First aid, the recovery position, and CPR
This article examines how to carry out first aid, why it is important, and the central role of recovery position and CPR in saving lives.
- The aims of first aid are to preserve life, prevent harm, and promote recovery.
- In first aid, ABC stands for airway, breathing, and circulation.
- The recovery position helps minimize further injury.
- CPR stands for cardiopulmonary resuscitation. It helps maintain the flow of oxygenated blood.
- While doing chest compressions, you may hear cracks. This is normal.
What is first aid?
First aid is vital at the scene of an emergency.
First aid is an emergency measure, generally consisting of simple, often life-saving techniques that most people can train to perform with minimal equipment and no previous medical experience.
The term usually refers to administering care to a human, although it can also be performed on animals.
It is not classed as medical treatment and does not replace interventions from a trained medical professional.
First aid is a combination of simple procedures and common sense.
Aims of first aid
The aims of first aid are:
- To preserve life: Saving lives is the main aim of first aid.
- To prevent further harm: The person who has experienced the injury must be kept stable, and their condition must not deteriorate before medical services arrive. This may include moving the individual away from harm, applying first aid techniques, keeping them warm and dry, and applying pressure to wounds to stop any bleeding.
- Promote recovery: Taking steps to promote recovery may include applying a bandage to a wound.
How to practice first aid
The most common term referred to in first aid is ABC. This stands for airway, breathing, and circulation. A fourth step will appear in the emergency procedures for some facilities.
- Airway: Make sure the airway is clear. Choking, which results from the obstruction of airways, can be fatal.
- Breathing: Once the airways are confirmed to be clear, determine whether the person can breathe, and, if necessary, provide rescue breathing.
- Circulation: If the person involved in the emergency situation is not breathing, the first aider should go straight for chest compressions and rescue breathing. The chest compressions will promote circulation. This saves valuable time. In emergencies that are not life-threatening, the first aider needs to check the pulse.
- Deadly bleeding or defibrillation: Some organizations consider dressing severe wounds or applying defibrillation to the heart a separate fourth stage, while others include this as part of the circulation step.
Evaluating and maintaining ABC with a patient depends on the training and experience of a first aider. As soon as ABC has been secured, the first aider can then focus on any additional treatments.
The ABC process must be carried out in that order.
However, there are times when a first aider might be performing two steps at the same time. This might be the case when providing rescue breathing and chest compressions to an individual who is not breathing and has no pulse.
It is important to use a primary survey to make sure the scene is clear of threats before stepping in to help:
- Danger: Check for dangers to the injured person and yourself. If there is danger, can it be cleared, or can the individual be moved away from further harm? If there is nothing you can do, stand clear, and call for professional help.
- Response: Once it is clear that all danger has ceased, check if the patient is conscious and alert, ask questions, and see if you get a response. It is also important to find out whether they respond to your touch and are aware of their pain.
- Airway: Check whether the airway is clear and, if not, try to clear it. Have the injured person lying on their back, and then place one hand on the forehead and two fingers from the other hand on the chin. Gently tilt the head back while slightly raising the chin upwards. Any obstructions need to be removed from the mouth, including dentures. Only insert fingers into the mouth of the injured indivisual if an obstruction is present.
- Breathing: Is the individual breathing effectively? The first aider should examine the chest for movement and the mouth for signs of breathing. Afterward, get close to the person to see if air can be felt on the cheek from breathing.
The first aider then needs to carry out a secondary survey, checking for deformities, open wounds, medic alert tags, and swellings.
If the injured person is breathing safely, carry out a rapid whole-body check for the following:
- open wounds
- medical alert tags advising of underlying conditions
This is known as a secondary survey. As soon as this has been completed, place the individual in a recovery position. At this point, the first aider should call for an ambulance.
Even if the individual is breathing but is unconscious, there is still a significant risk of airway obstruction. The recovery position reduces the risk to the patient. A first aider should do the following:
- If the individual is wearing glasses, remove them.
- Kneel next to the person, and place the arm nearest to you at a right angle to the body.
- Bring the other arm across the chest. Hold the back of your hand against their nearest cheek.
- With your other hand, hold the thigh furthest from you and pull up the knee. Make sure the foot is flat on the ground.
- Slowly pull down on the raised knee, and roll the body over towards you.
- Move the upper leg slightly, so that the hip and knee are bent at right angles. This makes sure that they do not roll onto their face.
- Gently tilt the head back so that the airway is kept open.
Cardio-pulmonary resuscitation (CPR)
CPR is one type of first aid that can save lives.
If the person is not breathing, the first aider will need to perform CPR.
In 2008, the European Resuscitation Council and the American Heart Association (AHA) reversed their policy on the effectiveness of only using chest compressions and advised that they can be used without artificial respiration on adults who suddenly collapse in cardiac arrest.
It is unlikely that CPR will start a heart. Its purpose is to maintain the flow of oxygenated blood to the brain and heart, preventing or at least delaying tissue death. CPR can extend the brief window of time during which successful resuscitation can take place without permanent brain damage.
In 2005, the International Liaison Committee on Resuscitation (ILCOR) agreed on new guidelines. The new guidelines make it simpler for first aiders and healthcare professionals to carry out early resuscitation.
The new guidelines stated that rescuers should progress straight to CPR if there is no breathing, rather than checking for a pulse. They also added that rescue breathing must not be performed without chest compression.
There are two main steps in CPR: Applying chest compressions and then providing breaths.
Apply 30 chest compressions:
The first aider should kneel next to the person who is injured. They should be lying on their back.
- For adults, place the heel of one hand in the middle of the chest. Place your other hand on top of the first hand and interlace the fingers.
- Push the chest down about 1.5 to 2 inches. If the person is a child aged between 1 and 8 years, compress to a maximum of 1.5 inches with one hand. Let go, and wait for the chest to come back up completely before repeating. Your elbows must remain straight throughout.
- Push the breastbone up and down to a depth of about 5 cm about 30 times, at a pulse rate of 100 beats per minute.
Provide two breaths:
- Make sure the airway is open, and pinch the nose so it closes.
- Gently raise the chin upwards with two fingers of your other hand.
- Take a deep breath, seal your mouth over that of the person with the injury, and exhale into the airway.
- You should see the chest rise and fall.
- To get another breath, lift your head and breathe in deeply. Perform steps 1, 2, 3, and 4 again.
Repeat the 30 chest compressions followed by the two breaths about five times, and then check for normal breathing. If they are not breathing normally, carry on performing CPR. If breathing restarts as normal, stay with the injured person until help arrives.
Chest compressions alone can be lifesavers – the crucial factor is time. Make sure you respond quickly.
It is important not to let your hands bounce when performing chest compressions. Make sure the heel of your hand is touching the chest throughout chest compressions.
You might hear some pops and snaps during chest compressions. These are normal, so do not stop.
You can seek official First Aid certification from the Red Cross by following this link.