FIRST AID TRAINING

First aid is the immediate temporary care given to a victim of accident or illness before the availability of a physician is acquired. It is imperative that people should have proper training in First Aid since an emergency may happen anytime. Certain countries have incorporated in their local laws the need for first aid training to certain individuals working in companies, hotels, resorts, and other places of work. Knowing what to do in an emergency will make us confident. We may have not done a great impact in society but by aiding someone in an emergency, or teaching a person how to respond during an emergency is a truly rewarding job.

Before approaching any person to help in an emergency, insure your safety first. There is no substitute for scene safety. The first thing to do is survey the scene for any hazards that could be dangerous to you, to the victim or to the bystanders. There could be hazards like incoming traffic, fire, possible explosion, electrocution, assailant, etc. Once the scene is safe, that is the only time that you can approach the victim and start your assessment of the victim or victims injuries or illness. As a professional responder they call this the scene size up. This is very important since this will give you an idea of the situation or an impression of what has happened as well as the need to call for assistance from the Emergency Medical Services (EMS).

After conducting the scene survey, you have to remember that you cannot do it alone. So you have to call for EMS. In most countries they already have a designated number for emergency responders. Usually these are three digit numbers (eg. 911 in the U.S.) and are answered by dispatchers. This dispatchers in turn will dispatch to you the necessary personnel, equipments, vehicles depending on the nature of the emergency. It would be worthwhile to post this emergency numbers near your telephone at home, in the office or keep a copy of it in your wallet most especially if in your locality the 3 digit number is not in effect. It would be difficult to remember them during the situation. If your using a mobile phone, you don't have to worry a single thing since this gadgets are designed to call emergency numbers in your area even without a sim card. The universal emergency number if your using a cellular phone is 112. Obviously if your in the U.S. if you dial 112 your call will connect you to 911. Remeber that wherever you may be, any country for that matter, once you dial 112 in your mobile phone, it will alayws connect yout to the emergency number in your area.

Upon calling the dispatcher be prepared to answer the following questions:

• your name and your phone number (some EMS system have caller ID and can record your call.)
• location of the emergency
• the nature of the emergency
• number of victims
• the victims condition

Do not hang up the phone until the dispatcher tell you to do so. Bear in mind that the dispatcher may advise you to provide care.

Consent must be acquired before you provide care so it is important that the person must conform to your offer for assistance. However, it would be a problem if assuming that the victim is unconscious or perhaps not in the position or not capable of making the right decision. Consent therefore is categorized into two:

• Expressed consent - as long as the person is conscious and is capable of making decisions, the consent must be acquired before rendering care. It could either be verbal or a gesture like a simple nod. Bear in mind that there are victims who cannot talk during the accident.
• Implied consent - any person who is unconscious or person not in the position to give consent like children, adults with mental illness is said to have given their consent already.

Now that we have consent, we can now provide care. Remember that lifesaving techniques are effective only if started immediately. Proper assessment should be done to identify life threatening conditions and immediately this should be corrected immediately. The basics for proper assessment are the A,B,C's. Airway, Breathing and Circulation. Any problem encountered on these areas should be addressed right away. A persons brain without oxygen for more than 4 minutes could likely suffer brain damage. Remember the basic rules of 3's. "you can survive for 3 weeks without food, 3 minutes without water, but you cannot survive for more than 3 minutes without air". So it is imperative that a person without breathing should be given the necessary care in the soonest possible time. A severe bleeding in turn could result into shock which basically deprives the body tissues with oxygen rich blood which may result to death. We will be dealing with the step on how to assess the victim and deal with the different conditions as we go on.

Certain conditions may hamper as from providing the best possible care. One of which is the fear of diseases. The risk of acquiring an infectious disease is extremely low. However, it is advisable to have protective equipments to bring the risk further down. Diseases can be transmitted through the blood of an infected person, these are what we call blood-borne diseases or through the air, airborne diseases.

BLOODBORNE DISEASES

Contact with infected persons blood may result to infection by one of the following blood-borne diseases

• Hepatitis B virus
• Hepatitis C virus
• Human Immunodeficiency virus

AIRBORNE DISEASES

• Tuberculosis

Using protective equipments and following simple procedures can control the risk of exposure from this infectious diseases. It is advisable that as a first aid provider the following protective equipments should be worn or utilized to keep the body isolated:

• gloves (at least several pairs)
• protective eye-wear
• standard mask or face mask
• Mouth to barrier devices
  • face shield
  • pocket mask

First aiders ordinarily will not have or need all equipments during an emergency. It would always depend on the case and situation. However, it is best to have them available just in case.

n the home setting there are certain things that we can prepare before hand which we could utilize the moment there is and emergency. It would be worthwhile to have them in advance. Likewise in the company setting certain items can be stored so as to have the necessary supplies the moment it is needed. Whether in the home or in the workplace, first aid supplies should be customized to make it appropriate for the specific setting. First aid supplies from the home-place may include personal medications while the workplace may contain more of some items base on the needs like if the company is a manufacturer of furniture, it is expected to have problems like cuts and bleeding, then several bandages, antiseptic, and other items for this concerns should be added more to the supply.

Now we are almost ready. But before we go into action, bear in mind that once you started your care, you must not leave the victim until another trained person takes over or the ambulance arrive. Leaving the victim without help is known as abandonment!

Now that we have fully understand what first aid is all about, its time to know the ABC's. Once you approach the victim, tap the victim to check the level of consciousness by saying " Are you okay?. If the victim does not respond, shake the shoulders. If there is no response, immediately identify and correct immediate threats to life. Life threatening problems are those problems affecting the Airway, Breathing and Circulation.

Open the Airway- do this by tilting the victim's head using the head tilt chin lift method. Put one hand on the victims head and put two fingers on the patients chin. Once in position, slowly tilt the head. If you suspect cervical spine injury then do the jaw thrust maneuver. A thorough discussion on the jaw thrust maneuver will be detailed in the later part.

Check the Breathing- place your ear near the patients mouth and chest and observe for rise and fall of the chest. If the breathing is absent, give your rescue breaths.

Circulation - Check for bleeding. Under the healthcare provider setting, you check the pulse while checking for bleeding. Remember that severe bleeding is a life threatening problem and should be corrected immediately.

Should the victim have no breathing and no pulse, provide CPR. This will be discussed in the later stage. You do not proceed to the physical exam unless you have corrected the problems on the ABC'. Otherwise it is useless and the patient or victim will not survive.

After checking and correcting the ABC's, you may now proceed with the physical exam. Start from the head and down to the feet. In doing so look for D.O.T.S, deformities, open wounds, tenderness and swelling. Remember that open wounds may have severe bleeding and should be corrected immediately if it was not corrected earlier during your ABC.

Another alternate method of doing the physical exam is by following the letters of the alphabet. Considering that from the very moment we started with our education we have been thought of the letters of the alphabet. This method is most likely easily remembered.

Assessment and Intervention guidelines:

• A - irway - open the airway and check for any obstruction

• B - reathing - check the breathing and provide rescue breaths if absent

• C - irculation - check for pulse or any signs of circulation problem (eg. severe bleeding)

• D -elicate Central Nervous System - check the patients head for any deformities or any signs of injuries, if the patient talks, ask for his name, and verify if he is aware of time, and place and what happened. Check also if he can move or not and if not check if he has sensation. (a person who is unaware of time and place may have brain injuries and a person without movement and sensation may have cervical or spinal column injury.)
• E - xtremities - check the upper and lower extremities for any signs of injuries or bleeding
• F - ractures - check for fractures. If the victim is conscious, ask for any areas of pain, deformities are typical signs of fractures and pain, tenderness and swelling could also be indicative of fractures.
• G - General Appearance - observe for skin color and temperature. A pale cold could indicate shock or just plain fainting. A flushed, warm face could be hypertension or stroke.
• H - istory- gather history of the victim, was it an accident or an illness. Ask the victim for other medical concerns like allergies, medication, etc. If the victim is unresponsive, information as to what have happened can be acquired from the bystanders or even perhaps by observing the scene. A person unconscious along the road could possibly be a victim of vehicular accident.

During your assesment and invtervention, it is necessary that you prevent additional injuries and even perhaps death by not moving the victim. This usually aplies to victims of vehicular accident, falling or any emergencies that you may suspect cervical spine injuries. Moving the victim with neck (cervical injury) may cause death. Unecessary movements may also cause paralysis if the victim has spinal column injury. As a general rule, any person who is unconscious should be suspected of having neck injuries. If someone else is available, insure that the victims head and neck is immobilized. This can be done by applying manual immobilization or with the use of a cervical collar if available. The only reason that the victim should be move outright prior to assessment and intervention is the presence of additional threats such as fire, explosion or other emergencies that poses a threat to both patient and the rescuer.

Certain items from the patient may also give you an idea as to the patients condition or history. These are useful most especially if the victim is unconscious or unable to speak. Here are some of the items that you give you an idea of the patients condition:

• Medical Tags - worn on the neck or on the wrist
• Medications in the form of tablet, capsule, injections,
• Inhalers - may indicate asthma
• doctors prescription

Looking at these items, may give the first aider additional information, contact numbers and other related details that might be vital in providing care.

Now that we have some idea about first aid, it is time to start learning first aid. In most cases of accident and illness, the endpoint if not treated early or if not treated properly, would be death. Clinical death occurs from the moment the person stops breathing and the heart stops pumping from 0 to 4 minutes. This is the best time to act and do something to bring the person back to life since brain damage may occur after such period. The most important thing to do in this case is Cardio Pulmonary Resuscitation

Cardio Pulmonary Resuscitation is one of the most important lifesaving technique a first aider must learn. We have to remember that the moment a person stops breathing or the heart stops pumping, the brain cells will start to die in 4 minutes time and eventually brain damage will occur. Once the brain cells die, it cannot be reversed. Doing CPR will prevent the the possibility of death. It is imperative that CPR should be started immediately once the victim goes into pulmonary and cardiac arrest.

Learning CPR is not a difficult task at all. The course involves lecture and demonstration and usually takes 6 to 8 hours depending on the instructor. Several institutes or training center offers emergency care courses including CPR. There are even online CPR courses available for those who have limited time to attend. After taking the online course, they can proceed to a training center and do the hands on demo or the skills demonstration to receive the course completion cards. Our training center, Basic Lifesaving Solutions, offers CPR courses. Check you locality for schedules and courses available.

Bleeding is a situation when blood goes out of the body due to injuries commonly called as wounds. Blood that can be seen flowing out are obviously a result of open wounds. However bear in mind that wounds could also be internal due to impact and other forces that may create wound inside our body. This is more difficult to control since no blood or wounds can be seen. If blood comes out in large amount, it is commonly called hemorrhage and is quite dangerous since the person might go into hemorrhagic shock. It is important to control the bleeding outright to prevent such event from happening. Internal bleeding however is difficult to control in the field since the wounds are from the inside. Therefore, the key is to immediately identify the signs and symptoms of internal bleeding so the first aider can make the necessary decision whether to have the patient loaded immediately for transport to the hospital.

The best method in controlling bleeding is by applying direct pressure over the wound. The pressure should be applied constantly. The average clotting time is around 7 minutes and this will aid in stopping the bleeding. If there is no fracture, and the situation permits, you can elevate the wound above the level of the heart, while continuously applying pressure. This will lessen the amount of blood heading towards the wound. If you are familiar with the supplying artery, then you can press the supplying artery as an added way to control the bleeding. However, this may require you to put a bandage on the dressing so as to free your hands and allow you to put pressure on the supplying artery.

A new medication (xelox) has been sold and available over the counter that is very effective in controlling bleeding. This was actually used by the military before and are now available for civilian use. This comes in powder form and all you have to do is pour it on the bleeding area.

For a complete guide in controlling bleeding click the link to visit my step by step bandaging hub.

For minor wounds -

Wash the wound with soap and water and apply antibiotic ointment. Observe for any signs of infection and seek medical care if necessary.

Shock is a dangerous condition if not treated immediately. It may result to death. When a person's tissues does not get enough oxygen, this may lead to a condition we call shock. There are several kinds of shock but the endpoint are all the same, it may cause the loss of life. In an uncontrolled bleeding, the victim will suffer hemorrhagic shock. For heart attack you may have cardiogenic shock. If it involves the brain like stroke, you may have neurogenic shock, for loss of fluid you may have hypovolemic shock. The bottom line is all problems of the body, if not treated early, may end up into shock. Considering that shock is a result of certain conditions, the best way to control or treat shock is to treat the underlying cause. Meaning, if there is bleeding, stop the bleeding. If the person losses fluid, rehydrate. We will be discussing different cases as we go on and learn how to provide first aid treatment for this problems to prevent or control shock. Generally, if the person is in shock, following signs and symptoms may appear as follows, pale, cold clammy skin, confusion, thirst. Aside from treating the underlying cause, position the victim on his back and raise the legs at about 10 to 12 inches from the ground. This will bring more blood to the brain and eventually add more oxygen.

Burns are caused by different factors. This could be thermal (heat), chemical and electrical. The most important thing to consider in handling burns is to stop the burning process and prevent infection.

Immersing the burn on cold water if possible would be the best way to stop the burning process. However, for burns in the face or other large areas where immersion in cold water is not possible, pouring cold water to the affected area, would suffice. It is important to cover the burned area most especially if the skin is broken to prevent infection.

Any substance that enters the body that tends to cause harm are poison. It could be by ingestion or through contact with the skin and other means.

The four common ways in which poison enters the body are following:

• Ingestion - swallowing poisonous substances either accidental or suicidal

• Inhalation - inhaling toxic fumes
• Absorption - harmful substances are absorbed through the skin
• Injection - this method of poisoning is when a poison is injected to the body through the bite of an animal or through a sting.

In most countries especially the United States, a poison control center is established and should be called immediately the moment poisoning is noted. One must know the poison control center number since the poison control center will direct the caller on what actions to do in the event poisoning occurs.

Fractures are a break or a crack in the bone. This are usually cause by direct or indirect impact to the bone creating injury. It is very important that the area affected should not be moved to avoid further injury and harm most especially if it involves the spinal column since this may result to paralysis.

There are several types of fractures but generally, it is classified into open and close fractures. Open fractures may be associated with bleeding and are easily identified since the bones will be seen protruding or are exposed. In case of doubt for any presence of fractures it is better not to move the injured area to avoid additional injury before an x-ray is conducted. A splint should be applied to avoid further injury or harm.

For a thorough guideline on recognizing and providing care for fractures, visit my my hubpage on fractures.

Stroke - is a condition that affects the brain. This may cause cause paralysis, coma or even death. When the blood flow to the brain is disrupted such as when the arteries supplying blood to the brain ruptures or is blocked, the brain cells will not get the oxygen supply needed and will eventually result to brain damage.

It is very important that stroke should be recognized immediately to insure that care should be given outright. The first aider can utilize or do some assessment to assess the possibility of stroke. Herewith are the following:

Check for arm drift - this is done by raising the victims arms forward. As you hold both hands, you ask the victim to close his or her eyes and advise him or her not to bring the arms down as you release the hold. Observe both arms. If one arm goes down, then arm drift has occurred. This is a sign of possible stroke.

Check for facial symmetry - you can observe if the patient by asking him or her to smile. Usually, when a person smiles, there is always equality when the mouth raises for the smile. Observe the lips and mouth for any equality or abnormalities. If the results were unequal, obviously something is wrong. Another option would be to ask the patient to show his or her teeth by opening both the mouth and exposing the teeth. See if upon opening, the upper lips and lower lips moves equally.

Check for slurring of speech - another indication of possible stroke is the disturbance or changes in speech. Ask the patient to say some words and listen as he or she speaks. If the words are unclear and slurring occurs, this could be another sign that the patient has suffered stroke.

If you encounter the following signs, the possibility of stroke is high. It is very important that the patient's head or upper body should be elevated to lessen the pressure of blood on the brain. To much pressure may cause further injury.

Fainting is actually a condition wherein the person losses consciousness due to lack of blood supply to the brain. When there is less blood supply to the brain, the brain does not receive enough oxygen to sustain consciousness.

Fainting actually results from lack of food, stress, fright, pain and other conditions wherein the brain will receive less blood and obviously less oxygenation.

How to recognize fainting:

• loss of consciousness
• sweating
• pale, cold, clammy skin

To treat a fainting victim, simply elevate the lower extremities (the victim is placed on supine position and legs raised at 10 to 12 inches from the ground). This will move the blood towards the head and eventually bring oxygen to the brain.

Convulsion usually occurs when there is fever and involves infants and children at the average age of 3 mos. to 6 years old.

Basically, when the fever reaches to a certain degree of temperature depending on the child, convulsion occurs and is characterized by seizure.

The best way to treat convusion is to prevent it from occuring. This is done by letting the childe wear light clothing and within a cool environment. This will tend to control the temperature. It would also be helpful to use a moistend cloth applied on the forehead, armpit and other body parts for cooling. Do not use cold water and ice. The best thing would be is to used ordinary tap water.

If the child is already suffering convulsion then make sure that the airway is clear. This can be accomplish by positioning the child on his or her side. Do not restrain the child as it may cause fracture. However, make sure to support the child to prevent injuries.

Epiliepsy is an attack that also involves seizure. Contrary to common beliefs that epilepsy is hereditary, it is not.

The most common cause of Epilepsy is actually of unknown cause (Ideopathic causes. This comprises 90 percent of epileptic individuals. They were just born with the problem already. The remaining 10 percent suffered epilepsy due to brain injuries. This could be due to vehicular accident, stroke, meningitis and other conditions that have caused damage to the brain.

Epilepsy as of the moment has no known cure. But the important thing is to insure that the patient will not suffer any injury during the attack and most impoertantly insure that the victim's airway is not obstructed.

If the patient experiences an aura ( a feeling of impending attack), position the victim down on the ground and put something in the mouth to insure that the toungue will not be injured when the victims goes into seizure. Support the victim and be prepared to put the victim on his side if there is a treat of airway obstruction.

If the victim is already on seizure, then simply support the victim right away to avoid injuries most especially on the head. Simply place the victim on his or her side to clear the airway from obstruction.

NEVER RESTRAIN THE VICTIM! This may cause fracture. You may support and hold the victim but only to the point of protecting and preventing injury.

It would be wise to place the victim on recovery position to insure that the airway will not be block by any fluids, like salive or perhaps by food particles.