[Home]First aid

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Next, evaluate the number of injured. If you can provide first-aid to all the injured, do so. If there are too many for you to provide first-aid, then if you are trained to perform triage, perform triage. If you are untrained in triage, get help.

Triage separates people into three groups: The dead or near-dead who are beyond your help, the severely injured who can be helped by immediate first-aid, and the moderately injured, those who need help less urgently.

Only perform triage for two or more injured persons. For a single injury, always perform first-aid!

Some form of marking is very helpful to ration care. If you have triage tags immediately available, (the right solution) use them. If you have a marker, or lipstick on your person, mark foreheads with "D" for dead, "S" for severely injured, or "M" for moderately injured. Unmarked or untagged persons have not been evaluated. If you cannot mark or tag, proceed anyway.

Triage 1: Ask the group to get up and walk to a safe area that you designate.
If you have not called for help, point at a particular 'walking wounded' person, and forcefully ask them to call for help. Make eye-contact, and get them to promise to do it. Say, "You! Get help! Will you do that?" or if your area has a designated emergency number, say, "You!, Call 911! Will you do that?"

Triage 2: On the remaining persons, check RPM, that is, Respiration, Perfusion, and Mental state. For each person, follow this procedure:

Triage 2R: If a person is not breathing, adjust their head and clear their airway. If that does not restore their breathing, they are beyond your ability to help. Mark them "dead."

Triage 2P: If a person is breathing, check their perfusion by pressing a fingernail, and seeing if it turns pink within two seconds. If it's dark, use your flashlight, if you have one on your person. If it's dark and you have no flashlight, you may check for a pulse at their neck. If they are not perfused, they are beyond your ability to help. If you have triage tags, mark them "dead."

Checking the fingernail is both faster and more reliable than checking the pulse, if the light permits, and this means you are less likely to mismark a person as "dead."

Triage 2M: If they are breathing and perfused, check their mental state. Ask them their name, and what happened. If they cannot reply, or say something unrelated, ask again, and tell them that you are testing to see if they are mentally confused. If they are confused, it probably indicates a brain injury, which is beyond your ability to help. If you have triage tags, mark them "dead."

Triage 3: Recruit the moderately injured and bystanders to perform first-aid operations, by telling them what to do for each severely injured person. There are almost always enough people to perform the needed first aid when given instruction. If you have triage tags, mark each person receiving first-aid as "severe."

Triage 4: As time permits, examine the 'severe' and 'moderate' patients for shock. Look for very rapid breathing, more than twice as rapid as yours, and confirm by touching their skin. If they are clammy or cold, or the breathing is sufficiently rapid, they are entering shock. Have them sit down. If they are sitting, have them lay down. If they are laying down, have them raise their legs. The object is to raise the blood pressure to their inner organs to prevent oxygen starvation of major tissues- which is one way that shock kills. If possible, try to keep shock victims dry and warm to reduce their need for oxygen. If you have oxygen, and know how to administer it, do so. If you have triage tags, as you have time, mark walking wounded as "moderate" and upgrade shock victims to "severe."
Next, evaluate the number of injured. If you can provide first-aid to all the injured, do so. If there are too many for you to provide first-aid, then if you are trained to perform triage, perform triage. If you are untrained in triage, get help.

First aid is a series of simple, life-saving medical procedures that laymen can be trained to perform in emergency situations, before trained medical personnel can arrive.

Start where you stand. First STOP: Stop Think, Observe, and Plan before you act.

The first rule is to do no harm. If you are not trained, or your training is more than two years old, limit yourself to calling for help. Most systems of law hold good samaritans harmless as long as they follow recognized first-aid procedures.

Next, if you have a phone or radio on your person, call for help. In a life or property-threatening emergency, most legal jurisdictions permit emergency traffic to take precedence over other traffic on a radio net.

Next, evaluate the number of injured. If you can provide first-aid to all the injured, do so. If there are too many for you to provide first-aid, then if you are trained to perform triage, perform triage. If you are untrained in triage, get help.

First Aid provides immediate help, before emergency services could arrive.

Remember, Do no harm! If another person with superior, or more recent training arrives, surrender the patient. If you are ocmpletely untrained, and unsure what to do, get help.

If there's an on-looker, point and say "You! Get Help now!" If you are in an area with a designated emergency dialing number (like '911'), way "You!, Call 911!"

The priority for first-aid is ABC: airway, breathing, and circulation.

As you perform each step, gently talk to the patient in a quiet, reassuring, unhurried tone. Ask their permission, and proceed if there is no response, or they give permission. If they deny permission, ask them their name. If they don't reply, they may be confused or have a brain injury. If you think they are confused, tell them so, and repeatedly ask permission, and give them care. If they become combative, stop giving care. When you do something, tell them what you are doing.

First aid 1: First, look the person over. Look for obvious wounds, or unsymmetrical body parts. Consider whether they are immediate danger. If they are about to die from fire, heavy traffic, or some other hazard, move them. If you are trained in spinal isolation, use it. However, remove them from the hazard. If they do not need to move, do not move them unless you have appropriate training and equipment.

First aid 2A: If they're breathing, skip to 1C, circulation. The best way to check for breathing is to feel a person's chest or stomach for motion. If modesty forbids, an alternative is to place the back of one's hand in front of the person's mouth or nose, and feel for warmth.

If the patient is not breathing, check their airway. Clear the person's airway: If they are unconscious, and they are lying on their back, tilt their head back so that the back of their tongue does not fall back to block their airway. If they are lying on their side, turn their head so that the tongue falls forward. If they still do not breath, put on a glove or shield your finger with plastic or cloth, and use your finger to attempt to sweep any debris from their mouth.

First aid 2B: Check their breathing. If there is a sucking wound in their chest, block it with petrolated gauze, plastic, or your hand. If you are trained in CPR, you can begin breathing for them- remember to use a face shield to prevent cross infection- improvise one from clothing if necessary.

First aid 2C: Check their circulation. Apply pressure to major wounds to prevent bleeding. If their heart is stopped, and you are trained in CPR, apply chest palpitation.

First aid 3: Examine the patient for shock. Look for very rapid breathing, more than twice as rapid as yours, and confirm by touching their skin. If they are clammy or cold, or the breathing is sufficiently rapid, they are entering shock. Have them sit down. If they are sitting, have them lay down. If they are laying down, have them raise their legs. The object is to raise the blood pressure to their inner organs to prevent oxygen starvation of major tissues- which is one way that shock kills. If possible, try to keep shock victims dry and warm to reduce their need for oxygen. If you have oxygen and know how to administer it, do so.

First aid 4: In some emergencies, such as earthquakes or an isolated accident, emergency services may be unable to arrive for several days. In this case, you or others you designate may need to perform longer-term care. For long term treatment in disasters, wound-care and cleanliness is the most important issue.

If possible, administer pressure bandages to stop bleeding, and free first-aid personnel.

Administer splints to broken limbs with the intent to immobilize broken limbs. Do not attempt to straighten limbs, because broken bones might cut an artery.

Severely wounded persons often have great thirsts. Over the long term, giving them water might increase their blood volume, but depending on the type of accident, their gastroinstestinal tract may have burst. Give water slowly at first, in very shallow sips. If they throw up, or retch immediately stop administering water.

If the patient(s) are exposed, and the weather is cold, rainy or very hot and sunny, shelter them (preferred) or (less preferred) move them to a less-exposed area. Temperatures as high as 55F or as low as 95F can injure by exposure for an hour- this is a major hazard in longer term care.

Proper bedding and dressings are preferable, but fresh, unopened newspapers are sterile, and can be used to improvise dressings, blankets and clean areas.

Antibiotic ointment, if available, can save limbs during long-term care. It should be spread freely on wounds. Some authorities even advocate gently packing it into deep, dirty, slowly-bleeding wounds.

A number of painful events usually end safely. Extreme toothaches usually end by forming an abcess, killing the tooth, and then possibly having it fall out. This is painful, but usually not life-threatening. Childbirth is also usually painful, but not life-threatening.

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Last edited October 14, 2001 8:49 am by 216.237.32.xxx (diff)
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