Friday, November 13, 2009

First-Aid - What first ?

1. What do I do in emergencies ?

I want to help - don't you ?

I should help - There is actually a good Samaritan law in Germany that requires a person to help someone in an emergency as long as he/she is physically fit to do so and is not personally endangered by the help offered. Not doing so can result in a fine or up to a year in prison (Remember the Seinfeld finale ?)

I can help - why ? Because I know how to, from attending a first-aid training.

2. What is an emergency ?
Any life threating situation and in this context, that is broadly classified into 3 categories. When a person ('s)
- becomes unconscious
- is unable to breathe
- circulatory system fails

3. What do I start with ?

A quick way to remember it is using the ABC of first-aid
A Airway
B Breathing
C Circulation

a. Is the person conscious ?
Yes - Try talking to the person, find out if he/she can understand the situation and respond to your questions. Make body contact. Tell them/show them you are there to help. Note: Children react better in emergencies when they are accosted by women than by men.

b.No, then is the person breathing ?
Yes - When a person is unconscious (but still breathing), his muscles are limp. This may result in an airway blockage.Make sure the person is laid down in a comfortable position and is kept warm. Note: Tip the head backwards to make sure the limp tongue is not blocking the airway (see picture - thanks to wikipedia)

No - Then it is highly likely that the circulatory system will fail any moment now, so its time for CPR (Cardiopulmonary Resuscitation). 30 chest compressions and 2 rescue breaths, should be repeated until help arrives.

As much as all tamil movies believe in and propagate use of ''mouth-to-mouth'', in truth ''mouth-to-nose'' is a lot more effective since the volume that one has to fill air with is less and there is no tongue blocking the airway.

Note: This is only for adults or anyone older than 13 years of age. The chest compression rate and force varies considerably for children and babies.

Compression point: Breast bone
Compression depth: 4-5cm
Compression frequency: approx 100 per minute

Ask another person, when available, to simultaneously call 112 (or any other local emergency number)

c.Emergency call - The ''Q''s to address are:

Where ? Explain the location as exactly as possible - which floor, where is the entrance, any other indications. Note: Switch on all the lights and if possible, make someone stand at the entrance to help the ambulance paramedics the place

What ? Describe the situation. There is a lot of difference between a bush fire and a burning city hall !

How many people ? Explain how many are injured or hurt. This would help them plan the evacuation and recovery measures more effectively

What kind of injuries ? Explaining that someone has fatal injuries will make the paramedics arrive with doctors as well.

Other questions ? Wait for other questions, do not hang up. Paramedics may need extra information like the number on the orange plate of a transporter indicating the nature of the material (inflammable, poisonous etc.) transported, in case of an accident on the auto-bahn.

d.Offer emotional support: Having your life flash in front of your eyes is not easy to handle, offer support to the person. Tell him/her - ''It will be all right'' and believe in it too. Keep talking and keep listening to the person. Make him/her aware that there are people out there doing all they can to make him/her live.

4. What did I forget ? Isolation of the accident area

Although the license exam theory says that this is the first thing one should be doing, this depends on the situation. If the accident is in the middle of the auto-bahn, it is imperative to place the warning triangles at the right positions to make sure that the others are warned. On the other head, if it is in a field and in broad daylight, you can place the emergency call and then go and get the warning triangles. Please assess the situation and use common sense !

5. What should I not do ?

As a first-aid worker, you are not supposed to
- remove foreign objects stuck in the body (that's what doctors are for)
- clean a wound (you may trigger an allergy when you use tincture or alchohol)
- administer medication (unless the person takes something regularly, has it with him/her and asks you for it)

6. How do I get better/make myself useful ?

- Start by knowing where the first-aid kits are in your work place and familiar yourself with what is inside a first-aid kit
- Attend a first-aid course from time-to-time (ideally, atleast once in 2 years)
- Take advanced first-aid training after you are done with the basics
- Be ready to help :)

Other Situations

1. Evacuating victims from a vehicle

- Ideally, 2 people would be needed in case of a car and 3 in case of truck
- Careful ! The airbag may go off when you are trying to get the person out.
- Turn off the engine, remove the key but leave it in the car in case it needs to be towed

2. Heart Attack

- Call 112, there is not much first-aid can help with
- If the person is conscious, open his tie/shirt, open the window and make the person sit on the floor (chances of falling down unconscious and hurting himself/herself are less)
- If the person is unconscious, start CPR !

3. Removing the helmet in case of bike accidents

- Ideally, 2 people are needed. One to hold the head still, while the other removes the helmet (remember the G forces encountered during the impact, moving the head carelessly may be fatal !)
- If the person is wearing glasses, remove them first.

4. Accident on the way to work ?

The way to work from home is ideally the optimal route that one takes and any accident on this way would mean that the employer takes care of the related expenses. This route
- Includes any intermediate stops made for people in case of car-pooling
- Excludes any intermediate stops made for personal reasons (buying coffee, newspaper etc.)
- Stopping for gas in the gas station on the route is included but any detours are not.

5. Vaccines (FYI)

In Germany, before a vaccine comes to the market, it has to be successfully tested on 1600 patients and the distribution is always the same - 20% children and 80% Adults, of which 60% are women and 40% are men.

So far, I have not had to chance to offer first-aid but if there arises a situation, I want to be prepared for it because I think it would be a lot better to assist rather than panic and feel helpless, right ?

PS: If you prefer the German version of this post, you can find it here.

Disclaimer: The first-aid course I attended was in Germany and so the methods/tips are also those followed in Germany and these may differ from place to place.
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