Brief Summary
This video provides a comprehensive guide to first aid, covering essential skills and knowledge for responding to emergencies. It emphasises the importance of immediate action and provides step-by-step instructions for assessing and treating various conditions. Key takeaways include:
- First aid is a life-saving skill that everyone should learn.
- The primary assessment (ABC or CAB) is crucial for identifying and addressing life-threatening conditions.
- The secondary assessment involves gathering patient history, conducting a head-to-toe examination, and monitoring vital signs.
- Understanding the mechanism of injury (MOI) helps predict potential injuries and tailor treatment.
First Aid: An Essential Skill
First aid is the immediate assistance given to someone injured or suddenly ill before professional medical help arrives. It can save lives, ensure full recovery, and prevent long-term disability. Knowing first aid basics equips individuals to act quickly and confidently in emergencies at home, work, or in public. First aid includes checking breathing and circulation (ABC), stopping bleeding, treating burns and cuts, and providing reassurance to reduce panic. Anyone can learn first aid, empowering them to make a real difference in critical situations.
The Primary Assessment: Foundation of Emergency Response
The primary assessment is the foundation of emergency response, involving a rapid, systematic approach to identify life-threatening conditions and provide immediate treatment. It focuses on assessing Airway, Breathing, and Circulation (ABCs). Key steps include ensuring scene safety, checking patient responsiveness, and assessing the airway for blockages. Life-saving treatments include using the jaw thrust maneuver for trauma patients, performing the Heimlich maneuver for choking, and initiating CPR if there's no breathing. The primary assessment enables first responders to act confidently, increasing the chances of survival and recovery.
ABC Framework: Airway, Breathing, Circulation
The ABC framework (Airway, Breathing, Circulation) is the cornerstone of life-saving first aid. Airway involves ensuring the passage to the lungs is clear, using techniques like the Heimlich maneuver or head tilt-chin lift. Breathing focuses on ensuring adequate oxygen intake and carbon dioxide removal, potentially requiring rescue breaths or a bag valve mask. Circulation ensures oxygen-rich blood is delivered throughout the body, which may involve applying pressure to wounds or starting CPR. Prioritising these three elements is crucial for keeping the patient alive in any emergency.
The Importance of Breathing
Breathing is fundamental to life, as every cell relies on oxygen for energy and function. Without oxygen, critical systems shut down within minutes. Breathing brings in oxygen and removes carbon dioxide, a waste product that can poison the body if not expelled. Ensuring an open airway and proper breathing is the first step in saving a life during any emergency, sustaining life and forming the foundation of all first aid.
Assessing an Unconscious Patient
When encountering an unconscious person, the initial steps are to remain calm, assess the situation, and call for help. Remove any immediate dangers and introduce yourself to the patient while gently tapping their collar bone to check for a response. If unresponsive, open their airway using the head tilt-chin lift technique. Check for breathing by looking, listening, and feeling for up to 10 seconds. If breathing, check for injuries and place them in the recovery position to keep the airway open. Keep the person warm and reassure them, even if unconscious, while seeking emergency services.
Emergency Scene Assessment: Triple H
The emergency scene assessment involves a "Triple H" approach: Hazard, Hello, Help. First, check for hazards like traffic or spilled fuel to ensure your safety. Then, approach the patient and call out loudly to check for consciousness. If there's no response or the situation is severe, call for help immediately. The ABC framework (Airway, Breathing, Circulation) is then used to assess the patient, with basic life support initiated if any of these are compromised.
ABC vs CAB: Understanding the Difference
ABC (Airway, Breathing, Circulation) and CAB (Circulation, Airway, Breathing) are both life-saving tools, but their application depends on the situation. ABC is best for conscious patients or those showing signs of life, focusing on clearing the airway, stabilising breathing, and addressing circulation issues. CAB is critical for unresponsive patients, particularly those in cardiac arrest, prioritising chest compressions before addressing airway and breathing to improve survival rates.
CAB: Prioritising Circulation in Basic Life Support
The CAB sequence (Circulation, Airway, Breathing) becomes critical in life-threatening situations where a patient is unresponsive and has no pulse. In cardiac arrest, chest compressions mimic the heart's pumping action, circulating oxygenated blood even when the heart isn't functioning. Research shows that starting chest compressions immediately dramatically increases survival rates. CAB prioritises circulation to buy time while addressing airway and breathing, ensuring the body cells and organs get the oxygen they need to survive.
CAB Steps in BLS
In Basic Life Support (BLS), the CAB sequence (Circulation, Airway, Breathing) prioritises what matters most in life-threatening situations: ensuring oxygenated blood reaches vital organs. Circulation takes precedence because the body retains a limited oxygen supply in the blood even after the heart stops. Immediate chest compressions act like an artificial heartbeat, moving oxygen-rich blood to the brain and heart. Airway and breathing are addressed after circulation is stabilised, giving unconscious patients the best chance of survival.
Checking the Scene, Airway, Breathing and Circulation
When responding to an emergency, first check the scene for hazards like glass or oncoming traffic, using gloves and a barrier device. Assess the patient by asking if they're okay and tapping their shoulder. If there's no response, call emergency services and ask for an AED. Check the airway by tilting the head back and lifting the chin. Look, listen, and feel for normal breathing for no more than 10 seconds. Check circulation by looking for deadly bleeding and signs of shock, performing a hands-on check if necessary.
The Secondary Assessment: A Deeper Examination
The secondary assessment is a deeper examination performed after the primary assessment rules out immediate life-threatening issues. It identifies other injuries, illnesses, or conditions that might not be obvious at first glance. This assessment includes patient history (using the SAMPLE acronym), a head-to-toe examination, and vital signs evaluation (pulse, breathing, level of consciousness, skin condition, pupils, and blood pressure). A thorough secondary assessment ensures no critical details are overlooked, enhancing the effectiveness of first aid.
Steps of the Secondary Assessment
The secondary assessment involves a structured approach to identify non-life-threatening injuries or illnesses. First, obtain the patient's history using the SAMPLE acronym (Signs and Symptoms, Allergies, Medications, Past medical history, Last oral intake, Events leading to the condition). Next, conduct a head-to-toe examination, looking for visible signs of trauma and feeling for hidden injuries. Finally, monitor vital signs, including pulse, breathing, level of consciousness, and skin condition.
Addressing Injuries and Conditions
After completing the secondary assessment, address the identified injuries or conditions. For fractures, immobilise the affected limb. Cover wounds with sterile dressings to prevent infection. Tailor treatment to the patient's needs, such as giving a sugary drink to a diabetic patient with low blood sugar or moving someone suffering from heat exhaustion to a cooler area. Prepare the patient for transport to advanced medical care, ensuring they are stabilised and their vital signs are monitored. Communicate your findings to emergency responders to ensure continuity of care.
The SAMPLE Assessment
The SAMPLE assessment is a mnemonic process used to assess a patient who is feeling unwell. It involves gathering information about Signs and Symptoms, Allergies, Medications, Pre-existing medical conditions, Last meal, and Events leading up to the situation. This information helps determine the appropriate action to take and provides valuable details to emergency services or family members. The questions should be adapted to suit the patient's age and understanding.
The Head-to-Toe Examination
The head-to-toe examination is a systematic evaluation of the patient's condition, checking each body part for injuries or abnormalities. Start with the head, looking for blood, lumps, or deformities. Examine the neck for deformities or pain, and ensure the shoulders are symmetrical. Observe the chest for deformities or unequal expansion, and check the abdomen for bruising, pain, or rigidity. Gently press inward on the pelvis to check for stability. Compare the left and right limbs for symmetry, and examine the back for deformities or bleeding.
Performing a Head-to-Toe Exam
The head-to-toe exam, or secondary survey, is performed on an awake and responsive patient to uncover non-obvious injuries. It involves asking the patient what happened and assessing their level of consciousness. Check for deformities, breathing abnormalities, and capillary refill. If a life-threatening condition is discovered, activate emergency services. This exam helps uncover what might not be obvious to someone who walks up to the scene.
In Case of Emergency (ICE) Devices
In case of emergency (ICE) devices are valuable tools for first aiders, providing critical medical information when the patient cannot communicate. These devices often list chronic conditions, allergies, and medications. ICE devices come in physical forms like bracelets and anklets, and electronic forms like smartphone apps. It's essential to check thoroughly for any medical alert tags the patient may have, and to inform emergency services of the information gathered.
Mechanism of Injury (MOI)
The mechanism of injury (MOI) refers to the forces or events that caused a patient's injury. Understanding the MOI helps first aiders predict the types of injuries the patient may have and tailor their treatment accordingly. MOIs can be classified into blunt trauma, penetrating trauma, and environmental factors. Understanding the MOI is essential in first aid because it helps you assess for hidden injuries and anticipate complications.
Mechanisms of Injury and Kinetics
Mechanisms of injury and kinetics involve understanding how accidents happen and how injuries occur. Every scenario is different, requiring assessment of the wreckage and the scene to determine critical injuries and the number of casualties. Safety is the first priority, followed by patient safety. A jigsaw approach involves building a picture of what happened by observing skid marks, impact zones, and bystander information. This helps determine the worst-injured patient and prioritise treatment.
Assessing Vital Signs: Pulse
When assessing vital signs, checking the pulse is a key priority. The carotid pulse is used for unresponsive patients, while the radial pulse is used for responsive patients. For the carotid pulse, place two fingers on the side of the neck and gently apply pressure. For the radial pulse, place your index and middle fingers on the wrist just below the base of the thumb. Normal pulse rates vary depending on age, with adults typically having a pulse of 60 to 100 beats per minute.
Assessing Vital Signs: Breathing
Assessing breathing is critical, especially if the patient is unresponsive. Scan their chest for the normal rise and fall of breaths for no more than 10 seconds, remembering that agonal gasps are not normal breathing. For responsive patients, look for signs of breathing distress, such as shallow breaths or wheezing. Evaluate the rate, rhythm, depth, ease, and sound of breathing. A healthy adult breathes at a normal rate of 10 to 20 breaths per minute.
Assessing Vital Signs: Level of Consciousness (LOC)
Assessing a patient's level of consciousness (LOC) is vital in understanding their condition and the urgency of medical intervention. A person with normal consciousness will be alert and respond appropriately to simple questions. Deviations in consciousness require attention, such as confusion or sleepiness. For unconscious individuals, immediate intervention is needed, such as placing them in the recovery position or starting CPR. The AVPU scale and the Glasgow Coma Scale are common tools used to assess LOC.
The AVPU Scale
The AVPU scale is a simple and efficient method to assess a patient's level of consciousness. AVPU stands for Alert, Voice, Pain, and Unresponsive. An alert patient opens their eyes spontaneously and is aware of their surroundings. A patient responding to voice will react to verbal stimuli. A patient responding to pain will react to painful stimuli. An unresponsive patient shows no response to any stimuli. The AVPU scale is a practical tool for determining a patient's condition and prioritising treatment.
The AVPU System
The AVPU (Alert, Voice, Pain, Unresponsive) system is used to assess a patient's mental capacity and alertness. It's important to establish a baseline set of observations to see if treatment is improving or worsening the patient's condition. Alert means the patient is talking back properly and answering questions concisely. Voice means the patient is not quite with it but responds when spoken to. Pain involves reacting to a painful stimulus. Unresponsive means no movement or reaction whatsoever.
Assessing Skin Condition and Temperature
Assessing skin condition and temperature provides valuable insights into a patient's health, indicating issues like poor circulation, shock, or infection. Observe for skin abnormalities, such as pale or bluish skin suggesting oxygen deprivation, or reddish skin indicating fever or allergic reaction. Use the back of your hand to feel the patient's forehead or arm, noting that normal skin temperature is around 37°C. Deviations may suggest hypothermia or fever.
Assessing Capillary Refill Time (CRT)
Capillary refill time (CRT) is a quick and easy way to assess a patient's circulation and hydration status. Elevate the patient's hand, press firmly on the nail bed until it blanches, and observe how quickly the pink colour returns. A normal CRT should be less than 2 seconds in adults and less than 3 seconds in infants. A prolonged CRT may indicate hypovolemic shock or dehydration. However, CRT results can be influenced by external factors like cold temperatures.
