Sunday, November 14, 2010

First aid rules that everyone needs to know-KevinMD.com

First aid is defined as the immediate care given to an acutely injured or ill person.  It can literally be life-saving so it behooves all of us to know some basic principles.

What follows are some rules that cover common conditions and general practices:

  1. Don’t panic.  Panic clouds thinking and causes mistakes.  When I was an intern and learning what to do when confronted with an unresponsive patient, a wise resident advised me when entering a “code blue” situation to always “take my own pulse first.”  In other words, I needed to calm myself before attempting to intervene.  It’s far easier to do this when you know what you’re doing, but even if you encounter a situation for which you’re unprepared, there’s usually some good you can do.  Focus on that rather than on allowing yourself an unhelpful emotional response.  You can let yourself feel whatever you need to feel later when you’re no longer needed.
  2. First, do no harm.  This doesn’t mean do nothing.  It means make sure that if you’re going to do something you’re confident it won’t make matters worse.  If you’re not sure about the risk of harm of a particular intervention, don’t do it.  So don’t move a trauma victim, especially an unconscious one, unless not moving them puts them at great risk (and by the way, cars rarely explode).  Don’t remove an embedded object (like a knife or nail) as you may precipitate more harm (e.g., increased bleeding).  And if there’s nothing you can think to do yourself, you can always call for help.  In fact, if you’re alone and your only means to do that is to leave the victim, then leave the victim.
  3. CPR can be life-sustaining.  But most people do it wrong.  First, studies suggest no survival advantage when bystanders deliver breaths to victims compared to when they only do chest compressions.  Second, most people don’t compress deeply enough or perform compressions quickly enough.  You really need to indent the chest and should aim for 100 compressions per minute.  That’s more than 1 compression per second.  If you’re doing it right, CPR should wear you out.  Also, know that CPR doesn’t reverse ventricular fibrillation, the most common cause of unconsciousness in a patient suffering from a heart attack.  Either electricity (meaning defibrillation) or medication is required for that.  But CPR is a bridge that keeps vital organs oxygenated until paramedics arrive.  Which is why…

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Any questions, please drop me a line.

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Andrew Lopez, RN
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