First Aid
Subtopic:
Life-Threatening Conditions
Medical Crises Requiring Immediate Action
The ability to administer immediate aid is a vital capability for everyone. It empowers individuals to offer immediate support and care to someone who has sustained an injury or is facing an urgent medical situation.
Numerous health emergencies necessitate timely first aid intervention. Among the most frequently encountered are:
Water accidents
- A water accident is characterized by breathing difficulties resulting from being submerged or immersed in a liquid.
- This occurs when the passage of air is obstructed, preventing proper respiration and leading to a lack of oxygen.
- Death can occur in water accidents due to reduced body temperature from being in cold water, sudden heart failure caused by throat spasms blocking the airway, or inhaling water that then blocks the airway.
Reasons for Water Accidents
Lack of swimming skill: An inability to swim or insufficient swimming competence elevates the chances of a water accident, especially when individuals unexpectedly find themselves in water.
Absence of safety measures: Inadequate safeguards, such as barriers around pools or the absence of lifeguards, can result in unrestricted entry to bodies of water, placing individuals, particularly children, at greater risk.
Intake of alcohol: Alcohol impairs judgment, coordination, and reaction time, increasing the likelihood of incidents and water accidents during activities in or near water.
Medical episodes or conditions: Individuals with conditions like epilepsy or other seizure-related disorders are at a heightened risk of water accidents if an episode occurs while they are close to water.
Inadequate oversight: A lack of sufficient adult supervision, especially for children and those with limited swimming experience, can lead to tragic outcomes when accidents happen in or around water.
Extreme tiredness: Particularly when an individual has been swimming for an extended period and becomes too exhausted to continue.
Explanation:
- What transpires during a water accident? The person struggling in the water attempts to inhale air forcefully, but ultimately descends below the surface, where they involuntarily exhale air and inhale water.
- If rescue efforts are not initiated promptly, this situation can lead to a fatal outcome.
INDICATIONS AND OBSERVATIONS
Trouble with breathing
Noisy respiration
Water expulsion from the mouth and nasal passages
Swollen abdomen
Bluish discoloration of the skin
State of confusion
Elevated heart rate
Loss of consciousness
Possible seizures
Cessation of breathing
INITIAL ASSISTANCE MEASURES
Goals of Intervention
To reinstate sufficient breathing.
To maintain the warmth of the affected person.
To arrange for prompt transfer to a medical facility.
(a) REACHING SOMEONE IN THE WATER
Retrieve the person from the water utilizing a rope, a tree branch, a pole, an article of clothing, etc.
Position yourself flat on your stomach and extend your arm or leg towards the person.
Provide a floating object, such as a tire, a piece of wood, empty plastic containers, or life-saving buoys.
Ensure your own safety during the rescue attempt.
Alternatively, use a boat and a personal flotation device if available, and either swim or tow the person to the shore or bank.
(b) UPON REACHING THE SHORE WITH THE AFFECTED PERSON
Assist them in lying down on a coat, blanket, or any piece of fabric, with their head positioned lower than the rest of their body to facilitate water drainage from the mouth and nose. This reduces the risk of inhaling water.
Address potential hypothermia by removing wet garments and replacing them with dry ones if possible, and cover them with a dry blanket or any available cloth.
If the person is fully aware, offer a warm beverage if available.
If the person is unresponsive, open their airway, assess their breathing, and if they are not breathing, start cardiopulmonary resuscitation (CPR).
Administer five (5) initial rescue breaths before commencing chest compressions.
Seek emergency medical assistance, even if the person appears to have fully recovered, due to the possibility of secondary drowning.
Any water entering the lungs can cause irritation, and the air passages may begin to swell several hours later, a condition known as secondary drowning.
Continuously monitor and record vital signs, such as level of consciousness, breathing, and pulse, until professional help arrives.
PREVENTATIVE MEASURES FOR WATER ACCIDENTS
Learn to swim: Gaining swimming proficiency and encouraging others, especially children, to learn to swim significantly lowers the risk of water accidents.
Consistent supervision: Ensure vigilant and dedicated supervision when individuals, particularly children, are in or near water. Avoid distractions like phones or other activities that divert attention.
Employ appropriate barriers: Install and maintain suitable barriers like pool fences, covers, or gates to restrict access to bodies of water and prevent unsupervised entry. Pool safety nets are also beneficial when children are present.
Utilize personal flotation devices: In situations where swimming ability is uncertain or limited, wearing properly fitted life jackets is essential and enhances safety.
INJURIES FROM HEAT AND CORROSIVES:
HEAT-RELATED INJURIES:
These are injuries to tissues caused by dry heat, extreme cold, corrosive substances, friction, or radiation. Alternatively, it is the destruction of the body’s surface by dry heat.
SCALDS:
These are injuries to tissues caused by moist heat from hot liquids or steam.
CATEGORIES OF HEAT-RELATED INJURIES:
(a) DRY HEAT INJURIES:
Dry heat injuries occur when the skin makes direct contact with a dry heat source. Examples include flames, hot implements, or heated surfaces like stoves or irons.
COMMON CAUSES
Contact with a heated object
Friction
Flames
(b) ELECTRICAL INJURIES:
Electrical injuries occur when the body comes into contact with an electrical current. These injuries can result from incidents involving defective electrical devices, exposed wires, lightning strikes, or high-voltage power lines.
COMMON CAUSES
High-voltage electricity
Lightning
(c)CHEMICAL INJURIES:
Chemical injuries occur when the skin or eyes come into contact with harmful or corrosive chemicals. These injuries can result from contact with acids, bases, solvents, cleaning products, or industrial chemicals.
COMMON CAUSES
Industrial chemicals, including inhaled fumes and corrosive gases, household chemicals and products, such as paint, pesticides, bleaching agents, or any potent acid or alkaline substance.
(d) RADIATION INJURIES:
These are caused by excessive exposure to ultraviolet radiation from the sun or radioactive sources like X-rays.
(e) COLD INJURIES:
- Cold injuries, also known as frostbite, occur when the skin and underlying tissues are exposed to extremely low temperatures.
- These injuries can result from direct contact with very cold objects, exposure to freezing conditions, or prolonged exposure to cold, including contact with freezing vapors like oxygen or nitrogen.
- Frostbite can cause the affected areas to become numb, pale, and firm to the touch.
INDIVIDUALS AT HIGHER RISK OF HEAT-RELATED INJURIES
Primarily children under the age of five.
Elderly individuals.
Those with underlying medical conditions such as seizure disorders due to epilepsy, diabetes, leprosy, and albinism.
Individuals who misuse alcohol or drugs.
Factory personnel.
Gas station attendants/workers.
CAUSES:
The origins of heat-related injuries and scalds are external and can be categorized as follows:
Dry heat from flames or hot object
Moist heat from hot water or steam
Corrosive chemicals, both acids and bases.
Electricity.
X-rays or ionizing radiation, including radiation dermatitis.
Friction.
Smoke and the inhalation of toxic substances.
INDICATIONS AND OBSERVATIONS
Reddening of the skin
Swelling
Formation of blisters
Pain due to nerve exposure, common in second-degree injuries
Peeling skin
Restlessness
Dehydration
Possible additional signs:
For airway injuries:
Difficulty breathing
Hoarseness
Shivering due to heat loss
CLASSIFICATION OF HEAT-RELATED INJURIES:
Injuries are classified based on their depth and the extent of the damage.
(a) BASED ON DEPTH
Superficial injuries.
Partial thickness injuries.
Full thickness injuries.
1. SUPERFICIAL INJURIES/ FIRST-DEGREE INJURIES
These involve only the outermost layer of skin. They are characterized by pain, redness, swelling, and tenderness but do not typically result in blistering. They usually heal well with timely first aid.2. PARTIAL THICKNESS INJURIES/ SECOND-DEGREE INJURIES
These involve the epidermis and dermis layers of the skin, and the skin may peel off. Medical treatment may be necessary in these cases.3. FULL THICKNESS INJURIES/ THIRD-DEGREE INJURIES.
All layers of the skin are affected. There may be damage to nerves, fatty tissues, and muscles. Full thickness injuries are characterized by a loss of pain sensation. This can be misleading for both the first aider and the injured person regarding the true severity of the injury (loss of pain indicates nerve damage, not a lesser injury). Immediate medical attention is always crucial for such injuries.
( b) BASED ON SEVERITY
(i) FIRST DEGREE:
Only the epidermis is involved, resulting in skin reddening (erythema) without blister formation.(ii) SECOND DEGREE:
The epidermis and a portion of the dermis are destroyed, leading to blister formation, intense pain due to nerve exposure, and mild to moderate swelling.(iii) THIRD DEGREE:
The epidermis, dermis, and hypodermis are involved, with potential damage to muscles. The skin appears dry, waxy, or hardened, and there is typically no pain.(iv) FOURTH DEGREE:
All skin layers are destroyed, including muscles, bones, tendons, and ligaments.
EXTENT OF INJURIES
Assessing the extent of the affected area is critical because the greater the surface area, the greater the fluid loss and the higher the risk of shock.
The extent of the injured area is assessed using a standard method known as
THE RULE OF NINES FOR ADULTS.
This rule divides the body into areas approximating 9%:
Head and neck – 09%
Front of trunk – 18%
Back of trunk – 18%
Each arm – 9*2= 18%
Lower limbs – 18*2=36%
Perineum – 1%
Total – 100%
THE RULE OF SEVENS FOR CHILDREN:
Head – 28%
Front of trunk – 14%
Back of trunk – 14%
Each lower limb – 14*2=28%
Each upper limb – 7*2=14%
Perineum – 2%
Total – 100%
This method divides the body into areas of approximately 7% and is used to estimate injuries in children.
NOTE:
If 60% of the skin is injured, or 40% in the very young or very old, kidney failure is likely within 6 weeks post-injury. Injuries covering 30–40% or more are considered severe and require hospitalization.
INITIAL ASSISTANCE MEASURES
(a) FOR MINOR INJURIES
These include superficial injuries and those covering a small area.
Objectives
To alleviate pain
To prevent further issues
To offer reassurance
To arrange for immediate transport.
MANAGEMENT
Extinguish any fire by dousing with water or wrapping the person in a blanket. Prevent the person on fire from running, especially into open air.
Immediately cool the injured area by immersing it in cold water or placing it under gently running cold water for at least 10 minutes. Avoid applying ice directly to the skin.
A clean, cold, damp cloth can also be applied to help reduce pain (cold compress).
If blisters form, leave them intact; do not puncture them.
Gently dry the area with a clean cloth and cover with a dry, sterile, non-adhesive dressing to prevent contamination and infection.
The first aider should gently pat the area dry.
Protect the injured area from pressure and friction.
Reassure the injured person to reduce anxiety.
Seek medical attention if the injury involves the airways, eyes, hands, or genitals.
Seek medical advice if signs of infection develop.
Inquire about the injured person’s tetanus immunization status.
INITIAL ASSISTANCE MEASURES FOR SUPERFICIAL BUT EXTENSIVE INJURIES:
Injuries that are not deep but cover a significant portion of the body require immediate medical attention.
Request assistance.
Extinguish any fire by dousing with water or wrapping in a blanket.
Remove clothing from the injured area if it comes off easily; otherwise, do not disturb clothing stuck to the skin.
Reassure the injured person to ease anxiety.
Remove any rings or constricting items, as the injured area may swell, making removal difficult later.
If the injured area is smaller than the person’s chest, cool it by gently applying a clean, cold, wet cloth or running cold water over it.
If the injury is larger than the person’s chest, do not immerse it in cold water due to the risk of overcooling. Instead, cover it with a dry, sterile, non-adhesive dressing to prevent contamination.
If fingers or toes are injured, separate them with a dry, sterile, non-adhesive dressing.
If the person shows signs of shock, take measures to address it or prevent its development.
Treat for shock.
Transport to a hospital as soon as possible, keeping the head stable during transit.
Stay with the injured person until medical help arrives.
Keep dressings clean and dry, changing them as needed.
Obtain information about tetanus immunization.
POTENTIAL COMPLICATIONS OF HEAT-RELATED INJURIES
Immediate
Damage to blood vessels, tendons, and nerves
Presence of foreign materials
Skin loss and tissue death
Airway obstruction or breathing difficulties
Intermediate
Secondary infections
Shock due to pain
Dehydration
Reduced blood volume
Electrolyte imbalances
Late
Infections
Contractures (tightening of skin)
Kidney failure
Unstable scars
Hair loss in the injured area
Marjolin’s ulcer (a type of skin cancer that can develop in old scars)
ELECTRICAL INJURIES:
Electrical injuries result from the effects of high-voltage electrical current. The heat produced during the current’s passage through the body causes deep tissue damage.
In direct contact with the source, the person may remain connected until the current is interrupted. This can lead to:
Physical injuries from falls
Respiratory arrest
Cardiac arrest
Sources of electrical current
High-voltage currents from main power lines or low-voltage currents from household devices.
Electrical appliances like coffee makers, irons, shavers, washing machines, televisions, workshop and shop equipment, office installations, etc., typically connected to a direct power source, either low or high voltage.
Note:
Damp clothing, footwear, and the ground increase electrical conductivity and worsen the damage.
DANGERS OF ELECTRICAL INJURIES:
Cardiac arrest due to current passing through the heart
Severe tissue damage
Shock
Unconsciousness
MANAGEMENT
Turn off the power and unplug the device to disconnect the person from the electrical source.
If the person is in water, avoid contact yourself, as water is a conductor of electricity.
If the person is in contact with a live wire and the power cannot be turned off, separate the wire using a long wooden object while standing on a non-conductive surface like a wooden board or newspapers. Use gloves if available.
Provide artificial respiration and chest compressions if needed.
Flood the injured area with cold water for at least 10 minutes or until pain relief. If water isn’t available, use any cold, safe liquid.
Carefully remove jewelry, watches, belts, or tight clothing from the injured area before swelling begins.
Cover the injured area with a sterile, non-adhesive dressing and bandage loosely.
Treat for shock if present.
Give fluids to drink if the person is conscious.
Reassure the person.
Monitor and record vital signs, such as responsiveness, breathing, and pulse.
Arrange for transport to a hospital.
THINGS TO AVOID
Do not touch the person if they are still in contact with the electrical current.
Do not use wet items to break the electrical contact.
Do not approach high-voltage wires until the power is confirmed to be off.
Do not move a person with an electrical injury unless they are in immediate danger and no longer in contact with the source.
PREVENTATIVE MEASURES FOR ELECTRICAL INJURIES AT HOME AND WORK
Wiring should be inspected by a qualified electrician regularly, and rewiring done as necessary.
Ensure an adequate number of outlets to avoid overloading circuits.
Plugs should be wired correctly.
Follow manufacturer instructions for electrical appliances.
Avoid touching switches or appliances with wet hands, and ensure wall heaters and lights have pull cords.
Keep electrical devices out of bathrooms.
Use shavers with properly insulated outlets.
Restrict children’s access to areas with electrical connections and educate them about the dangers of electric shock.
CHEMICAL INJURIES:
Certain chemicals can irritate, harm, or be absorbed through the skin, causing widespread and potentially fatal damage.
Symptoms may develop slower than with heat injuries.
INDICATIONS AND OBSERVATIONS
– Evidence of chemicals nearby.
– Intense, stinging pain.
– Later, discoloration, blistering, peeling, and swelling of the affected area.
TREATMENT
Objectives
To dilute the harmful chemical.
To arrange transport to a medical facility.
To secure the area and inform relevant authorities.
STEPS
First, ensure the area is safe by checking for hazardous substances.
Move the person from the area if necessary.
Flush the affected area with water to dilute the chemical and stop the burning for at least 20 minutes.
Gently remove contaminated clothing while flushing.
Transport the person to a hospital, monitoring airway and breathing closely.
Ask the person to identify the chemical, taking care to protect yourself with gloves.
Never attempt to neutralize acid or alkali burns unless trained to do so, and do not delay treatment to find an antidote.
Note the details of the chemical for medical personnel.
CHEMICAL INJURY TO THE EYE
Chemical splashes in the eye can cause severe injury if not treated promptly.
Chemicals can damage the eye’s surface, leading to scarring and blindness.
Be extremely cautious when irrigating the eye to avoid splashing contaminated water on yourself or the person.
Use gloves if available.
INDICATIONS AND OBSERVATIONS
Severe pain in the eye.
Inability to open the injured eye.
Redness and swelling around the eye.
Excessive tearing.
Evidence of chemical substances or containers nearby.
TREATMENT
OBJECTIVES
To dilute the harmful chemical.
To arrange transport to a medical facility.
ACTION STEPS
Do not allow the person to touch the injured eye or forcibly remove contact lenses.
Hold the affected eye under gently running cold water for at least 10 minutes.
Thoroughly irrigate both sides of the eyelid. Pouring water from a glass, eye wash, or tap is effective.
If the eye is shut due to pain, gently but firmly open the eyelids. Avoid splashing contaminated water into the uninjured eye.
Instruct the person to hold a sterile eye pad or clean, lint-free material over the injured eye and bandage it in place.
Transport the person to a hospital.
Identify the chemical if possible and provide details.
FAILURE OF CIRCULATION
Circulatory failure, also known as shock, is a condition where the circulatory system malfunctions, depriving vital organs like the heart and brain of oxygen.
Alternatively, shock is an acute failure of circulation. The severity varies with the nature and extent of the injury. It is a frequent cause of death in severe injuries, developing either suddenly or gradually, and can be worsened by pain.
Inadequate tissue perfusion can lead to:
Widespread cellular oxygen deprivation
Extensive impairment of cellular function
Tissue damage and organ failure
Death
Shock can be categorized into two types:
1. PRIMARY SHOCK:
This occurs immediately after an injury, due to excessive stimulation of nerve endings at the injury site, but usually resolves quickly with prompt treatment.2. SECONDARY SHOCK:
This develops within 30 minutes to an hour, typically caused by blood loss.
Secondary shock is serious and can be fatal if not treated promptly and effectively. First aiders should focus on preventing shock or minimizing its effects.
TYPES OF SHOCK BASED ON CAUSE:
NERVOUS SHOCK (PSYCHOGENIC SHOCK):
Caused by strong emotional distress from fear or pain, or due to receiving significant news, good or bad. Can also result from head or spinal injuries.HAEMORRHAGIC OR HYPOVOLEMIC SHOCK:
Caused by loss of blood or other bodily fluids, which may be from external bleeding, internal injuries, severe vomiting, or diarrhea.CARDIOGENIC SHOCK:
Occurs when the heart muscle cannot pump blood effectively, due to injury or pre-existing heart disease, resulting in insufficient pressure to circulate blood.BACTERIAL OR SEPTIC SHOCK:
Results from severe infection where toxins are released into the bloodstream, causing blood vessels to dilate and blood to pool.ANAPHYLATTIC SHOCK:
A severe allergic reaction to substances like drugs or foreign materials, leading to blood vessel dilation and reduced blood flow to organs.ELECTRIC SHOCK:
Caused by high-voltage electrical current passing through the body upon contact with a live wire or cable.NEUROGENIC SHOCK:
Can occur due to chemical injuries, aspiration of stomach contents during anesthesia (especially in Cesarean sections), or as a side effect of spinal anesthesia.
POTENTIAL CAUSES OF SHOCK
- The most common cause is significant blood loss (hemorrhage or bleeding).
- Other causes include severe burns and scalds.
- Bone fractures can lead to shock, possibly due to pain and associated bleeding.
- Severe pain itself.
- Excessive fluid loss from the body, such as through diarrhea or vomiting.
- Extreme fear.
- Severe heart conditions.
- Severe infections.
- Low blood sugar (hypoglycemia).
- Severe allergic reactions (anaphylactic shock).
- Drug overdose.
- Exposure to extreme heat or cold.
INDICATIONS AND OBSERVATIONS OF SHOCK
Dizziness and fainting
Nausea and vomiting
Rapid and weak pulse
Low blood pressure
Restlessness
Shallow and rapid breathing (gasping)
Subnormal body temperature
Cold extremities
Possible loss of consciousness and eventual heart stoppage
Weakness
Thirst
GENERAL TREATMENT FOR SHOCK
Treat primary shock promptly to prevent secondary shock.
OBJECTIVES OF TREATMENT
Improve blood flow to the brain, heart, and lungs; arrange for immediate medical referral.
Position the person lying down with their head lower than their body to improve blood flow to vital organs.
Turn the head to one side.
Minimize movement and handling.
Keep the person warm but not overheated.
Stop any bleeding.
Immobilize any fractures.
Treat any other injuries.
Loosen tight clothing around the neck and waist.
Check breathing, pulse, and responsiveness every 10 minutes.
If breathing becomes difficult or the person vomits, place them in the recovery position.
If the person becomes unconscious, ensure an open airway and check breathing.
Transport the person to a hospital while maintaining the treatment position.
Reassure the person if conscious, or their relatives.
If the person is conscious and not in severe shock, offer fluids.
If the cause of shock is unclear, give small sips of water.
If oral fluids are not advised, administer intravenous fluids carefully to avoid overloading the heart. Monitor pulse rate closely during IV administration.
Relieve pain by splinting fractures temporarily.
Cover burns with a smooth, clean cloth.
Administer analgesics (painkillers) like morphine, but avoid if the person has respiratory issues, as it can depress the respiratory center.
Provide continuous reassurance to the person and any accompanying individuals.
INABILITY TO BREATHE
Asphyxia is a critical condition resulting from insufficient oxygen reaching the body’s tissues.
This deficiency may be due to inadequate oxygen in the inhaled air or interference with the respiratory system. Without enough oxygen, tissues deteriorate rapidly, causing vital structures to lack oxygen, leading to unconsciousness or death.
CAUSES OF ASPHYXIA
Many conditions can cause asphyxia by affecting the airway and lungs:
Fluids in the air passages, such as in drowning.
Obstruction of the airway, caused by the tongue falling back in unconscious individuals, or by food, vomit, or foreign objects.
Swelling of throat tissues due to severe burns, stings (from wasps or bees), or blood.
Compression of the windpipe, such as in strangulation or chest compression.
Lung injuries.
Seizures can disrupt respiratory passages.
Conditions affecting the brain’s respiratory center, such as electrical injury (shock), poisoning, stroke, or paralysis due to spinal cord injury.
Inhalation of harmful gases or fumes like coal gas, exhaust fumes, smoke, sewage gas, and ammonia, which reduce blood oxygen levels.
Note: Some gases also affect the respiratory center.
Suffocation, where external factors prevent air from reaching the air passages.
INDICATIONS AND OBSERVATIONS OF ASPHYXIA
Dizziness and weakness.
Difficulty breathing.
Noisy breathing may develop.
Rapid pulse, which may slow and become irregular as the condition worsens.
Swollen neck veins.
Cyanosis (bluish skin, nails, and mucous membranes).
Possible semi-consciousness.
Objective
Restore adequate breathing and arrange transport.
MANAGEMENT
Immediately remove any obstruction or move the person to fresh air.
Ensure the airway is clear, especially in unconscious individuals, to prevent the tongue from blocking it.
Reassure conscious individuals while awaiting transport.
Maintain a clear airway for unconscious individuals, monitoring breathing.
Seek medical advice for any doubts about the condition, such as:
Frothing at the mouth.
Cyanosis.
Confusion.
Decreasing responsiveness.
Changes in breathing.
MANAGEMENT OF ASPHYXIA BASED ON CAUSE
Drowning: While performing artificial respiration, instruct others to remove wet clothing and wrap the person in dry materials.
Choking: To dislodge the obstruction, lean the person forward, or hold a small child upside down, and firmly strike their back between the shoulder blades. If unsuccessful, induce vomiting by inserting two fingers into the back of the throat.
Swelling in the throat: If breathing hasn’t stopped or has been restored, offer ice to suck or ice-cold water to sip. Butter, olive oil, or medicinal paraffin may also help.
Suffocation by smoke: Protect yourself with a wet cloth over your mouth and nose. Stay low and remove the person quickly.
Suffocation by poisonous gas: Before entering a potentially contaminated area, take and hold a deep breath. Ensure ventilation by opening doors or windows.
Hanging, strangling, and throttling:
Hanging:
If the person is suspended, support their lower limbs and lift the body. Free the neck by cutting or loosening the rope without waiting for authorities.Strangling: Remove any constricting material from the neck.
Throttling: Relieve pressure from the throat.
INDICATIONS AND OBSERVATIONS
If hanging, the body may still be suspended.
If not deceased, a rapid pulse, fast breathing, cyanosis, impaired consciousness, and facial congestion may be present.
Neck veins may be prominent.
Marks may indicate the rope’s position.
Constricting items may still be visible or hidden in skin folds.
TREATMENT OBJECTIVE
Restore adequate breathing and arrange hospital transport.
MANAGEMENT
Immediately remove the constriction, supporting the body’s weight if hanging.
If there’s a knot, cut below it (knots are hard to cut and may be evidence).
If unconscious, open the airway and check breathing. Perform ABCs of resuscitation if needed and place in the recovery position.
Arrange transport to a hospital.
Note: Seek medical attention even if recovery seems complete.
SUFFOCATION
Suffocation occurs when external obstruction blocks air from reaching the air passages, such as with a plastic bag, pillow, or falling on sand. Infants can suffocate by lying face down on soft bedding.
GENERAL INDICATIONS AND OBSERVATIONS:
Difficulty breathing, with increased rate and depth of breaths.
Noisy breathing with snoring or gurgling sounds.
Objective
Restore air supply and seek medical aid.
MANAGEMENT
Immediately remove the obstruction or move the person to fresh air.
If conscious and breathing, reassure and monitor.
If unconscious, open the airway and check breathing. Perform ABCs of resuscitation if needed and place in the recovery position.
Seek medical aid if uncertain or arrange transport to a hospital.
Possible frothing at the mouth.
Bluish discoloration of the face, lips, and nails (cyanosis).
Confusion.
Decreased responsiveness.
Possible unconsciousness.
Breathing may stop.
HEART STOPPAGE
Cardiac arrest is the sudden cessation of heart function, leading to inadequate brain circulation and coma within a minute. Recovery is possible if oxygen is restored within 3 minutes.
If oxygen deprivation lasts longer than 4–6 minutes, severe and permanent brain damage is likely.
CAUSES OF CARDIAC ARREST
Heart attack and myocardial infarction
Blockage in heart circulation
Heart injury
Electrolyte imbalances
Lack of oxygen to the heart
Severe drug reactions
Electric shock
Anesthetic drugs
Severe bleeding
INDICATIONS AND OBSERVATIONS OF CARDIAC ARREST
Absence of pulse in major arteries (carotid or femoral)
Unconsciousness
Bluish skin (cyanosis)
Cessation of breathing
Widely dilated pupils
No bleeding during surgery, or cessation of existing bleeding
INITIAL ASSISTANCE MEASURES
OBJECTIVES
- To preserve life.
- To save life.
MANAGEMENT OF CARDIAC ARREST
Confirm diagnosis (unconscious, death-like appearance, no pulse, no breathing).
Call for help and an ambulance.
Remove tight clothing around the neck, chest, and waist.
Place the person on their back on a firm surface.
Immediately begin cardiopulmonary resuscitation (CPR).
Follow the ABCs of resuscitation:
A – Airway: Clear any obstructions.
B – Breathing: Assist with artificial respiration.
C – Circulation: Perform chest compressions.
Continue chest compressions and mouth-to-mouth respiration at a 30:2 ratio.
Tilt the head back to open the airway and start artificial respiration with chest compressions.
Monitor vital signs and pupil reaction to assess effectiveness.
Continue basic life support and transport to a hospital.
HARMFUL SUBSTANCE INGESTION
A harmful substance is any substance that can cause harm to health or life if taken into the body in sufficient amounts, either accidentally or intentionally.
HOW HARMFUL SUBSTANCES ENTER THE BODY
Harmful substances can enter the body in several ways:
Ingestion (swallowing).
Absorption through the walls of the intestines.
Inhalation.
Of poisonous fumes, gases, or smoke.
Injection.
Intravenous introduction of poisonous substances.
Contact.
Absorption through the skin.
EFFECTS OF HARMFUL SUBSTANCES ON THE BODY
Once inside the body, harmful substances can act in various ways:
Affecting the central nervous system, disrupting vital functions like breathing.
Impairing heart function and other vital organs.
Disrupting oxygen distribution.
Causing convulsions or delirium by affecting the brain.
Corrosive substances can burn the lips, mouth, and digestive tract.
Inhaled poisons cause severe respiratory distress.
Overloading the kidneys and liver, the body’s filtration systems.
Interfering with red blood cells, reducing their ability to carry oxygen.
TYPES OF HARMFUL SUBSTANCES
Food poisoning
Drug poisoning
Alcohol poisoning
Industrial poisoning
OBJECTIVES OF INITIAL ASSISTANCE:
Maintain airway, breathing, and circulation.
Identify the type of harmful substance.
Obtain medical aid.
Remove contaminated clothing or articles.
Remove the person from danger.
GENERAL TREATMENT FOR HARMFUL SUBSTANCE INGESTION
Seek medical aid immediately, as the situation may have legal implications.
Save the container.
Do not discard vomit if vomiting occurs.
Position unconscious individuals on their side with their head turned.
Position vomiting individuals in a lateral position.
Monitor breathing; start artificial respiration if needed.
If conscious, give salty or warm water to induce vomiting and dilute the substance.
FOOD POISONING
Food poisoning, or foodborne illness, is caused by consuming contaminated food or drinks.
Contamination can occur from harmful microorganisms like bacteria, viruses, parasites, or toxins from bacteria or molds. These contaminants can cause adverse reactions when ingested.
Common Causes of Food Poisoning
Bacterial Contamination
From bacteria like Salmonella, E. coli, Campylobacter, and Listeria due to improper handling, cooking, or storage.
Viral Contamination
From viruses like norovirus and hepatitis A, often due to poor hygiene.
Parasitic Contamination
From parasites like Giardia and Toxoplasma in raw or undercooked food.
Toxins and Chemicals
From toxins produced by bacteria or chemical contaminants.
MANAGEMENT
Caused by eating contaminated food (bacteria).
PRESENTATION:
Gastrointestinal Symptoms
Nausea, vomiting, abdominal pain, diarrhea, possibly bloody stools.
Systemic Symptoms
Fever, headache, muscle aches, fatigue, weakness, sometimes shock.
TREATMENT
Provide plenty of fluids to prevent dehydration.
Do not induce vomiting if the substance was corrosive.
Collect and keep any vomit for analysis.
For corrosive substances, give milk or water to dilute.
For acids, consider a mild alkali like sodium bicarbonate.
For strong alkaline, give a weak acid, such as lime juice (two spoonfuls in a large amount of water).
Provide soothing drinks like milk or rice water, and arrange for transport to a medical facility.
Prevention of Food Poisoning
Prevention is crucial in minimizing the risk of food poisoning. Effective measures include:
Safe Food Handling
Practice good hand hygiene, use clean utensils and surfaces, and prevent cross-contamination between raw and cooked foods.
Proper Cooking and Storage
Cook foods thoroughly and maintain proper storage temperatures to inhibit bacterial growth.
Hygiene Practices
Maintain personal hygiene, especially regular handwashing before food preparation.
Avoiding Cross-Contamination
Keep raw and cooked foods separate and use different utensils and cutting boards for each.
ALCOHOL POISONING
Alcohol poisoning is a severe and potentially fatal condition where the blood alcohol concentration becomes dangerously high.
This occurs when a large amount of alcohol is consumed quickly. Alcohol is a depressant that affects the central nervous system, and excessive intake can severely impair vital functions.
Signs and Symptoms of Alcohol Poisoning
Common signs and symptoms include:
Mental and Behavioral Symptoms
Confusion and disorientation
Agitation or aggression
Delirium or unconsciousness
Slow or irregular breathing
Seizures
Physical Symptoms
Pale or bluish skin
Vomiting or retching
Hypothermia (low body temperature)
Slow heart rate
In severe cases, respiratory failure or cardiac arrest
Immediate First Aid for Alcohol Poisoning
When someone shows signs of alcohol poisoning, immediate action is necessary while waiting for emergency medical help. Follow these steps:
Call for Help / Emergency Assistance
Contact emergency services immediately with accurate details about the person’s condition and alcohol intake.
Stay with the Person
Do not leave the individual alone, especially if unconscious or severely symptomatic. Monitor their condition and offer reassurance.
Monitor and Support Breathing
Check their breathing and place them on their side in the recovery position to prevent choking on vomit. Be prepared to perform CPR if breathing becomes irregular or stops, provided you are trained.
Do Not Leave the Person Alone
Continuously monitor vital signs, mental state, and breathing until medical professionals arrive.
Complications
Alcohol poisoning can have serious and long-term consequences, including:
Brain damage due to lack of oxygen
Liver damage or alcoholic hepatitis
Damage to the gastrointestinal system
Increased risk of accidents or injuries
Worsening of existing health conditions
Prevention of Alcohol Poisoning
Preventing alcohol poisoning involves responsible drinking habits and promoting a safe environment:
Responsible Drinking
Drink in moderation and know your limits. Pace yourself, alternate alcoholic drinks with non-alcoholic ones, and avoid drinking games or peer pressure.
Know Your Limits
Understand your alcohol tolerance and know when to stop drinking. Avoid trying to keep up with others or exceeding your personal limits.
Avoid Peer Pressure
Resist pressure to drink excessively or engage in risky behaviors. Surround yourself with supportive friends who respect your choices.
Education and Awareness
Promote education about the risks of alcohol poisoning. Encourage open conversations about responsible drinking and looking out for others.
DRUG POISONING
Drug poisoning refers to the harmful effects from ingesting, inhaling, or being exposed to excessive amounts of medication or drugs.
This can result from accidental overdoses, intentional self-harm, adverse reactions, or drug interactions.
TYPES OF DRUG POISONING
Accidental Overdose
Unintentional intake of too much medication or drugs due to errors in reading labels, calculations, or dosing.
Intentional Overdose
Purposely taking an excessive amount of medication or drugs with the intent to harm oneself or commit suicide.
Adverse Reactions
Harmful and potentially life-threatening symptoms due to hypersensitivity or allergic reactions to certain medications.
Drug Interactions
Unexpected side effects or toxicity when two or more medications or drugs interact.
Signs and Symptoms of Drug Poisoning
The signs and symptoms vary depending on the drug and individual factors. Common symptoms include:
Central Nervous System Symptoms
Confusion or disorientation
Agitation or restlessness
Drowsiness or coma
Seizures or convulsions
Hallucinations or delirium
Cardiovascular Symptoms
Rapid or irregular heartbeat
High blood pressure
Chest pain or tightness
Palpitations or arrhythmias
Respiratory Symptoms
Shallow or labored breathing
Slow or irregular breathing
Respiratory distress or failure
TREATMENT.
If conscious, help the person into a comfortable position and ask what they have taken.
Monitor and record vital signs; transport or refer if necessary.
Prevention of Drug Poisoning
Proper Medication Use
Follow prescribed dosages, instructions, and durations. Avoid self-medicating or changing dosages without medical advice.
Awareness of Drug Interactions
Be aware of potential interactions between prescribed medications, over-the-counter drugs, and herbal supplements.
Storage and Disposal of Medications
Store medications securely and out of reach of children or those who might misuse them. Dispose of expired or unused medications properly.
Seeking Professional Help
Seek professional help for substance abuse or mental health issues. Proper treatment can reduce the risk of drug poisoning.
INDUSTRIAL POISONING
Industrial poisoning occurs when individuals are exposed to hazardous substances in industrial settings.
Exposure can happen through inhalation, ingestion, or skin contact. Industrial poisons can be chemicals, heavy metals, or biological agents, with effects ranging from acute to chronic.
Common Types of Industrial Poisons
Chemical Poisons
Toxic substances like solvents, pesticides, acids, alkalis, and industrial gases, including carbon monoxide and irritant gases like ammonia.
Heavy Metal Poisons
Metallic elements like lead, mercury, cadmium, and arsenic that can accumulate and cause chronic poisoning and organ damage.
Biological Poisons
Toxic substances from living organisms like bacteria, fungi, or plants, causing various health problems.
Signs and Symptoms of Industrial Poisoning
Symptoms vary based on the substance, exposure duration and intensity, and individual factors. Common symptoms include:
Acute Symptoms
Difficulty breathing or shortness of breath
Nausea, vomiting, or abdominal pain
Dizziness or lightheadedness
Skin rashes or irritation
Headaches or migraines
Chronic Symptoms
Fatigue or weakness
Memory loss or cognitive difficulties
Chronic respiratory problems
Organ dysfunction or failure
Development of cancers or other long-term health conditions
GENERAL ROLES FOR TREATMENT OF SWALLOWED POISONS
Get medical aid as soon as possible.
Keep the container to help identify the poison.
Check for burns on the lips. If the mouth is okay, consider inducing vomiting.
If conscious, give fluids to dilute the poison.
Where possible, administer an antidote.
Give soothing drinks.
Treat shock if necessary.
Keep the person warm.
Loosen tight clothing.
If unconscious, place in a semi-prone position and monitor breathing; provide artificial respiration if needed.
PREVENTION OF POISONING
All medicine bottles and packages should be clearly labeled. Do not use unlabeled medicines.
Label toxic medicines with the word “poison” and store them securely under lock.
Never take medicine with an unclear label.
Always read the label three times before use.
Label substances used for specific purposes.
Keep all poisonous substances out of children’s reach.
As a first aider, always follow safety regulations to avoid becoming a secondary victim.
For many poisons, neutralization can reduce harm.
In some cases, a stomach washout is performed.
Question: What is done for a person who has taken?
Acid
Alkali
Mercury poisoning
Opium
Acid Poisoning:
Immediately call emergency services or poison control.
Carefully remove contaminated clothing and rinse affected areas with plenty of water for at least 20 minutes.
Do not induce vomiting unless advised by medical professionals.
Keep the person calm and reassured until help arrives.
Alkaline Poisoning:
Contact emergency services or poison control immediately.
Rinse affected areas with large amounts of water for at least 20 minutes.
If ingested, give small sips of water or milk, unless they are unconscious or convulsing.
Do not induce vomiting.
Stay with the person until medical assistance arrives.
Mercury Poisoning:
For elemental mercury exposure (liquid mercury), avoid direct contact and isolate the area to prevent further spread.
If mercury is on the skin or clothing, use gloves or a barrier to remove it if possible.
Ventilate the area by opening windows and doors.
Contact emergency services or poison control for guidance on disposal and cleanup.
Seek medical attention for assessment and treatment.
Opium Poisoning:
If someone has ingested opium and is unconscious or has difficulty breathing, call emergency services immediately.
Do not induce vomiting unless advised by medical professionals.
Keep the person lying on their side to prevent choking.
Monitor breathing and provide first aid, such as CPR, if necessary.
Provide all relevant information about the substance to medical professionals.