First aid is the first and immediate assistance given to any person with a medical emergency, with care provided to preserve life, prevent the condition from worsening, or to promote recovery until medical services arrive. First aid is generally performed by someone with basic medical or first response training. Mental health first aid is an extension of the concept of first aid to cover mental health, while psychological first aid is used as early treatment of people who are at risk for developing PTSD. Conflict first aid, focused on preservation and recovery of an individual's social or relationship well-being, is being piloted in Canada.
There are many situations that may require first aid, and many countries have legislation, regulation, or guidance, which specifies a minimum level of first aid provision in certain circumstances. This can include specific training or equipment to be available in the workplace (such as an automated external defibrillator), the provision of specialist first aid cover at public gatherings, or mandatory first aid training within schools. Generally, five steps are associated with first aid:
Assess the surrounding areas. Move to a safe surrounding (if not already; for example, road accidents are unsafe to be dealt with on roads). Call for help: both professional medical help and people nearby who might help in first aid such as the compressions of cardiopulmonary resuscitation (CPR). Perform suitable first aid depending on the injury suffered by the casualty. Evaluate the casualty for any fatal signs of danger, or possibility of performing the first aid again.
Early history and warfare
Skills of what is now known as first aid have been recorded throughout history, especially in relation to warfare, where the care of both traumatic and medical cases is required in particularly large numbers. The bandaging of battle wounds is shown on Classical Greek pottery from , whilst the parable of the Good Samaritan includes references to binding or dressing wounds. There are numerous references to first aid performed within the Roman army, with a system of first aid supported by surgeons, field ambulances, and hospitals. Roman legions had the specific role of capsarii, who were responsible for first aid such as bandaging, and are the forerunners of the modern combat medic.
Further examples occur through history, still mostly related to battle, with examples such as the Knights Hospitaller in the 11th century AD, providing care to pilgrims and knights in the Holy Land.
Formalization of life saving treatments During the late 18th century, drowning as a cause of death was a major concern amongst the population. In 1767, a society for the preservation of life from accidents in water was started in Amsterdam, and in 1773, physician William Hawes began publicizing the power of artificial respiration as means of resuscitation of those who appeared drowned. This led to the formation, in 1774, of the Society for the Recovery of Persons Apparently Drowned, later the Royal Humane Society, who did much to promote resuscitation.New Scientist, Vol. 193 No. 2586 (13–19 Jan 2007), p. 50
Napoleon's surgeon, Baron Dominique-Jean Larrey, is credited with creating an ambulance corps, the ambulance volantes, which included medical assistants, tasked to administer first aid in battle.
In 1859, Swiss businessman Jean-Henri Dunant witnessed the aftermath of the Battle of Solferino, and his work led to the formation of the Red Cross, with a key stated aim of "aid to sick and wounded soldiers in the field". The Red Cross and Red Crescent are still the largest provider of first aid worldwide.
In 1870, Prussian military surgeon Friedrich von Esmarch introduced formalized first aid to the military, and first coined the term "erste hilfe" (translating to 'first aid'), including training for soldiers in the Franco-Prussian War on care for wounded comrades using pre-learnt bandaging and splinting skills, and making use of the Esmarch bandage which he designed. The bandage was issued as standard to the Prussian combatants, and also included aide-memoire pictures showing common uses.
In 1872, the Order of Saint John of Jerusalem in England changed its focus from hospice care, and set out to start a system of practical medical help, starting with making a grant towards the establishment of the UK's first ambulance service. This was followed by creating its own wheeled transport litter in 1875 (the St John Ambulance), and in 1877 established the St John Ambulance Association (the forerunner of modern-day St John Ambulance) "to train men and women for the benefit of the sick and wounded".Fletcher NC, The St John Ambulance Association: its history and its past in the ambulance movement. London: St John Ambulance Association, 1929:12–3.
Also in the UK, Surgeon-Major Peter Shepherd had seen the advantages of von Esmarch's new teaching of first aid, and introduced an equivalent programme for the British Army, and so being the first user of "first aid for the injured" in English, disseminating information through a series of lectures. Following this, in 1878, Shepherd and Colonel Francis Duncan took advantage of the newly charitable focus of St John, and established the concept of teaching first aid skills to civilians. The first classes were conducted in the hall of the Presbyterian school in Woolwich (near Woolwich barracks where Shepherd was based) using a comprehensive first aid curriculum.
First aid training began to spread through the British Empire through organisations such as St John, often starting, as in the UK, with high risk activities such as ports and railways.Industrial Revolution: St. John Ambulance , retrieved December 10, 2006.
The first recorded first aid training in the United States took place in Jermyn, Pennsylvania in 1899.
Common emergences that require first aid in humans List of common situations that require first aid, and information about them (in alphabetical order):
Bleeding
Bleeding or hemorrhage is the escape of blood from veins or arteries.
Cardiac arrest (total stop of heartbeat)
Cardiac arrest is the complete stop of heart function.
Choking
Choking is the obstruction of breathing caused by a blockage in the respiratory tract.
Diabetes, hyperglycemia
Hyperglycemia or hyperglycaemia is a condition in which an excessive level of glucose is present in the blood.
Diabetes, hypoglycemia
Hypoglycemia or hypoglycaemia is a condition in which an excessively low level of glucose is present in the blood.
It typically occurs due to complications with medication used to reduce blood sugar levels in diabetic patients.
Drowning
Drowning in humans is a type of suffocation caused by both the nose and mouth being submerged in liquid.
The first aid for drowning is very similar to that of cardiorespiratory arrest.
Infarction of the heart
A myocardial infarction, commonly known as a heart attack, is the sudden reduction in or lack of blood flow in one of the coronary arteries in the heart, causing infarction (tissue death due to inadequate blood supply). Risk factors for myocardial infarctions include living a sedentary lifestyle, age (being over 45 for men and 55 for women), tobacco and alcohol use, stress, obesity, high cholesterol, family history, and diabetes.
Stroke
A stroke is a sudden lack of blood supply to the brain caused by a burst or blocked artery.
Aims of first aid The primary goal of first aid is to prevent serious injury from worsening or resulting in death. The key aims of first aid can be summarized with the acronym of 'the three Ps':
Preserve life: The overriding aim of all medical care which includes first aid, is to save lives and minimize the threat of death. First aid done correctly should help reduce the patient's level of pain and calm them down during the evaluation and treatment process. Prevent further harm: Prevention of further harm includes addressing both external factors, such as moving a patient away from any cause of harm, and applying first aid techniques to prevent worsening of the condition, such as applying pressure to stop a bleed from becoming dangerous. Promote recovery: First aid also involves trying to start the recovery process from the illness or injury, and in some cases might involve completing a treatment, such as in the case of applying a plaster to a small wound.
First aid is not medical treatment, and cannot be compared with what a trained medical professional provides. First aid involves making common sense decisions in the best interest of an injured person.
Setting the priorities A first aid intervention would follow an order, which would try to attend in the best manner the main threats for the life and mobility of the victim.
There are some first aid protocols (such as ATLS, BATLS and SAFE-POINT) that define which are the priorities and the correct execution of the steps for saving human life. A major benefit of the use of official protocols is that they require minimum resources, time and skills, and have a great degree of success.
ABCDE and csABCDE general protocol The ABCDE method is the general protocol of first aid and implies a quite general view.
It was initially developed by Dr Peter Safar in the 1950s. But it has received some modifications, improvements and variations that were intended for more specific contexts. For example: it has been completed with improvements from the ATLS (Advanced Trauma Life Support) version of the American College of Surgeons and the BATLS (Battlefield Advanced Trauma Life Support) version of the British Army.
As a result, the mnemonic of the steps of this protocol is ABCDE, or its improved version (cs)ABCDE (sometimes called xABCDE, the words in the mnemonic may vary), which represent: —An attached first part (named as "cs" or "x", or in any other way) that will always mention stopping the critical losses of blood and managing with a special and careful treatment to patients with serious damages at the spine that threaten their future mobility:
catastrophic-bleeding (stopping urgently the massive external bleedings, as it is marked in the BATLS version). spine-protection (previous examination of the spine, and careful preventive treatment for its damages, as it is marked in the ATLS version). —The ABCDE protocol itself: Airway (clearing airways). Breathing (ensuring respiration). Circulation (ensuring effective cardiac output).Any Defibrillation process for a cardiac arrest (total stop of heartbeat) would be included here, or in 'Disability' (as a double mnemonic 'D'). Disability (neurological condition, level of glucose can also be examined). Exposure (or 'Evaluate': other questions in an overall examination of the patient, environment).
ABC and CABD cardiopulmonary resuscitation protocol This protocol (originally named as ABC) is a simplified version or concrete application of the previous csABCDE (or ABCDE) protocol, that focuses in the use of cardio-pulmonary resuscitation. The American Heart Association and the International Liaison Committee on Resuscitation teach it as a reference.
Its current mnemonic is CABD (an improvement in the sequence for most of the cases):
Circulation or Chest Compressions. Airway: attempt to open the airway (using a head-tilt and chin-lift technique; not in the case of babies, which require avoid tilting the head). Breathing or Rescue Breaths. Defibrillation: use of an automated external defibrillator to recover heart function.
Wider protocols These are the protocols that do not only deal with direct care to the victim but they also mention other complementary tasks (before and later).
European protocol