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FIRST AID

First aid - the care given before emergency medical help arrives - can literally mean the difference between life and death. But knowing the correct thing to do if someone has a nosebleed or cut is also important.

First aid is based on knowledge, training and expertise. A first aider will have completed a practical training course under the supervision of a recognised first aid organisation, such As Cambrian Independent Ambulance Service Ltd. HSE Approval Number F0005/97

If you're present at the scene of an accident, or during a medical emergency, you need to go through the following stages:

Assess the situation

 Assess the casualties

A quiet casualty may be an indication that the person is unconscious. Quiet casualties should always be your first priority. Do not allow yourself to become distracted from your assessments by screaming casualties; they are screaming therefore they are breathing, so they go further down the list of who to treat first.

 Further assistance to casualties

First aid is the action in an emergency prior to the arrival of somebody else more medically qualified.

A blocked airway can kill someone in three to four minutes, but it can take more than eight minutes for an ambulance to arrive. So a simple procedure such as opening someone's airway can save their life while they're waiting for emergency medical help.

The latest government figures, from 2002, estimate 2.7 million people in the UK went to A&E because of an accident in their home.

Of these, 910,000 were aged under 16.

Sadly, almost 4,000 people in England and Wales died because of accidents in or around their home in 2004, according to the Office for National Statistics.

This means you're more likely to give first aid to someone you know than a stranger. Knowing what to do will allow you to react rapidly if an accident does happen.

Top ten home accidents and injuries

Falls (1,248,000)

Strikes and collisions (530,000)

Cuts and tears (230,000)

Foreign bodies (128,000)

Acute overexertion, for example moving furniture (90,000)

Burns, scalds (84,000)

Pinching or crushing injuries (79,000)

Bites, stings (72,000)

Puncture wounds (54,000)

Suspected poisonings (33,000)

Top ten first aid misconceptions

You should put butter or cream on a burn. The only thing you should put on a burn is cold water - keep the butter for cooking.

If you can't move a limb, it must be broken/If you can move a limb, it can't be broken. The only accurate way to diagnose a broken limb is to x-ray it.

The best way to treat bleeding is to put the wound under a tap. If you put a bleeding wound under a tap you wash away the body's clotting agents and make it bleed more.

Nosebleeds are best treated by putting the head back. If you put the head back during a nosebleed, all the blood goes down the back of the airway.

A tourniquet is the best way to treat serious bleeding. It's harmful to stop the blood flow to a limb for more than 10-15 minutes.

If someone has swallowed a poison you should make them sick. If you make someone sick by putting your fingers in their mouth, the vomit may block their airway.

If you perform CPR on someone who has a pulse you can damage their heart. The evidence is that it isn't dangerous to do chest compressions on a casualty with a pulse.

You need lots of training to do first aid. You don't - what you mostly need is common sense. You can learn enough first aid in ten minutes to save someone's life.

You need lots of expensive equipment to do first aid. You don't need any equipment to do first aid, there are lots of ways to improvise anything you need.

 Remember: Anyone can save a life

 History

The earliest instances of recorded first aid were provided by religious knights, such as the Knights Hospitaller, formed in the 11th century, providing care to pilgrims and knights, and training other knights in how to treat common battlefield injuries. The practice of first aid fell largely in to disuse during the High Middle Ages, and organized societies were not seen again until in 1859 Henry Dunant organized local villagers to help victims of the Battle of Solferino, including the provision of first aid. Four years later, four nations met in Geneva and formed the organization which has grown into the Red Cross, with a key stated aim of "aid to sick and wounded soldiers in the field". This was followed by the formation of St. John Ambulance in 1877, based on the principles of the Knights Hospitaller, to teach first aid, and numerous other organization joined them, with the term first aid first coined in 1878 as civilian ambulance services spread as a combination of 'first treatment' and 'national aid' in large railway centres and mining districts as well as with police forces. First aid training began to spread through the empire through organisations such as St John, often starting, as in the UK, with high risk activities such as ports and railways.

Many developments in first aid and many other medical techniques have been driven by wars, such as in the case of the American Civil War, which prompted Clara Barton to organize the American Red Cross. Today, there are several groups that promote first aid, such as the military and the Scouting movement. New techniques and equipment have helped make today’s first aid simple and effective.

Aims

The key aims of first aid can be summarised in three key points:

First aid training also involves the prevention of initial injury and responder safety, and the treatment phases.

Key skills

Certain skills are considered essential to the provision of first aid and are taught ubiquitously. Particularly, the "ABC"s of first aid, which focuses on critical life-saving intervention, must be rendered before treatment of less serious injuries. ABC stands for Airway, Breathing, and Circulation. The same mnemonic is used by all emergency health professionals. Attention must first be brought to the airway to ensure it is clear. Obstruction (choking) is a life-threatening emergency. Following evaluation of the airway, a first aid attendant would determine adequacy of breathing and provide rescue breathing if necessary. Assessment of circulation is now not usually carried out for patients who are not breathing, with first aiders now trained to go straight to chest compressions (and thus providing artificial circulation) but pulse checks may be done on less serious patients.

Some organizations add a fourth step of "D" for Deadly bleeding or Defibrillation, while others consider this as part of the Circulation step. Variations on techniques to evaluate and maintain the ABCs depend on the skill level of the first aider. Once the ABCs are secured, first aiders can begin additional treatments, as required. Some organizations teach the same order of priority using the "3Bs": Breathing, Bleeding, and Bones (or "4Bs": Breathing, Bleeding, Breaks, and Burns). While the ABCs and 3Bs are taught to be performed sequentially, certain conditions may require the consideration of two steps simultaneously. This includes the provision of both artificial respiration and chest compressions to someone who is not breathing and has no pulse, and the consideration of cervical spine injuries when ensuring an open airway.

Preserving life

In order to stay alive, all persons need to have an open airway - a clear passage where air can move in through the mouth or nose through the pharynx and down in to the lungs, without obstruction. Conscious people will maintain their own airway automatically, but those who are unconscious (with a Glasgow Coma Scale (GCS) of less than 8) may be unable to maintain a patent airway, as the part of the brain which automatically controls breathing in normal situations may not be functioning.

If the patient was breathing, a first aider would normally then place them in the recovery position, with the patient leant over on their side, which also has the effect of clearing the tongue from the pharynx. It also avoids a common cause of death in unconscious patients, which is choking on regurgitated stomach contents.

The airway can also become blocked through a foreign object becoming lodged in the pharynx or larynx, commonly called choking. The first aider will be taught to deal with this through a combination of ‘back slaps’ and ‘abdominal thrusts’.

Once the airway has been opened, the first aider would assess to see if the patient is breathing. If there is no breathing, or the patient is not breathing normally, such as agonal breathing, the first aider would undertake what is probably the most recognized first aid procedure - Cardiopulmonary resuscitation or CPR, which involves breathing for the patient, and manually massaging the heart to promote blood flow around the body.

Promoting recovery

The first aider is also likely to be trained in dealing with injuries such as cuts, grazes or broken bones. They may be able to deal with the situation in its entirety (a small adhesive bandage on a paper cut), or may be required to maintain the condition of something like a broken bone, until the next stage of definitive care (usually an ambulance) arrives.

Training

Much of first aid is common sense. Basic principles, such as knowing to use an adhesive bandage or applying direct pressure on a bleed, are often acquired passively through life experiences. However, to provide effective, life-saving first aid interventions requires instruction and practical training. This is especially true where it relates to potentially fatal illnesses and injuries, such as those that require cardiopulmonary resuscitation (CPR); these procedures may be invasive, and carry a risk of further injury to the patient and the provider. As with any training, it is more useful if it occurs before an actual emergency, and in many countries, emergency ambulance dispatchers may give basic first aid instructions over the phone while the ambulance is on the way.

Training is generally provided by attending a course, typically leading to certification. Due to regular changes in procedures and protocols, based on updated clinical knowledge, and to maintain skill, attendance at regular refresher courses or re-certification is often necessary. First aid training is often available through community organizations such as the Red Cross and St. John Ambulance, or through commercial providers  such as Cambrian Independent Ambulance Service Ltd, who will train people for a fee. This commercial training is most common for training of employees to perform first aid in their workplace. Many community organizations also provide a commercial service, which complements their community programmes.

Australia

In Australia, Nationally recognized First Aid certificates may only be issued by Registered training organisations who are accredited on the National Training Information System (NTIS). Most First Aid certificates are issued at one of 3 levels:

Other courses outside these levels are commonly taught, including CPR-only courses, Advanced Resuscitation, Remote Area or Wilderness First Aid, Administering Medications (such as salbutamol or the Epi-Pen) and specialized courses for parents, school teachers, community first responders or hazardous workplace first aiders. CPR Re-accreditation courses are sometimes required yearly, regardless of the length of the overall certification.

Canada

In Canada, first aid certificates are awarded by one of several organizations including the Red Cross, the Lifesaving Society, St. John Ambulance, the Heart and Stroke Foundation, and Ski Patrol. Workplace safety regulations vary depending on occupation. Many workplaces opt to have their employees trained in Standard First Aid (see below).

CPR certification in Canada is broken into several levels. Depending on the level, the lay person will learn CPR and choking procedures for adults, children, and infants.

CPR H.C.P. (Health Care Professional) also provides training on artificial respiration, the use of bag valve masks, and suction. This level of qualification is usually not offered to the general public.

Ireland

In Ireland, the workplace qualification is the Occupational First Aid Certificate. The Health and Safety Authority issue the standards for first aid at work and hold a register of qualified instructors, examiners and organisations that can provide the course. A FETAC Level 5 certificate is awarded after passing a three day course and is valid for two years from date of issue. Occupational First Aiders are more qualified than Cardiac First Responders (Cardiac First Response and training on the AED is now part of the OFA course) but less qualified than Emergency First Responders but strangely Occupational First Aid is the only one of the three not certified by PHECC. Organisations offering the certificate include, Ireland's largest first aid organisation, the Order of Malta Ambulance Corps, the St John Ambulance Brigade, and the Irish Red Cross. The Irish Red Cross also provides a Practical First Aid Course aimed at the general public dealing primarily with family members getting injured. Many other (purely commercially run) organisations offer training.

The Netherlands

In The Netherlands first aid training and certification for lay persons are provided mostly by specialised (commercial) first aid training companies or volunteers of the "Dutch Red Cross" and the foundations "Het Oranje Kruis" and "LPEV". They offer a variety of levels in first aid training, from basic CPR to First Responder. Medical first aid must be provided by certified ambulance crews, physicians and in hospitals.

United Kingdom

In the United Kingdom, there are two main types of first aid courses offered. An “Emergency First Aid at Work” course typically lasts two day, and covers the basics, focusing on critical interventions for conditions such as cardiac arrest and severe bleeding, and is  formally assessed. A “First Aid at Work” course is usually a three-day course (two days for a re-qualification) that covers the full spectrum of first aid, and is formally assessed by recognized Health and Safety Executive assessors. Certificates for the “First Aid at Work” course are issued by the training organization and are valid for a period of three years from the date the delegate passes the course. Other courses offered by training organizations such as Cambrian Ambulance, or the British Red Cross include Baby & Child Courses, manual handling, people moving, and courses geared towards more advanced life support, such as defibrillation and administration of medical gases such as oxygen & entonox.

Specific disciplines

There are several types of first aid (and first aider) which require specific additional training. These are usually undertaken to fulfil the demands of the work or activity undertaken.

 Conditions that often require first aid

 

The above was extracted from wickipedia and edited.