So now you’ve read the 3 P’s of First Aid (I hope) and you know what needs doing to your casualty or casualties and in what order. Next thing people often ask us is ‘how do I approach a situation?’ For the most part, this means what you do as a first aider when you approach a problem situation (we’ll call it the accident scene here), but it could apply to when someone comes to you for help as well. Here’s the ‘Critical’ mnemonic for you:
- Careful Approach
- Recognize Danger
- Involve Others
- Inform Others
- Complete History
- Accurate Documentation
- Leave Nothing/No-one Behind
How you approach the accident scene can influence a lot of what comes next. Do it properly and your life will be a little easier. Run towards the scene panicked and screaming, well – you get the idea. A Careful Approach should include looking around you. Do not run into traffic, don’t trip over stuff, and don’t run into other people rushing to help.
Consider asking people to stay still and stop what they’re doing (especially if it’s dangerous or likely to cause things to get worse – the 2nd ‘P’ of First Aid). Look around to see what’s happening or about to happen: any fires, avalanches, rock-slides, or perhaps less dramatic, but still dangerous events. Look for anyone else who might be able to help and if needed, consider where you’re going to find a phone, AED, First Aid Kit or other equipment.
This goes along with step 1 above, as well as the ‘danger’ aspect of ‘the ABCs’. You’ll notice a few of these concepts repeat! You need to know what is, or could become, dangerous at an accident scene. If not, your casualty may come to further harm (see #2 of the 3Ps). What’s worse, you may also come to harm and then you can’t provide any help – and will need some yourself.
So, what exactly are the dangers you’re trying to recognise? Well it’s impossible to say from here – they’ll be different in every situation. Some trainers use the saying “Fire, Wire, Gas or Glass” to help you remember. Often it’s not very well explained beyond the obvious, so:
- Fire – or other natural dangers. Animals, people, environment, etc.
- Wire – man made dangers could include electrocution, traffic, etc. Also a reminder that sometimes the only thing we can do is call someone else to make the situation safe.
- Gas – a reminder that not all dangers are obvious or even visible. Give consideration to this for example if the person is passed out in a room full of engine exhaust, or if you enter a room in which everyone is unconscious.
- Glass – in the rush to deal with an accident, it’s easy to overlook the obvious. If the person is lying surrounded by broken glass, don’t kneel in it to check their breathing – your knees will thank you for remembering this.
Also part of Recognising Danger is being aware of what could be dangerous that you can’t see. For example, if someone comes to you having cut their finger in a meat slicer, did they turn it off? Will you just about finish bandaging them when the next careless butcher comes for help? Did the cleaner who swept dust into their eye put the broom somewhere safe, or are you going to be called to deal with ‘trip injuries’ next? Think outside the box and Recognise Dangers.
Sure you’re the big hero, but even Batman has a Robin! You do not need to go it alone here. Find other people at the accident scene who are able and willing to help and get them involved. They could be:
- Qualified and helping you with the treatments,
- Making phone calls,
- Waiting to direct EMS,
- Keeping traffic away,
- Controlling other dangers,
- Keeping people out of the way,
- Comforting family & friends,
- Looking around for other casualties,
- Making sure there are no other dangers,
- Contacting Friends/families.
There are many jobs that could need doing depending on the situation so remember to Involve others.
Now we actually come to the task most people think of when they consider ‘First Aid’: The active treatment of injured people. The steps above (possibly not the full extent of ‘involve others’) should be done within a few seconds, possibly/probably before you even reach the injured person/people.
Now you can begin treating them. Of course, all the first aid you could possibly do is beyond the scope of this article, but ‘The 4 Bs‘ and ‘The ABCs‘ will guide you as to what should be done when.
This step involves both the casualty and outside parties. Inform the person you’re treating as to what you’re doing. Of course you need consent to do it first, unless they’re unconscious. Keeping them informed gives them the change to ask questions or give you more information about what happened. Even if they’re non-responsive, try to keep talking to them – it will help your thought process and they may in fact still be able to hear you.
Informing others also means that people not at the scene need to be informed. This could be family, friends, next of kin, etc. The casualty may be able to tell you who needs calling. It isn’t necessarily your job to do this (remember, involve others) but give some thought to ensuring it is actually done. Of course, ‘people not at the scene’ when you first arrive include EMS and other services. Keep good written documentation if time allows, and remember you will need to pass on information about what you found out and what you’ve done so far.
Reminds you to find out as much as you can about your casualty and the event (as long as it’s relevant!) See the SAMPLE questions as to what you should be asking. Think about what happened to cause the person to need first aid, who else was involved, medical history of the person, etc.
Going along with the communications above, you need good written records of what happened and what you did. In some cases, this is good practice, in others it may be a legislative requirement. It is also useful for continuity of care. If you do not have time for documentation in the moment, make sure it’s done afterwards. Document the things you found out (Level of consciousness, pulse rates, breathing, pain, etc). Document the things you did (eg: applied bandage). Make sure you record specifics – applied bandage to second finger of left hand is better than ‘bandaged the cut’. Add times & dates to the documentation and make sure everyone can easily interpret them! Use 24 hr clock or add AM/PM. Remember that some people read 1/10 as 1st Oct while others read it as Jan 10th. Write out the month!
Leave Nothing/No-one Behind
Finally, when you’re all done at the accident scene and the casualty has gone to medical help or wherever you’re sending them, make sure nothing and no-one is left behind. Yes really!
Don’t send them in an ambulance without their glasses. The EMS crew may get a surprise if the casualty suddenly says ‘I can’t see’! Make sure possessions – bags, coats, etc. either go with the person or are appropriately taken care of.
Oh yes, and I have heard of casualties thrown into ditches or behind hedges being left behind, overlooked! Perhaps a careful approach to the scene would have helped? Then, don’t forget to take your own kit with you, clean up and don’t leave bits of bandage wrappers or other debris lying about.