PERSONAL SAFETY FOR THE FIRST AIDER

• Protecting both yourself and the injured person from infection and further harm is key. This involves preventing the spread of germs to the injured individual and avoiding catching infections from them.
• This is crucial because bloodborne illnesses such as hepatitis B and HIV can be transmitted through contact with bodily fluids, including during mouth-to-mouth resuscitation. The risk increases if infected blood enters your system via a cut.
• Always prioritize your own safety; avoid placing yourself in danger by attempting risky rescues in hazardous conditions.

Ways to Reduce Infection Risk:

• Wash your hands thoroughly and use disposable, latex-free gloves. If gloves aren’t available, have the injured person handle their own wound or cover your hands with clean plastic bags.

• Cover any cuts on your hands with waterproof dressings.

• Wear a plastic apron if handling significant amounts of body fluids and use protective eyewear.

• Dispose of all waste materials safely.

• Avoid touching the portion of the dressing that will come into direct contact with the wound.

• Refrain from breathing, coughing, or sneezing over an open wound while providing treatment.

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How to Observe a Casualty:

• Every injury and illness presents itself with unique characteristics that can aid in diagnosis. These indicators, helping to identify the problem, are classified into signs and symptoms. Some will be obvious, but others might be missed unless you conduct a thorough examination from head to toe.
• Examine a conscious person in the position they are found, ensuring any visible injuries are supported comfortably. For an unconscious person, the first step is to open and secure their airway.
• Use your senses: sight, touch, hearing, and smell. Be quick and attentive but also thorough; do not rush or make assumptions. Ask the injured person to describe any feelings caused by touch during the examination. While handling them gently, your touch should be firm enough to feel any swelling, irregularities, or tender areas.

What to Look For:

Symptoms:These are sensations the injured person experiences and can describe to you. You might need to ask questions to determine if they are present.

• Ask a conscious person if they are experiencing any pain and precisely where it is located. Examine that area closely and then any other sites where pain is reported. Intense pain in one location can sometimes hide a more serious, but less painful, injury elsewhere.
• Other helpful symptoms include nausea, dizziness (loss of balance), sensations of heat or cold, weakness, and altered sensation.
• All reported symptoms should be evaluated and confirmed by looking for physical signs of injury or illness.

Signs:

• These are details you discover using your senses: sight, touch, hearing, and smell, often during the examination.
• Common signs of injury include bleeding, swelling, tenderness, or deformities. Frequently observed signs of illness include pale or red skin, sweating, elevated body temperature, and a rapid pulse.
• Many signs are immediately apparent, while others might only be found through a detailed physical examination.
• If the person is unconscious, your assessment may rely solely on the circumstances of the incident, information from bystanders, and the signs you observe.

Emergencies:

An emergency is a sudden and potentially life-threatening situation requiring immediate medical intervention.

Being Ready for an Emergency:

• Being prepared for unexpected emergencies allows you to ensure care begins promptly for yourself, your family, and others.

You can prepare for most emergencies by taking these steps now:

• Keep essential information about yourself and your family readily available, such as addresses, ages, medical conditions, allergies, prescriptions, and doctor’s contact details.
• Keep the following in mind for emergencies:
• Learn and maintain proficiency in first aid techniques, including cardiopulmonary resuscitation (CPR).
• Ensure a first aid kit is easily accessible in your home, workplace, recreational areas, and vehicles. Keep the kit in a dry location and inspect and replenish it regularly to ensure items are always ready for use.

Goals of Emergency Medical Care:

• When providing care in an emergency, numerous critical decisions must be made. These decisions require sound judgment based on understanding the condition causing the emergency and its effects on the individual.

The primary goals of emergency medical care are:

• To save life.
• To prevent worsening of the condition before more definitive treatment can be given.
• To help the person return to a functional state.

Upon arrival at an emergency department, the initial goal is to determine the extent of the injury or illness and prioritize treatment. These priorities are based on the immediate threat to the person’s life. Injuries or conditions affecting vital functions (blocked airway, severe bleeding) take precedence. Typically, injuries to the face, neck, and chest that impair breathing have the highest priority. Every member of the emergency team must consider the patient’s overall condition, as the body functions as an integrated system.

Principles of Emergency Management:

The following principles apply to the emergency care of any patient:

• • Ensure a clear airway and provide adequate breathing support, using resuscitation methods if needed.
  • Assess for chest injuries that may obstruct breathing.
  • Control bleeding and its consequences.
  • Evaluate and restore heart function.
  • Prevent and treat shock, maintaining or restoring effective circulation.
  • Conduct a rapid initial and ongoing physical examination, as the condition of an injured or seriously ill person can change.
  • Assess the person’s ability to follow commands, evaluate pupil size and reaction, and motor responses.
    Initiate electrocardiogram (ECG) monitoring, if appropriate.
  • Stabilize suspected cervical spine fractures in individuals with head injuries.
  • Protect wounds with sterile dressings.
    Check for medical alert tags or similar identification indicating allergies.
  • Begin a record of the person’s vital signs, blood pressure, neurological status, etc., to guide decision-making.

Assessing an Injured Person:

This involves quickly determining what is wrong, but your safety is the first priority. Ensure the area is safe before approaching.

Objectives of Assessment:

• To assess the situation quickly and calmly while ensuring the safety of yourself and the injured person.
• To identify and treat any immediate life-threatening injuries.
• To conduct a more detailed assessment of all injuries.
• To seek appropriate help for emergencies or suspected serious injuries or illnesses.
• To be aware of your own needs and limitations.

There are two main methods of assessment:

1. Primary survey.
2. Secondary survey.

1. Primary Survey:

This is a rapid initial assessment to identify and treat conditions that pose an immediate threat to life. Address life-threatening issues in the following order, using the ABC principle:

Airway: Is the airway open and clear? If not, open and clear it. An obstructed airway will prevent breathing, leading to oxygen deprivation and ultimately death.
Breathing: Observe the rate and quality of breathing (slow, fast, absent, or gasping).
Circulation: Assess the pulse for rate, rhythm, strength, and quality. Observe for any severe bleeding.
Disability: Briefly assess the level of consciousness.
Exposure: Briefly expose the body to look for other obvious injuries, while preventing heat loss.

Is the person breathing normally? Look, listen, and feel for breaths. Blueness of the tongue, lips, earlobes, and nails indicates a lack of oxygen. If not breathing, call for emergency assistance and begin chest compressions with rescue breaths (Cardiopulmonary Resuscitation).

Circulation: Is the person bleeding severely? This requires immediate attention as it can lead to shock, a life-threatening condition.

Pallor: Note any paleness or unusual whiteness of the tongue, inner eyelids, and nails, which can indicate the severity of bleeding. Control any bleeding and treat the person to minimize the risk of shock. Look for bleeding from any part of the body and any swelling. Note: If life-threatening conditions are managed or are not present, proceed with a secondary survey.

2. Secondary Survey:

This is a more detailed examination to identify other injuries or conditions after the primary survey is complete. It involves :

(a) Head-to-Toe Examination:

(i) Head: Observe skin color, wounds, confusion, and facial symmetry. Check pupil size and reaction. Assess the level of consciousness. Gently feel for any depressions in the skull. Check ears and nose for any fluids or blood. Examine the mouth for bleeding, dentures, or foreign objects.
(ii) Neck: Observe and gently feel for any areas of tenderness or deformities.
(iii) Chest: Feel the collarbones and shoulders. Look for wounds and observe if the chest expands normally during breathing. Gently press on the sternum and ribs to check for any instability.
(iv) Arms: Feel along the entire length for pain, wounds, deformities, and sensation. Ask about any pain, tingling, numbness, or difficulty moving.
(v) Abdomen: Look for any swelling or wounds. Gently feel for any rigidity or tenderness.
(vi) Pelvis: Gently feel the hip bones and pubic bone for any pain. Observe for any loss of bladder or bowel control.
(vii) Spine: Gently feel for any tenderness, wounds, or deformities.
(viii) Legs: Feel along the entire length for pain, deformities, and sensation.

(b) History Taking:

Ask what happened.
Ask about any existing medical conditions.
Ask about any medications the person is currently taking.
Ask if the person has any allergies.
Ask when the person last ate or drank something.

Note: Use the acronym SAMPLE as a reminder during assessment:

Symptoms
Allergies
Medications
Past medical history
Last meal
Events leading to the incident.

(c) Symptoms:

These are the sensations the injured person feels and describes to you, for example, pain.

(d) Signs:

These are indicators you can detect by observing and feeling the injured person, such as swelling, bleeding, discoloration, deformities, and unusual smells. Use all your senses to look, listen, feel, and smell.

Important Considerations When Helping Someone:

• Make eye contact, but look away occasionally to avoid staring.
• Speak in a calm, confident voice that is loud enough to be heard but not shouting.
• Speak clearly and not too quickly.
• Use simple instructions with short sentences and easy-to-understand words.
• Use nods and verbal cues to show you are listening.
• Check that the person understands what you are saying.
• Do not interrupt the person, but acknowledge what they tell you by summarizing to show understanding.
• Be aware of any potential risks.
• Build and maintain the person’s trust.
• Call for appropriate help.

Positioning an Injured Person:

• Different situations require different positions:

Recovery Position: Used for unconscious individuals who are breathing and have a heartbeat.

Advantages: Maintains an open airway. Prevents the tongue from blocking the throat. Allows fluids to drain from the mouth.

How to Position: Place the person on their side. Turn their head to one side (no pillow).

Bend the leg and arm on the side the head is turned towards. Extend the other arm. Loosen tight clothing. Remove any dentures.

Note: Avoid the recovery position if there are suspected fractures of the limbs or spine, or if the person is in a confined space.

Prone Position: The person lies on their stomach with their head turned to one side. A pillow may be placed under the head. Used for patients with burns on their back.

Fowler’s Position/Sit-up Position: Used when a person has difficulty breathing. They are placed in a sitting position supported by pillows.

Dorsal Recumbent Position: The person lies on their back with a pillow under their head (unless a spinal injury is suspected). Used for examinations. Without a pillow, it’s used for suspected spinal fractures and during CPR.

Positioning in Shock: Lay the person on their back with their head turned to one side. Raise their legs slightly with pillows to improve blood flow to the heart, unless there are unsplinted lower limb fractures.