First Aid

What is the aim of First Aid ?

The key aims of first aid can be summarised in three key points

Preserve life is the overriding aim of all medical care, including first aid, is to save lives

Prevent further harm also sometimes called preventing the condition worsening, this covers both external factors, such as moving a patient away from a cause of harm, and applying first aid techniques to prevent worsening of the condition, such as applying pressure to stop a bleed becoming dangerous.

Promote recovery - first aid also involves trying to start the recovery process from the illness or injury, and in some cases might involve completing a treatment, such as in the case of applying a plaster to a small wound.

First aid training often also incorporates the prevention of initial injuryand responder safety, as well as the treatment phases.

What are the Key Skills Required?

Certain skills are considered essential to the provision of first aid and are taught ubiquitously. Particularly, the "ABC"s of first aid, which focus on critical life-saving intervention, must be rendered before treatment of less serious injuries. ABC stands for Airway, Breathing, and

Circulation. The same mnemonic is used by all emergency health professionals. Attention must first be brought to the airway to ensure it is clear. Obstruction (choking) is a life-threatening emergency. Following evaluation of the airway, a first aid attendant would determine adequacy of breathing and provide rescue breathing if necessary. Assessment of circulation is now not usually carried out for patients who are not breathing, with first aiders now trained to go straight to chest compressions (and thus providing artificial circulation) but pulse checks may be done on less serious patients.

Some organizations add a fourth step of "D" for Deadly bleeding or Defibrillation, while others consider this as part of the Circulation step. Variations on techniques to evaluate and maintain the ABCs depend on the skill level of the first aider. Once the ABCs are secured, first aiders can begin additional treatments, as required. Some organizations teach the same order of priority using the "3 Bs": Breathing, Bleeding, and Bones. While the ABCs and 3Bs are taught to be performed sequentially, certain conditions may require the consideration of two steps simultaneously. This includes the provision of both artificial respiration and chest compressions to someone who is not breathing and has no pulse, and the consideration of cervical spine injuries when ensuring an open airway.

Preserving life

As the key skill to first aid is preserving life, the single most important training a first aider can receive is in the primary diagnosis and care of an unconscious or unresponsive patient. The most common mnemonic used to remember the procedure for this is ABC, which stands for Airway,

Breathing and Circulation.

In order to preserve life, all persons require to have an open airway - a clear passage where air can move in through the mouth or nose through the pharynx and down in to the lungs, without obstruction. Conscious people will maintain their own airway automatically, but those who are unconscious (with a GCS of less than 8) may be unable to maintain a patent airway, as the part of the brain which autonomously controls in normal situations may not be functioning.

If an unconscious patient is lying on his or her back, the tongue may fall backward, obstructing the oropharynx (sometimes incorrectly called "swallowing" the tongue). This can be easily rectified by a first aider tipping the head backwards, which mechanically lifts the tongue clear.

If the patient was breathing, a first aider would normally then place them in the recovery position, with the patient leant over on their side, which also has the effect of clearing the tongue from the pharynx. It also avoids a common cause of death in unconscious patients, which is choking on regurgitated stomach contents.

The airway can also become blocked through a foreign object becoming lodged in the pharynx or larynx, commonly called choking. The first aider will be taught to deal with this through a combination of 'back slaps' and 'abdominal thrusts'.

Once the airway has been opened, the first aider would assess to see if the patient is breathing. If there is no breathing, or the patient is not breathing normally, such as agonal breathing, the first aider would undertake what is probably the most recognized first aid procedure - Cardiopulmonaryresuscitation or CPR, which involves breathing for the patient, and manually massaging the heart to promote blood flow around the body.

Promoting recovery

The first aider is also likely to be trained in dealing with injuries such as cuts, grazes or broken bones. They may be able to deal with the situation in its entirety (a small adhesive bandage on a paper cut), or may be required to maintain the condition of something like a broken bone, until the next stage of definitive care (usually an ambulance) arrives.

When First Aid is Required ?

Altitude sickness, which can begin in susceptible people at altitudes as low as 5,000 feet, can cause potentially fatal swelling of the brain or lungs.

Anaphylaxis, a life-threatening condition in which the airway can become constricted and the patient may go into shock. The reaction can be caused by a systemic allergic reaction to allergens such as insect bites or peanuts.Anaphylaxis is initially treated with injection of epinephrine.

Battlefield First aid - This protocol refers to treating shrapnel, gunshot wounds, burns, bone fractures, etc. as seen either in the 'traditional'battlefield setting or in an area subject to damage by large scale weaponry, such as a bomb blast or other terrorist activity.

Bone fracture, a break in a bone initially treated by stabilizing the fracture with a splint.

Burns, which can result in damage to tissues and loss of body fluids through the burn site.

Choking, blockage of the airway which can quickly result in death due to lack of oxygen if the patient's trachea is not cleared, for example by the Heimlich Maneuver.

Childbirth.

Cramps in muscles due to lactic acid build up caused either by inadequate oxygenation of muscle or lack of water or salt.

Joint dislocation.

Diving disorders resulting from too much pressure.

Near drowning or asphyxiation.

Gastrointestinal bleeding.

Gender-specific conditions, such as dysmenorrhea and testicular torsion.

Heart attack, or inadequate blood flow to the blood vessels supplying the heart muscle.

Heat stroke, also known as sunstroke or hyperthermia, which tends to occur during heavy

exercise in high humidity, or with inadequate water, though it may occur spontaneously in some chronically ill persons. Sunstroke, especially when the victim has been unconscious, often causes major damage to body systems such as brain, kidney, liver, gastric tract. Unconsciousness for more than two hours usually leads to permanent disability. Emergency treatment involves rapid cooling of the patient.

Heat syncope, another stage in the same process as heat stroke, occurs under similar conditions as heat stroke and is not distinguished from the latter by some authorities.

Heavy bleeding, treated by applying pressure (manually and later with a pressure bandage) to the wound site and elevating the limb if possible.

Hyperglycemia, or diabetic coma.

Hypoglycemia, or insulin shock.

Hypothermia, or Exposure, occurs when a person's core body temperature falls below 33.7°C (92.6°F). First aid for a mildly hypothermic patient includes rewarming, but rewarming a severely hypothermic person could result in a fatal arrhythmia, an irregular heart rhythm.

Insect and animal bites and stings.

Muscle strain.

Poisoning, which can occur by injection, inhalation, absorption, or ingestion.

Seizures, or a malfunction in the electrical activity in the brain. Three types

In General: First Aid pads are not effective at all when it comes to killing germs.

First Aid pads are normally packed in a sterile environment into sterile "bags" so that they keep sterile and "fresh" even after long term storage.

The thing about using them is that they are sterile to start with. Any bacteria present in a wound will most likely multiply in a First Aid pad. This is why it is important to change them regularly. Bacterias in the pad is not always bad though. Certain bacteria can actually kill off other more humanly dangerous bacteria.

We can use various creams or powders in order to promote the forming of new tissue where we have a wound, . These can have anti bacterial properties, they can have anti fungal properties and even anti viral properties, in addition to promoting the forming of new tissue.

There are of course different pads and some are manufactured with various additives that most likely will kill off a broad spectrum of bacteria. These are quite effective but not what I would expect to find or be given over a counter unless I ask for those in specific.

Exactly how effective they are on killing germs is difficult to give an accurate answer to.

They might be very good on certain common bacteria but not good at all on other not so common bacteria.

Thoughts to bear in mind:

The real killer for most all types of bacteria is good hygiene and "Dryness". Like all living things, bacterias can not live for long in a dry environment. Changing wet/moist pads is a method that can be used in order to slow down growth of bacteria. This is most often a better and safer way in order to heal up a wound rather than applying all sorts of creams in order to kill the germs.

There are considerations here too though. Our skin does not heal well without scarring in a very dry environment. Moist without being wet is good and increases the rate of healing; this unfortunately creates a place where bacteria might thrive.

The art of healing up wounds is indeed an art of its own. We wander in zones of grey, not black, not white. First Aid pads is one answer to many problems, but further in depth knowledge is often the key to a near perfect solution for specific wounds.