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| First aid - what everybody should know |
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Reviewed by Dr Stuart Crisp, specialist registrar
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Why learn first aid?
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WARNING!
This advice is a general guideline for use in an
emergency.
It is not intended to replace professional classes in
first aid and resuscitation.
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First aid is an important skill. By performing simple procedures
and following certain guidelines, it may be possible to save lives by giving
basic treatment until professional medical help arrives.
Remember, too, that practice makes perfect. In an emergency
there is no time to read instructions. If you've memorised some of the basic
procedures, it will help you react quickly and efficiently.
Breathing difficulties
If someone stops breathing, see if the person replies if talked
to or touched on the shoulder. If not, call an ambulance and then begin first
aid.
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Place the person on his or her back on the floor.
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Tilt the head so that the chin is pointing upwards. Do this by
placing the fingertips under the jawbone, then lift gently while pressing down
softly on the person's forehead. This is done to make sure the tongue is not
blocking the throat.
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Keep holding the head in this way while checking for breathing:
see if the chest is rising and falling, or place your ear next to their mouth
to listen for breathing.
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If there is breathing, hold the head as described above until
help arrives. If not, start artificial respiration.
How to give artificial respiration
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Tilt the head back and lift up the chin.
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Pinch the nostrils shut with two fingers to prevent leakage
of air.
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Take a deep breath and seal your own mouth over the person's
mouth.
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Breathe slowly into the person's mouth - it should take about
two seconds to adequately inflate the chest.
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Do this twice.
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Check to see if the chest rises as you breathe into the
patient's mouth.
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If it does, enough air is being blown in.
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If there is resistance, try to hold the head back further and
lift the chin again.
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Repeat this procedure until help arrives or the person starts
breathing again.
If an adult is unconscious and has no pulse
If an adult is unconscious, see if there is breathing. If not,
start artificial respiration as described above.
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Checking for a pulse
If you are inexperienced, you may waste valuable time checking
for a pulse.
How to take a pulse
Place your fingers in the groove between the windpipe and the
muscles of the side of the neck.
Press backwards here to check for a pulse.
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If there is no pulse, or if you are unsure, then proceed without
delay as follows.
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Look at the person's chest and find the 'upside-down V' shaped
notch that is made by the lower edge of the ribcage. Place your middle finger
in this notch and then place your index finger beside it, resting on the
breastbone.
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Take the heel of your other hand and slide it down the
breastbone until it is touching this index finger. The heel of your hand should
now be positioned on the middle of the lower half of the breastbone.
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Now place the heel of your other hand on top of the first. Keep
your fingers off the chest, by locking them together. Your pressure should be
applied through the heels of the hands only.
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Keep your elbows straight, and bring your body weight over your
hands to make it easier to press down.
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Press down firmly and quickly to achieve a downwards movement
of 4-5cm, then relax and repeat the compression.
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Do this 15 times, then give artificial respiration twice.
Continue this 15:2 procedure until help arrives.
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Aim for a rate of compression of about 100 per minute. You can
help your timing and counting by saying out loud 'one and two and three and
four ...' etc.
If a baby (up to 1 year) is unconscious and has no
pulse
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Find the place between the nipples where the ribs meet in the
breastbone. Move your fingers about 2cm to the right from this point - just
above their heart.
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Press firmly, but not forcefully, with your index and middle
fingers.
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If you can't see the baby's chest rise, the pressure is not
correct. But with babies, it is especially important to prevent further injury
by taking care not to press too hard.
Bleeding
With all types of bleeding, it's important to stop the flow of
blood as quickly as possible.
Small cuts
Small cuts in the veins stop bleeding and clot within a few
minutes. The area should then be washed, and a plaster placed gently on top.
Deeper cuts
Deeper cuts in the veins produce dark blood that seeps out
slowly and steadily. It can be stopped by gentle pressure on the wound with a
sterile or clean cloth, followed by the application of a clean or sterile
bandage.
Often, these wounds need sewing or glueing, and therefore
medical treatment will be necessary after first aid.
Arterial bleeding
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WARNING!
Arterial bleeding must always be treated by a
doctor.
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Bleeding from an artery can cause death within a few minutes,
so urgent first aid is essential. This type of bleeding pulsates and squirts
blood as the pulse beats. The blood is often a light red colour.
To stop bleeding from an artery:
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apply hard pressure on the wound and keep this up until the
patient receives medical treatment.
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press with a sterile cloth or just use your hand if nothing
else is available.
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put a bandage on the wound if possible. If the blood soaks
through the bandages, press harder until the bleeding stops.
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do not remove the soaked bandages, but place another on top
if necessary.
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do not attempt to clean the wound.
The person must be made to lie down, preferably with their
head lower than the rest of their body. This will ensure that enough oxygen
gets to the brain.
If possible, position the wounded area higher than the rest of
their body so that the pressure, and therefore the bleeding, will be
reduced.
Nosebleeds
Nosebleeds occur when one of the small blood vessels in the
mucous membranes of the nose bursts.
Do not bend the head backwards or lie down, because this
increases blood pressure in the head and so increases the bleeding. Blood may
also run into the stomach.
To limit the bleeding:
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pinch the nostrils shut with the index and middle finger for 10
minutes. This way, the vein is pressed together, which is often enough to stem
the flow.
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while the nostrils are shut, the person must breathe through
their mouth.
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if the bleeding continues, it is important to contact a
doctor.
If the person frequently suffers sudden, intense nosebleeds,
they should also consult a doctor.
Choking
Choking happens when the passage through the windpipe is
blocked. This usually occurs when food that has not been thoroughly chewed gets
stuck.
If someone looks like they are choking, ask them if they are
able to talk.
A person who is genuinely choking can usually only communicate
with hand movements, and may place their hand against their throat. In such a
case they will definitely need help, so summon assistance for them.
Provided the person is conscious and breathing, you should not
interfere. However, be prepared to do so if the obstruction appears to become
complete or markedly worse.
The best way to relieve choking is by using the Heimlich
manoeuvre.
The Heimlich manoeuvre
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Stand behind the person who is choking.
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Place your arms around their waist and bend them well
forward.
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Clench your fist and place it right above the person's navel
(belly button).
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Place your other hand on top, then thrust both hands
backwards into the stomach with a hard, upward movement.
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Repeat this until the object stuck in the throat is expelled
through their mouth.
If you need to carry out this manoeuvre on yourself, place a
clenched hand above your navel (belly button) and your other hand on top. Then
thrust your fist hard into your stomach.
Repeat this until the object stuck in the throat is expelled
through the mouth.
Shock and fainting
Shock and fainting occur when only a small amount of blood
circulates to the brain. This means that the brain is not receiving enough
oxygen, which leads to a feeling of faintness, disorientation and dizziness.
Shock may also occur:
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after an accident involving loss of blood
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after a serious infection with loss of fluids
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after a serious burn
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after other accidents that cause loss of fluids or blood.
When the flow of blood in the body is too slow, the blood
pressure drops and too little oxygen is circulated through the body. When this
occurs a person will:
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go pale
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turn sweaty, clammy and cold
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become dizzy
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have a weak, fast pulse
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have low blood pressure
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have slow, weak breathing
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lose consciousness
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become anxious or restless.
What to do if someone is in shock or fainting
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The person must lie on their back - preferably with their
feet raised - to ensure enough blood gets to the brain.
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Make sure the person is warm, comfortable and covered by a
blanket if possible.
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Do not give them anything to drink because they could run a
risk of choking.
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If the person vomits or bleeds from the mouth, he or she must
be placed on their side to prevent choking.
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Call for an ambulance. A person in shock must always be
treated by a doctor.
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References
Resuscitation council (UK) guidelines 2000.
http://www.resus.org.uk/pages/guide.htm
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Based on a text by Dr Henrik Omark Petersen
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Last updated 16.02.2005
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