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Friday, November 13, 2009

First Aid

Whatcha gonna do?

A child playing on a swing set is suddenly on the ground, and not moving.

An elderly man walking in the park suddenly drops to the ground in front of you.

While driving down a back road, you come upon an automobile accident and you see the driver - not moving - in the driver's seat.

Tag.  You're it.  You need to render aid.  But do you know what to do?  Do you know how to help the situation and not make it worse?

GENERALLY speaking you want to follow two assessment protocols - AVPU and ABCDE .

The first is to assess the responsiveness of the victim.  AVPU is an acronym for Alert, Verbal, Painful, Unresponsive.

Is the victim awake and aware of their surroundings?  Can they tell you what happened?  Are they in pain (they may appear to be unconscious, but are moaning in pain)?  Are they moving at all?

Up to this point, you haven't touched or physically interacted with the victim.  Most of what follows WILL require some sort of physical interaction.  That interaction may save the person's life, it may kill them or it may make their current injuries worse.

Tread lightly, here.

ABCDE stands for Airway Maintenance, Breathing, Circulation, Disability, and Exposure/Environmental Control.  You want to do each of these assessments/actions in the order they're presented.  The idea being, each of the items is more important than the next item in keeping the person alive and well.  Most of the time.

Airway Maintenance.  You must have a clear airway.  It may be a chunk of meat stuck in a throat.  If that meat is not removed, the person will never be able to draw a breath of air, and will die.  Do you know how to clear an airway?

Breathing.  They now have a clear airway.  Are they actually breathing?  How are your mouth-to-mouth skills?

Circulation.  They're breathing now, do the have a pulse?  Also, do they have any visible bleeding?  Can you perform CPR to get their heart working again?  Can you stop the blood from pouring out of their gaping wound?

Disability (This pertains to mental awareness).  Are they now aware of what's going on around them?  Can they assist you with letting you know what hurts?  Are they combative or disoriented?  How do you deal with that?

Exposure/Environmental.  If you found someone motionless in the snow or in the middle of the desert, would you know what to do?  What if they fell off a cliff at the beach, and the tide is now coming in?  Is anything in the current environment going to further injure or kill them?

This last item is a very touchy one.  The rule of thumb is that you never move a person that has had some sort of traumatic physical incident until their spine had been immobilized.  You don't want to inadvertently paralyze someone by moving them around.

But what if their car has run off the road and is sinking in the water below?  Or that twisted up hiker down on the beach now has the surf lapping at his feet?  Personally, I'm moving them and letting the Good Samaritan laws sort it out if they are injured by my actions.

Accept The Challenge

At the very bare minimum, take a first aid and CPR class.  A slight "bump up" in training would be to take a First Responder class.  This will give you skills above the first aid/CPR level, but not bring you up to the level of an EMT.

Aside from giving you the skills and knowledge to save a life, you will gain additional legal protection in the event something goes awry.

Additional Resources:

Online First Aid guide (PDF file)
Mayo Clinic First Aid guide
American Red Cross
Ranger Medic Handbook (PDF file)

Copyright 2009 Bison Risk Management Associates. All rights reserved. You are encouraged to repost this information so long as it is credited to Bison Risk Management Associates.

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