Basic First Aid

Chapter 1

Your role as a first aider

• Protect yourself first. Check for danger such as traffic, fire, electricity or aggression. Use gloves if available.
• Assess what happened and how many people are hurt.
• Get help early. Call 926 (Botsogo Pele EMS) or 997 (national ambulance). Give your exact location, what happened and how many casualties.
• Give first aid for the most serious problems first: breathing, then bleeding.
• Reassure the casualty and stay with them until help arrives.

Use the primary survey (DRS ABC) for any casualty: Danger, Response, Send for help, Airway, Breathing, Circulation. If someone is unresponsive and not breathing normally, start CPR (see the CPR & AED handbook).

A basic first aid kit

• Disposable gloves
• Sterile dressings and plasters
• Crepe and triangular bandages
• Adhesive tape and scissors
• Sterile saline or clean water for washing wounds
• Cling film (for burns)
• Foil emergency blanket
• CPR face shield

Chapter 2

Bleeding and wounds

Severe bleeding

1. Put on gloves if available. Apply firm, direct pressure on the wound with a dressing or clean cloth.
2. Keep pressing. If blood soaks through, add more padding on top. Do not remove the first dressing.
3. Secure the dressing with a firm bandage.
4. Lay the person down and keep them warm. Watch for signs of shock.
5. For life-threatening bleeding from an arm or leg that pressure cannot control, a trained person may apply a tourniquet 5–7 cm above the wound. Note the time it was applied.

Minor cuts and grazes

Rinse with clean running water, pat dry and cover with a plaster or dressing. Seek medical advice if the wound is deep, dirty, from an animal bite, or shows signs of infection.

Nosebleeds

Sit the person down, leaning forward. Pinch the soft part of the nose for 10–15 minutes. Seek help if bleeding continues beyond 20–30 minutes or follows a head injury.

Chapter 3

Choking

Mild choking: the person can cough, speak or breathe. Encourage them to keep coughing.

Severe choking: they cannot cough, speak or breathe, and may clutch their throat.

Adults and children over 1 year

1. Give up to 5 back blows: lean them forward and strike firmly between the shoulder blades with the heel of your hand.
2. If that fails, give up to 5 abdominal thrusts: stand behind, place a fist between the belly button and the bottom of the breastbone, grasp it with your other hand, and pull sharply inwards and upwards.
3. Repeat 5 back blows and 5 abdominal thrusts. Call 926 (Botsogo Pele EMS) or 997 (national ambulance) if the blockage does not clear.
4. If they become unresponsive, lower them to the ground and start CPR.

Infants under 1 year

1. Lay the baby face down along your forearm or thigh, head lower than the body, supporting the head.
2. Give up to 5 back blows between the shoulder blades.
3. Turn them face up and give up to 5 chest thrusts with two fingers in the centre of the chest.
4. Repeat and call for help. Never use abdominal thrusts on an infant.

Chapter 4

Burns

1. Cool the burn under cool or lukewarm running water for 20 minutes.
2. Remove jewellery and clothing near the burn, unless stuck to the skin.
3. Cover loosely with cling film or a clean, non-fluffy dressing.
4. Keep the person warm: cool the burn, not the patient.

Get medical help for burns larger than the casualty's palm, burns to the face, hands, feet, genitals or joints, deep burns, electrical or chemical burns, and any burn on a child or older person.

Chemical burns: brush off powders, then rinse with plenty of running water for at least 20 minutes. Electrical burns: make sure the power is off before touching the person.

Chapter 5

Bones, joints and head injuries

Signs of a fracture include pain, swelling, deformity, an inability to move the limb, and a grating feeling.

1. Tell the person to keep still.
2. Support the injured part in the position you found it, using your hands, padding or a sling.
3. Do not try to straighten a deformed limb.
4. For an open fracture, cover the wound with a sterile dressing and control bleeding without pressing on the bone.
5. Get medical help and watch for shock.

Sprains and strains: rest, apply a cold pack wrapped in cloth for up to 20 minutes, give gentle support with a bandage, and raise the limb.

Chapter 6

Shock

Shock is a life-threatening condition where not enough blood reaches the vital organs. It can follow severe bleeding, burns, serious infection or allergic reaction.

• Pale, cold, clammy skin
• Fast, weak pulse and fast, shallow breathing
• Feeling faint, dizzy, thirsty or anxious
• Confusion, then drowsiness

1. Treat the cause, for example by stopping the bleeding.
2. Lay the person down. If there is no leg injury, raise their legs slightly.
3. Keep them warm with a blanket. Loosen tight clothing.
4. Call 926 (Botsogo Pele EMS) or 997 (national ambulance). Do not give food or drink.
5. Monitor breathing. Be ready to start CPR.

Chapter 7

Medical emergencies

Heart attack

Chest pain or pressure that may spread to the arms, neck, jaw or back, with breathlessness, sweating or nausea. Sit them down in a comfortable position, Call 926 (Botsogo Pele EMS) or 997 (national ambulance), and if they are not allergic and the call-taker agrees, give one adult aspirin (300 mg) to chew slowly. Help with their own heart medication if they have it.

Stroke: think FAST

Seizures

• Protect them from injury: move hard objects away, cushion the head.
• Do not restrain them or put anything in their mouth.
• Time the seizure. Call for help if it lasts more than 5 minutes, repeats, is their first seizure, or they are injured.
• Afterwards, check breathing and place them in the recovery position.

Severe allergic reaction (anaphylaxis)

Swelling of the face or throat, difficulty breathing, wheezing, widespread rash, or collapse after contact with a trigger such as food, insect stings or medicine. Call 926 (Botsogo Pele EMS) or 997 (national ambulance). Help them use their adrenaline auto-injector in the outer thigh. A second dose may be given after 5 minutes if there is no improvement. Let them sit up if breathing is difficult, or lie down with legs raised if they feel faint.

Low blood sugar (diabetes)

Shaking, sweating, confusion or unusual behaviour in a person with diabetes. If they are awake and can swallow, give a sugary drink, glucose tablets or sweets, then a snack once they improve. If they do not improve or become drowsy, call for help.

Asthma attack

Help them sit upright and use their reliever (usually blue) inhaler, ideally with a spacer. If there is no improvement, keep using it as directed and call for help.

Chapter 8

Heat, bites and stings

Heat exhaustion and heatstroke

Botswana's heat makes this common at outdoor events and on work sites. Heat exhaustion causes heavy sweating, headache, dizziness and cramps. Move the person somewhere cool, have them lie down with legs raised, and give water or an oral rehydration drink.

Snake bites

1. Move away from the snake. Do not try to catch or kill it. Note its appearance if you can do so safely.
2. Keep the person calm and as still as possible. Call 926 (Botsogo Pele EMS) or 997 (national ambulance).
3. Remove rings, watches and tight clothing near the bite before swelling starts.
4. Keep the bitten limb still and at about heart level, supported with a splint or sling.
5. Do not cut the wound, suck out venom, apply a tight tourniquet, or use ice. Get to hospital quickly.

Bee and wasp stings

Scrape the sting out sideways with a fingernail or card. Apply a cold compress. Watch for signs of anaphylaxis.