The importance of first aid

First aid is an important skill. By performing simple procedures and following certain guidelines, it may be possible to save lives by giving basic treatment until professional medical help arrives (if available).

Remember, that practice makes perfect. In an emergency there may be no time to read instructions or a first aid manual. If you've learned some basic procedures, it will help you react quickly and more efficiently.

Breathing difficulties

If an adult is unconscious, see if they are breathing. If not, start artificial respiration as described below.

When someone has stopped breathing, see if the person responds by talking to them or shaking them by the shoulder. If not, call an ambulance (if possible) and then begin first aid treatment.

First, place the casualty flat on his or her back on the floor. Tilt the head so that the chin is pointing upwards by placing your fingertips under the jawbone, then lift gently while pressing down softly on the person's forehead. This ensures that the tongue is not blocking the throat.

Keep holding the head in this way while checking for breathing: see if the chest is rising and falling, or place your ear next to their mouth to listen for breathing.

If there is breathing, hold the head as described above until help arrives. If not, start artificial respiration.

How to give artificial respiration

• Tilt the head back and lift up the chin.
• Pinch the nostrils shut with two fingers to prevent leakage of air.
• Take a deep breath and seal your own mouth over the person's mouth.
• Breathe slowly into the person's mouth - it should take about two seconds to adequately inflate the chest.
• Do this twice.
• Check to see if the chest rises as you breathe into the patient's mouth.
• If it does, enough air is being blown in.
• If there is resistance, try to hold the head back further and lift the chin again.
• Repeat this procedure until help arrives or the person starts breathing again.

Checking for a pulse

If an adult is unconscious and has no pulse. If you are inexperienced, you may waste valuable time checking for a pulse.

How to take a pulse: Place your fingers in the groove between the windpipe and the muscles of the side of the neck. Press backwards here to check for a pulse. If there is no pulse, or if you are unsure, then proceed without delay as follows.

Look at the person's chest and find the 'upside-down V' shaped notch that is made by the lower edge of the ribcage. Place your middle finger in this notch and then place your index finger beside it, resting on the breastbone.

Take the heel of your other hand and slide it down the breastbone until it is touching this index finger. The heel of your hand should now be positioned on the middle of the lower half of the breastbone.

Now place the heel of your other hand on top of the first. Keep your fingers off the chest, by locking them together.

Pressure should be applied through the heels of the hands only.

Keep your elbows straight, and bring your body weight over your hands to make it easier to press down.

Press down firmly and quickly to achieve a downwards movement of 4-5cm, then relax and repeat the compression.

Do this 15 times, then give artificial respiration twice. Continue this 15:2 procedure until help arrives.

Aim for a rate of compression of about 100 per minute. You can help your timing and counting by saying out loud 'one and two and three and four ...' etc.

If a baby (up to 1 year) is unconscious and has no pulse:

Find the place between the nipples where the ribs meet in the breastbone. Move your fingers about 2cm to the right from this point - just above their heart.

Press firmly, but not forcefully, with your index and middle fingers.

If you can't see the baby's chest rise, the pressure is not correct. But with babies, it is especially important to prevent further injury by taking care not to press too hard.

Bleeding

With all types of bleeding, it's important to stop the flow of blood as quickly as possible.

Small cuts

Small cuts in the veins stop bleeding and clot within a few minutes. The area should then be washed, and a plaster placed gently on top.

Deeper cuts

Bleeding from most injuries can be stopped by applying direct pressure to the injury. This keeps from cutting off the blood supply to the affected limb.

Deeper cuts in the veins produce dark blood that seeps out slowly and steadily. It can be stopped by gentle pressure on the wound with a sterile or clean cloth, followed by the application of a clean or sterile bandage.

Often, these wounds need sewing or glueing, and therefore medical treatment will be necessary after first aid.

Arterial bleeding

Note!: Arterial bleeding must always be referred to a doctor.

Bleeding from an artery can cause death within a few minutes, so urgent first aid is essential. This type of bleeding pulsates and squirts blood as the pulse beats. The blood is often a light red colour.

To stop bleeding from an artery:

• apply hard pressure on the wound and keep this up until the patient receives medical treatment.
• press with a sterile cloth or just use your hand if nothing else is available.
• put a bandage on the wound if possible. If the blood soaks through the bandages, press harder until the bleeding stops.
• do not remove the soaked bandages, but place another on top if necessary.
• do not attempt to clean the wound.
• The person must be made to lie down, preferably with their head lower than the rest of their body. This will ensure that enough oxygen gets to the brain.
• If possible, position the wounded area higher than the rest of their body so that the pressure, and therefore the bleeding, will be reduced.

When there is severe bleeding where a major artery has been severed, pressure may be insufficient and a tourniquet may be necessary.

Tourniquets are an effective way of stopping bleeding from an extremity. They do, however, stop circulation to the affected extremity and should ONLY be used when other methods, such as pressure dressings, have failed (or are likely to fail). Pressure from tourniquets must be relieved periodically to prevent damage to the tissue from lack of oxygen.

Note: Tourniquets should only be used as a last resort if the bleeding cannot be stopped and the situation is life threatening.

Nosebleeds

Nosebleeds occur when one of the small blood vessels in the mucous membranes of the nose bursts.

Most nosebleeds look much worse than they really are. Almost all nosebleeds can be treated easily

If you or someone else does suffer a nosebleed do not bend the head backwards or lie down, because this increases blood pressure in the head and so increases the bleeding. Keeping your head above your heart will make your nose bleed less. Blood may also run into the stomach.

To limit the bleeding:

• if possible, sit down and lean forward
• pinch the nostrils shut with the index and middle finger for 10 minutes. This way, the vein is pressed together, which is often enough to stem the flow.
• while the nostrils are shut, the person must breathe through their mouth.
• if the bleeding continues, it is important to contact a doctor.

If the person frequently suffers sudden, intense nosebleeds, they should also consult a doctor.

Choking

Choking happens when the passage through the windpipe is blocked. This usually occurs when food that has not been thoroughly chewed gets stuck.

If someone looks like they are choking, ask them if they are able to talk.

A person who is genuinely choking can usually only communicate with hand movements, and may place their hand against their throat. In such a case they will definitely need help, so summon assistance for them.

Provided the person is conscious and breathing, you should not interfere. However, be prepared to do so if the obstruction appears to become complete or markedly worse.

The best way to relieve choking is by using the Heimlich manoeuvre:

The Heimlich manoeuvre

• Stand behind the person who is choking.
• Place your arms around their waist and bend them well forward.
• Clench your fist and place it right above the person's navel (belly button).
• Place your other hand on top, then thrust both hands backwards into the stomach with a hard, upward movement.
• Repeat this until the object stuck in the throat is expelled through their mouth.
• If you need to carry out this manoeuvre on yourself, place a clenched hand above your navel (belly button) and your other hand on top. Then thrust your fist hard into your stomach.
• Repeat this until the object stuck in the throat is expelled through the mouth.

Shock and fainting

Shock and fainting occur when only a small amount of blood circulates to the brain. This means that the brain is not receiving enough oxygen, which leads to a feeling of faintness, disorientation and dizziness.

Shock may also occur:

• after an accident involving loss of blood.
• after a serious infection with loss of fluids.
• after a serious burn.
• after other accidents that cause loss of fluids or blood.
• When the flow of blood in the body is too slow, the blood pressure drops and too little oxygen is circulated through the body.

When this occurs a person will:

• go pale
• turn sweaty, clammy and cold
• become dizzy
• have a weak, fast pulse
• have low blood pressure
• have slow, weak breathing
• lose consciousness
• become anxious or restless.

What to do if someone is in shock or fainting:

The person must lie on their back - preferably with their feet raised - to ensure enough blood gets to the brain.

Make sure the person is warm, comfortable and covered by a blanket if possible.

Do not give them anything to drink because they could run a risk of choking.

If the person vomits or bleeds from the mouth, he or she must be placed on their side to prevent choking.

Call for an ambulance. A person in shock must always be treated by a doctor.

Fractures (broken bones)

A fracture is a break in a bone. If the broken bone punctures the skin, it is called an open or compound fracture. Fractures commonly happen because of various accidents such as car accidents, falls or sports injuries.

Symptoms of a fracture are:

• Out-of-place or misshapen limb or joint
• Swelling, bruising or bleeding
• Intense pain
• Numbness and tingling
• Limited mobility or inability to move a limb

You need to get medical care as soon as possible for any fracture. Very often the limb needs to be immobilised in a cast or splint. Sometimes surgery is required to put in plates, pins or screws to keep the bone in place.

If a fracture should occur or is suspected take these actions immediately while waiting for medical help:

• Stop any bleeding. Apply pressure to the wound with a sterile bandage, a clean cloth or a clean piece of clothing.
• Immobilize the injured area. Don't try to realign the bone, but if you've been trained in how to splint and professional help isn't readily available, apply a splint to the area.
• Apply ice packs to limit swelling and help relieve pain until emergency personnel arrive. Don't apply ice directly to the skin — wrap the ice in a towel, piece of cloth or some other material.
• Treat for shock. If the person feels faint or is breathing in short, rapid breaths, lay the person down with the head slightly lower than the trunk and, if possible, elevate the legs.