 Kailangan mo bakit kwayani, sarap na pagsubo, wag kang sasubo Digeadang mo si Sang Sigaon ang masak, ang pag-pag-asa, asa'y muna siyong So when we talk about first aid, it's actually just one part of a whole line of activities which will lead to the improvement or to the increased survival of a patient or someone in need. Sa Tagalog ang tao'y ito ay paunang lunas, actually mas makandangang ang Tagalog version ang paunang lunas, ang unang-unang gagawin natin para makakamta natin ang lunas para siyong isang paciente Nandang nga ilangan dahil sa kanyang critical condition or life-threatening condition or sa isang calamidad So when we talk about paunang lunas or first aid, we talk about steps in what we will do to improve the survival So we map out five critical steps in determining what to do in times of crisis or life-threatening condition The first step is recognizing the emergency or recognizing the life-threatening injury and activation of the EMS or the emergency medical system When we perform first aid, we never do it alone. We always must ask for help In the Philippines, we can now dial 911 to call for assistance from somebody who knows how to help you bridge the gap between your area to the hospital The EMS dispatcher, when you dial 911, a dispatcher on the other end will talk to you The EMS dispatcher is knowledgeable in providing you step-by-step procedures in controlling whatever it is that the patient has So if the patient is bleeding or if the patient is no longer breathing or the patient has no pulse or the patient is choking, the dispatcher knows how to give you instructions Secondly, the dispatcher also has a gamut of resources at his fingertips He can call for an ambulance, he can call for a fire truck, he can call for police Which may aid you in increasing the survival of the patient The next part of the chain is activating first aid itself or performing early first aid or early CPR After you call for help, you may now do what you are trying to do in first aid To control the bleeding, to perform CPR and to give the patient relief After you have performed your CPR, should the patient have no pulse or no end, no breathing After you perform two minutes of CPR, the next chain is to perform rapid defibrillation Ito po yung kinokorientin natin yung sinasyak natin yung patiente To aid the heart in pumping back again In the country, there are a few buildings and a few clinics, a few hospitals that have defibrillators It was encouraged sometime ago that all facilities, resorts, offices, and modern, every building would have a defibrillator Of course, we don't wish to be able to use the defibrillator often as heart attacks don't really occur every day at a high rate But we can perform CPR best if we have a defibrillator at hand Once a patient has been defibrillated, continue CPR and wait for the ambulance to arrive That is the fourth link to the chain at the ambulance The ambulance will now transport the victim to the hospital for advanced medical care The final link to the chain is advanced medical care So all of these links, every link in this five-link chain of survival is important And it increases the chances of survival of a patient Remove one chain and then the chances of survival becomes less For example, you don't know CPR so you don't perform it But you call for help and the EMS arrives and they do the CPR In those cases, because you called for help and because help did arrive and the patient is transported to hospital The chances of survival is still great But greater even if you have performed a high quality CPR So what is first aid? As I mentioned a while ago First aid is immediate care given to an injured person who has had a life-threatening condition It does not take place of proper medical treatment Therefore, if the patient survives or if the patient becomes better, you don't just send him home You still refer the patient to the hospital or clinic Now, there are legal considerations when giving first aid Because everyone has the right to refuse assistance Some people simply don't want to be touched Some people don't want to be assisted So when you see or spot somebody who needs help, we approach them And we introduce ourselves Like, I am Dr. Ong I know first aid, how can I help you or can I help you Or I am Juan de la Cruz, I am trained in basic first aid, I know CPR, may I help you So whenever we perform first aid, we first have to have consent of the patient About 98-99% of the time people would want to be help And people would want to be well and to survive Now, in very, very slim percentage of the population all over the world Very, very slim, the people don't want to be help So what do you do? Do you just go away? Do you just simply leave the patient? No, you wait If the patient becomes worse and the patient collapses And loses consciousness or unable to communicate Or the patient becomes unresponsive You may now perform your first aid under the pretext of implied consent Implied meaning that it is implied that whenever a person loses consciousness They would want to be help And of course perform first aid only When you have been trained to do Meaning you do not perform any therapies, any procedures Which you do not know how to do So whenever you try to perform first aid Give the assistance the best you can, the way you will train The first part of helping somebody Of course to survey the scene or environmental survey When we want to assist somebody in need We need to assess the safety to which you will be assisting in So an example would be if you were in a highway And you see a motorcycle which has stumbled And the rider is down at the side And you stop Try to see if you smell gasoline Or if you see a pool of gasoline Or if the bike is spewing smoke Or is burning If the scene is too dangerous for you to enter Do not enter, simply call for help And they help through perhaps the fire department Will arrive where the Balangay who has a fire extinguisher Will arrive then help can be given So first do a quick survey of the environment Looking for these elements Number one hazards Hazards which would be dangerous to you Such that a pool of gasoline and fire Hazards that would be dangerous to the victim And to the bystanders Next, look for the mechanism of injury What happened to the person who needs help Is the mechanism of injury still there Is the causative agent of the injury still there If it is, it might not be safe for you to enter the scene Then count the number of victims Sometimes you will have to respond to A group of people needing help Let's say a vehicular accident again With this time a whole van full of people When you have that kind of emergency Then you will have to prioritize Which person they will give your assistance first Now the whole thing should only be done in a few seconds When you arrive at the scene And you see that the scene is safe For you to enter And you are now able to approach the patient Do the initial assessment Basically it's checking for three things You're checking for the person's consciousness Of the patient is responsive If the patient is talking If the patient is confused or sleepy or lethargic Second, you check for the pulse Then you check for breathing So these are the three main elements In your initial assessment Again, check for the consciousness Check for bleeding or the pulse And then check for breathing Determine if the patient is conscious Tap the shoulder If you know the name Call out the name Or call out Are you okay? So check the person's consciousness If the patient is able to respond to you Coherently Is able to understand you And respond to you Then the patient is responsive And you can now ask the patient What happened to him Where the source of pain is If he can move his legs or not Then check for CAB C for circulation So check for signs of circulation Such as pulse Check the airway if it is open If the airway is obstructed If you can breathe properly or not And check for breathing See if the chest is rising and falling In a rhythmic normal and regular pattern If the patient is responsive Is able to talk to you And they are able to understand you And talk to you coherently Ask them what injuries they have And what difficulties they are experiencing Check and provide first aid For these complaints As well as others that may be involved If the patient is unconscious Or incongherent Or the patient is unresponsive To your query Observe for obvious signs of injuries From head to toe Look for signs of bleeding Look for some deformities The limbs should there be a fracture And provide first aid as necessary For bleeding control If you see external bleeding Apply direct pressure Direct pressure stops most bleeding Please wear gloves or protection If you don't have gloves You can use a plastic bag Over your hand To protect your hand from the blood There are many many blood pathogens Hepatitis, HIV Which can enter your bloodstream And make and infect you So there are dangers To help the other people So we wear gloves Or wear any personal protective equipment To prevent the contamination From entering your body So you've worn a plastic bag Over your hand Or clean cloth Over the wound Once you apply direct pressure Elevate the injured limb In this case There is an injury In the patient's palm Or wrist And you apply direct pressure Using a gauze Or clean cloth And you elevate the limb Combine the direct pressure With elevation If bleeding continues Despite the elevation And direct pressure Apply pressure in the pressure points Or in the arterial pressure points Of the body To further stop the bleeding I have some examples here For example, if you are bleeding At the forearm You can press the artery here If you are bleeding from shoulder down You can press the artery there If you are bleeding At the lower extremity or leg There is the femoral artery So these are some of the pressure points You can use If direct pressure and elevation Do not work So this is another example So if you are bleeding From the shoulder down Or if you are bleeding here At the lateral aspect of the chest And abdomen You can press the subclavian artery This is your clavicle or collarbone You can press it Quite deeply And it will occlude or stop The blood flow from Going through the subclavian artery If you have a nose bleed For example Or bleeding here in this area Press the lower part of the jaw This is not the neck This is the jaw Press it firmly And you will see That the bleeding will stop When you have bleeding In your forearm This is the bicep And you can press The biceps to stop the bleeding At the femoral At the inner part of the thigh Inner part of the thigh So control methods For internal bleeding Of course you cannot see It has occurred inside Whether a muscle has torn Or a blood vessel inside has ruptured So you can see bruises Or contusions of the skin These are painful, tender Or rigid Or The abdomen can see it If there are internal bleeding Of the internal organs Stools that are black Or contain a bright red blood Meaning you have blood inside Your colon Or your clastrid teslo system If the stools are black Then you have bleeding ulcers in your stomach If the stools have bright red blood It means that you have Bleeding in your colon So what to do Of course you have to monitor again The CABs I made a mistake here CAB, circulation area in breathing Keep the victim lying down On his or her left side This will prevent the expulsion Of vomit From the stomach And it will allow The Drainage So it will help In removing If the patient Has eaten a lot of food Para hindi siyang masamid Lay the person on his side So that vomit Can easily drain away Treat Shock by raising the victim's legs Shock occurs when there is Compromise of the circulatory system When you've lost a lot of blood And the circulatory system Can no longer cope With the loss of blood Your heart is pumping very fast To try to oxygenate your body But blood Has already escaped Through bleeding The patient can go into shock Shock simply means That your internal organs Are now compromised Lack of oxygen So you raise the victim's legs Such as this Or you raise the victim's Arms such as here If you have a Bleeding for arm To help bring the blood back To the heart and into the brain Shock refers To the circulatory system I've mentioned before And it happens because There's insufficient amount of oxygenated blood To the vital organs So this can be the result Of the loss of blood Due to uncontrollable bleeding Or circulatory system Problem if the heart stops pumping Or becomes slower And slower and slower Then there is less oxygen Going into the vital organs I can have shock Due to loss of fluid Such as dehydration Or excessive sweating Water also So if you have diarrhea If you are Dehydrated From extreme heat stresses And you have excessive sweating You lose fluids You lose water And because blood is made also Of water it becomes thicker It's harder For the heart to pump The blood if it's thicker Therefore you have less oxygen Going into your vital organs Shock also occurs When you have trauma When your blood vessels are ruptured Shock also occurs When you have extreme emotional events When you are stressed You're highly stressed Your body tenses up Your body will try To bring The blood Towards the vital organs You look flushed You look pale Because blood is removed From your peripheral circulation And brought to the center Circulation So your hands are cold You look pale Your lips are whitish Because blood is now Brought to the core So what to look for As I've mentioned There is less oxygenated At the vital organs So if you have less oxygen To the brain You have altered mental status You have anxiety You're confused You're sleepy You cannot answer questions You also look for pallor Cold clammy skin Look at the nail beds Look at the pallor If you depressed the nail beds Your nail bed from pink If you have nausea and vomiting If you have rapid breathing And rapid pulse If the shock is severe You become unresponsive and you collapse You could become unconscious So what to do This is a very, very life-threatening condition So We are already talking about Loss of blood, loss of oxygen Failure of vital organs So as a A lay person Or a lay rescuer It might seem overwhelming But just do these simple steps Do not panic Just do these simple steps Call for help, do the simple steps And wait for the ambulance to arrive Lay the person on his back Elevate in the feet Provide blanket Because the patient feels cold Because of shock And do not leave the patient Assure the patient that you're there To help That when he loses consciousness That you will be there You will help the EMS And the ambulance crew Once they arrive So being there already is a big assurance A big A big cost for Relief for the patient Which relieves the emotional shock All right Another cost for shock Is dehydration as I've mentioned How can we dehydrate it apart from Excessive sweating, diarrhea We can have Shock through burns When your skin is burned When you are in an area which is too hot And you have excessive bleeding You lose sweat And you lose fluids So let's talk about burns So you have several kinds of burns The first degree, second degree, and third degree burns So The most superficial type of burn Is the first degree burn You often actually Encounter this at a beach When you have sunburn So first degree burn Sunburn is first degree burn Where only the outer part of the skin Is damaged As you know through your High school And grade school that the skin has The epidermis or the top layer Here it is, epidermis The dermis is where your blood vessels are And the sub Dermis or subcutaneous tissue Where your Nerves and your muscles Your subcutaneous fat is located So first degree burns occur In the epidermal layer So you have your redness And sometimes you see Skin peeling away So this is skin being peeled away So precisely what you have In sunburn So what do you do? Cool the area Cool the area Using tap water Clean Clean tap water For about 10 to 45 minutes Depending on the patient's Comfort Cold stops the burn from Progression Of course when you have heat stress As the heat destroys tissue And the heat can be progressive So you may destroy Issues Progressively So you have sunburn Progressively larger You may also use Aloe vera To address burns So basically for me It's just water Water is the universal Coolant For the body I would actually avoid And just use plain water Second degree burn Is deeper Than the epidermis So now you have The epidermis here And the dermis there Being burnt So this occurs when you have Scalding burns So you are cooking And you have blisters The blisters are actually fluid Your fluid Which tries to cool down The tissue So do not puncture the blisters It's helping your Body cool down Besides if you puncture them You might introduce infection You might introduce germs inside The blister And you can have Cellulitis Or infection of the skin So you have blisters, you have swelling You have fluids leaking out So your body is trying to Cool that area Of course you have severe pain First degree burn Is painful already What more In a second degree burn Where in More than half One third to one half Of the skin depth Is already burnt So what do you do? Cold water again Water You can have Cold wet packs You may give pain relievers But it is not your duty As a first aider to provide these Do not break the blister And call for help Again water Is the first aid for Second degree burns Because it cools down the body Even deeper are third degree burns So you have your dermis Your dermis and all the way down To the muscle And sometimes you can see bone already Third degree burns are full Thickness where the whole thickness Of your skin is burnt Allow me to go back So this is the dermis First degree burn is just the Top layer It's about Ten percent of your skin Second degree burn Is a third Of the thickness Half of the thickness of your skin Full thickness is third degree burns Third degree burns are not Painful at all because they have already Burnt The nerve ending So you do not feel any pain For third degree burns You see charring Or ashes or charring Of the tissues The tissues can appear Gray white Because of the lack of blood Or charred Because of Obvious profuse bleeding Or black Because of the extreme burn Of the skin Again, this is not painful So if you see somebody who has Burn At the hand Mostly the chest Third degree burns occur When the oil is really hot Oil is strong Oil is strong enough to cook Through your skin Full thickness burns If they say it's not painful At all suspect, third degree burns So will you go and get your universal coolant Water? No For third degree burns do not apply Anything to it Call for help Cover it But to not cover it just to protect it From dust and infection Light covering And do not put Anything Call for help It may seem that third degree burns Are the easiest to treat as a first aider But that's true For first aider is very Difficult to treat Second degree burns Even first degree burns because they're very painful In the patient will If your patient will be sick At full thickness And you will not apply anything Just cover it with light Covering just to protect it from the elements And then call for help So what are the types of burns? Obviously burns from flames Thermal burns can be from flames Can be from hot objects If you touch something hot Let's say You want to clean the car In the hot sun When you try to wipe the hood And you scald your hand A flammable Vapor ignites or steam Or hot liquid Or the vapor from a hot liquid Can cause thermal burns So your objective Is to cool the patient Stop the burning Remove the patient from The source of The heat, the thermal stress If there is open flames With a blanket Cover it Remove the oxygen from the Equation, remember Flame has three components Oxygen Oxygen The Combustible material And the How it is ignited So the fire The combustible material And oxygen Remove one of the three Just one of the three And the flame is extinguished So it is easier to remove oxygen By covering it with a wet blanket And ask the patient to roll So all the Areas where there is Flame will be extinguished Then afterwards Determine the degree of burn Again, first, second or third degree For chemical burns Chemical burns are caused by acids An example will be Car battery acid Or alkalis The stuff you put in your toilet If it's clogged They also cause alkaline burns Some oil products Do cause burns Especially when you have an allergic reaction Some people are very sensitive to oils And when they come in contact With industrial oils, for example They contract First to second degree burns What to do Remove the chemical Flush the air with water Water dilutes the acids So the strength of the acid is decreased When you dilute it With the universal solvent So water is not only the universal poolant It is the universal solvent If the chemical is Dry powder Brush it away Do not flush dry chemicals When you flush it with water It becomes liquid Become Concentrated acid So if it is a powder Brush it off Take precautions to protect yourself From the splash Of the chemicals When you try to douse it with water Or remove the chemical Remove the victims' contaminated clothing And jewelry while flushing water Back at jewelry, if the patient has a ring And the burn includes the hand The fingers will be swollen Such that the ring will be a constrictive band Which will constrict the blood vessel From entering the finger It might become Gangrinus The finger will have the chop off If it's gangrinus already Flush for Quite a lengthy amount of time About 20 to 30 minutes With running water If you have burns in your eyes On a skin or eye So this is an example Of a patient who has had a Vapor Which has come in contact With the eye and gets very irritated Very red Consider that a chemical burn And flush it continuously Turn on the faucet Not full blast Medium stream And keep the eye Under the flowing water For about 20 minutes Of course the patient can blink But try to open the eye So that water can indeed Go to their lute Whatever ashes there are In the eye And seek medical attention Another type of burn is electrical burns Mild electrical shock Can cause serious injuries There are three types of electrical shock Thermal burn From a flame In an electrical shock Patience, objects in direct contact With skin are ignited By an electric current Mostly caused by flames Produced by the electrical current Not by the passage of electricity Another Type of electrical burn Is arc burn Occurs when electricity jumps Or arcs from one place to another It burns the skin Every job it burns the skin And then contact True electrical shock Occurs with the electricity Current, electrical current Passes through the body So you have burns In your internal organs as well So in this case Here you have your Say electrical injury The electricity will burn Through the skin Into the deeper layers And can even reach your internal organs What to do If you have an electrical burn Always think Sa anang galang yung electrical burn There must be a short circuit somewhere A live electrical wire Or a fallen electrical Pose somewhere there Shot of the electricity Unplug Any appliance which the patient Might have handled Unplug it Disconnect it or turn off the power In your main electrical Circuit breaker So If that is impossible Let's say you don't know where the breaker is You don't seem to see any Source of electricity Call the power company Or call the brand guy For help Do not try to climb any high electrical wires To cut it Do not consider all wires You see as live Do not handle any down Electrical wires Do not come in contact with a person Let's say you see a person With a burn The skin And he's laying over an electrical wire Do not touch him Because he might conduct Electricity to you If the victim has fallen Check for spinal injury And elevate the legs As I've mentioned a while ago And of course call for help And seek medical attention immediately So we've tackled What first aid is The links to survival We've tackled A very very common occurrence In the household which burns Now we come To another very very common occurrence Also at home open wounds So what is the basic first aid Open wounds or wounds Here we have An open wound This is a break in the skin surface That results In external bleeding So of course when you have a break here You see blood coming out And it will allow bacteria to enter the body The skin is your first line Of defense against bacteria So whenever You are in a dirty area Your skin is the one that protects Bacteria can Come in contact with your skin But your skin will not allow it to enter If you have a wound The bacteria can now enter the wound What are the types of wounds So you have an abrasion Gas gas So that only the top layer of the skin Is removed from epidermis To some part of the epidermis Laceration when you have a jagged Cut in the skin Has irregular edges And forceful tearing away Of the tissue At home I've had cases Where in Sumasabit yung skin At nandaganan So you have laceration here Or tumamas sa barb wire So you have laceration Incisions If laceration is jagged Incisions are smooth and Precisely cut Or paper cut Incisions You can have knife cuts Accidental cuts from your scissors For example Punctures is when A sharp object Has gone through the skin Causing a deep narrow Tunnel Stab wounds Punctures can be from Thumbtack to a nail It can be as superficial as your skin Or to us deep As going inside your internal organs A valsion Is a flap of skin Which has been Removed or taken off So we have a valsion A flap of skin Toan loose And of course amputation When something is amputated A toe, a finger So what to do Again because there is blood You wear your protective equipment Just something to cover Your hands like a Sandwich bag or plastic bag Wear gloves Look at the wound Control bleeding through what Again direct contact Direct pressure Elevation Clean the wound To prevent infection Wash shallow wound gently With soap and water But in general I would prefer To just use water To clean away the grime And debris from the area Let the EMT's The nurses and the doctors take care Of cleaning the wound With disinfectant Wash and try to wipe From the center In the spiral From a smaller circle To a bigger circle In a spiral motion To remove the grime And debris If it's a severe wound Clean only when the bleeding has stopped So if it's a wound that is Actively bleeding Profusely bleeding Your first Your priority is to stop the bleeding Just pad The wound with Cloth, clean cloth Keep on padding it until the bleeding stops Remove small objects To not flush out By irrigation By using tweezers If the bleeding starts Apply pressure To control the bleeding Use roller bandages Apply Much firmer pressure When you roll bandages Around the limb Keep dressings Dry and clean Remove dressings If the dressing gets soaked With blood, do not remove it Just add another one Add another layer. Keep adding Gauze and clean cloth Until the bleeding Is controlled The dressing should be changed already in the hospital So you do not change dressings If the wound The bleeding is profuse Your job is only to stop the bleeding And pad more and more Gauze So No matter how careful we are Sometimes the wound gets infected So what are the signs Of wound infection? Number one It's swollen. There's redness It's tender to touch It's warm And it's very painful It's swollen The pain is probing The patient might have chills Because the bacteria might have gone The bloodstream already in cause Fever, chills Patients would have swollen Makulane, no? Lift toes And there are certain Bacteria, no? For example, tetanus Cause is lakjo And you should receive a Tetanus shot within 72 hours Or three days So for dressings and bandages The purpose of the dressing So one, of course Is to stop the bleeding Second, protect the wound From getting infected So protection, contamination Also absorbs blood And drains away the fluid Which comes out of the wound It also protects the wounds From further injury So again Always wear gloves when applying Dressings and bandages Use a dressing large enough To extend beyond the wound's edges In a dressing In a large wound that's useless You have a big dressing Which you put on top of the wound The dressing should extend To way beyond About an inch beyond The edges of the wound If the wound is Two inches Long, it's a laceration Which is two inches long You apply gauze or a dressing Which is four inches So it goes well beyond the edge Of the wound Cover the dressing With bandages, like the roller bandages That I mentioned a while ago So the roller bandage Which I talked about So we have the gauze The bandage Is used to Firmly keep the dressing In place over the wound It also creates pressure So when you roll the gauze Pressure Which can control bleeding It also helps prevent swelling Or reduce swelling by limiting The amount of blood rushing into the wound It provides stability And support For a joint Or an extremity The bandage should be kept clean But need not to be sterile It's only used to hold the dressing Remember, this is just first aid So For the first aid Is to control the bleeding Prevent infection Stabilize the patient It is the job of the hospital Or the medical personnel To keep the wound clean By dressing it with disinfectants And giving the patient Some antibiotics So that ends our First module on first aid We have actually Discussed already a lot of items First module So we have discussed the chain of survival How to control bleeding How to control shock Or how to respond to shock How to take care of burns Especially The most common ones The superficial burns And electrical burns Some of the Rareer ones But still can occur in the community Such as chemical burns In the eye Now you know some first aid On how to deal with them Hopefully you can apply These techniques When it is necessary Of course we hope that It might not You may not come in contact With the situations But it would help for you To know what to do When that time arrives So thank you very much And I hope You have some takeaway From the first module On basic first aid