WHAT IS FIRST AID?
The information given here is basic, not a replacement for good first-aid training. You are encouraged to get knowledge and practice by taking cardiopulmonary resuscitation (CPR) and first-aid courses when they are offered to you.
First aid is the immediate care given to a person with minor injuries, such as cuts, minor burns, and sprains. It may also be the initial stabilizing treatment given to a person with more serious injuries, such as broken bones.
Reporting medical emergencies and getting medical help are also first-aid functions. The first-aid provider who runs for help is just as important as the first-aid provider who stays with the victim. In an emergency, time is often wasted looking for a phone. Memorize the locations of your ship's phones and intercoms that you can use in an emergency.
Serious injuries require a doctor. Below are examples of injuries and illnesses the require medical treatment from a doctor. excessive bleeding, poisoning, loss of consciousness, severe head injuries, open chest wounds, open abdominal wounds, severe shock, burns covering more than 15 percent of the body, burns on the face, severe allergic reactions, cardiac problems, cardiac arrest, electrical shock, carbon-monoxide poisoning, gas poisoning, smoke inhalation, near-drowning, spinal injuries, broken bones, eye injuries.
When You Are First on
Shock is a condition where an injured persons vital organs slow down. Shock can happen to anyone who is badly injured, and it is worsened by extreme pain or fright. Here are the signs that a person has gone into shock: Pale or bluish skin, cold to the touch and sometimes clammy, weakness, rapid pulse, increased breathing rate, nausea, vomiting, apathy, unresponsiveness, dilated pupils.
There is nothing a first-aid provider can do to stop shock symptoms once they occur. There are, however, several ways to prevent shock from occurring:
· Control heavy
bleeding, often the cause of shock.
Immediately apply pressure to the wound that is bleeding heavily. Cut clothing to expose wound. When a clean pad is available, place the pad on the wound and press firmly with your hand. Add extra pads as needed. Do not remove the blood-soaked pads. Wrap the wound with a bandage and elevate the wound if possible. Continue to apply pressure and follow steps for preventing shock.
If you apply direct pressure and elevate the wound and you still cannot control the bleeding, and if the wound is to an arm or leg, then you need to apply pressure at a pressure point. With your hands, press firmly on the major artery supplying blood to the limb that is wounded. Do not apply pressure at a pressure point unless you really need to, and do not stop applying pressure to the wound. Use a tourniquet only as a last resort. Before you use a tourniquet, ask yourself if the situation is bad enough to risk losing a limb. Once a tourniquet is used, it must be removed by a doctor.
All persons who have been bleeding heavily should be seen by a doctor. While you wait for the doctor, keep the person lying down. If the wound was not to the head, elevate the feet. If the wound was to the head, then elevate the head. Keep the victim warm.
Remember to survey the scene. If you can de-energize the circuit locally, do so. Otherwise, use your radio or send someone to de-energize the circuit. Do not leave the victim. Move the victim away from the live circuit as quickly as possible. Do not touch the victim with your bare hands unless the power has been turned off. You may use rubber gloves, pieces of wood, and other nonconductors to try to move the victim away from the live circuit.
If the victim is not breathing after being moved away from the live current, give him or her rescue breaths as soon as possible. Then check for pulse. If there is no pulse, administer CPR.
After breathing and heartbeat are restored, check for other injuries. Keep the victim lying down and warm. Try to maintain a normal body temperature. Treat electrical burns the same way that you treat heat burns.
All electrical shock victims should be seen by a doctor.
A stroke is a brain injury. It can be caused by a blood clot entering the brain or it may be caused by a blood vessel rupturing in the brain. The symptoms of a stroke depend on whether the stroke is a minor one or a major one.
The signs of a major stroke are unconsciousness, heavy breathing, paralysis of facial muscles, paralysis of hands or feet, or paralysis on one side of the body.
The signs of a minor stroke are dizziness, headache, pupils of unequal size, blurred vision, sudden failure of memory, change of mood, muscular difficulty, difficulty speaking, or ringing in the ears.
If you believe a person has suffered a major stroke, have the victim lie down, maintain normal body temperature, and get medical help. Do not give the victim anything to eat or drink. Unconscious victims should be rolled on their sides so that fluids can drain from their mouths. Frequently check breathing and pulse.
If you believe a person has suffered a minor stroke, urge him or her to see a doctor. Minor stroke victims often do not want to believe that something is seriously wrong.
Gas poisoning occurs when a person is exposed to a hazardous concentration of gases or vapors. Asphyxia occurs when a person cannot get enough oxygen. Both conditions are life-threatening and should not occur if proper procedures are followed. Never enter a confined space before the atmosphere is tested with two instruments. A toxic-gas instrument that measures the expected gases must show that these gases are not present. An oxygen-deficiency meter must show that the oxygen concentration is at least 19 percent. Seafarers have died when they entered cargo holds that contained hazardous vapors or insufficient oxygen. Very often, the would-be rescuers also died for the same reason. Rescuers frequently believe that they can hold their breath long enough to pull a co-worker to safety. Sadly, that is usually not the case.
Workers who have been overcome in a cargo hold or any other confined space should be pulled into fresh air by a trained rescue team. Your ship should have a team of individuals trained in the use of SCBA (self-contained breathing apparatus) gear, safety harnesses, rescue hoists, and first aid.
Once the victim has been pulled into fresh air, check for breathing. If he or she is not breathing, tip the head back and give two full rescue breaths. Check for pulse. If there is no pulse, begin CPR. Call for medical help.
When working with chemicals, always wear the personal protective equipment (PPE) suggested by the Cargo Information Sheet, Material Safety Data Sheet (MSDS), or product label. Even very hazardous chemicals can be handled safely with the right protective equipment.
If the chemical was a strong acid or a strong caustic, you might need to use a neutralizing solution. Follow ship procedures for use of these solutions. Do not use such solutions unless you have been trained in their use.
Closely watch the victim. Call for medical help. Take precautions to prevent shock.
Do not use any neutralizing solution in the eyes. After flushing, cover the eyes with clean eye pads and seek medical help.
Check to see if the victim is conscious and breathing. If the victim is not conscious and not breathing, give two good rescue breaths. Check for pulse. If there is no pulse, perform CPR. If there is a pulse, but no breathing, perform rescue breathing. Call for medical help. If possible, call a poison control center, and follow the instructions given to you over the phone.
If the victim is conscious, try to determine from the victim what poison was ingested or inhaled. If the person cannot speak, look for clues such as smell of breath, burns around the mouth, and labels on nearby cans and bottles.
If there are clues that the poison was a petroleum product or a strong acid or caustic, and the person is not convulsing, encourage the victim to drink one glass of water or milk in small sips. Call for medical help. Keep the victim calm and warm until medical help arrives.
If there are clues that the poison was some other chemical, such as a pesticide, follow the instructions for that product on the Cargo Information Sheet or the Materials Safety Data Sheet. Call for medical help. Keep the person calm until medical help arrives.
If the victim is having convulsions, do not give anything to drink. Lay the victim down. Protect his head by placing pillows and rolled blankets around it. Stay with the victim and check breathing and pulse until medical help arrives.
When the victim is taken to the hospital, bring with you information on the chemical that you believe was ingested. You can bring the Cargo Information Sheet, the Materials Safety Data Sheet, or the product label. This information may be useful to the doctors.
Some signs of food poisoning are nausea, vomiting, chills, diarrhea, and cramps. You should suspect food poisoning if the victim recently consumed food that did not taste right or made others sick. Call for medical help.
If the person is conscious, not vomiting, and is not having trouble swallowing, then you can give milk or water in small sips. This will help dilute the poison. Never induce vomiting unless you are instructed to do so by a poison control center.
There are three major types of food poisoning: botulism, shellfish poisoning, and general food poisoning.
Botulism usually comes from eating smoked meats. Its symptoms are muscle weakness, headache, dizziness, slurred speech, disturbed vision, breathing difficulty, and swallowing difficulty. This person needs a doctor. While waiting for the doctor, keep checking breathing and pulse.
Shellfish poisoning comes from eating contaminated shellfish. Its symptoms are numbness (starting in the face and spreading throughout the body), dizziness, increased salivation, and muscle weakness. This person needs a doctor. While waiting for the doctor, keep checking breathing and pulse.
General food poisoning comes from eating poisonous plants, mushrooms, and berries. Symptoms include nausea, vomiting, cramps, hallucinations, and slurred speech. If the victim vomits, save a sample of the vomit so it can be analyzed by the doctor. If that is not possible, note the color and texture of the vomit so that you can describe it to the doctor. If there is going to be a delay before this person is seen by a doctor, give 30 grams of medicinal charcoal in a glass of water. The victim should sip it slowly. The charcoal will absorb some of the poison and lessen the amount absorbed into the victim's bloodstream. (Only give charcoal for general food poisoning. Do not give it for botulism or shellfish poisoning.)
Broken bones are also called fractures. A simple fracture is a broken bone that does not pierce the skin. A compound fracture is a broken bone that does pierce the skin. The signs of a broken bone are the sound of bone snapping, a bone with a strange or deformed appearance, a bone poking through the skin, or a swollen and discolored area that is painful when touched.
Do not move the victim until the broken bone has been splinted (unless he is near live electrical wires or some other hazard). There are three steps to follow: Stop the bleeding. Splint. Prevent the victim from going into shock.
If clothing is
bloody or wet, remove it without moving the injured part
of the body. You may need to cut away the wet clothing.
If the fracture is a compound one with the bone
protruding, do not try to push the bone in. Cover the
bone with sterile gauze or clean cloth. If there is heavy
bleeding, stop the bleeding by applying pressure. If the
fracture is in a finger, hand, arm, foot, leg, or other
part of the body that can be immobilized with a splint,
use a splint. Keep the injured
The signs of a sprain are swelling, tenderness, discoloration, and pain when the sprained area is moved. Treat the sprain by immobilizing the sprained area with a splint. Use ice packs to reduce swelling.
The primary sign of a strain is muscle soreness. Back strains are frequently caused by improper lifting. Treatment for a strain is rest and heat. A heating pad or hot moist towels can be used to provide some relief. If the strain is to a back muscle, the victim should lie on his back on a hard surface. Get medical attention for serious strains.
Fainting happens when the brain does not get enough blood for a few minutes. A person who feels faint should either sit down with his head between the knees, or lie down. It is important to try to breathe deeply. A person who faints actually loses consciousness for a moment, recovering almost immediately. After the fainting spells, the victim should lie down and rest for at least 10 minutes. If a victim does not recover from a faint immediately, there is a more serious problem. Call for a doctor. Stay with the victim and keep checking for breathing and pulse.
Burns can be caused by steam leaks, hot oil leaks, hot metal surfaces, the sun, electric shock, and chemicals. The treatment for the burn depends on the burn's depth, size, and location.
The terms first degree, second degree and third degree all describe the depth of a burn. Deep burns damage more tissue and are therefore more serious than shallow burns.
The signs of a shallow first-degree burn are red skin, pain, and swelling. The signs of a second-degree burn are deep red skin with a glossy appearance caused by leaking fluid. There may also be some skin loss and blisters. The sign of a third-degree burn is the loss of all skin layers. There may also be some charring of the skin.
Burns to the hands, feet, face, and genital organs are critical because of their location. Hospitalization is required for such burns.
If a person is unconscious, check breathing and pulse. If necessary, administer CPR.
If the person has received chemical burns, immediately flush the area with water. Follow the instructions detailed earlier for chemical contamination.
Remove clothing and jewelry from the burned area. If clothing sticks to the burn, do not try to remove it. Determine whether the burn is a first-, second-, or third-degree burn. If you are unsure, choose the higher degree. Follow the steps given below for the appropriate degree.
Heatstroke and heat exhaustion are two forms of heat stress. Watch your co-workers for signs of heat stress, and encourage them to watch for signs of heat stress in you.
Heatstroke is the more severe form of heat stress, and it is an emergency. A person with heatstroke has a very high internal body temperature and has lost the ability to control body temperature by sweating. This person's body temperature is so high that brain damage and death are both possibilities if the person is not cooled quickly. The signs of heatstroke are red or flushed skin that is hot and dry, dizziness, nausea, headache, rapid pulse, and unconsciousness. The body temperature can be as high as 106 F (41 C). You may have noticed that this person was sweating profusely a short time earlier but now is not sweating at all. Cool a heatstroke victim quickly. Soak the person in cool, but not cold water. You can sponge the person with rubbing alcohol or cool water. Do so until his body temperature falls below 102 F (39 C). Then stop the cooling and observe for 10 minutes. If the victim's temperature starts to rise again, start cooling again. Give the victim water to drink. Do not give any coffee, tea, or alcohol.
Heat exhaustion is less serious than heatstroke. The signs of heat exhaustion are fatigue, weakness, and collapse. First aid for heat exhaustion includes moving the victim out of the heat and encouraging the victim to drink lots of water or sports drink, but not alcohol. If the victim's temperature starts to rise, or if there is no improvement in one hour, get medical attention.
Heat cramps are muscle pains and muscle spasms that can occur after working or sweating in the heat. The cramps happen after excessive salt loss and are made worse by drinking too much water. Prevent heat cramps by drinking a sports drink that contains salts or by eating a snack food that contains salt. (Do not eat salty snack foods if you have a heart or kidney problem or have been told by a doctor to restrict your salt intake.)
First aid for heat cramps consists of drinking water that contains table salt. Add one teaspoon of salt to a full glass of water and sip it slowly.
Frostbite occurs when exposure to cold weather causes fluids under the skin to freeze. Frostbitten skin looks white or grayish yellow. It also looks pale and glossy. If the victim has lost feeling in the frostbitten part or if it is blue or blistered, the frostbite is severe and requires medical attention. Cover the frostbitten area with clothing or with a blanket and take the victim indoors. If the feet or legs are frostbitten, do not allow the victim to walk. If the hands have feeling and are not shaking violently, give the victim a warm drink, but not coffee, tea, or alcohol. Gradually warm the affected area.
The warming process is frequently painful and the victim may shiver or shake as frostbitten areas warm. Still, it is important to warm the skin quickly. If possible, immerse the frostbitten part in a bowl of warm water. As the skin thaws, it swells and becomes red. Stop the warming when the skin does turn red. Never massage frostbitten skin. Place sterile gauze between frostbitten fingers and toes. Elevate frostbitten parts. Get medical attention quickly for frostbite. The victim should not smoke. Smoking constricts blood vessels in the skin and slows the healing process.
Overexposure to cold weather can cause the following symptoms: shivering, numbness, low body temperature, drowsiness, and muscle weakness. Take a cold-exposure victim indoors. Remove any wet or frozen clothing. Warm cold, numb hands by running them first under cold tap water. Cold tap water is many degrees warmer than the numb skin, so it will feel like hot water. Remove any clothing or jewelry that might interfere with circulation as frozen arms and legs thaw and swell. Give the victim something warm to drink. Do not give alcohol.
An extreme case of overexposure is called hypothermia.The hypothermia victim may be pale or even unconscious. The breathing and pulse will be very weak. Take the hypothermia victim indoors. Bring the body temperature back to normal by wrapping the victim in warm blankets. Do not give any hot drinks until he is fully conscious. Get medical attention quickly.
Not everyone needs the same amount of sleep. Most people need about eight hours of sleep each day. That sleep is most effective when all eight hours are taken at once; two four-hour naps do not equal an eight-hour sleep. STCW 95 (Standards of Training, Certification, and Watchkeeping) recognizes this need for rest. See Chapter 11 for more information on STCW 95.
People who are sleep-deprived are less coordinated and more easily confused than those who have had sufficient sleep. They are also more susceptible to illness because their immune systems are weakened. Learn to recognize signs of fatigue in yourself and in your co-workers.
Fatigue can occur even when a person appears to be getting enough sleep. It can be caused by anemia, thyroid imbalance, or other medical conditions. Encourage anyone who is fatigued all the time to see a doctor.
There are numerous diseases spread by hundreds of kinds of bacteria, viruses, and parasites. We can prevent most of these by reducing our exposure to harmful germs. Four common ways we catch diseases are:
contaminated water or contaminated food
There are some simple precautions that you can take to reduce your chances of catching diseases spread in each of the above ways.
There are numerous
diseases spread by water and food. The infectious agents
are viruses, bacteria, and parasites. When you are in an
area where you are not sure whether the food and water
are safe, follow these rules:
Take advantage of vaccines that are available for polio, diphtheria, cholera, typhoid fever, and several types of hepatitis.
A few serious diseases are spread through the air. The germs can be bacteria or viruses that float in the air, near someone who is coughing or sneezing. You can avoid catching these diseases by staying away from strangers who appear to have them. During outbreaks of these diseases, avoid congested places such as buses and trains. You can also reduce your risk by washing your hands regularly. You pick up germs by touching surfaces where airborne germs have fallen. Then you infect yourself by rubbing your eyes with contaminated hands, and by handling your food with contaminated hands.
Some of our most feared diseases are carried by mosquitoes. Luckily, only a tiny portion of mosquitoes are infected with viruses and transmit diseases to humans. Most mosquitoes are annoying, but not harmful. Mosquitoes breed in standing water. Mosquitoes feed in the early morning and again in the late afternoon and evening. During these periods, wear insect repellent, or at least wear long sleeves and long pants.
Here are some simple rules for avoiding insect-borne diseases:
The medications that can be taken to prevent malaria have side effects, and they need to be taken regularly (before, during, and after exposure) in order to be effective. The most common side effects are nausea, vomiting, diarrhea, and dizziness. In some regions, the malaria viruses are resistant to some of the preventive medicines. The medications are recommended for use only in high-risk malaria areas during the wet season; the risk of infection during the dry season is small. The malaria risk is also smaller in urban areas than in rural areas.
There are more than 20 disease-causing microbes that can be spread by sexual contact. Diseases spread by sexual contact are called sexually transmitted diseases (STDs).
To absolutely prevent STDs, you can abstain from sex or be monogamous with someone who is not infected. Being monogamous means you have sex only with your lifetime partner, and your partner has sex only with you.
All STDs have an incubation period during which people are hosts to dangerous microbes. They can transmit diseases to other people, but they have no disease symptoms themselves. This means that you cannot tell who might be carrying a dangerous disease. To minimize your chances of acquiring STDs, use latex condoms. Condoms provide significant protection from many bacterial infections.
If you experience any STD symptoms, get prompt medical attention. Most STDs are treatable. If left untreated, some can cause very, very severe illnesses, including cancer, liver disease, and blindness. At the present time, there is no cure for HIV infections. HIV causes AIDS (acquired immunodeficiency syndrome) which can result in premature death. Early medical treatment for HIV can improve health and prolong life, so it should be sought.
Sheet, a list of contagious diseases, their causes,
symptoms, and steps that can be taken to avoid
contracting and/or spreading diseases. (Hawaii Department
of Health Communicable Disease Division):
Information and Referral Service:
Africa Health Tips (Malaria):
Centers for Disease Control and Prevention: Diseases,
Health Risks, Prevention Guidelines, and Strategies
Corner, Agency for Toxic Substances and Disease Registry: