First aid

Encyclopedia of Nursing and Allied Health, , by R.N. Lori Ann Beck, M.S.N., F.N.P.-C.

Definition

First aid is the initial basic treatment of an injured or ill person. First aid requires an observer first to evaluate the injured or ill person and then to intervene, using a small amount of supplies.

Purpose

First aid is provided to a person immediately following an accident or onset of illness to decrease complications and to offer psychological (emotional) and physical comfort. It is performed to decrease the individual's pain and suffering until emergency medical technicians (EMTs) or other health care givers arrive on the scene.

Precautions

The provision of first aid should never postpone the initial contact with the emergency medical system. The bystander should wear disposable latex gloves if available, in case of contact with blood or body fluids. If gloves are not available, plastic bags or wrap can be used as a protective barrier.

Description

First aid is a universal term that encompasses many general concepts for rapid assessment of health crises and intervention. The following sections present the most common injuries and illnesses requiring first aid, and the interventions appropriate in these situations.

Changes in mental status

Assessment

With any sudden changes in a person's brain functioning, first aid should start immediately. Assess the person for:

• unconsciousness

• lightheadedness

• weakness on one side of body

• aggressiveness

• confused state

• changes in orientation

• headache

• blurred or double vision

• unsteady balance

Intervention

Initiate cardiopulmonary resuscitation (CPR) if the person is not breathing. Secure the area around the person by removing any potential hazards, and maintain a favorable environment by providing an adequate area ventilation and room temperature. The person should be placed in a side-lying position.

Bleeding (hemorrhage)

Assessment

Assessing an injured person for bleeding must be done promptly, with first aid started immediately if there is active bleeding. All blood and body fluids must be regarded as potentially infectious, and protective barriers used.

Intervention

Direct pressure should be applied to the hemorrhaging (bleeding) area by placing a clean pad or bandage over the site and pressing down with the palm of the hand. If bleeding persists, increase the amount of pressure to the area. If the person is awake and no latex gloves or other protective barriers are available, have him or her apply direct steady pressure to the hemorrhaging area. If the bleeding occurs on an arm or leg, elevate the bleeding part higher than the person's heart; this will help decrease the amount of blood flow to the injured area. When a person is losing blood, body temperature tends to decrease. Maintaining body temperature is an essential first-aid intervention.

Poisoning: inhalation, ingestion, or exposure

Assessment

Initial evaluation of a poison victim is done after the threat of exposure to the rescuer is determined. If a noxious gas or fumes remain in the environment, the rescuer must first protect him- or herself and others. The rescuer must move the person to a secure environment as promptly as possible to start first aid.

Intervention

The first and most important intervention is to call a poison control center and get instructions on how to proceed. Having information on the type of poison ingested, if possible, as well as reading the label over the phone or spelling out the active ingredients on the bottle, will help the poison control center in determining the appropriate interventions. The rescuer must never induce vomiting or give any substance unless directed by the poison control center.

Burns

Assessment

Burns are categorized by the extent of damage to the skin or underlying tissue. First-degree burns are the least critical; they cause reddening of the skin without blistering. Second-degree burns cause damage to the superficial (outer) and the internal (inner) layers of skin, creating bubble-like sores (blisters) that contain clear, watery liquid. Third-degree burns are the most severe and most damaging of all burns; the destruction of all layers of skin occurs and the burnt area is left open and charred. When applying first-aid concepts to burns, the rescuer must quickly assess the extent of damage to the person's skin. The rescuer needs to determine through assessment what to do next.

Intervention

First-degree burns can usually be treated at home with a sterile burn gel, and complete healing should take place within one week. A person with a second-degree burn greater than the size of his or her palm should seek medical treatment, or if the burn is in a sensitive area like the groin. Third-degree burns need medical attention immediately. Ice application is not recommended for severe burns because ice can cause trauma to the area. Cool to lukewarm water is recommended. The burn victim must be covered, preferably with clean blankets, in order to maintain a normal body temperature.

Head/neck injuries

Assessment

It is vital for the rescuer to determine the nature of the head/neck injury, as well as if the person has had any loss of consciousness. This information should be conveyed to the emergency medical responders to help determine the need for further testing.