1. Cuts and bruises:
Apply little tincture of iodine or spirit. Once the wound is clean, put a piece of gauge over it and bandage/sticking plaster. In case of deep and big cuts the doctor may be sent for immediately and wound kept covered with a sterilized dressing/bandage till his arrival.
2. Wounds or open injuries:
There are four types of wounds each necessitating appropriate management as under: –
(a) Abrasions are caused by scraping the skin, as from falling on a street. In such cases, wash the area with soap and warm water to remove all dirt on the surface. Then cover it carefully with sterilized dressing and bandage.
(b) Incised wounds are deep cuts, such as made by broken glass razor blade or a sharp knife. Blood comes out freely from such wounds. In such cases, bandage the area firmly and take the patient to a doctor as early as possible.
(c) Lacerated wounds are torn wounds, made by blunt instruments or explosions. They are of serious nature because there is a danger of infection. In such a case, the patient should be removed to the hospital emergency ward for treatment.
(d) Punctured wounds are caused by narrow, pointed instruments like nails, needles, thorns or bullets. In such cases, wounds must be cleaned immediately and alcohol be rubbed over the surrounding area. After this, a firm pressure bandage should be applied and the patient be taken to a doctor.
It should always be remembered that whenever the skin is broken, there is always the danger of infection. So care should be taken not to touch the wound with the tips of fingers or with anything else that may carry germs.
Immediately after cleaning the wound and the area around, antiseptic solution may be applied if need be, and the patient be taken to a qualified doctor without delay if the injury is serious.
3. Closed Injuries:
They are also of three main types, as given below:
(a) Contusion: It is injury to the soft tissue, which produces hemorrhage into the tissue, while the skin remains intact. Such injuries are caused by blows or falls or strokes of sticks or fists, etc. The main signs of a contusion are swelling, pain in the injured part. Sometimes there may be slight fever or shock also.
In such cases, the patient must be given rest. His injured part should be placed in a elevated position and cold compresses be given on the injured part. In case of intense pain, the patient should be immediately removed to the hospital.
(b) Sprained ligaments are one of the most frequent injuries. The ligaments of the joints are stretched, the surrounding small blood vessels are partly or completely ruptured and most frequently an extra-particular and sometimes an intra particular hemorrhage occurs. There is pain and swelling in the region of the joint and movement of joints is painful and limited.
In such cases, complete rest should be given to the affected joint. If the ligaments of the leg are sprained, the patient must be put on bed with the leg raised. If it is a ligament of the arms, the arm should be carried in a sling. For reducing hemorrhage and pain, cold compresses or hot bath and massage, on the second day.
(c) Dislocation: Dislocation is the displacement of one or several bones from their normal position or joint. It may be caused by falls, blows and strong movements in the joints. Some dislocations are caused by a disease in the joint and some may be by birth. There is sharp pain and complete immobility in the joint.
In such cases, dislocation should be reduced as soon as possible, to lessen the pain and to restore the function of the joints. The patient should be taken to doctor for proper treatment.
Fractures are caused when bones break due to a fall, blow accident or being run over by vehicles. There is great pain and swelling and difficulty in movement, at the spot. Sometimes a cracking sound is also heard at the time of injury.
In all cases, fractures must be handled properly and carefully, from the very start. If there is slight negligence, a simple fracture may turn into a compound one. There is also the danger of injuring the lungs, bladder and other internal organs.
For rendering first aid, the injured person should be kept warm and comfortable, to fight the shock. Applying a splint before taking the injured to the hospital should prevent further damage.
Applying heavy pressure over the bleeding vessels, using a clear dressing and a bandage, must control bleeding. Any clothing, which obstructs the vision of the injured area, may be removed or cut. No movement of any kind should be allowed. Early removal to a hospital is a must, in case of all fractures.
5. Hemorrhage or Bleeding:
Hemorrhage is one of the most dangerous factors in an injury. If the blood flows out to the exterior from the wound it is external hemorrhage. If the blood flows into the tissues or cavities, it is known as internal hemorrhage.
(a) External bleeding is of three types: –
(i) Capillary Bleeding: In this case the blood is bright red and it oozes out from the wound. For checking this bleeding, the wound should be covered with a clean cloth and tightly bandaged.
(ii) Arterial Bleeding: In this type of bleeding the blood is bright red and comes out in jerks and spurts, it is rapid, therefore, dangerous and may prove fatal even before the medical aid reaches.
(iii) To check this type of bleeding, press the artery above the wound, and don’t give any stimulants or, medical comfort like tea, coffee, etc. till the bleeding stops completely as these stimulants might increase the flow of bleeding. Instead, give simple water. Doctor should arrive as early as possible.
(iv) Venous Bleeding: In this type of bleeding the blood is dark red and flows in a steady stream. To check this type of bleeding raise the injured part above the level of heart, and the part of the vein below the wound should be pressed.
(b) Internal Bleeding
It occurs when the internal organs like lungs, stomach, spleen or intestines, etc. are injured. It is internal because the actual bleeding cannot be seen externally, and causes paleness of the face, weak and rapid breathing, sweating, and quick and weak pulse necessitating immediate evacuation of the patient to a hospital.
Remove all tight clothing’s around the chest, abdomen and waist to allow for fresh air and easy breathing; Bandage the arms and legs upwards to allow for more blood to reach the brain.
(c) Bleeding from Nose
Take the following steps: –
(i) The child should be seated in a chair, with head slightly thrown backwards and the arms raised above the head.
(ii) His tight clothes, especially on the chest, should be loosened.
(iii) The child should be allowed as much fresh air as possible. He should be asked to breathe from the mouth.
(iv) The head, the face and the neck of the child, should be washed with cold or ice water.
(v) The child should be allowed to bend down or to blow his nose.
(vi) Alum solution in ice-cold water, if applied, can produce good results.
(vii) If the bleeding does not stop, the patient should be taken to a qualified doctor, or to the hospital at once.
(d) Bleeding from Cheek, Tongue or Teeth
Take the following steps: –
(i) Give ice cold water and ask the patient to hold it in the mouth.
(ii) Put some cotton if the bleeding is from some wound.
(iii) Give rest to patient.
(iv) If bleeding still persists, arrange for medical aid as soon as possible.
6. Bites: Bites may be of two types; animal bites and insect bites.
In this case, if the animal is healthy, the wound should be washed with warm water mixed with any antiseptic lotion like Dettol, and bandaged. In case the animal is rabid or poisonous, the blood circulation should be stopped immediately and poison sucked out after washing the wound with water mixed with antiseptic lotion. Ensure that the first aider does not have any injuries are cuts etc, in his mouth.
Remove the sting with a disinfected/sterilised needle or pin and apply ammonia or soda bicarbonate or potassium permanganate solution. In case of swelling and general indisposition, take the patient to a doctor immediately.
Take the following steps: –
(i) The place just above the bite should be bandaged so tightly with a cord or rope that it stops the flow of blood upward. Use of tourniquet is ideal in such conditions.
(ii) Enlarge the wound caused by the bite with the help of a disinfected sharp edged knife.
(iii) Press out the poisonous blood.
(iv) Fill the wound with potassium premangate.
(v) Do not let the patient sleep; keep him awake and conscious.
(vi) Evacuate to the hospital.
7. Burns & Scalds:
Burns are among the most common household emergencies. Young children are often burned by hot water, milk or oil, stoves, irons, gas fire, unguarded electric outlets, fire-crackers and sunburn, Burns can be minor as well as severe. In case of minor burns, ice or chilled water should be immediately applied to the spot burnt.
After this cold treatment, the area should be sponged with soap and warm water and Vaseline should be applied on it with a dressing and bandage. Tetanus toxide injections are also very useful.
(ii) In case of severe burns, which cause large blisters, the skin should be cleansed first with soap and water. Warm clothing may be put on the patient and he should be given plenty of fluids like tea or coffee to drink.
Vaseline gauze should then be applied to the burned area with a tight bandage. The patient must be carried gently to the hospital. No liquid should be given if the patient is unconscious.
(iii) In case of sunburn, olive oil or cold cream may be applied to the burned area. An ice bag or a towel dipped in ice water may be applied to the burned skin to relieve the pain.
(iv) For chemical burns, the burned area should be thoroughly washed with water for several minutes. If the chemical is a strong acid it should be neutralised with moist packs, soaked in a weak solution of baking soda.
8. Fainting Shock:
Fainting is common which may occur from hunger, fatigue, anxiety, bad news, overwork, excessive heat, injury or bleeding accident. When a person faints, his blood pressure falls. He becomes pale and his pulse becomes weak and rapid. If such a patient can lie down promptly, he may not lose consciousness.
In such a case, the patient may be asked or made to bend forward and place his head between the knees. If he does not improve, he may be laid flat on his back, with his head a little lower than the body.
His legs may be raised (except in case of fracture) for the blood to go to the heart. The patient may be kept warm and cold water may be splashed on his face. Nothing should be given by mouth.
If the victim is still in the water, he should be taken out with a rope or stick. If a boat is readily available, it may be used to the best advantage.
First of all the victim’s mouth or throat should be cleaned of mud or any other thing which might have gone in with water. Then the patient be put on his stomach, with the back up and face on one side. After that, the back should be pressed to bring out water from the lungs. Artificial breathing may be given to the patient, if he is not breathing.
Laying the patient on his back after taking out the water and bringing his chin forward and up can do this. Hold the nose of the patient firmly and breathe gently into mouth about 15 or 20 times a minute. This will inflate the lungs and help in restoring the circulation.
If the heart has stopped breathing, mouth to mouth breathing may be continued and some one else be asked to give cardiac massage, by pressing firmly with the palm of the hand over the middle of the breast bone, about 50 times a minute. But the hand must be lifted off each time, after each pressure.
While artificial respiration is being given, the patient’s wet clothes should be removed and dry clothes put instead. The patient must be kept warm. It should always be kept in mind that respiration should not stop. In every such condition, artificial respiration must be resorted to.
The patient should be removed to the hospital in an ambulance, as early as, possible.
10. Foreign body in the eye:
In such a case the patient should not be allowed to rub the eye. If the foreign body is seen, pull down the lower eye-lid and remove the foreign body with the corner of a wet handkerchief.
If the foreign body is beneath the upper eyelid, seat the patient facing light. Then place a matchstick on the upper eye-lid and pull the upper eyelashes gently upwards, over the matchstick in order to avert the eye-lid. Then remove the foreign body.
If the foreign body is embedded, do not try to remove it. Drop liquid paraffin and apply a pad of cotton wool and bandage. Then send the patient to hospital immediately.