First Aid & Emergencies
Comprehensive Nursing Study Guide
Emergency Response Excellence
Saving Lives Through Knowledge and Action
Table of Contents
1. Definition of First Aid
What is First Aid?
First aid is the immediate, temporary care given to a person who has been injured or suddenly becomes ill. It is the first assistance or treatment given to a casualty for any injury or sudden illness before the arrival of an ambulance, doctor, or other qualified person.
Key Objectives of First Aid
Preserve Life
Maintain vital functions and prevent deterioration
Prevent Deterioration
Stop conditions from becoming worse
Promote Recovery
Facilitate healing and comfort
Memory Aid: The 3 P’s of First Aid
Preserve Life
Prevent further injury
Promote recovery
2. Basic Principles of First Aid
Fundamental Principles
Assessment Before Action
Always assess the situation, the casualty, and yourself before providing care. Ensure scene safety first.
Do No Further Harm
Avoid actions that might worsen the injury or create additional problems.
Call for Help
Activate emergency medical services early. Don’t delay professional medical care.
Prioritize Care
Address life-threatening conditions first, then move to less critical injuries.
Obtain Consent
Always get permission before providing care to a conscious adult.
Reassure and Comfort
Provide emotional support and maintain the casualty’s dignity throughout care.
Memory Aid: ACTION
Assess the situation
Call for help
Treat for shock
Injury management
Observe vital signs
Never leave alone
3. Scope of First Aid
What First Aid Covers
First aid encompasses immediate care for a wide range of conditions and situations that require prompt attention before professional medical help arrives.
Life-Threatening Emergencies
- • Cardiac arrest
- • Severe bleeding
- • Choking
- • Respiratory arrest
- • Severe allergic reactions
- • Poisoning
Traumatic Injuries
- • Fractures
- • Sprains and strains
- • Burns
- • Head injuries
- • Spinal injuries
- • Eye injuries
Medical Emergencies
- • Heart attacks
- • Strokes
- • Seizures
- • Diabetic emergencies
- • Asthma attacks
- • Fainting
Environmental Emergencies
- • Heat exhaustion
- • Hypothermia
- • Frostbite
- • Near drowning
- • Electrical injuries
- • Bites and stings
Psychological First Aid
- • Crisis intervention
- • Trauma response
- • Panic attacks
- • Emotional support
- • Suicide prevention
- • Stress management
Special Populations
- • Pediatric emergencies
- • Geriatric considerations
- • Pregnancy complications
- • Special needs patients
- • Cultural considerations
- • Language barriers
Clinical Pearl
Remember that first aid is not a substitute for professional medical care. It’s a bridge that maintains life and prevents deterioration until advanced medical help arrives. Always know your limitations and when to step back.
4. Rules and Guidelines
Golden Rules of First Aid
Safety First
Always ensure your safety, the victim’s safety, and bystander safety before providing care.
Quick Assessment
Rapidly assess the situation to determine the nature and severity of injuries.
Early Activation
Call emergency services immediately for serious injuries or medical emergencies.
Proper Positioning
Position the victim appropriately based on their condition and level of consciousness.
Universal Precautions
Always assume that blood and body fluids are infectious. Use personal protective equipment (PPE) including gloves, masks, and eye protection when available. Practice proper hand hygiene before and after patient contact.
Consent and Communication
Obtain informed consent before providing care to conscious adults. For unconscious patients, implied consent applies. Maintain clear, calm communication and explain what you’re doing.
Documentation and Handoff
Document care provided, vital signs obtained, and changes in patient condition. Provide clear, concise handoff report to EMS or receiving healthcare professionals.
Memory Aid: SAFE-R
Safety – Ensure scene is safe
Assess – Evaluate the victim
First aid – Provide appropriate care
EMS – Call emergency services
Reassess – Monitor and adjust care
5. Types of Emergencies
Emergency Classification System
Understanding different types of emergencies helps prioritize care and determine the most appropriate interventions. Emergencies can be classified by urgency, cause, and body system affected.
Critical Emergencies
Respiratory Emergencies
Respiratory arrest, severe asthma, choking, pneumothorax
Cardiovascular Emergencies
Cardiac arrest, MI with arrhythmias, severe heart failure
Neurological Emergencies
Stroke, status epilepticus, severe head trauma
Trauma Emergencies
Severe bleeding, multiple trauma, spinal injuries
Urgent Emergencies
Metabolic Emergencies
Diabetic emergencies, electrolyte imbalances
Allergic Reactions
Anaphylaxis, severe allergic responses
Environmental
Heat stroke, severe hypothermia, poisoning
Psychological
Acute psychosis, suicide attempts
6. Emergency Assessment
Systematic Assessment Approach
Emergency assessment follows a systematic approach to quickly identify life-threatening conditions and prioritize interventions. This process should be rapid but thorough.
Scene Survey
Assess scene safety, mechanism of injury, number of victims
Primary Assessment
ABCDE approach to identify immediate threats to life
Secondary Assessment
Detailed examination when life-threatening issues are managed
Scene Survey Components
Safety Assessment
- • Environmental hazards
- • Traffic dangers
- • Fire or explosion risk
- • Chemical exposure
- • Violence potential
- • Structural instability
Situation Analysis
- • Mechanism of injury
- • Number of victims
- • Available resources
- • Bystander information
- • Need for additional help
- • Access/egress routes
Memory Aid: SCENE
Safety – Is the scene safe?
Cause – What happened?
Environment – What are the conditions?
Number – How many victims?
Equipment – What resources are needed?
7. Primary Survey: ABCDE Approach
The ABCDE Framework
The ABCDE approach is a systematic method for assessing and managing life-threatening conditions in order of priority. Each step must be addressed before moving to the next.
Airway Assessment & Management
Ensure patent airway with cervical spine protection
Assessment Signs
- • Ability to speak clearly
- • Audible breathing sounds
- • Visible chest movement
- • Absence of stridor or gurgling
- • Clear breath sounds
Management Techniques
- • Head-tilt, chin-lift maneuver
- • Jaw-thrust (if spinal injury suspected)
- • Suction visible secretions
- • Remove foreign objects
- • Insert airway adjuncts if trained
Breathing Assessment & Support
Evaluate respiratory function and provide ventilatory support
Look
- • Chest rise and fall
- • Respiratory rate
- • Use of accessory muscles
- • Skin color
Listen
- • Breath sounds
- • Stridor or wheeze
- • Voice changes
- • Absence of sounds
Feel
- • Air movement
- • Chest expansion
- • Subcutaneous emphysema
- • Tracheal position
Circulation & Hemorrhage Control
Assess perfusion status and control major bleeding
Circulation Assessment
- • Pulse rate, rhythm, quality
- • Blood pressure
- • Capillary refill time
- • Skin color and temperature
- • Mental status changes
Bleeding Control
- • Direct pressure
- • Elevation if appropriate
- • Pressure points
- • Tourniquet for extremities
- • Hemostatic agents
Disability (Neurological Assessment)
Evaluate neurological function and level of consciousness
AVPU Scale
- • Alert and responsive
- • Responds to Verbal stimuli
- • Responds to Painful stimuli
- • Unresponsive
Additional Assessment
- • Pupil size and reactivity
- • Motor response
- • Blood glucose level
- • Spinal immobilization needs
Exposure & Environmental Control
Full examination while preventing hypothermia
Exposure Considerations
- • Remove clothing to assess injuries
- • Maintain patient dignity
- • Look for hidden injuries
- • Check posterior surfaces
Environmental Control
- • Prevent heat loss
- • Cover with blankets
- • Control ambient temperature
- • Monitor core temperature
Master Memory Aid: ABCDE
Airway with C-spine protection
Breathing and ventilation
Circulation with hemorrhage control
Disability (neurological assessment)
Exposure and environmental control
8. CPR Fundamentals
Cardiopulmonary Resuscitation (CPR)
CPR is a lifesaving technique that combines chest compressions and rescue breathing to maintain blood circulation and oxygenation when someone’s heart and breathing have stopped.
Adult CPR Sequence (2020 Guidelines)
Check Responsiveness
Tap shoulders, shout “Are you okay?”
Call for Help
911 and AED if available
Check Pulse
Carotid pulse ≤10 seconds
Begin Compressions
30:2 ratio, 100-120/min
Continue Cycles
Until help arrives or ROSC
High-Quality Compressions
- Rate: 100-120 compressions per minute
- Depth: At least 2 inches (5 cm) for adults
- Recoil: Allow complete chest recoil
- Position: Lower half of breastbone
- Interruptions: Minimize (≤10 seconds)
Rescue Breathing
- Volume: Enough to make chest rise
- Duration: 1 second per breath
- Ratio: 30 compressions : 2 breaths
- Seal: Complete mouth-to-mouth or bag-mask
- Airway: Head-tilt, chin-lift
Critical Clinical Points
Compression-Only CPR
For untrained bystanders, continuous chest compressions without rescue breathing can be effective for witnessed adult cardiac arrest.
Team Communication
Clear, closed-loop communication is essential. Assign roles, rotate compressors every 2 minutes, and use structured handoff reports.
Compression Rate Memory Aid
Think of the beat of “Stayin’ Alive” by the Bee Gees – this song has approximately 100 beats per minute, perfect for CPR compressions!
9. Shock Management
Understanding Shock
Shock is a life-threatening condition that occurs when the body’s tissues don’t receive adequate oxygen and nutrients due to inadequate tissue perfusion. Early recognition and treatment are crucial for survival.
Hypovolemic
Blood/fluid loss, dehydration
Cardiogenic
Heart failure, MI, arrhythmias
Distributive
Septic, anaphylactic, neurogenic
Obstructive
Tension pneumothorax, PE, tamponade
Signs and Symptoms of Shock
Early Signs
- • Restlessness, anxiety
- • Increased heart rate
- • Normal blood pressure
- • Increased respiratory rate
- • Mild confusion
- • Cool, clammy skin
Progressive Signs
- • Decreased systolic BP
- • Weak, rapid pulse
- • Delayed capillary refill
- • Decreased urine output
- • Altered mental status
- • Pallor, mottled skin
Late Signs
- • Severe hypotension
- • Absent peripheral pulses
- • Unconsciousness
- • Absent urine output
- • Cyanosis
- • Cardiac arrest
First Aid Management of Shock
Immediate Actions
- 1 Ensure scene safety and call for help
- 2 Control obvious bleeding
- 3 Position appropriately (usually supine)
- 4 Maintain airway and breathing
Supportive Care
- 5 Prevent heat loss with blankets
- 6 Provide psychological support
- 7 Monitor vital signs continuously
- 8 Prepare for rapid transport
Memory Aid: SHOCK
Stop bleeding and ensure safety
Help is on the way (call 911)
Oxygen and airway management
Cover and keep warm
Keep monitoring and reassuring
10. Wound Care & Bleeding Control
Hemorrhage Control Principles
Bleeding control is often the most critical first aid intervention. The goal is to stop bleeding quickly while preventing contamination and preserving function.
Types of Bleeding
Arterial
Bright red, spurting, high pressure
Venous
Dark red, steady flow, lower pressure
Capillary
Slow oozing, usually minor
Wound Classifications
Bleeding Control Hierarchy
Direct Pressure
Apply firm, continuous pressure directly over the wound
Elevation
Raise injured area above heart level if no fracture suspected
Pressure Points
Apply pressure to arterial pressure points proximal to wound
Tourniquet
For life-threatening extremity hemorrhage when other methods fail
Wound Care Steps
- 1 Control bleeding first
- 2 Clean hands and use PPE
- 3 Irrigate with clean water if available
- 4 Apply sterile dressing
- 5 Secure with bandage
- 6 Monitor for signs of infection
When to Seek Emergency Care
- Arterial bleeding that won’t stop
- Deep wounds exposing bone/tendons
- Wounds with foreign objects embedded
- Animal or human bites
- Signs of infection developing
- Tetanus vaccination status unknown
Bleeding Control Memory Aid: STOP
Safety first – protect yourself
Take direct pressure approach
Other methods if bleeding continues
Prepare for shock treatment
11. Implementation in Nursing Practice
First Aid in Nursing Context
Nurses are often the first healthcare professionals to encounter emergency situations. Understanding first aid principles enhances clinical decision-making and improves patient outcomes across all healthcare settings.
Hospital Settings
- • Rapid response team activation
- • Code blue situations
- • Emergency department triage
- • Post-operative complications
- • Medical device emergencies
- • Medication adverse reactions
Community Settings
- • Home healthcare emergencies
- • School nursing situations
- • Occupational health incidents
- • Public event medical coverage
- • Disaster response nursing
- • Rural/remote area care
Long-term Care
- • Falls and injury management
- • Choking in dysphagia patients
- • Cardiac events in elderly
- • Medication emergencies
- • Behavioral health crises
- • End-of-life care decisions
Nursing Process in Emergency Situations
Assessment Phase
- Primary Survey: ABCDE assessment
- Vital Signs: Baseline measurements
- Pain Assessment: Location, quality, severity
- History Taking: SAMPLE or OPQRST
- Physical Exam: Head-to-toe evaluation
- Risk Assessment: Fall risk, suicide risk
Intervention Phase
- Life-saving Measures: CPR, bleeding control
- Comfort Measures: Pain management, positioning
- Safety Measures: Fall prevention, restraints
- Communication: Patient education, family updates
- Coordination: Healthcare team collaboration
- Documentation: Accurate, timely records
Evidence-Based Practice Tips
- • Use standardized assessment tools and protocols
- • Follow current AHA/ERC resuscitation guidelines
- • Implement fall prevention bundle protocols
- • Use sepsis screening and early warning systems
- • Apply trauma-informed care principles
- • Follow infection control best practices
Professional Development
- • Maintain CPR/AED certification
- • Complete ACLS/PALS training as appropriate
- • Practice emergency simulation scenarios
- • Stay current with clinical guidelines
- • Participate in quality improvement initiatives
- • Develop cultural competency skills
Interprofessional Collaboration in Emergencies
Physicians
Medical diagnosis and treatment orders
EMS Personnel
Pre-hospital care and transport
Pharmacists
Medication management and dosing
Social Workers
Psychosocial support and discharge planning
Nursing Emergency Response: NURSE
Note the emergency and ensure safety
Understand the situation quickly
Respond with appropriate interventions
Support the patient and family
Evaluate outcomes and document
12. Legal & Ethical Considerations
Legal Framework for First Aid
Understanding legal and ethical obligations is crucial for anyone providing first aid. These principles protect both the rescuer and the victim while ensuring appropriate care is delivered.
Types of Consent
Express Consent
Conscious adult verbally agrees to receive care
Implied Consent
Unconscious person or life-threatening emergency
Informed Consent
Understanding risks, benefits, and alternatives
Parental Consent
Minor children require parent/guardian permission
Good Samaritan Laws
Legal Protection
Protection from liability when providing emergency care
Limitations
Must act within scope of training and without gross negligence
Varies by Jurisdiction
Laws differ between states and countries
Professional Standards
Healthcare professionals held to higher standards
Legal Obligations and Responsibilities
Duty to Act
- • Healthcare professionals on duty
- • Designated first aiders at work
- • Lifeguards and safety personnel
- • Parents/guardians for children
Standard of Care
- • Act within scope of training
- • Follow established protocols
- • Use reasonable skill and care
- • Document actions taken
Ethical Principles in Emergency Care
Beneficence
Act in the patient’s best interest
Non-maleficence
“Do no harm” – avoid causing injury
Autonomy
Respect patient’s right to choose
Justice
Fair and equitable treatment
Documentation Requirements
- • Date, time, and location of incident
- • Patient’s condition upon arrival
- • Interventions performed and responses
- • Vital signs and changes over time
- • Patient statements and witness information
- • Transfer of care details and timing
- • Your signature and credentials
Confidentiality and Privacy
- • Protect patient health information (HIPAA)
- • Limit disclosure to need-to-know basis
- • Obtain consent for sharing information
- • Secure storage of medical records
- • Respect cultural and religious beliefs
- • Maintain professional boundaries
Special Ethical Considerations
Refusal of Care
Competent adults can refuse treatment. Document refusal and explain risks clearly.
Cultural Sensitivity
Respect cultural differences while providing necessary emergency care.
End-of-Life Issues
Honor advance directives and DNR orders when known and verified.
Ethical Decision-Making: ETHICS
Evaluate the situation and options
Think about consequences and alternatives
Honor patient autonomy and wishes
Identify ethical principles involved
Consider legal requirements
Seek guidance when uncertain
Key Takeaways
Essential Concepts
- First aid preserves life, prevents deterioration, and promotes recovery
- Scene safety and systematic assessment are paramount
- ABCDE approach guides priority-based emergency care
- Early recognition and intervention improve outcomes
Professional Practice
- Nurses must maintain current emergency care competencies
- Legal and ethical considerations guide all interventions
- Documentation and communication are critical components
- Interprofessional collaboration enhances patient outcomes
Remember: The goal of first aid is to sustain life until advanced medical care arrives. Your knowledge, skills, and quick thinking can make the difference between life and death.
