You may have witnessed or even be involved in a Road Traffic Accident at one time or the other.
The simple text below will help broaden your horizon as per possible intervention before the arrival of a Physician or an expert.
PRE-FIRST AID EVALUATION
ASSESSMENT OF VICTIM’S CONDITION
INTRODUCTION
First Aid is the initial intervention given to a victim to save his/her life before the arrival of the Physician.
Not so easy as it appears
Skill required, that’s why you are here
The first rule of first aid and the primary concern is SAFETY
AS A FIRST AIDER
First aiders are never required to place themselves in a situation which might put them in danger. Remember, you cannot help a victim if you become a victim yourself.
When a first aider is called upon to deal with a victim, they must always remember to safeguard themselves in the first instance and then assess the situation. Only after these steps are completed can treatment of the victim begin.
When called to a scene, remember that your own personal safety is above all else
Goes without saying
Before you enter a scene, put on personal protective equipment, especially impermeable gloves.
As you approach a scene, you need to be aware of the dangers which might be posed to you as a first aider, or to the victim. These can include obviously dangerous factors such as traffic, gas or chemical leaks, live electrical items, buildings on fire or falling objects. While many courses may focus on obvious dangers such as these, it is important not to neglect everyday factors which could be a danger.
There are also human factors, such as bystanders in the way, the victim not being co-operative, or an aggressor in the vicinity who may have inflicted the injuries on the victim. If these factors are present, retreat until the police are able to control the situation.
Always remember the big D for Danger.
Once you have assessed the scene for danger, you should continue to be aware of changes to the situation or environment that could present danger to you or your victim until you have left the scene.
Never put yourself in harm’s way
Unless the victim is in a life-threatening situation, he or she should NOT BE MOVED
If there are suspected spinal injuries, do not move the victim (except when the victim is in a life threatening situation).
How do you suspect spinal injuries?
What has happened?
Ask anybody, even a child, a mad man, the information might just be all you need
Preferably the most responsible-looking by-stander
Assess the Scene: Does this area have motor vehicle traffic? Is this area known for violent crime? What time of day is it? What are the weather conditions?
Look for Clues
Get some History – If there are witnesses, ask them what’s happened “Did you see what happened here?” and gain information such as how long ago it happened “How long have they been like this?”, but be sure to start your assessment and treatment of the victim simultaneous with your history taking
Be sure to Listen – While working on a victim you may overhear information from witnesses in the crowd.
Responsiveness
This can be started with an initial responsiveness check as you approach the victim. This is best as a form of greeting and question, such as:
“Hello, I’m here to help you. Are you alright?“
Or, “Are you okay?”
The best result would be the victim looking at you and replying. This means that the victim is alert at this time
AVPU
In an emergency setting, the level of responsiveness is categorized by using what is called the AVPU scale, AVPU stands for the four possible categories they can fit into. They are either “Alert”, “Verbal”, alert to “Pain”, or “Unresponsive”‘
If the victim looks at you spontaneously, can communicate (even if it doesn’t make sense) and seems to have control of their body, they can be termed Alert.
KEY INDICATORS
Eyes – Are they open spontaneously? Are they looking around? Do they appear to be able to see you? Do they look “glassed over”?
Response to voice –
Do they reply?
Do they seem to understand?
Can they obey commands, such as “Open your eyes!”?
Do they know where they are or what happened to them?
RESPONSE TO PAIN
The first, and most gentle stimulus to use is a tap/shake of the shoulder
Sternal rub – This is performed by grinding the knuckles of your clenched fist vertically up and down the victim’s sternum (or breastbone).
Nail bed squeeze – Using the flat edge of a pen or similar object, squeeze in to the bottom of the victim’s fingernail or toenail.
Ear lobe squeeze – using thumb and forefinger, squeeze or twist the victim’s ear.
Any of the responses A, V or P, mean that the victim has some level of consciousness. If they are not alert, you should always summon professional help – call an ambulance.
If they are only responsive to Voice or Pain, then consider using the Recovery position to help safeguard them if they need to vomit.
GO DR SHAVPU
A First Aider should have
GO – Put their gloves on
D – Checked for danger
R – Checked for responsiveness
S – Looked at the scene for clues about what has happened
H – Gained history on the incident
AVPU – Assessed to see how responsive the victim is.
VISUAL ASSESSMENT
Visually determine whether there are life-threatening or other serious problems that require quick care.
Breathing
Bleeding
Shock
Burn
Choking
Heart Attack
Fractures
CLINICAL ASSESSMENT
ABCH
Airway: Use your finger to sweep the mouth to remove any seen object.
Breathing: Look, listen and feel by watching the chest and placing your cheek a few inches above the mouth of the victim to sense any movement of air. If the victim is not breathing, they may need their head repositioned
Circulation: check the PULSE. The best place to check for a pulse is the carotid artery along the side of the neck along the windpipe
Haemorrhage: If the victim is bleeding, then provide the necessary care.
NEXT STEP – INTERVENTION
The last step is to actually provide care to the limits of the first aider’s training — but never beyond. In some jurisdictions, you open yourself to liability if you attempt treatment beyond your level of training.
Treatment should always be guided by the 3Ps:
Preserve life
Prevent further injury
Promote recovery
Primum non nocere
Above all, do no harm
Thank you
