First Aid - Accidents

Accidents can happen anywhere, at any time. If you witness an accident or are the first person to arrive when one has happened, there are a few basic principles to follow to protect yourself and the patient:

Call 911 from where you are standing

Identify where you are, what seems to have happened and how many people you can see who may need help.

Survey the Scene

Remember, you cannot help if you are hurt. Make sure that whatever happened to the patient doesn’t happen to you too. Take a few deep breaths and look around. Look for hazards like downed power lines, hazardous materials or fires, and pay extra attention on roadways. Traffic around accident scenes is very dangerous.

Primary Patient Survey

If it is safe for you to approach the patient, begin by calling out as you walk up. If they do not respond as you approach, touch them and call out again. A person who responds to you by talking or crying is conscious, has an open airway and is breathing adequately.

Perform CPR

If they do not respond, this is likely a life-threatening situation. Remember that for every minute of delay in starting CPR, a patient’s chance of survival decreases 10%.

Check quickly for breathing by placing your ear near the patient’s mouth and looking down their chest for movement. If the patient is not breathing at all, or you see gasping, prepare to do CPR. Ask someone to look for a nearby Automated External Defibrillator (AED) if you are trained to use one. Make sure that 911 has been called if you didn’t do it yourself.

CPR is most effective when the patient is on their back on a hard, flat surface. It is a good idea to move the person out of a cramped space like a vehicle or small bathroom.

If you have been trained to do CPR, do what you know. If not, perform hands-only CPR by placing one hand on top of the other in the center of the patient’s chest, over the breastbone and push hard and fast at a rate of 100 beats per minute (many people think of the song”Stayin’ Alive”, or “Another One Bites the Dust”). Push to one third of the depth of the chest and allow for full recoil. You may feel popping and cracking: this is normal. Continue for as long as you are physically able, or until help arrives.

CPR can be a lifesaving intervention, especially when it is done quickly and with an AED. Unfortunately, not everyone can or will be saved, even with the best possible care. In a disaster, you may need to stop doing CPR if help is not able to reach you, and you become exhausted and there is no one else who can rotate in, or the situation becomes too unsafe.

What Is Shock?

Shock is what results when injury, trauma or illness is very severe, and the body is losing its ability to compensate. Oxygen and nutrient-carrying blood is not reaching body tissues like the heart, brain or lungs, and the tissue is becoming damaged. This may happen because of loss of blood, a body-wide
infection (sepsis), anaphylaxis, psychological trauma or other possible cause. Good basic first aid will require recognizing and caring for potential shock.

Shock may look like one or more of the following:

• Anxiety, restlessness or a feeling of impending doom
• Weakness or fatigue
• Rapid heart rate or breathing
• Nausea or vomiting
• Shaking or shivering uncontrollably
• Blue or gray color in the lips, gums or nailbeds regardless of complexion
• Confusion or disorientation up to unconsciousness

Handle the patient gently and reassure them. Keep communications calm, supportive and ongoing. Keep them from moving if you suspect a head, neck or back injury. First aid for shock is about supportive care.

• Keep them warm; protect them from extreme ground temperatures.
• Help protect the airway by putting them on their side with one leg raised in the recovery position if they are unconscious. (Someone on their back is in danger of choking.) 
• Do not let them eat or drink, to reduce the risk of vomiting.

Bone Fractures

Two types of fractures:

• Closed Fracture: a break or crack in a bone that does not puncture or penetrate the skin.
• Open Fracture: a break in the skin caused by a protruding bone, or an open wound in the area of the fracture. Open fractures are more serious than closed fractures

Some symptoms of a fracture:

• The injured part appears deformed.
• Pain is present when attempting to move the part.
• Absence of feeling when touched.
• Bluish color and swelling in the area of the injury.

To treat a fracture:

• Splint the patient before moving.
• Pad the splint and place it so that it supports the joint above and below the fracture.
• Immobilize a leg fracture by splinting the fractured leg to the unbroken leg if no other materials are present.
• If the limb is grossly deformed by the fracture, splint it in place. Do not try to straighten it.
• Elevate and use indirect (not on skin) ice packs if available.

Caring for Wounds

If you see a wound that is spurting or pulsating large amounts of blood, immediate action is needed. In most cases, applying external pressure with your hands to the bleeding vessel will be enough to stop the bleed. If you have a tourniquet and have been trained to use it, do so. (Wear gloves to protect yourself from all bodily fluids.)

• For wounds to the limbs, take clean soft material, preferably gauze, and press it deep into the wound. Apply pressure with both hands, leaning into the wound with your body weight - do not stop. Do not remove or move thedressing -you want the blood to clot.
• For gaping wounds or wounds to the shoulder or groin, pack clean soft material like a roll of gauze in to fill the wound and hold pressure using both your hands and body weight. Do not remove or move the dressing. You can always add more, if needed. Leave a "tail" so that emergency personnel can easily locate the end of the gauze.