Emergency Aid

Emergency Aid Insights

During my time as a volunteer paramedic, I've encountered many emergencies, but one stands out: The presence of competent first aiders on-site can mean the difference between life and death.

I believe everyone should regularly attend first aid courses and continuously educate themselves in these areas.

That's why this page provides basic information for typical situations that can happen to any of us. Of course, these do not replace a professional course but can serve as a reminder and quick refresher for some.

As with all my articles, I strive to keep the information up to date. However, the medical field is constantly evolving, so I encourage you to verify that the information I provide is current. If you notice anything, please let me know.

Creating Preparation and Overview

No matter the situation, before starting first aid measures, it's always important to ensure your own safety and assess the situation first.

Try to quickly get an overview of the situation. If help is needed, the first thing to do is to call emergency services or assign another person present to do so.

Next, before approaching the injured or ill person, make sure it's safe for you to help them. Self-protection always comes before providing aid to others. Check for hazards such as traffic, fire, a gas leak, or unstable structures nearby.

If it's safe, you can begin the first aid measures. If there are multiple injured persons, assess the situation and assist the person who needs help the most first.

Then you can follow a sequence of steps according to established protocols.

The ABCDE Schema

The ABCDE schema is an established method for the structured assessment of emergency situations. It provides a clear guideline for addressing the most important aspects of first aid in order of urgency. Each step is followed sequentially, moving on to the next only after completing the previous one.

Airway:
Checking and ensuring the patient's airway is the first step in the ABCDE schema. This means ensuring that the patient's airway is not obstructed so they can breathe freely. Check if the mouth is free of foreign objects and if the tongue hasn't fallen back, which could block the airway. If necessary, remove foreign objects or position the patient's head to open the airway, such as in the recovery position.

Breathing:
After securing the airway, check the patient's breathing. Observe if the chest rises and falls and if breathing sounds are audible. By listening, feeling, and observing breathing, you can determine if it's present and normal. If there's no breathing, start ventilation immediately.

Circulation:
Next, check the patient's circulation by feeling for a pulse and assessing blood flow. The pulse can be felt at various points on the body, such as the wrist, neck, or groin. Checking the pulse can determine if the heart is functioning effectively and if enough blood is circulating through the body. An irregular or weak pulse perception may indicate problems in the circulatory system requiring immediate attention.

Disability:
After checking the airway and circulation, assess the patient's neurological function. Check if the patient is conscious and if they show normal responses, such as responding to verbal stimuli or moving limbs on command. Impairment of neurological function may indicate brain or spinal cord injuries requiring appropriate treatment.

Exposure:
Finally, gently undress the patient to identify and treat injuries or other problems. Undressing can reveal skin injuries, bleeding, fractures, or signs of burns or hypothermia. It's important to assist the patient without causing further injuries and to treat injuries appropriately to minimize further damage.

After completing the ABCDE schema and if the patient is stable, the SAMPLE schema is applied.

The SAMPLE Schema

By using the SAMPLE schema, important information can be gathered to understand the cause of the emergency and initiate targeted treatment. Typically, emergency services take over this task after first aid. However, if the patient is stable and emergency services are not present yet, as a first aider, you can gather this information beforehand and then relay it coherently to medical personnel. Additionally, this provides an opportunity to talk to the patient, which can help calm them down.

Symptoms:
This step involves documenting the patient's signs and symptoms to gain insight into the cause of the emergency. This includes observing physical signs such as pain, swelling, skin changes, or changes in the patient's behavior. These signs can provide valuable information to understand the situation and take appropriate action.

Allergies:
Here, it's determined if the patient has known allergies that could be relevant to the treatment. Allergies can trigger various reactions, from skin rashes to life-threatening conditions like anaphylactic shock. Therefore, obtaining information about allergies is important to avoid allergic reactions and ensure that no allergens are used.

Medications:
Information about the medications the patient is taking is recorded to identify possible interactions or causes for the emergency. Inquire about prescribed medications, over-the-counter medications, and supplements, as some medications can have side effects or become dangerous when combined with others.

Past medical history:
This step determines if the patient has had previous medical problems that could be relevant to the current situation. This includes chronic conditions such as diabetes, heart disease, asthma, or previous injuries or surgeries. The patient's medical history can provide valuable clues to better understand the current situation and take appropriate action.

Last oral intake:
Recording when the patient last ate or drank helps to identify possible causes of the emergency. The last oral intake can provide clues as to whether the patient is hypoglycemic, has been poisoned, or is suffering from dehydration. This information can help understand the cause of the emergency better and adjust treatment accordingly.

Events prior to incident:
Information about the events preceding the emergency is collected to gain insight into the cause. Inquire about activities the patient engaged in before the emergency, possible injuries or accidents, sudden illness episodes, or other events that could have triggered the emergency. This information can help understand the context of the emergency and take appropriate action.

This illustrates the ideal scenario of a first aider following a structured schema and handing over the patient stable and well to medical personnel. Unfortunately, not every emergency follows this pattern, as medical emergencies can have various causes and may require a variety of treatment methods. Next, we will look at specific medical conditions that occur more frequently.

Heart Attack

What is a Heart Attack?
A heart attack occurs when a part of the heart muscle suddenly stops receiving adequate blood flow. This usually happens due to a blockage in one of the coronary arteries, which supply the heart with oxygen and nutrients. The blockage can be caused by the accumulation of plaque, leading to a blood clot that obstructs blood flow. Without sufficient oxygen supply, the affected part of the heart muscle begins to die, resulting in a heart attack.

Frequency of Heart Attacks:
Heart attacks are common events and can affect people of all ages, although the risk increases with age and certain risk factors such as high blood pressure, diabetes, smoking, high cholesterol levels, and a family history of heart disease. An unhealthy lifestyle, including lack of physical activity, unhealthy diet, and excessive stress, also increases the risk.

Symptoms of a Heart Attack:
The symptoms of a heart attack can vary, but typically include sudden chest pain or pressure that lasts longer than a few minutes. The pain may radiate to the arm, back, neck, jaw, or abdomen. In addition to chest pain, other symptoms may occur, including shortness of breath, nausea, vomiting, dizziness, weakness, or sudden fatigue.

What to Do in the Case of a Heart Attack?
If someone shows signs of a heart attack, it's important to call emergency services immediately and request medical help. While waiting for emergency services, the affected person should rest and not exert themselves. Early treatment of a heart attack can be lifesaving and reduce the risk of complications.

Stroke

What is a Stroke?
A stroke occurs when the blood supply to part of the brain is interrupted, either by a blocked or ruptured blood vessel. Without adequate blood flow, the affected brain tissue does not receive enough oxygen and nutrients, leading to damage or death of brain cells.

Frequency of Strokes:
Strokes are very common and can affect people of all ages, although the risk increases with age. Certain risk factors such as high blood pressure, diabetes, smoking, high cholesterol levels, atrial fibrillation, and a family history of strokes increase the risk. An unhealthy lifestyle, including lack of physical activity, unhealthy diet, and excessive alcohol consumption, also increases the risk.

Symptoms of a Stroke:
Stroke symptoms can occur suddenly and vary depending on which part of the brain is affected. Typical symptoms include sudden weakness or paralysis on one side of the body, especially in the face, arm, or leg, sudden confusion, difficulty speaking or understanding, sudden vision problems, balance or coordination problems, and sudden severe headache without an apparent cause. With the BE-FAST scheme, you can quickly check if the patient is showing signs of a stroke.

What to Do in the Case of a Stroke?
If someone shows signs of a stroke, it's important to call emergency services immediately and request medical help. Every minute counts, as early treatment can increase the chance of recovery and reduce the risk of long-term damage. While waiting for emergency services, the affected person should rest and not exert themselves.

Trauma-related Emergencies

What are Trauma-related Emergencies?
Trauma-related emergencies encompass a variety of injuries that occur suddenly and require immediate medical attention. However, it's important never to neglect the ABCDE schemas before taking action. Because it's of little use to apply a perfectly crafted leg splint to the injured person if they have no pulse.

Bleeding:
With bleeding, it's important to stop the bleeding as quickly as possible by applying firm pressure to the wound and covering it with a clean cloth or bandage. If possible, the injured limb should be elevated to reduce bleeding. A good indicator that the pressure bandage has been applied correctly is that the bandage remains blood-free.

Foreign Object in the Body:
If a foreign object has entered the body, try not to remove it, as this could cause further damage. Instead, gently cover the wound to prevent further contamination.

Severed Body Parts:
With severed body parts, it's important to find the severed body part and cool it down as quickly as possible, but without direct contact with ice, as this could cause further tissue damage. The affected person should be reassured while stopping the bleeding and packing the severed body part in a clean, damp cloth.

Burns and Scalds:
With burns and scalds, it's important to immediately cool the affected area under cold, running water to remove heat and relieve pain. However, cooling should be limited to the burned or scalded area only to avoid hypothermia of the entire body. Afterward, the burned or scalded area should be gently covered with a clean, dry cloth to prevent infection.

Fractures:
With fractures, it's important to immobilize and stabilize the affected limb to prevent further damage. However, one must act situationally. For fractures affecting the hand or leg, this can be done by applying splints or wrapping with a bandage. A tip: for leg fractures, gently pulling on the foot can help alleviate pain. In cases of car accidents or similar situations where the patient is found lying or sitting and conscious, it's better not to move the injured person at all until emergency services arrive. In such cases, a cervical spine brace must be applied.

Cardiovascular Arrest

What is a Cardiovascular Arrest?
Cardiovascular arrest, commonly known as cardiac arrest, is a sudden stop in effective blood circulation due to the heart's failure to contract effectively or at all. This condition leads to the cessation of normal breathing and consciousness.

Call emergency services:
Immediately request professional medical help by calling emergency services or asking someone nearby to do so.

Start cardiopulmonary resuscitation (CPR):
If the patient is not breathing and has no pulse, start CPR immediately. Ideally, if you are two people: one person performs chest compressions while the other provides rescue breaths and prepares the defibrillator (if available).

• CPR for adolescents and adults:
  Chest compressions should be performed with a depth of about one-third to one-half of the chest depth and a rate of about 100-120 compressions per minute. Ventilation is done after 30 chest compressions with two breaths.

• CPR for children:
  For children aged 1 to puberty, chest compressions are performed using a similar technique to adults, but with slightly less depth. Chest compressions should be about one-third to one-half of the chest depth. Ventilation is done after 5 initial breaths before starting chest compressions. Subsequently, the ratio of 30:2 (chest compressions to ventilation) is applied.

• CPR for babies:
  For babies under 1 year of age, chest compressions are performed with two fingers in the middle of the chest, about the lower third of the breastbone. Depress the sternum about one-third to one-half (approximately 4 cm) deep. Ventilation is also done after 5 initial breaths before starting chest compressions. Subsequently, the ratio of 30:2 (chest compressions to ventilation) is applied.
  
  

The automated external defibrillator (AED):
An AED is a portable device that delivers an electric shock to restore the heart to a normal rhythm. If the patient is heavily hairy, the area should be quickly shaved to avoid burns. A razor is often included with the defib. Using an AED is also possible for children and babies. However, electrode placement and AED application vary by age according to the device's instructions.

Don't stop:
Continue resuscitation efforts until professional medical help arrives and takes over the patient or the patient resumes normal breathing and has a stable pulse. To avoid fatigue, alternate with another person if needed.

Closing Words

In any situation in life, we may be confronted with an emergency where quick action and basic knowledge of first aid measures are crucial. Or we have to trust that first aiders nearby have the necessary knowledge to help us. My article provides a basic introduction to first aid measures and serves as a reminder for emergencies. It is neither complete nor exhaustive. I recommend everyone to attend first aid courses regularly and stay up to date to always be ready - when the time comes.

Update Status:
Originally created post: 07/2013
Last updated: 04/2024