of First Aid

 

First aid is defined as the immediate and temporary

care given the victim of an accident or sudden illness until

the services of a physician can be obtained.

First aid commences with the steadying effect upon

the stricken person when he realizes that competent hands

will help him. The victim suddenly has new problems and

needs. Often he cannot think well temporarily. Events may

seem unreal and remote. His mind may be dull. The emo-

tonal reaction associated with a serious accident subsides

only gradually. Therefore first aid is more than a dressing

or a splint. It relates to the victim's mind and spirit as well

as to his physical injuries. Its contributions include the well-

selected word of encouragement, the expression of willingness 

to help, and the up lift in effect, of the first aider,

voice the immediate problems, the information given con

evident capability. The thoughtful suggestions made to

selfing nearby physicians and hospitals, the telephone ch

co summon medical help of an ambulance or to notify a

relative- these too are first aid.

The good first aider deals with the whole situation, the

person, and the injury. He knows what not to do as well as

what to do. Thus he avoids the etrots so commonly made

through well-meant but misguided efforts. He confines his

procedures to what is necessary, recalling that the handling

injured parts should be kept to a minimum.

The Value of First Aid Training

Value to self

Although many people study first aid in order to help

Others, the training primarily helps the student himself. It

enables him to give proper immediate care to his own

injuries. If he is too seriously injured to help himself, he may

be able to direct others toward proper care. He need not

entrust his injured body to the first aid knowledge of

random passers-by.

First aid training also helps the student by developing

his safety consciousness. Most people recognize the gravity

of our accident problem. Their efforts toward safety, how-

ever, may be occasional and hit-or-miss rather than a part

of a carefully organized plan developed by them for safe

living. The first aid course sharpens the desire for safety,

shows how accidents occur, and focuses attention upon

many specific ways to avoid accidents. A good way to guide

In one toward safety is to have him take a first aid course,

Value to others

Having studied first aid, one is more likely to assist

family members wisely if they are stricken, to give them

some instruction in first aid, and to promote among them a

reasonable safety attitude. While the principal benefits are

to the student and his family, they extend farther, usually,

to co-workers, acquaintances, and strangers. There is always

an obligation on a humanitarian basis to assist the stricken, the helpless.

Value in civil defense

First aid training is recognized as an important aspect

of civil defense. In case of catastrophe, with medical and

hospital service curtailed, citizens must rely largely upon

themselves for a time, caring for their own injuries and for

those of others. Possession of first aid knowledge is a civic

responsibility.

Value in fostering safety consciousness

Disabling accidents, severe enough to cause loss of time

from the usual duties for at least one day after the day of

injury, occur annually in from one-fifth to one-fourth of

our family units. After the first year of life, all through

childhood and early adulthood, accidents are the common-

est cause of death; thereafter they are one of the leading

causes. The rate is about twice as high among males as

females, with many wage-earners affected. The annual

costs for medical and hospital service and direct property

 

THE WHY AND HOW OF FIRST AID

damage alone total slightly less than one percent of national

personal income. When all wage losses and insurance costs

are added, the total is about three percent. Such costs, year

After a year, greatly affects welfare expenses, and rehabilitation needs.

They reflect the fact that many daily serious

accidents represent an enormous expense and a large number of personal tragedies.

How can first aid help us avoid accidents? Some rea-

sons have already been given. When we spend some hours

studying fractures, head injuries, and burns, we appreciate

with more force what it means to suffer injury. Thereafter

safety programs seem more important and we personalize

their message is better. Thus first aid training fosters force-

fully the safety consciousness that we all need.

 

General Directions for First Aid

Most accidents are minor and the first aid needed is

obvious to a trained person. In case of serious injury, the

following sequence of action is usually applicable: give the

urgently necessary first aid, have the victim lie down, check

for injuries, plan what to do, and carry out the indicated procedures.

Give urgently necessary first aid

Act quickly for injuries where each second of delay is

important: (a) severe bleeding, (b) stoppage of breathing

where artificial respiration helps, and (c) poisoning. The

proper first aid will be described later. While the first aider's

time and attention are devoted to the patient, someone else

should go or call for a physician: burns, for example-

Other injuries require prompt help. -severe

-but the immediate danger to life is

hot 50 great. The urgent cases are seldom encountered; they

Can usually be recognized and, the first aid requirements

are relatively simple. With most serious accidents, the first

Aider commences with the next step.

Keep the victim lying down

Protect him from unnecessary manipulation and dis-

turbance. Do not heat the patient but keep the body tem-

perature from falling. Blankets beneath are usually more

important than above, but there is hazard in placing them

before you know where the injuries are.

Check for injuries

Your clues are the story of what happened, the vic-

tim's reactions after the accident, his own ideas about his

injuries, and your findings upon examination. The direction 

and extent of examination should be guided by the

kind of accident and the needs of the situation. Have a

reason for what you do. If the urgent first aid has been

given and the patient is properly protected pending early

arrival of a physician, a detailed examination is unnecessary.

 If you must move the victim even a short distance

before the physician comes, you should first learn what

body parts are injured so that you can support them ade-

quately during the transfer.

Suppose, however, you must carry through with first

aid and perhaps transport the victim. Here you must check

carefully for injuries. Sometimes the task is simple because

it clearly involves a single exposed part, or because, by the

of the accident, there is no possibility of fractures,

pacerations, and the like. An example is poisoning. In other

cases you recognize that any body part may be injured and

require attention. These cases are the accidents caused by

force: for example, traffic accidents, falls, gunshot wounds, blows.

With them, you should assure yourself, through

consideration of the above-mentioned clues, about every

body part--the head, neck, trunk, each extremity in turn.

Remember always to consider head injury and back injury.

With each part, think of surface injury, of fractures, and

of internal organ injury. In addition, note the patient's

general condition and state of consciousness.

Surface injuries are readily evident. Fractures and internal 

Organ injuries present greater difficulties. Visual evi-

dence may be lacking with the former and almost always

is with the latter. Therefore your objective in checkup for

them is simple: find what body parts are, or possibly may

be injured. Your first aid should aim to keep these parts

immobile.

Checkup for injuries is far more accurate when the

body part is exposed. Such exposure may be possible in the

home. Utmost caution should be used when clothing is re-

moved, lest added injury result. In public places, with

strangers as victims, exposure of body parts that possibly

may be injured is not generally advisable. In such case you

must act in the light of such knowledge as you can obtain

from the story of the accident, the victim's ideas and re-

actions, and whatever checkup you can make. When in

doubt about a body part, keep it from twisting, bending, and shaking and do not jackknife the patient

Do not pick him up by head and heels.

 

Plan what to do

"Get a physician or ambulance or obtain medical advice

by telephone. This should be one of the first moves. Discuss

the problem with responsible relatives or friends of the vic:

him who are at hand or briefly with the victim. If helpers

are needed, instruct them carefully in their duties.

Carry out the indicated first aid

Knowing what to do presents few difficulties, once the

the nature and location of the injuries are learned. Do not

attempt to save time and effort by using second-best

methods of first aid for this person entrusted temporarily

to you in his distress. First, stop profuse bleeding and deter-

mine whether artificial respiration is necessary. After that,

one may take time for a more general examination.

Selected additional pointers

Find all the injuries. The checkup is often incomplete

or sketchy after the first injury is found--especially if it

is a major injury.

Give first aid to minor as well as major injuries. For

example, a common error upon finding a fracture of a large

bone and one of a small bone is to splint only the large bone.

Do not give fluids to an unconscious or partly con-

scious person, because they may enter the windpipe. Do not

attempt to rouse an unconscious person by shaking him,

talking, or shouting.

Following injury, do not lift a gasping person by the

belt. This is done very often and may aggravate injuries of

the back or internal organs. Gasping is not always caused by

Image insufficient oxygen but may be due to injury of back or

chest.

'with indoor accidents, use judgment about opening

windows when weather is cold except when noxious gases

are present and may have caused the accident. Indoors or

out, the victim has enough air, and cold air may be too

chilling.

Be reluctant to make statements to the victim and by.

standers about the injuries. It is not the first aider's province

Diagnose, evaluate and predict. Upon questioning from

the victim, you can answer that you would rather have the

physician give information. Helpers must be given neces-.

sary information, however.

Obtain the victim's name and address. When calling

for a physician or ambulance, be sure to give the exact loca-

tion of the injured person, and such information as you

have concerning the nature of the injuries. Be sure that the

physician or ambulance driver knows where to go. Take

advantage of the telephone call to obtain good advice con-

cerning first aid. To avoid missing questions or advice, wait

until the physician or driver hangs up.

Reassure the victim by telling him what first aid steps

you are going to take and how they will help him.

If the victim is unconscious, loosen clothing about his

neck. If there is no fracture turn the patient on his side,

maintaining this position by flexing the leg or legs, and place

a pillow under the head so that secretions may drool from

the corner of the mouth. This will usually allow good res-

piration.

 

WOUNDS

To protect the wound from contamination

Objective

and control bleeding.

Definition

A wound is a break in the skin or mucous membrane.

It is caused by force and usually extends into the under-

lying tissue. Wounds may be classified into four types.

1. Abrasions, made by rubbing or scraping. Floor

burns or scuff burns, although called burns, are

true wounds.

2. Incised wounds, sharp cuts that tend to bleed freely.

3. Lacerated wounds, jagged or

irregular wounds,

often associated with much tissue damage.

4. Puncture wounds. A tack, run through the skin,

makes a typical, small puncture wound.

Wounds are subject to infection and bleeding. Deep

wounds may be complicated by injury to internal organs

and by fractures.

Prevention

Wounds are common accidental injuries, but many

can be prevented. Some measures might include:

 

Fig. 3 Four types of wounds

A. Abrasion B. Incised

C. Lacerated

D. Punctured

1. Keep firearms and ammunition under lock and key.

2. Keep knives, scissors, and other sharp implements

in a special storage place, well out of reach of small children.

3. Caution children about running while carrying

sharp instruments and about running against glass doors.

4. Put razor blades in a closed container where chil-

dren cannot find them.

5. Take special care when using knives or other sharp

WOUNDS

implements. Always hand a knife to another person

with the point turned away from the recipient.

6. Be especially careful in handling such equipment

as power mowers or power tools. Follow instruc- tons carefully.

7. Make sure that broken glass is swept up promptly. Infection

The growth of harmful germs in a wound constitutes

a wound infection. The germs destroy tissue about them.

 

Some kinds liberate poisons (toxins) that are carried

throughout the body, causing fever, and systemic injury.

Germs are everywhere about us in great numbers.

Some kinds are not harmful to man. Few can penetrate the

intact skin; but when a break, however tiny, occurs in the

skin, there is danger of infection. The body, like virtually

all objects about us, has a coating of germs. Therefore a

penetrating object carries in its own supply of germs and

also pushes some from the skin and perhaps the clothing into

the wound.

Evidence of infection does not appear at once after

injury, because the germs need some time to grow and

multiply. The evidence usually appears from two to seven

days or more later. The wound area becomes tender, red,

warm, and swollen; sometimes pus appears. Pus consists of

white blood cells, germs, and tissue debris. White blood cells,

like certain body chemicals, aid in fighting germs. Some-

times red streaks extend from the wound up the arm or leg,

and there may be tender nodules (small lumps) in the arm-

pit or groin. These indicate that certain drainage channels,

the lymph vessels, are also infected and show that the infection 

is spreading. Fever and headache are often asso.

cited with infected wounds.

The tiniest wound permits entrance of thousands of

germs. Any wound, no matter how small, should have ade

quote attention. The man who boasts that he never has had

an infection has merely been fortunate. In the past, he hap.

pened to have resistance against the germs that entered his

wounds. Tomorrow he may meet a different variety. How.

ever, self-treatment is occasionally resorted to.

Wounds of the palms, of the lower extremities below

the knees, or the face, and those overlying joints involve

greater than usual danger. If infection develops in these

areas, results may be grave. Diabetics, and those with hardening 

of the arteries or other circulatory disease, especially

should beware of infection in the lower extremities.

First Aid

Wounds in which bleeding is not severe

Home care for minor scratches. The best source of in-

formation concerning home care for minor scratches is

the family physician. Lacking such advice, the following

procedure may be followed if you elect to assume personal

responsibility and the risks of home care:

1. Wash your hands thoroughly with clean water and soap.

2. Cleanse the injury thoroughly, using plain soap

and boiled water cooled to room temperature or

clean running tap water and soap, applying the

soap and water with a sterile dressing. Sterile

dressings are described below.

S. Apply a dry sterile, or clean dressing, and bandage

it snugly into place.

4 Toll the patient to see his doctor promptly it evidence 

of infection appears.

First aid preliminary to medical care. Usually the only

procedure should be to apply a sterile or clean dressing an

bandage it into place. Exceptions are noted with special

wounds later. The term "dressing," as used in this textbook

refers to the material that is placed directly over the wound,

and "bandage" means the material used to hold the dressing

in place. Sterile dressings are entirely free from germs. Such

dressings are available commercially in protective packets.

Care must be taken lest the dressing be contaminated with

germs while you apply it. The hands, the outside of the

packet, and any object touched by the dressing harbor

germs. Therefore wash your hands first. Upon opening the

packet, grasp the dressing by one corner and place it over

the wound so that the corner you touched does not overlie

the wound. Do not cough or breathe closely upon the

dressing. Dressings should be large enough to extend well

beyond the wound edges; remember that they may slip.

Then bandage the dressing into place. Bandages should

be clean, but not necessarily sterile. They should be snug,

but not tight enough to impede circulation.

If sterile dressings are not available, use a clean fabric,

with at least four layers over the wound. If possible, treat

the fabric to remove at least some of the germs. You can

scorch it with a flame, iron it, heat it under close observa-

tion in a hot oven, wash it with soap and water and then

ay it thoroughly, Or expose it for at least ten minutes to

re direct rays of the sun. The best method is to boil the

fabric for a few minutes, and then dry it. Fluff cotton

Should not be placed upon a wound; the fibers are hard to remove.