Blog

While not typically physiotherapy-related I thought it important to write on something everybody should know a little bit about – First Aid.

First Aid refers to emergency assistance given to an injured or ill person using readily available materials. This aid ranges from something as basic as removing a splinter from a child’s finger and putting on a plaster on the wound to giving care to casualties of a motor vehicle accident and handing them over to a medical team.

As you can imagine this is a broad area to cover. This article will touch on the basics of First Aid administered on an unconscious adult patient. Overall, I strongly recommend attending a First Aid course as you never know when this key knowledge could help to save a life!

First Aid always aims to:

• Preserve life
• Prevent the illness or injury from becoming worse
• Promote recovery

If in a situation where a patient is unconscious the first thing to do is quickly assess the area for any hazards. You will be no help to the person if you rush into a potentially risky scenario and injure yourself in the process adding to the casualty count. Once the area is safe ascertain the patient’s unresponsiveness  by talking to them – (ask and say ‘Hello?’) and then ask for assistance (call loudly for ‘Help’) to get someone to contact the emergency services. The sooner you get the patient medical attention the better! When deciding between calling an ambulance and transporting the patient yourself to the hospital, remember to ALWAYS preferably call an ambulance if you can. An ambulance is well equipped and the patient benefits from immediate medical help when trained paramedics arrive.

Administering CPR (Cardio-Pulmonary resuscitation):

While waiting for the ambulance, if an adult has collapsed and is unresponsive take 5 to 10 seconds to feel for a pulse.  This is done by placing two fingers on the patient’s carotid pulse where we feel for the artery found just below the angle of the jaw. 

If no pulse is felt ask a fellow bystander to contact the emergency services while you begin CPR as follows:

• Begin with chest compressions over the middle to lower half of the sternum (breast-bone). 
• Interlock your fingers and keep your elbows locked straight. 
• Press HARD and FAST. 
• You must press the chest down at least 5cm with each compression. 
• Remember to allow the chest to recoil between compressions. 
• Compress at a rate of at least 100 compressions per minute (believe it or not, this rhythm corresponds nicely with the beat of the Beegees’ hit “ Staying Alive”… I can hear you tapping your feet!)
• If you have a barrier device available (mask or one-way protective valve to protect you from blood and air-borne pathogens) you can interrupt compressions to give 2 breaths after every 30 compressions.  When giving breaths ensure that you see the chest rise with each breath you give.  If no barrier device is available it is acceptable to provide “hands-only” CPR – unless you are comfortable providing mouth to mouth breathing to the victim.

Automated Electronic Defibrillators

Many public places such as gyms and airports have access to Automated Electrical Defibrillators (AED’s).  Always call for one of these to be brought to a victim of cardiac arrest as soon as possible.  Do not be frightened of using such a device as it is voice prompted and very user friendly.  Once an AED has arrived turn it on and attach the pads to the victim by following the voice prompts.  Always minimize interruptions to your chest compressions even when applying the AED.  Follow the instructions of the AED. 

The AED will analyze the patient’s heart and will do one of two things:

1:  Recommend a shock – if a shock is required the AED will advise to keep clear of the patient and direct you to press a button to give the patient a shock.  After the shock has been administered you must immediately continue CPR, starting with chest compressions.

2:  No shock advised – If the AED does not recommend administration of a shock immediately continue with chest compressions until the AED commands “Re-analyze”

When contacting emergency services for a patient undergoing CPR make sure to be as specific as possible about the scenario and let the emergency services know that CPR is underway.  This will help prioritise your call at the dispatch office/call centre.

Key points: 

Early activation of emergency services, good quality CPR (push HARD, push FAST) and early access to an AED.

 If the victim resumes breathing and has a pulse place them on their side in what is called ‘the recovery position’. If they don’t resume breathing continue CPR until medical help arrives.

Useful First Aid courses are regularly held by the St John’s Ambulance Service and the academy of advanced life support {www.stjohn.org.za}

Emergency Services contact numbers:  Netcare911 (082-911), ER24(084-124), Gauteng EMS (10177) or dial 112 or 911 from any cellphone.

CPR saves lives.

If you don’t believe me ask Vinny Jones.  Watch  www.youtube.com/watch?v=JR0aZX1_TD8   and remember ‘push hard and fast to ‘Staying Alive’!’

Andrew@PhysioPRO