THE ABCD’S OF FIRST AID

THE ABCD’S OF FIRST AID

First aid

Aims of first aid

The aims of first aid are:

“To preserve life: Saving lives is the main aim of first aid.

To prevent further harm: The person who has experienced the injury must be kept stable, and their condition must not deteriorate before medical services arrive. This may include moving the individual away from harm, applying first aid techniques, keeping them warm and dry, and applying pressure to wounds to stop any bleeding.

Promote recovery: Taking steps to promote recovery may include applying a bandage to a wound.”

How to practice first aid

“The most common term referred to in first aid is ABC. This stands for airway, breathing, and circulation. A fourth step will appear in the emergency procedures for some facilities.”

Airway:

“Make sure the airway is clear. Choking, which results from the obstruction of airways, can be fatal.”

Breathing:

“Once the airways are confirmed to be clear, determine whether the person can breathe, and, if necessary, provide rescue breathing.”

Circulation:

“If the person involved in the emergency situation is not breathing, the first aider should go straight for chest compressions and rescue breathing. The chest compressions will promote circulation. This saves valuable time. In emergencies that are not life-threatening, the first aider needs to check the pulse.”

Deadly bleeding or defibrillation:

“Some organizations consider dressing severe wounds or applying defibrillation to the heart a separate fourth stage, while others include this as part of the circulation step.

Evaluating and maintaining ABC with a patient depends on the training and experience of a first aider. As soon as ABC has been secured, the first aider can then focus on any additional treatments.”

The ABC process must be carried out in that order.

“However, there are times when a first aider might be performing two steps at the same time. This might be the case when providing rescue breathing and chest compressions to an individual who is not breathing and has no pulse.”

It is important to use a primary survey to make sure the scene is clear of threats before stepping in to help:

Danger:

“ Check for dangers to the injured person and yourself. If there is danger, can it be cleared, or can the individual be moved away from further harm? If there is nothing you can do, stand clear, and call for professional help.”

Response:

“Once it is clear that all danger has ceased, check if the patient is conscious and alert, ask questions, and see if you get a response. It is also important to find out whether they respond to your touch and are aware of their pain.”

Airway:

“Check whether the airway is clear and, if not, try to clear it. Have the injured person lying on their back, and then place one hand on the forehead and two fingers from the other hand on the chin. Gently tilt the head back while slightly raising the chin upwards. Any obstructions need to be removed from the mouth, including dentures. Only insert fingers into the mouth of the injured individual if an obstruction is present.”

Breathing:

“Is the individual breathing effectively? The first aider should examine the chest for movement and the mouth for signs of breathing. Afterward, get close to the person to see if air can be felt on the cheek from breathing.

The first aider then needs to carry out a secondary survey, checking for deformities, open wounds, medic alert tags, and swellings.”

If the injured person is breathing safely, carry out a rapid whole-body check for the following:

  • medical alert tags advising of underlying conditions
  • swellings
  • open wounds
  • deformities

This is known as a secondary survey. As soon as this has been completed, place the individual in a recovery position. At this point, the first aider should call for an ambulance.

Recovery position

Even if the individual is breathing but is unconscious, there is still a significant risk of airway obstruction. The recovery position reduces the risk to the patient. A first aider should do the following:

•             “If the individual is wearing glasses, remove them.”

•             “Kneel next to the person, and place the arm nearest to you at a right angle to the body.”

•             “Bring the other arm across the chest. Hold the back of your hand against their nearest cheek.”

•             “With your other hand, hold the thigh furthest from you and pull up the knee. Make sure the foot is flat on the ground.”

  • “Slowly pull down on the raised knee, and roll the body over towards you.”
  • “Move the upper leg slightly, so that the hip and knee are bent at right angles. This makes sure that they do not roll onto their face.”
  • “Gently tilt the head back so that the airway is kept open.”

CPR

There are two main steps in CPR: Applying chest compressions and then providing breaths.

Apply 30 chest compressions:

“The first aider should kneel next to the person who is injured. They should be lying on their back.

For adults, place the heel of one hand in the middle of the chest. Place your other hand on top of the first hand and interlace the fingers.

Push the chest down about 1.5 to 2 inches. If the person is a child aged between 1 and 8 years, compress to a maximum of 1.5 inches with one hand. Let go, and wait for the chest to come back up completely before repeating. Your elbows must remain straight throughout.

Push the breastbone up and down to a depth of about 5 cm about 30 times, at a pulse rate of 100 beats per minute.”

Provide two breaths:

“Make sure the airway is open, and pinch the nose so it closes.

Gently raise the chin upwards with two fingers of your other hand.

Take a deep breath, seal your mouth over that of the person with the injury, and exhale into the airway.”

“You should see the chest rise and fall.

To get another breath, lift your head and breathe in deeply. Perform steps 1, 2, 3, and 4 again.

Repeat the 30 chest compressions followed by the two breaths about five times, and then check for normal breathing. If they are not breathing normally, carry on performing CPR. If breathing restarts as normal, stay with the injured person until help arrives.”

“Chest compressions alone can be lifesavers – the crucial factor is time. Make sure you respond quickly.

It is important not to let your hands bounce when performing chest compressions. Make sure the heel of your hand is touching the chest throughout chest compressions.

You might hear some pops and snaps during chest compressions. These are normal, so do not stop.”

HOME FIRST AID KIT

Home kit: A household first aid kit should include these items:

  • Polysporin antibiotic cream – to apply to simple wounds
  • Nonadhesive pads (Telfa) – for covering wounds and burns
  • Pocket mask for CPR
  • Resealable oven bag – as a container for contaminated articles, can become an ice pack
  • Safety pins (large and small) – for splinter removal and for securing triangular bandage sling
  • Scissors
  • Triangular bandage – as a sling, towel, tourniquet
  • Tweezers – for splinter or stinger or tick removal
  • Adhesive bandages (all sizes)
  • Diphenhydramine (Benadryl) – oral antihistamine for allergic reactions, itching rashes. Avoid topical antihistamine creams because they may worsen the rash in some people.
  • Exam gloves – for infection protection, and can be made into ice packs if filled with water and frozen
  • In case of a medical or trauma related emergency, a list of family member’s medical history, medications, doctors, insurance company, and contact persons should be readily available.
  • Adhesive tape
  • Anesthetic spray (Bactine) or lotion (Calamine, Campho-Phenique) – for itching rashes and insect bites
  • 4″ x 4″ sterile gauze pads – for covering and cleaning wounds, as a soft eye patch
  • 2″, 3″, and 4″ Ace bandages – for wrapping sprained or strained joints, for wrapping gauze on to wounds, for wrapping on splints

TRAVEL FIRST AID KIT

  • Travel kit: A travel first aid kit may contain these items:
  • Adhesive tape
  • 4″ x 4″ sterile gauze pads
  • Antacid – for indigestion
  • Antidiarrheal (Imodium, Pepto-Bismol, for example)
  • Cigarette lighter – to sterilize instruments and to be able to start a fire in the wilderness (to keep warm and to make smoke to signal for help, for examples)
  • Cough medication
  • Dental kit – for broken teeth, loss of crown or filling
  • Exam gloves
  • Small flashlight
  • Ibuprofen (Advil is one brand name); another good choice is naprosyn (Aleve is a brand name)
  • Insect repellant
  • Knife (small Swiss Army-type)
  • Antihistamine cream
  • Antiseptic agent (small bottle liquid soap) – for cleaning wounds and hands
  • Aspirin – for mild pain, heart attack
  • Adhesive bandages (all sizes)
  • Diphenhydramine (Benadryl) – oral antihistamine
  • Book on first aid
  • Thermometer
  • Tweezers
  • Nasal spray decongestant – for nasal congestion from colds or allergies
  • Nonadhesive wound pads (Telfa)
  • Polysporin antibiotic ointment
  • Oral decongestant
  • Moleskin – to apply to blisters or hot spots
  • Pocket mask for CPR (although now, CPR does not have to be mouth to mouth)
  • Safety pins (large and small)
  • Scissors
  • Sunscreen
  • Personal medications (enough for the trip duration and perhaps a couple of extra in case of delays) and items (for example, a cane or knee braces if needed)
  • Phone card with at least 60 minutes of time (and not a close expiration date) plus at least 10 quarters for pay phones and a list of important people to reach in an emergency; cell phone with charger (cell service is not available in may areas, especially remote areas)
  • Plastic resealable bags (oven and sandwich)

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