First Aid

First Aid: Care

STOP FOR RESCUE | CONNECT | CORDON ENVIRONMENT | AID | CARE

Care for any life-threatening conditions first. Give the care that is needed, within the scope of your knowledge and training, and follow these general guidelines.

  • Monitor the person’s breathing and level of responsiveness.
  • Help the person rest in the most comfortable position. If necessary, roll the person into the recovery position.
  • Keep the person from getting chilled or overheated.
  • Reassure the person by repeating that you are there to help and that EMS personnel have been called (if this is true).
  • Continue to watch for changes in the person’s condition.

Recovery Position

A person who is unresponsive or has an altered level of responsiveness should not be left in a face-up position, as the airway can become blocked by the person’s tongue or the person’s saliva or other bodily fluids. You can help protect the airway by rolling the person onto his or her side and into the recovery position.

It is usually safest for any ill or injured person to be in the recovery position, so long as this doesn’t interfere with providing care. However, the recovery position is unnecessary if the person is fully responsive and able to protect his or her own airway. You should avoid rolling a person if doing so could worsen his or her condition (e.g., if the person’s leg appears to be broken). As always, you should move the person only if it is safe to do so.

To roll a person safely into the recovery position

  1. Raise the person’s arm that is closest to you.
  2. Place the arm farther from you across the person’s chest with the palm against the cheek.
  3. Raise the knee of the leg farther from you.
  4. Roll the person toward you as one unit by pulling the raised knee and supporting the head and neck with your other hand.
  5. Position the person on his or her side, and slide the bent knee into a position that prevents the person from rolling onto his or her face. 6. Move the person’s other arm into a position of comfort in front of the body.
  6. Reassess the person’s ABCs.

The steps above are recommended, but there are other effective methods of moving a person into the recovery position. Regardless of how you do it, the important things to remember are as follows:

  • Support and protect the head while rolling the person.
  • Try to roll the person as one unit (head, back, and legs at the same time).
  • Roll the person into a position where the body will stay safely on its side.
  • Position the head so that it keeps the airway open.
  • Check the ABCs after you complete the roll.

When to Stop Giving Care

Once you begin providing care to an injured or ill person, you must continue to give the appropriate care until

  • Another trained First Aider or EMS personnel takes over.
  • You are too exhausted to continue.
  • The scene becomes unsafe.

When More Than One Person Is Ill or Injured

If you are in a situation where there are several ill or injured people, the general principle is to provide care to the people who need it the most urgently. This involves deciding whose illness or injuries pose the greatest risks, as well as for deciding who you are most able to help give your level of training. The process of sorting and providing care for multiple ill or injured people according to the severity of their conditions is called triage.

As an example, if one person has minor bleeding and another person has life-threatening bleeding, you should help the person with life-threatening bleeding first. EMS personnel will arrive before the minor bleeding becomes serious.

Guidelines for Helping an Ill or Injured Person with Medication

You should only help a person take his or her medication if

  • It is safe to do so.
  • The person is responsive and has in some way expressed a need for help with finding, preparing, and/or taking the medication.

When helping someone with his or her medication, check the label to ensure that it is the correct medication and, if it is a prescription medication, that it was prescribed for the person who will be taking it. You should also carefully read over any instructions or warnings (e.g., how much the person should take and when it should be taken). You should read the label at least twice: once when you find the medication, and again before you give it to the person. If there is no name on the label, confirm with the person that it is the medication he or she wants to take. You must also ask if the person has any allergies or is taking anything that could interfere with or react negatively with the medication. Quickly review these details with the ill or injured person and obtain his or her permission before helping.

NOTE: Write down what medication was taken, how much of it was taken, and when it was taken. This information will be useful to EMS personnel.

Finding the Medication

When helping a responsive ill or injured person find his or her medication, listen to instructions from the person on where to find it. If the person cannot speak, look in places where people typically keep their medication (e.g., backpack, purse, or pocket), or look for physical cues from the person (e.g., the person pointing at a bag). If the person cannot speak and you are helping with prescription medication, ask the person to confirm the name on the label by using physical signals (shaking or nodding the head, blinking once or twice, etc.). If the person is unable to do this, you may be able to confirm the person’s identity by asking bystanders, looking for a piece of photo ID, or checking for a medical identification product.

Preparing the Medication

Preparing the person’s medication varies depending on the type of the medication and its instructions. For example, preparing oral medication may simply involve handing the person the correct number of tablets. In the case of an inhaler or auto-injector, you may have to remove the cover and follow the preparation instructions provided on the package before handing it to the person for self-administration.

Guiding the Person in Taking the Medication

Guiding the person in taking his or her medication also varies depending on the type of medication. For example, with tablets, this may involve telling the person to chew them or place them under the tongue. With an inhaler, this may involve instructing the person to shake the inhaler and exhale before dispensing the medication or helping the person hold the inhaler to his or her mouth. When simply guiding the person, you do not press on the inhaler’s plunger yourself. With an auto-injector, you may guide the person by showing where on the outer thigh the epinephrine should be injected.

Giving Lifesaving Medication

Giving lifesaving medication involves helping an ill or injured person who has in some way expressed a need for help in taking his or her salbutamol (Ventolin) inhaler or using an epinephrine auto-injector. With an inhaler, you would dispense the correct number of sprays (from a metered-dose inhaler) either into a spacer or directly into the person’s mouth as he or she inhales. With an auto-injector, you would inject the epinephrine directly into the person’s outer thigh.

Giving Ingested Medications

Helping with ingested medications should be limited to finding the medication, preparing the medication, and guiding the person in taking the medication. In cases where the person is physically unable to get the medication into his or her mouth (e.g., the person has injured his or her hands), First Aiders may assist by placing the correct number of pills into the mouth or holding a liquid dispenser up to the person’s mouth, if the person has explicitly asked the First Aider to do so. Otherwise, you should never put anything into a person’s mouth, as this can be a choking hazard.

Secondary Assessment

After you have identified and cared for any life-threatening conditions found in the primary assessment, you must check the person for other injuries and conditions that may require care. This is called the secondary assessment.

If the person’s ABCs seem normal, do a secondary assessment to look for injuries or conditions that were not identified in your primary assessment. The secondary assessment consists of three steps:

  1. Asking questions
  2. Checking the quality of the person’s vital signs
  3. Doing an injury check

If possible, record the findings from the second assessment or have someone else record them to help you remember. When EMS personnel arrive, tell them what you found.

Ask Questions

Interview the ill or injured person (if he or she is responsive) and any bystanders at the scene to get more information. Asking the following SAMPLE questions can provide useful information about the person’s situation.

SIGNS AND SYMPTOMS — Do you have any cuts or bruises? How do you feel? Do you feel any pain? Does anything feel different?

ALLERGIES — Are you allergic to anything?

MEDICATIONS — Do you take any medicine? What is it for?

PAST MEDICAL HISTORY — Do you have any medical conditions such as heart disease or other illnesses? Has this happened before?

LAST ORAL INTAKE — When did you last eat or drink? What did you have?

EVENTS LEADING UP TO THE EMERGENCY — What happened?

Check the Vital Signs

Check the quality of the person’s vital signs by evaluating his or her level of responsiveness, breathing, and skin.

  • Level of Responsiveness: Is the person alert or sleepy? Does the person seem confused? Is the person’s awareness increasing, decreasing, or staying the same?
  • Breathing: Listen for sounds. Is the breathing fast or slow? Effective or adequate? Shallow or deep? Is breathing painful for the person?
  • Skin: Is it dry or wet? Is it an unusual colour or temperature?

A person’s respiratory rate directly impacts the amount of oxygen that enters his or her bloodstream. Slower breathing brings less air into the lungs in a given period and therefore decreases the amount of oxygen that crosses into the bloodstream. Breathing that is either too fast or too slow can also throw off the balance of oxygen and carbon dioxide in a person’s blood. In a first aid emergency, a person’s breathing rate can be affected by injury, blood loss, shock, pain, and anxiety. Providing continual care can help restore the person’s breathing rate to normal.

An ill or injured person’s skin may lose its underlying red tones, becoming more grey or white than usual. In people with darker skin, these changes may be harder to identify: skin may appear ashen-grey, yellow-brown, or grayish-green. Changes may be most easily visible on the inside of the lips, the nail beds, or the skin around the mouth, which may be paler or have a dark blue tone due to the blueish tint of deoxygenated blood. The important thing is to note any changes from the person’s normal skin tone, if possible.

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