Basic First Aid Training Materials

First aid training materials are important and useful for those interested in first aid skills. In the modern era, accidents occur suddenly and frequently. Therefore, mastering first aid skills can save many lives.

This document contains valuable knowledge and experience from first aid experts, helping readers establish a solid foundation in first aid. If you are concerned about health and safety, or if you are a healthcare worker, firefighter, security personnel, or someone working in a hazardous environment.

I. BASIC FIRST AID

1. OVERVIEW OF BASIC FIRST AID

A. BASIC AWARENESS OF BASIC FIRST AID FOR ACCIDENTS AND INJURIES

1. Definition

Basic first aid is the initial, immediate assistance provided to an injured or ill person (hereinafter referred to as the victim) until they receive care from professional medical personnel. It is not only the initial treatment of the victim’s injuries but also includes other initial care such as providing psychological reassurance to the victim and to witnesses or the victim’s relatives.

First aid often includes simple and commonly easy-to-perform procedures. Its purpose is to prevent the victim’s condition from worsening, and it is not a substitute for medical treatment. First aid is considered a part of emergency care with the aim to:

• Increase the chance of survival.
• Prevent the injury from worsening.
• Help stabilize the victim’s health.

First aiders must be trained in both theory and practical emergency skills.

2. Duties of the rescuer

• Place the victim in a safe rescue position.
• Call for help from people nearby.
• Provide initial first aid to the victim.
• Call or ask someone to call emergency services (115).
• Record or ask someone to record what happened and what was done.
• Use infection prevention measures for the rescuer: wash hands, wear gloves, use a mask for artificial respiration if needed.

3. Duties of the helper

• Search for all victims in the accident.
• Seek all possible care measures.
• Call emergency services and direct rescuers to the correct location.
• Provide necessary care to the victim as instructed by the first aider.
• Place the victim in the correct position.
• Record what happened and what was done.
• Provide psychological reassurance to the victim’s relatives (if present).

4. Consequences of not providing timely first aid

• Cardiac arrest leading to death.
• If the heart stops for more than 4 minutes, the brain can be damaged.
• If the heart stops for more than 10 minutes, brain damage is irreversible.

5. Steps of first aid include

• Assess the situation: Observe the scene to see if there is danger, whether there is one or multiple victims, whether the incident is far or near a medical facility, and what assistance has already been provided.
• Plan for first aid preparation.
• Carry out the first aid plan and assist the victim, such as performing rescue breaths and chest compressions.
• Reassess the results to see if the victim’s condition has improved. Inform family, relatives, or legal guardians as soon as possible. Reassure and explain to the victim about the first aid given. Complete the incident report.

B. BASIC FIRST AID PROCEDURE

1. Airway (A)

First, determine if the victim is conscious and responsive; if the airway is obstructed, perform the following immediately:

• Lean in with your ear close to the victim’s mouth to check for breathing.
• Open the victim’s mouth to check for mucus or foreign objects. If the victim still has difficulty breathing, check for tongue obstruction; if so, pull the tongue forward.
• Lift the chin and push the jaw forward to keep the airway aligned.
• Perform mouth-to-mouth or mouth-to-nose rescue breathing if the victim is not breathing.

2. Breathing (B)

Assess breathing issues based on respiratory rate, effort, and chest wounds, especially in cases that can be treated on the spot while waiting for medical personnel:

• If the victim has stopped breathing, is cyanotic, or is at risk of respiratory arrest, perform artificial respiration immediately.
• For open chest wounds, place a gauze pad or clean cloth over the wound and bandage it to stop bleeding and limit air entering the chest cavity. Never remove an embedded object from the chest, as it may cause massive bleeding and death.

3. Circulation (C)

While assessing and managing circulation, always monitor airway and breathing. For circulation, control bleeding. Assess circulation by:

• Checking pulse at the arm, wrist, or groin. In basic community emergencies, this may be skipped if the victim is in respiratory distress.
• Signs such as confusion, pale or ashen skin, and sweating indicate blood loss. Control external bleeding; internal bleeding requires surgical intervention.
• Simple bleeding control includes applying pressure with clean clothing or sterile gauze and keeping it in place until medical help arrives. Do not remove the applied dressing, as it may worsen bleeding.

If cardiac arrest is suspected, perform CPR with chest compressions (details in the basic life support section).

4. Disability (D)

Quickly assess nervous system injury in four levels:

• Level 1: Victim is alert and communicates normally.
• Level 2: Victim responds verbally or with gestures when spoken to.
• Level 3: Victim responds only to painful stimuli (if no response to voice).
• Level 4: No response to voice or pain — indicates coma, poor prognosis, and need for urgent transfer to medical facility.

If the victim is unconscious or at level 4, brain injury is likely. If a conscious victim later falls into a coma or shows declining awareness, it may indicate ongoing brain bleeding or worsening injury.

For head injuries, scalp lacerations, skull fractures, cerebrospinal fluid leakage, or exposed brain tissue, cover the wound with clean gauze or clothing. Do not apply ointments, chemicals, or plants, and do not remove embedded objects.

5. Exposure (E)

Once the victim is stable, remove clothing to check for other injuries and avoid missing any.

Immobilize the cervical spine if neck injury is suspected: If conscious, encourage the victim to stay still. Use a cervical collar or available materials such as sandbags, heavy objects, or rolled cloth to support both sides of the neck and back. Secure with tape or straps. Once on a rigid board, place sandbags on both sides of the neck (ear to collarbone length) and secure at the forehead, shoulders, pelvis, knees, and ankles.

Note: Place the victim in a safe position

• The safe position keeps the airway clear.
• All unconscious victims should be placed in a safe position. Do not move the victim if spinal injury is suspected, such as in paralysis or loss of bladder/bowel control.
• For unconscious victims, to prevent tongue obstruction or aspiration of vomit, place them on their side, upper arm bent, lower arm extended, upper leg bent, and lower leg straight. Use cloth or a pillow to maintain the position.

C. CALL FOR EMERGENCY HELP

1. Requirements for the caller seeking assistance

Speak clearly, concisely, and accurately. Provide complete information about:

• Scene: Location, address, directions, etc.
• Accident: Type of accident, severity of the accident.
• Victim: Number, gender, age, time to emergency arrival, victim’s signs, initial first aid performed, victim’s condition and developments, etc.
• Other hazards: Toxic gases, explosives, etc.
• Contact information: Your name, phone number, etc.
• Only end the call after the receiver has confirmed and ended the call.

2. Principles of victim transportation

Ideally, transport the victim using specialized medical equipment: Stretchers, wheelchairs, ambulances, etc. If professional support and specialized medical equipment are not available, victim transportation must always ensure correct technique, speed, and safety for both the victim and the transporter, specifically as follows:

1. Only transport the victim after initial first aid and emergency care have been provided.
2. Only move the victim when safety factors are ensured: Protect the victim during transportation.
3. Calmly assess and prioritize actions depending on the victim’s injuries.
4. Transportation should be performed evenly according to unified commands from the leader.
5. Continuously monitor the victim during transport to ensure they remain in the safest position.

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2. BASIC FIRST AID

A. DEFINITION

Basic first aid is the application of simple emergency techniques, where even a single rescuer can support vital functions such as breathing and circulation for a child experiencing cardiovascular collapse, even without emergency equipment. Once the victim has been safely approached and their consciousness assessed using simple methods, proceed with evaluation and intervention in the ABC sequence.

B. PROCEDURE

The general basic first aid sequence for a child victim in respiratory and cardiac arrest is as follows:

1. Initial approach: Danger, Responsive, Send for help (DRS)

In an outdoor environment, the rescuer must not become a second victim, and the injured child must be removed from danger as quickly as possible. These steps must be taken before assessing the airway. In cases where there is one rescuer, help should be called immediately upon finding the victim unresponsive.

When there are two rescuers, one performs basic first aid while the other calls for help, then returns to assist the first rescuer, switching roles every two minutes to prevent fatigue. If there are more than two rescuers, two will perform first aid while others assist as described in Lesson 1 of this manual. If only one rescuer is present and no help is available, they must perform basic first aid for one minute before calling emergency services. For infants or young children, the rescuer may carry the child to a phone while continuing basic first aid en route.

• Call for assistance first
  • In some cases, this sequence may be reversed. As described, in children, respiratory and circulatory arrest can quickly lead to cardiac arrest. Therefore, immediate support for breathing and chest compressions, as in basic first aid, is needed to save the child. However, in some cases, early defibrillation may save the child’s life, such as cardiac arrest due to arrhythmia. In such cases, with two rescuers, one performs basic first aid while the other calls emergency services as described above. If there is only one rescuer, call emergency services first, then begin basic first aid.
• Assess the condition of the injured child
  • Check responsiveness by simply asking: “Are you okay?” and stimulating them by holding their head and gently shaking their arm. This avoids worsening a possible neck spine injury. Younger children, if too frightened to answer, may still respond by opening their eyes or making small sounds.

2. Airway (A)

Airway obstruction may be the initial cause. Once cleared, the child may recover without further intervention. A child unable to breathe may have their tongue falling backward, obstructing the throat. In this case, open the airway using the head tilt and chin lift technique. Place one hand on the child’s forehead and gently tilt back. For younger children, keep the neck neutral; for older children, slightly extend the neck. Place fingers of the other hand under the chin and lift forward. Avoid soft tissue injury from excessive force. You may use your thumb to keep the mouth open during the maneuver.

If the child is breathing with difficulty but conscious, take them to the hospital as soon as possible. Normally, a child will find a comfortable position to maintain airway openness, so do not force them into an uncomfortable position.

Assess airway clearance by:

• LOOKING for chest and abdominal movement.
• LISTENING for breath sounds.
• FEELING for air flow.

The rescuer positions their head over the child’s face, ear above the nose, cheek above the mouth, and observes the chest for 10 seconds.

If unable to perform this maneuver or if there is a suspected neck spine injury, use the jaw thrust technique: Place 2–3 fingers under the angle of each jaw and push the jaw forward (as practiced in training).

Evaluate the success or failure of the intervention using the LOOK, LISTEN, and FEEL method described above.

Note: In trauma cases, head tilt may worsen neck spine injuries. In such cases, the safest method is a jaw thrust without head tilt. Neck spine control can only be maintained if a second rescuer stabilizes the neck.

3. Breathing (B)

After opening the airway, if the child has normal breathing, place them in the recovery position, maintain the airway, call for help or take them to the hospital, and continue monitoring during transport. If after opening the airway, the child does not resume breathing within 10 seconds, begin rescue breaths.

• Rescue breathing method: Give 5 initial rescue breaths.
  • While maintaining airway openness, give rescue breaths using the mouth-to-mouth method for older children or mouth-and-nose method for infants.

• • If using only mouth-to-mouth, pinch the child’s nose with your thumb and index finger of the hand on their head. Blow slowly for 1–1.5 seconds until the chest rises normally. Blowing too forcefully may cause stomach distension and increase the risk of gastric contents entering the lungs. Between breaths, the rescuer should inhale to provide more oxygen for the victim. If unable to cover both mouth and nose, give breaths through either the mouth or nose.

General guidance for rescue breathing:

• The chest should rise with each breath.
• Rescue breath pressure may be higher than normal due to smaller airways.
• Breathe slowly with the lowest pressure possible to reduce stomach distension (caused by air entering the stomach).
• Gently press on the thyroid cartilage to reduce air entering the stomach.

• • If the chest still does not rise, the airway may not be fully open; reposition the head and try again. If still unsuccessful, perform a jaw thrust. A single rescuer can both perform a jaw thrust and give rescue breaths. With two rescuers, one maintains the airway while the other gives breaths. Perform 5 rescue breaths and watch for coughing or other responses from the child during resuscitation.

• Chest compressions
  • Lay the child on their back on a firm surface for best results.
  • Due to differences in child size, techniques vary by age. For children over 8 years old, use the adult technique, adjusting for size. Compress to about one-third of the chest’s depth. The compression point is the same for all ages: the lower half of the sternum.
  • Children under 8 years old: Use the heel of one hand on the lower half of the sternum, lifting fingers to avoid pressing on the ribs. Keep your shoulders directly above the child’s chest and arms straight.
  • Children over 8 years old: Use both hands with fingers interlocked, pressing down at least one-third of chest depth. Once the correct technique and position are chosen, begin immediately.

4. Continuous Cardiopulmonary Resuscitation (CPR)

The chest compression rate for all age groups is 100–120 times per minute; the compression-to-rescue-breath ratio is 30:2 when there is only one rescuer. Basic life support must be continued without interruption until the child shows movement and can breathe. Chest compressions should be performed quickly and forcefully, to a depth of at least one-third of the chest’s thickness, with a rate of 100–120 cycles per minute, without stopping.

Summary of Basic Life Support in the following diagram:

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3. FRACTURES

• Definition
  • A fracture is a condition where the continuity of the bone is lost, which may present in various forms, from a crack to a complete break.

• Causes
  • Fractures are usually caused by the impact of a force on the bone, either at the site or distant from it. They can therefore be direct or indirect fractures.
  • Direct fracture: Rare; the fracture line usually cuts across the bone and the fracture site is located right where the impact occurred, often accompanied by soft tissue injuries. Bones most often broken directly are superficial bones just beneath the skin.
  • Indirect fracture: Usually caused by bending, twisting, compression of the bone, or muscle spasms, with the fracture site possibly far from the point of impact.
• Classification
  • Fractures are divided into two main types: closed fractures and open fractures, and both can be complicated fractures.
  • Closed fracture: The skin around the fracture site is intact or injured but does not connect with the fracture.
  • Open fracture: The skin is broken and connects to the fracture, or a bone end protrudes outside. Open fractures are serious injuries because they not only cause bleeding but also carry a high risk of severe infection.
  • Complicated fracture: Both open and closed fractures are considered complicated if accompanied by nerve damage, blood vessel injury, or injury to other organs.
• Symptoms
  • Functional: Commonly pain, limited movement, swelling followed by bruising at the injury site.
  • Physical:
    • Comparing the injured limb with the healthy one reveals deformity: swelling, bruising, angular fracture, twisting, shortening, etc.
    • Severe pain when pressing fingers on the fracture site.
    • Abnormal mobility and a grating sound between bones are typical signs of a fracture. However, these signs should only be sought if the diagnosis is unclear, and examination must be gentle and cautious. (Do not try to find these signs intentionally as it causes significant pain.)
    • Associated injuries such as blood vessel and nerve damage: cold extremity, loss of sensation, inability to move.
    • Shock symptoms may occur in cases of open fractures, pelvic fractures, femur fractures, and multiple injuries.
  • Note: Not all fractures present with the above signs and symptoms. Diagnosis should mainly rely on observation. Do not move any part of the body unless necessary.
  • If two or three of the above symptoms occur together, or if the patient shows signs of shock, or if there is suspicion of severe trauma, treat it as a fracture case.
• Treatment
  • Objective: Limit displacement of the fractured bone ends, relieve pain, prevent shock, and avoid secondary injuries at the injury site.
  • Management
    • Call for medical emergency services.
    • Assess and address airway, breathing, and circulation issues, especially in cases of open fractures, pelvic fractures, femur fractures, or multiple trauma.
    • Do not move the injured limb unless absolutely necessary.
    • Cover any wounds if present. Control bleeding.
    • Temporarily immobilize the fracture using a splint or compression bandage.
    • Elevate the injured limb after immobilization to reduce swelling.
    • Continuously monitor the patient’s overall condition.
  • Principles of fracture immobilization
    • Splints used must be of adequate length, width, and firmness. They may be made of wood, bamboo, metal bars, etc.
    • Do not place the splint directly on the patient’s skin; padding should be placed at the ends of the splint and bone ends. Cotton or fabric may be used as padding (do not remove clothing; cut it if necessary).
    • Immobilize one joint above and one joint below the fracture site. For femur fractures, immobilize three joints.
    • In closed fractures, especially femur fractures, continuous traction with a constant force is required.
    • In open fractures: Do not push the bone ends back in; if there is arterial damage, apply a tourniquet as needed, manage the wound, and immobilize the limb in its found position.
    • Immobilize in a functional position: for the upper limb, suspend at a right angle or keep straight and secure to the body; for the lower limb, keep straight at 180^o.
    • After immobilization, bind the injured limb to the healthy limb into a single unit.
    • After immobilization, promptly and gently transport the patient to a medical facility or call emergency services.
    • Note: Do not cause additional pain or injury to the patient.

 

 

 

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4. BLEEDING CONTROL AND WOUND DRESSING

A. BLEEDING

• Overview
  • When the skin is cut and blood vessels rupture, bleeding occurs; some vessels bleed more heavily than others. The severity of the wound is determined by the type of blood vessel and the depth of the cut.
  • To stop or control bleeding, use a sterile bandage or clean dry cloth to press on the wound. This is called direct pressure. Protect yourself by wearing sterile gloves, such as medical gloves. If gloves are not available, use another protective item such as tissue or any other clean soft material.
• Blood vessels
  • Capillaries: Very small vessels. The body contains thousands of capillaries.
  • Veins: Blood vessels near the surface of the skin that carry blood back to the heart.
  • Arteries: Large vessels that carry blood from the heart to all parts of the body. If an artery is torn or ruptured, a large amount of blood can be lost in a very short time.
• Severity of bleeding
  • Capillary bleeding is usually easy to control by pressing on the wound.
  • Venous bleeding can also be controlled by applying pressure to the wound.
  • Arterial bleeding can be life-threatening. Apply firm direct pressure to the wound immediately and call 115 for prompt management.
  • Note: Some parts of the body have more blood vessels than others, such as the head and face, which have more vessels than the fingers; therefore, cuts to the head or face tend to bleed more heavily than cuts to fingers.
• Bleeding control dressing materials
  • Use gauze pads or rolled bandages. Gauze pads are clean materials used to cover wounds. A piece of gauze may also be used as a pad; rolled bandages hold the gauze in place and can also apply direct pressure to control bleeding.
• Bleeding control
  • In children, due to play and running, bleeding usually involves small blood vessels, is easy to control, and rarely life-threatening. Remain calm if a child is bleeding heavily from a cut in any location. Bleeding may not stop on its own within the first minute, so initial first aid is needed. Press firmly on the wound to control bleeding before significant blood loss occurs.
• Using bandages or gauze to stop bleeding
  • To control bleeding from an injury, hold the wound firmly for several minutes. This quick method is suitable for small cuts such as finger cuts or abrasions. Use a clean, dry medical material like gauze, cotton wool, or a soft cloth, place it over the wound, then press firmly with both hands until the bleeding stops.
  • Note: Always supervise if a child is using small bandages or gauze as they may pull it off, put it in their mouth, and choke.
• Injury from accidents
  • Internal injuries: Some deep injuries to the chest, abdomen, or brain can lead to internal bleeding. Internal bleeding occurs deep inside the body beneath the skin; symptoms and signs vary depending on the type and location of the injury. Children with internal bleeding often have severe pain and appear seriously ill. Some causes include falling from a height, high-speed injuries such as car accidents, or crushing injuries from heavy objects. If internal bleeding is suspected, call 115 immediately and keep the injured child calm while waiting for help.
  • Open injuries: Cuts to the skin are often called open wounds. Types of open wounds include abrasions, cuts, blisters, punctures, and nosebleeds, etc.
    • Abrasion: Occurs when the top layer of skin is removed, causing minor bleeding. Children often get abrasions on the elbows or knees; abrasions are usually not serious but can become infected if not treated properly. Because skin nerve endings may be damaged, abrasions can be painful.
    • Cut: An injury to the skin, which may be jagged or smooth, shallow or deep, large or small. Examples include cuts from knives, ceramic shards, or glass.
    • Blister: Fluid-filled bubble under the skin; blisters may be large or small. The fluid inside is usually sterile if the skin is unbroken.
    • Puncture wound: A small hole in the skin, which may be deep or shallow. Puncture wounds often do not bleed heavily but have a high risk of infection because they are hard to clean. Examples include bullet wounds, sharp object stabs, or punctures from nails or sharp sticks.
    • Nosebleed: Blood flowing from the nose, often caused by nasal inflammation or nose picking. Nosebleeds are more common in winter due to respiratory infections and dry air. Allergies or trauma to the nose can also cause nosebleeds.
  • Check: Carefully examine the bleeding site. In young children, a small cut inside the lip may result in blood seen on the face, lips, tongue, and forearms. Therefore, quickly locate the bleeding source to avoid risk from large cuts.
    • Check whether the bleeding is ongoing or has stopped.
    • Observe the child carefully if they fell from a height. If they are in severe pain or appear pale, they may have internal bleeding.

B. Management

• Check (CHECK – C)
  • Assess the surrounding environment: First, observe the surroundings to see if they are safe. Inform everyone about the location on the victim’s body where there is bleeding or bodily fluids, and take appropriate measures to protect yourself and others during contact. Identify the main cause of the child’s injury, such as sharp objects or broken glass. If there is danger, move the victim to a safe location; be careful when moving a victim who has fallen from a height, as there may be spinal injuries. Look for involved persons and other injured victims and determine the cause of the accident.
• ABC First Aid

No more than 15 to 30 seconds (Quick assessment of life-threatening signs)

• Is the child conscious and responding quickly?
• Is the child not breathing or gasping?
• Skin perfusion? Is there any bleeding?

• ABCDE First Aid Sequence
  • Perform the ABCDE first aid sequence. Pay attention to the following points:
    • Do you see blood? If yes, find the source of bleeding. You cannot determine that a child is seriously injured without seeing the wound.
    • Do bodily fluids need to be cleaned? Take appropriate measures to protect yourself and others.
    • If the child has fallen? Be cautious when moving the child in case of possible spinal injury. Watch for signs of internal bleeding, such as severe pain.
• Call for Help (CALL – C)
  • You may need support from a caregiver or an adult to help care for the child or supervise other children. Ask others to move children away from areas with blood and bodily fluids.
  • Observe the child according to the plan if available. Include practical instructions for special medical situations. Call 115 in cases of severe bleeding or bleeding that does not stop after direct pressure on the wound.

• First Aid (CARE – C)
  • Severe bleeding
    • Accidents causing severe bleeding will cause pain to the child; if bleeding is not quickly controlled, it can lead to massive blood loss that threatens the victim’s life. Therefore, bleeding control and surgical wound closure must be performed quickly.
    • Warnings when a child has severe bleeding
      • Do not allow the child to eat or drink anything as anesthesia may be required.
      • Remove or cut away clothing to expose the wound if necessary, and do not remove anything stuck in the wound as it may cause more bleeding.
      • Do not press directly on the wound if there is an object embedded in it; instead, press on both sides of the wound edges to control bleeding.
      • If bleeding occurs after a head injury and there is fluid coming from the ears, nose, or an open skull fracture, urgently call 115 for timely assistance.
    • Handling instructions
      • Step 1. Use gauze, padding, or a clean cloth, or even your bare hand, to press directly on the wound immediately to control bleeding (as shown below). This can be guided and encouraged for the child to assist you in such situations.

• • • • Step 2: Continue maintaining pressure on the wound to stop the bleeding, while asking someone else to call 115 for assistance.
      • Step 3: Use a bandage to secure the wound, ensuring firm pressure to stop bleeding, but not so tight as to affect blood circulation. Check blood circulation by pressing the fingernail or toenail (depending on the wound’s location), if it does not return to its normal color immediately, the bandage is too tight. If the bleeding has stopped, loosen it slightly.
      • Step 4. Shock may develop if severe bleeding occurs. Support and elevate the injured part while maintaining pressure, and help the child lie down on a blanket, raise the legs above heart level, and cover the child with a blanket to keep warm (as shown below).

• • • • Step 5. If blood continues to soak through the first dressing, place another dressing on top and wrap with a bandage. If bleeding still continues, direct pressure may not be on the right spot; remove both dressings and re-bandage, making sure the new pad is placed directly over the wound. If bleeding still cannot be controlled with direct pressure, and if trained in the use of a tourniquet, this method may be applied (as shown below).

• • • • Step 6: Monitor breathing, pulse, and responsiveness while waiting for emergency help to arrive.
  • Foreign objects lodged in the wound
    • An object such as a piece of glass, ceramic, etc., lodged in a wound is serious because it may be plugging the wound and stopping the bleeding; do not remove it. Protect it with padding and a bandage, then seek medical help.
    • Warnings when foreign objects are lodged in the wound
      • Do not attempt to remove the object lodged in the wound as it may cause further injury and bleeding.
    • Handling instructions
      • Step 1. Help the child lie down and keep calm. Apply pressure to the wound to slow the bleeding, being careful not to move the foreign object and cause further injury (as shown below).

• • • • Step 2. Gently place a few gauze pads over the wound and the foreign object to minimize the risk of infection.
        • If the foreign object is small, create padding that is slightly higher than the object; roller bandages are suitable (as shown below).

• • • • • If the foreign object is very large, create padding on both sides, then bandage above and below the object instead of directly over it (as shown below).

• • • • Step 3. Secure the padding in place by wrapping a bandage over it, being careful not to push the foreign object down. Then take the victim to the nearest hospital or call emergency services
  • Forehead wound
    • This type of wound may bleed heavily. If the wound is caused by a blow to the head, monitor any changes in the child’s condition, especially responsiveness, while waiting for medical help.
    • Warnings for forehead wounds
      • If blood continues to soak through the first and second gauze pads, add another pad and apply more pressure to stop the bleeding.
      • If the bleeding is severe and uncontrollable or there is a possibility of brain injury, CALL IMMEDIATELY
      • If the child is unresponsive and not breathing normally, begin CPR immediately with 30 chest compressions, while also CALLING IMMEDIATELY
    • Handling instructions
      • Step 1. Cover the wound with a large sterile clean dressing, apply steady pressure on the dressing and wound to control bleeding. Place another pad on top if needed and continue to press on the wound (as shown below).

• • • • Step 2. Bandage securely in place. If bleeding continues, use your hand to keep pressing on the wound (as shown below).

• • • • Step 3. Help the child lie down with the head and shoulders slightly elevated.
      • Step 4. If the wound is large or deep and requires stitching, take the child to a doctor or emergency room.
  • Cuts or abrasions
    • Children are often distressed by even the smallest scratches. Reassure the child, clean and disinfect the wound, cover it with adhesive bandage, keep it clean to make the child more comfortable and prevent infection.
    • Notes when treating abrasions
      • Do not use cotton wool or any fine material when cleaning or covering the wound, as it can stick to the wound and delay healing.
      • Remove dirt particles by rinsing the wound with cool, clean water.
      • If dirt particles are embedded too deeply, take the child to a doctor or hospital for cleaning to prevent infection.
      • If the wound becomes infected, it can lead to tetanus. This is a dangerous bacterial infection found in soil; if tetanus bacteria enter the wound, they will release toxins into the nerves. Tetanus is best prevented through vaccination. Every child should receive a tetanus booster before starting school.
    • Handling instructions
      • Step 1. Help the child sit down and reassure them. Gently wash the abrasion with soap and water, use gauze and a clean towel to dry. If the wound is very dirty, rinse it under cold running water.
      • Step 2. Remove all dirt particles using the corner of a gauze pad or cold water; this may cause slight bleeding.
      • Step 3. Apply direct pressure with a clean gauze pad to stop the bleeding and gently pat the wound with a clean gauze pad.
      • Step 4. Apply antibiotic ointment and cover the wound with an adhesive bandage with a gauze pad large enough to cover the wound and the surrounding area.
  • Blisters
    • Notes when treating blisters
      • If the blister is large, cover it with a clean non-stick gauze pad and secure it with adhesive tape.
      • Do not intentionally burst the blister, as this can easily cause infection.
      • Do not use this method for burn blisters.
    • Handling instructions
      • Step 1. Wash the blister with soap and water, then rinse with clean water.
      • Step 2. Completely dry the blister and the surrounding skin, gently patting with a clean gauze pad or tissue.
      • Step 3. It is best to cover the blister with a specialized blister bandage if available. The adhesive bandage should have a pad large enough to cover the entire blister, ensuring the edges are flattened to prevent other blisters from developing.
  • Nosebleeds
    • Nosebleeds in children may be caused by a strong impact to the nose or from picking/nose probing. Nosebleeds usually stop quickly, but they can be alarming in young children.
    • Warnings for nosebleeds
      • If there is blood or blood-tinged fluid from the nose after a head injury, CALL
      • If the nosebleed is severe or lasts longer than 30 minutes, TAKE THE CHILD TO THE HOSPITAL.
    • Handling instructions
      • Step 1. Help the child sit down with the head tilted slightly back. Ask the child to breathe through their mouth, then pinch the fleshy part of the nose for 10 minutes, release, and tilt forward.
      • Step 2. Instruct the child to spit out any fluid or anything in the mouth. If the bleeding has not stopped, pinch the fleshy part of the nose for another 10 minutes; if bleeding continues, pinch for up to another 10 minutes.
      • Step 3. When the bleeding has stopped, use some cotton dipped in warm water to clean the child’s face.
      • Encourage the child to rest and avoid blowing the nose for several hours, and do not allow nose-picking after the bleeding has been stopped, as it may restart the bleeding.
  • Complete (COMPLETE – C)
    • Inform the child’s parents or guardians.
    • Write a detailed description of the incident.
    • Discuss with relevant staff to gather full details.
    • Fill out required records, such as a school incident report form, etc.

C. WOUND DRESSING

Includes two techniques: wound covering and pressure dressing.

Wound covering: Covering a wound helps stop bleeding, protect the wound, prevent infection, and avoid secondary injuries.

Steps to follow:

• Wash hands before and after dressing. Wear protective, disposable gloves (if available).
• Avoid direct contact with the wound. Do not talk, sneeze, or cough toward the wound.
• Clean and disinfect the wound with solutions such as saline, 1-3% hydrogen peroxide, etc., before dressing. DO NOT attempt to clean large wounds that require medical intervention.
• Cover the wound directly. Use sterile bandages (if available) or a clean piece of cloth wide enough (width covering 2 cm beyond the wound edges).

Pressure dressing: A pressure dressing involves wrapping bandages to create direct pressure on the wound to stop bleeding and cover it, while also helping to immobilize splints, limbs, or joints, and reduce swelling or edema.

Steps to follow:

• Apply the pressure dressing in a comfortable position, add extra padding if dressing over bony areas.
• Support the injured limb, dress firmly but not too tightly to avoid restricting circulation.
• Always check circulation after applying a pressure dressing to ensure it is not too tight.

Signs the dressing is too tight: Below the dressing there will be:

• Bluish or purplish fingers or toes.
• Hands or feet that are pale and cold.
• Itching, irritation, or loss of sensation in the limb.
• Inability to move fingers or toes.

Bleeding can result from various causes (household accidents, workplace accidents, traffic accidents). When bleeding occurs, proper bleeding control and pressure dressing for the victim will prevent risks such as circulatory failure, shock, and infection. If internal bleeding is suspected, closely monitor the victim to detect and handle signs of blood loss promptly.

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II. FIRST AID FOR COMMON ACCIDENTS AND INJURIES IN CHILDREN AND STUDENTS

1. Airway foreign bodies in children

• DEFINITION
  • Airway foreign bodies are objects lodged in the airway (larynx, trachea, bronchi). Statistics show that about 80% of airway foreign bodies are small objects, toys (building blocks, pins, hair clips, etc.), food (cereal grains, custard apple seeds, watermelon seeds, jelly, shrimp shells, small bones, etc.). Airway foreign bodies are a dangerous type of accident common in young children, especially those under 2 years old, caused by foreign objects falling into the airway and causing partial or complete blockage. This is a medical emergency—if not handled promptly, it can lead to severe consequences such as irreversible brain damage or even death.
• CAUSES
  • Children often have the habit of putting objects they hold into their mouths, increasing the risk of objects entering the airway or esophagus.
  • Foreign bodies can enter the airway when inhaling strongly or after laughing, crying, or being frightened.
  • Foreign bodies can enter the airway due to loss of pharyngeal reflex.
• RECOGNITION SIGNS
  • The caregiver witnesses the child choking on a foreign object or notices the child showing the following symptoms:
  • Penetration syndrome
    • The child suddenly has difficulty breathing, turns blue, then coughs violently, with the face turning red or bluish. The episode lasts a few minutes then eases. Afterward, the child coughs less and may develop localized symptoms.
    • If the foreign object is large and completely blocks the airway without being expelled, the patient will suffer severe suffocation and may die on the spot.
  • Localized signs/symptoms
    • Foreign body in the larynx: Hoarseness, barking cough, inspiratory stridor, high risk of sudden death if the foreign body is large.
    • Foreign body in the trachea: Wheezing, expiratory stridor. A mobile foreign body in the trachea (e.g., peanut shell, soybean shell): violent coughing fits, severe breathing difficulty, and fluttering sounds after coughing, back blows, or position changes.
    • Foreign body in the bronchus: Persistent cough, reduced or absent breath sounds, localized wheezing.
• FIRST AID STEPS

• • On-site first aid: When a child chokes on a foreign body, the caregiver should remain calm and take the following measures:
    • Basic precautions
      • Absolutely do not use fingers to scoop out the object, do not induce vomiting, and do not give food or drink.
      • If the child is conscious and coughing effectively, encourage them to continue coughing. Natural coughing is more effective than any physical intervention.
      • Physical interventions (back blows, chest thrusts, Heimlich maneuver) should only be performed if the child cannot cough or the cough is ineffective and breathing difficulty is increasing.
    • Rescue instructions
      • For infants, place the child horizontally across the rescuer’s lap and use the heel of the other hand to deliver 5 back blows. If the object does not come out, perform 5 chest thrusts at the compression site for CPR at a rate of 1 per second.

• • • • For children over 5 years old, in addition to back blows and chest thrusts as for younger children, the Heimlich maneuver can also be used with the child standing or sitting.
        • Heimlich maneuver when the child is standing or sitting: The rescuer stands behind the victim, wraps their arms around the victim. Because children are shorter, for greater effectiveness, the rescuer may lift the child or kneel behind them. Place the heel of one hand on the child’s abdomen above the navel and below the sternum, place the other hand on top, and push forcefully upward toward the chest 5 times until the object is expelled.
        • If the child loses consciousness and stops breathing, begin chest compressions and rescue breaths.
  • Transporting the patient
    • If airway foreign body is suspected, the child must be taken to a facility with bronchoscopy to remove it.
    • Avoid agitating the child during transport.
• PREVENTION OF AIRWAY FOREIGN BODIES
  • Do not give children under 3 years old hard foods, hard fruits, or seeds.
  • Do not let children play with small objects.
  • Do not leave pins, safety pins, etc., in the room.
  • Older children should not hold pen caps, screws, etc., in their mouths.
  • Do not make children laugh or cry while they have food in their mouths.
• SUMMARY OF HANDLING A CHOKING CHILD
  • If you suspect a child is choking, ask, ‘Are you choking?’
    • If the child can breathe, speak, or cough, encourage them to cough. If they cannot breathe, cough, or make any sound, help immediately.
    • Effective coughing: Encourage the child to cough to expel the object.
    • If coughing is ineffective, perform back blows/chest thrusts.
    • Check the mouth for any visible foreign objects in the mouth or throat. Do not attempt to scoop the object out.
    • If the airway remains blocked, call 115 immediately. Repeat 5 back blows/chest thrusts until help arrives, checking the mouth each time. If the child becomes unconscious, prepare to start CPR.

2. Traffic accidents and falls

• TRAFFIC ACCIDENTS
  • Definition
    • A traffic accident is an unexpected event causing injuries of varying degrees such as abrasions, fractures, head trauma, and internal injuries, which can lead to death or permanent disability.
  • Causes
    • Lack of supervision and care from adults: Allowing children to play freely in areas with heavy traffic.
    • Children crossing the street without looking.
    • Drivers not complying with traffic safety regulations.
  • First aid guidance for traffic accidents
    • Call emergency services or transport the child safely to the nearest medical facility.
    • Move the child out of danger, seek assistance.
    • Clean the wound, apply dressing to stop bleeding.
    • Immobilize suspected fractures, paying attention to cervical spine stabilization (as instructed in practice).
  • Prevention guidelines
    • Do not let children walk on the road or play on sidewalks without adult supervision.
    • Encourage participation in learning traffic safety knowledge and skills.
    • When participating in traffic, always follow safety rules. Teach children proper skills such as looking both ways before crossing and using age-appropriate vehicles, while following all safety rules.
• FALLS
  • Causes
    • Children fall due to adult negligence. Not supervising children properly may cause them to fall from strollers, hammocks, beds, or heights, or slip from an adult’s arms.
    • Children climbing or standing on unstable chairs or objects.
    • Children slipping when walking, running, or playing in wet, slippery places such as bathrooms, wet floors, freshly mopped floors, spilled water, or playgrounds.
    • Children running, playing, pushing each other, leading to falls, common at home, in schools, or on the way to school or play.
    • Children climbing trees, walls, electric poles, stairs, balconies, etc.
  • Symptoms
    • Soft tissue injuries: Skin bleeding, muscle damage.
    • Bone and joint injuries: Sprains, dislocations, fractures, hairline fractures.
    • Head trauma: Concussion, hematoma, hemorrhage, etc.
  • First aid guidance
    • Soft tissue injuries
      • Swelling or bruising: Immediately apply a cold towel or ice pack.
      • Open wounds or bleeding: Clean with saline or antiseptic solution and apply a pressure dressing.
      • Sprains: Immediately apply a cold towel or ice pack; immobilize and limit movement.
    • Fractures and head trauma
      • Call emergency services or medical personnel.
      • Check the child’s consciousness by calling their name, prevent shock.
      • Immobilize the fracture with available splints.
      • While moving the child or waiting for a doctor, note:
      • Avoid moving the child unnecessarily.
      • Lay the child flat, with the head slightly lower than the feet, turn their face to one side so that vomit or blood does not enter the mouth or nose, preventing choking.
      • Do not give the child anything to eat or drink.
  • Preventing accidents in children
    • Always have an adult supervise young children when they are eating, sleeping, or playing. Do not leave children who can roll over, crawl, or walk on hammocks or beds without supervision.
    • Install barriers or guards at places such as stairs, windows, and balconies with a minimum height of 75 cm.
    • Ensure stairs and steps are well-lit and safe to walk on.
    • Teach children not to push or climb.
    • Do not let children stand on unstable chairs or objects.
    • Keep floors dry and free from moss.
    • Keep objects out of children’s reach.
    • Do not allow children under 10 to take care of children under 3.

3. Poisoning

• DRUG AND FOOD POISONING
  • Causes
    • Due to the lack of knowledge and carelessness of adults; many people have the habit of buying medicine on their own based on experience when a child is sick or following the advice of people around them, leading to drug abuse, using the wrong medication, using the wrong dosage, or using the right medication but overdosing without knowing that medicine can harm children. In addition, stopping or increasing doses without consulting a doctor, reusing old prescriptions, giving medicine prescribed for one child to another, or even taking adult medication and adjusting doses for children can all lead to the risk of drug poisoning.
    • Unintentional poisoning: Occurs when children accidentally eat or drink medicine or food that parents carelessly leave within reach, most common in toddlers (average age: 2.5 years).
    • Poisoning due to suicide: Usually occurs in preadolescents (over 10 years old). These children need to be examined and counseled in terms of psychology and sociology.
    • Physician-caused poisoning: Some cases of poisoning may result from inappropriate prescriptions, dosage, administration route, or drug combinations. However, poisoning can also occur even when the correct dose and prescription are used if the body is too sensitive to the medication. Some drugs that may cause dangerous poisoning include cardiovascular medications, narcotics, etc.
    • Due to consuming expired food, spoiled food left for too long, or improperly processed food.
  • Symptoms
    • Common types of poisoning are drug poisoning and food poisoning, with symptoms such as:
      • Digestive: Stomach pain, nausea, vomiting, diarrhea.
      • Respiratory: Coughing, choking, rapid breathing, bluish lips, difficulty breathing.
      • Nervous system: Coma or seizures, trembling limbs, muscle twitching (in face, chest, thighs, arms), muscle weakness followed by paralysis. In severe cases, respiratory paralysis and arrhythmia may occur.
      • Increased secretion: Excess mucus, digestive fluids, sweating, salivation.
    • If poisoning is suspected, caregivers should carefully check the surroundings for suspected toxic substances and call the hospital for proper first aid instructions. When taking the child to the hospital, bring along the suspected toxic substances.
  • First aid instructions for poisoning
    • Call emergency services or quickly transport the child to the nearest medical facility.
    • While waiting for transportation:
      • Bathe or wash with soap and clean water if poisoning occurred through skin or mucosal contact.
      • Let the child rest and monitor for dehydration (thirst, lethargy, dry mouth/nose, reduced urination) due to vomiting or diarrhea, ensuring adequate fluid replacement.
      • Give the child oral rehydration solution (ORS) as needed to maintain water and electrolyte balance.
      • If the child has a high fever, common fever-reducing medications such as paracetamol 10–15 mg/kg/dose every 4–6 hours may be given (maximum 0.5 g/dose and 2 g/day).
      • Temporarily stop giving any suspected food or medication, keep all leftover food, stool, vomit, or used drugs for testing, and report immediately to health authorities.
  • Preventing poisoning in children
    • Drug poisoning
      • Do not buy medicine for children without a doctor’s prescription. Use medication strictly as prescribed for each visit. Do not use old prescriptions, prescriptions for other children, or adult medication for children.
      • Loose tablets should be stored carefully in sealed bottles with clear labels indicating the drug name and expiration date.
      • Keep medication out of children’s sight and reach, preferably in a locked cabinet.
      • Regularly clean the family medicine cabinet and discard expired or damaged medication.
      • Adults should avoid taking medication in front of children as they may imitate.
      • Mothers who are breastfeeding should consult a doctor before taking medication, as some drugs can pass into breast milk and poison the baby.
      • Always know the correct dosage and amount of medication as directed by a doctor, pharmacist, or the drug’s instruction leaflet.
      • Do not give children unknown or unverified medication.
    • Food poisoning
      • Wash hands thoroughly with soap before eating or drinking.
      • Store leftover food and other food items in the refrigerator if not immediately consumed.
      • Cook food thoroughly at the right temperature and store in clean containers.
      • Do not allow children to eat or drink without adult supervision.
      • Do not reuse old food that shows signs of spoilage. Always check expiration dates of packaged food before consumption.
      • Follow proper hygiene procedures in food purchasing, storage, and preparation.
• GELSEMIUM ELEGANS (LÁ NGÓN) POISONING
  • Identifying the Gelsemium elegans plant
    • The plant has hairless stems and branches, with slightly grooved vertical lines on the stem. Leaves are elongated, opposite, pointed, and glossy. Typically, leaves are about 7–12 cm long and 2.5–5.5 cm wide, often growing in clusters at branch tips. Flowers bloom in June, August, and October, with yellow petals (five per flower). The fruit is brown, slender, about 0.5 cm wide, and hairless. Seeds are small and light brown. Young branches have pale green leaves that turn light grayish brown when mature.

• • Symptoms of Gelsemium elegans poisoning
    • Abdominal pain, nausea, discomfort, fatigue, urinary retention, cold skin, sweating, weakness in arms and legs, difficulty moving, and in severe cases, complete muscle paralysis.
    • Dilated pupils leading to light sensitivity, glare, drooping eyelids, and jaw muscle paralysis causing the lower jaw to drop and inability to close the mouth.
    • Weak or slow breathing leading to respiratory failure; slow heartbeat, low blood pressure possibly leading to cardiac arrest; increased tendon reflexes and convulsions.
  • First aid for Gelsemium elegans poisoning
    • If not detected early and promptly treated, death often occurs within 1–7 hours. Therefore, once poisoning is suspected, it is critical to quickly remove the toxin from the body by inducing vomiting: Drink plenty of water and then trigger gag reflex by finger to throat, followed by rapid transfer to the nearest medical facility for gastric lavage, activated charcoal administration, and IV fluids to prevent severe complications and death.
• MUSHROOM POISONING
  • Causes
    • Most mushroom poisonings occur from eating wild mushrooms, often in spring and summer in mountainous areas. The most dangerous species is the Amanita phalloides (green death cap), which looks attractive but is highly toxic and causes most mushroom-related deaths in Vietnam every year.
  • Symptoms of mushroom poisoning
    • Early symptoms usually appear within 30 minutes to 2 hours after eating (maximum 6 hours). Late symptoms appear 6–40 hours after eating (average 12 hours). Severity depends on the mushroom type:
      • Red mushrooms (Amanita muscaria) and white warted mushrooms (Amanita pantherina) cause drowsiness, dizziness, discomfort, hallucinations, delirium, muscle twitching, and spasms.
      • Ink cap mushrooms cause poisoning when consumed with alcohol, leading to facial flushing, sweating, palpitations, rapid heartbeat, chest pain, rapid breathing, difficulty breathing, nausea, vomiting, headache, and low blood pressure.
      • Bell cap mushrooms (Conocybe spp.) cause loss of motor control, hallucinations, delusions, dilated pupils, agitation, and seizures.
      • Green death cap mushrooms cause late-onset symptoms 6–40 hours after ingestion, with severe vomiting, abdominal pain, and diarrhea. These symptoms may subside after 1–2 days, giving a false impression of recovery. However, the toxin continues damaging internal organs, and by days 3–4, jaundice, fatigue, poor appetite, reduced urination, swelling, bleeding, coma, and death may occur.
  • First aid for mushroom poisoning
    • Induce vomiting (mechanical method) within a few hours after ingestion (ideally within the first hour) if the patient is over 2 years old, conscious, and not vomiting excessively.
    • Administer activated charcoal at a dose of 1 g/kg body weight.
    • Provide adequate hydration, preferably with oral rehydration solution.
    • Quickly transport the patient to the nearest medical facility.
    • If the patient is unconscious or seizing, place them on their side.
    • If the patient has weak or absent breathing, perform mouth-to-mouth resuscitation or use available emergency breathing devices.
    • Late-onset mushroom poisoning requires treatment at medical facilities with advanced intensive care (usually provincial level or higher).

4. Electric Shock, Burns

• ELECTRIC SHOCK
  • Electric shock accidents often occur suddenly, either accidentally or due to not being well-versed in safety principles when using electricity. Electric shock can cause burns or, more seriously, nerve damage, cardiac arrest, or even death.
  • Causes
    • Children touching low power outlets or wires they cannot see.
    • Leakage from electrical devices that children accidentally touch.
    • Children playing with kites near power poles or power lines.
    • Taking shelter under a tree during rain.
  • First aid instructions for electric shock
    • Quickly turn off the power source or separate the electrical wire from the victim, or immediately call the police/power company if it is a high-voltage line.
    • When separating the victim from the electrical wire, remain calm and avoid direct contact. Use non-conductive objects to separate the victim from the power line.
    • Provide burn first aid (if any).
    • If the child is unconscious, call emergency services and perform basic first aid.
  • Electric shock prevention
    • Place outlets out of children’s reach; outlets must always have covers (for young children).
    • In homes, schools, and classrooms, power lines and electrical devices must be safe, properly insulated, and regularly inspected.
    • Do not insert objects into outlets, climb power poles, or fly kites where power lines pass.
    • Do not take shelter under large trees during rain to prevent lightning strikes.
    • Teach older children how to use electricity correctly and safely.
• BURNS
  • Definition
    • Burns are injuries to the skin and underlying tissues caused by physical heat, chemicals, radiation, etc. Burns can be fatal or leave severe aftereffects such as loss of mobility or disfigurement.
  • Causes
    • Burns from hot water or hot food.
    • Burns from fire: gasoline, alcohol, gas, vehicle fires, house fires, electric arc sparks, etc.
    • Burns from electricity: high voltage, low voltage.
    • Burns from chemicals: hot lime (alkali burns), acid burns.
    • Burns from hot gases or steam.
    • Burns from direct contact with hot objects.
    • Burns from radiation.
  • Symptoms
    • Mild burns: redness, blistering, skin peeling, causing pain and burning sensation.
    • Severe burns: shock, infection, poisoning, causing death or leaving aftereffects.
  • First aid instructions for burns
    • Quickly remove the burning source.
    • Immerse the burned area in cool water for 20 minutes (if caused by chemicals, rinse repeatedly except for dry chemicals) for mild burns without skin peeling.
    • Cut away clothing, remove jewelry.
    • Prevent shock, keep warm, and transport to a medical facility. NOTE:
    • Do not apply oil, grease, alcohol solutions, or antibiotic creams to burns.
    • Do not puncture blisters in burn wounds.
    • Do not peel skin or remove clothing stuck to the burn.
    • If possible, cover burns with sterile gauze; otherwise, use clean cloth.
    • Since burns release a lot of fluid, place an absorbent cotton layer over the gauze or cloth before using an elastic bandage to wrap the burn.
    • Take the child to a medical facility if the burn is severe.
  • Prevention guidelines
    • Teach children (especially older children) burn prevention skills.
    • Keep potential burn sources (hot water bottles, recently used irons, pots, pans, kettles, etc.) in safe places out of young children’s reach.
    • Keep children away from cooking areas.
    • Ensure safety when using heat or electrical devices.
    • Store chemicals properly with labels.
    • Experiments involving chemicals or electricity must be supervised by teachers and follow proper safety procedures.

5. Animal Bites and Insect Stings

• ANIMAL (DOG, CAT) BITES
  • Animal bites have a high risk of infection and may cause tetanus or rabies (dogs, cats). The aim of first aid is to stop bleeding, minimize infection risk, and care for the wound.
  • Causes
    • Teasing or provoking free-roaming animals (dogs, cats) in homes or residential areas.
    • Rabid dogs or cats.
    • Wild animals attacking children.
  • First aid instructions
    • If bleeding, stop it immediately by applying firm pressure to the wound.
    • Wash the wound with soap and warm water.
    • Dry the wound and bandage it with gauze.
    • Take the child immediately to a medical facility if the wound is large and needs stitching, or if rabies is suspected, for tetanus and rabies vaccinations.
    • Monitor for infection signs:
      • Severe pain.
      • Severe swelling and redness.
      • Swollen lymph nodes at the limb base.
    • Note: In dog or cat bites, children should receive rabies vaccination and the animal should be observed for at least 15 days.
  • Prevention guidelines
    • Teach children not to tease or provoke dogs and cats.
    • Regularly vaccinate household dogs and cats against rabies.
• INSECT STINGS
  • Insect bites are usually mild and can be treated with local care. However, some people allergic to venom (such as bee venom) can experience anaphylactic shock.
  • Causes: Often caused by bee stings, sometimes by centipedes, scorpions, or ants.
    • Symptoms
      • Mild: Pain at the bite site, swelling around the bite/sting.
      • Severe: Generalized hives; difficulty breathing; anaphylactic shock (cold limbs, weak pulse); blood in urine, reduced urination, kidney failure often in early days.
  • First aid for insect stings
    • Most bee stings leave a stinger and venom sac on the skin, except hornets. Remove the stinger by gently scraping or using tweezers, avoiding squeezing with fingers to prevent venom spread.
    • Wash the sting area with soap and warm water.
    • Apply a cold compress to reduce pain and swelling.
    • Take the child to a medical facility if: hives appear; the child feels tired, has cold limbs; passes dark or little urine; or receives more than 10 hornet stings.
  • Prevention
    • Teach children not to disturb beehives, especially in summer.
• SNAKE BITES
  • Except for venomous species, most snakes are harmless. It is important to identify the snake species to inform medical staff for appropriate antivenom treatment.
  • Venomous snakes belong to two families:
    • Elapidae: cobra, king cobra, banded krait, etc.
    • Viperidae: green pit viper, Malayan pit viper.
  • Symptoms of snake bites
    • Quick observation of the bite site helps determine if the bite was from a venomous snake:
      • Severe swelling and pain at the bite site.
      • Bite marks with two fang punctures.
      • Viperidae:
        • Local signs: swelling, bruising, necrosis, and fluid-filled blisters.
        • Blood clotting disorders: skin and mucosal bleeding.
      • Elapidae:
        • Minimal local signs.
        • Systemic signs: dizziness, nausea, difficulty breathing, limb weakness/paralysis.
  • First aid for snake bites
    • Keep the child still and calm.
    • Immobilize the bitten area and keep it lower than the heart to slow venom absorption.
    • Wash the wound with soap and water.
    • Cover the bite with a cool gauze pad to reduce pain and swelling.
    • Quickly take the child to a medical facility to identify the snake and administer appropriate antivenom.
  • Note:
    • All snake bites, even from non-venomous species, should be monitored closely like venomous bites for at least the first 6 hours. Particularly for venomous or suspected venomous bites, first aid should be applied immediately and the child taken quickly to a medical facility.
    • Calm the child to prevent venom spread.
    • Do not apply a tourniquet above the wound as it can cause limb necrosis. Do not cut, suck, or squeeze the wound, as these are ineffective and may cause bleeding, infection, and increased venom absorption.
  • Prevention guidelines
    • Wear high boots and long pants over boots when walking in tall grass or snake-prone areas.
    • Learn to recognize venomous snakes by appearance and habitat.
    • Clear vegetation around the house.
• ROVE BEETLES
  • Identification
    • Rove beetles (also called Paederus beetles, Nairobi flies, etc.) are insects with alternating black and orange-yellow body segments, slender bodies shaped like rice grains, measuring 1–1.2 cm long and 2–3 mm wide; they have 3 pairs of legs, 2 pairs of wings, with the transparent pair folded neatly under short hardened forewings; they can fly and run quickly.
    • They often live in rice fields, decayed grass, gardens, garbage dumps, construction sites, etc. They appear more in the rainy season when humidity is high. They are attracted to light at night and may fly indoors, landing on clothes, towels, beds, blankets, etc.
  • Signs of rove beetle contact
    • Lesions usually appear on exposed skin areas such as the face, arms, and legs.
    • The wound appears as streaks or patches. Initially, red spots appear, then swell into pustules with a yellowish-white depression in the center.
    • If not properly cared for, ulcers and fluid discharge may develop.
    • Usually causes burning pain, itching, and discomfort; in some cases, fever, swollen lymph nodes, or systemic infection may occur.

• • Instructions for handling Paederus (rove beetle) stings
    • Wash the sting area with cool clean water and soap. Wash very gently to avoid scratching or breaking the wound.
    • Quickly apply calamine lotion (available at pharmacies).
    • In the following days, depending on the severity of the sting, some medications may be used as prescribed by a doctor, and calamine lotion can also be applied.
    • If the red rash turns into pustules or blisters, apply zinc oxide ointment or antibiotic ointment.
    • If the sting shows signs of ulceration, infection, or pus discharge, apply 1% methylene blue solution and visit a medical facility for timely examination and treatment.
    • Apply medicine twice a day; before applying, wash the wound with diluted saline solution (available at pharmacies).
  • Instructions for preventing Paederus (rove beetle) stings
    • Keep living spaces clean and well-ventilated.
    • At night, turn off light bulbs with blue or purple light (fluorescent lamps, tube lights, etc.) and use bulbs with red or yellow light (incandescent lamps) instead.
    • Before going to bed, carefully check bedding, pillows, and blankets. Shake clothing before wearing to ensure there are no rove beetles inside.

6. Drowning

• Definition
  • Drowning refers to the process of causing initial respiratory damage due to the airway being submerged in liquid, which may leave aftereffects on the victim or result in death.
• Causes of drowning in children
  • Lack of safety knowledge and skills
    • Children lack the knowledge and skills to assess and recognize drowning risks when participating in daily activities, play, and work in the community. They do not identify safe locations for playing, swimming, or wading, often act spontaneously, and do not have the habit of following safety regulations to prevent drowning.
    • Some children know how to swim, even swim well, but lack safety skills in aquatic environments or do not know safe rescue techniques. There have been many cases where children, even strong swimmers, bravely attempted to rescue friends but drowned themselves.
  • Lack of adult supervision
    • Lack of supervision from relatives: In many cases, for various reasons, children are left unsupervised or wander away from parental/adult supervision, leading to falls into water and drowning.
    • Supervisors lacking capacity: For example, supervisors are younger siblings, elderly grandparents, people with illnesses or mobility difficulties, people with limited cognitive capacity, or those who cannot swim and have no rescue knowledge or skills.
    • Negligent supervisors: Boat operators, swimming area owners, or event organizers failing to comply with regulations when children are near open water or aquatic environments.
  • Hazardous surrounding water environments
    • Surrounding water environments are unsafe: Water jars, basins, tanks, or containers in households are not covered or securely locked; excavated pits are not marked with warning signs or fenced off; well walls are not high enough; swimming pools and beach areas lack lifeguards or have irresponsible ones, and there are no danger warning signs.
    • Water transport vehicles not meeting technical safety standards, lacking safety equipment like life jackets or rescue boats; overloaded vessels transporting children; swimming pools, beaches, and open water areas without supervision or rescue teams; bridges over canals, ditches, rivers, or streams not meeting technical safety requirements.
  • Natural disasters such as storms, floods, and heavy rain are uncontrollable objective factors that also cause child drowning.
  • Anyone can be at risk of drowning, even swimmers. Boys drown more often than girls. High-risk groups include children; non-swimmers; alcohol drinkers; people with epilepsy; deep divers; the overconfident; and sometimes even skilled swimmers or rescuers.
  • According to statistics, about 70% of drowning children could be saved if they receive proper basic first aid immediately at the scene. Without good basic first aid, only 40% survive, even with intensive hospital CPR efforts. Of those saved by hospital CPR, only 70% fully recover, 25% suffer mild neurological damage, and the rest are left severely disabled or in a permanent vegetative state.
• Instructions for handling child drowning cases
  • Rescue the child from the water
    • Call for help if there are others nearby.
      • Quickly seek help from people nearby when seeing a child drowning by shouting or calling.

• • • Rescuing the child from the water:
      • This is the first and most important step. The rescuer must know how to swim and have drowning rescue skills to avoid other risks. There are two methods: indirect rescue and direct rescue. Indirect rescue: Using available rescue tools (lifebuoys, ropes, poles, clothes, floating objects, etc.) to save a conscious drowning child. Depending on the situation, the rescuer chooses the safest and most effective method. Direct rescue: Entering the water to reach the victim. Note that direct rescue should be performed only by trained, certified, physically capable professional rescuers. In some cases, a non-professional but capable person may perform a direct rescue if they can ensure the victim’s and their own safety — for example, when a small child falls into a household water jar, tank, or bucket.
      • When seeing a child fall into a pond bank, ditch, well, canal, or creek and trying to cling to the edge, if within close reach, the rescuer may extend a hand to pull them out.
    • When the drowning person is in shallow water, at chest level of the rescuer (a familiar water area like a home pond or nearby water pit), the rescuer may wade in to grab and pull them ashore.

• • • Children are advised not to perform direct rescues, as they may become drowning victims themselves.
    • Note: Starting cardiopulmonary resuscitation (CPR) immediately is the most important thing you can do to prevent the child from dying.
      • If alone, follow the steps below for two minutes before stopping to call emergency services.
      • If there are others around, while you begin the steps below, have someone call 115 and notify rescue personnel.
      • Check if the child is breathing and conscious.
      • To check for breathing: Place your ear near the child’s mouth and nose. Can you feel their breath on your cheek? Look to see if their chest rises and falls. (Gasping is considered not breathing.) While checking for breathing, you can also call the child’s name to see if they respond.
  • If the child is not breathing, begin CPR
    • Carefully place the child on their back on a firm, flat surface.
    • If neck or head injury is suspected, move the child by keeping the head, neck, spine, and hips aligned.
    • If no neck injury: Tilt the head back and lift the chin to open the airway. If neck injury is suspected, do not tilt the head; just lift the jaw. For infants, be careful not to overextend the head.
    • For rescue breaths: For infants, place your mouth over both the nose and mouth to create a seal. For older children, pinch the nose and cover the mouth with yours.
    • Blow into the child’s mouth for 1 second until their chest rises. Repeat for a second breath.
    • Continue CPR for children.
  • Chest compressions
    • Compression position: Lower half of the sternum, compression-to-breath ratio of 30:2. Press down about 1/3–1/2 of the chest depth. Compression rate: 100–120 per minute (see Basic First Aid).
    • Points to note:
      • Hypothermia often occurs after drowning, especially in children. Therefore, warm the child immediately after removal from the water. Warming methods include:
      • Remove wet, cold clothing
      • Cover with warm blankets
      • Use lamps or heating pads
      • Wrap with electric heating blankets
  • Drowning prevention guidelines
    • Organize community awareness campaigns to prevent child drowning.
    • Educate children (from grade 1) about drowning prevention knowledge and skills and teach safe swimming.
    • Advise caregivers to always watch, manage, and supervise children at all times, everywhere.
    • Eliminate drowning risks for children in the community, family, and school.
    • Public swimming areas must be supervised by trained lifeguards.
    • Household ponds, lakes, and water containers must have covers or fences. Post warning signs at rivers, lakes, and other public water areas.
    • Educate older children to recognize dangerous places with high drowning risks.
    • Promote correct prevention and first aid methods to the public.
    • Organize Basic First Aid classes for the community.

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III. Where to Participate in First Aid Skills Training

An Toàn Nam Việt is one of the reputable and professional organizations in the field of first aid skills training in Vietnam. With an experienced team of instructors, modern equipment, and high-quality training programs, the First Aid Skills Training Center of An Toàn Nam Việt has been and continues to be an ideal destination for those interested in protecting the lives and health of themselves and the community.

By participating in courses at An Toàn Nam Việt, you will learn both basic and advanced first aid skills, from providing aid to people with cardiac arrest, respiratory arrest, poisoning, or injuries, to handling other emergency situations. The training programs are designed flexibly and tailored to suit each learner group, from adults to children, healthcare workers, rescue personnel, and even the general public.

The First Aid Skills Training Center of An Toàn Nam Việt not only helps you acquire the necessary skills to save lives in emergencies but also helps you develop a sense of responsibility for protecting your own life and health, as well as that of those around you. Especially, being trained by experienced and highly specialized instructors of An Toàn Nam Việt will give you confidence and readiness to face any emergency situation in life.

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IV. An Toàn Nam Việt’s Competence in First Aid Skills Training

An Toàn Nam Việt is a reputable and high-quality first aid skills training center in Vietnam today, with training sessions continuously conducted at production workshops, factories, or construction sites nationwide (63 provinces and cities across Vietnam).

First Aid Skills Training License

• An Toàn Nam Việt has been inspected and certified by the Department of Work Safety of the Ministry of Labour – Invalids and Social Affairs and granted a certificate of eligibility to operate in occupational safety and hygiene training. In the training program framework for group 2, there is content on first aid skills training. This further solidifies our capability in first aid skills training.

Materials and Lectures

• Before first aid training materials are included in the first aid training courses, they are reviewed and approved to ensure the lectures are always accurate in knowledge and effective in application.
• The teaching methods of the instructors are standardized according to An Toàn Nam Việt’s teaching standards—methods that first aid training experts have researched and refined during their teaching to achieve the highest knowledge acquisition efficiency for learners.

Facilities

• Controlling classroom factors that affect the training process will increase teaching efficiency and learners’ knowledge acquisition.
• Facilities supporting training courses at our center always meet the standards for spacious classrooms in terms of area, lighting, training equipment, etc.