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The basics of first aid
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Every day 15 people in Ireland suddenly die, either as a result of an accident, a road crash or a heart attack. Some of these deaths are instant, but many of those who die suddenly could have been saved by the timely intervention of emergency first aid. It is well known that the moments between an accident occurring and the arrival of medical help can be crucial in determining a patient's outcome.
A basic knowledge of first aid is the sort of skill that no one ever wishes to have to use, but nevertheless it could mean the difference between life and death for a loved one some day. The First Aid Training Service, a private firm of former ambulance staff who offer occupational first aid training, estimate that in eight out of ten accidental or sudden fatalities, the incident is witnessed by a close friend or relative of the victim.
Take a course
The best way to ensure you can help if you ever witness an accident or a heart attack is to actually take a course in first aid and learn the correct methods of resuscitation, CPR, and discover what to do if someone is choking, or poisoned, or bleeding. First aid should not be attempted by people who have not been trained.
"There is no substitute for a full-blown course in first aid", explained Richard Treacy, the Brigade training officer of the St John's Ambulance. "No matter what age you are, you can save someone's life if you have the proper training. We offer courses in first aid to juniors, some of whom are 11 years old, but adults can do a basic first aid course at any age. There is no greater gift you can give someone than to keep them alive".
Courses are available around the country from voluntary organisations like the Order of Malta ambulance corps and the St John's Ambulance brigade. The Irish Red Cross Society, which is affiliated to the Red Cross and Red Crescent Organisation worldwide, also offers inexpensive and comprehensive training in first aid from beginner's level up to advanced, including specialist courses in CPR, occupational first aid and safe lifting of ill people.
Farms are often the location for accidents involving children who do not understand the dangers of machinery. Agriculture workers ought to have at least a basic understanding of first aid since rural areas are usually the most remote from emergency health services.
Basic first aid knowledge equips people to deal with the immediate aftermath of emergencies. Most first aid courses will cover tending to fractures and burns, treating bleeding or shock, cardio-pulmonary resuscitation (CPR) and assisting people who are unconscious or have been poisoned. Techniques such as artificial respiration, CPR and fracture splinting should not be attempted without proper training.
Drowning is used medically to describe any death that results from a lack of oxygen caused by fluid in the lungs or stomach. Alcohol is often linked with cases of drowning and no one should attempt to swim, even in the relative safety of a pool, if they have been drinking.
Once someone in water becomes tired or begins to panic, they cease to keep themselves properly afloat. They may then begin to ingest water which can lead to death. Someone on the point of drowning can be saved by first aid, as long as immediate steps are taken to keep them afloat. Their head must be kept above water level until they can be brought to dry land where their condition can be assessed.
If they have been swimming in the open, they may also be experiencing exposure, or a lowering of body temperature, which can be treated by drying the person and wrapping them in many layers. If they are not breathing normally, they will require artificial respiration, or mouth-to-mouth. Near drowning cases should always be taken to hospital for assessment even if they seem fine, in order to be sure that they did not ingest too much fluids.
Fractures can be compound or simple, meaning that the affected bone has or has not broken the skin. In either case, fractures are treated the same. The affected body part should be immobilised, preferably with some form of splint and the patient should be made comfortable.
If the limb is badly distorted, it may need to be straightened, but this is best done by a trained medical professional. It should not be attempted unless there is no chance of medical help arriving for a long time. A compound fracture should be covered with a clean, dry dressing. There is no point in attempting to clean it as this will be done in hospital.
Burns are classified as to how far they burn into the skin. Third degree burns destroy all of the skin and require immediate hospital treatment. The first step in treating any burn is to pour cold water on the affected area. This prevents the burn from spreading to surrounding areas and helps to ease the pain somewhat. The burn should then be covered with a clean bandage. The dressing should be smooth and not fluffy, as materials like cotton wool can cause friction or stick to the exposed skin.
People have been known to bleed to death from cuts to an artery, but this is usually when no first aid has been available and the patient has been too fearful or loath to treat themselves. Firstly, all obvious dirt or debris should be removed from the wound area and then the edges of the wound should be pressed together tightly with the fingers, or preferably with a clean cloth.
The damaged part should be raised above the level of the heart if this is possible, and pressure continued for at least ten minutes. Most doctors contend that it is better to apply such pressure than to attempt to create a tourniquet, which is worse than ineffective if it is not tight enough.
Shock often occurs after a person is injured in a road traffic accident.
There are a number of different kinds of shock, varying from anaphylactic shock caused by an acute allergic reaction to septic shock, caused by the body becoming overwhelmed by bacterial toxins. Shock is usually defined as a lack of oxygen reaching the tissues and is most commonly caused by heart or circulatory failure.
The cause of shock is usually obvious - after a car crash shock is most likely due to blood loss. The patient is usually dizzy and nauseous and may lapse out of consciousness. They should be lain flat with their legs raised to increase blood flow to the brain. They should not be given anything to eat or drink and should be transferred to a hospital as quickly as possible.
Cardiac arrest occurs when a person's heart ceases to beat. This is an occasion when first aid is essential for saving a life, as every minute that the heart is not beating reduces the chances of that person recovering at all. Brain death can occur in a matter of minutes, so CPR (cardio-pulmonary resuscitation) is one of a number of methods that should be used in an attempt to get the heart beating again.
If attempts at mouth-to-mouth resuscitation fail and there is no defibrillator that could be used by a trained person, pressing rhythmically and firmly on the breastbone with both hands may help to start the person breathing again. With a child, only one hand should be used, in order not to cause damage to the ribcage or breastbone. With an infant, only two fingers should be used for the same reason. If two people are present, one should apply mouth-to-mouth while the other attempts CPR.
Poisoning occurs when the body ingests any substance which disrupts how the body functions. It can take many forms, from animal or insect bites to accidental or deliberate consumption of tablets, poisonous berries or household bleach. The important thing is to discover what the person has ingested. If it is tablets or berries, and they are conscious, induce vomiting by putting your fingers down their throat.
Do not do this if you suspect they have ingested anything corrosive, such as bleach or petrol. Instead, make them drink as much water or milk as possible. In all cases, move the victim into the recovery position until an ambulance arrives and tell the ambulance personnel what the poisonous substance was if you know. This can aid hospital staff in treating the patient.
The Irish Red Cross Society can be contacted at 16 Merrion Square, Dublin 2. Telephone (01) 6765135, Fax (01) 6614461, email email@example.com. Their website is at http://www.redcross.ie.
St John's Ambulance Brigade of Ireland is organised throughout the country. A number of local divisions have websites, though the national organisation does not. They can be contacted at 29 Upper Leeson Street, Dublin 4, Telephone (01) 6688077.
The Order of Malta can be contacted at St John's House, Clyde Road, Dublin 4. Telephone (01) 6684891, Fax (01) 6685288, email Webmaster@orderofmalta.ie. Their website is at http://www.orderofmalta.ie.
Books on first aid are also available in many good book shops.
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Last Reviewed: 21st August 2001