First aid advice

Before entering any first aid situation you should always check for any dangers/hazards that could pose a risk to either yourself or other first responders.

There are a whole range of hazards that a first aider could face, including:

> Moving vehicles
> Fire & smoke
> Electricity
> Chemicals (and their fumes)
> Other people
> Slip/trip hazards

You should ensure the scene is safe before administering first aid. You can use common sense steps such as asking bystanders to direct traffic, switching off running vehicles and opening windows to provide ventilation.

If the scene is too dangers to enter then don't. If you end up as a casualty, you may delay help getting to the other injured people!

Free online first aid training

There is a handy mnemonic which you can use if you find someone collapsed who you suspect is unconscious - DR ABC

Danger: Check for any dangers to yourself (see above).

Response: Check for a response from the casualty. Shout loudly and gently shake them on the shoulders.

Airway: Kneel by the casualty's head and open their airway by tilting their head backwards

Breathing: Place your ear above their mouth and look at their chest. Check for normal breathing (regular breaths) for up to 10 seconds.

Compressions: If the casualty is not breathing, you should call an ambulance and start Cardiopulmonary Resuscitation (CPR)

If someone's heart stops then they will quickly die if CPR is not performed promptly.

CPR involves doing chest compressions and rescue breaths. By doing chest compressions you are 'taking over' the role of the casualty's heart and keeping blood flowing around the body. By doing rescue breaths you are doing the work of their lungs to ensure a good supply of Oxygen.

Once you've found someone isn't breathing (see above), you should start CPR by administering 30 chest compressions. Interlock your hands and place them in the middle of the person's chest and push down 30 times. You should aim for a depth equal to a third the depth of their chest.

After 30 chest compressions, you should give 2 rescue breaths. Tilt the casualty's head backwards, make a seal over their mouth and breath in twice. Each breath should only last about one second so as not to over inflate their lungs.

Continue doing this cycle of 30 chest compressions to 2 rescue breaths until:

> A defibrillator arrives
> The casualty shows signs of life: coughing, breathing etc.
> You are asked to stop by a healthcare professional (ambulance crew etc.)
> You become too exhausted to continue
> The situation suddenly becomes too dangerous

Unfortunately CPR is very unlikely to revive the person. By doing chest compressions, you are taking over the job of the casualty's heart (which has stopped) by forcibly compressing it. In effect, you are acting as a life-support machine for the person.

In order for the heart to be restarted, it may require an electrical shock from a defibrillator or drugs given by a paramedic/doctor. CPR on its own is very unlikely to restart someone's heart.

However, good quality chest compressions will significantly increases the chance of the defibrillator being able to restart the heart.

Click for more information on CPR | Take our CPR quiz

The average person has around 8 - 10 pints of blood in their body. Our blood is vital to life. It carries Oxygen to all the cells in our body and removes waste products such as Carbon Dioxide. Blood is carried around the body in three main types of blood vessel:

Arteries: Carry blood under high pressure away from the heart.

Veins: Carry blood under low pressure back to the heart.

Capillaries: Carry blood to the individual cells and tissues, very small and very low pressures.

Damaging an artery (and even a vein) can lead to severe blood loss if the bleeding is not controlled. A severe bleed is a medical emergency which requires prompt first aid action in order to stop the bleeding and access emergency help.

Treatment for a severe bleed

You can use the mnemonic PEEP to remember how to deal with a severe bleed.

Position: Ask the casualty to sit on the floor if possible.

Expose & examine: Quickly find and examine the wound(s) for any embedded objects.

Elevation: If the injury is to a limb, elevate above the level of the heart.

Pressure: Ask the casualty to apply firm direct pressure over the wound (if the casualty is unable to do this, you will have to do it for them).

If possible, you should avoid coming into direct contact with another person's blood. Several infections can be carried in blood, and whilst the risk may be minimal you should always take precautions. This could involve wearing disposable gloves, or using clothing/tea-towels/plastic bags to create a barrier between your hands and the wound.

Once you have controlled the bleeding, call for an ambulance. Remember, the emphasis should be on applying and maintaining direct pressure over the wound as this will help stop significant blood loss.

If there is an object in the wound (such as a piece of glass), then you should not remove it. Removing the object may cause internal damage and further blood loss. Instead you should apply firm direct pressure around the wound, taking care not to move the object.
What happens if someone looses too much blood?

If someone looses too much blood, they will go into a condition known as "shock". Our body can cope with a small amount of blood loss (normally around a pint), this is why giving blood is perfectly safe. However, if you loose too much blood your body's cells & tissues are deprived of oxygen - this is a medical condition known as shock.

If someone is going into shock, they may show some of the following signs & symptoms:

> Pale, cold clammy skin
> Dizziness and confusion
> Weak fast pulse
> Rapid breathing
> Thirst
> Nausea and vomiting
> Reduced level of alertness/sleepy

You should suspect shock in any casualty who has lost a significant amount of blood.

The treatment for shock is to lie the person down, with their legs raised. This will increase blood flow to the vital organs (heart, lungs, brain etc.). An ambulance should be called if it hasn't already.

Don't give the person anything to eat or drink as this may cause them to be sick. If they go unconscious, you should check that they are still breathing and roll them onto their side.

Need a first aid manual?

Broadly, choking occurs when an object blocks our airway (the tube that takes air from our mouth/nose to our lungs - known as the trachea). An object can fully block or partially block this tube.

Some common signs that someone is in distress include:

> Clutching their chest and neck
> Possibly unable to speak
> Making attempts to breath which may be silent
> Coughing
> Red face, obvious anxiety

Generally, if someone can cough and speak then their airway is only partially blocked, in this case you should simply encourage them to cough and support them.

However, the real danger lies in someone who is unable to cough, speak or make any sounds. This means their airway is fully blocked. In this case you should administer back slaps and the Heimlich Maneuver.

Firstly, try to dislodge the object by delivering back slaps. Hit the person hard on the back in-between their shoulder blades. You should try this up to 5 times.

If this doesn't work then you should attempt the Heimlich Maneuver.

Step 1: Position yourself behind the patient.

Step 2: Pass your arms around in front of the person, make a fist with one hand and place this just below their belly button.

Step 3: With the help of the other hand, pull your fist sharply inwards and upwards.

Step 4: Check to see if the object has dislodged. If it hasn't then keep trying.

If this combination of back slaps and the Heimlich Maneuver doesn't work, ensure an ambulance has been called for the person and continue helping until the emergency services arrive. Remember to stay calm at all times and try to reassure the casualty.

1) Know the correct number! Whilst you may know the number for your country, if you go abroad make sure you find out the correct number to contact the emergency services. In Europe, you can use 112 which is the European Emergency number and will work in any European country.

2) Know where you are. The ambulance service will need quite detailed information (ie, roadname and town) in order to pinpoint your exact location. This isn't always easy, especially if you are in a remote or unfamiliar area. If you don't know where you are, then try to describe your location (using landmarks, last junction etc.). Some motorways in the UK have driver location sides. If you are in a remote area then a grid reference may also be useful.

3) Give a concise description of what has happened (high speed road accident, car has hit a lamppost) including details of casualties (one casualty, unconscious but breathing) and any other relevant information such as dangers & hazards as these may require other emergency services to attend. If the situation is volatile (a fight, robbery etc.) then make sure you tell the ambulance service so that they can inform the police.

4) Speak slowly and clearly. Follow any instructions the calltaker gives you and answer their questions. Some may offer simple first aid advice over the phone.

5) Don't hang up until asked to. In some cases the operator will stay on the line until the ambulance arrives.

6) Finally, before you call, make sure the situation warrants an emergency ambulance. Hoax and inappropriate calls can tie up valuable resources. Consider whether another service could deal with your situation. In the United Kingdom you can call NHS Direct for free medical advice over the phone - 0845 4647.

Remember, calls to the emergency services are normally free so you don't require any credit. In addition, many mobile phones allow you to make an emergency phone call without a sim card or even when the keypad has been locked.