BASIC

Handbook
1st Edition, 2013
2nd Edition, 2016

By: Kervin Clyde C. Go

Bea Danica U. Glory
and
Dr. Ann Willainne G. Tan
p. 2 Basic First Aid Handbook

Table of Contents
I. First Aid Concepts Page 3

II. Circulatory System and Shock Page 5

III. Soft Tissue Injury (Wounds) Page 8

IV. Poisoning Page 11

V. Burns Page 14

VI. Introduction to Basic Life Support (BLS) Page 17

VII. Common Medical Emergencies Page 24

VIII. Fractures Page 33

IX. Dressings and Bandages Page 36

X. Emergency Transport Page 41

Basic First Aid Handbook p. 3
I. FIRST AID CONEPTS
A. Definition

First Aid is the immediate and temporary care given to a person who has
been injured or suddenly taken ill. It includes self-help and home care if medical
assistance is not available or encouragement, evidence of willingness to help,
and promotion of confidence by demonstration of competence.

B. Roles of First Aid

1. It is the bridge that fills the gap between the victim and the physician.
2. It ends when the service of a physician begins.
3. It is not intended to compete with nor take the place of a physician.

C. Objectives of First Aid

1. To alleviate suffering
2. To prolong life
3. To prevent added injury or danger

D. Phases of First Aid

1. Self-aid
2. Assistance from a companion
3. Emergency Treatment
4. Initial Surgery

E. Needs and Value of First Aid

1. To minimize if not totally prevent accident.
2. To prevent added injury.
3. To train people to do the right thing at the right time.
4. Accidents happen and sudden illnesses are common and often serious.
5. People vary often harm rather than help.
6. Proper and immediate care is necessary.

F. Basic Principles of First Aid

1. Do first things first, quietly, quickly, and without fuss or panic.
2. Do not attempt too much - do the minimum that is essential to save life
and prevent the condition from worsening.
3. Give ABC if breathing has stopped - every second counts.
4. Stop any bleeding.
5. Guard against shock by protecting the patient from cold.
6. Don’t remove clothes unnecessarily.
7. Reassure the patient and those around and so help to avoid nervousness
and panic.
p. 4 Basic First Aid Handbook
8. Don’t allow people to crowd around, as fresh air is essential.
9. Arrange for the removal of the patient to the care of a doctor or a hospital
as soon as possible, and notify the police.

G. L. T. C. in First Aid
1. Love
2. Tender
3. Care

H. 4-H’s of First Aid

1. Head
2. Heart
3. Hand
4. Humanitarian Aspect

I. 5-C’s of First Aid

1. Calmness
2. Cheerfulness
3. Cleanliness
4. Carefulness
5. Common Sense

J. Characteristics of a Good First Aider

1. Sympathetic – should be comforting
2. Cheerful – a happy expression inspires confidence
3. Observant – should notice all signs
4. Resourcefulness – should make the best use of things at hand
5. Common Sense – should be prudent
6. Tactful – should not alarm the victim
7. Gentle – should not cause pain
8. Good Judgment – should foresee possibilities

K. Hindrances in giving emergency care

1. Unfavorable surroundings
2. The presence of crowd
3. Pressure from victim/s or relatives

L. Four Hurry Cases of First Aid

1. Stoppage of Breathing - The critical time is four minutes to restore the
victim to normal before brain damage takes place.
2. Severe Bleeding - Bleeding and Hemorrhage means the same thing,
namely, that blood is escaping from arteries, capillary vessels, or veins.
Basic First Aid Handbook p. 5
3. Poisoning - A poison is any substance, liquid, solid, or gas, that tends to
impair health or cause death when introduced into the body or on the skin
surface.
4. Shock - Shock is a condition in which there is insufficient blood in the cir-
culation to fill the blood vessels. As a result, the tissues do not receive enough
oxygen to maintain life and there is extreme body weakness or physical col-
lapse.

II. CIRCULATORY SYSTEM AND SHOCK

HEART
Heart is a hollow muscular organ, about the size of a man’s fist, lying
between the lungs behind the breast bone.

A. Heart Beat
1. Adults (10 years old and above) – 60-100 beats/min
2. Children (1-10 years old) – 70-130 beats/min
3. Infants – 80-160 beats/min

B. Pulse Rate
The pulse in normal people has the same rate as the heartbeat.

C. Blood
Blood – a red sticky fluid circulating through the blood vessels, has a
peculiar odor, salty, varies in color from bright scarlet to bluish red.

Composition of Blood
a. Red Blood Cells – carry oxygenated Blood
b. White Blood Cells – fight infection
c. Plasma – liquid portion

Amount of Blood in the Body

a. A healthy normal person weighing 110lbs (50kgs) has 16-18 glasses (3.6
liters) of blood circulating within the body.
b. Loss of
- 1-2 glasses of blood : no effect
- 3-4 glasses of blood : anemic like
- 5 or more glasses of blood : fatal

Blood Pressure
- Normal blood pressure is from 90 over 60(90/60) to 120 over 80 (120/80).
p. 6 Basic First Aid Handbook
D. Blood Vessels
1. Arteries – carry fresh blood supply (oxygenated) from the heart to the dif-
ferent parts of the body.
2. Veins – carry used blood (unoxygenated) to the heart from the different
parts of the body.
3. Capillaries – small blood vessels where exchange of gases and nutrients
take place.

SHOCK
Shock is a depressed condition of many of the body functions due to
the failure of enough blood to circulate through the body following serious
injury or illness.

A. Causes of Shock
1. Hemorrhage 6. Heart attack / stroke
2. Burns 7. Bullet wound, shell bomb
3. Crushing injuries 8. Poisoning
4. Infection 9. Choking
5. Fracture 10. Spinal injuries
B. Classification of Shock
1. Hypovolemic Shock – loss of blood (Hemorrhagic shock), plasma, intersti-
tial fluid (bowel obstruction), or a combination
2. Septic (Vasodilatory) Shock - severe infection, poisonous toxins (bacteria)
3. Traumatic Shock – resulting from a severe injury
4. Neurogenic Shock – autonomic nervous control of blood vessels, falls
cause by spinal or head injury, anesthesia
5. Cardiogenic Shock – heart damage or injury, ex. Heart attack
6. Obstructive Shock - resulting from an impediment to the cardiac circula-
tion ex. pulmonary embolism

C. Factors which contribute to shock

1. Pain
2. Rough Handling
3. Improper Transportation
4. Continuous Bleeding
5. Exposure to excessive heat or extreme cold
6. Fatigue

D. Signs and Symptoms of Shock

1. Early Stage
a. Cold and clammy skin
b. Rapid and faint pulse
c. Rapid and shallow breathing
Basic First Aid Handbook p. 7
d. Vacant, jack luster, dull eyes
e. Dizziness
f. Nausea and vomiting
g. Dilated / constricted pupils
h. Face is pale
i. Body temperature is very low
2 . Late Stage
a. Restlessness
b. Very weak
c. Hypotension
d. Unconsciousness

E. Treatment for Shock

1. Identify and control ongoing source of bleeding.
2. Proper position
a. If the victim’s color is normal and is conscious, let the victim lie flat
on the ground with his face facing up.
b. If the victim’s color is normal but unconscious, let the victim lie flat
on the ground with his face facing the ground.
c. If the victim is pale, let the victim lie on the ground with the lower
part of his body elevated to about 12-18 inches.
d. If the victim’s color is red and is vomiting and is conscious, elevate
the upper body part of the victim to about an angle of 450.
e. If the victim’s color is red and is vomiting but is unconscious, put the
victim in a side lying position.
f. If the victim’s color is bluish or black, establish CPR.
3. Proper temperature and ventilation
a. Maintain body warmth
b. In extremely cold weather, apply additional heat
4. Administration of fluids
a. Fluids have value. Water is useful only if the victim will not undergo
surgery within two hours or less.
p. 8 Basic First Aid Handbook
F. Summary
S – Saline Solution: Pinch of salt in a glass of water (Note: Damp the cotton in
the same solution then wet lips)
H – Heat: Keep the victim warm enough to overcome or avoid chilling. Nor-
mal body temperature should be maintained
O – Oxygen: Give artificial respiration if necessary
C – Careful handling of the victim
K – Keep the injured person in a comfortable position
III. SOFT TISSUE INJURY (WOUNDS)

A wound is a break in the continuity of a tissue of the body, either
internal or external.

A. Classification of Wounds
1. Open - A break in the skin or in the mucous membrane.
2. Close - Involves the underlying tissues without a break in
the skin or mucous membrane.

B. Kinds of Open Wounds (Code: A L I P A A)

1. Abrasion (Gasgas)- Caused by scrapping or rub-
bing against rough surface. Its characteristics are shallow,
wide, no bleeding, dirty.

2. Laceration (Laslas) - Caused by rough edged

instruments like broken glasses, tin cans, barbed
wire, blunt, instruments like pipe, baseball bats,
etc. Its characteristics are the following: torn,
irregular edges, serious bleeding, sometimes
slightly dirty.

3. Incision (Hiwa) - Cut by blocks of sharp instru-

ments like razor, knives, bolos, etc. It characteristics
are the following: clean cut, deep, severe bleeding,
wound is clean.

4. Puncture (Tusok) - Penetrating, pointed instru-

ments like nails, ice peak, daggers, knives, bullets, pins,
etc. It has the following characteristics: small opening,
deep serious, slight bleeding, dirty.
Basic First Aid Handbook p. 9
5. Avulsion (Laplap) - Motor vehicle accidents,
wrecks, gunshots, explosion, animal bites, other
body crashing injuries. It has the following charac-
teristics: tissue is forcibly separated or torn from the
victim’s body, there is heavy and rapid bleeding.

6. Amputation (Pagputol) - removal of part or all or a

body part that is enclose by skin.

C. Treatment for Open Wound

1. Emergency First Aid
a. Apply a sterile dressing and bandage in such a way that the dressing
does not slip.
b. Send the victim to a physician.
2. Home Care
a. Wash the wound with soap and water.
b. Apply antiseptic, if available.
c. Apply a dressing and bandage.
3. Some Do’s
a. The First Aider should first wash his hands thoroughly with soap and
water.
b. See to it that the antiseptic dries up first before covering the wound
with a dressing.
c. Refer the victim to a physician for possible danger of tetanus.
4. Some Don’ts
a. Don’t touch the wound with your hand or any unsterile material.
b. Don’t use absorbent cotton as dressing.
c. Don’t induce further bleeding to clean the wound.

D. Treatment for Severe Bleeding

1. Control Bleeding
2. Cover the wound
3. Care for shock
4. Consult or refer to physician

E. Methods of Stopping Severe Bleeding

1. Direct Pressure
2. Pressure Points
3. Elevation
4. Tourniquet -- is a tight band used to stop or control the bleeding. It is only
applied if and only if all the other methods have failed, and when there is a
partial or complete amputation of a limb.
p. 10 Basic First Aid Handbook
F. Pressure Points of the Body

A. Facial Artery
B. Temporal Artery
C. Subclavian Artery
D. Carotid Artery
E. Axillary Artery
F. Brachial Artery
G. Radial Artery
H/I. Femoral Artery
J. Popliteal Artery
K. Tibial Artery

G. Treatment of Close Wounds

1. Ice application
2. Compression (manual)
3. Elevate injured part
4. Splinting

H. Signs and Symptoms of Closed Wounds

1. Tender, swollen, bruised or hard areas of the body
2. Rapid, weak pulse
3. Skin that feels cool or moist or looks pale or bluish
4. An injured extremity that is blue or extremely pale
5. Vomiting of blood or coughing up blood

H. Kinds of Specific Wounds

1. Wounds with impaled objects – Don’t remove object, stabilize and care for
shock
2. Sucking Chest Wound – Watch out for breathing, cover with plastic and
care for shock
Basic First Aid Handbook p. 11
3. Abdominal Wounds – Cover with sterile dressing and keep them moist
4. Animal Bites (ex. Dog bites) – Care for simple wounds and minor bleeding

IV. POISONING

Poison is any substance, liquid, solid, or gas that tends to impair health
or cause death when introduced into the body or on the skin surface.

A. Kinds of Poisoning
1. Ingestion - swallowed poison, also called Oral Poisoning.
2. Inhalation - inhaled poison such as gases, also called Gas Poisoning.
3. Injection - injected poison such as snakebites
4. Absorption - contacted poison

B. Kinds of Ingestion or Oral Poisoning

1. Corrosive - acids, bases, alkaline, petroleum
2. Non-Corrosive - woods, drugs and other solid substances

C. Types of Antidote
An antidote refers to the substance to counter act poison. Here are
some types of antidotes:
1. Charcoal -- pulverize the charcoal and mix with water
2. Egg white -- mix about 10-12 pieces of egg white with water
3. Milk of magnesia

D. Treatment for Ingestion or Oral Poisoning

1. Corrosive - dilute with enough water and a glass of antidote
2. Non-corrosive - dilute with a large amount of water. Induce vomiting.

E. Treatment for Inhalation or Gas Poisoning

1. Survey the scene
2. If you can reach the victim, remove him or her from the poisonous envi-
ronment, to get fresh air.
3. Check the ABC’s

F. Treatment for Absorption Poisoning

1. Remove the contaminated clothing. Wash all exposed area thoroughly
with soap and water.
2. Apply calamine (Caladryl) or other soothing skin lotion if the rash is mild.
3. Seek medical advice if severe reaction occurs or if there is known history
of previous sensitivity.
p. 12 Basic First Aid Handbook
G. Snake Bites
1. Characteristics of Snake Bites
a. Nonvenomous snakes
- Horseshoe shaped bite mark, or four to six rows of teeth
- No fang marks on the victim
- With rounded head
- Has a round eye pupil
- Larger in size
b. Venomous snakes
- Strikes, recoils, is ready to strike again or run off
- With heart/triangular shaped head
- Has an eliptical eye pupil
- Fang marks 2 punctures on top and a half horseshoe bite
mark below
Basic First Aid Handbook p. 13
2. Signs and Symptoms of Snake Bites
a. Less than one hour
- Headache, vomiting, transcript faintness, confusion, uncon-
sciousness
b. One to three hours after
- Dropping eyelids, double vision, difficulty in swallowing,
enlarged lymph glands, abdominal pain, dark urine, rapid pulse, hemorrhage
c. After Three hours
- Paralysis in large muscles, respiratory paralysis, circulatory
failure
3. Treatment for Snake Bites
a. For nonvenomous bites
- Only the first aid recommended for minor scratches.
- The victim should not be subjected to the more serious
measures necessary for the caring of venomous bites.
- The experience of having a snake constricted around a limb,
the victim may develop shock.
- Treat for shock.
- See a doctor or physician for prompt evaluation.
b. For venomous bites
- PROMPT ACTION IS IMPERATIVE because removal of the
venom is more difficult or even impossible after it is absorbed.
- Immobilize the victim’s arm or leg in a lowered position.
Keeping the involved area below the level of the heart.
- Tie a constricting band firmly around the limb 2-4 inches
above the bite to decrease the flow of lymph from the affected area.
- The constricting band should be snug, but loose enough to
allow the blood to flow into the limb.
- You may place a cold wet cloth or ice wrapped in cloth, if
available, over the wound to allow constriction. Don’t pack the wound with ice.
- Treat the victim for shock.
- Send the victim to the nearest hospital or doctor as soon as
possible.
c. If the characteristic of snakebite cannot be determined, assume
venomous bite.
p. 14 Basic First Aid Handbook
V. BURNS

Burns are injuries to the skin due to exposure to heat, chemical, electric-
ity and radiation. It may cause shock by damaging surface and dilating underlying
blood vessels, which may lead to extensive loss of plasma. Burn is considered
severe if it involves the face, hands, feet or genital area.

A. Kinds of Burns
1. Thermal Burns or Heat Burns
2. Chemical Burns
3. Electrical Burns
4. Radiation

B. Degrees of Burns
1. First Degree Burns - (Superficial) Caused
by a flash, a flame, a scald, or the sun. The
skin looks pink and dry with slight swelling,
no blisters occur. The skin is reddened and
extremely painful, but the epidermal layer is
the only one affected.

2. Second Degree Burns - (Partial-

thickness) Result from contact with hot
liquids or solids, flash or flame contact
with clothing, direct flame from fires,
contact with chemical substances, or
the sun. The skin appears moist and
mottled, and it ranges in color from
white to cherry red. The burned area is
blistered and extremely painful.

3. Third Degree Burns - (Full-thickness) Other-

wise called the full-thickness burns, are the most
serious, resulting from contact with hot liquids or
solids, flame, chemicals, or electricity. The skin
becomes dry and charred blood vessels are often
visible. The skin is a mixture of colors: white (waxy-
pearly), dark, (khaki-mahogany), and charred. The
patient often feels little or no pain because the
nerve endings have been destroyed.
Basic First Aid Handbook p. 15
C. The Rule of Nines
The Rule of Nines is a method of estimating percentage of body surface
involved with burns. The body surface is divided into regions, each of which rep-
resents 9%, or a multiple of 9%, of the total surface, except in infants.

Head and neck -- 9% Left Rear Leg -- 9%

Right Arm -- 9% Genital -- 1%
Left Arm -- 9%
Front Chest -- 9%
Rear Chest -- 9% For infants:
Front Abdomen -- 9% Right Front Leg -- 7%
Rear Abdomen -- 9% Right Rear Leg -- 7%
Right Front Leg -- 9% Left Front Leg -- 7%
Right Rear Leg -- 9% Left Rear Leg -- 7%
Left Front Leg -- 9%

Total Body Surface Area (TBSA)

1. Up to 10% -- Minor
2. 11% to 60% -- Major
3. 61% over -- Severe
p. 16 Basic First Aid Handbook
B. Treatment for Thermal and Radiant Burns
1. For first degree burns and second degree burn with no open blister, flush
with lots of cool running water. Apply moist dressing and bandage loosely. Do
not attempt to open the blister.
2. For second degree burns with open blister and third degree burns, apply
dry dressing and bandage loosely. Do not use water because it increases the risk
of shock.

C. Treatment for Chemical Burns

1. Remove clothing and jewelry where chemical had spilled.
2. Flush with lots of running water for 15 minutes
3. Cover the burns with dry, loose dressing. Care for possible shock and do
primary survey frequently.

D. Treatment for Electrical Shock

1. Be careful in electrical emergencies not to get electrical shock yourself.
2. If the emergency is outside and you suspect downed power lines, call the
power company first.
3. Do not touch downed power lines.
4. Keep bystanders well away from any source of live current.
5. If the emergency is inside, turn off the electricity at the fuse box or circuit
breaker.
6. Do a primary survey. Be aware that electrical burns carry a strong possibility
of cardiac arrest.
7. Call Emergency Medical Assistance.
8. Do secondary survey. Check for more than one burn site. Cover all burns
with dry, loose dressing and then bandage.
9. Care for shock.

E. Treatment for First Degree Burns

1. Cool the burn. Hold the burned area under cool (not cold) running water
for 10 or 15 minutes or until the pain subsides. If this is impractical, immerse
the burn in cool water or cool it with cold compresses. Cooling the burn reduces
swelling by conducting heat away from the skin. Don't put ice on the burn.
2. Cover the burn with a sterile gauze bandage. Don't use fluffy cotton, or
other material that may get lint in the wound. Wrap the gauze loosely to avoid
putting pressure on burned skin. Bandaging keeps air off the burn, reduces pain
and protects blistered skin.
3. Take an over-the-counter pain reliever. These include aspirin, ibuprofen
(Advil, Motrin, others), naproxen (Aleve) or acetaminophen (Tylenol, others).
Use caution when giving aspirin to children or teenagers. Though aspirin is ap-
proved for use in children older than age 2, children and teenagers recovering
from chickenpox or flu-like symptoms should never take aspirin.
Basic First Aid Handbook p. 17
F. Treatment for Second Degree Burns
1. Follow the steps prescribed in the first degree except do not apply any
burn ointment.
2. Gently blot area dry with sterile gauze or clean cloth.
3. Apply sterile gauze or clean as a protective dressing.
4. Never break a blister.

G. Treatment for Third Degree Burns

1. Don't remove burned clothing. However, do make sure the victim is no
longer in contact with smoldering materials or exposed to smoke or heat.
2. Don't immerse large severe burns in cold water. Doing so could cause a
drop in body temperature (hypothermia) and deterioration of blood pressure
and circulation (shock).
3. Check for signs of circulation (breathing, coughing or movement). If there
is no breathing or other sign of circulation, begin CPR.
4. Elevate the burned body part or parts. Raise above heart level, when pos-
sible.
5. Cover the area of the burn. Use a cool, moist, sterile bandage; clean, moist
cloth; or moist cloth towels.
VI. INTRODUCTION TO BASIC LIFE SUPPORT (BLS)

A. Primary Assessment (DR-ABC)

D - Danger - initial rapid check for life threatening conditions/injuries
1. check if there is any danger to yourself or the victim
2. assess if there is a need to manage the crowd
3. activate medical help
R - Responsiveness - assess respond levels
A-lert
V-responsive to voice
P-responsive to pain
U-unresponsive/unconscious
A - Airway opened through:
1. Head Tilt Chin Lift Maneuver
2. Jaw Thrust Maneuver - for victims with suspected neck or
back injuries

Head Tilt Chin Lift Rescue Breathing

p. 18 Basic First Aid Handbook
B - Breathing restored: Artificial Respiration (Rescue Breathing),
checked through:
1. Look - at the rising/falling of the chest
2. Listen - to the breathing through the nose/mouth
3. Feel - the breathing
C - Circulation restored: External Chest Compressions (ECC), checked
through:
1. Pulse
2. Bleeding
3. Shock
4. Skin color, temperature
and moisture External Chest
Compression (ECC)
B. Basics of Artificial Respiration (AR)
Respiratory Arrest is when the breathing stops but circulation and
pulse continue for some time. Artificial Respiration (AR) or Rescue Breathing
is the procedure for causing air to flow into and out of the victim’s lungs when
his or her natural breathing ceases or is inadequate.

Causes of Respiratory Arrest

1. Drowning 5. Suffocation
2. Electrical Shock 6. Strangulation
3. Poisoning 7. Choking
4. Drug overdose 8. Heart attack or stroke

Manual Procedure of Artificial Respiration

1. Mouth to mouth resuscitation
2. Mouth to nose resuscitation
3. Mouth to mouth and nose resuscitation
4. Mouth to stoma resuscitation (Holger-Neilsen Method)

Applications of Artificial Respiration

1. Adults - 1 breathe in every 5 seconds (24 x per 2 minute)
2. Children/Infants - 1 breathe in every 3 seconds (40 x per 2 minute)

Assessment in Artificial Respiration

1. Hey, hey, hey, are you okay? (tap/shake the shoulder)
2. Unresponsive.
3. Help! Arrange for transfer facilities so we can transport the victim.
4. Position the victim in flat lying (if necessary).
5. Open the airway (head-tilt / chin-lift).
6. Look, Listen and Feel (LLF) for breathing 5 seconds; Count 1001, 1002,
1003, 1004, 1005.
Basic First Aid Handbook p. 19

7. If Breathless... give two full breaths (Initial Ventilatory Maneuver).

8. Look, Listen, Feel for breathing and feel for the carotid pulse (5-10 sec-
onds).
9. Still breathless, but with pulse, give AR.
Adults - 1001, 1002, 1003, 1001, breath...
Child and Infant - 1001, 1002, 1001, breath...
10. After giving AR for 2 minutes, check again for pulse and repeat the as-
sessment.
12. If the victim is still breathless but with pulse, continue AR... If the victim
has pulse and is now breathing, the VICTIM IS ALIVE. Place the victim in the
recovery position.
p. 20 Basic First Aid Handbook
C. Basics of Cardio-Pulmonary Resuscitation (CPR)
Cardiac Arrest is the condition wherein the heart has stopped. Cardio-
pulmonary Resuscitation (CPR) is an emergency procedure applied to a victim
who is not breathing and whose heart has stopped beating. The procedures in-
volve the combination of rescue breathing and artificial circulation or external
chest compression. Cardio refers to the heart, Pulmonary refers to the lungs, and
Resuscitation refers to ventilation or artificial respiration use to restore breath-
ing.
External Chest Compression (ECC) is the application of rhythmic pres-
sure over the lower half of the sternum, the pressure compresses the heart and
produces an artificial circulatory pulse.
Causes of Cardiac Arrest
1. Drowning 6. Suffocation
2. Electrical Shock 7. Strangulation
3. Poisoning 8. Choking
4. Drug overdose 9. Heart attack or stroke
5. Severe allergic reaction

Don’ts in CPR
1. Jerker 4. Rocker
2. Bender 5. Massager
3. Bouncer 6. Double Crosser

When to stop CPR

1. Victim revives (regains pulse and breathing).
2. Another trained rescuer takes over.
3. You are too exhausted to continue.
4. Scene becomes unsafe.
5. The doctor pronounces that the victim is dead.
6. Medical assistance arrives.
7. Cardiac arrest last longer then 30 minutes (with or without CPR).
Exceptions include cold water and drowning victims.

When Not to Start CPR

1. Severe mutilation and / or decapitation.
2. Rigor mortis
3. Evidence of tissue decomposition.
4. Lividity (purple-reddish color showing on parts of the body closest
to the ground).
5. Has a valid “Do not attempt resucitation” order
Basic First Aid Handbook p. 21
Application of CPR
1. Adult (With age 13 years above)
- One or two rescuer - 30 compressions: 2 breaths x 5 cycles per 2
minutes
- Margin the rib cage with your hand nearest to your abdomen, until
you feel the substernal notch. Place the middle finger on the substernal notch
and the index finger on the lower end of the sternum. Place the heel of the hand
beside the index finger. Then place the hand used for margining and measuring
the notch on the top of the other hand and interlock the fingers and start the
compression with locked elbows.
- Compress the chest 2 inches (5cm) deep at a rate of 100 per minute.
2. Child (Age between 1 to 12 years)
a. one rescurer: 30 compressions: 2 breaths x 5 cycles per 2 minutes
b. two rescurer: 15 compressions: 2 breaths x 10 cycles per 2 minutes
- Locate the lower margin of the child’s rib cage on the side next to you,
with the middle and index fingers - while the hand nearest to the child’s head
maintains head tilt. The chest is compressed with one hand to a depth of 2 inches
(5cm) at a rate of 100 compressions per minute. Keep the fingers off the ribs.
3. Infants (Under 1 year of age)
a. one rescurer: 30 compressions: 2 breaths x 5 cycles per 2 minutes
b. two rescurer: 15 compressions: 2 breaths x 10 cycles per 2 minutes
- The correct area of compression in the infant is one finger width below
an imaginary line between the nipples, and where that bone intersects the ster-
num (lower half of sternum). Use the flat part of your middle and ring fingers to
compress the infant’s sternum 1.5 inch (4cm). The compression rate for infants is
at least 100 times per minute.

Assessment in CPR
1. Hey, hey, hey, are you okay? (tap/shake the shoulder)
2. Unresponsive.
3. Help! Arrange for transfer facilities so we
can transport the victim.
4. Open the airway (head-tilt / chin-lift).
5. Place your ears just above the vic-
tim’s mouth and LOOK, LISTEN and FEEL for
breathing (5 seconds).
6. Breathless!
7. Give 2 long full breath : 1 breath (1.5 to 2 seconds).
8. Feel the Carotid pulse (5-10 seconds), 1001, 1002, 1003,.....,1010.
9. Still breathless and pulseless.
10. I’ll do CPR.
11. Margin the rib cage with your hand nearest to the victim’s abdomen, until
you feel the subternal notch. Place the middle finger on the subternal notch and
p. 22 Basic First Aid Handbook

the index finger on the lower end of the sternum. Place the heel of the hand
beside the index finger. Then place the hand used for margining and measuring
the notch on the top of the other hand and interlace the fingers and start the
compression with locked elbows.
12. 1&2&3&....20&1&2&3&4&5&6&7&8&9&1, breath, breath.
13. 1&2&3&....20&1&2&3&4&5&6&7&8&9&1, breath, breath.
14. 1&2&3&....20&1&2&3&4&5&6&7&8&9&1, breath, breath.
15. 1&2&3&....20&1&2&3&4&5&6&7&8&9&1 breath, breath.
16. 1&2&3&....20&1&2&3&4&5&6&7&8&9&1 breath, breath.
17. Check again the pulse of the victim or reassess. If the victim is still breath-
less, pulseless, give 2 slow full long breathe, then continue CPR. If the victim is
with pulse but still breathless, give 2 full long breath then proceed to AR. If the
victim has pulse and is breathing. Place the victim in the recovery position.
Basic First Aid Handbook p. 23

D. Secondary Assessment
If the injured or ill person is not in an immediate life-threatening condi-
tion, then check for other conditions that may need care.
Check the person from head to toe:
D - Deformity and discoloration
C - Concussion, crepitus and contusions
A - Abrasion and avulsion
P - Puncture and penetration
B - Bleeding and burns
T - Tenderness
L - Laceration
S - Swelling
Interview the victim or bystanders
S - Signs and symptoms
A - Allergies
M - Medications
P - Persistent past medical history
L - Last intake
E - Events leading up to injury
p. 24 Basic First Aid Handbook
VII. COMMON MEDICAL EMERGENCIES

A. Choking (Airway Obstruction)

I. Kinds of Airway Obstruction
1.Anatomic Obstruction - occurs when the airway is blocked by:
a. Back of the tongue dropped down into the throat.
b. Swelling of the airway passages caused by injuries, illness or
inflammation (ex. Blood clot, tonsil enlargement)
2. Mechanical Obstruction - occurs when the airway is partially or
completely blocked by:
a. Solid foreign object
b. Accumulation of fluids such as mucus, blood, saliva or vomit.

II. Types of Obstruction

1. Partial Airway Obstruction
a. Good Air Exchange - can cough forcefully
b. Poor Air Exchange - weak, ineffective coughing, high-
pitched noise while breathing
2. Complete Airway Obstruction
a. Cannot cough, breathe or talk
b. The victim may clutch his throat with one or both hands.
(Universal Distress Signal for Choking).

III. Treatment for Choking

1. Abdominal Thrust (Heimlich Maneuver)

- a quick upward thrust to the abdomen, just above
the navel and well below the xiphoid. It is given 5
times and distinct from one another with the pur-
pose of clearing the airway of a person with com-
plete airway obstruction.
Basic First Aid Handbook p. 25
2. Chest Thrust - Technique of pressing on the middle of the breast-
bone, use to clear the airway of an adult who is extremely obese or in late stages.
Technique used for pregnant victims.

3. Combination of 5 back blows and 5 chest

thrusts for infants.
p. 26 Basic First Aid Handbook
B. Stroke
Stroke is the condition that occurs when the blood flow to the brain
is interrupted long enough to cause damage. People over the age of 50 are the
most common victim, but younger people can have them too.

Signs and Symptoms of Stroke

1. Weakness and numbness 6. Difficulty in speaking
2. Dizziness 7. Pupils of unequal size
3. Headache 8. Ringing in the ears
4. Confusion 9. Difficulty in breathing and swallowing
5. Unconsciousness 10. Change of mood

Treatment for Stroke

1. Check the victim’s ABC. If necessary, begin rescue breathing, CPR or bleed-
ing control.
2. Have the victim rest in a comfortable position.
3. Seek immediate help.
4. Do not give the victim anything by mouth.
5. If the victim lost consciousness, place him or her in recovery position and
administer first aid for the unconscious.
6. Continue to monitor ABC’s.
7. Stay with the victim until medical help arrives.

C. Cardiac Arrest and Heart Attack (Myocardial Infarction)

Signs and Symptoms of Heart Attack

1. Sudden onset of weakness, nausea and sweating without a clear cause.
2. Pain, usually described as squeezing, it is substantial and perceived as
radiating to the jaw, left arm, or both arm.
3. The pain is not always related to physical exertion and not relieved by rest.
4. Arrhythmias and fainting
5. Pulmonary edema
6. Cardiac Arrest
7. Shock

Causes of Cardiac Arrest

1. Drowning 6. Severe allergic reaction
2. Electrical Shock 7. Strangulation
3. Poisoning 8. Choking
4. Drug overdose 9. Heart attack / stroke
5. Suffocation
Basic First Aid Handbook p. 27
Treatment for Cardiac Arrest and Heart Attack
1. For Cardiac Arrest: CPR is performed
2. For patients suspected of having a heart attack:
a. Place patient in a semi-reclining position
b. Administer oxygen by face mask if patient is irritable or anxious
c. Do not allow the patient to assist in moving himself
d. Loosen any of the patient’s tight clothing
e. Comfort and reassure the patient
f. Transport to hospital

D. Diabetes
Diabetes is a condition in which insulin, a hormone that helps the body
use the energy, is either lacking or ineffective. There are two types of diabetic
emergencies: Insulin Reaction or Insulin Shock and Diabetic Coma.

Causes of Insulin Shock

1. Taken too much insulin
2. Do not eat enough to provide his normal sugar intake
3. Over exercise or over exerted himself
4. Victim vomited a meal

Signs and Symptoms of Insulin Shock

1. Fast breathing and pulse 6. Sweating
2. Dizziness 7. Headache
3. Weakness 8. Numbness of hands and feet
4. Vision difficulties 9. Hunger and anxiety
5. Change in the level of consciousness

Treatment for Insulin Shock

1. For conscious patients, administer sugar.
2. Avoid giving liquid to the unconscious victim, “sprinkle granulated sugar
under the tongue”.
3. Turn the head to side or place in a lateral position.
4. Transport the victim to the nearest medical facility.

E. Seizure
Seizure is a sudden involuntary muscle contraction, usually due to
uncontrolled electrical activity in the brain.

Causes of Seizure
1. Epilepsy 3. Poisoning
2. Heat stroke 4. Electric shock
p. 28 Basic First Aid Handbook
Treatment for Seizure
1. Cushion the victim’s head something soft.
2. Loosen the victim’s tight neckwear.
3. Turn the victim onto side.
4. As seizure ends, offer your help. Most seizure in people with epilepsy are
not medical emergencies. They end after a minute or two without harm and
usually do not require medical attention.

Some Don’ts:
1. Do not give anything to eat or drink
2. Do not hold the victim down
3. Do not put anything between the victim’s teeth during the seizure
4. Do not throw any liquid on the victim’s face or into his/her mouth
5. Do not embarrass the victim – clear away bystanders

F. Nose Bleeding

Causes of Nose Bleeding

1. Trauma
2. Too much heat

Treatment for Nose Bleeding

1. Check for ABC
2. Grasp and pinch the entire nose maintaining continuous pressure for at
least 10 minutes
3. Place the person in a sitting position, make sure that he/she is comfortable
4. Some suggest inserting sterile cotton into each nostril
5. The victim should be quiet and not be permitted to blow his nose, walk,
smoke or drink coffee.
6. If the bleeding is intense and persists for more than 30 minutes, the victim
should be examined by a physician.

G. Fainting
Fainting is a loss of consciousness caused by a temporary reduction of
blood supply to the brain.

Causes of Fainting
1. Emotional
2. Hunger
3. Fatigue
Basic First Aid Handbook p. 29
Signs and Symptoms of Fainting
1. Weakness
2. Dizziness
3. Pale
4. Cold Sweat
5. Unconsciousness

Treatment for Fainting

1. Have the victim seated with knees far apart and hold head far down be-
tween knees for about five minutes.
2. If available, pour a little amount of spirit of ammonia on a piece of cotton
and let the victim smell the cotton.
3. If victim loses consciousness, lay him down on his back with head turned
to one side.
4. After consciousness returns, keep victim quiet for about 15 minutes.

H. Heat and Cold Emergencies

A. Hyperthermia - (Heat-Related Injury) is an increase in body temperature
that results from a hot environment. Heat related injury fall into three major
categories:
1. Heat Exhaustion – the most common heat injury can occur to a per-
son who is involved in extreme physical exertion in a hot, humid environment.
Signs and Symptoms:
- Headache, giddiness, and extreme weakness
- Nausea and possible vomiting
- Dizziness and faintness
- Profuse sweating
- Loss of appetite
- Collapse and unconsciousness (usually brief)
- Pale, cool, sweaty skin, usually ashen gray in color
- Possible heat cramps or muscle aches
- Body temperature – below normal, normal or slightly elevated
- Fatigue
- Diarrhea
- Thirst
- Dilated pupils
- Weak and rapid pulse
- Inelastic Skin
- Difficulty in walking
p. 30 Basic First Aid Handbook
Emergency Care:
1. Move the patient to a cool place away from the source of heat.
2. Have the patient lie down. Raise the feet 8-12 inches and lower the
head to help increase blood circulation to the brain. Remove as much clothing as
possible and loosen what you cannot remove.
3. If the patient is fully conscious, administer cool water at the rate of
one-half glassful every 15 minutes for one hour.
4. If the patient is unconscious, remove his or her clothing and sponge
off with cool water.
5. If the patient vomits, stop giving fluids and transport immediately to
a hospital.
6. Take the patient’s temperature every 10 or 15 minutes, transport as
soon as possible.

2. Heat Stroke – (Sun stroke) The condition results when the heat regu-
lating mechanisms of the body break down and fail to cool the body sufficiently.
The body becomes overheated, the body temperature rises to between 40 to 44
degree Celsius and no sweating occurs in about half of the victims. Because no
cooling takes place, the body stores increasingly more heat, the heat-producing
mechanisms speed up, and eventually the brain cells are damaged, causing per-
manent disability or death.

Signs and Symptoms:

- Temperature of 40 degrees Celsius or higher
- Hot, reddish skin which can be wet or dry
- Rapid, strong pulse of 160 or more
- Initially constricted pupils, later becoming dilated
- Mental confusion and anxiety
- Deep, rapid snore like breathing
- Loss of appetite, nausea or vomiting
- Convulsions, sudden collapse and possible unconsciousness
- Tremors
- Headache
- Dry mouth
- Shortness of breath
- Decreased urinary output
- Decreased blood pressure
- Dizziness and weakness

Emergency Care:
1. Remove the patient from the source of heat, establish an airway and
administer high concentration of oxygen.
2. Remove as much of the patient’s clothing as reasonable, pour cool
Basic First Aid Handbook p. 31
water over his/her body, fan the patient briskly, and shade him/her from the sun
if still outdoors.
3. Because heat stroke involves the entire body, care for a number of
complications that may result such as convulsions.
4. During transport, run the vehicle’s A/C system if possible and if not
wrap the patient in wet sheets and direct a fan at him.
5. Always transport a victim of heat stroke for hospital care.

3. Heat Cramps – are muscular spasms that occur when the body lose
too much salt during profuse sweating, when not enough salt is taken into the
body, when calcium levels are low, and when too much water is consumed. They
can also be caused by overexertion of muscles, inadequate stretching or warm-
up, and lactic acid buildup in poorly conditioned muscles. Cramping occurs when
the muscle contracts without relaxing again, the muscle remains firm in a knot-
ted configuration, leaving a cavity at its origin.

Signs and Symptoms:

- Severe muscular cramps and pain, especially of the arms, fingers,
legs, and abdomen
- Hot, sweaty skin
- Normal body temperature
- Rapid heartbeat
- Normal mental status and consciousness level
- Exhaustion or fatigue
- A stiff, board-like abdomen
- Possible nausea and vomiting
- Faintne ss and dizziness

Emergency Care:
1. If the patient is in a hot environment, remove him/her from the heat
immediately
2. Administer sips of saltwater to the patient at the rate of one-half
glassful every 15 minutes. Dilute one teaspoon of salt in one quart of water or
use a commercial product with a low glucose content. Do not give salt tablets.
3. Apply moist towels to the forehead and over the cramping muscles.
Massage the muscle unless it increases the pain, try gently stretching the in-
volved muscle groups by pushing back to its normal position.
4. Help the patient remain calm and relaxed to speed the recovery of
the muscle spasm.
5. Transport the patient if he/she has other injuries or illnesses, if other
symptoms develop or if the patient worsens and/or does not respond to care.
p. 32 Basic First Aid Handbook
B. Hypothermia - (Cold-Related Injury) General hypothermia is due to an
increase in heat loss, a decrease in heat production, or both. The most life threat-
ening cold injury, hypothermia affects the entire body with generalized severe
cooling.

Stages of Hypothermia:
1. Shivering – does not occur below a body temperature of 32 degrees
Celsius
2. Apathy and decrease muscle function, first fine motor and then
gross motor functions
3. Decreased level of consciousness with a glassy stare and possible
freezing of extremities
4. Decreased vital signs with slow pulse and slow respiration rate
5. Death
Note: This is an acute emergency requiring immediate medical attention.

Signs and Symptoms:

- Cyanosis or pallor, facial bloating
- Vague, slow, slurred, thick speech
- Muscular rigidity in later stages
- Memor y lapses, incoherence
- Disorientation, mental confusion
- Decreased heart and respiratory rate
- Weak, irregular pulse
- Uncont rolled shivering
- Apparent exhaustion
- Low blood pressure
- Apathy
- Drowsiness
- Poor judgment
- Dizziness, blackouts
- Unconsciousness
- Amnesia
- Sluggish pupils
- Dehydration

Emergency Care:
1. Keep the patient dry and remove wet clothing
2. Apply external heat to both sides of the patient using whatever heat
sources are available including the body heat of the rescuer.
3. If the patient is conscious and in a warm place have him breathe
warm, moist air or oxygen if available.
Basic First Aid Handbook p. 33
4. Monitor respirations and pulse and provide pulmonary and cardio-
pulmonary resuscitation as required.
5. Do not give liquids by mouth
6. Do not allow patient to exercise
7. Handle the patient gently

If less than 30 minutes from medical facility:

1. Prevent further heat loss
2. Handle with care
3. Administer oxygen
4. Transport

If more than 30 minutes from medical facility:

1. Prevent further heat loss
2. Handle with care
3. Administer oxygen
4. Follow rewarming techniques
5. Prepare for CPR
6. Transport
VIII. FRACTURES

Skeleton - the bony frameworks of the body

Joint – junction of two or more bones
Ligament – tissue which surround the movable joints, entering from
one bone to another.

Dislocation is an injury in which a bone comes out of place at a joint,

tearing the surrounding tissues to some extent.
Strain is an injury to muscles due to over stretching or tearing of strong
fibers that attached muscles to bones called tendons.
Sprain is a partial or complete stretching or tearing of the soft tissues
bonds that holds bones together on the joint called ligaments.
Cramps are usually caused by fatigue, or over exertion of the affect-
ed muscles that suddenly contract into a tight hard knot, which incapacitate or
greatly inhibit the movement of that muscle.
Fracture is a break in the continuity of a bone. It may be either closed,
in which the overlying skin is intact, or open, in which the skin over the fracture
site has been broken. Bone may or may not protrude through the wound. Open
fractures are more serious than closed fractures because the risk of contamina-
tion and infection are greater.
p. 34 Basic First Aid Handbook
A. Signs and Symptoms of Dislocation
1. Pain especially when in motion
2. Deformity
3. Swelling and discoloration
4. Inability to move the joint

B. Treatment for Dislocation

1. General -- immobilize, cold compress to the affected area.
2. Hip dislocation -- place a pillow or coat under the knees, transport
the victim in flat-lying position
3. Shoulder or elbow dislocation – arm sling, loosely tied
4. Do not attempt to fix the dislocation

C. Signs and Symptoms of Strain

1. Immediate burning pain
2. Little swelling
3. Little discoloration

D. Treatment for Strain

1. Rest
2. Application of cold compress for the first 24 hours, followed by
warm compress or gentle massage.

E. Signs and Symptoms of Sprain

1. Pain on movement
2. Tenderness
3. Swelling
4. Redness

F. Treatment for Sprain

1. Protect
2. Rest
3. Immobilize
4. Cold compress
5. Elevate the injured part

G. Treatment for Cramps

1. Gentle stretching of the affected area
2. Application of cold compress
Basic First Aid Handbook p. 35
H. Kinds of Fractures
1. Simple (Closed) - bones are broken, but there are no connecting
wounds from the break area to the skin.
2. Compound (Open) - bones are broken with connecting wound to
the skin surface.

I. Signs and Symptoms of Simple Fractures

1. Swelling
2. Pain upon moving the area above the injured part
3. Dislocation or deformity
4. Bleeding
5. Bruising
6. Tenderness

J. Signs and Symptoms of Compound Fractures

1. Presence of signs and symptoms of a simple fracture
2. Wounds through the skin
3. Bleeding
4. Bone may or may not protrude

K. Treatment for Fractures

1. Stop bleeding
2. Immobilize the injured area using a splint
3. Care for shock
4. Transport properly
5. Send to a physician

L. Purpose of Splinting
1. To immobilize a possibly fractured part of the body
2. To lessen pain
3. To prevent further damage to soft tissues
4. To reduce the risk of serious bleeding
5. To reduce the possibility of loss of circulation in the injured part
6. To prevent closed fractured from becoming open fractures.
p. 36 Basic First Aid Handbook
M. Basic Principles of Splinting
1. Splint only if you can do it without causing more pain and discomfort
to the victim.
2. Splint an injury in the position you find it.
3. Apply splint so that it immobilizes the fractured bone and the joints
above and below the fracture.
4. Check circulation before and after splinting.

IX. DRESSINGS AND BANDAGES

A dressing or compress is any sterile cloth material used to cover

wounds.

A. Other Uses:
1. Keeps out the germs
2. Controls bleeding
3. Absorbs liquid from the wound
Basic First Aid Handbook p. 37
B. Some Types
1. Commercial Types:
a. Gauze square or plain sterile gauze
b. Bandage compress
c. Compress on adhesive
d. Roller bandages
2. Improvised – any clean cloth

C. Applications
1. Completely cover the wound
2. Avoid contamination when handling and applying

A bandage is any clean cloth material, sterile or not, used to hold

dressing in place

A. Other uses:
1. Controls bleeding
2. Ties splint in place
3. Immobilize body parts
4. Supports body parts

B. Phases of Triangular Bandage

1. Open Phase
a. Top of the head bandage
b. Front and back of face bandage
c. Front and back of chest bandage
d. Overarm Arm sling
e. Underarm sling
f. Head and foot bandage
2. Broad Phase
a. Abdominal bandage
b. Knee bandage
3. Semi-Broad Cravat
a. Shoulder/hip bandage
b. Arm/leg bandage
c. Elbow bandage
4. Narrow Cravat
a. Forehead bandage
b. Eye bandage
c. Neck bandage
d. Ear, cheek and jaw bandage
e. Palm bandage
f. Palm pressure bandage
g. Sprained-ankle bandage
p. 38 Basic First Aid Handbook
C. Applications
1. Apply with care, not too loose, not too tight
2. Tie with a square knot
3. Check for tightness caused by later swelling

HEAD BANDAGE FOREHEAD BANDAGE

EAR-JAW-CHICK BANDAGE
Basic First Aid Handbook p. 39

ELBOW BANDAGE ARM/LEG BANDAGE

PALM BANDAGE

PALM-PRESSURE BANDAGE

LEG BANDAGE

FOOT BANDAGE
p. 40 Basic First Aid Handbook
ARM SLING BANDAGE
(OVER ARM and UNDER ARM)

TOURNIQUET BANDAGE

A B

C D
Basic First Aid Handbook p. 41

E F

X. EMERGENCY TRANSPORT

The first aider may need to initiate transfer of the casualty to shelter
home or medical aid. Skill in the use of simple techniques of transfer must be
practiced to avoid the casualty’s condition becoming worst. Careful selection and
use of the correct method of transfer is essential.

1. One – Rescuer
a. Assist to Walk (one-rescuer assist)
b. Carry in Arms (Lover’s Carry)
c. Packstrap Carry
d. Fireman’s Carry
e. Pick a back Carry
f. Foot Drag
g. Body Drag
h. Shoulder Drag
i. Fireman’s Crawl
j. Packstrap Crawl
k. Fireman’s Drag (inclined drag – head first)
2. Two – Rescuers
a. Hands as a litter (two handed seat)
b. Four hand seat
c. Carry by extremities
d. Chair as a litter
3. Three – Rescuers
a. Bearer’s along the side
b. Hammock Carry
4. Six-man to Eight-man Carry
5. Use of Stretcher
a. Improvised stretcher/blanket lift
b. Military stretcher
c. Ambulance stretcher
6. Use of Long Spinal Board
p. 42 Basic First Aid Handbook

ASSIST TO WALK CARRY IN ARMS

(LOVER’S CARY)

PICK A BACK CARRY PACKSTRAP CARRY

FIREMAN’S CARRY
Basic First Aid Handbook p. 43

FIREMAN’S CRAWL

FIREMAN’S DRAG
p. 44 Basic First Aid Handbook
TWO MAN LIFT (CARRY BY EXTREMITIES)

TWO MAN LIFT (HANDS A LITTER/TWO HANDED SEAT)

Basic First Aid Handbook p. 45
TWO MAN LIFT (FOUR HANDED SEAT)

IMPROVISED STRETCHER
Notes
Notes