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Updated 25 July 2012

First aid: the basics

First aid is immediate care given to someone with an injury or sudden illness - until this is resolved or more advanced care reaches them.

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First aid is immediate care given to someone with an injury or sudden illness - until this is resolved or more advanced care reaches them. It ranges from putting a plaster on a cut to performing CPR.

First aid procedures are generally simple, but also essential: they can mean saving a life.

The fundamental aims of first aid are:

  • Preserve life (including the first aider's, who should never endanger his own life)
  • Prevent further injury
  • Promote recovery

The following steps aim to keep an ill or injured person alive and protected from further harm while waiting for emergency medical services:

H H H ABC
It's difficult to remember what to do in an emergency situation, so first aiders learn this simple routine: H H H ABC

H: Hazards
H: Hello
H: Help
A: Airway
B: Breathing
C: Circulation

H: Hazards
Ask yourself: Are there any life-threatening dangers to you or the person? If so, manage them, or move yourself and him out of harm's way.

Wear disposable latex gloves to prevent contact with body fluids. Also, unless the person is a family member, during resuscitation it's best to use a pocket mask which covers the mouth and nose.

H: Hello
Is the person awake or unconscious? Ask loudly: Are you OK? If no response, tap the shoulder. In the case of a baby, tap the feet.

If there is no response it means the person isn't getting enough blood and oxygen to the brain and needs urgent help.

H: Help
Call for others around you to help - there may be a doctor or paramedic within shouting distance.

Phone for emergency medical help on one of the following numbers:

  • 112 on a cellular phone
  • 10177 National medical emergency number for ambulance services
  • 082 911 Netcare
  • 084 124 ER24

Tell the operator there is an unconscious person and state where you are. They will ask for a call-back number if you have one. They can advise you on first aid techniques over the phone if necessary.

A: AIRWAY
Open the airway.

The person will normally be lying on his back. Place two fingers on the forehead and two fingers under the bony part of the chin and gently tilt the head backwards - the "head-tilt chin-lift" method of opening the airway.

B: BREATHING
Listen, look and feel for breathing. Kneel next to the person with your head close to his. Look to see if the chest/abdomen rises and falls. Listen for sounds of breathing. Feel for air: hold your cheek near the nose and mouth to feel for exhaled air. Do this for up to 10 seconds.

If there is breathing (about 12 breaths or more per minute), place the person in the recovery position (turned on his side in case of vomit blocking the airway).

If there is no breathing, or you're unsure, log-roll the patient i.e. roll the body as a unit, keeping the spine in a straight line from head to buttocks, onto his back.

If the patient is not breathing you must breathe for them:

Again, ensure the airway is open using the head-tilt chin-lift method.

Blow gently and slowly. Each breath should take 2 seconds (one in one out). Between breaths, lift your head and see if the chest moves. If the chest rises and falls, it is effective breathing. If not, adjust the head and try again. Make up to 5 attempts.

(Airway obstruction is seldom due to foreign body obstruction. However, if there is no chest movement, check for a foreign body, and, if there is a blockage, switch to obstructed airway manoeuvres. See "Choking")

C is for CIRCULATION
In addition to breathing for the patient, you must perform chest compressions to keep blood circulating.

It's difficult for the lay rescuer to determine if a pulse is present. Therefore, the appropriate action is to start immediately with chest compressions once you have given 2 effective breaths.

Chest compressions:
Kneel beside the person. Place the heel of one hand in the centre of the chest on the nipple line (imaginary line joining the nipples) on the breastbone. Place the heel of your other hand on top of the first. Lean over the person with your arms straight and elbows locked, and your shoulders directly above your hands. Press down vertically on the breastbone 4-5 cm to a count of "one-and-two-and-three-and-four…", giving one push each time you say a number. When saying "and", release the pressure but don't move your hands from their location on the chest. Give 30 pumps at a rate of 100 per minute. Push hard and fast.

Give 2 slow breaths.

Repeat the cycle of 30 pumps, 2 breaths until help arrives or the person starts to recover. If you aren't sure the patient is breathing unaided, continue CPR.

Even if the person appears fully recovered, monitor him until medical help arrives.

Bleeding and fractures

Once the person is breathing, check the whole body for bleeding and fractures by patting gently.

  • Apply firm pressure directly to a bleeding wound (but around any embedded object) with a clean cloth.
  • Elevate and immobilize an injured limb. Splint a fractured limb if you have been trained to do so.

(See "Bleeding")

Shock

Shock is a life-threatening condition, when blood flow drops so low that oxygenated blood does not reach the vital organs.

Causes include severe blood loss and loss of other body fluids (e.g. bleeding wounds, major burns, severe diarrhoea and vomiting); drug overdose; poisoning; severe allergic reaction; extensive bacterial infection.

To treat and prevent shock:

  • Have the person lie down.
  • Raise the legs higher than the head.
  • Cover the person to keep them warm.
  • Give nil by mouth.

Last updated: July 2009

 
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