MODULE OF FUNDAMENTAL OF NURSING

UNIT: FIRST AID

BY MUGANZA GABRIEL
College of Medicine and Health Sciences
School of Nursing and Midwifery (RWAMAGANA
CAMPUS)
Facilitator information
• MUGANZA KULYA GABRIEL
• Email: [email protected]
• [email protected]
• Phone number: 0788562614
• 0722562614
COURSE DESCRIPTION

• First Aid will help 1st year students to acquire knowledge and skills
necessary to give care in an emergency situation, help sustain life and
minimize the consequences of injury or sudden illness until medical
help arrives.
LEARNING OUTCOMES
• At the end of the unit, learner will be able to:
Knowledge & understanding
• Define concepts and terminologies related to first aid
• Discuss a range of actions during first aid process
Cognitive/Intellectual skills/Application of Knowledge
• Apply the principles of first aid in the management of emergency
situations
Communication, ICT & numeracy skills
• Interpret and communicate vital sign findings
General transferable skills
• Recognize personal and bystanders’ safety and need for transfer during
emergence situation
COURSE PREREQUISITES

• Foundation of nursing Practice

• Anatomy and physiology

Unit content
• Definition of concepts
• Principles of first aid care
• First Aid And Basic Life Support
• Basic Life Saving Skills
• Management of common first aid emergencies (Medical, Physical,
Chemical)
LEARNING MATERIALS

• Canadian Medical Association, (1997) First-Aid Manual Emergency

procedures for everyone at home, at work, or at leisure. CAEP
(Canadian Association Emergency physicians) Co-Editors : Garth
Dickinson, MDFRCPC, Catheline younger –Lewis, MD, Montreal
• Canadian Red Cross, (2001) First Aid the vital link second edition,
Canada
• Green cross for safety, (1992) National safety council Essential of
first-aid and CPR, Boston
DEFINITION OF FIRST AID
The Encyclopedia states First Aid as "measures to be taken immediately after an accident
not with an idea to cure but in order to prevent further harm being done".
First Aid is the initial assistance or treatment given to a casualty for any injury or sudden
illness before the arrival of an ambulance, doctor, or other qualified personnel.
It uses the available human and material resources at the site of accident to provide initial
care to the victim of injury or sudden illness until more advance care is provided.
The person who provides this help is a first aider.
Bystanders: Somebody who observes the accident but is not involved in action.
Casualty :
A person who is involved in the accident or illness that may need
immediate help.
Emergency
unexpected situation that may cause injury, loss of life, damage to the
property, and/or interference with the normal activities of a person
which, therefore, requires immediate attention and remedial action.
 Triage
• Triage is process for sorting injured people into groups based on their
need for or likely benefit from immediate medical treatment.

• Triage is used in hospital emergency rooms, on battlefields, and at

disaster sites when limited medical resources must be allocated.
safety
• Absence of danger.
• Survey the emergency scene to make sure there are no dangers.
• If it is dangerous call for help, make the area safe, or move the person
from danger.
AIMS OF FIRST AID
First Aid has the following main objectives:
Preserve life and provide initial emergency care and treatment to sick
or injured people
Protect the unconscious
Prevent a casualty’s condition from becoming worse
Promote the recovery of the casualty
RESPONSIBILITIES AS A FIRST AIDER
1. To assess the situation quickly and safely and call for appropriate help
2. To protect casualties and others at the scene from possible danger
3. To identify, as far as possible, the nature of illness or injury affecting
casualty.
4. To give each casualty early and appropriate treatment, treating the most
serious condition first.
5. To arrange for the casualty’s removal to hospital or into the care of a health
professional.
6. To remain with a casualty until appropriate care is available.
7. To report observations to those taking care of the casualty, and to give
further assistance if required.
8. To prevent cross-infection between yourself and the injured as much as
possible
PRIORITY OF CASUALTIES
• Save the conscious casualties before the unconscious ones as they have a
higher chance of recovery.
• Save the young before the old.
• Do not jeopardize your own life while rendering First Aid. In the event of
immediate danger, get out of site immediately.
• Remember: One of your aims is to preserve life, and not endanger your own
in the process of rendering First Aid.
• Casualties should always be treated in the order of priority, usually given by
the “3 Bs”:
• Breathing
• Bleeding
• Bones
FIRST-AID BARRIERS TO ACTION
Presence of Other People
The presence of other people can cause confusion at an emergency
scene. Do not assume that, just because there is a crowd, someone is
giving first aid. Do not feel embarrassed in front of strangers. Even if
someone else is already giving care, offer your help.
Uncertainty About the Casualty
The person needing your first aid may be a stranger, someone much
older or much younger than you, or someone of a different gender or
race. Regardless of who the casualty is, put such concerns aside and
give first aid
• Nature of the Injury or Illness
An injury or illness can be very unpleasant because of blood, vomit,
unpleasant odors, or burned skin. If necessary, turn away for a moment
and take a few deep breaths. Then do your best. Remember the
situation is an emergency. Your help can save a life. Try to do for the
casualty what you would want someone to do for you.
• Fear of Disease Transmission
Some people hesitate to act because they fear they may catch some
disease from the casualty. This risk is actually very small. Although
many diseases can be passed from one person to another, you can
greatly reduce the risk by taking precautions when giving first aid.
PRINCIPLES OF FIRST AID
 In all first-aid situations, the rescuer must remain calm.
If you panic, you may lose control of the victim, as well as of
yourself.
To establish authority, speak and act calmly and purposefully.
Allow the victim to discuss the incident, his (or her) situation, and his
fears. If you can involve the victim in his rescue and treatment, it is
often good for morale
 Create a safety area. Do not engager additional inexperienced
rescuers. If you cannot get to the victim easily, send for help.
If you have paper and a writing instrument, record your observations. If you
send someone for help, have him carry a piece of paper that states the victim or
victims’ location, the nature of the emergency, the number of people needing help,
the condition of the victim(s), what is being done to treat the victim(s), and any
specific environmental conditions or physical obstacles.

Always assume the worst. Assume that each victim you encounter has a broken
neck or a heart attack until proven otherwise.

Never move a seriously injured victim unless he is in danger from the

environment or needs to be moved for medical reasons. Don’t encourage a
victim to get up and “shake it
Don't administer any thing or perform procedures if you are not sure
of what you are doing.

 Listen carefully to the patient / casualty. The story of what

happened and the medical history can be extremely important in
making swift and appropriate medical decisions
PHILOSOPHY OF FIRST AID

• In the pre-hospital setting, the key contributors to survival and

recovery from illness and injury are prompt and effective maintenance
of the body’s primary functions:
Airway
Breathing
Circulation
Bleeding control (life threatening)
• To restore and maintain vital functions. The ABC of basic life support
(Airway, Breathing, and Circulation) are always the first priority to
prevent further injury or deterioration and to reassure the victim and
make him or her as comfortable as possible
Airway must be open so that air containing oxygen enters the
body
Breathing must take place so that oxygen passes through the
lungs into the blood stream
The heart must circulate the oxygen carrying blood
THE PRIMARY SURVEY
• The primary assessment is a systematic checklist designed to
maximise safety and identify / treat immediate life-threatening
problems.
• The steps to be followed for an adult, child and Infant casualty are
remembered by the letters
• DRS ABCD:
• This Action Plan is a vital aid to the first aider in assessing whether the
victim has any life-threatening conditions and if any immediate first
aid is necessary. They are DRABC .
• D - Check for DANGER:
• To you
• To others
• To victim
• R - Check RESPONSE:
• Is victim conscious?
• Is victim unconscious
• S- S - Send for help: Activating the Emergency Medical Services
(EMS)
• A - Check AIRWAY:
Is airway clear of objects?
Is airway open?
• B - Check for BREATHING:
Is chest rising and falling?
Can you hear victim's breathing?
Can you feel the breath on your cheek?
• C - Check for CIRCULATION
Can you feel a pulse?
Can you see any obvious signs of life?
If not start Cardiopulmonary Resuscitation (CPR)
• D - Defibrillation
Why do you need to know this ?
• It is very important that you understand the correct procedure to
follow in order to offer effective primary care. At the same time, it is
necessary to protect yourself from any harm. The Initial steps of
resuscitation are:
D - Danger!
• Before approaching any situation, you must assess the scene for any threat
to:
• Yourself and anyone else assisting with the situation
• The casualty or casualties
• Bystanders near the scene
• By rushing into the situation without properly assessing what has occurred,
you are compromising your safety.
• If the scene is not safe, remove the threat from the casualty (or the casualty
from the threat).
Safety Note
• Always remember to reassess the safety while treating the casualty.
Bystanders should be warned about any dangers and kept at a safe
distance to ensure they do not become casualties.
• Once the scene is considered safe, bystanders can be asked to assist if
needed.
• Remember to ELIMINATE, ISOLATE or MINIMISE hazards
R – Response:
• Unconsciousness is a state of unresponsiveness, where the victim
cannot be roused, is unaware of their surroundings and no purposeful
response can be obtained.
• When checking a person’s response, you are assessing how well their
brain is functioning. The brain requires a constant supply of
oxygenated blood and glucose to function. Interruption of this supply
will cause loss of consciousness within a few seconds and permanent
brain damage in minutes. When the casualty’s brain is not functioning
normally, they may not be able to look after their own airway. Their
protective reflexes of coughing, swallowing, or gagging may not be
working very well.
How to check for responsiveness
• Assess the collapsed victim's response to verbal and tactile stimuli
(‘talk and touch’), ensuring that this does not cause or aggravate any
injury.
• Give a simple command such as, “open your eyes, squeeze my hand,
let it go”.
• Then grasp and squeeze the shoulders firmly to elicit a response
S - Send for help
• Activating the Emergency Medical Services (EMS)
• 'Activating EMS' means choosing an Emergency Medical Service response
appropriate to the severity of the injury or illness and the situation
encountered
• Useful Phone Numbers:
• Rwanda National Police:911
• Emergency traffic police : 912
• SAMU:
A - Airway
• When a victim is unconscious, all muscles are relaxed.
• If the victim is left lying on the back, the tongue, which is attached to the
back of the jaw, falls against the back wall of the throat and blocks air from
entering the lungs.
• Other soft tissues of the airway may worsen this obstruction. The mouth
falls open but this tends to block, rather than open, the airway
• The unconscious victim is further at risk because of being unable to
swallow or cough out foreign material in the airway
Airway management is required to provide an open airway when the victim:
• Is unconscious
• Has an obstructed airway
• Needs rescue breathing
How to check an Airway
Ensuring an airway is clear and open
• Open the mouth and look for foreign objects
• Finger sweep (only if an object can be seen and can be removed with a
sweep of a gloved finger)
• Perform a ‘Head-tilt, chin-lift’
(Include picture)
Finger sweep:
• The finger sweep is used to clear the mouth of fluid and debris in the
unresponsive casualty.
• It should only be performed if you can see something to remove.
• It should always be performed with a gloved hand with the casualty
positioned on their side in a stable side position.
• Insert your first finger into the high into the side of the casualty’s mouth
and perform a single sweeping motion to the opposite side, flicking out
vomit, blood, and debris
BREATHING
• Normal breathing is essential to maintaining life. Victims who are
gasping or breathing abnormally and are unresponsive require
resuscitation
Causes of absent or ineffective breathing:
• Direct depression of/or damage to the breathing control Centre of the brain
• Upper airway obstruction
• Paralysis or impairment of the nerves and/or muscles of breathing
• Problems affecting the lungs
• Drowning
• Suffocation
Signs of ineffective breathing
Include:
Little or unusual chest movement
Weak or abnormal breath sounds (wheezing, etc)
Occasional gasps
Reduced responsiveness
Anxiety
Unusual skin colour (pallor)
Rapid or slow breathing
Unusual posture.
How to check for breathing
The rescuer should
LOOK for movement of the upper abdomen or lower chest
LISTEN for the escape of air from nose and mouth
FEEL for breath on the side of your face / movement of the chest and
upper abdomen.
• This should take you no longer than 10 seconds.
Breathing
• If the unconscious victim is unresponsive and not breathing normally
after the airway has been opened and cleared, the rescuer must
immediately commence chest compressions and then rescue breathing
(CPR).
• Give 30 compressions and then two breaths allowing about one second
for each inspiration.