Basic first aid
Every year thousands of people die or are seriously injured in accidents. Many deaths could be prevented if first aid is given before emergency services arrive.
What to do
If someone is injured you should:
First check that you and the casualty aren't in any danger and if possible make the situation safe. If necessary, dial your countries emergency code for an ambulance when it's safe to do so.
Carry out basic first aid
If a person is unconscious but breathing, and has no other injuries that would stop them being moved, place them in the recovery position until help arrives.
If a person isn't breathing normally after an incident, call an ambulance and start CPR straight away. Use hands-only CPR if you aren't trained to perform rescue breaths.
Below, in alphabetical order, are some of the most common injuries that need emergency treatment and information about how to deal with them:
Anaphylaxis (or anaphylactic shock)
Bleeding
Burns and scalds
Choking
Drowning
Electric shock (domestic)
Fractures
Heart attack
Poisoning
Shock
Stroke
Anaphylaxis
Anaphylaxis (or anaphylactic shock) is a severe allergic reaction that can occur after an insect sting or after eating certain foods. The adverse reaction can be very fast occurring within seconds or minutes of coming into contact with the substance the person is allergic to. During anaphylactic shock, it may be difficult for the person to breathe, as their tongue and throat may swell, obstructing their airway.
Call for an ambulance immediately if you think someone is experiencing anaphylactic shock.
Check if the person is carrying any medication. Some people who know they have severe allergies may carry an adrenaline self-injector (Epi-pen), which is a type of pre-loaded syringe. You can either help the person administer their medication or if you're trained to do so give it to them yourself.
After the injection, continue to look after the person until medical help arrives. All casualties who have had an intramuscular or subcutaneous (under the skin) injection of adrenaline must be seen and medically checked by a healthcare professional as soon as possible after the injection has been given.
Make sure they're comfortable and can breathe as best they can while waiting for medical help to arrive. If they're conscious, sitting upright is normally the best position for them.
Bleeding
If someone is bleeding heavily, the main aim is to prevent further blood loss and minimise the effects of shock.
Firstly call for an ambulance as soon as possible. If you have disposable gloves use them to reduce the risk of any infection being passed on. Check that there's nothing embedded in the wound. If there is, take care not to press down on the object.
Instead, press firmly on either side of the object and build up padding around it before bandaging, to avoid putting pressure on the object itself.
If nothing is embedded apply and maintain pressure to the wound with your gloved hand, using a clean pad or dressing if possible; continue to apply pressure until the bleeding stops. Use a clean dressing to bandage the wound firmly if bleeding continues through the pad, apply pressure to the wound until the bleeding stops and then apply another pad over the top and bandage it in place; don't remove the original pad or dressing, but continue to check that the bleeding has stopped.
If a body part, such as a finger has been severed place it in a plastic bag or wrap it in cling film and make sure it goes with the casualty to hospital.
Always seek medical help for bleeding unless it's minor.
If someone has a nosebleed that hasn't stopped after 20 minutes, go to your nearest accident and emergency (A&E) department.
Burns and scalds
If someone has a mild burn or scald: cool the burn as quickly as possible with cool running water for at least 10 minutes, or until the pain is relieved. Carefully remove any clothing or jewellery, unless it's attached to the skin
If you're cooling a large burnt area, particularly in babies, children and elderly people, be aware that it may cause hypothermia (it may be necessary to stop cooling the burn to avoid hypothermia). Cover the burn loosely with cling film; if cling film isn't available, use a clean, dry dressing or non-fluffy material; don't wrap the burn tightly, because swelling may lead to further injury. Don't apply creams, lotions or sprays to the burn. Always see a doctor/call an ambulance for burns in children, just to get them checked over.
For chemical burns, wear protective gloves, remove any affected clothing, and rinse the burn with cool running water for at least 20 minutes to wash out the chemical. Call an ambulance for immediate medical help.
Choking
The information below is for choking in adults and children over one year old.
Mild choking
If the airway is only partly blocked, the person will usually be able to speak, cry, cough or breathe. In situations like this a person will usually be able to clear the blockage themselves.
If choking is mild encourage the person to cough to try to clear the blockage, ask them to try to spit out the object if it’s in their mouth. Don't put your fingers in their mouth to help them as it could push the object further down. If coughing doesn’t work, start back blows.
Severe choking
If choking is severe, the person won’t be able to speak, cry, cough or breathe, and without help they’ll eventually become unconscious.
To help an adult or child over one year old:
Stand behind the person and slightly to one side. Support their chest with one hand. Lean the person forward so that the object blocking their airway will come out of their mouth, rather than moving further down.
Give up to five sharp blows between the person’s shoulder blades with the heel of your hand (the heel is between the palm of your hand and your wrist).
Check if the blockage has cleared.
If not, give up to five abdominal thrusts (see below).
Abdominal thrusts shouldn't be used on babies under one year old, pregnant women or obese people.
To perform abdominal thrusts on a person who is severely choking and isn’t in one of the above groups:
Stand behind the person who is choking.
Place your arms around their waist and bend them well forward.
Clench one fist and place it just above the person's belly button.
Place your other hand on top of your fist and pull sharply inwards and upwards.
Repeat this up to five times.
The aim is to get the obstruction out with each chest thrust, rather than necessarily doing all five.
If the obstruction doesn't clear after three cycles of back blows and chest thrusts, call for an ambulance and continue until help arrives.
The person choking should always be seen by a healthcare professional afterwards to check for any injuries or small pieces of the obstruction that remain.
Drowning
If it’s safe to do so and you are a strong swimmer, enter the water and pull the casualty to land. If they're not breathing, open the airway and give five initial rescue breaths before starting CPR. If you're alone, perform CPR for one minute before calling for emergency help.
If the person is unconscious but still breathing, put them into the recovery position with their head lower than their body and call an ambulance immediately.
Continue to observe the casualty to ensure they don't stop breathing or that their airway becomes obstructed.
Electric shock
If someone has had an electric shock, switch off the electrical current at the mains to break the contact between the person and the electrical supply.
If you can't reach the mains supply, don't go near or touch the person until you're sure the electrical supply has been switched off. Once the power supply has been switched off, and if the person isn't breathing, call for an ambulance.
Afterwards, seek medical help - unless the electric shock is very minor.
Fractures
It can be difficult to tell if a person has a broken bone or a joint, as opposed to a simple muscular injury. If you're in any doubt, treat the injury as a broken bone.
If the person is unconscious, has difficulty breathing or is bleeding severely, these must be dealt with first, by controlling the bleeding with direct pressure and performing CPR.
If the person is conscious, prevent any further pain or damage by keeping the fracture as still as possible until you get them safely to hospital.
Assess the injury and decide whether the best way to get them to hospital is by ambulance or car. For example, if the pain isn’t too severe, you could transport them to hospital by car. It's always best to get someone else to drive, so that you can deal with the casualty if they deteriorate – for example, if they lose consciousness as a result of the pain or start to vomit.
However, if they’re in a lot of pain and in need of strong painkilling medication, don't move them and call an ambulance. If they have a broken leg, back or neck don't move them but keep them in the position you found them in and call an ambulance.
Don't give the casualty anything to eat or drink, because they may need an anesthetic when they reach hospital.
Heart attack
If you think a person is having, or has had, a heart attack, sit them down and make them as comfortable as possible, and for an ambulance.
Symptoms of a heart attack include:
Chest pain – the pain is usually located in the centre or left side of the chest and can feel like a sensation of pressure, tightness or squeezing
Pain in other parts of the body – it can feel as if the pain is travelling from the chest down one or both arms, or into the jaw, neck, back or abdomen (tummy)
Sit the person down and make them comfortable.
If they're conscious, reassure them and ask them to take a 300mg aspirin tablet to chew slowly (unless you know they shouldn't take aspirin – for example, if they're under 16 or allergic to it).
If the person has any medication for angina, such as a spray or tablets, help them to take it. Monitor their vital signs, such as breathing, until help arrives.
If the person deteriorates and becomes unconscious, open their airway, check their breathing and, if necessary, start CPR. Re-alert the emergency services that the casualty is now in cardiac arrest.
Poisoning
Poisoning is potentially life-threatening. Most cases of poisoning happen when a person has swallowed a toxic substance, such as bleach, taken an overdose of a prescription medication, or eaten wild plants and fungi. Alcohol poisoning can cause similar symptoms.
If you think someone has swallowed a poisonous substance, call for an ambulance to get immediate medical help and advice.
The effects of poisoning depend on the substance swallowed, but can include vomiting, loss of consciousness, pain or a burning sensation.
The following advice is important:
Find out what's been swallowed, so you can tell the paramedic or doctor.
Do not give the person anything to eat or drink unless a healthcare professional advises you to.
Do not try to cause vomiting.
Stay with the person, because their condition may get worse and they could become unconscious.
If the person becomes unconscious while you're waiting for help to arrive, check for breathing and, if necessary, perform CPR.
Don't perform mouth-to-mouth resuscitation if the casualty's mouth or airway is contaminated with the poison.
Don't leave them if they're unconscious because they may roll onto their back, which could cause them to vomit. The vomit could then enter their lungs and make them choke.
If the casualty is conscious and breathing normally, put them into the recovery position and continue to monitor their conscious state and breathing.
Shock
In the case of a serious injury or illness, it's important to look out for signs of shock. Shock is a life-threatening condition that occurs when the circulatory system fails to provide enough oxygenated blood to the body and as a result, deprives the vital organs of oxygen.
This is usually due to severe blood loss but it can also occur after severe burns, severe vomiting, a heart attack, bacterial infection or a severe allergic reaction (anaphylaxis).
The type of shock described here isn't the same as the emotional response of feeling shocked, which can also occur after an accident.
Signs of shock include:
Pale, cold, clammy skin
Sweating
Rapid, shallow breathing
Weakness and dizziness
Feeling sick and possibly vomiting
Thirst
Yawning
Sighing
Seek medical help immediately if you notice that someone has any of the above signs of shock. If they do, you should call for an ambulance, then treat any obvious injuries. Lie the person down if their injuries allow you to and, if possible, raise and support their legs. Use a coat or blanket to keep them warm and don't give them anything to eat or drink.
Monitor the person – if they stop breathing, start CPR and re-alert the emergency services.
Stroke
The FAST guide is the most important thing to remember when dealing with people who have had a stroke. The earlier they receive treatment, the better. Call for emergency medical help straight away.
If you think a person has had a stroke, use the FAST guide:
Facial weaknesses – is the person unable to smile evenly or are their eyes/mouth droopy?
Arm weakness – is the person only able to raise one arm?
Speech problems – is the person unable to speak clearly or understand you?
Time to call for emergency help if a person has any of these symptoms
Meningitis
I’ve not covered Meningitis in this blog as I have previously talked about it. To recap please click on the below link.
First aid training
I highly recommend attending a first aid course. I’ve attended quite a few over the years. In the UK, St John’s ambulance covers everything mentioned above and more.
In Australia, I’ve attended two workshops with Kids first Aid.
Kids first aid offer a free first aid lesson in video format, just like those you'd experience during one of their live first aid workshops.
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