LEARN FIRST AID
St John DRABCD Action Plan
This Action Plan is a vital aid to the first aider in assessing whether the casualty has any
life-threatening conditions and if any immediate first aid is necessary.

D
DANGER
  Check Danger . . . to you, to others, to casualty
R
 RESPONSE
  Check Response…ask casualty's name, gently shake casualty's shoulders
A
 AIRWAY
  Check Airway . . . is the airway clear of objects? Is the airway open?
B
BREATHING
  Check Breathing . . . look, listen and feel for breath.
If breathing, roll casualty into recovery position. Monitor for signs of life until medical aid arrives
RECOVERY POSITION



If NOT breathing call 000 for ambulance.
Calling for help as soon as possible will give the casualty the best chance of survival.
If there are other people around, send them to call 000 for an ambulance immediately.
Turn casualty on back.

Tilt head back. Lift chin to open airway.
Pinch nose closed. Breathe into casualty's mouth, give two initial breaths. Ensure chest rises with each breath.
Has the casualty's breathing returned? If yes, roll into recovery position and monitor until medical aid arrives.
If the casualty is still not breathing, begin CPR.
C
  CPR (Cardiopulmonary Resuscitation)


Giving Compressions for an Adult or child over one (1) year of age
*
 kneel beside the casualty, one knee level with their head and the other with their chest
*
 locate the lower half of the sternum (breastbone) in the centre of the chest
*
 place heel of your hand on lower half of sternum (breastbone) and place heel of your other hand on top of the first
*
 interlock fingers of both hands and raise fingers
*
 do not apply pressure over the casualty's ribs, upper abdomen or bottom part of the sternum
*
 position yourself vertically above the casualty's chest
*
with your arms straight, press down on the sternum (breastbone)
*
 press down about one third of the chest

Giving Compressions for an Infant under 1 year of age

*
 place two fingers (index and middle) over lower half of the sternum
*
 press down about one third of the chest
Release the pressure
*
 compressions and release should take equal amounts of time
Repeat compressions
*
 give 30 compressions at a rate of approximately 100 per minute
Giving breaths
*
 tilt head and lift chin (slightly for infants)
*
 give 2 breaths
Continue CPR
*
 return hands (fingers for infants) to correct position on chest
*
 continue compressions and breaths at a ratio of 30:2 until medical aid arrives

  CHOKING

A person chokes when the airway is partly or totally blocked. The casualty usually has trouble breathing and, if obstruction is complete, cannot breathe at all. Unless given first aid, the casualty may die. Infants and small children love to put things in their mouths. This can result in choking. Both toys and food may be responsible. Peanuts and hard sweets are especially dangerous for children under five.
If the casualty is an adult or child over 1 year of age and conscious, encourage them to relax and breathe deeply and cough to remove object.

If coughing doesn't remove the blockage call 000 for an ambulance.

If unsuccessful, Bend casualty well forward and give up to 5 sharp blows between the shoulder blades. Check to see if the obstruction has been relieved after each back blow

  
If an adult or child over one year of age is still choking after the 5 back blows, place one hand in the middle of the casualty's back for support, place the heel of the other hand in the CPR compression position on the chest.

Give 5 chest thrusts - slower but sharper than CPR compressions.
Check to see if the obstruction has been relieved after each chest thrust.

If the blockage has not cleared after 5 chest thrusts, continue alternating 5 back blows with 5 chest thrusts until medical aid arrives.
If the casualty becomes unconscious remove any visible obstruction from the mouth and commence CPR
  
  
If its an infant who is choking, call 000 for an ambulance.
Place the infant with their head downwards on your forearm.

Support the head and shoulders on your hand and hold the infants mouth
open with your fingers.

Give up to 5 sharp blows between the shoulders with the heel of your hand.
Check to seeif the obstruction has been relieved after each back blow
  
  
In an infant (under 1 year of age) is still choking after the 5 back blows,
place the infant on their back on a firm surface. Place 2 fingers in the CPR position.

Give 5 chest thrusts (slower but sharper than CPR compressions).
Check to see if the obstruction has been relieved after each chest thrust.

If the blockage has not cleared after the 5 chest thrusts,
continue alternating back blows and chest thrusts until medical aid arrives.

Be prepared to commence CPR if the infant becomes unconscious

  SEVERE BLEEDING
When there is an open wound and blood loss, act quickly to stop the bleeding. Take precautions to protect yourself and the casualty from infection. If possible, wash your hands before and after first aid, cover any cut or scratches on your hands and wear protective gloves when managing a wound that involves blood or body fluids.
1. Apply pressure to the wound
* remove or cut casualty's clothing to expose wound
* apply direct pressure over wound-instruct casualty to do this if possible
* if casualty is unable to apply pressure, apply pressure using a pad or your hands (use gloves if available)
* squeeze the wound edges together if possible
2. Raise and support injured part
* lie casualty down
* raise injured part above level of heart
* handle gently if you suspect a fracture
3. Bandage wound
* apply a pad over the wound if not already in place
* secure with bandage-ensure pad remains over wound
* if bleeding is still not controlled, leave initial pad in place and apply a second pad - secure with bandage
* if bleeding continues, replace second pad and bandage
4. Check circulation below wound
5. If severe bleeding persists, give nothing by mouth-Call 000 for an ambulance
6. Treat for shock.

WARNING Do not apply a tourniquet
If embedded object in wound, apply pressure either side of wound and place pad around it before bandaging. Wear gloves, if possible, to prevent infection. If casualty becomes unconscious, follow DRABCD.
Nose bleed
Sit casualty up with head slightly forward, pinch soft part of nostrils below the bridge of nose to at least 10 minutes. Loosen tight clothing around neck and place cold wet towels (or ice wrapped in wet cloth) on the neck and forehead. If bleeding persists, seek medical aid.

  FRACTURES & DISLOCATIONS


1. Follow DRABCD.
2. Control any bleeding and cover any wounds.
3. Check for fractures: . . . open, closed or complicated.
4. Ask casualty not to move injured part.
5. Immobilise fracture:
*
 Use broad bandages (where possible) to prevent movement at joints above and below the fracture.
*
 Support the limb, carefully passing bandages under the natural hollows of the body.
*
 Place a padded splint along the injured limb (under leg for fractured kneecap).
*
 Place padding between the splint and the natural contours of the body
and secure tightly.
*
 Check that bandages are not too tight (or too loose) every 15 minutes.
6. For leg fracture, immobilise foot and ankle: . . . use figure of eight bandage.
7. Watch for signs of loss of circulation to foot or hand.
8. Call 000 for an ambulance.
  
SIGNS & SYMPTOMS
 * Fracture and dislocation
* Pain at or near the site of the injury
* Difficult or impossible normal movement
* Loss of power
* Deformity or abnormal mobility
* Tenderness
* Swelling
* Discolouration and bruising
NOTE
 If collarbone fractured, support arm on injured side in a St John sling.
If dislocation of a joint is suspected, rest, elevate and apply ice to joint.
 It can be difficult to tell whether the injury is a fracture, dislocation, sprain or strain. If in doubt, always treat as a fracture.

SPRAINS AND STRAINS  

1. Follow DRABCD

2. Follow RICE management plan
R-rest   I-ice   C-compression   E-elevation

3. Seek medical aid

  HEAD INJURY

1. Monitor breathing and pulse:
* Casualty unconscious, follow DRABCD.
* Keep casualty's airway open with fingers (if face badly injured).

2. Support head and neck:
* Support casualty's head and neck during movement in case the spine is injured.

3. Control bleeding:
* Place a sterile pad or dressing over wound
* Apply direct pressure to wound unless you suspect a skull fracture
* If blood or fluid comes from ear, secure a sterile dressing lightly in place and allow to drain.

4. Lie casualty down:
* Place casualty in comfortable position with head and shoulders slightly raised
* Be prepared to turn casualty onto side if they vomit
* Clear the airway quickly after vomiting.

5. Call 000 for an ambulance.
WARNING
Wear gloves, if possible, to protect against infection.
If bleeding does not stop, without disturbing dressing, reposition pad and reapply pressure to control bleeding

  BURNS

Thermal burns are caused by heat-contact with open flame or hot object; scalding by steam or hot liquid; or burning by friction.
Follow DRABCD
If clothing catches alight, stop oxygen from feeding the fire.
STOP casualty from running around.
DROP casualty to the ground and wrap in a blanket; wool is best (do not use synthetic material).
ROLL casualty along ground until flames are smothered.
MANAGE as for a thermal burn.

Thermal burns
* Cool the burnt area
* If a scald, quickly remove casualty's wet clothing from affected area.
* Hold burnt area under cold running water-at least 20 minutes.
* If chemical burn - run cold water over burnt area at least twenty minutes; remove contaminated clothing.
(avoid contaminating yourself)
* If a bitumen burn, run cold water over burnt area for 30 minutes.
* If burn is to eye, flush eye with water for 20 minutes.
* Remove clothing and jewellery from burnt area - unless stuck.
* Cover with non-adherent/burns dressing/sheet or plastic wrap.
* Seek medical aid urgently.

WARNING
Do not apply lotions, ointment or fat to burn . . . Do not touch the injured areas or burst any blisters.
Do not remove anything sticking to the burn . . . If burn is large or deep, manage casualty for shock.

  EYE INJURY

1. Support casualty's head
* Support casualty's head to keep it as still as possible
* ask casualty to try not to move eyes.

2. Flush eye with cool, flowing water
* If chemical or heat burn, or smoke in eyes, flush with water.

3. Place dressing over eye
* Place a sterile pad or dressing over injured eye
* ask casualty to hold this in place
* bandage dressing in place, covering injured eye
* if penetrating eye injury, lie casualty on back, place pad around object
  and bandage in place.

4. Call 000 for an ambulance.

  
WARNING
Do not touch the eye or any contact lens.

Do not allow casualty to rub eye.

Do not try to remove any object which is penetrating the eye.

Do not apply pressure when bandaging the eye.

NOTE: A penetrating eye injury is usually caused by a sharp object which has gone in, or is protruding from the eye.



  POISONING

Poisons can enter the body through:

*Mouth-ingested/Swallowed

* Nose-inhaled/Breathed

* Skin-absorbed or injected
  
Unconscious casualty
 Follow DRABCD
Call 000 for an ambulance.
Call fire brigade if atmosphere is contaminated with smoke or gas.
Conscious casualty
 Check for danger
Give casualty reassurance-not advice. Determine the substance, if possible, and record.
Call 000 for ambulance - Call Poisons Information Centre 13 11 26.
 If casualty vomits, send a sample with casualty to hospital.

 Ingested poisons-corrosive, petroleum-based, medicinal, or unknown substance
WASH OR WIPE corrosive substances off mouth and face with water.
DO NOT induce vomiting   DO NOT give anything by mouth

Inhaled poisons
* Move casualty to fresh air    * Loosen tight clothing

Absorbed poisons
* Ask casualty to remove contaminated clothing-launder separately, avoid skin contact
* shower skin clean

  SHOCK

1. Lie casualty down
*follow DRABCD, calm casualty
* manage injuries such as bleeding.
2. Call 000 for an ambulance.
3. Position casualty
* raise legs over level of heart
(unless fractured or a snake bite).
4. Treat other injuries
* stop bleeding; treat wounds, burns,
* immobilize fractures.
5. Ensure comfort
* loosen tight clothing around neck, chest and waist
* maintain body warmth
* if casualty is conscious, does not have abdominal trauma and unlikely to require an operation immediately, give small amounts of clear fluid (preferably water) frequently.
6. Monitor and record breathing and pulse
7. Place casualty in recovery
* place in recovery position if casualty has difficulty breathing, is likely to vomit or becomes unconscious.


 INFANTILE CONVULSIONS

1. During convulsions
* Place child on floor for safety
* Turn child on side
* Do not restrain child

2. After convulsions
* Follow DRABCD
* Remove excessive clothing or wrapping
* Seek medical aid

 EPILEPTIC SEIZURES

1. Check for signs of life
* Follow DRABCD

2. Protect the casualty
* Protect from injury
* Do not restrict movement
* Do not place anything in mouth

3. Manage injuries
* Place on side as soon as possible
* Manage injuries resulting from seizure
* Do not disturb if casualty falls asleep
* Continue to check for signs of life
4. Seek medical aid if
* the seizure continues for more than 5 minutes
* another seizure quickly follows
* the person has been injured.


SIGNS & SYMPTOMS
Casualty may:
* suddenly cry out * fall to ground * bite the tongue
* have a congested and blue face and neck
* have jerky, spasmodic muscular movement
* froth at the mouth * lose control of bladder and bowel.

LEISURE KIT (MEDIUM)

*
 Bandage Crepe Heavy Duty 10cm
*
 Pins Safety 12 PK
*
 Bandage Crepe 5cm
*
 Notepad & Pencil
*
 Bandage Crepe 7.5cm
*
 Specimen Bag Biohazard
*
 Tape Hypoallergenic 2.5 x 9m
*
 Saline Eye & Wound Irrigation 15mL
*
 Bandage Triangular 110 x 110cm
*
 Primapore Dressing 8.3cm x 6cm
*
 Cold Pack Instant Disposable
*
 Adhesive Strips Plastic 50PK
*
 Swabs Gauze 7.5cm 3 PK
*
 Splinter Probes disposable 5's
*
 Pad Combine 10 x 10cm
*
 Swab Antiseptic 10 PK
*
 Pad Non Adherent 7.5 x 10cm
*
 Burnaid Sachets 3.5g
*
 Pad Eye Sterile
*
 Stingoes Sachets 3ml 5 PK
*
 Swabs Alcohol 10PK
*
 Glove Disposable Nitrile Large Pair
*
 Scissors SS Sharp/Blunt 12.5cm
*
 Guide Emergency First Aid
*
 Forceps SS Splinter Pointed
*
 Resuscitation Protection Shield
*
 Blanket Emergency Shock
*Kit Code 640002
A FIRST AID KIT IS NOT A SUBSTITUTE FOR A FIRST AID COURSE.
PLEASE CONTACT YOUR NEAREST ST JOHN CENTRE FOR INFORMATION ON 1300 360 455
© St John Ambulance Australia.

This information is not a substitute for first aid training. St John recommends that everyone is trained in first aid.
For more information about St John visit www.stjohn.org.au

LEARN FIRST AID WITH ST JOHN - call 1300 360 455
In the event of an emergency Dial 000