Introduction To First Aid

Key Takeaways – What is First Aid?

First aid is the immediate care given to an injured or ill person until professional medical help arrives.
The four main aims of first aid are to protect life, prevent further harm, promote recovery, and preserve life.
A first aider’s role is to bridge the gap between the incident and advanced medical care using steps like DRSABCD.
DRSABCD stands for Danger, Response, Send for help, Airway, Breathing, CPR, and Defibrillation (AED).
In Australia, call Triple Zero (000) in life-threatening emergencies; 112 is the mobile alternative.
Duty of care applies in certain situations, requiring first aiders to act within their training to avoid negligence.
Consent is usually required before treatment, but it can be implied if the casualty is unconscious or unable to respond.
Good Samaritan laws protect individuals who provide first aid in emergencies without expectation of payment.
Workplace first aiders must meet WHS requirements and maintain current training, including annual CPR refreshers.
Infection control—such as hand washing and PPE use—reduces the risk of spreading diseases during first aid.

What is First Aid?

First aid assistance is the initial care given to an injured or ill casualty until a expert, nurse, or medical doctor arrives.

The four aims of first aid are to:

Protect life
Prevent further deterioration
Promote recovery
Preserve life

Any attempt is better than no attempt!

Primary Purpose and Objective of Being a First Aider

A first aider is essential for any area, group, or organisation. The primary purpose of first aid is to preserve life. In the same way, when a person gets injured or is afflicted with an illness or disease, the first aider is there to help and ensure no further harm is caused, and that life is preserved. Their primary role is to act as the bridge of care for professional medical care to arrive. This includes basic first aid procedures contained in the DRSABCD steps.

What Are the First Aid Steps?

The DRSABCD steps are as follows:

Danger—Check for danger and ensure that the casualty, bystanders, and, most importantly, you—the first aider—are free from further threat. One important rule is that first aiders should never put themselves in danger, as they cannot give more care to casualties.
Response—Assess the casualty’s responsiveness. Check whether they are conscious and able to respond to you.
Send for Help—If the first aider cannot Call an ambulance, ask bystanders to do so. Also, seek help from those bystanders for any care the casualty needs.
Airway—Start administering first aid. The first step is to check the person’s airway. The goal is to ensure the person’s airway is clear and unobstructed. Whether it is obstructed or not will dictate the next step.
Breathing – If the airway is clear and the person is breathing clearly, this step and all subsequent steps are considered done. If they are not breathing, first aiders need to provide CPR.
CPR—Begin administering CPR. Successful and continuous administration of CPR increases the chances of survival. This must be done until medical assistance arrives or signs of life return.
AED – The final step is the Automated External Defibrillator, or AED, used on the casualty in tandem with CPR.

First Aid Basics – Calling for Medical Assistance

Triple Zero (000)

Stay focused, stay relevant, and stay on the line for immediate first aid procedures:

Is someone seriously injured or in need of urgent medical help?
Is your life or property being threatened?
Have you just witnessed a serious accident or crime?
If you answered YES, call Triple Zero (000). Triple Zero calls are free.

When you call Triple Zero (000), the medical emergency operator will ask:

Do you want Police, Fire, or Ambulance?
Stay calm, don’t shout, and speak slowly and clearly
Tell us exactly where to come. Give an address or location

If you are deaf or have a speech or hearing impairment, call 106:

This is a Text Emergency Call, not an SMS
You can call teletypewriters
State which service you need and where to come

Mobile phone services: Triple Zero (000) & One One Two (112):

Triple Zero (000) is Australia’s primary telephone number for assistance in life-threatening or time-critical emergencies.
112 is a secondary emergency number that can be dialled from mobile phones in Australia.
The misconception is that 112 calls will be carried by satellite without mobile coverage. Satellite phones use different technologies, and your mobile phone cannot access a satellite network.
Necessary – if there is no mobile coverage on any network, you cannot reach the Emergency Call Service via a mobile phone, regardless of which number you dialled.
112 is an international standard emergency number that can only be dialled on a digital mobile phone.

Legal Aspects – Duty of Care

In Australia, trained first aiders are only obliged to render reasonable care in an emergency (or carry a duty of care) if:

They were involved in the incident;
They are on the ocean (e.g. sailing); or
They choose to accept the responsibility for land

Other situations that would be considered ‘accepting responsibility” or ‘carrying a duty of care’ could be:

Parenting or babysitting a child
Employment that involves workplace health and safety or first aid provision (e.g. first aid officer role, police officer, teacher, personal trainer, etc.)
Suppose you are an employer, manager, supervisor, or person conducting business (PCBU). In that case, you must meet the workplace code of practice and work health and safety legislation (WHS), especially in high-risk workplaces.
Stopping at an emergency – remember that by starting to help, you are establishing a duty of care.

People with first aid qualifications and certificates are not always automatically expected to assist in emergencies. A duty of care must exist for the legal obligation to occur. Neglecting an existing duty of care may result in implications associated with negligence. You are encouraged to seek legal advice to identify your legal implications or for further clarification.

The standard of care required of a person with a duty of care to respond is higher. Like other persons in our community who hold themselves out to have a skill, they must perform their tasks to a standard expected of a reasonably competent person with their training and experience. However, this does not mean that the standard of care must be the highest level.

All first aiders should remain at the scene if safe, caring for the casualty until medical aid (such as a medical doctor, nurse, expert, ambulance officer, or fire brigade) takes over.

Legal Aspects – The Protection of Good Samaritans

A Good Samaritan is an individual who provides assistance, advice, or lifesaving care in an emergency or accident in circumstances in which he or she expects no money or any other financial reward.

First aiders providing life support should always stay within the limits of their training and use appropriate first aid equipment such as an AED, defibrillator, and disposable gloves when necessary. Unless the first aider is put in danger by staying, they are legally expected to continue supporting until a healthcare professional takes over. Neglecting a duty of medical care or ignoring the limits of first aid training may result in further implications associated with the law.

Should a casualty recover and the nature of their condition does not require medical attention, the first aider may end their duty of care to the casualty.

Legal Aspects – Casualty Consent

A first aider must obtain their consent before providing first aid to a “competent” casualty. If first aid is provided without permission, it has the potential of being counted as a “medical trespass” (assault). Conscious casualties have the right to refuse first aid treatment, and their wishes must be respected.

If a casualty is a minor (under 18 years old), you should gain consent from a parent or guardian. Parents and guardians have the right to refuse first aid treatment for their minors. In the absence of a parent or guardian, first aiders should regard children as having impaired decision-making capacity.

In the event of refusal, first aiders with a duty of care should contact 000 (ambulance) for advice and stay at the scene (if safe) until otherwise advised.

When is Consent Implied in First Aid?

There are some instances where consent is implied in first aid. If the victim cannot communicate with the first aider, this is implied consent. In this case, the first aider would assume that the victim would ask for help if they could communicate. Situations include being unconscious, having a mental disorder, and even being intoxicated.

Legal Aspects –Treatment Without Consent

Although first aid treatment typically requires consent, an injured or ill person should not be deprived of first aid merely because they lack decision-making capacity. The key legal factors which determine whether treatment can be given without consent are:

Whether the casualty has or does not have decision-making capacity;
Whether an advance care directive exists;
The degree of urgency of the situation and;
Whether a substitute decision-maker is present, willing, and able to consent

Suppose the casualty is incapable of consenting (e.g. the casualty is unconscious) and no substitute decision-maker is present. In that case, a first aider may perform a risk assessment and provide urgent first aid to preserve life and health without consent (unless an advance care directive prohibits such treatment).

This means the legal requirement to obtain consent before providing assistance or treatment is waived under Common Law and Statute law in several circumstances, e.g. if the casualty is unconscious or becomes unconscious before consent was discussed.

Refer to ARC Guideline 10.5, “Legal & ethical issues related to resuscitation.”

Legal Aspects – First Aid and Workplace Health and Safety

In all Australian states, there is legislation that requires all employers to provide a safe working environment for all employees to have good mental health. They are also obliged to ensure the provision of first aid and first aid equipment in the event of an emergency and the availability of first aid facilities.

Designated workplace first aiders meet competency and have a legal duty of care to give first aid to any person suffering an illness or injury in the workplace if they are safe. This requires the designated first aider to attend regular first aid training sessions to keep their skills current. Refresher CPR training should be undertaken annually according to ARC guidelines and the Code of Practice for First Aid.

For further information, contact your state government occupational health & safety regulator.

Legal Aspects – Privacy and Confidentiality

Where possible, a first aider who meets the first aid requirements must take steps to assist the casualty to maintain dignity and personal privacy. Methods of doing this can be by:

Having crowd control
Putting up a privacy screen
If appropriate to do so, move the casualty to a quiet area
Cover up any exposed body parts, e.g. emergency rescue blanket, sheets, blankets

The Privacy Act and Principles impact upon all first aid rendered, therefore a first aider needs to take steps to maintain confidentiality. This means you should not disclose the casualty’s details, incident details, medical conditions, and aid rendered to family members or close friends or answer questions from the media unless you have permission from the casualty.

Record Keeping

It is important that any serious injury and accident, occurring inside or outside of work, be recorded in writing.
Each workplace should have appropriate documentation for the reporting of illness or injury.
These documents need to be completed in full and should not be altered. Therefore, correction fluid or pencil should not be used on these documents.

If an incident occurs outside of the workplace, first aiders should take accurate, brief, and clear notes and keep them on hand in case an investigation takes place.

Notes should include:

At the time of the incident
The date of the incident
The location of the incident
What the first aider found upon arrival
What actions did the first aider carry out
Any changes in the casualty’s condition
Any witness details
Handover to medical professional’s details
Did the casualty recover and relieve the first aider of their duty of care?

All documentation should be signed and dated by the first aider and stored securely to maintain confidentiality, such as in a first aid room. Keep your notes clear and easy to understand, and ensure you write down exactly how things are presented.

(Childcare) – Law Section 174, Regulations 12, 85-87, 168, 177-178, 183

First aid in education and care settings is critical, especially since people are working with children. Centres must have incident, injury, trauma, and illness policies and procedures if a child: (a) is injured, (b) becomes ill, or (c) suffers a trauma.
A Centre must ensure that a child’s parent is notified as soon as practicable but no later than 24 hours after an occurrence if the child is involved in an incident, injury, trauma, or illness.
The details of the occurrence must be correctly and accurately recorded within 24 hours.
The occurrence records are stored safely and securely until the child is 25.
That the Regulatory Authority is notified of a severe incident which includes: (a) death of a child; or (b) where medical assistance was required; or (c) attendance of emergency services at the education and care service premises was sought, or ought reasonably to have been sought.

Human Anatomy

The human body comprises different anatomical and physiological systems, each performing a vital role. While it is not crucial for a first aider to know detailed information about these systems, having a basic knowledge of how the systems work will benefit the first aider.

Several are particularly useful for a first aider to have a basic knowledge of.

Skeletal System

The skeletal system consists of 206 bones that structure our bodies and protect our internal organs from damage. Muscles, ligaments, and tendons are closely linked to this system and play vital roles in allowing movement and function of limbs and body parts.

The bones of the skeleton have four main functions:

To give shape to the body
To produce blood cells
Support muscles to allow movement
Protect vital organs

Cardiovascular System

This system consists of the heart, blood, and blood vessels. Blood flowing from the heart delivers oxygen and nutrients to every body part. The bloodstream removes waste products by transporting them to the kidneys and other organs.

Heart – is a muscular organ in the chest that pumps blood around our body. The heart is divided into four chambers: upper left and right atria and lower left and right ventricles. The average adult resting heart rate is 60 – 100 beats per minute.

The heart is a muscle that pumps blood to all parts of the body. Blood provides the body with the oxygen and nourishment it needs to function. Organs such as the kidneys remove waste products carried by the blood from the body. The right side of the heart obtains deoxygenated blood via the central veins (Superior and Inferior Vena Cava). It pumps this blood to the lungs, where oxygen is absorbed and carbon dioxide is released.

The oxygenated blood returns to the heart via the pulmonary vein and enters the left atrium.
The blood is pumped into the left ventricle, which pumps it into the body’s main artery—the aorta. The aorta is the body’s largest artery and carries blood to smaller arteries that distribute it to all body parts. On the return trip, the now deoxygenated blood is pumped back to the heart via veins into the right atrium, and the cycle continues.

Blood – blood is composed of a transparent liquid called plasma. Red blood cells make the blood look red and deliver oxygen. White blood cells are part of your body’s defence against disease. Platelets are cells that help your body repair itself after injury through coagulation (clotting).

Blood Vessels—Arteries transport oxygenated blood away from the heart, while veins transport deoxygenated blood back to the heart. Arteries narrow into arterioles, and capillaries are the smallest vessels connecting the arterioles to the venules. It is at this level that the majority of cell transfusion takes place.

Heart Rate / Pulse – heart rate, or pulse, is the number of times the heart beats per minute. The average heart rate varies from person to person. The average regular resting heart rates, which vary with age, are:

Basic knowledge of this system will help me understand the mechanics of cardiopulmonary resuscitation (CPR) to treat cardiac arrest and DRS ABCD.

Nervous System

The nervous system comprises your brain, spinal cord, and a vast network of nerves threading throughout your body. The nerves receive and conduct information to the brain for processing, enabling the coordination of our actions and reactions. From applying correct pressure when gripping a cup to retracting your hand from a sharp or hot object.

Basic knowledge of this system is valuable when dealing with burns and pain management.

Respiratory System

As all cells in our body need oxygen to survive, our respiratory system is vital to our survival.

This system comprises of 2 parts:

Airway – mouth, nose, trachea, larynx, bronchi and bronchioles.

Lungs are large bags of air that contain tiny air sacs called alveoli. As we breathe, oxygen from the alveoli is filtered into the bloodstream, releasing carbon dioxide. This process is essential to our survival – 4-6 minutes without oxygen can cause permanent brain damage.
A basic understanding of this system is helpful when learning about airway management and CPR.

Breathing moves air in and out of the lungs or oxygen through other respiratory organs. This process is also known as ventilation

Children have quicker respiratory rates than adults, and women breathe more often than men. The normal ranges for different age groups are listed as follows:

Upper Airway

A child’s airway differs from an adult’s in that the child’s tongue is proportionately more significant in the oropharynx than an adult’s.
Also, a child’s airway is smaller, softer, and more prone to foreign body obstruction. The trachea is usually about the diameter of a pencil.

Infants have very short and softer tracheas than adults. This means that overextension of the head (Tilting the head) during CPR may result in airway collapse (not too dissimilar to kinking a narrow garden hose).

Unconsciousness

The causes of unconsciousness can be categorised into four general groups:

Low oxygen levels in the brain
Heart and circulation problems (e.g. fainting, abnormal heart rhythms, severe blood loss)
Metabolic problems (e.g. low blood sugar, drug overdose, intoxication)
Brain problems (e.g. stroke, head injury, tumour, epilepsy)

Signs and Symptoms

Before the casualty has loss of consciousness, they may experience:

Yawning
Dizziness and lightheadedness, confusion
Sweating
Normal skin colour changes
Changed or blurred vision, slurred speech
Nausea

Musculoskeletal System

The musculoskeletal system is a term used to describe the bones and the adjoining ligaments, tendons, and muscles. The following section will provide an overview of the names and locations of different bones; however, you are not expected to demonstrate a complete knowledge of all the bones listed.
It is recommended that you become familiar with the following section. It will assist you in understanding medical terminology and give you a more significant knowledge base as a first aider so that you can understand and communicate effectively.

Infection Control

When giving first aid to a sick or injured person, you should try to minimise the risks to yourself, bystanders, and the casualties.
All around the world, any one person could be infected with an infectious disease. This any one person could very well be your casualty. Life-threatening diseases can include HIV/AIDS and hepatitis strains.

Chain of Infection

Whether or not infection occurs will depend on several factors. The chain of infection best explains this.

The Six Links to the Chain of Infection

For infection to occur, the links to the Chain of Infection must occur.

Infectious Agent: Any disease-causing microorganism (pathogen), i.e. bacteria, viruses.
Reservoir: Where the pathogen is located (i.e. blood, saliva)
Portal of Exit: The route of escape of the pathogen from the reservoir (i.e. saliva via coughing, blood via a cut in the skin)
Mode of Transmission: How the pathogen gets from the reservoir to its new host (i.e. propelled through the air, direct contact)
Portal of Entry: The route in which the pathogen enters the new host (breaks in skin (cuts, wounds), inhalation, ingestion, sexual contact).
Susceptible Host: The organism that accepts the pathogen (you or the casualty)

How to Break the Chain of Infection

Correct Hand Washing—Proper hand washing by the First Aider remains the most critical factor in preventing the spread of microorganisms. The attached picture displays good hand-washing techniques.

Barriers—Use barrier equipment whenever possible (gloves, masks, face shields, eye protection, and tongs usually stored in a first aid kit). Barriers dramatically lessen the spread of infection, both to the casualty and you!

It is essential that when providing first aid treatment, standard precautions are taken to limit the risk of infection by avoiding direct contact with the infection. Besides the preventative measures already mentioned, you should:

Avoid coughing, breathing, or speaking over the wound
Avoid contact with body fluids

NOTE: In many emergencies, the first aider may not have access to gloves, masks, or other PPE. Where it is not practical to use PPE, as stated, one may ‘improvise’ by using plastic bags, clothing, or whatever is available to protect themselves and the casualty.

CONCLUSION

That’s it for our introduction to first aid! We hope you found this helpful and gave you an excellent foundation to build. If you are looking for more in-depth information or if you need to get a first aid or CPR certificate, we have a variety of courses available. A few worth mentioning include HLTAID011, Provide First Aid, and HLTAID012, Provide First Aid in an education and care setting. Check our available first aid courses to learn more and get started today!

Introduction to First Aid