OsteoBlog: First Aid Series 1-The Basics
I wanted to write some articles covering the basic core concepts of first aid.
More and more people are now aware of what to do in an emergency and there are defibrillators in phone booths and on the walls of public buildings.
This is positive and we are heading in the right direction, however, there are still plenty of confused and ill informed members of the public out there or people who have largely forgotten what they were taught, due to under use of skills (use it or lose it)!
The information here comes from my extensive experience as a paramedic working in central London for over 22 years.
I have taught numerous first aid courses to a wide range of people and try to keep things light hearted whilst maintaining serious undertones.
So, just to reiterate, these words are not a replacement for enrolling onto a proper first aid course where you get to roll around on the floor and play with kit in the presence of a qualified instructor. They are meant to give the basics so that you may save a life or improve an outcome the next time something dreadful happens.
The main principle of first aid echo’s what is taught to trainee doctors:
First, do no harm.
All anyone can ask of you is to act within your skill level, get help, reassure the patient, treat what you can and try to prevent the condition from worsening.
The priority for any first responder is to ensure your own safety. A dead/injured first aider is not much help and just gives someone else more work to do!
First aid training is full of mnemonics, and the most important one is the first one we learn: DR ABC
D is for Danger (check all around the patient, and underneath them)
R is for responsiveness of patient (are they awake or unconscious)
A is for airway (open it and check for obstructions)
B is for breathing (regular and effective)
C is for circulation (pulse check & arrest any major bleeding with pressure)
In a resuscitation situation, we say that if there is no 'B' then there is no 'C', and so CPR can begin without wasting time trying to find a pulse. Every second counts, so do all the above checks within seconds to establish the status of the patient.
Getting help by dialling 999, should be an early priority. You can always cancel the ambulance by calling back, if it is not required. So......
Approach patient if safe
Shake and shout "can you hear me" in both ears
Tilt head back slightly and lift chin (see pic below)
Look in mouth to check for and remove foreign bodies
Look, listen and feel for breathing by holding your ear next to their mouth and looking down the chest (10 seconds max see pic below)
If the patients lips are blue then they are not breathing effectively
If they have regular breaths with a good facial colour then you can check their pulse for rate, rhythm and strength
So, if the patient is breathing and has a pulse, you next need to assess what is wrong and why they have collapsed. Leave the patient on their back unless they start to vomit or their breathing becomes noisy. In this case you must support the head and roll them onto their side to maintain a clear airway. You can leave a patient in this position if you need to leave the scene to get help or there are other patients to deal with.
See the pic below for the recovery position...
You can now do a quick head to toe check of injuries....
Look for bleeding, bruising, deformity in limbs, foreign bodies sticking out, unequal pupils, blood from ears or nose.
Check the neck and wrist for medic alert jewellery which may tell you which major illnesses the patient suffers with.
Cover any wounds as best you can and stop bleeding with direct pressure.
Keep the patient warm, ask bystanders if they saw what happened and prepare to hand over to emergency services personnel.
Constantly reassess ABC's to check the patients status hasn't changed.
If the patient regains consciousness, keep them calm and reassure them that help is on the way.
Remember, the last sense to go is hearing, so keep talking to your patient as they may be able to hear you, even though they are not fully conscious.
Resources: www.resus.org.uk The UK resuscitation guidelines.
We will look at resuscitation of the patient in cardiac arrest with CPR for adults and children.
As always for osteopathy in High Wycombe and beyond, call Lucy from OsteoFusion on 07833 321604 or visit www.osteofusion.co.uk
Thanks for reading.