KUP 65 Have knowledge of elementary first aid

Welcome to this essential course on elementary first aid. As a maritime professional, you may find yourself in situations where immediate medical assistance is crucial, yet professional help is hours away. This course will equip you with the knowledge and skills to provide potentially life-saving care in emergency situations at sea.

Module 1: Principles of First Aid

First aid is the immediate care given to an injured or suddenly ill person. The primary aims of first aid, often referred to as the “3 Ps”, are:

1. Preserve life
2. Prevent the condition from worsening
3. Promote recovery

When approaching any emergency situation, always remember the following steps:

1. Ensure your own safety first. You cannot help others if you become a casualty yourself.
2. Assess the scene for any ongoing dangers.
3. Check the casualty’s response.
4. Call for help if needed.
5. Check the casualty’s Airway, Breathing, and Circulation (ABC).

Case Study:
In 2018, aboard a cargo ship in the Pacific, a crew member fell from a ladder, resulting in head trauma and unconsciousness. The first responder, remembering his training, first ensured there were no electrical hazards near the fallen crew member before approaching. This caution potentially prevented a second casualty and allowed for effective first aid to be administered.

Module 2: Assessing the Situation

When you encounter a medical emergency, use the SAMPLE approach to gather crucial information:

S – Signs and Symptoms: What can you observe? What does the casualty report feeling?
A – Allergies: Does the person have any known allergies?
M – Medications: Is the person taking any medications?
P – Past medical history: Any pre-existing conditions?
L – Last meal: When did the person last eat or drink?
E – Events leading to the incident: What happened?

This information will be vital for both your immediate care and for relaying to medical professionals later.

Module 3: Basic Life Support

Basic Life Support (BLS) is a crucial skill for any first aider. Here’s the process:

1. Check for responsiveness: Gently shake the person’s shoulders and ask loudly, “Are you okay?”
2. If unresponsive, check for breathing:

• Look for chest movement
• Listen for breath sounds
• Feel for air from the nose or mouth

1. If not breathing normally, begin CPR:

• Place the heel of one hand in the center of the chest
• Place your other hand on top and interlock your fingers
• Push hard and fast at a rate of 100-120 compressions per minute
• After 30 compressions, give 2 rescue breaths if trained and willing
• Continue this cycle until help arrives or the person starts breathing normally

1. If the person is unconscious but breathing normally, place them in the recovery position:

• Kneel beside the casualty and remove any bulky objects from their pockets
• Place the arm nearest you at a right angle to the body, elbow bent, palm up
• Bring the far arm across the chest and hold the back of the hand against the casualty’s cheek nearest you
• With your other hand, grasp the far leg just above the knee and pull it up, keeping the foot flat on the ground
• Keeping the hand pressed against the cheek, pull on the far leg to roll the casualty towards you onto their side
• Adjust the upper leg so both hip and knee are bent at right angles
• Tilt the head back to ensure the airway remains open

Case Study:
In 2019, on a passenger ferry in the Mediterranean, a passenger suffered a cardiac arrest. A crew member immediately began CPR while another fetched the Automated External Defibrillator (AED). The quick response and effective CPR kept the passenger alive until they could be transferred to a hospital upon reaching port.

Module 4: Bleeding Control

Severe bleeding can be life-threatening and must be controlled quickly:

1. Apply direct pressure to the wound using a clean cloth or sterile dressing.
2. If available, use protective gloves to minimize the risk of infection.
3. Elevate the injured area above the heart level if possible, unless you suspect a fracture.
4. If blood soaks through, apply additional dressings over the top – do not remove the original dressing.
5. For severe, life-threatening limb bleeding, consider using a tourniquet as a last resort. If used, note the time it was applied.

Remember, a tourniquet is a last resort due to the risk of tissue damage. Only use it if direct pressure fails to control severe limb bleeding.

Module 5: Shock Management

Shock is a life-threatening condition that occurs when the body isn’t getting enough blood flow. Signs include:

• Pale, cool, and clammy skin
• Rapid, shallow breathing
• Weakness or dizziness
• Nausea
• Thirst

To manage shock:

1. Lay the person flat on their back with legs elevated about 12 inches (unless this causes pain or further injury).
2. Keep the person warm and comfortable. Loosen tight clothing.
3. Do not give anything by mouth.
4. Treat any obvious injuries.
5. Reassure the person and explain what you’re doing.

Module 6: Fracture and Sprain Management

Fractures (broken bones) and sprains can be painful and potentially serious. Here’s how to manage them:

1. Do not attempt to realign broken bones.
2. Immobilize the injured area to prevent further damage:

• For arm injuries, use a sling
• For leg injuries, you may need to splint the limb

1. Apply cold packs wrapped in a cloth to reduce swelling. Apply for 20 minutes at a time.
2. For suspected spinal injuries, do not move the casualty unless absolutely necessary (e.g., immediate danger). If you must move them, try to keep the spine in alignment.

Remember: “If in doubt, treat as a fracture.”

Module 7: Burns Treatment

Burns can be thermal (heat), chemical, or electrical. Here’s how to treat them:

1. Ensure your own safety first. Remove the casualty from danger if necessary.
2. Cool the burn under cool (not cold) running water for at least 20 minutes.
3. Remove any clothing or jewelry near the burnt area, unless stuck to the skin.
4. Cover the burn with a sterile dressing or clean, non-fluffy material to protect from infection.
5. Do not:

• Use ice, creams, or lotions on the burn
• Break blisters
• Remove anything stuck to the burn

For chemical burns, brush off dry chemicals first, then flush with water for at least 20 minutes.

Module 8: Hypothermia and Heat-Related Illnesses

In maritime environments, both cold and heat can pose significant risks.

Hypothermia:
Signs include shivering, slurred speech, and gradually worsening confusion.

Treatment:

1. Move the person to a warm environment.
2. Remove wet clothing and wrap in warm blankets.
3. If conscious and able to swallow, provide warm (not hot) drinks.
4. Do not rub or massage the person to warm them.

Heat Exhaustion/Heat Stroke:
Signs include headache, dizziness, confusion, hot and flushed skin.

Treatment:

1. Move to a cool place.
2. Lie down and elevate legs slightly.
3. Drink cool water if conscious.
4. Apply cool, wet cloths to the skin.
5. If unconscious or not improving rapidly, seek immediate medical help.

Module 9: Drowning

Drowning is a significant risk in maritime environments. Here’s how to respond:

1. Ensure scene safety before attempting rescue. Do not endanger yourself.
2. Once out of the water, check for breathing and begin CPR if necessary.
3. Even if seemingly recovered, all drowning victims should receive medical evaluation due to the risk of secondary drowning.

Remember: In a drowning situation, time is critical. The sooner you can start rescue breathing and CPR, the better the chances of survival.

Module 10: Communication and Documentation

Effective communication can be crucial in emergency situations:

1. When calling for help, provide clear information about:

• Your location
• The nature of the emergency
• The number of casualties
• What actions you’ve taken so far

1. Keep a record of any first aid provided, including:

• Times of key events and actions taken
• Observations of the casualty’s condition
• Any changes in the casualty’s state

This information can be vital for medical professionals who take over care later.

Conclusion:

Remember, as a first aider, your role is to provide immediate, potentially life-saving care until professional medical help arrives. Your actions in the first few minutes of an emergency can make a significant difference to the outcome.

Regular practice and refresher training are essential to maintain these critical skills. Always stay calm, assess the situation carefully, and don’t hesitate to call for professional medical help when needed.