First Aid, emergency care for a victim of sudden illness or injury until more skillful medical treatment is available. First aid may save a life or improve certain vital signs including pulse, temperature, a patent (unobstructed) airway, and breathing. In minor emergencies, first aid may prevent a victim’s condition from worsening and provide relief from pain. First aid must be administered as quickly as possible. In the case of the critically injured, a few minutes can make the difference between complete recovery and loss of life.
The First aid measures depend upon a victim’s needs and the provider’s level of knowledge and skill. Knowing what not to do in an emergency is as important as knowing what to do. Improperly moving a person with a neck injury, for example, can lead to permanent spinal injury and paralysis.
Despite the variety of injuries possible, several principles of first aid apply to all emergencies. The first step is to call for professional medical help. Determine that the scene of the accident is safe before attempting to provide first aid. The victim, if conscious should be reassured that medical aid has been requested, and asked for permission to provide any first aid. Next, assess the scene, asking bystanders or the injured person’s family or friends about details of the injury or illness, any care that may have already been given, and preexisting conditions such as diabetes or heart trouble. The victim should be checked for a medical bracelet or card that describes special medical conditions. Unless the accident scene becomes unsafe or the victim may suffer further injury, do not move the victim.
First aid requires rapid assessment of victims to determine whether life-threatening conditions exist. One method for evaluating a victim’s condition is known by the acronym ABCs, which stands for:
A — Airway–is it open and unobstructed?
B — Breathing–is the person breathing? Look, listen, and feel for breathing.
C — Circulation–is there a pulse? Is the person bleeding externally? Check
skin color and temperature for additional indications of circulation problems.
Once obvious injuries have been evaluated, the injured person’s head should be kept in a neutral position in line with the body. If no evidence exists to suggest potential skull or spinal injury, place the injured person in a comfortable position. Positioned on one side, a victim can vomit without choking or obstructing the airway.
Before treating specific injuries, protect the victim from shock–a depression of the body’s vital functions that, left untreated, can result in death. Shock occurs when blood pressure (pressure exerted against blood vessel walls) drops and the organs do not receive enough blood, depriving them of oxygen and nutrients. The symptoms of shock are anxiety or restlessness; pale, cool, clammy skin; a weak but rapid pulse; shallow breathing; bluish lips; and nausea. These symptoms may not be apparent immediately, as shock can develop several hours after an accident. To prevent shock, the victim should be covered with blankets or warm clothes to maintain a normal body temperature. The victim’s feet should be elevated. Because of the danger of abdominal injuries, nothing should be administered by mouth.
Asphyxiation occurs when air cannot reach the lungs, cutting off the supply of oxygen to circulating blood. This can cause irreparable damage to the brain. Among the causes of asphyxiation are drowning, gas poisoning, overdose of narcotics, electrocution, choking, and strangulation. Victims may collapse, be unable to speak or breathe, and have bluish skin. Most people will suffer brain death within four to six minutes after breathing ceases unless first aid is administered.
In the case of choking, a procedure known as the Heimlich maneuver can be used to clear the windpipe of food or other objects. In this procedure quick upward thrusts are applied to the victim’s abdomen to eject the object blocking the windpipe.
For victims of other types of asphyxiation, the most practical method of artificial respiration is the mouth-to-mouth technique in which the first-aid provider forcefully exhales air into the victim’s lungs after first clearing the airway of any obstruction. The provider tilts the victim’s head backward by placing one hand under the victim’s chin and lifting while the other hand presses down on the victim’s forehead. At this point, the mouth and airway can be checked for foreign objects, which can be removed with the fingers.
In cases of drowning, artificial respiration should be attempted even if the victim appears dead. People submerged in cold water for more than 30 minutes who appeared blue have responded to first-aid efforts and recovered with no brain damage.
The presence of blood over a considerable area of a person’s body does not always indicate severe bleeding. The blood may ooze from multiple small wounds or be smeared, giving the appearance of more blood than is actually present. The rate at which blood is lost from a wound depends on the size and kind of blood vessel ruptured. Bright red, spurting blood indicates injury to an artery while welling or steadily flowing, dark red blood indicates injury to a vein.
Welling or spurting blood is an unmistakable sign of severe bleeding. If a major artery ruptures, a person may bleed to death within a minute. Injuries to veins and minor arteries bleed more slowly but may also be fatal if left unattended. Shock usually results from loss of fluids, such as blood, and must be prevented as soon as the loss of blood has been stopped.
A poisonous substance introduced into the body through the mouth or nose causes symptoms such as nausea, cramps, and vomiting. Poisons include toxic medications, herbicides, insecticides, rodenticides, household disinfectants, and noxious gases.
In a case of poisoning, the first-aid provider should remove the victim from a toxic environment, then contact the poison control center listed in most United States phone books. If the number is unavailable, the provider should call a physician or hospital emergency department. If possible, the provider should try to identify the poison, either by questioning the victim or searching for suspicious containers. Containers of many poisonous substances list the antidote, or remedy, on the label. Burns or stains on the skin or a characteristic odor on the breath may also help the first-aid provider recognize the poison.
Unless instructed to do so by the poison control center, the first-aid provider should never give a poisoning victim anything to eat or drink. Vomiting should not be induced unless the poison control center recommends it. If the victim vomits, the first-aid provider should turn the individual on the side and clear the airway. Before clearing the victim’s mouth of any obstructions, however, the provider should first put on clean first-aid gloves or wrap a cloth around his or her fingers. If the person who ingested the poison is unconscious, the airway, breathing, and circulation should be checked and CPR started if necessary.