FIRST AIDPrinciples and Practice

K.S. ChewLecturer/Emergency Physician

School of Medical SciencesUniversiti Sains Malaysia

First aid….. it is better to know it and not need it than to need it and not know it.

“Whatever can go wrong, will.”

- Murphy Law

“Whatever can happen to one man can happen to every man.”

Lucius Annaeus Seneca (4 B.C.? – A.D.65)

Definition of First Aid

What is First Aid?Definition:

• First aid is the immediate care given to an injured or suddenly ill person. First aid does not take the place of proper medical treatment.

First Aid

• Immediate care given to an injured or suddenly ill person– Without any proper medical equipment– Temporary assistance until arrival of

competent medical care– Does not take the place of proper

medical treatment

Who provides first aid?

• Police, Bomba/firefighters, JPA staffs• St. John’s Ambulance members, Red

Crescent members, Scouts, Girl Guides• Bystanders, public members• Relatives, family members, friends• Workmates, teachers• Medical students, anyone ……YOU!

Principles of First Aid

Principle #1: First, do no harmKnow what to do and know what NOT to do

First Do No Harm

• Do no harm does not mean do nothing.• The wisdom is not just to know what to do,

but what NOT to do• Sometimes the best thing you can do for a

casualty is to call for help.• Provide comfort and assurance to the

casualty may be the only thing you can do

First Do No Harm

• Use treatments you know of that are most likely to benefit a casualty

• Do not use a treatment that you are not sure about “just for the sake of trying”

Principle #2: First Aid Is Not An Exact Science And Is Open To

Error

First Aid Is Not An Exact Science

• First aid is practiced by people from all walks of life

• Therefore there are great variations in terms of methods and practice

• A casualty may not respond as you hoped no matter how good and how hard you try

First Aid Is Not An Exact Science

• Don’t feel bad if the casualty don’t respond as you would like him to.

• If you have done your best, your conscience should be clear.

• You may also have to deal with your own fear in real life situations

Principle #3: First Aid is about Putting First Things First

First Things First

• Get your priority right• If there are too many injuries in a casualty,

treat the most urgent injuries first• If there are too many casualties

– First, call for help– Treat the ones with the highest chance of

survival

Don’t treat him. Forget it!

They are also not your priority. Keep them aside and leave them to chat with each other!

• The first step to get our priority right is to know and recognize what is an emergency and what is not an emergency!

• Sometimes it is very difficult, e.g. heart attack can be silent

• Hollywood emergencies don’t always exist in real life

First Things First

Hollywood Heart Attack

Recognize An Emergency

• Factors that determine whether bystander recognize an emergency:

• Severity: motor-vehicle crash• Physical distance: the closer, the more

noticeable• Relationship: knowing the victim, the more

noticeable, e.g. mother and child• Time exposed: the longer exposed, the

more noticeable

Principle #4: Safety Is Of Utmost Importance In First Aid

Why Some Bystander Refuse To Help?

• Ignorance– Hiding own fear and incompetency

• Confused about what is an emergency– Too much Hollywood movies

• Characteristics of the emergency situation– The blood, smell, vomitus

• Fear it may be fake– Fear own safety; disguised as emergency

One important strategy that people use to avoid action is to refuse (consciously or

unconsciously) to acknowledge the emergency situation

Other Excuses

• It could be harmful– HIV infection

• Helping doesn’t matter– Victim is drunk

• Obstacles may prevent helping– Drowning victim in a mining pool (bystander

doesn’t know how to swim)

Decide to help

If you decide to help, you must:• Feel confident to help• Take time to help• Put the potential risks of helping in

perspective• Take charge at an emergency scene• Comfortable in seeing a victim who is

bleeding or vomiting

Chain of Survival

RECOGNITION

Is this an emergency condition?

DECIDE TO HELP

CONTACT EMS if

needed or if not sure

ASSESS SCENE AND VICTIM

FIRST AID

NOYES

MEDICAL CARE ARRIVED

CHANCE OF RECOVERY WITHOUT MEDICAL

CARE ASSURED

Scene Survey

• Scene safety• Mechanism of injury• Number of patients

RECOGNITION

Is this an emergency condition?

DECIDE TO HELP

CONTACT EMS if

needed or if not sure

ASSESS SCENE AND VICTIM

FIRST AID

NOYES

MEDICAL CARE ARRIVED

CHANCE OF RECOVERY WITHOUT MEDICAL

CARE ASSURED

Need EMS?Call EMS if1. The victim’s condition life threatening or

could get worse2. The victim need the skills or equipment

of EMS3. Distance or traffic could cause a delay in

getting to hospital4. If you are not sure

What Information To Relay• Identify yourself• E: Exact Location• T: Type of event• H: Hazard• A: Access• N: Number of casualties involved• E: Existing emergency services• Put down phone only if asked to

History

• Symptoms• Allergies• Medicatios• Past Medical History• Last oral intake• Events leading up to the illness or injury

Physical Examination• Deformity• Open wound• Tenderness• Swelling

• For extremities• Remember to add Pulses, Movement, Sensation (PMS)

Seven Essential First Aid Interventions

1. Call for ambulance2. DO NOT move and DO NOT allow

movement unnecessarily of a trauma casualty

3. Perform chin lift or head tilt chin lift4. Mouth-to-mouth breathing (if willing)

especially in children, drowning or poisoning

5. Chest compression6. Operate an automated external

defibrillator7. Stop any bleeding

Seven Essential First Aid Interventions