First Aid - Emergency First Aid

Good emergency first aid requires a priority response approach, you take care of the most life-threatening things first, then move to the less critical problems. One of the most common techniques to use is the ABCDEF'S principle;

A = Airway and Cervical Spine
B = Breathing
C = Circulation - bleeding
D = Disability
E = Exposure and examine
F = Freezing (cold injury)
S = Shock

We should always include the "S" for shock, since it may be present in any serious injury or illness.

Is it open? If there is anything obstructing their mouth (i.e. packed snow or blood or the tongue falling back blocking their throat), clear it away. To open the airway, move the lower jaw upward without moving their neck.

Assessment of the CERVICAL SPINE is important. To determine the possibility of injury note how the injury happened, what the victim tells you, if conscious, and carefully feel the back for deformity or tenderness. Immobilize the neck with a cervical collar or improvised collar.

Look, listen and feel for breathing. Remember, they may only live four minutes if victim is not.

Put your ear down next to their lips. Listen for breath, feel it on your ear or cheek, watch chest rise or fall. If victim is not breathing, start rescue breathing immediately.

Does victim have a pulse? The pulse in the neck (carotid pulse) is the easiest to check, because it is strongest and you can usually slip your fingers into the neck area without removing clothing and risking frostbite. If there is no pulse, and you have CPR training, start CPR. If their heart is beating and victim is breathing, then further assess his circulation by checking their nailbed refill.

Blood pressure cannot be estimated easily, but you can determine if a person's blood pressure is low by checking his nailbed refill. Squeeze the victim's fingertip and nail between your own thumb and forefinger, release suddenly, and time how long it take the nail to turn from white to its normal pink colour. If it takes longer than about two seconds, it indicates that blood pressure is low. If hands are severely chilled, this may not be accurate.

Check for SEVERE BLEEDING (wearing latex or surgical gloves if possible) by sliding a hand under the victim, from head to toe, both sides, feeling for the wetness of blood. You must be sure that he is not bleeding badly from a point you cannot see. If he is bleeding badly, you must stop it.

Check level of consciousness. If you suspect a neck or head injury, immobilize the neck immediately with a cervical collar. Feel carefully underneath the victim for any obvious bumps, irregularities, or tenderness in the spine indicating damage. Shock is a life-threatening disability. If the victim shows or is likely to show the signs and symptoms of shock, begin treatment immediately.

If the weather permits, bare as much of the body as possible to look for bleeding and injuries.

Prevent freezing and exposure by keeping the victim warm. Cover them to keep him warm, and get something between them and the snow or the cold ground.

Be sure that their hands and feet are protected. Protect victim from the wind and from moisture as soon as possible.

This complete check should take only a couple of minutes. Now you have done all you can to prevent quick death, and you have time to think about what to do next. These above steps are fairly simple and they do not even require a first aid kit. These steps are probably the most important first aid of all and you are more likely to save a life in the first few minutes.

Emergency scenes usually begin with a lot of confusion as people realize there is an emergency unfolding in front of them; no one knows what to do first, who should be in charge or how they can help. In this situation, the first aider needs to follow a sequence of actions that ensure safe and appropriate first aid is given and everyone's safety is protected. St. John Ambulance first aiders use emergency scene management (ESM) to do this. ESM has four steps:

Scene Survey - take control of the scene, get an idea of what has happened and what is going on, and get things organized so you can start helping any casualties

Primary Survey - assess each casualty for life-threatening injuries or illnesses and give the needed life-saving first aid

Secondary Survey - assess the casualty for injuries or illnesses that are not life threatening and give appropriate first aid; sometimes you don't have to do this

Ongoing Casualty Care - stay with the casualty until medical help arrives and takes over

These steps are always done in the order above, though sometimes you don't carry out the secondary survey.

A well-stocked first aid kit is a handy thing to have. To be prepared for emergencies, keep a first aid kit in your home and in your car.

First aid kits come in many shapes and sizes. You can purchase one or you may also make your own. Some kits are designed for specific activities, such as hiking, camping or boating.

Whether you buy a first aid kit or put one together yourself, make sure it has all the items you may need. Include any personal items such as medications and emergency phone numbers or other items your health-care provider may suggest.

Check the kit regularly. Make sure the flashlight batteries work. Check expiration dates and replace any used or out-of-date contents.

The Red Cross recommends that all first aid kits for a family of four include the following:

• 2 absorbent compress dressings (5 x 9 inches)
• 25 adhesive bandages (assorted sizes)
• 1 adhesive cloth tape (10 yards x 1 inch)
• 5 antibiotic ointment packets (approximately 1 gram)
• 5 antiseptic wipe packets
• 2 packets of aspirin (81 mg each
• 1 blanket (space blanket)
• 1 breathing barrier (with one-way valve)
• 1 instant cold compress
• 2 pair of nonlatex gloves (size: large)
• 2 hydrocortisone ointment packets (approximately 1 gram each)
• Scissors
• 1 roller bandage (3 inches wide)
• 1 roller bandage (4 inches wide)
• 5 sterile gauze pads (3 x 3 inches)
• 5 sterile gauze pads (4 x 4 inches)
• Oral thermometer (non-mercury/nonglass)
• 2 triangular bandages
• Tweezers
• First aid instruction booklet

A smaller kit that includes the following items should be kept inside your car, for example in the space under the front passenger seat of your car:

• Flashlight
• First-aid kit
• Blanket (special "survival" blankets are best)
• Sterile gauze
• Nonstick dressings
• Box of adhesive bandages
• Tape to secure dressings
• 2-3 triangular bandages
• Tweezers
• First aid manual
• Scissors
• Safety pins
• Packaged alcohol
• Wipes
• Instant cold packs
• Reflective rescue blanket

You should keep an emergency survival kit in your vehicle at all times.

Keep one kit in the trunk and make sure you include the following items:

• Shovel
• Traction mats
• Compass
• Warning light or road flares
• Emergency food pack
• Booster cables
• Road maps
• Matches and a "survival" candle in a deep can (to warm hands, heat a drink or use as an emergency light)
• Sand, salt or kitty litter
• Tow chain
• Cloth or roll of paper towels
• Extra clothing and footwear
• Axe or hatchet
• Ice scraper and brush
• Fire extinguisher
• Methyl hydrate (for fuel line and windshield de-icing)