First Aid SSCE

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First Aid

Being Able to Help in Emergencies


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2First Aid - Haufe Index: 2029471 - Version: 1.0.0.1 - Date: 11.09.2008

Knowledge

Basic knowledge about bodily functions and possible risks when they fail

Recognition of emergency situations and independent taking of suitable

emergency measures

Personal protection of the first aider

Skills

Grips and techniques to avert life-threatening situations

Motivation

Reduction of fears and inhibitions

First aid is easy

Training goals


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Basic information for first aiders

Chapter I


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Remain calm!

Make a general assessment

Quick emergency call

Think before you act

Protect yourself, if necessary firstremove danger

An emergency call is ALWAYS possible. It however does NOTreplace active first-aid assistance.

Send away "gawkers"

Ask bystanders for assistance

Help without hesitation

Calm down the victim, if necessaryalso the bystanders

Requirements of first aiders


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L

I

F

E

Check vital signs

Emotional support (talk, comfort)

Observe the victim

Keep the body warm (blanket)

! Emergency call/get help

LIFE: correct emergency measures for allemergencies

Universal emergency measures


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Respiration Consciousness

Circulation

Oxygen deficiency

Accident Illness Poisoning

What is a medical emergency?


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Section 323c StGB (Criminal code):

"Those who don't provide assistance in the event of accidentsor generaldangeror emergencyalthough this is necessary and expectedunder the

circumstances, and is possible without substantial personal riskorinfringement of other obligations, will face either imprisonment of up to oneyear or a monetary fine."

Obligation to help


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Immediate life-saving measures

Securing of theaccident site

Emergency call

Life saving

Firstprofessionaltreatment

Transportationto the clinic

Optimalmedicaltreatment

First aid Emergency medical care

Caringfor less seriousinjuries

Rescue chain

Further measuresAmbulance

Hospital


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1. Safety measures and emergency call

Secure the accident site

Bring yourself and the victim away from

the danger zone

Make an emergency call


Rescue chain


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2. Life saving

Check the victim for vital signs

Look for injuries

Reanimate persons with cardiac arrest

Stop bleeding

Fight against shock

Place the victim in the side recovery position


Rescue chain


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Treatment of non life-threatening injuries

Examples:

Warming Cooling

Treat minor bleeding

Immobilize broken bones

Continue to check vital signs

Further measures

Rescue chain


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Necessary information for the call

W

W

WW

W

here did it happen?

hat happened?

hat number of victims?

hich injuries are present?

ait for questions!

Emergency call


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Moment of the emergency call with only one first aider

1. Victim unconscious, breathing normal

First lay the victim in the recovery position to prevent blockage of theairways during the emergency call. Then call the ambulance.

2. Neither conscious nor with detectable normal breathing

First complete the emergency call. Upon return commence withcardiopulmonary resuscitation.

Emergency call


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silver side

gold side

RESCUE BLANKET

"If silver is on theoutside,the heat stays out."

"If silver is on the inside,the warmth stays inside."

for warming

BODYfor

BODYfor

for cooling

Using the rescue blanket/cover


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Laying of a blanket underneath

1. Turn the person on his side.

2. Lay the rolled blanket against the back.

5. Roll out the blanket.

6. Roll the person onto his/herback.

4. cover

3. Roll the person over therolled blanket onto theother side.

Warming


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Rauteck grip

Prop up the upper body.

Grasp the person under both arms and gripone arm of the victim.

The helper's thumbs face forward.

Straighten up with the victim and pull himaway.

When laying down the body pay particularattention to the head.

Rescue grips


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Impaired consciousness

Chapter II.


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Normal condition

With normal consciousness the various parts of the nervous system workunhampered together.

The senses perceive the surroundings and allow reaction to dangers.

Protective reflexes like coughing, blinking and swallowing are present.

Dangers of unconsciousness

Failure of protective reflexes risk of suffocation

The victim cannot move himself from the hazardous area without help.

Consequential injuries



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Check for consciousness by:

Speaking

Touching

Watching

if present

Help if required

Check for breathing by:

Seeing

Hearing

Feeling

Recovery position

if present

Recognizing unconsciousness

if not

present



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Help: side recovery position

1. Aider kneels at the side of theunconscious victim.

2. Bend the arm on the side of theaider in a right angle.

3. Lay the other arm across thechest. Lay the back of the handagainst the cheek.

4. The leg nearest to the helper isslightly bent with one hand.

5. Carefully rotate the victim ontohis side by carefully graspingknee and shoulder.

6. Tilt the head slightly backwards.

7. Open the mouth so that vomitcan flow out.



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Respiratory disturbances

Chapter III


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Causes of respiratory disturbances

Unconsciousness

Illness

Poisoning

Drowning accident

Foreign bodies in windpipe or esophagus

Insect bit in the throat area

Chest injury

Result: Oxygen deficiency



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Symptoms

Strained or difficult breathing

Typical accompanying noises

Anxiety, fear In case of acute shortness of breath: Blue colouring of face and nail bed

Help for shortness of breath

Calm the victim

Quick emergency call

Open windows and restraining clothing

Position upper body erect

Shortness of breath



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Foreign bodies in windpipes - severity level

Assessment of the severity level

light airway blockage severe airway blockage

allow coughing to continueconstantly check whether

the blockage loosens/dissolvesunconscious

begin reanimation

if conscioushit the back 5 times5 upper abdomen

compressions

inability to speak grasps the throat wheezing, whistling breathing

sounds quiet, unsuccessful coughing

attempts possible loss of consciousness

can at least speak a little ability to cough breathing is still present



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Recognize

Shortness of breath, struggling for air

Whistling respiratory noise

Coughing

Help

Loosen restraining clothing and openwindows

Bend the upper body slightlyforward and palpitate the areabetween the shoulder blades withyour flat hand

Risks

Shortness of breath

Apnoea

Foreign bodies in the windpipe



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Foreign bodies in windpipes - Heimlich manoeuvre

The helper stands behind the victim.

The victim is made to lean slightly forward, allowing the foreign body to beforced out of the mouth cavity.

Both arms are laid on the upper abdomen. The helper makes a fist and lays it between navel and breastbone.

The other hand covers the fist.

Finally the helper jerks the fist up to 5 times forcefully inward and upward.

Should the 5 upper abdomen compressions produce no result, then up to

five back palpitations are repeated.



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Circulatory disturbances

Chapter IV


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Causes

Cardiac and circulatory diseases(e. g. heart attack, stroke)

Electrical accidents, poisoning

Shock, drowning

Heavy bleeding, serious burns

Apnoea

Result: Oxygen deficiency

Cardiac arrest


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Check forconsciousness

Checkbreathing

Cardiac arrest

Begincardiopulmonary

resuscitation (CPR)

30 heartbeats

massage

2-X artificialrespiration

Recognize

if not

normal

alternating

if not

present

Cardiac arrest


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Two possible methods:

At the same time close the unneeded airwayopening of the victim!

1. Mouth-to-mouth resuscitation

The mouth of the first aider covers the mouth of the victim.2.Mouth-to-nose resuscitation

The mouth of the first aider covers the nose of the victim.

Respiration

Cardiac arrest


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1. Tilt the victim's head slightly back.

2. Close his/her mouth with one hand.

3. Breath in.

4. Now the mouth seals his nose.

5. The aider blows his exhaled air into theairways.

6. Repeat the artificial respiration a total oftwo times.

7. After each exhalation turn your head to theside to inhale fresh air.

Example:

Mouth-to-nose resuscitation

Performance of artificial respiration

Cardiac arrest


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1. Make an emergency call with indication of cardiac arrest.

2. Lay the victim with his back on a hard surface (e. g. floor).

3. Kneel at the side of the victim.

4. Uncover his chest.

Begin the reanimation as quickly as possible afterdetermination of the cardiac arrest.

Every second counts!

Heart massage

Cardiac arrest


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Heart massage

Localize the middle of thechest on the uncoveredupper body.

The goal is the compression

of the lower half of thebreastbone.

Chest

Pressurepoint

Breastbone

Finding the pressure point

Cardiac arrest


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Heart massage

Lay the heel of one hand onthe pressure point.

Lay the heel of the otherhand on the back of thefirst hand.

Positioning of the hands

Cardiac arrest


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Further notes:

If possible perform CPR with 2 aiders. One gives artificial respiration,the other massages, the ratio 2 : 30is maintained.

Reanimate until the ambulancearrives or the victim exhibits vitalsigns(e. g. coughing, swallowing, breathing motion).

A separate checking of breathing is not necessary. It would interrupt thecontinuous process of the reanimation.

Heart massage

Cardiac arrest


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Lungs Stomach

Blood

Circulation

Distribution and damage in the entire organism

Intestines

Absorption paths of poisons

Skin(contact poisons)

Airways(respiratory poison,

gases)Digestion

(e. g. pills)

Poisoning


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Illness, nausea, dizziness, vomiting, diarrhoea

Stomach pain, stomach cramps

Consciousness, respiratory and circulatory disorders

Symptoms

Poisoning


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Look forchemicals, bottles, glasses, information signs,distinctive odours and ask the victim what hashappened.

Important questions:

What was taken?

When did the poisoning occur?

How did the poisoning occur?

How much (concentration) was absorbed/ingested/inhaled from thepoison?

Unclear situation

Poisoning


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2. Specials measures to be taken for poisoning

Goal: Prevent or delay the absorption of the poison

1. Emergency measures + emergency call

Self protection

Live-saving measures

Help

Skin

rinse under runningwater

if no water isavailable: swab withcloths

Digestion

give plenty of waterto drink

do not inducevomiting, especiallynot in the case ofchemical burning/irritation

Respiration

ventilate with freshair

open restrictiveclothing

deep breathing

position upper bodyerect

Poisoning


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A shock is a life-threatening disturbance of the circulatory system.

The ratio of required to existing blood quantity shifts, the organs are no longerprovided with oxygen.

CAUSES

Decrease of heart output(e. g. illness)

"Dilation" of the arteries (e. g.anxiety, excitement, pain,fear)

other causes (e. g.poisoning, allergic reaction)

Decrease of blood or fluidquantity(e. g. heavy bleeding)

Often the injury itself is not life threatening,rather the shock.

Shock


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pale face, cold sweat, cool skin

quick, flat breathing

freezing, shivering

agitation, nervousness, anxiety,disorientation, subsequent apathy

partial insensitivity to pain

nausea, dizziness, possible vomiting

faster (100 beats/min), howeverweak pulse

Pulse check on the thumb side

with 3

4 fingers.

Symptoms

Never measure with thethumb; it has its own pulse.

Shock


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Help

remove the cause of shock

emergency call

provide emotional support

Shock position

raise the legs 2030 cm

warm the victim

keep the victim awake

Measures

Shock


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Low voltage

Recognize

anxiety

racing heart

agitation

sweating

nausea

Help

break the circuit

check vital signs

help as required

emergency call

Self protection always takesprecedence!

Electrical accidents


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Recognize

current entrance and exit marks(punctiform burns)

strong muscle cramps

Help

at least 5 m safety distance

emergency call

saving and treatment by

professionals

High voltage

Self protection always takesprecedence!

Electrical accidents


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Wound treatment

Chapter V


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Fundamentals of wound treatment

1. Never touchthe woundswith bare hands!

2. Don't wash outthe wounds!Exception:burns, scalds, chemical burns

3. Do not treatwounds with salves, powders, sprays, disinfectants or other"home remedies"!

4. Do not removelarge foreign bodies from wounds!

5. Coverevery woundwith sterile dressings!

6. Always have wounds evaluated by a physician!

Wounds and bleeding


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1. Elevateor prop up.Blood flow lessens.

2. For bleeding on the arm, apply pressure

to the aortawith four fingers in themuscle gap on the inside of the upperarm.Primary blood flow is reduced.

Never tie off a body part!

Aid for bleeding on arms and legs

Wounds and bleeding


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Application of a compress

Lay the dressing on the bleeding.

Wrap the dressing around the wound

2

3 times. Apply the pressure pad to the wound

area.

Wrap the dressing around the woundseveral more times and fasten.

If heavy bleeding occurs through the

bandage, a new one should beoverlaid.

In the case of blood congestion,slightly loosen the bandage.

Dressing

Pressure pad

Bandage

Aid for bleeding on arms and legs

Wounds and bleeding


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1. Wound treatment.

2. Stop the bleeding with suitable material.

3. Secure the body part.

Do not put the amputatedmember in the refrigerator orfreezer!

Do not clean the amputated member with water oranything else.

Wrap the amputated member in a clean towel, placeit in a plastic bag and seal it.

Place the bag with the amputated member in aplastic bag filled with ice water. Never use pure ice.

Help for amputation wounds

Wounds and bleeding


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Recognize

hard or arched abdomen

discoloration of the abdomen skin

stomach pain

Help

quick emergency call

for external bleeding apply bandagingwith hand pressure

position for relaxing the abdominalwall

Position

Lay the person on his side and bendthe knees

orbend the knees using a prop

Bleeding on or in the abdomen

Wounds and bleeding


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Arms Legs Head/Torso Amputation wound

compress

elevate

apply compress ifpossible

apply pressure ifpossible

apply compression

compress

apply compression

apply compress ifpossible

applypressure

elevate elevate

bleeding from nose,mouth

tilt head forward, apply cold cloths to the neck

Schematic representation of arrest of bleeding

Wounds and bleeding


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Recognize

white to brown or black skin, no painIII

redness, heavy pain, broken or filled blisters

II

redness, pain, feeling of tension, minorswelling

I

Identifying featuresDegree

Risks

infection, shock, pain

breathing difficulties, possible smoke poisoning

Burns


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9 %

9 % 9 %

in front

18 %

18 % 18 %

1 %

1. General rule

Estimation of the surface area ofa burn occurs by means of thegiven values.

Values are dependent on age.

2. Palm rule

The palm of the victimcorresponds to ca. 1 % of hisbody surface.

Should the palm, for example,cover the burn three times, thenthe burn covers 3 % of the body.

Body surface of an adult

in back18 %

Determination of the size of a burn

Burns


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If required, extinguish burningclothing.

Carefully remove burned clothing.

Cool for at least 1520 minutes with

cold water.

In conclusion cover the burn woundwith a sterile dressing.

Do not open burn blisters.

Quick emergency call.

Combat shock.

Help

Burns


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emergency call, checking of vital signs depending on condition: side recovery position, shock position, reanimationThe first aider must in any case protect himself!

General help

give plenty of water todrink

do not induce vomiting

rinse with water after rinsing, an eye

bandage

rinse with water orswab the chemicals (ifno water is available)

remove moistenedclothing

cover the woundSpecial help

increased flow of saliva swollen bloody or white

membranes pain

redness flow of tears vision disturbances squinting pain

damage to the skin redness coloured scab painRecognize

Stomach-intestinesEyesSkin

Chemical burns


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Types and risks

Closed fracture

no external wound

Open fracture

wound, from which the bone partcan protrude

Risks

internal/external bleeding

risk of infection

shock

pain

Fractures


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Body part immobile or only partially mobile

Intense pain in the fracture region

Resting posture

Fracture region is sensitive to pressure

Swelling, blood flow, discoloration

Shortening of limbs

Abnormal/false position of a limb

Recognize

Don't splint the fracture, just protect against motion.

Fractures


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Help

leave the fracture in the discoveredposition and cushion it with suitablematerial

in the case of shock symptoms do notelevate the legs, rather lay them flat

apply cooling against pain and swelling

Leg fractures

Fractures


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Help

treat with care (press the brokenarm against the upper body) bysupporting the arm with a sling

in case of shock shock position

cooling

Arm fractures

Fractures


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Recognize

pain in the rib area

flat breathing

the victim tries to straighten up

Help

provide side support to theaffected side of the body

prop up and support the upperbody

Broken ribs

Fractures


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Recognize

head wounds

bleeding from nose, mouth and/or ear

dizziness, possible hearing loss

effusion around the eye(s)

Help

calmness

wound treatment

in a face-down position let the bloodflow from the face

Fractures of skull base

Fractures


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Recognize

pain in lower abdominal or pelvicregion

victim can not sit up

victim tries to bend his legs

Help

support a natural relief posture

Pelvic fractures

Fractures


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Recognize

loss of feeling

numbness or prickling in the

limbs uncontrolled release of bowels

and/or bladder

Help

don't move (exception: rescue froma dangerous area)

no shock position, lay flat keep warm

Spine injury

Fractures

Ch


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Acute illnesses

Chapter VI

Ill


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Heart attack

Recognize

pain, tightness in the chest, victim grabs his chest

radiating sharp pain above all in the left arm,stomach, back, shoulders, face

anxiety, fear, nausea, shortness of breath

pale face, cold sweat

Help

quick emergency call

if victim is conscious: help him sit up to relieve theheart and to ease breathing

loosen restraining clothing and open windows

with cardiac arrest: begin reanimation

if unconscious: side recovery position

Illnesses

Ill


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Recognize

weakness of the face muscles

inability to speak

loss of bladder control

breathing and swallowing disorders

paralysis

visual problems, possible headache

Help

immediately call an ambulance

calm the victim

if victim is conscious: elevate upperbody

depending on condition: siderecovery position or cardiopulmonaryresuscitation

Stroke

Illnesses

Ill


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Recognize

some epileptics can sense anoncoming seizure

often initial outcry, moaning falls to the floor, muscle convulsions

in the limbs

foam (saliva) from the mouth

after seizure unconsciousness

Help

do not restrain the victim

do not place a bite protector in his

mouth remove or cushion objects which

could cause risk of injury

in case of unconsciousness:side recovery position

after seizure observe the victim for at

least 30 minutes

Epilepsy

Illnesses

Ill


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Recognize

whistling, wheezy breathing noise

cough attack, which often includes

the excretion of stringy mucus strong lack of oxygen: blue

colouring of face and nail beds

anxiety, fear, cold sweat

Help

calm the victim, ventilate withfresh air, loosen tight clothing

place upper body erect to easebreathing

"pursed lip breathing" deepbreathing with lips almost closed

assist with taking medicine(spray)

Asthma

Illnesses

Ill


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Recognize

agitation, concentration difficulties

vision disturbances, cravings

sweating, anxiety, shaking,paleness

Help

if conscious: give food or drinkswhich contain sugar (e. g. cola,chocolate)

if unconscious: side recoveryposition, emergency call

Diabetic emergencies hypoglycemia

Illnesses

Ill


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Recognize

deep breathing which releases astrong fruity smell

faintness, thirst, need to urinate possible loss of consciousness

Help

in case of unconsciousness:side recovery position

emergency call

Diabetic emergencies hyperglycemia

Illnesses


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