European Resuscitation Council publishes Guidelines for First Aid
2015 sees for the first time the European Resuscitation Council produce guidelines for first aid and not just resuscitation. Back in 2012 The International Liaison Committee on Resuscitation (ILCOR) convened a task force to examine 22 areas of first aid to provide a standard international set of guidance for dealing with specific first aid emergencies.
WorkSafe will be including all of these outcomes in our revised training programmes and student materials which will be introduced during early 2016. In the meantime we have summarised the key areas of the First Aid Guidelines below:
First Aid for medical emergencies
Positioning of a breathing but unresponsive victim
Position individuals who are unresponsive but breathing normally into a lateral, side-lying recovery position as opposed to leaving them supine (lying on back). In certain situations such as resuscitation related agonal respirations or trauma, it may not be appropriate to move the individual into a recovery position.
Optimal position for a shock victim
Place individuals with shock into the supine (lying on back) position. Where there is no evidence of trauma use passive leg raising to provide a further transient (<7 min) improvement in vital signs; the clinical significance of this transient improvement is uncertain.
Oxygen administration for first aid
There are no direct indications for the use of supplemental oxygen by first aid providers.
Assist individuals with asthma who are experiencing difficulty in breathing with their bronchodilator administration. First aid providers must be trained in the various methods of administering a bronchodilator.
Use a stroke assessment system to decrease the time to recognition and definitive treatment for individuals with suspected acute stroke. First Aid providers must be trained in the use of FAST (Face, Arm, Speech Tool) or CPSS (Cincinnati Pre-hospital Stroke Scale) to assist in the early recognition of stroke.
Aspirin administration for chest pain
In the pre-hospital environment, administer 150–300 mg chewable aspirin early to adults with chest pain due to suspected myocardial infarction (ACS/AMI). There is a relatively low risk of complications particularly anaphylaxis and serious bleeding. Do not administer aspirin to adults with chest pain of unclear aetiology.
Second dose of adrenaline for anaphylaxis
Administer a second intramuscular dose of adrenaline to individuals in the pre-hospital environment with anaphylaxis that has not been relieved within 5 to 15 min by an initial intramuscular auto-injector dose of adrenaline. A second intramuscular dose of adrenaline may also be required if symptoms re-occur.
Treat conscious patients with symptomatic hypoglycaemia with glucose tablets equating to glucose 15–20 g. If glucose tablets are not available, use other dietary forms of sugar.
Exertion-related dehydration and rehydration therapy
Use 3–8% oral carbohydrate–electrolyte (CE) beverages for rehydration of individuals with simple exercise-induced dehydration. Alternative acceptable beverages for rehydration include water, 12% CE solution, coconut water, 2% milk, or tea with or without carbohydrate electrolyte solution added.
Eye injury from chemical exposure
For an eye injury due to exposure to a chemical substance, take immediate action by irrigating the eye using continuous, large volumes of clean water. Refer the individual for emergency healthcare professional review.
First Aid for Traumatic Injuries
Control of bleeding
Apply direct pressure, with or without a dressing, to control external bleeding where possible. Do not try to control major external bleeding by the use of proximal pressure points or elevation of an extremity. However it may be beneficial to apply localised cold therapy, with or without pressure, for minor or closed extremity bleeding.
Use a haemostatic dressing when direct pressure cannot control severe external bleeding or the wound is in a position where direct pressure is not possible. Training is required to ensure the safe and effective application of these dressings.
Use of a tourniquet
Use a tourniquet when direct wound pressure cannot control severe external bleeding in a limb. Training is required to ensure the safe and effective application of a tourniquet.
Straightening an angulated fracture
Do not straighten an angulated long bone fracture.
Protect the injured limb by splinting the fracture. Realignment of fractures should only be undertaken by those specifically trained to perform this procedure.
First aid treatment for an open chest wound
Leave an open chest wound exposed to freely communicate with the external environment without applying a dressing, or cover the wound with a non-occlusive dressing if necessary. Control localised bleeding with direct pressure.
Spinal motion restriction
The routine application of a cervical collar by a first aid provider is not recommended. In suspected cervical spine injury, manually support the head in position limiting angular movement until experienced healthcare provision is available.
Recognition of concussion
Although a concussion scoring system would greatly assist first aid providers in the recognition of concussion, there is no simple validated scoring system in use in current practice. An individual with a suspected concussion should be evaluated by a healthcare professional.
Cooling of burns
Actively cool thermal burns as soon as possible for a minimum of 10 min duration using water.
Subsequent to cooling, burns should be dressed with a loose sterile dressing.
If a tooth cannot be immediately re-implanted, store it in Hank’s Balanced Salt Solution. If this is not available use egg white, coconut water, whole milk, saline or Phosphate Buffered Saline (in order of preference) and refer the individual to a dentist as soon as possible.