HELP ME! Please!
First Aide is that part of the Emergency Medical System that needs no special "tools" to accomplish its intended outcome. It is a skill that requires a lot of common sense to perform properly. Every first aid emergency begins with that awkward period between "every thing's fine" and "oh my, we need HELP!" A time when onlookers aren't really sure if "first aide" is needed, or if "all those people over there are just making a lot of noise." This is a time when the onlooker needs to focus and evaluate what is happening, and, if needed, act quickly, decisively and within the guidelines of proper first aide protocol. It has been suggested that the closer (physically and/or emotionally) one gets to any emergency, the less likely it becomes that he or she will know what to do in that emergency. This concept will help you if you remember that "all those people" who are making "all that noise" are VERY CLOSE to the emergency, and may seem somewhat confused by the situation. You, on the other hand, having completed this self instructional exercise, recognize the need to act, and feel confident enough to ignore the confusion and take charge of the situation.
This is an excellent attitude and it needs to be preserved. However, it is during this time, the first few minutes of rendering aid in an emergency, that many providers (First Aid Providers, Emergency Medical Technicians, Paramedics, Fire Fighters, Police Officers, Doctors, Nurses, Technicians, the guy next door, and YOU) get hurt. And this is due, in part, to our suggestion that you need to "focus" in order to evaluate the initial scene. AND YOU DO ! But, once evaluated, you need to un-focus and evaluate the entire scene surrounding the emergency ("scene survey.") Left unchecked, the recognition that something is "happening," leads to a phenomenon called Tunnel Vision. A deadly exercise for the emergency medical provider. "Something" caused this emergency. What you are focused on is the result, not the cause. Unless you identify and avoid the cause, you will likely be as affected by it (the cause) as was your new patient, and instead of a first aide provider you become a first aid recipient. So - instead of running into the situation, we suggest that you STOP. Take a nice deep breath and look around. It should only take a few seconds. See if you can determine what happened based on what you see at the scene. This will better prepare you to anticipate the kind of injury or needs you may find in your patient. If this scene is not safe or you cannot make it safe and you cannot enter the scene without placing yourself in danger, you should retreat to the nearest telephone and call Emergency Medical Services (9-1-1.) If the scene presents a potential danger and there is enough time and resource to remove the patient from the scene, then the patient should be removed from harms way, but you MUST be aware of, and protect against any further, neck or back injury.
Now that you are sure that the environment into which you are about to throw yourself is a safe one, start to narrow your field of view to include the patient(s) and those surrounding the patient(s.) Notice that we have introduced a new concept. The concept of "(s)." There may be more than one patient. If so, you will need to send for or enlist additional help. Think of how organized you will appear to this unruly crowd of confused people making all that noise, when you very simple say to one of them, "Come with me, I need your help." We will assume, for the sake of simplicity, that you have only one patient, but, understand that what you can do in the first few minutes of this first aide emergency, for one person, you can duplicate once or twice, as is necessary, and assign the enlisted individual to watch over your patient while you move on to the next. If the number of patients is so great as to tax your ability to cope (we're talking about 3 or more patients) then it is best to assume that this scene is not SAFE for you to enter, and we would suggest that you retreat to the nearest telephone and call Emergency Medical Services (9-1-1.)
Meanwhile, back at the oasis.......
Your patient now needs to be assessed. Patient assessment is an organized review of body systems performed by trained personnel with the purpose of locating and correcting life threatening and near life threatening abnormalities. WOW! For us, at a first aid level, we will concern ourselves with just the most basic assessment techniques. We will perform an assessment that will assure that our patient is ALIVE. To do this, we need to determine if the patient is breathing. Looking for chest movement, or feeling for chest movement by placing our hand on the chest just below the border of the rib cage, or feeling for the movement of air in and out of the nose and mouth, or listening for the sound of air moving past the nose and mouth are several ways to assess breathing. Utilize as many as is necessary in order to assure that the patient is breathing. If the patient is NOT breathing, you will need the skills taught in a CPR class. Classes are readily available through your local hospital, the American Red Cross, and the American Heart Association. Another page in this site will deal with some of the concepts of Cardiopulmonary Resuscitation (CPR.) For now we will assume that we have a patient that is breathing. If our breathing patient is unconscious, we must "protect the patient's airway." Sounds complicated, but it simply means that we need to position the patient's head so that the breathing "pipe" in the neck is not kinked or blocked. The position of the head is one called "hyperextension," and is attained by pushing back on the patient's forehead (the patient should be lying on his/her back) and lifting up on the patient's chin.
Now that you have determined that the scene is a safe one, and have assured that your patient is breathing, it is time to initiate the next step in the EMS system. You need to access the 9-1-1 system. The best way to do this is to assign one of the bystanders to that function. Instill in them a sense of importance and make them accountable for their actions by instructing them to report back to you once they have accomplished the goal. (" YOU, Go call 9-1-1, we need an ambulance. Then come back and let me know that it was done.)
The rest of the First Aide Section of this web site will concern itself with the individual emergencies listed above. It will suggest that there are things that you can do, while waiting for the ambulance to arrive, and that those things may actually improve the patient's chances for complete recovery. To view the information on each first aid emergency simple click on its name.