First Aid
First aid
Definition
First aid is the initial basic treatment of an injured or ill person. First aid requires an observer first to evaluate the injured or ill person and then to intervene, using a small amount of supplies.
Purpose
First aid is provided to a person immediately following an accident or onset of illness to decrease complications and to offer psychological (emotional) and physical comfort. It is performed to decrease the individual's pain and suffering until emergency medical technicians (EMTs) or other health care givers arrive on the scene.
Precautions
The provision of first aid should never postpone the initial contact with the emergency medical system. The bystander should wear disposable latex gloves if available, in case of contact with blood or body fluids. If gloves are not available, plastic bags or wrap can be used as a protective barrier.
Description
First aid is a universal term that encompasses many general concepts for rapid assessment of health crises and intervention. The following sections present the most common injuries and illnesses requiring first aid, and the interventions appropriate in these situations.
Changes in mental status
ASSESSMENT. With any sudden changes in a person's brain functioning, first aid should start immediately. Assess the person for:
- unconsciousness
- lightheadedness
- weakness on one side of body
- aggressiveness
- confused state
- changes in orientation
- headache
- blurred or double vision
- unsteady balance
INTERVENTION. Initiate cardiopulmonary resuscitation (CPR ) if the person is not breathing. Secure the area around the person by removing any potential hazards, and maintain a favorable environment by providing an adequate area ventilation and room temperature. The person should be placed in a side-lying position.
Bleeding (hemorrhage)
ASSESSMENT. Assessing an injured person for bleeding must be done promptly, with first aid started immediately if there is active bleeding. All blood and body fluids must be regarded as potentially infectious, and protective barriers used.
INTERVENTION. Direct pressure should be applied to the hemorrhaging (bleeding) area by placing a clean pad or bandage over the site and pressing down with the palm of the hand. If bleeding persists, increase the amount of pressure to the area. If the person is awake and no latex gloves or other protective barriers are available, have him or her apply direct steady pressure to the hemorrhaging area. If the bleeding occurs on an arm or leg, elevate the bleeding part higher than the person's heart ; this position will help decrease the amount of blood flow to the injured area. When a person is losing blood, body temperature tends to decrease. Maintaining body temperature is an essential first-aid intervention.
Poisoning: inhalation, ingestion, or exposure
ASSESSMENT. Initial evaluation of a poison victim is done after the threat of exposure to the rescuer is determined. If noxious gas or fumes remain in the environment, the rescuer must first protect him-or herself and others. The rescuer must move the person to a secure environment as promptly as possible to start first aid.
INTERVENTION. The first and most important intervention is to call a poison control center and get instructions on how to proceed. Having information on the type of poison ingested, if possible, as well as reading the label over the phone or spelling out the active ingredients on the bottle, will help the poison control center in determining the appropriate interventions. The rescuer must never induce vomiting or give any substance unless directed by the poison control center.
Burns
ASSESSMENT. Burns are categorized by the extent of damage to the skin or underlying tissue. First-degree burns are the least critical; they cause reddening of the skin without blistering. Second-degree burns cause damage to the superficial (outer) and the internal (inner) layers of skin, creating bubble-like sores (blisters) that contain clear, watery liquid. Third-degree burns are the most severe and most damaging of all burns; the destruction of all layers of skin occurs and the burnt area is left open and charred. When applying first-aid concepts to burns, the rescuer must quickly assess the extent of damage to the person's skin. The rescuer needs to determine through assessment what to do next.
INTERVENTION. First-degree burns can usually be treated at home with a sterile burn gel, and complete healing should take place within one week. A person with a second-degree burn greater than the size of his or her palm should seek medical treatment, or if the burn is in a sensitive area like the groin. Third-degree burns need medical attention immediately. Ice application is not recommended for severe burns because ice can cause trauma to the area. Cool to lukewarm water is recommended. The burn victim must be covered, preferably with clean blankets, in order to maintain a normal body temperature.
Head/neck injuries
ASSESSMENT. It is vital for the rescuer to determine the nature of the head/neck injury, as well as if the person has had any loss of consciousness. This information should be conveyed to the emergency medical responders to help determine the need for further testing.
INTERVENTION. It is important to limit the movement of the victim of a head or neck injury, because it could result in more damage. Do not move the head or neck unless absolutely necessary—for example, if vomiting starts. In such a situation, the rescuer must carefully turn the person to the side in order to prevent inhalation of vomit into the lungs .
Seizure
ASSESSMENT. A seizure occurs when the brain emits irregular electrical signals. The person having a seizure usually falls to the ground and shakes. The person may lose urinary or bowel functioning.
INTERVENTION. It is important to clear a safe area for a seizure victim. Protecting the skull with a cushion or blanket will help decrease injuries to the head and neck. The rescuer should never restrain the victim or put anything in the mouth. When the seizure stops, place the
KEY TERMS
Emergency medical technician (EMT) —A person who is trained and certified to provide basic life support.
Hemorrhage —To be actively bleeding.
Superficial —A term meaning outermost or not deep.
victim in a side-lying position to avoid the breathing in of mucus and other secretions.
Muscle/bone injuries
ASSESSMENT. When there have been muscle or bone injuries, the person initiating first aid should assume that the arm or the leg is broken.
INTERVENTION. If the arm or leg appears misshapen, the rescuer should not try to align it. The rescuer wants to stabilize the injured body part in order to protect it from further injury. Ice application can reduce swelling and pain. Heat should not be used, because it increases circulation to the injured site.
Preparation
A first-aid kit can have a variety of equipment in it.
The basic items should include:
- ace bandages in a variety of sizes
- antibiotic ointment
- latex gloves
- a protective barrier/shield for use in CPR
- sterile gauze pads and wraps in a variety of sizes
- sealed alcohol packets
- scissors
- tape
- tweezers
Aftercare
The care needed after first aid varies widely, depending on the type of injury or illness sustained. Health care professionals are excellent resources to consult about appropriate individualized aftercare.
Complications
Many unexpected complications can happen while providing first aid. The most severe complication is if the patient stops breathing or the heart stops beating. In such a situation, the rescuer should immediately start CPR.
Results
The results of first aid vary with the case. Successful first aid results in the improved health and recovery of the patient.
Health care team roles
All health care professionals have a professional obligation to know the basics of first aid. Accidental injuries account for 2.6 million hospital admissions annually. Unplanned injury is the fifth-leading cause of fatalities in the United States.
Patient education
Health care professionals are in a position that allows them to provide education about first aid to patients. Emphasis on the importance of having a first-aid kit available and well stocked is valuable information to pass on to patients. Information about local areas that offer first-aid training should be offered.
Training
Extensive training is not needed for first aid. The Occupational Safety and Health Administration (OSHA) advises that retraining in first aid should occur every three years.
Good Samaritan Law
Legally, health care professionals coming to a person's aid in an emergency situation are covered under the federal Good Samaritan Law. Protection under this law requires that the situation is deemed an emergency, that no monetary compensation for the treatment is provided, and that the care provided is done "in good faith." In most U.S. states, health care professionals have no mandatory obligation to help in an emergency situation, but the Good Samaritan Law is in place to protect from liability those who do offer assistance.
Resources
PERIODICALS
American Heart Association. "Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Part 5: New Guidelines for First Aid." Circulation 102 (August 22, 2000): 77-85.
Brown, S. M. "Good Samaritan Laws: Protection and Limits." RN 62 (November 1999): 65-67.
Fiske, S. "Why Employees Need First Aid Training." Occupational Hazards 61 (February 1999): 55-57.
OTHER
Fuerst, R. "First Aid Kit Preparation from AAEM Emergency Medical and Family Health Guide: Public Health." eMedicine.com 2001. <http://www.emedicine.com/aaem/topic205.htm> (April 1, 2001).
Levin, H. "Burns from Consumer Treatment Guidelines: Injury and Wound Problems." eMedicine.com 2000. <http://www.emedicine.com/general/topic24.htm> (November 30, 2000).
Plantz, S. H. "Seizures from Wilderness Emergencies: Medical Disorders." eMedicine.com 2000. <http://www.emedicine.com/wild/topic48.htm> (February 9, 2000).
Lori Ann Beck, R.N., M.S.N., F.N.P.-C.
First Aid
First Aid
Definition
First aid is the initial basic treatment of an injured or ill person. First aid requires an observer first to evaluate the injured or ill person and then to intervene, using a small amount of supplies.
Purpose
First aid is provided to a person immediately following an accident or onset of illness to decrease complications and to offer psychological (emotional) and physical comfort. It is performed to decrease the individual's pain and suffering until emergency medical technicians (EMTs) or other health care givers arrive on the scene.
Precautions
The provision of first aid should never postpone the initial contact with the emergency medical system. The bystander should wear disposable latex gloves if available, in case of contact with blood or body fluids. If gloves are not available, plastic bags or wrap can be used as a protective barrier.
Description
First aid is a universal term that encompasses many general concepts for rapid assessment of health crises and intervention. The following sections present the most common injuries and illnesses requiring first aid, and the interventions appropriate in these situations.
Changes in mental status
ASSESSMENT. With any sudden changes in a person's brain functioning, first aid should start immediately. Assess the person for:
- unconsciousness
- lightheadedness
- weakness on one side of body
- aggressiveness
- confused state
- changes in orientation
- headache
- blurred or double vision
- unsteady balance
INTERVENTION. Initiate cardiopulmonary resuscitation (CPR) if the person is not breathing. Secure the area around the person by removing any potential hazards, and maintain a favorable environment by providing an adequate area ventilation and room temperature. The person should be placed in a side-lying position.
Bleeding (hemorrhage)
ASSESSMENT. Assessing an injured person for bleeding must be done promptly, with first aid started immediately if there is active bleeding. All blood and body fluids must be regarded as potentially infectious, and protective barriers used.
INTERVENTION. Direct pressure should be applied to the hemorrhaging (bleeding) area by placing a clean pad or bandage over the site and pressing down with the palm of the hand. If bleeding persists, increase the amount of pressure to the area. If the person is awake and no latex gloves or other protective barriers are available, have him or her apply direct steady pressure to the hemorrhaging area. If the bleeding occurs on an arm or leg, elevate the bleeding part higher than the person's heart; this will help decrease the amount of blood flow to the injured area. When a person is losing blood, body temperature tends to decrease. Maintaining body temperature is an essential first-aid intervention.
Poisoning: inhalation, ingestion, or exposure
ASSESSMENT. Initial evaluation of a poison victim is done after the threat of exposure to the rescuer is determined. If a noxious gas or fumes remain in the environment, the rescuer must first protect him- or herself and others. The rescuer must move the person to a secure environment as promptly as possible to start first aid.
INTERVENTION. The first and most important intervention is to call a poison control center and get instructions on how to proceed. Having information on the type of poison ingested, if possible, as well as reading the label over the phone or spelling out the active ingredients on the bottle, will help the poison control center in determining the appropriate interventions. The rescuer must never induce vomiting or give any substance unless directed by the poison control center.
Burns
ASSESSMENT. Burns are categorized by the extent of damage to the skin or underlying tissue. First-degree burns are the least critical; they cause reddening of the skin without blistering. Second-degree burns cause damage to the superficial (outer) and the internal (inner) layers of skin, creating bubble-like sores (blisters) that contain clear, watery liquid. Third-degree burns are the most severe and most damaging of all burns; the destruction of all layers of skin occurs and the burnt area is left open and charred. When applying first-aid concepts to burns, the rescuer must quickly assess the extent of damage to the person's skin. The rescuer needs to determine through assessment what to do next.
INTERVENTION. First-degree burns can usually be treated at home with a sterile burn gel, and complete healing should take place within one week. A person with a second-degree burn greater than the size of his or her palm should seek medical treatment, or if the burn is in a sensitive area like the groin. Third-degree burns need medical attention immediately. Ice application is not recommended for severe burns because ice can cause trauma to the area. Cool to lukewarm water is recommended. The burn victim must be covered, preferably with clean blankets, in order to maintain a normal body temperature.
Head/neck injuries
ASSESSMENT. It is vital for the rescuer to determine the nature of the head/neck injury, as well as if the person has had any loss of consciousness. This information should be conveyed to the emergency medical responders to help determine the need for further testing.
INTERVENTION. It is important to limit the movement of the victim of a head or neck injury, because it could result in more damage. Do not move the head or neck unless absolutely necessary—for example, if vomiting starts. In such a situation, the rescuer must carefully turn the person to the side in order to prevent inhalation of vomit into the lungs.
Seizure
ASSESSMENT. A seizure occurs when the brain emits irregular electrical signals. The person having a seizure usually falls to the ground and shakes. The person may lose urinary or bowel functioning.
INTERVENTION. It is important to clear a safe area for a seizure victim. Protecting the skull with a cushion or blanket will help decrease injuries to the head and neck. The rescuer should never restrain the victim or put anything in the mouth. When the seizure stops, place the victim in a side-lying position to avoid the breathing in of mucus and other secretions.
Muscle/bone injuries
ASSESSMENT. When there have been muscle or bone injuries, the person initiating first aid should assume that the arm or the leg is broken.
INTERVENTION. If the arm or leg appears misshapen, the rescuer should not try to align it. The rescuer wants to stabilize the injured body part in order to protect it from further injury. Ice application can reduce swelling and pain. Heat should not be used, because it increases circulation to the injured site.
Preparation
A first-aid kit can have a variety of equipment in it. The basic items should include:
- ace bandages in a variety of sizes
- antibiotic ointment
- latex gloves
- a protective barrier/shield for use in CPR
- sterile gauze pads and wraps in a variety of sizes
- sealed alcohol packets
- scissors
- tape
- tweezers
Aftercare
The care needed after first aid varies widely, depending on the type of injury or illness sustained. Health care professionals are excellent resources to consult about appropriate individualized aftercare.
Complications
Many unexpected complications can happen while providing first aid. The most severe complication is if the patient stops breathing or the heart stops beating. In such a situation, the rescuer should immediately start CPR.
Results
The results of first aid vary with the case. Successful first aid results in the improved health and recovery of the patient.
Health care team roles
All health care professionals have a professional obligation to know the basics of first aid. Accidental injuries account for 2.6 million hospital admissions annually. Unplanned injury is the fifth-leading cause of fatalities in the United States.
Patient education
Health care professionals are in a position that allows them to provide education about first aid to patients. Emphasis on the importance of having a first-aid kit available and well stocked is valuable information to pass on to patients. Information about local areas that offer first-aid training should be offered.
Training
Extensive training is not needed for first aid. The Occupational Safety and Health Administration (OSHA) advises that retraining in first aid should occur every three years.
Good Samaritan Law
Legally, health care professionals coming to a person's aid in an emergency situation are covered under the federal Good Samaritan Law. Protection under this law requires that the situation is deemed an emergency, that no monetary compensation for the treatment is provided, and that the care provided is done "in good faith." In most U.S. states, health care professionals have no mandatory obligation to help in an emergency situation, but the Good Samaritan Law is in place to protect from liability those who do offer assistance.
KEY TERMS
Emergency medical technician (EMT)— A person who is trained and certified to provide basic life support.
Hemorrhage— To be actively bleeding.
Superficial— A term meaning outermost or not deep.
Resources
PERIODICALS
American Heart Association. "Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Part 5: New Guidelines for First Aid." Circulation 102 (August 22, 2000): 77-85.
Brown, S. M. "Good Samaritan Laws: Protection and Limits." RN 62 (November 1999): 65-67.
Fiske, S. "Why Employees Need First Aid Training." Occupational Hazards 61 (February 1999): 55-57.
OTHER
Fuerst, R. "First Aid Kit Preparation from AAEM Emergency Medical and Family Health Guide: Public Health." eMedicine.com 2001. 〈http://www.emedicine.com/aaem/topic205.htm〉 (April 1, 2001).
Levin, H. "Burns from Consumer Treatment Guidelines: Injury and Wound Problems." eMedicine.com 2000. 〈http://www.emedicine.com/general/topic24.htm〉 (November 30, 2000).
Plantz, S. H. "Seizures from Wilderness Emergencies: Medical Disorders." eMedicine.com 2000. 〈http://www.emedicine.com/wild/topic48.htm〉 (February 9, 2000).
first aid
first aid
first aid • n. help given to a sick or injured person until full medical treatment is available: an expert in emergency first aid [as adj.] a first-aid kit. DERIVATIVES: first aid·er / ˈādər/ n.