First Aid:

Act at once- delay is fatal



TREATMENT FOR ELECTRICAL SHOCK:

  1. In most of the cases of electric shock and collapse, it is the lungs and the diaphragm (the thin sheet of muscles which lies below the lungs) that have stopped working and there is a very good chance of revival by applying artificial respiration quickly.
  2. In case of severe shock, where respiration is rarely established, three to four hours found necessary to restore normal breathing. The patient is unconscious or not breathing, artificial resusci- tation should be continued until the patient breathes normally or until the doctor has pronounced life extinct.

REMOVAL FROM CONTACT:

  1. If the person is still in contact with the apparatus that has given the shock,
    • switch off the electric circuit at once, if there is switch, fuse or circuit breaker close at hand,
    • if not, lose no time from proceeding to remove the body from contact with the live conductor.
  2. Do not touch the victim's body with bare hands, but if rubber gloves are not at hand,
    • Pull him off the live conductor by his coat, shirt, etc., if they are not wet.
    • Fold your coat, or some dry article such as a news- paper into three or more folds/ thickness, and using this as a pad, take hold of the body and pull it away from the circuit.
    • An operating rod or a broom handle may be used to raise the body or to detach the wires from it.
    • A good plan is to stand on a dry board or stool or on a few layers of thick newspaper or bundle of dry sacking and remove the victim away from the live apparatus.

PRELIMINARY STEPS

Extinguish any sparks if the patient's clothes are smouldering. Ascertain if he is breathing, and send for a doctor at once. If apparently not breathing, proceed as detailed hereunder:

IMMEDIATE ACTION TO RECOVER THE PATIENT

  1. When a man has received a severe electric shock , his breathing has usually stopped. In accidents of this kind, speed may save the injured man's life, hence do not waste a second. Send for a doctor at once but do not neglect the patient in doing so.
  2. The first thing to do is, to get the injured man to a suitable place where you can work on him. This may necessitate lowering from a pole. This work usually involves considerable danger to the rescuer, because the injured man may be in contact with the dangerous circuit on the pole. You must, therefore, work very carefully.
  3. Avoid so placing the patient as to bring pressure on the burns he has sustained, if any. Do not expose the patient to cold. Stimulants should not be administered unless recommended by a Doctor. Cold water may be given in small quantities in cases of electric fire or asphyxiation cases and smelling salts may also be administered in moderation.
  4. Continue artificial respiration without interruption (if necessary for four hours) until breathing is restored. Cases are on record of success after 3 + hours or more of effort. Ordinary tests for death are inconclusive in cases of electric shocks and Doctor's pointed attention must be drawn to this, when necessary.
  5. Resuscitation should be carried on at the nearest possible place where the patient received his injuries. He should not be removed from this place until he is found breathing, normally and then also moved only in lying position. Should it be necessary due to extreme weather conditions, etc., to move the patient before he is breathing normally, he should be kept in a prone position, and placed on a hard surface (door or shutter) or on the floor of a conveyance, resuscitation being carried on during the time that he is being removed.
  6. A brief return of spontaneous respiration is not a certain indication for terminating the treatment. Not infrequently, the patient, after a temporary recovery of respiration, stops breathing again. The patient must be watched, and if normal breathing stops, artificial respiration should be resumed at once.

UPON RECOVERY:

When the patient revives, he should be kept lying down and not allowed to get up or be raised under any circumstances unless on the advice of a Doctor. If the Doctor has not arrived by the time the patient has revived, he should be given some stimulant, or a drink of hot ginger, tea or coffee. The patient should then have any other injuries attended to and be kept warm, being placed in the most comfortable position.

FIRST CARE OF BURNS:

  1. Burns, if serious, should be treated with a proper dressing.
  2. A raw or blistered surface should be protected from the air. If clothing sticks, do not peel it off but cut around it. The adherent cloth, or a dressing of cotton or other soft material applied to burnt surface should be saturated with picric acid (0.5%). If this is not at hand, use a solution of baking soda (one teaspoonful to a pint of water), or the wound may be coated with a paste of flour and water, or it may be protected with Vaseline, carron oil, olive oil, castor oil or machine oil, if clean. Cover the dressing with cotton gauze, linen, clean waste, handkerchief, or other soft cloth, held tightly in place by bandage. The same coverings should be tightly bandaged over a dry, charred burn, but without wetting the burnt region or by applying oil to it. Do not open blisters.

FIRST AID IN CASE OF ELECTRIC SHOCK:

DIRECT ARTIFICIAL RESPIRATION:

Direct Artificial respiration is the method whereby a person ventilates the lungs of an unconscious non-breathing victim by blowing his own breath directly into the mouth or nose of the victim.

Direct Artificial Respiration (mouth-to-mouth method):

  1. Place the victim on back immediately.
  2. Clear throat of water, mucus, toys, coins, or food.
  3. Tilt head back as far as possible.
  4. Lift jaw up to keep tongue out of air passage.
  5. Pinch nostrils to prevent air leakage when you blow.
  6. Blow until you see the chest rise.
  7. Listen for snoring and gurgling signs of throat obstruction.
  8. Repeat blowing 10-20 times a minute. .

In case of infants and small children tilt the head fully back, surround the mouth and nose completely with your mouth. Blow with only enough force to produce a visible rise in the victim's chest and no more. Repeat every 3 seconds.

Continue direct artificial respiration until victim breathes for himself, or until expert help is obtained.

The method is fully described hereunder:

Step (1) Lay the victim flat on his / her back and place a roll of clothing under the shoulders to ensure that his head is thrown well back. Tilt the victim's head back so that the chin points straight upward.


Step (2) Grasp the victim's jaw as in the Figure, and raise it upward until the lower teeth are higher than the upper teeth; or place finger on both sides of the jaw, near the ear lobes, and pull upward. Maintain jaw position throughout artificial respiration to prevent the tongue from blocking the air passage.


Step (3) Take a deep breath and place your mouth over the victim's mouth as in Figure. Making airtight contact. Pinch the victim's nose shut with thumb and forefinger. If you dislike direct contact, place a porous cloth between you and the victim's mouth. For an infant, place your mouth over its mouth and nose.


Step (4) Blow into the victim's mouth (gently in the case of an infant) until his chest rises. Remove your mouth, & release the hold on his nose, to let him exhale, turning your head to hear the out-rush of air. The first eight to ten breaths should be as rapid as the victim responds. Thereafter the rate should be slowed to about 12 times a minute (20 times for an infant).



Methods of Resuscitation:


Prone resuscitation:

This is also called Back Pressure arm lift method or Holger Nielsen method.


Mouth to mouth resuscitation:





Mouth to nose resuscitation:

Close the mouth and blow the air through the nose.

Pole top resuscitation:

Done when the person gets shock on the Pole.


Note:
(a) if air cannot be blown in, check the position of the victim's head and jaw and re-check the mouth for obstructions, then try again more forcefully. If the chest still does not rise, turn the victim's face down and strike his back sharply to dislodge obstructions.

(b) Sometimes air enters the victim's stomach, as evidenced by a swelling stomach. Expel air by gently pressing the stomach during the exhalation period. In any case where external cardiac compression and artificial respiration are being administered Pressure-Cycling mechanical resuscitators shall not be used in lieu of mouth-to-mouth or other approval artificial respiration, because they may not be effective in adequately ventilating the lungs with air (oxygen).


TREATMENT FOR ELECTRIC BURN:

If, as a result of electric shock the patient is suffering from burns, the following treat- ment should be given without hindrance to artificial respiration:
  1. Remove clothing locally to enable the burn to be treated but do not break blisters.
  2. Saturate burns with warm solution of one dessert spoonful of bicarbonate of soda to a pint of warm water, or a teaspoonful of salt to a pint of warm water.
  3. Cover with lint soaked in a similar solution and bandage (lightly if blisters have formed)
  4. If the above solutions are not availa- ble, cover with a sterile dressing.
  5. Warm, weak sweet tea may be given when the patient is able to swallow.

CARE FOR THE UNCONSCIOUS:

Oxygen is the element most vital for survival. Permanent brain damage or death may result within a few minutes from lack of air or oxygen. Therefore a victim's breathing requirements must receive your first attention.

  1. The case of unconsciousness may be obvious, as in the case of drowning, electric shock, smoke or gas inhalation, strangulation, severe injuries, etc.,
  2. The cause of unconsciousness may be obscure, as in the case of poisoning, overdose of drugs, alcoholism, heart disease, brain disease, diabetes, uremia, epilepsy etc.,
  3. An unconscious person may be breathing or not breathing.

In either case an open air passage to the lungs must be maintained. The human tongue is as large as a quarter pound beefsteak. The muscles of the tongue relax with loss of consciousness. In certain positions the tongue may fall back, obstructing the throat and cutting off the air passage.


a.The unconscious person who is breathing:

Many accident victims, especially those sustaining head injuries (common in home and traffic accidents), suffer temporary shock and loss of consciousness. This may lead to death by suffocation.

Accidental death may be avoided in such cases by first taking a simple pre- caution:


b.The unconscious person who is not breathing:

In such cases the unconscious victim requires immediate artificial respiration.
  1. Direct artificial respiration is the most positive and efficient means of ventilating his lungs.
  2. The indirect or manual chest compression methods of artificial respiration (Holger-Neilsen, Schafer, etc.,) depend on negative pressure, and are unsatisfactory unless provision has been made to establish and maintain an open air passage to the lungs.

c.The Unconscious person whose breathing is very slow or shallow:

The victim may be assisted by direct artificial respiration, timing the air inflation with the patient's breathing efforts.

SPECIAL CARE SITUATIONS

[a] Drawings:

[b] Inhalation of foreign bodies:

If the victim is a child, turn him over your knees in the "spanking position", with his head lower than his hips, slap him between shoulder blades in an attempt to dislodge the foreign body by causing him to cough it out. If the object is not dislodged and the child is in distress, quickly clean the throat with the fingers and begin direct artificial respiration.

[c] Infant and child victims:

The technique of direct artificial respiration is essentially the same in cases involving children and adults. However, in the case of infants and children:

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