FIRST AID
In the event of an accident or a sudden illness that endanger life, the applications that are made without drugs with the means at hand in order to save life or prevent it from getting worse until the help of the health officials is provided, is called “first aid”.
Going to the accident site quickly and taking immediate action are important in first aid. Because it has been determined that 10% of the deaths after the accidents occur in the first 3-5 minutes, and 54-66% in the first 30 minutes. In short, each time lost increases the death rate. For this reason, the most effective first aid should be given within 5 minutes, and the most conscious first aid should be given within 30 minutes.
OBJECTIVES OF FIRST AID
– Ensuring Respiration
-Stop Bleeding = Loss of 20% of the blood endangers life.
-Prevention of Shock
-Protection of the Wound from External Factors
-Maintenance of Body Heat
-Giving an Appropriate Position
-Notification, Communication
-Don’t dispatch
FEATURES OF THE FIRST AID
1. The first aider should be very calm.
2. Speak to the patient in a soft tone that will calm them down.
3. First aiders should never endanger their own safety.
4. Inform the people in the first aid environment to the health institutions, fire brigade, police.
should be organized in such a way that
5. Evaluate the casualty or the sick person well. You should know your priorities very well.
6. Must have the ability to make quick and correct decisions.
7. He should be sure of himself and his knowledge.
8. Must have the ability to perform first aid applications correctly.
9. The first aider should have sufficient knowledge about the health system of his country.
10. The first aider tries to change his knowledge and behavior in the light of new information,
should be ready for renewal.
11. It should not be forgotten that first aid is a civic duty.
POSITIONS TO BE GIVEN TO THE INJURED
a) In head injuries: The patient is brought to a semi-sitting position. Whichever ear the person has blood comes from, it is laid on its side with that side down. If the patient’s nose is bleeding, the patient is seated and his head is tilted slightly forward.
b) In chest injuries: The patient is placed in a semi-sitting or sitting position. The injured side is gently laid on it. His clothes are loosened.
c) In abdominal injuries: The position to be given to the patient changes according to the direction of the wound. In longitudinal injuries, the patient is placed on his back and his feet are extended. In transverse injuries, lie on the back, knees pulled towards the abdomen.
d) In fractures of the spine, hip and leg:
The patient is placed supine.
e) In case of shock: The patient is placed in the shock position.
f) Patients in coma, patients who vomit, those who are poisoned by respiratory tract, those with respiratory difficulties: They are placed in the Fixed Side Lying Position below.
HOW TO MAKE A HEART MASSAGE
1-The patient is laid on his back on a hard surface, his chest is opened, and after the sternum is found, the place called “The Board of Faith” by our people, heart massage is performed over two or three fingers from the lower end.
2-Place the two hands on top of each other where the heart massage will be performed on the patient or injured person, and it is done by pressing the shoulders while the elbows are tense. At each CPR, the adult’s sternum should collapse 4 to 5 cm. An adult person receives an average of 75-80 heart massages per minute.
3-It is checked twice in the first minute, then once every minute to see if the heart and respiration have returned.
4- Cardiac massage is performed with one hand until the sternum collapses 2-3 cm on average for children aged 2-8, 1-2 cm with two fingers for children up to the age of 2, and 100 times per minute on average.
5-In babies, heart massage is performed with the thumbs one finger below the middle of both breast lines.
If both artificial respiration and heart massage are to be performed on a casualty: If there is only one first aider, he first gives artificial respiration 2 times, then he gives 30 heart massages and so on. If there are two first aiders, one gives 30 heart massages and the other gives 2 times artificial respiration. An adult should perform 75-80 heart massages and 15 artificial respirations per minute.
OPENING THE AIRWAY
The oral cavity is cleaned using the index finger in adults and the pinky finger in infants, any foreign objects are removed (dentures, broken teeth, soil, etc.) In order for the tongue not to hang back and block the airway: One hand is held by the chin, the chin is brought up and forward, the other hand is gently moved from the forehead. the head of the injured person is pulled backwards.
In injured patients with neck injury, the head is not pushed back, the lower jaw is pulled upwards.
An adult person breathes 16-20 times per minute, this number is 20-26 times in children.
In any accident, first of all, the consciousness of the casualty, the patency of the airway and respiration are checked.
A person’s breathing can be understood in 3 ways;
LOOK: Chest movements are checked, the chest inflates with each inhale and descends as you exhale.
LISTEN: We put our ear close to the patient’s mouth and nose and listen to the sound of breathing.
FEEL: We bring our cheeks close to the patient’s mouth and nose and feel the air movements. If there is no chest movement and we cannot hear the breathing sound, we must first open the patient’s airway to intervene urgently.
The first problem encountered may be the obstruction of the airway, and if this obstruction is opened, the patient can be relieved without the need for anything else.
RESPIRATORY:
If the patient is not breathing despite the opening of the airway, artificial respiration is started immediately.
A First Aid can do CPR in five ways:
1- word of mouth
2- Mouth to nose (for those who have serious injuries in the mouth or those whose jaws are locked)
3- Mouth to mouth (in babies)
4-Holger – Nielsen method
5-Silvester method
Mouth-to-mouth artificial respiration method:
It is the most commonly used and the most beneficial method for the patient/injured. The patient is placed on his back and his head is slightly pushed back. The first aider moves to the side of the patient. The thumb and index fingers of the hand holding the head by the forehead close the patient’s nostrils. The first aider takes a deep breath and puts his mouth directly on the patient’s open mouth and breathes into the patient. Then he pulls his mouth and gives the patient a chance to exhale. An adult human is given artificial respiration every 5 seconds, 12 times a minute. For babies, it should be done 20 times a minute, every 3 seconds. Chest movements should be monitored as the baby breathes.
Mouth-to-nose artificial respiration:
This method should be chosen if the patient’s teeth are locked and cannot be opened, or if there is an injury around the mouth due to an accident, in short, if the mouth-to-mouth method cannot be applied.
In this method, the patient is still in the same position, this time the first aider grabs the patient’s chin, closes his mouth and gives air through his nose.
During artificial respiration, air can fill the stomach, in such cases, the patient can be turned to the side and the air can be discharged by pressing lightly between the navel and the ribs.
Mouth-to-mouth and nose-to-mouth artificial respiration:
It is a method that can be applied especially in small children and infants. Since the respiratory rate of babies is higher and their mouth, nose and lungs are smaller, artificial respiration to babies is done by breathing through the mouth and nose together at frequent intervals and with less power. The amount of air to be given is enough to raise the chest.
Holger Nielsen Method
- If you are injured and
If artificial respiration is not possible
Applied.
- In this method, the patient is placed face down, his hands are joined at the level of his head, his head is turned to the side and
placed on your hands.
- The first aider goes to the head of the injured person, grabs the injured person’s elbows and lifts them 25-30 cm, in this way, the injured person breathes, then slowly releases them and presses on the back, thus the injured exhales.
Silvester Method
- It is applied to people who cannot sleep on their face.
- The patient is placed on his back and the arms are crossed on the chest first.
- Then it opens towards the top of the head. Thus, the lungs are filled with air.
- The process is repeated.
HEIMLICH MANEUVER
- in adult
Get behind the patient and wrap your arms around the patient’s waist. Place a fist above the patient’s navel with your thumb in the palm of your hand, and place it under the ribs and sternum. Grasp your fist tightly with your other hand and quickly press and pull in and out.
This process should be repeated 6 – 10 times until the blockage is removed.
If the patient loses consciousness and the obstruction still persists, have the patient lie on their back. Perform the same maneuver on the floor by sitting on the patient’s knees and pressing and pulling the same area towards the chest.
If you were not successful in this, he is laid face down with his head slightly down, and he is hit with a fist between the shoulder blades. Here breathing and circulation are controlled. If still unsuccessful, the maneuver is continued in the supine position. If breathing and circulation have stopped, artificial respiration and heart massage are also applied.
HEIMLICH MANEUVER should be applied in the form of a chest thrust from a slightly higher region in overweight and advanced pregnancy.
In children up to 8 – 9 years old, the abdominal thrust is done with one hand.
- In Young Children and Babies
Check the inside of the mouth, try to remove the foreign body if you can see it. If you are unable to remove it, hold the baby by the chest with one hand and place the baby on your knee, face down. Tap between the shoulder blades with the palm of your other hand 5 times, not too hard.
Perform 5 chest lunges (with index and middle fingers).
Start artificial respiration if necessary.
Continue these steps in order until successful or medical help arrives.
drowning in water
People die due to suffocation under water. Body temperature may also drop in people who are underwater. Submersion time, trauma, alcohol or drug use, and illness, if any, may be important in drowning. Being underwater for more than 6 minutes usually affects the brain irreversibly.
Should be careful in terms of neck trauma. If possible, artificial respiration should be started while still in the water.
* Lay the person out of the water on his back and open the collar of the clothes, if any.
* Clean the foreign bodies in and around the mouth
* After opening the airway, give artificial respiration 5-6 times to allow the patient to breathe adequately and to drain the water.
- After that, lay the patient face down and lift the patient up with your hands folded under their stomach. Thus, since the chest will be raised, the water in the airways will be discharged. However, you should not worry too much about the water discharge process.
* - If the heart has stopped with respiration, heart massage should be applied together with artificial respiration.
Artificial respiration and heart massage are continued until the patient begins to breathe on his own or medical help arrives.
* - If the patient has started to breathe on his own, put him in a fixed side lying position.
* - It should be wrapped in a blanket and warmed to raise body temperature.
BLEEDINGS
If bleeding is classified according to the bleeding vessel:
Arterial bleeding: The arteries carry the blood pumped by the heart to the body, so the pressure is high. Our pulse is this roof
taken from the bees. In case of injuries, blood flows rapidly in an intermittent, gushing fashion, and a lot of blood is lost in a short time.
Venous hemorrhages: These are the veins that collect the blood dispersed in the body and take it to the heart. In this type of bleeding, blood flows uninterruptedly and slowly and pools.
Capillary bleeding: Flows in the form of leakage, may stop spontaneously.
If bleeding is classified according to the bleeding site:
1-External bleeding: It is bleeding outside the body, it is easy to diagnose because it is clearly visible.
2-Internal bleeding: Since there is no bleeding outside the body, it can be diagnosed only by looking at some symptoms. These symptoms are:
Dizziness, blackout
Chills, shivering
Cold sweating
Color fading
Fast but weak pulse
METHODS TO STOP BLEEDING
Manual pressure: A thick gauze is placed over the bleeding area and pressure is applied over it with our finger. Bleeding will also decrease as the underlying vein will be compressed.
Pressure dressing: A thick gauze is placed over the bleeding area and a tight bandage is applied over it. Bleeding will also decrease as the underlying vein will be compressed.
Lifting the bleeding site above the level of the heart: When the bleeding site is kept above the heart, the bleeding will decrease as the blood going up due to gravity will be less.
Pressure on pressure points: It is used in arterial bleeding. To apply this method, the pulse between the bleeding site and the heart is pressed to the point where we get the pulse, so that the artery under the point is compressed. Since the amount of blood going to the bleeding site will decrease, the bleeding will decrease. We can use several of these methods for bleeding in the arms and legs. A tourniquet is used as a last resort for arm and leg bleeding that does not stop with these methods.
TOURNIQUET
6 – 8 cm. It is applied in the form of compression of the bleeding vessel in the single bony areas of the arms and legs with a wide, soft and elastic material. Single bone regions: Between the elbow and the shoulder and between the knee and the hip. The tourniquet is loosened for 5-10 seconds every 20 minutes and the total time it is attached should not exceed 2 hours.
The bleeding person may be cold and may ask you to cover up, cover the top of the tourniquet, but note the time the tourniquet was put on.
Nose Bleeds
Nosebleeds are 90% anterior and usually come from one nostril. The causes are mostly infections or blows to the nose. The patient is seated, the head is slightly tilted forward, ice is applied to the root of the nose, continuous pressure is applied to the wings of the nose with the thumb and forefinger for 5-10 minutes.
Palm Bleeding
They are stubborn bleeding. A clean roll of cloth is placed in the palm of the hand. The hand is clenched into a fist and held above the level of the heart.
SHOCK
It occurs when there is insufficient blood flow to the brain and other tissues as a result of circulatory failure. In shock, the organism tries to send blood to vital organs such as the heart, brain, lungs, kidneys and spleen. Due to insufficient blood circulation, cells cannot perform their normal activities and cell death begins in the following periods. Shock can be the cause of death. In shock, we can save lives with simple applications.
Shock Causes:
1-Heavy bleeding, water and salt losses
2- Severe heart diseases
3-Severe allergic events and severe microbial diseases
Shock Symptoms: (Due to sudden blood or fluid loss)
Cold and pale skin; cold sweats, thirst
Dizziness, blackout. chills, shivering,
Palpitations and frequent breathing, rapid and light heartbeat
Weakness, restlessness, fear of death and panic.
First Aid in Shock
The patient lies on his back, feet 25-30 cm apart. is increased, so that the blood in the lower half of the body goes to more vital organs. This is called the shock position. The airway is kept open. External bleeding is tried to be stopped. Fractures are splinted. The patient’s clothes are loosened. It is covered so that it does not get cold. No food or drink is given to the patient as there is a risk of vomiting and suffocation or the possibility of undergoing surgery for any reason. Measures are taken for other reasons.
FAINTING
It is a temporary loss of consciousness caused by a short-term decrease in blood flow to the brain. As soon as the patient falls or lies on the ground, the brain and heart come to the same level. The amount of blood going to the brain increases and consciousness often returns after a short time.
People who do not regain consciousness after half an hour should be referred to the hospital, as another event will be considered.
Symptoms of fainting:
sudden loss of consciousness
muscle relaxation
pallor of the face
Weakening of the pulse
Weakening of breathing
Cold sweats and vomiting
First aid
1- The patient is immediately placed on his back. The head is turned.
2- The patient’s clothes are loosened.
3- Stimulant odors can be smelled (such as ammonia)
4-The patient is kept warm
5- When the consciousness of the person is restored, it is ensured that he rests.
6- Liquid drinks are given.
7- Head injuries that may occur during falling are checked.
FRACTURES AND SPRINGS
- BROKEN
A fracture is a disruption of the integrity of bone tissue. It is divided into three as closed, open and compression fractures.
In closed fractures, the ends of the broken bones are not separated from each other.
In open fractures, the bone tissue is in contact with air. The dislocated tip can cut the vessels and nerves passing near the bone, and can come out by piercing the skin.
If the broken bone ends are out, they are not pushed in. Broken bone fragments and foreign bodies are not removed. In blows to flat bones, that area may break, collapse and put pressure on the organ underneath.
Fracture symptoms
Pain, swelling, redness, bruising, deformity, limitation of movement are seen.
First aid
The broken bone should be identified and immobilized. The objects used for this work are called splints. Splints can be made of plaster, wire or wood. The first aider uses wooden splints or any materials he can find as a splint. It can be flat pieces of wood, tree branches as a wooden splint. If possible, a gauze should be wrapped on the board, if not, the splinters and nails, if any, should be cleaned. A splint is placed on both sides of the broken bone and tied. The length of the splint should be long enough to immobilize the joint above and below the fracture. In this way, the fracture becomes immobilized. If the broken bones are not detected and immobilized with the splint, the broken ends may play and cut the vessels or nerves passing by the bone, leading to more severe conditions.
Examples of some fractures:
No splint is used in rib fractures, the chest is tied with a triangular bandage.
A splint is not used in collarbone fractures, the shoulder is immobilized. For this, the arm on the broken side is joined to the body and wrapped with a bandage.
After the splint is applied in fractures of the forearm, the forearm is hung on the neck at an angle of 90 degrees with the arm. Splint length is important in leg fractures. If the fracture is above the knee, the splint should extend from the armpit to the heel. If the fracture is below the knee, the splint should extend from the hip to the heel. If a splint cannot be found in the fractures of the leg, a thick fabric such as a blanket is wrapped in a roll, placed between the two legs, and the healthy leg is brought closer to the broken leg and both legs are tied together. The healthy leg acts as a splint.
- DISLOCATION
The separation of one of the bones that make up a joint from its normal location as a result of an external effect is called dislocation. The bone ligaments, which are forced into a movement that the joint ligaments would not normally allow, move away from their place by opening or tearing. Symptoms:
– Disturbance in the appearance of the joint and body extension
– Restricted or absent movement due to pain
– Tenderness and swelling should suggest dislocation.
Only a competent and experienced person can reposition a dislocated bone into the joint space. Attempts made by unauthorized persons may cause vascular-nerve compression, destruction of joint ligaments beyond recovery, and frequent repetition of dislocation (habit dislocation). The task of the first aider is to immobilize the dislocated joint area until it reaches a qualified and experienced healthcare professional. For this purpose, sling, splint and dressing applications are made.
FIRST AID IN DISEASES
-If the swelling continues, cold application is made.
-The dislocated area is raised 10-15 cm
In delayed cases, swelling is relieved with hot and salt water baths.
Painkillers are given according to the doctor’s recommendation.
- SPRAIN
Injury to the ligaments of the joint is called a sprain. Sprains also occur in movable joints.
Sprain Symptoms:
-Pain, swelling, bruising in the joint area
-Restriction of movement
First aid for sprains
1-The sprained area is detected and immobilized. A bandage or splint is used for this.
2-The sprained organ is held high
3-In order to prevent swelling, cold is applied intermittently and indirectly for the first 8 hours.
4-Painkillers are given according to the doctor’s recommendation.
- BURNS
Soft and bone tissues; heat,ray,electricity,radiation,acid,b *raa
3, injuries caused by burns are called burns.
Burns are divided into three according to their severity and depth:
1st degree burns: These are the mildest burns. The upper surface of the skin is affected. The skin becomes red. It passes without a trace. For example, sunburns.
2nd degree burns: There is damage to the lower layer of the skin. Fluid-filled vesicles, called bullae, may form. It is painful. If treated, it may not leave a scar.
3rd degree burns: The skin and subcutaneous tissue are completely destroyed. The burn goes deeper and leaves scars. Since the nerves in that area are affected, pain may not be felt.
Burn percentage can be calculated according to a rule called the rule of nines in determining the burn area for treatment. More than 20% burns are life-threatening.
Head 9%
9% each of the arms
18% each of the legs
Front of hull 18%
Back side of body 18%
Reproductive organs 1%
First aid for burns
1- It is driven away from the fire scene by going low or by crawling, preferably with a firefighter’s crawl.
2- If there is clothing on the burnt area, it is removed by cutting
3- Jewelry in that area is removed
4- Keep the burned area clean, do not apply toothpaste, tomato paste or yogurt on it.
5-Chemical burns are washed with plenty of water
6-Burning body parts should be covered with bicarbonate-soaked gauze and clean ironed sheets.
The bullae (fluid-filled vesicles formed on the skin) are not ruptured.
Clean cold water or ice is applied indirectly until the pain subsides. (Cold application) The burned area is wrapped with wet gauze or, otherwise, a wet clean cloth and taken to the hospital.
- 1st Degree Burn
There is redness of the skin, pain, edema in the burned area.
The lightest burn
It heals spontaneously in about 48 hours.
