CPR First Aid

Introduction to First Aid

First aid is the initial care given to an injured until the arrival of a paramedic. Check our available first aid courses to learn more and get started today!

What is First Aid?

first aidFirst aid assistance is the initial care given to an injured or ill casualty until the arrival of a paramedic, nurse, or medical doctor.

The four aims of first aid are to:

  1. Protect life
  2. Prevent further deterioration
  3. Promote recovery
  4. Preserve life

Any attempt is better than no attempt!

Primary Purpose and Objective of Being a First Aider 

A first aider is important 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 included 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 – is free from any further danger. One important rule is that a first aider should never put themselves in danger as they will not be able to provide further care to casualties.
  • Response – Assess the responsiveness of the casualty. Check whether they are conscious and if they are able to respond to you.
  • Send for Help – Call an ambulance, or if the first aider cannot, ask bystanders to do so. If needed, also seek help from those bystanders for any care needed for the casualty.
  • 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. Depending on whether it is obstructed or not, it will dictate how the next step goes.
  • Breathing – If the airway is clear and the person is breathing clearly, then 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 sees increased 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 that is used on the casualty in tandem with CPR.

First Aid Basics – Calling for Medical Assistance

Triple Zero (000)

calling for emergency tripple zeroStay 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 to call for assistance in life-threatening or time-critical emergency situations.
  • 112 is a secondary emergency number that can be dialed from mobile phones in Australia.
  • There is a misconception that 112 calls will be carried by satellite if there is no mobile coverage. Satellite phones use different technology and your mobile phone cannot access a satellite network
  • Important – if there is no mobile coverage on any network, you will not be able to reach the Emergency Call Service via a mobile phone, regardless of which number you dialed.
  • 112 is an international standard emergency number that can only be dialed on a digital mobile phone.

Legal Aspects – Duty of Care

legal aspects duty careIn 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.)
  • If you are an employer, manager, supervisor, or person conducting business (PCBU) to 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 first aid certificates are not always automatically expected to assist in emergencies. A duty of care needs to exist for the legal obligation to take place. Neglecting an existing duty of care may result in implications associated with negligence. To identify your legal implications or for further clarification, you are encouraged to seek legal advice.

The standard of care required of a person who has 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 given must be of the highest level.

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

Legal Aspects – The Protection of Good Samaritans

legal aspects the protection of good samaritansA 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

Before providing first aid to a “competent” casualty, a first aider must obtain their consent. If first aid is provided without consent, 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 need to be respected.

If a casualty is a minor (under 18yrs) you should gain consent from a parent/guardian. Parents and guardians have the right to refuse first aid treatment for their minors. In the absence of a parent/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 should stay at the scene (if safe to do so) until otherwise advised.

When is Consent Implied in First Aid?

There are some instances where consent is implied in first aid. If the victim is unable to communicate with the first aider, this is considered implied consent. In this case, the first aider would assume that the victim would ask for help if they were able to communicate. Situations include being unconscious, having a mental disorder, and even being intoxicated.

Legal Aspects –Treatment Without Consent

Although first aid treatment normally 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

If the casualty is incapable of consenting, (e.g. the casualty is unconscious) and no substitute decision-maker is present, a first aider may perform 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

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

work safe australiaFor 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:

  • legal aspects privacy and contentHaving 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 answering questions from the media unless you have permission from the casualty.

Record Keeping

record keepingIt 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.

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

Notes should include:notes record keeping

  1. At the time of the incident
  2. The date of the incident
  3. The location of the incident
  4. What the first aider found upon arrival
  5. What actions the first aider carry out
  6. Any changes in the casualty’s condition
  7. Any witness details
  8. Handover to medical professional’s details
  9. 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 to you

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

  • First aid in education and care settings is especially important, 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 parent of a child 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 aged 25 years
  • That the Regulatory Authority is notified of a serious 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 is made up of different anatomical and physiological systems, each performing a vital role. Whilst is it not crucial for a first aider to know detailed information about these systems it will benefit the first aider to have a basic knowledge of how the systems work.

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

Skeletal Systemskeletal system

The skeletal system is made up of 206 bones that provide structure to our bodies and protects our internal organs from damage. Muscles, ligaments, and tendons are closely linked with this system and all play vital roles in allowing movement and function of limbs and body parts.

The bones of the skeleton have 4 main functions:

  1. To give shape to the body
  2. To produce blood cells
  3. Support muscles to allow movement
  4. Protect vital organs

Cardiovascular Systemhuman anatomy cardiovascular system

This system is made up of the heart, blood, and blood vessels. Blood flowing from the heart delivers oxygen and nutrients to every part of the body. The bloodstream removes waste products via transportation 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 between 60 – 100 beats per minute.

human anatomy cardiovascular system heartThe 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. Waste products carried by the blood are removed from the body by organs such as kidneys. The right side of the heart obtains deoxygenated blood via main veins (Superior and Inferior Vena Cava) and pumps this blood to the lungs where oxygen is absorbed and carbon dioxide is released.

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

Blood – blood is composed of a clear liquid called plasma. Red blood cells make the blood look red, and allow oxygen to be delivered around the body. 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. Veins transport de-oxygenated blood back to the heart. Arteries narrow into arterioles. Capillaries are the smallest vessels that connect the arterioles to the venules. It is at this level that the majority of transfusion with cells takes place.

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

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

Nervous System

human anatomy nervous systemThe nervous system is made up of your brain, spinal cord, and a huge network of nerves that thread throughout your entire body. The nerves receive and conduct information to the brain for processing, which enables the coordination of all 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 useful 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.

human anatomy respiratory systemThis system comprises of 2 parts:

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

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

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

respiratory rate based per age bracketOverall, children have quicker respiratory rates than adults, and women breathe more often than men. The normal ranges for different age groups are listed:

Upper Airway

The Upper Respiratory SystemA child’s airway differs from that of an adult in that the child’s tongue is proportionately larger in the oropharynx compared to that of an adult.
Also, a child’s airway is smaller and 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

human anatomy musculoskeletal systemhuman anatomy musculoskeletal system fullThe 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, as it will assist you in understanding medical terminology, and give you a greater knowledge base as a first aider in which to 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 to 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.

infection control diagram

infection control

Chain of Infection

Whether or not infection happens will depend on several things. This is best explained by looking at the chain of infection.

The Six Links to the Chain of Infection

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

  1. Infectious Agent: Any disease-causing micro-organism (pathogen) i.e. bacteria, virus.
  2. Reservoir: Where the pathogen is located (i.e. blood, saliva)
  3. 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)
  4. Mode of Transmission: How the pathogen gets from the reservoir to its new host (i.e. propelled through the air, direct contact)
  5. Portal of Entry: The route in which the pathogen enters the new host (breaks in skin (cuts, wounds), inhalation, ingestion, sexual contact).
  6. Susceptible Host: The organism that accepts the pathogen (you or the casualty)

How to Break the Chain of Infection

Correct Hand Washing – appropriate hand washing by the First Aider remains the most important factor in preventing the spread of micro-organisms. Good hand-washing techniques are displayed in the attached picture.

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 to you!

fight germs buy washing your hands

how to break the chain of infection

It is important 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 emergency situations, the first aider may not have access to gloves, masks, or other PPE. Where it is not practical to use the PPE stated, one may ‘improvise’, using plastic bags, clothing, or whatever is available to try to protect themselves and the casualty.

CONCLUSION

That’s it for our introduction to first aid! We hope you found this helpful and that it has given you a good foundation on which to build. If you are looking for more in-depth information, or if you need to get certified, we have a variety of courses available. Check our available first aid courses to learn more and get started today!

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